Journal of clinical gastroenterology最新文献

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Satisfaction With and Adherence to Off-Label Corticosteroids in Adolescents and Adults With Eosinophilic Esophagitis: Results of a Web-Based Survey in the United States. 嗜酸性粒细胞食管炎青少年和成人对标签外皮质类固醇的满意度和依从性:美国网络调查结果。
IF 2.9 4区 医学
Journal of clinical gastroenterology Pub Date : 2024-05-15 DOI: 10.1097/MCG.0000000000002006
Benjamin D Gold, Bridgett Goodwin, Kimberly Davis, Carolyn Sweeney, Ryan Ziemiecki, Jeanne Jiang, Tao Fan, Mena Boules, Szu-Ta Chen, David A Katzka
{"title":"Satisfaction With and Adherence to Off-Label Corticosteroids in Adolescents and Adults With Eosinophilic Esophagitis: Results of a Web-Based Survey in the United States.","authors":"Benjamin D Gold, Bridgett Goodwin, Kimberly Davis, Carolyn Sweeney, Ryan Ziemiecki, Jeanne Jiang, Tao Fan, Mena Boules, Szu-Ta Chen, David A Katzka","doi":"10.1097/MCG.0000000000002006","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002006","url":null,"abstract":"<p><strong>Goals: </strong>We assessed satisfaction with and adherence to off-label corticosteroids in patients with eosinophilic esophagitis (EoE) in the United States.</p><p><strong>Background: </strong>EoE is a chronic inflammatory disease for which there are currently no US Food and Drug Administration-approved swallowed topical corticosteroids.</p><p><strong>Study: </strong>This noninterventional, cross-sectional, web-based survey included caregivers of adolescents (aged 11 to 17 y) and adults (aged 18 years or older) with a self-reported [or caregiver-reported (adolescents)] physician diagnosis of EoE who were receiving corticosteroids. Participants were recruited through 2 nonprofit, patient advocacy groups. The 9-item Treatment Satisfaction Questionnaire for Medication (TSQM-9) was used to assess satisfaction across effectiveness, convenience, and global satisfaction domains (scale: 1 to 100 per domain); higher scores indicated greater satisfaction. The 4-item Morisky Green Levine Medication Adherence Scale (MGL-4) was used to assess adherence; an MGL-4 score of <3 indicated adherence. Participants also reported reasons for nonadherence.</p><p><strong>Results: </strong>Overall, 201 participants (caregivers of adolescents, n=98; adults, n=103) were included in this study. Mean TSQM-9 scores indicated low satisfaction with off-label corticosteroids across all 3 satisfaction domains in adolescents (≤61.1) and adults (≤55.7). Slightly fewer adolescents (37.1%) than adults (40.8%) were considered adherent. Forgetfulness was the most frequently reported reason for nonadherence; some patients chose not to take their medications, owing to poor palatability (adolescents), difficulty taking medications at specific times (adults), or feeling depressed/overwhelmed (adolescents and adults).</p><p><strong>Conclusions: </strong>Satisfaction with and adherence to off-label corticosteroids were low in this web-based survey of adolescents and adults with EoE in the United States.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140922275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Histological Outcomes of Pharmacological Interventions in Eosinophilic Esophagitis for Adults and Children: A Network Meta-analysis of Randomized Controlled Trials. 成人和儿童嗜酸性粒细胞食管炎药物干预的组织学结果:随机对照试验网络 Meta 分析》。
IF 2.9 4区 医学
Journal of clinical gastroenterology Pub Date : 2024-05-06 DOI: 10.1097/mcg.0000000000002017
Muhammad Aziz, Hossein Haghbin, Manesh K Gangwani, Rawish Fatima, Amir H Sohail, Hassam Ali, Zakaria A Alyousif, Dushyant S Dahiya, Wade Lee-Smith, Azizullah Beran, Faisal Kamal, Ali Nawras
