Daily Recap, Tuesday, October 13

Today marked the third and final day of UEG Week Virtual 2020. 

The programme featured a number of abstract-based sessions, including a late-breaker on COVID-19 and GI which featured breaking studies from Spain, Italy and the UK, three of the hardest hit countries in Europe.

There were more live demonstrations in the Demo Hall, with five sessions on endoscopy. 

Journal Best Paper Awardee: Andrew Wisniewski

During this morning’s “Good Morning UEG Week” session, Andrew Wisniewski was awarded with the Journal Best Paper Award 2020 for his article “Increased incidence of systemic serious viral infections in patients with inflammatory bowel disease associates with active disease and use of thiopurines.”

Andrew Wisniewski is a gastroenterologist at the Hôpital Charles-Lemoyne of the University of Sherbrooke, Quebec, Canada.

He attended medical school at the University of Szeged. Following his residencies in gastroenterology and internal medicine at the University of Montreal, Canada, he completed an IBD fellowship with Dr Laurent Beaugerie at Sorbonne University.

Watch the Good Morning UEG Week Session

Scientific Highlights: COVID-19 Impact on GI Practice

An internet-based survey conducted during the early months of the COVID-19 pandemic has illustrated the massive toll taken on GI practice and on gastroenterologists working in hospitals and private practices around the world. Personal protective equipment (PPE) was in short supply, and many hospital-based GI specialists were redeployed to care for COVID-19 patients. As a result, almost one in 10 specialists had tested positive for COVID-19 by April/May 2020.

The anonymous 25-item survey was sent out via email between April and May 2020 to recipients within the UEG community. Two thousand and sixty-three valid responses were received from hospital consultants and heads of department, trainee gastroenterologists, private practitioners, surgeons, medical students, and allied health professionals. Most survey respondents were working in university or general hospitals and/or in private practice.

A lack of PPE was illustrated by the finding that 44.1% of survey respondents said they were wearing surgical masks during upper GI endoscopy. Only 33.5% of respondents were wearing FFP2 masks and 15.1% of respondents were wearing the guideline-recommended FFP3 masks during upper GI endoscopy. Similar data was reported for mask use during lower GI endoscopy. The survey also found that 37% of hospital GIs had been redeployed to care for COVID-19 patients, with 48% of redeployed doctors being GI trainees. Perhaps, unsurprisingly given these findings, 9.7% of respondents had already tested positive for COVID-19.

The impact of COVID-19 on GI research was also found to be substantial: 47% of research centres had totally suspended all human clinical trials, and 36% were only allowed to conduct research under certain circumstances. Less than 5% of research centres were continuing their work as usual.

“GIs across the world in all settings face unprecedented challenges,” said Henriette Heinrich, who presented the survey findings. “PPE availability and testing for COVID-19 is a major concern for a lot of GIs…and 10% of GIs surveyed got infected with COVID-19.

“GI trainees are redeployed to a high degree, affecting their training possibilities.”

Scientific Highlights: NAFLD and Ultra-Processed Food Consumption

Consumption of ultra-processed food is an independent risk factor for non-alcoholic fatty liver disease (NAFLD), according to the results of a large population-based study conducted in Korea presented today by Youn Choi.

To investigate the prospective association of ultra-processed food consumption on the risk of NAFLD, study participants were divided into quintiles based on their ultra-processed food intake. During follow up, 2,331 of the 56,514 study participants (4.1%) developed NAFLD (FLI >60 or hepatic steatosis index >38).

Ultra-processed food consumption was associated with the development of NAFLD. In a univariate analysis, the risk of developing NAFLD was significantly increased in the two groups with the highest intake of ultra-processed food compared with the lowest-intake group (crude HR 1.51; 95% CI 1.34–1.70; p<0.001 in the highest-consumption group). The association remained significant after adjusting for multiple baseline variables including age, sex, BMI, total calorie, carbohydrate, and lipid intake, smoking, current drinking, regular exercise, stress perception, and other relevant comorbidities (HR 1.17; 95% CI 1.02–1.34; p<0.001 in the highest-consumption group).

