JGH OpenPub Date : 2024-10-14DOI: 10.1002/jgh3.70038
Angela J Forbes, Chris M A Frampton, Andrew S Day, Millie DeVries, Nina McVicar, Heidi Su, Richard B Gearry
{"title":"Ten-year outcomes of a prospective population-based incidence cohort of inflammatory bowel disease patients from Canterbury, New Zealand","authors":"Angela J Forbes, Chris M A Frampton, Andrew S Day, Millie DeVries, Nina McVicar, Heidi Su, Richard B Gearry","doi":"10.1002/jgh3.70038","DOIUrl":"https://doi.org/10.1002/jgh3.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Inflammatory bowel disease (IBD) is a progressive condition where ongoing inflammation in the gastrointestinal tract can lead to complications such as strictures, and fistulae. The long-term outcomes of newly diagnosed patients under current medical therapy can be used to plan health service provision and guide patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Prospective population-based data on all incident patients diagnosed with IBD in Canterbury was gathered in 2014 (<i>n</i> = 205). The medical records of these patients were followed for medication use, disease progression, hospitalization, surgery and mortality, in the 10 years since their diagnosis. Survival analysis and cox regression determined characteristics associated with earlier time to these outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Medical records of 184 IBD patients were able to be retrieved. Immunomodulators were used by 62% and biologics by 35%; hospitalization occurred for 42% and surgery for 15%. Montreal phenotype progression occurred for 21 and 7% of the cohort died. Younger age at diagnosis hazard ratio (HR) 2.1 (95% confidence interval [CI] 1.1–4.0) and Crohn's disease HR 1.7 (95% CI 1.1–2.6) was associated with immunomodulator use. Younger age was also associated with biologic use HR 2.9 (95% CI 1.2–6.9). Male gender was associated with surgery HR 2.8 (95% CI 1.2–6.4). Perianal disease at diagnosis (14.7%) was associated with immunomodulator use HR 2.58 (95% CI 1.44–4.59) and Montreal phenotype progression HR 2.93 (95% CI 1.10–7.77).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In the 10 years since diagnosis disease progression and treatment escalation occurred for most of this population-based cohort. Earlier intervention for patients with higher-risk characteristics may improve long-term outcomes reducing the burden on health systems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435437","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 : 2024-10-13DOI: 10.1002/jgh3.70039
Yu-Ming Cheng, Tsung-Han Hsieh, Chia-Chi Wang, Jia-Horng Kao
{"title":"Overlapping group between non-alcoholic fatty liver disease and metabolic associated fatty liver disease better for liver research","authors":"Yu-Ming Cheng, Tsung-Han Hsieh, Chia-Chi Wang, Jia-Horng Kao","doi":"10.1002/jgh3.70039","DOIUrl":"https://doi.org/10.1002/jgh3.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Metabolic associated fatty liver disease (MAFLD) was proposed to replace “non-alcoholic fatty liver disease (NAFLD) with new diagnostic criteria.” The group meeting these two diagnostic criteria is called “Overlapping Fatty Liver Disease (FLD).” Its clinical characteristics remain unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included participants from the Taiwan Bio-Bank database, where NAFLD was defined as hepatic steatosis in liver ultrasound, with exclusion of other known chronic liver diseases. MAFLD was defined as the presence of hepatic steatosis plus metabolic dysfunction, defined as having any of following three criteria: overweight/obesity, type 2 diabetes mellitus (DM), or ≥2 metabolic risk abnormalities in lean/normal weight subjects. According to these two diagnostic criteria, three groups were identified: “overlapping FLD”, “NAFLD alone”, and “MAFLD alone.” NAFLD fibrosis score (NFS) >0.675 was defined as advanced liver fibrosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight thousand thirty-eight NAFLD participants (age 55.86 ± 10.12; males 41.07%) were included in the final analysis. Of them, “overlapping FLD” was diagnosed in 7377 (91.8%) and “NAFLD alone” in 661 (8.2%) participants. “Overlapping FLD” patients were older and had a higher percentage of male, worse metabolic profiles, higher NFS, and the percentage of carotid plaques was higher than those with “NAFLD alone.” Multivariate analysis showed age, hypertension, DM, and BMI were positively associated with advanced liver fibrosis in “overlapping FLD” patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>“Overlapping FLD” is better for liver research due to identifying a high-risk population among NAFLD patients. NAFLD definition introduces the heterogeneity through “NAFLD alone” group and MAFLD criteria overcome this limitation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435631","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 : 2024-10-08DOI: 10.1002/jgh3.13112
