Arquivos de Gastroenterologia最新文献

{"title":"IMPACT OF SARCOPENIA ON THE PROGNOSIS OF PATIENTS WITH CIRRHOSIS HOSPITALIZED FOR ACUTE DECOMPENSATION OR ACUTE-ON-CHRONIC LIVER FAILURE.","authors":"Leticia Macedo Eifler, Thaís Rodrigues Moreira, João Pedro Pagani Possebon, Luis Fernando Ferreira, Raquel de Freitas Jotz, Ângelo Z Mattos","doi":"10.1590/S0004-2803.24612024-069","DOIUrl":"10.1590/S0004-2803.24612024-069","url":null,"abstract":"<p><strong>Background: </strong>Cirrhosis is a prevalent disease and ranks among the leading causes of death worldwide. Sarcopenia is believed to be associated with a poorer prognosis in patients with cirrhosis.</p><p><strong>Objective: </strong>To evaluate the impact of sarcopenia on the prognosis of patients hospitalized for acute decompensation of cirrhosis, with or without acute-on-chronic liver failure.</p><p><strong>Methods: </strong>This prospective cohort study evaluated patients hospitalized for acute decompensation of cirrhosis, with or without acute-on-chronic liver failure. Sarcopenia was assessed according to the European Working Group on Sarcopenia in Older People, using skeletal muscle mass analysis by bioelectrical impedance and handgrip strength testing. The data was collected between March-2019 and April-2020. Qualitative variables were presented as frequencies and percentages, and quantitative variables as means and standard deviations when symmetrical, or medians and 25th and 75th percentiles when asymmetrical. The association of sarcopenia and mortality with quantitative variables was tested using Student's t-test or the Mann-Whitney test, while associations with qualitative variables were tested using the Chi-square test or Fisher's Exact test. For significant associations, crude and adjusted (multivariate analysis) relative risk estimates with a 95% confidence interval were calculated using Poisson regression analysis. Results with P<0.05 were considered significant.</p><p><strong>Results: </strong>Fifty patients were included, with a mean age of 60.5 years (±10.4) and a slight predominance of men (56%). The main causes of cirrhosis were alcohol use disorder (28%) and hepatitis C (24%). The median Child-Pugh score was 8 points (7-10), and the median Model for End-stage Liver Disease score was 15 points (12.5-21). Ten patients were diagnosed with acute-on-chronic liver failure. Sarcopenia was present in 50% of the sample. Sarcopenia was present in 70.0% of patients with acute-on-chronic liver failure and in 43.2% of those without acute-on-chronic liver failure (P=0.168). Overall mortality was 48% in patients with sarcopenia and 44% in those without sarcopenia (P=1.000). In multivariate analysis, overall mortality was associated only with leukocyte count (relative risk=1.01, 95% confidence interval=1.01-1.01) and Model for End-stage Liver Disease score (relative risk=1.07, 95% confidence interval =1.03-1.10).</p><p><strong>Conclusion: </strong>In this study, sarcopenia was not associated with mortality in patients hospitalized for acute decompensation of cirrhosis, with or without acute-on-chronic liver failure. There was a non-significant trend towards a higher prevalence of sarcopenia among individuals with acute-on-chronic liver failure.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"61 ","pages":"e24069"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IS THERE AGREEMENT BETWEEN THE GLIM AND THE NRS CRITERIA IN THE NUTRITIONAL DIAGNOSIS OF HOSPITALIZED SURGICAL PATIENTS? PILOT STUDY.","authors":"Larissa Silveira Stopiglia, Vânia Aparecida Leandro-Merhi","doi":"10.1590/S0004-2803.24612024-072","DOIUrl":"10.1590/S0004-2803.24612024-072","url":null,"abstract":"<p><strong>Background: </strong>There is no consensus on which nutritional diagnosis methods are most relevant in the hospital clinical practice.</p><p><strong>Objective: </strong>This study investigated the agreement between the global leadership initiative on malnutrition (GLIM) criterion and the nutritional risk screening (NRS) instrument for the nutritional diagnosis of in-patients.</p><p><strong>Methods: </strong>Cross-sectional study with 95 hospitalized surgical patients. Clinical data, nutritional risk using the NRS and malnutrition using the GLIM criteria were evaluated. The data were analyzed using the chi-square, Mann-Whitney, McNemar and Kappa coefficient tests.</p><p><strong>Results: </strong>There was good agreement between the two methods (Kappa=0.6067). Patients who were malnourished according to the GLIM or at nutritional risk by NRS were older (P=0.0461 by GLIM and P=0.0200 by NRS) and had a higher diagnosis rate of neoplasms (38.5%, P=0.0006 by GLIM and 32.7%, P=0.0030 by NRS). The GLIM criterion identified a lower percentage of patients with malnutrition (41.05%) in relation to the NRS regarding patients with nutritional risk (54.7%).