Karen Ramírez-Cervantes | Universidad Autónoma de Sinaloa (original) (raw)
Papers by Karen Ramírez-Cervantes
Gastroenterology, 2018
vs 43.4%(p<0.001)). In the pre-intervention,4.940 colonoscopies were suitable for followup analys... more vs 43.4%(p<0.001)). In the pre-intervention,4.940 colonoscopies were suitable for followup analysis. In the 122 cased performed in a suitable interval 26,2% of them had colonic polyps vs 22,1% of the 4.818 performed in the inadequate interval(p=0.271).Among those with inadequate follow-up, there were colonic polyps in 29,5% of the colonoscopies performed beyond the appropriate time interval vs 21,8% of those that were performed earlier(p= 0.043). In the post-intervention, there were 1.225 colonoscopies available for follow-up. In the 368 colonoscopies performed in the appropriate time interval 48,9% of them had polyps vs 54,5% of the 857 performed in the inadequate interval(p=0.080). Among those with inadequate follow-up, there were polyps in 56,9% of the colonoscopies performed after the recommended time interval vs 53% of those performed earlier(p=0.108). Conclusions: The implementation of a specific recommendation document based on colonoscopy findings improves significantly the adherence of physicians to the current clinical recommendations of interval surveillance colonoscopies. Despite this intervention, there is still a high percentage of patients with inappropriate follow-up and further strategies are necessary to enhance appropriated clinical management standards. Reducing the time interval between follow-up colonoscopies does not improve clinical outcomes.
Background: The rate of compliance with a gluten-free diet in patients with gluten-related disord... more Background: The rate of compliance with a gluten-free diet in patients with gluten-related disorders is unknown in most Latin American countries. Objective: To study the adherence to a gluten-free diet of Mexican individuals with celiac disease and nonceliac gluten sensitivity at the time of their first medical and nutritional consultation at a tertiary referral center. Methods: A cross-sectional study was performed. A specific questionnaire was used to gather information on demographics, clinical condition, and self-reported adherence to a gluten-free diet, and to determine strict compliance and intentional or inadvertent gluten consumption. All questionnaires were applied by a nutritionist with expertise in gluten-related disorders. Results: Fifty-six patients with celiac disease and 24 with non-celiac gluten sensitivity were included. Overall, 46 (57.5%) subjects perceived themselves as strictly adherent; however, inadvertent gluten intake was frequent in both celiac disease and ...
Revista Portuguesa De Pneumologia, 2011
The role of acid is very well established in the pathogenesis of gastroesophageal reflux disease ... more The role of acid is very well established in the pathogenesis of gastroesophageal reflux disease (GERD). In the current era of frequent use of proton pump inhibitors, we are seeing increasing numbers of patients with symptoms that are refractory to acid suppression. Recent studies suggest that in patients being treated with proton pump inhibitors, non-acid reflux (composed of buffered gastric contents), esophageal hypersensitivity, esophageal motor dysfunction and psychological comorbidity can cause persistent symptoms. Concepts surrounding possible pathogenetic mechanisms leading to heartburn as a result of nonacid reflux and other mechanisms are explored, and potential treatments for this type of reflux are outlined in this review.
PeerJ, 2021
Background The complications from coronavirus disease 2019 (COVID-19) have been the subject of st... more Background The complications from coronavirus disease 2019 (COVID-19) have been the subject of study in diverse scientific reports. However, many aspects that influence the prognosis of the disease are still unknown, such as frailty, which inherently reduces resistance to disease and makes people more vulnerable. This study aimed to explore the complications of COVID-19 in patients admitted to a third-level hospital and to evaluate the relationship between these complications and frailty. Methods An observational, descriptive, prospective study was performed in 2020. A sample of 254 patients from a database of 3,112 patients admitted to a high-level hospital in Madrid, Spain was analyzed. To assess frailty (independent variable) the Clinical Frailty Scale (CFS) was used. The outcome variables were sociodemographic and clinical, which included complications, length of stay, intensive care unit (ICU) admission and prognosis. Results A total of 13.39% of the patients were pre-frail and...
