Clinical Gastroenterology and Hepatology最新文献_第3页

Secondhand Smoke Exposure and Metabolic Dysfunction-Associated Steatotic Liver Disease in US Adolescents. 美国青少年二手烟暴露与代谢功能障碍相关的脂肪肝。

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2024-10-25 DOI: 10.1016/j.cgh.2024.08.049

Donghee Kim, Brandon J Perumpail, Pojsakorn Danpanichkul, Karn Wijarnpreecha, Aijaz Ahmed

引用次数: 0

Prevalence of Gastroparesis in Chronic Pancreatitis and Predictive Factors: A Machine Learning Prediction Model. 慢性胰腺炎胃痉挛的患病率和预测因素：机器学习预测模型

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2024-10-25 DOI: 10.1016/j.cgh.2024.09.023

Daryl Ramai, Chun-Wei Pan, David M Troendle, Marcello Maida, Antonio Facciorusso, Jorge D Machicado

引用次数: 0

Long-term Effectiveness and Safety of Risankizumab in Patients with Crohn's Disease from a Large Tertiary Center. 一家大型三级医疗中心的利桑珠单抗对克罗恩病患者的长期有效性和安全性

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2024-10-24 DOI: 10.1016/j.cgh.2024.09.027

Adar Zinger, David Choi, Natalie Choi, Evan Fear, Zachary Fine, Russell D Cohen, David T Rubin

{"title":"Long-term Effectiveness and Safety of Risankizumab in Patients with Crohn's Disease from a Large Tertiary Center.","authors":"Adar Zinger, David Choi, Natalie Choi, Evan Fear, Zachary Fine, Russell D Cohen, David T Rubin","doi":"10.1016/j.cgh.2024.09.027","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.09.027","url":null,"abstract":"Background and aims: Risankizumab is a selective IL23 inhibitor approved for the treatment of Crohn's disease (CD). We report a large long-term real-world experience with risankizumab in CD.Methods: We performed a prospective monitoring of clinical outcomes in patients in our center who started treatment with risankizumab. Patients with active luminal disease who had at least 12 weeks of follow-up were included in the effectiveness analysis. Harvey-Bradshaw Index (HBI) as well as C-reactive protein (CRP) and fecal calprotectin (FCP) were used to monitor disease activity. Primary outcomes were clinical remission and steroid-free clinical remission rates at weeks 12, 26, and 52. Univariate analysis followed by a multivariate analysis using a logistic regression model was performed to identify predictors of steroid-free clinical remission at one year. All patients who started treatment with risankizumab for any indication were included in the safety analysis.Results: 134 patients were included in the effectiveness analysis. 70 (52%) were ustekinumab-experienced. Clinical remission rates were 69%, 64%, and 54% at weeks 12, 26, and 52, respectively. Steroid-free clinical remission rates at 12, 26, and 52 weeks were 58%, 58%, and 50% respectively. Remission rates in ustekinumab-experienced patients were not statistically lower compared to naïve patients, and in a multivariate analysis, prior ustekinumab treatment was not associated with lower odds of achieving steroid-free clinical remission at one year. Adverse effects were assessed in 243 patients and were consistent with previous literature.Conclusions: This large real-world experience with risankizumab with long-term follow-up demonstrates effectiveness and safety in patients with CD; there was comparable effectiveness in ustekinumab-naïve and ustekinumab-experienced patients.","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496182","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

Multi-dimensional patient-reported outcomes and quality of life at diagnosis of IBD: A population-based inception cohort study. 确诊 IBD 时患者报告的多维结果和生活质量：基于人群的初始队列研究。

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2024-10-24 DOI: 10.1016/j.cgh.2024.08.047

Mohamed Attauabi, Gorm Roager Madsen, Flemming Bendtsen, Jakob Benedict Seidelin, Johan Burisch

