Revista Medica del Hospital General de Mexico最新文献

{"title":"Clinical case series: Sedoanalgesia for thoracoscopic procedures","authors":"O. Carrillo Torres ,&nbsp;J.A. Morantes Acevedo ,&nbsp;R.A. Vieyra Jaime ,&nbsp;C.R. Ramos Hernández ,&nbsp;L. Rodríguez Contreras ,&nbsp;B. Vargas Ábrego","doi":"10.1016/j.hgmx.2016.11.003","DOIUrl":"10.1016/j.hgmx.2016.11.003","url":null,"abstract":"<div><p>Thoracoscopy is a procedure increasingly used because it is minimally invasive and assists in the diagnosis and treatment of different types of pathologies. The anaesthetic technique has evolved over time. In the beginning it was necessarily invasive, by selective or non-selective intubation; now it is non-invasive with appropriate regional anaesthesia and intravenous analgesia/sedation in selected cases. At the Hospital General de México “Dr. Eduardo Liceaga”, in a significant proportion of cases thoracoscopy is currently done with the patient awake so we consider it necessary to report some of these cases along with the results obtained.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"81 4","pages":"Pages 232-236"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.11.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46451009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Septic arthritis of the acromioclavicular joint due to Streptococcus agalactiae. Case report","authors":"C.A.J. Mangas-Loría ,&nbsp;M.A. Fuentes-Nucamendi ,&nbsp;A.F. Sánchez-Chávez ,&nbsp;C. Monreal-Chairez ,&nbsp;C. Ramos-Córdova","doi":"10.1016/j.hgmx.2016.10.008","DOIUrl":"10.1016/j.hgmx.2016.10.008","url":null,"abstract":"<div><p>Septic arthritis of the acromioclavicular joint is a rare entity: only 30 cases have been reported in the literature since 1985. We present the case of a 53-year-old diabetic male, with septic arthritis of one acromioclavicular joint due to <em>Streptococcus agalactiae</em>. Current condition characterised by neck pain, limited movement of the right shoulder; hyperthermia, hyperaemia and increased volume in the acromioclavicular joint. Upon physical examination, increased volume was found from the proximal third of the deltoid to the middle third of the clavicle, pain on palpation, localised hyperthermia, limited range of motion. X-ray with enlargement of soft tissues, presence of subcutaneous gas and increased space in the acromioclavicular joint compared with the contralateral. Ceftriaxone and Clindamycin were administered at therapeutic doses and an acromioclavicular arthrotomy was performed, obtaining 10<!--> <!-->ml of purulent material from the sub-deltoid and 2<!--> <!-->ml from the joint. Five days later, <em>Streptococcus agalactiae</em> was reported. Clinical improvement was observed and it was decided to discharge the patient.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"81 4","pages":"Pages 248-252"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.10.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54296286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A special case of intramedullary teratoma in an adult. Literature review","authors":"E. Ariñez Barahona ,&nbsp;J.L. Navarro Olvera ,&nbsp;M.A. Esqueda Liquidano ,&nbsp;A. Muñoz Cobos ,&nbsp;K.E. González Echeverria ,&nbsp;A.D. Rivera Arroyo ,&nbsp;E. Gómez Apo ,&nbsp;R.S. Torres Durán ,&nbsp;A. Méndez Viveros","doi":"10.1016/j.hgmx.2016.09.001","DOIUrl":"10.1016/j.hgmx.2016.09.001","url":null,"abstract":"<div><p>Spinal teratomas that occur in adulthood are rare. The most accepted theory is that of a disembryogenic origin, but in this case we present the theory of misplaced germ cells.</p><p>We present a 54-year-old male with saddle hypoesthesia, 3/5 paraesthesia of the lower extremities, urinary incontinence, loss of anal sphincter tone, and patellar and achilles hyporeflexia, of 10 months’ evolution. The MRI showed a heterogeneous, cystic and solid intramedullary lesion with defined edges. Laminoplasty surgery of L2 to L4 and complete resection of the lesion was performed. The histopathological study found a mature teratoma.</p><p>The incidence of intraspinal teratomas is very low. There are two theories: the disembryogenic theory (most accepted) and the misplaced germ cell theory (our case). This pathogenesis of teratoma formation involves a niche of pluripotent cells from the primitive knot or a caudal cell mass that may precede the formation of a dysraphism. In this modified theory, teratoma growth sometimes causes disruption of the development field and dysraphism.