Gastroenterología y Hepatología (English Edition)最新文献

{"title":"Secondary uncovered versus fully-covered metal stents for the management of occluded stent in unresectable distal malignant biliary obstruction","authors":"Javier Tejedor-Tejada,&nbsp;Aranzazu Alvarez-Alvarez,&nbsp;Jose Manuel Olmos,&nbsp;Ana Cristina González-Bernal,&nbsp;Andrea Jimenez-Jurado,&nbsp;Samuel Robles-Gaitero,&nbsp;Jose M. Perez-Pariente","doi":"10.1016/j.gastre.2024.502218","DOIUrl":"10.1016/j.gastre.2024.502218","url":null,"abstract":"<div><h3>Introduction</h3><div>Self-expandable metallic stents (SEMS) have been widely placed for unresectable distal malignant biliary obstruction (UDMBO). However, the dysfunction rate is 19–40% and its treatment is controversial. We aimed asses the efficacy and safety of a secondary biliary stents (uncovered (UC) versus fully-covered (FC) stent) for the management of occluded SEMS.</div></div><div><h3>Patients and methods</h3><div>Between 2015 and June 2023, 41 patients with UDMBO underwent secondary biliary stent placement as “stent-in-stent” (20 FCSEMS and 21 UCSEMS). The primary outcomes were technical and clinical success of SEMS placement. Secondary outcomes included adverse events (AEs), patency and survival. Patients were prospectively followed until death or loss of follow-up.</div></div><div><h3>Results</h3><div>Technical (100% vs 85.5%) and clinical (100% vs 95.2%) success rates were similar in FCSEMS and UCSEMS groups. The median follow-up period was 510 days (range 290–630). The median duration of stent patency of FCSEMS (220 days, IQR 137.5–442.5) was longer than UCSEMS (150 days, IQR 110–362.5) (<em>P</em> <!-->=<!--> <!-->0.395), although stent dysfunction within 6 months was not different between groups. Multivariate analysis indicated that sex (HR<!--> <!-->=<!--> <!-->0.909, 0.852–0.970), antitumor treatment (HR<!--> <!-->=<!--> <!-->0.248, 0.032–0.441), stent patency (HR<!--> <!-->=<!--> <!-->0.992, 0.986–0.998) and clinical success (HR<!--> <!-->=<!--> <!-->0.133, 0.026–0.690) were significant factors for overall survival. There were no remarkable differences in AEs.</div></div><div><h3>Conclusions</h3><div>The placement of additional biliary stent using the stent-in-stent method is an effective and safe rescue treatment for patients with UDMBO and occluded stent. In addition, the use of FCSEMS compared UCSEMS has unclear benefits regarding stent patency and overall survival.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 9","pages":"Article 502218"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662536","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":"Small Intestinal Bacterial Overgrowth (SIBO), a clinically overdiagnosed entity?","authors":"Jeannine Suárez Terán ,&nbsp;Francisco Guarner Aguilar","doi":"10.1016/j.gastre.2024.502190","DOIUrl":"10.1016/j.gastre.2024.502190","url":null,"abstract":"<div><div>Small intestinal bacterial overgrowth (SIBO) is a clinical entity recognised since ancient times; it represents the consequences of bacterial overgrowth in the small intestine associated with malabsorption. Recently, SIBO as a term has been popularized due to its high prevalence reported in various pathologies since the moment it is indirectly diagnosed with exhaled air tests.</div><div>In the present article, the results of duodenal/jejunal aspirate culture testing as a reference diagnostic method, as well as the characteristics of the small intestinal microbiota described by culture-dependent and culture-independent techniques in SIBO, and their comparison with exhaled air testing are presented to argue about its overdiagnosis.