JGH Open最新文献

{"title":"Global and Chinese Burden of Inflammatory Bowel Disease From 1990 to 2021: A Systematic Analysis and Prediction of Disease Burden","authors":"An Luo,&nbsp;Dongying Yao,&nbsp;Miao Wang,&nbsp;Liwen Jin,&nbsp;Zhihua Ran","doi":"10.1002/jgh3.70160","DOIUrl":"https://doi.org/10.1002/jgh3.70160","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recent shifts in the global epidemiology of inflammatory bowel disease (IBD), particularly in emerging industrialized nations like China, underscore the need for in-depth analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Utilizing the Global Burden Of Disease (GBD) 2021 database, we systematically examined IBD incidence, prevalence, death rates, and disability-adjusted life years (DALYs) across Global, different social development index (SDI) regions, and countries from 1990 to 2021. Age-standardized rates (ASR) and statistical metrics (APC, EAPC, AAPC) were employed to assess trends in IBD development, and a Bayesian age-period-cohort (BAPC) model was used to forecast future scenarios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 2021, the highest IBD incidence rates were observed in Canada (26.83/100000), Greenland (24.57/100000), and New Zealand (23.69/100000), markedly contrasting China's rate of 1.4/100000. Globally, IBD incidence increased modestly from 4.22/100000 in 1990 to 4.45/100000 in 2021 (EAPC = 0.29%). China experienced a more pronounced rise, with incidence jumping from 0.74/100000 to 1.4/100000 (EAPC = 2.93%). Notably, China also witnessed substantial declines in IBD deaths (56.00%) and DALYs (58.22%). The Middle SDI region exhibited a greater magnitude of change than Global and other SDI regions. The temporal trends in the incidence and prevalence of IBD in the countries are predominantly influenced by the period up to the year 2015. In China, between the ages of 15 and 49, the incidence and prevalence of IBD are projected to remain consistent with current standards, while the death rate and DALYs are predicted to exhibit a sustained decline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite the notable increase in IBD incidence in China, significant reductions in mortality and morbidity demonstrate the effectiveness of medical interventions and health system improvements.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70160","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143919561","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":"Predictive Factors for Procedure Time for Closure of Mucosal Defect Following Colorectal Endoscopic Submucosal Dissection","authors":"Hideaki Kazumori,&nbsp;Rurika Masatsugu,&nbsp;Kousuke Fukuda,&nbsp;Koji Onishi,&nbsp;Yasuhiko Ohno","doi":"10.1002/jgh3.70174","DOIUrl":"https://doi.org/10.1002/jgh3.70174","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Goals</h3>\u0000 \u0000 <p>The present study was conducted to clarify predictive factors related to procedure time for closure of a mucosal defect following colorectal endoscopic submucosal dissection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To prevent complications following a colorectal endoscopic submucosal dissection (ESD) procedure, closure of the resultant mucosal defect is considered to be most effective. However, closure after colorectal ESD is challenging, and technical difficulties can lead to a longer procedure time. Although it is important to clarify predictive factors related to the time needed for effective treatment planning, no such validated data obtained prior to the present study have been reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study</h3>\u0000 \u0000 <p>Overall, 61 consecutive patients who underwent colorectal ESD for a colorectal neoplasm sized greater than 20 mm were enrolled. Immediately after performing colorectal ESD, closure of the mucosal defect was implemented using a loop clip closure method. Factors with influence on closure procedure time were evaluated using multiple linear regression analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results obtained with a multiple linear regression model demonstrated that resected specimen size (<i>β</i> = 0.690, <i>p</i> &lt; 0.01) and colon site (<i>β</i> = −0.209, <i>p</i> = 0.027) were factors with influence on the closure procedure. Those results were considered relevant to explain the 50.5% variance in time until completion of closure; thus, goodness of fit was considered to be high.