United European Gastroenterology Journal最新文献

筛选
英文 中文
Multiple Concomitant Precipitating Factors of Hepatic Encephalopathy Are Associated With a Poor Prognosis in Patients With Cirrhosis Admitted to Intensive Care Unit. 肝性脑病的多重并发诱发因素与重症监护病房收治的肝硬化患者预后不良相关
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-06-01 Epub Date: 2025-03-11 DOI: 10.1002/ueg2.12706
Marika Rudler, Marie de Matharel, Charlotte Bouzbib, Sarah Mouri, Lyes Kheloufi, Nicolas Weiss, Philippe Sultanik, Dominique Thabut
{"title":"Multiple Concomitant Precipitating Factors of Hepatic Encephalopathy Are Associated With a Poor Prognosis in Patients With Cirrhosis Admitted to Intensive Care Unit.","authors":"Marika Rudler, Marie de Matharel, Charlotte Bouzbib, Sarah Mouri, Lyes Kheloufi, Nicolas Weiss, Philippe Sultanik, Dominique Thabut","doi":"10.1002/ueg2.12706","DOIUrl":"10.1002/ueg2.12706","url":null,"abstract":"<p><strong>Introduction: </strong>Management of hepatic encephalopathy relies on the identification and control of precipitating factors (PF). The prognostic value of a PF is unknown, which we aimed to explore.</p><p><strong>Patients and methods: </strong>Single-center retrospective study of cirrhotic patients included in a prospective cohort admitted to an intensive care unit (ICU) between 2019 and 2022.</p><p><strong>Inclusion criteria: </strong>cirrhosis; overt hepatic encephalopathy; ammonemia ≥ 50 μmol/L. PF considered: gastrointestinal bleeding, infection, acute renal injury (AKI), hyponatremia, constipation, non-adherence to ammonia-lowering therapy, TIPS, drugs precipitating overt hepatic encephalopathy. The primary endpoint was 1-year transplant-free survival (TFS). Secondary endpoint was recurrence of hepatic encephalopathy.</p><p><strong>Results: </strong>179/497 patients were included (men 72%, age 59, cause of cirrhosis alcohol (ALD)/metALD/MASLD/other in 41/21/6/32%, Child-Pugh A/B/C in 1/18/81%, West Haven grade 2/3/4 in 63/15/22%, MELD score 23). Reasons for admission were: gastrointestinal bleeding (31%), acute encephalopathy (28%), worsening liver function/jaundice (25%), infection (8%), and AKI (8%). All patients (100%) had at least one PF of hepatic encephalopathy (infection [64%], AKI [63%], drugs [41%], bleeding [36%], hyponatremia [22%], TIPS [12%], and constipation [1%]), and 82% had multiple concomitant PF. In-hospital mortality was 50%, and median TFS was 0.8 months. In multivariate analysis, factors associated with death or liver transplantation were the number of PF, MELD and Child-Pugh scores, ACLF, AKI and infection. Hepatic encephalopathy reoccurred in 42% (median delay of 30 months).</p><p><strong>Conclusion: </strong>All patients had precipitating factor of hepatic encephalopathy, 82% of them having multiple concomitant precipitating factors. Concomitant multiple precipitating factors were associated with death or liver transplantation. A systematic screening for all precipitating factors of hepatic encephalopathy should be proposed for cirrhotics admitted to intensive care unit.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"738-749"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Role of Environmental Factors Prior to Diagnosis on the Activity and Severity of Inflammatory Bowel Diseases-Results From the Prospective Population-Based Copenhagen Inflammatory Bowel Disease Inception Cohort. 诊断前环境因素对炎症性肠病活动性和严重程度的作用——来自前瞻性人群基础的哥本哈根炎症性肠病初始队列的结果
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-06-01 Epub Date: 2025-01-29 DOI: 10.1002/ueg2.12737
Mohamed Attauabi, Gorm Roager Madsen, Flemming Bendtsen, Johan Burisch, Jakob Benedict Seidelin
