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Pina-Oviedo S.,University of Houston | Ortiz-Hidalgo C.,Centro Medico ABC | Ayala A.G.,Houston Methodist Hospital
Archives of Pathology and Laboratory Medicine | Year: 2017

Context.-Colors are important to all living organisms because they are crucial for camouflage and protection, metabolism, sexual behavior, and communication. Human organs obviously have color, but the underlying biologic processes that dictate the specific colors of organs and tissues are not completely understood. A literature search on the determinants of color in human organs yielded scant information. Objectives.-To address 2 specific questions: (1) why do human organs have color, and (2) what gives normal and pathologic tissues their distinctive colors? Data Sources.-Endogenous colors are the result of complex biochemical reactions that produce biologic pigments: red-brown cytochromes and porphyrins (blood, liver, spleen, kidneys, striated muscle), brown-black melanins (skin, appendages, brain nuclei), dark-brown lipochromes (aging organs), and colors that result from tissue structure (tendons, aponeurosis, muscles). Yelloworange carotenes that deposit in lipid-rich tissues are only produced by plants and are acquired from the diet. However, there is lack of information about the cause of color in other organs, such as the gray and white matter, neuroendocrine organs, and white tissues (epithelia, soft tissues). Neoplastic tissues usually retain the color of their nonneoplastic counterpart. Conclusions.-Most available information on the function of pigments comes from studies in plants, microorganisms, cephalopods, and vertebrates, not humans. Biologic pigments have antioxidant and cytoprotective properties and should be considered as potential future therapies for disease and cancer. We discuss the bioproducts that may be responsible for organ coloration and invite pathologists and pathology residents to look at a ''routine grossing day'' with a different perspective.

Sanchez-Cardenas A.G.,Centro Medico ABC
Revista medica del Instituto Mexicano del Seguro Social | Year: 2016

La magnitud que tiene el sueño en el bienestar integral de una persona es similar a los efectos de la dieta y el ejercicio. La privación del sueño tiene efectos deletéreos graves en la salud del individuo y por lo general estos son ignorados. Entre un 30 y un 40 % de la población ha presentado insomnio en algún momento de su vida y del 9 al 15 % ha desarrollado insomnio crónico grave. Diversos estudios vinculan la falta de sueño con obesidad, enfermedades metabólicas, problemas cardiacos, desórdenes psiquiátricos y demencia. Existen actualmente grupos que se enfocan en las alteraciones en la respuesta inmune que genera la falta de sueño. Para realizar un diagnóstico oportuno de insomnio, es indispensable que durante la consulta se obtenga una historia clínica detallada de los hábitos del sueño. En la exploración física se debe enfatizar la búsqueda de signos y síntomas que sugieran una causa orgánica específica que contribuya a la alteración del sueño. Uno de los pilares del tratamiento es establecer en todos los pacientes una buena higiene del sueño con base en la optimización del ambiente y de las conductas asociadas con el mismo.The magnitude which sleep has on personal well-being is similar to the effects of diet and exercise. Sleep deprivation has severe negative effects on an individual's overall health, and this is usually overseen. From 30 to 40 % of the population has presented insomnia at a certain moment of life and from 9 to 15 % have evolved into a chronic and severe insomnia. Recent investigations have related sleep deprivation with obesity, metabolic disorders, heart disease, mental health problems and dementia. Recently, more investigations have focused on the multiple alterations suffered by the immune system in cases of sleep deprivation. In order to make an opportune diagnosis of insomnia, it is vital to obtain a detailed history of the patients' sleep habits. In the physical exam one must search for signs and symptoms which might suggest an organic cause that generates the patient's insomnia. One of the pillars in treatment of these patients consists in acquiring an adequate sleep hygiene based on the optimization of the environment and the behavior that are associated with sleep.

