Gastro hep advances最新文献

{"title":"Text Message System for the Prediction of Colonoscopy Bowel Preparation Adequacy Before Colonoscopy: An Artificial Intelligence Image Classification Algorithm Based on Images of Stool Output","authors":"Chethan Ramprasad ,&nbsp;Divya Saini ,&nbsp;Henry Del Carmen ,&nbsp;Lev Krasnovsky ,&nbsp;Rajat Chandra ,&nbsp;Ryan Mcgregor ,&nbsp;Russell T. Shinohara ,&nbsp;Eric Eaton ,&nbsp;Meghna Gummadi ,&nbsp;Shivan Mehta ,&nbsp;James D. Lewis","doi":"10.1016/j.gastha.2024.09.011","DOIUrl":"10.1016/j.gastha.2024.09.011","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Inadequate bowel preparation which occurs in 25% of colonoscopies is a major barrier to the effectiveness of screening for colorectal cancer. We aim to develop an artificial intelligence (machine learning) algorithm to assess photos of stool output after bowel preparation to predict inadequate bowel preparation before colonoscopy.</div></div><div><h3>Methods</h3><div>Patients were asked to text a photo of their stool in the commode when they believed that they neared completion of their colonoscopy bowel preparation. Boston Bowel Preparation Scores of 7 and below were labeled as inadequate or fair. Boston Bowel Preparation Scores of 8 and 9 were considered good. A binary classification image-based machine learning algorithm was designed.</div></div><div><h3>Results</h3><div>In a test set of 61 images, the binary classification machine learning algorithm was able to distinguish inadequate/fair preparation from good preparation with a positive predictive value of 78.6% and a negative predictive value of 60.8%. In a test set of 56 images, the algorithm was able to distinguish normal colonoscopy duration (&lt;25 minutes) from long colonoscopy duration (&gt;25 minutes) with a positive predictive value of 78.6% and a negative predictive value of 65.5%.</div></div><div><h3>Conclusion</h3><div>Patients are willing to submit photos of their stool output during bowel preparation through text messages before colonoscopy. This machine learning algorithm demonstrates the ability to predict inadequate/fair preparation from good preparation based on image classification of stool output. It was less accurate to predict long duration of colonoscopy.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 2","pages":"Article 100556"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049030","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 Varying Histology of Hepatic Sarcoidosis and the Relation of Bile Duct Damage and Loss to the Presence of Portal Hypertension and Cirrhosis","authors":"Divya B. Dasani ,&nbsp;Maria Isabel Fiel ,&nbsp;Camila C. Simoes ,&nbsp;Adam S. Morgenthau ,&nbsp;Thomas D. Schiano","doi":"10.1016/j.gastha.2024.10.001","DOIUrl":"10.1016/j.gastha.2024.10.001","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Sarcoidosis is a multisystem disorder characterized by nonnecrotizing granulomas. Studies suggest 20%–70% of patients with sarcoidosis have abnormal liver chemistries or abdominal imaging. Hepatic sarcoidosis may be complicated by portal hypertension (portal HTN) with or without cirrhosis. Few studies have reviewed the liver histopathology of sarcoidosis.</div></div><div><h3>Methods</h3><div>Searching the pathology database using the terms “sarcoidosis” and “liver,” patients were identified and cross-referenced to patients in the Sarcoidosis Clinic. Patients met the diagnostic criteria for sarcoidosis. Those with isolated granulomatous hepatitis were excluded. Demographics, abdominal imaging, biochemistries, and detailed histological features were cataloged.</div></div><div><h3>Results</h3><div>Patients were separated into 2 groups: those with portal HTN with or without cirrhosis (pHTN+) and those without portal HTN (pHTN-). Fifty-three patients had biopsies available for review (pHTN+, n = 33; pHTN-, n = 20). The groups did not differ in the location, type, or number of granulomas. The pHTN + group had more bile duct damage (<em>P</em> = .025) and loss (<em>P</em> = .019). Patients in the pHTN + group also had biliary cirrhosis, nodular regenerative hyperplasia, or outflow obstruction.</div></div><div><h3>Conclusion</h3><div>There are several causes for portal HTN in sarcoidosis. Thus, liver biopsy is essential in its evaluation. Bile duct damage and loss are associated with the presence of portal HTN and cirrhosis. Biliary abnormalities may occur independently of granulomatous inflammation, and can thus identify a subset of patients at risk for progressive liver disease.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 2","pages":"Article 100561"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049036","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":"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":"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":"Cover: Properties of Human Colonic Myenteric Neurons Differ Depending on Age, Disorder, and Colonic Region","authors":"","doi":"10.1016/j.gastha.2025.100616","DOIUrl":"10.1016/j.gastha.2025.100616","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 1","pages":"Article 100616"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143164272","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":"Anorectal Friction Force Is Reduced in Fecal Incontinence","authors":"Hans Gregersen ,&nbsp;Bhavesh Patel ,&nbsp;Xiaomei Guo ,&nbsp;Giuliana Barron Del Solar ,&nbsp;Samuel Eisenstein ,&nbsp;Ghassan Kassab","doi":"10.1016/j.gastha.2024.10.020","DOIUrl":"10.1016/j.gastha.2024.10.020","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100580"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167819","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-Integrin αvβ6 Antibody Titer as a Predictive Biomarker of Future Treatment Escalation in Patients With Ulcerative Colitis","authors":"Shuji Yamamoto,&nbsp;Takeshi Kuwada,&nbsp;Masahiro Shiokawa,&nbsp;Hiroki Kitamoto,&nbsp;Makoto Okabe,&nbsp;Hiroshi Seno","doi":"10.1016/j.gastha.2024.10.022","DOIUrl":"10.1016/j.gastha.2024.10.022","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100582"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167820","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":"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":"Shotgun Metagenomics Reveals Bacteroides stercoris as a Fecal Biomarker Depleted in Late-Stage Hepatocellular Carcinoma","authors":"Damien Esparteiro ,&nbsp;Grégory Fouquet ,&nbsp;Anoïsia Courtois ,&nbsp;Mickaël Naassila ,&nbsp;Eric Nguyen-Khac ,&nbsp;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}