American Journal of Gastroenterology最新文献

{"title":"Pill Esophagitis Resulting in Esophageal Mucosal Dissection and Stricture.","authors":"Zhiren Wang, Yifeng Zheng","doi":"10.14309/ajg.0000000000003560","DOIUrl":"10.14309/ajg.0000000000003560","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":"144172371","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":"The Augmented Colonoscopy With Computer-Aided Polyp Characterization Study: Prospective Study Comparing the Diagnostic Reliability of Optical Diagnosis of Trainees With Experts Without Artificial Intelligence.","authors":"Sebastian Bernhofer, Julian Prosenz, Christine Duller, David Venturi, Andreas Maieron","doi":"10.14309/ajg.0000000000003558","DOIUrl":"10.14309/ajg.0000000000003558","url":null,"abstract":"<p><strong>Introduction: </strong>Optical diagnosis (OD) is an essential part of a high-quality colonoscopy, but highly experience-dependent. Artificial intelligence (AI) in the form of computer-aided diagnosis (CADx) may bridge the gap between trainee endoscopists and experts. The aim of this study was to evaluate the diagnostic reliability of OD of trainee endoscopists with the help of AI compared with experts.</p><p><strong>Methods: </strong>This prospective, observational study included patients undergoing trainee-performed CADx-supported (GI Genius) colonoscopy. Resected polyps were recorded and video-reviewed without CADx information by experts. The primary outcome was the negative predictive value (NPV) for adenomatous histology of diminutive (≤5 mm) rectosigmoid polyps of trainees vs experts and CADx output alone. Secondary outcomes were the NPV for rectosigmoid polyps of any size and sensitivities and specificities of adenomas in the entire colon.</p><p><strong>Results: </strong>Overall, 630 polyps were resected in 225 patients (48.9% male, mean age 63.8 (SD 12.7) years). In the rectosigmoid, 252 lesions (40%) were found, 223 (88.5%) of which were ≤5 mm. The NPV for diminutive rectosigmoid polyps of trainees using CADx was 90.2% (95% confidence interval [CI] 0.85-0.94), NPV of the experts without CADx was 90.3% (95% CI 0.84-0.94). There was no statistically significant difference in NPV between these 2 groups. The NPV of CADx alone was 93.2% (95% CI 0.88-0.97). The NPV for rectosigmoid polyps of any sizes were 90.1% (95% CI 0.85-0.94) for trainees, 90.4% (95% CI 0.85-0.95) for experts, and 93.4% (95% CI 0.88-0.97) for CADx alone.</p><p><strong>Discussion: </strong>OD of rectosigmoid polyps by trainee endoscopists with CADx is highly accurate, fulfilling PIVI 2 \"diagnose-and-leave\" strategy.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155504","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":"Elisabetta Dell'Unto, Francesco Panzuto, Bruno Annibale","doi":"10.14309/ajg.0000000000003519","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003519","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148849","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 Giuffrè.","authors":"Sheza Malik, Lewis J Frey, Kamran Qureshi","doi":"10.14309/ajg.0000000000003517","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003517","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148850","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":"Retraction: Effects of Cholestasis on Primary Sclerosing Cholangitis in Patients Following Liver Transplantation: Insights From Mixed Censoring Outcomes.","authors":"Lingyu Xu, Xuefei Shen","doi":"10.14309/ajg.0000000000003516","DOIUrl":"10.14309/ajg.0000000000003516","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109312","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":"Efficacy of Rebamipide in the Prevention of Nonsteroidal Anti-Inflammatory Drug-Induced Gastrointestinal Mucosal Breaks: A Systematic Review and Meta-Analysis.","authors":"Rochelle Ivy A Cion, Ian Gabriel A Juyad, Eric B Yasay","doi":"10.14309/ajg.0000000000003535","DOIUrl":"10.14309/ajg.0000000000003535","url":null,"abstract":"<p><strong>Introduction: </strong>Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most used medications worldwide. A major limitation of these drugs is gastrointestinal (GI) mucosal injury. Several gastroprotective agents have been recommended but are limited by their long-term effects. Rebamipide is a promising mucoprotective agent, but its efficacy is not established. We performed a meta-analysis assessing the efficacy of rebamipide in preventing NSAID-induced GI mucosal breaks as compared with placebo and the standard proton-pump inhibitors (PPIs).</p><p><strong>Methods: </strong>Four electronic databases were searched from inception to October 2023 for randomized controlled trials that compared rebamipide with placebo or PPIs. Data were pooled to obtain the risk ratio (RR) with 95% confidence interval (CI). Heterogeneity and publication bias were assessed with I2 statistic and funnel plot, respectively.