GastroHep最新文献

{"title":"The Suitability of Stool Antigen Testing in the Detection of Helicobacter pylori in a Regional and Rural Area of Australia","authors":"Timothy Wearne,&nbsp;Safaa Nadeem,&nbsp;Bruce Wilson,&nbsp;Kylie J. Mansfield,&nbsp;Caitlin Keighley","doi":"10.1155/2023/6642474","DOIUrl":"10.1155/2023/6642474","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. <i>Helicobacter pylori</i> is considered the most widespread bacterial pathogen worldwide. Successful eradication protocols are well established, highlighting the importance of appropriate infection detection. Noninvasive testing (NIT) methods are commonly used to detect infection, with test selection dependent on access and previous infection. This study examined trends in NIT by age group and test selection for eradication screening as well as examining <i>H. pylori</i> area prevalence by socioeconomic status (SES) in the Illawarra Shoalhaven and surrounding region. <i>Materials and Methods</i>. This retrospective cohort quantitative study is based on 20,998 NIT including stool antigen test (SAT), urea breath test (UBT), or <i>H. pylori</i> serology via Southern.IML Pathology between 2018 and 2020. Test percentage positives per and total test percentages within age groups were calculated for each NIT. Positive sample postcode data was assigned to socioeconomic percentiles. Total test utilisation and prevalence were calculated and depicted as geospatial representations. <i>Results</i>. Overall: 58.5% UBT, 31% serology, and 10.5% SAT were performed, with 14.7% positive for any NIT. Highest percent positive age group: SAT 80-89yo (18.6%), UBT 0-9yo (20.8%), and serology 90–99yo (32.6%). Test majority per age group: SAT 0-9yo (67.4%), UBT 10-89yo (59.4%), and serology 90-99yo (48.3%). A trend was seen between increasing infection prevalence and increasing socioeconomic disadvantage (<i>p</i> = 0.161, <i>R</i>² = 0.0361). Prevalence rates visually correlated with total test utilisation. <i>Conclusions</i>. SAT was underutilised compared to UBT or serology. Serology was inappropriately used in older age groups, and the result validity was questioned following confirmed infection. SAT is a viable alternative for use in these settings. No significant correlation was seen between lower SES areas and higher <i>H. pylori</i> infection prevalence, but low-test utilisation suggests likely prevalence underestimation within the studied area and may indicate reduced accessibility to healthcare.</p>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2023 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/6642474","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135568075","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":"Visualized Quantitative Evaluation of Gastrointestinal Activity in Healthy Volunteers Using a Noninvasive Single-Channel Electroamplifier","authors":"Gen Aikawa,&nbsp;Misaki Kotani,&nbsp;Hideaki Sakuramoto,&nbsp;Akira Ouchi,&nbsp;Mitsuki Ikeda,&nbsp;Tetsuya Hoshino,&nbsp;Nobuyuki Araki,&nbsp;Yuki Enomoto,&nbsp;Nobutake Shimojo,&nbsp;Yoshiaki Inoue","doi":"10.1155/2023/6902635","DOIUrl":"10.1155/2023/6902635","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Electrogastrography and electroenterography are noninvasive methods for measuring gastric and intestinal electrical activities, respectively. Few studies have measured electroenterography in healthy humans; however, no studies have measured electrogastrography and electroenterography simultaneously. This study was performed to provide basic electrogastrography and electroenterography data for comparison with future studies in patients. <i>Methods</i>. Simultaneous preprandial and postprandial measurements of electrogastrography and electroenterography were taken for 30 min each in 50 healthy volunteers. Power spectrum analysis was performed to calculate dominant frequency, dominant power, and power ratio. <i>Results</i>. Gastric and small intestinal dominant frequencies were not significantly different between preprandial and postprandial periods. In preprandial and postprandial periods, normogastria was seen in 49 (98%) and 44 (88%) patients (<i>p</i> = 