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1.
BMC Psychiatry ; 24(1): 551, 2024 Aug 08.
Article in English | MEDLINE | ID: mdl-39118031

ABSTRACT

BACKGROUND: Major Depressive Disorder (MDD) and Alcohol Use Disorder (AUD) are two high-prevalent conditions where the Endocannabinoid system (ECS) is believed to play an important role. The ECS regulates how different neurotransmitters interact in both disorders, which is crucial for controlling emotions and responses to stress and reward stimuli. Measuring peripheral endocannabinoids (eCBs) in human serum and plasma can help overcome the limitations of detecting endocannabinoid levels in the brain. This systematic review aims to identify levels of peripheral eCBs in patients with MDD and/or AUD and find eCBs to use as diagnostic, prognostic biomarkers, and potential therapeutic targets. METHODS: We conducted a systematic literature search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines from the earliest manuscript until October 22, 2023, in three electronic databases. We included studies of human adults who had a current diagnosis of AUD and/or MDD and evaluated plasma or serum endocannabinoids. We carefully considered known variables that may affect endocannabinoid levels. RESULTS: We included 17 articles in this systematic review, which measured peripheral eCBs in 170 AUD and 359 MDD patients. Stressors increase peripheral 2-arachidonyl-glycerol (2-AG) concentrations, and 2-AG may be a particular feature of depression severity and chronicity. Anxiety symptoms are negatively correlated with anandamide (AEA) concentrations, and AEA significantly increases during early abstinence in AUD. Studies suggest a negative correlation between Oleoylethanolamide (OEA) and length of abstinence in AUD patients. They also show a significant negative correlation between peripheral levels of AEA and OEA and fatty acid amide hydrolase (FAAH) activity. Eicosapentaenoylethanolamide (EPEA) is correlated to clinical remission rates in depression. Included studies show known variables such as gender, chronicity, symptom severity, comorbid psychiatric symptoms, length of abstinence in the case of AUD, and stress-inducibility that can affect peripheral eCBs. CONCLUSIONS: This systematic review highlights the important role that the ECS plays in MDD and AUD. Peripheral eCBs appear to be useful biomarkers for these disorders, and further research may identify potential therapeutic targets. Using accessible biological samples such as blood in well-designed clinical studies is crucial to develop novel therapies for these disorders.


Subject(s)
Alcoholism , Depressive Disorder, Major , Endocannabinoids , Endocannabinoids/blood , Humans , Depressive Disorder, Major/blood , Alcoholism/blood , Biomarkers/blood , Arachidonic Acids/blood , Glycerides/blood , Polyunsaturated Alkamides/blood
2.
Rev Gastroenterol Mex ; 82(2): 156-178, 2017.
Article in English, Spanish | MEDLINE | ID: mdl-28104319

ABSTRACT

INTRODUCTION: Probiotics are frequently prescribed in clinical practice. Their efficacy in treating gastrointestinal disorders is supported by a significant number of clinical trials. However, the correct prescription of these agents is hampered due to a lack of knowledge of the scientific evidence and to the different presentations and microbial compositions of the probiotics that are currently available. AIM: To provide the clinician with a consensus review of probiotics and recommendations for their use in gastroenterology. MATERIALS AND METHODS: Controlled clinical trials, meta-analyses, and systematic reviews published up to 2015 were selected, using the MESH terms: probiotics, gastrointestinal diseases, humans, adults, AND children. The Delphi method was employed. Eighteen gastroenterologists treating adult patients and 14 pediatric gastroenterologists formulated statements that were voted on until agreement>70% was reached. The level of evidence based on the GRADE system was evaluated for each statement. RESULTS AND CONCLUSIONS: Eleven statements on the general concepts of probiotics and 27 statements on the use of probiotics in gastrointestinal diseases in both adults and children were formulated. The consensus group recommends the use of probiotics under the following clinical conditions: the prevention of diarrhea associated with antibiotics, the treatment of acute infectious diarrhea, the prevention of Clostridium difficile infection and necrotizing enterocolitis, the reduction of adverse events from Helicobacter pylori eradication therapy, relief from irritable bowel syndrome symptoms, the treatment of functional constipation in the adult, and the induction and maintenance of remission in patients with ulcerative colitis and pouchitis, and the treatment of covert and overt hepatic encephalopathy.


