Felipe Peraza Garay

Indicaciones inadecuadas en el consumo crónico de inhibidores de bomba de protones en un hospital de México. Estudio transversal

Introduction PPIs have been an enormous therapeutic advance in acid-related diseases. However, it has been detected an abuse in its consumption. The aim of this study was to determine the frequency of inadequate prescription of chronic use of PPIs in outpatients in a speciality hospital. Material and methods we performed a cross-sectional descriptive study review. The study population were patients, chronic users of proton pump inhibitors (PPIs), attending outpatient consult in a hospital of government workers. We defined as chronic user of PPIs that patient that takes medication daily for over a year and inappropriate prescription, that one that has not been approved by the clinical guidelines. A simple random sampling was utilized. The following parameters were investigated: diagnosis and prescription of PPIs, time of use, at which level of care PPIs were prescribed (primary care or specialist), self-medication, with or without endoscopy. Forthe statistical analysis, we used Student´s t-test and Chi-square, 95 % confidence intervals and significance 0.05 %. Results we reviewed 153 patients, 40 (26.1 %) men and 113 (73.9 %) women, mean age 58 ± 11.4 years. The prescription of chronic treatment with PPIs was adequate in 64.7 % of patients and inadequate in 35.3 %. The most common appropriate prescription (31.3 %) of chronic use of PPIs was due to gastroesophageal reflux disease. The most common inadequate prescription was absence of diagnosis (22.2 %), polypharmacy without nonsteroidal anti-inflammatory drugs (16.6 %) and chronic gastritis (16.6 %). History of endoscopy were not statistically significant. Conclusions the frequency of inappropriate prescriptions of chronic use of PPIs was high, around 35.3 %, similar to those reported in hospitals in developed countries.

Bowel obstruction secondary to deep infiltrating endometriosis of the ileum

Deep infiltrating endometriosis (DIE) of the ileum is an uncommon lesion that may be severe in its clinical presentation. Its diagnosis is challenging in the absence of a gynecological history of endometriosis and because of its anatomical location. We read the article by Sánchez, Candel, and Albarracín, and now report an additional case that was managed urgently.

Health-related quality of life in adults with irritable bowel syndrome in a Mexican specialist hospital. A cross-sectional study

BACKGROUND Evidence shows the negative impact of irritable bowel syndrome on the quality of life of patients who suffer from the condition as compared to the general population. OBJECTIVE The objective of this study was to determine the health-related quality of life in adults with irritable bowel syndrome who are receiving treatment at a specialist hospital. MATERIAL AND METHODS The study had a cross-sectional prospective design. The study included consecutive patients diagnosed with irritable bowel syndrome under the Rome III criteria and attending outpatient appointments. The SF-36 questionnaire was applied in its standard Spanish version and the results were compared with population reference scores in Mexico. Statistical analysis was performed with the Students t test, analysis of variance and the Chi-squared test, considering a significance of 0.05%. RESULTS One hundred and fifty-four patients were included in the study, 137 (89%) women and 17 (11%) men, with an average age of 52.8 (SD 12.6). The constipation, diarrhea and mixed subtypes comprised 85 (55.2%), 27 (17.5%) and 42 (27.3%) patients, respectively. The quality of life of patients with irritable bowel syndrome vs the population reference scores in Mexico were 50 vs 79 for the physical health sub-scale and 59.1 vs 76.7 for the mental health sub-scale, respectively (p = 0.000). No significant difference was found in quality of life among the irritable bowel syndrome subtypes (p > 0.05). CONCLUSIONS Health-related quality of life is lower in patients with irritable bowel syndrome in a population in the North East of Mexico compared to the data taken from a population reference study undertaken in the same country, enabling an inference in the female population and a cautious one from the results found in the small male sample studied. There was no significant difference found in the quality of life according to the clinical subtype of irritable bowel syndrome.