Medicina Universitaria最新文献

{"title":"The use of DTT in the resolution of the interferences generated by daratumumab in the blood bank","authors":"M.C. Barrientos-Soto ,&nbsp;M. Castañeda-García ,&nbsp;A. Herrera-García ,&nbsp;S. Padilla-López ,&nbsp;M.A. Dimas-Adame ,&nbsp;R. Cazares-Tamez","doi":"10.1016/j.rmu.2017.07.006","DOIUrl":"10.1016/j.rmu.2017.07.006","url":null,"abstract":"<div><p>Daratumumab (DARA) is a medication that in 2016 proved its efficacy and safety in the treatment of multiple myeloma. This product, based on a monoclonal antibody, technically generates an interference in most blood compatibility tests, artificially producing high blood pan-reactivity and incompatibility. The difficulty in finding blood compatible with the patient's serum can also mask the presence of other clinically significant alloantibodies and, above all, delays the timely delivery of erythrocyte concentrate, which, obviously, endangers the patient's life.</p><p>In transfusion medicine, very different strategies have recently been described for the resolution of this technical interference. We adopted the use of dithiothreitol (or DTT) to treat the red blood cells of the possible blood donors for the patient, thus achieving the elimination of this technical discrepancy and the adequate, safe and timely selection of this blood component. In the present paper, we describe the first case of a patient with a diagnosis of multiple myeloma treated with DARA, in which the interference caused by this drug in pretransfusion tests was successfully resolved.</p><p>Communication is a key element in the management of these patients. The doctor should inform the patient and the blood bank about the risk of presenting incompatible cross-tests when they are being treated with this medication. It is additionally recommended that all patients with multiple myeloma should undergo an erythrocyte phenotyping before receiving their treatment with DARA, and carry a card indicating that they are receiving this medication. Fortunately, hemolytic transfusion reactions have not yet been reported in these types of patients at the time of this publication.</p><p>For the staff at blood banks, it is evident that an additional operating procedure must be in place to describe the technical and administrative operation that must be followed from the admission of these patients to the hospital.</p><p>Technically speaking, we recommend, based on our experience reported in this case, the use of the DTT technique to resolve this discrepancy and technical difficulty in pretransfusion testing in patients treated with DARA.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"19 76","pages":"Pages 127-130"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2017.07.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90599748","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":"Analgesic effect of whole body cryotherapy in patients with trapezius myofascial pain syndrome: A longitudinal, non-blinded, experimental study","authors":"Ó.A. García-Espinoza,&nbsp;Ó. Salas-Fraire,&nbsp;P.P. Flores-Garza,&nbsp;K. Salas-Longoria,&nbsp;J.A. Valadez-Lira","doi":"10.1016/j.rmu.2017.07.004","DOIUrl":"10.1016/j.rmu.2017.07.004","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the analgesic effect of whole body cryotherapy (WBC) in patients with trapezius myofascial pain syndrome.</p></div><div><h3>Methods</h3><p>Twenty patients from an outpatient rehabilitation clinic were recruited. Patients were required to have clinical data for their diagnosis of myofascial pain syndrome in the trapezius. Twenty WBC sessions (−160<!--> <!-->°C) were prescribed at four sessions per week for five weeks. A visual analog scale for pain (VAS) and algometry at trigger points (TPs) were applied before and after each session to measure the Pressure Pain Threshold (PPT). Six blood samples per patient were obtained during the study to measure the serum concentration of pro-inflammatory and anti-inflammatory cytokines.</p></div><div><h3>Results</h3><p>A significant decrease in pain immediately after WBC was found from session 1 (<em>p</em> <!-->&lt;<!--> <!-->0.001) onwards. Furthermore, a significant difference was observed in VAS at baseline compared to the value before each cryotherapy session starting from session 6 (<em>p</em> <!-->&lt;<!--> <!-->0.001). Significant differences were found in algometry at each session (<em>p</em> <!-->&lt;<!--> <!-->0.001) and when comparing the initial and pre-session values starting from session 6 (<em>p</em> <!-->&lt;<!--> <!-->0.001). No significant differences were found in the concentrations of inflammatory or anti-inflammatory factors throughout the study (<em>p</em> <!-->&gt;<!--> <!-->0.05).</p></div><div><h3>Conclusions</h3><p>WBC is useful as an analgesic treatment for myofascial pain syndrome in trapezius.’</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"19 76","pages":"Pages 115-122"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2017.07.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83071700","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":"Child and adolescent obesity","authors":"L.G. Hinojosa Amaya","doi":"10.1016/j.rmu.2017.07.005","DOIUrl":"https://doi.org/10.1016/j.rmu.2017.07.005","url":null,"abstract":"","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"19 76","pages":"Pages 145-148"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2017.07.