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Is the Intestine a Portal of Entry for the Serious COVID-19 Complications of Endotoxemia and Thrombosis?
Alpers, David H. MD
doi : 10.14309/ctg.0000000000000367
June 2021 - Volume 12 - Issue 6 - p e00367
Severe acute respiratory syndrome coronavirus 2 infection has been associated with both endotoxemia and thrombosis of small and large vessels, but the relationship between these 2 phenomena has not been pursued. Oliva et al. in this issue of Clinical and Translational Gastroenterology demonstrate an association between the 2 findings and suggest that increased intestinal permeability is a possible mechanism to explain the endotoxemia. Although the evidence to support this hypothesis is only suggestive, the role of the small intestine in the illness produced by the virus needs to be further explored.
Haloperidol Use in the Emergency Department for Gastrointestinal Symptoms: Nausea, Vomiting, and Abdominal Pain
Shahsavari, Dariush MD1; Reznick-Lipina, Kaitlin RN2; Malik, Zubair MD1; Weiner, Mark MD3; Jehangir, Asad MD4; Repanshek, Zachary D. MD5; Parkman, Henry P. MD1
doi : 10.14309/ctg.0000000000000362
June 2021 - Volume 12 - Issue 6 - p e00362
Haloperidol (HL) has successfully been used for nausea and abdominal pain in emergency departments (EDs). This study examines outcomes and predictive factors for clinical improvement of patients presenting to an ED with gastrointestinal (GI) symptoms (nausea, vomiting, and abdominal pain) who received HL.
Low-Grade Endotoxemia and Thrombosis in COVID-19
Oliva, Alessandra MD1; Cammisotto, Vittoria MSc2; Cangemi, Roberto MD3; Ferro, Domenico MD4; Miele, Maria Claudia MSc1; De Angelis, Massimiliano PhD1; Cancelli, Francesca MD1; Pignatelli, Pasquale MD4,5; Venditti, Mario MD1; Pugliese, Francesco MD2; Mastroianni, Claudio Maria MD1; Violi, Francesco MD4,5
doi : 10.14309/ctg.0000000000000348
June 2021 - Volume 12 - Issue 6 - p e00348
Patients with community-acquired pneumonia display enhanced levels of lipopolysaccharides (LPS) compared with controls, suggesting that low-grade endotoxemia may be implicated in vascular disturbances. It is unknown whether this occurs in patients with coronavirus 2019 (COVID-19) and its impact on thrombotic complications.
Real-World Data on the Impact of COVID-19 on Endoscopic Procedural Delays
Issaka, Rachel B. MD, MAS1,2; Feld, Lauren D. MD2; Kao, Jason PA-C1,3; Hegarty, Erin MA4; Snailer, Brandon MPH2; Kalra, Gorav MD2; Tomizawa, Yutaka MD, MS2; Strate, Lisa MD, MPH2
doi : 10.14309/ctg.0000000000000365
June 2021 - Volume 12 - Issue 6 - p e00365
Issaka, Rachel B. MD, MAS1,2; Feld, Lauren D. MD2; Kao, Jason PA-C1,3; Hegarty, Erin MA4; Snailer, Brandon MPH2; Kalra, Gorav MD2; Tomizawa, Yutaka MD, MS2; Strate, Lisa MD, MPH2
A Gastrointestinal Endoscopy Quality Control System Incorporated With Deep Learning Improved Endoscopist Performance in a Pretest and Post-Test Trial
Yao, Liwen MD1,2,3; Liu, Jun MA1,2,3; Wu, Lianlian MD1,2,3; Zhang, Lihui MD1,2,3; Hu, Xiao MA4; Liu, Jinzhu MA4; Lu, Zihua MD1,2,3; Gong, Dexin MD1,2,3; An, Ping MD1,2,3; Zhang, Jun MD1,2,3; Hu, Guiying MD1,2,3; Chen, Di MD1,2,3; Luo, Renquan MD1,2,3; Hu, Shan PhD4; Yang, Yanning MD5; Yu, Honggang MD1,2,3
doi : 10.14309/ctg.0000000000000366
June 2021 - Volume 12 - Issue 6 - p e00366
Gastrointestinal endoscopic quality is operator-dependent. To ensure the endoscopy quality, we constructed an endoscopic audit and feedback system named Endo.Adm and evaluated its effect in a form of pretest and posttest trial.
Correlation of LINE-1 Hypomethylation With Size and Pathologic Extent of Dysplasia in Colorectal Tubular Adenomas
Jiang, Alice C. MD1; Buckingham, Lela PhD2; Bishehsari, Faraz MD, PhD1; Sutherland, Stephanie MS, MLS2; Ma, Karen MD1; Melson, Joshua E. MD, MPH1
doi : 10.14309/ctg.0000000000000369
June 2021 - Volume 12 - Issue 6 - p e00369
Conventional adenomas (tubular adenoma [TA] or tubulovillous adenoma) and sessile serrated lesions (SSLs) are neoplastic precancerous lesions frequently detected in patients undergoing average risk screening colonoscopy and polyp surveillance. Metachronous risk stratification of adenomas is currently limited to histologic features and size of polyps. We report long interspersed nucleotide element-1 (LINE-1) methylation levels in SSL in comparison to TA and the impact of TA size and presence of high-grade dysplasia (HGD) on LINE-1 methylation.
