Current Issue : April-June Volume : 2026 Issue Number : 2 Articles : 5 Articles
Background/Objectives: Ulcerative colitis (UC) is a chronic inflammatory bowel disease that significantly increases the colorectal cancer (CRC) risk. This study used nationwide data on intractable diseases to clarify the clinical epidemiology of UC-related CRC in Japan. Methods: Patients diagnosed with UC between FY 2003 and 2011 were included. The relative incidence ratio (RR) was calculated using the standardized incidence ratio from the National Cancer Registry. To compare prognostic factors, outcomes were evaluated using the Cox proportional hazards model analysis for cancer occurrence, and a prognostic prediction model was developed using machine learning. Results: Among 78,556 patients with UC, CRC was identified in 141 patients. The RR of CRC peaked in both males and females in the 25–39 age group. Univariate analysis revealed several risk factors, including pseudo-polyps observed during endoscopy (hazard ratio 2.92, p = 0.001), abnormal crypt architecture (hazard ratio 3.14, p < 0.001), and dysplasia (hazard ratio 11.31, p < 0.001) in biopsy. Conversely, 5-ASA was associated with reduced CRC risk (hazard ratio 0.36, p = 0.003). The machine learning model categorized patients into three groups, demonstrating that the group with the highest number of patients with pancolitis had a significantly higher risk of CRC than did the other groups. Conclusions: Pseudo-polyps and dysplasia represent CRC risk factors in patients with UC. Additionally, machine learning analysis indicates that pancolitis in individuals in their 50s increases the risk of colon cancer, while proctitis in those in their 30s raises rectal cancer risk. These findings aim to enhance early detection and improve prevention efforts for UC-related CRC....
Background and Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent and may influence the outcome of critical illness. Although abnormal liver function tests (LFTs) are frequent in the intensive care unit (ICU), the contribution of MASLD to organ-specific hepatic vulnerability and mortality remains unclear. This study aimed to evaluate whether pre-existing metabolic dysfunction-associated steatotic liver disease (MASLD) is associated with baseline and new-onset liver function test (LFT) abnormalities and with intensive care unit (ICU) outcomes in non-cirrhotic medical ICU patients. Materials and Methods: We conducted a retrospective cohort study of adult noncirrhotic patients admitted to a tertiary medical ICU between December 2020 and December 2023, who underwent hepatobiliary ultrasonography within six months before admission. MASLD was defined as hepatic steatosis with ≥1 cardiometabolic risk factor. The baseline and 72 h LFTs, injury patterns, and ICU outcomes were compared between MASLD and non-MASLD patients. Logistic regression was used to identify the independent predictors of new-onset LFT elevation and ICU mortality. Results: Among 609 patients, MASLD was diagnosed in 240 (39.4%). LFT elevation at admission was more frequent in patients with MASLD (52% vs. 39%, p = 0.03), driven mainly by higher alkaline phosphatase (ALP). At 72 h, ALP (96 [67–146] vs. 85 [60–137]) and gamma-glutamyl transferase (GGT) (50 [27–123] vs. 42 [20–100]) levels remained higher in patients with MASLD (p < 0.01), although rates of new-onset LFT elevation were similar (p > 0.05). Compared to non- MASLD patients, those with MASLD more often required invasive mechanical ventilation (IMV) (64% vs. 33%), central venous catheterization (70% vs. 44%), CRRT (28% vs. 10%), blood product replacement (50% vs. 28%), and developed nosocomial infections (44% vs. 29%) (p < 0.05 for all); however, MASLD was not an independent predictor of mortality. The independent risk factors for mortality were IMV, shock, and higher APACHE II scores. Conclusions: common among medical ICU patients and is associated with a cholestatic biochemical profile and poor ICU outcomes. However, early hepatic injury and ICU mortality are primarily determined by systemic severity and organ support requirements, not the MASLD itself....
