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Journal of Gastrointestinal and Liver... Jun 2024Ultra-microangiography (UMA) is a novel Doppler technique with optimized wall filtering that provides high sensitivity to low-velocity blood flows and optimized... (Comparative Study)
Comparative Study
BACKGROUND AND AIMS
Ultra-microangiography (UMA) is a novel Doppler technique with optimized wall filtering that provides high sensitivity to low-velocity blood flows and optimized visualization of microcirculation. The aim of this pilot study was to compare intestinal vascularization assessed by color Doppler signals (CDS) and UMA.
METHODS
We investigated intestinal vascularization using UMA and CDS in 13 patients with confirmed inflammatory bowel disease (IBD). A cohort of 28 patients without structural bowel disease served as the control.
RESULTS
Microcirculation and dysregulated microcirculation in patients without and with inflammatory bowel disease can be visualized and quantified using UMA. In 83 % of IBD patients and 76% of non-IBD patients, a high resolution of intestinal perfusion could be achieved using UMA.
CONCLUSIONS
To the best of our knowledge, this is the first study to investigate intestinal vascularization using UMA in patients with and without structural bowel disease. Quantification and visualization of intestinal vascularization should be further investigated in prospective studies and could help guide our therapy of patients with IBD.
Topics: Humans; Pilot Projects; Microcirculation; Female; Male; Adult; Middle Aged; Intestines; Inflammatory Bowel Diseases; Ultrasonography, Doppler, Color; Angiography; Aged; Young Adult; Predictive Value of Tests; Case-Control Studies
PubMed: 38944869
DOI: 10.15403/jgld-5495 -
Journal of Gastrointestinal and Liver... Jun 2024
Topics: Humans; Mucormycosis; COVID-19; Melena; SARS-CoV-2; Male; Antifungal Agents; Middle Aged
PubMed: 38944868
DOI: 10.15403/jgld-5302 -
Journal of Gastrointestinal and Liver... Jun 2024Recent research has shown that Western-style diets have been associated with an increased risk of inflammatory bowel diseases (IBD). Our aim was to examine the link...
BACKGROUND AND AIMS
Recent research has shown that Western-style diets have been associated with an increased risk of inflammatory bowel diseases (IBD). Our aim was to examine the link between an anti-inflammatory diet and the maintenance of IBD remission, as well as to assess the potential therapeutic advantages of this dietary approach in preserving IBD remission.
METHODS
The inclusion and exclusion criteria were applied to a total of 189 individuals with IBD, with 21 individuals not meeting the criteria. Therefore, 168 eligible patients were enrolled in the study and allocated to either an anti-inflammatory diet or a regular diet, based on their personal preference.
RESULTS
A cohort of 168 IBD adult patients was recruited for the study: 88 patients with ulcerative colitis and 80 with Crohn's disease. The intervention group received an anti-inflammatory diet consisting of the removal of red and processed meat, fried foods, high-lactose foods, fast food, white bread, sugar, and vegetable oils rich in omega-6 for a period of 1 year. The clinical response was maintained in 80 patients (95.2%) in the intervention group and in 72 patients (85.7%) in the control group (p-value=0.036). Although not statistically significant, fecal calprotectin was higher in the control group than in the intervention group at follow-up.
CONCLUSIONS
Patients who adhered to an anti-inflammatory diet exhibited a higher rate of maintenance of clinical remission. Furthermore, improvement in inflammation tests was observed in the intervention group, reinforcing the proposition that IBD is a lifestyle-related disease.
Topics: Humans; Female; Male; Adult; Prospective Studies; Crohn Disease; Colitis, Ulcerative; Biomarkers; Recurrence; Middle Aged; Feces; Remission Induction; Leukocyte L1 Antigen Complex; Treatment Outcome; Young Adult; Time Factors; Inflammation Mediators; Diet, Healthy
PubMed: 38944867
DOI: 10.15403/jgld-5482 -
Journal of Gastrointestinal and Liver... Jun 2024
Topics: Humans; COVID-19; COVID-19 Vaccines; SARS-CoV-2; Vaccination; Liver Diseases; Chronic Disease
PubMed: 38944866
DOI: 10.15403/jgld-5619 -
Journal of Gastrointestinal and Liver... Jun 2024There has been a growing emphasis on dietary therapies for irritable bowel syndrome (IBS). Furthermore, there has been an evolving evidence base for the low fermentable...
