JPGN reports最新文献

Incidence and characteristics of pediatric patients with Crohn's disease undergoing surgery: A cross-sectional study. 儿童克罗恩病手术患者的发病率和特点：一项横断面研究

JPGN reports Pub Date : 2025-06-24 eCollection Date: 2025-08-01 DOI: 10.1002/jpr3.70052

Hugo Gagnon, Marie-Frédérique Paré, Guillermo Costaguta, Marie-Catherine Turcotte, Prévost Jantchou, Laurence Chapuy, Colette Deslandres

{"title":"Incidence and characteristics of pediatric patients with Crohn's disease undergoing surgery: A cross-sectional study.","authors":"Hugo Gagnon, Marie-Frédérique Paré, Guillermo Costaguta, Marie-Catherine Turcotte, Prévost Jantchou, Laurence Chapuy, Colette Deslandres","doi":"10.1002/jpr3.70052","DOIUrl":"10.1002/jpr3.70052","url":null,"abstract":"Objectives: Despite biological treatments reducing the burden of pediatric inflammatory bowel disease, many patients still require surgery. Data on pediatric patient characteristics and surgical incidence are limited, often based on adult studies. This study aimed to assess the characteristics of pediatric Crohn's disease (CD) at diagnosis and compare surgery rates between two periods (before and after 2019) to understand which patients require surgery.Methods: We analyzed pediatric CD patients who underwent surgery at CHU Sainte-Justine, Montreal, between 2014 and 2023. Descriptive statistics and the Mann-Whitney U-test were used to compare means, while Kaplan-Meier curves assessed surgery-free survival, with significance set at p < 0.05.Results: The overall surgery incidence was 5.2/1000 person-years. Surgery rates were lower for patients diagnosed after 2019 than before 2019 (5.6/1000 vs. 14.7/1000 person-years). There were no significant differences in age at diagnosis, CD Paris score, reason for surgery, or disease severity. Among CD patients, surgeries were more frequent before 2019 (11.5% vs. 2.8%, p < 0.001). The reduction in surgery rates since 2019 is likely due to earlier initiation of biologics, with a median initiation of 14 days after 2019 compared to 142 days before 2019 (p = 0.01).Conclusion: The reduced incidence of surgery in pediatric CD is a significant achievement. Increased use of infliximab, proactive drug monitoring, and better nonresponder management likely contribute to this improvement.","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 3","pages":"219-226"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857325","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}

引用次数: 0

The Transition Care Index: Standardizing comprehensive transition and transfer for young adults with inflammatory bowel disease. 过渡护理指数：对炎症性肠病青年患者的综合过渡和转移进行标准化。

JPGN reports Pub Date : 2025-06-17 eCollection Date: 2025-08-01 DOI: 10.1002/jpr3.70045

Hilary K Michel, Jennifer L Dotson, Jennie G David, Amy Donegan, Ashley Kiel, Ross M Maltz, Hannah McKillop, Melanie Oates, Brendan Boyle

{"title":"The Transition Care Index: Standardizing comprehensive transition and transfer for young adults with inflammatory bowel disease.","authors":"Hilary K Michel, Jennifer L Dotson, Jennie G David, Amy Donegan, Ashley Kiel, Ross M Maltz, Hannah McKillop, Melanie Oates, Brendan Boyle","doi":"10.1002/jpr3.70045","DOIUrl":"10.1002/jpr3.70045","url":null,"abstract":"Objectives: In young adults with inflammatory bowel disease (IBD), the time following transfer to adult care is high-risk for adverse outcomes. We used quality improvement (QI) methods to standardize care, decrease variation, and improve preparation of young adults during the transition/transfer process.Methods: We created the IBD Transition Care Index (TCI), a list of 10 variables whose completion was felt to represent a more comprehensive transition/transfer process. Variables were organized into three domains: Disease Control/Physical Health, Psychosocial Well-being, and Transition/Transfer Preparation. We educated patients, caregivers, and providers on the value of completing the TCI to deliver complete, multidisciplinary preparation. We recorded variable completion in a database, reviewed results regularly with providers, and compared rates of variable completion between IBD-focused and general gastroenterology (GI) physicians.Results: Three hundred twenty-two patients transferred to adult care during the project period (211 pre-intervention and 121 post-intervention). In the overall cohort, the mean percentage of TCI variables completed increased from a baseline of 62%-71% in the post-intervention period, with a significant increase in the rate of multidisciplinary IBD annual visit (IBD AV) attendance (51% vs. 62%, p = 0.03). Patients cared for by general GI physicians had significantly increased rates of both overall TCI variable completion (54% vs. 72%, p = 0.02) and IBD AV attendance (34% vs. 57%, p = 0.02) in the pre- versus post-intervention period.Conclusions: Care Indexes such as the TCI can be used to reduce variability and standardize complex clinical processes like transition/transfer for young adults with IBD, with the goal of improving patient outcomes.","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 3","pages":"227-235"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857332","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}

