Publications by authors named "Guardiola J"
Background: Endoscopic evaluation 6-12 months after ileocolonic resection (ICR) in Crohn's disease (CD) is advised to assess the development of postoperative recurrence (POR) but no further recommendations are available for long-term monitoring if no POR is noticed.
Methods: Prospective, open-label, study including asymptomatic patients with CD and ICR in whom no POR was observed at the last endoscopic evaluation. Patients were followed-up for two years and ileocolonoscopy was performed by means of a faecal calprotectin (FC)-based strategy.
Introduction: Real-world data on the effectiveness of upadacitinib for inflammatory bowel disease (IBD) are limited. To assess upadacitinib persistence, effectiveness, and safety in a real-world scenario.
Methods: Retrospective multicenter study of patients with IBD who received upadacitinib before 31st December 2022 and at least 12 weeks before the recruitment date.
Article Synopsis
- Accurate reporting of polyp characteristics is essential for smart resource allocation in referring patients for endoscopic resection of colorectal lesions.
- A study analyzed data from 1,508 patients and found significant issues: 24% of lesions lacked size estimates, and 22% lacked morphologic descriptions.
- The findings suggest that improving adherence to established guidelines could reduce errors in prereferral management of these challenging cases.
: Bacterial/fungal coinfections (COIs) are associated with antibiotic overuse, poor outcomes such as prolonged ICU stay, and increased mortality. Our aim was to develop machine learning-based predictive models to identify respiratory bacterial or fungal coinfections upon ICU admission. : We conducted a secondary analysis of two prospective multicenter cohort studies with confirmed influenza A (H1N1)pdm09 and COVID-19.
View Article and Find Full Text PDFCold Snare Resection in the Colorectum: When to Choose it, When to Avoid it, and How to Do it.
Clin Gastroenterol Hepatol
September 2024
Article Synopsis
- * It is especially recommended for polyps that are 10 mm or smaller and for certain benign lesions of any size, but should not be used if there's a high risk of submucosal invasion or fibrosis.
- * The review covers strategies to enhance the effectiveness of cold snare resection, particularly for larger lesions between 11-19 mm and some spreading lesions over 20 mm.
Article Synopsis
- The study looked into why some people have a hard time preparing their bowels for a colonoscopy, which is a procedure to check inside the intestines.
- Researchers found 48 different factors that might make it harder for people to prepare, including age, health conditions, and some medications.
- Understanding these risk factors can help doctors predict who might struggle with bowel preparation, making colonoscopies easier and saving money on extra tests.
Background: The coexistence of human immunodeficiency virus (HIV) infection and inflammatory bowel disease (IBD) is uncommon. Data on the impact of HIV on IBD course and its management is scarce.
Aim: To describe the IBD phenotype, therapeutic requirements and prevalence of opportunistic infections (OI) in IBD patients with a coexistent HIV infection.
Expedited development of SARS-CoV-2 vaccines led to public concerns regarding impacts of the novel vaccine on gametes in patients seeking assisted reproduction. In cases of an acute intermittent illness or fever in men, it is often advised to postpone ART treatments so that efforts can be made to enhance wellbeing and improve sperm parameters. However, it is unknown whether sperm parameters are altered in the acute (24-72 hour) phase following COVID-19 vaccination.
View Article and Find Full Text PDFBackground And Aims: Familial inflammatory bowel disease (IBD) history is a controversial prognostic factor in IBD. We aimed to evaluate the impact of a familial history of IBD on the use of medical and surgical treatments in the biological era.
Methods: Patients included in the prospectively maintained ENEIDA database and diagnosed with IBD after 2005 were included.
Article Synopsis
- - The study evaluated a new type of endoscopic through-the-scope clip (TTSC) with anchor prongs, focusing on its effectiveness for hemostasis and closure in 50 patients across three hospitals in the U.S. and Canada.
- - A total of 56 clipping procedures were performed, with a high success rate of complete closure in various types of defects, including those after endoscopic mucosal resection and polypectomy.
- - The device demonstrated an acceptable safety profile with only three cases of delayed bleeding and no serious adverse events, while technical issues were minimal, highlighting its potential for effective clinical use.
Article Synopsis
- Markers for personalized treatment options for patients with inflammatory bowel diseases (IBD) remain unidentified, prompting a study on real-life treatment trends.