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings obtained in this study were helpful to clarify predictive factors with influence on procedure time. The fit of the model was good, thus allowing for closure performance based on outcome prediction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70174","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914103","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":"Validation of ICD-10 Consensus Code Set for Cirrhosis Detection Using Electronic Health Records in an Asian Population","authors":"Jason Pik-Eu Chang,&nbsp;Hong-Yi Lin,&nbsp;Pooi-Ling Loi,&nbsp;Jeanette Pei-Xuan Ng,&nbsp;Marianne De Roza,&nbsp;Rahul Kumar,&nbsp;Hiang-Keat Tan,&nbsp;Chanda Kendra Ho,&nbsp;Wei-Quan Teo,&nbsp;Amber Hwa Hwa Chung,&nbsp;Prema Raj","doi":"10.1002/jgh3.70156","DOIUrl":"https://doi.org/10.1002/jgh3.70156","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Systematic identification of patients with cirrhosis through electronic healthcare records (EHRs) using ICD-10 codes is essential for epidemiological research but is prone to discrepancies. We aim to validate and improve a recent consensus code set of nine ICD-10 codes to identify cirrhosis in a multi-ethnic Asian population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We applied an initial broad algorithm of 25 ICD-10 codes related to cirrhosis and its complications to identify patients potentially with cirrhosis admitted to Singapore General Hospital in 2018 and confirmed true cirrhosis cases via manual EHR review. We evaluated the consensus code set's sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in identifying cirrhosis cases. We examined alternative code sets to improve cirrhosis identification and validated them in another local hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One thousand, seven hundred thirty-three patients potentially with cirrhosis were identified, with 937 (54.1%) confirmed. The median age at diagnosis was 71 years (IQR: 64–78), with 65.6% males, 75.2%/8.8%/9.3%/6.7% Chinese/Indians/Malays/Others, and 56.7% Child-Pugh A. The main etiologies were chronic hepatitis B (29.5%) and metabolic dysfunction–associated steatotic liver disease (25.5%). The consensus code set demonstrated sensitivity/specificity/PPV/NPV of 76.1%/82.0%/83.3%/74.5%, respectively. We identified a set of 10 ICD-10 codes (SingHealth Chronic Liver Disease Registry [SoLiDaRity]-10) with sensitivity/specificity/PPV/NPV of 76.5%/84.8%/85.6%/75.4%, respectively, demonstrating an improved specificity versus the consensus code set (<i>p</i> = 0.001). External validation in another local hospital with 578 patients potentially with cirrhosis demonstrated improved sensitivity of the SoLiDaRity-10 code set versus the consensus code set (<i>p</i> = 0.033) (sensitivity/specificity/PPV/NPV: 78.0%/93.6%/94.1%/76.4% vs. 76.2%/93.6%/94.0%/75.0%, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While the consensus code set performs well in identifying patients with cirrhosis in a multi-ethnic Asian population, we propose the improved SoLiDaRity-10 code set.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70156","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909438","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":"Etiology and Short-Term Outcomes of Upper Gastrointestinal Bleeding in Patients Presenting at the Emergency Department in a Tertiary Hospital in a Low Resource Setting–A Prospective Cohort Study","authors":"Nyantakyi Adu-Darko,&nbsp;Solomon Gyabaah,&nbsp;Osei Yaw Asamoah,&nbsp;Tracey Afoley Laryea,&nbsp;Bright Oppong,&nbsp;Eileen Micah,&nbsp;Bernard Nkum","doi":"10.1002/jgh3.70167","DOIUrl":"https://doi.org/10.1002/jgh3.70167","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Upper gastrointestinal bleeding (UGIB) is one of the most common medical emergencies. Currently, there is a paucity of data on the clinical profile and outcome of UGIB in resource-limited settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aim to describe the etiology and outcomes of the patients who presented to the Emergency Department (ED) of a tertiary hospital in Ghana with UGIB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a single-center prospective cohort study involving 195 adults who presented with symptoms of UGIB from May 2022 to April 2023. Relevant baseline demographic and clinical characteristics were obtained. The cause of UGIB was determined as per findings at endoscopy. Patients were followed up for 6 weeks from admission, looking out for rebleeding, need for transfusion, length of hospital stay, and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 145 (74.4%) males and 50 (25.6%) females, and the mean age ± SD was 51.4 ± 17.4 years. The main clinical presentations included melena (87.2%), hematemesis (69.7%) and postural dizziness (73.8%). The commonest findings at endoscopy were esophageal and gastric varices (33.3%), erosive gastritis and duodenitis (27.7%) and peptic ulcers (21.5%). The median length of hospital stay (IQR) was 7 days (5 days). 