Journal of Public Health, 2020
Background To describe the implementation of a medicalized hotel in the community of Madrid as a ... more Background To describe the implementation of a medicalized hotel in the community of Madrid as a public health resource for the containment of coronavirus disease (COVID-19) and to describe the characteristics of population benefitted. Methods A descriptive study of the implementation of the Via Castellana Medicalised Hotel (VCMH) was conducted. The average monthly household income, educational level and occupational social class of the subjects admitted were obtained through a survey conducted during their stay. Results There was no guidance for launching; however the hotel was coordinated by a tertiary referral hospital and attended the preventive medicine regulations and the decrees of legal regimes and authorization of health services in Madrid. Between 19 March and the 9 May 2020, 399 patients were admitted; 59% (235) were migrant; the main reason for referral (58%) was a lack of house conditions for quarantining, including overcrowding, which when compared with the migrant sta...
Annals of Hepatology, 2011
Revista de Gastroenterología de México (English Edition), 2018
Introduction and aims: A strong genetic association between celiac disease (CD) and the human leu... more Introduction and aims: A strong genetic association between celiac disease (CD) and the human leukocyte antigen (HLA) has been widely demonstrated. In Europe, the HLA-DQ2 allele is predominant. However, studies in Latin America indicate that HLA-DQ8 could be more frequent. In Mexico, the frequency of those alleles has not been reported in subjects with CD. Therefore, the aim of the present study was to evaluate the distribution of HLA-DQ2 and HLA-DQ8 in Mexican individuals with CD. Material and methods: An exploratory study was conducted on a cohort of 49 subjects with chronic diarrhea. Autoantibodies for CD, duodenal atrophy, and HLA haplotypes were determined. Results: Thirty individuals had CD (23 women, mean age 54.2 ± 15.5 years), 24 (80%) of whom expressed HLA-DQ8, 15 (50%) expressed HLA-DQ2, and 11 (37%) presented with both alleles. However, neither the HLA-DQ2 nor the HLA-DQ8 allele was found in 5 (10%) individuals. In subjects with chronic diarrhea that did not have CD, 12 (63%) presented with HLA-DQ2, and 7 (37%) with HLA-DQ8. Individuals with CD expressed the combinations of the HLA-DQ8/DQ2 alleles (37 vs. 5%) and the HLA-DR4/DQ8 alleles (60 vs. 26%) more frequently than the subjects without CD.
Revista de gastroenterología de México
The role of acid is very well established in the pathogenesis of gastroesophageal reflux disease ... more The role of acid is very well established in the pathogenesis of gastroesophageal reflux disease (GERD). In the current era of frequent use of proton pump inhibitors, we are seeing increasing numbers of patients with symptoms that are refractory to acid suppression. Recent studies suggest that in patients being treated with proton pump inhibitors, non-acid reflux (composed of buffered gastric contents), esophageal hypersensitivity, esophageal motor dysfunction and psychological comorbidity can cause persistent symptoms. Concepts surrounding possible pathogenetic mechanisms leading to heartburn as a result of nonacid reflux and other mechanisms are explored, and potential treatments for this type of reflux are outlined in this review.
Colorectal Disease, 2011
Skip to Main Content. There will be a release of Wiley Online Library scheduled for Saturday 27th... more Skip to Main Content. There will be a release of Wiley Online Library scheduled for Saturday 27th November 2010. Access to the website will be disrupted as follows: New York 0630 EDT to 0830 EDT; London 1130 GMT to 1330 GMT; Singapore 1930 SGT to 2130 SGT. ...
International Journal of Environmental Research and Public Health
Background: The social determinants of health (SDOH) of patients with COVID-19-related thrombosis... more Background: The social determinants of health (SDOH) of patients with COVID-19-related thrombosis have been scarcely explored. Our objective was to investigate the cases of thrombosis in a group of socially disadvantaged populations with COVID-19. Methods: We investigated the thrombotic events that occurred in a cohort of migrant and Spanish patients with COVID-19 that were admitted to a medicalized hotel in Madrid. Demographic data, past medical history, and socio-economic backgrounds, such as monthly household income, level of education, and living conditions, were explored to determine the factors related to thrombosis. Results: A cohort of 383 subjects (mean age 55.4 ± 14.6 years old, 69% male), of which 58% were migrants, was studied. Fourteen (3.6%) cases of thrombosis were reported. Thrombosis was more frequent in Spanish than in migrant individuals (OR 5.3, 95%CI 1.4–19.5, p = 0.005). Neither a low monthly household income nor a low education level showed a statistical assoc...
