Digestive Diseases and Sciences最新文献

{"title":"A Mixed-Methods Approach to Assessing Barriers and Facilitators to Cancer Genetics Care in Black and Latino/a Individuals Impacted by Pancreatic Cancer: The Racial/ethnic Equity in GENetic Education, Risk Assessment, and TEsting (REGENERATE) Study.","authors":"Nicolette Juliana Rodriguez, Tara B Coffin, Andrew J Ward, Juan Felipe Rodriguez, Chinedu Ukaegbu, Allison Rosenzweig, Alyson Caruso, Anna Revette, Barbara Kenner, Scott H Nelson, Michael Goggins, Anirban Maitra, Sapna Syngal","doi":"10.1007/s10620-025-09018-7","DOIUrl":"https://doi.org/10.1007/s10620-025-09018-7","url":null,"abstract":"<p><strong>Purpose: </strong>Pancreatic ductal adenocarcinoma (PDAC) disproportionately impacts Black and Latino/a communities, who are less likely to receive genetic counseling/testing referrals, hindering early cancer detection/prevention access. This study aims to determine the barriers/facilitators to PDAC genetics care/surveillance among Black and Latino/a populations.</p><p><strong>Methods: </strong>This is a concurrent mixed-methods study that utilized electronic surveys and semi-structured focus groups/in-depth interviews (02/14/2022-12/21/2022). This was a volunteer sample of Black or Latino/a general participants with a personal or family history of PDAC and community leaders serving these groups. Participants discussed barriers/facilitators to PDAC cancer genetics care/surveillance. Health literacy, cancer worry, medical trust, and inherited cancer risk were assessed using electronic surveys. Discussions were recorded, transcribed, and analyzed using a content analysis approach. Chi-square tests, two-sample t-tests, and one-way analysis of variance were used to evaluate survey data using R v4.3.2.</p><p><strong>Results: </strong>55 participants (n = 27 general participants, 28 leaders) completed surveys. 27 (49%) self-identified as Black and 23 (42%) as Latino/a. Leaders (74%) reported higher levels of perceived medical mistrust among their communities than general participants (Trust in Physician Scale mean/SD 29.9/4.2 vs. 38.4/5.2, p < 0.001; Medical Mistrust Index = 18.8/4.2 vs. 24.4/3.6; p < 0.001, respectively). General participants self-reported higher digital health seeking capabilities than leaders' perception of that skillset (p < 0.001). 24 of these participants completed a focus group/in-depth interview, emphasizing informed discussions with a trusted/established provider.</p><p><strong>Conclusions: </strong>Individuals impacted by PDAC are open to genetics care and desire resources to promote PDAC surveillance. It is also crucial that leaders and providers be engaged to facilitate access to this care.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988021","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":"Endoscopic Capsule Removal from the Left Main Bronchus with a Gastroscope.","authors":"Adonis A Protopapas, Eleni Trypaki, Vaia Kyritsi, Athanasios Filippidis, Alexandra Tsankof, Christos Savopoulos, Andreas N Protopapas","doi":"10.1007/s10620-025-09078-9","DOIUrl":"https://doi.org/10.1007/s10620-025-09078-9","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978543","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":"Prenatal Exposure to Air Pollution and Pediatric Biliary Atresia: A Nationwide Population-Based Cohort Study.","authors":"Chieh-Chung Lin, Shu-Yen Chan, Wei-Szu Lin, Meng-Che Wu, Natchaya Polpichai, Chien-Heng Lin, James Cheng-Chung Wei","doi":"10.1007/s10620-025-08957-5","DOIUrl":"https://doi.org/10.1007/s10620-025-08957-5","url":null,"abstract":"<p><strong>Introduction: </strong>Biliary atresia (BA) is a serious pediatric liver disease and the leading cause of liver transplants in children. Although its cause is unknown, prior research suggests air pollution may influence childhood diseases. This study examines the potential association between prenatal air pollution exposure and BA incidence.</p><p><strong>Methods: </strong>This nationwide, longitudinal matched case-control study used data from the National Health Insurance Research Database in Taiwan. BA cases were identified using ICD codes in children who underwent the Kasai procedure or liver transplantation. Controls, matched by age, index month, and gender, were selected at a 1:10 ratio. Multivariable logistic regression models, adjusted for potential confounders (age, gender, maternal age, delivery mode, and preterm birth), were utilized to assess the association between individual air pollutants (PSI, SO₂, CO, O₃, PM_2.5, PM₁₀, NO, NO₂, and NO_x) and BA. Quartiles of cumulative air pollutant amounts were analyzed for dose-dependent effects.</p><p><strong>Results: </strong>A total of 1,663,737 first-time pregnancies were identified from 2004 to 2016. After excluding 8,523 newborns due to congenital neonatal defects, 1,655,214 individuals remained. Among them, a cohort of 253 BA patients was identified. After adjusting for multiple confounders, no significant associations were found between prenatal exposure to air pollutants and BA risk. Quartile analysis of cumulative air pollutant exposure also indicated no dose-response relationship with BA risk for each air pollutant.