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  1. Article: Acute seronegative hepatitis C: two case reports.

    Gómez Outomuro, Ana / Fraile, Miguel / Torner, María

    Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva

    2019  Volume 111, Issue 5, Page(s) 406

    Abstract: We present two cases of immunosuppressed patients diagnosed with acute hepatitis C (AHC) HCV-antibody negative by HCV-RNA testing. Delayed seroconversion in immunosuppressed patients may result in retarded diagnosis and treatment. Therefore, HCV-RNA ... ...

    Abstract We present two cases of immunosuppressed patients diagnosed with acute hepatitis C (AHC) HCV-antibody negative by HCV-RNA testing. Delayed seroconversion in immunosuppressed patients may result in retarded diagnosis and treatment. Therefore, HCV-RNA testing should be part of the initial evaluation.
    MeSH term(s) Acute Disease ; Adult ; Aged ; Female ; Hepatitis C/blood ; Hepatitis C Antibodies/blood ; Humans ; Male ; Seroconversion
    Chemical Substances Hepatitis C Antibodies
    Language English
    Publishing date 2019-04-19
    Publishing country Spain
    Document type Case Reports ; Letter
    ZDB-ID 1070381-0
    ISSN 1130-0108 ; 0212-7512
    ISSN 1130-0108 ; 0212-7512
    DOI 10.17235/reed.2019.5921/2018
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Efficacy and safety of the SB Knife™ Jr. for the treatment of Zenker's diverticulum: a case series.

    Gómez Outomuro, Ana / González-Bernardo, Óscar / Pérez Martinez, Isabel / Castaño-García, Andrés / Rodríguez-Escaja, Carlos / de Francisco, Ruth / Riestra, Sabino / Suárez, Adolfo

    Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva

    2020  Volume 112, Issue 3, Page(s) 216–218

    Abstract: Background and aims: the stag-beetle knife is a new scissor-like endoscopic device that can be used for the treatment of Zenker's diverticulum, although experience is limited. The aim of this study was to evaluate the efficacy and safety of the SB Knife™ ...

    Abstract Background and aims: the stag-beetle knife is a new scissor-like endoscopic device that can be used for the treatment of Zenker's diverticulum, although experience is limited. The aim of this study was to evaluate the efficacy and safety of the SB Knife™ for the endoscopic treatment of Zenker's diverticulum.
    Methods: a single-center prospective study of 16 patients was performed between May 2017 and April 2019. The rate of complications and symptom changes was evaluated.
    Results: the median age was 78 years and 62.5% of the patients were male. All had dysphagia, 43.8% choking, 31.3% regurgitation and 6.3% respiratory symptoms. The median size of the diverticulum was 20 mm and the median follow-up was 281 days. There were no intra-procedure complications and only one major post-procedure complication was reported that was a microperforation. All patients had clinical improvement. Two patients had relapsing symptoms and were successfully treated with the same method.
    Conclusions: the SB Knife™ seems to be a safe and effective technique for the treatment of Zenker's diverticulum.
    MeSH term(s) Aged ; Deglutition Disorders/etiology ; Esophagoscopy ; Humans ; Male ; Prospective Studies ; Retrospective Studies ; Treatment Outcome ; Zenker Diverticulum/diagnostic imaging ; Zenker Diverticulum/surgery
    Language English
    Publishing date 2020-01-17
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 1070381-0
    ISSN 1130-0108 ; 0212-7512
    ISSN 1130-0108 ; 0212-7512
    DOI 10.17235/reed.2020.6373/2019
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Changes in the characteristics of hospital admissions due to decompensated cirrhosis in the era of direct-acting antivirals against hepatitis C virus.

    Fraile López, Miguel / Franco, Lissa / Álvarez Navascués, Carmen / Varela, María / Cadahía, Valle / Torner, María / Gómez Outomuro, Ana / González-Diéguez, María Luisa / Rodríguez García, Manuel

    Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva

    2020  Volume 112, Issue 7, Page(s) 538–544

    Abstract: Background: the development of interferon-free regimens, based on direct acting antivirals (DAAs) has revolutionized the treatment of hepatitis C virus (HCV) infection.: Aims: to determine if there have been changes in the characteristics of hospital ...

