Clinical Gastroenterology and Hepatology最新文献

Novel Noninvasive Tests for Liver Fibrosis: Moving Beyond Simple Tests in Metabolic Dysfunction Associated Steatotic Liver Disease. 新型无创肝纤维化检测：代谢功能障碍相关脂肪变性肝病的简单检测

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2025-05-30 DOI: 10.1016/j.cgh.2025.02.035

John T Grady, John W Cyrus, Richard K Sterling

{"title":"Novel Noninvasive Tests for Liver Fibrosis: Moving Beyond Simple Tests in Metabolic Dysfunction Associated Steatotic Liver Disease.","authors":"John T Grady, John W Cyrus, Richard K Sterling","doi":"10.1016/j.cgh.2025.02.035","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.02.035","url":null,"abstract":"Background and aims: Noninvasive tests serve as alternative options to liver biopsy for the diagnosis of liver fibrosis. The fibrosis 4 (FIB-4) index, aspartate platelet ratio index (APRI), and liver stiffness measurement by transient and magnetic resonance elastography are guideline supported tools for noninvasive liver disease assessment but are limited by indeterminate ranges and varying diagnostic performance among different patient populations. In this scoping review, we evaluate the performance of novel noninvasive liver disease assessments in metabolic dysfunction associated steatotic liver disease (MASLD) not discussed in recent professional guidelines.Methods: We systematically reviewed the literature over the past 5 years (2020-present) to identify studies evaluating NILDAs in MASLD.Results: Of the 912 records, 48 met inclusion criteria: 37 through the systematic review and 11 identified by the authors. Of the 15 novel scores, several perform well in steatotic liver disease in validation studies and included routinely available elements. While several novel scores had good to excellent discrimination, their cost and availability may limit their use in practice. Based on our review, we propose starting with the FIB-4 index given its availability, low cost and high negative predictive value. In those with a FIB-4 >1.3, we propose using Agile 3+ or 4 to identify advanced fibrosis or cirrhosis.Conclusions: NILDAs are effective alternatives to liver biopsy for fibrosis assessment in MASLD and may serve as a tool to identify patients who are candidates for newer therapies.","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198394","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}

引用次数: 0

Primary Prevention of Pouchitis. 初级预防袋炎。

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2025-05-29 DOI: 10.1016/j.cgh.2025.03.008

Edward L Barnes, Hans Herfarth

引用次数: 0

Balancing Novelty and Pragmatism: Integrating GEMA-AI into Clinical Workflows. 平衡新颖性和实用主义：将GEMA-AI集成到临床工作流程中。

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2025-05-26 DOI: 10.1016/j.cgh.2025.02.034

Xinzhuo Tu, Yunpeng Liu, Kui Wang

引用次数: 0

Bias in the Bowels: Disparities Exist in Constipation Testing in a Diverse Patient Cohort. 肠道偏倚：便秘测试在不同患者队列中存在差异。

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2025-05-23 DOI: 10.1016/j.cgh.2025.05.006

Ahmun Zafar, Yuqing Liu, Joseph Menand, Christopher Vélez, Xiaotao Zhang, Yuying Luo

引用次数: 0

Blue Notes 蓝色笔记

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2025-05-23 DOI: 10.1016/j.cgh.2025.04.001

Charles J. Kahi MD, MS, AGAF

引用次数: 0

Elsewhere in the AGA Journals 在AGA期刊的其他地方

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2025-05-23 DOI: 10.1016/S1542-3565(25)00300-3

引用次数: 0

Effect of cecal intubation rate on post colonoscopy colorectal cancer deaths and detection of colorectal cancer precursors. 盲肠插管率对结肠镜术后结直肠癌死亡及结直肠癌前体检测的影响。

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2025-05-21 DOI: 10.1016/j.cgh.2025.01.035

Jasmin Zessner-Spitzenberg, Elisabeth Waldmann, Lisa-Maria Rockenbauer, Alexandra Demschik, Andreas Klinger, Daniela Penz, Michael Trauner, Monika Ferlitsch

{"title":"Effect of cecal intubation rate on post colonoscopy colorectal cancer deaths and detection of colorectal cancer precursors.","authors":"Jasmin Zessner-Spitzenberg, Elisabeth Waldmann, Lisa-Maria Rockenbauer, Alexandra Demschik, Andreas Klinger, Daniela Penz, Michael Trauner, Monika Ferlitsch","doi":"10.1016/j.cgh.2025.01.035","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.01.035","url":null,"abstract":"Background & aims: The visualization of the whole colonic mucosa with complete colonoscopy including cecal intubation has been accepted as a quality parameter for screening colonoscopy. However, there is little evidence regarding the cecal intubation rate (CIR) and its association with long-term patient outcome.Methods: We did a linkage of individuals that participated in an Austrian Colonoscopy Quality Assurance Program to the Austrian death registry to obtain information on deaths of post-colonoscopy colorectal cancer (PCCRC). We performed logistic regression and time-to-event analyses to estimate the association the CIR with the probability to detect adenomas or proximal serrated polyps and the hazards for PCCRC death.Results: 349782 screening participants between 01/2012 and 12/2022 were included. With every one percentage point increase in the CIR, the probability to detect an adenoma increased by one percentage point (OR 1.01, 95% CI 1.0 - 1.01, p <0.001) and increased by three percentage points to detect a proximal serrated polyp (OR 1.03, 95% CI 1.01 - 1.04, p<0.001). There was a significantly lower risk for PCCRC death when endoscopists had a CIR of 95%-100% (HR 0.44, 95% CI 0.33 - 0.59, p <0.001), compared to endoscopists with a CIR < 90% or 90% - 95%.Conclusions: the endoscopist's cecal intubation rate is strongly associated with their ability to detect adenomas and proximal serrated polyps. A CIR of 95-100% was associated with the lowest hazards for PCCRC death. Based on this data, a CIR above 95% is the desirable target.","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132068","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}