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 9","pages":"Article 502190"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662532","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":"Azathioprine: a rare cause of sialadenitis. Two cases report","authors":"Ana Hurtado-Soriano,&nbsp;Ana Tirado,&nbsp;Francisco Javier Puchol-Rodrigo,&nbsp;José Cameo,&nbsp;Lucía Madero,&nbsp;Ana Gutiérrez","doi":"10.1016/j.gastre.2024.502212","DOIUrl":"10.1016/j.gastre.2024.502212","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 10","pages":"Article 502212"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142720353","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":"Perception of the impact of intravenous biological treatment on the work and professional environment in patients with inflammatory bowel disease","authors":"Carlos González-Muñoza ,&nbsp;Cristina Gely ,&nbsp;Jordi Gordillo ,&nbsp;Margalida Calafat ,&nbsp;Federico Bertoletti ,&nbsp;Fiorella Cañete ,&nbsp;Míriam Mañosa ,&nbsp;Alberto López-Faba ,&nbsp;Paola Torres ,&nbsp;Eugeni Domènech ,&nbsp;Esther Garcia-Planella","doi":"10.1016/j.gastre.2024.502193","DOIUrl":"10.1016/j.gastre.2024.502193","url":null,"abstract":"<div><h3>Introduction</h3><div>In the treatment of inflammatory bowel disease (IBD), we have biologic therapies administered intravenously and subcutaneously. Recently, some drugs can be administered by either of these routes. The real impact that intravenous administration has on the perception of the disease and the personal and work life of the patient is unknown.</div></div><div><h3>Methods</h3><div>All IBD patients receiving intravenous infliximab treatment for at least 6 months were anonymously invited to participate. They were provided with a specific structured questionnaire with visual analogue scales (0–10) at two reference centers in the Barcelona area.</div></div><div><h3>Results</h3><div>A total of 90 patients with a median age of 45 years (36–56) and a median infliximab treatment duration of 48 months (24−84) were included. The visit and therapy with infliximab in the day hospital were globally well evaluated (9, IQR 7–10). 78% of patients combined day hospital stays with other activities (26% employment). The personal impact was generally low (4, IQR 0–5.8), but the patient’s job was threatened in 43% of patients on intensified treatment.</div></div><div><h3>Conclusions</h3><div>The intravenous administration of biologic drugs on an outpatient basis is highly satisfactory among IBD patients. The impact on the work sphere appears to be more pronounced than on the personal sphere, an aspect that should be considered in shared decision-making with the patient.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 10","pages":"Article 502193"},"PeriodicalIF":0.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142720356","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":"Changes in the intensified regimen of infliximab in patients with inflammatory bowel disease in sustained remission: Reflections on a series of cases","authors":"Laura Gutiérrez-Rios ,&nbsp;Eva Vayreda ,&nbsp;Margalida Calafat ,&nbsp;Fiorella Cañete ,&nbsp;Eugeni Domènech ,&nbsp;Míriam Mañosa","doi":"10.1016/j.gastre.2024.04.045","DOIUrl":"10.1016/j.gastre.2024.04.045","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 8","pages":"Pages 867-868"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419716","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 HLA-DQA1*05 on the loss of response to anti-TNF treatment in inflammatory bowel disease. Spanish cohort of real clinical practice","authors":"Jorge Pérez Pérez ,&nbsp;Jaime Escobar Ortiz ,&nbsp;Ana Isabel Franco Moreno ,&nbsp;María del Rocío Plaza Santos ,&nbsp;Marta Castillo Pradillo ,&nbsp;Ángel Ponferrada Díaz","doi":"10.1016/j.gastre.2024.04.046","DOIUrl":"10.1016/j.gastre.2024.04.046","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 8","pages":"Pages 869-871"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419722","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":"A booster dose of SARS-COV-2 vaccine improves suboptimal seroconversion rates in patients with inflammatory bowel disease. Results of a prospective multicenter study of GETECCU (VACOVEII study)","authors":"Diego Casas Deza ,&nbsp;Ana Belén Julián Gomara ,&nbsp;Eva Caudevilla Biota ,&nbsp;Belén Beltrán ,&nbsp;Eugeni Domènech ,&nbsp;Ana Gutiérrez