Gastroenterología y Hepatología (English Edition)最新文献

{"title":"Real-world clinical characteristics and therapeutic strategies in patients with moderate-to-severe inflammatory bowel disease in Argentina: Data from the RISE-AR study","authors":"Pablo Andres Olivera ,&nbsp;Domingo Balderramo ,&nbsp;Juan Sebastian Lasa ,&nbsp;Ignacio Zubiaurre ,&nbsp;Gustavo Correa ,&nbsp;Pablo Lubrano ,&nbsp;Orlando Ruffinengo ,&nbsp;Martin Yantorno ,&nbsp;Astrid Rausch ,&nbsp;Gisela Piñero ,&nbsp;Andrea Bolomo ,&nbsp;Carla Amigo ,&nbsp;Jazmin El-Hakeh ,&nbsp;Daiana Beatriz Leonardi ,&nbsp;Laura Brion ,&nbsp;Alicia Sambuelli","doi":"10.1016/j.gastre.2025.502287","DOIUrl":"10.1016/j.gastre.2025.502287","url":null,"abstract":"<div><h3>Objective</h3><div>Real-world evidence on the adoption of different pharmacological strategies in inflammatory bowel disease (IBD) in Latin America is scarce. Herein, we describe real-world sociodemographic, clinical characteristics, and different therapeutic approaches used in patients with IBD in Argentina.</div></div><div><h3>Methods</h3><div>RISE AR (<span><span>NCT03488030</span><svg><path></path></svg></span>) was a multicenter, non-interventional study with a cross-sectional evaluation and a 3-year retrospective chart review conducted in Argentina. Adult patients with a previous diagnosis of moderate-to-severe ulcerative colitis (UC) or Crohn's disease (CD) at least 6 months prior to enrollment were included.</div></div><div><h3>Results</h3><div>This study included 246 patients with IBD (CD: 41%; UC: 59%), with a median age of 39.5 years (IQR 30.7–51.7) for CD and 41.9 years (33.3–55.3) for UC. Overall, 51.5% of CD patients had colonic disease involvement, while 45.5% of UC patients had extensive colitis. At enrollment, the overall use of biologics was high, especially in CD patients (CD: 73.2% vs. UC: 30.3%, <em>p</em> <!-->&lt;<!--> <!-->0.001), while the use of immunosuppressants was similar (∼41%, <em>p</em> <!-->=<!--> <!-->1.000) for both diseases. IBD treatments ever prescribed and healthcare resources utilization during the retrospective period were (CD, UC): biologics: 79.2%, 33.8% (<em>p</em> <!-->&lt;<!--> <!-->0.001); immunosuppressants: 65.3%, 58.6% (<em>p</em> <!-->=<!--> <!-->0.352); aminosalicylates: 62.4%, 97.9% (<em>p</em> <!-->&lt;<!--> <!-->0.001); corticosteroids: 55.4%, 69.7% (<em>p</em> <!-->=<!--> <!-->0.031); surgery: 17.8%, 1.4% (<em>p</em> <!-->&lt;<!--> <!-->0.001); and hospitalizations: 33.7%, 21.4% (<em>p</em> <!-->=<!--> <!-->0.039).</div></div><div><h3>Conclusion</h3><div>In this cohort of IBD patients, overall prescription patterns of conventional therapy were similar to reports elsewhere; however, biologic therapy use was high, especially in CD, consistent with disease behavior and possibly reflecting better access to care in referral centers. Interestingly, over half of CD patients presented colonic involvement.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 8","pages":"Article 502287"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary clinical practice guideline on the management of metabolic hepatic steatosis","authors":"Manuel Romero-Gómez ,&nbsp;Javier Escalada ,&nbsp;Mar Noguerol ,&nbsp;Antonio Pérez ,&nbsp;Juana Carretero ,&nbsp;Javier Crespo ,&nbsp;Juan J. Mascort ,&nbsp;Ignacio Aguilar ,&nbsp;Francisco Tinahones ,&nbsp;Pedro Cañones ,&nbsp;Ricardo Gómez-Huelgas ,&nbsp;Daniel de Luis ,&nbsp;Idoia Genúa Trullos ,&nbsp;Rocío Aller ,&nbsp;Miguel A. Rubio","doi":"10.1016/j.gastre.2025.502442","DOIUrl":"10.1016/j.gastre.2025.502442","url":null,"abstract":"<div><div>Metabolic hepatic steatosis (MetHS) is a clinically heterogeneous, multisystemic, dynamic, and complex disease, whose progression is one of the main causes of cirrhosis and hepatocarcinoma. This clinical practice guideline aims to respond to its main challenges, both in terms of disease burden and complexity. To this end, recommendations have been proposed to experts through the Delphi method. The consensus was optimal in recommendations regarding type 2 diabetes as a risk factor (1.5.1, 4.5.1), in which cases early detection of MetHS should be