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92077260","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":"Distal radius fractures: Still a common problem","authors":"C. Acosta-Olivo","doi":"10.1016/j.rmu.2017.07.003","DOIUrl":"https://doi.org/10.1016/j.rmu.2017.07.003","url":null,"abstract":"","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"19 76","pages":"Pages 140-142"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2017.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92077261","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":"Levosimendan in acute decompensated heart failure: Systematic review and meta-analysis","authors":"J. Cornejo-Avendaño ,&nbsp;J. Azpiri-López ,&nbsp;A. Ramírez-Rosales","doi":"10.1016/j.rmu.2017.04.004","DOIUrl":"10.1016/j.rmu.2017.04.004","url":null,"abstract":"<div><h3>Objectives</h3><p>To assess the risks and benefits of levosimendan in acute decompensated heart failure compared to dobutamine or placebo.</p></div><div><h3>Methods</h3><p>Pubmed, the Cochrane Central Register of Controlled Trials (CENTRAL), the European Heart Journal, and the Journal of the American College of Cardiology and Circulation were searched for randomized clinical trials of a 24<!--> <!-->h IV infusion of levosimendan compared to dobutamine or a placebo in patients ≥18 years old admitted with a diagnosis of acute decompensated heart failure of any etiology with a NYHA class III and IV heart failure, a left ventricular ejection fraction &lt;0.35, pulmonary catheter wedge pressure &gt;15<!--> <!-->mmHg or cardiac index &lt;2.5<!--> <!-->ml/min/m².</p></div><div><h3>Results</h3><p>Eleven clinical trials (2747 patients) met the inclusion criteria for this review. Levosimendan was associated with a significant increase in NYHA class OR 3.06 (95% CI 1.23–7.59; <em>p</em> <!-->=<!--> <!-->0.02), and a tendency to improve fatigue OR 1.80 1.53 (IC95% 0.99–2.39, <em>p</em> <!-->=<!--> <!-->0.06) and clinical improvement composite OR 1.20 (IC95% 0.99–1.46; <em>p</em> <!-->=<!--> <!-->0.06), as compared to dobutamine or a placebo.</p></div><div><h3>Conclusions</h3><p>Levosimendan in acute decompensated heart failure improves NYHA functional class, LVEF and BNP levels when compared to dobutamine or a placebo, with an increase in side effects.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"19 75","pages":"Pages 80-97"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2017.04.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79992045","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":"Nutritional status in patients with Parkinson's disease at a third-level hospital in Northeastern Mexico","authors":"C.K. López-Botello ,&nbsp;S.M. González-Peña ,&nbsp;L.N. Berrún-Castañón ,&nbsp;I.E. Estrada-Bellmann ,&nbsp;P.R. Áncer-Rodríguez","doi":"10.1016/j.rmu.2017.03.002","DOIUrl":"10.1016/j.rmu.2017.03.002","url":null,"abstract":"<div><p>Parkinson's disease (PD) is recognized as the second most common neurodegenerative disorder after Alzheimer's; in PD, a patient's nutritional status may be compromised. This study involved 15 adults, aged 47–80 years of age, with idiopathic Parkinson's disease. Twenty percent of the population had low weight, of which 66% were over 60 years old and, according to the AMA, 26.7% presented malnutrition. In conclusion, PD can contribute to reduced nutritional status, so a nutritional assessment is essential for the early detection of PD patients at risk of malnutrition and for the development and implementation of nutritional intervention. The aim of our study was to describe an outpatient nutritional status with PD in a third level hospital.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"19 75","pages":"Pages 45-49"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2017.03.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86313594","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 comparison of anthropometric characteristics and somatotypes in a group of elite climbers, recreational climbers and non-climbers","authors":"M.F. Novoa-Vignau,&nbsp;O. Salas-Fraire,&nbsp;K. Salas-Longoria,&nbsp;G. Hernández-Suárez,&nbsp;M. Menchaca-Pérez","doi":"10.1016/j.rmu.2017.05.006","DOIUrl":"10.1016/j.rmu.2017.05.006","url":null,"abstract":"<div><p>Sport climbing has become a very popular and competitive sport. Despite growing interest in the research of climbing, there is still scant evidence regarding the adaptations it produces in the anthropometric characteristics of climbers. The objective of this study was to provide descriptive data about the anthropometric and somatotype characteristics of a group of elite and recreational climbers and compare them with a group of healthy non-climber volunteers. Twelve elite climbers (9 males and 3 females), 10 recreational climbers (7 males and 3 females), and 10 healthy non-climbers (6 males and 4 females) were assessed. Body mass, height, body mass index (BMI) and anthropometric measurements were used to obtain body fat percentage (BF%) and somatotype according to the Heath-Carter protocol. We found that females and males elite climbers (EC) have a significantly lower BF% and endomorphic component (<em>p</em> <!-->&lt;<!--> <!-->0.05) than non-climbers (NC). EC males also showed a significantly lower (<em>p</em> <!-->&lt;<!--> <!-->0.05) BMI than NC males. No differences were found between the anthropometric characteristics of EC and recreational climbers (RC); however, the EC had significantly higher mean results (<em>p</em> <!-->&lt;<!--> <!