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Pelaez-Ballestas I.,Hospital General Of Mexico | Sanin L.H.,Autonomous University of Chihuahua | Moreno-Montoya J.,Hospital General Of Mexico | Burgos-Vargas R.,National Autonomous University of Mexico | And 6 more authors.
Journal of Rheumatology | Year: 2011

To estimate the prevalence of musculoskeletal (MSK) disorders and to describe predicting variables associated with rheumatic diseases in 5 regions of México. Methods: This was a cross-sectional, community-based study performed in 5 regions in México. The methodology followed the guidelines proposed by the Community Oriented Program for the Control of the Rheumatic Diseases (COPCORD). A standardized methodology was used at all sites, with trained personnel following a common protocol of interviewing adult subjects in their household. A "positive case" was defined as an individual with nontraumatic MSK pain of > 1 on a visual analog pain scale (0 to 10) during the last 7 days. All positive cases were referred to internists or rheumatologists for further clinical evaluation, diagnosis, and proper treatment. Results: The study included 19,213 individuals; 11,602 (68.8%) were female, and their mean age was 42.8 (SD 17.9) years. The prevalence of MSK pain was 25.5%, but significant variations (7.1% to 43.5%) across geographical regions occurred. The prevalence of osteoarthritis was 10.5%, back pain 5.8%, rheumatic regional pain syndromes 3.8%, rheumatoid arthritis 1.6%, fibromyalgia 0.7%, and gout 0.3%. The prevalence of MSK manifestations was associated with older age and female gender. Conclusion: The prevalence of MSK pain in our study was 25.5%. Geographic variations in the prevalence of MSK pain and specific diagnoses suggested a role for geographic factors in the prevalence of rheumatic diseases.


Goycochea-Robles M.-V.,Colegio de Mexico | Sanin L.H.,Autonomous University of Chihuahua | Moreno-Montoya J.,Autonomous University of Chihuahua | Alvarez-Nemegyei J.,UMAE No. 25 | And 7 more authors.
Journal of Rheumatology | Year: 2011

Rheumatic diseases are vastly underdiagnosed and undertreated, particularly among minorities and those of low socioeconomic status. The WHO-ILAR Community Oriented Program in the Rheumatic Diseases (COPCORD) advocates screening of musculoskeletal complaints in the community. The objective of this study was to evaluate the performance of the COPCORD Core Questionnaire (CCQ) as a diagnostic tool for rheumatic diseases. Methods: We conducted a cross-sectional study designed in parallel with a large COPCORD survey in Mexico. A subsample of 17,566 questionnaires, selected from 4 of the 5 states included in a national COPCORD survey were included in the analysis as a diagnostic test to evaluate sensitivity, specificity, receiver operating characteristics curve (ROC), and positive likelihood ratio (LR+) of the CCQ as a case-detection tool for rheumatic diagnosis and for the most frequent diagnoses identified in the survey, osteoarthritis, regional rheumatic pain syndromes, and rheumatoid arthritis (RA). Logistic regression with the questions with LR+ ≥ 1 was performed to identify the strength of association (OR) for each question. Results: Pain in the last 7 days, high pain score (> 4), and previous diagnosis were the questions with highest LR+ for diagnosis, and for diagnosis of RA treatment with NSAID. The variables that contributed most to the model were pain in the last 7 days (OR 2.0, 95% CI 1.8-2.3), NSAID treatment (OR 3.3, 95% CI 3.0-3.7), a high pain score (OR 1.15, 95% CI 1.13-1.17), and having a previous diagnosis (OR 1.4, 95% CI 1.3-1.6). These 4 questions had R2 = 0.24, p < 0.01, for detection of any rheumatic diagnosis. The single variable that explains 16% (OR 1.33, 95% CI 1.31-134) of variance was a high pain score in the last 7 days. Conclusion: Some variables were identified in the CCQ that could be combined in a brief version for case detection of rheumatic diseases in community surveys. The validity of this proposal has to be tested against the original version.


Barbosa-Alanis H.J.,Sociedad de Dermatologia de Nuevo Leon | Barbosa-Moreno L.,Hospital Universitario Jose Eleuterio Gonzalez
Dermatologia Revista Mexicana | Year: 2016

This is a short review concerning the history of medicine in the northeast of Mexico, particularly in Monterrey, Nuevo Leon, dating since the 16th century to present day. As well, the foundation of the Department of Dermatology at the University Hospital and the Dermatology Society of Nuevo Leon, AC.


