Gastroenterologia y hepatologia最新文献

{"title":"Documento de posicionamiento del Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa (GETECCU) sobre la enfermedad cardiovascular en los pacientes con enfermedad inflamatoria intestinal","authors":"Ignacio Marín-Jiménez ,&nbsp;Daniel Carpio ,&nbsp;Vicent Hernández ,&nbsp;Fernando Muñoz ,&nbsp;Eduardo Zatarain-Nicolás ,&nbsp;Yamile Zabana ,&nbsp;Míriam Mañosa ,&nbsp;Francisco Rodríguez-Moranta ,&nbsp;Manuel Barreiro-de Acosta ,&nbsp;Ana Gutiérrez Casbas","doi":"10.1016/j.gastrohep.2024.502314","DOIUrl":"10.1016/j.gastrohep.2024.502314","url":null,"abstract":"<div><div>Cardiovascular diseases (CVD) are the leading cause of death worldwide. Therefore, it is essential to understand their relationship and prevalence in different diseases that may present specific risk factors for them. The objective of this document is to analyze the specific prevalence of CVD in patients with inflammatory bowel disease (IBD), describing the presence of classical and non-classical cardiovascular risk factors in these patients. Additionally, we will detail the pathophysiology of atherosclerosis in this patient group and the different methods used to assess cardiovascular risk, including the use of risk calculators in clinical practice and different ways to assess subclinical atherosclerosis and endothelial dysfunction. Furthermore, we will describe the potential influence of medication used for managing patients with IBD on cardiovascular risk, as well as the potential influence of commonly used drugs for managing CVD on the course of IBD. The document provides comments and evidence-based recommendations based on available evidence and expert opinion. An interdisciplinary group of gastroenterologists specialized in IBD management, along with a consulting cardiologist for this type of patients, participated in the development of these recommendations by the Spanish Group of Work on Crohn's Disease and Ulcerative Colitis (GETECCU).</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 5","pages":"Article 502314"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768283","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 diagnostic efficacy of metagenomic next-generation sequencing in spontaneous bacterial peritonitis: System review and meta-analysis.","authors":"Chen Wang, Hongru Zhang, Jingya Liu","doi":"10.1016/j.gastrohep.2025.502456","DOIUrl":"10.1016/j.gastrohep.2025.502456","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this research is to assess the accuracy and reliability of metagenomic next-generation sequencing (mNGS) in identifying pathogens in spontaneous bacterial peritonitis (SBP) patients and its impact on antibiotic treatment decisions.</p><p><strong>Methods: </strong>Electronic databases were searched up to July 31, 2023. Studies reporting mNGS diagnostic sensitivity and specificity in SBP were included. Random or fixed-effects models were used. Heterogeneity was assessed using Chi-squared test and I² statistics.</p><p><strong>Results: </strong>Out of 75 identified studies, four studies with a total of 420 SBP patients were included. The pooled sensitivity for mNGS in ascites was 94% (95% CI: 86-97%), and specificity was 81% (95% CI: 71-89%). The AUC was calculated to be 0.95 (95% CI: 0.92-0.96), indicating high diagnostic accuracy. The most common pathogens identified by mNGS were Gram-positive bacteria (36%), followed by Gram-negative bacteria (29%), viruses (22%), and fungi (11%).</p><p><strong>Conclusion: </strong>mNGS shows high diagnostic accuracy in detecting pathogens in SBP patients, offering significant value in optimizing antimicrobial therapy. Its ability to identify a broad spectrum of pathogens makes it a promising tool in clinical management of SBP.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502456"},"PeriodicalIF":2.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008471","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":"Timing of endoscopy in high-risk patients with acute upper gastrointestinal bleeding: Results of a multicenter international cohort study.","authors":"Javier Tejedor-Tejada, Benito Hermida, Cristina Camblor, Mohamed Emara, Salem Youssef Mohamed, Jose M Perez-Pariente","doi":"10.1016/j.gastrohep.2025.502455","DOIUrl":"10.1016/j.gastrohep.2025.502455","url":null,"abstract":"<p><strong>Objective: </strong>The optimal timing for high-risk patients with acute upper gastrointestinal bleeding (AUGIB) remains uncertain. The study aimed to evaluate whether the timing of endoscopy influences outcomes in high-risk patients with AUGIB.