Revista de gastroenterologia de Mexico (English)最新文献

{"title":"Role of immunosuppression in liver transplantation. Advantages and disadvantages","authors":"D. Aguirre-Villarreal ,&nbsp;L. Rosales-Rentería ,&nbsp;I. García-Juárez ,&nbsp;A. Rosales-Padrón ,&nbsp;F. Manzo-Santana","doi":"10.1016/j.rgmxen.2025.09.008","DOIUrl":"10.1016/j.rgmxen.2025.09.008","url":null,"abstract":"<div><div>Cirrhosis of the liver is a major cause of death worldwide, with a recent increase in cases secondary to metabolic dysfunction-associated steatotic liver disease and alcohol use. Liver transplantation is currently the only definitive treatment but requires immunosuppression for preventing graft rejection.</div><div>Calcineurin inhibitors are the cornerstone of immunosuppression in transplanted patients. However, their use conditions metabolic and renal complications, such as metabolic syndrome, post-transplant diabetes, and chronic kidney disease. Minimizing or discontinuing immunosuppression has been shown to reduce those adverse effects in selected patients, especially those with potential immunotolerance. Predictors of immunotolerance and cardiovascular complications in transplanted patients have been identified in recent studies. Thus, there is a need for developing individualized strategies for balancing metabolic risk and graft rejection prevention.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 3","pages":"Pages 499-501"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042612","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":"Hemostatic clip use for the control of ulcer bleeding after esophageal variceal ligation","authors":"S.A. Chávez-Sánchez,&nbsp;L.E. Flores-Egocheaga","doi":"10.1016/j.rgmxen.2025.09.014","DOIUrl":"10.1016/j.rgmxen.2025.09.014","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 3","pages":"Pages 483-485"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076855","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":"Mexican consensus on the approach to and treatment of acute variceal bleeding","authors":"F. Higuera-de-la-Tijera ,&nbsp;A. Noble-Lugo ,&nbsp;J. Crespo ,&nbsp;A. Albillos ,&nbsp;A.J. Montaño-Loza ,&nbsp;A.D. Cano-Contreras ,&nbsp;G.E. Castro-Narro ,&nbsp;L.F. De Giau-Triulzi ,&nbsp;E.S. García-Jiménez ,&nbsp;N.J. Fernández-Pérez ,&nbsp;J.M. Aldana-Ledesma ,&nbsp;O.E. Trujillo-Benavides ,&nbsp;J. Cerna-Cardona ,&nbsp;Y.M. Velasco-Santiago ,&nbsp;E. Cerda-Reyes ,&nbsp;D.K. Tapia-Calderón ,&nbsp;A. Bautista-Santos ,&nbsp;J.L. Pérez-Hernández ,&nbsp;R. Moreno-Alcántar ,&nbsp;J.A. Velarde-Ruiz Velasco","doi":"10.1016/j.rgmxen.2025.09.007","DOIUrl":"10.1016/j.rgmxen.2025.09.007","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>Portal hypertension is the main consequence of cirrhosis and the cause of most of its complications, such as ascites, variceal bleeding, and hepatic encephalopathy. The development of those complications marks the transition from compensated cirrhosis to decompensated cirrhosis, and the latter is associated with poor prognosis. Approximately 50% of cirrhotic patients have gastroesophageal varices. Acute variceal bleeding (AVB) is a medical emergency with high mortality rates ranging from 15 to 25% within 6 weeks. AVB management has evolved in recent years due to new evidence on fluid resuscitation and transfusion support, advances in endoscopic techniques, esophageal stent use, and transjugular intrahepatic portosystemic shunt (TIPS) placement. This consensus aimed to establish recommendations based on the best available evidence and expert opinion from Mexican specialists in gastroenterology for the diagnosis, management, and treatment of AVB in patients with portal hypertension. The goal was to improve clinical decision-making, reduce the associated mortality, and standardize care protocols across the different levels of medical care in Mexico.</div></div><div><h3>Material and methods</h3><div>Seventeen national and 3 international experts were divided into five working groups to address five thematic areas: 1) initial evaluation, 2) fluid resuscitation and initial pharmacologic therapy, 3) the role of endoscopy, 4) strategies for managing failed bleeding control, and 5) secondary prophylaxis recommendations. The consensus was developed utilizing the RAND/UCLA process, with a modified Delphi method.</div></div><div><h3>Results</h3><div>A total of 28 statements were produced, with specific recommendations on initial fluid resuscitation and transfusion strategy, and highlighting the importance of vasopressor use, the role of endoscopy, and AVB prophylaxis.</div></div><div><h3>Conclusions</h3><div>This first Mexican Consensus on Acute Variceal Bleeding establishes practical recommendations for standardizing AVB management in patients with cirrhosis in Mexico, from the initial evaluation to secondary prophylaxis, emphasizing the importance of specific strategies and laying the groundwork for future research.