Subject(s)
Gastroenterology , Probiotics/therapeutic use , Adult , Child , Consensus , Delphi Technique , Guidelines as Topic , Humans , Mexico
3.
Rev Gastroenterol Mex ; 80(4): 248-54, 2015.
Article in English, Spanish | MEDLINE | ID: mdl-26455483

ABSTRACT

BACKGROUND: Esophageal stricture due to caustic ingestion is one of the most difficult problems to manage. Esophageal dilations are the usual treatment and they require a great number of sessions in the majority of cases. This implies time, risks for the patient, anguish for the relatives, and very often, frustration for the physician. OBJECTIVES: To evaluate the efficacy of the application of topical mitomycin C and intralesional triamcinolone in the prevention of post-dilation esophageal stricture recurrence. MATERIAL AND METHODS: A prospective, comparative, nonrandomized, and longitudinal study was conducted that compared a cohort of 16 patients treated with mitomycin C (2009-2012) with a retrospective cohort of 34 patients treated with triamcinolone (2002-2009). RESULTS: The patients treated with intralesional triamcinolone had a median of 11 dilations (minimum 4 and maximum 24), whereas the median in the patients treated with topical mitomycin C was 4.5 (minimum 3 and maximum 8). The groups were compared using the Mann-Whitney U test, finding a statistically significant difference of a two-tailed P<.001. In the multiple linear regression model, the dependent variable was the number of dilations and the independent variables were the type of lesion and treatment. The result was an R(2) .676 with a significance level of P<.001, in which the regression coefficient for treatment was B -.682 (95% CI -8.286 to -5.025) and the lesion grade was B .435 (95% CI 2.043- 4.573). The ANOVA result was an F 49.08 and a P<.001 and showed that the independent variables of type of lesion and treatment had a linear relation with the number of dilations, reinforcing the fact that our results were not due to chance. CONCLUSIONS: Topical mitomycin C considerably reduced the number of esophageal dilations compared with the use of intralesional triamcinolone to alleviate dysphagia, and therefore we suggest it as a treatment option in strictures due to caustic ingestion.


Subject(s)
Anti-Inflammatory Agents/administration & dosage , Antibiotics, Antineoplastic/administration & dosage , Burns, Chemical/complications , Esophageal Stenosis/drug therapy , Mitomycin/administration & dosage , Triamcinolone/administration & dosage , Administration, Topical , Anti-Inflammatory Agents/therapeutic use , Antibiotics, Antineoplastic/therapeutic use , Caustics/toxicity , Child , Child, Preschool , Combined Modality Therapy , Dilatation , Esophageal Stenosis/chemically induced , Esophageal Stenosis/therapy , Esophagoscopy , Female , Humans , Infant , Injections, Intralesional , Longitudinal Studies , Male , Mitomycin/therapeutic use , Prospective Studies , Recurrence , Retrospective Studies , Treatment Outcome , Triamcinolone/therapeutic use
4.
Rev Gastroenterol Mex ; 80(1): 27-31, 2015.
Article in English, Spanish | MEDLINE | ID: mdl-25724742

ABSTRACT

UNLABELLED: The prevalence of cow's milk protein allergy (CMPA) has increased in recent years, and is associated with antimicrobial use during the perinatal period, prematurity, the type of childbirth, and the decrease in breastfeeding. The aim of this study was to analyze whether there is any association between these factors and the development of CMPA. MATERIAL AND METHODS: A retrospective, comparative, cross-sectional, observational study was conducted by reviewing the case records of 101 children diagnosed with CMPA and seen at the Department of Gastroenterology and Nutrition of the Instituto Nacional de Pediatría within the time frame of January 2012 and August 2013. The following variables were included: age, sex, weeks of gestation, history of maternal infection and antimicrobial use during the pregnancy, type of delivery, and feeding with human milk, and its duration. Likewise, the case records of 90 children were reviewed as a control group on not having CMPA or any other allergy. The chi-square test was used for proportions, and the Mann-Whitney U test was used for comparing means in the statistical analysis. RESULTS: The factors associated with CMPA were the use of antimicrobials during gestation and breastfeeding duration in months. Both factors were statistically significant (P<.001). No association was found between CMPA and gestational age or type of delivery. CONCLUSIONS: The statistically significant associated factors were breastfeeding duration and the use of antimicrobials during the gestational stage. These results underline the necessity for prospective studies.


