Gastro hep advances最新文献

{"title":"Unexpected Liver Hematoma After Endoscopic Submucosal Dissection for Duodenal Adenoma","authors":"Sachiyo Onishi, Masaya Kubota, Masahito Shimizu","doi":"10.1016/j.gastha.2025.100671","DOIUrl":"10.1016/j.gastha.2025.100671","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 7","pages":"Article 100671"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948832","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":"2024 Top Reviewers for GHA","authors":"","doi":"10.1016/S2772-5723(25)00117-7","DOIUrl":"10.1016/S2772-5723(25)00117-7","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 6","pages":"Article 100730"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548793","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":"Assessing Native Liver Post-Kasai Portoenterostomy for Biliary Atresia Through Stool Proteome Analysis","authors":"Eiichiro Watanabe ,&nbsp;Takeshi Saito ,&nbsp;Masahito Yoshihara ,&nbsp;Ryo Konno ,&nbsp;Jun Fujishiro ,&nbsp;Shinya Takazawa ,&nbsp;Akinori Ichinose ,&nbsp;Kazue Miyake ,&nbsp;Tomo Kakihara ,&nbsp;Tetsuya Ishimaru ,&nbsp;Akira Nishi ,&nbsp;Akinari Fukuda ,&nbsp;Mureo Kasahara ,&nbsp;Osamu Ohara ,&nbsp;Yusuke Kawashima","doi":"10.1016/j.gastha.2025.100688","DOIUrl":"10.1016/j.gastha.2025.100688","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Biliary atresia (BA) is a severe neonatal condition, characterized by jaundice and hyperbilirubinemia, resulting in cholestasis. Although early diagnosis followed by Kasai portoenterostomy (KPE) can rescue patients, they are prone to complications such as cholangitis. Moreover, a comprehensive study assessing intestinal environment is currently lacking. Therefore, in this study, we aimed to elucidate the stool protein profiles of patients with BA following KPE, provide insights into the native liver condition of BA, and open new avenues for clinical approaches through stool proteome analysis.</div></div><div><h3>Methods</h3><div>In this prospective study, stool proteome analysis was conducted on samples from 4 patients with well-controlled conditions, 4 patients with repeated cholangitis, and 3 patients with prolonged jaundice without cholangitis, all of whom had undergone KPE. Fifteen healthy individuals without BA were included for comparison.</div></div><div><h3>Results</h3><div>Principal component analysis revealed that the stool profiles of patients post-KPE with favorable outcomes closely resembled those of healthy controls, whereas the profiles of patients with unfavorable outcomes showed distinct patterns. Notably, C-reactive protein levels were elevated, whereas sodium/hydrogen exchanger 3 levels were decreased in the group with repeated cholangitis.</div></div><div><h3>Conclusion</h3><div>This study highlights distinct differences in stool protein profiles following KPE, particularly in patients with poor clinical outcomes. This suggests that stool proteome analysis has the potential to provide insights into the native liver conditions of BA patients post-KPE, reflecting their clinical status.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 8","pages":"Article 100688"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279683","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":"Nonselective Beta-Blocker Associated With Decreased Mortality in Patients With Gastric Varices","authors":"Rebecca H. Moon ,&nbsp;Joanie Chung ,&nbsp;Paul Chang ,&nbsp;Amandeep Sahota","doi":"10.1016/j.gastha.2025.100690","DOIUrl":"10.1016/j.gastha.2025.100690","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastric varices (GV) are a less common complication of portal hypertension than esophageal varices but are associated with higher mortality when hemorrhage occurs. While nonselective beta-blockers (NSBBs) have been extensively studied for the primary and secondary prevention of esophageal variceal hemorrhage, data on their efficacy in preventing gastric variceal hemorrhage remain limited. This study investigates the impact of NSBBs on clinical outcomes in patients with GV.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of patients aged 18–75 years diagnosed with GV between January 1, 2015, and July 31, 2021, within an integrated healthcare system in Southern California. The cohort was followed until February 28, 2022. Outcomes, including gastric variceal hemorrhage, esophageal variceal hemorrhage, liver transplantation, transjugular intrahepatic portosystemic shunt placement, and mortality, were compared between NSBB users and nonusers using multivariate logistic regression analyses.