Revista Medica del Hospital General de Mexico最新文献

{"title":"Duo test and aneuploidy detection in women under 35 years of age with high-risk pregnancy at the Hospital General de México","authors":"J.M. Valdés-Miranda ,&nbsp;A. Pérez-Cabrera ,&nbsp;F. Coronel-Cruz ,&nbsp;S.A. Cuevas-Covarrubias","doi":"10.1016/j.hgmx.2016.09.002","DOIUrl":"10.1016/j.hgmx.2016.09.002","url":null,"abstract":"<div><p>Non-invasive procedures for prenatal diagnosis are the most frequently used methods in the first trimester of pregnancy in pregnant women under 35 years of age because they do not involve risk of pregnancy loss; however, they are not considered to be a definitive diagnosis method. During the first trimester the duo test (PAPP-A and free βhGC), cell-free fetal DNA in maternal blood and structural ultrasound scans are the principal tools used; the quadruple marker test (αFP, E3, β-hCG, inhibin A) is used in the second trimester. However, the definitive diagnosis is performed by cytogenetic analysis through amniocentesis.</p></div><div><h3>Methods</h3><p>Thirty women, under 35 years of age with high-risk pregnancy, were studied with duo test and structural ultrasound in the first trimester and amniocentesis in weeks 15–18.</p></div><div><h3>Results</h3><p>Only five duo tests were positive: three showed risk of trisomy 18 and one of Turner syndrome, they all corroborated with the cytogenetic study; the fifth showed a risk of Down's syndrome, however it was a chromosomally normal product. Three patients with a negative duo test cytogenetically detected with karyotypes with structural abnormalities, which were: deletion of the short arm of chromosome 18 [46,XY, del(18)(p11)], Robertsonian translocation between chromosome 13 and 14 [45,XY, rob(13:14)] and a chromosome derived from X [46,X, der(X)]. The duo test is a very useful tool for the diagnosis of numerical chromosome abnormalities, but not for detecting structural chromosome aberrations. However, it is essential to perform amniocentesis to definitively rule out chromosomal aberrations in products of conception.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 2","pages":"Pages 73-76"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.09.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47981029","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":"Anthropometric variations and low resting energy expenditure as a cause of metabolic risk in adult patients with Turner syndrome","authors":"E. Sifuentes ,&nbsp;V. Fuchs-Tarlovsky ,&nbsp;G.N. Garibay Nieto ,&nbsp;K. Álvarez Altamirano ,&nbsp;L.L. Gallegos ,&nbsp;L.M. Malanco Hernández ,&nbsp;L. Plaza Benhumea ,&nbsp;M. Martí Saro ,&nbsp;M.Á. Fonseca-Sánchez ,&nbsp;G.E. Queipo García","doi":"10.1016/j.hgmx.2016.09.003","DOIUrl":"10.1016/j.hgmx.2016.09.003","url":null,"abstract":"<div><p>There is currently little evidence available about the metabolic behaviour in adult patients with Turner syndrome (TS). Metabolic complications are common in adult TS patients, increasing morbidity and impairing quality of life. Body composition is altered in TS, secondary to the short stature. Metabolic damage in patients with TS is an important medical issue due to complications observed in adulthood.</p></div><div><h3>Aim</h3><p>Study some of the aspects involved in the origin of the metabolic damage.</p></div><div><h3>Methods</h3><p>We conducted an observational, cross-sectional, comparative, descriptive study in 20 adult patients with TS and 20 control patients matched by age, waist circumference, waist circumference/height ratio (W/Hr) as sensitive parameters for metabolic risk. Anthropometric, body composition, resting energy expenditure data and blood samples for blood chemistry, lipid and thyroid profile were considered. Multivariate analysis of variance and the Student's <em>T</em>-test were used to analyse the data all the patients’ data were corrected according to the predicted specific formula for adult TS.</p></div><div><h3>Results</h3><p>Statistically significant differences in energy expenditure (REE) modifications and in free fat mass per weight percentage were observed.</p></div><div><h3>Conclusion</h3><p>Differences in anthropometric values and REE in TS could be implicated in the metabolic damage, and are attributable to the syndrome and not to the body composition.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 2","pages":"Pages 81-86"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.09.