Gastroenterologia y hepatologia最新文献

{"title":"Prevalence and Bidirectional Association Between Primary Sclerosing Cholangitis and Crohn's disease: A Systematic Review and Meta-Analysis.","authors":"Dongyuan Zheng, Xu Qinke, Wu Jin, Gu Zhouyue, Jieya Chen, Yingchao Liu","doi":"10.1016/j.gastrohep.2025.502346","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502346","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502346"},"PeriodicalIF":2.2,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004356","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":"The efficiency of artificial intelligence for management and clinical decision-making in the identification of patients with undiagnosed HCV infection (Intelligen-C strategy).","authors":"José Luis Castro Urda, Marta Álvarez, Helena Cantero, Victoria Ayala, Marta Vázquez, Javier Castro, Laura Salinas-Ortega, Raquel Domínguez-Hernández","doi":"10.1016/j.gastrohep.2025.502362","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502362","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI) allows the optimization of diagnostic processes for hepatitis C virus (HCV) patients. Our objective was to evaluate the clinical, economic, and management benefits of an AI-based clinical decision support system (Intelligen-C strategy).</p><p><strong>Methods: </strong>The Intelligen-C strategy consisted of (1) a retrospective phase (Dec 2013-Sep 2021), in which medical records were reviewed to search for anti-HCV-positive and/or HCV-RNA-positive patients lost in the system, and (2) a prospective phase (Feb 2022-Jan 2023), in which automated screening (40-70 years) and routine testing for risk factors were performed in patients who were admitted to the emergency department or were hospitalized. With the use of automated screening, the system identified patients without an HCV diagnosis among those requiring blood tests and requested HCV serology; if the results were positive, reflex testing for HCV RNA was performed. If a patient was HCV-RNA positive, an alert was generated and sent to the hepatology department. In addition, the prospective phase was compared with the previous period to evaluate its effectiveness and efficiency.</p><p><strong>Results: </strong>In the retrospective phase, the Intelligen-C strategy allowed the identification of 272 anti-HCV- or HCV-RNA-positive patients who were lost to follow-up, of whom 11 were treated; in the prospective phase, after 7,312 serologies were performed, 28 HCV-RNA-positive patients were identified, 14 attended the appointment, and 9 were treated. In the prospective phase vs. the previous period, increased serology (7,312 vs. 909), HCV RNA-positive detection (28 vs. 3), and treated patients (9 vs. 1) generated savings to the health system related to medical visits. In addition, Intelligen-C was cost-effective.</p><p><strong>Conclusions: </strong>The implementation of the Intelligen-C strategy allowed the identification of patients with undiagnosed infection, facilitated their diagnosis, reduced healthcare processes and associated hospital costs, and proved to be efficient.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502362"},"PeriodicalIF":2.2,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004358","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":"EXPLORING THE UTILITY OF CELLULAR INDICES IN THE DIAGNOSIS OF ULCERATIVE COLITIS.","authors":"Julio César Moreno Alfonso, Sharom Barbosa-Velásquez, Carlos Delgado-Miguel, Ada Molina Caballero, Sara Hernández-Martín, Alberto Pérez Martínez, María Concepción Yárnoz Irazábal","doi":"10.1016/j.gastrohep.2025.502349","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502349","url":null,"abstract":"<p><strong>Aim: </strong>To describe the usefulness of cellular indices in the diagnosis of ulcerative colitis (UC).</p><p><strong>Methods: </strong>Diagnostic study of patients under 15 years of age undergoing colonoscopy ± esophagogastroduodenoscopy for suspected inflammatory bowel disease between 2015-2022 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.</p><p><strong>Results: </strong>Twenty-six patients were included: 14 with normal biopsy and 12 with UC. PLR and MLR values were significantly higher in patients with UC (p <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; p= 0.041).