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Papers by Latife Salame Khouri
Anales médicos, 2022
In recent years, special attention has been paid to the microorganisms that inhabit the human bod... more In recent years, special attention has been paid to the microorganisms that inhabit the human body. It used to be believed that these were mere guests. However, attention has been focused on studying the relationship between these microorganisms and human health. In this review article, we intend to expose the relationship between the microbiota and certain gastrointestinal, metabolic, cardiovascular, neuropsychiatric and allergic diseases, according to current evidence. We conducted a review in PubMed, with the MeSH terms «microbiome», «microbiota», «gastrointestinal disease», «metabolic disease», «Neuropsychiatry» and «allergy». We included articles in English and Spanish, published between 2000 and 2021, that were meta-analyzes, review articles, and clinical and experimental trials of greater relevance to fulfill the objective of this manuscript. The microbiome is essential to maintain a good health in human beings. Alterations in the microbiome can cause many diseases, from those related to the gastrointestinal tract to neuropsychiatric ones.
Anales médicos, 2022
La formación de recursos humanos en salud es un tema de interés general, pues de eso depende la c... more La formación de recursos humanos en salud es un tema de interés general, pues de eso depende la calidad de los servicios sanitarios que se ofrecen a toda la población. Se trata de un ensayo de filosofía en medicina. Se revisaron textos e informes relevantes para poder argumentar los puntos expuestos en el artículo. México es la décimo sexta economía mundial, pero tiene una de las tasas de médicos más bajas de la Organización para la Cooperación y el Desarrollo Económicos (México: 2.2 versus promedio Organización para la Cooperación y el Desarrollo Económicos: 3.3 médicos por 1,000 habitantes). Contrasta este dato con la apertura de 45 nuevas escuelas de medicina en los últimos 10 años: en México hay 158 escuelas de medicina de las cuales se gradúan alrededor de 18,000 médicos al año; más de la mitad de las nuevas escuelas no están certificadas, lo que pone en duda la calidad de sus egresados. El desequilibrio entre demanda y oferta de la atención médica satura los sistemas de salud y a sus trabajadores. Las escuelas de medicina y el estado deben trabajar juntos para garantizar una atención sanitaria de calidad. La cobertura universal de salud depende de una adecuada formación de recursos humanos en salud.
BMC Medical Genomics
Background Pituitary adenomas (PA) are the second most common intracranial tumors and are classif... more Background Pituitary adenomas (PA) are the second most common intracranial tumors and are classified according to hormone they produce, and the transcription factors they express. The majority of PA occur sporadically, and their molecular pathogenesis is incompletely understood. Methods Here we performed transcriptome and proteome analysis of tumors derived from POU1F1 (GH-, TSH-, and PRL-tumors, N = 16), NR5A1 (gonadotropes and null cells adenomas, n = 17) and TBX19 (ACTH-tumors, n = 6) lineages as well as from silent ACTH-tumors (n = 3) to determine expression of kinases, cyclins, CDKs and CDK inhibitors. Results The expression profiles of genes encoding kinases were distinctive for each of the three PA lineage: NR5A1-derived tumors showed upregulation of ETNK2 and PIK3C2G and alterations in MAPK, ErbB and RAS signaling, POU1F1-derived adenomas showed upregulation of PIP5K1B and NEK10 and alterations in phosphatidylinositol, insulin and phospholipase D signaling pathways and TBX19...
Revista medica del Instituto Mexicano del Seguro Social, 2018
More than 70% of the population in Mexico is overweight or obese, affecting mainly people in prod... more More than 70% of the population in Mexico is overweight or obese, affecting mainly people in productive age. Obesity is associated with the development of diseases that increase cardiovascular risk (diabetes mellitus, hypertension or atherogenic dyslipidemia), diseases that limit the quality of life of the patient (osteoarthrosis or sleep apnea) and even with the increase in the incidence of certain types of cancer (breast or colon). It is evident that the decrease of at least 5% of body weight induces improvement in all these factors; however, in some patients it is difficult to achieve this goal only with lifestyle modifications. In this review we analyze some drugs approved for weight control by national and international agencies that can serve as an auxiliary in conjunction with diet and exercise. Treatment must be individualized according to each patient characteristics, with an adequate evaluation of their risks and benefits.
