Field Of Gastroenterology Research Articles

Factors to Consider for Successful Telemedicine Gastroenterology Subspecialty Visits in Disparate Populations

Introduction: Telemedicine was put at the forefront of the healthcare delivery process during the coronavirus disease 2019 (COVID-19) pandemic. Pre-COVID-19 research had shown telemedicine to be beneficial in the gastroenterology field with improved quality of life and reduced healthcare cost in the IBD population. However, telemedicine remained underutilized in subspecialty care with constraints at both provider and patient level. Objective: To analyze the telemedicine encounters in a gastroenterology clinic at a tertiary care hospital and identify factors that facilitate or limit the use of telemedicine modalities. Methods: The project was a retrospective, single-center study with continuous sampling of one hundred and fifty-three patients who scheduled one hundred and fifty-eight telemedicine encounters that included both Inflammatory Bowel Disease (IBD) and general gastroenterology patients. We examined the influence of age, sex, race, geographic location and payer source, on audio or video telemedicine encounters, as well as the show rate. Results: Our study showed a promising show rate of 90.5% with a majority of the patients preferring video over audio visits; however, increasing age proved to be a barrier in successfully completing video visits. In total, 26.2% of the patients who desired video encounters had to be switched to audio only. We found that race, sex, payor source, and living in a rural zip code did not influence the rate of completed telemedicine encounters or the patients’ preferred modality (audio vs video). Conclusion: The recurring COVID-19 surge due to different variants provides an opportunity to refine the telemedicine experience in our healthcare. Telemedicine encounters have a promising role in gastroenterology outpatient care and can be utilized to improve access to care and bridge healthcare disparities. In order to increase compliance further work needs to be done to make the digital platform user friendly for the elderly population.

Burnout and work satisfaction are differentially associated in gastroenterologists in Germany

Burnout in the field of gastroenterology is an under-researched phenomenon. So far, only a few studies have dealt with this topic. There are large geographical variations in burnout rates with 16-20% of gastroenterologists in Mexico and Germany being at risk or having burnout, 30-40% in the United Kingdom, and 50-55% in South Korea, Canada, and the USA. The investigation of differential associations of burnout with important factors in gastroenterologists leading to tailored therapy recommendations is lacking. Therefore, we investigated the associations between work satisfaction and burnout in this specialization. We distributed an electronic survey to gastroenterologists organized mainly in the Federal Organization of Gastroenterology in Germany (the BVGD - Bundesverband Gastroenterologie Deutschland). The Maslach Burnout Inventory (MBI) and the Work Satisfaction Questionnaire (WSQ) were examined regarding their postulated internal structure in our sample of gastroenterologists. Canonical correlations were performed to examine the association between work satisfaction and burnout in endoscopy physicians. An acceptable model fit was shown for both the MBI and the Work Satisfaction Questionnaire. The canonical correlation analysis resulted in two statistically significant canonical functions with correlations of .62 (p<.001) and .27 (p<.001). The full model across all functions was significant (χ 2 (18) = 386.26, p<.001). Burden, personal rewards, and global item regarding the job situation were good predictors for less exhaustion, while patient care and professional relations were good predictors for personal accomplishment. This supports the recognition of burnout as being a multidimensional construct which has to be thoroughly diagnosed. Specific interventions should be designed to improve symptoms of burnout in endoscopy physicians according to their individual complaints as burnout is a multidimensional construct. Differential interventions should be offered on the basis of our study results in order to alleviate the issue of work satisfaction and burnout in endoscopy physicians.

Burnout and work satisfaction are differentially associated in gastroenterologists in Germany.

