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Many Paradoxes of My Gastroenterology Practice
Sonnenberg, Amnon MD, MSc1,2
doi : 10.14309/ctg.0000000000000328
April 2021 - Volume 12 - Issue 4 - p e00328
A paradox describes the clash between 2 seemingly reasonable prepositions whose joint occurrence appears impossible. Like any other human endeavor, medicine is also filled with paradoxes that await resolution. This editorial lists several common paradoxes frequently encountered by clinical gastroenterologists. These examples illustrate the interplay between risk and benefit, cost and effect, disease and cure, and escape and exposure. It is hoped that addressing these paradoxes and trying to resolve their underlying contradictions will ultimately lead to a more efficacious and rational delivery of healthcare.
A Multicenter, Open-Label, Single-Arm Study to Evaluate the Efficacy and Safety of Saroglitazar in Patients With Primary Biliary Cholangitis
Vuppalanchi, Raj MD1; González-Huezo, Ma Saraí MD2; Payan-Olivas, Ramon MD3; Muñoz-Espinosa, Linda E. MD, PhD4; Shaikh, Farheen BUMS5; Pio Cruz-Lopez, Jose L. MD6; Parmar, Deven MD5
doi : 10.14309/ctg.0000000000000327
April 2021 - Volume 12 - Issue 4 - p e00327
Patients with primary biliary cholangitis (PBC) without biochemical response to ursodeoxycholic acid (UDCA) are at increased risk of liver-related mortality. Saroglitazar is a novel peroxisome proliferator-activated receptor (PPAR) agonist with dual PPAR agonistic properties (?/?). There is a strong mechanistic rationale for studying saroglitazar in PBC because PPAR? is a molecular target of fibrates that showed improvements in liver tests in patients with PBC.
Nonalcoholic Fatty Liver Disease in Lean Subjects: Associations With Metabolic Dysregulation and Cardiovascular Risk—A Single-Center Cross-Sectional Study
Semmler, Georg MD1; Wernly, Sarah MD1; Bachmayer, Sebastian MD1; Wernly, Bernhard MD, PhD2; Schwenoha, Lena1; Huber-Schönauer, Ursula Dr Mag1; Stickel, Felix MD3; Niederseer, David MD, PhD4; Aigner, Elmar MD5; Datz, Christian MD1
doi : 10.14309/ctg.0000000000000326
April 2021 - Volume 12 - Issue 4 - p e00326
Although a milder metabolic phenotype of nonalcoholic fatty liver disease (NAFLD) in lean patients (body mass index [BMI] <25 kg/m2) compared to overweight/obese patients with NAFLD is assumed, the relevance of NAFLD among lean subjects remains a matter of debate. We aimed to characterize the metabolic/cardiovascular phenotype of lean patients with NAFLD.
Identification of High-Risk Patients With Nonalcoholic Fatty Liver Disease Using Noninvasive Tests From Primary Care and Endocrinology Real-World Practices
Younossi, Zobair M. MD, MPH1,2; Pham, Huong BS1; Felix, Sean BS1; Stepanova, Maria PhD3; Jeffers, Thomas BS1,4; Younossi, Elena BS1; Allawi, Hussain MD1; Lam, Brian PA-C1,4; Cable, Rebecca BS1,4; Afendy, Mariam BS1,4; Younoszai, Zahra MPH1,4; Afendy, Arian BS1,4; Rafiq, Nila MD1,2,4; Alzubaidi, Nahrain MD2,4; Ousman, Yasser MD2; Bailey, Marc MD2; Chris, Zik MD2; Castillo-Catoni, Maria MD2; Fozdar, Pratima MD2; Ramirez, Maria MD2; Husain, Mehreen MD2; Hudson, Evis MD2; Schneider, Ingrid MD1; Golabi, Pegah MD1,2; Nader, Fatema MSBM3
doi : 10.14309/ctg.0000000000000340
April 2021 - Volume 12 - Issue 4 - p e00340
We aimed to identify high-risk nonalcoholic fatty liver disease (NAFLD) patients seen at the primary care and endocrinology practices and link them to gastrohepatology care.
