Journal of the Canadian Association of Gastroenterology最新文献

{"title":"A234 DOES FECAL CALPROTECTIN CORRELATE WITH INFLAMMATION ON ULTRASOUND IN CROHN’S DISEASE STRICTURES?","authors":"V. Gulhati, R. E. Rosentreter, M. Motamedi, A. Macci, R. Ingram, G. Kaplan, C Ma, C. Seow, K. Novak, R. Panaccione, C Lu","doi":"10.1093/jcag/gwad061.234","DOIUrl":"https://doi.org/10.1093/jcag/gwad061.234","url":null,"abstract":"Abstract Background Fibrostenotic Crohn’s Disease (CD) is a challenging phenotype particularly due to the absence of intestinal anti-fibrotic therapies. Differentiating between strictures that are predominantly fibrotic as opposed to inflammatory remains a diagnostic dilemma. The ability to make this differentiation is critical to inform decisions for therapeutic approach. Fecal calprotectin (FC) is a stool marker reflective of intestinal inflammation. Very few studies have evaluated the relationship of FC concentration in ileal CD strictures and parameters of inflammation on intestinal ultrasound (IUS). Strictures on imaging are defined as 1) increased bowel wall thickness (BWT), 2) narrowed luminal apposition, and 3) pre-stenotic dilation (PSD). BWT and hyperemia (color Doppler signal (CDS)) are the most sensitive markers for CD inflammation on IUS. It is predicted that FC will match CDS in ileal strictures, similar to non-stricture phenotypes. Aims We aim to correlate FC levels with IUS inflammation of ileal CD strictures. Methods We performed a retrospective cohort pilot study exploring the relationship between FC levels and IUS inflammatory parameters in ileal strictures. FC levels were obtained ≤ 60 days of index IUS in fibrostenotic ileal CD patients. Individuals who underwent medication changes or experienced a clinical flare during this period were excluded. Inflammation was measured as BWT and CDS using a modified Limberg (ML) score. Pearson correlation for continuous variables, Spearman rank correlation and a Kruskal-Wallis test for FC and Limberg scale were completed. Results A total of 25 fecal samples were obtained from 17 patients with ileal strictures (47% male, median age 59 years (range 18-76)) were assessed. Median FC concentrations was 204.9 ug/g, IQR: 250.4. Median ileal stricture BWT was 7.0 mm (range 3.0–10.0). 40% (10/25) had ML1 (short chains in bowel), 32% (8/25) ML2 (long chains in bowel), and 28% (7/25) ML3 (long chains and perienteric fat). There was no correlation between FC and BWT (r= .02, p = 0.92), nor FC with ML scores (r=0.20, p= 0.25). In those with ML1, median FC was 232.4, while those with ML2 or 3, had a FC of 155.6 and 469.7, respectively. FC values were significantly different between the ML scores, pampersand:003C0.0001. Conclusions FC levels were not correlated with inflammatory parameters as seen on IUS in ileal CD. This unexpected finding may be due to ML2 scores having lower FC than anticipated, and small sample size. Other imaging factors such as loss of wall stratification need to be taken into account, and are perhaps more reflective of inflammation than BWT and CDS. This study provides the initial data to assess accuracy of FC and hyperemia of ileal CD strictures on IUS compared to histologic measures of inflammation on resected specimens. Funding Agencies None","PeriodicalId":508018,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"145 ","pages":"187 - 188"},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139836570","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}

{"title":"A73 EVALUATING MENTAL HEALTH CONDITIONS IN YOUTH WITH INFLAMMATORY BOWEL DISEASE: A RETROSPECTIVE STUDY","authors":"K. Beaudoin, E. Mewhinney, J. Lo, S. Halder, K. Bortolin, J. Dowhaniuk, R. Issenman, N. Pai, M. Sherlock, M. Zachos, C. Grant, K. Beattie, K. Prowse","doi":"10.1093/jcag/gwad061.073","DOIUrl":"https://doi.org/10.1093/jcag/gwad061.073","url":null,"abstract":"Abstract Background Adolescents with chronic disease are at increased risk of psychosocial and socio-emotional challenges. During and after the COVID-19 pandemic, an increased prevalence of mental health conditions was observed in youth with chronic conditions. It is essential to understand the prevalence of mental health conditions in youth with Inflammatory Bowel Disease (IBD) to better support, advocate, and treat