Gastroenterología y Hepatología (English Edition)最新文献

{"title":"MELD-Lactate as a predictor of in-hospital mortality in patients with variceal gastrointestinal bleeding","authors":"Sofía Rodríguez-Jacobo,&nbsp;Raúl A. Jiménez-Castillo,&nbsp;Carlos A. Cortez-Hernández,&nbsp;Joel O. Jaquez-Quintana,&nbsp;José A. González-González,&nbsp;Héctor J. Maldonado-Garza","doi":"10.1016/j.gastre.2025.502369","DOIUrl":"10.1016/j.gastre.2025.502369","url":null,"abstract":"<div><h3>Introduction</h3><div>Variceal upper gastrointestinal bleeding is a common cause of decompensation in patients with liver cirrhosis. While mortality data, which are from 10 to 15%, are available, there are no validated scales to predict in-hospital mortality in this patient population.</div></div><div><h3>Objective</h3><div>To determine whether the MELD-Lactate (MELD-LA) level is associated with in-hospital mortality in patients with chronic liver disease who are admitted for variceal bleeding.</div></div><div><h3>Material and methods</h3><div>A prospective, observational, and analytical study was conducted that included 120 patients. The MELD-LA cut-off point was obtained, and in-hospital mortality was obtained using conventional prognostic scales that had the highest sensitivity and specificity for comparison purposes. Additionally, a survival analysis was performed using the MELD-LA cut-off point obtained.</div></div><div><h3>Results</h3><div>In our cohort, 6 (5.0%) patients died during hospitalization. Patients who died had a mean MELD-LA value of 20.0 (±4.97) as opposed to those who did not die, 13.62 (±3.29), (<em>p</em> <!-->&lt;<!--> <!-->0.001). The MELD-LA cut-off point of &gt;14.0, with a sensitivity of 100%, a specificity of 71.0%, a positive predictive value of 15.4%, a negative predictive value of 100.0%, and an AUC (area under the curve) of 0.886, was most well correlated with higher in-hospital mortality. Survival was 71.1% in patients with MELD-LA levels<!--> <!-->&gt;<!--> <!-->14.0 versus 100.0% in those with lower levels (<em>p</em> <!-->=<!--> <!-->0.001) during hospitalization.</div></div><div><h3>Conclusion</h3><div>The measurement of MELD-LA at admission seems to be a good complementary marker for the evaluation and prognosis of in-hospital mortality in patients with liver cirrhosis, and variceal upper gastrointestinal bleeding.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 8","pages":"Article 502369"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271111","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 silicosis as a rare cause of granulomatous liver disease","authors":"María Del Barrio ,&nbsp;Maria Luisa Cagigal ,&nbsp;Álvaro Díaz-González","doi":"10.1016/j.gastre.2025.502368","DOIUrl":"10.1016/j.gastre.2025.502368","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 8","pages":"Article 502368"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271094","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":"Exploring the utility of cellular indices in the diagnosis of ulcerative colitis","authors":"Julio César Moreno Alfonso ,&nbsp;Sharom Barbosa-Velásquez ,&nbsp;Carlos Delgado-Miguel ,&nbsp;Ada Molina Caballero ,&nbsp;Sara Hernández-Martín ,&nbsp;Alberto Pérez Martínez ,&nbsp;María Concepción Yárnoz Irazábal","doi":"10.1016/j.gastre.2025.502349","DOIUrl":"10.1016/j.gastre.2025.502349","url":null,"abstract":"<div><h3>Aim</h3><div>To describe the usefulness of cellular indices in the diagnosis of ulcerative colitis (UC).</div></div><div><h3>Methods</h3><div>Diagnostic study of patients under 15 years of age undergoing colonoscopy<!--> <!-->±<!--> <!-->esophagogastroduodenoscopy for suspected inflammatory bowel disease between 2015 and 2022 in a pediatric hospital. Patients with normal biopsy and anatomopathological diagnosis of UC were included. Using the area under the ROC curve, the values of platelet–lymphocyte ratio (PLR), neutrophil–lymphocyte ratio (NLR) and monocyte–lymphocyte ratio (MLR), calculated by dividing the number of platelets, neutrophils, and monocytes by the number of lymphocytes, respectively, were compared to establish the sensitivity, specificity, predictive values and odds ratio of each parameter in the diagnosis of UC.</div></div><div><h3>Results</h3><div>Twenty-six patients were included: 14 with normal biopsy and 12 with UC. PLR and MLR values were significantly higher in patients with UC (<em>p</em> <!-->&lt;<!--> <!-->0.05). The sensitivity, specificity, and negative predictive value of PLR, NLR and MLR for diagnosing UC were 58%, 83% and 91%; 85%, 35% and 50%; 70%, 71% and 87%, respectively. The biomarker with the highest diagnostic performance was MLR with a cutoff point of 0.235, area under the curve of 0.735 and odds ratio of 11 (95% CI 1.1–109.6; <em>p</em> <!-->=<!--> <!-->0.041).</div></div><div><h3>Conclusions</h3><div>MLR has a high sensitivity, negative predictive value, and odds ratio in the pre-endoscopic diagnosis of ulcerative colitis. These findings, although exploratory, suggest that MLR could be useful in clinical practice in the initial diagnostic workup of UC, and perhaps in the future in the prioritization of endoscopic studies according to MLR values.