Journal of clinical gastroenterology最新文献

{"title":"Real-World Clinical Effectiveness and Safety of Vedolizumab and Ustekinumab in Biologic-Naive Patients With Crohn's Disease By Disease Location: Results from the EVOLVE Expansion Study.","authors":"Michael Scharl, Britt Christensen, Brian Bressler, Neil R Brett, Lauren Gianchetti, Celine Gisler, Pravin Kamble, Shashi Adsul, Zeinab Farhat, Marc Ferrante","doi":"10.1097/MCG.0000000000002186","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002186","url":null,"abstract":"<p><strong>Goals: </strong>This analysis compared the real-world effectiveness and safety of vedolizumab versus ustekinumab in biologic-naive patients by CD location.</p><p><strong>Background: </strong>Crohn's disease (CD) location may affect disease course and treatment decisions.</p><p><strong>Study: </strong>Medical charts of biologic-naive patients with CD aged 18 years or older initiating vedolizumab or ustekinumab were analyzed in the multicenter, observational, retrospective EVOLVE Expansion study. Outcomes with vedolizumab versus ustekinumab over 36 months were compared in patients with baseline isolated ileal, ileocolonic, and isolated colonic CD (Montreal classification).</p><p><strong>Results: </strong>This analysis included 293 patients with ileal (vedolizumab, n=158, ustekinumab, n=135), 185 with ileocolonic (vedolizumab, n=91, ustekinumab, n=94), and 121 with colonic (vedolizumab, n=84, ustekinumab, n=37) CD. Cumulative rates over 36 months were similar between vedolizumab and ustekinumab in ileal, ileocolonic, and colonic CD subgroups for clinical response, remission, mucosal healing, and treatment persistence. There were no differences in risks of serious adverse events, serious infections, CD exacerbations, and CD-related hospitalizations between cohorts across disease location; the risk of CD-related surgeries was similar in patients with ileocolonic and colonic CD, and higher with vedolizumab versus ustekinumab in patients with ileal CD. CD-related surgeries for ileal CD were reported in 12 of 158 (7.6%) vedolizumab-treated patients and 3 of 135 (2.2%) ustekinumab-treated patients.</p><p><strong>Conclusions: </strong>Effectiveness, safety, and health care resource utilization outcomes over 36 months were similar between treatment cohorts regardless of baseline disease location. The number of patients requiring CD-related surgeries was low. Both vedolizumab and ustekinumab can be used as first-line biologics in patients with CD, regardless of disease location.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484504","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 Safety and Efficacy of Colorectal Endoscopic Submucosal Dissection in the Elderly: A Large Western Analysis of 710 Lesions.","authors":"Fares Ayoub, Mai Khalaf, Samanthika Sahasra Devalaraju, Tara Keihanian, Wasseem Skef, Salmaan Jawaid, Mohamed Othman","doi":"10.1097/MCG.0000000000002213","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002213","url":null,"abstract":"<p><strong>Background and study aims: </strong>Colorectal endoscopic submucosal dissection (ESD) is increasingly used for the management of laterally spreading colorectal lesions in the West. With increasing life expectancy and prevalence of colorectal neoplasia, ESD is frequently performed in the elderly. While ESD has been shown to be safe in elderly Eastern populations, there are key differences in endoscopist, patient, and lesion characteristics in the West. We investigated the safety and outcomes of colorectal ESD in a large Western cohort.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed 710 colorectal lesions undergoing ESD at a tertiary medical center from July 2015 to November 2024. Patients were divided into 3 age groups: under 65 years (n=342), 65 to 75 years (n=272), and older than 75 years (n=96). Outcomes included en-bloc and R0 resection rates, procedural and postprocedural adverse events, and length of stay.</p><p><strong>Results: </strong>En-bloc resection rates (87.4%, 80.9%, and 80.2%) and R0 resection rates (69.6%, 68%, and 61.5%) were comparable across the <65, 65 to 75, and ≥75 groups, respectively. Despite higher comorbidities and use of antithrombotics/anticoagulants in the elderly group, overall postprocedure adverse event rates were low and with no significant difference among groups (6.7%, 8.5%, and 6.3%) (P=0.651). A higher length of stay in the ≥75 group was noted compared with the <65, 65 to 75, respectively (1.1 d, vs. 0.6 and 0.5, P<0.001).</p><p><strong>Conclusions: </strong>Colorectal ESD in Western elderly patients by expert endoscopists is safe and effective, with outcomes comparable to younger cohorts. This study supports ESD as a feasible option for managing colorectal neoplasms in an aging population.