---
title: "Gastroenterology Clinical Research Feed | MedicHelpline"
specialty: "Gastroenterology"
specialty_slug: "gastroenterology"
canonical_url: "https://medichelpline.com/clinical-feed/gastroenterology"
content_type: "clinical_feed_specialty"
page: 1
articles_in_batch: 30
generated_at: "2026-09-05T23:52:20.758Z"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Gastroenterology — Clinical Research Feed
## Specialty Overview: Gastroenterology
Latest peer-reviewed clinical trials, guidelines, and observational research in **Gastroenterology**, indexed and structured for clinical intelligence and AI reasoning.
## Latest Gastroenterology Publications
### 1. [Very low‑calorie diet reduces hepatic steatosis and remodels circulating metabolite–miRNA networks](https://medichelpline.com/clinical-feed/medrxiv-1-very-low-calorie-diet-reduces-hepatic-steatosis-and-remodels-circulating.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-04
- **Detail Markdown URL:** [Very low‑calorie diet reduces hepatic steatosis and remodels circulating metabolite–miRNA networks](https://medichelpline.com/clinical-feed/medrxiv-1-very-low-calorie-diet-reduces-hepatic-steatosis-and-remodels-circulating.md)

> **Executive GIST:** - Pilot study of an 8‑week **very low‑calorie diet (VLCD)** in women with obesity and metabolic dysfunction‑associated steatotic liver disease (MASLD) but without diabetes. The trial is registered as NCT04861571 and received IRB approval from the University of Iowa. - VLCD produced substantial weight loss (~11%) with approximately **80% adherence** and was reported as well tolerated. - Significant improvements were observed in body composition and cardiometabolic measures: reduced fat mass, smaller waist circumference, lower blood pressure, decreased insulinemia, improved HOMA‑IR, lower HbA1c, and reduced triglycerides. Liver enzyme levels did not change. - Hepatic steatosis decreased markedly as measured by a fall in **controlled attenuation parameter (CAP)**; liver stiffness remained unchanged. - Untargeted metabolomics showed elevated **ketone bodies** and broad reductions in circulating amino acids, consistent with increased fatty acid oxidation and a catabolic state. - Correlation analyses linked CAP improvements positively with reductions in amino acids and negatively with increases in ketone bodies and tricarboxylic acid (TCA) cycle intermediates. - Circulating microRNAs underwent selective remodeling; a limited subset changed strongly and associated with clinical metrics including CAP and HOMA‑IR. VLCD altered levels of **miR‑148a‑3p, miR‑140‑3p, miR‑10b‑5p,** and **miR‑345‑5p**. - Integrated multi‑omics identified coordinated metabolite–miRNA modules involving glucose metabolism, branched‑chain amino acid catabolism, mitochondrial metabolism, purine metabolism, microbial metabolites, and cellular redox pathways. - Authors conclude that VLCD‑induced improvement in hepatic steatosis is accompanied by coordinated remodeling of circulating metabolite–miRNA networks and propose these modules as candidate biomarkers of therapeutic response. - No competing interests declared. All study data are available from the authors on reasonable request.

### 2. [Gut microbiota alterations in flatulence point to Faecalibacterium prausnitzii as a clinical target](https://medichelpline.com/clinical-feed/pubmed-42689867.md)
- **Source:** PubMed / NCBI | **Published:** 2026-09-03 | DOI: [10.1080/19490976.2026.2728332](https://doi.org/10.1080%2F19490976.2026.2728332)
- **Detail Markdown URL:** [Gut microbiota alterations in flatulence point to Faecalibacterium prausnitzii as a clinical target](https://medichelpline.com/clinical-feed/pubmed-42689867.md)

> **Executive GIST:** - This PubMed entry reports a 2026 Gut Microbes research article titled “Gut microbiota and metabolic alterations in participants with flatulence identify Faecalibacterium prausnitzii as a key microbial target for clinical intervention.” - Article citation: Ruimin Chen et al.; Gut Microbes. 2026;18(1):2728332. DOI 10.1080/19490976.2026.2728332. PubMed ID (PMID) 42689867. - The paper is indexed with the publication type “Randomized Controlled Trial.” - Authors are affiliated with Jiangnan University (State Key Laboratory of Food Science and Resources; School of Food Science and Technology), the Department of Gastroenterology at the Affiliated Hospital of Jiangnan University, and the National Engineering Research Center for Functional Food. - The article title identifies **Faecalibacterium prausnitzii** as a key microbial target linked to gut microbiota and metabolic changes in people reporting **flatulence**. - The PubMed record includes bibliographic metadata (authors, affiliations, PMID, DOI, journal, Epub date) but the abstract and detailed study results are not present in the provided source text. - Because the source content available here does not include study methods, participant numbers, measured outcomes, statistical findings, or specific metabolic markers, those details were not reported and cannot be summarized. - The title implies a link between microbial composition, metabolic alterations, and symptomatic flatulence, suggesting potential translational interest in targeting **F. prausnitzii** for clinical intervention, but the source does not provide interventional protocols or clinical recommendations. - Relevant clinical and research implications include the potential for microbiome-targeted therapies in patients with flatulence and the need to review the full article for methods, results, and evidence strength before applying findings clinically. - Users are advised to consult the full PubMed/Gut Microbes article (DOI provided) for complete data, methodology, and conclusions, since the current record lacks the abstract and primary data in the provided extract.

### 3. [NLP detection of endoscopy-related adverse events: transformer vs rule-based accuracy in Turkish t](https://medichelpline.com/clinical-feed/bmj-open-5-natural-language-processing-for-detecting-endoscopy-related-adverse-events-in.md)
- **Source:** BMJ Open | **Published:** 2026-09-03
- **Detail Markdown URL:** [NLP detection of endoscopy-related adverse events: transformer vs rule-based accuracy in Turkish t](https://medichelpline.com/clinical-feed/bmj-open-5-natural-language-processing-for-detecting-endoscopy-related-adverse-events-in.md)

> **Executive GIST:** - This retrospective diagnostic accuracy study evaluated automated detection of **endoscopy-related adverse events (AEs)** from non-English free-text procedure reports at a tertiary endoscopy unit in Türkiye from August 2015 to August 2025. It compared a **rule-based** natural language processing (NLP) approach with a **transformer-based** NLP model for classifying index procedure reports by 30-day clinician-adjudicated AE status. - The source cohort contained 140,385 procedure reports. All 1,512 lexicon-positive and 2,000 randomly sampled lexicon-negative reports were clinician-adjudicated, yielding 1,208 AE-positive reports overall. A 13,333-report corpus was allocated at the patient level to training (n=9,333), validation (n=2,000) and a locked, fully adjudicated test set (n=2,000; 180 AE-positive). - The primary outcome was confirmation of an attributable AE within 30 days. Models used only the index report for classification; adjudication used subsequent documentation as well. - Diagnostic accuracy measures included **sensitivity**, **specificity**, positive and negative predictive values, F1 score, and transformer precision–recall area under the curve (**PR-AUC**). - The rule-based model achieved 84.4% sensitivity (95% CI 78.4%–89.0%) and 99.5% specificity (95% CI 99.1%–99.7%). The transformer model achieved higher sensitivity (92.2%, 95% CI 87.4%–95.3%; McNemar p=0.01) and 98.4% specificity (95% CI 97.7%–98.9%). - Positive predictive values were 94.4% (rule-based) and 85.1% (transformer); negative predictive values were 98.5% and 99.2%, respectively. Both models had F1 scores of 0.89. Transformer PR-AUC was 0.91 (95% CI 0.87–0.94). - The transformer reduced false negatives from 28 to 14 but increased false positives from 9 to 29 compared with the rule-based model. - Because lexicon-negative reports were only partially verified, the study did not estimate cohort-wide AE incidence. - Authors conclude both approaches had high specificity; the transformer traded fewer missed AEs for more false positives. Results support clinician-supervised retrospective case identification and quality assurance, but do not support autonomous diagnosis, prospective prediction, or point-of-care deployment. External validation is required.