OBJECTIVE The new tobacco related products (TRP) have modified the smoking patterns, which have b... more OBJECTIVE The new tobacco related products (TRP) have modified the smoking patterns, which have been scarcely evaluated by independent studies. Our objective was to describe the patterns of electronic cigarette (e-cig) and tobacco heating products (THP) use among Spanish population. METHODS An electronic survey aimed to population who had used at least once in their lifetime e-cigs or THPs was used to gather personal data, patterns of e-cig and THP use, as well as risk perceptions and intention to quit these products. Chi-square and Kruskal-Wallis test were used to analyze qualitative and non-parametric quantitative variables, respectively, establishing statistical significance if p values <0.05. RESULTS The responses of 175 subjects were included. From them, 107 had consumed e-cig, 33 THP and 35 both devices. The daily use was more common among THP users, who were older than e-cig and both devices' consumers (median age 43 vs 38 vs 35 years old, p=0.013). Of the overall grou...
PeerJ
Background The complications from coronavirus disease 2019 (COVID-19) have been the subject of st... more Background The complications from coronavirus disease 2019 (COVID-19) have been the subject of study in diverse scientific reports. However, many aspects that influence the prognosis of the disease are still unknown, such as frailty, which inherently reduces resistance to disease and makes people more vulnerable. This study aimed to explore the complications of COVID-19 in patients admitted to a third-level hospital and to evaluate the relationship between these complications and frailty. Methods An observational, descriptive, prospective study was performed in 2020. A sample of 254 patients from a database of 3,112 patients admitted to a high-level hospital in Madrid, Spain was analyzed. To assess frailty (independent variable) the Clinical Frailty Scale (CFS) was used. The outcome variables were sociodemographic and clinical, which included complications, length of stay, intensive care unit (ICU) admission and prognosis. Results A total of 13.39% of the patients were pre-frail and...
Annals of hepatology
ABSTRACT none
International Journal of Environmental Research and Public Health
Background: The prognosis of older age COVID-19 patients with comorbidities is associated with a ... more Background: The prognosis of older age COVID-19 patients with comorbidities is associated with a more severe course and higher fatality rates but no analysis has yet included factors related to the geographical area/municipality in which the affected patients live, so the objective of this study was to analyse the prognosis of patients with COVID-19 in terms of sex, age, comorbidities, and geographic variables. Methods: A retrospective cohort of 6286 patients diagnosed with COVID-19 was analysed, considering demographic data, previous comorbidities and geographic variables. The main study variables were hospital admission, intensive care unit (ICU) admission and death due to worsening symptoms; and the secondary variables were sex, age, comorbidities and geographic variables (size of the area of residence, distance to the hospital and the driving time to the hospital). A comparison analysis and a multivariate Cox model were performed. Results: The multivariate Cox model showed that ...
Journal of Clinical Medicine
Background. COVID-19 is an ongoing global pandemic. Since the detection of the first cases of cor... more Background. COVID-19 is an ongoing global pandemic. Since the detection of the first cases of coronavirus disease 2019 (COVID-19) in Wuhan, China, the current pandemic has affected more than 25.3 million people worldwide. The aim of this study was to evaluate the relationship between coagulation abnormalities and prognosis in a cohort of patients with COVID-19. Methods. We performed a retrospective cohort study of 3581 patients admitted to Hospital La Paz (Madrid, Spain) due to respiratory infection by severe acute respiratory syndrome coronavirus from the beginning of the current pandemic to 15 July 2020. Results. Of the 3581 study patients, 48.94% were men, and 19.80% were healthcare workers. The median age was 62 years. Compared with the survivors, the non-survivors had lower prothrombin activity (82.5 (Interquartile range—IQR, 67–95) vs. 95.25 (IQR, 87–104) for non-survivors and survivors, respectively; p < 0.001), higher fibrinogen levels (748.5—IQR, 557–960) vs. 572.75 (IQR...
BMC Gastroenterology, 2015
Background: Celiac disease (CD) is a global health problem and its prevalence is underestimated, ... more Background: Celiac disease (CD) is a global health problem and its prevalence is underestimated, especially in Latin American populations. Our aim was to evaluate the clinical features, psychological factors, and health-related quality of life (QoL), before and after diagnosis, in a representative sample of adult Mexican Mestizo patients presenting with CD.