{"title":"Histological Outcomes of Pharmacological Interventions in Eosinophilic Esophagitis for Adults and Children: A Network Meta-analysis of Randomized Controlled Trials.","authors":"Muhammad Aziz, Hossein Haghbin, Manesh K Gangwani, Rawish Fatima, Amir H Sohail, Hassam Ali, Zakaria A Alyousif, Dushyant S Dahiya, Wade Lee-Smith, Azizullah Beran, Faisal Kamal, Ali Nawras","doi":"10.1097/mcg.0000000000002017","DOIUrl":"https://doi.org/10.1097/mcg.0000000000002017","url":null,"abstract":"Multiple pharmacological interventions have been studied for managing eosinophilic esophagitis (EoE). We performed a comprehensive systematic review and network meta-analysis of all available randomized controlled trials (RCT) to assess the efficacy and safety of these interventions in EoE in adults and children.","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140838143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Colorectal Cancer Prevention and Chat Generative Pretrained Transformer (ChatGPT). 大肠癌预防和聊天生成预处理转换器 (ChatGPT)。
IF 2.9 4区 医学
Journal of clinical gastroenterology Pub Date : 2024-05-01 Epub Date: 2024-03-07 DOI: 10.1097/MCG.0000000000001989
Hinpetch Daungsupawong, Viroj Wiwanitkit
{"title":"Colorectal Cancer Prevention and Chat Generative Pretrained Transformer (ChatGPT).","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1097/MCG.0000000000001989","DOIUrl":"10.1097/MCG.0000000000001989","url":null,"abstract":"","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140065273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improving Adherence to Clinical Practice Guidelines for Managing Gastric Intestinal Metaplasia Among Gastroenterologists at a US Academic Institution. 提高美国一家学术机构的消化科医生对胃肠道增生症治疗临床实践指南的依从性。
IF 2.9 4区 医学
Journal of clinical gastroenterology Pub Date : 2024-05-01 Epub Date: 2023-07-13 DOI: 10.1097/MCG.0000000000001890
Jake Jacob, Valentine Millien, Scott Berger, Ruben Hernaez, Gyanprakash A Ketwaroo, Avegail G Flores, Jason K Hou, Maria E Jarbrink-Sehgal, Natalia I Khalaf, Daniel G Rosen, Hashem B El-Serag, Mimi C Tan
{"title":"Improving Adherence to Clinical Practice Guidelines for Managing Gastric Intestinal Metaplasia Among Gastroenterologists at a US Academic Institution.","authors":"Jake Jacob, Valentine Millien, Scott Berger, Ruben Hernaez, Gyanprakash A Ketwaroo, Avegail G Flores, Jason K Hou, Maria E Jarbrink-Sehgal, Natalia I Khalaf, Daniel G Rosen, Hashem B El-Serag, Mimi C Tan","doi":"10.1097/MCG.0000000000001890","DOIUrl":"10.1097/MCG.0000000000001890","url":null,"abstract":"<p><strong>Background: </strong>Clinical guidelines reserve endoscopic surveillance after a gastric intestinal metaplasia (GIM) diagnosis for high-risk patients. However, it is unclear how closely guidelines are followed in clinical practice. We examined the effectiveness of a standardized protocol for the management of GIM among gastroenterologists at a US hospital.</p><p><strong>Methods: </strong>This was a preintervention and postintervention study, which included developing a protocol and education of gastroenterologists on GIM management. For the preintervention study, 50 patients with GIM were randomly selected from a histopathology database at the Houston VA Hospital between January 2016 and December 2019. For the postintervention study, we assessed change in GIM management in a cohort of 50 patients with GIM between April 2020 and January 2021 and surveyed 10 gastroenterologists. The durability of the intervention was assessed in a cohort of 50 GIM patients diagnosed between April 2021 and July 2021.</p><p><strong>Results: </strong>In the preintervention cohort, GIM location was specified (antrum and corpus separated) in 11 patients (22%), and Helicobacter pylori testing was recommended in 11 of 26 patients (42%) without previous testing. Gastric mapping biopsies were recommended in 14% and surveillance endoscopy in 2%. In the postintervention cohort, gastric biopsy location was specified in 45 patients (90%, P <0.001) and H. pylori testing was recommended in 26 of 27 patients without prior testing (96%, P <0.001). Because gastric biopsy location was known in 90% of patients ( P <0.001), gastric mapping was not necessary, and surveillance endoscopy was recommended in 42% ( P <0.001). One year after the intervention, all metrics remained elevated compared with the preintervention cohort.