{"title":"Prior Immune Checkpoint Inhibitor Treatment Is a Risk Factor for Treatment-Related Adverse Events in Unresectable Hepatocellular Carcinoma Treated With Durvalumab Plus Tremelimumab","authors":"Naohiro Watanabe, Takashi Kobayashi, Michihiro Iwaki, Asako Nogami, Naohiro Wada, Ayako Shimizu, Tomoya Komori, Hirofumi Koike, Yukiko Sahashi, Atsushi Nakajima, Masato Yoneda","doi":"10.1002/jgh3.70163","DOIUrl":"https://doi.org/10.1002/jgh3.70163","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>In March 2024, the American Society of Clinical Oncology recommended the combination of tremelimumab plus durvalumab as a treatment for advanced hepatocellular carcinoma (HCC). Although safety data for first-line treatments are available, information on adverse events related to late-line treatments is limited. This study aimed to identify risk factors for adverse events in patients who received this combination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study from March 2023 to January 2025 at Yokohama City University Hospital, involving 24 patients aged 18 years or older with unresectable HCC. All 24 patients experienced at least one adverse event during treatment. Of these, the incidence of treatment-related adverse events leading to treatment discontinuation after tremelimumab plus durvalumab therapy was 50.0% (12/24). In the discontinuation group, prior atezolizumab plus bevacizumab therapy (66.7% vs. 16.7%, <i>p</i> = 0.036) was more frequent than in the continuation group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients with unresectable HCC who received tremelimumab plus durvalumab, the risk of treatment-related adverse events was associated with prior atezolizumab plus bevacizumab therapy. These factors may increase the likelihood of developing treatment-related adverse events.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70163","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865979","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":"Urine TIMP2.IGFBP7 Reflects Kidney Injury After Moderate Volume Paracentesis in Patients With Ascites: A Randomized Control Study","authors":"Anuchit Suksamai, Sanpolpai Khaoprasert, Amnart Chaiprasert, Sakkarin Chirapongsathorn","doi":"10.1002/jgh3.70168","DOIUrl":"https://doi.org/10.1002/jgh3.70168","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Urinary biomarkers may predict acute kidney injury (AKI) in cirrhosis with ascites in a moderate volume paracentesis setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study aimed to assess the risk and consequence of AKI and its progression in patients with decompensated cirrhosis undergoing paracentesis using a urine test measuring tissue inhibitor of metalloproteinases-2 (TIMP2) and insulin-like growth factor-binding protein 7 (IGFBP7).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A randomized, controlled trial was performed. All outpatients with decompensated cirrhosis with ascites and diuretic complications were enrolled and randomized into 3 and 5 L paracentesis groups. Serial urine samples were analyzed for TIMP2. IGFBP7 concentration before and after paracentesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 90 patients with decompensated cirrhosis were consecutively enrolled during the study period. After screening, 29 patients were enrolled in the 3-L paracentesis group, and 25 patients were enrolled in the 5-L paracentesis group. The mean of the MELD score was 8 ± 1.2. Urine TIMP2.IGFBP7 > 2, rising urine TIMP2, and rising urine TIMP2/urine Cr were shown in patients within the 5-L group for 48% (<i>p</i> = 0.015), 32% (<i>p</i> = 0.049), and 76% (<i>p</i> = 0.010) respectively, indicating a higher incidence of renal tubular injury markers in this group. Urine TIMP2.IGFBP7/1000 > 2 was statistically significant to predict a hemodynamic event (<i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In cirrhotic patients with ascites undergoing paracentesis, a 5-L paracentesis volume was associated with a higher incidence of renal tubular injury markers.</p>\u0000 \u0000 <p><b>Trail Registration:</b> The national clinical registration number was TCTR20191116003.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70168","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856956","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}
