Gastro hep advances最新文献

{"title":"Recurrent Respiratory Distress Caused by Temporary Herniation of Transverse Colon Into Hiatal Hernia in Patient With Kyphosis","authors":"Hideaki Kazumori","doi":"10.1016/j.gastha.2024.10.009","DOIUrl":"10.1016/j.gastha.2024.10.009","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 2","pages":"Article 100569"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061510","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":"Shotgun Metagenomics Reveals Bacteroides stercoris as a Fecal Biomarker Depleted in Late-Stage Hepatocellular Carcinoma","authors":"Damien Esparteiro , Grégory Fouquet , Anoïsia Courtois , Mickaël Naassila , Eric Nguyen-Khac , Ingrid Marcq","doi":"10.1016/j.gastha.2024.07.020","DOIUrl":"10.1016/j.gastha.2024.07.020","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 1","pages":"Article 100539"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081392","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":"Successful Example of Implementing Screening of Liver Fibrosis in Specialist Diabetes Care","authors":"Muna Tajudin ,&nbsp;Hannes Hagström ,&nbsp;Sophia Rössner","doi":"10.1016/j.gastha.2024.10.017","DOIUrl":"10.1016/j.gastha.2024.10.017","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Patients with type 2 diabetes (T2D) constitute a risk group for presence and severity of metabolic dysfunction–associated steatotic liver disease (MASLD). Yet, there are few published examples of collaborations between endocrinologists and hepatologists in caring for patients with T2D and MASLD. Here, we describe a pathway for screening of liver fibrosis in routine specialist diabetes care at a tertiary care hospital.</div></div><div><h3>Methods</h3><div>Patients with T2D seen at the Endocrinology department at Karolinska University Hospital, Stockholm, Sweden, during a structured intervention for T2D between October 2016 and September 2023 were eligible for inclusion. Liver stiffness measurements (LSM) and controlled attenuation parameter (CAP) as proxies for liver fibrosis and steatosis, respectively, were obtained utilizing vibration-controlled transient elastography (VCTE). An LSM cut-off to exclude advanced fibrosis was set to &lt;8 kPa. Presence of MASLD was defined as a CAP value of CAP ≥ 294 dB/m.</div></div><div><h3>Results</h3><div>A total of 177 patients with a valid LSM were included. The median age was 60 years and 60% were women. The median LSM was 5.8 (interquartile range 4.6–8.1) kPa, and the median CAP was 306 (258–362) dB/m. In total, 27% had LSM ≥8 kPa and 11% had LSM ≥12 kPa. MASLD was present in 55%. The clinical score for aspartate aminotransferase, alanine aminotransferase, age, platelet count had a low sensitivity for identifying patients with VCTE measurements above 8 kPa (34%) and 12 kPa (37%).</div></div><div><h3>Conclusion</h3><div>This study provides an example of a productive partnership between endocrinologists and hepatologists using direct VCTE measurements, leading to the identification of a significant number of patients with presumed advanced fibrosis.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100577"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124112","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":"Supine-Position Endoscopic Retrograde Cholangiopancreatography for a Patient With Severe Motor and Intellectual Disabilities","authors":"Kimitoshi Kubo ,&nbsp;Issei Ashida ,&nbsp;Noriko Kimura","doi":"10.1016/j.gastha.2024.06.014","DOIUrl":"10.1016/j.gastha.2024.06.014","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 1","pages":"Article 100507"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141710315","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":"Role of Nutrition in the Management of Chronic Liver Disease","authors":"Matt Pelton ,&nbsp;Sarah Abdel-Meguid ,&nbsp;Eshani Goradia ,&nbsp;Arvind Bussetty ,&nbsp;Deborah Cohen ,&nbsp;Keerthana Kesavarapu","doi":"10.1016/j.gastha.2024.100613","DOIUrl":"10.1016/j.gastha.2024.100613","url":null,"abstract":"<div><div>Malnutrition is prevalent, detrimental, and associated with worse outcomes, including higher rates of hospitalization, morbidity, and mortality. In this review article, we aimed to