Journal of investigative medicine : the official publication of the American Federation for Clinical Research最新文献

{"title":"Alterations of body composition on 3-year prognosis of maintenance hemodialysis.","authors":"Jianyun Peng, Zhangda Chen, Peng Wang, Jiaxin Li","doi":"10.1177/10815589261483684","DOIUrl":"10.1177/10815589261483684","url":null,"abstract":"<p><strong>Background: </strong>Maintenance hemodialysis (MHD) patients commonly exhibit persistent inflammation and malnutrition, which are strongly associated with poor clinical outcomes.</p><p><strong>Objective: </strong>Aims to investigate the impact of 3-month changes in body composition on clinical prognosis in MHD patients and explore whether baseline inflammatory and nutritional biomarkers are correlated with body composition alterations.</p><p><strong>Methods: </strong>All patients received thrice-weekly hemodialysis sessions. Body composition assessments at baseline and 3 months were obtained from bioimpedance analysis results using body composition monitor under normal hydration conditions, with data retrieved from the hospital's bioimpedance database.</p><p><strong>Results: </strong>Advanced age, reduced albumin and hemoglobin levels were associated with a significantly diminished 3-year cumulative survival rate relative to the control group. Reductions in body mass index (BMI), waist circumference, percentage of body fat (PBF), and visceral fat area (VFA) within 3 months conferred a higher 3-year mortality risk, whereas alterations in skeletal muscle mass (SMM) and fat-free mass (FFM) were not significantly linked to 3-year mortality. Baseline neutrophil-to-lymphocyte ratio (NLR) were significantly negatively correlated with 3-month variations in SMM and FFM, whereas initial serum albumin, hemoglobin, and lymphocyte count showed significant positive correlations with concurrent changes in BMI, SMM, and FFM. No significant links were observed between baseline inflammatory/nutritional biochemical markers and 3-month shifts in adipose-associated body composition parameters (PBF, VFA, and waist circumference).</p><p><strong>Conclusion: </strong>Three-month reductions in adipose body composition conferred a significantly higher 3-year mortality risk in MDH patients. Baseline inflammatory and nutritional biochemical indices were significantly associated with changes in 3-month non-adipose mass, but not with changes in adipose tissue. Three-month changes in adipose components may be the critical factor modulating 3-year survival in MHD patients.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261483684"},"PeriodicalIF":2.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic accuracy of SPEED, NEWS, and NEWS-L for predicting 28-day mortality in geriatric sepsis: A prospective study.","authors":"Orhan İnaltekin, Serdar Özdemir","doi":"10.1177/10815589261483680","DOIUrl":"10.1177/10815589261483680","url":null,"abstract":"<p><strong>Background: </strong>Sepsis remains a leading cause of morbidity and mortality in older adults, and early risk stratification in the emergency department (ED) is essential for optimizing patient management. This study compared the prognostic performance of the Sequential Organ Failure Assessment (SOFA), National Early Warning Score (NEWS), National Early Warning Score-Lactate (NEWS-L), and Sepsis Prediction and Evaluation in the Emergency Department (SPEED) score for predicting 28-day mortality in geriatric patients with sepsis.</p><p><strong>Methods: </strong>This prospective, single-center observational diagnostic accuracy study included consecutive patients aged ≥ 65 years who met the Sepsis-3 criteria between November 15, 2023, and November 15, 2024. The primary outcome was 28-day all-cause mortality. Discriminatory performance was evaluated using receiver operating characteristic (ROC) curve analysis, and areas under the ROC curves (AUCs) were compared using the DeLong test.</p><p><strong>Results: </strong>A total of 330 geriatric patients (median age, 79 years) were included, of whom 213 (64.5%) died within 28 days. All four scoring systems demonstrated moderate discriminatory performance. NEWS-L achieved the highest AUC (0.694, 95% CI: 0.635-0.753), followed by NEWS (0.679, 95% CI: 0.620-0.738), SPEED (0.653, 95% CI: 0.593-0.713), and SOFA (0.644, 95% CI: 0.584-0.705). Although NEWS-L demonstrated the highest numerical discrimination and SPEED the highest sensitivity, pairwise DeLong comparisons revealed no statistically significant differences among the evaluated scoring systems (all <i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>All evaluated scoring systems demonstrated only moderate prognostic performance for predicting 28-day mortality in geriatric patients with sepsis, and no statistically significant differences were observed among SOFA, NEWS, NEWS-L, and SPEED. These findings suggest that currently available bedside prognostic tools may have limited discriminatory ability in older adults and highlight the need for the development and external validation of geriatric-specific prognostic models.