JGH Open最新文献

{"title":"Validation of the Updated Alternate Fistula Risk Score for Prediction of Postoperative Pancreatic Fistula After Pancreatoduodenectomy","authors":"Yugal Limbu,&nbsp;Bidur Prasad Acharya,&nbsp;Sneha Raut,&nbsp;Sujan Regmee,&nbsp;Roshan Ghimire,&nbsp;Dhiresh Kumar Maharjan,&nbsp;Prabin Bikram Thapa","doi":"10.1002/jgh3.70053","DOIUrl":"https://doi.org/10.1002/jgh3.70053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Postoperative pancreatic fistula (POPF) remains a significant challenge following pancreatoduodenectomy (PD), contributing to morbidity and mortality. Various risk assessment models have been established to predict the likelihood of POPF. An updated alternate fistula risk score (ua-FRS) has been recently refined and validated within European cohorts. However, the validation of this score in South Asian cohorts remains relatively unexplored. This study aims to validate the applicability of ua-FRS for the prediction of POPF in patients undergoing PD in the South Asian population, particularly Nepal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional, observational study was conducted by a single team across three tertiary care centers in Kathmandu, Nepal from July 2021 to October 2023. A total of 98 patients were studied in terms of their sex, body mass index (BMI), diameter of the main pancreatic duct (MPD), pancreatic consistency, pathological site, and estimated blood loss. The accuracy of ua-FRS for the prediction of postoperative pancreatic fistula after pancreatoduodenectomy was evaluated using the receiver operative characteristics curve.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Univariate analysis revealed that sex, pancreatic gland texture, the diameter of the main pancreatic duct, the site of pathology, and BMI were statistically significant factors. However, in the multivariate analysis, only BMI and the diameter of the MPD retained their statistical significance, with <i>p</i>-values less than 0.005. The ua-FRS demonstrated high sensitivity and specificity in predicting postoperative pancreatic fistula, as evidenced by an area under the curve (AUC) of 0.802.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The ua-FRS has validation in the context of the South Asian population to predict POPF following PD, offering a reliable tool to guide perioperative management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142737532","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":"Endoscopic Full-Thickness Plication for the Treatment of Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis of Randomized Sham Controlled Trials","authors":"Muhammad Shahzil,&nbsp;Ammad Javaid Chaudhary,&nbsp;Ali Akram Qureshi,&nbsp;Fariha Hasan,&nbsp;Muhammad Saad Faisal,&nbsp;Abdullah Sohail,&nbsp;Muhammad Ali Khaqan,&nbsp;Taher Jamali,&nbsp;Muhammad Zarrar Khan,&nbsp;Eva Alsheik,&nbsp;Tobias Zuchelli","doi":"10.1002/jgh3.70056","DOIUrl":"https://doi.org/10.1002/jgh3.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Gastroesophageal reflux disease (GERD) affects approximately 20% of adults in the United States. Proton pump inhibitors are the first-line treatment but are associated with long-term side effects. Endoscopic full-thickness plication (EFTP) is a minimally invasive alternative that improves the valvular mechanism of the gastroesophageal junction. This meta-analysis compared EFTP to a sham procedure for the treatment of refractory GERD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This meta-analysis followed the Cochrane guidelines and PRISMA standards and was registered with PROSPERO (CRD42023485506). We searched MEDLINE, Embase, SCOPUS, and Cochrane Library through December 2023. Inclusion criteria targeted Randomized controlled trials comparing EFTP with sham procedures for GERD were included. Statistical analyses utilized RevMan with a random-effects model, and the results were considered significant at <i>p</i> &lt; 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 2144 screened studies, three RCTs with 272 patients with GERD were included: 136 patients underwent EFTP and 136 underwent sham procedures. Primary outcomes showed a significant reduction in PPI usage (RR 0.51; 95% CI 0.35–0.73; <i>p</i> &lt; 0.01) and more than 50% improvement in