Journal of Gastroenterology and Hepatology最新文献

{"title":"Prevalence and etiologies of non-responsive celiac disease: A systematic review and meta-analysis","authors":"Nishant Aggarwal,&nbsp;Unnati Bhatia,&nbsp;Vignesh Dwarakanathan,&nbsp;Achintya Dinesh Singh,&nbsp;Prashant Singh,&nbsp;Vineet Ahuja,&nbsp;Govind K Makharia","doi":"10.1111/jgh.16808","DOIUrl":"10.1111/jgh.16808","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Non-responsive celiac disease (NRCD) is defined as ongoing symptoms despite 6–12 months of gluten-free diet (GFD), the only known treatment for celiac disease (CeD). There is inconsistency in studies describing the proportion of patients having NRCD and its various causes among patients with CeD. We therefore conducted a systematic review and meta-analysis to determine the prevalence and causes of NRCD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases were searched for original studies reporting the proportion of patients with persistent symptoms after ≥ 6 months of GFD. Studies reporting the etiologies of NRCD were also identified. The systematic review was conducted as per the Meta-analysis of Observational Studies in Epidemiology guidelines. Statistical analysis was performed in STATA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 2965 search results, nine studies met the inclusion and exclusion criteria. Five studies (<i>n</i> = 4414) reported data on prevalence, and seven studies (<i>n</i> = 790) reported the causes of NRCD. The pooled prevalence of NRCD was 22% (95% confidence interval, 11–35%). Among patients with NRCD, inadvertent exposure to gluten was the most common cause (33%), followed by functional gastrointestinal disorders including irritable bowel syndrome in 16%. Refractory CeD type II along with its premalignant and malignant sequelae was observed in 7% of patients with NRCD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>One in five patients with CeD may not respond to GFD and would likely be classified as NRCD. Inadvertent gluten exposure was the cause of ongoing symptoms in one-third of patients with NRCD. Improving adherence to GFD along with developing novel therapeutics to mitigate symptoms due to ongoing gluten exposure is critical.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 1","pages":"101-107"},"PeriodicalIF":3.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16808","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of Helicobacter pylori eradication therapy between tegoprazan-based concomitant and bismuth quadruple therapies: A real-world evidence","authors":"Yoon Suk Jung,&nbsp;Byung Wook Jung,&nbsp;Chan Hyuk Park","doi":"10.1111/jgh.16798","DOIUrl":"10.1111/jgh.16798","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Tegoprazan, a potassium-competitive acid blocker, can be used as a substitute for proton pump inhibitors in <i>Helicobacter pylori</i> eradication therapy; some studies have reported improved efficacy. In Korea, where clarithromycin resistance rates are high, we aimed to compare the efficacies of tegoprazan-based concomitant and bismuth quadruple therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed data from patients with <i>H. pylori</i> infection who received either 10-day tegoprazan-based concomitant therapy or 14-day tegoprazan-based bismuth quadruple therapy as first-line treatment. The primary outcome was <i>H. pylori</i> eradication rate, with secondary outcomes including adverse events and insufficient medication rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 1082 patients included in the study, 620 and 462 were treated with tegoprazan-based concomitant and bismuth quadruple therapies, respectively. Intention-to-treat analysis demonstrated no difference in eradication rates between the tegoprazan-based concomitant and bismuth quadruple therapy groups (74.7% [95% confidence interval—CI, 71.1–78.0%] <i>vs</i> 74.7% [95% CI, 70.6–78.5%], <i>P</i> = 0.999). Per-protocol analysis also showed similar eradication rates between the two groups (88.0% [95% CI, 85.0–90.6%] <i>vs</i> 89.7% [95% CI, 86.3–92.5%], <i>P</i> = 0.424). The overall adverse event rates (49.6% <i>vs</i> 39.2%, <i>P</i> = 0.001) and insufficient medication rates (4.8% <i>vs</i> 2.4%, <i>P</i> = 0.036) were higher in the bismuth quadruple therapy group than in the concomitant therapy group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The eradication rates of tegoprazan-based 10-day concomitant therapy and 14-day bismuth quadruple therapy were comparable. However, because of its shorter treatment duration, better medical adherence, and lower incidence of adverse events, tegoprazan-based concomitant therapy may be preferable in regions with high rates of clarithromycin and metronidazole resistance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 1","pages":"159-165"},"PeriodicalIF":3.