Gastroenterologia y hepatologia最新文献

{"title":"Spanish Working Group in Crohn's Disease and Ulcerative Colitis (GETECCU) position paper on cardiovascular disease in patients with inflammatory bowel disease.","authors":"Ignacio Marín-Jiménez, Daniel Carpio, Vicent Hernández, Fernando Muñoz, Eduardo Zatarain-Nicolás, Yamile Zabana, Míriam Mañosa, Francisco Rodríguez-Moranta, Manuel Barreiro-de Acosta, Ana Gutiérrez Casbas","doi":"10.1016/j.gastrohep.2024.502314","DOIUrl":"10.1016/j.gastrohep.2024.502314","url":null,"abstract":"<p><p>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).</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502314"},"PeriodicalIF":2.2,"publicationDate":"2024-11-28","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":"Utilidad de la cápsula endoscópica de intestino delgado en los pacientes con enfermedad de Crohn","authors":"Miquel Marquès-Camí ,&nbsp;Nuria Torres-Monclús ,&nbsp;Lucía Madero ,&nbsp;Eduard Brunet-Mas ,&nbsp;Margalida Calafat ,&nbsp;Iria Baston-Rey ,&nbsp;Grupo Joven de GETECCU","doi":"10.1016/j.gastrohep.2024.502294","DOIUrl":"10.1016/j.gastrohep.2024.502294","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 3","pages":"Article 502294"},"PeriodicalIF":2.2,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695159","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":"Inflammatory bowel disease in the gypsy community in England and Scotland.","authors":"Affifa Farrukh, John F Mayberry","doi":"10.1016/j.gastrohep.2024.502295","DOIUrl":"10.1016/j.gastrohep.2024.502295","url":null,"abstract":"<p><strong>Introduction: </strong>The travelling community in England and Scotland may consist of between 150,000 and 500,000 members. In Scotland ethnicity codings for hospital admissions includes: Gypsies, Roma, Irish travellers and show people. Few Trusts in England break down codings for \"Other British\" in such detail.</p><p><strong>Method: </strong>One hundred and thirty-two NHS Trusts were approached in England and 14 NHS Boards in Scotland through a Freedom of Information request to provide details of admission to hospital between 2016 and 2022 with ulcerative colitis and had undergone a panproctocolectomy and those with Crohn's disease and had undergone a hemicolectomy.</p><p><strong>Results: </strong>Of the 132 NHS Trusts approached in England only 7 were able to provide data on hospital admissions for inflammatory bowel disease from this community; whereas in Scotland 13 of 14 did so. There were 1012 admissions with ulcerative colitis and based on the number of admissions per patient in Somerset NHS Foundation Trust this would represent 138 patients. In contrast, there were 901 admissions with Crohn's disease and at least 9 patients underwent a hemicolectomy.</p><p><strong>Conclusion: </strong>The inadequacy of data collection related to this community is discussed.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502295"},"PeriodicalIF":2.2,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709950","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":"Endoscopic ultrasound-directed transgastric ERCP (EDGE) - An effective approach for bile duct stone treatment after gastric bypass.","authors":"Ivo Mendes, Francisco Vara-Luiz, Gonçalo Nunes, Júlio Veloso, Jorge Fonseca, Pedro Pinto-Marques","doi":"10.1016/j.gastrohep.2024.502293","DOIUrl":"10.1016/j.gastrohep.2024.502293","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502293"},"PeriodicalIF":2.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686892","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":"Gallstone ileus due to cholecystocolonic fistula with transverse colon.","authors":"Laia Codina Corrons, Maite Santamaría Gómez, Núria Mestres Petit, Alfredo Escartín Arias","doi":"10.1016/j.gastrohep.2024.502292","DOIUrl":"10.1016/j.gastrohep.2024.502292","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502292"},"PeriodicalIF":2.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686893","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":"Periendoscopic management of antithrombotic drugs: Is cold snare polypectomy the answer?","authors":"Victor Argumánez ,&nbsp;Gema Plumé ,&nbsp;Marco Bustamante-Balén","doi":"10.1016/j.gastrohep.2024.502286","DOIUrl":"10.1016/j.gastrohep.2024.502286","url":null,"abstract":"<div><div>Patients undergoing colonoscopy are increasingly taking antithrombotic medication. These patients, who are generally older, also have a higher prevalence of colon polyps. Therefore, it is general practice to modify or discontinue antithrombotic treatment before colonoscopy, to reduce the risk of post-polypectomy bleeding (PPB). However, this modification increases the risk of thrombotic events. Currently, the main clinical guidelines recommend cold-snare resection for polyps smaller than 10<!