Clinical Gastroenterology and Hepatology最新文献

{"title":"Blue Notes","authors":"Charles J. Kahi MD, MS, AGAF","doi":"10.1016/j.cgh.2025.05.008","DOIUrl":"10.1016/j.cgh.2025.05.008","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 9","pages":"Pages 1465-1466"},"PeriodicalIF":11.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exam 1: Global Progression Rates of Precursor Lesions for Gastric Cancer: A Systematic Review and Meta-Analysis","authors":"","doi":"10.1016/j.cgh.2025.05.009","DOIUrl":"10.1016/j.cgh.2025.05.009","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 9","pages":"Pages e9-e10"},"PeriodicalIF":11.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elsewhere in the AGA Journals","authors":"","doi":"10.1016/S1542-3565(25)00498-7","DOIUrl":"10.1016/S1542-3565(25)00498-7","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 9","pages":"Pages A13-A15"},"PeriodicalIF":11.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Equity in Gastroenterology: Perspectives From the AGA Women’s Committee on Current Frameworks and Future Directions","authors":"Loren G. Rabinowitz, Kira Newman, Elisa Boden, Blaire Burman, Asma Khapra, Aimee L. Lucas","doi":"10.1016/j.cgh.2025.05.007","DOIUrl":"10.1016/j.cgh.2025.05.007","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 9","pages":"Pages 1467-1471"},"PeriodicalIF":11.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Inflammatory Bowel Disease-driven Colorectal Cancer Management: Molecular Insights and Endoscopic Breakthroughs Towards Precision Medicine.","authors":"Marietta Iacucci, Olga Maria Nardone, Ilaria Ditonno, Ivan Capobianco, Cecilia Lina Pugliano, Yasuharu Maeda, Snehali Majumder, Irene Zammarchi, Giovanni Santacroce, Subrata Ghosh","doi":"10.1016/j.cgh.2025.06.035","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.06.035","url":null,"abstract":"<p><p>Colorectal cancer (CRC) is a serious complication of inflammatory bowel disease (IBD), significantly contributing to increased mortality and healthcare burden. While advances in IBD management have led to a decline in CRC incidence, it remains a major clinical concern. Recent breakthroughs in advanced imaging, molecular diagnostics, and artificial intelligence (AI) are poised to revolutionize precision medicine in IBD-associated CRC, potentially reducing neoplastic risk and improving patient outcomes. This review explores emerging concepts in colitis-associated cancer pathogenesis, including the intricate interplay between diet, microbiome alterations, and intestinal barrier dysfunction in CRC progression. Additionally, it highlights cutting-edge diagnostic and assessment techniques, such as ultra-high magnification endoscopy, and new spatial biology platforms for assessing intestinal barrier integrity and molecular biomarkers like miRNAs and liquid biopsy. The future of IBD-related CRC management will incorporate a holistic, multi-integrated approach, combining AI-driven diagnostics, omics data integration, endoscopic and surgical innovations and nanotechnology-based therapies. This paradigm shift aims to enhance precision medicine, promoting organ-sparing approaches, improved diagnostics, and personalized cancer treatment with the potential to reduce CRC risk.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of inflammatory bowel disease and primary sclerosing cholangitis on colorectal cancer risk:national cohort study.","authors":"Maie Abdalla, Michael Eberhardson, Kalle Landerholm, Roland E Andersson, Pär Myrelid","doi":"10.1016/j.cgh.2025.06.037","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.06.037","url":null,"abstract":"<p><strong>Background and aims: </strong>Inflammatory bowel disease (IBD) increases the risk of colorectal cancer (CRC). Previous studies concluded primary sclerosing cholangitis (PSC) as an independent risk factor for CRC in IBD. We aimed to investigate the impact of IBD and PSC on the risk of developing CRC, mortality and colectomy.</p><p><strong>Methods: </strong>IBD patients diagnosed 1969-2014 were identified from the Swedish National Patient Register, together with five matched controls per case from the background population. We estimated the impact of some risk factors including PSC+/- on the risk of CRC and mortality in the IBD patients compared to that in the controls, and colectomy within the IBD cohort.</p><p><strong>Results: </strong>Among all IBD patients, the hazard ratio (HR) of CRC was 1.83 (95% CI 1.72-1.96, p<0.001). The risk was highest in the PSC+ patients initially but decreased over time. PSC+ patients diagnosed with IBD ≤ 20 years of age had a highly increased risk with an incidence rate ratio (IRR) of 74.97 (95% CI 44.7-126.1, p<0.001) compared to controls. PSC+ patients had 9-16 times higher risk of cancer in caecum/ascending, transverse and descending colon compared to sporadic CRC among controls. Synchronous cancer was found in 4.7% of PSC+, 4.4% of PSC- patients and 1.9% among controls (p< 0.001).</p><p><strong>Conclusions: </strong>IBD patients have an increased risk of CRC, mostly prominent among young PSC+ patients. PSC+ patients display a tendency to develop CRC in the proximal colon and more synchronous CRC. This should be considered when monitoring and counselling IBD patients.