Revista de gastroenterologia de Mexico (English)最新文献

{"title":"Identification of prognostic factors for survival in patients with metastatic gastric adenocarcinoma in a Mexican population","authors":"","doi":"10.1016/j.rgmxen.2023.07.007","DOIUrl":"10.1016/j.rgmxen.2023.07.007","url":null,"abstract":"<div><h3>Introduction and aims</h3><p>Gastric adenocarcinoma is among the high-ranking tumors, with respect to frequency and mortality, worldwide. The inflammatory process and immune system activity are associated with oncologic control. Our aim was to identify whether the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and other variables are prognostic factors for survival in patients with metastatic gastric cancer in a Mexican population.</p></div><div><h3>Material and methods</h3><p>Patients diagnosed with metastatic gastric adenocarcinoma, hospitalized within the time frame of December 2011 to 2021, were analyzed. The NLR, PLR, and albumin and hemoglobin levels obtained from blood samples were calculated. Functional status (ECOG and Karnofsky), sex, histology, and the presence of signet ring cells were also considered possible prognostic factors. Each factor’s prognostic value for overall survival was determined through univariate and multivariate analyses.</p></div><div><h3>Results</h3><p>The study included 956 patients diagnosed with metastatic gastric cancer, of whom 494 (51.7%) were men and 462 (48.3%) were women. The main histologic finding was diffuse adenocarcinoma (n = 619, 64.7%), followed by intestinal adenocarcinoma (n = 293, 30.6%), and the presence of signet ring cells was found in 659 (68.9%) patients. Diagnostic laparoscopy was performed on 238 patients (24.9%) to confirm peritoneal carcinomatosis. The multivariate analysis showed that an NLR above 3.2 (HR 1.51, 95% CI 1.27–1.8; p &lt; 0.001), albumin below 3.5 g/dl (HR 1.25, CI 1.06–1.47; p = 0.006), and an ECOG performance status of 2 or higher (HR 1.39, CI 1.10–1.76; p = 0.005) were independent factors that predicted a lower survival rate, whereas a Karnofsky score above 70% (HR 0.69, CI 0.53–0.91; p = 0.008) was associated with a better survival rate. Lastly, the PLR was not statistically significant in the multivariate analysis.</p></div><div><h3>Conclusions</h3><p>The NLR, nutritional status assessed through albumin measurement, and functional status can act as independent prognostic survival factors in hospitalized Mexican patients diagnosed with metastatic gastric adenocarcinoma and be taken into account during therapeutic decision-making.</p></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"89 3","pages":"Pages 340-346"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2255534X24000057/pdfft?md5=5ac61608b699b6b69e3842b69d3d7e79&pid=1-s2.0-S2255534X24000057-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of endoscopic procedures performed at a tertiary care hospital before and during the SARS-CoV-2 pandemic","authors":"","doi":"10.1016/j.rgmxen.2023.10.003","DOIUrl":"10.1016/j.rgmxen.2023.10.003","url":null,"abstract":"<div><h3>Introduction and aim</h3><p>SARS-CoV-2 emerged in 2019 and had a huge impact on the world. The area of endoscopy suffered great changes, causing a reduction in the number of procedures and its indications. The aim of our study was to compare the quantity, indication, and type of procedures in 2019 with those in 2020.</p></div><div><h3>Method</h3><p>A retrospective, observational, analytic, and cross-sectional study was conducted, obtaining information from the endoscopy registry. The STROBE checklist was employed.</p></div><div><h3>Statistical analysis</h3><p>The quantitative variables were analyzed with descriptive statistics (measures of central tendency and dispersion) and the categorical variables with frequencies and percentages. The quantitative variables were compared, using the Student’s t test/Mann–Whitney U test, and the categorical variables with contingency tables, using the Fisher’s exact test.</p></div><div><h3>Results</h3><p>In 2019, a total of 277 procedures were performed, compared with 139 in 2020. Mean patient age was 98.53 months (61.46 SD) in 2019 and 77.02 months (59.81 SD) in 2020; 352 diagnostic procedures and 136 therapeutic procedures were carried out in 2019, compared with 51 diagnostic procedures and 88 therapeutic procedures in 2020. The number of diagnostic and therapeutic procedures were inverted (72.1%–36.7% and 27.9%–63.3%, respectively) (p<!