Jonathan Ng, Sujievvan Chandran, Kim Hay Be, Leonardo Zorron Cheng Tao Pu, Kevin Kyung Ho Choi, Payal Saxena, Arthur John Kaffes, Rhys Vaughan, Marios Efthymiou
{"title":"Evaluating the yield of digital single operator cholangioscopy in posttransplant biliary strictures after unsuccessful guidewire placement with ERCP","authors":"Jonathan Ng, Sujievvan Chandran, Kim Hay Be, Leonardo Zorron Cheng Tao Pu, Kevin Kyung Ho Choi, Payal Saxena, Arthur John Kaffes, Rhys Vaughan, Marios Efthymiou","doi":"10.1002/jgh3.13112","DOIUrl":"10.1002/jgh3.13112","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Strictures are the most common biliary complication after liver transplantation, and endoscopic retrograde cholangiopancreatography (ERCP) is considered the gold standard in its management. Failure to cross the biliary anastomosis requires a repeated attempt with ERCP, referral for percutaneous transhepatic cholangiography (PTC) or surgery. We present our experience with the digital single operator cholangioscope (D-SOC) in achieving guidewire access in a liver transplant cohort with difficult biliary strictures who have failed conventional ERCP methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective study involving two adult liver transplant centers servicing the two most populated states in Australia. Deceased-donor liver transplant recipients undergoing D-SOC for biliary strictures who have failed conventional methods to achieve biliary access were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between July 2017 to April 2022, eighteen patients underwent D-SOC after failing to achieve guidewire placement through standard ERCP techniques. Thirteen out of eighteen (72%) had successful guidewire placement with index D-SOC. Five of eighteen patients (28%) had unsuccessful guidewire placement with D-SOC. In two of these patients, use of D-SOC informed further endoscopic management, with one avoiding PTC and the other avoiding surgery. Two of the five patients required PTC and one patient was left unstented. Three patients developed post D-SOC cholangitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>D-SOC is effective at achieving guidewire access in post-liver transplant patients who fail conventional ERCP techniques and should be considered in the treatment algorithm as a step before PTC and surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394141","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":"Genotypes of carboxypeptidase A1 and gamma-glutamyltransferase 1 may be useful tools for the diagnosis and the predictor of worrisome features of intraductal papillary mucinous neoplasm in Japan","authors":"Shuhei Agawa, Seiji Futagami, Ken Nakamura, Mayu Habiro, Rie Kawawa, Yuto Shinagawa, Rina Motomiya, Kumiko Kirita, Teppei Akimoto, Takeshi Onda, Tomohide Tanabe, Nobue Ueki, Kazufumi Honda, Kok-Ann Gwee, Katsuhiko Iwakiri","doi":"10.1002/jgh3.70031","DOIUrl":"10.1002/jgh3.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>This study aimed to clarify whether several single-nucleotide polymorphisms (SNPs)-related chronic pancreatitis such as carboxypeptidase A1 (<i>CPA1</i>), carboxypeptidase B1 (<i>CPB1</i>), Gamma-glutamyltransferase 1 (<i>GGT1</i>), G-protein-coupled receptor Class C Group 6 Member A (<i>GPRC6A</i>), and serine protease inhibitor, Kazal type 1 (<i>SPINK-1</i>) genotypes were associated with clinical characteristics of patients with intraductal papillary mucinous neoplasm (IPMN) and worrisome features of IPMN.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled 100 patients with IPMN and 116 patients as a control. Serum p-amylase, lipase, trypsin, phospholipase A2 (PLA2), and elastase-1 levels were measured. An Olympus EUS (GF-UCT 260) was used to perform endosonography in 100 patients with IPMN. Total EUS score was evaluated using endosonography. DNA was isolated from the duodenal tissue using a commercial system and polymerase chain reaction (PCR) was performed on 7500 Fast PCR System.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were no associations between glucose tolerances, lipid levels and genotypes of <i>CPA1</i>, <i>GGT1</i>, <i>GPRC6A</i>, and <i>SPINK-1</i> in patients with IPMN. <i>CPA1</i> genotype was significantly associated with the pathophysiology of IPMN. Then, <i>GGT1</i> genotype was also significantly associated with EUS total score and the size of cyst more than 20 mm and more than 30 mm as one of worrisome features of IPMN.