Pub Date : 2024-08-09DOI: 10.3389/fgstr.2024.1411898
Ry Y Tweedie-Cullen, Brooke C. Wilson, JoséG B Derraik, Benjamin B. Albert, Keri Opai, Taygen Edwards, J. O’Sullivan, W. Cutfield
Gut microbiome transfer (GMT or faecal microbiome transfer) is gaining increasing attention as a potential treatment for a range of medical conditions. However, public awareness and acceptance are not well understood.To better understand the public perception of microbiome transfer in New Zealand, we undertook a nationwide online survey. The anonymous survey was designed and distributed between 2022-2023. Inclusion criteria included being aged 16 years or older and a resident of New Zealand. Distribution channels included social media advertising, posters in public areas, e-mail newsletters, and a survey facilitation company.A total of 2441 completed surveys were analyzed. Most respondents (71%) had tertiary education, 59% were female, with 62% identifying as NZ European, 12% as Māori, and 3% as Pacific peoples. The findings identified a high level of awareness and acceptability, with 76% of respondents having heard of GMT, and 96% indicating they would consider it if proven efficacious for a health condition they had. High levels of acceptance were observed across all ethnicities. Encapsulated oral FMT treatment was the preferred transfer method.Primary concerns related to GMT included the diet, health, and screening of stool donors, as well as the demonstration of safety and efficacy. These findings will help inform health professionals and researchers about the public’s needs and preferences regarding GMT.
{"title":"Awareness and acceptability of gut microbiome transfer","authors":"Ry Y Tweedie-Cullen, Brooke C. Wilson, JoséG B Derraik, Benjamin B. Albert, Keri Opai, Taygen Edwards, J. O’Sullivan, W. Cutfield","doi":"10.3389/fgstr.2024.1411898","DOIUrl":"https://doi.org/10.3389/fgstr.2024.1411898","url":null,"abstract":"Gut microbiome transfer (GMT or faecal microbiome transfer) is gaining increasing attention as a potential treatment for a range of medical conditions. However, public awareness and acceptance are not well understood.To better understand the public perception of microbiome transfer in New Zealand, we undertook a nationwide online survey. The anonymous survey was designed and distributed between 2022-2023. Inclusion criteria included being aged 16 years or older and a resident of New Zealand. Distribution channels included social media advertising, posters in public areas, e-mail newsletters, and a survey facilitation company.A total of 2441 completed surveys were analyzed. Most respondents (71%) had tertiary education, 59% were female, with 62% identifying as NZ European, 12% as Māori, and 3% as Pacific peoples. The findings identified a high level of awareness and acceptability, with 76% of respondents having heard of GMT, and 96% indicating they would consider it if proven efficacious for a health condition they had. High levels of acceptance were observed across all ethnicities. Encapsulated oral FMT treatment was the preferred transfer method.Primary concerns related to GMT included the diet, health, and screening of stool donors, as well as the demonstration of safety and efficacy. These findings will help inform health professionals and researchers about the public’s needs and preferences regarding GMT.","PeriodicalId":512079,"journal":{"name":"Frontiers in Gastroenterology","volume":"50 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141923836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-15DOI: 10.3389/fgstr.2024.1410816
Monica Contreras, Heisser Mujica, M. García-Amado
Antibiotic resistance in the treatment of H. pylori infection is the principal reason for the failure of eradication regimens using the triple therapy. We reviewed the mechanisms of H. pylori antibiotic resistance and assessed the molecular tools commonly used to detect antibiotic resistance in Latin America. Most commonly reported molecular techniques were PCR and sequencing, as well as its variants PCR-RFLP and qPCR to detect the genes and mutations involved in the resistance to clarithromycin (CLR), amoxicillin (AMX), levofloxacin (LVX), tetracycline (TET), and metronidazole (MTZ). The mutation-associated resistance rates varied from 2.2% to 83.3% for CLA and 12% to 100% for LVX in 7 and 4 countries, respectively, whereas for MTZ the resistance frequency was between 50% to 100% in 4 countries. For TET and AMX, frequency of the resistance was in the range of 0% to 27% (5 and 3 countries, respectively). Molecular tools can be used for the rapid detection of resistance to CLR, LVX, and TET, whereas genotypic analysis is not appropriate to detect resistance to AMX and MTZ due to genomic changes found in the rdxA and pbp1A genes. The revision of the different molecular methods showed that qPCR and RFLP are the best tools to detect the resistance of H. pylori. Few molecular tools have been developed in Latin America to detect H. pylori resistance to antibiotics. More studies would be needed to understand better efficient strategies to prevent further emergence of antimicrobial resistance.
