Hospital Militar

Veracruz, Mexico

Hospital Militar

Veracruz, Mexico
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Botero-Lopez J.E.,University of Chile | Araya M.,University of Chile | Parada A.,University of Chile | Mendez M.A.,University of Chile | And 4 more authors.
Journal of Pediatric Gastroenterology and Nutrition | Year: 2011

OBJECTIVE:: The extent of the digestive/absorptive involvement in atypical presentation of celiac disease (CD) is not always clear. The aim of the study was to assess nutritional status of iron (Fe), copper (Cu), and zinc (Zn) in patients with typical CD (TCD) and atypical CD (ACD). PATIENTS AND METHODS:: A cross-sectional study was done in patients with TCD, ACD, and healthy controls (HC). Hemoglobin, serum ferritin, free erythrocyte protoporphyrin, Fe, Cu, ceruloplasmin, Zn, anti-endomysial antibodies, and anti-tissue transglutaminase antibodies were measured. Data were analyzed by Kruskal-Wallis, principal component analysis, and linear discriminant analysis. RESULTS:: One hundred nine individuals were studied (54 TCD, 19 ACD, 36 HC); mean age±standard deviation was 23±15.8 (range 1.6-75.4) years. Median and range of hemoglobin were 12.8g/dL (8.1-17.6) in TCD, 12.4g/dL (10.5-14.5) in ACD, and 13.6g/dL (11.1-16.7) in HC (P<0.0001); serum ferritin was 17.7μg/L (2.9-157), 10.8μg/L (2.7-39.8), and 28.7μg/L (4.5-127.2), respectively (P<0.01). Cu was 105μg/dL (60-185), 97.5μg/dL (40-130), and 125μg/dL (80-205), respectively (P<0.05). Ceruloplasmin was 21.6mg/dL (14.2-73.2), 22.6mg/dL (0.9-34.3), and 32.1mg/dL (5.8-72.6), respectively (P<0.01). There were no differences in Fe, free erythrocyte protoporphyrin, and Zn. Principal component analysis showed that 58% of observed variability was explained by Fe and Cu indicators. Linear discriminant analysis revealed differences between CD and HC (P<0.0001), with high values of correct classification for TCD (73%) and HC (72%), but not ACD (16%), which were mostly classified as TCD (79%). CONCLUSIONS:: Deficiency of micronutrients was found both in typical as well as in atypical cases.Copyright © 2011 by European Society for Pediatric Gastroenterology.

Navarrete A.,University for Development | Navarrete A.,Hospital Militar
Surgery for Obesity and Related Diseases | Year: 2016

Background: Advanced age is considered to be a relative contraindication to bariatric surgery because of increased perioperative risk and suboptimal excess weight loss. Objectives: The aim of this study was to analyze the safety and effectiveness of the sleeve gastrectomy (SG) procedure in a cohort of elderly patients (aged≥60 yr) compared with younger patients (aged<60 yr). Setting: Hospital clinic, Barcelona, Spain. Methods: A retrospective analysis of all cases of SG in patients≥60 years old between January 2006 and December 2012 was performed. Results: The study included 206 patients, 103 in each group. The mean age was 63.3±2.8 years, and the body mass index was 45.8±22.8 kg/m2. The overall complication rate within the elderly group was 9.7% versus 15.5% in the younger group (P = .2). After SG, there was no statistical difference in body mass index between the groups until 24 (33.4 versus 31.5 kg/m2, P = .01) and 36 (34.6 versus 32.8 kg/m2, P = .01) months of follow-up, favoring the younger cohort. Mean percent excess weight loss was similar between the groups during all periods of follow-up. The mean percent total weight loss change was statistically higher in the younger group at 3 (15.1% versus 17.1%, P = .03); 6 (25.2% versus 27.5%, P = .04); 12 (32.4% versus 35.2%, P = .03); 24 (26.7% versus 32.4%, P<.01); and 36 months (24.9% versus 29.1%, P<.01). Neither groups revealed a statistical difference in resolution of all co-morbidities, except for obstructive sleep apnea (P = .02) in the younger group. Conclusions: SG is a safe and feasible procedure in the elderly with results comparable to those in the standard bariatric population. © 2016 American Society for Bariatric Surgery.