引用次数: 0

Reply letter to Matheus Souza et al. 给Matheus Souza等人的回信。

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2025-05-21 DOI: 10.1016/j.cgh.2025.03.029

Marilia de Brito Gomes, Bianca Barros

引用次数: 0

Symptoms of Constipation: Relationship between questionnaires and diaries and Impact on Quality of Life. 便秘症状：问卷和日记的关系及其对生活质量的影响。

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2025-05-20 DOI: 10.1016/j.cgh.2025.05.005

Gad Mehanna Al Snih, Kent R Bailey, Nicholas R Oblizajek, Adil E Bharucha

{"title":"Symptoms of Constipation: Relationship between questionnaires and diaries and Impact on Quality of Life.","authors":"Gad Mehanna Al Snih, Kent R Bailey, Nicholas R Oblizajek, Adil E Bharucha","doi":"10.1016/j.cgh.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.05.005","url":null,"abstract":"Background and aims: Widely used to identify constipation in clinical trials and epidemiological studies, bowel questionnaires have not been adequately validated vs the gold standard approach, diaries. Constipation is associated with poor quality-of-life (QoL). However, the contribution of individual symptoms to QoL is unknown.Methods: Bowel symptoms (questionnaires and 2-week bowel diaries), somatic symptom scores (SSS, range 0-4), and bowel symptom-related QoL were evaluated in healthy women and women with constipation in the community and clinic.Results: The bowel variables were significantly correlated and not significantly different between the first and second weeks of the diary. Agreement between bowel symptoms assessed with questionnaires and diaries was significant (P<.001) but varied among symptoms. Of 73 participants who reported 0-2 stools/week on questionnaires, 63 (86%) recorded more frequent stools in a diary. Among participants with frequent (≥25% of the time) hard stools, straining, and incomplete evacuation on a questionnaire, respectively 32%, 49%, and 23% recorded these symptoms less frequently in a diary. Only 116 of 222 (52%) of participants satisfied constipation criteria by questionnaires and diaries; the remainder satisfied either questionnaire or diary criteria. Stool form, excessive straining, incomplete evacuation, and somatic symptoms were independently associated with poor QoL. Each unit increase in the SSS score was associated with an increased odds of poor QoL (OR, 5.31; 95% CI, 4.54, 6.08).Conclusions: Disparities exist between bowel symptoms recorded with questionnaires and diaries. Bowel diaries characterize constipation symptoms in a refined manner; only 52% of participants satisfied constipation symptom criteria on both instruments. Somatic symptoms overshadow the contribution of bowel symptoms to QoL.","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126914","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}

引用次数: 0

Performance of a smartphone-based stool test for use in colorectal cancer screening: population-based study. 基于智能手机的粪便测试在结直肠癌筛查中的应用：基于人群的研究

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2025-05-20 DOI: 10.1016/j.cgh.2025.04.027

Michael Hoffmeister, Teresa Seum, Leopold Ludwig, Hermann Brenner

{"title":"Performance of a smartphone-based stool test for use in colorectal cancer screening: population-based study.","authors":"Michael Hoffmeister, Teresa Seum, Leopold Ludwig, Hermann Brenner","doi":"10.1016/j.cgh.2025.04.027","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.04.027","url":null,"abstract":"Background and aims: Non-invasive colorectal cancer (CRC) screening bears high potential for increasing participation if implemented in a straightforward way. We have evaluated the feasibility and diagnostic performance of a smartphone-based fecal immunochemical test (FIT) for CRC screening and compared its performance of with a laboratory-based FIT.Methods: Individuals scheduled for a screening colonoscopy in gastroenterology practices in Southern Germany enrolled into the BLITZ study between 2021 and 2023 were offered a smartphone-based FIT and a laboratory FIT. The smartphone-based FIT consists of a rapid test and a smartphone app. The app quantitatively evaluates the result of the rapid test using the smartphone camera.. The feasibility of the smartphone-based FIT was evaluated in a self-administered questionnaire. The comparative performance of the two FITs was evaluated by sensitivity, specificity and receiver-operator curve (ROC) measures.Results: Of 654 study participants who were offered both a smartphone-based FIT in addition to the laboratory FIT, 361 (55%) made use of the smartphone-based FIT, 274 (76%) of those had a valid smartphone-based FIT, and 643 (98%) used the laboratory FIT. Overall 89% considered the smartphone-based FIT as a useful alternative offer to the laboratory FIT. The reasons why the smartphone-based FIT was not used were mostly technical (app- or smartphone-related, 47%), or reflecting more general concerns or attitudes towards such a test (44%). The smartphone-based FIT showed a sensitivity for advanced neoplasms (28%, 95% confidence interval 13-47%) similar to the laboratory FIT (34%, 18-54%) at an identical specificity (92%, 87-95%).Conclusion: The smartphone-based FIT could serve as an alternative in addition to currently offered laboratory FITs. drks.de, DRKS00008737.","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126913","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}

引用次数: 0