JGH Open最新文献

{"title":"Navigating the Second Victim Experience in Gastrointestinal Endoscopy and Colonoscopy","authors":"Hareesha Rishab Bharadwaj, Syed Hasham Ali, Aditya Gaur, Muhtasim Fuad, Matan Bone, Khabab Abbasher Hussien Mohamed Ahmed, Dushyant Singh Dahiya","doi":"10.1002/jgh3.70215","DOIUrl":"https://doi.org/10.1002/jgh3.70215","url":null,"abstract":"<p>Gastrointestinal endoscopy is a cornerstone of modern gastroenterological practice, offering both diagnostic and therapeutic benefits with a commendably high safety profile. Nevertheless, despite its minimally invasive nature, endoscopic procedures are not without risk. Significant complications and adverse events (AEs) can occur. Certain studies reveal that up to 85% of colonoscopists experience AEs [<span>1</span>]. In the UK, for instance, AE rates range from 2.8 per 1000 colonoscopies in screening populations to 5 per 1000 in symptomatic patients—figures that align closely with international data [<span>2</span>]. Within the NHS Bowel Cancer Screening Programme, which evaluated 263 129 colonoscopies between 2006 and 2014, the perforation rate was reported at a low 0.06% [<span>3</span>]. Importantly, complication risks are notably higher in older adults; a JAMA study demonstrated significantly elevated 30-day post-colonoscopy complication rates in individuals aged ≥ 75 compared to those aged 50–74. Diagnostic colonoscopies also carry a higher risk (0.1%) relative to screening procedures (0.04%) [<span>2-4</span>]. Colonoscopy-related 30-day mortality remains low, estimated between 1 in 100 000 and 1 in 10 000 procedures [<span>5, 6</span>].</p><p>While the medical management of complications such as perforation, bleeding, pancreatitis, and cholangitis is well established—supported by evidence-based protocols—far less attention has been given to the broader implications for endoscopists themselves. The emotional, professional, and medico-legal consequences of AEs can be substantial, directly impacting clinicians' well-being, confidence, and quality of care provided [<span>7</span>].</p><p>Injuries resulting from medical management, rather than the underlying disease, can arise from a spectrum of circumstances ranging from preventable errors to unavoidable complications [<span>1</span>]. Although attention is often directed towards patient outcomes, issues such as miscommunication, insufficient informed consent, and lack of systemic support frequently intensify the endoscopist's burden [<span>1, 8</span>]. This underscores the pressing need for comprehensive strategies that not only focus on preventing complications but also provide meaningful support for clinicians managing their aftermath. Notably, some studies suggest that over half of AEs may be preventable with improved systems and training. Still, even when unavoidable, such events can significantly undermine an endoscopist's confidence and professional standing [<span>1</span>].</p><p>The emotional toll is particularly profound for trainees, who may lack the experience, mentorship, and structured guidance to manage complications effectively. Current training programs often inadequately address non-technical aspects of AE management—including disclosure, apology, and patient communication—leaving clinicians to confront these challenges without sufficient preparation or support. The abs","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70215","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519759","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":"Machine-Learning Prediction of Bleeding After Endoscopic Submucosal Dissection for Early Gastric Cancer: A Multicenter Study","authors":"Hiroki Maruyama,&nbsp;Kazuya Takahashi,&nbsp;Kosuke Kojima,&nbsp;Nao Nakajima,&nbsp;Hiroki Sato,&nbsp;Ken-ichi Mizuno,&nbsp;Soichi Sugitani,&nbsp;Shuji Terai","doi":"10.1002/jgh3.70203","DOIUrl":"https://doi.org/10.1002/jgh3.70203","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Endoscopic submucosal dissection (ESD) is a minimally invasive treatment for early gastric cancer (GC); however, post-ESD bleeding remains a serious and unpredictable complication. This study aimed to develop machine-learning (ML) models to predict post-ESD bleeding and identify associated risk factors, ensuring accurate and interpretable predictions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective, multicenter clinical database was constructed for patients who underwent ESD for early GC. An ML model was developed using patient characteristics and perioperative findings to predict bleeding within 28 days post-ESD. Its performance was compared with that of a logistic regression–based non-ML model. Feature importance analysis was performed to aid interpretation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1084 patients (median age: 75 years), post-ESD bleeding occurred in 63 (5.8%). The area under the curve