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":"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":"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":"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":"Increased Risk of Post-Acute Sequalae of COVID-19 in Patients With Immune-Mediated Inflammatory Diseases","authors":"Evangelin Shaloom Vitus ,&nbsp;Christian Nikolai Sørensen ,&nbsp;Anastasia Karachalia Sandri ,&nbsp;Rahma Elmahdi ,&nbsp;Tine Jess","doi":"10.1016/j.gastha.2025.100699","DOIUrl":"10.1016/j.gastha.2025.100699","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Dysregulation of the immune system and chronic inflammation, the primary drivers of post-acute sequalae of corona virus disease 2019 (COVID-19) (PASC), are at the heart of immune-mediated inflammatory disease (IMID) pathology. As PASC remains underexplored in IMID patients, we explored the risk of PASC in patients with IMIDs including spondylarthritis (SpA), rheumatoid arthritis (RA), hidradenitis suppurativa, ulcerative colitis, Crohn’s disease and psoriasis compared to a matched non-IMID population.</div></div><div><h3>Methods</h3><div>In this cohort study, all individuals with a recorded positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test (January 2020 to January 2022) were identified from the Danish national registers. Cox regression was used to compare COVID-positive IMID persons with matched COVID-positive non-IMID ones. Subgroup analysis by COVID-related hospitalization, COVID vaccination, IMID medication, and stratification analysis by age, sex, and SARS-CoV-2 variant were carried out.</div></div><div><h3>Results</h3><div>A total of 753 PASC cases were reported among 25,889 IMID and 51,778 matched individuals. The median age and follow-up time were 48 years (interquartile range: 35–61) and 7.7 months (interquartile range: 7.1–16.1), respectively, and 56% were women. An increased risk of PASC was seen in the IMID group as a whole compared to the non-IMID group (hazard ratio (HR): 1.64, 95% confidence interval (CI): 1.42–1.89), and for SpA (HR: 2.05, 95% CI: 1.30–3.22), RA (HR: 1.90, 95% CI: 1.38–2.61), and psoriasis (HR: 1.62, 95% CI: 1.31–2.01) individually. The risk of PASC remained higher among hospitalized and vaccinated IMID patients.</div></div><div><h3>Conclusion</h3><div>This study showed an increased risk of PASC in individuals with an IMID and in SpA, RA, and psoriasis individually. Results indicate chronic impact of early SARS-CoV-2 infection on IMID patients following acute COVID-19.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 8","pages":"Article 100699"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279684","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":"Metastatic Urothelial Carcinoma Presenting as Rectal Linitis Plastica: A Rare Case Report","authors":"Christina Lee ,&nbsp;Nader Awad ,&nbsp;Stuart Kostalas","doi":"10.1016/j.gastha.2025.100707","DOIUrl":"10.1016/j.gastha.2025.100707","url":null,"abstract":"<div><div>A 63-year-old male with history of cystoprostatectomy for bladder urothelial carcinoma presented with rectal pain, tenesmus, and altered bowel habits. Magnetic resonance imaging showed asymmetric rectal wall thickening with perirectal edema, while a positron emission tomography scan revealed increased metabolic activity in the midrectum. Digital examination demonstrated a firm, woody consistency of the rectal wall. Endoscopic examination of the rectum displayed subepithelial involvement with normal overlying mucosa. Endoscopic biopsies were nondiagnostic, but ultrasound-guided transperineal sampling confirmed metastatic high-grade urothelial cancer. The patient received palliative radiotherapy and pembrolizumab. This case illustrates rectal linitis plastica, characterized by carcinomatous infiltration of the deep rectal layers while preserving the mucosa, necessitating deep tissue sampling.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 9","pages":"Article 100707"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535631","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}