Digestive Diseases and Sciences

Gastroenterology (GI) fellowship remains one of the most competitive fellowships pursued after the completion of internal medicine (IM) residency training [1, 2]. Post-match analysis of data published by the National Resident Matching Program (NRMP) notes an incremental increase in the number of programs, available positions, and applicants from 2016 to 2020, which has consequently increased the percentage of unmatched candidates from 33.6% in 2017 to 37.3% in 2020 [3]. Prior studies have outlined prominent characteristics that programs seek in a candidate, including the quality of residency evaluations, letters of recommendation, and scholarly activity [1, 4, 5].

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Successful Distancing: Telemedicine in Gastroenterology and Hepatology During the COVID-19 Pandemic

Abhilash Perisetti & Hemant Goyal

doi : 10.1007/s10620-021-06874-x

Digestive Diseases and Sciences volume 66, pages945–953(2021)

Telemedicine involves delivering healthcare and preventative care services to patients without the need for in-person encounters. Traditionally, telemedicine has been used for acute events (e.g., stroke, used to relay essential information to the emergency department) and chronic disease management (e.g., diabetes and chronic kidney disease management). Though the utilization of telemedicine in gastroenterology and hepatology has been modest at best, especially for inflammatory bowel diseases and chronic liver disease management, since the onset of coronavirus disease 2019 (COVID-19) pandemic, utilization of telemedicine in gastroenterology increased by 4000% in the first two weeks, equivalent to the last six years of growth before the pandemic. The Center for Medicare and Medicaid (CMS) relaxed rules for the use of telemedicine with easing restrictions on reimbursements, location, licensing requirements (across state lines), and the need for a prior provider-patient relationship. These changes increased the use of telemedicine in inpatient and outpatient settings for gastroenterology-related referrals. The use of inpatient telephonic or video consults helps provide timely care during the pandemic while conserving personal protective equipment and decreasing provider and patient exposure. Nevertheless, telehealth use comes at the cost of no direct patient contact and lesser reimbursements. The appropriate use of technology and equipment, training of healthcare providers, use of platforms that can be integrated into the electronic health record while protecting the privacy and the flow of information are essential components of telemedicine. Furthermore, encouraging patients to seek medical care remotely with the proper equipment and improving digital literacy without the need for physical examinations is a challenge, further compounded in elderly or hard-of-hearing patients and in patients who are more comfortable with in-person visits. The authors will systematically review and discuss how telemedicine can be integrated into the practice of gastroenterology and hepatology, with emphasis placed on discussing barriers to success and the ways they can be mitigated.

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Growth Delay in Inflammatory Bowel Diseases: Significance, Causes, and Management

Kerry Wong, Daniela Migliarese Isaac & Eytan Wine

doi : 10.1007/s10620-020-06759-5

Digestive Diseases and Sciences volume 66, pages954–964(2021)

Growth delay with height and weight impairment is a common feature of pediatric inflammatory bowel diseases (PIBD). Up to 2/3 of Crohn Disease patients have impaired weight at diagnosis, and up to 1/3 have impaired height. Ulcerative colitis usually manifests earlier with less impaired growth, though patients can be affected. Ultimately, growth delay, if not corrected, can reduce final adult height. Weight loss, reduced bone mass, and pubertal delay are also concerns associated with growth delay in newly diagnosed PIBD patients. The mechanisms for growth delay in IBD are multifactorial and include reduced nutrient intake, poor absorption, increased fecal losses, as well as direct effects from inflammation and treatment modalities. Management of growth delay requires optimal disease control. Exclusive enteral nutrition (EEN), biologic therapy, and corticosteroids are the primary induction strategies used in PIBD, and both EEN and biologics positively impact growth and bone development. Beyond adequate disease control, growth delay and pubertal delay require a multidisciplinary approach, dependent on diligent monitoring and identification, nutritional rehabilitation, and involvement of endocrinology and psychiatry services as needed. Pitfalls that clinicians may encounter when managing growth delay include refeeding syndrome, obesity (even in the setting of malnutrition), and restrictive diets. Although treatment of PIBD has improved substantially in the last several decades with the era of biologic therapies and EEN, there is still much to be learned about growth delay in PIBD in order to improve outcomes.

