GastroHep最新文献

{"title":"Colorectal endoscopic full-thickness resection: Initial experience from a tertiary centre in Singapore","authors":"Chin Kimg Tan,&nbsp;James Weiquan Li,&nbsp;Lai Mun Wang,&nbsp;Andrew Boon Eu Kwek,&nbsp;Tiing Leong Ang","doi":"10.1002/ygh2.480","DOIUrl":"https://doi.org/10.1002/ygh2.480","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Aims</h3>\u0000 \u0000 <p>Colorectal endoscopic full-thickness resection using the full-thickness resection device is an emerging endoscopic therapy for non-lifting adenomas and subepithelial lesions. We aim to describe our initial experience and examine the outcomes of colorectal endoscopic full-thickness resection in our centre.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All colorectal endoscopic full-thickness resection performed from 2016 to 2021 were reviewed retrospectively. Demographic data, indication of endoscopic full-thickness resection, lesion size and location were collected. Outcomes assessed included technical success, complete resection, adverse events and need for surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirteen patients were included in the study. Four patients had recurrent/ residual adenoma and nine had rectal neuroendocrine tumours (NETs). The resected specimens measured 20-mm. Mean lesion size was 9.77 mm. All but one lesions were located in rectum. Technical success and complete resection rates were 100%. One patient underwent right hemicolectomy for unsuspected T1 adenocarcinoma with deep submucosal invasion. Four patients had minor post-procedure bleeding. No major adverse events were identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Colorectal endoscopic full-thickness resection with full-thickness resection device for treatment of residual/recurrent colorectal adenoma and rectal NET is efficacious and safe. It had a significant positive impact on management as it could definitively establish the adequacy of endoscopic resection by histology and confirm the feasibility of curative resection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"3 5","pages":"298-306"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ygh2.480","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71962228","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":"Iron deficiency anaemia and lower abdominal pain in a patient with resected Meckel's diverticulum","authors":"N. Sciberras, D. Babić, P. Ellul","doi":"10.1002/ygh2.481","DOIUrl":"https://doi.org/10.1002/ygh2.481","url":null,"abstract":"A 21‐year‐old male presented with worsening, intermittent lower abdominal pain associated with 10 kg weight loss over the preceding 6 months. His past medical history was significant in view of a prior 12‐cm small bowel resection secondary to subacute intestinal obstruction, with Meckel's diverticulum confirmed as the underlying cause on histology. Upon investigation, iron deficiency anaemia was noted, but oesophagogastroduodenoscopy and ileocolonoscopy were normal. Cross‐sectional imaging only showed the surgical clips. However, on capsule endoscopy, the capsule was retained and an ischaemic small bowel loop was resected laparoscopically. Small bowel anastomotic ulcers are either rare or underdiagnosed, have a wide differential diagnosis and as for other small bowel pathology, are best diagnosed via capsule endoscopy.","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"40 1","pages":"331 - 334"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87752103","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":"Iron deficiency anaemia and lower abdominal pain in a patient with resected Meckel's diverticulum","authors":"Nicole Sciberras,&nbsp;Darko Babic,&nbsp;Pierre Ellul","doi":"10.1002/ygh2.481","DOIUrl":"https://doi.org/10.1002/ygh2.481","url":null,"abstract":"<p>A 21-year-old male presented with worsening, intermittent lower abdominal pain associated with 10 kg weight loss over the preceding 6 months. His past medical history was significant in view of a prior 12-cm small bowel resection secondary to subacute intestinal obstruction, with Meckel's diverticulum confirmed as the underlying cause on histology. Upon investigation, iron deficiency anaemia was noted, but oesophagogastroduodenoscopy and ileocolonoscopy were normal. Cross-sectional imaging only showed the surgical clips. However, on capsule endoscopy, the capsule was retained and an ischaemic small bowel loop was resected laparoscopically. Small bowel anastomotic ulcers are either rare or underdiagnosed, have a wide differential diagnosis and as for other small bowel pathology, are best diagnosed via capsule endoscopy.