{"title":"Acute Kidney Injury in Cirrhosis Revisited—Implications in Clinical Practice","authors":"Akash Roy, Rohit Mehtani, Anand V. Kulkarni","doi":"10.1016/j.gastha.2024.10.023","DOIUrl":"10.1016/j.gastha.2024.10.023","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100583"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167834","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}
Gonzalo Latorre , Alberto Espino , Christine E. Orr , Robert Bechara
{"title":"Endoscopic Submucosal Dissection of Gastric High-Grade Foveolar Dysplasia With Normal Background Mucosa","authors":"Gonzalo Latorre , Alberto Espino , Christine E. Orr , Robert Bechara","doi":"10.1016/j.gastha.2024.10.005","DOIUrl":"10.1016/j.gastha.2024.10.005","url":null,"abstract":"<div><div>Most gastric neoplastic lesions appear in patients with gastric premalignant conditions. Here, we present the case of a 75-year-old woman with no prior history of <em>Helicobacter pylori</em> infection, with a big gastric adenoma resected by endoscopic submucosal dissection. Histopathological examination revealed high-grade foveolar dysplasia. Interestingly, surrounding mucosa was normal, without signs of <em>H. pylori</em> infection or gastric preneoplastic conditions. The presented case emphasizes that high-risk gastric lesions may be present within a normal stomach without endoscopic signs of <em>H. pylori</em> infection or premalignant conditions. This underscores the importance of careful examination in regular practice of esophagogastroduodenoscopy, even in low-risk patients.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 2","pages":"Article 100565"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049017","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}
Chris Varghese , Gabriel Schamberg , Emma Uren , Stefan Calder , Mikaela Law , Daphne Foong , Vincent Ho , Billy Wu , I-Hsuan Huang , Peng Du , Thomas Abell , Charlotte Daker , Christopher N. Andrews , Armen A. Gharibans , Gregory O’Grady
{"title":"A Standardized Classification Scheme for Gastroduodenal Disorder Evaluation Using the Gastric Alimetry System: Prospective Cohort Study","authors":"Chris Varghese , Gabriel Schamberg , Emma Uren , Stefan Calder , Mikaela Law , Daphne Foong , Vincent Ho , Billy Wu , I-Hsuan Huang , Peng Du , Thomas Abell , Charlotte Daker , Christopher N. Andrews , Armen A. Gharibans , Gregory O’Grady","doi":"10.1016/j.gastha.2024.09.002","DOIUrl":"10.1016/j.gastha.2024.09.002","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastric Alimetry™ (Alimetry, New Zealand) is a new clinical test for gastroduodenal disorders involving simultaneous body surface gastric electrical mapping and validated symptom profiling. Studies have demonstrated a range of distinct pathophysiological profiles, and a classification scheme is now required. We used Gastric Alimetry spectral and symptom profiles to develop a mechanism-based test classification scheme, then assessed correlations with symptom severity, psychometrics, and quality of life.</div></div><div><h3>Methods</h3><div>We performed a multicenter prospective cohort study of patients meeting the Rome IV criteria for functional dyspepsia and chronic nausea and vomiting syndromes. Patients underwent Gastric Alimetry profiling, and a standardized digital classification framework was devised and applied to separate patients into those with a) abnormal spectral analyses (ie aberrant gastric frequencies, amplitudes, and rhythms); and normal spectral analyses with b) symptoms <em>correlated</em> to gastric amplitude (subgroups: sensorimotor, postgastric, and activity-relieved), and c) symptoms <em>independent</em> of gastric amplitude (subgroups: continuous, meal-relieved, meal-induced).</div></div><div><h3>Results</h3><div>Two hundred ten patients were included (80% female, median age 37), of whom 169 met the criteria for chronic nausea and vomiting syndromes and 206 met the criteria for functional dyspepsia (79% meeting both criteria). Overall, 83% were phenotyped using the novel scheme, with 79/210 (37.6%) classified as having a spectral abnormality. Of the remainder, the most common phenotypes were “continuous pattern” (37, 17.6%), “meal-induced pattern” (28, 13.3%), and “sensorimotor pattern” (15, 7.1%). Symptom patterns independent of gastric amplitude were more strongly correlated with depression and anxiety (Patient Health Questionnaire 2: exp(β) 2.38, <em>P</em> = .024, State-Trait Anxiety Inventory Short-Form score: exp(β) 1.21, <em>P</em> = .021).