Nan Li, Mingyue Hu, Qiliu Qian, Jun Ouyang, Yulin Yang, Yongqi Zhang
Background
Fatty acid synthase (FASN) is a crucial enzyme that catalyzes endogenous lipogenesis in multiple diseases. However, the function and significance of FASN in colorectal cancer remain unclear.
Aims
This research aimed to explore the expression and role of FASN in colorectal cancer.
Results
Cancer, adjacent, and normal tissues were collected from patients with colorectal cancer and healthy controls. Immunohistochemistry and scoring were applied to analyze the expression of FASN in the different tissues, to investigate the differences in its expression among different tissue types, and to examine the potential correlation between FASN and gender, age, BMI, and other factors.
Discussion
In this study, 100 colorectal cancer patients and 100 healthy participants were recruited. Respectively, the average scores of cancer tissues, adjacent tissues, and normal tissues were 7.25, 2, and 1.25. Significant differences were found among these three tissue groups (p < 0.05). Moreover, no significant association was observed between sex, age, BMI, and FASN expression scores in colorectal cancer tissues (p > 0.05).
Conclusion
Based on these data, FASN was specifically overexpressed in cancer tissues and adjacent tissues. Hence, our results suggest that FASN may play an essential role in colorectal cancer and may be an attractive therapeutic target in the future.
{"title":"Potential Application Value of FASN in the Diagnosis of Colorectal Cancer","authors":"Nan Li, Mingyue Hu, Qiliu Qian, Jun Ouyang, Yulin Yang, Yongqi Zhang","doi":"10.1002/jgh3.70261","DOIUrl":"https://doi.org/10.1002/jgh3.70261","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Fatty acid synthase (FASN) is a crucial enzyme that catalyzes endogenous lipogenesis in multiple diseases. However, the function and significance of FASN in colorectal cancer remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This research aimed to explore the expression and role of FASN in colorectal cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Cancer, adjacent, and normal tissues were collected from patients with colorectal cancer and healthy controls. Immunohistochemistry and scoring were applied to analyze the expression of FASN in the different tissues, to investigate the differences in its expression among different tissue types, and to examine the potential correlation between FASN and gender, age, BMI, and other factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>In this study, 100 colorectal cancer patients and 100 healthy participants were recruited. Respectively, the average scores of cancer tissues, adjacent tissues, and normal tissues were 7.25, 2, and 1.25. Significant differences were found among these three tissue groups (<i>p</i> < 0.05). Moreover, no significant association was observed between sex, age, BMI, and FASN expression scores in colorectal cancer tissues (<i>p</i> > 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Based on these data, FASN was specifically overexpressed in cancer tissues and adjacent tissues. Hence, our results suggest that FASN may play an essential role in colorectal cancer and may be an attractive therapeutic target in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70261","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111095","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}
Laura Baldini, Elisabetta Dell'Unto, Maria Rinzivillo, Gianluca Esposito, Francesco Panzuto
Objective
The incidental diagnosis of type I gastric neuroendocrine tumors (gNETs) has become increasingly frequent in clinical practice, largely due to the widespread use of upper gastrointestinal endoscopy and improved recognition of these lesions. Although typically indolent, type I gNETs require accurate assessment to ensure appropriate risk stratification, management, and follow-up. This review provides a practical, evidence-based guide specifically designed for gastroenterologists and clinicians managing patients with incidentally discovered type I gNETs.
Methods
Structured in a step-by-step format, the review outlines key aspects of diagnosis and management, including endoscopic recognition and differential diagnosis, histological confirmation with a focus on corpus-restricted atrophic gastritis, initial risk assessment based on tumor characteristics and patient factors, and the use of additional imaging modalities such as endoscopic ultrasound, cross-sectional imaging, and functional imaging.
Results
The review emphasizes the importance of referring patients to specialized centers for multidisciplinary evaluation, a strategy shown to improve clinical outcomes and adherence to best practices. Finally, practical recommendations for long-term surveillance are provided, with clear indications tailored to individual patient risk profiles.
Conclusion
By integrating current guidelines with practical insights and highlighting critical decision points, this review serves as a concise, user-friendly tool to support clinicians in optimizing the care of patients with type I gastric NETs. This stepwise approach aims to bridge the gap between complex guideline recommendations and daily clinical practice, offering actionable guidance to ensure safe, effective, and standardized management of these increasingly encountered lesions.
