RESUMEN INVESTIGADORES-2

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 16949843 analysis showed that smoking was not a risk factor for NAFLD (OR = 0.89, 95% CI 0.65-1.21). PMID: 17060873 CONCLUSION: No differences in NAFLD prevalence were observed be- PMID: 17060879 tween current smokers and nonsmokers, and furthermore, no differences were observed in heavy smokers (more than 20 packs/year), indicating that there is no relationship between smoking and NAFLD. CITA: World J Gastroenterol. 2006 Aug 28;12(32):5196-200 DOI: 10.3748/wjg.v12.i32.5196 TÍTULO: Subdural hematoma in a teenager related to roller-coaster ride AUTORES: Roldan-Valadez E, Facha MT, Martinez-Lopez M, Herrera-Mora P. SUMMARY: Reports about neurological injury related to roller-coaster rides mostly involve adults; we present a case of subdural hematoma in a pediat- ric patient presented 14 days after a roller-coaster ride. These rides show extreme up-and-down, to-and-fro, and rotatory acceleration/deceleration forces that could produce tensile and shearing stresses with tearing of bridg- ing cerebral veins resulting in subdural hemorrhage. Pediatricians should consider roller-coaster riding a modern cause of subdural hematoma, as well as a possible cause of unexplained neurologic events in otherwise healthy adolescents. CITA: Eur J Paediatr Neurol. 2006 Jul;10(4):194-6 DOI: 10.1016/j.ejpn.2006.07.001 TÍTULO: Fused PET/CT images in hepatocarcinoma AUTORES: Vega-González IF, Roldán-Valadez E, Valdiviezo-Cárdenas G. SUMMARY: Case report CITA: Ann Hepatol. Jul-Sep 2006;5(3):164-5 DOI: 10.1016/S1665-2681(19)32001-0 TÍTULO: Effect of pregnancy on pre-existing liver disease physiological changes during pregnancy AUTORES: Angel García AL. SUMMARY: The pregnant woman experiences physiological changes to support fetal growth and development. Particularly the physiological chang- es of the liver are the results of the increment of estrogens and progesterone during the pregnancy, and also the hemodynamics changes. (hemodilu- tion). Telangiectasia may appear in up to 60% of normal pregnancies. Liver function test (LFT) abnormalities occurs in 3% of the pregnancies, and the Preeclampsia is the most frequent cause. Most of the articles agree that in normal pregnancy the LFT are either normal or slightly increase o de- crease but within normal range. Thus, an increase in serum ALT, AST and GGT activities and serum bilirubin and total bile acid concentration during pregnancy may be pathologic and should prompt further evaluation. In the same way the serum albumin levels is significantly low and the serum al- 51

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 17060885 kaline phosphatase concentrations are considerably higher and are a nor- PMID: 17060890 mal component of the pregnancy , and if they are within normal range, do PMID: 17061479 not usually indicate the presence of liver disease. The prothrombine time and the partial prothrombine time remain unchanged during pregnancy and serum fibrinogen increase in late pregnancy. Most of the articles related to plasma lipids in pregnancy agree that cholesterol. Triglyceride and lipopro- tein increase during pregnancy. Use of gestational age of the pregnancy are the best guide to the differential diagnosis of liver disease in the pregnancy. CITA: Ann Hepatol. Jul-Sep 2006;5(3):184-6 DOI: 10.1016/S1665-2681(19)32007-1 TÍTULO: Focal nodular hyperplasia and hepatic adenoma: a review AUTORES: Lizardi-Cervera J, Cuéllar-Gamboa L, Motola-Kuba D. SUMMARY: Focal Nodular Hyperplasia (FNH) and Hepatic Adenoma (HA) are a benign tumors of the liver. The association with the use of oral con- traception in women in middle age has been mentioned. This benign liver tumors are relatively rare lesions and are usually unrelated to subjective symptoms. They are increasingly being diagnosed as a result of the wide- spread use of ultrasound, computed tomography and magnetic resonance in the evaluation of patients with non-specific abdominal symptoms. CITA: Ann Hepatol. Jul-Sep 2006;5(3):206-11 DOI: 10.1016/S1665-2681(19)32013-7 TÍTULO: Pregnancy and gallbladder disease AUTORES: Mendez-Sanchez N, Chavez-Tapia NC, Uribe M. SUMMARY: Gallbladder disease is a highly prevalent disease in western countries as a consequence of several genetic, biochemical, and environ- mental factors. Females are a high risk group, and pregnancy increases this risk considerably. In fact, gallbladder diseases are the second most common indication for nonobstetric surgical intervention in pregnancy. In this review, we discuss the most important aspects of gallbladder disease and pregnan- cy as part of the Symposium on Liver and Pregnancy, co-sponsored by the Mexican Association of Hepatology and the Mexican Association of Gynecol- ogists and Obstetrics. CITA: Ann Hepatol. Jul-Sep 2006;5(3):227-30 DOI: 10.1016/S1665-2681(19)32018-6 TÍTULO: Intestinal lymphangiectasia: a forgotten cause of chronic diarrhea AUTORES: Rodríguez Leal G. SUMMARY: Intestinal lymphangiectasia is a rare autosomal dominant disorder or acquired condition that leads to lymph obstruction, poor chyle transport and concomitant problems. We describe the cases of two women with chronic diarrhea in whom the common signs of lymphagiectasia-hypo- albuminemia, lymphopenia and distal edema- were found. One of them also 52

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR had pleural effusion and chylous ascites. The diagnosis was performed by intestinal biopsy. We herein review the histopathologic, radiographic and en- doscopic features of this disorder and case reports in Mexican population. CITA: Rev Gastroenterol Mex. Jan-Mar 2006;71(1):55-8. PMID: 17063573 TÍTULO: [Assessment of high sensitivity C-reactive protein (HS-CRP) as a marker of liver inflammation in patients with metabolic syndrome] AUTORES: Rodríguez-Leal GA, Morán S, Gallardo I, Milke P, Gue- vara-González L. SUMMARY: C-reactive protein (CRP) plays an important role on inflamma- tory processes associated to the metabolic syndrome (MS), alike of insulin sensitivity, endothelial dysfunction and fibrinolysis insufficiency. Alanine ami- notransferase (ALT) may be a sensible marker for the diagnosis of hepatic damage and has therefore been used as an alternative method for the non- invasive diagnosis of non-alcoholic fatty liver disease (NAFLD), especially in epidemiological studies. At the present time, the possible utility of high sensitivity CRP (hsCRP) as a simple measure to detect the degree of he- patic inflammatory response during the development NAFLD in MS has not been explored. OBJECTIVE: To evaluate the measurement of serologic hsCRP for the iden- tification of hepatic inflammatory response in patients with MS. MATERIAL AND METHODS: Seven hundred and forty persons (526 men and 214 women), mean age 45 +/- 11 years who were asymptomatic and otherwise seeming healthy in whom a medical questionnaire was applied underwent physical examination, laboratory testing, hepatic ultrasound and measurement of hsCRP by the immuno-turbidimetric method. Receiver op- erating characteristic (ROC) analysis was used to evaluate the sensitivity and specificity of all possible hsCRP for detecting different degrees of he- patic inflammation (ALT > 44 U/L and ALT > 88 U/L). Patients were stratified according to the presence of metabolic syndrome (MS) and ALT concentra- tion in three groups: Group I, having MS and ALT > 44 U/L (n = 39); Group II, having ALT > 44 U/L without MS (n = 105) and Group III, having ALT < or = 44 U/L without MS (n = 596). RESULTS: The optimal hsCRP cut-off for detecting patients with ALT 44 U/L was 2.5 mg/L (sensibility 66%; specificity 50%) and for detecting patients with ALT > 88 U/L was 2.35 (sensibility 72%; specificity 59%). hsCRP se- rum concentrations in Group I were significantly higher than in Group II and Group III (p < 0.05) but no difference was found between Group II and Group III (Group I = 6.0 +/- 6.7 mg/L vs. Group II = 2.8 +/- 3.1 mg/L, vs. Group III = 2.9 +/- 4.1 mg/L). ALT concentrations were also significantly higher in Group I than in Group II and Group III, (p < 0.05) and a difference between Group II and Group III (p < 0.05) was also found (Group I = 72 +/- 31 U/L vs. Group II = 64 +/- 29 U/L vs. Group III = 24 +/- 8 U/L). CONCLUSIONS: These results suggest that the measurement of hsCRP for the identification of hepatic inflammatory response in patients with MS with NAFLD is limited because of its low sensibility and specificity observed on identifying different degrees of hepatic inflammation. CITA: Rev Gastroenterol Mex. Jan-Mar 2006;71(1):39-45 53

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 17128824 TÍTULO: [Traumatic dissection of extracranial internal carotid artery with PMID: 17149055 middle cerebral artery stroke: imaging diagnosis] AUTORES: Roldán-Valadez E, Corona-Cedillo R, Ruiz-González D, Del Valle R, Herrera-Serrano A, Sánchez-Sánchez JM. SUMMARY: Cervical carotid artery dissections (CCAD) are common in young adults with a mean age of 44 years and may account for as many as 20% of strokes in patients younger than 30 years. Trauma and primary dis- eases of the arterial wall such as fibromuscular dysplasia are the main pre- disposing factors. Some CCAD cases are diagnosed solely on clinical history and physical examination, and even imaging tools such as helical/multi-slice computed tomography (CT) and magnetic resonance imaging (MRI) some- times are not sufficient to reach a diagnosis. We describe the case of an 18-year-old male who presented to our emergency department due to loss of consciousness 18 hours after a car accident. Previously he had been in no acute distress, with fluent speech, and able to follow 3-step commands. Helical CT showed a hypodense lesion in the left-middle cerebral artery terri- tory, as well as hyperdensity of the M1 segment of the middle cerebral artery. Cerebral angiography depicted the left carotid artery dissection in the C1 segment. Physicians should consider this entity in \"asymptomatic\" patients during their first hours after head injury, among patients who later develop focal neurological symptoms and clinical deficits. Clinical suspicion followed by radiological findings allows early neurovascular treatment, trying to save viable brain tissue in the first hours post injury. CITA: Gac Med Mex. Sep-Oct 2006;142(5):419-22 TÍTULO: Sphygmomanometry-evoked allodynia--a simple bedside test indic- ative of fibromyalgia: a multicenter developmental study AUTORES: Vargas A, Vargas A, Hernández-Paz R, Sánchez-Huerta JM, Romero-Ramírez R, Amezcua-Guerra L, Kooh M, Nava A, Pineda C, Rodrí- guez-Leal G, Martínez-Lavín M. BACKGROUND: One of the 2 classification criteria for fibromyalgia (FM) is the presence of tender points on specific anatomic sites. It has been estab- lished that these tender points reflect a state of generalized allodynia (de- fined as pain resulting from a stimulus that does not normally provoke pain). Patients with FM often describe pain elicitation during blood pressure testing (sphygmomanometry). OBJECTIVE: The objective of this study was to define if a universally used clinical test, sphygmomanometry, is helpful in the identification of patients with FM. METHODS: The authors conducted a prospective multicenter study in 3 different public rheumatology outpatient services. Each center studied 20 patients with FM, 20 with rheumatoid arthritis, 20 with osteoarthritis, and 20 healthy individuals. The following question was asked of each participant: \"When I take your blood pressure, tell me if the cuff's pressure brings forth pain.\" The blood pressure cuff was inflated at an approximate rate of 10 mm Hg per second up to 180 mm Hg or to the point when pain was elicited. RESULTS: Sixty-nine percent of patients with FM had sphygmomanome- try-evoked allodynia in contrast to 10% of patients with osteoarthritis, 5% with rheumatoid arthritis, and 2% of healthy individuals (P < 0.001). The mean blood pressure value at which allodynia was elicited was lower in patients with 54

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 17151577 FM (143 +/- 40 mm Hg) when compared with the other 3 groups (176 +/- 11 PMID: 17151581 mm Hg) or higher (P < 0.001). In patients with FM, there was a significant negative correlation between the blood pressure value at which allodynia de- veloped and total Fibromyalgia Impact Questionnaire (FIQ) score, number of tender points, and the FIQ visual analog scales for pain intensity and fatigue (P < 0.05). The test yields a diagnostic sensitivity for FM of 0.7, specificity 0.96, positive predictive value 0.86, and negative predictive value 0.91. CONCLUSIONS: In this developmental study of patients attending rheu- matology clinics, the generation of pain during blood pressure testing was strongly associated with the diagnosis of FM. This robust linkage probably reflects a tautologic phenomenon. A sine qua nonelement for FM diagnosis is the presence of tender points in discrete anatomic sites. These tender points in turn reflect a state of generalized mechanical allodynia that can be locally elicited by the cuff pressure during blood pressure testing. Sphyg- momanometry is a simple bedside test that may be useful in the recognition of patients with FM. Blood pressure testing is a universal procedure in all clinical environments. Based on our results, we suggest searching for FM features in any person who has sphygmomanometry-evoked allodynia. CITA: J Clin Rheumatol. 2006 Dec;12(6):272-4 DOI: 10.1097/01.rhu.0000249770.86652.3b TÍTULO: Hepatitis C virus infection and non-Hodgkin's lymphoma: a review and case report of nine patient AUTORES: Lizardi-Cervera J, Poo JL, Romero-Mora K, Castañeda B, Pi- chardo-Bahena R, Morán S, Uribe M. SUMMARY: The role of hepatitis C virus (HCV) is well established in the de- velopment of chronic hepatitis, cirrhosis and hepatic carcinoma, as well as in mixed type II cryoglobulinemia, membranoproliferative glomerulonephritis (MPGN) and porphyria cutanea tarda (PCT). Increasing evidence has been reported of a close association of HCV infection with autoimmune and he- matological processes, mainly cytopenias and lymphoproliferative disorders such as B cell non-Hodgkin’s lymphoma. We describe the demographic, clin- ical and histopathological findings of nine patients from the Mexican popula- tion with non-Hodgkin’s lymphoma and HCV infection. CITA: Ann Hepatol. Oct-Dec 2006;5(4):257-62 DOI: 10.1016/S1665-2681(19)31984-2 TÍTULO: Risk factors and prevalence of hepatitis virus B and C serum mark- ers among nurses at a tertiary-care hospital in Mexico City, Mexico: a de- scriptive study AUTORES: Méndez-Sánchez N, Motola-Kuba D, Zamora-Valdés D, Sán- chez-Lara K, Ponciano-Rodríguez G, Uribe-Ramos MH, Vásquez-Fernández F, Lezama-Mora J, Pérez-Sosa JA, Baptista-González HA, Uribe M. BACKGROUND & AIM: Alcohol consumption and viral infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) are the first causes of chronic hepa- topathy in Mexico. Medical personnel are at high risk of developing HBV and HCV infection because both viruses are transmitted parenteraly. The aim of this study was to determine the prevalence of HCV and HBV infection as well as risk factors in nurses working at Medica Sur Clinic and Foundation. 55

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR METHODS: The complete nurse staff personal from our hospital was included; a questionnaire of risk factors for HCV and HBV infection was assessed. HBV and HCV infection (anti-HCV anti-HBc, and HBsAg) was determined to all of them. In anti-HCV positive persons HCV genotype and viral load was assessed. RESULTS: Three hundred seventy six nurses where studied, Anti-HBc was positive in 1.6% of all participants, none were positive for HBsAg. 0.8% of all studied population was positive for anti- HCV. Major risk factors for HBV infection where tattooing and having more than 4 sexual partners previously, and for HCV infection transfusions before 1992 and age. Only one person was anti-HCV positive with a viral charge of 5 X 106 copies, genotype 2b. CONCLUSIONS: HCV seropositivity in people with high risk was lower than general population. None was positive for HBV infection. CITA: Ann Hepatol. Oct-Dec 2006;5(4):276-80 DOI: 10.1016/S1665-2681(19)31988-X PMID: 17151582 TÍTULO: Efficacy of oral L-ornithine-L-aspartate in cirrhotic patients with hyperammonemic hepatic encephalopathy. Results of a randomized, lactu- lose-controlled study AUTORES: Poo JL, Góngora J, Sánchez-Avila F, Aguilar-Castillo S, García-Ramos G, Fernández-Zertuche M, Rodríguez-Fragoso L, Uribe M. SUMMARY: Despite steady progress in therapeutics of liver disease, por- tal systemic encephalopathy remains to be a great challenge for clinicians because of the heterogeneity of neuropsychiatric symptoms, multiple risk factors and complexity on achieving a sustained response. We aimed to evaluate the efficacy of L-Ornithin, L-Aspartate versus lactulose in Mexican patients with hyperammonemic hepatic encephalopathy. A total of 20 pa- tients were randomly allocated to receive either lactulose(n = 10) or L-orni- thine - L-aspartate (n = 10) for 2 weeks. At baseline, patients of both groups were comparable in age (64 +/- 7 versus 60 +/- 6) and degree of hepatic failure according to the Child-Pugh scale (9.2 +/- 1.3 versus 9.2 +/- 1.1). A significant decrease in ammonia levels was observed both in the lactulose group (120.4 +/- 8.1 versus 91.4 +/- 10, p < 0.05) and in the LOLA group (141.6 +/- 9.1 versus 96.9 +/- 9.3, p < 0.05). Moreover, in patients who re- ceived LOLA a significant improvement was observed in mental status (1.0 +/- 0.14 versus 0.4 +/- 0.16, p < 0.05), Number Connection Test (184 +/- 43 versus 88 +/- 7, p < 0.05), asterixis (14.6 +/- 2.8 versus 6.7 +/- 1.5, p < 0.05), as well as EEG findings (6.8 +/- 0.6 versus 8.1 +/- 0.2 cycles per second, p < 0.05). Compliance with study medications was similar between the lactulose group (94%) and the LOLA group (100%). No serious adverse events were reported in the two groups; however, in the lactulose group an increase in the number of weekly defecations was reported, as well as a higher inci- dence of abdominal pain or flatulence. Finally, both patient groups reported an improvement in the Visual Analogue Scale for EuroQol index (51.1 +/- 24.1 versus 61.5 +/- 15.8, p < 0.05, in the lactulose group; 56.5 +/- 24.5 versus 70 +/- 19.4, p < 0.05, in the LOLA group). In conclusion, oral ad- ministration of lactulose or L-ornithine - L-aspartate to Mexican patients with cirrhosis and hyperammonemic encephalopathy significantly reduced serum ammonia levels in study groups and additionally improved mental status pa- rameters, number connection test, asterixis scores, and EEG activity in the group receiving L-ornithine-L-aspartate. CITA: Ann Hepatol. Oct-Dec 2006;5(4):281-8 DOI: 10.1016/S1665-2681(19)31989-1 56