Fica A.,Hospital Militar | Dabanch J.,Hospital Militar | Farias C.,Hospital Militar | Castro M.,Hospital Militar | And 4 more authors.
Clinical Microbiology and Infection | Year: 2012

Because of its infrequent and protean presentation and the lack of clinical data, the management of acute infections with the foodborne trematode Fasciola hepatica is challenging. We report four serologically confirmed cases that illustrate our experience with this parasitic infection in Chile. All patients were adults presenting with upper abdominal pain. Other symptoms included fever, nausea/vomiting, and cutaneous manifestations. In all cases, marked eosinophilia was present. All patients lived in an urban environment, and three reported the consumption of raw watercress. Computed tomography (CT) scans showed hypodense hepatic lesions, whereas ultrasonography findings were unremarkable. One patient suffered portal vein thrombosis, which might be a rare complication of acute fascioliasis. All patients were successfully treated with triclabendazole. Our case series demonstrates that patients with acute fascioliasis typically present with a combination of upper abdominal pain, marked eosinophilia, and hypodense hepatic lesions on CT imaging. Diagnosis should be confirmed by serological investigation. A history of recent consumption of raw watercress is an important finding, but in some patients the source of infection remains obscure. © 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases.

Fernandez M.I.,Hospital Militar | Lopez J.F.,Hospital Militar | Lopez J.F.,University of Los Andes, Chile | Vivaldi B.,Hospital Militar | And 3 more authors.
Journal of Urology | Year: 2012

Purpose: In this study we assessed bladder cancer health care and mortality trends in recent decades in a well studied arsenic exposed area in Northern Chile. Materials and Methods: Arsenic levels in the affected region were obtained for the last 60 years, and correlated with bladder cancer hospital discharge and mortality rates in recent decades. Results: Bladder cancer hospital discharge rates were significantly higher in the affected region (peak RR 3.6, 95% CI 3.04.7). Mortality rates for bladder cancer showed a trend of increase during the period analyzed, reaching peak mortality rates of 28.4 per 100,000 for men and 18.7 per 100,000 for women in the last 10 years. Poisson regression models showed an increased mortality risk in the studied region compared to the rest of the country until the present for men (IRR 5.3, 95% CI 4.85.8) and women (IRR 7.8, 95% CI 7.08.7). Mean age at cancer specific death was significantly lower in the exposed region (69.6 years, 95% CI 68.470.7 vs 73.7 years, 95% CI 73.374.2, p <0.01). Conclusions: Exposure to arsenic is related to a significant need for bladder cancer health care and to high mortality rates even 20 years after having controlled arsenic levels in drinking water. Affected individuals should be aware of the significant impact of this ecological factor. Further research is required to identify strategies for the management of bladder cancer in arsenic exposed populations. © 2012 American Urological Association Education and Research, Inc.

Diaz-Solano D.,Venezuelan Institute for Scientific Research | Wittig O.,Venezuelan Institute for Scientific Research | Ayala-Grosso C.,Venezuelan Institute for Scientific Research | Pieruzzini R.,Hospital Militar | Cardier J.E.,Venezuelan Institute for Scientific Research
Stem Cells and Development | Year: 2012