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Genotypes of carboxypeptidase A1 and gamma-glutamyltransferase 1 may be useful tools for the diagnosis and the predictor of worrisome features of IPMN.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11458879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394142","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":"Initial treatment efficacy and safety of durvalumab plus tremelimumab combination therapy in unresectable hepatocellular carcinoma in clinical practice","authors":"Tetsu Tomonari, Joji Tani, Yasushi Sato, Hironori Tanaka, Akihiro Morishita, Koichi Okamoto, Yutaka Kawano, Masahiro Sogabe, Hiroshi Miyamoto, Tetsuji Takayama","doi":"10.1002/jgh3.70033","DOIUrl":"10.1002/jgh3.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>We aimed to evaluate the efficacy and safety of durvalumab plus tremelimumab (Dur + Tre) combination therapy in patients with unresectable hepatocellular carcinoma (uHCC) in clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively evaluated 37 patients with uHCC from our institutions between April 2023 and January 2024. Patients were divided into first- and later-line groups for analysis of antitumor efficacy, adverse events (AEs), and transition rate to second-line treatment according to the Response Evaluation Criteria in Solid Tumors (RECIST).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The disease control rate (DCR) for the first-line group was 80.9%, which was significantly higher than that for the later-line group (50%). The incidence of immune-related AEs (irAEs) was 24.3%, with grade 3 or higher irAEs including increased transaminase (8.1%), diarrhea (8.1%), and adrenal insufficiency (2.7%). The rates of drug withdrawal and discontinuation owing to AEs were 23.8% and 19%, respectively, in the first-line treatment and 31.2% and 12.5%, respectively, in the later-line treatment, with no significant difference. Analysis of changes in liver reserve using the albumin–bilirubin (ALBI) score showed no obvious loss of liver reserve for up to 12 weeks. The transition rate from first- to second-line therapy after progressive disease (PD) was as high as 94.7%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The efficacy and safety of Dur + Tre in clinical practice were comparable to those reported in a recent phase III trial. The first-line Dur + Tre therapy had a higher DCR than that of the later lines, and the transition rate to second-line therapy was considerably high, suggesting that Dur + Tre therapy would be more beneficial in first-line treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381924","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 : 2024-10-03DOI: 10.1002/jgh3.70008
Jennifer Gu, Leonardo Zorron Cheng Tao Pu, Jonathan Ng, Kim H Be, Rhys Vaughan, Sujievvan Chandran, Marios Efthymiou
{"title":"Procedure-related readmissions following endoscopic retrograde cholangiopancreatography in a liver transplant cohort","authors":"Jennifer Gu, Leonardo Zorron Cheng Tao Pu, Jonathan Ng, Kim H Be, Rhys Vaughan, Sujievvan Chandran, Marios Efthymiou","doi":"10.1002/jgh3.70008","DOIUrl":"10.1002/jgh3.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Data on post-endoscopic retrograde cholangiopancreatography (ERCP) adverse events and readmission rates in liver transplantation (LT) patients remain scarce. This study determined the 30-day procedure-related readmission rate following ERCP in an LT cohort at an Australian tertiary academic center.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All unplanned readmissions within 30 days following ERCP in orthotopic LT patients between December 2012 and August 2021 were retrospectively identified. Demographic data, procedure variables, and readmission characteristics were also collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-five procedure-related readmissions were identified (3.3%) from a total of 1369 ERCP procedures. This included 33 cases of cholangitis (2.4%), 7 cases of nonspecific abdominal pain (0.5%), 5 cases of mild post-ERCP pancreatitis (0.5%), and 3 cases of bleeding (0.2%). No procedure-related mortality was observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The procedure-related readmission rate following ERCP in this LT cohort was 3.3%, which is likely lower than comparable studies carried out on the overall population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373203","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":"Cronkhite–Canada syndrome tends to be accompanied by colorectal cancer: Report of seven cases","authors":"Masayuki Shimoyama, Hiroyoshi Iwagami, Kosuke Minaga, Takuji Akamatsu, Yoshito Uenoyama, Yukitaka Yamashita","doi":"10.1002/jgh3.70032","DOIUrl":"10.1002/jgh3.70032","url":null,"abstract":"<p>Cronkhite–Canada syndrome (CCS) can