0.063), bradygastria in 1 (2%) and 6 (12%) patients (<i>p</i> = 0.063), and tachygastria in 0 (0%) patients, respectively. Dominant power was significantly increased in the stomach (828 [460–3203] <i>μ</i>V² vs. 1526 [759–2958] <i>μ</i>V², <i>p</i> = 0.016) and small intestine (49 [27–86] <i>μ</i>V² vs. 68 [37–130] <i>μ</i>V², <i>p</i> &lt; 0.001). The power ratio was 1.6 (0.9–2.5) in the stomach and 1.4 (1.0–2.5) in the small intestine. Body mass index showed a negative correlation with the stomach and small intestinal dominant power in preprandial and postprandial periods (<i>r</i>_<i>s</i> = −0.566, <i>p</i> &lt; 0.001; <i>r</i>_<i>s</i> = −0.534, <i>p</i> &lt; 0.001; <i>r</i>_<i>s</i> = −0.459, <i>p</i> &lt; 0.001; and <i>r</i>_<i>s</i> = −0.529, <i>p</i> &lt; 0.001, respectively). The Bristol Stool Form Scale correlated positively with the small intestinal power ratio (<i>r</i>_<i>s</i> = −0.430, <i>p</i> = 0.002). <i>Conclusion</i>. There was no change in frequency in the stomach or small intestine, but power significantly increased in both the stomach and small intestine.</p>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2023 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/6902635","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135551756","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":"Clinical Outcomes and Patient Experience of Biosimilar to Biosimilar Infliximab Switching in Patients with Inflammatory Bowel Disease: A Prospective, Single-Centre, Phase IV Interventional Study with a Nested Qualitative Study","authors":"Clare Harris,&nbsp;Richard James Harris,&nbsp;David Young,&nbsp;Martin McDonnell,&nbsp;Bridget Clancy,&nbsp;Justin Harvey,&nbsp;Carlos Araujo,&nbsp;Ines Iria,&nbsp;Joao Goncalves,&nbsp;Susan Latter,&nbsp;J. R. Fraser Cummings","doi":"10.1155/2023/1248526","DOIUrl":"10.1155/2023/1248526","url":null,"abstract":"<div>\u0000 <p><i>Background and Aims</i>. Regulatory pathways compare biosimilars with originator molecules only and not with other biosimilars. With the development of multiple infliximab biosimilars, patients may be asked to transition between them. Data is emerging but there is still a gap in the evidence on switching between infliximab biosimilars. Our aim was to conduct a full evaluation of switching a cohort of IBD patients from one biosimilar (CT-P13) to another (SB2) in a real-world setting including clinical and patient experience and molecular and drug immunogenicity aspects of the process. <i>Methods</i>. Prospective, phase IV interventional study of patients on CT-P13 switched to SB2. Demographics, disease history, validated disease activity scores, PROMs, and laboratory measurements were collected. Semistructured qualitative interviews were also conducted. <i>Results</i>. 133 out of 158 patients agreed to participate. Mean disease duration was 9.2 years. There was no difference in mean haemoglobin, platelet count, albumin, and C-reactive protein before and after switching. Mean faecal calprotectin at baseline and at week 30/32 was 306 <i>μ</i>g/g versus 210 <i>μ</i>g/g. Mean pMCS and mHBI at baseline were 1.54 and 3.14 versus 1.18 and 2.91 at week 30/32, respectively. Thirty-five subjects discontinued. There were 16 serious adverse events. Thematic analysis identified six major themes that reflected the patient experience—trust, clinical status at the point of switching, past experience, general disposition, information provision, and concerns/anxiety. <i>Conclusions</i>. Switching from CT-P13 to SB2 is safe and effective. Certain factors must be considered in supporting patient decision-making. These results support the development of clear, streamlined, and well-monitored biosimilar switching programmes.