JGH Open最新文献

{"title":"Association of Helicobacter pylori Infection and Risk of Dyslipidemia: A Systematic Review and Meta-Analysis","authors":"Ankita Gaonkar,&nbsp;Quazi Syed Zahiruddin,&nbsp;Muhammed Shabil,&nbsp;Soumya V. Menon,&nbsp;Mandeep Kaur,&nbsp;Mukesh Kumari,&nbsp;Puneet Sudan,&nbsp;K. Satyam Naidu,&nbsp;Shailendra Thapliyal,&nbsp;Jyoti Uikey,&nbsp;Rachna Kathuria,&nbsp;Sanjay Singh Chauhan,&nbsp;Lokesh Verma,&nbsp;Amritpal Sidhu,&nbsp;Ganesh Bushi,&nbsp;Rohimah Binti Md Yusoff,&nbsp;Rachana Mehta,&nbsp;Prakasini Satapathy,&nbsp;Sanjit Sah","doi":"10.1002/jgh3.70128","DOIUrl":"https://doi.org/10.1002/jgh3.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although <i>Helicobacter pylori</i> (<i>H. pylori</i>) infections are widespread throughout the world, it is yet unknown whether they are linked to systemic illnesses like dyslipidemia. The purpose of this systematic review and meta-analysis was to examine the connection between lipid metabolism and <i>H. pylori</i> infection, with a particular emphasis on how it affects dyslipidemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a thorough search up until October 10, 2024, across databases such as PubMed, Web of Science, and Embase. Studies that reported lipid profiles in both <i>H. pylori</i>-infected and non-infected patients were considered eligible. The primary outcomes were triglyceride, LDL-C, HDL-C, and total cholesterol levels, which were examined using a random-effects model in R software version 4.4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 17 studies with more than 150,000 participants from 681 screened publications. Higher levels of LDL (MD: 5.32 mg/dL; 95% CI: 1.315 to 9.319) and total cholesterol (MD: 6.28 mg/dL; 95% CI: 0.718 to 11.842), as well as lower levels of HDL (MD: −2.06 mg/dL; 95% CI: −3.212 to −0.915), were the results of the meta-analysis. Among those infected, triglyceride levels were likewise higher (MD: 7.93 mg/dL; 95% CI: 0.413 to 15.436), but the odds ratio (OR) did not show a significant increase in risk (OR: 1.002; 95% CI: 0.995 to 1.010).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p><i>H. pylori</i> infection is associated with significant dyslipidemia, suggesting a potential link between chronic bacterial infection and lipid metabolism. The findings emphasize the need for further research to explore the mechanisms and potential therapeutic interventions.</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/jgh3.70128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689277","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 10-Day Versus 14-Day Bismuth-Containing Quadruple Therapy for Helicobacter pylori Eradication: A Systematic Review and Meta-Analysis","authors":"Najam Gohar,&nbsp;Zoya Ejaz,&nbsp;Faizan Ahmed,&nbsp;Abdul Rafay Ahmed,&nbsp;Muhammad Abdullah Humayun,&nbsp;Momna Nisar,&nbsp;Muhammad Ali Mushtaq,&nbsp;Aanusha Ghouri,&nbsp;Fatima Zafar,&nbsp;Hira Khalid,&nbsp;Sania Afzal,&nbsp;Hammad Khan,&nbsp;Huzaifa Ahmed Cheema,&nbsp;Muhammad Shahzil,&nbsp;Essam Rashad,&nbsp;Rehmat Ullah Awan,&nbsp;Prasun K. Jalal","doi":"10.1002/jgh3.70143","DOIUrl":"https://doi.org/10.1002/jgh3.70143","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nearly half of the world population is infected by <i>Helicobacter pylori</i> (<i>H. pylori</i>). Bismuth-containing quadruple therapy (BQT) has shown favorable outcomes. This study compares 10-day and 14-day BQT regimens to evaluate their efficacy, safety, and compliance rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched electronic databases from their inception until May 2024 to retrieve all randomized controlled trials (RCTs) that compared 10-day and 14-day BQT regimens for <i>H. pylori</i> eradication. Meta-analysis was performed using Review Manager 5.4. Dichotomous outcomes were compared using the risk ratio (RR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven RCTs and a total of 2424 patients were included in the meta-analysis. There was no significant difference in the intention-to-treat eradication rate (RR 0.97; 95% CI 0.94, 1.01) and the per-protocol eradication rate (RR 0.96; 95% CI 0.93, 1.00) between the 10-day BQT and 14-day BQT groups. Commonly reported adverse events in both groups were epigastric pain and discomfort, nausea, and vomiting. There was no significant difference in the risk of adverse events between the two groups (RR 0.85; 95% CI 0.70, 1.03). There was no significant difference in the compliance rate between the two groups (RR 1.02; 95% CI 1.00, 1.