Burnout in the field of gastroenterology is an under-researched phenomenon. So far, only a few studies have dealt with this topic. There are large geographical variations in burnout rates with 16-20% of gastroenterologists in Mexico and Germany being at risk or having burnout, 30-40% in the United Kingdom, and 50-55% in South Korea, Canada, and the USA. The investigation of differential associations of burnout with important factors in gastroenterologists leading to tailored therapy recommendations is lacking. Therefore, we investigated the associations between work satisfaction and burnout in this specialization. We distributed an electronic survey to gastroenterologists organized mainly in the Federal Organization of Gastroenterology in Germany (the BVGD - Bundesverband Gastroenterologie Deutschland). The Maslach Burnout Inventory (MBI) and the Work Satisfaction Questionnaire (WSQ) were examined regarding their postulated internal structure in our sample of gastroenterologists. Canonical correlations were performed to examine the association between work satisfaction and burnout in endoscopy physicians. An acceptable model fit was shown for both the MBI and the Work Satisfaction Questionnaire. The canonical correlation analysis resulted in two statistically significant canonical functions with correlations of .62 (p<.001) and .27 (p<.001). The full model across all functions was significant (χ 2 (18) = 386.26, p<.001). Burden, personal rewards, and global item regarding the job situation were good predictors for less exhaustion, while patient care and professional relations were good predictors for personal accomplishment. This supports the recognition of burnout as being a multidimensional construct which has to be thoroughly diagnosed. Specific interventions should be designed to improve symptoms of burnout in endoscopy physicians according to their individual complaints as burnout is a multidimensional construct. Differential interventions should be offered on the basis of our study results in order to alleviate the issue of work satisfaction and burnout in endoscopy physicians.

Burnout and work satisfaction are differentially associated in gastroenterologists in Germany

Background: Burnout in the field of gastroenterology is an under-researched phenomenon. So far, only a few studies have dealt with this topic. There are large geographical variations in burnout rates with 16–20% of gastroenterologists in Mexico and Germany being at risk or having burnout, 30–40% in the United Kingdom, and 50–55% in South Korea, Canada, and the USA. The investigation of differential associations of burnout with important factors in gastroenterologists leading to tailored therapy recommendations is lacking. Therefore, we investigated the associations between work satisfaction and burnout in this specialization. Methods: We distributed an electronic survey to gastroenterologists organized mainly in the Federal Organization of Gastroenterology in Germany (the BVGD - Bundesverband Gastroenterologie Deutschland). The Maslach Burnout Inventory (MBI) and the Work Satisfaction Questionnaire (WSQ) were examined regarding their postulated internal structure in our sample of gastroenterologists. Canonical correlations were performed to examine the association between work satisfaction and burnout in endoscopy physicians. Results: An acceptable model fit was shown for both the MBI and the Work Satisfaction Questionnaire. The canonical correlation analysis resulted in two statistically significant canonical functions with correlations of .62 (p<.001) and .27 (p<.001). The full model across all functions was significant (χ 2 (18) = 386.26, p<.001). Burden, personal rewards, and global item regarding the job situation were good predictors for less exhaustion, while patient care and professional relations were good predictors for personal accomplishment. This supports the recognition of burnout as being a multidimensional construct which has to be thoroughly diagnosed. Conclusions: Specific interventions should be designed to improve symptoms of burnout in endoscopy physicians according to their individual complaints as burnout is a multidimensional construct. Differential interventions should be offered on the basis of our study results in order to alleviate the issue of work satisfaction and burnout in endoscopy physicians.

Fecal microbiota transplantation for treatment of moderate to severe ulcerative colitis: a living systematic review protocol

Background: Primary studies and systematic reviews assessing the safety and effectiveness of fecal microbiota transplantation as a treatment for ulcerative colitis are being continuously published. The objective of this review is to synthesize and keep updated the evidence about the efficacy and safety of fecal microbiota transplantation for adult patients with moderate or severe ulcerative colitis through a living systematic review. Methods: We will carry out a living systematic review including only randomized controlled trials irrespective of publication type, year and language of publication. To prioritize the fecal microbiota transplantation administration route, comparators and outcomes more relevant for supporting the clinical decisions in the treatment of ulcerative colitis patients, we will perform a Delphi process conducted by an expert panel in the field of gastroenterology and colorectal surgery. Searches will be performed in Epistemonikos database and results will be incorporated into the L·OVE platform identified as “Fecal microbiota transplant in ulcerative colitis”. We will evaluate the risk of bias of the included randomized trials using the ROB-2 tool and assess the certainty of evidence using the GRADE approach. We will monitor the L ·OVE platform every two months searching for relevant trials that could imply changes in the available evidence. The living process will end after 12 months of surveillance. PROSPERO registration: CRD42021257579 (29/10/2021).

