GastroHep最新文献

{"title":"Correlation of Quality of Life and Symptoms in an Interventional Treatment Study for Celiac Disease","authors":"Jack A. Syage,&nbsp;Jennifer A. Sealey-Voyksner,&nbsp;Gail M. Comer,&nbsp;Peter H. R. Green","doi":"10.1155/ygh2/9935485","DOIUrl":"https://doi.org/10.1155/ygh2/9935485","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Celiac disease (CeD), characterized by autoimmune enteropathy, has a substantial symptom burden that adversely affects patients′ quality of life (QoL). This data analysis examines the correlation of individual and composite measures of symptoms and QoL for patient status at baseline and longitudinal change to end-of-study under therapeutic (latiglutenase) and placebo treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data from the CeliAction study (ALV003-1221), a multicenter randomized controlled trial of treatment with latiglutenase was analyzed. Daily symptom scores were captured using the Celiac Disease Symptom Diary (CDSD). QoL was assessed at baseline, Week 6, and Week 12 with three validated instruments: the Impact of Celiac Disease Symptoms Questionnaire (ICDSQ), the Patient Global Impression of Severity (PGI-S), and the SF-12v2 Health Survey. Pearson correlation coefficients (<i>r</i>) were used to quantify associations between symptom domains and QoL outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At baseline, strong correlations (<i>r</i> ≥ 0.50) were observed between composite symptom scores and QoL measures across the study population. In the analyses of change from baseline to Week 12, moderate-to-strong (<i>r</i> ≥ 0.30) correlations were identified in the high-dose latiglutenase seroactive cohort, with more modest correlations in nonseroactive and placebo groups. Tiredness consistently demonstrated strong correlations with QoL outcomes, both at baseline and in seroactive patients, underscoring its clinical relevance to patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CDSD scores correlate with established QoL instruments, supporting its use as a patient-reported outcome instrument in CeD. Tiredness appears as a highly prevalent and clinically important gluten-induced symptom, which correlates strongly with QoL measures and is responsive to therapeutic intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT01917630</p>\u0000 </section>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2026 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ygh2/9935485","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148466700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Nonmedical Switch From Adalimumab Originator to Biosimilar in Inflammatory Bowel Disease: Pharmacokinetics, Clinical Outcomes and Patient Experience in a Retrospective Real-World Study","authors":"X. Y. Choon,&nbsp;A. Moore,&nbsp;E. Sharma,&nbsp;D. Russell,&nbsp;M. Foster,&nbsp;D. Chester,&nbsp;M. Sastrillo,&nbsp;S. Coullouros,&nbsp;S. Dias,&nbsp;S. Ghuman,&nbsp;B. Petri,&nbsp;K. Gecse,&nbsp;J. Mawdsley,&nbsp;S. Ray,&nbsp;R. Dart,&nbsp;S. Anderson,&nbsp;P. M. Irving,&nbsp;M. A. Samaan","doi":"10.1155/ygh2/5150758","DOIUrl":"https://doi.org/10.1155/ygh2/5150758","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Data on the use of adalimumab (ADA) biosimilar Idacio (Fresenius Kabi) in inflammatory bowel disease is relatively sparse, whereas the efficacy and safety of other biosimilars have been well described. We evaluated the pharmacokinetics and clinical outcomes in a real-world cohort of patients who switched from originator to Idacio. In addition, we surveyed patients’ experiences of the switching process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of all IBD patients who participated in a nonmedical switch from ADA originator to Idacio at a tertiary centre was performed. Data on ADA drug levels, antibody levels and clinical and laboratory indices of disease activity (Harvey Bradshaw Index for Crohn’s disease, Simple Clinical Colitis Activity Index for ulcerative colitis, C-reactive protein and faecal calprotectin) were collected prior to and after switching to Idacio. An anonymised patient survey was undertaken to evaluate injection site pain, level of understanding and acceptability of the switch.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four hundred and three patients were included. No difference in the ADA levels before and after switching was found (<i>p</i> = 0.78). There were also no differences in clinical (<i>p</i> = 0.06), biochemical (<i>p</i> = 0.36) and biomarker (<i>p</i> = 0.84) remission rates after switching. In the survey, patients reported moderate injection site pain after switching. The majority of patients self-reported good levels of understanding of the financial rationale for switching, which correlated with a higher degree of acceptability of the switch (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Switching from ADA originator to Idacio appears effective and well tolerated. Patient engagement and education should be a key part of all nonmedical biosimilar switches.