Journal of Digestive Diseases

Publisher: Chinese Society of Gastroenterology, Wiley

Journal description

Current impact factor: 1.96

Impact Factor Rankings

2015 Impact Factor Available summer 2016
2014 Impact Factor 1.959
2013 Impact Factor 1.924
2012 Impact Factor 1.853
2011 Impact Factor 1.589
2010 Impact Factor 1.87
2009 Impact Factor 1.791

Impact factor over time

Impact factor

Additional details

5-year impact 2.07
Cited half-life 3.40
Immediacy index 0.22
Eigenfactor 0.00
Article influence 0.51
Other titles Journal of digestive diseases (Online)
ISSN 1751-2980
OCLC 123124871
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details


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    • 12 months embargo
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    • Non-Commercial
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    • Must link to publisher version with set statement (see policy)
    • If OnlineOpen is available, BBSRC, EPSRC, MRC, NERC and STFC authors, may self-archive after 12 months
    • If OnlineOpen is available, AHRC and ESRC authors, may self-archive after 24 months
    • Publisher last contacted on 07/08/2014
    • This policy is an exception to the default policies of 'Wiley'
  • Classification
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Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Aim: Small fundic submucosal tumors originating from the muscularis propria impose great difficulty on conventional therapies. We aim to evaluate endoscopic cap-aspiration lumpectomy as a new and simple full-thickness resection. Methods: Patients with small fundic submucosal tumors were included. Cap-aspiration lumpectomy was performed by suctioning the submucosal tumors into a transparent cap, which was ligated by a metal snare and resected. The wall deficit was closed using endoclips. Results: The study enrolled 28 patients. The mean total operation time was 23.9 minutes. The procedure resulted in 20/28 (71.4%) active perforations. Endoclips closed the wall defect in all 20 cases. Cap-aspiration lumpectomy achieved 28/28(100%) en bloc resection rate. Pneumoperitoneum developed in one patient and self-limited peritonitis developed in 2 patients, which were all managed successfully. Gastrointestinal stromal tumors were found in 20/28 (71.4%) resected tumors. No recurrence was found during follow-up. Conclusions: Cap-aspiration lumpectomy may be a simple, feasible and safe full-thickness resection for small submucosal tumors arising in the muscularis propria at the gastric fundus. Further randomized studies are needed. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 10/2015; DOI:10.1111/1751-2980.12292
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    ABSTRACT: Nonalcoholic fatty liver disease (NAFLD) has emerged as the most common chronic liver disease worldwide with a reported prevalence ranging from 6-33%, depending on the studied population. It encompasses a spectrum of liver manifestations ranging from simple steatosis (also known as nonalcoholic fatty liver, NAFL) to nonalcoholic steatohepatitis (NASH), fibrosis and cirrhosis, which may ultimately progress to hepatocellular carcinoma. NAFLD is strongly associated with components of the metabolic syndrome, mainly obesity and type 2 diabetes mellitus. NAFLD patients are at increased risk of liver-related as well as cardiovascular mortality. Current paradigm suggests a benign course for NAFL whereas NASH is considered to be the progressive phenotype. Although previously under-recognized accumulating evidence suggests that NAFL may also progress, suggesting a higher number of patients at risk than previously appreciated. Liver-biopsy remains the gold standard for definitive diagnosis, but the majority of patients can be diagnosed accurately by noninvasive methods. Approved therapies for NAFLD are still lacking and lifestyle modifications aiming at weight-loss remain the mainstay of NAFLD treatment. Intensive research could identify insulin resistance, lipotoxicity and dysbiosis of the gut microbiota as major pathophysiological mechanisms, leading to the development of promising targeted therapies which are currently investigated in clinical trials. In this review we summarize the current knowledge of NAFLD epidemiology, natural history, diagnosis, pathogenesis, and treatment and consider future directions. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 09/2015; DOI:10.1111/1751-2980.12291
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    ABSTRACT: Objective: The patients who take drugs regularly are increasing, not least due to the prevalence of metabolic and orthopedic diseases. The effects of the use of these drugs on colorectal neoplasms remain unclear, except the preventive effects of non-steroidal anti-inflammatory drugs and low-dose aspirin. Methods: In total, 1318 consecutive patients who underwent total colonoscopy for the first time in their life were cross-sectionally analysed. Personal data including comorbidities and all medications were obtained by questionnaire. Blood pressure, body weight, and waist circumference were measured just before colonoscopic examination. Results: Colorectal polyps were found in 577 (43.8%) subjects. The prevalence of colorectal polyps was 57.6% (296/514) in patients receiving hypertension treatment and 35.0% (281/804) in patients without such treatment. A multivariate analysis showed that age, waist circumference, drinking, smoking, and antihypertensive drug use were independent risk factors for colorectal polyps. In a secondary multivariate analysis incorporating the parameters of measured blood pressure and medication status, the number of antihypertensive drugs was strongly associated with the risk of colorectal polyps, whereas blood pressure showed no significant association. Conclusions: Antihypertensive drug use may be a risk factor for colorectal polyps. Furthermore, this risk increases with the intensive use of antihypertensive drugs.