Current Applications of Telemedicine in Gastroenterology.

Telemedicine generally refers to the use of technology to communicate with patients and provide health care from a distance. Advances in technology, specifically computers, cellphones, and other mobile devices, have facilitated healthcare providers' growing ability to virtually monitor and mentor patients. There has been a progressive expansion in the use of telemedicine in the field of gastroenterology (GI), which has been accelerated by the COVID-19 pandemic. In this review, we discuss telemedicine-its history, various forms, and limitations-and its current applications in GI. Specifically, we focus on telemedicine in GI practice in general and specific applications, including the management of inflammatory bowel disease, celiac disease, and colorectal cancer surveillance and its use as an aid in endoscopic procedures.

Helicobacter pylori Biofilm-Related Drug Resistance and New Developments in Its Anti-Biofilm Agents.

Helicobacter pylori is one of the most common pathogenic bacterium worldwide, infecting about 50% of the world’s population. It is a major cause of several upper gastrointestinal diseases, including peptic ulcers and gastric cancer. The emergence of H. pylori resistance to antibiotics has been a major clinical challenge in the field of gastroenterology. In the course of H. pylori infection, some bacteria invade the gastric epithelium and are encapsulated into a self-produced matrix to form biofilms that protect the bacteria from external threats. Bacteria with biofilm structures can be up to 1000 times more resistant to antibiotics than planktonic bacteria. This implies that targeting biofilms might be an effective strategy to alleviate H. pylori drug resistance. Therefore, it is important to develop drugs that can eliminate or disperse biofilms. In recent years, anti-biofilm agents have been investigated as alternative or complementary therapies to antibiotics to reduce the rate of drug resistance. This article discusses the formation of H. pylori biofilms, the relationship between biofilms and drug resistance in H. pylori, and the recent developments in the research of anti-biofilm agents targeting H. pylori drug resistance.

Video Capsule Endoscopy in Gastroenterology.

Video capsule endoscopy (VCE) is a wireless technology used by gastroenterologists for various indications in their clinical practice. There has been significant improvement in this technology since its start about two decades ago. Specific video capsules have been made to evaluate the small bowel, colon, and esophagus. Now pan-enteric video capsule is available to assess both the small bowel and colon. VCE is a non-invasive procedure that has been tremendously evaluated for various gastrointestinal disorders, particularly small intestinal bleeding. There are specific contraindications and complications of VCE. This procedure has the technical part and video reading part. Newer software programs will come to reduce the reading time. Artificial intelligence is also coming for quick and accurate diagnosis of any positive findings during VCE. VCE is an important diagnostic test in the field of gastroenterology. Although it is an addition to optical endoscopic procedures to visualize the gastrointestinal mucosa, it has advantages and disadvantages.

Burnout and work satisfaction are differentially associated in gastroenterologists in Germany.