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"81 4","pages":"Pages 237-242"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47450527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional magnetic resonance for the localization of eloquent areas in epilepsy surgery candidates: comparison to cortical electrostimulation mapping","authors":"D. Vázquez-Barrón ,&nbsp;M. Montes de Oca ,&nbsp;F. Espinoza-Velázquez ,&nbsp;F. Velasco ,&nbsp;A.L. Velasco","doi":"10.1016/j.hgmx.2017.07.001","DOIUrl":"10.1016/j.hgmx.2017.07.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Surgical treatment for epilepsy comprises resective techniques in most patients.</p><p>In those with epilepsy of sites close to highly specialized or eloquent areas, very precise anatomic delimitation is required. So far the most reliable method for anatomic localization of function is direct cortical electrostimulation mapping (CEM). Functional magnetic resonance (fMRI) is a non-invasive method that could also be used for this purpose.</p></div><div><h3>Objective</h3><p>To determine the sensitivity and specificity of fMRI for the identification of eloquent areas compared to CEM in epilepsy surgery candidates.</p></div><div><h3>Methods</h3><p>Four patients who underwent presurgical fMRI and grid implantation in eloquent areas for epileptic focus localization with video-EEG were included in this study. Once the seizure onset site was identified, CEM was performed and a postsurgical structural magnetic resonance was reconstructed with Eclipse software to determine grid position. After correlating pre and postsurgical images, the site of the grid contacts where eloquent areas were identified was compared to localization by fMRI.</p></div><div><h3>Results</h3><p>One hundred and twenty electrodes in six eloquent areas were evaluated and compared to location by fMRI: five hand motor areas and one language area in the temporal lobe. We found a global sensitivity of 0.86, specificity of 0.96, positive predictive value of 0.89, negative predictive value of 0.95 and accuracy of 0.94 for fMRI.</p></div><div><h3>Conclusion</h3><p>In this study fMRI showed high specificity and proved to be useful for language lateralization. It is necessary to study this technique further, especially for language areas.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"81 4","pages":"Pages 184-189"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2017.07.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41900060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathological findings in renal biopsies in Anderson–Fabry disease. Case series","authors":"A.L. Mena Rodríguez,&nbsp;M.V. Soto Abraham,&nbsp;M.Y. Valdespino Vázquez,&nbsp;B. de León Garza","doi":"10.1016/j.hgmx.2016.08.010","DOIUrl":"10.1016/j.hgmx.2016.08.010","url":null,"abstract":"<div><p>Anderson–Fabry disease is the second most common lysosomal storage disease after Gaucher disease. It is an X-linked lysosomal disorder that causes a deficiency in alpha-galactosidase, leading to the accumulation of globotriaosylceramide (Gb3) in the lysosomes of different cells, producing renal, cardiac and neurological deficits that can lead to an early death. The renal histologic analysis, applied using a standardised rating system, is useful for initiating enzyme replacement therapy and for assessing the prognosis. In this article we classify the histologic lesions found in light and electron microscopy in renal biopsies of patients with Anderson–Fabry disease, using the scoring system for renal pathology in Fabry disease: Report of the International Study Group of Fabry Nephropathy (ISGFN). More than half of the cases did not present any change in the clinical and laboratory assessment at the time of the biopsy; nevertheless there were changes in the light and electronic microscopy findings. The information from the renal biopsy is an early indicator of renal damage, even without proteinuria and with preserved renal function.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"81 4","pages":"Pages 243-247"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.08.