</p>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"3 5","pages":"331-334"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ygh2.481","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71980941","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 rare case of cholangiocarcinoma presenting with paraneoplastic syndrome","authors":"Stephanie Yung,&nbsp;Michael Arendse,&nbsp;Frank Weilert,&nbsp;Bong Suk Ko","doi":"10.1002/ygh2.479","DOIUrl":"https://doi.org/10.1002/ygh2.479","url":null,"abstract":"<p>Cholangiocarcinoma has a poor prognosis because of the poor early detection rate and limited treatment options. Therefore, it is important to understand the symptoms of paraneoplastic syndromes in order to detect occult malignancy early, when it is still at a highly treatable stage. Here, we report an extremely rare case of cholangiocarcinoma with paraneoplastic syndrome related to a clinical diagnosis of dermatomyositis (DM) sine dermatitis. A 74-year-old Caucasian man experienced 3 weeks of painless jaundice, progressive proximal muscle weakness and renal failure with rhabdomyolysis. Based on the results of laboratory tests and imaging (magnetic resonance cholangiopancreatography, endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography) and histological examination, the diagnosis was cholangiocarcinoma. The diagnosis was consistent with cholangiocarcinoma with paraneoplastic syndrome provoked by DM sine dermatitis. He was successfully treated with biliary stent insertion and supportive management. Eventually, Whipple surgery was successfully performed. Paraneoplastic syndrome is very rare in patients with cholangiocarcinoma, and it is extremely uncommon in the setting of DM. This is the first case in New Zealand.</p>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"3 5","pages":"326-330"},"PeriodicalIF":0.0,"publicationDate":"2021-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ygh2.479","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71955821","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":"Molecular detection of genotypic clarithromycin‐resistant strains and its effect on the eradication rate of concomitant therapy in Helicobacter pylori infection","authors":"K. Nyi, A. Soe, Zaw Min Htut","doi":"10.1002/ygh2.476","DOIUrl":"https://doi.org/10.1002/ygh2.476","url":null,"abstract":"Antimicrobial eradication rates for Helicobacter pylori have been decreasing and the reason for treatment failure was found to be resistance to one or more of the antibiotics. Clarithromycin resistance to H pylori was associated with point mutations in the 23S rRNA gene and the PCR‐RFLP method can detect these point mutations. The aim of this study was to determine the molecular detection of genotypic clarithromycin‐resistant strains and its effect on the eradication rate of concomitant therapy in H pylori infection. The presence of H pylori DNA was confirmed by amplifying the UreC gene by polymerase chain reaction (PCR) and point mutations on 23S rRNA (A2142G and A2143G) were detected by PCR‐RFLP. A total of 98 H pylori‐infected patients were involved and among them, genotypic clarithromycin‐sensitive strain was 93.9% and clarithromycin‐resistant strain was 6.1%. All patients were found to have the A2143G point mutation but A2142G was not detected. Successful eradication rate of concomitant therapy was found to be 89.8% and unsuccessful rate was 10.2%. Among patients with the clarithromycin‐resistant gene, only 16.7% had successful eradication and 83.3% had unsuccessful eradication. There was a statistically significant association between failure rate of concomitant therapy and detection of clarithromycin‐resistant genes (P < 0.01). The presence of A2143G point mutation in the clarithromycin‐resistant strain has a negative effect on the eradication rate of H pylori infection.","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"141 1","pages":"372 - 378"},"PeriodicalIF":0.0,"publicationDate":"2021-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86201442","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":"Levofloxacin-based Helicobacter pylori eradication in chronic dyspepsia","authors":"Wai Phyo Aung,&nbsp;Than Than Aye,&nbsp;Khin San Aye,&nbsp;Aye Mya Mya Kyaw","doi":"10.1002/ygh2.478","DOIUrl":"https://doi.org/10.1002/ygh2.478","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> infection in dyspepsia is an important clinical problem with increasing antibiotic resistance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the efficacy of levofloxacin-based triple therapy