American Journal of Gastroenterology最新文献_第3页

Letter to the Editor. 给编辑的信。

IF 8 1区医学

American Journal of Gastroenterology Pub Date : 2025-06-11 DOI: 10.14309/ajg.0000000000003526

Lei Sun, Yichen Zhou, Yue Lv, Wei Ye

引用次数: 0

Letter to the Editor. 给编辑的信。

IF 8 1区医学

American Journal of Gastroenterology Pub Date : 2025-06-11 DOI: 10.14309/ajg.0000000000003528

Zhenglei Xu, Lisheng Wang, Yueming Peng, Chao Yang

引用次数: 0

Association of Glucagon-Like Peptide-1 Receptor Agonists With Liver-Related Outcomes and All-Cause Mortality in Patients With Harmful Alcohol Use: A Target Trial Emulation Study. GLP-1受体激动剂与有害酒精使用患者肝脏相关结局和全因死亡率的关联：一项目标试验模拟研究

IF 8 1区医学

American Journal of Gastroenterology Pub Date : 2025-06-10 DOI: 10.14309/ajg.0000000000003585

Binu V John, Dustin Bastaich, Daniella Marchetti, Ponni Perumalswami, Mixael Zirio Mustafa, Bassam Dahman

{"title":"Association of Glucagon-Like Peptide-1 Receptor Agonists With Liver-Related Outcomes and All-Cause Mortality in Patients With Harmful Alcohol Use: A Target Trial Emulation Study.","authors":"Binu V John, Dustin Bastaich, Daniella Marchetti, Ponni Perumalswami, Mixael Zirio Mustafa, Bassam Dahman","doi":"10.14309/ajg.0000000000003585","DOIUrl":"10.14309/ajg.0000000000003585","url":null,"abstract":"Introduction: Anecdotal observations report a decrease in craving for alcohol among patients taking glucagon-like peptide-1 receptor agonists (GLP-1 RA). We aimed to assess liver-related outcomes and mortality among individuals with harmful alcohol use who received GLP-1 RAs.Methods: We emulated a target trial using the electronic health records of US Veterans with positive alcohol use disorders-concise score (AUDIT-C), comparing new initiators of GLP-1 RA between 1/3/2017 and 9/30/2024, with controls, with follow-up until outcomes or study end. Each GLP-1 RA new user with a positive AUDIT-C screen was propensity score (PS) matched 1:1 with a patient not on a GLP-1 RA. The primary outcomes were the time to a composite outcome of decompensation, hepatocellular carcinoma, liver-related death, and all-cause mortality. The secondary outcome was the proportion of patients with positive AUDIT-C scores.Results: We matched 8,040 patients with positive AUDIT-C initiated on GLP-1 RA with 8,040 noninitiators. GLP-1 RA use was associated with a lower risk of composite liver-related outcomes (adjusted hazard ratio [aHR], 0.70; 95% confidence interval [CI] 0.56-0.87) and death (aHR 0.43, 95% CI 0.37-0.49). Among semaglutide users, a 1 mg/wk dose increase was associated with a reduced risk of composite liver-related outcomes (aHR 0.50, 95% CI 0.29-0.88) and death (aHR 0.33, 95% CI 0.19-0.58). GLP-1 RA use was also associated with lower odds of positive AUDIT-C during follow-up (adjusted Odds ratio 0.75, 95% CI 0.68-0.82).Discussion: In this observational target trial emulation study, GLP-1 RA use was associated with a lower risk of liver outcomes, death, and harmful alcohol use.","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Global Prevalence of Celiac Disease in Patients With Rome III and Rome IV Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis. 罗马III型和罗马IV型肠易激综合征患者乳糜泻的全球患病率：系统回顾和荟萃分析

IF 8 1区医学

American Journal of Gastroenterology Pub Date : 2025-06-10 DOI: 10.14309/ajg.0000000000003586

Mohamed G Shiha, Annalisa Schiepatti, Francesca Manza, Stiliano Maimaris, Imran Aziz, David S Sanders