{"title":"Molecular tools of antibiotic resistance for Helicobacter pylori: an overview in Latin America","authors":"Monica Contreras, Heisser Mujica, M. García-Amado","doi":"10.3389/fgstr.2024.1410816","DOIUrl":"https://doi.org/10.3389/fgstr.2024.1410816","url":null,"abstract":"Antibiotic resistance in the treatment of H. pylori infection is the principal reason for the failure of eradication regimens using the triple therapy. We reviewed the mechanisms of H. pylori antibiotic resistance and assessed the molecular tools commonly used to detect antibiotic resistance in Latin America. Most commonly reported molecular techniques were PCR and sequencing, as well as its variants PCR-RFLP and qPCR to detect the genes and mutations involved in the resistance to clarithromycin (CLR), amoxicillin (AMX), levofloxacin (LVX), tetracycline (TET), and metronidazole (MTZ). The mutation-associated resistance rates varied from 2.2% to 83.3% for CLA and 12% to 100% for LVX in 7 and 4 countries, respectively, whereas for MTZ the resistance frequency was between 50% to 100% in 4 countries. For TET and AMX, frequency of the resistance was in the range of 0% to 27% (5 and 3 countries, respectively). Molecular tools can be used for the rapid detection of resistance to CLR, LVX, and TET, whereas genotypic analysis is not appropriate to detect resistance to AMX and MTZ due to genomic changes found in the rdxA and pbp1A genes. The revision of the different molecular methods showed that qPCR and RFLP are the best tools to detect the resistance of H. pylori. Few molecular tools have been developed in Latin America to detect H. pylori resistance to antibiotics. More studies would be needed to understand better efficient strategies to prevent further emergence of antimicrobial resistance.","PeriodicalId":512079,"journal":{"name":"Frontiers in Gastroenterology","volume":"36 50","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141645526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-13DOI: 10.3389/fgstr.2024.1395269
Basil A. Alzahrani, Jamal A. Aljuhani, Ziyad A. Badri, Rayan M. Alshamrani, Faisal Suliman Algaows, Mohamed Eldigire Ahmed
The hallmark of inflammatory bowel disease (IBD) is a persistent inflammation of the digestive system brought on by an imbalance in the gut microbiota. The two IBDs that are most well-known are ulcerative colitis (UC) and Crohn’s disease (CD). The purpose of the current study was to evaluate the Impact of smoking in inflammatory bowel disease.Data of 373 patients with IBD divided into 209 Crohn’s disease and 164 with ulcerative colitis disease. cases were collected from king Abdulaziz medical city, Jeddah, Saudi Arabia from 2016-2022. Patients older than 18 years, Patients with a history of cancer other than colon cancer or other GIT disorders were excluded from consideration.This study involved 373 participants, predominantly with Crohn’s disease 209. The participants exhibited diverse smoking habits, with complications observed in 53.6% of cases. Smoking status and duration showed significant associations with complications, particularly in Crohn’s disease. For ulcerative colitis, smoking correlated with lower complication rates. The analysis of smoking variables and disease remission highlighted nuanced relationships, emphasizing the need for further exploration. Specific associations between smoking and Crohn’s disease site or ulcerative colitis subtypes were observed, suggesting potential influences on disease manifestations.According to our research, smoking is negatively correlated with experiencing problems from ulcerative colitis (UC), and patients who smoke also appear to have higher rates of remission. Smoking has more issues with Crohn’s disease, though.