引用次数: 0

The environmental impact of pediatric celiac disease diagnosis and follow-up. 环境对小儿乳糜泻诊断及随访的影响。

JPGN reports Pub Date : 2025-06-17 eCollection Date: 2025-08-01 DOI: 10.1002/jpr3.70048

Mario Brusco, Sara Trivellini, Rita Cozzali, Andrea Brusaferro, Olivia Morelli, Rachele Simonte, Giuseppe Di Cara, Francesco Valitutti

{"title":"The environmental impact of pediatric celiac disease diagnosis and follow-up.","authors":"Mario Brusco, Sara Trivellini, Rita Cozzali, Andrea Brusaferro, Olivia Morelli, Rachele Simonte, Giuseppe Di Cara, Francesco Valitutti","doi":"10.1002/jpr3.70048","DOIUrl":"10.1002/jpr3.70048","url":null,"abstract":"Objectives: To evaluate carbon dioxide (CO2) footprint of celiac disease (CeD) diagnostic guidelines and follow-up practices for children/adolescents.Methods: Two-hundred and thirty-six patients diagnosed and followed up for CeD in Umbria region during 2020-2023 were included in this retrospective study. Patients were divided in two groups: Group 1 included patients diagnosed by duodenal biopsies (total: 43), while Group 2 included no-biopsy patients (total: 193). Transport emissions of CO2 per kilometer traveled by a diesel car was estimated as 171 g/km. CO2 cost was estimated as 22 kg for each anesthesia and as 5.4 kg for each upper GI endoscopy.Results: The median CO2 cost/patient/year in Group 1 was 397.9 kg, while the median CO2 cost/patient/year in Group 2 was 57.2 kg (p < 0.001). As regards the follow-up of these children, we estimated a median CO2 amount of 39.3 kg produced per year by car emission and there was no difference between the two groups (Group 1 40.5 kg vs. Group 2 38.1 kg; p:ns).Conclusions: The no-biopsy approach for the CeD diagnosis strongly decreases the CO2 emissions. Whether implementing telemedicine, handing over to primary care or reducing outpatient consultations for follow-up will be feasible and environmentally more sustainable should be evaluated.","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 3","pages":"236-240"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857331","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}

引用次数: 0

Barriers to treatment adherence in pediatric eosinophilic esophagitis. 儿童嗜酸性粒细胞性食管炎治疗依从性的障碍。

JPGN reports Pub Date : 2025-06-17 eCollection Date: 2025-08-01 DOI: 10.1002/jpr3.70031

Julia Primo, George Tankosich, Kristen Critelli, Elizabeth Sinclair

{"title":"Barriers to treatment adherence in pediatric eosinophilic esophagitis.","authors":"Julia Primo, George Tankosich, Kristen Critelli, Elizabeth Sinclair","doi":"10.1002/jpr3.70031","DOIUrl":"10.1002/jpr3.70031","url":null,"abstract":"Objectives: Treatment adherence in pediatric patients with eosinophilic esophagitis (EoE) is suboptimal. This study aimed to identify barriers to adherence, comparing experiences between patients on elimination diets and those prescribed medication.Methods: This observational study utilized a questionnaire incorporating elements from a previously validated medication adherence tool, in addition to studies assessing dietary and medication adherence in pediatric gastrointestinal disorders.Results: A total of 125 patients were enrolled. Among them, 94 patients were prescribed medication, and 58 patients were prescribed dietary elimination, with 27 subjects receiving both medication and dietary elimination. High rates of nonadherence were observed in both groups. In the pharmacological group, the most common barrier was forgetting to take medication, particularly among those prescribed swallowed topical corticosteroids. In the dietary therapy group, limited food options and challenges when away from home were key barriers. Furthermore, older children, those unsupervised by parents, and those living in single or separate households exhibited lower adherence to dietary therapy.Conclusion: Shared decision-making between healthcare providers, patients, and their families is critical for optimizing treatment adherence in pediatric EoE. Our findings offer new insights into the barriers to dietary and pharmacologic treatment in pediatric EoE, and understanding and addressing these barriers may enhance long-term treatment adherence and improve quality of life for this population.","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 3","pages":"241-247"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857341","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}