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475449","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":"Analysis of Esophageal Ulcers Using the Japanese Adverse Drug Event Report Database.","authors":"Teruaki Hayashi, Kazumasa Kotake, Miyu Fujioka, Kenta Yamaoka, Tadashi Shimizu","doi":"10.1097/MCG.0000000000002212","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002212","url":null,"abstract":"<p><strong>Goals: </strong>Identifying oral and parenteral drugs associated with esophageal ulcers is important. A comprehensive analysis of a spontaneous adverse event reporting database can support early detection and prevention of drug-induced esophageal ulcers.</p><p><strong>Background: </strong>Drug-induced esophageal ulcers are primarily associated with orally administered drugs. However, recent studies have suggested potential association with parenterally administered drugs. These parenteral cases have not been comprehensively analyzed in previous research.</p><p><strong>Study: </strong>We conducted disproportionality analysis using data from the Japanese Adverse Drug Event Report (JADER) database between April 2004 and December 2023. Signals for esophageal ulcers were detected using the reporting odds ratio with a 95% confidence interval. Weibull distribution analysis was performed to determine the time to adverse event onset for drugs showing signals of esophageal ulcers. Orally and parenterally administered drugs were analyzed separately.</p><p><strong>Results: </strong>Signals were detected for 15 orally administered drugs and 7 parenterally administered anticancer drugs. Weibull distribution analysis revealed that doxycycline and dabigatran etexilate induced the early onset of pill-induced esophagitis, with median onset times of 8 and 12.5 days. Meanwhile, bevacizumab and paclitaxel showed consistent occurrence patterns of esophageal ulcers throughout the treatment period.</p><p><strong>Conclusions: </strong>Our comprehensive analysis of the JADER database identified signals for esophageal ulcers associated with both oral and parenteral drugs, along with their characteristic onset patterns. These findings highlight the clinical importance of considering the potential for esophageal ulcers with specific oral and parenteral drugs and suggest that early intervention may be crucial in mitigating their occurrence.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475440","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":"Outcomes of Liver Cirrhosis Patients Hospitalized for Influenza Compared With COVID-19 Between 2020 and 2021 in the United States.","authors":"Renuka Verma, Kamleshun Ramphul, Kyaw M Tun, Yasmeen Obeidat, Lily Liu, Hemamalini Sakthivel, Tejas Joshi","doi":"10.1097/MCG.0000000000002199","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002199","url":null,"abstract":"<p><strong>Background: </strong>Early studies during the COVID-19 pandemic showed that liver cirrhosis patients were at risk of more severe outcomes of the disease. Past studies have also linked cirrhosis patients with poorer influenza outcomes following admissions.</p><p><strong>Aim: </strong>To compare how patients with liver cirrhosis fared when admitted for COVID-19 as compared with influenza in the United States.</p><p><strong>Methods: </strong>The National Inpatient Sample (NIS) from 2016 to 2021 was used. The influenza group of cirrhosis patients was extracted for admissions between 2016 and 2019, while the COVID-19 group involved hospitalizations in 2020 and 2021. Baseline characteristics and differences in outcomes were compared between cirrhosis patients with COVID-19 versus influenza.</p><p><strong>Results: </strong>We recruited 59,590 cirrhosis patients, among whom 6800 (11.4%) had influenza and 52790 (88.6%) were infected with COVID-19. COVID-19 cases were younger, with more patients having dyslipidemia, diabetes, chronic kidney disease (CKD), obesity, and dementia, but fewer patients were smokers, peripheral vascular disease (PVD), history of stroke, history of myocardial infarction, drug abuse, alcohol abuse, chronic ischemic heart disease (IHD), asthma, COPD, and cancer. Our propensity-score matched sample had 6670 cases with COVID-19 and 6670 with influenza. COVID-19 patients were more likely to suffer from hyponatremia, acute myocardial infarction, cardiogenic shock, severe septic shock, mechanical ventilation use, prolonged mechanical ventilation use, cardiac arrest, acute ischemic stroke, acute kidney injury, and all-cause death, but fewer cases with ascites, and hepatorenal syndrome.