Revista de gastroenterologia de Mexico (English)最新文献_第8页

Upper gastrointestinal bleeding in a patient with Kawasaki disease: A case report and literature review 川崎病患者上消化道出血1例报告并文献复习。

Revista de gastroenterologia de Mexico (English)

Pub Date : 2025-07-01 DOI: 10.1016/j.rgmxen.2025.09.013

C.A. González-Heredia , A.Y. Martínez-Vázquez , J.A. Galindo-Martínez

引用次数: 0

Gastroenteropancreatic neuroendocrine tumors: A retrospective study conducted in the Colombian Southwest 胃肠胰神经内分泌肿瘤：一项在哥伦比亚西南部进行的回顾性研究。

Revista de gastroenterologia de Mexico (English)

Pub Date : 2025-07-01 DOI: 10.1016/j.rgmxen.2025.09.009

J.C. Bravo-Ocaña , N. López-Moreno , E.D. Salazar-Cardona , A.F. Mejía-Hurtado , V. Gutiérrez-Aragón , M. Gonzáles-Hurtado , L.A. Satizabal-Mayor , J.F. Lbasseauny-Morales , N. Rojas-Rojas , C.A. Rojas-Rodríguez

Introduction and aim

Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are rare neoplasms originating in neuroendocrine cells from the gastric mucosa and submucosa, small intestine, large intestine, rectum, and pancreas. Our aim was to describe their histopathologic, endoscopic, and clinical characteristics and the experience with these tumors at a tertiary care hospital center in the Colombian Southwest.

Materials and methods

A retrospective, analytic, observational, and descriptive study included 93 patients diagnosed with GEP-NETs, within the time frame of 2018 and 2022. Their clinical histories were reviewed to collect the sociodemographic, clinical, endoscopic, pathologic, treatment, follow-up, and survival data.

Results

Median patient age was 55.8 years, and 60.2% were women. A total of 78.5% of the patients presented with symptoms, the most common of which was abdominal pain (78.1%). The tumors were mainly located in the stomach (32.3%) and small intestine (23.7%). Histopathologically, 53.8% of the tumors were grade1, 30.1% were grade 2, 9.68% were grade 3, and 7.52% were carcinomas. Tumor location was significantly related to stage; the majority of tumors in stage I were in the stomach, whereas the stage IV tumors were in the small intestine. At the last evaluation, 40.9% of the patients were disease-free, disease was stable in 24.7% and progressive in 11.8%, and 18.3% of the patients died.

Conclusions

GEP-NETs are clinically heterogeneous, and their early diagnosis is dependent on the recognition of lesions in endoscopic and imaging studies. Early tumors are mainly located in the stomach and advanced tumors in the small intestine, with metastases in the liver and regional lymph nodes. The present study suggests the importance of disease awareness in the early detection of GEP-NETs; said factor, combined with timely interdisciplinary management, could significantly impact patient outcomes.

胃肠胰神经内分泌肿瘤（gastroenteroppancreatic neuroendocrine tumors, GEP-NETs）是一种罕见的肿瘤，起源于胃粘膜及粘膜下层、小肠、大肠、直肠和胰腺的神经内分泌细胞。我们的目的是描述他们的组织病理学、内窥镜和临床特征，以及在哥伦比亚西南部三级护理医院中心治疗这些肿瘤的经验。材料和方法：一项回顾性、分析性、观察性和描述性研究纳入了2018年至2022年期间诊断为GEP-NETs的93例患者。我们回顾了他们的临床病史，收集了社会人口学、临床、内镜、病理、治疗、随访和生存数据。结果：患者中位年龄为55.8岁，60.2%为女性。共有78.5%的患者出现症状，最常见的是腹痛（78.1%）。肿瘤主要位于胃（32.3%）和小肠（23.7%）。组织学上，53.8%的肿瘤为1级，30.1%为2级，9.68%为3级，7.52%为癌。肿瘤位置与分期显著相关；I期肿瘤多发生在胃，而IV期肿瘤多发生在小肠。末次评估时，40.9%的患者无病，24.7%的患者病情稳定，11.8%的患者病情进展，18.3%的患者死亡。结论：GEP-NETs在临床上具有异质性，其早期诊断依赖于内镜和影像学检查对病变的识别。早期肿瘤以胃为主，晚期肿瘤以小肠为主，可转移至肝脏和局部淋巴结。本研究提示疾病意识在早期发现全球环境-网络中的重要性；上述因素，结合及时的跨学科管理，可以显著影响患者的预后。