{"title":"The effect of smoking in inflammatory bowel disease outcomes","authors":"Basil A. Alzahrani, Jamal A. Aljuhani, Ziyad A. Badri, Rayan M. Alshamrani, Faisal Suliman Algaows, Mohamed Eldigire Ahmed","doi":"10.3389/fgstr.2024.1395269","DOIUrl":"https://doi.org/10.3389/fgstr.2024.1395269","url":null,"abstract":"The hallmark of inflammatory bowel disease (IBD) is a persistent inflammation of the digestive system brought on by an imbalance in the gut microbiota. The two IBDs that are most well-known are ulcerative colitis (UC) and Crohn’s disease (CD). The purpose of the current study was to evaluate the Impact of smoking in inflammatory bowel disease.Data of 373 patients with IBD divided into 209 Crohn’s disease and 164 with ulcerative colitis disease. cases were collected from king Abdulaziz medical city, Jeddah, Saudi Arabia from 2016-2022. Patients older than 18 years, Patients with a history of cancer other than colon cancer or other GIT disorders were excluded from consideration.This study involved 373 participants, predominantly with Crohn’s disease 209. The participants exhibited diverse smoking habits, with complications observed in 53.6% of cases. Smoking status and duration showed significant associations with complications, particularly in Crohn’s disease. For ulcerative colitis, smoking correlated with lower complication rates. The analysis of smoking variables and disease remission highlighted nuanced relationships, emphasizing the need for further exploration. Specific associations between smoking and Crohn’s disease site or ulcerative colitis subtypes were observed, suggesting potential influences on disease manifestations.According to our research, smoking is negatively correlated with experiencing problems from ulcerative colitis (UC), and patients who smoke also appear to have higher rates of remission. Smoking has more issues with Crohn’s disease, though.","PeriodicalId":512079,"journal":{"name":"Frontiers in Gastroenterology","volume":"65 32","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141346758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-03DOI: 10.3389/fgstr.2024.1335380
Kristine Paridaens, Matthew J. Freddi, Simon P. L. Travis
Mesalazine is an established and recommended first-line treatment for mild-to-moderate ulcerative colitis (UC). For patients with moderately active UC, the choice to use mesalazine or to initiate treatment with an oral corticosteroid or anti-tumor necrosis factor (TNF) agent is not clearly informed from current guidelines. The use of mesalazine is supported by robust clinical evidence supporting its efficacy at inducing remission in patients with moderately active disease. A key advantage of mesalazine is its tolerability profile being similar to that of placebo, which contrasts with that of the corticosteroids and advanced therapies, where there is the potential for significant toxicities. Mesalazine also has cost advantages over anti-TNFs and other advanced therapies. Evidence supports the consideration of all patients with moderately active UC for first-line mesalazine therapy at an optimized dose of ≥4g/d (± 1g/d rectal). Patients responding to treatment within 2 weeks should continue at ≥4g/d for at least 6 months before a dose reduction is considered, since this then alters the pattern of disease.