mental health conditions within a pediatric healthcare setting. Aims We aimed to determine the number and proportion of patients with IBD at McMaster Children’s Hospital (MCH) whose medical charts have documentation of 1) a mental health condition (generalized anxiety disorder (GAD), social anxiety disorder (SAD), eating disorder, major depressive disorder (MDD), suicidal ideation, attention deficit disorder and other) and/or 2) medication(s) used to treat mental health conditions. Methods Patients 12-17 years old with IBD who were treated in the pediatric Gastroenterology Clinic at MCH and had at least one appointment since June 4, 2022 were eligible. Medical records were reviewed to identify documented mental health conditions and patients’ current medications. The prevalence was then determined. Results Of 114 patients (77 male) (mean (SD) age 15.1 (1.6) years old), 33 (29%, n=20 males) had ≥ 1 recorded mental health condition: GAD (n=27, 82%), SAD (n=1, 3%), eating disorders (n=4, 12%), MDD (n=9, 27%), suicide ideations (n=5, 15%), attention deficit disorder (n=9, 24%), and other mental health conditions (n=1, 3%). Among the 33 patients with documented mental health conditions, 19 (58%) patients were taking medications related to mental health (Table I). Conclusions Our results estimate a 29% prevalence of mental health conditions in youth with IBD at MCH. A lack of mental health resources and screening protocols within this setting could result in an underrepresentation of adolescents with IBD and mental health comorbidities. Future studies will focus on incorporating screening methods for mental health conditions within pediatric healthcare settings to determine current barriers and accessibility to mental health supports. Table I. Medications in patients (n=33) with documented mental health condition Note Medications were prevalent in patients with ampersand:003E1 mental health diagnosis, thus frequency is lower than # of documented mental health diagnoses. *Other mental health conditions: borderline personality disorder and bipolar disorder with depression. Funding Agencies None","PeriodicalId":508018,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"141 ","pages":"50 - 50"},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139836572","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}

{"title":"A39 DEVELOPMENTALLY REGULATED CECAL CONTENT MICRO-RNAS CORRELATE WITH MATURING MICROBIOTA GENES AND FUNCTIONS IN JUVENILE MICE","authors":"C. Cuinat, A. Taibi, J. Tremblay, G. Gargari, S. Guglielmetti, T. Tompkins, E. Comelli","doi":"10.1093/jcag/gwad061.039","DOIUrl":"https://doi.org/10.1093/jcag/gwad061.039","url":null,"abstract":"Abstract Background The gut microbiome establishment in early life is critical to life-long health and influenced by the maternal gut ecosystem. MicroRNAs (miRNAs) have emerged as a new player in host-microbiota interaction due to their regulatory effect on bacterial genes. We previously found that maternal supplementation with a probiotic mix of Lacticaseibacillus rhamnosus R0011 and Lactobacillus helveticus R0052 supported the maturation of microbial metabolic activity and altered the cecal content miRNA profile in juvenile mice. Aims To investigate the relationship between cecal content miRNAs and inferred microbiota genes and functions in early life and identify potential miRNA-bacterial gene targets. Methods We generated 16S rRNA gene sequencing and NanoString nCounter® data from the cecal content of 14, 21, and 36-days-old C57BL/6 mice born to dams receiving or not probiotic-supplemented water since preconception. Taxa contributions to bacterial enzyme-encoding genes and pathways were inferred with PICRUSt2. Time or group-altered genes, pathways, and miRNAs were identified with DESeq2. Spearman correlations were performed between miRNAs and bacterial genes or pathways (n= 3-5 male offspring/PND/group) and significant correlations (q ampersand:003C 0.05) were visualized with NAViGaTOR. Potential miRNA binding sites on bacterial genes were investigated using the ViennaRNA Package. Results Time-associated miR-433 positively correlated with two time-altered genes involved in the TCA and glyoxylate cycles. Group-associated miR-691 was positively correlated with genes related to tRNA charging