-->0.05) in climbing ability level and years of experience. The mesomorphic component was dominant in both groups of climbers. We concluded that EC, both males and females, are thin individuals with a predominance of musculoskeletal development, significantly less endomorphic characteristics, more ectomorphic characteristics and a lower BF% than the general population.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"19 75","pages":"Pages 69-73"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2017.05.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90024641","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":"Mechanisms involved in liver damage resolution after hepatitis C virus clearance","authors":"T.B. Salas-Villalobos ,&nbsp;S.A. Lozano-Sepúlveda ,&nbsp;A.R. Rincón-Sánchez ,&nbsp;M. Govea-Salas ,&nbsp;A.M. Rivas-Estilla","doi":"10.1016/j.rmu.2017.05.005","DOIUrl":"10.1016/j.rmu.2017.05.005","url":null,"abstract":"<div><p>Worldwide, the hepatitis C virus (HCV) infection is a leading etiology of cirrhosis and hepatocellular carcinoma (HCC). The main complications of chronic HCV infection are fibrosis, cirrhosis and HCC. Nowadays, there are several options accessible for HCV treatment, such as direct-acting antiviral agents (DAAs), including HCV protease inhibitors, polymerase inhibitors, and NS5A inhibitors. Once the virus is eliminated after the specific antiviral treatments, patients should try to re-establish their metabolic functions efficiently from an environment where there was great cellular destruction. Another goal for the liver can range from fibrosis to decompensate cirrhosis. For this reason, upon the use of DAAs therapy, assuming that SVR is reached, the use of antifibrotic drugs is increasing in order to improve liver regeneration by decreasing fibrotic tissue generated by HCV. Liver fibrosis is defined as the excessive accumulation of extracellular matrix proteins because of the interaction of a number of different cell types, among them hepatic stellate cells. Once the causative agent of damage is removed, the progression of liver disease is attenuated. However, if the patient has an advanced state of fibrosis or cirrhosis, hepatic regeneration becomes a challenge where numerous known and unknown cellular mechanisms are involved. Fortunately, there are drugs that facilitate this process of reversion, however, it is still not clear that conditions favor the success of this regression.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"19 75","pages":"Pages 100-107"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2017.05.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76110244","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":"Is complete regression of liver injury achievable?","authors":"F.J. Bosques-Padilla,&nbsp;E.I. González-Moreno","doi":"10.1016/j.rmu.2017.05.004","DOIUrl":"10.1016/j.rmu.2017.05.004","url":null,"abstract":"","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"19 75","pages":"Pages 43-44"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2017.05.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81165852","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":"Bone marrow architecture reconstitution after hematopoietic grafting: A cross-sectional study","authors":"J.C. Jaime-Pérez,&nbsp;C.D. Villarreal-Villarreal,&nbsp;Y. Alvarado-Bernal,&nbsp;J.R. Padilla-Medina,&nbsp;L.T. Fernández,&nbsp;D. Gómez-Almaguer","doi":"10.1016/j.rmu.2017.04.001","DOIUrl":"10.1016/j.rmu.2017.04.001","url":null,"abstract":"<div><h3>Objective</h3><p>Changes in bone marrow (BM) architecture and its remodeling after hematopoietic stem cell transplantation (HSCT) following a reduced-intensity conditioning regimen for treating malignant hematologic diseases are poorly documented. We assessed these changes and their correlation with the clinical course to investigate the dynamics of this process.</p></div><div><h3>Material and methods</h3><p>Hematology patients who received a reduced intensity conditioning (RIC) were followed after successful allogeneic or autologous HSCT. Patients had at least 100 days after hematopoietic grafting. Post-transplant BM architecture was assessed by expert examination of a trephine biopsy using age-adjusted scores and histopathology results were contrasted with clinical post-transplant evolution to determine meaningful associations.</p></div><div><h3>Results</h3><p>Twenty-seven HSCT recipients, 19 allogeneic and 8 autologous, were studied at a median 155 (100–721) days post-transplant. Eleven (40.7%) had hypocellular biopsies with around 50% of the expected cell composition for a normal individual at that age. Patients with increased fibrosis had lower peripheral white blood cell counts compared to those with normal reticulin distribution (<em>p</em> <!-->=<!--> <!-->0.015). A decrease in overall survival (OS) was documented in the group with more severe myelofibrosis at a median 813 days of follow-up. Infectious complications were more frequent in patients receiving an allogeneic (<em>n</em> <!-->=<!--> <!-->6) compared with the recipients of an autologous transplant (<em>n</em> <!-->=<!--> <!-->0).</p></div><div><h3>Conclusions</h3><p>Despite normal peripheral blood count and composition, significant post-transplant hypocellularity, revealing incomplete bone marrow reconstitution, was documented after HSCT in patients conditioned with a RIC regimen. Severe BM fibrosis was associated to decrease OS.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"19 75","pages":"Pages 74-79"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2017.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76105617","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}