</p><p><strong>Conclusion: </strong>The GLIM criteria and the NRS instrument are concordant methods for diagnosing malnutrition and nutritional risk in hospitalized surgical patients respectively.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"61 ","pages":"e24072"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NON-INVASIVE METHOD OF MONITORING INTRACRANIAL PRESSURE FOR THE EVALUATION OF HEPATIC ENCEPHALOPATHY.","authors":"Lucas Kleebank Fernandes, Ricardo Cesar Barbosa, Moacir Fernandes de Godoy","doi":"10.1590/S0004-2803.24612024-057","DOIUrl":"10.1590/S0004-2803.24612024-057","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Liver diseases often occur with hepatic encephalopathy (HE), whose pathophysiology may involve increased intracranial pressure (ICP). Tools for monitoring ICP and its pulse morphology can be useful for assessing HE. The use of a non-invasive and sensitive procedure would be extremely useful in managing these cases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the feasibility and performance of a new, non-invasive method of monitoring ICP, as an alternative to invasive methods, and to correlate the clinical diagnosis of HE with the morphological findings of ICP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a cross-sectional analytical study, conducted in a tertiary hospital and pioneer in the application of Brain4Care® BWS equipment. The ICP pulse morphology is parallel to the arterial one, where there are three frequent peaks: percussion peak (P1), due to plasma extravasated by the choroid plexus; tidal wave (P2), due to the degree of intracranial compliance to the reflection of P1, and dicrotic notch (P3), due to the closure of the aortic valve. Normality indicates P1&gt;P2&gt;P3. These peaks determine intracranial compliance through their relationship with cerebral blood volume, where P2/P1 ratio &gt;1 suggests a pathological morphology, with a sustained increase in ICP and decreased compliance. Another way to evaluate this would be by a change in the time-to-peak (TTP). These data were compared between patients with and without clinical signs indicative of HE. The study was approved by the Institution's Research Ethics Committee (number 5.493.775).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 40 liver disease patients were evaluated, of which, at the time of collection, 20 did not have a clinical picture of HE (59.5±9.3 years; 70.0% male) and 20 had a clinical picture of HE (59.6±11.9 years; 65.0% male). The groups are demographically, clinically and laboratory similar; and statistically significant differences were identified in the morphological patterns of ICP between the groups evaluated, as well as trends in the parameters. The difference in the P2/P1 ratio was not significant (Mann Whitney: two-tailed P=0.2978); however, TTP proved to be a parameter with a statistically significant difference between the groups (Mann Whitney: two-tailed P=0.0282; median difference = 0.04). Analysis using the C statistic, using the ROC curve, suggested P2/P1=1.31 (AUROC: 0.5975) and TTP=0.22 (AUROC: 0.7013) as optimal cutoff points, where the presence of HE in liver disease patients would be associated with obtaining parameters below these thresholds.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The brain4care® BWS system proved to be feasible for use in liver disease patients with or without clinical signs of hepatic encephalopathy and was able to differentiate them. Pathophysiological explanations, however, still require better causality explanation and understanding of the intracerebral hydrodynamic picture in hepatic encephalopathy. Given the l","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"61 ","pages":"e24057"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LEFT-SIDED APPENDICITIS IN LATIN AMERICA AND THE CARIBBEAN: A SYSTEMATIC REVIEW OF CASE REPORTS.","authors":"Fabian A Chavez-Ecos, Mayli M Condori-Orosco, Anahy de la Colina-Sosa, Sandra S Chavez-Malpartida, Carlos A Davila-Hernandez, Alba Zevallos","doi":"10.1590/S0004-2803.24612024-029","DOIUrl":"10.1590/S0004-2803.24612024-029","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, acute appendicitis (AA) is the most frequent cause of acute surgical abdomen. Although typically associated with pain migrating to the right iliac fossa, AA can also manifest with pain in the left lower quadrant, often linked to anatomical anomalies. Latin America and the Caribbean (LAC) have the highest incidence of AA compared to other regions of the world.