</p><p><strong>Patients and methods: </strong>We conducted a retrospective, international, multicenter cohort study. High-risk patients (Glasgow-Blatchford score >7 points) with AUGIB, who underwent therapeutic endoscopy between September and December 2023 (n=511), were recruited. Patients were classified into three groups based on endoscopic timing: urgent (t≤6h), early (6<t≤24h) and elective (t>24h). Using descriptive statistics and logistic regression analyses, we identified the optimal timing for endoscopy and analyzed its association with 30-day outcomes, adjusting for confounding factors.</p><p><strong>Results: </strong>The results showed that urgent timing (n=130) was associated with worse outcomes compared to early (n=205) and elective (n=176) endoscopy, including higher 30-day all-cause mortality (p=0.047), increased rates of repeat endoscopy (p=0.034), higher 30-day transfusion rates (p=0.021), and longer lengths of stay (p=0.038). These findings were particularly consistent among patients admitted with non-variceal bleeding. In the multivariate analysis, urgent endoscopy (OR 2.47, 1.28-4.57), Charlson index (OR 1.39, 1.01-1.93), systolic blood pressure <90mmHg (OR 3.66, 1.44-9.31), tachycardia (OR 1.02, 1.01-1.05), and malignancy (OR 1.68, 1.37-7.73) were identified as worse prognostic factors.</p><p><strong>Conclusions: </strong>High-risk patients with AUGIB who underwent urgent endoscopy exhibited worse outcomes, particularly those patients with non-variceal bleeding. Comorbidities, shock, urgent endoscopy and malignancy were identified as predictors of 30-day mortality. These findings highlight the importance of prior resuscitation, pharmacotherapy, and early endoscopy.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502455"},"PeriodicalIF":2.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010926","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":"Splanchnic vein thrombosis in acute pancreatitis: Answering key questions","authors":"Daniel Oyon ,&nbsp;Federico Bolado","doi":"10.1016/j.gastrohep.2025.502454","DOIUrl":"10.1016/j.gastrohep.2025.502454","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 7","pages":"Article 502454"},"PeriodicalIF":2.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988527","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 del Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa (GETECCU) para el manejo de la enfermedad fistulizante no perianal en la enfermedad de Crohn","authors":"Iago Rodríguez-Lago ,&nbsp;Diego Casas-Deza ,&nbsp;Jordi Rimola ,&nbsp;Margalida Calafat ,&nbsp;Rocío Ferreiro-Iglesias ,&nbsp;Gianluca Pellino ,&nbsp;Nicolás Avellaneda ,&nbsp;Marisa Iborra ,&nbsp;Manuel Barreiro-de Acosta ,&nbsp;Ana Gutiérrez Casbas ,&nbsp;Luis Menchén ,&nbsp;Ingrid Ordás ,&nbsp;Francisco Rodríguez-Moranta ,&nbsp;Yamile Zabana","doi":"10.1016/j.gastrohep.2025.502450","DOIUrl":"10.1016/j.gastrohep.2025.502450","url":null,"abstract":"<div><div>Crohn's disease consists on a complex condition where, despite most patients initially present with an inflammatory behavior, a significant proportion develop complicated lesions such as strictures, fistulas, abscesses, or even perforations. These lesions progressively increase over time and are associated with a higher risk of surgery and hospitalization. Despite significant advances in their management after the introduction of biological therapies, particularly anti-TNF agents, these complications continue to pose challenges for the multiple professionals involved in their care.</div><div>Fistulas that do not involve the perianal region (entero-enteric, entero-urinary, or entero-cutaneous) require a multidisciplinary strategy that combines medical, interventional, and surgical approaches. Their treatment ranges from general supportive measures to the use of antibiotics or, frequently, advanced therapies. Nevertheless, in cases of certain septic complications or those refractory to medical treatment, percutaneous drainage or surgical intervention remains essential.</div><div>Although these lesions have a significant impact, evidence regarding the best strategies in this context, as well as the efficacy and safety of different therapies in these patients, remains limited. This is highlighted by the absence of specific recommendations in current guidelines. The objective of this document is to provide a comprehensive overview of non-perianal fistulizing Crohn's disease, addressing its epidemiological, clinical, and therapeutic aspects from a multidisciplinary perspective.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 7","pages":"Article 502450"},"PeriodicalIF":2.