Subject(s)
Milk Hypersensitivity/etiology , Milk Proteins/adverse effects , Prenatal Exposure Delayed Effects/etiology , Anti-Bacterial Agents/adverse effects , Breast Feeding , Case-Control Studies , Cross-Sectional Studies , Female , Humans , Infant , Infant, Newborn , Male , Pregnancy , Retrospective Studies , Risk Factors
5.
Rev Gastroenterol Mex ; 80(2): 130-4, 2015.
Article in English, Spanish | MEDLINE | ID: mdl-26024572

ABSTRACT

BACKGROUND: Cow's milk protein allergy is the most common cause of food allergy. The challenge test, either open or doubled-blind with a placebo control, is regarded as the criterion standard. Endoscopy and histologic findings are considered a method that can aid in the diagnosis of this entity. AIMS: The aim of this study was to describe the histopathologic findings in children suspected of cow's milk protein allergy that were seen at our hospital. MATERIAL AND METHODS: A descriptive, observational study was conducted on 116 children clinically suspected of presenting with cow's milk protein allergy that were seen at the Department of Gastroenterology and Nutrition of the Instituto Nacional de Pediatría. Upper endoscopy and rectosigmoidoscopy with biopsies were performed and the findings were described. RESULTS: Of the 116 patients, 64 (55.17%) were girls and 52 (44.83%) were boys. The rectum was the site with the greatest presence of eosinophils per field in both groups, followed by the duodenum. In general, more than 15 eosinophils were found in 46% of the patients. CONCLUSIONS: Between 40 and 45% of the cases had the histologic criterion of more than 15 to 20 eosinophils per field and the rectosigmoid colon was the most affected site. Therefore, panendoscopy and rectosigmoidoscopy with biopsy and eosinophil count are suggested.


Subject(s)
Eosinophils/metabolism , Intestines/pathology , Milk Hypersensitivity/pathology , Milk Proteins/adverse effects , Biomarkers/metabolism , Biopsy , Cross-Sectional Studies , Endoscopy, Gastrointestinal , Female , Humans , Infant , Intestinal Mucosa/metabolism , Leukocyte Count , Male , Milk Hypersensitivity/metabolism , Prospective Studies
6.
Rev Gastroenterol Mex ; 79(4): 244-9, 2014.
Article in English, Spanish | MEDLINE | ID: mdl-25453721

ABSTRACT

BACKGROUND: Prehepatic portal hypertension in children can be asymptomatic for many years. Once diagnosed, the therapeutic measures (pharmacologic, endoscopic, and surgical) are conditioned by the specific characteristics of each patient. In Mexico, there are no recorded data on the incidence of the disease and patient characteristics. AIMS: To determine the main clinical, radiologic, and endoscopic characteristics upon diagnosis of these patients at the Instituto Nacional de Pediatría within the time frame of January 2001 and December 2011. METHODS: A cross-sectional, retrolective, descriptive, and observational study was conducted in which all the medical records of the patients with portal hypertension diagnosis were reviewed. RESULTS: There was a greater prevalence of prehepatic etiology (32/52) (61.5%) in the portal hypertension cases reviewed. Males (62.5%) predominated and 11 of the 32 patients were under 4 years of age. The primary reason for medical consultation was upper digestive tract bleeding with anemia (71.9%) and the main pathology was cavernomatous degeneration of the portal vein (65.6%). Splenoportography was carried out on 17 of the 32 patients. A total of 65.5% of the patients received the combination therapy of propranolol and a proton pump inhibitor. Initial endoscopy revealed esophageal varices in 96.9% of the patients, 12 of whom presented with gastroesophageal varices. Congestive gastropathy was found in 75% of the patients. The varices were ligated in 8 cases, sclerotherapy for esophageal varices was carried out in 5 cases (15.6%), and sclerotherapy for gastric varices was performed in 2 patients. Seventeen patients (53.1%) underwent portosystemic diversion: 10 of the procedures employed a mesocaval shunt and 7 a splenorenal shunt. Nine patients (28.1%) underwent total splenectomy. CONCLUSIONS: The primary cause of the disease was cavernomatous degeneration of the portal vein; it was predominant in males and the first symptom was variceal bleeding.