A Novel Multiparameter Scoring Model for Noninvasive Early Prediction of Ischemic Colitis: A Multicenter, Retrospective, and Real-World Study
Li, Shan MB1; Luo, Yiwei MM1; Wang, Wei MB1; Lu, Jinlai MM1; Hu, Miao MD1; Sun, Qinjuan MM1; Yang, Xiaoqing MB1; Han, Junyi MD; Zhong, Lan MD1
doi : 10.14309/ctg.0000000000000370
June 2021 - Volume 12 - Issue 6 - p e00370
Ischemic colitis (IC) is a common gastrointestinal ischemic disease caused by hypoperfusion or reperfusion injury. However, there are few studies on risk factors associated with poor prognoses of the disease. This study aimed to determine the predictors of poor prognoses in patients with IC and establish a prognostic scoring method with good internal and external validity for identifying severe cases in an early stage.
Validation of High-Sensitivity Severe Acute Respiratory Syndrome Coronavirus 2 Testing for Stool—Toward the New Normal for Fecal Microbiota Transplantation
Babiker, Ahmed MBBS1,2; Ingersoll, Jessica M. MS, MB(ASCP)2; Adelman, Max W. MD, MSc1; Webster, Andrew S. MD1; Broder, Kari J. DO2; Stittleburg, Victoria BS1; Waggoner, Jesse J. MD1; Kraft, Colleen S. MD, MSc1,2; Woodworth, Michael H. MD, MSc1
doi : 10.14309/ctg.0000000000000363
June 2021 - Volume 12 - Issue 6 - p e00363
Mounting evidence demonstrates potential for fecal–oral transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The US Food and Drug Administration now requires SARS-CoV-2 testing of potential feces donors before the use of stool manufactured for fecal microbiota transplantation. We sought to develop and validate a high-sensitivity SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR) procedure for testing stool specimens.
Detection of Postcolonoscopy Colorectal Neoplasia by Multi-target Stool DNA
Ebner, Derek W. MD1; Eckmann, Jason D. MD1; Burger, Kelli N. BS2; Mahoney, Douglas W. MS2; Bering, Jamie MD3; Kahn, Allon MD3; Rodriguez, Eduardo A. MD3; Prichard, David O. MD1,4; Wallace, Michael B. MD5; Kane, Sunanda V. MD, MSPH1; Finney Rutten, Lila J. PhD2; Gurudu, Suryakanth R. MD3; Kisiel, John B. MD1
doi : 10.14309/ctg.0000000000000375
June 2021 - Volume 12 - Issue 6 - p e00375
Significant variability between colonoscopy operators contributes to postcolonoscopy colorectal cancers (CRCs). We aimed to estimate postcolonoscopy colorectal neoplasia (CRN) detection by multi-target stool DNA (mt-sDNA), which has not previously been studied for this purpose.
Molecular and Histological Profiling Reveals an Innate-Shaped Immune Microenvironment in Solitary Juvenile Polyps
Zysset, Daniel PhD1; Montani, Matteo MD1; Spalinger, Johannes MD2; Schibli, Susanne MD3; Zlobec, Inti PhD1; Mueller, Christoph PhD1; Sokollik, Christiane MD3
doi : 10.14309/ctg.0000000000000361
June 2021 - Volume 12 - Issue 6 - p e00361
Solitary juvenile polyps (JP) are characterized by a benign disease course with low recurrence rate but present with signs of intestinal inflammation. To better understand the underlying pathogenesis, we performed histological and molecular evaluation targeting distinct immune mechanisms.
Internet Cognitive-Behavioral Therapy for Painful Chronic Pancreatitis: A Pilot Feasibility Randomized Controlled Trial
Palermo, Tonya M. PhD1,2; Law, Emily F. PhD1,2; Topazian, Mark D. MD3; Slack, Katherine BA2; Dear, Blake F. PhD4; Ko, Yeon Joo BS2; Vege, Santhi Swaroop MD3; Fogel, Evan MD5; Trikudanathan, Guru MD6; Andersen, Dana K. MD7; Conwell, Darwin L. MD8; Yadav, Dhiraj MD9, on behalf of the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC)
doi : 10.14309/ctg.0000000000000373
June 2021 - Volume 12 - Issue 6 - p e00373
Severe abdominal pain is a cardinal symptom of chronic pancreatitis (CP) associated with a high economic and societal burden. In other chronic pain conditions, cognitive-behavioral therapy (CBT) has demonstrated efficacy in improving patient outcomes (e.g., pain-related disability and depression). However, CBT has not yet been evaluated in adult patients with painful CP. We aimed to (i) evaluate the feasibility and acceptability of an adapted Internet CBT program for CP and (ii) generate pilot data regarding the effects of treatment on patient pain outcomes.