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Mast Cell Activation Syndrome: A Primer for the Gastroenterologist

Leonard B. Weinstock, Laura A. Pace, Ali Rezaie, Lawrence B. Afrin & Gerhard J. Molderings

doi : 10.1007/s10620-020-06264-9

Digestive Diseases and Sciences volume 66, pages965–982(2021)

Mast cell activation syndrome is thought to be a common, yet under-recognized, chronic multi-system disorder caused by inappropriate mast cell activation. Gastrointestinal symptoms are frequently reported by these patients and are often mistaken by physicians as functional gastrointestinal disorders. This syndrome can be diagnosed by the medical history and measurable biomarkers. Gastroenterologists manage diseases associated with active inflammatory cells including neutrophils, lymphocytes, macrophages, and eosinophils. The mast cell has only recently been recognized as a major player in our specialty. Gastrointestinal disorders from mast cell mediators often present with apparent irritable bowel syndrome, dyspepsia, chronic or cyclical nausea, and heartburn. Individuals with mast cell activation syndrome experience significant delays in diagnosis. The gastrointestinal symptoms are often refractory to symptom-targeted prescription medications. Beyond avoiding triggers, the best therapy is directed at modulating mast cell activation and the effects of the mediators. Many of these therapies are simple over-the-counter medications. In this article, we review mast cell function and dysfunction and the gastrointestinal symptoms, comorbid conditions, diagnosis, and management of mast cell activation syndrome. Gastroenterologists who become aware of this syndrome can dramatically improve the quality of life for their patients who previously have been labeled with a functional gastrointestinal disorder.

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Another Use for EUS: Removal of a Transesophageal-Migrated Mediastinal Foreign Body

Nico Pagano, Giampiero Dolci, Francesco Buttitta, Massimo De Matteis, Augusto Lauro & Piero Solli

doi : 10.1007/s10620-020-06769-3

Digestive Diseases and Sciences volume 66, pages983–987(2021)

Removal of foreign bodies from the upper gastrointestinal tract, though a common occurrence, can be technically challenging and risky. We report the case of a young man that, after eating a pizza cooked in a wood-burning oven, reported a sense of foreign body. Though the first evaluation by fiberoptic laryngoscopy found no foreign body, after a few weeks, the patient was readmitted from the ER for worsening symptoms and fever. A CT scan showed a metallic mediastinal foreign body inside a large fluid collection. After multidisciplinary evaluation, an endoscopic removal was attempted by accessing the mediastinal collection through EUS-guided positioning of a Hot Axios™ stent. The cavity was drained by naso-esophageal suction. The foreign body was a fragment of the brush used to clean the oven. The patient is now doing well after 7 months.

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Author Spotlight: Nico Pagano

Nico Pagano

doi : 10.1007/s10620-020-06784-4

Digestive Diseases and Sciences volume 66, page988(2021)

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The Mettle to Use the Petals: Using Over-the-Scope Rings to Optimize Endoscopic Submucosal Dissection

Mike T. Wei, George Triadafilopoulos & Shai Friedland

doi : 10.1007/s10620-020-06596-6

Digestive Diseases and Sciences volume 66, pages989–993(2021)

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Provider Variability in the Management Patterns of Increased Nonacid Reflux

Chanakyaram A. Reddy, Lydia Watts, Jason R. Baker & Joan W. Chen

doi : 10.1007/s10620-020-06348-6

Digestive Diseases and Sciences volume 66, pages994–998(2021)

Increased nonacid reflux is diagnosed in a subgroup of patients with gastroesophageal reflux disease who often present with reflux symptoms refractory to proton-pump inhibitor therapy. Despite the prevalence of this condition, the management approach for patients with increased nonacid reflux can often be varied and unclear.

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Incidence of Non-variceal Upper Gastrointestinal Bleeding Worsens Outcomes with Acute Coronary Syndrome: Result of a National Cohort

Lauren Pioppo, Abhishek Bhurwal, Debashis Reja, Augustine Tawadros, Hemant Mutneja, Akshay Goel & Anish Patel

doi : 10.1007/s10620-020-06266-7

Digestive Diseases and Sciences volume 66, pages999–1008(2021)

Upper gastrointestinal bleeding (UGIB) is a feared complication of acute coronary syndrome (ACS) and has been shown to increase morbidity and mortality. Our aim was to assess the incidence of non-variceal UGIB in patients with ACS in a national cohort and its impact on in-hospital mortality, length of stay (LOS), and cost of hospitalization.

