Gastroenterologia y hepatologia最新文献

{"title":"The phenotypic landscape of primary biliary cholangitis and autoimmune hepatitis variants","authors":"Francesca Bolis ,&nbsp;Giorgio Cazzaniga ,&nbsp;Fabio Pagni ,&nbsp;Pietro Invernizzi ,&nbsp;Marco Carbone ,&nbsp;Alessio Gerussi","doi":"10.1016/j.gastrohep.2024.502225","DOIUrl":"10.1016/j.gastrohep.2024.502225","url":null,"abstract":"<div><div>Autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC) stand as distinct diseases, yet occasionally intertwine with overlapping features, posing diagnostic and management challenges. This recognition traces back to the 1970s, with initial case reports highlighting this complexity.</div><div>Diagnostic scoring systems like IAIHG and simplified criteria for AIH were introduced but are inherently limited in diagnosing variant syndromes. The so-called Paris criteria offer a diagnostic framework with high sensitivity and specificity for variant syndromes, although disagreements among international guidelines persist.</div><div>Histological findings in AIH and PBC may exhibit overlapping features, rendering histology alone inadequate for a definitive diagnosis. Autoantibody profiles could be helpful, but similarly cannot be considered alone to reach a solid and consistent evaluation.</div><div>Treatment strategies vary based on the predominant features observed.</div><div>Individuals with overlapping characteristics favoring AIH ideally benefit from corticosteroids, while patients primarily manifesting PBC features should initially receive treatment with choleretic drugs like ursodeoxycholic acid (UDCA).</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 2","pages":"Article 502225"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476474","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}

{"title":"Pediatric gallstone disease—Management difficulties in clinical practice","authors":"Ana Losa ,&nbsp;Gisela Silva ,&nbsp;Sara Mosca ,&nbsp;Berta Bonet ,&nbsp;Helena Moreira Silva ,&nbsp;Ermelinda Santos Silva","doi":"10.1016/j.gastrohep.2024.502228","DOIUrl":"10.1016/j.gastrohep.2024.502228","url":null,"abstract":"<div><h3>Background</h3><div>Gallstone disease (GD) is no longer an exclusive condition of adulthood, and its prevalence is increasing in pediatric age. The management and the extent of the etiological investigation of GD in children and adolescents remains controversial. This study aimed to analyze the difficulties in the work-up and management of pediatric GD patients.</div></div><div><h3>Methods</h3><div>A retrospective study performed in a single tertiary center enrolled sixty-five patients with GD followed from January 2014 to June 2021. Patients were categorized conveniently according to their age at diagnosis: Group A (&lt;10<!--> <!-->years, <em>n</em> <!-->=<!--> <!-->35) and Group B (≥10<!--> <!-->years, <em>n</em> <!-->=<!--> <!-->30). We analyzed demographic, clinical and laboratory data, ultrasonographic findings at presentation, therapeutics and complications.</div></div><div><h3>Results</h3><div>Symptoms were more frequent in patients &gt;10<!--> <!-->years old (<em>p</em> <!-->=<!--> <!-->0.001). Cholecystectomy was performed in 31 patients (47.7%). A multivariate regression logistic model identified the age &gt;10<!--> <!-->years (OR<!--> <!-->=<!--> <!-->6.440, <em>p</em> <!-->=<!--> <!-->0.005) and underlying entities (OR<!--> <!-->=<!--> <!-->6.823, <em>p</em> <!-->=<!--> <!-->0.017) as independent variables to perform surgery. Spontaneous resolution of GD was more common in children &lt;2<!--> <!-->years old. A multivariate regression logistic model showed a trend for those &gt;10<!--> <!-->years old to develop more complications. Two out of 18 patients were diagnosed with ABCB4 gene mutations in heterozygosity.</div></div><div><h3>Conclusions</h3><div>Decision-making on cholecystectomy remains challenging in asymptomatic patients. Identifying predictive factors for the development of complications has proven difficult. However, we found a trend toward the development of complications in individuals older than 10<!--> <!-->years.