{"title":"The Role of Environmental Factors Prior to Diagnosis on the Activity and Severity of Inflammatory Bowel Diseases-Results From the Prospective Population-Based Copenhagen Inflammatory Bowel Disease Inception Cohort.","authors":"Mohamed Attauabi, Gorm Roager Madsen, Flemming Bendtsen, Johan Burisch, Jakob Benedict Seidelin","doi":"10.1002/ueg2.12737","DOIUrl":"10.1002/ueg2.12737","url":null,"abstract":"<p><strong>Background: </strong>The influence of environmental factors on the severity of early inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), is unclear. Herein, we aimed to investigate the role of environmental factors in the initial phenotype, activity, and severity of IBD.</p><p><strong>Methods: </strong>Copenhagen IBD Inception Cohort is a prospective population-based cohort of patients with newly diagnosed IBD between May 2021 and May 2023. Data on environmental factors were captured at IBD diagnosis using International Organisation of IBD (IOIBD) and HeartDiet questionnaires. Environmental factors' influence on outcome was analyzed and odds ratios (aOR) were adjusted for age, gender, and disease characteristics (adjusted OR, aOR [95% confidence interval]).</p><p><strong>Results: </strong>In total, 208 and 128 patients with incident UC and CD, respectively, were included. Active smoking was associated with increased risk of CD-related hospitalization (aOR = 2.84 [1.03; 7.88]) and stricturing phenotype (aOR = 5.28 [1.76; 15.85]) but lower risk of severe UC course (aOR = 0.28 [0.08; 0.95]). Further, previous smoking was not associated with negative effects in patients with CD in terms of early need for biologics, surgery, or hospitalization. In terms of diets, daily consumption of fruits (aOR = 0.27 [0.07; 0.99]) or vegetables (aOR = 0.27 [0.09; 0.80]) was inversely associated with stricturing CD, whereas whole meal bread was associated with reduced risk of severe CD activity (aOR = 0.40 [0.16; 0.98]).</p><p><strong>Conclusions: </strong>This prospective population-based study highlighted several environmental factors associated with the initial severity and activity of IBD, emphasizing their pivotal role in the initial disease burden and giving guidance to personalized patient counseling.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"697-709"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Concomitant Use of Etrasimod With Opioids or Antidepressants in Patients With Ulcerative Colitis-A Safety Analysis. 溃疡性结肠炎患者同时使用伊特拉西莫与阿片类药物或抗抑郁药的安全性分析
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-06-01 Epub Date: 2025-02-01 DOI: 10.1002/ueg2.12745
Anita Afzali, Miguel Regueiro, Andres J Yarur, Yamile Zabana, Siew C Ng, Sujatha Menon, Aoibhinn McDonnell, Krisztina Lazin, Michael Keating, Abhishek Bhattacharjee, Diogo Branquinho, Eustratios Bananis, Laurent Peyrin-Biroulet
{"title":"Concomitant Use of Etrasimod With Opioids or Antidepressants in Patients With Ulcerative Colitis-A Safety Analysis.","authors":"Anita Afzali, Miguel Regueiro, Andres J Yarur, Yamile Zabana, Siew C Ng, Sujatha Menon, Aoibhinn McDonnell, Krisztina Lazin, Michael Keating, Abhishek Bhattacharjee, Diogo Branquinho, Eustratios Bananis, Laurent Peyrin-Biroulet","doi":"10.1002/ueg2.12745","DOIUrl":"10.1002/ueg2.12745","url":null,"abstract":"<p><strong>Background: </strong>Etrasimod is an oral, once-daily (q.d.), selective sphingosine 1-phosphate (S1P)<sub>1,4,5</sub> receptor modulator for the treatment of moderately to severely active ulcerative colitis (UC). Unlike the S1P receptor modulator ozanimod, etrasimod does not have a molecular structure to inhibit monoamine oxidase (MAO). Coadministration of drugs that inhibit MAO with opioids and antidepressants may increase the risk of adverse events (AEs).</p><p><strong>Aims: </strong>This post hoc analysis evaluated the incidence of AEs potentially related to serotonin syndrome in patients taking etrasimod and concomitant opioids or antidepressants in the Phase 3 ELEVATE UC 52 and ELEVATE UC 12 trials.</p><p><strong>Methods: </strong>Safety data pooled from both trials were analysed in subgroups of patients receiving etrasimod 2 mg q.d. (up to 52 weeks of exposure) with/without concomitant opioids or antidepressants. We report the proportions of patients who had ≥ 1 concurrent AE potentially associated with serotonin syndrome, including hypertension-related events.