{"title":"Gastroenteropancreatic neuroendocrine tumors: A retrospective study conducted in the Colombian Southwest","authors":"J.C. Bravo-Ocaña , N. López-Moreno , E.D. Salazar-Cardona , A.F. Mejía-Hurtado , V. Gutiérrez-Aragón , M. Gonzáles-Hurtado , L.A. Satizabal-Mayor , J.F. Lbasseauny-Morales , N. Rojas-Rojas , C.A. Rojas-Rodríguez","doi":"10.1016/j.rgmxen.2025.09.009","DOIUrl":"10.1016/j.rgmxen.2025.09.009","url":null,"abstract":"<div><h3>Introduction and aim</h3><div>Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are rare neoplasms originating in neuroendocrine cells from the gastric mucosa and submucosa, small intestine, large intestine, rectum, and pancreas. Our aim was to describe their histopathologic, endoscopic, and clinical characteristics and the experience with these tumors at a tertiary care hospital center in the Colombian Southwest.</div></div><div><h3>Materials and methods</h3><div>A retrospective, analytic, observational, and descriptive study included 93 patients diagnosed with GEP-NETs, within the time frame of 2018 and 2022. Their clinical histories were reviewed to collect the sociodemographic, clinical, endoscopic, pathologic, treatment, follow-up, and survival data.</div></div><div><h3>Results</h3><div>Median patient age was 55.8 years, and 60.2% were women. A total of 78.5% of the patients presented with symptoms, the most common of which was abdominal pain (78.1%). The tumors were mainly located in the stomach (32.3%) and small intestine (23.7%). Histopathologically, 53.8% of the tumors were grade1, 30.1% were grade 2, 9.68% were grade 3, and 7.52% were carcinomas. Tumor location was significantly related to stage; the majority of tumors in stage I were in the stomach, whereas the stage IV tumors were in the small intestine. At the last evaluation, 40.9% of the patients were disease-free, disease was stable in 24.7% and progressive in 11.8%, and 18.3% of the patients died.</div></div><div><h3>Conclusions</h3><div>GEP-NETs are clinically heterogeneous, and their early diagnosis is dependent on the recognition of lesions in endoscopic and imaging studies. Early tumors are mainly located in the stomach and advanced tumors in the small intestine, with metastases in the liver and regional lymph nodes. The present study suggests the importance of disease awareness in the early detection of GEP-NETs; said factor, combined with timely interdisciplinary management, could significantly impact patient outcomes.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 3","pages":"Pages 357-365"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034852","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}

引用次数: 0

Descriptive study on the use of colonoscopy as a screening method for colorectal cancer 结肠镜检查作为结直肠癌筛查方法的描述性研究。

Revista de gastroenterologia de Mexico (English)

Pub Date : 2025-07-01 DOI: 10.1016/j.rgmxen.2024.11.008

F.E. Jabif, P.N. Cherne, C. Pintos, J.A. Pollán, A. Murujosa

Introduction and aims

The aim of this study was to estimate the number of patients diagnosed with colorectal cancer (CRC) that underwent their first screening colonoscopy and to describe the endoscopic and anatomopathologic findings and characteristics of the patients that had a screening colonoscopy for CRC.

Materials and methods

A cross-sectional study was conducted that included patients aged 50 to 79 years, with prepaid healthcare at a tertiary care hospital, that underwent a first colonoscopy within the time frame of 2013 and 2022. The demographic data, endoscopic findings, and biopsy results were collected. Patients with a history of previous colonoscopy or a previous CRC diagnosis were excluded. Descriptive statistics were utilized for the data analysis.

Results

Of 28,286 colonoscopies performed, 19,222 (68%) were for CRC screening. Mean patient age was 61 years, with a predominance of women (59.5%). The prevalence of CRC diagnosis was 0.6% and the most common findings were polyps (36.7%) and diverticula (35.5%). A total of 118 cases of CRC were diagnosed, as a result of the first colonoscopy. The post-colonoscopy hospitalization rate was 1.14%.

Conclusions

This study provides relevant information on the characteristics of the population undergoing CRC screening at our center. Our data contribute to having a better understanding of the profile of patients that access screening and provides a solid descriptive base through which clinical practices, diagnostic method quality, and screening program results can be evaluated.

简介和目的：本研究的目的是估计首次进行结肠镜筛查的结直肠癌（CRC）患者的数量，并描述结肠镜筛查CRC患者的内窥镜和解剖病理学结果和特征。材料和方法：进行了一项横断面研究，包括年龄在50至79岁之间，在三级保健医院预付费医疗的患者，这些患者在2013年至2022年期间接受了第一次结肠镜检查。收集了人口统计学数据、内窥镜检查结果和活检结果。既往有结肠镜检查史或既往结直肠癌诊断的患者被排除在外。采用描述性统计进行数据分析。结果：在28,286例结肠镜检查中，19,222例（68%）为CRC筛查。患者平均年龄61岁，以女性为主（59.5%）。CRC诊出率为0.6%，最常见的表现为息肉（36.7%）和憩室（35.5%）。第一次结肠镜检查共诊断出118例结直肠癌。结肠镜检查后住院率为1.14%。结论：本研究提供了本中心接受结直肠癌筛查人群特征的相关信息。我们的数据有助于更好地了解接受筛查的患者的概况，并为临床实践、诊断方法质量和筛查项目结果的评估提供了坚实的描述性基础。

