Endoscopic scoring system utilization for inflammatory bowel disease activity assessment: A multicenter real-world study from Argentina / Uso de puntajes endoscopicos para la medicion de la actividad mucosa en pacientes con enfermedades inflamatorias intestinales: un estudio de vida real multicentrico de la Argentina

Background The frequency and patterns of use of scores for the assessment of endoscopic activity in inflammatory bowel disease patients are not known. Aim To describe the prevalence of adequate use of endoscopic scores in IBD patients who underwent colonoscopy in a real-life setting. Materials and methods A multicenter observational study comprising six community hospitals in Argentina was undertaken. Patients with a diagnosis of Crohn's disease or ulcerative colitis who underwent colonoscopy for endoscopic activity assessment between 2018 and 2022 were included. Colonoscopy reports of included subjects were manually reviewed to determine the proportion of colonoscopies that included an endoscopic score report. We determined the proportion of colonoscopy reports that included all of the IBD colonoscopy report quality elements proposed by BRIDGe group. Endoscopist's specialty, years of experience as well as expertise in IBD were assessed. Results A total of 1556 patients were included for analysis (31.94% patients with Crohn's disease). Mean age was 45.94±15.46. Endoscopic score reporting was found in 58.41% of colonoscopies. Most frequently used scores were Mayo endoscopic score (90.56%) and SES-CD (56.03%) for ulcerative colitis and Crohn's disease, respectively. In addition, 79.11% of endoscopic reports failed to comply with all recommendations on endoscopic reporting for inflammatory bowel disease. Conclusions A significant proportion of endoscopic reports of inflammatory bowel disease patients do not include the description of an endoscopic score to assess mucosal inflammatory activity in a real-world setting. This is also associated with a lack of compliance in recommended criteria for proper endoscopic reporting. (AU)

Introduccion La frecuencia y el patrón de uso de puntajes para evaluar la actividad endoscópica en pacientes con enfermedades inflamatorias intestinales no se conoce bien. Objetivo Describir la prevalencia de uso adecuado de puntajes de actividad endoscópica en colonoscopias de pacientes con enfermedades inflamatorias intestinales en la vida real. Materiales y métodos Se realizó un estudio multicéntrico observacional en seis hospitales de comunidad en Argentina. Se incluyeron pacientes con enfermedad de Crohn o colitis ulcerosa sometidos a colonoscopia para evaluación de la actividad endoscópica entre 2018 y 2022. Se revisaron los reportes de colonoscopias de sujetos incluidos evaluando la proporción de reportes que incluyeron algún puntaje de actividad endoscópica. Se evaluó la proporción de reportes que incluyeron los elementos de calidad en reporte de colonoscopia en enfermedades inflamatorias intestinales sugeridos por el grupo BRIDGe. Se evaluó la especialidad de los operadores, sus años de experiencia y su experiencia en el manejo de enfermedades inflamatorias intestinales. Resultados Se incluyeron 1556 pacientes (31.94% con enfermedad de Crohn). La edad promedio fue de 45.94±15.46. El reporte de algún puntaje endoscópico se identificó en el 58.41% de las colonoscopias. Los puntajes más utilizados fueron el puntaje endoscópico de Mayo (90.56%) y el SES-CD (56.03%). El 79.11% de los reportes de colonoscopias no contaban con todas las recomendaciones para el correcto reporte de colonoscopias en enfermedades inflamatorias intestinales. Conclusiones Una proporción signifivativa de reportes de colonoscopias en sujetos con enfermedades inflamatorias intestinales no incluyen puntajes endoscópicos de actividad. (AU)

Endoscopic scoring system utilization for inflammatory bowel disease activity assessment: A multicenter real-world study from Argentina.