Burnout in the field of gastroenterology is an under-researched phenomenon. So far, only a few studies have dealt with this topic. There are large geographical variations in burnout rates with 16-20% of gastroenterologists in Mexico and Germany being at risk or having burnout, 30-40% in the United Kingdom, and 50-55% in South Korea, Canada, and the USA. The investigation of differential associations of burnout with important factors in gastroenterologists leading to tailored therapy recommendations is lacking. Therefore, we investigated the associations between work satisfaction and burnout in this specialization. We distributed an electronic survey to gastroenterologists organized mainly in the Federal Organization of Gastroenterology in Germany (the BVGD - Bundesverband Gastroenterologie Deutschland). The Maslach Burnout Inventory (MBI) and the Work Satisfaction Questionnaire (WSQ) were examined regarding their postulated internal structure in our sample of gastroenterologists. Canonical correlations were performed to examine the association between work satisfaction and burnout in endoscopy physicians. An acceptable model fit was shown for both the MBI and the Work Satisfaction Questionnaire. The canonical correlation analysis resulted in two statistically significant canonical functions with correlations of .62 (p<.001) and .27 (p<.001). The full model across all functions was significant (χ 2 (18) = 386.26, p<.001). Burden, personal rewards, and global item regarding the job situation were good predictors for less exhaustion, while patient care and professional relations were good predictors for personal accomplishment. This supports the recognition of burnout as being a multidimensional construct which has to be thoroughly diagnosed. Specific interventions should be designed to improve symptoms of burnout in endoscopy physicians according to their individual complaints as burnout is a multidimensional construct. Differential interventions should be offered on the basis of our study results in order to alleviate the issue of work satisfaction and burnout in endoscopy physicians.

Artificial intelligence in colonoscopy: A review on the current status.

Artificial intelligence has become an increasingly hot topic in the last several years, and it has also gained its way into the medical field. In recent years, the application of artificial intelligence in the gastroenterology field has been of increasing interest, particularly in the colonoscopy setting. Novel technologies such as deep neural networks have enabled real‐time computer‐aided polyp detection and diagnosis during colonoscopy. This might lead to increased performance of endoscopists as well as potentially reducing the costs of unnecessary polypectomies of hyperplastic polyps. Newly published prospective trials studying computer‐aided detection showed that the assistance of artificial intelligence significantly increased the detection of polyps and non‐advanced adenomas approximately by 10%, while three tandem randomized control trials proved that the adenoma miss rate was significantly reduced (e.g., 13.8% vs. 36.7% in one Japanese multicenter trial). Promising results have also been shown in prospective single‐arm trials on computer‐aided polyp diagnosis, but the evidence is insufficient to reach a conclusion.

Application of electron microscopy in gastroenterology.

Electron microscopy has long been used in research in the fields of life sciences and materials sciences. Transmission and scanning electron microscopy and energy-dispersive X-ray spectroscopy (EDX) analyses have also been performed in the field of gastroenterology. Electron microscopy and EDX enable (1) Observation of ultrastructural differences in esophageal epithelial cells in patients with gastroesophageal reflux and eosinophilic esophagitis; (2) Detection of lanthanum deposition in the stomach and duodenum; (3) Ultrastructural and elemental analyses of enteroliths and bezoars; (4) Detection and characterization of microorganisms in the gastrointestinal tract; (5) Diagnosis of gastrointestinal tumors with neuroendocrine differentiation; and (6) Analysis of gold nanoparticles potentially used in endoscopic photodynamic therapy. This review aims to foster a better understanding of electron microscopy applications by reviewing relevant clinical studies, basic research findings, and the state of current research carried out in gastroenterology science.

Biosimilární léčba v dětské gastroenterologii – současný pohled

Biosimilar drugs (BSD) have been used in the field of gastroenterology since 2013, when the European Medicines Agency approved biosimilar infliximab for the treatment of inflammatory bowel disease (IBD). The view of these drugs has changed significantly in the course of their use. At first, BSDs were used with hesitation, mainly due to the lack of published data on their efficacy and safety and also due to the lack of clinical experience. Over the following years, a number of studies were published that gradually support their importance in the treatment of IBD, and BSDs are now routinely administered to patients naïve to biological treatment, and a number of centres perform switches from the original treatment to a BSD. In paediatrics, a more reserved attitude towards their clinical use persisted for a long time, but with the growing amount of published data, they are also common in clinical practice. This summary article describes the development in the approach of both international and domestic professional societies and physicians-clinicians to the use of BSL and provides references to newly published studies of biosimilar drugs. Keywords pediatrie, biosimilární léčiva, biologic therapy, evropská léková agentura, switch, extrapolace

Gastroenterology Practice Consolidation Between 2012 and 2020.

