Revista de gastroenterologia de Mexico (English)最新文献

Introduction: Patients with metabolic dysfunction-associated steatotic liver disease (MASLD) have a higher incidence of periodontal disease. Both conditions are related to the oral and gut microbiota dysbiosis that conditions systemic inflammation. In our population, the frequency and importance of that association have not been documented.

Aim: To determine the prevalence of periodontal disease in patients with MASLD treated at a referral center in Veracruz.

Material and methods: A prospective, comparative, analytic, cross-sectional study was conducted on patients with MASLD and a group of healthy controls. Anthropometric characteristics, liver steatosis grade, dental involvement, and quality of life were analyzed. The statistical analysis included measures of central tendency and dispersion, as well as frequency and percentage. The two groups were compared using the Student's t test or Wilcoxon test, the chi-square test, and the Pearson or Spearman correlations, employing the SPSS-5 program.

Results: Thirty-seven patients with MASLD were studied. Mean patient age was 56.3 ± 12.3 years, 70.3% were women, and mean BMI was 34.2 ± 5.9. A total of 18.9% of patients presented with gingivitis and 81.1% with periodontitis (p < 0.0001), compared with the controls (mean age 54.6 ± 9.8 years, 65.5% women, BMI 28.7 ± 5.7), in which 13.8% had gingivitis and 37.9% periodontitis. Steatosis grade and periodontal disease were significantly correlated (r = 0.412, p = 0.003), with no differences in food quality (r = -0.037, p = 0.798); 36.9% of patients reported a decrease in quality of life.

Conclusions: Our results showed an elevated prevalence of periodontal disease in patients with MASLD that negatively impacted quality of life, suggesting the need for comprehensive management.

Introduction and aim: Ventral mesh rectopexy (VMR) for correcting rectal prolapse, rectocele, and enterocele improves obstructed defecation syndrome (ODS) and fecal incontinence (FI). This procedure is popular due to its minimally invasive approach and favorable clinical outcomes. Our aim was to evaluate the clinical response of patients that underwent VMR, focusing on changes in the ODS and FI scores.

Material and methods: A retrospective, observational, cohort study was conducted on patients that underwent VMR within the time frame of May 2019 and May 2024 at a high-volume hospital. Fifty case records were analyzed, measuring the changes in the scores of the ODS scale and CCF-FIS, before and after surgery. Statistical significance was set at a p < 0.05.

Results: The ODS scores decreased from 10.76 to 6.28 and the FI scores from 9 to 5, showing significant improvement. When analyzing individual items of each of the scales separately, all in the ODS scale were statistically significant, whereas in the FI scale, only pad use and impact on social life were significant. There were no major intraoperative complications or conversions to open surgery and the mean hospital stay was1.96 days. No significant differences in outcomes were found between the conventional and robotic laparoscopic approaches.

Conclusions: VMR is a safe and effective procedure for improving ODS and FI symptoms in the Mexican population. Long-term follow-up is required to confirm the persistence of benefits and evaluate late complications.

Introduction and aims: Anastomotic leakage is a critical complication in colorectal surgery, significantly associated with postoperative morbidity and mortality. Early detection of at-risk patients is essential for optimizing clinical outcomes. The present study investigates the utility of C-reactive protein (CRP) as a predictive inflammatory biomarker for anastomotic leakage.

Materials and methods: A retrospective observational study was conducted at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, analyzing 95 patients who underwent colorectal surgery within the time frame of March 2023 and July 2024. CRP levels were measured on postoperative days 1, 3, and 5. The predictive capacity was measured through ROC curves, determining the optimum cutoff points with the Youden index.

Results: CRP on day 3 showed an AUC of 0.91, with an optimum cutoff point of 18.69 mg/l (Youden index = 0.73). On day 5, the AUC was 0.93, with a cutoff point of 14.25 mg/l (Youden index = 0.73). Both measurements showed high sensitivity and specificity for predicting anastomotic leakage.

Conclusion: Elevated CRP levels on postoperative days 3 and 5 emerged as robust predictors of anastomotic leakage, potentially guiding early interventions and improving patient prognosis.

Helicobacter pylori (H. pylori) infection remains highly prevalent in Mexico and worldwide. In response to the advances in diagnosis, treatment, and epidemiologic surveillance, the Asociación Mexicana de Gastroenterología, through a multidisciplinary panel of experts, developed the "Fifth Mexican Consensus on H. pylori" in 2025, providing 38 evidence-based recommendations tailored to the Mexican context. The document highlights the establishment of the Hp-MexReg national registry and its collaboration with Hp-LatamReg and HpRESLA projects, enabling the collection of local data on eradication rates and antimicrobial resistance. The expert group reaffirms the high prevalence of H. pylori in Mexico (70.5%) related to social and sanitation factors, as well as the increase of antibiotic-resistant strains, particularly to clarithromycin and levofloxacin. Regarding diagnosis, the 13C-urea breath test is prioritized as the first-line noninvasive method and eradication of the bacterium should be confirmed at least four weeks after treatment. Regarding treatment, quadruple therapies, with or without bismuth, are recommended over standard triple therapy, and potassium-competitive acid blockers are endorsed as an effective alternative to high-dose proton pump inhibitors. H. pylori eradication is strongly recommended, with emphasis on the clinical scenarios in which it is indicated. The present consensus underscores the need to continue conducting national studies that enable strategies to be adapted to Mexico's epidemiologic reality.