Acta gastroenterológica latinoamericana最新文献

{"title":"Tratamiento del síndrome de intestino irritable por gastroenterólogos: resultados de un estudio de corte transversal a partir de una encuesta elaborada por expertos","authors":"L. Soifer, J. Tawil, Alejandro Rey, L. Solé, Silvia Bernstein","doi":"10.52787/kksx5531","DOIUrl":"https://doi.org/10.52787/kksx5531","url":null,"abstract":"Introduction. Irritable bowel syndrome (IBS) accounts for a significant deterioration in the quality of life of patients who suffer from it and is a common reason for consultation in gastroenterology. The treatment of this syndrome includes a wide variety of medications and recommendations based on different factors of its physiopathology. However, the results are usually variable and sometimes unsatisfactory for either the patient or the treating physician. The main objective of the present work is to describe the different treatments used by gastroenterologists in the management of IBS in Argentina. Materials and methods. Questionnaire of forty-seven questions, prepared by experts, distributed by medical associations of gastroenterology in Argentina and answered by specialists via Google Forms. Results. 304 responses, 157 from women (51.6%) and 147 from men (48.4%). The mean age was 44 and 49.9 years, respectively. 87.5% consider improvement of quality of life as the main goal of treatment. Regarding physiopathology of diarrhea variant irritable bowel syndrome (IBS-D), 49.5% considered emotional stress, while for constipation variant irritable bowel syndrome (IBS-C), 42.8% considered it multifactorial, with a predominance of slow colonic transit. No treatment option was rated as very effective by more than 50% of the respondents. Rifaximin was considered the most effective treatment in IBS-D, while polyethylene glycol was for IBS-C. Statistical significant differences were observed among gastroenterology subspecialties in the treatment of IBS-D with respect to the efficacy of diet, amitriptyline and antibiotics other than rifaximin, and regarding the effectiveness for bisacodyl/picosulfate and antibiotics in the treatment of IBS-C. Conclusion. The most common pathophysiological mechanismin IBS-D is stress. The vast majority of respondents consider that the main goal of treatment is the improvement of the quality of life, over symptomatic relief. None of the drugs is considered very effective in the treatment of the different IBS variants by at least 50% of those surveyed. Statistically significant differences were observed in the proportion of monthly consultations for IBS regarding to age and in the effectiveness considered for some treatments in relation to the subspecialty of physicians. The therapeutic approach to IBS by Argentine gastroenterologists is varied and somewhat heterogeneous, resulting in a still inappropriate management of this condition.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122437642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Úlcera gigante gástrica como forma de presentación del linfoma gástrico primario. Presentación de un caso y revisión de la bibliografía","authors":"Guillermo Rubén Fernandez, Matías Zanetti, Mariano Rubén Argüello, Liria Salomé Martínez Rejtman, M. Francisco, Jorge Gomila, P. Valdemoros","doi":"10.52787/sdee3831","DOIUrl":"https://doi.org/10.52787/sdee3831","url":null,"abstract":"Giant peptic ulcers are defined as having a diameter greater than 2 cm in the case of duodenal ulcers, and greater than 3 cm in the case of gastric ulcers. The presentation is infrequent, but raises questions about the etiological factor and the definitive treatment. The literature on its physio-pathology is scarce and the cases described are unusual. The following case is presented to review the conduct to be followed in the presence of a giant gastric ulcer. We highlight the difficulty to assess the differential diagnosis of malignant pathology, trying to emphasize the value of the predictive factors of malignancy to define the conduct to follow. Finally, we focus on the relationship between the clinical presentation of gastric giant ulcer with primary gastric lymphomas and their clinical characteristics.