{"title":"Descriptive study on the use of colonoscopy as a screening method for colorectal cancer","authors":"F.E. Jabif, P.N. Cherne, C. Pintos, J.A. Pollán, A. Murujosa","doi":"10.1016/j.rgmxen.2024.11.008","DOIUrl":"10.1016/j.rgmxen.2024.11.008","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>The aim of this study was to estimate the number of patients diagnosed with colorectal cancer (CRC) that underwent their first screening colonoscopy and to describe the endoscopic and anatomopathologic findings and characteristics of the patients that had a screening colonoscopy for CRC.</div></div><div><h3>Materials and methods</h3><div>A cross-sectional study was conducted that included patients aged 50 to 79 years, with prepaid healthcare at a tertiary care hospital, that underwent a first colonoscopy within the time frame of 2013 and 2022. The demographic data, endoscopic findings, and biopsy results were collected. Patients with a history of previous colonoscopy or a previous CRC diagnosis were excluded. Descriptive statistics were utilized for the data analysis.</div></div><div><h3>Results</h3><div>Of 28,286 colonoscopies performed, 19,222 (68%) were for CRC screening. Mean patient age was 61 years, with a predominance of women (59.5%). The prevalence of CRC diagnosis was 0.6% and the most common findings were polyps (36.7%) and diverticula (35.5%). A total of 118 cases of CRC were diagnosed, as a result of the first colonoscopy. The post-colonoscopy hospitalization rate was 1.14%.</div></div><div><h3>Conclusions</h3><div>This study provides relevant information on the characteristics of the population undergoing CRC screening at our center. Our data contribute to having a better understanding of the profile of patients that access screening and provides a solid descriptive base through which clinical practices, diagnostic method quality, and screening program results can be evaluated.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 3","pages":"Pages 366-372"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034861","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}

引用次数: 0

Consensus on the diagnosis, treatment, and follow-up in children and adolescents with overweight and obesity of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) 拉丁美洲儿科胃肠病学、肝病学和营养学会（LASPGHAN）关于超重和肥胖儿童和青少年的诊断、治疗和随访的共识。

Revista de gastroenterologia de Mexico (English)

Pub Date : 2025-07-01 DOI: 10.1016/j.rgmxen.2025.09.006

Y. Rivera-Suazo , J. Alberto-Meléndez , J.E. Alfaro-Bolaños , F.J. Álvarez-Chávez , A.G. Ayala-Germán , M.J. Galaviz-Ballesteros , M. Higuera-Carillo , C.L. Taquez-Castro , A.L. Villa-Gómez , B.N. Villaroel-Ibarra , B.A. Alvarado-Cárcamo , F.A. Reynoso-Zarzosa , Y.B. Quiñones-Pacheco , C.M. Timossi-Baldi , R. Vázquez-Frias

Introduction and aims

Childhood obesity is a pandemic with significant morbidity and mortality implications, impacting both quality of life and the economic burden on healthcare systems. Given the effects on health for the pediatric population, and aligned with the multidisciplinary management approach, the Obesity Working Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) summoned a group of healthcare professionals to develop a consensus on overweight and obesity. The aim of this document is to present those consensus results.

Material and methods

The LASPGHAN Obesity Working Group organized 6 working panels to formulate statements on diagnostic approach, treatment, and follow-up. We conducted a comprehensive review of the current literature across several databases utilizing different search criteria. Thirty-four panelists from the countries that make up the LASPGHAN were selected. They participated in an anonymous online voting process using the Delphi method. A priori consensus for each statement was defined as 80% agreement on a 3-point Likert scale.

Results

Twenty-six statements were discussed and voted upon, resulting in the final approval of 22 statements.

Conclusions

There is a lack of uniformity in diagnosing overweight and obesity in Latin America, especially in the choice of growth charts and cutoff points for the pediatric population.

