Gastroenterologia y hepatologia最新文献

{"title":"A rare cause of intussusception.","authors":"Yimin Ma, Zhenguo Qiao","doi":"10.1016/j.gastrohep.2026.502856","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2026.502856","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502856"},"PeriodicalIF":2.0,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008345","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":"Comment on \"Computer-assisted adenoma detection colonoscopy with an ENDO-AID artificial intelligence system and Endocuff- versus Endocuff-assisted colonoscopy: A randomized controlled trial\".","authors":"Deepti M Sati, Vanashri Dhananjay Shinde, Chhaya Agarwal","doi":"10.1016/j.gastrohep.2026.502857","DOIUrl":"10.1016/j.gastrohep.2026.502857","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502857"},"PeriodicalIF":2.0,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008315","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":"Prognostic value of the liver fragility index to predict hospitalization and mortality in outpatients with cirrhosis.","authors":"Dagoberto Rafael Duarte-Misol, Marco Antonio Medina-Ortega, María Paula Valera-Mass, Luis Ramón Molina Barrios, Fernando Garcia-Del Risco, Ismael Yepes Barreto","doi":"10.1016/j.gastrohep.2026.502855","DOIUrl":"10.1016/j.gastrohep.2026.502855","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between liver frailty index (LFI) and the risk of hospitalization and mortality in outpatients with liver cirrhosis.</p><p><strong>Patients and methods: </strong>Prospective observational study of ambulatory patients with cirrhosis. After removal of duplicate records, 118 unique patients were analyzed. LFI was measured at baseline and categorized as robust, pre-frail, or frail. Time to first hospitalization and mortality were assessed using Cox proportional hazards models. Multivariable models were fitted, and the prognostic performance of Child-Pugh versus Child-Pugh +LFI was compared using Harrell's C-index and likelihood-ratio testing.</p><p><strong>Results: </strong>Mean age was 65.5±11.0 years and 61.0% were women. Overall, 56.8% were pre-frail and 20.3% were frail. During follow-up, 29 patients (24.6%) were hospitalized and 13 (11.0%) died. Continuous LFI was associated with hospitalization (HR: 1.72; 95%CI: 1.10-2.68; P=.016) and mortality (HR: 2.67; 95%CI: 1.30-5.51; P=.008) in univariable Cox models, but it did not remain statistically significant in the broader multivariable models. Adding LFI to Child-Pugh class increased the C-index from 0.665 to 0.719 for hospitalization (likelihood-ratio P=.046) and from 0.765 to 0.859 for mortality (P=.025).</p><p><strong>Conclusion: </strong>LFI was associated with hospitalization and mortality in ambulatory patients with cirrhosis. Although independent prognostic value was not demonstrated in the broader multivariable models, adding LFI to Child-Pugh class improved model fit and numerically increased discrimination. These findings support further evaluation of LFI as a complementary risk-stratification tool in larger cohorts.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502855"},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001750","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":"Nutritional assessment in inflammatory bowel disease.","authors":"Olivia Belén-Galipienso, Iria Bastón, Eduard Brunet-Mas, Margalida Calafat, Lucía Madero","doi":"10.1016/j.gastrohep.2026.502854","DOIUrl":"10.1016/j.gastrohep.2026.502854","url":null,"abstract":"<p><p>Malnutrition is common in inflammatory bowel disease (IBD) and worsens the clinical course, quality of life and complications. It arises from reduced intake, malabsorption, digestive losses and the increased expenditure caused by inflammation. The European Crohn's and Colitis Organisation (ECCO) recommends screening to identify patients who require nutritional assessment. This assessment is complex, since inflammation alters the classic parameters and no single reference method is available. This review examines the pathophysiology and the assessment methods, with particular attention to screening tools, both the generic ones, not specific to IBD, and the disease-specific tools and the Global Leadership Initiative on Malnutrition (GLIM) criteria, still unevenly applied.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502854"},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001736","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":"Eosinophilic duodenitis as a rare cause of duodenal stenosis.","authors":"Lucía Milagros Galia, Roy López Grove","doi":"10.1016/j.gastrohep.2026.502852","DOIUrl":"10.1016/j.gastrohep.2026.502852","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502852"},"PeriodicalIF":2.