Gastroenterology最新文献

{"title":"Microscopic Colitis: Clearing the Usual Suspects","authors":"Daniel Keszthelyi","doi":"10.1053/j.gastro.2025.07.024","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.07.024","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"25 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694037","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":"Thoughts on “Noncontrast magnetic resonance imaging vs ultrasonography for hepatocellular carcinoma surveillance”","authors":"Valeria Michelle Fernández-Garibay, Norberto C. Chávez-Tapia","doi":"10.1053/j.gastro.2025.06.028","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.06.028","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"11 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694038","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":"Reply to Shi, Wang et al, and Fernández-Garibay and Chávez-Tapia","authors":"Hyungjin Rhee, Myeong-Jin Kim, Do Young Kim","doi":"10.1053/j.gastro.2025.07.025","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.07.025","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"7 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694036","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":"Enhancement of Inpatient Mortality Prognostication with Machine Learning in a Prospective Global Cohort of Patients with Cirrhosis with External Validation","authors":"Scott Silvey, Patrick S. Kamath, Jacob George, Ashok Choudhury, Qing Xie, Mark Topazian, Hailemichael Desalgn Mekonnen, Zhujun Cao, Aabha Nagral, K Rajender Reddy, Danielle Adebayo, Sumeet K. Asrani, Neil Rajoriya, Marco Arrese, Sevda Aghayeva, Mithun Sharma, Sarai Gonzalez Huezo, Adrian Gadano, Hasan Basri Yapici, Nabil Debzi, Jasmohan S. Bajaj","doi":"10.1053/j.gastro.2025.07.015","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.07.015","url":null,"abstract":"<h3>Background and aims</h3>Cirrhosis is a major global burden requiring frequent hospitalizations with a high inpatient mortality. Traditional prognostic tools focused on inpatient mortality are affected by global disparities, which impacts timely management. We aimed to deploy machine learning (ML) approaches to enhance inpatient mortality prognostication. <u>Methods</u>: Using the prospective CLEARED cohort that enrolls cirrhosis inpatients globally, we used admission-day data to predict inpatient mortality with ML approaches versus logistic regression. Internal validation (75/25 split) and subdivision using World-Bank income status [Low/low-middle (L-LMIC), upper-middle (UMIC), high (HIC)]were performed. The ML model with the best area-under-the-curve (AUC) was externally validated in a US-Veteran cirrhosis inpatient population.<h3>Results</h3>CLEARED Cohort included 7,239 cirrhosis inpatients (64% men, 56±13 years, median MELD-Na 25) from 115 centers globally. 22.5% belonged to LMICs, 41% to UMICs, and 34% to HICs. 11.1% (n=808) of patients died in-hospital. Random-Forest (RF) showed the best AUC (0.815) with high calibration, which was significantly better versus parametric logistic regression and LASSO models (AUC:0.774, <em>p</em>&lt;0.001, AUC:0.787, <em>p</em>=0.004 respectively). RF was the ML method with the highest AUC and remained better than logistic regression regardless of country income-level; HIC (AUC:0.806), UMIC (AUC:0.867), and L-LMICs (AUC:0.768). External validation was performed in 28,670 Veterans (96% men, 67.8±10.3 years, median MELD-Na:15) with 4% (n=1158) inpatient mortality. The AUC using the CLEARED-derived RF-model was 0.859. <u>Conclusion</u>: Random forest analysis trained on a global prospective cirrhosis cohort enhances mortality prediction over traditional methods, is consistent across country income levels, and is successfully validated externally in a US-Veteran population.