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helicobacter pylori Infection and Cholelithiasis","authors":"Evangelos Kazakos,&nbsp;Jannis Kountouras","doi":"10.1111/jgh.16820","DOIUrl":"10.1111/jgh.16820","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 2","pages":"548-550"},"PeriodicalIF":3.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The proinflammatory status, based on preoperative interleukin-6, predicts postpancreatectomy acute pancreatitis and associated postoperative pancreatic fistula after pancreaticoduodenectomy","authors":"Yuchen Ji,&nbsp;Haoda Chen,&nbsp;Zhiwei Xu,&nbsp;Yiran Zhou,&nbsp;Ningzhen Fu,&nbsp;Hongzhe Li,&nbsp;Shuyu Zhai,&nbsp;Xiaxing Deng,&nbsp;Baiyong Shen","doi":"10.1111/jgh.16797","DOIUrl":"10.1111/jgh.16797","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Early predictors of morbidity after pancreaticoduodenectomy (PD) can guide tailored postoperative management. Preoperative inflammatory data in patients who underwent PD remained poorly studied in investigating the clinical significance of predicting postpancreatectomy acute pancreatitis (PPAP) and PPAP-associated postoperative pancreatic fistula (POPF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The clinical data of 467 patients receiving PD between January 2020 and December 2022 were retrospectively reviewed. Preoperative inflammatory data were stratified according to PPAP, and independent risk factors were analyzed. Multivariate logistic regression and subgroup analyses were conducted to compare risk factors of PPAP-associated POPF and non-PPAP-associated POPF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PPAP occurred in 17.6% of patients. The incidence of other complications increased following PPAP. Among the preoperative inflammatory factors, only interleukin-6 (IL-6) increased (<i>P</i> &lt; 0.001), leading to a higher incidence of PPAP and POPF (<i>P</i> &lt; 0.001; <i>P</i> = 0.002). The area under the curve of IL-6 in predicting PPAP was 0.71 (0.65–0.77; <i>P</i> &lt; 0.001). Abnormal preoperative IL-6 levels (odds ratio [OR]: 5.01; <i>P</i> &lt; 0.001), soft pancreatic texture (OR: 2.15; <i>P</i> = 0.007), and pathology (OR: 2.03; <i>P</i> = 0.012) were independent risk factors for PPAP. The subgroup analysis showed that increased IL-6 (OR: 1.01; <i>P</i> = 0.006) and soft pancreatic texture (OR: 2.05; <i>P</i> = 0.033) resulted in a higher risk of PPAP-associated POPF, while increased IL-8 (OR: 1.01; <i>P</i> = 0.007), older age (OR: 1.05; <i>P</i> = 0.008), and higher body mass index (OR: 1.12; <i>P</i> = 0.021) correlated with non-PPAP-associated POPF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PPAP is common after PD; a high preoperative IL-6 level can predict its occurrence, in addition to associated POPF, which could be due to a preoperative proinflammatory status.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 1","pages":"315-324"},"PeriodicalIF":3.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large-scale genome-wide association studies identified causal relationship between multiple blood biomarkers and risk of acute pancreatitis","authors":"Wenhui Zhang,&nbsp;Yu Zhao,&nbsp;Tao Zhang,&nbsp;Shaocheng Lyu,&nbsp;Ren Lang,&nbsp;Tao Jiang","doi":"10.1111/jgh.16805","DOIUrl":"10.1111/jgh.16805","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Observational studies have shown that there is a connection between blood biomarkers and the occurrence of acute pancreatitis (AP). Nevertheless, the causal relationships are still not clear. The purpose of this study was to evaluate causal association between biomarkers and AP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method(s)</h3>\u0000 \u0000 <p>A bidirectional two-sample Mendelian randomization (MR) analysis was applied to investigate the causal association between blood biomarkers and AP. Summary statistics obtained from genome-wide association studies were utilized for this analysis. The primary statistical approach employed was the inverse variance weighted (IVW) method, complemented by sensitivity analyses aimed at assessing heterogeneity and pleiotropy. Furthermore, a multivariable MR (MVMR) analysis was performed to adjust for confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 11 red blood cell (RBC) traits, 6 white blood cell traits, platelet count, and 30 blood biomarkers were analyzed in this study. Genetically predicted RBC count (IVW odds ratio [OR] = 1.144, <i>P</i> = 0.004), the high light scatter reticulocyte count (HLSR) (OR = 1.127, <i>P</i> = 0.022), blood glucose (BG) (OR = 1.480, <i>P</i> = 0.019), and leptin (OR = 1.234, <i>P</i> = 0.050) were suggestively associated with an increased risk of AP. Reverse MR analysis showed no causal effect of AP on RBC, HLSR, BG, and leptin (IVW <i>P</i> &gt; 0.05). Sensitivity analyses and MVMR analysis still supported the earlier causality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion(s)</h3>\u0000 \u0000 <p>Our findings provide evidence of a suggestive association between RBC count, HLSR, BG, and leptin with an increased susceptibility to AP. These findings aid in our comprehension of the cause of AP and may be used as potential prognostic markers or predictors of severity with AP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 1","pages":"325-335"},"PeriodicalIF":3.