JGH Open最新文献

{"title":"Exploring the Role of Thy-1 and Its Soluble Form Regarding Fibrosis Severity in Primary Biliary Cholangitis and Metabolic Dysfunction-Associated Fatty Liver Disease","authors":"Mirjam Kolev,&nbsp;Rahel Bütikofer,&nbsp;Anja Saalbach,&nbsp;Florian Kollert,&nbsp;Matteo Montani,&nbsp;Nasser Semmo","doi":"10.1002/jgh3.70155","DOIUrl":"https://doi.org/10.1002/jgh3.70155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Portal myofibroblasts (PMF) are known to be critical in bile duct injury, but their role in liver fibrogenesis remains underexplored. Thy-1, an adhesion molecule detected as soluble Thy-1 (sThy-1) in serum, is primarily expressed by portal myofibroblasts (PMF) and, to a lesser extent, hepatic stellate cells (HSC), serving as a marker for myofibroblast activity in liver pathology. This study aimed to elucidate the correlation between Thy-1 expression in liver histology and sThy-1 levels in serum with the degree of liver fibrosis in patients with primary biliary cholangitis (PBC) and metabolic dysfunction-associated steatotic liver disease (MASLD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Liver histology samples were stained for Thy-1, and sThy-1 was measured using an enzyme-linked immunosorbent assay (ELISA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In patients with PBC and MASLD, an association between portal Thy-1 expression and the extent of fibrosis was observed. Notably, while sinusoidal Thy-1 expression aligned with fibrosis severity in PBC (<i>p</i> &lt; 0.001), this association was not statistically significant in MASLD (<i>p</i> = 0.059). Moreover, variations in soluble Thy-1 levels paralleled the progression from mild to advanced fibrosis stages in PBC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Thy-1 expression levels were associated with the severity of fibrosis, which could support its role in monitoring the presence and activity of myofibroblasts in liver diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809553","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":"Usefulness of the Bridge Formation Method for Colorectal Endoscopic Submucosal Dissection: A Propensity Score-Matched Study","authors":"Masahiro Abe,&nbsp;Takemasa Hayashi,&nbsp;Yuta Kouyama,&nbsp;Yutaro Ide,&nbsp;Tomoya Shibuya,&nbsp;Yuriko Morita,&nbsp;Kenichi Mochizuki,&nbsp;Yosuke Minegishi,&nbsp;Eri Tamura,&nbsp;Taishi Okumura,&nbsp;Tatsuya Sakurai,&nbsp;Yushi Ogawa,&nbsp;Yasuharu Maeda,&nbsp;Katsuro Ichimasa,&nbsp;Naoya Toyoshima,&nbsp;Masashi Misawa,&nbsp;Kunihiko Wakamura,&nbsp;Naruhiko Sawada,&nbsp;Toshiyuki Baba,&nbsp;Tetsuo Nemoto,&nbsp;Shin-ei Kudo","doi":"10.1002/jgh3.70149","DOIUrl":"https://doi.org/10.1002/jgh3.70149","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Colorectal endoscopic submucosal dissection (ESD) has become a standard treatment for superficial colorectal neoplasms worldwide. However, challenges remain in achieving dissection at the precise layer. In this study, we evaluated the effectiveness of a novel ESD technique involving natural traction, referred to as the bridge formation method (BFM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>The two main features of the BFM are creating a large mucosal flap and leaving normal mucosa on both sides of the lesion until the bridge is made at the end of the procedure. This retrospective study included consecutive patients with 2647 colorectal lesions resected by ESD from September 2003 to December 2023. We divided them into the BFM group and the non-BFM group and conducted propensity score matching.</p>\u0000 \u0000 <p>After propensity score matching, 1648 cases were enrolled (824 cases in each group). The en bloc resection rate was significantly higher in the BFM than non-BFM group (99.6% vs. 96.7%, <i>p</i> &lt; 0.01). The R0 resection rate and the average dissection speed (㎟/min) were significantly higher in the BFM than non-BFM group (98.8% vs. 96.4%, <i>p</i> &lt; 0.01, and 18.9 vs. 18.0, <i>p</i> = 0.03). The occurrence rates of perforation and delayed bleeding showed no significant difference between the non-BFM and BFM groups (2.8% vs. 3.6%, <i>p</i> = 0.40, and 1.1% vs. 1.0%, <i>p</i> = 1.00).