Publications by authors named "Aldo Barajas-Ochoa"

20 Publications

  • Page 1 of 1

Orbit and sinonasal metastasis as presenting sign of renal cell carcinoma.

BMJ Case Rep 2021 Apr 13;14(4). Epub 2021 Apr 13.

Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA

Orbit and sinonasal metastases are rare. Renal cell carcinoma (RCC) can metastasise to this region. We present the case of a 49-year-old woman with weight loss, diplopia and a rapidly growing facial mass. The initial diagnosis was a primary tumour and patient underwent excisional biopsy, which showed findings consistent with a diagnosis of RCC. On a subsequent focused review of system, the patient reported having intermittent haematuria. Imaging studies revealed a complex right renal mass as the primary tumour. Metastatic RCC should be in the differential diagnosis of patients with facial masses, especially if associated with symptoms suggestive of a systemic involvement such as haematuria. Despite treatment, patients with metastatic RCC tend to have a dismal prognosis. However, early stage diagnosis of metastatic disease can considerably limit surgical complications and improve survival rate in these patients.
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http://dx.doi.org/10.1136/bcr-2020-240588DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8051362PMC
April 2021

Complications of Endoscopic Retrograde Cholangiopancreatography in Patients With Previous Bariatric Surgery: A National Inpatient Sample Analysis, 2007-2013.

J Clin Gastroenterol 2021 Jan 5;Publish Ahead of Print. Epub 2021 Jan 5.

Department of Medicine Department of Medicine, Division of Gastroenterology and Hepatology Rutgers New Jersey Medical School, Newark, NJ Section of Digestive Diseases, Yale School of Medicine, New Haven, CT.

Background: Bariatric surgery (BS) has been proven to be effective in the treatment of obesity and weight-related diseases, but the anatomic changes after BS make endoscopic retrograde cholangiopancreatography (ERCP) technically challenging. This study aims to assess the safety and clinical outcomes of ERCP in patients with previous BS.

Materials And Methods: The National Inpatient Sample from 2007 to 2013 was queried for hospitalizations of adults over 18 years of age with procedure diagnoses of ERCP. Those with prior BS were selected as cases and those without BS as controls. Case-control matching at a ratio of 1 case to 2 controls was performed based on sex, age, race, comorbidities, and obesity. The primary outcomes were inpatient mortality and ERCP-related complications. Multivariate regression analysis was used to identify independent risk factors associated to the primary outcomes.

Results: A total of 1,068,862 weighted hospitalizations with ERCP procedure codes were identified. Of these, 6689 with BS were selected as cases, and 13,246 were matched as controls. The reason for hospital admission was most often biliary stone disease (60.7% vs. 55.5%), followed by malignancy (3.5% vs. 12.1%) and cholangitis (7.7% vs. 4.5%) with and without BS, P<0.05. The BS group had lower rates of post-ERCP pancreatitis (0.1% vs. 1.3%), cholecystitis (0.1% vs. 0.3%), bleeding (1.0% vs. 1.4%), and inpatient mortality (0.2% vs. 0.5%), but had higher rates of cholangitis (5.0% vs. 3.7%) and systemic infections (6.2% vs. 4.8%), all P<0.05.

Conclusions: BS group had lower post-ERCP pancreatitis, cholecystitis and bleeding while had more cholangitis, and systemic infection compared with those without BS. Also, BS was independently associated with reduced inpatient mortality after adjusted for age, race, and comorbidity.
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http://dx.doi.org/10.1097/MCG.0000000000001483DOI Listing
January 2021

Spontaneous pneumothorax secondary to an endometrial stromal sarcoma.

Lancet Oncol 2020 12;21(12):e589

Division of Pulmonary & Critical Care, Rutgers New Jersey Medical School, Newark, NJ, USA.

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http://dx.doi.org/10.1016/S1470-2045(20)30330-2DOI Listing
December 2020

The impact of bariatric surgery on in-patient clinical outcomes among patients with autoimmune hepatitis.

