T. Perez, María Belén Sánchez, M. J. Etchevers, María Josefina Sobrero, Ramiro Cruz González Sueyro, A. Mulinaris, María Lourdes Posadas Martínez, F. Vázquez, J. D. De Paula, M. Marcolongo
Introduction. Inflammatory bowel diseases are systemic disorders that affect the gastrointestinal tract and may present multiple extraintestinal manifestations. Among them, thromboembolic disease stands out and has a great impact on the morbidity and mortality of these patients. The risk of thrombosis in patients with inflammatory bowel disease is almost twice that of the general population, as reported in the literature. Risk factors described for this association include: inflammatory disease activity, hospitalization, recent surgeries, disease extension, and treatments of these conditions. Aim. The main objective of this study was to determine the prevalence of thrombotic events in the population of patients with inflammatory bowel disease followed in a third-level hospital in the city of Buenos Aires and, secondarily, to evaluate the rate of thrombosis in hospitalized patients and in the outpatient population, as well as the associated clinical characteristics. Materials and methods. A descriptive cross-sectional study was conducted that included patients with a diagnosis of inflammatory bowel diseases (Crohn's disease and ulcerative colitis) with follow-up in our center, who developed thrombotic events in the period from January 2002 to December 2020. The electronic medical record was used as a tool to detect and analyze the population of patients diagnosed with inflammatory bowel disease and who suffered the event of interest. Results. A total of 1,753 patients with inflammatory bowel disease were included: 1,352 with ulcerative colitis and 401 with Crohn's disease. Thirty-six of these patients developed the event of interest, resulting in a prevalence of thrombosis in patients with inflammatory bowel diseases of 2.0% (95% CI:1.0-2.8%). Within this group, 77.7% (28) of the events occurred in the outpatient setting and 22.2% (8) in patients. Of the patients with thrombosis, 39.2% (11) had a history of recent hospitalization (in the previous 60 days) and, of this group, 54% (6) developed thrombosis within the first month of discharge. Conclusions. The prevalence of thrombosis, in our population with this condition, was 2%. Most thrombotic events occurred in the outpatient setting. This raises the need for further studies to determine the behavior of instituting prophylactic measures in this group, especially in patients who have required recent hospitalization.
{"title":"Prevalencia de eventos trombóticos en pacientes con enfermedad inflamatoria intestinal con seguimiento en un centro de referencia de la Ciudad de Buenos Aires. Estudio de corte transversal","authors":"T. Perez, María Belén Sánchez, M. J. Etchevers, María Josefina Sobrero, Ramiro Cruz González Sueyro, A. Mulinaris, María Lourdes Posadas Martínez, F. Vázquez, J. D. De Paula, M. Marcolongo","doi":"10.52787/agl.v52i1.171","DOIUrl":"https://doi.org/10.52787/agl.v52i1.171","url":null,"abstract":"Introduction. Inflammatory bowel diseases are systemic disorders that affect the gastrointestinal tract and may present multiple extraintestinal manifestations. Among them, thromboembolic disease stands out and has a great impact on the morbidity and mortality of these patients. The risk of thrombosis in patients with inflammatory bowel disease is almost twice that of the general population, as reported in the literature. Risk factors described for this association include: inflammatory disease activity, hospitalization, recent surgeries, disease extension, and treatments of these conditions. Aim. The main objective of this study was to determine the prevalence of thrombotic events in the population of patients with inflammatory bowel disease followed in a third-level hospital in the city of Buenos Aires and, secondarily, to evaluate the rate of thrombosis in hospitalized patients and in the outpatient population, as well as the associated clinical characteristics. Materials and methods. A descriptive cross-sectional study was conducted that included patients with a diagnosis of inflammatory bowel diseases (Crohn's disease and ulcerative colitis) with follow-up in our center, who developed thrombotic events in the period from January 2002 to December 2020. The electronic medical record was used as a tool to detect and analyze the population of patients diagnosed with inflammatory bowel disease and who suffered the event of interest. Results. A total of 1,753 patients with inflammatory bowel disease were included: 1,352 with ulcerative colitis and 401 with Crohn's disease. Thirty-six of these patients developed the event of interest, resulting in a prevalence of thrombosis in patients with inflammatory bowel diseases of 2.0% (95% CI:1.0-2.8%). Within this group, 77.7% (28) of the events occurred in the outpatient setting and 22.2% (8) in patients. Of the patients with thrombosis, 39.2% (11) had a history of recent hospitalization (in the previous 60 days) and, of this group, 54% (6) developed thrombosis within the first month of discharge. Conclusions. The prevalence of thrombosis, in our population with this condition, was 2%. Most thrombotic events occurred in the outpatient setting. This raises the need for further studies to determine the behavior of instituting prophylactic measures in this group, especially in patients who have required recent hospitalization.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"51 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131324712","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}
