JGH Open最新文献

{"title":"Texture and Color Enhanced Imaging in the Diagnosis of Colonic Neoplasia: A Systematic Review and Analysis","authors":"Ciaran Judge,&nbsp;David Law,&nbsp;Glynis Jones,&nbsp;Sherman Picardo,&nbsp;Krish Ragunath","doi":"10.1002/jgh3.70191","DOIUrl":"https://doi.org/10.1002/jgh3.70191","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Image enhanced endoscopy (IEE) can augment the detection of colorectal cancer (CRC) and its precursor lesions, potentially reducing incidence and mortality. Early data on texture and color enhancement imaging (TXI) support its use for neoplasia screening. This study aimed to systematically review and perform a meta-analysis to assess the impact of TXI on colonic adenoma detection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The systematic review and meta-analysis followed PRISMA guidelines. Studies comparing TXI with white light imaging (WLI) were eligible for inclusion. Searches were conducted through relevant databases and major conferences up to July 1, 2024. The primary outcome was ADR, with secondary outcomes including polyp detection rate (PDR), mean number of adenomas per patient (MAP), and size, location, morphology, and withdrawal time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 1270 results, 4 studies were included in the meta-analysis (<i>n</i> = 5481). TXI significantly increased ADR compared to WLI (55.8% vs. 47.8%, RR 1.24, <i>p</i> &lt; 0.001), PDR (63.7% vs. 54.7%, RR 1.23, <i>p</i> &lt; 0.001), and MAP (mean difference 0.41, <i>p</i> = 0.005). and improved detection of proximal lesions (MD 0.21, 95% CI [0.15–0.27], <i>p</i> &lt; 0.001, <i>I</i>² = 0%). Pooled withdrawal times were not different between groups, with no differences between endoscopist experience or quality of bowel preparation, where reported. Sub-analysis further demonstrated superiority of TXI, with an absolute difference in ADR of 14.2%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TXI significantly improves ADR, PDR, and MAP compared to WLI, highlighting its potential to enhance CRC screening efficacy without impact from user experience, bowel prep, or withdrawal times. TXI is a useful and practical adjunct to enhance the detection of colonic neoplasia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861884","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":"Conservative Management Versus Early Cholecystectomy for Gallstone Disease: A Meta-Analysis of Randomized Controlled Trials","authors":"Kissan Ghose,&nbsp;Arooj Waheed,&nbsp;Samina Khan,&nbsp;David Losier,&nbsp;Anumalasetty Venkata Chandana Heshma,&nbsp;Avni Bhatia,&nbsp;Deepalee Mehta,&nbsp;Ayesha Abbas,&nbsp;Iqra Yaseen Khan,&nbsp;Ibtesam Allahi,&nbsp;Muhammad Ayyan,&nbsp;Muhammad Shahzil,&nbsp;Ambreen Nabeel,&nbsp;Amna Iqbal,&nbsp;Rehmat Ullah Awan","doi":"10.1002/jgh3.70253","DOIUrl":"https://doi.org/10.1002/jgh3.70253","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>While most individuals with gallstone disease remain asymptomatic, symptoms of gallstone disease range from biliary pain to acute cholecystitis. Surgery is a popular choice of treatment, but evidence has also suggested conservative management as a safe and viable approach. We aim to investigate the evidence on conservative management versus early cholecystectomy for the management of gallstone disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched electronic databases to retrieve and include all randomized controlled trials (RCTs) that analyzed the efficacy and safety of conservative management versus early cholecystectomy in the management of gallstone disease. The revised Cochrane “Risk of bias” tool for randomized trials (RoB 2.0) was used to assess the risk of bias in the included studies. We calculated risk ratios (RR) along with the 95% confidence intervals (95% CI) for all the outcomes. The random-effects model was used in our analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 11 RCTs were included in our meta-analysis. We found no statistically significant difference between conservative management and early cholecystectomy regarding the incidence of total intraoperative complications (RR 0.45; 95% CI: 0.14–1.42), total postoperative complications (RR 0.85; 95% CI: 0.48–1.50), total surgical complications (RR 0.68; 95% CI: 0.43–1.10), and mortality (RR 1.24; 95% CI: 0.81–1.89). The conservative management group was associated with a statistically significant higher incidence of total biliary complications (RR 3.63; 95% CI: 2.07–6.37), biliary colic (RR 2.75; 95% CI: 1.23–6.15), and common bile duct (CBD) stones (RR 3.96; 95% CI: 1.46–10.71). There was no difference in the incidence of biliary pancreatitis (RR 1.46; 95% CI: 0.49–4.35) and cholangitis (RR 1.52; 95% CI: 0.47–4.89).