Publications by authors named "Luis Bujanda"

Pancreatic cystic lesions (PCLs) are a heterogeneous group of lesions with increasing incidence, usually identified incidentally on imaging studies (multidetector computed tomography (MDCT), magnetic resonance imaging (MRI), or endoscopic ultrasound (EUS)) [...

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Background: Cholangiocarcinoma (CCA) represents a global health challenge, with rising incidence and mortality rates. This study aimed to elucidate the clinical course and practices of CCA in Latin America.

Methods: This observational cohort study investigated individuals diagnosed with CCA between 2010 and 2023 at five referral centres across Latin America.

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Background: Pancreatic ductal adenocarcinoma (PDAC) is associated with a significant percentage of germline pathogenic variants (GPVs). Unlike in the United States, routine universal genetic testing is not performed in Europe. The aim of the study is to evaluate the diagnostic yield of germline genetic testing in all patients with PDAC.

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  • Metabolic dysfunction-associated steatotic liver disease (MASLD) is a serious liver condition that includes simple fat buildup in the liver (steatosis) and can progress to more severe forms, like metabolic dysfunction-associated steatohepatitis (MASH) and cirrhosis, affecting over a third of the population.* -
  • The causes of MASLD are complex and involve factors like metabolism, environment, genetics, gut microbiota, and dysregulated lipid levels that lead to harmful fat and cell stress.* -
  • This review focuses on how lipotoxicity contributes to the development of MASLD, detailing important lipid types and their effects, and exploring potential therapies to improve lipid metabolism and reduce liver damage.*
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Background: Whether blood lipids are causally associated with colorectal cancer (CRC) risk remains unclear.

Methods: Using two-sample Mendelian randomisation (MR), our study examined the associations of genetically-predicted blood concentrations of lipids and lipoproteins (primary: LDL-C, HDL-C, triglycerides, and total cholesterol), and genetically-proxied inhibition of HMGCR, NPC1L1, and PCSK9 (which mimic therapeutic effects of LDL-lowering drugs), with risks of CRC and its subsites. Genetic associations with lipids were obtained from the Global Lipids Genetics Consortium (n = 1,320,016), while genetic associations with CRC were obtained from the largest existing CRC consortium (n = 58,221 cases and 67,694 controls).

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Introduction: Cyclic vomiting syndrome (CVS) is a disorder of gut-brain interaction of unknown origin. The aim of this study was to evaluate the global prevalence of this disorder and its associated factors.

Methods: Data were collected from nationwide Internet surveys in 26 countries, with subjects evenly distributed by age, sex, and country.

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  • A study examined how different reasons for testing for Helicobacter pylori (H. pylori) affect treatment prescriptions and their success rates across Europe from 2013 to 2023.
  • Out of 53,636 cases, the most common reasons for testing included dyspepsia with normal endoscopy and various types of ulcers, with treatment effectiveness ranging from 87% to 91% based on the indication.
  • Patients with ulcers and preneoplastic lesions experienced higher treatment success and compliance, while those tested for dyspepsia had higher rates of adverse effects.
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Despite extensive global research into genetic predisposition for severe COVID-19, knowledge on the role of rare host genetic variants and their relation to other risk factors remains limited. Here, 52 genes with prior etiological evidence were sequenced in 1,772 severe COVID-19 cases and 5,347 population-based controls from Spain/Italy. Rare deleterious TLR7 variants were present in 2.

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  • A study was conducted to evaluate the effectiveness and safety of ustekinumab and vedolizumab in treating complex perianal fistula in patients with Crohn's disease.
  • Out of 155 patients analyzed, ustekinumab achieved a remission rate of 54%, while vedolizumab had a remission rate of 46%, with some patients relapsing during the follow-up period.
  • Both medications exhibited mild adverse events and showed favorable safety profiles, indicating their potential effectiveness in managing this condition.
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Background: CDH1 and CTNNA1 remain as the main genes for hereditary gastric cancer. However, they only explain a small fraction of gastric cancer cases with suspected inherited basis. In this study, we aimed to identify new hereditary genes for early-onset gastric cancer patients (EOGC; < 50 years old).

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  • 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.
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Trained immunity (TRAIM) or the enhanced non-specific immune response after primary stimulation by infection or vaccination is a recent but well-recognized concept. To verify its predictions, our objective was to determine the effects of two bacterial vaccines, typhoid fever (TFV) and diphtheria-tetanus-pertussis (DTP) on the infection, hospitalization and death frequencies associated to COVID-19 in a retrospective study on subjects vaccinated or not with TFV and DTP in the 4 years prior to the start of COVID-19 pandemia in the Basque Country (Spain). The studied outcome records were split into two periods according to COVID-19 vaccination, the pre-vaccination (ACV) from March to December 2020 and the post-vaccination (PCV) from September 2021 to June 2022).

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Introduction: Risk factors for developing pancreatitis due to thiopurines in patients with inflammatory bowel disease (IBD) are not clearly identified. Our aim was to evaluate the predictive pharmacogenetic risk of pancreatitis in IBD patients treated with thiopurines.