Gastroenterology, 2018
vs 43.4%(p<0.001)). In the pre-intervention,4.940 colonoscopies were suitable for followup analys... more vs 43.4%(p<0.001)). In the pre-intervention,4.940 colonoscopies were suitable for followup analysis. In the 122 cased performed in a suitable interval 26,2% of them had colonic polyps vs 22,1% of the 4.818 performed in the inadequate interval(p=0.271).Among those with inadequate follow-up, there were colonic polyps in 29,5% of the colonoscopies performed beyond the appropriate time interval vs 21,8% of those that were performed earlier(p= 0.043). In the post-intervention, there were 1.225 colonoscopies available for follow-up. In the 368 colonoscopies performed in the appropriate time interval 48,9% of them had polyps vs 54,5% of the 857 performed in the inadequate interval(p=0.080). Among those with inadequate follow-up, there were polyps in 56,9% of the colonoscopies performed after the recommended time interval vs 53% of those performed earlier(p=0.108). Conclusions: The implementation of a specific recommendation document based on colonoscopy findings improves significantly the adherence of physicians to the current clinical recommendations of interval surveillance colonoscopies. Despite this intervention, there is still a high percentage of patients with inappropriate follow-up and further strategies are necessary to enhance appropriated clinical management standards. Reducing the time interval between follow-up colonoscopies does not improve clinical outcomes.
Background: The rate of compliance with a gluten-free diet in patients with gluten-related disord... more Background: The rate of compliance with a gluten-free diet in patients with gluten-related disorders is unknown in most Latin American countries. Objective: To study the adherence to a gluten-free diet of Mexican individuals with celiac disease and nonceliac gluten sensitivity at the time of their first medical and nutritional consultation at a tertiary referral center. Methods: A cross-sectional study was performed. A specific questionnaire was used to gather information on demographics, clinical condition, and self-reported adherence to a gluten-free diet, and to determine strict compliance and intentional or inadvertent gluten consumption. All questionnaires were applied by a nutritionist with expertise in gluten-related disorders. Results: Fifty-six patients with celiac disease and 24 with non-celiac gluten sensitivity were included. Overall, 46 (57.5%) subjects perceived themselves as strictly adherent; however, inadvertent gluten intake was frequent in both celiac disease and ...
Revista Portuguesa De Pneumologia, 2011
The role of acid is very well established in the pathogenesis of gastroesophageal reflux disease ... more The role of acid is very well established in the pathogenesis of gastroesophageal reflux disease (GERD). In the current era of frequent use of proton pump inhibitors, we are seeing increasing numbers of patients with symptoms that are refractory to acid suppression. Recent studies suggest that in patients being treated with proton pump inhibitors, non-acid reflux (composed of buffered gastric contents), esophageal hypersensitivity, esophageal motor dysfunction and psychological comorbidity can cause persistent symptoms. Concepts surrounding possible pathogenetic mechanisms leading to heartburn as a result of nonacid reflux and other mechanisms are explored, and potential treatments for this type of reflux are outlined in this review.
PeerJ, 2021
Background The complications from coronavirus disease 2019 (COVID-19) have been the subject of st... more Background The complications from coronavirus disease 2019 (COVID-19) have been the subject of study in diverse scientific reports. However, many aspects that influence the prognosis of the disease are still unknown, such as frailty, which inherently reduces resistance to disease and makes people more vulnerable. This study aimed to explore the complications of COVID-19 in patients admitted to a third-level hospital and to evaluate the relationship between these complications and frailty. Methods An observational, descriptive, prospective study was performed in 2020. A sample of 254 patients from a database of 3,112 patients admitted to a high-level hospital in Madrid, Spain was analyzed. To assess frailty (independent variable) the Clinical Frailty Scale (CFS) was used. The outcome variables were sociodemographic and clinical, which included complications, length of stay, intensive care unit (ICU) admission and prognosis. Results A total of 13.39% of the patients were pre-frail and...
