We conducted a retrospective study to identify incidence rates and potential risk factors of major adverse cardiac events (MACE) in Japanese patients with ulcerative colitis (UC), as existing data are scarce, inconsistent, and provide limited representation of the real-world situation of MACE in Japan.
Methods
We utilized administrative claims data, collected between January 2013 and December 2022, from Medical Data Vision, Japan. Patients (aged ≥ 20 years) diagnosed with UC within ± 1 month of the prescription date during the study period were included in the incident cohort. Exclusions comprised patients diagnosed with UC in the first 365 days or with myocardial infarction, heart failure, stroke, or other ischemic heart diseases within 30 days pre-index. The cumulative incidence rate of MACE was calculated using the Kaplan–Meier method. Multivariate Cox regression models were used to calculate hazard ratios (HRs) for all relevant potential risk factors.
Results
Of 11 407 patients in the incident cohort, 91 (0.8%) experienced incident MACE. Over 120 months, the cumulative incidence rate of MACE was 2.86% (95% confidence interval [CI]: 1.89–4.32). Significant HRs (95% CI) were found for age category (≥ 65 years) (4.557 [2.786–7.452]), diabetes (1.709 [1.030–2.835]), and atrial fibrillation (AF) (2.759 [1.188–6.405]) (all p < 0.05). Patients with a history of stroke showed numerically increased risk (1.871 [0.508–6.886]) of MACE.
Conclusions
The cumulative incidence rate of MACE was 2.86% over 120 months. Age, comorbidities of diabetes and AF, and history of stroke were the major risk factors for MACE in Japanese UC patients.
背景和目的：我们进行了一项回顾性研究，以确定日本溃疡性结肠炎（UC）患者的主要不良心脏事件（MACE）的发生率和潜在危险因素，因为现有的数据很少，不一致，并且对日本MACE的真实情况提供了有限的代表。方法：我们使用了2013年1月至2022年12月期间从日本Medical data Vision收集的行政索赔数据。在研究期间处方日期±1个月内诊断为UC的患者（年龄≥20岁）被纳入事件队列。排除包括在365天内诊断为UC或在指数前30天内诊断为心肌梗死、心力衰竭、中风或其他缺血性心脏病的患者。采用Kaplan-Meier法计算MACE的累积发病率。采用多变量Cox回归模型计算所有相关潜在危险因素的风险比（hr）。结果：在事件队列的1407例患者中，91例（0.8%）发生了事件性MACE。在120个月内，MACE的累积发生率为2.86%（95%可信区间[CI]: 1.89-4.32）。年龄组别（≥65岁）（4.557[2.786-7.452]）、糖尿病（1.709[1.030-2.835]）和房颤（2.759[1.189 -6.405]）的hr （95% CI）均有显著差异（p < 0.05）。结论：MACE在120个月内的累计发生率为2.86%。年龄、糖尿病和房颤合并症以及卒中史是日本UC患者发生MACE的主要危险因素。
{"title":"Identifying Risk Factors of Major Adverse Cardiac Events in Patients With Ulcerative Colitis: A Retrospective Japanese Claims Data Analysis","authors":"Tomohisa Takagi, Linghua Xu, Masato Hoshi, Shoko Arai","doi":"10.1111/jgh.16831","DOIUrl":"10.1111/jgh.16831","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>We conducted a retrospective study to identify incidence rates and potential risk factors of major adverse cardiac events (MACE) in Japanese patients with ulcerative colitis (UC), as existing data are scarce, inconsistent, and provide limited representation of the real-world situation of MACE in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We utilized administrative claims data, collected between January 2013 and December 2022, from Medical Data Vision, Japan. Patients (aged ≥ 20 years) diagnosed with UC within ± 1 month of the prescription date during the study period were included in the incident cohort. Exclusions comprised patients diagnosed with UC in the first 365 days or with myocardial infarction, heart failure, stroke, or other ischemic heart diseases within 30 days pre-index. The cumulative incidence rate of MACE was calculated using the Kaplan–Meier method. Multivariate Cox regression models were used to calculate hazard ratios (HRs) for all relevant potential risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 11 407 patients in the incident cohort, 91 (0.8%) experienced incident MACE. Over 120 months, the cumulative incidence rate of MACE was 2.86% (95% confidence interval [CI]: 1.89–4.32). Significant HRs (95% CI) were found for age category (≥ 65 years) (4.557 [2.786–7.452]), diabetes (1.709 [1.030–2.835]), and atrial fibrillation (AF) (2.759 [1.188–6.405]) (all <i>p</i> < 0.05). Patients with a history of stroke showed numerically increased risk (1.871 [0.508–6.886]) of MACE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The cumulative incidence rate of MACE was 2.86% over 120 months. Age, comorbidities of diabetes and AF, and history of stroke were the major risk factors for MACE in Japanese UC patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 2","pages":"421-432"},"PeriodicalIF":3.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16831","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813002","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}
The APDW Congress last came to Bali in 2014 to great success, and we are pleased to once again welcome you to the beautiful island of Bali.
This year, we received more than 1500 abstracts from 1100 authors for presentation at the APDW2024 Congress. Within this abstract supplement, we have curated some of the best and most exciting research carried out over the past year.
The digitization of medical education over the past few years has significantly improved the ease of access to knowledge, but has also resulted in the compartmentalization and regionalization of medical education across the Asia-Pacific region.
Through APDW 2024, we seek to reaffirm the core ideals of the APDWF with the deepening of understanding and collaboration with colleagues across the myriad yet important specialties spanning gastroenterology, hepatology, digestive endoscopy, and digestive surgery.
The great response in terms of registrations and abstract submissions has reaffirmed our belief that the diversity of solutions made possible by a multidisciplinary approach represents the greatest ideal in optimizing patient management and that the APDW Congress serves as an important vehicle in which to connect with colleagues across diverse backgrounds and experiences to elevate the standards of our patient care.
On behalf of the Local Organizing Committee, thank you for joining us for the finale of this incredible 2-year journey. I trust that the knowledge revealed in this abstract supplement will serve you well in your practice.
