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      "titulo" => "Extrahepatic disease in a cohort of HCV infected patients succesfully treated with direct acting antivirals. One year follow up."
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          "autoresLista" => "Clara C. Sánchez-Rodríguez, Jorge H. Luna-Domínguez"
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      "titulo" => "Epidemiology and demographic aspects in patients with acute on chronic liver failure in a third-level care hospital in Mexico."
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    "titulo" => "CLIF-C-ACLF scale to predict mortality in pediatric patients with acute-on-chronic liver failure"
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      0 => array:3 [
        "autoresLista" => "Diego R. Arellano-Sánchez, Elizabeth Hernández-Chávez"
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            "nombre" => "Diego R."
            "apellidos" => "Arellano-Sánchez"
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            "apellidos" => "Hernández-Chávez"
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            "entidad" => "Pediatric Gastroenterology and Nutrition Service, UMAE Pediatric Hospital, Western National Medical Center, IMSS, Guadalajara Jalisco, Mexico"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="para0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Ethical statement</span></p><p id="para0006" class="elsevierStylePara elsevierViewall">The protocol was registered and approved by the Ethics Committee&#46; The identity of the patients is protected&#46; Consentment was obtained&#46;</p><p id="para0007" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Declaration of interests</span></p><p id="para0008" class="elsevierStylePara elsevierViewall">None</p><p id="para0009" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Funding</span></p><p id="para0010" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public&#44; commercial&#44; or not-for-profit sectors&#46;</p><p id="para0011" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">AUROC of CLIF-C ACLF&#44; MELD&#47;PELD&#44; Child Pugh&#44; AARC in predicting at admission&#44; 28- and 90 - days mortality&#46;</span><elsevierMultimedia ident="fig0001"></elsevierMultimedia></p></span>"
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        "resumen" => "<span id="abss0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0001">Introduction and Objectives</span><p id="spara001" class="elsevierStyleSimplePara elsevierViewall">The acute decompensation of liver cirrhosis associated with organ failure is known as acute-on-chronic liver failure &#40;ACLF&#41;&#59; in pediatrics&#44; it develops &#62;22&#37;&#44; with mortality &#62;33&#37; per month&#59; Based on prognosis&#44; CLIF-C ACLF is a score with greater discriminative capacity to predict short-term mortality &#40;25&#37;&#41; compared to already established scales&#44; which require more complex variables&#46; To describe the utility of the CLIF-C ACLF scale in pediatrics&#46; Specific&#58; In children with cirrhosis who developed ACLF&#58; Describe the sociodemographic&#44; clinical&#44; and biochemical characteristics&#59; Determine the MELD&#44; PELD&#44; Child Pugh&#44; AARC and CLIF-C ACLF scales and compare their predictive value&#46;</p></span> <span id="abss0002" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0002">Materials and Patients</span><p id="spara002" class="elsevierStyleSimplePara elsevierViewall">Retrospective cohort&#44; age&#58; 6 months to 18 years&#44; temporality&#58; March 2018 - February 2022&#46; Frequency and percentage were reported for qualitative variables&#44; and median variables and range for quantitative variables&#59; Inferential with Pearson and Spearman correlation between the scales at admission&#44; 28 and 90 days&#44; an area under the receiver operating characteristics &#40;AUROC&#41; and Whitney U were calculated&#46;</p></span> <span id="abss0003" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0003">Results</span><p id="spara003" class="elsevierStyleSimplePara elsevierViewall">Out of 95 cases with chronic liver disease&#44; 63&#46;1&#37; presented ACLF&#44; mostly stage II &#40;35&#46;3&#37;&#41;&#46; The female sex predominated &#40;72&#46;1&#37;&#41; and bile duct atresia was the most common entity &#40;80&#37;&#41;&#44; with a mean age at diagnosis of 38 months and mortality of 55&#37;&#46; Ascites &#40;97&#37;&#41; and hepatic encephalopathy &#40;58&#46;3&#37;&#41; were the main complications&#46; The major precipitating factors described were infections &#40;57&#46;4&#37;&#41;&#58; bacterial cholangitis &#40;16&#46;2&#37;&#41; and pneumonia &#40;8&#46;8&#37;&#41;&#46; Through AUROC we compared CLIF cACLF with PELD&#44; MELD&#44; Child Pugh and AARC&#44; observing greater statistical significance at 28 and 90 days &#40;sensitivity&#58; 0&#46;63&#44; specificity&#58; 0&#46;85&#41; and through the U test&#44; we observed that coagulopathy is the biochemical index with higher prediction for acute decompensation in ACLF&#46;</p></span> <span id="abss0004" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0004">Conclusions</span><p id="spara004" class="elsevierStyleSimplePara elsevierViewall">CLIF-C ACLF compared to ACLF scores predicted increased risk of 28-day mortality &#40;AUROC&#58; 0&#46;758&#41; relative to PELD&#44; MELD &#40;AUROC&#58; 0&#46;721&#41;&#44; Child Pugh &#40;AUROC&#58; 0&#46;746&#41;&#44; AARC &#40;AUROC&#58; 0&#46;621&#41;&#44; and at 90 days &#40;AUROC&#58; 0&#46;663&#41; with PELD&#44; MELD &#40;AUROC&#58; 0&#46;505&#41;&#44; Child Pugh &#40;AUROC&#58; 0&#46;598&#41;&#44; AARC &#40;AUROC&#58; 0&#46;357&#41;&#46; We established a CLIF-C ACLF score &#8805; 77&#46;5 as a high predictor of mortality &#40;95&#37; CI&#41;&#46; The scale is useful in pediatrics&#46;</p></span>"
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