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 2","pages":"Article 502228"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579463","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":"Profiling the patient with inflammatory bowel disease in the relationship between physical activity and partner/social network status: A post hoc patient-tailored analysis of the “BE-FIT-IBD” study","authors":"Antonietta Gerarda Gravina ,&nbsp;Raffaele Pellegrino ,&nbsp;Giovanna Palladino,&nbsp;Giuseppe Imperio,&nbsp;Andrea Ventura,&nbsp;Marina Cipullo,&nbsp;Annachiara Coppola,&nbsp;Alessandro Federico","doi":"10.1016/j.gastrohep.2024.502203","DOIUrl":"10.1016/j.gastrohep.2024.502203","url":null,"abstract":"<div><h3>Introduction</h3><div>Normal quality of life is an ultimate target in the therapeutic approach to inflammatory bowel diseases (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC) in the context of which regular physical activity (PA) is often a chimeric parameter that is not standardized in terms of quality/quantity. The study aimed to profile a sample of IBD patients about the relationship between PA-partner status and social network support.</div></div><div><h3>Patients and methods</h3><div>A <em>post hoc</em> analysis of the “BE-FIT-IBD” study was set up by stratifying the data of PA with that of partner status and the support that the patient's social network (i.e., relatives, friends) provided in inciting the patient to practice regular PA.</div></div><div><h3>Results</h3><div><span>In the 219 patients included, there was a greater tendency for patients with stable partners to view the risk of reactivation/worsening of IBD as a barrier to conducting regular PA (</span><em>p</em> <!-->&lt;<!--> <!-->0.0001). Single patients considered PA more as a protective factor (<em>p</em> <!-->=<!--> <!-->0.045). Patients without a PA-supporting social network retained IBD-related treatment as a PA barrier (<em>p</em> <!-->=<!--> <span>0.016) and PA as a risk for IBD complications (</span><em>p</em> <!-->=<!--> <span>0.01), with less confidence that PA could improve the course of IBD (</span><em>p</em> <!-->&lt;<!--> <!-->0.001). Rectal syndrome was an IBD-related barrier more represented in patients with PA-deterring social network (<em>p</em> <!-->&lt;<!--> <!-->0.0001).</div></div><div><h3>Conclusions</h3><div>These factors are potential targets for recovering the IBD patient's adherence to regular PA.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 2","pages":"Article 502203"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897841","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":"Strongyloides stercolaris hyperinfection syndrome in ulcerative colitis treated with corticotherapy: The importance of strongyloides screening","authors":"Marc Vidal-Delso ,&nbsp;Marta Fortuny ,&nbsp;Laura González-González ,&nbsp;Anna Pèlach ,&nbsp;Laura Soldevila ,&nbsp;Sílvia Roure-Díez ,&nbsp;Míriam Mañosa ,&nbsp;Eugeni Domènech","doi":"10.1016/j.gastrohep.2024.502230","DOIUrl":"10.1016/j.gastrohep.2024.502230","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 2","pages":"Article 502230"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590166","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":"Leishmania colitis: An uncommon cause of gastrointestinal bleeding in an immunosuppressed patient","authors":"Francisco Vara-Luiz ,&nbsp;Helena Pires ,&nbsp;Ivo Mendes ,&nbsp;Carolina Palma ,&nbsp;Eduardo Fernandes ,&nbsp;Ana Elisa Teles ,&nbsp;Francisco Martins do Vale ,&nbsp;Marta Patita ,&nbsp;Jorge Fonseca ,&nbsp;Pedro Pinto-Marques","doi":"10.1016/j.gastrohep.2024.502254","DOIUrl":"10.1016/j.gastrohep.2024.502254","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 2","pages":"Article 502254"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284424","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":"Characterizing Hepatitis Delta in Spain and the gaps in its management","authors":"Sergio Rodríguez-Tajes ,&nbsp;Adriana Palom ,&nbsp;Álvaro Giráldez-Gallego ,&nbsp;Antonio Moreno ,&nbsp;Juan José Urquijo ,&nbsp;Manuel Rodríguez ,&nbsp;Marta