</p><p><strong>Results: </strong>Among 527 patients receiving etrasimod, 77 (14.6%) and 35 (6.6%) were taking concomitant opioids or antidepressants, respectively. The incidence of AEs potentially related to serotonin syndrome, including hypertension-related AEs, was low (≤ 8.6%) and generally comparable in all subgroups. No reported AEs were serious or led to treatment discontinuation among patients taking these concomitant medications.</p><p><strong>Conclusions: </strong>The incidence of AEs was low and comparable in patients receiving etrasimod with or without concomitant opioids or antidepressants. This analysis further supports the low likelihood of clinically relevant drug-drug interactions between etrasimod and medications commonly prescribed to patients with UC, such as opioids or antidepressants. (ClinicalTrials.gov: NCT03945188; NCT03996369).</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"719-727"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CiThroModel Improves Prediction of Symptomatic Venous Thromboembolism in Hospitalized Patients With Cirrhosis Without Hepatocellular Carcinoma. CiThroModel提高对住院肝硬化无肝细胞癌患者症状性静脉血栓栓塞的预测
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-06-01 Epub Date: 2025-01-23 DOI: 10.1002/ueg2.12758
Alberto Zanetto, Alessandro Vitale, Filippo Pelizzaro, Vittorio Simeon, Elena Campello, Laura Turco, Lorenz Balcar, Francesco Paolo Russo, Patrizia Burra, Paolo Simioni, Marco Senzolo
{"title":"CiThroModel Improves Prediction of Symptomatic Venous Thromboembolism in Hospitalized Patients With Cirrhosis Without Hepatocellular Carcinoma.","authors":"Alberto Zanetto, Alessandro Vitale, Filippo Pelizzaro, Vittorio Simeon, Elena Campello, Laura Turco, Lorenz Balcar, Francesco Paolo Russo, Patrizia Burra, Paolo Simioni, Marco Senzolo","doi":"10.1002/ueg2.12758","DOIUrl":"10.1002/ueg2.12758","url":null,"abstract":"<p><strong>Background & aims: </strong>Venous thromboembolism (VTE) is a recognized complication of acutely ill patients, but its incidence and risk factors in those with cirrhosis are uncertain.</p><p><strong>Methods: </strong>We retrospectively studied a consecutive cohort of cirrhosis patients non-electively admitted to our medical unit to determine the rates of symptomatic VTE during hospitalization. Firstly, we explored associations with baseline, clinical and laboratory characteristics using logistic regression. Secondly, we developed a clinical prediction model that could predict the risk of in-hospital VTE.</p><p><strong>Results: </strong>We included 687 patients (median age 61 years old; 68% male; Child-Pugh A/B/C, 13%/40%/47%). During hospitalization, 34 patients (4.9%) experienced VTE. Multivariate analysis showed that male sex (OR: 2.56, p = 0.05), AKI (OR: 3.1, p = 0.001), bacterial infections (OR: 2.6, p = 0.008), Pugh score (OR: 1.6. p < 0.001), family history of thrombosis (OR: 3.1, p = 0.04), reduced mobility (OR: 4.6, p < 0.001), and C-reactive protein (OR: 1.1, p = 0.005) were independent predictors of VTE. We combined these variables in a prediction model (CirrhosisThrombosisModel) that accurately discriminated between high- and low-risk patients. The AUROC of CiThroModel was significantly higher than that of Padua prediction score (0.882 vs. 0.742). After validating the CiThroModel using bootstrapping, the adjusted model maintained optimal discrimination ability (0.862) and calibration. The adjusted formula to calculate the in-hospital risk of VTE was -9.00 + 0.82 [Male sex] + 1.14 [AKI] + 0.98 [Infection] + 0.48 * Child Pugh score + 1.14 [VTE family history] + 1.54 [Reduced mobility] + 0.15 * PCR/10.</p><p><strong>Conclusion: </strong>The CiThroModel seems a valuable tool for identifying hospitalized patients with cirrhosis at risk of VTE (https://majinzin.shinyapps.io/vterisk/).</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"728-737"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Duodenal Ablation Under the Spotlight of Science: A Promising Approach With Open Questions. 科学聚光灯下的十二指肠消融术:一个有前途的方法和开放的问题。
