Clinical Gastroenterology and Hepatology最新文献

{"title":"Outcomes in Female Patients with Chronic Liver Disease Undergoing Infertility Treatment.","authors":"Meera Garriga, Marcelle Cedars, Monika Sarkar","doi":"10.1016/j.cgh.2024.12.019","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.12.019","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074025","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":"Guarding the Gate: The Sentinel Role of Endosonography in Precluding Unwarranted.","authors":"Gregory A Coté, Michael L Kochman, Nikhil R Thiruvengadam","doi":"10.1016/j.cgh.2024.12.016","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.12.016","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074050","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":"Colorectal cancer incidence in steatotic liver disease (MASLD, MetALD, and ALD).","authors":"Takefumi Kimura, Nobuharu Tamaki, Shun-Ichi Wakabayashi, Naoki Tanaka, Takeji Umemura, Namiki Izumi, Rohit Loomba, Masayuki Kurosaki","doi":"10.1016/j.cgh.2024.12.018","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.12.018","url":null,"abstract":"<p><strong>Background and aims: </strong>Obesity and alcohol consumption are established risk factors for colorectal cancer (CRC). Recently, a multi-society consensus group has introduced a new classification for steatotic liver disease (SLD), which encompasses metabolic dysfunction-associated SLD (MASLD), MASLD and increased alcohol intake (MetALD), and alcohol-associated liver disease (ALD). However, the risk of developing CRC in each of these SLD subgroups is unknown. This nationwide cohort study investigated the risk of CRC in MASLD, MetALD, and ALD patients. The primary endpoint was the occurrence of CRC in each SLD subgroup.</p><p><strong>Methods: </strong>We conducted a nationwide, population-based study that included 1,497,813 patients diagnosed with MASLD, MetALD, or ALD, alongside 4,885,536 individuals with no known liver disease as a comparison group. The primary outcome was the incidence of CRC and the risk of CRC was compared between MASLD, MetALD and ALD.</p><p><strong>Results: </strong>The 5- and 10-year cumulative CRC incidence rates were 0.22% and 0.48% for MASLD, 0.32% and 0.73% for MetALD, and 0.43% and 0.97% for ALD, and 0.15% and 0.31% for the comparison group, respectively. The cumulative incidence of CRC was highest for ALD and significantly greater than that for MetALD, MASLD, and the comparison groups (both p < 0.001). Using the comparison group as the reference and adjusting for age, sex, smoking habit, number of colorectal examinations, diabetes mellitus, dyslipidemia, hypertension, and medication use, the adjusted hazard ratios (95% confidence interval) for CRC were 1.73 (1.59-1.87) for ALD, 1.36 (1.28-1.45) for MetALD, and 1.28 (1.22-1.35) for MASLD.</p><p><strong>Conclusion: </strong>The risk of CRC differs significantly among patients with SLD, with the highest incidence observed in those with ALD, followed by MetALD and MASLD.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074043","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":"Melting the Celiac Iceberg to Improve Outcomes in Celiac Disease: Two Tales of Success.","authors":"Alberto Rubio-Tapia","doi":"10.1016/j.cgh.2024.11.021","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.11.021","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074024","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 assessment of gastrointestinal transit by the Atmo Capsule: A comparison with the SmartPill Capsule.","authors":"Braden Kuo, Allen A Lee, Thomas Abell, Ashok Attaluri, Michael Cline, William Hasler, Vincent Ho, Anthony Lembo, Amir Masoud, Richard McCallum, Baharak Moshiree, Eamonn Mm Quigley, Satish Sc Rao, Abigail Stocker, Mayra Sanchez, Irene Sarosiek, Brian Surjanhata, Jerry Zhou, William D Chey","doi":"10.1016/j.cgh.2024.12.013","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.12.013","url":null,"abstract":"<p><strong>Background and aims: </strong>Wireless motility capsules (WMCs) can be used to assess gastrointestinal transit time to facilitate diagnosis and treatment of motility disorders. The Atmo Capsule is a novel WMC that measures gases (H₂, CO₂, O₂) and temperature. We aimed to compare and evaluate the performance characteristics of the Atmo Capsule and the SmartPill Capsule (discontinued reference standard WMC) for measurement of gastric emptying time (GET) and colonic transit time (CTT) , in patients with confirmed or suspected disordered gastrointestinal transit.</p><p><strong>Methods: </strong>Patients with symptoms indicative of an upper and/or lower gastrointestinal motility disorder ingested the two WMCs in a random order. Gastrointestinal transit times were assessed using Spearman correlation and Bland-Altman analysis. Device agreement was assessed for delayed GET (≥ 5 hours) and CTT (≥ 59 hours).</p><p><strong>Results: </strong>There were 213 participants from 12 sites, yielding 177 paired GET and 147 paired CTT measurements. The measurements for GET and CTT with the Atmo Capsule and SmartPill Capsule were strongly correlated (GET, R=0.73, P<0.01; CTT, R=0.69, P<0.01) and their observed biases were within 10% of the delayed transit margin. Both delayed GET (68/177) and CTT (56/147) were identified in 38% of participants with 84% agreement for identification of both delayed GET (sensitivity 78%, specificity 86%) and CTT (sensitivity 67%, specificity 93%). No serious adverse device effects were reported.