Telemonitoring-Supported Exercise Training in Employees With Metabolic Syndrome Improves Liver Inflammation and Fibrosis
Haufe, Sven MSc1,2; Hupa-Breier, Katharina L. MD3; Bayerle, Pauline MSc1; Boeck, Hedwig T. MA1; Rolff, Simone MSc1; Sundermeier, Thorben MSc1; Kerling, Arno MD1; Eigendorf, Julian MSc1; Kück, Momme1; Hanke, Alexander A. MD1; Ensslen, Ralf MD4; Nachbar, Lars MD4; Lauenstein, Dirk5; Böthig, Dietmar MD6; Hilfiker-Kleiner, Denise MD7; Stiesch, Meike MD8; Terkamp, Christoph MD3; Wedemeyer, Heiner MD3; Haverich, Axel MD6; Tegtbur, Uwe MD1
doi : 10.14309/ctg.0000000000000371
June 2021 - Volume 12 - Issue 6 - p e00371
Metabolic syndrome (MetS) is a major health problem worldwide and the main risk factor for metabolic-associated fatty liver disease (MAFLD). Established treatment options are lifestyle interventions facilitating dietary change and increased physical activity. Here, we tested the effect of a telemonitoring-supported intervention on liver parameter of inflammation and fibrosis in individuals with MetS.
Potential Benefits of Underdilation of 8-mm Covered Stent in Transjugular Intrahepatic Portosystemic Shunt Creation
Liu, Jiacheng MD1,2; Ma, Jinqiang MS1,2; Zhou, Chen MS1,2; Yang, Chongtu MS1,2; Huang, Songjiang MS1,2; Shi, Qin MS1,2; Xiong, Bin PhD1,2
doi : 10.14309/ctg.0000000000000376
June 2021 - Volume 12 - Issue 6 - p e00376
Hepatic encephalopathy (HE) is a major complication of transjugular intrahepatic portosystemic shunt (TIPS) creation. This study was aimed to determine whether underdilated TIPS with 8-mm polytetrafluoroethylene-covered stents could reduce the risk of HE and liver damage yet maintain clinical and hemodynamic efficacy.
Contemporary Trends in Hospitalizations for Comorbid Chronic Liver Disease and Substance Use Disorders
Desai, Archita P. MD1; Greene, Marion PhD, MPH2; Nephew, Lauren D. MD1; Orman, Eric S. MD, MSc1; Ghabril, Marwan MD1; Chalasani, Naga MD1; Menachemi, Nir PhD, MPH2
doi : 10.14309/ctg.0000000000000372
June 2021 - Volume 12 - Issue 6 - p e00372
Chronic liver diseases (CLDs) and substance use disorders (SUDs) are increasingly prevalent and often coexist. Contemporary studies describing the characteristics and hospitalization trends of those with comorbid CLD-SUD are lacking. We aimed to characterize a population-based cohort with comorbid CLD-SUD and describe trends in these hospitalizations over time by individual-level characteristics.
Bariatric and Metabolic Endoscopy: A New Paradigm
Telese, Andrea MD1; Sehgal, Vinay PhD1; Magee, Cormac G. MB, BChir, MA1,2; Naik, S. MD3; Alqahtani, S.A. MD4,5; Lovat, L.B. PhD1,6; Haidry, Rehan J. MD, FRCP1
doi : 10.14309/ctg.0000000000000364
June 2021 - Volume 12 - Issue 6 - p e00364
The prevalence of obesity, type 2 diabetes mellitus, and metabolic syndromes is increasing globally. Minimally invasive metabobariatric (MB) endoscopic therapies are adjunct treatments that can potentially bridge the gap between surgical interventions and medical therapy. A growing number of MB techniques are becoming available, allowing for more personalized and patient-targeted treatment options for specific disease states. MB techniques are less invasive than surgery and can precisely target different parts of the gastrointestinal tract that may be responsible for the pathophysiology of obesity and metabolic syndromes such as type 2 diabetes mellitus. These alternatives should be selected on an individualized patient basis to balance the expected clinical outcomes and desired anatomical targets with the level of invasiveness and degree of acceptable risk. Each MB intervention presents great flexibility allowing for a tailored intervention and different levels of patient engagement. Patient awareness and motivation are essential to avoid therapy withdrawal and failure. Differences between MB procedures in terms of weight loss and metabolic benefit will be discussed in this review, along with the insights on clinical decision-making processes to evaluate the potential of further evolution and growth of bariatric and metabolic endoscopy.
