Digestive Diseases and Sciences最新文献

{"title":"Integration of Artificial Intelligence-Enhanced Capsule Endoscopy in Clinical Practice: A Review of Market-Available Tools for Clinical Practice.","authors":"Antonio Giordano, Cristina Romero-Mascarell, Begoña González-Suárez, Carlos Guarner-Argente","doi":"10.1007/s10620-025-09099-4","DOIUrl":"10.1007/s10620-025-09099-4","url":null,"abstract":"<p><p>The integration of artificial intelligence (AI) into capsule endoscopy is transforming gastrointestinal diagnostics by enhancing lesion detection and optimizing reading efficiency. This review focuses on the clinical applications of commercially available AI-powered capsule endoscopy systems, particularly for small bowel evaluation. Recent clinical trials and observational studies are analyzed to assess the diagnostic performance, practical benefits, and limitations of these systems. Additionally, key challenges related to standardization, data quality, and clinical validation are discussed. Currently available AI systems significantly reduce reading times and demonstrate high detection capabilities, depending on the algorithm and device used. However, a substantial number of lesions remain undetected, preventing full reliance on these tools. Future advancements must focus on improving detection rates and validating the clinical relevance of missed lesions. Additionally, standardizing AI algorithms across different capsule systems is essential to ensure consistency, reliability, and broader clinical adoption. Establishing homologation frameworks will be key to achieving uniform performance and seamless integration into routine practice.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"2966-2976"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy, Safety and Long-Term Clinical Outcomes of Low-Dose Versus High-Dose Prednisolone Induction in Autoimmune Hepatitis: A Propensity Score-Matched Analysis.","authors":"Arnav Aggarwal, Shekhar Swaroop, Sagnik Biswas, Shubham Mehta, Sarthak Saxena, Rajkumar Bayye, Umang Arora, Ayush Agarwal, Rimlee Dutta, Rajni Yadav, Prasenjit Das, Samagra Agarwal, Deepak Gunjan, Baibaswata Nayak, Shalimar","doi":"10.1007/s10620-025-09129-1","DOIUrl":"10.1007/s10620-025-09129-1","url":null,"abstract":"<p><strong>Background and aims: </strong>Multiple corticosteroid dosing regimens are used in managing autoimmune hepatitis (AIH). We aimed to compare the efficacy of a low- versus high-dose prednisolone induction regimen in achieving a biochemical response in AIH.</p><p><strong>Methods: </strong>In this retrospective review of a prospectively maintained database, treatment-naive AIH patients treated with prednisolone were categorized into high-dose (> 20 mg/day) and low-dose (≤ 20 mg/day) groups. The primary outcome was the biochemical response, defined as normalization of serum transaminases within 6 months of treatment. Propensity score matching was applied in a 1:1 ratio. Kaplan-Meier survival analysis was used to compare index or further decompensation, and mortality.</p><p><strong>Results: </strong>Of 121 patients, 47 received low-dose and 74 high-dose prednisolone. After matching 45 patients remained in each group: 92.2% received concomitant azathioprine or mycophenolate mofetil, whereas the remaining received prednisolone monotherapy. Six-month biochemical response rates were similar between low- and high-dose groups (62.2% vs. 60.0%; p = 0.829). Patients with cirrhosis had lower response rates than those without cirrhosis, with no difference between low- and high-dose prednisolone in either group. Index decompensation among compensated patients (HR, 1.17; 95% CI 0.26-5.37; p = 0.838), further decompensation among previously decompensated patients (HR, 1.41; 95% CI 0.54-3.71; p = 0.480) were also comparable in the 2 groups. Mortality rates were also similar. There was a trend toward fewer steroid-related side effects in the low-dose group (27.7% vs. 43.2%; p = 0.084).</p><p><strong>Conclusion: </strong>Low-dose (≤ 20 mg/day) prednisolone induction results in similar biochemical response and clinical outcomes compared to a high-dose (> 20 mg/day) regimen in patients with AIH.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"3135-3144"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316193","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":"The Combination of PF-543 and TRAIL Effectively Induces Apoptotic Cell Death and Inhibits Stem Cell-Like Properties Through the SPHK1/S1PR1/STAT3 Pathway in TRAIL-Resistant Colorectal Cancer Cells.","authors":"Se Lim Kim, Min Woo Shin, Byung Chul Jin, Seung Young Seo, Sang Wook Kim","doi":"10.1007/s10620-025-09091-y","DOIUrl":"10.1007/s10620-025-09091-y","url":null,"abstract":"<p><strong>Purpose: </strong>Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) induces apoptosis in various tumor cell types. Although TRAIL can directly trigger cell death, cancer cells may acquire resistance to its apoptotic effects during treatment. Sphingosine kinase 1 (SPHK1) is a key regulator of cancer progression and resistance to therapy. In this study, we determined whether combining TRAIL with PF-543, a specific SPHK1 inhibitor, could circumvent TRAIL resistance in previously established TRAIL-resistant colorectal cancer cells (HCT116-TR cells).