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 17151583 TÍTULO: Necrotizing hepatitis and intrahepatic cholestasis associated to Cryptococcus sp. and Pneumocystis carinii AUTORES: Méndez-Sánchez N, Pichardo-Bahena R, Castrejón HV, Ber- ron-Pérez RD, Hernández-Bautista VM, Soto-Ramírez L, Alessio LP. SUMMARY: Case report CITA: Ann Hepatol. Oct-Dec 2006;5(4):289-90 DOI: 10.1016/S1665-2681(19)31990-8 PMID: 17203555 TÍTULO: The efficacy of adipokines and indices of metabolic syndrome as PMID: 17542273 predictors of severe obesity-related hepatic steatosis AUTORES: Méndez-Sánchez N, Chávez-Tapia NC, Medina-Santillán R, Villa AR, Sánchez-Lara K, Ponciano-Rodríguez G, Ramos MH, Uribe M. SUMMARY: The aim of this study was to investigate adiponectin, leptin, and metabolic syndrome as predictors of the severity of obesity-related steato- sis. By ultrasonography steatosis-positive (cases) subjects (n = 141) were compared with controls (n = 111). Demographic and anthropometric data and serum concentrations of adiponectin, leptin, and insulin were measured. The impact of several criteria of metabolic syndrome, serum adiponectin concentrations, and serum leptin concentrations were tested using a mul- tivariate logistic regression analysis. The frequency of metabolic syndrome was higher in cases (44.0% versus 9.2%; P < .0001). Cases were older and had higher insulin resistance, waist circumference, and lower concentrations of adiponectin (all P < .001). The upper adiponectin quartile was associated with a lesser grade of steatosis. Metabolic syndrome and adiponectin con- centrations were independently associated with the probability of steatosis. In conclusion, adipokines and metabolic syndrome are useful indices for the prediction of the severity of obesity-related steatosis. CITA: Dig Dis Sci. 2006 Oct;51(10):1716-22 DOI: 10.1007/s10620-006-9093-5 TÍTULO: [Surgical treatment of hemorroids with rectal mucosal resection us- ing a stapler] AUTORES: Correa-Rovelo JM, Tellez O, Moran S, Bahena-Aponte JA, Mo- reno CA. OBJECTIVE: To analyze the results of Longo stapled mucosectomy for hemorrhoidal disease in a 1 to 3 years follow up. PATIENTS AND METHODS: Clinical response and complications where an- alyzed in patients treated for grade II to IV non-complicated hemorrhoidal disease with Longo stapled hemorrhoidectomy. RESULTS: In a 27 months period, 160 patients were treated (105 men and 55 women), mean age was 44.1 years (range: 24 to 72 years), and 110 patients had grade III hemorrhoid disease. Non procedure complications were noted, early complications were detected in 5% of patients and late complications were detected in 10% of patients. In a mean follow-up of 18.8 months, 82.5% of the patients remained asymptomatic and 94.4 of the pa- tients reported a good satisfaction score. A second surgery was required in three patients because of recurrence. 57

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 17542278 CONCLUSION: Longo stapled mucosectomy is a safe treatment for non complicated hemorrhoid disease. In a 18 month follow up most patients were 2007 asymptomatic. CITA: Rev Gastroenterol Mex. Oct-Dec 2006;71(4):422-7 TÍTULO: [Prevalence of NAFLD and metabolic syndrome in asymtomatics subjects] AUTORES: Lizardi-Cervera J, Laparra DI, Chávez-Tapia NC, Ostos ME, Esquivel MU. SUMMARY: Non Alcoholic Fatty Liver Disease (NAFLD) is a frequent entity to progress to liver fibrosis and cirrhosis, and it is associated with several metabolic disturbances. The insulin resistance is often considered the link between metabolic disturbances and NAFLD. The aim of this study was to determine the prevalence of NAFLD in healthy population and the preva- lence of metabolic syndrome in this patients. The associated factors to de- velop liver cirrhosis were identified. METHODS: 2,503 records were reviewed and the presence of steatosis was determined by ultrasonography. A clinical and biochemical examination was carried out and the metabolic criteria were defined according to the ATP III. RESULTS: 427 (17.05%) patients with NAFLD were detected. 359 (14.3%) with NAFLD were included, the mean age was 46.26 +/- 9.85 years. Over- weight was present in 46.79% and obesity in 36.49% of patients. The asso- ciation between DM, HAS, high levels of cholesterol and triglicerides was found in 3.6, 13.6, 63 and 43%, respectively. Steatohepatitis was found in in 34% of patients high levels of AST. AST/ALT ratio > 1 was detected in 76 pa- tients (21.16%). According to the ATP III criteria, the prevalence of metabolic syndrome in patients with NAFLD was 22.8%. CONCLUSIONS: The frequency of NAFLD and metabolic syndrome in this study was 14.3% and 22.8%, respectively. Overweight, obesity and dyslipid- emia were the main associated factors to NAFLD. CITA: Rev Gastroenterol Mex. Oct-Dec 2006;71(4):453-9 PMID: 17055469 TÍTULO: Role of diet in cholesterol gallstone formation AUTORES: Méndez-Sánchez N, Zamora-Valdés D, Chávez-Tapia NC, Uribe M. BACKGROUND: There is a high prevalence of gallstone disease in West- ern countries as a consequence of genetic, biochemical, and environmental factors. Animal and clinical studies have explored the importance of dietary elements. Overwhelming but conflicting information has been reported about the relationship between specific dietary components and gallstone disease. Although the detailed biochemical pathways have been described in experi- mental models, human studies are mainly epidemiological. METHODS: We performed a Medline search with the terms \"diet\", \"gall- stones\", \"cholesterol\", \"risk factors\", including results from 1965 to 2006 and the author's personal library to review the relationship between dietary fac- tors and cholesterol gallstone disease. 58

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 17133184 RESULTS: We identified over 150 references and present their results with PMID: 17297431 respect to the author's criteria. CONCLUSIONS: The best delineated relationship between cholesterol gall- stones and diet was found in the studies that analyzed total calorie intake, refined sugars and fiber. The possible mechanisms are discussed in base of experimental studies. CITA: Clin Chim Acta. 2007 Feb;376(1-2):1-8 DOI: 10.1016/j.cca.2006.08.036 TÍTULO: Severe stunned myocardium after lightning strike AUTORES: Rivera J, Romero KA, González-Chon O, Uruchurtu E, Márquez MF, Guevara M. OBJECTIVE: To report the development of myocardial stunning and severe heart failure after lightning strike with total recovery of function. DESIGN: Case report. SETTING: Coronary care unit at Medica Sur Clinic, Mexico. PATIENT: A 42-yr-old woman who was hit by lightning developed rapid and progressive hemodynamic deterioration manifested by cardiogenic shock that required invasive monitoring. Twenty-four hours after the strike, intrave- nous levosimendan and intra-aortic balloon pump were initiated because the patient demonstrated no significant response to management with conven- tional inotropic agents. Two days later, echocardiographic signs of systolic and diastolic dysfunction improved markedly. Dual-isotope-imaging myocar- dial perfusion testing with technetium-99m-sestamibi and thallium-201, per- formed 9 days after admission, showed normal perfusion and normal left ventricular systolic function. The patient exhibited complete recovery of func- tion. The exact mechanism of abnormal contractility in the absence of direct electrofulguration is unknown but may be explained by release of oxygen free radicals, proteolysis of the contractile apparatus, and cytosolic overload of intracellular calcium, followed by reduced myofilament sensitivity to calci- um. These abnormalities are consistent with stunned myocardium. CONCLUSIONS: Lightning strike may cause serious contractile dysfunction in the absence of irreversible myocardial injury, but the exact mechanism of this phenomenon remains unknown. We propose that lighting strike can cause myocardial stunning resulting in severe but reversible left ventricular dysfunc- tion. The patient's recovery was facilitated by support treatment including ad- ministration of levosimendan, which increases the intracellular sensitivity to calcium, a mechanism disturbed in patients with myocardial stunning. CITA: Crit Care Med. 2007 Jan;35(1):280-5 DOI: 10.1097/01.CCM.0000251129.70498.C1 TÍTULO: Hepatic pseudolesion frequent image at multislice computed tomogra- phy AUTORES: Rumoroso A. SUMMARY: Case report CITA: Ann Hepatol. Jan-Mar 2007;6(1):61-2 DOI: 10.1016/S1665-2681(19)31955-6 59

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 17386238 TÍTULO: Incidental finding of horseshoe kidneys in whole-body 18F-FDG PET/CT evaluation AUTORES: Roldán-Valadez E, Ortega-López N, Vega-González I, Valdivie- so-Cárdenas G, Rumoroso-García A, Morales Santillán O. SUMMARY: Case report CITA: Rev Esp Med Nucl. Mar-Apr 2007;26(2):105-6 DOI: 10.1157/13099951 PMID: 17403181 TÍTULO: Current concepts in the pathogenesis of nonalcoholic fatty liver PMID: 17429740 disease AUTORES: Méndez-Sánchez N, Arrese M, Zamora-Valdés D, Uribe M. SUMMARY: Nonalcoholic fatty liver disease (NAFLD) is an increasingly recognized cause of chronic liver disease, representing the leading cause of hepatology referral in some centres. However, its pathophysiology is not completely understood. Insulin resistance is one of the major mechanisms involved in disease prevalence and progression. Owing to the lack of an ef- fective pharmacological therapy, recommendations on treatment are scarce and are based mainly on lifestyle changes, including diet and exercise. A review of the current literature on pathogenesis of NAFLD is presented in this article. CITA: Liver Int. 2007 May;27(4):423-33 DOI: 10.1111/j.1478-3231.2007.01483.x TÍTULO: Eosinophilic gastroenteritis: a review AUTORES: Méndez-Sánchez N, Chávez-Tapia NC, Vazquez-Elizondo G, Uribe M. SUMMARY: Méndez-Sánchez N, Chávez-Tapia NC, Vazquez-Elizondo G, Uribe M. CITA: Dig Dis Sci. 2007 Nov;52(11):2904-11 DOI: 10.1007/s10620-005-9011-2 PMID: 17458697 TÍTULO: Association among C-reactive protein, Fatty liver disease, and car- diovascular risk AUTORES: Lizardi-Cervera J, Chavez-Tapia NC, Pérez-Bautista O, Ra- mos MH, Uribe M. SUMMARY: Nonalcoholic fatty liver disease (NAFLD) is associated with several metabolic disturbances involving inflammation. Ultrasensitive C-re- active protein (uCRP), a marker of coronary heart disease and other chronic diseases, has not been investigated in NAFLD. We tested the relationship between uCRP and NAFLD in middle-aged asymptomatic subjects, inde- pendently of other metabolic disturbances associated with metabolic syn- drome and cardiovascular risk. We compared 310 subjects with steatosis 60

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 17524310 visible on ultrasound (cases) with 630 and without (controls). Body mass PMID: 17691941 index (BMI), blood pressure and serum levels of uCRP, glucose, lipids, and lipoproteins were measured in all subjects. Differences between groups and the impact of serum uCRP levels were tested by univariate and multivariate logistic regression analysis. Cases were statistically different from controls in the frequency of metabolic syndrome (66.4% vs. 26.7%; P < 0.001). Cas- es were significantly older (P < 0.001), and had significantly higher values for BMI, glucose, total cholesterol and triglycerides (P < 0.001), and mean uCRP concentrations (4.5 vs. 2.79 mg/L; P < 0.001). By univariate analysis, variables significantly associated with cases were glucose (OR, 4.09; 95% CI, 2.98-5.61), BMI (OR 5.54; 95% CI, 4.09-7.49), and uCRP (OR 7.06; 95% CI, 4.51-11.02). By multivariate analysis, uCRP levels were associated with hepatic steatosis (OR 5.83; 95% CI, 3.07-11.06). Cardiovascular risk was also higher in subjects with NAFLD (4.7 vs. 2.8). Subjects with hepatic ste- atosis showed an increased concentration of uCRP independently of other metabolic disturbances; this suggests an increased risk of cardiovascular diseases and could be used as a marker of chronic inflammation. CITA: Dig Dis Sci. 2007 Sep;52(9):2375-9 DOI: 10.1007/s10620-006-9262-6 TÍTULO: Non-resected solid papillary epithelial tumor of the pancreas: 18F-FDG PET/CT evaluation at 5 years after diagnosis AUTORES: Roldán-Valadez E, Rumoroso-García A, Vega-González I, Valdivieso-Cárdenas G, Morales-Santillán O, Osorio-Cardiel L. SUMMARY: Solid and papillary epithelial neoplasm of the pancreas (SPEN) is an encapsulated, slowly enlarging abdominal mass that generally shows no evidence of capsular invasion, regional lymph node involvement, or dis- tal metastases. We present a 68 years old Hispanic male diagnosed with SPEN 5 years earlier that refused surgical excision. Presently he under- went a whole-body 18F-FDG PET/CT. Although tumor size, location and CT features did not seem to depict significant changes, FDG-PET was useful showing persistent tumoral activity. A brief review of the differential diagnosis as well as the usefulness of FDG-PET in SPEN (a slow growing pancreatic neoplasm) is presented. CITA: Rev Esp Med Nucl. May-Jun 2007;26(3):160-4 DOI: 10.1157/13102486 TÍTULO: Hepatobiliary diseases and insulin resistance AUTORES: Méndez-Sánchez N, Chávez-Tapia NC, Zamora-Valdés D, Me- dina-Santillán R, Uribe M. SUMMARY: In recent years, there has been an increasing prevalence of obesity and related diseases. This epidemiological change has increased the interest of researchers in the molecular and biochemical pathways in- volved in the pathogenesis of hepatic and biliary diseases. Insulin resistance is considered the major mechanism involved in the hepatic and biliary man- ifestations of obesity. Epidemiological, clinical, and basic research demon- strates that insulin resistance is associated with gallstone disease, nonal- coholic fatty liver disease, and poor outcomes in viral hepatitis C treatments. Fascinating experimental evidence demonstrates that fat-induced hepatic in- 61

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 17786150 sulin resistance may result from the activation of kinases leading to impaired PMID: 17919226 insulin signaling. The insulin-resistant state is characterized by a failure to suppress hepatic glucose production and glycogenolysis, with enhanced PMID: 17959916 fat accumulation in hepatocytes because of increased lipolysis, increased free fatty acid uptake by hepatocytes, and increased hepatic synthesis of tri- glycerides. This molecular signaling induces a low-grade chronic inflamma- tory state, characterized by increased levels of proinflammatory molecules and acute-phase proteins. This review summarizes the most important mo- lecular and biochemical issues in the hepatic and biliary diseases associated with insulin resistance. CITA: Curr Med Chem. 2007;14(18):1988-99 DOI: 10.2174/092986707781368540 TÍTULO: Worldwide mortality from cirrhosis AUTORES: Méndez-Sánchez N, Villa AR, Zamora-Valdés D, Morales- Espinosa D, Uribe M. SUMMARY: Letter to the editor CITA: Ann Hepatol. Jul-Sep 2007;6(3):194-5 DOI: 10.1016/S1665-2681(19)31930-1 TÍTULO: Treating nonalcoholic fatty liver disease AUTORES: Méndez-Sánchez N, Arrese M, Zamora-Valdés D, Uribe M. SUMMARY: Nonalcoholic fatty liver disease (NAFLD) is a chronic illness with multiple consequences. The spectrum of disease ranges from simple steatosis, with benign prognosis, to a potentially progressive form, nonalcoholic steato- hepatitis, which may lead to liver fibrosis and cirrhosis, leading to an increase in morbidity and mortality. Furthermore, hepatocellular carcinoma incidence in NAFLD is comparable with that observed in hepatitis C-infected patients once cirrhosis is established. Current therapy is limited to lifestyle changes and control of associated metabolic disorders; however, new treatments are on the way from basic research to bedside. A review of the current literature on treatment of nonalcoholic fatty liver disease is presented in this article. CITA: Liver Int. 2007 Nov;27(9):1157-65 DOI: 10.1111/j.1478-3231.2007.01567.x TÍTULO: Tomographic findings in traumatic globe evulsion caused by blunt head trauma AUTORES: Roldan-Valadez E, Corona-Cedillo R, Rojas-Marin C, Valdivie- so-Cardenas G, Sanchez-Sanchez JM, Quiroz-Mercado H. SUMMARY: Evulsion of the globe as a result of trauma is a rarity; to the best of our knowledge, only four \"evulsions of the globe\" have been described. We present the case of a 35-year-old Hispanic woman with traumatic evul- sion of the right eye and subarachnoid haemorrhage. The management of brain injury was the priority over preservation of globe structures. We briefly 62

