Gastro hep advances最新文献

{"title":"Initial Diagnostic Strategies for Helicobacter Pylori in Patients With Bleeding Peptic Ulcers Undergoing Endoscopy: A Cost-Effectiveness Analysis","authors":"Michael G. Artin ,&nbsp;Josephine Soddano ,&nbsp;Sheila D. Rustgi ,&nbsp;Zainab Aziz ,&nbsp;Francesca Lim ,&nbsp;Jeong Yun Yang ,&nbsp;Myles A. Ingram ,&nbsp;John T. Nathanson ,&nbsp;John Y. Kao ,&nbsp;Chin Hur","doi":"10.1016/j.gastha.2024.100602","DOIUrl":"10.1016/j.gastha.2024.100602","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Helicobacter pylori (H. pylori) is a major cause of peptic ulcer disease (PUD) and upper gastrointestinal bleeding. Testing for and eradication of H. pylori reduces the risk of future PUD-related complications including readmission for gastrointestinal bleeding. Our aim was to determine the most cost-effective testing strategy for H. pylori in patients hospitalized with bleeding peptic ulcers.</div></div><div><h3>Methods</h3><div>We developed a Markov cohort model to compare the following 6 H. pylori testing strategies: no testing, histology, rapid urease test, stool antigen test, urea breath test (UBT), and serology. Histology and rapid urease test require biopsies, while stool antigen test, UBT, and serology do not. We assumed a 17% H. pylori prevalence in patients admitted with bleeding ulcers. Model outcomes included hospitalizations for rebleeds, number needed to treat to avoid another hospitalization, life expectancy, total cost, quality-adjusted life years, and incremental cost-effectiveness ratios.</div></div><div><h3>Results</h3><div>Compared to no testing, UBT resulted in a gain of 0.02 quality-adjusted life years, total cost savings of $2140 per patient, and 1675 hospitalizations avoided per 10,000 patients per year. Additionally, the number needed to treat to avoid an additional hospitalization over 35 years was 167. UBT was the preferred strategy as it was both less costly and more effective than no testing.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that UBT is the cost-effective strategy to identify H. pylori in patients admitted with PUD. Noninvasive H. pylori testing at the point of care or during inpatient admission should be considered, as it presents limited risk to patients and offers potential clinical benefits.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 4","pages":"Article 100602"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143237940","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":"Trends in Acute Pancreatitis-Related Mortality Among US Adults from 1999 to 2020","authors":"Chun-Han Lo ,&nbsp;Rahul Pannala ,&nbsp;N. Jewel Samadder","doi":"10.1016/j.gastha.2025.100615","DOIUrl":"10.1016/j.gastha.2025.100615","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 5","pages":"Article 100615"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792367","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":"Pilot Study of Fecal Mitochondrial DNA in Inflammatory Bowel Disease Patients Demonstrates a High Sensitivity Assay With Likely Capacity to Differentiate Between Disease and Histologic Remission","authors":"Kevin Zhu ,&nbsp;Thomas Wallach ,&nbsp;Shagun Sharma ,&nbsp;Vivian Vega ,&nbsp;Meredith Pittman ,&nbsp;Joe Brown","doi":"10.1016/j.gastha.2025.100622","DOIUrl":"10.1016/j.gastha.2025.100622","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 5","pages":"Article 100622"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825600","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":"Enteropathic Arthritis Accompanied by Tuberculous Colitis: A Case Report","authors":"Agung Sandi Ramadan ,&nbsp;Cahyo Wibisono Nugroho","doi":"10.1016/j.gastha.2024.10.011","DOIUrl":"10.1016/j.gastha.2024.10.011","url":null,"abstract":"<div><div>Enteropathic arthritis (EnA) is a type of spondyloarthritis with inflammatory bowel disease, such as ulcerative colitis and Crohn’s disease, which is challenging to differentiate from tuberculous colitis. Patients with EnA living in endemic tuberculosis have a high risk of tuberculosis infection (tuberculous colitis), which triggers a recurrent increase in disease activity. Discontinuation of corticosteroid therapy in EnA and early start to antituberculosis drugs are recommended in the patients. Complete treatment of tuberculosis helps improve the prognosis of tuberculous colitis. Patient compliance in treatment plays a crucial role in managing tuberculous colitis exacerbated by EnA in endemic areas.