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130913968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatitis autoinmune. Serie de casos y actualización bibliográfica","authors":"A. Pasqua, J. C. Spina, E. Mullen","doi":"10.52787/qfzz3586","DOIUrl":"https://doi.org/10.52787/qfzz3586","url":null,"abstract":"The concept and diagnostic criteria for autoimmune pancreatitis have evolved since the first case reports published in the 1960s. The advances in knowledge during the past two decades have resulted in the recognition of several pancreatic conditions that show, on histological evaluation, variable combinations of inflammation and fibrosis. In fact, autoimmune pancreatitis comprises two distinct diseases: type 1 and type 2. Type 2 autoimmune pancreatitis is a particular pancreatic disease about which there is limited data; it differs from the ‘classic’ IgG4-related type 1 autoimmune pancreatitis in terms of epidemiology, pathological characteristics and natural evolution. There are patients with complex pancreatic conditions where an autoimmune component and good response to steroids are demonstrated, but they do not meet the suggested criteria for the diagnosis of type 1 or type 2 autoimmune pancreatitis. Although the term steroid-responsive pancreatitis may be interpreted as a synonym to type 1 and 2 autoimmune pancreatitis, these are not the only pancreatic conditions that improve with this type of treatment. Here, we present three clinical cases and a literature review related to the diagnosis and treatment of autoimmune pancreatitis and other less frequent pancreatic disorders that present a good response to steroid therapy.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116472912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Avances, descubrimientos y potencial del microbioma intestinal en gastroenterología","authors":"Elena F. Verdu","doi":"10.52787/oqlg2049","DOIUrl":"https://doi.org/10.52787/oqlg2049","url":null,"abstract":"Correspondencia: Elena F Verdu Correo electrónico: verdue@mcmaster.ca En las últimas décadas, el microbioma intestinal surgió como un órgano vital adicional, capaz de realizar funciones metabólicas, inmunológicas y neuroendócrinas especializadas y complementarias a las de su huésped, el ser humano. En la mayoría de los casos, el microbioma intestinal, compuesto de billones de microorganismos integrados por bacerias, virus, y fungi (hongos), establece una relación de mutualismo con los tejidos y sistemas de su huésped. Este equilibrio puede ser alterado por muchos factores internos y externos, con consecuencias potencialmente graves, en su extremo, la invasión sistémica descontrolada. ¿Por qué, entonces hemos evolucionado para funcionar en un estado de “colonización microbiana”, no sólo en el tubo digestivo sino en la piel? La respuesta lógica es que los beneficios superan los peligros. Un ejemplo clave es la señalización por parte del microbioma al sistema immune mucoso, lo cual promueve su maduración, permitiendo la discriminación eficiente entre agentes infecciosos o tóxicos, o inocuos y necesarios, como los nutrientes. De esta manera el microbioma intestinal, es clave en el mantenimiento de la homeostasis del organismo hospedador. Siendo unas de las áreas de evolución más dinámica en el campo biomédico y de investigación, actualmente la tecnología biomolecular y de secuenciación supera nuestra capacidad para interpretar los resultados. Esto provoca en investigadores, médicos y pacientes, más preguntas que respuestas. ¿Qué microbios están más adaptados a la homeostasis? ¿Existen taxones con mayor potencialidad patogénica? Debemos centrarnos en cambios de composición microbiana o funcionalidad? ¿Podemos prevenir o curar enfermedades a través de la modulación terapéutica del microbioma? ¿Qué modular, cuando aún no conseguimos definir aspectos fundamentales cómo lo que contituye un microbioma sano? En relación, a esta pregunta crítica, quizás debamos admitir que un microbioma sano no puede definirse en forma absoluta y universal, sino que es relativo a cada individuo y sus circunstancias. En ésta, y las siguientes ediciónes de la Revista ACTA Gastroenterológica Latinoamericana, le proponemos a nuestros lectores una serie de artículos de revisión con la intención de actualizar de manera didáctica los avances recientes en torno al microbioma intestinal en gastroenterología. Los artículos propuestos se focalizan en mecanismos específicos en situaciones patológicas definidas, con potencialidad de modulación terapéutica, y posiblemente personalizada. En esta edición, Caminero, describe el papel del microbioma intestinal en las reacciones adversas a los alimentos. La prevalencia de estas reacciones adversas está en aumento, lo cual sugiere factores ambientales como los cambios en el microbioma intestinal. Avances, descubrimientos y potencial del microbioma intestinal en gastroenterología","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124946980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Probióticos en Síndrome de Intestino Irritable: ¿Están listos para la práctica clínica?","authors":"M. A. Valdovinos-Diaz","doi":"10.52787/mrrq4655","DOIUrl":"https://doi.org/10.52787/mrrq4655","url":null,"abstract":"Probiotics