{"title":"Foreword from the APDW 2024 Congress president","authors":"","doi":"10.1111/jgh.16818","DOIUrl":"10.1111/jgh.16818","url":null,"abstract":"<p>The APDW Congress last came to Bali in 2014 to great success, and we are pleased to once again welcome you to the beautiful island of Bali.</p><p>This year, we received more than 1500 abstracts from 1100 authors for presentation at the APDW2024 Congress. Within this abstract supplement, we have curated some of the best and most exciting research carried out over the past year.</p><p>The digitization of medical education over the past few years has significantly improved the ease of access to knowledge, but has also resulted in the compartmentalization and regionalization of medical education across the Asia-Pacific region.</p><p>Through APDW 2024, we seek to reaffirm the core ideals of the APDWF with the deepening of understanding and collaboration with colleagues across the myriad yet important specialties spanning gastroenterology, hepatology, digestive endoscopy, and digestive surgery.</p><p>The great response in terms of registrations and abstract submissions has reaffirmed our belief that the diversity of solutions made possible by a multidisciplinary approach represents the greatest ideal in optimizing patient management and that the APDW Congress serves as an important vehicle in which to connect with colleagues across diverse backgrounds and experiences to elevate the standards of our patient care.</p><p>On behalf of the Local Organizing Committee, thank you for joining us for the finale of this incredible 2-year journey. I trust that the knowledge revealed in this abstract supplement will serve you well in your practice.</p><p>Professor Dadang Makmun</p><p>President, APDW2024-Bali</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"39 S2","pages":"23"},"PeriodicalIF":3.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16818","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818345","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}
Chenxia Zhang, Xiao Tao, Jie Pan, Li Huang, Zehua Dong, Jiejun Lin, Huang Su, Yijie Zhu, Hongliu Du, Bing Xiao, Mingkai Chen, Lianlian Wu, Honggang Yu
Background: Several recent studies have found that the efficacy of computer-aided polyp detection (CADe) on the adenoma detection rate (ADR) diminished in real-world settings. The role of unmeasured factors in AI-human interaction, such as monitor approaches, remains unknown. This study aimed to validate the effectiveness of CADe in the real world and assess the impact of monitor approaches.
Methods: A retrospective propensity score-matched cohort study was conducted using routine data from a tertiary endoscopy center in China before and after the implementation of CADe. Four propensity score-matched cohorts were established: Cohort 1: pre-CADe matched with dual-monitor CADe-assisted group; Cohort 2: dual-monitor CADe-assisted with single-monitor CADe-assisted group; Cohort 3: pre-CADe with single-monitor CADe-assisted group; and Cohort 4: pre-CADe with CADe period. ADR was set as the primary outcome.
Results: There were 5390, 6083, and 6131 eligible patients in the pre-CADe group, dual-monitor group, and single-monitor group, respectively. In the matched analysis, results indicated that regardless of the monitor setup, CADe-assisted groups showed a trend of increased ADR compared with the pre-CADe period (CADe period: OR 1.141, 95% CI 1.047-1.243; p = 0.003; dual-monitor: OR 1.178, 95% CI 1.069-1.299, p = 0.001; single-monitor: OR 1.094, 95% CI 0.998-1.200, p = 0.056). Moreover, no significant difference between different monitor approaches was observed, although dual-monitor setup showed an increasing tendency on ADR compared with single-monitor setup (OR 1.069, 95% CI 0.985-1.161, p = 0.109).
Conclusion: CADe shows great potential to improve ADR during colonoscopy in the real world. Meanwhile, changes in monitor setup do not significantly impact the assistance capability of CADe. Further research dedicated to evaluating the unmeasured elements in the AI-clinician hybrid for better implementation of CADe would be beneficial.
背景：最近的几项研究发现，计算机辅助息肉检测（CADe）对腺瘤检出率（ADR）的影响在现实环境中有所下降。未测量因素在人工智能-人类互动中的作用，如监测方法，仍然未知。本研究旨在验证CADe在现实世界中的有效性，并评估监测方法的影响。方法：采用回顾性倾向评分匹配队列研究，使用中国三级内镜中心实施CADe前后的常规数据。建立4个倾向评分匹配的队列：队列1:cade前与双监测cade辅助组匹配；队列2：双监测cade辅助组和单监测cade辅助组；队列3:cade前与单监视器cade辅助组；队列4:CADe前期和CADe期。ADR作为主要观察指标。结果：cade前组、双监测组和单监测组分别有5390例、6083例和6131例符合条件的患者。在匹配分析中，结果显示，无论监测设置如何，与CADe前相比，CADe辅助组出现了不良反应增加的趋势(CADe期：OR 1.141, 95% CI 1.047-1.243；p = 0.003；双监视器：OR 1.178, 95% CI 1.069 ~ 1.299, p = 0.001；单监视器：OR 1.094, 95% CI 0.998-1.200, p = 0.056)。此外，不同监测方式之间无显著差异，尽管双监测设置比单监测设置有增加不良反应的趋势（OR 1.069, 95% CI 0.985-1.161, p = 0.109）。结论：凯德在改善结肠镜不良反应方面具有很大的潜力。同时，监视器设置的变化不会显著影响CADe的辅助能力。进一步的研究致力于评估人工智能-临床混合系统中未测量的元素，以更好地实施CADe将是有益的。
{"title":"The Effect of Computer-Aided Device on Adenoma Detection Rate in Different Implement Scenarios: A Real-World Study.","authors":"Chenxia Zhang, Xiao Tao, Jie Pan, Li Huang, Zehua Dong, Jiejun Lin, Huang Su, Yijie Zhu, Hongliu Du, Bing Xiao, Mingkai Chen, Lianlian Wu, Honggang Yu","doi":"10.1111/jgh.16847","DOIUrl":"https://doi.org/10.1111/jgh.16847","url":null,"abstract":"<p><strong>Background: </strong>Several recent studies have found that the efficacy of computer-aided polyp detection (CADe) on the adenoma detection rate (ADR) diminished in real-world settings. The role of unmeasured factors in AI-human interaction, such as monitor approaches, remains unknown. This study aimed to validate the effectiveness of CADe in the real world and assess the impact of monitor approaches.</p><p><strong>Methods: </strong>A retrospective propensity score-matched cohort study was conducted using routine data from a tertiary endoscopy center in China before and after the implementation of CADe. Four propensity score-matched cohorts were established: Cohort 1: pre-CADe matched with dual-monitor CADe-assisted group; Cohort 2: dual-monitor CADe-assisted with single-monitor CADe-assisted group; Cohort 3: pre-CADe with single-monitor CADe-assisted group; and Cohort 4: pre-CADe with CADe period. ADR was set as the primary outcome.</p><p><strong>Results: </strong>There were 5390, 6083, and 6131 eligible patients in the pre-CADe group, dual-monitor group, and single-monitor group, respectively. In the matched analysis, results indicated that regardless of the monitor setup, CADe-assisted groups showed a trend of increased ADR compared with the pre-CADe period (CADe period: OR 1.141, 95% CI 1.047-1.243; p = 0.003; dual-monitor: OR 1.178, 95% CI 1.069-1.299, p = 0.001; single-monitor: OR 1.094, 95% CI 0.998-1.200, p = 0.056). Moreover, no significant difference between different monitor approaches was observed, although dual-monitor setup showed an increasing tendency on ADR compared with single-monitor setup (OR 1.069, 95% CI 0.985-1.161, p = 0.109).</p><p><strong>Conclusion: </strong>CADe shows great potential to improve ADR during colonoscopy in the real world. Meanwhile, changes in monitor setup do not significantly impact the assistance capability of CADe. Further research dedicated to evaluating the unmeasured elements in the AI-clinician hybrid for better implementation of CADe would be beneficial.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813065","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}
