Revista Medica del Hospital General de Mexico最新文献

{"title":"Acculturation impact on some metabolic parameters of the Lacandon communities from Chiapas","authors":"S. Islas-Andrade ,&nbsp;A. Pérez-Vargas ,&nbsp;R.E. Juárez-Pérez ,&nbsp;S. Flores-Martínez ,&nbsp;A.G. Gallardo-Hernández ,&nbsp;A. García-Zapién ,&nbsp;J. Sánchez-Corona ,&nbsp;C. Revilla-Monsalve","doi":"10.1016/j.hgmx.2016.09.004","DOIUrl":"10.1016/j.hgmx.2016.09.004","url":null,"abstract":"<div><p>The Lacandones are considered descendants of the Maya Civilization that found refuge in the jungle during the Spanish colonization. They were able to live in absolute isolation until 1990 when an acculturation process began. This is a cross-sectional study that included 46.7% of the total Lacandon population. Weight, height, overnight fasting plasma glucose, urea, creatinine, uric acid, hemoglobin, triglycerides and HDL-cholesterol levels were determined. BMI and age have a positive correlation for subjects younger than 40 years (<em>r</em> <!-->=<!--> <!-->0.51). Diabetes prevalence is 1.1%, and all cases are in the most acculturated town (Palenque). Prediabetes prevalence is 5.85% and all the cases have also hypertriglyceridemia. 19% of the prediabetes cases are between 10 and 19 years old. Hypercholesterolemia and hypertriglyceridemia prevalences are 20.7% and 45.1% respectively and there are cases in all the age groups.</p><p>The study showed the need to implement public health programs to revert the obesity tendency in the young Lacandon population to avoid in long term the burden of non-communicable diseases that would affect most of their productive life.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 3","pages":"Pages 148-153"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.09.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43729050","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":"Red cell distribution width: A marker of in-hospital mortality in ST-segment elevation myocardial infarction patients?","authors":"V.H. Contreras Gutiérrez","doi":"10.1016/j.hgmx.2016.10.001","DOIUrl":"10.1016/j.hgmx.2016.10.001","url":null,"abstract":"<div><h3>Background</h3><p>Red cell distribution width (RDW) is the percentage of the erythrocyte volume variation and has been identified as a biological marker in patients with cardiovascular disease. Increased levels have been associated to worse clinical outcomes and it is suggested that it could be useful as a prognostic risk factor in this group of patients.</p></div><div><h3>Methods</h3><p>This was an observational, prospective, longitudinal and analytic study with the objective of determining the correlation between RDW and in-hospital mortality in ST elevation myocardial infarction (STEMI) patients. 61 patients were included. We analyzed the correlation between RDW and in-hospital mortality as well as that between RDW and the GRACE risk score at hospital admission. Pearson correlation was determined in both cases by using IBM SPSS statistics software.</p></div><div><h3>Results</h3><p>61 STEMI patients were included, 77% (47) male and 14% (14) female. Average age was 61.8<!--> <!-->±<!--> <!-->11.7 years. Average GRACE risk score was 154.9<!--> <!-->±<!--> <!-->40.3. Average RDW was 14.3<!--> <!-->±<!--> <!-->1.07. In-hospital mortality presented in 5 (8.1%) cases. It was found, as expected, a positive correlation between in-hospital mortality and the GRACE risk score (<em>r</em> <!-->=<!--> <!-->0.314, <em>P</em> <!-->=<!--> <!-->0.05). Regarding the primary end-point of the study, it was found a positive correlation between RDW and in-hospital mortality (<em>r</em> <!-->=<!--> <!-->0.343), however there was no statistical significance. Regarding the secondary end-point we observed a positive statistically significant correlation between RDW and the GRACE risk score at hospital admission (<em>r</em> <!-->=<!--> <!-->0.410, <em>P</em> <!-->=<!--> <!-->0.01).</p></div><div><h3>Conclusions</h3><p>RDW is a biological marker of easy acquisition that does not generate additional cost to neither the patient nor the health institutions. High RDW levels could be useful to predict in-hospital mortality in STEMI patients, as well as to give additional value to established risk scores such as the GRACE.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 3","pages":"Pages 165-169"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.10.