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The eradication rates, risk of adverse events, and compliance rates were comparable between the two groups. Future research comparing similar drug doses with larger sample sizes and longer patient follow-ups can improve the quality of results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689563","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":"Ex Vivo Analysis of the Effect of Endoscopic Premedications on the Microbiota Profile in Gastric Juice","authors":"Toshiki Futakuchi,&nbsp;Hiroto Furuhashi,&nbsp;Kimio Isshi,&nbsp;Yuko Hara,&nbsp;Shingo Ono,&nbsp;Rina Kurokawa,&nbsp;Lena Takayasu,&nbsp;Wataru Suda,&nbsp;Kazuki Sumiyama","doi":"10.1002/jgh3.70141","DOIUrl":"10.1002/jgh3.70141","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Dimethicone (GAS), lidocaine (XYL), and protease (PRO) are commonly used as premedications during esophagogastroduodenoscopy (EGD). However, the effects of these drugs on the gastric microbiota remain unexplored. Therefore, we aimed to investigate the effects of these premedications on gastric juice collected from patients undergoing EGD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Gastric juice was endoscopically aspirated from six patients and divided into six aliquots for in vitro analysis. The samples were mixed with premedications in corresponding treatment sets: GAS, XYL, PRO, MIX (a mixture of GAS, XYL, and PRO), and control (CTL1 and 2; no medication treatment). After extraction of microbial DNA from the treated samples, the 16S rRNA amplicon sequence was analyzed to determine the microbiota profile in terms of (1) the amount of genomic DNA (gDNA), (2) α-diversity indices, Shannon index, number of observed operational taxonomic units (OTUs), and Chao1 index, (3) weighted and unweighted UniFrac distances, and (4) the relative abundance of phyla and genera.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The total amount of extracted gDNA did not significantly differ between the six groups. The α-diversity indices did not significantly differ between treatment groups. Although GAS, PRO, and MIX differed significantly from the technical replicates in the weighted UniFrac distance (<i>p</i> = 0.03 all), no significant difference was observed in the unweighted UniFrac distance. However, significant differences were observed in the relative abundance of several bacterial microbiota at the phylum and genus levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Premedications affect the microbiota profile of specific phylum- and genus-level bacterial groups.</p>\u0000 \u0000 <p><b>Trial Registration:</b> University Hospital Medical Information Network Clinical Trials Registry: UMIN-CTR 000040192 and UMIN-CTR 000051289</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671433","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":"Hypozincemia Is Associated With Increased Tyrosine Levels, Low Handgrip Strength, Increased Incidence of HCC, and Liver Disease Progression—A Cross-Sectional Study","authors":"Tomoo Kobayashi,&nbsp;Jun Inoue,&nbsp;Yu Tanaka,&nbsp;Mitsuru Yamakawa,&nbsp;Makoto Kurihara,&nbsp;Tomoko Handa,&nbsp;Yutaka Kondo,&nbsp;Akihiro Saitou,&nbsp;Manabu Shiraki,&nbsp;Yasuhiro Kojima,&nbsp;Motoki Ohyauchi,&nbsp;Atsushi Masamune","doi":"10.1002/jgh3.70124","DOIUrl":"https://doi.org/10.1002/jgh3.70124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Serum zinc levels decrease in chronic liver disease (CLD), but their effects on liver reserve function, tyrosine, skeletal muscle mass, handgrip strength (HGS), and hepatocellular carcinoma (HCC) development remain poorly understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective, cross-sectional study was conducted on 516 CLD cases. Patients were divided into a low zinc group (&lt; 80 μg/dL) and a high zinc group (≥ 80 μg/dL). Serum zinc levels were analyzed with liver reserve function (assessed by modified albumin-bilirubin [mALBI] grade), tyrosine, branched-chain amino acid/tyrosine ratio (BTR), and HCC development. In 180 cases, the relationship between serum zinc levels and skeletal muscle characteristics, including sarcopenia and HGS, was investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Tyrosine levels increased significantly with mALBI grade progression. Patients in the low zinc group had higher tyrosine levels (76.9 vs. 67.2 μmol/L, <i>p</i> &lt; 0.001), a greater proportion of high tyrosine levels (5.3% vs. 1.7%, <i>p</i> &lt; 0.001), and more HCC cases (10.5% vs. 3.7%, <i>p</i> &lt; 0.005). Zinc levels were lower with more severe CLD (81 μg/dL [mALBI grade 1] vs. 35.2 μg/dL [grade 3], <i>p</i> &lt; 0.001). Tyrosine levels were higher in HCC patients than in non-HCC patients (93.1 vs. 70.7 μmol/L, <i>p</i> &lt; 0.001). Sarcopenia prevalence did not differ between groups (56.6% vs. 52.0%, <i>p</i> = 0.344), but low HGS was more frequent in low zinc patients (61.2% vs. 46.3%, <i>p</i> = 0.032). In a subset of patients with low zinc levels (<i>n</i> = 12), zinc supplementation reduced tyrosine levels after 3 months (86.3 vs. 73.3 μmol/L, <i>p</i> = 0.017).