Diagnosis and management of anemia in pediatric inflammatory bowel diseases: Clinical practice guidelines on behalf of the SIGENP IBD Working group
Anemia is one of the most frequent extra-intestinal manifestations of inflammatory bowel disease. Insidious onset, variability of symptoms and lack of standardized screening practices may increase the risk of underestimating its burden in children with IBD. Despite its relevance and peculiarity in everyday clinical practice, this topic is only dealt with in a few documents specifically for the pediatric field. The aim of the current guidelines is therefore to provide pediatric gastroenterologists with a practical update to support the clinical and therapeutic management of children with IBD and anemia. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - March 18, 2024 Category: Gastroenterology Authors: Massimo Martinelli, Maria Teresa Fioretti, Marina Aloi, Patrizia Alvisi, Serena Arrigo, Claudia Banzato, Matteo Bramuzzo, Angelo Campanozzi, Fortunata Civitelli, Daniela Knafelz, Paolo Lionetti, Antonio Marseglia, Francesca Musto, Lorenzo Norsa, Giuseppe Tags: Guidelines Source Type: research
Charting new AI education in gastroenterology: Cross-sectional evaluation of ChatGPT and perplexity AI in medical residency exam
Conversational chatbots, fueled by large language models, spark debate over their potential in education and medical career exams. There is debate in the literature about the scientific integrity of the outputs produced by these chatbots. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - March 18, 2024 Category: Gastroenterology Authors: Antonietta Gerarda Gravina, Raffaele Pellegrino, Giovanna Palladino, Giuseppe Imperio, Andrea Ventura, Alessandro Federico Tags: Alimentary Tract Source Type: research
A solitary polyp of the stomach
A 64-year-old man presented to the gastroenterology department applying for gastroscopy for cancer screening. He was asym-ptomatic. Physical examination and routine laboratory tests showed no abnormalities. Gastroscopy revealed a 0.9 cm polyp located at the junctional region between the antrum and the body (Fig. 1A), which was markedly congested. Magnifying endoscopy with narrow band imaging showed regularly arranged glandular tubes (Fig. 1B). Histopathological examination of endoscopic mucosal resection specimens revealed irregular hyperplastic glands with focal cystic dilatation (Fig. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - March 9, 2024 Category: Gastroenterology Authors: Jinpei Dong, Yu Tian Tags: Image of the Month Source Type: research
Positive phosphatidyl-ethanol test in liver disease patients: You can't handle the truth!
The limited diagnostic accuracy of patients' self-reported alcohol use in assessing alcohol-drinking behavior from an objective standpoint has led to development of biomarkers of alcohol use. Of the amount of alcohol consumed, 92% undergoes metabolism, 98% is metabolized to acetaldehyde and remaining 2% via non-oxidative mechanisms to ethyl glucuronide and phosphatidylethanol (PEth) [1]. Measurement of whole blood phosphatidylethanol (PEth) level has the advantages of being most accurate (sensitivity of 90 –99% and specificity of 100% at level>20 ng/mL and a window period of detection of up to 3, 4 weeks from the last al...
Source: Digestive and Liver Disease - March 9, 2024 Category: Gastroenterology Authors: Yaser Al-Salmay, Ashwani K. Singal Tags: Editorial Source Type: research
Association between low-dose aspirin and the risk of gastric cancer and adenoma according to a family history of gastric cancer
This study aimed to evaluate the association between low-dose aspirin use and the risk of GC and gastric adenoma according to a family history of GC. We conducted a population-based study of 7,596,003 participants screened for GC between 2013 and 2014. Aspirin users and non-users were matched in a 1:1 ratio through propensity score matching (PSM). After PSM, 51,818 participants with a family history of GC and 359,840 without a family history of GC were analyzed (mean follow-up periods: 4.9 ± 0.8 and 4.8 ± 0.8 years, respectively). (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - March 9, 2024 Category: Gastroenterology Authors: Yoon Suk Jung, Mai Thi Xuan Tran, Boyoung Park, Chang Mo Moon Tags: Oncology Source Type: research
Targeting inflammation to prevent severe acute pancreatitis: NSAIDs are not the holy grail
In the current issue of DLD, a multicenter study by Wu et al. [1] reported no association between the peri-onset administration of non-steroidal anti-inflammatory drugs (NSAIDs) and the clinical outcome in terms of the development of severe acute pancreatitis (SAP). Although limited by its retrospective design, the small number of patients receiving NSAIDS prior to or within 3 days from admission, and by the uncontrolled dosage of drugs, this study strongly challenges the conclusions of previous interventional studies. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - March 9, 2024 Category: Gastroenterology Authors: Gabriele Capurso, Alberto Malesci Tags: Editorial Source Type: research
Position paper on transanal irrigation in chronic non-organic constipation
The practice of recto-colonic water irrigation to treat constipation has been used since ancient times with different, uncontrolled, and variably performing methods which have been considered interchangeably all alike. The use of better-performing devices with a standardized methodology is relatively recent, and the term Trans Anal Irrigation (TAI) defines a methodology performed with devices able to control the timing, volume, and pressure of the water introduced into the rectum and colon utilizing a catheter or a cone through the anus. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - March 8, 2024 Category: Gastroenterology Authors: G. Bazzocchi, E.S. Corazziari, A. Staiano, G. Bassotti, M. Bellini, G. Chiarioni, L. D'Alba, E. Scarpato Tags: Position Paper Source Type: research
Artificial Intelligence-assisted colonoscopy and colorectal cancer screening: Where are we going?
