Ijarotimi O, Betiku O.A, Osasona E.O, Umenze I, Adekanle O, Ndububa D.A
Two cases of HBsAg seroconversion, following treatment with Tenofovir disoproxil fumarate, a nucleotide reverse transcriptase inhibitor, were reported amongst the patients with chronic hepatitis B infection attending gastrointestinal clinic in a tertiary hospital. The patients had liver biopsy done during their evaluation, following which they were commenced on the medication. Tenofovir was taken for four years and two years respectively before they lost the hepatitis B surface antigen and developed quantifiable antibodies to the surface antigen (Anti-HBs). Loss of HBsAg is a rare event, and seroconversion in patients with CHB is even less common. Studies have shown that HBsAg loss and seroconversion is less likely with patients on the oral antiviral agents compared with pegylated interferon. Although, both patients had very low pretreatment hepatitis B viral load which might indicate strong immune response to the virus, a factor that could have been partly responsible for the seroconversion. They however, had significant liver fibrosis on histology prior to their seroconversion and will require hepatocellular cancer surveillance until normalization of the liver histology can be ascertained.
{"title":"Tenofovir Induced Hepatitis B Surface Antigen Loss and Seroconversion in Two Patients with E-Antigen Negative Chronic Hepatitis B Infection: Case Series","authors":"Ijarotimi O, Betiku O.A, Osasona E.O, Umenze I, Adekanle O, Ndububa D.A","doi":"10.33425/2639-9334.1069","DOIUrl":"https://doi.org/10.33425/2639-9334.1069","url":null,"abstract":"Two cases of HBsAg seroconversion, following treatment with Tenofovir disoproxil fumarate, a nucleotide reverse transcriptase inhibitor, were reported amongst the patients with chronic hepatitis B infection attending gastrointestinal clinic in a tertiary hospital. The patients had liver biopsy done during their evaluation, following which they were commenced on the medication. Tenofovir was taken for four years and two years respectively before they lost the hepatitis B surface antigen and developed quantifiable antibodies to the surface antigen (Anti-HBs). Loss of HBsAg is a rare event, and seroconversion in patients with CHB is even less common. Studies have shown that HBsAg loss and seroconversion is less likely with patients on the oral antiviral agents compared with pegylated interferon. Although, both patients had very low pretreatment hepatitis B viral load which might indicate strong immune response to the virus, a factor that could have been partly responsible for the seroconversion. They however, had significant liver fibrosis on histology prior to their seroconversion and will require hepatocellular cancer surveillance until normalization of the liver histology can be ascertained.","PeriodicalId":338144,"journal":{"name":"Gastroenterology, Hepatology & Digestive Disorders","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133496177","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}
Background: Infection with the hepatitis B virus is highly endemic in much of sub-Saharan Africa where it remains an important cause of chronic ill-health. Quantitative assay of HBV DNA and HBsAg are emerging as useful tools in the management of chronic HBV infection. However, it is not yet clear how well each of these might accurately correlate with the extent of liver damage during the course of the disease. Nevertheless, liver biopsy, albeit an invasive test, affords a superior direct assessment of all stages of the disease. Objective: Thus, we set out to determine how well-correlated serum levels of HBV-DNA and/or HBsAg might be with each other and with the liver biopsy appearances. Methodology: This study was prospective and we enrolled, 83 new treatment-naïve patients, who met the study criteria. Each patient had liver biopsy assessments of the grade of necroinflammation (A) and stage of fibrosis (F), according to the METAVIR Scoring System. In addition, quantitative HBsAg serum levels by immunoassay and HBV DNA by real-time quantitative PCR protocols were made. The Spearman’s and Kruskal-Wallis statistical tests were employed to determine the correlations between these assays separately and with the respective histological grades and stages of liver biopsy. (p=0.05) Results: The greatest number of the patients were within the 21-40 year- age group. Using the Spearman rho’s statistical correlation test, we found a positive but weak correlation between the serum HBsAg and HBVDNA levels (p=0.075, r=0.198). The Kruskal-Wallis analysis revealed statistically significant correlation between HBV-DNA and the grade of necroinflammation but not with the stage of fibrosis. Conclusions: We found that the serum HBV DNA levels had the only statistically significant correlation with the liver histological disease. This relationship needs to be further examined in larger studies in the future.
