JGH Open最新文献

{"title":"A Quantitative Analysis of Human and Material Resources for Endoscopy Services in Pacific Island Countries","authors":"Mai Ling Perman,&nbsp;Chris Hair,&nbsp;Joji Malani,&nbsp;Finlay Macrae,&nbsp;Dianne Jones,&nbsp;Eileen Natuzzi,&nbsp;Rooney Jagilly","doi":"10.1002/jgh3.70068","DOIUrl":"10.1002/jgh3.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aims to evaluate the current state of endoscopy services in Pacific Island Countries (PICs) by quantifying human and material resources, including the number of trained endoscopists and nurses, the types of procedures performed, and the availability and maintenance of endoscopic equipment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>A mixed methods survey was conducted in 2023, targeting doctors and nurses who participated in the WGO-FNU-ANZGITA endoscopy training program as well as non-participants. Survey invitations were sent through email, WhatsApp, and Facebook Messenger. Data were collected from 16 sites across 12 PICs, achieving an 85% response rate. Survey results indicated a total of 58 endoscopists (2.1/100000 population) and 52 nurses (1.9/100000 population), with a majority having received training through international partnerships. Basic endoscopy services, such as gastroscopy and colonoscopy, were widely available, but advanced procedures were limited to a few sites. Most sites reported using donated equipment, with significant challenges in equipment maintenance and repair. The availability of functional endoscopes averaged four per site. Common issues included outdated equipment, lack of qualified personnel, and insufficient funding for new equipment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite efforts to enhance endoscopy services in PICs through international collaborations, significant gaps remain, particularly in terms of advanced procedural capacity and equipment maintenance. Recommendations include expanding training programs, improving equipment maintenance infrastructure, securing funding for new equipment, and fostering stronger partnerships to support the sustainability of endoscopy services. Addressing these areas can enhance the quality and availability of endoscopy services, ultimately improving healthcare outcomes for populations in PICs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818857","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 Association Between Atopic Dermatitis and Inflammatory Bowel Disease Risk: A Meta-Analysis of Longitudinal Studies","authors":"Pengfei Yu,&nbsp;Li Lin,&nbsp;Kaiyuan Xue,&nbsp;Jingwen Yang,&nbsp;Shanshan Wang,&nbsp;Yuepeng An,&nbsp;Suqing Yang","doi":"10.1002/jgh3.70077","DOIUrl":"10.1002/jgh3.70077","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This review aimed to investigate whether atopic dermatitis (AD) increases the risk of inflammatory bowel disease (IBD) by analyzing data from longitudinal studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cohort and case–control studies evaluating the association between AD and the risk of IBD, Crohn's disease (CD), or ulcerative colitis (UC) were included. Literature searches were conducted in PubMed, CENTRAL, Embase, Scopus, and Web of Science databases up to April 15, 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of eight retrospective cohort studies comprising 61 190 816 participants were included. Meta-analysis revealed that AD significantly increased the risk of IBD (OR: 1.37, 95% CI: 1.31–1.43) without statistical heterogeneity. Further pooled analysis showed that AD was a significant risk factor for CD (OR: 1.51, 95% CI: 1.31–1.76) and UC (OR: 1.33, 95% CI: 1.13–1.56), with high inter-study heterogeneity (<i>I</i>² = 83% and 89%, respectively). Sensitivity analyses confirmed the robustness of the results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AD is associated with an increased risk of IBD, significantly elevating the risk of both CD and UC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830273","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":"Clinical and high-resolution manometry of 801 patients with esophageal dysmotility, including achalasia, in relation to age","authors":"Uday C Ghoshal,&nbsp;Akshay Kulkarni,&nbsp;Vivek V Shirol,&nbsp;Anshuman Elhence,&nbsp;Bushra Fatima,&nbsp;Anand P Agrahari,&nbsp;Asha Misra","doi":"10.1002/jgh3.70040","DOIUrl":"10.1002/jgh3.70040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Spectrum of esophageal motility disorders may differ according to age, but studies on this are scanty, contradictory, and included small number of patients. Accordingly, we retrospectively analyzed data of a large sample of