Medicina Universitaria最新文献

{"title":"Local anesthesia and sedation vs. spinal anesthesia for knee arthroscopy","authors":"V. Díaz-Osuna ,&nbsp;F. Vilchez-Cavazos ,&nbsp;D. Palacios-Ríos ,&nbsp;E.A. Ibarra-Malacara ,&nbsp;A.M. Espinosa-Galindo","doi":"10.1016/j.rmu.2016.06.004","DOIUrl":"10.1016/j.rmu.2016.06.004","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the efficacy of local anesthesia and diagnostic or therapeutic Arthroscopy procedures and compare them with spinal anesthesia.</p></div><div><h3>Material and methods</h3><p>We conducted a longitudinal, prospective, non-blind and analyst comparative clinical trial with two groups of 54 patients, aged 18–65 years. In the group assigned to local anesthesia and sedation, fentanyl, midazolam and propofol infusions were administered at the beginning of the surgery, the surgeon infiltrated ports and articular cavities with lidocaine and bupivacaine to provide postoperative analgesia. In the spinal anesthesia group, 7.5<!--> <!-->mg of simple bupivacaine was injected into the cerebro-spinal fluid (CSF). Clinical indicators were evaluated and were contrasted using inferential statistics.</p></div><div><h3>Results</h3><p>There was a significant difference in the following variables: time from the patient's entry to the beginning of the surgery (Local 39.19<!--> <!-->min SBA 55. 56<!--> <!-->min,), the group treated with SBA showing a statistically greater value (<em>p</em> <span>&lt;</span> <!-->0.01), and length of stay in the recovery area (Local 102.33<!--> <!-->min SBA 143<!--> <!-->min), with the SBA group having the longest time (<em>p</em> <span>&lt;</span> <!-->0.01).</p></div><div><h3>Conclusions</h3><p>Values were observed to be significantly lower in the time from the anesthetic procedure until the beginning of the surgery and the time of discharge from the recovery in the group treated with local anesthesia and sedation technique, with a maximum value of EVA 3. In conclusion, this technique is a good choice for this type of procedure, having a lesser total duration for the procedure and recovery.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 72","pages":"Pages 153-157"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.06.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79825699","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":"Transfusion medicine zeitgeist and coming of age","authors":"José Carlos Jaime-Pérez","doi":"10.1016/j.rmu.2016.07.002","DOIUrl":"10.1016/j.rmu.2016.07.002","url":null,"abstract":"","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 72","pages":"Pages 137-138"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.07.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74705530","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":"Neonatal spontaneous biliary perforation: Case report","authors":"F. Reyna-Sepúlveda,&nbsp;A. Esparza-González,&nbsp;V. Govea-Ortiz,&nbsp;G. Martínez-Flores,&nbsp;F. Montes-Tapia,&nbsp;U. Garza-Luna,&nbsp;G. Muñoz-Maldonado","doi":"10.1016/j.rmu.2016.05.006","DOIUrl":"10.1016/j.rmu.2016.05.006","url":null,"abstract":"<div><h3>Objective</h3><p>Spontaneous biliary perforation in neonates is rare. The etiology of this pathology is idiopathic and various management strategies ranging from non-operative treatment to complex operations, such as biliary-enteric reconstruction, are performed, with few reported outcomes.</p></div><div><h3>Case report</h3><p>A 3-week-old female, born at term, presented fever, abdominal distension, and acholic stool. An ultrasound was performed, which revealed generalized ascites and a poorly-defined collection. An emergency laparotomy confirmed perforation in the distal common bile duct and a biliary-enteric-anastomosis was performed.</p></div><div><h3>Discussion</h3><p>Wide drainage has been reported as the best initial management strategy for spontaneous biliary perforation, although it depends on the patient's clinical status and intraoperative findings.</p></div><div><h3>Conclusions</h3><p>Spontaneous infantile biliary perforation is rare. Main management is wide drainage with, most perforations being resolved in 2 weeks.