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

{"title":"Association between dapagliflozin use and coronary collateral circulation in patients with type 2 diabetes: A hypothesis-generating study.","authors":"Gokhan Koker, Yasin Sahinturk, Muhammed Ali Coskuner, Lutfullah Zahit Koc, Fatih Han Kumas, Gizem Zorlu Gorgulugil, Bilgin Bahadir Basgoz, Nizameddin Koca","doi":"10.1177/10815589251382270","DOIUrl":"10.1177/10815589251382270","url":null,"abstract":"<p><p>Coronary collateral circulation (CCC) plays a vital compensatory role in patients with type 2 diabetes mellitus (T2DM) and obstructive coronary artery disease (CAD). However, impaired collateral development is common in T2DM, and therapeutic strategies to enhance CCC are underexplored. We aimed to evaluate the association between sodium-glucose cotransporter-2 inhibitor dapagliflozin use and coronary collateral development in T2DM patients with obstructive CAD. This cross-sectional study evaluated 59 T2DM patients undergoing coronary angiography for total coronary occlusion. CCC was graded using the Rentrop classification, and patients were divided into poor and good CCC groups. Propensity score matching (PSM) and multivariate logistic regression analyses were performed to identify independent predictors of good CCC. Good CCC was observed in 74.6% of patients. Dapagliflozin use was significantly more common among patients with good CCC (81.8% vs 13.3%, <i>p</i> < 0.001). In multivariate analysis, dapagliflozin use was significantly associated with good CCC (odds ratio: 32.5; 95% confidence interval (CI): 5.21-642, <i>p</i> = 0.002). After PSM, the dapagliflozin use remained a significant predictor. ROC analysis demonstrated strong discriminative ability (AUC: 0.821; 95% CI: 0.711-0.932). Dapagliflozin use is likely associated with enhanced coronary collateral development in T2DM patients with obstructive CAD, indicating a possible mechanism underlying its cardioprotective effects beyond glycemic control.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"458-467"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067663","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":"Managing visceral leishmaniasis-associated hemophagocytic lymphohistiocytosis in pediatric patients: Clinical insights and treatment strategies.","authors":"Jing Zhang, Taoli Suo, Yanli Cheng, Hongyu Shi, Haiyan Lu","doi":"10.1177/10815589251390398","DOIUrl":"10.1177/10815589251390398","url":null,"abstract":"<p><p>Hemophagocytic lymphohistiocytosis (HLH) secondary to visceral leishmaniasis (VL-HLH) is a severe and often fatal condition marked by systemic inflammation and immune dysfunction. In this retrospective cohort study at Shanxi Children's Hospital, 31 pediatric patients diagnosed with VL-HLH were analyzed to assess clinical characteristics, treatment outcomes, and the potential impact of stibogluconate (SSG) + adjunctive corticosteroids. Patients exhibited multisystem involvement, including persistent fever, hepatosplenomegaly, anemia, and thrombocytopenia. Laboratory findings reflected elevated inflammation markers and immune dysregulation, with effective treatment achieved through anti-leishmanial therapy utilizing SSG. The study compared outcomes between monotherapy and SSG + corticosteroids groups, revealing no significant difference in overall recovery time but higher triglyceride levels in the SSG + corticosteroids cohort. While SSG + corticosteroids did not reduce recovery time, it potentially impacted lipid metabolism. The results underscore the need for larger-scale studies to further delineate the applicability and benefits of SSG + corticosteroids in managing VL-HLH, highlighting the significance of understanding immune activation and treatment strategies in this rare and high-risk condition.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"503-514"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644301","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":"The silent epidemic: Cardiovascular mortality among patients with thyroid disorders-Insights from CDC-WONDER database (1999-2023).","authors":"Maryam Saghir, F N U Kritika, Mirza Mohammad Ali Baig, Sahil Jairamani, Eshal Saghir, Nida Shoaib, Muhammad Ahmed, Saad Ahmed Waqas, Rutvi Amin, Patrick Deladem Pekyi-Boateng, Kamleshun Ramphul, Raheel Ahmed, Syed Sadam Hussain","doi":"10.1177/10815589261448842","DOIUrl":"https://doi.org/10.1177/10815589261448842","url":null,"abstract":"<p><p>Thyroid disorders substantially contribute to cardiovascular diseases (CVDs) in the United States. Although current U.S. data provides general mortality rates attributed to these diseases individually, trends specific to CVD-related mortality among patients with thyroid disorders remain underexplored. We examined the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database for deaths related to concomitant CVD and thyroid disorders among adults aged ≥25 years from 1999 to 2023. Age-adjusted mortality rates (AAMRs) per 100,000 with 95% confidence intervals (CIs) and annual percent change (APC) were calculated and categorized by demographics and geographic region. A total of 513,974 deaths were recorded due to CVD and thyroid disorders. Ischemic heart disease reported the highest burden in these patients, with a total of 305,497 deaths (59.43%). The AAMR observed a significant incline from 8.63 in 1999 to 10.82 in 2023, with an average APC of 0.76 (95% CI: -0.16 to 1.69). Women had consistently higher AAMRs than men (10.96 vs 6.22). Racially, non-Hispanic (NH) White population had the highest overall AAMR (9.74). Regionally, the Midwest recorded the highest overall AAMR (9.91). A higher overall AAMR was observed in Nonmetropolitan areas as compared to metropolitan areas (10.84 vs 8.41). States that fell in the top 90th percentile were Wyoming, Nebraska, Oklahoma, South Dakota, and West Virginia. In this retrospective analysis spanning from 1999 to 2023, we identified a notable rise in mortality among adults with coexisting CVD and thyroid disorders. The concurrent escalation in both prevalence and mortality highlights the pressing need for strengthened surveillance, proactive prevention, and therapeutic interventions.