Gastroenterologia y hepatologia最新文献

{"title":"The efficiency of artificial intelligence for management and clinical decision-making in the identification of patients with hidden HCV infection (Intelligen-C strategy)","authors":"José Luis Castro Urda ,&nbsp;Marta Álvarez ,&nbsp;Helena Cantero ,&nbsp;Victoria Ayala ,&nbsp;Marta Vázquez ,&nbsp;Javier Castro ,&nbsp;Laura Salinas-Ortega ,&nbsp;Raquel Domínguez-Hernández","doi":"10.1016/j.gastrohep.2025.502362","DOIUrl":"10.1016/j.gastrohep.2025.502362","url":null,"abstract":"<div><h3>Introduction</h3><div>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).</div></div><div><h3>Methods</h3><div>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+ 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+, 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.</div></div><div><h3>Results</h3><div>In the retrospective phase, the Intelligen-C strategy allowed the identification of 272 anti-HCV- or HCV-RNA+ patients who were lost to follow-up, of whom 11 were treated; in the prospective phase, after 7312 serologies were performed, 28 HCV-RNA+ patients were identified, 14 attended the appointment, and 9 were treated. In the prospective phase vs. the previous period, increased serology (7312 vs. 909), HCV-RNA+ 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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 6","pages":"Article 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":"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 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.</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":"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 50mg of granule mesalamine, with an increase in the dose by 50mg every week up to 200mg, followed by incremental doses of 100mg every week. After patients received dosages of more than 1000mg, the dose was increased by 200mg 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 (3000-4000mg/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":"Cricopharyngeal bar: A rare entity","authors":"Jeronimo Toro-Calle ,&nbsp;Daniel Herrera ,&nbsp;Maria Alejandra Mesa","doi":"10.1016/j.gastrohep.2025.502348","DOIUrl":"10.1016/j.gastrohep.2025.502348","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 6","pages":"Article 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":"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 an experts panel.</p><p><strong>Results: </strong>A total of 2180 patients with hidden HDV infection were estimated; of these, 1188 (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 € 17.8million (€ 16.9million with advanced disease and € 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":"The role of renal replacement therapy in improving normothermic machine perfusion of liver grafts","authors":"Jordi Vengohechea,&nbsp;Aida Vaquero-Rey,&nbsp;Constantino Fondevila,&nbsp;Amelia J. Hessheimer","doi":"10.1016/j.gastrohep.2025.502336","DOIUrl":"10.1016/j.gastrohep.2025.502336","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 4","pages":"Article 502336"},"PeriodicalIF":2.2,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023240","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":"P-38 - IMPLICACIÓN DEL CMV EN LA EVOLUCIÓN DE LOS PACIENTES CON COLITIS INMUNOMEDIADAS: RESULTADOS DEL ESTUDIO REGIC PROMOVIDO POR GETECCU","authors":"Diego Casas Deza,&nbsp;Marta Gascón Ruiz,&nbsp;Cristina Polo Cuadro,&nbsp;Manuel Barreiro,&nbsp;Míriam Mañosa,&nbsp;Francisco Rodríguez Moranta,&nbsp;Yamile Zabana,&nbsp;Elena Céspedes Martínez,&nbsp;Ingrid Ordás,&nbsp;José Miranda Bautista,&nbsp;María José García,&nbsp;Irene García de la Filia Molina,&nbsp;Cristina Roig Ramos,&nbsp;Alexandra Ruiz Cerulla,&nbsp;José Xavier Segarra Ortega,&nbsp;Virginia Matallana Royo,&nbsp;G. Esther Rodríguez González,&nbsp;Fernando Martínez de Juan,&nbsp;Noemí Manceñido Marcos,&nbsp;Lucía Madero Velázquez,&nbsp;Ana Gutierrezy Santiago García López","doi":"10.1016/S0210-5705(25)00199-2","DOIUrl":"10.1016/S0210-5705(25)00199-2","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 ","pages":"Article 104495"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844472","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":"P-6 - RIESGO DE CÁNCER COLORRECTAL O ADENOMA AVANZADO TRAS LA RESECCIÓN ENDOSCÓPICA DE ADENOMAS PROXIMALES VS. DISTALES: REVISIÓN SISTEMÁTICA Y METAANÁLISIS","authors":"Sandra Baile-Maxía,&nbsp;Víctor Ausina-Poüs,&nbsp;María Sáez-Rico,&nbsp;Noelia Sala-Miquel,&nbsp;Pedro Zapater,&nbsp;Carolina Mangas-Sanjuány Rodrigo Jover","doi":"10.1016/S0210-5705(25)00167-0","DOIUrl":"10.1016/S0210-5705(25)00167-0","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 ","pages":"Article 104463"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844598","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":"P-30 - EFICACIA DE FILGOTINIB EN VIDA REAL COMO TRATAMIENTO DE LA COLITIS ULCEROSA: RESULTADOS DEL REGISTRO ENEIDA","authors":"Iago Rodríguez-Lago,&nbsp;Laura Cudero,&nbsp;Cristina Martínez Pascua,&nbsp;Alejandro Mínguez,&nbsp;Rocío Ferreiro-Iglesias,&nbsp;Laura Arranz,&nbsp;Ana María Royo,&nbsp;Daniel Martín-Rodríguez,&nbsp;María de los Ángeles Mejías,&nbsp;Margalida Calafat,&nbsp;Marta Calvo,&nbsp;Carla J. Gargallo-Puyuelo,&nbsp;Alicia Granja,&nbsp;Javier Santos-Fernández,&nbsp;Patricia Ucha,&nbsp;Daniel Ceballos,&nbsp;María Dolores Martín-Arranz,&nbsp;Isabel Ferrer,&nbsp;Laura Ramos,&nbsp;Pedro Almela,&nbsp;Eugeni Domènechy Manuel Barreiro-de Acosta","doi":"10.1016/S0210-5705(25)00191-8","DOIUrl":"10.1016/S0210-5705(25)00191-8","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 ","pages":"Article 104487"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844602","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":"P-36 - VALOR DIAGNÓSTICO DEL CORTISOL BASAL PARA DESCARTAR INSUFICIENCIA SUPRARRENAL TRAS TRATAMIENTO CON CORTICOIDES SISTÉMICOS EN LA ENFERMEDAD INFLAMATORIA INTESTINAL: ANÁLISIS DE RESULTADOS DEL ESTUDIO CORTIRISC","authors":"Mercè Navarro-Llavat,&nbsp;Orlando García-Bosch,&nbsp;Jesús Castro-Poceiro,&nbsp;Ana Bargalló García,&nbsp;Montse Martín Baranera,&nbsp;Dolores Ruiz Arroyo,&nbsp;Iolanda Bial Mula,&nbsp;Álex Blasco Pelicano,&nbsp;Mercè Albareda Rieray Eugeni Domènech Morral","doi":"10.1016/S0210-5705(25)00197-9","DOIUrl":"10.1016/S0210-5705(25)00197-9","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 ","pages":"Article 104493"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844614","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}