Pub Date : 2023-11-01DOI: 10.1097/pg9.0000000000000387
Jason A. Silverman, Sabina A. Ali, Anna Rybak, Johannes B. van Goudoever, Neal S. Leleiko
Generative artificial intelligence (AI) has attracted enormous attention since the release of ChatGPT (1) in late 2022. Other generative AI chatbots used to generate text (including Bard, Claude, and CoPilot (2–4)) and images (including Dall-E, Midjourney, and Stable Diffusion (5–7)) have likewise seen a remarkable explosion in development and uptake. While ChatGPT has been promoted for its potential to assist users in efficiently and easily creating text to serve a wide range of purposes, this editorial focuses on the journal’s opinion on the use of generative AI technology in creating articles submitted to this journal. ChatGPT utilizes a technology known as a generative pretrained transformer large language model (8). This is a form of machine learning in which very large language-based data sets are used to train computers to comprehend natural language. While natural language processing is not new, ChatGPT is currently unique in its ability to not only understand queries and information to which it has access, but also to generate new, comprehensive, and fluent language-based content. Models, such as ChatGPT, which generates language, and Dall-E, Midjourney, or Stable Diffusion, which all generate images, are collectively referred to as “generative AI”, and can be seen as marking a dramatic shift in both the capabilities and widespread access to AI technology. Since its release on November 30, 2022, ChatGPT achieved the most rapid adoption of a consumer software application in history by amassing over 100 million users by January 2023 (9). Users have leveraged ChatGPT to write software, song lyrics, stories, poems, and letters. With its ability to recall previous prompts within a conversation, users can fine-tune its responses to modify the content or tone of the content it generates. The underlying model used to generate content is continuously improved through feedback from users. While users easily identified flaws in the responses provided by the earlier GPT-3 version, the model has iterated quickly. GPT-4, OpenAI’s latest effort in scaling up deep learning, has been described by its creators to exhibit “human-level performance on various professional and academic benchmarks” (10). It has demonstrated impressive abilities in passing standardized examinations including the Law School Admission Test, Scholastic Aptitude Test, a unified bar exam, and even the United States Medical Licensing Exam (10). ChatGPT, and other large language model-based applications, use large data sets consisting of text available on the web. Sources may include articles, books, web-based advertising, and social media posts. ChatGPT offers several exciting and desirable potential benefits, including its potential to make completing written articles more quickly as well as completing literature review summaries. With its ability to help users write in English fluently, it has been touted as a way to help make academic publishing more equitable and diverse (11). Th
{"title":"Generative AI: Potential and Pitfalls in Academic Publishing","authors":"Jason A. Silverman, Sabina A. Ali, Anna Rybak, Johannes B. van Goudoever, Neal S. Leleiko","doi":"10.1097/pg9.0000000000000387","DOIUrl":"https://doi.org/10.1097/pg9.0000000000000387","url":null,"abstract":"Generative artificial intelligence (AI) has attracted enormous attention since the release of ChatGPT (1) in late 2022. Other generative AI chatbots used to generate text (including Bard, Claude, and CoPilot (2–4)) and images (including Dall-E, Midjourney, and Stable Diffusion (5–7)) have likewise seen a remarkable explosion in development and uptake. While ChatGPT has been promoted for its potential to assist users in efficiently and easily creating text to serve a wide range of purposes, this editorial focuses on the journal’s opinion on the use of generative AI technology in creating articles submitted to this journal. ChatGPT utilizes a technology known as a generative pretrained transformer large language model (8). This is a form of machine learning in which very large language-based data sets are used to train computers to comprehend natural language. While natural language processing is not new, ChatGPT is currently unique in its ability to not only understand queries and information to which it has access, but also to generate new, comprehensive, and fluent language-based content. Models, such as ChatGPT, which generates language, and Dall-E, Midjourney, or Stable Diffusion, which all generate images, are collectively referred to as “generative AI”, and can be seen as marking a dramatic shift in both the capabilities and widespread access to AI technology. Since its release on November 30, 2022, ChatGPT achieved the most rapid adoption of a consumer software application in history by amassing over 100 million users by January 2023 (9). Users have leveraged ChatGPT to write software, song lyrics, stories, poems, and