Revista de gastroenterologia de Mexico (English)最新文献

英文中文

Fecal microbiota transplantation through colonoscopy in the treatment of recurrent Clostridioides difficile: Experience at a university center 通过结肠镜进行粪便微生物群移植治疗复发性艰难梭菌：一家大学中心的经验。

Revista de gastroenterologia de Mexico (English)

Pub Date : 2024-10-01 DOI: 10.1016/j.rgmxen.2024.03.004

R. Quera , P. Nuñez , C. von Muhlenbrock , R. Espinoza

Introduction

The majority of cases of Clostridioides difficile infection (CDI) respond to antibiotic treatment. Fecal microbiota transplantation (FMT) has been accepted as an effective treatment in cases of recurrent CDI.

Aim

Our aim was to describe the clinical results of FMT performed for the treatment of recurrent CDI.

Material and methods

The study was conducted on patients with recurrent CDI treated with FMT through colonoscopy, within the time frame of January 2021 and December 2023. Demographic and clinical data were collected, including pre-FMT treatment data, the FMT success rate, and clinical progression during follow-up. Telephone surveys were carried out to evaluate satisfaction.

Results

Thirteen patients with a mean age of 55 years underwent FMT (including 7 patients above 65 years of age and one pregnant woman). Patients presented with a median of 3 previous episodes of CDI (range 2-4). The median time interval from first episode of CDI to FMT was 4 months (range 3-10). The effectiveness of a single FMT session was 100%. During post-FMT follow-up (median of 11 months, range 3-32), 3 patients have presented with a new CDI episode, and a successful second FMT was performed on 2 of them. No adverse events were registered, and all patients had a positive perception of FMT.

Conclusions

In the present study, despite its small size, FMT through colonoscopy was shown to be a safe, effective, and lasting therapy in cases of recurrent CDI, concurring with results from larger studies.

导言：大多数艰难梭菌感染（CDI）病例对抗生素治疗有反应。粪便微生物群移植（FMT）已被认为是治疗复发性 CDI 的有效方法。目的：我们的目的是描述粪便微生物群移植治疗复发性 CDI 的临床效果：研究对象为 2021 年 1 月至 2023 年 12 月期间通过结肠镜接受 FMT 治疗的复发性 CDI 患者。研究收集了人口统计学和临床数据，包括 FMT 治疗前的数据、FMT 成功率以及随访期间的临床进展情况。此外，还进行了电话调查以评估满意度：13名平均年龄为55岁的患者接受了FMT治疗（包括7名65岁以上的患者和1名孕妇）。患者既往感染 CDI 的中位数为 3 次（2-4 次不等）。从首次发作 CDI 到接受 FMT 治疗的中位时间间隔为 4 个月（3-10 个月）。单次 FMT 治疗的有效率为 100%。在 FMT 后的随访期间（中位数为 11 个月，范围为 3-32 个月），3 名患者又出现了新的 CDI 病例，其中 2 人成功接受了第二次 FMT 治疗。没有发生任何不良事件，所有患者都对 FMT 有积极的评价：本研究尽管规模较小，但通过结肠镜对复发性 CDI 病例进行 FMT 是一种安全、有效和持久的疗法，这与大型研究的结果一致。

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引用次数: 0

Response to Hernández-Almonacid and Marín-Quintero concerning their comments on the article: “Metabolic disorders across the body mass index spectrum in a Colombian population with nonalcoholic fatty liver disease” 就 Hernández-Almonacid 和 Marín-Quintero 对文章的评论做出答复："哥伦比亚非酒精性脂肪肝患者的体重指数谱代谢紊乱"。

Revista de gastroenterologia de Mexico (English)

Pub Date : 2024-10-01 DOI: 10.1016/j.rgmxen.2024.08.002

C.E. Builes-Montaño , E. Pérez-Giraldo , S. Castro-Sánchez , N.A. Rojas-Henao , O.M. Santos-Sánchez , J.C. Restrepo-Gutierrez