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The BFM is a suitable method for colorectal ESD as it enables rapid dissection and improves both en bloc resection and R0 resection rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793624","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":"AI-Based Platelet-Independent Noninvasive Test for Liver Fibrosis in MASLD Patients","authors":"Shun-ichi Wakabayashi,&nbsp;Takefumi Kimura,&nbsp;Nobuharu Tamaki,&nbsp;Takanobu Iwadare,&nbsp;Taiki Okumura,&nbsp;Hiroyuki Kobayashi,&nbsp;Yuki Yamashita,&nbsp;Naoki Tanaka,&nbsp;Masayuki Kurosaki,&nbsp;Takeji Umemura","doi":"10.1002/jgh3.70150","DOIUrl":"https://doi.org/10.1002/jgh3.70150","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Noninvasive tests (NITs), such as platelet-based indices and ultrasound/MRI elastography, are widely used to assess liver fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD). However, platelet counts are not routinely included in Japanese health check-ups, limiting their utility in large-scale screenings. Additionally, elastography, while effective, is costly and less accessible in routine practice. Most existing AI-based models incorporate these markers, restricting their applicability. This study aimed to develop a simple yet accurate AI model for liver fibrosis staging using only routine demographic and biochemical markers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study analyzed biopsy-proven data from 463 Japanese MASLD patients. Patients were randomly assigned to training (<i>N</i> = 370, 80%) and test (<i>N</i> = 93, 20%) cohorts. The AI model incorporated age, sex, BMI, diabetes, hypertension, hyperlipidemia, and routine blood markers (AST, ALT, γ-GTP, HbA1c, glucose, triglycerides, cholesterol).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Support Vector Machine model demonstrated high diagnostic performance, with an area under the curve (AUC) of 0.886 for detecting significant fibrosis (≥ F2). The AUCs for advanced fibrosis (≥ F3) and cirrhosis (F4) were 0.882 and 0.916, respectively. Compared to FIB-4, APRI, and FAST score (0.80–0.96), SVM achieved comparable accuracy while eliminating the need for platelet count or elastography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This AI model accurately assesses liver fibrosis in MASLD patients without requiring platelet count or elastography. Its simplicity, cost-effectiveness, and strong diagnostic performance make it well-suited for large-scale health screenings and routine clinical use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770179","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":"Development of a Predictive Model for Classifying Immune Checkpoint Inhibitor-Induced Liver Injury Types","authors":"Jun Kitadai,&nbsp;Toshifumi Tada,&nbsp;Takanori Matsuura,&nbsp;Mayumi Ehara,&nbsp;Tatsuya Sakane,&nbsp;Miki Kawano,&nbsp;Yuta Inoue,&nbsp;Shoji Tamura,&nbsp;Aya Horai,&nbsp;Yuuki Shiomi,&nbsp;Yoshihiko Yano,&nbsp;Yuzo Kodama","doi":"10.1002/jgh3.70147","DOIUrl":"https://doi.org/10.1002/jgh3.70147","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Immune checkpoint inhibitors (ICIs) have transformed cancer therapy; however, they are associated with ICI-induced liver injury (ICI-LI), which manifests as hepatocellular, mixed, or cholestatic patterns with variable treatment responses. This study aimed to develop and validate a predictive model to identify ICI-LI type using clinical data available at ICI initiation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of 297 patients with ICI-LI was conducted. Baseline clinical data were analyzed using univariate and multivariate logistic regression to predict ICI-LI types in the training and validation cohorts. A predictive model was developed and validated using receiver operating characteristic (ROC) curve analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Multivariate analysis in the training cohort identified male sex (odds ratio [OR]: 3.33, 95% confidence interval [CI]: 1.57–7.06, <i>p</i> = 0.002), serum albumin levels (OR: 0.42, 95% CI: 0.19–0.91, <i>p</i> = 0.027), and serum alanine aminotransferase (ALT) levels (OR: 0.97, 95% CI: 0.94–0.99, <i>p</i> = 0.015) as significant predictors, along with ICI regimen types selected using the Akaike information criterion. The logistic regression model, expressed as <i>p</i> = 1/{1 + (−(5.02 + 1.20 × (sex [F:0, M:1])) − 0.87 × albumin [g/dL] − 0.03 × ALT [U/L] − 0.9 × (drug [non-anti-cytotoxic T lymphocyte antigen 4 (CTLA-4) related regimen:0, anti-CTLA-4 related regimen:1]))}, achieved an area under the ROC (AUROC) of 0.73 (95% CI: 0.63–0.82) in the training cohort. At a cut-off of 0.86, the sensitivity was 60.3%, specificity 74.4%, positive predictive value 92.3%, and negative predictive value 26.9%. In the validation cohort, the AUROC was 0.752 (95% CI: 0.476–1.00).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This predictive model demonstrates its utility in classifying ICI-LI types.