{"title":"Global Prevalence of Celiac Disease in Patients With Rome III and Rome IV Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis.","authors":"Mohamed G Shiha, Annalisa Schiepatti, Francesca Manza, Stiliano Maimaris, Imran Aziz, David S Sanders","doi":"10.14309/ajg.0000000000003586","DOIUrl":"10.14309/ajg.0000000000003586","url":null,"abstract":"Introduction: Irritable bowel syndrome (IBS) and celiac disease (CeD) are common disorders that share overlapping symptoms. In this systematic review and meta-analysis, we aimed to provide up-to-date and comprehensive estimates of the prevalence of CeD in patients with IBS.Methods: We searched several databases through January 2025 for studies reporting the prevalence of CeD in patients with IBS. Eligible studies used Rome III or Rome IV criteria for IBS diagnosis and used serological screening with tissue transglutaminase, endomysial antibodies, or deamidated gliadin peptide, and/or confirmatory duodenal biopsies for CeD diagnosis. We used random-effects meta-analysis to estimate the pooled prevalence of seropositive and biopsy-proven CeD with 95% confidence intervals (CI). We calculated pooled odds ratios to compare the likelihood of CeD between patients with IBS and controls.Results: A total of 29 studies comprising 7,209 patients with IBS were included. The pooled seroprevalence of CeD in patients with IBS was 6% (95% CI, 5%-8%), and the pooled prevalence of biopsy-proven CeD was 2% (95% CI, 2%-3%). A significant proportion of seropositive patients (15%; 95% CI, 6%-24%) did not undergo endoscopy and biopsy. Patients with IBS had significantly higher odds of a positive serology than controls (odds ratio 4.42; 95% CI, 2.82-6.92). The odds of CeD were similar across genders and IBS subtypes. There was a limited number of studies from Europe and no studies from the United States.Discussion: CeD is highly prevalent in patients with IBS, according to the Rome III and Rome IV criteria. A positive diagnosis of IBS should not be made without excluding CeD.","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Magnetic Flexible Endoscope: Phase 1 First-in-Human Clinical Trial. 磁性柔性内窥镜：第一阶段人体临床试验。

IF 8 1区医学

American Journal of Gastroenterology Pub Date : 2025-06-10 DOI: 10.14309/ajg.0000000000003584

Keith L Obstein, Claire A Landewee, James Martin, Simone Caló, Joseph Norton, Jun Wai Kow, Bruno Scaglioni, Pietro Valdastri

{"title":"The Magnetic Flexible Endoscope: Phase 1 First-in-Human Clinical Trial.","authors":"Keith L Obstein, Claire A Landewee, James Martin, Simone Caló, Joseph Norton, Jun Wai Kow, Bruno Scaglioni, Pietro Valdastri","doi":"10.14309/ajg.0000000000003584","DOIUrl":"10.14309/ajg.0000000000003584","url":null,"abstract":"Introduction: Magnetic actuation of endoscopes is promising-as the endoscope can be pulled from its front. Our team developed a novel magnetic flexible endoscope (MFE) that uses magnetic field sensing, robotic control, and real-time image processing for colonoscopy. We conducted a Phase 1 first-in-human clinical trial to assess platform safety and tolerability.Methods: Platform: The MFE contains an internal permanent magnet, camera, illumination module, and channels for instruments, insufflation/camera cleaning, irrigation, and suction. A robotic arm maneuvers a second permanent magnet coupled to the MFE. System software facilitates controlled intelligent magnetic actuation. Experiment: 5 patients scheduled for screening colonoscopy ( ICD-10 z12.11) were enrolled. Patients underwent standard of care colonoscopy with monitored anesthesia care. On withdrawal of the colonoscope, sedation was stopped, and after colonoscope removal, the MFE was inserted into the colon through the anus. The MFE was advanced through the colon while the patient was unsedated. After colon traversal, the MFE was withdrawn. Outcomes of interest included safety and tolerability of the MFE, participant sentiment through structured interview, platform usability, and robot pose data.Results: All patients underwent successful standard of care colonoscopy. All patients were awake and alert for MFE colonoscopy, tolerating the examination well without discomfort, pain, or other complaint. There were no adverse events or trauma. The system was robust without software or function failure.Discussion: The MFE successfully traversed the human colon without adverse event or patient discomfort. System performance was successful without unanticipated events. This is the first-time safety and tolerability of the novel platform has been demonstrated in vivo .","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Impact of Violence and Trauma on Patient Care: What the Gastroenterologist Needs to Know. 暴力和创伤对病人护理的影响：胃肠病学家需要知道的。