### 4. [Cholesterol and p53 drive senescence and multiorgan fibrosis in MASH](https://medichelpline.com/clinical-feed/biorxiv-1-cholesterol-and-p53-promote-senescence-and-systemic-fibrosis-in-metabolic.md)
- **Source:** bioRxiv (Biomedical Preprints) | **Published:** 2026-09-03
- **Detail Markdown URL:** [Cholesterol and p53 drive senescence and multiorgan fibrosis in MASH](https://medichelpline.com/clinical-feed/biorxiv-1-cholesterol-and-p53-promote-senescence-and-systemic-fibrosis-in-metabolic.md)

> **Executive GIST:** - This study examines how hepatic **p53** activity and **cholesterol** influence fibrosis locally in the liver and systemically across organs during metabolic dysfunction-associated steatohepatitis (**MASH**). - Authors used an inducible mouse model that stabilises p53 via loss of the MDM2 E3 ubiquitin ligase, diet-induced MASH models with varying cholesterol content, and an in vitro obesogenic liver spheroid system to probe mechanisms. - Hepatocellular stabilisation of p53 (MDM2 E3 loss) produced progressive liver fibrosis, strong hepatocellular expression of the p53 target **CDKN1A/p21**, and induced **p21** expression and fibrosis in the kidneys of male mice, demonstrating a sex-specific effect. - Diet-induced MASH with cholesterol reproduced similar findings: cholesterol- and p53-dependent hepatic fibrosis, elevated hepatocellular **p21**, and induction of **p21** and fibrosis in male kidneys; lungs and heart also showed fibrosis in male MASH mice. - Both a cholesterol-free obesogenic diet and liver-specific loss of p53 reduced hepatic fibrosis and prevented systemic induction of **p21** and fibrosis, implicating hepatic p53 and dietary cholesterol in driving multi-organ fibrotic responses. - Mechanistic data indicate p53 promotes hepatic expression of senescence-associated secretory phenotype (SASP) factors, including **GDF15**, in vivo; human multicomponent LiverACE spheroids showed a trend to increased GDF15 protein with steatotic stress. - In human MASH datasets, circulating **GDF15** was elevated in advanced disease and correlated with markers (TNFRSF1A, EPHA2) previously linked to kidney injury, suggesting potential circulating biomarkers for at-risk patients. - The work highlights undue hepatic p53 activity as a driver of multiorgan fibrosis in a sex-specific (male) manner and implicates cholesterol as a promoter of this pro-fibrotic environment. Details such as quantitative effects, exact sample sizes, and statistical measures were not reported in the summary available.

### 5. [Housing-Based SES (HOUSES) and Geospatial Targeting to Improve Colorectal Cancer Screening in Rura](https://medichelpline.com/clinical-feed/medrxiv-9-from-housing-to-hotspots-integrating-a-housing-based-measure-of-individual.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-02
- **Detail Markdown URL:** [Housing-Based SES (HOUSES) and Geospatial Targeting to Improve Colorectal Cancer Screening in Rura](https://medichelpline.com/clinical-feed/medrxiv-9-from-housing-to-hotspots-integrating-a-housing-based-measure-of-individual.md)

> **Executive GIST:** - This study evaluated the association between a validated housing-based individual socioeconomic status measure called **HOUSES** and adherence to **colorectal cancer (CRC)** screening among rural Mayo Clinic Midwest patients in 2019. - The sample included 34,489 individuals with a median age of 64.0 years and 52.4% female. CRC screening adherence was compared across HOUSES quartiles, adjusting for demographics, comorbidity, distance to clinic, and area-level deprivation. - Using multilevel mixed-effects logistic regression, those in the lowest SES category (HOUSES Q1) had 37% lower odds of CRC screening adherence than those in the highest category (HOUSES Q4) (adjusted OR 0.63, 95% CI 0.58–0.69). - Geospatial analyses identified 14 geographic hotspots with concentrations of HOUSES Q1 residents; counts of HOUSES Q1 and low CRC screening in these hotspots were strongly correlated (correlation coefficient = 0.81), indicating co-location of low SES and low screening. - The authors conclude that lower **socioeconomic status (SES)** is significantly associated with lower CRC screening in rural populations and that **HOUSES-enabled geospatial analysis** can identify target areas for interventions. - The study used patients living in cities without ready access to routine care within the Mayo Clinic Health System as a proxy for rural communities and applied adjustment covariates including age, sex, race/ethnicity, comorbidity, distance from home to clinic, and area deprivation index. - Data are not publicly available due to protected health information. The study had Mayo Clinic IRB approval (IRB #19-009328) and reported no competing interests. - Funding sources included the National Institute on Aging (R21AG65639), the National Heart, Lung, and Blood Institute (R01HL171508), the National Center for Advancing Translational Sciences (UL1 TR002377), and the Mayo Clinic HOUSES Program.

### 6. [Hiatal Hernia Size and Risk of De Novo GERD After Sleeve Gastrectomy: Single-Center Retrospective](https://medichelpline.com/clinical-feed/medrxiv-2-hiatal-hernia-size-and-de-novo-gastroesophageal-reflux-disease-after-sleeve.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-02
- **Detail Markdown URL:** [Hiatal Hernia Size and Risk of De Novo GERD After Sleeve Gastrectomy: Single-Center Retrospective](https://medichelpline.com/clinical-feed/medrxiv-2-hiatal-hernia-size-and-de-novo-gastroesophageal-reflux-disease-after-sleeve.md)

> **Executive GIST:** - This single-center retrospective study examined whether **preoperative hiatal hernia size** is associated with development of de novo gastroesophageal reflux disease (GERD) after sleeve gastrectomy. - The cohort included 56 patients who underwent sleeve gastrectomy between 2018 and 2025 at Hospital Central Norte de Petróleos Mexicanos; mean age was 48.3 ± 8.1 years and 67.9% were male. - Hiatal hernia size was classified endoscopically as small ( 4 cm); classification was conclusive in 46 patients (82.1%). - Among those classified, 63.0% had no hernia, 4.3% had a small hernia, 30.4% had a medium hernia, and 2.2% had a large hernia. - De novo GERD occurred in 14.0% of patients without preexisting GERD (6 of 43 patients). - Statistical analysis (Fisher’s exact test, odds ratios with 95% CI, and binary logistic regression) found no significant association between hiatal hernia size and de novo GERD (Fisher p = 0.515). - In a reduced logistic regression model, medium/large hernia versus absent/small hernia had OR 3.47 (95% CI 0.50–29.43; p = 0.207); age had OR 1.02 (95% CI 0.90–1.13; p = 0.754); neither reached significance. - Other evaluated factors (sex, smoking, alcohol) also did not reach statistical significance for association with de novo GERD. - Authors note the low number of outcome events limits power to exclude a clinically meaningful association and emphasize a likely multifactorial mechanism for post‑sleeve GERD. - The study calls for prospective studies with larger samples and standardized reflux assessment methods to confirm these findings.

### 7. [Reduced memory B-cell and antibody responses to mRNA COVID-19 boosters in IBD patients on anti-TNF](https://medichelpline.com/clinical-feed/medrxiv-16-impaired-memory-b-cell-formation-after-mrna-based-covid-19-booster-vaccination.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-02
- **Detail Markdown URL:** [Reduced memory B-cell and antibody responses to mRNA COVID-19 boosters in IBD patients on anti-TNF](https://medichelpline.com/clinical-feed/medrxiv-16-impaired-memory-b-cell-formation-after-mrna-based-covid-19-booster-vaccination.md)

> **Executive GIST:** - Study compared antibody and **memory B cell (Bmem)** responses after mRNA COVID-19 booster vaccination in 27 inflammatory bowel disease (IBD) patients receiving intravenous **anti-TNF** therapy and 44 control participants. Blood was sampled at baseline, 1 month and 6 months post-booster. - Boosters administered were WH1/BA.5 **bivalent** or XBB.1.5 **monovalent** mRNA vaccines. Measurements included neutralizing antibody titers (infectious virus assay), RBD-specific serum IgG by ELISA, and flow cytometric immunophenotyping of RBD-specific Bmem to ancestral and Omicron subvariants (BA.1, BA.5, XBB.1.5, JN.1). - Serum RBD-specific **IgG** and neutralizing antibodies rose from baseline to 1 month after vaccination in anti-TNF patients, but absolute levels were lower than in controls. - Frequencies of RBD-specific **Bmem** recognizing ancestral, BA.5 and XBB.1.5 increased after vaccination in both groups but were significantly lower in anti-TNF-treated patients compared with controls. - The proportion of recently activated CD21lo RBD-specific Bmem increased after vaccination in both groups and was higher in anti-TNF patients than in controls, indicating altered activation phenotype. - Isotype distribution within antigen-specific Bmem differed: fewer antigen-specific Bmem in anti-TNF patients expressed **IgG4**, while more expressed **IgG3** or **IgD** after vaccination. - Vaccination increased the proportion of RBD-specific Bmem that cross-recognized multiple variants overall, but anti-TNF-treated patients had fewer Bmem capable of binding Omicron subvariants compared with controls, indicating reduced cross-reactivity. - Authors conclude that anti-TNF therapy in IBD is associated with reduced magnitude, durability and cross-reactivity of antibody and memory B-cell responses to COVID-19 boosters, suggesting impaired immune memory and supporting annual booster recommendations to prevent severe disease and transmission. - The work is a preprint (not peer reviewed). Ethics approvals were reported from Alfred Health, Monash University and Erasmus MC. Funded by the Australian Medical Research Future Fund (2016108).