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-06-01 Epub Date: 2025-03-05 DOI: 10.1002/ueg2.70010
Mladen Maksic
{"title":"Duodenal Ablation Under the Spotlight of Science: A Promising Approach With Open Questions.","authors":"Mladen Maksic","doi":"10.1002/ueg2.70010","DOIUrl":"10.1002/ueg2.70010","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"840"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inadequate Therapy Response on Advanced Therapy in Ulcerative Colitis Adult Patients: A Retrospective Analysis of German Health Claims Data. 溃疡性结肠炎成人患者的先进治疗反应不足:德国健康声明数据的回顾性分析。
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-06-01 Epub Date: 2025-01-29 DOI: 10.1002/ueg2.12755
Axel Dignass, Irina Blumenstein, Carolina Schwedhelm, Katrin Strassen, Leonie Kunk, Sophie Marquardt, Anna Seiffert, Nataliia Kulchytska, Ivonne Hänsel, Alexa Benson, Agnes Kisser
{"title":"Inadequate Therapy Response on Advanced Therapy in Ulcerative Colitis Adult Patients: A Retrospective Analysis of German Health Claims Data.","authors":"Axel Dignass, Irina Blumenstein, Carolina Schwedhelm, Katrin Strassen, Leonie Kunk, Sophie Marquardt, Anna Seiffert, Nataliia Kulchytska, Ivonne Hänsel, Alexa Benson, Agnes Kisser","doi":"10.1002/ueg2.12755","DOIUrl":"10.1002/ueg2.12755","url":null,"abstract":"<p><strong>Background: </strong>The treatment landscape for active ulcerative colitis is rapidly evolving and current real-world evidence on response to advanced therapy is limited. This study aimed to determine indicators of inadequate therapeutic response among patients with ulcerative colitis in Germany initiating advanced therapy.</p><p><strong>Methods: </strong>This retrospective analysis used German claims data (2015-2022) from adult patients (≥ 18 years). The prevalence and incidence of ulcerative colitis (ICD-10-GM: K51.X) were estimated. Inadequate response to therapy was evaluated in patients initiating advanced therapy based on eight predefined indicators observed for 12 months following dispensation of index treatment.</p><p><strong>Results: </strong>Mean ulcerative colitis patient age in 2016-2022 ranged from 49.6 to 51.5 years, 47.6%-48.3% were female. Administrative prevalence ranged from 0.45% in 2016 to 0.53% in 2022. The number of patients initiating advanced treatment ranged from 157 to 347 across the study years (3.2%-4.9% of overall treated study population). On average from 2016-2021, 78.8% had inadequate response in the 12 months following index treatment. Common indicators included prolonged use of corticosteroids (46.2%) and augmentation with conventional therapies (43.9%).</p><p><strong>Conclusions: </strong>Adult ulcerative colitis patients showed a high prevalence of inadequate response to advanced therapies. Our findings reveal a need for improved UC advanced therapy options, providing insight into inadequate response patterns. This may help identify patients who could benefit from a change in therapy to improve long-term outcomes.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"710-718"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Defining Optimal Surveillance Intervals Following Post-Colorectal Endoscopic Submucosal Dissection. 确定结肠内镜下粘膜下夹层后最佳监测间隔。
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-06-01 Epub Date: 2025-02-17 DOI: 10.1002/ueg2.12763
Daryl Ramai, Hiroyuki Aihara, Lumir Kunovsky
{"title":"Defining Optimal Surveillance Intervals Following Post-Colorectal Endoscopic Submucosal Dissection.","authors":"Daryl Ramai, Hiroyuki Aihara, Lumir Kunovsky","doi":"10.1002/ueg2.12763","DOIUrl":"10.1002/ueg2.12763","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"669-671"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inter-Rater Disagreements in Applying the Montreal Classification for Crohn's Disease: The Five-Nations Survey Study. 对克罗恩病应用蒙特利尔分类的评分者之间的分歧:五国调查研究。
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-06-01 Epub Date: 2025-01-18 DOI: 10.1002/ueg2.12757
