Participants will undergo intestinal ultrasound (IUS) assessments using both a high-end (Samsung RS85) and a mid-end (Siemens ACUSON S2000) ultrasound machine to evaluate ileocolonic inflammation in inflammatory bowel disease (IBD). Each device is used within the same session, focusing on bowel wall thickness, vascularity, and structural changes. The high-end ultrasound provides advanced imaging capabilities, while the mid-end device offers standard IUS functionalities. Tandem ileo-colonoscopy is performed as the reference standard to validate findings.

Primary Outcome: Diagnostic accuracy (sensitivity, specificity) of high-end vs. mid-end ultrasound.

Secondary Outcome: Impact of ultrasound findings on clinical management decisions, evaluating cost-effective options for routine IBD monitoring.

This study compares two intestinal ultrasound (IUS) devices-a high-end machine (Samsung RS85) and a mid-end machine (Siemens ACUSON S2000)-for assessing ileocolonic inflammation in IBD patients. The high-end device offers advanced imaging features, including high-resolution, speckle reduction, and extended field of view, allowing for detailed visualization of the bowel wall and vascularity. The mid-end device, while more basic, provides essential IUS functions for examining bowel wall thickness, structure, and inflammation markers. Both devices are used in a single clinical session, with results compared against tandem ileo-colonoscopy as the reference standard. This unique dual approach enables evaluation of the diagnostic performance of each device type. If comparable, the mid-end device may offer a cost-effective solution, increasing access to routine IUS in various healthcare settings, especially where high-end technology is limited.

Comparative Use of High-End and Mid-End Intestinal Ultrasound Devices for IBD Disease activity assessment

Asian Institute of Gastroenterology, India

Duvvuru Nageshwar Reddy, MD, DM, MASGE, FACG, AGAF

Partha Pal, MD, DNB, MRCP(UK), FASGE

Mohammad Abdul Mateen, MD

disease activity guided dose reduction strategy of JAKi

JAKi dose reduction strategy

disease activity guided continuation of same dose strategy of JAKi (randomised)

JAKi disease activity guided continuation of same dose strategy

disease activity guided continuation of same dose strategy of JAKi

Dr. N. van Herwaarden

Prof dr. A. van Tubergen

Dr. L Schipper

Prof dr. H. Vonkeman

Dr A.E. van der Bijl

Dr. P.H.P. de Jong

Dr. M. Kok

ACF/TPT intervention will be delivered in a community setting, in geographic areas judged likely to have a high burden of undiagnosed TB

ACF/TPT in both intervention arms will consist of TB screening by mobile chest X-ray (with artificial intelligence-based reading, followed by confirmatory sputum testing with Xpert MTB/RIF Ultra for participants with abnormal x-rays), and linkage to preventive therapy for those who are TB-negative and eligible for TPT (limited in April 2024 to those with close TB contact or known HIV infection).

Active TB case finding with linkage to preventive therapy (ACF/TPT)

ACF/TPT intervention will be delivered on the grounds of a health facility (hospital or large public health center)

Achilles Katamba

Achilles Katamba, MBChB PhD

The Verve RPD™ system is used to perform renal pelvic denervation via the urinary collecting system for the treatment of hypertension. The system does so through the delivery of RF energy to the walls of the renal pelvis - delivered via natural orifice through the urinary tract. During the course of the study, patients will be on active medical therapy for their hypertension.

Prespecified two medication regimen for control of hypertension

Active hypertension medical therapy

Sham procedure will include all steps employed in the renal pelvis denervation with exception of activation of the RPD™ Device. Sham procedure includes advancing guidewire, cystoscope and sheath to position within the renal pelvis, then deploying the RPD™ Device into the renal pelvis (within each kidney), keeping the device in place for 2 minutes (within each kidney) to simulate activation, and then withdrawing the device and sheath. During the course of the study, sham patients will be on active medical therapy for their hypertension.

IBD 질환 활동성 평가를 위한 고급 및 중급 장 초음파 장비의 비교 사용

JAKi 용량 감소 전략, JAKi 질병 활동성 유도 동일 용량 전략 지속

활동성 결핵 환자 발견 및 예방 치료 연계(ACF/TPT)

RPD, 활동성 고혈압 약물 치료