Digestive Diseases and Sciences最新文献

{"title":"The Limits of Visual Size Estimation in Large Colorectal Laterally Spreading Tumours.","authors":"Tomoaki Matsumura, Kenichiro Okimoto, Jun Kato","doi":"10.1007/s10620-026-09918-2","DOIUrl":"10.1007/s10620-026-09918-2","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"3983-3984"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of the ABC and AIMS65 Scores in Predicting Outcomes in Patients with Acute Upper Gastrointestinal Bleeding: A Retrospective Multicenter Study.","authors":"Ali Sohail, Uday Sankar Akash Vankayala, Bivin George, Taimur Aslam, Jon Javor, Liliane Deeb","doi":"10.1007/s10620-026-09978-4","DOIUrl":"10.1007/s10620-026-09978-4","url":null,"abstract":"<p><strong>Background: </strong>Upper gastrointestinal bleeding (UGIB) remains a significant clinical emergency with substantial mortality. Accurate risk stratification is essential for optimal patient triage and management. The ABC score (Age, Blood tests, Comorbidities) and AIMS65 score are prominent pre-endoscopy risk stratification tools, yet direct comparative studies within diverse United States healthcare populations remain limited.</p><p><strong>Aims: </strong>To compare the predictive accuracy of ABC and AIMS65 scores for in-hospital mortality and secondary clinical outcomes in patients with acute UGIB.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 2,009 adult patients admitted with acute UGIB across multiple Northwell Health hospitals between January 2019 and January 2024. Both ABC and AIMS65 scores were calculated for each patient using structured EMR data, ICD-10 diagnosis codes, and anesthesiology procedure documentation. Primary outcomes included in-hospital mortality and 30-day readmission. Secondary outcomes encompassed hospital length of stay, ICU admission, development of complications (shock, sepsis, acute kidney injury), vasopressor use, and need for mechanical ventilation. Univariable logistic regression models assessed predictive accuracy using area under the receiver operating characteristic curve (AUC), with bootstrap internal validation (10,000 resamples) confirming negligible optimism bias. DeLong's test compared discriminative abilities between scores. Sensitivity analyses evaluated score performance across pandemic periods and in a broader AIMS65-computable cohort.</p><p><strong>Results: </strong>Among 2,009 patients (56.1% male; median age 70 years), 97 (4.8%) experienced in-hospital mortality and 59 (2.9%) had 30-day readmission. The ABC score demonstrated significantly superior predictive accuracy for mortality compared to AIMS65 (AUC 0.793 vs. 0.661; p < 0.0001 by DeLong's test; optimism-corrected AUCs: 0.793 and 0.661, respectively). Each one-unit increase in ABC score corresponded to a 50.7% increase in mortality odds (OR 1.507; 95% CI: 1.386-1.638). Neither score significantly predicted 30-day readmission. ABC score showed stronger correlations with secondary outcomes including hospital length of stay (r = 0.47 vs. r = 0.33), ICU length of stay (r = 0.35 vs. r = 0.22), and vasopressor requirements (r = 0.30 vs. r = 0.21). ABC's superiority was consistent across pre-pandemic, peak pandemic, and post-peak subgroups. In the broader AIMS65-computable cohort (n = 6,766), AIMS65 demonstrated an AUC of 0.706, confirming that the cohort restriction modestly attenuated its discrimination but that ABC's advantage persisted.</p><p><strong>Conclusions: </strong>The ABC score demonstrates significantly superior predictive accuracy for in-hospital mortality compared to AIMS65 in patients with acute UGIB, with consistent advantages across secondary outcomes, pandemic periods, and cohort definitions. ","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4298-4307"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing the Efficacy and Safety of Advanced Therapies in Older Adults with Inflammatory Bowel Disease.","authors":"Kian Keyashian","doi":"10.1007/s10620-026-09947-x","DOIUrl":"10.1007/s10620-026-09947-x","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4010-4011"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Idiopathic Acute Pancreatitis in Europe: An International Pancreas2000 Survey.","authors":"Afrodita Panaitescu-Damian, Barbara Wlodarczyk, Vytautas Kiudelis, Amer Hadi, Lucía Guilabert, Anu Aronen, Johanna Laukkarinen, Sara Regner","doi":"10.1007/s10620-026-09888-5","DOIUrl":"10.1007/s10620-026-09888-5","url":null,"abstract":"<p><strong>Background: </strong>Identifying the underlying cause of acute pancreatitis is fundamental for prevention of recurrence. However, no standardised algorithm for determining its aetiology exists.