pathway, pyruvate fermentation to acetate and lactate, and amino acids biosynthesis. Additionally, miR-691 was negatively correlated with six group-altered genes involved in myo-inositol degradation. We identified potential miRNA binding sites (total free energy of binding ampersand:003C -10 kcal/mol) for miR-691 with genes involved in pyruvate fermentation, lysine biosynthesis, and myo-inositol degradation, and for miR-433 with genes annotated to the TCA and glyoxylate cycles. Conclusions Host miRNAs correlate with bacterial pathways and genes maturing during the weaning transition, highlighting their potential to regulate microbial metabolic activity. Maternal probiotics supplementation may accelerate the development of microbial metabolic pathways through epigenetic mechanisms, independently of weaning dietary shift. Correlations identified include energy production pathways and may become clinical targets in infants with delayed maturation of the intestinal ecosystem. Funding Agencies NSERC","PeriodicalId":508018,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"64 13","pages":"22 - 23"},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139836663","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}

{"title":"A11 TELOCYTES-FOXL1+ REGULATES THE EXTRACELLULAR MATRIX NETWORK IN COLITIS-ASSOCIATED CANCER","authors":"V. Reyes Nicolás, A. B. Alfonso, J. Raisch, F. Boisvert, M. A. Lauzon, N. Perreault","doi":"10.1093/jcag/gwad061.011","DOIUrl":"https://doi.org/10.1093/jcag/gwad061.011","url":null,"abstract":"Abstract NOT PUBLISHED AT AUTHOR’S REQUEST Please acknowledge all funding agencies listed below Funding Agencies CIHRDoctoral Scholarship Fonds de recherche du Québec (FRQS)","PeriodicalId":508018,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"528 28","pages":"6 - 6"},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139836830","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}

{"title":"A186 INFLAMMATION MODIFIES DOSE-DEPENDENT RESPONSES OF INTESTINAL ANTI-TUMOUR MICRORNAS TO CRANBERRY PROANTHOCYANIDIN AND ITS MICROBIAL METABOLITE 3-(4-HYDROXYPHENYL)-PROPIONIC ACID","authors":"Z. Dimoff, Z. Lofft, F. Liang, S Chen, I. Paetau-Robinson, C. Khoo, A. Taibi, E. Comelli","doi":"10.1093/jcag/gwad061.186","DOIUrl":"https://doi.org/10.1093/jcag/gwad061.186","url":null,"abstract":"Abstract Background Cranberries are a rich source of proanthocyanidins (PAC), a type of polyphenol with anti-cancer properties. We previously found that PAC, along with its microbially-derived metabolite 3-(4-hydroxyphenyl)-propionic acid (HPPA), trigger unique regulatory responses of microRNAs (miRNAs) in intestinal epithelial cells including the upregulation of miR-146a-5p. Both miR-146a-5p and miR363-3p are anti-inflammatory and downregulate anti-tumorigenic signalling pathways such as the interleukin (IL)-17 and wingless-related integration site (Wnt) respectively. miR-146a-5p also attenuates IL-17-promoting cytokines levels (e.g., IL-6). Aims To determine if miR-146a-5p and miR-363-3p respond to different physiologically relevant concentrations of PAC and HPPA in inflammatory and non-inflammatory conditions. Methods Fully differentiated Caco-2BBe1 colonic epithelial cells were treated with two doses of PAC-enriched cranberry extract (50μg/ml, 100μg/ml), HPPA (5μg/ml, 10μg/ml), or with Dulbecco’s Modified Eagle Medium (DMEM; control) for 24 hours, followed by IL-1β (1ng/ml) or mock stimulation for three hours. Human IL-6 homogeneous time-resolved fluorescence (HTRF) kits were used to quantify IL-6 in cell supernatant. RNA was extracted and used for miRNA profiling using Nanostring technology. Statistical analysis was performed in R version 4.2.1 with the R-packages NanostringDiff, NanostringNorm, and Pheatmap. Results At homeostasis, 42 and 2 (miR-146a and miR363-3p) miRNAs, respectively, uniquely responded to increasing PAC or HPPA concentrations. In the inflammatory state, no miRNAs responded to increasing concentrations of PAC and HPPA. However, the expression of miR-363-3p increased (qampersand:003C0.001) in response to 50μg/ml of PAC + IL-1β but decreased in response to 5μg/ml of HPPA + IL-1β , and the expression of miR-146a-5p increased (qampersand:003C0.001) in response to 5μg/ml of HPPA + IL-1β, and 50μg/ml PAC + IL-1β. Predicted