Ren Yi Jonas Ho, R Rajesh, Wei Keat Wan, Chang Chuen Mark Cheah, Yi Yuan Tan
Background
Linitis plastica is a challenging diagnosis in the setting of a patient with previous breast cancer.
Case presentation
We present a case of a 74-year-old Chinese Female with a history of breast cancer who presented with epigastric pain, nausea, early satiety, and weight loss of 5 kg in 3 months. Endoscopic diagnosis of linitis plastica was made, but subsequent management plans were dependent on accurate histological assessment in view of her oncological history.
Discussion and conclusion
Our case highlights the clinical conundrum confronting the endoscopist in evaluating suspected linitis plastica where the imaging, endoscopic, and macroscopic histological findings between primary gastric adenocarcinoma and metastatic breast cancer can be indistinguishable. Optimal deep tissue acquisition is required to differentiate the true diagnosis in such cases.
{"title":"Linitis Plastica in a Patient With Previous Breast Cancer: Primary Gastric Cancer or Breast Cancer Metastases?","authors":"Ren Yi Jonas Ho, R Rajesh, Wei Keat Wan, Chang Chuen Mark Cheah, Yi Yuan Tan","doi":"10.1002/jgh3.70071","DOIUrl":"https://doi.org/10.1002/jgh3.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Linitis plastica is a challenging diagnosis in the setting of a patient with previous breast cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>We present a case of a 74-year-old Chinese Female with a history of breast cancer who presented with epigastric pain, nausea, early satiety, and weight loss of 5 kg in 3 months. Endoscopic diagnosis of linitis plastica was made, but subsequent management plans were dependent on accurate histological assessment in view of her oncological history.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and conclusion</h3>\u0000 \u0000 <p>Our case highlights the clinical conundrum confronting the endoscopist in evaluating suspected linitis plastica where the imaging, endoscopic, and macroscopic histological findings between primary gastric adenocarcinoma and metastatic breast cancer can be indistinguishable. Optimal deep tissue acquisition is required to differentiate the true diagnosis in such cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142868930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eosinophilic esophagitis (EoE) is a chronic inflammatory process of the esophagus often associated with structural and motility problems. Previous studies have shown an increased prevalence in males over females, however there is little data exploring the risk of esophageal complications among genders, which may be indicative of differences in disease severity.
Methods
This is a retrospective cohort study using National Inpatient Sample data including adults hospitalized between 2016 and 2020 presenting with EoE. The primary outcome measured was inpatient complications related to the patient's history of EoE and secondary outcomes include demographics, comorbidities, month of presentation, and age of patients.
Results
Of the 21 755 patients with history of EoE, 112 260 (52%) were male and 10 495 (48%) were female. Males had higher rates of several EoE complications, including esophageal obstruction, food bolus, esophageal rupture, requiring esophageal dilation, requiring esophageal laceration repair with p < 0.05 for all. Higher rates of females with EoE were seen in the Black population (p < 0.05). We also found that males were most likely to have esophageal impaction and esophageal rupture in the month of March (p < 0.05). Esophageal impaction was more common in males ages 25–29 (p < 0.05), whereas females were more likely from age 75–79 (p < 0.05).
Conclusion
Males have an overall high rate of complication from EoE. There was a higher prevalence of females with EoE in the Black population although the rates of complication remained higher in males in this subpopulation. The month of March carries a risk of esophageal impaction and rupture pronounced particularly in men. Age also appears to have an influence on the rate of esophageal impaction.
