Revista de gastroenterologia de Mexico (English)最新文献

{"title":"Enterocolitis and other immunotherapy and targeted therapy-related gastrointestinal manifestations: A review for gastroenterologist","authors":"O. Gómez Escudero","doi":"10.1016/j.rgmxen.2023.11.001","DOIUrl":"10.1016/j.rgmxen.2023.11.001","url":null,"abstract":"<div><p>New oncologic treatments, particularly immunotherapy (IT), have revolutionized the treatment of advanced-stage malignant tumors. Immune checkpoint inhibitors are the main form of IT and act by increasing T cell activity and the organism’s immune response against neoplastic cells. Targeted therapy is another form of IT that acts by inhibiting oncogenes or inflammation signaling and tumor angiogenesis pathways. However, these mechanisms of tumor destruction can interfere with the host’s immune self-tolerance or with the mechanisms of epithelial tissue repair and predispose to immune system-mediated adverse events that can affect multiple organs, including the digestive tract. The gastrointestinal manifestations of damage caused by IT can range from low-grade mucositis to ulceration, and in some cases, necrosis and perforation. Any part of the gastrointestinal tract can be affected, but there is greater involvement of the small bowel and colon, with a pattern similar to that seen in inflammatory bowel disease. The most common clinical manifestation is chronic diarrhea. The differential diagnosis includes enteropathogenic infections, especially those caused by opportunistic microorganisms; adverse drug reactions; and other inflammatory and malabsorption disorders. Treatment is guided by damage severity. Mild cases can be treated with antidiarrheals and rehydration in the outpatient setting; moderate cases with hospitalization, systemic steroids, and temporary suspension of IT; and severe cases with immunosuppressants or biologic agents and definitive suspension of IT.</p></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"89 1","pages":"Pages 89-105"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2255534X2400001X/pdfft?md5=12c6aac43f319074b9f20faa7ffd9836&pid=1-s2.0-S2255534X2400001X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133469","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":"Unexpected finding after polyp resection during colonoscopy","authors":"A. Chatterjee ,&nbsp;S. Robertson ,&nbsp;A. Rubio-Tapia","doi":"10.1016/j.rgmxen.2023.11.003","DOIUrl":"10.1016/j.rgmxen.2023.11.003","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"89 1","pages":"Pages 163-164"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2255534X24000100/pdfft?md5=86dd94dc86d6d8bd2bb0d3180171d9b2&pid=1-s2.0-S2255534X24000100-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140330433","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":"Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio on postoperative day three as a biochemical predictor of clinically significant pancreatic fistula in patients undergoing distal pancreatectomy","authors":"G.E. Sánchez-Morales ,&nbsp;J. Cisneros-Correa ,&nbsp;D. Lanzagorta-Ortega ,&nbsp;R.H. Pérez-Soto ,&nbsp;I. Domínguez-Rosado ,&nbsp;C. Chan","doi":"10.1016/j.rgmxen.2023.03.004","DOIUrl":"10.1016/j.rgmxen.2023.03.004","url":null,"abstract":"<div><h3>Introduction and aims</h3><p>Distal pancreatectomy is a frequent procedure and postoperative fistula, its most common complication, has an incidence of 30 to 60%. The aim of the present work was to study the role of the neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio, as indicators of inflammatory response in the setting of pancreatic fistula.</p></div><div><h3>Methods</h3><p>A retrospective observational study was conducted on patients that underwent distal pancreatectomy. The diagnosis of postoperative pancreatic fistula was made according to the definition proposed by the International Study Group on Pancreatic Fistula. The relation of postoperative pancreatic fistula to the neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio was determined in the postoperative evaluation. SPSS v.21 software was utilized for the statistical analysis and a <em>P</em>&lt;.05 was considered statistically significant.