Pub Date : 2025-04-01DOI: 10.1016/j.rgmx.2025.02.001
M.A. Valdovinos-Díaz , A. Hani , C. Defilippi-Guerra , L. Fernando-Pineda , J.M. Remes-Troche , A. Riquelme , L.J. Abrahão-Junior , L. Aguilar-Paiz , C. Almonte-Nuñez , H. Burgos , C. Días , O. Gómez-Escudero , I. Hanna-Jairala , C. Olano , J.A. Olmos , A. Ortiz , G. Otoya , J.L. Tamayo-de la Cuesta , J. Suazo-Barahona , E. Vesco-Monteagudo , J.S. Arenas-Martínez
Introduction and aim
Due to its elevated prevalence, complex pathophysiology, and broad spectrum of clinical manifestations, gastroesophageal reflux disease (GERD) requires precision diagnosis and treatment. The aim of this Latin American expert review was to provide good clinical practice recommendations for the rational use of diagnostic tests and the personalized treatment of GERD.
Methods
Good clinical practice recommendations were developed by a group of Latin American experts in GERD. A thorough review of the literature was conducted, and recommendations on the diagnosis and treatment of GERD were issued after three group discussions.
Results
Twenty-one experts on GERD formulated 30 clinical recommendations for appropriately indicating diagnostic tests for disease phenotypes and their medical treatment, refractory GERD management, endoscopic and surgical treatment indications, the control of GERD in obesity, pregnancy, and older adults, as well as the role of Helicobacter pylori infection and GLP-1 agonists.
Conclusions
Determining GERD phenotypes in patients through the appropriate use of diagnostic tests enables personalized treatment to be prescribed. The recommendations established in this document may contribute to improving the quality of care of patients with GERD.
{"title":"Recomendaciones de buena práctica clínica para el manejo de la enfermedad por reflujo gastroesofágico. Revisión por expertos latinoamericanos","authors":"M.A. Valdovinos-Díaz , A. Hani , C. Defilippi-Guerra , L. Fernando-Pineda , J.M. Remes-Troche , A. Riquelme , L.J. Abrahão-Junior , L. Aguilar-Paiz , C. Almonte-Nuñez , H. Burgos , C. Días , O. Gómez-Escudero , I. Hanna-Jairala , C. Olano , J.A. Olmos , A. Ortiz , G. Otoya , J.L. Tamayo-de la Cuesta , J. Suazo-Barahona , E. Vesco-Monteagudo , J.S. Arenas-Martínez","doi":"10.1016/j.rgmx.2025.02.001","DOIUrl":"10.1016/j.rgmx.2025.02.001","url":null,"abstract":"<div><h3>Introduction and aim</h3><div>Due to its elevated prevalence, complex pathophysiology, and broad spectrum of clinical manifestations, gastroesophageal reflux disease (GERD) requires precision diagnosis and treatment. The aim of this Latin American expert review was to provide good clinical practice recommendations for the rational use of diagnostic tests and the personalized treatment of GERD.</div></div><div><h3>Methods</h3><div>Good clinical practice recommendations were developed by a group of Latin American experts in GERD. A thorough review of the literature was conducted, and recommendations on the diagnosis and treatment of GERD were issued after three group discussions.</div></div><div><h3>Results</h3><div>Twenty-one experts on GERD formulated 30 clinical recommendations for appropriately indicating diagnostic tests for disease phenotypes and their medical treatment, refractory GERD management, endoscopic and surgical treatment indications, the control of GERD in obesity, pregnancy, and older adults, as well as the role of <em>Helicobacter pylori</em> infection and GLP-1 agonists.</div></div><div><h3>Conclusions</h3><div>Determining GERD phenotypes in patients through the appropriate use of diagnostic tests enables personalized treatment to be prescribed. The recommendations established in this document may contribute to improving the quality of care of patients with GERD.</div></div>","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 2","pages":"Pages 288-308"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134346","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}
Pub Date : 2025-04-01DOI: 10.1016/j.rgmx.2024.12.005
J.A. Torres-Díaz, I. García-Juárez
{"title":"¿Debe ser micofenolato de mofetilo el tratamiento de primera línea en la hepatitis autoinmune?","authors":"J.A. Torres-Díaz, I. García-Juárez","doi":"10.1016/j.rgmx.2024.12.005","DOIUrl":"10.1016/j.rgmx.2024.12.005","url":null,"abstract":"","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 2","pages":"Pages 323-325"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134352","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}
Pub Date : 2025-04-01DOI: 10.1016/j.rgmx.2025.01.007
E. Murcio-Pérez, I. Bartnicki-Navarrete, J.C. Pintor-Belmontes, O.M. Solórzano-Pineda, O.V. Hernández-Mondragón