El acto médico se basa en la toma de decisiones en condiciones de incertidumbre. Todo lo que hagamos para reducirla aumenta nuestra probabilidad de éxito. Para ello, es fundamental hacer una adecuada interpretación de los resultados de los test diagnósticos. Vamos a recordar las principales definiciones que hacen a la precisión de un test diagnóstico. Las dos medidas básicas son su sensibilidad (S) y especificidad (E). La S es la probabilidad de tener un resultado positivo del test en pacientes que tienen la enfermedad. La E es la probabilidad de tener un resultado negativo en pacientes que no tienen la enfermedad. Al hablar de enfermedad nos estamos refiriendo a la condición que el test sea capaz de detectar. Al realizar un test diagnóstico vamos a encontrar cuatro situaciones posibles. Los verdaderos positivos (VP) son aquellos pacientes con la enfermedad en quienes el test es positivo. Los verdaderos negativos (VN) son aquellos pacientes sin la enfermedad en quienes el test es negativo. Los falsos negativos (FN) son aquellos con la enfermedad en quienes el test es falsamente negativo. Los falsos positivos (FP) son aquellos sin la enfermedad en quienes el test es falsamente positivo. Entonces, podemos definir la S como la probabilidad de encontrar un VP entre los pacientes que tienen la enfermedad (VP/VP+FP) y la E como la probabilidad de tener un VN entre aquellos que no tienen la enfermedad (VN/VN+FP) (Tabla 1). Test diagnósticos: ¿Nos basta con considerar su sensibilidad y especificidad?
{"title":"Test diagnósticos: ¿Nos basta con considerar su sensibilidad y especificidad?","authors":"E. Rossi","doi":"10.52787/fyyw6593","DOIUrl":"https://doi.org/10.52787/fyyw6593","url":null,"abstract":"El acto médico se basa en la toma de decisiones en condiciones de incertidumbre. Todo lo que hagamos para reducirla aumenta nuestra probabilidad de éxito. Para ello, es fundamental hacer una adecuada interpretación de los resultados de los test diagnósticos. Vamos a recordar las principales definiciones que hacen a la precisión de un test diagnóstico. Las dos medidas básicas son su sensibilidad (S) y especificidad (E). La S es la probabilidad de tener un resultado positivo del test en pacientes que tienen la enfermedad. La E es la probabilidad de tener un resultado negativo en pacientes que no tienen la enfermedad. Al hablar de enfermedad nos estamos refiriendo a la condición que el test sea capaz de detectar. Al realizar un test diagnóstico vamos a encontrar cuatro situaciones posibles. Los verdaderos positivos (VP) son aquellos pacientes con la enfermedad en quienes el test es positivo. Los verdaderos negativos (VN) son aquellos pacientes sin la enfermedad en quienes el test es negativo. Los falsos negativos (FN) son aquellos con la enfermedad en quienes el test es falsamente negativo. Los falsos positivos (FP) son aquellos sin la enfermedad en quienes el test es falsamente positivo. Entonces, podemos definir la S como la probabilidad de encontrar un VP entre los pacientes que tienen la enfermedad (VP/VP+FP) y la E como la probabilidad de tener un VN entre aquellos que no tienen la enfermedad (VN/VN+FP) (Tabla 1). Test diagnósticos: ¿Nos basta con considerar su sensibilidad y especificidad?","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127119038","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}
nflammatory bowel disease is an immune mediated condition that includes Crohn’s disease and ulcerative colitis and causes chronic inflammation of the gastrointestinal tract. Although the exact cause for inflammatory bowel disease is unknown, there is consensus that a combination of genetic, environmental, and immune factors participate in its pathogenesis. To date, all the studies have been focused on alterations that occur once IBD has developed, however, the causes triggering the onset of the disease are still unclear. There is an evident genetic basis in which multiple genes involved in intestinal homeostasis are affected, such as NOD2, ATG16L1 and XBP1. However, these genetic factors are not sufficient for disease onset and additional environmental factors such as those related to dysregulation of gut microbiota and the immune system are required. A lower microbial diversity and a decrease in the relative abundance of Firmicutes, as well as an increase in Proteobacteria, have been described in patients with inflammatory bowel disease, but are not found in all studies. In addition to variations in microbial composition, functional changes have also been observed in cross-sectional studies. Longitudinal cohorts in patients at risk for inflammatory bowel disease have recently been conducted allowing us to interrogate whether specific microbial communities and functions could be influencing the onset of the disease. Indeed, a translational study performed in a cohort of at-risk individuals for inflammatory bowel disease (GEM cohort) showed an increased fecal proteolytic activity, associated with microbial composition changes, before the onset of ulcerative colitis. These findings may help develop new non-invasive diagnostic techniques, as well as new therapeutical approaches for inflammatory bowel disease.