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 72","pages":"Pages 163-164"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.05.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78676225","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 Zika virus disease: An overview","authors":"K.A. Galán-Huerta ,&nbsp;A.M. Rivas-Estilla ,&nbsp;E.A. Martinez-Landeros ,&nbsp;D. Arellanos-Soto ,&nbsp;J. Ramos-Jiménez","doi":"10.1016/j.rmu.2016.05.003","DOIUrl":"10.1016/j.rmu.2016.05.003","url":null,"abstract":"<div><p>The zika virus, another re-emerging Flavivirus transmitted to humans by mosquitoes, is responsible for the most recent fever outbreak in the Americas and the Pacific, starting in 2015. The immunologically naïve population in the Americas favors the spread of epidemics. The zika fever is characterized by febrile illness, malaise, conjunctivitis and a maculopapular rash. Similar to other arboviroses recently spread in the Americas, there is no specific or effective antiviral therapy and vaccines are still in trials. The only effective preventive measures consist of individual protection against mosquito bites and vector control. This febrile illness increases the epidemiological and public health challenge existing in America, where the population is already fighting against dengue and chikungunya fever. Disease prevention is important due to the economic burden it entails. The fact of sexual and transfusion virus transmission is a great challenge to overcome. Doctors need to distinguish between dengue, chikungunya and other diseases to give a successful treatment and prevent the disease spreading.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 71","pages":"Pages 115-124"},"PeriodicalIF":0.0,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.05.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75683694","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 of a rapid systemic guide on pediatric patients with suspicion of epilepsy","authors":"L.R. Morales-Mancías,&nbsp;S. Vázquez-Fuentes,&nbsp;A.C. Cantú-Salinas,&nbsp;L. de León-Flores,&nbsp;B.E. Chávez-Luévanos,&nbsp;H. Villarreal-Velázquez","doi":"10.1016/j.rmu.2016.02.001","DOIUrl":"10.1016/j.rmu.2016.02.001","url":null,"abstract":"<div><h3>Objectives</h3><p>Increase the percentage of etiological diagnosis of epilepsy (according to the classification by the 2010 ILAE) using a systematic quick guide for pediatric patients with suspected epilepsy.</p></div><div><h3>Methods</h3><p>Ambispective cohort study. Patients under 16 years old with suspected epilepsy were studied, and a systematic quick guide was applied to the prospective group, and later the two groups were compared. It was a convenience sample, with a study period of one year for both groups.</p></div><div><h3>Results</h3><p>The prospective group was 120 patients and the retrospective group 71 patients. Comparing the epileptic diagnosis by etiology groups, in the prospective group (only outpatient patients), 3.3% had epilepsy of an unknown cause, 55% had epilepsy of a genetic cause, 36.7% had epilepsy of a structural/metabolic cause, and 5% had conditions that are not epilepsy itself. Meanwhile in the retrospective group, 52.1% had epilepsy of an unknown cause, 11.3% had epilepsy of a genetic cause, and 36.6% had epilepsy of a structural/metabolic cause (<em>p</em> <!-->&lt;<!--> <!-->0.001).</p></div><div><h3>Conclusions</h3><p>Compared to other similar studies, the etiological percentages of epilepsy increased. Using the systematic quick guide proposed, the percentage of etiological definitions of epilepsy was increased in pediatric patients.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 71","pages":"Pages 63-72"},"PeriodicalIF":0.0,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.02.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77130398","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":"Emphysema model in rats exposed to tobacco smoke. Morphometric and functional analysis","authors":"F. Reyna-Sepúlveda ,&nbsp;E. Caballero-Mendoza ,&nbsp;F. Guzmán-de-la-Garza ,&nbsp;N. Fernández-Garza ,&nbsp;G.E. Muñoz-Maldonado ,&nbsp;J. Ancer-Rodríguez","doi":"10.1016/j.rmu.2016.05.004","DOIUrl":"10.1016/j.rmu.2016.05.