miRNA gene-pathway analysis revealed that miR-146a-5p, miR-363-3p, and the other 42 miRNAs commonly target pathways involved in the tumorigenesis of colorectal cancer such as mitogen-activated protein kinases (MAPK), hedgehog, and Wnt pathways. Though, in inflamed cells, only HPPA (5 or 10 μg/ml) attenuated IL-6 secretion (pampersand:003C0.05), which may be driven by increased expression of miR-146a-5p. Conclusions These findings suggest that cranberries proanthocyanidins and their metabolites affect miRNAs involved in cancer related pathways in different manners and concentrations, which may depend on the inflammatory status. The gut microbiota may be partially responsible for unlocking these effects. Funding Agencies Ocean Spray Cranberries, Inc. and the Natural Sciences of Engineering Research Council of Canada (NSERC)","PeriodicalId":508018,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"746 ","pages":"146 - 147"},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139836878","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}

{"title":"A288 ALCOHOL RELAPSE AND ADVERSE OUTCOMES IN EARLY VERSUS ROUTINE LIVER TRANSPLANT FOR ALCOHOL-ASSOCIATED LIVER DISEASE IN THE PROVINCE OF BRITISH COLUMBIA","authors":"A. Hemy, A. Fetz, S. Jayakumar","doi":"10.1093/jcag/gwad061.288","DOIUrl":"https://doi.org/10.1093/jcag/gwad061.288","url":null,"abstract":"Abstract Background Liver transplant is a life-saving treatment for patients with alcohol-associated liver disease (ALD) resulting in decompensated cirrhosis or severe alcoholic hepatitis, significantly reducing mortality compared to supportive treatment. Despite its previous wide acceptance, there is a lack of strong evidence to justify a 6-month abstinence period. In 2019, BC Transplant policies were updated to allow liver transplant within 6-months of alcohol use in carefully selected patients with limited life expectancy and favorable multidisciplinary psychosocial assessment. Aims This study aims to assess alcohol relapse rates and adverse outcomes in patients who received an early liver transplant for ALD. Methods A retrospective chart review was performed on all adult patients who underwent liver transplant in the province of British Columbia between January 1, 2020, and December 31, 2022. Follow up data was extracted until May 31, 2023. Patients were included if they had alcohol documented as a contributing factor to their liver disease prior to transplant. Early transplant was defined as alcohol abstinence of 179-days or less and routine transplant as 180-days or more. Alcohol use and time to alcohol use were determined by patient history, random biochemical testing, and health-care utilization for an alcohol-associated complication. Graft dysfunction or rejection resulting in a change in therapeutic management, noncompliance determined by clinician documentation, rehospitalization, and death were recorded as adverse events. Results 278 patients underwent liver transplant during the study period. 81 patients were classified as alcohol-related, and 15 received early transplant. The mean follow-up period was 20.5 months. Early transplant recipients were more likely to be younger (median 45 vs. 58 years, p = 0.003) and have a higher MELD score at the time of transplant (median 37 vs. 17, p ampersand:003C 0.001). There was no significant difference in post-transplant alcohol relapse (13 vs. 15%, hazard ratio = 0.78, 95% CI [0.17, 3.55], p = 0.74). Graft dysfunction was increased in patients who received early transplant (53 vs. 25%, relative risk = 2.17, 95% CI [1.15, 4.10]). There was no significant difference between rates of noncompliance (0 vs. 9%), rehospitalization (53 vs. 56%), or death (0 vs. 2%). Conclusions Alcohol relapse is similar between early and routine liver transplant. Graft dysfunction is increased in early transplant, although other adverse events including medication noncompliance, rehospitalization, and death are not significant different. These results are favorable for the continued use of early liver transplant for ALD, providing an effective treatment for ALD and significantly reducing mortality in patients with a limited life expectancy. Funding Agencies None","PeriodicalId":508018,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"551 ","pages":"232 - 233"},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139836912","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}

