Gastroenterologia y hepatologia最新文献

{"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}

{"title":"Comunicaciones orales. Sesión General 3","authors":"","doi":"10.1016/S0210-5705(25)00109-8","DOIUrl":"10.1016/S0210-5705(25)00109-8","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 ","pages":"Pages S12-S17"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791333","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":"MELD-Lactate as a predictor of in-hospital mortality in patients with variceal gastrointestinal bleeding.","authors":"Sofía Rodríguez-Jacobo, Raúl A Jiménez-Castillo, Carlos A Cortez-Hernández, Joel O Jaquez-Quintana, José A González-González, Héctor J Maldonado-Garza","doi":"10.1016/j.gastrohep.2025.502369","DOIUrl":"10.1016/j.gastrohep.2025.502369","url":null,"abstract":"<p><strong>Introduction: </strong>Variceal upper gastrointestinal bleeding is a common cause of decompensation in patients with liver cirrhosis. While mortality data, which are from 10 to 15%, are available, there are no validated scales to predict in-hospital mortality in this patient population.</p><p><strong>Objective: </strong>To determine whether the MELD-Lactate (MELD-LA) level is associated with in-hospital mortality in patients with chronic liver disease who are admitted for variceal bleeding.</p><p><strong>Material and methods: </strong>A prospective, observational, and analytical study was conducted that included 120 patients. The MELD-LA cut-off point was obtained, and in-hospital mortality was obtained using conventional prognostic scales that had the highest sensitivity and specificity for comparison purposes. Additionally, a survival analysis was performed using the MELD-LA cut-off point obtained.</p><p><strong>Results: </strong>In our cohort, 6 (5.0%) patients died during hospitalization. Patients who died had a mean MELD-LA value of 20.0 (±4.97) as opposed to those who did not die, 13.62 (±3.29), (p<0.001). The MELD-LA cut-off point of >14.0, with a sensitivity of 100%, a specificity of 71.0%, a positive predictive value of 15.4%, a negative predictive value of 100.0%, and an AUC (area under the curve) of 0.886, was most well correlated with higher in-hospital mortality. Survival was 71.1% in patients with MELD-LA levels>14.0 versus 100.0% in those with lower levels (p=0.001) during hospitalization.</p><p><strong>Conclusion: </strong>The measurement of MELD-LA at admission seems to be a good complementary marker for the evaluation and prognosis of in-hospital mortality in patients with liver cirrhosis, and variceal upper gastrointestinal bleeding.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502369"},"PeriodicalIF":2.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074676","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":"Genetic study as a tool in the diagnosis of rare diseases with nonspecific hepatic manifestations.","authors":"Neus Saloni Gomez, Ignacio Ros Arnal, Silvia Izquierdo Álvarez, Ruth García Romero","doi":"10.1016/j.gastrohep.2025.502367","DOIUrl":"10.1016/j.gastrohep.2025.502367","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502367"},"PeriodicalIF":2.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074638","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":"Hepatic silicosis as a rare cause of granulomatous liver disease.","authors":"María Del Barrio, María Luisa Cagigal, Álvaro Díaz-González","doi":"10.1016/j.gastrohep.2025.502368","DOIUrl":"10.1016/j.gastrohep.2025.502368","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502368"},"PeriodicalIF":2.2,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046410","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":"Etrasimod: Review of the efficacy and therapeutic prospects of a new oral therapy for the treatment of ulcerative colitis.","authors":"Javier P Gisbert, María Chaparro","doi":"10.1016/j.gastrohep.2025.502363","DOIUrl":"10.1016/j.gastrohep.2025.502363","url":null,"abstract":"<p><p>Etrasimod is a synthetic, non-biological, orally administered small molecule sphingosine-1-phosphate receptor (S1PR) modulator. Etrasimod was approved by the Food and Drug Administration in 2023 and by the European Medicine Agency in 2024, constituting a new therapeutic option for the treatment of moderately to severely active ulcerative colitis in patients 16 years of age and older in the European Union. Its efficacy and tolerability have been demonstrated in several clinical trials both as induction and maintenance treatment, as well as in long-term extension studies. This article reviews the pharmacodynamic characteristics of etrasimod, its main differences with biological drugs and other small molecules (janus kinases inhibitors), as well as its clinical efficacy including certain subpopulations such as patients with isolated ulcerative proctitis, and the impact on their quality of life.