Journal of the Canadian Association of Gastroenterology最新文献

{"title":"Correction to 153 abstracts to correct abstract citation ID in the PDF version.","authors":"","doi":"10.1093/jcag/gwag026","DOIUrl":"https://doi.org/10.1093/jcag/gwag026","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/jcag/gwaf042.221.][This corrects the article DOI: 10.1093/jcag/gwaf042.185.][This corrects the article DOI: 10.1093/jcag/gwaf042.186.][This corrects the article DOI: 10.1093/jcag/gwaf042.187.][This corrects the article DOI: 10.1093/jcag/gwaf042.188.][This corrects the article DOI: 10.1093/jcag/gwaf042.189.][This corrects the article DOI: 10.1093/jcag/gwaf042.190.][This corrects the article DOI: 10.1093/jcag/gwaf042.191.][This corrects the article DOI: 10.1093/jcag/gwaf042.192.][This corrects the article DOI: 10.1093/jcag/gwaf042.193.][This corrects the article DOI: 10.1093/jcag/gwaf042.194.][This corrects the article DOI: 10.1093/jcag/gwaf042.195.][This corrects the article DOI: 10.1093/jcag/gwaf042.196.][This corrects the article DOI: 10.1093/jcag/gwaf042.197.][This corrects the article DOI: 10.1093/jcag/gwaf042.198.][This corrects the article DOI: 10.1093/jcag/gwaf042.199.][This corrects the article DOI: 10.1093/jcag/gwaf042.200.][This corrects the article DOI: 10.1093/jcag/gwaf042.201.][This corrects the article DOI: 10.1093/jcag/gwaf042.202.][This corrects the article DOI: 10.1093/jcag/gwaf042.203.][This corrects the article DOI: 10.1093/jcag/gwaf042.204.][This corrects the article DOI: 10.1093/jcag/gwaf042.205.][This corrects the article DOI: 10.1093/jcag/gwaf042.206.][This corrects the article DOI: 10.1093/jcag/gwaf042.207.][This corrects the article DOI: 10.1093/jcag/gwaf042.208.][This corrects the article DOI: 10.1093/jcag/gwaf042.209.][This corrects the article DOI: 10.1093/jcag/gwaf042.210.][This corrects the article DOI: 10.1093/jcag/gwaf042.211.][This corrects the article DOI: 10.1093/jcag/gwaf042.212.][This corrects the article DOI: 10.1093/jcag/gwaf042.213.][This corrects the article DOI: 10.1093/jcag/gwaf042.214.][This corrects the article DOI: 10.1093/jcag/gwaf042.215.][This corrects the article DOI: 10.1093/jcag/gwaf042.216.][This corrects the article DOI: 10.1093/jcag/gwaf042.217.][This corrects the article DOI: 10.1093/jcag/gwaf042.218.][This corrects the article DOI: 10.1093/jcag/gwaf042.219.][This corrects the article DOI: 10.1093/jcag/gwaf042.220.][This corrects the article DOI: 10.1093/jcag/gwaf042.222.][This corrects the article DOI: 10.1093/jcag/gwaf042.223.][This corrects the article DOI: 10.1093/jcag/gwaf042.224.][This corrects the article DOI: 10.1093/jcag/gwaf042.225.][This corrects the article DOI: 10.1093/jcag/gwaf042.226.][This corrects the article DOI: 10.1093/jcag/gwaf042.227.][This corrects the article DOI: 10.1093/jcag/gwaf042.228.][This corrects the article DOI: 10.1093/jcag/gwaf042.229.][This corrects the article DOI: 10.1093/jcag/gwaf042.230.][This corrects the article DOI: 10.1093/jcag/gwaf042.231.][This corrects the article DOI: 10.1093/jcag/gwaf042.232.][This corrects the article DOI: 10.1093/jcag/gwaf042.233.][This corrects the article DOI: 10.1093/jcag/gwaf042.234.][This corrects the article DOI: 10.1093/jcag/gwaf042.235.][This corrects the article DOI: 10.1","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"9 5","pages":"353-354"},"PeriodicalIF":3.8,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111447","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":"Effectiveness of vedolizumab to reduce bowel urgency in a Canadian real-world inflammatory bowel disease cohort.","authors":"Parul Tandon, Yvette Leung, Ryan Ward, Abhinav Wadhwa, Jessica Weiss, Ruth Moulson, Christopher Pettengell, Robert Battat","doi":"10.1093/jcag/gwag031","DOIUrl":"10.1093/jcag/gwag031","url":null,"abstract":"<p><strong>Background and aims: </strong>Bowel urgency is a burdensome symptom of inflammatory bowel disease (IBD) that greatly impacts quality of life. This study evaluated vedolizumab effectiveness on bowel urgency in Canadian patients with ulcerative colitis (UC) and Crohn's disease (CD).</p><p><strong>Methods: </strong>Adults with moderately to severely active UC or CD with baseline Urgency Numeric Rating Scale (UNRS) scores enrolled in the Canadian Patient Support Program (July 2024-March 2025) were included. Bowel urgency and clinical endpoints were evaluated at 2, 6, and 14 weeks. Clinically meaningful improvement (CMI) was defined as UNRS change from baseline ≥3 among patients with baseline UNRS ≥3. UC clinical remission was defined as pM (partial Mayo) score <3. CD clinical response was defined as Harvey-Bradshaw Index (HBI) decrease ≥3 and ≥25% from baseline; remission as HBI <5.