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761922","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 Therapy With Oral Tacrolimus Provides Long-Term Benefit in Thiopurine-Naïve Refractory Ulcerative Colitis Patients Despite Low Serum Albumin Levels","authors":"Shoko Igawa,&nbsp;Toshihiro Inokuchi,&nbsp;Sakiko Hiraoka,&nbsp;Junki Toyosawa,&nbsp;Yuki Aoyama,&nbsp;Yasushi Yamasaki,&nbsp;Hideaki Kinugasa,&nbsp;Masahiro Takahara,&nbsp;Hiroyuki Okada,&nbsp;Motoyuki Otsuka","doi":"10.1002/jgh3.70139","DOIUrl":"https://doi.org/10.1002/jgh3.70139","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Oral tacrolimus is an effective treatment for refractory ulcerative colitis (UC). However, tacrolimus is underutilized because of the difficulties in transitioning to subsequent maintenance therapy and concerns about adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We evaluated the clinical outcomes, adverse events, and accumulated medication costs in consecutive 72 UC patients treated with tacrolimus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-five (76%) patients with pancolitis and 43 (60%) patients with acute severe disease were entered. Fifty-four (75%) achieved clinical remission 8 weeks after starting tacrolimus. At the last visit, 62 (86%) patients had colectomy-free remission, and 55 (76%) patients had corticosteroid-free remission. Eighteen (25%) patients maintained remission without additional treatment after tacrolimus discontinuation. Patients with continuous remission had a significantly lower history of thiopurine use and lower serum albumin levels at the induction of tacrolimus than patients with failure to induce or maintain remission. No severe adverse events due to tacrolimus treatment were observed. The accumulated medication costs over 3 years in patients with continuous remission after the start of tacrolimus were lower than those in patients with induction and maintenance of infliximab (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Tacrolimus could have an irreplaceable role in the era of biologic therapies, especially for refractory UC patients with thiopurine-naïve and low serum albumin levels.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70139","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749639","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":"Unmasking an Incidental Trichuris trichiura Infection in a Patient With Acute Hepatobiliary and Gastrointestinal Illness","authors":"Yung-Che Chou,&nbsp;Yu-Ta Lin,&nbsp;Tze-Kiong Er","doi":"10.1002/jgh3.70146","DOIUrl":"https://doi.org/10.1002/jgh3.70146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Trichuris trichiura</i> is a common intestinal parasite, but its systemic impact remains unclear. While severe infections may cause gastrointestinal complications, hepatobiliary involvement is rare. This case describes an incidental <i>T. trichiura</i> infection identified during colonoscopy in a patient hospitalized with acute pancreatitis and suspected gastric outlet obstruction. The study underscores the importance of differentiating incidental parasitic infections from true pathology to prevent misdiagnosis and unnecessary treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 52-year-old female presented with persistent nausea, vomiting, postprandial discomfort, and weight loss for 2 weeks. Imaging revealed hepatomegaly and gastric distension, raising concerns for gastric outlet obstruction or severe gastritis. Laboratory findings showed elevated liver enzymes (ALT: 101 IU/L, Alk-P: 189 IU/L, r-GT: 288 U/L). A viral etiology was suspected but not confirmed. The patient received supportive intravenous therapy, and her symptoms resolved. Colonoscopy revealed a partially clamped <i>T. trichiura</i> adult worm in the transverse colon. Given her clinical improvement without anthelmintic treatment, the infection was deemed incidental and not causative.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case highlights the need to critically evaluate incidental parasitic infections before attributing them to clinical symptoms. Routine screening is valuable but should be accompanied by a thorough assessment of parasite burden, patient history, and clinical presentation to guide appropriate management and prevent unnecessary interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749638","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":"Low Intrahepatic Distant Recurrence Rate Following RFA Using Linear Mode in Patients With Hepatocellular Carcinoma","authors":"Hiroaki Takaya,&nbsp;Tadashi Namisaki,&nbsp;Yusuke Komeda,&nbsp;Hiroki Kinoshita,&nbsp;Naoki