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Mashup Score: 5GLP1 agonists and risk of major adverse liver outcomes - 7 hour(s) ago
To cite: Wester A, Shang Y, Toresson Grip E, et al. Glucagon-like peptide-1 receptor agonists and risk of major adverse liver outcomes in patients with chron…
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Mashup Score: 16Coeliac disease: the paradox of diagnosing a food hypersensitivity disorder with autoantibodies - 15 hour(s) ago
Serum antibodies to the autoantigen transglutaminase 2 (TG2) are increasingly harnessed to diagnose coeliac disease. Diagnostic guidelines for children give recommendation for a no-biopsy-based diagnosis through detection of high amounts of IgA anti-TG2 antibodies in serum with confirmation of positivity in a separate blood sample by characteristic autoantibody-staining of tissue. While measurement of IgA anti-TG2 also is important in the diagnostic workup of adults, the adult guidelines still mandate examination of gut biopsies. This requirement might well change in the future, as might the necessity for confirming autoantibody positivity by tissue staining. The key role of autoantibody serology for diagnosis of coeliac disease is paradoxical. Coeliac disease was considered, and still can be considered, a food intolerance disorder where autoantibodies at face value are out of place. The immunological mechanisms underlying the formation of autoantibodies in response to gluten exposure
Source: gut.bmj.comCategories: General Medicine News, GastroenterologyTweet
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Mashup Score: 8Predicting treatment response in ASUC: do we measure systemic severity, organ response or both? - 16 hour(s) ago
We would like to congratulate Adams et al on the paper addressing the important issue regarding the development of prognostic clinical indexes for patients with acute severe ulcerative colitis (ASUC) leading to the development of the ADMIT-ASC score.1 Although we acknowledge the initiative, the development of a static prognostic index might be reconsidered with the increased availability and use of noninvasive and real-time cross-sectional imaging. Recently, we investigated the use of intestinal ultrasound (IUS) to measure early changes in the sigmoid bowel wall thickness (BWT) as an indicator of intravenous corticosteroid (CS) response in patients admitted with ASUC. A >20% reduction in BWT after 48 hours predicted CS response within 7 days (p<0.0001 for pMayo response, p=0.006 for no need of rescue therapy) and was superior to CRP, albumin or pMayo response at 48 hours in multivariate analysis.2 With C-reactive protein (CRP), albumin and endoscopic severity scores being major compone
Source: gut.bmj.comCategories: General Medicine News, GastroenterologyTweet
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Mashup Score: 33Serum ferritin levels can predict long-term outcomes in patients with metabolic dysfunction-associated steatotic liver disease - 2 day(s) ago
Objective Hyperferritinaemia is associated with liver fibrosis severity in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), but the longitudinal implications have not been thoroughly investigated. We assessed the role of serum ferritin in predicting long-term outcomes or death. Design We evaluated the relationship between baseline serum ferritin and longitudinal events in a multicentre cohort of 1342 patients. Four survival models considering ferritin with confounders or non-invasive scoring systems were applied with repeated five-fold cross-validation schema. Prediction performance was evaluated in terms of Harrell’s C-index and its improvement by including ferritin as a covariate. Results Median follow-up time was 96 months. Liver-related events occurred in 7.7%, hepatocellular carcinoma in 1.9%, cardiovascular events in 10.9%, extrahepatic cancers in 8.3% and all-cause mortality in 5.8%. Hyperferritinaemia was associated with a 50% increased risk of li
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#GUTImages from the paper by @AngeloArmandi et al on "Serum ferritin levels can predict long-term outcomes in patients with metabolic dysfunction-associated steatotic liver disease" via https://t.co/oap3sTWjmt @DinaTiniakos @lucavalenti75 @lmiele74 @hanneshagstrom @mromerogomez https://t.co/6KG8WdxzSU
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Mashup Score: 0Gut: 73 (5) - 2 day(s) ago
(21 November, 2023) Emily L Black, Emma Ococks, Ginny Devonshire, Alvin Wei Tian Ng, Maria O’Donovan, Shalini Malhotra, Monika Tripathi, Ahmad Miremadi, Adam Freeman, Hannah Coles, Oesophageal Cancer Clinical and Molecular Stratification (OCCAMS) Consortium, Rebecca C Fitzgerald (8 February, 2024) Free Kurtis F Budden, Shakti D Shukla, Kate L Bowerman, Annalicia Vaughan, Shaan L Gellatly, David L A Wood, Nancy Lachner, Sobia Idrees, Saima Firdous Rehman, Alen Faiz, Vyoma K Patel, Chantal Donovan, Charlotte
Source: gut.bmj.comCategories: General Medicine News, GastroenterologyTweet
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Mashup Score: 35
