Gastroenterologia y hepatologia最新文献

{"title":"Exploring infliximab serum level variability in inflammatory bowel disease: Comprehensive analysis of patient subgroups and treatment outcomes \"Infliximab trough levels variability in inflammatory bowel disease\".","authors":"Carles Iniesta-Navalón, Lorena Rentero-Redondo, Rosa Gómez-Espín, Manuel Ríos Saorín, Isabel Nicolás de Prado, Juan José Gascón-Cánovas","doi":"10.1016/j.gastrohep.2025.502472","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502472","url":null,"abstract":"<p><strong>Background and aims: </strong>Inflammatory bowel disease (IBD) features diverse clinical presentations and progressions, impacting IFX exposure. Understanding IFX serum concentration changes is crucial for tailored monitoring in specific patient groups. The main objective of this study was to analyze ITL trajectories in patients with IBD to identify distinct groups and subgroups, revealing heterogeneity in treatment responses Methods: A retrospective cohort study was conducted involving IBD patients treated with infliximab in a regional reference hospital in Spain. Latent class linear mixed models were applied to identify subgroups based on serum infliximab measurements over time. To analyze the factors associated with IFX discontinuation, we employed both logistic regression and Cox regression models.</p><p><strong>Results: </strong>The study included 165 IBD patients, and a total of 799 ITL samples were analyzed. The selected model included three clusters, with a random intercept and a random effect on both time and natural cubic spline time in the linear mixed model. Cluster 1 (20.6%) had lower IFX exposure, with 93.9% experiencing treatment discontinuation, compared to 45.1% in Cluster 2 (43.0%) and 43.3% in Cluster 3 (36.4%) (p<0.001). Treatment discontinuation was observed in 91 individuals (55.2%) out of the total patients. In the multivariate analysis, the presence of cluster 1 was a significant predictor (OR: 7.25, 95% CI: 1.45-36.12). Bayesian dose adjustment was found to significantly reduce the risk of IFX discontinuation (OR: 0.19, 95% CI: 0.46-1.96).</p><p><strong>Conclusions: </strong>The lack of TDM during induction and a lower proportion of adjustments made through Bayesian methods were associated with a subgroup demonstrating suboptimal pharmacokinetic profiles and reduced drug persistence. These findings highlight the clinical relevance of model-informed TDM in optimizing IFX exposure and minimizing treatment discontinuation in IBD.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502472"},"PeriodicalIF":2.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colonoscopy in Symptomatic Patients: Validation of AEG-SEED Prioritization Criteria and Added Value of FIT. The Endoprior Study.","authors":"Liseth Rivero-Sánchez, Joaquín Castillo-Iturra, Ana García-Rodríguez, Beatriz García Zafra, Pilar Díez Redondo, Henar Núñez Rodríguez, Marta Ponce, Mileidis San Juan, Pilar Borque Barrera, Agustín Seoane, Marc Albert Carrasco, Diana Zaffalon, Carlos Guarner, Marianette Murzi, Rodrigo Jover, Lucía Medina-Prado, Kattalin Aspuru Rubio, Diana João Matias, Begoña González Suárez, Henry Córdova, Alejandro Fernández-Simón, Isis Araujo, Àngels Ginés, María Pellisé, Francesc Balaguer, Gloria Fernández-Esparrach","doi":"10.1016/j.gastrohep.2025.502471","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502471","url":null,"abstract":"<p><strong>Background and aims: </strong>Colorectal cancer (CRC) is one of the leading causes of cancer-related mortality. Colonoscopy is the diagnostic gold standard, although its performance in symptomatic patients is limited. During the COVID-19 pandemic, the AEG-SEED societies proposed a clinical prioritization system. The aim of this study was to validate its diagnostic performance in detecting clinically relevant lesions (CRLs), including CRC, and to compare it with the fecal immunochemical test (FIT).</p><p><strong>Patients and methods: </strong>A national multicenter retrospective study was conducted in 12 Spanish hospitals. A total of 1,078 adult patients with digestive symptoms attended between April and December 2020 were included. Colonoscopies were prospectively classified according to priority levels (P1, P2, P3).