<p><b>PP-01-001</b></p><p><b>Long-term prognosis after ESD for superficial spreading esophageal squamous cell carcinoma of ≥50 mm</b></p><p><b>Satoshi Masuda</b><sup>1</sup>, Yuji Urabe<sup>1</sup>, Takahiro Uda<sup>1</sup>, Tomoyuki Gurita<sup>1</sup>, Yoshiki Hatsushika<sup>1</sup>, Yukiko Sako<sup>1</sup>, Takeo Nakamura<sup>1</sup>, Kazuki Ishibashi<sup>1</sup>, Hirona Konishi<sup>1</sup>, Junichi Mizuno<sup>1</sup>, Yuichi Hiyama<sup>1</sup>, Akira Ishikawa<sup>2</sup>, Toshio Kuwai<sup>1</sup> and Shiro Oka<sup>1</sup></p><p><sup>1</sup><i>Department of Gastroenterology, Hiroshima University Hospital;</i> <sup>2</sup><i>Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University</i></p><p>Poster (Day 1), Poster Area, November 22, 2024, 8:30 AM - 5:00 PM</p><p><b><i>Objective:</i></b> To evaluate the outcomes and prognosis after ESD for superficial spreading esophageal squamous cell carcinoma (SESCC).</p><p><b><i>Subjects and Methods:</i></b> We examined treatment outcomes (en bloc resection rate, tumor depth, lymphovascular invasion, and complications) in 79 patients with SESCC of 50 mm or more diameter and 79 lesions who underwent ESD between 2011 and 2018 at our department (observation period 86.9±33.2 months).</p><p><b><i>Results:</i></b> En bloc resection rate was 99% (78/79). Tumor depth was pT1a-EP/LPM 45 (57%), pT1a-MM 16 (20%), pT1b-SM1 5 (6%), pT1b-SM2 13 (16%), lymphovascular invasion was observed in 12 (15%). No postoperative bleeding, intraoperative perforation in 4 (5%), and refractory stenosis (≥5 times endoscopic balloon dilatation) in 32 (41%) were observed. No local recurrence was observed, and 16 patients received additional treatment (CRT in 12, and operation in 4). Prognosis was 91%/84% for overall survival, 87%/80% for recurrence-free survival, and 77%/67% for disease-free surviva (3/5 years). Lymph node or other organ metastasis was observed in 6 patients (pT1a-MM,Ly0,V0/pT1b-SM1/pT1b-SM2 3/1/2). Death due to the primary disease was observed in 4 patients (pT1a-MM,Ly0,V0/pT1b-SM1/pT1b-SM2 2/1/1).</p><p><b><i>Conclusion:</i></b> Although ESD for SESCC could be safely performed with en bloc resection, metastasis and primary death were observed in pT1a-MM lymphovascular invasion-negative cases that did not receive any additional treatment.</p><p><b>PP-01-002</b></p><p><b>A rare case of mycobacterium avium complex enteritis in advanced HIV</b></p><p><b>Isaac Chan</b><sup>1</sup>, Alyssa Sim<sup>2</sup>, Raymond Liang<sup>2</sup>, Hwei Yee Lee<sup>2</sup> and Stephanie Sutjipto<sup>3</sup></p><p><sup>1</sup><i>National Healthcare Group, Singapore, Singapore;</i> <sup>2</sup><i>Tan Tock Seng Hospital, Singapore, Singapore;</i> <sup>3</sup><i>National Centre for Infectious Diseases, Singapore, Singapore</i></p><p>Poster (Day 1), Poster Area, November 22, 2024, 8:30 AM - 5:00 PM</p><p><b><i>Introduction:</i></b> Mycobacterium Avium Complex (MAC) infection is an AIDS-defining oppor
{"title":"Poster Presentations","authors":"","doi":"10.1111/jgh.16780","DOIUrl":"10.1111/jgh.16780","url":null,"abstract":"<p><b>PP-01-001</b></p><p><b>Long-term prognosis after ESD for superficial spreading esophageal squamous cell carcinoma of ≥50 mm</b></p><p><b>Satoshi Masuda</b><sup>1</sup>, Yuji Urabe<sup>1</sup>, Takahiro Uda<sup>1</sup>, Tomoyuki Gurita<sup>1</sup>, Yoshiki Hatsushika<sup>1</sup>, Yukiko Sako<sup>1</sup>, Takeo Nakamura<sup>1</sup>, Kazuki Ishibashi<sup>1</sup>, Hirona Konishi<sup>1</sup>, Junichi Mizuno<sup>1</sup>, Yuichi Hiyama<sup>1</sup>, Akira Ishikawa<sup>2</sup>, Toshio Kuwai<sup>1</sup> and Shiro Oka<sup>1</sup></p><p><sup>1</sup><i>Department of Gastroenterology, Hiroshima University Hospital;</i> <sup>2</sup><i>Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University</i></p><p>Poster (Day 1), Poster Area, November 22, 2024, 8:30 AM - 5:00 PM</p><p><b><i>Objective:</i></b> To evaluate the outcomes and prognosis after ESD for superficial spreading esophageal squamous cell carcinoma (SESCC).</p><p><b><i>Subjects and Methods:</i></b> We examined treatment outcomes (en bloc resection rate, tumor depth, lymphovascular invasion, and complications) in 79 patients with SESCC of 50 mm or more diameter and 79 lesions who underwent ESD between 2011 and 2018 at our department (observation period 86.9±33.2 months).</p><p><b><i>Results:</i></b> En bloc resection rate was 99% (78/79). Tumor depth was pT1a-EP/LPM 45 (57%), pT1a-MM 16 (20%), pT1b-SM1 5 (6%), pT1b-SM2 13 (16%), lymphovascular invasion was observed in 12 (15%). No postoperative bleeding, intraoperative perforation in 4 (5%), and refractory stenosis (≥5 times endoscopic balloon dilatation) in 32 (41%) were observed. No local recurrence was observed, and 16 patients received additional treatment (CRT in 12, and operation in 4). Prognosis was 91%/84% for overall survival, 87%/80% for recurrence-free survival, and 77%/67% for disease-free surviva (3/5 years). Lymph node or other organ metastasis was observed in 6 patients (pT1a-MM,Ly0,V0/pT1b-SM1/pT1b-SM2 3/1/2). Death due to the primary disease was observed in 4 patients (pT1a-MM,Ly0,V0/pT1b-SM1/pT1b-SM2 2/1/1).</p><p><b><i>Conclusion:</i></b> Although ESD for SESCC could be safely performed with en bloc resection, metastasis and primary death were observed in pT1a-MM lymphovascular invasion-negative cases that did not receive any additional treatment.</p><p><b>PP-01-002</b></p><p><b>A rare case of mycobacterium avium complex enteritis in advanced HIV</b></p><p><b>Isaac Chan</b><sup>1</sup>, Alyssa Sim<sup>2</sup>, Raymond Liang<sup>2</sup>, Hwei Yee Lee<sup>2</sup> and Stephanie Sutjipto<sup>3</sup></p><p><sup>1</sup><i>National Healthcare Group, Singapore, Singapore;</i> <sup>2</sup><i>Tan Tock Seng Hospital, Singapore, Singapore;</i> <sup>3</sup><i>National Centre for Infectious Diseases, Singapore, Singapore</i></p><p>Poster (Day 1), Poster Area, November 22, 2024, 8:30 AM - 5:00 PM</p><p><b><i>Introduction:</i></b> Mycobacterium Avium Complex (MAC) infection is an AIDS-defining oppor","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"39 S2","pages":"182-487"},"PeriodicalIF":3.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16780","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818305","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}
I have the privilege to write the foreword on behalf of the Asian Pacific Digestive Week Federation (APDWF) for the APDW2024 Abstract Supplement published in the Journal of Gastroenterology and Hepatology. The APDW Congress is a reflection of APDWF's commitment to the expansion of cross-disciplinary education in Gastroenterology and Hepatology. Ground-breaking developments in Digestive Endoscopy and Digestive Surgical techniques from around the world in the last few decades have given us a wealth of options on top of traditional practices.