GERD-HRQL scores at 3 months (RR 15.81; 95% CI 1.40–178.71; <i>p</i> = 0.03). No significant difference was found in the DeMeester scores (MD: 12.57; 95% CI −35.12 to 9.98; <i>p</i> = 0.27). Secondary outcomes showed no significant difference in time with esophageal pH &lt; 4, but a significant reduction in total reflux episodes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EFTP significantly reduced PPI usage, improved GERD-HRQL scores, and decreased total reflux episodes compared with sham procedures, highlighting its potential as a minimally invasive treatment. Further research is needed to compare EFTP with other minimally invasive techniques to determine the most effective treatment option.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142737533","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":"Gastroduodenal Polyposis Secondary to Extrahepatic Portal Venous Obstruction","authors":"Christopher Wen Wei Ho,&nbsp;Kenneth Tou En Chang,&nbsp;Fang Kuan Chiou","doi":"10.1002/jgh3.70060","DOIUrl":"https://doi.org/10.1002/jgh3.70060","url":null,"abstract":"&lt;p&gt;This is a 16-year-old male who first presented in infancy for poor weight gain and splenomegaly. Ultrasound and computed tomography imaging of the abdomen revealed extrahepatic portal vein obstruction (EHPVO) and portal hypertension, with chronic portal vein thrombosis, cavernous transformation of the portal vein, splenomegaly, and portal venous shunts.&lt;/p&gt;&lt;p&gt;He developed his first variceal bleed at 3 years old, with endoscopic variceal ligation of esophageal varices and injection sclerotherapy of gastric varices done successfully. Over the years, there was no recurrence of variceal bleed, though his spleen size had gradually increased in size with hypersplenic effect of leukopaenia, thrombocytopaenia, and anemia. There was no evidence of liver cirrhosis. At 16 years of age, he presented with hepatic encephalopathy and a drop in hemoglobin (from 10.4 to 7.0 g/DL) with suspected occult gastrointestinal bleeding. There was no overt haematemesis or melaena. Oesophagogastroduodenoscopy showed non-bleeding Grade II esophageal varices for which endoscopic variceal ligation was performed. Multiple sessile polyps measuring approximately up to 5 mm were seen in the stomach antrum as well as in the second part of duodenum (Figure 1a–d). Overlying mucosa of these polyps appeared congested and although there was increased venous bleeding during biopsy, bleeding resolved without further intervention. Histology showed increased ectatic lamina proprial capillaries in the laminal propria with no dysplasia, findings which were in keeping with microscopic changes attributable to portal hypertension (Figure 1e).&lt;/p&gt;&lt;p&gt;Portal hypertensive polyps (PHP) have been described as a rare endoscopic feature of portal hypertension, along with other more common findings of oesphageal varices, gastropathy, gastric antral vascular ectasia, enteropathy, and colopathy [&lt;span&gt;1&lt;/span&gt;]. It has been postulated that polyps develop because of neovascularization secondary to high portal pressure. PHP have been mainly described in the stomach and duodenal involvement is not common, with paucity of literature in children [&lt;span&gt;2&lt;/span&gt;]. Differential diagnoses of PHP include pancreatic or gastric heterotopia, adenomatous polyps, and inflammatory polyps. Histological findings of proliferating capillaries in the lamina propria indicates a vascular etiology, distinguishing them from inflammatory polyps [&lt;span&gt;3&lt;/span&gt;]. The absence of dysplasia rules out an adenomatous nature for these polyps. Other histological findings of PHP described are vascular ectasia/congestion/thrombi, gastric foveolar metaplasia, reactive nuclear atypia, fibrosis, and smooth muscle proliferation.&lt;/p&gt;&lt;p&gt;PHP have been associated with increased risk of bleeding due to underlying vascular congestion. In this case, the patient did not present with overt variceal bleeding, and ectopic bleeding from the PHP was postulated to have contributed to the anemia and triggered hepatic encephalopathy. Lowering portal pressur","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724179","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":"Readmission Rate, Predictors, Outcomes, and Burden of Readmission of Hepatorenal Syndrome in the United States: A Nationwide Analysis","authors":"Abdullah Sohail,&nbsp;Ammad J. Chaudhary,&nbsp;Muhammad Mujtaba Bhinder,&nbsp;Khadija Zahid,&nbsp;Kyle Brown","doi":"10.1002/jgh3.70062","DOIUrl":"10.1002/jgh3.