Multipotent mesenchymal stromal cells (MSCs) from the human olfactory mucosa (OM) are cells that have been proposed as a niche for neural progenitors. OM-MSCs share phenotypic and functional properties with bone marrow (BM) MSCs, which constitute fundamental components of the hematopoietic niche. In this work, we investigated whether human OM-MSCs may promote the survival, proliferation, and differentiation of human hematopoietic stem cells (HSCs). For this purpose, human bone marrow cells (BMCs) were co-cultured with OM-MSCs in the absence of exogenous cytokines. At different intervals, nonadherent cells (NACs) were harvested from BMC/OM-MSC co-cultures, and examined for the expression of blood cell markers by flow cytometry. OM-MSCs supported the survival (cell viability >90%) and proliferation of BMCs, after 54 days of co-culture. At 20 days of co-culture, flow cytometric and microscopic analyses showed a high percentage (73%) of cells expressing the pan-leukocyte marker CD45, and the presence of cells of myeloid origin, including polymorphonuclear leukocytes, monocytes, basophils, eosinophils, erythroid cells, and megakaryocytes. Likewise, T (CD3), B (CD19), and NK (CD56/CD16) cells were detected in the NAC fraction. Colony-forming unit-granulocyte/macrophage (CFU-GM) progenitors and CD34+ cells were found, at 43 days of co-culture. Reverse transcriptase-polymerase chain reaction (RT-PCR) studies showed that OM-MSCs constitutively express early and late-acting hematopoietic cytokines (i.e., stem cell factor [SCF] and granulocyte-macrophage colony-stimulating factor [GM-CSF]). These results constitute the first evidence that OM-MSCs may provide an in vitro microenvironment for HSCs. The capacity of OM-MSCs to support the survival and differentiation of HSCs may be related with the capacity of OM-MSCs to produce hematopoietic cytokines. © Copyright 2012, Mary Ann Liebert, Inc. 2012.

Espinosa J.,Plastica Colombia | Valencia D.P.,Hospital Militar
Facial Plastic Surgery | Year: 2013

The neck has always been one of the most difficult areas to manage in rejuvenation surgery. Even patients with adequate results after a facelift may be dissatisfied because of the appearance of the neck. Moreover, not all neck problems are the same in all patients. Some cases only require fat removal to obtain good results, whereas others require complete neck- and facelift to achieve the desired results. This article offers a detailed step-by-step description of the approach to aesthetic pathologies of the neck, tailored to the needs of each individual patient. The article also includes a discussion of topics such as double chin liposuction, platysma plication, corset platysmaplasty, platysmal suspension to the mastoid, mentoplasty, and neck- and facelift. © 2013 by Thieme Medical Publishers, Inc.

Urrutia J.,University of Santiago de Chile | Mery P.,University of Santiago de Chile | Martinez R.,University of Santiago de Chile | Pizarro F.,University of Santiago de Chile | And 2 more authors.
Journal of Clinical Neuroscience | Year: 2010

Mesenchymal stem cells (MSCs) have been isolated from various tissues and expanded in culture. MSCs add osteogenic potential to ceramic scaffolds when used together. A spinal fusion rabbit model was used to evaluate whether a pellet of cultured, autologous bone marrow MSCs (BMSCs) with osteogenic differentiation could increase the fusion rate when co-grafted with an autologus bone graft compared to autograft alone. Thirty rabbits were randomly assigned to two groups. Group 1 received bone autograft alone and Group 2 received bone autograft plus a pellet of cultured and differentiated BMSCs. Group 2 rabbits had a bone marrow puncture, after which the BMSC were cultured and osteoblastic differentiation was induced. BMSC cultures were obtained from 12 of 15 rabbits. The 27 rabbits underwent a bilateral, L4-L5 intertransverse fusion with an autograft and in Group 2 rabbits a pellet of differentiated BMSCs was added to the autograft. In Group 1, the fusion rate was 53% (8 of 15 rabbits) and in Group 2 the fusion rate was 0% (p < 0.05). Adding differentiated BMSCs in a pellet without a scaffold not only failed to increase fusion rate, but completely inhibited bony growth. © 2009 Elsevier Ltd. All rights reserved.