前言和目的：儿童肥胖是一种具有显著发病率和死亡率的流行病，影响生活质量和卫生保健系统的经济负担。考虑到对儿童健康的影响，并与多学科管理方法相一致，拉丁美洲儿科胃肠病学、肝病学和营养学学会（LASPGHAN）肥胖工作组召集了一组卫生保健专业人员，就超重和肥胖问题达成共识。本文件的目的是介绍这些协商一致的结果。材料和方法：LASPGHAN肥胖工作组组织了6个工作小组，就诊断方法、治疗和随访制定声明。我们利用不同的检索标准对多个数据库的当前文献进行了全面的综述。来自组成LASPGHAN的国家的34名小组成员被选中。他们使用德尔菲法参与了一个匿名的在线投票过程。每个陈述的先验共识被定义为在3点李克特量表上80%的一致性。结果：对26项提案进行讨论和表决，最终通过22项提案。结论：拉丁美洲在超重和肥胖诊断方面缺乏一致性，特别是在儿科人口生长图和截止点的选择上。

{"title":"Consensus on the diagnosis, treatment, and follow-up in children and adolescents with overweight and obesity of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN)","authors":"Y. Rivera-Suazo , J. Alberto-Meléndez , J.E. Alfaro-Bolaños , F.J. Álvarez-Chávez , A.G. Ayala-Germán , M.J. Galaviz-Ballesteros , M. Higuera-Carillo , C.L. Taquez-Castro , A.L. Villa-Gómez , B.N. Villaroel-Ibarra , B.A. Alvarado-Cárcamo , F.A. Reynoso-Zarzosa , Y.B. Quiñones-Pacheco , C.M. Timossi-Baldi , R. Vázquez-Frias","doi":"10.1016/j.rgmxen.2025.09.006","DOIUrl":"10.1016/j.rgmxen.2025.09.006","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>Childhood obesity is a pandemic with significant morbidity and mortality implications, impacting both quality of life and the economic burden on healthcare systems. Given the effects on health for the pediatric population, and aligned with the multidisciplinary management approach, the Obesity Working Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) summoned a group of healthcare professionals to develop a consensus on overweight and obesity. The aim of this document is to present those consensus results.</div></div><div><h3>Material and methods</h3><div>The LASPGHAN Obesity Working Group organized 6 working panels to formulate statements on diagnostic approach, treatment, and follow-up. We conducted a comprehensive review of the current literature across several databases utilizing different search criteria. Thirty-four panelists from the countries that make up the LASPGHAN were selected. They participated in an anonymous online voting process using the Delphi method. <em>A priori</em> consensus for each statement was defined as 80% agreement on a 3-point Likert scale.</div></div><div><h3>Results</h3><div>Twenty-six statements were discussed and voted upon, resulting in the final approval of 22 statements.</div></div><div><h3>Conclusions</h3><div>There is a lack of uniformity in diagnosing overweight and obesity in Latin America, especially in the choice of growth charts and cutoff points for the pediatric population.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 3","pages":"Pages 428-450"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058791","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}

引用次数: 0

Response to the comments on the article “Good clinical practice recommendations for proton pump inhibitor prescription and deprescription. A review by experts from the AMG” 对《质子泵抑制剂处方和去处方的良好临床实践建议》一文中评论的回应。AMG专家的评论”。

Revista de gastroenterologia de Mexico (English)

Pub Date : 2025-07-01 DOI: 10.1016/j.rgmxen.2025.09.021

L.R. Valdovinos-García

引用次数: 0

Clinical practice recommendations on the use of neuromodulators in gastroenterology: AMG (Asociación Mexicana de Gastroenterología) - AMNM (Asociación Mexicana de Neurogastroenterología y Motilidad) expert joint review 关于在胃肠病学中使用神经调节剂的临床实践建议：AMG (Asociacion Mexicana de Gastroenterologia) - AMNM （Asociacion Mexicana de Neurogastroenterologia y Motilidad）专家联合综述。

Revista de gastroenterologia de Mexico (English)

Pub Date : 2025-04-01 DOI: 10.1016/j.rgmxen.2024.12.001

O. Gómez-Escudero , J.M. Remes-Troche , E. Coss-Adame , K.R. García-Zermeño , J. Aquino-Matus , J. Jiménez-Pavón , L.R. Valdovinos-García , M.A. Vargas-Martínez , M. Amieva-Balmori , J.S. Arenas-Martínez , F.A. Félix-Téllez , P.C. Gómez-Castaños , M. Mejía-Rivas , M.A. Valdovinos-Díaz , G. Vázquez-Elizondo , A.S. Villar-Chávez , C.P. Gyawali

Disorders of gut-brain interaction (DGBI) are characterized by alterations in both central and peripheral gut-brain axis (GBA)-related stimuli, and include esophageal, gastroduodenal, intestinal and anorectal disorders. Despite the fact that several pathophysiologic mechanisms are involved, the mainstay of treatment is neuromodulators, a heterogeneous group of drugs that act on pathways related to central and peripheral pain processing. This expert review by both the AMG (Asociación Mexicana de Gastroenterología) and AMNM (Asociación Mexicana de Neurogastroenterología y Motilidad) summarizes a series of updated clinical recommendations based on an exhaustive review of the literature, regarding the use of neuromodulators for DGBI, and is grouped into six sections: pharmacologic principles, definition, classification, mechanism of action, indications and use in each DGBI subtype, up/downscaling strategies, combination therapy, adverse events, joint use along with psychiatry in the case of comorbidities, and non-pharmacologic neuromodulation. Furthermore, drug selection process tips and dose personalization according to individual groups and sensitivities are provided, and special cases with DGBI-psychiatric comorbidity, as well as overlap with another DGBI, are considered.

