<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1665-5044</journal-id>
<journal-title><![CDATA[Revista mexicana de neurociencia]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. mex. neurocienc.]]></abbrev-journal-title>
<issn>1665-5044</issn>
<publisher>
<publisher-name><![CDATA[Academia Mexicana de Neurología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1665-50442020000500180</article-id>
<article-id pub-id-type="doi">10.24875/rmn.20000145</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Myasthenia gravis in a reference Western Mexican Hospital: Comparison of a new cohort versus a historical one]]></article-title>
<article-title xml:lang="es"><![CDATA[Miastenia gravis en un hospital de referencia del occidente de México: Comparación de una cohorte nueva versus una histórica]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Parada-Garza]]></surname>
<given-names><![CDATA[Juan D.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Miranda-García]]></surname>
<given-names><![CDATA[Luis A.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González-Jaime]]></surname>
<given-names><![CDATA[José de J.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jiménez-Ruiz]]></surname>
<given-names><![CDATA[Amado]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García-Almeida]]></surname>
<given-names><![CDATA[Gabriela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López-Valencia]]></surname>
<given-names><![CDATA[Germán]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez-Gómez]]></surname>
<given-names><![CDATA[Héctor R.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ruiz-Sandoval]]></surname>
<given-names><![CDATA[José L.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Civil de Guadalajara “Fray Antonio Alcalde” Department of Neurology ]]></institution>
<addr-line><![CDATA[Guadalajara ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Civil de Guadalajara “Fray Antonio Alcalde” Department of Rehabilitation ]]></institution>
<addr-line><![CDATA[Guadalajara ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Civil de Guadalajara “Fray Antonio Alcalde” Internal Medicine ]]></institution>
<addr-line><![CDATA[Guadalajara ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Civil de Guadalajara &#8220;Fray Antonio Alcalde&#8221; Department of Infectology ]]></institution>
<addr-line><![CDATA[Guadalajara ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Centro Universitario de Ciencias de la Salud Universidad de Guadalajara Department of Neurosciences ]]></institution>
<addr-line><![CDATA[Guadalajara ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>10</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>10</month>
<year>2020</year>
</pub-date>
<volume>21</volume>
<numero>5</numero>
<fpage>180</fpage>
<lpage>186</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1665-50442020000500180&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1665-50442020000500180&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1665-50442020000500180&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background: Myasthenia gravis (MG) is a post-synaptic autoimmune disease of the neuromuscular junction, whose cardinal manifestations are weakness and fatigue.  Objective: The objective of the study was to report a cohort of patients with a diagnosis of MG in a West Mexican hospital and compare the clinical profile, diagnostic, and therapeutic approach and prognosis against a previously published cohort of the same hospital.  Materials and methods: Consecutive patients included in two cohorts: the first one already published from 1999 to 2007 and the second one reported here from 2008 to 2018.  Results: The most recent cohort included 39 patients, 23 women (59%), with an average age of 50 years, and superior to the previous cohort (43 years). Hypertension (39%) and diabetes (18%) were observed with a marked increase in the current cohort. The distribution in the Osserman staging was very similar. The positivity of acetylcholine receptor antibodies (ACRA) increased from 37% to 88%. In both cohorts, most patients received pyridostigmine and in two-thirds steroids. The previous cohort recorded 4% of patients treated with a steroid-sparing immunosuppressant, contrasting with 90% (azathioprine 85%, and mycophenolate 5%) of the current cohort. Thymectomy was a less frequent practice in 12%. Mortality showed a significant decrease from 16% to 0%.  Conclusion: Differences were observed among the cohorts, highlighting in the most recent one a higher age, the appearance of chronic-degenerative diseases, greater positivity to ACRA, optimization of pharmacological management, less thymectomy, and no mortality. Replicas of this work in other hospital settings are pertinent.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Antecedentes: La miastenia gravis (MG) es una enfermedad autoinmune postsináptica de la unión neuromuscular, cuyas manifestaciones cardinales son debilidad y fatiga.  Objetivo: Reportar una cohorte de pacientes con diagnóstico de MG en un hospital del occidente de México y comparar el perfil clínico, el enfoque diagnóstico y terapéutico, y el pronóstico frente a una cohorte publicada previamente del mismo hospital.  Material y métodos: Pacientes consecutivos incluidos en dos cohortes; la primera ya publicada (de 1999 al 2007) y la reportada aquí (del 2008 al 2018).  Resultados: En la cohorte más reciente se incluyeron 39 pacientes, 23 mujeres (59%), con edad promedio de 50 años, superior a la cohorte previa (43 años). Hipertensión arterial (39%) y diabetes (18%) se observan con marcado incremento en la cohorte actual. La distribución en la estadificación de Osserman fue similar. La positividad de los anticuerpos contra el receptor de acetilcolina (ACRA) aumentó del 37 al 88%. En ambas cohortes la mayoría de los pacientes recibieron piridostigmina y dos terceras partes esteroides. La cohorte previa registró un 4% de pacientes tratados con inmunosupresores ahorradores de esteroides, contrastando con el 90% (azatioprina 85%, micofenolato 5%) de la cohorte actual. La timectomía fue una práctica menos frecuente, en el 12%. La mortalidad presentó un importante decremento, del 16% al 0%.  Conclusión: Se observan diferencias entre las cohortes, destacando en la más reciente una mayor edad de presentación, aparición de enfermedades cronicodegenerativas, mayor positividad a ACRA, optimización del manejo farmacológico, menos timectomía y nula mortalidad. Son pertinentes réplicas de este trabajo.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Acetylcholine receptor antibodies]]></kwd>
<kwd lng="en"><![CDATA[Mexico]]></kwd>
<kwd lng="en"><![CDATA[Myasthenia gravis]]></kwd>
<kwd lng="en"><![CDATA[Thymectomy]]></kwd>
<kwd lng="es"><![CDATA[Anticuerpos contra receptor de acetilcolina]]></kwd>
<kwd lng="es"><![CDATA[México]]></kwd>
<kwd lng="es"><![CDATA[Miastenia gravis]]></kwd>
<kwd lng="es"><![CDATA[Timectomía]]></kwd>
</kwd-group>
</article-meta>
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