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National Landscape of Unplanned 30-Day Readmission Rates for Acute Non-hemorrhagic Diverticulitis: Insight from National Readmission Database

Dhruv Mehta, Aparna Saha, Lavneet Chawla, Mohamed Tausif Siddiqui, Supreet Kaur, Dishita Pandya, Priti Poojary, Shanti Patel, Virendra Tewari & Edward Lebovics

doi : 10.1007/s10620-020-06284-5

Digestive Diseases and Sciences volume 66, pages1009–1021(2021)

Early readmissions are an important indicator of the quality of care. Limited data exist describing hospital readmissions in acute diverticulitis. The study aimed to describe unplanned, 30-day readmissions among adult acute diverticulitis patients and to assess readmission predictors.

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Antioxidant Analogue 6-Amino-2,4,5-Trimethylpyridin-3-ol Ameliorates Experimental Colitis in Mice

Hoyul Lee, Joon Seop Lee, Hyun Jung Cho, Yu-Jeong Lee, Eun Soo Kim, Sung Kook Kim, Tae-gyu Nam, Byeong-Seon Jeong & Jung-Ae Kim

doi : 10.1007/s10620-020-06267-6

Digestive Diseases and Sciences volume 66, pages1022–1033(2021)

Oxidative stress has been suggested to be a factor contributing to the disease severity of inflammatory bowel disease (IBD). BJ-1108, a derivative of 6-amino-2,4,5-trimethylpyridin-3-ol, is reported to significantly inhibit the generation of reactive oxygen species (ROS) in vitro. However, whether this molecule affects intestinal inflammation is largely unknown. We aimed to investigate the effect of BJ-1108 on dextran sulfate sodium (DSS)-induced experimental colitis in mice.

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Filtrated Adipose Tissue-Derived Mesenchymal Stem Cell Lysate Ameliorates Experimental Acute Colitis in Mice

Takahiro Nishikawa, Keiko Maeda, Masanao Nakamura, Takeshi Yamamura, Tsunaki Sawada, Yasuyuki Mizutani, Takanori Ito, Takuya Ishikawa, Kazuhiro Furukawa, Eizaburo Ohno, Ryoji Miyahara, Hiroki Kawashima, Takashi Honda, Masatoshi Ishigami, Tokunori Yamamoto, Seiji Matsumoto, Yuji Hotta & Mitsuhiro Fujishiro

doi : 10.1007/s10620-020-06359-3

Digestive Diseases and Sciences volume 66, pages1034–1044(2021)

Inflammatory bowel disease (IBD) is a chronic, persistent, and intractable enteritis; however, an effective treatment strategy is yet to be established. Mesenchymal stem cells (MSCs) and their paracrine factors exhibit anti-inflammatory actions and have been proposed as a new therapeutic candidate for IBD treatment, although the efficacy of MSC lysate on enteritis is unclear.

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Preparation of Internalizing RGD-Modified Recombinant Methioninase Exosome Active Targeting Vector and Antitumor Effect Evaluation

Lin Xin, Yi-Wu Yuan, Chuan Liu, Li-Qiang Zhou, Li Liu, Qi Zhou & Shi-Hao Li

doi : 10.1007/s10620-020-06262-x

Digestive Diseases and Sciences volume 66, pages1045–1053(2021)

Targeted drug delivery vehicles with low immunogenicity and toxicity are needed for cancer therapy. Here, we prepare an active targeting drug carrier of low immunogenicity and toxicity for targeted therapy.

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BBOX1-AS1 Accelerates Gastric Cancer Proliferation by Sponging miR-3940-3p to Upregulate BIRC5 Expression

Yan Yang, Qiong Yu, Bing Li, Renzhen Guan, ChangYong Huang & XiuCheng Yang

doi : 10.1007/s10620-020-06308-0

Digestive Diseases and Sciences volume 66, pages1054–1062(2021)

Gastric cancer (GC) is one type of the most general malignancies in the globe. Research increasingly suggests long non-coding RNAs (lncRNAs) exert crucial roles in GC. However, the function of BBOX1-AS1 in GC has not been reported yet, it needs more explorations.

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Negative Regulation of SIRT1 by IRF9 Involved in Hyperlipidemia Acute Pancreatitis Associated with Kidney Injury

Yi Liu, Yun Sun, Bin-Hua Xue, Xiao-Die Wang & Wei-Li Yu

doi : 10.1007/s10620-020-06331-1

Digestive Diseases and Sciences volume 66, pages1063–1071(2021)

Interferon regulatory factor 9 (IRF9) acts as a negative regulator of sirtuin-1 (SIRT1) to participate in many diseases. However, the role of SIRT1 and IRF9 in hyperlipidemia acute pancreatitis associated with kidney injury is unclear.