letters. With its ability to recall previous prompts within a conversation, users can fine-tune its responses to modify the content or tone of the content it generates. The underlying model used to generate content is continuously improved through feedback from users. While users easily identified flaws in the responses provided by the earlier GPT-3 version, the model has iterated quickly. GPT-4, OpenAI’s latest effort in scaling up deep learning, has been described by its creators to exhibit “human-level performance on various professional and academic benchmarks” (10). It has demonstrated impressive abilities in passing standardized examinations including the Law School Admission Test, Scholastic Aptitude Test, a unified bar exam, and even the United States Medical Licensing Exam (10). ChatGPT, and other large language model-based applications, use large data sets consisting of text available on the web. Sources may include articles, books, web-based advertising, and social media posts. ChatGPT offers several exciting and desirable potential benefits, including its potential to make completing written articles more quickly as well as completing literature review summaries. With its ability to help users write in English fluently, it has been touted as a way to help make academic publishing more equitable and diverse (11). Th","PeriodicalId":17618,"journal":{"name":"JPGN Reports","volume":"236 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135566385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1097/pg9.0000000000000381
Carolena Trocchia, Tian Mauer, Sally Mitchell, Michael Collard, Alfred Asante-Korang, Michael Wilsey
Protein-losing enteropathy (PLE) is a severe complication of the Fontan procedure that leads to systemic complications owing to enteric protein loss. Hepatoduodenal lymphatic leakage resulting from increased lymphatic pressure is one such complication. We present the case of a pediatric heart transplant patient who experienced refractory PLE symptoms requiring serial albumin infusions and exhibited lymphatic leakage into the duodenum. Using diagnostic lymphangiography and endoscopy, we identified the affected area and treated it successfully with endoscopic sclerotherapy using ethanolamine injection. This treatment allowed for the cessation of lymphatic fluid and may serve as a potential intervention for PLE-associated hepatoduodenal lymphatic leakage. The present case highlights the importance of early recognition and timely intervention with radiology and endoscopic therapy to manage PLE and its associated complications.
{"title":"Lymphatic Leakage in Pediatric Heart Transplantation: Early Recognition and Timely Management with Interventional Radiologic and Endoscopic Therapy","authors":"Carolena Trocchia, Tian Mauer, Sally Mitchell, Michael Collard, Alfred Asante-Korang, Michael Wilsey","doi":"10.1097/pg9.0000000000000381","DOIUrl":"https://doi.org/10.1097/pg9.0000000000000381","url":null,"abstract":"Protein-losing enteropathy (PLE) is a severe complication of the Fontan procedure that leads to systemic complications owing to enteric protein loss. Hepatoduodenal lymphatic leakage resulting from increased lymphatic pressure is one such complication. We present the case of a pediatric heart transplant patient who experienced refractory PLE symptoms requiring serial albumin infusions and exhibited lymphatic leakage into the duodenum. Using diagnostic lymphangiography and endoscopy, we identified the affected area and treated it successfully with endoscopic sclerotherapy using ethanolamine injection. This treatment allowed for the cessation of lymphatic fluid and may serve as a potential intervention for PLE-associated hepatoduodenal lymphatic leakage. The present case highlights the importance of early recognition and timely intervention with radiology and endoscopic therapy to manage PLE and its associated complications.","PeriodicalId":17618,"journal":{"name":"JPGN Reports","volume":"120 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135714461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1097/pg9.0000000000000390
Daphna T. Katz, Suzzette Curia, Amanda C. Fifi, Liz Febo-Rodriguez, Alejandro Llanos-Chea
Congenital glucose-galactose malabsorption is a rare cause of life-threatening diet-induced diarrhea in infants. Mutations in the SLC5A1 gene, which encodes for the sodium-dependent glucose transporter, result in large-volume diarrhea due to aberrant glucose and galactose transport across the intestinal brush border. The diagnosis can be made clinically based on the presence of diarrhea soon after birth, evidence of carbohydrate malabsorption in the stool, and resolution of diarrhea with dietary elimination of glucose and galactose. Genetic testing can confirm the diagnosis. Here we report the first confirmed case of glucose-galactose malabsorption in an infant from Central America due to a novel mutation in the SLC5A1 gene. The patient began growing and thriving after being diagnosed and with the correct dietary interventions.