APDW Congress serves as a stage to unify the various disciplines in the pursuit of the optimization of patient care. It also provides a great platform for exchange of knowledge and networking. More than 3200 participants gathered in Bali, and among them, at least 40% will be sharing their work and research papers during the congress to an audience from 60 countries.
We trust some of the research work and latest development presented will inspire positive changes in your practices in the years ahead.
{"title":"Foreword from the APDW federation president","authors":"","doi":"10.1111/jgh.16819","DOIUrl":"10.1111/jgh.16819","url":null,"abstract":"<p>I have the privilege to write the foreword on behalf of the Asian Pacific Digestive Week Federation (APDWF) for the APDW2024 Abstract Supplement published in the Journal of Gastroenterology and Hepatology. The APDW Congress is a reflection of APDWF's commitment to the expansion of cross-disciplinary education in Gastroenterology and Hepatology. Ground-breaking developments in Digestive Endoscopy and Digestive Surgical techniques from around the world in the last few decades have given us a wealth of options on top of traditional practices.</p><p>APDW Congress serves as a stage to unify the various disciplines in the pursuit of the optimization of patient care. It also provides a great platform for exchange of knowledge and networking. More than 3200 participants gathered in Bali, and among them, at least 40% will be sharing their work and research papers during the congress to an audience from 60 countries.</p><p>We trust some of the research work and latest development presented will inspire positive changes in your practices in the years ahead.</p><p>Justin Che-Yuen Wu</p><p>President</p><p>Asian Pacific Digestive Week Federation</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"39 S2","pages":"24"},"PeriodicalIF":3.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16819","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818353","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}
<p><b>YIA-01</b></p><p><b>Piezo1-mediated lactate metabolism in intestinal vascular endothelial cell is involved in macrophage activation in IBD</b></p><p>Chang Liang and Yan Zhang</p><p><i>Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, China</i></p><p>APDWF and JGHFoundation Young Investigator's Awards, November 23, 2024, 5:10 PM - 6:30 PM.</p><p><b><i>Objectives:</i></b> In IBD patients, elevated mesenteric blood flow alters mechanical forces in intestinal vascular endothelial cells (VECs). These cells sense changes via the mechanosensitive ion channel Piezo1, converting mechanical stimuli into inflammatory signals and inducing inflammation. VECs also secrete lactate, contributing to inflammation. The role of Piezo1 in regulating intestinal vascular lactate metabolism in IBD remains unclear.</p><p><b><i>Materials and Methods:</i></b> Single-cell sequencing was performed on colon tissues from IBD patients and healthy controls to investigate Piezo1 expression and lactate metabolism. Endothelial cell-specific Piezo1 knockout (Piezo1iΔEC/iΔEC) mice were generated and subjected to DSS-induced colitis. Inflammation severity, lactate levels in endothelial cells and plasma, and macrophage polarization were measured. HIF-1α-MCT signaling was explored.</p><p><b><i>Results:</i></b> Piezo1 expression was significantly higher in the colonic mucosa of active IBD patients and DSS-induced colitis mice compared to controls. Single-cell sequencing showed Piezo1 enrichment in intestinal VECs in active IBD. Piezo1iΔEC/iΔEC mice with DSS-induced colitis showed reduced IL-6, TNF-α, IL-1β levels, decreased M1 macrophage activation, and lower lactate levels compared to controls. Piezo1 knockdown inhibited HIF-1α and MCT expression in VECs.</p><p><b>YIA-02</b></p><p><b>Prevalence and endoscopic characteristics of dyspepsia in Japanese adults: insights from a cancer screening initiative</b></p><p>Suguo Suzuki<sup>1</sup>, Takeshi Kanno<sup>1,2</sup>, Tomoyuki Koike<sup>1</sup>, Takashi Chiba<sup>3</sup>, Kiyotaka Asanuma<sup>3</sup>, Katsuaki Kato<sup>3</sup>, Yutaka Hatayama<sup>1</sup>, Yohei Ogata<sup>1</sup>, Masahiro Saito<sup>1</sup>, Xiaoyi Jin<sup>1</sup>, Waku Hatta<sup>1</sup>, Kamane Uno<sup>1</sup>, Akira Imatani<sup>1</sup> and Atsushi Masamune<sup>1</sup></p><p><sup>1</sup><i>Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan;</i> <sup>2</sup><i>R and D Division of Career Education for Medical Professionals, Medical Education Center, Jichi Medical University, Shimotsuke, Japan;</i> <sup>3</sup><i>Miyagi Cancer Society, Sendai, Japan</i></p><p>APDWF and JGHFoundation Young Investigator's Awards, November 23, 2024, 5:10 PM - 6:30 PM.</p><p><b><i>Objectives:</i></b> Dyspepsia is a significant social issue due to its negative impact on quality of life, with substantial cases showing no findings on upper gastrointestinal endoscopy (EGD). Recent Japanese epidemiologic reports on dyspeps
