Revista de gastroenterologia de Mexico (English)最新文献

{"title":"Clinical practice recommendations on the use of neuromodulators in gastroenterology: AMG (Asociación Mexicana de Gastroenterología) - AMNM (Asociación Mexicana de Neurogastroenterología y Motilidad) expert joint review","authors":"O. Gómez-Escudero ,&nbsp;J.M. Remes-Troche ,&nbsp;E. Coss-Adame ,&nbsp;K.R. García-Zermeño ,&nbsp;J. Aquino-Matus ,&nbsp;J. Jiménez-Pavón ,&nbsp;L.R. Valdovinos-García ,&nbsp;M.A. Vargas-Martínez ,&nbsp;M. Amieva-Balmori ,&nbsp;J.S. Arenas-Martínez ,&nbsp;F.A. Félix-Téllez ,&nbsp;P.C. Gómez-Castaños ,&nbsp;M. Mejía-Rivas ,&nbsp;M.A. Valdovinos-Díaz ,&nbsp;G. Vázquez-Elizondo ,&nbsp;A.S. Villar-Chávez ,&nbsp;C.P. Gyawali","doi":"10.1016/j.rgmxen.2024.12.001","DOIUrl":"10.1016/j.rgmxen.2024.12.001","url":null,"abstract":"<div><div>Disorders of gut-brain interaction (DGBI) are characterized by alterations in both central and peripheral gut-brain axis (GBA)-related stimuli, and include esophageal, gastroduodenal, intestinal and anorectal disorders. Despite the fact that several pathophysiologic mechanisms are involved, the mainstay of treatment is neuromodulators, a heterogeneous group of drugs that act on pathways related to central and peripheral pain processing. This expert review by both the AMG (Asociación Mexicana de Gastroenterología) and AMNM (Asociación Mexicana de Neurogastroenterología y Motilidad) summarizes a series of updated clinical recommendations based on an exhaustive review of the literature, regarding the use of neuromodulators for DGBI, and is grouped into six sections: pharmacologic principles, definition, classification, mechanism of action, indications and use in each DGBI subtype, up/downscaling strategies, combination therapy, adverse events, joint use along with psychiatry in the case of comorbidities, and non-pharmacologic neuromodulation. Furthermore, drug selection process tips and dose personalization according to individual groups and sensitivities are provided, and special cases with DGBI-psychiatric comorbidity, as well as overlap with another DGBI, are considered.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 252-287"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082695","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":"Effect of quarterly meeting and email report of ADR, cecal intubation rate, and withdrawal time on personal and group quality measures in colonoscopy","authors":"F.I. Téllez-Ávila ,&nbsp;B. Bailey ,&nbsp;S. Dehmel ,&nbsp;M. Deneke ,&nbsp;K. Rude ,&nbsp;S. Inamdar ,&nbsp;M. García","doi":"10.1016/j.rgmxen.2024.11.004","DOIUrl":"10.1016/j.rgmxen.2024.11.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Colonoscopy is the most utilized screening test for colorectal cancer (CRC). The adenoma detection rate (ADR), cecal intubation rate (CIR), and withdrawal time (WT) are established quality indicators (QIs) for colonoscopy. The aim was to measure the effect of individual and group QIs in colonoscopy by providing quarterly meetings and email feedback on ADR, CIR, and WT.</div></div><div><h3>Material and methods</h3><div>This is a prospective study in 2 steps. In the initial phase, we aimed to collect the QIs in colonoscopy from our division and in the second step, we aimed to assess the impact of a quarterly report. <em>Pre-Intervention:</em> Using electronic medical records (EMRs), an automated method for calculating the ADR was devised. ADRs from 6 months were obtained. <em>Periodic Feedback:</em> Endoscopists received quarterly feedback during staff meetings and emails for 9 months. <em>Post-Intervention:</em> QIs were recalculated for 8 months, and physicians did not receive reports.</div></div><div><h3>Results</h3><div>Over 23 months, 1,137 screening colonoscopies were conducted. Seven gastroenterologists participated, distributed into high (n = 6) and low (n = 1) detector groups. The mean patient age was 58.6 ± 9.2 years, with 659 (57.9%) females. Moderate sedation was used in 892 (78.4%) cases. QIs did not show significant improvement during the feedback or post-intervention periods compared with the pre-intervention period. Endoscopists initially categorized as «low detectors» exhibited the most substantial improvement, with the ADR increasing from 23.5% to 61.5% (<em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>Quarterly feedback and email reports did not significantly improve colonoscopy quality measures. Regarding the ADR, the intervention’s impact was most prominent in «low detectors».</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 207-213"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227810","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":"C-reactive protein as a predictor of complicated acute cholecystitis: A cohort study","authors":"G. Renau ,&nbsp;D. Abelló ,&nbsp;F. Sabench ,&nbsp;J. Doménech ,&nbsp;A. Sánchez","doi":"10.1016/j.rgmxen.2025.02.004","DOIUrl":"10.1016/j.rgmxen.2025.02.004","url":null,"abstract":"<div><h3>Introduction</h3><div>The Tokyo Guidelines for the severity classification of acute cholecystitis (AC) include leukocytosis as a severity classifier, without considering C-reactive protein (CRP). Our aim was to determine which of the two variables has a greater predictive capacity for local complications in AC (LCAC).