carried out (4.5.2). Its results also emphasize the importance of the use of non-invasive tests (FIB-4, NFS, HFS) for the exclusion of significant fibrosis in patients with suspected MetHS (2.3.1, 2.3.3). Diagnosis should be carried out through the sequential combination of non-invasive indices and transient elastography by FibroScan® for its risk stratification (2.3.3). A nearly unanimous consensus was reached regarding the role of early prevention in the impact on the quality of life and survival of patients (5.1.2), as well as on the effectiveness of the Mediterranean diet and physical exercise in relation to the improvement of steatosis, steatohepatitis and fibrosis in MetHS patients (5.2.2) and on the positive results offered by resmiterom and semaglutide in promoting fibrosis regression (5.4.1). Finally, a great consensus has been reached regarding the importance of multidisciplinary management in MetHS, for which it is essential to agree on multidisciplinary protocols for referral between levels in each health area (6.2.1), as well as ensuring that referrals to Hepatology/Digestive and Endocrinology or Internal Medicine services are effective and beneficial to prevent the risk of disease progression (6.2.3, 6.3.1).</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 8","pages":"Article 502442"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and bidirectional association between primary sclerosing cholangitis and Crohn's disease: A systematic review and meta-analysis","authors":"Dongyuan Zheng ,&nbsp;Qinke Xu ,&nbsp;Jin Wu ,&nbsp;Zhouyue Gu ,&nbsp;Jieya Chen ,&nbsp;Yingchao Liu","doi":"10.1016/j.gastre.2025.502346","DOIUrl":"10.1016/j.gastre.2025.502346","url":null,"abstract":"<div><h3>Purpose</h3><div>This meta-analysis aimed to evaluating the prevalence of Crohn's disease in primary sclerosing cholangitis (PSC) and the incidence of primary sclerosing cholangitis in Crohn's disease (CD), along with their interrelation.</div></div><div><h3>Methods</h3><div>An extensive search was conducted in the PubMed and Embase to identify available publications up to December 2023. Studies were included if they reported the prevalence of CD in PSC patients, or vice versa. Proportions were assessed using the DerSimonian and Laird method, followed by transformation via the Freeman–Tukey double inverse sine transformation. The quality of the included studies utilizing the Joanna Briggs Institute Critical Appraisal Checklist.</div></div><div><h3>Results</h3><div>Based on quantitative analysis of 61 studies, the prevalence of PSC in patients with CD was 0.88% (95% CI: 0.53–1.30%). The prevalence of PSC in male CD patients was 0.45% (95% CI: 0.03–1.16%). In female CD patients, the prevalence was 0.51% (95% CI: 0.09–1.14%). The prevalence of CD with PSC was 11.27% (95% CI: 9.56–13.10%). The prevalence of CD in male PSC patients was 10.71% (95% CI: 7.42–14.50%). Among female PSC patients, the pooled prevalence of CD was 13.05% (95% CI: 11.05–15.19%).</div></div><div><h3>Conclusions</h3><div>We found a significant bidirectional association between PSC and CD, with a higher prevalence of CD in female with PSC compared to male. These findings provide important epidemiological data for clinical practice.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 8","pages":"Article 502346"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of nursing advice on influenza vaccination in patients with hepatic oncologic disease","authors":"M. José Sánchez-Iturri ,&nbsp;Carmen Alonso ,&nbsp;Eva Zapata ,&nbsp;Cristina Sarasqueta ,&nbsp;Agustín Castiella","doi":"10.1016/j.gastre.2025.502448","DOIUrl":"10.1016/j.gastre.2025.502448","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 8","pages":"Article 502448"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastric intussusception caused by submucosal eminence of gastric antrum","authors":"Jianhong Xu ,&nbsp;Kai Yang ,&nbsp;Zhenguo Qiao ,&nbsp;Ling Fan","doi":"10.1016/j.gastre.2025.502441","DOIUrl":"10.1016/j.gastre.2025.502441","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 8","pages":"Article 502441"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthetic