Clinical Gastroenterology and Hepatology最新文献

{"title":"Prediction and Prevention of Inflammatory Bowel Disease","authors":"Emily W. Lopes , Williams Turpin , Kenneth Croitoru , Jean-Frederic Colombel , Joana Torres","doi":"10.1016/j.cgh.2024.05.047","DOIUrl":"10.1016/j.cgh.2024.05.047","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 3","pages":"Pages 396-405.e1"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141598780","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)00036-9","DOIUrl":"10.1016/S1542-3565(25)00036-9","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 3","pages":"Pages A5-A7"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388055","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":"Missed Opportunity to Triage Patients With Irritable Bowel Syndrome to Multidisciplinary Therapy","authors":"Bhavana Tetali, William D. Chey, Stacy B. Menees","doi":"10.1016/j.cgh.2024.08.019","DOIUrl":"10.1016/j.cgh.2024.08.019","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 2","pages":"Pages 371-373.e1"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104959","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":"Screening for Social Determinants of Health in Underserved Populations to Promote Better Outcomes in ALD and MASLD","authors":"Michael Sun, Aivi A. Rahman, Vincent J.H. Yao","doi":"10.1016/j.cgh.2024.05.027","DOIUrl":"10.1016/j.cgh.2024.05.027","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 2","pages":"Pages 379-380"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141316864","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":"Development and Validation of a Noninvasive Model for the Detection of High-Risk Varices in Patients With Unresectable Hepatocellular Carcinoma","authors":"Neehar D. Parikh ,&nbsp;Patricia Jones ,&nbsp;Reena Salgia ,&nbsp;Irun Bhan ,&nbsp;Lauren T. Grinspan ,&nbsp;Janice H. Jou ,&nbsp;Kali Zhou ,&nbsp;Prasun Jalal ,&nbsp;Giorgio Roccaro ,&nbsp;Amol S. Rangnekar ,&nbsp;Jihane N. Benhammou ,&nbsp;Anjana Pillai ,&nbsp;Neil Mehta ,&nbsp;Joel Wedd ,&nbsp;Ju Dong Yang ,&nbsp;Amy K. Kim ,&nbsp;Andres Duarte-Rojo ,&nbsp;Omobonike O. Oloruntoba ,&nbsp;Amit Tevar ,&nbsp;Jennifer S. Au ,&nbsp;Amit G. Singal","doi":"10.1016/j.cgh.2024.07.008","DOIUrl":"10.1016/j.cgh.2024.07.008","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Noninvasive variceal risk stratification systems have not been validated in patients with hepatocellular carcinoma (HCC), which presents logistical barriers for patients in the setting of systemic HCC therapy. We aimed to develop and validate a noninvasive algorithm for the prediction of varices in patients with unresectable HCC.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study in 21 centers in the United States including adult patients with unresectable HCC and Child-Pugh A5-B7 cirrhosis diagnosed between 2007 and 2019. We included patients who completed an esophagogastroduodonoscopy (EGD) within 12 months of index imaging but before HCC treatment. We divided the cohort into a 70:30 training set and validation set, with the goal of maximizing negative predictive value (NPV) to avoid EGD in low-risk patients.</div></div><div><h3>Results</h3><div>We included 707 patients (median age, 64.6 years; 80.6% male; 74.0% White). Median time from HCC diagnosis to EGD was 47 (interquartile range, 114) days, with 25.0% of patients having high-risk varices. A model using clinical variables alone achieved an NPV of 86.3% in the validation cohort, whereas a model integrating clinical and imaging variables had an NPV 97.4% in validation. The clinical and imaging model would avoid EGDs in more than half of low-risk patients while misclassifying 7.7% of high-risk patients.</div></div><div><h3>Conclusions</h3><div>A model incorporating clinical and imaging data can accurately predict the absence of high-risk varices in patients with HCC and avoid EGD in many low-risk patients before the initiation of systemic therapy, thus expediting their care and avoiding treatment delays.</div></div>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 2","pages":"Pages 281-290.e4"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874341","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 Large B-Cell Duodenal Lymphoma Presenting With Obstruction and Pneumatosis","authors":"Ramzi Hassouneh ,&nbsp;Michael Morton ,&nbsp;Christen K. Dilly","doi":"10.1016/j.cgh.2024.06.045","DOIUrl":"10.1016/j.cgh.2024.06.045","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 2","pages":"Pages A23-A24"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787378","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":"Performance of a Multi-cancer Early Detection Test for Detection of Hepatocellular Carcinoma in Patients With Cirrhosis","authors":"Darine Daher,&nbsp;Purva Gopal,&nbsp;Marie V. Coignet,&nbsp;Vivian Xiao ,&nbsp;Kathryn N. Kurtzman ,&nbsp;Amit G. Singal","doi":"10.1016/j.cgh.2024.07.016","DOIUrl":"10.1016/j.cgh.2024.07.016","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 2","pages":"Pages 369-370"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792121","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":"Disparities for Hispanic Adults With Metabolic Dysfunction-associated Steatotic Liver Disease in the United States: A Systematic Review and Meta-analysis","authors":"Kaleb Tesfai ,&nbsp;Jordan Pace ,&nbsp;Nora El-Newihi ,&nbsp;Maria Elena Martinez ,&nbsp;Monica A. Tincopa ,&nbsp;Rohit Loomba","doi":"10.1016/j.cgh.2024.06.038","DOIUrl":"10.1016/j.cgh.2024.06.038","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Prevalence and severity of metabolic dysfunction-associated steatotic liver disease (MASLD) is reported to be higher in Hispanic adults in the United States (U.S.), although rates vary substantially across studies and have increased given the evolving obesity epidemic. This systematic review and meta-analysis quantifies MASLD disease burden and severity in contemporary cohorts to characterize health disparities experienced by adult Hispanic individuals in the U.S.