JGH Open最新文献

{"title":"Small-Bowel Capsule Endoscopy in Immune-Mediated Enterocolitis: A Case Series of Four Patients","authors":"Masayuki Orikasa,&nbsp;Tomoyoshi Shibuya,&nbsp;Hirotaka Ishino,&nbsp;Masashi Omori,&nbsp;Rina Odakura,&nbsp;Masao Koma,&nbsp;Kentaro Ito,&nbsp;Takafumi Maruyama,&nbsp;Kei Nomura,&nbsp;Dai Ishikawa,&nbsp;Mariko Hojo,&nbsp;Akihito Nagahara","doi":"10.1002/jgh3.70201","DOIUrl":"https://doi.org/10.1002/jgh3.70201","url":null,"abstract":"<p>Immune checkpoint inhibitors (ICIs) have emerged as a cornerstone of cancer immunotherapy but are associated with immune-mediated adverse events (imAEs), including gastrointestinal toxicities. Among these, enteritis is a less common but clinically significant complication. However, small intestinal involvement remains under-recognized, and endoscopic findings are not well characterized. We report four cases of imAE enteritis in which small-bowel capsule endoscopy (SBCE) was performed. SBCE revealed variable mucosal abnormalities, including villous atrophy, aphthous ulcers, and extensive erosions; in one case, deep circumferential ulcers with stricture were observed. While one patient responded to corticosteroids, the other three required escalation to biologic therapy due to steroid-refractory disease. These findings suggest that SBCE may play a valuable role in assessing disease extent and predicting treatment responsiveness in imAE enteritis. Early utilization of SBCE could facilitate timely therapeutic decision-making in affected patients.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315018","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":"Assessment of Prognostic Factors of Acute Hepatitis Among Pediatric Patients: A Cross-Sectional Study","authors":"Neda Ezoddin,&nbsp;Fateme Ziamanesh,&nbsp;Alireza Ramandi,&nbsp;Pejman Rohani,&nbsp;MohammadHassan Sohouli,&nbsp;Hosein Alimadadi","doi":"10.1002/jgh3.70164","DOIUrl":"https://doi.org/10.1002/jgh3.70164","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Early identification of acute hepatitis etiology and specific management is crucial for reducing morbidity and mortality. Therefore, this study aims to investigate the prognostic factors of acute hepatitis in children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study was conducted on children with diagnosis of acute hepatitis According to the criteria of ESPHAGAN, admitted to the Children's Hospital from March 2018 to March 2023. Data were analyzed using SPSS statistical software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 164 patients with acute hepatitis were included, comprising 78 patients with acute liver failure and 86 patients without acute liver failure. Viral infections were identified as the most common etiology of acute hepatitis and were significantly more prevalent in patients without acute liver failure. Wilson's disease was significantly more prevalent in patients with acute liver failure. All patients with viral etiology recovered. Among the 24 patients with Wilson's disease, 14 (58.3%) underwent transplantation, 4 (16.6%) were deceased, and 6 (25%) survived without transplantation. Patients with other etiologies did not experience any mortality, with only 13.8% undergoing transplantation due to autoimmune causes. Low albumin (&lt; 2.5), prolonged PT (&gt; 22), elevated INR (&gt; 3), encephalopathy, low phosphorus (&lt; 3), and a duration of more than 7 days between symptom onset and hospitalization significantly increased the risk of mortality or need for transplantation in patients with acute liver disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Albumin levels, PT, INR, encephalopathy, phosphorus levels, and the duration between symptom onset and hospitalization are significant prognostic factors for acute hepatitis in pediatric patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70164","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144314984","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":"Cemiplimab-Induced Colitis Causing Hypovolemic Shock: A Case Report and Literature Review","authors":"Saeed S. Graham,&nbsp;Kena J. Lemu,&nbsp;Victoria Mofopefoluwa Thomas,&nbsp;Stanley O. Oghoghorie,&nbsp;Abdulazeez R. Swaiti,&nbsp;Jinye Liu,&nbsp;Alina Faheem","doi":"10.1002/jgh3.70198","DOIUrl":"https://doi.org/10.1002/jgh3.70198","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The use of immune checkpoint inhibitors (ICI), such as Cemiplimab, has become prevalent in oncology, providing significant anti-tumor effects. However, these agents can induce severe gastrointestinal inflammation, which may be potentially life-threatening. This case report details an instance of Cemiplimab-induced colitis resulting in hypovolemic shock in a patient with cutaneous squamous cell carcinoma (cSCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>An 