Nishimura,&nbsp;Yuki Tsuji,&nbsp;Shinya Sato,&nbsp;Norihisa Nishimura,&nbsp;Ko Saito,&nbsp;Shigeyuki Aizawa,&nbsp;Chie Morioka,&nbsp;Ryuichi Noguchi,&nbsp;Motoyuki Yoshida,&nbsp;Kosuke Kaji,&nbsp;Hitoshi Yoshiji","doi":"10.1002/jgh3.70145","DOIUrl":"https://doi.org/10.1002/jgh3.70145","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. Radiofrequency ablation (RFA) can be utilized in elderly patients and those with cirrhosis with reduced functional liver reserve as it is less invasive. The arfa RFA system is the first system to offer a linear mode. However, the differences in performance between the linear and existing (nonlinear) modes remain unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This retrospective observational study compared the performance of the linear (linear group) and nonlinear RFA modes (nonlinear group) in HCC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data of 425 patients with one to three HCC tumors measuring ≤ 3 cm who underwent RFA were analyzed. Recurrence (local and distant), survival, and complication rates between the linear and nonlinear groups were determined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The intrahepatic distant recurrence rate was lower in the linear group than in the nonlinear group (<i>p</i> &lt; 0.05). Multivariate analysis showed that the high platelet count, low AFP-L3 levels, initial case, and linear mode were independent factors associated with a low intrahepatic distant recurrence rate following RFA. Liver disease-related survival, HCC survival, overall survival of the initial HCC, local recurrence, and complication rates were comparable between the linear and nonlinear groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The linear mode of the RFA protocol results in a lower intrahepatic distant recurrence rate compared with the nonlinear protocol.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741245","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":"Characteristics of Superficial Gastric Neoplasms Detected Not by White Light Imaging but by Linked Color Imaging","authors":"Minoru Yamaoka,&nbsp;Hiroyuki Imaeda,&nbsp;Kazuya Miyaguchi,&nbsp;Hisashi Matsumoto,&nbsp;Rie Shiomi,&nbsp;Hideki Ohgo,&nbsp;Nobutaka Hirooka,&nbsp;Yoshikazu Tsuzuki,&nbsp;Hidetomo Nakamoto","doi":"10.1002/jgh3.70104","DOIUrl":"https://doi.org/10.1002/jgh3.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Laser endoscopy has a linked color imaging (LCI) mode which has been reported to be superior to white light imaging (WLI) in detecting early gastric cancer (EGC). In this study, we retrospectively investigated the characteristics of superficial gastric neoplasms detected not by WLI but by LCI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>From April 2018 to May 2023, EGC or gastric adenoma identified by EGD was observed using LCI after WLI. The size, location, macroscopic type, color, skill level of the endoscopists, and treatment were examined for lesions detected by WLI (WLI group) and lesions detected not by WLI but by LCI (LCI group).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-eight lesions of EGCs were differentiated adenocarcinomas, 13 undifferentiated adenocarcinomas, and 28 gastric adenomas. There were 117 lesions (90.7%) in the WLI group and 12 (9.2%) in the LCI group. The mean diameter was 22.9 mm in the WLI group and 9.3 mm in the LCI group, with the latter being significantly smaller (<i>p</i> = 0.003). The numbers of protruding, depressed, and flat lesions were 58, 59, and 0 in the WLI group, and 7, 4, and 1 in the LCI group, respectively, indicating that more protruding lesions were detected in the LCI group (<i>p</i> = 0.005). After multivariate analysis, there was a significant difference in diameter only in the LCI group compared to the WLI group (odds ratio, 0.834; 95% CI, 0.728–0.956).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>LCI is more useful than WLI for detecting smaller superficial gastric neoplasms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717250","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":"Morbidity and Mortality Predictors of Acute Respiratory Failure in Acute Pancreatitis: A Cohort Study Conducted in Vietnam","authors":"Qui Huu Nguyen,&nbsp;Dung Thi My Vo,&nbsp;Thong Duy Vo","doi":"10.1002/jgh3.70136","DOIUrl":"https://doi.org/10.1002/jgh3.70136","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Acute pancreatitis (AP) can result in severe complications, with acute respiratory failure (ARF) being among the most critical. Research on ARF in AP remains limited. This study aims to investigate the occurrence, outcomes, and predictors of ARF in AP patients at Cho Ray Hospital, a tertiary care center in Vietnam.