Gastroenterologia y hepatologia最新文献

英文中文

Scale for endoscopic detection of Helicobacter pylori infection in a high prevalence area. 内镜下检测幽门螺杆菌感染量表在高发地区的应用。

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2025-10-10 DOI: 10.1016/j.gastrohep.2025.502578

Carlos Mauricio Martínez Montalvo, Martín Alonso Gómez Zuleta, Oscar Fernando Ruiz, Lina Marcela Muñoz-Solano, Daniel Andrés Forero Vargas

Introduction: Colombia is a country with a high prevalence of Hp infection and gastric cancer (GC). The objective of this study was to evaluate the diagnostic yield of endoscopic findings for the diagnosis of Hp infection and, based on these findings, develop a new prediction score applicable to the local population.

Methods: Endoscopic findings were evaluated, and photographs were taken according to K. Yao's 22 stations in all individuals who underwent gastroscopy between January 1 and August 2023. All patients underwent biopsy with the Sydney protocol and hematoxylin, eosin, and Giemsa staining. Univariate and bivariate analysis was performed, with logistic regression evaluating a new score applicable to the cohort.

Results: A total of 200 patients were included. The prevalence of Hp was 47.5%. The presence of nodular gastropathy and abnormalities in the regular arrangement of collecting venules (RAC) were the endoscopic findings with the highest PPV and NPV, respectively, while atrophy assessed with the Kimura-Takemoto score had a very poor correlation with Hp. The Kyoto score had an AUC of 0.71 and the modified Kyoto score had an AUC of 0.76, which is lower than the performance in the Asian population. With the findings with better correlation, a new endoscopic score called ROVIRA was created with a cut-off point ≥3 and an AUC of 0.91 for this cohort, which suggests that it could become a more accurate clinical tool to identify active infection.

Conclusion: Endoscopic findings are useful for predicting Hp infection, highlighting that the preserved RAC is sensitive to rule out Hp infection with a high NPV and on the other hand the nodularity or follicular pattern due to its good specificity. The new ROVIRA scale showed better performance than the Kyoto and modified Kyoto scores in this cohort, suggesting its potential as a clinical tool in Colombia or countries where, in addition to a high prevalence of gastric cancer, there is also a high prevalence of Hp. However, these data will require further validation.

哥伦比亚是Hp感染和胃癌（GC）高发的国家。本研究的目的是评估内窥镜检查结果对Hp感染诊断的诊断率，并基于这些结果，开发一种适用于当地人群的新的预测评分。方法：对2023年1月1日至8月期间接受胃镜检查的所有患者进行内镜检查结果评估，并根据K. Yao的22个站点拍摄照片。所有患者均行悉尼方案活检，苏木精、伊红和吉姆萨染色。进行单因素和双因素分析，用逻辑回归评估适用于该队列的新评分。结果：共纳入200例患者。Hp患病率为47.5%。结节性胃病和集静脉规则排列异常（RAC）分别是最高PPV和NPV的内镜表现，而用Kimura-Takemoto评分评估的萎缩与Hp的相关性很差。京都得分的AUC为0.71，修正京都得分的AUC为0.76，低于亚洲人群的表现。由于研究结果具有更好的相关性，我们创建了一种新的内镜评分，称为ROVIRA，该队列的截断点≥3，AUC为0.91，这表明它可以成为一种更准确的临床工具来识别活动性感染。结论：内镜检查结果有助于预测Hp感染，强调保留的RAC对排除NPV高的Hp感染敏感，另一方面由于其良好的特异性，结节性或滤泡性模式被排除。在该队列中，新的ROVIRA量表表现出比京都量表和修改的京都量表更好的表现，这表明它在哥伦比亚或除了胃癌高患病率外，Hp也高患病率的国家具有作为临床工具的潜力。然而，这些数据还需要进一步的验证。

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引用次数: 0

Severe acute hepatitis E with unilateral amyotrophic neuralgia: A diagnostic challenge. 严重急性戊型肝炎伴单侧肌萎缩性神经痛：诊断挑战。

