Therapeutic Advances in Gastroenterology最新文献

{"title":"Middle small-bowel segment Lewis score may predict long-term outcomes among patients with quiescent Crohn's disease.","authors":"Offir Ukashi,&nbsp;Doron Yablecovitch,&nbsp;Adi Lahat,&nbsp;Limor Selinger,&nbsp;Sandra Neuman,&nbsp;Rami Eliakim,&nbsp;Shomron Ben-Horin,&nbsp;Uri Kopylov","doi":"10.1177/17562848231188587","DOIUrl":"https://doi.org/10.1177/17562848231188587","url":null,"abstract":"<p><strong>Background: </strong>Video capsule endoscopy (VCE) has been proven to accurately diagnose small-bowel inflammation and predict flares among patients with quiescent Crohn's disease (CD). However, data regarding its predictive role in this population over an extended follow-up are scarce.</p><p><strong>Objectives: </strong>To predict clinical exacerbation and to assess the yield of Lewis score in identifying CD patients with future clinical exacerbation during an extended follow-up (>24 months).</p><p><strong>Design: </strong>A <i>post hoc</i> analysis study.</p><p><strong>Methods: </strong>Adult patients with quiescent small-bowel CD who were followed with VCE, inflammatory biomarkers and magnetic resonance enterography in a prospective study (between 2013 and 2018). We extracted extended clinical data (up to April 2022). The primary composite outcome (i.e. clinical exacerbation) was defined as intestinal surgery, endoscopic dilation, CD-related admission, corticosteroid administration, or biological/immunomodulator treatment change during follow-up.</p><p><strong>Results: </strong>Of the 61 patients in the study [median age 29 (24-37) years, male 57.4%, biologic treatment 46.7%], 18 patients met the primary outcome during an extended follow-up [median 58.0 (34.5-93.0) months]. On univariable analysis, complicated [hazard ratio (HR) 7.348, <i>p</i> = 0.002] and stricturing disease phenotype (HR 5.305, <i>p</i> = 0.001) were associated with higher risk for clinical exacerbation during follow-up. A baseline VCE middle small-bowel segment Lewis score (midLS) ⩾ 135 identified patients with future exacerbation [AUC (area under the curve) 0.767, 95% confidence interval (CI) 0.633-0.902, <i>p</i> = 0.001, HR 6.317, 93% negative predictive value], whereas the AUC of the conventional Lewis score was 0.734 (95% CI: 0.589-0.879, <i>p</i> = 0.004). Sensitivity analysis restricted to patients with either complicated (<i>n</i> = 34) or stricturing (<i>n</i> = 26) disease phenotype revealed that midLS still predicted clinical exacerbation during follow-up (AUC 0.747/0.753, respectively), in these patients.</p><p><strong>Conclusion: </strong>MidLS predicts treatment failure in quiescent CD patients (median follow-up of 5 years) independently of disease phenotype.</p>","PeriodicalId":23022,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"16 ","pages":"17562848231188587"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dd/89/10.1177_17562848231188587.PMC10392190.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10290011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatiotemporal analysis of small bowel capsule endoscopy videos for outcomes prediction in Crohn's disease.","authors":"Raizy Kellerman,&nbsp;Amit Bleiweiss,&nbsp;Shimrit Samuel,&nbsp;Reuma Margalit-Yehuda,&nbsp;Estelle Aflalo,&nbsp;Oranit Barzilay,&nbsp;Shomron Ben-Horin,&nbsp;Rami Eliakim,&nbsp;Eyal Zimlichman,&nbsp;Shelly Soffer,&nbsp;Eyal Klang,&nbsp;Uri Kopylov","doi":"10.1177/17562848231172556","DOIUrl":"https://doi.org/10.1177/17562848231172556","url":null,"abstract":"<p><strong>Background: </strong>Deep learning techniques can accurately detect and grade inflammatory findings on images from capsule endoscopy (CE) in Crohn's disease (CD). However, the predictive utility of deep learning of CE in CD for disease outcomes has not been examined.</p><p><strong>Objectives: </strong>We aimed to develop a deep learning model that can predict the need for biological therapy based on complete CE videos of newly-diagnosed CD patients.</p><p><strong>Design: </strong>This was a retrospective cohort study. The study cohort included treatment-naïve CD patients that have performed CE (SB3, Medtronic) within 6 months of diagnosis. Complete small bowel videos were extracted using the RAPID Reader software.</p><p><strong>Methods: </strong>CE videos were scored using the Lewis score (LS). Clinical, endoscopic, and laboratory data were extracted from electronic medical records. Machine learning analysis was performed using the TimeSformer computer vision algorithm developed to capture spatiotemporal characteristics for video analysis.