{"title":"Young Investigator's Award Finals","authors":"","doi":"10.1111/jgh.16777","DOIUrl":"10.1111/jgh.16777","url":null,"abstract":"<p><b>YIA-01</b></p><p><b>Piezo1-mediated lactate metabolism in intestinal vascular endothelial cell is involved in macrophage activation in IBD</b></p><p>Chang Liang and Yan Zhang</p><p><i>Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, China</i></p><p>APDWF and JGHFoundation Young Investigator's Awards, November 23, 2024, 5:10 PM - 6:30 PM.</p><p><b><i>Objectives:</i></b> In IBD patients, elevated mesenteric blood flow alters mechanical forces in intestinal vascular endothelial cells (VECs). These cells sense changes via the mechanosensitive ion channel Piezo1, converting mechanical stimuli into inflammatory signals and inducing inflammation. VECs also secrete lactate, contributing to inflammation. The role of Piezo1 in regulating intestinal vascular lactate metabolism in IBD remains unclear.</p><p><b><i>Materials and Methods:</i></b> Single-cell sequencing was performed on colon tissues from IBD patients and healthy controls to investigate Piezo1 expression and lactate metabolism. Endothelial cell-specific Piezo1 knockout (Piezo1iΔEC/iΔEC) mice were generated and subjected to DSS-induced colitis. Inflammation severity, lactate levels in endothelial cells and plasma, and macrophage polarization were measured. HIF-1α-MCT signaling was explored.</p><p><b><i>Results:</i></b> Piezo1 expression was significantly higher in the colonic mucosa of active IBD patients and DSS-induced colitis mice compared to controls. Single-cell sequencing showed Piezo1 enrichment in intestinal VECs in active IBD. Piezo1iΔEC/iΔEC mice with DSS-induced colitis showed reduced IL-6, TNF-α, IL-1β levels, decreased M1 macrophage activation, and lower lactate levels compared to controls. Piezo1 knockdown inhibited HIF-1α and MCT expression in VECs.</p><p><b>YIA-02</b></p><p><b>Prevalence and endoscopic characteristics of dyspepsia in Japanese adults: insights from a cancer screening initiative</b></p><p>Suguo Suzuki<sup>1</sup>, Takeshi Kanno<sup>1,2</sup>, Tomoyuki Koike<sup>1</sup>, Takashi Chiba<sup>3</sup>, Kiyotaka Asanuma<sup>3</sup>, Katsuaki Kato<sup>3</sup>, Yutaka Hatayama<sup>1</sup>, Yohei Ogata<sup>1</sup>, Masahiro Saito<sup>1</sup>, Xiaoyi Jin<sup>1</sup>, Waku Hatta<sup>1</sup>, Kamane Uno<sup>1</sup>, Akira Imatani<sup>1</sup> and Atsushi Masamune<sup>1</sup></p><p><sup>1</sup><i>Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan;</i> <sup>2</sup><i>R and D Division of Career Education for Medical Professionals, Medical Education Center, Jichi Medical University, Shimotsuke, Japan;</i> <sup>3</sup><i>Miyagi Cancer Society, Sendai, Japan</i></p><p>APDWF and JGHFoundation Young Investigator's Awards, November 23, 2024, 5:10 PM - 6:30 PM.</p><p><b><i>Objectives:</i></b> Dyspepsia is a significant social issue due to its negative impact on quality of life, with substantial cases showing no findings on upper gastrointestinal endoscopy (EGD). Recent Japanese epidemiologic reports on dyspeps","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"39 S2","pages":"25-27"},"PeriodicalIF":3.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16777","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818258","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}
<p><b>OP-01-01</b></p><p><b>Innovations in diagnosing indeterminate biliary strictures: Pilot comparison of the specs tool and peroral cholangioscopy</b></p><p><b>James Emmanuel</b> and Raman A/L Muthukaruppan</p><p><i>Queen Elizabeth Hospital, Kota Kinabalu, Malaysia</i></p><p>Oral Presentation 1, APDW Theatre 1, Exhibition Hall, November 22, 2024, 10:30 AM - 11:50 AM</p><p><b><i>Objective:</i></b> This study evaluates the diagnostic capabilities of a new tool, Stent Pusher- guided Endobiliary Forceps (SPECS) in assessing indeterminate biliary strictures.</p><p><b><i>Procedure (Material):</i></b> SPECS procedure utilises a 10F sized stent pusher, advanced over a guidewire. Once pusher is correctly positioned with confirmation by fluoroscopy, contrast is injected via the pusher to redelineate the stricture followed by biopsies that are performed using a paediatric biopsy forceps.</p><p><b><i>Methods:</i></b> 6 patients with indeterminate biliary strictures underwent evaluation and biopsy using ERCP and POCS followed by a tandem SPECS procedure. Key metrics evaluated included and the technical and clinical success, size of tissue samples, procedure length, and complications.</p><p><b><i>Results:</i></b> Technical success for both procedures were 100%. SPECS demonstrated higher diagnostic accuracy compared to POCS 4/6 (66.7%) vs 2/6 (33.3%). Average size of tissue samples (mm) obtained with SPECS were comparable to those with POCS ( median 5.5 vs 4.0 ; p = 0.285). Procedure length (minutes) was shorter with SPECS (median 9.6 vs 14.6 ; p = 0.005). There were no complications reported for both methods.</p><p><b><i>Discussion:</i></b> While both modalities have strengths, SPECS which allows contrast instillation, shows advantages in diagnostic accuracy, tissue adequacy and procedure duration. Although our study did not measure cost, accessories used in SPECS are generally more cost-effective. Additionally, SPECS addresses technical challenges and complications seen with free-handed cannulation with biopsy forceps.</p><p><b><i>Conclusion:</i></b> Our study highlights SPECS as an effective alternative to POCS for biliary strictures; further research is needed to confirm findings and assess cost-effectiveness in larger populations.</p><p><b>OP-01-02</b></p><p><b>Differences in peroral cholangioscopic findings between primary sclerosing cholangitis and other bile duct diseases</b></p><p><b>Taito Fukuma</b>, Toshio Fujisawa and Hiroyuki Isayama</p><p><i>Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan</i></p><p>Oral Presentation 1, APDW Theatre 1, Exhibition Hall, November 22, 2024, 10:30 AM - 11:50 AM</p><p><b><i>Objective:</i></b> To evaluate the utility of peroral cholangioscopy (POCS) in distinguishing primary sclerosing cholangitis (PSC) from cholangiocarcinoma by comparing POCS findings among PSC, cholangiocarcinoma, and intrahepatic stones.</p><p><b><i>Methods:</i></b> We analyzed POCS findings from pati
