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Best Practice & Research Clinical Gastroenterology最新文献

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The exposome as a target for primary prevention and a tool for early detection of pancreatic cancer 暴露体作为初级预防的靶点和早期发现胰腺癌的工具
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2025-02-01 DOI: 10.1016/j.bpg.2025.101991
Gaetano Lauri , Krystal Mills , Shounak Majumder , Gabriele Capurso
{"title":"The exposome as a target for primary prevention and a tool for early detection of pancreatic cancer","authors":"Gaetano Lauri ,&nbsp;Krystal Mills ,&nbsp;Shounak Majumder ,&nbsp;Gabriele Capurso","doi":"10.1016/j.bpg.2025.101991","DOIUrl":"10.1016/j.bpg.2025.101991","url":null,"abstract":"<div><div>Pancreatic Ductal Adenocarcinoma (PDAC) is a highly aggressive malignancy with limited survival due to late stage diagnosis and scarce therapeutic options. Emerging evidence highlights the role of the \"exposome,\" which encompasses environmental, lifestyle, and metabolic exposures, as a crucial determinant in PDAC risk and a potential avenue for early detection. This review synthesizes findings on modifiable risk factors, including smoking, obesity, diabetes, diet, and alcohol consumption, and their interplay with genetic and metabolic profiles in PDAC development. Additionally, we explore cutting-edge approaches in exposomic research, such as biobanking, electronic health record analysis, and AI-driven predictive models, to identify early biomarkers and stratify high-risk populations. This integrated framework aims to inform prevention strategies and improve early detection of PDAC.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"74 ","pages":"Article 101991"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Integrating artificial intelligence with endoscopic ultrasound in the early detection of bilio-pancreatic lesions: Current advances and future prospects 人工智能与超声内镜在胆胰病变早期检测中的结合：现状与展望
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2025-02-01 DOI: 10.1016/j.bpg.2025.101975
Matteo Tacelli , Gaetano Lauri , Daniela Tabacelia , Cristian George Tieranu , Paolo Giorgio Arcidiacono , Adrian Săftoiu
{"title":"Integrating artificial intelligence with endoscopic ultrasound in the early detection of bilio-pancreatic lesions: Current advances and future prospects","authors":"Matteo Tacelli ,&nbsp;Gaetano Lauri ,&nbsp;Daniela Tabacelia ,&nbsp;Cristian George Tieranu ,&nbsp;Paolo Giorgio Arcidiacono ,&nbsp;Adrian Săftoiu","doi":"10.1016/j.bpg.2025.101975","DOIUrl":"10.1016/j.bpg.2025.101975","url":null,"abstract":"<div><div>The integration of Artificial Intelligence (AI) in endoscopic ultrasound (EUS) represents a transformative advancement in the early detection and management of biliopancreatic lesions. This review highlights the current state of AI-enhanced EUS (AI-EUS) for diagnosing solid and cystic pancreatic lesions, as well as biliary diseases. AI-driven models, including machine learning (ML) and deep learning (DL), have shown significant improvements in diagnostic accuracy, particularly in distinguishing pancreatic ductal adenocarcinoma (PDAC) from benign conditions and in the characterization of pancreatic cystic neoplasms. Advanced algorithms, such as convolutional neural networks (CNNs), enable precise image analysis, real-time lesion classification, and integration with clinical and genomic data for personalized care.</div><div>In biliary diseases, AI-assisted systems enhance bile duct visualization and streamline diagnostic workflows, minimizing operator dependency. Emerging applications, such as AI-guided EUS fine-needle aspiration (FNA) and biopsy (FNB), improve diagnostic yields while reducing errors. Despite these advancements, challenges remain, including data standardization, model interpretability, and ethical concerns regarding data privacy. Future developments aim to integrate multimodal imaging, real-time procedural support, and predictive analytics to further refine the diagnostic and therapeutic potential of AI-EUS.</div><div>AI-driven innovation in EUS stands poised to revolutionize pancreatico-biliary diagnostics, facilitating earlier detection, enhancing precision, and paving the way for personalized medicine in gastrointestinal oncology and beyond.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"74 ","pages":"Article 101975"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Early detection of pancreatobiliary cancers: How to unveil a silent epidemic to change the outcomes - Preface 胰胆管癌的早期发现：如何揭示一种无声的流行病以改变结果-前言