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evidence for probiotics in the treatment of digestive disorders in the pediatric population","authors":"Kok-Ann Gwee,&nbsp;Wei Ren Warren Lee,&nbsp;QiQi Chua,&nbsp;Fang Kuan Chiou,&nbsp;Marion M. Aw,&nbsp;Yu Han Koh","doi":"10.1111/jgh.16809","DOIUrl":"10.1111/jgh.16809","url":null,"abstract":"<p>Health claims for many probiotic-labeled products are poorly substantiated. This technical review addressed the clinical question: “Do probiotics have a role in the management of the following conditions in childhood?” Evidence supports efficacy for probiotic strains of <i>Saccharomyces boulardii</i>, <i>Lactobacillus reuteri</i>, and <i>Lactobacillus rhamnosus</i> GG for improving outcomes of acute gastroenteritis, of <i>S. boulardii</i> and <i>L. rhamnosus</i> GG for antibiotic-associated diarrhea, and of <i>S. boulardii</i> for <i>Clostridium difficile</i> diarrhea. For functional constipation and GERD, a role for probiotics is questionable as evidence of efficacy is either absent or marginal and as existing treatments are effective. For infantile colic and chronic abdominal pain, where existing treatments have limited efficacy and some important side effects, the use of probiotics, given their safety, is recommended, notwithstanding the evidence is low to moderate. While there is some evidence that probiotics could improve outcomes in the management of celiac disease, obesity, and, to a lesser extent, promotion of growth, their role is adjunctive as dietary management is fundamental. The evidence also supports an adjunctive role for probiotics in the treatment of <i>Helicobacter pylori</i> infection and ulcerative colitis. Decisions on probiotic prescription need to take into account disease tempo, severity, and burden, as well as probiotic strain and dose. Any potential advantage will have to be weighed against the complexity and costs of an additional treatment.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 1","pages":"41-47"},"PeriodicalIF":3.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16809","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automatic localization and deep convolutional generative adversarial network-based classification of focal liver lesions in computed tomography images: A preliminary study","authors":"Pushpanjali Gupta,&nbsp;Yao-Chun Hsu,&nbsp;Li-Lin Liang,&nbsp;Yuan-Chia Chu,&nbsp;Chia-Sheng Chu,&nbsp;Jaw-Liang Wu,&nbsp;Jian-An Chen,&nbsp;Wei-Hsiu Tseng,&nbsp;Ya-Ching Yang,&nbsp;Teng-Yu Lee,&nbsp;Che-Lun Hung,&nbsp;Chun-Ying Wu","doi":"10.1111/jgh.16803","DOIUrl":"10.1111/jgh.16803","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Computed tomography of the abdomen exhibits subtle and complex features of liver lesions, subjectively interpreted by physicians. We developed a deep learning-based localization and classification (DLLC) system for focal liver lesions (FLLs) in computed tomography imaging that could assist physicians in more robust clinical decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective study (approval no. EMRP-109-058) on 1589 patients with 17 335 slices with 3195 FLLs using data from January 2004 to December 2020. The training set included 1272 patients (male: 776, mean age 62 ± 10.9), and the test set included 317 patients (male: 228, mean age 57 ± 11.8). The slices were annotated by annotators with different experience levels, and the DLLC system was developed using generative adversarial networks for data augmentation. A comparative analysis was performed for the DLLC system <i>versus</i> physicians using external data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our DLLC system demonstrated mean average precision at 0.81 for localization. The system's overall accuracy for multiclass classifications was 0.97 (95% confidence interval [CI]: 0.95–0.99). Considering FLLs ≤ 3 cm, the system achieved an accuracy of 0.83 (95% CI: 0.68–0.98), and for size &gt; 3 cm, the accuracy was 0.87 (95% CI: 0.77–0.97) for localization. Furthermore, during classification, the accuracy was 0.95 (95% CI: 0.92–0.98) for FLLs ≤ 3 cm and 0.97 (95% CI: 0.94–1.00) for FLLs &gt; 3 cm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This system can provide an accurate and non-invasive method for diagnosing liver conditions, making it a valuable tool for hepatologists and radiologists.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 1","pages":"166-176"},"PeriodicalIF":3.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: Non-alcoholic fatty liver disease: The importance of physical activity and nutrition education—A randomized controlled study","authors":"S Khan,&nbsp;U Idrees,&nbsp;B Ahmad,&nbsp;A Munir,&nbsp;I Khan","doi":"10.1111/jgh.16817","DOIUrl":"10.1111/jgh.16817","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 1","pages":"342"},"PeriodicalIF":3.