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Several models of chronic obstructive pulmonary disease (COPD) in mice have been developed; the most similar to the habit of smoking is the inhalation of the smoke in mice. The objective was to develop and implement an experimental model of COPD in mice through the passive inhalation of smoke and demonstrate the physiological changes on ventilatory function and its correlation with 3 emphysema quantification methods.</p></div><div><h3>Materials and methods</h3><p>Twenty Wistar mice were included in an experimental and control group. The experimental group was exposed to tobacco smoke, and we performed several pulmonary functional tests and imaging techniques.</p></div><div><h3>Results</h3><p>Pulmonary function tests showed the volume expiration in the first second (VEF1) differs significantly between groups (<em>p</em> <!-->&lt;<!--> <!-->0.001). Pulmonary compliance was reduced in the experimental group by 50% in comparison to the control group (male vs control <em>p</em> <!-->&lt;<!--> <!-->0.001). Morphometric analysis: 17% reduction in lung volume with a destructive index (DI) of 45%. The intersection test had a DI of 43%. The free point test showed a DI of 44%.</p></div><div><h3>Conclusions</h3><p>The implementation of our model generated the presence of emphysema and alterations in the lung physiology in the experimental group. We demonstrated evidence of 90% with emphysema.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 71","pages":"Pages 79-84"},"PeriodicalIF":0.0,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.05.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88599633","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":"Pedicle screw sublaminary wiring (PSSW) combined with anti-tuberculosis chemotherapy for treating spinal tuberculosis in adults: A cohort study","authors":"A. Azharuddin ,&nbsp;J.K. Fajar","doi":"10.1016/j.rmu.2016.04.003","DOIUrl":"10.1016/j.rmu.2016.04.003","url":null,"abstract":"<div><h3>Background</h3><p>Operative procedures and anti-tuberculosis combinations are controversial for tuberculous spondylitis (TS) management in cases with risk of deformity, fragments, instability, and neurological disorders.</p></div><div><h3>Purpose</h3><p>To assess the effectiveness of a combination of anti-tuberculosis and pedicle screw sublaminary wiring (PSSW) for treating TS.</p></div><div><h3>Method</h3><p>This study was a cohort study with a pre-test/post-test control design. This study was conducted at the Dr. Zainoel Abidin Hospital (Banda Aceh) from March 2005 to March 2007. Sampling technique was judgement sampling. Neurological data deficit (Frankel classification) was analyzed before and after treatment using the Spearman test. Kyphosis angles were analyzed before and after treatment using the regression correlation test.</p></div><div><h3>Results</h3><p>A total of 18 patients (61.1% male and 38.9% female) participated in this study. The spinal column involved in this study was 55.6% thoracic, 27.8% thoraco-lumbar, and 16.7% lumbar. Neurological status before the treatment was 11.1% Frankel C, 72.2% Frankel, D, and 16.7% Frankel E. Neurological status after the treatment was 5.55% Frankel C and 94.4% Frankel E. It showed that there was no significant association between a combination of anti-tuberculosis and PSSW for neurological deficit improvement (<em>P</em> <!-->=<!--> <!-->0.212). The mean angle of kyphosis before the treatment was 23.05<!--> <!-->±<!--> <!-->11.9 while after the treatment it was 10.5<!--> <!-->±<!--> <!-->5.9. It showed that there was a significant association between a combination of anti-tuberculosis and PSSW for kyphosis degree improvement (<em>P</em> <!-->=<!--> <!-->0.000).</p></div><div><h3>Conclusions</h3><p>A combination of anti-tuberculosis and PSSW for six months provided significant results if assessed from degree of kyphosis, but did not provide significant results if assessed from Frankel classification.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 71","pages":"Pages 73-78"},"PeriodicalIF":0.0,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.04.