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2026 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ygh2/5150758","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148282023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2026 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148089186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucagon-Like Peptide-1 Receptor Agonists Are Associated With Improved Outcomes in Inflammatory Bowel Disease","authors":"Michael Saadeh,&nbsp;Apoorva Krishna Chandar,&nbsp;Revital Gorodeski Baskin,&nbsp;Jeffry Katz,&nbsp;Fabio Cominelli,&nbsp;Emad Mansoor,&nbsp;Miguel Regueiro,&nbsp;Vu Quang Nguyen","doi":"10.1155/ygh2/2239686","DOIUrl":"https://doi.org/10.1155/ygh2/2239686","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The co-existence of diabetes and obesity in patients with inflammatory bowel disease (IBD) increases morbidity and mortality associated with IBD, yet it remains unclear how medications used to treat these metabolic disorders affect IBD course. This study examines the impact of glucagon-like peptide-1 receptor agonists (GLP-1RAs), a predominant class of antidiabetic and antiobesity medications, on IBD outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using TriNetX, a healthcare database comprising over 110 million patients in the United States, we identified cohorts of IBD patients based on their exposure to GLP-1RA as well as a metformin comparator cohort. Cases were IBD patients on GLP-1RA, while controls were IBD patients without exposure to GLP-1RA. The two cohorts were propensity score matched for demographics, comorbidities, and IBD medications. Outcomes of interest were IBD-related surgeries, inpatient hospitalizations, emergency room (ER) visits, and steroid use within 5 years after the index event of GLP-1RA use. Chi-square and <i>t</i>-tests were used for significance testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 11,559 IBD cases with prior GLP-1RA exposure and 258,046 IBD controls without prior GLP-1RA exposure. After propensity score matching, 9596 cases and controls were evenly matched. Compared to controls, IBD patients on GLP-1RA were less likely to have IBD-related surgeries (OR 0.36, 95% CI 0.29–0.46), inpatient hospitalizations (OR 0.44, 95% CI 0.41–0.46), ER visits (OR 0.56, 95% CI 0.52–0.59), or steroid use (OR 0.56, 95% CI 0.53–0.60). In matched analyses against metformin, GLP-1RA exposure was also associated with lower odds across all endpoints.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with IBD on GLP-1RA therapy had fewer IBD-related surgeries, inpatient hospitalizations, ER visits, and steroid use, even when compared to those on metformin. Further research is needed to investigate the role of GLP-1RA in modulating inflammation in IBD patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2026 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ygh2/2239686","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helicobacter pylori VacA, CagA, IceA and DupA Virulence Genes’ Distribution and Accompanying Clinical Outcomes: The Cameroon Situation","authors":"Laure Brigitte Kouitcheu Mabeku,&nbsp;Ghislaine Florice Faujo Nintewoue,&nbsp;Lionel Danny Tali Nguefack,&nbsp;Paul Talla,&nbsp;Fernando Greluk Szykman,&nbsp;Livia Jesus Ferreira,&nbsp;Maria Luiza Sato de Castro,&nbsp;Márcia Aparecida Sperança","doi":"10.1155/ygh2/4034800","DOIUrl":"https://doi.org/10.1155/ygh2/4034800","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> colonization results in site-specific disorders of the upper digestive tract, such as inflammatory, ulcerative and neoplastic lesions. The development of these disorders is related to the virulence genes carried by the bacterium. This study is aimed at identifying the different virulence genes of <i>H. pylori</i> strains from Cameroon, as well as their association with clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 138 <i>H. pylori</i> urease-positive biopsy samples were used in this study. They were collected from patients that underwent an upper gastrointestinal endoscopy for the investigation of dyspepsia in health facilities in Cameroon. The alterations of the gastric mucosa were recorded during the endoscopic procedure. PCR confirmation of <i>H. pylori</i> in biopsy samples was performed, followed by the identification of vacA, cagA, IceA and DupA virulence genes. The results were analysed using the SPSS software Version 22.