</p><p><strong>Conclusions: </strong>GIM management guidelines are not consistently followed. A protocol for GIM management and education of gastroenterologists increased adherence to H. pylori testing and GIM surveillance recommendations.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10787041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9776196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Agave tequilana Fructans Versus Psyllium plantago for Functional Constipation : Randomized Double-blind Clinical Trial. 龙舌兰果聚糖与车前子对功能性便秘的治疗 :随机双盲临床试验。
IF 2.9 4区 医学
Journal of clinical gastroenterology Pub Date : 2024-05-01 Epub Date: 2023-07-03 DOI: 10.1097/MCG.0000000000001888
Enrique Coss-Adame, Maria F García-Cedillo, Gustavo Bustillo-Armendáriz, Maria F Huerta-de la Torre, Melisa K Delgado-Bautista, Josealberto Arenas-Martinez, Lorena Cassis-Nosthas
{"title":"Agave tequilana Fructans Versus Psyllium plantago for Functional Constipation : Randomized Double-blind Clinical Trial.","authors":"Enrique Coss-Adame, Maria F García-Cedillo, Gustavo Bustillo-Armendáriz, Maria F Huerta-de la Torre, Melisa K Delgado-Bautista, Josealberto Arenas-Martinez, Lorena Cassis-Nosthas","doi":"10.1097/MCG.0000000000001888","DOIUrl":"10.1097/MCG.0000000000001888","url":null,"abstract":"<p><strong>Goal: </strong>The aim of this study was to evaluate the efficacy of supplementation with Agave tequilana Weber blue variety fructans (Predilife) in the improvement of symptoms in functional constipation.</p><p><strong>Background: </strong>Fiber supplementation is the first-line treatment for constipation. Fibers-like fructans have a known prebiotic effect.</p><p><strong>Materials and methods: </strong>A randomized, double-blind, study comparing agave fructans (AF) against psyllium plantago (PP). Four groups were randomized. Group 1: AF 5 g (Predilife), group 2: AF 10 g (Predilife), group 3: AF 5 g (Predilife)+10 g maltodextrin (MTDx), and group 4: PP 5 g+10 g MTDx. The fiber was administered once daily for 8 weeks. All fibers were similarly flavored and packaged. Patients kept their usual diet and fiber sources were quantified. Responders were defined as ≥1 complete spontaneous bowel movement from baseline to 8 weeks. Adverse events were reported. The study was registered in Clinicaltrials.gov with registration number NCT04716868.</p><p><strong>Results: </strong>Seventy-nine patients were included (group 1: 21, group 2: 18, group 3: 20, and group 4: 20), of which 62 (78.4%) were women. The responders were similar across groups (73.3%, 71.4%, 70.6%, and 69%, P >0.050). After 8 weeks, all groups significantly increased complete spontaneous bowel movements, showing the greatest increase in spontaneous bowel movements in group 3 ( P =0.008). All groups improved in symptoms, stool consistency, and quality of life. Diet and fiber intake were similar between groups. Adverse events were mild and similar between groups.</p><p><strong>Conclusions: </strong>AF (Predilife) are as effective at different doses and combined with MTDx as PP and are a feasible option for the treatment of functional constipation.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9702226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Elastography for Evaluation of Regression in Liver Fibrosis After Surgical Biliary Drainage for Benign Biliary Strictures: A Practical Possibility? 弹性成像评估良性胆道狭窄手术引流后肝纤维化消退的可行性?
