Dr Alfredo I Servín-Caamaño, Md - Hospital general de mexico - Dr

Dr Alfredo I Servín-Caamaño

Md

Hospital general de mexico

Dr

Mexico city, Mexico | Mexico

Main Specialties: Internal Medicine

Additional Specialties: Adults medicine

Dr Alfredo I Servín-Caamaño, Md - Hospital general de mexico - Dr

Dr Alfredo I Servín-Caamaño

Md

Introduction

Internal medicine specialist, internal medicine department Hospital General de Mexico, Profesor in medicine by IPN, Clinical investigator.

Primary Affiliation: Hospital general de mexico - Mexico city, Mexico , Mexico

Specialties:

Additional Specialties:

Research Interests:

Publications

9Publications

1060Reads

181Profile Views

3PubMed Central Citations

Primary Prophylaxis to Prevent the Development of Hepatic Encephalopathy in Cirrhotic Patients with Acute Variceal Bleeding.

Can J Gastroenterol Hepatol 2018 10;2018:3015891. Epub 2018 Jul 10.

Research Department, Chief of the Medical Direction of "Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado" (ISSSTE), Mexico City 14050, Mexico.

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http://dx.doi.org/10.1155/2018/3015891DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069577PMC
February 2019
156 Reads

Malnutrition negatively impacts the quality of life of patients with cirrhosis: An observational study

World J Hepatol 2017; 9(5): 263-269

World J Hepatol.

https://www.wjgnet.com/1948-5182/full/v9/i5/263.htm

Abstract

AIM:

To verify how malnutrition is related to health-related quality of life (HRQL) impairment in patients with cirrhosis.

METHODS:

Data was retrospectively abstracted from medical records and obtained by direct interview. We included patients with cirrhosis from any etiology, evaluated at the Liver Clinic from Gastroenterology Department in a tertiary healthcare center, from June 2014 to June 2016. Child-Pugh score, data about complications, and demographic, clinical and anthropometric characteristics of patients were obtained. Nutritional status was evaluated by the Subjective Global Assessment (SGA). HRQL was evaluated through the Chronic Liver Disease Questionnaire. Patients were requested to assess their global HRQL with the following code: 0 = impairment of HRQL, when it was compared with other healthy subjects; 1 = good HRQL, if it was similar to the quality of life of other healthy subjects. To compare the primary outcome between malnourished and well-nourished groups, the χ2 test, Fisher's exact test or Student's t-test were used, based on the variable type. Associations between predictor variables and deterioration of HRQL were determined by calculating the hazard ratio and 95% confidence interval using Cox proportional hazards regression.

RESULTS:

A total of 127 patients with cirrhosis were included, and the mean age was 54.1 ± 12.3 years-old. According to Child-Pugh scoring, 25 (19.7%) were classified as A (compensated), 76 (59.8%) as B, and 26 (20.5%) as C (B/C = decompensated). According to SGA, 58 (45.7%) patients were classified as well-nourished. Sixty-nine patients identified HRQL as good, and 76 patients (59.8%) perceived impairment of their HRQL. Multivariate analysis to determine associations between predictor variables and self-perception of an impairment of HRQL found strong association with malnutrition (P < 0.0001). The most important impaired characteristics in malnourished patients were: Presence of body pain, dyspnea on exertion with daily activities, decreased appetite, generalized weakness, trouble lifting or carrying heavy objects, and decreased level of energy (P < 0.0001).

CONCLUSION:

Malnutrition is a key factor related to impairment of HRQL in patients with cirrhosis.

KEYWORDS:

Chronic liver disease questionnaire; Cirrhosis; Health-related quality of life; Malnutrition; Subjective global assessment

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December 2018
168 Reads

Uncontrolled Glycaemia Is the Strongest Predictive Factor of Liver-Related and Cardiovascular Death in Diabetic Patients with Cirrhosis

Diabetes 2018 Jul; 67(Supplement 1): -. https://doi.org/10.2337/db18-2362-PUB

Diabetes

Diabetes is a common comorbidity in cirrhotic patients; there are insufficient studies in this context. Aim: to investigate risk factors for liver-related death (LRD) and cardiovascular death (CVD) in a cohort of diabetic patients with cirrhosis. Follow-up 10 years. We included 380 diabetics with cirrhosis, according to Child-Pugh: 141(37.1%) A, 170(44.7%) B, 69(18.2%) C. Thirty three (8.7%) died for LRD, 29(7.6%) died for CVD. Those died for LRD, compared with those alive, had higher glucose 211±80 vs. 143±62 mg/dL p<0.0001; HbA1c 8.0±1.4 vs. 6.8±1.1% p<0.0001. Univariate analysis (UA): hepatic encephalopathy (HE) p=0.02; ascites, spontaneous bacterial peritonitis (SBP), HbA1c >7.0%, and decompensated cirrhosis (Child B/C) were factors associated with LRD p<0.0001. Variceal bleeding (VB) was not significant (NS). Multivariate analysis (MA): only HbA1c >7.0% was associated with liver-related death HR=3.0; 95% CI=1.4-6.6 p<0.006. Those died for CVD had higher glucose 230±92 vs. 143±62 mg/dL p<0.0001; HbA1c 8.8±1.6 vs. 6.8±1.1% p<0.0001. UA: ascites p=0.001; HE, SBP, HbA1c ≥7.0% were associated with CVD p<0.0001. Child B/C and VB were NS. MA: HbA1c ≥7.0% was the strongest factor related to CVD HR=8.4; 95% CI=3.1-22.6 p<0.0001. Uncontrolled glycaemia is the most important risk factor predicting LRD and CVD. A tight glycemic control is need in cirrhotic patients.

