Medicina Universitaria最新文献

{"title":"Multidisciplinary College Camp for Services and Research (CUMIS) in Colombia: Experience and perspectives","authors":"D.M. Bados-Enriquez , D.E. Arboleda-Prado , A.F. Rincón-Zapata , Y. Ortiz-Martínez","doi":"10.1016/j.rmu.2016.10.004","DOIUrl":"10.1016/j.rmu.2016.10.004","url":null,"abstract":"","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 73","pages":"Pages 210-211"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.10.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82728146","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":"Tumor Necrosis Factor alpha, prognosis and stroke subtype etiology","authors":"H. Flores-Cantú ,&nbsp;F. Góngora-Rivera ,&nbsp;F. Lavalle-González ,&nbsp;J.Z. Villarreal-Pérez ,&nbsp;D. Cantú-Sánchez ,&nbsp;A. Anaya-Escamilla ,&nbsp;H.J. Villarreal-Montemayor ,&nbsp;H.J. Villarreal-Velázquez ,&nbsp;GECEN collaborators","doi":"10.1016/j.rmu.2016.10.007","DOIUrl":"10.1016/j.rmu.2016.10.007","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the relationship between TNF alpha and the etiology, localization, extension, intima media thickness, carotid atherosclerotic plaque, and outcome after an acute stroke.</p></div><div><h3>Methods</h3><p>We randomly selected 75 patients with acute strokes from a total of 253 patients that were admitted prospectively from May, 2008 to December, 2010. We analyzed TNF alpha levels and compared it with demographic data, clinical outcome upon hospital discharge, and at 3 months post discharge with neuroimaging studies. We used the Chi-square test, the <em>U</em>-Mann–Whiney test and the Cox logistic regression adjusted for age, gender and stroke extension.</p></div><div><h3>Results</h3><p>We included 47 men and 28 women. The most common etiologies were atherosclerotic (39%) and small vessel disease (27%). TNF alpha levels did not differ between atherosclerotic and cardioembolic stroke etiologies, except for the lacunar infarction, which had the lowest levels (<em>p</em> <!-->=<!--> <!-->0. 048), and did not correlate with a worse functional outcome upon hospital discharge (<em>p</em> <!-->=<!--> <!-->0. 852) or at 3 months following discharge (<em>p</em> <!-->=<!--> <!-->0.194). Additionally, we found a positive relation between intima media thickness &gt;1<!--> <!-->mm and TNF alpha (<em>p</em> <!-->=<!--> <!-->0. 004). TNF alpha was not associated with the extension of the stroke by an ASPECTS score with CT or MRI (<em>p</em> <!-->=<!--> <!-->0.323) or with the arterial territory involved (<em>p</em> <!-->=<!--> <!-->0. 289).</p></div><div><h3>Conclusions</h3><p>TNF alpha was not globally associated with functional outcome after acute stroke, just in the lacunar infarction, which has the lowest levels. We also found a positive relation between TNF alpha and intima-media thickness.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 73","pages":"Pages 194-200"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.10.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74623244","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":"Twenty-five years of knowledge of the prevention of neural tube defects with folic acid","authors":"L.E. Martínez-Garza","doi":"10.1016/j.rmu.2016.10.001","DOIUrl":"10.1016/j.rmu.2016.10.001","url":null,"abstract":"","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 73","pages":"Pages 187-188"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.10.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79735762","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":"Rediscovering the Coombs test","authors":"J.C. Jaime-Pérez,&nbsp;C. Almaguer-Gaona","doi":"10.1016/j.rmu.2016.07.001","DOIUrl":"https://doi.org/10.1016/j.rmu.2016.07.001","url":null,"abstract":"","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 72","pages":"Pages 185-186"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.07.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137310472","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":"Current state and perspectives of stem cell therapy for stroke","authors":"D.M. Martínez-Garza ,&nbsp;O.G. Cantú-Rodríguez ,&nbsp;J.C. Jaime-Pérez ,&nbsp;C.H. Gutiérrez-Aguirre ,&nbsp;J.F. Góngora-Rivera ,&nbsp;D. Gómez-Almaguer","doi":"10.1016/j.rmu.2016.07.005","DOIUrl":"10.1016/j.rmu.2016.07.005","url":null,"abstract":"<div><p>Stroke represents a public health enemy. Currently, and in spite of multiple clinical trials, thrombolysis remains as the only approved therapy. Most preclinical trials and animal trials employing stem cell-based therapies have shown very promising evidence of benefits. The aim of this review is to provide a landscape of what has been done in human clinical trials, and what are the possible ways that stem cell therapy may enhance functional recovery in stroke patients.