</p><p><strong>Objective: </strong>To explore the sociodemographic characteristics; clinical characteristics, and postoperative outcomes in patients with left-sided AA in LAC.</p><p><strong>Methods: </strong>We performed a systematic review including PubMed, Scopus, Web of Science, Embase, LILACS, Dialnet, Redalyc, Scielo, and Google Scholar databases. We considered as inclusion criteria case reports of left-sided appendicitis involving specific anatomical anomalies, and studies conducted in LAC. Morevoer, we assessed methodologic quality using Joanna Briggs Institute tool for case reports.</p><p><strong>Results: </strong>A total of 23 patients were included in 23 case reports. Colombia accounted for the majority of left-sided AA cases. The median age was 37 years (8-65). Initial pain location was diffuse abdominal pain (39.1%), pain was refered (n=5; 55.6%) and migrated (n=11; 78.6%) mainly to left iliac fossa. Situs inversus totalis (SIT) was the most prevalent anatomical anomaly (69.6%), while laparotomy emerged as the predominant surgical approach (65.2%).</p><p><strong>Conclusion: </strong>Considering left-sided AA in the diagnosis of adults with diffuse abdominal pain towards the left lower quadrant is crucial. SIT is the primary associated anatomical variation. These emphasize the significance of understanding atypical presentations for effective management in the LAC population.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"61 ","pages":"e24029"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PROTON-PUMP INHIBITORS ARE ASSOCIATED WITH AN INCREASED RISK OF MICROSCOPIC COLITIS: A POPULATION-BASED STUDY AND REVIEW OF THE LITERATURE.","authors":"Rashid Abdel-Razeq, Antoine Boustany, Somtochukwu Onwuzo, Mustafa Saleh, Riya Gupta, Hadi Khaled Abou Zeid, Chidera N Onwuzo, David Farhat, Mimi Najjar, Abdallah El Alayli, Imad Asaad","doi":"10.1590/S0004-2803.24612024-053","DOIUrl":"10.1590/S0004-2803.24612024-053","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Microscopic colitis is a relatively new diagnosis that was first described in the 1980s. Patients usually present with chronic watery and non-bloody diarrhea and are typically characterized by an unremarkable gross appearance of the colon on lower endoscopy while having evidence of lymphocytic infiltration of the lamina propria and the epithelium on histology. Two subtypes have been described in the literature: Collagenous colitis, with marked thickening of the subepithelial layer, and Lymphocytic colitis. Multiple risk factors such as female gender, older age and celiac disease have been associated with this entity. A few studies have found an association between microscopic colitis and proton-pump inhibitor (PPI). The aim of our study was to evaluate the risk of developing microscopic colitis and its subtypes for patients who are on PPI therapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A validated multicenter and research platform database of more than 360 hospitals from 26 different healthcare systems across the United States from 1999 to September 2022 was utilized to construct this study. Patients aged 18 years and above were included. Individuals who have been diagnosed with any autoimmune disease have been excluded. A multivariate regression analysis was performed to assess risk of developing microscopic, lymphocytic, and collagenous colitis by accounting for potential confounders including female gender, smoking history, and the use of proton pump inhibitor, nonsteroidal anti-inflammatory drugs, and selective serotonin receptor inhibitors. A two-sided P value &lt;0.05 was considered as statistically significant, and all statistical analyses were performed using R version 4.0.2 (R Foundation for Statistical Computing, Vienna, Austria, 2008).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;78,256,749 individuals were screened in the database and 69,315,150 were selected in the final analysis after accounting for inclusion and exclusion criteria. The baseline characteristics of patients with microscopic, lymphocytic, and collagenous colitis is seen in table 1. Using a multivariate regression analysis, the risk of developing microscopic, lymphocytic, and collagenous colitis was calculated and illustrated in table 2.