“In this nationwide, population-based, long-term follow-up study, we revealed the ultra-processed food intake had an adverse effect for the risk of NAFLD, even after adjusting for known NAFLD risk factors,” said investigator, Youn Choi. “The more ultra-processed food intake, the more the risk of NAFLD in [a] linear association.

Scientific Highlights: Gut Microbiome Instability Linked to Host Phenotypic Changes

Long-term changes in the composition and genetic profile of the gut microbiome have been linked with host phenotypic changes associated with disease. The population-based Dutch Lifelines-DEEP cohort contains >300 individuals who have been followed for 4 years and who have been extensively phenotyped for lifestyle, clinical, and physiological factors, with metagenomic sequencing of faecal samples performed twice in that time. “This unique dataset allows us to investigate the long-term stability of the gut microbiome composition and genetic make-up,” explained Lianmin Chen.

Chen and co-workers have analysed data from this unique cohort (n=338; age 22–84 years; 44% male) and found substantial changes in microbial compositional stability over 4 years, with 60% of microbiome species (n=157) and 40% of pathways (n=343) significantly altered during that time (false discovery rate [FDR]-adjusted p<0.05 for both analyses). 

Scientific Highlights: Endoscopic Procedure Shown to Discontinue Insulin Treatment in Type 2 Diabetics

A revolutionary endoscopic therapeutic procedure may lead to the discontinuation of insulin treatment in a significant number of people with type 2 diabetes, new research presented today by Suzanne Meiring has shown.

Researchers from the Netherlands tested a novel, minimally-invasive ablation procedure, which rejuvenates the lining of the duodenum, in combination with daily doses of glucagon-like peptide agonists and mild lifestyle counselling. The study found that 75% of previously insulin-dependent people with type 2 diabetes treated with the ablation technique did not need insulin six months later, with HbA1c (a long-term parameter of glucose control) readings of 7.5% or below. HbA1c readings also fell to 6.7% at 12 months.

Patients who responded to the treatment also saw significant reductions in their body mass index (BMI), which was down from an average of 29.8 kg/m2 at the beginning of the research to 25.5 kg/m2 after 12 months.

The minimally-invasive technique, called Duodenal Mucosal Resurfacing (DMR), is performed in an outpatient setting and is delivered via an integrated over-the-wire catheter attached to a custom console that performs a synchronized lifting of the duodenal mucosa and then ablation of the treatment area.

"Based on the results of this pilot study, a large international randomised controlled trial, called Revita T2Di Pivotal, will soon start to further investigate its effectiveness in greater numbers", explained Suzanne Meiring.

Don't Miss... Best of Postgraduate Teaching from UEG Week

The action doesn’t stop today! The “Best of Postgraduate Teaching from UEG Week” will take place on November 27-28, 2020.

Join us for this live, interactive, 2-day experience, where the most popular past UEG Week sessions have been given state-of-the-art scientific updates. Every session will occur in real-time and feature direct interactivity with the experts via our Q&A tool.

Find out more

Times Change, World Class Science Remains: See you in 2021

Don't forget to mark your diaries for UEG Week next year, taking place between October 2-6, 2021.

We hope to meet you in Vienna, but will remain flexible and adaptable in establishing the best possible, but safest, programme for everyone.  

Thank You

We'd like to take this opportunity to thank our fantastic faculty, speakers, partners, and delegates during this virtual congress. It's been a different experience, but I'm sure everyone will agree that state-of-the-art science, a feature of every UEG Week, has remained at the very forefront of the meeting. On-demand content is available for the remainder of 2020, and we hope you continue to learn, enhance and engage with the congress beyond today. Stay tuned for the UEG Week Congress Review, published next week, which will include programme highlights from across the meeting. 

We hope to see you again soon!