### 8. [Fatigue Burden in Compensated Chronic Liver Disease: Multinational a:GAP Survey Findings](https://medichelpline.com/clinical-feed/medrxiv-0-burden-of-fatigue-in-compensated-chronic-liver-disease-findings-from-the.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-02
- **Detail Markdown URL:** [Fatigue Burden in Compensated Chronic Liver Disease: Multinational a:GAP Survey Findings](https://medichelpline.com/clinical-feed/medrxiv-0-burden-of-fatigue-in-compensated-chronic-liver-disease-findings-from-the.md)

> **Executive GIST:** - This multinational cross-sectional a:GAP survey assessed the burden of **fatigue** in adults with compensated **chronic liver disease (CLD)** in China, India and Mexico between July and November 2024. - A total of 505 participants (China 200, India 200, Mexico 105) who self-reported physician‑diagnosed CLD and current fatigue completed quantitative assessments. - The survey combined symptom burden questions with validated patient‑reported outcome (PRO) instruments: **PROMIS-29+2**, **WPAI: SHP**, and **MFI** to quantify fatigue, mental health, pain, sleep interference and work/activity impairment. - Participants commonly reported moderate (51.3%) or serious (26.9%) fatigue; 33.5% experienced fatigue every day or almost every day. - Fatigue affected self‑esteem/confidence (45.1%) and ability to maintain or obtain employment (38.6%); many reported negative effects on social life (47.3%) and finances (53.9%). - PRO results indicated severe fatigue on the **MFI** (overall mean general fatigue 13.9 [SD 3.4]; physical fatigue 13.4 [SD 3.6]) and substantial work and activity impairment on **WPAI: SHP** (overall mean 53.0 [SD 26.4]). - **PROMIS** T-scores showed elevated anxiety, pain interference, depression and sleep interference (T-scores ≥54). - The authors conclude that **fatigue** substantially reduces **health-related quality of life (HRQoL)** among adults with compensated CLD across countries and identify a global unmet need for targeted identification and management. - The study was funded by Abbott Products Operations AG, approved by country-specific ethics committees, and is a preprint not yet peer reviewed.

### 9. [RAR-modified SOFA score predicts 28-day mortality in acute pancreatitis: MIMIC‑IV retrospective st](https://medichelpline.com/clinical-feed/plos-one-3-correlation-of-red-cell-distribution-width-to-albumin-ratio-combined-with-sofa.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-09-01
- **Detail Markdown URL:** [RAR-modified SOFA score predicts 28-day mortality in acute pancreatitis: MIMIC‑IV retrospective st](https://medichelpline.com/clinical-feed/plos-one-3-correlation-of-red-cell-distribution-width-to-albumin-ratio-combined-with-sofa.md)

> **Executive GIST:** - This retrospective study used the MIMIC‑IV (v3.1) database to evaluate whether combining the **red cell distribution width‑to‑albumin ratio (RAR)** with the **SOFA** score improves prediction of **28‑day all‑cause mortality** in ICU patients with acute pancreatitis (AP). - From 2008–2022 MIMIC‑IV admissions, 702 adult ICU patients with AP met inclusion criteria after excluding repeat ICU admissions, ICU stay <24 hours, and missing RDW, albumin, or SOFA data. - The primary analysis used univariate and multivariate Cox regression to test the RAR‑modified SOFA score as an independent risk factor for 28‑day mortality. - The optimal cutoff for the combined indicator was identified using the Youden index; Kaplan‑Meier survival curves compared high and low groups defined by that cutoff. - ROC curve analysis showed the **RAR‑modified SOFA score** had better discriminatory performance than RAR or SOFA alone for predicting 28‑day mortality. - A RAR‑modified SOFA score threshold of **12.69** separated higher from lower risk: the high‑value group (≥12.69) had significantly higher 28‑day mortality by K‑M analysis. - Subgroup analyses were conducted to assess robustness across different patient populations; the RAR‑modified SOFA score remained an independent predictor in adjusted models. - The authors conclude that integrating RAR (a marker of inflammation/nutritional status) with the organ dysfunction–focused SOFA score yields a simple, more accurate prognostic indicator for short‑term mortality in AP ICU patients. - Data source, cohort selection process, statistical approaches (Cox regression, ROC, Youden index, Kaplan‑Meier), and the key cutoff value are reported in the source. No additional external data or recommendations were provided.

### 10. [Fluconazole reduces gut Candida and reshapes the microbiome in IBD with oral thrush](https://medichelpline.com/clinical-feed/nature-2-antifungal-therapy-improves-microbiome-dynamics-in-inflammatory-bowel-disease.md)
- **Source:** Nature Medicine | **Published:** 2026-09-01
- **Detail Markdown URL:** [Fluconazole reduces gut Candida and reshapes the microbiome in IBD with oral thrush](https://medichelpline.com/clinical-feed/nature-2-antifungal-therapy-improves-microbiome-dynamics-in-inflammatory-bowel-disease.md)

> **Executive GIST:** - This prospective observational study enrolled 53 patients with mild-to-moderate ulcerative colitis or Crohn’s disease who had mild oral thrush, a condition linked to Candida overgrowth. - Patients were assigned to oral nystatin fungal targeting (ORNT; swish-and-spit nystatin; n = 18) or gastrointestinal and oral fluconazole fungal targeting (GIFT; fluconazole; n = 35). - **Fluconazole**, but not **nystatin**, significantly reduced intestinal **Candida** burden and altered overall gut fungal-community composition. - Fluconazole treatment was associated with increased bacterial diversity and expansion of **short-chain-fatty-acid-producing taxa**, notably butyrate producers. - Metabolomics showed restoration of anti-inflammatory microbial metabolites in fluconazole-treated patients and identified metabolite modules linked to specific fungal taxa and treatment types. - Cross-kingdom microbial network analyses revealed durable shifts after fluconazole, indicating altered fungus–bacterium interactions. - Clinical measures improved with fluconazole: disease activity indices improved and the risk of disease progression decreased over an 8-week follow-up period; such benefits were not observed with nystatin. - The study supports feasibility of **mycobiome**-based patient stratification and suggests targeted antifungal cotherapy can reshape the intestinal microbiota in IBD patients with fungal-associated manifestations. - Raw sequencing data are available through NCBI SRA (BioProject PRJNA1449485); supplementary tables provide clinical, sequencing, bacterial abundance, and metabolomics data. Analysis code is available on GitHub and archived on Zenodo. - Additional individual-level clinical data are restricted for privacy and IRB reasons; requests can be directed to the corresponding author under institutional requirements.