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48460510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical importance of olfactory function in neurodegenerative diseases","authors":"N. Aguilar Martínez ,&nbsp;G. Aguado Carrillo ,&nbsp;P.E. Saucedo Alvarado ,&nbsp;C.A. Mendoza García ,&nbsp;A.L. Velasco Monroy ,&nbsp;F. Velasco Campos","doi":"10.1016/j.hgmx.2017.05.007","DOIUrl":"https://doi.org/10.1016/j.hgmx.2017.05.007","url":null,"abstract":"<div><p>Impairments in olfactory function can be potential indicators of the onset or progression of neurological disorders. Nevertheless, olfaction is barely explored in routine clinical examination. This review provides a general idea of how olfaction is related to normal ageing and neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease and epilepsy, and an overview of recent studies in this field.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"81 4","pages":"Pages 268-275"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2017.05.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137140950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain in patients in critical condition and its environment","authors":"O. Carrillo-Torres ,&nbsp;M.A. Mendiola-Roa ,&nbsp;M.A. Ramirez-Torres","doi":"10.1016/j.hgmx.2016.05.018","DOIUrl":"10.1016/j.hgmx.2016.05.018","url":null,"abstract":"<div><p>It is known that pain is the most disturbing symptom-syndrome in patients in any context of medical therapy, so the comprehensive critical care (biological–psychological–social–spiritual) approach should be adequately addressed in the patient–family–healthcare team triad when structuring major therapeutic care. Health status, as well as admission to the High Dependency Unit and/or Intensive Care Unit represents an event often accompanied by dependency, uncertainty, fear, multiple losses, vulnerability, suffering and near-death experiences. Patients in intensive care often experience multiple and recurrent acute stressors, where their response and ability to cope depend on a variety of neuropsychological, cognitive, emotional, and social functions and the support that is given to them in these areas.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"81 4","pages":"Pages 276-281"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.05.018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54294907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Language lateralisation through dichotic listening in a group of patients with temporal lobe epilepsy","authors":"D. Trejo-Martínez ,&nbsp;D.A. Manjarrez-Garduño ,&nbsp;H. Becerril-Montes ,&nbsp;L. Granados-Domínguez ,&nbsp;A.L. Velasco-Monroy","doi":"10.1016/j.hgmx.2017.05.006","DOIUrl":"10.1016/j.hgmx.2017.05.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Dichotic listening is one of the most common techniques used to determine the hemispheric lateralisation of language, using pairs of stimuli that are presented simultaneously, one in each ear to induce auditory competition between the two ears. Right-ear advantage for the perception of words is considered the most important indicator of left hemispheric lateralisation of language. Greater variability in hemispheric lateralisation has been found in patients with temporal lobe epilepsy due to mechanisms of brain plasticity.</p></div><div><h3>Objective</h3><p>Confirm right-ear advantage for the perception of word pairs using the dichotic listening technique in a group of right-handed patients with temporal lobe epilepsy.</p></div><div><h3>Methods</h3><p>A 60 word-pair dichotic listening technique was used, controlling the appearance, duration and ending of each pair of stimuli. Twenty-seven (27) right-handed patients with temporal lobe epilepsy were studied, obtaining their laterality index based on the number of words perceived in each ear.</p></div><div><h3>Results</h3><p>Right-ear advantage with a significant difference (<em>p</em> <!-->&lt;<!--> <!-->0.0001) was observed between both ears. According to the laterality index, 78% of the patients had left hemispheric lateralisation of language.</p></div><div><h3>Conclusion</h3><p>The presence of right-ear advantage for the perception of word pairs is a constant pattern that suggests hemispheric lateralisation of language in patients with epilepsy. Considering its scope and limitations, dichotic listening can be used to screen preoperative patients with temporal lobe epilepsy. There are no reports on the Mexican population on this subject.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"81 4","pages":"Pages 190-196"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2017.05.