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Development of Pancreatic Acinar Cell Metaplasia During Gastric Repair in a Rat Duodenal Contents Reflux Model

Yasuhiro Wada, Ken-ichi Mukaisho, Shunpei Kanai, Takahisa Nakayama, Masahide Fukuda, Kazuhiro Mizukami, Tadayoshi Okimoto, Masaaki Kodama, Hiroyuki Sugihara, Kazunari Murakami & Ryoji Kushima

doi : 10.1007/s10620-020-06342-y

Digestive Diseases and Sciences volume 66, pages1072–1079(2021)

We previously reported the development of pancreatic acinar cell metaplasia (PACM) in the glandular stomach of a duodenal contents reflux model (reflux model).

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Targeting Aspartate Beta-Hydroxylase with the Small Molecule Inhibitor MO-I-1182 Suppresses Cholangiocarcinoma Metastasis

Katsuya Nagaoka, Kousuke Ogawa, Chengcheng Ji, Kevin Y. Cao, Xuewei Bai, Joud Mulla, Zhixiang Cheng, Jack R. Wands & Chiung-Kuei Huang

doi : 10.1007/s10620-020-06330-2

Digestive Diseases and Sciences volume 66, pages1080–1089(2021)

Cholangiocarcinoma is a devastating disease with a 2% 5-year survival if the disease has spread outside the liver. The enzyme aspartate beta-hydroxylase (ASPH) has been demonstrated to be highly expressed in cholangiocarcinoma but not in normal bile ducts and found to stimulate tumor cell migration. In addition, it was found that targeting ASPH inhibits cholangiocarcinoma malignant progression. However, it is not clear whether targeting ASPH with the small molecule inhibitor MO-I-1182 suppresses cholangiocarcinoma metastasis. The current study aims to study the efficacy of MO-I-1182 in suppressing cholangiocarcinoma metastasis.

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G-Protein-Coupled Receptors 120 Agonist III Improves Hepatic Inflammation and ER Stress in Steatohepatitis

Xiaoyuan Chen, Chao Liu & Litao Ruan

doi : 10.1007/s10620-020-06280-9

Digestive Diseases and Sciences volume 66, pages1090–1096(2021)

GPR120 plays a crucial role in insulin sensitization, inflammatory responses and obesity and is considered as an attractive potential target for the treatment of metabolic dysfunctions. However, the mechanisms of GPR120 agonist III in NAFLD/NASH treatment are still unclear.

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Upregulation of Excision Repair Cross-Complementation Group 6-Like (ERCC6L) Promotes Tumor Growth in Hepatocellular Carcinoma

Guangcong Zhang, Jiamei Ma, Ju Xiong, Xiaoxi Huang, Xiangyang Han, Xiangnan Yu & Xuemei Jiang

doi : 10.1007/s10620-020-06277-4

Digestive Diseases and Sciences volume 66, pages1097–1109(2021)

Excision repair cross-complementation group 6-like (ERCC6L) is overexpressed in some malignancies; however, its role in hepatocellular carcinoma (HCC) remains to be further investigated.

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Identification of METTL3 as an Adverse Prognostic Biomarker in Hepatocellular Carcinoma

Gao-Min Liu, Hua-Dong Zeng, Cai-Yun Zhang & Ji-Wei Xu

doi : 10.1007/s10620-020-06260-z

Digestive Diseases and Sciences volume 66, pages1110–1126(2021)

N6-methyladenosine (m6A), the most prominent mRNA modification, plays a critical role in many physiological and pathological processes. However, the roles of m6A RNA modification in hepatocellular carcinoma (HCC) remain largely unknown.

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Pathophysiology of Gastroparesis Syndromes Includes Anatomic and Physiologic Abnormalities

Thomas L. Abell, Archana Kedar, Abigail Stocker, Karen Beatty, Lindsay McElmurray, Michael Hughes, Hani Rashed, William Kennedy, Gwen Wendelschafer-Crabb, Xiu Yang, Mostafa Fraig, Leila Gobejishvili, Endashaw Omer, Ed Miller, Michael Griswold & Christina Pinkston

doi : 10.1007/s10620-020-06259-6

Digestive Diseases and Sciences volume 66, pages1127–1141(2021)

Factors underlying gastroparesis are not well defined.

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Audit of Gastrointestinal Manifestations in Patients with Loeys–Dietz Syndrome and Vascular Ehlers–Danlos Syndrome

Xiao Jing Wang, Mary Babameto, Dusica Babovic-Vuksanovic, Juan M. Bowen & Michael Camilleri

doi : 10.1007/s10620-020-06265-8

Digestive Diseases and Sciences volume 66, pages1142–1152(2021)

Loeys–Dietz syndrome (LDS) and vascular Ehlers–Danlos Syndrome (vEDS) are genetically heterogeneous heritable disorders of connective tissue. Both are multi-system disorders with dominant vascular pathology and associated gastrointestinal manifestations.

