Management of nonurgent common gastroenterology referrals using primary care clinical pathways: Clinical outcomes, health care use, and avoided costs.

Objective: To evaluate health system use, health outcomes, and avoided costs when patients with chronic gastrointestinal (GI) conditions are managed in the medical home.

Design: A retrospective, observational cohort study was conducted through a single-point-of-entry referral system.

Setting: Calgary, Alta.

A next-generation mt-sDNA test had 94% sensitivity for colorectal cancer and 91% specificity for advanced neoplasia.

Imperiale TF, Porter K, Zella J, et al; BLUE-C Study Investigators. N Engl J Med. 2024;390:984-993.

In grade C/D erosive esophagitis, vonoprazan ranks highest among PPIs and P-CABs for healing and maintaining remission.

Zhuang Q, Chen S, Zhou X, et al. Am J Gastroenterol. 2024;119:803-813.

Success of Guideline-based Treatment of Newly Diagnosed and Previously Treated Patients During 2007-2021 in Edmonton, Alberta.

Background: Updated 2016 consensus guidelines recommend treatment for 14 days with concomitant therapy (proton-pump inhibitor (PPI)-amoxicillin-metronidazole-clarithromycin (PAMC) or bismuth-based quadruple therapy (PPI-bismuth-metronidazole-tetracycline, PBMT)) as first line, PBMT or PPI-amoxicillin-levofloxacin (PAL) as second or third line, and PPI-amoxicillin-rifabutin (PAR) as fourth line for 10 days.

Objectives: This was a retrospective cohort study to describe and compare the efficacy of anti- treatment regimens over the periods 2007-2015 and 2016-2021 as well as antibiotic resistance.

Methods: A modified intention-to-treat (mITT) analysis was used to analyze the success rate of therapies.

Biomarker risk assessment model identified high-risk patients with cancer who benefit from thromboprophylaxis.

Alexander M, Harris S, Underhill C, et al. JAMA Oncol. 2023;9:1536-1545.

Variation in Testing for and Incidence of Celiac Autoimmunity in Canada: A Population-Based Study.

Background & Aims: The incidence of biopsy-confirmed celiac disease has increased. However, few studies have explored the incidence of celiac autoimmunity based on positive serology results.

Methods: A population-based cohort study assessed testing of tissue transglutaminase antibodies (tTG-IgA) in Alberta from 2012 to 2020.

Anti-Inflammatory Diet Prevents Subclinical Colonic Inflammation and Alters Metabolomic Profile of Ulcerative Colitis Patients in Clinical Remission.

A relationship between ulcerative colitis (UC) and diet has been shown in epidemiological and experimental studies. In a 6-month, open-label, randomized, placebo-controlled trial, adult UC patients in clinical remission were randomized to either an “Anti-inflammatory Diet (AID)” or “Canada’s Food Guide (CFG)”. Menu plans in the AID were designed to increase the dietary intake of dietary fiber, probiotics, antioxidants, and omega-3 fatty acids and to decrease the intake of red meat, processed meat, and added sugar.

Nurse-Led, Shared Medical Appointments for Common Gastrointestinal Conditions-Improving Outcomes Through Collaboration With Primary Care in the Medical Home: A Prospective Observational Study.

Background: Gastroesophageal reflux disease (GERD), dyspepsia and irritable bowel syndrome (IBS) are common gastrointestinal disorders accounting for a significant demand for specialty care. The aim of this study was to evaluate safety, access and outcomes of patients assessed by a nurse-led, shared medical appointment.

Methods: This prospective observational study utilized a sample of 770 patients referred to a gastroenterology Central Access and Triage for routine GERD, dyspepsia or IBS from 2011 to 2014.

Internet-based interpersonal psychotherapy for stress, anxiety, and depression in prenatal women: study protocol for a pilot randomized controlled trial.

Background: Psychological distress, defined as depression, anxiety and perceived stress, during pregnancy is common, with 15-25% of women experiencing clinically significant levels of such distress. Despite the far-reaching impact of prenatal psychological distress on mothers and their children, and that women are receptive to screening, few providers routinely screen for prenatal psychological distress and less than one in five women will receive the mental health care that they require. There is a lack of certainty regarding the most effective treatments for prenatal psychological distress.

The Safety and Efficacy of Single-Operator Cholangioscopy in the Treatment of Difficult Common Bile Duct Stones after Failed Conventional ERCP.

