Clinical and Translational Gastroenterology最新文献_第2页

IF 3.6 3区医学

Clinical and Translational Gastroenterology Pub Date : 2026-10-06 DOI: 10.14309/ctg.0000000000001112

M E Delgado, J Benet, I Herrero-Fresneda

引用次数: 0

Correction to: Acute and Long-Term Effects of App-Delivered Heartfulness Meditation on Psychological Outcomes and the Endocannabinoid Signaling System in Cyclic Vomiting Syndrome. 更正：应用程序传递的心念冥想对周期性呕吐综合征心理结局和内源性大麻素信号系统的急性和长期影响。

IF 3.6 3区医学

Clinical and Translational Gastroenterology Pub Date : 2026-10-05 DOI: 10.14309/ctg.0000000000001106

Thangam Venkatesan, Cecilia J Hillard, Lina Iyer, Saranya Arumugam, Stacey Culp, Mahima Vyas, Kebire Gofar, Ana Petrova, Olafur S Palsson

引用次数: 0

The Impact of Dietary Fiber Supplementation on Gut-Brain Axis Biomarkers and Symptoms in Functional Constipation: A Meta-Analysis of Randomized Controlled Trials. 膳食纤维补充对功能性便秘肠脑轴生物标志物和症状的影响：一项随机对照试验的荟萃分析

IF 3.6 3区医学

Clinical and Translational Gastroenterology Pub Date : 2026-10-05 DOI: 10.14309/ctg.0000000000001114

Yue Wang, Qi Yan, Fangfang Liu, Zhenlian Song, Ningning Song

{"title":"The Impact of Dietary Fiber Supplementation on Gut-Brain Axis Biomarkers and Symptoms in Functional Constipation: A Meta-Analysis of Randomized Controlled Trials.","authors":"Yue Wang, Qi Yan, Fangfang Liu, Zhenlian Song, Ningning Song","doi":"10.14309/ctg.0000000000001114","DOIUrl":"https://doi.org/10.14309/ctg.0000000000001114","url":null,"abstract":"Background aims: Dietary fiber is first-line for functional constipation (FC), but its mechanism remains unclear. Emerging evidence suggests gut-brain axis modulation. We conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate fiber's clinical efficacy and its effects on gut-brain axis biomarkers in FC.Methods: We searched PubMed, Embase, Web of Science, and Cochrane CENTRAL from inception to January 2026 for RCTs assessing fiber supplementation in Rome-diagnosed FC patients. Primary outcomes: spontaneous bowel movements (SBMs), complete SBMs (CSBMs), stool consistency. Secondary outcomes: short-chain fatty acids (SCFAs), serotonin (5-HT), inflammatory markers. Random-effects models calculated mean differences (MD) or standardized mean differences (SMD) with 95% CIs.Results: Fourteen RCTs (1,284 participants) were included. Fiber significantly increased SBMs (MD 1.42/week; 95% CI 0.98-1.86) and CSBMs (MD 0.96/week; 95% CI 0.52-1.40), and improved stool consistency (SMD 0.64; 95% CI 0.39-0.89). Fiber increased total SCFAs (SMD 0.78; 95% CI 0.45-1.11) and 5-HT (SMD 0.52; 95% CI 0.18-0.86), and reduced inflammatory markers (SMD -0.34; 95% CI -0.62 to -0.06). Soluble/fermentable fibers at >10 g/day for ≥4 weeks showed greater efficacy. Evidence certainty: moderate to high.Conclusions: Dietary fiber improves clinical outcomes in FC and is associated with changes in gut-brain axis-related biomarkers, including microbial metabolites, serotonergic signalling, and inflammatory markers. These associations are consistent with effects that extend beyond stool bulking; however, the clinical significance of the biomarker changes is not yet established, and the findings should be interpreted as hypothesis-generating rather than as evidence that fermentable fiber restores neuroenteric homeostasis.","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter to the Editor. 给编辑的信。

IF 3.6 3区医学

Clinical and Translational Gastroenterology Pub Date : 2026-10-01 DOI: 10.14309/ctg.0000000000001113

