Veinte de Noviembre (Santa Lucía), Mexico
Veinte de Noviembre (Santa Lucía), Mexico

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Del Olmo J.C.B.,Academia Mexicana de Pediatria | Mora E.U.,Hospital Angeles Mexico | Silva R.V.,CMN Siglo XXI | Marmolejo L.C.,Hospital General Of Mexico | And 13 more authors.
Revista Mexicana de Pediatria | Year: 2011

The survival of a growing number of premature infants suffering from respiratory distress syndrome has caused increased morbidity and mortality despite advances in diagnostic and therapeutic procedures applied to various criteria, according to the level of knowledge and care in the neonatal intensive care units. Therefore, to improve and standardize the criteria for treatment of newborns with RDS, met a group of experts to develop a clinical practice guideline adapted to our environment, according to the criteria of evidence-based medicine for national dissemination, implementation and impact in a better prognosis for life and the function of the preterm newborns.


Gallardo-Rincon D.,Instituto Nacional Of Cancerologia | Cantu-de-Leon D.,Instituto Nacional Of Cancerologia | Alanis-Lopez P.,Hospital Of Gineco Obstetricia No 3 | Alvarez-Avitia M.A.,Instituto Nacional Of Cancerologia | And 79 more authors.
Revista de Investigacion Clinica | Year: 2011

Introduction. Ovarian cancer (OC) is the third most common gynecologic malignancy worldwide. Most of cases it is of epithelial origin. At the present time there is not a standardized screening method, which makes difficult the early diagnosis. The 5-year survival is 90% for early stages, however most cases present at advanced stages, which have a 5-year survival of only 5-20%. GICOM collaborative group, under the auspice of different institutions, have made the following consensus in order to make recommendations for the diagnosis and management regarding to this neoplasia. Material and methods. The following recommendations were made by independent professionals in the field of Gynecologic Oncology, questions and statements were based on a comprehensive and systematic review of literature. It took place in the context of a meeting of two days in which a debate was held. These statements are the conclusions reached by agreement of the participant members. Results. No screening method is recommended at the time for the detection of early lesions of ovarian cancer in general population. Staging is surgical, according to FIGO. In regards to the pre-surgery evaluation of the patient, it is recommended to perform chest radiography and CT scan of abdomen and pelvis with IV contrast. According to the histopathology of the tumor, in order to consider it as borderline, the minimum percentage of proliferative component must be 10% of tumor's surface. The recommended standardized treatment includes primary surgery for diagnosis, staging and cytoreduction, followed by adjuvant chemotherapy. Surgery must be performed by an Oncologist Gynecologist or an Oncologist Surgeon because inadequate surgery performed by another specialist has been reported in 75% of cases. In regards to surgery, it is recommended to perform total omentectomy since subclinic metastasis have been documented in 10-30% of all cases, and systematic limphadenectomy, necessary to be able to obtain an adequate surgical staging. Fertility-sparing surgery will be performed in certain cases, the procedure should include a detailed inspection of the contralateral ovary and also negative for malignancy omentum and ovary biopsy. Until now, laparoscopy for diagnostic-staging surgery is not well known as a recommended method. The recommended chemotherapy is based on platin and taxanes for 6 cycles, except in Stage IA, IB and grade 1, which have a good prognosis. In advanced stages, primary cytoreduction is recommended as initial treatment. Minimal invasion surgery is not a recommended procedure for the treatment of advanced ovarian cancer. Radiotherapy can be used to palliate symptoms. Follow up of the patients every 2-4 months for 2 years, every 3-6 months for 3 years and anually after the 5th year is recommended. Evaluation of quality of life of the patient must be done periodically. Conclusions. In the present, there is not a standardized screening method. Diagnosis in early stages means a better survival. Standardized treatment includes primary surgery with the objective to perform an optimal cytoreduction followed by chemotherapy. Treatment must be individualized according to each patient. Radiotherapy can be indicated to palliate symptoms.


Sanchez-Avila J.F.,INCMNSZ | Dehesa-Violante M.,Mexican Association of Hepatology | Mendez-Sanchez N.,Liver Research Unit | Bosques-Padilla F.,Hospital Universitario Je Gonzalez | And 16 more authors.
Annals of Hepatology | Year: 2015

Chronic hepatitis due to hepatitis C (HCV) viral infection is one of the main causes of chronic liver disease in the world. In the near future, the number of cases developing complications is expected to rise and include the following: liver cirrhosis, liver failure (ascites, encephalopathy, spontaneous bacterial peritonitis, variceal hemorrhage), hepatocellular carcinoma, death or the need for liver transplantation. However, research in the field of hepatitis C diagnosis and treatment is one of the most active specially on the development of new therapeutic strategies potentially offering better viral eradication rates and fewer adverse events. Although this disease is a frequent cause of consultation and hospitalization, data published in our country are insufficient. The last guidelines proposed by a medical association in Mexico were published in 2007 and those suggested by the General Council of Health were published in 2009. The aim of this study group was to analyze the available evidence on the diagnosis and treatment of hepatitis C in the Mexican population, in the context of published international clinical and therapeutic guidelines, in order to issue recommendations that are applicable in our midst. The Mexican Association of Hepatology convened a work group in Mexico City, on April 25th and 26th, 2014. Twenty specialists with particular interest and experience. © 2014 Annals of Hepatology. All rights reserved