</p><p><strong>Results: </strong>CRLs were identified in 18% of patients, including 36 cases of CRC (3%). The diagnostic yield was highest in P1 (PPV 27%, AUC 0.57 for CRLs; PPV 7%, AUC 0.64 for CRC), and decreased in P2 and P3. FIT was performed in 26% of patients based on the referring physician's clinical judgment, showing higher sensitivity and negative predictive value (NPV) for CRC (100%) and a higher AUC (0.69) compared to clinical criteria.</p><p><strong>Conclusions: </strong>The AEG-SEED clinical criteria offer moderate value for prioritizing colonoscopies in the absence of FIT. However, FIT demonstrates superior diagnostic performance and should be systematically incorporated. The combination of symptoms improves accuracy compared to isolated symptoms.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502471"},"PeriodicalIF":2.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empleo De Ustekinumab Como Tratamiento De Elección En Paciente Con Colitis Inmunomediada Corticodependiente Y Secundaria A Pembrolizumab.","authors":"Alejandro García Martínez, María Regla Gallego Gallegos","doi":"10.1016/j.gastrohep.2025.502469","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502469","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502469"},"PeriodicalIF":2.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Portal vein thrombosis in the absence of cirrhosis: Diagnostic and Therapeutic Approach in Clinical Practice\".","authors":"Asunción Ojeda, M Aranzazu Gelabert, Virginia Hernández Gea, Juan Carlos García Pagán","doi":"10.1016/j.gastrohep.2025.502470","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502470","url":null,"abstract":"<p><p>Non-cirrhotic non tumoral portal vein thrombosis is an entity of low prevalence but with a potential risk of developing complications of portal hypertension, which has a significant prognostic impact on patients. In the absence of liver cirrhosis, it is essential to rule out other chronic liver disease as well as local factors and prothrombotic conditions. Therefore, a thorough workup should be initiated immediately. In acute thrombosis, anticoagulation is the main treatment to prevent progression of thrombosis and development of intestinal ischaemia. In chronic forms, however, close follow-up is essential to prevent and treat complications of portal hypertension. For refractory complications of portal hypertension, endovascular recanalization techniques have promising results and are becoming increasingly important.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502470"},"PeriodicalIF":2.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enfermedad relacionada con IgG4 simulando una neoplasia colónica: implicaciones diagnósticas y terapéuticas.","authors":"Víctor Gómez Carrillo, Luis Alonso Lobato Bancalero, Fernando Durán Botía, Alejandro Martín Quirós","doi":"10.1016/j.gastrohep.2025.502467","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502467","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502467"},"PeriodicalIF":2.2,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transoral Outlet Reduction for Dumping Syndrome After Gastric Bypass: A Case Series.","authors":"Joan Llach, Lilliam Flores, Ana de Hollanda, Alba Andreu, Eduard Espinet-Coll, Gherzon Casanova, Maria Isabel Olivé, Eva Rivas, Ainitze Ibarzabal, Javier Osorio, Josep Vidal, Francesc Balaguer, Maria Pellisé","doi":"10.1016/j.gastrohep.2025.502468","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502468","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502468"},"PeriodicalIF":2.2,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HISTOLOGICAL FEATURES AND INFLAMMATORY CYTOKINE PROFILES IN ANAL FISTULA: A PROSPECTIVE COHORT STUDY.","authors":"Edward Sanchez-Haro, Laura Hernández Leon, José Troya, Sandra Vela, Ingrid Tapiolas, Eva Martínez-Cáceres, Pedro-Luis Fernandez, David Parés","doi":"10.1016/j.gastrohep.2025.502465","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502465","url":null,"abstract":"<p><strong>Introduction: </strong>Traditionally, anorectal abscesses and anal fistulas have been considered to originate from a common site within the fistula tract (the intersphincteric space), according to the cryptoglandular hypothesis. Understanding the distribution of cells and inflammatory mediators in different parts of the anal fistula tract is of significant interest. This study aimed to analyze the inflammatory characteristics of anal fistula tract specimens.