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Gopar-Nieto R.,Centro Medico Nacional Siglo XXI
Revista medica del Instituto Mexicano del Seguro Social | Year: 2015

Sharps injuries are one of the most frequent health-care related accidents. It is estimated globally that 35 million workers are at risk; in Mexico there is no data available for this type of injuries. They are associated with lack of training, instrument and procedure risk, fatigue and stress. The occupational distribution is nurses 45 %, technicians 20 %, doctors 20 % and maintenance workers 5 %. The most commonly associated procedures are injection, venipuncture, suture, and insertion and manipulation of IV catheters. Hepatitis B is the most commonly transmitted agent. Emotional distress is huge as well as the cost of prophylaxis and follow-up. More than half of the injuries are not notified. The most common reasons for not reporting are: the belief that the exposure has low risk of infection, the lack of knowledge of reporting systems and the assumption that it is difficult to notify. Many strategies have been created to reduce the incidence of sharps injuries, such as: identifying the risk of blood exposure, the creation of politics to minimize the risk, the education and training to create a safe workplace, the enhancing of the reporting system, the use of double-gloving and using safety-engineered sharps devices. In many countries these politics have reduced the incidence of sharps injuries as well as the economic burden.Las heridas por objetos punzocortantes son uno de los accidentes intrahospitalarios más frecuentes. A nivel mundial se estima que 35 millones de trabajadores de la salud se encuentran en riesgo; en México no se tienen datos actualizados para estas heridas. Los accidentes están relacionados con falta de entrenamiento, características de los instrumentos y procedimientos, y fatiga y estrés de quien los practica. La distribución por ocupación es: enfermeras 45 %, técnicos 20 %, médicos 20 % y mantenimiento 5 %. Los procedimientos asociados son: inyección, venopunción, sutura, manipulación e inserción de catéter intravenoso. La infección más comúnmente transmitida es la hepatitis B. La afectación emocional por ansiedad es grande al igual que los costos por profilaxis y seguimiento. Más de la mitad de las heridas por punzocortantes no son notificadas. Las razones más comunes para no reportar son: la suposición de que hay bajo riesgo de infección, la falta de conocimientos sobre métodos de reporte y la creencia de que es difícil notificar. Numerosas estrategias han sido creadas para reducir la incidencia, por ejemplo: la identificación del riesgo de exposición a sangre, la creación de procesos y políticas, la educación y el entrenamiento para laborar en un ambiente seguro, asícomo alentar el reporte de accidentes, el uso de doble enguantado y la utilización de dispositivos de seguridad. En varios países, estas políticas han logrado disminuir la incidencia de heridas por punzocortantes a la vez que se ha generado un ahorro para los sistemas de salud.

Ceballos N.A.,Centro Medico Nacional Siglo XXI | Moron S.V.,Research Center Biomedicaen Red Of Epidemiologiay Salud Publica | Berciano J.M.,Research Center Biomedicaen Red Of Epidemiologiay Salud Publica | Lopez C.A.,Research Center Biomedicaen Red Of Epidemiologiay Salud Publica | And 4 more authors.
Emerging Infectious Diseases | Year: 2013

A new tentative lyssavirus, Lleida bat lyssavirus, was found in a bent-winged bat (Miniopterus schreibersii) in Spain. It does not belong to phylogroups I or II, and it seems to be more closely related to the West Causasian bat virus, and especially to the Ikoma lyssavirus.

Gonzalez-Trujano M.E.,Instituto Nacional Of Psiquiatria Ramon Of La Fuente Muniz | Ventura-Martinez R.,National Autonomous University of Mexico | Chavez M.,Centro Medico Nacional Siglo XXI | Diaz-Reval I.,University of Colima | Pellicer F.,Instituto Nacional Of Psiquiatria Ramon Of La Fuente Muniz
Planta Medica | Year: 2012

Agastache mexicana is a plant in high demand that has long been used in Mexican folk medicine to treat anxiety, insomnia, and stomachache, among other afflictions. Ursolic acid and acacetin were isolated and identified as two possible active compounds of A.mexicana aerial parts. An antinociceptive response was demonstrated in a significant and dose-dependent manner with ursolic acid and acacetin (i. p. and p. o.) in comparison to the analgesic diclofenac by using the writhing test in mice. Moreover, acacetin also produced a significant concentration-dependent spasmolytic response with major efficacy compared to ursolic acid and papaverine by using rings from the isolated guinea pig ileum. These results provide evidence of the presence of two active constituents of Agastache mexicana reinforcing its utility as a therapy for visceral pain as used in traditional medicine. © Georg Thieme Verlag KG Stuttgart · New York.