Subject(s)
Hypertension, Portal/diagnosis , Adolescent , Child , Child, Preschool , Cross-Sectional Studies , Endoscopy , Female , Humans , Hypertension, Portal/pathology , Hypertension, Portal/therapy , Infant , Male , Mexico
7.
Rev Gastroenterol Mex ; 79(1): 7-12, 2014.
Article in Spanish | MEDLINE | ID: mdl-24655928

ABSTRACT

BACKGROUND: Primary intestinal lymphangiectasia is a rare congenital disease described by Waldmann in 1961 that is a consequence of obstruction of the lymphatic drainage of the small bowel with secondary lymph vessel dilation. This distorts the architecture of the villi and causes a leakage of lymph into the intestinal lumen, resulting in protein-losing enteropathy and malabsorption. AIM: To describe the clinical, biochemical, radiologic, endoscopic, and histologic characteristics in children with primary intestinal lymphangiectasia. METHOD: A retrospective observational, descriptive, cross-sectional study was conducted that reviewed the case records of children diagnosed with primary intestinal lymphangiectasia that were seen at the Department of Gastroenterology and Nutrition of the Instituto Nacional de Pediatría within the time frame of January 1, 1992 to September 30, 2012. RESULTS: Four patients were found that presented with primary intestinal lymphangiectasia. Three of them had been diagnosed before 3 years of age. All the patients presented with chronic diarrhea, edema, lymphopenia, hypocalcemia, and hypogammaglobulinemia, and 3 patients presented with hypocholesterolemia. Bowel transit time, endoscopy, and intestinal biopsies were characteristic of this pathology. CONCLUSIONS: Intestinal lymphangiectasia should be suspected when there is a clinical picture of chronic diarrhea and protein-losing enteropathy accompanied with edema at any level, as well as hypoalbuminemia, hypocalcemia, lymphopenia, hypogammaglobulinemia, and hypocholesterolemia, which are the main biochemical findings of this pathology. All children presenting with intestinal lymphangiectasia should undergo an upper gastrointestinal series with bowel transit time and endoscopy with biopsies taken at the level of the duodenum. Treatment includes diet and the periodic administration of albumin and gamma globulin.


Subject(s)
Lymphangiectasis, Intestinal/therapy , Tertiary Care Centers , Adolescent , Child , Child, Preschool , Cross-Sectional Studies , Diarrhea/diagnosis , Diarrhea/etiology , Diet , Endoscopy, Gastrointestinal , Female , Humans , Infant , Lymphangiectasis, Intestinal/complications , Lymphangiectasis, Intestinal/diagnosis , Male , Mexico , Retrospective Studies
8.
Rev Gastroenterol Mex ; 79(1): 3-6, 2014.
Article in Spanish | MEDLINE | ID: mdl-24656514

ABSTRACT

BACKGROUND: Cow's milk protein allergy (CMPA) is being seen more frequently on a daily basis in pediatric consultations. It shares symptoms with gastroesophageal reflux (GER), which can complicate the differential diagnosis. AIMS: To attempt to corroborate the presence of acid GER in children with CMPA, as well as to find a characteristic profile through the 24-hour pH monitoring study in children with GER and CMPA METHODS: The intraesophageal pH monitoring studies performed on 47 children with CMPA were reviewed. The measurements in all the studies were carried out within a 24-hour period using Digitrapper® equipment with a multi-use GeroFlex® catheter, after calibration with pH 7 and pH 1 buffer solutions. RESULTS: Of the 47 children, 23 were boys (32.4%) and 24 were girls (33.8%) and the mean age was 5±3.7 years. Fourteen of the 47 children (29%) presented with GER, according to the result of the 24-hour intraesophageal measurement. Only 2 of the 47 patients studied fit the phasic profile. CONCLUSIONS: The findings show the existing relation between the two pathologies. Nevertheless, it is important to determine the presence of non-acid or weak acid reflux, because their existence can increase this association.