Offir Ukashi, Aurelien Amiot, David Laharie, Luis Menchén, Ana Gutiérrez, Samuel Fernandes, Tommaso Pessarelli, Fábio Correia, Carlos Gonzalez-Muñoza, Julia López-Cardona, Giulio Calabrese, Rocio Ferreiro-Iglesias, Natalie Tamir-Degabli, Nikolas Konstantine Dussias, Amjad Mousa, Raquel Oliveira, Nicolas Richard, Ido Veisman, Kassem Sharif, Shomron Ben-Horin, Carlos Soutullo-Castiñeiras, Gabriele Dragoni, Silvia Rotulo, Agnese Favale, Louis Calméjane, Thomas Bazin, Alfonso Elosua, Sara Lopes, Carla Felice, Violeta Mauriz, Inês Coelho Rodrigues, Julia Jougon, Inês Botto, Helena Tavares de Sousa, Lorenzo Bertani, Paula Ripoll Abadía, Alice De Bernardi, Yamile Zabana, Xavier Serra-Ruiz, Anna Viola, Manuel Barreiro-de Acosta, Henit Yanai, Alessandro Armuzzi, Fernando Magro, Uri Kopylov
{"title":"Inter-Rater Disagreements in Applying the Montreal Classification for Crohn's Disease: The Five-Nations Survey Study.","authors":"Offir Ukashi, Aurelien Amiot, David Laharie, Luis Menchén, Ana Gutiérrez, Samuel Fernandes, Tommaso Pessarelli, Fábio Correia, Carlos Gonzalez-Muñoza, Julia López-Cardona, Giulio Calabrese, Rocio Ferreiro-Iglesias, Natalie Tamir-Degabli, Nikolas Konstantine Dussias, Amjad Mousa, Raquel Oliveira, Nicolas Richard, Ido Veisman, Kassem Sharif, Shomron Ben-Horin, Carlos Soutullo-Castiñeiras, Gabriele Dragoni, Silvia Rotulo, Agnese Favale, Louis Calméjane, Thomas Bazin, Alfonso Elosua, Sara Lopes, Carla Felice, Violeta Mauriz, Inês Coelho Rodrigues, Julia Jougon, Inês Botto, Helena Tavares de Sousa, Lorenzo Bertani, Paula Ripoll Abadía, Alice De Bernardi, Yamile Zabana, Xavier Serra-Ruiz, Anna Viola, Manuel Barreiro-de Acosta, Henit Yanai, Alessandro Armuzzi, Fernando Magro, Uri Kopylov","doi":"10.1002/ueg2.12757","DOIUrl":"10.1002/ueg2.12757","url":null,"abstract":"<p><strong>Background: </strong>The Montreal classification has been widely used in Crohn's disease since 2005 to categorize patients by the age of onset (A), disease location (L), behavior (B), and upper gastrointestinal tract and perianal involvement. With evolving management paradigms in Crohn's disease, we aimed to assess the performance of gastroenterologists in applying the Montreal classification.</p><p><strong>Methods: </strong>An online survey was conducted among participants at an international educational conference on inflammatory bowel diseases. Participants classified 20 theoretical Crohn's disease cases using the Montreal classification. Agreement rates with the inflammatory bowel diseases board (three expert gastroenterologists whose consensus rating was considered the gold standard) were calculated for gastroenterologist specialists and fellows/specialists with ≤ 2 years of clinical experience. A majority vote < 75% among participants was considered a notable disagreement. The same cases were classified using three large language models (LLMs), ChatGPT-4, Claude-3, and Gemini-1.5, and assessed for agreement with the board and gastroenterologists. Fleiss Kappa was used to assess within-group agreement.</p><p><strong>Results: </strong>Thirty-eight participants from five countries completed the survey. In defining the Montreal classification as a whole, specialists (21/38 [55%]) had a higher agreement rate with the board compared to fellows/young specialists (17/38 [45%]) (58% vs. 49%, p = 0.012) and to LLMs (58% vs. 18%, p < 0.001). Disease behavior classification was the most challenging, with 76% agreement among specialists and fellows/young specialists and 48% among LLMs compared to the inflammatory bowel diseases board. Regarding disease behavior, within-group agreement was moderate (specialists: k = 0.522, fellows/young specialists: k = 0.532, LLMs: k = 0.577; p < 0.001 for all). Notable points of disagreement included: defining disease behavior concerning obstructive symptoms, assessing disease extent via video capsule endoscopy, and evaluating treatment-related reversibility of the disease phenotype.</p><p><strong>Conclusions: </strong>There is significant inter-rater disagreement in applying the Montreal classification, particularly for disease behavior in Crohn's disease. Improved education or revisions to phenotype criteria may be needed to enhance consensus on the Montreal classification.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"685-696"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Leishmaniasis in Patients With Inflammatory Bowel Disease: A National Multicenter Study of GETECCU. 炎症性肠病患者的利什曼病:GETECCU的国家多中心研究