{"title":"Multi-dimensional patient-reported outcomes and quality of life at diagnosis of IBD: A population-based inception cohort study.","authors":"Mohamed Attauabi, Gorm Roager Madsen, Flemming Bendtsen, Jakob Benedict Seidelin, Johan Burisch","doi":"10.1016/j.cgh.2024.08.047","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.08.047","url":null,"abstract":"Background and aims: Patient-reported outcomes (PROs) are pivotal in assessing treatment efficacy and estimating the burden of inflammatory bowel diseases (IBD). We investigated PROs at the time of IBD diagnosis.Methods: The Short Inflammatory Bowel Disease Questionnaire (SIBDQ), IBD-Disability Index (IBD-DI), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and disease activity-related PROs were assessed in the Copenhagen IBD Inception Cohort, a prospective, population-based cohort of patients newly diagnosed with IBD between May 2021 and May 2023.Results: A total of 203 UC and 116 CD patients were recruited. At diagnosis, 160 (78.8%) and 99 (85.3%) patients with UC and CD, respectively, reported moderate-to-severe impairment in at least one PRO (p=0.18), with 89 (43.8%) and 74 (63.8%), respectively, reporting moderate-to-severe impairment in at least two PROs (p<0.01). Being female, the disease extent of UC, and extraintestinal manifestations were associated with impaired PROs. There were no differences found according to CD phenotype. FACIT-F, IBD-DI, and SIBDQ scores showed weak, but significant, correlations with the Mayo Endoscopic Score in UC, and the FACIT-F score with C-reactive protein (CRP). In CD, SIBDQ, IBD-DI, and FACIT-F correlated moderately with CRP and fecal calprotectin, but not with the endoscopic severity of CD. None of the PROs correlated with iron, ferritin, or vitamin D levels. Among the most prevalent symptoms reported were fatigue, abdominal pain, urgency, and passing of blood in both CD and UC.Conclusion: We found a substantial patient-reported disease burden in newly diagnosed IBD, underscoring the importance of vigilant PRO monitoring in clinical practice.Funding: This study was funded by an unrestricted grant from the Novo Nordisk Fonden.","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496184","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

Dysphagia Megalatriensis. Megalatriensis 吞咽困难症。

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2024-10-24 DOI: 10.1016/j.cgh.2024.08.050

Zehra Naseem, Arjun Chatterjee, Yi Qin

引用次数: 0

Calibration, Clinical Utility and Specificity of Clinical Decision Support Tools in Inflammatory Bowel Disease. 炎症性肠病临床决策支持工具的校准、临床实用性和特异性。

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2024-10-24 DOI: 10.1016/j.cgh.2024.09.020

Dahham Alsoud, João Sabino, Marc Ferrante, Bram Verstockt, Séverine Vermeire

{"title":"Calibration, Clinical Utility and Specificity of Clinical Decision Support Tools in Inflammatory Bowel Disease.","authors":"Dahham Alsoud, João Sabino, Marc Ferrante, Bram Verstockt, Séverine Vermeire","doi":"10.1016/j.cgh.2024.09.020","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.09.020","url":null,"abstract":"Background and aims: Clinical decision support tools (CDSTs) have been developed to predict response to vedolizumab (VDZ) and ustekinumab (UST) in Crohn's disease (CD) and ulcerative colitis (UC). In addition to assessing their discrimination performance, our study aimed to evaluate their calibration, clinical utility and specificity.Methods: We included 280 CD and 218 UC patients initiating VDZ, and 194 CD patients initiating UST. We assessed discrimination by comparing rates of effectiveness outcomes between response probability groups forecasted by CDSTs. Calibration curves and decision curve analysis evaluated the calibration and clinical utility of VDZ-CDSTs. Additionally, we examined the agreement between UST-CDST and VDZ-CDST in assigning response probability groups among CD patients starting UST.Results: In the overall cohort, CDSTs allocated 7.2%, 50.0% and 42.8% of the patients to the low, intermediate and high response probability groups, respectively. VDZ-CDSTs groups demonstrated significant differences in the rates of clinical and endoscopic response and remission, while UST-CDST groups showed significant discrimination only for clinical remission. Although VDZ-CDSTs overestimated clinical remission rates, they more accurately predicted rates of VDZ persistence without need for surgery or dose escalation. Compared to empirically treating all patients with VDZ, VDZ-CDSTs yielded higher net benefits in selecting patients who would continue VDZ without need for surgery or dose escalation. Finally, the agreement between UST-CDST and VDZ-CDST in predicting response was 73.7%.Conclusion: VDZ-CDSTs significantly discriminated response to VDZ and were more beneficial in identifying patients who would continue therapy without requiring surgery or dose escalation, compared to treating all patients empirically.","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496258","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