{"title":"Novel Mutation in the SLC5A1 Gene Causing Glucose-Galactose Malabsorption: First Confirmed Case From Central America","authors":"Daphna T. Katz, Suzzette Curia, Amanda C. Fifi, Liz Febo-Rodriguez, Alejandro Llanos-Chea","doi":"10.1097/pg9.0000000000000390","DOIUrl":"https://doi.org/10.1097/pg9.0000000000000390","url":null,"abstract":"Congenital glucose-galactose malabsorption is a rare cause of life-threatening diet-induced diarrhea in infants. Mutations in the SLC5A1 gene, which encodes for the sodium-dependent glucose transporter, result in large-volume diarrhea due to aberrant glucose and galactose transport across the intestinal brush border. The diagnosis can be made clinically based on the presence of diarrhea soon after birth, evidence of carbohydrate malabsorption in the stool, and resolution of diarrhea with dietary elimination of glucose and galactose. Genetic testing can confirm the diagnosis. Here we report the first confirmed case of glucose-galactose malabsorption in an infant from Central America due to a novel mutation in the SLC5A1 gene. The patient began growing and thriving after being diagnosed and with the correct dietary interventions.","PeriodicalId":17618,"journal":{"name":"JPGN Reports","volume":"118 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135714306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1097/pg9.0000000000000379
Denise D. Young, Sharon Perry, Sindhoosha Malay, Thomas J. Sferra, Michael Finkler, Jonathan Moses
Background: 5-aminosalicylates (5-ASA) are used to treat mild to moderate ulcerative colitis. Despite their lack of efficacy in Crohn disease (CD), they are still used in real-world practice. Additionally, when patients have progressive disease, they may escalate to biologic therapy, at which time 5-ASA may or may not be discontinued. Objectives: The aim of this study is to assess the clinical outcomes of patients started on 5-ASA for the treatment of pediatric CD. The secondary aims were to evaluate the outcomes of those who continue 5-ASA to those who discontinue 5-ASA upon biologic escalation. Methods: We performed a single-center retrospective chart review of pediatric CD patients from 2010 to 2019 who were initially treated with 5-ASA. Demographics, medication and laboratory data, and clinical disease activity were collected. Results: Sixty-one patients were included in the study; the majority had inflammatory CD with ileocolonic involvement. Twenty-four patients were on a concomitant immunomodulator. The majority of patients (85.2%) required escalation to biologics. Thirty-two patients (61.5%) who escalated to biologic therapy continued on 5-ASA. Eighty percent of patients achieved clinical remission at 1 year, and there was no difference between those who continued 5-ASA at time of biologic initiation compared to those who did not continue the medication. Patients who discontinued 5-ASA had an average annual cost savings of $6741. Conclusion: 5-ASA is not a durable monotherapy for the treatment of pediatric CD. Patients who require escalation from 5-ASA to biologic therapy do not benefit from concomitant 5-ASA therapy. Further prospective studies are needed to confirm these findings.