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100571"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420411","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":"Disparities in Gastrointestinal Cancer Incidence in Asian American, Native Hawaiian, and Other Pacific Islander Groups","authors":"Vicki Tang ,&nbsp;Cynthia W. Ko","doi":"10.1016/j.gastha.2025.100653","DOIUrl":"10.1016/j.gastha.2025.100653","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The Asian American, Native Hawaiian, and Other Pacific Islander (AANHPI) population are heterogeneous in health risk factors, socioeconomic status, and health outcomes. Disaggregating AANHPI groups may reveal disparities in cancer incidence. The aim of this study was to examine patterns and trends in incidence of common gastrointestinal cancers in AANHPI groups compared to the non-Hispanic White (NHW) population.</div></div><div><h3>Methods</h3><div>Using the detailed AANHPI Surveillance, Epidemiology, and End Results database, we retrospectively analyzed trends in incidence of colorectal adenocarcinoma (CRC), gastric adenocarcinoma (GC), hepatocellular carcinoma, pancreatic adenocarcinoma, and esophageal cancer from 1990 to 2014 using Surveillance, Epidemiology, and End Results∗Stat and Joinpoint software, compared to NHW. Additional analyses were stratified by age at diagnosis for CRC (&lt;50 and ≥50 years of age), for cardia and noncardia GC, and in esophageal cancer, for squamous cell carcinoma compared to esophageal adenocarcinoma.</div></div><div><h3>Results</h3><div>CRC incidence was comparable in Hawaiian, Japanese, and NHW groups, with differing trends in younger and older age groups. Hepatocellular carcinoma incidence was highest in Chinese and Southeast Asian groups, while GC incidence was high in Other Pacific Islander, Korean, and Japanese groups. There was less variability in pancreatic adenocarcinoma incidence between NHW and AANHPI groups. AANHPI groups had a higher incidence of esophageal squamous cell carcinoma but a lower incidence of esophageal adenocarcinoma compared to NHW.</div></div><div><h3>Conclusion</h3><div>Examining incidence of common gastrointestinal cancers in disaggregated AANHPI groups reveals differences in incidence rates and disparate trends over time. Further studies are needed to elucidate the reasons for these differing trends and to evaluate whether efforts to reduce cancer risk factors and promote appropriate cancer screening in high-risk AANHPI groups are needed to reduce cancer disparities.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 6","pages":"Article 100653"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936783","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":"Use of Artificial Intelligence–Generated Synthetic Data to Augment and Enhance the Performance of Clinical Prediction Models in Patients With Alcohol-Associated Hepatitis and Acute Cholangitis","authors":"Joseph C. Ahn ,&nbsp;Yung-Kyun Noh ,&nbsp;Mingzhao Hu ,&nbsp;Xiaotong Shen ,&nbsp;Vijay H. Shah ,&nbsp;Patrick S. Kamath","doi":"10.1016/j.gastha.2025.100643","DOIUrl":"10.1016/j.gastha.2025.100643","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 6","pages":"Article 100643"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917640","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":"Modeling Reductions in Liver Fat: Comparing Noninvasive Tests to Magnetic Resonance Imaging–Proton Density Fat Fraction","authors":"Santos Carvajal-Gonzalez ,&nbsp;Theresa Tuthill ,&nbsp;Vincent Wai-Sun Wong ,&nbsp;Amy Lauren Ashworth ,&nbsp;Zeid Kayali ,&nbsp;Céline Fournier-Poizat ,&nbsp;Neeta B. Amin","doi":"10.1016/j.gastha.2025.100669","DOIUrl":"10.1016/j.gastha.2025.100669","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Magnetic resonance imaging–proton density fat fraction (MRI-PDFF) is an accurate, noninvasive tool for diagnosing metabolic dysfunction–associated steatotic liver disease, but its feasibility is limited in routine clinical practice. We aimed to assess the clinical utility of alternative, cost-efficient approaches for assessing liver fat changes and their relationship with MRI-PDFF changes.