{"title":"Exploring the Impact of Gender on the Characteristics and Complications of Eosinophilic Esophagitis","authors":"Het Patel, Joshua Elmer, Hammad Liaquat","doi":"10.1002/jgh3.70059","DOIUrl":"https://doi.org/10.1002/jgh3.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Eosinophilic esophagitis (EoE) is a chronic inflammatory process of the esophagus often associated with structural and motility problems. Previous studies have shown an increased prevalence in males over females, however there is little data exploring the risk of esophageal complications among genders, which may be indicative of differences in disease severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a retrospective cohort study using National Inpatient Sample data including adults hospitalized between 2016 and 2020 presenting with EoE. The primary outcome measured was inpatient complications related to the patient's history of EoE and secondary outcomes include demographics, comorbidities, month of presentation, and age of patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 21 755 patients with history of EoE, 112 260 (52%) were male and 10 495 (48%) were female. Males had higher rates of several EoE complications, including esophageal obstruction, food bolus, esophageal rupture, requiring esophageal dilation, requiring esophageal laceration repair with <i>p</i> < 0.05 for all. Higher rates of females with EoE were seen in the Black population (<i>p</i> < 0.05). We also found that males were most likely to have esophageal impaction and esophageal rupture in the month of March (<i>p</i> < 0.05). Esophageal impaction was more common in males ages 25–29 (<i>p</i> < 0.05), whereas females were more likely from age 75–79 (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Males have an overall high rate of complication from EoE. There was a higher prevalence of females with EoE in the Black population although the rates of complication remained higher in males in this subpopulation. The month of March carries a risk of esophageal impaction and rupture pronounced particularly in men. Age also appears to have an influence on the rate of esophageal impaction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142868973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Identifying the factors contributing to the progression of metabolic dysfunction-associated steatotic liver disease (MASLD), a lifestyle-related disease, is crucial for preventing future liver-related deaths. This study aimed to epidemiologically investigate factors, including single-nucleotide polymorphisms (SNPs) associated with alanine aminotransferase (ALT) levels >30 U/L and potential risk factors for liver fibrosis, in a general population cohort of patients with MASLD.
Methods
Among 1059 participants in the health checkup project, 228 who were diagnosed with MASLD were analyzed. Liver fat content and stiffness were measured using FibroScan, and 13 SNPs associated with non-alcoholic fatty liver disease (NAFLD) were measured in addition to other clinical parameters.
Results
In the multivariate analysis, male sex, younger age, and high triglyceride levels were significant risk factors for ALT levels >30 U/L (P-value < 0.05). Furthermore, among the 13 SNPs measured, only the GG genotypes of patatin-like phospholipase domain-containing 3 gene (PNPLA3) rs738409 and rs2896019 were significant risk factors for ALT levels >30 U/L (P-value 0.004 and 0.007). The GG genotypes of PNPLA3 rs738409 and rs2896019 had higher FibroScan-aspartate aminotransferase (FAST) and APRI scores than the CC + CG and TT + TG genotypes (P-value < 0.05). In addition, multivariate analysis revealed that the GG genotypes of rs738409 and rs2896019 were significant risk factors independent of cardiovascular metabolic risk for patients with MASLD (P-value 0.038 and 0.021).
Conclusion
An individualized treatment approach is warranted for patients with MASLD due to the influence of various factors on its progression, including genetic factors and lifestyle diseases.
