American Journal of Gastroenterology最新文献

{"title":"Gastric-Shaped Esophagus in Achalasia.","authors":"Fu Guan, Shengbing Wang","doi":"10.14309/ajg.0000000000003567","DOIUrl":"10.14309/ajg.0000000000003567","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232965","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":"A Case of Gallbladder Cancer With a Rare H-Like Morphology Pancreaticobiliary Maljunction.","authors":"Takafumi Tokunaga, Shinya Kohashi, Arata Sakai","doi":"10.14309/ajg.0000000000003569","DOIUrl":"10.14309/ajg.0000000000003569","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232950","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":"Evaluation of the PAN-PROMISE Symptom Scale in a Randomized Controlled Trial of Fluid Resuscitation in Acute Pancreatitis.","authors":"Lucía Guilabert, Karina Cárdenas-Jaén, James L Buxbaum, Ana García García de Paredes, Alicia Vaillo-Rocamora, Jesús Donate-Ortega, Eduardo Tavío Hernández, Edgard E Lozada-Hernández, Diego Hinojosa Ugarte, Alba Lira-Aguilar, Patricia Pedregal Pascual, Rajiv M Mehta, Dhvani D Adhvaryu, Pablo Navarro Cortés, Isabel Pascual Moreno, Claudia Sánchez-Marin, Marina Cobreros-Del-Caz, Idaira Fernández-Cabrera, Fernando Casals-Seoane, Diego Casas-Deza, Eugenia Lauret-Braña, Andrea García-Gómez, Laura M Camacho-Montaño, David Ruíz-Clavijo García, Belén González de la Higuera Carnicer, Federico Bolado, Rodrigo Jover, José J Mira, Enrique de-Madaria","doi":"10.14309/ajg.0000000000003570","DOIUrl":"10.14309/ajg.0000000000003570","url":null,"abstract":"<p><strong>Introduction: </strong>The PAN-PROMISE symptom score is the first patient-reported outcome in acute pancreatitis (AP). It was developed and validated in a prospective cohort of patients to be used as an endpoint in research. The aim of this study was to assess the performance of the score in a large randomized controlled trial and its association with well-established AP endpoints.</p><p><strong>Methods: </strong>This is an ancillary study of the WATERFALL trial, where PAN-PROMISE was evaluated at baseline, 24, 48, and 72 hours. The study examined the association between PAN-PROMISE with established endpoints in AP: severity, pancreatic and/or peripancreatic fat necrosis (necrosis), infected necrosis, intensive care unit admission, persistent organ failure, prolonged hospital stay, and mortality. Areas under the receiver operating characteristic curve were calculated and used to compare baseline PAN-PROMISE and baseline Bedside Index for Severity in AP (BISAP) for the prediction of these endpoints.</p><p><strong>Results: </strong>In total, 248 patients from the WATERFALL trial were included. A statistically significant association was found between PAN-PROMISE and severity, necrosis, persistent organ failure, intensive care unit admission, and prolonged hospital stay at all checkpoints ( P < 0.05). Higher scores were also significantly associated with infected pancreatic necrosis at 24, 48, and 72 hours and death at baseline and 24 hours. The PAN-PROMISE baseline score had slightly higher areas under the receiver operating characteristic curve than BISAP for severity and necrosis, but the results were not statistically significant.</p><p><strong>Discussion: </strong>In the context of a randomized controlled trial, the PAN-PROMISE score, a patient-centered measure, has been validated with established AP outcomes and as an endpoint for future clinical trials.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232964","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":"Optimizing the Cost-Effective Evaluation of Gastroesophageal Reflux by Typical Symptom Phenotypes After Failure of Empiric Acid Suppression Trial.","authors":"Eric D Shah, C Prakash Gyawali, Walter W Chan","doi":"10.14309/ajg.0000000000003576","DOIUrl":"10.14309/ajg.0000000000003576","url":null,"abstract":"<p><strong>Introduction: </strong>Concern for gastroesophageal reflux disease (GERD) is the most common reason to consult gastroenterology. We aimed to optimize routine GERD evaluation on cost-effectiveness according to the dominant typical symptom among patients with persistent symptoms failing empiric proton-pump inhibitors (PPI).</p><p><strong>Methods: </strong>We developed a decision analytic model evaluating all permutations of GERD diagnostics including empiric trials of PPI optimization or discontinuation, upper endoscopy, wireless pH-monitoring, and pH-impedance monitoring. The model was applied to patients with heartburn, regurgitation, and chest pain in general gastroenterology to identify the appropriate combination and order of testing from insurer and patient perspectives. Health outcomes were informed by systematic reviews of clinical trials. Cost outcomes were informed by Centers for Medicare and Medicaid Services and commercial datasets and national observational studies. The time horizon was 1 year, and willingness-to-pay threshold was $100,000/quality-adjusted life year gained.</p><p><strong>Results: </strong>For patients with typical persistent GERD symptoms failing empiric PPI, routine up-front ambulatory reflux testing saved $2,500-$4,500 compared with endoscopy alone when no erosive esophagitis is found. The most cost-effective initial ambulatory reflux test was 96-hour wireless pH-monitoring for patients with heartburn and chest pain and 24-hour pH-impedance monitoring for patients with regurgitation, both performed OFF-PPI. Adding ON-PPI pH-impedance monitoring optimized cost-effectiveness for patients with documented evidence of GERD and PPI-refractory symptoms. Patient and insurer perspectives aligned on these optimal diagnostic strategies.</p><p><strong>Discussion: </strong>Compared with a one-size-fits-all strategy, a tailored approach based on Lyon 2.0 optimizes cost-effective evaluation and management of GERD by phenotyping the appropriate diagnostics to dominant symptom.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232967","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":"Comment on a Risk Stratification Tool for Relapse After Intravenous-to-Subcutaneous Switching of Infliximab in Patients With Inflammatory Bowel Diseases.","authors":"Thomas Aviles, Phillip Minar","doi":"10.14309/ajg.0000000000003521","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003521","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214666","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 Ge and Chen.","authors":"Akira Higashimori, Natsumi Maeda, Yasuhiro Fujiwara","doi":"10.14309/ajg.0000000000003513","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003513","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214667","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":"Rethinking Surveillance Timing in MSH6-Associated Lynch Syndrome: Is a Later Start Justified?","authors":"Maartje Nielsen, Sanne Willie Bajwa-Ten Broeke","doi":"10.14309/ajg.0000000000003515","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003515","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198061","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":"Letter to the Editor.","authors":"Marco Vincenzo Lenti, Emanuela Miceli, M Constanza Camargo, Antonio Di Sabatino","doi":"10.14309/ajg.0000000000003522","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003522","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198060","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":"Percutaneous Endoscopic Gastrostomy Tube Gone Rogue: An Unusual Cause of Acute Pancreatitis.","authors":"Akshay Venugopal, Akhil Baby, Shubham Suryavanshi, Rajesh Sasidharan","doi":"10.14309/ajg.0000000000003561","DOIUrl":"10.14309/ajg.0000000000003561","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172369","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":"Primary Biliary Cholangitis in 2025: A New Frontier.","authors":"Hannah Klatzkow, Indira Bhavsar-Burke, Meredith Pearson, Brian J Wentworth","doi":"10.14309/ajg.0000000000003559","DOIUrl":"10.14309/ajg.0000000000003559","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172372","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}