</div></div><div><h3>Conclusion</h3><div>A mechanistic classification scheme for assessing gastroduodenal disorders is presented. Classified phenotypes showed independent relationships with symptom severity, quality of life, and psychological measures. The scheme is now being applied clinically and in research studies.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 1","pages":"Article 100547"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973640","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":"Massive Gastric Dilation Secondary to Recurrent Benign Idiopathic Prepyloric Stenosis Managed With Lumen-Apposing Metal Stent","authors":"Bibek Saha , Kayla Finnegan , Bright Thilagar","doi":"10.1016/j.gastha.2024.100597","DOIUrl":"10.1016/j.gastha.2024.100597","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 4","pages":"Article 100597"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143105065","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}
Sojeong Yi , Insook Kim , Rebecca Hager , Marian M. Strazzeri , Lili Garrard , Toru Matsubayashi , Ruby Mehta
{"title":"Food and Drug Administration Approval Summary: Odevixibat (Bylvay) for the Treatment of Pruritus With Progressive Familial Intrahepatic Cholestasis","authors":"Sojeong Yi , Insook Kim , Rebecca Hager , Marian M. Strazzeri , Lili Garrard , Toru Matsubayashi , Ruby Mehta","doi":"10.1016/j.gastha.2024.100596","DOIUrl":"10.1016/j.gastha.2024.100596","url":null,"abstract":"<div><div>On July 20, 2021, the Food and Drug Administration approved odevixibat (Bylvay) for the treatment of pruritus in patients 3 months of age and older with progressive familial intrahepatic cholestasis (PFIC). PFIC is a rare disease that results in impaired bile secretion and transport, leading to cholestatic liver injury. Odevixibat is a reversible inhibitor of the ileal bile acid transporter. It decreases the reabsorption of bile acids from the terminal ileum (distal small intestines). Approval was based on the improvement in pruritus demonstrated in a 24-week randomized double-blind placebo-controlled trial conducted in 62 pediatric subjects, aged 6 months to 17 years, with a confirmed molecular diagnosis of PFIC type 1 or type 2 with the presence of pruritus at baseline. Given the subjects’ young age, a single-item observer-reported outcome (ObsRO) was used to measure scratching as observed by the caregiver. Subjects had an average scratching score of greater than or equal to 2 (medium scratching) in the 2 weeks before baseline. The mean percentage of ObsRO assessments over the 24-week treatment period that were scored as 0 (no scratching) or 1 (a little scratching) was 35.4% and 30.1% for 40 mcg/kg/day and 120 mcg/kg/day odevixibat treatment, respectively, compared to 13.2% for placebo. There was general alignment between subject and caregiver assessments of worst weekly pruritus severity among subjects for whom both patient-reported outcome (Worst Weekly Itching Score) and ObsRO (Worst Weekly Scratching Score) data were available. The most common adverse reactions included diarrhea, liver test abnormalities, vomiting, abdominal pain, and fat-soluble vitamin deficiency. The benefit-risk assessment for odevixibat for the treatment of pruritus in the labeled population was considered favorable.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 4","pages":"Article 100596"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395983","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}
Karan Sachdeva , Daniyal Raza , Lovekirat Singh Dhaliwal , Rohit Goyal , Pooja Shah , Lena Kawji , Ashley Deville , Brittany Pass , Natalie Roppolo , Ahmad Alkurd , Farhan Mohiuddin , Hailey Canezaro , Victoria Andrus , Elizabeth Armstrong , Michelle Neice , Maryam Mubashir , Shazia Rashid , Michael Tran , Omar Khan , Qiang Cai
