Arquivos de Gastroenterologia最新文献

{"title":"NUTRITIONAL ASSESSMENT AND ITS IMPACT ON QUALITY OF LIFE IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE IN COLOMBIA: NUTRIBD - COL.","authors":"Viviana Parra-Izquierdo, Carlos Augusto Cuadros, Ginary Orduz-Diaz, Paula Daniela Bonilla-Ribero, Oscar Mariano Pinto, Cristian Fabian Florez, Juan Javier Acevedo, Julian Ferreira, Vanessa Duran, Luis Felipe Murcia, Juan Sebastian Frias-Ordoñez","doi":"10.1590/S0004-2803.24612025-090","DOIUrl":"10.1590/S0004-2803.24612025-090","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) significantly affects patients' nutritional status and quality of life (QoL). Nutritional deficiencies are frequent and may worsen disease outcomes. The aim of this study is to assess the association between nutritional status and quality of life in patients with IBD.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in a specialised IBD centre. Nutritional status was evaluated using the MUST and MIRT tools in adults and the \"Strong Kids\" scale in paediatrics. An individualised nutritional support protocol was implemented. Quality of life was assessed with the EQ-5D and IBDQ-32 instruments.</p><p><strong>Results: </strong>Among 90 patients, 26.6% required hospitalisation, predominantly adults and females. The mean age was 36.7 years. Crohn's disease (CD) was more prevalent (58.3%), and 83.3% received biological therapy. Malnutrition risk in hospitalised patients with ulcerative colitis (UC) and CD was significantly increased, with odds ratios of 8.33 (95%CI: 1.16-27) and 25 (95%CI: 11.6-45.2), respectively. All hospitalised patients with severe disease presented with malnutrition. In the paediatric group, 87.5% received enteral nutrition and 25% required parenteral nutrition. Nutritional support improved nutritional status in 75% of cases within three months. Malnutrition was significantly associated with poorer QoL, particularly affecting mobility, self-care, and daily activities (P<0.05).</p><p><strong>Conclusion: </strong>Malnutrition has a substantial negative impact on quality of life in IBD patients. Early detection using tools such as MUST, MIRT, and strong kids is essential. Integrating systematic nutritional screening and tailored support into routine clinical practice is imperative to improve outcomes and promote recovery.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"62 ","pages":"e25090"},"PeriodicalIF":0.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12788825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ARTIFICIAL INTELLIGENCE IN THE HISTOLOGICAL DIAGNOSIS OF COLON CANCER: A RAY OF HOPE.","authors":"Akhilesh Vikram Singh, Anudwipa Singh, K Vanitha Prakash","doi":"10.1590/S0004-2803.24612025-095","DOIUrl":"10.1590/S0004-2803.24612025-095","url":null,"abstract":"","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"62 ","pages":"e25095"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12683942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EFFICACY OF PROBIOTICS IN PREVENTING CHEMOTHERAPY-INDUCED DIARRHEA IN GASTROINTESTINAL CANCER PATIENTS.","authors":"Gabriel Caio DE Souza, Humberto Bezerra de Araujo Filho, Cleyton Zanardo DE Oliveira, Ana Paula Ribeiro Paiotti, Nora Manoukian Forones","doi":"10.1590/S0004-2803.24612025-020","DOIUrl":"10.1590/S0004-2803.24612025-020","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy-induced diarrhea is a common and distressing side effect experienced by patients undergoing cancer treatment, particularly those with gastrointestinal cancer. It can lead to significant health complications, including dehydration, electrolyte imbalances, and treatment interruptions. Recent studies have shown that the gut microbiome plays an important role in the development and severity of chemotherapy-induced diarrhea. Modulating the gut microbiome with probiotics has emerged as a potential strategy for preventing and managing chemotherapy-induced diarrhea.</p><p><strong>Objective: </strong>In this study we aimed to evaluate the efficacy of one probiotic containing a mixture of several strains of Lactobacillus and Bifidobacterium species in prevention of chemotherapy induced diarrhea among patients with gastrointestinal cancer.</p><p><strong>Methods: </strong>Between April 2022 and June 2024, a total of 28 patients diagnosed with gastrointestinal cancer who were intended to receive chemotherapy based on fluoropyrimidine, oxaliplatin, and/or irinotecan were randomized in a ratio 1:1 to receive either a placebo or 20 billion colony-forming units (CFU) of a mixture containing five viable strains including 335 mg of Lactobacillus acidophilus NCFM®, Lactobacillus paracasei Lpc-37TM, Bifidobacterium lactis Bi-04TM, Bifidobacterium lactis Bi-07TM, and Bifidobacterium bifidum Bb-02TM. Patients were instructed to take the product orally once daily for 90 days and to record their bowel habits in a diary using the Bristol stool scale.