bluuebunny/crossref_metadata_2025_split huggingface dataset:
P167 Functional outcomes of transanal versus transabdominal proctectomy with ileal pouch-anal anastomosis in Ulcerative Colitis. A comparative study
Authors: Bislenghi G , Denolf M , Wolthuis A , D’Hoore A 
Published: January 2022

Abstract

Background
This study aimed at comparing functional outcomes and quality of life (QoL) after transanal and transabdominal approach for ileal-pouch surgery in ulcerative colitis (UC)Ileal-pouch surgery ensures satisfactory intestinal function and QoL. The transanal ileal pouch-anal anastomisis (Ta-IPAA) has recently been developed in the effort to address the technical shortfalls of the traditional transabdominal approach (Tabd-IPAA). According to previous studies, Ta-IPAA is safe. However, functional outcomes after ta-IPAA are scarcely described.

Methods
This is a retrospective study of consecutive UC patients who underwent IPAA from 2011 to 2017. Only patients operated according to a modified-2 or 3 stage approach were included in the analysis. Close rectal dissection was systematically performed in Ta-IPAA as opposed to total mesorectal excision in Tabd-IPAA. Groups were compared after propensity score weighting. Functional outcomes were assessed using two functional scoring systems: the Pouch Functional Score (PFS) and the Öresland score (OS). The global quality of life scale (GQOL) was used for patients’ overall perspective on QoL. Follow-up was scheduled at 1, 3, 6, and 12 months postoperatively.

Results
One hundred and nine patients were included. Of them, 38 patients underwent Ta-IPAA. At 12 months follow-up, mean OS and PFS were 4.6 (CI 3.2–6.0) vs 6.2 (CI 5.0–7.3), p=0.02 and 6.1 (CI 3.5–8.8) vs 7.4 (CI 5.4–9.5), p=0.32, for Ta and Tabd-IPAA, respectively. Mean GQOL score for Ta-IPAA was 82.7 (CI 75.1–90.2) vs 75.5 (69.4–81.6) for Tabd-IPAA (p=0.038).

Conclusion
Transanal IPAA provides better functional results and QoL scores than Tabd-IPAA in UC patients.
P173 Endoscopic findings in the upper gastrointestinal tract in Crohn’s Disease – highly specific and closely related to Helicobacter pylori negative gastritis
Authors: Graca-Pakulska K , Błogowski W , Zawada I , Urasińska E , Deskur A , Bielicki D , Dąbkowski K , Starzynska MD- PhD T 
Published: January 2022

Abstract

Background
Scientific data indicates that in the course of Crohn’s disease (CD), certain endoscopic abnormalities in the upper gastrointestinal tract (UGIT), such as bamboo joint-like appearance (BJA) in the stomach, may be frequently present. However, there are not many clinical analyses available, in which prevalence of various endoscopic UGIT lesions would be comprehensively evaluated.
The purpose of the study was to investigate the characteristic of UGIT involvement in CD, with a particular focus on the Helicobacter pylori (Hp) status, BJA lesions and presence of microscopic changes in the stomach.

Methods
A total of 565 consecutive patients were prospectively recruited into the study (98 with CD and 467 controls). All individuals underwent upper esophagogastroduodenoscopy (EGD) with biopsy using a high definition endoscope with narrow band image. Chi-square and t-student tests were used for statistical analysis.

Results
The majority of CD patients (n=77; 79%) were found to have different abnormalities in EGD. Most commonly these were found in the stomach (n = 73; 74%), followed by duodenum (n= 39; 40%) and oesophagus (n=6; 6%). Mucosal redness/edema, BJA in the proximal part of the body and/or fundus, as well as antral erosions were the most prevalent gastric lesions. BJA was present in 44 (45%) of CD patients, and in one individual from the control group (0.002%), p&lt;0.00001. BJA presence among CD patients was irrespective of sex, age, location, duration, intensity or course of the disease, as well as medications taken. Ulcerations and erosions were most commonly found lesions in the duodenum. Most of the CD patients were Hp negative (n = 94; 95.9%), while in the control group the majority of individuals were infected with Hp (57,1%), p&lt;0.0001. Comparison between Hp negative patients with CD and controls revealed that gastric BJA lesions, duodenal ulcers and erosions were present exclusively in CD. These lesions were accompanied by chronic microscopic gastritis in all cases. Finally, the prevalence of microscopic HP negative gastritis was significantly higher in patients with CD than in controls (95.7% vs 15%, p&lt;0.0002).