</p></div><div><h3>Results</h3><p>A total of 12 patients (27.2%) developed grade B or grade C postoperative pancreatic fistula. ROC curves were constructed and a threshold of 8.3 (PPV 0.40, NPV 0.86) was established for the neutrophil-to-lymphocyte ratio, with an area under the curve of 0.71, sensitivity of 0.81, and specificity of 0.62, whereas a threshold of 33.2 (PPV 0.50, NPV 0.84) was established for the platelet-to-lymphocyte ratio, with an area under the curve of 0.72, sensitivity of 0.72, and specificity of 0.71.</p></div><div><h3>Conclusion</h3><p>The neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio are serologic markers that can aid in identifying patients that will present with grade B or grade C postoperative pancreatic fistula, thus helping to provide an opportune focus on care and resources.</p></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"89 1","pages":"Pages 42-51"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2255534X23000282/pdfft?md5=06402e2fbdbdca7861486a7b3c6ee283&pid=1-s2.0-S2255534X23000282-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9192641","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":"Psychosocial quality-of-life correlates in functional gastrointestinal disorders","authors":"A. Sundas ,&nbsp;H. Sampath ,&nbsp;S.C. Lamtha ,&nbsp;G. Soohinda ,&nbsp;S. Dutta","doi":"10.1016/j.rgmxen.2022.04.005","DOIUrl":"10.1016/j.rgmxen.2022.04.005","url":null,"abstract":"<div><h3>Introduction and aim</h3><p>Functional gastrointestinal disorders (FGIDs) are complex illnesses characterized by gastrointestinal symptoms, with no underlying organic pathology. They are common, chronic, recurrent, and disabling disorders that significantly impair quality of life (QoL). The aim of the present cross-sectional analytical study was to assess QoL and its correlates in adult patients with FGIDs.</p></div><div><h3>Materials and methods</h3><p>A cross-sectional, observational, hospital-based study was conducted at the gastroenterology outpatient department of a tertiary care teaching hospital. The ROME IV diagnostic criteria were used to identify the FGIDs. Anxiety, depression, coping strategies, social support, and QoL were assessed by the hospital anxiety and depression scale, the coping strategies inventory, the multidimensional scale of perceived social support, and the functional digestive disorders quality-of-life questionnaire, respectively.</p></div><div><h3>Results</h3><p>Of the 52 consecutive patients diagnosed with FGIDs, functional dyspepsia (51.92%) and irritable bowel syndrome (40.38%) were the most common. There were no significant associations between sociodemographic variables (age, sex, marital status, socioeconomic status, educational level, employment, occupation, dietary pattern) and QoL scores (all <em>p</em> values &gt;0.05). Duration and social support were not significantly associated with QoL (all <em>p</em> values &gt;0.05). In contrast, psychological variables, such as disengagement coping (<em>r</em> <!-->=<!--> <!-->–0.344, <em>p</em> <!-->=<!--> <!-->0.012), depression (<em>r</em> <!-->=<!--> <!-->–0.600, <em>p</em> <!-->=<!--> <!-->0.000), and anxiety (<em>r</em> <!-->=<!--> <!-->–0.590, <em>p</em> <!-->=<!--> <!-->0.000), were significantly correlated with QoL.</p></div><div><h3>Conclusions</h3><p>Despite advances in neurogastroenterology, patients continue to be disabled by FGIDs. Psychological factors, especially depression, significantly contribute to poor QoL in those patients and should be addressed in a holistic, multidisciplinary way. The biopsychosocial framework, as it applies to FGIDs, should lead to the inclusion of psychosocial assessments in the clinical management and research of those disorders.</p></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"89 1","pages":"Pages 11-18"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2255534X22000822/pdfft?md5=86963d8954ba56a8ed85bc79976d8934&pid=1-s2.0-S2255534X22000822-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40578694","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":"Immune-mediated hepatitis: Basic concepts and treatment","authors":"J.A. Velarde-Ruiz Velasco ,&nbsp;D.K. Tapia Calderón ,&nbsp;S. Cerpa-Cruz ,&nbsp;J.A. Velarde-Chávez ,&nbsp;J.F. Uribe Martínez ,&nbsp;E.S. García Jiménez ,&nbsp;J.M. Aldana Ledesma ,&nbsp;Á. Díaz-González ,&nbsp;J. Crespo","doi":"10.1016/j.rgmxen.2023.12.001","DOIUrl":"10.1016/j.rgmxen.2023.12.001","url":null,"abstract":"<div><p>Immunotherapy with immune checkpoint inhibitors (ICIs) has revolutionized advanced cancer management. Nevertheless, the generalized use of these medications has led to an increase in the incidence of adverse immune-mediated events and the liver is one of the most frequently affected organs.