</p><p><strong>Results: </strong>The use of probiotics, compared to placebo, did not result in reduction of grade 2/3 diarrhea episodes (placebo arm 55.56% vs probiotic arm 44.44%; P=1). Likewise, no statistically significant difference was observed in the overall incidence of diarrhea between the two groups (71.43% vs 64.29%; P=1). The median number of diarrhea episodes during the 90-day follow-up tended to be lower in the probiotic group (eight episodes) compared to the placebo group (9 episodes) (P=0.639) Subgroup analyses failed to identify any specific patient characteristics that associated any benefit from the probiotic use, regardless of diarrhea grade. Also, no infections related to the probiotic strains administered in this study were detected.</p><p><strong>Conclusion: </strong>Probiotic in comparison to a placebo did not result in a statistically significant effect, suggesting a lack of benefit of administered probiotic for prevention of chemotherapy induced diarrhea among patients with gastrointestinal cancer.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"62 ","pages":"e25020"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12683943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PATTERNS OF ALCOHOL CONSUMPTION AND MENTAL HEALTH IN HCV-INFECTED PATIENTS: IMPLICATIONS FOR ANTIVIRAL ELIGIBILITY.","authors":"Lívia Beraldo de Lima, André Malbergier, Priscila Dib Gonçalves, Suzane Kioko Ono, Anderson Sousa Martins-DA-Silva, Mário Guimarães Pessoa, Mariana Akemi Nabeshima, Maria Cassia Mendes-Corrêa, Arthur Guerra de Andrade, João Maurício Castaldelli-Maia","doi":"10.1590/S0004-2803.24612025-054","DOIUrl":"10.1590/S0004-2803.24612025-054","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis C virus (HCV) infection remains a significant public health concern. Behavioral factors such as alcohol use and psychiatric comorbidities, particularly depression, may influence disease progression and eligibility for antiviral treatment.</p><p><strong>Objective: </strong>To assess the prevalence and clinical impact of current alcohol consumption in patients with chronic HCV infection eligible for treatment with direct-acting antivirals (DAAs), and to explore its associations with depressive symptoms and clinical characteristics.</p><p><strong>Methods: </strong>This was a cross-sectional study including 109 monoinfected HCV outpatients. Sociodemographic, clinical, and laboratory data were collected. Current alcohol use was assessed using the alcohol, smoking and substance involvement screening test (ASSIST), and depressive symptoms were measured by the Beck Depression Inventory (BDI).</p><p><strong>Results: </strong>Among participants, 46 (43.4%) reported current alcohol consumption. No statistically significant difference in alcohol use was found between male and female participants (P=0.15). Women showed significantly higher depressive symptom scores compared to men (11.33 vs 7.67; P=0.024). However, no significant association was observed between levels of alcohol consumption (<12 g/day, ≥12 g/day, or abstinent) and the presence of moderate to severe depressive symptoms. Additionally, alcohol use was positively associated with tobacco use (P=0.01), but not with clinical comorbidities.</p><p><strong>Conclusion: </strong>Moderate alcohol use in HCV-infected patients was not associated with increased depressive symptoms or worse clinical parameters prior to DAA therapy. These findings suggest that moderate alcohol consumption should not be an absolute contraindication for initiating HCV treatment, though further studies are needed.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"62 ","pages":"e25054"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12683945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ARTIFICIAL INTELLIGENCE IN COLONOSCOPY: EVALUATION OF ADENOMA DETECTION RATE AND PERFORMANCE CHARACTERIZATION.","authors":"Carolina Roos Mariano DA Rocha, Sophia Andreola Borba, Thales Tomaz Richinho, Leonardo Wagner Grillo, Fernando Comunello Schacher, Rafael Castilho Pinto, Fernando Herz Wolff, Fabio Segal","doi":"10.1590/S0004-2803.24612024-121","DOIUrl":"10.1590/S0004-2803.24612024-121","url":null,"abstract":"<p><strong>Background/objective: </strong>Colonoscopy is a known tool for diagnosing precursor lesions of colorectal cancer. The use of AI has the potential to enhance the detection of these lesions. The aim of this study is to compare the adenoma detection rate (ADR) in colonoscopies performed with and without AI software.</p><p><strong>Methods: </strong>An observational study was conducted in the endoscopy department with the contribution of the gastroenterology, coloproctology and pathology services, all from a tertiary hospital in the southern region of Brazil. A total of 305 patients undergoing screening colonoscopy were evaluated. Patients were scheduled for colonoscopy through random assignment to procedure rooms with high definition conventional colonoscopy (CC) or with \"Cadeye\" (CADe) system. The metrics associated with patients, the procedure and polyps' features were recorded.