Clinics and research in hepatology and gastroenterology最新文献

{"title":"Metabolomic biomarkers enhance prediction of feeding intolerance in ICU septic patients","authors":"Kunlin Hu ,&nbsp;Shulin Xiang ,&nbsp;Jing Pang ,&nbsp;Baoyue Huang ,&nbsp;Bin Xiong","doi":"10.1016/j.clinre.2025.102731","DOIUrl":"10.1016/j.clinre.2025.102731","url":null,"abstract":"<div><h3>Background</h3><div>Accurate assessment of enteral feeding intolerance (ENFI) in septic patients remains challenging, as existing clinical tools show limited predictive value.</div></div><div><h3>Methods</h3><div>A prospectively cohort of 60 patients with sepsis (30 ENFI, 30 with feeding tolerance) and 20 healthy controls was enrolled. Serum samples were drawn for metabolomic profiling on the 1st day following sepsis. LC/MS was used to profile serum metabolites. The feeding intolerance outcome was collected at 14 days after ICU admission. Using a deep learning algorithm, we developed three ENFI prediction models: a metabolite-based model, a clinical risk model, and a new combined model integrating both feature types.</div></div><div><h3>Results</h3><div>The metabolite-based model included four key biomarkers—palmitic acid, histidine-threonine, glutamate-histidine, and dehydrobilirubin—and achieved an area under the receiver operating characteristic curve (AUC) of 0.85. The clinical model, based on variables such as APACHE II score, intra-abdominal pressure, and albumin, achieved an AUC of 0.88. The combined model demonstrated the best performance, with an AUC of 0.94. It also showed higher accuracy, precision, F1-score, and net benefit in decision curve analysis, particularly when the risk threshold exceeded 4%. Statistical comparisons confirmed its superiority (Net Reclassification Index = 0.33, Integrated Discrimination Improvement = 0.31, <em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Integrating metabolomics with clinical data significantly improves ENFI risk prediction in septic patients. External validation is warranted before clinical application.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102731"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherent-invasive E. coli (AIEC) in Crohn’s disease: where are we in 2025? Tribute to Professor Nicolas Barnich","authors":"Anthony Buisson ,&nbsp;Jérémy Denizot","doi":"10.1016/j.clinre.2025.102727","DOIUrl":"10.1016/j.clinre.2025.102727","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102727"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal stromal tumor presenting in the pancreas","authors":"Jia-Lu Long,&nbsp;Peng Liu","doi":"10.1016/j.clinre.2025.102715","DOIUrl":"10.1016/j.clinre.2025.102715","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102715"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and economic outcomes of adding durvalumab to gemcitabine/cisplatin in advanced biliary tract cancers: A multicenter descriptive study","authors":"Lena Luciani ,&nbsp;Claire Carlier ,&nbsp;Léonie Leuk ,&nbsp;Justine Clarenne ,&nbsp;Violaine Lepage ,&nbsp;Marine Perrier ,&nbsp;Olivier Bouché ,&nbsp;Elia Gigante ,&nbsp;Florian Slimano","doi":"10.1016/j.clinre.2025.102733","DOIUrl":"10.1016/j.clinre.2025.102733","url":null,"abstract":"<div><h3>Background</h3><div>Durvalumab in combination with gemcitabine/cisplatin (GemCis) has expanded therapeutic options for advanced biliary tract cancers (BTCs), raising both clinical and economic considerations. We aim to describe the efficacy, safety and economic impact of durvalumab addition.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed cohorts of patients receiving GemCis ± durvalumab. Progression-Free Survival (PFS) and Overall Survival (OS) were estimated using the Kaplan–Meier method. The economic impact of different dosing strategies was explored through scenario-based analyses.</div></div><div><h3>Results</h3><div>Median PFS was 7.4 months (95 %CI: 5.4–10.8) in the GemCis-durvalumab group and 6.1 months (95 %CI: 4.0–7.1) in the GemCis group. Median OS was 10.0 months (95 %CI: 5.9–12.8) and 9.7 months (95 %CI: 6.5–12.8), respectively. No severe immune related adverse events were reported. The median treatment cost per patient was €36,342 for GemCis-Durvalumab versus €173 for GemCis alone. Economic analysis suggested that adjusting durvalumab dosing (20mg/kg instead of a flat dose) could lead to saved costs of €344 to €2547 per infusion without affecting outcomes.</div></div><div><h3>Conclusions</h3><div>This study confirms effectiveness of durvalumab, aligning with clinical trial results. However, the substantial economic burden underscores the importance of optimizing dosing strategies. The recent approval of pembrolizumab further highlights the need for prospective cost-benefit comparisons studies incorporating predictive biomarkers.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102733"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cirrhotic cardiomyopathy in children: A comprehensive assessment using ECG, echocardiography, and NT-Pro-BNP","authors":"Ataollahi Maryam ,&nbsp;Naghshzan Amir ,&nbsp;Haghighat Mahmood ,&nbsp;Dehghani Mohsen ,&nbsp;Amuzgar Hamid ,&nbsp;Kalvandi Gholamreza ,&nbsp;Mehdizadegan Nima ,&nbsp;Salarian Leila","doi":"10.1016/j.clinre.2025.102721","DOIUrl":"10.1016/j.clinre.2025.102721","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the prevalence, diagnostic criteria, and predictive factors of cirrhotic cardiomyopathy (CCMP) in pediatric patients with portal hypertension (PHTN), using electrocardiography (ECG), echocardiography, and NT-proBNP levels.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 54 children with portal hypertension (45 with cirrhosis and 9 without), and 54 age- and sex-matched healthy controls. All participants underwent ECG, echocardiography, and NT-proBNP testing. CCMP was diagnosed based on the Møller-Henriksen criteria. Demographic, clinical, and laboratory variables, including PELD/MELD and Child-Pugh scores, were analyzed. Logistic regression was used to identify predictors of CCMP.