</p><p><strong>Conclusion: </strong>This population-based study found no statistically significant association between prenatal air pollution exposure and the risk of BA in newborns in Taiwan.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990756","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":"Endoscopic Therapy for Anastomotic Bleeding in Inflammatory Bowel Disease.","authors":"Weiwei Zheng, Ravi P Kiran, Bo Shen","doi":"10.1007/s10620-025-09029-4","DOIUrl":"https://doi.org/10.1007/s10620-025-09029-4","url":null,"abstract":"<p><p>Lower gastrointestinal (GI) anastomotic bleeding in patients with inflammatory bowel disease (IBD) is rare but can be detrimental. Time and effective management is critical to prevent morbidity. Endoscopy has emerged as a minimally invasive and highly effective treatment modality for the management of this complication. However, endoscopic treatment for anastomotic bleeding faces challenges such as recurrent bleeding, complication of the procedure, and need for interdisciplinary collaboration. In this study, we focus on the techniques, efficacy, and safety of endoscopic interventions for the treatment of lower GI anastomotic bleeding in patients with IBD.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988374","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":"Regional Portal Hypertension Related to Pancreatic Cancer Surgery.","authors":"Feifei Hou, Hao Yan, Cong Gao, Ran Wang, Xingshun Qi","doi":"10.1007/s10620-025-09063-2","DOIUrl":"https://doi.org/10.1007/s10620-025-09063-2","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973249","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":"Perception and Understanding of Artificial Intelligence Among Gastroenterology Fellows and Early Career Gastroenterologists: A Nationwide Cross-Sectional Survey Study.","authors":"Raseen Tariq, Saam Dilmaghani, Rashmi Advani, Ali Soroush, Tyler Berzin, Sahil Khanna","doi":"10.1007/s10620-025-09067-y","DOIUrl":"https://doi.org/10.1007/s10620-025-09067-y","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI) is expanding rapidly in healthcare, particularly in gastroenterology (GI). Applications include enhancing colonoscopy accuracy, identifying dysplasia, and predicting clinical outcomes in inflammatory bowel disease. Despite AI's potential, concerns about ethical use and inadequate training persist.</p><p><strong>Aims: </strong>This study aimed to evaluate the perceptions and understanding of AI among U.S. GI trainees and early career professionals.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among members of the American College of Gastroenterology. The survey assessed AI experience, confidence, and educational needs, with comparisons between fellows and early career. Fisher's exact test and multivariate regressions were applied to assess differences in responses.</p><p><strong>Results: </strong>A total of 193 respondents completed the survey (54.1% fellows, 45.9% early career). Most respondents (73%) were aged 25-35, and 91.6% believed AI would significantly impact healthcare. Only 6.7% currently use AI in practice, with fellows less likely to use AI compared to early career gastroenterologists (65.4 vs. 82.0%, P = 0.031). Confidence was low overall, with fellows reporting significantly less confidence in interpreting AI findings (P = 0.025) and understanding AI limitations (P = 0.050). A notable gap in the basic understanding of AI concepts, such as machine learning and neural networks, was evident among both groups, particularly fellows. Common concerns included misuse (64.2%), data privacy (40.2%), and financial costs (32.7%).</p><p><strong>Conclusions: </strong>Interest in AI is high, but confidence and experience are limited. Ethical concerns and knowledge gaps highlight the urgent need for structured AI education in GI training. Comprehensive AI curricula focusing on practical use, critical interpretation, and ethics are strongly needed to equip gastroenterologists with the skills for responsible and effective clinical integration.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992149","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":"Liver Transplantation and Metabolic Dysfunction Associated Steatotic Liver Disease Is Associated with Markers of Metabolic Risk and Inflammation.","authors":"Rehan Razzaq, Madison Nguyen, Margery A Connelly, Alok Baral, Hiba Khan, Shreya Garg, Audrey Ang, Alexis Kim, Geneva Roache, Kavish R Patidar, Idris Yakubu, Irina Shalaurova, Stephan J L Bakker, Robin P F Dullaart, Vinay Kumaran, Anh T Bui, Vaishali Patel, Mohammad Shadab Siddiqui","doi":"10.1007/s10620-025-09072-1","DOIUrl":"https://doi.org/10.1007/s10620-025-09072-1","url":null,"abstract":"<p><strong>Background: </strong>Liver transplant (LT) recipients are at high risk of cardiometabolic disease and mortality. However, routinely employed clinical risk tools have sub-optimal diagnostic performance due to transplant related biological changes. Metabolic vulnerability index (MVX) is a serum-based composite biomarker comprised of nutritional risk [metabolic malnutrition index or MMX] and chronic inflammation [inflammatory vulnerability index or IVX]. MVX is a predictor of cardiovascular risk and all-cause mortality in the general population, however, the effect of LT on MVX is unknown.