JGH OpenPub Date : 2025-04-17DOI: 10.1002/jgh3.70154
Katrina Collins, Ani Toklu, Nishi Dave, Hector Mesa
{"title":"Primary Gastrointestinal EBV-Associated Classical Hodgkin Lymphoma in Crohn Disease on Anti-TNF-α Therapy: A Rare Association","authors":"Katrina Collins, Ani Toklu, Nishi Dave, Hector Mesa","doi":"10.1002/jgh3.70154","DOIUrl":"https://doi.org/10.1002/jgh3.70154","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lymphomas present a significant challenge in the field of gastrointestinal diseases, often being mistaken for other gastrointestinal tumors or inflammatory bowel disease conditions, causing clinical confusion. Early diagnosis plays a pivotal role in effective treatment. This case highlights the importance of recognizing lymphoproliferative disorders as a rare association of anti-tumor necrosis factor-α (TNF-α) therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 41-year-old man with a 15-year history of Crohn disease on long-term therapy with adalimumab underwent a right hemicolectomy due to a semi-circumferential lesion at the ileocecal valve causing near complete obstruction and severe anemia (Hgb 6.4 g/dL). Previous biopsies of the mass showed an Epstein Barr Virus-positive (EBV+) classic Hodgkin lymphoma (CHL) in Crohn disease. At resection, the lymphoma showed transmural involvement of the ileum and regional lymph nodes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Primary intestinal CHL comprises less than 5% of gastrointestinal lymphomas; CHL arising in the context of Crohn disease is even more rare. Most lymphomas associated with inflammatory bowel disease and/or immunosuppression are non-Hodgkin type. In this case, the long-term treatment with anti-TNF-α and EBV positivity suggested an iatrogenic immunodeficiency-associated lymphoma, an emerging group of lymphoproliferative disorders associated with the increased use of immunosuppressants.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70154","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846104","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}
JGH OpenPub Date : 2025-04-17DOI: 10.1002/jgh3.70148
Ajay Malvi, Nipun Verma, Mahalaqua Nazli Khatib, Subbulakshmi Ganesan, Mandeep Kaur, Manish Srivastava, Amit Barwal, G. V. Siva Prasad, Pranchal Rajput, Rukshar Syed, Kamal Kundra, Kratika Sharma, Diptismitha Jena, Frederick Sidney Correa, Abhinav Rathour, Ganesh Bushi, Rachana Mehta, Sanjit Sah, Prakasini Satapathy, Shilpa Gaidhane, Muhammed Shabil, Hashem Abu Serhan
{"title":"Impact of Quinolone Prophylaxis on Spontaneous Bacterial Peritonitis and Mortality in Cirrhosis Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Ajay Malvi, Nipun Verma, Mahalaqua Nazli Khatib, Subbulakshmi Ganesan, Mandeep Kaur, Manish Srivastava, Amit Barwal, G. V. Siva Prasad, Pranchal Rajput, Rukshar Syed, Kamal Kundra, Kratika Sharma, Diptismitha Jena, Frederick Sidney Correa, Abhinav Rathour, Ganesh Bushi, Rachana Mehta, Sanjit Sah, Prakasini Satapathy, Shilpa Gaidhane, Muhammed Shabil, Hashem Abu Serhan","doi":"10.1002/jgh3.70148","DOIUrl":"https://doi.org/10.1002/jgh3.70148","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cirrhosis is a major global health concern due to its progressive nature and high risk of complications, including spontaneous bacterial peritonitis (SBP), which significantly increases mortality. Quinolone antibiotics, especially norfloxacin, are commonly used for SBP prophylaxis in high-risk cirrhotic patients, but the long-term impact on overall mortality remains uncertain. The purpose of this meta-analysis and systematic review is to evaluate how quinolone prophylaxis affects the SBP incidence, mortality, and non-SBP infections in cirrhosis patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search of Web of Science, Embase, and PubMed identified research evaluating quinolone prophylaxis on the risk of spontaneous bacterial peritonitis (SBP) and mortality in cirrhotic patients. Inclusion criteria included randomized controlled trials reporting risk ratios for patients on quinolone prophylaxis versus controls. A random-effects meta-analysis pooled the results, with heterogeneity assessed by the I<sup>2</sup> statistic. Sensitivity analyses were performed for robustness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The