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  1. Article ; Online: Diagnostic accuracy of artificial intelligence-aided capsule endoscopy (TOP100) in overt small bowel bleeding.

    Giordano, Antonio / Escapa, Miriam / Urpí-Ferreruela, Miquel / Casanova, Gherzon / Fernández-Esparrach, Gloria / Ginès, Àngels / Llach, Josep / González-Suárez, Begoña

    Surgical endoscopy

    2023  Volume 37, Issue 10, Page(s) 7658–7666

    Abstract: Background: Capsule endoscopy (CE) is the first-choice exploration in case of overt small bowel bleeding (SBB). An early CE is known to increase diagnostic yield, but long reading times may delay therapeutics. The study evaluates the diagnostic ... ...

    Abstract Background: Capsule endoscopy (CE) is the first-choice exploration in case of overt small bowel bleeding (SBB). An early CE is known to increase diagnostic yield, but long reading times may delay therapeutics. The study evaluates the diagnostic performance of the artificial intelligence tool TOP100 in patients with overt SBB undergoing early CE with Pillcam SB3.
    Methods: Patients who underwent early CE (up to 14 days from the bleeding episode) for suspected overt SBB were included. One experienced endoscopist prospectively performed standard reading (SR) and a second blind experienced endoscopist performed a TOP100-based reading (TR). The primary endpoint was TR diagnostic accuracy for lesions with high bleeding potential (P2).
    Results: A total of 111 patients were analyzed. The most common clinical presentation was melena (64%). CE showed angiodysplasias in 40.5% of patients (45/111). In per-patient analysis, TR showed a sensitivity of 90.48% (95% CI 82.09-95.80), specificity of 100% (95% CI 87.23-100) with a PPV of 100% (95% CI 94.01-100), NPV of 77.14% (95% CI 63.58-86.71) and diagnostic accuracy of 92.79 (86.29-96.84). At multivariate analysis, adequate intestinal cleansing was the only independent predictor of concordance between TR and SR (OR 2.909, p = 0.019). The median reading time for SR and TR was 23 min (18.0-26.8) and 1.9 min (range 1.7-2.1), respectively (p < 0.001).
    Conclusions: TOP100 provides a fast-reading mode for early CE in case of overt small bowel bleeding. It identifies most patients with active bleeding and angiodysplasias, aiding in the prioritization of therapeutic procedures. However, its accuracy in detecting ulcers, varices and P1 lesions seems insufficient.
    MeSH term(s) Humans ; Capsule Endoscopy ; Artificial Intelligence ; Gastrointestinal Hemorrhage/diagnostic imaging ; Gastrointestinal Hemorrhage/etiology ; Intestine, Small/diagnostic imaging ; Intestine, Small/pathology ; Angiodysplasia/diagnosis ; Angiodysplasia/diagnostic imaging
    Language English
    Publishing date 2023-07-26
    Publishing country Germany
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639039-0
    ISSN 1432-2218 ; 0930-2794
    ISSN (online) 1432-2218
    ISSN 0930-2794
    DOI 10.1007/s00464-023-10273-w
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  2. Article ; Online: An imported case of e-cigarette or vaping associated lung injury in Barcelona.

    Casanova, Gherzon Simón / Amaro, Rosanel / Soler, Néstor / Sánchez, Marcelo / Badía, Joan Ramón / Barberà, Joan Albert / Agustí, Alvar

    The European respiratory journal

    2020  Volume 55, Issue 2

    MeSH term(s) Electronic Nicotine Delivery Systems ; Humans ; Illinois ; Lung Injury ; Vaping ; Wisconsin
    Language English
    Publishing date 2020-02-06
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 639359-7
    ISSN 1399-3003 ; 0903-1936
    ISSN (online) 1399-3003
    ISSN 0903-1936
    DOI 10.1183/13993003.02076-2019
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  3. Article: Fecal Calprotectin for Small Bowel Crohn's Disease: Is It a Cutoff Issue?