</p><p><strong>Aims: </strong>This survey study aimed to investigate the international variations in diagnosis, workup protocols and follow-up of acute pancreatitis.</p><p><strong>Methods: </strong>A 37-item international questionnaire was developed by a multidisciplinary team within the Pancreas 2000 program. The survey was distributed through social media platforms, e-mails and conference presentations. Responses were collected anonymously.</p><p><strong>Results: </strong>The survey received 247 responses from 36 countries, with 96% of respondents based in Europe; there were 56% gastroenterologists (N = 138), 34% surgeons (N = 84). Endoscopic ultrasound and magnetic resonance cholangiopancreatography were equally chosen as the preferred initial diagnostic test (34%, N = 85 each) in cases of acute pancreatitis without identified aetiology after the standard workup. Compared to surgeons, gastroenterologists used endoscopic ultrasound more (5% vs. 29%, p < 0.001) and favoured it as the ideal initial diagnostic tool for determining the aetiology (17% vs. 41%, p < 0.001). Most respondents (79%, N = 194) didn't recommend cholecystectomy when there was no evidence of biliary aetiology. The majority (89%, N = 220) recommended follow-up for moderate and severe acute pancreatitis with an unknown aetiology after initial admission; 17% (N = 42) did not recommend any follow-up.</p><p><strong>Conclusions: </strong>This survey reveals significant disparities in the methods used to determine the aetiology of acute pancreatitis across different regions and centres within Europe. We share a common understanding that identifying the acute pancreatitis aetiology is critical to prevent recurrence. However, the absence of a validated protocol for this process is a notable gap in the clinical practice.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4021-4029"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Specific Prompt Engineering Techniques on the Readability of LLM-Generated Patient Materials in Gastroenterology and Hepatology.","authors":"Husayn F Ramji, Aishwarya Gatiganti, Anveet Janwadkar, Jacob Lampenfeld, Ilaria M Simeone, Abhijith Atkuru, Jason Mathias, Stephanie Mrowczynski, Sharan Poonja, Chandler Gilliard, Shaquille Lewis, Pooja Arumugam, Clara Freedman, Luis Morales, Everette Martin, Larry Zhou, Corinne Zalomek, Devika Dixit, Saba Abdulsada, Matthew Houle, Matthew Alias, Molly Delk, Sarah C Glover, Peng-Sheng Ting","doi":"10.1007/s10620-026-09879-6","DOIUrl":"10.1007/s10620-026-09879-6","url":null,"abstract":"<p><strong>Background and aims: </strong>Health literacy significantly impacts patient outcomes. While the average American reads at an 8th grade reading level, healthcare materials are often written above this, potentially contributing to our nation's health literacy gap. Large language models (LLM) and prompt engineering may be able to help address this gap by consistently generating materials at the recommended 6th grade reading level. Our study aims to assess how different prompting techniques affect the readability of LLM-generated materials.</p><p><strong>Methods: </strong>We assessed the effects of five prompt techniques (Zero-Shot, Contextualized, Constrained, Meta, Persona) on the readability of LLM-generated explanations for fifteen common gastroenterology and hepatology conditions across twelve LLMs. Output (n = 2655) readability was assessed with two readability metrics (Simple Measure of Gobbledygook (SMOG) index, Flesch-Kincaid Grade Level (FKGL)), followed by significance testing and post-hoc analysis.</p><p><strong>Results: </strong>No prompt technique or model consistently produced outputs at or below a 6th grade reading level when assessed by the SMOG index, the preferred metric when assessing healthcare materials (p < 0.001). However, prompts with less constraints yield less readable outputs, while prompts with more constraints yield significantly more readable outputs (p < 0.001).