JGH Open最新文献

{"title":"Association Between Digestive Diseases, Nighttime Sleep, and Depressive Symptoms Among the Middle-Aged and Elderly Adults: A Mediation Analysis.","authors":"Congcong Cheng, Dinghui Guo, Xu Cao, Dingmin Wang, Wenling Li, Bei Miao, Sujuan Fei","doi":"10.1002/jgh3.70294","DOIUrl":"https://doi.org/10.1002/jgh3.70294","url":null,"abstract":"<p><strong>Objective: </strong>To explore the mediating effect of nighttime sleep duration between digestive diseases and depressive symptoms among middle-aged and elderly adults, so as to guide clinical intervention and treatment of depression related to digestive diseases.</p><p><strong>Methods: </strong>Based on the data of the China Health and Retirement Longitudinal Study (CHARLS) from 2015 to 2020, difference analysis, Spearman correlation analysis, and multivariate logistic regression were conducted to analyze the relationships among digestive diseases, nighttime sleep duration, and depressive symptoms. The mediating effect model was established and tested by the Bootstrap method.</p><p><strong>Results: </strong>The prevalence rate of digestive diseases was 23.05%, and the detection rate of depressive symptoms was 35.90%. Correlation and regression analysis indicated that digestive diseases (OR = 1.62, 95% CI: 1.45-1.81) and insufficient nighttime sleep (OR = 2.22, 95% CI: 2.01-2.45) significantly impacted depressive symptoms. The results of the mediating effect model showed that insufficient nighttime sleep had a partial mediating effect between digestive diseases and depressive symptoms among middle-aged and elderly adults.</p><p><strong>Conclusion: </strong>Digestive diseases can lead to insufficient nighttime sleep and promote the occurrence of depressive symptoms among middle-aged and elderly adults. Therefore, in clinical practice, when treating digestive patients with comorbid depression, the quality and duration of their nighttime sleep should not be ignored. Improving sleep conditions is expected to alleviate depressive symptoms.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 10","pages":"e70294"},"PeriodicalIF":1.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary Intervention Trial Design in Patients With an Ileoanal Pouch: Lessons From a Randomized, Double-Blind, Placebo-Controlled Feeding Study.","authors":"Zaid S Ardalan, Miles P Sparrow, Faran Rohani, Peter R Gibson, Chu K Yao","doi":"10.1002/jgh3.70287","DOIUrl":"10.1002/jgh3.70287","url":null,"abstract":"<p><strong>Purpose: </strong>The aims of this study were to assess the effects of a whole diet strategy, a Monash Pouch Diet (MPD), on pouch-related symptoms, inflammation, quality of life, and stool characteristics in a cohort of patients with symptomatic pouches and a history of pouchitis compared with a typical Australian pouch diet.</p><p><strong>Methods: </strong>In this randomized, double-blind, placebo-controlled dietary feeding trial, patients with ileoanal pouches received either a Monash Pouch diet or a typical Australian diet for 7 weeks. Clinical scores (Pouch Disease Activity Index, PDAI), pouch symptoms, tolerability, fecal calprotectin, and quality of life were measured pre- and post-intervention. The primary outcome consisted of the proportion of patients achieving symptomatic remission (clinical PDAI ≤ 2).</p><p><strong>Results: </strong>All patients on the MPD experienced worsening symptoms, and the trial was terminated early. The majority of the participants reported partial adherence (50%-80%) and poor tolerability (median: 40 mm). Quality of life outcomes were highly variable across dietary arms, and fecal indices showed no consistent trends related to diet.</p><p><strong>Conclusion: </strong>This double-blinded, placebo-controlled, dietary feeding trial failed to determine the effect of the Monash Pouch Diet on pouchitis but suggests that the design of dietary trials for pouch patients requires careful consideration.