search screened 1754 items and identified 6 relevant studies. Quinolone prophylaxis was associated with a significantly lower risk of spontaneous bacterial peritonitis (SBP), non-SBP infections, and mortality in cirrhotic patients, with a pooled relative risk (RR) for SBP of 0.47 (95% CI: 0.22–1.01), for non-SBP infections of 0.79 (95% CI: 0.66–0.94), and for mortality of 0.67 (95% CI: 0.52–0.86). Sensitivity analysis confirmed the robustness of these findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This meta-analysis reveals that quinolone prophylaxis significantly lowers the risk of spontaneous bacterial peritonitis (SBP), other infections, and mortality in high-risk cirrhotic patients. The results support incorporating quinolone prophylaxis in cirrhosis management to improve outcomes, with future studies needed to refine treatment duration and patient-specific strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143840692","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":"Frequency and Characteristics of Gastrointestinal Diseases in Patients With Neurofibromatosis","authors":"Manami Honda, Masaya Iwamuro, Takehiro Tanaka, Yasushi Yamasaki, Seiji Kawano, Sakiko Hiraoka, Yoshiro Kawahara, Motoyuki Otsuka","doi":"10.1002/jgh3.70151","DOIUrl":"https://doi.org/10.1002/jgh3.70151","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Patients with neurofibromatosis (NF) frequently experience gastrointestinal symptoms, but the specific characteristics of these lesions are not well understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To investigate the prevalence and nature of gastrointestinal diseases in this population, we analyzed the gastrointestinal lesions identified through endoscopic examinations in patients with NF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 225 patients with NF type 1 (NF1) and 15 with NF type 2 (NF2). None of the NF2 patients underwent endoscopy. Among the NF1 patients, 27 received endoscopies, and 13 (59%) had gastrointestinal lesions. These 13 patients were predominantly male (10 males and three females), with a median age of 53 years (range: 19–76 years). The identified lesions included colorectal polyps (<i>n</i> = 6), gastrointestinal stromal tumors ([GIST], <i>n</i> = 4), subepithelial lesions (<i>n</i> = 3), gastric fundic gland polyps (<i>n</i> = 3), diffuse intestinal ganglioneuromatosis (<i>n</i> = 2), esophageal polyps (<i>n</i> = 2), a Schwann cell hamartoma (<i>n</i> = 1), esophageal cancer (<i>n</i> = 1), and a gastric hyperplastic polyp (<i>n</i> = 1). All GISTs and one case of diffuse intestinal ganglioneuromatosis were surgically resected. Interestingly, six out of 13 patients were asymptomatic. Additionally, all patients who required surgery were 40 years of age or older.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings suggest that routine endoscopic examinations, along with imaging techniques like computed tomography and magnetic resonance imaging, could be beneficial for the early detection of gastrointestinal lesions in NF1 patients aged 40 and above.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70151","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143840850","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":"Gastric Schwannoma Mimicking Gastrointestinal Stromal Tumor (GIST)—A Diagnostic Dilemma","authors":"Aneeqa Qureshi, Huzafa Ali, Husnain Abbas, Dipendra Adhikari, Huzaifa Saqib, Talha Rashid, Layba Ahmed, Ayesha Siddiqa, Fatima Anjum","doi":"10.1002/jgh3.70152","DOIUrl":"https://doi.org/10.1002/jgh3.70152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gastric schwannomas (GS) are rare benign neurogenic tumors that can mimic gastrointestinal stromal tumors (GISTs) due to overlapping clinical and radiological features, posing a significant diagnostic challenge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>We present the case of a 67-year-old female with epigastric swelling, initially suspected to be a GIST based on contrast-enhanced CT findings. However, an ultrasound-guided true-cut biopsy and immunohistochemistry confirmed the diagnosis of gastric schwannoma. The tumor was resected through a successful wedge resection, and the patient recovered well postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case underscores the importance of histopathological evaluation and immunohistochemistry in differentiating GS from GISTs, highlighting the need for a correct preoperative diagnosis to guide appropriate management. Gastric schwannomas are typically benign with minimal malignant potential, and surgery is the treatment of choice. Further studies are needed to explore their long-term outcomes and prognostic factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70152","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143830980","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}