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261448842"},"PeriodicalIF":2.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148020482","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 atrial arrhythmias on long-term survival in non-small cell lung cancer patients.","authors":"Yonglin Pu, Amulya Gampa, Cassie Simon, Aysenur Musaogullari, Nicholas Feinberg, Daniel Appelbaum, Mark K Ferguson, Chuanhong Liao, Cevher Ozcan","doi":"10.1177/10815589261455329","DOIUrl":"10.1177/10815589261455329","url":null,"abstract":"<p><p>Atrial arrhythmias (AA), including atrial fibrillation (AF) and atrial flutter, are a significant clinical problem in oncological patients. The effect of AA on clinical outcome of patients with non-small cell lung cancer (NSCLC) is not well-known. We assessed the impact of AA on overall survival (OS) in patients with NSCLC. All consecutive NSCLC patients with baseline FDG-PET/CT in our institutional cancer registry from 2004 to 2017 were included. The incidence and prevalence of AA were determined. Cox regression models and Kaplan-Meier survival curves were used for the analysis. A total of 998 NSCLC patients (mean age 67 years, 54.3% female, 45.5% African American) were enrolled. AA were documented in 142 patients (14.2%); 6.9% had baseline AA and 7.3% had new-onset AA during the treatment of NSCLC. Baseline AA was more common in older, male, White, and comorbid patients. Univariate analysis showed baseline AA was associated with worse OS compared to no AA (hazard ratio (HR) 1.48, <i>p</i> = 0.004), whereas new-onset AA did not significantly impact OS (HR 1.02, <i>p</i> = 0.875). Baseline AA was associated with worse OS compared to new-onset AA (HR 1.45, <i>p</i> = 0.044). In multivariate analysis, baseline AA remained an independent predictor of worse OS (HR 1.59, <i>p</i> = 0.001) after adjusting for nine prognostic variables, including TNM stage, treatment, whole-body metabolic tumor volume, and performance status. New-onset AA did not affect OS (HR 1.16, <i>p</i> = 0.30). In conclusion, baseline AA is an independent prognostic marker for worse OS in NSCLC patients, while new-onset AA does not have an impact on OS.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261455329"},"PeriodicalIF":2.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147985093","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":"PANoptosis in environmental pollutants-induced chronic respiratory diseases.","authors":"Xiaoqing Jiang, Zhenyu Peng, Siqi Li, Qiong Huang, Baimei He","doi":"10.1177/10815589261454667","DOIUrl":"10.1177/10815589261454667","url":null,"abstract":"<p><p>Chronic respiratory diseases, including asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, lung cancer and so on, pose a substantial global health challenge. Environmental pollutants such as cigarette smoke, particulate matter (PM), house dust mite (HDM), silicon, and volatile organic compounds (VOCs) are key contributors to these diseases, yet the underlying mechanisms remain not fully elucidated. PANoptosis, a recently identified form of programmed cell death that integrates apoptosis, pyroptosis, and necroptosis, has emerged as a crucial player in various diseases. PANoptosis is orchestrated by the PANoptosome, a multi-protein complex driven by key sensors such as Z-DNA binding protein 1 (ZBP1), absent in melanoma 2 (AIM2), and receptor-interacting protein kinase 1 (RIPK1). Increasing evidence suggests that PANoptosis contributes to lung diseases progression by exacerbating lung tissue damage in response to environmental pollutants. This review consolidates current findings on PANoptosis in pollutant-induced chronic respiratory diseases, which might provide new insights into underlying mechanisms and potential therapeutic targets.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261454667"},"PeriodicalIF":2.0,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966881","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":"Artificial intelligence in diabetes care: Toward precision diagnosis and personalized management.","authors":"Talal Aburjai, Ahmed S A Ali Agha, Yara Abuhilaleh, Anas Miqdad, Ahmad Aburjai, Muhammed Alzweiri, Thaqif El Khassawna","doi":"10.1177/10815589261452671","DOIUrl":"10.1177/10815589261452671","url":null,"abstract":"<p><p>Diabetes mellitus is a global health challenge requiring innovative solutions for early diagnosis, personalized treatment, and ongoing management. This review aims to examine the impact of artificial intelligence (AI) on diabetes care, focusing on precision diagnosis, tailored therapies, and real-time monitoring, while addressing challenges related to model transparency and equitable access to health care. We conducted