Diagnostic Performance of FibroTouch Ultrasound Attenuation Parameter and Liver Stiffness Measurement in Assessing Hepatic Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease
Qu, Ying MD1; Song, Yan-Yan PhD2; Chen, Cheng-Wei MD3; Fu, Qing-Chun MD3; Shi, Jun-Ping MD4; Xu, Yun MD5; Xie, Qing MD6; Yang, Yong-Feng MD7; Zhou, Yong-Jian MD8; Li, Liang-Ping MD9; Xu, Ming-Yi MD1; Cai, Xiao-Bo MD1; Zhang, Qi-Di MD1; Yu, Hao PhD10; Fan, Jian-Gao MD11; Lu, Lun-Gen MD1
doi : 10.14309/ctg.0000000000000323
April 2021 - Volume 12 - Issue 4 - p e00323
To evaluate the diagnostic performance of ultrasound attenuation parameter (UAP) and liver stiffness measurement (LSM) by FibroTouch for diagnosis of hepatic steatosis and fibrosis in patients with nonalcoholic fatty liver disease (NAFLD).
Prediction of Hepatocellular Carcinoma by Liver Stiffness Measurements Using Magnetic Resonance Elastography After Eradicating Hepatitis C Virus
Kumada, Takashi MD, PhD1; Toyoda, Hidenori MD, PhD2; Yasuda, Satoshi MD, PhD2; Sone, Yasuhiro MD, PhD3; Ogawa, Sadanobu4; Takeshima, Kenji4; Tada, Toshifumi MD, PhD5; Ito, Takanori MD, PhD6; Sumida, Yoshio MD, PhD7; Tanaka, Junko PhD8
doi : 10.14309/ctg.0000000000000337
April 2021 - Volume 12 - Issue 4 - p e00337
Liver fibrosis stage is one of the most important factors in stratifying the risk of developing hepatocellular carcinoma (HCC). We evaluated the usefulness of liver stiffness measured by magnetic resonance elastography (MRE) to stratify the risk of developing HCC in patients who underwent MRE before receiving direct-acting antivirals (DAAs) and subsequently achieved sustained virological response (SVR).
Pretreatment HLADQA1-HLADRB1 Testing for the Prevention of Azathioprine-Induced Pancreatitis in Inflammatory Bowel Disease: A Prospective Cohort Study
Wilson, Aze MD, PhD1,2,3; Wang, Qian BSc4; Choi, Yun-Hee PhD5; Ponich, Terry MD2; Gregor, James C. MD2; Chande, Nilesh MD2; Yan, Brian MD2; Sey, Michael MD2; Beaton, Melanie MD2; Kim, Richard B. MD1,3
doi : 10.14309/ctg.0000000000000332
April 2021 - Volume 12 - Issue 4 - p e00332
Azathioprine-induced pancreatitis is an idiosyncratic and unpredictable response, occurring in up to 7% of azathioprine-exposed patients with inflammatory bowel disease (IBD). The haplotype HLADQA1-HLADRB1*07:01A>C is strongly associated with azathioprine-induced pancreatitis in IBD. We aimed to evaluate whether pretreatment HLADQA1-HLADRB1*07:01A>C screening will reduce the risk of azathioprine-induced pancreatitis.
Increased Gene Copy Number of DEFA1A3 Is Associated With the Severity of Ulcerative Colitis
Kanmura, Shuji MD, PhD1; Morinaga, Yuko MS1; Tanaka, Akihito MD, PhD1; Komaki, Yuga MD, PhD1; Iwaya, Hiromichi MD1; Kumagai, Kotaro MD, PhD1; Mawatari, Seiichi MD, PhD1; Sasaki, Fumisato MD, PhD1; Tanoue, Shiroh MD, PhD1; Hashimoto, Shinichi MD, PhD1; Sameshima, Yoichi MD2; Ono, Yohei MD, PhD3; Ohi, Hidehisa MD, PhD3; Ido, Akio MD, PhD1
doi : 10.14309/ctg.0000000000000331
April 2021 - Volume 12 - Issue 4 - p e00331
DEFA1A3 encodes human neutrophil peptides (HNPs) 1–3 and has multiple copy number variations (CNVs). HNPs are associated with innate immunity. Ulcerative colitis (UC), a chronic inflammatory gastrointestinal disorder, is a life-threatening condition, and predictive markers of UC severity are needed. This study investigated the relationship between DEFA1A3 CNV and UC severity.