</p><p><strong>Results: </strong>A total of 472 studies were screened, with 13 studies included. Pooled analyses showed that rebamipide significantly reduced the incidence of NSAID-induced GI mucosal breaks as compared with placebo (RR 0.55, 95% CI 0.31-0.99, P ≤ 0.00001). Rebamipide is also comparable with the standard PPIs in preventing NSAID-induced mucosal breaks (RR 1.00, 95% CI 0.51-1.95, P = 1.00). Regarding addition of rebamipide to PPIs, there are still insufficient data to support its effect on further improving prevention of GI mucosal breaks as compared with PPIs alone (RR 0.72, 95% CI 0.43-1.21; P = 0.11).</p><p><strong>Discussion: </strong>Rebamipide is effective in preventing NSAID-induced GI mucosal breaks. Rebamipide may also be as good as the standard PPIs in preventing NSAID-induced GI mucosal breaks and, hence, may be an alternative, especially in those with contraindications to long-term PPI use.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965052","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":"Glucagon-Like Peptide-1 Receptor Agonists Use Does Not Increase the Risk for Acute Pancreatitis and Is Associated With Lower Complications in Patients With Type 2 Diabetes Who Develop Acute Pancreatitis: A Multicenter Analysis.","authors":"Luis M Nieto, John Martinez, Sharon I Narvaez, Donghyun Ko, Do Han Kim, Kenneth J Vega, Saurabh Chawla","doi":"10.14309/ajg.0000000000003525","DOIUrl":"10.14309/ajg.0000000000003525","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 diabetes mellitus (T2DM) can lead to structural pancreatic changes potentially predisposing to acute pancreatitis (AP), increasing morbidity and mortality. Scarce data exist on the outcomes of AP in patients with T2DM who are taking glucagon-like peptide-1 receptor agonists (GLP-1 RAs). The study aim was to evaluate AP outcome and all-cause mortality in patients with T2DM using GLP-1 RAs.</p><p><strong>Methods: </strong>A retrospective cohort study was performed using population-based data from the TriNetX platform. Patients with T2DM receiving GLP-1 RAs drugs (semaglutide, liraglutide, dulaglutide, and tirzepatide) between January 1, 2015, and October 31, 2023, were included. This patient cohort was matched with patients with T2DM who did not receive GLP-1 RAs according to age, demographics, comorbidities, and medication by using 1:1 propensity matching. To avoid confounding, etiologies of AP including alcohol-induced, trauma, biliary, class Ia drug-induced, hypertriglyceridemia, and postendoscopic retrograde cholangiopancreatography were excluded from both cohorts. Primary outcomes were risk of developing AP, need for parenteral nutrition, systemic complications (sepsis, systemic inflammatory response syndrome, shock, mechanical ventilation, acute kidney injury), and local pancreatic complications. The secondary outcome was all-cause mortality. Cox proportional hazards models were used to estimate hazard ratios (HRs).</p><p><strong>Results: </strong>A total of 740,370 patients with T2DM were identified with 29,423 on GLP-1 RAs; 20,459 of those 29,423 (mean [SD] age, 58.1 [11.9] years; 10,190 [49.85%] female) were matched with 20,459 individuals (mean [SD] age, 57.5 [13.9] years; 10,301 [50.35%] female) who did not take GLP-1 RAs. The GLP-1 RAs group had lower risk of complicated pancreatitis (HR 0.32; 95% confidence interval [CI] 0.14-0.74), parenteral nutrition needs (HR 0.28; 95% CI 0.09-0.83), sepsis (HR 0.71; 95% CI 0.59-0.84), acute kidney injury (HR 0.54; 95% CI 0.49-0.60), shock (HR 0.52; 95% CI 0.36-0.75), and mechanical ventilation support during admission (HR 0.23; 95% CI 0.16-0.33) compared with the non-GLP-1 RAs group. In addition, all-cause mortality was decreased in the GLP-1 agonist group compared with the non-GLP-1 agonist group (HR 0.45; 95% CI 0.41-0.49). Important to note that the GLP-1 RAs group had a tendency of lower risk of uncomplicated pancreatitis (HR 0.71; 95% CI 0.49-1.01) but without statistically significant result. No difference was found between the groups in risk of developing systemic inflammatory response syndrome if it occurs.</p><p><strong>Discussion: </strong>GLP-1 RAs use does not increase AP risk is associated with lower complications in those who developed AP and linked with lower all-cause mortality in patients with T2DM. Prospective studies are needed to determine the mechanisms behind these findings.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962065","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 Wei et al.","authors":"Guy Boeckxstaens, Runze Quan, Hind Hussein","doi":"10.14309/ajg.0000000000003496","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003496","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952629","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 Gao and Ma.","authors":"Bishoi Aziz, Andrew Mason","doi":"10.14309/ajg.0000000000003473","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003473","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957276","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":"Validation of an Epigenetic Prognostic Assay to Accurately Risk Stratify Patients With Barrett's Esophagus.","authors":"Yichen Zhou, Lei Sun, Yue Lv","doi":"10.14309/ajg.0000000000003469","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003469","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958498","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}