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July 2018
150 Reads

Malnutrition is a key prognostic factor related to high mortality-rate in patients with severe alcoholic hepatitis

Nutr Hosp 2018;35(3):677-682

Nutricion Hospitalaria

Background and aim: comparatively with European or North-American populations, severe alcoholic hepatitis has a high mortality rate in Mexican population, becoming as high as 50 to 81% in those classified as ABIC B or C; this is true even when they receive specific therapy with steroids or pentoxifylline. The aim of this study was to know which clinical factors are related to early mortality (first 30 days) in Mexican patients with severe alcoholic hepatitis. Subjects and methods: this was a retrospective cohort study that included patients with severe alcoholic hepatitis, defined by a Maddrey’s discriminant function ≥ 32, treated at a tertiary care center in a period of five years (2010 to 2015). Results: seventy-six patients were included, 72 (94.7%) were males, mean age was 43 ± 9.1 year-old, and 58 (76.3%) had also cirrhosis. According to the subjective global assessment (SGA), 38 (50%) had severe malnutrition, 22 (28.9%) were at risk of malnutrition, and 16 (21.1%) were well-nourished. At 30 days, 46 patients (60.5%) died. In the multivariate analysis, only the presence of severe malnutrition was associated with 30-day mortality: OR = 6.4; 95% CI: 1.9-22.1; p = 0.003. Conclusions: the nutritional status seems to be a cardinal prognostic factor associated with early mortality (first 30 days). Malnutrition can explain the high mortality rate observed in Mexican patients with severe alcoholic hepatitis.

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July 2018
46 Reads

PROTON PUMP INHIBITORS INCREASE THE OVERALL RISK OF DEVELOPING BACTERIAL INFECTIONS IN PATIENTS WITH CIRRHOSIS.

Arq Gastroenterol 2018 Jan-Mar;55(1):28-32

The Liver Clinic´s Research Group from Gastroenterology and Hepatology Department, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico.

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http://dx.doi.org/10.1590/S0004-2803.201800000-09DOI Listing
April 2018
267 Reads

Pathophysiological mechanisms involved in non-alcoholic steatohepatitis and novel potential therapeutic targets.

World J Hepatol 2015 Jun;7(10):1297-301

Fátima Higuera-de la Tijera, Liver Clinic, Gastroenterology Department, Mexico's General Hospital "Dr. Eduardo Liceaga", Mexico City 06726, Mexico.

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http://dx.doi.org/10.4254/wjh.v7.i10.1297DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4450193PMC
June 2015
182 Reads
3 Citations

Mean platelet volume as a novel predictor of systemic inflammatory response in cirrhotic patients with culture-negative neutrocytic ascites.

World J Hepatol 2015 May;7(7):1001-6

Marisol Gálvez-Martínez, Eduardo Pérez-Torres, Francisco Salas-Gordillo, Fátima Higuera-de la Tijera, Gastroenterology Department, Hospital General de México "Dr. Eduardo Liceaga", Mexico City 06720, Mexico.

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http://dx.doi.org/10.4254/wjh.v7.i7.1001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4419093PMC
May 2015
40 Reads

Metadoxine improves the three- and six-month survival rates in patients with severe alcoholic hepatitis.

World J Gastroenterol 2015 Apr;21(16):4975-85

Fátima Higuera-de la Tijera, Eduardo Pérez-Torres, Juan M Abdo-Francis, Francisco Salas-Gordillo, José L Pérez-Hernández, Liver Clinic, Gastroenterology Department, Hospital General de México, Dr. Eduardo Liceaga, Mexico City 06720, Mexico.

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http://dx.doi.org/10.3748/wjg.v21.i16.4975DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408471PMC
April 2015
283 Reads
2.369 Impact Factor

Treatment with metadoxine and its impact on early mortality in patients with severe alcoholic hepatitis.

Ann Hepatol 2014 May-Jun;13(3):343-52

Gastroenterology Department, Hospital General de México, México.

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January 2015
132 Reads
2.193 Impact Factor