Gastroenterología y Hepatología (English Edition)最新文献

{"title":"Combination of granulocyte–monocyte apheresis and tofacitinib: Multicentre and retrospective study","authors":"Iago Rodríguez-Lago ,&nbsp;Fiorella Cañete ,&nbsp;Elena Guerra-del-Río ,&nbsp;Claudia Herrera-deGuise ,&nbsp;Eva Iglesias ,&nbsp;Eduardo Leo ,&nbsp;Yamile Zabana ,&nbsp;Manuel Barreiro-de Acosta ,&nbsp;Daniel Ginard ,&nbsp;José Luis Cabriada","doi":"10.1016/j.gastre.2024.04.052","DOIUrl":"10.1016/j.gastre.2024.04.052","url":null,"abstract":"<div><h3>Objective</h3><p>Granulocyte–monocyte apheresis (GMA) has shown to be safe and effective in treating ulcerative colitis (UC), also in combination with biologics. The objective of this study is to evaluate the efficacy and safety of combining GMA after primary non-response (PNR) or loss of response (LOR) to tofacitinib (TOFA) in patients with UC.</p></div><div><h3>Patients and methods</h3><p>Retrospective study including all patients with refractory UC who received GMA plus TOFA. Efficacy was assessed 1 and 6 months after finishing GMA by partial Mayo score, C-reactive protein (CRP) and fecal calprotectin (FC). Descriptive statistics and non-parametric tests were used in the statistical analysis.</p></div><div><h3>Results</h3><p>Twelve patients were included (median 46 years [IQR, 37–58]; 67% female; 67% E3). Patients were mostly receiving TOFA 10<!--> <!-->mg bid (75%), and 33% also concomitant steroids at baseline. Median partial Mayo score at baseline was 7 (IQR, 5–7), and it decreased to a median of 2 (IQR, 0–3) and 0 (IQR, 0–3) after 1 and 6 months (<em>p</em> <!-->=<!--> <!-->0.027 and 0.020, respectively), while no differences were found in CRP and FC. Clinical remission was achieved by 6 patients both at 1 (50%) and 6 months (67%). CF values<!--> <!-->&lt;<!--> <!-->250<!--> <!-->mg/kg were achieved by 2 and 4 patients at 1 and 6 months (data available in 5 and 7 patients, respectively). No patient required dose-escalation of TOFA, and one patient was able to de-escalate the drug. No patient required colectomy and all patients under steroids were able to stop them.</p></div><div><h3>Conclusion</h3><p>The combination of GMA and TOFA can be effective in selected cases of UC after PNR or LOR to this drug.</p></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 7","pages":"Pages 727-733"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S244438242400124X/pdfft?md5=1a3f92ed15f069ba63ec64514e787b2c&pid=1-s2.0-S244438242400124X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141979355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"De-escalating therapy in inflammatory bowel disease: Results from an observational study in clinical practice","authors":"Alex Arenas ,&nbsp;María José Moreta ,&nbsp;Ingrid Ordás ,&nbsp;Agnès Fernández-Clotet ,&nbsp;Berta Caballol ,&nbsp;Marta Gallego ,&nbsp;Alejandro Vara ,&nbsp;Rebeca Barastegui ,&nbsp;Angel Giner ,&nbsp;Cristina Prieto ,&nbsp;Maria Carme Masamunt ,&nbsp;Roberto Candia ,&nbsp;Elena Ricart","doi":"10.1016/j.gastre.2024.04.030","DOIUrl":"10.1016/j.gastre.2024.04.030","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Combination therapy with an immunomodulator (IMM) and an anti-TNF is commonly recommended in Crohn's disease (CD) and ulcerative colitis (UC) patients. However, little is known about relapse rates after therapeutic de-escalation. This study aimed to evaluate the risk of relapse in a cohort of UC and CD patients with long-standing clinical remission after discontinuation of IMM or anti-TNF and to identify predictive factors for relapse.</p></div><div><h3>Methods</h3><p>This retrospective study included patients with UC or CD on combination therapy and clinical remission for at least 6 months. IMM or anti-TNF was stopped upon physician decision. Primary objective was to evaluate the relapse rates after discontinuation of IMM or anti-TNF and to analyze predictors of relapse.</p></div><div><h3>Results</h3><p>The study included 88 patients, 48 patients (54.5%) discontinued IMM and 40 (45.5%) anti-TNF. During follow-up, relapse rates were 16.7% and 52.5% in the IMM discontinuation group and anti-TNF discontinuation group, respectively (<em>p</em> <!-->&lt;<!--> <!-->0.001). Multivariate analysis showed that anti-TNF discontinuation (HR<!--> <!-->=<!--> <!-->3.01; 95% CI<!--> <!-->=<!--> <!-->1.22–7.43) and ileal CD location (HR<!--> <!-->=<!--> <!-->2.36; 95% CI<!--> <!-->=<!--> <!-->1.02–5.47) were predictive factors for relapse while inflammatory CD phenotype was a protective factor (HR<!--> <!-->=<!--> <!-->0.32; 95% CI<!--> <!-->=<!--> <!-->0.11–0.90). Reintroduction of anti-TNF upon relapse was effective and safe.