</div></div><div><h3>Results</h3><div>CCMP was identified in 14 cirrhotic patients (31.1 %), with 9 symptomatic and 5 silent cases. No cases were observed among non-cirrhotic patients or controls. The presence of ascites and higher PELD/MELD scores were significantly associated with CCMP. QTc prolongation and reduced ejection fraction were key diagnostic findings. Systolic dysfunction was present in 3 patients, and 4 patients with CCMP died before or shortly after liver transplantation. Multivariate analysis confirmed PELD/MELD score as a significant predictor of CCMP (OR 1.19; 95 % CI 1.038–1.367; p=0.01).</div></div><div><h3>Conclusion</h3><div>Cirrhotic cardiomyopathy is a prevalent but often silent complication in children with cirrhosis and PHTN. Elevated PELD/MELD scores and the presence of ascites are important predictive factors. Routine cardiac evaluation using ECG, echocardiography, and biomarkers like NT-proBNP is recommended for early detection and risk stratification in this population.</div></div><div><h3>Main Points</h3><div>Cirrhotic cardiomyopathy (CCMP) is an uncommon yet serious condition in children with liver disease. Current diagnostic criteria require reassessment for pediatric use, particularly considering regional genetic and environmental differences.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102721"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145408441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discrete, but devastating: duodenal lymphangiosis carcinomatosa","authors":"Vincent Zimmer ,&nbsp;Roland Heyny-von Haußen","doi":"10.1016/j.clinre.2025.102729","DOIUrl":"10.1016/j.clinre.2025.102729","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102729"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is cholecystectomy a real risk factor for Metabolic dysfunction-associated steatotic liver disease (MASLD)? A longitudinal cohort study from a population with a high burden of gallbladder diseases","authors":"Oscar Corsi ,&nbsp;Constanza Jara ,&nbsp;Magdalena Fernandez ,&nbsp;Antonia Pastore ,&nbsp;Diego Pérez ,&nbsp;Alonso Valdes ,&nbsp;Álvaro Huete ,&nbsp;Eduardo Briceño ,&nbsp;Juan Pablo Arab ,&nbsp;Francisco Barrera ,&nbsp;Marco Arrese ,&nbsp;Roberto Candia","doi":"10.1016/j.clinre.2025.102732","DOIUrl":"10.1016/j.clinre.2025.102732","url":null,"abstract":"<div><h3>Background</h3><div><strong>:</strong> Cholecystectomy due to gallstones is one of the most frequent surgeries worldwide. Observational studies suggest that cholecystectomy may be a risk factor for metabolic dysfunction associated with steatotic liver disease (MASLD). However, gallstone disease and MASLD share common risk factors, which could make cholecystectomy a confounder.</div></div><div><h3>Aim</h3><div>To assess the relationship among cholecystectomy, gallstones, and MASLD in a longitudinal cohort study from a population at high risk of gallbladder diseases.</div></div><div><h3>Methods</h3><div>A longitudinal retrospective cohort study compared consecutive patients undergoing cholecystectomy with a control group composed of patients with their gallbladder intact. All participants had normal liver imaging and biochemistry at baseline. Participants with incomplete clinical records or significant alcohol consumption were excluded. The primary outcome was the development of MASLD after a follow-up of at least 3 years. Cox regression models were used to conduct multivariable analyses.</div></div><div><h3>Results</h3><div>We included 427 participants 132 in the cholecystectomy group and 295 controls. The mean age was 47.2 years, with 71.7% being female, and 43.6% having gallstone disease. The median follow-up was 9.7 years. In the Cox multivariate analysis, male gender (aHR: 1.56 [1.09-2.24]), gallstone disease (aHR: 2.18 [1.42-3.36]), prediabetes (aHR: 1.56 [1.06-2.3]), diabetes (aHR: 2.39 [1.38-4.13]), and overweight/obesity (aHR: 5.7 [3.19-10.21]) were independent risk factors for MASLD. After adjustment, cholecystectomy was not associated with MASLD incidence (aHR: 0.68 [0.44-1.03]). Sensitivity analyses supported these findings.</div></div><div><h3>Conclusion</h3><div>Cholecystectomy was not found to significantly influence the incidence of MASLD after adjusting for metabolic risk factors. The risk of developing MASLD is likely driven by metabolic factors and previous gallstone disease.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102732"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145556324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on IBD management: What's new in acute severe UC? - Modern management of perianal disease","authors":"David Laharie ,&nbsp;Pauline Rivière ,&nbsp;Amandine Landemaine ,&nbsp;Guillaume Bouguen","doi":"10.1016/j.clinre.2025.102725","DOIUrl":"10.1016/j.clinre.2025.102725","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102725"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A fishbone hidden for 2 months: Successfully located by endoscopic ultrasound and removed by submucosal tunnel endoscopic resection","authors":"Jingxia Yu ,&nbsp;Wenhui Xia ,&nbsp;Lei Xu ,&nbsp;Qianqian Wang ,&nbsp;Yuxuan Chen ,&nbsp;Shuo Zhang","doi":"10.1016/j.clinre.2025.102730","DOIUrl":"10.1016/j.clinre.2025.102730","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102730"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A strawberry-like polyp in the rectum","authors":"Vincent Zimmer ,&nbsp;Kristina Welte","doi":"10.1016/j.clinre.2025.102711","DOIUrl":"10.1016/j.clinre.2025.102711","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 9","pages":"Article 102711"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}