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-eight out of the 138 biopsy samples were PCR confirmed as <i>H. pylori</i> positive. VacAs1, vacAm1, vacAs1m1 and vacAm2 were identified in 88.5%, 83.3%, 82.1% and 1.3% of <i>H. pylori</i> strains, respectively, while the vacAs2 genotype was absent. The prevalence of cagA, DupA, IceA1 and IceA2 was 66.7%, 27.4%, 25.7% and 57.5%, respectively, whereas vacAs1m1 and cagA (64.9%) were the most frequent combination. Strains harbouring IceA1 (<i>p</i> = 0.039), IceA1 and vacAs1m1 (<i>p</i> = 0.008) and IceA1 and cagA (<i>p</i> = 0.042) genotype were significantly associated with gastric inflammatory lesions, while those harbouring IceA1 (<i>p</i> = 0.032), vacAs1m1 and IceA1 (<i>p</i> = 0.016), cagA and IceA1 (<i>p</i> = 0.029) and DupA and IceA1 (<i>p</i> = 0.044) genotype were significantly associated with ulcerated lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our data showed a higher prevalence of vacAs1, vacAm1, vacAs1m1, cagA and IceA2 genotype, lower prevalence of DupA and IceA1, absence of vacAs2 and vacAs1m1 and cagA as the most frequent genotype combination among <i>H. pylori</i> strains circulating in Cameroon. Strains harbouring IceA1, IceA1 and vacAs1m1, IceA1 and cagA and IceA1 and DupA genotype are highly predictive of gastric injuries in our context.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2025 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ygh2/4034800","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145580951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring Excretion of Gluten Immunogenic Peptides (GIPs): An Assay for Monitoring Gluten Exposure","authors":"Sunari Kulasekera,&nbsp;Jaymini Pankhania,&nbsp;Carol Leppard,&nbsp;Jacquita Affandi,&nbsp;Sue Critchley,&nbsp;Glen Lichtenberger,&nbsp;Dewruwan Gammanpila,&nbsp;Christopher Reid,&nbsp;Geoffrey Forbes,&nbsp;Narelle Hadlow,&nbsp;Mina John","doi":"10.1155/ygh2/3859529","DOIUrl":"https://doi.org/10.1155/ygh2/3859529","url":null,"abstract":"<p>Individuals with coeliac disease are required to exclude all gluten from their diet to prevent small bowel inflammation and associated complications. Life-long adherence to a gluten-free diet is challenging because of the potential presence of gluten in common noncereal foods, cross-contamination, and potentially small amounts of gluten in cereal-based foods formally labelled as “gluten-free.” For people living with coeliac disease, current tests to monitor the efficacy of a gluten-free diet may not detect ongoing, low level, or intermittent unintentional gluten exposure. The iVYCHECK and iVYLISA assays by Biomedal detect gluten-derived peptides, which are resistant to digestion, known to be immunogenic and are excreted in urine and stool. The urine test is qualitative for recent short-term exposure while the faecal test is quantitative and reflects gluten exposure over a longer interval. Several studies have validated the performance of these assays in monitoring compliance to gluten-free diets. We sought to evaluate these assays in a community-based pathology service by comparing values obtained in individuals with no dietary restrictions compared with those following a gluten-free diet. We performed 124 assays in 21 subjects over 9 days. The quantitative faecal gluten immunogenic peptide assay was highly precise. Faecal gluten immunogenic peptide assays were moderately sensitive (66%) and highly specific (97%) while the urine assay had sensitivity of 100% and lesser specificity (48%). Both assays had very high negative predictive value (90%) for detection of clinically relevant levels of oral gluten, as verified by participant self-reported diet diary over a 9-day period. An episode of inadvertent gluten exposure in one individual on an otherwise gluten-free diet was associated with temporally high gluten immunogenic peptide levels in stool. The majority of participants regarded accidental gluten exposures as important to their health and rated monitoring for gluten contamination as their strongest reason for utilizing this assay. Our study was limited by use of self-report rather than independent tests of gluten intake or clinical disease markers; however, our findings do provide support for implementation of these assays to assist in monitoring efficacy of a gluten-free diet.</p>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2025 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ygh2/3859529","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143645673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis D Virus Status Among People With Hepatitis B Virus Infection: A Disconnect Between Guidelines and Practice","authors":"Kathryn Jack,&nbsp;Rachel Jackson,&nbsp;William Lucien Irving","doi":"10.1155/2024/6622276","DOIUrl":"https://doi.org/10.1155/2024/6622276","url":null,"abstract":"<p><b>Background:</b> Hepatitis D virus (HDV) infection is an important cause of chronic liver disease yet remains a poorly met clinical challenge. The current European and UK guidelines recommend that all patients with hepatitis B virus (HBV) are tested for HDV, but emerging UK data indicates that only approximately 20% have been tested. The World Health Organization viral hepatitis elimination strategy first requires the systematic testing of people with relevant risk factors, so there is a need to understand factors contributing to low anti-HDV rates of testing.