70.8% required whole blood transfusion with a median (IQR) of 2 units (2 units). The 6-week mortality and rebleeding rates were 17.4% and 7.2%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Variceal bleeding was the most common cause of UGIB at the emergency. One out of every fourteen patients that recover from acute UGIB may rebleed within the first six weeks one out of every six patients who present with acute UGIB may die within the succeeding six weeks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905267","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":"Follicular Lymphoma Manifesting as an Isolated Colorectal Polyp-Like Morphology","authors":"Yasuhiko Hamada,&nbsp;Yuhei Umeda,&nbsp;Hayato Nakagawa","doi":"10.1002/jgh3.70170","DOIUrl":"https://doi.org/10.1002/jgh3.70170","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Primary gastrointestinal (GI) follicular lymphoma (FL) is a rare entity, and colorectal FL presenting as a solitary polyp is particularly uncommon.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 60-year-old woman presented with hematochezia. Colonoscopy incidentally identified an 8-mm polyp in the transverse colon, which was subsequently removed via cold snare polypectomy. Histopathological examination confirmed Grade 1 FL, with immunohistochemical analysis revealing positivity for CD10, CD20, and Bcl-2. Further diagnostic evaluation demonstrated FL involvement in the proximal jejunum, leading to a diagnosis of clinical stage I primary GI-FL. The patient elected to undergo a watch-and-wait approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case highlights the potential for colorectal-FL lesions to be misidentified as adenomatous polyps, posing a diagnostic challenge.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70170","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892917","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":"Crohn's Colitis Care, a Disease-Specific Electronic Medical Record, Enhances Data Capture in Pediatric Inflammatory Bowel Disease Care","authors":"Joseph Louis Pipicella,&nbsp;Shoma Dutt,&nbsp;Kunal Thacker,&nbsp;Susan Jane Connor,&nbsp;Jane Mary Andrews,&nbsp;Angharad Vernon-Roberts","doi":"10.1002/jgh3.70153","DOIUrl":"https://doi.org/10.1002/jgh3.70153","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Crohn's Colitis Care, a structured, disease-specific electronic medical record, is proven to promote more complete data capture in adult Inflammatory Bowel Disease care. This study aimed to determine whether similar effectiveness was seen in pediatrics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Matched patient records from a hospital's standard electronic medical record (pre-Crohn's Colitis Care) and those in Crohn's Colitis Care were retrospectively reviewed (12 months each). The presence of disease-specific data items per platform were compared (21 core, 5 age-specific). Data are presented as percentage recorded (recorded items/total eligible for age). Descriptive and statistical analytics were used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Paired records were reviewed for 114 children, of whom 78 (68%) had Crohn's disease and 69 (61%) were male. Median age at diagnosis was 13.5 years (IQR12.0–15.5), with mean disease duration 3.6 years (±2.4). Crohn's Colitis Care was more likely to capture 9 items: general wellbeing, stool urgency and frequency, disease duration, comorbidities, pubertal stage, sexual activity, alcohol and drug usage (each <i>p</i> &lt; 0.05). The standard platform was more likely to capture 4 items: liquid stools, phenotype, disease indices, and vaccinations (each <i>p</i> &lt; 0.05). Crohn's Colitis Care achieved more eligible data items recorded per patient (75.3% ±11.5 vs. 67.7% ± 8.9; <i>p</i> &lt; 0.001). Item completion rate in both platforms inversely correlated with