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Our study showed that the risk of microscopic colitis, lymphocytic colitis and collagenous colitis was higher in females and smokers. Although medications like SSRI and NSAIDs showed a positive correlation with colitis, the highest likelihood of developing this disease was associated with PPIs. Lansoprazole has been documented to be associated with microscopic colitis as it is believed to inhibit colonic proton pumps, and subsequently promote diarrhea and inflammation. Interestingly, the prevalence of lymphocytic colitis and collagenous colitis was similar in the cohort of patients treated with PPIs, indicating no specific predisposition to either subtype. This study further confirms the risk","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"61 ","pages":"e24053"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ROBOTIC RESECTION OF A GIANT GASTROINTESTINAL STROMAL TUMOR (GIST): A PATH WE DARED TO TAKE.","authors":"Marcel Autran C Machado, Marina G Epstein, Ana Luísa M Nobre, Murillo M Lobo Filho, Bruno H Mattos, Fábio F Makdissi","doi":"10.1590/S0004-2803.24612024-038","DOIUrl":"10.1590/S0004-2803.24612024-038","url":null,"abstract":"","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"61 ","pages":"e24038"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"III BRAZILIAN CONSENSUS STATEMENT ON ENDOSCOPIC ULTRASOUND.","authors":"Ricardo Rangel de Paula Pessoa, Alexandre Moraes Bestetti, Victor Lira de Oliveira, Wladimir Campos de Araujo, Simone Guaraldi, Rodrigo Roda Rodrigues Silva, Francisco Antonio Araujo Oliveira, Maria Sylvia Ierardi Ribeiro, Fred Olavo Aragão Andrade Carneiro, Marco Aurélio D'Assunção, Bruno Frederico Oliveira Azevedo Medrado, Felipe Alves Retes, Gustavo Andrade de Paulo, Nutianne Camargo Schneider, Lucio Giovanni Battista Rossini, Leonardo Vallinoto, Jose Celso Ardengh, Djalma Ernesto Coelho Neto, Edson Ide, Marcos Clarencio Batista Silva, Matheus Cavalcante Franco, Sergio Eiji Matuguma, Diogo Turiani Hourneaux de Moura, Vitor Nunes Arantes, Rafael Nahoum, Vitor Ottoboni Brunaldi, Marcos Eduardo Lera Dos Santos, Dalton Marques Chaves, Otávio Micelli-Neto, Bruno Chaves Salomao, Fauze Maluf-Filho, Gustavo de Oliveira Luz","doi":"10.1590/S0004-2803.24612024-062","DOIUrl":"10.1590/S0004-2803.24612024-062","url":null,"abstract":"<p><strong>Background: </strong>In the past decades, endoscopic ultrasound has developed from a diagnostic tool to a platform for many therapeutic interventions. Various technological advancements have emerged since the last Brazilian Consensus, demanding a review and update of the recommendations based on the best scientific evidence.</p><p><strong>Methods: </strong>A group of 32 renowned echoendoscopists selected eight relevant topics to be discussed to generate clinical questions. After that, a literature review was conducted to answer these questions based on the most updated evidence.</p><p><strong>Results: </strong>Thirty-three statements were formulated and voted on by the experts to reach a consensus. The Oxford System was used to grade the level of evidence.</p><p><strong>Conclusion: </strong>There is mo-derate evidence to support that the needle shape, gauge, or aspiration technique does not influence the yield of endoscopic ultrasound (EUS)-guided tissue sampling of pancreatic solid lesions. There is moderate evidence to support using EUS-TTNB of the cyst wall to differentiate between mucinous and non-mucinous cystic neoplasms. There is little evidence to support the EUS-guided treatment of gastric varices. There is a high level of evidence to support that EUS-guided biliary drainage and ERCP present similar outcomes in patients with distal malignant biliary obstruction. There is a high level of evidence for using EUS to diagnose neoplastic pancreatic cysts and detect necrosis before indicating drainage. There is moderate evidence to support EUS-GE over duodenal stent for malignant gastric outlet obstruction in patients with a life expectancy higher than 2 months. There is a high level of evidence to support the use of RFA in treating both functioning and non-functioning types of NET.