define malnutrition in patients with chronic liver disease (CLD), elucidate the pathogenesis of malnutrition, discuss the advantages and disadvantages of current screening methods, and highlight the latest evidence-based dietary recommendations. Emerging evidence suggests that CLD-specific tools such as the Liver Disease Undernutrition Screening Tool and the Royal Free Hospital-Nutritional Prioritizing Tool can accurately identify patients at high risk for malnutrition and should be used in conjunction with more standard tools such as subjective global assessments. The pathogenesis of malnutrition in CLD is multifactorial but seems to arise in large from altered metabolism, namely a reduction in protein synthesis and an increase in resting energy expenditure. However, decreased nutrient intake, impaired nutrient absorption and increased nutrient losses have also been shown to contribute. Key findings in this review argue against protein-restricted diets in patients with CLD and support the use of plant-based proteins over dairy and meat proteins for those with liver cirrhosis complicated by hepatic encephalopathy. Frequent small meals are recommended in patients with liver cirrhosis in addition to the avoidance of prolonged fasts &gt;12 hours due to their hypercatabolic state. CLD covers a wide spectrum of diseases, and this review calls for an individualized approach to addressing the specific nutritional needs, depending on the etiology of CLD, its severity, associated complications, and comorbid conditions. This can be best achieved by close, longitudinal follow-up with a multidisciplinary team including a registered dietitian who can obtain a comprehensive, accurate nutritional assessment.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 5","pages":"Article 100613"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786110","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":"Genome-Wide DNA Methylation Markers Associated With Metabolic Liver Cancer","authors":"Samuel O. Antwi ,&nbsp;Ampem Darko Jnr. Siaw ,&nbsp;Sebastian M. Armasu ,&nbsp;Jacob A. Frank ,&nbsp;Irene K. Yan ,&nbsp;Fowsiyo Y. Ahmed ,&nbsp;Laura Izquierdo-Sanchez ,&nbsp;Loreto Boix ,&nbsp;Angela Rojas ,&nbsp;Jesus M. Banales ,&nbsp;Maria Reig ,&nbsp;Per Stål ,&nbsp;Manuel Romero Gómez ,&nbsp;Kirk J. Wangensteen ,&nbsp;Amit G. Singal ,&nbsp;Lewis R. Roberts ,&nbsp;Tushar Patel","doi":"10.1016/j.gastha.2025.100621","DOIUrl":"10.1016/j.gastha.2025.100621","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Metabolic liver disease is the fastest-rising cause of hepatocellular carcinoma (HCC), but the underlying molecular processes that drive HCC development in the setting of metabolic perturbations are unclear. We investigated the role of aberrant DNA methylation in metabolic HCC development in a multicenter international study.</div></div><div><h3>Methods</h3><div>We used a case-control design, frequency-matched on age, sex, and study site. Genome-wide profiling of peripheral blood leukocyte DNA was performed using the 850k EPIC array. The study sample was split 80% and 20% for training and validation. Cell type proportions were estimated from the methylation data. Differential methylation analysis was performed adjusting for cell type, generating area under the receiver-operating characteristic curves (AUC-ROC).</div></div><div><h3>Results</h3><div>We enrolled 272 metabolic HCC patients and 316 control patients with metabolic liver disease from 6 sites. Fifty-five differentially methylated CpGs were identified; 33 hypermethylated and 22 hypomethylated in cases vs controls. The panel of 55 CpGs discriminated between the cases and controls with AUC = 0.79 (95% confidence interval [CI] = 0.71–0.87), sensitivity = 0.77 (95% CI = 0.66–0.89), and specificity = 0.74 (95% CI = 0.64–0.85). The 55-CpG classifier panel performed better than a base model that comprised age, sex, race, and diabetes mellitus (AUC = 0.65, 95% CI = 0.55–0.75; sensitivity = 0.62, 95% CI = 0.49–0.75; and specificity = 0.64, 95% CI = 0.52–0.75). A multifactorial model that combined the 55 CpGs with age, sex, race, and diabetes yielded AUC = 0.78 (95% CI = 0.70–0.86), sensitivity = 0.81 (95% CI = 0.71–0.92), and specificity = 0.67 (95% CI = 0.55–0.78).