Subject(s)
Esophagus/metabolism , Milk Hypersensitivity/metabolism , Milk Proteins/immunology , Animals , Cattle , Child , Child, Preschool , Esophagus/chemistry , Female , Gastroesophageal Reflux/etiology , Humans , Hydrogen-Ion Concentration , Male , Milk Hypersensitivity/complications , Tertiary Care Centers
9.
Rev Gastroenterol Mex (Engl Ed) ; 89(3): 347-353, 2024.
Article in English | MEDLINE | ID: mdl-38862360

ABSTRACT

INTRODUCTION: Esophageal pH-impedance monitoring is a tool for diagnosing gastroesophageal reflux in children. The position of the pH catheter is essential for a reliable reading and the current formulas for calculating catheter insertion length are not completely accurate. The aim of the present study was to develop a new formula for adequate insertion of the pH catheter. MATERIAL AND METHODS: A cross-sectional study was conducted on children that underwent pH-impedance monitoring and later radiographic control, to calculate the correct catheter insertion length. The documented variables were age, sex, weight, height, naris to tragus distance, tragus to sternal notch distance, sternal notch to xiphoid process distance, and initial insertion length determined by the Strobel and height interval formulas. A multivariate regression analysis was carried out to predict the final insertion length. Regression ANOVA and Pearson's adjusted R-squared tests were performed. RESULTS: Forty-five pH-impedance studies were carried out, 53% of which were in males. The age and weight variables were not normally distributed. In the initial regression model, the variables that did not significantly correlate with the final insertion length were: sex (P 0.124), length determined by the Strobel or height interval formulas (P 0.078), naris to tragus distance (P 0.905), and tragus to sternal notch distance (P 0.404). The final equation: 5.6 + (height in cm * 0.12) + (sternal notch to xiphoid process distance * 0.57) produced an R2 of 0.93 (P 0.000). CONCLUSIONS: This formula can be considered a valid option for placement of the pH-impedance monitoring catheter in pediatrics.


Subject(s)
Electric Impedance , Esophageal pH Monitoring , Humans , Male , Female , Cross-Sectional Studies , Child , Child, Preschool , Infant , Adolescent , Gastroesophageal Reflux
10.
Rev Gastroenterol Mex (Engl Ed) ; 89(3): 362-368, 2024.
Article in English | MEDLINE | ID: mdl-38862359

ABSTRACT

INTRODUCTION AND AIM: SARS-CoV-2 emerged in 2019 and had a huge impact on the world. The area of endoscopy suffered great changes, causing a reduction in the number of procedures and its indications. The aim of our study was to compare the quantity, indication, and type of procedures in 2019 with those in 2020. METHOD: A retrospective, observational, analytic, and cross-sectional study was conducted, obtaining information from the endoscopy registry. The STROBE checklist was employed. STATISTICAL ANALYSIS: The quantitative variables were analyzed with descriptive statistics (measures of central tendency and dispersion) and the categorical variables with frequencies and percentages. The quantitative variables were compared, using the Student's t test/Mann-Whitney U test, and the categorical variables with contingency tables, using the Fisher's exact test. RESULTS: In 2019, a total of 277 procedures were performed, compared with 139 in 2020. Mean patient age was 98.53 months (61.46 SD) in 2019 and 77.02 months (59.81 SD) in 2020; 352 diagnostic procedures and 136 therapeutic procedures were carried out in 2019, compared with 51 diagnostic procedures and 88 therapeutic procedures in 2020. The number of diagnostic and therapeutic procedures were inverted (72.1%-36.7% and 27.9%-63.3%, respectively) (p<0.0001). Esophageal varices, upper gastrointestinal bleeding (UGIB), and foreign body extraction were the indications, in order of predominance in 2019, compared with foreign body extraction (p<0.05), UGIB, and esophageal varices in 2020. There were no differences regarding colonoscopy. CONCLUSION: There was a clear difference in indication and type of procedure, with an increase in foreign body extraction in preschoolers.