Casbas ,&nbsp;Miriam Mañosa ,&nbsp;Yamile Zabana ,&nbsp;Lourdes Roc Alfaro ,&nbsp;Emilio Valverde Romero ,&nbsp;Elena García González ,&nbsp;Beatriz Sicilia ,&nbsp;Viviana Laredo ,&nbsp;Maria José Alcalá Escriche ,&nbsp;Lucia Madero Velázquez ,&nbsp;Rocío Ferreiro-Iglesias ,&nbsp;Antonia Palmero Pérez ,&nbsp;Margalida Calafat ,&nbsp;Saioa Rubio Iturria ,&nbsp;Irene Moraleja Yudego ,&nbsp;Santiago García-López","doi":"10.1016/j.gastre.2024.04.041","DOIUrl":"10.1016/j.gastre.2024.04.041","url":null,"abstract":"<div><h3>Background</h3><div>The response to SARS-CoV-2 vaccination decreases in inflammatory bowel disease (IBD) patients, specially under anti-TNF treatment. However, data on medium-term effectiveness are limited, specially using new recommended seroconversion rate (&gt;260<!--> <!-->BAU/mL). Our aim was to evaluate the 6-month<!--> <!-->&gt;<!--> <!-->260 BAU-seroconversion rate after full vaccination and after booster-dose.</div></div><div><h3>Methods</h3><div>VACOVEII is a Spanish multicenter, prospective study promoted by GETECCU. IBD patients full vaccinated against SARS-CoV-2 and without previous COVID-19 infection, treated or not with immunosuppressants, were included. The booster dose was administered 6 months after the full vaccination. Seroconversion was set at 260<!--> <!-->BAU/mL, according to most recent recommendations and was assessed 6 months after the full vaccination and 6 months after booster-dose.</div></div><div><h3>Results</h3><div>Between October 2021 and March 2022, 313 patients were included (124 no treatment or mesalazine; 55 immunomodulators; 87 anti-TNF; 19 anti-integrin; and 28 ustekinumab). Most patients received mRNA-vaccines (86%). Six months after full vaccination, overall seroconversion rate was 44.1%, being significantly lower among patients on anti-TNF (19.5%, <em>p</em> <!-->&lt;<!--> <!-->0.001) and ustekinumab (35.7%, <em>p</em> <!-->=<!--> <!-->0.031). The seroconversion rate after booster was 92%. Again, anti-TNF patients had a significantly lower seroconversion rate (67%, <em>p</em> <!-->&lt;<!--> <!-->0.001). mRNA-vaccine improved seroconversion rate (OR 11.720 [95% CI 2.26–60.512]).</div></div><div><h3>Conclusion</h3><div>The full vaccination regimen achieves suboptimal response in IBD patients, specially among those anti-TNF or ustekinumab. The booster dose improves seroconversion rate in all patients, although it remains limited in those treated with anti-TNF. These results reinforce the need to prioritize future booster doses in patients on immunosuppressants therapy, specially under anti-TNF, and using mRNA-vaccines.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 8","pages":"Pages 821-833"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419802","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":"Biological therapy, surgery, and hospitalization rates for inflammatory bowel disease: An observational Latin American comparative study between adults and pediatric patients","authors":"Ana Carolina Veronese Silva ,&nbsp;Tainá Júlia Tumelero ,&nbsp;Danielle Reis Yamamoto ,&nbsp;Sabine Kruger Truppel ,&nbsp;Giovana Stival da Silva ,&nbsp;Luciana Bandeira Mendez Ribeiro ,&nbsp;Patricia Zacharias ,&nbsp;Marcia Olandoski ,&nbsp;Daniela Oliveira Magro ,&nbsp;Mário César Vieira ,&nbsp;Paulo Gustavo Kotze","doi":"10.1016/j.gastre.2024.04.040","DOIUrl":"10.1016/j.gastre.2024.04.040","url":null,"abstract":"<div><h3>Objective</h3><div>Compare the proportions of use of biological therapy, surgeries, and hospitalizations between adults and pediatric inflammatory bowel disease (IBD)—Crohn's disease (CD) and ulcerative colitis (UC)—patients.</div></div><div><h3>Patients and methods</h3><div>Observational, retrospective, and multicenter study. Data were collected from all consecutive IBD patients seen as outpatients or admitted to hospital, during 2015–2021, in two IBD tertiary centers in a South Brazilian capital. Patients with unclassified colitis diagnosis were excluded from this study. Patients were classified as having CD or UC and sub-categorized as adult or pediatric according to age. Data were analyzed using frequency, proportion, Fisher's exact test, and Chi-square test.