引用次数: 0

Left lateral decubitus position during sedation-free transnasal endoscopy: A pilot study. 无镇静经鼻内窥镜检查时左侧卧位：一项初步研究。

JPGN reports Pub Date : 2025-06-11 eCollection Date: 2025-08-01 DOI: 10.1002/jpr3.70047

Rose Lee, Yonna Oparaugo, Molly Mackensen, Katherine Vaidy

{"title":"Left lateral decubitus position during sedation-free transnasal endoscopy: A pilot study.","authors":"Rose Lee, Yonna Oparaugo, Molly Mackensen, Katherine Vaidy","doi":"10.1002/jpr3.70047","DOIUrl":"10.1002/jpr3.70047","url":null,"abstract":"Objectives: Sedation-free transnasal endoscopy (TNE) is a safe, feasible, and well tolerated procedure performed in children to evaluate the upper gastrointestinal tract. The procedural technique of TNE in children is adopted from procedural standards in adults, typically using the upright seated position. The left lateral decubitus (LLD) position may be preferred for optimal safety and visualization during TNE. This pilot study explored the feasibility and tolerance of TNE in pediatric patients using the LLD position.Methods: This was a retrospective review of 13 children who underwent sedation-free TNE in the LLD position from October 2024 to February 2025 in an outpatient gastroenterology procedure suite. Procedure time, patient tolerance (TNEase score), adverse events, and patient demographics were collected and analyzed.Results: A total of 13 TNE procedures were successfully completed in the LLD position. The mean (standard deviation (SD)) age of the cohort was 12 years (2.7); 38% were female. The mean (SD) procedural time for esophagoscopy was 5.1 min (1.6). All patients had TNEase score of 2 or lower. Ten (77%) of patients had a TNEase score of 1. Two patients with history of anxiety and orthostasis experienced syncope in the upright seated position but subsequently completed the TNE in the LLD position without adverse events.Conclusions: LLD position for sedation-free TNE is feasible and well tolerated in children. Findings should prompt further, prospective investigations of the benefits of LLD versus upright seated position, particularly in children with orthostatic intolerance.","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 3","pages":"215-218"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857327","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}

引用次数: 0

Endoscopic remodeling of esophageal stenosis refractory to traditional endoscopic treatment. 传统内镜治疗难治性食管狭窄的内镜重构。

JPGN reports Pub Date : 2025-06-03 eCollection Date: 2025-08-01 DOI: 10.1002/jpr3.70029

María Camila Beltrán-Ramírez, Jose Fernando Vera-Chamorro, Ailim Margarita Carias-Dominguez

引用次数: 0

Elevated tissue transglutaminase immunoglobulin A: Celiac disease or polytypic plasmacytosis? 组织转谷氨酰胺酶免疫球蛋白A升高：乳糜泻还是多型浆细胞病？

JPGN reports Pub Date : 2025-06-02 eCollection Date: 2025-08-01 DOI: 10.1002/jpr3.70037

Andrew Turunen, Aisha Ahmed, Philip Thrush, Paula North, Ankur Chugh

引用次数: 0

Global insights on the diagnosis, management, and prevention of pediatric ingestions: A report from the FISPGHAN expert panel. 关于儿科摄入的诊断、管理和预防的全球见解：来自FISPGHAN专家组的报告。

JPGN reports Pub Date : 2025-05-26 eCollection Date: 2025-08-01 DOI: 10.1002/jpr3.70025

Michael A Manfredi, Reinaldo P Alvarez, Katsuhiro Arai, Huma A Cheema, Andy Darma, Mamoun Elawad, Claudio Iglesias, Matjaz Homan, Omar I Saadah, Catharine M Walsh, Lissy de Ridder