Multiple studies have indicated physicians are practicing medicine in increasingly larger groups. However, specialty-specific data on the extent of consolidation are lacking for many specialties, including gastroenterology. We aim to determine the extent of consolidation for gastroenterology in recent years. The Physician Compare database was used to gather information at both an individual and group level. This information included location and number of providers for each group. Cochran-Armitage tests were used to test for differences between practice sizes in 2012 and 2020. Between 2012 and 2020, the number of physicians increased from 12,766 to 13,934, while the total number of practices decreased from 4517 to 3865. The total number of physicians who practice in groups of less than 9 physicians decreased by 23.9%, while the total number of physicians in practices of 100 + increased by 16.8%. Significant consolidation has occurred in the field of gastroenterology in every geographic region of the USA. The causes of consolidation are multi-faceted and include the legislative environment, private equity and hospital acquisition of private groups, individual physician lifestyle preferences, and economic benefits of economies of scale. However, the consequences of consolidation are still unclear. Over the last eight years, gastroenterologists have been practicing in increasingly larger groups. This trend has been consistent in each area of the country. Future research should focus on the impact of consolidation on patient care and physician wellbeing.

Fecal microbiota transplantation for treatment of moderate to severe ulcerative colitis: a living systematic review protocol

Background: Several primary studies and systematic reviews (SRs) have been published over the past 10 years to assess the safety and effectiveness of fecal microbiota transplantation (FMT) as a treatment for ulcerative colitis. The objective of this review is to evaluate the efficacy and safety of fecal microbiota transplantation for adult patients with moderate or severe ulcerative colitis. Methods: We will carry out a living systematic review including only randomized controlled trials (RCT) irrespective of publication type, year and language of publication. To prioritize the intervention (TFM administration route), comparisons (placebo, alternative treatment or no treatment) and outcomes (clinical remission, clinical relapse, serious adverse events, clinical response, free time without corticosteroid treatment and health related quality of life) more relevant for supporting the clinical decisions in the treatment of UC patients, we will perform a Delphi process conducted by an expert panel in the field of gastroenterology and colorectal surgery. Searches will be performed in Epistemonikos database and results will be incorporated into the L·OVE platform identified as “Fecal microbiota transplant in ulcerative colitis”. We will evaluate the risk of bias of the included randomized trials using the ROB-2 tool and assess the certainty of evidence using the GRADE approach. We will monitor the L ·OVE platform every two months searching for relevant trials that could imply changes in the available evidence. The living process will end after 12 months of surveillance. PROSPERO registration: CRD42021257579 (29/10/2021).

How to Embrace Gene Therapy in Gastroenterology

For gastroenterology clinicians, gene therapy is closer to something that they read about in the popular media rather than a modality that could become an integral part of their careers. The purpose of this article is to change that perception and show how gene therapy will be implemented in the field of gastroenterology, such that the clinician will be well suited to prescribe and deliver these therapies in the years to come. In fact, there are already 2 gene therapy products approved by the US Food and Drug Administration (FDA) (onasemnogene abeparvovec [Zolgensma] for spinal muscular atrophy and voretigene neparvovec [Luxturna] for hereditary blindness).