--> <!-->mm because of its better safety profile, especially in reducing post-polypectomy bleeding. This reduced PPB rate could open the door to maintaining antithrombotic drugs in patients undergoing colonoscopy. This review aims to evaluate the evidence available so far that may support a modification of current guidelines on the management of antithrombotic drugs in the periendoscopic period.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 4","pages":"Article 502286"},"PeriodicalIF":2.2,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643819","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":"Acute cholestatic hepatitis secondary to idiopathic adult ductopenia.","authors":"Julia López De-La-Cruz, María Concepción Aso Gonzalvo, María Ortíz de Solórzano Reig, Antonio Aguilar Muñiz, Marta Latre Santos, Enrique Ceamanos Ibarra, María Escuín Sanmartín, Guillén Bernal Bandrés, Sergio García Mateo, Luis Cortés García","doi":"10.1016/j.gastrohep.2024.502289","DOIUrl":"10.1016/j.gastrohep.2024.502289","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502289"},"PeriodicalIF":2.2,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643818","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":"Real-world clinical characteristics and therapeutic strategies in patients with moderate-to-severe inflammatory bowel disease in Argentina: Data from the RISE-AR study.","authors":"Pablo Andres Olivera, Domingo Balderramo, Juan Sebastian Lasa, Ignacio Zubiaurre, Gustavo Correa, Pablo Lubrano, Orlando Ruffinengo, Martin Yantorno, Astrid Rausch, Gisela Piñero, Andrea Bolomo, Carla Amigo, Jazmin El-Hakeh, Daiana Beatriz Leonardi, Laura Brion, Alicia Sambuelli","doi":"10.1016/j.gastrohep.2024.502287","DOIUrl":"10.1016/j.gastrohep.2024.502287","url":null,"abstract":"<p><strong>Objective: </strong>Real-world evidence on the adoption of different pharmacological strategies in inflammatory bowel disease (IBD) in Latin America is scarce. Herein, we describe real-world sociodemographic, clinical characteristics, and different therapeutic approaches used in patients with IBD in Argentina.</p><p><strong>Methods: </strong>RISE AR (NCT03488030) was a multicenter, non-interventional study with a cross-sectional evaluation and a 3-year retrospective chart review conducted in Argentina. Adult patients with a previous diagnosis of moderate-to-severe ulcerative colitis (UC) or Crohn's disease (CD) at least 6 months prior to enrollment were included.</p><p><strong>Results: </strong>This study included 246 patients with IBD (CD: 41%; UC: 59%), with a median age of 39.5 years (IQR 30.7-51.7) for CD and 41.9 years (33.3-55.3) for UC. Overall, 51.5% of CD patients had colonic disease involvement, while 45.5% of UC patients had extensive colitis. At enrollment, the overall use of biologics was high, especially in CD patients (CD: 73.2% vs. UC: 30.3%, p<0.001), while the use of immunosuppressants was similar (∼41%, p=1.000) for both diseases. IBD treatments ever prescribed and healthcare resources utilization during the retrospective period were (CD, UC): biologics: 79.2%, 33.8% (p<0.001); immunosuppressants: 65.3%, 58.6% (p=0.352); aminosalicylates: 62.4%, 97.9% (p<0.001); corticosteroids: 55.4%, 69.7% (p=0.031); surgery: 17.8%, 1.4% (p<0.001); and hospitalizations: 33.7%, 21.4% (p=0.039).</p><p><strong>Conclusion: </strong>In this cohort of IBD patients, overall prescription patterns of conventional therapy were similar to reports elsewhere; however, biologic therapy use was high, especially in CD, consistent with disease behavior and possibly reflecting better access to care in referral centers. Interestingly, over half of CD patients presented colonic involvement.