</p><p><strong>Results: </strong>Of 412 vedolizumab-treated patients (319 UC, 93 CD), most were bio-naïve (UC: 89%, CD: 63%) with median disease durations of 4 years (UC) and 7 years (CD). At baseline, 268 (84%) UC and 74 (80%) CD patients had UNRS ≥3. Median time to CMI was 6 weeks in both cohorts. By week 14, UC patients experienced a 5-point median UNRS reduction (80%) and CD patients a 4-point reduction (62%). Patients achieving CMI at weeks 6 and 14 were significantly more likely to achieve clinical remission. Week 2 urgency outcomes were significant predictors of later outcomes.</p><p><strong>Conclusions: </strong>Most UC and CD patients achieved CMI by 6 weeks. CMI was significantly associated with validated clinical outcomes, demonstrating real-world effectiveness of vedolizumab in reducing bowel urgency.</p>","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"9 5","pages":"320-326"},"PeriodicalIF":3.8,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111611","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":"Sustainability indicators for gastrointestinal endoscopy: a framework proposed by the Canadian Association of Gastroenterology and the American Society for Gastrointestinal Endoscopy.","authors":"Desmond Leddin, John Igoe, Geoffrey C Nguyen, Sonali Palchaudhuri, Neal Shahidi, Heiko Pohl","doi":"10.1093/jcag/gwag030","DOIUrl":"10.1093/jcag/gwag030","url":null,"abstract":"","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"9 5","pages":"283-292"},"PeriodicalIF":3.8,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109897","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":"Taking a pragmatic approach to implement colonoscopy quality at a health system level: Ontario's colonoscopy quality strategy.","authors":"Catherine Dubé, Akua Kyei, Andrea Hatvani, Meghan Walker, Julia Gao, Jane Ahn, David Morgan, Nancy N Baxter, Linda Rabeneck, Jill Tinmouth","doi":"10.1093/jcag/gwag028","DOIUrl":"10.1093/jcag/gwag028","url":null,"abstract":"<p><strong>Objectives: </strong>To describe Ontario's colonoscopy quality strategy (OCQS), to review outcomes to date, to assess it against the Health Quality Ontario framework, and to identify areas for improvement.</p><p><strong>Methods: </strong>We provide a descriptive analysis of the OCQS, tracing its development from the launch of the ColonCancerCheck program in 2007 through subsequent initiatives, including funding mechanisms, evidence-based standards, systematic data collection, provider-level performance reporting and feedback. The impact of the OCQS is assessed via temporal trends in colonoscopy quality indicators.</p><p><strong>Results: </strong>The OCQS has evolved into a multipronged, system-wide strategy emphasizing evidence generation, collaboration with clinical leaders, and embedding quality improvement within regional cancer programs. Key achievements include standardized reporting, provincial and regional accountability structures, and integration of quality metrics into practice. Over time, there has been improvement in colonoscopy and screening indicators, reflecting the impact of the OCQS. Challenges include addressing endoscopists with persistent performance issues, optimizing accountability mechanisms, and sustaining engagement in a resource-constrained system.</p><p><strong>Conclusions: </strong>Ontario's experience demonstrates that implementing colonoscopy quality initiatives within a complex health system requires pragmatism, iterative refinement, and continuous evaluation. Lessons learned may inform other jurisdictions in designing and scaling endoscopy quality strategies.</p>","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"9 5","pages":"275-282"},"PeriodicalIF":3.8,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110541","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 sustainability and environmental impact of virtual care for inflammatory bowel disease: a population-based retrospective cohort study.","authors":"Luke J Nguyen, Vivian Huang, Peter Habashi, Daniel McCormack, Christopher A Chong, Parul Tandon","doi":"10.1093/jcag/gwag029","DOIUrl":"10.1093/jcag/gwag029","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic prompted rapid expansion of virtual specialist care, yet its sustainability and environmental implications remain unclear. We evaluated temporal trends in virtual inflammatory bowel disease (IBD) care and quantified associated reductions in travel-related carbon emissions.