Gastroenterologia y hepatologia最新文献

{"title":"Resultados clínicos y manométricos de la miotomía endoscópica peroral en pacientes con acalasia: experiencia en un centro de referencia latinoamericano","authors":"","doi":"10.1016/j.gastrohep.2024.01.010","DOIUrl":"10.1016/j.gastrohep.2024.01.010","url":null,"abstract":"<div><h3>Introduction</h3><p>Currently there is little information in Latin America on the clinical outcome and manometric evolution of patients with Achalasia undergoing peroral endoscopic myotomy (POEM).</p></div><div><h3>Primary outcome</h3><p>Evaluate the manometric and clinical changes in adult patients with achalasia after peroral endoscopic myotomy at a referral center in Bogotá, Colombia.</p></div><div><h3>Methods</h3><p>Observational, analytical, longitudinal study. Adult patients with achalasia according to the Chicago 4.0 criteria were included. Sociodemographic, clinical and manometric variables were described. To compare the pre- and post-surgical variables, the Student's or Wilcoxon's t test was used for the quantitative variables according to their normality, and McNemar's chi-square for the qualitative variables.</p></div><div><h3>Results</h3><p>29 patients were included, 55.17% (n<!--> <!-->=<!--> <!-->16) women, with a mean age at the time of surgery of 48.2 years (±11.33). The mean post-procedure evaluation time was 1.88<!--> <!-->±<!--> <!-->0.81 years. After the procedure, there was a significant decrease in the proportion of patients with weight loss (37.93% vs 21.43% p 0.0063), chest pain (48.28% vs 21.43, p 0.0225) and the median Eckardt score (8 (IQR 8 -9) vs 2(IQR 1-2), p &lt;<!--> <!-->0.0001). In addition, in fourteen patients with post-surgical manometry, significant differences were found between IRP values (23.05<!--> <!-->±<!--> <!-->14.83<!--> <!-->mmHg vs 7.69<!--> <!-->±<!--> <!-->6.06<!--> <!-->mmHg, p 0.026) and in the mean lower esophageal sphincter tone (9.63<!--> <!-->±<!--> <!-->7.2<!--> <!-->mmHg vs 28.8<!--> <!-->±<!--> <!-->18.60<!--> <!-->mmHg, p 0.0238).</p></div><div><h3>Conclusion</h3><p>Peroral endoscopic myotomy has a positive impact on the improvement of symptoms and of some manometric variables (IRP and LES tone) in patients with achalasia.</p></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691650","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":"Incidencia de herpes zóster en pacientes con enfermedad inflamatoria intestinal: estudio observacional y retrospectivo en dos hospitales españoles de tercer nivel","authors":"Anna Calm ,&nbsp;Margalida Calafat ,&nbsp;Carlos González-Muñoza ,&nbsp;Fiorella Cañete ,&nbsp;Cristina Roig ,&nbsp;Míriam Mañosa ,&nbsp;Esther García-Planella ,&nbsp;Eugeni Domènech","doi":"10.1016/j.gastrohep.2024.01.011","DOIUrl":"10.1016/j.gastrohep.2024.01.011","url":null,"abstract":"<div><h3>Background</h3><p>Herpes zoster (HZ) is a prevalent disease caused by the reactivation of the varicella-zoster virus (VZV) and associated with chronic morbidity, particularly with post-herpetic neuralgia (PHN). Inflammatory bowel disease (IBD) has been associated with an increased risk of HZ, mainly when immunosuppressive treatment (IMT) is used. However, studies assessing the risk of HZ in IBD are scarce.</p></div><div><h3>Aims</h3><p>To evaluate the incidence rate and risk factors of HZ in IBD.</p></div><div><h3>Methods</h3><p>Retrospective study in IBD patients with a positive VVZ serology from two referral hospitals from the area of Barcelona. Diagnosis of HZ and its clinical features were recorded.</p></div><div><h3>Results</h3><p>A total of 398 IBD patients with a positive IgG-VVZ serology were identified. Fifty-eight percent of the patients received IMT (46.5% immunosuppressants monotherapy, 20.6% biologics monotherapy and, 32.7% combination therapy). After a median follow-up of 71 months (IQR 41.5-138.0), 17 (4.3%) patients developed HZ (cumulative incidence of 5.2 per 1000 person-year), 12 of them (70.6%) while receiving IMT. Median age at HZ episode was 38 years (IQR 27.5-52.5). Two (11%) developed PHN. Biological therapy was the only risk factor for developing HZ (OR 3.8 IC 95% 1.3-11.5; p<!