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"61 ","pages":"e24062"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RE-THINKING FIBEROPTIC ENDOSCOPIC EVALUATION OF SWALLOWING FOR CLINICAL DECISION-MAKING IN OROPHARYNGEAL DYSPHAGIA: AN EXPERT OPINION.","authors":"Roberta Gonçalves da Silva, Thaís Coelho Alves, Paula Cristina Cola, Leandro Pernambuco, Hipólito Virgílio Magalhães Júnior, Ana Maria Furkim, Suely Mayumi Motonaga Onofri","doi":"10.1590/S0004-2803.24612024-018","DOIUrl":"10.1590/S0004-2803.24612024-018","url":null,"abstract":"","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"61 ","pages":"e24018"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE IMPACT OF THE COVID-19 PANDEMIC RESTRICTIVE MEASURES ON THE DIAGNOSIS OF ADENOMATOUS POLYPS AND COLORRECTAL ADENOCARCINOMA IN A POPULATION SUBMITTED TO COLONOSCOPY.","authors":"Natália Ribeiro Silvério, Isabela Costa Monteiro, Ana Luiza Naves Prudente, Anna Caroliny Navarro Rosa, Américo de Oliveira Silvério","doi":"10.1590/S0004-2803.24612024-027","DOIUrl":"10.1590/S0004-2803.24612024-027","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is globally the third most common malignant neoplasm and the second leading cause of cancer-related death worldwide. The COVID-19 pandemic led to the suspension of routine screening tests by health services. A 35.5% drop in total cancer diagnoses in 2020 is estimated when compared to 2019.</p><p><strong>Objective: </strong>To evaluate the impact of the COVID-19 pandemic on the diagnosis of adenomatous polyps (AP) and CRC in a population undergoing colonoscopy (COL) in a clinic in Goiânia, Brazil.</p><p><strong>Methods: </strong>A cross-sectional study evaluating COL performed during the periods from 20 March to 31 October of 2019 and of 2020, was approved by the Research Ethics Committee (CAAE-45631421.0.0000.0037). We analyzed data related to identification, referral for medical examination, colonoscopic and histopathological findings.</p><p><strong>Results: </strong>We evaluated 10,232 (93.4%) COL, divided into two groups according to the year of performance. In 2019, 6,777 (66.2%) COL were performed and in 2020, 3,455 (33.8%), demonstrating a reduction of 51.0%. A total of 3,267 (31.9%) colonoscopies found polyps, 72.1% of which were AP (68.8% in 2019 and 78.3% in 2020, P<0.001). High-grade dysplasia was found in 5.0% of the AP (4.9% in 2019 and 5.8% in 2020, P<0.34). CRC was diagnosed in 121 (1.2%) (0.9% in 2019 and 1.6% in 2020, P<0.001).</p><p><strong>Conclusion: </strong>The COVID-19 pandemic significantly reduced COL in 2020, mainly due to infection fears and restrictions. However, the detection rate of cancer and polyps per procedure increased, indicating more symptomatic patients sought medical attention. Despite this, the absolute number of tumors and adenomas found decreased, potentially causing diagnostic losses and fewer prevented colorectal cancer cases. Thus, adaptive strategies are vital for maintaining essential healthcare services during similar crises.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"61 ","pages":"e24027"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GOOD CORRELATION BETWEEN LIVER STIFFNESS MEASUREMENT AND APRI, FIB-4, PLATELET COUNT, IN PEDIATRIC AUTOIMMUNE HEPATITIS.","authors":"Lucas Rocha Alvarenga, Natascha Silva Sandy, Gabriel Hessel, Tiago Sevá Pereira, Maria Ângela Bellomo-Brandão","doi":"10.1590/S0004-2803.24612024-047","DOIUrl":"10.1590/S0004-2803.24612024-047","url":null,"abstract":"<p><strong>Background: </strong>There is limited evidence focusing on the use of non-invasive markers to assess liver fibrosis in pediatric chronic liver diseases.</p><p><strong>Objective: </strong>The aim of the study was to evaluate the correlation between liver stiffness measurement (LSM) using transient liver elastography (TLE) and serum non-invasive markers in pediatric autoimmune hepatitis (AIH).</p><p><strong>Methods: </strong>Cross-sectional study between May 2016 and February 2020. Twenty-eight children with AIH (age range between 3 and 20 years old) who had undergone TLE and had routine serum tests were enrolled. Patients were divided into 2 groups: (1) Liver fibrosis degree ≥F2 (TLE ≥6.45 kPa) and (2) <F2 (TLE <6.45 kPa). The groups were compared using Fisher's exact test for categorical variables and the Mann-Whitney test for quantitative variables. The correlation between TLE, APRI, FIB-4 and platelet count was assessed using the Spearman coefficient (Rs).</p><p><strong>Results: </strong>Twenty-eight AIH pediatric patients were enrolled, 21 were female and 22 had AIH type 1. Following the cut-off of 6.45 kPa in TLE, 20 patients (71%) were included in group 1, and 8 in group 2. A statistically significant difference was found between the two groups on APRI and FIB-4 results (P=0.0306 and P=0.0055, respectively). There was a significant correlation between TLE with APRI and FIB-4 (Rs=0.67 and 0.78, respectively; P<0.01) as well as with platelet count (Rs=-0.68; P<0.01).</p><p><strong>Conclusion: </strong>APRI, FIB-4 and Platelet Count showed a good and positive correlation with transient liver elastography in pediatric patients with AIH.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"61 ","pages":"e24047"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}