### 11. [Probiotics Speed Microbiota and Metabolic Pathway Recovery After PEG Bowel Prep in Ulcerative Coli](https://medichelpline.com/clinical-feed/pubmed-42678923.md)
- **Source:** PubMed / NCBI | **Published:** 2026-09-01 | DOI: [10.12659/MSM.953589](https://doi.org/10.12659%2FMSM.953589)
- **Detail Markdown URL:** [Probiotics Speed Microbiota and Metabolic Pathway Recovery After PEG Bowel Prep in Ulcerative Coli](https://medichelpline.com/clinical-feed/pubmed-42678923.md)

> **Executive GIST:** - This randomized, single-center, open-label trial (ChiCTR2200064456) enrolled 79 adults undergoing colonoscopy: **40 healthy controls** and **39 patients with ulcerative colitis (UC)**. - All participants received polyethylene glycol (PEG)-based bowel preparation before colonoscopy, which induced a measurable disruption in gut microbial diversity and composition. - Fecal samples were collected at baseline and on days 2, 14, and 28; microbial profiling used 16S rRNA gene sequencing to assess diversity, composition, and predicted functional pathways. - Healthy controls experienced a significant but generally reversible decline in alpha diversity and altered beta diversity after bowel prep, with gradual recovery by day 28. - Patients with **UC** had lower baseline diversity and showed delayed microbiota recovery compared with healthy controls. - Participants were randomized to receive **probiotics** or no probiotics for 28 days post-colonoscopy; probiotic supplementation produced modest microbial recovery in healthy subjects and more pronounced improvements in patients with UC. - In UC patients receiving probiotics, measures of **Shannon diversity** and evenness improved; taxa associated with **short-chain fatty acid (SCFA)** production (including **Faecalibacterium, Blautia,** and **Lachnospiraceae**) were enriched. - Probiotics were also associated with reductions in potentially pathogenic groups such as **Proteobacteria** and **Fusobacteria**. - Predicted microbial functional pathways related to energy metabolism and nucleotide biosynthesis were transiently suppressed after bowel preparation and partially recovered over time. - The study concludes that PEG-based bowel prep causes reversible microbiota disruption with slower recovery in UC, and that post-colonoscopy probiotic supplementation is associated with improved microbial diversity and enrichment of beneficial taxa, particularly in UC patients. - Specific probiotic strains, dosing, safety outcomes beyond microbial measures, and detailed statistical metrics were not reported in the abstract and thus are not available from this source.

### 12. [Submucosal Lidocaine vs Saline for Colonic Endoscopic Submucosal Dissection: Randomized Double-Bli](https://medichelpline.com/clinical-feed/pubmed-42666074.md)
- **Source:** PubMed / NCBI | **Published:** 2026-09-01 | DOI: [10.1111/den.70272](https://doi.org/10.1111%2Fden.70272)
- **Detail Markdown URL:** [Submucosal Lidocaine vs Saline for Colonic Endoscopic Submucosal Dissection: Randomized Double-Bli](https://medichelpline.com/clinical-feed/pubmed-42666074.md)

> **Executive GIST:** - This single-center, double-blind, randomized controlled trial evaluated whether **submucosal lidocaine injection** reduces technical difficulty during **colonic endoscopic submucosal dissection (ESD)** by addressing colonic spasm. - A total of **110 patients** scheduled for colonic ESD were randomized to either the lidocaine group or a control group. - The lidocaine arm received **1% lidocaine with 0.6% sodium alginate** for submucosal injection; the control arm received **saline with 0.6% sodium alginate**. - The predefined **primary outcome** was **procedure time**. Secondary outcomes were mentioned but the abstract text in the provided source is truncated and does not report them in full. - The trial is reported as double-blind and randomized at a single center and published in Dig Endosc (Sep 2026) with PMID 42666074 and DOI 10.1111/den.70272. - Authors and affiliations are from the Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Kyoto University Graduate School of Medicine, and The University of Osaka Graduate School of Medicine. - The provided source abstract is incomplete: details on secondary outcomes, numerical results, statistical findings, adverse events, and conclusions are not reported in the supplied text. - Because the supplied source is truncated, no efficacy or safety results, effect sizes, or authors’ conclusions can be stated here beyond the trial design and interventions.

### 13. [Acetate- vs Lactate-Buffered Crystalloids to Prevent Post-ERCP Pancreatitis: Multicentre Double-Bl](https://medichelpline.com/clinical-feed/pubmed-42640715.md)
- **Source:** PubMed / NCBI | **Published:** 2026-09-01 | DOI: [10.1002/ueg2.70281](https://doi.org/10.1002%2Fueg2.70281)
- **Detail Markdown URL:** [Acetate- vs Lactate-Buffered Crystalloids to Prevent Post-ERCP Pancreatitis: Multicentre Double-Bl](https://medichelpline.com/clinical-feed/pubmed-42640715.md)

> **Executive GIST:** - This is a multicentre, double-blind, randomized controlled trial comparing **acetate-buffered** and **lactate-buffered** crystalloid solutions for prevention of **post-ERCP pancreatitis** in patients who do not have access to **rectal NSAIDs**. - The trial is reported in United European Gastroenterol J (2026 Sep;14[7]:e70281). DOI: 10.1002/ueg2.70281; PMID: 42640715; PMCID: PMC13505811. - Lead and coauthors include Woo Hyun Paik, Gunn Huh, Young Hoon Choi and a multicentre author group from institutions in the Republic of Korea and the United States (Seoul National University Hospital, Asan Medical Center, Samsung Medical Center, Cleveland Clinic, MetroHealth, University of Colorado School of Medicine, among others). - The publication is described as a randomized controlled trial; the paper title and metadata indicate double-blinding and multicentre recruitment. - The central clinical question is whether the choice of buffer in intravenous crystalloid (acetate versus lactate) influences rates of **post-ERCP pancreatitis** when **rectal NSAIDs** are not available. - Source record provides bibliographic and authorship details but the provided PubMed page content does not include the trial abstract text, numerical results, specific methods, inclusion/exclusion criteria, sample size, endpoints, statistical analyses, safety data, or conclusions. - Because the abstract and full trial data are not present in the provided source text, specific outcomes, effect sizes, and authors' conclusions are not reported here. Those details are available only in the full text (linked on Wiley and PMC) and are not included in the PubMed content supplied. - The trial appears indexed and accessible via PubMed Central (free full text), indicating the full report can be consulted for complete methodology, results, and clinical implications.

### 14. [Hepatology Update: Key Topics from the First Paris International Liver Meeting 2026](https://medichelpline.com/clinical-feed/pubmed-42613687.md)
- **Source:** PubMed / NCBI | **Published:** 2026-09-01 | DOI: [10.1111/liv.70806](https://doi.org/10.1111%2Fliv.70806)
- **Detail Markdown URL:** [Hepatology Update: Key Topics from the First Paris International Liver Meeting 2026](https://medichelpline.com/clinical-feed/pubmed-42613687.md)

> **Executive GIST:** - This article is a conference summary published in Liver International (Sep 2026, 46[9]:e70806; doi:10.1111/liv.70806) reporting highlights from the First Annual Paris International Liver Meeting 2026. - The summary addresses emerging paradigms across major hepatology domains: **MASLD**, **Viral Hepatitis**, **Cholestatic Liver Disease**, **Portal Hypertension**, and **Hepatocellular Carcinoma**. - The work is a multi-author review with a large international author group representing academic liver centres and research networks across Europe, North America and Asia; affiliations are listed in the PubMed entry. - The article functions as a meeting synthesis rather than a primary study report; the PubMed page links to the full text on Wiley and to a free PMC full text for complete details. - Specific study results, trial outcomes, numerical data or detailed recommendations from the meeting are not reported in the PubMed abstract view; readers are referred to the full-text article for granular content. - The summary reflects multidisciplinary contributions spanning clinical hepatology, hepatobiliary oncology, liver transplantation and population-level liver outcomes and policy research. - The Paris meeting is described as the first annual edition; the summary aggregates expert perspectives and highlights on evolving diagnostic and therapeutic paradigms in liver disease. - Because the PubMed abstract and page excerpt do not include the meeting’s granular findings, recommendations, or specific new evidence, those details must be retrieved from the linked full text (PMC/Wiley) for clinical use.