--> <!-->&lt;<!--> <!-->0.0001). Esophageal varices, upper gastrointestinal bleeding (UGIB), and foreign body extraction were the indications, in order of predominance in 2019, compared with foreign body extraction (p<!--> <!-->&lt;<!--> <!-->0.05), UGIB, and esophageal varices in 2020. There were no differences regarding colonoscopy.</p></div><div><h3>Conclusion</h3><p>There was a clear difference in indication and type of procedure, with an increase in foreign body extraction in preschoolers.</p></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"89 3","pages":"Pages 362-368"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2255534X24000495/pdfft?md5=2cd0609ca8ccd693fa5a853a7e5ade9d&pid=1-s2.0-S2255534X24000495-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new formula proposal for placing pH-impedance catheters in pediatric patients","authors":"","doi":"10.1016/j.rgmxen.2023.08.009","DOIUrl":"10.1016/j.rgmxen.2023.08.009","url":null,"abstract":"<div><h3>Introduction</h3><p>Esophageal pH-impedance monitoring is a tool for diagnosing gastroesophageal reflux in children. The position of the pH catheter is essential for a reliable reading and the current formulas for calculating catheter insertion length are not completely accurate. The aim of the present study was to develop a new formula for adequate insertion of the pH catheter.</p></div><div><h3>Material and methods</h3><p>A cross-sectional study was conducted on children that underwent pH-impedance monitoring and later radiographic control, to calculate the correct catheter insertion length. The documented variables were age, sex, weight, height, naris to tragus distance, tragus to sternal notch distance, sternal notch to xiphoid process distance, and initial insertion length determined by the Strobel and height interval formulas. A multivariate regression analysis was carried out to predict the final insertion length. Regression ANOVA and Pearson’s adjusted R-squared tests were performed.</p></div><div><h3>Results</h3><p>Forty-five pH-impedance studies were carried out, 53% of which were in males. The age and weight variables were not normally distributed. In the initial regression model, the variables that did not significantly correlate with the final insertion length were: sex (<em>P</em> 0.124), length determined by the Strobel or height interval formulas (<em>P</em> 0.078), naris to tragus distance (<em>P</em> 0.905), and tragus to sternal notch distance (<em>P</em> 0.404). The final equation: 5.6 + (height in cm * 0.12) + (sternal notch to xiphoid process distance * 0.57) produced an R² of 0.93 (<em>P</em> 0.000).</p></div><div><h3>Conclusions</h3><p>This formula can be considered a valid option for placement of the pH-impedance monitoring catheter in pediatrics.</p></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"89 3","pages":"Pages 347-353"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2255534X24000471/pdfft?md5=38299e837174239f94ece846b65afa9c&pid=1-s2.0-S2255534X24000471-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blundering in high-resolution esophageal manometry in patients with achalasia","authors":"","doi":"10.1016/j.rgmxen.2024.04.003","DOIUrl":"10.1016/j.rgmxen.2024.04.003","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"89 3","pages":"Pages 444-446"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2255534X24000550/pdfft?md5=6a8dcec625f5b12d3000e5a4075205c7&pid=1-s2.0-S2255534X24000550-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Position paper on perioperative management and surgical risk in the patient with cirrhosis","authors":"J.A. Velarde-Ruiz Velasco ,&nbsp;J. Crespo ,&nbsp;A. Montaño-Loza ,&nbsp;J.M. Aldana-Ledesma ,&nbsp;A.D. Cano-Contreras ,&nbsp;E. Cerda-Reyes ,&nbsp;N.J. Fernández Pérez ,&nbsp;G.E. Castro-Narro ,&nbsp;E.S. García-Jiménez ,&nbsp;J.E. Lira-Vera ,&nbsp;Y.I. López-Méndez ,&nbsp;J. Meza-Cardona ,&nbsp;R. Moreno-Alcántar ,&nbsp;J. Pérez-Escobar ,&nbsp;J.L. Pérez-Hernández ,&nbsp;D.K. Tapia-Calderón ,&nbsp;F. Higuera-de-la-Tijera","doi":"10.1016/j.rgmxen.2024.05.001","DOIUrl":"10.1016/j.rgmxen.2024.05.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Management of the patient with cirrhosis of the liver that requires surgical treatment has been relatively unexplored. In Mexico, there is currently no formal stance or expert recommendations to guide clinical decision-making in this context.