--> <!-->=<!--> <!-->0.018).</p></div><div><h3>Conclusions</h3><p>HZ is quite prevalent in IBD, occurring at early ages and particularly among patients using IMT. NPH appears to occur in a notable proportion of cases.</p></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691651","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":"Monitorización terapéutica de los fármacos biológicos en la enfermedad inflamatoria intestinal. Documento de Posicionamiento del Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa (GETECCU)","authors":"Francisco Rodríguez-Moranta ,&nbsp;Federico Argüelles-Arias ,&nbsp;Joaquín Hinojosa del Val ,&nbsp;Marisa Iborra Colomino ,&nbsp;M. Dolores Martín-Arranz ,&nbsp;Luis Menchén Viso ,&nbsp;Fernando Muñoz Núñez ,&nbsp;Elena Ricart Gómez ,&nbsp;José Germán Sánchez-Hernández ,&nbsp;Teresa Valdés-Delgado ,&nbsp;Jordi Guardiola Capón ,&nbsp;Manuel Barreiro-de Acosta ,&nbsp;Míriam Mañosa Ciria ,&nbsp;Yamile Zabana Abdo ,&nbsp;Ana Gutiérrez Casbas","doi":"10.1016/j.gastrohep.2024.01.007","DOIUrl":"10.1016/j.gastrohep.2024.01.007","url":null,"abstract":"<div><p>The treatment of inflammatory bowel disease has undergone a significant transformation following the introduction of biologic drugs. Thanks to these drugs, treatment goals have evolved from clinical response and remission to more ambitious objectives, such as endoscopic or radiologic remission. However, even though biologics are highly effective, a significant percentage of patients will not achieve an initial response or may lose it over time. We know that there is a direct relationship between the trough concentrations of the biologic and its therapeutic efficacy, with more demanding therapeutic goals requiring higher drug levels, and inadequate exposure being common.</p><p>Therapeutic drug monitoring of biologic medications, along with pharmacokinetic models, provides us with the possibility of offering a personalized approach to treatment for patients with IBD. Over the past few years, relevant information has accumulated regarding its utility during or after induction, as well as in the maintenance of biologic treatment, in reactive or proactive strategies, and prior to withdrawal or treatment de-escalation.</p><p>The aim of this document is to establish recommendations regarding the utility of therapeutic drug monitoring of biologics in patients with inflammatory bowel disease, in different clinical practice scenarios, and to identify areas where its utility is evident, promising, or controversial.</p></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S021057052400027X/pdfft?md5=3d7d6fe14d0abfd8da795012af26f181&pid=1-s2.0-S021057052400027X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139680940","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":"Chilean consensus by expert panel using the Delphi technique for primary and secondary prevention of gastric cancer.","authors":"Óscar Corsi Sotelo, Margarita Pizarro Rojas, Antonio Rollán Rodríguez, Verónica Silva Figueroa, Raúl Araya Jofré, María Ester Bufadel Godoy, Pablo Cortés González, Robinson González Donoso, Eduardo Fuentes López, Gonzalo Latorre Selvat, Patricio Medel-Jara, Diego Reyes Placencia, Mauricio Pizarro Véliz, María Jesús Garchitorena Marqués, María Trinidad Zegers Vial, Francisca Crispi Galleguillos, Manuel A Espinoza, Arnoldo Riquelme Pérez","doi":"10.1016/j.gastrohep.2024.01.008","DOIUrl":"10.1016/j.gastrohep.2024.01.008","url":null,"abstract":"<p><strong>Introduction: </strong>Gastric cancer (GC) is the first cause of cancer-related death in Chile and 6^th in Latin America and the Caribbean (LAC). Helicobacter pylori (H. pylori) is the main gastric carcinogen, and its treatment reduces GC incidence and mortality. Esophageal-gastro-duodenoscopy (EGD) allows for the detection of premalignant conditions and early-stage GC. Mass screening programs for H. pylori infection and screening for premalignant conditions and early-stage GC are not currently implemented in LAC. The aim of this study is to establish recommendations for primary and secondary prevention of GC in asymptomatic standard-risk populations in Chile.