### 15. [Ethical imperatives in global nutrition care: addressing inequities in gastroenterology](https://medichelpline.com/clinical-feed/pubmed-42093244.md)
- **Source:** PubMed / NCBI | **Published:** 2026-09-01 | DOI: [10.1097/MCO.0000000000001231](https://doi.org/10.1097%2FMCO.0000000000001231)
- **Detail Markdown URL:** [Ethical imperatives in global nutrition care: addressing inequities in gastroenterology](https://medichelpline.com/clinical-feed/pubmed-42093244.md)

> **Executive GIST:** - Malnutrition related to disease, termed **disease-related malnutrition (DRM)**, is a major and continuing concern among patients with digestive disorders and is especially prevalent in gastrointestinal and oncological settings. - Recent data indicate DRM affects approximately **30–50% of hospitalized patients**, highlighting a large, neglected clinical problem. - Educational attainment has emerged as a **super-determinant of diet quality**, with stronger effects on nutritional outcomes than income alone. - Major systemic barriers persist: mandatory nutritional screening is often unavailable across care settings, and a pervasive knowledge gap exists among healthcare professionals regarding identification and management of DRM. - The Cartagena and Vienna Declarations have framed nutritional care as a **human right**, creating new legal and ethical grounds for action at policy and clinical levels. - Integrating nutritional care into **Universal Health Coverage (UHC)** and mandating standardized screening and diagnosis using the **Global Leadership Initiative on Malnutrition (GLIM)** criteria are recommended core actions to reduce inequities. - Strategic alternatives to bridge gaps include **educational reform** for health professionals, formation of **interdisciplinary support teams**, and efforts to **empower patients** in nutrition decisions. - Ensuring equitable access to medical nutrition is presented as essential to uphold human dignity and to fulfill the right to health for people with gastrointestinal diseases. - The review emphasizes the ethical imperative to align duty-bearers and rights-holders in nutritional care and to translate human-rights declarations into actionable clinical and policy measures.

### 16. [Project ECHO telelearning for chronic intestinal failure: pilot patient-facing program](https://medichelpline.com/clinical-feed/medrxiv-9-project-echo-for-patients-with-chronic-intestinal-failure-empowering-people.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-08-28
- **Detail Markdown URL:** [Project ECHO telelearning for chronic intestinal failure: pilot patient-facing program](https://medichelpline.com/clinical-feed/medrxiv-9-project-echo-for-patients-with-chronic-intestinal-failure-empowering-people.md)

> **Executive GIST:** - This pilot evaluated a patient-facing adaptation of **Project ECHO** for people living with **chronic intestinal failure** (CIF), a rare condition requiring complex **parenteral nutrition** or intravenous fluids via central venous catheter. - The intervention, termed PIF-ECHO, offered 12 weekly sessions via Zoom connecting 19 adult patients and family caregivers with multidisciplinary intestinal failure experts and patient advocates between April and July 2026. - All 19 participants completed a post-intervention questionnaire; 16 took part in three virtual focus groups. Mixed methods evaluation used the Theoretical Framework of Acceptability across seven domains and iterative thematic analysis of qualitative data. - Participants reported strong or very strong agreement that sessions were accessible, enjoyable, worthwhile, and improved understanding of CIF and its management. - Reported benefits included increased confidence for self-advocacy, improved disease and therapy self-management, better well-being, and reduced emotional strain due to supportive resources and knowledge gained. - Interaction with facilitators, expert presenters, and peers was described as positive, non-judgemental, validating, and respectful; participants perceived the program as distinct from existing peer-led support groups. - Four patient advocates with lived experience contributed to program design, recruitment, presentation, analysis, and logic-model refinement and are co-authors on the report. - Ethical approvals were obtained from BRANY IRB (STUDY-24-01292, Nov 12, 2025) and New York Academy of Medicine IRB (#011426, Jan 20, 2026). The study was funded by AHRQ (1R03HS030321-01). - The authors conclude the PIF-ECHO model is feasible, acceptable, and appears to yield short- and medium-term benefits; they suggest the model could be applied to other rare diseases. - Details on longer-term outcomes, comparator groups, or scalability metrics beyond the pilot were not reported in the source.

### 17. [Patient and Carer Perspectives on Virtual Hospital Pathways After Colorectal Surgery](https://medichelpline.com/clinical-feed/medrxiv-15-beyond-length-of-stay-patient-and-carer-perspectives-on-virtual-hospital.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-08-27
- **Detail Markdown URL:** [Patient and Carer Perspectives on Virtual Hospital Pathways After Colorectal Surgery](https://medichelpline.com/clinical-feed/medrxiv-15-beyond-length-of-stay-patient-and-carer-perspectives-on-virtual-hospital.md)

> **Executive GIST:** - This PPIE consultation explored experiences of **virtual hospital (VH)** pathways after colorectal resection, using one 90-minute Microsoft Teams session with eight participants (seven patients, one carer). - Participants were purposively sampled to include 50% who had experienced **readmission** after early discharge. - Reflexive thematic analysis identified seven themes: **readmission**, **remote monitoring**, **carer burden**, **recovery**, **equity**, **readiness for discharge**, and **information delivery**. - Patients generally accepted early discharge when **remote monitoring** allowed timely detection of complications and when readmission routes were efficient. - Readmission was viewed as appropriate escalation and not a failure of the VH pathway; dissatisfaction related mainly to delays in emergency care during readmission. - Remote monitoring provided psychological safety; patients reported feeling ‘held’ at home because of ongoing surveillance. - Carers often undertook substantial, sometimes unrecognised, quasi-clinical roles in supporting recovery at home. - Recovery was defined by return to functional activities rather than the numerical **length of stay**. - Equity concerns included reliance on home support, digital literacy, and language proficiency—factors that may advantage some patients for VH participation. - Discharge readiness encompassed both clinical indicators and psychological preparedness. - Information given at discharge was frequently poorly retained; participants recommended reinforcement of information preoperatively and at multiple encounters for patients and carers. - Authors conclude VH pathways are acceptable and valued, with scalable implementation dependent on psychological preparedness, carer support, and equitable access. - The study was conducted as a service evaluation at West Hertfordshire Teaching Hospitals NHS Trust and did not require formal NHS Research Ethics Committee approval; informed consent and recording consent were obtained.

### 18. [Illness perceptions linked to symptoms and gastric electrophysiology in functional dyspepsia and c](https://medichelpline.com/clinical-feed/medrxiv-9-associations-between-illness-perceptions-reported-symptoms-and-gastric.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-08-26
- **Detail Markdown URL:** [Illness perceptions linked to symptoms and gastric electrophysiology in functional dyspepsia and c](https://medichelpline.com/clinical-feed/medrxiv-9-associations-between-illness-perceptions-reported-symptoms-and-gastric.md)

> **Executive GIST:** - This preprint evaluated how patients' **illness perceptions** relate to reported symptoms, mental health, quality of life, and gastric electrophysiology in functional dyspepsia (FD) and chronic nausea and vomiting syndrome (CNVS). - The study included 309 patients (80% female; median age 36, range 15–88) who met self-reported Rome IV criteria for FD and/or CNVS. - Gastric electrophysiology was recorded using **body surface gastric mapping (BSGM)** with **Gastric Alimetry**: 30-minute fasting baseline, a 482 kCal test meal, and 4-hour postprandial recording with symptom logging. - Patient-level electrophysiologic phenotypes were assigned using established rule-based criteria via the **Auckland Classification**. - Illness perceptions were measured with the Brief Illness Perceptions Questionnaire; validated psychological and quality-of-life instruments were also used. - Patients reported highly negative illness perceptions that correlated significantly with worse gastrointestinal symptoms, poorer quality of life, and worse mental health; correlations had medium-to-large effect sizes. - In multivariable analyses, perceived **consequences** and **emotional response** to illness were the strongest predictors of patient-reported outcomes. - Illness perceptions significantly mediated the relationship between mental health and gastrointestinal symptoms, with large effect sizes. - Objective electrophysiology associations were limited: **BMI-Adjusted Amplitude** correlated with poorer perceived treatment control and greater emotional response. - The Continuous Phenotype (normal spectral activity with continuous symptoms) was associated with worse illness perceptions (higher perceived consequences, symptom identity, concern, emotional response); the High Frequency Phenotype was associated with lower illness understanding. - Authors propose that **illness perceptions** are a quantifiable component of the illness experience in FD and CNVS and recommend incorporating perception assessment into multidisciplinary care, including targeted education and interventions to address maladaptive beliefs. - Ethical approvals were obtained from multiple institutional committees; competing interests include company affiliations and intellectual property related to gastric electrophysiology. Deidentified data available on request.