</p><p><strong>Results: </strong>The patient cohort included 101 patients. The median duration of follow-up was 902 (354-1626) days. Biological therapy was initiated by 37 (36.6%) out of 101 patients. TimeSformer algorithm achieved training and testing accuracy of 82% and 81%, respectively, with an Area under the ROC Curve (AUC) of 0.86 to predict the need for biological therapy. In comparison, the AUC for LS was 0.70 and for fecal calprotectin 0.74.</p><p><strong>Conclusion: </strong>Spatiotemporal analysis of complete CE videos of newly-diagnosed CD patients achieved accurate prediction of the need for biological therapy. The accuracy was superior to that of the human reader index or fecal calprotectin. Following future validation studies, this approach will allow for fast and accurate personalization of treatment decisions in CD.</p>","PeriodicalId":23022,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"16 ","pages":"17562848231172556"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9b/40/10.1177_17562848231172556.PMC10333642.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10302226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"At admission hemodynamic instability is associated with increased mortality and rebleeding rate in acute gastrointestinal bleeding: a systematic review and meta-analysis.","authors":"Edina Tari,&nbsp;Levente Frim,&nbsp;Tünde Stolcz,&nbsp;Brigitta Teutsch,&nbsp;Dániel Sándor Veres,&nbsp;Péter Hegyi,&nbsp;Bálint Erőss","doi":"10.1177/17562848231190970","DOIUrl":"https://doi.org/10.1177/17562848231190970","url":null,"abstract":"<p><strong>Background: </strong>Acute gastrointestinal bleeding (GIB) is a life-threatening event. Around 20-30% of patients with GIB will develop hemodynamic instability (HI).</p><p><strong>Objectives: </strong>We aimed to quantify HI as a risk factor for the development of relevant end points in acute GIB.</p><p><strong>Design: </strong>A systematic search was conducted in three medical databases in October 2021.</p><p><strong>Data sources and methods: </strong>Studies of GIB patients detailing HI as a risk factor for the investigated outcomes were selected. For the overall results, pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated based on a random-effects model. Subgroups were formed based on the source of bleeding. The Quality of Prognostic Studies tool was used to assess the risk of bias.</p><p><strong>Results: </strong>A total of 62 studies were eligible, and 39 were included in the quantitative synthesis. HI was found to be a risk factor for both in-hospital (OR: 5.48; CI: 3.99-7.52) and 30-day mortality (OR: 3.99; CI: 3.08-5.17) in upper GIB (UGIB). HI was also associated with higher in-hospital (OR: 3.68; CI: 2.24-6.05) and 30-day rebleeding rates (OR: 4.12; 1.83-9.31) among patients with UGIB. The need for surgery was also more frequent in hemodynamically compromised UGIB patients (OR: 3.65; CI: 2.84-4.68). In the case of in-hospital mortality, the risk of bias was high for 1 (4%), medium for 13 (48%), and low for 13 (48%) of the 27 included studies.</p><p><strong>Conclusion: </strong>Hemodynamically compromised patients have increased odds of all relevant untoward end points in GIB. Therefore, to improve the outcomes, adequate emergency care is crucial in HI.</p><p><strong>Registration: </strong>PROSPERO registration number: CRD42021285727.</p>","PeriodicalId":23022,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"16 ","pages":"17562848231190970"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8f/8c/10.1177_17562848231190970.PMC10467304.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10304091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of bowel cleansing on the composition of the gut microbiota in inflammatory bowel disease patients and healthy controls.","authors":"Péter Bacsur,&nbsp;Mariann Rutka,&nbsp;András Asbóth,&nbsp;Tamás Resál,&nbsp;Kata Szántó,&nbsp;Boldizsár Jójárt,&nbsp;Anita Bálint,&nbsp;Eszter Ari,&nbsp;Walliyulahi Ajibola,&nbsp;Bálint Kintses,&nbsp;Tamás Fehér,&nbsp;Daniella Pigniczki,&nbsp;Renáta Bor,&nbsp;Anna Fábián,&nbsp;József Maléth,&nbsp;Zoltán Szepes,&nbsp;Klaudia Farkas,&nbsp;Tamás Molnár","doi":"10.1177/17562848231174298","DOIUrl":"https://doi.org/10.1177/17562848231174298","url":null,"abstract":"<p><strong>Background: </strong>In patients with inflammatory bowel disease (IBD), Crohn's disease (CD), and ulcerative colitis (UC), numerous cases of exacerbations could be observed after colonoscopy, raising the possible pathogenetic effect of colonic microbiota alterations in IBD flare.</p><p><strong>Objectives: </strong>We aimed to investigate the changes in the fecal microbiota composition in IBD patients influenced by the bowel preparation with sodium picosulfate.