</div></div><div><h3>Results</h3><div>A total of 1276 patients with GV were identified, including 767 (62.5%) on NSBBs and 509 (41.5%) not receiving NSBBs. After a 7-year follow-up, mortality was lower in the NSBB group (39.2%) than in the non-NSBB group (50.9%) (OR = 0.62; 95% CI: 0.46–0.84). No significant differences were observed between groups for other clinical outcomes. The overall mortality rate at study completion was 40.1%.</div></div><div><h3>Conclusion</h3><div>In our study, NSBB use in patients with GV was associated with reduced mortality, suggesting a potential prognostic benefit in real-world clinical settings.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 8","pages":"Article 100690"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221139","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":"Cover: LincPRKD: A Long Intergenic Noncoding RNA Activated in Gastric Cancer","authors":"","doi":"10.1016/S2772-5723(25)00089-5","DOIUrl":"10.1016/S2772-5723(25)00089-5","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 5","pages":"Article 100702"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212803","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":"Ulcerative Colitis Preceding Asymptomatic Wilson’s Disease: A Case Report and Literature Review","authors":"Jun Kunizaki ,&nbsp;Yuko Yoto ,&nbsp;Yoshinobu Nagaoka ,&nbsp;Akira Ishii ,&nbsp;Tomoe Kazama ,&nbsp;Kohei Wagatsuma ,&nbsp;Noriyuki Akutsu ,&nbsp;Aki Ishikawa ,&nbsp;Toju Tanaka ,&nbsp;Shintaro Sugita ,&nbsp;Takeshi Tsugawa ,&nbsp;Hiroshi Nakase","doi":"10.1016/j.gastha.2024.09.003","DOIUrl":"10.1016/j.gastha.2024.09.003","url":null,"abstract":"<div><div>An 11-year-old girl with quiescent ulcerative colitis had sustained elevation of liver enzymes. Although she had no clinical symptoms suggestive of Wilson’s disease, such as Kayser–Fleischer rings, laboratory data showed decreased serum copper and ceruloplasmin levels and increased urinary copper excretion. Genetic testing showed pathogenic variants in <em>ATP7B</em> allele 1: c.2004_2006delGAT (p. Met668del) and allele 2: c.1708-5T&gt;G. After starting copper chelators, her liver function normalized, and she maintained clinical and endoscopic remission of ulcerative colitis. Mutations or defective functions of <em>ATP7B</em> lead to hepatic dysfunction and intestinal inflammation.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 1","pages":"Article 100548"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11714711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959718","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 Endoscopic Retrograde Cholangiopancreatography for Management of Choledocholithiasis in a Patient With Situs Inversus Totalis: A Case Report and Literature Review","authors":"Bashayer Alrufayi ,&nbsp;Saad Almutairi ,&nbsp;Abbas Zagnoon","doi":"10.1016/j.gastha.2024.09.010","DOIUrl":"10.1016/j.gastha.2024.09.010","url":null,"abstract":"<div><div>Situs inversus totalis is a rare congenital disorder defined by the transposition of all viscera to the opposite side of the body. Because of this anatomical alteration, endoscopic retrograde cholangiopancreatography (ERCP) in such a population is significantly challenging.</div><div>Herein we report a case of a 50-year-old woman presented with epigastric and left upper quadrant pain. Preoperative examination revealed abnormal liver chemistries, situs inversus totalis, and multiple distal common bile duct stones with intrahepatic and extrahepatic bile duct dilatation on abdominal ultrasound. The patient underwent a successful ERCP to relieve biliary obstruction. It was performed while the patient was placed in a supine position with the endoscopist standing on the left side of the patient.</div><div>The major emphasis in ERCP is adjusting the patient and endoscopist positions during the procedure. The advantage of the supine position is that the endoscope could easily reach the pyloric ring and, after reaching the duodenum, the papilla could be reached without difficulty.