be difficult to diagnose. To diagnose CCS, it is important to perform endoscopic examination for patients with chronic diarrhea, check for the presence or absence of polyposis, and evaluate inflammation in the mucosa between the polyps. This study reported seven cases of CCS. The age of the patients, which included four men and three women, ranged 48–72 years, and all patients were Asian. The most common symptom among these patients was chronic diarrhea. Three of the patients had rectal cancer. In two patients, the lesions were detected at an early stage and resected via endoscopic treatment. CCS is associated with a high risk of malignant gastrointestinal lesions, especially rectal cancers, and periodic surveillance endoscopy and careful observation are required.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142374020","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 : 2024-10-01DOI: 10.1002/jgh3.70025
Hashim Talib Hashim, Ahmed Qasim Mohammed Alhatemi, Sania Riaz, Mohammedbaqer Ali Al-Ghuraibawi, Arwa S. Alabide, Humza Saeed, Fatimah Abdullah Sulaiman, Mustafa Ali Abd Alhussain, Maythum Ali Shallan, Ahmed Dheyaa Al-Obaidi, Omar Saab, Hasan Al-Obaidi, Ali Talib Hashim, Nooraldin Merza
{"title":"Unveiling Resmetirom: A systematic review and meta-analysis on its impact on liver function and safety in non-alcoholic steatohepatitis treatment","authors":"Hashim Talib Hashim, Ahmed Qasim Mohammed Alhatemi, Sania Riaz, Mohammedbaqer Ali Al-Ghuraibawi, Arwa S. Alabide, Humza Saeed, Fatimah Abdullah Sulaiman, Mustafa Ali Abd Alhussain, Maythum Ali Shallan, Ahmed Dheyaa Al-Obaidi, Omar Saab, Hasan Al-Obaidi, Ali Talib Hashim, Nooraldin Merza","doi":"10.1002/jgh3.70025","DOIUrl":"10.1002/jgh3.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>The role of Resmetirom in non-alcoholic steatohepatitis (NASH) represents a promising therapeutic approach in addressing the growing global burden of liver disease. With NASH emerging as a leading cause of liver-related morbidity and mortality worldwide, there is an urgent need for effective treatments. Resmetirom, a selective thyroid hormone receptor-β agonist, offers potential benefits in improving liver histology and metabolic parameters in patients with NASH. This review examines the current evidence surrounding Resmetirom's role in NASH management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis was done by searching in Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE (including MEDLINE InProcess) (OvidSP), Web of Science, Embase (OvidSP), and Scopus databases. ROB2 Cochrane tool was used for assessing risk of bias in randomized controlled trials (RCTs). In the analysis, we used RevMan Cochrane software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study showed that patients who were treated with Resmetirom had significantly lower low-density lipoprotein-cholesterol (LDL-C) levels (mean difference [MD] −10.45; 95% confidence interval [CI] −15.86 to −5.83; <i>P</i> < 0.001) and alanine aminotransferase (ALT) levels (MD −7.18; 95% CI −12.67 to −1.68; <i>P</i> = 0.01) as compared with those in the placebo group. The risk of adverse events including diarrhea [risk ratio (RR) 1.81; 95% CI 1.40 to 2.35; <i>P</i> < 0.001] and nausea (RR 1.72; 95% CI 1.31 to 2.27; <i>P</i> < 0.001) was significantly increased for the Resmetirom group as compared with the placebo group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Resmetirom presents a promising therapeutic option for NASH, offering potential benefits in reducing liver fat content and improving histological outcomes. The encouraging results from clinical trials suggest that Resmetirom may address an unmet need in NASH management, providing hope for patients with this progressive liver disease. Further research and long-term studies are warranted to validate its efficacy and safety profile in larger patient populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366883","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 : 2024-09-25DOI: 10.1002/jgh3.70030
Jin L Tan, Dileepa Pitawela, Mohamed A Chinnaratha, Andrawus Beany, Enrik J Aguila, Hsiang-Ting Chen, Gustavo Carneiro, Rajvinder Singh