Christos Zavos

引用次数: 0

A Markov model cost threshold analysis of potential hepatitis B virus cure regimens. 乙型肝炎病毒治疗方案的马尔可夫模型成本阈值分析。

IF 3.6 3区医学

Clinical and Translational Gastroenterology Pub Date : 2026-09-28 DOI: 10.14309/ctg.0000000000001108

Grace Lai-Hung Wong, Robert John Wong, Boyu Yang, Vincent Wai-Sun Wong, Jimmy Che-To Lai, Henry Lik-Yuen Chan, Honglian Bai, Hongzhou Lu, Xiaoping Tang, Jian Sun, Anna Suk-Fong Lok, Terry Cheuk-Fung Yip

{"title":"A Markov model cost threshold analysis of potential hepatitis B virus cure regimens.","authors":"Grace Lai-Hung Wong, Robert John Wong, Boyu Yang, Vincent Wai-Sun Wong, Jimmy Che-To Lai, Henry Lik-Yuen Chan, Honglian Bai, Hongzhou Lu, Xiaoping Tang, Jian Sun, Anna Suk-Fong Lok, Terry Cheuk-Fung Yip","doi":"10.14309/ctg.0000000000001108","DOIUrl":"https://doi.org/10.14309/ctg.0000000000001108","url":null,"abstract":"Introduction: Novel treatment regimens to achieve functional cure (FC) of chronic hepatitis B (CHB) may soon be available. We aimed to evaluate treatment cost-effectiveness thresholds for a potential cure regimen in the U.S. and China using a Markov model, with long-term nucleos(t)ide analogue (NUC) treatment as reference.Methods: We simulated disease progression comparing achieving FC defined as HBsAg loss and unquantifiable HBV DNA 24 weeks off treatment with a novel therapeutic regimen to long-term NUC treatment. Cost-effectiveness thresholds for FC of CHB, incorporating various anticipated success rates for FC, incidence rates of major liver outcomes including hepatocellular carcinoma post-FC, health utility values, and medical costs, were estimated.Results: The base case was a 50-year-old man with hepatitis B e antigen (HBeAg)-negative non-cirrhotic CHB and NUC-suppressed HBV DNA ≥1year. Compared to long-term NUC, a 30% effective FC regimen would yield 17.18 and 16.14 quality-adjusted life years (QALYs), and 0.30 and 0.57 QALYs gained per patient in the U.S. and China, respectively. With an HCC annual incidence rate of 0.1% after FC, a FC regimen could be cost-effective at a one-time treatment cost under the threshold of USD46,642 in the U.S., and USD13,008 in China. The cost-effectiveness threshold increases with higher FC rates, younger patients, and increasing medical costs, but may be lower in women.Discussion: A Markov model-based cost-effectiveness analysis demonstrates that CHB cure regimen with 30% FC in aforementioned base case could be cost-effective at a threshold of USD46,642 in the U.S. and USD13,008 in China.","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Effect of Antifungal Therapy on Disease Activity in Patients with Inflammatory Bowel Disease: A Retrospective Matched Analysis. 抗真菌治疗对炎症性肠病患者疾病活动性的影响：回顾性匹配分析

IF 3.6 3区医学

Clinical and Translational Gastroenterology Pub Date : 2026-09-22 DOI: 10.14309/ctg.0000000000001105

Sarah Chen, Tanya Zeina, Ahmed Fares, Brian Yan, Nurgul Yegembayeva, Sonia Friedman, Sushrut Jangi