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 2","pages":"Article 100555"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049020","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 Nonrandomized Pilot Study to Investigate the Acceptability and Feasibility of LivR Well: A Multifaceted 28-Day Home-Based Liver Optimization Program for Acute-on-Chronic Liver Failure","authors":"Natalie L.Y. Ngu ,&nbsp;Edward Saxby ,&nbsp;Thomas Worland ,&nbsp;Patricia Anderson ,&nbsp;Lisa Stothers ,&nbsp;Jo Hunter ,&nbsp;Alexander T. Elford ,&nbsp;Phil Ha ,&nbsp;Imogen Hartley ,&nbsp;Andrew Roberts ,&nbsp;Dean Seah ,&nbsp;George Tambakis ,&nbsp;Declan Connoley ,&nbsp;Anita Figredo ,&nbsp;Dilip Ratnam ,&nbsp;Danny Liew ,&nbsp;Benjamin Rogers ,&nbsp;William Sievert ,&nbsp;Sally Bell ,&nbsp;Suong Le","doi":"10.1016/j.gastha.2024.10.007","DOIUrl":"10.1016/j.gastha.2024.10.007","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Acute-on-chronic liver failure (ACLF) has a 22%–74% 28-day mortality rate and 30%–40% 30-day readmission rate. We investigated the acceptability and feasibility of a multimodal community intervention for ACLF.</div></div><div><h3>Methods</h3><div>A single-arm nonrandomized pilot study of consecutive participants with ACLF was conducted in a tertiary health service. Participants received weekly medical and nursing reviews, dietetics, physiotherapy, pharmacy, social work, addiction medicine, and neuropsychiatry, where indicated. A digital platform included remote weight monitoring and online surveys. The primary outcome was acceptability/feasibility. Secondary outcomes included safety, mortality, readmission, liver disease severity, and costs.</div></div><div><h3>Results</h3><div>Fifty-nine patients were enrolled with median age 51 years (interquartile range (IQR): 45–59); majority alcohol etiology (74%),and median Model for End-Stage Liver Disease Sodium score 16 (IQR: 12–21). LivR Well was acceptable with low attrition (8 of 59), adherence to the program including home visits (mean 8.4 ± 4.2) and consultations (mean 2.4 ± 1.5) per patient. This was supported by positive feedback and themes identified through a qualitative subanalysis. Feasibility was demonstrated by recruitment rate of 4.94 patients/month and 86% completion. Mortality was lower than expected at 3%, 30-day readmission rate was 15%, and median Model for End-Stage Liver Disease Sodium score reduced to 15 (<em>P</em> = .01). Median 6-month costs reduced from $30,454 (IQR: $21,953–$65,657) to $17,657 ($4249–$42,876) (<em>P</em> = .009). The total 6-month health-care cost was $1,868,859 (95% confidence interval 1,081,821–2,655,897) compared to $2,518,227 (95% confidence interval 1,959,610–3,076,844).</div></div><div><h3>Conclusion</h3><div>LivR Well was acceptable, feasible, and safe with low short-term mortality and readmission rates. Health-care costs were reduced by 26% driven by a 40% reduction in 30-day readmission. Further evaluation includes a randomized controlled trial of LivR Well compared to standard care.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 2","pages":"Article 100567"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061392","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":"Large Language Models Outperform Traditional Natural Language Processing Methods in Extracting Patient-Reported Outcomes in Inflammatory Bowel Disease","authors":"Perseus V. Patel ,&nbsp;Conner Davis ,&nbsp;Amariel Ralbovsky ,&nbsp;Daniel Tinoco ,&nbsp;Christopher Y.K. Williams ,&nbsp;Shadera Slatter ,&nbsp;Behzad Naderalvojoud ,&nbsp;Michael J. Rosen ,&nbsp;Tina Hernandez-Boussard ,&nbsp;Vivek Rudrapatna","doi":"10.1016/j.gastha.2024.10.003","DOIUrl":"10.1016/j.gastha.2024.10.003","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Patient-reported outcomes (PROs) are vital in assessing disease activity and treatment outcomes in inflammatory bowel disease (IBD). However, manual extraction of these PROs from the free-text of clinical notes is burdensome. We aimed to improve data curation from free-text information in the electronic health record, making it more available for research and quality improvement. This study aimed to compare traditional natural language processing (tNLP) and large language models (LLMs) in extracting 3 IBD PROs (abdominal pain, diarrhea, fecal blood) from clinical notes across 2 institutions.