    Abstract Background: the development of interferon-free regimens, based on direct acting antivirals (DAAs) has revolutionized the treatment of hepatitis C virus (HCV) infection.
    Aims: to determine if there have been changes in the characteristics of hospital admissions due to decompensated cirrhosis in a general hospital since the introduction of DAAs.
    Patients and methods: this was a prospective study of all hospital admissions due to decompensated cirrhosis during two periods: October 2012-October 2014 (P-I) and July 2016-July 2018 (P-II). Clinical and demographic variables were collected and standard statistical methods were used for the analysis.
    Results: there were 746 hospital admissions; 347 in P-I and 399 in P-II. P-I patients were younger (59 vs 63 years; p = 0.034), while the proportion of admissions due to HCV-cirrhosis was lower in P-II (15.8 % vs 21.6 %; p = 0.041). There were no significant differences in the proportion of admissions due to other etiologies of cirrhosis between both periods. Patients in the P-II group presented an active viral infection (57.1 vs 97.3 %; p = 0.001) less frequently and had a higher rate of excessive alcohol consumption (55.5 vs 30.7 %; p = 0.003) when admitted, while HIV co-infection was less frequent (1.6 % vs 10.7 %; p = 0.039).
    Conclusion: the proportion of admissions due to decompensated HCV-related cirrhosis has decreased by almost 30 % since the introduction of the DAA. In addition, the characteristics of patients admitted have changed since the application of interferon-free regimens.
    MeSH term(s) Antiviral Agents/therapeutic use ; Hepacivirus ; Hepatitis C/complications ; Hepatitis C/drug therapy ; Hepatitis C/epidemiology ; Hepatitis C, Chronic/complications ; Hepatitis C, Chronic/drug therapy ; Hepatitis C, Chronic/epidemiology ; Hospitals ; Humans ; Liver Cirrhosis/drug therapy ; Liver Cirrhosis/epidemiology ; Prospective Studies
    Chemical Substances Antiviral Agents
    Language English
    Publishing date 2020-06-03
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 1070381-0
    ISSN 1130-0108 ; 0212-7512
    ISSN 1130-0108 ; 0212-7512
    DOI 10.17235/reed.2020.7024/2020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Noninvasive Prediction of Outcomes in Autoimmune Hepatitis-Related Cirrhosis.

    Llovet, Laura-Patricia / Gratacós-Ginès, Jordi / Téllez, Luis / Gómez-Outomuro, Ana / Navascués, Carmen A / Riveiro-Barciela, Mar / Vinuesa, Raquel / Gómez-Camarero, Judith / García-Retortillo, Montserrat / Díaz-Fontenla, Fernando / Salcedo, Magdalena / García-Eliz, María / Horta, Diana / Guerrero, Marta / Rodríguez-Perálvarez, Manuel / Fernández-Rodriguez, Conrado / Albillos, Agustín / G-Abraldes, Juan / Parés, Albert /
    Londoño, Maria-Carlota

    Hepatology communications

    2022  Volume 6, Issue 6, Page(s) 1392–1402

    Abstract: The value of noninvasive tools in the diagnosis of autoimmune hepatitis (AIH)-related cirrhosis and the prediction of clinical outcomes is largely unknown. We sought to evaluate (1) the utility of liver stiffness measurement (LSM) in the diagnosis of ... ...

    Abstract The value of noninvasive tools in the diagnosis of autoimmune hepatitis (AIH)-related cirrhosis and the prediction of clinical outcomes is largely unknown. We sought to evaluate (1) the utility of liver stiffness measurement (LSM) in the diagnosis of cirrhosis and (2) the performance of the Sixth Baveno Consensus on Portal Hypertension (Baveno VI), expanded Baveno VI, and the ANTICIPATE models in predicting the absence of varices needing treatment (VNT). A multicenter cohort of 132 patients with AIH-related cirrhosis was retrospectively analyzed. LSM and endoscopies performed at the time of cirrhosis diagnosis were recorded. Most of the patients were female (66%), with a median age of 54 years. Only 33%-49% of patients had a LSM above the cutoff points described for the diagnosis of AIH-related cirrhosis (12.5, 14, and 16 kPa). Patients with portal hypertension (PHT) had significantly higher LSM than those without PHT (15.7 vs. 11.7 kPa; P = 0.001), but 39%-52% of patients with PHT still had LSM below these limits. The time since AIH diagnosis negatively correlated with LSM, with longer time being significantly associated with a lower proportion of patients with LSM above these cutoffs. VNT was present in 12 endoscopies. The use of the Baveno VI, expanded Baveno VI criteria, and the ANTICIPATE model would have saved 46%-63% of endoscopies, but the latter underpredicted the risk of VNT. Conclusions: LSM cutoff points do not have a good discriminative capacity for the diagnosis of AIH-related cirrhosis, especially long-term after treatment initiation. Noninvasive tools are helpful to triage patients for endoscopy.
    MeSH term(s) Elasticity Imaging Techniques ; Esophageal and Gastric Varices/diagnosis ; Female ; Hepatitis, Autoimmune/complications ; Humans ; Hypertension, Portal/complications ; Liver Cirrhosis/complications ; Male ; Middle Aged ; Retrospective Studies ; Varicose Veins/complications
    Language English
    Publishing date 2022-01-06
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ISSN 2471-254X
    ISSN (online) 2471-254X
    DOI 10.1002/hep4.1889
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Early predictors of corticosteroid response in acute severe autoimmune hepatitis: a nationwide multicenter study.