Alvarez-Argüelles ,&nbsp;Moisés Diago ,&nbsp;María García-Eliz ,&nbsp;Javier Fuentes ,&nbsp;Ana María Martínez-Sapiña ,&nbsp;Pilar Castillo ,&nbsp;Marta Casado ,&nbsp;Elena Pérez-Campos ,&nbsp;Raquel Muñoz ,&nbsp;Marta Hernández-Conde ,&nbsp;Rosa María Morillas ,&nbsp;Rafael Granados ,&nbsp;Mireia Miquel ,&nbsp;María Julia Morillas ,&nbsp;Sabela Lens","doi":"10.1016/j.gastrohep.2024.502222","DOIUrl":"10.1016/j.gastrohep.2024.502222","url":null,"abstract":"<div><h3>Background and aims</h3><div>Chronic hepatitis D (CHD) is a severe form of chronic viral hepatitis. The estimated hepatitis delta prevalence in Spain is around 5% of patients with hepatitis B. Reimbursement of new antiviral therapies (Bulevirtide, BLV) was delayed in our country until February 2024. We aimed to characterize the clinical profile of patients with HDV/HBV infection in Spain and current barriers in their management at the time of BLV approval.</div></div><div><h3>Method</h3><div>Multicenter registry including patients with positive anti-HDV serology actively monitored in 30 Spanish centers. Epidemiological, clinical and virological variables were recorded at the start of follow-up and at the last visit.</div></div><div><h3>Results</h3><div>We identified 329 anti-HDV patients, 41% were female with median age 51 years. The most common geographical origin was Spain (53%) and East Europe (24%). Patients from Spain were older and had HCV and HIV coinfection probably associated to past drug injection (<em>p</em> <!-->&lt;<!--> <!-->0.01). HDV-RNA was positive in 138 of 221 assessed (62%). Liver cirrhosis was present at diagnosis in 33% and it was more frequent among viremic patients (58% vs 25%, <em>p</em> <!-->&lt;<!--> <!-->0.01). After a median follow-up of 6 (3–12) years, 44 (16%) resolved infection (18 spontaneously and 26 after Peg-INF). An additional 10% of patients developed cirrhosis (<em>n</em> <!-->=<!--> <span>137) during follow-up (45% had portal hypertension and 14% liver decompensation). Liver disease progression was associated to persisting viremia.</span></div></div><div><h3>Conclusion</h3><div>One-third of the patients with CHD already have cirrhosis at diagnosis. Persistence of positive viremia is associated to rapid liver disease progression. Importantly, barriers to locally determine/quantify HDV-RNA were present.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 2","pages":"Article 502222"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440412","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":"Aspectos legales relativos al uso de inteligencia artificial en ciencias de la salud","authors":"Carlos Alventosa Mateu ,&nbsp;Robert Giner Alventosa ,&nbsp;María Lorena Tobar Peñaherrera","doi":"10.1016/j.gastrohep.2024.502227","DOIUrl":"10.1016/j.gastrohep.2024.502227","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 2","pages":"Article 502227"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476473","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":"Esófago en empedrado, una forma infrecuente de esofagitis grave en la esclerodermia","authors":"Raúl Fernández García,&nbsp;Maria del Carmen Fernández Cano,&nbsp;Eduardo Redondo Cerezo","doi":"10.1016/j.gastrohep.2024.502238","DOIUrl":"10.1016/j.gastrohep.2024.502238","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 2","pages":"Article 502238"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142092728","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":"Long-term outcomes of endoscopic ultrasound-guided pancreatic duct interventions: A single tertiary center experience","authors":"Joan B. Gornals ,&nbsp;Albert Sumalla-Garcia ,&nbsp;Daniel Luna-Rodriguez ,&nbsp;Maria Puigcerver-Mas ,&nbsp;Julio G. Velasquez-Rodriguez ,&nbsp;Silvia Salord ,&nbsp;Sandra Maisterra ,&nbsp;Juli Busquets","doi":"10.1016/j.gastrohep.2024.502221","DOIUrl":"10.1016/j.gastrohep.2024.502221","url":null,"abstract":"<div><h3>Background and aims</h3><div>Endoscopic ultrasound-guided pancreatic duct intervention (EUS-PDI) is one of the most technically challenging procedures. There remains a knowledge gap due to its rarity. The aim is to report the accumulated EUS-PDI experience in a tertiary center.