james Emmanuel and Raman A/L muthukaruppan伊丽莎白女王医院，马来西亚亚打基那巴鲁。演讲1，APDW 1剧院，展馆，2024年11月22日，10:30 AM - 11:50 AM目的：本研究评估一种新工具，支架推手引导的胆道钳（specs）在评估不确定性胆道狭窄中的诊断能力。程序（材料）：SPECS程序使用一个10F大小的支架推手，在导丝上推进。在透视确认推片器正确定位后，通过推片器注射造影剂以重新划定狭窄，然后使用儿科活检钳进行活检。方法：6例不确定胆道狭窄患者行ERCP和POCS评估和活检，然后进行串联SPECS手术。评估的关键指标包括技术和临床成功、组织样本的大小、手术时间和并发症。结果：两种手术技术成功率均为100%。与POCS 4/6（66.7%）和2/6（33.3%）相比，SPECS显示出更高的诊断准确性。SPECS获得的组织样本的平均尺寸（mm）与POCS相当(中位数5.5 vs 4.0；P = 0.285)。SPECS的手术时间（分钟）较短(中位数9.6 vs 14.6；P = 0.005)。两种方法均无并发症报道。讨论：虽然两种方式都有各自的优势，但允许造影剂灌注的SPECS在诊断准确性、组织充分性和手术持续时间方面显示出优势。虽然我们的研究没有衡量成本，但SPECS中使用的配件通常更具成本效益。此外，SPECS解决了技术上的挑战和并发症，看到与活检钳的自由手插管。结论：我们的研究强调SPECS是胆道狭窄的有效替代POCS；需要进一步的研究来确认研究结果并评估在更大人群中的成本效益。原发性硬化性胆管炎与其他胆管疾病经口胆管镜检查结果的差异estaito Fukuma， Toshio Fujisawa和Hiroyuki isayama日本东京俊天道大学医学院消化内科口头报告1，APDW 1剧院，展览厅，2024年11月22日，10:30 AM - 11:50 AM通过比较经口胆管镜检查（POCS）在原发性硬化性胆管炎（PSC）、胆管癌和肝内结石中的表现，评估POCS在区分原发性硬化性胆管炎（PSC）和胆管癌中的应用价值。方法：我们分析了2018年2月至2023年2月期间PSC、胆管癌和肝内结石患者的POCS结果。结果分为活动性（粘膜红斑、溃疡、白色渗出、表面不规则）、慢性（横断面瘢痕、圆形瘢痕、假性憩室、狭窄）和肿瘤性（血管扭曲、血管扩张、脆性、肿块形成）。还评估了浅簇状凹陷（打孔病变：POL）的存在。结果按0-4分进行评分，并在不同疾病组之间进行比较。结果：本组共纳入PSC 22例，胆管癌25例，肝内结石19例。横纹瘢痕、圆形瘢痕和POL在PSC组明显更频繁(p <；0.001)。胆管癌组表面不规则、血管扩张、血管扭曲、脆性和肿块形成的发生率显著高于胆管癌组(p <；0.001)。假性憩室仅出现在PSC组。三级导线疤痕是PSC独有的。91%的PSC病例出现POL， 88%的胆管癌病例出现血管扩张。讨论：POL对PSC诊断高度敏感，而假憩室对PSC诊断具有高度特异性。导线疤痕对PSC的诊断也有重要意义。区分PSC相关的胆管癌和单独的PSC是具有挑战性的，但不规则的表面和肿瘤表现可以帮助鉴别。扩张血管对胆管癌的诊断具有高度的敏感性和特异性。需要进一步的研究来验证。胆道结核的胆道镜和放射学特征-最初的单中心经验eleah Anne Legaspi和Evan ong菲律宾马尼拉大都会医疗中心口头报告1，APDW 1剧院，展览厅，2024年11月22日，上午10:30 - 11:50目的：肝胆结核（HBTB）是胆管癌最接近的鉴别。治疗和预后不同，因此明确诊断至关重要。我们的目的是描述HBTB的胆道镜和放射学特征。材料与方法：在本中心因肝门狭窄而行直接胆道镜检查的患者中，我们收集了7例TB GeneXpert阳性。 肠结核与克罗恩病患者肠道菌群的比较[J] ajith C Kuriakose1， Dilip Abraham2, A J Joseph3, Ebby George Simon3, Sudipta Dhar Chowdhury3， Reuben Thomas Kurien3和Amit Kumar dutta，印度；2维康信托研究实验室，基督教医学学院，印度Vellore；目的：越来越多的证据表明克罗恩病（CD）中微生物生态失调，但对肠结核（ITB）中微生物生态失调的研究缺乏。我们的目的是研究和比较ITB和CD患者的肠道微生物群特征。材料和方法：在结肠镜检查期间，从ITB （n=25）和CD （n=24）患者中共收集49份粘膜样本（炎症部位），然后使用Illumina MiSeq平台进行16S rRNA基因测序。使用QIIME2（Quantitative Insights into Microbial Ecology）生物信息学管道进行微生物组分析。结果：α多样性分析显示，香农（p=0.05）和Faith系统发育多样性指数（p=0.04）显著降低。包括Bray-Curtis和加权UniFrac在内的Beta多样性指标显示，ITB的样本与cd的样本是分开聚集的。在门水平上评估相对丰度时，ITB的厚壁菌门和拟杆菌门显著减少。在属水平上，ITB显著减少了suterella、subdoligranulum、lachnospiraceae、howardella、faecalibacterium、enhydrobacter、厌氧杆菌。利用属水平信息构建随机森林分类器模型，检验结果表明该模型能够区分ITB和CD患者，AUC = 71.43%。PICRUSt用于推断宏基因组的功能含量。ITB微生物组的功能变化包括细胞结构、碳水化合物、多胺、核苷酸生物合成等2级途径的显著减少。结论:通过这项研究，我们发现了ITB和CD之间肠道微生物特征的关键差异，需要进一步的研究来验证肠道微生物群在ITB和CD之间分化的潜在能力。p -24-06肠道微生物群代谢物吲哚-3-乙酸通过粘蛋白硫酸化维持肠上皮稳态李梦凡丁一云魏景阁董玥王景义曹海龙目的：炎症性肠病（IBD）的全球发病率和患病率正在逐渐上升。已知高脂肪饮食（HFD）会破坏肠道内稳态并加重IBD，但其潜在机制仍未明确。材料和方法：一项膳食调查研究了膳食脂肪摄入量与IBD严重程度之间的相关性。给小鼠补充HFD，分析粪便中色氨酸代谢的变化。结肠炎小鼠模型补充IAA，评估结肠炎严重程度。采用RNA-seq、HID-AB染色和凝集素MALII染色检测肠道硫酸粘蛋白水平。采用Ahr-/-小鼠和Cut&；Tag实验探讨IAA调控粘蛋白硫酸化的机制。结果：在IBD患者和小鼠结肠炎模型中观察到饮食脂肪摄入量与疾病严重程度呈正相关。HFD可显著降低IAA，导致肠屏障损伤。此外，补充IAA可提高肠道粘蛋白硫酸化，有效缓解结肠炎。在机制上，IAA通过AHR上调参与粘蛋白硫酸化的关键分子，包括3 ' -磷酸腺苷5 ' -磷酸硫酸合成酶2 （Papss2）和溶质载体家族35成员B3 （Slc35b3）。口服可产生IAA的罗伊氏乳杆菌有助于预防结肠炎和促进粘蛋白硫酸化，而缺乏产生IAA能力的改良罗伊氏乳
{"title":"Oral Presentations","authors":"","doi":"10.1111/jgh.16779","DOIUrl":"10.1111/jgh.16779","url":null,"abstract":"<p><b>OP-01-01</b></p><p><b>Innovations in diagnosing indeterminate biliary strictures: Pilot comparison of the specs tool and peroral cholangioscopy</b></p><p><b>James Emmanuel</b> and Raman A/L Muthukaruppan</p><p><i>Queen Elizabeth Hospital, Kota Kinabalu, Malaysia</i></p><p>Oral Presentation 1, APDW Theatre 1, Exhibition Hall, November 22, 2024, 10:30 AM - 11:50 AM</p><p><b><i>Objective:</i></b> This study evaluates the diagnostic capabilities of a new tool, Stent Pusher- guided Endobiliary Forceps (SPECS) in assessing indeterminate biliary strictures.</p><p><b><i>Procedure (Material):</i></b> SPECS procedure utilises a 10F sized stent pusher, advanced over a guidewire. Once pusher is correctly positioned with confirmation by fluoroscopy, contrast is injected via the pusher to redelineate the stricture followed by biopsies that are performed using a paediatric biopsy forceps.</p><p><b><i>Methods:</i></b> 6 patients with indeterminate biliary strictures underwent evaluation and biopsy using ERCP and POCS followed by a tandem SPECS procedure. Key metrics evaluated included and the technical and clinical success, size of tissue samples, procedure length, and complications.</p><p><b><i>Results:</i></b> Technical success for both procedures were 100%. SPECS demonstrated higher diagnostic accuracy compared to POCS 4/6 (66.7%) vs 2/6 (33.3%). Average size of tissue samples (mm) obtained with SPECS were comparable to those with POCS ( median 5.5 vs 4.0 ; p = 0.285). Procedure length (minutes) was shorter with SPECS (median 9.6 vs 14.6 ; p = 0.005). There were no complications reported for both methods.</p><p><b><i>Discussion:</i></b> While both modalities have strengths, SPECS which allows contrast instillation, shows advantages in diagnostic accuracy, tissue adequacy and procedure duration. Although our study did not measure cost, accessories used in SPECS are generally more cost-effective. Additionally, SPECS addresses technical challenges and complications seen with free-handed cannulation with biopsy forceps.