Limited research has examined the clinical consequences of sarcopenia and myosteatosis in Crohn's disease. This study aimed to determine the prevalence, risk factors, and effects of sarcopenia and ...myosteatosis on prognostic outcomes in Crohn's disease patients who underwent magnetic resonance enterography.
This retrospective observational study included 116 Crohn's disease patients who underwent magnetic resonance enterography between January 2015 and August 2021. Skeletal muscle index was the ratio of the cross-sectional area of skeletal muscles at the L3 vertebral level to the square of the neck in cross-sectional imaging. Sarcopenia was defined as skeletal muscle index <38.5 cm2/m2 in women and <52.4 cm2/m2 in men. Myosteatosis was considered positive if the ratio of the mean signal intensity of the psoas muscle to the mean signal intensity of the cerebrospinal fluid was above 0.107.
Among the negative results in the post-procedure follow-up of the patients, a significant increase was observed in the sarcopenia group regarding abscess and the need for surgery (P < .05). Anti-tumor necrosis factor initiation was found to be significantly higher in the follow-up than in patients without myosteatosis (P = .029). In the multivariate model established with these variables, the presence of sarcopenia in the surgical follow-up was odds ratio = 5.34 (CI: 1.02-28.03, P = .047) and was found to be significantly associated with the increased risk.
The presence of myosteatosis and sarcopenia detected in magnetic resonance enterography may be a harbinger of negative outcomes in Crohn's disease patients. Nutritional support should be provided to these patients with the potential to alter the course of the disease.
Aim: Novel Coronavirus disease (COVİD-19) pandemic had caused various problems in follow up and treatment of many chronic diseases such as Inflammatory Bowel Diseases (IBD). This study aimed to ...determine the level of fear and anxiety of COVID-19 and evaluate the quality of life of patients with IBD during the pandemic.
Materials and Methods: This study was conducted as a cross-sectional study, and a total of 150 participants (IBD patient group=75, control group=75) were included. In order to evaluate the level of COVID-19 fear and anxiety, the Fear of COVID-19 Scale (FCV-19S) and Coronavirus Anxiety Scale (CAS) were used. In addition, Short Form-36 (SF-36) test was used to evaluate health-related quality of life.
Results: FCV-19S and CAS scores were significantly higher in IBD patients compared to the control group. (p<0.05). In IBD patients some subscores of SF-36 were significantly lower than the control group (p<0.05). Univariate regression analyses showed that university degree of education, having Crohn’s disease, and using anti-TNF drugs were significantly correlated with the high level COVID-19 fear (p<0.05). FCV-19S results were found to be negatively correlated with emotional role limitation, energy, and mental health subscores of SF-36 in patients with IBD (p<0.05).
Conclusion: This study showed that IBD patients had higher levels of fear and anxiety regarding COVID-19. Increased levels of fear and anxiety decreased quality of life specifically mentally. One should keep in mind that the probability of nonadherence to drugs in patients with IBD during the pandemic and psychiatric support should be provided if necessary.
Amaç: Yeni koronavirüs hastalığı (COVİD-19) pandemisi, İnflamatuvar Barsak Hastalıkları (İBH) gibi birçok kronik hastalığın takip ve tedavisinde çeşitli sorunlara neden olmuştur. Bu çalışma pandemi döneminde İBH’lı hastaların COVİD-19 korku ve anksiyete düzeylerini ve hayat kalitelerini değerlendirmeyi amaçladı.
Gereç ve yöntem: Bu çalışma kesitsel bir çalışma olarak yapılmış ve toplamda 150 hasta (İBH hasta grubu=75, kontrol grubu=75) çalışmaya dahil edilmiştir. COVİD-19 korku ve anksiyete seviyelerini değerlendirmek için COVİD-19 korku skalası (FCV-19S) ve koronavirüs anksiyete skalası (CAS) kullanıldı. Ayrıca sağlıkla ilgili yaşam kalitesini değerlendirmek için kısa form-36 (SF-36) testi kullanıldı.
Bulgular: İBH hastalarında kontrol grubuna göre FCV-19S ve CAS puanları anlamlı olarak daha yüksek, SF-36’nın bazı alt parametreleri anlamlı olarak daha düşük bulundu (p<0.05). Univaryant regresyon analizinde üniversite mezunu olmak, Crohn hastalığı tanılı olmak ve anti-TNF ilaç kullanmak yüksek COVİD-19 korkusuyla anlamlı olarak ilişkili olduğu saptandı (p<0.05). İBH hastalarında FCV-19S puanları ile SF-36’nın emosyonel rol kısıtlaması, enerji ve mental sağlık parametreleri arasında negatif korelasyon olduğu görüldü (p<0.05).
