Gastroenterologia y hepatologia最新文献

{"title":"Associations of sociodemographic factors, healthy habits, and weight stigma with non-alcoholic fatty liver disease risk in obese workers: Findings from a large occupational cohort.","authors":"Mónica Egea Sancho, José Ignacio Ramírez-Manent, Pedro Juan Tárraga López, Irene Coll Campayo, María Teófila Vicente-Herrero, Ángel Arturo López-González","doi":"10.1016/j.gastrohep.2025.502560","DOIUrl":"10.1016/j.gastrohep.2025.502560","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern, particularly among individuals with obesity. While metabolic and behavioral risk factors have been well described, the role of psychosocial determinants, such as weight stigma, remains underexplored.</p><p><strong>Objectives: </strong>To assess the association between sociodemographic variables, healthy lifestyle behaviors, and internalized weight stigma with MASLD risk in a large cohort of obese workers across Spain.</p><p><strong>Patients and methods: </strong>This cross-sectional study analyzed data from 26,816 obese employees who underwent occupational health screenings between January 2021 and December 2024. MASLD risk was assessed using three validated indices: the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP). Sociodemographic characteristics, adherence to the Mediterranean diet, physical activity, smoking status, and weight stigma (assessed by the Weight Bias Internalization Scale) were evaluated. Multivariable logistic regression models were used to estimate associations.</p><p><strong>Results: </strong>Weight stigma was significantly associated with higher risk of MASLD across all three indices, independent of age, sex, social class, and health behaviors. Participants with internalized weight stigma were 1.6-2.3times more likely to present with high-risk scores. Sociodemographic disparities and unhealthy lifestyle factors also contributed to elevated MASLD risk.</p><p><strong>Conclusions: </strong>Beyond metabolic and behavioral determinants, internalized weight stigma emerges as a strong independent factor associated with MASLD risk. These findings underscore the importance of incorporating psychosocial components into liver disease prevention strategies in occupational settings.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502560"},"PeriodicalIF":1.9,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023209","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":"Early advanced therapies and real-world outcomes in Crohn's disease: A population-based comparison of two incident cohorts in Navarra.","authors":"Alfonso Elosua, Óscar Nantes, María Chaparro, Lucía Zabalza, Rebeca Irisarri, Miren Vicuña, Marcos Kutz, Saioa Rubio, Julián Librero, Ramón Angós, Ana Garre, Javier P Gisbert, Cristina Rodríguez","doi":"10.1016/j.gastrohep.2025.502540","DOIUrl":"10.1016/j.gastrohep.2025.502540","url":null,"abstract":"<p><strong>Objective: </strong>The introduction of biologic therapies has transformed the management of Crohn's disease (CD), yet few studies have evaluated their impact on real-world outcomes over time. We aimed to compare two population-based cohorts of CD patients in Navarra, Spain, diagnosed in 2001-2003 (cohort A) and in 2017 (cohort B), to assess whether early use of advanced therapies has altered disease trajectory.</p><p><strong>Patients and methods: </strong>This prospective, multicentre cohort study included adult patients with confirmed CD from two periods. Clinical characteristics, treatments, hospitalizations, and surgical outcomes were analysed over five years. Time-to-event analyses were performed using Kaplan-Meier curves and Cox regression models.</p><p><strong>Results: </strong>A total of 128 patients were included (83 in cohort A, 45 in cohort B). At diagnosis, immunomodulators were used in 1.2% of cohort A vs. 21% in cohort B, and biologics in 0% vs. 51%, respectively. Initiation of immunomodulators (hazard ratio [HR]: 1.94; 95% CI: 1.11-3.39) and biologics (HR: 5.42; 95% CI: 2.57-11.42) occurred earlier in cohort B. Hospitalization at diagnosis was more frequent in cohort A (47% vs. 22%), and five-year hospitalization rates were significantly lower in cohort B (34% vs. 63%; HR: 0.52; 95% CI: 0.28-0.96). No significant differences in intestinal or perianal surgery rates were observed between cohorts.</p><p><strong>Conclusions: </strong>Earlier and more widespread use of advanced therapies in CD has been associated with reduced hospitalization over time, although surgical rates have remained stable. These findings suggest a shift toward earlier and more intensive treatment strategies in routine clinical practice.