of the ML model was better than that of the non-ML model (0.80 vs. 0.71, <i>p</i> = 0.03). Furthermore, the ML model demonstrated a trend toward higher sensitivity compared with the non-ML model (0.74 vs. 0.58, <i>p</i> = 0.58). When stratified by ML-estimated bleeding probability, observed bleeding rates were 2.3%, 8.8%, and 28.6% in the low- (&lt; 50%), intermediate- (50%–80%), and high-probability (≥ 80%) groups, respectively. The odds of bleeding were significantly higher in the intermediate- (OR 4.03, <i>p</i> = 0.03) and high-probability (OR 16.7, <i>p</i> &lt; 0.01) groups compared to the low-probability group. Anticoagulant use with atrial fibrillation emerged as a key predictor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The ML model effectively rules out post-ESD bleeding and identifies clinically meaningful risk factors, supporting its use in personalized prophylactic strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514645","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":"Anti-Inflammatory Peptides as Promising Therapeutics Agent Against Inflammatory Bowel Diseases: A Systematic Review","authors":"Kiarash Ghazvini,&nbsp;Zahra Taghiabadi,&nbsp;Mohammad Ali Karimi,&nbsp;Mahdi Hosseini Bafghi,&nbsp;Mahdiesadat Paryan,&nbsp;Razieh Amirfakhrian","doi":"10.1002/jgh3.70212","DOIUrl":"https://doi.org/10.1002/jgh3.70212","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Inflammatory bowel disease (IBD) is linked to dysregulated mucosal immunity, microbiota imbalances, and environmental factors, though its exact cause remains unknown. Current treatments often have limitations, necessitating innovative therapies. This review evaluates anti-inflammatory peptides (AIPs) as emerging therapeutic agents, focusing on their efficacy in Ulcerative Colitis and Crohn's disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>A systematic review was conducted in February 2023, adhering to PRISMA 2020 guidelines. Studies published from 2010 to 2023 on AIPs for IBD treatment were retrieved from Medline, Web of Science, and Cochrane databases using keywords such as IBDs, AIPs, Crohn's disease, Ulcerative Colitis, and therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen studies met the inclusion criteria, comprising 12 animal studies, four clinical trials, and one case–control study. H-SN1 (snake venom peptide) and GLP-2② (glucagon-like peptide-2 dimer) effectively inhibited TNF cytotoxicity. Oral AVX-470 (bovine-derived anti-TNF antibody) reduced enterocyte TNF, MPO, and apoptosis levels. Ac2-26 (annexin A1 mimic) and αs2-casein peptide combined with synbiotics were shown to restore gut homeostasis and dysbiosis. AMP-18 (gastrokine-1) and MBCP (buffalo milk peptide) stabilized tight junctions, preserving intestinal barrier integrity and potentially preventing IBD progression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AIPs effectively reduce inflammation, regulate gut microbiota, and stabilize the intestinal barrier, showing promise for managing IBD. However, their therapeutic potential is limited by protease degradation, poor bioavailability, and possible cytotoxicity. Future research should enhance their stability, delivery systems, and pharmacokinetic properties to optimize their clinical applicability and safety.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514643","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":"Examination of the Diameter of the Rectum and the Thickness of the Anterior Wall of the Rectum by Ultrasound in Children With Chronic Constipation and Abdominal Pain in the Age Range of 2–18 Years","authors":"Mitra Azra Aldaghi,&nbsp;Nafiseh Shourideh Yazdi,&nbsp;Mohammad Esmail Ahmad Abadi,&nbsp;Rahil Mahmoudi,&nbsp;Hadi Lotfi","doi":"10.1002/jgh3.70202","DOIUrl":"https://doi.org/10.1002/jgh3.70202","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Abdominal pain is one of the most common complaints to the pediatric clinic and can be challenging for the physician. Among children who present with abdominal pain, constipation is one of the main causes of abdominal pain, and its incidence in childhood is estimated at 1%–30%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Hundrerd children with chronic constipation, defined according to the Rome IV constipation criteria, who were referred to Sabzevar Children's Clinic, were included in the study. Hundred people in the control group were selected from children without constipation who underwent abdominal ultrasound due to abdominal pain. Consent was obtained from the children's parents, and the child's consent was also obtained for ultrasound. Rectal diameter and rectal anterior wall thickness were measured by an experienced radiologist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results determined that the diameter of the rectum measured by ultrasound in children with constipation is greater than