</p></div><div><h3>Aims</h3><p>The present position paper reviews the existing evidence on risks, prognoses, precautions, special care, and specific management or procedures for patients with cirrhosis that require surgical interventions or invasive procedures. Our aim is to provide recommendations by an expert panel, based on the best published evidence, and consequently ensure timely, quality, efficient, and low-risk care for this specific group of patients.</p></div><div><h3>Results</h3><p>Twenty-seven recommendations were developed that address preoperative considerations, intraoperative settings, and postoperative follow-up and care.</p></div><div><h3>Conclusions</h3><p>The assessment and care of patients with cirrhosis that require major surgical or invasive procedures should be overseen by a multidisciplinary team that includes the anesthesiologist, hepatologist, gastroenterologist, and clinical nutritionist. With respect to decompensated patients, a nephrology specialist may be required, given that kidney function is also a parameter involved in the prognosis of these patients.</p></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"89 3","pages":"Pages 418-441"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2255534X24000574/pdfft?md5=5cee550d2160a3852de6a2d958dc232b&pid=1-s2.0-S2255534X24000574-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival analysis of the surgical treatment of hepatocellular carcinoma at a tertiary care center","authors":"","doi":"10.1016/j.rgmxen.2022.12.001","DOIUrl":"10.1016/j.rgmxen.2022.12.001","url":null,"abstract":"<div><h3>Introduction and aims</h3><p>Hepatocellular carcinoma (HCC) is a primary malignant tumor of liver epithelial cells and is the most frequent primary liver cancer. The broadening of transplantation and resectability criteria has made therapeutic decisions more complex. Our aim was to describe the clinical and survival characteristics of patients with HCC treated through resection or liver transplantation at our hospital and identify the presence of factors that enable outcome prediction and facilitate therapeutic decision-making.</p></div><div><h3>Materials and methods</h3><p>Patients with HCC that underwent surgery with curative intent at the <em>Hospital Universitario Marqués de Valdecilla</em>, within the time frame of 2007 and 2017, were retrospectively identified. Survival, mortality, disease-free interval, and different outcome-related variables were analyzed.</p></div><div><h3>Results</h3><p>Ninety-six patients with a mean follow-up after surgery of 44 months were included. Overall mortality and recurrence were higher in the resection group. Mean survival was 51.4 months in the liver transplantation group and 37.5 months in the resection group, and the disease-free interval was 49.4 ± 37.2 and 27.4 ± 28.7 months, respectively (p = 0.002). The tumor burden score was statistically significant regarding risk for recurrence and specific mortality.</p></div><div><h3>Conclusions</h3><p>There appears to be no patient subgroup in whom the results of surgical resection were superior or comparable to those of transplantation. Tumor burden determination could be a useful tool for patient subclassification and help guide therapeutic decision-making.</p></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"89 3","pages":"Pages 323-331"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2255534X24000392/pdfft?md5=ccfbfbb8ad720031933157b65cff1b4c&pid=1-s2.0-S2255534X24000392-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jejunal perforation associated with immune reconstitution inflammatory syndrome due to cytomegalovirus: A case report","authors":"","doi":"10.1016/j.rgmxen.2024.04.007","DOIUrl":"10.1016/j.rgmxen.2024.04.007","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"89 3","pages":"Pages 457-459"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2255534X24000604/pdfft?md5=7a32bb3d97b32c55c71bc01b2d2aa1b8&pid=1-s2.0-S2255534X24000604-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The string sign in Crohn’s disease","authors":"","doi":"10.1016/j.rgmxen.2024.04.004","DOIUrl":"10.1016/j.rgmxen.2024.04.004","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"89 3","pages":"Pages 