JGH Open最新文献

{"title":"Outcomes of <i>Clostridium difficile</i> Infection in Patients With Idiopathic Pulmonary Fibrosis: Analysis of the Nationwide Inpatient Sample, 2016-2020.","authors":"Chun Ho Szeto, Gloria Erazo Montalvan, Chung Yin Tai, Edgar Luna Landa, Godfrey Tabowei, Raymond Wadie, Raghavendra Sanivarapu","doi":"10.1002/jgh3.70416","DOIUrl":"10.1002/jgh3.70416","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with poor prognosis. Patients with IPF are frequently exposed to risk factors for <i>Clostridium difficile</i> infection (CDI), such as advanced age, antibiotic use, and gastric acid suppression. However, the outcomes of CDI in hospitalized IPF patients remain unclear.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the National Inpatient Sample (2016-2020) to compare outcomes among hospitalized CDI adults with or without IPF as a pre-existing comorbidity. Hospitalizations were identified using ICD-10 codes. Propensity score matching (1:4) was performed to balance demographics and comorbidities. The primary outcome was all-cause in-hospital mortality; secondary outcomes included length of stay, hospitalization costs, mechanical ventilation, vasopressor use, and major adverse events.</p><p><strong>Results: </strong>Of 1 450 860 CDI hospitalizations, 1600 (0.11%) had IPF. After matching, IPF was independently associated with higher in-hospital mortality (aOR 1.85, 95% CI 1.22-2.76), longer hospital stays, and increased hospitalization costs. IPF patients were more likely to require mechanical ventilation (aOR 1.79, 95% CI 1.27-2.52). However, rates of fulminant CDI complications (severe sepsis, toxic megacolon, ileus, colectomy, ileostomy) were not significantly increased in the IPF cohort after matching.</p><p><strong>Conclusions: </strong>Hospitalized CDI patients with IPF experience significantly higher mortality and resource utilization compared to those without IPF. The absence of increased fulminant CDI complications suggests that CDI may act as a marker of underlying disease severity in IPF rather than a direct cause of death. These findings highlight the need for risk stratification in CDI patients with chronic lung diseases.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 ","pages":"e70416"},"PeriodicalIF":1.6,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934428","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148072007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intestinal Ultrasound Adds Diagnostic Value and Safety to a Dietitian-Led Clinic for Disorders of Gut-Brain Interaction.","authors":"R M Mathias, S L Plush, L E Edwards, D Bogatic, L Bibb, T M Goodsall, A S Day, R V Bryant","doi":"10.1002/jgh3.70415","DOIUrl":"10.1002/jgh3.70415","url":null,"abstract":"<p><strong>Background: </strong>Disorders of gut-brain interaction (DGBI) affect approximately 40% of the global population. Multidisciplinary models incorporating dietetic management are increasingly used, yet objective assessment tools remain limited. This study evaluated the clinical utility of intestinal ultrasound (IUS) within a dietitian-led DGBI clinic.</p><p><strong>Methods: </strong>Consecutive patients underwent IUS at baseline and after dietetic intervention. Irritable bowel syndrome severity scores (IBS-SSS) and sonographic parameters were recorded at both visits. Fecal loading was defined by posterior acoustic shadowing and/or colonic diameter > 50 mm. Patient satisfaction was assessed using a 100-point Visual Analog Scale (VAS), with scores ≥ 75 indicating satisfaction.</p><p><strong>Results: </strong>Ninety-seven patients underwent IUS: 85 met Rome IV criteria for irritable bowel syndrome, 7 for functional constipation, and 5 for functional diarrhea. IUS confirmed the clinical diagnosis in 67% (65/97) and led to management changes in 28% (27/97). Fecal loading was identified in 22% (6/27) of patients reporting diarrhea. Mean satisfaction with IUS was high (97; 95% CI: 87.5-100). Sequential IUS was performed in 38 patients; management of IUS-defined fecal loading significantly reduced colonic diameter (<i>p</i> < 0.001) and posterior acoustic shadowing (<i>p</i> < 0.001), with corresponding improvement in IBS-SSS scores (<i>p</i> < 0.0001). New inflammatory bowel disease was detected in 3 (8%) patients.</p><p><strong>Conclusion: </strong>IUS enhances diagnostic confidence and informs management in a dietitian-led DGBI clinic. It represents a safe, well-tolerated, and cost-effective adjunct to clinical assessment, supporting its integration into multidisciplinary models of care. Further studies should clarify its role in functional gastrointestinal evaluation.