{"title":"Artificial Intelligence in Gastroenterology - Promises and Limits.","authors":"Ludovico Abenavoli, Pietro Hiram Guzzi","doi":"10.15403/jgld-5824","DOIUrl":"https://doi.org/10.15403/jgld-5824","url":null,"abstract":"","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"33 4","pages":"444-447"},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904583","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}
Ernst Michael Jung, Lukas Pleyer, Ivor Dropco, Ulrich Kaiser, Dong Yi, Christian Stroszczynski, Friedrich Jung
{"title":"Dynamic Contrast Ultrasound Diagnostics (CEUS) of Liver Lesions and Post-treatment Control with A New High-resolution Examination Technique (HiFR) and Perfusion.","authors":"Ernst Michael Jung, Lukas Pleyer, Ivor Dropco, Ulrich Kaiser, Dong Yi, Christian Stroszczynski, Friedrich Jung","doi":"10.15403/jgld-5589","DOIUrl":"https://doi.org/10.15403/jgld-5589","url":null,"abstract":"<p><strong>Background and aims: </strong>To evaluate, if high frame rate (HiFR) contrast-enhanced ultrasound (CEUS) and external perfusion analysis (VueBox®)can give answers on liver tumour diagnostics.</p><p><strong>Methods: </strong>A multifrequency probe (C1-6 /Resona R9) and 1-2.4 ml ultrasound contrast medium were used for CEUS up to 5-6 min. Independent analysis of DICOM-CINE files was performed, correlated to follow-up, computed tomography, magnetic resonance imaging, or histopathology.</p><p><strong>Results: </strong>In 110 patients the difference between marginal peak enhancement (PE) of malignant and benign leasions was significant. In the peripheral area, the AUCs were lower in malignant lesions (144.8±139.3) than in benign lesions (123.6±119.8). The mean transit time (mTT) was shorter in malignant lesions in the center. In the liver parenchyma, however, the mTT was significantly longer in malignant lesions (141.6±107.9s) than in benign lesions (128.8±138.6 s). The rise time (RT) was significantly shorter central (66.5±30.9s) and peripheral (72.8±35.1s) in malignant lesions than in benign lesions (114.33±159.58s). The wash in rate (WiR) in benign lesions was 848.3±2,563.7 rU in the center. Wash-out rate (WoR) in the center, peripheral and in the liver parenchyma showed a significantly lower wash-out in the malignant lesions.</p><p><strong>Conclusions: </strong>HiFR CEUS with perfusion analysis enables the assessment of focal, diffuse and post-interventional liver changes.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"33 3","pages":"362-371"},"PeriodicalIF":0.0,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335251","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}
Isha Kohli, Aalam Sohal, Jay Patel, Marina Roytman
{"title":"Analysis of the Association between Eosinophilic Esophagitis and MASLD: Retrospective, Observational, Cohort Analysis of the National Inpatient Sample 2016-2020.","authors":"Isha Kohli, Aalam Sohal, Jay Patel, Marina Roytman","doi":"10.15403/jgld-5409","DOIUrl":"10.15403/jgld-5409","url":null,"abstract":"<p><strong>Background and aims: </strong>Eosinophilic esophagitis (EoE) is a chronic immune-mediated inflammatory condition. Associated pathologies for EoE are similar to those with metabolic-dysfunction-associated steatotic liver disease (MASLD). This study assesses whether an association exists between MASLD and EoE.</p><p><strong>Methods: </strong>We used National Inpatient Sample (NIS) 2020 data to identify adult patients. ICD-10 codes were used to identify patients with MASLD and EoE. The relationship between MASLD and EoE was assessed by multivariate analysis after adjusting for confounding factors, such as patient demographics, hospital characteristics, Charlson comorbidity index, obesity, obstructive sleep apnea (OSA), diabetes, hypertension (HTN), hyperlipidemia (HLD), inflammatory bowel disease (IBD), celiac disease (CD), gastroesophageal reflux disease (GERD), smoking, alcohol use, and irritable bowel syndrome (IBS).