IF 2.9 4区 医学
Journal of clinical gastroenterology Pub Date : 2024-05-01 Epub Date: 2023-07-31 DOI: 10.1097/MCG.0000000000001895
Jayapal Rajendran, Santhosh Irrinki, Vikas Gupta, Virendra Singh, Saroj Kanth Sinha, Anupam Lal, Kailash Kurdia, Ashim Das, Thakur Deen Yadav
{"title":"Elastography for Evaluation of Regression in Liver Fibrosis After Surgical Biliary Drainage for Benign Biliary Strictures: A Practical Possibility?","authors":"Jayapal Rajendran, Santhosh Irrinki, Vikas Gupta, Virendra Singh, Saroj Kanth Sinha, Anupam Lal, Kailash Kurdia, Ashim Das, Thakur Deen Yadav","doi":"10.1097/MCG.0000000000001895","DOIUrl":"10.1097/MCG.0000000000001895","url":null,"abstract":"<p><strong>Background: </strong>Hepatic fibrosis and secondary biliary cirrhosis are consequences of long-standing benign biliary strictures. Evidence on the reversibility of fibrosis after the repair is incongruous.</p><p><strong>Methodology: </strong>A prospective observational study on patients who underwent Roux-en-Y hepaticojejunostomy for benign biliary stricture. A liver biopsy was performed during repair and correlated with preoperative elastography. The improvement in liver functions and regression of fibrosis was compared with preoperative liver function tests and elastography.</p><p><strong>Results: </strong>A Total of 47 patients [mean age-38.9 y (Range: 21 to 66)] with iatrogenic benign biliary stricture were included. A strong female preponderance was noted. High strictures (type III and IV) comprised 72.7% of the study group. The median interval (injury to repair) was 7 months (2 to 72 mo). The median duration of jaundice was 3 months (1 to 20 mo). Both factors had a significant correlation with the stage of fibrosis ( P =0.001 and P =0.03, respectively). Liver biopsy revealed stage I, II, III, and IV fibrosis in 26 (55.3%), 11 (23.4%), 2 (4.3%), and 2(4.3%), respectively. The remaining 6 (12.8%) had no fibrosis. The severity of fibrosis had a good correlation with preoperative liver stiffness measurement-value on FibroScan. Significant improvement in liver function tests (bilirubin-3.55±3.48 vs. 0.59±0.52; Albumin-3.85±0.61 vs. 4.14±0.37; ALP-507.66±300.65 vs. 167±132.07; P value 0.00) and regression of fibrosis (liver stiffness measurement; 10.42±5.91 vs. 5.85±3.01, P value 0.00) was observed after repair of the strictures.</p><p><strong>Conclusion: </strong>Improved biliary function and regression of liver fibrosis can be achieved with timely repair of benign biliary stricture and it is feasible to be evaluated using elastography.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41132781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors Associated With Difficult Endoscopic Ultrasonography-guided Biliary Drainage. 内镜超声引导胆道引流困难的相关因素
IF 2.9 4区 医学
Journal of clinical gastroenterology Pub Date : 2024-05-01 Epub Date: 2023-06-26 DOI: 10.1097/MCG.0000000000001876
Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Yuichi Waragai, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Jun Nakamura, Mika Takasumi, Minami Hashimoto, Tsunetaka Kato, Takumi Yanagita, Takuto Hikichi, Hiromasa Ohira
{"title":"Factors Associated With Difficult Endoscopic Ultrasonography-guided Biliary Drainage.","authors":"Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Yuichi Waragai, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Jun Nakamura, Mika Takasumi, Minami Hashimoto, Tsunetaka Kato, Takumi Yanagita, Takuto Hikichi, Hiromasa Ohira","doi":"10.1097/MCG.0000000000001876","DOIUrl":"10.1097/MCG.0000000000001876","url":null,"abstract":"<p><strong>Background and aims: </strong>When endoscopic retrograde cholangiopancreatography-guided biliary drainage is challenging, endoscopic ultrasound-guided biliary drainage (EUS-BD) can be used as an alternate treatment; however, this method requires operator expertise. Therefore, this study aimed to clarify the factors that are associated with a difficult EUS-BD.</p><p><strong>Patients and methods: </strong>Patients who successfully underwent EUS-BD were enrolled in this study. The patients were divided into the easy group and difficult group depending on whether the procedural time was more than 60 minutes, which was the cutoff value elicited from past reports. Patient characteristics and procedural factors were compared between the two groups. The factors associated with difficult procedures were also investigated.