</p></div><div><h3>Conclusion</h3><p>Anti-TNF discontinuation led to significantly higher relapse rates compared to IMM discontinuation in UC and CD patients on combination therapy. Anti-TNF discontinuation and ileal CD location were identified as predictive factors for relapse while inflammatory CD phenotype was a protective factor. Retreatment after anti-TNF discontinuation was effective and safe.</p></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 7","pages":"Pages 673-682"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141979350","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":"Spontaneously ruptured hepatocellular carcinoma on non-cirrhotic liver: A prospective case series","authors":"Marta Romero-Gutiérrez ,&nbsp;Sonia Pascual ,&nbsp;Laura Márquez ,&nbsp;Mariano Gómez-Rubio ,&nbsp;Mireia Miquel ,&nbsp;Cristina Alarcón ,&nbsp;Teresa Ferrer ,&nbsp;Carles Aracil ,&nbsp;Diana Horta ,&nbsp;Raquel Latorre ,&nbsp;Jesús González Santiago ,&nbsp;Vanesa Bernal ,&nbsp;Cristina Fernández ,&nbsp;Belén Piqueras ,&nbsp;María Luisa Gutiérrez ,&nbsp;Ana Martín ,&nbsp;Julia Morillas ,&nbsp;Dalia Morales ,&nbsp;Sonia Blanco ,&nbsp;Paloma Rendón ,&nbsp;Rafael Gómez Rodríguez","doi":"10.1016/j.gastre.2024.04.032","DOIUrl":"10.1016/j.gastre.2024.04.032","url":null,"abstract":"<div><h3>Background and aims</h3><p>Spontaneous ruptured hepatocellular carcinoma is an uncommon complication, and there are scarce data about non-cirrhotic patients. Tumor treatment is not standardized and the risk of peritoneal dissemination is unclear. <em>Aim</em>: we analyzed the treatment and survival in patients with rHCC on non-cirrhotic liver.</p></div><div><h3>Methods</h3><p>One hundred and forty-one non-cirrhotic patients with hepatocellular carcinoma diagnosed by histology were included in a multicenter prospective registry (2018–2022). Seven of them (5%) presented with hemoperitoneum due to spontaneous rupture.</p></div><div><h3>Results</h3><p>Liver disease was associated in three patients (42.9%). A single nodule was detected in three cases (42.9%). One patient had vascular invasion and none extrahepatic spread.</p><p>Initial hemostatic therapy and sequential treatment was individualized. Patients with single nodule were treated: resection (one case) with recurrence at 4 months treated with TACE and sorafenib. TACE/TAE followed by surgery (two cases) one in remission 43 months later, the other had liver recurrence at 18 months and was transplanted. Patients with multiple lesions were treated: TAE/emergency surgery and subsequent systemic therapy (two cases), one received lenvatinib (1-year survival) and the other sorafenib (5-month survival). TAE and surgery with subsequent systemic therapy (one case). Initial hemostatic surgery, dying on admission (one case).</p><p>No patient developed intraperitoneal metastasis. All patients with multiple lesions died by tumor. The 3-year survival rate was 42.9%.</p></div><div><h3>Conclusions</h3><p>Initial hemostasis was achieved in all patients by TAE/TACE or surgery. Subsequent treatment was individualized, based on tumor characteristics, regardless of rupture. Long-time remission could be achieved in single nodule patients.</p></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 7","pages":"Pages 683-690"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141979351","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":"Diagnostic accuracy of the Oakland score versus haemoglobin for predicting outcomes in lower gastrointestinal bleeding","authors":"Pilar Garcia-Iglesias ,&nbsp;Salvador Machlab ,&nbsp;Eva Martinez-Bauer ,&nbsp;Alba Lira ,&nbsp;Rafel Campo ,&nbsp;Susana Marín ,&nbsp;Maria Raurich-Seguí ,&nbsp;Xavier Calvet ,&nbsp;Enric Brullet","doi":"10.1016/j.gastre.2024.04.054","DOIUrl":"10.1016/j.gastre.2024.04.054","url":null,"abstract":"<div><h3>Background</h3><p>Acute lower gastrointestinal bleeding (ALGIB) is a common cause of hospitalization. Recent guidelines recommend the use of prognostic scales for risk stratification. However, it remains unclear whether risk scores are more accurate than some simpler prognostic variables.</p></div><div><h3>Objective</h3><p>To compare the predictive values of haemoglobin alone and the Oakland score for predicting outcomes in ALGIB patients.</p></div><div><h3>Design</h3><p>Single-centre, retrospective study at a University Hospital. Data were extracted from the hospital's clinical records. The Oakland score was calculated at admission. Study outcomes were defined according to the original article describing the Oakland score: safe discharge (the primary Oakland score outcome), transfusion, rebleeding, readmission, therapeutic intervention and death. Area under the receiver operating characteristics (AUROC) curve and accuracy using haemoglobin and the Oakland score were calculated for each outcome.