    Téllez, Luis / Sánchez Rodríguez, Eugenia / Rodríguez de Santiago, Enrique / Llovet, Laura / Gómez-Outomuro, Ana / Díaz-Fontenla, Fernando / Álvarez López, Patricia / García-Eliz, María / Amaral, Carla / Sánchez-Torrijos, Yolanda / Fortea, José Ignacio / Ferre-Aracil, Carlos / Rodríguez-Perálvarez, Manuel / Abadía, Marta / Gómez-Camarero, Judith / Olveira, Antonio / Calleja, José Luis / Crespo, Javier / Romero, Manuel /
    Hernández-Guerra, Manuel / Berenguer, Marina / Riveiro-Barciela, Mar / Salcedo, Magdalena / Rodríguez, Manuel / Londoño, María Carlota / Albillos, Agustín

    Alimentary pharmacology & therapeutics

    2022  Volume 56, Issue 1, Page(s) 131–143

    Abstract: Background and aims: To assess whether corticosteroids improve prognosis in patients with AS-AIH, and to identify factors at therapy initiation and during therapy predictive of the response to corticosteroids.: Methods: This was a retrospective ... ...

    Abstract Background and aims: To assess whether corticosteroids improve prognosis in patients with AS-AIH, and to identify factors at therapy initiation and during therapy predictive of the response to corticosteroids.
    Methods: This was a retrospective cohort study including all patients with AS-AIH admitted to 13 tertiary centres from January 2002 to January 2019. The composite primary outcome was death or liver transplantation within 90 days of admission. Kaplan-Meier and Cox regression methods were used for data analysis.
    Results: Of 242 consecutive patients enrolled (mean age [SD] 49.7 [16.8] years), 203 received corticosteroids. Overall 90-day transplant-free survival was 61.6% (95% confidence interval [CI] 55.4-67.7). Corticosteroids reduced the risk of a poor outcome (adjusted hazard ratio [HR] 0.25; 95% CI 0.2-0.4), but this treatment failed in 30.5%. An internally validated nomogram composed of older age, MELD, encephalopathy and ascites at the initiation of corticosteroids accurately predicted the response (C-index 0.82; [95% CI 0.8-0.9]). In responders, MELD significantly improved from days 3 to 14 but remained unchanged in non-responders. MELD on day 7 with a cut-off of 25 (sensitivity 62.5%[95% CI: 47.0-75.8]; specificity 95.2% [95% CI: 89.9-97.8]) was the best univariate predictor of the response. Prolonging corticosteroids did not increase the overall infection risk (adjusted HR 0.75; 95% CI 0.3-2.1).
    Conclusion: Older patients with high MELD, encephalopathy or ascites at steroid therapy initiation and during treatment are unlikely to show a favourable response and so prolonged therapy in these patients, especially if they are transplantation candidates, should be avoided.
    MeSH term(s) Acute Disease ; Adolescent ; Adrenal Cortex Hormones/therapeutic use ; Ascites ; Brain Diseases ; Hepatitis, Autoimmune/diagnosis ; Hepatitis, Autoimmune/drug therapy ; Humans ; Prognosis ; Retrospective Studies ; Severity of Illness Index
    Chemical Substances Adrenal Cortex Hormones
    Language English
    Publishing date 2022-04-25
    Publishing country England
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 639012-2
    ISSN 1365-2036 ; 0269-2813 ; 0953-0673
    ISSN (online) 1365-2036
    ISSN 0269-2813 ; 0953-0673
    DOI 10.1111/apt.16926
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Endoscopy-Related Bleeding and Thromboembolic Events in Patients on Direct Oral Anticoagulants or Vitamin K Antagonists.