{"title":"The continuing value of mesalazine as first-line therapy for patients with moderately active ulcerative colitis","authors":"Kristine Paridaens, Matthew J. Freddi, Simon P. L. Travis","doi":"10.3389/fgstr.2024.1335380","DOIUrl":"https://doi.org/10.3389/fgstr.2024.1335380","url":null,"abstract":"Mesalazine is an established and recommended first-line treatment for mild-to-moderate ulcerative colitis (UC). For patients with moderately active UC, the choice to use mesalazine or to initiate treatment with an oral corticosteroid or anti-tumor necrosis factor (TNF) agent is not clearly informed from current guidelines. The use of mesalazine is supported by robust clinical evidence supporting its efficacy at inducing remission in patients with moderately active disease. A key advantage of mesalazine is its tolerability profile being similar to that of placebo, which contrasts with that of the corticosteroids and advanced therapies, where there is the potential for significant toxicities. Mesalazine also has cost advantages over anti-TNFs and other advanced therapies. Evidence supports the consideration of all patients with moderately active UC for first-line mesalazine therapy at an optimized dose of ≥4g/d (± 1g/d rectal). Patients responding to treatment within 2 weeks should continue at ≥4g/d for at least 6 months before a dose reduction is considered, since this then alters the pattern of disease.","PeriodicalId":512079,"journal":{"name":"Frontiers in Gastroenterology","volume":"61 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141269013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-24DOI: 10.3389/fgstr.2024.1363130
Valentina Medici, Nehemiah Kebede, Jennifer Stephens, Mary Kunjappu, John M. Vierling
Wilson disease (WD) is a rare and potentially fatal genetic disorder caused by accumulation of toxic levels of copper. Current treatments include chelating agents and/or zinc. We characterized real-world US treatment patterns in patients with WD.This retrospective, observational medical chart review utilized deidentified clinical data, including treatment patterns, abstracted from patient medical charts between 01/2012 and 06/2017. Line of therapy was assessed based on disease presentation and aggregated. Index treatment was defined as the first line of therapy, followed by second line of therapy and third line of therapy. Results were summarized using descriptive statistics.A total of 225 patients were included (mean [SD] age at diagnosis: 24.7 [9.8] years). Initial disease presentation was both neurologic/psychiatric and hepatic in 52.9%, followed by neurologic/psychiatric (20.0%), hepatic (16.9%), and asymptomatic (10.2%). Median (first and third quartiles) duration of follow-up from diagnosis was 39.5 (33.8–60.4) months. The most common first line of therapy was penicillamine monotherapy in 45.5%, followed by trientine monotherapy (26.1%) and chelator/zinc combination therapy (21.2%). A total of 167/222 (75.2%) patients remained on first line of therapy during the follow-up period. Of the 13.5% who switched to second line of therapy, most changed to trientine monotherapy (53.3%). All those who switched to third line of therapy transitioned to zinc monotherapy (100.0%). Unexpectedly, 11.3% discontinued first line of therapy without transitioning to a subsequent therapy. The primary rationale for index monotherapy selection was improved efficacy (61.6%). Most discontinuations were due to side effects/tolerability (40.8%). Treatment patterns varied by initial disease presentation, practice setting, physician specialty, and geographic location.These results demonstrate a lack of consensus in the US regarding first-line treatment for patients with WD. Evidence-based treatment pathways informed by high-quality clinical trials for improved health outcomes are needed.
