September top 10: gut microbiome, HPV vaccinations, IBS
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Healio Gastroenterology presents the following report on the top 10 peer-tested stories from September 2021.
Coverage includes the gut microbiome’s impact on weight loss, HPV vaccinations, irritable bowel syndrome research, COVID-19 and more.
Gut microbiome impacts future weight loss
Certain baseline gut microbiome features correlated with future changes in weight following intervention, according to study results published in mSystems, an open-access journal of the American Society for Microbiology.
“In our study, we observed that only very few blood and lifestyle measures associate with future weight loss after a change in lifestyle,” Christian Diener, PhD, a research scientist at the Institute for Systems Biology in Seattle, Washington, told Healio Gastroenterology. “However, the genes carried by the bacteria in our gut do. Our results underscore the fact that our intestinal bacteria are an important filter between the food we consume and our bloodstream. Weight loss may be especially hard when our gut bacteria slow their own growth, while also breaking down dietary fibers into energy-rich sugars that make their way into our bloodstream before they can be fermented into organic acids by the microbiota.” Read more.
HPV vaccinations will slow oropharynx cancer rates but may take more than 25 years to see impact
According to projections in JAMA Oncology, it will take more than 25 years to slow increasing oropharynx cancer incidence by human papillomavirus vaccinations because the disease will be observed in older populations not yet vaccinated.
“HPV vaccination will eventually prevent oropharynx cancers, but it will take more than 25 additional years to see these impacts in the United States,” lead author, Yuehan Zhang, MS, a PhD candidate in cancer epidemiology at Johns Hopkins Bloomberg School of Public Health, told Healio Gastroenterology. “Overall incidence of oropharynx cancer is projected to continue to increase between 2020 and 2045 because most of these cancers will occur among older individuals who have not yet been vaccinated.” Read more.
Antibiotic use may increase IBS outcomes after colonoscopy
Patients simultaneously exposed to antibiotics and bowel purgative had slightly higher rates of surrogate irritable bowel syndrome outcomes than matched controls, according to study results.
“For the general population of patients undergoing colonoscopy, the rate of developing IBS after using antibiotics while undergoing bowel preparation is low,” Ravy K. Vajravelu, MD, MSCE, of the division of gastroenterology, hepatology and nutrition at the University of Pittsburgh School of Medicine, told Healio Gastroenterology. “In this study, we also explored whether there are subgroups of patients who developed IBS at higher rates. We found that those who were prescribed quinolone antibiotics, such as ciprofloxacin and levofloxacin, around the time of colonoscopy had higher rates of IBS compared with those who were not prescribed them.” Read more.
Researchers recommend continuation of COVID-19 prevention strategies
In the wake of the COVID-19 delta variant, prevention strategies must be continued — including vaccination, masking and distancing for all — according to a presenter at the ACG Virtual Grand Rounds 2021.
“The delta variant is the most common strain in the U.S. since late June 2021 with viral loads 1,000 to 1,200 times higher than the original strain,” Francis A. Farraye, MD, MSc, MACG, of the Mayo Clinic, said. “It is more than twofold more contagious than previous variants and as contagious as chicken pox.” Read more.
Corticosteroids decrease COVID-19 vaccine efficacy in IBD
Though there is no significant difference in COVID-19 infection rates among patients with inflammatory bowel disease compared with the general public, some IBD therapies correlated with increased infection severity.
“The therapies for IBD are predominantly immune-based, immune modifying and sometimes immune suppressive,” David T. Rubin, MD, FACG, of the University of Chicago, said at the ACG Virtual Grand Rounds 2021. “There's been increased concern and fear that the therapies for IBD are increasing the risk for severe COVID-19 outcomes or might affect the response to vaccinations. In addition, CDC and FDA information is not specific to IBD and, therefore, has been confusing.” Read more.
Lipitor reduces colectomy rate in ulcerative colitis
Lipitor may be a novel therapeutic option in patients with ulcerative colitis, according to study results published in Journal of the American Medical Informatics Association.
“Long-term atorvastatin (Lipitor) use is associated with reduced rate of colectomy in patients with UC,” Purvesh Khatri, PhD, of the Institute for Immunity, Transplantation and Infection at Stanford University School of Medicine in Stanford, California, told Healio Gastroenterology. “Our results also suggest that it may also be associated with lower rates of hospitalization and new steroid prescriptions.” Read more.
Early endoscopy linked to superior outcomes in upper GI bleeding
Compared with urgent endoscopy and late endoscopy, early endoscopy correlated with better outcomes among patients presenting with acute upper gastrointestinal bleeding, according to research published in Gut.
“Acute upper gastrointestinal bleeding (AUGIB) is a common medical emergency. ... Fortunately, the mortality rates of AUGIB have decreased over the past few decades, largely attributable to improvements in endoscopic and pharmacological therapies,” Cosmos L.T. Guo, of the department of medicine and therapeutics at The Chinese University of Hong Kong, and colleagues wrote. “Currently, it is recommended that endoscopy should be performed within 24 hours on presentation to hospital. ... However, there is limited clinical data regarding the optimal timing of endoscopy within the 24-hour period.” Read more.
UDCA response linked to mortality in primary biliary cholangitis with cirrhosis
In a cohort of predominantly men with primary biliary cholangitis with cirrhosis, ursodeoxycholic acid response correlated with a decrease in decompensation, all-cause, and liver-related death or transplantation, according to study results.
“In a cohort of primarily male patients with PBC cirrhosis, we demonstrate that response to UDCA is associated with a 51% reduction in death or transplantation and a greater magnitude (60%) reduction in liver-related death or transplantation,” Binu V. John, MD, MPH, of the division of hepatology at the Bruce W. Carter Veterans Affairs Medical Center in Miami, Florida, told Healio Gastroenterology. “These data suggest that the benefit of response to UDCA continues even after the development of cirrhosis.” Read more.
Disparities impact job satisfaction for women mentees, mentors in gastroenterology
Career advancement and job satisfactory may be affected by the inequities that women mentees and mentors experience in the field of gastroenterology, according to a study published in the American Journal of Gastroenterology.
“Mentorship is deeply important for career advancement in any field,” Loren Galler Rabinowitz, MD, instructor of Medicine at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, told Healio Gastroenterology. “Our study found that women mentees in gastroenterology reported more difficulty finding a mentor and cited the inability to identify a mentor of the same gender as a barrier to mentorship. Senior women physicians reported more pressure to serve as mentors, higher rates of burnout, and lower overall job satisfaction when compared to their colleagues, who are men.” Read more.
Researchers recommend COVID-19 vaccination prior to organ transplant
Solid organ transplant recipients, including liver transplant recipients, are likely at an increased risk for severe COVID-19, therefore researchers recommended priority vaccination status for patients’ pre-transplantation.
“Transplant patients are at higher risk for severe COVID-19 infection. We have found many reports show once infection is acquired by these immunosuppressed patients, it may be of greater severity than in normal hosts,” Rita German, MD, of the department of medicine at the University of Wisconsin, said during the ACG Virtual Grand Round 2021. “These severe infections are likely due to a number of factors including higher rates of comorbidities, frequent contact with medical care as well as being on chronic immunosuppression.” Read more.
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