{"title":"Mecanismos patogénicos del microbioma en la enfermedad inflamatoria intestinal: rol de la actividad proteolítica bacteriana","authors":"Alba Santiago Badenas, Elena F. Verdu","doi":"10.52787/zdtt9566","DOIUrl":"https://doi.org/10.52787/zdtt9566","url":null,"abstract":"nflammatory bowel disease is an immune mediated condition that includes Crohn’s disease and ulcerative colitis and causes chronic inflammation of the gastrointestinal tract. Although the exact cause for inflammatory bowel disease is unknown, there is consensus that a combination of genetic, environmental, and immune factors participate in its pathogenesis. To date, all the studies have been focused on alterations that occur once IBD has developed, however, the causes triggering the onset of the disease are still unclear. There is an evident genetic basis in which multiple genes involved in intestinal homeostasis are affected, such as NOD2, ATG16L1 and XBP1. However, these genetic factors are not sufficient for disease onset and additional environmental factors such as those related to dysregulation of gut microbiota and the immune system are required. A lower microbial diversity and a decrease in the relative abundance of Firmicutes, as well as an increase in Proteobacteria, have been described in patients with inflammatory bowel disease, but are not found in all studies. In addition to variations in microbial composition, functional changes have also been observed in cross-sectional studies. Longitudinal cohorts in patients at risk for inflammatory bowel disease have recently been conducted allowing us to interrogate whether specific microbial communities and functions could be influencing the onset of the disease. Indeed, a translational study performed in a cohort of at-risk individuals for inflammatory bowel disease (GEM cohort) showed an increased fecal proteolytic activity, associated with microbial composition changes, before the onset of ulcerative colitis. These findings may help develop new non-invasive diagnostic techniques, as well as new therapeutical approaches for inflammatory bowel disease.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"38 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123659844","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}
Gustavo Javier Tagliaferro, Verónica Busoni, María Cecilia Bertinotti, Carmen De Cunto, M. Orsi
Vasculitis is characterized by presenting inflammation of the wall of blood vessels, one type of these diseases are those associated with anti-neutrophil cytoplasm antibodies. They usually occur in adulthood and are rare in childhood. The disease generally affects the lung, kidney, and skin, with gastrointestinal involvement being rare. Here we describe the case of a pediatric patient with gastrointestinal bleeding secondary to ANCA positive vasculitis. Endoscopy revealed patchy erythematous lesions and wall hematoma at the level of the colon. Although we report a fairly infrequent clinical condition, it is not without complications. We believe it is appropriate to suspect it, first of all, intestinal involvement where the underlying inflammatory process is not clear, even more so when it involves other organs.