{"title":"A Correlation Study of Liver Biopsy Appearances, Serum HBV DNA and HBsAg Quantification Levels of Nigerian Patients with Chronic Liver Disease","authors":"O. Betiku, O. Adekanle, D. Ndububa, O. Ojo","doi":"10.33425/2639-9334.1070","DOIUrl":"https://doi.org/10.33425/2639-9334.1070","url":null,"abstract":"Background: Infection with the hepatitis B virus is highly endemic in much of sub-Saharan Africa where it remains an important cause of chronic ill-health. Quantitative assay of HBV DNA and HBsAg are emerging as useful tools in the management of chronic HBV infection. However, it is not yet clear how well each of these might accurately correlate with the extent of liver damage during the course of the disease. Nevertheless, liver biopsy, albeit an invasive test, affords a superior direct assessment of all stages of the disease. Objective: Thus, we set out to determine how well-correlated serum levels of HBV-DNA and/or HBsAg might be with each other and with the liver biopsy appearances. Methodology: This study was prospective and we enrolled, 83 new treatment-naïve patients, who met the study criteria. Each patient had liver biopsy assessments of the grade of necroinflammation (A) and stage of fibrosis (F), according to the METAVIR Scoring System. In addition, quantitative HBsAg serum levels by immunoassay and HBV DNA by real-time quantitative PCR protocols were made. The Spearman’s and Kruskal-Wallis statistical tests were employed to determine the correlations between these assays separately and with the respective histological grades and stages of liver biopsy. (p=0.05) Results: The greatest number of the patients were within the 21-40 year- age group. Using the Spearman rho’s statistical correlation test, we found a positive but weak correlation between the serum HBsAg and HBVDNA levels (p=0.075, r=0.198). The Kruskal-Wallis analysis revealed statistically significant correlation between HBV-DNA and the grade of necroinflammation but not with the stage of fibrosis. Conclusions: We found that the serum HBV DNA levels had the only statistically significant correlation with the liver histological disease. This relationship needs to be further examined in larger studies in the future.","PeriodicalId":338144,"journal":{"name":"Gastroenterology, Hepatology & Digestive Disorders","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123589139","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}
Ryouni K, Chahid I, Atrassi M, Bensabbahia D, Abkari A
Introduction: Multisystem Inflammatory Syndrome in Children (MIS-C) is a new phenomenon reported worldwide with temporal association with COVID-19. Objective: The aim of our case report is to clarify the manifestations of a pims syndrome in a osteosarcoma field, which can be confused with metastases. Patients and methods: We report a case of a 12-year-old male patient followed for osteosarcoma of the right humerus who was admitted for hepatocellular failure with cutaneous-mucosal jaundice revealing a PIMS syndrome. Results: The patient had initially received 3 courses of chemotherapy, followed by monobloc resection of the tumour mass and osteosynthesis, who met the case definition of PIMS-TS presented with fever, multi organ and mucocutaneous involvement, cardiovascular and gastrointestinal symptoms. His biological work-up showed a significant inflammatory syndrome with very high ferritin levels, high D-dimer and pro-BNP levels, associated with lymphopenia and liver cytolysis. An echocardiogram revealed a dilated cardiomyopathy with an LVEF of 13% associated with a moderate pericardial effusion. The work-up was completed by a PCR covid which came back negative, when the serology came back positive confirming a PIMS-TS. Therapeutically, he received a course of immunoglobulin, corticosteroid, and in view of the myocardial damage, he was put on Aspirin, ACE inhibitor, beta-blocker and spironolactone after normalization of his blood pressure. The evolution was spectacular, marked by a clear clinical improvement, the normalisation of biological parameters and the improvement of his LVEF on echocardiography. Conclusion: Although the pathogenesis is not clearly known, immune-mediated injury has been implicated. We herein provide current information on this condition, in order to raise awareness amongst pediatricians.