</p><p><b><i>Conclusion:</i></b> Our study highlights SPECS as an effective alternative to POCS for biliary strictures; further research is needed to confirm findings and assess cost-effectiveness in larger populations.</p><p><b>OP-01-02</b></p><p><b>Differences in peroral cholangioscopic findings between primary sclerosing cholangitis and other bile duct diseases</b></p><p><b>Taito Fukuma</b>, Toshio Fujisawa and Hiroyuki Isayama</p><p><i>Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan</i></p><p>Oral Presentation 1, APDW Theatre 1, Exhibition Hall, November 22, 2024, 10:30 AM - 11:50 AM</p><p><b><i>Objective:</i></b> To evaluate the utility of peroral cholangioscopy (POCS) in distinguishing primary sclerosing cholangitis (PSC) from cholangiocarcinoma by comparing POCS findings among PSC, cholangiocarcinoma, and intrahepatic stones.</p><p><b><i>Methods:</i></b> We analyzed POCS findings from pati","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"39 S2","pages":"37-181"},"PeriodicalIF":3.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16779","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818288","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}
Biliary tuberculosis is a rare type of hepatobiliary tuberculosis. Clinical presentation, imaging, or cholangiogram are difficult to distinguish from other common causes of cholangiopathy or malignancy. Direct visualization of bile duct via cholangioscopy and targeted biopsy was introduced as one of effective investigations for tissue acquisition and diagnosis.
Case Report
We present a case of biliary tuberculosis presented with pruritus, progressive painless jaundice and significant weight loss. Laboratory findings showed an obstructive jaundice. MRI showed multifocal bile duct stricture and intrahepatic duct stone. Single operator cholangioscopy revealed ductal stricture with papillary projection at common hepatic duct and pigmented stone. Targeted biopsy was performed, which showed non-necrotizing granulomatous inflammation and detection of Mycobacterium tuberculosis complex DNA.
Conclusion
Direct visualization via cholangioscopy can aid and increase diagnostic yield of biliary tuberculosis.
{"title":"Gastrointestinal: Direct Visualization of Biliary Tuberculosis","authors":"Aniwat Saleepol, Thitinan Chulroek, Thanrada Vimonsuntirungsri, Thanawat Luangsukrerk","doi":"10.1111/jgh.16836","DOIUrl":"10.1111/jgh.16836","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Biliary tuberculosis is a rare type of hepatobiliary tuberculosis. Clinical presentation, imaging, or cholangiogram are difficult to distinguish from other common causes of cholangiopathy or malignancy. Direct visualization of bile duct via cholangioscopy and targeted biopsy was introduced as one of effective investigations for tissue acquisition and diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Report</h3>\u0000 \u0000 <p>We present a case of biliary tuberculosis presented with pruritus, progressive painless jaundice and significant weight loss. Laboratory findings showed an obstructive jaundice. MRI showed multifocal bile duct stricture and intrahepatic duct stone. Single operator cholangioscopy revealed ductal stricture with papillary projection at common hepatic duct and pigmented stone. Targeted biopsy was performed, which showed non-necrotizing granulomatous inflammation and detection of <i>Mycobacterium tuberculosis</i> complex DNA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Direct visualization via cholangioscopy can aid and increase diagnostic yield of biliary tuberculosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 2","pages":"351-354"},"PeriodicalIF":3.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16836","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813001","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}
Luoyao Yang, Ye Zong, Fandong Meng, Yongdong Wu, Shutian Zhang
Objective
The objective of this study is to compare the efficacy and safety of lubiprostone (Lub) with osmotic laxatives in the treatment of chronic idiopathic constipation (CIC).
Methods
A comprehensive literature search was conducted using PubMed, EMBASE, and the Cochrane Library in May 2024. Studies that met the inclusion criteria were manually searched by two independent reviewers. The efficacy was assessed by the proportion of patients with spontaneous bowel movements (SBMs) within 24 h after the first administration of the medication and SBMs in Weeks 1 and 4. Safety was evaluated based on adverse events including nausea, diarrhea, and abdominal distension. Optimal probability values and the surface under the cumulative ranking area (SUCRA) were also calculated for all interventions. Higher SUCRA values indicate better efficacy and safety of the intervention.
Results
Following a thorough search and screening process, 25 articles were included. Among the selected trials, 8 compared Lub to placebo, 10 compared polyethylene glycol (PEG) to placebo, 4 compared lactulose (Lac) to placebo, and 3 compared PEG to Lac. The meta-analysis results indicated that Lub and osmotic laxatives were significantly more effective than placebo. According to the SUCRA results, the highest rank probabilities were for Lub in increasing the SBMs and reducing abdominal distension.
Conclusion
Lubiprostone is more effective than PEG and Lactulose for treating CIC, with comparable safety profiles. However, this conclusion requires further validation through large-scale, high-quality studies.