Prevalence of H. Pylori Infection in Non-Cirrhotic Patients with Chronic Delta Hepatitis

Objective: The relationship between Hepatitis Delta infection and Helicobacter infection in patients with non-cirrhotic hepatitis B infection was retrospectively investigated. Material and Methods: Stool samples of 117 patients included with Delta hepatitis infection in the study At total 36 of them were tested for H. Pylori infection. To detect H. Pylori, stool samples were tested using a commercial stool H. Pylori antigen assay. Results: Of these, 13 (19%) patients had H. Pylori seropositivity in the Hepatitis B infection group and 23 (48%) patients tested positive for H. Pylori infection in hepatitis delta infection group. There was a statistically significant difference between groups regarding H. Pylori seropositivity by the faecal test (p= 0.001). Conclusion: This study provides new knowledge on H. Pylori infection and reflects the need for evidence-based and comorbid dieases-oriented guidelines in the field of gastroenterology.

How should radiation exposure be handled in fluoroscopy-guided endoscopic procedures in the field of gastroenterology?

Fluoroscopy‐guided endoscopic procedures (FGEPs) are rapidly gaining popularity in the field of gastroenterology. Radiation is a well‐known health hazard. Gastroenterologists who perform FGEPs are required to protect themselves, patients, as well as nurses and radiologists engaged in examinations from radiation exposure. To achieve this, all gastroenterologists must first understand and adhere to the International Commission on Radiological Protection Publication. In particular, it is necessary to understand the three principles of radiation protection (Justification, Optimization, and Dose Limits), the As Low As Reasonably Achievable principle, and the Diagnostic Reference Levels (DRLs) according to them. This review will mainly explain the three principles of radiation exposure protection, DRLs, and occupational radiological protection in interventional procedures while introducing related findings. Gastroenterologists must gain knowledge of radiation exposure protection and keep it updated.

Achieving Health Equity Through Digestive Diseases Research and Scientific Workforce Diversity

In recent years, the COVID-19 pandemic, economic instability, and tragic cases of race-based violence and injustice have brought to light deep-seated inequalities with profound impacts on health. These events have served as a clarion call to confront health disparities related to race, ethnicity, and gender. This moment compels us to listen, reflect, and take collective action in a meaningful way within our spheres of influence in research and medicine, including the field of gastroenterology. We applaud the American Gastroenterological Association (AGA) on its efforts to address disparities in digestive diseases and ensure health equity, including its Equity Project and this “DEI in GI” column in Gastroenterology, emphasizing diversity, equity, and inclusion activities.

Retracted articles in Gastroenterology.

We read the publication on "Analysis of retracted articles in the field of Gastroenterology." Only a few retractions were due to honest errors, according to Jiang et al., who searched the Retraction Watch database for retracted studies in the field of gastroenterology and found that many articles were retracted for authors committing some type of misconduct.

Seeing Is Believing: The Effect of Graphical Abstracts on Citations and Social Media Exposure in Gastroenterology & Hepatology Journals.

Graphical abstracts (GAs) have recently been included as an essential element in various journals, including those in the field of Gastroenterology & Hepatology. However, there has been no study on the effect of GAs on the impact factor (IF) of journals, and the citation index or social media exposure of individual articles. We investigated the presence of GAs, total citations and social media exposure of full-length original articles in the top ten journals of gastroenterology and hepatology for three years (2019-2021). Citations and social media exposure were evaluated with the Web of Science citation index, Altmetric Attention score, Dimension recorded citation count, and PlumX index. A total of 4,205 articles from ten journals were evaluated for three years. First, journals that have adopted GAs demonstrated significantly higher IF increases for the past three years than those of journals without GAs. The longer GAs have been utilized in a journal, the higher IFs the journal had. Secondly, individual articles with GAs had significantly higher Web of Science citation counts (median 14 vs. 12), more social media exposure (median 23 vs. 5) and more Altmetric.com tweet counts (median 15 vs. 7) than those of articles without GAs. In multiple regression analysis, the inclusion of GAs was particularly effective in increasing the number of Web of Science citations (β = 14.1, SE = 1.9, P < 0.001) and social media exposure (β = 13.3, SE = 6.1, P = 0.030) after adjusting for journal IFs and topics. GAs are effective in increasing IFs of journals in the field of gastroenterology and hepatology, as well as increasing citations and social media exposure of individual articles.