</div></div><div><h3>Material and methods</h3><div>A retrospective single-center study was conducted on patients that underwent emergency cholecystectomy within the time frame of June 2022 and December 2023. The variables associated with LCAC were analyzed and an ROC analysis was carried out.</div></div><div><h3>Results</h3><div>The multivariate analysis of 145 patients identified the following associations with LCAC: CRP (<em>p</em> &lt; 0.001; OR 11.8), AUC of 0.88 (<em>p =</em> 0.029), and cutoff point of 4 mg/dl (88% sensitivity, 71% specificity); leukocytosis (<em>p</em> &lt; 0.031; OR 5), AUC of 0.81(<em>p</em> = 0.037), and cutoff point of 11.09 x 10⁹/l (78% sensitivity, 70% specificity).</div></div><div><h3>Conclusions</h3><div>CRP may have a higher predictive capacity for LCAC than leukocytosis.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 330-333"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268112","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":"Good clinical practice recommendations for the diagnosis and treatment of functional dyspepsia: An expert review from the Asociación Mexicana de Gastroenterología","authors":"R.I. Carmona-Sánchez ,&nbsp;G. Vázquez-Elizondo ,&nbsp;M.C. Rodríguez-Leal ,&nbsp;O. Gómez-Escudero ,&nbsp;M.V. Bielsa-Fernández ,&nbsp;E. Coss-Adame ,&nbsp;K. García-Zermeño ,&nbsp;P. Gómez-Castaños ,&nbsp;M. Morales-Arámbula ,&nbsp;E.C. Morel-Cerda ,&nbsp;A. Noble-Lugo ,&nbsp;J.M. Remes-Troche ,&nbsp;S. Solórzano-Olmos ,&nbsp;O.E. Trujillo-Benavides ,&nbsp;M.A. Valdovinos-Díaz ,&nbsp;L.R. Valdovinos-García","doi":"10.1016/j.rgmxen.2025.05.001","DOIUrl":"10.1016/j.rgmxen.2025.05.001","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>Functional dyspepsia (FD) is a highly prevalent condition characterized by upper gastrointestinal symptoms with no apparent organic cause. It is a complex and multifactorial disease that frequently overlaps with other disorders of gut-brain interaction. It is recurrent, has a variable therapeutic response, and affects patient quality of life. Our aim was to formulate good practice recommendations for the management of FD through a consensus review of the disease, updating and complementing the 2017 consensus on dyspepsia from the <em>Asociación Mexicana de Gastroenterología</em> (<em>AMG</em>).</div></div><div><h3>Methods</h3><div>Sixteen experts summoned by the <em>AMG</em> carried out a literature review (2017–2024) and formulated good clinical practice recommendations for the diagnosis and treatment of FD. They were discussed until reaching a consensus, and the most recent evidence on the theme was evaluated, utilizing the GRADE system.</div></div><div><h3>Results</h3><div>Twenty-three good clinical practice recommendations for the management of FD were developed that addressed the following aspects: (1) definition, pathophysiology, and epidemiology; (2) diagnosis; (3) nonpharmacologic treatment; (4) <em>Helicobacter pylori</em> eradication; (5) antisecretory and anti-acid therapy; and (6) prokinetics and neuromodulators.</div></div><div><h3>Conclusions</h3><div>FD is one of the most frequent gastrointestinal conditions seen in daily practice. We present good clinical practice recommendations for the specific management of this disorder, taking into account the most recent advances that complement and update the consensus on dyspepsia published by the <em>AMG</em> in 2017.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 227-251"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121638","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":"Comparison of the predictive capacity of the Alvarado and AIR scores in the diagnosis of acute appendicitis: A prospective study","authors":"L.M. Sanabria-Arévalo ,&nbsp;L.C. Domínguez-Torres ,&nbsp;J. Kock ,&nbsp;J.D. Lotero ,&nbsp;J.C. Gómez-Cáceres ,&nbsp;E. Tuta-Quintero","doi":"10.1016/j.rgmxen.2024.07.007","DOIUrl":"10.1016/j.rgmxen.2024.07.007","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>Acute appendicitis stands out as one of the most frequent surgically-treated diseases. Risk scales for acute appendicitis, such as the Alvarado and AIR scoring systems, show good diagnostic yield. The aim of our study was to compare the predictive capacity between the Alvarado and Air scores in the diagnosis of acute appendicitis.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted on patients that underwent appendectomy due to suspected acute appendicitis, confirmed by histopathology. The predictive capacity of the Alvarado and Air scores was evaluated through an ROC curve analysis, determining the area under the ROC curve. The STROBE checklist was utilized.