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 72","pages":"Pages 169-180"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.07.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73052741","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":"Impact on costs related to inadequate indication of blood transfusion","authors":"M.A. Cázares-Benito ,&nbsp;R. Cázares-Tamez ,&nbsp;F. Pérez-Chávez ,&nbsp;C.G. Díaz-Olachea ,&nbsp;A.G. Ramos-García ,&nbsp;E.A. Díaz-Chuc ,&nbsp;B.A. Lee-González","doi":"10.1016/j.rmu.2016.07.003","DOIUrl":"10.1016/j.rmu.2016.07.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Blood component wastage has become a financial and ethical challenge in everyday hospital practice. Inadequate indication of blood products has been reported in up to 57.3% of cases. This has caused a significant increase in the costs associated with blood transfusion. The aim of this study was to establish the impact of inadequate indication of blood products on costs related to blood transfusion in a university hospital.</p></div><div><h3>Material and methods</h3><p>A retrospective, descriptive, observational study was conducted to evaluate blood product transfusions performed between January 1 and June 30, 2015, based on the criteria of the American Association of Blood Banks. The direct cost of blood product units was determined and transfusions were classified by type of indication, and the service ordering the transfusion.</p></div><div><h3>Results</h3><p>Based on the American Association of Blood Banks guidelines, 1028 transfusions were evaluated and 47.8% of these had an inadequate indication, equivalent to an estimated $38,766.87 USD for direct processing costs. According to the type of blood product transfused, 29.4% of fresh frozen plasma, 38.6% of packed red blood cells, and 68.2% of platelet concentrates had an inadequate indication.</p></div><div><h3>Conclusions</h3><p>An inadequate blood transfusion indication produces a high impact on costs related to blood transfusion involving an estimated yearly unnecessary expense of $860,766.64 USD in our hospital.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 72","pages":"Pages 148-152"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80913850","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":"Observations in relation to myocardial infarction: Are there three different Mexicos?","authors":"J.R. Azpiri-López","doi":"10.1016/j.rmu.2016.06.003","DOIUrl":"10.1016/j.rmu.2016.06.003","url":null,"abstract":"","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 72","pages":"Pages 181-184"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.06.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77222797","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":"Case report: Intestinal tuberculosis with perforation of the colon and psoas abscess associated with Escherichia coli ESBL","authors":"J.T. Palacios-Zertuche,&nbsp;Q.G. Limas-Rodríguez,&nbsp;C.M. González-Cantú,&nbsp;D.A. Pérez-Salazar,&nbsp;D.E. Saldivar-Martínez,&nbsp;G.E. Muñoz-Maldonado","doi":"10.1016/j.rmu.2016.05.005","DOIUrl":"10.1016/j.rmu.2016.05.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Abdominal tuberculosis is the sixth most common form of extra-pulmonary tuberculosis. It manifests predominantly in four forms: tuberculous lymphadenopathy, peritoneal tuberculosis, intestinal tuberculosis and visceral tuberculosis. The perforation of the colon in intestinal tuberculosis is a complication which should be recognized, and treated surgically, as quickly as possible.</p></div><div><h3>Clinical case</h3><p>A 17-year-old female who was admitted with low back pain, limiting flexion of the thigh, fever, vaginal discharge, abdominal pain and weight loss. The CT scan showed a left tubo-ovarian abscess, pelvic cavity collection, reactive retroperitoneal lymph nodes, left psoas abscess and spondylodiscitis from L2 to L3. An exploratory laparotomy was performed, and we found a perforation in the cecum and ascending colon, left tubo-ovarian abscess, and a collection of fecal matter in the pelvic gap. We debrided and drained the left psoas collection, and performed a right hemicolectomy, an ileostomy, a transverse colon mucocutaneus fistula and a left salpingo-oophorectomy. The trans-operatory biopsy of the retroperitoneal adenopathy revealed a chronic granulomatous process compatible with tuberculosis. The Gram stain showed abundant polymorphonuclears and moderate Gram bacilli (−), and the BAAR stain was negative. The cultures showed <em>Escherichia coli</em> ESBL (Extended-spectrum beta-lactamases) sensitive to imipenem. Pathology reported chronic granulomatous salpingitis, chronic granulomatous peritonitis, and ulcerated and perforated cronic granulomatous colitis.