</p><p><strong>Methods: </strong>We conducted a population-based cohort study of individuals with IBD in Ontario, using linked ICES administrative data. Individuals with established IBD as of April 1, 2020, were followed through March 31, 2025. Outcomes included quarterly rates of virtual IBD specialist visits per 100 IBD capita, the proportion delivered virtually, and estimated carbon emissions avoided from reduced travel. Logistic regression identified predictors of ongoing virtual care.</p><p><strong>Results: </strong>Among 98 099 individuals with IBD, 95% of specialist encounters among 62 265 patients with any visit were virtual during the first pandemic fiscal year. Virtual visit rates declined after 2021 and stabilized at approximately one-third of encounters by 2023-2025, while total ambulatory rates were modestly lower than pre-pandemic baseline. Of patients with a virtual visit in 2020-2021, 28% had one in 2023-2024. Older age, lower comorbidity, and residence in low-access regions were associated with reduced odds of continued virtual care. In the first pandemic year, virtual care was estimated to avoid 1268 tonnes of CO₂ emissions, equivalent to the annual emissions of 275 passenger cars.</p><p><strong>Conclusions: </strong>Virtual IBD specialist care was associated with substantial reductions in estimated travel-related carbon emissions, which diminished as care returned to in-person delivery. Sustainable hybrid care models may preserve environmental benefits while maintaining specialist access.</p>","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"9 5","pages":"327-335"},"PeriodicalIF":3.8,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110607","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":"Elective colorectal surgery in those with cirrhosis: a population-based study assessing practice patterns and patient outcomes.","authors":"Kelly Brennan, Lisa Zhang, Hayton Chui, Jennifer A Flemming, Sulaiman Nanji, Maya Djerboua, Shaila Merchant, Antonio Caycedo-Marulanda, Sunil V Patel","doi":"10.1093/jcag/gwag027","DOIUrl":"10.1093/jcag/gwag027","url":null,"abstract":"<p><strong>Background: </strong>Patients with cirrhosis have significant postoperative risks following major abdominal surgery. Historic literature and prediction tools do not reflect current practices and outcomes. An assumed 30-day mortality by the model for end-stage liver disease (MELD) score of <12 and 12+ in patients undergoing abdominal surgery is 8% and 33%, respectively. The study objectives were to describe relevant practice patterns and postoperative outcomes in cirrhosis after elective colorectal surgery.</p><p><strong>Methods: </strong>This retrospective cohort study included 1439 individuals in Ontario with a diagnosis of cirrhosis who underwent colorectal surgery from 2009 to 2017. Demographics, cirrhosis-specific characteristics, and outcomes were identified using linked administrative databases. Univariable and multivariable analyses were performed.</p><p><strong>Results: </strong>The median MELD-Sodium score was 8 (IQR 7-11). The most common cirrhosis etiologies were metabolic dysfunction-associated steatotic liver disease (58%) and alcohol-associated (24%). Indications for surgery included colorectal cancer (70%), diverticulitis (11%), and inflammatory bowel disease (10%). The 3 most common procedures performed were colon resection with primary anastomosis (66%), rectal resection with primary anastomosis (17%), and abdominal perineal resection (6%). In-hospital and 90-day mortality were 5% and 7%, respectively. Ninety-day complications included readmission (24%), emergency department visit (39%), intensive care admission (27%), and hepatic decompensation (6%). Ninety-day mortality based on MELD-Sodium score included 6% versus 21% in those with a score <12 compared to 12+. Alcohol-related cirrhosis, age, and comorbidities were associated with mortality (<i>P</i> < .01).</p><p><strong>Conclusion: </strong>This work confirms that the increased surgical risks are lower than once believed in patients with cirrhosis undergoing colorectal surgery in the elective setting. This evidence will guide management of patients in this high-risk group.</p>","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"9 5","pages":"343-352"},"PeriodicalIF":3.8,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111540","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":"Real-world effectiveness and predictors of need for extended induction of mirikizumab therapy in ulcerative colitis.","authors":"Cathy McShane, Itay Kalisky, Jonah S Moore, Raquel Milgrom, Joanne Stempak, Pablo A Olivera, Geoffrey Nguyen, Kenneth Croitoru, Vivian W Huang, Laura E Targownik, Adam V Weizman, A Hillary Steinhart, Zane Gallinger, Sun-Ho Lee, Greg Rosenfeld, Mark S Silverberg","doi":"10.1093/jcag/gwag023","DOIUrl":"10.1093/jcag/gwag023","url":null,"abstract":"<p><strong>Background: </strong>Mirikizumab (MIR), a selective interleukin-23p19 inhibitor, has demonstrated efficacy in randomized trials for moderate-to-severe ulcerative colitis (UC). Real-world data remain limited. Here, we evaluated the effectiveness, durability, and safety of MIR in routine clinical practice.