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nationwide US data on readmission rates for patients with cirrhosis admitted with hepatorenal syndrome (HRS) is lacking. We reviewed 30-day readmission rates after HRS-related hospitalizations, the associated predictors of readmissions, and their impact on resource utilization and mortality in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We identified all adults admitted with HRS between 2016 and 2019 using the Nationwide Readmission database of the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project. The primary outcome was all-cause 30-day readmission rate. Secondary outcomes were inpatient mortality rate, predictors of readmission, and resource utilization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 245 850 hospitalizations of patients admitted for HRS in the United States from 2016 to 2019. Of these, 214 890 met the inclusion criteria. Mean age was 59.16 years, and 61.31% were males. Medicare was the most common primary payer (44.82%) followed by Medicaid (25.58%). The readmission rate was 24.6% within 30 days of discharge from index hospitalization. The most common cause of readmission was alcoholic cirrhosis with ascites (14.87%), followed by sepsis (9.32%) and unspecified hepatic failure (9%). The in-hospital mortality rate for index hospitalization was 29.52% and 14.35% among those readmitted within 30 days. The mean length of stay (12.33 days vs. 7.15 days, <i>p</i> &lt; 0.01) and hospitalization costs ($44 903 vs. $22 353, <i>p</i> &lt; 0.01) were higher for index hospitalizations than readmissions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study demonstrated that all-cause 30-day readmission and in-hospital mortality rates after the development of HRS were strikingly high. This warrants health policies and interventions at the institutional level, including close post-hospital discharge follow-up, to decrease readmission rates, improve patient outcomes, and reduce cost burden.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733165","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":"Switching to Tenofovir Therapy Versus Continuation of Entecavir for Patients With Hepatitis B Virus Infection: A Systematic Review and Meta-Analysis","authors":"Muhammad Shahzil,&nbsp;Ammad Javaid Chaudhary,&nbsp;Talha Kashif,&nbsp;Ali Akram Qureshi,&nbsp;Anza Muhammad,&nbsp;Faiza Khan,&nbsp;Muhammad Saad Faisal,&nbsp;Muhammad Ali Khaqan,&nbsp;Hassam Ali,&nbsp;Yara Dababneh,&nbsp;Dilip Moonka","doi":"10.1002/jgh3.70055","DOIUrl":"https://doi.org/10.1002/jgh3.70055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hepatitis B virus (HBV) infection causes liver disease, including hepatocellular carcinoma. Controlling viral activity is crucial to reducing complications. Tenofovir may offer benefits over entecavir, but it is unclear if switching from entecavir to tenofovir improves outcomes. This study assesses the clinical impact of switching to tenofovir therapy for chronic HBV infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following the PRISMA guidelines, we conducted a literature search within the Cochrane Library, PubMed, MEDLINE, Embase, and Scopus for studies of patients with HBV infection who were switched to tenofovir from entecavir or were maintained on entecavir. Both formulations of tenofovir, that is, tenofovir disoproxil fumarate and tenofovir alafenamide were included and analyzed in subgroup analysis. Meta-analyses were performed with RevMan 5.4 using a random-effects model, with statistical significance set at <i>p</i> &lt; 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of eight studies, comprising 833 patients, were included in the meta-analysis. Tenofovir showed a significantly higher likelihood of achieving complete virological response (RR 5.60; 95% CI 3.51–8.94; <i>p</i> &lt; 0.00001) and a greater reduction in HBV DNA levels (MD −1.03 log IU/mL; 95% CI −1.69 to −0.36; <i>p</i> = 0.002) compared to