Barbosa-Alanis H.J.,Sociedad de Dermatologia de Nuevo Leon | Gonzalez-Cabello D.,Monterrey | Barbosa-Moreno L.,Hospital Universitario Jose Eleuterio Gonzalez
Dermatologia Revista Mexicana | Year: 2016

Vulva diseases have not been of much interest among dermatologists. The main goal of this review is to raise awareness of these frequent illnesses that are poorly cared for. There is not much information available for treating these diseases, and since there is no clear division between specialties for treating the vulvar pathology, it has lead to its relegation. This review exposes the most frequent inflammatory dermatoses of the vulva, based on histopathologic patterns according to a classification of the International Society for the Stu dy of the Vulvar Diseases (ISSVD).


PubMed | Hospital General Of Mexico, Instituto Nacional Of Salud Publica, Instituto Mexicano del Seguro Social and Hospital Universitario Jose Eleuterio Gonzalez
Type: Journal Article | Journal: Rheumatology international | Year: 2016

The aim of this study was to validate the paediatric Gait, Arms, Legs, Spine (pGALS) tool for Mexican Spanish to screen Mexican paediatric population for musculoskeletal (MSK) disorders. A cross-sectional study was performed in the Paediatric Hospital of the Mexican Social Security Institute in Guadalajara, Jalisco. The validation included children and adolescents aged 6-16years, 87 patients with musculoskeletal disorders and 88 controls without musculoskeletal disorders. The cross-cultural validation followed the current published guidelines. The average pGALS administration time was 2.9min (SD 0.54). The internal consistency score (Cronbachs ) was 0.90 (0.89 for inflammatory and 0.77 for non-inflammatory disorders) for MSK disorders, with a sensitivity of 97% (95% CI 92-99%), a specificity of 93% (95% CI 86-97%), a LR+ of 14.3, and a ROC curve of 0.95 (95% CI 0.92-0.98%). The inflammatory disorders group had a sensitivity of 97% (95% CI 86-99%), a specificity of 93% (95% CI 86-97%), a LR+ of 14.2, and a ROC curve of 0.95% (95% CI 0.91-0.99%). The non-inflammatory disorders group had a sensitivity of 98% (95% CI 89-99%), a specificity of 93% (95% CI 86-97%), and a LR+ of 14.37, with a ROC curve of 0.95% (95% CI 0.92-0.98%). pGALS is a valid screening tool, fast, easy to administer, and useful for detecting musculoskeletal disorders in Mexican children and adolescents.


Camara-Lemarroy C.R.,Autonomous University of Nuevo León | Guzman-de la Garza F.J.,Autonomous University of Nuevo León | Alarcon-Galvan G.,Hospital Universitario Jose Eleuterio Gonzalez | Cordero-Perez P.,Autonomous University of Nuevo León | And 3 more authors.
Archives of Medical Research | Year: 2014

Background and Aims: Temporal occlusion of the hepatoduodenal ligament (HDL) is often used during liver surgeries in order to reduce blood loss, resulting in ischemia/reperfusion injury (I/R). The aim of the study was to investigate the effects of atorvastatin (ATOR) on hepatic I/R injury and on serum levels of tumor necrosis factor-alpha (TNF-α), endothelin-1 (ET-1), antithrombin III (ATIII) and intracellular adhesion molecule-1 (ICAM-1). Methods: Liver ischemia was induced in Wistar rats by clamping the HDL for 60 min, followed by either 60 or 180 min reperfusion. Rats received either vehicle or 10 mg/kg ATOR before hepatic I/R. Control group received sham surgery. Livers were examined for histological damage and serum AST, ALT, TNF-α, ET-1, ATIII and ICAM-1 concentrations were measured. Results: After I/R, AST and ALT were significantly elevated, ATIII levels were significantly depleted, both TNF-α and ICAM-1 levels increased and ET-1 was significantly elevated (at 180 min). ATOR pretreatment attenuated these alterations and diminished histological injury scores. Conclusions: Our results show that ATOR protects the liver from I/R injury. © 2014 IMSS.


Eichelmann K.,Hospital Universitario Jose Eleuterio Gonzalez | Gonzalez Gonzalez S.E.,Hospital Universitario Jose Eleuterio Gonzalez | Salas-Alanis J.C.,Hospital Universitario Jose Eleuterio Gonzalez | Ocampo-Candiani J.,Hospital Universitario Jose Eleuterio Gonzalez
Actas Dermo-Sifiliograficas | Year: 2013

Leprosy is a chronic granulomatous disease caused by the bacillus Mycobacterium leprae. It primarily affects the skin and peripheral nerves and is still endemic in various regions of the world. Clinical presentation depends on the patient's immune status at the time of infection and during the course of the disease. Leprosy is associated with disability and marginalization. Diagnosis is clinical and is made when the patient has at least 1 of the following cardinal signs specified by the World Health Organization: hypopigmented or erythematous macules with sensory loss; thickened peripheral nerves; or positive acid-fast skin smear or skin biopsy with loss of adnexa at affected sites. Leprosy is treated with a multidrug combination of rifampicin, clofazimine, and dapsone. Two main regimens are used depending on whether the patient has paucibacillary or multibacillary disease. © 2011 Elsevier España, S.L. and AEDV. All rights reserved.