83-year-old male veteran with a complex history of scalp squamous cell carcinoma, treated initially with excision and radiation, experienced recurrence necessitating Cemiplimab therapy. One year post-initiation, the patient presented with severe diarrhea, leading to hypovolemic shock and acute renal failure. Initial tests ruled out infectious causes. Endoscopic evaluation revealed inflammatory mucosal changes in the sigmoid colon, and histopathology confirmed active colitis. The patient responded well to high-dose prednisone, with rapid improvement in symptoms, leading to a transfer to a lower level of care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Cemiplimab, approved for advanced cSCC, fulfills a crucial therapeutic need but is associated with immune-related adverse events, including severe colitis. Management of such cases requires early endoscopy and corticosteroid therapy, which can significantly improve outcomes. This report underscores the importance of vigilant monitoring for gastrointestinal symptoms in patients undergoing ICI therapy and prompt intervention to mitigate severe complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70198","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273348","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":"Consensus Statement on Metabolic Dysfunction-Associated Steatotic Liver Disease in Children and Adolescents From the Joint TASL-TSPGHAN Expert Committee","authors":"Yu-Cheng Lin,&nbsp;Fang-Min Liao,&nbsp;Hsun-Ching Chao,&nbsp;An-Chyi Chen,&nbsp;Yung-Ming Jeng,&nbsp;Chieh-Chung Lin,&nbsp;Mao-Meng Tiao,&nbsp;Yao-Jong Yang,&nbsp;Chun-Yan Yeung,&nbsp;Huey-Ling Chen,&nbsp;Yen-Hsuan Ni","doi":"10.1002/jgh3.70137","DOIUrl":"https://doi.org/10.1002/jgh3.70137","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver condition in children and adolescents, driven by the global rise in pediatric obesity. In this consensus statement by the Taiwan Association for the Study of the Liver (TASL) and the Taiwan Society of Pediatric Gastroenterology, Hepatology, and Nutrition (TSPGHAN), we highlight the unique clinical challenges in diagnosing and managing this condition in Asian children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This consensus was developed by expert members of TASL and TSPGHAN through a comprehensive review of current literature and clinical practice. Key topics included prevalence, screening policies, diagnostic criteria, disease characteristics, and management strategies relevant to pediatric MASLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We emphasize the rising prevalence of pediatric MASLD, which correlates strongly with obesity but often remains underdiagnosed due to the lack of screening policy for at-risk individuals and variations in diagnostic criteria. This review also discusses the distinct natural history and histopathological features of pediatric MASLD, underscoring the critical need for a greater understanding of its long-term outcomes. Currently, liver enzymes and ultrasonography are commonly used for screening and diagnosis, though these methods have limitations. The diagnostic imaging and novel non-invasive biomarkers specifically tailored for pediatric MASLD are in urgent need. Clinical management continues to rely on lifestyle interventions, with no pharmacological treatments currently approved for pediatric MASLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Effective management of pediatric MASLD requires a comprehensive approach to risk assessment, early detection, and intervention, tailored to the disease's unique pathophysiology in children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70137","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273206","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":"Peroxisome Proliferator-Activated Receptor (PPAR) Agonists for Patients With Primary Biliary Cholangitis With Inadequate Response to Ursodeoxycholic Acid (UDCA): A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Maadeha H. Zaidi,&nbsp;Zaroon Haider,&nbsp;FNU Sadia,&nbsp;Muhammad Tayyab,&nbsp;Muhammad Naveed Tariq,&nbsp;Hasaan H. Ans,&nbsp;Muhammad Bilal Javaid,&nbsp;Ahmad Khan,&nbsp;Muhammad Hassan Ahmad,&nbsp;Rahman Rasheed,&nbsp;Uzair Jafar,&nbsp;Huzaifa Ahmad Cheema,&nbsp;Asma'a Munasar Ali Alsubari,&nbsp;Muhammad Shahzil,&nbsp;Essam Rashad,&nbsp;Rehmat Ullah Awan,&nbsp;Hassam Ali,&nbsp;Prasun K. Jalal","doi":"10.1002/jgh3.70196","DOIUrl":"https://doi.org/10.1002/jgh3.70196","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Peroxisome proliferator-activated receptor (PPAR) agonists are agents used for patients with primary biliary cholangitis (PBC) who do not respond to conventional agents like ursodeoxycholic acid (UDCA). This meta-analysis aimed to assess the safety and efficacy of PPAR agonists, including fibrates and selective PPAR