Abstract：
BACKGROUND & AIMS:Triage of patients with acute upper gastrointestinal hemorrhage (UGIH) has traditionally required urgent upper endoscopy. The aim of this study is to evaluate the use of artificial neural network for nonendoscopic triage. METHODS:A cohort of 387 patients was used to train (n = 194) and internally validate (n = 193) the neural network, which was then externally validated in 200 patients and compared with the clinical and complete Rockall score. Two outcome variables were assessed: major stigmata of recent hemorrhage and need for endoscopic therapy. Patient cohort data from 2 independent tertiary-care medical centers were prospectively collected. Adult patients hospitalized at both sites during the same time period with a primary diagnosis of acute nonvariceal UGIH. RESULTS:In predicting the 2 measured outcomes, sensitivity of neural network was >80%, with high negative predictive values (92-96%) in both cohorts but with lower specificity in the external cohort. Both Rockall scores had adequate sensitivity (>80%) but poor specificity (<40%) at outcome prediction. Comparing areas under receiver operating characteristic curves, the clinical Rockall score was significantly inferior to neural network in both cohorts (/= 0.78), while in the external cohort, neural network performed similarly to the complete Rockall score (>/= 0.78). CONCLUSIONS:In acute nonvariceal UGIH, artificial neural network (nonendoscopic triage) performed as well as the complete Rockall score (endoscopic triage) at predicting stigmata of recent hemorrhage and need for endoscopic therapy, even when tested in an external patient population.
journal_name
Gastroenterologyjournal_title
Gastroenterologyauthors
Das A,Ben-Menachem T,Farooq FT,Cooper GS,Chak A,Sivak MV Jr,Wong RCdoi
10.1053/j.gastro.2007.10.037subject
Has Abstractpub_date
2008-01-01 00:00:00pages
65-74issue
1eissn
0016-5085issn
1528-0012pii
S0016-5085(07)01917-8journal_volume
134pub_type
杂志文章相关文献
GASTROENTEROLOGY文献大全abstract：:The noninvasive assessment of intestinal permeability in humans has a 20-year history. Because the tests are increasingly used in clinical practice and research and because there is much controversy, we reviewed the literature and outlined the potential and possible shortcomings of these procedures. Data was obtained ...
journal_title：Gastroenterology
pub_type： 杂志文章,评审
doi：10.1016/0016-5085(95)90708-4
更新日期：1995-05-01 00:00:00
abstract：BACKGROUND & AIMS:Senescence prevents cellular transformation. We investigated whether vascular endothelial growth factor (VEGF) signaling via its receptor, VEGFR2, regulates senescence and proliferation of tumor cells in mice with colitis-associated cancer (CAC). METHODS:CAC was induced in VEGFR2(ΔIEC) mice, which do...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：10.1053/j.gastro.2015.03.016
更新日期：2015-07-01 00:00:00
abstract：:Sporadic colorectal cancer (CRC) is a somatic genetic disease in which pathogenesis is influenced by the local colonic environment and the patient's genetic background. Consolidating the knowledge of genetic and epigenetic events that occur with initiation, progression, and metastasis of sporadic CRC has identified so...
journal_title：Gastroenterology
pub_type： 杂志文章,评审
doi：10.1053/j.gastro.2015.06.047
更新日期：2015-10-01 00:00:00
abstract：BACKGROUND & AIMS:Guidelines recommend a 10-year interval between screening colonoscopies with negative results for average-risk individuals. However, many patients are examined at shorter intervals. We investigated outcomes of individuals with no polyps who had repeat colonoscopy in <10 years. METHODS:Data were colle...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：10.1053/j.gastro.2014.04.020
更新日期：2014-08-01 00:00:00
abstract：:In 6 anesthetized dogs receiving 400 pmoles kg-1 hr-1 of natural human little gastrin intravenously, blood samples for radioimmunoassay of gastrin were taken repeatedly from a carotid artery, jugular vein, femoral vein, renal vein, and mesenteric vein. The calculated removal of gastrin in a single passage through thes...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：
更新日期：1978-01-01 00:00:00
abstract：BACKGROUND & AIMS:We assessed the risk of ulcers with low-dose aspirin and the interaction of low-dose aspirin with a COX-2 selective inhibitor in a double-blind trial that compared placebo, low-dose aspirin, rofecoxib + low-dose aspirin, and ibuprofen. METHODS:Osteoarthritis patients > or =50 years of age without ulc...