BACKGROUND AND AIMS
There has been a growing emphasis on dietary therapies for irritable bowel syndrome (IBS). Furthermore, there has been an evolving evidence base for the low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet, gluten-free diet (GFD), and lactose-free diet. This study examines the dietary approaches employed and the factors influencing dietetic decision-making for IBS interventions.
METHODS
Participants, including registered dietitians and nutritionists, were recruited from diverse healthcare settings at the point of registration for the 4th Sheffield National Dietetic Gastroenterology Symposium, 2023. A 15-question online survey investigated the practices of dietitians and nutritionists in managing IBS patients, covering dietary approaches, decision-making factors, and patient education. The evidence base for different dietary interventions was provided and a follow-up survey assessed symposium attendees, views on current IBS dietary practices.
RESULTS
Out of 731 respondents, primarily registered dietitians (93%) and females (93%), 54% spent 10-50% of clinic time on IBS. Respondents noted that a GFD (34%), low lactose (32%), and traditional dietary advice (TDA) (18%) were the most frequently used dietary interventions that patients try before seeking professional advice. Delegates were asked to rank their dietary intervention preferences pre- and post-meeting (after the evidence base had been presented): TDA pre-meeting 75% versus post-meeting 87% (p=0.04), fibre modification 59% versus 6% (p<0.0001), low FODMAP 25% versus 10% (p=0.0001), low lactose 12% versus 62% (p<0.0001) and GFD 6% to 23% (p<0.0001).
CONCLUSIONS
TDA remains the choice of diet for dietitians. After our educational event, the use of low-lactose and gluten-free diet significantly increased. Factors influencing the decision-making process were based on patient acceptability, counselling time, supporting evidence base and dietary triggers.
Topics: Humans; Irritable Bowel Syndrome; Female; Male; Nutritionists; Patient Education as Topic; Diet, Gluten-Free; Diet, Carbohydrate-Restricted; Surveys and Questionnaires; Health Care Surveys; Adult; Middle Aged; Clinical Decision-Making
PubMed: 38944865
DOI: 10.15403/jgld-5466 -
Journal of Gastrointestinal and Liver... Jun 2024The "tumbling gallstone sign" is a diagnostic imaging finding described on radiologic examinations of the abdomen, in patients with cholelithiasis associated with...
The "tumbling gallstone sign" is a diagnostic imaging finding described on radiologic examinations of the abdomen, in patients with cholelithiasis associated with intermittent episodes of gallstone obstructive ileus. Best seen on serial radiographs or CT studies of the abdomen, this sign indicates a sudden change in position of the gallstone(s) within the intestinal lumen from the upper segments of the bowel to the lower segments of the bowel, causing transient mechanical bowel obstruction. The tumbling gallstone sign has been likened to that of the classic childrens' tumbling tower balancing game. On repeat CT scans, the dislodged gallstone(s) may be seen proceeding distally and impact in the ileum at a level lower than that seen on the previous CT scans, analogous to the tumbling gallstone sign.
Topics: Humans; Gallstones; Ileus; Tomography, X-Ray Computed; Intestinal Obstruction; Predictive Value of Tests
PubMed: 38944864
DOI: 10.15403/jgld-5332 -
Journal of Gastrointestinal and Liver... Jun 2024
Response to Letter to Editor on "Reduction of Fecal Calprotectin Levels Induced by a Short Course of Escherichia Coli Nissle is Associated with a Lower Likelihood of Disease Flares in Patients with Ulcerative Colitis in Clinical Remission".
Topics: Humans; Leukocyte L1 Antigen Complex; Colitis, Ulcerative; Feces; Escherichia coli; Remission Induction; Symptom Flare Up; Probiotics; Biomarkers
PubMed: 38944863
DOI: 10.15403/jgld-5660 -
Journal of Gastrointestinal and Liver... Jun 2024Colorectal cancer is a prevalent malignancy, with advanced and metastatic forms exhibiting poor treatment outcomes and high relapse rates. To enhance patient outcomes, a... (Review)
Review
Colorectal cancer is a prevalent malignancy, with advanced and metastatic forms exhibiting poor treatment outcomes and high relapse rates. To enhance patient outcomes, a comprehensive understanding of the pathophysiological processes and the development of targeted therapies are imperative. The high heterogeneity of colorectal cancer demands precise and personalized treatment strategies. Colorectal cancer organoids, a three-dimensional in vitro model, have emerged as a valuable tool for replicating tumor biology and exhibit promise in scientific research, disease modeling, drug screening, and personalized medicine. In this review, we present an overview of colorectal cancer organoids and explore their applications in research and personalized medicine, while also discussing potential future developments in this field.