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Hypozincemia is linked to elevated tyrosine levels, reduced HGS, increased HCC incidence, and CLD progression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646021","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":"Optimizing achalasia diagnosis in the era of high-resolution manometry: A Pakistani perspective","authors":"Sameen Abbas,&nbsp;Tayyab S Akhtar,&nbsp;Sampath Chinnam,&nbsp;Saima Mushtaq,&nbsp;Nafees Ahmad,&nbsp;Yu Fang,&nbsp;Amjad Khan","doi":"10.1002/jgh3.70041","DOIUrl":"https://doi.org/10.1002/jgh3.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>High-resolution manometry (HRM) is a gold standard for diagnosing achalasia and identification of its subtypes, but data regarding its correlation with clinical, endoscopic, and radiological features in low-resource settings like Pakistan are limited. This study aims to identify and compare manometric parameters with other diagnostic parameters among achalasia subtypes in Pakistani population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>A retrospective analysis of clinical, endoscopic, and radiological features of 381 patients who underwent HRM at Center for Liver and Digestive Diseases, Holy Family Hospital, Rawalpindi, Pakistan, from December 2015 to February 2024 was performed. Based on the HRM criterion, 213 patients were identified and categorized into subtypes: 132 cases for type I and 64 and 17 for type II and III, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patient demographics were similar across subtypes except for sex (male-dominant in types I and II, female-dominant in type III). Symptom duration was longest in type III (8 years vs. 4.1 years). Almost all patients had dysphagia; 83% reported regurgitation/weight loss, 71% chest pain, and 64% vomiting. The endoscopy results were normal in 40% of patients, and barium swallow was inconclusive in just 13% of achalasia patients. Type III exhibited the highest EGJ relaxation pressure and lowest LES pressure. Notably, all subtypes displayed elevated IRP, with type I showing highest value.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study identified type I achalasia as the most prevalent subtype. While barium swallow and endoscopy showed limited diagnostic accuracy, HRM confirmed subtypes in all patients. Despite challenges with GERD-like symptoms and inconclusive findings, further research is warranted to investigate specific clinical features of each subtype, potentially attributing to personalized treatment strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646023","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":"Dysplasia and Malignancy in Colonic Polyps: Preparing for a Resect and Discard Strategy in Canada","authors":"Vishesh V. Patel,&nbsp;Robert Bechara,&nbsp;Mandip Rai","doi":"10.1002/jgh3.70113","DOIUrl":"https://doi.org/10.1002/jgh3.70113","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Aims</h3>\u0000 \u0000 <p>Colonoscopies are commonly performed to evaluate and remove polyps. Currently, at most centers in Canada, all resected polyps are submitted for histologic examination. A resect and discard strategy has not been widely adopted in the Canadian population. The objective of this study was to characterize polyps and their rates of dysplasia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods/Results</h3>\u0000 \u0000 <p>Colonoscopies and pathology reports were analyzed at a tertiary care hospital. We recorded polyp size, histology, and the presence of high-grade dysplasia (HGD)/cancer. Out of a total of 2218 colonoscopies, 2945 polyps were removed. In descending order, tubular adenomas, hyperplastic, sessile serrated, tubulovillous, and inflammatory polyps represented 67.4%, 16.2%, 9.9%, 5.6%, and 0.8% of all polyps, respectively. Regarding size, 1703 polyps were between 1 and 5 mm, with only 2 (0.12%) showing HGD. Similarly, in the 6–9 mm group, there were 699 polyps, with only 3 (0.43%) showing HGD. Neither of these groups had evidence of cancer. In contrast, the &gt; 10 mm group had 543 polyps, of which 87 (16.02%) showed HGD, and 15 (2.76%) exhibited cancer. In our patient population, only 0.04% of patients would have a change in their screening interval due to HGD in polyps that were &lt; 5 mm in size.