肠-脑相互作用紊乱（DGBI）的特征是中央和外周肠-脑轴（GBA）相关刺激的改变，包括食管、胃十二指肠、肠道和肛肠疾病。尽管涉及多种病理生理机制，但主要的治疗方法是神经调节剂，这是一组不同的药物，作用于与中枢和外周疼痛处理相关的途径。AMG （Asociación Mexicana de Gastroenterología）和AMNM （Asociación Mexicana de Neurogastroenterología y Motilidad）的专家综述总结了一系列最新的临床建议，这些建议基于对文献的详尽回顾，涉及神经调节剂在DGBI中的使用，并分为六个部分：药理学原理、定义、分类、作用机制、适应症和每种DGBI亚型的使用、上升/下降策略、联合治疗、不良事件、在合并症的情况下与精神病学联合使用，以及非药物神经调节。此外，根据个体群体和敏感性提供药物选择过程提示和剂量个性化，并考虑DGBI-精神合并症的特殊情况，以及与另一DGBI重叠的情况。

{"title":"Clinical practice recommendations on the use of neuromodulators in gastroenterology: AMG (Asociación Mexicana de Gastroenterología) - AMNM (Asociación Mexicana de Neurogastroenterología y Motilidad) expert joint review","authors":"O. Gómez-Escudero , J.M. Remes-Troche , E. Coss-Adame , K.R. García-Zermeño , J. Aquino-Matus , J. Jiménez-Pavón , L.R. Valdovinos-García , M.A. Vargas-Martínez , M. Amieva-Balmori , J.S. Arenas-Martínez , F.A. Félix-Téllez , P.C. Gómez-Castaños , M. Mejía-Rivas , M.A. Valdovinos-Díaz , G. Vázquez-Elizondo , A.S. Villar-Chávez , C.P. Gyawali","doi":"10.1016/j.rgmxen.2024.12.001","DOIUrl":"10.1016/j.rgmxen.2024.12.001","url":null,"abstract":"<div><div>Disorders of gut-brain interaction (DGBI) are characterized by alterations in both central and peripheral gut-brain axis (GBA)-related stimuli, and include esophageal, gastroduodenal, intestinal and anorectal disorders. Despite the fact that several pathophysiologic mechanisms are involved, the mainstay of treatment is neuromodulators, a heterogeneous group of drugs that act on pathways related to central and peripheral pain processing. This expert review by both the AMG (Asociación Mexicana de Gastroenterología) and AMNM (Asociación Mexicana de Neurogastroenterología y Motilidad) summarizes a series of updated clinical recommendations based on an exhaustive review of the literature, regarding the use of neuromodulators for DGBI, and is grouped into six sections: pharmacologic principles, definition, classification, mechanism of action, indications and use in each DGBI subtype, up/downscaling strategies, combination therapy, adverse events, joint use along with psychiatry in the case of comorbidities, and non-pharmacologic neuromodulation. Furthermore, drug selection process tips and dose personalization according to individual groups and sensitivities are provided, and special cases with DGBI-psychiatric comorbidity, as well as overlap with another DGBI, are considered.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 252-287"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082695","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}

引用次数: 0

Effect of quarterly meeting and email report of ADR, cecal intubation rate, and withdrawal time on personal and group quality measures in colonoscopy 不良反应季度会议及邮件报告、盲肠插管率及停药时间对结肠镜个人及团体质量措施的影响。

Revista de gastroenterologia de Mexico (English)

Pub Date : 2025-04-01 DOI: 10.1016/j.rgmxen.2024.11.004

F.I. Téllez-Ávila , B. Bailey , S. Dehmel , M. Deneke , K. Rude , S. Inamdar , M. García

Introduction

Colonoscopy is the most utilized screening test for colorectal cancer (CRC). The adenoma detection rate (ADR), cecal intubation rate (CIR), and withdrawal time (WT) are established quality indicators (QIs) for colonoscopy. The aim was to measure the effect of individual and group QIs in colonoscopy by providing quarterly meetings and email feedback on ADR, CIR, and WT.

Material and methods

This is a prospective study in 2 steps. In the initial phase, we aimed to collect the QIs in colonoscopy from our division and in the second step, we aimed to assess the impact of a quarterly report. Pre-Intervention: Using electronic medical records (EMRs), an automated method for calculating the ADR was devised. ADRs from 6 months were obtained. Periodic Feedback: Endoscopists received quarterly feedback during staff meetings and emails for 9 months. Post-Intervention: QIs were recalculated for 8 months, and physicians did not receive reports.