are used as non-pharmacological therapy for Irritable Bowel Syndrome (IBS). Probiotics have mechanisms of action that can influence the complex pathophysiology of IBS. Evidence of the efficacy and safety of probiotics in IBS is based on various meta-analysis that showed these agents have a limited but superior effect on the management of IBS. The recommendations on the use of probiotics in IBS in the clinical practice guidelines published to date remain controversial. Some recommend the use of probiotics for global symptoms and abdominal pain, while others state that there is low quality evidence for a recommendation. Currently, probiotics are frequently prescribed by doctors for the treatment of patients with IBS. A greater number of high-quality clinical trials are needed to define which probiotic strains are effective in the different IBS phenotypes.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"104 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131895436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disección endoscópica con técnica de bolsillo submucoso. ¿Puede reemplazar a la disección convencional?","authors":"M. Yantorno, Gustavo Javier Correa, Sebastián Esteves, F. Giraudo, A. Redondo, É. Martínez, Pablo Cura, A. Villaverde, Fernando Baldoni, Francisco Tufare","doi":"10.52787/ujns2488","DOIUrl":"https://doi.org/10.52787/ujns2488","url":null,"abstract":"Endoscopic submucosal dissection is a complex technique that allows en bloc resection of large lesions. It is associated with long-term, technically complex procedures and a high risk of complications. The creation of a submucosal pocket is a variant of the conventional technique that reduces these difficulties, generating a high rate of complete resection with a shorter procedure time, a faster dissection speed and a lower rate of adverse events. Even though this variant was initially described in the stomach, its application has been generalized to other areas of the digestive tract. We present two cases where this variant technique was applied to treat large early lesions, with technical success.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"1048 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116279573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Risk of COVID-19 Infection in an Ambulatory Gastrointestinal Endoscopy Center in Argentina","authors":"J. Tawil, J. Libertucci, Ana Adet Caldelari, Irene I. Banchero, Sandra Canseco, Ricardo F. Figueredo, María Garcia, C. Machado, Vanesa Del Arbol, Christian Sánchez, E. Verdú, C. Cerisoli, L. Caro","doi":"10.52787/ZOJK8572","DOIUrl":"https://doi.org/10.52787/ZOJK8572","url":null,"abstract":"Background and Objectives. Since the onset of the COVID-19 pandemic, concerns have been raised regarding the risk of infection to both healthcare staff and patients during gastrointestinal endoscopy procedures. Given the importance of performing routine endoscopic procedures to an individual’s future health, we sought to estimate the risk of COVID-19 infection for healthcare staff and patients undergoing endoscopic studies at an ambulatory endoscopy center during the pandemic. Material and Methods. This is a prospective(and) analytical cohort study conducted in an ambulatory gastroenterology center located in the Autonomous City of Buenos Aires, Argentina. Patients undergoing different endoscopic procedures were evaluated for COVID-19 between April 14 and August 31, 2020. COVID-19 was also evaluated in all healthcare and associated staff during the same time period. The risk (cumulative incidence) of acquiring COVID-19 in all patients and staff was calculated. Results. Between April 14 and August 31, 2020, procedures were performed in 3,745 patients with a mean age of 51.12 years; 2,102 (56.18%) were male and 1,643 (43.82%) were female. Follow-up was completed in 3,492 patients, 18 of whom tested positive for COVID-19 standing for an incidence of 0.52% (95%CI 0.31 – 0.81%). Six (5.45%) out of 110 staff members were infected with COVID-19 (1 endoscopist, 4 endoscopy assistants and 1 administrative staff member). In this group, the incidence of positive tests for COVID-19 was 5.45% (95%CI: 2.03 – 11.50%). The increased rates of positive cases among our patients and healthcare professionals were respectively 7.9 and 23.6 times lower than in general population. Conclusion. During the study period, the proportion of COVID-19 infections in our ambulatory specialized in gastrointestinal endoscopy was low and much lower than that in the general population for both patients and healthcare professionals. Endoscopic procedures undertaken at this center were low risk, likely due to strict compliance with established pandemic protocols. Future studies should compare the risk of infection in the hospital setting.