No abstract

Non-alcoholic fatty liver disease (NAFLD) is considered the most common liver injury worldwide. NAFLD can evolve into non-alcoholic steatohepatitis (NASH) with or without fibrosis. The objectives of this study were to determine the nutritional profile and dietary patterns of NAFLD Lebanese patients and to report the type of diet-related to the presence of hepatic fibrosis. We hypothesized that the traditional pattern was related to a low risk of fibrosis. This cross-sectional study included 320 eligible Lebanese NAFLD patients. Three dietary patterns were identified: the Traditional diet, the High Fruit diet, and the Westernized diet. Multivariate analysis showed a significant relationship between high adherence to the traditional diet and absence of hepatic fibrosis with a decreased risk of 82%, p = 0.031 after adjusting for its covariables. Fruits were absent from this dietary pattern. Although our results pointed to a possible relationship between fibrosis in NAFLD patients and fruit intake, experimental studies are needed to show whether this is a causal relationship. However, the results obtained in this study may contribute to the planning of dietary interventions and recommendations and enable a better follow-up for NAFLD patients with fibrosis.

No abstract

Introduction: Postoperative recurrence of Crohn's disease is estimated approximately up to 50%. Postoperative prophylactic therapy is implemented for Crohn's disease to reduce both clinical and endoscopic recurrence. We conducted a systematic review and meta-analysis comparing adalimumab to azathioprine in the prophylaxis of postoperative Crohn's disease recurrence. Methods: We conducted a systematic search of the PubMed database from inception through 2017 for studies comparing adalimumab to azathioprine using the terms "Adalimumab", "azathioprine", "postoperative Crohn's disease" and "post-surgical resection Crohn's". Relevant data were extracted and analyzed using Comprehensive Meta-Analysis software. The random-effects model was used for all variables, and publication bias was assessed using Egger's test. Results: Three randomized controlled trials published between 2013 and 2017, examining a total of 218 patients, were included in our analysis. Out of the 218 patients, 118 were males and 100 were females, and the recurrence rate was reported as 6.3%, 21% and 29.7% in the adalimumab group compared to 64.7%, 45%, and 33.3% in the azathioprine among the three clinical trials. We found no difference between adalimumab and azathioprine in the prevention of postoperative disease recurrence by looking at endoscopic recurrence in this analysis which is the primary endpoint with a risk ratio of 3.25 (95% CI 0.52 to 20.22) (I 2 582.92%). We also found no significant difference in total adverse effects between the two medications with an estimated risk ratio of 1.05 (95% CI 0.22 to 5.03) (I 2 580.16%), in addition, no significant difference was found in postoperative CDAI between adalimumab and azathioprine with a respective risk ratio of 2.94 (95% CI 0.42 to 20.56) (I 2 585.28%). Conclusion: Our results suggest that adalimumab is not superior to azathioprine in the prevention of postoperative disease recurrence with no difference in total adverse events. Clinical implication: No difference between adalimumab and azathioprine in the prevention of postoperative disease recurrence.

No abstract