{"title":"Step-by-Step Approach to the Incidental Diagnosis of Type I Gastric Neuroendocrine Tumors: Practical Insights","authors":"Laura Baldini, Elisabetta Dell'Unto, Maria Rinzivillo, Gianluca Esposito, Francesco Panzuto","doi":"10.1002/jgh3.70260","DOIUrl":"https://doi.org/10.1002/jgh3.70260","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The incidental diagnosis of type I gastric neuroendocrine tumors (gNETs) has become increasingly frequent in clinical practice, largely due to the widespread use of upper gastrointestinal endoscopy and improved recognition of these lesions. Although typically indolent, type I gNETs require accurate assessment to ensure appropriate risk stratification, management, and follow-up. This review provides a practical, evidence-based guide specifically designed for gastroenterologists and clinicians managing patients with incidentally discovered type I gNETs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Structured in a step-by-step format, the review outlines key aspects of diagnosis and management, including endoscopic recognition and differential diagnosis, histological confirmation with a focus on corpus-restricted atrophic gastritis, initial risk assessment based on tumor characteristics and patient factors, and the use of additional imaging modalities such as endoscopic ultrasound, cross-sectional imaging, and functional imaging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The review emphasizes the importance of referring patients to specialized centers for multidisciplinary evaluation, a strategy shown to improve clinical outcomes and adherence to best practices. Finally, practical recommendations for long-term surveillance are provided, with clear indications tailored to individual patient risk profiles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>By integrating current guidelines with practical insights and highlighting critical decision points, this review serves as a concise, user-friendly tool to support clinicians in optimizing the care of patients with type I gastric NETs. This stepwise approach aims to bridge the gap between complex guideline recommendations and daily clinical practice, offering actionable guidance to ensure safe, effective, and standardized management of these increasingly encountered lesions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70260","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110962","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}
This study aims to compare the diagnostic performance and accuracy of non-invasive fibrosis scoring tools, including the Fibrosis-4 index (Fib-4), Nonalcoholic Fatty Liver Disease Fibrosis Score (NFS), AST-to-Platelet Ratio Index (APRI), and BARD score among patients with biopsy-proven MASLD or MASH, to either diagnose or exclude advanced fibrosis.
Methods and Results
A retrospective cohort of patients with biopsy-proven MASLD or MASH was analyzed. Inclusion criteria for the study included patients over the age of 18, liver biopsy-proven MASLD or MASH, and availability of laboratory findings prior to the biopsy to perform calculations for the non-invasive liver fibrosis scoring tools. Patients were excluded based on a history of alcohol use and evidence of another or coexisting cause of chronic liver disease based on laboratory or pathology findings. Data were collected on patient demographics, comorbidities, and liver biopsy findings. The stage of fibrosis was determined using the Metavir Scoring System (F0–F4) categorized into mild to moderate (score: 1–2) and advanced fibrosis (score: 3–4). The statistical analysis of the four non-invasive fibrosis scoring tools in this study resulted in a higher negative predictive value for all patients, particularly in the young adult population. There was significant variability and limitations regarding sensitivity, specificity, and AUROC for all four scores.
Conclusions
The study suggests that the Fib-4, NFS, APRI, and BARD scores are valuable biomarkers for excluding advanced fibrosis in patients with MASLD or MASH. These four biomarkers are precluded as confirmatory tests; thus, further research and risk stratification with other non-invasive scoring modalities or imaging are needed.