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261483680"},"PeriodicalIF":2.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative corrected carotid flow time is associated with spinal anesthesia-induced hypotension in hypertensive patients: A prospective observational study.","authors":"Mahmut Sami Tutar, Hasan Alp Mermer, Ali Aydin Oner, Ali Ihsan Birler, Yusuf Salih Mutluay, Muhammed Halit Satici, Munise Yildiz, Betul Kozanhan","doi":"10.1177/10815589261483669","DOIUrl":"10.1177/10815589261483669","url":null,"abstract":"<p><strong>Background: </strong>Spinal anesthesia-induced hypotension (SAIH) is common in hypertensive patients, yet reliable preoperative markers remain limited. Corrected carotid flow time (CCFT) is a Doppler-derived index influenced by preload and ventricular ejection timing, but its association with SAIH in this population has not been established.</p><p><strong>Objective: </strong>To evaluate whether preoperative CCFT is independently associated with SAIH in hypertensive patients undergoing spinal anesthesia.</p><p><strong>Design: </strong>Single-center prospective observational study.</p><p><strong>Patients: </strong>In total, 110 hypertensive adults scheduled for lower abdominal or lower extremity surgery under spinal anesthesia.</p><p><strong>Setting: </strong>University hospital, operating room.</p><p><strong>Interventions: </strong>Preoperative carotid and brachial ultrasound assessments (CCFT, carotid intima-media thickness (CIMT), flow-mediated dilation (FMD), carotid blood flow, and internal jugular vein collapsibility index) were performed. Hemodynamics were recorded for 30 min after spinal injection.</p><p><strong>Main outcome measures: </strong>Primary outcome: SAIH (≥20% decrease in systolic blood pressure or SBP <90 mmHg sustained for ≥1 minute).</p><p><strong>Secondary outcomes: </strong>hemodynamic trends and discriminative performance of ultrasound parameters.</p><p><strong>Results: </strong>SAIH occurred in 54 patients (49.1%). CCFT was shorter in patients who developed hypotension (326.5 ± 71.3 vs 437.3 ± 82.9 ms, <i>p</i> < 0.001). In the primary multivariable model including CIMT, FMD, and beta-blocker use, CCFT remained independently associated with SAIH (adjusted odds ratio 0.980 per 1-ms increase, 95% confidence interval (CI) 0.973-0.988, <i>p</i> < 0.001). CCFT alone had an area under the curve (AUC) of 0.854 (95% CI 0.785-0.924); the 358.5-ms cut-off had 74.1% sensitivity and 87.5% specificity. A clinical model including age, baseline SBP, and beta-blocker use had an AUC of 0.572 (95% CI 0.465-0.679); adding CCFT increased the AUC to 0.866 (95% CI 0.799-0.932; paired comparison <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Preoperative CCFT was independently associated with SAIH and improved discrimination when added to a parsimonious clinical model. The cohort-derived threshold requires external validation before clinical implementation.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (https://clinicaltrials.gov/), NCT06749184.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261483669"},"PeriodicalIF":2.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discrepancies in widely used serological methods to detect <i>Borrelia</i> infections may cause missed Lyme diagnoses.","authors":"Elena Volokhina, Annette Stemerding, Yesper Smits, Jordi Lankhof, Milou Kouwijzer, Anja Garritsen","doi":"10.1177/10815589261483668","DOIUrl":"10.1177/10815589261483668","url":null,"abstract":"<p><strong>Background: </strong>Accurate diagnosis of Lyme disease, caused by <i>Borrelia burgdorferi</i>, is essential for timely treatment and prevention of long-term complications. This study investigates discrepancies in widely used serological assays and their impact on diagnostic sensitivity in high-risk populations. We analyzed samples from an annual Lyme screening program conducted by Innatoss Laboratories between November 2020 and May 2022, targeting individuals with occupational exposure to ticks.</p><p><strong>Methods: </strong>A retrospective cohort of 60 positive serum samples from 57 participants (aged 23-64) was evaluated using three tier one protocols: EUROIMMUN/ZEUS enzyme-linked immunosorbent assay (ELISA), SERION ELISA, and Diasorin chemiluminescence immunoassay, followed by Viramed immunoblots for confirmation.