TRAUMA-INFORMED CARE IN GASTROENTEROLOGY: A SURVEY OF PROVIDER ATTITUDES, KNOWLEDGE, AND SKILLS. 胃肠病学中的创伤知情护理：医疗服务提供者的态度、知识和技能调查。

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2024-10-24 DOI: 10.1016/j.cgh.2024.09.015

Christina Tsai, Sara Abdelhalim, Serre-Yu Wong, Xianhong Xie, Manasi Agrawal, Laurie A Keefer

引用次数: 0

Hepatitis Delta Virus Testing and Prevalence Among Chronic Hepatitis B Patients Across Three U.S. Safety-Net Health Systems. 美国三个安全网医疗系统中慢性乙型肝炎患者的 Delta 病毒检测和流行率。

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2024-10-24 DOI: 10.1016/j.cgh.2024.09.025

Robert J Wong, Mamta K Jain, Bolin Niu, Yi Zhang, George Therapondos, Mae Thamer

{"title":"Hepatitis Delta Virus Testing and Prevalence Among Chronic Hepatitis B Patients Across Three U.S. Safety-Net Health Systems.","authors":"Robert J Wong, Mamta K Jain, Bolin Niu, Yi Zhang, George Therapondos, Mae Thamer","doi":"10.1016/j.cgh.2024.09.025","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.09.025","url":null,"abstract":"Background & aims: Despite a high prevalence of risk factors associated with hepatitis delta virus (HDV) infection among safety-net populations, data evaluating HDV testing and prevalence are limited. We aim to evaluate HDV testing practices and HDV prevalence among an ethnically diverse, multi-center cohort of safety-net patients with chronic hepatitis B (CHB).Methods: We retrospectively evaluated 13,218 patients with CHB (54.2% male, 57.9% non-white minorities, 12.5% HIV, 23.0% HCV) across three U.S. safety-net health systems from 2010-2022 to evaluate proportion tested for HDV and proportion positive among those tested. Adjusted multivariate logistic regression models evaluated for predictors of HDV testing and predictors of anti-HDV positive.Results: Anti-HDV testing was performed in 6.1% overall and in 4.9% that met AASLD criteria for HDV testing. Greater odds of testing was observed in men vs. women (OR 1.49, 95%CI 1.27-1.75), Asian individuals vs. white individuals (OR 2.18, 95%CI 1.74-2.72), black/African American individuals vs. white individuals (OR 1.29, 95%CI 1.07-1.56), and patients with Medicare or Medicaid. Among CHB patients tested for HDV, 15.7% were positive (22.9% among those meeting AASLD HDV testing criteria). Only 2 (1.6%) patients had follow-up HDV RNA testing. Greater proportion of anti-HDV positive was observed in patients with baseline cirrhosis (47.4% vs. 13.3%, p<0.001), and patients with Medicare or Medicaid vs. those with commercial insurance.Conclusions: Among an ethnically diverse, multi-center safety-net cohort of CHB patients, low rates of HDV testing were observed, even among those with high-risk HDV risk factors. Among those tested, 15.7% were positive, only 2 had follow up RNA testing. This highlights the need for greater awareness, education, and advocacy to improve HDV testing rates.","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496264","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

Patients with Inflammatory Bowel Disease are at Increased Risk for Complications of Herpes Zoster. 炎症性肠病患者并发带状疱疹的风险更高。

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2024-10-24 DOI: 10.1016/j.cgh.2024.09.022

Freddy Caldera, Siddharth Singh, Emily E Zona, Oscar Ramirez Ramirez, Jonathan Inselman, Herbert Heien, Andrew P Keaveny, Mary S Hayney, Francis A Farraye