{"title":"Diagnostic Performance of Fibrosis-4 Index, Nonalcoholic Fatty Liver Disease Fibrosis Score, AST-To-Platelet Ratio Index, and BARD Score Among Young and Older Adults for the Diagnosis of Advanced MASLD Fibrosis: A Retrospective Cohort Study","authors":"Frank Lin, Ayah Obeid, Mehak Sharma, Parampreet Kaur, Kimberly Chaput, Hammad Liaquat","doi":"10.1002/jgh3.70281","DOIUrl":"https://doi.org/10.1002/jgh3.70281","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aims to compare the diagnostic performance and accuracy of non-invasive fibrosis scoring tools, including the Fibrosis-4 index (Fib-4), Nonalcoholic Fatty Liver Disease Fibrosis Score (NFS), AST-to-Platelet Ratio Index (APRI), and BARD score among patients with biopsy-proven MASLD or MASH, to either diagnose or exclude advanced fibrosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>A retrospective cohort of patients with biopsy-proven MASLD or MASH was analyzed. Inclusion criteria for the study included patients over the age of 18, liver biopsy-proven MASLD or MASH, and availability of laboratory findings prior to the biopsy to perform calculations for the non-invasive liver fibrosis scoring tools. Patients were excluded based on a history of alcohol use and evidence of another or coexisting cause of chronic liver disease based on laboratory or pathology findings. Data were collected on patient demographics, comorbidities, and liver biopsy findings. The stage of fibrosis was determined using the Metavir Scoring System (F0–F4) categorized into mild to moderate (score: 1–2) and advanced fibrosis (score: 3–4). The statistical analysis of the four non-invasive fibrosis scoring tools in this study resulted in a higher negative predictive value for all patients, particularly in the young adult population. There was significant variability and limitations regarding sensitivity, specificity, and AUROC for all four scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study suggests that the Fib-4, NFS, APRI, and BARD scores are valuable biomarkers for excluding advanced fibrosis in patients with MASLD or MASH. These four biomarkers are precluded as confirmatory tests; thus, further research and risk stratification with other non-invasive scoring modalities or imaging are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70281","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102314","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}
Inflammatory bowel disease (IBD) is an immune-mediated disorder with rising global incidence. Adolescents and young adults (15–49 years) bear major psychological, social, and economic burdens, yet few studies have examined their disease trends. We aimed to estimate global, regional, and national incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of IBD in this age group and to project future burden.
Methods and Results
Using data from the Global Burden of Disease 2021, we analyzed age-standardized rates of incidence, prevalence, mortality, and DALYs (ASIR, ASPR, ASMR and ASDR) among people aged 15–49 across 204 countries and territories. Estimated annual percentage changes, Joinpoint regression, and age-period-cohort modelling were employed to evaluate temporal patterns, while Bayesian modelling projected trends to 2050. Inequalities were evaluated using the Socio-demographic Index (SDI). In 2021, global ASIR was 5.01/100,000 and ASPR was 41.56/100,000. ASMR and ASDR were 0.13/10,000 and 13.56/100,000 person-years, respectively. From 1990 to 2021, ASIR and ASPR increased slightly overall, with the most rapid rise in East Asia. ASMR and ASDR declined globally but remained highest in Western Sub-Saharan Africa. SDI was positively correlated with incidence and prevalence, and negatively with mortality. Projections to 2050 indicate continued declines in incidence and prevalence, stable DALYs, and a slight increase in mortality.
Conclusion
IBD remains a significant burden in people aged 15–49. Growing incidence in East Asia and sustained mortality in disadvantaged regions highlight the need for early diagnosis, equitable care, and targeted public health strategies.
{"title":"Global Trends and Future Projections in the Burden of Inflammatory Bowel Disease Among Adolescents and Young Adults (15–49 Years) From 1990 to 2021","authors":"Xueyi Ren, Jun Xu, Xiaolei Zhao","doi":"10.1002/jgh3.70282","DOIUrl":"https://doi.org/10.1002/jgh3.70282","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Inflammatory bowel disease (IBD) is an immune-mediated disorder with rising global incidence. Adolescents and young adults (15–49 years) bear major psychological, social, and economic burdens, yet few studies have examined their disease trends. We aimed to estimate global, regional, and national incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of IBD in this age group and to project future burden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>Using data from the Global Burden of Disease 2021, we analyzed age-standardized rates of incidence, prevalence, mortality, and DALYs (ASIR, ASPR, ASMR and ASDR) among people aged 15–49 across 204 countries and territories. Estimated annual percentage changes, Joinpoint regression, and age-period-cohort modelling were employed to evaluate temporal patterns, while Bayesian modelling projected trends to 2050. Inequalities were evaluated using the Socio-demographic Index (SDI). In 2021, global ASIR was 5.01/100,000 and ASPR was 41.56/100,000. ASMR and ASDR were 0.13/10,000 and 13.56/100,000 person-years, respectively. From 1990 to 2021, ASIR and ASPR increased slightly overall, with the most rapid rise in East Asia. ASMR and ASDR declined globally but remained highest in Western Sub-Saharan Africa. SDI was positively correlated with incidence and prevalence, and negatively with mortality. Projections to 2050 indicate continued declines in incidence and prevalence, stable DALYs, and a slight increase in mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>IBD remains a significant burden in people aged 15–49. Growing incidence in East Asia and sustained mortality in disadvantaged regions highlight the need for early diagnosis, equitable care, and targeted public health strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70282","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102005","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}
Tran Thi Luong Vo, Hoang Anh Vu, Chuong Quoc Ho, Nguyen Phuoc Ma, Dung Dang Quy Ho, Hoang Huu Bui
Aims
Mutations in the PRSS1 and SPINK1 genes are recognized as important risk factors for chronic pancreatitis (CP); however, their clinical relevance in Vietnamese populations remains unclear. This cross-sectional study investigated the prevalence and associated factors of these mutations in Vietnamese CP patients.