Subject(s)
COVID-19 , Tertiary Care Centers , Humans , COVID-19/epidemiology , Retrospective Studies , Cross-Sectional Studies , Male , Female , Child , Endoscopy, Gastrointestinal/statistics & numerical data , Endoscopy, Gastrointestinal/methods , Aged , Middle Aged , Child, Preschool , Adolescent , Endoscopy/methods , Endoscopy/statistics & numerical data
11.
Rev Gastroenterol Mex ; 77(3): 130-40, 2012.
Article in Spanish | MEDLINE | ID: mdl-22921210

ABSTRACT

Short bowel syndrome (SBS) refers to the sum of the functional alterations that are the result of a critical reduction in the length of the intestine, which in the absence of adequate treatment, presents as chronic diarrhea, chronic dehydration, malnutrition, weight loss, nutriment and electrolyte deficiency, along with a failure to grow that is present with greater frequency during the neonatal period. The aim was to carry out a review of the literature encompassing the definition and the most frequent causes of SBS, together with an understanding of its physiopathology, prognostic factors, and treatment. An Internet search of PubMed articles was carried out for the existing information published over the last 20 years on SBS in children, using the keywords "short bowel syndrome". From a total of 784 potential articles, 82 articles were chosen for the literature review. The treatment of patients presenting with SBS is quite a challenge and therefore it is necessary to establish multidisciplinary management with a focus on maintaining optimal nutritional support that covers the necessities of growth and development and at the same time provides a maximum reduction of short, medium, and long-term complications. The diagnosis and treatment of a child with SBS require a team of professionals that are experts in gastroenterologic, pediatric, and nutritional management. The outcome for the child will be directly related to opportune management, as well as to the length of the intestinal resection and the presence or absence of the ileocecal valve.


Subject(s)
Short Bowel Syndrome/complications , Short Bowel Syndrome/diagnosis , Short Bowel Syndrome/therapy , Child , Combined Modality Therapy , Humans , Parenteral Nutrition , Prognosis , Short Bowel Syndrome/epidemiology , Short Bowel Syndrome/physiopathology , Treatment Outcome
12.
Rev Gastroenterol Mex ; 77(4): 216-9, 2012.
Article in Spanish | MEDLINE | ID: mdl-23153416

ABSTRACT

Blue Rubber Bleb Nevus Syndrome (BRBS) is a rare disease, characterized by multiple vascular malformations in the skin and gastrointestinal tract. Other organs can also be affected, presenting different clinical manifestations such as arthralgia, epistaxis, hemoptysis, hematuria, hemothorax, mild thrombocytopenia, consumptive coagulopathy, and bone deformities, among others. We present a case of BRBS in a nine-year-old boy with the characteristic clinical manifestations of punctated purplish-blue skin lesions that vary in size and gastrointestinal vascular malformations with upper digestive tract bleeding.


Subject(s)
Gastrointestinal Neoplasms/pathology , Nevus, Blue/pathology , Skin Neoplasms/pathology , Anemia, Iron-Deficiency/complications , Child , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/pathology , Gastrointestinal Neoplasms/complications , Gastrointestinal Neoplasms/surgery , Humans , Magnetic Resonance Imaging , Male , Nevus, Blue/complications , Nevus, Blue/surgery , Skin/pathology , Skin Neoplasms/complications , Skin Neoplasms/surgery , Vascular Malformations/etiology , Vascular Malformations/pathology , Vascular Malformations/surgery
13.
Rev Gastroenterol Mex (Engl Ed) ; 87(1): 20-28, 2022.
Article in English | MEDLINE | ID: mdl-34635446