entecavir. However, there was no significant difference in HBsAg reduction or HBeAg seroconversion between the two groups. ALT reductions were not statistically significant overall, although entecavir showed better outcomes in subgroup analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Switching from entecavir to tenofovir improves virological response and reduces HBV DNA levels, but shows no significant advantage in HBsAg reduction, HBeAg seroconversion, or overall, ALT reduction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708025","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":"Influence of patient characteristics on Helicobacter pylori eradication with Vonoprazan: A subgroup analysis of the pHalcon-HP trial","authors":"William D Chey,&nbsp;Francis Mégraud,&nbsp;Loren Laine,&nbsp;Neila Smith,&nbsp;Eckhard Leifke,&nbsp;Barbara Hunt,&nbsp;Colin W Howden","doi":"10.1002/jgh3.70044","DOIUrl":"https://doi.org/10.1002/jgh3.70044","url":null,"abstract":"<p>The efficacy of vonoprazan-based dual and triple therapy vs. lansoprazole-based triple therapy in the treatment of <i>H. pylori</i> infection was largely consistent regardless of age, sex, race, ethnicity, BMI, alcohol intake, smoking status, and study drug compliance.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142642123","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":"Outcomes and validity of risk stratification tools for endoscopic submucosal dissection of early gastric cancer in Western Australia","authors":"Ciaran Judge,&nbsp;Abir Halder,&nbsp;Puraskar Pateria,&nbsp;Tzeng Khor,&nbsp;Niroshan Muwanwella,&nbsp;Marcus Chin,&nbsp;Krish Ragunath","doi":"10.1002/jgh3.70034","DOIUrl":"https://doi.org/10.1002/jgh3.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Endoscopic submucosal dissection (ESD) has become the treatment of choice for many superficial gastric neoplasms. Clinical outcomes are increasingly comparable between Japanese and Western series; however, data are lacking on the validity of risk stratification tools in Western cohorts. We aimed to evaluate clinical outcomes, explore risk stratification, and compare our data with published Western series.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective, observational cohort study in a single tertiary referral center over a 13-year period. Primary outcomes were rates of en bloc, complete (R0) and curative resection. Secondary outcomes included adverse events, recurrence, metachronous lesions, eCura grades, and ESGE criteria. A comparative analysis was performed with existing published series from Western centers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Totally 112 patients were included in the study cohort. 50.9% were male, 87.5% Caucasian, and median age was 75.5 years (IQR 14.3 years). Lesions were predominantly antral (36.6%) or body (35.7%); median size 20 mm (IQR 15 mm). Rates of en bloc, R0 resection, and curative resection were 96.4%, 89.3%, and 78.6% (identical between eCura and ESGE), respectively. Adverse events occurred in 5.8%, recurrence in 0%, and metachronous lesions in 9.9%. Our data compared favorably with a review existing Western series, which illustrates increasing adoption of ESD and stable outcomes over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ESD represents a safe and effective method of treatment for gastric neoplasia in the Western setting. This study highlights the potential for excellent outcomes in a single center with a heterogeneous patient cohort and supports the use of eCura in guiding post procedural management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142642122","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":"Association between serum alder-specific immunoglobulin E positivity and seasonal onset of eosinophilic esophagitis","authors":"Akihiro Watanabe,&nbsp;Fumio Tanaka,&nbsp;Akinari Sawada,&nbsp;Yu Nishida,&nbsp;Hirotsugu Maruyama,&nbsp;Masaki Ominami,&nbsp;Koji Otani,&nbsp;Shusei Fukunaga,&nbsp;Shuhei Hosomi,&nbsp;Yasuhiro Fujiwara","doi":"10.1002/jgh3.70052","DOIUrl":"10.1002/jgh3.70052","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Pollen exposure may induce seasonal onset of eosinophilic esophagitis. However, whether serum pollen-specific immunoglobulin E positivity can predict such