Ileal Crohn's Disease Exhibits Similar Transmural Fibrosis Irrespective of Phenotype
Tavares de Sousa, Helena MD1,2; Gullo, Irene MD, PhD3,4,5; Castelli, Claudia MD6; Dias, Cláudia Camila BSc, MSc, PhD7,8; Rieder, Florian MD, PhD9,10; Carneiro, Fátima MD, PhD3,4,5; Magro, Fernando MD, PhD11,12,13
doi : 10.14309/ctg.0000000000000330
April 2021 - Volume 12 - Issue 4 - p e00330
In Crohn's disease (CD), the assessment of transmural inflammation and fibrosis is of utmost importance. This study aimed to quantify these parameters in CD ileal specimens and correlate them with disease progression.
Influence of Proton Pump Inhibitors and Histamine Receptor 2 Antagonists on Blastocystis ST3 and Selected Microorganisms of Intestinal Microbiota In Vitro
Lepczy?ska, Ma?gorzata MS1; Dzika, Ewa PhD1; Chen, WenChieh MD2; Lu, Chien-Yu MD3,4
doi : 10.14309/ctg.0000000000000325
April 2021 - Volume 12 - Issue 4 - p e00325
Proton pump inhibitors (PPIs) and histamine receptor 2 (H2) antagonists are commonly prescribed medications. Association between PPIs and alteration of the gut microbiota has been reported. Blastocystis, the most common intestinal protozoan worldwide, occurs in both healthy and symptomatic people with gastrointestinal or cutaneous disorders, with controversial pathogenicity. The current study was aimed to investigate the influence of PPIs and H2 blockers on the in vitro proliferation of selected intestinal bacteria, fungi, and protozoa.
Differential mRNA Expression in Ileal Mucosal Biopsies of Patients With Diarrhea- or Constipation-Predominant Irritable Bowel Syndrome
Wang, Xiao Jing MD1; Carlson, Paula BS1; Chedid, Victor MD1; Maselli, Daniel B. MD1; Taylor, Ann L. BA1; McKinzie, Sanna MS1; Camilleri, Michael MD1
doi : 10.14309/ctg.0000000000000329
April 2021 - Volume 12 - Issue 4 - p e00329
Previous studies in patients with irritable bowel syndrome (IBS) showed immune activation, secretion, and barrier dysfunction in duodenal, jejunal, or colorectal mucosa. This study aimed to measure ileal mucosal expression of genes and proteins associated with mucosal functions.
Endoscopic Resection Before Surgery Does Not Affect the Recurrence Rate in Patients With High-Risk T1 Colorectal Cancer
Takamaru, Hiroyuki MD, PhD1; Saito, Yutaka MD, PhD1; Sekiguchi, Masau MD, PhD1,2; Yamada, Masayoshi MD, PhD1; Sakamoto, Taku MD, PhD1; Matsuda, Takahisa MD, PhD1,2; Sekine, Shigeki MD, PhD3; Ochiai, Hiroki MD, PhD4; Tsukamoto, Shunsuke MD, PhD4; Shida, Dai MD, PhD4; Kanemitsu, Yukihide MD4
doi : 10.14309/ctg.0000000000000336
April 2021 - Volume 12 - Issue 4 - p e00336
Patients with high-risk T1 colorectal cancer (CRC) after endoscopic resection (ER) should undergo surgery in view of the risk of lymph node metastasis. Although additional surgery can potentially prevent recurrence, there is a paucity of data and longitudinal studies exploring this potential. Hence, this study aimed to evaluate the prolonged influence of ER before additional surgery on recurrence in T1 CRC.
