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1.
United European Gastroenterology Journal ; 9(SUPPL 8):782, 2021.
Article in English | EMBASE | ID: covidwho-1490993

ABSTRACT

Introduction: In the continuous battle against the COVID-19 pandemic, searches to reduce the transmission during aerosol formatting procedures became key in health care. For upper gastrointestinal (GI) endoscopy, several typologies of face masks have been examined with various outcomes. Aims & Methods: We aimed to compare a commercially available droplet reduction mouthpiece B1 (Fujifilm Corporation, Tokyo, Japan) with a conventional one, in terms of aerosol formation both during and after upper GI endoscopy. Between March and April 2020 eighty COVID-19 negative patients referred for diagnostic upper GI endoscopy procedures, of which 7 also comprised through-the-scope balloon dilation, were included in the study and randomized in a 1:1 ratio between a conventional mouthpiece and the mouthpiece B1. Aerosol generation (0.3;0.5;1.0;3.0;5.0 and 10.0 micron particles) was measured using a Lasair® II Particle Counter (Particle Measuring Systems, Inc., United States) at different standardized time points (before endoscopy, 1-3-5 minutes during endoscopy, at the end and 1-3-5-10-15 minutes after endoscopy). Statistical analysis was performed using an unpaired student t-test to compare both groups, two-way ANOVA was used to test for differences over time and considered significant for a p<0.05. Ethical approval was obtained for this study (KU Leuven trial S65197) and every patient provided informed consent. Study was registered on clinicaltrials.gov (registration number NCT04864015). Results: There were no differences in baseline characteristics, type of sedation, insufflation rate or procedural duration between both groups. Comparison of aerosol formation at the different time-points showed no statistically significant difference for the 0.3;0.5;1.0;3.0;5.0 or 10.0 micron particles. Also the cumulative total number of particles over time were was not significantly different, see table 1. Conclusion: Compared to conventional mouthpieces, the commercially available mouthpiece B1 did not result in a statistically significant reduction in aerosol formation during routine upper GI endoscopy in this single center randomized trial.

2.
United European Gastroenterology Journal ; 9(SUPPL 8):415, 2021.
Article in English | EMBASE | ID: covidwho-1490971

ABSTRACT

Introduction: More than 2.5 million people in Europe are diagnosed with inflammatory bowel diseases (IBD). IBD affects the quality of life, but also has important consequences for health systems. It remains unknown if variations in IBD care and education differs across Europe and to help address this question, we conducted this European Variation In IBD PracticE suRvey (VIPER) to study potential differences. Aims & Methods: This trainee-initiated survey, run through SurveyMonkey ®, consisted of 47 questions inquiring basic demographics, IBD training and clinical care. The survey was distributed through social media and national GI societies from December 2020 - January 2021. Results were compared according to GDP per capita, for which countries were divided into 2 groups (low/high income, according to the World Bank). Differences between groups were calculated using the chi2 statistic. Results: The online survey was completed by 1268 participants from 39 European countries. Most of the participants are specialists (65.3 %), followed by fellows in training (>/< 3 years, 19.1%, 15.6 %). Majority of the responders are working in academic institutions (50.4 %), others in public/ district hospitals (33.3 %) or private practices (16.3 %). Despite significant differences in access to IBD-specific training between high (56.4%) and low (38.5%) GDP countries (p<0.001), majority of clinicians feels comfortable in treating IBD (77.2% vs 72.0%, p=0.04). GDP was not a factor that dictated confidence in treating patients. IBD patients seen per week, IBD boards and especially IBD specific training were factors increasing confidence in managing IBD patients. Interestingly, a difference in availability of dedicated IBD units could be observed (58.5% vs 39.7%, p<0.001), as well as an inequality in multidisciplinary meetings (72.6% vs 40.2%, p<0.001), which often take place on a weekly basis (53.0%). In high GDP countries, IBD nurses are more common (86.2%) than in low GDP countries (36.0%, p<0.001), which is mirrored by differences in nurse-led IBD clinics (40.6% vs 13.8%, p<0.001). IBD dieticians (32.4% vs 16.6%) and psychologists (16.7% vs 7.5%) are mainly present in high GDP countries (p<0.001). In the current COVID era, telemedicine is available in 58.4% vs 21.4% of the high/low GDP countries respectively (p<0.001), as well as urgent flare clinics (58.6% vs 38.7%, p<0.001) and endoscopy within 24 hours if needed (83.0% vs 86.7% p=0.1). Treat-to-target approaches are implemented everywhere (85.0%), though access to biologicals and small molecules differs significantly. Almost all (94.7%) use faecal calprotectin for routine monitoring, whereas half also use intestinal ultrasound (47.9%). Conclusion: A lot of variability in IBD practice exists across Europe, with marked differences between high vs low GDP countries. Further work is required to help address some of these inequalities, aiming to improve and standardise IBD care across Europe.

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