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-06-01 Epub Date: 2025-01-08 DOI: 10.1002/ueg2.12740
L Madero-Velázquez, A Mínguez, L Mayorga, J J Ramírez, N Moreno, C Amorós, M A Nieto, R Mena, J M Benítez, L Gimeno-Pitarch, N Maroto, C Suria, F Rodríguez-Moranta, I Ordás, L Ruiz, M A García-Brenes, A Martín-Cardona, C Rubín de Célix, K Cárdenas, D Ginard, L Medina, N Pedrero, R Plaza, R Salmoral, T J Martínez-Pérez, V Algara, E Merino, Y Zabana, A Gutiérrez
{"title":"Leishmaniasis in Patients With Inflammatory Bowel Disease: A National Multicenter Study of GETECCU.","authors":"L Madero-Velázquez, A Mínguez, L Mayorga, J J Ramírez, N Moreno, C Amorós, M A Nieto, R Mena, J M Benítez, L Gimeno-Pitarch, N Maroto, C Suria, F Rodríguez-Moranta, I Ordás, L Ruiz, M A García-Brenes, A Martín-Cardona, C Rubín de Célix, K Cárdenas, D Ginard, L Medina, N Pedrero, R Plaza, R Salmoral, T J Martínez-Pérez, V Algara, E Merino, Y Zabana, A Gutiérrez","doi":"10.1002/ueg2.12740","DOIUrl":"10.1002/ueg2.12740","url":null,"abstract":"<p><strong>Background: </strong>Leishmaniasis (LI) is a vector-borne illness caused by a protozoan of the genus Leishmania. Data on the features of LI in patients with inflammatory bowel disease (IBD) are scarce.</p><p><strong>Aim: </strong>To describe the characteristics of patients with IBD who present with leishmaniasis, infection outcomes and the risk factors associated with developing visceral leishmaniasis (VL).</p><p><strong>Methods: </strong>An observational retrospective study performed in 26 hospitals in Spain, including all adult patients with IBD who developed Leishmaniasis from 2012 to 2022.</p><p><strong>Results: </strong>A total of 73 patients were included [mean age 48 years; 65% male; 68% Crohn's disease]. Sixty patients (82.2%) presented localized cutaneous Leishmaniasis (CL), 2 (2.7%) diffuse CL, 3 (4.1%) mucocutaneous Leishmaniasis (MCL) and 8 (11%) VL. All patients were under biologicals (69 [94.5%]) or immunosuppressants (IMM) (4 [5.5%]) at Leishmaniasis diagnosis. AntiTNF was used in 97%, while 2 patients (3%) were receiving ustekinumab. Leishmaniasis resolution was achieved by 48% and 96% of the patients after 1 and 12 months, respectively. Biological withdrawal after Leishmaniasis diagnosis was not statistically related to increased rates of infection resolution among patients with localized CL. Age was the only risk factor associated with VL (OR 1.2, 95%CI 1.04-1.39; p = 0.012).</p><p><strong>Conclusions: </strong>Leishmaniasis in patients with IBD doesn't seem to follow a complicated clinical course, even in those with localized CL who do not discontinue biological therapy after infection diagnosis. Age might be a risk factor for developing VL. This infection should be considered for immunosuppressed patients with IBD and suggestive symptoms dwelling or travelling to endemic areas.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"674-684"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Post-COVID-19 Disorders of Gut-Brain Interaction: A New Challenge for Gastroenterologists. covid -19后肠脑相互作用疾病:胃肠病学家面临的新挑战。
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-06-01 Epub Date: 2025-03-05 DOI: 10.1002/ueg2.70008
Mohamed G Shiha, Imran Aziz
{"title":"Post-COVID-19 Disorders of Gut-Brain Interaction: A New Challenge for Gastroenterologists.","authors":"Mohamed G Shiha, Imran Aziz","doi":"10.1002/ueg2.70008","DOIUrl":"10.1002/ueg2.70008","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"672-673"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信