patients to study the spectrum of esophageal motility disorders in relation to age, and to evaluate the clinical profile and high-resolution manometry parameters and achalasia subtypes according to Chicago IV criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Of 909 patients evaluated by high-resolution water perfusion or solid-state manometry during a 3-year period, data on 801 were finally analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Achalasia cardia was the commonest motility disorder of esophagus in this large study and type II was the commonest subtype. There was no difference in clinical and manometry parameters among elderly patients as compared to younger patients with achalasia. Type I achalasia patients less often had chest pain and tended to have nocturnal coughing spells more often, and patients with achalasia experiencing chest pain tended to have higher distal contractile integral (DCI) than those not having pain irrespective of age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The clinical and high-resolution manometry parameters among young and elderly patients with esophageal motility disorders are quite comparable. However, these differed in relation to achalasia subtypes and symptoms. Type I achalasia patients less often had chest pain and those experiencing chest pain tended to have higher DCI values than those not having pain irrespective of age.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819319","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":"Underwater Versus Conventional Endoscopic Mucosal Resection for Colorectal Laterally Spreading Tumors: A Post Hoc Analysis of Efficacy","authors":"Quang Dinh Le,&nbsp;Nhan Quang Le,&nbsp;Duc Trong Quach","doi":"10.1002/jgh3.70075","DOIUrl":"10.1002/jgh3.70075","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Underwater endoscopic mucosal resection (UEMR) has emerged as a promising alternative to conventional endoscopic mucosal resection (CEMR) for the treatment of colorectal laterally spreading tumors (LSTs). This study aimed to compare the efficacy and safety of UEMR and CEMR in managing LSTs measuring 10–30 mm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A post hoc analysis was performed on 88 patients with 88 colorectal LSTs, who were randomly assigned to two treatment groups: 42 with CEMR and 46 with UEMR. The primary outcome was the rate of R0 resection, defined as the absence of neoplastic cells at the resection margin. The secondary outcomes included en bloc resection rates, procedure times, and postprocedural complications. The data were analyzed via chi-square tests, <i>t</i> tests, and the Mann–Whitney U test where appropriate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant difference was found in the R0 resection rate between UEMR and CEMR. However, UEMR achieved a significantly higher en bloc resection rate, particularly for LSTs ranging from 20 to 30 mm (42.9% for CEMR vs. 100% for UEMR; <i>p</i> = 0.009). Additionally, UEMR resulted in a shorter median procedure time (85.0 s for UEMR vs. 207.5 s for CEMR; <i>p</i> &lt; 0.001). There was no significant difference in bleeding complications or the number of clips used between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared with CEMR, UEMR offers a higher en bloc resection rate and a shorter procedure time, particularly for larger lesions, without increasing the risk of complications. UEMR should be considered a preferred option for managing colorectal LSTs, especially those measuring 20–30 mm.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819389","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":"Remodeling of Colonic Self-Expandable Nitinol Stent Using Low Power Argon Plasma Coagulation: A Brief Report","authors":"Stefano Bargiggia,&nbsp;Davide Scalvini,&nbsp;Antonio Cilona,&nbsp;Nur Fardowza,&nbsp;Patrizia Busseni,&nbsp;Andrea Anderloni","doi":"10.1002/jgh3.70076","DOIUrl":"10.1002/jgh3.70076","url":null,"abstract":"&lt;p&gt;Approximately 10%–40% of patients with colorectal cancer, especially those with left side or rectosigmoid cancer, debut with an acute bowel obstruction, and the use of self-expandable metal stents has increasingly become a valid alternative to emergency surgery, primarily in the palliative setting [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;However, there are a few situations in which colonic stenting may be less effective, such as colonic flexures or rectum resulting in a higher risk of migration or patient's intolerance.&lt;/p&gt;&lt;p&gt;In this case report, we present a colonic stenting in metastatic cancer, where the stent caused rectal discomfort that has been effectively managed by the use of argon plasma coagulation (APC) to trim the distal portion of the stent with a lower power than usually applied.