</p><p><strong>Methods: </strong>HCT116-TR cells were treated with TRAIL and/or PF-543. Apoptotic cell death and signaling pathways were evaluated using MTT assay, colony formation assay, and flow cytometry analysis. Cell aggressiveness and cancer stemness were assessed through wound healing assay, Matrigel-coated Transwell assay, and tumorsphere formation assay. The underlying molecular mechanisms were examined by Western blotting.</p><p><strong>Results: </strong>Combined treatment with PF-543 significantly enhanced TRAIL-induced apoptosis in HCT116-TR cells and exhibited a synergistic effect. Mechanistically, PF-543 sensitized HCT116-TR cells to TRAIL by activating the mitochondrial apoptosis pathway. Moreover, PF-543 increased TRAIL sensitivity by regulating DcR1 and DR5 through the SPHK1/S1PR1/STAT3 pathway. In addition, combination treatment reduced the aggressiveness and cancer stemness of HCT116-TR cells by modulating the epithelial-mesenchymal transition (EMT) pathway as well as cancer stemness markers.</p><p><strong>Conclusion: </strong>We identified the molecular mechanisms underlying acquired TRAIL resistance in CRC cells and suggest that targeting SPHK1 represents a potential strategy to overcome TRAIL resistance and inhibit CRC metastasis.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"3041-3055"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224740","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":"Application and Value of Percutaneous Catheter Drainage in Contemporary Surgical Treatment of Pancreatic Necrosis.","authors":"Ya Liu, Xiaohan Wang, Haoyu Wang, Yanzhang Tian, Xifeng Fu","doi":"10.1007/s10620-025-09110-y","DOIUrl":"10.1007/s10620-025-09110-y","url":null,"abstract":"<p><p>Acute necrotizing pancreatitis (ANP) is a relatively severe disease in clinical practice, and the selection of treatment strategies has a significant impact on the prognosis of patients. Percutaneous catheter drainage (PCD) serves as an effective treatment method and holds an important position in the treatment of ANP. With the in-depth development of medical research, the intervention strategies and management methods for ANP are constantly evolving. However, there is still controversy regarding when to adopt the step-up approach. This review aims to elaborate on the role of percutaneous catheter drainage, different drainage timings, and the evaluation of various drainage techniques, explore the current status and deficiencies of the research, with the expectation of providing more scientific and reasonable treatment decision-making basis for clinicians in dealing with ANP.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"2977-2989"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Didactic Education on Viral Hepatitis Elimination within Medical School Curricula in the United States.","authors":"Michelle T Martin, Zeba Saiyad, Gerda Mordarski, Alexander Pan, Adam E Mikolajczyk","doi":"10.1007/s10620-025-09111-x","DOIUrl":"10.1007/s10620-025-09111-x","url":null,"abstract":"<p><strong>Background: </strong>The Viral Hepatitis National Strategic Plan documents the value of a collaborative provider workforce trained in the provision of hepatitis treatment and prevention to facilitate the United States' 2030 viral hepatitis elimination efforts.</p><p><strong>Aims: </strong>This study aims to characterize the amount and type of viral hepatitis education topics provided to Doctor of Medicine students during the preclinical phase of medical school.</p><p><strong>Methods: </strong>Investigators developed a 19-item Qualtrics survey and sent survey links to curricula content experts at 157 accredited medical colleges/schools in April-May 2023, and allotted 28 days for survey completion. Survey questions assessed the type, amount, and topics of viral hepatitis instruction provided to Doctor of Medicine students, and the hepatitis instructors' training/experience. We used descriptive statistics for analysis.</p><p><strong>Results: </strong>51 medical institutions across 22 jurisdictions responded; 90% of programs presented hepatitis education as a required part of the curriculum. All education topic respondents confirmed that their institutions provided instruction on viral hepatitis epidemiology, diagnostics, and HBV vaccination. Screening and linkage to care for HBV, HCV, and HDV were included in 69%, 78%, and 33% of curricula, respectively, while 11% of curricula discussed national efforts to eliminate hepatitis by 2030.</p><p><strong>Conclusions: </strong>Survey results show similarities, variability, and gaps in topics devoted to viral hepatitis education across United States medicine curricula. Most programs required hepatitis education in their curricula, many discussed HBV and HCV screening, and few discussed hepatitis elimination. To support national viral hepatitis elimination efforts, ideally, all medical schools should provide education on (1) screening, (2) linkage to care, and (3) national elimination strategies to better equip all future physicians to work toward viral hepatitis elimination.