American Journal of Gastroenterology最新文献

{"title":"Is ChatGPT-4 a Reliable Tool in Autoimmune Hepatitis?","authors":"Francesca Colapietro, Daniele Piovani, Nicola Pugliese, Alessio Aghemo, Vincenzo Ronca, Ana Lleo","doi":"10.14309/ajg.0000000000003179","DOIUrl":"10.14309/ajg.0000000000003179","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence-based chatbots offer a potential avenue for delivering personalized counseling to patients with autoimmune hepatitis. We assessed accuracy, completeness, comprehensiveness, and safety of Chat Generative Pretrained Transformer-4 responses to 12 inquiries out of a pool of 40 questions posed by 4 patients with autoimmune hepatitis.</p><p><strong>Methods: </strong>Questions were categorized into 3 areas: diagnosis (1-3), quality of life (4-8), and medical treatment (9-12). 11 key opinion leaders evaluated responses using a Likert scale with 6 points for accuracy, 5 points for safety, and 3 points for completeness and comprehensiveness.</p><p><strong>Results: </strong>Median scores for accuracy, completeness, comprehensiveness, and safety were 5 (4-6), 2 (2-2), and 3 (2-3), respectively; no domain exhibited superior evaluation. Postdiagnosis follow-up question was the trickiest with low accuracy and completeness, but safe and comprehensive features. Agreement among key opinion leaders (Fleiss Kappa statistics) was slight for the accuracy (0.05) but poor for the remaining features (-0.05, -0.06, and -0.02, respectively).</p><p><strong>Discussion: </strong>Chatbots show good comprehensibility, but lack reliability. Further studies are needed to integrate Chat Generative Pretrained Transformer within clinical practice.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"914-919"},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Diabetes, Drug-Induced Liver Injury, and Sepsis on Outcomes in Metabolic Dysfunction Associated Fatty Liver Disease-Related Acute-on-Chronic Liver Failure.","authors":"Ashish Kumar, Anil Arora, Ashok Choudhury, Vinod Arora, Mohamed Rela, Dinesh Kumar Jothimani, Mamun A Mahtab, Harshad Devarbhavi, Chundamanni E Eapen, Ashish Goel, Cesar Yaghi, Qin Ning, Tao Chen, Jidong Jia, Duan Zhongping, Saeed S Hamid, Amna S Butt, Wasim Jafri, Akash Shukla, Seok S Tan, Dong J Kim, Anoop Saraya, Jinhua Hu, Ajit Sood, Omesh Goyal, Vandana Midha, Girish K Pati, Ayaskant Singh, Guan H Lee, Sombat Treeprasertsuk, Kessarin Thanapirom, Ameet Mandot, Ravikiran Maghade, Rinaldi C Lesmana, Hasmik Ghazinyan, Virukalpatti G Mohan Prasad, Abdul K Dokmeci, Jose D Sollano, Zaigham Abbas, Ananta Shrestha, George K Lau, Diana A Payawal, Gamal E Shiha, Ajay Duseja, Sunil Taneja, Nipun Verma, Padaki N Rao, Anand V Kulkarni, Fazal Karim, Vivek A Saraswat, Shahinul Alam, Debashis Chowdhury, Chandan K Kedarisetty, Sanjiv Saigal, Praveen Sharma, Ghulam N Yattoo, Abraham Koshy, Ajay K Patwa, Mohamed Elbasiony, Pravin M Rathi, Sudhir Maharshi, Vishwa M Dayal, Ashish K Jha, Kemal F Kalista, Rino A Gani, Man F Yuen, Virendra Singh, Violeta A Sargsyan, Chien H Huang, Saurabh S Mukewar, Shaojie Xin, Ruveena B Rajaram, Charles Panackel, Sunil Dadhich, Sanjeev Sachdeva, Ajay Kumar, Sanatan Behera, Lubna Kamani, Hemamala V Saithanyamurthi, Babita Prasad, Shiv K Sarin","doi":"10.14309/ajg.0000000000002951","DOIUrl":"10.14309/ajg.0000000000002951","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) and its complication, MAFLD-related acute-on-chronic liver failure (MAFLD-ACLF), is rising. Yet, factors determining patient outcomes in MAFLD-ACLF remain understudied.</p><p><strong>Methods: </strong>Patients with MAFLD-ACLF were recruited from the Asian Pacific Association for the Study of the Liver-ACLF Research Consortium (AARC registry). The diagnosis of MAFLD-ACLF was made when the treating unit had identified the etiology of chronic liver disease as MAFLD (or previous nomenclature such as non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, or non-alcoholic steatohepatitis-cirrhosis). Patients with coexisting other etiologies of chronic liver disease (such as alcohol, hepatitis B virus, hepatitis C virus, etc.) were excluded. Data were randomly split into derivation (n = 258) and validation (n = 111) cohorts at a 70:30 ratio. The primary outcome was 90-day mortality. Only the baseline clinical, laboratory features and severity scores were considered.</p><p><strong>Results: </strong>The derivation group had 258 patients; 60% were male, with a mean age of 53. Diabetes was noted in 27% and hypertension in 29%. The dominant precipitants included viral hepatitis (hepatitis A virus and hepatitis E virus, 32%), drug-induced injury (drug-induced liver injury, 29%), and sepsis (23%). Model for End-Stage Liver Disease-Sodium (MELD-Na) and AARC scores on admission averaged 32 ± 6 and 10.4 ± 1.9. At 90 days, 51% survived. Nonviral precipitant, diabetes, bilirubin, international normalized ratio, and encephalopathy were independent factors influencing mortality. Adding diabetes and precipitant to MELD-Na and AARC scores, the novel MAFLD-MELD-Na score (+12 for diabetes, +12 for nonviral precipitant), and MAFLD-AARC score (+5 for each) were formed. These outperformed the standard scores in both cohorts.</p><p><strong>Discussion: </strong>Almost half of patients with MAFLD-ACLF die within 90 days. Diabetes and nonviral precipitants such as drug-induced liver injury and sepsis lead to adverse outcomes. The new MAFLD-MELD-Na and MAFLD-AARC scores provide reliable 90-day mortality predictions for patients with MAFLD-ACLF.