&lt;/p&gt;&lt;p&gt;A non-resectable rectosigmoid malignant stenosis in a 75-year-old man was successfully managed by placing an uncovered single-wire self-expandable Nitinol stent.&lt;/p&gt;&lt;p&gt;We intentionally left ~15 mm of stent distal to the stenosis to prevent pressure decubitus on the healthy wall immediately downstream of the distal end of the neoplasm, precisely at the rectosigmoid junction.&lt;/p&gt;&lt;p&gt;A follow-up endoscopy performed a few weeks later, confirmed the successful resolution of the stenosis although with a slight distal stent displacement. The patient reported normal bowel movements but experienced remarkable discomfort in the rectal area. This pain intensified in a few months and became poorly tolerated by the patient.&lt;/p&gt;&lt;p&gt;Thus, a new rectosigmoidoscopy was performed and it evidenced a considerable contact area between the distal portion of the stent and the rectal wall.&lt;/p&gt;&lt;p&gt;We decided to cut a distal portion of the stent using APC technique.&lt;/p&gt;&lt;p&gt;We employed the ERBE VIO 200-D, set at a power of 50 W and a flow rate of 2 L/min, to perform the cutting was performed first sagittally, then longitudinally near the boundary with the neoplasm (Figure 1). Some fragments were removed with forceps as foreign bodies, while others remained in the rectum, and their softness facilitated their spontaneous expulsion.&lt;/p&gt;&lt;p&gt;The procedure was well-tolerated by the patient without any complications (Figure 2).&lt;/p&gt;&lt;p&gt;Subsequently, the patient's previously reported rectal symptoms disappeared and his bowel transit was always regular without tenesmus or rectal discomfort until his death 12 months after the stent implantation due to tumor cachexia.&lt;/p&gt;&lt;p&gt;The trimming of the distal portion of self-expandable metal stents has been previously described, primarily for biliary types [&lt;span&gt;2&lt;/span&gt;]. Few cases have been reported involving stents rectosigmoid malignant stenosis [&lt;span&gt;3-7&lt;/span&gt;], which were made of cobalt-chromium-nickel-molybdenum alloys or nitinol (nickel-titanium): Nitinol is a member of the shape-memory alloy, which, in turn, are part of the even broader category of Smart Materials. The particular feature of these materials is the ability to change their properties when su","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814522","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":"Prevalence and Risk Factors of Helicobacter pylori Infection in Elderly Patients With Upper Gastrointestinal Symptoms in Vietnam","authors":"Loi N. Ho,&nbsp;Duc T. Quach","doi":"10.1002/jgh3.70074","DOIUrl":"10.1002/jgh3.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> infection is a major cause of peptic ulcer disease and gastric cancer. Limited data exist on <i>H. pylori</i> prevalence and risk factors of infection among elderly individuals in Vietnam. This study aimed to determine the prevalence and associated risk factors of <i>H. pylori</i> infection in elderly Vietnamese patients with upper gastrointestinal symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted on patients aged ≥ 60 years with upper gastrointestinal symptoms who underwent endoscopy. The exclusion criteria included recent antibiotic or proton pump inhibitor use, prior <i>H. pylori</i> eradication, or upper gastrointestinal surgery. Data on demographics, hygiene, diet, and history were collected through structured questionnaires. <i>H. pylori</i> was diagnosed by a rapid urease test. Logistic regression was used to analyze risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 406 participants (mean age 65.4 ± 4.5 years, male-to-female ratio 1:2), <i>H. pylori</i> prevalence was 55.6%. The risk factors for <i>H. pylori</i> infection included infrequent tooth brushing (OR 18.14, 95% CI 3.94–83.55), overweight/obesity (OR 5.82, 95% CI 3.44–9.88), spicy food consumption (OR 5.18, 95% CI 2.74–9.79), a family history of upper gastrointestinal symptoms (OR 3.15, 95% CI 1.84–5.39), and cat ownership (OR 2.01, 95% CI 1.10–3.68). The vegetarian diet was protective (OR 0.04, 95% CI 0.01–0.18).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p><i>H. pylori</i> prevalence in elderly Vietnamese is high, with risk factors including poor hygiene, obesity, spicy food, family history, and cat ownership. A vegetarian diet may be protective.