    Romero-Mascarell, Cristina / Fernández-Esparrach, Gloria / Rodríguez-De Miguel, Cristina / Masamunt, Maria Carme / Rodríguez, Sonia / Rimola, Jordi / Urpí, Miguel / Casanova, Gherzon Simon / Ordás, Ingrid / Ricart, Elena / Caballol, Berta / Fernández-Clotet, Agnès / Panés, Julià / Llach, Josep / González-Suárez, Begoña

    Diagnostics (Basel, Switzerland)

    2022  Volume 12, Issue 9

    Abstract: 1) Background: Fecal calprotectin (FC) correlates well with colonic inflammatory activity of Crohn’s disease (CD); data about relation of FC and small bowel (SB) lesions are still contradictory. The main aim was to analyze the relationship between FC ... ...

    Abstract (1) Background: Fecal calprotectin (FC) correlates well with colonic inflammatory activity of Crohn’s disease (CD); data about relation of FC and small bowel (SB) lesions are still contradictory. The main aim was to analyze the relationship between FC levels and SB inflammatory activity in patients with established or suspected Crohn’s disease, assessed by small bowel capsule endoscopy (SBCE) or magnetic resonance enterography (MRE). (2) Methods: Two cohorts of patients were included: 1. Prospective data were collected from patients with established or suspected CD who underwent SBCE and FC (Cohort A); 2. A retrospective cohort of patients who underwent MRE and FC determination (Cohort B). Different cutoffs for FC were tested in both cohorts. (3) Results: 83 patients were included and 66 were finally analyzed. A total of 69.6% had SB lesions seen by SBCE (n = 25) or MRE (n = 21). FC mean levels were 605.74 + 607.07 μg/g (IQ range: 99.00−878.75), being significantly higher in patients with SB lesions compared to patients without lesions (735.91 + 639.70 μg/g (IQ range: 107.75−1366.25) vs. 306.35 + 395.26 μg/g (IQ range: 78.25−411.0), p < 0.005). For cohort A, 25 out of 35 patients had SB lesions and a significant correlation between Lewis Score and FC levels was achieved (R2: 0.34; p = 0.04). FC sensitivity (S), specificity (E), positive predictive value (PPV), and negative predictive values (NPV) for predicting SB lesions were 80%, 50%, 80%, and 50%, respectively, for FC > 100 µg/g. For cohort B, inflammatory SB activity, measured by MaRIA score, was detected in 21 out of 31 patients (67.7%). Patients with positive findings in MRE had significantly higher values of FC than those with no lesions (944.9 + 672.1 µg/g vs. 221 + 212.2 µg/g, p < 0.05). S, E, PPV, and NPV of FC were 89%, 50%, 77.2%, and 71.4% for FC levels > 100 µg/g. The higher sensitivity and specificity of the FC levels for the detection of SB lesions with SBCE and MRE was obtained for an FC cutoff >265 μg/g and >430 μg/g, respectively. (4) Conclusions: FC has a good correlation with the presence of SB lesions, assessed by SBCE and MRE, in patients with established or suspected Crohn’s disease. However, the ideal cutoff is here proven to be higher than previously reported. Multicenter and large prospective studies are needed in order to establish definitive FC cutoff levels.
    Language English
    Publishing date 2022-09-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics12092226
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  4. Article: Serological levels of IGF-1 and IGFBP-3 in patients with Barrett's esophagus and esophageal adenocarcinoma: Longitudinal study.

    Uchima, Hugo / Da Fieno, Angella / Bonilla, Araceli / Melo-Borges, Jordana / Sánchez-Montes, Cristina / Cuatrecasas, Míriam / Córdova, Henry / Elizalde, Ignasi / Rakislova, Natalia / Gratacós-Ginès, Jordi / Bayarri, Carolina / Casanova, Gherzon / Ginès, Àngels / Llach, Josep / Balaguer, Francesc / Fernández-Esparrach, Glòria

    Gastroenterologia y hepatologia

    2022  Volume 46, Issue 5, Page(s) 360–368

    Abstract: Background: Barrett's esophagus (BE) is an entity with a known histological progression to malignancy. The insulin-like growth factor (IGF) system is involved in the carcinogenesis through obesity-related mechanisms that include IGF and it has been ... ...