{"title":"Natural History of Pediatric Patients With Crohn’s Disease Treated With Mesalamine Therapy","authors":"Denise D. Young, Sharon Perry, Sindhoosha Malay, Thomas J. Sferra, Michael Finkler, Jonathan Moses","doi":"10.1097/pg9.0000000000000379","DOIUrl":"https://doi.org/10.1097/pg9.0000000000000379","url":null,"abstract":"Background: 5-aminosalicylates (5-ASA) are used to treat mild to moderate ulcerative colitis. Despite their lack of efficacy in Crohn disease (CD), they are still used in real-world practice. Additionally, when patients have progressive disease, they may escalate to biologic therapy, at which time 5-ASA may or may not be discontinued. Objectives: The aim of this study is to assess the clinical outcomes of patients started on 5-ASA for the treatment of pediatric CD. The secondary aims were to evaluate the outcomes of those who continue 5-ASA to those who discontinue 5-ASA upon biologic escalation. Methods: We performed a single-center retrospective chart review of pediatric CD patients from 2010 to 2019 who were initially treated with 5-ASA. Demographics, medication and laboratory data, and clinical disease activity were collected. Results: Sixty-one patients were included in the study; the majority had inflammatory CD with ileocolonic involvement. Twenty-four patients were on a concomitant immunomodulator. The majority of patients (85.2%) required escalation to biologics. Thirty-two patients (61.5%) who escalated to biologic therapy continued on 5-ASA. Eighty percent of patients achieved clinical remission at 1 year, and there was no difference between those who continued 5-ASA at time of biologic initiation compared to those who did not continue the medication. Patients who discontinued 5-ASA had an average annual cost savings of $6741. Conclusion: 5-ASA is not a durable monotherapy for the treatment of pediatric CD. Patients who require escalation from 5-ASA to biologic therapy do not benefit from concomitant 5-ASA therapy. Further prospective studies are needed to confirm these findings.","PeriodicalId":17618,"journal":{"name":"JPGN Reports","volume":"33 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135411734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1097/pg9.0000000000000389
Jonathan A. Salazar, Jeffrey D. Goldsmith, Lissette Jimenez, Victor L. Fox, Christopher P. Duggan, Alexandra N. Carey
The natural history of short bowel syndrome involves intestinal adaptation wherein the remnant small intestine undergoes histologic and anatomic changes aimed at increasing absorption. Teduglutide—a glucagon-like peptide 2 analog approved for pediatric use in 2019—stimulates this process by causing proliferation of intestinal epithelial cells resulting in increased villous height and crypt depth. Food and Drug Administration approval for pediatric patients followed safety and efficacy studies in children that were limited to 24-week duration. Pediatric-specific postmarketing studies evaluating long-term safety and efficacy are underway. Formation of colorectal polyps has been repeatedly observed in studies of adult patients on long-term teduglutide, including in individuals without endoscopic evidence of polyps before treatment initiation. Recent studies, however, suggest increased risk of small bowel hyperplastic and dysplastic polyp formation with long-term glucagon-like peptide 2 analog use. We report 2 cases of small bowel foveolar hyperplastic polyps found during surveillance endoscopies after 1 year of treatment with teduglutide.