agonists, on biochemical response and safety outcomes in patients with primary biliary cholangitis who were non-responders to UDCA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched various electronic databases, including MEDLINE (via PubMed), Embase, the Cochrane Library, and ClinicalTrials.gov, to retrieve randomized controlled trials (RCTs) comparing PPAR agonists to placebo in patients with PBC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our meta-analysis, including 12 RCTs involving 973 patients, showed that PPAR agonists, including fibrates and selective PPAR agonists, significantly reduce mean alkaline phosphatase (ALP) levels from baseline to follow-up as compared to placebo. They also increase the number of patients with the composite biochemical response (RR 5.51; 95% CI: 2.80, 10.86) and normalize ALP levels with a reduction in pruritus NRS Score and the incidence of pruritus. There was no significant change between the two groups when assessing the mean change in total bilirubin, adverse events, serious adverse events, or mean change in PBC-40 score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In conclusion, our research underscores the potential of novel PPAR agonists in improving biochemical markers in PBC, particularly in patients unresponsive to UDCA. However, further studies with larger sample sizes, longer follow-up durations, and a focus on patient-centered outcomes are necessary. Additionally, exploring combination therapies and mechanistic insights will help us fully realize the therapeutic potential of PPAR agonists in PBC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144219980","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 Myoelectrical Activity Patterns and Water-Load Satiety Test in Patients With Chronic Dyspeptic Symptoms","authors":"Uday C. Ghoshal,&nbsp;Mahesh K. Goenka,&nbsp;Uzma Mustafa,&nbsp;Awanish Tewari,&nbsp;Nikhil Sonthalia,&nbsp;Subhamoy Das,&nbsp;Nabaruna Chakraborty,&nbsp;Akash Roy,&nbsp;Shruti Keyal,&nbsp;Sourish Roy","doi":"10.1002/jgh3.70189","DOIUrl":"https://doi.org/10.1002/jgh3.70189","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Aims</h3>\u0000 \u0000 <p>Patients with chronic dyspeptic symptoms may or may not experience nausea and vomiting. Consensus papers suggested that gastroparesis should be defined by symptoms like nausea and vomiting rather than investigations only. Recognizing that gastric dysrhythmias contribute to nausea, vomiting, and maybe a biomarker and therapeutic target, the primary hypothesis of the study was that dyspeptic patients with predominant nausea and vomiting, without mechanical obstruction, would show different gastric myoelectrical activity (GMA) on electrogastrography (EGG) and tolerance to the water-load satiety test (WLST) than those without these symptoms. The secondary aim was to assess the relationship between GMA, WLST, and demographic and clinical profiles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data of 660 chronic dyspeptic patients undergoing WLST-based EGG were retrospectively analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 660 patients, 287 (females 158[55%]) experienced nausea with or without vomiting, while 373 (females 151[41%]) did not. Nausea with or without vomiting was significantly associated with female gender, younger age, and weight loss (151[40.5%] vs. 158[55.1%], <i>p</i> &lt; 0.001; 47[36,59] vs. 41[29,55], <i>p</i> &lt; 0.001; 62[16.6%] vs. 85[29.6%], <i>p</i> &lt; 0.001). Patients with nausea with/without vomiting could drink lesser volumes of water compared to those without (500[400,500] vs. 500[450,550], <i>p</i> = 0.007). Gastric dysrhythmia was present in both groups. Normogastric power change was significantly lower in patients with nausea with or without vomiting, compared to those with neither nausea nor vomiting (3.7[−5.5, 11.5] vs. 7.3[−1.7,16], <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients experiencing nausea with or without vomiting have significantly more GMA abnormalities as evidenced by reduced power change in the normogastria range after water intake, and could drink lesser water, compared to patients without these symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214082","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 of Estimated Plasma Volume Status With Invasive Hemodynamics and All-Cause Mortality in Patients With Liver Cirrhosis","authors":"Esteban Kosak Lopez,&nbsp;Phuuwadith Wattanachayakul,&nbsp;Jose Manuel Martinez Manzano,&nbsp;Andrew Geller,&nbsp;Simone A. Jarrett,&nbsp;John Malin,&nbsp;Raul Leguizamon,&nbsp;Tara A. John,&nbsp;Rasha Khan,&nbsp;Ian McLaren,&nbsp;Alexander Prendergast,&nbsp;Kevin Bryan Lo,&nbsp;Zurab Azmaiparashvili","doi":"10.1002/jgh3.70195","DOIUrl":"https://doi.org/10.1002/jgh3.70195","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Estimated