</p><p><strong>Results: </strong>Our findings revealed significant variability in test sensitivity: the EUROIMMUN/ZEUS protocol detected 96.8% of cases, compared to 84.1% for SERION (<i>p</i> = 0.023) and 69.8.0% for Diasorin (<i>p</i> < 0.001). Notably, six recent <i>Borrelia</i> infections were missed due to test selection, as confirmed by longitudinal comparison with previous samples. One case study illustrated the clinical consequences of missed diagnoses, including delayed treatment and symptom persistence.</p><p><strong>Conclusion: </strong>These results underscore the need for standardized serological protocols and routine longitudinal sample comparison. We propose the establishment of a consensus panel to define assay performance criteria and recommend integration of electronic health records with laboratory systems to enable automated historical data retrieval. Adoption of more sensitive testing strategies and harmonized interpretation guidelines could significantly improve diagnostic accuracy and patient outcomes in Lyme disease.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261483668"},"PeriodicalIF":2.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between albumin-corrected anion gap and in-hospital mortality in patients with traumatic lung injury: A multicenter retrospective cohort study and the development of machine learning-based prediction models.","authors":"Hong Wang, Fanghao Liu, Dong Wu, Wei Yi, Zixin Qi","doi":"10.1177/10815589261483651","DOIUrl":"10.1177/10815589261483651","url":null,"abstract":"<p><strong>Background: </strong>The anion gap is primarily utilized as an indicator for evaluating acid-base imbalances in critically ill patients. However, its accuracy is reduced in such patients due to low albumin levels. The albumin-corrected anion gap (ACAG) enhances the accuracy of assessing acid-base imbalances. Individuals with traumatic lung injury (TLI) in the intensive care unit (ICU) often have severe metabolic acidosis and hypoalbuminemia. Nevertheless, the association of ACAG with the prognosis of patients with TLI is still unknown.</p><p><strong>Methods: </strong>Clinical data of individuals with TLI were acquired from the Medical Information Mart for Intensive Care (MIMIC)-IV-3.1 database and the eICU Collaborative Research Database (eICU-CRD), created by Philips Healthcare and the Massachusetts Institute of Technology. Data from the MIMIC-IV database were utilized as the training set to develop machine learning-based models. In contrast, data from the eICU-CRD were adopted for external validation of the established models. The primary outcome was in-hospital mortality. The association of ACAG with in-hospital mortality was evaluated using restricted cubic spline (RCS) models, Cox proportional hazards models, and Kaplan-Meier curves. The Boruta algorithm was adopted for the selection of feature variables. The predictive power of ACAG was evaluated, and prediction models were established utilizing machine learning algorithms. Model performance was verified with receiver operating characteristic curves and decision curve analysis.</p><p><strong>Results: </strong>A total of 239 and 467 individuals were incorporated from the MIMIC-IV database and the eICU-CRD, respectively. RCS curve analysis revealed a linear association of ACAG with in-hospital mortality. Elevated ACAG was substantially linked to a high risk of mortality in individuals with TLI (hazard ratio (95% confidence interval) = 1.115 (1.037-1.199)). The Boruta algorithm demonstrated that ACAG possessed higher feature importance. Prediction models established based on ACAG exhibited the optimal predictive performance.</p><p><strong>Conclusion: </strong>ACAG exhibited a linear association with in-hospital mortality among individuals with TLI, and a high ACAG was related to a markedly elevated risk of in-hospital death. Therefore, ACAG may serve as a potential predictor of adverse outcomes in individuals with TLI.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261483651"},"PeriodicalIF":2.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Programmed death-ligand 1 expression is associated with local invasion and distant metastases in differentiated thyroid cancer: Systematic review and meta-analysis.","authors":"Rajan K Mediratta, Ilia Bernstein, Cheng Zheng, Cindy Schmidt, Apar Kishor Ganti, Hamid Band, Robert G Bennett, Anupam Kotwal","doi":"10.1177/10815589261415900","DOIUrl":"10.1177/10815589261415900","url":null,"abstract":"<p><p>Programmed death-ligand 1 (PD-L1) is an immune checkpoint protein that tumors exploit to evade T-cell-mediated surveillance. While PD-L1 overexpression has been linked to advanced disease and poor prognosis in many cancers, its clinicopathological significance in differentiated thyroid cancer (DTC) remains unclear. We conducted