Methods and Results
CP was diagnosed according to the 2020 American College of Gastroenterology Clinical Guidelines. Genetic analysis was performed via Sanger DNA sequencing. One hundred sixty CP patients were included from December 2022 to June 2024 at Cho Ray Hospital, Vietnam. Pathogenic mutations were identified in 64 patients (40.0%), with SPINK1 mutations found in 36.8% and PRSS1 mutations in 4.4%. The most frequent SPINK1 variants were c.101A>G (23.7%) and c.194+2T>C (14.3%), and their prevalence was highest in idiopathic CP cases. Multivariate logistic regression analysis revealed that younger age (OR: 0.95; 95% CI: 0.92–0.98), diabetes mellitus (OR: 2.55; 95% CI: 1.11–6.04), pancreatic duct stones (OR: 7.08; 95% CI: 2.81–20.40), and prior surgical intervention (OR: 4.14; 95% CI: 1.34–14.10) were independently associated with pathogenic mutations.
Conclusion
These findings suggest a high prevalence of SPINK1 mutations, particularly c.101A>G and c.194+2T>C, among Vietnamese CP patients. The significant factors associated with genetic mutations were younger age, diabetes mellitus, pancreatic duct stones, and prior surgical intervention.
{"title":"PRSS1, SPINK1 Mutations and Associated Factors in Vietnamese Patients With Chronic Pancreatitis","authors":"Tran Thi Luong Vo, Hoang Anh Vu, Chuong Quoc Ho, Nguyen Phuoc Ma, Dung Dang Quy Ho, Hoang Huu Bui","doi":"10.1002/jgh3.70275","DOIUrl":"https://doi.org/10.1002/jgh3.70275","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Mutations in the <i>PRSS1</i> and <i>SPINK1</i> genes are recognized as important risk factors for chronic pancreatitis (CP); however, their clinical relevance in Vietnamese populations remains unclear. This cross-sectional study investigated the prevalence and associated factors of these mutations in Vietnamese CP patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>CP was diagnosed according to the 2020 American College of Gastroenterology Clinical Guidelines. Genetic analysis was performed via Sanger DNA sequencing. One hundred sixty CP patients were included from December 2022 to June 2024 at Cho Ray Hospital, Vietnam. Pathogenic mutations were identified in 64 patients (40.0%), with <i>SPINK1</i> mutations found in 36.8% and <i>PRSS1</i> mutations in 4.4%. The most frequent <i>SPINK1</i> variants were c.101A>G (23.7%) and c.194+2T>C (14.3%), and their prevalence was highest in idiopathic CP cases. Multivariate logistic regression analysis revealed that younger age (OR: 0.95; 95% CI: 0.92–0.98), diabetes mellitus (OR: 2.55; 95% CI: 1.11–6.04), pancreatic duct stones (OR: 7.08; 95% CI: 2.81–20.40), and prior surgical intervention (OR: 4.14; 95% CI: 1.34–14.10) were independently associated with pathogenic mutations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings suggest a high prevalence of <i>SPINK1</i> mutations, particularly c.101A>G and c.194+2T>C, among Vietnamese CP patients. The significant factors associated with genetic mutations were younger age, diabetes mellitus, pancreatic duct stones, and prior surgical intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145101668","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}
Toni Habib, Nadim Zaidan, Karim Jaber, Hachem Araji, Liliane Deeb, George Bonifant, Elie El-Charabaty, Suzanne El-Sayegh, Lama Nazzal
Background
While many studies have identified steatotic liver disease (SLD) as a risk factor for kidney stone disease (KSD), the impact of the severity of steatosis has not been clearly elucidated in the context of other metabolic risk factors for KSD. This cross-sectional population-based study of a large inpatient database sought to investigate the association between KSD and SLD.