PubMed | University of Chile, Hospital Italiano and Hospital Militar
Type: Journal Article | Journal: International urology and nephrology | Year: 2016

Between 5 and 10% of patients undergoing percutaneous nephrolithotomy (PCNL) develop postoperative sepsis 1, 2. Strategies to prevent infectious complications are based on information provided by preoperative midstream urine cultures (PMUC). The aim of this study is to evaluate the concordance of the microbiologic findings of PMUC, cultures of the renal stone (RSC) and urine obtained directly from the renal pelvis (RPUC) in patients undergoing PCNL.This is a multicenter prospective study. The study included all patients who underwent PCNL from May 2013 to July 2015 in three academic hospitals. All patients underwent a PMUC. Samples for RPUC were obtained by renal puncture for PCNL. Stone fragments extracted during the procedure were sent for culture (RSC). Clinical variables, stone configuration, burden and microbiology reports of cultures were recorded. We analyzed concordance between cultures and association with infectious complications.One hundred and twenty-two patients underwent PCNL. Twenty-four percent had positive culture, 3.2% (4/122) PMUC, 14.7% (18/122) RPUC and 13.9% (17/122) RSC. Positive PMUC demonstrated multidrug-susceptible Escherichia coli and Staphylococcus aureus, while RPUC showed multidrug-resistant pathogens and/or fungus. Seven patients (5.7%) developed postoperative infectious complications prior to discharge. There was a weak correlation between PMUC and intraoperative urine cultures (RPUC and RSC). Concordance rate between RPUC and RSC was 83.3%. The most common isolated pathogens were multidrug-resistant bacteria or fungus.PMUC did not reflect the microbiological environment found in stones and urine directly obtained from the renal pelvis. Patients with postoperative infectious complications had negative PMUC with positive RPUC or RSC. RPUC and RSC can help guide prompt and appropriate antibiotic treatment for patients who develop postoperative infectious complications after PCNL.

PubMed | Programa de Prevencion de la Salud del Personal en Comision de Servicio en el Extranjero, University for Development, University of Bonn and Hospital Militar
Type: Journal Article | Journal: Travel medicine and infectious disease | Year: 2016

Haiti has the highest prevalence of lymphatic filariasis (Wuchereria bancrofti) in the Western Hemisphere. Still, the risk of filarial infection for long-term visitors such as humanitarian aid workers or military personnel is uncertain. The presented study analyzed the exposure to W. bancrofti in Chilean participants of the UN Stabilization Mission in Haiti (MINUSTAH) in 2011.Blood samples collected from 531 participants were screened for antifilarial antibodies by IgG ELISA, and, if positive, analyzed by immunofluorescence assay (IFA), IgG4 ELISA, Real-Time PCR, and circulating filarial antigen (CFA) card test.ELISA screening was positive in 10 cases. Seroconversion occurred in only two cases (0.38%) based on ELISA values determined in samples taken before and after deployment. Positive IgG ELISA values could not be confirmed by IFA and IgG4 ELISA. Real-Time PCR and CFA testing did not reveal the presence of filaria.Our data indicate that in the examined cohort of MINUSTAH participants in 2011, the risk of filarial exposure or infection was low.

PubMed | Servicio de Radioterapia, CNRS Gustave Roussy Institute and Hospital Militar
Type: | Journal: Ecancermedicalscience | Year: 2016

The high recurrence rate following keloid resection has generated interest in adjuvant treatments for this disease.This study assesses keloid recurrence when treated with surgery and adjuvant radiotherapy.Retrospective analysis of resected keloids in patients referred to a Chilean radiation oncology centre between 2006 and 2013. Local recurrence was defined as new tissue growth on the surgical scar margin.Around103 keloids were analysed in 63 patients treated with 15 Gy in three fraction radiotherapy which was initiated on the same day as the surgery (75% of cases). The median keloid diameter was 6 cm; the most common site was thoracic (22%); the most common cause was prior surgery (35%); 37% caused symptoms, and several (47%) had received prior treatment with corticosteroids (32%), or surgery (30%). The median follow-up was three years, and 94% of recurrences occurred during the first year following treatment. Uni and multivariate analyses showed that an absence of symptoms was a protective factor for recurrence (OR: 0.24), while the time interval from onset to treatment with surgery plus radiotherapy >4.2 years was a risk factor (OR: 2.23). The first year recurrence rate was 32% and stabilised at 32% by the second year with no recurrences after 15 months.The combination of surgery and radiotherapy proved to be a good therapeutic alternative in the management of keloids. Our results are similar to those described in the literature for a dose of 15 Gy. Given these results, our centre will implement a new dose escalation protocol to improve future outcomes.

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