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>According to our meta-analysis, conservative management offers no benefit over early cholecystectomy for gallstone disease; it increases the incidence of biliary complications in patients with gallstone disease. More studies are needed to better ascertain the role of conservative management in the management of gallstone disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70253","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833209","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":"Bioengineered Bile Duct for Liver Regenerative Medicine and Bile Duct Reconstruction","authors":"Peilin Li,&nbsp;Di Huang,&nbsp;Weili Gu,&nbsp;Yi Gao,&nbsp;Yu Huang","doi":"10.1002/jgh3.70254","DOIUrl":"https://doi.org/10.1002/jgh3.70254","url":null,"abstract":"<p>Bioengineered tubular bile ducts are an emerging strategy in liver regenerative medicine and extrahepatic bile duct reconstruction, offering potential solutions to address biliary diseases and improve outcomes in liver transplantation. Disorders of the biliary system, such as biliary atresia, primary sclerosing cholangitis, and bile duct injury, often result in irreversible damage and cannot be adequately treated with conventional therapies. This review explores the latest advancements in the bioengineering of both intrahepatic and extrahepatic bile ducts, focusing on approaches that leverage cholangiocyte biology, stem cell technologies, and biomaterial innovations. Key cell sources, including primary cholangiocytes, induced pluripotent stem cells (iPSCs), liver progenitor cells (LPCs), and transdifferentiated hepatocytes, are discussed for their potential to generate functional bile duct epithelial cells capable of restoring biliary function. The role of biomaterials in providing structural support and promoting cellular growth and differentiation is critically examined, emphasizing synthetic and natural scaffolds, such as poly(lactic acid) (PLA) and collagen-based materials, for creating viable tubular structures. This review provides a comprehensive overview of the current progress and challenges in bioengineered bile duct tissue, focusing on the goals of enhancing liver regeneration and enabling extrahepatic bile duct reconstruction for clinical applications. Integrating cellular, biomaterial, and bioengineered strategies offers promising avenues for advancing treatments for biliary diseases and improving liver transplantation outcomes.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70254","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832888","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":"Lymphocyte Fractions as Indicators of T-Helper 1/T-Helper 2 Cytokine Profiles in Inflammatory Bowel Disease","authors":"Yusuke Asai,&nbsp;Natsuki Ishida,&nbsp;Tomohiro Takebe,&nbsp;Kenichi Takahashi,&nbsp;Tomoharu Matsuura,&nbsp;Satoshi Tamura,&nbsp;Mihoko Yamade,&nbsp;Takanori Yamada,&nbsp;Moriya Iwaizumi,&nbsp;Yasushi Hamaya,&nbsp;Satoshi Osawa,&nbsp;Ken Sugimoto","doi":"10.1002/jgh3.70243","DOIUrl":"https://doi.org/10.1002/jgh3.70243","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Inflammatory bowel disease is characterized by various cytokine patterns. In this study, we aimed to investigate the markers that can distinguish Th1/Th2 cytokines in patients with inflammatory bowel disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>In patients with inflammatory bowel disease treated at our hospital, the Th1/Th2 ratio (interferon-γ/interleukin-4 ratio), serum immunoglobulin E level, leucine-rich alpha 2 glycoprotein level, serum amyloid A level, and leukocyte fraction were measured simultaneously, and the relationship between them was examined. We enrolled 108 patients with Crohn's disease and 153 patients with ulcerative colitis. No significant difference was observed in the Th1/Th2 ratio between the ulcerative colitis and Crohn's disease groups. In the inflammatory bowel disease and Crohn's disease groups, the lymphocyte fraction was significantly correlated with the Th1/Th2 ratio (<i>r</i> = 0.154, <i>p</i> = 0.013 and <i>r</i> = 0.204, <i>p</i> = 0.0346, respectively). In ulcerative colitis, lymphocyte fraction and Th1/Th2 ratio were significantly correlated in the group without steroid treatment; however, no significant correlation was observed in the steroid-treated group. Serum immunoglobulin E, leucine-rich alpha 2 glycoproteins, and serum amyloid A levels did not significantly correlate with the Th1/Th2 ratio.