in the control group. Also, the thickness of the rectum was lower in children with constipation compared to the control group. It was found that there was no significant relationship between gender and constipation in children. There was a significant relationship between constipation in children and their body mass index (BMI) and age. The results of the study showed that there was no significant relationship between history of urinary tract infection and constipation and socioeconomic status in children. There was a significant relationship between the diameter of the rectum and the duration of constipation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Ultrasound can be useful in diagnosing children with constipation in whom it is difficult to take a history and physical examination.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514587","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":"Risk of Pseudogallstones and Biliary Complications in Rehabilitation Patients Administered Ceftriaxone: A Retrospective Study","authors":"Hidehiro Kamezaki,&nbsp;Terunao Iwanaga,&nbsp;Takahiro Maeda,&nbsp;Junichi Senoo,&nbsp;Hiroshi Ohyama,&nbsp;Naoya Kato,&nbsp;Nobuyuki Sugiura","doi":"10.1002/jgh3.70214","DOIUrl":"https://doi.org/10.1002/jgh3.70214","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We aimed to evaluate the risk of pseudogallstones and biliary tract infections after ceftriaxone administration in patients undergoing rehabilitation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>This retrospective observational study was conducted from October 2016 to May 2022. During this period, 41 patients with gastrointestinal and hepatobiliary conditions were transferred from a rehabilitation hospital to an acute care facility. Of these, 22 patients were diagnosed with biliary tract infections, and they were included in the study. Data collection focused on patient demographics, antibiotic history, incidence of pseudogallstones, and related biliary complications. The median patient age was 83.5 years, with 45.5% male and 54.5% female patients. The primary reasons for rehabilitation included orthopedic and neurological diseases. A history of antibiotic administration was noted in 63.6% of patients, with 18.2% developing pseudogallstones after ceftriaxone administration. Individual case studies highlighted acute cholangitis and biliary sludge formation following ceftriaxone therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study identified a significant incidence of pseudogallstones and biliary complications associated with ceftriaxone administration, particularly in elderly patients, patients with immobility, and those with renal impairment. By using ceftriaxone in appropriate patients, the number of patients with biliary tract infections transferred from rehabilitation hospitals to acute-care hospitals can be reduced by 18.2%, thereby improving patient outcomes in rehabilitation settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514646","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 Randomized Double-Blind, Placebo-Controlled Trial of Artesunate and Curcumin in Patients With Crohn's Disease: A Pilot Study","authors":"Devinder Kumar,&nbsp;Uday C Ghoshal,&nbsp;Vamika Mansi Saigal,&nbsp;Moni Chaudhary,&nbsp;Shikha Sahu,&nbsp;Vishruti Pandya,&nbsp;Ujjala Ghoshal","doi":"10.1002/jgh3.70211","DOIUrl":"https://doi.org/10.1002/jgh3.70211","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Less than half of all patients with Crohn's disease remain in remission with long-term use of azathioprine. Our aim was to assess the efficacy of Artesunate and Curcumin in maintaining remission in patients with Crohn's disease, who had ongoing evidence of disease activity despite taking azathioprine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with Crohn's disease being treated with azathioprine for at least 3 months but still had mild to moderate Crohn's disease (CDAI 150–450) were included. Patients were randomized into four blocks of 10 patients each in a 2 × 2 factorial design to receive artesunate 200 mg PO daily for 2 weeks and/or curcumin 200 mg PO daily for 3 months or placebo. Harvey–Bradshaw Index, CDAI, and fecal calprotectin were measured at baseline, 1 week, 1 month, 3 months, and 6 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty patients were recruited and randomized into the study. Both Artesunate and Curcumin were well tolerated with no adverse effects. The Harvey–Bradshaw Index statistically differed across the treatment groups at 6 months (<i>p</i> = 0.047), there were no significant group differences in the post hoc pairwise analysis. The differences in CDAI from baseline to 6 months were statistically significant in Artesunate + Curcumin (<i>p</i> = 0.0098) and Curcumin + Placebo (<i>p</i> = 0.0431) groups. Similarly, statistically significant differences were observed between Baseline and 6 months for the Harvey–Bradshaw Index in the Artesunate + Curcumin (<i>p</i> = 0.0070) and Curcumin + Placebo (<i>p</i> = 0.0138) groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A combination of artesunate and curcumin in patients with ongoing inflammatory activity appears to be effective as measured by CDAI and Harvey–Bradshaw Index.