</div></div><div><h3>Methods</h3><div>We searched the MEDLINE, Embase, and Cochrane databases per the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies from 2010 to December 2023 were included to capture data representative of current populations given the obesity epidemic. Studies from overlapping cohorts were excluded. Meta-analyses were conducted using random-effects models to estimate pooled prevalence and relative risk (RR) with 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>We identified 22 studies, comprising 756,088 subjects, of which 62,072 were Hispanic. The pooled prevalence in U.S. Hispanic adults was 41% (95% CI, 30%–52%) for MASLD, 61% (95% CI, 39%–82%) for metabolic dysfunction-associated steatohepatitis (MASH), 27% (95% CI, 15%–39%) for MASH-associated advanced fibrosis (AF), and 5% (95% CI, 1%–8%) for MASH cirrhosis. Compared with non-Hispanic adults, Hispanic adults had a RR of 1.50 (95% CI, 1.32–1.69) for MASLD, 1.42 (95% CI, 1.04–1.93) for MASH, 1.37 (95% CI, 0.96–1.96) for MASH-associated AF, and 0.93 (95% CI, 0.49–1.77) for MASH cirrhosis.</div></div><div><h3>Conclusion</h3><div>Health disparities for U.S. Hispanic adults continue to worsen with significantly higher relative risk of MASLD and MASH compared with non-Hispanic adults. Public health efforts to optimize screening and care delivery for the adult Hispanic population are urgently needed.</div></div>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 2","pages":"Pages 236-249"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141691930","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":"How Artificial Intelligence Will Transform Clinical Care, Research, and Trials for Inflammatory Bowel Disease","authors":"Anna L. Silverman ,&nbsp;Dennis Shung ,&nbsp;Ryan W. Stidham ,&nbsp;Gursimran S. Kochhar ,&nbsp;Marietta Iacucci","doi":"10.1016/j.cgh.2024.05.048","DOIUrl":"10.1016/j.cgh.2024.05.048","url":null,"abstract":"<div><div>Artificial intelligence (AI) refers to computer-based methodologies that use data to teach a computer to solve pre-defined tasks; these methods can be applied to identify patterns in large multi-modal data sources. AI applications in inflammatory bowel disease (IBD) includes predicting response to therapy, disease activity scoring of endoscopy, drug discovery, and identifying bowel damage in images. As a complex disease with entangled relationships between genomics, metabolomics, microbiome, and the environment, IBD stands to benefit greatly from methodologies that can handle this complexity. We describe current applications, critical challenges, and propose future directions of AI in IBD.</div></div>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 3","pages":"Pages 428-439.e4"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141589746","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":"All FODMAPs Aren’t Created Equal: Results of a Randomized Reintroduction Trial in Patients With Irritable Bowel Syndrome","authors":"Shanti Eswaran ,&nbsp;Kara J. Jencks ,&nbsp;Prashant Singh ,&nbsp;Samara Rifkin ,&nbsp;Theresa Han-Markey ,&nbsp;William D. Chey","doi":"10.1016/j.cgh.2024.03.047","DOIUrl":"10.1016/j.cgh.2024.03.047","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div><span>A diet low in fermentable oligo, di, monosaccharides<span>, and polyols (FODMAPs) is one of the recommended management strategies for </span></span>irritable bowel syndrome (IBS). However, while effective, adherence to restricting dietary FODMAPs can be challenging and burdensome. The question remains whether limiting all FODMAPs during the restrictive phase of the diet is necessary for symptomatic improvement in the dietary treatment of IBS, or if targeting selected groups of FODMAPs for restriction is sufficient for clinical response. Our study aimed to determine which individual FODMAPs are most likely to lead to symptom generation in patients with IBS who have improved with fodmap restriction.</div></div><div><h3>Methods</h3><div>Patients meeting Rome IV criteria for IBS were invited to participate in a 12-week study to identify individual FODMAP sensitivities. Those subjects who demonstrated symptom improvement after a 2- to 4-week open-label FODMAP elimination period were recruited to a 10-week blinded-phased FODMAP reintroduction phase of 7 days for each FODMAP. Throughout the study period, daily symptom severity (0–10 point numerical rating system) was recorded. A mixed effect statistical analysis model was used.</div></div><div><h3>Results</h3><div><span>Between 2018 and 2020, 45 subjects were enrolled. Twenty-five subjects improved with FODMAP elimination, and 21 patients continued into the reintroduction phase of the study. Fructans and galacto-oligosaccharides (GOS) both were associated with worsened abdominal pain (</span><em>P</em> = .007 and <em>P</em> = .04, respectively). GOS were associated with an increase in bloating (<em>P</em> = 03). Both bloating and abdominal pain worsened throughout the study, regardless of the FODMAP reintroduction (<em>P</em> = .006).</div></div><div><h3>Conclusion</h3><div>Our results suggest that the reintroduction of select FODMAPs may be responsible for symptom generation in patients with IBS who have responded to a low FODMAP diet, and provide a strong rationale for performing a future trial comparing the treatment effects of a limited low-FODMAP diet and a standard low-FODMAP diet.</div></div><div><h3>Clinicaltrials.gov</h3><div><span><span>NCT03052439</span><svg><path></path></svg></span></div></div>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 2","pages":"Pages 351-358.e5"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904262","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}