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015005","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":"Hemostasis management optimization in patients with advanced chronic liver disease","authors":"Alejandro Fernández Soro ,&nbsp;Carlos Alventosa-Mateu ,&nbsp;David Martí-Aguado ,&nbsp;Inmaculada Castelló Miralles ,&nbsp;Mercedes Latorre Sánchez ,&nbsp;Juan José Urquijo Ponce","doi":"10.1016/j.gastrohep.2025.502453","DOIUrl":"10.1016/j.gastrohep.2025.502453","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 8","pages":"Article 502453"},"PeriodicalIF":1.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014246","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":"Influence of nursing advice on influenza vaccination in patients with hepatic oncologic disease","authors":"M. José Sánchez-Iturri ,&nbsp;Carmen Alonso ,&nbsp;Eva Zapata ,&nbsp;Cristina Sarasqueta ,&nbsp;Agustín Castiella","doi":"10.1016/j.gastrohep.2025.502448","DOIUrl":"10.1016/j.gastrohep.2025.502448","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 8","pages":"Article 502448"},"PeriodicalIF":1.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969676","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":"Infección por citomegalovirus como causa infrecuente de reservoritis","authors":"Marta Carreras i Hoyos ,&nbsp;Alba Correa Bonito ,&nbsp;Javier García Septiem ,&nbsp;Silvia Eugenia Barreta Vargas ,&nbsp;Francisco Viamontes Ugalde ,&nbsp;Fernando Gijón Moya ,&nbsp;Marta del Carmen Álvarez Hernández ,&nbsp;Elena Martín Pérez","doi":"10.1016/j.gastrohep.2025.502449","DOIUrl":"10.1016/j.gastrohep.2025.502449","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 7","pages":"Article 502449"},"PeriodicalIF":2.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963846","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":"Spontaneous cholecysto-cutaneous fistula in a patient with peritoneal carcinomatosis.","authors":"Miriam Bragado Pascual, Rosanna Villanueva Hernández, M Pilar Delgado Alvarez, Luis Ricardo Gotuzzo Altez, Juan Manuel Blanco Esteban","doi":"10.1016/j.gastrohep.2025.502447","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502447","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502447"},"PeriodicalIF":2.2,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997197","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":"Guía de práctica clínica multidisciplinar de manejo de la esteatosis hepática metabólica","authors":"Manuel Romero-Gómez ,&nbsp;Javier Escalada ,&nbsp;Mar Noguerol ,&nbsp;Antonio Pérez ,&nbsp;Juana Carretero ,&nbsp;Javier Crespo ,&nbsp;Juan J. Mascort ,&nbsp;Ignacio Aguilar ,&nbsp;Francisco Tinahones ,&nbsp;Pedro Cañones ,&nbsp;Ricardo Gómez-Huelgas ,&nbsp;Daniel de Luis ,&nbsp;Idoia Genúa Trullos ,&nbsp;Rocío Aller ,&nbsp;Miguel A. Rubio","doi":"10.1016/j.gastrohep.2025.502442","DOIUrl":"10.1016/j.gastrohep.2025.502442","url":null,"abstract":"<div><div>Metabolic hepatic steatosis (MetHS) is a clinically heterogeneous, multisystemic, dynamic, and complex disease, whose progression is one of the main causes of cirrhosis and hepatocarcinoma. This clinical practice guideline aims to respond to its main challenges, both in terms of disease burden and complexity. To this end, recommendations have been proposed to experts through the Delphi method. The consensus was optimal in recommendations regarding type 2 diabetes as a risk factor (1.5.1, 4.5.1), in which cases early detection of MetHS should be carried out (4.5.2). Its results also emphasize the importance of the use of non-invasive tests (FIB-4, NFS, HFS) for the exclusion of significant fibrosis in patients with suspected MetHS (2.3.1, 2.3.3). Diagnosis should be carried out through the sequential combination of non-invasive indices and transient elastography by FibroScan® for its risk stratification (2.3.3). A nearly unanimous consensus was reached regarding the role of early prevention in the impact on the quality of life and survival of patients (5.1.2), as well as on the effectiveness of the Mediterranean diet and physical exercise in relation to the improvement of steatosis, steatohepatitis and fibrosis in MetHS patients (5.2.2) and on the positive results offered by resmiterom and semaglutide in promoting fibrosis regression (5.4.1). Finally, a great consensus has been reached regarding the importance of multidisciplinary management in MetHS, for which it is essential to agree on multidisciplinary protocols for referral between levels in each health area (6.2.1), as well as ensuring that referrals to Hepatology/Digestive and Endocrinology or Internal Medicine services are effective and beneficial to prevent the risk of disease progression (6.2.3, 6.3.1).</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 8","pages":"Article 502442"},"PeriodicalIF":1.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992797","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}