{"title":"Gastroyeyunostomía guiada por ultrasonido endoscópico para manejo de síndrome de pinzamiento de la arteria mesentérica superior: reporte de caso con seguimiento a 18 meses","authors":"E. Murcio-Pérez, I. Bartnicki-Navarrete, J.C. Pintor-Belmontes, O.M. Solórzano-Pineda, O.V. Hernández-Mondragón","doi":"10.1016/j.rgmx.2025.01.007","DOIUrl":"10.1016/j.rgmx.2025.01.007","url":null,"abstract":"","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 2","pages":"Pages 327-329"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134344","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}
Pub Date : 2025-04-01DOI: 10.1016/j.rgmx.2024.09.009
G.R. Medina-Murillo , U. Rodríguez-Medina , U. Rodríguez-Wong
{"title":"Pseudoangiosarcoma de Masson de localización perianal. Una entidad poco común","authors":"G.R. Medina-Murillo , U. Rodríguez-Medina , U. Rodríguez-Wong","doi":"10.1016/j.rgmx.2024.09.009","DOIUrl":"10.1016/j.rgmx.2024.09.009","url":null,"abstract":"","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 2","pages":"Pages 309-310"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134347","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}
Pub Date : 2025-04-01DOI: 10.1016/j.rgmx.2025.01.006
F. Higuera-de-la-Tijera, F. Lajud-Barquín, A. Tovar-Aguilar
{"title":"Respuesta a Hinpetch Daungsupawong et al. respecto a «Cambios de peso y modificaciones de estilo de vida implementados durante el confinamiento por la pandemia COVID-19: Correspondencia»","authors":"F. Higuera-de-la-Tijera, F. Lajud-Barquín, A. Tovar-Aguilar","doi":"10.1016/j.rgmx.2025.01.006","DOIUrl":"10.1016/j.rgmx.2025.01.006","url":null,"abstract":"","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 2","pages":"Pages 339-341"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134355","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}
Pub Date : 2025-04-01DOI: 10.1016/j.rgmx.2024.07.004
L.M. Sanabria-Arévalo , L.C. Domínguez-Torres , J. Kock , J.D. Lotero , J.C. Gómez-Cáceres , E. Tuta-Quintero
Introduction and aim
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.
Methods
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.
Results
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 2 scores (p = 0.266).
Conclusion
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.
{"title":"Comparación de la capacidad predictiva de las escalas Alvarado y AIR en el diagnóstico de apendicitis aguda: un estudio prospectivo","authors":"L.M. Sanabria-Arévalo , L.C. Domínguez-Torres , J. Kock , J.D. Lotero , J.C. Gómez-Cáceres , E. Tuta-Quintero","doi":"10.1016/j.rgmx.2024.07.004","DOIUrl":"10.1016/j.rgmx.2024.07.004","url":null,"abstract":"<div><h3>Introduction and aim</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 2 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":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 2","pages":"Pages 176-181"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134471","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}
Pub Date : 2025-04-01DOI: 10.1016/j.rgmx.2025.02.003
R.A. Jiménez-Castillo , S. Arumugam , J.M. Remes-Troche , T. Venkatesan
Cannabinoid hyperemesis syndrome (CHS) is a chronic disorder characterized by episodes of severe vomiting, alternating with asymptomatic or minimally symptomatic periods. The episodes of emesis tend to be disabling, negatively affecting quality of life. The disorder's main characteristic is that it is associated with previous chronic heavy cannabis use. CHS is similar to cyclic vomiting syndrome (CVS), with the exception that the sustained cessation of cannabis use is expected to resolve the vomiting episodes.
The average time between the onset of acute CHS episodes and diagnosis ranges from three to six years, based on previously published cases. This delay in the diagnosis reflects a lack of awareness of the condition on the part of physicians. Delayed diagnosis of CHS results in frequent emergency room visits and increased healthcare costs, and the lack of effective treatment leads to poor patient outcomes. The diagnosis is challenging, and some authors have diagnosed CHS when patients had cyclic vomiting, in the context of chronic cannabis use, regardless of the duration of use or the potency of the product used.
The aim of this narrative review is to provide a detailed and critical analysis of current knowledge about CHS. The present document focuses on a thorough review of the literature on worldwide cannabis use, the role of the endocannabinoid system in the pathophysiology of CHS, diagnostic criteria, and current management of CHS.
