Gastroenterologia y hepatologia最新文献

{"title":"Evolution of lymphocytic gastritis on a gluten-free diet: A case report.","authors":"María Hernández-Rodríguez, María Jesús Callejo-Plazas, Miguel Ángel Sáez-García","doi":"10.1016/j.gastrohep.2026.502836","DOIUrl":"10.1016/j.gastrohep.2026.502836","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502836"},"PeriodicalIF":2.0,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430320","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":"Medical deserts in gastroenterology: A nationwide study of specialists perceptions in a universal public healthcare system.","authors":"Rut Fernandez, Luis Hernandez, Raul Velamazán","doi":"10.1016/j.gastrohep.2026.502835","DOIUrl":"10.1016/j.gastrohep.2026.502835","url":null,"abstract":"<p><strong>Objective: </strong>Medical deserts - areas with insufficient healthcare services - represent a growing challenge to equitable care access in Spain and Europe, particularly in rural regions. While most studies focus on general practitioners, little is known about what drives specialists to work in these settings. The objective was to identify factors influencing Spanish gastroenterologists' employment decisions in medical deserts.</p><p><strong>Patients and methods: </strong>We conducted a cross-sectional survey among members of the Spanish Association of Gastroenterology (AEG). The questionnaire included demographic/professional data, along with 38 potential attractors grouped into seven domains: training, work environment, clinical activity, quality of life, research/teaching, on-call duties, and job/financial stability. The survey adhered to CHERRIES guidelines to ensure methodological transparency and reliability. Each item was rated from 1 (least important) to 10 (most important). Descriptive and subgroup analyses (by age and prior district hospital experience) were conducted.</p><p><strong>Results: </strong>Among 110 respondents, the most influential factors were job stability (mean median score 9.00), quality of life (8.62), reduced on-call duties (8.66). Highly rated individual items included exemption from emergency/internal medicine shifts: median 10 (IQR 9-10), long-term contracts with competitive salaries: 10 (IQR 8-10), flexible scheduling: 10 (IQR 9-10) and maintaining endoscopic activity: 10 (IQR 6-10). Prior district hospital experience was associated with greater value placed on autonomy (p=0.016) and reduced on-call duties (p=0.036).</p><p><strong>Conclusions: </strong>Job stability and lifestyle factors outweigh academic incentives in determining specialists' choices, underscoring the need for multifaceted strategies and targeted workforce policies to ensure equitable specialist distribution.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502835"},"PeriodicalIF":2.0,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430364","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":"Primary aorto-esophageal fistula: a rare and lethal cause of upper gastrointestinal bleeding.","authors":"Carlos Pardillos Ruiz, Alba Sola Sáez, María Badía Martínez","doi":"10.1016/j.gastrohep.2026.502832","DOIUrl":"10.1016/j.gastrohep.2026.502832","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502832"},"PeriodicalIF":2.0,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404675","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":"Early real-world effectiveness of mirikizumab in a difficult-to-treat ulcerative colitis cohort.","authors":"Alfonso Elosua, Lucía Zabalza, Miren Vicuña, Saioa Rubio, Óscar Nantes, Amaya Arrondo, Cristina Rodríguez","doi":"10.1016/j.gastrohep.2026.502833","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2026.502833","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502833"},"PeriodicalIF":2.0,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404583","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":"An uncommon endoscopic finding: Esophageal intramural pseudodiverticulosis.","authors":"Elena Granda Villanueva, Aroa González Llaneza, Daniel Fernández García, Daniel Muiño Domínguez","doi":"10.1016/j.gastrohep.2026.502827","DOIUrl":"10.1016/j.gastrohep.2026.502827","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502827"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368221","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":"Anemia and hypoalbuminemia are associated with hepatic encephalopathy and mortality after portal hypertension-related bleeding.","authors":"Laura Bordoy, Anna Brujats, Montserrat Camps, Javier Fajardo, Amparo Moscardo, Laura Tapias, Cristina Roig, Cristina Romero, Andreu Ferrero-Gregori, Edilmar Alvarado-Tapias","doi":"10.1016/j.gastrohep.2026.502828","DOIUrl":"10.1016/j.gastrohep.2026.502828","url":null,"abstract":"<p><strong>Background/objectives: </strong>Modifiable factors may influence prognosis in patients with cirrhosis and portal hypertension-related bleeding (PHB). This study characterized metabolic and hematological profiles during and after PHB and evaluated their impact on liver-related events and mortality.</p><p><strong>Patients and methods: </strong>Observational, single-center, retrospective cohort study including patients with cirrhosis admitted for PHB and followed for 1 year. Epidemiological, clinical, analytical, and hemodynamic data were collected. Anemia was defined according to World Health Organization criteria, and the hypoalbuminemia threshold was established using receiver operating characteristic (ROC) curves and the Youden index. Risk factors for liver-related events and death were assessed using Cox regression and cumulative incidence functions with competing risks.</p><p><strong>Results: </strong>Forty-eight patients were included (60.4% men; 35.5% alcohol-related cirrhosis), with a median age of 63 years (IQR 55-74). During one-year follow-up, hepatic encephalopathy (HE) was the most frequent liver-related event (21%). Hypoalbuminemia was independently associated with an increased risk of hepatic encephalopathy at 6 months (sHR 5.70, 95% CI 1.36-23.8, p=0.017) and at 1 year (sHR 7.28, 95% CI 1.08-48.8, p=0.041). One-year survival was significantly lower in patients with HE (60% vs. 100%, p<0.001), hypoalbuminemia (60% vs. 96.7%, p=0.005), and anemia (80% vs. 100%, p=0.016). Patients receiving red blood cell transfusion during PHB showed better liver function at 1 year (median MELD 9 [IQR 7-10] vs. 10 [IQR 9.8-12.5], p=0.017).