{"title":"The Effect of Antifungal Therapy on Disease Activity in Patients with Inflammatory Bowel Disease: A Retrospective Matched Analysis.","authors":"Sarah Chen, Tanya Zeina, Ahmed Fares, Brian Yan, Nurgul Yegembayeva, Sonia Friedman, Sushrut Jangi","doi":"10.14309/ctg.0000000000001105","DOIUrl":"https://doi.org/10.14309/ctg.0000000000001105","url":null,"abstract":"Introduction: The purpose of our study was to report indications for fluconazole use in IBD and examine whether fluconazole was associated with IBD activity. Our hypothesis was fluconazole did not increase rate of relapse in IBD.Methods: We performed a retrospective review on IBD patients at our institution who received oral fluconazole between January 2012 and December 2023. These patients were matched 1:2 to controls who did not take fluconazole. Patients were matched based on age, sex, disease phenotype (ulcerative colitis or Crohn's disease), and baseline disease activity (remission or active). Time-to-relapse/remission was compared between the fluconazole and control groups using Cox regression.Results: Seventy-seven patients took fluconazole, and 152 patients did not. Among the fluconazole group, 57 were in remission (Cohort A) and 20 had active disease at baseline (Cohort B). The most common indication for fluconazole was vaginal candidiasis (51.9%). Among patients in remission (Cohort A), there was no significant difference in time-to-relapse between groups, even when adjusting for biologic exposure, (HR = 0.85, 95% CI: 0.27- 2.6, p=0.78). Among patients with active disease (Cohort B), there was no significant difference in time-to-remission between groups (HR = 0.68, 95% CI: 0.33-1.4, p=0.29). In an exploratory sub-group analysis, patients who received a long course of fluconazole (>2 weeks) achieved remission faster compared to patients who received a short course (1-3 days), P< 0.05.Discussion: Fluconazole administration did not increase relapse rate; similarly, patients who had active disease at time of fluconazole were just as likely to achieve remission.","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Validation of a Machine Learning Model to Noninvasively Exclude Spontaneous Bacterial Peritonitis. 验证非侵入性排除自发性细菌性腹膜炎的机器学习模型。

IF 3.6 3区医学

Clinical and Translational Gastroenterology Pub Date : 2026-09-22 DOI: 10.14309/ctg.0000000000001103

Stephanie Y Tsai, Scott Silvey, Anas Aljabi, Nilang Patel, Jacqueline G O'Leary, Jasmohan S Bajaj

{"title":"Validation of a Machine Learning Model to Noninvasively Exclude Spontaneous Bacterial Peritonitis.","authors":"Stephanie Y Tsai, Scott Silvey, Anas Aljabi, Nilang Patel, Jacqueline G O'Leary, Jasmohan S Bajaj","doi":"10.14309/ctg.0000000000001103","DOIUrl":"10.14309/ctg.0000000000001103","url":null,"abstract":"Introduction: There remains a gap between guideline recommendations and real-world practice for the performance of timely paracentesis to diagnose spontaneous bacterial peritonitis (SBP). A machine learning (ML) model to noninvasively exclude SBP using 20 routinely collected clinical and laboratory values was previously developed and validated in a pre-COVID-19 era cohort. Because of the considerable health care delivery changes post-COVID-19 pandemic, we sought to validate this ML model in a contemporary cohort of admitted veterans affairs patients.Methods: We included patients in the Veterans Health Administration Corporate Data Warehouse admitted between 2020 and 2023 with cirrhosis and ascites who underwent timely paracentesis identified by International Classification of Diseases-10 codes (validation cohort), then performed manual chart review on a subset of patients admitted at 2 tertiary-care veterans affairs hospitals to confirm the SBP (validation subgroup). We evaluated the performance metrics of the previously developed ML model with this cohort and subgroup.Results: The validation cohort included 4,192 patients, of which 630 (15.0%) had SBP. At the <5%, <10%, and <15% thresholds for probability of SBP-negativity predicted by the ML model, negative predictive values (NPVs) were 93.6%, 92.0%, and 90.9%, respectively. In the validation subgroup, 7 (6.5%) of 107 patients had confirmed SBP. NPVs at the <5%, <10%, and <15% thresholds were 100%, 97.5%, and 95.4%, respectively.Discussion: In a national cohort and manual confirmation subgroup of Veterans with cirrhosis admitted after 2020, a ML model noninvasively excluded SBP with high NPV. This could help in risk-stratification, especially in limited-resource settings.","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Associations Between Attention-Deficit/Hyperactivity Disorder Stimulant Medications and Irritable Bowel Syndrome. 注意缺陷/多动障碍兴奋剂药物与肠易激综合征之间的关系。