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2025-02-01 DOI: 10.1016/j.bpg.2025.101993
Giuseppe Vanella MD, PhD, Paolo Giorgio Arcidiacono MD, FASGE
{"title":"Early detection of pancreatobiliary cancers: How to unveil a silent epidemic to change the outcomes - Preface","authors":"Giuseppe Vanella MD, PhD,&nbsp;Paolo Giorgio Arcidiacono MD, FASGE","doi":"10.1016/j.bpg.2025.101993","DOIUrl":"10.1016/j.bpg.2025.101993","url":null,"abstract":"","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"74 ","pages":"Article 101993"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Recommendations, evidence and sustainability of screening for pancreatic cancer in high-risk individuals 对高危人群进行胰腺癌筛查的建议、证据和可持续性
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2025-02-01 DOI: 10.1016/j.bpg.2025.101974
Aleksander M. Bogdanski , Pilar Acedo , Michael B. Wallace , Monique E. van Leerdam , Derk C.F. Klatte
{"title":"Recommendations, evidence and sustainability of screening for pancreatic cancer in high-risk individuals","authors":"Aleksander M. Bogdanski ,&nbsp;Pilar Acedo ,&nbsp;Michael B. Wallace ,&nbsp;Monique E. van Leerdam ,&nbsp;Derk C.F. Klatte","doi":"10.1016/j.bpg.2025.101974","DOIUrl":"10.1016/j.bpg.2025.101974","url":null,"abstract":"<div><div>Pancreatic cancer is a highly lethal malignancy and is predicted to become the second leading cause of cancer-related deaths by 2030. Early detection significantly improves outcomes, but general population screening remains infeasible due to the low prevalence of the disease and lack of specific biomarkers. This review evaluates current recommendations for pancreatic cancer surveillance in high-risk individuals, synthesises evidence from recent studies and explores the sustainability of current imaging-based surveillance programmes. Challenges such as overdiagnosis, economic feasibility and disparities in access highlight the need for targeted, cost-effective strategies. Collaborative initiatives and consortia are needed to advance biomarker research and refine risk stratification. By integrating evidence-based recommendations with sustainable approaches, this review outlines pathways to improve early detection and reduce mortality from pancreatic cancer.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"74 ","pages":"Article 101974"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Copyright Information 版权信息
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2025-02-01 DOI: 10.1016/S1521-6918(25)00029-0
{"title":"Copyright Information","authors":"","doi":"10.1016/S1521-6918(25)00029-0","DOIUrl":"10.1016/S1521-6918(25)00029-0","url":null,"abstract":"","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"74 ","pages":"Article 102002"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Genetic landscape for screening and early diagnosis of pancreatic ductal adenocarcinoma: is there a signature? 胰腺导管腺癌筛查和早期诊断的遗传景观：有一个标志吗？
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2025-02-01 DOI: 10.1016/j.bpg.2025.101988
Daniele Campa, Manuel Gentiluomo, Cosmeri Rizzato
{"title":"Genetic landscape for screening and early diagnosis of pancreatic ductal adenocarcinoma: is there a signature?","authors":"Daniele Campa,&nbsp;Manuel Gentiluomo,&nbsp;Cosmeri Rizzato","doi":"10.1016/j.bpg.2025.101988","DOIUrl":"10.1016/j.bpg.2025.101988","url":null,"abstract":"<div><div>The last 15 years have seen unprecedent advancement in genomics techniques such as dense single nucleotide variants (SNVs) arrays or next generation Sequencing. In parallel, new analytical methodologies have been developed to streamline data understanding and integration. These advances have been instrumental in identifying common genetic variants associated with pancreatic ductal adenocarcinoma (PDAC) risk. The role of the individual variants is rather small, and they have no clinical utility for screening or early detection. However, their combined effect computed though polygenic risk scores (PGS) are showing promising potentiality in PDAC risk prediction. There still caveats, and limitations that need to be properly addressed however it is foreseeable that the genetic background will become a powerful tool in PDAC prediction, leveraging the advantage that it has compared to other biomarkers: germline genetics is invariable from birth to death.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"74 ","pages":"Article 101988"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation and management of neurological complications in acute liver failure 急性肝衰竭神经系统并发症的评价与处理。