### 19. [Baseline gut microbial diversity predicts response to paraprobiotic Lactiplantibacillus plantarum](https://medichelpline.com/clinical-feed/pubmed-42640624.md)
- **Source:** PubMed / NCBI | **Published:** 2026-08-26 | DOI: [10.1080/19490976.2026.2722835](https://doi.org/10.1080%2F19490976.2026.2722835)
- **Detail Markdown URL:** [Baseline gut microbial diversity predicts response to paraprobiotic Lactiplantibacillus plantarum](https://medichelpline.com/clinical-feed/pubmed-42640624.md)

> **Executive GIST:** - The study tested whether baseline **gut microbial diversity** influences clinical, microbiome, and metabolic responses to a paraprobiotic derived from **Lactiplantibacillus plantarum** LRCC5282 (LP5282-P) in overweight adults. - Design: 12-week, randomized, double-blind, placebo-controlled, multicenter trial with 120 overweight participants; outcomes reported for the per-protocol population. - Across the overall per-protocol cohort, LP5282-P produced no significant between-group differences in clinical outcomes. - In a predefined or post hoc **low-diversity** subgroup, LP5282-P was associated with significant reductions in body weight, body mass index, and circulating **leptin** levels. - Those clinical improvements in the low-diversity group coincided with gut microbiota compositional shifts, including higher relative abundances of **Christensenellaceae**, **Faecalibacterium**, and **Alistipes**. - Fecal metabolite profiling in the low-diversity subgroup showed increased **acetate** and **butyrate** concentrations and changes in bile acid composition. - Within the low-diversity subgroup, changes in **Akkermansia** and **Eubacterium** abundances were inversely correlated with changes in body weight, body fat mass, and leptin. - The **high-diversity** subgroup did not show consistent responses across clinical, microbiome, or metabolic outcomes. - Authors conclude that baseline gut microbial diversity is associated with differential responsiveness to LP5282-P and may serve as a stratification variable in future microbiota-targeted trials; they call for studies that integrate direct measures of microbial activity and host response. - Trial registration: Clinical Research Information Service (CRIS), KCT0008119.

### 20. [Author correction: Survodutide in adults with obesity and MASLD — SYNCHRONIZE‑MASLD phase 3 trial](https://medichelpline.com/clinical-feed/nature-1-author-correction-survodutide-in-adults-with-obesity-and-metabolic-dysfunction.md)
- **Source:** Nature Medicine | **Published:** 2026-08-25
- **Detail Markdown URL:** [Author correction: Survodutide in adults with obesity and MASLD — SYNCHRONIZE‑MASLD phase 3 trial](https://medichelpline.com/clinical-feed/nature-1-author-correction-survodutide-in-adults-with-obesity-and-metabolic-dysfunction.md)

> **Executive GIST:** - This document is an **Author Correction** to the SYNCHRONIZE‑MASLD phase 3 trial report of **survodutide** in adults with obesity and metabolic dysfunction‑associated steatotic liver disease (MASLD). - The Original Article was published online 7 June 2026 (DOI: 10.1038/s41591-026-04479-3); the correction notice was published 25 August 2026. - Corrections to the author list: Juan M. Pericás and Michael Zimmerman were omitted from the SYNCHRONIZE‑MASLD Investigators list and have been added. - Corrections to author name and affiliation: Antonio Olveira was originally listed with an incorrect surname (reported as Antonio O. Martin) and an incorrect additional affiliation; this has been corrected to Antonio Olveira with the appropriate affiliation. - Correction to an affiliation for Rizwana Mohseni: an incorrect second affiliation was previously listed and has been corrected. - Text correction in the Results “Participants” section: a typographical error was fixed so the sentence now reads that treatment discontinuation occurred at similar frequency in the **survodutide** (41.1% (60/146)) and placebo (40.0% (28/70)) arms; the denominator originally printed as “72” is now corrected to “70.” - Figure caption correction: in the caption to Extended Data Fig. 5 the timepoint label was changed from “week 48” to “week 52.” - The corrections have been implemented in both the HTML and PDF versions of the article. - The correction notice lists the full author and affiliation details and identifies that the changes apply to the published record of the SYNCHRONIZE‑MASLD Investigators and the Original Article metadata.

### 21. [Holmium Laser Lithotripsy for Bile Duct Stones in Elderly Patients: A Study on Efficacy and Safety](https://medichelpline.com/clinical-feed/plos-one-17-percutaneous-transhepatic-cholangioscopy-guided-holmium-laser-lithotripsy-for.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-08-24
- **Detail Markdown URL:** [Holmium Laser Lithotripsy for Bile Duct Stones in Elderly Patients: A Study on Efficacy and Safety](https://medichelpline.com/clinical-feed/plos-one-17-percutaneous-transhepatic-cholangioscopy-guided-holmium-laser-lithotripsy-for.md)

> **Executive GIST:** - This study assesses the use of **percutaneous transhepatic endoscopic holmium laser lithotripsy (PTEHL)** for treating biliary stones in patients aged 80 and above. - A total of 50 elderly patients with intra- and/or extrahepatic bile duct stones were evaluated, achieving a high rate of **stone clearance**. - The procedure was predominantly performed successfully in one session for most patients, though two required additional sessions. - Among participants, stone clearance rates were 72% complete and 28% near-complete, with only one case of moderate adverse event and no mortality. - Complications were primarily minor, with longer hospital stays noted in patients with cholangitis. - The study concluded that PTEHL is a viable minimally invasive option for elderly patients, potentially reducing the need for invasive interventions.

### 22. [Age-related liver transcriptomes: MASLD shows disease-specific proteostasis and stress-response re](https://medichelpline.com/clinical-feed/plos-one-1-integrated-liver-transcriptomic-data-reveal-differences-in-aging-associated.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-08-21
- **Detail Markdown URL:** [Age-related liver transcriptomes: MASLD shows disease-specific proteostasis and stress-response re](https://medichelpline.com/clinical-feed/plos-one-1-integrated-liver-transcriptomic-data-reveal-differences-in-aging-associated.md)

> **Executive GIST:** - The study integrated 1,354 public human liver transcriptomes (289 controls, 1,065 MASLD) from GEO and GTEx spanning ages 9–92 to compare age-related molecular changes in **MASLD** versus physiological liver aging. - After filtering and batch-effect correction, differential expression analysis identified 1,258 DEGs in the overall MASLD versus control comparison, with upregulated genes predominating and the number of DEGs increasing with age. - Age-stratified DEA (young ≤39, middle 40–59, elderly ≥60) found 602, 882, and 1,693 DEGs respectively; 247 DEGs were shared across all age strata and the global analysis, indicating a stable core MASLD signature. - Within MASLD samples, Spearman correlation (padj 0.2) identified 180 age-associated genes (121 positive, 59 negative). Integration with global DE results classified these into synergistic and antagonistic groups, including genes with opposite age trends in controls versus MASLD. - Generalized additive models (GAM) modeled non-linear age trajectories and revealed four dominant patterns in MASLD expression: stable, early-life change, mid-life fluctuation, and late-life acceleration; major trajectory inflection points clustered near ages ~35 and ~75. - Functional enrichment showed control age-associated genes were largely linked to classical **cell cycle** processes. In contrast, MASLD age-associated changes were enriched for **protein deubiquitination**, impaired **proteostasis**, and **p53**-related stress and apoptotic signaling. - Many MASLD age-associated genes also associated with histological severity (fibrosis stage or NAFLD activity score) in largely concordant directions, suggesting clinical relevance of the age-related transcriptional remodeling. - The authors conclude that aging in MASLD reflects disease-specific transcriptional reorganization—not merely accelerated normal liver aging—characterized by disturbed protein quality control and activation of stress-response and apoptotic programs.

