Acta Gastroenterologica Latinoamericana最新文献

Ménétrier disease is a rare condition of an unknown origin,with a wide spectrum of clinical signs and symptoms atpresentation. Diagnosis is made through the combination ofclinical, analytical, endoscopic and histological data. Surgeryis the classical treatment. However, new medical approacheshave emerged.

Functional dyspepsia impacts on quality of life. Due to itsmultifactorial etiology its characterization proves difficult,especially in populations at risk such as medical students.

Objetives: To determine if behavioral and harmful habitsof medical students from eight universities of Peru wereassociated to functional dyspepsia.

Methods: Multicentric,cross-sectional study. A self-administered questionnaire was taken among students enrolled in eight medical facultiesin Peru. Functional dyspepsia was measured using a validatedtest; diet characteristics, alcohol, tobacco, coffee or energydrinks consumption were considered behavioral habits.Furthermore, others from the social and educational spherewere measured. Bivariate and multivariate statistical analyseswere made.

Results: From a total of 1.923 students, themedian of the ages was 20, 55% were women and 24% sufferedfrom functional dyspepsia. Factors which diminishedthe frequency of functional dyspepsia were masculine gender(aPR:0,75; 95%CI:0.64-0.87; p < 0,001), hours spentstudying (aPR:0,97; 95%CI:0,96-0,99; p < 0,001) andeating following a fixed schedule (aPR:0,80; 95%CI:0,67-0,95; p = 0,013); however, having failed a course increasesthe frequency of functional dyspepsia (aPR:1.24;95%CI:1.13-1.37; p < 0,001)adjusted for age, as well asdifficulties to fall asleep and depression.

Conclusion: Manymedical students suffered from functional dyspepsia, this beingrelated to several behavioral variables; therefore furtherstudies as well as educational institutions’ intervention is required,due to the short and long term problems that mayarise from this situation.

Obesity is an epidemic with important health repercussionsin addition to high treatment-related costs. Between 2006and 2007 the WHO developed new assessment tools, whicharen't being globally used. In fact, there is no unified problemmanagement across the hemisphere.

Objectives: To updateobesity epidemiology, to promote application of WHO’sstandards, to review new findings on physiopathology (i.e.,fatty tissue as endocrine organ, intestinal microbiota), toupdate epidemiological information, and to provide managementguidelines that can be integrated in clinical care.

Methods: LAPSGHAN called up its members to collaboratein preparing this review article under the direction ofan editor/coordinator, who selected the contents and literaturewith the best evidencetogether with the members. Eachmember prepared a separate document for each content. Thechosen contents were later collated, unified, and edited. Results.This documents highlights the following: 1) Althoughextreme obesity is increasing in the US, overweight and obesityprevalence has stabilized, while in other countries it isalarmingly increasing; 2) New information regarding role offatty tissue as endocrine organ and self-regulator of obesity;3) The promising role of microbiota; and 4) Guidelines forchildren handling during consultation and follow-up.

Conclusions: There is no widespread implementation of standardsand guidelines from the World Health Organization(WHO). There is no agreement as to whether z-scores or percentilesshould be used, especially regarding children under 2due to their changing body complexion. The most acceptedtool to assess overweight, obesity and severe obesity is the BodyMass Index (BMI). This document provides recommendationson how to approach clinical care with affected children.

GERD is a highly prevalent disease in our country. It has adeep impact in patient´s quality of life, representing extremelyhigh costs regarding health. The correct understanding ofits pathophysiology is crucial for the rational use of diagnosesmethods and the implementation of appropriate treatmentadjusted to each individual case. In this review we evaluatethis disorder based on the best available evidence, focusingin pathophysiological mechanisms, its epidemiology, moderndiagnosis methods and current management standards.

Sacral neuromodulation involves electrical stimulation of af­ferent nerve roots to restore the balance between inhibitory and excitatory reflexes who improve the functional activity of the pelvic floor. With benefits in patients with fecal inconti­nence, constipation and chronic anorectal pain. Objective. The aim of this study is present the results obtained with sacral neuromodulation for the treatment of patients with fecal incontinence, severe and intractable chronic constipa­tion and chronic anorectal pain. Patients and methods. 33 patients had indication for transitory electrical sacral stimu­lation, 25 patients performed transitory electrical stimula­tion for fecal incontinence, 5 with refractary constipation and 3 with chronic anorectal pain. In cases of fecal inconti­nence, the patients performed previous anorectal manometry and ultrasonography examination of anal sphincters. When the constipation is the indication, we performed stimulation in patients with severe and refractary constipation like step before total colectomy. In cases of chronic anorectal pain, the electrical transitory test was performed according to our treatment algorithm for management of functional anorectal pain. In all cases, if the patients had satisfactory results after 2 weeks period the definitive implant was placed. Results. Mean follow-up was 69 months (range 6-130). Definitve implant was placed for treatment of fecal incontinence in 23 patients with a decrease in fecal incontinence scores in 98%, with an average success rate of 66% (range: 45-92). In cases of constipation, 3 definitive implants were placed, the mean follow-up was 77 months (range: 51-96) with a success rate between 50%-80% as measured by bowel frequency. We performed definitive electrical stimulation in 3 patients wit chronic and intractable anorectal pain. Response rates as measured by visual analog scale were between 40%-70%. Conclusions. Sacral neuromodulation is an area in constant growth, with more indications. The success depends on the correct indication and the patients need to be treated with other therapeutic options before sacral neuromodulation.