Background. Inadequate bowel preparation is common in outpatients undergoing screening colonoscopy because of unawareness and poor adherence to instruction.Methods. Herein, 105 consecutive outpatients referred for screening colonoscopy were enrolled in this prospective, colonoscopist-blinded study. The patients were assigned to an intensive-education group, with 10 minutes of physician-delivered education, or to standard care. At the time of colonoscopy, the quality of bowel preparation was assessed using the Boston Bowel Preparation Scale (BBPS). The primary outcome was a BBPS score ≥5. The secondary outcomes were the mean BBPS score, insertion time, adenoma detection rate, and number of adenomas detected.Results. We analyzed 39 patients who received intensive education and 60 controls. The percentage of adequate bowel preparations with a BBPS score ≥5 was higher in the intensive-education group than in the control group (97.4% versus 80.0%;P=0.01). The adjusted odds ratio for having a BBPS score ≥5 in the intensive-education group was 10.2 (95% confidence interval = 1.23–84.3;P=0.03). Other secondary outcomes were similar in the 2 groups.Conclusions. Physician-delivered education consisting of a brief counseling session in addition to written instructions improves the quality of bowel preparation in outpatients undergoing screening colonoscopy.

Branched‐chain amino acids (BCAAs) are one of the important biomarkers for monitoring liver disease such as hepatitis or hepatoma. In this communication, we present the determination of the concentrations of BCAA in ascites by CE light‐emitted diode‐induced fluorescence (LEDIF) using 1.5% m/v poly(ethylene oxide) (average M_v: ∼8 000 000 g/mol) that was prepared in 10 mM sodium tetraborate solution (pH 9.3). Naphthalene‐2,3‐dicarboxaldehyde was used to derivatize 15 amino acids (AAs) to form naphthalene‐2,3‐dicarboxaldehyde (NDA)‐AA derivatives prior to CE analysis. The separation of 15 NDA‐AA derivatives was accomplished within 15 min, with RSD values of <5.8% (within‐day) and 7.4% (between‐days) with respect to their migration times. The limits of detection for the tested BCAAs ranged from 10.6 to 10.9 nM. We determined the concentrations of three BCAAs – leucine, isoleucine and valine – in ascites by applying a standard addition method, with recovery percentages ranging from 93.9 to 111%. The results obtained from this CE‐LEDIF method is in good agreement with those by a gold standard method using an AA analyzer. We have found that the concentrations of the three BCAAs in ascites obtained from patients suffering from liver diseases were lower than those from healthy individuals. Our approach is highly efficient, sensitive, and cost‐effective, which holds great potential for the diagnosis of liver diseases.

Effects of Helicobacter pylori infection in gastrointestinal tract malignant diseases: From the oral cavity to rectum

The connection between microbial infections and tumor formation is notably exemplified by Helicobacter pylori (H. pylori) and its association with gastric cancer (GC) and colorectal cancer (CRC). While early studies hinted at a link between H. pylori and colorectal neoplasms, comprehensive retrospective cohort studies were lacking. Recent research indicates that individuals treated for H. pylori infection experience a significant reduction in both CRC incidence and mortality, suggesting a potential role of this infection in malignancy development. Globally, H. pylori prevalence varies, with higher rates in developing countries (80–90%) compared to developed nations (20–50%). This infection is linked to chronic gastritis, peptic ulcers, and GC, highlighting the importance of understanding its epidemiology for public health interventions. H. pylori significantly increases the risk of non-cardia GC. Some meta-analyses have shown a 1.49-fold increased risk for colorectal adenomas and a 1.70-fold increase for CRC in infected individuals. Additionally, H. pylori eradication may lower the CRC risk, although the relationship is still being debated. Although eradication therapy shows promise in reducing GC incidence, concerns about antibiotic resistance pose treatment challenges. The role of H. pylori in colorectal tumors remains contentious, with some studies indicating an increased risk of colorectal adenoma, while others find minimal association. Future research should investigate the causal mechanisms between H. pylori infection and colorectal neoplasia, including factors like diabetes, to better understand its role in tumor formation and support widespread eradication efforts to prevent both gastric and colorectal cancers.

Cost-effective serology tests may increase the predictive accuracy of colonoscopy for colorectal cancer screening. Reportedly, gamma-glutamyl transferase (GGT) is associated with oxidative stress and carcinogenesis and has been found to be elevated in the serum of cancer patients and colorectal adenoma tissue. We aimed to investigate the association between serum GGT levels and colorectal adenoma. This single-center, health examination-based cohort enrolled 2475 subjects from 2006 to 2015. Baseline characteristics, laboratory data, bidirectional gastrointestinal endoscopy, and transabdominal ultrasonography were used to evaluate the severity of fatty liver. We found an elevated median GGT level in subjects with tubular adenoma compared with those without (23 IU/L and 20 IU/L, p<0.001). A GGT cutoff of ≥20 IU/L reached a maximal Youden index in receiver operating curve (ROC) analyses. Subsequent regression analyses showed an odds ratio of 1.46 (95% CI 1.17–1.82, p<0.001) for age, body mass index, diabetes diagnosis, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and positive Helicobacter pylori urease test, all being associated with an increased incidence of colon adenoma. Subgroup analysis showed that the odds ratio (OR 1.27, 95% CI 1.15–1.68, p20 IU/L, which is within the normal range. The effect may be most prominent for those without steatohepatitis.

Background: Helicobacter pylori infection and hyperglycemia are associated with an increased risk of colorectal neoplasm, and may have a synergistic effect in combination. However, these 2 factors that affect colorectal neoplasm remain controversial. We aimed to carry out a meta-analysis to evaluate the study population diabetes prevalence rate and H pylori infection rate with colorectal adenoma risk for adults. Methods: We conducted systemic research through English databases for medical reports. We also recorded the diabetes prevalence and H pylori infection prevalence in each study. We classified these studies into 4 subgroups as their background population diabetes prevalence <6% (Group 1); between 6% and 8% (Group 2); between 8% and 10% (Group 3), and more than 10% (Group 4). The random-effects model had used to calculate pooled prevalence estimates with 95% confidence interval (CI). Results: Twenty-seven studies were finally eligible for meta-analysis. The random-effects model of the meta-analysis was chosen, showing pooled odds ratio (OR) equal to 1.51 (95% CI 1.39–1.63). The subgroup meta-analyses showed in Group 1 the H pylori infection associated colorectal adenoma risk OR was 1.24 (95% CI 0.86–1.78). As the diabetes rate exceed 6%, the H pylori infection became the more significant increased risk of colorectal adenoma (Group 2: OR 2.16 (95% CI 1.61–2.91); Group 3: OR 1.40 (95% CI 1.24–1.57); and Group 4: OR 1.52 (95% CI 1.46–1.57)). Conclusions: The results of this meta-analysis showed elevated diabetes prevalence combined H pylori infection increasing the risks of colorectal adenoma in the adult population.