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing detection of various pancreatic lesions on endoscopic ultrasound through artificial intelligence: a basis for computer-aided detection systems","authors":"Tom Konikoff,&nbsp;Nadav Loebl,&nbsp;Ariel A. Benson,&nbsp;Orr Green,&nbsp;Hunter Sandler,&nbsp;Rachel Gingold-Belfer,&nbsp;Zohar Levi,&nbsp;Leor Perl,&nbsp;Iris Dotan,&nbsp;Steven Shamah","doi":"10.1111/jgh.16814","DOIUrl":"10.1111/jgh.16814","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Endoscopic ultrasound (EUS) is the most sensitive method for evaluation of pancreatic lesions but is limited by significant operator dependency. Artificial intelligence (AI), in the form of computer-aided detection (CADe) systems, has shown potential in increasing accuracy and bridging operator dependency in several endoscopic domains. However, the complexity of integrating AI into EUS is far more challenging. This aims to develop and test the basis for a CADe system for real-time detection and segmentation of all pancreatic lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this single-center study EUS studies of pancreatic findings were included. Lesions were outlined by two expert (&gt;5 years performing EUS) endoscopists, and the two leading types of models were benchmarked. The models' performance was evaluated through per-pixel intersection over union (IoU).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1497 EUS images from 165 patients were evaluated. The dataset included malignancies, neuroendocrine tumors, benign cysts, chronic and acute pancreatitis, normal fatty pancreas, and benign lesions. The best model demonstrated detection and segmentation on the test set with a mean IoU of 0.73, achieving a PPV, NPV, total accuracy, and ROC of 0.82, 0.96, 0.95, and 0.95, respectively. The algorithm is adaptable for real-time processing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We developed and tested deep learning models for real-time detection and segmentation of pancreatic lesions during EUS with promising results. This constitutes the basis for a CADe system for EUS, which could be valuable in future detection and evaluation of pancreatic lesions. Further studies for validation and generalization are underway.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 1","pages":"235-240"},"PeriodicalIF":3.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clostridioides difficile infection increases in-hospital mortality, length of stay, and hospital cost but not 30-day mortality in cirrhotic patients","authors":"Aunchalee Jaroenlapnopparat,&nbsp;Vitchapong Prasitsumrit,&nbsp;Ben Ponvilawan,&nbsp;Palapun Waitayangkoon,&nbsp;Nipith Charoenngam","doi":"10.1111/jgh.16807","DOIUrl":"10.1111/jgh.16807","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p><i>Clostridioides difficile</i> infection (CDI) is a leading cause of nosocomial infection and is associated with both higher morbidity and mortality. Cirrhotic patients are more susceptible to CDI because of impaired gut immune response, use of proton pump inhibitor, and frequent hospitalization. We aim to investigate the impact of CDI on cirrhotic patients' in-hospital and 30-day mortality, length of stay, and hospital cost.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Potentially eligible studies were identified from Embase, Medline, and Web of Sciences databases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 2320 articles were identified. After reviewing, nine studies reporting in-hospital mortality and three reporting 30-day mortality of cirrhotic patients with CDI versus those without CDI were included. The meta-analysis of nine studies, consisting of 7 746 126 patients, revealed a significant association between CDI and in-hospital mortality in cirrhotic patients with the pooled OR of 1.68 (95% CI 1.29–1.85, <i>I</i>² 94%). Length of stay and hospital cost were also higher in the CDI group (pooled MD of 6.56 days [95% CI 5.75–7.36, <i>I</i>² 94%] and 27.85 (×$1000) [95% CI 10.41–45.29, <i>I</i>² 100%], respectively). The funnel plots for the meta-analysis of the association between CDI and in-hospital mortality, length of stay, and hospitalization cost were not suggestive of publication bias. From three studies consisting of 3694 patients, we found that CDI was not associated with 30-day mortality in cirrhotic patients (pooled OR 1.20, 95% CI 0.75–2.24, <i>I</i>² 74%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CDI is associated with increased in-hospital mortality, length of stay, and hospital costs, but not with 30-day mortality in cirrhotic patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 1","pages":"89-100"},"PeriodicalIF":3.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16807","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}