{"title":"Gastric Foveolar Hyperplastic Polyps in 2 Children With Short Bowel Syndrome on Long-Term Teduglutide","authors":"Jonathan A. Salazar, Jeffrey D. Goldsmith, Lissette Jimenez, Victor L. Fox, Christopher P. Duggan, Alexandra N. Carey","doi":"10.1097/pg9.0000000000000389","DOIUrl":"https://doi.org/10.1097/pg9.0000000000000389","url":null,"abstract":"The natural history of short bowel syndrome involves intestinal adaptation wherein the remnant small intestine undergoes histologic and anatomic changes aimed at increasing absorption. Teduglutide—a glucagon-like peptide 2 analog approved for pediatric use in 2019—stimulates this process by causing proliferation of intestinal epithelial cells resulting in increased villous height and crypt depth. Food and Drug Administration approval for pediatric patients followed safety and efficacy studies in children that were limited to 24-week duration. Pediatric-specific postmarketing studies evaluating long-term safety and efficacy are underway. Formation of colorectal polyps has been repeatedly observed in studies of adult patients on long-term teduglutide, including in individuals without endoscopic evidence of polyps before treatment initiation. Recent studies, however, suggest increased risk of small bowel hyperplastic and dysplastic polyp formation with long-term glucagon-like peptide 2 analog use. We report 2 cases of small bowel foveolar hyperplastic polyps found during surveillance endoscopies after 1 year of treatment with teduglutide.","PeriodicalId":17618,"journal":{"name":"JPGN Reports","volume":"119 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135714302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1097/pg9.0000000000000368
Andreas Tridimas, Raja Padidela, John Bassett, Rachel Wood, Maureen Lawson, Andrew Fagbemi, Timothy J. Morris
Objective: To determine the prevalence of secondary hyperparathyroidism in a cohort of pediatric patients receiving home parenteral nutrition. Methods: For a service review, a population-based cohort of 37 pediatric intestinal failure patients receiving long-term parenteral nutrition that underwent serial biochemical monitoring during a study period of approximately 4 years were examined. Following the production of an algorithm, a follow-up audit was carried out (n = 33) after approximately 6 months. Results: Of the 37 patients examined in the initial service review, 22 (59%) were found to have an elevated parathyroid hormone (PTH) during the period of monitoring and 5 (14%) had a persistently elevated PTH. In the follow-up audit following the implementation of an algorithm, the number with elevated PTH reduced to 6 (18%) and no patients had persistently high levels. Conclusion: Elevated PTH is a common biochemical finding in pediatric intestinal failure patients receiving home parenteral nutrition and its presence should alert clinicians to the need to optimize nutritional parameters such as calcium to phosphate molar ratio and vitamin D status; failure to do so may increase the future burden of metabolic bone disease in such patients. We propose that an algorithm may help in this endeavor.
{"title":"Reducing Metabolic Bone Disease Burden in Intestinal Failure Children on Home Parenteral Nutrition","authors":"Andreas Tridimas, Raja Padidela, John Bassett, Rachel Wood, Maureen Lawson, Andrew Fagbemi, Timothy J. Morris","doi":"10.1097/pg9.0000000000000368","DOIUrl":"https://doi.org/10.1097/pg9.0000000000000368","url":null,"abstract":"Objective: To determine the prevalence of secondary hyperparathyroidism in a cohort of pediatric patients receiving home parenteral nutrition. Methods: For a service review, a population-based cohort of 37 pediatric intestinal failure patients receiving long-term parenteral nutrition that underwent serial biochemical monitoring during a study period of approximately 4 years were examined. Following the production of an algorithm, a follow-up audit was carried out (n = 33) after approximately 6 months. Results: Of the 37 patients examined in the initial service review, 22 (59%) were found to have an elevated parathyroid hormone (PTH) during the period of monitoring and 5 (14%) had a persistently elevated PTH. In the follow-up audit following the implementation of an algorithm, the number with elevated PTH reduced to 6 (18%) and no patients had persistently high levels. Conclusion: Elevated PTH is a common biochemical finding in pediatric intestinal failure patients receiving home parenteral nutrition and its presence should alert clinicians to the need to optimize nutritional parameters such as calcium to phosphate molar ratio and vitamin D status; failure to do so may increase the future burden of metabolic bone disease in such patients. We propose that an algorithm may help in this endeavor.","PeriodicalId":17618,"journal":{"name":"JPGN Reports","volume":"14 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135455749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1097/pg9.0000000000000385
Hugo Quezada, Anne E. Levine, Matthew Dellinger, Samuel Rice-Townsend, Hengqi Betty Zheng
A 17-month-old female had an unwitnessed ingestion of 26 high-powered magnets, resulting in the creation of an esophagogastric fistula via the left crus of the diaphragm. This case highlights a rare injury to the stomach and esophagus caused by high-powered magnets requiring surgical intervention. Furthermore, this case report illustrates the risks that high-powered magnets pose to young children. Additionally, this case highlights the importance of maintaining a high level of suspicion for ingestion in young patients along with a multidisciplinary team to manage sequelae of injury.