</div></div><div><h3>Methods</h3><div>This is a secondary analysis of a phase 2a study that included adults with metabolic dysfunction–associated steatotic liver disease who received clesacostat, a selective, reversible inhibitor of acetyl-CoA carboxylase. In this secondary analysis, responders were defined as those in whom a ≥30% decrease in liver fat by MRI-PDFF was observed with clesacostat or placebo. Other endpoints were evaluated for their ability to predict MRI-PDFF responder status, including controlled attenuation parameter (CAP), liver enzymes (alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase), metabolic dysfunction–associated steatohepatitis–related biomarkers (liver stiffness measurement by vibration-controlled transient elastography, cytokeratin 18-M30, and cytokeratin 18-M65), and markers of hepatic steatosis (hepatic steatosis index and fatty liver index). These relationships were investigated through correlation, univariate, and multivariable regression analyses.</div></div><div><h3>Results</h3><div>Of 260 participants with a baseline and on-treatment measure at week 12 or week 16, 143 were responders. Based on correlation analyses, a significant but weak positive correlation between MRI-PDFF and CAP measurements of relative percentage change from baseline in liver fat was observed. By combining the selected 6 parameters (CAP, hepatic steatosis index, fatty liver index, alanine aminotransferase, gamma-glutamyl transferase, and cytokeratin 18-M65) through multivariable regression modeling, responders can be predicted with a high level of sensitivity and specificity (mean area under the receiver operating characteristic curve = 0.831 from 10-fold cross-validation).</div></div><div><h3>Conclusion</h3><div>Modeling multiple noninvasive assessments of liver fat closely aligned with MRI-PDFF measurements. These data support further assessment of its suitability in real-world clinical practice.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 7","pages":"Article 100669"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071825","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":"Multiple Myeloma Presenting as Hypercalcemia-Induced Acute Severe Pancreatitis: A Case Report","authors":"Anjuman Fayaz,&nbsp;Altaf Hussain Shah,&nbsp;Mushtaq Ahmad Khan,&nbsp;Shaheena Parveen","doi":"10.1016/j.gastha.2024.09.004","DOIUrl":"10.1016/j.gastha.2024.09.004","url":null,"abstract":"<div><div>Hypercalcemia is a known presentation of multiple myeloma along with anemia, renal failure, and bone pains (CRAB: hypercalcemia, renal failure, anemia, and bone lesions). Hypercalcemia is a known cause of pancreatitis besides the common causes like gallstones, alcohol and hypertriglyceridemia. However, hypercalcemia secondary to multiple myeloma is a rare cause of pancreatitis and only a few cases of the same have been reported. We present a case of a 60-year-old female who presented with acute severe pancreatitis induced by hypercalcemia secondary to multiple myeloma.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 8","pages":"Article 100549"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168869","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":"Multiomic Sequencing Reveals Distinctive Gene Expression and Epigenetic Alterations Associated With Primary Sclerosing Cholangitis Development in Treatment-Naïve Pediatric Ulcerative Colitis","authors":"Alejandra Rodriguez-Sosa ,&nbsp;Ololade Lawal ,&nbsp;Ciaran McDonnell ,&nbsp;Luke Grant ,&nbsp;John O’Brien ,&nbsp;Muhammad Ali ,&nbsp;Ian Stephens ,&nbsp;Grainne Kirwan ,&nbsp;Flavia Genua ,&nbsp;Alexander Kel ,&nbsp;Anna Dominik ,&nbsp;Roisin Stack ,&nbsp;Gregory Yochum ,&nbsp;Michael McDermot ,&nbsp;Glen Doherty ,&nbsp;Seamus Hussey ,&nbsp;Sudipto Das","doi":"10.1016/j.gastha.2024.11.002","DOIUrl":"10.1016/j.gastha.2024.11.002","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Primary sclerosing cholangitis (PSC) is a progressive cholestatic disease with up to 80% of patients also suffering from ulcerative colitis (PSC-UC). The difficulty in the diagnosis along with the increased risk for developing cancer represents a clinical challenge. Furthermore, the precise molecular factors regulating the phenotype of this disease subtype remain unknown.