Gastroenterologia y hepatologia最新文献

{"title":"Influence of psychiatric comorbidities on outcomes in cirrhosis: A propensity-matched cohort analysis.","authors":"Muhammad Ali Ibrahim Kazi, Mahnoor Sarfraz, Siraj Ahmad, Qetevan Gvazava, Imran Qureshi, Zurabi Lominadze, Maia Tavadze","doi":"10.1016/j.gastrohep.2026.502712","DOIUrl":"10.1016/j.gastrohep.2026.502712","url":null,"abstract":"<p><strong>Background: </strong>Cirrhosis is a progressive liver disease associated with high morbidity and reduced quality of life. Mood disorders are common in chronic liver disease and may worsen outcomes through inflammation, poor adherence and reduced care engagement. Their specific impact on cirrhosis outcomes, however, remains unclear.</p><p><strong>Methods: </strong>Using the TriNetX global research network, we conducted a retrospective cohort study of adults with cirrhosis, comparing those with comorbid mood disorders to those without. Propensity score matching (1:1) was performed using demographic variables. Outcomes included variceal bleeding, ascites, spontaneous bacterial peritonitis (SBP), hepatic encephalopathy, hepatorenal syndrome, liver transplantation, and all-cause mortality.</p><p><strong>Results: </strong>After matching, cirrhotic patients with mood disorders had significantly higher complication rates than controls, including varices (RR 1.19), ascites (RR 1.13), SBP (RR 1.40), hepatic encephalopathy (RR 1.52), and hepatorenal syndrome (RR 1.34) (all p<0.001). They were also more likely to undergo liver transplantation (RR 1.76) and had a modest increase in all-cause mortality (RR 1.06).</p><p><strong>Conclusion: </strong>Mood disorders in cirrhosis are associated with increased decompensation, transplant utilization, and mortality, highlighting the need for integrated psychiatric care and further prospective evaluation.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502712"},"PeriodicalIF":1.9,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354764","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":"Vaccination recommendations and adherence in inflammatory bowel disease: A physician-patient discordance study.","authors":"Rocío Ferreiro-Iglesias, Alejandro Hernández-Camba, Antonio Valdivia, Iago Rodríguez-Lago, Yamile Zabana, Manuel Barreiro-de Acosta","doi":"10.1016/j.gastrohep.2026.502714","DOIUrl":"10.1016/j.gastrohep.2026.502714","url":null,"abstract":"<p><strong>Objective: </strong>Despite specific recommendations, immunization rates among patients with inflammatory bowel disease (IBD) remain suboptimal. This study aimed to assess vaccination management by exploring the concordance and discordance between physicians' reported vaccination recommendations and patients' recall of having received those recommendations, as well as patients' adherence following a medical recommendation.</p><p><strong>Patients and methods: </strong>An anonymous online survey was sent to 8000 patients from a national patient association (ACCU Spain) and 1000 members of the Spanish IBD Working Group (GETECCU).</p><p><strong>Results: </strong>A total of 144 physicians and 1302 patients responded (mean age of 43 years). Almost all physicians expressed concern about vaccination in IBD and 63% deemed them very important. Although 69% of physicians reported recommending influenza vaccination during pregnancy, only 11.1% of pregnant patients recalled having received such advice. Among patients who reported having received a vaccination recommendation, adherence varied widely by vaccine type, ranging from 55% for HPV to over 80% for influenza, pneumococcal, hepatitis B, and tetanus vaccines. The main reasons for non-adherence were the perception that vaccination was unnecessary and fear of adverse events.</p><p><strong>Conclusions: </strong>Discordance exists between physicians' reported vaccination practices and patients' recall of the information received. Although physicians awareness is high, communication gaps and other barriers may limit effective implementation.