{"title":"Treatment patterns in a real-world cohort of patients with Wilson disease in the United States","authors":"Valentina Medici, Nehemiah Kebede, Jennifer Stephens, Mary Kunjappu, John M. Vierling","doi":"10.3389/fgstr.2024.1363130","DOIUrl":"https://doi.org/10.3389/fgstr.2024.1363130","url":null,"abstract":"Wilson disease (WD) is a rare and potentially fatal genetic disorder caused by accumulation of toxic levels of copper. Current treatments include chelating agents and/or zinc. We characterized real-world US treatment patterns in patients with WD.This retrospective, observational medical chart review utilized deidentified clinical data, including treatment patterns, abstracted from patient medical charts between 01/2012 and 06/2017. Line of therapy was assessed based on disease presentation and aggregated. Index treatment was defined as the first line of therapy, followed by second line of therapy and third line of therapy. Results were summarized using descriptive statistics.A total of 225 patients were included (mean [SD] age at diagnosis: 24.7 [9.8] years). Initial disease presentation was both neurologic/psychiatric and hepatic in 52.9%, followed by neurologic/psychiatric (20.0%), hepatic (16.9%), and asymptomatic (10.2%). Median (first and third quartiles) duration of follow-up from diagnosis was 39.5 (33.8–60.4) months. The most common first line of therapy was penicillamine monotherapy in 45.5%, followed by trientine monotherapy (26.1%) and chelator/zinc combination therapy (21.2%). A total of 167/222 (75.2%) patients remained on first line of therapy during the follow-up period. Of the 13.5% who switched to second line of therapy, most changed to trientine monotherapy (53.3%). All those who switched to third line of therapy transitioned to zinc monotherapy (100.0%). Unexpectedly, 11.3% discontinued first line of therapy without transitioning to a subsequent therapy. The primary rationale for index monotherapy selection was improved efficacy (61.6%). Most discontinuations were due to side effects/tolerability (40.8%). Treatment patterns varied by initial disease presentation, practice setting, physician specialty, and geographic location.These results demonstrate a lack of consensus in the US regarding first-line treatment for patients with WD. Evidence-based treatment pathways informed by high-quality clinical trials for improved health outcomes are needed.","PeriodicalId":512079,"journal":{"name":"Frontiers in Gastroenterology","volume":"14 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141102673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-22DOI: 10.3389/fgstr.2024.1345466
Rebecca Metzger, Per Suppa, Zhen Li, Anant Vemuri
Navigation assistance has become part of our daily lives and its implementation in medicine has been going on for the last 3 decades. Navigation is defined as the determination of a position in space in the context of its surroundings. While routing applications used in cars highlight the street to follow, in medical applications the real-world perception of the user is enriched by digital elements that provide guidance and help the user navigate. Unlike Virtual Reality (VR) solutions, which are mainly used for training, Augmented Reality systems (AR) do not require the user to wear specific headsets/goggles, but the virtual elements are overlaid over the real image displayed on a monitor. Depending on the application and the indication, there are large differences in how much these solutions have entered clinical routine. Especially in the fields of GI endoscopy and laparoscopy, AR navigation solutions are less prominently employed in clinical practice today and still hold significant potential to elevate patient care by improved physician support. This review touches upon why AR navigation systems are currently just starting to become implemented in the GI/laparoscopic clinical routine and which applications can be expected in the GI endoscopy and laparoscopy field. By taking the practitioner’s perspective and following the intuitive navigation workflow, it gives an overview of major available and potential future AR-applications in the GI endoscopy and laparoscopy space, the respective underlying technologies, their maturity level and their potential to change clinical practice.
导航辅助已成为我们日常生活的一部分，其在医学中的应用已持续了 30 年。导航的定义是根据周围环境确定空间位置。汽车中使用的路由应用程序突出显示了要遵循的街道，而在医疗应用中，用户的真实世界感知则通过提供指导和帮助用户导航的数字元素得以丰富。与主要用于培训的虚拟现实（VR）解决方案不同，增强现实系统（AR）不需要用户佩戴特定的头盔/护目镜，而是将虚拟元素叠加到显示器上显示的真实图像上。根据应用和适应症的不同，这些解决方案进入临床常规的程度也有很大差异。特别是在消化道内窥镜和腹腔镜领域，AR 导航解决方案目前在临床实践中的应用并不突出，但仍具有通过改善医生支持来提升患者护理水平的巨大潜力。本综述探讨了 AR 导航系统目前刚刚开始在消化道/腹腔镜临床常规中应用的原因，以及在消化道内窥镜和腹腔镜领域的应用前景。通过从从业人员的角度出发，按照直观的导航工作流程，概述了消化内镜和腹腔镜领域现有的和未来潜在的主要 AR 应用、各自的底层技术、其成熟度以及改变临床实践的潜力。