</p>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2023 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/1248526","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87436901","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":"T-HAD Score: A Novel Diagnostic Model for Advanced Fibrosis in Nonalcoholic Fatty Liver Disease (NAFLD)","authors":"Tharun Tom Oommen,&nbsp;Jijo Varghese,&nbsp;Krishnadas Devadas,&nbsp;Atul Hareendran,&nbsp;Nibin Nahaz,&nbsp;Suprabhat Giri","doi":"10.1155/2023/7712360","DOIUrl":"https://doi.org/10.1155/2023/7712360","url":null,"abstract":"<div>\u0000 <p><i>Background and Aims</i>. The NAFLD disease spectrum includes simple steatosis, nonalcoholic steatohepatitis (NASH), advanced fibrosis, and cirrhosis. Progression from NASH, the forerunner of developing cirrhosis, portends a poor outcome as mortality is proportionately increased. This study sought to propose a new diagnostic model for advanced fibrosis in an Asian population cohort affected with NAFLD. <i>Methods</i>. Cross-sectional study conducted in the Department of Medical Gastroenterology, Medical College, Trivandrum. The study period was 2 years. After excluding secondary causes of hepatic steatosis, patients were subjected to vibration-controlled transient elastography or transient elastography (VCTE or TE) to assess hepatic fibrosis. Subjects were grouped into those with advanced fibrosis (TE &gt; 10 Kpa) and those without (TE &lt; 10 Kpa) based on the estimation of TE. A new scoring system was then developed. This was then validated in a cohort of 84 biopsy-proven patients.<i>Results</i>. 1617 NAFLD patients were included in the study. Independent predictors of advanced fibrosis in this cohort were hip circumference, triglycerides, aspartate aminotransferase (AST), and diabetes mellitus (duration more than 10 years). The coefficient of beta for these variables was calculated. T-HAD score was calculated using the following formula: (Hip circumference × 0.044 + AST × 0.028 + diabetes mellitus × 3.7) − (0.03 × triglycerides). The AUROC of the T-HAD score was 0.929. The T-HAD score had a sensitivity of 90% and a specificity of 77% at a cut off of &gt;2 for advanced fibrosis. We validated this score in another cohort of liver biopsy with advanced fibrosis. In the validation cohort, the T-HAD score had an AUROC of 0.926 in diagnosing advanced fibrosis (sensitivity of 89% and specificity of 71% at a cut off of &gt;2). <i>Conclusion</i>. The T-HAD score based on data from the Asian population is a new diagnostic model which is beneficial in estimating the risk of advanced fibrosis. It is a simple yet effective tool that could be in-cooperated into day-to-day practice in a resource-limited setting.</p>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2023 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/7712360","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143253262","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":"Treatment Patterns and Survival in Patients with Intermediate, Advanced, or Terminal Stage of Hepatocellular Carcinoma in France over the Period 2015-2017: A Real-Life Study","authors":"Jean-Frédéric Blanc,&nbsp;Caroline Laurendeau,&nbsp;Marie de Zélicourt,&nbsp;Manel Dhaoui,&nbsp;Nadia Kelkouli,&nbsp;Francis Fagnani,&nbsp;Philippe Mathurin","doi":"10.1155/2023/5800168","DOIUrl":"10.1155/2023/5800168","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. The prognosis of patients with hepatocellular carcinoma (HCC) not eligible to curative treatment is poor. Little information is available on treatment modalities and outcomes of these patients in everyday practice. The aim of this analysis was to describe the characteristics of patients with a newly diagnosed intermediate, advanced, or terminal (IAT) stage of HCC (ICD-10: C220) between 2015 and 2017, either present at diagnosis of HCC or having occurred after disease progression; treatment patterns, HCC aetiologies, and the associated survival were determined using the nationwide claims database. <i>Methods</i>. Patients with HCC were identified using the ICD-10 code C220. IAT stages, defined according to the terminology used in the Barcelona Clinic Liver Cancer classification, were indirectly identified by the presence of at least one of the following treatments: transarterial chemoembolization (TACE), transarterial radioembolization (TARE), HCC systemic therapy, best supportive care (BSC), or an ICD-10 code of metastatic HCC. Treatment patterns were described with an algorithm based on a ranking of palliative treatments identified. Survival was analysed by using Kaplan-Meier curves. <i>Results</i>. 