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"816-826"},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Migration of a Surgical Ligation Device to the Appendix Tube After Appendectomy.","authors":"Xinrui Zhu, Jianming Xiong, Kai Deng","doi":"10.14309/ajg.0000000000003081","DOIUrl":"10.14309/ajg.0000000000003081","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"698"},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duodenal Obstruction Caused by an Isolated Spontaneous Celiac Artery Dissection.","authors":"Avi Toiv, Zachary Saleh, Andrew M Watson, Cyrus R Piraka","doi":"10.14309/ajg.0000000000003134","DOIUrl":"10.14309/ajg.0000000000003134","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"700-701"},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuing Medical Education Questions: April 2025.","authors":"Bhavana Bhagya Rao","doi":"10.14309/ajg.0000000000003393","DOIUrl":"10.14309/ajg.0000000000003393","url":null,"abstract":"<p><p>Article Title: Optimizing Bowel Preparation Quality for Colonoscopy: Consensus Recommendations by the US Multi-Society Task Force on Colorectal Cancer.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":"120 4","pages":"708"},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Yu Yang et al.","authors":"Yuzuru Tamaru, Toshio Kuwai, Yoshiki Kajiwara, Shiro Oka, Shoichi Saito, Yosuke Fukunaga, Hiroshi Kawachi, Manabu Takamatsu, Kinichi Hotta, Hiroaki Ikematsu, Motohiro Kojima, Yutaka Saito, Yukihide Kanemitsu, Masayoshi Yamada, Shigeki Sekine, Shinji Tanaka, Shinji Nagata, Takahiro Nakamura, Kazutaka Yamada, Maki Konno, Soichiro Ishihara, Yusuke Saitoh, Kenji Matsuda, Kazutomo Togashi, Koji Komori, Megumi Ishiguro, Takashi Okuyama, Akihiro Ohuchi, Shinobu Ohnuma, Kazuhiro Sakamoto, Tamotsu Sugai, Kenji Katsumata, Hiro-O Matsushita, Hiro-O Yamano, Keisuke Nakai, Toshio Uraoka, Naohiko Akimoto, Hirotoshi Kobayashi, Yoichi Ajioka, Kenichi Sugihara, Hideki Ueno","doi":"10.14309/ajg.0000000000003336","DOIUrl":"10.14309/ajg.0000000000003336","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"925-926"},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Intrapancreatic Fat Deposition and Pancreatitis Research With Additional Considerations.","authors":"Qing Zhou","doi":"10.14309/ajg.0000000000003095","DOIUrl":"10.14309/ajg.0000000000003095","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"926-927"},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Management of Refractory Benign Esophageal Strictures: What's New?","authors":"Kulwinder S Dua","doi":"10.14309/ajg.0000000000003057","DOIUrl":"10.14309/ajg.0000000000003057","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"689-693"},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ACG Clinical Guideline: Diagnosis and Management of Gastric Premalignant Conditions.","authors":"Douglas R Morgan, Juan E Corral, Dan Li, Elizabeth A Montgomery, Arnoldo Riquelme, John J Kim, Bryan Sauer, Shailja C Shah","doi":"10.14309/ajg.0000000000003350","DOIUrl":"10.14309/ajg.0000000000003350","url":null,"abstract":"<p><p>Gastric premalignant conditions (GPMC) are common and include atrophic gastritis, gastric intestinal metaplasia, dysplasia, and certain gastric epithelial polyps. GPMC have an increased risk of progression to gastric adenocarcinoma. Gastric cancer (GC) in the United States represents an important cancer disparity because incidence rates are 2- to 13-fold greater in non-White individuals, particularly early-generation immigrants from regions of high GC incidence. The US 5-year survival rate for GC is 36%, which falls short of global standards and is driven by the fact that only a small percentage of GC in the US is diagnosed in the early, curable stage. This document represents the first iteration of American College of Gastroenterology guidelines on this topic and encompasses endoscopic surveillance for high-risk patients with GPMC, the performance of high-quality endoscopy and image-enhanced endoscopy for diagnosis and surveillance, GPMC histology criteria and reporting, endoscopic treatment of dysplasia, the role of Helicobacter pylori eradication, general risk reduction measures, and the management of autoimmune gastritis and gastric epithelial polyps. There is insufficient evidence to make a recommendation on upper endoscopic screening for GC/GPMC detection in US populations deemed high-risk for GC. Surveillance endoscopy is recommended for individuals at high risk for GPMC progression, as defined by endoscopic, histologic, and demographic factors, typically every 3 years, but an individualized interval may be warranted. H. pylori testing, treatment, and eradication confirmation are recommended in all individuals with GPMC. Extensive high-quality data from US populations regarding GPMC management are lacking, but continue to accrue, and the quality of evidence for the recommendations presented herein should be interpreted with this dynamic context in mind. The GPMC research and education agendas are broad and include high-quality prospective studies evaluating opportunistic endoscopic screening for GC/GPMC, refined delineation of what constitutes \"high-risk\" populations, development of novel biomarkers, alignment of best practices, implementation of training programs for improved GPMC/GC detection, and evaluation of the impact of these interventions on GC incidence and mortality in the US.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"709-737"},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2025 CME Information.","authors":"","doi":"10.14309/ajg.0000000000003228","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003228","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":"120 4","pages":"705-706"},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}