{"title":"The Influence of Psychiatric Factors on Health-Care Resource Utilization in Patients With Gastroparesis: A National Population-Based Study","authors":"Karan Sachdeva , Daniyal Raza , Lovekirat Singh Dhaliwal , Rohit Goyal , Pooja Shah , Lena Kawji , Ashley Deville , Brittany Pass , Natalie Roppolo , Ahmad Alkurd , Farhan Mohiuddin , Hailey Canezaro , Victoria Andrus , Elizabeth Armstrong , Michelle Neice , Maryam Mubashir , Shazia Rashid , Michael Tran , Omar Khan , Qiang Cai","doi":"10.1016/j.gastha.2025.100620","DOIUrl":"10.1016/j.gastha.2025.100620","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastroparesis, characterized by delayed gastric emptying, leads to debilitating gastrointestinal symptoms and often experience comorbid psychiatric disorders, possibly linked to brain-gut network dysfunction. This adversely affects quality of life and necessitates medical care. We aimed to characterize the longitudinal impact of comorbid anxiety, depression, or bipolar disorder on health-care resource utilization in adults hospitalized primarily with gastroparesis.</div></div><div><h3>Methods</h3><div>A retrospective observational study using the 2016–2019 National Inpatient Sample Healthcare Cost and Utilization Project identified patients aged ≥18 years hospitalized with an index diagnosis of gastroparesis (International Classification of Diseases-10 code K31.84). The cohort was stratified based on the presence of comorbid psychiatric mood disorders (depression, anxiety, and bipolar spectrum disorders). We compared the frequency of computed tomography (CT) imaging, gastric emptying studies, endoscopic procedures, length of stay, and hospitalization costs. Chi-square and analysis of variance tests were used.</div></div><div><h3>Results</h3><div>Of 47,265 patients hospitalized with gastroparesis, 21,545 (45.6%) had comorbid psychiatric mood disorders. These patients had a higher mean Elixhauser comorbidity index (3.6 ± 1.8 vs 2.9 ± 1.8, <em>P</em> < .001) and a longer median hospital stay (4, interquartile range: 2–6 vs 3, interquartile range: 2–6, <em>P</em> < .001). Adjusted analysis showed higher CT imaging frequency in this group (adjusted Odds ratio: 1.15; 95% confidence interval: 1.04–1.67). Although the frequency of endoscopic procedures, gastric scintigraphy, and total hospitalization costs were higher in the psychiatric comorbidity group, these differences were not statistically significant in univariable analysis.</div></div><div><h3>Conclusion</h3><div>Nearly 50% of gastroparesis patients had concurrent psychiatric disorders and underwent more frequent CT imaging and had longer hospital stays. This underscores the importance of screening all gastroparesis patients for psychiatric disorders upon admission and exploring the effectiveness of incorporating psychosocial interventions into the treatment plan for gastroparesis patients.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 5","pages":"Article 100620"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825601","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}
Xin-Fang Zhu , Rong-Rong Ding , Bing-Yao Wang , Yun-hui Yang , Fu-Xia Ta , Yuan Wang , Qing-Mei Gao , Qi Zhang , Rong Xia , Xing-Guang Luo , Xuan Wang , Jian-Ming Zheng , Hui-Qing Zhu
{"title":"Iodine-131 Combined With Plasma Exchange Treatment in Graves’ Hyperthyroidism Patients With Severe Liver Injury Whose Average Model for End-Stage Liver Disease Scores >20","authors":"Xin-Fang Zhu , Rong-Rong Ding , Bing-Yao Wang , Yun-hui Yang , Fu-Xia Ta , Yuan Wang , Qing-Mei Gao , Qi Zhang , Rong Xia , Xing-Guang Luo , Xuan Wang , Jian-Ming Zheng , Hui-Qing Zhu","doi":"10.1016/j.gastha.2024.100600","DOIUrl":"10.1016/j.gastha.2024.100600","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The purpose of this retrospective study is to describe the Graves’ hyperthyroidism patients with severe liver injury treated by iodine-131 combined with plasma exchange (PE).</div></div><div><h3>Methods</h3><div>The patients who had hyperthyroidism caused by Graves’ disease, with severe liver injury (The level of total bilirubin ≥12 mg/dL), and after 1 week of liver protective medication treatment, the patient’s liver function did not improve, were enrolled in this study. All patients were treated with iodine-131 and PE. The patients’ laboratory data after 3 months of isotope therapy were collected.</div></div><div><h3>Results</h3><div>In this study, there were 8 patients included, the average model for end-stage liver disease (MELD) scores were greater than 20 (ranges from 19 to 30) at baseline. The levels of hemoglobin, platelet count, alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin, alkaline phosphatase, glutamyl transpeptidase, MELD scores, free triiodothyronine, free thyroxine, antithyroid peroxidase autoantibody and serum thyrotropin receptor antibodies after PE treatment were significantly lower than before PE treatment (<em>P</em> < .05). The level of total bilirubin at 3 months post-131I treatment was significantly lower than pre-131I treatment (<em>P</em> = .0200), the same was the level of direct bilirubin (<em>P</em> = .0200).