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"19 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694035","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":"Noncontrast MRI in Hepatocellular Carcinoma Surveillance: Considerations for Implementation in Clinical Practice","authors":"Yuning Wang, Yufei Huang, Guochao Zhang, Shuhang Wang, Ning Li","doi":"10.1053/j.gastro.2025.05.032","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.05.032","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"47 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693994","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":"Visualization Score Might be Considered for Hepatocellular Carcinoma Surveillance","authors":"Xinlong Shi","doi":"10.1053/j.gastro.2025.03.063","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.03.063","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"47 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694029","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":"Semaglutide in MASH: A Promising Step Forward with Room for Improvement","authors":"Sabela Lens","doi":"10.1053/j.gastro.2025.07.023","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.07.023","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"115 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694179","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 (Preview Section)","authors":"","doi":"10.1053/S0016-5085(25)00915-1","DOIUrl":"10.1053/S0016-5085(25)00915-1","url":null,"abstract":"","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"169 2","pages":"Pages A11-A13"},"PeriodicalIF":25.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678267","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":"Gender Equity in Gastroenterology: Perspectives From the AGA Women’s Committee on Current Frameworks and Future Directions","authors":"Loren G. Rabinowitz,&nbsp;Kira Newman,&nbsp;Elisa Boden,&nbsp;Blaire Burman,&nbsp;Asma Khapra,&nbsp;Aimee L. Lucas","doi":"10.1053/j.gastro.2025.06.013","DOIUrl":"10.1053/j.gastro.2025.06.013","url":null,"abstract":"","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"169 2","pages":"Pages 195-199"},"PeriodicalIF":25.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678335","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":"Early infliximab levels and clearance predict outcomes after infliximab rescue in acute severe ulcerative colitis: Results from PREDICT-UC","authors":"Christopher F.D. Li Wai Suen, Matthew C. Choy, Danny Con, Kaylene Cheng, Julie Nigro, Kerry Breheney, Kristy Boyd, Raquel Pena, Kathryn Burrell, Ourania Rosella, David Proud, Richard Brouwer, Alexandra Gorelik, Danny Liew, William Connell, Emily K. Wright, Kirstin Taylor, Aviv Pudipeddi, Michelle Sawers, Britt Christensen, Peter De Cruz","doi":"10.1053/j.gastro.2025.07.020","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.07.020","url":null,"abstract":"<h3>Background and Aims</h3>The role of infliximab therapeutic drug monitoring (TDM) in acute severe ulcerative colitis (ASUC) management is unknown. We aimed to identify whether infliximab TDM is associated with ASUC outcomes.<h3>Methods</h3>Serum and stool samples were collected from patients enrolled in the PREDICT-UC randomised controlled trial (NCT02770040), which compared intensified and standard infliximab rescue in steroid-refractory ASUC. Infliximab levels measured after trial conclusion and clearance derived using pharmacokinetic modelling were correlated with outcomes.<h3>Results</h3>Infliximab levels were measured in 681 serum and 198 faecal samples from 135 patients. Lower day 3 serum infliximab levels predicted infliximab failure on day 14 (AUROC=0.63, <em>P</em>=0.043) and colectomy by 3 months (AUROC=0.77, <em>P</em>=0.0027); a threshold of ≤57.9 ug/mL had 83% sensitivity, 67% specificity, 24% PPV and 97% NPV for colectomy. Patients with high clearance between day 1-7 (≥0.62L/day) were more likely to respond to an initial 10 mg/kg vs 5 mg/kg infliximab dose (RR 1.50, 95%CI 1.01-2.23), and had a higher risk of colectomy if they received an initial 5 mg/kg vs 10 mg/kg dose (HR 4.81, 95%CI 1.09-21.37). In patients with high clearance who did not respond to the first infliximab dose, day 14 response rate was higher with a second 10 mg/kg vs 5 mg/kg dose (38% vs 11%; RR 3.43, 95%CI 1.05-11.19). Day 3 faecal infliximab levels correlated with endoscopic severity and was associated with day 7 non-response (<em>P</em>=0.016).<h3>Conclusion</h3>Early infliximab levels and clearance calculation can predict outcomes in ASUC. This is the first study to demonstrate that high infliximab clearance may be overcome by intensified infliximab dosing.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"24 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678268","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}