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Hot-Water Bathing Improves Symptoms in Patients with Cyclic Vomiting Syndrome and Is Modulated by Chronic Cannabis Use

Sheldon Rosen, Robert Diaz, Zhuping Garacci, Vishnu Charan Suresh Kumar, Shashank R. Thyarala, Cecilia J. Hillard & Thangam Venkatesan

doi : 10.1007/s10620-020-06343-x

Digestive Diseases and Sciences volume 66, pages1153–1161(2021)

Cyclic vomiting syndrome (CVS) is a chronic functional GI disorder; a characteristic compulsive “hot-water bathing” pattern is reported to alleviate symptoms during an acute episode. There is limited data on this bathing pattern: proposed mechanisms include core temperature increase via effects on cannabinoid type 1 receptors in the brain, skin transient receptor potential vanilloid 1 receptor stimulation, and blood flow shift from viscera to skin.

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Initial Computed Tomography Findings of Long and Distended Colon Are Risk Factors for the Recurrence of Sigmoid Volvulus

Ryusaku Kusunoki, Hirofumi Fujishiro, Tatsuya Miyake, Shinsuke Suemitsu, Masatoshi Kataoka, Aya Fujiwara, Kosuke Tsukano, Satoshi Kotani, Satoshi Yamanouchi, Masahito Aimi, Masaki Tanaka, Youichi Miyaoka, Naruaki Kohge, Tomonori Imaoka, Kouji Yuasa, Kouji Kodama, Shunji Ishihara & Yoshikazu Kinoshita

doi : 10.1007/s10620-020-06317-z

Digestive Diseases and Sciences volume 66, pages1162–1167(2021)

Sigmoid volvulus is a common condition in elderly patients with elongated colons. Although endoscopic de-torsion is effective as the primary treatment of sigmoid volvulus, elective surgery is recommended because of the high risk of recurrence and high mortality rate.

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Longer Withdrawal Time Is More Important than Excellent Bowel Preparation in Colonoscopy of Adequate Bowel Preparation

Ji Min Choi, Ji Yeon Seo, Jooyoung Lee, Yoo Min Han, Eun Hyo Jin, Jung Ho Bae & Joo Hyun Lim

doi : 10.1007/s10620-020-06321-3

Digestive Diseases and Sciences volume 66, pages1168–1174(2021)

Adequate bowel preparation is crucial for effective screening colonoscopy. However, it is unclear whether higher bowel preparation scores correspond to beneficial effects on the adenoma and polyp detection rate (ADR and PDR) in the adequate bowel preparation group.

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Adenoma and Advanced Adenoma Detection Rates of Water Exchange, Endocuff, and Cap Colonoscopy: A Network Meta-Analysis with Pooled Data of Randomized Controlled Trials

Paul P. Shao, Aileen Bui, Tahmineh Romero, Hui Jia & Felix W. Leung

doi : 10.1007/s10620-020-06324-0

Digestive Diseases and Sciences volume 66, pages1175–1188(2021)

A network meta-analysis showed that low-cost optimization of existing resources was as effective as distal add-on devices in increasing adenoma detection rate (ADR). We assessed the impacts of water exchange (WE), Endocuff, and cap colonoscopy on ADR and advanced adenoma detection rate (AADR). We hypothesized that WE may be superior at improving ADR and AADR.

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Factors Associated with Inflammatory Bowel Disease Flare During Pregnancy Among Women with Preconception Remission

Amihai Rottenstreich, Zlil Shifman, Sorina Grisaru-Granovksy, Tali Mishael, Benjamin Koslowsky & Ariella Bar-Gil Shitrit

doi : 10.1007/s10620-020-06282-7

Digestive Diseases and Sciences volume 66, pages1189–1194(2021)

The factors associated with inflammatory bowel diseases (IBD) relapse throughout gestation in those with preconception remission remain unknown.

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Zinc Gluconate Induces Potentially Cancer Chemopreventive Activity in Barrett’s Esophagus: A Phase 1 Pilot Study

M. C. Valenzano, E. Rybakovsky, […]J. M. Mullin

doi : 10.1007/s10620-020-06319-x

Digestive Diseases and Sciences volume 66, pages1195–1211(2021)

Chemopreventive effects of zinc for esophageal cancer have been well documented in animal models. This prospective study explores if a similar, potentially chemopreventive action can be seen in Barrett’s esophagus (BE) in humans.