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502349"},"PeriodicalIF":2.2,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004354","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":"Novel desensitization therapy of mesalamine intolerance in patients with ulcerative colitis.","authors":"Kenji Kinoshita, Shintaro Sawaguchi, Kai Toyoshima, Sonoe Yoshida, Takahiro Yamamura, Kosuke Nagai, Ikko Tanaka, Kazuteru Hatanaka, Yoshiya Yamamoto, Hirohito Naruse, Takehiko Katsurada, Naoya Sakamoto","doi":"10.1016/j.gastrohep.2025.502347","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502347","url":null,"abstract":"<p><strong>Background: </strong>Mesalamine is the first-line drug for treating mild-to-moderate ulcerative colitis (UC); however, some patients develop symptoms of intolerance. Although several desensitization methods have been reported, these desensitization regimens were rather complicated for physicians to prescribe in daily clinical practice; therefore, it has not yet become a major therapeutic option for intolerance patients. Thus, we developed an alternative desensitization protocol.</p><p><strong>Methods: </strong>We performed a single-center, retrospective study of patients with UC, who were intolerant to mesalamine and had undergone desensitization therapy. Desensitization starts with 50 mg of granule mesalamine, with an increase in the dose by 50 mg every week up to 200 mg, followed by incremental doses of 100 mg every week. After patients received dosages of more than 1000 mg, the dose was increased by 200 mg every week up to the target dose. Concomitant medications such as oral prednisolone or budesonide rectal foam were allowed during the protocol but were withdrawn before the end of desensitization. We evaluated the success rate of our mesalamine desensitization method and performed safety assessments during the protocol.</p><p><strong>Results: </strong>Of 115 patients, 17 were intolerant to mesalamine. We excluded six patients who had severe disease or organ disorders. Overall, 11 patients received desensitization therapy without hospitalization. All 11 patients successfully underwent desensitization therapy and received the target dose of mesalamine (3000-4000 mg/day) at the end of the protocol. No serious adverse events were observed during this protocol.</p><p><strong>Conclusions: </strong>This retrospective study reports a successful and safe desensitization method for UC patients with mesalamine intolerance.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502347"},"PeriodicalIF":2.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970491","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":"Barra cricofaringea: una entidad poco habitual.","authors":"J Toro-Calle, D Herrera, M A Mesa","doi":"10.1016/j.gastrohep.2025.502348","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502348","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502348"},"PeriodicalIF":2.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970490","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":"Cost analysis of hidden hepatitis D virus infection in Spain.","authors":"Xavier Forns, Manuel Rodríguez, Raquel Domínguez-Hernández, Helena Cantero, Laura Salinas-Ortega, Miguel Ángel Casado","doi":"10.1016/j.gastrohep.2025.502337","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502337","url":null,"abstract":"<p><strong>Introduction: </strong>A significant percentage of patients coinfected with hepatitis B virus (HBV) and hepatitis D virus (HDV) are undiagnosed. Coinfected patients progress to advanced liver disease faster than HBV monoinfected patients, thereby consuming more healthcare resources. The aim was to perform an analysis to determine the cost of hidden HDV infection in Spain.</p><p><strong>Methods: </strong>An analytical model was developed to estimate the prevalence of hidden HDV infection with/without advanced liver disease at the time of diagnosis. An epidemiological flow chart was established to quantify undiagnosed chronic hepatitis D patients. The percentages of patients with compensated cirrhosis (CC), decompensated cirrhosis (DC), hepatocellular carcinoma (HCC) and requiring liver transplantation (LT) and their annual costs were subsequently obtained from the literature. Direct healthcare costs were considered within a time horizon of 1 year. For patients without advanced disease, the consumption of healthcare resources was obtained from a experts panel.