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 10","pages":"e70287"},"PeriodicalIF":1.5,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Administration of Metoclopramide Prior to Endoscopy for Acute Upper Gastrointestinal Bleeding: A Systematic Review and GRADE Meta-Analysis of Randomized Controlled Trials.","authors":"Muhammad Hassan Waseem, Zain Ul Abideen, Ayesha Ahmed, Barka Sajid, Noor Ul Huda Ramzan, Amina Tahir, Sania Aimen, Muhammad Arslan Tariq, Aleeza Afzal, Pawan Kumar Thada, Ameer Haider Cheema","doi":"10.1002/jgh3.70289","DOIUrl":"10.1002/jgh3.70289","url":null,"abstract":"<p><p>Acute Upper Gastrointestinal Bleeding (UGIB) is a critical condition where endoscopy is often hindered by poor visibility. This meta-analysis assesses the safety and efficacy of metoclopramide as a pre-endoscopic aid to improve visualization. Databases including PubMed, Cochrane Library, ScienceDirect, and Google Scholar were searched from inception till October 2024. Review Manager 5.4.1 software was utilized to combine standard and weighted mean differences as well as risk ratios for continuous and dichotomous outcomes, respectively. Quality assessment was carried out by the Cochrane Risk of Bias Tool 2.0. Publication bias was assessed through funnel plots. GRADE assessment was conducted to determine the certainty of the evidence. The protocol of this review was registered on PROSPERO under the ID CRD42024569658. A total of eight studies were included, resulting in a pooling of 665 patients. Metoclopramide significantly increases the Endoscopic Visualization Score of the Fundus (SMD = 0.30, 95% CI: [0.12, 0.47]; <i>p</i> = 0.0008; <i>I</i> ² = 0%), Endoscopic Visualization Score Body (SMD = 0.25, 95% CI: [0.07, 0.42]; <i>p</i> = 0.006; <i>I</i> ² = 0%), Endoscopic Visualization Score Antrum (SMD = 0.23, 95% CI: [0.05, 0.40]; <i>p</i> = 0.01; <i>I</i> ² = 0%), and Endoscopic Visualization Score Total (SMD = 0.32, 95% CI: [0.15, 0.50]; <i>p</i> = 0.0003; <i>I</i> ² = 0%). Outcomes such as length of hospital stay, re-endoscopy, RBC transfusion units, second look endoscopy, duration of endoscopy, and mortality showed insignificant results. In conclusion, metoclopramide usage improved the endoscopic visualization, but it showed no significant results when evaluated for the secondary outcomes. However, there is a clear need for more full-length clinical trials demonstrating the safety and efficacy of metoclopramide to establish robust evidence.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 10","pages":"e70289"},"PeriodicalIF":1.5,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Induction Efficacy and Safety of Upadacitinib for Active Crohn's Disease in Japanese Patients: A Multicenter Retrospective Study.","authors":"Takuto Saiki, Junji Umeno, Yuichi Matsuno, Keisuke Kawasaki, Tomohiko Moriyama, Hironobu Takedomi, Nanae Tsuruoka, Shinya Ashizuka, Noritaka Takatsu, Takashi Hisabe, Yoshiaki Nozaka, Koichi Kurahara, Masatoshi Nakashima, Yoki Furuta, Masaru Morita, Kotaro Kuwaki, Nobuaki Nishimata, Shinichi Kawano, Shigeo Nakamura, Kanami Ota, Akira Harada, Fumihito Hirai, Takehiro Torisu, Motohiro Esaki","doi":"10.1002/jgh3.70291","DOIUrl":"10.1002/jgh3.70291","url":null,"abstract":"<p><strong>Background: </strong>While Western real-world studies have demonstrated the therapeutic effect of upadacitinib in Crohn's disease (CD), data on Asian populations are scarce, and no real-world data from Japan have been reported. Therefore, this study aimed to assess the induction efficacy and safety of upadacitinib in Japanese patients with active CD.</p><p><strong>Methods: </strong>This retrospective study included CD patients who initiated upadacitinib at 10 inflammatory bowel disease (IBD) centers in Japan by December 2024. Clinical response, clinical remission, biomarker improvements, and adverse events were analyzed. Clinical response was defined as Crohn's Disease Activity Index (CDAI) < 150 or a decrease in CDAI (ΔCDAI) > 70, while clinical remission was defined as CDAI < 150.