R. Cioeta, Paola Muti, M. Rigoni, Andrea Cossu, Emiliano Giovagnoni
Diarrhea continues to be a global health problem as acute diarrhea carries the risk of dehydration, while both acute and chronic diarrhea can significantly affect patients’ quality of life and reduce productivity. The innovative medical device Actitan, which consists of a complex of natural molecules, could be an effective option for the treatment of diarrhea from various causes. The aim of this post-market cross-sectional study was to evaluate the perceived efficacy, safety and usage pattern of the two formulations for adults (Actitan-P) and children (Actitan-F) among patients/child caregivers, physicians and pharmacists. Participants completed online questionnaires with closed multiple-choice questions that were rated on a verbal 5-point Likert scale. These surveys were conducted via the online platform Real World Data, which provides digital questionnaires for patients, doctors and pharmacists. Two separate surveys were conducted for the two formulations, with a total of 2630 participants (1488 participants for Actitan-P and 1142 participants for Actitan-F). Overall, the results indicate a high level of efficacy and safety of the product. In the case of Actitan-F, more than 96% of caregivers rated safety as good or excellent, and over 92% rated efficacy as good or excellent. Actitan-P also received positive feedback: nearly 86% of patients reported good/excellent efficacy, and more than 93% rated safety as good or excellent. These positive evaluations were confirmed by physicians and pharmacists, who also did not report adverse effects. In summary, this study confirms the role of Actitan as a safe and effective option for the treatment of diarrhea of different causes and in different patient groups, including young children.
腹泻仍然是一个全球性的健康问题，因为急性腹泻有脱水的风险，而急性和慢性腹泻都会严重影响患者的生活质量，降低工作效率。由天然分子复合物组成的创新医疗设备 Actitan 可以有效治疗各种原因引起的腹泻。这项上市后横断面研究旨在评估患者/儿童护理人员、医生和药剂师对成人（Actitan-P）和儿童（Actitan-F）两种制剂的疗效、安全性和使用模式的认知。参与者填写了在线问卷，问卷中包含封闭式多选题，采用口头 5 点李克特量表评分。这些调查是通过在线平台 Real World Data 进行的，该平台为患者、医生和药剂师提供数字问卷。针对两种制剂分别进行了两次调查，共有 2630 人参与（1488 人参与 Actitan-P，1142 人参与 Actitan-F）。总体而言，调查结果表明该产品具有很高的疗效和安全性。对于 Actitan-F，96% 以上的护理人员将其安全性评为 "良好 "或 "优秀"，92% 以上的护理人员将其疗效评为 "良好 "或 "优秀"。Actitan-P 也获得了积极的反馈：近 86% 的患者表示疗效良好/出色，93% 以上的患者将安全性评为良好或优秀。这些积极评价得到了医生和药剂师的证实，他们也没有报告不良反应。总之，这项研究证实了 Actitan 是治疗不同病因和不同患者群体（包括幼儿）腹泻的一种安全有效的选择。
{"title":"Actitan: A Natural Complex for Managing Diarrhea—Insights from Cross-Sectional Survey Research Involving Patients, Pharmacists and Physicians","authors":"R. Cioeta, Paola Muti, M. Rigoni, Andrea Cossu, Emiliano Giovagnoni","doi":"10.3390/gidisord6030051","DOIUrl":"https://doi.org/10.3390/gidisord6030051","url":null,"abstract":"Diarrhea continues to be a global health problem as acute diarrhea carries the risk of dehydration, while both acute and chronic diarrhea can significantly affect patients’ quality of life and reduce productivity. The innovative medical device Actitan, which consists of a complex of natural molecules, could be an effective option for the treatment of diarrhea from various causes. The aim of this post-market cross-sectional study was to evaluate the perceived efficacy, safety and usage pattern of the two formulations for adults (Actitan-P) and children (Actitan-F) among patients/child caregivers, physicians and pharmacists. Participants completed online questionnaires with closed multiple-choice questions that were rated on a verbal 5-point Likert scale. These surveys were conducted via the online platform Real World Data, which provides digital questionnaires for patients, doctors and pharmacists. Two separate surveys were conducted for the two formulations, with a total of 2630 participants (1488 participants for Actitan-P and 1142 participants for Actitan-F). Overall, the results indicate a high level of efficacy and safety of the product. In the case of Actitan-F, more than 96% of caregivers rated safety as good or excellent, and over 92% rated efficacy as good or excellent. Actitan-P also received positive feedback: nearly 86% of patients reported good/excellent efficacy, and more than 93% rated safety as good or excellent. These positive evaluations were confirmed by physicians and pharmacists, who also did not report adverse effects. In summary, this study confirms the role of Actitan as a safe and effective option for the treatment of diarrhea of different causes and in different patient groups, including young children.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141926159","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}
Yeliz Serin, Camilla Manini, Pasqualino Amato, Anil K. Verma
A healthy and balanced diet is a critical requirement for pregnant women as it directly influences both the mother’s and infant’s health. Poor maternal nutrition can lead to pregnancy-related complications with undesirable effects on the fetus. This requirement is equally important for pregnant women with celiac disease (CD) who are already on a gluten-free diet (GFD). Although the GFD is the sole treatment option for CD, it still presents some challenges and confusion for celiac women who wish to conceive. Poorly managed CD has been linked to miscarriages, preterm labor, low birth weight, and stillbirths. Current CD guidelines primarily focus on screening, diagnosis, treatment, and management but lack an evidence-based approach to determine appropriate energy requirements, recommended weight gain during pregnancy, target macronutrient distribution from the diet, the recommended intake of vitamins and minerals from diet and/or supplementation, timing for starting supplementation, and advised portions of gluten-free foods during pregnancy. We recommend and call for the development of such guidelines and/or authoritative papers in the future.