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75344004","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":"Outpatient surgery anesthesia","authors":"B.I. Garduño-Chávez,&nbsp;D. Palacios-Rios,&nbsp;G.M. Cornejo","doi":"10.1016/j.rmu.2016.06.002","DOIUrl":"10.1016/j.rmu.2016.06.002","url":null,"abstract":"","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 71","pages":"Pages 130-133"},"PeriodicalIF":0.0,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82758686","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":"Laparoscopic diaphragmatic plication for paralysis posterior to trauma. Case report","authors":"F. Reyna-Sepúlveda,&nbsp;F. Vásquez-Fernández,&nbsp;Á. Rodríguez-Briseño,&nbsp;C. Montero-Cantú,&nbsp;G.E. Muñoz-Maldonado","doi":"10.1016/j.rmu.2016.05.002","DOIUrl":"10.1016/j.rmu.2016.05.002","url":null,"abstract":"<div><h3>Background</h3><p>Diaphragmatic paralysis is a pathology characterized by the elevation of a plastic and inactive atrophic diaphragm, followed by an injury to the spinal column or to the phrenic nerve. Because it involves the phrenic nerve, it is often associated with an injury at its exit in the spinal cord at the radicular level, at the conduct or in the peripheral nerve.</p></div><div><h3>Clinical case</h3><p>A 50-year-old male patient with a history of thoracic trauma and diagnosis of unstable thorax is admitted for progressive dyspnea in the following 8 months. Diaphragmatic paralysis is diagnosed and a laparoscopic diaphragmatic plicature is performed. Patient improved his clinical status by 29%.</p></div><div><h3>Discussion</h3><p>The consequences of the elevation of a hemidiaphragm can be respiratory, causing hypoxemia and decreases in the ventilation–perfusion ratio. This procedure is considered a corrective surgery from the morphological and functional point of view.</p></div><div><h3>Conclusions</h3><p>Our patient's clinical status improved according to the Saint George respiratory questionnaire, thanks to an improved perfusion of the basal lung expansion. Laparoscopic diaphragmatic plicature is a safe procedure associated with a minimal hospital stay, and more cases need to be reported. This is the procedure of choice in our institution.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 71","pages":"Pages 95-97"},"PeriodicalIF":0.0,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.05.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72831337","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":"Evaluation of inter-batch variability in the establishing and quality control of glucose","authors":"J. Moya-Salazar ,&nbsp;L. Pio-Dávila","doi":"10.1016/j.rmu.2016.03.004","DOIUrl":"10.1016/j.rmu.2016.03.004","url":null,"abstract":"<div><p>This research evaluated the inter-batch variability in the identification and quality control of glucose, according to international specifications detailed in the guide CLSI EP-15. Type of qualitative research, analytical, not experimental, prospective cross-sectional conducted at the Department of Clinical Laboratory at Polyclinic “La Fe” during January 2015 was performed. The inter-batch variability for glucose in the semi-automated biochemical analyzer URIT-810 with liquid enzyme glucose-LS reagent (GOD-PAP) Valtek® batch 140825 was evaluated. The calibrators (CS) were the lot CS-A: 140 428, CS-B: 120912 and CS-C: 131 202. Data analysis was performed in SPSS version 20.0 statistical analyzer and Microsoft Office Excel 2010 for Windows. The values found by calculating the sigma metric were: 2 (ΔSE −0.35), 0 (ΔSE 1.65) −0.9 (ΔSE −0.75) to CS-A, CS-B and CS-C, respectively <em>(p</em> <!-->&lt;<!--> <em>0.05)</em>. Only CS-A might be able to improve their performance, although with greater cost. Sub-optimal performance characteristics by using standard calibrators show high inter-lot variability, suggesting the choice and search for a new and better calibration method to ensure results that contain no medically important errors affecting patient health.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 71","pages":"Pages 85-90"},"PeriodicalIF":0.0,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.03.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86714669","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}