{"title":"An epidemiological study on the factors including genetic polymorphism influencing ALT >30 U/L and liver fibrosis progression in metabolic dysfunction-associated steatotic liver disease among the general population","authors":"Satoshi Sato, Chikara Iino, Takafumi Sasada, Go Soma, Keisuke Furusawa, Kenta Yoshida, Kaori Sawada, Tatsuya Mikami, Shinsaku Fukuda, Shigeyuki Nakaji, Hirotake Sakuraba","doi":"10.1002/jgh3.70043","DOIUrl":"https://doi.org/10.1002/jgh3.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Identifying the factors contributing to the progression of metabolic dysfunction-associated steatotic liver disease (MASLD), a lifestyle-related disease, is crucial for preventing future liver-related deaths. This study aimed to epidemiologically investigate factors, including single-nucleotide polymorphisms (SNPs) associated with alanine aminotransferase (ALT) levels >30 U/L and potential risk factors for liver fibrosis, in a general population cohort of patients with MASLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Among 1059 participants in the health checkup project, 228 who were diagnosed with MASLD were analyzed. Liver fat content and stiffness were measured using FibroScan, and 13 SNPs associated with non-alcoholic fatty liver disease (NAFLD) were measured in addition to other clinical parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the multivariate analysis, male sex, younger age, and high triglyceride levels were significant risk factors for ALT levels >30 U/L (<i>P</i>-value < 0.05). Furthermore, among the 13 SNPs measured, only the GG genotypes of patatin-like phospholipase domain-containing 3 gene (PNPLA3) rs738409 and rs2896019 were significant risk factors for ALT levels >30 U/L (<i>P</i>-value 0.004 and 0.007). The GG genotypes of PNPLA3 rs738409 and rs2896019 had higher FibroScan-aspartate aminotransferase (FAST) and APRI scores than the CC + CG and TT + TG genotypes (<i>P</i>-value < 0.05). In addition, multivariate analysis revealed that the GG genotypes of rs738409 and rs2896019 were significant risk factors independent of cardiovascular metabolic risk for patients with MASLD (<i>P</i>-value 0.038 and 0.021).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>An individualized treatment approach is warranted for patients with MASLD due to the influence of various factors on its progression, including genetic factors and lifestyle diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jin Li, Xiaoshan Huang, Jiayu Lin, Jian Huang, Wanjie Zhu
An old woman with severe constipation was dignosed with sigmoid torsion and time-limited surgery was performed to save her life.
一位患有严重便秘的老妇人被诊断为乙状结肠扭转，并进行了有限的手术以挽救她的生命。
{"title":"Extremely dilated intestine","authors":"Jin Li, Xiaoshan Huang, Jiayu Lin, Jian Huang, Wanjie Zhu","doi":"10.1002/jgh3.70050","DOIUrl":"https://doi.org/10.1002/jgh3.70050","url":null,"abstract":"<p>An old woman with severe constipation was dignosed with sigmoid torsion and time-limited surgery was performed to save her life.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 79-year-old man undergoing treatment with warfarin for atrial fibrillation and hemodialysis for renal failure was transferred to our hospital for rehabilitation. During a maintenance hemodialysis session, blood pressure was shown to be elevated and an intramural duodenal hematoma suddenly occurred. After 3 days, the hematoma had enlarged and angiographic embolization was performed, with complete resolution noted after 2 months. Occurrence of an intramural duodenal hematoma during hemodialysis is rare. However, acute abdominal pain with symptoms indicating obstruction in patients undergoing such treatment should raise suspicion regarding an intramural duodenal hematoma. Although conservative treatment is often effective for a nontraumatic intramural hematoma, early angiographic embolization is preferred when disruption of anticoagulant therapy is difficult or for patients with failed medical treatment.
{"title":"Sudden Onset of Intramural Duodenal Hematoma During Hemodialysis in Hypertensive Patient","authors":"Hideaki Kazumori","doi":"10.1002/jgh3.70078","DOIUrl":"10.1002/jgh3.70078","url":null,"abstract":"<p>A 79-year-old man undergoing treatment with warfarin for atrial fibrillation and hemodialysis for renal failure was transferred to our hospital for rehabilitation. During a maintenance hemodialysis session, blood pressure was shown to be elevated and an intramural duodenal hematoma suddenly occurred. After 3 days, the hematoma had enlarged and angiographic embolization was performed, with complete resolution noted after 2 months. Occurrence of an intramural duodenal hematoma during hemodialysis is rare. However, acute abdominal pain with symptoms indicating obstruction in patients undergoing such treatment should raise suspicion regarding an intramural duodenal hematoma. Although conservative treatment is often effective for a nontraumatic intramural hematoma, early angiographic embolization is preferred when disruption of anticoagulant therapy is difficult or for patients with failed medical treatment.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad Ehsan, Aamna Badar Ahmad, Haseeba Javed, Afra Zahid, Hafiz Sheheryar Aamir, Huzaifa Ahmad Cheema, Muhammad Ayyan, Biah Mustafa, Abia Shahid, Muhammad Abdullah Ilyas, Kamal Kandel, Rehmat Ullah Awan, Sana Iqbal
Background
A conservative strategy is the primary modality of treatment for acute pancreatitis of which fluid replacement is an important component. Since the results regarding early aggressive versus moderate fluid replenishment for acute pancreatitis are inconsistent, we sought to compare outcomes between the two resuscitation strategies in our meta-analysis.