    Title translation Niveles séricos de IGF-1 e IGFBP-3 en pacientes con esófago de Barrett y adenocarcinoma de esófago. Estudio longitudinal.
    Abstract Background: Barrett's esophagus (BE) is an entity with a known histological progression to malignancy. The insulin-like growth factor (IGF) system is involved in the carcinogenesis through obesity-related mechanisms that include IGF and it has been associated with several types of cancer.
    Objectives: To evaluate the serological levels of IGF-1 and IGFBP-3 in patients with BE and esophageal adenocarcinoma.
    Patients and methods: Prospective study of patients with BE and esophageal adenocarcinoma who underwent upper endoscopy between September 2012 and December 2015. A baseline determination of IGF-1 and IGFBP-3 was performed. We included a control group of patients without BE.
    Results: One hundred sixteen patients were included: 36 controls, 62 with BE (42 without dysplasia and 20 with dysplasia) and 18 with adenocarcinoma. IGF-1 and IGF-1/IGFBP-3 molar ratio showed a progression to high levels in BE and adenocarcinoma than in controls (IGF-1: 135.55±66.07ng/ml, 148.33±81.5ng/ml, 108.19±46.69ng/ml, respectively; P=.049) (molar ratio: 0.23±0.91, 0.29±0.11, 0.19±0.06, respectively; P=.001), without differences between the histological types of BE. Fifty-four out of the 65 patients with BE were followed up (median of 58.50 months, range 12-113) and 11 of them (20.4%) presented progression to low-grade dysplasia (n=8) or high-grade dysplasia/adenocarcinoma (n=3), without differences in the IGF system compared with patients without progression.
    Conclusions: Patients with BE and esophageal adenocarcinoma have changes in the IGF system although the serological levels of IGF-1 and IGFBP-3 do not correlate with histological progression of BE.
    MeSH term(s) Humans ; Barrett Esophagus/metabolism ; Barrett Esophagus/pathology ; Longitudinal Studies ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I/metabolism ; Prospective Studies ; Disease Progression ; Esophageal Neoplasms/pathology ; Adenocarcinoma/pathology
    Chemical Substances Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I (67763-96-6)
    Language Spanish
    Publishing date 2022-09-28
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 632502-6
    ISSN 0210-5705
    ISSN 0210-5705
    DOI 10.1016/j.gastrohep.2022.09.005
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    Zs.A 2044: Show issues Location:
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  5. Article ; Online: Motorized Spiral Enteroscopy Is Effective in Patients with Prior Abdominal Surgery.

    Giordano, Antonio / Casanova, Gherzon / Escapa, Miriam / Fernández-Esparrach, Gloria / Ginès, Àngels / Sendino, Oriol / Araujo, Isis K / Cárdenas, Andrés / Córdova, Henry / Martínez-Ocon, Julia / Martínez-Palli, Graciela / Balaguer, Francesc / Llach, Josep / Ricart, Elena / González-Suárez, Begoña

    Digestive diseases and sciences

    2022  Volume 68, Issue 4, Page(s) 1447–1454

    Abstract: Background: Motorized Spiral Enteroscopy (MSE) reduces procedure time and increases insertion depth into the small bowel; however, there is scarce evidence on factors affecting MSE efficacy.: Aims: To evaluate diagnostic yield and adverse events of ... ...