{"title":"A221 AZATHIOPRINE DOSING THRESHOLD IN ANTI-TNF COMBINATION THERAPY FOR MINIMIZING IMMUNOGENICITY AND OPTIMIZING TREATMENT EFFICACY FOR PATIENTS WITH INFLAMMATORY BOWEL DISEASE. A RETROSPECTIVE COHORT STUDY","authors":"N. Alajeel, J. Choi, R. Khanna, A Wilson","doi":"10.1093/jcag/gwad061.221","DOIUrl":"https://doi.org/10.1093/jcag/gwad061.221","url":null,"abstract":"Abstract Background Reported rates of anti-drug antibody (ADA) formation to tumor necrosis factor-a antagonists (anti-TNF) range from 20-75%. One way to reduce the risk of ADA formation is to combine a second immune-suppressing agent such as azathioprine (AZA) with the anti-TNF agent, known as combination therapy. However, it is unknown if the risk of combination therapy, including the additive risk of AZA and anti-TNF side effects, could be reduced by exposing individuals with inflammatory bowel disease (IBD) to the lowest dose of azathioprine while still maintaining the beneficial effect of ADA prevention. Aims To identify the minimum dose of AZA needed to prevent ADA formation to anti-TNF agents in individuals with IBD receiving combination therapy. We also assessed the occurrence of adverse drug events, treatment loss of response, treatment discontinuation and the need for treatment dose escalation. Methods A retrospective cohort study is ongoing in adult participants with IBDreceiving either infliximab or adalimumab in combination with AZA. Patients are divided based on their AZA dosage (low dose group, AZA ampersand:003C2mg/kg/day versus standard dose group, AZA 2mg/kg/day). All participants will be followed for 1 year and observed for the occurrence of ADA formation, adverse drug events, treatment loss of response, treatment discontinuation and the need for treatment dose escalation. Results To date, 48 participants are currently included (low dose, n=29; standard dose, n=19). 42 are on Infliximab and 6 are on Adalimumab. The occurrence of ADA was 17.4% in the low dose group and 20% in the standard dose group (pampersand:003E0.99). More participants lost response to treatment and discontinued anti-TNF therapy in the standard dose group (n=7/19, 36.8%) versus the low-dose group (n=8/29, 27.6%, p=0.54). More participants in the low-dose group received anti-TNF dose escalation (n= 20/29,68.9%) compared to the standard dose group (n=6/19, 31.6%, p=0.017). Adverse events, to Anti-TNF was seen in (n=3/19, 15.7%) in the standard dose group, in comparison to (n=4/29, 13.79%, pampersand:003E0.99) in the low dose group. Adverse events to AZA were surprisingly higher in the low dose group (n=14/29, 48.3%) while in the standard dose, it was (n=5/19, 26.3%, p=0.14). Conclusions The preliminary result of the study suggests that there is no significant difference in anti-drug antibody formation between standard and low doses of azathioprine in combination with anti-TNF therapy, in addition, data showed significant lower rates of Anti-TNF discontinuation and loss of response to treatment in low Azathioprine dose group. Completion of the study will help further define if low-dose AZA can be used for ADA prevention in anti-TNF combination therapy without compromising important clinical outcomes. Funding Agencies None","PeriodicalId":508018,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"547 ","pages":"176 - 177"},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139836914","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}

{"title":"A105 PILOT STUDY ON THE ACCURACY OF CHATGPT IN ARTICLE SCREENING FOR SYSTEMATIC REVIEWS IN GASTROENTEROLOGY","authors":"C. Na, G. Sinanian, N. Gimpaya, A. Mokhtar, D. Chopra, M. Scaffidi, E. Yeung, S. Grover","doi":"10.1093/jcag/gwad061.105","DOIUrl":"https://doi.org/10.1093/jcag/gwad061.105","url":null,"abstract":"Abstract Background Systematic reviews synthesize extant research to answer a research question in a way that minimizes bias. After articles for potential inclusion are identified by sensitive searches, screening requires human expert review, which may be time-consuming and subjective. Large language models such as ChatGPT may have potential for this application. Aims This pilot