儿童多系统炎症综合征(multi - system Inflammatory Syndrome in Children, MIS-C)是全球范围内报道的一种新现象，与COVID-19存在时间相关性。目的:我们的病例报告的目的是澄清皮姆斯综合征在骨肉瘤领域的表现，这可能与转移混淆。患者和方法:我们报告一例12岁的男性右肱骨骨肉瘤患者，因肝细胞衰竭合并皮肤黏膜黄疸显示PIMS综合征而入院。结果:患者最初接受3个疗程的化疗，随后进行肿瘤整体切除和骨整合，符合PIMS-TS的病例定义，表现为发热，多器官和皮肤粘膜受累，心血管和胃肠道症状。他的生物学检查显示明显的炎症综合征，铁蛋白水平非常高，d -二聚体和bnp前水平高，伴有淋巴细胞减少和肝细胞溶解。超声心动图显示扩张性心肌病，LVEF为13%，伴有中度心包积液。当血清学结果为阳性确认PIMS-TS时，通过PCR检测完成了检查，结果为阴性。在治疗上，他接受了一个疗程的免疫球蛋白、皮质类固醇，鉴于心肌损伤，在血压恢复正常后，他又服用了阿司匹林、ACE抑制剂、受体阻滞剂和螺内酯。进化是惊人的，以明显的临床改善为标志，生物参数正常化，超声心动图显示他的LVEF改善。结论:虽然发病机制尚不清楚，但可能与免疫介导的损伤有关。我们在此提供有关这种情况的最新信息，以提高儿科医生的认识。
{"title":"SARS-CoV-2-Related Multisystem Inflammatory Syndrome in an Immunocompromised Child with Osteosarcoma Revealed by Hepatocellular Failure","authors":"Ryouni K, Chahid I, Atrassi M, Bensabbahia D, Abkari A","doi":"10.33425/2639-9334.1068","DOIUrl":"https://doi.org/10.33425/2639-9334.1068","url":null,"abstract":"Introduction: Multisystem Inflammatory Syndrome in Children (MIS-C) is a new phenomenon reported worldwide with temporal association with COVID-19. Objective: The aim of our case report is to clarify the manifestations of a pims syndrome in a osteosarcoma field, which can be confused with metastases. Patients and methods: We report a case of a 12-year-old male patient followed for osteosarcoma of the right humerus who was admitted for hepatocellular failure with cutaneous-mucosal jaundice revealing a PIMS syndrome. Results: The patient had initially received 3 courses of chemotherapy, followed by monobloc resection of the tumour mass and osteosynthesis, who met the case definition of PIMS-TS presented with fever, multi organ and mucocutaneous involvement, cardiovascular and gastrointestinal symptoms. His biological work-up showed a significant inflammatory syndrome with very high ferritin levels, high D-dimer and pro-BNP levels, associated with lymphopenia and liver cytolysis. An echocardiogram revealed a dilated cardiomyopathy with an LVEF of 13% associated with a moderate pericardial effusion. The work-up was completed by a PCR covid which came back negative, when the serology came back positive confirming a PIMS-TS. Therapeutically, he received a course of immunoglobulin, corticosteroid, and in view of the myocardial damage, he was put on Aspirin, ACE inhibitor, beta-blocker and spironolactone after normalization of his blood pressure. The evolution was spectacular, marked by a clear clinical improvement, the normalisation of biological parameters and the improvement of his LVEF on echocardiography. Conclusion: Although the pathogenesis is not clearly known, immune-mediated injury has been implicated. We herein provide current information on this condition, in order to raise awareness amongst pediatricians.","PeriodicalId":338144,"journal":{"name":"Gastroenterology, Hepatology & Digestive Disorders","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116317176","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}
Noninvasive tests for Helicobacter pylori are important in primary care, both for initial diagnosis of H. pylori infection and for confirmation of eradication. The objective of the present study was to evaluate the effectiveness of a stool antigen test after therapy. We studied 30 patients (16 males & 14 females) infected with H. pylori at the outpatient clinic in Azady teaching hospital. After the completion of triple eradication therapy, all patients were subjected to the examination of the stool antigen test. Of the total 30 cases, there were 23 cases with negative stool Ag test after therapy. All seven cases without therapy were positive stool, Ag. The result of the stool antigen test after therapy was 76% (negative in 23 patients, false-negative in 7 patients). We concluded that a negative result on stool antigen testing after completion of therapy recognizes patients in whom the eradication of H. pylori was successful.