a comprehensive review of AI applications in diabetes management. Studies utilizing supervised and unsupervised learning, deep learning, federated learning, and reinforcement learning were analyzed for predictive accuracy, clinical impact, and integration. Comparisons with conventional methods were also included. Machine learning models show strong predictive performance for diabetes risk assessment, with random forest algorithms reporting accuracy up to 97% in hospital-based datasets. Deep learning models applied to clinical cohorts have achieved approximately 94.6% accuracy in predicting adverse events in patients with type 2 diabetes. Reinforcement learning approaches for automated insulin delivery have maintained glucose within the normoglycemic range for up to 95.66% of simulated time in artificial pancreas studies. Federated learning enables privacy-preserving collaborative model development with performance comparable to centralized models. AI-driven decision-support systems and wearable technologies further support improved glycemic monitoring and patient self-management. However, model performance varies depending on dataset characteristics, patient populations, and evaluation protocols. AI has reshaped diabetes care by enabling precise diagnosis, individualized treatments, and adaptive disease management. Responsible implementation is essential to addressing ethical concerns and ensure equitable access. Future work should refine AI frameworks for broader clinical adoption, prioritizing patient-centered care and data security.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261452671"},"PeriodicalIF":2.0,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937191","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":"Nail changes associated with mortality in end-stage renal disease: A national retrospective cohort study.","authors":"Kathleen E Daly, Mary Virginia Glennon, Jennifer L Waller, Stephanie L Baer, Wendy B Bollag","doi":"10.1177/10815589261452220","DOIUrl":"10.1177/10815589261452220","url":null,"abstract":"<p><p>End-stage renal disease (ESRD) is characterized by irreversible loss of kidney function requiring dialysis or a kidney transplant to maintain fluid homeostasis. The integumentary system is known to be affected, and nail changes, such as Terry's nails and half-and-half nails, are frequently observed. However, the prognostic significance of nail manifestations in this population remains poorly defined. This study sought to determine whether a diagnosis of changes in nails was associated with an increased risk of all-cause mortality. A retrospective cohort analysis was performed using the United States Renal Data System (USRDS), which contains medical claims of all ESRD patients in the United States. Patients in the USRDS database with no missing data and enrolled between 2005 and 2018, allowing for at least a 1-year follow-up, were included. A nail change diagnosis and several clinical covariates were determined using International Classification of Disease (ICD)-9 and ICD-10 codes. Mortality risk was evaluated using Cox Proportional Hazards (CPH) models controlling for various demographic and clinical parameters. Of the 1,028,817 ESRD subjects included in this analysis, 66,704 (6.5%) subjects had a nail change diagnosis. In the final CPH model, a nail change diagnosis was independently associated with an increased risk of all-cause mortality (hazard ratio = 1.22; 95% confidence interval = 1.20-1.23) after controlling for demographic and clinical risk factors. Despite this association, nail changes are likely underdiagnosed in the ESRD population. Our findings underscore the importance of a comprehensive dermatological evaluation of ESRD patients and recognition of nail changes as a possible prognostic indicator.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261452220"},"PeriodicalIF":2.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849271","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":"Diagnostic value of short-term longitudinal clinical and laboratory trajectories for gram-negative bacteremia in intensive care units patients.","authors":"Olcay Dilken, Ahmet Doğukan Bayrak, Okan Derin, Uğur Tekbaş, Mustafa Altınay, Mehmet Nuri Yakar, Bülent Ergin, Serpil Kılıç Depren","doi":"10.1177/10815589261451202","DOIUrl":"10.1177/10815589261451202","url":null,"abstract":"<p><p>Early identification of gram-negative bacteremia (GN-BSI) in intensive care units (ICUs) remains challenging at the time of blood culture sampling, when clinical signs are often nonspecific and existing diagnostic approaches typically rely on single-timepoint measurements. We conducted a retrospective cohort study of adult ICU patients admitted between July 2022 and January 2024 to investigate whether short-term longitudinal patterns in routinely collected clinical and laboratory data contain diagnostically relevant information for GN-BSI. Clinical and laboratory variables were extracted at three consecutive timepoints (Day -2, -1, and 0 relative to blood culture collection), and diagnostic models incorporating this temporal information were developed using complementary statistical and machine-learning approaches. Model performance was evaluated on a held-out test set using discrimination, calibration, and decision curve analysis. Among 568 patients, models incorporating short-term longitudinal data demonstrated good and consistent discrimination for GN-BSI (AUC range 