Gastro hep advances最新文献

{"title":"All-Cause Mortality and Gastrointestinal Adverse Effects in Adults With Type 2 Diabetes on Glucagon-Like Peptide-1 Receptor Agonists vs Sodium–Glucose Cotransporter-2 Inhibitors","authors":"Samita Garg ,&nbsp;Thabet Qapaja ,&nbsp;Osama Hamid ,&nbsp;Gizem Kaya ,&nbsp;Rashid Abdel-Razeq ,&nbsp;Dina Alayan ,&nbsp;Mohammed Abu-Rumaileh ,&nbsp;Anthony Lembo ,&nbsp;Steven Nissen","doi":"10.1016/j.gastha.2025.100736","DOIUrl":"10.1016/j.gastha.2025.100736","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Glucagon-like peptide-1 receptor agonists (GLP-1RA) are increasingly used in adults with type 2 diabetes (T2D), with or without obesity. The incidence of gastrointestinal (GI) adverse effects (AEs) of GLP-1RA in T2D is unclear. This study aimed to evaluate all-cause mortality and GI AEs in T2D patients treated with GLP-1RA compared to those treated with sodium–glucose cotransporter-2 inhibitors (SGLT-2i).</div></div><div><h3>Methods</h3><div>A retrospective cohort study used electronic health records from the TriNetX Multi-Institutional Database (January 1, 2021, to December 31, 2022). T2D patients on GLP-1RA were compared to those on SGLT-2i. Primary outcomes were incident GI AEs and all-cause mortality. 1:1 propensity score matching was performed to reduce confounding, and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated for each outcome.</div></div><div><h3>Results</h3><div>The study included 3.2 million adults with T2D, with 104,947 prescribed a GLP-1RA compared with a matched cohort prescribed a SGLT-2i. After matching, baseline characteristics were similar, with a mean age of 62 ± 12 years and mean glycated hemoglobin of 8.0 ± 2.0%. About 30% of participants were from under-represented minority groups. At 24-month follow-up, patients prescribed a GLP-1RA had higher odds of being diagnosed with gastroparesis (GP) and gastroesophageal reflux disease (GERD) compared those prescribed a SGLT-2i, with aORs of 1.24 (95% CI, 1.11–1.38) for GP and 1.14 (95% CI, 1.11–1.18) for GERD. The risk of acute pancreatitis was lower in the GLP-1RA group. All-cause mortality at 24 months had an odds ratio of 0.83 (95% CI: 0.80, 0.87) compared to SGLT-2i.</div></div><div><h3>Conclusion</h3><div>After 24 months of follow-up, patients treated with a GLP-1RA had higher odds of GP and GERD compared to those treated with a SGLT-2i. However, the odds of acute pancreatitis were lower in the GLP-1RA group. All-cause mortality was reduced by 17% in the GLP-1RA group.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 10","pages":"Article 100736"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144920034","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":"Concomitant Use of Prescription-Based Agents for Chronic Constipation: A Single-Center Retrospective Study","authors":"Tushar Khanna ,&nbsp;MariaLisa Itzoe ,&nbsp;Josh Mukherjee ,&nbsp;Nitin K. Ahuja","doi":"10.1016/j.gastha.2025.100755","DOIUrl":"10.1016/j.gastha.2025.100755","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 10","pages":"Article 100755"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096181","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":"Unexpected Liver Hematoma After Endoscopic Submucosal Dissection for Duodenal Adenoma","authors":"Sachiyo Onishi,&nbsp;Masaya Kubota,&nbsp;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":"Extramedullary Involvement of Myelofibrosis in the Colon: A Case Report","authors":"Krystal Mills ,&nbsp;Naseema Gangat ,&nbsp;Victor Chedid","doi":"10.1016/j.gastha.2024.11.003","DOIUrl":"10.1016/j.gastha.2024.11.003","url":null,"abstract":"<div><div>Colitis refers to a range of inflammatory conditions of the colon and each condition requires a distinct diagnostic and therapeutic approach. Common differentials include inflammatory bowel disease, ischemic colitis, and infections. Endoscopic evaluation is often a critical adjunct in determining the underlying cause of colitis and concomitant biopsies further improve diagnostic accuracy. Work up of this clinical case revealed the diagnosis of extramedullary hematopoiesis presenting as colonic ulcers in a patient with myelofibrosis, which has not yet been described in the existing literature.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100587"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167815","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":"Comparative Efficacy of NAFLD Therapies and Biomarker Associations: A Meta-Analysis Based on Liver Fat Content","authors":"Haoxiang Zhu ,&nbsp;Ling Xu ,&nbsp;Yinhua Lv ,&nbsp;Juan Yang ,&nbsp;Jihan Huang ,&nbsp;Qingshan Zheng ,&nbsp;Guang Ji ,&nbsp;Lujin Li","doi":"10.1016/j.gastha.2024.100593","DOIUrl":"10.1016/j.gastha.2024.100593","url":null,"abstract":"<div><h3>Background and Aims</h3><div>This study aims to conduct a comprehensive quantitative analysis of various nonalcoholic fatty liver disease (NAFLD) therapeutics, utilizing magnetic resonance (MR)-detected liver fat content (LFC) as the efficacy endpoint, and to identify biomarkers correlated with changes in LFC based on published literature.