</p><p><strong>Results: </strong>A total of 33 patients (16 males, 17 females) were included. The median age at upadacitinib administration was 40 years, with a median disease duration of 9.3 years. The median baseline values were 264 for CDAI, 14 for Simple Endoscopic Score for Crohn's Disease (SES-CD), and 9.8 mg/L for serum C-reactive protein (CRP). Corticosteroids were co-administered in 11 patients (33.3%). Prior biologic therapy had been used in 25 patients (75.8%), including 7 patients with one biologic and 18 patients with two or more biologics. Extraintestinal manifestations were observed in 12 patients (36.4%), and perianal lesions in 15 patients (45.5%). All patients started upadacitinib at 45 mg/day. The clinical response, clinical remission, and steroid-free clinical remission rates were 76.7%, 53.3%, and 36.7% by week 4; 83.3%, 63.3%, and 56.7% by week 8; and 86.7%, 70%, and 70% by week 12, respectively. Significant improvements in CDAI, serum CRP, and albumin were observed at week 12 or the last visit, compared to baseline. Improvement was observed in 66.7% of cases with extraintestinal manifestations and 46.7% of cases with perianal lesions. Adverse events occurred in 45.5% of patients, with acne being the most common (12.1%). No serious adverse events leading to death were reported. The continuation rate of upadacitinib at week 12 or the last visit was 93.3%.</p><p><strong>Conclusion: </strong>Upadacitinib demonstrated high induction efficacy and acceptable safety in Japanese patients with active CD.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 10","pages":"e70291"},"PeriodicalIF":1.5,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative Impact of Coronavirus Disease 2019 Pandemic on Gastric Cancer Care in Japan: A Tokushukai Real-World Data Project 08 (TREAD 08)","authors":"Rai Shimoyama,&nbsp;Yoshinori Imamura,&nbsp;Kiyoaki Uryu,&nbsp;Takahiro Mase,&nbsp;Masataka Taguri,&nbsp;Tadahisa Okuda,&nbsp;Megumi Shiragami,&nbsp;Yoshiaki Fujimura,&nbsp;Maki Hayashi,&nbsp;Hironobu Minami","doi":"10.1002/jgh3.70285","DOIUrl":"https://doi.org/10.1002/jgh3.70285","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Concerns regarding the adverse impact of coronavirus disease 2019 (COVID-19) on cancer care survival have been raised; however, clear evidence remains limited. Therefore, we aimed to investigate the influence of the COVID-19 pandemic on gastric cancer management in Japan using real-world data from the Tokushukai Real-World Data project.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>This retrospective cohort study was conducted across 46 Tokushukai Medical Group hospitals in Japan, identifying patients newly diagnosed with gastric cancer between January 2017 and December 2022. Patients with active double cancers or non-epithelial tumors were excluded. We used data between January 2017 and March 2020 as the baseline (pre-COVID-19 period) to assess the changes in the number of diagnoses, screening detections, disease stage at diagnosis, and prognosis between April 2020 and December 2022 (mid-COVID-19 period). This study included 14 125 patients with 14 446 gastric cancer cases. Compared with the pre-COVID-19 period, the mid-COVID-19 period exhibited a 12% (95% confidence interval [CI]: 3%–20%) decrease in screening detections, a 9% (95% CI: 1%–18%) increase in metastatic stage detection, a 14% (95% CI: 7%–20%) decrease in curative surgery, and a 32% (95% CI: 19%–43%) decrease in radiation therapy. The analysis also revealed a 9.4% (95% CI: 2.0%–17.2%) increase in mortality in the mid-COVID-19 period compared with the pre-COVID-19 period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This nationwide, real-world study provides robust evidence that COVID-19 has reduced survival rates for Japanese patients with gastric cancer by disrupting diagnosis and treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70285","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy of Triple Versus Quadruple Therapy for the Eradication of Helicobacter pylori Infection in Asian Adults—A Systematic Review and Meta-Analysis","authors":"Abdur Razzak,&nbsp;Nymur Rahman,&nbsp;Nikkon Sarker,&nbsp;Monira Swapna Nil,&nbsp;Md. Arifur Rahman,&nbsp;Md. Toslim Mahmud","doi":"10.1002/jgh3.70292","DOIUrl":"10.1002/jgh3.70292","url":null,"abstract":"<p><i>Helicobacter pylori</i> infection remains a major health issue in Asia due to its strong association with gastric ulcers and cancer. Rising antibiotic resistance has reduced the success of standard triple therapy, leading to broader use