    Journal of Digestive Diseases 09/2015; DOI:10.1111/1751-2980.12289
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    ABSTRACT: To explore the influence of tagging single nucleotide polymorphisms (tagSNPs) at adiponectin gene in the natural course of nonalcoholic fatty liver diseases (NAFLD). The subjects were chosen from our previous survey, which has been published. Totally, 696 people were included. The cohort was followed-up for 3.6-4.8 years (median 4 years). Each subject received interview, physical examination, blood tests and ultrasonic examination at baseline and endpoint. PCR-RFLP was applied to determine seven tagSNPs at adiponectin gene i.e. rs182052, rs16861205, rs822396, rs7627128, rs1501299, rs2241767, rs3774261. Ordinal logistic regression was used to screen risk factors of NAFLD progression as well as susceptibility. Haplotypes analysis was performed to confirm the results. After adjusting age and gender, rs1501299 (G276T), rs2241767 (A45G) and rs3774261 (A712G) were found to be risk factors of both susceptibility (OR: 5.04, 7.47, 3.55 respectively) and progression (OR: 1.73, 3.83, 1.89 respectively) to NAFLD. Nevertheless, rs182052, rs16861205, rs822396 and rs7627128 had no impact on both of them. These findings were confirmed by haplotype analysis. The tagSNPs rs2241767, rs1501299, rs3774261 at adiponectin gene were risk factors NAFLD initiation and progression. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 09/2015; DOI:10.1111/1751-2980.12288
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    ABSTRACT: Achalasia as the primary manifestation of acquired immunodeficiency disease (AIDS) is very rare. There are isolated case reports of AIDS patients presenting with dysphagia symptoms caused by opportunistic infections, such as such as candida, cytomegalovirus, or herpes simplex virus. Here we reported a case of patient with AIDS, who was diagnosed as achalasia by high resolution impedance manometry and recovered only by the combination of antiretroviral and anti-TB therapy. The findings in this patient suggest that HIV may cause achalasia through both neurotrophic effect and opportunistic infection infectious agents. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 09/2015; DOI:10.1111/1751-2980.12287
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    ABSTRACT: OBJECTIVE Helminth immunomodulation in host has been shown to have therapeutic implications in inflammatory bowel diseases. Herein we have evaluated the therapeutic effect of Brugia malayi recombinant cystatin (rBmCys) in a dose dependent manner on dextran sulfate sodium (DSS)-induced colitis in mice.METHODS Anti-inflammatory activity of rBmCys on mice peritoneal exudate cells was initially checked in in vitro. BALB/c mice were fed 5% DSS for 7 days to induce ulcerative colitis. Colitis mice were treated intraperitoneally (i.p.) with rBmCys (10, 25 or 50 µg/dose) on day 1, 3 and 5 of the DSS administration. Disease severity was assessed by evaluation of disease activity index (DAI), macroscopic and histopathological scores of colon and myeloperoxidase activity in colonic mucosa. Cytokine profiles were measured in sera and in cultured splenocytes of treated mice followed by stimulation with rBmCys.RESULTSrBmCys showed anti-inflammatory activity in in vitro. Treatment of DSS colitis with rBmCys in mice ameliorated the overall disease severity as reflected from the significant reduction in the weight loss, DAI, mucosal edema, colon damage and myeloperoxidase activity of the colonic mucosa. While the mRNA expression of IFN-γ, TNF-α, IL-5, IL-6 and IL-17 was down-regulated, the IL-10 expression was up-regulated in the splenocytes of colitis mice treated with rBmCys. The amelioration effect in DSS-colitis was in a dose dependent manner.CONCLUSIONS The results of this study indicate the anti-inflammatory potential of rBmCys and provide evidential support for this protein to be used as a promising therapeutic agent in ulcerative colitis. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 09/2015; DOI:10.1111/1751-2980.12290