</p><p><strong>Design: </strong>We enrolled patients with IBD undergoing bowel preparation for colonoscopy in the prospective cohort study. The control group (Con) comprised non-IBD patients who underwent colonoscopy. Clinical data, blood, and stool samples were collected before colonoscopy (timepoint A), 3 days later (timepoint B), and 4 weeks later (timepoint C).</p><p><strong>Methods: </strong>Disease activity and gut microbiota changes were assessed at each timepoint. Fecal microbiota structure - at family level - was determined by sequencing the V4 region of the 16S rRNA gene. Statistical analysis included differential abundance analysis and Mann-Whitney tests.</p><p><strong>Results: </strong>Forty-one patients (9 CD, 13 UC, and 19 Con) were included. After bowel preparation, alpha diversity was lower in the CD group than in the UC (<i>p</i> = 0.01) and Con (<i>p</i> = 0.02) groups at timepoint B. Alpha diversity was significantly higher in the UC group than in the CD and Con (<i>p</i> = 0.03) groups at timepoint C. Beta diversity difference differed between the IBD and Con (<i>p</i> = 0.001) groups. Based on the differential abundance analysis, the Clostridiales family was increased, whereas the <i>Bifidobacteriaceae</i> family was decreased in CD patients compared to the Con at timepoint B.</p><p><strong>Conclusions: </strong>Bowel preparation may change the fecal microbial composition in IBD patients, which may have a potential role in disease exacerbation after bowel cleansing.</p>","PeriodicalId":23022,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"16 ","pages":"17562848231174298"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10265323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10351449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peptic ulcer disease burden, trends, and inequalities in 204 countries and territories, 1990–2019: a population-based study","authors":"Zhongmian Zhang, Weitian Yan, Xiyan Zhang, Jiaqi Wang, Zhonghan Zhang, Zili Lin, Lan Wang, Jiaqin Chen, Daming Liu, Wen Zhang, Zhihong Li","doi":"10.1177/17562848231210375","DOIUrl":"https://doi.org/10.1177/17562848231210375","url":null,"abstract":"Background: Peptic ulcer disease has been a major threat to the world’s population, which remains a significant cause of hospitalization worldwide and healthcare resource utilization. Objectives: We aimed to describe the global burden, trends, and inequalities of peptic ulcer disease. Design: An observational study was conducted. Methods: In this secondary analysis of the Global Burden of Disease, Injuries, and Risk Factors Study 2019, we extracted data for age-standardized incidence rates (ASIRs), disability-adjusted life year rates (ASDRs), and mortality rates (ASMRs); then, we stratified by age, level of regionals, and country; subsequently, we calculated estimated annual percentage changes (EAPC) of ASIR, ASDR, ASMR, and quantified cross-country inequalities in peptic ulcer disease mortality. Results: Globally, ASIR showed a continuous downward trend, from 63.84 in 1990 to 44.26 per 100,000 population in 2019, with an annual decrease of 1.42% [EAPC = −1.42 (95% CI: −1.55 to −1.29)]. ASDR showed a continuing downward trend, and the EAPC was −3.47% (−3.58 to −3.37). ASMR showed a persistent decline, declining by nearly half in 2019 compared to 1990 (3.0 versus 7.39 per 100,000 population), with an annual decrease of 2.55% [EAPC = −3.36 (95% CI: −3.47 to −3.25)]. A significant reduction in sociodemographic index (SDI)-related inequality, from an excess of 190.43 disability-adjusted life years (DALY) per 100,000 (95% CI: −190.83 to −190.02) between the poorest and richest countries in 1990 to 62.85 DALY per 100,000 (95% CI −62.81 to −62.35) in 2019. Conclusion: Global peptic ulcer disease morbidity and mortality rates decreased significantly from 1990 to 2019. These health gains were in accordance with a substantial reduction in the magnitude of SDI-related inequalities across countries, which is paired with overall socioeconomic and health improvements observed in the region.","PeriodicalId":23022,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135704628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of antidepressants on psychological comorbidities, disease activity, and quality of life in inflammatory bowel disease: a systematic review and meta-analysis.","authors":"Liangfang Wang,&nbsp;Chang Liang,&nbsp;Pingrun Chen,&nbsp;Yubin Cao,&nbsp;Yan Zhang","doi":"10.1177/17562848231155022","DOIUrl":"https://doi.org/10.1177/17562848231155022","url":null,"abstract":"<p><strong>Background: </strong>Patients with inflammatory bowel disease (IBD) are often accompanied by a more significant burden of depression or anxiety, and approximately one-third are prescribed antidepressants. However, previous studies on the efficacy of antidepressants in IBD have shown inconsistent results.