IF 8 1区医学

American Journal of Gastroenterology Pub Date : 2025-06-10 DOI: 10.14309/ajg.0000000000003587

Christina Awad, Mark Hubner

引用次数: 0

Traditional Serrated Adenomas Associated With Risk of Subsequent High-Risk Polyps and Colorectal Cancer. 传统的锯齿状腺瘤与随后的高风险息肉和结直肠癌的风险相关。

IF 8 1区医学

American Journal of Gastroenterology Pub Date : 2025-06-10 DOI: 10.14309/ajg.0000000000003588

Yufeng Chen, Georgios Polychronidis, Yueyang Zhang, Jiaxian Shen, Yujia Lu, Mengxi Du, Mingyang Song

{"title":"Traditional Serrated Adenomas Associated With Risk of Subsequent High-Risk Polyps and Colorectal Cancer.","authors":"Yufeng Chen, Georgios Polychronidis, Yueyang Zhang, Jiaxian Shen, Yujia Lu, Mengxi Du, Mingyang Song","doi":"10.14309/ajg.0000000000003588","DOIUrl":"10.14309/ajg.0000000000003588","url":null,"abstract":"Introduction: Traditional serrated adenoma (TSA) is a rare yet established precursor to colorectal cancer (CRC). The risk of colorectal neoplasia after TSA removal remains unclear.Methods: We identified participants without polyps or with TSAs during index colonoscopy from the Mass General Brigham Colonoscopy Cohort (2007-2023). Participants were prospectively followed for recurrence of high-risk polyps and incidence of CRC. We used the time-varying multivariable-adjusted Cox proportional hazards model to estimate the risk of CRC and high-risk polyps associated with baseline diagnosis of TSAs.Results: We identified 109,218 participants without polyps and 252 with TSAs, of whom 35,124 (32%) and 139 (55%) had undergone a follow-up colonoscopy, respectively. TSAs were predominantly located in the distal colon (35%) and rectum (38%), with approximately half sized <10 mm. TSAs tended to demonstrate as a single lesion (84%) but coexist with other types of polyps (70%). Compared with participants without polyps, those with TSAs had higher risk of developing high-risk polyps, high-risk adenomas, high-risk serrated polyps, and CRC, with the hazard ratio (95% confidence interval) of 3.31 (2.35-4.66), 3.07 (2.12-4.44), 6.66 (3.79-11.71), and 7.23 (2.23-23.44), respectively. The risk elevation of high-risk polyps peaked at 3 years post-TSA removal (hazard ratio = 10.85, 95% confidence interval, 6.36-18.52). Among recurrent polyps after TSA removal, 54% (52/96) occurred in the proximal colon and 69% (66/96) was serrated polyps.Discussion: Patients with TSA removal had an elevated risk of colorectal neoplasia, particularly within 3 years after TSA removal, supporting the current US recommendations for a surveillance colonoscopy at 3 years.","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Psychomotor Speed From Minimal Hepatic Encephalopathy Testing Is Associated With Physical Frailty in Patients With Advanced Chronic Liver Disease. 晚期慢性肝病患者最小肝性脑病检测的精神运动速度与身体虚弱相关

IF 8 1区医学

American Journal of Gastroenterology Pub Date : 2025-06-09 DOI: 10.14309/ajg.0000000000003583

Miguel Sogbe, Randi Wong, Pamela M Bloomer, Alexandra Steinberg, Robert S Rahimi, Jennifer C Lai, Andres Duarte-Rojo