IF 3.6 3区医学

Clinical and Translational Gastroenterology Pub Date : 2026-09-21 DOI: 10.14309/ctg.0000000000001102

Sarah Kim, Jack Loesch, Elizabeth J Short, Prashant Singh, Li Tang, Jaime Pérez, Madison Simons, Eyad Hamza, Sara Valencia, Trisha Pasricha, Samita Garg, Anthony Lembo

{"title":"The Associations Between Attention-Deficit/Hyperactivity Disorder Stimulant Medications and Irritable Bowel Syndrome.","authors":"Sarah Kim, Jack Loesch, Elizabeth J Short, Prashant Singh, Li Tang, Jaime Pérez, Madison Simons, Eyad Hamza, Sara Valencia, Trisha Pasricha, Samita Garg, Anthony Lembo","doi":"10.14309/ctg.0000000000001102","DOIUrl":"https://doi.org/10.14309/ctg.0000000000001102","url":null,"abstract":"Objectives: Irritable Bowel Syndrome (IBS) is a disorder of gut-brain interaction affecting 11% of the global population. Patients with Attention-Deficit/Hyperactivity Disorder (ADHD) have increased odds of IBS, but this may be confounded by stimulant use. The present study examined the association between ADHD and subsequent IBS, comparing ADHD patients treated with stimulants to those who were unmedicated.Methods: This retrospective cohort study used the TriNetX U.S. Collaborative Network, a multi-institutional electronic health record platform with de-identified data from 117 million patients across 71 U.S. healthcare organizations. Adults with ADHD were divided into those who had ever received stimulants (\"stimulant cohort\") or never received ADHD medications (\"control cohort\"). The primary outcome was a diagnostic record of IBS any time after the index event. IBS with Constipation (IBS-C), IBS with Diarrhea, and mixed IBS were assessed separately. Cohorts were propensity score matched for demographics, comorbidities, and behavioral factors. Odds ratios (OR) with 95% confidence intervals (CI) were calculated.Results: In the stimulant cohort, 2,104 of 112,832 patients (1.9%) received an IBS diagnosis versus 2,333 of 112,506 patients (2.1%) in the control cohort. Stimulant exposure was associated with a 10.3% decreased risk of any IBS (OR, 0.90; 95% CI, 0.85-0.95) and a 14.1% decreased risk for IBS-C (OR, 0.86; 95% CI, 0.74-0.99).Conclusions: Stimulant exposure was associated with a decreased risk of IBS and IBS-C. This supports the view among ADHD researchers that stimulants are effective and low-risk treatments. Future studies using longitudinal or prospective data are needed to validate these findings.","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association between index adenomas and advanced neoplasia at third surveillance colonoscopy: Data from the New Hampshire Colonoscopy Registry. 第三次结肠镜检查时指数腺瘤与晚期肿瘤之间的关系：来自新罕布什尔结肠镜检查登记处的数据。

IF 3.6 3区医学

Clinical and Translational Gastroenterology Pub Date : 2026-09-21 DOI: 10.14309/ctg.0000000000001107

Joseph Anderson, Obaida Dairi, Darius Javidi, Todd MacKenzie, Christopher I Amos, Christina M Robinson, Lynn F Butterly