</div></div><div><h3>Conclusion</h3><div>A panel of 55 blood leukocyte DNA methylation markers differentiates patients with metabolic HCC from control patients with benign metabolic liver disease, with a slightly higher sensitivity when combined with demographic and clinical information.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 5","pages":"Article 100621"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143830264","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":"Functional and Structural Investigation of Myenteric Neurons in the Human Colon","authors":"Kristin Elfers ,&nbsp;Alina Sophia Sehnert ,&nbsp;Alexander Wagner ,&nbsp;Ulrich Zwirner ,&nbsp;Helena Linge ,&nbsp;Ulf Kulik ,&nbsp;Daniel Poehnert ,&nbsp;Markus Winny ,&nbsp;Benjamin Gundert ,&nbsp;Heiko Aselmann ,&nbsp;Gemma Mazzuoli-Weber","doi":"10.1016/j.gastha.2024.08.016","DOIUrl":"10.1016/j.gastha.2024.08.016","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The enteric nervous system independently controls gastrointestinal function including motility, which is primarily mediated by the myenteric plexus, therefore also playing a crucial role in functional intestinal disorders. Live recordings from human myenteric neurons proved to be challenging due to technical difficulties. Using the neuroimaging technique, we are able to record human colonic myenteric neuronal activity and investigate their functional properties in a large cohort of patients.</div></div><div><h3>Methods</h3><div>Activity from myenteric neurons in wholemount preparations of different sampling sites of fresh, human colonic tissue was recorded using neuroimaging with the voltage sensitive dye 1-(3-sulfanatopropyl)-4-[beta[2-(di-n-octylamino)-6-naphthyl]vinyl]pyridinium betaine. Neuronal responses were analyzed following stimulation with nicotine and serotonin (5-HT) for differences based on the donor’s age, the disorder indicative for surgery and the colonic region. Immunohistochemistry was performed to calculate the total neuronal numbers.</div></div><div><h3>Results</h3><div>Stimulation with nicotine and 5-HT elicited reproducible action potential discharge in a proportion of human myenteric neurons. The responses to 5-HT were significantly greater in tissues from older patients and from those with inflammatory disorders, while neuronal activity to nicotinergic stimulation was comparable in all patients. Neuronal numbers declined with rising patient’s age and was highest in the sigmoid colon.</div></div><div><h3>Conclusion</h3><div>Neuroimaging with 1-(3-sulfanatopropyl)-4-[beta[2-(di-n-octylamino)-6-naphthyl]vinyl]pyridinium betaine was successfully adapted to record reproducible responses from human colonic myenteric neurons upon pharmacological stimulation. Evidence exists for an impact of age and inflammation on the serotonergic neuronal signaling and for differences in neuronal numbers in the distinct colonic regions as well as a neuronal decrease with age.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 1","pages":"Article 100537"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11714724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959690","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":"Provider Adherence to the 2020 US Multi-Society Task Force Guidelines for Surveillance After Colonoscopy With Polypectomy","authors":"Benjamin E. Cassell ,&nbsp;Katherine Scholand ,&nbsp;Wyatt Tarter ,&nbsp;Camille J. Hochheimer ,&nbsp;Colleen Long ,&nbsp;Gregory L. Austin","doi":"10.1016/j.gastha.2024.08.011","DOIUrl":"10.1016/j.gastha.2024.08.011","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The 2020 United States Multi-Society Task Force on Colorectal Cancer guidelines for surveillance after colonoscopy with polypectomy introduced significant changes in surveillance intervals. We sought to identify rates of adherence to these new guidelines at an academic medical center.</div></div><div><h3>Methods</h3><div>Average-risk screening colonoscopies where 1 to 4 polyps &lt;10 mm were removed between January 1, 2020, and June 30, 2021 were included. To determine predictors of nonadherence, a multivariable logistic regression analysis was conducted and included patient and procedure-related variables. Bayesian changepoint analysis was applied to identify timing of change in adherence. Multinomial logistic regression was used to identify predictors of variability within the guidelines.