</p><p><strong>Methods: </strong>Two on-line synchronous workshops and a seminar were conducted with Chilean experts. A Delphi panel consensus was conducted over 2 rounds to achieve>80% agreement on proposed primary and secondary prevention strategies for the population stratified by age groups.</p><p><strong>Results: </strong>10, 12, and 12 experts participated in two workshops and a seminar, respectively. In the Delphi panel, 25 out of 37 experts (77.14%) and 28 out of 52 experts (53.85%) responded. For the population aged 16-34, there was no consensus on non-invasive testing and treatment for H. pylori, and the use of EGD was excluded. For the 35-44 age group, non-invasive testing and treatment for H. pylori is recommended, followed by subsequent test-of-cure using non-invasive tests (stool antigen test or urea breath test). In the ≥45 age group, a combined strategy is recommended, involving H. pylori testing and treatment plus non-invasive biomarkers (H. pylori IgG serology and serum pepsinogens I and II); subsequently, a selected group of subjects will undergo EGD with gastric biopsies (Sydney Protocol), which will be used to stratify surveillance according to the classification Operative Link for Gastritis Assessment (OLGA); every 3 years for OLGA III-IV and every 5 years for OLGA I-II.</p><p><strong>Conclusion: </strong>A \"test-and-treat\" strategy for H. pylori infection based on non-invasive studies (primary prevention) is proposed in the 35-44 age group, and a combined strategy (serology and EGD) is recommended for the ≥45 age group (primary and secondary prevention). These strategies are potentially applicable to other countries in LAC.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139680939","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 experience of vedolizumab use in Colombian patients with inflammatory bowel disease-EXVEDOCOL.","authors":"Viviana Parra, Sandra Cifuentes, Sandra Avendaño, Enrique Ponce de León, Cristian Florez, Gustavo Reyes, Fabian Puentes, Manuel Ballesteros, Edilberto Nuñez, Federico Gómez, Juan Ricardo Márquez","doi":"10.1016/j.gastrohep.2024.01.009","DOIUrl":"10.1016/j.gastrohep.2024.01.009","url":null,"abstract":"<p><strong>Background: </strong>Real-world studies about the effectiveness and safety of vedolizumab (VDZ) in the treatment of inflammatory bowel disease (IBD) in Latin America are scarce. Our study describes the effectiveness and safety of VDZ in Colombian patients with IBD.</p><p><strong>Methods: </strong>EXVEDOCOL (EXperience of VEDOlizumab in COLombia) was a retrospective, multicenter, observational study. Adults with IBD receiving a first dose of VDZ between July 2016 and October 2018 were included. The co-primary outcomes clinical response, and remission, were determined at week 14 and last visit during the maintenance phase (LVMP). The secondary outcomes, deep remission and loss of response were recorded at LVMP.</p><p><strong>Results: </strong>Thirty-one patients (25 ulcerative colitis (UC), 6 Crohn's disease (CD)) were included. At week 14, clinical response was achieved by 87.1% (27/31) of the patients treated with VDZ, while loss of response was reported in 6.7% (2/30). The remission rate at week 14 was 65.5% (19/29) and 75.9% (22/29) at LVMP. Prior anti-TNF exposure was reported in 61.3% (19 patients) of whom 84.2% (16/19) achieved clinical response at week 14 and 89.5% (17/19) at LVMP. For anti-TNF naïve patients, clinical response was recorded in 91.7% (11/12) at week 14 and 100% (12/12) at LVMP.</p><p><strong>Conclusions: </strong>High clinical remission rates and safety profile highlight VDZ as a valuable treatment option for IBD patients. Anti-TNF naïve patients may derive greater benefit from therapy. Studies with larger cohorts could confirm these findings.