</div></div><div><h3>Results</h3><div>A total of 358 patients with clinical suspicion of acute appendicitis were included, 51% of whom were men (183/358). Median patient age was 36 years (IQR: 24−46). The ROC curve of the Alvarado score was 0.767 (95% CI: 0.716−0.818), and with a cutoff point of 0−4, had 78% sensitivity and 84% specificity. The AIR score had a ROC curve of 0.741 (95% CI: 0.691−0.788), and with a 0−4 cutoff point, 87% sensitivity and 56% specificity. There was no statistically significant difference between the two scores (p = 0.266).</div></div><div><h3>Conclusion</h3><div>The Alvarado and AIR scores have a similar predictive capacity for acute appendicitis. The low cutoff points of the risk scales are related to greater diagnostic sensitivity of the disease.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 176-181"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251224","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":"Commentary on “First Mexican consensus on Crohn’s disease” from the pathologist’s perspective","authors":"J.A. Teco-Cortes","doi":"10.1016/j.rgmxen.2024.10.013","DOIUrl":"10.1016/j.rgmxen.2024.10.013","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Page 342"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268111","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":"Masson’s pseudoangiosarcoma located in the perianal region: A rare entity","authors":"G.R. Medina-Murillo ,&nbsp;U. Rodríguez-Medina ,&nbsp;U. Rodríguez-Wong","doi":"10.1016/j.rgmxen.2024.09.010","DOIUrl":"10.1016/j.rgmxen.2024.09.010","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 309-310"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295461","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":"Dietary characteristics of Mexican patients with irritable bowel syndrome: Is there a distinction from the general population?","authors":"M. Amieva-Balmori,&nbsp;G.P. Martínez-Pérez,&nbsp;M.R. Francisco,&nbsp;A. Triana-Romero,&nbsp;A.A. Ortiz-Lorenzo,&nbsp;G.A. Hernández-Ramírez,&nbsp;J.A. Martínez-Conejo,&nbsp;G.A. Violante-Hernández,&nbsp;A.D. Cano-Contreras,&nbsp;J.M. Remes-Troche","doi":"10.1016/j.rgmxen.2025.05.004","DOIUrl":"10.1016/j.rgmxen.2025.05.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Irritable bowel syndrome (IBS) is a multifactorial condition, in which diet is a main trigger of symptoms. Many patients modify their diet without professional supervision, which can cause nutritional risks or aggravate symptoms. The aim of this study was to evaluate the dietary intake of patients with IBS versus healthy subjects.</div></div><div><h3>Material and methods</h3><div>An observational, analytic, cross-sectional study was conducted on 108 subjects: 77 (71.3%) diagnosed with IBS (Rome IV criteria) and 31 (28.7%) healthy controls. Patient age was from 18 to 66 years and the woman-to-man ratio was 4.1:1. Both groups completed a 7-day food diary, registering their usual diet that was then analyzed using a nutrition software program.</div></div><div><h3>Results</h3><div>Macronutrient intake was similar between the two groups but the patients with IBS had a significantly higher intake of vitamins D (p ≤ 0.001), B1 (p ≤ 0.001), B2 (p ≤ 0.001), and B3 (p ≤ 0.001). There was greater vitamin B3 intake in patients with an IBS subtype (p = 0.005). There were no significant differences in fiber consumption.</div></div><div><h3>Conclusion</h3><div>The diet of Mexican patients with IBS was slightly different from that of healthy subjects. The IBS patients consumed more fiber and their FODMAP intake was similar to that of the healthy controls. Even though the majority of the IBS patients met the recommendations for macronutrient and micronutrient intake, nutritional guidance in the management of IBS is recommended because dietary adjustments can significantly improve symptoms.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 182-191"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227809","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":"Bile acid malabsorption (BAM): A rarely suspected cause of chronic diarrhea – Towards an efficient and economic diagnosis","authors":"J.M. Remes-Troche","doi":"10.1016/j.rgmxen.2025.01.002","DOIUrl":"10.1016/j.rgmxen.2025.01.002","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 167-168"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217767","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":"An unusual type of early gastric cancer with aggressive behavior: It is not always adenocarcinoma!","authors":"R. Ruiz ,&nbsp;L. Marín-Calderón ,&nbsp;H. Benites-Goñi ,&nbsp;N. Fernández ,&nbsp;M. Kapsoli","doi":"10.1016/j.rgmxen.2024.11.006","DOIUrl":"10.1016/j.rgmxen.2024.11.006","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 320-322"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227807","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}