ABSTRACT

INTRODUCTION AND AIMS: Foreign body (FB) ingestion is a common problem in children under 5 years of age and is one of the main indications for endoscopy. The aim of the present study was to describe the clinical, radiographic, and endoscopic characteristics of patients with FB ingestion, as well as the factors associated with the anatomic location and the type of object ingested. MATERIALS AND METHODS: An analytic cross-sectional study was conducted on all patients with FB ingestion seen at the gastroenterology service from January 2013 to December 2018. The data were analyzed using the SPSS program, obtaining frequencies, percentages, medians, and interquartile ranges. Associations were assessed through the chi-square test. RESULTS: Eighty-five patients (52 males and 33 females) were included, with a median age of 4 years. The most common symptom was vomiting (29.4%). Two radiographic projections were carried out in 72.9% of the cases and the stomach was the site where the FB was most frequently visualized (32.9%). The objects most commonly ingested were coins (36%), with esophageal location (p<0.05), as well as objects with a diameter larger than 2cm (p<0.05). An endoscopic procedure was performed on 76 patients (89.4%) for FB extraction, with findings of erythema (28.9%), erosion (48.6%), ulcer (10.5%) and perforation (1.3%). CONCLUSIONS: Numerous factors should be taken into account in the approach to FB ingestion in pediatric patients, including type and size of the FB, time interval from ingestion to hospital arrival, and patient clinical status and age.


Subject(s)
Foreign Bodies , Child , Child, Preschool , Cross-Sectional Studies , Eating , Endoscopy, Gastrointestinal , Female , Foreign Bodies/diagnostic imaging , Foreign Bodies/epidemiology , Humans , Male , Retrospective Studies , Tertiary Care Centers
15.
Dalton Trans ; 50(5): 1746-1753, 2021 Feb 09.
Article in English | MEDLINE | ID: mdl-33459319

ABSTRACT

A new family of mononuclear lanthanide complexes with the formula [CeIII(L)(NO3)3(MeOH)] (1) and [LnIII(L)(NO3)3]·MeOH where Ln = Gd (2) or Dy (3) and L = N,N'-bis(pyridin-2-ylmethylene)cyclohexane-1,2-diamine has been obtained with the use of enantiomerically pure Schiff bases. Dynamic magnetic studies indicate that 1-3 present field-induced slow relaxation of the magnetization and their response has been compared with the magnetically diluted complexes 2d and 3d. Structural studies have been carried out by single crystal X-ray and powder diffraction.

16.
Article in English, Spanish | MEDLINE | ID: mdl-33892985

ABSTRACT

INTRODUCTION AND AIMS: Foreign body (FB) ingestion is a common problem in children under 5 years of age and is one of the main indications for endoscopy. The aim of the present study was to describe the clinical, radiographic, and endoscopic characteristics of patients with FB ingestion, as well as the factors associated with the anatomic location and the type of object ingested. MATERIALS AND METHODS: An analytic cross-sectional study was conducted on all patients with FB ingestion seen at the gastroenterology service from January 2013 to December 2018. The data were analyzed using the SPSS program, obtaining frequencies, percentages, medians, and interquartile ranges. Associations were assessed through the chi-square test. RESULTS: Eighty-five patients (52 males and 33 females) were included, with a median age of 4 years. The most common symptom was vomiting (29.4%). Two radiographic projections were carried out in 72.9% of the cases and the stomach was the site where the FB was most frequently visualized (32.9%). The objects most commonly ingested were coins (36%), with esophageal location (p <0.05), as well as objects with a diameter larger than 2cm (p <0.05). An endoscopic procedure was performed on 76 patients (89.4%) for FB extraction, with findings of erythema (28.9%), erosion (48.6%), ulcer (10.5%) and perforation (1.3%). CONCLUSIONS: Numerous factors should be taken into account in the approach to FB ingestion in pediatric patients, including type and size of the FB, time interval from ingestion to hospital arrival, and patient clinical status and age.