</div></div><div><h3>Results</h3><div>A total of 829 patients were included: 509 with CD (378 adults/131 pediatric) and 320 with UC (225/95). Among patients with CD, no differences were observed for proportions of use of biological therapy (80.2% in pediatric vs. 73.3% in adults; <em>P</em> <!-->=<!--> <!-->0.129), surgery (46.6% vs. 50.8%; <em>P</em> <!-->=<!--> <!-->0.419), or hospitalization (64.9% vs. 56.9%; <em>P</em> <!-->=<!--> <!-->0.122). In UC, significant differences were observed for biological therapy (40.0% vs. 28.0%; <em>P</em> <!-->=<!--> <!-->0.048) and hospitalization (47.4% vs. 24.0%; <em>P</em> <!-->&lt;<!--> <!-->0.001). No significant difference was observed in surgery rates (17.9% vs. 12.4%; <em>P</em> <!-->=<!--> <!-->0.219).</div></div><div><h3>Conclusions</h3><div>Biological therapy and incidence of hospitalization were greater among pediatric patients with UC, compared with adults; no difference was observed in the need for abdominal surgery. In CD, no significant difference was observed in the three main outcomes between the age groups.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 8","pages":"Pages 813-820"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419801","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":"Malignant transformation in fistula after proctosigmoidectomy: A rare complication of long-standing Crohn's disease","authors":"Francisco Vara-Luiz ,&nbsp;Ivo Mendes ,&nbsp;Ana Elisa Teles ,&nbsp;Carla Oliveira ,&nbsp;Ana Pascoal ,&nbsp;Cláudia Afonso ,&nbsp;Marta Patita ,&nbsp;Irina Mocanu ,&nbsp;Ana Vieira ,&nbsp;Vítor Fernandes ,&nbsp;Pedro Moniz Pereira ,&nbsp;Jorge Fonseca","doi":"10.1016/j.gastre.2024.04.047","DOIUrl":"10.1016/j.gastre.2024.04.047","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 8","pages":"Pages 871-872"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419723","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":"Recommendations and quality criteria to improve the early diagnosis of primary biliary cholangitis","authors":"Álvaro Díaz-González ,&nbsp;Noelia Fontanillas ,&nbsp;Eva Gil-Hernández ,&nbsp;Mercedes Guilabert ,&nbsp;Maria-Carlota Londoño ,&nbsp;Mar Noguerol ,&nbsp;Fernando Pérez Escanilla ,&nbsp;José J. Mira ,&nbsp;Manuel Santiñá","doi":"10.1016/j.gastre.2024.04.060","DOIUrl":"10.1016/j.gastre.2024.04.060","url":null,"abstract":"<div><h3>Objective</h3><div>The study aimed to establish recommendations and quality criteria to enhance the healthcare process of PBC.</div></div><div><h3>Patients and methods</h3><div>It was conducted using qualitative techniques, preceded by a literature review. A consensus conference involving five specialists in the field was held, followed by a Delphi process developed in two waves, in which 30 specialist physicians in family and community medicine, digestive system and internal medicine were invited to participate.</div></div><div><h3>Results</h3><div>Seven recommendations and 15 sets of quality criteria, indicators and standards were obtained. Those with the highest consensus were «Know the impact on the patient’s quality of life. Consider their point of view and agree on recommendations and care» and «Evaluate possible fibrosis at the time of diagnosis and during PBC follow-up, assessing the evolution of factors associated with poor disease prognosis: noninvasive fibrosis (elastography &gt; 2.1 kPa/year), GGT, ALP and bilirubin annually», respectively.</div></div><div><h3>Conclusions</h3><div>The implementation of the consensus recommendations and criteria would provide better patient care. The need for multidisciplinary follow-up and an increased role of primary care is emphasized.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 8","pages":"Pages 834-844"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419741","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}