Paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) is a newly described condition. It has a spectrum of presentations related to hyperinflammation and cytokine storm. We report the first case of PIMS-TS in a child on established anti-Tumor Necrosis Factor-alpha (anti-TNF-α) therapy; a 10 year-old girl with ulcerative colitis treated with infliximab. The patient had 6-weeks of daily fever with mucocutaneous, gastrointestinal, renal and hematologic involvement. Biomarkers of hyperinflammation were present including: hyperferritinaemia (up to 691 µ/L; normal 15-80 µg/L), C-reactive protein (CRP) (>100mg/L for >10 days, normal 0-5 mg/L), erythrocyte sedimentation rate (ESR) consistently >100mm/hr (normal 0-15 mm/hr), raised white cell count with neutrophilia, elevated D-dimer and lactate dehydrogenase (LDH), anaemia and Mott cells on bone marrow analysis. Extensive investigations for alternative diagnoses for pyrexia of unknown origin (PUO) were negative. The condition was refractory to treatment with intravenous immunoglobulin (IVIG) but improved within 24hrs of high dose methylprednisolone. Infliximab treatment followed and the patient has remained well at follow up. Polymerase chain reaction (PCR) and serology for SARS-CoV-2 were negative. Current series report such negative findings in up to half of cases. The patient experienced a milder clinical phenotype without cardiac involvement, shock or organ failure. It is postulated that prior anti-TNF-α therapy attenuated the disease course. Infliximab therapy may interfere with serology testing and produce false negative results. This case supports the need for investigation into infliximab as primary therapy for PIMS-TS.

Introduction: Endoscopic biliary stenting is a widely utilized procedure in the realm of interventional gastroenterology, primarily employing plastic stents for short-term biliary drainage. This case series endeavours to investigate the occurrence and ensuing clinical ramifications of forgotten or retained biliary stents. Methods: Carried out over an 8-month duration at King George Hospital in Visakhapatnam, this case series encompasses 12 patients diagnosed with forgotten biliary stents. Diagnostic confirmation was established through a combination of X-ray, abdominal ultrasound, and magnetic resonance cholangiopancreatography (MRCP). Four patients experienced complications such as fractured distal pigtails and obstructed stents, thwarting retrieval efforts via endoscopic retrograde cholangiopancreatography (ERCP) and cholangioscopy. Results: This case series featured 12 patients with a median age of 48 years (range: 18-76), comprising 7 females (58.3%) and 5 males (41.7%). The primary indication for initial stent placement was choledocholithiasis in 10 instances (83.3%), while benign biliary strictures accounted for 3 cases (25%). On average, patients presented 31.3 months post-initial stenting, primarily manifesting cholangitis symptoms (83.3%). ERCP succeeded in stent removal in 8 cases (66.6%), while the remaining cases necessitated advanced procedures such as cholangioscopy, with two patients being referred for surgical intervention. It is noteworthy that there were no instances of mortality. Conclusion: This case series, conducted against the backdrop of the COVID-19 pandemic, highlights an increased prevalence of neglected plastic biliary stents. The principal complication encountered was cholangitis, often coexisting with common bile duct (CBD) stones. Standard ERCP techniques demonstrated reduced efficacy in instances characterized by fractured, obstructed, or displaced stents, necessitating the exploration of alternative strategies like cholangioscopy or surgical intervention. This compilation of cases underscores the pressing imperative for prompt stent retrieval and the enhancement of management protocols to proactively mitigate the potential for complications.

Modern gastroenterology, which occupies the pages of scientific journals without alternative, began as an initiative of manufacturers of diagnostic equipment. For widespread advertising, they selected practical doctors who were not familiar with the methodology of science and superficial knowledge of physiology. This is how a group led by DeMeester arose, which in 1976 published the DeMeester score, i.e., the normal limit for esophageal pH monitoring. pH <4, less than 4% of the time per day was considered normal, i.e., it was unreasonably claimed that such reflux is physiological. This article proves that this study was carried out with numerous methodological errors, which led to an erroneous conclusion. For a long time, pH monitoring was considered the gold standard and with its help hypotheses were proposed that form the basis of modern gastroenterology. The article proves the fallacy of 13 hypotheses, which are presented as theories. Numerous articles using pH monitoring have publicized this method. Practitioners became "great scientists", equipment manufacturers became successful businessmen. Over time, they found other groups of practitioners to promote devices for impedance ph monitoring, high-resolution manometry, and many others. At the same time, a network of reviewers who believe in the infallibility of the luminaries do not allow studies that contradict their faith to be published. Thus, fundamental science was destroyed, which alone could assess the harm of false research both for science and for patients. Conclusion This study provides a list of hypotheses, that were previously considered theories, but since scientific evidence has proven these assumptions to be false, they should be excluded from subsequent use and citation.