of bismuth-based quadruple regimens. However, the relative effectiveness of these regimens in Asian populations remains uncertain. To evaluate which treatment is more effective in Asian populations, this systematic review and meta-analysis assessed randomized controlled trials comparing these two regimens. A comprehensive search across four major databases (PubMed, Web of Science, The Cochrane Library, and Scopus) up to May 2024 retrieved 16,398 studies. After thorough title and abstract (TIAB) and full-text screening, nine eligible studies involving 2266 adult patients from six Asian countries were included for this analysis. The analysis showed that quadruple therapy achieved higher eradication rates than triple therapy within all nine studies, with a pooled risk ratio of 1.21 (95% CI: 1.09–1.35; <i>p</i> = 0.0003), indicating a 21% greater likelihood of treatment success. Although adverse effects were somewhat more frequent with quadruple therapy, adherence remained high in most trials. The overall risk of bias was low to moderate. These findings support the use of quadruple therapy as a more effective first-line option for <i>H. pylori</i> eradication in Asia, especially in regions where clarithromycin resistance is common. Further research should focus on optimizing regimen tolerability and incorporating local antibiotic resistance patterns to guide treatment.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home Management of Refractory Ascites in Decompensated Cirrhosis With Long-Term Abdominal Drains, a Pilot Study","authors":"Jeyamani Ramachandran,&nbsp;Kylie Bragg,&nbsp;Sumudu Narayana,&nbsp;Jodi Altschwager,&nbsp;Lindsey Moore,&nbsp;Ramon Pathi,&nbsp;Adam Koukourou,&nbsp;Kate Muller,&nbsp;Alan Wigg","doi":"10.1002/jgh3.70228","DOIUrl":"10.1002/jgh3.70228","url":null,"abstract":"&lt;p&gt;The prevalence of decompensated liver cirrhosis (DC) is increasing worldwide [&lt;span&gt;1&lt;/span&gt;]. Ascites-related readmissions are the predominant cause of hospitalizations in DC [&lt;span&gt;1, 2&lt;/span&gt;]. Refractory ascites (RA), characterized by diuretic non-responsiveness or intolerance, is encountered in 10% of patients with cirrhosis and is associated with reduced survival without liver transplantation (LT) or trans-jugular intrahepatic portosystemic shunts (TIPSS) [&lt;span&gt;3&lt;/span&gt;]. Large volume paracentesis (LVP) and albumin infusions are the only therapeutic options in those with RA who cannot undergo LT or TIPSS. LVPs are often required weekly or fortnightly, placing significant burden on hospital systems and often leading to unplanned hospitalizations. These recurrent admissions, with adverse impacts on patients' quality of life (QoL) and health expenditure, are potentially avoidable if ascites drainage can be regularly performed in patients' homes. Since ascites drainage in patients unsuitable for LT is a palliative procedure, it is best approached along principles of palliative care. Drainage using indwelling catheters is a well-accepted model of care in patients with malignant ascites and hydrothorax [&lt;span&gt;4&lt;/span&gt;]. There is limited evidence supporting this procedure in cirrhotic patients with RA [&lt;span&gt;5&lt;/span&gt;]. The aim of this study was therefore to explore the feasibility, effectiveness, safety, and acceptability of home drainage of ascites with long-term abdominal drains (LTAD) in an Australian health care setting as a management pathway for RA. The complete study protocol is included as Supporting Information, Section 1.&lt;/p&gt;&lt;p&gt;After obtaining informed consent, Rocket LTAD catheters (Rocket Medical, Watford, UK) were inserted by interventional radiologists. Participants underwent complete drainage with albumin replacement. They were discharged the next day with sufficient drainage kits for 4 weeks of drainage. The local community nurses' pathway was utilized for ongoing LTAD drains. Nurses were provided with instructions and a referral form regarding the frequency and amount of drainage to be done for each participant. Participants underwent drainage two to three times per week at home as guided by their abdominal discomfort. During each visit, one to two liters of ascites was drained, as per the previously published experience [&lt;span&gt;5&lt;/span&gt;]. Antibiotic prophylaxis with norfloxacin or equivalent was given throughout the duration of LTAD being in situ. No albumin replacement was given. Whenever bacterial peritonitis (BP) was suspected, ascitic fluid was sampled via LTAD and from the abdominal wall. Emergency contact numbers for reporting any adverse events were provided.