</p><p><strong>Methods: </strong>We conducted a retrospective, multicentre cohort study of adults with UC initiating MIR at two tertiary centres in Canada. Clinical, biomarker, endoscopic, and safety outcomes were assessed at weeks 12, 28, and 52. The primary outcome was corticosteroid-free (CSF) clinical remission at week 12. Secondary outcomes included CSF clinical remission at weeks 28 and 52, CSF clinical response, mucosal healing, treatment persistence, extended induction, and serious adverse events. Predictors of extended induction were evaluated using logistic regression.</p><p><strong>Results: </strong>Eighty-two patients were included; 94% were previously exposed to at least one advanced therapy. CSF clinical remission was achieved in 24% of patients at week 12, 35% at weeks 28, and 33% at week 52, with corresponding CSF clinical response rates of 45%, 53%, and 40%. Moreover, 40% of the cohort received extended induction. In the extended induction subgroup, CSF clinical remission was observed in 19% at week 28 and 22% at week 52, with CSF clinical response rates observed in 37% and 30%, respectively. Early CSF clinical response at week 12 was associated with treatment persistence. The incidence of serious adverse events was low, with no new safety signals.</p><p><strong>Conclusions: </strong>In this multicentre real-world Canadian cohort of predominantly treatment-experienced patients with UC, MIR demonstrated clinically relevant effectiveness, acceptable durability, and a favourable safety profile over 1 year.</p>","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"9 5","pages":"312-319"},"PeriodicalIF":3.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111555","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":"Global variability in colorectal cancer screening guidelines: panel composition and recommendations.","authors":"Koki Nakajima, Hiroaki Saito, Yoshitaka Nishikawa","doi":"10.1093/jcag/gwag024","DOIUrl":"10.1093/jcag/gwag024","url":null,"abstract":"<p><strong>Objective: </strong>Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide. Although many countries have developed CRC screening guidelines, how CRC screening guidelines are developed across countries remains unclear. This study examined guideline-development funding, stakeholders, and their conflicts of interest (COI), and compared CRC screening recommendations across Group of Seven (G7) countries.</p><p><strong>Methods: </strong>We reviewed the most recent CRC screening guidelines issued by official research organizations or governmental bodies in G7 countries. We extracted information on responsible organizations, panel composition, recommendations, target ages, screening tests and intervals, supporting evidence, funding, and COI.</p><p><strong>Results: </strong>While CRC screening recommendations showed some similarities across G7 countries, some differences were observed in starting age, screening modality, and implementation structure. Differences were also identified in funding, COI reporting and management, and stakeholder composition, including limited involvement of patient and public representatives.</p><p><strong>Conclusions: </strong>Colorectal cancer screening guidelines among G7 countries varied despite shared international evidence. These differences likely reflect country-specific factors, including population characteristics, screening participation, health system capacity, and cultural context. Given that guideline development involves diverse stakeholders, ensuring transparency in the guideline-development process is essential.</p>","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"9 5","pages":"271-274"},"PeriodicalIF":3.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111535","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":"Evaluation of fecal microbiota, live (RBL) for the prevention of recurrent <i>Clostridioides difficile</i> infection: Canadian subgroup analysis of an open-label phase 3 study.","authors":"Theodore Steiner, Thomas Louie, Dina Kao, Dan Smyth, Beth Guthmueller, Tracey Jason, Susan N Elliott, Shivam Srivastava, Christine Lee","doi":"10.1093/jcag/gwag021","DOIUrl":"10.1093/jcag/gwag021","url":null,"abstract":"<p><strong>Background: </strong>Fecal microbiota, live (RBL) is a single-dose, broad consortium, microbiota-based product approved in the United States and Canada for preventing recurrent <i>Clostridioides difficile</i> (<i>C. diff</i>) infection in adults following standard-of-care (SOC) treatment.