Medicine (Baltimore) 2020 Oct;99(42):e22446

Department of Gastroenterology and Hepatology, Rutgers New Jersey Medical School, Newark, NJ, USA.

Autoimmune hepatitis (AIH) is a form of liver inflammation in which immune cells target hepatocytes, inducing chronic inflammatory states. Bariatric surgery (BS) was shown to reduce inflammation in severely obese patients. We hypothesize that obese patients with AIH and BS have lower prevalence of liver-related complications and in-patient mortality compared to those without BS.The National Inpatient Sample from 2007 to 2013 was queried for hospitalizations of adults over 18 years of age with a diagnosis of AIH. Of those, hospitalizations with BS were selected as cases and those with morbid obesity as controls. Case-control 1:2 matching was done based on sex, age, race, and comorbidities. Primary outcomes were prevalence of liver-related complications and in-patient mortality. Independent risk factors of in-patient clinical outcomes were identified using multivariate regression analysis.From 137,834 hospitalizations with a diagnosis of AIH, 688 with BS were selected as cases, and 1295 were matched as controls. The prevalence of ascites was higher in the BS group compared to the control (odds ratio 1.73, 95% confidence interval (CI) 1.27-2.36). The prevalence of cirrhosis (36.8% vs 33.2%), portal hypertension (7.4% vs 10.0%), hepatic encephalopathy (10.6% vs 8.7%), and varices and variceal bleeding (3.9% vs 5.5%) was not statistically different from case controls, (P > .05).BS was an independent risk factor for ascites (adjusted odds ratio (aOR) 1.87; 95% CI 1.36-2.56) and hepatic encephalopathy (aOR 1.42; 95% CI 1.03-1.97) but was an independent protective factor against in-patient mortality (aOR 0.21, 95% CI 0.08-0.55) once adjusted for age, sex, race, and comorbidities.
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http://dx.doi.org/10.1097/MD.0000000000022446DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7572015PMC
October 2020

Chest pain in a middle-aged smoker with heart failure and missing lung.

Eur J Intern Med 2020 11 24;81:87-88. Epub 2020 Sep 24.

Department of Medicine, Rutgers New Jersey Medical School, 185 S Orange Avenue, Newark, NJ 07107. Electronic address:

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http://dx.doi.org/10.1016/j.ejim.2020.09.013DOI Listing
November 2020

Cardiac Metastases from Renal Cell Carcinoma.

J Gen Intern Med 2020 12 9;35(12):3711-3712. Epub 2020 Sep 9.

Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.

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http://dx.doi.org/10.1007/s11606-020-06200-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7728881PMC
December 2020

Assessment of the Effect of the Go Red for Women Campaign on Search Engine Queries for Cardiovascular Disease in Women.

Cardiol Res 2020 Oct 1;11(5):348-352. Epub 2020 Aug 1.

Heart Failure and Pulmonary Hypertension Program, Hackensack University Medical Center, 30 Prospect Ave, Hackensack, NJ 07601, USA.

Background: The Go Red for Women (GoRedW) campaign aims to increase awareness of cardiovascular disease (CVD) and stroke in women. However, assessing the effects of social campaigns on information-seeking behaviors may be challenging. The purpose of this study was to ascertain the effect of GoRedW using a large sample of unbiased real-world data from Google Trends (GTr) and evaluate the temporal correlation of online search queries for CVD and stroke in women with GoRedW.

Methods: We conducted a retrospective study using GTr, a public tool from the Google search engine to obtain relative search volumes (RSVs) related to CVD and stroke in women in the period January 2004 to April 2019 in the USA. In addition, trends of GoRedW were compared with those of the well-established Breast Cancer Awareness Month (BCAM) campaign.