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    ABSTRACT: To investigate the association between inflammatory bowel disease (IBD) and Gallstone disease (GD) by performing a meta-analysis. PubMed, Medline, Embase, Web of Science, and the Cochrane Library were searched for relevant articles published between January 1980 and February 2015. All statistical analyses were performed using STATA 12.0 software. A fixed-effects model was adopted; heterogeneity was evaluated by chi-square test and I(2) statistic; publication bias was assessed by Begg's and Egger's tests. Five studies qualified for inclusion in the meta-analysis. Patients with IBD had a significantly higher prevalence of GD when compared with subjects in the control group (Odds Ratio [OR] 1.73, 95% Confidence Interval [CI]: 1.40-2.12, P < 0.0001). Subgroup analyses showed a significantly higher prevalence of GD in patients with Crohn's disease (CD) (OR 2.05, 95% CI: 1.61-2.63, P ˂ 0.0001]. However, no significant difference in prevalence of gallstone disease was observed between patients with ulcerative colitis (UC) and controls (OR 1.12, 95% CI: 0.75-1.68, P = 0.585). Studies from Italy, Sweden and U.K revealed a higher prevalence of GD in patients with IBD. No heterogeneity (I(2) = 25.2%, P = 0.228) or publication bias was observed in our meta-analysis (Begg's test, P = 0.711; Egger's test, P = 0.805). Our meta-analysis suggests a trend of higher prevalence of GD in IBD patients, and especially in patients with CD. More rigorous, large scale multi-center studies are required to investigate the association between GD and IBD. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 09/2015; DOI:10.1111/1751-2980.12286
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    ABSTRACT: Autoimmune hepatitis (AIH) is a complex multifactorial liver disease with unknown etiology. It may be induced by certain triggers that cause immune disorders and autoimmune attack in genetically susceptible individuals, which ultimately results in chronic persistent interface inflammation of the liver. The diagnosis of AIH is made based on comprehensive evaluation score system. All AIH patients should receive interventions and the mainstay therapy is prednisone alone or in combination with azathioprine. Further exploratory researches on refractory AIH have been developed. Liver transplantation is still the only effective option for patients with decompensated cirrhosis or hepatic failure.
    Journal of Digestive Diseases 08/2015; 16(9). DOI:10.1111/1751-2980.12285
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    ABSTRACT: Ulcerative colitis (UC) is a chronic inflammatory disease of the mucosa of the large intestine. The treatment of UC depends on the severity of symptoms and on the extent of the disease. Acute Severe Colitis (ASC) occurs in 12-25%. Patients with Acute Severe Colitis must be managed by a multidisciplinary team. A medical or surgical aggressive treatment is carried out with the final aim of reducing mortality. Intravenous corticosteroids are the mainstay of the therapy. Medical rescue therapy based on Cyclosporine or Infliximab should be considered if there is no response to corticosteroids after 3 days. In the event that there has been no response to medical rescue therapy after 4-7 days, the patient must undergo a colectomy surgery in urgency. Prolonged observation is counterproductive, as over time it increases the risk of toxic megacolon and of perforation, burdened with a very high mortality rate. The best possible treatment is a subtotal colectomy with ileostomy and preservation of the rectum. Emergency surgery in UC should not be seen as a last chance, but can be considered as a life-saving procedure. Colectomy in an emergency setting is characterized by high morbidity rates but the mortality is low. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 08/2015; DOI:10.1111/1751-2980.12278
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    ABSTRACT: Endoscopic resection of a foregut neuroendocrine tumor (NET) is increasingly performed instead of surgery. This study aimed to verify the long-term therapeutic results of endoscopic resection (ER) and surgical resection (SR) in foregut NETs. From 2002 to 2012, a total of 49 patients were confirmed histologically as foregut NETs treated by ER (stomach = 19, duodenum = 14) and SR (stomach = 11, duodenum = 5). The clinicopathological characteristics and therapeutic outcomes were evaluated. Of the 33 patients who underwent ER (endoscopic mucosal resection = 26, endoscopic mucosal dissection = 7), 32 cases were diagnosed as type NET-G1 and one case as neuroendocrine carcinoma (NEC). Of the 16 patients who underwent SR, 10 were diagnosed as NET-G1, two as NET-G2 and four as NEC. The median tumor size was significantly smaller in ER than SR patients (0.7 cm vs. 1.9 cm, p = 0.001). In almost all ER patients (32/33 cases), NET invasion was limited to mucosa and submucosa. Non-curative resections were achieved in eight ER patients (8/33, 24.2%) and in four SR patients (4/16, 25%). No recurrence occurred in seven NET cases defined as non-curative resection with positive resection margins by ER; however, all cases of non-curative resection with lymphatic invasion (ER = 1, SR = 4) experienced recurrence during the follow up period despite complete resections. They were all NEC histologically. ER may have a good prognosis if the tumor size is small and histologically low-grade without lymphatic invasion. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 08/2015; DOI:10.1111/1751-2980.12279
