Gastro hep advances最新文献

{"title":"Endoscopic Submucosal Dissection of Gastric High-Grade Foveolar Dysplasia With Normal Background Mucosa","authors":"Gonzalo Latorre ,&nbsp;Alberto Espino ,&nbsp;Christine E. Orr ,&nbsp;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}

{"title":"A Standardized Classification Scheme for Gastroduodenal Disorder Evaluation Using the Gastric Alimetry System: Prospective Cohort Study","authors":"Chris Varghese ,&nbsp;Gabriel Schamberg ,&nbsp;Emma Uren ,&nbsp;Stefan Calder ,&nbsp;Mikaela Law ,&nbsp;Daphne Foong ,&nbsp;Vincent Ho ,&nbsp;Billy Wu ,&nbsp;I-Hsuan Huang ,&nbsp;Peng Du ,&nbsp;Thomas Abell ,&nbsp;Charlotte Daker ,&nbsp;Christopher N. Andrews ,&nbsp;Armen A. Gharibans ,&nbsp;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":"Food and Drug Administration Approval Summary: Odevixibat (Bylvay) for the Treatment of Pruritus With Progressive Familial Intrahepatic Cholestasis","authors":"Sojeong Yi ,&nbsp;Insook Kim ,&nbsp;Rebecca Hager ,&nbsp;Marian M. Strazzeri ,&nbsp;Lili Garrard ,&nbsp;Toru Matsubayashi ,&nbsp;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}

{"title":"Massive Gastric Dilation Secondary to Recurrent Benign Idiopathic Prepyloric Stenosis Managed With Lumen-Apposing Metal Stent","authors":"Bibek Saha ,&nbsp;Kayla Finnegan ,&nbsp;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}

{"title":"Hepatitis Delta Virus Testing, Prevalence, and Liver-Related Outcomes Among US Veterans With Chronic Hepatitis B","authors":"Robert J. Wong ,&nbsp;Zeyuan Yang ,&nbsp;Janice H. Jou ,&nbsp;Binu V. John ,&nbsp;Joseph K. Lim ,&nbsp;Ramsey Cheung","doi":"10.1016/j.gastha.2024.10.015","DOIUrl":"10.1016/j.gastha.2024.10.015","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Hepatitis delta virus (HDV) infection in patients with chronic hepatitis B (CHB) is associated with worse liver-related outcomes. We aim to comprehensively evaluate HDV testing, diagnosis, and liver-related outcomes among a national cohort of US Veterans with CHB.</div></div><div><h3>Methods</h3><div>US Veterans with CHB from 2010 to 2023 were evaluated to determine trends in HDV testing (anti-HDV antibody, HDV RNA) and proportion positive among those tested. HDV positive patients were 1:2 propensity score matched to CHB patients who were HDV negative to evaluate incidence (per 100,000 person-years) of cirrhosis, hepatic decompensation, or hepatocellular carcinoma using competing risks Nelson-Aalen methods for estimating cumulative hazards.</div></div><div><h3>Results</h3><div>Among the 27,548 CHB patients identified, 16.1% completed HDV testing, among whom 3.25% (n = 144) were positive. After excluding patients with cirrhosis or HCC at baseline, 71 patients with HDV (median follow-up 5.3 years, interquartile range 2.5–7.6) were propensity score matched to 140 CHB patients without HDV (median follow-up 4.5 years, interquartile range 2.6–8.1). Compared to CHB patients without HDV, those with concurrent HDV had significantly greater incidence of cirrhosis (4.39 vs 1.30 per 100,000 person-years, <em>P</em> &lt; .01) and hepatic decompensation (2.18 vs 0.41 per 100,000 person-years, <em>P</em> = .01).</div></div><div><h3>Conclusion</h3><div>Among a national cohort of US Veterans with CHB, low rates of HDV testing were observed. This is concerning given that patients with concurrent HDV infection had &gt;3 times and &gt;5 times greater risks of cirrhosis and hepatic decompensation, respectively, compared to CHB patients without HDV, highlighting the importance of timely HDV diagnosis and treatment.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100575"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167817","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":"Acute Kidney Injury in Cirrhosis Revisited—Implications in Clinical Practice","authors":"Akash Roy,&nbsp;Rohit Mehtani,&nbsp;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}