Conclusion
Our results demonstrated that chronic Hp negative gastritis is present in nearly all CD patients, and is strongly associated with presence of gastric BJA lesions, as well as ulcerations and erosions of the duodenum. Furthermore, the results of our study support previously reported observations that BJA is a specific lesion for CD and may be used as an endoscopic diagnostic marker.
This work was financed by the Program of the Minister of Science and Higher Education - “Regional Initiative of Excellence” in 2019–2022, no. 002/RID/2018/19.
P189 Perceptions of Cannabis use in women with Inflammatory Bowel Disease of reproductive age: A cross-sectional study
Authors: Tandon P , O’Connor K , Steinhart H , Desphande A , Maxwell C , Huang V 
Published: January 2022

Abstract

Background
Cannabis use in inflammatory bowel disease (IBD) may lead to improvement in pain and general health perception. However, its use during pregnancy may result in adverse outcomes such as preterm birth and altered fetal brain development. It remains unknown how women with IBD perceive Cannabis use during pregnancy and whether they discuss its use with their health-care providers. We aimed to determine practices in, and perceptions of, cannabis use during pregnancy in women with IBD of reproductive age.

Methods
Women with IBD (age 18–45) were recruited at Mount Sinai Hospital and via social media platforms. Participants anonymously completed surveys on baseline demographics and IBD characteristics. They also completed a Cannabis questionnaire which asked about current use, perceived risks during pregnancy, and discussions with health-care providers. Categorical variables were reported as frequencies and compared using the chi-square test. Continuous variables were reported as medians and compared using the Mann-Whitney U test.

Results
Sixty-four women were included, 26 (40.6%) with ulcerative colitis, 37 (57.8%) with Crohn’s disease, and 1 (1.6%) with indeterminate colitis. Nineteen (29.7%) were preconception, 40 (62.5%) were pregnant, and 5 (7.8%) were post-partum. Eleven (18.0%) patients reported current Cannabis use, 4 (6.3%) during pregnancy. Cannabis users were more likely to have discussed its use with a health-care provider compared to non-users (45.5% vs. 5.7%, p&lt;0.001) and had longer IBD duration (12.00 vs. 9.00 years, p=0.05). Twenty-five (42.4%) were unsure of the risks of Cannabis use in pregnancy, of which only two had discussed this with a health-care provider. Reasons for fear of Cannabis use included risk of fetal oxygen restriction (n=13, 20.3%), impact on brain development (n=29, 46.0%), and risk of fetal respiratory issues (n=18, 28.6%). Only eight (12.5%) patients reported having a conversation about Cannabis use during pregnancy with their health-care provider; all of whom felt its consumption was unsafe during pregnancy.

Conclusion
Many women with IBD report being unsure of risks of Cannabis use during pregnancy. With the legalization of Cannabis in Canada, it is imperative patients and health-care providers discuss the risks and benefits of its use, particularly during vulnerable times such as pregnancy.
P191 Development and validation of a 13-item short version of the IBD self-efficacy scale
Authors: Tanaka M , Kawakami A , Sakagami K , Terai T , Fernandez J , Keefer L , Ito H 
Published: January 2022

Abstract

Background
The IBD-Self-Efficacy Scale (IBD-SES) is an outcome measurement scale used in various countries, with psychometric properties that predicted psychological distress and showed moderate correlation with QOL. Although the 29-item IBD-SES is useful, a shorter instrument would increase the likelihood of usage. In this study, we aimed to develop a substantially shorter, but still as valid version of IBD-SES.

Methods
A total of 919 patients, 482 from a specialized IBD clinic (UC: 184, CD: 298) and 437 online (UC: 255, CD: 182), were used for psychometric assessment. The original 29-item IBD-SES was reduced using three major analytic steps (assessed ceiling or floor effect, correlation between items, test-retest reliability). The shorter version was evaluated on construct validity by confirmatory factor analysis, criterion validity by Pearson’s correlation coefficients with original version, and internal consistency by Cronbach’s alpha coefficient.

Results
In the item reduction process, the following items were removed: 2 items due to a ceiling effect, 12 additional items due to high correlation, 2 more items due to a low intraclass correlation coefficient (ICC). The short version was confirmed to consist of the same 4 subscales as the original version, [Managing Stress and Emotions], [Managing Medical Care], [Managing Symptoms and Disease] and [Maintaining Remission] and was validated by confirmatory factor analysis. The fit indices were as follows: Normed χ2 = 7.18 (p &lt; 0.001), comparative fit index (CFI) = 0.94, goodness-of-fit index (GFI) = 0.93, adjusted goodness-of-fit index (AGFI) =0.89, parsimony goodness-of-fit index (PGFI) = 0.60, and the root mean square error of approximation (RMSEA) = 0.084. Correlation with the original IBD-SES in each subscale was high (0.97–0.98). Cronbach’s alpha for each subscale ranged from 0.68 to 0.86.

