Risk Scoring Systems for Predicting the Presence of Colorectal Neoplasia by Fecal Immunochemical Test Results in Chinese Population
Clinical and Translational Gastroenterology
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1M ago
INTRODUCTION: Adherence to colonoscopy screening for colorectal cancer (CRC) is low in general populations, including those tested positive in the fecal immunochemical test (FIT). Developing tailored risk scoring systems by FIT results may allow for more accurate identification of individuals for colonoscopy. METHODS: Among 807,109 participants who completed the primary tests in the first-round Shanghai CRC screening program, 71,023 attended recommended colonoscopy. Predictors for colorectal neoplasia were used to develop respective scoring systems for FIT-positive or FIT-negative populations ..read more
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A Multicenter Study of Left Ventricular Assist Device-Related Gastrointestinal Bleeding
Clinical and Translational Gastroenterology
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1M ago
INTRODUCTION: Continuous left ventricular assist devices (LVADs) offer hemodynamic support in advanced and decompensated heart failure but are often complicated by gastrointestinal bleeding (GIB) in medically fragile patients. METHODS: We performed a retrospective analysis of 475 consecutive patients who underwent LVAD implantation at the Massachusetts General Hospital and Tufts Medical Center from 2008 to 2019 and identified 128 patients with clinically significant GIB. Clinical characteristics of each bleeding event, including procedures and interventions, were recorded. We examined LVAD pat ..read more
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Reevaluation of Gastric Cancer Screening by Levin's Equation
Clinical and Translational Gastroenterology
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1M ago
INTRODUCTION: This study aimed to reevaluate the effectiveness of fluoroscopy and endoscopy in reducing gastric cancer mortality at the population level. METHODS: Crude and age-adjusted mortality rates of gastric cancer and the introduction rates of gastric cancer screening were extracted from the Cancer Registry and Statistics database. The population-attributable risk (PAR) percent of no screening for gastric cancer mortality was calculated using Levin's equation. The PAR of each mortality rate in the no-screening group was estimated as follows: mortality × PAR%. The Jonckheere-Terpstra test ..read more
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Circulating Bile Acids and Adenoma Recurrence in the Context of Adherence to a High-Fiber, High-Fruit and Vegetable, and Low-Fat Dietary Intervention
Clinical and Translational Gastroenterology
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1M ago
INTRODUCTION: Diet may affect bile acid (BA) metabolism and signaling. In turn, BA concentrations may be associated with cancer risk. We investigated (i) associations of BA concentrations with adenoma recurrence and (ii) the effect of a high-fiber, high-fruit and vegetable, and low-fat dietary intervention on serum BA concentrations. METHODS: The Polyp Prevention Trial is a 4-year randomized, controlled trial that investigated the effect of a high-fiber, high-fruit and vegetable, and low-fat diet on colorectal adenoma recurrence. Among 170 participants who reported adhering to the intervention ..read more
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Microbial Associations With Microscopic Colitis
Clinical and Translational Gastroenterology
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1M ago
INTRODUCTION: Microscopic colitis is a relatively common cause of chronic diarrhea and may be linked to luminal factors. Given the essential role of the microbiome in human gut health, analysis of microbiome changes associated with microscopic colitis could provide insights into the development of the disease. METHODS: We enrolled patients who underwent colonoscopy for diarrhea. An experienced pathologist classified patients as having microscopic colitis (n = 52) or controls (n = 153). Research biopsies were taken from the ascending (ASC) and descending (DES) colon, and the microbiome was char ..read more
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Decreased Gut Microbiome Tryptophan Metabolism and Serotonergic Signaling in Patients With Persistent Mental Health and Gastrointestinal Symptoms After COVID-19
Clinical and Translational Gastroenterology
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1M ago
INTRODUCTION: An estimated 15%–29% of patients report new gastrointestinal (GI) symptoms after coronavirus-19 disease (COVID-19) while 4%–31% report new depressive symptoms. These symptoms may be secondary to gut microbiome tryptophan metabolism and 5-hydroxytryptamine (5-HT)-based signaling. METHODS: This study used specimens from 2 patient cohorts: (i) fecal samples from patients with acute COVID-19 who participated in a randomized controlled trial testing prebiotic fiber and (ii) blood samples from patients with acute COVID-19. Six months after recovering from COVID-19, both cohorts answere ..read more
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Blood and Intestine eQTLs from an Anti-TNF-Resistant Crohn's Disease Cohort Inform IBD Genetic Association Loci
Clinical and Translational Gastroenterology
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1M ago
OBJECTIVES: Genome-wide association studies (GWAS) have identified loci reproducibly associated with inflammatory bowel disease (IBD) and other immune-mediated diseases; however, the molecular mechanisms underlying most of genetic susceptibility remain undefined. Expressional quantitative trait loci (eQTL) of disease-relevant tissue can be employed in order to elucidate the genes and pathways affected by disease-specific genetic variance. METHODS: In this study, we derived eQTLs for human whole blood and intestine tissues of anti-tumor necrosis factor-resistant Crohn's disease (CD) patients. W ..read more
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Satisfaction With Telehealth Among Patients With Irritable Bowel Syndrome During COVID-19: Cross-Sectional Survey Findings
Clinical and Translational Gastroenterology
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2M ago
INTRODUCTION: Coronavirus disease 2019 rapidly shifted health care toward telehealth. We assessed satisfaction with and preferences for telehealth among patients with irritable bowel syndrome (IBS). METHODS: We conducted a cross-sectional survey in an integrated healthcare system in Southern California with members aged 18–90 years with an International Classification of Diseases 9 and 10 codes for IBS from office-based encounters between June 1, 2018, and June 1, 2020. Eligible patients were emailed a survey assessing telehealth satisfaction overall and by patient-related factors, IBS charact ..read more
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A Community-Based Pancreatic Cancer Screening Study in High-Risk Individuals: Preliminary Efficacy and Safety Results
Clinical and Translational Gastroenterology
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2M ago
INTRODUCTION: Pancreatic cancer (PC) screening recommendations have been based on studies performed solely at high-volume academic centers. To make PC screening more widely available, community-based efforts are essential. We implemented a prospective PC screening study in the community of Fairfield County, CT, and report our early safety and efficacy results. METHODS: Eligible individuals were enrolled into an investigator-initiated study and underwent a baseline and 3 annual magnetic resonance imagings/magnetic resonance cholangiopancreatographies (MRIs/MRCPs) with gadolinium, biannual blood ..read more
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Artificial Intelligence and Device-Assisted Enteroscopy: Automatic Detection of Enteric Protruding Lesions Using a Convolutional Neural Network
Clinical and Translational Gastroenterology
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2M ago
INTRODUCTION: Device-assisted enteroscopy (DAE) plays a major role in the investigation and endoscopic treatment of small bowel diseases. Recently, the implementation of artificial intelligence (AI) algorithms to gastroenterology has been the focus of great interest. Our aim was to develop an AI model for the automatic detection of protruding lesions in DAE images. METHODS: A deep learning algorithm based on a convolutional neural network was designed. Each frame was evaluated for the presence of enteric protruding lesions. The area under the curve, sensitivity, specificity, and positive and n ..read more
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