</p><p>Liver involvement associated with the administration of immunotherapy is known as immune-mediated hepatitis (IMH), whose incidence and clinical characteristics have been described by different authors. It often presents as mild elevations of amino transferase levels, seen in routine blood tests, that spontaneously return to normal, but it can also manifest as severe transaminitis, possibly leading to the permanent discontinuation of treatment.</p><p>The aim of the following review was to describe the most up-to-date concepts regarding the epidemiology, diagnosis, risk factors, and progression of IMH, as well as its incidence in different types of common cancers, including hepatocellular carcinoma. Treatment recommendations according to the most current guidelines are also provided.</p></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"89 1","pages":"Pages 106-120"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2255534X24000082/pdfft?md5=b67ff01dcde78e310b6d32ebb25ab07c&pid=1-s2.0-S2255534X24000082-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133471","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":"Adherence to a gluten-free diet: Can just a little bit be harmful?","authors":"L F Uscanga","doi":"10.1016/j.rgmxen.2023.04.003","DOIUrl":"10.1016/j.rgmxen.2023.04.003","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":" ","pages":"305-306"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9390592","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":"Performance of the predictive criteria of the American Society for Gastrointestinal Endoscopy in the diagnosis of choledocholithiasis at a secondary care public hospital in the State of Nuevo León, Mexico.","authors":"C Ovalle-Chao, D A Guajardo-Nieto, R A Elizondo-Pereo","doi":"10.1016/j.rgmxen.2022.06.005","DOIUrl":"10.1016/j.rgmxen.2022.06.005","url":null,"abstract":"<p><strong>Introduction and aims: </strong>Currently there is no ideal diagnostic/therapeutic approach for patients with suspected choledocholithiasis. The primary aim of our study was to evaluate the performance of the criteria for predicting choledocholithiasis proposed by the American Society for Gastrointestinal Endoscopy (ASGE) in 2019.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted that included 352 patients seen at a secondary care public healthcare institution in Monterrey, Nuevo León, that treats an open population and does not have endoscopic ultrasound or magnetic resonance cholangiopancreatography at its disposal.</p><p><strong>Results: </strong>The most frequent predictor presented by the patients was abnormal liver function tests (90.63%), and with their use alone, sensitivity was higher than that of all the predictors analyzed (91.41%). In addition, the finding of common bile duct stones on ultrasound imaging was the only predictor independently associated with the confirmatory diagnosis of choledocholithiasis. Regarding the general performance of the 2019 criteria, the high-risk category had 68.75% sensitivity, 52.08% specificity, a positive predictive value of 79.28%, a negative predictive value of 38.46%, diagnostic accuracy of 64.20%, and a confirmatory diagnosis of choledocholithiasis in 79.28% of the patients of that risk category.</p><p><strong>Conclusions: </strong>The study corroborated that the presence of choledocholithiasis could be predicted using the choledocholithiasis predictors and risk categories proposed by the ASGE, with acceptable accuracy, in accordance with the standards suggested by those same guidelines.</p>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":" ","pages":"322-332"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40578696","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":"Adherence to a gluten-free diet in celiac disease patients from Paraguay.","authors":"R E Real-Delor, M E Chamorro-Aguilera","doi":"10.1016/j.rgmxen.2021.10.011","DOIUrl":"10.1016/j.rgmxen.2021.10.011","url":null,"abstract":"<p><strong>Introduction and aim: </strong>The treatment for celiac disease is a gluten-free diet that should be strictly and permanently carried out. Our aims were to determine adherence to the gluten-free diet and the risk factors for non-adherence.