{"title":"Síndrome de hiperémesis cannabinoide: una revisión","authors":"R.A. Jiménez-Castillo , S. Arumugam , J.M. Remes-Troche , T. Venkatesan","doi":"10.1016/j.rgmx.2025.02.003","DOIUrl":"10.1016/j.rgmx.2025.02.003","url":null,"abstract":"<div><div>Cannabinoid hyperemesis syndrome (CHS) is a chronic disorder characterized by episodes of severe vomiting, alternating with asymptomatic or minimally symptomatic periods. The episodes of emesis tend to be disabling, negatively affecting quality of life. The disorder's main characteristic is that it is associated with previous chronic heavy cannabis use. CHS is similar to cyclic vomiting syndrome (CVS), with the exception that the sustained cessation of cannabis use is expected to resolve the vomiting episodes.</div><div>The average time between the onset of acute CHS episodes and diagnosis ranges from three to six years, based on previously published cases. This delay in the diagnosis reflects a lack of awareness of the condition on the part of physicians. Delayed diagnosis of CHS results in frequent emergency room visits and increased healthcare costs, and the lack of effective treatment leads to poor patient outcomes. The diagnosis is challenging, and some authors have diagnosed CHS when patients had cyclic vomiting, in the context of chronic cannabis use, regardless of the duration of use or the potency of the product used.</div><div>The aim of this narrative review is to provide a detailed and critical analysis of current knowledge about CHS. The present document focuses on a thorough review of the literature on worldwide cannabis use, the role of the endocannabinoid system in the pathophysiology of CHS, diagnostic criteria, and current management of CHS.</div></div>","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 2","pages":"Pages 214-226"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134340","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}
Pub Date : 2025-04-01DOI: 10.1016/j.rgmx.2025.02.002
G. Renau , D. Abelló , F. Sabench , J. Doménech , A. Sánchez
Introduction
The Tokyo Guidelines for the severity classification of acute cholecystitis include leukocytosis as a severity classifier, without considering C-reactive protein (CRP). Our aim was to determine which of the 2 variables has a greater predictive capacity for local complications in acute cholecystitis (LCAC).
Material and methods
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 a ROC analysis was carried out.
Results
The multivariate analysis of 145 patients identified the following associations with LCAC: CRP (p < 0.001; OR 11.8), AUC of 0.88 (p= 0.029), and cutoff point of 4 mg/dl (88% sensitivity, 71% specificity); leukocytosis (p = 0.031; OR 5), AUC of 0.81(p = 0.037), and cutoff point of 11.09 × 109/l (78% sensitivity, 70% specificity).
Conclusions
CRP may have a higher predictive capacity for LCAC than leukocytosis.
{"title":"Proteína C reactiva como predictor de colecistitis aguda complicada: Estudio de cohortes","authors":"G. Renau , D. Abelló , F. Sabench , J. Doménech , A. Sánchez","doi":"10.1016/j.rgmx.2025.02.002","DOIUrl":"10.1016/j.rgmx.2025.02.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The Tokyo Guidelines for the severity classification of acute cholecystitis include leukocytosis as a severity classifier, without considering C-reactive protein (CRP). Our aim was to determine which of the 2<!--> <!-->variables has a greater predictive capacity for local complications in acute cholecystitis (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 a 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> <!--><<!--> <!-->0.001; OR 11.8), AUC of 0.88 (<em>p</em> <em>=</em> <!-->0.029), and cutoff point of 4<!--> <!-->mg/dl (88% sensitivity, 71% specificity); leukocytosis (<em>p</em> <!-->=<!--> <!-->0.031; OR 5), AUC of 0.81(<em>p</em> <!-->=<!--> <!-->0.037), and cutoff point of 11.09<!--> <!-->×<!--> <!-->10<sup>9</sup>/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":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 2","pages":"Pages 330-333"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134341","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}
Pub Date : 2025-01-01DOI: 10.1016/j.rgmx.2024.09.001
E.A. Montemayor-Garza , L. Santoyo-Fexas , M.I. Wah-Suárez , L.A. González-Torres , R.A. López-Pérez , S. Ramírez-Peña
{"title":"Hemobezoar causa obstrucción aguda de intestino delgado en un caso de úlcera péptica","authors":"E.A. Montemayor-Garza , L. Santoyo-Fexas , M.I. Wah-Suárez , L.A. González-Torres , R.A. López-Pérez , S. Ramírez-Peña","doi":"10.1016/j.rgmx.2024.09.001","DOIUrl":"10.1016/j.rgmx.2024.09.001","url":null,"abstract":"","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 1","pages":"Pages 151-153"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695983","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}
Pub Date : 2025-01-01DOI: 10.1016/j.rgmx.2024.07.008
J.E. Aquino-Matus , M. Figueroa-Palafox , C. Culebro-García , L.R. Valdovinos-García
{"title":"Síndrome de Wilkie con dilatación gástrica aguda y gas portal hepático","authors":"J.E. Aquino-Matus , M. Figueroa-Palafox , C. Culebro-García , L.R. Valdovinos-García","doi":"10.1016/j.rgmx.2024.07.008","DOIUrl":"10.1016/j.rgmx.2024.07.008","url":null,"abstract":"","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 1","pages":"Pages 131-133"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697034","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}
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