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"3014-3020"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Per-Oral Pancreatoscopy-Guided Lithotripsy Versus Extracorporeal Shock Wave Lithotripsy in Pancreatic Stone: A Meta-Analysis\".","authors":"Noppachai Siranart, Kittithat Tantitanawat","doi":"10.1007/s10620-025-09115-7","DOIUrl":"10.1007/s10620-025-09115-7","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"3172-3173"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246963","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":"Dieulafoy's Disease: Tracing the Hidden Cause of Upper Gastrointestinal Bleeding Using Cinematic Rendering Computed Tomography Angiography.","authors":"Qingzhu Zheng, Xuehua Li","doi":"10.1007/s10620-025-09140-6","DOIUrl":"10.1007/s10620-025-09140-6","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"2902-2903"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274369","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":"Looking Beyond the Barrier for Fecal Incontinence: The Brain-Gut Axis and Central Neurosensory Processes as Treatment Targets.","authors":"Brent A Hiramoto, Susie Lee, Walter W Chan","doi":"10.1007/s10620-025-09114-8","DOIUrl":"10.1007/s10620-025-09114-8","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"2937-2939"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274370","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":"Long-Term Follow-Up of Patients with Cryoglobulinemia After Successful Treatment of Chronic C Virus Hepatitis.","authors":"Noor Fatima, Waqas Ahmed Usmani","doi":"10.1007/s10620-025-09119-3","DOIUrl":"10.1007/s10620-025-09119-3","url":null,"abstract":"<p><p>This critique on the study by Vitalis et al. on al. on \"Long-Term Follow-Up of Patients with Cryoglobulinemia After Successful Treatment of Chronic C Virus Hepatitis\" acknowledge the contributions of authors on investigations of serological response with antiviral therapy. However, the study suggests the remission of vasculitis and non-Hodgkin lymphoma, while the previous studies show the relapse of vasculitis even after extended follow-up. The study lacks to completely describe the biochemical markers (ALT, TC, TG) and the dose or duration of antiviral regimen.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"3165-3166"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191650","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":"Urinary Dysfunction Is Common in Patients with Fecal Urgency and May Relate to Altered Rectal Biomechanics.","authors":"Matthew Woo, Krystyna Pokraka, Milli Gupta, Dorothy Li, Michelle Buresi, Yasmin Nasser, Christopher N Andrews","doi":"10.1007/s10620-025-09105-9","DOIUrl":"10.1007/s10620-025-09105-9","url":null,"abstract":"<p><strong>Background: </strong>Fecal urgency is a common symptom in both healthy patients and in those with bowel dysfunction. Fecal urgency is often thought to be associated with diarrhea and incontinence; however, a portion of patients present with constipation.</p><p><strong>Aim: </strong>Our aim was to assess for the presence of urinary symptoms in patients with fecal urgency and to elucidate the relationship between colorectal/urinary symptoms and anorectal physiologic parameters.</p><p><strong>Methods: </strong>Patients referred for anorectal function testing between 2019 and 2024 were assessed. Those who underwent anorectal manometry, balloon expulsion test, and rapid barostat bag testing alongside completing the Pelvic Floor Distress Inventory (PFDI) were included. Anorectal physiologic parameters were compared with colorectal/urinary symptom burden ((as measured by the CRAD-8 and UDI-6 subscale of the PFDI).</p><p><strong>Results: </strong>Fecal urgency was seen in 50.7% of patients. Patients with fecal urgency reported more fecal incontinence (64.4 vs. 15.5%) and urge urinary incontinence (40.3 vs. 21.5%) and had a higher burden of colorectal and urinary symptoms. Their mean resting anal sphincter pressures (68.0 vs. 78.9 mmHg) were lower as were their squeeze (128.9 vs. 162.9 mmHg) and residual pressures (68.6 vs. 82.4 mmHg). Patients with fecal urgency had feeling of urge and sensation at lower balloon volume (131 vs. 153 ml and 81 vs. 107 ml, respectively.</p><p><strong>Conclusion: </strong>Manometric and biomechanical parameters in patients with fecal urgency, with and without incontinence, are altered. Fecal urgency was associated with higher burden of urinary symptoms, specifically urge incontinence. The correlation between symptoms of fecal and urinary urgency may indicate a shared pathophysiology that requires further study with anorectal physiology and urodynamic testing.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"3110-3119"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198542","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}