patient age (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Consistent with findings in adult care, Crohn's Colitis Care achieved more complete disease-data capture in pediatrics compared to a standard platform. Given that not all items were better recorded in the structured platform, work to understand and address barriers is needed to optimize complete data capture for care and research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70153","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889007","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":"Seroprevalence and Risk Factors of Hepatitis B Virus Among Newly Diagnosed Cancer Patients in Khartoum State: Implications for Chemotherapy Management and Screening Protocols","authors":"Anwaar Abdulgader Merghani Alkhdir,&nbsp;Abubaker A. Mohamedsharif,&nbsp;Isra Bdraldein Salih Mohammed,&nbsp;Amin Mohamed Abbas","doi":"10.1002/jgh3.70171","DOIUrl":"https://doi.org/10.1002/jgh3.70171","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to determine the seroprevalence of hepatitis B virus (HBV) among newly diagnosed cancer patients in Khartoum State, Sudan, prior to chemotherapy initiation and to identify associated risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>A cross-sectional study was conducted from October 2022 to April 2023 at various oncology centers in Khartoum State. A total of 300 newly diagnosed cancer patients, aged 18 years and older, were included. Blood samples were screened for Hepatitis B surface antigen (HBsAg) using a rapid immunochromatographic test (ICT) and confirmed by enzyme-linked immunosorbent assay (ELISA). The study found that 31 patients (10.3%) were HBsAg positive. A significant association was observed between HBV positivity and patients' history of blood transfusions (41.9% of positive cases), as well as geographic origin, with higher rates among those from Western Sudan (44.7%) and Central Sudan (40.6%). Patients diagnosed with hematological malignancies exhibited the highest HBV prevalence. Statistical analysis revealed significant correlations between HBV positivity and factors such as age, gender, residence, and transfusion history, indicating these as key risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study reveals a notable HBV seroprevalence among cancer patients in Khartoum, particularly linked to blood transfusion history and specific regions. These findings emphasize the need for routine HBV screening in oncology patients before chemotherapy to prevent reactivation and improve clinical outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70171","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143888941","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":"Prior Immune Checkpoint Inhibitor Treatment Is a Risk Factor for Treatment-Related Adverse Events in Unresectable Hepatocellular Carcinoma Treated With Durvalumab Plus Tremelimumab","authors":"Naohiro Watanabe,&nbsp;Takashi Kobayashi,&nbsp;Michihiro Iwaki,&nbsp;Asako Nogami,&nbsp;Naohiro Wada,&nbsp;Ayako Shimizu,&nbsp;Tomoya Komori,&nbsp;Hirofumi Koike,&nbsp;Yukiko Sahashi,&nbsp;Atsushi Nakajima,&nbsp;Masato Yoneda","doi":"10.1002/jgh3.70163","DOIUrl":"https://doi.org/10.1002/jgh3.70163","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>In March 2024, the American Society of Clinical Oncology recommended the combination of tremelimumab plus durvalumab as a treatment for advanced hepatocellular carcinoma (HCC). Although safety data for first-line treatments are available, information on adverse events related to late-line treatments is limited. This study aimed to identify risk factors for adverse events in patients who received this combination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study from March 2023 to January 2025 at Yokohama City University Hospital, involving 24 patients aged 18 years or older with unresectable HCC. All 24 patients experienced at least one adverse event during treatment. Of these, the incidence of treatment-related adverse events leading to treatment discontinuation after tremelimumab plus durvalumab therapy was 50.0% (12/24). In the discontinuation group, prior atezolizumab plus bevacizumab therapy (66.7% vs. 16.7%, <i>p</i> = 0.036) was more frequent than in the continuation group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients with unresectable HCC who received tremelimumab plus durvalumab, the risk of treatment-related adverse events was associated with prior atezolizumab plus bevacizumab therapy. These factors may increase the likelihood of developing treatment-related adverse events.