Methods
We searched MEDLINE (PubMed), Embase, the Cochrane Library, and ClinicalTrials.gov for all available randomized controlled trials (RCTs) assessing outcomes for patients treated with aggressive fluid replacement compared to moderate fluid replacement. Our primary outcome was all-cause mortality.
Results
Our meta-analysis included 6 RCTs involving a total of 632 patients. Our results showed that aggressive fluid resuscitation increased the risk of all-cause mortality as compared to moderate fluid replacement (RR 2.40, CI: 1.38–4.19). For all of our secondary outcomes which included the development of organ failure, severe pancreatitis, pancreatic necrosis, clinical improvement, development of SIRS, persistent SIRS, and length of hospital stay, the results indicate that there was no significant difference between the two groups.
Conclusions
Aggressive fluid resuscitation is associated with higher mortality as compared to moderate fluid replacement in patients with acute pancreatitis. RCTs with larger sample sizes are needed to provide greater statistical power and establish more definitive conclusions.
{"title":"Aggressive Versus Moderate Fluid Replacement for Acute Pancreatitis: An Updated Systematic Review and Meta-Analysis","authors":"Muhammad Ehsan, Aamna Badar Ahmad, Haseeba Javed, Afra Zahid, Hafiz Sheheryar Aamir, Huzaifa Ahmad Cheema, Muhammad Ayyan, Biah Mustafa, Abia Shahid, Muhammad Abdullah Ilyas, Kamal Kandel, Rehmat Ullah Awan, Sana Iqbal","doi":"10.1002/jgh3.70073","DOIUrl":"10.1002/jgh3.70073","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A conservative strategy is the primary modality of treatment for acute pancreatitis of which fluid replacement is an important component. Since the results regarding early aggressive versus moderate fluid replenishment for acute pancreatitis are inconsistent, we sought to compare outcomes between the two resuscitation strategies in our meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched MEDLINE (PubMed), Embase, the Cochrane Library, and ClinicalTrials.gov for all available randomized controlled trials (RCTs) assessing outcomes for patients treated with aggressive fluid replacement compared to moderate fluid replacement. Our primary outcome was all-cause mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our meta-analysis included 6 RCTs involving a total of 632 patients. Our results showed that aggressive fluid resuscitation increased the risk of all-cause mortality as compared to moderate fluid replacement (RR 2.40, CI: 1.38–4.19). For all of our secondary outcomes which included the development of organ failure, severe pancreatitis, pancreatic necrosis, clinical improvement, development of SIRS, persistent SIRS, and length of hospital stay, the results indicate that there was no significant difference between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Aggressive fluid resuscitation is associated with higher mortality as compared to moderate fluid replacement in patients with acute pancreatitis. RCTs with larger sample sizes are needed to provide greater statistical power and establish more definitive conclusions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mai Ling Perman, Chris Hair, Joji Malani, Finlay Macrae, Dianne Jones, Eileen Natuzzi, Rooney Jagilly
Aims
This study aims to evaluate the current state of endoscopy services in Pacific Island Countries (PICs) by quantifying human and material resources, including the number of trained endoscopists and nurses, the types of procedures performed, and the availability and maintenance of endoscopic equipment.