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Linked Color Imaging Can Improve Detection Rate of Early Gastric Cancer in a High-Risk Population: A Multi-Center Randomized Controlled Clinical Trial

Jie Gao, Xiaofeng Zhang, […]Dong Wang

doi : 10.1007/s10620-020-06289-0

Digestive Diseases and Sciences volume 66, pages1212–1219(2021)

Early diagnosis of gastric cancer is difficult in China due to the lack of a valid method for endoscopic screening. Early gastric cancer, especially flat gastric cancer, lacks specific endoscopic features. Many cases appear to be similar to ordinary gastritis cases under normal white light endoscopy, which can lead to misdiagnosis.

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Low Epstein–Barr Virus Prevalence in Cardia Gastric Cancer Among a High-Incidence Chinese Population

John G. Aversa, Minkyo Song, Nan Hu, Alisa M. Goldstein, Stephen M. Hewitt, Margaret L. Gulley, Sanford Dawsey, Maria Constanza Camargo, Philip R. Taylor & Charles S. Rabkin

doi : 10.1007/s10620-020-06288-1

Digestive Diseases and Sciences volume 66, pages1220–1226(2021)

Epstein–Barr virus (EBV) positivity is associated with better gastric cancer prognosis and is found in a relatively fixed 9% of tumors worldwide.

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Histogram Analysis of Diffusion-Weighted MR Imaging as a Biomarker to Predict Survival of Surgically Treated Colorectal Cancer Patients

Yumiko Takahashi, Koichi Hayano, Gaku Ohira, Shunsuke Imanishi, Toshiharu Hanaoka, Hiroki Watanabe, Atsushi Hirata, Yohei Kawasaki, Hideaki Miyauchi & Hisahiro Matsubara

doi : 10.1007/s10620-020-06318-y

Digestive Diseases and Sciences volume 66, pages1227–1232(2021)

Structural abnormality is a well-recognized feature of malignancy. On the other hand, diffusion-weighted MRI (DWI) has been reported as a tool that can reflect tumor biology.

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Experience with Esophageal Granular Cell Tumors: Clinical and Endoscopic Analysis of 22 Cases

Yongsheng Shi, Ningli Chai, Lisen Zhong, Longsong Li, Jiale Zou, Jingyuan Xiang, Xiangyao Wang & Enqiang Linghu

doi : 10.1007/s10620-020-06337-9

Digestive Diseases and Sciences volume 66, pages1233–1239(2021)

Esophageal granular cell tumors (GCTs) are rare tumors. Differences in reports on the clinical features of GCTs in the esophagus and some controversies about the diagnostic strategy for esophageal GCTs exist.

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Signet Ring Cell Gastric Carcinoma: Clinical Epidemiology and Outcomes in a Predominantly Latino County Hospital Population

Brian M. Fung, Mital Patel, Neha Patel, Arleen F. Brown, Nora L. Ostrzega & James H. Tabibian

doi : 10.1007/s10620-020-06341-z

Digestive Diseases and Sciences volume 66, pages1240–1248(2021)

Gastric signet ring cell carcinoma (GSRC) is a rare but increasingly prevalent tumor histotype whose clinical features and natural history are poorly understood, particularly in the USA and minorities.

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High Body Mass Index and Central Adiposity Is Associated with Increased Risk of Acute Pancreatitis: A Meta-Analysis

Dagfinn Aune, Yahya Mahamat-Saleh, Teresa Norat & Elio Riboli

doi : 10.1007/s10620-020-06275-6

Digestive Diseases and Sciences volume 66, pages1249–1267(2021)

Higher body mass index and waist circumference have been associated with increased risk of pancreatitis in several prospective studies; however, the results have not been entirely consistent.

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Clinical Usefulness of Serum Autotaxin for Early Prediction of Relapse in Male Patients with Type 1 Autoimmune Pancreatitis

Ayami Fukiage, Hatsue Fujino, Daiki Miki, Yasutaka Ishii, Masahiro Serikawa, Masataka Tsuge, Michio Imamura, Hiroshi Aikata, C. Nelson Hayes & Kazuaki Chayama

doi : 10.1007/s10620-020-06338-8

Digestive Diseases and Sciences volume 66, pages1268–1275(2021)

Serum IgG4 level is a useful diagnostic marker for autoimmune pancreatitis (AIP), but it is difficult to use to predict relapse.