</p><p><strong>Conclusions: </strong>The characteristics of cirrhosis patients admitted with COVID-19 differed from those admitted for influenza, with COVID-19 showing a higher mortality risk and varying differences in other complications.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475445","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":"Gastroesophageal Reflux Disease and Related Conditions Are Associated With Increased Risk for Nontuberculous Mycobacterium Infection.","authors":"Dove-Anna Johnson, Benjamin Liu, Richard J Blinkhorn, Ronnie Fass","doi":"10.1097/MCG.0000000000002201","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002201","url":null,"abstract":"<p><strong>Goals: </strong>We aimed to assess the relationship between nontuberculous mycobacterium (NTM) and gastroesophageal reflux disease (GERD) and associated conditions using a large international database.</p><p><strong>Background: </strong>Several studies suggest increased incidence of NTM pulmonary disease in patients with GERD.</p><p><strong>Study: </strong>Within TriNetX database of over 130 million patients from 16 countries, a test cohort of patients with ICD-10 codes for GERD after esophagogastroduodenoscopy (EGD) was compared with controls without a GERD diagnosis who underwent screening colonoscopy. Five additional test cohorts were created: GERD without esophagitis (NERD), GERD with esophagitis (ERD), esophageal stricture, Barrett's without dysplasia (BWOD), and Barrett's with dysplasia (BWD). Sequential diagnoses were allowed in the test cohorts. One-to-one propensity score matching was performed between the control group and each test group based on age, gender, ethnicity, BMI, comorbidities, use of oral contraceptives, NSAIDs, bisphosphonate, ferrous sulfate, or immunosuppressant agents. Kaplan-Meier and Cox proportional hazards models (HR) were utilized for time-to-event analysis in matched cohorts with the outcome of de novo NTM diagnosis.</p><p><strong>Results: </strong>After matching, cohort populations included: GERD 982,194; NERD 772,557; ERD 287,803; esophageal stricture 72,545; BWOD 79,520; BWD 14,401. After analysis, most cohorts displayed increased risk of NTM diagnosis, but no between-group differences: GERD (HR2.024), NERD (HR2.06), ERD (HR1.758), esophageal stricture (HR1.875), BWOD (HR1.28), and BWD (HR2.781).</p><p><strong>Conclusions: </strong>Our findings suggest a significant association between GERD and its complications with NTM. There was an increased risk of NTM in GERD patients compared with control and no relationship between severity of GERD and likelihood of contracting NTM.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258121","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":"Attentional Biases in Irritable Bowel Syndrome Patients: The Role of Interoception and Anxiety.","authors":"Mladenka Tkalčić, Marko Tončić, Sanda Pletikosić Tončić, Rosana Troskot Perić, Goran Hauser","doi":"10.1097/MCG.0000000000002200","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002200","url":null,"abstract":"<p><strong>Background: </strong>Irritable bowel syndrome (IBS) is considered a disorder of brain-gut interaction. Central processes like selective attention to visceral stimuli are involved in the pathophysiology of IBS. The primary aim of this study was to replicate the Tkalčić and colleagues' experiment using the same modified Stroop task to assess the reliability of previously obtained results. A secondary objective was to explore the proposed associations between attentional indices and various aspects of anxiety and interoceptive accuracy.</p><p><strong>Methods: </strong>Ninety IBS patients and 77 healthy controls (HC) completed a set of questionnaires [State-Trait Anxiety Inventory (STAI-T), Visceral Sensitivity Index (VSI), Anxiety Sensitivity Index (ASI) and Anxious Thoughts Inventory (ATI)] followed by a heartbeat counting task and an emotional Stroop task.</p><p><strong>Results: </strong>Repeated measures 2-way ANOVA showed no significant effects. GLMM results showed that IBS patients had shorter RTs (~50 ms) than HCs. The IBS group scored higher than HC in all anxiety measures, while there were no differences in IAcc. Positive correlations were found among all anxiety measures in both groups. There was a negative correlation of average RT with ASI, ATI, and IAcc, only in the IBS group. IBS patients with higher ASI and ATI have faster RTs, while patients with higher IAcc have lower RTs.</p><p><strong>Conclusions: </strong>Stroop facilitation was not replicated, but IBS patients were faster than HCs. This study provides preliminary evidence that IBS patients may show distinct attentional patterns, marked by a general tendency for faster engagement, independent of stimulus type. This effect may relate to higher interoceptive accuracy and anxiety, and was not observed in HCs.