Revista medica del Instituto Mexicano del Seguro Social最新文献_第6页

[Diagnosis of congenital heart disease using Deep Learning in pediatric chest X-rays: A proof of concept]. [在儿童胸部x光中使用深度学习诊断先天性心脏病：概念证明]。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2026-07-13 DOI: 10.5281/zenodo.19076180

Óscar Andrés Ramírez-Terán, Eduardo Tomás-Alvarado, Salvador Ruiz-Correa, Héctor Segura-Quintanilla, Rubén López-Revilla, Cesaré Moisés Ovando-Vázquez, Rubicel Trujillo-Acatitla

{"title":"[Diagnosis of congenital heart disease using Deep Learning in pediatric chest X-rays: A proof of concept].","authors":"Óscar Andrés Ramírez-Terán, Eduardo Tomás-Alvarado, Salvador Ruiz-Correa, Héctor Segura-Quintanilla, Rubén López-Revilla, Cesaré Moisés Ovando-Vázquez, Rubicel Trujillo-Acatitla","doi":"10.5281/zenodo.19076180","DOIUrl":"10.5281/zenodo.19076180","url":null,"abstract":"Background: In Mexico, congenital heart diseases (CHD) are the most common birth defects. Despite their high mortality rate, many CHD are not detected early by general practitioners and pediatricians at the primary care level. Echocardiography, the diagnostic standard for CHD, is only available at tertiary care facilities with specialized equipment and personnel. In contrast, chest X-rays are an inexpensive and accessible test, and their analysis using artificial intelligence (AI) could allow for the presumptive diagnosis of CHD.Objective: Create a database of pediatric chest X-rays and develop a proof of concept that evaluates the feasibility of applying AI algorithms for the presumptive detection of CHD from these images.Material and methods: A retrospective cross-sectional study was conducted based on the analysis of pediatric chest X-ray images using a deep convolutional neural network implemented under a Residual Network (ResNet) architecture.Results: Among the radiographs included in the study, 426 (65%) corresponded to patients with CC and 230 (35%) to patients without CC. A deep learning algorithm for binary classification (Healthy/Cardiopath) applied to this set achieved a diagnostic precision of 75%.Conclusions: According to available records, this database represents the largest collection of chest X-rays from Mexican pediatric patients with CHD confirmed by clinical experts. This resource enabled the training of an AI-based model with sufficient diagnostic performance to support its potential utility as a presumptive screening tool in healthcare settings with limited access to pediatric cardiology subspecialists.","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e6971"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451167","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}

引用次数: 0

[Interlaminar Distance and Bony Landmarks in Lumbar Neuraxial Anesthesia: A Concordance Study]. 腰椎轴束麻醉的椎间距离和骨标志：一项一致性研究。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2026-07-13 DOI: 10.5281/zenodo.19076202

Jimena Alexandra González-Sandoval, Patricia Berenice Bolado-García, Alberto Alfonso Álvarez-Pérez

{"title":"[Interlaminar Distance and Bony Landmarks in Lumbar Neuraxial Anesthesia: A Concordance Study].","authors":"Jimena Alexandra González-Sandoval, Patricia Berenice Bolado-García, Alberto Alfonso Álvarez-Pérez","doi":"10.5281/zenodo.19076202","DOIUrl":"10.5281/zenodo.19076202","url":null,"abstract":"Background: Accurate identification of the puncture site in neuraxial anesthesia is essential. Accordingly, this study examines the concordance between interlaminar distance and bone landmark palpation in cases of difficult blockade.Objective: To reduce the risk of complications by enhancing the understanding of lumbar anatomy.Material and methods: A concordance study was conducted in 90 patients scheduled for neuraxial anesthesia, using bone landmark palpation and ultrasound measurement, with descriptive and inferential statistics applied through Cohen's Kappa coefficient.Results: The agreement between interlaminar distance and difficult blockade was κ = 0.565, p = 3.07×10⁻⁸; and between bone landmark palpation and difficult blockade was κ = 0.308, p = 0.00086. The odds ratio between difficult blockade and bone palpation was OR = 5.71 (95%CI: 1.93-16.93); for interlaminar distance and difficult blockade, the OR was 19.5 (95%CI: 5.85-65.00). The probability of encountering a difficult neuraxial blockade using the clinical technique was 80.77%, and with ultrasound guidance, it was 57.78%.Conclusions: An interlaminar distance <1.38 cm and grades 3 or 4 show moderate agreement with difficult blockade. Grades 3 or 4 were associated with a 5.71-fold increased likelihood of encountering a difficult blockade, whereas an interlaminar distance <1.38 cm was associated with a 19.5-fold increase. Based on probability difference, the use of ultrasound prior to neuraxial blockade reduces the likelihood of technical difficulty by 22.99% compared to the traditional clinical technique.","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e6931"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13405257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451175","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}