</div></div><div><h3>Methods</h3><div>Clinic notes were annotated for each PRO using preset protocols. Models were developed and internally tested at the University of California, San Francisco, and then externally validated at Stanford University. We compared tNLP and LLM-based models on accuracy, sensitivity, specificity, positive, and negative predictive value. In addition, we conducted fairness and error assessments.</div></div><div><h3>Results</h3><div>Interrater reliability between annotators was &gt;90%. On the University of California, San Francisco test set (n = 50), the top-performing tNLP models showcased accuracies of 92% (abdominal pain), 82% (diarrhea) and 80% (fecal blood), comparable to GPT-4, which was 96%, 88%, and 90% accurate, respectively. On external validation at Stanford (n = 250), tNLP models failed to generalize (61%–62% accuracy) while GPT-4 maintained accuracies &gt;90%. Pathways Language Model-2 and Generative Pre-trained Transformer-4 showed similar performance. No biases were detected based on demographics or diagnosis.</div></div><div><h3>Conclusion</h3><div>LLMs are accurate and generalizable methods for extracting PROs. They maintain excellent accuracy across institutions, despite heterogeneity in note templates and authors. Widespread adoption of such tools has the potential to enhance IBD research and patient care.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 2","pages":"Article 100563"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061557","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":"Plasma Circulating Metabolites Associated With Steatotic Liver Disease and Liver Enzymes: A Multiplatform Population-Based Study","authors":"Yasir J. Abozaid ,&nbsp;Ibrahim Ayada ,&nbsp;Laurens A. van Kleef ,&nbsp;Neil J. Goulding ,&nbsp;Jessica S. Williams-Nguyen ,&nbsp;Robert C. Kaplan ,&nbsp;Robert J. de Knegt ,&nbsp;Lynne E. Wagenknecht ,&nbsp;Nicholette D. Palmer ,&nbsp;Nicholas J. Timpson ,&nbsp;Jill M. Norris ,&nbsp;Yii-Der Ida Chen ,&nbsp;M. Arfan Ikram ,&nbsp;Willem Pieter Brouwer ,&nbsp;Mohsen Ghanbari","doi":"10.1016/j.gastha.2024.09.006","DOIUrl":"10.1016/j.gastha.2024.09.006","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Steatotic liver disease (SLD) is the most common chronic liver disease strongly associated with metabolic dysfunction, but its pathogenesis remains incompletely understood. Exploring plasma circulating metabolites may help in elucidating underlying mechanisms and identifying new biomarkers for SLD.</div></div><div><h3>Methods</h3><div>We examined cross-sectionally the association between plasma metabolites and SLD as well as liver enzymes using data from 4 population-based cohort studies (Rotterdam study, Avon Longitudinal Study of Parents and Children, The Insulin Resistance Atherosclerosis Family Study, and Study of Latinos). Metabolites were assessed in the Nightingale platform (n = 225 metabolites) by nuclear magnetic resonance spectroscopy and in the Metabolon platform (n = 991 metabolites) by ultra-high-performance liquid chromatography-mass spectrometry. Serum levels of liver enzymes (alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transpeptidase) were measured and SLD was diagnosed by ultrasound or computed tomography scan. Logistic and linear regression models were performed per cohort and meta-analyzed. A false discovery rate &lt; 0.05 was considered as significant threshold.</div></div><div><h3>Results</h3><div>Several metabolites were significantly associated with SLD and liver enzymes, of which 21 metabolites were associated with both traits. The most significant associations were observed with phenylalanine, triglycerides in (high-density lipoprotein, intermediate-density lipoprotein, and small low-density lipoprotein), fatty acid (FA) ratios of (18:2 linoleic acid-to-total FA, omega 6 FA-to-total FA, and polyunsaturated FA-to-total FA) from the Nightingale and glutamate and sphingomyelin from the Metabolon platform. Other associated metabolites were mainly involved in lipid, amino acid, carbohydrates, and peptide metabolism.</div></div><div><h3>Conclusion</h3><div>Our study indicates a landscape of circulating metabolites associated with SLD. The identified metabolites may contribute to a better understanding of the metabolic pathways underlying SLD and hold promising for potential biomarkers in early diagnosis and monitoring of the disease.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 2","pages":"Article 100551"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061559","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}