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234295","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":"Diagnostic Accuracy of Tethered Control and Magnetically Controlled Capsule Endoscopy in Esophageal Diseases: A Meta-analysis.","authors":"Jian Yang, Yi-Hu Mao, Qian Zeng","doi":"10.1097/MCG.0000000000002184","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002184","url":null,"abstract":"<p><strong>Background: </strong>Magnetic-controlled capsule endoscopy (MCCE), primarily represented by the ANKON and Mirocam capsule systems, uses tethered control and magnetic control methods, respectively, for esophageal examination. However, due to variations in results and capsule types across studies, conclusions regarding its diagnostic accuracy remain inconsistent.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Embase, Web of Science, and Wanfang databases, covering studies published up to November 4, 2024. To assess the diagnostic accuracy of MCCE for esophageal diseases, we used a bivariate random-effects model in Stata 15.0, synthesizing estimates for sensitivity, specificity, likelihood ratios (LR), diagnostic odds ratio (DOR), and generating a summary receiver operating characteristic (SROC) curve with the corresponding area under the curve (AUC). Where appropriate, sensitivity analyses were performed to assess the stability of the results, and meta-regression was conducted to investigate potential sources of heterogeneity.</p><p><strong>Results: </strong>Ten studies with 1155 patients were analyzed. The pooled sensitivity and specificity of MCCE for diagnosing esophageal diseases were 0.95 (95% CI: 0.92-0.97) and 0.97 (95% CI: 0.92-0.99), respectively. The diagnostic odds ratio (DOR) was 663.00 (95% CI: 157.24-2795.56), and the area under the curve (AUC) was 0.99. The pooled positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 32.72 (95% CI: 11.94-89.71) and 0.05 (95% CI: 0.03-0.09), respectively.</p><p><strong>Conclusions: </strong>This meta-analysis highlights the high sensitivity, specificity, and accuracy of MCCE in diagnosing esophageal diseases, suggesting it as a promising alternative for patients unable to undergo esophagogastroduodenoscopy. However, limited studies and observed heterogeneity may restrict its routine use, emphasizing the need for large-scale, multicenter prospective studies.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234297","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":"Machine Learning for Predicting Colorectal Cancer and Advanced Colorectal Polyps: A Systematic Review and Meta-Analysis.","authors":"Sheza Malik, Arsalan Naqvi, Bettina G Tenorio, Faiqa Farrukh, Raseen Tariq, Douglas G Adler","doi":"10.1097/MCG.0000000000002172","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002172","url":null,"abstract":"<p><strong>Introduction: </strong>Machine learning (ML) has become increasingly pivotal in health care, particularly in colorectal cancer (CRC) detection and diagnosis with the use of predictive models and artificial intelligence-assisted colonoscopies. This study evaluates the efficacy of ML models in predicting the risk for CRC and advanced colorectal polyps (ACP) before colonoscopy.</p><p><strong>Methods: </strong>A systematic literature review was conducted following PRISMA guidelines, focusing on studies using ML for CRC and ACP prediction. Data extraction regarding study type, ML methodology, quality of data, and bias assessment was in line with the CHARMS checklist. Meta-analysis was also performed to assess the performance of models for the prediction of CRC, adenoma, or both.</p><p><strong>Results: </strong>This systematic review included 14 studies with 3618 median patients (333 to 263,879). Our study demonstrated considerable heterogeneity in methodologies and outcomes, with area under the receiver operating characteristic (AUROC) ranging from 0.6 to 1. The derivation+validation cohorts showed a pooled sensitivity of 0.832 (95% CI: 0.755-0.889) and specificity of 0.802 (95% CI: 0.722-0.863), with an overall AUROC of 0.883.</p><p><strong>Conclusion: </strong>The review underscores the significant role of ML in CRC and ACP diagnosis and its routine use could efficiently direct high-risk patients to timely colonoscopies and spare the low-risk ones from unnecessary procedures. Despite the promise shown, the variability in methodologies and outcomes highlights the need for standardized approaches and further investigation in this field.