American Journal of Gastroenterology最新文献

{"title":"Mycobacterium fortuitum : A Liver Mass in Luck.","authors":"Vivian Ortiz, Malak Itani, Ige A George","doi":"10.14309/ajg.0000000000003970","DOIUrl":"10.14309/ajg.0000000000003970","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"2075"},"PeriodicalIF":8.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269471","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":"Esophageal Band Ligation Successfully Controlled Sentinel Bleeding From an Aortoesophageal Fistula.","authors":"Daniel Yee Lee Ng, Alvin Yik Shian Ting, Sumaya Al-Ukaidey","doi":"10.14309/ajg.0000000000003954","DOIUrl":"10.14309/ajg.0000000000003954","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"2073"},"PeriodicalIF":8.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146163677","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 Workforce of the Future Task Force: Physician Workforce Subgroup Report.","authors":"Neil Stollman, Jean-Paul Achkar, Mariam Naveed, K Gautham Reddy, Vonda Reeves, Drew Schembre, Ronald Vender, Patrick E Young","doi":"10.14309/ajg.0000000000004107","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004107","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":"121 9S","pages":"S4-S16"},"PeriodicalIF":8.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015415","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: September 2026.","authors":"Sean Bhalla","doi":"10.14309/ajg.0000000000004161","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004161","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":"121 9","pages":"2085"},"PeriodicalIF":8.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872693","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":"Sevoflurane Dose and Timing Affects Esophageal Contractility During Functional Lumen Imaging Probe.","authors":"Erin E Toaz, Alain J Benitez, Eric C Cheon, Mark Mahon, Natalie V Hoffmann, Amanda B Muir, Joshua B Wechsler","doi":"10.14309/ajg.0000000000003845","DOIUrl":"10.14309/ajg.0000000000003845","url":null,"abstract":"<p><strong>Introduction: </strong>Functional lumen imaging probe (FLIP) can assess the esophageal contractile response (CR). Anesthetic agents used during endoscopy affect esophageal contractility, however, the time or dose-dependent effect of specific medications on the esophageal CR in children is unknown.</p><p><strong>Methods: </strong>Charts of patients aged 3-22 years undergoing endoscopy with FLIP for evaluation of dysphagia at 2 tertiary pediatric hospitals were reviewed. Anesthetic dose and timing were collected. FLIP data were exported to Wklytics to generate Panometry plots, and the CR was classified as normal, borderline, spastic, impaired, or absent based on established definitions. Binary logistic regression was performed to assess whether anesthetic administration was associated with absent CR. End-tidal sevoflurane concentration was compared across groups with normal, borderline, and absent/impaired CR.</p><p><strong>Results: </strong>Three hundred-three pediatric patients with a mean (SD) age of 13 years (4), 65% adolescent boys, were included. Totally, 80 (26%) had abnormal esophageal CR, where 16 (5%) were impaired, 63 (21%) were absent, and 1 was spastic. Two hundred twenty-eight (75%) were diagnosed with eosinophilic esophagitis, and 215 (71%) received sevoflurane. The odds ratio for absent CR if sevoflurane was administered was 8.4 ( P < 0.001). Sevoflurane was used significantly more often for both induction and maintenance in patients with abnormal CR compared with normal CR (70% vs 38%, P < 0.001). During the maintenance phase of anesthesia, end-tidal sevoflurane concentration was higher in patients with abnormal CR compared with normal CR independent of propofol infusion, recruitment site, and distensibility.</p><p><strong>Discussion: </strong>The timing and dose of sevoflurane is strongly associated with esophageal CR impairment during FLIP.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"2142-2148"},"PeriodicalIF":8.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145779988","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":"Associations Between Mean Arterial Pressure Thresholds and Clinical Outcomes in Decompensated Cirrhosis With Septic Shock.","authors":"Kavish R Patidar, Lauren Hall, Gerald O Ogola, Francis Pike, Rakhi Maiwall, Constantine J Karvellas, Fabiha Syed, Luis F Garrido-Trevino, Olivia C Walker, Nagasri Shankar, Giuseppe Cullaro, Mohammed Mogri, Nithya Iyer, Sumeet K Asrani","doi":"10.14309/ajg.0000000000003854","DOIUrl":"10.14309/ajg.0000000000003854","url":null,"abstract":"<p><strong>Introduction: </strong>Short-term mortality remains high in decompensated cirrhosis patients with septic shock. While a mean arterial pressure (MAP) >65 mm Hg is recommended for the management of septic shock in the general population, the optimal MAP for decompensated cirrhosis is not well defined. We evaluated the association between various MAP thresholds, 28-day mortality, and acute kidney injury (AKI) nonrecovery.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective analysis of decompensated cirrhosis patients with septic shock admitted to intensive care units across 20 Texas hospitals (January 1, 2014-December 31, 2022). Time weighted average MAP (TWA-MAP) during the initial 72 hours of admission was calculated to quantify hypotension exposure. Multivariable logistic regression models assessed the impact of various TWA-MAP thresholds (60-90 mm Hg) on 28-day mortality and AKI nonrecovery, adjusting for relevant confounders.