</p><p>The patient was treated with broad-spectrum antibiotic therapy for tuberculosis.</p></div><div><h3>Conclusion</h3><p>With patients that present a perforation in an intestine with tuberculosis, their general condition should be evaluated, as well as their nutritional state and intestinal viability, before performing primary repair, resection and anastomosis or resection and bowel diversion surgery.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 72","pages":"Pages 165-168"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.05.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76118422","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":"Muscle mass measured using bioelectrical impedance analysis, calf circumference and grip strength in older adults","authors":"C.G. Quiñonez-Olivas ,&nbsp;R. Salinas-Martínez ,&nbsp;X.A. Ortiz-Jiménez ,&nbsp;D.G. Gámez-Treviño ,&nbsp;G. Guajardo-Álvarez ,&nbsp;B. González-García","doi":"10.1016/j.rmu.2016.06.005","DOIUrl":"10.1016/j.rmu.2016.06.005","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the correlation between muscle mass, measured using bioelectrical impedance analysis (BIA), with calf circumference and grip strength.</p></div><div><h3>Materials and methods</h3><p>Cross-sectional and observational study. Including all functional adults over 60 years of age seen in our Geriatric Clinic during the months of March 2013–February 2014. Measurements of weight, height, BMI, calf circumference, grip strength and muscle mass by BIA were made after the signature of informed consent.</p></div><div><h3>Results</h3><p>105 patients were evaluated, 73 women and 32 men, with a mean age of 76 years (SD<!--> <!-->±<!--> <!-->7.3). Muscle mass showed a mild positive correlation with calf circumference: Pearson (<em>r</em> <!-->=<!--> <!-->0.31; <em>p</em> <!-->=<!--> <!-->0.000) and a moderate positive correlation with grip strength: Pearson (<em>r</em> <!-->=<!--> <!-->0.50; <em>p</em> <!-->=<!--> <!-->0.000).</p></div><div><h3>Discussion</h3><p>Muscle mass by BIA has a positive correlation with calf circumference and grip strength, and is a reliable measure to assess muscle mass and physical performance in older adults in geriatric ambulatory clinics and can be used in the diagnosis of sarcopenia in Mexican patients.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 72","pages":"Pages 158-162"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.06.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83990101","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":"Assessment of physicians in training's knowledge of transfusion medicine at a university hospital","authors":"D.M. Alvarado-Navarro ,&nbsp;R. Cázares-Tamez ,&nbsp;F. Pérez-Chávez ,&nbsp;C.G. Díaz-Olachea ,&nbsp;B.A. Lee-González ,&nbsp;A.G. Ramos-García ,&nbsp;A. Castillo-Macías ,&nbsp;E.A. Díaz-Chuc ,&nbsp;F.N. Domínguez-González","doi":"10.1016/j.rmu.2016.07.004","DOIUrl":"10.1016/j.rmu.2016.07.004","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the basic knowledge of transfusion medicine of medical residents who prescribe blood product transfusion.</p></div><div><h3>Material and methods</h3><p>We evaluated medical residents’ knowledge of transfusion medicine using multiple-choice questions.</p></div><div><h3>Results</h3><p>We evaluated a total of 186 residents from different departments. The mean score was 47.2 (0–100). The department with the highest score was Hematology (61.5). First-year residents achieved a score of 48.4, a score that was greater than those of subsequent years (44.7). Those who had read a practical guide on transfusion medicine obtained a better mean score than those who had not (55.4 vs. 44.6). No association was found between the mean score and the hours of transfusion medicine classes received during undergraduate training. The topic with the lowest score was related to red blood cell transfusion and fresh frozen plasma in emergency situations (7.5).</p></div><div><h3>Conclusion</h3><p>The results of this study show a general lack of knowledge on transfusion medicine; therefore, we believe it is important to increase the number of topics related to this subject in undergraduate and graduate classes.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 72","pages":"Pages 139-147"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.07.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87842141","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}