&lt;/p&gt;&lt;p&gt;Management of RA in DC patients without definitive options should be in line with the principles of palliative care by prioritizing symptomatic management and preserving QoL. This pilot study explored the option of LTAD in an Australian health care setting an","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structured Versus Non-Structured Reporting of Inflammatory Bowel Disease Imaging: A Systematic Review","authors":"Richard Lo,&nbsp;Ziang Ma,&nbsp;Lynna Chen,&nbsp;Abhinav Vasudevan,&nbsp;Ashish Srinivasan","doi":"10.1002/jgh3.70288","DOIUrl":"10.1002/jgh3.70288","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Effective communication between radiologists and clinicians is essential for optimal inflammatory bowel disease (IBD) management. Structured reporting (SR) of imaging reports may enhance interdisciplinary communication and clinical decision-making; however, its utility compared to non-structured reporting (NSR) in IBD remains unclear. This systematic review evaluated IBD clinician perceptions of SR versus NSR in IBD-related imaging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Embase, MEDLINE, and CENTRAL were searched to January 2025 for studies comparing SR and NSR in abdominal and pelvic imaging for IBD, including magnetic resonance imaging (MRI), computed tomography (CT), and intestinal ultrasound (IUS). The primary outcome was perceived clarity and clinical utility by the referring clinician, with report completeness evaluated as a secondary outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six studies met inclusion criteria, comprising 199 IBD patients and 224 scans (105 MRI, 119 CT), with a total of 550 SR/NSR report pairs evaluated by 19 clinicians. No eligible studies assessed pelvic MRI or IUS. In four of five studies, clinicians perceived SR as clearer than NSR. Similarly, SR were viewed as having greater clinical utility for assessing disease activity, identifying disease phenotype, and influencing management decisions in four studies. SR were also associated with more complete reporting based on predefined radiological criteria in three studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Clinicians generally perceived SR to provide greater clarity and clinical utility than NSR in IBD-related imaging, potentially enhancing interdisciplinary communication and clinical decision-making. Further research is needed to validate these findings and evaluate their impact on patient outcomes in routine IBD practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Gastrointestinal Lymphoma: A Retrospective Cohort Study on Clinical Presentation, Treatment Outcomes, and Survival Trends With a Focus on Emergency Versus Elective Management","authors":"Thamir Alshamari,&nbsp;Priscilla Chong,&nbsp;Lau Min Yi,&nbsp;Diviya Pergassam,&nbsp;Dhanushan Gnanendran","doi":"10.1002/jgh3.70283","DOIUrl":"https://doi.org/10.1002/jgh3.70283","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Primary gastrointestinal lymphoma (PGIL) is a rare cancer, with diffuse large B-cell lymphoma (DLBCL) as the most common subtype. PGIL can be acute, requiring emergency surgery, or non-acute, allowing elective management. This article evaluates the clinical presentation, treatments, and survival outcomes of PGIL by comparing emergency and elective cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study from January 2013 to December 2019 included patients with histologically confirmed PGIL, excluding secondary GI involvement. Survival distributions were performed using SPSS v.20 and Kaplan–Meier analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 33 patients, 54.5% were male, with a mean age of 69. The most common site of lymphoma was