"Very early" intrahepatic cholangiocarcinoma in cirrhotic patients: should liver transplantation be reconsidered in these patients?

A retrospective cohort multicenter study was conducted to analyze the risk factors for tumor recurrence after liver transplantation (LT) in cirrhotic patients found to have an intrahepatic cholangiocarcinoma (iCCA) on pathology examination. We also aimed to ascertain whether there existed a subgroup of patients with single tumors ≤2 cm ("very early") in which results after LT can be acceptable. Twenty-nine patients comprised the study group, eight of whom had a "very early" iCCA (four of them incidentals). The risk of tumor recurrence was significantly associated with larger tumor size as well as larger tumor volume, microscopic vascular invasion and poor degree of differentiation. None of the patients in the "very early" iCCA subgroup presented tumor recurrence compared to 36.4% of those with single tumors >2 cm or multinodular tumors, p = 0.02. The 1-, 3- and 5-year actuarial survival of those in the "very early" iCCA subgroup was 100%, 73% and 73%, respectively. The present is the first multicenter attempt to ascertain the risk factors for tumor recurrence in cirrhotic patients found to have an iCCA on pathology examination. Cirrhotic patients with iCCA ≤2 cm achieved excellent 5-year survival, and validation of these findings by other groups may change the current exclusion of such patients from transplant programs.

Intrahepatic cholangiocarcinoma or mixed hepatocellular-cholangiocarcinoma in patients undergoing liver transplantation: a Spanish matched cohort multicenter study.

OBJECTIVE: To evaluate the outcome of patients with hepatocellular-cholangiocarcinoma (HCC-CC) or intrahepatic cholangiocarcinoma (I-CC) on pathological examination after liver transplantation for HCC. BACKGROUND: Information on the outcome of cirrhotic patients undergoing a transplant for HCC and with a diagnosis of HCC-CC or I-CC by pathological study is limited. METHODS: Multicenter, retrospective, matched cohort 1:2 study. STUDY GROUP: 42 patients undergoing a transplant for HCC and with a diagnosis of HCC-CC or I-CC by pathological study; and control group: 84 patients with a diagnosis of HCC. I-CC subgroup: 27 patients compared with 54 controls; HCC-CC subgroup: 15 patients compared with 30 controls. Patients were also divided according to the preoperative tumor size and number: uninodular tumors 2 cm or smaller and multinodular or uninodular tumors 2 cm or larger. Median follow-up: 51 (range, 3-142) months. RESULTS: The 1-, 3-, and 5-year actuarial survival rate differed between the study and control groups (83%, 70%, and 60% vs 99%, 94%, and 89%, respectively; P < 0.001). Differences were found in 1-, 3-, and 5-year actuarial survival rates between the I-CC subgroup and their controls (78%, 66%, and 51% vs 100%, 98%, and 93%; P < 0.001), but no differences were observed between the HCC-CC subgroup and their controls (93%, 78%, and 78% vs 97%, 86%, and 86%; P = 0.9). Patients with uninodular tumors 2 cm or smaller in the study and control groups had similar 1-, 3-, and 5-year survival rate (92%, 83%, 62% vs 100%, 80%, 80%; P = 0.4). In contrast, patients in the study group with multinodular or uninodular tumors larger than 2 cm had worse 1-, 3-, and 5-year survival rates than their controls (80%, 66%, and 61% vs 99%, 96%, and 90%; P < 0.001). CONCLUSIONS: Patients with HCC-CC have similar survival to patients undergoing a transplant for HCC. Preoperative diagnosis of HCC-CC should not prompt the exclusion of these patients from transplant option.

Ethnic variation of the C677T and A1298C polymorphisms in the methylenetetrahydrofolate-reductase (MTHFR) gene in southwestern Mexico.