JGH OpenPub Date : 2025-04-15DOI: 10.1002/jgh3.70157
Jonas Wizenty, Martin Maibier, Michael Sigal
{"title":"Persistent Abdominal Pain and Diarrhea After Appendectomy—Crohn's Disease Versus Intestinal Tuberculosis","authors":"Jonas Wizenty, Martin Maibier, Michael Sigal","doi":"10.1002/jgh3.70157","DOIUrl":"https://doi.org/10.1002/jgh3.70157","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>In Western Europe, intestinal tuberculosis is a rare differential diagnosis for Crohn's disease. In this report, we present a case of intestinal tuberculosis in a 59-year-old female initially suspected of Crohn's disease with persistent abdominal pain and diarrhea after appendectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case highlights the need for TB culture in patients with positive IGRA and suspected Crohn's disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143830975","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":"Influence of Obesity Class on Clinical Outcomes in Alcoholic Hepatitis: A National Cohort Study of Mortality, Complications, and Resource Use","authors":"Ali Jaan, Mostafa Suhail Najim, Umer Farooq, Ashish Dhawan, Hassan Nawaz, Vinay Jahagirdar, Hassam Ali, Sushil Ahlawat","doi":"10.1002/jgh3.70166","DOIUrl":"https://doi.org/10.1002/jgh3.70166","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background & Aims</h3>\u0000 \u0000 <p>Alcoholic hepatitis (AH) is a severe manifestation of alcoholic liver disease with high morbidity and mortality. This study used the 2016–2020 National Readmission Database to investigate how obesity influences AH outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adult hospitalizations were categorized as those without obesity, Class 1 obesity (BMI 30–34.9), Class 2 obesity (BMI 35–39.9), or Class 3 obesity (BMI ≥ 40). We compared mortality, complications, and resource utilization across these groups using regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 82 367 AH admissions, 4.09% had Class 1 obesity, 2.73% had Class 2 obesity, and 4.02% had Class 3 obesity. After adjusting for confounders, Class 3 obesity was associated with higher odds of mortality (Odds ratio OR = 1.74; 95% CI: 1.40–2.17; <i>p</i> < 0.01), septic shock (OR = 2.27; 95% CI: 1.60–3.22; <i>p</i> < 0.01), hepatic encephalopathy (OR = 2.53; 95% CI: 1.15–5.56; <i>p</i> = 0.02), and intensive care unit (ICU) admission (OR = 1.93; 95% CI: 1.57–2.36; <i>p</i> < 0.01). All obesity classes had increased associations with hepatorenal syndrome. No significant differences emerged for spontaneous bacterial peritonitis or variceal bleeding. Resource utilization rose with increasing obesity severity, with Class 3 obesity having a 1.84-day longer adjusted length of stay (<i>p</i> < 0.01) and an additional $20 174 in total hospitalization charges (<i>p</i> < 0.01) compared with hospitalizations without obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Class 3 obesity conferred the greatest burden of mortality, complications, and healthcare costs among hospitalizations with AH. Further research is warranted to clarify the intricate interplay between obesity and AH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70166","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831045","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":"Spectrum of Functional Abdominal Pain Disorders in Children and Their Clinical, Social Characteristics: A Cross-Sectional Study","authors":"Jayendra Seetharaman, Ujjal Poddar, Anshu Srivastava, Moinak Sen Sarma, Surender Kumar Yachha","doi":"10.1002/jgh3.70162","DOIUrl":"https://doi.org/10.1002/jgh3.70162","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Aims</h3>\u0000 \u0000 <p>Pediatric functional abdominal