### 23. [Spatial CD8+ T Cell–Macrophage Niche Drives Checkpoint Inhibitor–Related Hepatotoxicity](https://medichelpline.com/clinical-feed/medrxiv-4-macrophage-cd8-t-cell-spatial-coupling-defines-an-innate-adaptive-injury-niche.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-08-21
- **Detail Markdown URL:** [Spatial CD8+ T Cell–Macrophage Niche Drives Checkpoint Inhibitor–Related Hepatotoxicity](https://medichelpline.com/clinical-feed/medrxiv-4-macrophage-cd8-t-cell-spatial-coupling-defines-an-innate-adaptive-injury-niche.md)

> **Executive GIST:** - Study used **imaging mass cytometry** with a 32-marker panel to profile human liver biopsies from checkpoint inhibitor hepatotoxicity (ILICI), autoimmune hepatitis (AIH), and healthy controls, generating spatially resolved single-cell proteomic data across 144 regions of interest and ~297,000 single cells. - Cohorts included ILICI (n = 12), AIH (n = 14), and healthy control liver (n = 2); apoptosis and pyroptosis were detected by cleaved caspase-3 (cC3) and cleaved gasdermin D (cGSDMD) respectively. - Histiocyte-rich granulomas were a distinguishing histologic feature in ILICI, composed principally of **macrophages** and **CD8+ T cells**, including activated memory-effector CD8+ subsets. - Permutation-based spatial analysis identified **CD8+ T cell–macrophage co-localization** as the most frequent significant interaction in ILICI, forming integrated innate–adaptive cellular neighborhoods that concentrated cC3- and cGSDMD-positive cells. - In contrast, AIH showed more spatial compartmentalization of immune cells and stroma rather than tightly coupled CD8–macrophage neighborhoods. - Densities of **CD8+ T cells** and macrophages correlated with Ishak necroinflammation scores, clinical jaundice, and granuloma formation in ILICI samples. - The human data recapitulate a previously described tri-cellular **CD8–macrophage–hepatocyte** injury niche from a murine model, suggesting conserved mechanisms between species. - Authors propose that myeloid signaling and CD8–macrophage interactions are candidate liver-directed targets to dissociate hepatotoxicity from antitumor immune activity, though the study is a preprint and not yet peer-reviewed. - Raw IMC images and processed single-cell objects are deposited in the BioImage Archive (S-BIAD3614); ethical approvals and informed consent were obtained and funders are listed in the source.

### 24. [Blood Pressure, Not BMI or Sex, Predicts Cholecystitis Risk in Plateau Gallstone Patients](https://medichelpline.com/clinical-feed/medrxiv-7-clinical-epidemiological-features-and-risk-factor-weight-remodeling-in.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-08-18
- **Detail Markdown URL:** [Blood Pressure, Not BMI or Sex, Predicts Cholecystitis Risk in Plateau Gallstone Patients](https://medichelpline.com/clinical-feed/medrxiv-7-clinical-epidemiological-features-and-risk-factor-weight-remodeling-in.md)

> **Executive GIST:** - Study population: single-center retrospective cohort of 605 elective laparoscopic cholecystectomy patients at Qinghai Red Cross Hospital (2,260 m) collected 2020–2023, divided into simple gallstones (n=434) and gallstones with cholecystitis (n=171). - Objective: test whether **BMI** replaces sex as the core risk factor for **cholecystitis** in a high-altitude (plateau) population and define true risk factor weights. - Core demographics: mean age 43.7 ± 11.8 years, mean BMI 24.2 ± 3.8 kg/m2, female:male ratio 2.10:1, mean systolic blood pressure (SBP) 117.4 ± 15.8 mmHg. - Statistical approach: univariate analyses, multivariate logistic regression adjusting for age, BMI categories, sex, SBP and DBP; nested model comparisons, interaction and sensitivity analyses. Analyses were recomputed in Python 3.11 and cross-validated against original outputs. - Primary finding: the original hypothesis was falsified—**SBP** emerged as the only significant positive predictor of cholecystitis in multivariate models (OR=1.027 per mmHg, 95% CI 1.008–1.047, P=0.005). - BMI and sex were not significant predictors in multivariate analysis: overweight OR=1.038 (P=0.856), obesity OR=0.645 (P=0.137), sex OR=0.814 (P=0.322). - Age had an inverse association with cholecystitis risk (OR=0.978 per year, P=0.007), an “age paradox” with higher cholecystitis proportions in younger patients (<30 years: 36.8% vs ≥60 years: 25.0%; Spearman rho = -0.087, P=0.032). - Nested model comparison: classical model (age+BMI+sex) AUC=0.575; adding blood pressure increased discrimination to AUC=0.615 (DeltaAUC +0.040, 95% CI +0.007 to +0.084; LR chi2=8.19, P=0.017). - SBP was non-significant in univariate analysis (OR=1.005, P=0.346) likely due to suppression/confounding by age, which increases SBP while decreasing cholecystitis risk. - Interpretation: in this plateau hypoxic environment, risk weight for cholecystitis is remodeled opposite to the original hypothesis—**blood pressure management** should be considered in risk stratification for plateau cholecystitis. - The authors explicitly state the hypothesis that **BMI replaces sex** was falsified. Ethics approval (Qinghai Red Cross Hospital Ethics Committee Approval No. LW-2026-71) and data/code availability upon request were reported. - Funding declared: Qinghai Red Cross Hospital (YNZXKT2026009). No competing interests declared.

### 25. [Histopathologic Spectrum of Focal Liver Lesions and Predictors of HCC from US-Guided Biopsy in Sub](https://medichelpline.com/clinical-feed/medrxiv-22-histopathologic-spectrum-of-focal-liver-lesions-diagnosed-by-ultrasound-guided.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-08-18
- **Detail Markdown URL:** [Histopathologic Spectrum of Focal Liver Lesions and Predictors of HCC from US-Guided Biopsy in Sub](https://medichelpline.com/clinical-feed/medrxiv-22-histopathologic-spectrum-of-focal-liver-lesions-diagnosed-by-ultrasound-guided.md)

> **Executive GIST:** - Retrospective single-center study of ultrasound-guided percutaneous liver biopsy (US-PLB) for focal liver lesions (FLLs) performed at Adera Medical and Surgical Center from January 2021 to December 2024. - 119 adult patients (≥18 years) included; median age 56 years (IQR 45–65); 59.7% male. - Exclusions: indeterminate pathology results, incomplete records, biopsies for diffuse liver disease, and lesions classified as LI-RADS 1, 2, or 5. - No major biopsy-related complications were reported, indicating a favorable safety profile for US-PLB in this setting. - **Hepatocellular carcinoma (HCC)** was the most frequent histopathologic diagnosis (42.9% of cases). - Secondary metastatic tumors and regenerative nodules each accounted for 15.9% of diagnoses; other findings included chronic hepatitis (8.4%), cholangiocarcinoma (5.9%), and hepatic abscess (3.4%). - Hepatitis B virus (HBV) infection was present in 14.3% and hepatitis C virus (HCV) in 12.4% of patients. - On multivariate logistic regression, HBV (AOR 7.85; 95% CI 1.45–42.60; p=0.017), HCV (AOR 9.03; 95% CI 1.41–57.76; p=0.020), and larger tumor size (AOR 1.27 per unit increase; 95% CI 1.11–1.46; p<0.01) were independently associated with HCC. - Authors conclude US-PLB remains a valuable diagnostic tool for indeterminate FLLs in this SSA tertiary center and emphasize the public health importance of viral hepatitis prevention, surveillance, and early detection given the high HCC burden. - Study approved by the Institutional Review Board of Adera Medical and Surgical Center; written informed consent obtained for biopsies; retrospective chart-review waiver granted by IRB. - As a preprint, the findings have not undergone peer review and should not alone guide clinical practice.

### 26. [Engineered Clostridial Mini-Consortium Controls Intestinal Inflammation via isoDCA and pTreg Induc](https://medichelpline.com/clinical-feed/biorxiv-22-an-engineered-clostridial-mini-consortium-modulates-intestinal-inflammation.md)
- **Source:** bioRxiv (Biomedical Preprints) | **Published:** 2026-08-18
- **Detail Markdown URL:** [Engineered Clostridial Mini-Consortium Controls Intestinal Inflammation via isoDCA and pTreg Induc](https://medichelpline.com/clinical-feed/biorxiv-22-an-engineered-clostridial-mini-consortium-modulates-intestinal-inflammation.md)

> **Executive GIST:** - Modern lifestyle-driven changes to the gut microbiota alter mucosal immunity; Clostridia-derived metabolites, including **secondary bile acids**, influence host responses. - The study engineered **Ruminococcus gnavus** by targeted mutagenesis of bile acid epimerization genes to eliminate production of the secondary bile acid **isodeoxycholic acid (isoDCA)**. - A two-member, controllable consortium was created by combining R. gnavus (wild-type or knockout) with **Peptacetobacter hiranonis**, enabling isoDCA production to be toggled on or off while holding other variables constant. - Using this system, the authors show that **isoDCA** promotes colonic lamina propria **RORγt+ Foxp3+ peripheral regulatory T cells (pTregs)**. - Induction of these pTregs by isoDCA required both the bile acid receptors **TGR5** (Takeda G protein-coupled receptor 5) and **FXR** (Farnesoid X receptor), indicating a receptor-dependent mechanism. - Engraftment of the isoDCA-producing consortium protected mice in an adoptive T cell transfer colitis model, associated with microbiota reshaping and reduced host inflammation. - The consortium provides a controlled experimental platform to dissect how a single microbial metabolite influences immunity and disease outcomes. - The authors declared no competing interests; funding sources were reported. - Specific experimental details, quantitative results, and full mechanistic pathways beyond receptor requirement were not reported in the source abstract and would require consultation of the full manuscript.