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502714"},"PeriodicalIF":1.9,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354721","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":"Progression of FIB-4 index predicts major adverse cardiovascular events in patients with metabolic dysfunction","authors":"Francisco Idalsoaga ,&nbsp;Verónica Cambindo ,&nbsp;Eduardo Fuentes-López ,&nbsp;Eitan Dukes ,&nbsp;Samuel Ibañez ,&nbsp;Paola Hunfan ,&nbsp;Constanza Mollo ,&nbsp;Jorge Gonzalez ,&nbsp;Gustavo Ayares ,&nbsp;Carolina Ramirez-Cadiz ,&nbsp;Francisco Barrera ,&nbsp;Monica Acevedo ,&nbsp;Patrick S. Kamath ,&nbsp;Richard Sterling ,&nbsp;Marco Arrese ,&nbsp;Luis Antonio Díaz ,&nbsp;Juan Pablo Arab","doi":"10.1016/j.gastrohep.2025.502608","DOIUrl":"10.1016/j.gastrohep.2025.502608","url":null,"abstract":"<div><h3>Introduction</h3><div>Metabolic dysfunction is highly prevalent worldwide and is associated with metabolic dysfunction-associated steatotic liver disease and an increased risk of cardiovascular disease. However, it remains unclear whether non-invasive tests assessing liver disease severity can predict major adverse cardiovascular events (MACEs).</div></div><div><h3>Objective</h3><div>We aimed to explore the relationship between changes in fibrosis-4 scores (FIB-4) and MACEs in patients with metabolic dysfunction.</div></div><div><h3>Patients and methods</h3><div>We conducted a retrospective cohort study including participants from a primary care clinic between 2009 and 2021, focusing on adults with metabolic dysfunction – risk of MASLD. We used FIB-4 to track MACEs over a 10-year follow-up period. Adjusted binomial regression models evaluated associations between FIB-4 progression (change in at least one stage of risk) and MACEs.</div></div><div><h3>Results</h3><div>We included 695 patients with a median age of 63.5 years [IQR 56–74]; 34.6% were women. Among them, 29% had diabetes mellitus, 21.5% had prediabetes, 58.1% had hypertension, and 93.3% had dyslipidemia. Patients who developed MACEs were older, had a higher proportion of men, and showed greater prevalence of hypertension, dyslipidemia, and obesity. Both baseline and final FIB-4 scores were higher in patients with MACEs. Adjusted analysis showed that FIB-4 progression was associated with a 106% increased risk of myocardial infarction (RR<!--> <!-->=<!--> <!-->2.06, 95% CI: 1.34–3.15; <em>p</em> <!-->=<!--> <!-->0.001), but not with an increased risk of stroke (RR<!--> <!-->=<!--> <!-->1.13, 95% CI: 0.73–1.74; <em>p</em> <!-->=<!--> <!-->0.591). Conversely, reductions in FIB-4 were protective for MI.</div></div><div><h3>Conclusions</h3><div>Progression and reduction in FIB-4 scores are associated with an increased and decreased risk of myocardial infarction, respectively, in patients with metabolic dysfunction.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 3","pages":"Article 502608"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426818","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":"Relevance of endoscopy and Helicobacter pylori infection in the preoperative management of obesity with sleeve gastrectomy","authors":"Mª Jesús Fernández Aceñero ,&nbsp;Lucía Olmos Rodríguez ,&nbsp;Carlos Galindo Fernández","doi":"10.1016/j.gastrohep.2025.502607","DOIUrl":"10.1016/j.gastrohep.2025.502607","url":null,"abstract":"<div><h3>Objectives</h3><div>Obesity has reached pandemic dimensions, representing a large health burden. Conservative therapy has recently been improved, but the most definitive therapy is still surgery. Gastric sleeve is one of the most frequent techniques. Preoperative guidelines sometimes recommend preoperative endoscopy. The aim of this study is to review the preoperative use of endoscopy in bariatric surgery and the possible importance of <em>Helicobacter pylori</em> therapy to avoid surgical complications.</div></div><div><h3>Patients and methods</h3><div>Retrospective case series of patients undergoing sleeve gastrectomy in two large hospitals. We have reviewed demographic data, associated pathologies, endoscopic findings prior to surgery, histopathological findings in the surgical resection specimen and rate of complications after surgery, as the outcome measure.</div></div><div><h3>Results</h3><div>455 patients fulfilled criteria for the study. 69% were women and the mean age was 46.93 (SD: 10.6). 68.7% of the patients show at least one comorbid disease, mainly dyslipidemia, but only 7.2% showed three or more comorbidities. Endoscopy was performed in 41.5% of the patients and biopsy in 35.8%, with significant differences between both hospitals. <em>H. pylori</em> were detected in 53 of the patients undergoing endoscopy and eradicated before surgery. <em>Helicobacter</em> was present in 7% of the surgical resection specimens, 68.75% of whom had not undergone a preoperative endoscopy. The postsurgical complication rate was 23.5% in our series and <em>H. pylori</em> was present in 20% of these patients.