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Flaws in the design of the Examen Nacional para Aspirantes a Residencias Médicas produce inequity.

Background: The Go Red for Women (GoRedW) campaign aims to increase awareness of cardiovascular disease (CVD) and stroke in women. However, assessing the effects of social campaigns on information-seeking behaviors may be challenging. The purpose of this study was to ascertain the effect of GoRedW using a large sample of unbiased real-world data from Google Trends (GTr) and evaluate the temporal correlation of online search queries for CVD and stroke in women with GoRedW. Methods: We conducted a retrospective study using GTr, a public tool from the Google search engine to obtain relative search volumes (RSVs) related to CVD and stroke in women in the period January 2004 to April 2019 in the USA. In addition, trends of GoRedW were compared with those of the well-established Breast Cancer Awareness Month (BCAM) campaign. Results: RSVs increased for queries of GoRedW and all searched terms for CVD but not for stroke in women during February compared to other months of the year without active campaign. The strong pattern with peaks of temporal increase was consistent over the 15-year study period. RSV of "Go Red for Women" in February increased on average 494% (range: 211% to 789%). The highest temporal increase on search queries for CVD was for the term "heart disease (in) women" with an average of 114% (24% to 182%). We found a positive correlation between RSVs of GoRedW and the term "heart disease (in) women" (r = 0.54, P < 0.001). RSVs for "Breast Cancer Awareness Month" had a higher increase during the active campaign month compared to GoRe-dW and showed a stronger positive correlation (r = 0.78, P < 0.001). Conclusions: Search engines are a valuable resource to provide insights on information demand and to assess the effectiveness of social campaigns and interventions. Our study showed an increase in the RSVs for queries of GoRedW and all CVD terms which correlated with the active campaign months over a 15-year period.

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Background: Bariatric surgery (BS) has been proven to be effective in the treatment of obesity and weight-related diseases, but the anatomic changes after BS make endoscopic retrograde cholangiopancreatography (ERCP) technically challenging. This study aims to assess the safety and clinical outcomes of ERCP in patients with previous BS. Materials and Methods:The National Inpatient Sample from 2007 to 2013 was queried for hospitalizations of adults over 18 years of age with procedure diagnoses of ERCP. Those with prior BS were selected as cases and those without BS as controls. Case-control matching at a ratio of 1 case to 2 controls was performed based on sex, age, race, comorbidities, and obesity. The primary outcomes were inpatient mortality and ERCP-related complications. Multivariate regression analysis was used to identify independent risk factors associated to the primary outcomes.Results: A total of 1,068,862 weighted hospitalizations with ERCP procedure codes were identified. Of these, 6689 with BS were selected as cases, and 13,246 were matched as controls. The reason for hospital admission was most often biliary stone disease (60.7% vs. 55.5%), followed by malignancy (3.5% vs. 12.1%) and cholangitis (7.7% vs. 4.5%) with and without BS, P < 0.05. The BS group had lower rates of post-ERCP pancreatitis (0.1% vs. 1.3%), cholecystitis (0.1% vs. 0.3%), bleeding (1.0% vs. 1.4%), and inpatient mortality (0.2% vs. 0.5%), but had higher rates of cholangitis (5.0% vs. 3.7%) and systemic infections (6.2% vs. 4.8%), all P < 0.05.Conclusions: BS group had lower post-ERCP pancreatitis, cholecystitis and bleeding while had more cholangitis, and systemic infection compared with those without BS. Also, BS was independently associated with reduced inpatient mortality after adjusted for age, race, and comorbidity.

Señor editor: La formación de recursos humanos de alta calidad en las especialidades médicas es de gran importancia para la sociedad. El proceso inicia cada año con la selección de los candidatos a través del Examen Nacional para Aspirantes a Residencias Médicas (ENARM). En 2016, más de 36 000 médicos generales compitieron a través del ENARM por una de las, aproximadamente, 8 250 plazas ofertadas. Según fuentes oficiales, algunos de los atributos conferidos al proceso del ENARM incluyen “equitativo”, “transparente”, “objetivo” y “válido”.

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