{"title":"Augmented reality navigation systems in endoscopy","authors":"Rebecca Metzger, Per Suppa, Zhen Li, Anant Vemuri","doi":"10.3389/fgstr.2024.1345466","DOIUrl":"https://doi.org/10.3389/fgstr.2024.1345466","url":null,"abstract":"Navigation assistance has become part of our daily lives and its implementation in medicine has been going on for the last 3 decades. Navigation is defined as the determination of a position in space in the context of its surroundings. While routing applications used in cars highlight the street to follow, in medical applications the real-world perception of the user is enriched by digital elements that provide guidance and help the user navigate. Unlike Virtual Reality (VR) solutions, which are mainly used for training, Augmented Reality systems (AR) do not require the user to wear specific headsets/goggles, but the virtual elements are overlaid over the real image displayed on a monitor. Depending on the application and the indication, there are large differences in how much these solutions have entered clinical routine. Especially in the fields of GI endoscopy and laparoscopy, AR navigation solutions are less prominently employed in clinical practice today and still hold significant potential to elevate patient care by improved physician support. This review touches upon why AR navigation systems are currently just starting to become implemented in the GI/laparoscopic clinical routine and which applications can be expected in the GI endoscopy and laparoscopy field. By taking the practitioner’s perspective and following the intuitive navigation workflow, it gives an overview of major available and potential future AR-applications in the GI endoscopy and laparoscopy space, the respective underlying technologies, their maturity level and their potential to change clinical practice.","PeriodicalId":512079,"journal":{"name":"Frontiers in Gastroenterology","volume":"59 34","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141108248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-15DOI: 10.3389/fgstr.2024.1334877
Tiago Ribeiro, Guilherme Macedo
Climate change poses a growing threat to human health and well-being, with emerging evidence pointing to its intricate relationship with liver diseases. Indeed, climate change influences liver diseases through various direct and indirect mechanisms. Alcohol-related liver disease, Metabolic dysfunction-associated liver disease (MASLD), and viral hepatitis are the three most common causes of liver disease, and all are susceptible to the effects of climate change. Shifts in dietary habits driven by altered food availability, substance abuse exacerbated by social instability, extreme weather events affecting healthcare access, and the emergence of waterborne infections are among the factors exacerbating liver disease incidence and severity. On the flip side, healthcare systems, including liver units, significantly contribute to climate change through energy consumption, medical waste, and transportation emissions. The need for sustainable healthcare practices, telemedicine, and waste reduction strategies is becoming increasingly evident. Recognizing this intricate interplay and addressing the dual interaction between climate change and liver disease is imperative for safeguarding human health and reducing the environmental footprint of healthcare facilities. As climate change continues to unfold, understanding its implications for liver disease is critical for public health and environmental sustainability.
{"title":"Climate change and liver disease: a mini review","authors":"Tiago Ribeiro, Guilherme Macedo","doi":"10.3389/fgstr.2024.1334877","DOIUrl":"https://doi.org/10.3389/fgstr.2024.1334877","url":null,"abstract":"Climate change poses a growing threat to human health and well-being, with emerging evidence pointing to its intricate relationship with liver diseases. Indeed, climate change influences liver diseases through various direct and indirect mechanisms. Alcohol-related liver disease, Metabolic dysfunction-associated liver disease (MASLD), and viral hepatitis are the three most common causes of liver disease, and all are susceptible to the effects of climate change. Shifts in dietary habits driven by altered food availability, substance abuse exacerbated by social instability, extreme weather events affecting healthcare access, and the emergence of waterborne infections are among the factors exacerbating liver disease incidence and severity. On the flip side, healthcare systems, including liver units, significantly contribute to climate change through energy consumption, medical waste, and transportation emissions. The need for sustainable healthcare practices, telemedicine, and waste reduction strategies is becoming increasingly evident. Recognizing this intricate interplay and addressing the dual interaction between climate change and liver disease is imperative for safeguarding human health and reducing the environmental footprint of healthcare facilities. As climate change continues to unfold, understanding its implications for liver disease is critical for public health and environmental sustainability.","PeriodicalId":512079,"journal":{"name":"Frontiers in Gastroenterology","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140972849","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}