Revista medica del Instituto Mexicano del Seguro Social, 2020
Coronavirus disease 19 (COVID-19) is the infection caused by the SARS-CoV-2 virus and it has beco... more Coronavirus disease 19 (COVID-19) is the infection caused by the SARS-CoV-2 virus and it has become a global emergency. The disease has a hughe impact on cardiopaths. Under regular conditions, patients entering the emergency room with a ST-segment elevation myocardial infarction (STEMI) must be urgently treated with reperfusion strategy. However, due to the scarce knowledge about COVID-19, there have not being yet established the guidelines for management of patients with STEMI and COVID-19. In this review we expose the main conclusions of relevant articles published about STEMI management during this pandemic. We aim to provide a review to guide the decisions about the management of STEMI during the COVID-19 emergency.
Escherichia coli es el principal patogeno asociado a infecciones del torrente sanguineo. Las bact... more Escherichia coli es el principal patogeno asociado a infecciones del torrente sanguineo. Las bacteriemias han aumentado a nivel mundial por patogenos multidrogorresistentes (MDR). En Mexico la informacion epidemiologica de cada hospital es invaluable. Objetivo: Describir la epidemiologia de las bacteriemias por Escherichia coli en ambos campus del Centro Medico ABC. Material y metodos: Se realizo un estudio de cohorte retrospectivo, se incluyen 98 pacientes mayores de 18 anos con diagnostico de bacteriemia por Escherichia coli que fueron hospitalizados entre el 1o de enero y el 31 de diciembre de 2014 en los dos campus del Centro Medico ABC. Se analizaron las caracteristicas clinicas, microbiologicas y del tratamiento. Se clasificaron los casos en comunitarios e intrahospitalarios. Los desenlaces fueron el tiempo de estancia intrahospitalaria y la mortalidad. Resultados: Durante 2014 se registraron 98 casos de bacteriemia por Escherichia coli en ambos hospitales. Ochenta y dos de lo...
Medicina Crítica, 2020
Posición prono en pacientes con síndrome de insuficiencia respiratoria progresiva aguda por COVID... more Posición prono en pacientes con síndrome de insuficiencia respiratoria progresiva aguda por COVID-19 Prone position in patients with acute respiratory failure syndrome due to COVID-19 Posição prona em pacientes com síndrome da insuficiência respiratória aguda devido ao COVID-19
Monash Bioethics Review, 2020
End-of-life decision-making in patients with dementia is a complex topic. Belgium and the Netherl... more End-of-life decision-making in patients with dementia is a complex topic. Belgium and the Netherlands have been at the forefront of legislative advancement and progressive societal changes concerning the perspectives toward physician-assisted death (PAD). Careful consideration of clinical and social aspects is essential during the end-of-life decision-making process in patients with dementia. Geriatric assent provides the physician, the patient and his family the opportunity to end life with dignity. Unbearable suffering, decisional competence, and awareness of memory deficits are among the clinical considerations that physicians should incorporate during the end-of-life decision-making process. However, as other societies introduce legislature granting the right of PAD, new social determinants should be considered; Mexico City is an example. Current perspectives regarding advance euthanasia directives (AED) and PAD in patients with dementia are evolving. A new perspective that hing...
PLOS ONE, 2021
Background Coronavirus disease 2019 (COVID-19) is a systemic disease that can rapidly progress in... more Background Coronavirus disease 2019 (COVID-19) is a systemic disease that can rapidly progress into acute respiratory failure and death. Timely identification of these patients is crucial for a proper administration of health-care resources. Objective To develop a predictive score that estimates the risk of invasive mechanical ventilation (IMV) among patients with COVID-19. Study design Retrospective cohort study of 401 COVID-19 patients diagnosed from March 12, to August 10, 2020. The score development cohort comprised 211 patients (52.62% of total sample) whereas the validation cohort included 190 patients (47.38% of total sample). We divided participants according to the need of invasive mechanical ventilation (IMV) and looked for potential predictive variables. Results We developed two predictive scores, one based on Interleukin-6 (IL-6) and the other one on the Neutrophil/Lymphocyte ratio (NLR), using the following variables: respiratory rate, SpO2/FiO2 ratio and lactic dehydro...