{"title":"Esophagogastric Fistula: The Consequence of High-Powered Magnets Ingestion","authors":"Hugo Quezada, Anne E. Levine, Matthew Dellinger, Samuel Rice-Townsend, Hengqi Betty Zheng","doi":"10.1097/pg9.0000000000000385","DOIUrl":"https://doi.org/10.1097/pg9.0000000000000385","url":null,"abstract":"A 17-month-old female had an unwitnessed ingestion of 26 high-powered magnets, resulting in the creation of an esophagogastric fistula via the left crus of the diaphragm. This case highlights a rare injury to the stomach and esophagus caused by high-powered magnets requiring surgical intervention. Furthermore, this case report illustrates the risks that high-powered magnets pose to young children. Additionally, this case highlights the importance of maintaining a high level of suspicion for ingestion in young patients along with a multidisciplinary team to manage sequelae of injury.","PeriodicalId":17618,"journal":{"name":"JPGN Reports","volume":"118 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135714305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1097/pg9.0000000000000391
Cary C. Cotton, Elizabeth T. Jensen, Kate Hoffman, Daniel J. Green, Amanda L. Tapia, Kevin O. Turner, Robert M. Genta, Evan S. Dellon
We aimed to determine whether residential proximity to permitted swine facilities was associated with an increased risk of eosinophilic esophagitis (EoE) by conducting a case-control study using 2 complementary data sources: 1 from a tertiary care center (n = 401 cases and 1805 controls) and 1 from a large pathology group (n = 904 cases and 4074 controls). Addresses of the subjects and swine facilities were geocoded, and adjusted odds of EoE relative to proximity to and density of swine facilities were calculated. We observed a positive association between proximity to a permitted swine facility (<1 mile) and odds of EoE (adjusted odds ratio R, 2.56; 95% CI, 1.33–4.95) in the tertiary center data; density of farms (>10 farms/census tract) was also positively associated (adjusted odds ratio, 2.76; 95% CI, 1.30–5.84). However, this association was not observed in the pathology database. Though proximity to and density of swine operations were associated with EoE, associations were sensitive to the database used.
{"title":"Proximity to Swine Farming Operations as a Risk Factor for Eosinophilic Esophagitis","authors":"Cary C. Cotton, Elizabeth T. Jensen, Kate Hoffman, Daniel J. Green, Amanda L. Tapia, Kevin O. Turner, Robert M. Genta, Evan S. Dellon","doi":"10.1097/pg9.0000000000000391","DOIUrl":"https://doi.org/10.1097/pg9.0000000000000391","url":null,"abstract":"We aimed to determine whether residential proximity to permitted swine facilities was associated with an increased risk of eosinophilic esophagitis (EoE) by conducting a case-control study using 2 complementary data sources: 1 from a tertiary care center (n = 401 cases and 1805 controls) and 1 from a large pathology group (n = 904 cases and 4074 controls). Addresses of the subjects and swine facilities were geocoded, and adjusted odds of EoE relative to proximity to and density of swine facilities were calculated. We observed a positive association between proximity to a permitted swine facility (<1 mile) and odds of EoE (adjusted odds ratio R, 2.56; 95% CI, 1.33–4.95) in the tertiary center data; density of farms (>10 farms/census tract) was also positively associated (adjusted odds ratio, 2.76; 95% CI, 1.30–5.84). However, this association was not observed in the pathology database. Though proximity to and density of swine operations were associated with EoE, associations were sensitive to the database used.","PeriodicalId":17618,"journal":{"name":"JPGN Reports","volume":"38 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135564272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1097/pg9.0000000000000376
Jessica V. Baran, Rowan O’Flanagan, Carolena Trocchia, Jerry M. Brown, Johnny Nguyen, Sara Karjoo, Michael J. Wilsey
Esophagitis dissecans superficialis (EsoDS) is a rare condition characterized by the shedding of superficial esophageal epithelium. Limited data exists on EsoDS in the pediatric population. We present a case of a 17-year-old female with chronic nausea and vomiting diagnosed with EsoDS. Endoscopy revealed esophageal mucosal sloughing, and histology confirmed esophagitis with mucosal necrosis. EsoDS is underrecognized, and its association with psychoactive medications remains unclear. Fortunately, EsoDS cases tend to resolve spontaneously without complications. Awareness of EsoDS is essential, and further research is needed to understand its prevalence and outcomes in pediatric patients.