健康均衡的饮食是孕妇的一项重要要求，因为它直接影响到母婴健康。孕妇营养不良会导致与妊娠有关的并发症，对胎儿造成不良影响。对于已经在接受无麸质饮食（GFD）的腹腔疾病（CD）孕妇来说，这一要求同样重要。虽然无麸质饮食是 CD 的唯一治疗方案，但它仍然给希望怀孕的乳糜泻妇女带来了一些挑战和困惑。处理不当的 CD 与流产、早产、低出生体重和死胎有关。目前的 CD 指南主要关注筛查、诊断、治疗和管理，但缺乏循证方法来确定适当的能量需求、孕期建议的体重增加、饮食中目标宏量营养素的分配、饮食和/或补充剂中维生素和矿物质的建议摄入量、开始补充剂的时间以及孕期无麸质食品的建议份量。我们建议并呼吁今后制定此类指南和/或权威文件。
{"title":"The Impact of a Gluten-Free Diet on Pregnant Women with Celiac Disease: Do We Need a Guideline to Manage Their Health?","authors":"Yeliz Serin, Camilla Manini, Pasqualino Amato, Anil K. Verma","doi":"10.3390/gidisord6030045","DOIUrl":"https://doi.org/10.3390/gidisord6030045","url":null,"abstract":"A healthy and balanced diet is a critical requirement for pregnant women as it directly influences both the mother’s and infant’s health. Poor maternal nutrition can lead to pregnancy-related complications with undesirable effects on the fetus. This requirement is equally important for pregnant women with celiac disease (CD) who are already on a gluten-free diet (GFD). Although the GFD is the sole treatment option for CD, it still presents some challenges and confusion for celiac women who wish to conceive. Poorly managed CD has been linked to miscarriages, preterm labor, low birth weight, and stillbirths. Current CD guidelines primarily focus on screening, diagnosis, treatment, and management but lack an evidence-based approach to determine appropriate energy requirements, recommended weight gain during pregnancy, target macronutrient distribution from the diet, the recommended intake of vitamins and minerals from diet and/or supplementation, timing for starting supplementation, and advised portions of gluten-free foods during pregnancy. We recommend and call for the development of such guidelines and/or authoritative papers in the future.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141830332","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}
S. G. Testoni, P. Testoni, C. Notaristefano, E. Viale, G. M. Cavestro
Background. The large number of lesions detected via high-definition (HD) imaging during colonoscopy calls for the reliable real-time histological characterization of polyps, especially diminutive and small ones, to permit tailored management based on the neoplastic risk, such as a “resect-and-discard” or a “diagnose-and-leave” strategy for low-risk adenomas and hyperplastic polyps (HPs). The Kudo classification of glandular pit pattern is currently used for predicting polyp histology. Aim. The aim in this study was to assess whether Kudo’s glandular pit pattern, assessed via HD digital chromoendoscopy (i-Scan) without magnification and optical enhancement, reliably predicts polyp histology and differentiates neoplastic lesions (NLs) from non-neoplastic lesions (non-NLs) during routine colonoscopy. Methods. Consecutive colorectal lesions recorded in a database over 12 months, with Kudo’s glandular pit pattern classification, were retrospectively compared with histology. The diagnostic accuracy and negative predictive value (NPV) for adenomatous histology of Kudo’s pit patterns were assessed separately for diminutive (≤5 mm) and small (6–9 mm) polyps, accordingly to the American Society for Gastrointestinal Endoscopy (ASGE) Preservation and Incorporation of Valuable Endoscopic Innovations (PIVI), and in large (≥10 mm) lesions. Results. A total of 2230 lesions were recorded: 898 diminutive, 704 small, and 628 large. Kudo’s type II pit pattern was prevalent in diminutive polyps and recognized mostly in HPs (83.27%); it was also found in 38.8% of adenomas. In the right colon, Kudo’s type II pit pattern was prevalent in adenomas (70.04% vs. 20.74% in HPs); among the serrated lesions, it was evenly distributed between HPs and adenomas. Kudo’s type IIIL/IIIs/IV pit pattern was prevalent in NLs (61% vs. 8.37% of non-NLs) in diminutive polyps, evenly distributed between non-NLs and NLs in small polyps, and found only in NLs in large polyps. Kudo’s type Vi/Vn pit pattern correctly identified all but one adenocarcinoma. The NPV for adenomatous histology did not reach the recommended 90% PIVI threshold for differentiation between NLs and non-NLs in diminutive polyps showing Kudo’s type II pit pattern and in small polyps showing type IIIL/IIIs/IV pit pattern. Conclusions. Kudo’s pit pattern classification carried out with digital chromoendoscopy (i-Scan) during routine colonoscopy does not allow the reliable differentiation between non-NLs and NLs in diminutive and small polyps, so a “diagnose-and-leave” strategy for diminutive polyps may leave undetected adenomas, while a “resect-and-discard” strategy could miss lesions requiring closer follow-up.