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 ","pages":"e70415"},"PeriodicalIF":1.6,"publicationDate":"2026-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934380","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148067385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut Microbiota and Extraintestinal Cancers: Mechanistic Insights and Microbiome-Targeted Interventions.","authors":"Rishi Chowdhary, Manjeet Kumar Goyal, Kirti Arora, Tanisha Sehgal, Prachi Dawer, F N U Anirudh, Jeffrey Berinstein, Shrinivas Bishu, Laurie Matt-Amaral","doi":"10.1002/jgh3.70409","DOIUrl":"10.1002/jgh3.70409","url":null,"abstract":"<p><p>The gut microbiota is a dynamic community of bacteria, viruses, fungi, and archaea that plays a pivotal role in regulating host immunity, metabolism, and systemic homeostasis. Dysbiosis, characterized by an imbalance in the microbial composition, is being increasingly recognized as a contributor not only to gastrointestinal cancers but also to extraintestinal malignancies. Mechanistic studies highlight the gut-microbiota-cancer axis, where microbial metabolites such as bile acids, short-chain fatty acids (SCFAs), and tryptophan derivatives influence genetic, epigenetic, and immune pathways, influencing carcinogenesis. Germ-free models demonstrate that commensal signals are essential for CD4⁺ and CD8⁺ T-cell differentiation, IgA production, and anti-tumor immunity. Dysbiosis-induced immune dysregulation is believed to impair immune checkpoint inhibitor (ICI) efficacy, while specific taxa such as <i>Bifidobacterium</i> and <i>Akkermansia</i> have been shown to enhance therapeutic responses. Emerging evidence links gut microbiota to breast cancer via estrogen metabolism \"estrobolome\" to lung cancer through the gut-lung axis and modulation of ICI responses, to melanoma by shaping systemic T-cell function and immunotherapy outcomes, and to prostate cancer through androgen receptor signaling and microbial metabolite interactions. These findings underscore the systemic oncogenic and tumor-suppressive potential of microbial communities. Microbiome-targeted interventions, including fecal microbiota transplantation (FMT), defined live biotherapeutics, probiotics, prebiotics, dietary modulation, and postbiotic delivery, are being actively investigated to optimize cancer treatment. While early trials have demonstrated feasibility, variability between individuals and methodological challenges remain significant hurdles. Hence, understanding how gut microbes influence extraintestinal cancers could revolutionize diagnostics, risk prediction, and treatment strategies.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 ","pages":"e70409"},"PeriodicalIF":1.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869946","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":"Comparison of Changes in Biomarkers With Changes in Endoscopic Scores in Patients With Ulcerative Colitis: A Single-Center, Retrospective, Observational Study.","authors":"Yosuke Yamada, Natsuki Ishida, Tomohiro Takebe, Kenichi Takahashi, Yusuke Asai, Mihoko Yamade, Moriya Iwaizumi, Yasushi Hamaya, Takanori Yamada, Satoshi Osawa, Ken Sugimoto","doi":"10.1002/jgh3.70405","DOIUrl":"10.1002/jgh3.70405","url":null,"abstract":"<p><strong>Aim: </strong>Fecal occult blood concentration, fecal calprotectin (FC) level, serum C-reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR) are valuable biomarkers for ulcerative colitis (UC). However, their clinical utility for longitudinal disease assessment remains unclear. This retrospective, observational study assessed correlations between biomarker changes and endoscopic activity scores in UC.</p><p><strong>Methods: </strong>Spearman's rank correlation coefficient analysis was applied to examine the relationship between longitudinal variations in endoscopic activity scores, including the Mayo endoscopic subscore (MES), ulcerative colitis endoscopic index of severity (UCEIS), and sum of Mayo endoscopic subscores (S-MES), and corresponding biomarker changes in patients with UC.</p><p><strong>Results: </strong>The study included 97 patients, contributing to 145 observation intervals (48 contributed two intervals each and 49 contributed one each). All endoscopic scores and biomarkers were significantly correlated with disease activity, with corresponding increases or decreases (<i>p</i> < 0.05). Changes in MES and S-MES correlated most strongly with FC level changes (<i>r</i> = 0.62 and 0.66, respectively). Changes in the UCEIS exhibited the strongest correlation with fecal occult blood concentration changes (<i>r</i> = 0.67). Changes in fecal occult blood and FC (<i>r</i> = 0.55) and in serum CRP and ESR (<i>r</i> = 0.58) were strongly correlated.</p><p><strong>Conclusions: </strong>All four biomarkers reflected endoscopic activity in UC. Changes in fecal occult blood concentration and FC level had stronger correlations with endoscopic score changes than blood biomarker concentration changes. FC assessment is valuable for monitoring inflammatory activity during remission maintenance, whereas fecal occult blood concentration reflects mucosal bleeding. Serum CRP level and ESR are useful adjunctive biomarkers, particularly in cases of increased disease activity.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 ","pages":"e70405"},"PeriodicalIF":1.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844206","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148067161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148067252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148087513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148087514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}