{"title":"Evaluation of Stool Antigen Test in patients infected by Helicobacter pylori after Eradication Therapy","authors":"P. Tahir","doi":"10.33425/2639-9334.1067","DOIUrl":"https://doi.org/10.33425/2639-9334.1067","url":null,"abstract":"Noninvasive tests for Helicobacter pylori are important in primary care, both for initial diagnosis of H. pylori infection and for confirmation of eradication. The objective of the present study was to evaluate the effectiveness of a stool antigen test after therapy. We studied 30 patients (16 males & 14 females) infected with H. pylori at the outpatient clinic in Azady teaching hospital. After the completion of triple eradication therapy, all patients were subjected to the examination of the stool antigen test. Of the total 30 cases, there were 23 cases with negative stool Ag test after therapy. All seven cases without therapy were positive stool, Ag. The result of the stool antigen test after therapy was 76% (negative in 23 patients, false-negative in 7 patients). We concluded that a negative result on stool antigen testing after completion of therapy recognizes patients in whom the eradication of H. pylori was successful.","PeriodicalId":338144,"journal":{"name":"Gastroenterology, Hepatology & Digestive Disorders","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114662125","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}
Lad Sneha, Pawar Apoorva, K. Vishakha, Koppikar Mohan, B. Suryaprakash, P. Sitaram, Patankar Roy
Transmural defects of the upper gastrointestinal (UGI) tract can be either leaks, perforations or fistulae. Endoscopic vac is a good option for management for localized leaks where stent placement is not feasible. We present a case of a 31-year-old lady who was operated for strangulated Bochdalek hernia with partial gastrectomy with esophago-gastric anastomosis. She then underwent 2 sittings of endo vac placement for management of an anastomotic leak with mediastinitis. She was followed up on outpatient basis with imaging and interval endoscopies. Post 6 months of the procedure, patient is well and is on full oral feeds.
{"title":"Management of Esophago-Gastric Anastomotic Leak with Endoscopic Vacuum Therapy- A Case Report and Review of Literature","authors":"Lad Sneha, Pawar Apoorva, K. Vishakha, Koppikar Mohan, B. Suryaprakash, P. Sitaram, Patankar Roy","doi":"10.33425/2639-9334.1066","DOIUrl":"https://doi.org/10.33425/2639-9334.1066","url":null,"abstract":"Transmural defects of the upper gastrointestinal (UGI) tract can be either leaks, perforations or fistulae. Endoscopic vac is a good option for management for localized leaks where stent placement is not feasible. We present a case of a 31-year-old lady who was operated for strangulated Bochdalek hernia with partial gastrectomy with esophago-gastric anastomosis. She then underwent 2 sittings of endo vac placement for management of an anastomotic leak with mediastinitis. She was followed up on outpatient basis with imaging and interval endoscopies. Post 6 months of the procedure, patient is well and is on full oral feeds.","PeriodicalId":338144,"journal":{"name":"Gastroenterology, Hepatology & Digestive Disorders","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126503227","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}
Hamid Ullah, L. Burstiner, Lucas B. Buchanan, S. Iqbal, A. Royer, Sarah Glover, Pegah Hosseini-Carroll
Introduction: Telemedicine was put at the forefront of the healthcare delivery process during the coronavirus disease 2019 (COVID-19) pandemic. Pre-COVID-19 research had shown telemedicine to be beneficial in the gastroenterology field with improved quality of life and reduced healthcare cost in the IBD population. However, telemedicine remained underutilized in subspecialty care with constraints at both provider and patient level. Objective: To analyze the telemedicine encounters in a gastroenterology clinic at a tertiary care hospital and identify factors that facilitate or limit the use of telemedicine modalities. Methods: The project was a retrospective, single-center study with continuous sampling of one hundred and fifty-three patients who scheduled one hundred and fifty-eight telemedicine encounters that included both Inflammatory Bowel Disease (IBD) and general gastroenterology patients. We examined the influence of age, sex, race, geographic location and payer source, on audio or video telemedicine encounters, as well as the show rate. Results: Our study showed a promising show rate of 90.5% with a majority of the patients preferring video over audio visits; however, increasing age proved to be a barrier in successfully completing video visits. In total, 26.2% of the patients who desired video encounters had to be switched to audio only. We found that race, sex, payor source, and living in a rural zip code did not influence the rate of completed telemedicine encounters or the patients’ preferred modality (audio vs video). Conclusion: The recurring COVID-19 surge due to different variants provides an opportunity to refine the telemedicine experience in our healthcare. Telemedicine encounters have a promising role in gastroenterology outpatient care and can be utilized to improve access to care and bridge healthcare disparities. In order to increase compliance further work needs to be done to make the digital platform user friendly for the elderly population.