Methods
We queried the National Inpatient Database between 2016 and 2020 to identify patients with urolithiasis as well as patients with SLD, and identify other risk factors for stone disease, such as obesity, type II diabetes, and gout using ICD10 codes. Logistic regression was computed for strength and significance of the relationship between both SLD severity levels and KSD, in univariate and multivariate regression adjusted for patient characteristics and comorbidities burden. All statistical analyses were performed using SAS Enterprise Software 9.4.
Results
Odds of being a kidney stone former were significantly higher in patients with MASLD and MASH than in patients without liver injury in the general hospitalized population. Analysis performed in a cohort of hospitalizations that included BMI identifiers showed that this association of both degrees of SLD with KSD was more pronounced than that with diabetes and gout. Finally, comparing both forms of disease severity head-to-head, MASLD was found to have a stronger association with KSD than MASH.
Conclusion
Patients with SLD were found to have a higher prevalence of KSD. The more pronounced association in MASLD and the lower-than-expected contribution of other conditions involving dysregulation of metabolic homeostasis such as gout or diabetes highlights the central role of SLD in KSD pathogenesis.
{"title":"Association of Kidney Stone Disease With Metabolic Dysfunction Associated Liver Disease and Metabolic Dysfunction Associated Steatohepatitis: A National Inpatient Sample Study","authors":"Toni Habib, Nadim Zaidan, Karim Jaber, Hachem Araji, Liliane Deeb, George Bonifant, Elie El-Charabaty, Suzanne El-Sayegh, Lama Nazzal","doi":"10.1002/jgh3.70280","DOIUrl":"10.1002/jgh3.70280","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>While many studies have identified steatotic liver disease (SLD) as a risk factor for kidney stone disease (KSD), the impact of the severity of steatosis has not been clearly elucidated in the context of other metabolic risk factors for KSD. This cross-sectional population-based study of a large inpatient database sought to investigate the association between KSD and SLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We queried the National Inpatient Database between 2016 and 2020 to identify patients with urolithiasis as well as patients with SLD, and identify other risk factors for stone disease, such as obesity, type II diabetes, and gout using ICD10 codes. Logistic regression was computed for strength and significance of the relationship between both SLD severity levels and KSD, in univariate and multivariate regression adjusted for patient characteristics and comorbidities burden. All statistical analyses were performed using SAS Enterprise Software 9.4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Odds of being a kidney stone former were significantly higher in patients with MASLD and MASH than in patients without liver injury in the general hospitalized population. Analysis performed in a cohort of hospitalizations that included BMI identifiers showed that this association of both degrees of SLD with KSD was more pronounced than that with diabetes and gout. Finally, comparing both forms of disease severity head-to-head, MASLD was found to have a stronger association with KSD than MASH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with SLD were found to have a higher prevalence of KSD. The more pronounced association in MASLD and the lower-than-expected contribution of other conditions involving dysregulation of metabolic homeostasis such as gout or diabetes highlights the central role of SLD in KSD pathogenesis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087732","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}
Hookworms primarily parasitize in the intestinal tract, and the gastric involvement is extremely rare, which often leads to misdiagnosis. We present two cases of hookworm infection that mimicked early gastric carcinoma.
Case Summary
Two patients presented with clear boundaries gastric mucosa lesions exhibiting brownish discoloration, resembling early gastric mucosal cancer. Live hookworms were identified on the gastric mucosal surface using magnifying endoscopy combined with narrow-band imaging. Hookworm eggs were detected in both patients through fecal etiological evaluation. Following standard anthelmintic treatment, both the lesions and the worms resolved.
Conclusions
In the differential diagnosis of localized well-defined gastric mucosal lesions, parasitic infections should be considered in addition to neoplastic lesions. Magnifying endoscopy plays a critical role in distinguishing gastric mucosal lesions suspicious for parasitic infection.