{"title":"Psychomotor Speed From Minimal Hepatic Encephalopathy Testing Is Associated With Physical Frailty in Patients With Advanced Chronic Liver Disease.","authors":"Miguel Sogbe, Randi Wong, Pamela M Bloomer, Alexandra Steinberg, Robert S Rahimi, Jennifer C Lai, Andres Duarte-Rojo","doi":"10.14309/ajg.0000000000003583","DOIUrl":"10.14309/ajg.0000000000003583","url":null,"abstract":"Introduction: Physical frailty and minimal hepatic encephalopathy (MHE) are common in advanced chronic liver disease (AdvCLD). Although the Psychometric Hepatic Encephalopathy Score is used for MHE diagnosis, its complexity limits routine use. The Stroop EncephalApp (StE) offers a simpler method for MHE diagnosis. We aimed to investigate the association between MHE using the StE and physical frailty by the Liver Frailty Index (LFI), in patients with AdvCLD.Methods: This multicenter study analyzed data from patients with AdvCLD awaiting liver transplantation. Patients were categorized into 2 groups based on the presence or absence of MHE and compared using the LFI and its components. To identify factors influencing the various StE modalities and MHE diagnosis, we used the Spearman rank correlation coefficient and logistic regression models.Results: Of the 267 patients, 73% were diagnosed with MHE, and 18% of the total cohort were classified as frail. Patients with MHE demonstrated poorer LFI scores and were more likely to be categorized as prefrail or frail. Notably, there was a significant correlation between StE time modalities, especially off-time, and the LFI score (rho = 0.438, P < 0.001). Furthermore, multivariable analyses indicated that the LFI was independently associated with MHE (OR 2.41, 95% CI 1.52-3.82).Discussion: The findings suggest that the LFI score in this population reflects its ability to capture the crucial role of psychomotor speed, particularly evident in off-time performance, thus connecting neurocognitive and physical function. Further research is warranted to investigate the effectiveness of interventions targeting cognitive and physical impairments to enhance clinical outcomes in patients with AdvCLD.","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Monitoring Inflammatory Bowel Disease Activity: When, How, and Why. 监测炎症性肠病活动：何时，如何和为什么。

IF 8 1区医学

American Journal of Gastroenterology Pub Date : 2025-06-09 DOI: 10.14309/ajg.0000000000003582

Jill K J Gaidos, Jana G Hashash

引用次数: 0

Short-Term and Long-Term Outcomes Among a National Cohort of US Veterans Hospitalized for Alcohol-Associated Hepatitis. 酒精相关性肝炎住院的美国退伍军人全国队列的短期和长期结果

IF 8 1区医学

American Journal of Gastroenterology Pub Date : 2025-06-09 DOI: 10.14309/ajg.0000000000003581

Zeyuan Yang, Judah Kupferman, Wei Zhang, Ashwani K Singal, Michael Ostacher, Ramsey Cheung, Robert J Wong

{"title":"Short-Term and Long-Term Outcomes Among a National Cohort of US Veterans Hospitalized for Alcohol-Associated Hepatitis.","authors":"Zeyuan Yang, Judah Kupferman, Wei Zhang, Ashwani K Singal, Michael Ostacher, Ramsey Cheung, Robert J Wong","doi":"10.14309/ajg.0000000000003581","DOIUrl":"10.14309/ajg.0000000000003581","url":null,"abstract":"Introduction: Excessive alcohol use is highly prevalent among US Veterans, contributing to alcohol-associated hepatitis (AH), a severe form of alcohol-associated liver disease. We evaluate longitudinal outcomes among a national cohort of US Veterans hospitalized with AH.Methods: US Veterans hospitalized with AH from 2010 to 2023 were evaluated to determine the rate of death during index hospitalization and at 28 days and 90 days after hospitalization. Adjusted Cox proportional hazards models evaluated for predictors of aforementioned outcomes. Additional analyses were performed among patients with severe AH with model for end-stage liver disease (MELD) >20.Results: Among 1,560 unique adults hospitalized for AH (58.8% with MELD >20), 6.8% died during index hospitalization, 12.5% within 28 days, and 24.2% within 90 days. Among patients with severe AH with MELD>20, 10.3% died during index hospitalization, 19.2% within 28 days, and 34.9% within 90 days. Older age and increasing number of organ failures were associated with worse outcomes. Black/African Americans had lower risk of death compared with non-Hispanic whites. Treatment with steroids was not associated with significant difference in outcomes among patients with severe AH.Discussion: Among a national cohort of hospitalized Veterans with AH, ∼25% of patients overall and over one-third with severe AH died within 90 days, respectively. These findings emphasize the importance of effective screening for unhealthy alcohol use and prompt linkage to alcohol treatment resources in Veterans to curb this rising epidemic of alcohol-associated liver disease in this vulnerable population.","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0