</div></div><div><h3>Methods</h3><div>We performed a systematic search of public databases for placebo-controlled randomized trials on NAFLD up to September 29, 2023. A random-effects meta-analysis was employed to assess efficacy differences between drugs with various mechanisms and placebo. Initial Pearson correlation analysis explored the relationships between biomarkers and LFC. For biomarkers showing significant correlations with LFC, further modeling analysis was conducted to examine their relationship characteristics.</div></div><div><h3>Results</h3><div>Our analysis included 36 studies with 3222 subjects and 33 investigational drugs, which were categorized into 6 mechanistic groups. Drugs such as fibroblast growth factor agonists, and those targeting adipocytes, inflammation, or fibrosis, showed greater efficacy in reducing LFC compared to Resmetirom, which has an efficacy of reducing LFC by 5.2%. From the 121 biomarkers analyzed, alanine aminotransferase and aspartate aminotransferase demonstrated moderate correlations with LFC; specifically, changes of −5.9 U/L in alanine aminotransferase or −3.3 U/L in aspartate aminotransferase were associated with an additional 1% reduction in LFC.</div></div><div><h3>Conclusion</h3><div>The results of this study provide valuable insights for the clinical development of future NAFLD therapeutics, highlighting the efficacy of specific drug mechanisms and the potential of certain biomarkers as surrogate endpoints.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 4","pages":"Article 100593"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377538","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}

{"title":"In Vitro Acid Resistance of Pathogenic Candida Species in Simulated Gastric Fluid","authors":"Eri Ikeda ,&nbsp;Masaya Yamaguchi ,&nbsp;Masayuki Ono ,&nbsp;Shigetada Kawabata","doi":"10.1016/j.gastha.2024.100591","DOIUrl":"10.1016/j.gastha.2024.100591","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Although species in the fungal genus <em>Candida</em> are often commensal residents of the gastrointestinal (GI) tract, they can also cause high-mortality systemic candidiasis. Most pathogenic <em>Candida</em> species are dimorphic fungi that exist predominantly in filamentous forms in the invading tissues. <em>Candida albicans</em> is the most prominent pathogen among <em>Candida</em> species, but nonalbicans <em>Candida</em> species have also emerged as important pathogens. The stomach is the most acidic niche in the GI tract and is maintained at pH 1–2 in healthy individuals. The aim of the present study was to determine whether <em>Candida</em> species can survive in gastric fluid and to observe their morphology under varied pH conditions.</div></div><div><h3>Methods</h3><div>We investigated the in vitro survival of the pathogenic <em>Candida</em> species <em>C. albicans, Candida glabrata, Candida parapsilosis,</em> and <em>Candida tropicalis</em> in simulated gastric fluid.</div></div><div><h3>Results</h3><div>We first described that a portion of the 4 <em>Candida</em> species can survive under highly acidic conditions. Moreover, dimorphic <em>Candida</em> species, namely, <em>C. albicans, C. parapsilosis,</em> and <em>C. tropicalis,</em> exhibited yeast–hyphal transition in simulated gastric fluid with elevated pH. Pathogenic filamentous cells had lower acid resistance than yeast cells.</div></div><div><h3>Conclusion</h3><div>These findings may illuminate the migration to the lower GI tract by commensal fungi of the oral cavity.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 4","pages":"Article 100591"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143237193","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":"Distinct Clinical Characteristics and Predictors of Sporadic Mismatch Repair-Deficient Colorectal Cancer","authors":"Dan Li ,&nbsp;Sheng-Fang Jiang ,&nbsp;Theodore R. Levin ,&nbsp;Ajay Goel ,&nbsp;Douglas A. Corley","doi":"10.1016/j.gastha.2024.09.013","DOIUrl":"10.1016/j.gastha.2024.09.013","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 2","pages":"Article 100558"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049013","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":"Gastric Acid Suppression Is Associated With Higher Rates of Colectomy in Patients With Inflammatory Bowel Disease","authors":"Aun R. Shah ,&nbsp;Nurlan Aliyev ,&nbsp;Zarak H. Khan ,&nbsp;Rubab Ali ,&nbsp;Mohammad Bilal","doi":"10.1016/j.gastha.2024.09.008","DOIUrl":"10.1016/j.gastha.2024.09.008","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 2","pages":"Article 100553"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049019","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}