BACKGROUND: The frequency and patterns of use of scores for the assessment of endoscopic activity in inflammatory bowel disease patients are not known. AIM: To describe the prevalence of adequate use of endoscopic scores in IBD patients who underwent colonoscopy in a real-life setting. MATERIALS AND METHODS: A multicenter observational study comprising six community hospitals in Argentina was undertaken. Patients with a diagnosis of Crohn's disease or ulcerative colitis who underwent colonoscopy for endoscopic activity assessment between 2018 and 2022 were included. Colonoscopy reports of included subjects were manually reviewed to determine the proportion of colonoscopies that included an endoscopic score report. We determined the proportion of colonoscopy reports that included all of the IBD colonoscopy report quality elements proposed by BRIDGe group. Endoscopist's specialty, years of experience as well as expertise in IBD were assessed. RESULTS: A total of 1556 patients were included for analysis (31.94% patients with Crohn's disease). Mean age was 45.94±15.46. Endoscopic score reporting was found in 58.41% of colonoscopies. Most frequently used scores were Mayo endoscopic score (90.56%) and SES-CD (56.03%) for ulcerative colitis and Crohn's disease, respectively. In addition, 79.11% of endoscopic reports failed to comply with all recommendations on endoscopic reporting for inflammatory bowel disease. CONCLUSIONS: A significant proportion of endoscopic reports of inflammatory bowel disease patients do not include the description of an endoscopic score to assess mucosal inflammatory activity in a real-world setting. This is also associated with a lack of compliance in recommended criteria for proper endoscopic reporting.

Star'd y mas allá: una mirada profunda a la eficacia de los antidepresivos / Star'd and Beyond: An In-Depth Look at the Efficacy of Antidepressants

El estudio STAR'D busco identificar las intervenciones terapéuticas más eficaces para pacientes con trastorno depresivo mayor no tratado previamente. Se trató de un ensayo clínica naturalista y a gran escala, diseñado para determinar las estrategias terapéuticas más eficiente en aquellos pacientes que no responden a un tratamiento inicial. Aunque algunos profesionales consideraron el estudio alentador al proporcionar una ruta secuencias de alternativas farmacológicas, muchos lo vieron como un recordatorio revelador de las limitaciones inherentes de los antidepresivos: estos medicamentos no son la solución definitiva para la depresión. Este artículo tiene como propósito brindar un panorama conciso del estudio STAR'D, seguido de una reflexión crítica sobre sus hallazgos e implicaciones en el ámbito clínico.

Impact of an Educational Mobile App on Inflammatory Bowel Disease Colonoscopy Report Quality.

BACKGROUND: Inadequate endoscopic assessment of disease activity might lead to suboptimal treatment of patients with inflammatory bowel disease (IBD). AIMS: We aimed to determine if the implementation of an educational mobile app could help improving the quality of colonoscopy reports in patients with IBD. METHODS: We retrospectively analyzed a consecutive series of colonoscopy reports in patients with IBD during the period 2016-2023. The sample was divided into two groups: before and after the implementation of an educational mobile app (JEDII app ™). The main outcome was the inclusion of validated activity assessment scoring systems and previously stablished reporting required elements. RESULTS: A total of 883 IBD colonoscopy reports were included for analysis; 621 (70.3%) procedures were performed before the implementation of the app and 262 (29.7%) after. An IBD scoring system was included in 201 (32.4%) and 148 (56.5%) colonoscopy reports before and after the adoption of the mobile app, respectively (p < 0.001). The mean number of recommended elements for quality IBD colonoscopy reporting was significantly increased after the app implementation (4.3 vs. 1.9, p < 0.001). Diagnosis of ulcerative colitis, gastroenterologist as endoscopist, endoscopist with IBD clinical interest, and the implementation of the educational mobile app were independently associated with the inclusion of an IBD score in the colonoscopy report. CONCLUSION: The inclusion of scoring systems and recommended elements for quality IBD colonoscopy report significantly increased after the implementation of an educational mobile app. E-health technologies should be further explored to improve quality of care in patients with IBD.

Meta-analysis of genome-wide association studies for cattle stature identifies common genes that regulate body size in mammals.

Stature is affected by many polymorphisms of small effect in humans 1 . In contrast, variation in dogs, even within breeds, has been suggested to be largely due to variants in a small number of genes2,3. Here we use data from cattle to compare the genetic architecture of stature to those in humans and dogs. We conducted a meta-analysis for stature using 58,265 cattle from 17 populations with 25.4 million imputed whole-genome sequence variants. Results showed that the genetic architecture of stature in cattle is similar to that in humans, as the lead variants in 163 significantly associated genomic regions (P < 5 × 10-8) explained at most 13.8% of the phenotypic variance. Most of these variants were noncoding, including variants that were also expression quantitative trait loci (eQTLs) and in ChIP-seq peaks. There was significant overlap in loci for stature with humans and dogs, suggesting that a set of common genes regulates body size in mammals.