In this study, we examined the distribution of genotype and allele frequencies of the C677T and A1298C polymorphisms in the methylenetetrahydrofolate-reductase gene (MTHFR) in two ethnic groups in the State of Guerrero, Mexico, which were compared with those of the Mestizo population of the region. A comparative study was conducted on 455 women from two ethnic groups and a group of Mestizo women of the State of Guerrero, Mexico: 135 Nahuas, 124 Mixtecas, and 196 Mestizas. Genotyping of both polymorphisms were performed by using polymerase chain reaction-restriction fragment length polymorphism methods. We found that the 677TT genotype was more frequent in Nahua and Mixteca women compared to Mestiza women (P = 0.008), and the most prevalent genotype in both ethnic groups was the 1298AA genotype (P < 0.001). We also compared the 677T allele frequency obtained from the groups studied with the frequencies reported in other ethnic groups of Mexico (Huichol, Tarahumara, and Purepecha). There were significant differences between the three ethnic groups compared to Nahuas (Huicholes, P = 0.004; Tarahumaras, P < 0.001; Purepechas, P = 0.042). Our results indicated significant differences in the frequencies of the C677T and A1298C polymorphisms between the two ethnic groups and the Mestizo population of the State of Guerrero. In addition, we found strong differences with other ethnic groups in Mexico. These results could be useful for future studies investigating diseases related to folate metabolism, and could help the government to design specific nutrition programs for different ethnic groups.

First Mexican Consensus on Crohn's disease.

INTRODUCTION: Crohn's disease (CD) is a subtype of chronic and incurable inflammatory bowel disease. It can affect the entire gastrointestinal tract and its etiology is unknown. OBJECTIVE: The aim of this consensus was to establish the most relevant aspects related to definitions, diagnosis, follow-up, medical treatment, and surgical treatment of Crohn's disease in Mexico. MATERIAL AND METHODS: Mexican specialists in the areas of gastroenterology and inflammatory bowel disease were summoned. The consensus was divided into five modules, with 69 statements. Applying the Delphi panel method, the pre-meeting questions were sent to the participants, to be edited and weighted. At the face-to-face meeting, all the selected articles were shown, underlining their level of clinical evidence; all the statements were discussed, and a final vote was carried out, determining the percentage of agreement for each statement. RESULTS: The first Mexican consensus on Crohn's disease was produced, in which recommendations for definitions, classifications, diagnostic aspects, follow-up, medical treatment, and surgical treatment were established. CONCLUSIONS: Updated recommendations are provided that focus on definitions, classifications, diagnostic criteria, follow-up, and guidelines for conventional medical treatment, biologic therapy, and small molecule treatment, as well as surgical management.

[Increase in severe acute respiratory infections in children during the last phase of the COVID-19 pandemic]. / Incremento de infecciones respiratorias agudas graves en niños durante la última etapa de la pandemia COVID-19.

OBJECTIVE: The COVID-19 pandemic has caused a variation in the circulation of respiratory pathogens. Our aim was to analyze the epidemiology of severe acute respiratory infections (SARI) in children during 3 years of the COVID-19 pandemic, in comparison with a previous period. METHODS: An observational study was conducted in a tertiary hospital in Spain, which analyzed the frequency and characteristics of patients admitted for SARI in the Pediatric Intensive Care Unit (PICU) during the COVID-19 pandemic (1 March 2020 to 28 February 2023), compared to pre-pandemic period (1 March 2017 to 29 February 2020). RESULTS: A total of 268 patients were included (59.6% males). The median age was 9.6 months (IQR 1.7 - 37). In the pre-pandemic period, there were 126 admissions with an average of 42 admissions/year. During the pandemic, there were 142 admissions, observing a significant reduction in admissions in the first year (12 admissions/year), in contrast to 82 admissions during the third year, which represented an increase of 95% compared to the average of admissions/year in pre-pandemic. In addition, in the last year there was evidence of an increase in viral coinfections in relation to pre-pandemic period (54.9% vs 39.7%; p=0.032). There were no differences in length of hospital stay or PICU stay. CONCLUSIONS: During the last year, coinciding with low rates of hospitalization for COVID in Spain, we observed a notable increase in admissions to the PICU for SARI. Probably, the prolonged period of low exposure to pathogens due to the measures adopted during the pandemic might have caused a decrease in population immunity with a rise in severe respiratory infections.