{"title":"Reliability of Kudo’s Glandular Pit Pattern in Predicting Colorectal Lesion Histology at Routine Colonoscopy with Digital Chromoendoscopy","authors":"S. G. Testoni, P. Testoni, C. Notaristefano, E. Viale, G. M. Cavestro","doi":"10.3390/gidisord6030044","DOIUrl":"https://doi.org/10.3390/gidisord6030044","url":null,"abstract":"Background. The large number of lesions detected via high-definition (HD) imaging during colonoscopy calls for the reliable real-time histological characterization of polyps, especially diminutive and small ones, to permit tailored management based on the neoplastic risk, such as a “resect-and-discard” or a “diagnose-and-leave” strategy for low-risk adenomas and hyperplastic polyps (HPs). The Kudo classification of glandular pit pattern is currently used for predicting polyp histology. Aim. The aim in this study was to assess whether Kudo’s glandular pit pattern, assessed via HD digital chromoendoscopy (i-Scan) without magnification and optical enhancement, reliably predicts polyp histology and differentiates neoplastic lesions (NLs) from non-neoplastic lesions (non-NLs) during routine colonoscopy. Methods. Consecutive colorectal lesions recorded in a database over 12 months, with Kudo’s glandular pit pattern classification, were retrospectively compared with histology. The diagnostic accuracy and negative predictive value (NPV) for adenomatous histology of Kudo’s pit patterns were assessed separately for diminutive (≤5 mm) and small (6–9 mm) polyps, accordingly to the American Society for Gastrointestinal Endoscopy (ASGE) Preservation and Incorporation of Valuable Endoscopic Innovations (PIVI), and in large (≥10 mm) lesions. Results. A total of 2230 lesions were recorded: 898 diminutive, 704 small, and 628 large. Kudo’s type II pit pattern was prevalent in diminutive polyps and recognized mostly in HPs (83.27%); it was also found in 38.8% of adenomas. In the right colon, Kudo’s type II pit pattern was prevalent in adenomas (70.04% vs. 20.74% in HPs); among the serrated lesions, it was evenly distributed between HPs and adenomas. Kudo’s type IIIL/IIIs/IV pit pattern was prevalent in NLs (61% vs. 8.37% of non-NLs) in diminutive polyps, evenly distributed between non-NLs and NLs in small polyps, and found only in NLs in large polyps. Kudo’s type Vi/Vn pit pattern correctly identified all but one adenocarcinoma. The NPV for adenomatous histology did not reach the recommended 90% PIVI threshold for differentiation between NLs and non-NLs in diminutive polyps showing Kudo’s type II pit pattern and in small polyps showing type IIIL/IIIs/IV pit pattern. Conclusions. Kudo’s pit pattern classification carried out with digital chromoendoscopy (i-Scan) during routine colonoscopy does not allow the reliable differentiation between non-NLs and NLs in diminutive and small polyps, so a “diagnose-and-leave” strategy for diminutive polyps may leave undetected adenomas, while a “resect-and-discard” strategy could miss lesions requiring closer follow-up.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141661803","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}
Laith Alrubaiy, L. Pitsillides, Thomas O’Connor, Matilda Woodhill, Harry Higgins, T. K. Swaid, Doa’a Alkhader, Z. Koutoubi
Introduction: The management of Crohn’s disease (CD) in the Middle East, like in other parts of the world, is rapidly evolving with the introduction of novel advanced medical and biological therapies. In the United Arab Emirates (UAE), several biological therapies are used to achieve remission in severe and resistant cases of CD. We carried out a literature search to analyze the effectiveness and safety of biologic treatments currently licensed in the UAE. Methods: We searched the PubMed, Embase and Cochrane library databases from inception to January 2020 to identify relevant studies. Search terms were generated using established treatment guidelines for CD. We also manually searched the bibliographies of relevant literature to obtain additional papers. Results: Biologic and small molecule agents for CD include four core drug classes: anti-tumor necrosis factor-α agents (TNF-α), integrin receptor antagonists, Janus kinase (JAK) inhibitors and IL-12/IL-23 antagonists. All drug classes showed good efficacy and safety in managing patients with CD. Some drug classes had distinguishable side effect profiles. This included an increased lymphoma and tuberculous risk for TNF-α and integrin receptor antagonists. Many trials supported the effectiveness of these licensed drugs. Biologic agent intolerance was common; one-third of patients receiving TNF-α treatment will develop intolerance to that specific drug. Conclusions: Advanced medical therapies licensed in the UAE have proven to be safe and efficacious. Additional research is required to evaluate the safety and efficacy of newer biologics and biosimilars.