引用次数: 0

[Early detection of Insuline Resistence in Pregnant Women]. [孕妇胰岛素抵抗的早期检测]。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2026-07-13 DOI: 10.5281/zenodo.19076171

Sergio Iván Domínguez-Santos, Cesar Arturo Serrano-Arrazola, Corina Mariela Alba-Alba

{"title":"[Early detection of Insuline Resistence in Pregnant Women].","authors":"Sergio Iván Domínguez-Santos, Cesar Arturo Serrano-Arrazola, Corina Mariela Alba-Alba","doi":"10.5281/zenodo.19076171","DOIUrl":"10.5281/zenodo.19076171","url":null,"abstract":"Background: Gestational diabetes due to insulin resistance (IR) is a priority health problem for the WHO given its consequences for both mother and fetus.Objective: To determine the suitability of HOMA-IR for early detection of insulin resistance in the first trimester of pregnancy.Materials and methods: A quantitative, comparative, and correlational study was conducted in 30 pregnant women, selected by convenience sampling. IR was determined in the first trimester using the HOMA-IR test with cut-off points based on pre-pregnancy Body Mass Index (BMI) in the first trimester and oral glucose tolerance test (OGTT) in the second trimester. Analysis was performed using SPSS with the following statistical methods: Shapiro-Wilk normality test; Pearson's and Spearman's r correlation coefficients; Levene's test for independent samples; Student's t-test; and Mann-Whitney U test; as well as risk analysis with respect to BMI.Results: The average age was 27 years. No relationship was found between HOMA-IR and sociodemographic variables or pre-pregnancy BMI. During the first trimester, HOMA-IR detected IR in 56.6% of pregnant women; while in the second trimester, the OGTT detected IR in 66.3% of pregnant women. A moderate relationship was found between HOMA-IR and OGTT values at one and two hours, but not in the fasting state. The difference in mean HOMA-IR values between the groups with and without IR persisted in the OGTT tests performed in the fasting, one-hour, and two-hour states. Pre-pregnancy BMI indicating overweight and obesity did not represent a significant risk.Conclusions: The HOMA-IR study proved useful for the early detection of IR, which can be used to guide lifestyle modifications in women with risk factors. Further scientific evidence is recommended.","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e6882"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451143","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}

引用次数: 0

Response to benralizumab in patients with severe eosinophilic asthma. 严重嗜酸性哮喘患者对苯那利单抗的反应。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2026-07-13 DOI: 10.5281/zenodo.19076191

Jorge Isaac Velasco-Santos, Francisco Javier Núñez-Martínez, Brian Humberto Martínez-Sánchez, Alejandro de Jesús Chávez-Lárraga

{"title":"Response to benralizumab in patients with severe eosinophilic asthma.","authors":"Jorge Isaac Velasco-Santos, Francisco Javier Núñez-Martínez, Brian Humberto Martínez-Sánchez, Alejandro de Jesús Chávez-Lárraga","doi":"10.5281/zenodo.19076191","DOIUrl":"10.5281/zenodo.19076191","url":null,"abstract":"Background: Severe asthma represents a significant public health challenge, and monoclonal antibodies such as benralizumab represent an effective therapeutic option for achieving disease control.Objective: To evaluate the effectiveness of benralizumab in patients with severe eosinophilic asthma by assessing changes in fractional exhaled nitric oxide (FeNO), peripheral blood eosinophils, symptom control, forced expiratory volume in 1 second (FEV1), and exacerbation rates six months after treatment initiation.Materials and methods: A prospective observational study was conducted in 11 patients with severe uncontrolled eosinophilic asthma. Clinical outcomes (ACT), quality of life (mini-AQLQ), FEV1, exacerbations, and biomarkers of blood eosinophils and FeNO were assessed at baseline and six months.Results: After six months of benralizumab therapy, > 90% of patients showed significant improvement in quality of life (mini-AQLQ, p < 0.05), and 72.7% achieved better asthma control (ACT, p < 0.05). Exacerbations decreased by 66.9% (p < 0.05). Blood eosinophils decreased by 97.5% (p < 0.05), FeNO by 57% (p < 0.05), and FEV1 increased by 27.7% (p < 0.05).Conclusions: Benralizumab demonstrated significant clinical and inflammatory benefits in this cohort, improving biomarkers, lung function, exacerbation rates, and patient-reported outcomes, supporting its effectiveness in real-world management of severe eosinophilic asthma.","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e7001"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451225","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}