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48875360","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":"Left temporal cerebral syphilitic gumma: Case report and literature review","authors":"E. Ariñez Barahona ,&nbsp;J.L. Navarro Olvera ,&nbsp;M.A. Esqueda Liquidano ,&nbsp;A. Muñoz Cobos ,&nbsp;Á.D. Rivera Arroyo ,&nbsp;E. Gomez Apo","doi":"10.1016/j.hgmx.2016.04.008","DOIUrl":"10.1016/j.hgmx.2016.04.008","url":null,"abstract":"<div><p>Syphilis is a systemic disease caused by the spirochaete <em>Treponema pallidum</em> that affects the central nervous system at any time and whose clinical presentation has undergone changes in recent decades, due to the emergence of the acquired immune deficiency virus. We present the case of a 50-year-old immunocompetent woman with no significant changes in sexual behaviour, who only presented with headache and speech disturbances (mixed aphasia). MRI and CT scans initially showed left parietal injury, and later left temporal recurrence. The patient was treated for neurosyphilis for 5 weeks and showed improvement at her one-month follow-up appointment, before once again manifesting speech disturbances with sensory aphasia six months after treatment onset. Another control MRI was performed, revealing a relapse of the tumour lesion in the left temporal region. Intravenous treatment was once again initiated with benzathine penicillin and new serological and imaging tests were conducted, revealing the absence of lesions. Gummatous neurosyphilis is a rare condition, which explains why it tends to be erroneously diagnosed and treated. It is for this reason that we have presented our case study and literature review.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 2","pages":"Pages 119-124"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.04.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42978339","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":"Chromosomal abnormalities in patients with haematologic malignancies in the General Hospital of Mexico","authors":"R.M. Arana Trejo ,&nbsp;A. del Castillo Moreno ,&nbsp;L.G. Alcalá Carmona ,&nbsp;V. Madrid Cedillo ,&nbsp;J.J. Kassack Ipiña ,&nbsp;M. Gutiérrez Romero ,&nbsp;A.B. Cervantes Peredo ,&nbsp;E. Rozen Fuller ,&nbsp;E. Aguilar Martínez ,&nbsp;A. Pérez Cabrera ,&nbsp;E. Gálvez Galicia ,&nbsp;J. Collazo Jaloma ,&nbsp;S.A. Cuevas-Covarrubias","doi":"10.1016/j.hgmx.2016.11.006","DOIUrl":"10.1016/j.hgmx.2016.11.006","url":null,"abstract":"<div><h3>Background</h3><p>Haematologic malignancies are generated by alterations in haematopoietic stem cells. Chromosomal rearrangements are present in &gt;50% of patients and are useful as diagnostic and prognostic factors.</p></div><div><h3>Objective</h3><p>In this study we describe the cytogenetic characteristics observed in patients with haematological malignancies in the Genetics Department during the period 2000–2014.</p></div><div><h3>Material and Methods</h3><p>The karyotype was performed on bone marrow (85%) and peripheral blood (15%) with conventional techniques in 9717 samples.</p></div><div><h3>Results</h3><p>The average age was 40 years (range 0.3–95) and the male/female distribution was 50.5%/49.5%. 352 cases (3.6%) were paediatric with a male/female distribution of 59/41%. The diagnosis was: acute leukaemia 4445 (45.7%), CML 2058 (20.4%), and MDS or some form of cytopenia 1573 (16%). Fewer than 5% of samples received were from AA, MM, CMPD, NHL, CLL, LPD and others. The distribution of acute leukaemia was: ALL 44%, AML 43% and unspecified 13%; the predominant subtypes were ALL-L2 at 50.7% and AML-M3 at 54.2%. Only 61% of the 9717 samples were processed. The karyotype was normal in 3956 (66.7%) samples, the rest (1972, 33.3%) had chromosomal abnormalities: 65% structural and 35% numerical. The changes observed most frequently were t(9;22)(q34;q11) 26%, hyperdiploidy/polyploidy 19.3%, diverse translocations 8.4%, hypodiploidy 8%, t(15;17)(q22;q12) 7.8%, and MDS-related disorders (del5q/-5/-7/+8) 7.7%. Different deletions, trisomy, monosomy and/or complex karyotype were present in smaller proportion (&lt;7%).</p></div><div><h3>Conclusions</h3><p>The karyotype remains useful to confirm the diagnoses, establish risk-based prognoses, and classify based on risk to patients; for example in cases with t(9;22) in CML or t(15;17) in M3.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 2","pages":"Pages 87-91"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.11.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47857371","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 case report of a patient with mucopolysaccharidosis type II","authors":"M.R. Rivera Vega,&nbsp;H. García Vidaña,&nbsp;G. Pacheco Cuéllar,&nbsp;S.A. Cuevas-Covarrubias","doi":"10.1016/j.hgmx.2016.08.004","DOIUrl":"10.1016/j.hgmx.2016.08.004","url":null,"abstract":"<div><p>Mucopolysaccharidosis type II (MPS II) or Hunter syndrome is an inborn error of metabolism due to lysosomal accumulation, with a recessive inheritance pattern linked to the X chromosome. It is caused by a deficiency in the activity of the lysosomal enzyme iduronate-2-sulfatase encoded by the <em>IDS</em> gene. Iduronate-2-sulphatase enzyme activity in plasma was measured and the <em>IDS</em> gene was analysed in genomic DNA by automated direct sequencing. Enzyme activity was 1.2<!--> <!-->μmol/l/h (reference value: &gt;2<!--> <!-->μmol/l/h), while the molecular analysis detected the mutation c.1403G&gt;A (p.R468Q), confirming the diagnosis of MPS II. In conclusion, since here in Mexico there are few groups dedicated to this family of diseases, we must emphasise the need to keep up to date and create expert teams of doctors and scientists specialised in inborn errors of metabolism.