{"title":"Factors to Consider for Successful Telemedicine Gastroenterology Subspecialty Visits in Disparate Populations","authors":"Hamid Ullah, L. Burstiner, Lucas B. Buchanan, S. Iqbal, A. Royer, Sarah Glover, Pegah Hosseini-Carroll","doi":"10.33425/2639-9334.1065","DOIUrl":"https://doi.org/10.33425/2639-9334.1065","url":null,"abstract":"Introduction: Telemedicine was put at the forefront of the healthcare delivery process during the coronavirus disease 2019 (COVID-19) pandemic. Pre-COVID-19 research had shown telemedicine to be beneficial in the gastroenterology field with improved quality of life and reduced healthcare cost in the IBD population. However, telemedicine remained underutilized in subspecialty care with constraints at both provider and patient level. Objective: To analyze the telemedicine encounters in a gastroenterology clinic at a tertiary care hospital and identify factors that facilitate or limit the use of telemedicine modalities. Methods: The project was a retrospective, single-center study with continuous sampling of one hundred and fifty-three patients who scheduled one hundred and fifty-eight telemedicine encounters that included both Inflammatory Bowel Disease (IBD) and general gastroenterology patients. We examined the influence of age, sex, race, geographic location and payer source, on audio or video telemedicine encounters, as well as the show rate. Results: Our study showed a promising show rate of 90.5% with a majority of the patients preferring video over audio visits; however, increasing age proved to be a barrier in successfully completing video visits. In total, 26.2% of the patients who desired video encounters had to be switched to audio only. We found that race, sex, payor source, and living in a rural zip code did not influence the rate of completed telemedicine encounters or the patients’ preferred modality (audio vs video). Conclusion: The recurring COVID-19 surge due to different variants provides an opportunity to refine the telemedicine experience in our healthcare. Telemedicine encounters have a promising role in gastroenterology outpatient care and can be utilized to improve access to care and bridge healthcare disparities. In order to increase compliance further work needs to be done to make the digital platform user friendly for the elderly population.","PeriodicalId":338144,"journal":{"name":"Gastroenterology, Hepatology & Digestive Disorders","volume":"226 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132685009","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}
Despite significant therapeutic progress, gastric cancer remains among the deadliest forms of cancer encountered in clinical practice, and this remains true even in the context of declining incidence. Outcomes in advanced disease remain poor and therapy is rarely curative in this setting. Different therapies have developed in the hopes of altering nearly uniformly poor outcomes.
{"title":"Gastric Cancer and QIAPI, Case Report","authors":"A. Herrera, Nicolas Saavedra Rojas","doi":"10.33425/2639-9334.1061","DOIUrl":"https://doi.org/10.33425/2639-9334.1061","url":null,"abstract":"Despite significant therapeutic progress, gastric cancer remains among the deadliest forms of cancer encountered in clinical practice, and this remains true even in the context of declining incidence. Outcomes in advanced disease remain poor and therapy is rarely curative in this setting. Different therapies have developed in the hopes of altering nearly uniformly poor outcomes.","PeriodicalId":338144,"journal":{"name":"Gastroenterology, Hepatology & Digestive Disorders","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127420729","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}
Background: The prevalence of cannabis use has been increasing in the United States in recent years. We examined the prevalence and predictors of cannabis use disorder among IBD hospitalizations and its effect on length of stay. Methods: Using the 2017 National Inpatient Sample, cannabis use disorder was identified using ICD-10-CM code F12.xxx in adult IBD patients. Other variables of interest included age, sex, race, Crohn’s disease (vs. ulcerative colitis), region, metropolitan status, zip code household income, primary insurance, and length of stay. Multivariate logistic and Poisson regressions were used in statistical analysis. Results: Of the 17,857 IBD hospitalizations, 565 (3.1%) had cannabis use disorder. Patients with cannabis use disorder were younger (mean ± standard deviation [years]: 35.1 ± 11.8 vs. 45.6 ± 18.1), less likely female (32.7% vs. 54.1%), more likely African American (24.8% vs. 13.9%), and more likely Crohn’s disease (72.0% vs. 62.2%) (all p<0.001). There were also significant differences by region, income, and insurance. Multivariate logistic regression confirmed age (odds ratio [95% confidence interval]: 0.964 [0.957, 0.971]), female (0.444 [0.369, 0.531]), African American (1.405 [1.124, 1.750]), and Crohn’s disease (1.363 [1.126, 1.657]) as predictors of cannabis use disorder. There was no association between cannabis use disorder and length of stay, confirmed in multivariate Poisson regression. Conclusions: Young age, male sex, African American race, and Crohn’s disease were positively associated with cannabis use disorder in IBD hospitalizations. There was no effect of cannabis use disorder on length of stay.