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The lymphocyte fraction may serve as a marker of Th1/Th2 cytokines and could be particularly useful in non-steroid-treated patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70243","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144814640","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":"Response Rate to Treatment of Achalasia Patients With Thyroid Disorders Versus Euthyroid Patients: A Cross-Sectional Study in Iran","authors":"Alireza Mehrban,&nbsp;Mehdi Karimi,&nbsp;Fatemeh Ahmadi Hajikolaei,&nbsp;Mohammad Sadra Saghafi,&nbsp;Aydin Hassanpour Adeh,&nbsp;Pegah Refahi,&nbsp;Amir Anushiravani,&nbsp;Javad Mikaeli","doi":"10.1002/jgh3.70197","DOIUrl":"https://doi.org/10.1002/jgh3.70197","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Achalasia, characterized by impaired esophageal motility, presents a challenge in diagnosis and management. Emerging evidence suggests a potential association between achalasia and thyroid disorders (TD). Understanding the prevalence and treatment response of achalasia in Iranian patients with TD compared to euthyroid counterparts is crucial for optimizing clinical care and informing further research efforts. This study aimed to investigate and compare the response rate to treatment in euthyroid and TD achalasia patients and to determine the prevalence rate of autoimmune TD in individuals with achalasia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Materials</h3>\u0000 \u0000 <p>This cross-sectional study was conducted on 393 achalasia patients. Initially, the patients underwent thyroid tests to identify any TD. Following these tests, they were treated for achalasia and followed up at 1, 6, and 12 months. The collected data were analyzed to assess the outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study examined data from 393 patients with achalasia and found no statistically significant correlation between the response rate to treatment in patients with normal thyroid function and those with TD (<i>p</i> = 0.176). Of all the participants, 292 (74.3%) underwent anti-TPO testing, revealing that 60 patients (20.5%) had autoimmune thyroiditis. The analysis showed a notable link between autoimmune thyroiditis and the patients' age (<i>p</i> = 0.024).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Achalasia is linked to various TD, including hyperthyroidism, hypothyroidism, and thyroid nodular diseases. Patients with autoimmune TD and esophageal issues should undergo a thorough examination, especially for excessive weight loss. Autoimmune diseases may contribute to inflammation in the esophageal myenteric plexus.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70197","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144814733","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":"A Sequential Combination of Baveno VI Criteria With Spleen Stiffness Measurement Improves the Screening of High-Risk Esophageal Varices in Compensated Advanced Chronic Liver Disease","authors":"Nichamon Suttitossatam,&nbsp;Sakkarin Chirapongsathorn,&nbsp;Kachonsak Yongwatana","doi":"10.1002/jgh3.70252","DOIUrl":"https://doi.org/10.1002/jgh3.70252","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Detecting high-risk esophageal varices (HRV) in cirrhotic patients is crucial for intervention and preventing variceal bleeding. While endoscopy is the gold standard for diagnosis, it is invasive and carries risks. Spleen stiffness measurement (SSM) may improve HRV screening and increase the spared endoscopy rate (SER).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled 129 patients with compensated advanced chronic liver disease (cACLD) who were candidates for variceal screening based on Baveno VI criteria (transient elastography ≥ 20 kPa or platelet count ≤ 150 × 10⁹/L). We collected SSM50Hz, SSM100Hz, liver stiffness measurement (LSM), and associated laboratory tests. Upper endoscopy was performed, and esophageal varices (EVs) types were defined as HRV according to Baveno VI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>Ninety-two patients met the inclusion criteria. Alcohol was the most common etiology (32.6%). HRVs were found in 33 patients (35.9%). The AUROC values for SSM100Hz, SSM50Hz, Aspartate aminotransferase to Platelet Ratio Index (APRI), the combination of APRI and Fibrosis-4 (FIB-4), and FIB-4 were 0.807, 0.775, 0.753, 0.740, and 0.715, respectively. With a cutoff of 40 kPa, SSM100Hz showed a sensitivity of 97%, specificity of 45.8%, PPV of 50%, and NPV of 96.4%. The SER and missed HRV rate were 31.5% and 3%, respectively. The cutoff values for the greatest diagnostic accuracy in predicting HRV were 52.4 kPa for SSM50Hz, 0.98 for APRI, and 5.44 for FIB-4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The sequential combination of Baveno VI with SSM100Hz improves HRV screening and SER. The SSM100Hz demonstrates the highest diagnostic accuracy with a low missed HRV rate of &lt; 5%.