- The study analyzed data from 10,009 patients from the ENEIDA registry, revealing that anti-TNF drugs were the most commonly used first-line treatments, but their usage declined over time in Crohn's disease (CD) while remaining stable in ulcerative colitis (UC).
- Despite exploring Machine Learning for treatment pattern prediction, researchers found that these models were ineffective, indicating distinct treatment approaches for CD and UC and highlighting the rising importance of drugs like ustekinumab and vedolizumab.
Background & Aims: The impact of patient sex on the presentation of inflammatory bowel disease (IBD) has been poorly evaluated. Our aims were to assess potential disparities in IBD phenotype and progression between sexes.
Methods: We performed an observational multicenter study that included patients with Crohn's disease (CD) or ulcerative colitis from the Spanish Estudio Nacional en Enfermedad Inflamatoria intestinal sobre Determinantes genéticos y Ambientales registry.
Article Synopsis
- Guidelines suggest follow-up endoscopic surveillance for nonpedunculated colorectal lesions ≥20 mm after piecemeal EMR should be 6 months, but this study questions if a 12-month interval is sufficient for low-risk cases.
- The analysis involved 561 colorectal lesions and found similar recurrence rates (10%) for both the 6-month and 12-month surveillance groups, although the lesions in the 12-month group were typically smaller and less aggressive.
- The findings support the potential for 12-month surveillance as a reasonable option for certain patients, which could reduce healthcare costs and patient burden while maintaining safety.
Article Synopsis
- Prophylactic closure using clips after endoscopic resections helps decrease the risk of delayed hemorrhage, particularly for larger non-pedunculated colorectal lesions removed using electrocautery.
- Cold resections, which are less invasive and have a lower risk of bleeding, generally do not require clip closure, and audit of clip usage revealed varying and often unnecessary application for smaller lesions.
- A study involving 3,784 colorectal lesions showed that clip placement was significantly more common after electrocautery (71.1%) compared to cold resection (3.9%), indicating potential areas for improving practice and reducing waste in outpatient colonoscopy procedures.
Objective: To describe other reasons for requesting HIV serology in emergency departments (ED) other than the 6 defined in the SEMES-GESIDA consensus document (DC-SEMES-GESIDA) and to analyze whether it would be efficient to include any of them in the future.
Methods: Review of all HIV serologies performed during 2 years in 20 Catalan EDs. Serologies requested for reasons not defined by the DC-SEMES-GESIDA were grouped by common conditions, the prevalence (IC95%) of seropositivity for each condition was calculated, and those whose 95% confidence lower limit was >0.
Aims: Methotrexate (MTX) is used to induce and maintain remission in patients with steroid-dependent Crohn's disease (CD). Despite its proven efficacy, its use is limited due to associated adverse events. Polymorphisms involving folate pathway genes might influence MTX efficacy and toxicity.
View Article and Find Full Text PDFArticle Synopsis
- * A study of 520 adult patients showed that small abscesses (<30 mm) can be treated effectively with antibiotics, while larger abscesses require drainage methods, with surgical drainage being more effective but riskier.
- * Post-treatment, luminal resection lowers the risk of abscess recurrence within a year, but anti-TNF therapy shows similar effectiveness for preventing recurrences regardless of resection.
Objective: To evaluate the impact of obesity on ICU mortality.
Design: Observational, retrospective, multicentre study.
Setting: Intensive Care Unit (ICU).
The most recent and promising therapeutic strategies for inflammatory bowel disease (IBD) have engaged biologics targeting single effector components involved in major steps of the immune-inflammatory processes, such as tumor necrosis factor, interleukins or integrins. Nevertheless, these molecules have not yet met expectations regarding efficacy and safety, resulting in a significant percentage of refractory or relapsing patients. Thus, novel treatment options are urgently needed.
View Article and Find Full Text PDFThe aim of this study is to investigate the effectiveness of prolonged versus standard course oseltamivir treatment among critically ill patients with severe influenza. A retrospective study of a prospectively collected database including adults with influenza infection admitted to 184 intensive care units (ICUs) in Spain from 2009 to 2018. Prolonged oseltamivir was defined if patients received the treatment beyond 5 days, whereas the standard-course group received oseltamivir for 5 days.
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