0.81-0.83). A parsimonious logistic regression model of the mean values of seven predictors achieved an AUC of 0.81, which was not significantly different from the best-performing machine learning model (MILD-SVM, AUC 0.83; bootstrap test, <i>p</i> = 0.728). Diagnostic performance was stable across modeling approaches, indicating robustness of the underlying signal rather than dependence on a specific algorithm. Decision curve analysis suggested a higher net benefit of model-based risk stratification compared with treat-all or treat-none strategies across clinically relevant threshold probabilities. Central venous catheter presence, prior antibiotic use, hemoglobin, creatinine, and albumin consistently emerged as influential predictors. These findings indicate that short-term longitudinal clinical trajectories contain diagnostically meaningful information for GN-BSI at the time of blood culture sampling and support further external validation and prospective evaluation prior to clinical implementation.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261451202"},"PeriodicalIF":2.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849294","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":"Acute stroke treatment with mechanical thrombectomy without IV tPA in nonagenarian patients: A single-center experience.","authors":"Sena Boncuk Ulaş, Vasfiye Sezer, Ayşe Kristina Polat, Esra Ünal, Halil Alper Eryilmaz, Derya Kara Genç, Türkan Acar, Yeşim Güzey Aras, Bilgehan Atılgan Acar","doi":"10.1177/10815589261451177","DOIUrl":"10.1177/10815589261451177","url":null,"abstract":"<p><p>Age is one of the most critical non-modifiable risk factors for stroke. With the increasing aging of the global population, the incidence of stroke is expected to increase. The current evidence makes treatment decisions regarding MT in patients over 90 years of age challenging. The aim of this study is to evaluate the efficacy of mechanical thrombectomy (MT) and the factors associated with outcomes in patients aged 90 years and older. This is an observational study that follows STROBE guidelines. Patients aged 90 years and older with a pre-stroke Modified Rankin Scale (mRS) score of 0-1 a proximal large-vessel occlusion, who did not receive IV tPA were included in the study. A total of 28 patients were included. To assess clinical outcomes, the 90-day mRS score was evaluated. Patients were categorized into two groups: good clinical outcome (mRS 0-2) and poor clinical outcome (mRS 3-6). The mean age was 91.2 ± 1.5 years. Female patients accounted for 71.4%. The mean National Institutes of Health Stroke Scale (NIHSS) score was 18.7 ± 4.3. Hypertension was the most common comorbidity. The admission glucose levels were significantly higher in the poor clinical outcome group (<i>p</i> = 0.03). Type 3 aortic arch was significantly more frequent in the group with poor clinical outcomes. Isolated middle cerebral artery (MCA) occlusion was significantly more common in the good clinical outcome group (<i>p</i> = 0.03). Our findings suggest that MT can be successful in certain nonagenarian patients. In this study, we identified that admission blood glucose level, aortic arch morphology, location of the occluded vessel, and puncture-to-recanalization time are determinant factors for clinical outcomes.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261451177"},"PeriodicalIF":2.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849283","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":"The clinical utility and outcomes of Hemospray as primary versus salvage therapeutic modality for endoscopic hemostasis: A retrospective cohort study.","authors":"Keith R Garrison, Luis O Chavez, Jeff Angelo Taclob, Alejandro Robles, Marc J Zuckerman, Sherif E Elhanafi","doi":"10.1177/10815589261451201","DOIUrl":"10.1177/10815589261451201","url":null,"abstract":"<p><p>Hemospray, an inorganic hemostatic powder, has emerged as a promising tool for managing gastrointestinal bleeding (GIB), offering advantages in ease of use and effectiveness across various bleeding etiologies. In this retrospective cohort study of 55 patients at a tertiary care center, we evaluated Hemospray as either a primary or salvage endoscopic hemostatic therapy. Immediate hemostasis was achieved in 100% of primary cases and 97% of salvage cases. Although not statistically significant, rebleeding occurred less frequently in the primary group (14%) than in the salvage group (30%). Patients in the primary therapy group required fewer post-procedure transfusions and had shorter hospital stays, though this may be related to the differing bleeding etiologies rather than treatment modality. Mortality did not differ significantly between groups. These findings align with previous literature highlighting high rates of immediate hemostasis but variable rebleeding outcomes. While concerns persist about long-term hemostatic durability, particularly in monotherapy use, Hemospray's efficacy in treating bleeding from tumors and friable lesions-especially when used as a primary modality-underscores its clinical value. Despite limitations related to sample size and study design, our results support Hemospray's role as an effective primary or adjuvant intervention for both upper and lower GIB.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261451201"},"PeriodicalIF":2.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849281","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}