Anales médicos, 2022
In recent years, special attention has been paid to the microorganisms that inhabit the human bod... more In recent years, special attention has been paid to the microorganisms that inhabit the human body. It used to be believed that these were mere guests. However, attention has been focused on studying the relationship between these microorganisms and human health. In this review article, we intend to expose the relationship between the microbiota and certain gastrointestinal, metabolic, cardiovascular, neuropsychiatric and allergic diseases, according to current evidence. We conducted a review in PubMed, with the MeSH terms «microbiome», «microbiota», «gastrointestinal disease», «metabolic disease», «Neuropsychiatry» and «allergy». We included articles in English and Spanish, published between 2000 and 2021, that were meta-analyzes, review articles, and clinical and experimental trials of greater relevance to fulfill the objective of this manuscript. The microbiome is essential to maintain a good health in human beings. Alterations in the microbiome can cause many diseases, from those related to the gastrointestinal tract to neuropsychiatric ones.
Anales médicos, 2022
La formación de recursos humanos en salud es un tema de interés general, pues de eso depende la c... more La formación de recursos humanos en salud es un tema de interés general, pues de eso depende la calidad de los servicios sanitarios que se ofrecen a toda la población. Se trata de un ensayo de filosofía en medicina. Se revisaron textos e informes relevantes para poder argumentar los puntos expuestos en el artículo. México es la décimo sexta economía mundial, pero tiene una de las tasas de médicos más bajas de la Organización para la Cooperación y el Desarrollo Económicos (México: 2.2 versus promedio Organización para la Cooperación y el Desarrollo Económicos: 3.3 médicos por 1,000 habitantes). Contrasta este dato con la apertura de 45 nuevas escuelas de medicina en los últimos 10 años: en México hay 158 escuelas de medicina de las cuales se gradúan alrededor de 18,000 médicos al año; más de la mitad de las nuevas escuelas no están certificadas, lo que pone en duda la calidad de sus egresados. El desequilibrio entre demanda y oferta de la atención médica satura los sistemas de salud y a sus trabajadores. Las escuelas de medicina y el estado deben trabajar juntos para garantizar una atención sanitaria de calidad. La cobertura universal de salud depende de una adecuada formación de recursos humanos en salud.
BMC Medical Genomics
Background Pituitary adenomas (PA) are the second most common intracranial tumors and are classif... more Background Pituitary adenomas (PA) are the second most common intracranial tumors and are classified according to hormone they produce, and the transcription factors they express. The majority of PA occur sporadically, and their molecular pathogenesis is incompletely understood. Methods Here we performed transcriptome and proteome analysis of tumors derived from POU1F1 (GH-, TSH-, and PRL-tumors, N = 16), NR5A1 (gonadotropes and null cells adenomas, n = 17) and TBX19 (ACTH-tumors, n = 6) lineages as well as from silent ACTH-tumors (n = 3) to determine expression of kinases, cyclins, CDKs and CDK inhibitors. Results The expression profiles of genes encoding kinases were distinctive for each of the three PA lineage: NR5A1-derived tumors showed upregulation of ETNK2 and PIK3C2G and alterations in MAPK, ErbB and RAS signaling, POU1F1-derived adenomas showed upregulation of PIP5K1B and NEK10 and alterations in phosphatidylinositol, insulin and phospholipase D signaling pathways and TBX19...
Revista medica del Instituto Mexicano del Seguro Social, 2018
More than 70% of the population in Mexico is overweight or obese, affecting mainly people in prod... more More than 70% of the population in Mexico is overweight or obese, affecting mainly people in productive age. Obesity is associated with the development of diseases that increase cardiovascular risk (diabetes mellitus, hypertension or atherogenic dyslipidemia), diseases that limit the quality of life of the patient (osteoarthrosis or sleep apnea) and even with the increase in the incidence of certain types of cancer (breast or colon). It is evident that the decrease of at least 5% of body weight induces improvement in all these factors; however, in some patients it is difficult to achieve this goal only with lifestyle modifications. In this review we analyze some drugs approved for weight control by national and international agencies that can serve as an auxiliary in conjunction with diet and exercise. Treatment must be individualized according to each patient characteristics, with an adequate evaluation of their risks and benefits.