pain disorders (FAPDs) subtypes; functional dyspepsia (FD), irritable bowel syndrome (IBS), functional abdominal pain-not otherwise specified (FAP-NOS), and abdominal migraine (AM) are influenced by demographic and social factors. The study aimed to evaluate the spectrum and demographic and social factors associated with FAPD subtypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Consecutive children (< 18 years) diagnosed with FAPD subtypes according to ROME-IV criteria between April 2018 and March 2020 were included. The clinical, demographic, and social parameters were analyzed between various subtypes of FAPD, and factors responsible for severe symptoms were studied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 479 children (mean age 12.34 ± 3.82 years, 60% boys) were included. FAP-NOS (63%) was the most commonly diagnosed subtype followed by IBS (17.4%) and FD (15%). The age at presentation, site of pain, duration of symptoms, and associated symptoms were significantly different among the three main subtypes (<i>p</i> < 0.001). Stressors could be identified in 39.3% and academic pressure (22.3%) was the most common. Family members with functional disorders (OR: 2.21, 95% CI: 1.31–3.42, <i>p</i> = 0.02), presence of stressors (OR: 2.03, 95% CI: 1.14–3.65, <i>p</i> = 0.016), and rural origin (OR: 1.75, 95% CI: 1.08–2.83, <i>p</i> = 0.023) predicted severe symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>FAP-NOS is the most common FAPD subtype in children in India. Children with FAP-NOS are much younger than other subtypes of FAPD. The presence of stressors and functional disorders in family members could be associated with severe symptoms. However, it mandates more prospective studies to validate the findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70162","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831044","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":"Association Between Gastroesophageal Reflux Disease and Hypertension: A Systematic Review and Meta-Analysis","authors":"Ganesh Bushi, Abhay M. Gaidhane, Nasir Vadia, Soumya V. Menon, Kattela Chennakesavulu, Rajashree Panigrahi, Muhammed Shabil, Diptismita Jena, Harish Kumar, Anju Rani, Sanjit Sah, Mahendra Pratap Singh, Swastik Subhankar Sahu, Suraj Tiwari, Khang Wen Goh","doi":"10.1002/jgh3.70158","DOIUrl":"https://doi.org/10.1002/jgh3.70158","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gastroesophageal reflux disease (GERD) and hypertension (HTN) are common conditions with substantial health burdens. While prior studies suggest a link between GERD and HTN, findings remain inconsistent. This systematic review and meta-analysis aimed to clarify the relationship between GERD and HTN.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A systematic search of PubMed, Web of Science, and Embase was conducted to identify observational studies published through December 2024. Studies evaluating the prevalence and association between GERD and HTN were included. Screening and data extraction were performed using Nested Knowledge software, with quality assessed via the Modified Newcastle–Ottawa Scale. Random-effects meta-analyses were used to calculate pooled prevalence and risk estimates, while heterogeneity was quantified using the <i>I</i><sup>2</sup> statistic. Publication bias was evaluated using DOI and funnel plots.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twelve studies, with sample sizes ranging from 71 to 12 960 participants, were included. The pooled prevalence of HTN among GERD patients was 16.80% (95% CI: 6.28%–31.02%) with high heterogeneity (<i>I</i><sup>2</sup> = 99%). The pooled risk ratio (RR) for HTN was 1.381 (95% CI: 0.992–1.922) and heterogeneity (<i>I</i><sup>2</sup> = 76%) highlighted variability. Sensitivity analyses and publication bias were evident.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>GERD is a potential risk factor for HTN, with GERD patients demonstrating an elevated likelihood of developing HTN. Future research is required to investigate the underlying mechanisms and confounding factors that may influence this association.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70158","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822136","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}