{"title":"Peeling Back the Layers: Sloughing Esophagitis in a Teenager with Chronic Vomiting","authors":"Jessica V. Baran, Rowan O’Flanagan, Carolena Trocchia, Jerry M. Brown, Johnny Nguyen, Sara Karjoo, Michael J. Wilsey","doi":"10.1097/pg9.0000000000000376","DOIUrl":"https://doi.org/10.1097/pg9.0000000000000376","url":null,"abstract":"Esophagitis dissecans superficialis (EsoDS) is a rare condition characterized by the shedding of superficial esophageal epithelium. Limited data exists on EsoDS in the pediatric population. We present a case of a 17-year-old female with chronic nausea and vomiting diagnosed with EsoDS. Endoscopy revealed esophageal mucosal sloughing, and histology confirmed esophagitis with mucosal necrosis. EsoDS is underrecognized, and its association with psychoactive medications remains unclear. Fortunately, EsoDS cases tend to resolve spontaneously without complications. Awareness of EsoDS is essential, and further research is needed to understand its prevalence and outcomes in pediatric patients.","PeriodicalId":17618,"journal":{"name":"JPGN Reports","volume":"119 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135714303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1097/pg9.0000000000000392
Narmeen Khan, Kate Keenan, Hilary Jericho
Strict adherence to a gluten-free diet (GFD), the current treatment for celiac disease (CD), is socially challenging for adolescents, especially in the college setting. We conducted a survey of factors contributing to GFD adherence during college among patients meeting the ESPGHAN criteria for CD. One-hundred-one young adults (18 years and older) were contacted; 59 completed the survey, of which 47 were enrolled or had attended college. The survey was developed by the study team. Most patients were able to maintain strict adherence to the GFD, whereas at college and reported that GF food was available and consistent with expectations. Nearly all participants reported a lack of resources for students with CD. Strong family support helped, and school stress and lack of peer support impeded diet adherence. Although colleges may meet the basic needs of celiac students, the availability and quality of gluten-free options, and improved campus resources are needed.
{"title":"Not Quite Meeting the Mark: College Experiences for Patients With Celiac Disease","authors":"Narmeen Khan, Kate Keenan, Hilary Jericho","doi":"10.1097/pg9.0000000000000392","DOIUrl":"https://doi.org/10.1097/pg9.0000000000000392","url":null,"abstract":"Strict adherence to a gluten-free diet (GFD), the current treatment for celiac disease (CD), is socially challenging for adolescents, especially in the college setting. We conducted a survey of factors contributing to GFD adherence during college among patients meeting the ESPGHAN criteria for CD. One-hundred-one young adults (18 years and older) were contacted; 59 completed the survey, of which 47 were enrolled or had attended college. The survey was developed by the study team. Most patients were able to maintain strict adherence to the GFD, whereas at college and reported that GF food was available and consistent with expectations. Nearly all participants reported a lack of resources for students with CD. Strong family support helped, and school stress and lack of peer support impeded diet adherence. Although colleges may meet the basic needs of celiac students, the availability and quality of gluten-free options, and improved campus resources are needed.","PeriodicalId":17618,"journal":{"name":"JPGN Reports","volume":"119 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135714304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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