The common causes of rectovaginal fistula include obstetric trauma, local infection, and rectal surgery, while rectovaginal fistula following hemorrhoid surgery is extremely rare. Rectovaginal fistulae (RVF) rarely heal without intervention. Surgical treatment is usually performed, but the optimal surgical method remains controversial. The patient was a 37-year-old woman who was transferred to our hospital due to an unsuccessful repair of a rectovaginal fistula after hemorrhoid surgery in a local hospital. The next day after admission, she had prophylactic ileostomy, fecal diversion and combined treatment with cephalosporin antibiotic to create a clean postoperative area. However, there was still fecal outflow from the vagina, with no significant reduction in excretion compared to previous surgery. Digestive endoscopy confirmed a failure of the repair for rectovaginal fistula. Therefore, preventive ileostomy was continued to reduce the accumulation of bacteria in the fistula and control the inflammation. After 8 weeks, the endoscopic fistula inflammation disappeared, and the condition of endoscopic surgery was considered to be mature. Subsequently, a new surgical method combining transanal endoscopy and transvaginal endoscopy was performed. After 12 weeks of surgery, a follow-up endoscopic examination showed that the fistula had been repaired and healed. During the 1-year follow-up, no serious complication was encountered, no recurrence was found, and the repair effect was satisfactory. In conclusion, a new technique combining transanal endoscopy and transvaginal endoscopy can effectively be used for the surgical repair of rectovaginal fistula after a hemorrhoid operation.
{"title":"Surgical repair of rectovaginal fistula by combined transanal and transvaginal endoscopy: a case report","authors":"Tian He, Wen Zhang, Nian-fen Mao, Xuan Bai, Lin Zhao, Ke-lin Yue, Guo-qing Yang, Chun-mei Rao, Jing Wang, Ping Wan, Qiang Guo, Zan Zuo","doi":"10.3389/fgstr.2024.1364379","DOIUrl":"https://doi.org/10.3389/fgstr.2024.1364379","url":null,"abstract":"The common causes of rectovaginal fistula include obstetric trauma, local infection, and rectal surgery, while rectovaginal fistula following hemorrhoid surgery is extremely rare. Rectovaginal fistulae (RVF) rarely heal without intervention. Surgical treatment is usually performed, but the optimal surgical method remains controversial. The patient was a 37-year-old woman who was transferred to our hospital due to an unsuccessful repair of a rectovaginal fistula after hemorrhoid surgery in a local hospital. The next day after admission, she had prophylactic ileostomy, fecal diversion and combined treatment with cephalosporin antibiotic to create a clean postoperative area. However, there was still fecal outflow from the vagina, with no significant reduction in excretion compared to previous surgery. Digestive endoscopy confirmed a failure of the repair for rectovaginal fistula. Therefore, preventive ileostomy was continued to reduce the accumulation of bacteria in the fistula and control the inflammation. After 8 weeks, the endoscopic fistula inflammation disappeared, and the condition of endoscopic surgery was considered to be mature. Subsequently, a new surgical method combining transanal endoscopy and transvaginal endoscopy was performed. After 12 weeks of surgery, a follow-up endoscopic examination showed that the fistula had been repaired and healed. During the 1-year follow-up, no serious complication was encountered, no recurrence was found, and the repair effect was satisfactory. In conclusion, a new technique combining transanal endoscopy and transvaginal endoscopy can effectively be used for the surgical repair of rectovaginal fistula after a hemorrhoid operation.","PeriodicalId":512079,"journal":{"name":"Frontiers in Gastroenterology","volume":" 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141000132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07DOI: 10.3389/fgstr.2024.1374777
A. Rabiee
{"title":"Editorial: Women in hepatology: 2023","authors":"A. Rabiee","doi":"10.3389/fgstr.2024.1374777","DOIUrl":"https://doi.org/10.3389/fgstr.2024.1374777","url":null,"abstract":"","PeriodicalId":512079,"journal":{"name":"Frontiers in Gastroenterology","volume":"32 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141005308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-02DOI: 10.3389/fgstr.2024.1342888