17.
Rev Gastroenterol Mex (Engl Ed) ; 86(3): 253-258, 2021.
Article in English | MEDLINE | ID: mdl-34210459

ABSTRACT

INTRODUCTION AND AIMS: Post-fundoplication dysphagia is resolved with no therapeutic intervention in the majority of cases but it can persist in 5.3% of children that undergo the procedure. Among the differential diagnoses, esophagogastric junction outflow obstruction (EGJOO) is a disorder that should be suspected if there is a persistence of dysphagia. The aim of our study was to describe the clinical characteristics, treatment, and follow-up in a case series of patients diagnosed with post-fundoplication EGJOO. MATERIALS AND METHODS: The clinical records of patients diagnosed with EGJOO at a tertiary care hospital within the time frame of September 2015 to September 2019 were reviewed, with respect to manometry, etiology, treatment, and clinical course of the disease. RESULTS: Of the 213 high-resolution esophageal manometries performed, 4 patients met the criteria for post-fundoplication EGJOO. The primary symptom was dysphagia, presenting 15 days after the procedure. Esophageal dilations were carried out on all the patients but with no improvement. Symptoms related to the condition resolved spontaneously in three of the four patients. CONCLUSION: The management of children with post-fundoplication EGJOO continues to be a challenge. Even though more than half of the cases resolve with no intervention, optimum management of the motility disorder is still limited, given the scant experience with the condition in the pediatric population.


Subject(s)
Deglutition Disorders , Esophageal Motility Disorders , Child , Deglutition Disorders/diagnosis , Diagnosis, Differential , Esophageal Motility Disorders/diagnosis , Esophagogastric Junction , Fundoplication , Humans
19.
Eur J Cancer Care (Engl) ; 18(3): 280-6, 2009 May.
Article in English | MEDLINE | ID: mdl-19076208

ABSTRACT

Daily granulocyte colony-stimulating factors [(G-CSFs); e.g. filgrastim, lenograstim] are frequently used to reduce the duration of chemotherapy-induced neutropenia (CIN) and the incidence of febrile neutropenia (FN) in cancer patients. A pegylated formulation of filgrastim, pegfilgrastim, which is administered once per cycle, was introduced in Spain in 2003. LEARN was a multi-centre, retrospective, observational study in Spain comparing patterns of use of daily G-CSF and pegfilgrastim, and CIN-related outcomes in adults with non-myeloid malignancies receiving myelosuppressive chemotherapy. Outcome measures were the percentage of patients receiving G-CSF for primary prophylaxis versus secondary prophylaxis/treatment, duration of treatment with G-CSF and incidence of CIN-related complications. Medical records from consecutive patients with documented pegfilgrastim (n = 75) or daily G-CSF (n = 111) use during 2003 were included. The proportion of patients receiving primary or secondary prophylaxis was comparable between the pegfilgrastim (39 and 48% respectively) and daily G-CSF (40 and 48% respectively) groups. However, there was a trend towards less frequent use to treat a neutropenic event such as FN or neutropenia in the pegfilgrastim group (17 versus 30% with daily G-CSF). Chemotherapy-induced neutropenia-related complications were less frequent in patients receiving pegfilgrastim (e.g. FN 11 versus 24% with daily G-CSF). This is the first study to show the potential benefits of pegfilgrastim over daily G-CSF in Spanish clinical practice.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Granulocyte Colony-Stimulating Factor/administration & dosage , Neoplasms/drug therapy , Neutropenia/drug therapy , Adult , Aged , Aged, 80 and over , Female , Fever/chemically induced , Fever/drug therapy , Filgrastim , Granulocyte Colony-Stimulating Factor/adverse effects , Humans , Male , Middle Aged , Neutropenia/chemically induced , Polyethylene Glycols , Recombinant Proteins , Retrospective Studies , Spain , Young Adult
20.
Dalton Trans ; 48(35): 13139-13142, 2019 Sep 21.
Article in English | MEDLINE | ID: mdl-31292570

ABSTRACT

The characterization of a decanuclear FeIII cluster with α-methyl-2-pyridinemethanolate, generated by the hydrolysis of Schiff bases, inspired us to carry out an initial exploration of the direct syntheses of medium nuclearity FeIII clusters starting from aldehydes in methanolic medium. The new complexes exhibit an unprecedented {Fe10(µ3-O)8} cluster core.

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