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2025-10-09 DOI: 10.1016/j.gastrohep.2025.502585

Ana Pascual-Dapena, Anna Pocurull, Xavier Forns

引用次数: 0

Diagnostic value and clinical implications of ⁷⁵SeHCAT scan in bile acid diarrhea. 75SeHCAT扫描对胆汁酸性腹泻的诊断价值及临床意义。

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2025-09-24 DOI: 10.1016/j.gastrohep.2025.502584

Daniel Riado Mínguez, Flor María Fernández-Gordón, Miguel Casado Portolés, Celia Gómez Labrador, Cristina Cuadrado Tiemblo, Carolina Georgina Suárez Cabredo, Luis Wesley Wong Becerra, Carlos Castaño Milla

引用次数: 0

On the need for patient-centered approaches to Helicobacter pylori management in geriatric populations. 在老年人群中以患者为中心的幽门螺杆菌管理方法的必要性。

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2025-09-24 DOI: 10.1016/j.gastrohep.2025.502583

Camila S Badell, Eloy F Ruiz

引用次数: 0

Pancreatic panniculitis as the only manifestation. 胰腺膜炎为唯一表现。

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2025-09-24 DOI: 10.1016/j.gastrohep.2025.502582

Sara Rodríguez Vega, Yaiza Rey Fanjul, Jorge Rodríguez Prida

引用次数: 0

The Spanish National Strategic Plan for Hepatitis C: A legacy of success 西班牙国家丙型肝炎战略计划：成功的遗产。

IF 2.2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2025-07-07 DOI: 10.1016/j.gastrohep.2025.502457

Javier Crespo , Agustín Albillos , María Buti

引用次数: 0

The Spanish National Strategic Plan for Hepatitis C: A legacy of success. 西班牙国家丙型肝炎战略计划：成功的遗产。

IF 2.2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2025-05-28 DOI: 10.1016/j.gastrohep.2025.502457

Javier Crespo, Agustín Albillos, María Buti

引用次数: 0

Colonoscopy in symptomatic patients: Validation of AEG-SEED prioritization criteria and added value of FIT. The endoprior study 有症状患者的结肠镜检查：验证AEG-SEED优先标准和FIT的附加价值。内啡肽研究。

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2025-05-21 DOI: 10.1016/j.gastrohep.2025.502471

Liseth Rivero-Sánchez , Joaquín Castillo-Iturra , Ana García-Rodríguez , Beatriz García Zafra , Pilar Díez Redondo , Henar Núñez Rodríguez , Marta Ponce , Mileidis San Juan , Pilar Borque Barrera , Agustín Seoane , Marc Albert Carrasco , Diana Zaffalon , Carlos Guarner , Marianette Murzi , Rodrigo Jover , Lucía Medina-Prado , Kattalin Aspuru Rubio , Diana João Matias , Begoña González Suárez , Henry Córdova , Gloria Fernández-Esparrach

Background and aims

Colorectal cancer (CRC) is one of the leading causes of cancer-related mortality. Colonoscopy is the diagnostic gold standard, although its performance in symptomatic patients is limited. During the COVID-19 pandemic, the AEG-SEED societies proposed a clinical prioritization system. The aim of this study was to validate its diagnostic performance in detecting clinically relevant lesions (CRLs), including CRC, and to compare it with the fecal immunochemical test (FIT).

Patients and methods

A national multicenter retrospective study was conducted in 12 Spanish hospitals. A total of 1078 adult patients with digestive symptoms attended between April and December 2020 were included. Colonoscopies were prospectively classified according to priority levels (P1, P2, P3).

Results

CRLs were identified in 18% of patients, including 36 cases of CRC (3%). The diagnostic yield was highest in P1 (PPV 27%, AUC 0.57 for CRLs; PPV 7%, AUC 0.64 for CRC), and decreased in P2 and P3. FIT was performed in 26% of patients based on the referring physician's clinical judgment, showing higher sensitivity and negative predictive value (NPV) for CRC (100%) and a higher AUC (0.69) compared to clinical criteria.