</p><p><strong>Conclusions: </strong>The performance characteristics of the Atmo capsule for measurements of GET and CTT, were equivalent to the reference standard WMC with a strong correlation and good device agreement. These results demonstrate that the Atmo Capsule is a valid method for evaluating gastrointestinal transit.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074029","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":"Piecemeal Endoscopic Mucosal Resection is Appropriate for the Majority of Large Nonpedunculated Polyps In The Right Colon.","authors":"Julia L Gauci, Anthony Whitfield, Michael J Bourke","doi":"10.1016/j.cgh.2024.12.012","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.12.012","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074027","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":"Diffuse Esophageal Adenocarcinoma.","authors":"Huijie Wu, Xiaolu Lin, Wanyin Deng","doi":"10.1016/j.cgh.2024.12.021","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.12.021","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074047","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":"Diagnosis and Treatment of Hemochromatosis.","authors":"Paul C Adams, John D Ryan","doi":"10.1016/j.cgh.2024.10.041","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.10.041","url":null,"abstract":"<p><p>Hemochromatosis is not a new disease and genetic variants for hemochromatosis have been identified in human fossils that are over 4,000 years old in North Western Europe¹. These variants were postulated to promote iron absorption as a survival benefit. In contrast, excess iron absorption can lead to serious complications, including arthritis, liver fibrosis, cirrhosis, primary liver cancer, and diabetes. In this review, the emphasis is on recent developments in the diagnosis and treatment of hemochromatosis, focusing on those homozygous for the C282Y variant in the HFE gene. In this condition, there is a clear need for earlier diagnosis leading to earlier treatment to prevent morbidity and mortality from iron overload.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074044","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":"Diagnosis of Retrograde Cricopharyngeus dysfunction using high resolution impedance manometry and comparison with control subjects.","authors":"Karlien Raymenants, Friedel Vulsteke, Tim Vanuytsel, Nathalie Rommel, Filip Baert, Kathelijne Delsupehe, Alexandre Bohyn, Jan Tack, Joris Arts","doi":"10.1016/j.cgh.2024.12.014","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.12.014","url":null,"abstract":"<p><strong>Background and aims: </strong>Retrograde cricopharyngeal dysfunction (R-CPD) or inability to belch has been linked to ineffective relaxation of the upper esophageal sphincter (UES) during gastroesophageal gas reflux, and botulinum toxin (BT) injection into the UES has demonstrated success in case series. However, the diagnosis is often overlooked. High resolution impedance manometry (HRiM) with belch provocation was recently suggested as diagnostic tool. Our aim was to confirm manometric findings in patients with R-CPD before and after BT treatment, and to compare with control patients and healthy volunteers.</p><p><strong>Methods: </strong>Retrospective analysis of HRiM with belch provocation performed between May 2021 and April 2024. Gas reflux episodes were counted and analyzed for UES relaxation, air clearance, air entrapment or oscillatory movements of air in the esophagus, amongst others.</p><p><strong>Results: </strong>Fifty-five patients with symptoms suggestive of R-CPD, 30 control patients and 15 healthy volunteers were included (n=100). Twenty-nine patients had a repeat measurement after treatment with BT (n=29). Median esophageal contractility was lower in R-CPD versus control patients and healthy volunteers (DCI: 146, 577 and 316mmHg.cm.s, p_adj = 0.0109). During belching, we saw higher UES pressures in R-CPD patients vs. controls, leading to incomplete air clearance and air oscillating in the esophagus (p<0.0001). After BT injection, median UES pressures during belching decreased (56 vs 3mmHg) andair clearance improved (p<0.0001). A maximum UES pressure during belching >31mmHg adequately discriminated patients from controls.</p><p><strong>Conclusion: </strong>Rapid drinking challenge with sparkling water can serve as belch provocation test during HRiM, with higher UES pressures during gas reflux and oscillations discriminating R-CPD patients from controls.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074046","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":"Comprehensive Multidisciplinary Evaluation of Dysphagia.","authors":"Jessica W Gregor, David G Lott, Allon Kahn","doi":"10.1016/j.cgh.2024.12.002","DOIUrl":"10.1016/j.cgh.2024.12.002","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037495","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}