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929086","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":"Very early versus early endoscopy in acute non-variceal upper gastrointestinal bleeding: A prospective cohort study with propensity score matching.","authors":"Eray Can Akdag, Mustafa Comoglu, Fatih Acehan, Numan Aydin, Busra Dugeroglu, Ihsan Ates","doi":"10.1016/j.gastrohep.2026.502851","DOIUrl":"10.1016/j.gastrohep.2026.502851","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether endoscopy within 12h improves clinical outcomes compared with endoscopy performed between 12 and 24h in patients with acute non-variceal upper gastrointestinal bleeding (NVUGIB).</p><p><strong>Patients and methods: </strong>This prospective cohort study included adults with acute NVUGIB who underwent upper GI endoscopy within 24h of emergency department presentation. Patients were grouped according to endoscopy timing: within 12h and between 12 and 24h. Clinical outcomes were compared before and after propensity score matching. The primary outcome was a 30-day composite adverse outcome, defined as death or rebleeding.</p><p><strong>Results: </strong>A total of 285 patients were included, of whom 108 underwent endoscopy within 12h and 177 between 12 and 24h. After PSM, 103 patients remained in each group. The 30-day composite adverse outcome was similar between the within-12-h and 12-24-h groups (6.8% vs. 7.8%, p=1.000). No significant differences were observed in 30-day mortality (4.9% vs. 2.9%, p=0.727), rebleeding (1.9% vs. 5.8%, p=0.289), ICU admission (29.1% vs. 35.9%, p=0.371), inotropic support (3.9% vs. 6.8%, p=0.549), or prolonged hospitalization (24.3% vs. 31.1%, p=0.324). In multivariable logistic regression, endoscopy within 12h was not independently associated with the 30-day composite adverse outcome (adjusted OR 0.768, 95% CI 0.313-1.881; p=0.564).</p><p><strong>Conclusion: </strong>In acute NVUGIB managed within the 24-h window, routine endoscopy within 12h was not associated with a statistically significant improvement in clinical outcomes compared with endoscopy performed between 12 and 24h, supporting risk-adapted timing after stabilization.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502851"},"PeriodicalIF":2.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905953","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":"AWaRe-aligned doxycycline-based bismuth quadruple therapy achieves high Helicobacter pylori eradication rates and supports antimicrobial stewardship.","authors":"Giovanna Casadiego Santiago, Ismael de Jesús Yépez Barreto, Betty P Morales, Fernando García Del Risco","doi":"10.1016/j.gastrohep.2026.502850","DOIUrl":"10.1016/j.gastrohep.2026.502850","url":null,"abstract":"<p><strong>Objective: </strong>Helicobacter pylori infects a large proportion of the global population. The World Health Organization (WHO) developed the Access, Watch and Reserve (AWaRe) classification to promote rational antibiotic use and reduce antimicrobial resistance. The aim of this study was to evaluate the efficacy of a doxycycline-based bismuth quadruple therapy aligned with this strategy, as a potential alternative for H. pylori eradication in settings with limited availability of tetracycline.</p><p><strong>Patients and methods: </strong>A prospective observational study was conducted (October 2023-October 2024) in adults with confirmed H. pylori infection. Patients received a 14-day regimen with esomeprazole, bismuth, amoxicillin, and doxycycline. Eradication was assessed ≥4 weeks after treatment using a urea breath test or histology.</p><p><strong>Results: </strong>A total of 138 patients were included in the ITT population and 118 in the PP/mITT populations (mean age 51.3 years; 66.1% female). Overall eradication rates were 77.5% in the ITT analysis and 90.7% in the PP/mITT analyses. In the PP/mITT populations, eradication reached 94.5% in treatment-naïve patients, 85.7% after one prior treatment failure, and 61.5% after two or more prior treatment failures. Adverse events were mild (7.6%), and 92.4% of patients reported symptomatic improvement.</p><p><strong>Conclusions: </strong>This AWaRe-aligned doxycycline-based quadruple therapy achieved an acceptable eradication rate in the PP/mITT populations, with good tolerability. However, the lower ITT eradication rate warrants cautious interpretation of its overall effectiveness.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502850"},"PeriodicalIF":2.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887100","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":"Redefining the Role of TIPS in Decompensated Cirrhosis: From Portal Hypertension to Hepatic Recompensation.","authors":"José Sánchez, Paloma Poyatos, Sheila González, David Martí-Aguado, Paloma Lluch, María Pilar Ballester","doi":"10.1016/j.gastrohep.2026.502849","DOIUrl":"10.1016/j.gastrohep.2026.502849","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502849"},"PeriodicalIF":2.