</div></div><div><h3>Methods</h3><div>Single tertiary center, retrospective cohort study of prospectively collected data during the study period, from January 2013 to June 2021.</div></div><div><h3>Results</h3><div><span>In total, 14 patients (85% male; mean age, 61 years, range 37–81) and 25 EUS-PDI procedures for unsuccessful endoscopic retrograde pancreatography (ERP) were included. Principal etiology was chronic pancreatitis with pancreatic duct obstruction (78%). EUS-guided assisted (colorant and/or guidewire, </span><em>rendezvous</em><span>) ERP was performed in 14/25 (56%); and transmural drainage in 11 procedures, including pancreaticogastrosmy in 9/25 (36%) and pancreaticoduodenostomy in 2/25 (8%). Overall technical and clinical success was 78.5% (11/14). Three (21%) patients required a second procedure with success in all cases. Two failed cases required surgery. Three (21%) adverse events (AEs) were noted (fever, </span><em>n</em> <!-->=<!--> <!-->1; perforation, <em>n</em> <!-->=<!--> <!-->1; pancreatitis, <em>n</em> <!-->=<!--> <!-->1). Patients underwent a median of 58 months (range 24–108) follow-up procedures for re-stenting. Spontaneous stent migration was detected in 50% of cases.</div></div><div><h3>Conclusions</h3><div>EUS-PDI is an effective salvage therapy for unsuccessful ERP, although 21% of patients may still experience AEs. In case of EUS-guided <em>rendezvous</em> failure, it can cross over to a transmural drainage.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 2","pages":"Article 502221"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436767","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":"Búsqueda de optimización de la cápsula endoscópica mediante análisis observacional","authors":"Benito Velayos ,&nbsp;Loreto Calleja ,&nbsp;María Fe Muñoz ,&nbsp;Antonella Rizzo ,&nbsp;Ana Macho ,&nbsp;Lourdes Olmo ,&nbsp;Concepción García ,&nbsp;Beatriz Antolín ,&nbsp;Sandra Izquierdo ,&nbsp;Luis Fernández","doi":"10.1016/j.gastrohep.2024.502223","DOIUrl":"10.1016/j.gastrohep.2024.502223","url":null,"abstract":"<div><h3>Objectives</h3><div>To search for parameters susceptible to optimization when performing capsule endoscopy (CE) in a third level hospital with high volume and experience in this test.</div></div><div><h3>Patients and methods</h3><div>Retrospective observational study, including 1325 CEs performed between 2017 and 2022. Overall diagnostic yield, effective diagnostic yield, by indication, place of request and waiting list, as well as complete examination rate and cleansing degree were analyzed.</div></div><div><h3>Results</h3><div>The overall diagnostic yield was 70.99%, while the effective diagnostic yield was 72.7%. Diagnostic yields varied between 60.2% and 77.9% depending on the indication and between 64.7% and 74.3% depending on the requesting center. The mean waiting list was 101.15 days, with a tendency to worse results when the waiting list was longer. A total of 77.8% of the examinations were complete. Completion rates were lower in patients &gt;<!--> <!-->70 years of age (p<!--> <!-->=<!--> <!-->0.001), as well as in those with gastric transit &gt;<!--> <!-->60<!--> <!-->minutes (p<!--> <!-->=<!--> <!-->0.000). A total of 77.3% were clean, with debris that did not impede diagnosis being found in 16.9% and debris that did impede diagnosis in 5.8%. There was a relationship, although not significant, between cleansing degree and age.</div></div><div><h3>Conclusions</h3><div>The diagnostic yields of CE in our center are in line with those previously reported. Differences were found according to the place of request. Waiting list could also influence diagnostic yield. Completion rates are lower in &gt;<!--> <!-->70 years of age and when gastric transit is &gt;<!--> <!-->60<!--> <!-->minutes. Cleansing degree achieved is acceptable.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 2","pages":"Article 502223"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440413","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}