Conclusion
The study showed that the revised scale has improved psychometric properties and demonstrated the reliability and validity of the IBD-SES13. The revised scale could provide clinical usefulness with the possibility of higher response rates.
P198 An inflammatory serum metabolomic signature predicts response to vedolizumab treatment in people with Crohn’s Disease
Authors: Radford-Smith D , Yates A , Hageman I , Joustra V , Li Yim A , Davids M , Henneman P , Hakvoort T , D’Haens G , de Jong W , Anthony D , Satsangi J , Probert F 
Published: January 2022

Abstract

Background
While Vedolizumab (VDZ) is an established treatment for Crohn’s disease (CD), primary non-response is well-recognised – there is an urgent clinical need for biomarkers that predict response, before initiation of treatment. Metabolomic profiling is a rapidly growing field in biomarker discovery and can distinguish between active and quiescent inflammatory bowel diseases. Here, we sought to identify a metabolic signature able to predict response to VDZ.

Methods
Prospective serum samples from 62 CD patients before (baseline) and post-treatment follow-up (FU) (median 30 weeks, IQR 27–35) were analyzed. Patients were stratified into n=35 responders (R) and n=27 non-responders (NR) using endoscopic (≥50% reduction in SES-CD score), clinical (≥3 point drop in HBI or HBI ≤4, no systemic steroids), and/or biochemical assessments (≥50% reduction in C-reactive protein (CRP) and fecal calprotectin (fCal) or a basal CRP ≤5 g/mL and fecal calprotectin ≤250 µg/g). Untargeted metabolomic profiling was carried out using high-resolution nuclear magnetic resonance (NMR) spectroscopy. Significant differences in metabolite signatures were identified by orthogonal partial least squares discriminant analysis (OPLS-DA). Model accuracy (acc.) was assessed by external 10-fold cross-validation (CV), permutation testing, and validated on an independent test set.

Results
We first demonstrate that bowel preparation required for endoscopy had a significant impact on the serum metabolite profile (CV acc. 77±4%, acc. n=10 independent test set 80%, KS test p-value &lt; 0.001) and samples taken from patients at colonoscopy were excluded from further analysis. This reduced the cohort size; 19 baseline (12R/7NR) and 25 FU (16R/9NR). No significant difference in baseline fCal or CRP was observed between R and NR (t-test p-value &gt;0.05). The metabolite profiles at baseline and FU were indistinguishable (KS test p-value &gt; 0.05) suggesting the metabolome was stable. However, high (&gt;300 µg/g) fCal values were associated with elevated N-acetyl-glycoprotein (GlycA), a known inflammatory marker, elevated serum glucose along with decreased lipoprotein and lactate levels (CV acc. 74±3%, acc. n=10 independent test set 100%, KS test p-value &lt; 0.001). This same metabolite signature predicts response (CV acc. 61±5%, acc. n=6 independent test set 83%, KS test p-value &lt; 0.001) with responders exhibiting increased metabolic inflammation at baseline.

Conclusion
Here, we identify an inflammatory metabolic signature which predicts response to VDZ. Work to confirm these findings in a larger cohort and extend this method to investigate infliximab, adalimumab and ustekinumab treated patients, as part of the EPIC Pioneer study, is ongoing.
P200 The diagnostic yield of pan-enteric capsule endoscopy in inflammatory bowel disease: A systematic review and meta-analysis
Authors: Tamilarasan A G , Tran Y , Paramsothy S , Leong R 
Published: January 2022

Abstract

Background
Capsule endoscopy (CE) is a non-invasive diagnostic modality enabling real time video imaging of the gastrointestinal (GI) mucosa with an ingestible recording device. Major technological advancements now allow pan-enteric capsule endoscopy (PCE) to thoroughly assess the entire GI tract. CE is increasingly utilised in the inflammatory bowel disease (IBD) diagnostic algorithm. Our aim was to evaluate the diagnostic accuracy of PCEs in IBD.

Methods
We comprehensively searched electronic databases (MEDLINE, SCOPUS, EMBASE and Cochrane Central Register of Controlled Trials) for studies comparing the diagnostic accuracy of PCE with colonoscopy or magnetic resonance enterography (MRE). Prospective studies with ≥ 10 IBD patients were included in our final analysis. Diagnostic accuracy and yield were calculated for the detection of active IBD. Meta-analysis of proportions was performed to assess for an incremental benefit between modalities. The risk of bias was determined by the Quality Assessment of Diagnostic Accuracy in Systematic Reviews (QUADAS-2). Data was analysed by calculating forest plots and the use of the I2 statistic for heterogeneity.