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 8","pages":"Article 502349"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271420","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":"Cytomegalovirus infection as an infrequent cause of pouchitis","authors":"Marta Carreras i Hoyos ,&nbsp;Alba Correa Bonito ,&nbsp;Javier García Septiem ,&nbsp;Silvia Eugenia Barreta Vargas ,&nbsp;Francisco Viamontes Ugalde ,&nbsp;Fernando Gijón Moya ,&nbsp;Marta del Carmen Álvarez Hernández ,&nbsp;Elena Martín Pérez","doi":"10.1016/j.gastre.2025.502449","DOIUrl":"10.1016/j.gastre.2025.502449","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 7","pages":"Article 502449"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828116","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":"Hyperinfestation by Strongyloides stercolaris in an immunodepressed patient due to inflammatory bowel disease","authors":"Marta Fernández Carrasco,&nbsp;Ana Plaza Fernández,&nbsp;Olga Sánchez García","doi":"10.1016/j.gastre.2025.502317","DOIUrl":"10.1016/j.gastre.2025.502317","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 7","pages":"Article 502317"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828118","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":"Uncommon etiologies of mesenteric ischemia: Beyond atherosclerosis","authors":"Ana Lancho Muñoz ,&nbsp;José María López Tobaruela ,&nbsp;Estefanía Domínguez Banegas ,&nbsp;Eduardo Redondo Cerezo","doi":"10.1016/j.gastre.2025.502402","DOIUrl":"10.1016/j.gastre.2025.502402","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 7","pages":"Article 502402"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828117","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":"Splanchnic vein thrombosis in acute pancreatitis: Answering key questions","authors":"Daniel Oyon ,&nbsp;Federico Bolado","doi":"10.1016/j.gastre.2025.502454","DOIUrl":"10.1016/j.gastre.2025.502454","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 7","pages":"Article 502454"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828120","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":"Nationwide trends in colectomy rates for ulcerative colitis in Brazil: An analysis of the unified public healthcare system","authors":"Mariane Christina Savio ,&nbsp;Julia Ceconello Coelho ,&nbsp;Emilia Oliveira ,&nbsp;Daniela Oliveira Magro ,&nbsp;Douglas Andreas Valverde ,&nbsp;Abel Botelho Quaresma ,&nbsp;Rafaela de Araujo Molteni ,&nbsp;Maria Paz Gimenez Villamil ,&nbsp;Paulo Gustavo Kotze","doi":"10.1016/j.gastre.2025.502434","DOIUrl":"10.1016/j.gastre.2025.502434","url":null,"abstract":"<div><h3>Introduction</h3><div>Ulcerative colitis (UC) is a chronic inflammatory bowel disease with significant global prevalence. Despite advancements in medical management, including the widespread use of biologic agents and small molecules, approximately 15–20% of patients eventually require surgery. This study aimed to analyze colectomy and hospitalization rates for UC in Brazil from 2012 to 2022 and assess their temporal trends.</div></div><div><h3>Methods</h3><div>This was a retrospective, observational, population-based study using public database records from January 1, 2012, to December 31, 2022. The study included all patients with one or more diagnostic codes associated with UC (ICD-10) who underwent a UC-related surgical procedure during the study period.</div></div><div><h3>Results</h3><div>A total of 178,552 unique UC patients were identified. UC prevalence increased significantly, from 17.31 per 100,000 in 2012 to 84.23 per 100,000 in 2022, with an annual average percentage change (AAPC) of 15% (95% CI 14.97–15.11, <em>p</em> <!-->&lt;<!--> <!-->0.001). The Southeastern and Southern regions accounted for the highest number of cases. Among the 1374 surgical procedures identified, 69.4% were total colectomies, and 10.6% were pouch procedures. By the end of 2022, the proportion of surgeries relative to the total number of UC patients was 0.7%, with a declining trend (AAPC −11.8%; 95% CI −13.38 to −10.33, <em>p</em> <!-->&lt;<!--> <!-->0.001). Hospitalization rates also showed a significant decline over time (AAPC −14.3%; 95% CI −14.75 to −14.03, <em>p</em> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusions</h3><div>UC prevalence in Brazil has increased substantially over the past decade. However, colectomy rates remain low and have shown a declining trend over the same period. Additionally, there has been a notable reduction in hospitalization rates, reflecting potential improvements in UC management and disease control.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 7","pages":"Article 502434"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830275","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":"Evaluation of remission in ulcerative colitis: Relationship between clinical, endoscopic, and histological markers as predictors of relapse","authors":"Francisca Carvajal ,&nbsp;Karin Herrera ,&nbsp;Paulina Núñez ,&nbsp;Lilian Flores ,&nbsp;Andrea Córdova ,&nbsp;Gonzalo Pizarro ,&nbsp;Pamela San Martín ,&nbsp;Luis Contreras ,&nbsp;Rodrigo Quera","doi":"10.1016/j.gastre.2025.502437","DOIUrl":"10.1016/j.gastre.2025.502437","url":null,"abstract":"<div><h3>Introduction</h3><div><span>In ulcerative colitis (UC), STRIDE-II consensus has established the long-term goal of achieving endoscopic remission (ER), which helps reduce inflammatory burden, prevent permanent </span>intestinal damage<span><span>, and improve patient’s quality of life. However, achieving histological remission (HR) is also associated with a lower risk of experiencing outbreaks of inflammatory activity, the need for corticosteroids, hospitalizations, and the development of </span>colorectal cancer.