Journal of Public Health, 2020
Background To describe the implementation of a medicalized hotel in the community of Madrid as a ... more Background To describe the implementation of a medicalized hotel in the community of Madrid as a public health resource for the containment of coronavirus disease (COVID-19) and to describe the characteristics of population benefitted. Methods A descriptive study of the implementation of the Via Castellana Medicalised Hotel (VCMH) was conducted. The average monthly household income, educational level and occupational social class of the subjects admitted were obtained through a survey conducted during their stay. Results There was no guidance for launching; however the hotel was coordinated by a tertiary referral hospital and attended the preventive medicine regulations and the decrees of legal regimes and authorization of health services in Madrid. Between 19 March and the 9 May 2020, 399 patients were admitted; 59% (235) were migrant; the main reason for referral (58%) was a lack of house conditions for quarantining, including overcrowding, which when compared with the migrant sta...
Annals of Hepatology, 2011
Revista de Gastroenterología de México (English Edition), 2018
Introduction and aims: A strong genetic association between celiac disease (CD) and the human leu... more Introduction and aims: A strong genetic association between celiac disease (CD) and the human leukocyte antigen (HLA) has been widely demonstrated. In Europe, the HLA-DQ2 allele is predominant. However, studies in Latin America indicate that HLA-DQ8 could be more frequent. In Mexico, the frequency of those alleles has not been reported in subjects with CD. Therefore, the aim of the present study was to evaluate the distribution of HLA-DQ2 and HLA-DQ8 in Mexican individuals with CD. Material and methods: An exploratory study was conducted on a cohort of 49 subjects with chronic diarrhea. Autoantibodies for CD, duodenal atrophy, and HLA haplotypes were determined. Results: Thirty individuals had CD (23 women, mean age 54.2 ± 15.5 years), 24 (80%) of whom expressed HLA-DQ8, 15 (50%) expressed HLA-DQ2, and 11 (37%) presented with both alleles. However, neither the HLA-DQ2 nor the HLA-DQ8 allele was found in 5 (10%) individuals. In subjects with chronic diarrhea that did not have CD, 12 (63%) presented with HLA-DQ2, and 7 (37%) with HLA-DQ8. Individuals with CD expressed the combinations of the HLA-DQ8/DQ2 alleles (37 vs. 5%) and the HLA-DR4/DQ8 alleles (60 vs. 26%) more frequently than the subjects without CD.
Revista de gastroenterología de México
The role of acid is very well established in the pathogenesis of gastroesophageal reflux disease ... more The role of acid is very well established in the pathogenesis of gastroesophageal reflux disease (GERD). In the current era of frequent use of proton pump inhibitors, we are seeing increasing numbers of patients with symptoms that are refractory to acid suppression. Recent studies suggest that in patients being treated with proton pump inhibitors, non-acid reflux (composed of buffered gastric contents), esophageal hypersensitivity, esophageal motor dysfunction and psychological comorbidity can cause persistent symptoms. Concepts surrounding possible pathogenetic mechanisms leading to heartburn as a result of nonacid reflux and other mechanisms are explored, and potential treatments for this type of reflux are outlined in this review.
Colorectal Disease, 2011
Skip to Main Content. There will be a release of Wiley Online Library scheduled for Saturday 27th... more Skip to Main Content. There will be a release of Wiley Online Library scheduled for Saturday 27th November 2010. Access to the website will be disrupted as follows: New York 0630 EDT to 0830 EDT; London 1130 GMT to 1330 GMT; Singapore 1930 SGT to 2130 SGT. ...
International Journal of Environmental Research and Public Health
Background: The social determinants of health (SDOH) of patients with COVID-19-related thrombosis... more Background: The social determinants of health (SDOH) of patients with COVID-19-related thrombosis have been scarcely explored. Our objective was to investigate the cases of thrombosis in a group of socially disadvantaged populations with COVID-19. Methods: We investigated the thrombotic events that occurred in a cohort of migrant and Spanish patients with COVID-19 that were admitted to a medicalized hotel in Madrid. Demographic data, past medical history, and socio-economic backgrounds, such as monthly household income, level of education, and living conditions, were explored to determine the factors related to thrombosis. Results: A cohort of 383 subjects (mean age 55.4 ± 14.6 years old, 69% male), of which 58% were migrants, was studied. Fourteen (3.6%) cases of thrombosis were reported. Thrombosis was more frequent in Spanish than in migrant individuals (OR 5.3, 95%CI 1.4–19.5, p = 0.005). Neither a low monthly household income nor a low education level showed a statistical assoc...