### 27. [PC1-guided stratification identifies hepatic transcriptional heterogeneity and a myeloid 20-gene s](https://medichelpline.com/clinical-feed/biorxiv-1-pc1-guided-transcriptomic-stratification-reveals-hepatic-transcriptional.md)
- **Source:** bioRxiv (Biomedical Preprints) | **Published:** 2026-08-18
- **Detail Markdown URL:** [PC1-guided stratification identifies hepatic transcriptional heterogeneity and a myeloid 20-gene s](https://medichelpline.com/clinical-feed/biorxiv-1-pc1-guided-transcriptomic-stratification-reveals-hepatic-transcriptional.md)

> **Executive GIST:** - The study reanalyzed a public hyperlipidemic liver transcriptomic dataset (GSE338111) to address inter-individual molecular heterogeneity that can obscure treatment effects. - Conventional sex-adjusted comparison of Amlexanox versus DMSO in that dataset yielded only **21 differentially expressed genes** (FDR < 0.05, |log2FC| ≥ 1) and no GO Biological Process enrichment by Metascape. - The authors implemented a treatment-independent, **PC1-guided transcriptomic stratification** using the 500 most variable genes to capture dominant axes of transcriptional variation. - This PC1-guided approach resolved **three PC1-derived groups** (G1, G2, G3) within the cohort, revealing transcriptional heterogeneity not apparent from treatment labels alone. - A **myeloid-associated 20-gene signature** was derived from the G2-versus-G1 contrast; this signature reflects myeloid-related hepatic transcriptional programs. - Independent bulk-transcriptomic cohorts showed the signature is responsive to dietary challenge and pharmacologic intervention, supporting cross-cohort relevance. - Single-cell transcriptomic analysis localized expression of the signature predominantly to **hepatic myeloid populations**, indicating a cellular source for the bulk signal. - Human cis-eQTL Mendelian randomization and colocalization analyses implicated **TAGLN2** among signature genes as having the strongest genetic support for association with coronary heart disease in the datasets analyzed. - The authors conclude that PC1-guided stratification can improve resolution of heterogeneous hepatic transcriptional responses and generate cross-cohort molecular signatures for further mechanistic and translational study.

### 28. [Gastrointestinal Manifestations and Nutrition Support in hEDS, POTS, and MCAS](https://medichelpline.com/clinical-feed/pubmed-42611376.md)
- **Source:** PubMed / NCBI | **Published:** 2026-08-18 | DOI: [10.1007/s11894-026-01050-5](https://doi.org/10.1007%2Fs11894-026-01050-5)
- **Detail Markdown URL:** [Gastrointestinal Manifestations and Nutrition Support in hEDS, POTS, and MCAS](https://medichelpline.com/clinical-feed/pubmed-42611376.md)

> **Executive GIST:** - Gastrointestinal symptoms are common and often severe in patients with **hypermobile Ehlers-Danlos syndrome (hEDS)/hypermobility spectrum disorders (HSD)**, **postural orthostatic tachycardia syndrome (POTS)**, and **mast cell activation syndrome (MCAS)**. - Emerging evidence shows high prevalence of **disorders of gut–brain interaction (DGBI)**, **avoidant/restrictive food intake disorder (ARFID)**, and **malnutrition** in these overlapping conditions. - Current practice displays variability; **enteral** and **parenteral nutrition** are sometimes initiated without adequate trials of conservative and behavioral therapies. - De-escalation from non-oral nutrition once established is often difficult. - A structured, coordinated evaluation using validated tools should precede escalation to non-oral nutrition support. - When oral measures fail, **enteral nutrition** is preferred; **parenteral nutrition** should be reserved for true intestinal failure. - Multidisciplinary, biopsychosocial care models are essential to optimize outcomes and reduce unnecessary harm in this complex population. - The review emphasizes practical frameworks for assessment and appropriate use of nutrition support given the risk of premature escalation and the need for coordinated evaluation.

### 29. [Sialidase inhibitor restores mucus barrier and reshapes gut microbiota in ulcerative colitis](https://medichelpline.com/clinical-feed/pubmed-42429666.md)
- **Source:** PubMed / NCBI | **Published:** 2026-08-18 | DOI: [10.1128/msystems.00194-26](https://doi.org/10.1128%2Fmsystems.00194-26)
- **Detail Markdown URL:** [Sialidase inhibitor restores mucus barrier and reshapes gut microbiota in ulcerative colitis](https://medichelpline.com/clinical-feed/pubmed-42429666.md)

> **Executive GIST:** - This randomized clinical and preclinical study evaluated a **sialidase inhibitor (SI)** as a targeted therapy for **ulcerative colitis (UC)**, focusing on mucus preservation and microbiota modulation. - In a pilot randomized clinical trial of mild-to-moderate UC patients, SI treatment produced significant improvements in clinical symptoms and endoscopic outcomes; details of sample size and exact metrics were not reported in the abstract. - Clinical response correlated with an enrichment of **butyrate-producing** bacterial taxa and metabolic pathways associated with mucosal health. - In a dextran sulfate sodium (DSS) mouse colitis model, SI reduced inflammation and restored mucus layer integrity with increased intestinal expression of **Muc2** and **Tff3**. - Unlike broad-spectrum antibiotics, SI preserved microbial community resilience while selectively enriching beneficial mucolytic commensals, notably **Akkermansia muciniphila** and **Bacteroides acidifaciens**. - The intervention curtailed microbial sialidase activity implicated in mucin degradation, suggesting a mechanism that protects the mucus barrier without wholesale disruption of microbiota. - The authors propose that SI offers a dual-action therapeutic strategy for UC by reinforcing the mucus barrier and restoring gut homeostasis; trial registration: ChiCTR2000028767. - Conflict of interest: the authors declared no conflicts of interest.

### 30. [DOAC resumption after high-risk endoscopy: clinician equipoise and patient preferences supporting](https://medichelpline.com/clinical-feed/medrxiv-19-clinical-equipoise-and-patient-preferences-for-doac-resumption-after-high-risk.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-08-17
- **Detail Markdown URL:** [DOAC resumption after high-risk endoscopy: clinician equipoise and patient preferences supporting](https://medichelpline.com/clinical-feed/medrxiv-19-clinical-equipoise-and-patient-preferences-for-doac-resumption-after-high-risk.md)

> **Executive GIST:** - The study surveyed practicing **endoscopists** (n=201) and patients with atrial fibrillation (n=477; 92.5% taking a **DOAC**) to inform the design of the planned RESUME randomized trial on timing of DOAC resumption after high-risk endoscopic procedures. - Endoscopists showed wide variability in preferred timing of DOAC restart after a standardized high-risk mucosal resection vignette, ranging from same-day to beyond five days; postoperative day (POD) +2 was the single most commonly chosen strategy. - Most endoscopists judged more than one proposed RESUME trial arm (early POD +1, intermediate POD +3, late POD +5) to be acceptable, and 98.9% rated a randomized trial to define optimal timing as important, indicating strong **clinical equipoise** among clinicians. - Patient preferences for prioritizing bleeding risk versus thromboembolic (stroke) risk were heterogeneous and symmetrically distributed around neutral on a five-point ordinal scale, with no significant differences by prior stroke/TIA, prior major bleeding, age, sex, or geographic region. - Despite lack of high-quality randomized evidence, 54.6% of patients reported being very or somewhat confident that clear guidance exists on DOAC resumption timing. - The authors conclude that clinician variability and balanced, heterogeneous patient outcome preferences ethically and practically support conducting the planned RESUME randomized trial to determine optimal timing for DOAC resumption after high-risk endoscopy. - Competing interests: authors declared no competing interest. IRB/ethics registration and approvals for the patient survey are reported; study data are available on reasonable request from the authors.

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