    Abstract Background: Motorized Spiral Enteroscopy (MSE) reduces procedure time and increases insertion depth into the small bowel; however, there is scarce evidence on factors affecting MSE efficacy.
    Aims: To evaluate diagnostic yield and adverse events of MSE including patients with prior major abdominal surgery.
    Methods: A prospective observational study was conducted on patients undergoing MSE from June 2019 to December 2021. Demographic characteristics, procedure time, depth of maximum insertion (DMI), technical success, diagnostic yield, and adverse events were collected.
    Results: Seventy-four anterograde (54.4%) and 62 retrograde (45.6%) enteroscopies were performed in 117 patients (64 males, median age 67 years). Fifty patients (42.7%) had prior major abdominal surgery. Technical success was 91.9% for anterograde and 90.3% for retrograde route. Diagnostic yield was 71.6% and 61.3%, respectively. The median DMI was 415 cm (264-585) for anterograde and 120 cm (37-225) for retrograde enteroscopy. In patients with prior major abdominal surgery, MSE showed significantly longer small bowel insertion time (38 vs 29 min, p = 0.004), with similar diagnostic yield (61 vs 71.4%, p = 0.201) and DMI (315 vs 204 cm, p = 0.226). The overall adverse event rate was 10.3% (SAE 1.5%), with no differences related to prior abdominal surgery (p = 0.598). Patients with prior surgeries directly involving the gastrointestinal tract showed lower DMI (189 vs 374 cm, p = 0.019) with equal exploration time (37.5 vs 38 min, p = 0.642) compared to those with other abdominal surgeries.
    Conclusions: MSE is effective and safe in patients with major abdominal surgery, although longer procedure times were observed. A lower depth of insertion was detected in patients with gastrointestinal surgery.
    MeSH term(s) Male ; Humans ; Aged ; Intestinal Diseases/diagnosis ; Endoscopy, Gastrointestinal/adverse effects ; Endoscopy, Gastrointestinal/methods ; Prospective Studies ; Laparoscopy ; Intestine, Small/surgery ; Double-Balloon Enteroscopy/methods
    Language English
    Publishing date 2022-09-14
    Publishing country United States
    Document type Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 304250-9
    ISSN 1573-2568 ; 0163-2116
    ISSN (online) 1573-2568
    ISSN 0163-2116
    DOI 10.1007/s10620-022-07688-1
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  6. Article ; Online: Hepatitis C-related cirrhosis will be a marginal cause of hospital admissions by 2025.

    Rodríguez-Tajes, Sergio / Pocurull, Anna / Castillo, Joaquín / Casanova, Gherzon / Vega, Laia / Lens, Sabela / Mariño, Zoe / Londoño, María-Carlota / Forner, Alejandro / Torres, Ferran / Forns, Xavier

    Journal of hepatology

    2020  Volume 73, Issue 6, Page(s) 1360–1367

    Abstract: Background & aims: Complications of cirrhosis are the main cause of hospital admissions in liver units. In areas where HCV is prevalent, most of these admissions are attributable to HCV-related cirrhosis (HCV-cirrhosis). This study assessed the impact ... ...

    Abstract Background & aims: Complications of cirrhosis are the main cause of hospital admissions in liver units. In areas where HCV is prevalent, most of these admissions are attributable to HCV-related cirrhosis (HCV-cirrhosis). This study assessed the impact of direct-acting antivirals (DAA) in the profile of patients with liver disease admitted to a referral liver unit from a university hospital.
    Methods: We registered hospital admissions resulting from cirrhosis to the Liver Unit of the Hospital Clinic of Barcelona, from 2011 to 2014 (pre-DAA period) and from 2015 to 2019 (post-DAA period).
    Results: From a total of 14,865 hospital admissions, 10,053 resulted from cirrhosis (corresponding to 6,272 patients). The number and proportion of hospital admissions because of HCV-cirrhosis remained stable during the period 2011-2014 (525 per year, 48.8% of the total), but decreased progressively after 2015 (p <0.001), reaching <300 (27.1%) admissions in 2019. Similarly, HCV-cirrhosis accounted for 3,885 inpatient days per year (44.9%) during the pre-DAA period and decreased steadily after 2015 (p >0.001), reaching only 1,909 inpatient days (22%) in 2019. The figures for intensive care unit admissions followed a similar pattern. By means of a slope analysis (binomial regression model), we predicted that HCV-cirrhosis hospital admissions will be residual by 2025 (2.3%, 95% CI 0-10.9%). By contrast, we observed a significant increase in hospital admissions because of metabolic-associated fatty liver disease (5-fold) and autoimmune hepatitis (4-fold) during the study period.
    Conclusions: In summary, our data showed a profound reduction in HCV-cirrhosis hospitalisation burden since 2015, coincident with the wide use of DAAs in Spain. Our predictions suggest that, by 2025, HCV-cirrhosis will be a marginal cause of hospital admissions for patients with liver disease.
    Lay summary: Over the past few years, the wide use of antiviral drugs that cure HCV has had a significant effect on patients being admitted to hospital. Most patients with HCV and cirrhosis are treated (and often cured) in the community and, thus, the number of hospital admissions because of severe forms of HCV has decreased drastically. HCV is no longer the first cause of admission into liver units and, in only a few years from now, it is likely to be only a residual cause of hospitalisation.
    MeSH term(s) Antiviral Agents/pharmacology ; Antiviral Agents/therapeutic use ; Disease Progression ; Female ; Hepacivirus/drug effects ; Hepacivirus/isolation & purification ; Hepatitis C, Chronic/diagnosis ; Hepatitis C, Chronic/drug therapy ; Hepatitis C, Chronic/epidemiology ; Hepatitis C, Chronic/physiopathology ; Hospitalization/statistics & numerical data ; Humans ; Liver Cirrhosis/epidemiology ; Liver Cirrhosis/etiology ; Liver Cirrhosis/therapy ; Liver Cirrhosis/virology ; Male ; Middle Aged ; Patient Admission/trends ; Retrospective Studies ; Spain/epidemiology
    Chemical Substances Antiviral Agents
    Language English
    Publishing date 2020-07-19
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 605953-3
    ISSN 1600-0641 ; 0168-8278
    ISSN (online) 1600-0641
    ISSN 0168-8278
    DOI 10.1016/j.jhep.2020.07.018
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  7. Article: Applicability of the Barcelona scale to assess the quality of cleanliness of mucosa at esophagogastroduodenoscopy.