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A prospective cohort study was conducted with 230 AP patients at a national hospital in Ho Chi Minh City, Vietnam. Patients were divided into ARF and non-ARF groups, and clinical characteristics were compared. Key outcomes included invasive mechanical ventilation, in-hospital mortality, and length of hospital stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ARF developed in 26.1% of patients, with a mortality rate of 25.0% in the ARF group versus 1.2% in the non-ARF group. Mechanical ventilation was required in 48.3% of ARF patients. Significant predictors of ARF were abnormal body mass index (BMI) (<i>p</i> = 0.021), prolonged systemic inflammatory response syndrome (SIRS) (<i>p</i> &lt; 0.001), modified computed tomography severity index (mCTSI) (<i>p</i> = 0.041), and a high bedside index for severity in acute pancreatitis (BISAP) score (<i>p</i> &lt; 0.001). BISAP scores ≥ 2 had a sensitivity of 90.0%, specificity of 73.5%, and AUC of 0.878 (95% CI 0.829–0.921) for predicting ARF. Predictors of mortality in ARF patients included cardiovascular failure (HR 15.83, <i>p</i> = 0.001), prolonged SIRS (HR 4.76, <i>p</i> = 0.038), and high BISAP scores (HR 3.41, <i>p</i> = 0.015).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ARF significantly worsens outcomes in AP patients. Early identification of key predictors, like abnormal BMI, prolonged SIRS, mCTSI, and BISAP scores, could improve interventions and patient prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690080","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":"Post COVID Condition and Long-Term COVID-19 Impact on Hepatic Decompensation and Survival in Cirrhosis: A Propensity Matched Observational Study","authors":"Prerna Sharma,&nbsp;Madhumita Premkumar,&nbsp;Rashmi Ranjan Guru,&nbsp;Anchal Sandhu,&nbsp;Kamal Kajal,&nbsp;Arka De,&nbsp;Sahaj Rathi,&nbsp;Nipun Verma,&nbsp;Sunil Taneja,&nbsp;Virendra Singh,&nbsp;Ajay Kumar Duseja","doi":"10.1002/jgh3.70142","DOIUrl":"https://doi.org/10.1002/jgh3.70142","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Patients with cirrhosis are susceptible to decompensation events, including ascites, variceal bleeding (VB), hepatic encephalopathy, or death after COVID-19 infection. Patients may experience post-COVID condition (PCC) with multisystem involvement that persists for at least 2 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Hospitalized patients with cirrhosis and COVID-19 between January 2021 and January 2023 were assessed for decompensation events and mortality and compared to a propensity-matched cohort of cirrhosis and non-COVID-19 sepsis. Both groups were followed for outcomes over 1 year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 252 patients with Cirrhosis+ COVID-19 (73% men, aged 48.9 ± 13.7 years, 31%-diabetes, 44%-hypertension, 35%-alcohol-associated, 34.5%-metabolic dysfunction-associated steatotic liver disease; MASLD), 72 (28.6%) died in hospital and 180 (71.4%) recovered, similar to Cirrhosis+ non-COVID-sepsis (58/214, 27.1%). Finally,60 (33.3%) met criteria for PCC, 19 (10.5%) had no post COVID-19 sequelae and 101 (56.1%) patients died (<i>N</i> = 45) or were lost to follow up (<i>N</i> = 56). Late Mortality was higher in Cirrhosis+ COVID-19 than non-COVID-sepsis (56.1% vs. 35.3%, <i>p</i> = 0.026). Patients with PCC were aged 47.6 years, 63.3%-men, Charlson Comorbidity Index &gt; 4 (51.7%), 45%-diabetes, 56.7%-hypertension, with 33.3%, 23.3%, and 43.3% in Child-Turcotte-Pugh class A, B and C, respectively. PCC symptoms included persistent dyspnea (34, 43%), cognitive impairment (20, 25.3%), and anxiety (47, 59.4%). On multivariable analysis, predictors of the development of PCC were baseline MELDNa (HR 1.12, 95% CI: 1.05–1.17, <i>p</i> &lt; 0.001) and age (HR 0.9, 95% CI: 0.91–0.99, <i>p</i> = 0.012). Predictors of mortality following COVID-19 recovery were MELDNa (HR 1.03, 95% CI: 1.01–1.05, <i>p</i> = 0.008), age (HR 1.2, 95% CI: 1.1–1.5, <i>p</i> = 0.002) and hypertension (HR 1.63, 95% CI: 1.07–2.49, <i>p</i> = 0.025).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>COVID-19 is associated with long-term mortality in cirrhosis even after recovery from respiratory infection. Long COVID is seen in a third of COVID-19 survivors in patients with cirrhosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70142","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690081","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}