</p><p><b>Methods:</b> An audit was conducted to ascertain the perspectives of patients and healthcare professionals about identifying HDV infection. During a 4-month period, 39 hepatology healthcare professionals and 70 patients with chronic HBV were recruited. The attitudes of healthcare professionals about HDV testing were surveyed according to the seven constructs of the theoretical framework of acceptability (TFA). Patients were surveyed by telephone about their knowledge of HDV and their own testing status.</p><p><b>Results:</b> Among the 39 healthcare professionals, only 66.6% and 53.8% were able to correctly cite EASL (European) HDV and NICE (UK) testing guidelines, respectively, although there were high levels of anti-HDV testing acceptability according to the TFA. Among the patients, 95.7% (67/70) had been tested for anti-HDV and all were seronegative. Only 23% (16/70) knew of the existence of HDV. There was extensive ethnic heterogeneity with 23 countries of birth and 24 different primary languages.</p><p><b>Conclusion:</b> Some clinicians lack familiarity with clinical guideline recommendations for universal testing of all HBsAg-positive patients. Similarly, most patients lack knowledge about HDV. Staff and patient education are required to increase HDV diagnosis.</p>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2024 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/6622276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142574118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Antibiotics for the Prophylaxis of Spontaneous Bacterial Peritonitis: A Retrospective Review and Quality Improvement Study","authors":"Ariana Tagliaferri,&nbsp;Nida Ansari,&nbsp;Gabriel Melki,&nbsp;Yana Cavanagh","doi":"10.1155/2024/9271718","DOIUrl":"https://doi.org/10.1155/2024/9271718","url":null,"abstract":"<p><b>Background:</b> Primary and secondary prophylaxis for spontaneous bacterial peritonitis (SBP) should be reserved for high-risk cirrhotic patients, such as those with a history of SBP, gastrointestinal (GI) hemorrhage, high Child–Pugh score, or low ascitic fluid protein (AFP) with liver and renal failure. Due to a multitude of reasons, many patients who require prophylaxis do not receive it. We present a retrospective analysis and quality improvement project. High-risk cirrhotic patients were identified to see if antibiotic prophylaxis was initiated upon admission and the 1-year outcomes for those individuals.</p><p><b>Methods and Results:</b> One hundred twenty-six patients were included in the study. The mean age was 57.38 years. A total of 59.5% (<i>n</i> = 75) of patients were current or former alcohol users. A total of 54.8% (<i>n</i> = 69) of patients met the criteria for SBP prophylaxis; however, only 26% (<i>n</i> = 18) received it (<i>p</i> ≤ 0.073). Ciprofloxacin and cephalosporins were the most used antibiotics. Although none of the analyses for readmissions produced statistical significance, there were clinically more patients readmitted for SBP when prophylaxis was not prescribed. No patients who received prophylaxis were hospitalized within 6 months following a discharge for SBP. Only two of the 18 patients who received prophylaxis died compared to 30 of the 51 patients who did not (<i>p</i> ≤ 0.001). Twenty-eight of the 32 who met the criteria but did not receive prophylaxis were deceased within 1 year following discharge (<i>p</i> ≤ 0.042). When stratified by basic demographics, mortality was significant in the nonprophylaxis groups for males (<i>p</i> ≤ 0.0001), 25–30 body mass index (BMI) group (<i>p</i> ≤ 0.003), and alcohol use (<i>p</i> ≤ 0.002).</p><p><b>Conclusion:</b> We intend to educate providers on the appropriate time to intervene to reduce mortality and subsequent hospitalizations for those with advanced liver disease.</p>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2024 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/9271718","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Antithrombotic Agents During Emergency Endoscopy for Upper Gastrointestinal Bleeding: A Propensity Score Matching Analysis","authors":"Daisuke Yamaguchi,&nbsp;Satoshi Ishida,&nbsp;Kasumi Gondo,&nbsp;Tadahiro Nomura,&nbsp;Azuki Yamaguchi,&nbsp;Ryosuke Asahi,&nbsp;Yumi Mizuta,&nbsp;Goshi Nagatsuma,&nbsp;Shota Fukami,&nbsp;Shunichiro Kimura,&nbsp;Shun Fujimoto,&nbsp;Akane Shimakura,&nbsp;Amane Jubashi,&nbsp;Yuki Takeuchi,&nbsp;Kei Ikeda,&nbsp;Yuichiro Tanaka,&nbsp;Wataru Yoshioka,&nbsp;Naoyuki Hino,&nbsp;Tomohito Morisaki,&nbsp;Keisuke Ario,&nbsp;Seiji Tsunada","doi":"10.1155/2024/7561793","DOIUrl":"https://doi.org/10.1155/2024/7561793","url":null,"abstract":"<p><b>Background/Aims:</b> This study is aimed at comparing the outcomes of upper gastrointestinal bleeding (UGIB) during emergency endoscopy between patients taking and not taking antithrombotic agents to inform antithrombotic management.