study aims to assess the accuracy of ChatGPT 3.5 in screening of articles for systematic reviews in gastroenterology by (1) identifying if articles were correctly included and (2) excluding articles reported by authors as difficult to assess. Methods We searched the Cochrane Library for gastroenterology systematic reviews (January 1, 2022 to May 31, 2023) and selected the 10 most cited studies. The test set used to determine the accuracy of Open AI’s ChatGPT 3.5 model for included studies was the final list of included studies for each Cochrane review. The test set used for studies challenging to assess was the “excluded studies” list as defined in the Cochrane Handbook. Figure 1 shows the prompt used for the screening query. Articles were omitted if they did not have digital sources, abstracts or methods. Each article was screened 10 times to account for variability within ChatGPT’s outputs. Articles with ≥5 inclusion results were counted as an included study. Results ChatGPT correctly identified included studies at rates ranging from 60% to 100%. ChatGPT correctly identified exlcuded studies at rates ranging from 0% to 50% (Table 1). A total of 265 articles were screened. Conclusions In this pilot study, we demonstrated that ChatGPT is accurate in identifying articles screened for inclusion in Cochrane reviews; however, it is inaccurate in excluding articles described by the authors as being difficult to assess. We hypothesize that the GPT 3.5 model can read for keywords and broad interventions but is unable to reason cognitively, as an expert would, as to why a study may be excluded. We aim to review reasons for exclusion in future work. Table 1. Screening Results of ChatGPT Review author and date Topic No. of studies included by authors No. of studies excluded by authors No. of studies correctly included by ChatGPT (%) No. of studies correctly excluded by ChatGPT(%) Tse, 2022 Guide-wire assisted cannulation 7 14 7 (100%) 0 (0%) Gordon, 2023 Remote care through telehealth for IBD patients 14 10 14 (100%) 3 (30%) Candy, 2022 Mu-opioid antagonists for opioid-induced bowel dysfunction 10 7 10 (100%) 0 (0%) El-Nakeep, 2022 Stem cell transplantation in Crohn 7 10 7 (100%) 5 (50%) Okabayashi, 2022 Certolizumab pegol in Crohn 5 5 3 (60%) 1 (20%) Gordon, 2023 Patient education in IBD management 19 20 18 (95%) 2 (10%) Dichman, 2022 Antibiotics for uncomplicated diverticulitis 6 6 6 (100%) 0 (0%) Grobbee, 2022 Faecal occult blood tests versus faecal immunochemical tests for colorectal cancer screening 53 26 46 (87%) 2 (8%) Midya, 2022 Fundoplication in laparoscopic Heller 9 3 8 ","PeriodicalId":508018,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"523 1","pages":"76 - 78"},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139836927","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}

{"title":"A127 ENDOSCOPIC MUCOSAL RESECTION WITH HYBRID-ARGON PLASMA ABLATION TO PREVENT RECURRENCE OF 20 MM NON-PEDUNCULATED COLORECTAL POLYPS: A MULTI-CENTER PROSPECTIVE CLINICAL STUDY","authors":"R. Djinbachian, J. Levenick, S. Bouchard, M. Moyer, E. Deslandres, J. Mosko, C. Teshima, N. Shahidi, D. von Renteln","doi":"10.1093/jcag/gwad061.127","DOIUrl":"https://doi.org/10.1093/jcag/gwad061.127","url":null,"abstract":"Abstract Background Endoscopic mucosal resection (EMR) is the mainstay of therapy for non-pedunculated colorectal polyps 20 mm or larger. Post EMR recurrence rates are about 15% if no margin ablation technique is used. Aims Study aim was to evaluate recurrence rates if hybrid Argon Plasma Coagulation ablation (h-APC) is routinely used after the EMR to ablate the margins, base and vessels. Methods A prospective multi-center study including adult patients (18-89 years) undergoing EMR of non-pedunculated colorectal polyps 20 mm or larger was conducted. h-APC was used to ablate all post EMR margins and to ablate the post EMR resection surface and visible submucosal vessels. The primary outcome was the biopsy proven recurrence rate at the first follow-up colonoscopy (4-6 months after EMR). All the resection sites were visually inspected, and biopsies were obtained from the EMR scar. Secondary outcomes included technical success and complication rates. Results A total of 220 EMRs were performed during the study for h-APC ablation of