</p><p><strong>Conclusions: </strong>Anemia and hypoalbuminemia are potentially modifiable factors associated with increased risk of HE and mortality within 1 year after PHB. Whether correction of anemia and nutritional status improves prognosis remains to be determined.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502828"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368234","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":"Optimization of a mobile application for the management of hepatitis D based on patient experience: An observational study in a hepatology cohort.","authors":"Judit Romero-Vico, Belén Duarte, Elena Vargas-Accarino, Adriana Palom, Núria Fabrellas, Maria Buti","doi":"10.1016/j.gastrohep.2026.502826","DOIUrl":"10.1016/j.gastrohep.2026.502826","url":null,"abstract":"<p><p>Chronic hepatitis caused by the hepatitis D virus (HDV) represents one of the most aggressive forms of viral liver disease, associated with accelerated progression to cirrhosis and an increased risk of hepatocellular carcinoma. Its management is not yet well standardized, which justifies the exploration of digital tools to improve the care of these patients.</p><p><strong>Objective: </strong>To evaluate the user experience, perceived usefulness, and usability of the NORA mobile application in patients with hepatitis D virus and/or HDV infection, as well as to analyze the determinants of non-use from a patient-centered perspective.</p><p><strong>Patients and methods: </strong>Cross-sectional observational study conducted in outpatient hepatology clinics. A total of 52 patients were included (19 users, 11 non-users, and 22 new users). Sociodemographic, clinical, and app usage variables were collected. Usability was assessed using the Mobile App Usability Questionnaire.</p><p><strong>Results: </strong>Users rated the application positively (Mobile App Usability Questionnaire 5.07±1.43), particularly highlighting the quality-of-life and education modules, while biometric modules were the least used. The main improvements proposed included expanded educational content (57.9%), improved data visualization (31.6%), and greater communication with the healthcare team (21.1%). Lack of motivation was the main barrier among non-users (72.7%). Expectations exceeded actual use in most modules, suggesting areas for improvement. Adoption was associated with detectable HDV RNA and recent follow-up.</p><p><strong>Conclusions: </strong>NORA is a well accepted tool among users and is perceived as useful for the follow-up of patients with HDV. Optimizing aspects related to education, communication, and functionality could further enhance its impact in telemedicine. However, the methodological limitations of the study prevent any conclusions from being drawn regarding its clinical impact.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502826"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367877","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 REMOVAL OF BONE FOREIGN BODY EMBEDDED IN THE COLON.","authors":"Óscar Pérez Aznar, Glòria Ramoneda I Gasch, Natalia Iriarte Gurbindo","doi":"10.1016/j.gastrohep.2026.502830","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2026.502830","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502830"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367884","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":"Assessment of training in pancreatology and biliary diseases during gastroenterology residency: A national survey by AEG-AESPANC.","authors":"Raúl Velamazan, Irene Blanco, Juan Lerma-Irureta, Karina Cardenas-Jaen, Daniel de la Iglesia-García, Emma Martinez Moneo, Enrique de-Madaria","doi":"10.1016/j.gastrohep.2026.502829","DOIUrl":"10.1016/j.gastrohep.2026.502829","url":null,"abstract":"<p><strong>Introduction: </strong>Biliopancreatic diseases are prevalent, complex, and associated with significant morbidity and mortality. Despite their clinical importance, training in these conditions remains poorly defined across Europe. We aimed to assess self-perceived knowledge in biliopancreatic diseases among gastroenterology trainees and early-career specialists, and to identify training-related factors associated with higher competence.</p><p><strong>Patients and methods: </strong>A nationwide cross-sectional online survey was conducted among final-year residents and specialists completing residency between 2018 and 2024 under the auspices of the Spanish Association of Gastroenterology (AEG) and the Spanish Association of Pancreatology (AESPANC). Participants reported demographics and training characteristics. General self-perceived knowledge was rated on a 0-10 scale, and knowledge of 45 pancreatic and biliary conditions was assessed using a 5-point Likert scale.</p><p><strong>Results: </strong>Of 216 respondents (60.5% women; mean age 32.3 years), 28.8% were residents and 71.2% specialists. Median general knowledge scores were 7/10 for both pancreatic and biliary diseases. Highest competence was reported in common conditions (acute pancreatitis, biliary colic, cholecystitis, cholangitis), lowest scores were observed for chronic pancreatitis, autoimmune pancreatitis, cystic fibrosis, pancreatic cystic lesions, and benign biliary disorders. Factors associated with higher self-perceived knowledge included presence of pancreatology specialists, larger case volumes, outpatient clinic exposure, participation in multidisciplinary committees, structured teaching, and formal competency assessment.</p><p><strong>Conclusions: </strong>Training in biliopancreatic diseases among gastroenterology trainees in Spain is heterogeneous, with significant gaps in clinically relevant domains. Structured clinical exposure, mentorship, formal evaluation, and targeted teaching are key factors. These findings highlight the need to standardise and strengthen pancreatology training pathways to improve patient care.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502829"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367928","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":"Merkel cell carcinoma: An unexpected cause of fulminant hepatic failure on pre-existing chronic liver disease.","authors":"Inés Magide Yáñez, Francisco Javier Pérez Rastrollo, Sofía Díaz López, Mario Álvarez Díez, Julio Otero Figar, Carmen Álvarez Navascues, Jacobo Martín Sanz","doi":"10.1016/j.gastrohep.2026.502820","DOIUrl":"10.1016/j.gastrohep.2026.502820","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502820"},"PeriodicalIF":2.0,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148224477","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}