Topics: Humans; Organoids; Colorectal Neoplasms; Precision Medicine; Animals
PubMed: 38944855
DOI: 10.15403/jgld-5388 -
Journal of Gastrointestinal and Liver... Jun 2024Colonoscopy has a vital role in the diagnosis of inflammatory bowel disease (IBD), as well as in the estimation of disease severity, monitoring response to therapy, and... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND AIMS
Colonoscopy has a vital role in the diagnosis of inflammatory bowel disease (IBD), as well as in the estimation of disease severity, monitoring response to therapy, and surveillance for neoplasia. We performed a systematic review of randomised trials of various bowel preparations for colonoscopy in IBD.
METHODS
We searched various electronic databases (PubMed, Embase, and CENTRAL) for studies reporting about the use of various strategies to improve colonoscopy preparation in IBD. We included only randomized clinical trials (RCTs). A network meta-analysis was done using a frequentist approach to compare the effectiveness of various bowel preparations. The risk of bias was assessed using Cochrane risk of bias tool 2.0. Other outcome parameters like compliance, tolerance, acceptance, and adverse effects were assessed qualitatively.
RESULTS
Seven RCTs reporting about 960 patients were included. On comparison with 4 liter (L) of poliethylen glycol (PEG), oral sulfate solution (OR=1.1, 95%CI: 0.65-1.86); PEG2L/Ascorbate (OR=0.98, 95%CI: 0.65-1.48); PEG1L (OR=1, 95%CI: 0.55-1.81); PEG2L plus bisacodyl (OR=1.08, 95%CI: 0.71-1.65); PEG4L plus simethicone (OR=1, 95%CI: 0.67-1.50); PEG/ sodium picosulfate and magnesium citrate (SPMC) 1.5L (OR=0.99, 95%CI: 0.55-1.78); SPMC 2L (OR=1.09, 95%CI: 0.61-1.97) had similar effectiveness. Three RCTs reported compliance, five RCTs reported tolerance, two studies reported patient acceptance and five RCTs reported data on the willingness of patients to repeat the procedure in the future. Low-volume preparations had better compliance, tolerance, acceptance, and willingness to repeat. No difference in additional outcomes like change in disease activity after colonoscopy, procedure-related outcomes after colonoscopy like cecal intubation rate, and change in electrolyte levels were found.
CONCLUSION
Various bowel preparations had similar effectiveness in respect to colonoscopy preparation in IBD patients. Low-volume preparations have better compliance, tolerance, and acceptance. The systematic review was limited by a small number of included RCTs.
Topics: Humans; Colonoscopy; Randomized Controlled Trials as Topic; Cathartics; Inflammatory Bowel Diseases; Network Meta-Analysis
PubMed: 38944852
DOI: 10.15403/jgld-5433 -
The Oncologist Jun 2024Lung cancer in never-smoker (LCINS) patients accounts for 20% of lung cancer cases, and its biology remains poorly understood, particularly in genetically admixed...
INTRODUCTION
Lung cancer in never-smoker (LCINS) patients accounts for 20% of lung cancer cases, and its biology remains poorly understood, particularly in genetically admixed populations. We elucidated the molecular profile of driver genes in Brazilian LCINS.
METHODS
The mutational and gene fusion status of 119 lung adenocarcinomas from self-reported never-smoker patients, was assessed using targeted sequencing (NGS), nCounter, and immunohistochemistry. A panel of 46 ancestry-informative markers determined patients' genetic ancestry.
RESULTS
The most frequently mutated gene was EGFR (49.6%), followed by TP53 (39.5%), ALK (12.6%), ERBB2 (7.6%), KRAS (5.9%), PIK3CA (1.7%), and less than 1% alterations in RET, NTRK1, MET∆ex14, PDGFRA, and BRAF. Except for TP53 and PIK3CA, all other alterations were mutually exclusive. Genetic ancestry analysis revealed a predominance of European (71.1%), and a higher African ancestry was associated with TP53 mutations.
CONCLUSION
Brazilian LCINS exhibited a similar molecular profile to other populations, except the increased ALK and TP53 alterations. Importantly, 73% of these patients have actionable alterations that are suitable for targeted treatments.
PubMed: 38944844
DOI: 10.1093/oncolo/oyae129