{"title":"Prevalence and Predictors of Cannabis Use Disorder among Inflammatory Bowel Disease Hospitalizations in the United States and its Effect on Length of Stay","authors":"Y. Wang","doi":"10.33425/2639-9334.1063","DOIUrl":"https://doi.org/10.33425/2639-9334.1063","url":null,"abstract":"Background: The prevalence of cannabis use has been increasing in the United States in recent years. We examined the prevalence and predictors of cannabis use disorder among IBD hospitalizations and its effect on length of stay. Methods: Using the 2017 National Inpatient Sample, cannabis use disorder was identified using ICD-10-CM code F12.xxx in adult IBD patients. Other variables of interest included age, sex, race, Crohn’s disease (vs. ulcerative colitis), region, metropolitan status, zip code household income, primary insurance, and length of stay. Multivariate logistic and Poisson regressions were used in statistical analysis. Results: Of the 17,857 IBD hospitalizations, 565 (3.1%) had cannabis use disorder. Patients with cannabis use disorder were younger (mean ± standard deviation [years]: 35.1 ± 11.8 vs. 45.6 ± 18.1), less likely female (32.7% vs. 54.1%), more likely African American (24.8% vs. 13.9%), and more likely Crohn’s disease (72.0% vs. 62.2%) (all p<0.001). There were also significant differences by region, income, and insurance. Multivariate logistic regression confirmed age (odds ratio [95% confidence interval]: 0.964 [0.957, 0.971]), female (0.444 [0.369, 0.531]), African American (1.405 [1.124, 1.750]), and Crohn’s disease (1.363 [1.126, 1.657]) as predictors of cannabis use disorder. There was no association between cannabis use disorder and length of stay, confirmed in multivariate Poisson regression. Conclusions: Young age, male sex, African American race, and Crohn’s disease were positively associated with cannabis use disorder in IBD hospitalizations. There was no effect of cannabis use disorder on length of stay.","PeriodicalId":338144,"journal":{"name":"Gastroenterology, Hepatology & Digestive Disorders","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126367057","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}
M. Guèye, Melissa C. E Sengue, S. Diallo, Djimby Sow, M. P. Fall, Cheikh Ahmadou Bamba Cissé, G. Diouf, M. Thioubou, Mame Coumba Cissé, M. Evra, M. L. Basséne, D. Dia, M. Mbengue
Introduction: All the manifestations of cirrhosis, sexual dysfunction, mainly because of its taboo nature. The least sought after by hepatologists and the least reported spontaneously by patients. Taking this condition into account is a necessity to improve the quality of life of patients. Methods: We conducted a prospective descriptive and analytical study over 14 months from March 2020 to April 2021 in patients followed for cirrhosis. Recruitment was multicenter. We included all cirrhotic patients who gave their consent to participate in the study. The diagnosis of cirrhosis was made on the basis of clinical, biological, radiological, endoscopic and histological evidence. The classification used was the simplified ASEX classification. Each element of the classification was scored from 1 to 3. Sexual Dysfunction was defined by a total ≥7, or a score of 3 on any item, or 2 on at least 3 items. Data were entered with Sphinx software version 5.1.0.2 and analyzed with version 18. The comparison of frequencies was done using Pearson's Chi-square test or Fisher's two-tailed exact test according to their applicability conditions with a significance threshold of 0.05. Results: We interviewed 50 patients with cirrhosis during our study period. Sexual dysfunction was observed in 34 patients, 68% of our population. The mean age was 52 years with extremes of 23 and 73 years. An age below 50 years was found in 40% of the patients.In patients with sexual dysfunction, the average age was 53 years with extremes of 35 and 73 years. Of these, 32.4% were younger than 50 years of age. The population was composed of 35 men and 15 women, for a sex ratio of 2.33. Sexual dysfunction was found in 24 men (84%). Active smoking was present in 18 patients. Alcohol abuse was present in 21 patients. Alcohol abuse was present in 21 patients. 