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Cortes G.M.,Universidad Michoacana de San Nicolás de Hidalgo | Sandoval M.E.V.,Universidad Michoacana de San Nicolás de Hidalgo | Martinez C.A.A.,General Hospital Dr Miguel Silva | Gomez H.E.V.,Regional General Hospital No 1 | And 2 more authors.
Journal of Atrial Fibrillation | Year: 2014

Atrial Fibrillation (AF) is the most common cardiac arrhythmia of clinical significance; it increases the risk of mortality due to stroke. The mechanisms behind cerebral thromboembolism in AF are associated with a prothrombotic state, demonstrated by higher levels of von Willebrand Factor (vWF), a multimeric glycoprotein that plays a crucial role in platelet adhesion and aggregation and it has been proposed as a biomarker of endothelial dysfunction. Plasma vWF levels are elevated in patients with nonvalvular Atrial Fibrillation (NVAF) associated to the presence of cardiovascular risk factors. The variability in vWF plasma levels in healthy subjects has a wide distribution, but there is no description available of the variability in AF patients and among types of AF. The aim of this study was to determine the variability of vWF plasma concentrations in patients with NVAF, associated to cardiovascular risk factors. Search strategy included PubMed and Ovid. Keywords used were "Atrial Fibrillation" and "von Willebrand Factor". It includes original articles, with analysis of plasma vWF levels by ELISA, without acute stroke. Review articles and meta-analysis were excluded. Reviewed studies include 22 trials and 6542 patients with nonvalvular AF associated to cardiovascular disease risk factors: age, sex, hypertension, heart failure, diabetes mellitus, prior stroke, coronary artery disease. Variability in vWF plasma levels was wide, with minimum values of 77 IU/dl and maximum values of 245 IU/dl and a mean of 146 IU/dl. Age of patients ranged between 54 and 78 years, and the percentage of males ranged between 23% and 80%. According to type of AF vWF levels were as follows, in paroxysmal AF: 92-264 IU/dl; persistent AF: 76-234 IU/dl; permanent AF: 91-247 IU/dl. The variability in vWF plasma levels is affected by risk factors and the AF type, however vWF levels in AF patients are higher when compared with healthy subjects.


Hernandez-Da Mota S.E.,General Hospital Dr Miguel Silva | Arellanes-Garcia L.,Asociacion Para Evitar la Ceguera en Mexico | Recillas-Gispert C.,Instituto Nacional Of Ciencias Medicas Y Nutricion Salvador Zubiran | Cornejo-Ballesteros H.,General Hospital Dr Miguel Silva | And 3 more authors.
Ocular Immunology and Inflammation | Year: 2011

Purpose: To describe a systemic lupus erythematosus (SLE) relapse, which presented as frosted branch retinal angiitis. Design: Clinical case report. Methods: A 16-year-old female patient had an SLE relapse that appeared as frosted branch angiitis while being treated with deflazacort and azathioprine. Results: Complete resolution of the vasculitis was achieved with a 3-day course of pulsed intravenous methylprednisolone and oral prednisone 3 weeks later. Conclusions: Even with proper immunosuppressive treatment, SLE can relapse. This case presented as frosted branch retinal angiitis, which is a clinical picture that is rarely described in SLE. © 2011 Informa Healthcare USA, Inc.


Alvarez-Nemegyei J.,Medical Research Unit | Pelaez-Ballestas I.,Hospital General Of Mexico | Sanin L.H.,Autonomous University of Chihuahua | Cardiel M.H.,General Hospital Dr Miguel Silva | And 2 more authors.
Journal of Rheumatology | Year: 2011

To assess the prevalence of musculoskeletal (MSK) pain and rheumatic diseases in the southeastern Mexican state of Yucatán. Methods: Using the Community Oriented Program in the Rheumatic Diseases (COPCORD) methodology, we performed a door-to-door, cross-sectional study generated through a multistage, stratified, randomized method on 3915 adult residents (age 42.7 ± 17.1 yrs; women 61.8%; urban setting 45.7%) of the Mexican state of Yucatán. We used universally accepted criteria for the diagnosis or classification of rheumatoid arthritis (RA), osteoarthritis (OA; knee and hand), fibromyalgia, systemic lupus erythematosus (SLE), gout, ankylosing spondylitis, regional rheumatic pain syndromes, and inflammatory back pain. Results: Nontraumatic MSK pain in the last 7 days was present in 766 (19.6%; 95% CI 18.3-20.8) individuals. MSK pain was more prevalent in women (26.6%) versus men (12.2%; p < 0.01). Self-reported MSK disability occurred in 1.7%. Most MSK pain-related variables were consistently more prevalent in the urban setting. The prevalence of rheumatic disease was: OA 6.8% (95% CI 6.0-7.6); back pain 3.8% (95% CI 3.2-4.4); RA 2.8% (95% CI 2.2-3.3); rheumatic regional pain syndromes 2.3% (95% CI 1.9-2.8); inflammatory back pain 0.7% (95% CI 0.5-1.0); fibromyalgia 0.2% (95% CI 0.1-0.4); gout 0.1% (95% CI 0.07-0.3); and SLE 0.07% (95% CI 0.01-0.2). Conclusion: The prevalence of MSK pain was 19.6%. MSK pain was more prevalent in women and in the urban setting. A remarkably high prevalence of RA was found in this population, which suggests a role for geographic factors.


Hernandez-Da Mota S.E.,General Hospital Dr Miguel Silva | Nunez-Solorio S.M.,Hospital Infantil Eva Samano Of Lopez Mateos
European Journal of Ophthalmology | Year: 2010

PURPOSE. To evaluate the safety and efficacy of intravitreal injection of bevacizumab before vitrectomy in advanced proliferative diabetic retinopathy. METHODS. A randomized clinical trial was performed on 40 eyes of 40 patients. Inclusion criteria were advanced proliferative diabetic retinopathy with tractional retinal detachment and HbA1c <7%. Patients were randomly assigned into 2 groups. Patients in one group had an intravitreal injection (1.25 mg) of bevacizumab 48 hours before 23-G pars plana vitrectomy surgery was performed, whereas the other group did not. Best-corrected visual acuity, intraocular pressure, and fundus photographs were taken prior to surgery 1 week and 3 and 6 months postoperatively. RESULTS. Effective vitrectomy time was 8.05 minutes in the bevacizumab group vs 16.8 minutes in the non-bevacizumab group. Statistically significant differences were observed in visual acuity at 1 week and 3 and 6 months follow-up between the 2 groups (p<0.05 for each visit). Also, there was less bleeding intraoperatively in the bevacizumab group. Mean final visual acuity in the bevacizumab group was 0.82 logMAR and 2.01 logMAR in the non-bevacizumab group. CONCLUSIONS. Adjuvant intravitreal injection of bevacizumab prior to vitrectomy in diabetic retinopathy with tractional retinal detachment significantly eases the procedure, diminishing intraoperative complications, and leads to a better visual outcome. © 2010 Wichtig Editore.


PubMed | General Hospital Dr Miguel Silva
Type: Journal Article | Journal: Case reports in ophthalmology | Year: 2011

To describe a case of bilateral pigmented paravenous chorioretinal atrophy.Observational case report.A 50-year-old female patient complained of right eye pain and decreased near visual acuity. She had a best-corrected visual acuity of 20/20 in both eyes. In the posterior segment, there were atrophic changes along retinal vessels, and bony spicule pigmentation was observed in a paravenous distribution. There were some abnormal changes in the electroretinogram and electrooculogram in both eyes.A diagnosis of bilateral pigmented paravenous chorioretinal atrophy was made.

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