</div></div><div><h3>Conclusions</h3><div>Our study confirms the relevance of <em>Helicobacter</em> eradication before bariatric surgery, as <em>Helicobacter</em> infection is significantly linked to the surgical outcome in our area.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 3","pages":"Article 502607"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145400608","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":"Tuberculosis y enfermedad inflamatoria intestinal","authors":"Lucía Madero ,&nbsp;Iria Bastón ,&nbsp;Eduard Brunet-Mas ,&nbsp;Margalida Calafat ,&nbsp;Grupo Joven de GETECCU","doi":"10.1016/j.gastrohep.2025.502587","DOIUrl":"10.1016/j.gastrohep.2025.502587","url":null,"abstract":"<div><div>Inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, carries an increased risk of tuberculosis (TB), particularly in patients treated with immunosuppressive therapies such as anti-TNF agents. The risk is further elevated when combined with immunomodulators. Other drugs, including anti-integrins, IL-12/23 inhibitors, and JAK inhibitors (JAK-i), present a variable risk of TB reactivation. Given this risk, screening for latent tuberculosis infection (LTBI) is essential in IBD patients before initiating immunosuppressive therapy. Guidelines recommend performing this screening ideally at the time of IBD diagnosis or, alternatively, before advanced therapy. Diagnostic tests include the tuberculin skin test (TST) and interferon-gamma release assays (IGRA). In immunocompromised patients, false negatives may occur; therefore, dual testing is advised. Chest X-rays are reserved for cases with positive tests or clinical suspicion. In the presence of LTBI, chemoprophylaxis with isoniazid or rifampicin is recommended prior to initiating immunosuppression. If active TB is diagnosed, immunosuppressive therapy must be discontinued and standard antituberculous treatment initiated. The reintroduction of immunosuppressive therapy should be assessed on a case-by-case basis, prioritizing agents with lower reactivation risk. Finally, BCG vaccination is not recommended in IBD patients undergoing immunosuppressive treatment due to its nature as a live vaccine.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 3","pages":"Article 502587"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307822","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":"Eficacia de la inducción extendida intravenosa con risankizumab en enfermedad de Crohn refractaria","authors":"Marcos A. Rodríguez Amado,&nbsp;Aitor Villalba Campano,&nbsp;María Ruiz Sierras,&nbsp;Begoña Ortiz Pérez,&nbsp;Cristina Rubín de Célix ,&nbsp;Fernando Bermejo","doi":"10.1016/j.gastrohep.2025.502635","DOIUrl":"10.1016/j.gastrohep.2025.502635","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 3","pages":"Article 502635"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145700884","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":"Non-polypoid growth colorectal cancer","authors":"Joaquín Fisac Vázquez ,&nbsp;Aurora Burgos ,&nbsp;Laura Guerra Pastrián ,&nbsp;Vivian Díaz Castro","doi":"10.1016/j.gastrohep.2025.502605","DOIUrl":"10.1016/j.gastrohep.2025.502605","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 3","pages":"Article 502605"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512672","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":"Chilean Association of Digestive Endoscopy (ACHED) guidelines for the detection of early gastric cancer and surveillance of gastric premalignant conditions in high-risk populations","authors":"Gonzalo Latorre ,&nbsp;Alberto Espino ,&nbsp;Raúl Araya ,&nbsp;Matías Arteaga ,&nbsp;Harold Benites-Goñi ,&nbsp;María Ester Bufadel ,&nbsp;Dacio Cabrera-Hinojosa ,&nbsp;Roberto Candia ,&nbsp;Julian Cordero ,&nbsp;Oscar Corsi ,&nbsp;Pablo Cortés ,&nbsp;Felipe Donoso ,&nbsp;Fabian Emura ,&nbsp;Carolina Heredia ,&nbsp;Daniel Martínez ,&nbsp;Rodrigo Mansilla-Vivar ,&nbsp;Leticia Moreira ,&nbsp;Felipe Moscoso ,&nbsp;María Blanca Piazuelo ,&nbsp;Mauricio Pizarro ,&nbsp;Antonio Rollán","doi":"10.1016/j.gastrohep.2025.502633","DOIUrl":"10.1016/j.gastrohep.2025.502633","url":null,"abstract":"<div><div>Gastric