Prevalence of past or current Hepatitis B infection and factors for non-vaccination in Chinese patients with inflammatory bowel diseases

The Conference program's website is located at http://jsibd.jp/1staocc/program.htmlPoster Oral: PO-46Information on the prevalence and natural history of chronic hepatitis B (HBV) among Asian IBD patients are scarce. Moreover, the prevalence of HBV vaccination coverage in Asian IBD patients remains unknown. AIM: We determined the prevalence and clinical course of current and past HBV infection among Chinese IBD patients. We also determined the proportion of Chinese IBD patients without protective antibody against HBV and factors associated with non-vaccination. METHODS: All patients attending our IBD Clinic had blood tests for viral hepatitis B markers. The prevalence of current and past infection with HBV, and effective HBV vaccination were determined. We also identified for risk factors associated with non-vaccination. RESULTS: A total of 267 Chinese IBD (166 ulcerative colitis and 101 Crohn’s disease) patients were studied. The mean follow up was 10.5 years. Current HBV infection was detected in 6.7% patients whereas 28.5% had evidence of past HBV infection. One hundred and two (38.2%) patients had no detectable anti-HBs antibodies. Multivariate analysis found that young age of diagnosis (OR 1.021; 95% CI 1.00 – 1.04) and the use of thiopurines (OR 0.51; 95%CI 0.29 – 0.91) were associated with absence of anti-HBs. Deranged liver function was detected in 27 (10.1%) IBD patients including three (16.7%) HBsAg-positive patients. The corresponding proportion of patients with liver derangement was 7.9% in patients with past HBV infection, 8.9% in HBsAg-negative patients without anti-HBs and 11.2% in patients with effective HBV vaccination (P = 0.71). CONCLUSION: Current and past infection with HBV was detected in about one-third of Chinese IBD patients. Approximately 40% of IBD patients lacked protective antibody against HBV. The use of thiopurines and young age of diagnosis was associated with non-vaccination among Chinese IBD patients. A more intensive HBV vaccination program with regular monitoring of anti-HBs may be needed in this group of patients.published_or_final_versio

Characteristics and prognosis of gastric cancer patients diagnosed within 5 years of prior negative gastroscopy

This journal suppl. entitled: 18th Medical Research Conference; Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong KongINTRODUCTION: Gastric cancer diagnosed within 3 years of previous negative gastroscopy (OGD) is considered as missed cancers. Little is known about the characteristics and prognosis of these patients. This study aimed to compare the frequency, characteristics, and prognosis of gastric cancer patients with a previous negative OGD …postprin

Evaluation of an automated immunochemical faecal occult blood test for colorectal neoplasia screening in a Chinese population

published_or_final_versio

Characteristics and prognosis of patients diagnosed with gastric cancer after prior negative gastroscopy

Poster Session - Oesophageal, Gastric and Duodenal Disorders 2: abstract no. P1055Conference Theme: Our birthday event marked by record numbersINTRODUCTION/OBJECTIVES: Gastric cancer diagnosed within 3 years of previous 'negative' gastroscopy is usually considered as possible missed cancers. Little is known about the characteristics and prognosis of patients who were subsequently diagnosed with gastric cancer after a prior negative gastrosco…link_to_OA_fulltex

Findings on surveillance colonoscopy in patients with serrated lesions of the colon

This journal suppl. contain AGA abstract

Long term rebleeding in patients with obscure gastrointestinal bleeding after first deep enteroscopy

This journal suppl. contain AGA abstract

Treatment of Gastric Metaplasia or Dysplasia by Endoscopic Radiofrequency Ablation: A Pilot Study

BACKGROUND/AIMS: Patients with gastric intestinal metaplasia and dysplasia are at increased risk of gastric cancer development. We tested the feasibility of using endoscopic radiofrequency ablation for the treatment of dysplasia and metaplasia in the stomach. METHODOLOGY: Patients who had histologically confirmed low-grade gastric dysplasia or IM were recruited. Endoscopic RFA was performed at 8 week-intervals for a maximum of 3 sessions. All patients were followed up by endoscopy until 12 months post-RFA. The primary outcome was the complete eradication of dysplasia or IM on follow-up. Secondary outcome was adverse events related to RFA. RESULTS: A total of 12 patients were recruited. Four patients had low-grade dysplasia and the remaining 8 patients had non-dysplastic IM at baseline. At one year after RFA, complete eradication of dysplasia was noted in four patients with low-grade dysplasia (100%). Gastric IM persisted in all patients with baseline metaplasia but the severity of IM improved in 6 (75%) patients. Endoscopic RFA was safe with minimal complications encountered. CONCLUSIONS: RFA successfully eradicated low-grade dysplasia of the stomach. Gastric IM however persisted after RFA but most patients had evidence of histological improvement on follow up. TRIAL REGISTRATION: ClinicalTrials.gov NCT01614418