</p><p><strong>Results: </strong>Out of 26 million patients, 4,820 had a diagnosis of EoE. The majority of the patients were between 18 and 44 years of age (47.82%), male (54.05%), had private insurance (50.1%), and were in the highest income quartile (29.25%). A higher incidence of MASLD was noted in the EoE group than those without (6.1% vs.2.9%, p<0.001). After adjusting for confounding factors, MASLD had 2.38 times higher odds of having EoE (95% CI-1.82-3.11, p<0.001). Other factors noted to be associated with higher odds of EoE included younger age, Caucasian race, IBS, GERD, IBD, and CD.</p><p><strong>Conclusions: </strong>Our study reports a novel finding that MASLD and EoE are associated. Future prospective studies are needed to confirm and understand the clinical significance of this relationship and how one disease affects the other.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"33 3","pages":"309-315"},"PeriodicalIF":0.0,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335247","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}
Govind K Makharia, Samagra Agrawal, Christopher Hansen-Barkun, Anahita Sadgehi, Leticia Moreira, Yeong Yeh Lee, Wai K Leung, Gilaad Kaplan, Desmond Leddin, Geoffrey Metz, Alan Barkun
{"title":"Virtual Education is the Need of the Hour for the Global Gastroenterology Community: A Survey of Leaders of Professional Gastroenterology Organizations.","authors":"Govind K Makharia, Samagra Agrawal, Christopher Hansen-Barkun, Anahita Sadgehi, Leticia Moreira, Yeong Yeh Lee, Wai K Leung, Gilaad Kaplan, Desmond Leddin, Geoffrey Metz, Alan Barkun","doi":"10.15403/jgld-5827","DOIUrl":"https://doi.org/10.15403/jgld-5827","url":null,"abstract":"<p><strong>Background and aims: </strong>Since the onset of the Coronavirus disease 2019 (COVID-19) pandemic, there has been a significant opportunity to leverage virtual platforms for communication and dissemination of knowledge. An online survey was conducted to examine the viewpoints of World Gastroenterology Organization (WGO) leaders concerning the necessity, primary priority areas, and implementation strategies for a virtual global gastroenterology educational program.</p><p><strong>Methods: </strong>We conducted a survey of leaders of WGO member societies to assess their opinions on creating opportunities for global education using virtual platforms, identifying practical implementation steps and priority educational areas.</p><p><strong>Results: </strong>Responses were obtained from 57/117 (48.7%) contacted leaders with 56/57 (98.2%) identifying such a need. Five mutually exclusive priority educational topics were proposed in the survey: clinical gastroenterology, endoscopy, nutritional support, research methodology, and professional development. Overall, most participants prioritized clinical gastroenterology (45/57; 78.9%) and endoscopy/hand skills (27/57; 47.3%) as educational topics to be addressed by the virtual global gastroenterology educational program. A majority of WGO member society leaders surveyed favored monthly teaching activities (33/57; 57.8%), ideally carried out between 1500-2100 local time (31/57; 54.3%), ideally with no administrative fees (47/57; 82.4%).</p><p><strong>Conclusions: </strong>This truly global survey of WGO member societies achieved a good response rate and provides important insights into the need for and scope of future virtual education programs under the aegis of the WGO.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"33 3","pages":"418-423"},"PeriodicalIF":0.0,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335281","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}
Alberto Busatto, Francesco Ferrara, Matteo Todisco, Enrico Gringeri, Marco Senzolo
{"title":"Endoscopic Complications in Treating Portal Biliopathy: A Rare Case of Porto-biliary Fistula.","authors":"Alberto Busatto, Francesco Ferrara, Matteo Todisco, Enrico Gringeri, Marco Senzolo","doi":"10.15403/jgld-5568","DOIUrl":"10.15403/jgld-5568","url":null,"abstract":"","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"33 3","pages":"308"},"PeriodicalIF":0.0,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335266","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}
Halime Selen, Aylin Seylam Küșümler, Tarkan Karakan, Kenan Moral