{"title":"Hookworm Infection Mimicking Early Gastric Mucosal Carcinoma: Magnifying Endoscopy Findings in Two Cases","authors":"Fengrui Zhang, Yan Tao, Junkun Niu","doi":"10.1002/jgh3.70279","DOIUrl":"10.1002/jgh3.70279","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hookworms primarily parasitize in the intestinal tract, and the gastric involvement is extremely rare, which often leads to misdiagnosis. We present two cases of hookworm infection that mimicked early gastric carcinoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Summary</h3>\u0000 \u0000 <p>Two patients presented with clear boundaries gastric mucosa lesions exhibiting brownish discoloration, resembling early gastric mucosal cancer. Live hookworms were identified on the gastric mucosal surface using magnifying endoscopy combined with narrow-band imaging. Hookworm eggs were detected in both patients through fecal etiological evaluation. Following standard anthelmintic treatment, both the lesions and the worms resolved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In the differential diagnosis of localized well-defined gastric mucosal lesions, parasitic infections should be considered in addition to neoplastic lesions. Magnifying endoscopy plays a critical role in distinguishing gastric mucosal lesions suspicious for parasitic infection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082073","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}
Arun J. Sanyal, K. Rajender Reddy, Kimberly A. Brown, Charles S. Landis, Giuseppe Cullaro, Xingyue Huang, Sneha S. Kelkar, Rutika Raina, Shelby Corman, Nehemiah Kebede, Patrick Edmundson, Khurram Jamil, Andrew S. Allegretti
Background
Treatments for hepatorenal syndrome with acute kidney injury (HRS-AKI) that are not FDA-approved have been widely used in the United States (US) with variable outcomes. This study describes the practice patterns, outcomes, and healthcare utilization around vasopressor use before terlipressin approval in 2022.
Methods
A retrospective chart review study was conducted at 10 US medical centers, assessing adult patients diagnosed with HRS-AKI between 2016 and 2019. The primary outcome was treatment response (change in serum creatinine [SCr] from the day of vasopressor treatment initiation to Day 14/vasopressor discontinuation). Secondary outcomes included overall and transplant-free survival, treatment patterns, and healthcare resource use.
Results
Of the 198 eligible patients, 129 and 69 had mild/moderate (SCr < 5 mg/dL, acute-on-chronic liver failure [ACLF] ≤ 2) and severe disease (SCr ≥ 5 mg/dL, ACLF > 2), respectively. The mean age was 57 years; 52.5% were males, and 71.2% were White. Alcohol-associated cirrhosis (53.5%) was the most common cause of cirrhosis. All 198 patients had a physician-diagnosed HRS-AKI, and only 30.3% met all International Club of Ascites (ICA)-HRS criteria. Most patients (85.4%) initiated treatment with midodrine and octreotide for a median of 7 days. The overall response rate (n = 157) was 20.3%. Median (95% CI) overall and transplant-free survival from vasopressor initiation was 48 (32–81) and 28 (19–36) days. Notably, 33.8% of patients died during hospitalization, and 31.3% required renal replacement therapy.
Conclusion
Before 2022, hospitalized HRS-AKI patients experienced suboptimal treatment response with off-label treatments and poor survival. There remains an unmet need for safe and effective non-transplant treatments for hospitalized HRS-AKI patients in the United States.
{"title":"Challenges in the Treatment of Hepatorenal Syndrome–Acute Kidney Injury: A US Chart Review of Treatment Patterns and Survival Outcomes","authors":"Arun J. Sanyal, K. Rajender Reddy, Kimberly A. Brown, Charles S. Landis, Giuseppe Cullaro, Xingyue Huang, Sneha S. Kelkar, Rutika Raina, Shelby Corman, Nehemiah Kebede, Patrick Edmundson, Khurram Jamil, Andrew S. Allegretti","doi":"10.1002/jgh3.70255","DOIUrl":"https://doi.org/10.1002/jgh3.70255","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Treatments for hepatorenal syndrome with acute kidney injury (HRS-AKI) that are not FDA-approved have been widely used in the United States (US) with variable outcomes. This study describes the practice patterns, outcomes, and healthcare utilization around vasopressor use before terlipressin approval in 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective chart review study was conducted at 10 US medical centers, assessing adult patients diagnosed with HRS-AKI between 2016 and 2019. The primary outcome was treatment response (change in serum creatinine [SCr] from the day of vasopressor treatment initiation to Day 14/vasopressor discontinuation). Secondary outcomes included overall and transplant-free survival, treatment patterns, and healthcare resource use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 198 eligible patients, 129 and 69 had mild/moderate (SCr < 5 