Results
Fourteen studies, including 797 patients, were identified comparing PCE diagnostic yield with colonoscopy or MRE. Seven studies evaluated PCE diagnostic yield in CD and 7 studies in UC. There was a low risk of bias for the majority of included studies; only 1 study was found to have a high risk of bias. In CD, there was a trend to superiority of PCE over MRE and colonoscopy (individually and for pooled outcomes) with a pooled odds ratio (OR) of 1.25 (95% CI 0.85–1.86) (Fig 1) for the detection of CD. This translates to an incremental benefit in diagnostic yield of 5% and 7% for PCE compared with MRE and colonoscopy respectively. PCE performed comparably with colonoscopy in the terminal ileum and colon with ORs of 1.19 (95% CI 0.78–1.79) (Fig 2), and 1.14 (95% CI 0.76–1.71) (Fig 3) respectively. PCEs had a diagnostic sensitivity for the detection of UC of 93.8% (95% CI 87.6%-97.0%) (Fig 4) and a specificity of 69.8% (95% CI, 38.2%-89.6%). This equates to a diagnostic OR of 24.0 (95% CI 10.4–55.3). Subgroup analysis suggested that newer PCEs had greater diagnostic yield than the earlier devices (for UC and CD).

Conclusion
PCEs have a comparable diagnostic yield to colonoscopy and MRE in Crohn’s disease. This was true for the small and large bowel, giving PCE an advantage over standard CE as a single pan-enteric assessment tool for CD. Limitations include the standardisation of PCE scoring systems and the lack of transmural assessment. In UC, PCE has an excellent diagnostic sensitivity and positive predictive value, but is limited by the lack of histologic assessment and poor specificity.
P206 Comparison of dye-spraying chromoendoscopy and virtual chromoendoscopy for colonic dysplasia detection in longstanding Inflammatory Bowel Disease
Authors: Correia J , Ponte A , Proença L , Rodrigues A , Pinho R , Leite S , Fernandes C , Rodrigues J , Silva J C , Gomes C , Afecto E , Estevinho M M , Freitas T 
Published: January 2022

Abstract

Background
Dye-spraying chromoendoscopy (DCE) is the technique of choice for colonic surveillance in patients with long-standing extensive Inflammatory Bowel Disease (IBD). Conversely, the use of virtual chromoendoscopy (VCE) is still controversial. This study aimed to compare lesion and dysplasia detection and accuracy of margins delineation between VCE and DCE.

Methods
Eleven gastroenterologists were given a survey with 20 pairs of pictures of IBD surveillance colonoscopies (10 with nondysplastic lesions, 5 with dysplastic lesions and 5 with no lesions). Each pair contained the same image captured during colonoscopy using VCE and DCE. The 40 pictures were randomly ordered to avoid any classification bias. For each picture, the gastroenterologist assessed the presence/absence of lesion and, when a lesion was identified, assessed the presence/absence of dysplasia and delineated its margins. To compare lesion and dysplasia detections between techniques, the sensitivity, specificity and inter-observer agreement (using fleiss’ kappa (K) test) were calculated. The chi-square test was used to assess the accuracy of margins delineation.

Results
When assessing lesion detection using VCE, sensitivity (S) and specificity (E) were 0.93 and 0.49 and in, DCE, 0.97 and 0.38, respectively. When assessing dysplasia detection using VCE, S and E were 0.74 and 0.60 and, in DCE, 0.67 and 0.62, respectively. Interobserver agreement analysis revealed that VCE and DCE had a moderate agreement in lesion detection - 0.57 and 0.58, respectively; however, for dysplasia detection, VCE had a fair agreement (k=0.30) and DCE a slight agreement (k=0.11). The rate of accurately defined margins was similar for both techniques (p=0.22).

