Gastroenterologia y hepatologia最新文献

Granulocyte and monocyte adsorptive apheresis (GMA) in patients with inflammatory bowel disease: A useful therapeutic tool not just in ulcerative colitis but also in Crohn's disease 炎症性肠病患者的粒细胞和单核细胞吸附性分离术（GMA）：不仅对溃疡性结肠炎，而且对克罗恩病都是一种有用的治疗工具。

IF 2.2 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-11-01 DOI: 10.1016/j.gastrohep.2024.502196

{"title":"Granulocyte and monocyte adsorptive apheresis (GMA) in patients with inflammatory bowel disease: A useful therapeutic tool not just in ulcerative colitis but also in Crohn's disease","authors":"","doi":"10.1016/j.gastrohep.2024.502196","DOIUrl":"10.1016/j.gastrohep.2024.502196","url":null,"abstract":"<div><h3>Introduction</h3><div>Granulocyte and monocyte adsorptive apheresis (GMA) removes neutrophils and monocytes from peripheral blood, preventing their incorporation into the inflamed tissue also influencing cytokine balance. Published therapeutic efficacy in ulcerative colitis (UC) is more consistent than in Crohn's disease (CD). We assessed clinical efficacy of GMA in UC and CD 4 weeks after last induction session, at 3 and 12 months, sustained remission and corticosteroid-free remission.</div></div><div><h3>Patients and method</h3><div>Retrospective observational study of UC and CD patients treated with GMA. Partial Disease Activity Index-DAIp in UC and Harvey-Bradshaw Index-HBI in CD assessed efficacy of Adacolumn® with induction and optional maintenance sessions.</div></div><div><h3>Results</h3><div>We treated 87 patients (CD-25, UC-62), 87.3% corticosteroid-dependent (CSD), 42.5% refractory/intolerant to immunomodulators. In UC, remission and response were 32.2% and 19.3% after induction, 35.5% and 6.5% at 12 weeks and 29% and 6.5% at 52 weeks. In CD, remission rates were 60%, 52% and 40% respectively. In corticosteroid-dependent and refractory or intolerant to INM patients (UC-41, CD-14), 68.3% of UC achieved remission or response after induction, 51.2% at 12 weeks and 46.3% at 52 weeks, and 62.3%, 64.3% and 42.9% in CD. Maintained remission was achieved by 66.6% in CD and 53.1% in UC. Up to 74.5% of patients required corticosteroids at some timepoint. Corticosteroid-free response/remission was 17.7% in UC and 24% in CD.</div></div><div><h3>Conclusions</h3><div>GMA is a good therapeutic tool for both in UC and CD patients. In corticosteroid-dependent and refractory or intolerant to INM patients it avoids biological therapy or surgery in up to 40% of them in one year.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Uso de herramientas digitales en salud en enfermedad inflamatoria intestinal 在炎症性肠病中使用数字健康工具。

IF 2.2 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-11-01 DOI: 10.1016/j.gastrohep.2024.502200

{"title":"Uso de herramientas digitales en salud en enfermedad inflamatoria intestinal","authors":"","doi":"10.1016/j.gastrohep.2024.502200","DOIUrl":"10.1016/j.gastrohep.2024.502200","url":null,"abstract":"<div><h3>Objective</h3><div>To analyse the characteristics and use of digital health tools (DHT) in inflammatory bowel disease (IBD).</div></div><div><h3>Methods</h3><div>We performed a qualitative study based on a narrative literature review, a questionnaire and on the opinion of 3 expert gastroenterologists. Several searches were carried out until September 2022 through Medline to identify articles on the use of DHT in IBD by healthcare professionals. A structured questionnaire was designed to be answered by health professionals involved in the care of patients with IBD. The experts generated a set of recommendations.</div></div><div><h3>Results</h3><div>There are multiple DHT for IBD with different characteristics and contents. We received 29 questionnaires. Almost 50% of the participants were 41-50 years old, the majority were women (83%) and 90% were gastroenterologists. A total of 96% reported the use of several DHT, but 20% used them occasionally or infrequently. Web pages were found the most used (62%). DHT are mostly used to get information (80%), followed by clinical practice issues (70%) and educational purposes (62%). G-Educainflamatoria website is the best known and most used HDS (96% and 64%, respectively). The main barriers to the use of DHT in IBD were the lack of time (55%), doubts about the benefit of DHT (50%) and the excess of information (40%).</div></div><div><h3>Conclusions</h3><div>Healthcare professionals involved in the care of patients with to IBD frequently use DHT, although actions are needed to optimize their use and to guarantee their efficient and safe use.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897846","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}

引用次数: 0

Secondary uncovered versus fully-covered metal stents for the management of occluded stent in unresectable distal malignant biliary obstruction 在治疗无法切除的远端恶性胆道梗阻的闭塞支架时，二次覆盖与全覆盖金属支架的比较。

IF 2.2 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-11-01 DOI: 10.1016/j.gastrohep.2024.502218

{"title":"Secondary uncovered versus fully-covered metal stents for the management of occluded stent in unresectable distal malignant biliary obstruction","authors":"","doi":"10.1016/j.gastrohep.2024.502218","DOIUrl":"10.1016/j.gastrohep.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>          <!-->0.133, 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":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300495","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}

引用次数: 0

Vesícula biliar septada 胆囊隔膜

IF 2.2 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-11-01 DOI: 10.1016/j.gastrohep.2024.502189

