Artificial intelligence-assisted identification and retrieval of chronic hepatitis C patients lost to follow-up in the health area of Pontevedra and O Salnés (Spain).

OBJECTIVE: Direct-acting antivirals (DAAs) to treat hepatitis C virus (HCV) infection offer an opportunity to eliminate the disease. This study aimed to identify and relink to care HCV patients previously lost to medical follow-up in the health area of Pontevedra and O Salnés (Spain) using an artificial intelligence-assisted system. PATIENTS AND METHODS: Active retrospective search of previously diagnosed HCV cases recorded in the Galician Health Service proprietary health information exchange database using the Herramientas para la EXplotación de la INformación (HEXIN) application. RESULTS AND CONCLUSIONS: Out of 99 lost patients identified, 64 (64.6%) were retrieved. Of these, 62 (96.88%) initiated DAA treatment and 54 patients (87.1%) achieved a sustained virological response. Mean time from HCV diagnosis was over 10 years. Main reasons for loss to follow-up were fear of possible adverse effects of treatment (30%) and mobility impediments (21%). Among the retrieved patients, almost one in three presented advanced liver fibrosis (F3) or cirrhosis (F4) at evaluation. In sum, HCV patients lost to follow-up can be retrieved by screening past laboratory records. This strategy promotes the achievement of HCV elimination goals.

Seudomixoma peritoneal presentado como ascitis en paciente cirrótico / Peritoneal pseudomyxoma presenting as ascites in a patient with cirrhosis

Presentamos el caso de un paciente cirrótico con ascitis y gradiente de albúmina menor de 1,1g/dl. Tras la realización de pruebas endoscópicas, incluyendo ecoendoscopia alta con PAAF, se decide llevar a cabo una laparoscopia exploradora para esclarecer el diagnóstico, observándose mucina por toda la cavidad peritoneal y nódulos sobre el peritoneo parietal y elvisceral. Tras el estudio anatomopatológico se estableció seudomixoma peritoneal como diagnóstico. Esta infrecuente entidad, de pronóstico infausto en ausencia de tratamiento, suele generarse en tumores mucinosos apendiculares, y en segundo lugar desde tumores ováricos (AU)

We present the case of a cirrhotic patient with ascites and an albumin gradient of less than 1.1g/dl. After endoscopic tests, including upper gastrointestinal endoscopic ultrasound-guided fine-needle aspiration, exploratory laparoscopy was performed to provide the diagnosis, revealing mucin throughout the peritoneal cavity and nodules on the parietal and visceral peritoneum. Histopathological analysis established the diagnosis as peritoneal pseudomyxoma. This uncommon entity, which has a poor prognosis without treatment, is most frequently associated with mucinous tumors of the appendix, and secondly, with tumors of the ovary (AU)

[Peritoneal pseudomyxoma presenting as ascites in a patient with cirrhosis]. / Seudomixoma peritoneal presentado como ascitis en paciente cirrótico.

We present the case of a cirrhotic patient with ascites and an albumin gradient of less than 1.1 g/dl. After endoscopic tests, including upper gastrointestinal endoscopic ultrasound-guided fine-needle aspiration, exploratory laparoscopy was performed to provide the diagnosis, revealing mucin throughout the peritoneal cavity and nodules on the parietal and visceral peritoneum. Histopathological analysis established the diagnosis as peritoneal pseudomyxoma. This uncommon entity, which has a poor prognosis without treatment, is most frequently associated with mucinous tumors of the appendix, and secondly, with tumors of the ovary.