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Based on these findings, a resect and discard strategy should be further evaluated for diminutive polyps in this population. While current recommendations for post-polypectomy screening include pathological assessment, further research on screening intervals based on size, location, and optical diagnosis may reduce resource utilization without compromising outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70113","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646022","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":"Use of a Side-Viewing Endoscope for Superficial Non-Ampullary Duodenal Epithelial Tumors Located in the Groove Area","authors":"Kiyoyuki Kobayashi,&nbsp;Maki Ayaki,&nbsp;Takako Nomura,&nbsp;Hironobu Suto,&nbsp;Minoru Oshima,&nbsp;Keiichi Okano,&nbsp;Masafumi Ono,&nbsp;Hideki Kobara","doi":"10.1002/jgh3.70140","DOIUrl":"https://doi.org/10.1002/jgh3.70140","url":null,"abstract":"&lt;p&gt;Forward-viewing (FV) endoscopy shows limitations in the detection of superficial non-ampullary duodenal epithelial tumors (SNADETs) located on the ampullary side [&lt;span&gt;1, 2&lt;/span&gt;]. Particularly, the area above the papilla, called the groove area (Figure 1a–c), often prevents operators from managing SNADETs endoscopically. These failures are attributed to their horizontal orientation relative to the scope. Recent statements have recommended the use of a side-viewing (SV) endoscope to perform papillectomy for ampullary tumors [&lt;span&gt;3, 4&lt;/span&gt;]. Furthermore, it has been reported that the use of an SV-endoscope is a viable option for endoscopic resection (ER) of lesions in the medial part of the descending duodenum, even in non-ampullary tumors [&lt;span&gt;5, 6&lt;/span&gt;]. However, there have been no obvious reports of ER using an SV endoscope for SNADETs located in the groove area. Herein, we introduce two cases in which the ER technique, similar to endoscopic papillectomy using an SV endoscope, was efficacious in completely resecting SNADETs located in the groove area by obtaining an overall view of the tumors.&lt;/p&gt;&lt;p&gt;Case 1: A 54-year-old male presented with an 8-mm SNADET located in the groove area. While the anal side of the lesion was invisible to the FV endoscope (Figure 1d), the SV endoscope (TJF-Q290V; Olympus, Tokyo, Japan) enabled visualization of the entire tumor (Figure 1e) and facilitated cold snare polypectomy (Figure 1f) followed by defect closure using hemoclips (Sure Clip; Micro-Tech Co. Ltd., Nanjing, China). Histopathological examination confirmed the curative resection of a moderate-grade tubular adenoma.&lt;/p&gt;&lt;p&gt;Case 2: A 74-year-old male presented with a 15-mm SNADET located in the groove area that was incidentally detected during treatment for common bile duct stones. In contrast to the limited view of the tumor by the FV endoscope (Figure 1g), the SV endoscope enabled tumor visualization (Figure 1h), facilitating subsequent endoscopic mucosal resection (Figure 1i) and clip closure. Histopathological examination confirmed curative resection of the high-grade tubular adenoma.&lt;/p&gt;&lt;p&gt;The present technique has several limitations. Compared to the FV endoscope, ER using the SV endoscope for tumors in the groove area may be only indicated for small-sized tumor less than 15 mm as described in the present cases. While underwater endoscopic resection are acceptable techniques for 10 &lt; tumor ≦ 20 mm, endoscopic submucosal dissection (ESD) is indicated for suspicious carcinoma with larger tumors of more than 20 mm in size [&lt;span&gt;7&lt;/span&gt;]. Because the technical principle is based on papillectomy, we consider that technical difficulties associated with tumor resection and wound closure, and risks of complications would be almost similar to papillectomy. However, the size limitation and technical aspects should be further investigated.&lt;/p&gt;&lt;p&gt;In summary, the strength of this study is the improvement of the endoscopic view in the groove area ","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639170","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":"Small Bowel Obstruction Caused by Enteroliths Formed in the Duodenal Diverticulum","authors":"Jing Yu,&nbsp;Sheng-Yi Zhu,&nbsp;Jing-Jing Li,&nbsp;Lin-Hua Yao","doi":"10.1002/jgh3.70125","DOIUrl":"https://doi.org/10.1002/jgh3.70125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>Small bowel obstruction is a common acute abdomen. The disease presentation changes rapidly and differential diagnosis is difficult. If diagnosis and treatment are delayed or inappropriate, the consequences will be serious.