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 17966372 describe the tomographic features of this uncommon situation and the pro- PMID: 7966373 posed \"evulsion\" mechanism. PMID: 17970562 CITA: Br J Radiol. 2007 Oct;80(958):e247-9 DOI: 10.1259/bjr/77061359 TÍTULO: Splenic hydatidosis: a rare differential diagnosis in a cystic lesion of the spleen AUTORES: Rodríguez-Leal GA, Morán-Villota S, Milke-García Mdel P. SUMMARY: Cystic tumours of the spleen are generally rare, and a parasit- ic origin is relatively unlikely. The present case report shows, however that when a splenic cyst is found, the differential diagnosis must always consider the possibility of echinococcosis. We report the case of a patient suffering from a cystic lesion of the spleen where surgery and histopathology yielded the diagnosis of splenic echinococcosis. Abdominal pain in the left upper quadrant and splenomegaly detected by simple abdominal radiology are the most commonly found indicators for this disease. The treatment should be surgical, attempting to preserve as much splenic tissue as possible, although conservative treatment is frequently unfeasable due to massive involvement of the spleen. Although rare, splenic hydatidosis should be included in the differential diagnosis when a cystic splenic lesion is identified with sonogra- phy or CT scan. CITA: Rev Gastroenterol Mex. Apr-Jun 2007;72(2):122-5 TÍTULO: [Imaging diagnosis of infantile hypertrophic pyloric stenosis: report of a case and review of the literature] AUTORES: Roldán-Valadez E, Solórzano-Morales S, Osorio-Peralta S. SUMMARY: Infantile hypertrophic pyloric stenosis (IHPS) is familiar to most pediatric and general practitioners, it is a pathology where the radiologist now- adays has a key role confirming the clinical suspicion based in ultrasound and upper-gastrointestinal barium examinations. There is hypertrophy and hyper- plasia of the antropyloric portion of the stomach, which becomes abnormally thickened, it manifests as obstruction to gastric emptying. Infants with IHPS are clinically normal at birth, but they develop a nonbilious forceful vomiting during the first weeks of postnatal life, which is described as \"projectile\". Sur- gical treatment is curative. The clinical diagnosis hinges on palpation of the thickened pylorus. Imaging findings include the \"string sign\" (elongation of the pyloric canal) and the \"double-track sign\" (presence of linear tracts of contrast material separated by the intervening mucosa) on fluoroscopic observation. Sonographic examination demonstrates the thickened prepyloric antrum bridging the duodenal bulb and distended stomach. We present the case of a 26-days-old infant with IHPS; presenting this case we make a brief review of the clinical features and main imaging findings of IHPS. CITA: Rev Gastroenterol Mex. Apr-Jun 2007;72(2):126-32 TÍTULO: [Use of the orthofix intramedullary nail in tibial shaft fractures. A review of 22 cases] AUTORES: García Juárez JD, Aguilera Zepeda JM, Bienvenu AT, Encalada Díaz MI, Sheldon OD. 63

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 18007562 INTRODUCTION: Tibial shaft fractures are common since they account for PMID: 18007563 9% of all fractures. Intramedullary nailing is described in the literature as the PMID: 18246938 gold standard for their treatment and the most recent research emphasizes minimum exposure. OBJECTIVE: To present the clinical and radiological course of closed, un- reamed intramedullary fixation for tibial shaft fractures in a group of patients seen at Medica Sur Hospital. MATERIAL AND METHODS: Twenty-two male patients with a diagnosis of tibial shaft fracture were analyzed retrospectively; mean age was 28 years. In all of them the Orthofix nail was inserted through the patellar tendon, with a closed approach and without reaming the medullary cavity. RESULTS: Twenty patients had closed fractures (90.90%) and 2 patients had open fractures (9.09%). The mean time to starting ambulation with protected weight bearing was two weeks in 18 patients (81.81%); with full weight bearing, six weeks in 13 patients (91%). The mean time to full weight bearing without crutches was 10 weeks in 21 patients (95.45%). Mean ra- diographic grade III-IV healing time was 16 weeks. Complications were: de- layed union in two patients (9.09%), compartmental syndrome, in one patient (4.45%). CONCLUSION: The Orthofix interlocking intramedullary nail placed with a closed approach provides immediate stability due to the proximal and distal locking. Patient rehabilitation is quicker, with total mobility, providing an early stimulation for callus formation and the added benefit of sparing the endoste- al blood supply. CITA: Acta Ortop Mex. Jul-Aug 2007;21(4):212-6 TÍTULO: Hepatocellular carcinoma in Hispanics AUTORES: Méndez-Sánchez N, Zamora-Valdés D, Vásquez-Fernández F, Uribe M. SUMMARY: Letter to the editor CITA: Ann Hepatol. Oct-Dec 2007;6(4):279-80 DOI: 10.1016/S1665-2681(19)31913-1 TÍTULO: Experimental evidence of obstructive sleep apnea syndrome as a second hit accomplice in nonalcoholic steatohepatitis pathogenesis AUTORES: Zamora-Valdés D, Méndez-Sánchez N. SUMMARY: Letter to the editor CITA: Ann Hepatol. Oct-Dec 2007;6(4):281-3. DOI: 10.1016/S1665-2681(19)31914-3 TÍTULO: [Wallenberg syndrome: magnetic imaging findings and clinical cor- relation] AUTORES: Roldán-Valadez E, Juárez-Jiménez H, Corona-Cedillo R, Martí- nez-López M. 64

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 18246939 SUMMARY: Wallenberg's syndrome is one of the most common clinically PMID: 18269080 recognized conditions due to brain stem infarct, which can nowadays be identified by modern neuro-imaging techniques. We describe a patient com- plaining of miosis, dysphonia, and dysphagia followed by ataxia. An MRI evaluation was performed including diffusion-weighted imaging, apparent diffusion coefficient, T2-weighted images, fluid attenuated inversion recovery (FLAIR) and perfusion. A brief discussion of imaging findings is presented as well as a clinical correlation of the symptoms with the anatomic location of the lesion. This case report emphasizes the importance of imaging findings and their clinical correlation with neurological examination. CITA: Gac Med Mex. Sep-Oct 2007;143(5):429-32 TÍTULO: [Mesial temporal sclerosis in temporal lobe epilepsy: quantitative magnetic resonance imaging assesment with 3.0 Tesla] AUTORES: Roldán-Valadez E, Corona-Cedillo R, Cosme-Labarthe J, Martínez-López M. SUMMARY: Recent studies show that up to 70% of patients with temporal lobe epilepsy (TLE) have a hippocampal deficit known as temporal mesial sclerosis (TME) characterized by neuron loss and gliosis, and considered the main epileptogenic focus among this type of patients. The magnetic resonance imaging (MRI) features of TME include atrophy and hippocam- pus hyperintensity in the long TR sequences (Flair and T2). The 3.0 Tesla MRI allows the study of the brain's anatomy and physiology using different sequences and post processing mechanisms. Volumetry can determine the accurate volume and, together with spectroscopy, makes possible a quan- titative assessment of the hyppocampus. Both techniques help to locate cerebral areas with epileptogenic activity. We describe the imaging findings from spectroscopy and volumetry in a patient with TLE and briefly review the related literature. CITA: Gac Med Mex. Sep-Oct 2007;143(5):433-6 TÍTULO: [A review of current concepts in evidence-based radiology] AUTORES: Roldán-Valadez E, Lee A, Jiménez-Corona A, Vega-González I, Martínez-López M, Vázquez-LaMadrid J. SUMMARY: It has been noted that \"Good doctors use both individual clini- cal expertise and the best available external evidence, and neither alone is enough. \" Evidence-based medicine (EBM) is defined as the process of sys- tematically finding, critically appraising, and using contemporary research published in the medical literature as a basis to make decisions regarding individual patient care and health care policy. In radiology, including its diag- nostic and interventional aspects, the principles and practice of EBM have not been thoroughly studied. In this brief review article, we describe key as- pects of evidence-based radiology (EBR), concepts and steps followed in EBM and meta-analysis. The skills required to practice EBR are identified, and the roles of EBR in radiologic practice, education, and research are dis- cussed. The application of EBM principles to diagnostic imaging facilitates the interpretation of imaging studies and produces a sound and comprehen- sive radiologic evaluation. This review could be useful for radiologists and clinicians at any stage of their training or career. It encourages the practice of EBM and EBR especially in developing countries. CITA: Gac Med Mex. Nov-Dec 2007;143(6):489-97 65

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 18269081 TÍTULO: [Are statins a therapeutic alternative in sepsis?] AUTORES: Carrillo-Esper R, Rivera-Buendía S, Carrillo-Córdova JR, Car- PMID: 18416041 rillo-Córdova LD. PMID: 18595324 SUMMARY: Sepsis continues to be a major cause of morbidity and mor- tality. Evidence is emerging from observational studies and basic science research that statins might be associated with reduced mortality in sepsis. Statins have diverse immunomodulatory and antiinflammatory properties in- dependent of their lipid-lowering ability. The protective association between statins and sepsis persisted in high-risk subgroups including patients with diabetes mellitus, those with malignancy, and those receiving steroids. This review discusses the basis of these observations and the current place of statin therapy in patients with sepsis. This is a rapidly growing field of fas- cinating experimental biology. It suggests an urgent need to investigate the pharmacology of these drugs and reappraise their therapeutic indications in critically ill patients. If this finding is supported by prospective controlled trials, statins may play an important role in sepsis related mortality. By the other hand statins are significantly cheaper than other therapies that have been shown to improve outcome in sepsis, and the demonstration of mortal- ity benefit would have enormous cost-benefit implication. CITA: Gac Med Mex. Nov-Dec 2007;143(6):499-503 TÍTULO: [Obesity and not alcoholic esteatohepatits] AUTORES: Esquivel MU SUMMARY: Review article CITA: An R Acad Nac Med (Madr). 2007;124(3):599-611 TÍTULO: Effect of Helicobacter pylori infection on gastric ghrelin expression and body weight AUTORES: Méndez-Sánchez N, Pichardo-Bahena R, Vásquez-Fernández F, Lezama-Mora JI, León-Canales AL, Barredo-Prieto B, González-Avila D, Ponciano-Rodríguez G, Uribe M. BACKGROUND & AIM: Ghrelin is a peptide mainly produced by gastric tis- sue playing an important role in energy homeostasis. It has been suggested that inflammatory and atrophic events induced by Helicobacter pylori (H. py- lori) infection in gastric mucosa compromise the survival of the ghrelin-pro- ducing cells. The aim of this study was to investigate the effect of H. pylori infection on gastric ghrelin expression and body weight. METHODS: Consecutive patients referred for upper endoscopy were invited to participate. Patients with H. pylori infection (determined by histology) were defined as cases and patients without infection as controls. The density of colonization was classified in mild, moderate, or severe infection. Body mass index (BMI) was calculated. Ghrelin-immunoreactive cells were quantified in gastric biopsies by immunohistochemical staining. RESULTS: We studied 189 cases (92 males, 97 females) and 94 controls (55 males, 39 females). Cases were older (48.16 +/- 16.44 vs. 42.88 +/- 17.04 years, p < 0.05) and exhibited a lower percentage of ghrelin-immu- noreactive cells (2.13% vs. 10.43%, p < 0.05) than controls. The prevalence 66

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 21960819 of obesity was significantly lower than normal-weight among all cases, in- dependently of the severity of infection (mild infection, 17.6% vs. 47.3%, p 2008 = 0.001; moderate-severe infection, 10.4% vs. 50%, p = 0.001). Univariate analysis showed a non-significant trend suggesting a protective effect of H. pylori against obesity. Nevertheless, BMI did not differ significantly between cases and controls. CONCLUSION: Chronic H. pylori infection contributes to a lower percentage of gastric ghrelin-immunoreactive cells but has no effect on the body weight of infected patients. CITA: Rev Gastroenterol Mex. Oct-Dec 2007;72(4):359-64. TÍTULO: Review AUTORES: Méndez-Sánchez N, Chávez-Tapia NC, Zamora-Valdés D, Uribe M. SUMMARY: Review article CITA: Gastroenterol Hepatol (N Y). 2007 Feb;3(2):105-7 PMID: 18069975 TÍTULO: Gallstones are associated with carotid atherosclerosis AUTORES: Méndez-Sánchez N, Zamora-Valdés D, Flores-Rangel JA, Pérez-Sosa JA, Vásquez-Fernández F, Lezama-Mora JI, Vázquez-Elizondo G, Ponciano-Rodríguez G, Ramos MH, Uribe M. BACKGROUND/AIMS: Gallstone disease (GD) and cardiovascular disease (CD) are common diseases worldwide with considerable economical impact and they are strongly associated. Carotid atherosclerosis is an excellent marker of risk for CD like stroke and myocardial infarction. The aim of this study was to assess the association between gallstones and carotid athero- sclerosis. METHODS: A cross-sectional study was conducted. We evaluated subjects with ultrasonographical evidence of GD and asymptomatic subjects without such evidence. Anthropometric, clinical and biochemical variables were col- lected. The Metabolic syndrome was evaluated using adult treatment panel III criteria. Carotid artery intima-media thickness (CIMT) was determined by a standard ultrasound protocol. Insulin-like growth factor-1 (IGF-1) serum levels were measured in all subjects. RESULTS: We studied 191 subjects: 62 subjects with GD (53.2% males) and 129 asymptomatic subjects without GD (65.9% males). Subjects with GD ex- hibited a higher body mass index, body fat percent, insulin serum levels and CIMT (P<0.05 for all). The prevalence of GD was higher in subjects with a CIMT>0.75 independently of other factors [odds ratio (OR) 2.12, 95% con- fidence interval (CI) 1.04-4.34; P=0.039], and for every 0.1 mm increase in CIMT the independent probability to be a case of GD increased by a factor of 1.25 (95% CI 1.02-1.53; P=0.027). IGF-1 levels did not differ among groups. CONCLUSIONS: Subjects with GD exhibit greater carotid atherosclerosis, and therefore have a higher risk for stroke and myocardial infarction. 67

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR CITA: Liver Int. 2008 Mar;28(3):402-6 DOI: 10.1111/j.1478-3231.2007.01632.x PMID: 18208780 TÍTULO: Whole-body (18)F-FDG PET/CT in primary non-Hodgkin's lympho- ma of the thyroid associated with Hashimoto's thyroiditis and bilateral kidney infiltration AUTORES: Roldán-Valadez E, Ortega-López N, Cervera-Ceballos E, Valdivieso-Cárdenas G, Vega-González I, Granados-García M. SUMMARY: An 82-year-old female patient with hypothyroidism and Hashimoto's thyroiditis noted three years ago to have a small asymmetric goiter (left > right). Nevertheless, a rapid growth of the thyroid over 3-6 months caused dysphagia and shortness of breath. Ultrasound and a thyroid gammagram showed an image consistent with multinodular goiter with a hy- perfunctioning nodule in the right lobe. Due to the history of Hashimoto's thy- roiditis and a rapid increase in size of the thyroid gland, diagnoses of thyroid lymphoma and anaplastic thyroid cancer were considered. Thyroidectomy was attempted at an outside facility to relieve compressive symptoms. Fine needle aspiration was insufficient for diagnosis, and the product of thyroid- ectomy confirmed the diagnosis of diffuse large B-cell lymphoma. A positron emission tomography/computed tomography scan was performed in our in- stitution for staging, revealing nodal and extranodal metastasis. Chemother- apy using cyclophosphamide, vincristine and dexamethasone (COP modi- fied) led to a dramatic response of the tumor and a complete resolution of compressive symptoms. CITA: Rev Esp Med Nucl. Jan-Feb 2008;27(1):34-9 DOI: 10.1157/13114368 PMID: 18208781 TÍTULO: (18)F-FDG PET/CT for discrimination between tumor extension and blood thrombus in pancreatic adenocarcinoma associated with portal vein thrombosis AUTORES: Roldán-Valadez E, Ortega-López N, Valdivieso-Cárdenas G, Vega-González I, Herrera-Gómez A. SUMMARY: Pancreatic cancer is a malignancy with an extremely poor prog- nosis. Less than 3 % of patients are alive 5 years after diagnosis. Pancreatic neoplasms represent a possible but uncommon etiology of portal venous invasion. It is important to differentiate the nature of the thrombus, if it is a bland thrombus or is a direct tumor extension. Intense uptake of 18F-fluoro- deoxyglucose ((18)F-FDG) has been reported in portal vein tumor thrombus. We present a case of pancreatic adenocarcinoma and clinical findings of portal hypertension due to portal vein thrombosis. (18)F-FDG positron emis- sion tomography (PET)/computed tomography (CT) evaluation discarded a tumor thrombus; imaging findings of the pancreatic tumor and the bland thrombus are presented. CITA: Rev Esp Med Nucl. Jan-Feb 2008;27(1):40-4 DOI: 10.1157/13114369 68

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 18320915 TÍTULO: European allergen extract units and potency: review of available information AUTORES: Larenas-Linnemann D, Cox LS BACKGROUND: There is considerable variability in how allergen extract potency is measured and reported worldwide. In Europe, where many sub- lingual immunotherapy studies have been conducted, manufacturers report allergen extract potency as units based on an in-house reference, making it difficult to understand the exact doses used and to compare studies. OBJECTIVES: To describe the various methods of expressing extract poten- cy that European allergen extract manufacturers use and to gather reports on the micrograms of major allergen of the in-house units of European aller- gen extract manufacturers. METHODS: Information was derived from 3 sources: data on extract poten- cy in micrograms of major allergen in articles on sublingual immunotherapy found by PubMed (references through October 2005) and in reference arti- cles, brochures on allergen extracts from the manufacturers, and information provided by structured questionnaires e-mailed to the manufacturers. RESULTS: All but 1 of the European allergen extract manufacturers use in- house reference standards that are based on titrated skin prick testing of allergic patients. Subsequently, in vitro tests compare the potency of com- mercial batches with the in-house reference and potency is assigned as ar- bitrary units. Most manufacturers measure major allergen content of their standardized products but do not release this information with the package insert. Diversity in major allergen content was found. CONCLUSIONS: Micrograms of major allergens given in articles on sublin- gual immunotherapy to express the dose administered cannot be used to translate the dose to US extracts. Extract potency can only be compared if uniform test methods and reference extracts are used. CITA: Ann Allergy Asthma Immunol. 2008 Feb;100(2):137-45 DOI: 10.1016/S1081-1206(10)60422-X PMID: 18376365 TÍTULO: Sorafenib, a systemic therapy for hepatocellular carcinoma AUTORES: Méndez-Sánchez N, Vásquez-Fernández F, Zamora-Valdés D, Uribe M. SUMMARY: Hepatocellular carcinoma is a lethal disease that requires a mul- tidisciplinary approach and management. Surgical therapy offers long-term survival; however, few patients are candidates. There has been no accepted systemic therapy for this disease until recently. This article briefly discusses the role of RAS/RAF/MEK/ERK signaling pathway in the pathogenesis of the disease and the promising role of sorafenib for advanced disease. CITA: Ann Hepatol. Jan-Mar 2008;7(1):46-51 DOI: 10.1016/S1665-2681(19)31886-1 69