Treatment of gastric dysplasia and metaplasia by endoscopic radiofrequency ablation: a feasibility study

Saturday poster abstract: no. Sa1413This journal suppl. entitled: DDW Abstract Issue 2013, Digestive Disease Week 2013INTRODUCTION: Patients with pre-neoplastic gastric lesions including intestinal metaplasia (IM) and dysplasia are at increased risk of developing gastric cancer. Endoscopic radiofrequency ablation (RFA) has been successfully used in the eradication of dysplasia and IM associated with Barrett's esophagus. We tested the feasibility of using RFA for the treatment of dysplasia and IM in the stomach. METHODS: Patients who had histologically confirmed gastric dysplasia or IM were recruited. All patients had H. pylori eradicated prior to RFA. Gastroscopy was performed by high definition endoscope with narrow band imaging and chromoendoscopy. Gastric pre-neoplastic lesions should be endoscopically visible, well defined and not raised. Ablation was performed using a HALO90 catheter (Covidien GI Solutions) attached to gastroscope and conducted under direct visualization until the target gastric mucosal lesions were treated. All procedures were performed on an outpatient basis under intravenous sedation. Endoscopy and RFA was repeated at 8 week intervals for a maximum of 3 sessions or when there were no further endoscopically visible lesions. All patients were followed up by endoscopy at 6 and 12 months post-RFA. During follow up examination, reference to previous tattoo marks and video-recordings were made to ensure accurate localization of previous RFA treated lesions. Areas suspicious for dysplasia and/or metaplasia were biopsied for histological examination. The primary outcome was the complete eradication of dysplasia and/or IM. The secondary outcome was improvement in grading of IM as stipulated in updated Sydney Classification. The histological assessment was made by two pathologists who were blinded to the sequences of the biopsy samples. RESULTS: A total of 12 patients were recruited (median age 73 years; 7 male). Four patients had low-grade dysplasia (LGD) and the remaining 8 patients had non-dysplastic IM at baseline. Up to the time of writing this abstract, a total of 25 treatment sessions were applied and 4 patients had completed 3 sessions of RFA. Nine patients, including 2 patients with LGD, had completed their 6-month follow up endoscopy and 5 patients had completed their 12-month follow up. Complete eradication of dysplasia was noted in both patients with LGD at baseline (100%). The severity of IM improved in 6 (67%) patients and the remaining 3 patients showed no interval changes on histology at 6-months. At 12-months, 3 (60%) patients had histological improvement in IM. Most patients tolerated the procedure well, except one patient who had a minor mucosal laceration of the cricopharyngeus during insertion of the catheter. CONCLUSION: Radiofrequency ablation successfully eradicated low-grade dysplasia of the stomach. Gastric IM persisted with RFA treatment, but most showed histological improvement on follow up

Seven-day rifabutin containing triple therapy versus seven-day levofloxacin containing quadruple therapy as second-line treatment for Helicobacter pylori in Chinese patients: an open label, randomized trial

Oral PresentationINTRODUCTION: Rifabutin containing triple therapy (RIF) and levofloxacin containing quadruple therapy (QUAD) has been used as rescue therapy for resistant H. pylori infection. We compared the efficacy and tolerability of 7-day RIF with 7-day QUAD as second-line treatment for H. pylori infection. Levofloxacin was used instead of bismuth subcitrate for the quadruple therapy, as bismuth is no longer available in Hong Kong. METHODS: Patients who have failed the triple therapy (esomeprazole, amoxicillin, and clarithromycin) and remained H. pyloripositive were randomly assigned to receive either 7-day RIF (esomeprazole, rifabutin and amoxicillin) or QUAD (esomeprazole, levofloxacin, tetracycline and metronidazole) treatments. H. pylori eradication was confirmed by urea breath test at 8 weeks. The primary outcome was the eradication rates by intention-to-treat (ITT) and per-protocol (PP) analyses. RESULTS: One hundred and fifty-one patients were randomized to receive either RIF or QUAD. The PP eradication rate of the RIF and QUAD groups were 89.3% and 95.6%, respectively (P = 0.16). Base on ITT analysis, the corresponding eradication rate was 88.2% and 90.7% (P = 0.62). One patient (1.3%) in the RIF and seven (9.3%) patients in the QUAD failed to complete the treatment regime. The overall incidences of adverse events were higher in the QUAD (30.7%) than in the RIF (15.8%) group (P = 0.03). CONCLUSION: Seven-day rifabutin containing triple therapy and levofloxacin containing quadruple therapy are both highly effective and should be considered as second-line treatment for resistant H. pylori infection

Effectiveness of gastroprotective agents on prevention of dabigatran related gastrointestinal bleeding: a population-based restrospective cohort study

Oral Presentationpp. 831-891 of this journal issue entitled: International Society of Pharmacovigilance AbstractsConference Theme: New Ideas in Ancient Cultures: Advancing Pharmacovigilance in Asi