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502540"},"PeriodicalIF":1.9,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951630","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":"Appendiceal angiodysplasia: An unexpected cause of gastrointestinal bleeding.","authors":"Marc Lleixà-Rioboo, Andrés Arango, Alexandre Rey, Ignasi Elizalde, Eva C Vaquero, Míriam Cuatrecasas, Ariadna Sánchez, María Daca-Álvarez","doi":"10.1016/j.gastrohep.2025.502538","DOIUrl":"10.1016/j.gastrohep.2025.502538","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502538"},"PeriodicalIF":1.9,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951489","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":"Adjunctive resection of residual mucosal flap during Z-POEM for large Zenker's diverticulum.","authors":"Zhongshang Sun, Fazhen Xu, Xiaozhong Yang, Aijun Zhou, Bing Hu, Liansong Ye, Feng Pan","doi":"10.1016/j.gastrohep.2025.502537","DOIUrl":"10.1016/j.gastrohep.2025.502537","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502537"},"PeriodicalIF":1.9,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951509","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":"Banding-and-SINK for small (≤10-mm) gastrointestinal subepithelial tumours: A valid and effective alternative.","authors":"Joan B Gornals, Sandra Maisterra, Francesc Bas-Cutrina","doi":"10.1016/j.gastrohep.2025.502539","DOIUrl":"10.1016/j.gastrohep.2025.502539","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502539"},"PeriodicalIF":1.9,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951605","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":"Antithrombotics drugs in Gastrointestinal Endoscopy. Position Statment of the Catalan Society of Gastroenterology.","authors":"Faust Riu Pons, Noèlia Vilalta, Gemma Ibáñez-Sanz, Sergi Quintana-Carbó, Andrea Calvo, Hugo Uchima, Pilar García-Iglesias, Cristina Romero-Mascarell, Ermengol Vallès, Marco Antonio Álvarez","doi":"10.1016/j.gastrohep.2025.502536","DOIUrl":"10.1016/j.gastrohep.2025.502536","url":null,"abstract":"<p><strong>Introduction: </strong>The use of antiplatelet and anticoagulant drugs is common in patients undergoing elective endoscopic procedures. To minimize both bleeding and thromboembolic risks, an individualized assessment is essential. For this purpose, the Societat Catalana de Digestologia (SCD) commissioned a consensus document aimed at providing practical recommendations based on the best available evidence and expert agreement.</p><p><strong>Material and methods: </strong>A panel of 10 specialists from the fields of Gastroenterology, Cardiology, Hematology, and Anesthesiology were involved in the development of the document. A non-systematic review of the literature was conducted using a modified Delphi method through online voting. Recommendations were reviewed and discussed during each round until consensus was reached. Recommendations with ≥80% agreement were accepted.</p><p><strong>Results: </strong>A total of 16 endoscopic procedures were assessed based on their hemorrhagic risk, and tailored management guidelines were defined to different groups of antithrombotic agents. The document includes a management algorithm and stratification tables for bleeding and thrombotic risk.</p><p><strong>Conclusion: </strong>The recommendations developed by the SCD integrate international evidence and are adapted to the local healthcare context, providing a valuable tool for clinical practice. The importance of multidisciplinary coordination and effective communication with the patient is emphasized to ensure safety throughout the periprocedural period.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502536"},"PeriodicalIF":1.9,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144845588","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":"Duodenal cystic dystrophy with a final diagnosis of pancreatic adenocarcinoma: Direct relationship or incidental finding?","authors":"Pablo Fernández Rodriguez, Lidia Castillo Gázquez, Tomás Álvarez Malé, Mirella Jiménez Gómez","doi":"10.1016/j.gastrohep.2025.502534","DOIUrl":"10.1016/j.gastrohep.2025.502534","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502534"},"PeriodicalIF":1.9,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811967","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":"Bridging the gap: The need for a standardized referral pathway for urgent TIPS placement in portal-hypertension related bleeding (\"Code TIPS\").","authors":"Clara Usón Peirón, Julia Del Rio Izquierdo, Anna Baiges, Andrés Conthe","doi":"10.1016/j.gastrohep.2025.502535","DOIUrl":"10.1016/j.gastrohep.2025.502535","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502535"},"PeriodicalIF":1.