Effect of antispasmodic agents, alone or in combination, in the treatment of Irritable Bowel Syndrome: systematic review and meta-analysis.

INTRODUCTION: Irritable bowel syndrome (IBS) is characterized by recurrent abdominal pain, bloating, and changes in bowel habit. AIMS: To determine the clinical effectiveness of the antispasmodic agents available in Mexico for the treatment of IBS. METHODS: We carried out a systematic review and meta-analysis of randomized controlled clinical trials on antispasmodic agents for IBS treatment. Clinical trials identified from January 1960 to May 2011 were searched for in MEDLINE, the Cochrane Library, and in the ClinicalTrials.gov registry. Treatment response was evaluated by global improvement of symptoms or abdominal pain, abdominal distention/bloating, and frequency of adverse events. The effect of antispasmodics vs placebo was expressed in OR and 95% CI. RESULTS: Twenty-seven studies were identified, 23 of which fulfilled inclusion criteria. The studied agents were pinaverium bromide, mebeverine, otilonium, trimebutine, alverine, hyoscine, alverine/simethicone, pinaverium/simethicone, fenoverine, and dicyclomine. A total of 2585 patients were included in the meta-analysis. Global improvement was 1.55 (CI 95%: 1.33 to 1.83). Otilonium and the alverine/simethicone combination produced significant values in global improvement while the pinaverium/simethicone combination showed improvement in bloating. As for pain, 2394 patients were included with an OR of 1.52 (IC 95%: 1.28 a 1.80), favoring antispasmodics. CONCLUSIONS: Antispasmodics were more effective than placebo in IBS, without any significant adverse events. The addition of simethicone improved the properties of the antispasmodic agents, as seen with the alverine/simethicone and pinaverium/simethicone combinations.

[Clinical characteristics of acute pancreatitis in Mexico]. / Características clínicas de la pancreatitis aguda en México.

BACKGROUND: Acute pancreatitis (AP) etiology and frequency vary in relation to geographic region. AIMS: To determine the etiology, frequency, and mortality of AP in a Mexican population. PATIENTS AND METHODS: We carried out a prospective study of first episode AP patients over a period of 6 years. RESULTS: A total of 605 patients with a mean age of 40 years were included in the study. Sixty-four percent of them presented with overweight and/or obesity determined through BMI. Etiology was biliary in 66.60%, it was due to alcohol consumption in 15.90%, hypertriglyceridemia in 7.80%, it was post-endoscopic retrograde cholangiopancreatography (ERCP) in 2.10%, and was undetermined in 7.20%. Pancreatic infection was suspected in 70 patients and they underwent CT-guided fine needle aspiration. Thirty-two of those patients were diagnosed with pancreatic infection in which Staphylococcus spp was the most common microorganism. Overall mortality was 5.00% (2.60% < 30 years and 10.00% > 70 years). Necrosis, pancreatic infection, and mortality were more frequent in the cases in which etiology was due to alcohol ingestion. CONCLUSIONS: The most frequent AP etiology was biliary, but that caused by alcohol presented with more complications. Overall mortality was 5.00% and was higher in the elderly patients.

[Epidemiology and clinical characteristics of ulcerative colitis in north-eastern Mexico]. / Epidemiología y características clínicas de la colitis ulcerosa crónica idiopática en el noreste de México.