OBJECTIVE The new tobacco related products (TRP) have modified the smoking patterns, which have b... more OBJECTIVE The new tobacco related products (TRP) have modified the smoking patterns, which have been scarcely evaluated by independent studies. Our objective was to describe the patterns of electronic cigarette (e-cig) and tobacco heating products (THP) use among Spanish population. METHODS An electronic survey aimed to population who had used at least once in their lifetime e-cigs or THPs was used to gather personal data, patterns of e-cig and THP use, as well as risk perceptions and intention to quit these products. Chi-square and Kruskal-Wallis test were used to analyze qualitative and non-parametric quantitative variables, respectively, establishing statistical significance if p values <0.05. RESULTS The responses of 175 subjects were included. From them, 107 had consumed e-cig, 33 THP and 35 both devices. The daily use was more common among THP users, who were older than e-cig and both devices' consumers (median age 43 vs 38 vs 35 years old, p=0.013). Of the overall grou...
PeerJ
Background The complications from coronavirus disease 2019 (COVID-19) have been the subject of st... more Background The complications from coronavirus disease 2019 (COVID-19) have been the subject of study in diverse scientific reports. However, many aspects that influence the prognosis of the disease are still unknown, such as frailty, which inherently reduces resistance to disease and makes people more vulnerable. This study aimed to explore the complications of COVID-19 in patients admitted to a third-level hospital and to evaluate the relationship between these complications and frailty. Methods An observational, descriptive, prospective study was performed in 2020. A sample of 254 patients from a database of 3,112 patients admitted to a high-level hospital in Madrid, Spain was analyzed. To assess frailty (independent variable) the Clinical Frailty Scale (CFS) was used. The outcome variables were sociodemographic and clinical, which included complications, length of stay, intensive care unit (ICU) admission and prognosis. Results A total of 13.39% of the patients were pre-frail and...
Annals of hepatology
ABSTRACT none
International Journal of Environmental Research and Public Health
Background: The prognosis of older age COVID-19 patients with comorbidities is associated with a ... more Background: The prognosis of older age COVID-19 patients with comorbidities is associated with a more severe course and higher fatality rates but no analysis has yet included factors related to the geographical area/municipality in which the affected patients live, so the objective of this study was to analyse the prognosis of patients with COVID-19 in terms of sex, age, comorbidities, and geographic variables. Methods: A retrospective cohort of 6286 patients diagnosed with COVID-19 was analysed, considering demographic data, previous comorbidities and geographic variables. The main study variables were hospital admission, intensive care unit (ICU) admission and death due to worsening symptoms; and the secondary variables were sex, age, comorbidities and geographic variables (size of the area of residence, distance to the hospital and the driving time to the hospital). A comparison analysis and a multivariate Cox model were performed. Results: The multivariate Cox model showed that ...
Journal of Clinical Medicine
Background. COVID-19 is an ongoing global pandemic. Since the detection of the first cases of cor... more Background. COVID-19 is an ongoing global pandemic. Since the detection of the first cases of coronavirus disease 2019 (COVID-19) in Wuhan, China, the current pandemic has affected more than 25.3 million people worldwide. The aim of this study was to evaluate the relationship between coagulation abnormalities and prognosis in a cohort of patients with COVID-19. Methods. We performed a retrospective cohort study of 3581 patients admitted to Hospital La Paz (Madrid, Spain) due to respiratory infection by severe acute respiratory syndrome coronavirus from the beginning of the current pandemic to 15 July 2020. Results. Of the 3581 study patients, 48.94% were men, and 19.80% were healthcare workers. The median age was 62 years. Compared with the survivors, the non-survivors had lower prothrombin activity (82.5 (Interquartile range—IQR, 67–95) vs. 95.25 (IQR, 87–104) for non-survivors and survivors, respectively; p < 0.001), higher fibrinogen levels (748.5—IQR, 557–960) vs. 572.75 (IQR...
BMC Gastroenterology, 2015
Background: Celiac disease (CD) is a global health problem and its prevalence is underestimated, ... more Background: Celiac disease (CD) is a global health problem and its prevalence is underestimated, especially in Latin American populations. Our aim was to evaluate the clinical features, psychological factors, and health-related quality of life (QoL), before and after diagnosis, in a representative sample of adult Mexican Mestizo patients presenting with CD.