Background and Aims: Hepatokines have a regulatory function in adipose tissue inflammation, metabolic dysfunction-associated steatotic liver disease (MASLD), cardiovascular diseases, and atherosclerosis. Our aim was to evaluate the profile of proinflammatory cytokines and hepatokines in patients with MASLD and carotid atherosclerosis (CA). Methods: A prospective and basic research study was conducted on patients with MASLD. Clinical data were collected from a detailed medical history. Liver stiffness was measured using transient elastography, and carotid Doppler ultrasound was performed. Levels of basic biochemical parameters, systemic inflammation markers (TNF-α, IL-6, IL-10, IL-18), and hepatokines (FGF21, ANGPTL4, fetuin-A) were determined. The results were analyzed with SPSS v22.0 software. Results: Sixty-seven patients with MASLD were included, 72.1% were women, and the mean patient age was 53.9 + 11.3 years. Atherosclerosis was found in 11 patients (16.2%), and carotid intima–media thickness (CIMT) was altered in the right carotid of 13 patients (19.1%), in the left carotid of 19 (27.9%), and bilaterally in 7 (10.3%). Greater age (p = 0.001) and high blood pressure (p = 0.028) were correlated with atherosclerosis. There were no differences in systemic inflammation markers, and the hepatokines FGF21 and fetuin-A tended to increase in the presence of CIMT and CA alterations, regardless of fibrosis. Conclusions: In our population, patients with MASLD had a 16.6% prevalence of CA, and the risk increased with age and a history of high blood pressure. FGF21 tended to increase in patients with MASLD + atherosclerosis, and fetuin-A was correlated with CIMT alterations, suggesting that the combination of these markers could guide us to suspect early endothelial alterations in patients with MASLD.

Los bloqueadores ácidos competitivos de potasio (P-CABs), como vonoprazan, fexuprazan, tegoprazan y revaprazan, representan una clase innovadora de medicamentos diseñados para tratar afecciones relacionadas con la secreción de ácido gástrico, incluida la enfermedad por reflujo gastroesofágico (ERGE), la infección por Helicobacter pylori (Hp) y la enfermedad ulcerosa péptica. Estos fármacos actúan inhibiendo de manera reversible y competitiva la bomba de protones H+/K+-ATPasa, lo cual les permite suprimir la producción de ácido gástrico de forma más efectiva y con una rapidez superior en comparación con los inhibidores de la bomba de protones (IBP) tradicionales. Además, estos fármacos no se ven interferidos por la enzima CYP2C19 y su efecto es independiente de la ingesta de alimentos, lo que les confiere ventajas sobre la mayoría de los IBP. Los estudios clínicos han demostrado que los P-CABs son superiores a los IBP en el manejo de la ERGE erosiva severa, y no inferiores en los grados leves y en la enfermedad no erosiva.Por otra parte, los P-CABs ofrecen tasas de erradicaciónde Hp no inferiores y, en algunos casos, superiores a las delos IBP, en los tratamientos de primera línea, pero no enlos de segunda. En conclusión, los P-CABs emergen comoalternativas prometedoras en el manejo de trastornos gastrointestinalesácido-dependientes.

Background: Potassium‐competitive acid blockers provide rapid and sustained acid suppression, but tegoprazan has not been studied in non‐Asian populations. Aim: To compare the efficacy and safety of tegoprazan 50 mg once daily with pantoprazole 40 mg once daily for healing erosive oesophagitis and improving reflux symptoms. Methods: In this multicentre, randomized, double‐blind, active‐controlled trial, Mexican adults with Los Angeles grade B–D erosive oesophagitis received tegoprazan or pantoprazole for 4 weeks. The primary outcome was superior endoscopic healing at week 4. Secondary outcomes included early symptom response, complete symptom resolution, changes in symptom severity, health‐related quality of life, and adverse events. Results: Seventy participants were randomized and 64 completed treatments. In the intention‐to‐treat population, endoscopic healing occurred in 88.9% receiving tegoprazan and 79.4% receiving pantoprazole ( p = 0.33). In the per‐protocol population, healing occurred in 100% and 84.4%, respectively ( p = 0.053). Among participants with Los Angeles grade C or D oesophagitis, per‐protocol healing rates were 100% with tegoprazan and 68.8% with pantoprazole ( p = 0.04). During the first treatment week, at least 50% symptom improvement occurred in 84.4% and 31.3%, respectively ( p < 0.001), and complete symptom resolution was more frequent with tegoprazan from day 1. Symptom severity and health‐related quality of life improved in both groups. Adverse events were infrequent, mild, and unrelated to treatment. Conclusions: There was a nonsignificant 9.5% difference in the primary intention‐to‐treat 4‐week healing endpoint between tegoprazan and pantoprazole. Tegoprazan provided faster symptom improvement, while the per‐protocol findings and the higher healing rate observed in the exploratory severe oesophagitis subgroup were encouraging and warrant further investigation. (ClinicalTrials.gov Identifier: NCT06991348).

Background/Objectives: The Observational Clinical Human Reliability Assessment (OCHRA) system evaluates surgical performance by identifying intraoperative errors, yet evidence on error patterns and procedural safety in laparoscopic cholecystectomy (LC) remains limited. This study aimed to assess LC safety using established parameters and to describe intraoperative errors through the OCHRA system in patients with gallstone disease in Veracruz, Mexico. Methods: An observational, retrospective, analytical study was conducted between January 2022 and March 2025. Surgical videos from 11 surgical teams were reviewed. Intraoperative errors were classified using the OCHRA system across the three key steps of LC, while procedural safety was assessed through achievement of the Critical View of Safety (CVS) using the Doublet Photographic Score (DPS). Comparisons were performed according to the Parkland Grading Scale. Statistical analysis was conducted using SPSS version 26. Results: A total of 106 patients were included (67% women; mean age 45 ± 13 years; BMI 25.1 ± 3.2 kg/m²). Total LC was performed in 95% of cases and subtotal LC in 5%. Parkland grade 3 was the most frequent (32.1%). Overall, 3180 operative steps were evaluated, and 705 errors (22.1%) were identified. Procedural errors predominated across all phases (97–99%), mainly due to step repetition or additional steps, whereas execution errors were uncommon (1–3%). A satisfactory CVS was achieved in 54.7% of cases. No bile duct injuries were observed. Conclusions: The OCHRA system enabled detailed the identification of intraoperative error patterns and their relationship with surgical difficulty. Higher anatomical severity was associated with increased procedural errors and lower rates of adequate CVS achievement. These findings support structured video-based performance assessment as a complementary tool to established safety principles, with the potential to guide targeted training and improve surgical consistency in laparoscopic cholecystectomy.