    Rodríguez de Santiago, Enrique / Sánchez Aldehuelo, Rubén / Riu Pons, Fausto / Rodríguez Escaja, Carlos / Fernández-Esparrach, Gloria / Cañete-Ruiz, Ángel / Ferre Aracil, Carlos / Pérez-Corte, Daniel / Ríos León, Raquel / Marcos-Prieto, Héctor Miguel / Delgado-Guillena, Pedro G / García-Rodríguez, Ana / Guarner-Argente, Charly / Muriel, Alfonso / de la Fuente-Briongos, Elsa / García García de Paredes, Ana / Parejo-Carbonell, Sofía / Téllez, Luis / Senosiaín-Lalastra, Carla /
    Burgos-Santamaría, Diego / Aicart-Ramos, Marta / Mateos Muñoz, Beatriz / Peñas-García, Beatriz / Pagano, Giulia / Casals Urquiza, Gemma / Urpi Ferreruela, Miguel / Ángel de Jorge-Turrión, Miguel / Barreiro-Alonso, Eva / Fraile-López, Miguel / Gómez-Outomuro, Ana / Altamirano, María Isabel / Núñez Esteban, Matilde / Ruiz-Andreu, Mireia / Arribas-Anta, Julia / de Frutos, Diego / Herreros-de-Tejada, Alberto / Arias-Rivera, María Luisa / Roldán-Fernández, Marta / Marcos Martín, Ángel F / Zamora, Javier / Vázquez-Sequeiros, Enrique / Albillos, Agustín

    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

    2020  Volume 20, Issue 3, Page(s) e380–e397

    Abstract: Background & aims: Few prospective studies have assessed the safety of direct oral anticoagulants (DOACs) in elective endoscopy. Our primary aim was to compare the risks of endoscopy-related gastrointestinal bleeding and thromboembolic events in ... ...

    Abstract Background & aims: Few prospective studies have assessed the safety of direct oral anticoagulants (DOACs) in elective endoscopy. Our primary aim was to compare the risks of endoscopy-related gastrointestinal bleeding and thromboembolic events in patients on DOACs or vitamin K antagonists (VKAs) in this setting. Secondarily, we examined the impact of the timing of anticoagulant resumption on the risk of delayed bleeding in high-risk therapeutic procedures.
    Methods: We conducted a multicenter, prospective, observational study from January 2018 to March 2020 of 1602 patients on oral anticoagulants (1004 on VKAs and 598 on DOACs) undergoing 1874 elective endoscopic procedures. Our primary outcomes were 90-day thromboembolic events and 30-day endoscopy-related gastrointestinal bleeding. The inverse probability of treatment weighting propensity score method was used for baseline covariate adjustment.
    Results: The 2 groups had similar risks of endoscopy-related gastrointestinal bleeding (VKAs vs DOACs, 6.2% vs 6.7%; adjusted odds ratio [OR], 1.05; 95% CI, 0.67-1.65) and thromboembolic events (VKAs vs DOACs, 1.3% vs 1.5%; adjusted OR, 0.90; 95% CI, 0.34-2.38). In high bleeding risk procedures (n = 747), delayed anticoagulant resumption (> 48 hours or 24-48 hours vs < 24 hours) did not reduce the risk of postprocedural bleeding (10.3%, 9%, and 5.8%, respectively; adjusted P = .43). Hot and cold snare polypectomy were the most frequent high-risk interventions (41.8% and 39.8%, respectively).
    Conclusion: In a prospective study of patients on DOACs or VKAs undergoing elective endoscopy, endoscopy-related bleeding and thromboembolic events showed similar risk. Our study suggests that early anticoagulant resumption is safe in most patients, but more data are needed for advanced high-risk therapeutic procedures.
    MeSH term(s) Administration, Oral ; Anticoagulants/adverse effects ; Colonic Polyps ; Colonoscopy ; Gastrointestinal Hemorrhage/chemically induced ; Gastrointestinal Hemorrhage/epidemiology ; Humans ; Prospective Studies ; Vitamin K
    Chemical Substances Anticoagulants ; Vitamin K (12001-79-5)
    Language English
    Publishing date 2020-12-04
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2119789-1
    ISSN 1542-7714 ; 1542-3565
    ISSN (online) 1542-7714
    ISSN 1542-3565
    DOI 10.1016/j.cgh.2020.11.037
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