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Mexico City, Mexico

Background: Postoperative epidural analgesia is the administration of local anesthetic with or without opioid in the epidural space to keep the individual free from pain. Method: clinical, comparative, controlled, prospective, randomized study, patients after hysterectomy and open cholecystectomy Tula Regional Hospital, the period from March to June 2013. 40 patients were selected without importing age, randomly distributed into five groups were selected depending on the concentration of bupivacaine administered by epidural catheter 0.120%, 0.130%, 0.150%, 0.170% and 0.20% more 50 μg fentanyl recovering, at 6, 12 and 24 hours, 20 minutes after administration of each dose was evaluated pain by visual analog scale, and vital signs were taken. Results: The concentrations of bupivacaine 0.120%, 0.130% and 0.150% more fentanyl 50 μg maintained patients had moderate pain, while 0.170% bupivacaine and 0.20% more fentanyl 50 μg remained without pain in patients throughout the study. Conclusions: Epidural analgesia bolus is effective in patients undergoing open abdominal surgery in hospitals with limited resources, accelerates recovery, reduces costs for the patient and the institution. © 2015, Colegio Mexicano de Anestesiologia A.C. All rights reserved. Source

In this paper is done an historical review of the clinical studies done in infants with acute diarrhea, treated only by of voluntary oral rehydration: since the first outcome in 1959 in 508 dehydrated infants with diarrhea, to others published in recent years with similar findings. All of this contribution, among others, supported the decision of the WHO for the development of a oral serum and the use of oral rehydration solution in all the world. Source

Medina-Villasenor E.A.,Cirugia Oncologica | Oliver-Parra P.A.,Clinica de Colposcopia | Neyra-Ortiz E.,Hospital Angeles Metropolitano | Perez-Castro J.A.,Medico Pasante | And 2 more authors.
Gaceta Mexicana de Oncologia

Introduction: Cervical intraepithelial neoplasia (CIN) is the most common pre-malignant lesion. Atypical squamous changes occur in the transformation zone of the cervix with mild, moderate or severe changes described by their depth (CIN 1, 2, 3). Human papillomaviruses (HPVs) are a group of more than 100 DNA viruses that infect human epithelial cells. About 15 of these viruses can cause intraepithelial lesions and cervical cancer. Persistent high-risk HPV types can cause cancer of the lower genital tract if not treated. Up to 79% of sexually active women acquire a genital HPV infection during their lifetime, but the infection is usually transient and asymptomatic. Objective: Analyze the sociodemographic characteristics, risk factors and presenting symptoms in patients with pre-invasive cervical disease. Material and methods: A retrospective, observational and descriptive study of electronic files from patients with CIN from March 2002 to March 2012. Results: Five hundred sixty eight patients were included, the most common age of CIN was 24-45 years, the age of first intercourse was 16 years, mostly had multiple sexual partners. Other risk factors found were: high parity, sexually transmitted diseases, tobacco smoking, and use of oral contraceptives. In 85.22% of cases presented with nonspecific symptoms such as itching, genital burning, and vaginal discharge. Only 9.85% of cases presented with classic signs of infection with HPV like genital warts in the lower genital tract. The cervicovaginal cytology had a sensitivity of 64.47%, the diagnosis of ASCUS was detected in 17.26%. The colposcopic study showed acetowhitening lesion, vessels of fine caliber, fine mosaic and iodine negative in 75% of cases that corresponded to low grade lesion. HPV testing (through polymerase chain reaction testing) was performed in 17.26% of cases with ASCUS. The histopathological study was 83.98% CIN1, 6.87% CIN2 and 9.15% CIN3. Conclusions: The cervical pre-invasive lesion has similar risk factors for cervical cancer. The HPV is a necessary, but not the unique factor for the progression to invasive cancer. CIN is initially asymptomatic, spontaneously refers, in latent phase can only be detected by HPV tests. When there are symptoms, they are nonspecific and can be detected by colposcopy and Pap smear, but there are false positives and false negatives. The histopathological study of cervical biopsy is needed to determine the high grade lesions, which are the true precursors of invasive cancer. © 2014 Gaceta Mexicana de Oncologia. Source

Rosario-Cruz M.,Centro Medico Nacional Siglo XXI | Medina-Villasenor E.A.,Hospital Angeles Metropolitano | Artiachi-De Leon G.,Clinica Y Terapia del Dolor | Quezada-Adame I.,Hospital Angeles Metropolitano
Gaceta Mexicana de Oncologia

Objective: To review the advances in the treatment of cancer pain. To present Clinical recommendations for the management of cancer patients. Methods: Bibliographic review. It was searched databases Medline, PubMed, Cochrane, Medigraphic under the keyword "cancer pain". Original articles and clinical practice guidelines in oncology were included in the review. Results: Most cancer patients can attain satisfactory relief of pain through an approach that incorporates primary anti-tumor treatments, systemic analgesic therapy and other non-invasive techniques such as psychological or rehabilitative interventions. Source

Garcia Vidal M.,Hospital Angeles Metropolitano | Encampira Nava B.A.,Hospital Angeles Metropolitano | Luna Pineda L.A.,Hospital Juarez de Mexico | Akaki Blancas J.L.,Hospital Angeles Metropolitano
Medicina Interna de Mexico

Background: In obese patients with metabolic syndrome are decreased serum concentrations of vitamin D, the intra-abdominal fat deposition favors this and hypovitaminosis. Objective: To document the insulin resistance through measurement of fasting insulin and glucose that allow for and value equation HOMA insulin sensitivity for subsequent statistical testing of correlation between vitamin D status and resistance to insulin in obese population of Juarez Hospital of Mexico. Patients and methods: Prospective, cross sectional, descriptive, open, experimental performed in patients who agreed to participate in the study protocol, after receiving detailed information about the purpose of the study patients were recruited from the outpatient internal medicine among March and June 2009 with the inclusion and exclusion criteria. Results: We diagnosed 19 (63.3%) patients with metabolic syndrome according to ATP III criteria, 7 (23.3%) women and 12 (40%) men and 11 (36.7%) only with obesity, 10 (33.3% ) women and 1 (3.3%) men, who were compared with a control group of five healthy subjects with adequate height and weight and BMI less than 25. Conclusions: This work was conducted in order to know the status of vitamin D in the Hispanic population with an initial diagnosis of obesity. Important was the finding that a high percentage of patients who were obese only considered the defining criteria for metabolic syndrome. Source

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