Results: RSVs increased for queries of GoRedW and all searched terms for CVD but not for stroke in women during February compared to other months of the year without active campaign. The strong pattern with peaks of temporal increase was consistent over the 15-year study period. RSV of "Go Red for Women" in February increased on average 494% (range: 211% to 789%). The highest temporal increase on search queries for CVD was for the term "heart disease (in) women" with an average of 114% (24% to 182%). We found a positive correlation between RSVs of GoRedW and the term "heart disease (in) women" (r = 0.54, P < 0.001). RSVs for "Breast Cancer Awareness Month" had a higher increase during the active campaign month compared to GoRedW and showed a stronger positive correlation (r = 0.78, P < 0.001).

Conclusions: Search engines are a valuable resource to provide insights on information demand and to assess the effectiveness of social campaigns and interventions. Our study showed an increase in the RSVs for queries of GoRedW and all CVD terms which correlated with the active campaign months over a 15-year period.
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http://dx.doi.org/10.14740/cr1107DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7430885PMC
October 2020

Challenges for medical education in Mexico in the time of COVID-19.

Gac Med Mex 2020;156(3):253-256

Montefiore Medical Center, Albert Einstein College of Medicine, New York. United States of America.

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http://dx.doi.org/10.24875/GMM.M20000376DOI Listing
June 2020

Challenges for medical education in Mexico in the time of COVID-19.

Gac Med Mex 2020 May 14;156(4). Epub 2020 May 14.

Montefiore Medical Center, Albert Einstein College of Medicine, New York, United States of America.

By April 2, 2020, only 116 days after the description of the first case of SARS-CoV2 virus infection, which causes the COVID-19 disease, 1,014,673 cases and 50,030 deaths have been recorded in 181 countries.1 In the United States, there have been 244,678 cases and 5,911 deaths recorded (in New York State alone, there are 93,053 cases and 2,538 deaths), while in Mexico, 1,378 cases and 37 deaths have been recorded. This number is expected to keep on increasing in both countries. The health system in Mexico, as well as in the rest of the world, will face an enormous problem in the months to come.
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May 2020

A Young Man with Red Eyes, Polymorphous Rash, and Mucositis-an On-the-Spot Diagnosis.

J Gen Intern Med 2020 04 21;35(4):1309-1310. Epub 2020 Jan 21.

Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.

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http://dx.doi.org/10.1007/s11606-020-05663-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174476PMC
April 2020

[Performance of medical schools in Mexico: results from the Examen Nacional para Aspirantes a Residencias Médicas].

Salud Publica Mex 2019 Jul-Ago;61(4):495-503. Epub 2019 Jul 17.

Universidad de Guanajuato. Guanajuato, México.

Objective: To assess the performance of medical schools (FEM) by analyzing the results of their applicants in the Examen Nacional para Aspirantes a Residencias Médicas (ENARM).

Materials And Methods: Five performance criteria, two official and three created on purpose, were calculated from the ENARM-2016 and -2017 official databases to assess FEM performance.

Results: In 2016 and 2017, applicants registered from 112 and 115 FEM, respectively. Depending on the performance criteria, the FEM in the first place obtained 5 to 20 points more than the one placed second, and 23 to 98 points more than the FEM in the last place. Approximately 25% applicants were classified as "knowledge-deficient," and about 80% of these originated from less than one third of the FEM.

Conclusions: The ENARM results provide information on the performance of the FEM. Approximately one of every four applicants obtained scores lower than the approval threshold of any specialty.
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http://dx.doi.org/10.21149/10042DOI Listing
February 2020

Análisis bibliométrico de las revistas médicas del Sistema de Clasificación de Revistas Mexicanas de Ciencia y Tecnología.

Gac Med Mex 2019 ;155(3):258-265

Unidad de Investigación en Enfermedades Crónico-Degenerativas, Guadalajara, Jalisco, México.

Introduction: CONACYT's Mexican Science and Technology Journals Classification System (SCRMCYT) includes the area of medicine and health sciences (M&HS).

Objective: A bibliometric analysis of M&HS journals listed in SCRMCYT in 2018 was performed.