Translating Fecobionics Into a Technique That Addresses Clinical Needs for Objective Perineal Descent Measurements
Zhuang, Z. MEng1; Hung, H.Y. MD, PhD2; Chen, S.C. MD1; Futaba, K. MD, PhD1; Gregersen, H. MD, PhD1
doi : 10.14309/ctg.0000000000000342
April 2021 - Volume 12 - Issue 4 - p e00342
Perineal descent is a phenomenon associated with anorectal dysfunction. It is diagnosed by defecography but subjected to manual measurements on the images/videos and interobserver bias. Fecobionics is a simulated feces for assessing important physiological parameters during defecation. Here, we translate Fecobionics into a new method for estimation of perineal descent based on electronic signals from the embedded inertial measurement units (IMUs).
Functional Dyspepsia, Peptic Ulcer, and Helicobacter pylori Infection in a Rural Community of South Asia: An Endoscopy-Assisted Household Survey
Rahman, M. Masudur FCPS, MD, FACP, FACG, FRCP1; Ghoshal, Uday C. MD, DNB, DM, FACG, RFF, FAMS, FRCP2; Kibria, Md. Golam FCPS, MD, FACG1; Sultana, Nigar FCPS3; Yusuf, M. Abdllah MPhil4; Nahar, Shamsun MSc5; Ahmed, Faruque FCPS, MD, FRCP1; Rowshon, AHM FCPS, MD6; Hasan, Mahmud FCPS, FRCP, PhD7
doi : 10.14309/ctg.0000000000000334
April 2021 - Volume 12 - Issue 4 - p e00334
Functional dyspepsia (FD), although commoner than organic dyspepsia (OD) in-hospital studies, community data, particularly from rural areas, are lacking. We performed a rural community study in Bangladesh with the primary aims to evaluate (i) the prevalence of uninvestigated dyspepsia (UD), FD, and OD and (ii) the risk factors for UD.
Increased Risk of Major Depressive Disorder After Cholecystectomy: A Nationwide Population-Based Cohort Study in Korea
Jin, Eun Hyo MD, PhD1; Han, Kyungdo PhD2; Lee, Dong Ho MD, PhD3; Shin, Cheol Min MD, PhD3; Lim, Joo Hyun MD, PhD1; Yoon, Hyuk MD, PhD3; Kim, Nayoung MD, PhD3
doi : 10.14309/ctg.0000000000000339
April 2021 - Volume 12 - Issue 4 - p e00339
This study investigated the risk of depression in Korean adults who underwent cholecystectomy and appeared for subsequent long-term follow-ups. A national population-based data set was used for analysis.
Prevalence and Persistent Shedding of Fecal SARS-CoV-2 RNA in Patients With COVID-19 Infection: A Systematic Review and Meta-analysis
Zhang, Yawen MD, PhD1; Cen, Mengsha MM1; Hu, Mengjia MM2; Du, Lijun MD, PhD1; Hu, Weiling MD, PhD1; Kim, John J. MD, MS3; Dai, Ning MD, PhD1,4
doi : 10.14309/ctg.0000000000000343
April 2021 - Volume 12 - Issue 4 - p e00343
The prevalence and shedding of fecal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA indicate coronavirus disease 2019 (COVID-19) infection in the gastrointestinal (GI) tract and likely infectivity. We performed a systemic review and meta-analysis to evaluate the prevalence and the duration of shedding of fecal RNA in patients with COVID-19 infection.
Oral Proton Pump Inhibitors May Be as Effective as Intravenous in Peptic Ulcer Bleeding: A Systematic Review and Meta-analysis
Csiki, Endre MD1,2; Szabó, Hanna MD1,3; Hanák, Lilla MSc1; Szakács, Zsolt MD1; Kiss, Szabolcs MD1,4; Vörhendi, Nóra MD1; Pécsi, Dániel MD, PhD5; Hegyi, Eszter MD, PhD1; Hegyi, Péter MD, PhD, DSc1; Er?ss, Bálint MD, PhD1
doi : 10.14309/ctg.0000000000000341
April 2021 - Volume 12 - Issue 4 - p e00341
Current guidelines recommend intravenous (IV) proton pump inhibitor (PPI) therapy in peptic ulcer bleeding (PUB). We aimed to compare the efficacy of oral and IV administration of PPIs in PUB.
Reviewer Recognition 2020
doi : 10.14309/ctg.0000000000000352
April 2021 - Volume 12 - Issue 4 - p e00352