Sonuç: Bu çalışma İBH hastalarının COVİD-19 ile ilgili daha yüksek korku ve anksiyete seviyesine sahip olduğunu gösterdi. Artan korku ve anksiyete seviyeleri özellikle mental olarak yaşam kalitesini düşürmüştür. Bu dönemde İBH’lı hastalarda ilaç uyumsuzluğu olabileceği akılda tutulmalı ve gerekirse bu hastalara psikiyatrik destek sağlanmalıdır.
Post-colonoscopy pain (PCP) is a negative condition that causes physical and psychological distress to patients and may lead to noncompliance with treatment and follow-up. The most common hypothesis ...for the cause of PCP is the inflation of the lumen with air to examine the mucosa. There are no previous studies that have examined the effects of thermal therapy in patients with PCP.
In this study, we aimed to investigate the effects of the Hot Pack (HP) method in patients with PCP.
Randomized, controlled, prospective study.
Patients were randomized 1:1 into 2 groups of HP and control. In the HP group, hot packs of 40-45°C, kept in a hydrocollator heating unit for 30-35 minutes and wrapped in towels, were applied to the umbilical and hypogastric region of patients in the supine position for 30 minutes. Visual analog scale (VAS) scores were used to measure the pain after colonoscopy. Visual analog scores at 1, 6, and 24 hours were recorded and compared in both groups.
There was a significant difference in the presence and severity of pain between the two groups at 1 and 6 hours after colonoscopy (p < .001 and p = .004, respectively). There was no significant difference in pain scores at 24 hours between two groups.
This study showed that the application of HP to patients after colonoscopy is effective in reducing pain in the early period.
Aims: The optimal duration of endoscopic retrograde cholangiopancreatography (ERCP) in patients with mild cholangitis and when it should be performed is unclear. This study aimed to compare the ...results of patients with mild cholangitis who underwent early and elective ERCP. Methods: This study was designed as a retrospective study to compare the results of elective (time from admission to ERCP>72 h) and early (time from admission to ERCP≤72 h) ERCP in patients with mild cholangitis according to the Tocyo 18 (TC18) guideline. The study included patients with naive papillae and mild cholangitis who underwent ERCP between February 2019 and 2023 at a single tertiary center’s gastroenterology clinic. Results: A total of 432 mild cholangitis patients were included in our study. The mean age and ASA score of the elective ERCP group was slightly higher than the other group (respectively, p=0.039 and p=0.025). No significant difference was found between the two groups in terms of technical and clinical success, mortality, ERCP-related adverse events, organ failure and intensive care unit admission. Length of hospital stay (LHS) was significantly (p
Background and aims In this study, we aimed to investigate the frequency of adverse events (AEs) in patients undergoing endoscopic retrograde cholangiopancreticography (ERCP) for choledocholithiasis ...and the independent risk factors that may cause these conditions. We planned to evaluate all AEs including cardiopulmonary complications and the risk factors that may affect them holistically. Methods This study was designed as a retrospective cohort study conducted at a single tertiary center's gastroenterology clinic. The study included patients with naive papillae and undergoing ERCP for choledocholithiasis between May 2019 and June 2022. Risk factors that may lead to AEs were analyzed in terms of both patient-related factors and procedure-related factors. Patients with and without AEs after ERCP were compared. Results This study included 812 patients who underwent ERCP for choledocholithiasis. AE occurred in 149 (18.3%) of patients, and the most common complication was pancreatitis (n=112, 13.8%). In regression analysis, of the patient- and procedure-related factors, only difficult cannulation was a significant independent risk factor for AEs (odds ratio=3.85, 95% CI: 1.102-13.498, p=0.035). Conclusion This study showed that, of patient- and procedure-related factors, only difficult cannulation is an independent risk factor for ERCP-related AEs.