mg/dL, acute-on-chronic liver failure [ACLF] ≤ 2) and severe disease (SCr ≥ 5 mg/dL, ACLF > 2), respectively. The mean age was 57 years; 52.5% were males, and 71.2% were White. Alcohol-associated cirrhosis (53.5%) was the most common cause of cirrhosis. All 198 patients had a physician-diagnosed HRS-AKI, and only 30.3% met all International Club of Ascites (ICA)-HRS criteria. Most patients (85.4%) initiated treatment with midodrine and octreotide for a median of 7 days. The overall response rate (<i>n</i> = 157) was 20.3%. Median (95% CI) overall and transplant-free survival from vasopressor initiation was 48 (32–81) and 28 (19–36) days. Notably, 33.8% of patients died during hospitalization, and 31.3% required renal replacement therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Before 2022, hospitalized HRS-AKI patients experienced suboptimal treatment response with off-label treatments and poor survival. There remains an unmet need for safe and effective non-transplant treatments for hospitalized HRS-AKI patients in the United States.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70255","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145062374","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}
Diverticular hemorrhage is the most common cause of lower gastrointestinal bleeding (LGIB). Because spontaneous hemostasis frequently occurs, identifying the bleeding diverticulum via colonoscopy or iodinated contrast angiography remains challenging. Recently, several reports have demonstrated the utility of CO2 angiography in identifying the bleeding source.
Case Presentation
The patient was a 73-year-old male referred to our hospital for hematochezia and was ultimately diagnosed with colonic diverticular hemorrhage. Despite repeated massive hemorrhage, spontaneous hemostasis prevented localization of the bleeding site; neither colonoscopy nor conventional iodinated contrast angiography detected the source. Finally, CO2 angiography was performed to successfully identify the bleeding site, which enabled transcatheter arterial embolization to achieve hemostasis.
Conclusion
In cases of recurrent diverticular bleeding where the bleeding site remains undetectable, CO2 angiography may be an effective method to identify the source and guide targeted therapy.
{"title":"Use of CO2 Angiography in the Identification of the Bleeding Source of Colonic Diverticular Hemorrhage: A Case Report","authors":"Yuya Miyake, Yoshiki Morihisa, Satoko Inoue, Shigeki Arizono, Tetsuro Inokuma","doi":"10.1002/jgh3.70276","DOIUrl":"https://doi.org/10.1002/jgh3.70276","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Diverticular hemorrhage is the most common cause of lower gastrointestinal bleeding (LGIB). Because spontaneous hemostasis frequently occurs, identifying the bleeding diverticulum via colonoscopy or iodinated contrast angiography remains challenging. Recently, several reports have demonstrated the utility of CO2 angiography in identifying the bleeding source.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>The patient was a 73-year-old male referred to our hospital for hematochezia and was ultimately diagnosed with colonic diverticular hemorrhage. Despite repeated massive hemorrhage, spontaneous hemostasis prevented localization of the bleeding site; neither colonoscopy nor conventional iodinated contrast angiography detected the source. Finally, CO2 angiography was performed to successfully identify the bleeding site, which enabled transcatheter arterial embolization to achieve hemostasis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In cases of recurrent diverticular bleeding where the bleeding site remains undetectable, CO2 angiography may be an effective method to identify the source and guide targeted therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145062375","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}
Muhammad Shahzad, Kanz Ul Eman Maryam, Ali Hashim, Amna Zaman Khan, Muhammad Abdullah Ali, Ahmed Yar Khan, Muhammad Younas, Syeda Sundus Shah Bokhari, Wania Khalid, Farah Shahzad, Kashmala Zia, Ali Hassan, Muhammad Uzair Khan Niazi, Fahad Rahman, Saad Ahmed Waqas, Raheel Ahmed
Introduction
Vascular intestinal disorders (VID), including mesenteric ischemia, ischemic colitis, and intestinal angiodysplasia, have a global incidence of 8.11/100 000/year and a mortality of 1.26/100 000/year (15.5% death rate), rising from ~1% to ~3% in childhood to ~50% after 95 years. In the US, the incidence of acute vascular insufficiency of the intestine (AVII) is rising, warranting detailed trend analysis.
Methods
CDC WONDER death certificates (1999–2020) for adults > 25 years were analyzed using ICD-10 code N55. Age-adjusted mortality rates (AAMRs) per 100 000 were stratified by year, sex, race/ethnicity, and region. Joinpoint Regression (v5.2.0) calculated annual percent changes (APCs); significance was defined as p < 0.05.