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42490280","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":"Relapse and gastrointestinal toxicity associated with radiotherapy treatment in stage I seminoma patients","authors":"A.A. Quezada Bautista ,&nbsp;J.C. Lara Bejarano ,&nbsp;J.A. García García ,&nbsp;O. Ortega-García ,&nbsp;M.Y. Bautista Hernández","doi":"10.1016/j.hgmx.2016.09.006","DOIUrl":"10.1016/j.hgmx.2016.09.006","url":null,"abstract":"<div><h3>Background</h3><p>The results preceding this study documented that patients with early stage classical seminoma treated with radiotherapy in the Hospital General de Mexico, using doses of 30<!--> <!-->Gy in 15 fractions using the modified dog-leg technique have lower gastrointestinal toxicity than the conventional dog-leg technique, but with no difference in overall survival and disease-free survival, both resulting in 100% 60 month-survival.</p></div><div><h3>Objective</h3><p>To determine the results of treatment in terms of relapse and gastrointestinal toxicity, comparing radiotherapy with conventional dog-leg, modified dog-leg and inverted-Y techniques.</p></div><div><h3>Material and methods</h3><p>retrospective, observational, comparative, analytical, retrolective study; 40 patients were analysed, all diagnosed with stage I seminoma treated at the RT Hospital General de Mexico between October 2009 and May 2016.</p></div><div><h3>Results</h3><p>The age of the patients was 33<!--> <!-->±<!--> <!-->8 years; 32 (80%) were treated in Accelerator linear and 8 patients (20%) in cobalt-60. The modified dog-leg technique was used in 24 patients (60%), conventional dog-leg technique in 12 patients (30%), and inverted-Y technique in 4 patients (10%). The radiation dose in 87% of patients was 25.2<!--> <!-->Gy. The most commonly found acute gastrointestinal toxicity was grade 2, present in 22% with modified dog-leg technique, 13% conventional dog-leg technique, and 3% for the inverted-Y technique (<em>p</em> <!-->=<!--> <!-->0.95). There was one relapse associated with the modified dog-leg technique; predicting factors for relapse including rete testis invasion, trans-scrotal violation, and lymphovascular invasion had no statistically significant impact.</p></div><div><h3>Conclusions</h3><p>Radiotherapy continues to be the treatment of choice in patients with early stage seminoma, with a low probability of relapse and acceptable gastrointestinal toxicity. There is no difference in relapse or gastrointestinal toxicity associated with the different radiation techniques in patients with stage I seminoma, therefore the modified dog-leg technique is recommended as the field of irradiation is already reduced without a negative impact on relapse.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 3","pages":"Pages 154-164"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.09.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49134545","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":"Disseminated pulmonary histoplasmosis with multiple cutaneous lesions: Case report and literature review","authors":"Dyanne N. De la Rosa ,&nbsp;Mayron D. Nakandakari ,&nbsp;Jorge Gutiérrez-Gutiérrez ,&nbsp;Walter Bryson-Malca","doi":"10.1016/j.hgmx.2016.05.013","DOIUrl":"10.1016/j.hgmx.2016.05.013","url":null,"abstract":"<div><p>Histoplasmosis is the most prevalent endemic mycosis on the American continent. It is caused by the dimorphic fungi <em>Histoplasma</em> spp. The infection is acquired by inhaling microconidia. It regularly starts in the lungs and then spreads to different organs. Skin involvement only occurs in 10% of cases. We present the case of a patient with a history of alcoholism. The disease initially manifested with non-specific respiratory symptoms such as cough with bloody sputum, dyspnoea, fever and multiple skin lesions. Using the PAS (periodic acid–Schiff) and Grocott stain histochemical techniques, the skin biopsy revealed intracellular microorganisms with peripheral nuclei and perinuclear ring, identified as <em>Histoplasma capsulatum</em>. The spread of primary pulmonary histoplasmosis led to the presentation of skin lesions. Correct diagnosis and treatment in this case helped to reduce the high mortality of the disease.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 3","pages":"Pages 170-173"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.05.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48937347","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":"Cardiovascular response estimated by ETCO2 after leg-raising test","authors":"L.A. Rosillo Meneses ,&nbsp;O. Carrillo Torres","doi":"10.1016/j.hgmx.2016.06.007","DOIUrl":"10.1016/j.hgmx.2016.06.007","url":null,"abstract":"<div><p>The perioperative administration of fluids in critically ill patients is of particular interest to the anaesthetist, as a reduction in mortality rates and the harmful systemic effects of volume has been demonstrated, as long as they are administered in the context of individualised goals.