Genomic and the tumor microenvironment heterogeneity in multifocal hepatocellular carcinoma.

Background And Aims: Ambiguous understanding of tumors and tumor microenvironments (TMEs) hinders accurate diagnosis and available treatment for multifocal hepatocellular carcinoma (HCC) covering intrahepatic metastasis (IM) and multicentric occurrence (MO). Here, we characterized the diverse TMEs of IM and MO identified by whole-exome sequencing at single-cell resolution.

Approach And Results: We performed parallel whole-exome sequencing and scRNA-seq on 23 samples from 7 patients to profile their TMEs when major results were validated by immunohistochemistry in the additional cohort.

Are Nuts Safe in Diverticulosis? A Mixed-Methods Systematic Review of Available Evidence.

Diverticulosis is defined as the presence of diverticula in the intestinal tract. While asymptomatic in most cases, severe complications can arise. The precise etiology of diverticulosis is still being investigated, but its correlation to dietary exposures has been proven.

Therapeutic Targeting of Oncogene-Induced Transcription-Replication Conflicts in Pancreatic Ductal Adenocarcinoma.

Background & Aims: Transcription-replication conflicts (TRCs) are a key source of replication stress in cancer, with pancreatic ductal adenocarcinoma (PDAC) showing uniquely high levels. This study investigated the mechanism, oncogene dependency, subtype specificity, and preclinical activity of the TRC-targeting molecule AOH1996 in PDAC models. Initial clinical evidence of AOH1996 activity in patients with PDAC is also provided.

Defining Pharyngeal and Upper Esophageal Sphincter Disorders on High-Resolution Manometry-Impedance: The Leuven Consensus.

Introduction: The Leuven Consensus provides a classification scheme for the diagnosis of pharyngeal and upper esophageal sphincter (UES) motor disorders using metrics derived from pharyngeal high-resolution manometry-impedance (P-HRM-I).

Methods: Twenty-six experts with broad multidisciplinary backgrounds contributed their knowledge and experience to this initiative via a formal deliberative Delphi process. Guidance on a swallow assessment protocol as well as diagnostic criteria for UES dysfunction and pharyngeal contractile dysfunction is provided.

Management of patients with CHB outside the guidelines: Insights from Egyptian cohort with long-term follow-up.

It is alarming that globally, only 2.2% (6.6 million) of patients with chronic hepatitis B (CHB) received treatment in 2019.

Deciphering an expanding array of clinical and research frailty measures.

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The impending hepatology workforce shortage: Ethical considerations for closing the gap.

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HBV elimination in Africa-Current status and challenges.

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Acute liver failure.

Acute liver failure, commonly caused by acetaminophen overdose, is associated with numerous systemic complications including cerebral edema, hypotension, acute kidney injury, and infection. Management is primarily supportive, with an emphasis on excellent neurocritical care. Although some antidotes and targeted treatments exist, the only definitive treatment remains orthotopic liver transplant.

Association of Proton Pump Inhibitor Use With Incident Dementia and Cognitive Decline in Older Adults: A Prospective Cohort Study.

Background & Aims: Prior studies have suggested that proton pump inhibitor (PPI) use is associated with increased risk of dementia; however, these have been limited by incomplete assessment of medication use and failure to account for confounders. Furthermore, prior studies have relied on claims-based diagnoses for dementia, which can lead to misclassification. We investigated the associations of PPI and histamine-2 receptor antagonist (H2RA) use with dementia and cognitive decline.

AGA Clinical Practice Update on Medical Management of Colonic Diverticulitis: Expert Review.

Colonic diverticulitis is a painful gastrointestinal disease that recurs unpredictably and can lead to chronic gastrointestinal symptoms. Gastroenterologists commonly care for patients with this disease. The purpose of this Clinical Practice Update is to provide practical and evidence-based advice for management of diverticulitis.

A method to objectively assess swallow function in adults with suspected aspiration.

Background & Aims: Pharyngeal manometry and impedance provide information on swallow function. We developed a new analysis approach for assessment of aspiration risk.

Methods: We studied 20 patients (30-95 years old) with suspected aspiration who were referred for videofluoroscopy, along with controls (ages 24-47 years).

Nut, corn, and popcorn consumption and the incidence of diverticular disease.

Context: Patients with diverticular disease are frequently advised to avoid eating nuts, corn, popcorn, and seeds to reduce the risk of complications. However, there is little evidence to support this recommendation.

Objective: To determine whether nut, corn, or popcorn consumption is associated with diverticulitis and diverticular bleeding.