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159402","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":"Prevalence of MASLD, Met-ALD, and ALD and Associated Fibrosis Among US Adults: Insights From NHANES 2017 to 2023.","authors":"James M Paik, Kathryn Hobbs, Amolika Gupta, Rand Jamal Alkalbani, Manuel Alexander Reyes, Zobair M Younossi","doi":"10.1097/MCG.0000000000002202","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002202","url":null,"abstract":"<p><strong>Background and aim: </strong>Steatotic liver diseases (SLD) encompasses metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic alcohol-related liver disease (MetALD), and alcohol-related liver disease (ALD). Our aim was to determine the age-standardized prevalence of fibrosis stages and cirrhosis in US adults with different subtypes of SLD.</p><p><strong>Methods: </strong>We utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2017 to 2023. SLD was defined by a controlled attenuation parameter (CAP) ≥280 dB/m. MASLD, MetALD, and ALD were defined according to the new nomenclature. Fibrosis and cirrhosis were estimated by liver stiffness measurements.</p><p><strong>Results: </strong>The age-standardized prevalence of SLD was 37.08% (MASLD: 32.42%, MetALD: 2.20%, and ALD: 1.29%) with males having higher prevalence rates versus females [SLD (42.40% vs. 31.59%), MASLD (35.84% vs. 28.88%), MetALD (2.82% vs. 1.56%), and ALD (2.17% vs. 0.38%) (all P < 0.03)]. For MASLD, the highest burden was observed in Mexicans (43.96%), followed by Whites (31.75%), Hispanics (32.69%), Asians (32.41%), and Blacks (27.39%). MetALD was most prevalent among Whites (2.56%) and least prevalent among Asians (0.25%). Between 2017 and 2020 and 2021 and 2023, the prevalence of SLD and its subtypes with fibrosis and cirrhosis increased, coinciding with rising alcohol consumption. Among individuals with MASLD, component of metabolic syndrome (type 2 diabetes and Obesity, especially severe obesity with BMI ≥40 kg/m²) were associated with increased risk of fibrosis and cirrhosis.</p><p><strong>Conclusion: </strong>The burden of SLD, its subtypes, and associated fibrosis in the US is substantial. This highlights an urgent need for targeted public health strategies to manage the rising burden of this important liver disease in the US population.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150533","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":"Photodocumentation of Large Colorectal Polyps: An Audit of Image Quality.","authors":"Anthony Kerbage, Natalie Farha, Muhammad T Sarmini, Carole Macaron, Carol Rouphael, Afshin Khan, Carol A Burke","doi":"10.1097/MCG.0000000000002206","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002206","url":null,"abstract":"<p><strong>Background: </strong>Numerous guidelines recommend photodocumentation (PD) of large colorectal polyps ≥10 mm (LP) preresection relative to an open snare or forceps, and suggests postresection PD of the clear resection base. However, no quality metrics have been proposed. We recently reported that preresection and postresection PD occurred in 82% and 52% of 1693 resected LPs, respectively; however, the quality of PD was not ascertained.</p><p><strong>Aims: </strong>To assess the quality of preresection and postresection PD of LPs based on consensus definitions.</p><p><strong>Methods: </strong>Images of LPs resected between 2016 and 2021 were reviewed by 3 gastroenterologists and 1 fellow for assessment of (1) high-quality preresection PD (enough polyp visualized to estimate size), (2) presence of a tool relative to the LP, (3) estimated polyp size, and (4) high-quality postresection PD (clean base without visible polyp tissue). Confidence levels in PD quality assessment and estimated size were provided. Agreement on size was assessed using free-marginal kappa.</p><p><strong>Results: </strong>One hundred ninety-nine LPs with both preresection and postresection images were included. Reviewers' assessment of high-quality preresection PD ranged from 49% to 82% and 51% to 70% for high-quality postresection PD. One percent of preresection images demonstrated an open snare or forceps relative to the LP. Only 74% to 89% of polyps were estimated by reviewers to be ≥10 mm [Kappa=0.66 (95% CI: 0.48-0.64)]. High-level confidence in PD quality and size assessment was lowest in the fellow compared with established gastroenterologists.</p><p><strong>Conclusions: </strong>Although guidelines recommend PD of LPs preresection and postresection, the quality of PD appears suboptimal. Quality standards in LP PD should be considered and the impact of high-quality PD on patient outcomes should be studied.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150485","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}