</p><p>The aim is to optimise cardiac output. It is therefore necessary to analyse each patient's situation individually, particularly important being the physiological basis, identification of the area of the Frank–Starling curve they are in and the correct clinical application of static and dynamic parameters offered by modern monitoring techniques; the dynamic being the ones that predict with the greatest accuracy.</p><p>We carried out a non-systematic review of the passive leg-raising test and its correlation with end-tidal carbon dioxide. This is an affordable dynamic parameter and is easy to determine in the operating theatre as it does not require invasive surgical instruments. It predicts the response to volume on the basis of the increase in cardiac output by identifying patients who are responders to volume according to their ventricular function curve.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 3","pages":"Pages 178-184"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.06.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41708385","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":"Different clinical manifestations in two siblings with cytomegalovirus infection","authors":"L. Álvarez-Hernández ,&nbsp;J.E. Cuevas-Castillejos ,&nbsp;H. Cuevas-Castillejos ,&nbsp;C.M. Aboitiz-Rivera ,&nbsp;R. Blachman-Braun","doi":"10.1016/j.hgmx.2016.06.002","DOIUrl":"10.1016/j.hgmx.2016.06.002","url":null,"abstract":"<div><p>In immunocompetent patients, human cytomegalovirus (CMV) infections are generally asymptomatic. Infection by this virus takes on particular importance during pregnancy owing to a risk of congenital infection occurring as a result of fetal transmission. In this article, we report the case of two siblings with this infection. The younger sibling had cystic microphthalmia, which was believed to be secondary to prenatal CMV infection. Given her status as an infectious carrier, she infected her older brother, who had signs and symptoms similar to those of infectious mononucleosis. CMV infection has a wide clinical spectrum, and prenatal CMV infection must be considered in patients within the differential diagnosis of eye malformations.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 3","pages":"Pages 174-177"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46837110","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":"Epidemiological surveillance of meningeal and encephalic syndrome in the Mexican Social Security Institute, 2012–2014","authors":"D.A. Cabrera-Gaytán ,&nbsp;G.F. Pérez-Pérez ,&nbsp;L. Arriaga-Nieto ,&nbsp;A. Vallejos-Parás ,&nbsp;R. Padilla-Velázquez ,&nbsp;C. Grajales-Muñiz","doi":"10.1016/j.hgmx.2016.06.014","DOIUrl":"10.1016/j.hgmx.2016.06.014","url":null,"abstract":"<div><h3>Objective</h3><p>To describe the incidence, clinical characteristics and laboratory findings of meningitis and cephalic disorder from 2012 to 2014 at the Mexican Social Security Institute (MSSI).</p></div><div><h3>Material and methods</h3><p>Descriptive analysis of the epidemiological surveillance system for meningococcal disease. A univariate analysis was performed to measure the main trends and dispersion. The Wilson test was used to calculate 95% confidence intervals for proportions and a Kaplan–Meier analysis for survival.</p></div><div><h3>Results</h3><p>113 probable cases of meningococcal disease. Cases with a positive result for meningococcus had an overall crude incidence rate of 0.02 cases per 100,000 social security beneficiaries. The disease is predominant in winter. The clinical symptoms in adults differ from those in children. In all, 20 deaths were reported, with an overall mortality rate of 17.7% and a rate of 20% for meningitis cases. The estimated mean survival time was 61.6 days (95% CI, 45.08, 75.18). The probability of surviving meningitis 2 days after the onset of symptoms was 0.944; after 20 days, it was 0.758 and after 87 days it was 0.427. Survival models were used, stratified by sex and age, with no statistically significant differences.</p></div><div><h3>Conclusions</h3><p>Epidemiological surveillance needs to be strengthened in terms of coverage between districts and timely reporting, with health personnel involved.