BACKGROUND: Inflammatory Bowel Disease (IBD) compromises two entities: Ulcerative Colitis (UC) and Crohn Disease (CD). The incidence and prevalence vary widely in relation to ethnicity and demographic localization. Historically it has been considered a rare disease in Mexico. OBJECTIVE: To determine the frequency of new UC cases and their clinical characteristics in a referral hospital of North-Eastern Mexico. METHODS: An epidemiological, descriptive and retrospective study was made which included newly diagnosed patients with UC in a five years period. RESULTS: The adjusted rate of patients diagnosed with UC to the number of admissions for year was 2.3, 2.6, 3.0, 3.6 and 4.1/1000 admissions between 2004 and 2008. The rate of newly diagnosed patients with UC has doubled in the year 2008 compared with the year 2004 (p < 0.05). Fifty five percent of the patients showed mild disease, 30% showed moderate disease and 15% showed severe disease. Fifty percent of the patients had pancolitis, left sided colitis was present in 21% and 29% of the patients just had proctitis. Other clinical aspects of UC corresponded to those previously described. CONCLUSION: The frequency of new patients diagnosed with UC has significantly increased in this tertiary-care referral hospital for the last five years.

Risk and vulnerability assessment in coastal environments applied to heritage buildings in Havana (Cuba) and Cadiz (Spain).

In this paper, diagnostic tools are utilized to conduct a vulnerability analysis of monuments located in a coastal environment in accordance with a raft of standards drawn up by the International Organization for Standardization (ISO) 31000, in order to identify the main risks for Cultural Heritage in Havana (Cuba) and Cadiz (Spain). Vulnerability analysis is based on a Leopold matrix, which models the relationship between major hazards and pathologies in order to evaluate coastal influence and the risks for the conservation of cultural heritage. The quantitative matrix allows for a cause-effect analysis to be conducted for the main scenarios, related to the state of conservation. These relationships are a key step in risk assessment and treatment strategies. Major hazards have been identified by different public bodies and agencies to provide information about the probability and intensity of these variables in the vulnerability matrix. The combination of vulnerability index assessment, which depends on intrinsic variables and environmental scenarios, and knowledge of the main hazards in Havana and Cadiz, has provided useful tools to conduct risk assessments for cultural heritage conservation in coastal environments, where climate conditions, geomorphology and social issues are the main hazards, while vulnerability is associated with conservation plans. These tools provide information that will enable decision-makers in different coastal environments to prioritize strategies for cultural heritage preservation.

Second Mexican consensus on biologic therapy and small-molecule inhibitors in inflammatory bowel disease. / Segundo Consenso Mexicano de terapia biológica y moléculas pequeñas en enfermedad inflamatoria intestinal.

INTRODUCTION: Inflammatory bowel disease (IBD) is a chronic and incurable entity. Therapy with anti-TNF-α agents was the first biologic therapy approved in Mexico for IBD. New biologic agents, such as vedolizumab and ustekinumab, have recently been added, as have small-molecule inhibitors. AIM: To update the biologic therapeutic approach to IBD in Mexico with new anti-TNF-α agents and novel biologics whose mechanisms of action induce and maintain remission of Crohn's disease and ulcerative colitis (UC). MATERIALS AND METHODS: Mexican specialists in the areas of gastroenterology and inflammatory bowel disease were summoned to participate. The consensus was divided into 3 modules, with 49 statements. The Delphi method was applied, sending the statements to all participants to be analyzed and edited, before the face-to-face meeting. During said meeting, the clinical studies were shown, emphasizing the level of clinical evidence, and the final discussion and voting round on the level of agreement of all the statements was conducted. RESULTS: In this second Mexican consensus, recommendations are made for new anti-TNF-α agents, such as golimumab, new biologics with other mechanisms of action, such as vedolizumab and ustekinumab, as well as for the small-molecule inhibitor, tofacitinib. CONCLUSIONS: The updated recommendations focus on patient-reported outcomes, biologic therapy, small-molecule inhibitors, and the safety aspects of each of the drugs.