Background/Objectives: Helicobacter pylori (H. pylori) is a well-established pathogen associated with chronic gastritis and gastric malignancies. Recent studies suggest that members of the Streptococcus anginosus group (SAG), particularly S. anginosus and S. constellatus, may also contribute to gastric mucosal damage, especially when co-infecting with H. pylori. This study aimed to evaluate the prevalence of these three bacterial species and their associations with gastric lesions in Vietnamese patients. Methods: A cross-sectional study was conducted on 200 adult patients with gastritis diagnosed by endoscopy and biopsy. PCR analysed gastric tissue samples from the antrum and corpus for H. pylori, S. anginosus, and S. constellatus. Gastric lesions were classified histologically, and associations with bacterial infections were assessed using odds ratios (OR) and 95% confidence intervals. Results: Infection rates were 62.5% for H. pylori, 62% for S. constellatus, and 48.5% for S. anginosus. Coinfections were frequent, with 25% of patients infected by all three bacteria. Atrophic gastritis was the most common lesion (80%) and was significantly associated with all three bacteria, particularly H. pylori (OR = 7.7), and in co-infections (e.g., H. pylori + S. constellatus, OR = 7.4, p < 0.0001). Triple infection was strongly linked to both atrophy (OR = 5.1) and intestinal metaplasia/ dysplasia (OR = 3.4, p = 0.007). Conclusions: Polymicrobial infections involving H. pylori and SAG bacteria are common in Vietnamese patients with gastritis and are significantly associated with more severe gastric lesions. These findings highlight the need for broader microbial screening and integrated management strategies to improve gastritis treatment and gastric cancer prevention in high-prevalence settings....
Introduction: Gastrointestinal stromal tumors (GIST) constitute a rare subset of digestive tract malignancies classified within the sarcoma group. The objective of this study was to describe the epidemiological, therapeutic, and prognostic characteristics of GISTs and to determine factors associated with poor outcomes in a developing country context. Patients and Methods: A retrospective, descriptive study was conducted over a seven-year period (January 2016 to December 2022) in the Onco-hematology Department of Dalal Jamm National Hospital Center, Senegal. All patients with a diagnosis of GIST confirmed by histological and immunohistochemical analysis were included. Data were extracted from medical charts, operative records, pathology, and immunohistochemistry reports, and analyzed using Sphinx software version 23. Results: Fifty-seven cases of GIST were identified, corresponding to an average annual hospital incidence of eight cases. The mean age of patients was 56 years (range: 29 - 80), with a sex ratio (M/F) of 1.03. The stomach represented the predominant tumor site (54.32%), followed by the mesentery (19%). Abdominal pain was the most frequent presenting symptom (64.91%). Upper gastrointestinal endoscopy revealed endophytic lesions in 24.56% of patients, while computed tomography demonstrated exophytic growth in 87.72%. The mean tumor size was 16.5 cm (range: 2.9 - 31 cm). Spindle-cell morphology predominated histologically (92.08%), and C-kit positivity was observed in 70.17% of cases. According to the AFIP classification, available for 33 patients (57.89%), a high risk of recurrence was noted in 36.36%. All patients received imatinib therapy. Surgical management was performed in 54.40% of cases, and one patient underwent full-thickness endoscopic resection. After a mean follow-up of 27.9 months, complete remission was maintained in 24.56% of patients. Mortality occurred in 28.07% and tumor recurrence in 21.05% of cases. Conclusion: GIST remain uncommon in our setting. Diagnostic delays and limited access to comprehensive management significantly affect patient prognosis. The high recurrence rate underscores the need to improve availability of advanced targeted therapies in resource-limited environments....
Inflammatory bowel diseases (IBDs) encompass Crohn’s disease and ulcerative colitis. They represent idiopathic and chronic inflammatory conditions. Mucosal immune dysfunction and compromised gastrointestinal barrier integrity are implicated in the pathophysiological mechanisms of inflammatory bowel diseases. Recent studies have identified endothelial dysfunction as a pivotal mediator in IBD pathogenesis. Through multiple cellular and molecular interactions, endothelial dysfunction orchestrates inflammatory responses. Objectives: This systematic review examines contemporary evidence (2019–2025), emphasising the role of endothelial dysfunction in intestinal inflammation mechanisms, focusing on vascular-epithelial crosstalk, molecular signalling pathways, and therapeutic implications. Methods and results: A comprehensive literature search was conducted using PubMed, Google Scholar, Europe PMC and DOAJ databases, focusing on peer-reviewed articles published between 2019 and 2025. Following the database search and screening process, a total of 53 studies met the eligible criteria and were included in the final analysis. Keywords included “endothelial dysfunction,” “inflammatory bowel disease,” “gut-vascular barrier,” “nitric oxide,” and “intestinal inflammation.” Contemporary research demonstrates that endothelial dysfunction in IBD manifests through decreased nitric oxide bioavailability, enhanced oxidative stress, aberrant cytokine networks, pathological angiogenesis, and compromised gut-vascular barrier integrity. The emerging concept of dual barrier dysfunction highlights the interdependent relationship between epithelial and endothelial barriers in maintaining intestinal homeostasis. Conclusions: Offering novel therapeutic targets for precision medicine approaches, endothelial dysfunction represents a central driver in the pathophysiological mechanism in IBD. Understanding vascular-epithelial interactions provides fundamental insights for developing targeted interventions to restore intestinal barrier function and resolve chronic inflammation....
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