Nahum Méndez-Sánchez

Dear friends and colleagues, we are pleased to share our recent publication in the Journal of Clinical and Translational Hepatology “The Mechanisms behind Thrombocytopenia in Patients with Portal Hypertension and Chronic Liver Disease”.
This mini-review explores the complex interplay between thrombocytopenia, portal hypertension, and chronic liver disease, emphasizing the multifactorial mechanisms that contribute to platelet destruction and reduced thrombopoiesis.
By integrating current evidence, it highlights how splenic sequestration, immune-mediated mechanisms, reduced hepatic thrombopoietin synthesis, and bone marrow suppression converge to impact clinical outcomes and management strategies.
Understanding these mechanisms is crucial for improving diagnostic precision and optimizing therapeutic approaches in patients with advanced liver disease and portal hypertension.
This work was developed through international collaboration between Mexico and China, and represents an effort to contribute to the translational understanding of hematologic complications in hepatology.
📘 Full article available: https://doi.org/10.14218/JCTH.2025.00279

Dear friends and colleagues, we are pleased to share our recent publication in Exploration of Digestive Diseases, titled “How the gut-liver axis shapes hepatic encephalopathy: mechanistic and therapeutic perspectives.”

This review explores how the communication between the gut, liver, and brain influences the pathogenesis of hepatic encephalopathy, highlighting the roles of microbiota, bile acid signaling, and systemic inflammation. It also discusses emerging therapeutic and technological approaches—including microbiota modulation, receptor-based interventions, and AI-driven monitoring tools—that are redefining personalized management of this condition.

📖 Read the full article here: https://doi.org/10.37349/edd.2025.100597

Dear colleagues and friends,
I am pleased to share our recent article: “Epidemiology and etiologic trends of hepatocellular carcinoma in cirrhotic patients in Mexico: a multicenter retrospective study (2018–2024).”
This study included 2,182 patients with cirrhosis from 13 tertiary hospitals across Mexico and provides one of the most up-to-date perspectives on hepatocellular carcinoma (HCC) in our country. Overall, 8.8% of patients developed HCC. The disease was more frequent in women (55.1%), peaking at ages 70–79, while men were most affected between 60–69 years. Regional variation was evident, with central Mexico showing the highest prevalence (10.4%) and the south the lowest (3.8%).
The most relevant finding is the clear etiologic shift: metabolic dysfunction–associated steatotic liver disease (MASLD) now accounts for nearly 40% of HCC cases, overtaking hepatitis C virus infection (33%) and alcohol-associated liver disease (19%).
These results underscore that MASLD has become the leading driver of HCC in cirrhotic patients in Mexico, reflecting the broader impact of obesity, diabetes, and metabolic dysfunction. By documenting this transition, our study underscores the pressing need to integrate MASLD into national cancer control strategies and to enhance multidisciplinary approaches that involve hepatology, endocrinology, and public health.

Dear colleagues and friends,

This past weekend I had the opportunity to participate in the Mexico City Marathon, an unforgettable experience of endurance, resilience, and community. Beyond the personal challenge, this event reminded me of the profound impact that regular physical activity can have on health—particularly in the prevention of chronic liver diseases.
As we know, MASLD has become the leading cause of chronic liver disease worldwide. Lifestyle interventions remain the cornerstone of prevention and treatment, with exercise playing a pivotal role. Evidence consistently shows that regular aerobic activity improves insulin sensitivity, reduces hepatic steatosis, lowers systemic inflammation, and contributes to long-term cardiovascular and liver health.
Running a marathon is, of course, an extreme example of physical activity. But what truly matters is the consistent incorporation of exercise into daily life—whether through walking, cycling, or other accessible activities. Each step represents a powerful tool to combat the global burden of metabolic and liver diseases.
Participating in this marathon was not only a personal milestone, but also a reminder of the message we share as hepatology researchers and clinicians: movement is medicine, and investing in active lifestyles is one of the most effective strategies to reduce the growing burden of MASLD and related conditions.

Dirigido a todo futuro pasante del servicio social que inicie en enero 2026, quien esté interesado en hacer su servicio social en investigación en Médica Sur.

Para más información envía tu CV al correo: [email protected]

Dear colleagues and friends,
We are pleased to share our recent study titled Machine learning based CAGIB score predicts in-hospital mortality of cirrhotic patients with acute gastrointestinal bleeding. Acute gastrointestinal bleeding (AGIB) is a life-threatening complication in patients with cirrhosis and remains one of the most frequent causes of hospitalization and mortality in this population. Early and accurate risk stratification is critical to guide clinical decision-making, allocate resources efficiently, and improve patient outcomes. However, existing prognostic tools often lack precision or generalizability across diverse patient populations.

In this international multicenter study, we validated the predictive capacity of the CAGIB score to estimate in-hospital mortality among 2,467 patients with cirrhosis and AGIB. Building upon this foundation, we developed several machine learning models using the CAGIB score components, aiming to enhance predictive accuracy. Among these, the least square support vector machine regression (LS-SVMR) model demonstrated outstanding performance, with an area under the curve (AUC) of 0.986 in the training cohort. Patients were stratified into three risk categories based on their LS-SVMR scores: low risk (0.160) with a markedly increased mortality rate of 64.37%. These results were confirmed in an independent validation cohort.

This study underscores the potential of artificial intelligence and machine learning to transform prognostication in hepatology by providing clinicians with more precise and reliable tools. The integration of such models into clinical practice may support earlier interventions, reduce preventable mortality, and optimize care for patients with cirrhosis presenting with AGIB. We believe these findings represent an important step toward precision medicine in the management of acute complications of chronic liver disease.

Every year on July 28, we commemorate World Hepatitis Day to raise global awareness about viral hepatitis—a major global health threat that affects over 350 million people and causes more than one million deaths annually, many due to liver cancer and liver failure. The theme for 2025, “Hepatitis: Let’s Break It Down,” calls for urgent action to dismantle the financial, social, and systemic barriers that continue to hinder progress toward hepatitis elimination and liver cancer prevention. These barriers include lack of access to testing and treatment, limited healthcare resources, and persistent stigma that prevents individuals from seeking care. Despite the availability of vaccines for hepatitis A and B, and curative treatments for hepatitis C, millions remain undiagnosed and untreated. This year’s campaign reminds us that breaking down these barriers is not just a medical challenge—it is a public health imperative. We must work together to expand access to affordable diagnostics and treatment, strengthen prevention and vaccination programs, and promote education to eliminate misinformation and stigma. On this World Hepatitis Day, we reaffirm our commitment to equity, awareness, and action—because eliminating hepatitis is not only possible, it is essential.

Dirigido a todo futuro pasante del servicio social que inicie en agosto 2025, quien esté interesado en hacer su servicio social en investigación en Médica Sur.

Para más información envía tu CV al correo: [email protected]

Es hoy, no falten!

📆 07 de Febrero 13:00 hrs

📍 Auditorio Fernando Ocaranza, FacMed, CU

📚Presentación del Libro Metabolic Dysfunction-Associated Steatotic Liver Disease 📚

🗓️7 de febrero
📍Auditorio Dr. Fernando Ocaranza

Dirigido a todo futuro pasante del servicio social que inicie en febrero 2025, quien esté interesado en hacer su servicio social en investigación en Médica Sur.

Para más información envía tu CV al correo: [email protected]