引用次数: 0

Clinical utility of the solid meal test during high-resolution esophageal manometry. A study in a Latin American population 高分辨率食管测压中固体餐测试的临床实用性。拉丁美洲人群研究。

Revista de gastroenterologia de Mexico (English)

Pub Date : 2024-10-01 DOI: 10.1016/j.rgmxen.2023.05.009

K.R. García-Zermeño , J. Argüero , M. Amieva-Balmori , O. Rodríguez-Aguilera , A. Martínez-Conejo , M. Marcolongo , J.M. Remes-Troche

Introduction and aims

The solid test meal (STM) is a challenge test that is done during esophageal manometry and appears to increase the diagnostic yield of the study. The aim of our analysis was to establish the normal values for STM and evaluate its clinical utility in a group of Latin American patients with esophageal disorders versus healthy controls.

Material and methods

A cross-sectional study was conducted on a group of healthy controls and consecutive patients that underwent high-resolution esophageal manometry, in which STM was done at the final part of the study and consisted of asking the subjects to eat 200 g of precooked rice. The results were compared during the conventional protocol and the STM.

Results

Twenty-five controls and 93 patients were evaluated. The majority of the controls (92%) completed the test in under 8 min. The STM changed the manometric diagnosis in 38% of the cases. The STM diagnosed 21% more major motor disorders than the conventional protocol; it doubled the cases of esophageal spasm and quadrupled the cases of jackhammer esophagus, whereas it demonstrated normal esophageal peristalsis in 43% of the cases with a previous diagnosis of ineffective esophageal motility.

Conclusions

Our study confirms the fact that complementary STM during esophageal manometry adds information and enables a more physiologic assessment of esophageal motor function to be made, compared with liquid swallows, in patients with esophageal motor disorders.

简介和目的：固体试验餐（STM）是在食管测压过程中进行的一项挑战性试验，似乎可以提高研究的诊断率。我们的分析旨在确定 STM 的正常值，并评估其在一组拉丁美洲食管疾病患者和健康对照组中的临床实用性：我们对一组健康对照组和连续接受高分辨率食管测压的患者进行了横断面研究，其中 STM 在研究的最后部分进行，要求受试者吃 200 克事先煮熟的米饭。结果比较了传统方案和 STM 的结果：对 25 名对照组和 93 名患者进行了评估。大多数对照组（92%）在 8 分钟内完成了测试。在 38% 的病例中，STM 改变了测压诊断。与传统方案相比，STM 诊断出的主要运动障碍增加了 21%；食管痉挛病例增加了一倍，"千斤顶食管 "病例增加了四倍，而在之前诊断为食管运动无效的病例中，有 43% 的病例显示食管蠕动正常：我们的研究证实了这样一个事实，即与液体吞咽相比，食管测压过程中的补充性 STM 可以为食管运动障碍患者提供更多信息，对食管运动功能进行更生理学的评估。

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引用次数: 0

Comments on the article «Metabolic disorders across the body mass index spectrum in a Colombian population with nonalcoholic fatty liver disease» 关于 "哥伦比亚非酒精性脂肪肝患者的体重指数谱代谢紊乱 "一文的评论

Revista de gastroenterologia de Mexico (English)

Pub Date : 2024-10-01 DOI: 10.1016/j.rgmxen.2024.08.001

P.G. Hernández-Almonacid , X. Marin-Quintero

引用次数: 0

Gastrointestinal adverse effects of old and new antidiabetics: How do we deal with them in real life? 新旧抗糖尿病药物的胃肠道不良反应：在现实生活中如何应对？

Revista de gastroenterologia de Mexico (English)

Pub Date : 2024-10-01 DOI: 10.1016/j.rgmxen.2024.10.008

J.R. Barrientos-Ávalos , E.C. Morel-Cerda , F.A. Félix-Téllez , B.E. Vidrio-Huerta , A.R. Aceves-Ayala , Á.R. Flores-Rendón , J.A. Velarde-Ruiz Velasco