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Combination of ERCP-Based Modalities Increases Diagnostic Yield for Biliary Strictures

Samuel Han, Philip Tatman, Sanjana Mehrotra, Sachin Wani, Augustin R. Attwell, Steven A. Edmundowicz, Brian C. Brauer, Mihir S. Wagh, Hazem T. Hammad & Raj J. Shah

doi : 10.1007/s10620-020-06335-x

Digestive Diseases and Sciences volume 66, pages1276–1284(2021)

Biliary stricture evaluation with brush cytology and intraductal forceps biopsy carries a low sensitivity, but the combination of newer modalities may improve sensitivity.

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Use of an Ultra-slim Gastroscope to Accomplish Endoscopist-Facilitated Rescue Intubation During ERCP: A Novel Approach to Enhance Patient and Staff Safety

Monique T. Barakat, Timothy P. Angelotti & Subhas Banerjee

doi : 10.1007/s10620-020-06360-w

Digestive Diseases and Sciences volume 66, pages1285–1290(2021)

ERCP is often performed under monitored anesthesia care (MAC) rather than general anesthesia (GA), with patients positioned semi-prone on the fluoroscopy table. Rarely, a MAC ERCP must be converted to GA due to hypoxia or retained food in the stomach. In these circumstances, standard intubation is associated with a significant delay and potential for patient/staff injury during repositioning. We report a novel endoscopist-driven approach to intubation during ERCP using an ultra-slim, flexible gastroscope with an endotracheal tube backloaded onto it.

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Safety and Efficacy of Endoscopic Retrograde Cholangiopancreatography in Patients with Performance Status 4

Rena Kitano, Tadahisa Inoue, Mayu Ibusuki, Yuji Kobayashi, Tomohiko Ohashi, Yoshio Sumida, Yukiomi Nakade, Kiyoaki Ito & Masashi Yoneda

doi : 10.1007/s10620-020-06339-7

Digestive Diseases and Sciences volume 66, pages1291–1296(2021)

The risk related to endoscopic retrograde cholangiopancreatography (ERCP) in patients with Eastern Cooperative Oncology Group performance status (PS) 4 is uncertain and remains a concern.

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How Good Are Controlled Attenuation Parameter Scores from Fibroscan to Assess Steatosis, NASH, and Fibrosis?

Joshua Trowell, Joseph Alukal, Talan Zhang, Li Liu, Anurag Maheshwari, Hwan Y. Yoo & Paul J. Thuluvath

doi : 10.1007/s10620-020-06269-4

Digestive Diseases and Sciences volume 66, pages1297–1305(2021)

The objective of our study was to determine the concordance rates of steatosis staging by controlled attenuation parameter (CAP) scores from transient elastography (TE) in comparison with liver histology in patients with chronic liver disease and to determine the optimal CAP cutoffs to predict the severity of steatosis and identify those with nonalcoholic steatohepatitis (NASH).

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Hospitalizations for Acute on Chronic Liver Failure at Academic Compared to Non-academic Centers Have Higher Mortality

Ashwani K. Singal, Zunirah Ahmed, Page Axley, Sumant Arora, Juan P. Arab, Allen Haas, Yong-Fang Kuo & Patrick S. Kamath

doi : 10.1007/s10620-020-06263-w

Digestive Diseases and Sciences volume 66, pages1306–1314(2021)

Acute on chronic liver failure (ACLF) in patients with cirrhosis has high short-term mortality. Data comparing ACLF admissions to academic centers (AC) and non-academic centers (NAC) are scanty.

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Cost–Utility of All-Oral Direct-Acting Antiviral Regimens for the Treatment of Genotype 1 Chronic Hepatitis C Virus-Infected Patients in Hong Kong

Man-Fung Yuen, Sze-Hang Liu, Wai-Kay Seto, Lung-Yi Mak, Shelby L. Corman, Danny C. Hsu, Mary Y. K. Lee, Tsz K. Khan & Amy Puenpatom

doi : 10.1007/s10620-020-06281-8

Digestive Diseases and Sciences volume 66, pages1315–1326(2021)

Direct-acting antivirals (DAAs) are entering the hepatitis C virus (HCV) treatment landscape in Hong Kong, prompting the need for cost–effectiveness evaluations of these interventions to enable optimal use of healthcare resources.