cancer is one of the leading causes of cancer mortality in Chile. To optimize early detection and surveillance of gastric premalignant conditions, the Chilean Association of Digestive Endoscopy (ACHED), together with the Chilean Society of Gastroenterology, updated its 2014 clinical guideline. Using the AGREE II methodology, multidisciplinary working groups conducted systematic reviews in PubMed, Cochrane, and Scielo through December 2024. Recommendations were agreed upon <em>via</em> a Delphi panel (≥80% agreement) and graded according to GRADE, assessing evidence quality and recommendation strength. An expert panel of Chilean and international gastroenterology, endoscopy and pathology specialists reviewed the evidence and reached consensus to issue recommendations for opportunistic gastric cancer screening and surveillance using upper GI endoscopy in adults. These recommendations are feasible to implement in Chile and other Latin American countries with a high incidence of gastric cancer that have the necessary resources available. They complement any future efforts at population screening and aim to improve early detection and prognosis of gastric cancer in high-risk populations.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 3","pages":"Article 502633"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677261","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":"Association between triglyceride glucose-body mass index and chronic diarrhea: A cross-sectional study of NHANES 2005–2010 data","authors":"Jingjing Feng ,&nbsp;Liang Ding ,&nbsp;Tao Yang","doi":"10.1016/j.gastrohep.2025.502604","DOIUrl":"10.1016/j.gastrohep.2025.502604","url":null,"abstract":"<div><h3>Objective</h3><div>Insulin resistance (IR) and obesity are reported to impair physiological processes in the intestinal system, but associations between triglyceride glucose-body mass index (TyG-BMI), a marker of IR and obesity, and chronic diarrhea (CD) remain unclear. Thus, this study explored such relationship to provide novel insights for CD management.</div></div><div><h3>Patients and methods</h3><div>This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010. Univariate and multivariable logistic regression analyses were performed on weighted data to examined potential associations between TyG-BMI and CD. Additionally, subgroup analyses and interaction tests were performed.</div></div><div><h3>Results</h3><div>This research encompassed 5354 participants, including 416 with CD. In univariate logistic regression analyses, participants with high TyG-BMI had a significantly higher risk of CD (per 10 units, OR<!--> <!-->=<!--> <!-->1.041, 95% CI: 1.027–1.055). This connection was consistent (per 10 units, OR<!--> <!-->=<!--> <!-->1.038, 95% CI: 1.019–1.057) after adjusting for all confounding covariates. The smoothed curve fitting analysis and threshold effect analysis revealed a stronger positive association between TyG-BMI and chronic diarrhea at lower TyG-BMI levels (&lt;247.15, per 10 units: OR<!--> <!-->=<!--> <!-->1.098, 95% CI: 1.040–1.161 vs &gt;247.15: OR<!--> <!-->=<!--> <!-->1.024, 95% CI: 1.002–1.048). Furthermore, subgroup analyses and interaction tests suggested that the correlation between TyG-BMI and CD was more pronounced in those aged 20 to 44 years (per 10 units, OR<!--> <!-->=<!--> <!-->1.072, 95% CI: 1.043–1.103) or non-Hispanic whites (per 10 units, OR<!--> <!-->=<!--> <!-->1.068, 95% CI: 1.041–1.097).</div></div><div><h3>Conclusions</h3><div>This cross-sectional study revealed that TyG-BMI is positively associated with the risk of CD in US adults, especially in those aged 20–44 years or non-Hispanic whites. This association may provide new management strategies for CD.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 3","pages":"Article 502604"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388095","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":"On the need for patient-centered approaches to Helicobacter pylori management in geriatric populations","authors":"Camila S. Badell ,&nbsp;Eloy F. Ruiz","doi":"10.1016/j.gastrohep.2025.502583","DOIUrl":"10.1016/j.gastrohep.2025.502583","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 3","pages":"Article 502583"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174731","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}