Methods and Results
A mixed methods survey was conducted in 2023, targeting doctors and nurses who participated in the WGO-FNU-ANZGITA endoscopy training program as well as non-participants. Survey invitations were sent through email, WhatsApp, and Facebook Messenger. Data were collected from 16 sites across 12 PICs, achieving an 85% response rate. Survey results indicated a total of 58 endoscopists (2.1/100000 population) and 52 nurses (1.9/100000 population), with a majority having received training through international partnerships. Basic endoscopy services, such as gastroscopy and colonoscopy, were widely available, but advanced procedures were limited to a few sites. Most sites reported using donated equipment, with significant challenges in equipment maintenance and repair. The availability of functional endoscopes averaged four per site. Common issues included outdated equipment, lack of qualified personnel, and insufficient funding for new equipment.
Conclusion
Despite efforts to enhance endoscopy services in PICs through international collaborations, significant gaps remain, particularly in terms of advanced procedural capacity and equipment maintenance. Recommendations include expanding training programs, improving equipment maintenance infrastructure, securing funding for new equipment, and fostering stronger partnerships to support the sustainability of endoscopy services. Addressing these areas can enhance the quality and availability of endoscopy services, ultimately improving healthcare outcomes for populations in PICs.
{"title":"A Quantitative Analysis of Human and Material Resources for Endoscopy Services in Pacific Island Countries","authors":"Mai Ling Perman, Chris Hair, Joji Malani, Finlay Macrae, Dianne Jones, Eileen Natuzzi, Rooney Jagilly","doi":"10.1002/jgh3.70068","DOIUrl":"10.1002/jgh3.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aims to evaluate the current state of endoscopy services in Pacific Island Countries (PICs) by quantifying human and material resources, including the number of trained endoscopists and nurses, the types of procedures performed, and the availability and maintenance of endoscopic equipment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>A mixed methods survey was conducted in 2023, targeting doctors and nurses who participated in the WGO-FNU-ANZGITA endoscopy training program as well as non-participants. Survey invitations were sent through email, WhatsApp, and Facebook Messenger. Data were collected from 16 sites across 12 PICs, achieving an 85% response rate. Survey results indicated a total of 58 endoscopists (2.1/100000 population) and 52 nurses (1.9/100000 population), with a majority having received training through international partnerships. Basic endoscopy services, such as gastroscopy and colonoscopy, were widely available, but advanced procedures were limited to a few sites. Most sites reported using donated equipment, with significant challenges in equipment maintenance and repair. The availability of functional endoscopes averaged four per site. Common issues included outdated equipment, lack of qualified personnel, and insufficient funding for new equipment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite efforts to enhance endoscopy services in PICs through international collaborations, significant gaps remain, particularly in terms of advanced procedural capacity and equipment maintenance. Recommendations include expanding training programs, improving equipment maintenance infrastructure, securing funding for new equipment, and fostering stronger partnerships to support the sustainability of endoscopy services. Addressing these areas can enhance the quality and availability of endoscopy services, ultimately improving healthcare outcomes for populations in PICs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pengfei Yu, Li Lin, Kaiyuan Xue, Jingwen Yang, Shanshan Wang, Yuepeng An, Suqing Yang
Aims
This review aimed to investigate whether atopic dermatitis (AD) increases the risk of inflammatory bowel disease (IBD) by analyzing data from longitudinal studies.
Methods
Cohort and case–control studies evaluating the association between AD and the risk of IBD, Crohn's disease (CD), or ulcerative colitis (UC) were included. Literature searches were conducted in PubMed, CENTRAL, Embase, Scopus, and Web of Science databases up to April 15, 2024.
Results
A total of eight retrospective cohort studies comprising 61 190 816 participants were included. Meta-analysis revealed that AD significantly increased the risk of IBD (OR: 1.37, 95% CI: 1.31–1.43) without statistical heterogeneity. Further pooled analysis showed that AD was a significant risk factor for CD (OR: 1.51, 95% CI: 1.31–1.76) and UC (OR: 1.33, 95% CI: 1.13–1.56), with high inter-study heterogeneity (I2 = 83% and 89%, respectively). Sensitivity analyses confirmed the robustness of the results.
