Gastroenterology最新文献

{"title":"A Rare Cause of Refractory Melena and Recurrent Intestinal Obstruction","authors":"Pengguang Yan, Xiang XU, Ji Li","doi":"10.1053/j.gastro.2025.03.020","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.03.020","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"28 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734410","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":"AI-Enabled Clinical Trials in IBD: Automating and Enhancing Disease Assessment and Study Management","authors":"Ryan W. Stidham, Louis R. Ghanem, Joel G. Fletcher, David H. Bruining","doi":"10.1053/j.gastro.2025.02.039","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.02.039","url":null,"abstract":"Artificial intelligence (AI) will fundamentally improve how we perform clinical trials by addressing issues of standardizing disease scoring, improving the sensitivity and precision of activity and phenotype assessments, and automating laborious and time-consuming study functions. Progress in AI image analysis is quickly proving to replicate expert judgement in endoscopy, histology, and cross-sectional imaging with speed, reproducibility, and reduced bias. However, AI analytics offer the ability to quantify disease characteristics with more detail and precision than human experts. Large language models and generative AI are automating the collection of high-quality data from electronic records and improving our ability to predict patient outcomes. This narrative review will focus on AI tools available today, their expected implementation, and future-facing opportunities for AI to reimagine IBD clinical trials.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"125 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723646","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":"Heavy Metals and Inflammatory Bowel Disease","authors":"Samuel Narvey, Jean-Eric Ghia, Ruth Ann Marrie, Heather Armstrong, Charles N. Bernstein","doi":"10.1053/j.gastro.2025.03.018","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.03.018","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"41 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723647","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":"Active inflammatory bowel disease on intestinal ultrasound during pregnancy is associated with an increased risk of adverse pregnancy and neonatal outcomes independent of clinical and biochemical disease activity.","authors":"Ralley E. Prentice, Emma K. Flanagan, Emily K. Wright, Michael T. Dolinger, Zoe Gottlieb, Alyson L. Ross, Megan Burns, Danny Con, Edward Shelton, Ray Boyapati, Ilyra Aronsky, Gregory T. Moore, William Connell, Miles P. Sparrow, Peter De Cruz, Michael A. Kamm, Ilana Prideaux, Rimma Goldberg, Katerina V. Kiburg, Marla C. Dubinsky, Sally J. Bell","doi":"10.1053/j.gastro.2025.03.016","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.03.016","url":null,"abstract":"<h3>Background and Aims</h3>Clinically active inflammatory bowel disease (IBD) is associated with an increased risk of adverse pregnancy outcomes. However, the validity of clinical scores to assess antenatal disease activity is questionable. We aimed to assess whether active disease defined by intestinal ultrasound (IUS) may predict adverse pregnancy outcomes.<h3>Methods</h3>This international prospective cohort study recruited pregnant individuals with IBD from 2017-2023 from three specialist IBD pregnancy services. Participants underwent clinical assessments and fecal calprotectin (FCP) testing in each trimester (T1, T2, and T3), and six weeks postpartum. IUS was performed in T1 and/or T2 when referral timing allowed. Univariable and multivariable log-binomial regression analyses were used to estimate the impact of IUS activity on pregnancy outcomes. Cohen κ coefficients were used to determine agreement between FCP, IUS and clinical disease activity.<h3>Results</h3>377 participants, 198 with Crohn’s Disease (CD), were recruited. 234 women underwent an IUS during pregnancy. A maximal bowel wall thickness (BWT) &gt;6mm in T2 was associated with a four-fold increased risk of prematurity (RR 4.01; 95% CI1.26-12.72, p=0.018) and two-fold increased risk of low-birth-weight delivery (2.19; 1.01-4.72, p=0.046). Hyperemia on IUS in T2 was associated with a three-fold increase in preeclampsia risk (3.46, 1.03-11.12, p=0.046). Each 1mm increase in BWT in T2 was estimated to increase the risk of gestational diabetes (1.08 (1.088-1.089) p&lt;0.001) Agreement between clinical (HBI or SCCAI) and IUS/FCP activity during pregnancy was weak, particularly for CD.<h3>Conclusion</h3>Active IBD on IUS in pregnancy is associated with an increased risk of adverse pregnancy outcomes, independent of clinical activity and FCP. Use of IUS monitoring antenatally should be considered to guide therapeutic decision making.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"4 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143703041","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":"Deconstructing Diagnostic Upper Endoscopy for the Novice Learner: A Delphi Survey of Gastroenterology Program Directors","authors":"Navin L. Kumar, Ryan F. Flanagan, Adam E. Mikolajczyk, Justin L. Sewell","doi":"10.1053/j.gastro.2025.03.017","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.03.017","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"70 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675385","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":"Clinical Implementation of Artificial Intelligence in Gastroenterology: Current Landscape, Regulatory Challenges, and Ethical Issues","authors":"Ahmed El-Sayed, Laurence B. Lovat, Omer F. Ahmad","doi":"10.1053/j.gastro.2025.01.254","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.01.254","url":null,"abstract":"Artificial intelligence (AI) is set to rapidly transform gastroenterology, particularly in the field of endoscopy, where algorithms have demonstrated efficacy in addressing human operator variability. However, implementing AI in clinical practice presents significant challenges. The regulatory landscape for AI as a medical device (AIaMD) continues to evolve with areas of uncertainty. More robust studies generating real-world evidence are required to ultimately demonstrate impact on patient outcomes. Cost-effectiveness data and reimbursement models will be pivotal for widespread adoption. Novel challenges are posed by emerging technologies such as generative AI. Ethical and medicolegal concerns exist relating to data governance, patient harm, liability and bias. This review provides an overview for AI clinical implementation in gastroenterology and offers potential solutions to current barriers.