Aim: To elucidate the international network structures and evolution of collaborations in capsule endoscopy research from 2000 to 2023 by analyzing co-authorship networks. Method: This study analyzed co-authorship patterns in capsule endoscopy research articles published from 2000 to 2023 using data from the Web of Science (WoS). I employed Python (version 3.10.5) in the PyCharm development environment (version 2022.1.3) to conduct a network analysis using social network analysis principles. The analysis included macro-level metrics (network density, clustering coefficient, components, and average path length) and micro-level metrics (degree centrality, closeness centrality, and betweenness centrality) to assess collaboration intensity, key contributors, and network cohesion. Result: The co-authorship network analysis revealed evolving collaboration patterns over three distinct periods (2000-2009, 2010-2019, and 2020-2023). Initially, the network exhibited low density and high fragmentation, with key contributors such as Guido Costamagna and Jonathan A. Leighton prominently positioned. Over time, the network expanded with increased density and clustering, though it remained fragmented. In recent years, the network showed increased cohesion with reduced components and notable contributors like Anastasios Koulaouzidis and Xavier Dray, reflecting the growing importance of international collaborations, particularly involving researchers from Japan, Italy, and Israel. Conclusion: The study highlights the dynamic nature of international collaborations in capsule endoscopy research, with increasing connectivity and influential contributors playing pivotal roles in advancing the field. These findings underscore the value of international cooperation in enhancing diagnostic and therapeutic approaches in capsule endoscopy, pointing to future opportunities for deeper collaboration and integration.

Until recently there was a paucity of published information on the demographics of themedical and surgical workforce for the subspecialty of liver transplantation. This is relevant as it relates to whether gender equity is being achieved across the workforce. This manuscript focuses on what eventually led to the recognition that more data were required along with what is now actually known. This involves exploring the genders of the liver transplant workforce along with their related academic activities. Potential solutions to address any ongoing imbalances are also examined. The extent and range of gender disparities previously reported for other cohorts of physicians and surgeons, are also apparent amongst the liver transplant workforce in most regions of the world. This also pertains to the higher leadership positions within liver transplant centers as well as for the relevant editorial and scientific congress roles. Common themes/recommendations are now emerging as to how best to address the lack of progress towards gender equity. These include the development and implementation of policies, the removal of barriers to career progression, plus adequate governance. Hence ongoing actions are going to be required to achieve gender equity across the relevant workforce in liver transplantation around the world.

Objective: Mechanical bowel preparation is essential for the visualisation of the colon during colonoscopy, and previous studies have identified changes in gut microbiota composition after bowel preparation and colonoscopy. Considering the gut microbiota is increasingly implicated in mood, we aimed to explore the potential impact of this intervention on mood and the microbiota-gut-brain axis. Methods: We conducted a pre-post intervention study, with timepoints of one week before and one month after bowel preparation and colonoscopy, in community-dwelling adults referred for colonoscopy. Our primary outcome was change in average Hospital Anxiety and Depression Scale depression sub-scores using generalised estimating equations. We also examined changes in average anxiety, stress, and quality of life scores, and faecal microbiota composition and potential function using 16S rRNA sequencing. We further explored associations between changes in depressive symptoms and the gut microbiota and conducted post-hoc analyses to explore potential effect modifiers. Key Results: 59 participants were included in the analyses. Depressive symptoms decreased one-month post-procedure compared to baseline (adjusted β=−0.64; 95%CI: −1.18, −0.11). Irritable bowel syndrome (IBS) appeared to moderate this relationship (1.78; 0.292, 3.26); depressive symptoms increased in those with, and decreased in those without, IBS. Changes in gut microbiome composition included reduced alpha diversity, modest effects on beta-diversity, and increases in genera associated with potential health benefits, one-month post-procedure compared to baseline. Increases in the CLR-transformed abundance of Ruminococcaceae UCG-009 were associated with improvements in depressive symptoms. Conclusions: There is preliminary evidence of a potential mental health effect of bowel preparation and colonoscopy, which may be associated with changes to the gut microbiota. There may also be a differential mental health impact of this procedure for those with and without IBS. Considering the limitations of our study, further research is required to confirm these findings and their clinical relevance.

The management of patients with spinal muscular atrophy type 1 (SMA1) is constantly evolving. In just a few decades the medical approach has switched from an exclusively palliative therapy to a targeted therapy, transforming the natural history of the disease, improving survival time and quality of life, and creating new challenges and goals. Many nutritional problems, gastrointesti-nal disorders and metabolic and endocrine alterations are commonly identified in patients af-fected by SMA1 during childhood and adolescence. For this reason, a proper pediatric multidis-ciplinary approach is then required in the clinical care of these patients, with a specific focus on the prevention of most common complications. The purpose of this narrative review is to provide the clinician with a practical and usable tool about SMA1 patients care, through a comprehensive insight into the nutritional, gastroenterological, metabolic and endocrine management of SMA1. Considering the possible horizons opened thanks to new therapeutic frontiers, a nutritional and endo-metabolic surveillance is a crucial element to be considered for a proper clinical care of these patients.