journal_title：Gastroenterology
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1053/j.gastro.2004.05.001
更新日期：2004-08-01 00:00:00
abstract：:Development of an intraabdominal bile collection (biloma) usually occurs secondary to traumatic or iatrogenic injury including abdominal surgery, percutaneous catheter drainage, and transhepatic cholangiogram. We present a case of hepatic subcapsular biloma following endoscopic retrograde cholangiography and identifie...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：
更新日期：1988-05-01 00:00:00
abstract：BACKGROUND & AIMS:The duodenum is a cystic fibrosis transmembrane conductance regulator (CFTR)-expressing epithelium with high bicarbonate secretory capacity. We aimed to define the role of CFTR in human duodenal epithelial bicarbonate secretion in normal (NL) subjects and patients with cystic fibrosis (CF). METHODS:E...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：10.1016/s0016-5085(00)70358-1
更新日期：2000-06-01 00:00:00
abstract：:To determine the effect of intraduodenal calcium on pancreatic, gallbladder, and gastric functions in healthy man, a validated perfusion method was employed to quantify total pancreatic, biliary, and gastric outputs during duodenal perfusion of either 6 mM, 12 mM,or 25 mM of elemental calcium (as isotonic calcium chlo...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：
更新日期：1976-05-01 00:00:00
abstract：:The target appearance of grey scale ultrasound is thought to be a characteristic sign of gastrointestinal wall thickening. It consists of a strong echogenic center surrounded by a sonolucent rim. In a prospective controlled study, the sensitivity and specificity of the ultrasonic B-scan for Crohn's disease were invest...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：
更新日期：1982-08-01 00:00:00
abstract：:The effect of local intraarterial infusion of arginine vasopressin was studied in a vascularly perfused segment of cat ileum. Systemic arterial pressure (Pa), superior mesenteric arterial pressure (Pma), superior mesenteric venous pressure (Pv), blood flow (QB) and intestinal volume (V) were continuously monitored. In...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：
更新日期：1977-12-01 00:00:00
abstract：BACKGROUND & AIMS:CD8(+) T cells that produce interleukin (IL)-17 (Tc17 cells) promote inflammation and have been identified in tumors. We investigated their role in the pathogenesis of gastric cancer. METHODS:We used flow cytometry analyses to determine levels and phenotype of Tc17 cells in blood and tumor samples fr...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：10.1053/j.gastro.2012.06.010
更新日期：2012-10-01 00:00:00
abstract：:In vitro neurite outgrowth and neuronal survival are promoted by laminin, and neuronal migration is promoted by collagen type IV. This led to the hypothesis that Hirschsprung's disease (HD) could be the result of an abnormal extracellular matrix microenvironment in the affected bowel during embryogenesis. Using indire...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：
更新日期：1992-04-01 00:00:00
abstract：BACKGROUND & AIMS:In experimental animals, the indigenous microbiota modulates mucosal immunity. In humans, such direct evidence is scarce. The aim of this study was to examine the effect of intestinal bacteria on the local immunoglobulin (Ig) response. METHODS:The numbers of IgA-, IgM-, and IgG-producing immunocytes ...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：10.1016/0016-5085(95)90389-5
更新日期：1995-09-01 00:00:00
abstract：BACKGROUND & AIMS:Few data are available concerning the long-term prognosis of chronic liver disease associated with hepatitis C virus infection. This study examined the morbidity and survival of patients with compensated cirrhosis type C. METHODS:A cohort of 384 European cirrhotic patients was enrolled at seven terti...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：10.1053/gast.1997.v112.pm9024300
更新日期：1997-02-01 00:00:00
abstract：BACKGROUND & AIMS:The metaplastic process in which the normal squamous epithelium of the distal esophagus is replaced by columnar-lined epithelium, known as Barrett's esophagus (BE), is poorly understood. The aim of this study was to define, analyze, and compare transcription profiles of BE, normal cardia epithelium, a...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：10.1053/j.gastro.2005.07.026
更新日期：2005-10-01 00:00:00
abstract：:Gastric mucosa of the rat generates both PGE2 and PGI2 activity in significantly higher concentrations in the antrum than in the fundus. Aspirin, given intravenously or intragastrically in doses producing gastric mucosal lesions, causes a dose-dependent decrease in the generation of mucosal PGE2 and PGI2, which is fur...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：
更新日期：1981-01-01 00:00:00
abstract：:A case of a 29-year-old woman who has had two episodes both clinically and biochemically consistent with acute fatty liver of pregnancy is described. These episodes occurred in two successive pregnancies, and liver biopsy confirmed the diagnosis in the second pregnancy. Both pregnancies were managed by prompt fetal de...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：10.1016/0016-5085(91)90228-d