Benardete-Harari D.N.,Centro Medico ABC
Revista medica del Instituto Mexicano del Seguro Social | Year: 2016

La presencia de tumores malignos durante la gestación complica tanto el manejo como el propio embarazo, ya que cualquier intervención diagnóstica o terapéutica puede conllevar riesgos que puedan generar efectos nocivos para la madre o para el feto. Los riesgos que tiene un feto sometido a la administración de la terapia citotóxica se correlacionan directamente con la edad gestacional y con el tiempo de la exposición intrauterina a la misma. El tratamiento antineoplásico busca dos objetivos principales; el primero es el control local por medio de cirugía complementada con radioterapia; el segundo busca erradicar la enfermedad sistémica a través de quimioterapia, inmunoterapia, hormonoterapia o terapias blanco.The presence of malignant tumors during pregnancy complicates the management of both tumor and pregnancy, since any diagnostic or therapeutic intervention could imply risks that may bring on detrimental effects to fetus or mother. The risks involved in exposing a fetus to cytotoxic therapy are associated to gestational age and the time of in utero exposure to that therapy. Cancer treatment has two different objectives: local control by surgery and radiotherapy, and one that seeks to eradicate systemic disease through chemotherapy, immunotherapy, hormone therapy, or targeted therapies.

Dal-Lago A.H.,Institute Neurociencias San Lucas | Ceballos-Lizarraga R.,Centro Medico ABC | Carmona S.,National University of Rosario
Acta Otorrinolaringologica Espanola | Year: 2014

Introduction and objective: This work presents deeper studies of comorbidity between anxiety and vestibular pathology. The aim of this work was to comprehend the reasons why patients do not feel «fully recovered» even though the treating professionals discharge them. We studied the features of personality that can favour the continuity of the condition. Methods: The questionnaire for measuring the emotional impact of vertigo makes it possible to determine if the patient has a psychological style with a tendency to develop pathological anxiety levels. Anxiety is a subjective characteristic determinant in difficulties with medical treatment. The questionnaire was applied to 198 patients in Argentina and Mexico in parallel. Each pathology was treated by standard medical procedures. The study focused on determining the correlation between «feeling fully recovered or not at the end of treatment» and the questionnaire scores obtained before the approach. Results: In more than 80% of cases, high scores (>15 points) on the questionnaire were correlated with the difficulty presented by the patients for full recovery from the pathology after medical treatment. Conclusions: The objective assessments (duration and intensity of symptoms, time of onset of the disease, etc.) do not exactly predict possible difficulties during treatment of vertigo. Consequently, we consider the patient's subjective assessment of how the vestibular pathology affects him or her to be determinant. That key information allows us to predict the course of the illness and the probability of a full recovery. © 2013 Elsevier España, S.L.

Segovia-Gamboa N.,CINVESTAV | Rodriguez-Arellano M.E.,Hospital Regional Lic Adolfo Lopez Mateos | Rangel-Cruz R.,Hospital Regional Lic Adolfo Lopez Mateos | Sanchez-Diaz M.,Hospital Regional Lic Adolfo Lopez Mateos | And 4 more authors.
Clinical Immunology | Year: 2014

Tolerogenic dendritic cells (tDC) constitute a promising therapy for autoimmune diseases, since they can anergize T lymphocytes recognizing self-antigens. Patients with type 1 diabetes mellitus (T1D) have autoreactive T cells against pancreatic islet antigens (insulin, glutamic acid decarboxylase 65 -GAD65-). We aimed to determine the ability of tDC derived from T1D patients to inactivate their insulin- and GAD65-reactive T cells. CD14 + monocytes and CD4 + CD45RA- effector/memory lymphocytes were isolated from 25 patients. Monocyte-derived DC were generated in the absence (control, cDC) or presence of IL-10 and TGF-β1 (tDC), and loaded with insulin or GAD65. DC were cultured with T lymphocytes (primary culture), and cell proliferation and cytokine secretion were determined. These lymphocytes were rechallenged with insulin-, GAD65- or candidin-pulsed cDC (secondary culture) to assess whether tDC rendered T cells hyporesponsive to further stimulation. In the primary cultures, tDC induced significant lower lymphocyte proliferation and IL-2 and IFN-γ secretion than cDC; in contrast, tDC induced higher IL-10 production. Lymphocytes from 60% of patients proliferated specifically against insulin or GAD65 (group 1), whereas 40% did not (group 2). Most patients from group 1 had controlled glycemia. The secondary cultures showed tolerance induction to insulin or GAD65 in 14 and 10 patients, respectively. A high percentage of these patients (70-80%) belonged to group 1. Importantly, tDC induced antigen-specific T-cell hyporesponsiveness, since the responses against unrelated antigens were unaffected. These results suggest that tDC therapy against multiple antigens might be useful in a subset of T1D patients. © 2014 Elsevier Inc.