a systematic review and meta-analysis by searching MEDLINE, Embase, the Cochrane Library, and PubMed from inception to 2 January, 2023. Eligible studies reported PD-L1 immunohistochemical positivity in DTC and its correlation with clinicopathological features. Data were extracted in duplicate, and study quality was assessed with a modified Newcastle-Ottawa Scale (NOS). Pooled odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity was evaluated by the I² value. Twelve retrospective studies met the inclusion criteria. All were retrospective and of moderate quality. High tumoral PD-L1 expression was significantly associated with the presence of lymphovascular invasion (LVI) (pooled OR 4.2, 95% CI 1.7-10.5), extrathyroidal extension (ETE) (pooled OR 1.7, 95% CI 1.2-2.4; <i>p</i> = 0.005) and distant metastases (pooled OR 4.6, 95% CI 1.6-13.0; <i>p</i> = 0.004). In other words, PD-L1-positive tumors were more likely to exhibit local invasion and distant metastasis. By contrast, PD-L1 status showed no significant association with tumor size, multifocality, lymph node metastasis, AJCC tumor stage, disease recurrence, or disease-specific mortality (<i>p</i> > 0.05 for all). Between-study heterogeneity was not significant for our key outcomes. PD-L1 overexpression in DTC is associated with a higher risk of local invasion and distant metastases, suggesting that PD-L1 may contribute to tumor progression via immune evasion.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"527-535"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145937403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of anesthesia precision intervention on perioperative serum myocardial injury markers and major adverse cardiac events in high-risk cardiovascular patients undergoing non-cardiac surgery.","authors":"Li Zhang, Haoyu Zhai, Heng Zeng, Liya Qiu, Rong Huang","doi":"10.1177/10815589251388962","DOIUrl":"10.1177/10815589251388962","url":null,"abstract":"<p><p>This study aims to unravel the impact of anesthesia precision intervention on perioperative serum myocardial injury markers and major adverse cardiac events in high-risk cardiovascular patients undergoing non-cardiac surgery. One hundred and sixty high-risk cardiovascular disease patients were randomly allocated into two groups. The control group received conventional empirical management, while the observation group underwent precise anesthesia interventions. We compared the general data, the levels of myocardial injury markers, including cardiac troponin (cTn), creatine kinase isoenzyme (CK-MB), and myoglobin (Mb). Furthermore, the levels of cardiac function markers, such as brain natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), as well as the levels of inflammatory factors and the incidence of adverse cardiac events were compared between the two groups. Postoperatively, the observation group exhibited significantly lower levels of cTn, CK-MB, Mb, BNP, NT-proBNP, C-reactive protein. Additionally, the total incidence of adverse cardiac events in the observation group was noticeably lower than that in the control group. The application of precise anesthetic intervention in the perioperative period of non-cardiac surgery for high-risk cardiovascular patients can further mitigate cardiac injury and reduce the incidence of adverse cardiac events, making it worthy of clinical application.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"547-553"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated backscatter intravascular ultrasound features of diffuse coronary artery disease with triglyceride-deposit atherosclerosis.","authors":"Takayuki Nakano, Hiroki Ikenaga, Ken-Ichi Hirano, Mikio Shigehara, Ayano Osawa, Yuichi Morita, Tasuku Higashihara, Noriaki Watanabe, Yoshiharu Sada, Yukiko Nakano","doi":"10.1177/10815589251393918","DOIUrl":"10.1177/10815589251393918","url":null,"abstract":"<p><p>Triglyceride-deposit cardiomyovasculopathy (TGCV) is characterized by diffuse narrowing of the coronary arteries because of triglyceride-deposit atherosclerosis. However, the plaque characteristics and prognosis of TGCV in patients with diffuse coronary artery disease remain unclear. This study aimed to describe the morphology of coronary arteries in TGCV using integrated backscatter intravascular ultrasound (IB-IVUS) and assess the effects on clinical outcomes. This single-center, retrospective observational study compared the IB-IVUS findings and clinical outcomes of patients with native coronary lesions of TGCV with those of patients with non-TGCV, all of whom had diffuse coronary artery disease. TGCV was diagnosed as (1) a low washout rate of iodine-123-β-methyl iodophenyl-pentadecanoic acid (BMIPP; <10%) on BMIPP single-photon emission computed