seasonal eosinophilic esophagitis onset remains unclear. Here, we aimed to evaluate the association between pollen-specific immunoglobulin E positivity and the seasonal onset of eosinophilic esophagitis during the pollen dispersal period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We seasonally classified eosinophilic esophagitis patients and compared their clinical and endoscopic findings. Seasonal trends with respect to the positivity rate of serum pollen-specific immunoglobulin E were examined. Pollens such as alder, cedar, cypress, birch, orchard grass, timothy, ragweed, and mugwort were evaluated. We classified patients into two groups: tested positive or negative for each pollen-specific immunoglobulin E. We then evaluated whether the positivity of each pollen-specific immunoglobulin E was associated with the seasonal onset of eosinophilic esophagitis during the pollen dispersal period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 122 patients diagnosed with eosinophilic esophagitis between 2010 and 2019. Among them, 31 (25.4%), 42 (34.4%), 29 (23.8%), and 20 (16.4%) patients were diagnosed during spring, summer, fall, and winter, respectively. No significant differences were observed in clinical and endoscopic findings across seasons. No significant seasonal trends were observed in the positivity rate of each pollen-specific immunoglobulin E. The positivity rate of alder-specific immunoglobulin E was significantly associated with the seasonal onset of eosinophilic esophagitis (<i>P</i> &lt; 0.01). However, the positivity rates of other pollen-specific immunoglobulin E were not associated with the seasonal onset of eosinophilic esophagitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Serum alder-specific immunoglobulin E positivity was associated with the seasonal onset of eosinophilic esophagitis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629990","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":"Metastatic renal cell carcinoma presenting as gastrointestinal bleeding","authors":"Steffanie Nario,&nbsp;Zaid Househ,&nbsp;Sam I Al-Sohaily","doi":"10.1002/jgh3.70048","DOIUrl":"10.1002/jgh3.70048","url":null,"abstract":"<p>A 73-year-old female with metastatic renal cell carcinoma (RCC) presented with melena and lethargy. She was found to be iron deficient with a hemoglobin of 101 g/L. Her gastroscopy found six irregular pedunculated non-bleeding polyps, 10–20 mm in diameter. Histopathology of the resected polyp returned as metastatic clear cell renal cell carcinoma. Gastric metastases from any primary malignancy are rare and metastatic RCC accounts for only 7% of these tumors. Furthermore, while RCC commonly metastasises to the lung, bone and lymph nodes, metastasis to the gastrointestinal tract is extremely rare, occurring in &lt;1% of patients. Presentation of RCC as a gastric polyp is usually a late event, and on average occurs 6.7 years after initial diagnosis of RCC. Therefore, this case highlights a rare but important late complication of RCC, presenting as gastrointestinal bleeding secondary to gastric metastases.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11540832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606812","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":"Feasibility of transperineal intestinal ultrasound in assessing ulcerative proctitis during pregnancy","authors":"Tessa Greeve,&nbsp;Ralley E. Prentice,&nbsp;Edward Shelton,&nbsp;Frauke Lever,&nbsp;Ray Boyapati,&nbsp;Megan Burns,&nbsp;Sally J. Bell","doi":"10.1002/jgh3.70035","DOIUrl":"10.1002/jgh3.70035","url":null,"abstract":"<p>This study explored the use of transperineal intestinal ultrasound (TPIUS) for assessment of ulcerative colitis (UC) in pregnancy. 8 pregnant women with UC underwent TP-US, clinical assessment and fecal calprotectin. TP-IUS was well tolerated and feasible with adequate rectal views obtained in all trimesters of pregnancy. No correlation between TP-IUS, clinical, or biochemical rectal disease activity assessment was found in this small cohort. Further studies are required to define the optimal technique and references ranges in the pregnant population.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584666","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}