Diseases of the digestive system, including inflammatory bowel disease, liver disease, gastrointestinal cancers, endoscopy, and functional gastrointestinal disorders
12 papersThis large randomized trial showed that inviting people for colonoscopy screening reduced their risk of colorectal cancer by 18% over 10 years. However, the benefit for preventing death from colorectal cancer was not statistically significant, and the overall benefit for cancer prevention was lower than anticipated.
In a simulated test, the specialized AI model GastroGPT performed better than general AI models in several key gastroenterology tasks, such as diagnosis, treatment planning, and patient counseling. However, the study was limited by its use of simulated cases, and further research with real patient data is necessary to confirm its real-world applicability.
This study found that a 14-day dual therapy of vonoprazan and high-dose amoxicillin (VHA) was as effective as the standard bismuth-containing quadruple therapy (BQT) for treating persistent H. pylori infection after initial treatment failure. Importantly, the VHA therapy resulted in significantly fewer side effects. Further research is needed to confirm these results in diverse populations and evaluate the role of antibiotic resistance testing.
In a large observational study of patients with pancreatic cysts, small (<15 mm) and slow-growing (<2.5 mm/year) cysts without other risk factors were associated with a very low risk of developing high-grade dysplasia or pancreatic cancer, similar to the risk in the general population. This suggests that less frequent surveillance may be adequate for these "low-risk" cysts. However, caution is warranted due to limitations related to non-standardized management, inconsistent imaging modality use, and potential referral bias.
Ozanimod and etrasimod, two new drugs for ulcerative colitis, work by stopping lymphocytes from reaching the inflamed colon, leading to reduced inflammation and improved symptoms. While clinical trials indicate a manageable safety profile, potential for cardiovascular, ocular, hepatic, pulmonary, and infectious complications necessitates precautions and careful monitoring.
This paper presents a joint position statement on quality standards for upper gastrointestinal (UGI) endoscopy in Australia and Aotearoa New Zealand, covering pre-, intra-, and post-procedural recommendations. It emphasizes the need for tailored guidelines relevant to the diverse patient population and healthcare settings of the region, and also gives recommendations for specific conditions of the esophagus, stomach, and duodenum.
This review paper suggests a correlation between glyphosate exposure and celiac disease due to alterations in gut bacteria, impaired nutrient absorption, and inhibited enzyme function. However, it's crucial to note that this study relies on correlations, animal data, and proposed mechanisms without direct causal evidence in humans, making its conclusions speculative. Further, independent research is needed to confirm these claims.
This paper benchmarks several deep learning models for real-time polyp detection, localization, and segmentation in colonoscopy videos and introduces ColonSegNet, a novel lightweight architecture. ColonSegNet achieves competitive performance compared to state-of-the-art methods while being significantly faster, processing up to 182 frames per second.
This guideline recommends adjusting proton pump inhibitor (PPI) dosing based on a patient's CYP2C19 genotype to optimize efficacy and minimize adverse effects. Patients with genotypes predicting lower PPI exposure (rapid metabolizers) may benefit from higher doses, while those with genotypes predicting higher exposure (intermediate and poor metabolizers) may benefit from lower doses, especially during long-term therapy.
The guideline recommends endoscopic ultrasound (EUS) as the primary tool for characterizing subepithelial lesions (SELs). It suggests tissue diagnosis for SELs with GIST features if they are >20mm or high-risk, recommends endoscopic resection for growing type 1 gastric NENs, and advises against surveillance for most benign SELs if the diagnosis is clear.
This review discusses the link between gut dysbiosis, leaky gut syndrome (LGS), and autoimmune diseases. It suggests that dysbiosis can disrupt the intestinal barrier, leading to LGS, which in turn may contribute to the development or exacerbation of autoimmune conditions by facilitating the translocation of pathobionts and antigens into systemic circulation.
This retracted study suggested a link between the measles, mumps, and rubella (MMR) vaccine and the onset of autism and gastrointestinal problems in a small group of children. This study has been widely discredited due to serious methodological flaws and ethical violations.