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 18376369 TÍTULO: Hepatic expression of ghrelin and adiponectin and their receptors in patients with nonalcoholic fatty liver disease AUTORES: Uribe M, Zamora-Valdés D, Moreno-Portillo M, Berme- jo-Martínez L, Pichardo-Bahena R, Baptista-González HA, Ponciano-Rodrí- guez G, Uribe MH, Medina-Santillán R, Méndez-Sánchez N. BACKGROUND & AIM: Adiponectin and ghrelin are hormones that partic- ipate in hepatic lipid metabolism, and their expression in liver tissue could have important implications for nonalcoholic fatty liver disease (NAFLD). The aim of this study was to evaluate the hepatic expression of ghrelin, adi- ponectin, AdipoR, and IL-6 in patients with NAFLD and normal liver. METHODS: We studied patients with clinical-pathological diagnosis of NAFLD or a normal liver. Patients were classified according to their diag- nosis into three groups: normal liver, nonalcoholic hepatic steatosis, and nonalcoholic steatohepatitis (NASH). Adiponectin, AdipoR1, AdipoR2, IL-6, and ghrelin mRNA levels were assessed in biopsies by reverse transcrip- tase-polymerase chain reaction. RESULTS: Of the 21 patients, three had a normal liver biopsy, 14 had nonal- coholic steatosis, and four had NASH. Patients with NAFLD exhibited signifi- cantly higher HOMA-IR and triglyceride concentration (both P<0.05). There was a nonsignificant trend towards higher ghrelin expression in patients with NASH > nonalcoholic steatosis > normal liver. Patients with NASH had significantly higher mRNA adiponectin levels and lower IL-6 levels than did those with a normal liver (P<0.05). AdipoR expression did not differ signifi- cantly between groups. CONCLUSION: Adiponectin overexpression was observed in patients with NASH. The role of hepatic ghrelin in NAFLD requires further research. CITA: Ann Hepatol. Jan-Mar 2008;7(1):67-71 DOI: 10.1016/S1665-2681(19)31890-3 PMID: 18376374 TÍTULO: Interstitial pneumonitis associated with pegylated interferon al- pha-2b therapy for chronic hepatitis C: case report AUTORES: Carrillo-Esper R, González-Avila D, Uribe-Ríos M, Mén- dez-Sánchez N. SUMMARY: Since 2004, pegylated interferon (P-IFN) in combination with ribavirin has become the optimal choice of therapy for chronic hepatitis C virus (HCV) infection. IFN a-2b suppresses HCV replication and restores elevated serum aminotransferase levels, leading to improvements in the his- tological changes in the livers of patients with chronic hepatitis C. Unfortu- nately, P-IFN has several adverse effects, including pneumonitis. This com- plication has been reported in the treatment of malignant diseases and CHC. We report a patient with interstitial pneumonitis thought to be caused by an IFN-based treatment in an unusual scenario of a patient with HCV-related Child-Pugh stage A cirrhosis, who experienced dyspnea, fever, and cough after 12 months of treatment with P-IFN a-2b. Her lung injury and pulmonary symptoms did not disappear despite discontinuation of IFN and the admin- istration of corticosteroid. We concluded that the patient developed a fatal interstitial pneumonitis associated with P-INF a-2b therapy. CITA: Ann Hepatol. Jan-Mar 2008;7(1):87-90 DOI: 10.1016/S1665-2681(19)31895-2 70

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 18430309 TÍTULO: Sublingual immunotherapy: dosing in relation to clinical and immu- nological efficacy AUTORES: Larenas-Linnemann DE. SUMMARY: An increasing number of clinical immunotherapy trials have been published in the United States and Europe. In the allergy community on both sides of the Atlantic, there is a growing interest in obtaining a better understanding of the allergen doses used in these studies. The question of effective allergen dose is particularly important in sublingual immunotherapy, but the effective dose range still is to be determined. CITA: Allergy Asthma Proc. Mar-Apr 2008;29(2):130-9 DOI: 10.2500/aap.2008.29.3093 PMID: 18498918 TÍTULO: Bioavailability of two single-dose oral formulations of omeprazole 20 mg: an open-label, randomized sequence, two-period crossover compari- son in healthy Mexican adult volunteers AUTORES: Poo JL, Galán JF, Rosete A, de Lago A, Oliva I, González-de la Parra M, Jiménez P, Burke-Fraga V, Namur S. BACKGROUND: Omeprazole is a proton-pump inhibitor that acts to reduce acid secretion in the stomach and is used for treating various acid-related gastrointestinal disorders. There are several generic formulations of ome- prazole available in Mexico; however, a literature search failed to identify published data concerning the bioavailability of these formulations in the Mexican population. OBJECTIVE: The aim of this study was to compare the bioavailability of 2 oral formulations of omeprazole 20-mg capsules, marketed for use in Mex- ico, in healthy volunteers: Inhibitron (test formulation) and LosecA 20 mg (reference formulation). METHODS: This study used a single-dose, open-label, randomized se- quence, 2 x 2 crossover (2 administration periods x 2 treatments) design to compare the 2 formulations. Eligible subjects were healthy adult Mexican volunteers of both sexes. Subjects were randomly assigned in a 1:1 ratio to receive a single 20-mg dose of the test formulation followed by the reference formulation, or vice versa, with a 7-day washout period between adminis- tration periods. After a 12-hour (overnight) fast, subjects received a single, 20-mg dose of the corresponding formulation. Plasma samples were ob- tained over a 12-hour period after administration. Plasma omeprazole con- centrations were analyzed by a nonstereospecific high-performance liquid chromatography method. For analysis of pharmacokinetic properties, includ- ing C(max), AUC from time 0 (baseline) to time t (AUC(0-t)), and AUC from baseline to infinity (AUC(0-infinity)), blood samples were drawn at baseline and 0.17, 0.33, 0.50, 0.75, 1, 1.25, 1.50, 1.75, 2, 2.50, 3, 4, 6, 8, and 12 hours after administration. The formulations were considered bioequivalent if the natural log (ln)-transformed ratios of C(max) and AUC were within the predetermined equivalence range of 80% to 125%, and if P <or= 0.05 for the 90% CIs. Tolerability was determined by clinical assessment, monitoring vital signs, laboratory analysis results, and subject interviews regarding ad- verse events (AEs). AEs were considered serious when the patient outcome was death, life threatening, required hospitalization, led to disability, or re- quired intervention to prevent permanent impairment or damage. 71

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR RESULTS: Thirty-four subjects were enrolled and completed the study (25 men and 9 women; mean [SD] age, 24.7 [5.5] years; weight, 64.3 [8.9] kg; and height, 167 [8] cm). Seventeen subjects received the test formulation first. No period or sequence effect was observed. The 90% CIs for the corre- sponding differences of ln C(max), ln AUC(0-t), and ln AUC(0-infinity) were 86.70% to 109.76%, 93.81% to 108.22%, and 102.09% to 114.21%, respec- tively (all, P<0.05), meeting the predetermined criteria for bioequivalence. Eight patients experienced 13 AEs that appeared to be not associated with study drug administration; none of the AEs were considered serious. CONCLUSIONS: In this small study in healthy Mexican adult volunteers, a single, 20-mg dose of the test formulation appeared to be bioequivalent to the reference formulation, based on the rate and extent of absorption. Both formulations were generally well tolerated. CITA: Clin Ther. 2008 Apr;30(4):693-9 DOI: 10.1016/j.clinthera.2008.04.004 PMID: 18499962 TÍTULO: [Critical analysis of awards in gastroenterology research. The Mex- ican experience] AUTORES: Chávez-Tapia NC, Téllez-Avila FI, Hernández-Calleros J, López-Arce G, Franco-Guzmán A, Uribe M. SUMMARY: The impact of Mexican gastrointestinal research worldwide is limited and the outcome of the best research papers awarded by the Aso- ciación Mexicana de Gastroenterología (AMG) is unknown. The objective of this study was to analyze the publication pattern of the research work, awarded by the AMG and their impact in international journals. The abstracts accepted for the annual meeting of the AMG from 1998 to 2006 were re- viewed. Those presented in a plenary session or awarded were included. Their abstracts were searched in electronic databases. When not found, the main author was contacted by e-mail. In those papers published in a journal with an impact factor, the times it was cited were assessed. 35 abstracts were identified, mainly in gastroenterology (57.1%) and hepatology (34.3). Only in 5.7% (n=2) some of the authors were members of the governing board of AMG. The awarded institutions were Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (48.6%), Universities (Universidad Autónoma de Nuevo León, Universidad Nacional Autónoma de México and the Benemérita Universidad Autónoma de Puebla) (31.4%), Instituto Mexica- no del Seguro Social (8.6%), Fundación Clínica Médica Sur (5.7%), Hospital Juárez (2.9%), Private hospital (2.9%). Most of the papers were published within a year (73.7%). Only 2 papers had more than 10 citations in another international journal with impact factor, with a median for all paper of 5 cita- tions (0-45). Considering all institutions, the rate of publication is 48%. Only half of the awarded works were published and mainly in journals of local distribution. The impact of these studies worldwide is limited. CITA: Medicina (B Aires). 2008;68(2):135-8 PMID: 18590033 TÍTULO: [Basic concepts on 18F-FDG PET/CT: definitions and normal vari- ants] AUTORES: Roldán-Valadez E, Vega-González I, Valdivieso-Cárdenas G, Rumoroso-García A, Morales-Santillán O, Osorio-Cardiel L. 72

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR SUMMARY: The PET/CT (positron emission tomography with multislice helical computed tomography), is nowadays one of the leader imaging diagnostic tools in medicine. This technology has been present in Mexico since the last three years. Although the physical principles of PET has been known for more than 30 years, it has been the introduction of PET/CT what let the acquisition and post processing of fused PET/CT images currently used in imaging diagnosis in clinical medicine. These fused PET/CT images allow an accurate localization of the abnormal fluorine-18 Fluorodeoxyglu- cose (18F-FDG) uptake, which can be related to inflammation or neoplastic processes. This article presents a brief review of the fundamentals of PET/ CT, the basic physics principles and examples of normal variants of the 18F-FDG uptake that are not associated with a neoplastic entity. CITA: Gac Med Mex. Mar-Apr 2008;144(2):137-46 PMID: 18626441 TÍTULO: Gallbladder disease in patients with primary sclerosing cholangitis AUTORES: Vázquez-Elizondo G, Muciño-Bermejo J, Méndez-Sánchez N. BACKGROUND/AIMS: Gallbladder abnormalities may be part of the spec- trum in primary sclerosing cholangitis (PSC). The aim of the present study was to evaluate the occurrence and prognostic importance of gallbladder abnormalities in patients with PSC. METHODS: Presence of gallbladder abnormalities was assessed in 286 patients with PSC treated at the Liver Unit, Karolinska University Hospital, Huddinge, between 1970 and 2005. RESULTS: One or more gallbladder abnormalities were found in 41% of the patients. Gallstones were found in 25% and cholecystitis in 25%. Cholecys- titis among patients with extrahepatic involvement of PSC (30% (65/214)) was significantly higher than among those with intrahepatic involvement (9% (6/70)) (P<0.0001). A gallbladder mass lesion with a mean size of 21 (+/-9) mm (S.D.) was found in 18 (6%) patients, in 56% (10/18) of whom it consti- tuted gallbladder carcinoma. In 9 patients without a gallbladder mass lesion, histological re-evaluation disclosed epithelial dysplasia of the gallbladder. CONCLUSIONS: Gallbladder disease is common in patients with PSC. Dys- plasia and carcinoma are commonly found in gallbladder epithelium, sug- gesting that regular examination of the gallbladder in PSC patients could be of value for early detection of a gallbladder mass lesion. Cholecystectomy is recommended when such a lesion is detected, regardless of its size. CITA: Ann Hepatol. Apr-Jun 2008;7(2):182- DOI: 10.1016/S1665-2681(19)31880-0 PMID: 18672755 TÍTULO: [Treatment of cervical disc herniation with total arthroplasty. Case report] AUTORES: Moreno Monter L, Ordóñez Conde LE. SUMMARY: Treatment for discopathy has 3 goals: diminish pain, improve function and avoid recurrence. Fusion with graft, plates and cages is com- mon, leading to greater fusion needing other interventions. Total disc arthro- 73

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR plasty is an alternative that maintains mobility of the affected segment, di- minishes overload and impedes fusion of intersomatic spaces, relieving pain and improving mobility. In this patient, an implant made of 2 chrome-cobalt plates covered with rugged surfaced titanium that helps bone growth and permits mobility was used as an alternative of treatment to disc herniation considering it a minimally invasive and rapid rehabilitation surgery. CITA: Acta Ortop Mex. Jan-Feb 2008;22(1):59-61 PMID: 18697449 TÍTULO: [Practice patterns in Mexican allergologists about skin tests with allergens during 2005-2006] AUTORES: Larenas Linnemann D, Fogelbach GA, Cruz AA. BACKGROUND: Immunotherapy has been practiced since over a hundred years. The exact composition of the immunotherapy concentrate, with which the patient is treated, depends partly on the results of the skin prick tests ap- plied to the allergic patient. As such, the effectiveness of the immunotherapy depends heavily on the quality of the skin prick test. The detailed recommen- dations for the realization of the skin prick tests have evolved and changed over the years, leading to multiple variations in its application in Mexico. OBJECTIVE: We tried to get a picture of the daily practice patterns of the members of CMICA and CoMPedIA concerning the application of skin prick tests. MATERIALS AND METHODS: Aquestionnaire was sent in various occa- sions to all members of the Colegio Mexicano de Inmunologia Clinica y Aler- gia (CMICA) and of the Colegio Mexicano de Pediatras, Especialistas en Inmunologia y Alergia (CoMPedIA). The results are presented descriptively and by calculation of the frequency/percentages of intervals of replies, in the case of numerical responses. RESULTS: A response rate of 61 (17%) was obtained of the College mem- bers, showing consistency in some replies but a wide variation in others, for example in the time certain medication has to be suspended before the execution of the skin prick test. Comparing the replies obtained with recent recommendations in international publications, some discrepancy can be detected. CONCLUSIONS: In some aspects of the survey there is coincidence of the skin test practices among the participants; however, in other items there is an important variation. CITA: Rev Alerg Mex. Jan-Feb 2008;55(1):10-7 PMID: 18753987 TÍTULO: Imaging techniques for assessing hepatic fat content in nonalco- holic fatty liver disease AUTORES: Roldan-Valadez E, Favila R, Martínez-López M, Uribe M, Mén- dez-Sánchez N. SUMMARY: Nonalcoholic fatty liver disease (NAFLD), an emerging clinical entity with worldwide recognition, is today the most common cause of ab- normal liver function tests among adults in the United States. In Mexico City, its prevalence has been reported by our group to be around 14%, but its 74

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR incidence is higher in the hispanic population in the United States (hispanic population 45%, white population 33%, black population 24%). The main is- sues in the diagnosis, follow-up, and management of NAFLD are our limited understanding of its pathophysiology and the difficulties involved in develop- ing a noninvasive diagnostic method. Several imaging techniques can detect fatty infiltration of the liver, each with its own advantages and disadvantages. Ultrasound is still in the first option for diagnosis, but its accuracy depends on the operator and the patient's features. Computed tomography can detect hepatic fat content, but only at a threshold of 30%, and it involves ionizing radiation. Magnetic resonance (MR) spectroscopy is probably the most ac- curate and fastest method of detecting fat, but it is expensive and the neces- sary software is still not easily available in most MRI units. MR elastography, a new technique to detect liver stiffness, has not been demonstrated to de- tect NAFLD, and is still undergoing research in patients with hepatitis and cirrhosis. In conclusion, all these imaging tools are limited in their ability to detect coexisting inflammation and fibrosis. In this review, we discuss the radiological techniques currently used to detect hepatic fat content. CITA: Ann Hepatol. Jul-Sep 2008;7(3):212-20 DOI: 10.1016/S1665-2681(19)31850-2 PMID: 18753989 TÍTULO: Mortality trends for liver cancer in Mexico from 2000 to 2006 AUTORES: Méndez-Sánchez N, Villa AR, Vázquez-Elizondo G, Ponciano- -Rodríguez G, Uribe M. SUMMARY: Hepatocellular carcinoma (HCC) is the most common primary liver cancer, with an estimated incidence of half a million new cases per year around the world. Furthermore, HCC is the third greatest cause of can- cer-related death in the world, and most of these deaths are registered in developing countries. Recently it has been suggested that Hispanics in the United States have high rates of HCC, but no information regarding this is available in Mexico. The aim of this study was to investigate recent trends (2000-2006) in HCC mortality rates in Mexico. METHODS: Data on national mortality (death certificates) reported for the years 2000-2006 by the Health Ministry of Mexico were analyzed (www.sa- lud.gob.mx). HCC as a cause of death was analyzed. Mortality rates were calculated for all population ages. Causes of death related to HCC were se- lected in accordance with the International Classification of Diseases, 10th Revision, Liver Cancer (C22.0, C22.7, C22.9). RESULTS: We found that age-adjusted mortality rates were remarkably higher in men than in women in the period 2000-2006. In addition, we found an increase in the general mortality rates of HCC from 4.1 per 100,000 in 2000 to 4.7 per 100,000 in 2006. CONCLUSIONS: The results of this study suggest an increase in the mor- tality rate for HCC in the period 2000-2006. HCC will become a significant cause of morbidity and mortality in the near future. CITA: Ann Hepatol. Jul-Sep 2008;7(3):226-9 DOI: 10.1016/S1665-2681(19)31852-6 75