{"title":"Compromiso gastrointestinal inusual en paciente pediátrico con vasculitis asociada a anticuerpos anticitoplasma de neutrófilos. Reporte de un caso","authors":"Gustavo Javier Tagliaferro, Verónica Busoni, María Cecilia Bertinotti, Carmen De Cunto, M. Orsi","doi":"10.52787/uscw3486","DOIUrl":"https://doi.org/10.52787/uscw3486","url":null,"abstract":"Vasculitis is characterized by presenting inflammation of the wall of blood vessels, one type of these diseases are those associated with anti-neutrophil cytoplasm antibodies. They usually occur in adulthood and are rare in childhood. The disease generally affects the lung, kidney, and skin, with gastrointestinal involvement being rare. Here we describe the case of a pediatric patient with gastrointestinal bleeding secondary to ANCA positive vasculitis. Endoscopy revealed patchy erythematous lesions and wall hematoma at the level of the colon. Although we report a fairly infrequent clinical condition, it is not without complications. We believe it is appropriate to suspect it, first of all, intestinal involvement where the underlying inflammatory process is not clear, even more so when it involves other organs.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"57 8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124481643","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}
Gastón Horacio, Rueda, Gastón H Rueda, Inés Pinto-Sánchez
Probiotics, live microorganisms that produce a beneficial effect on health, are a possible supplement to a gluten-free diet in the treatment of celiac disease. Several clinical studies have shown that celiac patients treated with probiotics improved their gastrointestinal symptoms. Although the mechanisms of probiotics in celiac disease are unclear, preclinical studies in mice suggest different mechanisms, such as the modulation of the intestinal microbiota and the immune system, or through the production of proteases. We conducted a review of the literature to address the current evidence on the efficacy of probiotics in the treatment of celiac disease, possible mechanisms of action, and areas of interest for future research studies.
{"title":"Probióticos en enfermedad celíaca: ¿estamos listos para su aplicación en la práctica clínica?","authors":"Gastón Horacio, Rueda, Gastón H Rueda, Inés Pinto-Sánchez","doi":"10.52787/gqme9827","DOIUrl":"https://doi.org/10.52787/gqme9827","url":null,"abstract":"Probiotics, live microorganisms that produce a beneficial effect on health, are a possible supplement to a gluten-free diet in the treatment of celiac disease. Several clinical studies have shown that celiac patients treated with probiotics improved their gastrointestinal symptoms. Although the mechanisms of probiotics in celiac disease are unclear, preclinical studies in mice suggest different mechanisms, such as the modulation of the intestinal microbiota and the immune system, or through the production of proteases. We conducted a review of the literature to address the current evidence on the efficacy of probiotics in the treatment of celiac disease, possible mechanisms of action, and areas of interest for future research studies.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117225243","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}
Irritable bowel syndrome is the most common functional gastrointestinal disorder, affecting up to 9% individuals globally. Although the etiology of this syndrome is likely heterogenous, it presents with its hallmark symptoms of abdominal pain and altered intestinal motility. Moreover, it is considered to be a disorder of the gut-brain interaction, and the microbiome has often been implicated as a central player in its pathophysiology. Patients with irritable bowel syndrome display altered composition and function of the gut microbiota compared to healthy controls. Microbiome directed therapies, such as probiotics, antibiotics and fecal microbiome transplantation, appear to be beneficial for both gut symptoms and psychiatric comorbidities. This review aims to recapitulate the available literature on the microbiome contribution to the pathophysiology and symptoms presentation of irritable bowel syndrome, as well as the current literature on microbiome-targeted treatments for this disease.
{"title":"Gut Microbiome and Its Role in the Pathophysiology of Irritable Bowel Syndrome","authors":"G. De Palma, P. Bercik","doi":"10.52787/dxfc9250","DOIUrl":"https://doi.org/10.52787/dxfc9250","url":null,"abstract":"Irritable bowel syndrome is the most common functional gastrointestinal disorder, affecting up to 9% individuals globally. Although the etiology of this syndrome is likely heterogenous, it presents with its hallmark symptoms of abdominal pain and altered intestinal motility. Moreover, it is considered to be a disorder of the gut-brain interaction, and the microbiome has often been implicated as a central player in its pathophysiology. Patients with irritable bowel syndrome display altered composition and function of the gut microbiota compared to healthy controls. Microbiome directed therapies, such as probiotics, antibiotics and fecal microbiome transplantation, appear to be beneficial for both gut symptoms and psychiatric comorbidities. This review aims to recapitulate the available literature on the microbiome contribution to the pathophysiology and symptoms presentation of irritable bowel syndrome, as well as the current literature on microbiome-targeted treatments for this disease.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122951077","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}
Tomas Pérez, Romina Lorena Alsina Farreta, M. L. González, A. Pasqua, María Josefina Sobrero, J. Santino, M. Marcolongo
Endometriosis is defined as the presence of endometrial glands in extrauterine sites. Intestinal deep infiltrating endometriosis is considered when the endometriotic lesion is located more than 5 mm below the peritoneum. Intestinal obstruction due to endometriosis is rare, occurring in approximately 1% of cases. We present three cases with intestinal occlusion as deep infiltrating endometriosis debut. Its symptomatic presentation can mimic multiple gastroenterological entities, mainly irritable bowel syndrome or inflammatory bowel disease so its diagnosis can be difficult. However, suspecting this pathology and diagnosing it is important to define therapeutic behavior and improve the quality of life of our patients.
