2017 · Article · Case-Control · CGH · Podcast · Study

GI Pearls Episode 8 – Last two weeks of August 2017 Gastroenterology Literature Review

Show Notes for last two weeks of August 007

  1. Celiac Disease and Nonceliac Gluten Sensitivity – Jama
  2. Comparison of Infliximab and Adalimumab in Biologic-Naive Patients With Ulcerative Colitis: A Nationwide Danish Cohort Study – Clin Gastro Hep
  3. Use of Thiopurines During Conceptions and Pregnancy is Not Associated with Adverse Pregnancy Outcomes or Health of Infants at One year in a Prospective Study – CGH
  4. Efficacy of Rectal Tacrolimus for Induction Therapy in Patients With Resistant Ulcerative Proctitis – CGH
  5. Use of Liver Imaging and Biopsy in Clinical Practice – NEJM
  6. Hospital-Level Balloon Tamponade Use is Associated with Increased Mortality for All Patients Presenting with Acute Variceal Hemorrhage – Liver international
  7. Clinical Predictors of the Risk of Early Colectomy in Ulcerative Colitis: A Population-based Study – IBD journal
  8. High-Quality Diets Associate With Reduced Risk of Colorectal Cancer: Analyses of Diet Quality Indexes in the Multiethnic Cohort – CGH
  9. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study – The Lancet
  10. Efficacy of dietary and physical activity intervention in non-alcoholic fatty liver disease: a systematic review. – BMJ – Gastro
  11. Safety of Adding Oats to a Gluten-Free Diet for Patients With Celiac Disease: Systematic Review and Meta-analysis of Clinical and Observational Studies – Gastro
  12. Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis – Gastro
  13. Undetectable negative tissue transglutaminase IgA antibodies predict mucosal healing in treated coeliac disease patients – Alimentary Phar and Ther
  14. Death of a Farm Worker After Exposure to Manure Gas in an Open Air Environment – MMWR
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2015 · Article · Case-Control

Unexpected reduction in polyp numbers in Chronic Inflammatory conditions of the Colon

Tubular_adenoma_4_low_magI have read this article back in July, and immediately found it interesting.  One reason is that it is (albeit a poor one) an example of the use of “Big Data” type analysis where a large database of patient biopsy specimens can be searched.

Second reason – is the actual clinical finding – less polyps than expected in those with microscopic colitis – prevalence of ALL types of polyps was reduced.

Summary:  130,000 patients with symptoms of diarrhea had a colonoscopy with biopsies.  Compared with 97,000 control cases.  So, in this CASE-CONTROL study for patients with workup of diarrhea – less polyps (Odds ratios = 0.46 for hyperplastic, 0.24for serrated adenomas, and 0.35 for tubular adenomas).

Criticism: It would have been nice if the authors have age-matched the cases one for one from the beginning, even though these were adjusted for. There is no duration of disease, so the mechanism would remain elusive. Although it would be interesting to have someone do a database review of patients whose clinical history is known. It can even be compared to the current study, if the data is available, i.e. authors had 14% of colons have polyps in normals, and 8.3% in microscopic colitis,  is there an influence of disease duration or is this an all or none phenomenon?

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