</p></div><div><h3>Results</h3><p>Two hundred and fifty-eight patients were included. Eighty-four (32.6%) needed transfusion, 50 (19.4%) presented rebleeding, 31 (12.1%) required therapeutic intervention, 20 (7.8%) were readmitted and six (2.3%) died. There were no differences in the AUROC curve values for haemoglobin versus the Oakland score with regard to safe discharge (0.82 (0.77–0.88) vs 0.80 (0.74–0.86), respectively) or to therapeutic intervention and death. Haemoglobin was significantly better for predicting transfusion and rebleeding, and the Oakland score was significantly better for predicting readmission.</p></div><div><h3>Conclusion</h3><p>In our study, the Oakland score did not perform better than haemoglobin alone for predicting the outcome of patients with ALGIB. The usefulness of risk scores for predicting outcomes in clinical practice remains uncertain.</p></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 7","pages":"Pages 742-749"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141979468","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":"Clinical outcomes and manometry results of peroral endoscopic myotomy in patients with achalasia: experience in a Latin American referral centre","authors":"Angélica Tobón ,&nbsp;Gustavo Rafael Cantillo Nassar ,&nbsp;Albis Cecilia Hani ,&nbsp;Nancy Muriel Herrera Leaño ,&nbsp;Cristiam Pulgarin ,&nbsp;Oscar Mauricio Muñoz","doi":"10.1016/j.gastre.2024.04.053","DOIUrl":"10.1016/j.gastre.2024.04.053","url":null,"abstract":"<div><h3>Introduction</h3><p>Currently there is little information in Latin America on the clinical outcome and manometric evolution of patients with Achalasia<span> undergoing peroral endoscopic myotomy (POEM).</span></p></div><div><h3>Primary outcome</h3><p>Evaluate the manometric and clinical changes in adult patients with achalasia after peroral endoscopic myotomy at a referral center in Bogotá, Colombia.</p></div><div><h3>Methods</h3><p>Observational, analytical, longitudinal study. Adult patients with achalasia according to the Chicago 4.0 criteria were included. Sociodemographic, clinical and manometric variables were described. To compare the pre- and post-surgical variables, the Student’s or Wilcoxon’s t test was used for the quantitative variables according to their normality, and McNemar’s chi-square for the qualitative variables.</p></div><div><h3>Results</h3><p>29 patients were included, 55.17% (n = 16) women, with a mean age at the time of surgery of 48.2 years (±11.33). The mean post-procedure evaluation time was 1.88 ± 0.81 years. After the procedure, there was a significant decrease in the proportion of patients with weight loss (37.93% vs 21.43% p = 0.0063), chest pain<span> (48.28% vs 21.43, p = 0.0225) and the median Eckardt score (8 (IQR 8–9) vs 2 (IQR 1–2), p &lt; 0.0001). In addition, in fourteen patients with post-surgical manometry, significant differences were found between IRP values (23.05 ± 14.83 mmHg vs 7.69 ± 6.06 mmHg, p = 0.026) and in the mean lower esophageal sphincter tone (9.63 ± 7.2 mmHg vs 28.8 ± 18.60 mmHg, p = 0.0238).</span></p></div><div><h3>Conclusion</h3><p>Peroral endoscopic myotomy has a positive impact on the improvement of symptoms and of some manometric variables (IRP and LES tone) in patients with achalasia.</p></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 7","pages":"Pages 734-741"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141706172","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":"Perihilar cholangiocarcinoma resection: Is it beneficial for survival in elderly patients?","authors":"Min Yu ,&nbsp;Lina Lu ,&nbsp;Rongjin Wu","doi":"10.1016/j.gastre.2024.04.034","DOIUrl":"10.1016/j.gastre.2024.04.034","url":null,"abstract":"<div><h3>Introduction</h3><p>As the population ages, surgeons are growing frequently faced with hard choices among a vast array of treatment options for the elderly. This study was to investigate safety and efficacy of resection in elderly patients with perihilar cholangiocarcinoma (PHCC).</p></div><div><h3>Patients and methods</h3><p>Literature reading and meta-analysis unveiled that elderly PHCC patients held a higher risk of death within 90 days after hepatectomy relative to younger patients, but their 5-year overall survival and disease-free survival were comparable. Among PHCC patients who underwent hepatectomy, the proportion of elderly patients with tumor classification Bismuth I–II and tumor stage pStage 1–3 was significantly higher than that of younger patients.