</p><p><b>Methods:</b> We conducted a retrospective analysis of 389 patients who underwent emergency endoscopy for UGIB from 2016 to 2021. The patients were categorized into group A (taking antithrombotic agents) and group NA (not taking antithrombotic agents). The clinical characteristics, types of antithrombotic agents, patient status upon admission, and causes of UGIB were examined. Treatment outcomes and adverse events were assessed by propensity score matching (PSM).</p><p><b>Results:</b> Group A was significantly older and the primary antithrombotic agent was low-dose aspirin, with multiple antithrombotics taken by 38 patients (29.0%). Peptic ulcers were the most common cause of UGIB in both groups. PSM generated 83 matched pairs. The success rate of endoscopic hemostasis in group A was significantly higher than in group NA (96.4% vs. 84.3%, <i>P</i> = 0.02). Despite promptly resuming antithrombotic agent posthemostasis, there was no significant difference in the rebleeding rate or 30-day mortality.</p><p><b>Conclusion:</b> The high success rate of endoscopic hemostasis and no difference in adverse events made the prompt resumption of antithrombotic medications after emergency endoscopy for UGIB acceptable.</p><p><b>Trial Registration:</b> ClinicalTrials.gov identifier: UMIN000053561</p>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2024 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/7561793","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141489016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Technical Success Rate of Endoscopic Balloon Dilatation Reduces Surgical Requirement for Patients With Stricturing Crohn’s Disease","authors":"Emily Lim,&nbsp;Maxter Thai,&nbsp;Yoon-Kyo An,&nbsp;Peter Hendy,&nbsp;Mahmoud Alchlaihawi,&nbsp;Rupert Leong,&nbsp;Susan Connor,&nbsp;Watson Ng,&nbsp;Bonita Gu,&nbsp;Lena Thin,&nbsp;Miles Sparrow,&nbsp;Robert Gilmore,&nbsp;Kirstin Taylor,&nbsp;Olivia Sallis,&nbsp;Jane M. Andrews,&nbsp;Charlotte Daker,&nbsp;Richard B. Gearry,&nbsp;Gabrielle Wark,&nbsp;Simon Ghaly,&nbsp;Matt Begun,&nbsp;Krupa Krishnaprasad,&nbsp;Tianhong Wu,&nbsp;Leonie Ruddick-Collins,&nbsp;Veronika Schreiber,&nbsp;Satomi Okano,&nbsp;Graham Radford-Smith,&nbsp;Julien Schulberg,&nbsp;Daniel van Langenberg,&nbsp;Jakob Begun","doi":"10.1155/2024/3686618","DOIUrl":"https://doi.org/10.1155/2024/3686618","url":null,"abstract":"<p><b>Background:</b> Endoscopic balloon dilatation (EBD) is an alternative therapy to avoid or delay surgery in stricturing Crohn’s disease (CD); however, certain factors determining outcomes remain poorly defined, and conflicting evidence exists in current studies. In one of the largest cohorts to date, we assess outcomes following EBD for stricturing CD for both anastomotic and de novo strictures.</p><p><b>Methods:</b> A retrospective cohort study of CD patients undergoing EBD was conducted at 12 hospitals across Australia and New Zealand. Local databases were used to identify cases from February 1999 to November 2019. Data from patient endoscopy reports and medical records were used to determine patient medical details and EBD outcomes. Multivariable analysis was undertaken to identify factors associated with technical and long-term success.</p><p><b>Results:</b> A total of 273 patients with stricturing CD were identified (48% female; 49.6% Montreal L3 disease). Of 695 EBD procedures (355 anastomotic, 340 de novo strictures), the majority (80.1% of strictures with identified length) was performed on short strictures (&lt; 4 cm). Technical success, defined as the ability to traverse the stricture with a colonoscope after dilation, was achieved in 577 (83%) of endoscopic procedures, with success more likely with de novo strictures compared with anastomotic strictures (aOR: 3.21, <i>P</i> = 0.010). A significantly higher failure rate was noted with long strictures (aOR: 0.09, <i>P</i> &lt; 0.001). A total of 74 patients (27%) required surgery within 5 years with stricture length, the only significant factor associated with increased surgery risk (aHR: 2.37, <i>P</i> &lt; 0.01).</p><p><b>Conclusion:</b> EBD is a highly effective and safe procedure in both de novo and anastomotic strictures &lt; 4 cm that can prevent or delay the need for surgical treatment.</p>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2024 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/3686618","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141298408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}