{"title":"Effect of Ramadan Fasting on Intestinal Microbiota and Fatty Acid Binding Protein 4 in Overweight and Obese Individuals.","authors":"Halime Selen, Aylin Seylam Küșümler, Tarkan Karakan, Kenan Moral","doi":"10.15403/jgld-5559","DOIUrl":"10.15403/jgld-5559","url":null,"abstract":"<p><strong>Background and aims: </strong>Intermittent fasting is a nutritional strategy that focuses on when to eat, rather than what to eat. Although the effectiveness of intermittent fasting practices in many metabolic diseases is known, its effect on microbiota and its underlying mechanism has not yet been clarified. This study aimed to investigate the effect of Ramadan fasting, one of the intermittent fasting practices, on gut microbiota and fatty acid binding protein 4 (FABP4).</p><p><strong>Methods: </strong>The study involved 10 male volunteers, 6 of whom were overweight and 4 were obese. They fasted for an average of 14-15 hours daily from dawn to sunset during the 29-day Ramadan month between 23 March - 20 April 2023 and met the inclusion criteria. The participants' nutritional and physical activity status before and during Ramadan, as well as their anthropometric measurements before and after Ramadan, intestinal microbiota, transaminases, gamma-glutamyl transferase, C reactive protein, total cholesterol (C), high-density lipoprotein (HDL) C, low-density lipoprotein C, triglycerides (TG), and FABP4 levels, were evaluated within the scope of the study.</p><p><strong>Results: </strong>The study found a statistically significant increase in both alpha and beta diversity in the intestinal microbiota following Ramadan fasting (p<0.05). The F/B ratio, Firmicutes phylum, Clostridia class, Clostridiales order, and Ruminococcaceae family exhibited statistically significant decreases, while the Bacteroidetes and Proteobacteria phyla, Bacteroidia, Alphaproteobacteria, and Erysipelotrichi classes, Bacteroidales, Erysipelotrichales, and Actinomycetales orders, Erysipelotrichaceae family and Prevotella genus, demonstrated statistically significant increases (p<0.05). Participants who achieved an average weight loss of 2.3±0.99 kg at the end of Ramadan showed a significant increase in HDL-C and a significant decrease in TG levels (p<0.05). Although FABP4 levels decreased after fasting, this difference was not statistically significant (p>0.05).</p><p><strong>Conclusion: </strong>Ramadan fasting induces weight loss, modifies gut microbiota, and improves blood lipid profile and FABP4 levels, suggesting the need for more extensive studies.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"33 3","pages":"330-338"},"PeriodicalIF":0.0,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335252","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}
Robert Botea, Madalina Piron-Dumitrascu, Tiberiu Augustin Georgescu, Camil Laurentiu Bohiltea, Silviu Cristian Voinea, Valentin Nicolae Varlas, Simona Raluca Iacoban, Nicolae Suciu
{"title":"Lynch Syndrome-associated Genomic Variants.","authors":"Robert Botea, Madalina Piron-Dumitrascu, Tiberiu Augustin Georgescu, Camil Laurentiu Bohiltea, Silviu Cristian Voinea, Valentin Nicolae Varlas, Simona Raluca Iacoban, Nicolae Suciu","doi":"10.15403/jgld-5856","DOIUrl":"10.15403/jgld-5856","url":null,"abstract":"<p><strong>Background and aims: </strong>Lynch Syndrome, a hereditary disorder characterized by germline mutations in mismatch repair (MMR) genes, is a major contributor to colorectal cancers. It has also been identified in endometrial cancer. Despite the established role of MMR deficiency in tumorigenesis, the specific genomic alterations driving Lynch syndrome-associated endometrial cancer, and their overlap with colorectal cancer, remain incompletely understood. This study aims to fill this gap by performing a detailed comparative analysis of germline and somatic mutations in endometrial cancer within the context of Lynch syndrome.</p><p><strong>Methods: </strong>We conducted whole exome sequencing on matched germline and somatic DNA from 13 patients diagnosed with Lynch syndrome-associated endometrial cancer. High-depth sequencing was performed, followed by rigorous bioinformatics analysis to identify and annotate variants, focusing on their potential pathogenicity and relevance to both endometrial and colorectal cancer.