{"title":"Endometriosis intestinal, una causa de suboclusión intestinal poco sospechada. Serie de casos","authors":"Tomas Pérez, Romina Lorena Alsina Farreta, M. L. González, A. Pasqua, María Josefina Sobrero, J. Santino, M. Marcolongo","doi":"10.52787/rjpf3089","DOIUrl":"https://doi.org/10.52787/rjpf3089","url":null,"abstract":"Endometriosis is defined as the presence of endometrial glands in extrauterine sites. Intestinal deep infiltrating endometriosis is considered when the endometriotic lesion is located more than 5 mm below the peritoneum. Intestinal obstruction due to endometriosis is rare, occurring in approximately 1% of cases. We present three cases with intestinal occlusion as deep infiltrating endometriosis debut. Its symptomatic presentation can mimic multiple gastroenterological entities, mainly irritable bowel syndrome or inflammatory bowel disease so its diagnosis can be difficult. However, suspecting this pathology and diagnosing it is important to define therapeutic behavior and improve the quality of life of our patients.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"506 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128849690","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}
M. Arregui, Andrea Besga, Teresita González, C. Zubiri, Verónica Garrido, Julieta Hernández, María Victoria Fasano
Introduction. Nonalcoholic fatty liver disease is the leading cause of chronic liver disease in children with an increasing prevalence and incidence, that evolves with fat deposition in the liver and generates a negative impact on the health and quality of life of patients. Objective. To determine the presence of variables associated with non-alcoholic fatty liver disease in the pediatric population studied. Methods. Observational, cross-sectional study, in which overweight or obese patients aged from 18 months to 16 years were included, treated in the Gastroenterology and Nutrition services of a tertiary pediatric hospital, from September 2009 to February 2019. Two groups were included: 1) "With Fatty Liver": patients with increased liver echogenicity and 2) "Without fatty liver": patients with normal ultrasound study. Both groups were compared analyzing anthropometric, biochemical, perinatal and personal history variables. Results. 371 overweight or obese patients were included, showing that a history of prematurity and low birth weight were factors associated with fatty liver. Preterm newborns have 14 times more chances of fatty liver than term newborns [OR 14.08 95% CI (2.31- 577.54)]; while patients with low birth weight (< 2500 g) have three times the chances of having fatty liver [OR 3.38 95% CI (1.01; 17.77)]. Exclusive breastfeeding up to the sixth month reduced the chances of fatty liver [OR 0.29 95% CI (0.15-0.53)]. Physical examination showed that acanthosis nigricans in the neck and armpits, and increased abdominal circumference were more prevalent in the Fatty Liver group (p < 0.05) as well as, the altered biochemical variables of aspartate aminotransferase and alanine aminotransferase, insulin (p < 0.05) and triglycerides (p = 0.0004). Conclusion: The search for variables associated with fatty liver is of vital importance in the early and timely diagnosis of this entity. The history of prematurity and low weight represent a risk factor, while exclusive breastfeeding up to the sixth month would prove to be a protective factor for the development of fatty liver. On physical examination, acanthosis nigricans and increased abdominal circumference were more common in the fatty liver group. Regarding the biochemical variables, the alteration of transaminases, insulin and triglycerides were significantly greater in the group with fatty liver.