95.2% of them had an alcohol abuse (p = 0.0001). Cirrhosis was most often associated with diabetes (13 cases), metabolic syndrome (11 cases) and hypertension (10 cases). In multivariate analysis, only diabetes was significantly associated with sexual dysfonction (p = 0.027). The most common etiologies of cirrhosis were alcohol (25 cases), HBV (15 cases), and NASH (10 cases). Sexual dysfonction was found in 84% of patients with alcoholic cirrhosis, in 80% of patients with postNASH cirrhosis, and 40% of patients with post-HBV cirrhosis. In multivariate analysis, there was a significant association between alcohol and sexual dysfonction (p = 0.015), and between HBV and Sexual dysfonction (p = 0.002). Twenty-nine patients had cirrhosis classified as CHILD A (58% of cases), and 18 patients (36% of cases) had cirrhosis classified as CHILD B. All patients with cirrhosis classified as CHILD C had sexual dysfonction. Sexual dysfonction was significantly related to the severity of the CHILD PUGH score (p = 0.002). Twenty-nine patients had cirrhosis classified as CHILD A (58% of cases), and 18 patients (36% of cases) had cirrhosis classified as CHILD
{"title":"Sexual Dysfunction In Cirrhosis: A Prospective Multicenter Study","authors":"M. Guèye, Melissa C. E Sengue, S. Diallo, Djimby Sow, M. P. Fall, Cheikh Ahmadou Bamba Cissé, G. Diouf, M. Thioubou, Mame Coumba Cissé, M. Evra, M. L. Basséne, D. Dia, M. Mbengue","doi":"10.33425/2639-9334.1064","DOIUrl":"https://doi.org/10.33425/2639-9334.1064","url":null,"abstract":"Introduction: All the manifestations of cirrhosis, sexual dysfunction, mainly because of its taboo nature. The least sought after by hepatologists and the least reported spontaneously by patients. Taking this condition into account is a necessity to improve the quality of life of patients. Methods: We conducted a prospective descriptive and analytical study over 14 months from March 2020 to April 2021 in patients followed for cirrhosis. Recruitment was multicenter. We included all cirrhotic patients who gave their consent to participate in the study. The diagnosis of cirrhosis was made on the basis of clinical, biological, radiological, endoscopic and histological evidence. The classification used was the simplified ASEX classification. Each element of the classification was scored from 1 to 3. Sexual Dysfunction was defined by a total ≥7, or a score of 3 on any item, or 2 on at least 3 items. Data were entered with Sphinx software version 5.1.0.2 and analyzed with version 18. The comparison of frequencies was done using Pearson's Chi-square test or Fisher's two-tailed exact test according to their applicability conditions with a significance threshold of 0.05. Results: We interviewed 50 patients with cirrhosis during our study period. Sexual dysfunction was observed in 34 patients, 68% of our population. The mean age was 52 years with extremes of 23 and 73 years. An age below 50 years was found in 40% of the patients.In patients with sexual dysfunction, the average age was 53 years with extremes of 35 and 73 years. Of these, 32.4% were younger than 50 years of age. The population was composed of 35 men and 15 women, for a sex ratio of 2.33. Sexual dysfunction was found in 24 men (84%). Active smoking was present in 18 patients. Alcohol abuse was present in 21 patients. Alcohol abuse was present in 21 patients. 95.2% of them had an alcohol abuse (p = 0.0001). Cirrhosis was most often associated with diabetes (13 cases), metabolic syndrome (11 cases) and hypertension (10 cases). In multivariate analysis, only diabetes was significantly associated with sexual dysfonction (p = 0.027). The most common etiologies of cirrhosis were alcohol (25 cases), HBV (15 cases), and NASH (10 cases). Sexual dysfonction was found in 84% of patients with alcoholic cirrhosis, in 80% of patients with postNASH cirrhosis, and 40% of patients with post-HBV cirrhosis. In multivariate analysis, there was a significant association between alcohol and sexual dysfonction (p = 0.015), and between HBV and Sexual dysfonction (p = 0.002). Twenty-nine patients had cirrhosis classified as CHILD A (58% of cases), and 18 patients (36% of cases) had cirrhosis classified as CHILD B. All patients with cirrhosis classified as CHILD C had sexual dysfonction. Sexual dysfonction was significantly related to the severity of the CHILD PUGH score (p = 0.002). Twenty-nine patients had cirrhosis classified as CHILD A (58% of cases), and 18 patients (36% of cases) had cirrhosis classified as CHILD","PeriodicalId":338144,"journal":{"name":"Gastroenterology, Hepatology & Digestive Disorders","volume":"252 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121423713","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}