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502287"},"PeriodicalIF":2.2,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643820","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":"Externalized nurse-led model for hepatitis C virus microelimination and impact of drug use profile.","authors":"Anna Miralpeix, Paula Ibáñez, Víctor Navarro, Patricia Colomera, Montserrat Gálvez, Zoe Mariño, Xavier Major, Joan Colom, Xavier Forns, Sabela Lens","doi":"10.1016/j.gastrohep.2024.502288","DOIUrl":"10.1016/j.gastrohep.2024.502288","url":null,"abstract":"<p><strong>Background and objective: </strong>Direct-acting antivirals have greatly simplified the treatment of hepatitis C virus (HCV), yet circuits that bring diagnosis and treatment closer to people who inject drugs (PWID) are needed to achieve the elimination targets of the WHO. With this purpose we have established an externalized nurse-driven circuit among former and active PWID in an addiction centre (AC) and a harm reduction centre (HRC).</p><p><strong>Methods and settings: </strong>The nursing staff offered HCV screening, diagnosis and treatment to the AC and HRC users, administered medication after the hepatologist's remote prescription to those with an active infection who accepted being treated, and implemented educational and harm reduction interventions.</p><p><strong>Participants and results: </strong>Between October 2018 and March 2021, 566 users accepted screening. 134 (24%) had an active infection, with a higher prevalence among HRC users (42% vs 17%; p<0.001), who were more frequently foreigners, homeless and reported active drug use and syringe sharing. Treatment initiation was similar between groups. Overall sustained viral response (SVR) for intention-to-treat (ITT) and per protocol (PP) was 70% and 88% respectively. Overall adherence was good in both groups; however, SVR was higher in AC users compared to HRC users (ITT-SVR 81% vs 55%). All reinfections (6% by ITT) occurred in the HRC group. Overall loss to follow-up rate was 21%.</p><p><strong>Conclusions: </strong>This patient-centred nurse-driven circuit demonstrates that HCV treatment can be successfully delivered to PWID even with active drug use and socio-economic complexity. User-specific characteristics need to be considered when setting up these interventions to maximize success.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502288"},"PeriodicalIF":2.2,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638648","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":"Granulocyte and monocyte adsorptive apheresis (GMA) in patients with inflammatory bowel disease: A useful therapeutic tool not just in ulcerative colitis but also in Crohn's disease","authors":"","doi":"10.1016/j.gastrohep.2024.502196","DOIUrl":"10.1016/j.gastrohep.2024.502196","url":null,"abstract":"<div><h3>Introduction</h3><div>Granulocyte and monocyte adsorptive apheresis (GMA) removes neutrophils and monocytes from peripheral blood, preventing their incorporation into the inflamed tissue also influencing cytokine balance. Published therapeutic efficacy in ulcerative colitis (UC) is more consistent than in Crohn's disease (CD). We assessed clinical efficacy of GMA in UC and CD 4 weeks after last induction session, at 3 and 12 months, sustained remission and corticosteroid-free remission.</div></div><div><h3>Patients and method</h3><div>Retrospective observational study of UC and CD patients treated with GMA. Partial Disease Activity Index-DAIp in UC and Harvey-Bradshaw Index-HBI in CD assessed efficacy of Adacolumn® with induction and optional maintenance sessions.</div></div><div><h3>Results</h3><div>We treated 87 patients (CD-25, UC-62), 87.3% corticosteroid-dependent (CSD), 42.5% refractory/intolerant to immunomodulators. In UC, remission and response were 32.2% and 19.3% after induction, 35.5% and 6.5% at 12 weeks and 29% and 6.5% at 52 weeks. In CD, remission rates were 60%, 52% and 40% respectively. In corticosteroid-dependent and refractory or intolerant to INM patients (UC-41, CD-14), 68.3% of UC achieved remission or response after induction, 51.2% at 12 weeks and 46.3% at 52 weeks, and 62.3%, 64.3% and 42.9% in CD. Maintained remission was achieved by 66.6% in CD and 53.1% in UC. Up to 74.5% of patients required corticosteroids at some timepoint. Corticosteroid-free response/remission was 17.7% in UC and 24% in CD.</div></div><div><h3>Conclusions</h3><div>GMA is a good therapeutic tool for both in UC and CD patients. In corticosteroid-dependent and refractory or intolerant to INM patients it avoids biological therapy or surgery in up to 40% of them in one year.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"47 9","pages":"Article 502196"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864444","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}