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814517","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":"Relationship of difficult endoscopic retrograde cholangiopancreatography cannulation and visual characteristics of papilla","authors":"Amjad Khan,&nbsp;Syeda Qumreen Ahmad,&nbsp;Tayyab Saeed Akhtar,&nbsp;Hamama Tul Bushra,&nbsp;Muhammad Imran,&nbsp;Javeria Zahid Khan,&nbsp;Sanjida Shah,&nbsp;Nadia Haddayat,&nbsp;Saima Mushtaq,&nbsp;Yalin Dong,&nbsp;Weiyi Feng,&nbsp;Yu Fang","doi":"10.1002/jgh3.70045","DOIUrl":"10.1002/jgh3.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Endoscopic retrograde cholangiopancreatography (ERCP) is commonly used to diagnose and treat bile duct and pancreatic disorders. Successful cannulation of the papilla is crucial for the effectiveness of ERCP; however, sometimes, it can be challenging to achieve. This study explores the relationship between net difficult ERCP cannulation with bile visibility, papilla orifice visibility, and papilla position and compares it with successful cannulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>These data were collected from the ERCP database at the Center for Liver Disease, Holy Family Hospital, Rawalpindi, between November 2019 and November 2022. IBM SPSS version 26.0 software was used for statistical analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 329 patients, with 186 (56.6%) female and 143 (43.5%) male participants. Most patients were in the 39–48 age group (28.3%), with a mean age of 51 ± 1. Bile visibility was noted in 268 (81.5%) cases, papilla orifice visibility in 296 (90%) participants, atypical papilla in 20 (6.1%), and typical papilla in 309 (93.9%) participants. Bile visibility (<i>P</i> = 0.004) and papilla orifice visibility (<i>P</i> = 0.006) were significantly associated with successful cannulation, while papilla position (<i>P</i> = 0.116) was not. Significant associations were also found between difficult cannulation and bile visibility (<i>P</i> = 0.000), papilla orifice visibility (<i>P</i> = 0.000), and papilla position (<i>P</i> = 0.000).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Understanding this relationship can improve success rates and reduce complications associated with difficult cannulation during ERCP procedures. Further research is needed to establish clear correlations and guidelines for endoscopists to plan appropriate strategies for challenging cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814519","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":"Defining Renal Recovery in Patients With Hepatorenal Syndrome-Acute Kidney Injury: Experience From North American Studies","authors":"Muhammad A. Mujtaba,&nbsp;Hussien Elsiesy,&nbsp;Sara Faiz,&nbsp;Syed A. Hussain,&nbsp;Ann Kathleen N. Gamilla-Crudo,&nbsp;Aftab Karim,&nbsp;Mohammad Irfan Khan,&nbsp;Muhammad Waqar Khattak,&nbsp;Zunaira Zafar,&nbsp;Michael Kueht,&nbsp;Khurram Jamil","doi":"10.1002/jgh3.70058","DOIUrl":"10.1002/jgh3.70058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The degree of improvement in serum creatinine (SCr) has previously been suggested as a sensitive indicator of treatment response in patients with hepatorenal syndrome-acute kidney injury (HRS-AKI), while HRS reversal remains the primary endpoint in clinical trials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of ≥ 30% SCr improvement was analyzed as an exploratory prespecified endpoint in the CONFIRM trial. In this post hoc analysis, intent-to-treat population data from three Phase 3 studies (OT-0401, REVERSE, and CONFIRM) conducted in North America in patients with HRS-AKI were pooled to assess the incidence of &gt; 30% improvement in SCr and its association with clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significantly more patients treated with terlipressin achieved &gt; 30% improvement in SCr compared with those who received a placebo (42.9% vs. 23.4%; <i>p</i> &lt; 0.001). Compared with patients who did not achieve &gt; 30% improvement in SCr, those who achieved this threshold had a lower incidence of renal replacement therapy (RRT) (55.2% vs. 14%, respectively; <i>p</i> &lt; 0.001) and greater overall survival at Day 90 (41.6% vs. 71.1%, respectively; <i>p</i> &lt; 0.001); a greater proportion achieved durability of HRS reversal (1% [95% confidence interval, 95% CI: 0] vs. 68.9% [95% CI: 0.6, 0.8]) and more patients were alive without RRT (22.7% vs. 61.6%, respectively; <i>p</i> &lt; 0.001) or transplant (11.6% vs. 43.0%, respectively; <i>p</i> &lt; 0.0001). Additionally, the overall survival and RRT-free survival in the group that achieved &gt; 30% improvement in SCr without HRS reversal were comparable to the overall group that achieved HRS reversal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A total of &gt; 30% improvement