</p><p><strong>Results: </strong>The patient characteristics were not significantly different between the easy group (n=22) and the difficult group (n=19). The diameter of the punctured bile duct was significantly different between the two groups. In the multivariate analysis, the diameter of the punctured bile duct was the only factor associated with a difficult EUS-BD (odds ratio 0.65, 95% confidence interval 0.46-0.91, P value=0.012). The cutoff value for the diameter of the punctured bile duct in predicting a difficult EUS-BD was 7.0 mm (area under the curve: 0.83, sensitivity 84.2%, specificity 86.4%).</p><p><strong>Conclusions: </strong>A nondilated bile duct might be a predictive factor for a difficult EUS-BD. For beginners of EUS-BD, the cutoff value for the punctured bile duct diameter found in this study, 7.0 mm, might become a barometer for puncture point selection.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9726869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk Factors and Prognosis Analysis of Upper Gastrointestinal Bleeding in Patients With Acute Severe Cerebral Stroke. 急性重症脑卒中患者上消化道出血的风险因素和预后分析
IF 2.9 4区 医学
Journal of clinical gastroenterology Pub Date : 2024-05-01 Epub Date: 2023-06-22 DOI: 10.1097/MCG.0000000000001877
Zengdian Chen, Weiguo Lin, Faqin Zhang, Wen Cao
{"title":"Risk Factors and Prognosis Analysis of Upper Gastrointestinal Bleeding in Patients With Acute Severe Cerebral Stroke.","authors":"Zengdian Chen, Weiguo Lin, Faqin Zhang, Wen Cao","doi":"10.1097/MCG.0000000000001877","DOIUrl":"10.1097/MCG.0000000000001877","url":null,"abstract":"<p><strong>Goals: </strong>We aim to explore the relationship between the use of proton pump inhibitors (PPIs) and upper gastrointestinal bleeding (UGIB). We develop a nomogram model to predict mortality in critically ill stroke patients.</p><p><strong>Study: </strong>This is a retrospective study based on the MIMIC IV database. We extracted clinical information including demographic data, comorbidities, and laboratory indicators. Univariate and multivariable logistic regressions were used to assess and identify risk factors for the occurrence of UGIB and for the in-hospital mortality of critically ill stroke patients. The resulting model was used to construct a nomogram for predicting in-hospital mortality.</p><p><strong>Results: </strong>Five thousand seven hundred sixteen patients from the MIMIC-IV database were included in our analysis. UGIB occurred in 109 patients (1.9%), whereas the PPI use rate was as high as 60.6%. Chronic liver disease, sepsis, shock, anemia, and increased level of urea nitrogen were independent risk factors for the occurrence of UGIB in severe stroke patients. We identified age, heart failure, shock, coagulopathy, mechanical ventilation, continuous renal replacement therapy, antiplatelet drugs, anticoagulation, simplified acute physiology score-II, and Glasgow coma score as independent risk factors for in-hospital mortality in severe stroke patients. The C-index for the final nomograms was 0.852 (95% confidence interval: 0.840, 0.864).</p><p><strong>Conclusions: </strong>We found that the overall rate of UGIB in severe stroke patients is low, whereas the rate of PPI usage is high. In our study, PPI was not identified as a risk factor for the occurrence of UGIB and UGIB was not associated with all-cause mortality. More clinical trials are needed to evaluate the benefits of using PPI in critically ill stroke patients.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10994183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9673004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Influence of Colorectal Cancer Risk Factors on Predictive Value of a Positive Multitarget Stool DNA Test. 结直肠癌风险因素对多目标粪便 DNA 检测阳性预测值的影响
IF 2.9 4区 医学
Journal of clinical gastroenterology Pub Date : 2024-05-01 Epub Date: 2023-06-27 DOI: 10.1097/MCG.0000000000001884
Kaden R Narayani, Raj I Narayani
{"title":"Influence of Colorectal Cancer Risk Factors on Predictive Value of a Positive Multitarget Stool DNA Test.","authors":"Kaden R Narayani, Raj I Narayani","doi":"10.1097/MCG.0000000000001884","DOIUrl":"10.1097/MCG.0000000000001884","url":null,"abstract":"<p><strong>Goals: </strong>We analyzed if the predictive value of multitarget stool-based DNA (mt-sDNA) varied when patients had pre-existing known colorectal cancer (CRC) risk factors.</p><p><strong>Background: </strong>mt-sDNA test is approved for CRC screening in average-risk patients. Whether patients with a personal history of adenomatous colon polyps or a family history of CRC (CRC risk factors) benefit from mt-sDNA testing is unknown.