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    ABSTRACT: There is a considerable high prevalence of vitamin D deficiency, which is defined by the serum level of 25-hydroxyvitamin D [25(OH)D] lower than 20 ng/ml, in all populations of the world. Unfortunately, the prevalence of vitamin D deficiency in patients with intestinal malabsorption syndromes, including cystic fibrosis (CF), celiac disease (CD), short bowel syndrome, and inflammatory bowel disease (IBD), is higher than that in the general population, indicating the presence of disease-specific causative factors. In this review, we aim to present clinical findings to highlight the roles of insufficient sunlight exposure and inflammation in the development of vitamin D deficiency in patients with intestinal malabsorption syndromes. Also, we aim to present experimental evidence that supports a role of vitamin D deficiency in the pathogenesis of IBD. Finally, we review clinical intervention strategies that aim to normalize vitamin D status in and/or even improve the conditions of patients and discuss certain issues that need to be addressed in future research. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 08/2015; DOI:10.1111/1751-2980.12283
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    ABSTRACT: Research on inflammatory bowel disease (IBD) highlighted genes involved in the regulation of inflammatory responses as contributors to disease pathogenesis. Objective of this study was to evaluate associations between IBD and variations in NOD2, TLR4, TNF-α, IL-6, IL-1β, IL-1RN genes, and to use obtained genetic data in predictive modeling. We genotyped 167 IBD patients and 101 healthy donors by PCR-RFLP procedure. Using attained genotype data as input to various classification algorithms, we designed IBD prediction models. Area under the receiver operating curve (AUC) was used as measure of their performance. Significant associations were found between Crohn's disease (CD) and NOD2 minor variants, as well as TLR4 299Gly, TNF-α -308A, IL-6 -174C and IL-1RN VNTR A2 variants, while ulcerative colitis (UC) was associated only with IL-1RN VNTR A2. CD and UC showed highly significant difference in allelic distribution of TNF-α G-308A, where A allele was found to be related to CD, and G allele to UC occurrence. Among CD patients, combined effect of gender and TLR4 variants was observed. When all analyzed genotype and gender data were used, prediction performance achieved maximum AUC of 0.69 for CD and 0.60 for UC dataset. These results showed that variations in genes involved in immune regulation are genetic factors of importance in IBD susceptibility that can be used as predictors of disease development. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 08/2015; DOI:10.1111/1751-2980.12281
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    ABSTRACT: The aim of this study was to evaluate the efficacy of esophageal self-expanding metal stent (E-SEMS) insertion for malignant esophageal obstruction (MEO) in patients with or without additional palliative treatments. We retrospectively reviewed the medical records of the patients with E-SEMS for MEO at Seoul National University Hospital. Baseline characteristics, changes of Mellow-Pinkas score about dysphagia, and complications were compared between two groups. A total of 236 E-SEMS were inserted to 192 patients (esophageal cancer 46.4%, gastric cardia cancer 33.3%, lung cancer 15.1%). Mellow-Pinkas score significantly decreased in 1 week (1.66 ± 0.79, P = 0.000) and 1 month (1.71 ± 0.87, P = 0.000) after the insertion of E-SEMS (3.09 ± 0.79). Complications occurred in 54 cases (22.9%); 28 stent obstruction (11.9%), 5 perforation (2.1%), 10 stent migration (4.2%), 5 tracheoesophageal fistula (2.1%), no procedure-related death (0.0%). Most complications were managed with insertion of additional SEMS (74.1%). The risk of stent obstruction was significantly higher in uncovered SEMS than covered (OR 4.31, 95%CI 1.75-4.52, P = 0.001). Mean interval to the development of complication was 74.8 ± 111.1 days. Overall survival (169.0 ± 127.8 days vs. 96.4 ± 90.6 days, P = 0.000) and stent patency (143.3 ± 123.9 days vs. 67.6 ± 71.3 days, P = 0.000) were significantly favorable in the patients with E-SEMS and additional palliative treatments than E-SEMS alone. E-SEMS insertion could be effective and safe for MEO, and the additional palliative treatment might lengthen stent patency by extension of survival. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 08/2015; DOI:10.1111/1751-2980.12280