447-448"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2255534X24000562/pdfft?md5=86eeea4ff29179f2db577bf018e01cbc&pid=1-s2.0-S2255534X24000562-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute liver failure: Management update and prognosis","authors":"L.M. Martínez-Martínez ,&nbsp;G. Rosales-Sotomayor ,&nbsp;E.A. Jasso-Baltazar ,&nbsp;J.A. Torres-Díaz ,&nbsp;D. Aguirre-Villarreal ,&nbsp;I. Hurtado-Díaz de León ,&nbsp;V.M. Páez-Zayas ,&nbsp;A. Sánchez-Cedillo ,&nbsp;S.E. Martínez-Vázquez ,&nbsp;H.N. Tadeo-Espinoza ,&nbsp;J.P. Guerrero-Cabrera ,&nbsp;M. García-Alanis ,&nbsp;I. García-Juárez","doi":"10.1016/j.rgmxen.2024.05.002","DOIUrl":"10.1016/j.rgmxen.2024.05.002","url":null,"abstract":"<div><p>Acute liver failure is a rare but serious syndrome, with an incidence of approximately 2,000 to 3,000 cases per year in North America. Its pathophysiology and clinical course vary, depending on the cause of the primary liver injury, and can lead to high morbidity and mortality or the need for liver transplantation, despite available therapies. This syndrome involves excessive activation of the immune system, with damage in other organs, contributing to its high mortality rate. The most accepted definition includes liver injury with hepatic encephalopathy and coagulopathy within the past 26 weeks in a patient with no previous liver disease. The main causes are paracetamol poisoning, viral hepatitis, and drug-induced liver injury, among others. Identifying the cause is crucial, given that it influences prognosis and treatment. Survival has improved with supportive measures, intensive therapy, complication prevention, and the use of medications, such as N-acetylcysteine. Liver transplantation is a curative option for nonresponders to medical treatment, but adequate evaluation of transplantation timing is vital for improving results. Factors such as patient age, underlying cause, and severity of organ failure influence the post-transplant outcomes and survival.</p></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"89 3","pages":"Pages 404-417"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2255534X24000628/pdfft?md5=c8db886ea379421ed12b38f3a466c347&pid=1-s2.0-S2255534X24000628-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cyclic vomiting syndrome: From pathophysiology to treatment","authors":"R.A. Jiménez-Castillo ,&nbsp;R. Frazier ,&nbsp;T. Venkatesan ,&nbsp;J.M. Remes-Troche","doi":"10.1016/j.rgmxen.2024.06.001","DOIUrl":"10.1016/j.rgmxen.2024.06.001","url":null,"abstract":"<div><p>Cyclic vomiting syndrome (CVS) is a disorder characterized by recurrent and unpredictable episodes of intense vomiting, interspersed with periods of apparent wellbeing. This disorder, which primarily affects children and adolescents but can persist into adulthood, has recently been the subject of extensive study and analysis in the medical literature. The aim of the present review is to examine the most important aspects of the epidemiology, pathophysiology, subtypes, diagnostic criteria, and current management of CVS. Even though the exact etiology remains unknown, genetic factors (polymorphisms), nervous system alterations and autonomic dysregulation, and environmental factors (use and abuse of cannabinoids) are postulated as possible triggers. CVS has significant diagnostic challenges, given that there is no specific test for confirming its presence. Thorough evaluation of symptoms and the ruling out of other possible causes of recurrent vomiting are required. Management of CVS typically involves a multidisciplinary approach. Pharmacologic options are explored, such as antiemetics and preventive medications, as well as behavioral and psychologic support therapies. Treatment personalization is essential, adapting it to the individual needs of each patient. Despite advances in the understanding of CVS, it remains a significant clinical challenge. This disorder impacts the quality of life of those affected and their families, underscoring the ongoing need for research and the development of more effective treatment strategies.</p></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"89 3","pages":"Pages 389-403"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2255534X24000616/pdfft?md5=bbb72d6aa141ff7bff490e20bc845ef7&pid=1-s2.0-S2255534X24000616-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}