</p><p><strong>Results: </strong>Our analysis revealed 1,118 germline and 14,051 somatic variants, with 493 variants common to both. Recurrent pathogenic mutations in MLH1, MSH2, and MSH6 were confirmed, highlighting their critical role in Lynch syndrome. Notably, frequent somatic mutations in the PIK3CA and PTEN genes were identified, implicating the PI3K/AKT/mTOR pathway as a key oncogenic driver in these cancers. Additionally, novel somatic mutations in genes related to the extracellular matrix such as FBN1 and SPARC were uncovered, suggesting a possible unique role in endometrial tumor progression.</p><p><strong>Conclusions: </strong>This study provides new insights into the molecular basis of Lynch syndrome-associated endometrial cancer, emphasizing the overlap in oncogenic pathways with colorectal cancer. The discovery of shared and unique genetic mutations highlights the importance of developing combined treatment strategies and suggests that targeting these specific mutations could improve therapy for patients with Lynch syndrome-associated cancers.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":" ","pages":"339-347"},"PeriodicalIF":0.0,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304968","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}
Ioan Cristian Lupescu, Speranța Maria Iacob, Corina Pietrăreanu, Liana Gheorghe
{"title":"Validation of EncephalApp Stroop Test for Diagnosing Minimal Hepatic Encephalopathy in the Romanian Population.","authors":"Ioan Cristian Lupescu, Speranța Maria Iacob, Corina Pietrăreanu, Liana Gheorghe","doi":"10.15403/jgld-5231","DOIUrl":"10.15403/jgld-5231","url":null,"abstract":"<p><strong>Background and aims: </strong>Minimal hepatic encephalopathy (MHE) represents the mildest form of hepatic encephalopathy. MHE has been associated with impairment of quality of life and job performance, and is a major cause of premature retiring in cirrhotic patients. However, MHE is usually overlooked by most physicians, due to its asymptomatic nature. We aim to present our experience with the EncephalApp Stroop Test for diagnosing MHE in cirrhotic patients. We also want to establish if Stroop test performance correlates with age, educational level, liver disease severity (as assessed by the MELD and Child-Pugh scores), duration of disease, previous episodes of overt hepatic encephalopathy, and other relevant clinical or laboratory parameters.</p><p><strong>Methods: </strong>A cross-sectional observational single-center study, in which 100 adult patients diagnosed with liver cirrhosis were evaluated for the presence of MHE by using the EncephalApp Stroop Test. In parallel, 45 healthy adult controls without liver cirrhosis were recruited and tested under the same conditions as the patients.</p><p><strong>Results: </strong>There were no age-related differences between the two groups (p=0.6). Stroop test performance of the controls (143.1 ± 20.8 seconds) was significantly better than that of the patients (171.9 ± 33.3 seconds) (p<0.0001). Stroop test results correlated with the MELD (R=0.28, p=0.005) and Child-Pugh scores (R=0.2, p=0.04). There was a positive correlation between Stroop test results and age in patients (R=0.45, p<0.0001) and controls (R=0.75, p<0.0001). Stroop test performance was not influenced by the duration of liver disease (p=0.4) or prior episodes of overt hepatic encephalopathy (p=0.25). Gender and level of education did not have an impact on Stroop test results. Alcoholic liver disease, diabetes mellitus, hyperglycemia, anemia and hyponatremia were associated with poorer performances.</p><p><strong>Conclusions: </strong>EncephalApp Stroop Test proved to be a quick and simple method for diagnosing minimal hepatic encephalopathy in the hospital setting. Test performance was influenced primarily by age, but also by liver disease severity, anemia, hyponatremia and hyperglycemia.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":" ","pages":"355-361"},"PeriodicalIF":0.0,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304972","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}