Introduction: Breast Cancer, locally advanced-stage, requires a multidisciplinary treatment aimed at increasing overall survival in patients. Objective: To evaluate the complete pathological responses of patients under this treatment strategy. Methods: Patients with locally advanced breast cancer eligible to receive 4 cycles of chemotherapy to preoperative epirubicin and docetaxel 75 mg/m2 to 75 mg/m2 Day 1 every 3 week. Results: A total of 128 patients enrolled from June 2004 through January 2007 received 4 cycles of preoperative chemotherapy. The completed pathologic response rate was 32.5%; the persistent illness was 55.8% of the patients. The final clinical response was: 39.1% complete response, 40% partial response, 14.1% stable disease and 6.67% progressions. Survival time without progression presents a mean of 211.4 days and mean of 380 days in function with death survival. Of the 128 enrolled patients 3.9% died. Incidence of adverse events was 80.4% and of this 6.2% was serious adverse events and 3.13% of the same discontinued the study medication. By security, percentages of patients presenting the most frequently adverse events were: 72.6 alopecia, 60.9 nausea, 44.5 vomiting, 31.2 diarrhea and 24.2 asthenia. Conclusion: The combination of Epirubicin and Docetaxel is active and reaches complete pathological responses with a substantial and acceptable toxicity profile.


Serna-Camacho M.E.,Hospital Regional Lic Adolfo Lopez Mateos Issste | Cortes-Cardenas S.A.,CMN 20 de Noviembre
Gaceta Mexicana de Oncologia | Year: 2012

Malignant pleural mesothelioma is a neoplasm with high mortality of 99% at 5 years and with little prospect of treatment, facing different problems such as the rarity of the disease, the difficulty of staging, aggressive nature, little sensitivity to this combined chemotherapy aggressive surgical procedures that few patients can tolerate because of their age and suffer various diseases coomorbidas. The surgical procedures used are extrapleral pleurotomy and more pleurotomy pleurodesis decortication and yet all these procedures are palliative only limited control and high rates of recurrence as a single treatment. Has been offered other treatments such as conventional chemotherapy having little benefit with platinum-based schemes more pemetrexed giving a benefit of 3 months compared with platinum alone have survivals of four to 12 months. Attempts have been combining chemotherapy with other therapies such as anti angiogenic inhibitors tirosinkinasa, the use of immunosuppressants which have shown no benefit or is able to overcome the combination of pemetrexed with platinum.


Rojano-Mejia D.,C.M.N. 20 de Noviembre | Rojano-Mejia D.,Instituto Mexicano Del Seguro Social | Coral-Vazquez R.M.,National Polytechnic Institute of Mexico | Coral-Vazquez R.M.,Institute Seguridad Y Servicios Sociales Of Los Trabajadores Del Estado | And 7 more authors.
Maturitas | Year: 2012

Objective: Osteoporosis is a complex health disease characterized by low bone mineral density (BMD), which is determined by an interaction of genetics with metabolic and environmental factors. The tumor necrosis factor receptor superfamily, member 11b (TNFRSF11B) gene, has been investigated in relation to BMD. Three polymorphisms in/nearby TNFRSF11B have been associated with BMD variations in some populations. The aim of this study was to investigate the possible association among three SNPs of TNFRSF11B and their haplotypes with the presence of BMD variations in postmenopausal Mexican Mestizo women. Subjects and methods: One thousand unrelated postmenopausal women of Mexican-Mestizo ethnic origin, who attended the outpatient clinic for routine, general medical evaluation, were invited and 750 women accepted to participate in the study. A structured questionnaire for risk factors was applied and BMD was measured in total hip and lumbar spine by dual-energy X-ray absorptiometry. DNA was obtained from blood leukocytes. Three single-nucleotide polymorphisms in TNFRSF11B gene were studied: rs4355801, rs2073618, and rs6993813. Real-time PCR allelic discrimination was used for genotyping. Deviations from Hardy-Weinberg equilibrium were tested. Pairwise linkage disequilibrium between single nucleotide polymorphisms was calculated by direct correlation r 2, and haplotype analysis was conducted. Results: Of the subjects, 31% had osteoporosis, 45.1% had osteopenia, and 23.9% had normal BMD. Genotype and allele distributions showed no significant differences; however, A-G-T haplotype was associated with variations in femoral neck BMD (P = 0.022). Conclusions: In our study population, analysis of the haplotypes of TNFRSF11B is a better genetic marker for variations in BMD. © 2011 Elsevier Ireland Ltd. All rights reserved.

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