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    ABSTRACT: Gastric cancer is a typical type of inflammation-related tumor. p42.3 gene highly expresses in gastric cancer but whether it is associated with gastritis is still unknown. Here we will explore the relationship between inflammation and p42.3 gene. Normal gastric epithelium cells (GES-1) were treated with H. pylori and tumor necrosis factor alpha (TNF-α) separately. Total cell mRNA and protein were collected and PCR and western blotting were conducted to determine the relative expression of p42.3 gene. 291 chronic non-atrophic gastritis tissue samples were collected and immunohistochemistry method was used to measure the rate of p42.3 protein expression. The associations between p42.3 protein and the clinicopathological characteristics of patients with chronic non-atrophic gastritis were analyzed. H. pylori can significantly enhance the p42.3 protein expression in GES-1 cells. Moreover, inflammatory cytokines TNF-α can stimulate the p42.3 gene expression in GES-1 cells and further the effect showed a time and dose dependent manner. In addition, the p42.3 gene expression was positively associated with the gastric mucosa inflammation degree and H. pylori infection (P = 0.000). Its expression rate was significantly high in gastric mucosa with severe inflammation and in H. pylori infection cases. The p42.3 gene expression is associated with the gastric mucosa inflammation and it can be stimulated by TNF-α and H. pylori respectively. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 08/2015; DOI:10.1111/1751-2980.12282
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    ABSTRACT: Up to 100 trillion bacteria are harbored in the human intestine in a mutualistic and interdependent relationship with the host during a long period of co-evolution. The so-called intestinal microbiota (IM) fulfill important metabolic tasks and the impaired stability may lead to the microbiota-related diseases, including inflammatory bowel disease (IBD), colorectal cancer (CRC), metabolic syndromes (MS), liver diseases, et al. Here, we review the past and development of IM research in China, including achievements that Chinese researchers have made both in basic and clinical scientific field. Moreover, we evaluate the contributions of the National Natural Science Foundation of China (NSFC), the 973 National Basic Research Program of China (973 Program), the 863 National High Technology Research and Development Program of China (863 Program), and funds from the public health industry in the field of IM research. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 07/2015; 16(8). DOI:10.1111/1751-2980.12274
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    ABSTRACT: Helicobacter pylori (H. pylori) antibiotic resistance has increased worldwide. Because antibiotic resistance is the major cause of eradication failure, alternate therapies are needed. To evaluate in vitro susceptibility and resistance patterns for antibiotics used in empirical H. pylori infection regimens, to determine the optimal antibiotics for eradication. H. pylori strains (n=181) were obtained from gastric biopsies of patients with upper-gastrointestinal symptoms who underwent esophagogastroduodenoscopies from March to December, 2013. Amoxicillin (AMX), metronidazole (MTZ), clarithromycin (CLR), amoxicillin-clavulanate (AMC), cephalothin (CEP), cefuroxime (CXM), cefixime (CFM), moxifloxacin (MFX), and minocycline (MNO) susceptibility was determined. H. pylori resistance rates and MIC90 results were: AMX, 3.87%, 0.032 mg/L; MTZ, 61.33%, >256 mg/L; CLR, 30.94%, 256 mg/L; AMC, 0%, 0.023 mg/L; CEP, 1.10%, 0.094 mg/L; CXM, 0%, 0.047 mg/L; CFM, 0.55%, 0.125 mg/L; MFX, 74.03%, 32 mg/L; and MNO, 6.63%, 8 mg/L. Dual resistance to MTZ+CLR was detected in 48 isolates (26.52%), MTZ+MFX in 94 isolates (51.93%), and CLR+MFX in 49 isolates (27.07%). 41 isolates (22.56%) resistant to MTZ+CLR+MFX. MTZ and CLR resistance was significantly associated with the history of eradication, but there was no difference in MFX resistance rate between treated and untreated patients (P=0.674). No significant relationship existed between antibiotic resistance and gender, age, endoscopic findings, inflammation degree, or gastric mucosa atrophy. AMX, AMC, MNO and cephalosporins, but not MTZ, CLR and MFX, showed good in vitro anti-H. pylori activity. Among cephalosporins, cefuroxime was most active. H.pylori resistance is higher in the patients with histories of eradication. These results can help adapt treatment strategies. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 07/2015; DOI:10.1111/1751-2980.12271