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502363"},"PeriodicalIF":2.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143038148","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":"Documento de posicionamiento de la Sociedad Española de Médicos de Atención Primaria (SEMERGEN) y del Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa (GETECCU) sobre el manejo de la enfermedad inflamatoria intestinal en atención primaria","authors":"Daniel Ginard ,&nbsp;Noelia Fontanillas ,&nbsp;Iria Bastón-Rey ,&nbsp;M. Elena Pejenaute ,&nbsp;Marta Piqueras ,&nbsp;Silvia Alcalde ,&nbsp;Pilar Nos ,&nbsp;Mercedes Ricote ,&nbsp;Lucía Expósito ,&nbsp;Míriam Mañosa ,&nbsp;Manuel Barreiro-de Acosta ,&nbsp;Francisco Rodríguez-Moranta ,&nbsp;Yamile Zabana ,&nbsp;José Polo ,&nbsp;Ana Gutiérrez ,&nbsp;en representación de GETECCU y SEMERGEN","doi":"10.1016/j.gastrohep.2024.502255","DOIUrl":"10.1016/j.gastrohep.2024.502255","url":null,"abstract":"<div><div>Primary Care is the first point of contact for most patients after the onset of symptoms of inflammatory bowel disease (IBD). Establishing an initial diagnostic process based on compatible symptoms and agreed criteria and referral pathways, depending on the degree of suspicion and the patient's situation, can reduce diagnostic delays. Once the patient is referred to the Digestive specialist and the diagnosis of IBD is established, a treatment and follow-up plan is structured. The management of the patient must be shared with the participation of the family practitioners in the diagnosis and treatment of concomitant or intercurrent pathologies, the recognition of flare-ups or complications (of IBD or treatments), education tasks or adherence control.</div><div>With the purpose of developing a comprehensive guide on the management of IBD aimed at Primary Care doctors, we have developed this positioning document collaboratively between the Spanish Society of Primary Care Physicians (SEMERGEN) and the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU).</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 3","pages":"Article 502255"},"PeriodicalIF":2.2,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444686","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":"Prevalence and bidirectional association between primary sclerosing cholangitis and Crohn's disease: A systematic review and meta-analysis.","authors":"Dongyuan Zheng, Qinke Xu, Jin Wu, Zhouyue Gu, Jieya Chen, Yingchao Liu","doi":"10.1016/j.gastrohep.2025.502346","DOIUrl":"10.1016/j.gastrohep.2025.502346","url":null,"abstract":"<p><strong>Purpose: </strong>This meta-analysis aimed to evaluating the prevalence of Crohn's disease in primary sclerosing cholangitis (PSC) and the incidence of primary sclerosing cholangitis in Crohn's disease (CD), along with their interrelation.</p><p><strong>Methods: </strong>An extensive search was conducted in the PubMed and Embase to identify available publications up to December 2023. Studies were included if they reported the prevalence of CD in PSC patients, or vice versa. Proportions were assessed using the DerSimonian and Laird method, followed by transformation via the Freeman-Tukey double inverse sine transformation. The quality of the included studies utilizing the Joanna Briggs Institute Critical Appraisal Checklist.</p><p><strong>Results: </strong>Based on quantitative analysis of 61 studies, the prevalence of PSC in patients with CD was 0.88% (95% CI: 0.53-1.30%). The prevalence of PSC in male CD patients was 0.45% (95% CI: 0.03-1.16%). In female CD patients, the prevalence was 0.51% (95% CI: 0.09-1.14%). The prevalence of CD with PSC was 11.27% (95% CI: 9.56-13.10%). The prevalence of CD in male PSC patients was 10.71% (95% CI: 7.42-14.50%). Among female PSC patients, the pooled prevalence of CD was 13.05% (95% CI: 11.05-15.19%).</p><p><strong>Conclusions: </strong>We found a significant bidirectional association between PSC and CD, with a higher prevalence of CD in female with PSC compared to male. These findings provide important epidemiological data for clinical practice.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502346"},"PeriodicalIF":2.2,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004356","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 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, Marta Álvarez, Helena Cantero, Victoria Ayala, Marta Vázquez, Javier Castro, Laura Salinas-Ortega, Raquel Domínguez-Hernández","doi":"10.1016/j.gastrohep.2025.502362","DOIUrl":"10.1016/j.gastrohep.2025.502362","url":null,"abstract":"<p><strong>Introduction: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"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}