</div></div><div><h3>Conclusion</h3><div>Our study enrolled Graves’ hyperthyroidism patients with severe liver injury whose average MELD scores were greater than 20, and shows that liver function test can recover on about 3 months treated iodine-131 combined with PE therapy.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 4","pages":"Article 100600"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143237534","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}
Laura E. Kane , Brian Flood , Joan Manils , Donna E. McSkeane , Aoife P. Smith , Miriam Tosetto , Fatema Alalawi , Joanna Fay , Elaine Kay , Cara Dunne , Stephen McQuaid , Maurice B. Loughrey , Jacintha O’Sullivan , Elizabeth J. Ryan , Kieran Sheahan , Glen A. Doherty , Emma M. Creagh
{"title":"Caspase-4 Has Potential Utility as a Colorectal Tissue Biomarker for Dysplasia and Early-Stage Cancer","authors":"Laura E. Kane , Brian Flood , Joan Manils , Donna E. McSkeane , Aoife P. Smith , Miriam Tosetto , Fatema Alalawi , Joanna Fay , Elaine Kay , Cara Dunne , Stephen McQuaid , Maurice B. Loughrey , Jacintha O’Sullivan , Elizabeth J. Ryan , Kieran Sheahan , Glen A. Doherty , Emma M. Creagh","doi":"10.1016/j.gastha.2024.09.007","DOIUrl":"10.1016/j.gastha.2024.09.007","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Colorectal cancer (CRC) is the second most deadly cancer globally. The rapidly rising incidence rate of CRC, coupled with increased diagnoses in individuals <50 years, indicates that early detection of CRC, and those at an increased risk of CRC development, is paramount to improve the survival rates of these patients. Here, we profile caspase-4 expression across 2 distinct CRC development pathways, sporadic CRC (sCRC) and inflammatory bowel disease-associated CRC (IBD-CRC), to examine its utility as a novel biomarker for CRC risk and diagnosis.</div></div><div><h3>Methods</h3><div>Tissue samples from patients with CRC, colonic polyps, IBD-CRC, and sCRC were assessed by immunohistochemistry for caspase-4 expression in epithelial and stromal compartments. RNAseq expression data for caspase-4 in CRC and normal tissue samples were mined from online databases.</div></div><div><h3>Results</h3><div>Epithelial caspase-4 expression is selectively elevated in CRC tumor tissue compared to adjacent normal tissue, where it is not expressed. In the sCRC pathway, caspase-4 is expressed in the epithelial and stromal tissue of all histological subtypes of colonic polyps, with a significant increase in epithelial expression from low-grade dysplasia to high-grade dysplasia progression. For the IBD-CRC pathway, caspase-4 epithelial expression was specifically upregulated in dysplastic and neoplastic tissue of IBD-CRC but was not expressed in normal or inflamed tissue.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that epithelial caspase-4 is selectively expressed in colon tissue during the development of dysplasia. As such, epithelial caspase-4 represents a promising novel tissue biomarker for CRC risk and diagnosis.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 2","pages":"Article 100552"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048994","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":"Addressing Colorectal Cancer Among Alaska Native Peoples: A Community and Subject Matter Expert Symposium","authors":"Diana Redwood , Samantha McNelly , Kate Flynn , Claire Siekaniec , Charissa Habeger , Kyle Wark , Todd Takeno , Timothy Thomas","doi":"10.1016/j.gastha.2024.10.012","DOIUrl":"10.1016/j.gastha.2024.10.012","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Alaska Tribal health organizations are working to increase colorectal cancer (CRC) prevention and control as well as awareness of its impact among Alaska Native peoples, who have the highest rates of CRC in the world.</div></div><div><h3>Methods</h3><div>The Alaska Native Tribal Health Consortium convened the first Alaska Native CRC Research Symposium (symposium) held June 12–13, 2023 in Anchorage, Alaska. The symposium had 3 objectives: (1) Describe the epidemiology of Alaska Native CRC, clinical practices, and risk factors; (2) Share CRC prevention research happening in Alaska; and (3) Explore future ideas to reduce Alaska Native CRC. We report on the symposium design, findings, knowledge gaps, and future directions for others seeking to combat CRC in their state or Tribal community.