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70163","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urine TIMP2.IGFBP7 Reflects Kidney Injury After Moderate Volume Paracentesis in Patients With Ascites: A Randomized Control Study","authors":"Anuchit Suksamai,&nbsp;Sanpolpai Khaoprasert,&nbsp;Amnart Chaiprasert,&nbsp;Sakkarin Chirapongsathorn","doi":"10.1002/jgh3.70168","DOIUrl":"https://doi.org/10.1002/jgh3.70168","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Urinary biomarkers may predict acute kidney injury (AKI) in cirrhosis with ascites in a moderate volume paracentesis setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study aimed to assess the risk and consequence of AKI and its progression in patients with decompensated cirrhosis undergoing paracentesis using a urine test measuring tissue inhibitor of metalloproteinases-2 (TIMP2) and insulin-like growth factor-binding protein 7 (IGFBP7).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A randomized, controlled trial was performed. All outpatients with decompensated cirrhosis with ascites and diuretic complications were enrolled and randomized into 3 and 5 L paracentesis groups. Serial urine samples were analyzed for TIMP2. IGFBP7 concentration before and after paracentesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 90 patients with decompensated cirrhosis were consecutively enrolled during the study period. After screening, 29 patients were enrolled in the 3-L paracentesis group, and 25 patients were enrolled in the 5-L paracentesis group. The mean of the MELD score was 8 ± 1.2. Urine TIMP2.IGFBP7 &gt; 2, rising urine TIMP2, and rising urine TIMP2/urine Cr were shown in patients within the 5-L group for 48% (<i>p</i> = 0.015), 32% (<i>p</i> = 0.049), and 76% (<i>p</i> = 0.010) respectively, indicating a higher incidence of renal tubular injury markers in this group. Urine TIMP2.IGFBP7/1000 &gt; 2 was statistically significant to predict a hemodynamic event (<i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In cirrhotic patients with ascites undergoing paracentesis, a 5-L paracentesis volume was associated with a higher incidence of renal tubular injury markers.</p>\u0000 \u0000 <p><b>Trail Registration:</b> The national clinical registration number was TCTR20191116003.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70168","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Gastrointestinal EBV-Associated Classical Hodgkin Lymphoma in Crohn Disease on Anti-TNF-α Therapy: A Rare Association","authors":"Katrina Collins,&nbsp;Ani Toklu,&nbsp;Nishi Dave,&nbsp;Hector Mesa","doi":"10.1002/jgh3.70154","DOIUrl":"https://doi.org/10.1002/jgh3.70154","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lymphomas present a significant challenge in the field of gastrointestinal diseases, often being mistaken for other gastrointestinal tumors or inflammatory bowel disease conditions, causing clinical confusion. Early diagnosis plays a pivotal role in effective treatment. This case highlights the importance of recognizing lymphoproliferative disorders as a rare association of anti-tumor necrosis factor-α (TNF-α) therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 41-year-old man with a 15-year history of Crohn disease on long-term therapy with adalimumab underwent a right hemicolectomy due to a semi-circumferential lesion at the ileocecal valve causing near complete obstruction and severe anemia (Hgb 6.4 g/dL). Previous biopsies of the mass showed an Epstein Barr Virus-positive (EBV+) classic Hodgkin lymphoma (CHL) in Crohn disease. At resection, the lymphoma showed transmural involvement of the ileum and regional lymph nodes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Primary intestinal CHL comprises less than 5% of gastrointestinal lymphomas; CHL arising in the context of Crohn disease is even more rare. Most lymphomas associated with inflammatory bowel disease and/or immunosuppression are non-Hodgkin type. In this case, the long-term treatment with anti-TNF-α and EBV positivity suggested an iatrogenic immunodeficiency-associated lymphoma, an emerging group of lymphoproliferative disorders associated with the increased use of immunosuppressants.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70154","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}