Transcription of the murine iNOS gene is inhibited by docosahexaenoic acid, a major constituent of fetal and neonatal sera as well as fish oils.

Macrophage activation is deficient in the fetus and neonate when the serum concentrations of docosahexaenoic acid (DHA) are 150 microM, or 10-50-fold higher than in the adult. We now show that DHA inhibits production of nitric oxide (NO) by macrophages stimulated in vitro by IFNgamma plus LPS, or by IFNgamma plus TNFalpha. The half-maximal inhibitory activity of DHA was approximately 25 microM. There were strict biochemical requirements of the fatty acid for inhibition. Polyenoic fatty acids with 22 carbons were more inhibitory than those with 20 carbons. Among 22-carbon fatty acids, those with a greater number of double bonds and a double bond in the n-3 position were more inhibitory. DHA was the most inhibitory of the polyenoic acids we tested. Inducible nitric oxide synthase (iNOS) is the enzyme responsible for the production of NO by macrophages. NO production is initiated after new iNOS enzyme is synthesized following transcription of the iNOS gene. In macrophages stimulated by IFNgamma plus LPS, DHA inhibited accumulation of iNOS mRNA, as measured by Northern blotting, and iNOS transcription, as measured by nuclear run-on assays. We transfected RAW 264.7 macrophages with a construct containing the iNOS promoter fused to the chloramphenicol acetyl transferase gene. DHA inhibited activation of this promoter by IFN gamma plus LPS. By inhibiting iNOS transcription in the fetus and neonate, DHA may contribute to their increased susceptibility to infection.

[Hepatic actinomycosis ; presentation a case in a diabetic patient]. / Actinomicosis hepática; presentación de un caso en un paciente diabético.

We report the case of an Hispanic female diabetic patient admitted to our hospital complaining of progressive abdominal pain, weight loss, nausea and vomiting. Work-up included an abdominal computed tomography (CT) scan which reported a large liver mass consistent with atypical abscess. Serum alpha-fetoprotein value was normal, so a fine needle aspiration biopsy of the liver was performed and the report was consistent with an actinomycosis-induced abscess. Patient was treated with intravenous and oral amoxicillin with satisfactory clinical response.

Estimation of cutoff for the Severity of Dependence Scale (SDS) for opiate dependence by ROC analysis.

BACKGROUND: The Severity of Dependence Scale (SDS) is a five-item scale that has been reported to be a reliable and valid screening instrument for dependence in several types of substances. Optimal cutoff points on the SDS indicative of clinically significant dependence have been determined for a large range of substance types, however, to date no data have been reported on its performance in a population with opiate dependence. SAMPLE: A structured interview was administered to 315 opiate-dependent patients in treatment. METHOD: The diagnostic performance of the SDS was measured via Receiver Operating Characteristic (ROC) analysis according to the DSM-IV diagnosis of heroin dependence, as measured by section 12 of the Schedule for Clinical Assessment in Neuropsychiatry (SCAN). RESULTS: ROC analysis revealed the SDS to be a test of high diagnostic utility for the measurement of opiate dependence (Area Under Curve =0.8875). The cut-off point on the SDS at which there is optimal discrimination between the presence and absence of a diagnosis of heroin dependence was found to be 5 (i.e. a score of 5 or more). This score provides the best trade-off between sensitivity (83.15%) and specificity (84.51%). Similar results were found for heroin current consumption (AUC = 0.8325; cut-off = 5; sensitivity = 77.94 and specificity = 77.33). CONCLUSION: The SDS can be recommended as an effective short instrument for the discrimination of the degree of dependency and heroin consumption in the clinical area.

Effectiveness of the Sex Pheromone for Monitoring Stenoma catenifer (Lepidoptera: Elachistidae) in Avocado Orchards.