tomography and (2) diffuse narrowing of the coronary arteries on coronary angiography. Thirty-one patients with diffuse coronary artery disease who underwent percutaneous coronary intervention were enrolled. Among these patients 10 (32%) were diagnosed with TGCV. IB-IVUS revealed that TGCV lesions had a significantly smaller ratio of the lipid area than non-TGCV lesions (20% ± 0.8% vs 23% ± 0.5%, <i>p</i> = 0.02). Conversely, the ratio of the calcification area tended to be larger. The Kaplan-Meier analysis revealed a significant increase in the rates of major adverse cardiovascular events in the TGCV group (<i>p</i> = 0.01). Patients with diffuse coronary artery disease present TGCV characterized by a smaller ratio of the lipid area. TGCV might be associated with worse clinical outcomes. The study findings may contribute to its early diagnosis and management.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"554-563"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of esophagogastroduodenoscopy in positive FOBT with negative colonoscopy: Yield of upper gastrointestinal malignancy and clinically significant findings.","authors":"Randa Taher Natour, Ahmad Mahamid, Oren Gal, Amir Mari, Majd Khader, Rawi Hazzan, Fadi Abu Baker","doi":"10.1177/10815589251393972","DOIUrl":"10.1177/10815589251393972","url":null,"abstract":"<p><p>The role of esophagogastroduodenoscopy (EGD) in evaluating patients with a positive fecal occult blood testing (FOBT) or fecal immunochemical testing (FIT) and normal colonoscopy findings remains uncertain, with current recommendations based on limited and low-quality evidence. This retrospective cohort study (2012-2022) included consecutive patients with positive FOBT or fecal FIT and normal colonoscopy, alongside asymptomatic controls referred for routine EGD prior to bariatric surgery. Demographic, clinical, and endoscopic data were collected and analyzed. Predictors of upper gastrointestinal malignancy and clinically significant findings (CSFs) were examined. Among 858 patients with positive FOBT/FIT and 2010 controls, significant differences in age and sex distribution were observed (<i>p</i> < 0.001). Hiatus hernia and reflux esophagitis were more common in controls (<i>p</i> < 0.01). CSFs were more frequent in the FOBT-positive group (11.3% vs 8.3%, <i>p</i> < 0.01). On multivariate analysis, male sex, older age, and endoscopist experience (>3 years) were independent predictors of CSFs, while positive FOBT was not independently associated with their presence. The diagnostic yield of EGD in patients with positive FOBT/FIT but normal colonoscopy is modest and comparable to that of asymptomatic controls. These findings suggest that universal EGD may not be routinely warranted in this setting, supporting instead a selective, risk-based approach. Prospective studies are warranted to confirm these findings and assess the cost-effectiveness of universal versus selective EGD in this population.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"564-570"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rise of AI-generated open-access review articles after ChatGPT: A case example in inflammatory bowel disease.","authors":"Armin Bashashati, Anagha Sampath, Deepak Agrawal, Mohammad Bashashati","doi":"10.1177/10815589261415897","DOIUrl":"10.1177/10815589261415897","url":null,"abstract":"<p><p>Biomedical review articles are important for education, evidence synthesis, and clinical decision-making. Large language models such as ChatGPT may contribute to a surge in the number of AI-written reviews, raising concerns about the quality and reliability of scientific content. We searched PubMed for open-access reviews in inflammatory bowel disease (IBD) published before ChatGPT (period 1), during the first year after ChatGPT's release (period 2, 2023-2024), and the year after (period 3, 2024-2025), and randomly selected 60 articles for analysis from each period. Using an AI text detector, no articles were identified as AI-written in period 1, versus 1.7% and 6.7% in periods 2 and 3, respectively. None of the potentially AI-written articles disclosed AI use. None of them had an IBD expert as the first author; only one article from period 2 and one from period 3 had an IBD expert among the authors. While the absolute number of AI-written reviews remains relatively low at present, the growing trend is a cause for concern regarding the potential decline of the quality and trustworthiness of biomedical review articles. Safeguards should be established to maintain the values of review articles.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"617-620"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145937405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}