19,649 eligible patients were identified. Their mean age was 70.5 years (SD: 11.0), and 82.5% were males. For 68.8% of patients, the IAT stage was present at HCC diagnosis. On the whole population, 5,114 patients (26.0%) were treated initially with a TACE or TARE, and 4,681 (23.8%) received a targeted systemic therapy at any moment during follow-up with sorafenib in 99.5% of cases. About 7,628 patients (45.6%) received only BSC. Survival since the diagnosis of the AIT stage of HCC differed according to the type of the first received palliative treatment. Median overall survival was 23.8, 9.6, 7.4, and 1.0 months in patients initially receiving TACE, TARE, systemic therapy, and BSC only, respectively. <i>Conclusion</i>. Over the period 2015-2017, hepatocellular carcinoma was still often diagnosed in France at late-stage disease with a very poor prognosis.</p>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2023 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/5800168","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88667599","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":"Corrigendum to “Safety, Tolerability, Pharmacokinetics, and Efficacy of Terlipressin Delivered by Continuous Intravenous Infusion in Patients with Cirrhosis and Refractory Ascites”","authors":"Jasmohan S. Bajaj,&nbsp;James H. Fischer,&nbsp;Patrick Yeramian,&nbsp;Edith A. Gavis,&nbsp;Andrew Fagan,&nbsp;Paolo Angeli,&nbsp;Guadalupe Garcia-Tsao,&nbsp;Jonathan M. Adams,&nbsp;Penelope Markham","doi":"10.1155/2023/9815951","DOIUrl":"10.1155/2023/9815951","url":null,"abstract":"<p>In the article titled “Safety, Tolerability, Pharmacokinetics, and Efficacy of Terlipressin Delivered by Continuous Intravenous Infusion in Patients with Cirrhosis and Refractory Ascites” [<span>1</span>], there was an error in the Conflicts of Interest section, where Jasmohan S. Bajaj was incorrectly listed as an employee of BioVie, Inc. Additionally, some additional information was omitted in error. The corrected section appears in the following:</p><p>JF and PY are consultants who received compensation from BioVie. EG and AF received none. PA is a clinical advisor who received honorarium from BioVie and from Grifols. GG-T is a clinical advisor who received honorarium from BioVie. JSB received grant support to his institution from BioVie. JA and PM are BioVie employees.</p>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2023 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/9815951","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135006926","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":"Primary Hereditary Haemochromatosis and Pregnancy","authors":"Ambrin Gull Shamas","doi":"10.1155/2023/2674203","DOIUrl":"10.1155/2023/2674203","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Haemochromatosis is a rare autosomal genetic disease that can cause multiple organ failure. In the past, this condition was not considered to affect pregnancy. The objectives of this study are to update the management of haemochromatosis in general as there are new treatments being investigated other than phlebotomy and to summarise the effects of the condition on pregnancy and vice versa. <i>Methods</i>. The initial search was in Ovid Medline® from 2002 to 2013. Review articles for haemochromatosis and case reports of its related complications in pregnancy were found. None of the reviews addressed pregnancy in detail. A second search in PubMed from 2014 to 2016 included studies regarding haemochromatosis and pregnancy and iron metabolism association with other metals and biomarkers, defining the mechanism of foetomaternal risks in maternal haemochromatosis. A third search at PubMed from 2017 to 2022 using key words haemochromatosis and pregnancy was done to look at the new data. <i>Results</i>. The results are qualitative indicating that even in the absence of abnormal iron parameters, haemochromatosis increases the risk of foetomaternal complications due to genetic predisposition, necessitating antenatal monitoring. Newer medications targeting the pathophysiology of the disease to eliminate it are being