Colorectal cancer is a significant global health concern, necessitating effective screening strategies to reduce its incidence and mortality rates. Colonoscopy plays a crucial role in the detection and removal of colorectal neoplastic precursors. However, there are limitations and variations in the performance of endoscopists, leading to missed lesions and suboptimal outcomes. The emergence of artificial intelligence (AI) in endoscopy offers promising opportunities to improve the quality and efficacy of screening colonoscopies. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - March 7, 2024 Category: Gastroenterology Authors: Marco Spadaccini, Joel Troya, Kareem Khalaf, Antonio Facciorusso, Roberta Maselli, Alexander Hann, Alessandro Repici Tags: Special Article Source Type: research
Frailty risk and treatment strategy in elderly-onset inflammatory bowel disease. A Norwegian nationwide population-based registry study
To determine real-world medical and surgical treatment patterns in elderly-onset inflammatory bowel disease in a nationwide cohort, and to investigate associations between frailty and treatment choices. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - March 2, 2024 Category: Gastroenterology Authors: Karoline Anisdahl, Sandre Svatun Lirhus, Asle W Medhus, Bj ørn Moum, Hans Olav Melberg, Marte Lie Høivik Tags: Alimentary Tract Source Type: research
You can't handle the truth! Comparing serum phosphatidylethanol to self-reported alcohol intake in chronic liver disease patients
Serum phosphatidylethanol (PEth) testing has emerged as a promising biomarker for assessing recent alcohol consumption, surpassing the limitations of self-reported data. Limited clinical data exists comparing PEth levels and patients' reported alcohol intake. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - March 1, 2024 Category: Gastroenterology Authors: Kyle Scholten, Patrick Twohig, Kaeli Samson, Kevin Brittan, Alexandra Fiedler, Josh Warner, Tomoki Sempokuya, Anna Willet, Thoetchai(Bee) Peeraphatdit, Marco Olivera Tags: Liver, Pancreas and Biliary Tract Source Type: research
Aetiology and diagnostic utility of serum ascites albumin gradient in children with ascites
Ascites in children is multifactorial and serum ascites albumin gradient (SAAG) ≥1.1 helps differentiate portal hypertension (PHTN) related from non-PHTN ascites. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - February 29, 2024 Category: Gastroenterology Authors: Srinivas Srinidhi Vadlapudi, Anshu Srivastava, Nidhi Saini, Moinak Sen Sarma, Ujjal Poddar, Surender Kumar Yachha Tags: Liver, Pancreas and Biliary Tract Source Type: research
Integrating AI in medicine: Lessons from Chat-GPT's limitations in medical imaging
We read with interest the recent publication by Zhang et al., "Unexpectedly low accuracy of GPT-4 in identifying common liver diseases from CT scan images," published in Digestive and Liver Disease [1]. Large Language Models (LLMs) have excelled in text-based medical tasks, proving adept at processing medical data and supporting diagnostic reasoning [2]. Notably, ChatGPT has demonstrated the ability to answer board exam questions effectively in some subspecialties [3,4]. It has also been effective in generating comprehensive differential diagnosis lists, showcasing its utility in synthesizing medical knowledge [5,6]. (Sour...
Source: Digestive and Liver Disease - February 29, 2024 Category: Gastroenterology Authors: Shunsuke Koga, Wei Du Tags: Correspondence Source Type: research
The 1st EoETALY Consensus on the Diagnosis and Management of Eosinophilic Esophagitis – Definition, Clinical Presentation and Diagnosis
Eosinophilic esophagitis (EoE) is a chronic type 2-mediated inflammatory disease of the esophagus that represents the most common eosinophilic gastrointestinal disease. Experts in the field of EoE across Italy (i.e., EoETALY Consensus Group) including gastroenterologists, endoscopists, allergologists/immunologists, and paediatricians conducted a Delphi process to develop updated consensus statements for the management of patients with EoE and update the previous position paper of the Italian Society of Gastroenterology (SIGE) in light of recent evidence. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - February 28, 2024 Category: Gastroenterology Authors: Nicola de Bortoli, Pierfrancesco Visaggi, Roberto Penagini, Bruno Annibale, Federica Baiano Svizzero, Giovanni Barbara, Ottavia Bartolo, Edda Battaglia, Antonio Di Sabatino, Paola De Angelis, Ludovico Docimo, Marzio Frazzoni, Manuele Furnari, Andrea Iori, Tags: Guidelines Source Type: research
Characteristics of microbiomes of the saliva, duodenal bulb, and descending portion of superficial nonampullary duodenal epithelial tumors
Nonampullary duodenal epithelial tumors are rare, but their prevalence is increasing. Various gastrointestinal cancers have been associated with microbiomes. We evaluated the characteristics of the salivary and duodenal microbiomes of patients with nonampullary duodenal epithelial tumors. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - February 26, 2024 Category: Gastroenterology Authors: Hiroyuki Shibata, Kenta Yamamoto, Takashi Hirose, Satoshi Furune, Naomi Kakushima, Kazuhiro Furukawa, Masanao Nakamura, Takashi Honda, Mitsuhiro Fujishiro, Hiroki Kawashima Tags: Alimentary Tract Source Type: research
Endoscopic papillectomy for simultaneous epithelial tumors of major and minor duodenal papillae
A 75-year-old male was referred to our hospital for endoscopic treatment of cancer at the esophagogastric junction. Preceding the treatment, endoscopic examination revealed tumors in the major and minor duodenal papillae (Fig. 1A –C), diagnosed as adenocarcinoma and adenoma, respectively, through biopsy. CT scans ruled out lymph node metastasis, and MRCP excluded pancreatic divisum. In the endoscopic ultrasound examination, no infiltration into the common bile duct or pancreatic duct was observed. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - February 24, 2024 Category: Gastroenterology Authors: Shinya Matsumura, Yasuyuki Sai, Kiyoshi Ogiso, Kentaro Suzuki Tags: Image of the Month Source Type: research