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 18798412 TÍTULO: [Evidence-based medicine: benefits, inconveniences and risks of a new dogma] AUTORES: Durá JR. SUMMARY: Progress in biostatistics and epidemiology during twentieth cen- tury contributed to clinical research development. Controversy about the real role of these disciplines in validating clinical activity isn't new: in history of medicine there are evidence since nineteenth century. Evidence-based med- icine is a recent methodology to evaluate clinical investigation that begins to be considered gold standard in knowledge and medical practice evalua- tion. Its method is based mainly in systematized meta-analyses or revisions through which tries to offer answers to concrete clinical questions. These answers are, however, clearly of statistical nature. It is not useful in clinical practice but rather should be focused to teaching-learning process, as well as on the creation of work regulations. Its application implies certain benefits, but also several practical difficulties in cultural, academic and socio-econom- ic fields, due to its use without discriminating. Thus, its correct use is a chal- lenge to contemporary medicine. CITA: Ginecol Obstet Mex. 2008 Mar;76(3):167-73 PMID: 18840372 TÍTULO: Bioavailability of two sublingual formulations of ketorolac trometh- amine 30 mg: a randomized, open-label, single-dose, two-period crossover comparison in healthy Mexican adult volunteers AUTORES: Galán-Herrera JF, Poo JL, Maya-Barrios JA, de Lago A, Oliva I, González-de la Parra M, Jiménez P, López-Bojórquez E, Burke-Fraga V, Namur S. BACKGROUND: Ketorolac tromethamine (ie, ketorolac) is an NSAID that appears to have several mechanisms of action, including inhibition of pros- taglandin synthesis, modulatory effect on opioid receptors, and nitric oxide synthesis. Ketorolac is used in the treatment of pain. There are various ge- neric formulations of sublingual ketorolac available in Mexico. However, a literature search did not identify published data concerning the bioavailability of these formulations in the Mexican population. OBJECTIVE: The aim of this study was to compare the bioavailability of 2 sublingual formulations of ketorolac 30-mg tablets in healthy Mexican adult volunteers. METHODS: This was a randomized-sequence, open-label, single-dose, 2-period crossover (2 dosing periods x 2 treatments) study comparing the bioavailability of two 30-mg sublingual tablet formulations of ketorolac. Healthy Mexican adult (aged, 18-55 years) men and women were eligible for inclusion. Subjects were randomly assigned in a 1:1 ratio to receive a single dose of the test formulation or the reference formulation. After a 12- hour overnight fast, subjects received a single dose of the corresponding for- mulation. There was a 7-day washout period between administration periods. Plasma samples were obtained over a 24-hour period after administration. Plasma ketorolac concentrations were analyzed by high-performance liquid chromatography for analysis of pharmacokinetic properties, including Cmax, AUC0-24, and AUC0-infinity. Blood samples were drawn immediately after sublingual placement of the drug and at 10, 20, 30, 40, 50, 60, 75, and 90 minutes and 2, 4, 6, 8, 10, 12, and 24 hours after dosing. The formulations were considered bioequivalent if the geometric mean ratios of Cmax and 76

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 18940136 AUC were within the predetermined range of 80% to 125% and if P for the PMID 18942271 90% CIs was <0.05. Tolerability was assessed by vital sign monitoring, labo- ratory analysis results, and subject interviews. RESULTS: A total of 27 subjects (18 women, 9 men; mean [SD] age, 27 [9] years [range, 18-47 years]; weight, 61 [8] kg [48-79 kg]; height, 163 [8] cm [150-180 cm]) were enrolled and completed the study. Fourteen subjects re- ceived the test formulation first. No period or sequence effect was observed. The 90% CIs for the corresponding differences in natural log Cmax, AUC0-24, and AUC0-infinity were 95.94% to 114.66%, 98.34% to 105.90%, and 99.25% to 108.36%, respectively (all, (P) < 0.05), meeting the predetermined criteria for bioequivalence. Sixteen subjects experienced a total of 20 adverse events (AEs) during the study. None of the AEs were considered serious. One AE (nausea) appeared to be related to use of the reference formulation. CONCLUSIONS: In this small study in 27 healthy Mexican adult volunteers, the test formulation of a single, 30-mg sublingual tablet of ketorolac ap- peared to be bioequivalent to the reference formulation based on the rate and extent of absorption. Both formulations were well tolerated. CITA: Clin Ther. 2008 Sep;30(9):1667-74 DOI: 10.1016/j.clinthera.2008.09.011 TÍTULO: Subcutaneous and sublingual immunotherapy in children: com- plete update on controversies, dosing, and efficacy AUTORES: Larenas-Linnemann D. SUMMARY: For this review, articles on immunotherapy dosing in pediatric respiratory allergy were identified via PubMed, through congressional ab- stracts for 2008, in reference lists of recent review articles, and via person- al communication with experts. In pediatric subcutaneous immunotherapy (SCIT), doses shown to be effective, mostly in aluminium-adsorbed prepa- rations administered every 6 weeks, contain 20 microg of group 5 major al- lergen, 12 microg Bet v 1, 15 microg Fel d 1, and 5 to 20 microg Der p 1. Evidence indicates that SCIT prevents new sensitizations and asthma onset 7 years after discontinuation and reduces symptoms 12 years after a 5-year SCIT course, even though skin reactivity returns. Consistent evidence of ef- fect exists for sublingual immunotherapy in pediatric respiratory allergy with daily 15- to 25-microg grass group 5 major allergen and 6 microg Bet v 1. Der p/f doses of 0.8/0.4 microg three times weekly (up to 27/57 microg daily) demonstrate inconsistent findings. Evidence of effect exists for SCIT in pe- diatric allergic rhinitis and asthma as treatment and preventive management. Evidence of effect exists for sublingual immunotherapy in pediatric allergic rhinoconjunctivitis and seasonal asthma. Similar results are doubtful for pe- rennial asthma. CITA: Curr Allergy Asthma Rep. 2008 Nov;8(6):465-74 DOI: 10.1007/s11882-008-0087-6 TÍTULO: [Type 1 Arnold Chiari malformation, syringomielia, syringobulbia and IV ventricle entrapment] AUTORES: Carrillo-Esper R, Vázquez-Elizondo G, Gutiérrez-Delgado LG, Guevara-Arnal L, Méndez-Sánchez N. 77

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR SUMMARY: Arnold-Chiari Malformation (ACM) was first described by Hans Chiari in 1890. Four types of this malformation are recognized, of those, type I is the most common among adults. It is caused by an elongation of the cerebellum into the conic projections that accompany the brain stem within the spinal channel. It is mostly congenital but \"acquired\" forms can be seen in the context of infections or posterior fossa tumors. Clinically, it can pres- ent as an asymptomatic finding, but it can produce brain stem compression. Syringomielia--cavitation of the brain stem central areas--is associated with MAC type I in 75 to 85% of cases. Clinical signs include pain, weakness, ex- tremity parestesia. A shunt to the lateral ventricles can produce IV ventricle entrapment and is associated with cerebrospinal fluid blockage. We describe a case of MAC type I associated with the presence of syringomielia, syrin- gobulbia and IV ventricle entrapment. CITA: Gac Med Mex. Jul-Aug 2008;144(4):351-4 PMID: 19034238 TÍTULO: Efficacy of triple therapy with thymalfasin, peginterferon alpha-2a, and ribavirin for the treatment of hispanic chronic HCV nonresponders AUTORES: Poo JL, Sánchez Avila F, Kershenobich D, García Samper X, Torress-Ibarra R, Góngora J, Cano C, Parada M, Uribe M. BACKGROUND/AIMS: Thymalfasin has shown efficacy in the treatment of chronic HCV infection. The aim of this study was to evaluate the efficacy and tolerability of triple therapy with thymalfasin, peginterferon alpha-2a (PEG-IFN alpha-2a), and ribavirin in Hispanic patients with chronic viral hepatitis C who were nonresponders to prior treatment with interferon alfa (IFN-alpha)/ribavirin. METHODS: In this open-label study, 40 subjects received thymalfasin (1.6 mg twice a week), PEG-IFN alpha-2a (180 microg once a week), and ribavi- rin (800-1,000 mg/day) for 48 weeks. All patients had positive HCV RNA by PCR analysis, abnormal levels of ALT, compensated hepatic disease, and liver biopsy with chronic damage. RESULTS: Viral response was observed in 52.5% patients at week 12 and 50% at week 24. Of the per protocol group, 52.6% showed an end-of-treat- ment response at week 48 and 21.1% achieved an SVR at week 72. Among genotype 1 patients, 23.5% achieved an SVR at week 72. A reduction of the dose of PEG IFN alpha-2a and ribavirin was required. Thymalfasin was well tolerated without dose reduction. CONCLUSION: Triple therapy with thymalfasin, PEG IFN alpha-2a, and rib- avirin is an effective treatment option for difficult-to-treat HCV patients who are refractory to prior conventional treatment, with adequate tolerability. CITA: Ann Hepatol. Oct-Dec 2008;7(4):369-75 DOI: 10.1016/S1665-2681(19)31839-3 PMID: 19034240 TÍTULO: A 25 years old women after Kasai operation for biliary atresia AUTORES: Baptista-González H, Ponciano-Rodríguez G, Uribe M, Mén- dez-Sánchez N. SUMMARY: Case report CITA: Ann Hepatol. Oct-Dec 2008;7(4):381 DOI: 10.1016/S1665-2681(19)31841-1 78

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 19043964 TÍTULO: [The cachexia-anorexia syndrome among oncological patients] AUTORES: Sosa-Sánchez R, Sánchez-Lara K, Motola-Kuba D, Green-Ren- ner D. SUMMARY: Approximately two thirds of cancer patients at advanced stages of the disease suffer from anorexia, which leads to significant weight loss and progressive cachexia, an important factor that contributes to death. It has been observed that cancer cachexia differs from simple starvation, al- though the exact mechanisms associated with cancer cachexia are not well known. Several theories regarding its pathogenesis point to a complex mix- ture of tumor, host and treatment variables. Unfortunately, the wasting syn- drome also constitutes for the patient, a progression of the cancer process, significantly affecting quality of life and social interactions. Treatable causes should be identified and treated. Knowledge of the mechanisms underlying the effects of caquexia on the patient may play a role in identifying treatment measures targetted to muscle wasting and to maintain body strength. In this article we review the main features and mechanisms of the anorexia-cachex- ia syndrome in patients with cancer. CITA: Gac Med Mex. Sep-Oct 2008;144(5):435-40 PMID: 19058482 TÍTULO: [Practice patterns in Mexican allergologists about specific immuno- therapy with allergens] AUTORES: Larenas Linnemann D, Guidos Fogelbach GA, Arias Cruz A. BACKGROUND: Immunotherapy has been practiced since over a hundred years. Since the first applications up today changes have occurred in the preparation, dose and duration of the treatment, as well as in the extracts used. Guidelines have been published in Mexico and other countries to try to unify these practice patterns of immunotherapy. PARTICIPANTS AND METHODS: By means of a questionnaire, sent in various occasions to all members of the Colegio Mexicano de Inmunología Clínica y Alergia (CMICA) and of the Colegio Mexicano de Pediatras, Espe- cialistas en Inmunología y Alergia (CoMPedIA) we tried to get a picture of the daily practice patterns of immunotherapy in the allergist's office. Results will be presented in a descriptive manner. RESULTS: A response rate of 61 (17%) was obtained from the College members. For immunotherapy allergists use locally made and imported ex- tracts, generally mixed in their office (20% over 10 allergens in one bottle). Eighty percent adds bacterial vaccine at some point and 60% uses sublin- gual immunotherapy. Most use Evans without albumin as diluent, don't rou- tinely premedicate, reach maintenance treatment after more than six months and 46% recommends a maximum duration of immunotherapy of two years or less. CONCLUSIONS: We present a diagnosis on the current situation of practice patterns concerning allergen immunotherapy among the members of both Mexican colleges of allergists. The methods used by the allergists for indica- tion, preparation and administration are quite diverse. CITA: Rev Alerg Mex. Mar-Apr 2008;55(2):53-61 79

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 19058483 TÍTULO: [Adverse reactions to skin tests and immunotherapy in the practice of Mexican allergologists] AUTORES: Larenas Linnemann D, Rodríguez Pérez N, Becerril M. BACKGROUND: Immunotherapy is the only curative treatment recommend- ed for allergic rhinoconjunctivitis and asthma, in which small amounts of al- lergen are administered sublingually or subcutaneously until the maximum tolerated dose has been reached. However, local or systemic adverse reac- tions (AR) -rarely even fatal- an occur. In Mexico there is no nationwide data on adverse reactions. OBJECTIVE: To document the frequency of adverse reactions secondary to skin tests (ST) or immunotherapy (IT) in the allergist's office in Mexico, paying special attention to fatal and near fatal allergic reactions. PARTICIPANTS AND METHODS: We mailed a survey to all members of the Mexican Colleges of Allergy (CMICA) and Pediatric Allergy (CoMPedIA). RESULTS: A response rate of 59 (16%) for the adverse reactions part of the questionnaire was obtained from the College members. We found a near fatal reaction rate of 0.005 cases per year per allergy practice for skin test- ing and the same number -0.005 cases- for immunotherapy. This can be extrapolated to a total of 1.5 cases per year in the whole country of Mexico. No fatalities were reported. CONCLUSIONS: In Mexico the frequency of severe or near fatal adverse reactions to immunotherapy or skin tests is low and no fatal case has been reported till today. CITA: Rev Alerg Mex. Mar-Apr 2008;55(2):62-70 PMID: 19061290 TÍTULO: Reduction of blood loss from laboratory testing in hospitalized adult patients using small-volume (pediatric) tubes AUTORES: Sanchez-Giron F, Alvarez-Mora F. CONTEXT: Blood loss from laboratory testing (BLLT) can be significant in hospitalized patients. It is a common practice to draw full large-volume tubes of blood from adults. OBJECTIVE: To determine whether BLLT occurred when a small-volume (pediatric) blood collection tube (SVT) was substituted for each large-vol- ume blood collection tube and to note whether an adequate sample still was obtained. DESIGN: During 2 consecutive weeks, hospital test requisitions were re- viewed to collect patient demographics, tests requested, and number and type of tubes obtained. The amount of blood collected and BLLT per pa- tient were calculated. Reduced sample requirements were calculated, and phlebotomists and ward nurses were required to use SVTs. After 2 weeks of familiarization, data were collected as previously described. Laboratory technicians logged problems related to the use of SVTs. RESULTS: Baseline: 227 patients had 664 requisitions, and median BLLT per patient was 13.5 mL (interquartile range [IQR], 7.6-27.3 mL). In critical care patients, the median was 19.9 mL (IQR, 12.0-35.8 mL), and maximum 80

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 19062514 BLLT was 159.8 mL. Intervention phase: 246 patients had 696 requisitions, PMID: 19123887 median BLLT was 3.7 mL (IQR, 1.2-6.3 mL; P < .001). In critical care pa- tients, the median was 5.1 mL (IQR, 2.3-10.9 mL), and maximum BLLT was 61.8 mL (P < .001). All tests requested could be performed using SVTs, and no additional blood collections were required. Use of SVTs reduced overall BLLT per patient by 73% and by 74% in critical care patients. CONCLUSIONS: By decreasing the size of the blood collection tube for adults, we were able to markedly reduce BLLT without noting any insufficient specimen volumes. CITA: Arch Pathol Lab Med. 2008 Dec;132(12):1916-9 DOI: 10.5858/132.12.1916 TÍTULO: [Current use of vacuum extractor] AUTORES: Cueto GR, Bergeron GR. SUMMARY: Erratum CITA: Ginecol Obstet Mex. 2008 Oct;76(10):629-31 TÍTULO: Definition of the key target volume in radiosurgical manage- ment of arteriovenous malformations: a new dynamic concept based on angiographic circulation time AUTORES: Valle RD, Zenteno M, Jaramillo J, Lee A, De Anda S. OBJECT: The cumulative experience worldwide indicates complete radio- surgical obliteration rates of brain arteriovenous malformations (AVMs) rang- ing from 35 to 90%. The purpose of this study was to propose a strategy to increase the obliteration rate for AVMs through the dynamic definition of the key target volume (KTV). METHODS: A prospective series of patients harboring an AVM was as- sessed using digital subtraction angiography in which a digital counter was used to measure the several stages of the frame-by-frame circulation time. All the patients were analyzed using dynamic measurement planning to de- fine the KTV, corresponding to the volume of the shunt with the least vascu- lar resistance and the earliest venous drainage. All patients underwent cath- eter-based angiography, a subgroup was additionally assessed by means of a superselective catheterization, and among these a further subgroup received embolization. The shunts were also categorized according to their angioarchitectural type: fistulous, plexiform, or mixed. The authors applied the radiosurgery-based grading system (RBGS) as well to find a correlation with the obliteration rate. RESULTS: This series includes 44 patients treated by radiosurgery; global angiography was performed for all patients, including dynamic measure- ment planning. Eighty-four percent of them underwent superselective cath- eterization, and 50% of the total population underwent embolization. In the embolized arm of the study, the pretreatment volume was up to 120 ml. In patients with a single treatment, the mean volume was 8.5 ml, and the me- dian volume was 6.95 +/- 4.56 ml (mean +/- standard deviation), with a KTV of up to 15 ml. For prospectively staged radiosurgery, the mean KTV was 28 ml. The marginal radiation dose was 18-22 Gy, with a mean of dose 20 Gy. 81