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139680941","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":"Agreement between the perception of colon cleansing reported by patients and colon cleansing assessed by a validated colon cleansing scale","authors":"Antonio Z. Gimeno-García ,&nbsp;Federica Benítez-Zafra ,&nbsp;Anjara Hernández ,&nbsp;Domingo Hernandez-Negrín ,&nbsp;David Nicolás-Pérez ,&nbsp;Goretti Hernández ,&nbsp;José Luis Baute-Dorta ,&nbsp;Yaiza Cedrés ,&nbsp;Rocío del-Castillo ,&nbsp;Jorge Mon ,&nbsp;Alejandro Jiménez ,&nbsp;Marco A. Navarro-Dávila ,&nbsp;Eduardo Rodríguez-Hernández ,&nbsp;Onofre Alarcon ,&nbsp;Rafael Romero ,&nbsp;Vanessa Felipe ,&nbsp;Noemi Segura ,&nbsp;Manuel Hernandez-Guerra","doi":"10.1016/j.gastrohep.2023.02.009","DOIUrl":"10.1016/j.gastrohep.2023.02.009","url":null,"abstract":"<div><h3>Aims</h3><p>Patients’ perception of their cleansing quality can guide strategies to improve cleansing during colonoscopy. There are no studies assessing the agreement between the quality of cleansing perceived by patients and cleansing quality assessed during colonoscopy using validated bowel preparation scales. The main aim of this study was to compare the cleansing quality reported by patients with the quality during colonoscopy using the Boston Bowel Preparation Scale (BBPS).</p></div><div><h3>Patients and methods</h3><p>Consecutive patients referred to an outpatient colonoscopy were included. Four drawings representing different degrees of cleansing were designed. Patients chose the drawing that most resembled the last stool. The predictive ability of the patient's perception and agreement between the patient's perception and the BBPS were calculated. A BBPS score of &lt;2 points in any segment was considered inadequate.</p></div><div><h3>Results</h3><p>Six hundred and thirty-three patients were included (age: 62.8<!--> <!-->±<!--> <!-->13.7 years, male: 53.4%). Overall, 107 patients (16.9%) had inadequate cleansing during colonoscopy, and in 12.2% of cases, the patient's perception was poor. The patient's perception compared to the quality of cleanliness during colonoscopy presented a positive and negative predictive value of 54.6% and 88.3%, respectively. The agreement between patient perception and the BBPS was significant (<em>P</em> <!-->&lt;<!--> <!-->0.001), although fair (<em>k</em> <!-->=<!--> <!-->0.37). The results were similar in a validation cohort of 378 patients (<em>k</em> <!-->=<!--> <!-->0.41).</p></div><div><h3>Conclusions</h3><p>The cleanliness perceived by the patient and the quality of cleanliness using a validated scale were correlated, although fair. However, this measure satisfactorily identified patients with adequate preparation. Cleansing rescue strategies may target patients who self-report improper cleaning.</p><p><em>Registration number of the trial</em>: <span>NCT03830489</span><svg><path></path></svg>.</p></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9222161","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 4","authors":"","doi":"10.1016/S0210-5705(24)00178-X","DOIUrl":"https://doi.org/10.1016/S0210-5705(24)00178-X","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089734","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":"Sesión Oral del XI Curso de Enfermería","authors":"","doi":"10.1016/S0210-5705(24)00181-X","DOIUrl":"https://doi.org/10.1016/S0210-5705(24)00181-X","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089883","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":"Enfermedad de Crohn metastásica con afectación esplénica: un caso muy poco frecuente","authors":"Eugenia Navarro Moreno,&nbsp;José López González,&nbsp;Marta Lázaro Sáez","doi":"10.1016/j.gastrohep.2023.03.009","DOIUrl":"10.1016/j.gastrohep.2023.03.009","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9444674","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":"Las infecciones de transmisión sexual como diagnóstico diferencial de la enfermedad inflamatoria intestinal","authors":"Belén Martínez Benito ,&nbsp;Javier P. Gisbert ,&nbsp;Lucio Jesús García Fraile Fraile ,&nbsp;Ana Barrios Blandino ,&nbsp;María Chaparro","doi":"10.1016/j.gastrohep.2023.05.003","DOIUrl":"10.1016/j.gastrohep.2023.05.003","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9540772","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}