Revista medica del Instituto Mexicano del Seguro Social, 2020
Coronavirus disease 19 (COVID-19) is the infection caused by the SARS-CoV-2 virus and it has beco... more Coronavirus disease 19 (COVID-19) is the infection caused by the SARS-CoV-2 virus and it has become a global emergency. The disease has a hughe impact on cardiopaths. Under regular conditions, patients entering the emergency room with a ST-segment elevation myocardial infarction (STEMI) must be urgently treated with reperfusion strategy. However, due to the scarce knowledge about COVID-19, there have not being yet established the guidelines for management of patients with STEMI and COVID-19. In this review we expose the main conclusions of relevant articles published about STEMI management during this pandemic. We aim to provide a review to guide the decisions about the management of STEMI during the COVID-19 emergency.
Escherichia coli es el principal patogeno asociado a infecciones del torrente sanguineo. Las bact... more Escherichia coli es el principal patogeno asociado a infecciones del torrente sanguineo. Las bacteriemias han aumentado a nivel mundial por patogenos multidrogorresistentes (MDR). En Mexico la informacion epidemiologica de cada hospital es invaluable. Objetivo: Describir la epidemiologia de las bacteriemias por Escherichia coli en ambos campus del Centro Medico ABC. Material y metodos: Se realizo un estudio de cohorte retrospectivo, se incluyen 98 pacientes mayores de 18 anos con diagnostico de bacteriemia por Escherichia coli que fueron hospitalizados entre el 1o de enero y el 31 de diciembre de 2014 en los dos campus del Centro Medico ABC. Se analizaron las caracteristicas clinicas, microbiologicas y del tratamiento. Se clasificaron los casos en comunitarios e intrahospitalarios. Los desenlaces fueron el tiempo de estancia intrahospitalaria y la mortalidad. Resultados: Durante 2014 se registraron 98 casos de bacteriemia por Escherichia coli en ambos hospitales. Ochenta y dos de lo...
Medicina Crítica, 2020
Posición prono en pacientes con síndrome de insuficiencia respiratoria progresiva aguda por COVID... more Posición prono en pacientes con síndrome de insuficiencia respiratoria progresiva aguda por COVID-19 Prone position in patients with acute respiratory failure syndrome due to COVID-19 Posição prona em pacientes com síndrome da insuficiência respiratória aguda devido ao COVID-19
Monash Bioethics Review, 2020
End-of-life decision-making in patients with dementia is a complex topic. Belgium and the Netherl... more End-of-life decision-making in patients with dementia is a complex topic. Belgium and the Netherlands have been at the forefront of legislative advancement and progressive societal changes concerning the perspectives toward physician-assisted death (PAD). Careful consideration of clinical and social aspects is essential during the end-of-life decision-making process in patients with dementia. Geriatric assent provides the physician, the patient and his family the opportunity to end life with dignity. Unbearable suffering, decisional competence, and awareness of memory deficits are among the clinical considerations that physicians should incorporate during the end-of-life decision-making process. However, as other societies introduce legislature granting the right of PAD, new social determinants should be considered; Mexico City is an example. Current perspectives regarding advance euthanasia directives (AED) and PAD in patients with dementia are evolving. A new perspective that hing...
PLOS ONE, 2021
Background Coronavirus disease 2019 (COVID-19) is a systemic disease that can rapidly progress in... more Background Coronavirus disease 2019 (COVID-19) is a systemic disease that can rapidly progress into acute respiratory failure and death. Timely identification of these patients is crucial for a proper administration of health-care resources. Objective To develop a predictive score that estimates the risk of invasive mechanical ventilation (IMV) among patients with COVID-19. Study design Retrospective cohort study of 401 COVID-19 patients diagnosed from March 12, to August 10, 2020. The score development cohort comprised 211 patients (52.62% of total sample) whereas the validation cohort included 190 patients (47.38% of total sample). We divided participants according to the need of invasive mechanical ventilation (IMV) and looked for potential predictive variables. Results We developed two predictive scores, one based on Interleukin-6 (IL-6) and the other one on the Neutrophil/Lymphocyte ratio (NLR), using the following variables: respiratory rate, SpO2/FiO2 ratio and lactic dehydro...