</p></div><div><h3>Results</h3><p>Curative resection R0 was more common in elderly patients than younger patients, but the difference was not statistically significant. Because of more comorbidities and less physiological reserve of elderly patients, they seemed to suffer more postoperative complications.</p></div><div><h3>Conclusion</h3><p>Considering improved life expectancy, it is crucial to treat elderly PHCC patients appropriately and attempts should be made to radical surgery based on comorbidities and functional status.</p></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 7","pages":"Pages 691-701"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141979352","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":"Selective granulocyte–monocyte apheresis during induction with vedolizumab in moderate–severe ulcerative colitis: Experience in a tertiary hospital","authors":"Cristina Suárez Ferrer ,&nbsp;Eduardo Martin-Arranz ,&nbsp;María Dolores Martín-Arranz","doi":"10.1016/j.gastre.2024.04.037","DOIUrl":"10.1016/j.gastre.2024.04.037","url":null,"abstract":"<div><h3>Aim</h3><p>Granulocyte and monocyte apheresis (GMA) is a potential therapeutic option when combined with various drugs for treatment of ulcerative colitis (UC). In this study, we analyze the efficacy and safety of GMA combined with vedolizumab (VDZ) during induction in patients with moderate–severe UC and incomplete response to steroids.</p></div><div><h3>Patients and methods</h3><p>Single-center retrospective review of patients receiving GMA<!--> <!-->+<!--> <!-->VDZ. Data on the disease and previous treatments were collected. Clinical response was classified as no response, response without remission, and remission. Available data on biochemical and endoscopic response were included. Adverse events (AEs) were recorded.</p></div><div><h3>Results</h3><p>The study population comprised 6 patients with UC who had received GMA<!--> <!-->+<!--> <!-->VDZ during induction after failure of an anti-TNF agent. The median number of GMA sessions was 5 (IQR 4–5; 3–10). All the patients received VDZ 300<!--> <!-->mg iv at 0, 2, and 6 weeks, and 5 (83%) received an additional dose at week 10. During maintenance, all the patients continued VDZ iv every 8 weeks. The median follow-up was 57.6 months (IQR: 39–74). Four of the 6 patients achieved clinical remission after GMA<!--> <!-->+<!--> <!-->VDZ and continued in deep remission until the end of follow-up. A median, non-significant decrease of 1378<!--> <!-->μg/g (IQR: 924–5778<!--> <!-->μg/g) was observed for calprotectin and 42.2<!--> <!-->mg/l (IQR: 15.3–113.5) for CRP vs. baseline. No patient underwent colectomy. No treatment-related AEs were observed.</p></div><div><h3>Conclusions</h3><p>GMA<!--> <!-->+<!--> <!-->VDZ during induction can be effective and safe in selected patients with moderate–severe UC and partial response to steroids.</p></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 7","pages":"Pages 721-726"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2444382424001093/pdfft?md5=e7f2a9643bd827232ca6bbaf5a943dbe&pid=1-s2.0-S2444382424001093-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141979354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalised therapy in inflammatory bowel disease","authors":"Paula Calderón ,&nbsp;Paulina Núñez ,&nbsp;Pilar Nos ,&nbsp;Rodrigo Quera","doi":"10.1016/j.gastre.2024.04.057","DOIUrl":"10.1016/j.gastre.2024.04.057","url":null,"abstract":"<div><p>Inflammatory bowel diseases<span> (IBD), with ulcerative colitis<span> and Crohn's disease<span> being their most common presentations, comprise a spectrum of diverse disease phenotypes, exhibiting variable behaviors ranging from an indolent course to aggressive phenotypes that impact quality of life of these patients.</span></span></span></p><p>The last two decades have been marked by the development of new medications (biological therapy and novel small molecules) with diverse mechanisms of action, which have revolutionized the management of IBD, thereby enhancing the quality of life for these patients. This landscape of multiple therapeutic options underscores the need to define which medication will benefit each patient the most and at what speed it should be started.</p><p>The objective of this review is to present personalized approaches for patients with IBD, thus contributing to therapeutic management.