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 19671502 The mean RBGS score was 1.70. The overall obliteration rate was 91%, in- cluding the repeated radiosurgery group (4 patients), in which 100% showed complete obliteration. The overall permanent deficit was 2 of 44 patients, 1 in each group. CONCLUSIONS: Dynamic definition of the KTV might increase the oblit- eration rate, even in complex AVMs, allowing the treatment of smaller vol- umes off the recruitment vessels (pseudonidus). By using this technique, the authors avoided double-blind treatment, where the neurosurgeon does not know precisely which type of lesion he or she is irradiating and the interven- tionalist does not know why and what he or she is embolizing. CITA: J Neurosurg. 2008 Dec;109 Suppl:41-50 DOI: 10.3171/JNS/2008/109/12/S8 TÍTULO: [Comparative study of the clinical presentation and complications of acute colonic diverticulitis in patients older and younger than 65 years.] AUTORES: Lizardi-Cervera J, Vázquez-Elizondo G, Becerra-Laparra I, Chávez-Tapia N, Noriega-Iriondo MF, Uribe M. BACKGROUND AND AIM: Colonic diverticular disease has an incidence from 66 to 85% in population older than 65 years. Most of them remain as- ymptomatic;20% will be symptomatic and about 35%will present an episode of Acute Colonic Diverticulitis(ACD). To date, there are not studies to com- pare its presentation in elderly patients. The aim of this study was to com- pare the clinical presentation, diagnostic procedures, treatment and com- plications of acute colonic diverticulitis (ACD)in patients older and younger than 65 years. MATERIAL AND METHODS: A retrospective review of patients diagnosed with ACD from January 2003 to May 2006. Exclusion criteria included pa- tients with incomplete medical records and those who didn't complete the in hospital treatment. Demographic,clinical, laboratory, and radiological,prog- nostic variables as well as chosen treatment,presence of complications were evaluated. Descriptive and comparative statistic analysis was performed by the Fisher Exact Test for categorical variables and Student t-Test for contin- ual variables considering a statistically significant difference for p <0.05. The analysis was made with SPSS/PC v12.0 software. RESULTS: Of 126 patients, 69 were men and 57 women; 93 younger than 65 years and 33 older than 65 years. 20 patients were excluded by previ- ously defined criteria. Significant statistical differences were found for pres- ence of pain in the left inferior quadrant (73.2% vs. 48.5% p <0.01); mean hemoglobin level (14.6 vs. 13.2 g/dL p<0.01), presence of anemia (10.8% vs. 27.3% p <0.05) use of ultrasonography (24.7% vs. 6.1%,p < 0.05) and presence of hemorrhage (3.3% vs.21.3% p < 0.01) respectively. There was not mortality in the series. CONCLUSION: This series demonstrates that elderly patients with ACD have a greater rate of lower gastrointestinal bleeding and greater degree of anemia than younger patients. CITA: Rev Gastroenterol Mex. 2008;73(3):153- 82

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR 2009 TÍTULO: Human leukocyte antigens among primary biliary cirrhosis patients born in Mexico PMID: 19221531 AUTORES: Vázquez-Elizondo G, Ponciano-Rodríguez G, Uribe M, Mén- dez-Sánchez N. BACKGROUND AND AIM: Primary biliary cirrhosis (PBC) is a chronic cholestatic disease of autoimmune origin and has a genetic component. Al- though it has been reported that the prevalence of the HLA-DRB1*08 allele is high in various populations, the prevalence of HLA alleles in Mexican PBC patients has not been described. The aim of this study was to quantify the prevalence of HLA-B/-DR alleles in Mexican PBC patients. MATERIALS AND METHODS: A case-control transversal study was per- formed during January and July 2008 with adult patients diagnosed with PBC. Cases were defined as subjects with PBC and controls were obtained from healthy subjects evaluated for bone marrow transplantation. Laboratory was performed at the moment of diagnosis. HLA-B/-DR allele frequency was obtained by gene counting and allele presence was determined by PCR- SSP procedure. Descriptive statistics between groups was evaluated by Chi- square with Yates correction. RESULTS: Nine patients (seven females and two males, mean +/- SD age = 57.5 +/- 10.5 years) were studied. The most prevalent alleles were HLA- DRB1*01 (n = 4), DRB1*04 (n = 4), B*39 (n = 34), B*14 (n = 3), and B*51 (n = 2). Linkage disequilibrium was detected for alleles HLA-B*39/DRB1*04 (n = 3), HLA-B*14/HLA-DRB1*01 (n = 2), and B*51-DRB1*04 (n = 1). IN CONCLUSION: Mexican PBC patients express genes of native and Med- iterranean origin. CITA: Ann Hepatol. Jan-Mar 2009;8(1):32-7 DOI: 10.1016/S1665-2681(19)31808-3 PMID: 19221536 TÍTULO: Embryonal sarcoma of the liver in a young PMID: 19326509 AUTORES: Sánchez-Aguilar AC, Díaz-Flores O, Albores-Saavedra J. SUMMARY: Case report CITA: Ann Hepatol. Jan-Mar 2009;8(1):63 DOI: 10.1016/S1665-2681(19)31813-7 TÍTULO: Sublingual immunotherapy in children: complete and updated re- view supporting evidence of effect AUTORES: Larenas-Linnemann D. PURPOSE OF REVIEW: The interest in sublingual immunotherapy (SLIT) is still growing worldwide and especially for the pediatric age group, this modal- ity is appealing. Lately, some negative systematic review articles have been published on SLIT in children. However, high quality articles published from 2007 onward had not been included. 83

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR RECENT FINDINGS: Explanations are sought for the negative outcomes in these reviews and shortcomings are discussed. New pediatric studies - not included in the previous reviews -designed taking into account the golden rules for SLIT (high daily dose, starting at least 4 months before pollen sea- son) do show statistically significant improvement in symptom and medica- tion scores for rhinitis and asthma in pollen allergy. New house dust mite studies still show inconsistent data. SUMMARY: Evidence of effect is confirmed for SLIT in children with allergic rhinitis or asthma caused by pollen exposure. For house dust mite asthma, evidence is still nonconcordant. New techniques to improve SLIT efficacy are under investigation. CITA: Curr Opin Allergy Clin Immunol. 2009 Apr;9(2):168-76 DOI: 10.1097/aci.0b013e328329a2a9 PMID: 19365949 TÍTULO: [Postoperative analgesia in gyneco-obstetrics] PMID: 19381123 AUTORES: Calderón Vidal M, Zamora Meraz R, Zavaleta Bustos M, Rita Escamilla MT, Santibáñez Moreno G, Castorena Arellano G, Reyes AR. INTRODUCTION: Frequently, postoperative pain lacks of systematic evalu- ation and follow-up. OBJECTIVES: 1. To determine the proportion of cases without appropriate pain relief in an Obstetrics and Gynecology hospital service. 2. To describe analgesics' use patterns and medication errors detected in a case series. METHODS: Our study was conducted in a private teaching hospital. To fulfill the first objective, an analogue numeric scale and a color scale were applied to 278 patients, in order to evaluate severity of pain. Measurements equal or higher to 30 mm were considered as inappropriate pain control. For the second objective, a retrospective random sample of 42 cases was selected to analyze analgesic use patterns and to detect medication errors. RESULTS: The 278 cases contributed with 3526 pain registries, average 12.7 +/- 5.46 measurements per patient, 348 data were > or = 30 mm, involv- ing 136/278 patients. For the second objective we included patients with an average age 34.1 +/- 11 years-old, diagnoses were: cesareans n = 15, labor n = 4, myomectomy n = 4, hysterectomy n = 15 y 13 with diverse disease conditions, where an average of 2.47 +/- 1.48 analgesics were prescribed, 8 cases with simultaneous NSAIDs use, 24 cases had medication errors as overdose, therapeutic duplicity, transcription omission, none of them with consequences for patients. CONCLUSIONS: 1. Systematic pain evaluation and its scaled management, according to severity, are essential to improve postoperative health care quality. 2. Studies, as the one presented here, are desirable in any postoper- ative setting. CITA: Ginecol Obstet Mex. 2009 Feb;77(2):82-8 TÍTULO: Nonalcoholic fatty liver disease and its association with cardiovas- cular disease AUTORES: Lizardi-Cervera J, Aguilar-Zapata D. 84

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR SUMMARY: An association between non-alcoholic fatty liver disease (NA- FLD) and cardiovascular disease (CVD) has been recently suggested. In- deed, different studies have demonstrated that NAFLD patients present increased subclinical atherosclerosis compared to non-steatosic individuals, and are supported by the few follow-up studies revealing that CVD is the second most common cause of death in NAFLD patients. However, the na- ture of the relationship NAFLD/CVD is still under debate. CITA: Ann Hepatol. 2009;8 Suppl 1:S40-3 DOI: 10.1016/S1665-2681(19)31825-3 PMID: 19496522 TÍTULO: [Clinical practice guidelines 2008. Mexican College of Obstetrics PMID: 19808138 and Gynecology Specialists. Prenatal monitoring in adolescents: risk mater- nal-infant] AUTORES: García Alonso López A, Rosales Ortiz S, Jiménez Solís G SUMMARY: Practice Guideline CITA: Ginecol Obstet Mex. 2009 May;77(5):S129-54 TÍTULO: Bioavailability of two oral formulations of a single dose of levofloxa- cin 500 mg: an open-label, randomized, two-period crossover comparison in healthy Mexican volunteers AUTORES: Galan-Herrera JF, Poo JL, Rosales-Sanchez O, Fuentes-Fuen- tes E, Cariño L, Burke-Fraga V, Namur S, Parra MG. BACKGROUND: Levofloxacin is a synthetic fluoroquinolone with a broad spectrum of antibacterial activity. It is indicated for the treatment of respirato- ry, sinus, skin, and urinary tract infections. Although generic formulations of oral levofloxacin are marketed in Mexico, a literature search did not identify published data concerning the bioavailability of these formulations; these data would be relevant to secure marketing of a test formulation in Mexico. OBJECTIVE: The aim of this study was to compare the bioavailability and determine the bioequivalence of a test formulation (an oral tablet containing levofloxacin 500 mg) with its corresponding listed reference-drug formula- tion in Mexico (a list issued by Mexican Health Authorities). METHODS: A single-dose, open-label, randomized-sequence, 2-period crossover design was used in this study. Eligible participants were healthy Mexican adults of either sex, randomly assigned to receive the test formula- tion followed by the corresponding reference formulation, or vice versa, with a 1-week washout period between doses. After a 10-hour overnight fast, the participants received the assigned formulation. Plasma concentrations of levofloxacin were determined using high-performance thin-layer chromatog- raphy, and densitometric analysis was performed at 300 nm. For the analysis of pharmacokinetic parameters, including C(max), AUC0(-24), and AUC(0-in- finity)), blood samples were drawn at baseline and at 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.5, 3, 4, 6, 8, 12, and 24 hours after administration. The test formulation was considered to meet the criteria for bioequivalence if the geo- metric mean ratios (test/reference) were with- in the predetermined range of 80% to 125%. Tolerability was determined by clinical assessment, vital signs, laboratory analysis, and interviews with participants about adverse events. 85

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR RESULTS: A total of 26 participants were enrolled, including 14 men and 12 women with a mean (SD) age of 24 (4) years (range, 18-34 years), weight of 62.2 (10.0) kg (range, 45.5-80.0 kg), height of 163 (9) cm (range, 148-176 cm), and body mass index of 23.3 (2.4) kg/m(2) (range, 19.2-27.1 kg/m(2)). The 90% CIs for log-transformed C(max), AUC(0-24), and AUC(0-infinity) were 94.48% to 106.22%, 90.01% to 116.44%, and 85.11% to 114.00%, re- spectively. Eleven participants reported a total of 20 adverse events during the study. None of the adverse events were considered serious. CONCLUSIONS: In this small study in healthy, fasting Mexican adults, a single 500-mg dose of the test formulation of orally administered levofloxa- cin met the regulatory requirements to assume bioequivalence based on the rate and extent of absorption. Both formulations were well tolerated. CITA: Clin Ther. 2009 Aug;31(8):1796-803 DOI: 10.1016/j.clinthera.2009.08.004 PMID: 19812482 TÍTULO: Certainties and doubts about sublingual and oral immunotherapy in children AUTORES: Larenas-Linnemann D. PURPOSE OF REVIEW: Sublingual (SLIT) and oral immunotherapy (OIT) are two variants of immunotherapy that might be especially of interest for children. After adult studies, lately many trials in children are published. However, the quality of published material varies. In the present review we analyze paediatric SLIT publications from the past 2 years in the light of a new system of evaluation of quality of evidence, the grading of recommen- dations assessment, development and evaluation system. RECENT FINDINGS: High quality evidence in children: high-dose daily grass SLIT reduces symptoms and medication use; low-dose pollen SLIT reduces the development of new sensitizations. Low-dose SLIT reduces symptoms and medication in mild-moderate atopic dermatitis. Latex SLIT for 3 years results in a negative glove test. The evidence for the effectiveness of SLIT for seasonal and perennial asthma is still of moderate-low quality, as is the evidence for asthma prevention. Too high dose of mite SLIT seems ineffective for asthma. Oral allergen immunotherapy is promising for some food allergies. Some definite immunological changes are seen with SLIT; fa- cilitated antibody presentation and IL-17 might correlate with efficacy. SUMMARY: Even after a hundred years of immunotherapy, it is still an ever changing field with SLIT and OIT making fast progress. CITA: Curr Opin Allergy Clin Immunol. 2009 Dec;9(6):558-67 DOI: 10.1097/ACI.0b013e328332b8fa PMID: 19841513 TÍTULO: Physical activity and nonalcoholic fatty liver disease AUTORES: Gutierrez-Grobe Y, Gavilanes-Espinar JG, Méndez-Sánchez N. SUMMARY: Letter to the editor CITA: Ann Hepatol. Jul-Sep 2009;8(3):273-4 DOI: 10.1016/S1665-2681(19)31781-8 86

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 19858016 TÍTULO: Ulcerative colitis in husband and wife. First report in Mexico PMID: 19919792 AUTORES: Méndez-Sánchez N, Pichardo-Bahena R, Uribe Esquivel M. SUMMARY: The prevalence of inflammatory bowel disease in Mexico is low. The occurrence in familial cases has been attributed to genetic influences. We described the first report of inflammatory bowel diseases in one pairs of husband-wife in Mexico. According with characteristics of this case, we can speculate that the environmental and infectious etiology might play some role in the development of IBD. CITA: Rev Gastroenterol Mex. 2009;74(3):246-8 TÍTULO: Epidemiological study of sepsis in Mexican intensive care units AUTORES: Carrillo-Esper R, Carrillo-Córdova JR, Carrillo-Córdova LD. BACKGROUND: Consistent data about sepsis in Mexico are lacking. The objective of this epidemiological study is to better define the incidence, char- acteristics and outcome of sepsis in Mexican intensive care units (ICUs). METHODS: This is a multicenter, transverse study performed in both private and public ICUs. Demographic data, comorbid diseases and clinical and lab- oratory data were collected prospectively. RESULTS: A total of 135 ICUs from 24 states of Mexico were studied. From 40,957 annual hospitalizations 11,183 were due to sepsis, which represent- ed 27.3% of admissions to ICU. From 11,183 patients with sepsis, 3402 died, representing a mortality rate of 30.4%. The most frequent sepsis trigger was abdominal infection (47%) followed by pulmonary infection (33%), soft tis- sue infection (8%) and kidney infection (7%); 5% were from other sources (neurological, osteoarticular). From the isolated bacteria, 52% were gram negative, 38% gram positive and 10% fungal infection; 60% of the private hospital ICUs and 40% of public hospital ICUs applied the Surviving Sepsis Campaign (p<0.05). In 50% of each of the ICUs, they adhere to the cam- paign recommendations. Costs in septic patients are high. CONCLUSIONS: This study documents the high incidence of sepsis in Mexi- can ICUs, with high mortality rate and low adherence to Surviving Sepsis Cam- paign. Our data suggest that sepsis is a public health problem in Mexico. CITA: Cir Cir. Jul-Aug 2009;77(4):301-8; 279-85 PMID: 19919796 TÍTULO: Pulmonary ultrasound in the intensive care unit AUTORES: Carrillo-Esper R, Brom-Valladares R, Carrillo-Córdova LD, Car- rillo-Córdova JR. SUMMARY: Pulmonary ultrasonography (PUSG) is a new diagnostic tool for pleuropulmonary disease in the critically ill patient. Images obtained in this study result from the interaction between the ultrasound shaft with the pleura, the pulmonary parenchyma and the air/liquid interface. These images are classified as horizontal and vertical. Their correct identification and interpre- tation requires a learning curve. Currently, PUSG is an excellent alternative to evaluate pulmonary condition of hospitalized patients in the intensive care unit (ICU). Sensitivity and specificity are high for pneumothorax, alveolar-in- terstitial syndrome and pleural effusion diagnosis. PUSG practiced in the 87

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 19944021 ICU is one of the most promising diagnostic procedures in intensive care PMID: 20073450 medicine, and the practice and indications of this tool will surely extend in PMID: 20077871 the coming years. The objective of this study is to make known the general principles of PUSG and their use in the critically ill patient, based on cases of hospitalized patients in the ICU of the Medica Sur Clinical Foundation that were studied with PUSG. CITA: Cir Cir. Jul-Aug 2009;77(4):323-8; 301-6 TÍTULO: Statins in influenza: time for a controlled clinical study AUTORES: Carrillo-Esper R. SUMMARY: Mexico recently experienced the impact of an influenza epidem- ic. This outbreak, the H1N1 strain, affected a large number of citizens and caused panic, economic instability and increased health care costs to the federal government and public and private institutions. Influenza outbreaks are periodic. They may or may not be seasonal, and severity of the disease is linked to host immunity and to the virus strain. In the event of a pandem- ic as happened in 1918, it is estimated that approximately 175-350 million people may die, and health systems would face a catastrophic situation due to the insufficiency of antivirals and vaccines, as well as affecting hospital infrastructure. CITA: Cir Cir. Sep-Oct 2009;77(5):351-2 TÍTULO: [Imatinib-induced pulmonary toxicity] AUTORES: Carrillo-Esper R, Morales-Victorino N. SUMMARY: Antineoplasic agent-induced pulmonary toxicity is an important cause of respiratory failure. These novel antineoplastic agents include ima- tinib mesylate, a protein tyrosine kinase inhibitor that is encoded by the Bcr- Abl gen created by the Philadelphia chromosome abnormality in chronic my- eloid leukemia. Pulmonary toxicity of imatinib is directly related to the dose used. The more severe pulmonary manifestations include pleural effusion by water retention and interstitial pneumonitis. We report the first case pub- lished in Mexico ofimatinib-induced pulmonary toxicity and its management in the intensive care unit of the Medica Sur Clinic Foundation. CITA: Gac Med Mex. Sep-Oct 2009;145(5):437-9 TÍTULO: [Rhabdomyolysis and acute renal failure in human influenza A H1N1 mediated infection] AUTORES: Carrillo-Esper R, Ornelas-Arroyo S, Pérez-Bustos E, Sánchez-Zúñiga J, Uribe-Esquivel M. SUMMARY: Rabdomiolysis and acute renal failure secondary to influenza infection are rare. Up to now, few cases have been reported and most of them are primarily among children. Myositis associated to influenza infection is caused by the toxic effect of the virus in the muscular fiber, dysregulation of inflammatory cytokines and a cross reaction between the muscle fiber and the viral particles. We present the case of a 57 year old male with a diagno- sis of H1N1 influenza who developed polyuria, oligoanuria, elevation of lactic dehydrogenase, myoglobin, creatinin phosphokinase and an electromyogra- phy with a myopathic pattern. The diagnosis of rabdomyolisis and acute renal failure were made, hemodyalisis was started and the patient improved satis- 88