</span></div></div><div><h3>Objective</h3><div>Evaluate the role of ER and HR in the development of inflammatory activity flares in patients who have achieved these long-term goals and are being followed in the Inflammatory Bowel Disease (IBD) Program.</div></div><div><h3>Materials and methods</h3><div><span>A retrospective study was conducted on patients with UC treated in the IBD Program at the Universidad de los Andes, between January 2021 and April 2023. Patients with ER (Mayo Endoscopic Index [MEI] 0) or endoscopic response (MEI 1), with at least one year of follow-up, were included. HR was defined using the Nancy (&lt;2), Geboes (&lt;2), and Robarts (&lt;3) indices. Inflammatory activity was assessed by a Partial Mayo Index (PMI) ≥2 and fecal calprotectin &gt;250</span> <!-->μg/g.</div></div><div><h3>Results</h3><div>A total of 84 patients were included, 57.1% were women, with a median age of 37 years (IQR 31–45). During follow-up, 71 patients continued in the study, and 24 (31%) experienced inflammatory flares. In the MEI 0 group, the percentage of flares at 12 and 44 months was 15% and 53%, respectively, compared to 43% and 67% in the MEI 1 group (<em>p</em> <!-->=<!--> <span>0.0302). PMI and fecal calprotectin levels were significantly lower in MEI 0 than in MEI 1 (</span><em>p</em> <!-->&lt;<!--> <!-->0.001 and <em>p</em> <!-->&lt;<!--> <span>0.05, respectively). Although the Nancy, Geboes, and Robarts indices showed significant differences between MEI 0 and MEI 1, none were associated with a lower risk of flares in the MEI 0 group. No cases of colorectal neoplasia or need for surgery were reported during follow-up.</span></div></div><div><h3>Conclusion</h3><div>In this cohort, ER is a significant predictor of the development of inflammatory flares in patients with UC, while HR did not show a clear impact in this regard. Further studies are needed to clarify the role of HR as a therapeutic target in UC.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 7","pages":"Article 502437"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828146","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 and microbiological profile in obstructive biliary disease in a tertiary center: Observational study","authors":"Marusia González-Villarreal ,&nbsp;Joel Omar Jáquez-Quintana ,&nbsp;Paola Bocanegra-Ibarias ,&nbsp;Juan Manuel Millán-Alanís ,&nbsp;Ariadnee Irma Reyna-Aréchiga ,&nbsp;Víctor Andrés Cab-Morales ,&nbsp;Valeria Hernández-Rodarte ,&nbsp;Adrián Camacho-Ortiz ,&nbsp;Héctor Jesús Maldonado-Garza","doi":"10.1016/j.gastre.2025.502431","DOIUrl":"10.1016/j.gastre.2025.502431","url":null,"abstract":"<div><h3>Aims</h3><div>There is limited information on bacterial isolation, antibiotic susceptibility, and microbiological profile in obstructive biliary disease (OBD). Providing information on this could help offer more effective empirical antibiotic therapy in clinical cholangitis. This study aims to evaluate the clinical and microbiological profile in obstructive biliary disease.</div></div><div><h3>Patients and methods</h3><div>The study was conducted at a tertiary academic center between August 2021 and January 2023. Hospitalized patients with OBD, with indication for biliary drainage by endoscopic retrograde cholangiopancreatography, were recruited. Biliary samples were obtained following a standardized protocol, and were processed in laboratory for Gram staining, culture, subculture. Microorganisms were identified and subjected to antibiotic susceptibility testing.</div></div><div><h3>Results</h3><div>A total of 61 patients were included, 73.8% were women, average age was 44.8 years. Overweight/obesity was the most common comorbidity (62.3%); clinical cholangitis was present in 75.4%. Biliary lithiasis was the most common etiology of OBD (86.9%). Positive cultures were obtained in 44.3% of participants, predominating the group of Gram-positive bacteria; individually, <em>Escherichia coli</em> was the most isolated microorganism. A 68.2% of bacteria showed resistance to at least one antibiotic. We found significant associations between bile appearance and cholangitis, bile appearance and OBD etiology, OBD etiology and cholangitis severity. Male sex, increased age, tobacco use were associated with positive cultures. We found a spectrum of microorganisms and antibiotic susceptibilities partially different from those of Tokyo Guidelines 2018 and other publications.</div></div><div><h3>Conclusions</h3><div>Our findings highlight the need to characterize microbiological profile in OBD according to each region.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 7","pages":"Article 502431"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830274","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}