Aim: This study aims to analyze the structure and impact of research collaborations in colonoscopy from 2000 to 2023 by examining co-authorship networks. The goal is to understand the evolution of these networks, identify key contributors, and assess how collaborative relationships influence the field. Method: I conducted a comprehensive network analysis of co-authorship patterns using data from the Web of Science (WoS) Core Collection database. The analysis included 41,213 articles related to colonoscopy published between 2000 and 2023. Using Python (Version 3.10.5) and PyCharm (Software Version 2022.1.3), we evaluated the networks through macro-level indicators (network density, clustering coefficient, number of components, average distance) and micro-level indicators (degree centrality, closeness centrality, betweenness centrality).Result: The analysis revealed a network with increasing but still fragmented collaboration over the years. The network density showed low proportions of realized connections relative to potential ones, with a high clustering coefficient indicating tight-knit groups when collaborations occurred. The number of components remained high, reflecting a fragmented structure. Prominent researchers such as Hassan, Cesare (Italy) and Dekker, Evelien (Netherlands) consistently emerged as central figures across different periods, demonstrating significant roles in facilitating connections between various research clusters.Conclusion: The study highlights a growing but fragmented collaborative landscape in colonoscopy research. Key researchers have played central roles in connecting different parts of the network, yet there remains substantial room for further integration. Strengthening collaborations across isolated groups could enhance the cohesiveness and impact of research in this field.

Aim: This study aims to analyze the structure of the co-authorship network in viral hepatitis research from 2000 to 2023 using data from the Web of Science (WoS) Core Collection. The objective is to identify key researchers, evaluate the collaborative dynamics, and understand the evolution of scientific contributions in this field. Method: This study utilized network analysis techniques to evaluate 60,720 publications related to viral hepatitis research indexed in the WoS Core Collection between 2000 and 2023. The analysis was conducted using Python (Version 3.10.5) in the PyCharm development environment (Software Version 2022.1.3). The co-authorship networks were assessed using macro-level indicators such as network density (the ratio of actual to possible connections), clustering coefficient (degree of node clustering), number of components (distinct connected subgroups), and average path length (average distance between nodes). Micro-level indicators including degree centrality (importance based on the number of connections), closeness centrality (proximity to other nodes), and betweenness centrality (frequency of a node on the shortest paths between others) were also analyzed.Result: The findings reveal that the viral hepatitis research network is characterized by low network density, indicating sparse overall collaboration. However, the clustering coefficient is high, suggesting strong collaborations within small, cohesive groups. Over the years, researchers such as Stefan Zeuzem, Maria Buti, and Fabien Zoulim have played pivotal roles, serving as central figures in the network. A noticeable increase in network density and clustering from 2020-2023 suggests growing collaboration in recent years.Conclusion: This study underscores the importance of international collaboration in advancing viral hepatitis research. Key researchers have emerged as influential contributors, facilitating global research activities. Network analysis provides valuable insight into the structure of these collaborations and helps identify potential areas for future research and partnerships to combat viral hepatitis globally. The results of this study should be used to reduce global healthcare disparities, promote research collaboration, and address viral hepatitis as a global public health problem.

Aim: This study aims to analyze the collaborative networks and identify key players in autoimmune pancreatitis (AIP) research from 2000 to 2023. Using data from the Web of Science (WoS) Core Collection, I assess the structure and evolution of co-authorship networks to understand collaboration trends and influential researchers in the field.Method: I conducted a network analysis of co-authorship patterns in AIP research using Python (Version 3.10.5) in the PyCharm development environment (Software Version 2022.1.3). The analysis included macro-level indicators: network density, clustering coefficient, components, and average distance, as well as micro-level indicators: degree centrality, closeness centrality, and betweenness centrality. These metrics were used to evaluate the connectivity, clustering, and key nodes within the network across three distinct periods: 2000-2009, 2010-2019, and 2020-2023.Result: The analysis revealed that the co-authorship network in AIP research evolved from a fragmented structure with limited collaboration in the early 2000s to a more interconnected but still dispersed network in recent years. Despite an increase in network density and a decrease in the number of disconnected components over time, the overall structure remains highly clustered, with many researchers operating within isolated groups. Key figures, such as Kazuichi Okazaki, Terumi Kamisawa, and Shigeyuki Kawa from Japan, consistently ranked high in centrality measures, highlighting their significant influence and leadership in the field. The findings suggest that while local collaborations are strong, broader international connections are still developing.Conclusion: This study provides a comprehensive overview of the collaborative landscape in AIP research, identifying central researchers and highlighting persistent fragmentation within the network. The prominent role of Japanese researchers in shaping the field underscores the importance of fostering greater international collaboration to bridge gaps between research clusters. Enhancing global partnerships could lead to more integrated and impactful research outcomes, ultimately advancing the understanding and management of autoimmune pancreatitis.