</p><p><strong>Methods: </strong>An observational study was conducted on specimens retrieved from consecutive cases. We analyzed samples of chronic anorectal fistulas, which were topographically divided into 3 parts: superficial part (including the external fistula opening, close to the perianal skin), middle (including the intersphincteric space), and deep part (close to the anal canal, including the internal fistula opening). These samples were reviewed under microscopy to describe cell types using hematoxylin-eosin staining and the presence of pro-inflammatory cytokines TNF-alpha and IL-36 using immunohistochemical staining.</p><p><strong>Results: </strong>Fistula tract samples were obtained surgically from 15 patients. No epithelial lining was observed in any part of the samples. We found a predominance of granulation tissue with chronic inflammatory components and no signs of acute inflammation, with no differences among the different parts of each sample studied. Immunohistochemistry revealed the presence of TNF-alpha throughout the fistulous tract, with an increasing trend towards the deep third (internal opening), although this was not statistically significant. In contrast, IL-36 was uniformly distributed across all three parts of the fistula tract.</p><p><strong>Conclusions: </strong>There is no specific site within the anal fistula tract that shows distinct findings related to the inflammatory process.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502465"},"PeriodicalIF":2.2,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling the Gut-Fat-Inflammation Connection in Crohn's Disease: A Path to New Therapeutic Targets?","authors":"Antonio Giordano, Iria Bastón, Lucía Madero, Eduard Brunet-Mas, Margalida Calafat","doi":"10.1016/j.gastrohep.2025.502466","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502466","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502466"},"PeriodicalIF":2.2,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights into the status of the quality of nursing care in patients with inflammatory bowel disease: A nationwide survey (The MAPEA Project).","authors":"Ester Navarro Correal, Diana Muñoz Gómez, Adriana Rivera Sequeiros, Francisca Murciano Gonzalo","doi":"10.1016/j.gastrohep.2025.502464","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502464","url":null,"abstract":"<p><strong>Background and aims: </strong>This study aimed to provide a comprehensive nationwide assessment of the status of nursing management in inflammatory bowel disease (IBD).</p><p><strong>Methods: </strong>A nationwide observational cross-sectional survey study was conducted. Nurses involved in the care of patients with IBD completed the 90-item Nursing Care Quality in IBD Assessment (NCQ-IBD) questionnaire which classifies the level of quality of care from A (highest) to D (lowest).</p><p><strong>Results: </strong>A total of 71 f questionnaires were analysed. In this study, category A was achieved in 2 (2.8%) cases, category B in 53 (74.6%), and category C in 16 (22.5%). Of the list of 27 professional competencies identified for a specialized IBD nurse, 23 (85.2%) were met by more than 70% of participants. Regarding the presence of specific nursing IBD care only 28 (39.4%) worked for more than 4.5 days/week. About 88.7% of nurses used clinical practice guidelines or protocols and 74.6% applied scales for assessing anxiety and depression, but just 18.8% and 25.4% evaluated IBD classification and activity indexes, respectively. Only 53.5% of participants reported to have available training plan in IBD. In the last 5 years, 25.4% of professionals had participated in more than five research projects, 9.9% had presented more than five communications in meetings, and 14.1% had published more than three articles.</p><p><strong>Conclusions: </strong>Nursing care was highly satisfactory. Signage on nursing consultation doors, administrative support, holiday coverage, encouraging research, and primarily increasing the ratio of nurses working full-time, are areas for improvement.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502464"},"PeriodicalIF":2.2,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatitis follicular que imita cáncer de páncreas: Un desafío diagnóstico.","authors":"Yu Lu, Qiu Wu, Tao Yin","doi":"10.1016/j.gastrohep.2025.502463","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502463","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502463"},"PeriodicalIF":2.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}