AIMWe aimed to evaluate the performance of Chat Generative Pre-trained Transformer (ChatGPT) within the context of inflammatory bowel disease (IBD), which is expected to become an increasingly ...significant health issue in the future. In addition, the objective of the study was to assess whether ChatGPT serves as a reliable and useful resource for both patients and healthcare professionals.METHODSFor this study, 20 specific questions were identified for the two main components of IBD, which are Crohn's disease (CD) and ulcerative colitis (UC). The questions were divided into two sets: one set contained questions directed at healthcare professionals while the second set contained questions directed toward patients. The responses were evaluated with seven-point Likert-type reliability and usefulness scales.RESULTSThe distribution of the reliability and utility scores was calculated into four groups (two diseases and two question sources) by averaging the mean scores from both raters. The highest scores in both reliability and usefulness were obtained from professional sources (5.00± 1.21 and 5.15±1.08, respectively). The ranking in terms of reliability and usefulness, respectively, was as follows: CD questions (4.70±1.26 and 4.75±1.06) and UC questions (4.40±1.21 and 4.55±1.31). The reliability scores of the answers for the professionals were significantly higher than those for the patients (both raters, p=0.032). Conclusion: Despite its capacity for reliability and usefulness in the context of IBD, ChatGPT still has some limitations and deficiencies. The correction of ChatGPT's deficiencies and its enhancement by developers with more detailed and up-to-date information could make it a significant source of information for both patients and medical professionals.
Summary
Background
Inflammatory bowel disease (IBD), a multisystemic inflammatory disorder, has been associated with increased risk of cardiovascular problems, including complications such as ...conduction defects and arrhythmias. Therefore, the early assessment of the risk factors predisposing to ventricular arrhythmias is crucial, since it can improve clinical outcomes. The objective of the present study is to evaluate ventricular repolarization by using Tp‑e interval and Tp-e/QTc ratio as candidate markers of ventricular arrhythmias in patients with IBD.
Methods
The presented study was designed as a single-center prospective cohort study. The study population consisted of 175 patients with IBD and 175 healthy volunteers. The Tp‑e interval, corrected QT (QTc), and Tp-e/QTc ratio were measured from the 12-lead electrocardiogram. These parameters were compared between groups.
Results
The groups were similar in terms of electrocardiographic findings such as heart rate, QRS interval, and QTc interval. However, Tp‑e interval (87.0 ms, interquartile range, IQR 81.0–105.0 ms vs. 84.0 ms, IQR 74.0–92.0 ms;
p
< 0.001) and Tp-e/QTc ratio (0.21 ± 0.04 vs. 0.19 ± 0.05;
p
< 0.001) were significantly increased in IBD patient group compared to control group. Notably, a positive correlation was demonstrated between Tp‑e interval, Tp-e/QTc ratio and disease duration (Spearman’s Rho = 0.36,
p
< 0.001 for Tp‑e; Spearman’s Rho = 0.28,
p
< 0.001 for Tp-e/QTc).
Conclusion
This study demonstrated that IBD patients are at increased risk of disrupted ventricular repolarization (increased Tpe, Tpe/QTc ratio). In addition, a positive correlation was demonstrated between Tp‑e interval, Tp-e/QTc ratio, and disease duration. Therefore, IBD patients, especially those with long-standing diseases, should be more closely screened for ventricular arrhythmias.
In European Society of Gastrointestinal Endoscopy guidelines, biliary cannulation of naive papillae is defined as difficult in the presence of more than 5 papilla contacts, more than 5min cannulation ...time or more than one unintended pancreatic duct cannulation or opacification. It is not known whether cholecystectomy is a cause of difficult biliary cannulation. This study aimed to investigate whether cholecystectomy (CCY) is a cause of difficult biliary cannulation in patients who have undergone Endoscopic Retrograde Cholangiopancreatography (ERCP) for choledocholithiasis.
Adult patients with naive papillae and those who underwent ERCP for common bile duct stones and/or sludge were included in this retrospective study. Patient demographics, clinical presentation (acute cholangitis, biliary pancreatitis or biliary colic), periprocedural data including laboratory and radiological findings and ERCP results were compared between no-CCY and post-CCY groups.
438 patients were included in the present study and 347 of these patients were in the no-CCY group and 91 patients were in post-CCY group. A statistically significant difference was found in the number of patients with difficult cannulation in the post-CCY group (n=30, 33.0%) patients compared to the no- CCY group (n=67, 19.3%) (p=0.011). According the multivariate analyses results, presence of history of cholecystectomy was found an independent risk factor of difficult cannulation (Odds ratio: 2.014; 95 % Cl 1.205-3.366; p=0.008).
The results showed that biliary cannulation was significantly more difficult in patients with cholecystectomy who underwent ERCP for common bile duct stones.
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