management experince in patients undergoing motorized spiral enteroscopy","authors":"María Leonor Moreno Vigil ,&nbsp;Matilde Núñez Esteban ,&nbsp;María Isabel Altamirano Jiménez ,&nbsp;María Pérez Sánchez ,&nbsp;Marc Salazar Bardía ,&nbsp;Elisa Ruíz Blanco ,&nbsp;Julia Martínez-Ocón ,&nbsp;Begoña González-Suárez ,&nbsp;Fernando Dana Muzzio ,&nbsp;Eva Rivas","doi":"10.1016/j.gastre.2025.502436","DOIUrl":"10.1016/j.gastre.2025.502436","url":null,"abstract":"<div><h3>Introduction</h3><div><span>The implementation of motorised spiral enteroscopy (MSE) in digestive </span>endoscopy units<span><span> required the upgrading of assistencial guidelines to perform general anaesthesia with </span>orotracheal intubation in a systematic and safe manner.</span></div></div><div><h3>Objective</h3><div>To describe the anaesthetic management during MSE and to evaluate the incidence of complications during and within 24 h after the procedure. To assess whether there is a relationship between the difficulty of inserting and withdrawing the MSE and the patient’s airway characteristics.</div></div><div><h3>Patients and methods</h3><div>Observational, prospective study in patients undergoing anterograde MSE under GA in our endoscopy unit between 2021 and 2023. We recorded clinical and demographic, and airway characteristics. We registered the anaesthesia and MSE procedure, as well as the peri-procedure complications within 24 h.</div></div><div><h3>Results</h3><div>After excluding one patient due to a full stomach, 49 patients were included (mean age 63 ± 14 years, 53% women, 41% ASA III-IV). All underwent total intravenous general anaesthesia and orotracheal intubation, with a 12% incidence of difficult VA. The incidence of anaesthetic complications<span> was 4%, with no serious events. 18% had difficulties in inserting and/or withdrawing the MSE and 33% had difficult airway<span>. During recovery, 46% had sore throat and VAS &gt; 3 in 31%. At 24 h, VAS &gt; 3 persisted in 47% of cases.</span></span></div></div><div><h3>Conclusions</h3><div>Motorized spiral enteroscopy under GA in the endoscopy unit is a safe procedure, with a low incidence of serious complications. Multidisciplinary collaboration and preanesthetic assessment are essential to minimize risk.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 8","pages":"Article 502436"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatic abscess secondary to gastrohepatic migration of a fishbone","authors":"Alex Gil-Ordóñez ,&nbsp;Gerard Rafart ,&nbsp;Carles Pérez-Serrano ,&nbsp;Carolina González-Abós ,&nbsp;Sergio Jiménez-Serrano","doi":"10.1016/j.gastre.2025.502435","DOIUrl":"10.1016/j.gastre.2025.502435","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 8","pages":"Article 502435"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients’ and paediatric gastroenterologists’ assessments of the follow-up of coeliac disease in Spain","authors":"David Pérez Solís ,&nbsp;Juan Ignacio Serrano-Vela ,&nbsp;Cristóbal Pérez Sixto ,&nbsp;Teresa Bermejo Delgado ,&nbsp;M. Luz Cilleruelo Pascual ,&nbsp;Josefa Barrio Torres ,&nbsp;Ester Donat Aliaga ,&nbsp;Ricardo Torres Peral ,&nbsp;Enriqueta Román Riechmann ,&nbsp;on behalf of the Spanish Society of Paediatric Gastroenterology, Hepatology and Nutrition (SEGHNP) Coeliac Disease Working Group","doi":"10.1016/j.gastre.2025.502371","DOIUrl":"10.1016/j.gastre.2025.502371","url":null,"abstract":"<div><h3>Introduction</h3><div>There is high variability in the follow-up of paediatric<span> patients with coeliac disease (CD) in Europe. The aim of this study was to know the current reality of paediatric CD follow-up in Spain through professionals and the patients themselves and their families.</span></div></div><div><h3>Patients and methods</h3><div>A cross-sectional descriptive study was conducted using two anonymous web surveys, one aimed at paediatric gastroenterologists, and the other at members of CD patients’ associations.</div></div><div><h3>Results</h3><div>A total of 96 responses from paediatricians and 4745 from patients (1362<!--> <!-->&lt;<!