Rivas-Ruiz R.,Centro Medico Nacional Siglo XXI
Revista médica del Instituto Mexicano del Seguro Social | Year: 2012

In the process of responding to questions generated during medical care, the number of articles appearing in the search is so vast that a strategy must be considered. This article describes the process to find and select the information to help us respond the needs of our patients. The judgment of the quality and relevance of the answer depends on each reader. Initially you have to look in places where there is medical arbitration for publications, reasons why we recommend PubMed. Start the search once the acronym PICO breakdown, where P is for patients, I intervention, C comparator and O outcome or result; these words are used as MeSH (Medical Subject Headings) and are linked with Boolean terms (and, or, and not). The acronym PICO shares components with the classical model of the Architecture of the Research described by Dr. Alvan R. Feinstein. A good search should participate in the response to our question in the first 20 articles, if it does not happen, the search must be more specific with the use of filters.

Cruz-Gomez N.S.,Centro Medico Nacional Siglo XXI | Plascencia G.,Instituto Mexicano Del Seguro Social | Villanueva-Padron L.A.,Centro Medico Nacional Siglo XXI | Jauregui-Renaud K.,Centro Medico Nacional Siglo XXI
Obesity Facts | Year: 2011

Objective: To assess the influence of BMI group (lean/overweight/obese) and gender on the postural sway of adults and adolescents during quiet upright stance. Methods: 90 women and 90 men, aged 12 to 67 years old, accepted to participate. The center of pressure during quiet upright stance was recorded using a force platform, during 4 conditions (eyes open/closed on hard/soft surface). Statistical analysis was performed using multivariate analysis of covariance. Results: During recordings on hard surface, closing the eyes produced a larger increase of sway on obese subjects than on lean and overweight subjects, with a larger increase on the length and the area of sway. Although gender differences were found during the four sensory conditions, no interaction was observed between the BMI group and the gender. These results were not related to the age of the subjects. Conclusion: Compared to non-obese subjects, the postural stability of obese subjects may be more vulnerable when vision is not available, with no influence of the gender. Copyright © 2011 S. Karger AG, Basel.

Medrano-Guzman R.,Centro Medico Nacional Siglo XXI
Revista médica del Instituto Mexicano del Seguro Social | Year: 2012

to determine surgical prognostic variables from a retrospective cohort of histopathologically confirmed gastroenteropancreatic neuroendocrine tumors (GEP-NET) in Mexican subjects. consecutive patients treated for GEP-NET from 1999 through 2007 at Oncological Hospital were included. Demographic, clinical variables, disease-free survival were retrieved. forty-eight patients were included, 29 (60.4 %) female with a mean age of 54 years. Overall survival time was 43.7 months and disease-free survival was 33 months. Negative statistically significant overall survival time predictors were 2 and 3 histological types (HR 5.5. CI 2.0-21, p = 0.0001), tumor size > 2 cm (HR 8.8, CI 1 .29-75, p = 0.002), the presence of metastasis (HR 2.4, CI 1.2-9.6, p = 0.0001) and tumor resectability (HR 9.8, CI 2.9-40.2, p = 0.0001). For the disease-free period, only the histological type (2 or 3) was a negative outcome variable. histological type, tumor size, the presence of metastasis, and tumor non resectability were significant survival predictors.

Viniegra-Velazquez L.,Centro Medico Nacional Siglo XXI
Revista de Investigacion Clinica | Year: 2014

In this paper about the role of ideas within knowledge, the importance of identifying theoretical problems beyond empirical ones (scientific facts) are emphasized. Theoretical problems arise when we reflect upon what underlies scientific discourse: A) Paradigms that rule logical thought and way of understanding, b) Inveterate beliefs and convictions, c) Universally accepted theories considered the objective reality. The paradigm proposed by E. Morin of disjunction, reduction, simplification and exclusion (DRSE) is discussed, as well as its effects in the splitting of humanistic culture from science and the predominance of analytical tradition in exclusion of the synthetic one in scientific research. The premises of neopositivism that rule scientific work are criticized and alternatives that recognize the importance of explicative ideas are proposed. By arguing that intellectual possibilities depend on ideas, it is highlighted the approaching quality of every theory and its potential contributions: comprehension, explication, understanding and description. The DRSE paradigm underlines mechanism which is the prevailing approach to understand living beings in both health and illness (the optimized machine and the broken down one), and the mechanist causality (MC) used to identify causes of disease and its natural history. The attributes of MC are described, demonstrating its limitations to understand human life and its vicissitudes. Alternative theories to understand both health and disease such as: cultural history of disease, the environment inieriorization and anticipation theory and the contextual causality, are introduced and discussed briefly. The text concludes with the importance of recognizing theoretical problems along the way of knowledge about life, health and disease.