compared with clarithromycin-based triple therapy for <i>Helicobacter pylori</i> eradication in chronic dyspepsia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a prospective, single-blinded randomized trial. Rapid urease test and histology were performed in patients with chronic dyspepsia who underwent gastroscopy. <i>H pylori</i>-infected patients were randomly allocated into two equal groups prescribing 10-day course of levofloxacin-based or clarithromycin-based regime. Endoscopic responses and eradication status of both regimes were rechecked with gastroscopy 4 weeks after therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>Two hundred and ninety-one treatment-naïve patients were enrolled. Eradication rates were 40% vs 47.5% on intention to treat (ITT) analysis and 43.7% vs 50.8% on per-protocol (PP) for clarithromycin group vs levofloxacin group, respectively. In levofloxacin arm, eradication occurred in 62.5% (ITT) &amp; 71.4% (PP) of ulcer dyspepsia and 43.2% (ITT) and 46.6% (PP) of nonulcer dyspepsia.</p>\u0000 \u0000 <p>Among ulcer dyspepsia, 58.3% healed in clarithromycin group and 64.3% in levofloxacin group. In nonulcer dyspepsia, gastritis was resolved in 21% of clarithromycin group and 10% of levofloxacin group. Adverse effects occurred in 30% of clarithromycin group and 27.6% of levofloxacin group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In the study, eradication rates of both therapies were very low to unacceptable level. Levofloxacin was not effective in both ulcer and nonulcer dyspepsia. The emergence of primary levofloxacin resistant strains due to widespread usages in various infections might be the reason.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"3 6","pages":"394-400"},"PeriodicalIF":0.0,"publicationDate":"2021-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ygh2.478","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71948575","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":"Molecular detection of genotypic clarithromycin-resistant strains and its effect on the eradication rate of concomitant therapy in Helicobacter pylori infection","authors":"Khun Nyi Nyi,&nbsp;Aye Min Soe,&nbsp;Zaw Min Htut","doi":"10.1002/ygh2.476","DOIUrl":"https://doi.org/10.1002/ygh2.476","url":null,"abstract":"<p>Antimicrobial eradication rates for <i>Helicobacter pylori</i> have been decreasing and the reason for treatment failure was found to be resistance to one or more of the antibiotics. Clarithromycin resistance to <i>H pylori</i> was associated with point mutations in the 23S rRNA gene and the PCR-RFLP method can detect these point mutations. The aim of this study was to determine the molecular detection of genotypic clarithromycin-resistant strains and its effect on the eradication rate of concomitant therapy in <i>H pylori</i> infection. The presence of <i>H pylori</i> DNA was confirmed by amplifying the UreC gene by polymerase chain reaction (PCR) and point mutations on 23S rRNA (A2142G and A2143G) were detected by PCR-RFLP. A total of 98 <i>H pylori</i>-infected patients were involved and among them, genotypic clarithromycin-sensitive strain was 93.9% and clarithromycin-resistant strain was 6.1%. All patients were found to have the A2143G point mutation but A2142G was not detected. Successful eradication rate of concomitant therapy was found to be 89.8% and unsuccessful rate was 10.2%. Among patients with the clarithromycin-resistant gene, only 16.7% had successful eradication and 83.3% had unsuccessful eradication. There was a statistically significant association between failure rate of concomitant therapy and detection of clarithromycin-resistant genes (<i>P</i> &lt; 0.01). The presence of A2143G point mutation in the clarithromycin-resistant strain has a negative effect on the eradication rate of <i>H pylori</i> infection.</p>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"3 6","pages":"372-378"},"PeriodicalIF":0.0,"publicationDate":"2021-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ygh2.476","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71955820","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 status of Helicobacter pylori infection related extraintestinal diseases in Myanmar","authors":"T. Aye, T. Win, M. Tun","doi":"10.1002/ygh2.472","DOIUrl":"https://doi.org/10.1002/ygh2.472","url":null,"abstract":"Myanmar is the country where the prevalence of Helicobacter pylori (H. pylori) infection is high among Southeast Asia region. Many studies have demonstrated association of H. pylori infection with extraintestinal diseases as in pathogenic