</p><p><strong>Results: </strong>Of 305 colonoscopies, 112 were in the CADe system and 193 in the CC. 470 polyps were detected. The overall ADR was 53.8% and the overall polyp detection was 74.8%. There was no difference in the ADR between CC and CADe (57% vs 48.2%, respectively. P=0.138).</p><p><strong>Conclusions: </strong>Although data argue for an increase in ADR with AI systems, our study did not show difference between conventional colonoscopy or AI. These findings suggest that, in settings with high ADR, the added benefit of AI may be limited.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"62 ","pages":"e24121"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12683683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VALIDATION OF THE PAGE-B SCORE AS A PROGNOSIS OF DEVELOPMENT TO HEPATOCELLULAR CARCINOMA (HCC) IN CHRONIC HEPATITIS B, IN THE BRAZILIAN POPULATION.","authors":"Ingrid Laise Vivas Silva, Liliane Lins-Kusterer, Walter da Silva Júnior, Jadson Dourado Costa Fernandes, Sidelcina Rugieri Pacheco, Simone Muniz Carvalho Fernandes da Cunha, Juan Miguel Villalobos Salcedo, Luiz Felipe Monteiro Darzé, Raymundo Paraná, Maria Isabel Schinoni","doi":"10.1590/S0004-2803.24612025-009","DOIUrl":"10.1590/S0004-2803.24612025-009","url":null,"abstract":"<p><strong>Context: </strong>Due to the potential risk for chronic and severe progression, hepatitis B virus (HBV) infection requires antiviral medications, such as Tenofovir (TDF) and Entecavir (ETV), to reduce the HBV viral load and prevent the risk of liver cirrhosis and hepatocellular carcinoma (HCC). The PAGE-B score is a simple and reliable tool for assessing the risk of developing HCC, although it has not yet been validated in Brazil.</p><p><strong>Objective: </strong>To validate the PAGE-B risk score for predicting HCC development in HBV carriers in Brazil. To analyze the association between the PAGE-B score and demographic, laboratory, and HBV treatment variables.</p><p><strong>Methods: </strong>An observational cohort. retrospective study. Study sample - 659 individuals with chronic HBV mono-infection treated with antivirals for at least 3 years at two reference centers in Brazil's Northeast and Amazon regions. The PAGE-B score was used to analyze its association with sex, age, and platelet count, classifying each patient's HCC risk as low, moderate, or high.</p><p><strong>Results: </strong>The mean PAGE-B score was 12.77±5.63. PAGE-B scores were classified as low, moderate, and high in 206 (31.2%), 287 (43.5%), and 166 (25.3%) individuals, respectively. Among the 659 patients, 31 (4.7%) developed HCC, a higher frequency than reported in PAGE-B score validation studies from other countries. Of these patients, 29 were male, with a mean age of 57.4±12.6 years and lower platelet levels (<200,000 10³/mL). Patients who developed HCC had fibrosis stages: F0-F1:6 (19.3%); F2:2 (6.4%); F3:2 (6.4%); and F4:21 (67.7%). High-risk patients were treated with ETV (n=129, 32%) versus TDF (n=37, 14,4%), P<0.00.</p><p><strong>Conclusion: </strong>The PAGE-B score demonstrated, in the Brazilian population, a performance similar to that observed in studies with European and Asian populations in terms of sensitivity, specificity, and predictive values for HCC prediction. Based on these results, the PAGE-B score can be used in the Brazilian population to predict the risk of HCC.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"62 ","pages":"e25009"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12683684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE ROLE OF DIGESTIVE MANIFESTATIONS IN COVID-19 MORTALITY: EVIDENCES FROM BRAZIL'S FIRST EPIDEMIC WAVE.","authors":"Elvis Paim Ferreira, Mariana da Silva Arbués, André Castro Lyra, Lourianne Nascimento Cavalcante","doi":"10.1590/S0004-2803.24612025-061","DOIUrl":"10.1590/S0004-2803.24612025-061","url":null,"abstract":"<p><strong>Context: </strong>COVID-19, caused by SARS-CoV-2, is primarily characteri-zed by respiratory symptoms but also significantly affects the gastrointestinal (GI) tract and liver. Emerging evidence suggests that GI and hepatic manifestations may influence disease severity and outcomes. In Brazil, where disparities between public and private healthcare systems are pronounced, understanding these associations is crucial for optimizing patient management. This study aimed to evaluate the frequency and prognostic implications of digestive and hepatic injuries in hospitalized COVID-19 patients.</p><p><strong>Objective: </strong>To analyze the frequency of hepatic and gastrointestinal injuries and their association with outcomes (discharge or death).