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125955403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalencia de mucosa gástrica heterotópica cervical y su relación con síntomas de reflujo gastroesofágico. Estudio observacional","authors":"Natalia Marina Zeytuntsian, J. Tawil, A. A. Caldelari, Álvaro Falzone, Patricio Sheridan, G. Bello, Christian Sánchez, Luis E. Caro, Cecilio L. Cerisoli","doi":"10.52787/OQGH3367","DOIUrl":"https://doi.org/10.52787/OQGH3367","url":null,"abstract":"Introduction. The heterotopic gastric mucosal patch or inlet patch is the presence of gastric columnar mucosa outside the stomach, most frequently located in the proximal esophagus. Its manifestations vary from esophageal and extraesophageal reflux symptoms to major complications, most of them being asymptomatic. Aim. To determine the prevalence of cervical heterotopic gastric mucosa in our environment and its association with esophageal and extraesophageal reflux symptoms. Material and methods. Prospective cross-sectional and observational study; consecutive patients who came to our institution between December 2018 and October 2019 for diagnostic upper gastrointestinal videoendoscopy were included, following a questionnaire on clinical manifestations. Results. A total of 1,408 patients were included. In 89 (6.3%), a cervical heterotopic gastric mucosal patch was described. The mean age of the patients without this condition was 54.6 and 55.5 in patients with it. The esophageal symptoms of gastroesophageal reflux (heartburn, regurgitation, and chest pain) in patients with cervical heterotopic gastric mucosa was observed in 40 (44.9% / p = 0.473), 12 (13.5% / p = 0.783) and 4 (4.5% / p = 0.199) patients respectively. The presence of extraesophageal symptoms (globus, chronic cough, dysphonia, and throat clearing) in patients with cervical heterotopic gastric mucosa was: 9 (10.1% / p = 0.011); 7 (7.9% / p = 0.155); 4 (4.5% / p = 0.458) and 9 (10.1% / p = 0.036) respectively. Conclusions. A statistically significant association was found between the presence of cervical heterotopic gastric mucosal patch and symptoms of globus (p = 0.011) and throat clearing (p = 0.036). It could be interpreted that this group of patients would benefit from the research and treatment of this condition with the intention of improving their symptoms.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"86 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116419681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sesgo de inmortalidad en estudios observacionales","authors":"D. P. D. Arenaza","doi":"10.52787/AJUJ5684","DOIUrl":"https://doi.org/10.52787/AJUJ5684","url":null,"abstract":"evidence-based and proven efficacy and/or associated with a better adherence to the interventions performed. The immediate reduction observed can only be explained by the immortal time bias. The Hemmelgarn's study was to examine the association between multidisciplinary care clinic and survival. It consisted of a retropective cohort of 187 clinical patients, who were exposed to a multidisciplinary care clinic, that were matched with 187 clinical control","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"231 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134059272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resección endoscópica bajo visión coledocoscópica de pólipo biliar. Reporte de un caso","authors":"A. Soler, Gonzalo Palmili, E. Cassone, A. Silva","doi":"10.52787/CFHN9238","DOIUrl":"https://doi.org/10.52787/CFHN9238","url":null,"abstract":"Inflammatory pseudotumors of the biliary tract represent an infrequent biliary pathology, with few cases reported in literature. In radiological or surgical explorations, these tumors are usually diagnosed as unsuspected findings. They represent a challenge in preoperative diagnosis, due to the cost of specific technology such as Spyglass DS (Boston Scientific) and the need of trained personnel for its correct use. This means that most patients are usually treated with major resections with wrong preoperative diagnosis of cholangiocarcinoma, missing a chance of an endoscopic solution while adding unnecessary morbidity and mortality in benign pathology. We present a case that underwent endoscopic resection by ERCP under direct choledochoscopic view for Kehr’s biliary fístula in the General Surgery Department of a central hospital.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121232490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}