Although Tissue Banks and their activities are not new in Mexico, the specific regulations for the activities of tissue banks and musculoskeletal tissues considered as health supplies are still under development. This review paper intends to provide information on the national situation of musculoskeletal tissue banks, major aspects concerning their regulation and organization, and the recognition of the national instances pertaining to the Coordination for Organ and Tissue Donation for Transplant Purposes for the obtention of (musculoskeletal) tissues from deceased donors.

Cherem J.H.,Centro Medico ABC | Ulloa I.H.,Centro Medico ABC
Gaceta Medica de Mexico | Year: 2014

Recurrent clostridium difficile infection (CDI) is a challenge for infectious disease specialists. A third of first recurrences will fail antibiotic therapy1. Several mechanisms have been proposed to explain this, such as persistence of spores, inadequate antibody response, and altered gut microbiota2-4. Standard recommendations for CDI treatment include metronidazole and vancomycin5. Fecal transplant has proven to be an effective therapy for recurrent CDI. Infusion of stools can be administered to the upper or lower gastrointestinal tract during an endoscopic procedure or using nasogastric/duodenal or rectal tubes6-9. Elderly persons have an increased incidence of recurrent infection and have a higher mortality rate10. We propose a home-based delivery method using a 5 ml syringe for intrarectal infusion of stools.

Cardenas-Salomon C.M.,Centro Medico ABC
Cirugia y cirujanos | Year: 2011

There is an ongoing debate over certain aspects of laparoscopic appendectomy (LA) over open appendectomy (OA) in regard to hospitalization costs and associated complications. A database was used to obtain the charts for either LA or OA performed during a 5-year period. Variables analyzed were age, gender, hospitalization cost, length of stay and complications. Of 1792 appendectomies performed, 633 (35.3%) were OA and 1159 (64.6%) were LA. Both groups were statistically similar with regard to gender (p = 0.075) but differed with respect to age, demonstrating an older patient population in the LA group (p <0.0001). Length of stay was significantly higher in the OA group (3.33 vs. 2.52) days, p <0.0001). The overall hospitalization cost of LA was 25% higher than the OA cost (p = 0.0005). The cost of an uncomplicated LA case was 1.7 times higher than in the OA group (p ≤ 0.0001). We found no statistically significant differences between the hospitalization cost of an OA and LA group when both procedures were associated with a complication (p = 0.5319). A higher complication rate was observed in the OA group, 60 cases (9.47%) as compared to the LA group, 46 cases (3.96%), p <0.0001. The increased rate of complications observed was related to cardiovascular, wound and infectious problems. Noncomplicated LA was associated with a higher hospitalization cost. There was no difference with regard to complicated cases. The incidence of complications increased in the OA group.

Cervantes Castro J.,Centro medico ABC
Gaceta médica de México | Year: 2011

The interesting case of Albert Einstein's abdominal aortic aneurysm is presented. He was operated on at age 69 and, finding that the large aneurysm could not be removed, the surgeon elected to wrap it with cellophane to prevent its growth. However, seven years later the aneurysm ruptured and caused the death of the famous scientist.

Over the last decade, the prevalence of type 2 diabetes and obesity (T2DM) has dramatically increased, and it is in the group of young adult individuals that both medical problems are increasing most rapidly. The definition of early onset T2DM is arbitrary and includes individuals with clinical and metabolic characteristics of T2DM diagnosed before the age of 40. Most of these cases do not differ from those who start with diabetes after this age other than in the earlier age of presentation and, probably, in an increased prevalence of a familial history of the disease (increased genetic predisposition). There is a very strong correlation between diabetes duration and the appearance of late complications of diabetes. In early onset T2DM they become present in individuals that are still in their productive years with the strongest familial, economic and psychosocial impact. Currently, early onset T2DM represents one fifth of all the cases of diabetes in Mexico. A longer duration of the disease and poorer glycemic control in this particular age group contribute to the high prevalence of diabetes-related complications and increased mortality rates. Copyright © Sociedad Iberoamericana de Información Científica (SIIC), 2012.

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