导言：与世界其他地区一样，中东地区的克罗恩病（CD）治疗也随着新型先进医疗和生物疗法的引入而迅速发展。在阿拉伯联合酋长国（UAE），一些生物疗法被用于缓解严重和耐药的克罗恩病病例。我们进行了文献检索，以分析目前在阿联酋获得许可的生物疗法的有效性和安全性。方法：我们检索了 PubMed、Embase 和 Cochrane 图书馆数据库中从开始到 2020 年 1 月的相关研究。检索词是根据 CD 的既定治疗指南生成的。我们还人工检索了相关文献的书目，以获取更多论文。结果：治疗CD的生物制剂和小分子药物包括四类核心药物：抗肿瘤坏死因子-α制剂（TNF-α）、整合素受体拮抗剂、Janus激酶（JAK）抑制剂和IL-12/IL-23拮抗剂。所有类别的药物在治疗 CD 患者方面均显示出良好的疗效和安全性。某些类别的药物具有不同的副作用。其中包括 TNF-α 和整合素受体拮抗剂会增加淋巴瘤和结核病的风险。许多试验支持这些已获许可药物的有效性。生物制剂不耐受很常见；三分之一接受TNF-α治疗的患者会对该特定药物产生不耐受。结论在阿联酋获得许可的先进医疗疗法已被证明是安全和有效的。还需要开展更多研究，以评估新型生物制剂和生物仿制药的安全性和疗效。
{"title":"Biologics in Focus: A Comprehensive Review of Current Biological and Small Molecules Therapies for Crohn’s Disease in the United Arab Emirates (UAE)","authors":"Laith Alrubaiy, L. Pitsillides, Thomas O’Connor, Matilda Woodhill, Harry Higgins, T. K. Swaid, Doa’a Alkhader, Z. Koutoubi","doi":"10.3390/gidisord6030043","DOIUrl":"https://doi.org/10.3390/gidisord6030043","url":null,"abstract":"Introduction: The management of Crohn’s disease (CD) in the Middle East, like in other parts of the world, is rapidly evolving with the introduction of novel advanced medical and biological therapies. In the United Arab Emirates (UAE), several biological therapies are used to achieve remission in severe and resistant cases of CD. We carried out a literature search to analyze the effectiveness and safety of biologic treatments currently licensed in the UAE. Methods: We searched the PubMed, Embase and Cochrane library databases from inception to January 2020 to identify relevant studies. Search terms were generated using established treatment guidelines for CD. We also manually searched the bibliographies of relevant literature to obtain additional papers. Results: Biologic and small molecule agents for CD include four core drug classes: anti-tumor necrosis factor-α agents (TNF-α), integrin receptor antagonists, Janus kinase (JAK) inhibitors and IL-12/IL-23 antagonists. All drug classes showed good efficacy and safety in managing patients with CD. Some drug classes had distinguishable side effect profiles. This included an increased lymphoma and tuberculous risk for TNF-α and integrin receptor antagonists. Many trials supported the effectiveness of these licensed drugs. Biologic agent intolerance was common; one-third of patients receiving TNF-α treatment will develop intolerance to that specific drug. Conclusions: Advanced medical therapies licensed in the UAE have proven to be safe and efficacious. Additional research is required to evaluate the safety and efficacy of newer biologics and biosimilars.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141670950","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}
C. Petruzziello, A. Saviano, M. Brigida, A. Migneco, Luca Luigi Manetti, M. Candelli, Veronica Ojetti
(1) Background: Lower gastrointestinal bleeding (LGIB) accounts for 20% of all gastrointestinal bleeds. LGBI originates in the colon, rectum, and anus, mainly in patients who are receiving antiaggregant or anticoagulant treatment. The major causes are diverticular disease, colitis, hemorrhoids, and angiodysplasia. The literature studies underline that Direct Oral Anticoagulants (DOACs) are effective in reducing the risk of thromboembolic events but are associated with a higher risk of lower gastrointestinal bleeding (LGIB), particularly lower hemorrhoid bleeding. (2) Methods: The aim of our review is to revise the risk of hemorrhoid bleeding, pathophysiology, and management in patients taking DOACs in light of the most modern evidence. (3) Conclusions: central to the management of hemorrhoid bleeding in patients receiving DOAC therapy is the consideration of a tailored approach that respects the delicate equilibrium between the need for thromboembolic prophylaxis and the potential for bleeding complications. Cessation of anticoagulation, if clinically feasible, constitutes a fundamental cornerstone in the control of hemorrhage. This pause in therapy aims to mitigate the exacerbation of bleeding risk while offering a window for the implementation of local measures to manage hemorrhoid bleeding.