Results

Over 23 months, 1,137 screening colonoscopies were conducted. Seven gastroenterologists participated, distributed into high (n = 6) and low (n = 1) detector groups. The mean patient age was 58.6 ± 9.2 years, with 659 (57.9%) females. Moderate sedation was used in 892 (78.4%) cases. QIs did not show significant improvement during the feedback or post-intervention periods compared with the pre-intervention period. Endoscopists initially categorized as «low detectors» exhibited the most substantial improvement, with the ADR increasing from 23.5% to 61.5% (P < .001).

Conclusion

Quarterly feedback and email reports did not significantly improve colonoscopy quality measures. Regarding the ADR, the intervention’s impact was most prominent in «low detectors».

结肠镜检查是结直肠癌（CRC）最常用的筛查方法。腺瘤检出率（ADR）、盲肠插管率（CIR）和停药时间（WT）是结肠镜检查的既定质量指标（QIs）。目的是通过提供季度会议和关于ADR、CIR和wt的电子邮件反馈来衡量个人和群体QIs在结肠镜检查中的作用。材料和方法：这是一项两步前瞻性研究。在初始阶段，我们的目标是从我们的部门收集结肠镜检查的QIs，在第二步，我们的目标是评估季度报告的影响。干预前：利用电子病历（EMRs），设计了一种自动计算ADR的方法。获得6个月的adr。定期反馈：内镜医师每季度通过员工会议和电子邮件收到反馈，为期9个月。干预后：重新计算QIs 8个月，医生未收到报告。结果：在23个月的时间里，进行了1137次结肠镜筛查。7名胃肠病学家参与，分为高检出率组（n = 6）和低检出率组（n = 1）。患者平均年龄58.6 ± 9.2岁，女性659例（57.9%）。892例（78.4%）患者使用中度镇静。与干预前相比，在反馈期间或干预后，QIs没有显示出显著的改善。最初被归类为“低检出率”的内窥镜医师表现出最显著的改善，ADR从23.5%增加到61.5% （P ）结论：季度反馈和电子邮件报告并没有显著改善结肠镜检查质量措施。关于ADR，干预的影响在“低检测器”中最为突出。

{"title":"Effect of quarterly meeting and email report of ADR, cecal intubation rate, and withdrawal time on personal and group quality measures in colonoscopy","authors":"F.I. Téllez-Ávila , B. Bailey , S. Dehmel , M. Deneke , K. Rude , S. Inamdar , M. García","doi":"10.1016/j.rgmxen.2024.11.004","DOIUrl":"10.1016/j.rgmxen.2024.11.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Colonoscopy is the most utilized screening test for colorectal cancer (CRC). The adenoma detection rate (ADR), cecal intubation rate (CIR), and withdrawal time (WT) are established quality indicators (QIs) for colonoscopy. The aim was to measure the effect of individual and group QIs in colonoscopy by providing quarterly meetings and email feedback on ADR, CIR, and WT.</div></div><div><h3>Material and methods</h3><div>This is a prospective study in 2 steps. In the initial phase, we aimed to collect the QIs in colonoscopy from our division and in the second step, we aimed to assess the impact of a quarterly report. <em>Pre-Intervention:</em> Using electronic medical records (EMRs), an automated method for calculating the ADR was devised. ADRs from 6 months were obtained. <em>Periodic Feedback:</em> Endoscopists received quarterly feedback during staff meetings and emails for 9 months. <em>Post-Intervention:</em> QIs were recalculated for 8 months, and physicians did not receive reports.</div></div><div><h3>Results</h3><div>Over 23 months, 1,137 screening colonoscopies were conducted. Seven gastroenterologists participated, distributed into high (n = 6) and low (n = 1) detector groups. The mean patient age was 58.6 ± 9.2 years, with 659 (57.9%) females. Moderate sedation was used in 892 (78.4%) cases. QIs did not show significant improvement during the feedback or post-intervention periods compared with the pre-intervention period. Endoscopists initially categorized as «low detectors» exhibited the most substantial improvement, with the ADR increasing from 23.5% to 61.5% (<em>P</em> < .001).</div></div><div><h3>Conclusion</h3><div>Quarterly feedback and email reports did not significantly improve colonoscopy quality measures. Regarding the ADR, the intervention’s impact was most prominent in «low detectors».</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 207-213"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227810","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}

引用次数: 0

C-reactive protein as a predictor of complicated acute cholecystitis: A cohort study c反应蛋白作为复杂急性胆囊炎的预测因子：一项队列研究。

Revista de gastroenterologia de Mexico (English)

Pub Date : 2025-04-01 DOI: 10.1016/j.rgmxen.2025.02.004

G. Renau , D. Abelló , F. Sabench , J. Doménech , A. Sánchez

Introduction

The Tokyo Guidelines for the severity classification of acute cholecystitis (AC) include leukocytosis as a severity classifier, without considering C-reactive protein (CRP). Our aim was to determine which of the two variables has a greater predictive capacity for local complications in AC (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 an 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 x 10⁹/l (78% sensitivity, 70% specificity).