</div></div><div><h3>Methods</h3><div>We applied methyl-capture sequencing and mRNA sequencing to colonic mucosal biopsies from 3 groups of treatment-naïve children at diagnosis from the Determinants and Outcomes in CHildren and AdolescentS study: UC (n = 10), PSC-UC (n = 10), and healthy controls (n = 10).</div></div><div><h3>Results</h3><div>Differential gene expression between UC and PSC-UC showed significantly higher gene expression changes in PSC-UC patients when compared to UC. Specifically, expression of these genes was regulated by master transcriptional regulators (NLRP3, DLL1) and transcription factors (RELA, Myogenin, and FOXO1), which are shown to regulate expression of inflammatory response and immune-associated genes in PSC-UC patients exclusively. Differential methylation analysis between PSC-UC and UC demonstrated &gt;2000 differentially methylated regions with a large proportion of them enriched in gene promoter and enhancer regions. We further show no difference in epigenetic age between PSC-UC and UC. Finally, we identify KLHL17 as hypomethylated and upregulated in PSC-UC patients.</div></div><div><h3>Conclusion</h3><div>Our study, for the first time, identifies distinct gene expression and DNA methylation alterations that differentiate UC from PSC-UC at diagnosis in treatment-naïve pediatric patients. We show the gene expression differences observed between PSC-UC and UC are modulated by intricate molecular mechanisms involving master transcriptional regulator-mediated signaling through transcription factors. These findings suggest the potential utility of these molecular markers as predictive biomarkers for PSC development in UC at an early stage of development. Further validation in larger patient cohorts is warranted.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100586"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167818","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 Comparison of Intravenous Infliximab Versus Subcutaneous Infliximab on Remission Rates, Safety, Costs, Patient Preferences in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis","authors":"Alejandro Nieto Dominguez ,&nbsp;Abhishek Bhurwal ,&nbsp;Hemant Mutneja ,&nbsp;Sarah E. Eichinger ,&nbsp;Bhanu Pinnam ,&nbsp;Daniel Guifarro Rivera ,&nbsp;Chun-Wei Pan","doi":"10.1016/j.gastha.2024.11.004","DOIUrl":"10.1016/j.gastha.2024.11.004","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Infliximab, widely used as a mainstay treatment of inflammatory bowel disease (IBD), is traditionally administered intravenously. The subcutaneous (SC) formulation appears to offer a more convenient route of administration. This is a systematic review and meta-analysis comparing the outcomes of intravenous (IV) and SC routes of administration of Infliximab.</div></div><div><h3>Methods</h3><div>All observational studies and randomized controlled trials comparing efficacy, effectiveness, safety, costs, and patient preferences between IV vs SC infliximab in adult human patients with IBD between January 1, 1997, and September 9, 2023, were analyzed. The primary outcome was comparison of the remission rates between SC and IV infliximab in IBD patients. Secondary outcomes were analyzing the different safety profiles and adverse events of IV infliximab vs SC infliximab qualitatively and quantitatively, comparing costs between both groups and evaluating patient preferences among the different studies found on our systematic review.</div></div><div><h3>Results</h3><div>Twenty studies were included in the qualitative synthesis and 9 were included in the quantitative synthesis, with a total of 960 patients. There was no significant difference in clinical remission rates between the IV and SC infliximab groups at 8 weeks, 6 months, and 1 year. Switching to SC infliximab was overall safe. Patient satisfaction was higher in patients using SC infliximab, with additional cost-saving benefits.</div></div><div><h3>Conclusion</h3><div>The systematic review and meta-analysis reveal that SC infliximab could be a safe, cost-effective, well tolerated alternative for achieving disease remission in patients with IBD.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100588"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167832","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}