{"title":"Patients with Inflammatory Bowel Disease are at Increased Risk for Complications of Herpes Zoster.","authors":"Freddy Caldera, Siddharth Singh, Emily E Zona, Oscar Ramirez Ramirez, Jonathan Inselman, Herbert Heien, Andrew P Keaveny, Mary S Hayney, Francis A Farraye","doi":"10.1016/j.cgh.2024.09.022","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.09.022","url":null,"abstract":"Background and aims: Patients with inflammatory bowel disease (IBD) are at an increased risk for vaccine-preventable diseases, such as herpes zoster (HZ). The aim of this study was to determine whether complications of HZ are more frequent in patients with IBD than in non-IBD controls.Methods: This was a retrospective, cohort study using the Optum Research Database. Patients with IBD were matched 1:1 to non-IBD controls based on age, sex, and index year, which was defined as the diagnosis of HZ. We then identified the complications of HZ that occurred up to 90 days after the index date. We compared patients with IBD with non-IBD controls and evaluated the 90-day risk of HZ complications. We used a composite primary outcome for any HZ complication. Secondary outcomes were risk factors for complications.Results: Four thousand seven fifty-six patients with IBD met the inclusion criteria and were matched to the controls. Patients with IBD were more likely to have complications of HZ than controls [738 (15.52%) vs. 595 (12.51%), p < 0.0001]. Patients with IBD with higher comorbidity scores were more likely to develop complications (1.86 vs. 1.18 p < 0.0001). In the logistic regression analysis of patients with IBD having a higher comorbidity score, above 50 years of age, on anti-TNF or corticosteroids were all at increased risk of a complication of HZ.Conclusion: Patients with IBD are more likely to have complications of HZ than controls. Efforts are needed to increase HZ vaccine uptake to reduce the morbidity of HZ.","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496272","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

Hepatitis D virus infection markedly increases the risk of hepatocellular carcinoma in patients with viral B cirrhosis. D 型肝炎病毒感染会显著增加病毒性 B 型肝硬化患者罹患肝细胞癌的风险。

IF 11.6 1区医学

Clinical Gastroenterology and Hepatology Pub Date : 2024-10-24 DOI: 10.1016/j.cgh.2024.08.046

Dominique Roulot, Richard Layese, Ségolène Brichler, Nathalie Ganne, Tarik Asselah, Fabien Zoulim, Emmanuel Gordien, Pierre Nahon, Françoise Roudot-Thoraval

{"title":"Hepatitis D virus infection markedly increases the risk of hepatocellular carcinoma in patients with viral B cirrhosis.","authors":"Dominique Roulot, Richard Layese, Ségolène Brichler, Nathalie Ganne, Tarik Asselah, Fabien Zoulim, Emmanuel Gordien, Pierre Nahon, Françoise Roudot-Thoraval","doi":"10.1016/j.cgh.2024.08.046","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.08.046","url":null,"abstract":"Background and aims: The specific causative role of HDV infection in the development of hepatocellular carcinoma (HCC) remains debated and was not specifically demonstrated in cirrhotic patients. Here we compared HCC incidence in HBV-HDV co-infected and HBV mono-infected cirrhotic patients.Methods: A total of 142 HBV-HDV and 271 HBV-infected cirrhotic patients from the French ANRSCO12 CirVir and DeltaVir cohorts, with histologically proven cirrhosis and no history of decompensation, were included in the study.Results: HBV-HDV patients were younger than HBV patients (37.2 vs. 53.8 years), they were more often immigrants from sub-Saharan Africa, and displayed less co-morbidities and more altered liver tests. After adjustment for age, cumulative incidences of HCC in co-infected and mono-infected patients at 1, 3 and 5 years were 5.2%, 11.8% and 20.2% vs. 1.1%, 2.5% and 4.4%, respectively (P< .001). In multivariate analysis, HDV infection was an independent factor associated with the development of HCC (HR 2.94, 95% CI 1.19-7.25; P= .019). Other independent factors were age (HR 1.08, 1.05-1.11; P< .001), overweight (HR 0.45, 0.22-0.93; P= .031), smoking (HR 2.26, 1.23-4.16; P= .009), increased GGT (HR 2.73, 1.24-6.00; P= .013), total bilirubin >17 μmol/L (HR 2.68, 1.33-5.42; P= .006) and platelet count <150.000/mm3 (HR 3.11, 1.51-6.41; P= .002). HDV co-infection was not an independent factor of liver decompensation, transplantation or death.Conclusion: The incidence of HCC appears significantly higher in HBV-HDV than in HBV-infected cirrhotic patients. HDV infection emerges as an independent risk factor for HCC, indicating that in cirrhotic patients, HDV plays a causative role for HCC independently of HBV.","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496263","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