non-pedunculated colorectal polyps, with a size of ≥20 mm. The average size of the polyps included in the study was 35.7 mm (ranging from 20 mm to 100 mm). Among all resected polyps, 16.8% were sessile serrated lesions (SSL), while 66.3% were adenomas. Additionally, 4 cases of cancer were in the study. The application of hot snare EMR with h-APC ablation was technically successful and completed for all cases. The mean duration of the EMR procedure was 19.6 minutes, ranging from 2.3 to 103 minutes, while the mean duration of h-APC ablation was 6.4 minutes, ranging from 1 to 65 minutes. A total of 147 EMRs with follow up examination (57 EMR involving lesions 40mm or larger) are available currently. The overall recurrence rate was 1.3% (2 out of 147 cases). For cases where complete base ablation was achieved, there was a 0% recurrence rate, including lesions 40mm or larger. For lesions measuring 40mm or larger, the recurrence rate was 1.8% (1 out of 54 cases). Out of the 220 total EMRs conducted, perforations were observed in 0.9% (2 cases, managed conservatively with antibiotics only), and clinically significant bleeding occurred in 2.3% (5 cases). In particular, clinically significant bleeding was noted in 2.3% (4 out of 167 cases) of lesions without clipping and in 4.0% (4 out of 99 cases) for right-sided lesions without clipping. Conclusions In this multicenter study EMR in combination with h-APC demonstrated a high technical success rate with low complication rates and showed very low post EMR recurrence in the preliminary data analysis. Funding Agencies Erbe","PeriodicalId":508018,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"92 ","pages":"96 - 97"},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139837177","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}

{"title":"A161 IMPACT OF EARLY-ONSET COLORECTAL CANCER ON DISABILITY-ADJUSTED LIFE YEARS IN CANADA: 1990 TO 2019","authors":"I. Stukalin, M Gupta, K. Buhler, C Ma","doi":"10.1093/jcag/gwad061.161","DOIUrl":"https://doi.org/10.1093/jcag/gwad061.161","url":null,"abstract":"Abstract Background Colorectal cancer is the third most common malignancy and remains a leading cause of potentially preventable morbidity and mortality. Early-onset colorectal cancer (EOCRC) is a growing public health focus, particularly in North America, where incidence rates have increased over time. Aims Recognizing that EOCRC affects patients in the prime of their life, we aimed to estimate the impact of EO-CRC on disability-adjusted life years (DALYs) lost in Canada between 1990 and 2019. Methods We used the Global Burden of Diseases (GBD) Study to assess temporal trends in incidence, mortality and DALYs for EOCRC (patients ampersand:003C50 years old) in Canada between 1990 and 2019. Point estimates are available from http://ghdx.healthdata. org/gbd-results-tool. Rates were estimated per 100 0000 individuals at risk and stratified by age and sex. Annual percentage changes (APC) were estimated using joinpoint regression with 95% confidence intervals (CIs). Results In 2019, the incidence, mortality and corresponding DALYs rates for EOCRC were 15.67 (95% CI 11.58, 20.81), 3.19 (95% CI 2.81, 3.61), and 161.88 (95% CI 142.50, 183.53) per 100,000 individuals, respectively. Overall incidence increased significantly during the study period by 1.12%/year (95% CI 0.91%, 1.62%). An analysis of the temporal trends demonstrates that the most significant increase in incidence in EOCRC occurred between 2000 - 2006 with an APC of 3.19% (95% CI 2.40%, 3.99%), which was primarily driven by an increased incidence in men. Mortality (APC 3.30%, 95% CI 2.41%, 4.19%) and DALYs (APC 3.28%, 95% CI 2.34%, 4.22%) for EOCRC also significantly increased for males between 2001 - 2006. Conclusions Our study reveals a substantial burden in early-onset colorectal cancer in Canada, with a significant increase in incidence over time and over 160 DALYs/100,000 population. Figure 1: Incidence (A), Mortality (B) and DALYs (C) for EOCRC in Canada between 1990 and 2019 with 95% CIs. Funding Agencies None","PeriodicalId":508018,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"32 ","pages":"124 - 125"},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139837216","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}