Method: Twelve characteristics related to indexation in the Web of Science Core Collection (WoSCC), Scopus, and PubMed databases were analyzed. Indexed journals were analyzed on whether they had recent indexed publications (2017 and 2018). Indexed journals' 50 most-cited articles in WoSCC and Scopus were analyzed.

Results: Of the 35 M&HS journals included in the 2018 SCRMCYT list, 31 (89 %) were indexed in Scopus (22 with indexed publications in 2017; 18 in 2018), 17 (49 %) in PubMed (10 with indexed publications in 2017 and 2018), and 12 (34 %) in WoSCC (12 with indexed publications in 2017; 8 in 2018). The 50 most-cited articles had been published only in 4 journals indexed in WoSCC and 5 in Scopus; 60 % were review articles.

Conclusions: Approximately half the 2018 SCRMCYT M&HS journals lack publications indexed in 2018; this suggests that national and international relevance of these journals can be improved.
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http://dx.doi.org/10.24875/GMM.19005030DOI Listing
January 2020

Happy Birthday?… Happy Birthday!

J Am Geriatr Soc 2019 09 13;67(9):1977-1978. Epub 2019 Jun 13.

Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey.

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http://dx.doi.org/10.1111/jgs.16031DOI Listing
September 2019

Respecto al consentimiento informado y su documentación.

Gac Med Mex 2019 ;155(2):217

Instituto Mexicano del Seguro Social, Hospital de Especialidades 25, Monterrey, Nuevo León, México.

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http://dx.doi.org/10.24875/GMM.19005031DOI Listing
February 2020

Flaws in the design of the Examen Nacional para Aspirantes a Residencias Médicas produce inequity.

Salud Publica Mex 2019 Mar-Apr;61(2):125-135

Universidad Autónoma de Guadalajara. Zapopan, Jalisco, México.

Objective: To assess the assumption of 'equity' of Mexico's resident-selection assessment tool, the Examen Nacional para Aspirantes a Residencias Médicas (ENARM).

Materials And Methods: Official ENARM-2016 and -2017 databases were analyzed. Differences in the absolute number of correct answers (multivariable linear regression) and the number of applicants reaching their specialty minimum score (SMS) per test day (odds ratio [OR]) were calculated. Applicants affected by test-day inequity were estimated.

Results: There were 36 114 applicants in 2016, and 38 380 in 2017. In 2016, day-2 applicants had significantly higher scores and more reached the SMS than on days 1-3-4 (OR 1.55), and 5 (OR 3.8); 3 565 non-passing applicants were affected by inequity (equivalent to 44.64% of those selected). In 2017, day-1 and -2 applicants had significantly higher scores and more reached the SMS than on days 3-4 (OR 1.85), and 5 (OR 4.04); 3,155 non-passing applicants were affected by inequity (37.2% of those selected).

Conclusions: Analysis of official ENARM databases does not support the official attribution of equity, suggesting the test should be redesigned.
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http://dx.doi.org/10.21149/DOI Listing
December 2019

Potential uses of an infodemiology approach for health-care services for rheumatology.

Clin Rheumatol 2019 Mar 17;38(3):869-876. Epub 2018 Nov 17.

Unidad de Investigación en Enfermedades Cronico-Degenerativas, Colomos 2292, Providencia, 44620, Guadalajara, Jalisco, Mexico.

Objectives: This is a demand-based infodemiology study using the Google Trends and AdWords tools to illustrate infodemiology's potential use in rheumatology. The study investigates three questions in North American countries: (1) What terms associated with "rheumatology" and "arthritis" do people search for on Google? (2) What is the search volume for disease-modifying antirheumatic drugs (DMARDs)? and (3) What is the search volume for the term "arthritis" compared with for "hepatitis C" and "breast cancer"?

Methods: We conducted independent searches by country and search term for 2015-2017. Seventeen DMARDs were searched for 2015 through May 2018, with the turmeric remedy included for comparison. Data were exported to Excel for further analysis, adjusted by country population, and expressed as searches per 100,000 inhabitants (SpTh).