Gomez-Alvarez F.B.,Centro Medico Nacional Siglo XXI | Jauregui-Renaud K.,Centro Medico Nacional Siglo XXI
Archives of Medical Research | Year: 2011

Background and Aims: We undertook this study to assess the correlation between the results of simple tests of spatial orientation and the occurrence of common psychological symptoms during the first 3 months after an acute, unilateral, peripheral, vestibular lesion. Methods: Ten vestibular patients were selected and accepted to participate in the study. During a 3-month follow-up, we recorded the static visual vertical (VV), the estimation error of reorientation in the yaw plane and the responses to a standardized questionnaire of balance symptoms, the Dizziness Handicap Inventory (DHI), the depersonalization/derealization inventory by Cox and Swinson (DD), the Dissociative Experiences Scale (DES), the 12-item General Health Questionnaire (GHQ-12), the Zung Instrument for Anxiety Disorders and the Hamilton Depression Rating Scale. Results: At week 1, all patients showed a VV >2° and failed to reorient themselves effectively. They reported several balance symptoms and handicap as well as DD symptoms, including attention/concentration difficulties; 80% of the patients had a Hamilton score ≥8. At this time the balance symptom score correlated with the DHI. After 3 months, all scores decreased. Multiple regression analysis of the differences from baseline showed that the DD score difference was related to the difference on the balance score, the reorientation error and the DHI score (p <0.01). No other linear relationships were observed (p >0.5). Conclusions: During the acute phase of a unilateral, peripheral, vestibular lesion, patients may show poor spatial orientation concurrent with DD symptoms including attention/concentration difficulties, and somatic depression symptoms. After vestibular rehabilitation, DD symptoms decrease as the spatial orientation improves, even if somatic symptoms of depression persist. © 2011 IMSS Elsevier Inc.

Talavera J.O.,Centro Medico Nacional Siglo XXI
Revista médica del Instituto Mexicano del Seguro Social | Year: 2011

When we look at the difference between two therapies or the association of a risk factor or prognostic indicator with its outcome, we need to evaluate the accuracy of the result. This assessment is based on a judgment that uses information about the study design and statistical management of the information. This paper specifically mentions the relevance of the statistical test selected. Statistical tests are chosen mainly from two characteristics: the objective of the study and type of variables. The objective can be divided into three test groups: a) those in which you want to show differences between groups or inside a group before and after a maneuver, b) those that seek to show the relationship (correlation) between variables, and c) those that aim to predict an outcome. The types of variables are divided in two: quantitative (continuous and discontinuous) and qualitative (ordinal and dichotomous). For example, if we seek to demonstrate differences in age (quantitative variable) among patients with systemic lupus erythematosus (SLE) with and without neurological disease (two groups), the appropriate test is the "Student t test for independent samples." But if the comparison is about the frequency of females (binomial variable), then the appropriate statistical test is the χ(2).

Rodriguez-Moyado H.,Centro Medico Nacional Siglo XXI
Revista médica del Instituto Mexicano del Seguro Social | Year: 2011

Acute lung injury (ALI) has been recognized as a consequence of blood transfusion (BT) since 1978; the Food and Drug Administration, has classified it as the third BT mortality issue, in 2004, and in first place related with ALI. It can be mainly detected as: Acute respiratory distress syndrome (ARDS), transfusion associated circulatory overload (TACO) and transfusion related acute lung injury (TRALI). The clinical onset is: severe dyspnea, bilateral lung infiltration and low oxygen saturation. In USA, ARDS has an incidence of three to 22.4 cases/100 000 inhabitants, with 58.3 % mortality. TACO and TRALI are less frequent; they have been reported according to the number of transfusions: one in 1275 to 6000 for TRALI and one in 356 transfusions for TACO. Mortality is reported from two to 20 % in TRALI and 20 % in TACO. Antileukocyte antibodies in blood donors plasma, caused TRALI in 89 % of cases; also it has been found antigen specificity against leukocyte blood receptor in 59 %. The UCI patients who received a BT have ALI as a complication in 40 % of cases. The capillary pulmonary endothelia is the target of leukocyte antibodies and also plasma biologic modifiers of the stored plasma, most probable like a Sanarelli-Shwar-tzman phenomenon.

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