</p><p><strong>Materials and methods: </strong>An observational, cross-sectional, comparative study was conducted. It included individuals of both sexes and of any age that presented with celiac disease, lived in Paraguay from January to April 2021, and agreed to participate in the survey. Incomplete questionnaires were excluded. Non-probabilistic convenience sampling was utilized. Adherence was measured using the Leffler questionnaire. The study was approved by the Ethics Committee of the Universidad Privada del Este.</p><p><strong>Results: </strong>The sample consisted of 371 respondents, 322 (87%) of whom were adults, with a mean age of 38 ± 12 years, and 49 (13%) of whom were children and adolescents, with a mean age of 10 ± 5 years. Female sex was predominant (85%). Adherence to the gluten-free diet was detected in 59% of the adults and 73% of the children and adolescents. The factors significantly associated with adherence included belonging to the child and adolescent age group and having had the diagnosis for a longer time: 9 ± 8 years for the adherence group and 7 ± 8 years for the non-adherence group.</p><p><strong>Conclusions: </strong>The present study demonstrated the frequency of adherence to the gluten-free diet in celiac patients in Paraguay. Psychologic and nutritional support is recommended for individuals with celiac disease that do not adhere to their treatment.</p>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":" ","pages":"307-314"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40578697","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":"Beyond conventional physical examination in hepatology: POCUS.","authors":"J A Velarde-Ruiz Velasco, D K Tapia Calderón, E Llop Herrera, G Castro Narro, E S García Jiménez, E Cerda Reyes, F Higuera de la Tijera, A D Cano Contreras, R Moreno Alcántar, R M Chávez Ramírez, J L Calleja Panero","doi":"10.1016/j.rgmxen.2023.07.003","DOIUrl":"10.1016/j.rgmxen.2023.07.003","url":null,"abstract":"<p><p>Point-of-care ultrasound (POCUS) refers to the use of ultrasound imaging through pocket-sized sonographic devices at the patient's bedside, to make a diagnosis or direct a procedure and immediately answer a clinical question. Its goal is to broaden the physical examination, not to replace conventional ultrasound studies. POCUS has evolved as a complement to physical examination and has been adopted by different medical specialties, including hepatology. A narrative synthesis of the evidence on the applications of POCUS in hepatology was carried out, describing its usefulness in the diagnosis of cirrhosis of the liver, metabolic dysfunction-associated steatotic liver disease (MASLD), decompensated cirrhosis, and portal hypertension. The review also encompasses more recent applications in the hemodynamic evaluation of the critically ill patient with cirrhosis of the liver, patients with other liver diseases, as well as in the ultrasound guidance of procedures. POCUS could make up part of the daily clinical practice of gastroenterologists and hepatologists, simplifying the initial evaluation of patients and optimizing clinical management. Its accessibility, ease of use, and low adverse event profile make POCUS a useful tool for the properly trained physician in the adequate clinical setting. The aim of this review was to describe the available evidence on the usefulness of POCUS in the daily clinical practice of gastroenterologists and hepatologists.</p>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":" ","pages":"381-391"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41222979","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":"Ménétrier disease: A rare cause of hypertrophic gastropathy.","authors":"C E Alcántara-Figueroa, D C Calderón-Cabrera, Y K Pariona-Martínez, R de la Cruz-Rojas, R A Alcántara-Ascón","doi":"10.1016/j.rgmxen.2023.05.010","DOIUrl":"10.1016/j.rgmxen.2023.05.010","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":" ","pages":"435-436"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10210635","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}