</p><p><strong>Methods: </strong>A retrospective cross-sectional study analyzed 3,555 patients from 50 private hospitals in Brazil (March-December 2020). Inclusion criteria were age ≥18 years, RT-PCR-confirmed COVID-19, and written consent. Demographic data, comorbidities, GI symptoms (diarrhea, nausea/vomiting, abdominal pain), liver enzymes (ALT, AST), and outcomes (discharge, mortality, ICU admission) were collected via REDCap. Statistical analyses included logistic regression to identify mortality predictors.</p><p><strong>Results: </strong>Among 3,555 patients (59.9% male, mean age 55.8 years). A total of 42.2% of patients presented with at least one gastrointestinal (GI) symptom at admission. Diarrhea was reported in 15%, nausea or vomiting in 13.6%, and abdominal pain in 6.5%, with symptom overlap among patients. The deceased group exhibited significantly higher alanine aminotransferase (ALT) (p=0.019) and aspartate aminotransferase (AST) (p=0.026) levels, representing 4.2- and 8.4-fold increases, respectively, with a higher AST/ALT ratio in fatal cases (1.69 vs 0.84). COVID-19 patients in Brazilian private hospitals showed hepatic abnormalities (AST 354.1 IU/L vs 42.1 IU/L in deceased vs discharged patients, P=0.026), with diarrhea associated with lower mortality (OR 0.61; 95%CI 0.42-0.88), while chronic liver disease (OR 2.95; 95%CI 1.35-6.41) and hypoalbuminemia (OR 0.22; 95%CI 0.11-0.38) emerged as independent predictors of death.</p><p><strong>Conclusion: </strong>Hepatic abnormalities and gastrointestinal symptoms are important markers of COVID-19 severity. Diarrhea, liver enzyme alterations, and serum albumin levels were significant predictors of mortality. Future strategies should prioritize hepatic monitoring, nutritional support, and healthcare equity through targeted interventions for high-risk groups, particularly in resource-limited settings.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"62 ","pages":"e25061"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12683944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INTERLEUKIN-6 AND INTERLEUKIN-10 AS BIOMARKERS OF HEPATOCELLULAR CARCINOMA PROGRESSION: A CROSS-SECTIONAL ANALYSIS OF NUTRITIONAL, CYTOKINE AND SURVIVAL PARAMETERS.","authors":"Iara Carvalho Faria, Leonardo Trevizan Monici, Célia Regina Pavan, Jazon Romilson de Souza Almeida, Sergio Henrique Dias Marques Faria, Tiago Sevá-Pereira","doi":"10.1590/S0004-2803.24612025-058","DOIUrl":"10.1590/S0004-2803.24612025-058","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is the leading cause of mortality among cirrhotic patients, often linked to advanced liver disease.</p><p><strong>Objective: </strong>This cross-sectional study evaluated the nutritional factors, cytokine profiles, liver function parameters, and survival of patients with liver cirrhosis (LC) and HCC.</p><p><strong>Methods: </strong>Forty-seven patients were grouped as LC (n=21) or LC with HCC (n=26). Nutritional status was assessed through anthropometry, bioelectrical impedance analysis, and dietary recall, while cytokine levels (IL-6, IL-10, TNF-α) and biochemical markers (AST, ALT, albumin, prealbumin) were analyzed. Survival data were evaluated using Kaplan-Meier curves and Cox regression.</p><p><strong>Results: </strong>HCC patients exhibited higher IL-6 levels, correlating with advanced disease stages (P=0.035). IL-10 levels were elevated in early-stage HCC (BCLC A) compared to BCLC B (P=0.006). AST and ALT levels were significantly higher in HCC patients, reflecting greater hepatocyte damage. Survival analysis revealed a median of 756 days, with shorter survival in HCC patients (P=0.0172).</p><p><strong>Conclusion: </strong>This study highlights the roles of IL-6 and IL-10 as potential biomarkers in HCC progression and provides critical insights into the biochemical and nutritional profiles associated with LC and HCC. These findings may inform future therapeutic interventions.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"62 ","pages":"e25058"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12683946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EXTRA-PANCREATIC MANIFESTATION IN AUTOIMMUNE PANCREATITIS VERSUS CONVENTIONAL PANCREATITIS: AN EGYPTIAN COHORT.","authors":"Rania A M Abouyoussef, Mohamed Saied Abdelgawad, Mahmoud Agha, Marwa Ibrahim","doi":"10.1590/S0004-2803.24612024-124","DOIUrl":"10.1590/S0004-2803.24612024-124","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Autoimmune pancreatitis (AIP) is a specific form of pancreatitis that is characterized by obstructive jaundice and sometimes associated with pancreatic masses, lymphoplasmacytic infiltrate and fibrosis, with a marked response to steroids. According to International Consensus Diagnostic Criteria AIP is categorized into type 1, type 2, and not otherwise specified (NOS). AIP-1 is one of the presentations of the IgG4-related disease (IgG4-RD) characterized by lymphoplasmacytic infiltration and more than ten IgG4-positive plasma cells per high-power field (HPF), storiform fibrosis, and obliterative phlebitis. Clinically, IgG4-RD is a systemic disease that can affect all organs. It can affect the bile ducts, kidneys, lymph nodes, prostate, and retroperitoneum.