</div></div><div><h3>Results</h3><div>The symposium brought together Alaska Tribal healthcare leaders, community members, clinicians, scientists, and public health professionals. A third of attendees (32%) were Alaska Native or American Indian people and/or from rural/remote Alaska (27%). The symposium consisted of 6 different scientific sessions organized around the following themes: CRC Trends in Alaska and the United States, Risk and Protective Factors, Alaska Tribal Prevention Activities, Alaska Native Research and Initiatives, Knowledge Gaps, and New Research and Other Initiatives.</div></div><div><h3>Conclusion</h3><div>Reducing the burden of CRC among Alaska Native peoples will require persistent efforts to conduct quality research in partnership with Alaska Native communities; dedication of resources to fund research, prevention, and screening activities; and a steadfast, multisectoral commitment to addressing the persistent inequity of CRC experienced by Alaska Native peoples, families, and communities. This symposium was an important step in engaging in the collective journey to prevent CRC and promote health and wellness among Alaska Native peoples.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100572"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081872","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}
Shyam Patel , Diana Partida , Catherine Magee , Flor E. Garza Romero , Jennifer Y. Chen , Michelle Tana , Mandana Khalili
{"title":"Steatotic Liver Disease Education Enhances Knowledge and Confidence to Adhere to Provider Recommendations in Diverse and Vulnerable Populations","authors":"Shyam Patel , Diana Partida , Catherine Magee , Flor E. Garza Romero , Jennifer Y. Chen , Michelle Tana , Mandana Khalili","doi":"10.1016/j.gastha.2024.11.005","DOIUrl":"10.1016/j.gastha.2024.11.005","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Patient knowledge of steatotic liver disease (SLD) is suboptimal. We assessed the impact of SLD education on patient knowledge and confidence to follow provider recommendations among a diverse vulnerable population.</div></div><div><h3>Methods</h3><div>In this prospective study from February 19, 2020, to January 31, 2024, 296 adults with SLD were surveyed before and after receipt of formal SLD education. Linear regression (adjusted for age, sex, race) assessed factors associated with baseline SLD knowledge score and its change after education (delta in prescores and postscores), along with confidence to follow provider recommendations following receipt of education.</div></div><div><h3>Results</h3><div>Participant characteristics were as follows: median age 53 years, 40.9% male, 55.1% Hispanic (27.0% Asian and 10.5% White), and 23.8% reported heavy alcohol use. SLD knowledge and confidence to follow provider recommendations increased posteducation (all <em>P</em> < .05). On multivariable analyses, greater than high school education (vs high school or less) (coef. 0.62), perceived severity of disease (coef. 0.62), treatment efficacy (coef. 1.38), self-efficacy to discuss SLD (coef. 0.71), and perceived susceptibility to disease risk (coef. 0.93) were associated with greater baseline knowledge (all <em>P</em> < .05). Following education, heavy alcohol use (vs none) was associated with greater change in knowledge (coef. 0.74), while perceived severity (coef. −0.52) and treatment efficacy (coef. −0.72) were associated with lesser change in knowledge (all <em>P</em> < .05). While perceived barriers (coef. −0.14) were associated with less confidence, self-efficacy to discuss SLD, older age, Hispanic, and other race was associated with greater confidence to follow provider recommendations (coef. 0.38, 0.18, 0.64, and 1.26, respectively, all <em>P</em> < .05).</div></div><div><h3>Conclusion</h3><div>Formal SLD education enhanced knowledge and confidence to follow provider recommendations in Hispanics and heavy alcohol users. SLD education is integral to SLD management in safety net populations.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100589"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167831","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}