developed. The coabsorption of lead with iron causes increased risk of maternal preeclampsia, gestational hypertension, foetal congenital abnormalities, and growth problems. There is risk of neurodevelopmental delays, large for gestational age and childhood leukaemia in babies whose mothers and themselves have mutations for haemochromatosis. <i>Conclusion</i>. Previously, women with haemochromatosis were thought to have no higher risk of complications than the general population. However, there is evidence of foetomaternal complications. As a result, pregnancy with haemochromatosis necessitates additional monitoring for both mother and baby.</p>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2023 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/2674203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87518214","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":"Spleen Stiffness Measured by 2D-Shear Wave Elastography and Rebleeding Risk in Cirrhotic Patients Undergoing Endoscopic Variceal Ligation for Variceal Bleeding","authors":"Swetha Sattanathan,&nbsp;Krishnadas Devadas,&nbsp;Shanid Ahmed,&nbsp;Atul Hareendran,&nbsp;Arun Prabhakaran,&nbsp;Nidhin Raveendran","doi":"10.1155/2023/4912991","DOIUrl":"10.1155/2023/4912991","url":null,"abstract":"<div>\u0000 <p><i>Background and Aims.</i> Endoscopic variceal ligation (EVL) of esophageal varices alters the portal pressure. We observed the changes in 2D-shear wave elastography (2D-SWE) measurements of spleen and liver following EVL and tried to identify the predictors for rebleeding and mortality at 6 months. <i>Methods.</i> A prospective observational study of 202 patients who underwent EVL for bleeding esophageal varices was done. 2D-SWE measurements of liver stiffness (LS) and spleen stiffness (SS) and spleen volume (SV) were measured half an hour before, 1 hour, 2 weeks, and 6 weeks after EVL. All were followed up for 6 months for rebleeding and all-cause mortality. <i>Results.</i> 83 patients were in child C (41%). Difference in SV, SS, and LS at 2 and 6 weeks from baseline was noted as Delta 2 (2^nd week post-EVL - pre-EVL SV, LS, and SS) and Delta 3 (6^th week post EVL - pre - EVL SV, LS and SS), respectively. Mean Delta 2 VOL and Delta 3 VOL were lower in the bleeding and mortality groups. Delta 2 SS, Delta 3 SS, Delta 2 LS, and Delta 3 LS were higher in the rebleeding and mortality groups. These changes were statistically significant. AUROC in predicting rebleeding was the highest for Delta 2 VOL (0.773) and Delta 3 LS (0.764) amongst the USG parameters that performed better than MELD score (0.677). AUROC in predicting mortality was the highest for Delta 3 VOL and Delta 2 VOL-0.873 and 0.842, respectively, and higher than MELD’s (0.641). Statistically significant variables in binary logistic regression analysis for rebleeding were Delta 3 LS and Delta 3 SS and none for mortality. <i>Conclusion.</i> LS, SS, and SV change after EVL. Changes in liver and spleen stiffness at 6 weeks from baseline had good diagnostic accuracy for predicting rebleeding at 6 months.</p>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2023 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/4912991","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78221445","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":"Upper Gastrointestinal Tract Video Capsule as an Alternative to Oesophago-Gastro-Duodenoscopy in Clinical Practice","authors":"Mary Nwaezeigwe,&nbsp;John O’Grady,&nbsp;Lorraine Nolan,&nbsp;Julie O’Neill,&nbsp;Aidan Kaar,&nbsp;Lucy Quinlivan,&nbsp;Martin Buckley","doi":"10.1155/2022/4652730","DOIUrl":"10.1155/2022/4652730","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. Upper gastrointestinal (UGI) video capsule endoscopy (VCE) provides a possible alternative to conventional oesophago-gastro-duodenoscopy (OGD). In Ireland, the COVID-19 pandemic led to unprecedented change in endoscopy services, accelerating the need for UGI VCE to help reduce patient exposure but allow the continuation of endoscopy services. We report on using UGI VCE as an alternative to OGD throughout all phases of COVID-related endoscopy adjustments. <i>Aims/Background</i>. Prospective observational study to assess identification of relevant UGI anatomical landmarks on UGI VCE as defined in the British Society of Gastroenterology. <i>Method</i>. Inclusion criteria were: patients with dyspepsia under 40 years of age with no alarm symptoms; known cirrhosis for variceal screening; UGI bleeds with the Blatchford score ≤ 2. A protocol for preparation and a series of positional movements were adapted for the procedure. Landmarks and pathology detection were evaluated by two independent endoscopists. <i>Results</i>. 