{"title":"The Influence of Psychiatric Factors on Health-Care Resource Utilization in Patients With Gastroparesis: A National Population-Based Study","authors":"Karan Sachdeva ,&nbsp;Daniyal Raza ,&nbsp;Lovekirat Singh Dhaliwal ,&nbsp;Rohit Goyal ,&nbsp;Pooja Shah ,&nbsp;Lena Kawji ,&nbsp;Ashley Deville ,&nbsp;Brittany Pass ,&nbsp;Natalie Roppolo ,&nbsp;Ahmad Alkurd ,&nbsp;Farhan Mohiuddin ,&nbsp;Hailey Canezaro ,&nbsp;Victoria Andrus ,&nbsp;Elizabeth Armstrong ,&nbsp;Michelle Neice ,&nbsp;Maryam Mubashir ,&nbsp;Shazia Rashid ,&nbsp;Michael Tran ,&nbsp;Omar Khan ,&nbsp;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> &lt; .001) and a longer median hospital stay (4, interquartile range: 2–6 vs 3, interquartile range: 2–6, <em>P</em> &lt; .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}

{"title":"Cover: Metabolomic Signatures Highlight Fiber-Degrading Bacteroides Species in Mediterranean Diet Response Among UC","authors":"","doi":"10.1016/j.gastha.2025.100675","DOIUrl":"10.1016/j.gastha.2025.100675","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 4","pages":"Article 100675"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143888117","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":"Advancing Understanding of Anorectal Malformations Through Microfocus Computed Tomography Imaging of Resected Material","authors":"Daniël Docter ,&nbsp;Bernadette S. de Bakker ,&nbsp;Jaco Hagoort ,&nbsp;Joris J.T.H. Roelofs ,&nbsp;Sjoerd de Beer ,&nbsp;Ernst van Heurn ,&nbsp;Joep Derikx ,&nbsp;Marc A. Benninga ,&nbsp;Justin de Jong ,&nbsp;Ramon R. Gorter","doi":"10.1016/j.gastha.2025.100633","DOIUrl":"10.1016/j.gastha.2025.100633","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Patients born with anorectal malformations (ARMs) might experience constipation and fecal incontinence. During ARM surgery (anterior and posterior sagittal anorectoplasty procedure), the distal part of the bowel (fistula) is usually resected. Microfocus computed tomography (micro-CT) imaging, capable of imaging samples in ultra-high 3-dimensional resolution, can be used to learn from this resected material. Through this technique, we aim to investigate whether or not structures, such as the internal anal sphincter (IAS), are present within this fistula.</div></div><div><h3>Methods</h3><div>Pediatric patients undergoing surgical reconstruction for ARM were eligible for inclusion. Resected fistulas were fixed using 4% paraformaldehyde and stained with 3.75% B-Lugol for 48 hours to improve soft tissue contrast. Scans were performed on a Phoenix Nanotom micro-CT with a voxel size between 4–6 μm. Samples were destained for subsequent histopathological examination. Outcomes were presence of structures like the IAS, epithelial transition zone and ganglia. ARM fistulas were compared with a fetal anal canal sample derived from the Dutch Fetal Biobank.</div></div><div><h3>Results</h3><div>Eleven ARM fistulas were analyzed. All samples showed evidence of normal development of the rectal wall. Columnar epithelium and stratified squamous epithelium were observed. Muscle fibers were present, arranged in circular pattern that expanded toward the distal end, becoming the intrinsic sphincter (IAS). Ganglia were present with normal appearance.</div></div><div><h3>Conclusion</h3><div>We present micro-CT imaging to research resected material to provide new insights in microscale anatomy. The fistula, currently resected during surgical reconstruction for ARM, contains vital structures like the IAS, normal epithelial transition zone and normal ganglion cells. Although clinical functionality should be studied in the future, our results indicate that the fistula has a normal anal canal morphology and should be spared during ARM reconstruction if possible.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 5","pages":"Article 100633"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923328","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":"Current Use, Training & Barriers to Point-of-Care Ultrasound Use in Gastroenterology: National Survey of Veterans Affairs Medical Centers","authors":"Keerthi Thallapureddy ,&nbsp;Nagasri Shankar ,&nbsp;Khyathi Thallapureddy ,&nbsp;Elizabeth Coss ,&nbsp;Robert Nathanson ,&nbsp;Nilam J. Soni","doi":"10.1016/j.gastha.2025.100658","DOIUrl":"10.1016/j.gastha.2025.100658","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 7","pages":"Article 100658"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934923","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}