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 3","pages":"Pages 451-473"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076775","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":"Sister Mary Joseph’s nodule: Umbilical cutaneous metastasis as initial presentation of sigmoid adenocarcinoma","authors":"A. Hokama","doi":"10.1016/j.rgmxen.2025.09.019","DOIUrl":"10.1016/j.rgmxen.2025.09.019","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 3","pages":"Page 502"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082671","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":"The frequency of sessile serrated adenomas detected during surveillance colonoscopy in patients with a history of colorectal cancer","authors":"J.P. Pérez-Macías,&nbsp;J.C. Sánchez-del Monte,&nbsp;A.I. Hernández-Guerrero,&nbsp;W.D. Torrecilla-Ramírez,&nbsp;B.A. Sánchez-Jiménez,&nbsp;G.M. Salgado-Castellón","doi":"10.1016/j.rgmxen.2025.09.002","DOIUrl":"10.1016/j.rgmxen.2025.09.002","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>Sessile serrated adenomas (SSAs) are precursor lesions of colorectal cancer (CRC) in 15–30% of cases, but due to their subtle characteristics, their endoscopic detection is a challenge. The present work aimed to determine the frequency of SSAs in patients with a history of CRC who underwent index and surveillance colonoscopies after their cancer diagnosis.</div></div><div><h3>Material and methods</h3><div>An observational cohort study was conducted on patients diagnosed with CRC who underwent an index colonoscopy and at least two surveillance colonoscopies at the <em>Instituto Nacional de Cancerología</em> in Mexico City, between January 2015 and December 2018. Demographic and clinical variables and endoscopic findings were analyzed. SSA frequency was calculated as the number of patients with one or more SSAs divided by the total number of patients analyzed. Means were compared for the bivariate inferential analysis and the chi-square test and Fisher’s exact test were used for the nominal variable analysis. Logistic regression was carried out to search for factors related to SSA.</div></div><div><h3>Results</h3><div>Four hundred patients were included; the mean patient age was 58 years and 52% were women. SSA frequency was 5.25%. Thirty-three percent of the SSAs were found in the index colonoscopy and 38% in subsequent colonoscopies. SSAs had a mean size of 5.52 mm, 84% were classified as Paris Is, 45% as KUDO II, and most were located in the ascending or transverse colon (21% and 20%, respectively).</div></div><div><h3>Conclusions</h3><div>SSAs are rare premalignant lesions, and their endoscopic diagnosis is a challenge. Their identification during the follow-up of patients with a history of CRC is essential for reducing the risk of metachronous progression.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 3","pages":"Pages 381-387"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034828","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":"Systematic review: Effect of proton pump inhibitors on Helicobacter pylori physiology","authors":"V. Blandón-Arias ,&nbsp;A.M. Ospina-Gil ,&nbsp;B.E. Salazar-Giraldo ,&nbsp;T.L. Pérez-Cala","doi":"10.1016/j.rgmxen.2025.09.003","DOIUrl":"10.1016/j.rgmxen.2025.09.003","url":null,"abstract":"<div><h3>Introduction and aims</h3><div><em>Helicobacter pylori</em> is a Gram-negative bacillus that colonizes the gastric mucosa and infects more than half of the world population. Treatment consists of two antibiotics and a proton pump inhibitor (PPI) that favors the replication of the bacterium and enhances the activity of the antibiotics. Despite the importance of proton pump inhibitor use in treating <em>H. pylori</em> infection, the precise mechanisms through which PPIs affect the physiology of the bacterium are not yet understood.</div></div><div><h3>Aim</h3><div>Our aim was to compile information pertaining to the effect of PPIs on the physiology of <em>H. pylori</em> and the mechanisms through which they produce alterations in the bacterium.</div></div><div><h3>Methods</h3><div>A bibliographic search was conducted, utilizing the PubMed, Science Direct, and LILACS databases, and included preclinical and clinical original articles published in any language.</div></div><div><h3>Results</h3><div>The sulfenamide form of PPIs was shown to have effects on <em>H. pylori,</em> including the induction of structural changes, inhibition of bacterial growth, and interference with enzymes, such as urease, ATPases, and alcohol dehydrogenase.</div></div><div><h3>Conclusions</h3><div>The binding of the sulfenamide form of PPIs to the bacterial structural and enzymatic components was the main mechanism through which <em>H. pylori</em> physiology was altered <em>in vitro</em>, but how they induce alterations in the bacterium was not established in the clinical studies analyzed.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 3","pages":"Pages 388-399"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058805","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":"Fecal microbiota transplantation in recurrent Clostridioides difficile: Is greater methodological rigor and the analysis of other populations relevant?","authors":"J.A. Castrillón-Lozano ,&nbsp;J.A. Lozano-Arce ,&nbsp;R.L. Arroyave-Zuluaga","doi":"10.1016/j.rgmxen.2025.09.022","DOIUrl":"10.1016/j.rgmxen.2025.09.022","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 3","pages":"Pages 506-507"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076843","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":"Colon tumor location: Right side versus left side as a prognostic factor for colon cancer survival: Analysis of a retrospective cohort","authors":"S.P. Molina-Meneses ,&nbsp;L.J. Palacios-Fuenmayor ,&nbsp;F.D. Molina-Mercado ,&nbsp;D.F. Caycedo-Medina ,&nbsp;R. Castaño-Llano ,&nbsp;L.R. Gómez-Wolff ,&nbsp;Y.E. Pérez-García","doi":"10.1016/j.rgmxen.2025.09.004","DOIUrl":"10.1016/j.rgmxen.2025.09.