{"title":"Association between index adenomas and advanced neoplasia at third surveillance colonoscopy: Data from the New Hampshire Colonoscopy Registry.","authors":"Joseph Anderson, Obaida Dairi, Darius Javidi, Todd MacKenzie, Christopher I Amos, Christina M Robinson, Lynn F Butterly","doi":"10.14309/ctg.0000000000001107","DOIUrl":"https://doi.org/10.14309/ctg.0000000000001107","url":null,"abstract":"Background: Due to a lack of data, the USMTSF does not provide guidance for the 3rd surveillance exam for adenomas detected on index colonoscopy. Our aim was to assess advanced outcome risk at 3rd surveillance in patients with index adenomas.Methods: We included patients from the New Hampshire Colonoscopy Registry with no genetic syndromes, inflammatory bowel disease, those with first degree relative with CRC < 50 years of age, adequate bowel preparation and no colorectal cancer (CRC) on index, and with three follow-up colonoscopies each >12 months apart. Only patients with normal or low risk findings (1-2 small TAs/SSPs) on 1st and 2nd surveillance exam were included. Individuals were stratified by index adenomas: no adenomas, 1-2 non-advanced adenomas (NAA), 3-4 NAA, 5+NAA and advanced adenomas. A Poisson model adjusting for age, sex, index serrated polyps, endoscopist adenoma detection rates and months to follow up exam (offset variable) predicting advanced neoplasia on 3rd surveillance was performed.Results: Patients (n=1021) with an advanced adenomas on index were found to have a statistically significant increased risk of advanced neoplasia on 3rd surveillance as compared to those patients with no adenomas (adjusted rate ratio=3.96(95%CI:1.96-7.98)). In addition, after adjusting for endoscopists ADRs, the RR was still statistically higher for this group (RR=3.00(95%CI:1.20-7.48)).Conclusion: Our data suggest that those with an advanced adenomas on index exam continue to have a statistically significant increased risk of advanced neoplasia on 3rd surveillance. This finding supports close surveillance in patients with these lesions.","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Interpretable prediction model for short- and long-term hepatic encephalopathy and variceal rebleeding after TIPS: a real-world study. TIPS术后短期和长期肝性脑病和静脉曲张再出血的可解释预测模型：一项真实世界的研究。

IF 3.6 3区医学

Clinical and Translational Gastroenterology Pub Date : 2026-09-18 DOI: 10.14309/ctg.0000000000001096

Shang Wan, Longbin Zhang, Jianyu Li, Hongxi Chen, Min Zhang, Xiao Zhang, Bin Song

{"title":"Interpretable prediction model for short- and long-term hepatic encephalopathy and variceal rebleeding after TIPS: a real-world study.","authors":"Shang Wan, Longbin Zhang, Jianyu Li, Hongxi Chen, Min Zhang, Xiao Zhang, Bin Song","doi":"10.14309/ctg.0000000000001096","DOIUrl":"https://doi.org/10.14309/ctg.0000000000001096","url":null,"abstract":"Introduction: Transjugular intrahepatic portosystemic shunt (TIPS) relieves portal hypertension, but post-TIPS overt hepatic encephalopathy (OHE) and variceal rebleeding (VRB) remain outcomes that significantly impair survival. We aimed to identify risk factors and develop an interpretable machine learning model predicting 2- and 6-year OHE and VRB.Methods: In this multicenter retrospective study, 636 patients undergoing TIPS (2014-2023) with 2-6 years follow-up were analyzed. A detailed perioperative dataset was curated. LASSO selected key predictors for model training in an integrated machine learning voting ensemble (ML-VE) framework. Efficacy was assessed by AUC and compared with conventional clinical scores (Child-Pugh, MELD, MELD-Na). Subgroup analyses were conducted, and SHapley Additive exPlanations (SHAP) were used for interpretation.Results: The cumulative incidence of OHE and VRB was 22.2% and 8.2% at 2 years, increasing to 24.8% and 10.1% at 6 years, respectively. Internally, ML-VE achieved AUCs of 0.960 (OHE) and 0.966 (VRB) at 2 years, and 0.849(OHE) and 0.828(VRB) at 6 years; external validation for OHE yielded AUCs of 0.914 at 2 years and 0.924 at 6 years, outperforming conventional scores (AUC 0.528-0.563 for OHE; 0.528-0.555 for VRB). All prespecified subgroups had 2-year AUCs≥0.93 (OHE prediction in portal vein thrombosis: 0.993; VRB prediction in portal pressure gradient 9-12 mmHg: 0.987). SHAP identified \"diabetes\" as the strongest predictor for OHE and \"recent bleeding\" for VRB at 2-years.Conclusions: The interpretable ML-VE model showed good discrimination for 2- and 6-year post-TIPS OHE and VRB risk, suggesting potential utility for short- and long-term risk stratification after TIPS.","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0