</p><p><strong>Methods: </strong>To better quantify MVX after transplantation, LT recipients (n = 181) prospectively enrolled in a natural history study were matched with non transplant controls from the MESA study of healthy individuals. All controls were matched 1:1 regarding age and gender. Additionally, lean controls were identified as those with BMI < 25 kg/m² and BMI-matched controls who were propensity matched for BMI.</p><p><strong>Results: </strong>Compared to matched controls, LT recipients had significantly higher MVX (56.9 ± 10.1 vs. 45.8 ± 9.4 vs. 44.8 ± 9.3, p < 0.001), IVX [53.1 ± 12 vs. 39.3 ± 11.2 vs. 40.2 ± 10.9, p < 0.001), and MMX (58.7 ± 8.2 vs. 55.4 ± 6.5 vs. 53.1 ± 6.0, p < 0.001). No significant differences were noted in MVX in LT recipients who developed metabolic dysfunction associated steatotic liver disease (MASLD) after LT. In a multivariate analysis, MVX scores were positively associated with female gender, diabetes, serum AST and BMI, and negatively with dyslipidemia.</p><p><strong>Conclusion: </strong>LT is associated with a significant increase in MVX and its components, suggesting a heightened risk in LT recipients that is above that of the non-LT population. Future well designed prospective studies are required to calibrate MVX to clinical outcomes in LT patients.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962227","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":"Anti-tumor Necrosis Factor Drug Concentration Is Not Associated with Disease Outcomes in Pouchitis.","authors":"Punya Chittajallu, Gaurav Syal","doi":"10.1007/s10620-025-09060-5","DOIUrl":"https://doi.org/10.1007/s10620-025-09060-5","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972591","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":"Predictive Factors of Post-ERCP Hepatic Decompensation in Patients with Cirrhosis: A Retrospective Case-Control Study.","authors":"Mohammed Abusuliman, Sanad Dawod, Faisal Nimri, Taher Jamali, Gordon Jacobsen, Muhammad Zarrar Khan, Remy Arwani, Omar Shamaa, Suhaib Alhaj Ali, Spandana Alluri, Rami Youssef, Abdulmalik Saleem, Ahmad Alomari, Muhammad Saad Faisal, Haya Omeish, Muhammad Salman Faisal, Amr Abusuliman, Sumit Singla, Cyrus Piraka, Mazen Elatrache, Tobias Zuchelli","doi":"10.1007/s10620-025-09071-2","DOIUrl":"https://doi.org/10.1007/s10620-025-09071-2","url":null,"abstract":"<p><strong>Background and aim: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) is a crucial diagnostic and therapeutic procedure in patients with cirrhosis; however, it carries the risk of post-procedural hepatic decompensation. This study aims to identify predictive factors associated with post-ERCP hepatic decompensation in patients with cirrhosis to better inform clinical decision-making and minimize adverse outcomes.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients with cirrhosis undergoing ERCP. Clinical, biochemical, and procedural variables were evaluated to determine their association with hepatic decompensation. Multivariate analysis was performed to identify independent predictors.</p><p><strong>Results: </strong>A total of 277 patients with cirrhosis who underwent an ERCP were included. The cohort had a mean age of 63.4 years, with a male predominance (65.3%) and various etiologies of cirrhosis, including alcohol-related (39.3%) and hepatitis C (11.4%). Post-ERCP complications occurred in 26.7% of patients. The most common complications were hepatic decompensation events (18.4%), sepsis (10.8%), and cholangitis (6.1%). Patients with complications had significantly higher baseline MELD scores, INR, chronic kidney disease (CKD) and history of ascites, hepatic encephalopathy, and hepatorenal syndrome (HRS). A Multivariate analysis revealed that factors such as higher MELD score, ascites, hepatic encephalopathy, and stent placement were associated with post-ERCP complications. Subgroup analyses indicated that patients who developed hepatic decompensation events (ascites, SBP, or HRS) had a more severe liver dysfunction at baseline, as reflected by a higher MELD score and INR, and prior episodes of ascites and hepatic encephalopathy.</p><p><strong>Conclusion: </strong>Pre-procedural liver function parameters and procedural factors are crucial predictors of post-ERCP hepatic decompensation in patients with cirrhosis. Key risk factors include higher MELD score, CKD, history of ascites, and hepatic encephalopathy. Careful pre-procedural evaluation and management are essential to reduce these risks.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972872","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":"Vanished! Auto-amputated Ileal Polyp in a Patient with Lynch Syndrome.","authors":"Abdulmalik Saleem, Abdullah S Shaikh, Michael Overman, Sagar A Naik, Wai Chin Foo, Eduardo Vilar, George Triadafilopoulos, Gottumukkala S Raju, David M Richards","doi":"10.1007/s10620-025-09065-0","DOIUrl":"https://doi.org/10.1007/s10620-025-09065-0","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997670","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}