{"title":"Risk of Hemorrhoidal Bleeding in Patients Treated with Direct Oral Anticoagulants (DOACs)","authors":"C. Petruzziello, A. Saviano, M. Brigida, A. Migneco, Luca Luigi Manetti, M. Candelli, Veronica Ojetti","doi":"10.3390/gidisord6030042","DOIUrl":"https://doi.org/10.3390/gidisord6030042","url":null,"abstract":"(1) Background: Lower gastrointestinal bleeding (LGIB) accounts for 20% of all gastrointestinal bleeds. LGBI originates in the colon, rectum, and anus, mainly in patients who are receiving antiaggregant or anticoagulant treatment. The major causes are diverticular disease, colitis, hemorrhoids, and angiodysplasia. The literature studies underline that Direct Oral Anticoagulants (DOACs) are effective in reducing the risk of thromboembolic events but are associated with a higher risk of lower gastrointestinal bleeding (LGIB), particularly lower hemorrhoid bleeding. (2) Methods: The aim of our review is to revise the risk of hemorrhoid bleeding, pathophysiology, and management in patients taking DOACs in light of the most modern evidence. (3) Conclusions: central to the management of hemorrhoid bleeding in patients receiving DOAC therapy is the consideration of a tailored approach that respects the delicate equilibrium between the need for thromboembolic prophylaxis and the potential for bleeding complications. Cessation of anticoagulation, if clinically feasible, constitutes a fundamental cornerstone in the control of hemorrhage. This pause in therapy aims to mitigate the exacerbation of bleeding risk while offering a window for the implementation of local measures to manage hemorrhoid bleeding.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141671446","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}
Omar Sharif, A. Freije, S. Al-Thawadi, D. Alromaihi, Fida Alsaffar, Essam Juma, Faisal Abubaker, Abdulrahman Barakat, Mariam Alhammadi, Zeyad Mahmood, Suha Hejres, Hanan Matar, Alice Trezza, M. Rondanelli, Simone Perna
Background/Objectives: Colorectal cancer incidence in Bahrain occurs at a ratio of 13.4–18.8 per 100,000 persons after age standardization. This study aims to explore the relationship between colorectal cancer/abnormalities and different lifestyle factors. Secondly, it aims to explore the association between f-Hb levels, colonoscopy findings, and lifestyle factors in a FIT-positive population in Bahrain. Method: A retrospective cross-sectional study was performed for patients positive for FIT and who had a colonoscopy. Different dietary and demographic factors as well as f-Hb levels were assessed. Results: A total of 559 (M: 330; F: 229) subjects were enrolled in this study. Subjects with CRC had significantly higher f-Hb concentrations (median: 1269 μg/mg) when compared with subjects of other groups. Higher percentages of CRC as well as large and small polyps were recorded in males. However, there was no significant difference in f-Hb concentration between males and females (p = 0.90). Higher median levels were found for f-Hb in patients with Q3 (higher red meat consumption) compared to Q1 and Q2 in the category with CRC, despite there being no statistically significant differences among the groups (p = 0.742). Similar results for coffee consumption and f-Hb concentrations in the different groups have been recorded (p = 0.697). A higher quartile of red meat consumption was associated with an increase in CRC risk of 79.9%. Coffee consumption reflected a lower risk of CRC by −47% moving from Q1 to Q2, while BMI was found to be a risk factor (+44%) for CRC. Conclusion: This study highlighted that high f-Hb concentration can be used as a predictive biomarker of CRC.