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Here, we report here a rare case of small bowel obstruction caused by enteroliths formed in the duodenal diverticulum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Conservative treatment was not effective. Six days later, the patient underwent emergency exploratory laparotomy to confirm small bowel obstruction, and enterotomy for lithotomy was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Obstruction of the small intestine due to passage of enteroliths from the duodenal diverticulum is rare. There is currently no definitive evidence delineating the optimal duration for non-surgical treatment. However, it should be noted that the postponement of surgical intervention may elevate mortality rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70125","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639139","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":"Evaluating the Effectiveness of Pegbelfermin in MASH-Associated Hepatic Fibrosis A Meta-Analysis and Systematic Review of Randomized Controlled Trials","authors":"Muhammad Shahzil,&nbsp;Fariha Hasan,&nbsp;Syeda Kanza Kazmi,&nbsp;Manesh Kumar Gangwani,&nbsp;UmmeSalma Shabbar,&nbsp;Ammad Javaid Chaudhary,&nbsp;Muhammad Ali Khaqan,&nbsp;Muhammad Saad Faisal,&nbsp;Kathy N. Williams,&nbsp;Babu P. Mohan,&nbsp;Christina Tofani","doi":"10.1002/jgh3.70131","DOIUrl":"https://doi.org/10.1002/jgh3.70131","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Metabolic dysfunction-associated steatohepatitis (MASH), an advanced form of fatty liver disease, is characterized by liver inflammation and fibrosis, with an emerging interest in fibroblast growth factor (FGF)-21 analogs, particularly pegbelfermin (PGBF). This study evaluates the efficacy and safety of PGBF in treating MASH-associated hepatic fibrosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This meta-analysis followed Cochrane guidelines and PRISMA standards. A comprehensive search of databases up to January 2023 focused on randomized controlled trials (RCTs) comparing PGBF to placebo for MASH. Meta-analyses were performed with RevMan 5.4 using a random-effects model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data from 452 participants across three RCTs were analyzed. Significant improvements in adiponectin concentration were observed in both the 10 mg [MD = 18.23, 95% CI (6.35, 30.11), <i>p</i> = 0.003] and 20 mg [MD = 18.09, 95% CI (5.88, 30.31), <i>p</i> = 0.004] PGBF groups compared to placebo. Significant reductions in PRO-C3 concentration were noted in both the 10 mg [MD = −25.50, 95% CI (−43.95, −7.05), <i>p</i> = 0.007] and 20 mg [MD = −19.54, 95% CI (−33.33, −5.76), <i>p</i> = 0.005] groups. Significant improvement in MASH was seen in the 10 mg group [RR = 2.84, 95% CI (1.18, 6.78), <i>p</i> = 0.02] but not in the 20 mg group. No significant improvements in liver stiffness, Modified Ishak scores, collagen proportionate area, ALT and AST levels, or treatment-emergent adverse events (TEAEs) were observed in either dosage group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Pegbelfermin, a promising therapy for MASH fibrosis, has demonstrated effectiveness at 10 mg, significantly improving MASH and biomarkers including adiponectin and PRO-C3, while maintaining a generally safe profile.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143638657","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":"Rapid Resolution of Anabolic Androgenic Steroid-Induced Refractory Pruritus and Bile Cast Nephropathy With Therapeutic Plasma Exchange","authors":"Samuel Wong,&nbsp;Danny Con,&nbsp;Avik Majumdar","doi":"10.1002/jgh3.70130","DOIUrl":"https://doi.org/10.1002/jgh3.70130","url":null,"abstract":"<p>The proportion of non-paracetamol drug-induced liver injury (DILI) is increasing in Australia and other Western countries. Androgenic anabolic steroids (AAS) commonly cause a bland cholestasis that can persist for months despite withdrawal. A 35-year-old male presented with progressive painless jaundice associated with pruritus, nausea, loss of weight, dark urine, and pale stools. He had recently commenced AAS; DILI was suspected and confirmed on biopsy. His pruritus was refractory to medical therapy, and PLEX was commenced. He also developed renal failure from bile cast nephropathy (BCN) and required hemodialysis. At 10 weeks post-discharge, his pruritus and jaundice were significantly improved, and his renal function had completely recovered. The case adds to the growing evidence that PLEX can be used safely and effectively to treat cholestatic pruritus and BCN.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70130","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632699","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}