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    ABSTRACT: We aimed to compare plasma pantoprazole levels between patients with type 2 diabetes mellitus and non-diabetic patients during helicobacter pylori eradication treatment and the effect of plasma pantoprazole level on treatment success rates. This study included 40 diabetic and 40 non-diabetic naïve H.pylori infected patients. Bismuth based standart quadruple treatment was used 14 days for H.pylori eradication in both group. Plasma Pantoprazole levels (PPL) were measured via Square-Wave Voltammetry method. H. pylori eradication rate (%60.0vs. %87.5,p=0.005) and the plasma Pantoprazole level was significantly lower in diabetic group (0.25±0.03 μgmL-1vs 0.34±0.03 μgmL-1, p<0.001). Patients with treatment failure had lower PPL (p<0.001). A ROC curve demonstrated that, PPL had a significant (p <0.0001) predictive value for H.pylori eradication success. This is the first study investigating PPL and its effect on H. Pylori eradication success in type 2 diabetic and nondiabetic patients. Diabetic patients had lower PPL that caused lower H.pylori eradication rates. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 07/2015; DOI:10.1111/1751-2980.12272
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    ABSTRACT: Syncytial giant cell hepatitis, commonly occurring in the pediatric population, is unusually rare in adults, diagnosed histologically by the presence of multinucleated cells in the liver. The literature has only recorded approximately one hundred cases in adults during the past two decades with malignancy rarely associated with giant cell hepatitis. Our patient is a 66-year-old female who was diagnosed with chronic lymphocytic leukemia (CLL) and subsequently developed syncytial giant cell hepatitis. While giant cell hepatitis is rare in adults, it is usually linked to viruses, autoimmune diseases, and medications. The association between CLL and giant cell hepatitis is rare with only three reported cases in the literature. The majority of cases report viral particles on electron microscopy and usually has a history of chemotherapy and hypogammaglobulinemia. Unlike other cases, our patient developed giant cell hepatitis in the absence of other confounding variables, such as viral particles on electron microscopy, chemotherapy treatments, or low immunoglobulin levels. The treatment for our patient was high dose corticosteroid and rituxan with improvement in liver enzymes. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 07/2015; DOI:10.1111/1751-2980.12273
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    ABSTRACT: The incidence of NSAID-induced enteropathy is currently increasing. However, the clinical predictor of small bowel bleeding (SBB) associated with NSAID-induced enteropathy are unknown. This study aimed to know the risk factors of SBB in chronic NSAID users. We retrospectively compared records of 147 patients receiving NSAIDs at a tertiary-care setting (31 cases with SBB and 124 controls without previous bleeding events) and analyzed clinical predictors of SBB. Thirty-one patients underwent capsule endoscopy to evaluate SBB, 74.2% of which demonstrated evidence of SBB. Non-invasive treatment was performed in 90.3% of patients. Multivariable logistic regression analysis revealed that presence of coronary artery disease (adjusted odds ratio [aOR], 12.4; 95% confidence interval [CI], 1.2-130.3; p=0.04), use of thienopyridine (aOR,16.9;95%CI,3.8-75.7;p<0.001), and prior use of rebamipide (aOR 0.3;95%CI,0.12-0.82;p=0.02) were independently associated with SBB in NSAID users. Coronary artery disease and co-use of thienopyridine were associated with SBB in NSAID users. In patients with coronary artery disease and co-use of thienopyridine, it is necessary for clinicians to monitor for occurrence of SBB when they prescribe NSAIDs. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 07/2015; DOI:10.1111/1751-2980.12269