{"title":"Exploring the Dietary, Lifestyle, and Demographic Factors Associated with Risk for Colorectal Cancer and Colorectal Abnormalities in a Fecal Immunochemical Test-Positive Population: A Cross-Sectional Study in the Kingdom of Bahrain","authors":"Omar Sharif, A. Freije, S. Al-Thawadi, D. Alromaihi, Fida Alsaffar, Essam Juma, Faisal Abubaker, Abdulrahman Barakat, Mariam Alhammadi, Zeyad Mahmood, Suha Hejres, Hanan Matar, Alice Trezza, M. Rondanelli, Simone Perna","doi":"10.3390/gidisord6030041","DOIUrl":"https://doi.org/10.3390/gidisord6030041","url":null,"abstract":"Background/Objectives: Colorectal cancer incidence in Bahrain occurs at a ratio of 13.4–18.8 per 100,000 persons after age standardization. This study aims to explore the relationship between colorectal cancer/abnormalities and different lifestyle factors. Secondly, it aims to explore the association between f-Hb levels, colonoscopy findings, and lifestyle factors in a FIT-positive population in Bahrain. Method: A retrospective cross-sectional study was performed for patients positive for FIT and who had a colonoscopy. Different dietary and demographic factors as well as f-Hb levels were assessed. Results: A total of 559 (M: 330; F: 229) subjects were enrolled in this study. Subjects with CRC had significantly higher f-Hb concentrations (median: 1269 μg/mg) when compared with subjects of other groups. Higher percentages of CRC as well as large and small polyps were recorded in males. However, there was no significant difference in f-Hb concentration between males and females (p = 0.90). Higher median levels were found for f-Hb in patients with Q3 (higher red meat consumption) compared to Q1 and Q2 in the category with CRC, despite there being no statistically significant differences among the groups (p = 0.742). Similar results for coffee consumption and f-Hb concentrations in the different groups have been recorded (p = 0.697). A higher quartile of red meat consumption was associated with an increase in CRC risk of 79.9%. Coffee consumption reflected a lower risk of CRC by −47% moving from Q1 to Q2, while BMI was found to be a risk factor (+44%) for CRC. Conclusion: This study highlighted that high f-Hb concentration can be used as a predictive biomarker of CRC.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141679339","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}
I. Sarosiek, Alexandra N. Willauer, Karina Espino, J. Sarosiek, G. Galura, Luis Alvarado, A. Dwivedi, Brian Davis, M. Bashashati, Richard McCallum
Background: Gastric electrical stimulation (GES) therapy is indicated for the treatment of drug-refractory gastroparesis (GP). However, the long-term effects of GES therapy on GP symptom control and identification of the optimal parameters to activate this long-term efficacy have not been investigated. Methods: We conducted a retrospective cohort analysis of 57 GP patients who received GES and pyloroplasty (PP). The interrogation of the GES system and assessment of GP symptoms were conducted at the initiation of GES therapy and during follow-up visits. We determined the changes in GES parameters including voltage (V), impedance (I), and current (C). The outcome was total symptom score (TSS), which was measured by self-reported GP symptoms. Results: The mean age of patients was 44 (±14) years, and 72% were females. The etiology for GP was diabetes mellitus in 72% and idiopathic in 28%. The median duration of GES follow-up was 47 months (range 5–73) A significant decrease was found in individual symptom scores and the TSS (−10.8; 95%CI: −12.6, −9.08) compared to baseline scores (p < 0.0001). During follow-up, readings for I (515 vs. 598 Ω), V (3.3 vs. 4.8 V), and C (6.5 vs. 8.4 mA) significantly increased (p ≤ 0.0001 for all parameters). Higher GES settings were associated with lower TSS in the adjusted analysis (RC, −1.97; 95%CI: −3.81, −0.12, p = 0.037). Conclusions: these findings suggest that adjusting GES parameters over time based on optimizing symptom improvement should be incorporated into the long-term care of patients receiving gastric neurostimulation therapy.
背景：胃电刺激疗法（GES）适用于治疗药物难治性胃瘫（GP）。然而，GES疗法对GP症状控制的长期效果以及激活这种长期疗效的最佳参数尚未得到研究。方法：我们对 57 名接受 GES 和幽门成形术 (PP) 的 GP 患者进行了回顾性队列分析。在开始接受 GES 治疗时和随访期间，我们对 GES 系统进行了检查，并对 GP 症状进行了评估。我们测定了 GES 参数的变化，包括电压 (V)、阻抗 (I) 和电流 (C)。治疗结果为症状总分（TSS），通过自我报告的 GP 症状进行测量。研究结果患者平均年龄为 44（±14）岁，72% 为女性。72%患者的GP病因为糖尿病，28%为特发性。GES 随访时间的中位数为 47 个月（5-73 个月）。与基线分数相比，单个症状分数和 TSS（-10.8；95%CI：-12.6，-9.08）均有显著下降（p < 0.0001）。在随访期间，I（515 vs. 598 Ω）、V（3.3 vs. 4.8 V）和C（6.5 vs. 8.4 mA）读数显著增加（所有参数的 p 均小于 0.0001）。在调整分析中，较高的 GES 设置与较低的 TSS 相关（RC，-1.97；95%CI：-3.81，-0.12，p = 0.037）。结论：这些研究结果表明，在接受胃神经刺激治疗的患者的长期护理中，应根据症状改善的最佳情况逐步调整 GES 参数。