plasma volume status (ePVS) correlates with intravascular congestion and prognosis in patients with heart failure. The ePVS relationship with invasive hemodynamic profiling and clinical outcomes in patients with liver cirrhosis (LC) remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center retrospective cohort study included LC patients who underwent right heart catheterization (RHC) between 2018 and 2023. Estimated plasma volume status (ePVS) was calculated using the Strauss-derived Duarte formula, with patients classified into high (&gt; 5.5%) and low-ePVS (≤ 5.5%) groups. Cox-multivariable analysis was used to determine if ePVS was associated with all-cause mortality within 1 year post-RHC among transplant-free patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 353 patients with LC (median age 59 years, 59% male, 45% Caucasian, and 29% African American), 79% were classified into the high-ePVS group. Compared to the low-ePVS group, the high-ePVS group had significantly higher right atrial pressure (9 vs. 6 mmHg, <i>p</i> = 0.01), pulmonary arterial wedge pressure (14 vs. 11 mmHg, <i>p</i> = 0.014), cardiac output (9.8 vs. 6.4 L/min, <i>p</i> &lt; 0.0001), and cardiac index (5 vs. 3.1 L/min/m², <i>p</i> &lt; 0.0001). Additionally, the high-ePVS group exhibited a higher prevalence of cirrhosis-related complications, including ascites, splenomegaly, and varices, and a greater likelihood of receiving orthotopic liver transplantation within 1 year (38% vs. 11%, <i>p</i> &lt; 0.0001). Among transplant-free patients, ePVS was independently associated with all-cause mortality at 1 year (HR 1.15, 95% CI: 1.00–1.32, <i>p</i> = 0.048).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study demonstrated that ePVS was associated with intravascular congestion, hyperdynamic circulation, and cirrhosis complications. Furthermore, ePVS was independently associated with all-cause mortality among transplant-free LC patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70195","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190958","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":"Impact of Reviewing Procedure With Visual Gaze Patterns on Improving Endoscopic Submucosal Dissection Skills","authors":"Huy Thanh Dang,&nbsp;Fumiaki Ishibashi,&nbsp;Kosuke Okusa,&nbsp;Kentaro Mochida,&nbsp;Takao Tonishi,&nbsp;Sho Suzuki","doi":"10.1002/jgh3.70193","DOIUrl":"https://doi.org/10.1002/jgh3.70193","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>No previous studies have reported on whether tracking and reviewing physicians' gaze patterns affect the endoscopic submucosal dissection (ESD) training process. This study investigated differences in physicians' gaze patterns during ESD and assessed how reviewing their procedure afterward impacted ESD skills.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>The gazing points of three trainees during mucosal incision, submucosal dissection, and hemostasis were captured and recorded using the eye-tracking device. Fifteen short video clips were created from six recorded videos. Three trainees and two expert endoscopists later reviewed these video clips. Key outcomes included: (1) time spent gazing at the appropriate mucosal incision direction, (2) time spent gazing at the appropriate submucosal dissection line, and (3) time required to identify bleeding points. During video review, the trainees spent significantly more time fixating on the appropriate mucosal incision direction than during live performance (24.9 s vs. 6.4 s, <i>p</i> &lt; 0.01). However, this was still shorter than expert reviewers (28.4 s, <i>p</i> &lt; 0.01). Similarly, the trainees spent more time observing the appropriate submucosal dissection line during review than in real-time (12.9 s vs. 4.8 s, <i>p</i> &lt; 0.05), with no significant difference compared to the experts (14.6 s, <i>p</i> = 0.66). However, there was no significant difference in time to identify the bleeding point between review and real-time performance (9.3 s vs. 11.4 s, <i>p</i> = 1.00).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This pilot study suggests that video-based review with eye-tracking feedback may help trainees adopt expert-like visual strategies during ESD, potentially enhancing procedural performance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171846","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":"Compounding Prevalence of Inflammatory Bowel Disease in a 2024 Population-Based Study From Canterbury, New Zealand","authors":"Angela J. Forbes,&nbsp;Andrew S. Day,&nbsp;Chris M. A. Frampton,&nbsp;Richard B. Gearry","doi":"10.1002/jgh3.70192","DOIUrl":"https://doi.org/10.1002/jgh3.70192","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>The epidemiological patterns of inflammatory bowel disease (IBD) can give insights into disease etiology