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70211","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514644","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":"Effects of Stress, Vagal Nerve Stimulation and Disease Activity on Circulating Cytokines, Quantified by an Ultrasensitive Technique, in Ulcerative Colitis: A Pilot Study","authors":"Tamara Mogilevski,&nbsp;Melinda Y. Hardy,&nbsp;Kazuya Takahashi,&nbsp;Rebecca Smith,&nbsp;Anke L. Nguyen,&nbsp;Adam Farmer,&nbsp;James O. Lindsay,&nbsp;Jason A. Tye-Din,&nbsp;Qasim Aziz,&nbsp;Peter R. Gibson","doi":"10.1002/jgh3.70206","DOIUrl":"https://doi.org/10.1002/jgh3.70206","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The utility of circulating cytokine concentrations in ulcerative colitis is limited due to poor assay sensitivity. We aimed to examine the relationship of circulating cytokine concentrations, when measured by ultrasensitive detection, to disease activity, response to induction therapy, and physiological stimuli associated with mucosal injurious events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Plasma was obtained from adult patients with ulcerative colitis in whom disease activity was assessed; before/after induction therapy; and before/after acute psychological stress and cervical transcutaneous vagal nerve/sham stimulation. Cytokines were measured using an ultrasensitive electrochemiluminescence-based multiplex assay. For stress/vagal-stimulation studies, epithelial injury was quantified by plasma concentrations of intestinal-type fatty acid-binding protein.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 12 patients in remission, 15 with mild-moderately active disease and 6 with severe colitis, concentrations of interleukin-17, IL10, interferon-<b>γ</b>, interleukin-8 and interleukin-6, but not tumor necrosis factor-α or interleukin-12p70, significantly reflected disease activity. In five patients in whom clinical remission was achieved with induction therapy, only interleukin-12p70 changed with a median increase of 65 (IQR 42–303)% (<i>p</i> = 0.006), with no consistent changes in the 10 not in remission. Vagal nerve stimulation had no effect on cytokine concentrations, but, following stress, interleukin-12p70 increased by 37 (13–60)% compared with a reduction of 29 (3–55)% following sham stimulation (<i>p</i> = 0.012), an effect that mirrored that of epithelial injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Multiple cytokines were detected at sub-pg/mL levels and many showed relationships to disease activity in patients with ulcerative colitis. Effects exerted by interventions associated with epithelial injury were consistently detected by changes in interleukin-12p70 concentrations, but not other cytokines.</p>\u0000 \u0000 <p><b>Trial Registration:</b> Australian New Zealand Clinical Trials Registry: ACTRN12621000168853 and ANZCTR 12620000569909 [Ultrasound studies]; ClinicalTrials.gov identifier: NCT03908073</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70206","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511234","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":"Rectal Neuroendocrine Tumor With Non-Atypical Mucous Cell Glands: A Case Report","authors":"Akira Ishikawa,&nbsp;Hidenori Tanaka,&nbsp;Ken Yamashita,&nbsp;Shiro Oka,&nbsp;Shinji Mii","doi":"10.1002/jgh3.70208","DOIUrl":"https://doi.org/10.1002/jgh3.70208","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Neuroendocrine neoplasms (NENs) of rectal origin containing non-neuroendocrine components are extremely rare. Additionally, there have been no previous reports of NENs accompanied by nonmalignant components. Herein, we report a case of an NEN accompanied by mucous cell glands that could not be regarded as a carcinoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A Japanese woman in her 30s underwent a colonoscopy that revealed a yellowish submucosal tumor-like protrusion in the rectum. Endoscopic findings suggested a high possibility of NEN; therefore, endoscopic mucosal resection was performed. Histopathologically, it was found that tumor cells had invaded beyond the muscularis mucosa into the submucosa. The tumor predominantly consisted of neuroendocrine tumor (NET) components with mucous cell glands observed in 5% of the tumor. The mucous cell glands were Periodic acid-Schiff-positive and immunohistochemically positive for CK20, whereas synaptophysin, CD56, and chromogranin A were negative. Based on the above findings, the pathological diagnosis was NET G1 with mucous cell glands.