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887106","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":"Comparing NAFLD, MAFLD, and MASLD criteria for identifying significant liver fibrosis: A cross-sectional study.","authors":"Hung Cao Dinh, Tuong Thi Khanh Tran, Hoang Huu Nguyen","doi":"10.1016/j.gastrohep.2026.502823","DOIUrl":"10.1016/j.gastrohep.2026.502823","url":null,"abstract":"<p><strong>Objective: </strong>Different diagnostic frameworks for fatty liver disease include the exclusion-based non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) and the inclusion-based metabolic dysfunction-associated fatty liver disease (MAFLD) criteria. Their implications remain debated, especially in high viral hepatitis and alcohol use settings. This study evaluated diagnostic concordance and compared fibrosis detection across frameworks in a Vietnamese cohort.</p><p><strong>Patients and methods: </strong>In this cross-sectional study of 360 adults, liver fibrosis and steatosis were assessed using transient elastography. Significant fibrosis was defined as LSM ≥7.0kPa (F2), with F3 (≥8.7) and F4 (≥11.5). Steatosis was classified by CAP (S1-S3). Patients were classified categorized as NAFLD, MASLD, and MAFLD. Univariable and multivariable logistic regression were performed to identify factors associated with significant fibrosis.</p><p><strong>Results: </strong>Among participants, 76.67% (n=276) met all three definitions, while 15.83% (n=57) fulfilled only MAFLD criteria. The MAFLD group demonstrated higher liver stiffness than non-MAFLD group (median 5.0 vs. 4.1kPa; p=0.004). In multivariable analysis, NAFLD and MASLD were inversely associated with significant fibrosis (OR=0.418, p=0.045; OR=0.418, p=0.046, respectively). MAFLD showed a positive but non-significant association (OR=1.347, p=0.791), reflecting inclusion of dual-etiology patients (e.g., metabolic dysfunction with viral hepatitis or alcohol use) who are excluded under NAFLD/MASLD criteria.</p><p><strong>Conclusion: </strong>The observed inverse association between NAFLD/MASLD and significant fibrosis likely reflects the exclusion of patients with coexisting metabolic dysfunction and viral or alcohol-related liver disease. MAFLD, by contrast, retains these dual-etiology cases and captures a more heterogeneous risk profile.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502823"},"PeriodicalIF":2.0,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301521","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":"Effectiveness and safety of ustekinumab in older patients with Crohn's disease with high comorbidity burden: A real-world study.","authors":"Cristina Martínez-Cuevas, Lucía Morera-Sauca, Rosa Eva Madrigal, Jesús Barrio Andrés, Carmen Bocos Asenjo, Sandra Utrilla Utrilla, Manuel Pérez-Miranda Castillo, Carmen López Ramos, Laura Mata, Francisco Javier García-Alonso","doi":"10.1016/j.gastrohep.2026.502831","DOIUrl":"10.1016/j.gastrohep.2026.502831","url":null,"abstract":"<p><strong>Objective: </strong>Elderly patients are an increasingly relevant group in inflammatory bowel disease, yet clinical trials often exclude them. Ustekinumab might be a suitable treatment due to its adequate clinical and excellent safety outcomes. Our primary aim was to evaluate 1- and 2-year clinical remission rates. Secondary aims included steroid-free clinical and biochemical remission rates and treatment persistence.</p><p><strong>Patients and methods: </strong>A bi-center retrospective observational study was performed, including patients aged ≥50 years with CD and an age-adjusted Charlson comorbidity index ≥3 starting ustekinumab between January 2017 and October 2023. Clinical remission was defined as a Harvey-Bradshaw index <5 and biochemical remission as fecal calprotectin <250mg/kg together with C-reactive protein <5mg/L. Severe infections were those requiring hospitalization, and incident malignancies were defined as new diagnoses following the first ustekinumab dose.</p><p><strong>Results: </strong>Eighty-two patients were included, with a median age of 70.1 (IQR: 62.3-76) years and a median Charlson index of 4 (3-5). Ustekinumab achieved 1- and 2-year clinical remission rates of 88.1% and 77.6%, respectively, with a 2-year biochemical remission rate of 35.4%. Steroid free clinical remission at 1- and 2-years were 88.1% and 75.5%, respectively. Prior exposure to biologics was associated with lower remission rates. The 2-year treatment persistence rate was 94% (84.6%-97.8%). Overall, 54 (65.9%) patients underwent dose intensification. Severe infections and new malignancies occurred in 4.9% of patients during follow-up.</p><p><strong>Conclusions: </strong>Ustekinumab attained high 2-year clinical remission and treatment persistence rates, although with a 35.4% biochemical remission rate. Besides, the incidence of severe infections was low and within the expected range for this age group.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502831"},"PeriodicalIF":2.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404613","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}