MyMedR

Precision endoscopy in the era of climate change and sustainability

Ueda T, Li JW, Ho SH, Singh R, Uedo N

J Gastroenterol Hepatol, 2024 Jan;39(1):18-27.

Global warming caused by increased greenhouse gas (GHG) emissions has a direct impact on human health. Gastrointestinal (GI) endoscopy contributes significantly to GHG emissions due to energy consumption, reprocessing of endoscopes and accessories, production of equipment, safe disposal of biohazardous waste, and travel by patients. Moreover, GHGs are also generated in histopathology through tissue processing and the production of biopsy specimen bottles. The reduction in unnecessary surveillance endoscopies and biopsies is a practical approach to decrease GHG emissions without affecting disease outcomes. This narrative review explores the role of precision medicine in GI endoscopy, such as image-enhanced endoscopy and artificial intelligence, with a focus on decreasing unnecessary endoscopic procedures and biopsies in the surveillance and diagnosis of premalignant lesions in the esophagus, stomach, and colon. This review offers strategies to minimize unnecessary endoscopic procedures and biopsies, decrease GHG emissions, and maintain high-quality patient care, thereby contributing to sustainable healthcare practices.

Asia-Pacific Working Party on Non-alcoholic Fatty Liver Disease guidelines 2017-Part 1: Definition, risk factors and assessment

Wong VW, Chan WK, Chitturi S, Chawla Y, Dan YY, Duseja A, et al.

J Gastroenterol Hepatol, 2018 Jan;33(1):70-85.

PMID: 28670712 DOI: 10.1111/jgh.13857

Rome foundation Asian working team report: Real world treatment experience of Asian patients with functional bowel disorders

Xiong L, Gong X, Siah KT, Pratap N, Ghoshal UC, Abdullah M, et al.

J Gastroenterol Hepatol, 2017 Aug;32(8):1450-1456.

PMID: 28084664 DOI: 10.1111/jgh.13730

BACKGROUND AND AIM: Information on real world treatment experiences of patients with functional bowel disorders is lacking from Asia. This study aimed to describe the medication exposure and treatment satisfaction of patients presenting to gastroenterology clinics across a sampling of Asian cities.

METHODS: From March 2011 to October 2013, adult patients presenting to hospital-based gastroenterology outpatient clinics in 11 cities across Asia, who fulfilled screening criteria for any functional gastrointestinal disorder, were asked to complete a validated culturally adapted translation of the Rome III diagnostic questionnaire, a checklist of medications received in the preceding 3 months and questions on treatment satisfaction.

RESULTS: A total of 1376 patients (female 755, male 621, 41.36 ± 13.25 years) comprising irritable bowel (621, 45.1%), unspecified functional bowel disorder (372, 27.8%), functional constipation (202, 14.7%), functional bloating (144, 10.5%), and functional diarrhea (56, 4.1%) completed the study. Of 1105 patients with a previous consultation, 509 (46.1%) were dissatisfied with their treatment, with ineffective treatment being the commonest reason. Satisfaction with previous consultation was lowest by diagnosis for functional constipation (29.2%), and the most bothersome symptom was straining (37.5%). Of 1046 patients who had taken medications for their gastrointestinal symptoms in the last 3 months, 793 (75.8%) had received two or more drugs. For irritable bowel syndrome patients, treatment with proton pump inhibitors and antispasmodics was recorded in 57% and 31%, with overlapping epigastric pain and heartburn predicting proton pump inhibitors use.

CONCLUSIONS: More attention should be given to treatment gaps with regards to possible under-treatment with antispasmodics in irritable bowel syndrome and to critically evaluating the efficacy of constipation management.

Recent advances in translating gut microbiota research into clinical practice at 12th Asian Pacific Topic Conference 2023

Yim HCH, El-Omar E, Wu JC, Sung JJY, Lee YY

J Gastroenterol Hepatol, 2024 Apr 17.

PMID: 38629218 DOI: 10.1111/jgh.16565

Recurrence rate and lesions characteristics after cold snare polypectomy of high-grade dysplasia and T1 lesions: A multicenter analysis

Yoshida N, Fukumoto K, Hasegawa D, Inagaki Y, Inoue K, Hirose R, et al.

J Gastroenterol Hepatol, 2021 Dec;36(12):3337-3344.

PMID: 34260116 DOI: 10.1111/jgh.15625

BACKGROUND AND AIM: High-grade dysplasia (HGD) and T1 lesions are accidentally resected by cold snare polypectomy (CSP) and the characteristics, and follow-up of them has not been reported. In this study, we analyzed the histopathological findings and recurrence of them.

METHODS: This was a multicenter retrospective-cohort study. We collected HGD and T1 lesions of ≤ 10 mm resected by CSP among 15 520 patients receiving CSP from 2014 to 2019 at nine related institutions, and we extracted only cases receiving definite follow-up colonoscopy after CSP of HGD and T1 lesions. We analyzed these tumor's characteristics and therapeutic results such as R0 resection and local recurrence and risk factors of recurrence.