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49162939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Necrotising enterocolitis: Case series, of General Hospital of Mexico Dr. Eduardo Liceaga","authors":"L. Sansón-Riofrío ,&nbsp;V.R. Chávez-Gómez ,&nbsp;M.P. Peralta-Álvarez ,&nbsp;M.A. Durán-Padilla","doi":"10.1016/j.hgmx.2017.03.006","DOIUrl":"10.1016/j.hgmx.2017.03.006","url":null,"abstract":"<div><h3>Background</h3><p>Necrotising enterocolitis (NEC) is an acute inflammatory condition of the colon involving a wide range of diseases with one end result: necrosis. This disease entity is very common in preterm infants, since 5–10% of premature babies weighing less than 1.5<!--> <!-->kg are believed to suffer from it, and it has a mortality rate of around 50% of cases.</p></div><div><h3>Objective</h3><p>To describe the clinical and pathological characteristics of 24 patients with an established diagnosis of NEC and to identify their characteristics in terms of demographics, concomitant diagnoses and treatment response in order to provide preliminary data for designing prospective studies and future medical interventions.</p></div><div><h3>Materials and methods</h3><p>Information for 24 autopsied neonates who died of complications of NEC between 1993 and 2013 was compiled and analysed retrospectively.</p></div><div><h3>Results</h3><p>Of all 24 cases diagnosed with necrotising enterocolitis, only 15 were diagnosed clinically; all others (9 cases) were diagnosed <em>post mortem.</em> During autopsy, the most common finding was bleeding in different gastrointestinal segments (<em>n</em> <!-->=<!--> <!-->13 patients [53.9%]), followed by necrosis (<em>n</em> <!-->=<!--> <!-->9 [37.5%]) and perforation (<em>n</em> <!-->=<!--> <!-->10 [41.6%]). Four of the eight cases in which the Bell's clinical stage was reported could not be correlated with the pathological findings.</p></div><div><h3>Conclusions</h3><p>As NEC is a disease with a high mortality rate, it is necessary to increase our knowledge of the demographic and clinical characteristics of patients with the disease to make a diagnosis that enables the patient to have early access to efficient therapeutic interventions. Our results demonstrate broad difficulty in the clinical diagnosis of this condition, as well as a weak relationship between the clinical stage reported and the pathological characteristics found during autopsy. The significance of this case series lies in its demonstration of the lack of accurate knowledge and identification of the clinical and demographic characteristics of patients with necrotising enterocolitis and the need for greater understanding of the pathophysiological foundations of this disease.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"81 4","pages":"Pages 211-216"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2017.03.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43259888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal stromal tumor of the stomach. Case report","authors":"P.R. Arellano-López ,&nbsp;R. Solalinde-Vargas ,&nbsp;J.I. Guzmán-Mejía ,&nbsp;L.G. González-Pérez ,&nbsp;A.C. Zamora-García","doi":"10.1016/j.hgmx.2016.12.001","DOIUrl":"10.1016/j.hgmx.2016.12.001","url":null,"abstract":"<div><p>Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors of the alimentary tract. Nowadays GISTs represents 0.1–3% of all gastrointestinal malignancies, making it a diagnostic challenge. Lesions are frequently located in stomach and proximal small intestine but rarely elsewhere in the abdomen. They are believed to result from mutations of proto-oncogenes c-Kit or platelet-derived growth factor receptor alpha polypeptide, this increase tyrosine kinase receptor activity, leading to uncontrolled proliferation of stem cells that differentiate into cells of Cajal. They can occur at any age but predominantly in middle-aged people and in elderly. We report the case of a 28-year-old male presented to our hospital with upper gastrointestinal bleeding, findings in diagnostic image studies suggested a gastric GIST without evidence of metastatic disease; therefore totally tumor excision was performed. Cytologic and inmunohistochemistry analysis confirm diagnosis of GISTs.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"81 4","pages":"Pages 226-231"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.12.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54296589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}