Conclusion
AD is associated with an increased risk of IBD, significantly elevating the risk of both CD and UC.
{"title":"The Association Between Atopic Dermatitis and Inflammatory Bowel Disease Risk: A Meta-Analysis of Longitudinal Studies","authors":"Pengfei Yu, Li Lin, Kaiyuan Xue, Jingwen Yang, Shanshan Wang, Yuepeng An, Suqing Yang","doi":"10.1002/jgh3.70077","DOIUrl":"10.1002/jgh3.70077","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This review aimed to investigate whether atopic dermatitis (AD) increases the risk of inflammatory bowel disease (IBD) by analyzing data from longitudinal studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cohort and case–control studies evaluating the association between AD and the risk of IBD, Crohn's disease (CD), or ulcerative colitis (UC) were included. Literature searches were conducted in PubMed, CENTRAL, Embase, Scopus, and Web of Science databases up to April 15, 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of eight retrospective cohort studies comprising 61 190 816 participants were included. Meta-analysis revealed that AD significantly increased the risk of IBD (OR: 1.37, 95% CI: 1.31–1.43) without statistical heterogeneity. Further pooled analysis showed that AD was a significant risk factor for CD (OR: 1.51, 95% CI: 1.31–1.76) and UC (OR: 1.33, 95% CI: 1.13–1.56), with high inter-study heterogeneity (<i>I</i><sup>2</sup> = 83% and 89%, respectively). Sensitivity analyses confirmed the robustness of the results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AD is associated with an increased risk of IBD, significantly elevating the risk of both CD and UC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Uday C Ghoshal, Akshay Kulkarni, Vivek V Shirol, Anshuman Elhence, Bushra Fatima, Anand P Agrahari, Asha Misra
Background and Aim
Spectrum of esophageal motility disorders may differ according to age, but studies on this are scanty, contradictory, and included small number of patients. Accordingly, we retrospectively analyzed data of a large sample of patients to study the spectrum of esophageal motility disorders in relation to age, and to evaluate the clinical profile and high-resolution manometry parameters and achalasia subtypes according to Chicago IV criteria.
Methods
Of 909 patients evaluated by high-resolution water perfusion or solid-state manometry during a 3-year period, data on 801 were finally analyzed.
Results
Achalasia cardia was the commonest motility disorder of esophagus in this large study and type II was the commonest subtype. There was no difference in clinical and manometry parameters among elderly patients as compared to younger patients with achalasia. Type I achalasia patients less often had chest pain and tended to have nocturnal coughing spells more often, and patients with achalasia experiencing chest pain tended to have higher distal contractile integral (DCI) than those not having pain irrespective of age.
Conclusion
The clinical and high-resolution manometry parameters among young and elderly patients with esophageal motility disorders are quite comparable. However, these differed in relation to achalasia subtypes and symptoms. Type I achalasia patients less often had chest pain and those experiencing chest pain tended to have higher DCI values than those not having pain irrespective of age.
{"title":"Clinical and high-resolution manometry of 801 patients with esophageal dysmotility, including achalasia, in relation to age","authors":"Uday C Ghoshal, Akshay Kulkarni, Vivek V Shirol, Anshuman Elhence, Bushra Fatima, Anand P Agrahari, Asha Misra","doi":"10.1002/jgh3.70040","DOIUrl":"10.1002/jgh3.70040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Spectrum of esophageal motility disorders may differ according to age, but studies on this are scanty, contradictory, and included small number of patients. Accordingly, we retrospectively analyzed data of a large sample of patients to study the spectrum of esophageal motility disorders in relation to age, and to evaluate the clinical profile and high-resolution manometry parameters and achalasia subtypes according to Chicago IV criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Of 909 patients evaluated by high-resolution water perfusion or solid-state manometry during a 3-year period, data on 801 were finally analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Achalasia cardia was the commonest motility disorder of esophagus in this large study and type II was the commonest subtype. There was no difference in clinical and manometry parameters among elderly patients as compared to younger patients with achalasia. Type I achalasia patients less often had chest pain and tended to have nocturnal coughing spells more often, and patients with achalasia experiencing chest pain tended to have higher distal contractile integral (DCI) than those not having pain irrespective of age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The clinical and high-resolution manometry parameters among young and elderly patients with esophageal motility disorders are quite comparable. However, these differed in relation to achalasia subtypes and symptoms. Type I achalasia patients less often had chest pain and those experiencing chest pain tended to have higher DCI values than those not having pain irrespective of age.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Underwater endoscopic mucosal resection (UEMR) has emerged as a promising alternative to conventional endoscopic mucosal resection (CEMR) for the treatment of colorectal laterally spreading tumors (LSTs). This study aimed to compare the efficacy and safety of UEMR and CEMR in managing LSTs measuring 10–30 mm.