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Excellent Safety and Sustained Virologic Response to Direct-Acting Antivirals Treatment in HCV-Infected Geriatric Patients: A Real-World Data

Tung Huynh & Ke-Qin Hu

doi : 10.1007/s10620-020-06286-3

Digestive Diseases and Sciences volume 66, pages1327–1334(2021)

Direct-acting antivirals (DAAs) are current standard of HCV treatment (Rx). However, data remain lacking on real-world safety, patterns of biochemical, virologic responses, and sustained virologic response (SVR12) rate in geriatric patients.

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Ultrasonographic (US) Two-Dimensional Measurement of Spleen Is Superior to Traditional Length Measurement Alone in Diagnosing Cirrhosis

Felix H. Lui, Patrick Ma, Mohammad Helmy & Ke-Qin Hu

doi : 10.1007/s10620-020-06332-0

Digestive Diseases and Sciences volume 66, pages1335–1342(2021)

Splenomegaly measured by spleen length has been an imaging evidence for cirrhosis. However, data remains lacking on the value of other US findings for diagnosing cirrhosis. This study evaluated the value of spleen two-dimensional measurements (2D, i.e., length?×?thickness) in diagnosing cirrhosis by comparing with other US parameters.

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Validation of the Expanded Baveno-VI Criteria for Screening Gastroscopy in Asian Patients with Compensated Advanced Chronic Liver Disease

Pik-Eu Chang, Chee-Kiat Tan, Chang-Chuen Cheah, Weiquan Li, Wan Cheng Chow & Yu-Jun Wong

doi : 10.1007/s10620-020-06334-y

Digestive Diseases and Sciences volume 66, pages1343–1348(2021)

The expanded Baveno-VI criteria may further reduce the need for screening gastroscopy compared to Baveno-VI criteria.

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To Protect Fatty Livers from Ischemia Reperfusion Injury: Role of Ischemic Postconditioning

Julia Schewe, Marie-Christine Makeschin, Andrej Khandoga, Jiang Zhang, Doris Mayr, Simon Rothenfu?er, Max Schnurr, Alexander L. Gerbes & Christian J. Steib

doi : 10.1007/s10620-020-06328-w

Digestive Diseases and Sciences volume 66, pages1349–1359(2021)

The benefit of ischemic postconditioning (IPostC) might be the throttled inflow following cold ischemia. The current study investigated advantage and mechanisms of IPostC in healthy and fatty rat livers.

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Liver Transplant Is Associated with Sustained Improvement in Tandem Gait and Risk of Falls

Chathur Acharya, Melanie B. White, Andrew Fagan, Richard K. Sterling, R. Todd Stravitz, Puneet Puri, Michael Fuchs, Velimir Luketic, Arun J. Sanyal, James B. Wade, HoChong Gilles, Douglas M. Heuman, Felicia Tinsley, Scott Matherly, Hannah Lee, Mohammad S. Siddiqui, Leroy R. Thacker & Jasmohan S. Bajaj

doi : 10.1007/s10620-020-06261-y

Digestive Diseases and Sciences volume 66, pages1360–1366(2021)

Cirrhosis is associated with poor health-related quality of life (HRQOL), cognitive dysfunction (CD), and lack of coordination leading to falls. Tandem gait (TG; heel-toe) can be used to assess coordination. The impact and relationship between CD, TG and falls pre-/post-liver transplant (LT) is unclear. We aimed to determine the impact of LT on CD, abnormal TG, and HRQOL in cirrhosis.

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Post-partum Primary Biliary Cholangitis Preceded by Intrahepatic Cholestasis of Pregnancy in Three First Nation Patients

Daljeet Chahal, Eric M. Yoshida, Laura Arbour & Jean-Phillipe Wallach

doi : 10.1007/s10620-020-06333-z

Digestive Diseases and Sciences volume 66, pages1367–1369(2021)

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Novel Modifications for a Virtual Interview Visit to Simulate the Traditional, Live, Site Visit for GI Fellowship Applicants for an Academic GI Fellowship Program Due to the COVID-19 Pandemic

Mitchell S. Cappell

doi : 10.1007/s10620-020-06741-1

Digestive Diseases and Sciences volume 66, pages1370–1371(2021)

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Correction to: High?Resolution Colonic Manometry Pressure Profiles Are Similar in Asymptomatic Diverticulosis and Controls

Rebekah Jaung, Chris Varghese, Anthony Y. Lin, Niranchan Paskaranandavadivel, Peng Du, David Rowbotham, Phil Dinning, Gregory O’Grady & Ian Bissett

doi : 10.1007/s10620-020-06524-8

Digestive Diseases and Sciences volume 66, pages1372–1374(2021)

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