</p><p><strong>Study: </strong>We reviewed charts for all positive mt-sDNA referrals between 2017 and 2021. Diagnostic colonoscopy adherence rates were calculated. In those who had colonoscopy, we compared detection rates for any colorectal neoplasia (CRN), multiple (3 or more) adenomas, sessile serrated polyps (SSP), advanced CRN, and CRC between patients with and without known CRC risk factors.</p><p><strong>Results: </strong>Of 1297 referrals for positive mt-sDNA, 1176 (91%) completed a diagnostic colonoscopy. The absence of neoplasia was noted in 27% of colonoscopy exams. When neoplasia was identified, findings were as follows: any CRN (73%), multiple adenomas (34%), SSP (23%), advanced CRN (33%), and CRC (2.5%). One or more CRC risk factors were present in 229 (19%) of cases. In the CRC risk factor subgroup, patients having a prior history of adenomatous polyps or a family history of CRC were no more likely to have any CRN, multiple adenomas, SSP, advanced CRN, or CRC compared to average-risk patients when mt-sDNA was positive.</p><p><strong>Conclusions: </strong>In this real-world analysis of positive mt-sDNA referrals, adherence to subsequent diagnostic colonoscopy recommendations was high. The presence of pre-existing CRC risk factors did not affect the positive predictive value of mt-sDNA.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9724931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Increasing Antibiotic-Resistant Infections With Inpatient Endoscopic Retrograde Cholangioscopies (ERCP) Is Associated With Higher Mortality in the United States: A Cross-sectional Cohort Study. 美国住院病人内镜逆行胆管造影术 (ERCP) 抗生素耐药感染增加与死亡率升高有关:一项横断面队列研究。
IF 2.9 4区 医学
Journal of clinical gastroenterology Pub Date : 2024-05-01 Epub Date: 2023-06-19 DOI: 10.1097/MCG.0000000000001874
Patrick W Chang, Aileen Bui, Selena Zhou, Ara B Sahakian, James L Buxbaum, Jennifer Phan
{"title":"Increasing Antibiotic-Resistant Infections With Inpatient Endoscopic Retrograde Cholangioscopies (ERCP) Is Associated With Higher Mortality in the United States: A Cross-sectional Cohort Study.","authors":"Patrick W Chang, Aileen Bui, Selena Zhou, Ara B Sahakian, James L Buxbaum, Jennifer Phan","doi":"10.1097/MCG.0000000000001874","DOIUrl":"10.1097/MCG.0000000000001874","url":null,"abstract":"<p><strong>Goals: </strong>This study aims to investigate associated mortality with inpatient endoscopic retrograde cholangiopancreatography (ERCP) with and without resistant infections. The co-primary objective compares frequencies of inpatient ERCP with resistant infections to overall hospitalizations with resistant infections.</p><p><strong>Background: </strong>The risks of inpatient antibiotic-resistant organisms are known, but the associated mortality for inpatient ERCP is unknown. We aim to use a national database of hospitalizations and procedures to understand trends and mortality for patients with antibiotic-resistant infections during inpatient ERCP.</p><p><strong>Study: </strong>The largest publicly available all-payer inpatient database in the United States (National Inpatient Sample) was used to identify hospitalizations associated with ERCPs and antibiotic-resistant infections for MRSA, VRE, ESBL, and MDRO. National estimates were generated, frequencies were compared across years, and multivariate regression for mortality was performed.</p><p><strong>Results: </strong>From 2017 to 2020, national weighted estimates of 835,540 inpatient ERCPs were generated, and 11,440 ERCPs had coincident resistant infections. Overall resistant infection, MRSA, VRE, and MDRO identified at the same hospitalization of inpatient ERCPs were associated with higher mortality (OR CI(95%): Overall: 2.2(1.77-2.88), MRSA: 1.90 (1.34-2.69), VRE: 3.53 (2.16-5.76), and MDRO: 2.52 (1.39-4.55)). While overall hospitalizations with resistant infections have been decreasing annually, there has been a yearly increase in admissions requiring ERCPs with simultaneous resistant infections ( P =0.001-0.013), as well as infections with VRE, ESBL, and MDRO ( P =0.001-0.016). Required Research Practices for Studies Using the NIS scoring was 0, or the most optimal.</p><p><strong>Conclusions: </strong>Inpatient ERCPs have increasing coincident resistant infections and are associated with higher mortality. These rising infections during ERCP highlight the importance of endoscopy suite protocols and endoscopic infection control devices.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10024860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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