Diabetes is a public health problem with an estimated worldwide prevalence of 10% and a prevalence of 12% in Mexico. The costs resulting from this chronic-degenerative disease are significant. Treatment for diabetes involves different medication groups, some of which can cause significant gastrointestinal adverse effects, such as dyspepsia, nausea, vomiting, bloating, diarrhea, and constipation. The medications most frequently associated with said adverse effects are metformin, acarbose, and GLP-1 agonists. Gastrointestinal adverse effects negatively impact the quality of life and management of patients with diabetes. The factors of visceral neuropathy, acute dysglycemia, dysbiosis, and intestinal bacterial overgrowth contribute to the gastrointestinal symptoms in patients with diabetes, making it necessary to consider multiple etiologic factors in the presence of gastrointestinal symptoms, and not exclusively attribute them to the use of antidiabetics. Personalized treatment, considering gastrointestinal comorbidity and the type of drug utilized, is essential for mitigating the adverse effects and improving the quality of life in patients with diabetes. The aim of the present narrative review was to describe the gastrointestinal adverse effects of the antidiabetic drugs, their pathophysiologic mechanisms, and the corresponding therapeutic measures.

糖尿病是一个公共卫生问题，估计全球发病率为 10%，墨西哥的发病率为 12%。这种慢性退行性疾病造成的费用非常高昂。糖尿病的治疗涉及不同的药物组别，其中一些药物可引起严重的胃肠道不良反应，如消化不良、恶心、呕吐、腹胀、腹泻和便秘。最常出现上述不良反应的药物是二甲双胍、阿卡波糖和 GLP-1 激动剂。胃肠道不良反应会对糖尿病患者的生活质量和治疗产生负面影响。内脏神经病变、急性血糖异常、菌群失调和肠道细菌过度生长等因素导致糖尿病患者出现胃肠道症状，因此在出现胃肠道症状时有必要考虑多种致病因素，而不能将其完全归咎于抗糖尿病药物的使用。考虑到胃肠道合并症和所用药物类型的个性化治疗对于减轻不良反应和提高糖尿病患者的生活质量至关重要。本综述旨在描述抗糖尿病药物的胃肠道不良反应、其病理生理机制以及相应的治疗措施。

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引用次数: 0

Comparative evaluation of APRI, FIB-4, HFS, and NFS: Scoring tools for liver fibrosis in a Mexican population with MASLD APRI、FIB-4、HFS 和 NFS 的比较评估：墨西哥 MASLD 患者的肝纤维化评分工具。

Revista de gastroenterologia de Mexico (English)

Pub Date : 2024-10-01 DOI: 10.1016/j.rgmxen.2024.09.002

B.A. Priego-Parra , A. Triana-Romero , R. Bernal-Reyes , M.E. Icaza-Chávez , S.E. Martínez-Vázquez , M. Amieva-Balmori , A.D. Cano-Contreras , H. Vivanco-Cid , J.M. Remes-Troche

Introduction and aim

Liver fibrosis is a complication of metabolic dysfunction-associated steatotic liver disease (MASLD). Given the limitations and risks of liver biopsy, examining noninvasive scoring systems that are affordable for the population is necessary. Our aim was to evaluate and compare the diagnostic yield of the APRI, FIB-4, NAFLD score, and Hepamet fibrosis score instruments for detecting liver fibrosis in Mexican subjects with MASLD.

Material and methods

A retrospective study was conducted on a sample of subjects with MASLD. Liver fibrosis was calculated through transient liver elastography. Sociodemographic, epidemiologic, and biochemical variables were evaluated. Scores were calculated utilizing the fibrosis-4 (FIB-4) index, the aspartate aminotransaminase-to-platelet ratio index (APRI), the Hepamet fibrosis score (HFS), and the NAFLD score (NFS), and then compared. ROC curves were constructed, and the optimum cutoff points were determined utilizing the Youden index. Sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio were calculated.