Background: Common bile duct (CBD) stones are extracted with a basket or balloon during ERCP with sphincterotomy. However, some stones are difficult to extract by conventional means. Cholangioscopy with lithotripsy is a modality to treat these difficult stones.

Burden of disease from Helicobacter pylori infection in western Canadian Arctic communities.

Background: Indigenous communities across the circumpolar north have elevated H. pylori (Hp) prevalence and stomach cancer incidence. We aimed to describe the Hp-associated disease burden among western Canadian Arctic participants in community-driven projects that address concerns about health risks from Hp infection.

Adversity in childhood and depression in pregnancy.

Adverse childhood experiences (ACEs) have been found to be associated with various health conditions; however, there is dearth of evidence on the relationship between ACEs and prenatal depression. This study was conducted to determine the association between overall ACE score and prenatal depression symptoms, assess the moderating effect of social support and partner support on this relationship, and determine the association between individual ACE scores and prenatal depression. A secondary analysis was conducted of data from an RCT that assessed the feasibility of e-screening for maternal mental health among 636 pregnant women recruited from antenatal clinics.

Comparison of Urdu Versions of the Resilience Scale and the Resilience Scale for Adults.

Background And Purpose: Several methodological challenges are associated with measuring resilience in women. This study compares the 14-item Resilience Scale (RS-14) and the Resilience Scale for Adults (RSA) in a community sample of women.

Methods: Data were collected from 120 women residing in low socioeconomic areas of Karachi, Pakistan.

Social support intervention to promote resilience and quality of life in women living in Karachi, Pakistan: a randomized controlled trial.

Objectives: This study tested the efficacy of a 6-week social support intervention for enhancing resilience and quality of life among women living in low socioeconomic areas of Karachi, Pakistan.

Methods: One hundred and twenty women were randomly allocated to the intervention (n = 60) or control group (n = 60). Women in the intervention group attended a 6-week social support program, while those in the control group attended a single mental health awareness session.

Patient-ly Waiting: A Review of Patient-Centered Access to Inflammatory Bowel Disease Care in Canada.

Canada has one of the highest prevalence estimates of inflammatory bowel disease (IBD) in the world. Like other chronic illnesses, access to specialist care is required for disease management. Traditionally, access to care is evaluated through wait times (actual access); however, new patient-oriented definitions of access (perceived access) highlight other equally important facets of access to care (e.

The Toronto Consensus for the Treatment of Helicobacter pylori Infection in Adults.

Background & Aims: Helicobacter pylori infection is increasingly difficult to treat. The purpose of these consensus statements is to provide a review of the literature and specific, updated recommendations for eradication therapy in adults.

Methods: A systematic literature search identified studies on H pylori treatment.

Upper gastrointestinal bleeding due to peptic ulcer disease is not associated with air pollution: a case-crossover study.

Background: Recent studies have demonstrated an association between short-term elevations in air pollution and an increased risk of exacerbating gastrointestinal disease. The objective of the study was to evaluate if day-to-day increases in air pollution concentrations were positively associated with upper gastrointestinal bleeding (UGIB) secondary to peptic ulcer disease (PUD).

Methods: A time-stratified case-crossover study design was used.

Barriers and facilitators of mental health screening in pregnancy.

Background: Access to mental health services during pregnancy is most commonly mobilized through formal mental health screening. However, few studies to date have identified barriers and facilitators that affect pregnant women's responses to mental health screening. The objective was to identify barriers and facilitators that influence pregnant women's responses to the screening process and factors associated with their identification.

Gastric antral vascular ectasia: a prospective study of treatment with endoscopic band ligation.

Gastric antral vascular ectasia (GAVE) is characterized by red, angiomatous lesions in the antrum organized either in stripes or in a diffuse pattern that can be associated with upper gastrointestinal bleeding. Endoscopic band ligation (EBL) has been reported as an effective alternative therapy for patients with GAVE. Consecutive patients with a diagnosis of GAVE were prospectively followed while undergoing EBL every 2 months.

Upper-gastrointestinal bleeding secondary to peptic ulcer disease: incidence and outcomes.

Aim: To evaluate the incidence, surgery, mortality, and readmission of upper gastrointestinal bleeding (UGIB) secondary to peptic ulcer disease (PUD).

Methods: Administrative databases identified all hospitalizations for UGIB secondary to PUD in Alberta, Canada from 2004 to 2010 (n = 7079) using the International Classification of Diseases Codes (ICD-10). A subset of the data was validated using endoscopy reports.