Camara-Lemarroy C.R.,Autonomous University of Nuevo León | Guzman-de la Garza F.J.,Autonomous University of Nuevo León | Alarcon-Galvan G.,Hospital Universitario Jose Eleuterio Gonzalez | Cordero-Perez P.,Autonomous University of Nuevo León | And 2 more authors.
Transplantation Proceedings | Year: 2010

Objective: We investigated the effects of thalidomide alone or in combination with pentoxyphylline upon intestinal ischemia/reperfusion (I/R) injury in the rat. Materials and Methods: Twenty male Wistar rats were randomized into 5 groups: sham-operated (SHAM), control (CTL), thalidomide (400 mg/kg) treatment (THAL), pentoxyphylline (50 mg/kg) treatment and a combination group (THAL + POX). I/R was induced by clamping the superior mesenteric artery for 45 minutes, followed by 120 minutes of reperfusion. We measured serum concentrations of aspartate-aminotransferase (AST), lactate dehydrogenase (LDH), tumor necrosis factor (TNF)-α as well as lipid peroxidation and antioxidant status. Intestinal samples were morphologically analyzed, and dry to wet (W/D) ratios calculated in intestinal, lung and liver samples, as a measurement of tissue edema. Results: Serum concentrations of AST, LDH, and TNF-α were increased after I/R in the CTL compared with the SHAM group (P < .05). Lipid peroxidation was also increased, and antioxidant capacity in serum, decreased (P < .05). The W/D ratio was elevated in all tissue samples as well (P < .05). Both thalidomide and pentoxyphylline effectively reduced AST, LDH, TNF-α, and lipid peroxidation levels, as well as attenuated tissue edema and intestinal injury induced by I/R (P < .05). Combination treatment showed only modest additive effects on lung W/D ratio and TNF-α levels. Conclusion: Both drugs protected the intestine, lungs, and liver against intestinal I/R injury, probably by inhibition of TNF-α and lipid peroxidation. However, combination treatment showed small, additive effects. © 2010 Elsevier Inc. All rights reserved.


Guzman-De La Garza F.J.,Autonomous University of Nuevo León | Camara-Lemarroy C.R.,Autonomous University of Nuevo León | Ballesteros-Elizondo R.G.,Autonomous University of Nuevo León | Alarcon-Galvan G.,Hospital Universitario Jose Eleuterio Gonzalez | And 2 more authors.
Surgery Today | Year: 2010

Purpose: Intestinal ischemia reperfusion (I/R) induces severe injury and significant mortality. New therapeutic interventions are needed; ketamine is an anesthetic with anti-inflammatory properties, which has shown protective effects on I/R in various organs. This study investigated effects of ketamine on intestinal I/R injury. Methods: Male Wistar rats underwent either sham surgery or 30 min of intestinal ischemia followed by 60 min reperfusion. Ketamine pretreatment was administered by intraperitoneal injections at doses of 100, 50, 12.5, or 6.25 mg/kg. The intestinal morphology, mucosal damage, leukocyte infiltration, serum P-selectin, serum intracellular adhesion molecule-1 (ICAM-1), serum antithrombin-III (ATIII), and myenteric ganglion cell structure were evaluated. Results: Intestinal I/R led to severe mucosal damage, leukocyte (especially neutrophil) infiltration, P-selectin and ICAM-1 elevations, ATIII depletion, and myenteric ganglion cell morphological alterations. The ketamine dose dependently diminished these alterations (except for ICAM-1 serum levels), reaching statistical significance at 100, 50, and 12.5 mg/kg. Conclusions: Ketamine protects the intestine against I/R injury. Ketamine anesthesia has been recommended for clinical situations of sepsis and hemodynamic instability, both frequent during intestinal I/R. The clinical application of ketamine in situations of intestinal I/R warrants consideration. © 2010 Springer.


Gomez-Flores M.,Hospital Universitario Jose Eleuterio Gonzalez
Revista médica del Instituto Mexicano del Seguro Social | Year: 2011

Isotretinoin was authorized since 1982 for the treatment of acne vulgaris associated to severe cutaneous lesions. It has been used in others clinical conditions in various plans of prescription. Since the Isotretinoin was launched, it caused controversies in our country and around the world, especially in relation with the security. Isotretinoin is proscribed in pregnant patient. As a security rule we must measure serum lipids and hepatic enzymes. The aim of the consensus was to spread information worked by a group of Mexican experienced dermatologists to the health professionals about the use and the specific indications about isotretinoin.

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