</p><p><strong>Results: </strong>Among 1,145 patients (mean age 64, Model for End-Stage Liver Disease 26, 43% female, 19% non-White, 22% Hispanic, 38% alcohol-associated cirrhosis), 66% had AKI, with 37% nonrecovery; 28-day mortality was 56%. Increasing TWA-MAP from <60 mm Hg to 75 mm Hg was associated with a stepwise reduction in the odds of 28-day mortality (<60 odds ratio [OR] 2.775; <65 OR 1.607; <70 OR 1.305; <75 OR 1.180). However, the survival benefit plateaued >75 mm Hg. Similar associations were found for AKI nonrecovery (<60 1.151; <65 OR 1.153; <70 OR 1.110; <75 OR 1.079) and reductions attenuated >75 mm Hg.</p><p><strong>Discussion: </strong>Maintaining MAP between 70 and 75 mm Hg may optimize survival and kidney recovery in patients with decompensated cirrhosis and septic shock. Randomized trials are needed to compare traditional MAP targets (60-65 mm Hg) with intermediate targets (70-75 mm Hg) to improve outcomes in this high-risk population.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"2211-2218"},"PeriodicalIF":8.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931780","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":"Do Patients on Glucagon-Like Peptide-1 Receptor Agonists Require Longer Fasting Before Vibration Controlled Transient Elastography?","authors":"Sunny Sandhu, Catherine Blandon, Ruth Canovas, Maria Romero, Victoria Fuentes, Sara Patino, Farah Alkilani, David S Goldberg","doi":"10.14309/ajg.0000000000004191","DOIUrl":"10.14309/ajg.0000000000004191","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872671","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 Utility of Mucin 2 and Caudal-Type Homeobox Transcription Factor 2 Expression in the Diagnosis of Barrett's Esophagus: A Community-Based Study of Wide-Area Transepithelial Sampling and Forceps Biopsies.","authors":"Nicholas J Shaheen, F Scott Corbett, Mendel E Singer, William J Salyers, Sachin Srinivasan, Vivek Kaul, Arvind J Trindade, Amit Aravapalli, Robert D Herman, Michael S Smith, Walker D Redd, Natalie J Wilson, Dan Lister, Matthew J McKinley, Maxx B Cadmus, Robert D Odze","doi":"10.14309/ajg.0000000000003904","DOIUrl":"10.14309/ajg.0000000000003904","url":null,"abstract":"<p><strong>Introduction: </strong>The diagnosis of Barrett's esophagus (BE) requires identification of goblet cells in esophageal columnar-lined epithelium. Forceps biopsies (FB) may miss goblet cells because of sampling error. In addition, pathologists may misidentify distended pseudogoblet cells as true goblet cells. Caudal-type homeobox transcription factor 2 (CDX2) and mucin 2 (MUC2) are molecules involved in BE pathogenesis. The utility of CDX2 and MUC2 immunohistochemistry is assessed in the diagnosis of BE.</p><p><strong>Methods: </strong>We performed a prospective, community-based registry study of patients with gastroesophageal reflux disease undergoing endoscopy for BE screening. All patients underwent both FB and Wide Area Transepithelial Sampling with 3-Dimensional Computer Analysis (WATS3D). CDX2 and MUC2 immunohistochemistry was performed on WATS3D samples. We assessed concordance between CDX2 and MUC2 staining and goblet cells, on both WATS3D and FB. Operating characteristics of FB for diagnosing BE were calculated using MUC2 positivity and goblet cells on WATS3D as the gold standard.</p><p><strong>Results: </strong>Of 35,265 patients enrolled, 11,040 (31.3%) met endoscopic criteria for BE. Of these, 8,464 (76.7%) were CDX2+ and 3,563 (32.3%) were MUC2+. Whereas there was almost perfect concordance between MUC2 positivity and goblet cells on WATS3D, only 65.4% of patients with goblet cells on FB were MUC2+ on WATS3D. When using MUC2+ and goblet cells on WATS3D as the reference standard, FB diagnosed BE with sensitivity of 46.3%, specificity 88.3%, positive predictive value 65.4%, and negative predictive value 77.5%.</p><p><strong>Discussion: </strong>MUC2 immunohistochemistry may be more sensitive and specific for diagnosing BE than goblet cells by FB. FB misses approximately half of BE when using MUC2/WATS3D as an alternative gold standard. The addition of MUC2 immunohistochemistry may aid in the recognition of BE.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"2166-2177"},"PeriodicalIF":8.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931792","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: September 2026.","authors":"Kanwarpreet S Tandon","doi":"10.14309/ajg.0000000000004160","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004160","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":"121 9","pages":"2084"},"PeriodicalIF":8.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148981927","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":"Calendar of Courses, Symposiums and Conferences.","authors":"","doi":"10.14309/ajg.0000000000004162","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004162","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":"121 9","pages":"2355"},"PeriodicalIF":8.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148981849","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}