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 2","pages":"Pages 97-100"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.08.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41954324","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":"Low-grade inflammation and its relation to obesity and chronic degenerative diseases","authors":"A.M. Castro,&nbsp;L.E. Macedo-de la Concha,&nbsp;C.A. Pantoja-Meléndez","doi":"10.1016/j.hgmx.2016.06.011","DOIUrl":"10.1016/j.hgmx.2016.06.011","url":null,"abstract":"<div><p>Overweight and obesity are two of the most important public health problems in Mexico. There is a clear association between lifestyle and obesity. This relationship means that unhealthy lifestyles can modify people's physiological response through adipocytokines, proinflammatory factors which are closely related to chronic degenerative diseases.</p><p>Obesity causes low-grade chronic inflammation. Adipose tissue, in addition to its function of storing energy reserves in the form of triglycerides, has important functions as an endocrine organ, producing a variety of molecules called adipocytokines such as IL-1, IL-6, IL-8, IFNγ, TNFα, leptin and resistin. The production of these molecules by adipocytes, coupled with the destruction of these cells, induces the inflammation to become chronic, and influences other systems by altering their functions, which leads to different diseases. Understanding the relationship between the different components of lifestyle and the production of adipocytokines involved in the development of chronic degenerative diseases, will allow us to address the problem and hence reduce the morbidity and mortality caused by these diseases.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 2","pages":"Pages 101-105"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.06.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47138907","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":"Pre- and post-natal nutritional factors in the metabolic regulation of obesity","authors":"E. Villanueva-Ortega,&nbsp;M.J. Garcés-Hernández,&nbsp;G.N. Garibay Nieto","doi":"10.1016/j.hgmx.2016.08.006","DOIUrl":"10.1016/j.hgmx.2016.08.006","url":null,"abstract":"<div><p>In recent decades there has been a very significant increase in obesity in most developing countries. In addition to environmental, genetic and hormonal factors, nutritional and maternal environment factors influencing critical periods of foetal development have acquired increasing significance since the thrifty phenotype theory was described by Harles and Barker and epidemiological studies demonstrated that perinatal conditions may modify individuals’ future metabolic responses <em>via</em> genomic reprogramming. Perinatal programming corresponds to a critical and accelerated period of developmental plasticity from preconception through early postnatal life. This characteristic may also have a long-term influence on metabolic health and obesity. Epigenetic modifications favour the survival of the individual in critical periods when nutritional restriction is established, but exerts long-term risks, as metabolic programming tracks into infancy and adulthood and induces fat mass accumulation, particularly if energy consumption is exceeded. Although the mechanisms are not yet fully understood, it is evident that hormonal factors such as insulin and leptin may influence the programming of hypothalamic circuits for energy balance regulation. Nutritional interventions in animal models at critical stages of development have demonstrated that microenvironmental modifications might induce a permanent modulation of the progeny genome expression <em>via</em> epigenetic mechanisms. A transgenerational transmission of obesity has been proposed.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 2","pages":"Pages 111-118"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.08.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44123023","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":"Exome sequencing analysis reveals homozygous GJB2 gene mutation in a Mexican family with profound hearing loss","authors":"M. Martínez-Saucedo ,&nbsp;M.R. Rivera-Vega ,&nbsp;L.M. Gonzalez-Huerta ,&nbsp;H. Urueta-Cuéllar ,&nbsp;S.A. Cuevas-Covarrubias","doi":"10.1016/j.hgmx.2016.08.001","DOIUrl":"10.1016/j.hgmx.2016.08.001","url":null,"abstract":"<div><h3>Background</h3><p>Sensorineural hearing loss (SNHL) is a clinically and genetically heterogeneous disease. In some populations, c.365delG mutation in the <em>GJB2</em> gene represents the most frequent cause of hereditary SNHL. The great diversity of mutations in the <em>GJB2</em> gene worldwide highlights the participation of ethnic background in SNHL.</p></div><div><h3>Objective</h3><p>To describe the presence of homozygous c.del35G mutation in the <em>GJB2</em> gene in a Mexican family with SNHL.