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811162","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":"Randomized, Placebo-Controlled, Double-Blind 8-Week Trial on the Efficacy of A Proprietary Kiwifruit Extract on Constipation-Predominant Irritable Bowel Syndrome.","authors":"Gerald Holtmann, Nicholas J Talley, Sanjay Nandurkar, Peter R Gibson","doi":"10.1002/jgh3.70250","DOIUrl":"10.1002/jgh3.70250","url":null,"abstract":"<p><strong>Background: </strong>Green kiwifruit (<i>Actinidia deliciosa</i> <i>var Hayward</i>) extract improves constipation. This study aimed to determine its efficacy in patients with constipation-predominant irritable bowel syndrome (IBS-C).</p><p><strong>Methods: </strong>A randomized, multicenter, double-blind, parallel-group, placebo-controlled trial was conducted in 186 IBS-C patients (Rome III criteria). Patients received either placebo or kiwifruit extract (575 mg twice daily for 4 weeks, followed by 575 mg daily for 4 weeks). Outcomes included measures of bowel movement frequency, Bristol Stool Scores, and abdominal pain and related measures (100 mm visual analog scale). The primary efficacy end point was the combined improvement of the number of complete spontaneous bowel movements and reduction of weekly average abdominal pain symptom score by at least 30% for at least half of the weeks during treatment.</p><p><strong>Results: </strong>On kiwifruit extract, the proportion of subjects with increased frequency of spontaneous bowel movements (54% vs. 36%, <i>p</i> = 0.012), improved Bristol Stool Score (87 vs. 73%, <i>p</i> = 0.014), and abdominal pain (74% vs. 59%, <i>p</i> = 0.023) was greater than in controls. However, no difference was observed in the combined two-variable primary end point (24% vs. 26%; <i>p</i> = 0.798). In post hoc analyses of 49 subjects with severe pain (≥ 50 mm), kiwifruit extract improved the primary end point (33% vs. 8%, <i>p</i> = 0.028) and normalized or maintained normal bowel actions with kiwifruit extract (44% vs. 24%, <i>p</i> = 0.005).</p><p><strong>Conclusions: </strong>In patients with IBS-C, kiwifruit extract improves bowel habits and abdominal pain. The predefined end point for the whole study population was not met because the 30% or greater improvement of pain only occurred in patients with more pain.</p><p><strong>Trial registration: </strong>Australian Clinical Trial Research Network (ACTRN 12613001222730).</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":"e70250"},"PeriodicalIF":1.5,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817857","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":"Don't Fall for the FOBT Fib-An Observational Study.","authors":"A Tanousian, P Watanakunakorn, N Obad, T Singh","doi":"10.1002/jgh3.70229","DOIUrl":"10.1002/jgh3.70229","url":null,"abstract":"<p><strong>Introduction: </strong>Fecal occult blood testing (FOBT) is often ordered in emergency settings for patients presenting with hematemesis or hematochezia. However, FOBT is FDA-approved solely for colorectal cancer screening in the outpatient setting. Its use in evaluating suspected acute gastrointestinal (GI) bleeding may misguide clinical decision-making and contribute to unnecessary healthcare utilization.</p><p><strong>Methods: </strong>This retrospective observational study assessed the diagnostic utility of FOBT in patients admitted to Sierra View Medical Center between 2022 and 2024 with suspected GI bleeding. Electronic medical records were reviewed to identify patients with positive FOBT results and an admitting diagnosis related to GI bleeding. Data collected included physical examination findings, hemoglobin trends, transfusion requirements, and endoscopic outcomes.</p><p><strong>Results: </strong>Seventy-five patients were identified, of whom 70 met inclusion criteria. Among these, only 11 patients (15.7%) underwent endoscopic intervention for an acute bleeding source. Patients requiring endoscopic intervention were approximately 10% more likely to have positive physical exam findings compared to those who did not.</p><p><strong>Conclusion: </strong>The findings support existing evidence that FOBT has limited diagnostic value in the setting of suspected acute GI bleeding. Current gastroenterology guidelines do not recommend the use of single-card FOBT for this indication. This study reinforces that positive FOBT results should not guide admission or diagnostic decision-making in the inpatient evaluation of suspected GI bleeding.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":"e70229"},"PeriodicalIF":1.