Conclusion
Similar lesion and dysplasia detection and margins delineation were achieved with both techniques. However, concerning dysplasia detection, interobserver agreement was slightly better using VCE. Therefore, VCE may constitute a valid alternative to DCE for dysplasia screening in IBD. Further studies are needed to validate these findings.
P215 Correlation between small bowel capsule endoscopy and biomarkers in postoperative recurrence in Crohn’s Disease
Authors: Elosua Gonzalez A , Rullan M , Rubio S , Oquiñena S , Macías E , Elizalde I , Vicuña M , Aznárez M R , Juanmartiñena J F , Borda A , Rodriguez C , Fernández-Urién I , Nantes Ó 
Published: January 2022

Abstract

Background
Endoscopic postoperative recurrence (POR) measured by the Rutgeert′s score is a strong predictor of clinical recurrence. Ileocolonoscopy is the gold standard in the diagnosis of POR by recent guidelines and is recommended within the first 6 to 12 months after surgery. After the initial ileocolonoscopy the monitoring is usually based on non-invasive test such as fecal calprotectin (FCP), imaging studies or small bowel capsule endoscopy (SBCE) since symptoms are not reliable of mucosal lesions. Our aim was to evaluate the accuracy of FCP and C-reactive protein (CRP) for detection of endoscopic recurrence measured by SBCE.

Methods
We included all patients with known CD with previous ileocolonic resection followed in the Inflammatory Bowel Disease Unit of Hospital Universitario de Navarra from 01/01/2008 to 31/12/2019 in which a SBCE was performed. CRP was considered elevated if &gt;5g/L. To avoid bias from disease activity in colon undetectable by SBCE, only L1 patients were included in this specific analysis. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and diagnostic Odds Ratio (DOR) were calculated. Receiver operating characteristic curve (ROC) and its area under the curve (AUC) were calculated with FCP and CRP.

Results
A total of 113 SBCE procedures were performed for evaluation of POR but only 89 were L1 patients. CRP was available for all patients (16.9% elevated) and FCP for 66.3% within 3 months previous to SBCE. Patients with significant POR had a higher mean CRP (4.8 ± 6.6 vs 2.5 ± 5.2, p= 0.017) and FCP (176.3 ± 178 vs 86.3 ± 132, p= 0.04). Diagnostic performance for detecting ≥i2 in neoterminal ileum for CRP was: sensitivity 24.4 %, specificity 89.6%, PPV 66.7%, NPV 58.1%, DOR 2.8. Diagnostic accuracy was obtained for FCP levels of 50 µg/g, 100 µg/g, 150 µg/g and 200µg/g and shown on the table.CRP and FCP had an AUC of 0.7 (95% CI 0.56–0.84) and 0.7 (95% CI 0.56–0.84) respectively.

Conclusion
FCP is an accurate surrogate marker of postoperative endoscopic recurrence.
The FCP cut-off 100 µg/g appears to have the best overall accuracy.
P230 Ultrasonography-based and Magnetic Resonance-based Lémann Index: two sides of the same coin
Authors: Allocca M , Dell’Avalle C , Radice S , Bonifacio C , Furfaro F , Zilli A , D’Amico F , Peyrin-Biroulet L , Danese S , Fiorino G 
Published: January 2022

Abstract

Background
Lémann Index (LI) is a well-established validated index to assess cumulative bowel damage in Crohn’s disease (CD). Magnetic resonance imaging and colonoscopy are usually used to measure LI. We assessed the accuracy of bowel ultrasound in assessing LI and its sensitivity to change in a longitudinal cohort of CD patients, in comparison with magnetic resonance imaging.

Methods
We performed a prospective observational study of 60 patients with active CD. All patients underwent bowel ultrasound, magnetic resonance imaging, and colonoscopy at baseline and at reassessment, within 1 year from treatment with biologics (30 patients were treated with adalimumab, 22 with ustekinumab, four patients with infliximab, and four with vedolizumab). The primary analysis was to determine the correlation between magnetic resonance-based LI and ultrasonography-based LI, both at baseline and at reassessment. Additional analyses established the magnitude of change in LI over time, measured by magnetic resonance imaging and colonoscopy, and its correlation with those in LI measured by bowel ultrasound and colonoscopy.

Results
The mean values of magnetic resonance-based LI and ultrasonography-based LI at baseline were 6.3 (± 4.8) and 6.4 (± 4.9) respectively, p= 0.39; at reassessment, 5.3 (± 4.6) and 5.5 (± 4.9) respectively, p= 0.30. No differences were observed according to different treatments (Table1). There were significant differences between LI assessed at baseline and LI at reassessment, independently by the imaging tool used for measuring it (p &lt; 0.05). Very high correlations were observed between the magnetic resonance-based LI and ultrasonography-based LI (at baseline, r= 0.964, p &lt; 0.0001; at reassessment, r= 0.970, p &lt; 0.0001) (Figure 1). The magnitude of change in magnetic resonance-based LI correlated with those in ultrasonography-based LI (r= 0.871; p &lt; 0.0001) (Figure 1).

Conclusion
LI can be measured by bowel ultrasound alternatively to magnetic resonance imaging, without no meaningful change in its value.