Results: There were approximately 550 associated terms for "arthritis" in each country, and 5679 SpTh for DMARDs across the three countries. Searches for turmeric numbered slightly lower than for all DMARDs together in Canada and the USA, but were 70% higher in Mexico. Turmeric was also searched four times more than the most-searched biological DMARD in Canada and the USA, and 60 times more in Mexico. Arthritis was more commonly searched for in Canada than hepatitis C and breast cancer, but hepatitis C was highest in the USA and breast cancer in Mexico. Monthly trends did not show expected peaks associated with arthritis awareness campaigns.

Conclusion: Infodemiology provides preliminary information that could help in generating hypotheses, assessing health-care interventions, or even in providing patient-centered care.
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http://dx.doi.org/10.1007/s10067-018-4364-zDOI Listing
March 2019

Trends of Informed Consent forms for industry-sponsored clinical trials in rheumatology over a 17-year period: Readability, and assessment of patients' health literacy and perceptions.

Semin Arthritis Rheum 2018 12 16;48(3):547-552. Epub 2018 Mar 16.

Unidad de Investigación en Enfermedades Cronico-Degenerativas, Guadalajara, México; Universidad Autonoma de Guadalajara, Guadalajara, México. Electronic address:

Objective: To assess trends in the length and readability of informed consent forms (ICFs) for industry-sponsored multinational clinical trials (RCTs) in rheumatology over a 17-year period. Additionally, to assess the health literacy (HL) and perceptions of ICFs among participants of current RCTs.

Methods: The readability of ICFs conducted at an outpatient rheumatology clinic between 1999 and 2016 were assessed using the INFLESZ scale. Patients' HL was assessed using SALHSA-50 and STOFHLA. Patient opinions were assessed using a self-reported, in-office questionnaire with an independent patient sample who had signed an ICF in the past 6 months.

Results: Thirty-nine ICFs about 22 drugs from 13 pharmaceutical companies were analyzed. The global mean readability was 57 ± 3 (95% CI: 56-58), and all ICFs were categorized as either "somewhat difficult to read" or "average." Readability remained at these levels without significant changes from 1999 to 2016. The mean length of the ICFs written between 1999 and 2005 was 13 ± 5 pages, with a significant increase thereafter (mean 22 ± 8 pages, p = 0.004). Depending on the instrument, of 95 patients participating in the HL assessment, between 18% and 44% had limited HL. Of 90 patients participating in the perceptions questionnaire, 84% reported understanding the ICF well. However, 2-57% misunderstood basic concepts, including the study drug name and placebo.

Conclusions: The disparity between the readability of ICFs with patients' HL and their comprehension of ICFs continues, even after decades of attempts of regulatory agencies and numerous published suggestions.
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http://dx.doi.org/10.1016/j.semarthrit.2018.03.008DOI Listing
December 2018

[[Recognizing diagnostic errors as a necessary step to address them]].

Salud Publica Mex 2018 Jan-Feb;60(1):109-110

Coordinación Institucional de Proyectos de Investigación Independientes, Unidad de Investigación en Enfermedades Crónico-Degenerativas. Guadalajara, Jalisco.

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http://dx.doi.org/10.21149/8418DOI Listing
June 2019

[Equity, validity and reliability of the National Examination for Candidates to Medical Residences (ENARM): opportunities for improvement].

Salud Publica Mex 2017 Sep-Oct;59(5):501-502

Universidad Autónoma de Guadalajara. Zapopan, México.

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http://dx.doi.org/10.21149/8769DOI Listing
June 2019

Is gout an easy-to-treat disease? The importance of health determinants.

Reumatol Clin 2018 Jan - Feb;14(1):59-60. Epub 2017 Apr 12.

Universidad Autónoma de Guadalajara, Guadalajara, Mexico.

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http://dx.doi.org/10.1016/j.reuma.2017.03.008DOI Listing
October 2018