</p></div><div><h3>Materials and methods</h3><p>A Mexican family with SNHL was included in the study. Analysis of the <em>GJB2</em> gene was performed through whole exome sequencing (WES) and DNA direct sequencing analysis in all members of the family and in 100 normal controls</p></div><div><h3>Results</h3><p>Affected sibs showed the homozygous c.del35G mutation in the <em>GJB2</em> gene. Parents of the families were heterozygous for the molecular defect and had normal audition.</p></div><div><h3>Conclusion</h3><p>We describe a homozygous c.del35G mutation in the <em>GJB2</em> gene through WES analysis, a homozygous mutation with a very low occurrence in Mexican population.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 2","pages":"Pages 77-80"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41578658","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":"Identification and molecular characterization of Roseomonas genomospecies 5 isolated from Umbilical Cord Blood Unit","authors":"J.M. Bello-López ,&nbsp;I. Trejo-Uriostegui ,&nbsp;C.A. Domínguez-Mendoza ,&nbsp;C. Castañeda-García ,&nbsp;J. Rojo-Medina","doi":"10.1016/j.hgmx.2016.05.003","DOIUrl":"10.1016/j.hgmx.2016.05.003","url":null,"abstract":"<div><h3>Introduction</h3><p><em>Roseomonas</em> is rarely involved in pathology but represents an important case of contamination when is associated to hematopoietic stem cells, having intrinsic resistance to multiple classes of antibiotics and the ability to gain new resistance factors. This is a report that follows a previous identification of contamination microorganisms in the cryopreserved Umbilical Cord Blood Units (UCBU) stored in the Cord Blood Bank (CBB) of the National Center of Blood Transfusion (NCBT) at Mexico City.</p></div><div><h3>Objective</h3><p>Phenotypic and molecular characterization of <em>Roseomonas</em> genomospecies 5 isolated from UCBU.</p></div><div><h3>Materials and methods</h3><p>Phenotypic enzyme diffusion tests in solid phase (proteases, amylases, hemolysins and lipases detection) and antimicrobials (for Gram negative bacteria) resistance tests were performed to determine the potential virulence and resistance of the strain isolated of the Umbilical Cord Blood Unit 2191. Additional PCR assays were performed to determine the presence of genetic elements associated to antimicrobial resistance: bla genes and Class 1 integrons. Also, a 16S rRNA gene sequence analysis was done on microbial strains isolated from UCBU.</p></div><div><h3>Results</h3><p>Broad-spectrum penicillins, third generation cephalosporins, and fluoroquinolones did not show inhibitory activity in the 2191 strain. We could only identify extracellular amylase activity. Gene detection by PCR of encoding antimicrobial resistance (β-lactamases) and Class 1 integrons revealed the presence of bla_–HSV and bla_–TEM variants in the 2191 strain. Phylogenetic analysis revealed the presence of <em>Roseomonas</em> genomospecies 5 in the 2191 UCBU (named 2191 strain).</p></div><div><h3>Conclusions</h3><p>This is the first report on the isolation of <em>Roseomonas</em> genomospecies 5 in a UCBU for transplantation, an unusual bacteria isolated from umbilical cord blood, associated with a possible immunosuppression in the donor. Its presence in UCBU can be fatal in immunocompromised patients if it were used for transplantation of Hematopoietic Stem Cells (HSC), due to the potential virulence of the strains and the resistance to antimicrobials commonly used.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 1","pages":"Pages 24-30"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.05.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54293934","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":"Remifentanil and dexmedetomidine as an alternative to regional analgesia in obstetrics","authors":"M. Aguilar-Montiel ,&nbsp;O. Carrillo-Torres","doi":"10.1016/j.hgmx.2016.08.009","DOIUrl":"10.1016/j.hgmx.2016.08.009","url":null,"abstract":"<div><p>Epidural analgesia for controlling pain in labour has been the gold standard over the past 2 decades as it is considered the least harmful technique for the newborn. In reality, however, it is not without risk. That said, there are few options for pain management in labour when epidural analgesia is contraindicated. A recent survey to investigate the use of alternatives showed remifentanil to be the first choice when using systemic analgesia intravenously, as short-acting opioids administered systemically relieve pain adequately without the need for epidural analgesia.</p><p>Another safe option for providing obstetric analgesia is dexmedetomidine, a selective alpha-2 agonist that improves the quality of analgesia and reduces opioid requirements. Dexmedetomidine promotes stability and maintains uterine/placental homeostasis.</p></div>","PeriodicalId":31559,"journal":{"name":"Revista Medica del Hospital General de Mexico","volume":"80 1","pages":"Pages 67-70"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hgmx.2016.08.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54295541","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}