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Turcios R.A.S.,Centro Medico Nacional Siglo XXI
Revista Mexicana de Cardiologia | Year: 2015

Student's t test is based on two premises; first: normality of distribution and second: the independence of the samples. This allows comparing samples N = 30 and/or establishes the differences between the means of the two samples. The mathematical and statistical analysis of the test is frequently minimalized N > 30, using non parametric tests, when the test has enough statistical power. Source


Montoya-Martinez G.,Centro Medico Nacional Siglo XXI
Cirugia y cirujanos | Year: 2011

Retrocaval ureter is a rare congenital anomaly with an incidence of approx. 1/1000 live births. Recently, the laparoscopic approach has become the gold standard for treatment, relegating open surgery as a second option. We present the case of a 27-year-old male with a 2-year history of colicky pain in the right flank radiating to the ipsilateral thigh and genital region. The patient was initially treated with a right double-pigtail catheter stent due to obstructive uropathy as evidenced by ultrasound. He underwent laparoscopic ureteral anteposition with a successful outcome and has remained asymptomatic during a 12-month follow-up. Retrocaval ureter is a rare entity that requires a high grade of suspicion for initial diagnosis to provide adequate and opportune treatment that will have repercussions on kidney function and quality of life for the patient. Open surgery has traditionally been the treatment of choice; however, in recent decades laparoscopic surgery has been practiced more during this era of minimally invasive therapy, without yet displacing open surgery in our country. Source


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. Source


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. Source


Background: Hyperfibrinogenemia is a predictor of cardiovascular events in healthy subjects and in patients with chronic ischemic heart disease. Bezafibrate decreases fibrinogen levels and also the incidence of major cardiovascular events in primary prevention, but its effects in acute coronary syndrome are unknown. methods: This is a randomized, controlled clinical trial with conventional therapy. We included patients with acute ST-elevation myocardial infarction (STEAMI) and fibrinogen concentration >500 mg/dl at 72 h of evolution. We randomized subjects into two groups: bezafibrate 400 mg (group I) and conventional therapy (group II). Primary end point was decrease of fibrinogen concentrations. Secondary end points were recurrence of angina or infarction, left ventricular failure and combined end points during hospitalization. results: We included 25 patients in each group. Fibrinogen concentrations were lower at hospital discharge in Group I than in Group II (532.42 ± 129.6 vs. 889 ± 127.32 mg/dl in group II, p <0.0001). Secondary end points were more frequent in Group II than in Group I: angina (56% vs. 4%, RR 0.071 [0.010-0.503], p <0.0001), left ventricular failure (24% vs. 4%, RR 0.167 [0.022-1.286], p = 0.049) and combined end points (76% vs. 8%, RR 0.105 [0.027-0.405], p <0.001). Conclusions: Bezafibrate treatment was a safe treatment and reduced fibrinogen levels in patients with STEAMI and hyperfibrinogenemia. In the short term, this reduction was associated with a lower incidence of major cardiovascular events. Source

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