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"220 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675415","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":"Systemic identification of functionally conserved lncRNA metabolic regulators in human and mouse livers","authors":"Chengfei Jiang, Zhe Li, Sunmi Seok, Ping Li, Yonghe Ma, Stephanie K. Podguski, Shria Moturi, Nao Yoneda, Kenji Kawai, Shotaro Uehara, Yasuyuki Ohnishi, Hiroshi Suemizu, Jinwei Zhang, Haiming Cao","doi":"10.1053/j.gastro.2025.03.015","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.03.015","url":null,"abstract":"<h3>BACKGROUND &amp; AIMS</h3>Unlike protein-coding genes, most human long non-coding RNAs (lncRNAs) lack conservation based on their sequences, posing a challenge for investigating their role in a pathophysiological context for clinical translation. This study explores the hypothesis that non-conserved lncRNAs in human and mouse livers may share similar metabolic functions, giving rise to functionally conserved lncRNA metabolic regulators (fcLMRs).<h3>METHODS</h3>We developed a sequence-independent strategy to select putative fcLMRs, and performed extensive analysis to determine the functional similarities of putative human and mouse LMR pairs (h/mLMRs).<h3>RESULTS</h3>We found that several pairs of putative fcLMRs share similar functions in regulating gene expression. We further demonstrated that a pair of fcLMRs, h/mLMR1, robustly regulated triglyceride levels by modulating the expression of a similar set of lipogenic genes. Mechanistically, h/mLMR1 binds to PABPC1, a regulator of protein translation, via short motifs on either lncRNA with divergent sequences but similar structures. This interaction inhibits protein translation, activating an amino acid-mTOR-SREBP1 axis to regulate lipogenic gene expression. Intriguingly, PABPC1-binding motifs on each lncRNA fully rescued the functions of their corresponding LMRs in the opposite species. Given the elevated expression of h/mLMR1 in humans and mice with hepatic steatosis, the PABPC1-binding motif on hLMR1 emerges as a potential non-conserved human drug target whose functions can be fully validated in a physiologically relevant setting before clinical studies.<h3>CONCLUSIONS</h3>Our study supports that fcLMRs represent a novel and prevalent biological phenomenon, and deep phenotyping of genetic mLMR mouse models constitutes a powerful approach to understand the pathophysiological role of lncRNAs in the human liver.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"33 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675416","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":"Rifaximin does not increase the rate of 30-day mortality in patients with cirrhosis and daptomycin in two National US-based cohorts","authors":"Scott Silvey, Nilang Patel, Alexander Khoruts, Jasmohan S. Bajaj","doi":"10.1053/j.gastro.2025.03.014","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.03.014","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"27 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672493","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":"Complications of ERCP","authors":"Monique Barakat, Monica Saumoy, Nauzer Forbes, B. Joseph Elmunzer","doi":"10.1053/j.gastro.2025.03.009","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.03.009","url":null,"abstract":"Up to one in six patients will experience an unplanned hospitalization after endoscopic retrograde cholangiopancreatography (ERCP), largely for the evaluation and management of adverse events. Therefore, a commitment to the prevention, early recognition, and effective rescue of complications related to ERCP is critical toward improving outcomes. ERCP is most often complicated by acute pancreatitis, bleeding, infection, or perforation, although myriad other adverse events may occur. The prevention of post-ERCP pancreatitis has been the area of greatest interest and progress in the last decade, but the application of evidence-based prophylactic measures remains inconsistent. Innovations in stent, hemostasis, and perforation closure technology now allow effective and efficient endoscopic management of several important non-pancreatitis complications. Overall, our ability to prevent and treat ERCP related adverse events has improved substantially, amplifying the importance of a high level of suspicion for, and a thorough understanding of these events.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"37 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660553","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":"High-flow nasal cannula oxygen therapy reduces the incidence of hypoxia during deeply sedated endoscopy","authors":"Rishad Khan","doi":"10.1053/j.gastro.2025.03.012","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.03.012","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"70 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143666331","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}