</p><p><strong>Objectives: </strong>To evaluate the effect of antidepressants on depression, anxiety, disease activity, and quality of life (QoL) in IBD patients.</p><p><strong>Design: </strong>A systematic review and meta-analysis.</p><p><strong>Methods: </strong>We searched MEDLINE <i>via</i> Ovid, EMBASE <i>via</i> Ovid, the Cochrane Library, CINAHL, PsycINFO, Chinese CBM Database, China National Knowledge Infrastructure, VIP, and Wanfang Database from inception to 13th July 2022 without language restrictions.</p><p><strong>Results: </strong>In all, 13 studies containing 884 individuals were included. Compared with the control group, antidepressants were superior in reducing depression scores [standardized mean difference (SMD) = -0.791; 95% confidence interval (CI): -1.009 to -0.572; <i>p</i> < 0.001], anxiety scores (SMD = -0.877; 95% CI: -1.203 to -0.552; <i>p</i> < 0.001), and disease activity scores (SMD = -0.323; 95% CI: -0.500 to -0.145; <i>p</i> < 0.001). Antidepressants had a positive effect in reaching clinical remission [risk ratio (RR) = 1.383; 95% CI: 1.176-1.626; <i>p</i> < 0.001]. Higher physical QoL (SMD = 0.578; 95% CI: 0.025-1.130; <i>p</i> = 0.040), social QoL (SMD = 0.626; 95% CI: 0.073-1.180; <i>p</i> = 0.027), and Inflammatory Bowel Disease Questionnaire (SMD = 1.111; 95% CI: 0.710-1.512; <i>p</i> < 0.001) were found in the experimental group. No significant differences were observed in clinical response (RR = 1.014; 95% CI: 0.847-1.214; <i>p</i> = 0.881), psychological QoL (SMD = 0.399; 95% CI: -0.147 to 0.944; <i>p</i> = 0.152), and environmental QoL (SMD = 0.211; 95% CI: -0.331 to 0.753; <i>p</i> = 0.446).</p><p><strong>Conclusion: </strong>Antidepressants are effective for ameliorating depression, anxiety, disease activity, and QoL in IBD patients. Due to most studies having a small sample size, further well-designed studies are required.</p>","PeriodicalId":23022,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"16 ","pages":"17562848231155022"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3d/f5/10.1177_17562848231155022.PMC9989376.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9093068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of post-ERCP pancreatitis: current strategies and novel perspectives.","authors":"Federica Borrelli de Andreis,&nbsp;Pietro Mascagni,&nbsp;Tommaso Schepis,&nbsp;Fabia Attili,&nbsp;Andrea Tringali,&nbsp;Guido Costamagna,&nbsp;Ivo Boškoski","doi":"10.1177/17562848231155984","DOIUrl":"https://doi.org/10.1177/17562848231155984","url":null,"abstract":"<p><p>Endoscopic retrograde cholangiopancreatography (ERCP) is an advanced endoscopic procedure that might lead to severe adverse events. Post-ERCP pancreatitis (PEP) is the most common post-procedural complication, which is related to significant mortality and increasing healthcare costs. Up to now, the prevalent approach to prevent PEP consisted of employing pharmacological and technical expedients that have been shown to improve post-ERCP outcomes, such as the administration of rectal nonsteroidal anti-inflammatory drugs, aggressive intravenous hydration, and the placement of a pancreatic stent. However, it has been reported that PEP originates from a more complex interaction of procedural and patient-related factors. Appropriate ERCP training has a pivotal role in PEP prevention strategy, and it is not a chance that a low PEP rate is universally considered one of the most relevant indicators of proficiency in ERCP. Scant data on the acquisition of skills during the ERCP training are currently available, although some efforts have been recently done to shorten the learning curve by way of simulation-based training and demonstrate competency by meeting technical requirements as well as adopting skill evaluation scales. Besides, the identification of adequate indications for ERCP and accurate pre-procedural risk stratification of patients might help to reduce PEP occurrence regardless of the endoscopist's technical abilities, and generally preserve safety in ERCP. This review aims at delineating current preventive strategies and highlighting novel perspectives for a safer ERCP focusing on the prevention of PEP.</p>","PeriodicalId":23022,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"16 ","pages":"17562848231155984"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/45/10.1177_17562848231155984.PMC9989421.