Methods: We conducted an observational pharmacogenetic study of acute pancreatitis events in a cohort study of IBD patients treated with thiopurines from the prospectively maintained ENEIDA registry biobank of GETECCU.

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Background: The advent of new therapeutic agents and the improvement of supporting care might change the management of acute severe ulcerative colitis (ASUC) and avoid colectomy.

Aims: To evaluate the colectomy-free survival and safety of a third-line treatment in patients with ASUC refractory to intravenous steroids and who failed either infliximab or ciclosporin.

Methods: Multicentre retrospective cohort study of patients with ASUC refractory to intravenous steroids who had failed infliximab or ciclosporin and received a third-line treatment during the same hospitalisation.

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The clinical manifestations of SARS-CoV-2 infection vary widely among patients, from asymptomatic to life-threatening. Host genetics is one of the factors that contributes to this variability as previously reported by the COVID-19 Host Genetics Initiative (HGI), which identified sixteen loci associated with COVID-19 severity. Herein, we investigated the genetic determinants of COVID-19 mortality, by performing a case-only genome-wide survival analysis, 60 days after infection, of 3904 COVID-19 patients from the GEN-COVID and other European series (EGAS00001005304 study of the COVID-19 HGI).

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Colorectal cancer (CRC) commonly arises in individuals with premalignant colon lesions known as polyps, with both conditions being influenced by gut microbiota. Host-related factors and inherent characteristics of polyps and tumors may contribute to microbiome variability, potentially acting as confounding factors in the discovery of taxonomic biomarkers for both conditions. In this study we employed shotgun metagenomics to analyze the taxonomic diversity of bacteria present in fecal samples of 90 clinical subjects (comprising 30 CRC patients, 30 with polyps and 30 controls).

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Cytokine mediated sustained inflammation increases the risk to develop different complex chronic inflammatory diseases, but the implicated mechanisms remain unclear. Increasing evidence shows that long noncoding RNAs (lncRNAs) play key roles in the pathogenesis of inflammatory disorders, while inflammation associated variants are described to affect their function or essential RNA modifications as N-methyladenosine (mA) methylation, increasing predisposition to inflammatory diseases. Here, the functional implication of the intestinal inflammation associated lncRNA LOC339803 in the production of cytokines by intestinal epithelial cells is described.

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  • Infliximab is considered the most effective anti-TNF treatment for ulcerative colitis (UC), but there is limited information on its use as a second anti-TNF option.
  • This study analyzed 473 UC patients to compare outcomes between those receiving their first anti-TNF treatment via intravenous (IV) versus subcutaneous (SC) routes.
  • Results showed similar clinical response and remission rates after 14 and 52 weeks, suggesting that while a second anti-TNF can be effective, prior failure of the first anti-TNF significantly impacts long-term success.
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The clinical relevance of the colorectal cancer serrated pathway is evident, but the screening of serrated lesions remains challenging. We aimed to characterize the serum methylome of the serrated pathway and to evaluate circulating cell-free DNA (cfDNA) methylomes as a potential source of biomarkers for the non-invasive detection of serrated lesions. We collected serum samples from individuals with serrated adenocarcinoma (SAC), traditional serrated adenomas, sessile serrated lesions, hyperplastic polyps and individuals with no colorectal findings.

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Background: Thromboembolic events are frequent among patients with inflammatory bowel disease (IBD). However, there is little information on the prevalence, features and outcomes of splanchnic vein thrombosis (SVT) in patients with IBD.

Aims: To describe the clinical features and outcomes of SVT in patients with IBD and to perform a systematic review of these data with published cases and series.

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  • - The management of Helicobacter pylori infection involves a combination of proton pump inhibitors (PPIs) and antibiotics to effectively eradicate the bacteria, as evaluated by the European Registry on Helicobacter pylori management (Hp-EuReg).
  • - Analysis of data from 36,579 patients across five countries revealed that 14-day treatments with specific antibiotic combinations and high-dose PPIs resulted in optimal effectiveness, while 10- and 14-day therapies with high-dose PPIs were also successful.
  • - The study concludes that for first-line treatment, the use of high-dose PPIs is recommended, especially in certain combinations and durations, while shorter 7-day therapies showed suboptimal results.
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  • Antibiotic resistance significantly affects the treatment success rates for Helicobacter pylori infections, with noted resistance levels in Europe.
  • A study analyzed 2,852 naive patients and found that the 3-in-1 single capsule with bismuth, metronidazole, and tetracycline, as well as a quadruple therapy with bismuth, had the highest effectiveness against H. pylori, even with existing resistances.
  • For non-naive patients, resistance was even higher, but the same 3-in-1 capsule and triple therapy with levofloxacin showed promising results, highlighting the need for effective treatment options based on resistance patterns.
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Background: Irritable bowel syndrome is a heterogeneous syndrome and it is difficult to find an effective treatment. Previously, a starch- and sucrose-reduced diet (SSRD) demonstrated promising short-term outcomes. It was proposed that genetic variants in the sucrose-isomaltase gene might influence this success.

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  • * 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.
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