更新日期：1991-02-01 00:00:00
abstract：:We report the case of a female patient suffering from Waldenström's macroglobulinemia with three different liver lesions: peliosis hepatis, nodular regenerative hyperplasia, and light-chain deposits within the sinusoidal walls. We hypothesize that both peliosis hepatis and nodular regenerative hyperplasia might be the...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：10.1016/0016-5085(88)90508-2
更新日期：1988-08-01 00:00:00
abstract：:Lower esophageal sphincter pressure, basal gastric pH, fasting plasma gastrin, and plasma concentrations of estrone, estradiol, and progesterone were measured in pregnant volunteers at 12, 24, and 36 weeks of gestation, and again at 1 to 4 weeks postpartum. In addition, basal and pentagastrin-stimulated acid secretory...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：
更新日期：1977-04-01 00:00:00
abstract：:The influence of adaptive cell proliferation on colonic carcinogenesis was studied in male Fischer rats with a defunctioning transverse colostomy that was closed 4 wk later. Control observations were made in other rats after colonic transection, repeated at 4 wk, after laparotomy alone, or after permanent colostomy. T...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：
更新日期：1981-09-01 00:00:00
abstract：:Non-major histocompatibility complex-restricted cytotoxicity triggered by antibodies to the CD3 component of the human T-cell receptor complex is thought to be an indirect measure of in vivo primed cytotoxic T-cell activity. We have used this technique to examine the lytic activity of freshly isolated T cells from non...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：10.1016/0016-5085(88)90554-9
更新日期：1988-04-01 00:00:00
abstract：BACKGROUND/AIMS:Staphylococcal enterotoxin B (SEB) acts as a superantigen binding to class II major histocompatibility complex proteins, and this complex stimulates T cells. The aim of this study was to investigate the pathogenic effects of SEB on hepatic injury and lethal shock in mice. METHODS:SEB was administered t...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：10.1016/0016-5085(94)90604-1
更新日期：1994-02-01 00:00:00
abstract：BACKGROUND & AIMS:It is not clear whether H2-receptor antagonists (H2RAs) reduce the risk of gastrointestinal (GI) bleeding in aspirin users at high risk. We performed a double-blind randomized trial to compare the effects of a proton pump inhibitor (PPI) vs a H2RA antagonist in preventing recurrent upper GI bleeding a...
journal_title：Gastroenterology
pub_type： 杂志文章,随机对照试验
doi：10.1053/j.gastro.2016.09.006
更新日期：2017-01-01 00:00:00
abstract：BACKGROUND & AIMS:Nonalcoholic chronic pancreatitis is usually idiopathic and often associated with cystic fibrosis gene (CFTR) mutations. It is unknown whether pancreatitis risk correlates with having 1 or 2 CFTR mutations, abnormal epithelial ion transport, or mutations of other genes. METHODS:We tested 39 patients ...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：10.1053/gast.2001.29673
更新日期：2001-12-01 00:00:00
abstract：:Disappearance of symptoms, resolution of most biochemical abnormalities, and histologic improvement to mild chronic inflammation were accomplished in 69 of 123 patients (56%) with severe chronic active liver disease treated with corticosteroids for up to 6.5 yr. Remission of at least 6 mo duration was possible in 35 o...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：
更新日期：1980-03-01 00:00:00
abstract：:Fifty consecutive patients with symptomatic endoscopically proven duodenal ulcer were randomized double-blind to Mylanta II or cimetidine treatment schedules. Smoking habits were noted, but patients were not advised to alter these. Healing was determined by reendoscopy at 6 wk. Eighty percent of patients on active cim...
journal_title：Gastroenterology
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1981-06-01 00:00:00
abstract：BACKGROUND & AIMS:Glutamine is an essential amino acid for rapidly dividing cells such as enterocytes. The progress of cancer is associated with a decrease of arterial and muscle glutamine concentrations. The aim of this study was to test whether increasing tumor loads affect gut intracellular glutamine handling, prote...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：10.1016/s0016-5085(97)70226-9
更新日期：1997-01-01 00:00:00
abstract：:2-Camphanone is under clinical evaluation for alleviation of hemorrhoidal bleeding and inflammation. Reduced portal venous blood flow may distend, whereas improved portal venous blood flow may alleviate, hemorrhoidal vein distention. The effects of 2-camphanone on canine portal venous blood flow were investigated usin...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：10.1016/0016-5085(92)90082-a
更新日期：1992-02-01 00:00:00
abstract：:Serum gastrin and gastric endocrine cell numerical densities were examined in 22 patients with long-standing Zollinger-Ellison syndrome who were receiving either ranitidine, omeprazole, or other antisecretory drugs (SMS 201-995 or pirenzepine with or without ranitidine) for long periods of time. Fifteen patients had i...
journal_title：Gastroenterology
pub_type： 杂志文章
doi：10.1016/0016-5085(89)91620-x
更新日期：1989-04-01 00:00:00