--> <span><span>15 years) were analysed. Among the professionals, 84.4% carry out follow-up only at the hospital level. 80.2% lack a joint follow-up protocol with primary health care. The transition after the paediatric age is made to adult gastroenterologists by 56.2% of professionals (only 8.3% in a protocolized manner). 58.3% do not have a </span>dietitian<span> and 64.6% do not use quality of life questionnaires. The patients stated that they mainly performed follow-up visits in the hospital (68.8%). Only 15.7% ever consult a dietitian. Scheduled visits were more frequent in paediatric patients than in adults (95.1% vs. 63.5%, </span></span><em>P</em> <!-->&lt;<!--> <!-->.001). The variable most associated with attendance at follow-up visits was that the survey had been answered by the patient's parents (<em>odds ratio</em> 2.6, <em>P</em> <!-->&lt;<!--> <!-->.001).</div></div><div><h3>Conclusions</h3><div>In Spain, there is a lack of follow-up protocols for paediatric CD patients integrating hospitals and primary care, as well as protocols for the transition to adult professionals. The participation of dietitians is very low. Adult patients adhere less to follow-up visits.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 8","pages":"Article 502371"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemostasis management optimization in patients with advanced chronic liver disease","authors":"Alejandro Fernández Soro ,&nbsp;Carlos Alventosa-Mateu ,&nbsp;David Martí-Aguado ,&nbsp;Inmaculada Castelló Miralles ,&nbsp;Mercedes Latorre Sánchez ,&nbsp;Juan José Urquijo Ponce","doi":"10.1016/j.gastre.2025.502453","DOIUrl":"10.1016/j.gastre.2025.502453","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 8","pages":"Article 502453"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of biologic therapy for Crohn's disease: An overview of meta-analyses and systematic reviews","authors":"Ping Jiang ,&nbsp;Yunchen Li ,&nbsp;Jidong Tian ,&nbsp;Yuan Luo ,&nbsp;Xiangxiang Hu ,&nbsp;Xinhui Qiu ,&nbsp;Chen Guo ,&nbsp;Cuicui Fu","doi":"10.1016/j.gastre.2025.502432","DOIUrl":"10.1016/j.gastre.2025.502432","url":null,"abstract":"<div><h3>Objective</h3><div>To present an overview to summarize the efficacy and safety of biologics for the treatment of Crohn's disease (CD).</div></div><div><h3>Methods</h3><div>We gathered systematic reviews or meta-analyses on the efficacy and safety of biologic therapy for CD from the beginning to September 30, 2023, by searching the databases of the Chinese National Knowledge Infrastructure (CNKI), WanFang Data, China Science and Technology Journal Database, Web of Science, the Cochrane Library, PubMed, and Embase. Analysing reviews and extracting data, two researchers worked independently. Any discrepancies in the two researchers’ assessments of the review process were reevaluated, and the argument was settled by consulting to other researchers. The following details was taken out of the data: author, publication year, study type, number of included studies, country of study, sample size, risk bias tools, biologic therapy, and primary outcomes. Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) and the AMSTAR-2, a critical appraisal tool for systematic reviews (2nd edition), were then utilized to assess the methodological quality and reporting quality of the evidence.</div></div><div><h3>Results</h3><div>There were 19 reviews in all. One systematic review, 5 meta-analyses, and 13 systematic reviews and meta-analyses were among the reviews that were included. Nine studies met the high quality, 5 met the moderate quality, 3 met the poor quality, and 2 met the critically low quality requirements of the AMSTAR-2 criteria.</div></div><div><h3>Conclusions</h3><div>The analysis of the evidence finds biologic agents for CD are effective and safe. Overall, there was moderate to high quality biologic evidence for CD, but future head-to-head controlled studies are required to better inform the relative positioning of these drugs for the management of CD.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 8","pages":"Article 502432"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}