{"title":"Global insights on the diagnosis, management, and prevention of pediatric ingestions: A report from the FISPGHAN expert panel.","authors":"Michael A Manfredi, Reinaldo P Alvarez, Katsuhiro Arai, Huma A Cheema, Andy Darma, Mamoun Elawad, Claudio Iglesias, Matjaz Homan, Omar I Saadah, Catharine M Walsh, Lissy de Ridder","doi":"10.1002/jpr3.70025","DOIUrl":"10.1002/jpr3.70025","url":null,"abstract":"This is a comprehensive review of pediatric foreign body (FB) ingestions, emphasizing the global burden, epidemiology, and management strategies. Predominantly occurring in children under 6, with a peak between 6 months and 3 years, these incidents pose significant health risks with substantial regional variations in ingested objects-ranging from household items to caustic substances. The pathophysiological effects of ingestions are outlined, highlighting specific dangers associated with button batteries, sharp objects, and caustic agents, which can lead to severe tissue damage and long-term complications. A survey of (70) pediatric gastroenterologists from FISPGHAN societies revealed varied regional practices in the frequency of different FB ingestions with food impaction highest in North America and Ocenaia and caustic ingestion more common is Asia. Button batterers were serious concerns across all regions. Management approaches, specifically intubation practice varied across regions. A review of management protocols for different types of ingestions are provided, emphasizing the urgency of endoscopic removal and follow-up care. Prevention strategies are critical, with a focus on public health interventions, legislation, and education to mitigate the risks associated with FB and caustic ingestions. This report underscores the need for enhanced preventive measures and uniform management guidelines to reduce the incidence and improve outcomes of pediatric ingestions worldwide.","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 3","pages":"274-287"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857348","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}

引用次数: 0

Homozygosity for a variant in SLC10A2 and infancy onset severe fat-soluble vitamin deficiency due to bile acid malabsorption. SLC10A2变异的纯合子性与婴儿因胆汁酸吸收不良而发生严重脂溶性维生素缺乏症。

JPGN reports Pub Date : 2025-05-22 eCollection Date: 2025-08-01 DOI: 10.1002/jpr3.70030

Christine Rungoe, Stefan Stender, Nawar Dalila, Emil D Bartels, Christian Jakobsen

{"title":"Homozygosity for a variant in SLC10A2 and infancy onset severe fat-soluble vitamin deficiency due to bile acid malabsorption.","authors":"Christine Rungoe, Stefan Stender, Nawar Dalila, Emil D Bartels, Christian Jakobsen","doi":"10.1002/jpr3.70030","DOIUrl":"10.1002/jpr3.70030","url":null,"abstract":"We present a case of a young female patient with persistent and severe fat-soluble vitamin deficiency since infancy. Despite extensive investigations during childhood, the underlying cause remained elusive. The patient was generally asymptomatic while receiving continuous vitamin subsidy. Exome sequencing performed at age 18 revealed a homozygous missense variant (Pro65Leu) in the gene SLC10A2, which encodes a bile acid transporter in the ileum. A bile retention scan showed severe bile acid malabsorption, with only 1.6% of radioactively labeled bile acids retained 7 days after intake. Treatment with a bile acid sequestrant was attempted but discontinued due to side effects and no significant effect on intestinal vitamin uptake. This case highlights the importance of early genetic testing in patients with unexplained fat-soluble vitamin deficiency. It also emphasizes the need for further research to elucidate the clinical spectrum and management of primary bile acid malabsorption due to SLC10A2 deficiency.","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 3","pages":"296-299"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857324","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}

引用次数: 0

Hematochezia: An abnormal presenting symptom of an extensive vascular malformation in a 6-year-old boy. 便血：6岁男孩广泛血管畸形的异常表现。

JPGN reports Pub Date : 2025-05-20 eCollection Date: 2025-08-01 DOI: 10.1002/jpr3.70032

Kathleen Ordas, Joy Brusenback, Sahana Ummadi, Shannon Tocchio, Razan Alkhouri, Soha Shah

{"title":"Hematochezia: An abnormal presenting symptom of an extensive vascular malformation in a 6-year-old boy.","authors":"Kathleen Ordas, Joy Brusenback, Sahana Ummadi, Shannon Tocchio, Razan Alkhouri, Soha Shah","doi":"10.1002/jpr3.70032","DOIUrl":"10.1002/jpr3.70032","url":null,"abstract":"Gastrointestinal (GI) bleeding can be a common symptom in the pediatric population. Vascular malformations, which cause symptoms based on their location and effect on surrounding structures, are an uncommon cause of GI bleeding. We present the case of a 6-year-old male with a 1-year history of hematochezia, constipation, and microcytic anemia. Physical exam demonstrated a firm, mobile, non-circumferential anal mass measuring 4 cm in diameter, and located predominantly at the right-anterior bowel wall. Initial imaging, including abdominal radiograph and abdominal ultrasound, was unremarkable. Colonoscopy was visually and histologically negative. Magnetic resonance imaging of the pelvis showed an extensive pelvic venous-lymphatic malformation in the left hemipelvis, with extension to the right hemipelvis and left lower extremity, displacement of the rectum and colon, and protrusion into the anal canal. He was started on Sirolimus with symptom improvement. This case discusses a rare presentation of a pediatric vascular malformation presenting with a protruding anal mass.","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 3","pages":"300-304"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857323","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}

引用次数: 0