J. F. Mimiesse, N. A. Itoua-Ngaporo, S. R. Ngami, C. Ahoui-Apendi, A. Mongo-Onkouo, M. Ibobi, Bénédicte Ahombo, Hostaud Atipo Ibara, Lesty Ibara Kolo, Pérès Mordoché Motoula Latou, M. N. Mouakosso, Deby-Gassaye G, B. I. Atipo Ibara
Introduction: Our study aimed to describe the epidemiological, clinical, paraclinical and evolutionary aspects of esophageal cancer. Patients and Methods: This is a descriptive retrospective study carried out over 08 years (January 2012 to December 2020) in the gastroenterology and internal medicine department of the Brazzaville University Hospital. We included the files of patients hospitalized for CO retained on a clinical and endoscopic argument bundles. Results: During the study period, 34 cases of esophageal cancer were diagnosed, ie a hospital frequency of 0.63%. The average age was 52.97 years with extremes ranging from 29-90 years. They are made up of 24 men and 10 women with a sex ratio of 2.4 in favor of men. Alcohol-smoking poisoning was found in 21 male patients with an average of 27 packs / year. The main symptom at diagnosis was dysphagia (55.88%). Esogastroduodenal fibroscopy showed ulcerative budding and hemorrhagic lesions (50%), the site of which was mainly the abdominal esophagus (64.70%). Adenocarcinoma was the most common histologic type, 16 patients received palliative care. Conclusion: Esophageal cancer is common in males over the age of 50. Dysphagia is the most frequent reason for consultation. The distal esophagus is the most common site of esophageal cancer and the histologic type is adenocarcinoma. Among our patients, 16 received palliative care.
{"title":"Esophagus Cancer: Epidemiological, Clinical, Para Clinic and Evolving Aspects at Brazzaville Chu","authors":"J. F. Mimiesse, N. A. Itoua-Ngaporo, S. R. Ngami, C. Ahoui-Apendi, A. Mongo-Onkouo, M. Ibobi, Bénédicte Ahombo, Hostaud Atipo Ibara, Lesty Ibara Kolo, Pérès Mordoché Motoula Latou, M. N. Mouakosso, Deby-Gassaye G, B. I. Atipo Ibara","doi":"10.33425/2639-9334.1062","DOIUrl":"https://doi.org/10.33425/2639-9334.1062","url":null,"abstract":"Introduction: Our study aimed to describe the epidemiological, clinical, paraclinical and evolutionary aspects of esophageal cancer. Patients and Methods: This is a descriptive retrospective study carried out over 08 years (January 2012 to December 2020) in the gastroenterology and internal medicine department of the Brazzaville University Hospital. We included the files of patients hospitalized for CO retained on a clinical and endoscopic argument bundles. Results: During the study period, 34 cases of esophageal cancer were diagnosed, ie a hospital frequency of 0.63%. The average age was 52.97 years with extremes ranging from 29-90 years. They are made up of 24 men and 10 women with a sex ratio of 2.4 in favor of men. Alcohol-smoking poisoning was found in 21 male patients with an average of 27 packs / year. The main symptom at diagnosis was dysphagia (55.88%). Esogastroduodenal fibroscopy showed ulcerative budding and hemorrhagic lesions (50%), the site of which was mainly the abdominal esophagus (64.70%). Adenocarcinoma was the most common histologic type, 16 patients received palliative care. Conclusion: Esophageal cancer is common in males over the age of 50. Dysphagia is the most frequent reason for consultation. The distal esophagus is the most common site of esophageal cancer and the histologic type is adenocarcinoma. Among our patients, 16 received palliative care.","PeriodicalId":338144,"journal":{"name":"Gastroenterology, Hepatology & Digestive Disorders","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116319979","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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