No abstract

After 12-18 months on a gluten-free diet, 8% of the patients do not present a satisfactory histological response; only some of them could have been identified with a serological and/or clinical re-evaluation. Therefore, a duodenal biopsy seems to be the only tool that could identify patients with unsatisfactory histological response.

Patients with VA and negative endomysial antibodies are rare. However, these forms of VA identify specific causes that can be diagnosed. These patients are affected by a very high mortality.

No abstract

Background and aim: Computer-Aided Detection (CADe) increases adenoma detection in primary screening colonoscopy. The potential benefit of CADe in a fecal immunochemical test (FIT)-based colorectal cancer (CRC) screening programs is lacking. This study assesses whether the use of CADe increases the Adenoma Detection Rate (ADR) in FIT-based CRC screening program. Patients and methods: In a multicenter, randomized trial, 50-74 years old FIT-positive subjects undergoing colonoscopy, were randomized (1:1) to receive high-definition white light (HDWL) colonoscopy, with or without a real-time deep-learning CADe (CADEYE Fujifilm Co., Tokyo, Japan) by endoscopists with baseline ADR>25%. Main outcomes were ADR (primary outcome), mean number (SD) of adenomas per colonoscopy (APC) and advanced adenoma detection rate (Advanced-ADR). Subgroup analysis according to baseline endoscopists’ ADR (group 1: <40%, group 2: 41-45%, group 3 >46%) was also performed. Results: Eight hundred subjects (median age: 61.0 years, IQR: 55-67; 409 men) were included: 405 underwent CADe-assisted and 395 HDWL colonoscopy, respectively. ADR and APC were significantly higher in the CADe than in the HDWL arm: ADR: 53.6%; 95%CI: [48.6-58.5%] vs. 45.3%; 95%CI [40.3-50.45] (RR: 1.180; 95%CI: [1.026-1.361]); APC: 1.13 (1.54) vs. 0.90 (1.32), p=0.028. No significant difference in advanced-ADR (18.5%; 95%CI [14.8-22.6%] vs. 15.9%; 95%CI [12.5-19.9%]) was found. An increase in ADR was observed in all endoscopists' groups regardless of baseline ADR. Conclusions: Incorporating CADe significantly increases ADR and APC in the framework of a FIT-based CRC screening program. The impact of CADe appears to be consistent regardless of the endoscopist baseline ADR.