The sex pheromone of the avocado moth Stenoma catenifer Walsingham has potential use in the detection of S. catenifer males in the Antillean race avocado in Chiapas, Mexico, although the study of local parameters that influence its effectiveness is required. In this study, trap type, trap height, pheromone release rate and duration of pheromone activity were evaluated to determine the effectiveness of this pheromone in field conditions in the Antillean race avocado crops of the coast of Chiapas, Mexico. The results obtained indicate that the capture of moths with the traps Pherocon III (delta type) and Pherocon 1C (wing type) was higher than that with the boat-type traps. The frequency of capture of S. catenifer males was higher when the traps were placed 4 and 6 m above ground level than that when they were 2 m high. The septum releases 85% of the amount of pheromone during the first 4 weeks, and there were no differences between the number of moth captures during the first 3 weeks, only between the fourth and the first 2 weeks. Our results suggest that the efficiency of the pheromone in Antillean race avocado depends on trap placement height and type as well as on the time of use of the pheromone septum.

Development of Technologies for Local Composting of Food Waste from Universities.

The amount of biowaste generated by university canteens (BWUC) in the faculties of the University of A Coruña (UDC) varies between 6 and 100 kg/day. In addition, the gardening services of the campus generate even higher amounts of garden waste (GrW), including pruning, which, once crushed, serves as bulking material for composting the biowaste from the canteens. Decentralized composting has been chosen with the aim of producing high quality organic fertilizers for university urban gardens while reducing the environmental burdens of both waste management and agricultural practice. Small static home composters of 340 L (SHC) for smaller amounts of generation (up to 20 kg BWUC/day) were used, while, for faculties of higher generation (up to 40 kg BWUC/day on average), the first composting stage was carried out in a closed and dynamic composter (DC). The dynamic composter was designed and built specifically for this project and its features were improved and optimized throughout the study. The pilot project was carried out in two centers of the UDC, which are known as the Philology Faculty (PF) and the School of Architecture (SA). All the organic waste generated by the canteens of these two colleges from January 2011 to July 2011 (approximately 3000 kg) was treated. Composting in SHC included a thermophilic phase that extended one month beyond the loading period for which thermophilic temperatures were also recorded. The use of the DC as the first stage in combination with static composters (SC) for the maturation stage reduced the overall thermophilic phase to 6-8 weeks. The complete maturation (Rottegrade class IV-V) was achieved after about four months in SHC and after two months when using the combined DC-SC system, if the right conditions of moisture were maintained. The chemical quality of the compost produced was compatible with Class A of Spanish legislation (equivalent to organic farmer quality) and the C/N ratio ranged from 9 to 15 depending on the relation BWUC:GrW.

Effect of protamine in obesity induced by high-fat diets in rats.

OBJECTIVE: Protamine has been shown to have an inhibitory effect on protein lipase in vitro; the objective of this study was to evaluate the antiobesity activity effect of protamine in obese induced rats, and to evaluate the effect of protamine on postprandial hypertriacylglyceridemia in rats by intragastric administration of a lipid emulsion containing corn oil. DESIGN: Two experiments were carried out: (1) In a parallel study in rats, we administered a lipid emulsion containing corn oil plus 0, 200 or 500 mg kg(-1) of protamine intragastrically. (2) In a randomized parallel prospective rats experiment, rats were fed with a high-fat diet and 0, 200 or 500 mg of protamine per kg of animal weight during 5 weeks. SUBJECTS: Male Sprague-Dawley rats. MEASUREMENTS: In experiment 1, plasma triacylglycerol levels after oral administration of lipid emulsion were determined. In experiment 2, weight gain, concentrations of plasma triacylglycerol, plasma total cholesterol and albumin were determined, and the subcutaneous and visceral adipose tissues were weighed. RESULTS: Plasma triacylglycerol concentration in rats administered with 200 or 500 mg kg(-1) of protamine was significantly lower than that in rats in the control group (200 mg kg(-1) of protamine, P<0.05 at 1, 2, 3 and 4 h; 500 mg kg(-1) of protamine P<0.05 at 2, 3 and 4 h). In rats fed with a high-fat diet, and 200 and 500 mg kg(-1) of protamine, there was a decreased body weight gain by 52 and 66 g, respectively, reduced visceral fat by 5 and 8 g, respectively and subcutaneous tissue weights by 12 and 15 g, respectively. Plasma triacylglycerol was 17 and 45 mg per 100 ml lower in rats fed with high-fat diet plus 200 and 500 mg kg(-1) of protamine, respectively. And cholesterol concentrations were 18 and 22 mg per 100 ml lower in both protamine groups, respectively. CONCLUSION: Our study demonstrates that protamine reduce weight gain and body fat accumulation through the inhibition of dietary fat absorption.