127 UGI VCE was performed from June 2020 to December 2021, of which 22 required further evaluation with OGD. The most common indications were dyspepsia and abdominal pain, 71% and 19%, respectively. With the use of the dual-facing camera, clear views of the OGJ in 100% of cases, cardia 100%, fundus 97%, greater curve 99%, lesser curve 98%, incisura angularis 95%, antrum 95%, pylorus 94%, D1/bulb 83%, and D2 82% were obtained. The main findings at UGI VCE were reflux oesophagitis and gastritis, with normal mucosa observed in 48% of cases. Findings suggesting a neoplastic lesion at the OG junction were detected in 1 case. <i>Conclusion</i>. Since June 2020, 81% (<i>N</i> = 103) of a selected cohort of patients referred for UGI endoscopy avoided invasive traditional endoscopy and were successfully managed by VCE, thus reducing endoscopy waiting lists. UGI VCE may serve as a clinical diagnostic tool, used alongside OGD in appropriate cases, to help improve patient services and care delivery.</p>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2022 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2022/4652730","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88907158","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":"Changes in Liver and Splenic Stiffness after Direct-Acting Antiviral Therapy in Chronic Hepatitis C: A Single-Centre, Prospective, Observational Study","authors":"Ryo Sugio,&nbsp;Yoshiyuki Sawai,&nbsp;Kazuto Fukuda,&nbsp;Takumi Igura,&nbsp;Sachiyo Kogita,&nbsp;Masahiro Ichihi,&nbsp;Yasushi Seki,&nbsp;Norihiko Fujita,&nbsp;Masahide Oshita,&nbsp;Yasuharu Imai","doi":"10.1155/2022/1374410","DOIUrl":"10.1155/2022/1374410","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Liver and spleen stiffness measured by shear-wave elastography have been demonstrated to correlate well with liver fibrosis and hepatic venous pressure gradient, respectively. <i>Aim</i>. To investigate the long-term effect of direct-acting antivirals (DAA) on liver and splenic stiffness in patients with chronic hepatitis C. <i>Methods</i>. We conducted a single-centre prospective observational study including 129 chronic hepatitis C patients who achieved a sustained virological response (SVR) with DAA treatment. Liver and spleen stiffness were measured by point shear-wave elastography at pretreatment, end of treatment (EOT), and 48 and 96 weeks after EOT (SVR48 and SVR96, respectively). <i>Results</i>. Liver stiffness measurements (LSM) continued to decline to SVR96, whereas there was no change in spleen stiffness measurements (SSM). Stratified analysis at the SSM 3.2 m/s, which was estimated as the cut-off value of clinically significant portal hypertension, showed that SSM did not change in the low SSM group (SSM &lt;3.2 m/s, n =81), whereas in the high SSM group (SSM ≥3.2 m/s, n =48), the SSM decreased significantly between pretreatment and EOT but did not change thereafter. Moreover, multivariate analysis of risk factors for the SSM remaining in the range of SSM ≥3.2 m/s at SVR96 in the high SSM group revealed that LSM ≥1.93 m/s was a significant factor (p =0.019). <i>Conclusion</i>. These results suggest that DAA treatment of chronic hepatitis C patients may improve liver fibrosis in the long term and some patients with advanced liver fibrosis may not expect an improvement of portal hypertension even if an SVR is achieved.</p>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"2022 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2022/1374410","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76357795","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}