and health system burden. This study aimed to measure the population-based prevalence in Canterbury and consider the region's position within the 4-stage epidemiological model of IBD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Gastroenterology clinics in Canterbury were searched for patients with a confirmed diagnosis of IBD. Demographic and disease details (including Montreal phenotype) were extracted from individual medical records. The prevalence of IBD, Crohn's disease (CD), ulcerative colitis (UC) and inflammatory bowel disease unclassified (IBDU) was established for the total population and for age, sex, and ethnic sub-groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Altogether 4042 individuals (1 in 150 people) in Canterbury with IBD were identified. The point prevalence of IBD on 1st January 2024 was 671 (95% CI 651–692) per 100 000 persons. The prevalence of CD 386 (95% CI 370–402) was higher than UC 264 (95% CI 251–277) each per 100 000. Almost three times as many individuals had IBD in 2024, compared to a 2005 study. The majority of the cohort were New Zealand European (92.9%) followed by Māori (4.2%), Asian (2.6%) and Pacific peoples (0.3%). Older adults (65+ years) comprised 21% of the population with a prevalence of 845 (95% CI 789–904) per 100 000 persons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Canterbury has the highest reported prevalence of IBD in Oceania to date, and there is a growing proportion of older age patients. The rapid rise in cases supports the hypothesis that Canterbury is in the compounding prevalence stage of the epidemiological model of IBD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179312","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":"Proctitis and Other Gastrointestinal Manifestations in Mpox Disease: A Systematic Review and Meta-Analysis","authors":"Prakasini Satapathy,&nbsp;Abhay M. Gaidhane,&nbsp;Nasir Vadia,&nbsp;Soumya V. Menon,&nbsp;Kattela Chennakesavulu,&nbsp;Rajashree Panigrahi,&nbsp;Sanjit Sah,&nbsp;Suraj Tiwari,&nbsp;S. Govinda Rao,&nbsp;Khang Wen Goh,&nbsp;Rachana Mehta,&nbsp;Muhammed Shabil,&nbsp;Mahendra Singh,&nbsp;Ganesh Bushi","doi":"10.1002/jgh3.70190","DOIUrl":"https://doi.org/10.1002/jgh3.70190","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mpox, caused by the monkeypox virus (MPXV), is primarily recognized for its dermatologic and systemic symptoms. However, emerging evidence suggests a significant prevalence of gastrointestinal (GI) manifestations, particularly proctitis, diarrhea, nausea, vomiting, and abdominal pain. Despite the growing clinical recognition of these symptoms, their epidemiology and impact remain poorly understood. This systematic review and meta-analysis aim to quantify the prevalence of GI manifestations in Mpox patients and assess their clinical significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review following PRISMA guidelines was conducted across PubMed, Embase, and Web of Science, including quantitative studies published up until October 2024 that reported GI manifestations in Mpox patients. Screening and data extraction were performed using Nested Knowledge software, and study quality was assessed using the Newcastle–Ottawa Scale. Meta-analysis was conducted using R version 4.4, with heterogeneity evaluated via the <i>I</i>² statistic. Sensitivity analyses and publication bias were assessed using Doi plots and the Luis Furuya-Kanamori (LFK) index.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 1229 records, 33 studies met the eligibility criteria, yielding a pooled prevalence of proctitis in Mpox patients at 24.75% (95% CI: 18.93%–31.04%) across 5878 participants, with high heterogeneity (<i>I</i>² = 94.8%). The prediction interval for proctitis ranged from 1.46% to 61.76%. The pooled prevalence of other GI manifestations was 30.45% (95% CI: 18.27%–44.14%) across 2237 participants, with significant heterogeneity (<i>I</i>² = 95.2%) and a prediction interval ranging from 0.00% to 85.28%. Sensitivity analyses confirmed the stability of these estimates, while publication bias was indicated by LFK index values exceeding 2.77.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This meta-analysis highlights the substantial burden of GI manifestations in Mpox, particularly proctitis, with considerable variability across studies. The findings underscore the need for standardized diagnostic criteria and increased clinical recognition of GI symptoms in Mpox management. Further research into the underlying pathophysiology and integrating GI symptom assessment into Mpox surveillance and treatment strategies could enhance diagnostic accuracy and patient care outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70190","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148293","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}