the small bowel (54.5%), with DLBCL being the predominant subtype (66.7%). Emergency cases comprised 57.6% of the cohort. Poorer survival was noted in emergency cases, with significant differences in survival by age (<i>p</i> = 0.036) and lymphoma site (<i>p</i> = 0.038). Surgical excision was the main diagnostic method in emergency cases (54.5%), while endoscopic biopsy was more common in elective cases (39.4%) (<i>p</i> &lt; 0.001). Chemotherapy was given to 69.7%, with R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, Prednisone) (65.2%) being the most used regimen. Median survival was 17 months (interquartile range, IQR: 10–44.5). Survival differences were significant by age (<i>p</i> = 0.036) and lymphoma site (<i>p</i> = 0.038).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Emergency surgery is often needed for PGIL, especially with small bowel lymphomas, which have poorer outcomes. Early diagnosis and elective care may improve prognosis. Further research should explore prognostic markers and standardize treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70283","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145135747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and Demographics of Liver Fibrosis and Cirrhosis-Related Mortality Among Adults Living in the United States From 1999 to 2020: A CDC Wonder Analysis","authors":"Muhammad Shahzad,&nbsp;Syeda Sundus Shah Bokhari,&nbsp;Fnu Rabia,&nbsp;Amna Zaman Khan,&nbsp;Muhammad Abdullah Ali,&nbsp;Ali Hashim,&nbsp;Farah Shahzad,&nbsp;Maryam Tariq,&nbsp;Zarhaish Barkat-Ullah,&nbsp;Malaika Rasheed,&nbsp;Muhammad Uzair Khan Niazi,&nbsp;Ali Hassan,&nbsp;Asfand Yar Khan,&nbsp;Taha Mazhar Awan,&nbsp;Saad Ahmed Waqas,&nbsp;Raheel Ahmed","doi":"10.1002/jgh3.70247","DOIUrl":"https://doi.org/10.1002/jgh3.70247","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Liver cirrhosis, the fifth leading cause of adult mortality, involves progressive, irreversible liver fibrosis and loss of function. Its rising prevalence necessitates studying trends, identifying high-risk groups, and enhancing preventive strategies. This study aims to assess temporal trends and demographic disparities in liver fibrosis and cirrhosis-related mortality in the United States from 1999 to 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Death certificates from the CDC WONDER(Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) database for 1999–2020 were analyzed for liver fibrosis and cirrhosis-associated mortality in adults &gt; 25 years. AAMRs per 100 000 were stratified by year, sex, race/ethnicity, and region. Joinpoint Regression (v5.3.0.0) calculated annual percent change (APC) and average APC (AAPC), identifying significant trends (<i>p</i> &lt; 0.05, two-tailed <i>t</i> test).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 1999 to 2020, 787 375 liver cirrhosis-related deaths occurred in adults &gt; 25. AAMR increased from 16.61 (1999) to 18.93 (2020). Men had a higher AAMR (21.51; 95% CI: 21.44 to 21.57) than women (11.73; 95% CI: 11.68 to 11.77). AAMRs were highest in Non-Hispanic (NH) American Indian (26.42; 95% CI: 25.91 to 26.93) followed by Hispanics (24.93; 95% CI: 24.77 to 25.09), NH White (16.71; 95% CI: 16.67 to 16.75), NH Black (15.13; 95% CI: 15.02 to 15.24), and NH Asian/Pacific Islander (9.29; 95% CI: 9.15 to 9.42). By region, the South had the highest AAMR (18.87; 95% CI: 18.8 to 18.93), followed by the West (15.75; 95% CI: 15.67 to 15.82), Midwest (14.55; 95% CI: 14.47 to 14.62), and Northeast (14.17; 95% CI: 14.1 to 14.25). Micropolitan (Nonmetro) areas had the highest AAMR (17.62; 95% CI: 17.49 to 17.74), while Large Fringe Metro Areas had the lowest AAMR (14.2; 95% CI: 14.13 to 14.27). Texas reported the highest AAMR (25.7); Nebraska reported the lowest (9.4).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Liver cirrhosis-related mortality has risen since 1999, especially among Hispanic adults, men, and those in Southern or nonmetropolitan regions. Targeted prevention is needed to reduce mortality in these high-risk groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70247","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}