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the first reported case worldwide. Further discussion is needed to address the atypical nature of the glandular component and explore the differences and similarities with entities such as mixed neuroendocrine–non-NENs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144492831","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":"Carbohydrate-Deficient Transferrin Evaluation Over Time Has Usefulness for Confirming Sobriety of Alcohol Rehabilitation Program Patients","authors":"Noriyo Yamashiki,&nbsp;Miki Murata,&nbsp;Shunichiro Ikeda,&nbsp;Kazushi Sugimoto,&nbsp;Akiko Eguchi,&nbsp;Motoh Iwasa,&nbsp;Saeko Nagao,&nbsp;Kanehiko Suwa,&nbsp;Toshihito Seki,&nbsp;Makoto Naganuma","doi":"10.1002/jgh3.70185","DOIUrl":"https://doi.org/10.1002/jgh3.70185","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>For treating severe alcohol-related liver disease (ALD), abstinence from alcohol is essential. Because underreporting can occur, abstinence biomarkers are necessary during hepatology outpatient service. This study assesses whether serial changes of the serum carbohydrate-deficient transferrin to transferrin ratio (%CDT) reflect patient abstinence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively investigated serial %CDT measurements and laboratory data from two outpatient settings: patients in an alcohol rehabilitation program (A), and ALD patients at a hepatology clinic (H) who attempted abstinence with self-diary monitoring. Using group A data, correlation coefficients were determined between the number of days from the last drink (abstinence days) and laboratory data. Linear approximation was applied for significant coefficients. Using these results, %CDT was validated for group H.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Group A data were 223 data samples from 55 cases with abstinence days. Four (7%) were diagnosed as having cirrhosis. Eighteen patients continued abstinence over 30 days. %CDT (<i>Rho</i> = −0.50, <i>p</i> &lt; 0.001) and GGT (<i>Rho</i> = −0.34, <i>p</i> &lt; 0.01) were negatively correlated with abstinence days. For %CDT, negative linear approximation was maintained with the number of days (<i>y</i> = 2.01–0.004 <i>x</i>).</p>\u0000 \u0000 <p>Group H data were 18 cases, of which 12 (66%) were diagnosed as cirrhosis cases. Seven patients reported continued abstinence for 8 weeks, during which time %CDT values dropped significantly. The group H %CDT was higher than the group A %CDT, perhaps because of severer liver disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The %CDT trend assessment is useful to support continued, multi-month self-reported abstinence from alcohol, but it must be interpreted carefully in severe liver disorder cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144323648","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":"Genetic Evidence of Association Between Gastroesophageal Reflux Disease and Hypertensive Disorders in Pregnancy","authors":"Qiong Li,&nbsp;Yajing Pang,&nbsp;Chaoyan Yue,&nbsp;Chenyang Zhao,&nbsp;Dongzhu Lei,&nbsp;Jin Zhou","doi":"10.1002/jgh3.70176","DOIUrl":"https://doi.org/10.1002/jgh3.70176","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The association between gastroesophageal reflux disease (GERD) and hypertensive disorders in pregnancy (HDP) is unclear. A bidirectional Mendelian randomization (MR) analysis was conducted to investigate the causal association between GERD and HDP using the public databases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four methods were applied in our MR analysis, including the inverse variance weighting (IVW), MR–Egger, weighted median, and weighted mode. A series of sensitivity analyses were conducted to affirm the stability and reliability of the results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>IVW analysis showed a potential causal association between GERD and pre-eclampsia (PE) (OR = 1.20, <i>p</i> = 0.048), as well as gestational hypertension (GH) (OR = 1.26, <i>p</i> = 0.008). The other three methods, including MR–Egger, weighted median, and weighted mode, yielded consistent results. Heterogeneity existed between GERD and PE (<i>p</i> &lt; 0.05), as well as GH (<i>p</i> &lt; 0.05) in sensitivity analyses. However, there was no pleiotropy in MR analysis results (<i>p</i> &gt; 0.05). Leave-one-out analysis indicated that none of the SNPs had a potential impact on IVW results. In the reverse MR analysis, there is no causal effect of HDP on GERD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results demonstrated that GERD exhibited a causal relationship with a high risk of HDP, which contributed to the ongoing discourse of GERD in the etiology of HDP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315223","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}