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Hernandez-Bringas O.,Centro Medico ABC | Ortiz-Hidalgo C.,Centro Medico ABC | Ortiz-Hidalgo C.,Panamerican University of Mexico
Archivos de Cardiologia de Mexico | Year: 2013

Mixomas are the most common primary cardiac tumors with an estimate incidence of 0,5-1 per 106 individuals per year. These tumors have generated interest due to their unique location (left side of the atrial septum near the fossa ovalis), variable clinical presentation and undefined histogenesis. Most cardiac myxomas occur sporadically while approximately 10% of diagnosed cases develop as part of Carney complex. This neoplasm is of uncertain histogenesis, however, endothelial, neurogenic, fibroblastic, and cardiac and smooth muscle cells differentiation has been proposed, and rarely glandular differentiation has been observed. Recently, due to the expression of certain cardiomyocyte-specific factors, an origin of mesenchymal cardiomyocytes progenitor cells has been suggested. Histologically cardiac myxomas are mainly composed of stellated, fusiform and polygonal cells, immersed in an amorphous myxoid matrix. Immunohistochemically some endothelial markers, such as CD31, CD34, FVIIIAg, are present. Positive staining has also been reported for S-100 protein, calretinin, vimentin, desmin, smooth muscle myosin, CD56, α1 antitrypsin and α1 antichymotrypsin. Surgical resection is currently the only treatment of choice. We present in this article a histopathological and immunohistochemical review of cardiac myxomas. © 2012 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

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.

Mendoza-Popoca C.,Centro Medico ABC | Suarez-Morales M.,Centro Medico ABC
Revista Mexicana de Anestesiologia | Year: 2016

Delayed recovery from anesthesia is an enigmatic problem and a cause of concern not only for the anesthesiologist but also for the rest of the surgical team. This issue is frequently multifactorial and it's probable cause can fall in one of the next groups: those regarding the patient, drugs and their disposal, metabolic aspects and surgical related. Even though the great advance in technology and investigation has allowed a better understanding of the central nervous system areas where the awake-sleep physiological cycle resides as well as the near similarity with the anesthetic state, there is a great amount of knowledge not yet available. Keeping in mind the probable causes aforementioned and the probable correlation between them can lead to find out thecause of a delayed recovery from anesthesia and its proper and fast treatment. © 2016, Colegio Mexicano de Anestesiologia A.C. All rights reserved.

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.

Castro J.C.,Centro medico ABC
Gaceta Medica de Mexico | 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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