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 20077883 factorily. This is the first report of a patient with radmoyolisis and acute renal PMID: 20433787 failure secondary to A H1N1 influenza treated during the Mexico epidemic. CITA: Gac Med Mex. Nov-Dec 2009;145(6):519-21 TÍTULO: [Fetal cardiac rhabdomyoma as a rare cause of hydrops fetalis. A report of a case] AUTORES: Gayón Vera E, López CC, Carrera González JE. SUMMARY: Cardiac tumors are rare entities at any age. The reported inci- dence in fetal echocardiograms is 0.17%. This case report presents the de- tection of a cardiac rhabdomyoma in a 27.5 weeks of gestational age (WGA) fetus during a routine sonogram. Treatment with terbutaline, as a cardiac inotropic and chronotropic agent, was started because of fetal bradichardia of 86 beats per minute, as well as fetal lung maturity inductors. At 30 WGA furosemide was added because of fetal hydrops. At 32 WGA a cesarean section was performed. The fetal development at the time of birth was in accordance to the gestational age, the newborn weight was 1,820 g and the Apgar score was 1-0, at one and five minutes after delivery. The newborn died immediately after the interruption of the umbilical circulation, because of a 90% obstruction of the left ventricular cavity caused by the tumor. The present case is an evidence of the utility of a medical treatment in a severe- ly ill fetus, that allowed it to continue with its normal development for four weeks after the diagnosis and opens the possibility for fetal medical therapy in the future for similar cases. CITA: Ginecol Obstet Mex. 2009 Dec;77(12):583-8 TÍTULO: Stapled rectal mucosectomy alone and in combination with other surgical anorectal procedures: multivariate analysis of factors affecting clini- cal outcome AUTORES: Correa-Rovelo JM, Téllez-Reynoso O, Obregón-Casanueva L, Morán-Villota S, Duque-López X, García-Osogobio S. BACKGROUND: We undertook this study to compare the clinical outcome of stapled rectal mucosectomy (SRM) alone and in combination with sphinc- terotomy and cutaneous flap anoplasty and to determine the influence of fac- tors related to complications and patient satisfaction. METHODS: Patients with second- to fourth-degree hemorrhoids who un- derwent SRM alone or in combination with other anorectal procedures were included. Postoperative complications, symptom resolution and patient sat- isfaction were analyzed. RESULTS: Two hundred forty one patients with a minimum follow-up of 1 year were divided into three groups: SRM alone (n = 187), SRM combined with sphincterotomy (n = 31) and SRM combined with cutaneous flap ano- plasty (n = 23). Patients with SRM with sphincterotomy showed a higher complication rate than the other groups (32 vs. 12.8% and 13%, respectively, p = 0.02). SRM combined with sphincterotomy was associated with a higher rate of complications (OR = 3.5; 95% CI = 1.4-8.7). SRM alone with low mucosal resection was associated with a lower complications rate (OR = 0.4, 95% CI = 0.2-0.8). Resolution of preoperative symptoms was >80% among the three groups. There was no association between complications and type of procedure with satisfaction level. Resolution of symptoms <80% was as- sociated with low/intermediate level of satisfaction (p <0.001). 89

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR CONCLUSIONS: Resolution of preoperative symptoms is similar among the three groups. SRM combined with sphincterotomy has a higher risk of com- plications. The satisfaction level is associated with resolution of preoperative symptoms. CITA: Cir Cir. Nov-Dec 2009;77(6):429-35 PMID: 20433790 TÍTULO: Chylothorax secondary to gunshot wound PMID: 20873055 AUTORES: Carrillo-Esper R, Sosa-García JO, Carrillo-Córdova CA. BACKGROUND: Chylothorax is the occurrence of chyle in the pleural space due to damage or obstruction of the thoracic duct. Its etiology can be trau- matic or nontraumatic. Traumatic lesion of the thoracic duct occurs after ac- cidents or cardiothoracic surgery. Non-Hodgkin's lymphoma is the most fre- quent nontraumatic etiology. Milky aspect and high content of triglycerides in pleural fluid confirm the diagnosis. The objective of this paper is to present a case of chylothorax secondary to shotgun lesion as well as to review current concepts about chylothorax and its treatment. CLINICAL CASE: We present the case of a 33-year-old male patient with chylothorax secondary to gunshot lesion. Management was based on fasting, parenteral nutrition and pleural drainage. Patient's evolution was satisfactory. CONCLUSIONS: Chylothorax is an entity associated with high morbidity and mortality. Early diagnosis and appropriate treatment are essential. CITA: Cir Cir. Nov-Dec 2009;77(6):447-9 TÍTULO: [Asthma treatment] AUTORES: Larenas-Linnemann D. SUMMARY: Treatment of asthma begins with primary prevention in high risk populations. The proper management of asthma in secondary prevention (to avoid exposure to allergens and aggravating factors such as cigarette smoke, diet rich in fruits and vegetables, oils and timely vaccination against influenza and pneumococcal), patient education, pharmacotherapy and, in allergic patients can be considered immunotherapy. The drugs were divided into rescue treatment for episodes of symptoms and maintenance treatment to maintain control. In patients with asthma and mild intermittent symptoms no more than twice a week, no nocturnal awakenings and no asthma attack last year, will only rescue treatment. In all other patients will install a mainte- nance treatment with inhaled anti-inflammatory and possibly other drugs that increase the control. To choose the right treatment takes into account the se- verity of chronic symptoms and at the time of consultation, following five lev- els of the algorithm that will lead the physician to maintain control of asthma. Level 1. RESCUE: bronchodilators. 1st option inhaled beta2 agonist, applied for exacerbations at any level below. Level 2. Maintenance: inhaled cortico- steroid (CElnhal) at low or intermediate doses. Alternative anti-leukotrienes, theophylline extended release, oral beta2 agonists. Level 3. Maintenance: intermediate dose CEinhal combination with long acting beta2 agonist. Al- ternative: CEInhal with anti-leukotrienes, theophylline extended release, oral beta2 agonists. Level 4. Increase at high doses--very high inhaled steroid plus combined treatment. Level 5. Immunosuppression and Anti-lgE. CITA: Rev Alerg Mex. 2009;56 Suppl 1:S64-78 90

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR 2010 TÍTULO: High ghrelin and obestatin levels and low risk of developing fatty liver PMID: 20308723 AUTORES: Gutierrez-Grobe Y, Villalobos-Blasquez I, Sánchez-Lara K, Villa AR, Ponciano-Rodríguez G, Ramos MH, Chavez-Tapia NC, Uribe M, PMID: 20308733 Méndez-Sánchez N. AIM: Obesity and insulin resistance are associated with nonalcoholic fatty liver disease (NAFLD). It was recently reported that the ratio between levels of ghrelin and obestatin is also associated with obesity and insulin resis- tance. We investigated the association between the ghrelin/obestatin ratio and NAFLD. METHODS: This cross-sectional study included 98 subjects (51 NAFLD pa- tients and 47 controls). Anthropometric, metabolic and biochemical variables were measured and serum concentrations of ghrelin and obestatin were determined. Logistic regression analyses (univariate and multivariate) were conducted to determine whether NAFLD was associated with ghrelin and obestatin levels and the ghrelin/obestatin ratio. RESULTS: We studied 51 NAFLD cases and 47 controls. Men comprised 82% of cases and 61% of controls. The mean ages of the groups differed significantly. Body mass index (P < 0.001), waist circumference (P < 0.001) and WHR (P < 0.001) were significantly greater in the NAFLD group than in the control group. The NAFLD group had higher mean fasting glucose level (P = 0.001), HOMA-IR index (P < 0.001) and triglyceride level (P < 0.001) than the controls. Ghrelin and obestatin concentrations were classed according to tertiles. Multivariate analysis revealed a negative correlation between ghrelin and obestatin levels and an overweight status, obesity and metabolic syndrome. Ghrelin and obestatin were evaluated in multivariate logistic regression analysis, they had a protective effect against hepatic ste- atosis after controlling for potential confounders. CONCLUSION: Serum ghrelin and obestatin concentrations are correlated with a low risk of developing NAFLD. However, ghrelin/obestatin ratio was not correlated with NAFLD. CITA: Ann Hepatol. Jan-Mar 2010;9(1):52-7 DOI: 10.1016/S1665-2681(19)31679-5 TÍTULO: Liver involvement in severe human influenza a H1N1 AUTORES: Carrillo-Esper R, Pérez-Bustos E, Ornelas-Arroyo S, Al- bores-Saavedra J, Uribe M. SUMMARY: Influenza A is a disease caused by a RNA virus, member of the orthomyxoviridae family. The influenza infection is characterized primarily by pulmonary affection that may advance to an acute pulmonary respiratory failure course. Hepatic involvement is not frequent and accounts for < 3% of all cases. We describe two patients with acute Influenza A H1N1 infection who developed hepatic involvement. Needle core liver biopsy of one of the patient revealed only micro and macrovesicular steatosis. CITA: Ann Hepatol. Jan-Mar 2010;9(1):107-11 DOI: 10.1016/S1665-2681(19)31691-6 91

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 20334666 TÍTULO: Influence of taste disorders on dietary behaviors in cancer patients under chemotherapy AUTORES: Sánchez-Lara K, Sosa-Sánchez R, Green-Renner D, Rodrí- guez C, Laviano A, Motola-Kuba D, Arrieta O. OBJECTIVES: To determine the relationship between energy and nutrient consumption with chemosensory changes in cancer patients under chemo- therapy. METHODS: We carried out a cross-sectional study, enrolling 60 subjects. Cases were defined as patients with cancer diagnosis after their second chemotherapy cycle (n = 30), and controls were subjects without cancer (n = 30). Subjective changes of taste during treatment were assessed. Food con- sumption habits were obtained with a food frequency questionnaire validated for Mexican population. Five different concentrations of three basic flavors --sweet (sucrose), bitter (urea), and a novel basic taste, umami (sodium glu- tamate)-- were used to measure detection thresholds and recognition thresh- olds (RT). We determine differences between energy and nutrient consump- tion in cases and controls and their association with taste DT and RT. RESULTS: No demographic differences were found between groups. Cases showed higher sweet DT (6.4 vs. 4.4 micromol/ml; p = 0.03) and a higher bitter RT (100 vs. 95 micromol/ml; p = 0.04) than controls. Cases with sweet DT above the median showed significant lower daily energy (2,043 vs.1,586 kcal; p = 0.02), proteins (81.4 vs. 54 g/day; p = 0.01), carbohydrates (246 vs.192 g/day; p = 0.05), and zinc consumption (19 vs.11 mg/day; p = 0.01) compared to cases without sweet DT alteration. Cases with sweet DT and RT above median were associated with lower completion of energy require- ments and consequent weight loss. There was no association between fla- vors DT or RT and nutrient ingestion in the control group. CONCLUSION: Changes of sweet DT and bitter RT in cancer patients un- der chemotherapy treatment were associated with lower energy and nutrient ingestion. Taste detection and recognition thresholds disorders could be im- portant factors in malnutrition development on patients with cancer under chemotherapy treatment. CITA: Nutr J. 2010 Mar 24;9:15 DOI: 10.1186/1475-2891-9-15 PMID: 20338683 TÍTULO: A comparison of in vitro potency between European and Mexican allergen extracts and US (CBER/FDA) reference extracts AUTORES: Larenas-Linnemann D, Esch RE, Guidos-Fogelbach G, Rodrí- guez-Pérez N. BACKGROUND: The most important allergen manufacturers are based in Europe and in the US. In some countries local products are also sold. No com- parison between European, US and local products has been made until now. AIM OF THE STUDY: To determine total protein content and total specific IgE binding capacity or major allergen content of diagnostic extracts from European, US and Mexican origins relative to the CBER/FDA reference ex- tracts for Dermatophagoides pteronyssinus (Dpt), Bermuda grass and cat (10,000(B) AU/mL). 92

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR METHODS: Diagnostic extracts were purchased from various manufacturers, blinded and shipped to the analysing laboratory, where the following assays were conducted: total protein concentration (Bradford), specific IgE compe- tition ELISA (Dpt and Bermuda grass) and determination of Fel d 1 U/mL. When available, CBER/FDA recommended tests and reagents were used. RESULTS: Total protein content of US reference extracts was higher than all other extracts. Relative potency of European and US-bought Dpt extracts 3,300-4,400 AU/mL, Bermuda grass 800-2,500 BAU/mL and cat 2.1-4.4 Fel d IU/mL (Ref. 19 U/mL), with one exception. Locally produced Mexican prod- ucts were almost all below 1,000 (B)AU/mL. CONCLUSIONS: Three diagnostic extracts from European manufacturers and from Mexican providers which obtain extracts in US have a <50% rel- ative potency compared to 10,000 (B)AU/mL US extracts. Locally produced Mexican extracts have much lower total protein content and specific IgE binding capacity. These in vitro results must be complemented with other in vitro and in vivo skin prick tests to obtain a more complete picture of compar- ison of potency. Nevertheless results are quite consistent for the allergens tested here. CITA: Allergol Immunopathol (Madr). Jul-Aug 2010;38(4):170-3 DOI: 10.1016/j.aller.2009.11.005 PMID: 20419605 TÍTULO: Oralair Birch, a recombinant major birch pollen allergen tablet for sublingual immunotherapy of allergic rhinitis caused by birch pollen AUTORES: Larenas-Linnemann D. SUMMARY: Oralair Birch is a dissolving tablet being developed for sublin- gual immunotherapy (SLIT) of allergic rhinitis caused by birch pollen allergy. Oralair Birch is being developed by Stallergenes SA and Canadian licensee Paladin Labs Inc. Oralair Birch is a recombinant protein that is synthesized from the DNA coding region of Bet v 1a, the major birch pollen allergen. During preclinical characterization, Oralair Birch had comparable structural and biological properties to the natural Bet v 1 allergen. However, Oralair Birch was more homologous than the natural Bet v 1 allergen, making a greater level of quality control possible. The administration of SLIT in tablet formulation provides a more uniform dose compared with liquid drops and better local application, which might enhance local uptake into dendritic cells of the sublingual submucosa and efficacy. Using skin prick testing, the performance of recombinant Bet v 1 was comparable to the natural Bet v 1 allergen. The results of a dose-finding phase IIb/III clinical trial of Oralair Birch were positive, with the primary endpoint met by all three tested doses. A confirmatory phase III trial was planned for 2011. Oralair Birch is a very promising treatment option for patients with birch pollen allergic rhinitis. CITA: Curr Opin Investig Drugs. 2010 May;11(5):586-9 PMID: 20422930 TÍTULO: [RH hybrid box identification in subjects with Rh negative pheno- type from Mexico's Valley] AUTORES: Baptista-González HA, Rosenfeld-Mann F, Trueba-Gómez R, Reyes-Maldonado E, Jiménez-Zamudio LA. 93

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 20422938 BACKGROUND: The prevalence of the RhD and RhCE gene alleles is re- PMID: 20486333 lated to the ethnic mixture. The aim of this report is to describe the pre- dominant molecular mechanisms in RhD negative subjects residents from Mexico's valley according to the phenotype of RhCE. METHODS: Blood samples from RhD negative women and men were stud- ied. The RhD/RhCE phenotype was identified by hemagglutination and Rh hybrid box by PCR-FRLP with PstI. RESULTS: 216 subjects were included. The RhD phenotypes were ccdee in 179 cases (82.8%), Ccdee in 15 cases (11.6%), ccdEe in seven (3.2%), CcdEe in four (1.9%), and CcdEE in a single subject (0.5%). In five cas- es, RhD hybrid box was not amplified (2.3%), 21 cases were hemizygotes (9.7%), and 188 cases homozygotes (87%), for RhD hybrid box. The ho- mozygote condition was more frequent in those individuals with phenotype ccdee (87%). The allelic frequency of RhD hybrid box was 0.928. The fre- quency of Rhcc haplotype was higher in those subjects homozygotes for RhD hybrid box (chi2 = 4.658, p < 0.05). CONCLUSIONS: In this population, RhD gene deletion is the main molecu- lar mechanism to generate to RhD negative condition and this depends on the European mixture. CITA: Gac Med Mex. Jan-Feb 2010;146(1):19-23 TÍTULO: [Libman-Sacks endocarditis] AUTORES: Carrillo-Esper R, Carrillo-Córdova JR, Carrillo-Córdova LD, Carrillo-Córdova CA. SUMMARY: In 1924, Libman and Sacks described valvular lesions in pa- tients with lupus erythematosus. Libman-Sacks valvular lesions are sterile fibrinous vegetations that preferentially develop at the left-sided heart valves. Reports of their prevalence range from 53 to 74%. Libman-Sacks endocar- ditis is associated with disease activity and antiphospholipid antibodies ti- ter. Echocardiography is a useful tool for documenting valvular involvement and dysfunction as well as disease progression. Transesophageal echocar- diography is superior to transthoracic echocardiography in detecting Lib- man-Sacks endocarditis. This report describes the echocardiographic image of Libman-Sacks endocarditis in a patient with active lupus erithematosus. CITA: Gac Med Mex. Jan-Feb 2010;146(1):67-9 TÍTULO: Skin prick test evaluation of Dermatophagoides pteronyssinus di- agnostic extracts from Europe, Mexico, and the United States AUTORES: Larenas-Linnemann D, Matta JJ, Shah-Hosseini K, Michels A, Mösges R. BACKGROUND: Previous Food and Drug Administration (FDA)-approved enzyme-linked immunosorbent assay testing of Dermatophagoides pteron- yssinus diagnostic extracts showed potencies of 36% to 44% for 3 European extracts relative to the FDA standard (10,000 AU/mL). OBJECTIVE: To compare biological activity of various European D pteronys- sinus diagnostic extracts against an FDA-validated extract using quantitative skin prick tests. 94