Anjali J. T. Fernandes, Anna L. Farrell, Sara V. Naveh, Subhankar Chakraborty
Irritable Bowel Syndrome (IBS) is a highly prevalent functional gastrointestinal disease that is commonly associated with psychological comorbidities and maladaptive thought patterns. Previous studies report psychological therapies such as cognitive behavioral therapy (CBT) and gut-directed therapy (GDP) improve IBS symptom management and quality of life. This review seeks to understand the effectiveness of various psychotherapies across delivery methods for patients with irritable bowel syndrome.A scoping literature review of PubMed articles highlighting psychological and stress reduction treatments for IBS was conducted. 120 studies were included in the title and abstract screening. 32 studies were selected for full text review. Primary and secondary research studies that investigated the benefit of psychological therapies focusing on stress reduction and cognitive therapies for patients with gastrointestinal condition’s symptom relief met inclusion criteria for the review. 12 studies were selected for inclusion.All 12 reviewed studies reported statistically significant improvements in IBS symptoms with psychological therapies. 8 studies also addressed quality of life and reported statistically significant improvement in intervention groups. 3 studies demonstrated persistent improvement after 12 months. 2 studies compared different types of psychotherapies and reported improvements compared to control groups but no significant differences between psychotherapies. 6 studies that compared face to face therapy with minimal contact or telephone therapy showed no difference in clinical outcomes.Psychological therapies demonstrate reported statistically significant improvements in IBS symptoms and patient quality of life with no reported statistically significant difference across forms of healthcare delivery. Most improvements reportedly persist long-term. Further research with a broader demographic base is needed to assess the economic costs of psychological therapies and their implications for underserved communities.
{"title":"Stress reduction and psychological therapy for IBS: a scoping review","authors":"Anjali J. T. Fernandes, Anna L. Farrell, Sara V. Naveh, Subhankar Chakraborty","doi":"10.3389/fgstr.2024.1342888","DOIUrl":"https://doi.org/10.3389/fgstr.2024.1342888","url":null,"abstract":"Irritable Bowel Syndrome (IBS) is a highly prevalent functional gastrointestinal disease that is commonly associated with psychological comorbidities and maladaptive thought patterns. Previous studies report psychological therapies such as cognitive behavioral therapy (CBT) and gut-directed therapy (GDP) improve IBS symptom management and quality of life. This review seeks to understand the effectiveness of various psychotherapies across delivery methods for patients with irritable bowel syndrome.A scoping literature review of PubMed articles highlighting psychological and stress reduction treatments for IBS was conducted. 120 studies were included in the title and abstract screening. 32 studies were selected for full text review. Primary and secondary research studies that investigated the benefit of psychological therapies focusing on stress reduction and cognitive therapies for patients with gastrointestinal condition’s symptom relief met inclusion criteria for the review. 12 studies were selected for inclusion.All 12 reviewed studies reported statistically significant improvements in IBS symptoms with psychological therapies. 8 studies also addressed quality of life and reported statistically significant improvement in intervention groups. 3 studies demonstrated persistent improvement after 12 months. 2 studies compared different types of psychotherapies and reported improvements compared to control groups but no significant differences between psychotherapies. 6 studies that compared face to face therapy with minimal contact or telephone therapy showed no difference in clinical outcomes.Psychological therapies demonstrate reported statistically significant improvements in IBS symptoms and patient quality of life with no reported statistically significant difference across forms of healthcare delivery. Most improvements reportedly persist long-term. Further research with a broader demographic base is needed to assess the economic costs of psychological therapies and their implications for underserved communities.","PeriodicalId":512079,"journal":{"name":"Frontiers in Gastroenterology","volume":"34 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141021638","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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