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803961","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":"Clinical outcomes in the implementation of peroral endoscopic myotomy (POEM): Results from the Spanish multicenter registry.","authors":"Fermín Estremera-Arevalo, Silvia Bravo-Meléndez, Gonzalo Hijos-Mallada, Carlos Guarner-Argente, Marianette Murzi, Enrique Rodríguez-Santiago, Alberto Herreros de Tejada, Hugo Uchima-Koecklin, Pablo Miranda-García, David Barquero-Declara, Jose María Riesco-López, Pedro de María-Pallarés, Mª Gloria Fernández-Esparrach, Andrés Sánchez-Yagüe, Irene Aresté-Anduaga, Gonzalo Gonzalez-Gete, Carlos Teruel Sanchez-Vegazo, Beatriz Peñas-García, Sofía Parejo-Carbonell, Alba Martínez-Sánchez, Eukene Rojo, Alfredo Mata-Bilbao, Isis K Araujo, Sheyla Montori, Marta Gómez, Eduardo Albeniz","doi":"10.1016/j.gastrohep.2025.502527","DOIUrl":"10.1016/j.gastrohep.2025.502527","url":null,"abstract":"<p><strong>Objective: </strong>Peroral endoscopic myotomy (POEM) has emerged as a prominent endoscopic treatment for achalasia and other esophageal motility disorders (EMD). The objective of this study is to evaluate its clinical efficacy and safety after its implementation in Spain.</p><p><strong>Patients and methods: </strong>This is a multicenter registry conducted across 13 hospitals in Spain. Symptomatic patients undergoing POEM for any EMD were recruited between June 2016 and February 2023. Baseline characteristics, procedural details and outcomes related to efficacy and safety during short and long-term follow-up were analyzed.</p><p><strong>Results: </strong>A total of 441 patients were enrolled, with type II achalasia representing the most common diagnosis (62.1%). POEM was the primary treatment in 277 patients (62.8%). Clinical success data were available for 396 patients, with a success rate of 94.4% at the last available follow-up (2 years in 117 patients, 1 year in 140, <1 year in 139). A higher baseline Eckardt score was an independent risk factor for clinical failure in the long-term follow-up (p=0.024). Symptomatic reflux occurred in 4.7% of the patients, with a significant esophagitis rate of 11.3%. Complication incidence was 9.3% (41/441), including 14 (3.2%) severe events. Older age (p=0.025) and total procedure duration (p=0.036) were independent risk factors for complications, while mucosal injury was found to be a predictor of severe complications (p=0.027).</p><p><strong>Conclusions: </strong>These findings confirm the clinical efficacy and safety during the implementation phase of POEM for all EMD in Spain.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502527"},"PeriodicalIF":1.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794284","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":"Predictors of early immunosuppression at ulcerative colitis onset in the biological era.","authors":"Gisela Piñero, Edgar Castillo, Carlos González-Muñoza, Anna Calm, Clàudia Pujol, Jordi Gordillo, Margalida Calafat, Federico Bertoletti, Esther Garcia-Planella, Míriam Mañosa, Eugeni Domènech","doi":"10.1016/j.gastrohep.2025.502533","DOIUrl":"10.1016/j.gastrohep.2025.502533","url":null,"abstract":"<p><strong>Background: </strong>Unlike Crohn's disease, ulcerative colitis (UC) lacks predictive factors of a bad prognosis. Therefore, immunosuppressant therapy is only considered in a step-up strategy when steroid refractoriness or dependency develops.</p><p><strong>Objective: </strong>To identify predictive factors for the early use of immunosuppressants, biological agents and colectomy in UC.</p><p><strong>Patients and methods: </strong>Retrospective, observational study of an incident cohort of UC at two referral centres over a 7-year period. Demographic, clinical, endoscopic and biologic variables at UC diagnosis were collected and early use (within five years) of immunosuppressants, biological agents and colectomy was assessed for a maximum of five years.</p><p><strong>Results: </strong>A total of 239 patients were included. At baseline, 32% presented with extensive colitis, 15% severe disease activity and 13% large ulcers at diagnostic endoscopy. At the end of follow-up, 24% were exposed to thiopurines, 18% to biologicals and 4% were colectomized. The need for thiopurines, biological agents or colectomy was independently associated with extensive UC at diagnosis (OR 5.3; IC95% 1.6-17.2), the need for corticosteroids at disease onset (OR 7.8; IC95% 2.6-23.9) and proximal progression during follow-up (OR 13; IC95% 2.3-73.4).</p><p><strong>Conclusions: </strong>Less than a third of patients with UC use thiopurines or biological agents within the first five years of disease course. Unfortunately, there are no predictive factors robust enough to allow for the early introduction of advanced therapies at disease onset.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502533"},"PeriodicalIF":1.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667556","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}