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9093073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers in inflammatory bowel disease care in Central and Eastern Europe: a region-specific analysis.","authors":"Michal Prokopič,&nbsp;Georgiana Gilca-Blanariux,&nbsp;Peter Lietava,&nbsp;Anca Trifan,&nbsp;Anna Pietrzak,&nbsp;Agata Ladic,&nbsp;Marko Brinar,&nbsp;Svetlana Turcan,&nbsp;Tamás Molnár,&nbsp;Peter Bánovčin,&nbsp;Milan Lukáš","doi":"10.1177/17562848231174290","DOIUrl":"https://doi.org/10.1177/17562848231174290","url":null,"abstract":"<p><p>Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, are chronic immune-mediated diseases with a high incidence and prevalence in Europe. Since these are diseases with associated disability, they require complex management and the availability of high-quality healthcare resources. We focused on the analysis of IBD care in selected countries of Central and Eastern Europe (Croatia, the Czech Republic, Hungary, Moldova, Poland, Romania and Slovakia) targeting the availability and reimbursement of diagnostic and therapeutic modalities, the role of IBD centers and also education and research in IBD. As part of the analysis, we created a questionnaire of 73 statements organized in three topics: (1) diagnostics, follow-up and screening, (2) medications and (3) IBD centers. The questionnaire was filled out by co-authoring IBD experts from individual countries, and then the answers and comments on the questionnaire were analyzed. We identified that despite the financial burden, which still partially persists in the region, the availability of some of the cost-saving tools (calprotectin test, therapeutic drug monitoring) differs among countries, mainly due to variable reimbursement from country to country. In most participating countries, there also remains a lack of dedicated dietary and psychological counseling, which is often replaced by recommendations offered by gastroenterologists. However, there is adequate availability of most of the currently recommended diagnostic methods and therapies in each participating country, as well as the implementation of established IBD centers in the region.</p>","PeriodicalId":23022,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"16 ","pages":"17562848231174290"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/f1/10.1177_17562848231174290.PMC10272651.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9663227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adequate amounts of probiotics increase the success rate of <i>Helicobacter pylori</i> eradication therapy in children.","authors":"Toshihiko Kakiuchi","doi":"10.1177/17562848231191669","DOIUrl":"https://doi.org/10.1177/17562848231191669","url":null,"abstract":"Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the Sage and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). TherapeuTic advances in Gastroenterology","PeriodicalId":23022,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"16 ","pages":"17562848231191669"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ea/6b/10.1177_17562848231191669.PMC10467169.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10136726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IBD barriers across the continents: a continent-specific analysis - Australasia.","authors":"Alexander T Elford,&nbsp;Rupert W Leong,&nbsp;Emma P Halmos,&nbsp;Manal Morgan,&nbsp;Kate Kilpatrick,&nbsp;Peter J Lewindon,&nbsp;Richard B Gearry,&nbsp;Britt Christensen","doi":"10.1177/17562848231197509","DOIUrl":"https://doi.org/10.1177/17562848231197509","url":null,"abstract":"<p><p>Australasia, encompassing Australia, New Zealand, and Papua New Guinea, has some of the highest prevalence's of inflammatory bowel disease (IBD) in the world. The way IBD medicine is practiced varies between and within these countries. There are numerous shared issues of IBD care between Australia and New Zealand, whereas Papua New Guinea has its' own unique set of circumstances. This review looks to explore some of the barriers to IBD care across the continent from the perspective of local IBD healthcare professionals. Barriers to IBD care that are explored include access to IBD multidisciplinary teams, provision of nutritional-based therapies, the prevalence and engagement of IBD-associated mental health disorders, access to medicine, access to endoscopy, rural barriers to care, Indigenous IBD care and paediatric issues. We look to highlight areas where improvements to IBD care across Australasia could be made as well as address research needs.</p>","PeriodicalId":23022,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"16 ","pages":"17562848231197509"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10493058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10242991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}