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-12-01 DOI: 10.1016/j.bpg.2024.101963
Nuruddin Ansari, Manav Wadhawan
{"title":"Evaluation and management of neurological complications in acute liver failure","authors":"Nuruddin Ansari,&nbsp;Manav Wadhawan","doi":"10.1016/j.bpg.2024.101963","DOIUrl":"10.1016/j.bpg.2024.101963","url":null,"abstract":"<div><div>Neurological complications in acute liver failure are the most common cause of mortality in this group of patients. Almost all neurologic complications arise from underlying increase in intracranial pressure in ALF. In addition to symptomatic management, the treatment relies on measures to bring down ICP. Recently role of renal replacement therapy is gaining a lot of ground in ALF management, primarily due to its ammonia lowering effects indirectly leading to decrease in ICP. In this review we cover the neurologic issues in ALF in detail. We discuss the various non invasive techniques for ICP monitoring &amp; their current application in ALF patients. We also focus on the management protocols in ALF &amp; their role in improving the ICP &amp; hence the outcome.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"73 ","pages":"Article 101963"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Basic concepts in the management of Acute Liver Failure 急性肝衰竭处理的基本概念。
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-12-01 DOI: 10.1016/j.bpg.2024.101960
Georg Auzinger
{"title":"Basic concepts in the management of Acute Liver Failure","authors":"Georg Auzinger","doi":"10.1016/j.bpg.2024.101960","DOIUrl":"10.1016/j.bpg.2024.101960","url":null,"abstract":"","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"73 ","pages":"Article 101960"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Copyright Information 版权信息
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-12-01 DOI: 10.1016/S1521-6918(24)00098-2
{"title":"Copyright Information","authors":"","doi":"10.1016/S1521-6918(24)00098-2","DOIUrl":"10.1016/S1521-6918(24)00098-2","url":null,"abstract":"","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"73 ","pages":"Article 101973"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Liver transplantation in acute liver failure 肝移植治疗急性肝衰竭。
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-12-01 DOI: 10.1016/j.bpg.2024.101968
Philippe Ichai, Didier Samuel
{"title":"Liver transplantation in acute liver failure","authors":"Philippe Ichai,&nbsp;Didier Samuel","doi":"10.1016/j.bpg.2024.101968","DOIUrl":"10.1016/j.bpg.2024.101968","url":null,"abstract":"<div><div>ABO-compatible Orthotopic Liver Transplantation (OLT) is the standard treatment for patients with acute liver failure (ALF) who meet the criteria for poor prognosis. Contraindications to liver transplantation may be related to the presence of severe medical or psychiatric comorbidities, or to an unstable clinical state incompatible with transplantation. Early mortality predictive scores and factors have been developed to identify futile transplantations that exacerbate organ shortage. However, these scores are not sufficiently reliable to contraindicate transplantation. Auxiliary liver transplantation, two-stage transplantation (total hepatectomy with portal-caval anastomosis followed by delayed orthotopic liver transplantation), ABO-incompatible liver transplantation, living-donor transplantation, and living-auxiliary liver donor transplantation are alternatives to OLT. The selection of appropriate techniques must fulfill specific criteria. ABO-incompatible transplantation remains an exception, even though immunosuppressive strategies have improved prognosis. The overall survival and graft survival rates at 1 and 5 years after liver transplantation for ALF are 79 % and 72 % in Europe, and 84 % and 73 % in the United States, respectively. The survival rate has significantly improved in recent years.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"73 ","pages":"Article 101968"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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