RANKL/OPG in primary cultures of osteoblasts from post-menopausal women. Differences between osteoporotic hip fractures and osteoarthritis.

The OPG/RANKL/RANK system is important in the balance between bone formation and resorption. We used primary human osteoblasts (hOBs) cells to examine the impact of 17-beta-estradiol (E2) or/and 1,25-dihydroxyvitamin D (1,25D) in OPG/RANKL system in 28 post-menopausal (PM) women; (a) with hip fracture (OP) or (b) with osteoarthritis (OA). The hOB from OP patients proliferated slower during the first stage, than the OA women (31.5+/-2.6 and 21.4+/-1.3 days, respectively, p<0.05). The OP group secreted significantly higher OPG protein levels than the OA women (10.1+/-2.6 and 4.4+/-0.8pmol/L, respectively, p<0.05). The 1,25D and 1,25D+E2 induce an increase in RANKL and RANKL/OPG mRNA expression in OP patients above 200% (p<0.05). HOBs from the osteoporotic hip initially proliferate slower but after reaching the first cellular confluence, the proliferation rate is equal in both groups. Furthermore, hOBs from hips with OP present a higher protein secretion of OPG, and higher RANKL and RANKL/OPG expression ratio in response to 1,25D and 1,25D+E2, than hOBs from OA women. All this could suggest that the greater bone loss that characterizes OP patients can be mediated due to differences in the secretion and expression of the RANKL/OPG system in response to different stimuli.

Inferior vena cava (IVC) filter thrombosis in a renal transplant recipient.

We report a renal transplant patient with a functioning allograft who had an inferior vena cava (IVC) filter placed above the renal allograft vein. The patient occluded the IVC filter and developed extensive distal thrombosis. This included complete occlusion of the renal allograft vein (RAV). However, this complication did not lead to a loss of kidney transplant function. Alternate allograft venous drainage via capsular collaterals and subsequent recanalization of transplant vein were demonstrated.

[Considerations in evaluating the quality of life of patients with digestive, liver and bile disorders in Mexico]. / Consideraciones en la evaluación de la calidad de vida de enfermos con afecciones digestivas, hepáticas y biliares en México.

BACKGROUND: In Mexico, there are few reviews of life quality related to health. These reviews do not substitute symptom, analytic and morphologic evaluations by physicians. They only complement them, by introducing the patient;s vision about his perception of his own health. They also intent to reflect the impact of disease on the patient and on his general health. Besides, they also recognize the influence of health on a daily living basis. Objetive: To analyze the nowadays literature existing in Mexico, with regard to the instruments to evaluate the quality of life within patients with gastrointestinal diseases. METHODS: Search of instruments for measuring the status of life related to health in the mexican population in the MEDLINE database, with emphasis on gastrointestinal and hepatobiliar diseases. RESULTS: One hundred references had been found, but only 10 correspond to studies that use different instruments of evaluation of life status related to gastrointestinal diseases in Mexico. Five of these studies are specific questionnaires and five are generic. CONCLUSION: Actually there are few investigations about evaluation of quality of life in Mexican patients, because of the cultural differences within the Hispano-American countries. All of the questionnaires must be evaluated before using them in our population.