Conclusions

CRP may have a higher predictive capacity for LCAC than leukocytosis.

导论：东京急性胆囊炎（AC）严重程度分级指南包括白细胞增多作为严重程度分级，没有考虑c反应蛋白（CRP）。我们的目的是确定这两个变量中哪一个对AC （LCAC）的局部并发症有更大的预测能力。材料和方法：对2022年6月至2023年12月期间行急诊胆囊切除术的患者进行回顾性单中心研究。分析与LCAC相关的变量，并进行ROC分析。结果：145例患者的多因素分析确定了以下与LCAC的相关性：CRP (p 9/l（78%敏感性，70%特异性）。结论：CRP对LCAC的预测能力可能高于白细胞计数。

{"title":"C-reactive protein as a predictor of complicated acute cholecystitis: A cohort study","authors":"G. Renau , D. Abelló , F. Sabench , J. Doménech , A. Sánchez","doi":"10.1016/j.rgmxen.2025.02.004","DOIUrl":"10.1016/j.rgmxen.2025.02.004","url":null,"abstract":"<div><h3>Introduction</h3><div>The Tokyo Guidelines for the severity classification of acute cholecystitis (AC) include leukocytosis as a severity classifier, without considering C-reactive protein (CRP). Our aim was to determine which of the two variables has a greater predictive capacity for local complications in AC (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 an 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> 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 x 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":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 330-333"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268112","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}

引用次数: 0

Good clinical practice recommendations for the diagnosis and treatment of functional dyspepsia: An expert review from the Asociación Mexicana de Gastroenterología 诊断和治疗功能性消化不良的良好临床实践建议：来自Asociación Mexicana de Gastroenterología的专家评论。

Revista de gastroenterologia de Mexico (English)

Pub Date : 2025-04-01 DOI: 10.1016/j.rgmxen.2025.05.001

R.I. Carmona-Sánchez , G. Vázquez-Elizondo , M.C. Rodríguez-Leal , O. Gómez-Escudero , M.V. Bielsa-Fernández , E. Coss-Adame , K. García-Zermeño , P. Gómez-Castaños , M. Morales-Arámbula , E.C. Morel-Cerda , A. Noble-Lugo , J.M. Remes-Troche , S. Solórzano-Olmos , O.E. Trujillo-Benavides , M.A. Valdovinos-Díaz , L.R. Valdovinos-García

Introduction and aims

Functional dyspepsia (FD) is a highly prevalent condition characterized by upper gastrointestinal symptoms with no apparent organic cause. It is a complex and multifactorial disease that frequently overlaps with other disorders of gut-brain interaction. It is recurrent, has a variable therapeutic response, and affects patient quality of life. Our aim was to formulate good practice recommendations for the management of FD through a consensus review of the disease, updating and complementing the 2017 consensus on dyspepsia from the Asociación Mexicana de Gastroenterología (AMG).

Methods

Sixteen experts summoned by the AMG carried out a literature review (2017–2024) and formulated good clinical practice recommendations for the diagnosis and treatment of FD. They were discussed until reaching a consensus, and the most recent evidence on the theme was evaluated, utilizing the GRADE system.

Results

Twenty-three good clinical practice recommendations for the management of FD were developed that addressed the following aspects: (1) definition, pathophysiology, and epidemiology; (2) diagnosis; (3) nonpharmacologic treatment; (4) Helicobacter pylori eradication; (5) antisecretory and anti-acid therapy; and (6) prokinetics and neuromodulators.

Conclusions

FD is one of the most frequent gastrointestinal conditions seen in daily practice. We present good clinical practice recommendations for the specific management of this disorder, taking into account the most recent advances that complement and update the consensus on dyspepsia published by the AMG in 2017.

简介和目的：功能性消化不良（FD）是一种非常普遍的疾病，以上消化道症状为特征，无明显的器质性病因。它是一种复杂的多因素疾病，经常与其他肠脑相互作用疾病重叠。它是反复发作的，有不同的治疗反应，并影响患者的生活质量。我们的目标是通过对该疾病的共识审查制定FD管理的良好实践建议，更新和补充Asociación Mexicana de Gastroenterología (AMG) 2017年关于消化不良的共识。方法：由AMG召集的16位专家进行文献综述（2017-2024），并制定FD诊断和治疗的良好临床实践建议。他们进行了讨论，直到达成共识，并利用GRADE系统评估了有关该主题的最新证据。结果：制定了23项FD管理的良好临床实践建议，涉及以下方面：(1)定义、病理生理学和流行病学；(2)诊断;(3)非药物治疗；(4)根除幽门螺杆菌；(5)抗分泌抗酸治疗；(6)原动力学和神经调节剂。结论：FD是临床上最常见的胃肠道疾病之一。考虑到AMG在2017年发布的关于消化不良共识的最新进展，我们提出了针对该疾病具体管理的良好临床实践建议。