</p><p><strong>Conclusions: </strong>This study demonstrates the potential of LLMs as a tool in addressing America's health literacy gap, as we show prompt engineering affects the readability of gastroenterology and hepatology-related explanations. We also found limitations to this technique. Further optimization is necessary before LLMs can consistently generate patient materials without appropriate clinician oversight, but it implies prompt engineering as a tool in addressing our nation's health literacy gap.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4046-4055"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Utility of Systemic Inflammatory Response Syndrome (SIRS) Criteria in Acute Alcohol-Associated Hepatitis.","authors":"Joseph Spengler, Geetha Ramalingam, Yiwei Hang, Rosa Yang, Marcus Healey, Ekaterina Smirnova, Amon Asgharpour, Vaishali Patel, Hannah Lee, Scott C Matherly, Velimir A Luketic, Mohammad S Siddiqui, Joel P Wedd, Arun Sanyal, Juan Pablo Arab Verdugo, Richard K Sterling","doi":"10.1007/s10620-026-09945-z","DOIUrl":"10.1007/s10620-026-09945-z","url":null,"abstract":"<p><strong>Objectives: </strong>Acute alcohol-associated hepatitis (AAH) is a severe inflammatory liver condition with high morbidity and mortality. Many patients with AAH exhibit features of the Systemic Inflammatory Response Syndrome (SIRS). While Maddrey's Discriminant Function (MDF) and Model for End-Stage Liver Disease (MELD) are established tools used to assess severity and guide treatment, the prognostic utility of SIRS criteria remains unclear. We hypothesized that AAH patients with more SIRS criteria would show greater illness severity, reduced steroid responsiveness, and worse 30-day survival.</p><p><strong>Methods: </strong>Retrospective analysis was conducted on 531 AAH patients hospitalized between 2012 and 2019. Patients were stratified into ≥ 2 SIRS criteria (n = 243) and < 2 criteria (n = 288). Demographics, laboratory parameters, and scoring system measures (MDF, MELD) were collected. The primary outcome was 30-day (30-d) survival. Secondary outcomes were disease severity (MELD) and response to steroids.</p><p><strong>Results: </strong>The mean age was 47; the majority were male (56%) and White (66%). Several baseline characteristics differed between groups. Patients with ≥ 2 SIRS criteria had significantly lower albumin (2.86 vs 2.97 g/dL, p = 0.035), higher MDF (40.1 vs 36.1, p = 0.004), higher admission MELD scores (20.9 vs 20.1, p = 0.04), and similar response to steroids (68% vs 64%). Thirty-day survival was numerically lower in the ≥ 2 SIRS group (86.9%) vs the < 2 group (91.5%) (p = 0.18), suggesting a trend toward worse outcomes with higher SIRS burden.</p><p><strong>Conclusion: </strong>Higher SIRS criteria are associated with greater disease severity, similar biochemical and prognostic scoring abnormalities, as well as a non-significant trend toward worse 30-day survival. Further prospective studies are warranted to clarify prognostic value of SIRS, guide treatment and risk stratification in AAH.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4184-4192"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Massive Obscure Bleeding from a Duodenal Varix in Short Telomere Syndrome.","authors":"Readon Teh","doi":"10.1007/s10620-026-09928-0","DOIUrl":"10.1007/s10620-026-09928-0","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"3912-3914"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colonic AL Amyloidosis: An Atypical Cause of Persistent Hematochezia.","authors":"Timothy Ring, Tatini Mal Sarkar, Arjun Chatterjee, Shahana Prakash, Thomas Plesec, Katherine Falloon","doi":"10.1007/s10620-026-09926-2","DOIUrl":"10.1007/s10620-026-09926-2","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"3915-3917"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Recognition to Resolution: Why \"Time-to-Decision\" Matters as Much as \"Time-to-Diagnosis\" Following Colonoscopic Perforation.","authors":"Alberto Arezzo","doi":"10.1007/s10620-026-09972-w","DOIUrl":"10.1007/s10620-026-09972-w","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4018-4019"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sporadic Fundic Gland Polyp with High-Grade Dysplasia in a Helicobacter pylori-Negative Non-atrophic Stomach.","authors":"Jing Wang, Wenwen Hou, Guangyao Zhao, Jindong Fu","doi":"10.1007/s10620-026-09981-9","DOIUrl":"10.1007/s10620-026-09981-9","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"3962-3964"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}