{"title":"Exploring vision transformers for classifying early Barrett's dysplasia in endoscopic images: A pilot study on white-light and narrow-band imaging","authors":"Jin L Tan, Dileepa Pitawela, Mohamed A Chinnaratha, Andrawus Beany, Enrik J Aguila, Hsiang-Ting Chen, Gustavo Carneiro, Rajvinder Singh","doi":"10.1002/jgh3.70030","DOIUrl":"https://doi.org/10.1002/jgh3.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Various deep learning models, based on convolutional neural network (CNN), have been shown to improve the detection of early esophageal neoplasia in Barrett's esophagus. Vision transformer (ViT), derived from natural language processing, has emerged as the new state-of-the-art for image recognition, outperforming predecessors such as CNN. This pilot study explores the use of ViT to classify the presence or absence of early esophageal neoplasia in endoscopic images of Barrett's esophagus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A BO dataset of 1918 images of Barrett's esophagus from 267 unique patients was used. The images were classified as dysplastic (D-BO) or non-dysplastic (ND-BO). A pretrained vision transformer model, ViTBase16, was used to develop our classifier models. Three ViT models were developed for comparison based on imaging modality: white-light imaging (WLI), narrow-band imaging (NBI), and combined modalities. Performance of each model was evaluated based on accuracy, sensitivity, specificity, confusion matrices, and receiver operating characteristic curves.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The ViT models demonstrated the following performance: WLI-ViT (Accuracy: 92%, Sensitivity: 82%, Specificity: 95%), NBI-ViT (Accuracy: 99%, Sensitivity: 97%, Specificity: 99%), and combined modalities-ViT (Accuracy: 93%, Sensitivity: 87%, Specificity: 95%). Combined modalities-ViT showed greater accuracy (94% <i>vs</i> 90%) and sensitivity (80% <i>vs</i> 70%) compared with WLI-ViT when classifying WLI images on a subgroup testing set.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ViT exhibited high accuracy in classifying the presence or absence of EON in endoscopic images of Barrett's esophagus. ViT has the potential to be widely applicable to other endoscopic diagnoses of gastrointestinal diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 9","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142324619","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 : 2024-09-24DOI: 10.1002/jgh3.70024
Chandra Bhati, Danielle Kirkman, Mikael F Forsgren, Hiba Kamal, Hiba Khan, Sherry Boyett, Olof Dahlqvist Leinhard, Jennifer Linge, Vaishali Patel, Samarth Patel, Susan Wolver, Mohammad S Siddiqui
{"title":"Liver transplant recipients have worse metabolic body phenotype compared with matched non-transplant controls","authors":"Chandra Bhati, Danielle Kirkman, Mikael F Forsgren, Hiba Kamal, Hiba Khan, Sherry Boyett, Olof Dahlqvist Leinhard, Jennifer Linge, Vaishali Patel, Samarth Patel, Susan Wolver, Mohammad S Siddiqui","doi":"10.1002/jgh3.70024","DOIUrl":"https://doi.org/10.1002/jgh3.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Quantification of body compartments, particularly the interaction between adipose tissue and skeletal muscle, is emerging as novel a biomarker of metabolic health. The present study evaluated the impact of liver transplant (LT) on body compartments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Totally 66 adult LT recipients were enrolled in whom body compartments including visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (ASAT), muscle fat infiltration (MFI), fat-free muscle volume (FFMV), and liver fat (LF) were quantified via whole body magnetic resonance imaging (MRI). To provide non-LT comparison, each LT recipient was matched to at least 150 non-LT controls for same sex, age, and body mass index (BMI) from the UK Biobank registry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>LT recipients (<i>vs</i> matched non-LT controls) had significantly higher subcutaneous (13.82 ± 5.47 <i>vs</i> 12.10 ± 5.10 L, <i>P</i> < 0.001) and visceral fat (7.59 ± 3.75 <i>vs</i> 6.72 ± 3.06 L, <i>P</i> = 0.003) and lower LF (5.88 ± 7.14 <i>vs</i> 8.75 ± 6.50%, <i>P</i> < 0.001) and muscle volume (11.69 ± 2.95 <i>vs</i> 12.12 ± 2.90 L, <i>P</i> = 0.027). In subgroup analysis, patients transplanted for metabolic dysfunction-associated steatohepatitis (MASH) cirrhosis (<i>vs</i> non-MASH cirrhosis) had higher ASAT, VAT, and MFI. A trend toward higher LF content was noted; however, this did not reach statistical significance (6.90 ± 7.35 <i>vs</i> 4.04 ± 6.23%, <i>P</i> = 0.189). Finally, compared with matched non-LT controls, patients transplanted for MASH cirrhosis had higher ASAT and VAT; however, FFMV and MFI were similar.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Using non-LT controls, the current study established the higher-than-expected adiposity burden among LT recipients, which is even higher among patients transplanted for MASH cirrhosis. These findings provide data needed to design future studies developing radiomics-based risk-stratification strategies in LT recipients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 9","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142313321","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}