Conclusions

The AEG-SEED clinical criteria offer moderate value for prioritizing colonoscopies in the absence of FIT. However, FIT demonstrates superior diagnostic performance and should be systematically incorporated. The combination of symptoms improves accuracy compared to isolated symptoms.

背景和目的：结直肠癌（CRC）是癌症相关死亡的主要原因之一。结肠镜检查是诊断的金标准，尽管其在有症状患者中的表现有限。在COVID-19大流行期间，AEG-SEED协会提出了临床优先级系统。本研究的目的是验证其在检测包括CRC在内的临床相关病变（crl）方面的诊断性能，并将其与粪便免疫化学试验（FIT）进行比较。患者和方法：在西班牙12家医院进行了一项全国性多中心回顾性研究。在2020年4月至12月期间，共有1078名有消化系统症状的成年患者被纳入研究。结肠镜检查按照优先级（P1, P2, P3）进行前瞻性分类。结果：18%的患者发现了crl，其中36例为CRC（3%）。P1的诊断率最高(PPV为27%，crl的AUC为0.57；PPV为7%，CRC的AUC为0.64)，P2和P3降低。26%的患者根据转诊医师的临床判断进行FIT，与临床标准相比，对CRC的敏感性和阴性预测值（NPV）更高（100%），AUC更高（0.69）。结论：在没有FIT的情况下，AEG-SEED临床标准对优先进行结肠镜检查具有中等价值。然而，FIT表现出优越的诊断性能，应系统地纳入。与孤立症状相比，症状组合可提高准确性。

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引用次数: 0

Portal vein thrombosis in the absence of cirrhosis: Diagnostic and therapeutic approach in clinical practice 无肝硬化门静脉血栓形成：临床诊断和治疗方法。

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2025-05-21 DOI: 10.1016/j.gastrohep.2025.502470

Asunción Ojeda , Arantxa Gelabert , Virginia Hernández-Gea , Juan Carlos García-Pagán

Non-cirrhotic non tumoral portal vein thrombosis is an entity of low prevalence but with a potential risk of developing complications of portal hypertension, which has a significant prognostic impact on patients. In the absence of liver cirrhosis, it is essential to rule out other chronic liver disease as well as local factors and prothrombotic conditions. Therefore, a thorough workup should be initiated immediately. In acute thrombosis, anticoagulation is the main treatment to prevent progression of thrombosis and development of intestinal ischemia. In chronic forms, however, close follow-up is essential to prevent and treat complications of portal hypertension. For refractory complications of portal hypertension, endovascular recanalization techniques have promising results and are becoming increasingly important.

非肝硬化非肿瘤性门静脉血栓是一种低患病率的实体，但具有发展为门静脉高压并发症的潜在风险，对患者的预后有重要影响。在没有肝硬化的情况下，必须排除其他慢性肝病以及局部因素和血栓形成前疾病。因此，应该立即进行彻底的检查。在急性血栓形成中，抗凝是预防血栓形成和肠缺血发展的主要治疗方法。然而，对于慢性形式的门脉高压，密切的随访对于预防和治疗并发症是必不可少的。对于门静脉高压症的难治性并发症，血管内再通技术有很好的效果，并且变得越来越重要。

引用次数: 0

Transoral outlet reduction for dumping syndrome after gastric bypass: A case series 经口出口复位治疗胃旁路术后倾倒综合征：一个病例系列。

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2025-05-18 DOI: 10.1016/j.gastrohep.2025.502468

Joan Llach , Lilliam Flores , Ana de Hollanda , Alba Andreu , Eduard Espinet-Coll , Gherzon Casanova , Maria Isabel Olivé , Eva Rivas , Ainitze Ibarzabal , Javier Osorio , Josep Vidal , Francesc Balaguer , Maria Pellisé

引用次数: 0

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