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Primary tumor location has emerged as an important prognostic factor due to different biologic characteristics.</div></div><div><h3>Aim</h3><div>To analyze the prognostic effect of tumor location in patients with colon cancer, comparing right-sided colon cancer with left-sided disease.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study was conducted on patients above 18 years of age operated on for right-sided or left-sided colon cancer within the time frame of January 2016 and June 2022 at a quaternary care hospital. Sociodemographic and histopathologic variables were analyzed. Overall survival and progression-free survival were calculated.</div></div><div><h3>Results</h3><div>From a total of 247 patients, 145 (58.7%) had right-sided colon cancer and 102 (41.2%) had left-sided disease. Mean age of the right-sided tumor patients was 70 years and mean age of the left-sided tumor patients was 64 years. The majority of the patients were women. Laparoscopic surgery was performed on 71.6% of patients and most of them presented with adenocarcinoma, 68.4% of which were well differentiated tumors. Poorly differentiated tumors were more likely in the right colon than the left, with 9.7% and 0.4%, respectively. Most of the patients did not have lymph node dissemination (N0: 54.7%), but there were more positive lymph nodes (28% vs 16.5%) and more microsatellite instability (48 vs 4 patients) in right-sided tumors. Fifty-three patients presented with metastasis, with no differences regarding laterality. Forty-four patients with right-sided cancer and 18 with left-sided cancer died. Right-sided location was the independent risk variable for overall survival (HR:1.97 [1.10–3.53]). Perineural invasion, metastasis, and disease stage were independent risk variables. Laterality was not a factor in progression-free survival.</div></div><div><h3>Conclusion</h3><div>Tumor located in the right colon was an independent risk factor impacting overall survival in colon cancer.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 3","pages":"Pages 400-411"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058703","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":"Differences in risk factors, demographic and clinicopathologic characteristics at diagnosis between proximal and distal colon cancer: A multicenter retrospective cohort analysis","authors":"R.A. Muñoz ,&nbsp;F.J. Miranda ,&nbsp;A.A. Ramírez ,&nbsp;D. Regalado ,&nbsp;J.C. Ortiz ,&nbsp;G. Gallardo ,&nbsp;S. Pizarro","doi":"10.1016/j.rgmxen.2025.09.001","DOIUrl":"10.1016/j.rgmxen.2025.09.001","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>There are differences, with genetic and embryologic support, in the clinical behavior of proximal colon cancer (PCC) (right colon: cecum, ascending colon, and transverse colon) and distal colon cancer (DCC) (left colon: descending colon, sigmoid colon, rectum). Our aim was to determine whether there was a divergent pattern in the demographic characteristics, risk factors, TNM stage, and clinical stage at diagnosis between patients with PCC and those with DCC.</div></div><div><h3>Material and methods</h3><div>A retrospective, analytic, and multicenter study was conducted. Medical records of patients diagnosed with colorectal cancer, confirmed by histopathology and with TNM staging, within the time frame of 2018-2023, were collected from two hospital centers in the city of Chihuahua. They were divided into the PCC and DCC groups, for evaluating the abovementioned characteristics.</div></div><div><h3>Results</h3><div>From a total of 513 cases, 404 were included in the study. Significant differences were found in the demographic characteristics of female sex and a history of cholecystectomy, both with a greater relative frequency for PCC. Distant metastasis was present in 35.6% of patients, despite their younger age at diagnosis. The rectum was the most commonly affected segment in the DCC group, as was the ascending colon in the PCC group. There was a greater prevalence of peritoneal carcinomatosis in the PCC group. In contrast, the DCC group had a greater prevalence of distant metastasis to other organs, as both individual metastasis (M1a) and multiple site metastasis (M1b). There were no considerable differences in the KRAS, NRAS, or BRAF gene mutations between the two groups.</div></div><div><h3>Conclusions</h3><div>PCC was associated with a history of cholecystectomy and female sex and had more aggressive TNM staging, compared with DCC.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 3","pages":"Pages 373-380"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058769","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":"Unanticipated encounter with Ascaris lumbricoides during endoscopic bile duct stone removal: A case report","authors":"S. Gómez-Jordan ,&nbsp;A. Sepúlveda ,&nbsp;A. Montes ,&nbsp;N. Forti-Sosa","doi":"10.1016/j.rgmxen.2025.09.012","DOIUrl":"10.1016/j.rgmxen.2025.09.012","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 3","pages":"Pages 479-480"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082664","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}