{"title":"Factores asociados al hígado graso en una población pediátrica","authors":"M. Arregui, Andrea Besga, Teresita González, C. Zubiri, Verónica Garrido, Julieta Hernández, María Victoria Fasano","doi":"10.52787/hsps8298","DOIUrl":"https://doi.org/10.52787/hsps8298","url":null,"abstract":"Introduction. Nonalcoholic fatty liver disease is the leading cause of chronic liver disease in children with an increasing prevalence and incidence, that evolves with fat deposition in the liver and generates a negative impact on the health and quality of life of patients. Objective. To determine the presence of variables associated with non-alcoholic fatty liver disease in the pediatric population studied. Methods. Observational, cross-sectional study, in which overweight or obese patients aged from 18 months to 16 years were included, treated in the Gastroenterology and Nutrition services of a tertiary pediatric hospital, from September 2009 to February 2019. Two groups were included: 1) \"With Fatty Liver\": patients with increased liver echogenicity and 2) \"Without fatty liver\": patients with normal ultrasound study. Both groups were compared analyzing anthropometric, biochemical, perinatal and personal history variables. Results. 371 overweight or obese patients were included, showing that a history of prematurity and low birth weight were factors associated with fatty liver. Preterm newborns have 14 times more chances of fatty liver than term newborns [OR 14.08 95% CI (2.31- 577.54)]; while patients with low birth weight (< 2500 g) have three times the chances of having fatty liver [OR 3.38 95% CI (1.01; 17.77)]. Exclusive breastfeeding up to the sixth month reduced the chances of fatty liver [OR 0.29 95% CI (0.15-0.53)]. Physical examination showed that acanthosis nigricans in the neck and armpits, and increased abdominal circumference were more prevalent in the Fatty Liver group (p < 0.05) as well as, the altered biochemical variables of aspartate aminotransferase and alanine aminotransferase, insulin (p < 0.05) and triglycerides (p = 0.0004). Conclusion: The search for variables associated with fatty liver is of vital importance in the early and timely diagnosis of this entity. The history of prematurity and low weight represent a risk factor, while exclusive breastfeeding up to the sixth month would prove to be a protective factor for the development of fatty liver. On physical examination, acanthosis nigricans and increased abdominal circumference were more common in the fatty liver group. Regarding the biochemical variables, the alteration of transaminases, insulin and triglycerides were significantly greater in the group with fatty liver.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114255276","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}
A. Romano-Munive, C. Moctezuma-Velázquez, D. Keil-Ríos, S. Sixtos-Alonso, R. I. Que-Rodríguez, D. Kershenobich-Stalnikowitz
10 cases was confirmed the diagnosis of autoimmune hepatitis and in 4 cases the biopsy was compatible with steatosis/ steatohepatitis. Twenty-two patients were included in the control group. No statistically significant differences were found between the groups in terms of plasma CCL16 levels (p = NS). Its concentration was not associated with the presence of liver fibrosis in the biopsy (p = 0.28) or with the response after 6 months of treatment (p = 0.90). Conclu-sion . This is a study that has determined the expression of chemokine CCL16 in patients with autoimmune hepatitis. It was observed that the plasma secretion of CCL16 decreased in the autoimmune hepatitis group, compared to the control group, but this difference was not statistically significant.