    Córdova, Henry / Barreiro-Alonso, Eva / Castillo-Regalado, Edgar / Cubiella, Joaquín / Delgado-Guillena, Pedro / Díez Redondo, Pilar / Galdín, Martin / García-Rodríguez, Ana / Hernández, Luis / Huerta, Alain / Jover, Rodrigo / Núñez, Henar / Rodríguez-D'Jesús, Antonio / Seoane, Agustín / Surís, Gerard / Tejedor-Tejada, Javier / Jiménez Sánchez, Javier / Martín, Francisco / Moreira, Leticia /
    Carballal, Sabela / Rivero, Liseth / Da Fieno, Angella / Casanova, Gherzon / Luzko Scheid, Irina / Llach, Joan / Fernández-Esparrach, Gloria

    Gastroenterologia y hepatologia

    2023  Volume 47, Issue 3, Page(s) 246–252

    Abstract: Background and objectives: There are few scales with prospective validation for the assessment of the upper gastrointestinal mucosal cleanliness during an esophagogastroduodenoscopy (EGD). The aim of this study was to develop a valid and reproducible ... ...

    Abstract Background and objectives: There are few scales with prospective validation for the assessment of the upper gastrointestinal mucosal cleanliness during an esophagogastroduodenoscopy (EGD). The aim of this study was to develop a valid and reproducible cleanliness scale for use during an EGD.
    Methods: We developed a cleanliness scale (Barcelona scale) with a score (0-2 points) of five segments of the upper gastrointestinal tract with thorough cleaning techniques (esophagus, fundus, body, antrum, and duodenum). First, 125 photos (25 of each area) were assessed, and a score was assigned to each image by consensus among 7 experts endoscopists. Subsequently, 100 of the 125 images were selected and the inter- and intra-observer variability of 15 previously trained endoscopists was evaluated using the same images at two different times.
    Results: In total, 1500 assessments were performed. In 1336/1500 observations (89%) there was agreement with the consensus score, with a mean kappa value of 0.83 (0.45-0.96). In the second evaluation, in 1330/1500 observations (89%) there was agreement with the consensus score, with a mean kappa value of 0.82 (0.45-0.93). The intra-observer variability was 0.89 (0.76-0.99).
    Conclusions: The Barcelona cleanliness scale is a valid measure and reproducible with minimal training. Its application in clinical practice is a significant step to standardize the quality of the EGD.
    MeSH term(s) Humans ; Mucous Membrane ; Consensus ; Duodenum ; Endoscopy, Digestive System
    Language Spanish
    Publishing date 2023-05-24
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 632502-6
    ISSN 0210-5705
    ISSN 0210-5705
    DOI 10.1016/j.gastrohep.2023.05.011
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