in SCr levels even without HRS reversal may serve as a clinically meaningful endpoint to define renal recovery in patients with HRS-AKI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Survey Assessing Nonalcoholic Fatty Liver Disease Knowledge Among Hepatologists and Non-Hepatologists in China","authors":"Laura Colombo","doi":"10.1002/jgh3.70054","DOIUrl":"10.1002/jgh3.70054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>A global increase in nonalcoholic fatty liver disease (NAFLD) prevalence has been observed in the last decade. This study assesses knowledge, awareness, and clinical practice gaps of hepatologists and non-hepatologists in NAFLD management across hospitals in China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A web-based quantitative survey was conducted, and participants included hepatologists (gastroenterologists and infectious disease specialists) and non-hepatologists (internal medicine specialists, cardiologists, and pharmacists) from various hospitals across China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 1627 healthcare practitioners (HCPs) responded to the survey. This included 658 hepatologists and 969 non-hepatologists. In comparison to 92.6% hepatologists, only 58.0% of non-hepatologists were aware of NAFLD. A higher proportion of hepatologists (82.8%) performed screening for NAFLD compared to non-hepatologists (56.9%). Majority of the hepatologists (70%) and non-hepatologists (67%) were aware of the four primary recommendations for managing NAFLD. Only 11% of hepatologists did not manage NAFLD patients, mainly because they felt they did not have enough time (66.7%). Of the 36% non-hepatologists who did not manage NAFLD, 78.4% stated that NAFLD is not their specialty, and 38.6% were not familiar with the treatment options.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Most hepatologists were aware of and agreed to performing screening for NAFLD compared to non-hepatologists. Both hepatologists and non-hepatologists exhibited similar level of understanding on NAFLD management. However, a small percentage of both hepatologists and non-hepatologists admitted that they did not manage NAFLD patients because they were not familiar with available treatment options. This underscores the importance of further educating HCPs involved in managing NAFLD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808011","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":"Prevalence of Liver Steatosis Among Workers in Ouagadougou and Associated Factors: A Cross-Sectional Study","authors":"Delphine Napon-Zongo,&nbsp;Jeoffray Diendere,&nbsp;Armel M. Sanou,&nbsp;Abou Coulibaly,&nbsp;Abdoulaye Dera,&nbsp;Nina G. M. Ouattara,&nbsp;Augustin N. Zeba,&nbsp;Seni Kouanda","doi":"10.1002/jgh3.70069","DOIUrl":"10.1002/jgh3.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Liver steatosis prevalence is growing, linked to the current worldwide epidemics of obesity and Type 2 diabetes. In sub-Saharan Africa, data on apparent healthy workers must still be included. This study aimed to determine the prevalence of hepatic steatosis and its associated factors in the workplace.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>A cross-sectional study was conducted from July to October 2022 in seven selected public and private works places in Ouagadougou, Burkina Faso. Workers still in activity were enrolled by random sampling. Sociodemographic and anthropometric characteristics and blood pressure measurements were performed using standard procedures. Blood samples for fasting blood glucose, cholesterol (total, HDL, LDL), triglycerides, transaminases (AST, ALT), gamma-glutamyl-transferase, C reactive protein, uric acid, surface antigen of hepatitis B (HBsAg), antibody to hepatitis C virus (anti-HCV), and HIV antibodies have been realized. Liver steatosis was assessed by FIBROSCAN with controlled attenuation parameter (CAP). An adjusted logistic regression analysis was performed. A significance level of 5% was applied. A total of 500 workers were included in this study. Among them, 293 (58.6%) were men. The prevalence of hepatic steatosis was 18% (95% CI: 14.7–21.7). Factors associated with hepatic steatosis were age over 50 (<i>p</i> = 0.038), waist circumference (<i>p</i> = 0.0001), body mass index (<i>p</i> = 0.008), and cytolysis (<i>p</i> = 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Liver steatosis affects almost a fifth of working people. Health policies must step up the fight against obesity and other nutrition-related noncommunicable diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802633","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}