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Recognize patients with extra pancreatic manifestation in autoimmune pancreatitis as soon as possible to achieve optimal outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective comparative study was conducted on the previously hospitalized patients to our main university hospital, during the period from June 2022 till June 2024. It is a retrospective study that was done through revision of the patient clinical, laboratory and imaging including CT/MRI of the abdomen and chest CT of all patients. 60 patients with pancreatitis were enrolled in the study. It was diagnosed based on at least two criteria of the following: (1) typical abdominal pain, (2) elevated amylase and/or lipase greater than 3 times, and (3) radiological findings match with pancreatitis. Cases were divided according to the International Consensus Diagnostic Criteria (ICDC) into group A: Autoimmune pancreatitis (AIP) defined by a specific form of pancreatitis characterized by obstructive jaundice with or without pancreatic masses, lymphoplasmacytic infiltrate and fibrosis (from laparotomy biopsies in suspected pancreatic cancer) and a marked response to steroids. And group B: conventional pancreatitis, with 30 patients in each group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A raised serum IgG4 was found in group A patients ranging from 135.0 mg/dL to 212.0 mg/dL with &gt;95% specificity and sensitivity for AIP. The extra pancreatic associated diseases in AIP candidates, were detected in 23 patients (76.6%). Biliary tree complications were seen at 22 patients (73.3%), non calcular gall bladder disease was detected in 9 patients (30%), renal complications were found in 11 patients (36.6%), irrelevant lymphadenopathy in 10 patients (33.3%), retroperitoneal 3 patients (10%). In group B: there were biliary obstructive in 9 patients (30%), calcular cholecystitis was found in 19 patients (63%), with no other recorded extra pancreatic diseases. Chi square and Fisher Exact tests revealed significant differences between the two groups, as regards the extra pancreatic diseases in association with group A.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Type 1 AIP has been associated with several extr","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"62 ","pages":"e24124"},"PeriodicalIF":0.0,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12560843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LIPOTOXICITY PLAYS A KEY ROLE IN THE DEVELOPMENT OF ANGIOGENESIS AND MICROCIRCULATORY MODULATION IN MASLD SPECTRUM.","authors":"André Bubna Hirayama, Isabela Bodaczny Taliberti, Claudia Pinto Marques Souza de Oliveira, Venâncio Avancini Ferreira Alves","doi":"10.1590/S0004-2803.24612025-053","DOIUrl":"10.1590/S0004-2803.24612025-053","url":null,"abstract":"<p><strong>Background: </strong>Chronic liver diseases (CLDs), particularly metabolic-associated steatotic liver disease (MASLD), represent a significant global health burden, with potential progression to fibrosis, portal hypertension, and hepatocellular carcinoma (HCC). This review explores the role of vascular remodeling and angioarchitecture in MASLD pathogenesis, emphasizing the importance of microvascular changes, endothelial dysfunction, and angiogenesis in disease progression. Hepatic steatosis leads to hepatocyte enlargement and sinusoidal compression, disrupting microcirculation and oxygenation. Lipotoxicity, which is driven by excess fatty acids and oxidative stress, triggers inflammation and vascular permeability, fostering a proangiogenic environment. Capillarization of liver sinusoidal endothelial cells (LSECs) and activation of hepatic stellate cells (HSCs) contribute to fibrosis and neovascularization. Angiogenesis, especially via VEGF and other cytokines, is implicated in the transition from steatosis to steatohepatitis (MASH) and ultimately HCC, even in non-cirrhotic livers. Notably, portal hypertension may develop early in MASLD, independent of cirrhosis. Given the central role of vascular alterations in MASLD, future therapies may target endothelial and stromal cell interactions. Further research is needed to delineate disease-specific mechanisms and their implications for fibrosis and carcinogenesis.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"62 ","pages":"e25053"},"PeriodicalIF":0.0,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12560840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}