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR METHODS: Six diagnostic D pteronyssinus extracts (1 reference extract, which was made up of 10,000 AU/mL of the FDA-approved extract; 3 Eu- ropean extracts; 1 US-Mexican extract, which is imported as raw material from the United States and sold in Mexico; and 1 Mexican extract) were tested during 2 skin prick test sessions as a concentrate and 2 serial 2-fold dilutions, in quadruplicate, on the backs of 19 patients with D pteronyssinus allergic rhinitis. The Wilcoxon test for linked random samples was used in each group to investigate whether the distribution of the reference extract differed from each of the test extracts to a statistically significant degree (test level alpha = .05). RESULTS: Extracts showed good dose response in wheal size for the con- centrate compared with the 2 dilutions (steep part of the curve). All 3 Europe- an extracts (2-sided asymptotic significance, P = .003, P = .009, and P = .01, respectively) and 1 Mexican (P < .001) extract were less potent than the ref- erence extract. European extracts varied in potency from 5,400 to 6,126 AU/ mL, the US-Mexican extract had a potency of 7,444 AU/mL, and the Mexican extract had a potency of 2,099 AU/mL. CONCLUSIONS: Our study confirmed the results from previous in vitro test- ing. Various diagnostic extracts of D pteronyssinus used in Europe and Mexi- co are less potent than those used in the United States. Similar comparisons using therapeutic extracts would be of interest. CITA: Ann Allergy Asthma Immunol. 2010 May;104(5):420-5 DOI: 10.1016/j.anai.2010.03.009 PMID: 20594607 TÍTULO: In vivo 3T spectroscopic quantification of liver fat content in non- alcoholic fatty liver disease: Correlation with biochemical method and mor- phometry AUTORES: Roldan-Valadez E, Favila R, Martínez-López M, Uribe M, Ríos C, Méndez-Sánchez N. BACKGROUND & AIMS: The clinical application of liver fat quantification has increased in recent years, paralleling the epidemic increase in nonal- coholic fatty liver disease. The aim of this study was to perform a diagnostic evaluation of spectroscopy by comparing its measurement of total lipid con- tent with that from liver biopsies and morphometry in normal subjects and patients with nonalcoholic fatty liver disease. METHODS: Patients with symptomatic cholelithiasis underwent 3T MR chol- angiography with spectroscopic quantification of TLC. A laparoscopic chole- cystectomy was performed on the day of admission, with liver samples taken during surgery. Microcolorimetric assessment quantified lipid content in liver samples and morphometric evaluation in stained slides. Statistical analysis included bivariate correlation, regression, and ROC analysis. RESULTS: The study was conducted in 18 patients, 5 men (mean age, 35.2+/-11.03 years; range, 27-54 years) and 13 women (mean age, 46.77+/- 11.77 years; range, 21-61 years). Using a cut-off value >5% for fat content, 8 patients presented with steatosis and 10 patients presented with normal liver fat content. A significant correlation was observed between fat spectroscopy and lipid content (r=0.876, p<0.001). A lower and non-significant correlation was observed between lipid content and morphometry (r=0.190, p>0.05). 95

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR CONCLUSIONS: The accuracy of spectroscopy in assessing fat concentra- tion with a cut-off level of 7.48% was 100%. Spectroscopy showed a strong and significant correlation with lipid content. It may reliably replace liver biop- sy for the assessment of liver fat content. CITA: J Hepatol. 2010 Oct;53(4):732-7 DOI: 10.1016/j.jhep.2010.04.018. PMID: 20626134 TÍTULO: [Electrocardiographic abnormalities in left pneumothorax] AUTORES: Carrillo-Esper R, Garnica-Escamilla MA, Carrillo-Córdova JR. SUMMARY: Pneumothorax is a frequent complication among patients un- der mechanical ventilation or undergoing various invasive procedures. Its prevalence in intensive care units ranges from 3% to 14%. The electrocar- diographic abnormalities described in left pneumothorax include poor precor- dial R-wave progression, precordial T wave inversion, phasic QRS voltage variation. QRS voltage ratio (aVF/DI) greater than 2 has high sensitivity and specificity. Electrocardiographic changes are secondary to several factors in- cluding clockwise rotation axis of the heart, dilated right ventricle, posterior displacement of the mediastinum, hypoxemia, and decreased coronary blood flow. We here describe a patient with left pneumothorax whose electrocardio- graphic features successfully reversed upon pneumothorax resolving. CITA: Gac Med Mex. Mar-Apr 2010;146(2):157-9 PMID: 20713989 TÍTULO: The Latin American Association for the Study of the Liver in its meeting on diagnosis, management and treatment of hepatitis C AUTORES: Méndez-Sánchez N. SUMMARY: Letter to the editor CITA: Ann Hepatol. 2010;9 Suppl:7 DOI: 10.1016/S1665-2681(19)31717-X PMID: 20713991 TÍTULO: Epidemiology of HCV infection in Latin America AUTORES: Méndez-Sánchez N, Gutiérrez-Grobe Y, Kobashi-Margáin RA. SUMMARY: Hepatitis C virus is one of the most common causes of chron- ic liver disease and one of the principal indications for liver transplantation. The prevalence and incidence worldwide is variable, although there may be some similarities among different regions. Worldwide prevalence has been estimated around 3.1% or 170 million infected people. The Latin America region has one of the lowest prevalence around the world with an overall prevalence estimated around 1.23%, nevertheless it varies from country to country and even between regions of the same country. Although the prin- cipal route of transmission continues being blood transfusion, the epide- miological change around the world is affecting our region, increasing the virus transmission among intravenous drugs users. Also in Latin America the most prevalent genotype is 1 different from other regions like Africa and Asia. 96

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 20713995 The knowledge of epidemiology of Hepatitis C in our region is basic for the prevention and treatment of this arising disease, and further research with greater general population based studies must be carried out. CITA: Ann Hepatol. 2010;9 Suppl:27-9 DOI: 10.1016/S1665-2681(19)31719-3 TÍTULO: Noninvasive markers of liver fibrosis in Latin America and Mexico AUTORES: Uribe M, Gutiérrez-Grobe Y, Kobashi-Margáin RA, Mén- dez-Sánchez N. SUMMARY: Review article CITA: Ann Hepatol. 2010;9 Suppl:43-8 DOI: 10.1016/S1665-2681(19)31723-5 PMID: 20720269 TÍTULO: Prevalence of type 2 diabetes mellitus and chronic liver disease: a PMID: 20736149 retrospective study of the association of two increasingly common diseases in Mexico AUTORES: Kobashi-Margáin RA, Gutiérrez-Grobe Y, Ponciano-Rodrí- guez G, Uribe M, Méndez-Sánchez N. BACKGROUND: Recent studies have demonstrated a relationship between insulin resistance (IR) and type 2 diabetes mellitus (T2DM). The aim of this study was to determine the prevalence of T2DM among patients with liver disease. METHODS: A retrospective study was performed by examining the charts of patients who presented with a diagnosis of liver disease at a university hospital between January 2006 and April 2010. RESULTS: Liver disease was found in 129 patients. The most prevalent liver disease was cirrhosis, with 61 patients (47.2%), 44 patients had hepatitis C virus (34.1%) and 28 patients had hepatocellular carcinoma (21.7%). T2DM was diagnosed in 30 patients, 18 of whom were male (18/60; 30%) and 12 of whom were female (12/69; 17.4%). Only liver cirrhosis was significantly related to T2DM (21 of 61 patients; 34.4%, p < 0.004). CONCLUSIONS: The prevalence of T2DM among patients with liver dis- ease (23.2%) is well established and similar to that reported in Western and some Eastern countries. CITA: Ann Hepatol. Jul-Sep 2010;9(3):282-8. DOI: 10.1016/S1665-2681(19)31638-2 TÍTULO: Efficacy and safety of maraviroc versus efavirenz, both with zidovu- dine/lamivudine: 96-week results from the MERIT study AUTORES: Sierra-Madero J, Di Perri G, Wood R, Saag M, Frank I, Craig C, Burnside R, McCracken J, Pontani D, Goodrich J, Heera J, Mayer H. 97

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 20824832 BACKGROUND: The MERIT study evaluated maraviroc versus efavirenz, both with zidovudine/lamivudine, in treatment-naïve patients with CCR5-trop- ic (R5) HIV-1. Post hoc analyses previously assessed week 48 outcomes in patients rescreened with R5 virus by a more sensitive tropism assay. METHODS: Week 96 efficacy (post hoc, n = 614) and safety (n = 721) were assessed. RESULTS: Proportions of subjects <50 copies/mL (58.8% maraviroc, 62.7% efavirenz) and time to loss of virologic response (TLOVR) responders (<50 copies/mL: 60.5% vs 60.7%) were similar. Maraviroc recipients had greater CD4 increases (+ 212 vs + 171 cells/mm(3)) and fewer adverse event dis- continuations (6.1% vs 15.5%), malignancies, and category C events. CONCLUSION: Week 96 data confirm week 48 observations in MERIT. CITA: HIV Clin Trials. May-Jun 2010;11(3):125-32 DOI: 10.1310/hct1103-125 TÍTULO: Antibiotic prophylaxis for cirrhotic patients with upper gastrointesti- nal bleeding AUTORES: Chavez-Tapia NC, Barrientos-Gutierrez T, Tellez-Avila FI, Soares-Weiser K, Uribe M. BACKGROUND: Bacterial infections are a frequent complication in patients with cirrhosis and upper gastrointestinal bleeding. Antibiotic prophylaxis seems to decrease the incidence of bacterial infections. Oral antibiotics, ac- tive against enteric bacteria, have been commonly used as antibiotic prophy- laxis in patients with cirrhosis and upper gastrointestinal bleeding. This is an update of a Cochrane review first published in 2002. OBJECTIVES: To assess the benefits and harms of antibiotic prophylaxis in cirrhotic patients with upper gastrointestinal bleeding. SEARCH STRATEGY: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, The Cochrane Central Register of Controlled Tri- als (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index EXPANDED until June 2010. In addition, we hand searched the references of all identified studies. SELECTION CRITERIA: Randomized clinical trials comparing different types of antibiotic prophylaxis with no intervention, placebo, or another anti- biotic to prevent bacterial infections in cirrhotic patients with upper gastroin- testinal bleeding. DATA COLLECTION AND ANALYSIS: Three authors independently as- sessed trial quality, risk of bias, and extracted data. We contacted study authors for additional information. Association measures were relative risk (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes. MAIN RESULTS: Twelve trials (1241 patients) evaluated antibiotic prophy- laxis compared with placebo or no antibiotic prophylaxis. All trials were at risk of bias. Antibiotic prophylaxis compared with no intervention or placebo was associated with beneficial effects on mortality (RR 0.79, 95% CI 0.63 to 0.98), mortality from bacterial infections (RR 0.43, 95% CI 0.19 to 0.97), bacterial infections (RR 0.36, 95% CI 0.27 to 0.49), rebleeding (RR 0.53, 95% CI 0.38 to 0.74), days of hospitalisation (MD -1.91, 95% CI -3.80 to 98

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 20959193 -0.02), bacteraemia (RR 0.25, 95% CI 0.15 to 0.40), pneumonia (RR 0.45, PMID: 20981588 95% CI 0.27 to 0.75), spontaneous bacterial peritonitis (RR 0.29, 95% CI 0.15 to 0.57), and urinary tract infections (RR 0.23, 95% CI 0.12 to 0.41). No serious adverse events were reported. The trials showed no significant heterogeneity of effects. Another five trials (650 patients) compared different antibiotic regimens. Data could not be combined as each trial used different antibiotic regimen. None of the examined antibiotic regimen was superior to the control regimen regarding mortality or bacterial infections. AUTHORS' CONCLUSIONS: Prophylactic antibiotic use in patients with cirrhosis and upper gastrointestinal bleeding significantly reduced bacterial infections, and seems to have reduced all-cause mortality, bacterial infection mortality, re- bleeding events, and hospitalisation length. These benefits were observed independently of the type of antibiotic used; thus, no specific antibiotic can be preferred. Therefore, antibiotic selection should be made considering lo- cal conditions such as bacterial resistance profile and treatment cost. CITA: Cochrane Database Syst Rev. 2010 Sep 8;2010(9):CD002907 DOI: 10.1002/14651858.CD002907.pub2 TÍTULO: Pyloric gland adenoma: case report AUTORES: Gutiérrez-Grobe Y, Gavilanes-Espinar JG, Uribe M, Ko- bashi-Margáin RA, Méndez-Sánchez N. SUMMARY: Pyloric gland adenoma (PGA), also called adenoma with gastric differentiation, is a rare neoplasm of the gastric mucosa that can appear as gastric heterotopia in several organs. A 49-year-old woman presented with gastric reflux and chronic elevation of liver enzymes. She had a history of type 2 diabetes mellitus, hypothyroidism and an unspecified allergy treated with deflazacor, and a family history of autoimmune diseases. A liver biop- sy showed macro- and microvesicular steatohepatitis. Hepatitis B and virus serum tests were negative. Autoimmune hepatitis was suspected and inves- tigated. As an evaluation for dyspeptic symptoms an upper gastrointestinal endoscopy was performed, showing diffuse gastroduodenitis. A few polyps were found and resected from the gastric fundus; histopathology revealed a pyloric gland adenoma. There is very few clinical data on this tumor type because it is frequently underdiagnosed and reported as dysplasia. Further research is needed on the pathophysiology of this disease. CITA: Rev Gastroenterol Mex. 2010;75(3):360-2 TÍTULO: [Antimicrobial and clinical efficacy of nitrofurantoin in the treatment of acute lower urinary tract infections in adults] AUTORES: Mendoza-Valdes A, Rosete A, Rios Bueno E, Frentzel A, Trapp S, Kirch W, Mueller EA. BACKGROUND AND PURPOSE: In the light of increasing resistance to antibiotics used for the treatment of acute urinary tract infections, nitrofuran- toin currently experiences a renaissance. Nitrofurantoin shows good efficacy against most bacteria expected in urinary tract infection, and the develop- ment of resistance is low. A study on the antimicrobial and clinical efficacy 99

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR of nitrofurantoin in the treatment of acute lower urinary tract infections was conducted in Mexico City, an area where resistance rates of uropathogens to trimethoprim/sulfamethoxazole (cotrimoxazole) are high. PATIENTS AND METHODS: In this open-label, single-arm study 20 adult patients (18 females, 2 males) with positive urine culture were treated orally with nitrofurantoin sustained release 100 mg twice daily for 7 days. Urinary nitrofurantoin concentrations were determined at baseline and day 4 of the study. Primary endpoint was the antimicrobial efficacy of nitrofurantoin at 12 to 16 days after baseline, assessed by changes in urine culture results. RESULTS: In the patient population treated per protocol, primary endpoint analysis revealed a microbial eradication rate of 92.3%. At 35 to 42 days, the eradication rate was 83.3%. At these times, all patients in the per protocol population were free of symptoms. In patients with complicating factors, e.g. diabetic polyneuropathy, both antimicrobial and clinical efficacy appeared to be reduced. Urinary nitrofurantoin concentrations were mostly above mini- mum inhibitory concentrations of the isolated uropathogens. The study drug was generally well tolerated. Most frequent drug-related adverse event was mild headache, occurring in 10.8% of patients. Two patients discontinued the study due to rash. CONCLUSION: The results of the present study indicate good antimicrobial and clinical efficacy of nitrofurantoin in the treatment of acute uncomplicated urinary tract infections as well as acceptable tolerability in adults. CITA: Med Klin (Munich). 2010 Oct;105(10):698-704 DOI: 10.1007/s00063-010-1121-2 PMID: 21057159 TÍTULO: Prevalence of non alcoholic fatty liver disease in premenopausal, posmenopausal and polycystic ovary syndrome women. The role of estro- gens AUTORES: Gutierrez-Grobe Y, Ponciano-Rodríguez G, Ramos MH, Uribe M, Méndez-Sánchez N. BACKGROUND & AIM: Non alcoholic fatty liver disease (NAFLD) is the most common liver disease in Western countries. Population studies have demonstrated that men and posmenopausal women have higher prevalence of NAFLD. The aim was to investigate the prevalence of NAFLD in premeno- pausal, posmenopausal and polycystic ovary syndrome (PCOS) women. METHODS: A cross sectional study carried out at University Hospital in Mex- ico City from January 2009 to November 2009. One hundred ninety seven women who agreed to participate were divided into groups, comprising 93 with NAFLD and without NAFLD. Anthropometric, metabolic and biochem- ical variables were measured. Serum estradiol and cortisol concentrations were determined and compared between the groups. RESULTS: Of the 197 patients, 93(47.2%) had NAFLD and 104 (52.8%) did not have NAFLD. The prevalence of NAFLD in premenopausal, postmeno- pausal and PCOS patients was 32.2, 57.9, and 62%, respectively. Age, BMI, hip to waist ratio, fasting glucose, HOMA -IR, and insulin were significantly higher in NAFLD patients. Women without NAFLD had significantly high- er levels of serum estradiol (100 ± 95.4) compared with NAFLD patients (55.5 ± 66.6) p = 0.001. By group with and without NAFLD: premenopausal 100