</div></div><div><h3>Results</h3><div>One thousand twenty-six procedures were analyzed. Adherence to the guidelines was 85%. In procedures with 1 to 2 polyps, increasing size (odds ratio [OR] 0.84 per mm; 95% confidence interval [CI]: 0.75–0.93) and a mixture of tubular adenomas (TA) and hyperplastic polyps (OR 0.35; 95% CI: 0.21–0.59) were associated with nonadherence. Among procedures with 1 to 2 TAs, age (OR 0.86 per 5-year increase; 95% CI: 0.75–0.99), increasing size (OR 0.86 per mm; 95% CI: 0.75–0.99) and polyp number (OR 0.54; 95% CI: 0.33–0.90) were associated with nonadherence. Changepoint analysis identified a potential changepoint on September 2, 2020 (95% credible interval April 2, 2020–February 22, 2020). Larger TAs were less likely to receive a 10-year recommendation (OR 0.61, 95% CI 0.5–0.75).</div></div><div><h3>Conclusion</h3><div>Adherence rates to the 2020 surveillance guidelines were high with a potential changepoint identified on 2/9/20. Deviation from guidelines was associated with patient and procedure related variables.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 1","pages":"Article 100532"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11714692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959710","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":"The Clinical Utility of Anorectal Manometry: A Review of Current Practices","authors":"Eleanor Aubrey Belilos ,&nbsp;Zoë Post ,&nbsp;Sierra Anderson ,&nbsp;Mark DeMeo","doi":"10.1016/j.gastha.2024.10.002","DOIUrl":"10.1016/j.gastha.2024.10.002","url":null,"abstract":"<div><div>Anorectal manometry (ARM) is a diagnostic test that utilizes pressure sensors to dynamically measure intraluminal anal and rectal pressures, thus providing an objective evaluation of anorectal functional parameters (tone, contractility, and relaxation), coordination and reflex activity, and sensation. ARM is a useful test for numerous indications including for the assessment and management of functional anorectal disorders such as fecal incontinence, functional defecatory disorders, and functional anorectal pain, preoperative assessment of anorectal function, and in facilitating/assessing response to biofeedback training. In addition, while many functional anorectal disorders present with overlapping symptoms (ie constipation, anorectal pain), ARM allows delineation of more specific disease processes and may guide treatment more effectively. In recent years the development of advanced manometric methodologies such as high-resolution anorectal manometry has also led to improved spatial resolution of data acquisition, further increasing the potential for the expansion of ARM. However, despite its ability to provide detailed information on anorectal and pelvic floor muscle function and synergy as well as the endorsements of several national and international organizations, ARM is still infrequently utilized in clinical practice. The purpose of this review is to address the current clinical applications and limitations of ARM for various disorders of the lower gastrointestinal tract. In so doing, we will provide clinicians with a framework for the use of ARM in clinical practice. This review will also discuss potential barriers to widespread adoption of ARM in clinical practice and propose possible solutions to these challenges.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 2","pages":"Article 100562"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049034","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":"Medicaid and Medicare Utilization of Direct-Acting Antiviral Medications for Patients With Hepatitis C","authors":"Xiaohan Ying ,&nbsp;Alexander Zhao ,&nbsp;Nicole Ng ,&nbsp;Russell Rosenblatt ,&nbsp;Catherine Lucero ,&nbsp;Arun B. Jesudian","doi":"10.1016/j.gastha.2024.10.024","DOIUrl":"10.1016/j.gastha.2024.10.024","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100584"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139832","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}