Aim: This study aims to analyze the structure of the co-authorship network in Budd-Chiari syndrome (BCS) research from 2000 to 2023 using data from the Web of Science (WoS) Core Collection. The objective is to identify key researchers, evaluate the collaborative dynamics, and understand the evolution of scientific contributions in this field. Method: This study utilized network analysis techniques to evaluate 2,877 publications related to BCS research indexed in the WoS Core Collection between 2000 and 2023. The analysis was conducted using Python (Version 3.10.5) in the PyCharm development environment (Software Version 2022.1.3). The co-authorship networks were assessed using macro-level indicators such as network density (the ratio of actual to possible connections), clustering coefficient (degree of node clustering), number of components (distinct connected subgroups), and average path length (average distance between nodes). Micro-level indicators including degree centrality (importance based on the number of connections), closeness centrality (proximity to other nodes), and betweenness centrality (frequency of a node on the shortest paths between others) were also analyzed.Result: The results revealed a highly fragmented network structure in the early years (2000-2009), characterized by low network density (0.0017) and a large number of disconnected components (533). Key researchers such as Aurelie Plessier and Dominique Valla emerged as central figures in terms of degree and closeness centrality. In the 2010-2019 period, the network showed slight improvements, with density decreasing to 0.0016 but an increase in the number of components to 645, indicating persistent fragmentation. From 2020 to 2023, the network demonstrated increased cohesiveness with a density of 0.0032 and a reduction in components to 376. Influential researchers in the final period included Virginia Hernandez-Gea and Valerie Paradis, who played pivotal roles in connecting disparate research clusters.Conclusion: The co-authorship network analysis of BCS research over the past two decades highlights a gradual yet incomplete evolution towards greater collaboration and integration among researchers. While the network's cohesiveness has improved, significant fragmentation remains, suggesting that further efforts are needed to enhance global and interdisciplinary collaboration. Addressing these challenges is crucial for fostering a more connected and productive research community that can advance the understanding and management of BCS.

Aim: This study aims to analyze the collaborative structure of Intestinal Behçet’s Disease (IBD) research by examining co-authorship networks in publications indexed in the Web of Science (WoS) Core Collection from 2000 to 2023. The goal is to identify key researchers, institutions, and collaboration patterns that have shaped the field over the past two decades. Method: This study utilized network analysis techniques to evaluate 484 publications related to IBD research indexed in the WoS Core Collection between 2000 and 2023. The analysis was conducted using Python (Version 3.10.5) in the PyCharm development environment (Software Version 2022.1.3). The co-authorship networks were assessed using macro-level indicators such as network density (the ratio of actual to possible connections), clustering coefficient (degree of node clustering), number of components (distinct connected subgroups), and average path length (average distance between nodes). Micro-level indicators including degree centrality (importance based on the number of connections), closeness centrality (proximity to other nodes), and betweenness centrality (frequency of a node on the shortest paths between others) were also analyzed.Result: From 2000 to 2009, the co-authorship network was highly fragmented with a low network density of 0.0114 and 84 distinct components, indicating limited collaboration. Key contributors during this period included Kim, Won Ho, and Cheon, Jae Hee (South Korea), who played central roles in connecting disparate research clusters. In the following decade (2010-2019), network density decreased slightly to 0.0086, and the number of components increased to 113, reflecting continued fragmentation despite growing research output. However, from 2020 to 2023, network density increased to 0.0171, and the number of components decreased to 73, indicating a trend towards greater integration and collaboration. Notable researchers in this period included Emmi, Giacomo (Italy), and Hatemi, Gulen (Turkey), who emerged as central figures, highlighting a shift in research leadership from Asia to Europe..Conclusion: The co-authorship network analysis of IBD research reveals an evolving collaborative landscape with increasing network density and decreasing fragmentation over time, particularly in the most recent period. From 2000 to 2019, Japanese and Korean researchers were prominent contributors, highlighting the significance of Asia in the global research arena. However, since 2020, researchers from Italy and Turkey have gained significant international prominence, suggesting a shift in the research focus from Asia to Europe. This transition may be attributed to changes in the incidence rates of IBD, where rapid increases were observed in Asian countries like Japan, Korea, and China until 2020, followed by stabilization or decline, while incidence rates have been increasing in European countries such as Italy and Turkey. These findings underscore the importance of expanding international collaborations to enhance the understanding of IBD. Fostering global partnerships could further advance the field, promoting more integrated and innovative research efforts, and addressing the shifting dynamics of IBD prevalence across regions.