{"title":"Good clinical practice recommendations for the diagnosis and treatment of functional dyspepsia: An expert review from the Asociación Mexicana de Gastroenterología","authors":"R.I. Carmona-Sánchez , G. Vázquez-Elizondo , M.C. Rodríguez-Leal , O. Gómez-Escudero , M.V. Bielsa-Fernández , E. Coss-Adame , K. García-Zermeño , P. Gómez-Castaños , M. Morales-Arámbula , E.C. Morel-Cerda , A. Noble-Lugo , J.M. Remes-Troche , S. Solórzano-Olmos , O.E. Trujillo-Benavides , M.A. Valdovinos-Díaz , L.R. Valdovinos-García","doi":"10.1016/j.rgmxen.2025.05.001","DOIUrl":"10.1016/j.rgmxen.2025.05.001","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>Functional dyspepsia (FD) is a highly prevalent condition characterized by upper gastrointestinal symptoms with no apparent organic cause. It is a complex and multifactorial disease that frequently overlaps with other disorders of gut-brain interaction. It is recurrent, has a variable therapeutic response, and affects patient quality of life. Our aim was to formulate good practice recommendations for the management of FD through a consensus review of the disease, updating and complementing the 2017 consensus on dyspepsia from the <em>Asociación Mexicana de Gastroenterología</em> (<em>AMG</em>).</div></div><div><h3>Methods</h3><div>Sixteen experts summoned by the <em>AMG</em> carried out a literature review (2017–2024) and formulated good clinical practice recommendations for the diagnosis and treatment of FD. They were discussed until reaching a consensus, and the most recent evidence on the theme was evaluated, utilizing the GRADE system.</div></div><div><h3>Results</h3><div>Twenty-three good clinical practice recommendations for the management of FD were developed that addressed the following aspects: (1) definition, pathophysiology, and epidemiology; (2) diagnosis; (3) nonpharmacologic treatment; (4) <em>Helicobacter pylori</em> eradication; (5) antisecretory and anti-acid therapy; and (6) prokinetics and neuromodulators.</div></div><div><h3>Conclusions</h3><div>FD is one of the most frequent gastrointestinal conditions seen in daily practice. We present good clinical practice recommendations for the specific management of this disorder, taking into account the most recent advances that complement and update the consensus on dyspepsia published by the <em>AMG</em> in 2017.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 227-251"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121638","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}

引用次数: 0

Comparison of the predictive capacity of the Alvarado and AIR scores in the diagnosis of acute appendicitis: A prospective study Alvarado评分与AIR评分对急性阑尾炎诊断预测能力的比较：一项前瞻性研究。

Revista de gastroenterologia de Mexico (English)

Pub Date : 2025-04-01 DOI: 10.1016/j.rgmxen.2024.07.007

L.M. Sanabria-Arévalo , L.C. Domínguez-Torres , J. Kock , J.D. Lotero , J.C. Gómez-Cáceres , E. Tuta-Quintero

Introduction and aims

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 two 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.

简介和目的：急性阑尾炎是外科治疗中最常见的疾病之一。急性阑尾炎的风险量表，如Alvarado和AIR评分系统，显示出良好的诊断率。本研究的目的是比较Alvarado评分和Air评分在急性阑尾炎诊断中的预测能力。方法：对疑似急性阑尾炎行阑尾切除术并经组织病理学证实的患者进行横断面研究。通过ROC曲线分析评价Alvarado和Air评分的预测能力，确定ROC曲线下面积。使用了STROBE检查表。结果：共纳入临床疑似急性阑尾炎患者358例，其中男性占51%（183/358）。患者年龄中位数为36岁（IQR: 24-46）。Alvarado评分的ROC曲线为0.767 (95% CI: 0.716-0.818)，截止点为0-4，敏感性78%，特异性84%。AIR评分的ROC曲线为0.741 (95% CI: 0.691-0.788)，截止点为0-4，敏感性为87%，特异性为56%。两组评分差异无统计学意义（p = 0.266）。结论：Alvarado评分与AIR评分对急性阑尾炎的预测能力相近。风险量表的低截止点与疾病的更高诊断敏感性有关。

{"title":"Comparison of the predictive capacity of the Alvarado and AIR scores in the diagnosis of acute appendicitis: A prospective study","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.rgmxen.2024.07.007","DOIUrl":"10.1016/j.rgmxen.2024.07.007","url":null,"abstract":"<div><h3>Introduction and aims</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 two 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":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 176-181"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251224","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}

引用次数: 0