{"title":"Plasma CCL16 Chemokine Secretion and Expression in Liver Tissue of Patients with Autoimmune Hepatitis: A Pilot Study","authors":"A. Romano-Munive, C. Moctezuma-Velázquez, D. Keil-Ríos, S. Sixtos-Alonso, R. I. Que-Rodríguez, D. Kershenobich-Stalnikowitz","doi":"10.52787/mmne5431","DOIUrl":"https://doi.org/10.52787/mmne5431","url":null,"abstract":"10 cases was confirmed the diagnosis of autoimmune hepatitis and in 4 cases the biopsy was compatible with steatosis/ steatohepatitis. Twenty-two patients were included in the control group. No statistically significant differences were found between the groups in terms of plasma CCL16 levels (p = NS). Its concentration was not associated with the presence of liver fibrosis in the biopsy (p = 0.28) or with the response after 6 months of treatment (p = 0.90). Conclu-sion . This is a study that has determined the expression of chemokine CCL16 in patients with autoimmune hepatitis. It was observed that the plasma secretion of CCL16 decreased in the autoimmune hepatitis group, compared to the control group, but this difference was not statistically significant.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128917601","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}
Larisse Longo, Henrique Mariano Pereira Matheus, Deivid Cruz dos Santos, Matheus Trucollo Michalczuk, Carlos Thadeu Schmidt Cersk, M. Álvares-da-Silva
Introduction and Objectives. Liver biopsy is the gold standard for assessing fibrosis and inflammation in liver transplant recipients. As this study has risks, the use of noninvasive tools has been proposed, including transient elastography, a method that needs further study in this population, which is the purpose of this research. Material and methods. Demographic and clinical data were collected retrospectively in patients who received a liver transplant, underwent liver biopsy and transient elastography less than 1 year apart. Sensitivity, specificity, diagnostic accuracy and Kappa concordance test between the two methods were determined. Results. Of 356 patients evaluated after transplantation, 45 underwent liver biopsy and transient elastography within 1 year; 60.0% were male and 75.6% had hepatitis C virus infection. At the time of transient elastography, laboratory values were: mean total bilirubin 1.5 mg/dL, alanine aminotransferase 108.1 U/L, aspartate aminotransferase, 101.6 U/L, alkaline phosphatase, 96.0 U/L and gamma-glutamyl transferase 9.0 U/L. The main indications for liver biopsy were assessment for rejection, hepatitis C virus infection or both. According to liver biopsy, 82.2% presented absent or minimal fibrosis and 75.6% had no inflammation. Acute cellular rejection was present in 20.0% of cases. A cut-off point of > 9.5 kPa was used to define advanced fibrosis, while a value < 7.5 kPa was set to indicate absent or mild fibrosis. Poor agreement was found between transient elastography and liver biopsy for these categories (Kappa 0.125, sensitivity 69.5%, specificity 66.7%) and for specific stages of fibrosis (Kappa 0.095). Conclusions. Accuracy, sensitivity and specificity were low for fibrosis staging when comparing transient elastography with liver biopsy. In liver transplant recipients, transient elastography would overestimate fibrosis, probably due to inflammation secondary to other causes.
{"title":"Transient Hepatic Elastography in the Assessment of Liver Fibrosis in Patients After Liver Transplantation","authors":"Larisse Longo, Henrique Mariano Pereira Matheus, Deivid Cruz dos Santos, Matheus Trucollo Michalczuk, Carlos Thadeu Schmidt Cersk, M. Álvares-da-Silva","doi":"10.52787/wdom2933","DOIUrl":"https://doi.org/10.52787/wdom2933","url":null,"abstract":"Introduction and Objectives. Liver biopsy is the gold standard for assessing fibrosis and inflammation in liver transplant recipients. As this study has risks, the use of noninvasive tools has been proposed, including transient elastography, a method that needs further study in this population, which is the purpose of this research. Material and methods. Demographic and clinical data were collected retrospectively in patients who received a liver transplant, underwent liver biopsy and transient elastography less than 1 year apart. Sensitivity, specificity, diagnostic accuracy and Kappa concordance test between the two methods were determined. Results. Of 356 patients evaluated after transplantation, 45 underwent liver biopsy and transient elastography within 1 year; 60.0% were male and 75.6% had hepatitis C virus infection. At the time of transient elastography, laboratory values were: mean total bilirubin 1.5 mg/dL, alanine aminotransferase 108.1 U/L, aspartate aminotransferase, 101.6 U/L, alkaline phosphatase, 96.0 U/L and gamma-glutamyl transferase 9.0 U/L. The main indications for liver biopsy were assessment for rejection, hepatitis C virus infection or both. According to liver biopsy, 82.2% presented absent or minimal fibrosis and 75.6% had no inflammation. Acute cellular rejection was present in 20.0% of cases. A cut-off point of > 9.5 kPa was used to define advanced fibrosis, while a value < 7.5 kPa was set to indicate absent or mild fibrosis. Poor agreement was found between transient elastography and liver biopsy for these categories (Kappa 0.125, sensitivity 69.5%, specificity 66.7%) and for specific stages of fibrosis (Kappa 0.095). Conclusions. Accuracy, sensitivity and specificity were low for fibrosis staging when comparing transient elastography with liver biopsy. In liver transplant recipients, transient elastography would overestimate fibrosis, probably due to inflammation secondary to other causes.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125434107","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}
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