Results
Overall AAMR declined from 9.35 (1999) to 5.81 (2020). Women had higher AAMRs (7.63; 95% CI: 7.6–7.66) than men (6.5; 95% CI: 6.49–6.56). By race/ethnicity, AAMRs were highest in NH American Indian (7.89; 95% CI: 7.57–8.21), NH Black (7.84; 95% CI: 7.75–7.9), NH White (7.25; 95% CI: 7.22–7.28), Hispanic (5.91; 95% CI: 5.83–6), and NH Asian (3.59; 95% CI: 3.5–3.68). Micropolitan areas had higher AAMRs (7.92) than metropolitan (6.99). Regional AAMRs were highest in the Midwest (7.7; 95% CI: 7.65–7.75), followed by South (7.17; 95% CI: 7.13–7.21), West (7.02; 95% CI: 6.96–7.07), and Northeast (6.85; 95% CI: 6.79–6.9). Kentucky had the highest state AAMR (9.67; 95% CI: 9.43–9.9), Hawaii the lowest (4.59; 95% CI: 4.31–4.87). Oklahoma, Rhode Island, Tennessee, West Virginia, and Wyoming ranked in the top 90th percentile.
Conclusion
Despite an overall decline, VID mortality remains high among women, NH American Indians, rural areas, and the Midwest—underscoring the need for targeted interventions.
{"title":"Trends and Demographics of Vascular Intestinal Diseases-Related Mortality Among Adults Living in United States From 1999 to 2020; A CDC Wonder Analysis","authors":"Muhammad Shahzad, Kanz Ul Eman Maryam, Ali Hashim, Amna Zaman Khan, Muhammad Abdullah Ali, Ahmed Yar Khan, Muhammad Younas, Syeda Sundus Shah Bokhari, Wania Khalid, Farah Shahzad, Kashmala Zia, Ali Hassan, Muhammad Uzair Khan Niazi, Fahad Rahman, Saad Ahmed Waqas, Raheel Ahmed","doi":"10.1002/jgh3.70267","DOIUrl":"https://doi.org/10.1002/jgh3.70267","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Vascular intestinal disorders (VID), including mesenteric ischemia, ischemic colitis, and intestinal angiodysplasia, have a global incidence of 8.11/100 000/year and a mortality of 1.26/100 000/year (15.5% death rate), rising from ~1% to ~3% in childhood to ~50% after 95 years. In the US, the incidence of acute vascular insufficiency of the intestine (AVII) is rising, warranting detailed trend analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>CDC WONDER death certificates (1999–2020) for adults > 25 years were analyzed using ICD-10 code N55. Age-adjusted mortality rates (AAMRs) per 100 000 were stratified by year, sex, race/ethnicity, and region. Joinpoint Regression (v5.2.0) calculated annual percent changes (APCs); significance was defined as <i>p</i> < 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall AAMR declined from 9.35 (1999) to 5.81 (2020). Women had higher AAMRs (7.63; 95% CI: 7.6–7.66) than men (6.5; 95% CI: 6.49–6.56). By race/ethnicity, AAMRs were highest in NH American Indian (7.89; 95% CI: 7.57–8.21), NH Black (7.84; 95% CI: 7.75–7.9), NH White (7.25; 95% CI: 7.22–7.28), Hispanic (5.91; 95% CI: 5.83–6), and NH Asian (3.59; 95% CI: 3.5–3.68). Micropolitan areas had higher AAMRs (7.92) than metropolitan (6.99). Regional AAMRs were highest in the Midwest (7.7; 95% CI: 7.65–7.75), followed by South (7.17; 95% CI: 7.13–7.21), West (7.02; 95% CI: 6.96–7.07), and Northeast (6.85; 95% CI: 6.79–6.9). Kentucky had the highest state AAMR (9.67; 95% CI: 9.43–9.9), Hawaii the lowest (4.59; 95% CI: 4.31–4.87). Oklahoma, Rhode Island, Tennessee, West Virginia, and Wyoming ranked in the top 90th percentile.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite an overall decline, VID mortality remains high among women, NH American Indians, rural areas, and the Midwest—underscoring the need for targeted interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70267","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038279","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}
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