引用次数: 0

[Screening of Hepatitis C virus in blood donors over 11 years]. [11岁以上献血者丙型肝炎病毒筛查]。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2026-07-13 DOI: 10.5281/zenodo.19076194

José Luis Rodríguez-Rivera, Alondra Daniel-Cravioto, Gamaliel Benítez-Arvizu

{"title":"[Screening of Hepatitis C virus in blood donors over 11 years].","authors":"José Luis Rodríguez-Rivera, Alondra Daniel-Cravioto, Gamaliel Benítez-Arvizu","doi":"10.5281/zenodo.19076194","DOIUrl":"10.5281/zenodo.19076194","url":null,"abstract":"Background: HCV infection remains a global concern due to its often asymptomatic course and the potential for transfusion transmission during the window period. In this setting, nucleic acid testing (NAT) can detect early viremia that is not yet identifiable by serology, thereby strengthening blood safety.Objective: To quantify HCV NAT yield (NAT-reactive donations with non-reactive anti-HCV serology, consistent with window-period detection) in blood donors using combined NAT and serology over an 11-year period.Material and methods: Cross-sectional, observational study including 568,569 donations recorded at the CMN Siglo XXI Blood Bank (2014-2025). NAT and serology results were analyzed in accordance with NOM-253-SSA1-2012 to identify donations with a NAT-reactive/serology-non-reactive pattern.Results: One NAT-reactive/serology-non-reactive case was identified, consistent with window-period infection. The NAT yield rate was 0.18 per 100,000 donations (1.8 per million). No risk factors or coinfections were reported, indicating that serology alone would have missed the infection. Because only one case was documented over 11 years, population-level inferences and epidemiologic impact estimates are not supported.Conclusions: In a large cohort within a very low-frequency setting, NAT identified a potentially infectious donation that serology did not detect. Although the absolute yield was low, each detected case is relevant to transfusion safety. Expanding NAT coverage and strengthening voluntary donation are recommended to optimize transfusion safety in Mexico.","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e7025"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13378682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451205","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}

引用次数: 0

[Genetic Susceptibility to Metabolic Syndrome: A Comparative Overview of the Mexican Population in a Global Context]. [代谢综合征的遗传易感性：墨西哥人口在全球背景下的比较综述]。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2026-07-13 DOI: 10.5281/zenodo.19076283

Carlos Arturo Gallardo-Hernández, Jaqueline Díaz-Alberto, José Antonio Palma-Jacinto, Oreth Montero-Ruíz, Ulises Ramírez-Franco

{"title":"[Genetic Susceptibility to Metabolic Syndrome: A Comparative Overview of the Mexican Population in a Global Context].","authors":"Carlos Arturo Gallardo-Hernández, Jaqueline Díaz-Alberto, José Antonio Palma-Jacinto, Oreth Montero-Ruíz, Ulises Ramírez-Franco","doi":"10.5281/zenodo.19076283","DOIUrl":"10.5281/zenodo.19076283","url":null,"abstract":"Metabolic syndrome (MetS) is a multifactorial condition involving environmental factors, lifestyle behaviors, and genetic variants. The objective of this review was to analyze and compare the available evidence on genetic susceptibility to MetS in the Mexican population and in other regions of the world, in order to identify convergences and population-specific features. A narrative review of the scientific literature published between 2020 and 2025 was conducted using international databases. The methodological quality and scientific relevance of the studies were assessed using criteria adapted from the Q-Genie instrument. The results show that genetic variants involved in glucose and lipid metabolism, as well as in blood pressure regulation, are associated with MetS across diverse populations. However, relevant differences were identified in the frequency and phenotypic effects of these variants between the Mexican population and other regions worldwide. In conclusion, the evidence suggests that genetic susceptibility to MetS exhibits a population-specific component in Mexico. In this context, further investigation of genetic variants associated with MetS is warranted to contribute to the strengthening of preventive strategies aimed at reducing the burden of MetS in the Mexican population.","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e6935"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13446170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451131","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}