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Meta-Epidemiological Analysis of Sex Disparities in Hepatology Clinical Trials.","authors":"Anna M Goebel, Emily Sheng, Pedro Ochoa-Allemant, Nosheen Reza, Nadim Mahmud","doi":"10.1016/j.cgh.2025.07.017","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.07.017","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatGPT Is Not Yet Ready to Replace Motility Experts.","authors":"Ofer Z Fass, Dustin A Carlson, John E Pandolfino","doi":"10.1016/j.cgh.2025.04.033","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.04.033","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-Center Validation of Video-Based Deep Learning to Evaluate Defecation Patterns on 3D High-Definition Anorectal Manometry.","authors":"Zarif Azher, Brian D Ginnebaugh, David Justin Levinthal, Nelson Valentin, Joshua J Levy, Dinesh Shah Eric","doi":"10.1016/j.cgh.2025.06.038","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.06.038","url":null,"abstract":"<p><strong>Background: </strong>Deep learning technologies have demonstrated the ability to identify dyssynergic defecation for diagnosis of common gastrointestinal motility disorders through nuanced interpretation of 3-dimensional high definition anal manometry (3D-HDAM). We aimed to validate a deep learning algorithm capable of spatiotemporal analysis of 3D-HDAM in a multi-center setting.</p><p><strong>Methods: </strong>We included 1,214 consecutive anorectal manometry studies performed across three large healthcare systems between 2018-2022. Deep learning results were compared to expert interpretation according to the London consensus protocol as reference standard. Diagnostic accuracy was assessed using bootstrap sampling to calculate area-under-the-curve (AUC). We used Wilcoxon tests to analyze how well the confidence scores from the deep learning model correlated with the likelihood that experts would assign ambiguous labels in cases where determinations were uncertain. Video-based deep learning features were clustered using Gaussian Mixture Modeling to reveal novel dyssynergia subtypes.</p><p><strong>Results: </strong>The deep hybrid learning algorithm achieved AUCs of 0.99 (± 0.001 standard deviation), 0.90 ± 0.008, and 0.79 ± 0.003 at Dartmouth Health, Henry Ford Hospital, and University of Pittsburg Medical Center respectively, performance comparable or superior to solely deep learning or traditional modeling on every cohort. The algorithm appeared capable of reporting confidence aligned with manual expert interpretation of ambiguity (W=-20.50 [p<0.001]; -1.73 [p=0.08]; -3.22 [p=0.001]). We further identified two novel classes of dyssynergia patterns that may represent clinically relevant phenotypes of dyssynergia.</p><p><strong>Conclusions: </strong>3D high-definition anorectal manometry combined with video-based deep learning is a useful and clinically relevant technology for evaluating anorectal dyssynergia. Future use cases can be expanded to evaluating other motility disorders and their treatment.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Real-World Impact of Vitamin D Supplementation on Inflammatory Bowel Disease Clinical Outcomes.","authors":"Jared A Sninsky, Shubhada Sansgiry, Thomas Taylor, Michael Perrin, Fasiha Kanwal, Jason K Hou","doi":"10.1016/j.cgh.2025.07.013","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.07.013","url":null,"abstract":"<p><strong>Background and aims: </strong>Vitamin D deficiency is common in inflammatory bowel disease (IBD) and linked to adverse outcomes, yet the therapeutic role of vitamin D supplementation remains uncertain. We evaluated the real-world impact of vitamin D supplementation on corticosteroid use, emergency department (ED) visits, and hospitalizations in patients with IBD.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients with IBD patients seen in the national Veterans Health Administration system from 2000 to 2023. All patients who had a vitamin D lab assay without a vitamin D prescription in the preceding three months were included. We used the quasi-experimental design with difference-in-differences analysis to compare vitamin D-treated and untreated groups before and after the 25-hydroxyvitamin D assay. Sensitivity analyses used regression discontinuity design (RDD) and inverse probability weighting (IPW) regression to confirm results from the primary analysis.</p><p><strong>Results: </strong>Among 5,021 IBD patients (median age 63; 89% male; 58% ulcerative colitis, 39% Crohn's disease, 3% indeterminate colitis), the median 25-hydroxyvitamin D level was 23 ng/mL, and 41% received vitamin D supplementation. Vitamin D supplementation was associated with reduction in IBD-related ED visits by 2.17% (34.4% RRR, p=0.007), hospitalizations by 2.64% (53.18% relative risk reduction (RRR), p=0.003), and corticosteroid prescriptions by 1.29% (25.13% RRR, p=0.066). Similar results were seen in the inverse probability weighted regression and RDD analyses.</p><p><strong>Conclusion: </strong>Vitamin D supplementation was associated with reduced IBD-related ED visits, hospitalizations, and corticosteroid use, supporting its potential as a low-cost adjunct in IBD management. Prospective studies are needed to optimize dosing strategies and define target serum levels for improved long-term outcomes.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}