{"title":"Comparative Efficacy and Safety of Lubiprostone and Osmotic Laxatives in Chronic Idiopathic Constipation: A Systematic Review and Network Meta-Analysis","authors":"Luoyao Yang, Ye Zong, Fandong Meng, Yongdong Wu, Shutian Zhang","doi":"10.1111/jgh.16844","DOIUrl":"10.1111/jgh.16844","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study is to compare the efficacy and safety of lubiprostone (Lub) with osmotic laxatives in the treatment of chronic idiopathic constipation (CIC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature search was conducted using PubMed, EMBASE, and the Cochrane Library in May 2024. Studies that met the inclusion criteria were manually searched by two independent reviewers. The efficacy was assessed by the proportion of patients with spontaneous bowel movements (SBMs) within 24 h after the first administration of the medication and SBMs in Weeks 1 and 4. Safety was evaluated based on adverse events including nausea, diarrhea, and abdominal distension. Optimal probability values and the surface under the cumulative ranking area (SUCRA) were also calculated for all interventions. Higher SUCRA values indicate better efficacy and safety of the intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Following a thorough search and screening process, 25 articles were included. Among the selected trials, 8 compared Lub to placebo, 10 compared polyethylene glycol (PEG) to placebo, 4 compared lactulose (Lac) to placebo, and 3 compared PEG to Lac. The meta-analysis results indicated that Lub and osmotic laxatives were significantly more effective than placebo. According to the SUCRA results, the highest rank probabilities were for Lub in increasing the SBMs and reducing abdominal distension.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Lubiprostone is more effective than PEG and Lactulose for treating CIC, with comparable safety profiles. However, this conclusion requires further validation through large-scale, high-quality studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 2","pages":"387-397"},"PeriodicalIF":3.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16844","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807263","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}
Hyeong Sik Ahn, Heather Swan, Sayada Zartasha Kazmi, Young Shin Kim, Gahwi Hong, Seeun Choi, Taeuk Kang, Minjung Kim, Jaewoo Cha, Hoo Jae Hann, Hyun Jung Kim
Background
The impact of smoking on ulcerative colitis (UC) among Asian populations is controversial, and interactions between genetic factors and smoking are not well studied. We evaluated the association between smoking and UC and assessed interactions between smoking and family history.
Methods
Using the National Health Insurance database, we identified 5.5 million individuals from 2002 to 2019 with information on familial relationships and smoking history. Cox proportional hazard regression was used to examine the association between UC and current/former smoking and estimate familial risk. Interactions between family history and smoking were assessed on an additive scale using relative excess risk due to interaction (RERI).
Results
Current smoking was associated with a decreased risk of disease (hazard ratio [HR] 0.53 95% CI 0.49–0.56), whereas former smoking was associated with an increased risk (HR 1.62 95% CI 1.53–1.71), compared to nonsmokers. Familial risk was HR 7.51 (95% CI 6.68–8.48). The protective effect of current smoking was more pronounced among those with a family history, as their combined effect was lower than the sum of their individual risks (HR 4.37 vs. 7.55), whereas the harmful effect of former smoking was more prominent among this group, and their combined effect exceeded the sum of their individual effects (HR 10.20 vs. 8.57), indicating statistically significant interactions (RERI current: −3.18 95% CI −4.89 to −1.47; former: 1.63 95% CI −1.00–4.25).
Conclusion
The effects of smoking on UC do not appear to differ between Asian and Western populations. Possible gene-smoking interactions were observed but in opposing directions for current/former smoking.
背景：吸烟对亚洲人群溃疡性结肠炎（UC）的影响是有争议的，遗传因素与吸烟之间的相互作用也没有得到很好的研究。我们评估了吸烟与UC之间的关系，并评估了吸烟与家族史之间的相互作用。方法：利用国家健康保险数据库，从2002年到2019年，我们确定了550万人的家庭关系和吸烟史信息。Cox比例风险回归用于检查UC与当前/以前吸烟之间的关系，并估计家族风险。家族史和吸烟之间的相互作用采用累加性量表，使用相互作用的相对过量风险（rei）进行评估。结果：与不吸烟者相比，当前吸烟与疾病风险降低相关（危险比[HR] 0.53 95% CI 0.49-0.56），而以前吸烟与风险增加相关（危险比[HR] 1.62 95% CI 1.53-1.71）。家族性风险为HR 7.51 （95% CI 6.68-8.48）。目前吸烟的保护作用在有家族史的人群中更为明显，两者的综合影响低于个体风险的总和（HR 4.37 vs. 7.55），而既往吸烟的有害影响在该人群中更为突出，两者的综合影响超过了个体影响的总和（HR 10.20 vs. 8.57），表明具有统计学意义的相互作用(RERI current: -3.18 95% CI: -4.89 ~ -1.47；前者：1.63 95% CI -1.00-4.25)。结论：吸烟对UC的影响在亚洲和西方人群中似乎没有差异。可能的基因与吸烟的相互作用被观察到，但在当前/曾经吸烟的人群中方向相反。
{"title":"The Impact of Smoking on Ulcerative Colitis and Interaction With Family History: A Population-Based Cohort Study","authors":"Hyeong Sik Ahn, Heather Swan, Sayada Zartasha Kazmi, Young Shin Kim, Gahwi Hong, Seeun Choi, Taeuk Kang, Minjung Kim, Jaewoo Cha, Hoo Jae Hann, Hyun Jung Kim","doi":"10.1111/jgh.16834","DOIUrl":"10.1111/jgh.16834","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The impact of smoking on ulcerative colitis (UC) among Asian populations is controversial, and interactions between genetic factors and smoking are not well studied. We evaluated the association between smoking and UC and assessed interactions between smoking and family history.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the National Health Insurance database, we identified 5.5 million individuals from 2002 to 2019 with information on familial relationships and smoking history. Cox proportional hazard regression was used to examine the association between UC and current/former smoking and estimate familial risk. Interactions between family history and smoking were assessed on an additive scale using relative excess risk due to interaction (RERI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Current smoking was associated with a decreased risk of disease (hazard ratio [HR] 0.53 95% CI 0.49–0.56), whereas former smoking was associated with an increased risk (HR 1.62 95% CI 1.53–1.71), compared to nonsmokers. Familial risk was HR 7.51 (95% CI 6.68–8.48). The protective effect of current smoking was more pronounced among those with a family history, as their combined effect was lower than the sum of their individual risks (HR 4.37 vs. 7.55), whereas the harmful effect of former smoking was more prominent among this group, and their combined effect exceeded the sum of their individual effects (HR 10.20 vs. 8.57), indicating statistically significant interactions (RERI current: −3.18 95% CI −4.89 to −1.47; former: 1.63 95% CI −1.00–4.25).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The effects of smoking on UC do not appear to differ between Asian and Western populations. Possible gene-smoking interactions were observed but in opposing directions for current/former smoking.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 2","pages":"446-455"},"PeriodicalIF":3.7,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801020","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号