引用次数: 0

[Embryonic origin of temperament: notochord and early signaling]. 气质的胚胎起源：脊索和早期信号。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2026-07-13 DOI: 10.5281/zenodo.19076218

Samuel Ruesga-Mundo

{"title":"[Embryonic origin of temperament: notochord and early signaling].","authors":"Samuel Ruesga-Mundo","doi":"10.5281/zenodo.19076218","DOIUrl":"10.5281/zenodo.19076218","url":null,"abstract":"It is proposed that the origin of temperament is rooted in events of the third week of gestation, when gastrulation and the notochord organize body axes and morphogenetic gradients, integrated through intracellular pathways with downstream effects on circuit architecture and locomotion.\u0000The aim of this article is to propose a theoretical mechanistic model that articulates how gastrulation, the notochord, and prenatal epigenetic programming could contribute—probabilistically rather than deterministically—to the origin of human temperament.\u0000A three-phase mechanistic flow is proposed: Phase 1, in which gastrulation and the notochord establish axes and gradients that could modulate the organization of ventral circuits and central pattern generators; Phase 2, in which prenatal epigenetic programming calibrates stress, immune, and affective axes; and Phase 3, in which these levels integrate into profiles of activity, exploration, reactivity, and inhibition, consistent with the distributed polygenic architecture described by personality genomics.\u0000The notochord emerges as a plausible morphogenetic axis of temperament. Upon this embryonic scaffold, prenatal epigenetic programming may calibrate allostasis, stress reactivity, and affectivity, contributing to long-term temperamental variation. The model formulates falsifiable hypotheses and suggests translational priorities in perinatal prevention, multimodal biomarkers, and personalized neurodevelopmental medicine, whose short-term clinical feasibility remains uncertain.","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e6850"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537694","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}

引用次数: 0

[From ICU to recovery: recurrent pneumonia due to Lophomonas blattarum]. 【从ICU到康复：乙肝单胞菌所致复发性肺炎】。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2026-07-13 DOI: 10.5281/zenodo.19076302

María Julieta Cárdenas-de Luna, Evelin Bugarin-Cortes, Carlos Fernando Gómez-Rodríguez, Luis Adrián De Jesus-González, Juan Carlos Borrego-Moreno

{"title":"[From ICU to recovery: recurrent pneumonia due to Lophomonas blattarum].","authors":"María Julieta Cárdenas-de Luna, Evelin Bugarin-Cortes, Carlos Fernando Gómez-Rodríguez, Luis Adrián De Jesus-González, Juan Carlos Borrego-Moreno","doi":"10.5281/zenodo.19076302","DOIUrl":"10.5281/zenodo.19076302","url":null,"abstract":"Background: Lophomonas blattarum is a multiflagellate protozoan considered an endocommensal parasite of the cockroach gut. Its identification is clinically relevant in cases of recurrent or refractory pneumonia. The infection manifests with cough, dyspnea, expectoration, bronchiectasis, and pleural effusion; its diagnosis is based on the morphological recognition of the protozoan in respiratory samples, and treatment with metronidazole or tinidazole is usually effective. To describe the manifestations, diagnostic findings, and evolution of a patient with recurrent pneumonia caused by Lophomonas blattarum, the following case is presented.Clinical case: A 73-year-old female patient with type 2 diabetes mellitus, hypertension, hypothyroidism, and depressive disorder, with a history of hospitalization for pneumonia, was admitted with chest pain, progressive dyspnea, hyporexia, edema, and perioral cyanosis. Laboratory studies revealed a ground-glass opacity pattern and bilateral alveolar infiltrates. Given the poor response to treatment, bronchoalveolar lavage was performed, and Lophomonas blattarum was identified by direct microscopy. Treatment with metronidazole was initiated, resulting in clinical improvement and resolution.Conclusions: This case highlights the importance of considering parasitic etiologies in patients with recurrent pneumonia and chronic comorbidities. The timely identification of Lophomonas blattarum by bronchoalveolar lavage allowed for targeted treatment and a favorable clinical outcome.","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e6965"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451151","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}

引用次数: 0

[Esophageal perforation: surgical outcomes in a referral center]. 食道穿孔：转诊中心的手术结果。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2026-07-13 DOI: 10.5281/zenodo.19076346