</p><p><strong>Methods: </strong>PUNCH CD3-OLS was a phase 3, open-label, multicenter study evaluating safety and effectiveness of RBL in adults, including those with comorbidities, with recurrent <i>C. diff</i> infection. Participants were aged ≥18 years, had recurrent <i>C. diff</i> infection (≥1 recurrence/≥2 severe episodes; diagnostic method was site-specific), and received SOC antibiotics before rectal administration of RBL. The primary endpoint was treatment-emergent adverse events (TEAEs) through 6 months post-administration. Secondary endpoints included treatment success at 8 weeks and sustained clinical response at 6 months. This subgroup analysis examined outcomes among Canadian participants across 5 sites.</p><p><strong>Results: </strong>Among 117 Canadian participants who received RBL, most were female and White, with a mean age of 61.3 years; 24.8% reported a first recurrence. The enrolling <i>C. diff</i> infection was diagnosed via polymerase chain reaction for 70.9% of participants. TEAEs, reported in 59.8% of participants, were mostly mild-to-moderate gastrointestinal events. Serious TEAEs occurred in 5.1% of participants within 8 weeks and 6.8% between 8 weeks and 6 months. Treatment success was achieved by 75.2% of participants at 8 weeks, among whom 90.9% maintained a sustained clinical response at 6 months.</p><p><strong>Conclusions: </strong>Safety and effectiveness outcomes in Canadian participants were consistent with those observed in the PUNCH CD3 randomized controlled trial population, supporting the use of RBL for prevention of recurrent <i>C. diff</i> infection in Canada.</p><p><strong>Clinicaltrialsgov identifier: </strong>NCT03931941.</p>","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"9 5","pages":"336-342"},"PeriodicalIF":3.8,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111608","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":"Optimizing tissue acquisition to improve the diagnostic yield of endoscopic ultrasound-guided fine needle biopsy of solid masses: a quality improvement initiative.","authors":"Samina Khan, Narges Ashrafinia, Pamela Mathura, Lakshmi Puttagunta, Safwat Girgis, Aducio Thiesen, Julie Zhang, Jan-Erick Nilsson, Shawn Wasilenko, Sergio Zepeda-Gomez, Gurpal Sandha","doi":"10.1093/jcag/gwag022","DOIUrl":"10.1093/jcag/gwag022","url":null,"abstract":"<p><strong>Background: </strong>A chart audit (pre-intervention, PRE) of endoscopic ultrasound (EUS)-fine needle biopsy (FNB) of solid masses identified a diagnostic yield of 75%. To improve diagnostic yield, a quality improvement intervention targeting tissue procurement and processing was developed and trialed (post-intervention, POST).</p><p><strong>Intervention: </strong>Increase needle passes to ≥3/mass, limit the personnel preparing cytology slides, and replace saline with formalin for cell block preparation.</p><p><strong>Methods: </strong>A POST chart audit was undertaken for solid mass EUS-FNB from January 2024-December 2024, with quarterly reviews. Only a definite diagnosis was used to calculate diagnostic yield.</p><p><strong>Resultsabout: </strong>241 patients underwent 262 EUS-FNBs. Diagnostic yield was 81% in POST vs. 75% in PRE (<i>p</i> = ns). Single passes decreased to 14% in POST vs. 20% in PRE (<i>p</i> = ns), with similar diagnostic yield (57% vs. 56%, respectively). Number of ≥3 passes increased significantly (47% POST vs. 12% PRE, <i>P </i>< .0001). In POST, 86% of single passes were performed in the first half vs. 14% in the second (<i>P </i>= .012). Only 25% of ≥3 passes were performed in the first half vs. 75% in the second (<i>P </i>= .06). Diagnostic yield improved significantly between the first and second halves (72% vs. 90%, <i>P </i>< .0001). Replacing saline with formalin for cell block improved diagnostic yield (57% vs. 75%, <i>P </i>= .062). Limiting the personnel making slides from 25 nurses (PRE) to 3 endoscopists (POST) had no impact on diagnostic yield.</p><p><strong>Conclusions: </strong>Critical practice assessment, regular audit, and continued reinforcement led to a significant improvement in EUS-FNB diagnostic yield to 90% by increasing the number of needle passes to ≥3/mass.</p>","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"9 4","pages":"210-217"},"PeriodicalIF":3.8,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13436820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673898","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}