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 3","pages":"Pages 130-138"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.06.014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46368613","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":"Something about genetics","authors":"S.A. Cuevas-Covarrubias","doi":"10.1016/j.hgmx.2017.03.002","DOIUrl":"10.1016/j.hgmx.2017.03.002","url":null,"abstract":"","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 2","pages":"Pages 71-72"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2017.03.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49555140","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":"The Rectal Cancer Project of the Spanish Association of Surgeons","authors":"H. Ortiz Hurtado ,&nbsp;A. Codina Cazador","doi":"10.1016/j.hgmx.2016.05.002","DOIUrl":"10.1016/j.hgmx.2016.05.002","url":null,"abstract":"<div><p>The Spanish Rectal Cancer Project was established in 2006, inspired by the Norwegian Rectal Cancer Project. It consisted of an educational project aiming to introduce mesorectal excision surgery to surgeons, pathologists and radiologists to establish a network of the Spanish National Health Service in Spain.</p></div><div><h3>Methods</h3><p>All hospitals covering a population area of at least 300,000 inhabitants and operating on more than 12 patients per year were invited to participate. The project was carried out similarly to the Norwegian one. Several “hands on” workshops were arranged yearly between 2006 and 2012. A central registry measured the effectiveness of the project with feedback to participating institutions of their own results compared with the national average.</p></div><div><h3>Results</h3><p>The National Health System consists of 261 hospitals of which 103 were included in the project. Of these 23 were excluded due to non-compliance with data registration. Therefore, the analysis included results from 80 hospitals covering a geographical area with 19,329,992 inhabitants. From 2006 to 2015 a total of 14,815 patients had a curative resection. The postoperative mortality rate was 1.8%; postoperative complications were observed in 39.9% patients; 10% developed anastomotic leakage and 9% required reoperation. The outcomes observed in 3088 cancer patients who have completed a five-year follow-up were: 6.2% local recurrence, metastasis 18.8% and 73.5% overall survival.</p></div><div><h3>Conclusions</h3><p>This project shows that the results obtained in Scandinavia have been reproduced in a larger population in Spain applying a similar methodology focused on the spread of competence and auditing of results.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 2","pages":"Pages 106-110"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.05.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47022925","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":"Pharmacokinetics of diclofenac in healthy controls with wild-type phenotype for CYP2C9 shows metabolism variability","authors":"M. Martín-De Saro ,&nbsp;O. Amancio-Chassin ,&nbsp;H. Urueta-Cuéllar ,&nbsp;L. González-Huerta ,&nbsp;S.A. Cuevas-Covarrubias","doi":"10.1016/j.hgmx.2017.02.001","DOIUrl":"10.1016/j.hgmx.2017.02.001","url":null,"abstract":"<div><h3>Background</h3><p>Cytochrome P450 2C9 (CYP2C9) is an important enzyme in the metabolism of many drugs, including NSAIDs, antidepressants and anticoagulants. <em>In vitro</em> and <em>in vivo</em> studies have demonstrated that CYP2C9 polymorphisms modify the activity of the enzyme and subsequently the metabolism of different drugs.</p></div><div><h3>Objective</h3><p>To characterize the diclofenac pharmacokinetics in healthy subjects with the wild type form of CYP2C9 genotype.</p></div><div><h3>Methods</h3><p>Twenty five healthy women were included in the study; a single dose of diclofenac (50<!--> <!-->mg) was administered orally. Pharmacokinetic analyses at 12 different times were performed. DNA was extracted from peripheral blood and analyzed through direct sequencing. The CYP2C9*1/*1 allele was found in all subjects. Using the AUC 0-inf parameter, we classified the 25 volunteers as poor, intermediate and extensive metabolizer (2285.421/3217.442/4637.450, respectively). We detected statistical significant differences between the groups, especially between poor metabolizers <em>versus</em> intermediate and extensive metabolizers.</p></div><div><h3>Conclusions</h3><p>This data indicate that CYP2C9 is not the only enzyme responsible of the metabolism of diclofenac, so it is important to analyze other cytochromes and their variants potentially involved in the metabolism of this drug.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 2","pages":"Pages 92-96"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2017.02.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44577658","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}