role.","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"16 1","pages":"344 - 351"},"PeriodicalIF":0.0,"publicationDate":"2021-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84519352","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":"Patient perceptions of successful hepatitis C virus treatment adherence in Veterans","authors":"Grace Y. Zhang,&nbsp;Krupa Patel,&nbsp;Olufunso Agbalajobi,&nbsp;Wheytnie Alexandre,&nbsp;Andrea Reid,&nbsp;Marina Serper,&nbsp;Linda Calgaro,&nbsp;Susan Zickmund,&nbsp;Tami Coppler,&nbsp;Margaret Mizah,&nbsp;Obaid Shaikh,&nbsp;Shari Rogal","doi":"10.1002/ygh2.474","DOIUrl":"https://doi.org/10.1002/ygh2.474","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Treatment adherence remains a potential barrier to achieving population-level hepatitis C virus (HCV) elimination by 2030. We aimed to understand barriers to and facilitators of HCV treatment adherence pre- and post-direct-acting antiviral (DAA) treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cohort of US Veterans who were initiating DAA treatment completed pre- and post-treatment surveys assessing demographic information, psychological symptoms and perceived barriers to adherence. DAA adherence was assessed through self-report and pharmacy records. Sustained virologic response (SVR) was evaluated using the medical record. Mann-Whitney <i>U</i>, Fisher's exact tests, and logistic regression were employed to evaluate associations of patient characteristics and survey responses with adherence and SVR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 97 participants, the majority were male (98%), white (62%), low-income (less than 35 000/y; 82%), and had a history of self-reported prior substance use (93%). The most common anticipated adherence barrier prior to treatment was having side effects (21%). Over follow-up, 62% of participants missed doses and 84% achieved SVR. Decreased pain (OR 0.32, 95% CI 1.06-1.72), agreeing with ‘the medication will improve my health’ (OR 4, 95% CI 1.22-15.8) and disagreeing with being ‘worried about my liver disease getting worse’ (OR 0.2, 95% CI 0.05, 0.59) predicted successfully achieving SVR. After treatment, the most commonly reported barriers to adherence were being busy (13%) and being away from home (13%). Veterans reported non-significantly decreased substance use after treatment (38% vs 28%, <i>P</i> = .18).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this population of Veterans with high rates of substance use, most participants missed doses but still achieved SVR. HCV treatment may also serve as an opportunity for substance use treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"3 5","pages":"307-325"},"PeriodicalIF":0.0,"publicationDate":"2021-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ygh2.474","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71941516","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 rare case of cholangiocarcinoma presenting with paraneoplastic syndrome","authors":"Stephanie L. Yung, M. Arendse, F. Weilert, B. Ko","doi":"10.1002/ygh2.479","DOIUrl":"https://doi.org/10.1002/ygh2.479","url":null,"abstract":"Cholangiocarcinoma has a poor prognosis because of the poor early detection rate and limited treatment options. Therefore, it is important to understand the symptoms of paraneoplastic syndromes in order to detect occult malignancy early, when it is still at a highly treatable stage. Here, we report an extremely rare case of cholangiocarcinoma with paraneoplastic syndrome related to a clinical diagnosis of dermatomyositis (DM) sine dermatitis. A 74‐year‐old Caucasian man experienced 3 weeks of painless jaundice, progressive proximal muscle weakness and renal failure with rhabdomyolysis. Based on the results of laboratory tests and imaging (magnetic resonance cholangiopancreatography, endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography) and histological examination, the diagnosis was cholangiocarcinoma. The diagnosis was consistent with cholangiocarcinoma with paraneoplastic syndrome provoked by DM sine dermatitis. He was successfully treated with biliary stent insertion and supportive management. Eventually, Whipple surgery was successfully performed. Paraneoplastic syndrome is very rare in patients with cholangiocarcinoma, and it is extremely uncommon in the setting of DM. This is the first case in New Zealand.","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"1 1","pages":"326 - 330"},"PeriodicalIF":0.0,"publicationDate":"2021-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88759037","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}