José Antonio Vera-Bernal, José Luis Beristain-Hernande, Lucero Antares Rosas-Espinoza, Manuel García-Sánchez, Francisco Bevia-Pérez, Gerardo Guerrero-Rebaja, Adrian Regalado-Aquino, Juan Carlos Rivera-Martinez, Alejandro García-Meza

{"title":"[Esophageal perforation: surgical outcomes in a referral center].","authors":"José Antonio Vera-Bernal, José Luis Beristain-Hernande, Lucero Antares Rosas-Espinoza, Manuel García-Sánchez, Francisco Bevia-Pérez, Gerardo Guerrero-Rebaja, Adrian Regalado-Aquino, Juan Carlos Rivera-Martinez, Alejandro García-Meza","doi":"10.5281/zenodo.19076346","DOIUrl":"10.5281/zenodo.19076346","url":null,"abstract":"Background: Esophageal perforation is a rare and potentially life-threatening condition. Its main etiologies include iatrogenic, traumatic, and neoplastic causes. Diagnosis is based on imaging and endoscopic studies. Although some cases can be managed conservatively, most require endoscopic or surgical interventions.Clinical case: A case study was conducted analyzing the clinical characteristics, treatment, and outcomes of patients with esophageal perforation treated at a referral hospital between 2019 and 2023.\u0000Twenty patients were included, with a mean age of 52 years and a predominance of men. The most frequent perforation sites were the cervical and abdominal regions, followed by the thoracic region. The etiology was iatrogenic in 13 cases and traumatic in 7 patients. The most common symptoms were pain, edema, and purulent drainage, and the predominant radiographic finding was contrast medium leakage. The mean time to diagnosis was 5.5 days. All patients required surgical management: primary closure in 4 cases, primary closure with jejunostomy in 5, primary closure with muscle patch in 3, and esophagectomy with esophagostomy and jejunostomy in 8 patients. The overall mortality rate was 20%.Conclusions: In this series, a high proportion of late diagnoses were observed, related to the time of referral to the unit; however, all patients required surgical treatment. Despite this, the observed mortality rate was comparable to that reported in the international literature.","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e6726"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451158","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}

引用次数: 0

[Ultrasound glossopharyngeal block for oropharyngeal pain management in cancer patients]. 超声舌咽部阻滞治疗癌症患者口咽疼痛

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2026-07-13 DOI: 10.5281/zenodo.19076210

Karla Itzel Gutiérrez-Riveroll, Jocelyn Ivette Ríos-Figueroa, Luis Ángel Pozos-Rojas, Juan Manuel Rodríguez-Zepeda

{"title":"[Ultrasound glossopharyngeal block for oropharyngeal pain management in cancer patients].","authors":"Karla Itzel Gutiérrez-Riveroll, Jocelyn Ivette Ríos-Figueroa, Luis Ángel Pozos-Rojas, Juan Manuel Rodríguez-Zepeda","doi":"10.5281/zenodo.19076210","DOIUrl":"10.5281/zenodo.19076210","url":null,"abstract":"Background: Oropharyngeal pain due to oral mucositis and base of tongue tumors is a frequent and highly disabling condition that significantly impacts quality of life. Its management is often complex, involving nociceptive, inflammatory, and neuropathic mechanisms with limited response to conventional therapy. Ultrasound-guided glossopharyngeal nerve block has emerged as a safe and effective alternative to improve analgesia.Objective: To evaluate pain control using ultrasound-guided glossopharyngeal nerve block in patients with oral mucositis or base of tongue tumors.Material and methods: A prospective observational study was conducted in a tertiary care hospital, fifteen cancer patients are inlcuded with severe oropharyngeal pain associated with mucositis or base of tongue tumors. All patients underwent ultrasound-guided glossopharyngeal nerve block with local anesthetic and corticosteroid. Pain was assessed using the ENA and FLACC scales, along with evaluation of oral intake tolerance, adjuvant analgesic use, and complications.Results: Pain intensity significantly decreased from 9 to 0 at 30 minutes (p < 0.05) and remained low at 7 days. One minor complication (10%) was reported. The procedure suggested to be safe and effective.Conclusions: Ultrasound-guided glossopharyngeal nerve block is a minimally invasive, is potentially safe, and effective technique for managing oropharyngeal pain in cancer patients.","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e6940"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13378683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451186","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}

引用次数: 0