Results

The study included 194 subjects (63% women), of whom 150 (77.3%) were classified with MASLD and 44 (22.7%) as controls with no liver disease. There was a 15.3% prevalence of advanced fibrosis. The cutoff points of 0.57 for APRI, 1.85 for FIB-4, 0.08 for HFS, and −0.058 for NFS showed diagnostic yields with areas under the ROC curves of 0.79, 0.80, 0.70, and 0.68, respectively.

Conclusion

The APRI, FIB-4, NFS, and HFS scores are useful for evaluating liver fibrosis in Mexican subjects with MASLD. Better diagnostic yield was found with the FIB-4 and APRI scores.

简介和目的：肝纤维化是代谢功能障碍相关性脂肪性肝病（MASLD）的并发症之一。鉴于肝脏活组织检查的局限性和风险，有必要研究大众负担得起的无创评分系统。我们的目的是评估和比较 APRI、FIB-4、NAFLD 评分和 Hepamet 纤维化评分工具在检测墨西哥 MASLD 患者肝纤维化方面的诊断率：对MASLD患者样本进行了一项回顾性研究。通过瞬时肝弹性成像计算肝纤维化程度。对社会人口学、流行病学和生化变量进行了评估。利用肝纤维化-4（FIB-4）指数、天冬氨酸转氨酶与血小板比值指数（APRI）、肝纤维化评分（HFS）和非酒精性脂肪肝评分（NFS）计算评分，然后进行比较。构建了 ROC 曲线，并利用尤登指数确定了最佳截断点。计算灵敏度、特异性、阳性预测值、阴性预测值和似然比：研究包括 194 名受试者（63% 为女性），其中 150 人（77.3%）被归类为 MASLD，44 人（22.7%）为无肝病的对照组。晚期肝纤维化发生率为 15.3%。APRI的临界点为0.57，FIB-4的临界点为1.85，HFS的临界点为0.08，NFS的临界点为-0.058，这些临界点的ROC曲线下面积分别为0.79、0.80、0.70和0.68：APRI、FIB-4、NFS 和 HFS 评分有助于评估墨西哥 MASLD 患者的肝纤维化情况。FIB-4和APRI评分的诊断率更高。

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引用次数: 0

Response to the editorial commentary by Crisostomo-Estrada JK, et al. on the article “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” 对 Crisostomo-Estrada JK 等人就 "美国消化内镜学会预测标准在墨西哥新莱昂州一家二级公立医院诊断胆总管结石中的应用 "一文发表的社论评论的回应。

Revista de gastroenterologia de Mexico (English)

Pub Date : 2024-10-01 DOI: 10.1016/j.rgmxen.2024.06.004

C. Ovalle-Chao

引用次数: 0

Lymphangioma of the pancreas diagnosed through endoscopic ultrasound-guided fine-needle aspiration biopsy: A case report 通过内镜超声引导下细针穿刺活检确诊的胰腺淋巴管瘤：病例报告。

Revista de gastroenterologia de Mexico (English)

Pub Date : 2024-10-01 DOI: 10.1016/j.rgmxen.2024.05.004

J.M. Jiménez-Gutiérrez , J.O. Alonso-Lárraga , L.F. Villegas-González , A.Y. Ortega-Caballero

引用次数: 0

Cricopharyngeal achalasia: A rare cause of dysphagia in infancy 环咽贲门失弛缓症：婴儿期吞咽困难的罕见病因。

Revista de gastroenterologia de Mexico (English)

Pub Date : 2024-10-01 DOI: 10.1016/j.rgmxen.2024.10.006

C.A. Cuadros-Mendoza, K. Lozano-Agudelo, M.C. Gómez-Franco, L.V. Parra Izquierdo

引用次数: 0

Neurofibromatosis type 1-associated gastrointestinal stromal tumor of the stomach 神经纤维瘤病 1 型相关胃肠道间质瘤。

Revista de gastroenterologia de Mexico (English)

Pub Date : 2024-10-01 DOI: 10.1016/j.rgmxen.2024.10.003

M. Cernat , L. Antoci , I. Mishin

引用次数: 0

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全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

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Revista de gastroenterologia de Mexico (English)

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