引用次数: 0

Colitis secundaria a hipogammaglobulinemia: EII-like, la gran desconocida 低丙种球蛋白血症引起的结肠炎：IBD 样性，巨大的未知。

IF 2.2 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-11-01 DOI: 10.1016/j.gastrohep.2024.502205

引用次数: 0

The Oakland score: When low specificity implies excessive costs and time consume 奥克兰分数：当低特异性意味着过高的成本和时间消耗时。

IF 2.2 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-11-01 DOI: 10.1016/j.gastrohep.2024.502204

引用次数: 0

Expanding horizons: The benefits of pursuing international fellowship experience 拓展视野：追求国际奖学金经历的益处。

IF 2.2 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-11-01 DOI: 10.1016/j.gastrohep.2024.502240

引用次数: 0

Protocolo de adquisición de imágenes y medición de la elasticidad pancreática mediante elastografía por onda de cizallamiento bidimensional (2D-SWE) transabdominal 经腹二维剪切波弹性成像（2D-SWE）图像采集和胰腺弹性测量规程。

IF 2.2 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-11-01 DOI: 10.1016/j.gastrohep.2024.502198

{"title":"Protocolo de adquisición de imágenes y medición de la elasticidad pancreática mediante elastografía por onda de cizallamiento bidimensional (2D-SWE) transabdominal","authors":"","doi":"10.1016/j.gastrohep.2024.502198","DOIUrl":"10.1016/j.gastrohep.2024.502198","url":null,"abstract":"<div><h3>Introduction</h3><div>Transabdominal ultrasound (TU) pancreatic 2D-SWE elastography is a developing technique that needs to be protocolized.</div></div><div><h3>Objectives</h3><div>Establish a protocol for image acquisition and measurement of TU pancreatic - 2D-SWE elastography and estimate the minimum number of measurements to be performed.</div></div><div><h3>Materials and methods</h3><div>Ten measurements of pancreatic elasticity were taken in healthy volunteers using TU-2D-SWE, following a strict protocol for image acquisition and measurement.</div></div><div><h3>Results</h3><div>The 70% of the participants were women, with an average age, weight, and BMI of 49.5±15.7 years, 65.9±11.9kg, and 24.5±4.2kg/m<sup>2</sup>, respectively. Measurements were taken from the body (70%), tail (16.7%), and pancreatic head (13.3%). The median mean velocity and elasticity were 1.46±0.25cm/sec and 6.46±2.87KPa, respectively. The ROI depth was 4.12±1cm and the SP-ROI distance was 5.2mm on average. There were no statistically significant differences between the 10 measurements. The reliability analysis of the measurements showed high internal consistency and repeatability. Taking 5-6 measurements ensured high concordance with the ten reference measurements. The measurements were significantly lower when the SP-ROI values were intermediate (0.3-0.6cm). The measurement accuracy was higher when performed at a depth less than 4.8cm.</div></div><div><h3>Conclusion</h3><div>To measure pancreatic elasticity using TU-2D-SWE, we propose a strict protocol for image acquisition and measurement, taking a minimum of 5 measurements in the best visualized and accessible pancreatic portion, and preferably at a depth of less than 4.8cm.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897843","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}

引用次数: 0

Sobrecrecimiento bacteriano del intestino delgado (SIBO), ¿una entidad clínica sobrediagnosticada? 小肠细菌过度生长 (SIBO)，临床上被过度诊断的实体？

IF 2.2 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-11-01 DOI: 10.1016/j.gastrohep.2024.502190

引用次数: 0

Evaluación de la duración de la baja laboral en pacientes con enfermedad inflamatoria intestinal 评估炎症性肠病患者的病假时间。

IF 2.2 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-11-01 DOI: 10.1016/j.gastrohep.2024.502194

{"title":"Evaluación de la duración de la baja laboral en pacientes con enfermedad inflamatoria intestinal","authors":"","doi":"10.1016/j.gastrohep.2024.502194","DOIUrl":"10.1016/j.gastrohep.2024.502194","url":null,"abstract":"<div><h3>Introduction</h3><div>Inflammatory bowel disease (IBD) is a chronic disorder that can lead to periods of work-related temporary disability (TD), which may result in the need for permanent disability. The objective was to assess the impact of IBD on patients’ temporary disability by analyzing periods, duration, and causes. It also investigates risk factors influencing the severity, frequency, and duration of flare-ups and associated complications in IBD patients.</div></div><div><h3>Method</h3><div>The study includes patients aged 18 to 65, with at least 1 day of TD in 2019 (Pre-COVID), referred or not by UMEVI, due to reasons related to IBD.</div></div><div><h3>Results</h3><div>A total of 172 patients were included, and in all cases, TD was associated with IBD. TD was higher in patients over 30 years old, with anxious depressive disorder, who required hospitalization and did not receive prednisone treatment (p<0.05). TD duration was longer in patients belonging to the Special Regime for Self-Employed Workers (RETA): 67 days (IQR: 22-160) versus the General Regime (RG): 33 days (IQR: 8-110), with no statistically significant difference (p=0.120). The mean cost (€) per worker in this series was €745.5 (IQR: 231-2608.2).</div></div><div><h3>Conclusions</h3><div>IBD has a significant impact on patients’ temporary work disability. The duration of TD was longer in patients older than 30 years, with anxious-depressive disorder, who required hospital admission and did not receive steroid treatment.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876264","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}

引用次数: 0