</p></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 7","pages":"Pages 763-770"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141703348","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":"Position statement of the Spanish Working Group on Crohn’s Disease and Ulcerative Colitis on sexuality and inflammatory bowel disease","authors":"Marta Calvo Moya ,&nbsp;Francisco Mesonero Gismero ,&nbsp;Cristina Suarez Ferrer ,&nbsp;Alejandro Hernández-Camba ,&nbsp;Danízar Vásquez Carlón ,&nbsp;Fátima García Benasach ,&nbsp;Mariam Aguas Peris ,&nbsp;Francisco José Delgado Oliva ,&nbsp;Yago González-Lama ,&nbsp;Mónica Millán Scheiding ,&nbsp;Isabel Alonso Sebastián ,&nbsp;Laura Camacho Martel ,&nbsp;Vanesa Gallardo Arriero ,&nbsp;Ana Echarri Piudo ,&nbsp;Pablo Bella Castillo ,&nbsp;Noelia Cano Sanz ,&nbsp;María Isabel Vera Mendoza ,&nbsp;Ruth Serrano Labajos ,&nbsp;Antonio Valdivia Martínez ,&nbsp;Lourdes Pérez Restoy ,&nbsp;Ana Gutiérrez Casbas","doi":"10.1016/j.gastre.2024.04.059","DOIUrl":"10.1016/j.gastre.2024.04.059","url":null,"abstract":"<div><p>It is widely acknowledged that inflammatory bowel disease (IBD) is associated with a high prevalence of sexual dysfunction (SD). However, there is a notable paucity of specific literature in this field. This lack of information impacts various aspects, including the understanding and comprehensive care of SD in the context of IBD. Furthermore, patients themselves express a lack of necessary attention in this area within the treatment of their disease, thus creating an unmet need in terms of their well-being.</p><p>The aim of this position statement by the Spanish Working Group on Crohn’s Disease and Ulcerative Colitis (GETECCU) is to provide a review on the most relevant aspects and potential areas of improvement in the detection, assessment, and management of SD in patients with IBD and to integrate the approach to sexual health into our clinical practice. Recommendations are established based on available scientific evidence and expert opinion. The development of these recommendations by GETECCU has been carried out through a collaborative multidisciplinary approach involving gastroenterologists, gynecologists, urologists, surgeons, nurses, psychologists, sexologists, and, of course, patients with IBD.</p></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 7","pages":"Pages 774-792"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2444382424001317/pdfft?md5=c46a8c1d087106369d8e1cad20b818e3&pid=1-s2.0-S2444382424001317-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141702962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between histopathological findings, clinical severity and the need for surgery in patients with Crohn's disease","authors":"Laura Andrea Peña Mejía ,&nbsp;Geraldine Victoria Ruiz Niño ,&nbsp;Ariel Antonio Arteta Cueto","doi":"10.1016/j.gastre.2024.04.035","DOIUrl":"10.1016/j.gastre.2024.04.035","url":null,"abstract":"<div><h3>Introduction</h3><p>Defining histological variables that make it possible to establish the activity of Crohn’s disease (CD) and predict the patients who may present a higher risk of clinical complications and surgical interventions could lead to timely adjustments in medical therapy and elective surgeries that represent a lower risk of complications. The purpose of the study is to determine the relation between the histopathological findings using the Naini and Cortina score, the clinical severity, and the indication for surgery in a group of patients with CD.</p></div><div><h3>Materials and methods</h3><p>Descriptive, retrospective, cross-sectional study of 44 patients diagnosed with CD, treated at the San Vicente Fundación University Hospital in Medellín between 2010 and 2022.</p></div><div><h3>Results</h3><p>Of the 44 patients, 36 ileum samples and 34 colon samples were obtained. Of the patients with inflammatory behavior, 87.5% did not have surgical intervention (<em>P</em> = .022), a value that remained significant in the ileum subgroup (<em>P</em> = .0058). 91.3% of the patients with ileal involvement did not develop perianal disease (<em>P</em><span> = .01). Granulomas only occurred in 2 patients with a colon sample (5.8%). In the histological score of N&amp;C both in the ileum and in the colon, no statistically significant differences were obtained in relation to the surgical outcome (</span><em>P</em> = .34 and .054), respectively.</p></div><div><h3>Conclusion</h3><p>The histological index of N&amp;C was not a predictor in Crohn’s disease (CD) related to the surgical outcome.</p></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 7","pages":"Pages 702-710"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141693953","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}