</p><p><strong>Results: </strong>A total of 2,180 patients with hidden HDV infection were estimated; of these, 1,188 (54%) had advanced liver disease (29%-CC, 57%-DC, and 8%-HCC) or underwent LT (6%), and 992 (46%) patients did not have advanced disease. The total annual cost of hidden HDV would be euro 17.8 million (euro 16.9 million with advanced disease and euro 882,400 for those without).</p><p><strong>Conclusions: </strong>Hidden HDV infection represents a high economic burden in Spain due to the rapid progression of liver disease in affected patients. These results highlight the importance of early diagnosis to prevent future clinical and economic burden related to liver disease progression.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502337"},"PeriodicalIF":2.2,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964501","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":"Thromboembolic phenomena in inflammatory bowel disease and risk with JAK inhibitor treatments.","authors":"José Luis Rueda García, José Manuel Benitez, Iria Baston Rey, Margalida Calafat Sard, Cristina Suárez Ferrer","doi":"10.1016/j.gastrohep.2024.502257","DOIUrl":"10.1016/j.gastrohep.2024.502257","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502257"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284422","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":"Treatment of severe hypertriglyceridemia through therapeutic plasma exchange in patients with acute pancreatitis or at risk of developing it.","authors":"Eva Marín-Serrano, Ana Kerguelen Fuentes, Rubén Fernández-Martos, José Mostaza Prieto, Aurora Viejo Llorente, Ana Barbado Cano, Pedro Luis Martínez Hernández, María Dolores Martín-Arranz","doi":"10.1016/j.gastrohep.2024.502229","DOIUrl":"10.1016/j.gastrohep.2024.502229","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>TPE drastically reduces serum triglyceride (sTG), but its role in the treatment of hypertriglyceridemia-induced acute pancreatitis (HTG-AP) or at risk of developing it, is not well established. The objectives were to assess the effectiveness and safety of TPE in the treatment of severe HTG (sHTG), as well as to evaluate the severity of HTG-AP treated with TPE.</p><p><strong>Materials and methods: </strong>Observational-retrospective-single-center study, in which a descriptive analysis of sHTG treated with TPE was conducted, with the aim of treating HTG-AP or preventing its recurrence. TPE was performed if sTG≥ 1000 mg/dL after 24 hours of admission.</p><p><strong>Results: </strong>42 TPE were performed to treat 35 sHTG in 23 patients: 29 HTG-AP, and 6 sHTG with previous HTG-AP. Among the patients, 37% (13/55) were women, with 37 ± 14 years-old, 74.3% had normal BMI (25/35), 34% (12/35) were drinking > 40 g/alcohol/day and 54% (19/35) were diabetics. TPE significantly reduced the baseline sTG (4425 ± 2782 mg/dL vs. 709 ± 353 mg/dL, p < 0.001) in a single session, achieving a mean percentage reduction of 79 ± 13%; 20% (7/35) of sHTG cases required two TPE sessions to reduce sTG to < 1000 mg/dL. Adverse effects were reported in 4/42 TPE sessions (9,5%). sHTG-AP was observed in 3% of cases (1/29), and there were no deaths. sTG at 24 hours of admission showed no relation with the severity of APs.</p><p><strong>Conclusion: </strong>The treatment of sHTG with TPE, with the aim of treating HTG-AP or preventing its recurrence, reduces sTG quickly and safety.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502229"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590167","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":"Gastric antral ectasia and diaphragmatic hernia: A rare cause of iron deficiency anemia.","authors":"Ana Lancho Muñoz, Patricia Abellán Alfocea, Eduardo Redondo Cerezo","doi":"10.1016/j.gastrohep.2024.502209","DOIUrl":"10.1016/j.gastrohep.2024.502209","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502209"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140916061","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":"Heterotaxia syndrome: when almost nothing is as it should be.","authors":"Luisa Adán-Merino, Francisco Garrido Gallego, Rodrigo Pastorín-Salis, Ángel Ponferrada-Díaz","doi":"10.1016/j.gastrohep.2024.502233","DOIUrl":"10.1016/j.gastrohep.2024.502233","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502233"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727052","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}