{"title":"Optimal Parameters for Gastric Electrical Stimulation Therapy for Long-Term Symptom Control in Patients with Gastroparesis","authors":"I. Sarosiek, Alexandra N. Willauer, Karina Espino, J. Sarosiek, G. Galura, Luis Alvarado, A. Dwivedi, Brian Davis, M. Bashashati, Richard McCallum","doi":"10.3390/gidisord6020037","DOIUrl":"https://doi.org/10.3390/gidisord6020037","url":null,"abstract":"Background: Gastric electrical stimulation (GES) therapy is indicated for the treatment of drug-refractory gastroparesis (GP). However, the long-term effects of GES therapy on GP symptom control and identification of the optimal parameters to activate this long-term efficacy have not been investigated. Methods: We conducted a retrospective cohort analysis of 57 GP patients who received GES and pyloroplasty (PP). The interrogation of the GES system and assessment of GP symptoms were conducted at the initiation of GES therapy and during follow-up visits. We determined the changes in GES parameters including voltage (V), impedance (I), and current (C). The outcome was total symptom score (TSS), which was measured by self-reported GP symptoms. Results: The mean age of patients was 44 (±14) years, and 72% were females. The etiology for GP was diabetes mellitus in 72% and idiopathic in 28%. The median duration of GES follow-up was 47 months (range 5–73) A significant decrease was found in individual symptom scores and the TSS (−10.8; 95%CI: −12.6, −9.08) compared to baseline scores (p < 0.0001). During follow-up, readings for I (515 vs. 598 Ω), V (3.3 vs. 4.8 V), and C (6.5 vs. 8.4 mA) significantly increased (p ≤ 0.0001 for all parameters). Higher GES settings were associated with lower TSS in the adjusted analysis (RC, −1.97; 95%CI: −3.81, −0.12, p = 0.037). Conclusions: these findings suggest that adjusting GES parameters over time based on optimizing symptom improvement should be incorporated into the long-term care of patients receiving gastric neurostimulation therapy.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141352285","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}
V. Ionescu, G. Gheorghe, T. Georgescu, Vlad Buică, Mihai-Ștefan Cătănescu, Iris-Andreea Cercel, Beatrice Budeanu, Mihail Budan, Nicolae Bacalbasa, Camelia Diaconu
Colorectal cancer is currently a public health concern due to its high incidence, morbidity, and mortality rates. Researchers have identified the intestinal microbiome as a crucial factor in the development of this disease. Currently, specialized literature data support the role of the microbiota in both the development of colorectal cancer and resistance to oncological therapies. Therefore, studying the composition of the gut microbiome can aid in creating risk assessment tools to identify specific populations that would benefit from tailored screening approaches. Also, manipulation of the intestinal microbiome can be useful in improving the response to chemotherapy or immunotherapy. Identifying the pathogenic mechanisms responsible for this causal link can aid in the discovery of novel treatment targets. This article will provide the latest information regarding the influence of the intestinal microbiota on the development and progression of colorectal cancer.
{"title":"Exploring the Role of the Gut Microbiota in Colorectal Cancer Development","authors":"V. Ionescu, G. Gheorghe, T. Georgescu, Vlad Buică, Mihai-Ștefan Cătănescu, Iris-Andreea Cercel, Beatrice Budeanu, Mihail Budan, Nicolae Bacalbasa, Camelia Diaconu","doi":"10.3390/gidisord6020036","DOIUrl":"https://doi.org/10.3390/gidisord6020036","url":null,"abstract":"Colorectal cancer is currently a public health concern due to its high incidence, morbidity, and mortality rates. Researchers have identified the intestinal microbiome as a crucial factor in the development of this disease. Currently, specialized literature data support the role of the microbiota in both the development of colorectal cancer and resistance to oncological therapies. Therefore, studying the composition of the gut microbiome can aid in creating risk assessment tools to identify specific populations that would benefit from tailored screening approaches. Also, manipulation of the intestinal microbiome can be useful in improving the response to chemotherapy or immunotherapy. Identifying the pathogenic mechanisms responsible for this causal link can aid in the discovery of novel treatment targets. This article will provide the latest information regarding the influence of the intestinal microbiota on the development and progression of colorectal cancer.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141350930","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}
Inflammatory bowel disease (IBD) is a clinical condition of the gastrointestinal tract that has significant incidence in childhood. Major symptoms include abdominal pain, dyspepsia, delayed gastric emptying, anorexia, diarrhea and weight loss. IBD etiopathogenesis is multifactorial, with a proven involvement of cytokines. In this regard, cytokines like resistin and adiponectin produced by adipose tissue play a crucial role in inflammation. Particularly, resistin seems related to IBD severity and is considered a promising marker of disease occurrence and progression. Unraveling its mechanism of action and downstream effectors is mandatory when designing novel therapies. This preclinical study aims to further elucidate the action of resistin in causing functional gastrointestinal alterations, comparing it with the well-defined effect of adiponectin. To this end, we carried out electrophysiological analysis on murine gastric fundus. We found that resistin, similarly to adiponectin, increases smooth muscle cell (SMC) capacitance, indicative of cell surface remodeling, which is consistent with relaxation. However, contrary to adiponectin, resistin unalters membrane potential and inward Ca2+ entry and scarcely affects outward current, suggesting its inefficacy in markedly modifying electrical phenomena on the SMC membrane. This outcome, supporting the role of resistin in gastrointestinal distention, as observed in IBD, rules out a strikingly direct effect on SMCs.