The progression of cirrhosis with clinically significant portal hypertension towards decompensated cirrhosis remains clinically challenging and the evolution towards acute-on-chronic liver failure (ACLF), with one or more extrahepatic organ failures, is associated with very high mortality. In the last decade, significant progress has been made in the understanding of the mechanisms leading to decompensation and ACLF. As portal hypertension advances, bacterial translocation across an impaired gut barrier culminates in endotoxaemia, systemic inflammation and cirrhosis-associated immune dysfunction (CAID). Gut-derived systemic inflammation and CAID have become the logical targets for innovative therapies that prevent hepatic decompensation episodes and the progression to ACLF. Furthermore, classification of disease and biomarker discovery to personalise care have advanced in the field. This review discusses progress in biomarker discovery and personalisation of treatment in decompensated
Source: gut.bmj.comCategories: General Medicine News, GastroenterologyTweet-
Read the #RecentAdvancesInClinicalPractice paper on "Recent advances in the prevention & treatment of decompensated cirrhosis & acute-on-chronic liver failure & the role of biomarkers" via https://t.co/BqwvAYBf63 @JonelTrebicka @ruben_hernaez @DebbieShawcros1 @AlexanderGerbes https://t.co/MEq074vo8B
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Mashup Score: 8
Objective Whether gastric metaplasia (GM) of the oesophagus should be considered as Barrett’s oesophagus (BO) is controversial. Given concern intestinal metaplasia (IM) may be missed due to sampling, the UK guidelines include GM as a type of BO. Here, we investigated whether the risk of misdiagnosis and the malignant potential of GM warrant its place in the UK surveillance. Design We performed a thorough pathology and endoscopy review to follow clinical outcomes in a novel UK cohort of 244 patients, covering 1854 person years of follow-up. We complemented this with a comparative genomic analysis of 160 GM and IM specimens, focused on early molecular hallmarks of BO and oesophageal adenocarcinoma (OAC). Results We found that 58 of 77 short-segment ( < 3 cm) GM (SS-GM) cases (75%) continued to be observed as GM-only across a median of 4.4 years of follow-up. We observed that disease progression in GM-only cases and GM+IM cases (cases with reported GM on some occasions, IM on others) was
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#GUTImages from the paper by @RC_Fitzgerald @RFitzgerald_lab on "Understanding the malignant potential of gastric metaplasia of the oesophagus & its relevance to Barrett’s oesophagus surveillance: individual-level data analysis" via https://t.co/vv4B6YNRfk #BarrettsOesophagus https://t.co/fkW5571DDJ
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Mashup Score: 21Early-life diet and risk of IBD - 2 day(s) ago
To cite: Guo A, Ludvigsson J, Brantsæter AL, et al. Early-life diet and risk of inflammatory bowel disease: a pooled study in two Scandinavian birth cohorts….
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Mashup Score: 14British Society of Gastroenterology guidelines for the management of hepatocellular carcinoma in adults - 2 day(s) ago
Deaths from the majority of cancers are falling globally, but the incidence and mortality from hepatocellular carcinoma (HCC) is increasing in the United Kingdom and in other Western countries. HCC is a highly fatal cancer, often diagnosed late, with an incidence to mortality ratio that approaches 1. Despite there being a number of treatment options, including those associated with good medium to long-term survival, 5-year survival from HCC in the UK remains below 20%. Sex, ethnicity and deprivation are important demographics for the incidence of, and/or survival from, HCC. These clinical practice guidelines will provide evidence-based advice for the assessment and management of patients with HCC. The clinical and scientific data underpinning the recommendations we make are summarised in detail. Much of the content will have broad relevance, but the treatment algorithms are based on therapies that are available in the UK and have regulatory approval for use in the National Health Servi
Source: gut.bmj.comCategories: General Medicine News, GastroenterologyTweet
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Mashup Score: 7Spatial transcriptomics reveals a low extent of transcriptionally active hepatitis B virus integration in patients with HBsAg loss - 3 day(s) ago
Objective Hepatitis B virus (HBV) can integrate into the chromosomes of infected hepatocytes, contributing to the production of hepatitis B surface antigen (HBsAg) and to hepatocarcinogenesis. In this study, we aimed to explore whether transcriptionally active HBV integration events spread throughout the liver tissue in different phases of chronic HBV infection, especially in patients with HBsAg loss. Design We constructed high-resolution spatial transcriptomes of liver biopsies containing 13 059 tissue spots from 18 patients with chronic HBV infection to analyse the occurrence and relative distribution of transcriptionally active viral integration events. Immunohistochemistry was performed to evaluate the expression of HBsAg and HBV core antigen. Intrahepatic covalently closed circular DNA (cccDNA) levels were quantified by real-time qPCR. Results Spatial transcriptome sequencing identified the presence of 13 154 virus-host chimeric reads in 7.86% (1026 of 13 059) of liver tissue spot
Source: gut.bmj.comCategories: General Medicine News, GastroenterologyTweet
#GUTVideo by @wester_axel @YingShang1 @hanneshagstrom et al on "Glucagon-like peptide-1 receptor agonists and risk of major adverse liver outcomes in patients with chronic liver disease and type 2 diabetes" via https://t.co/BlS2UqJNuD Paper: https://t.co/VxgpMLEGqh https://t.co/pA19v02pqP