RESULTS: We collected 103 patients (0.63%) and extracted 80 lesions in 74 patients receiving follow-up colonoscopy for CSP scar. Mean age was 68.4 ± 12.0, and male rate was 68.9% (51/80). The mean tumor size (mm) was 6.6 ± 2.5, and the rate of polypoid morphology and rectum location was 77.5% and 25.0%. The rate of magnified observation was 53.8%. The rates of en bloc resection and R0 resection were 92.5% and 37.5%. The local recurrence rate was 6.3% (5/80, median follow-up period: 24.0 months). The recurrence developed within 3 months after CSP for four out of five recurrent cases. Comparing five recurrent lesions to 75 non-recurrent lesions, a positive horizontal margin was a significant risk factor (60.0% vs 10.7%, P

Common variant in the glucokinase regulatory gene rs780094 and risk of nonalcoholic fatty liver disease: a meta-analysis

Zain SM, Mohamed Z, Mohamed R

J Gastroenterol Hepatol, 2015 Jan;30(1):21-7.

PMID: 25167786 DOI: 10.1111/jgh.12714

BACKGROUND AND AIM: Although studies have suggested that rs780094, a common variant in the glucokinase regulatory (GCKR) gene to be associated with type 2 diabetes, obesity, and their related traits, the genetic basis of the association between GCKR rs780094 and nonalcoholic fatty liver disease (NAFLD) is still being examined. This meta-analysis was performed to evaluate the effect strength caused by GCKR rs780094 on NAFLD.
METHODS: We searched Medline, PubMed, Scopus, and Embase for relevant articles published up to April 2014. Data were extracted, and summary estimates of the association between GCKR rs780094 and NAFLD were examined. Heterogeneity and publication bias were also examined.
RESULTS: This meta-analysis incorporated a total of 2091 NAFLD cases and 3003 controls from five studies. Overall, the pooled result indicated that the GCKR rs780094 was significantly associated with increased risk of NAFLD (additive: odds ratio (OR) 1.25, 95% confidence interval (CI) 1.14-1.36, P

Impact of leptin receptor gene variants on risk of non-alcoholic fatty liver disease and its interaction with adiponutrin gene

Zain SM, Mohamed Z, Mahadeva S, Cheah PL, Rampal S, Chin KF, et al.

J Gastroenterol Hepatol, 2013 May;28(5):873-9.

PMID: 23278404 DOI: 10.1111/jgh.12104

Genetic polymorphism has been implicated as a factor for the occurrence of non-alcoholic fatty liver disease (NAFLD). This study attempted to assess whether polymorphisms in the leptin receptor (LEPR) gene and its combined effect with patatin-like phospholipase domain-containing protein 3 (PNPLA3/adiponutrin) are associated with risk of NAFLD.

East Asian perspective on the interaction between proton pump inhibitors and clopidogrel

Zou D, Goh KL

J Gastroenterol Hepatol, 2017 Jun;32(6):1152-1159.

PMID: 28024166 DOI: 10.1111/jgh.13712

Both proton pump inhibitors (PPIs) and clopidogrel are widely prescribed in the Asia-Pacific population. PPIs are the mainstay therapeutic agents for prophylaxis against aspirin gastropathy and for acid-related disorders including gastroesophageal reflux disease. They are also co-prescribed with oral anticoagulant agents and with dual-antiplatelet therapy for the treatment and prevention of gastrointestinal bleeding. Clopidogrel belongs to the drug class of thienopyridines and is currently the most widely prescribed oral anticoagulant agent either alone or in combination with aspirin. Platelet inhibition by clopidogrel is prone to significant inter-individual variability and is believed to be affected by several factors such as genetics and drug-drug interactions. Since it was first reported in 2009, the potential for drug-drug interactions between PPIs and clopidogrel has remained headline news, and its significance in clinical practice is the subject of an ongoing debate. For East Asian patients in particular, the clinical relevance of the interaction between PPIs and clopidogrel remains unclear because of conflicting data, as well as underrepresentation of East Asian subjects in landmark trials. Increased CYP2C19 genetic polymorphisms in individuals from Asia-Pacific countries only fuel the confusion. Recent studies in East Asian cohorts suggests that the potential of PPIs to attenuate the efficacy of clopidogrel could be minimized by the use of newer PPIs with weaker affinity for the CYP2C19 isoenzyme, namely, pantoprazole, dexlansoprazole, and rabeprazole. This review aims to help clinicians choose the most appropriate PPI for co-prescription with clopidogrel in patients from Asia-Pacific countries.

Abstracts of the Asian Pacific Monothematic Meeting on Helicobacter Pylori 2012. January 13-15, 2012. Kuala Lumpur, Malaysia

J Gastroenterol Hepatol, 2012 Jan;27 Suppl 1:1-36.

PMID: 22216459

Abstracts of Gastroenterology in Asia Pacific - Excellence in the New Decade. September 19-22, 2010. Kuala Lumpur, Malaysia

J Gastroenterol Hepatol, 2010 Sep;25 Suppl 2:A1-188.

PMID: 21182654 DOI: 10.1111/j.1440-1746.2009.06462.x

Stomach '96: Kuala Lumpur International meeting on diseases of the stomach. Kuala Lumpur, Malaysia, 3-6 July 1996. Abstracts

J Gastroenterol Hepatol, 1996;11 Suppl 2:A51-75.

PMID: 8954201

Asia Pacific Digestive Week (APDW), Kuala Lumpur, Malaysia, 19-22 August 2021 | Virtual

J Gastroenterol Hepatol, 2021 08;36 Suppl 2:27-300.

PMID: 34435685 DOI: 10.1111/jgh.15604

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