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817855","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":"Efficacy and Safety of Anticoagulants in Patients With Cirrhosis and Portal Vein Thrombosis: A Systematic Review and Meta-Analysis of Randomized and Non-Randomized Studies.","authors":"Muhammad Hassan Waseem, Zain Ul Abideen, Marium Khan, Barka Sajid, Noor Ul Huda Ramzan, Rabeya Farid, Javed Iqbal, Jalib Ahmed, Aqsa Kabir, Maryam Shahzad, Javeria Asif, Muhammad Osama, Sania Aimen, Ammad Javaid Chaudhary, Ameer Haider Cheema","doi":"10.1002/jgh3.70194","DOIUrl":"10.1002/jgh3.70194","url":null,"abstract":"<p><strong>Background: </strong>Portal vein thrombosis (PVT) contributes substantially to morbidity and mortality in cirrhotic patients. A clear insight into the anticoagulation therapy benefits in these patients could improve clinical decision-making. This meta-analysis aimed to assess the efficacy and safety of Anticoagulants in cirrhotic patients with PVT.</p><p><strong>Methods: </strong>PubMed, Cochrane Library, and ScienceDirect were searched from inception to September 2024. The Risk Ratios (RR) with 95% Confidence Interval (CI) were pooled for dichotomous outcomes under the random effects model using Review Manager 5.4.1. The primary endpoint of interest is PVT recanalization. Quality assessment was done through the Newcastle Ottawa Scale and the Cochrane RoB2.0 tool. Leave-one-out sensitivity analysis was done to investigate the cause of heterogeneity. Publication bias was assessed through funnel plots.</p><p><strong>Results: </strong>Twenty-three studies (including 19 cohorts and 4 Randomized trials), pooling 81,599 patients, were included in the analysis. Anticoagulants significantly increased the PVT recanalization (RR = 2.00; 95% CI: [1.59, 2.52]; <i>p</i> < 0.00001; <i>I</i> ² = 13%), PVT improvement (RR = 1.98; 95% CI: [1.70, 2.29], <i>p</i> < 0.00001; <i>I</i> ² = 0%) while decreasing the PVT stability (RR = 0.78; 95% CI: [0.62,0.99], <i>p</i> = 0.04; <i>I</i> ² = 19%) and PVT progression (RR = 0.42; 95% CI: [0.29, 0.60], <i>p</i> < 0.00001; <i>I</i> ² = 27%). Other outcomes including mortality (RR = 0.53; 95% CI: [0.27, 1.03]; <i>p</i> = 0.06; <i>I</i> ² = 94%), total bleeding (RR = 1.02; 95% CI: [0.76, 1.37], <i>p</i> = 0.89; <i>I</i> ² = 31%), esophageal variceal bleeding (RR = 0.74; 95% CI: [0.54, 1.01], <i>p</i> = 0.06; <i>I</i> ² = 56%), Gastrointestinal bleeding (RR = 1.07; 95% CI: [0.78, 1.48]; <i>p</i> = 0.66, <i>I</i> ² = 13%) and Intracranial hemorrhage (RR = 1.19; 95% CI: [0.89, 1.58], <i>p</i> = 0.24, <i>I</i> ² = 0%) were comparable between the 2 arms.</p><p><strong>Conclusion: </strong>Anticoagulants significantly increased PVT recanalization and PVT improvement while decreasing PVT stability and PVT progression in cirrhotic patients. Other outcomes were comparable between the two groups.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":"e70194"},"PeriodicalIF":1.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817856","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 Patient-Reported Outcome Measures in Patients Undergoing Bowel Preparation With Mannitol for Colonoscopy: The SATISFACTION Study.","authors":"Gian Eugenio Tontini, Cristiano Spada, Peter Uebel, Renato Cannizzaro, Giorgio Ciprandi, Maurizio Vecchi","doi":"10.1002/jgh3.70237","DOIUrl":"10.1002/jgh3.70237","url":null,"abstract":"<p><strong>Background: </strong>Bowel preparation for colonoscopy causes significant discomfort to patients. Large volumes, unpleasant taste, and split-dosing are the main disadvantages of most laxatives. Oral mannitol could be an attractive option because it acts quickly, requires low volumes, and has a pleasant taste.</p><p><strong>Aims: </strong>A Phase III study (SATISFACTION) compared oral mannitol with polyethylene glycol-ascorbate (PEG-ADC). This <i>post hoc</i> analysis investigated the effects on patient-reported outcomes (PROMs), mainly concerning the perception of using the preparations.</p><p><strong>Methods: </strong>The SATISFACTION Phase III study was an international, multicenter, randomized (1:1), parallel-group, endoscopist-blinded, non-inferiority trial. Taste of preparations, ease of use, and willingness to repeat the preparation with the same product were scored and assessed by the patients.</p><p><strong>Results: </strong>Bowel preparation with oral mannitol resulted in a better patient satisfaction profile for all PROMs evaluated.</p><p><strong>Conclusion: </strong>Oral mannitol for bowel preparation achieved high patient satisfaction and might be a valuable option for colonoscopy.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT04759885).</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":"e70237"},"PeriodicalIF":1.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817837","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}