Methods
A post hoc analysis was performed on 88 patients with 88 colorectal LSTs, who were randomly assigned to two treatment groups: 42 with CEMR and 46 with UEMR. The primary outcome was the rate of R0 resection, defined as the absence of neoplastic cells at the resection margin. The secondary outcomes included en bloc resection rates, procedure times, and postprocedural complications. The data were analyzed via chi-square tests, t tests, and the Mann–Whitney U test where appropriate.
Results
No significant difference was found in the R0 resection rate between UEMR and CEMR. However, UEMR achieved a significantly higher en bloc resection rate, particularly for LSTs ranging from 20 to 30 mm (42.9% for CEMR vs. 100% for UEMR; p = 0.009). Additionally, UEMR resulted in a shorter median procedure time (85.0 s for UEMR vs. 207.5 s for CEMR; p < 0.001). There was no significant difference in bleeding complications or the number of clips used between the two groups.
Conclusions
Compared with CEMR, UEMR offers a higher en bloc resection rate and a shorter procedure time, particularly for larger lesions, without increasing the risk of complications. UEMR should be considered a preferred option for managing colorectal LSTs, especially those measuring 20–30 mm.
{"title":"Underwater Versus Conventional Endoscopic Mucosal Resection for Colorectal Laterally Spreading Tumors: A Post Hoc Analysis of Efficacy","authors":"Quang Dinh Le, Nhan Quang Le, Duc Trong Quach","doi":"10.1002/jgh3.70075","DOIUrl":"10.1002/jgh3.70075","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Underwater endoscopic mucosal resection (UEMR) has emerged as a promising alternative to conventional endoscopic mucosal resection (CEMR) for the treatment of colorectal laterally spreading tumors (LSTs). This study aimed to compare the efficacy and safety of UEMR and CEMR in managing LSTs measuring 10–30 mm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A post hoc analysis was performed on 88 patients with 88 colorectal LSTs, who were randomly assigned to two treatment groups: 42 with CEMR and 46 with UEMR. The primary outcome was the rate of R0 resection, defined as the absence of neoplastic cells at the resection margin. The secondary outcomes included en bloc resection rates, procedure times, and postprocedural complications. The data were analyzed via chi-square tests, <i>t</i> tests, and the Mann–Whitney U test where appropriate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant difference was found in the R0 resection rate between UEMR and CEMR. However, UEMR achieved a significantly higher en bloc resection rate, particularly for LSTs ranging from 20 to 30 mm (42.9% for CEMR vs. 100% for UEMR; <i>p</i> = 0.009). Additionally, UEMR resulted in a shorter median procedure time (85.0 s for UEMR vs. 207.5 s for CEMR; <i>p</i> < 0.001). There was no significant difference in bleeding complications or the number of clips used between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared with CEMR, UEMR offers a higher en bloc resection rate and a shorter procedure time, particularly for larger lesions, without increasing the risk of complications. UEMR should be considered a preferred option for managing colorectal LSTs, especially those measuring 20–30 mm.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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