{"title":"Adipokines as Possible Players in Inflammatory Bowel Disease: Electrophysiological Evaluation of Their Role in Causing Functional Gastrointestinal Alterations in Murine Tissue","authors":"R. Garella, Francesco Palmieri, R. Squecco","doi":"10.3390/gidisord6020035","DOIUrl":"https://doi.org/10.3390/gidisord6020035","url":null,"abstract":"Inflammatory bowel disease (IBD) is a clinical condition of the gastrointestinal tract that has significant incidence in childhood. Major symptoms include abdominal pain, dyspepsia, delayed gastric emptying, anorexia, diarrhea and weight loss. IBD etiopathogenesis is multifactorial, with a proven involvement of cytokines. In this regard, cytokines like resistin and adiponectin produced by adipose tissue play a crucial role in inflammation. Particularly, resistin seems related to IBD severity and is considered a promising marker of disease occurrence and progression. Unraveling its mechanism of action and downstream effectors is mandatory when designing novel therapies. This preclinical study aims to further elucidate the action of resistin in causing functional gastrointestinal alterations, comparing it with the well-defined effect of adiponectin. To this end, we carried out electrophysiological analysis on murine gastric fundus. We found that resistin, similarly to adiponectin, increases smooth muscle cell (SMC) capacitance, indicative of cell surface remodeling, which is consistent with relaxation. However, contrary to adiponectin, resistin unalters membrane potential and inward Ca2+ entry and scarcely affects outward current, suggesting its inefficacy in markedly modifying electrical phenomena on the SMC membrane. This outcome, supporting the role of resistin in gastrointestinal distention, as observed in IBD, rules out a strikingly direct effect on SMCs.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141370857","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/Aims: The purpose of this study was to determine the factors affecting positive diagnostic yields in patients with obscure gastrointestinal bleeding (OGIB) according to the guideline of small bowel capsule endoscopy (SBCE). Method: Patients with a complaint of melena or hematochezia who were admitted were consecutively enrolled. In patients with gastrointestinal bleeding, examination was performed according to the guideline. When OGIB was suspected, SBCE was performed. Patients were categorized into two subgroups based on the SBCE results: a positive group (n = 78) and a negative group (n = 67). Results: The rate of the positive diagnostic yield of SBCE was 53.8% (78/145). In patients over 60 years, the diagnostic yield was 61.5%, which was higher than in patients younger than 60 years (40.7%). In the multivariate analysis, there was a significant difference in the positive diagnostic yield in the patients aged over 60 years (p < 0.01). Factors related to the procedure and clinical characteristics also showed significant differences in the positive predictive rates according to the degree of bowel preparation, small bowel transit time, and transfusion requirements. Conclusions: SBCE could be recommended as a diagnostic tool for OGIB, especially in those with old ages (>60 years) and those who need transfusion, because of its relatively high diagnostic yields in these populations. Proper bowel preparation and a prolonged small bowel transit time may have clinical significance in relation to the positive diagnostic yield of SBCE in patients with OGIB.
{"title":"Factors Affecting Diagnostic Yields of Capsule Endoscopy for Obscure Gastrointestinal Bleeding","authors":"Na Rae Lim, Keep Yung Hong, Woo Chul Chung","doi":"10.3390/gidisord6020032","DOIUrl":"https://doi.org/10.3390/gidisord6020032","url":null,"abstract":"Background/Aims: The purpose of this study was to determine the factors affecting positive diagnostic yields in patients with obscure gastrointestinal bleeding (OGIB) according to the guideline of small bowel capsule endoscopy (SBCE). Method: Patients with a complaint of melena or hematochezia who were admitted were consecutively enrolled. In patients with gastrointestinal bleeding, examination was performed according to the guideline. When OGIB was suspected, SBCE was performed. Patients were categorized into two subgroups based on the SBCE results: a positive group (n = 78) and a negative group (n = 67). Results: The rate of the positive diagnostic yield of SBCE was 53.8% (78/145). In patients over 60 years, the diagnostic yield was 61.5%, which was higher than in patients younger than 60 years (40.7%). In the multivariate analysis, there was a significant difference in the positive diagnostic yield in the patients aged over 60 years (p < 0.01). Factors related to the procedure and clinical characteristics also showed significant differences in the positive predictive rates according to the degree of bowel preparation, small bowel transit time, and transfusion requirements. Conclusions: SBCE could be recommended as a diagnostic tool for OGIB, especially in those with old ages (>60 years) and those who need transfusion, because of its relatively high diagnostic yields in these populations. Proper bowel preparation and a prolonged small bowel transit time may have clinical significance in relation to the positive diagnostic yield of SBCE in patients with OGIB.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141109610","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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