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Garcia-Pena C.,Instituto Mexicano del Seguro Social | Garcia-Fabela L.C.,Institute Seguridad Social Del Estado Of Mexico Y Municipios | Gutierrez-Robledo L.M.,Instituto Nacional Of Geriatria | Garcia-Gonzalez J.J.,Instituto Mexicano del Seguro Social | And 2 more authors.
PLoS ONE | Year: 2013

Functional decline after hospitalization is a common adverse outcome in elderly. An easy to use, reproducible and accurate tool to identify those at risk would aid focusing interventions in those at higher risk. Handgrip strength has been shown to predict adverse outcomes in other settings. The aim of this study was to determine if handgrip strength measured upon admission to an acute care facility would predict functional decline (either incident or worsening of preexisting) at discharge among older Mexican, stratified by gender. In addition, cutoff points as a function of specificity would be determined. A cohort study was conducted in two hospitals in Mexico City. The primary endpoint was functional decline on discharge, defined as a 30-point reduction in the Barthel Index score from that of the baseline score. Handgrip strength along with other variables was measured at initial assessment, including: instrumental activities of daily living, cognition, depressive symptoms, delirium, hospitalization length and quality of life. All analyses were stratified by gender. Logistic regression to test independent association between handgrip strength and functional decline was performed, along with estimation of handgrip strength test values (specificity, sensitivity, area under the curve, etc.). A total of 223 patients admitted to an acute care facility between 2007 and 2009 were recruited. A total of 55 patients (24.7%) had functional decline, 23.46% in male and 25.6% in women. Multivariate analysis showed that only males with low handgrip strength had an increased risk of functional decline at discharge (OR 0.88, 95% CI 0.79-0.98, p = 0.01), with a specificity of 91.3% and a cutoff point of 20.65 kg for handgrip strength. Females had not a significant association between handgrip strength and functional decline. Measurement of handgrip strength on admission to acute care facilities may identify male elderly patients at risk of having functional decline, and intervene consequently. © 2013 García-Peña et al. Source

Fonseca-Entzana M.T.,Medico Residente de Tercer Ano | Trejo-Martinez M.A.,Institute Seguridad Social Del Estado Of Mexico Y Municipios
Medicina Interna de Mexico | Year: 2015

Myxedema coma is the most extreme manifestation of hypothyroidism, a condition being rare but potentially lethal. Few cases are reported in the literature, yet they all agree on the severity of this condition and report a mortality of 30% to 60%. It occurs mostly in women older than 60 years, with a history of hypothyroidism and mainly during the winter months. This condition occurs when body's compensatory mechanisms are overcome secondary to a trigger (infection, burns, trauma, hypothermia, etc.). For diagnosis these triggers should be taken into account, as well as impaired alertness and impaired thermoregulation. Diagnosis might be supported in the presence of hypotension, hypoxia, hypercapnia and changes in laboratory, such as thyroid profile, serum electrolytes, increased serum creatinine and creatine phosphokinase. Treatment should be based on early recognition, replacement thyroid hormones, steroids and appropriate management support. We present a representative case of this entity attended at Regional Hospital of Tlalnepantla, Mexico. Source

Lopez E.C.B.,Institute Seguridad Social Del Estado Of Mexico Y Municipios | Sebastialn J.A.S.,Institute Seguridad Social Del Estado Of Mexico Y Municipios | Castro J.M.M.,Institute Seguridad Social Del Estado Of Mexico Y Municipios | Cuevas G.O.,Comisionado Nacional de Proteccion en Salud | And 2 more authors.
Gaceta Mexicana de Oncologia | Year: 2015

The mucosa-associated lymphoid tissue (MALT) non-Hodgkin lymphoma of the marginal zone is an extranodal lymphoma morphologically comprised by small and heterogeneous B-immunophenotype cells, including cells of the marginal zone (centroblastic type). Infiltration occurs at the epithelium level, resulting in lymphoepithelial lesions. MALT lymphomas account for 7-8% of all B-cell lymphomas, and for up to 50% of primary lymphomas of the stomach. Most cases occur in adults with a mean of 61 years, with a slight predominance in women (male: female ratio: 1:1.2). Hussell et al. have demonstrated that constant cell stimulation by H. pylori activates lymphoid T-cells. In the case of ocular annexes MALT lymphomas, C. psittaci-associated infections have been associated. Fifty percent of this type of lymphomas account for gastric maltomas, whereas non-gastric maltomas are more common in the head, neck, lung, and ocular orbit. A case report is presented of a patient with an orbital non-Hodgkin MALT-type lymphoma who was treated with radiotherapy. © 2015, Sociedad Mexicana de Oncología. Source

Castaneda-Espinosa S.,Institute Seguridad Social Del Estado Of Mexico Y Municipios | Gallardo-Rivera C.E.,Institute Seguridad Social Del Estado Of Mexico Y Municipios
Medicina Interna de Mexico | Year: 2015

Infective endocarditis is defined as inflammation of the endocardium with compromise of the heart valves caused by an infection, mainly of bacterial origin; it remains a serious disease with a mortality rate between 18-30%. This paper reports the case of a patient with income data of cerebrovascular ischemic event and then the diagnosis was of septic embolism secondary to infective endocarditis. Source

Gomez-Olivan L.M.,National Autonomous University of Mexico | Miranda-Mendoza G.D.,National Autonomous University of Mexico | Cabrera-Galeana P.A.,Institute Seguridad Social Del Estado Of Mexico Y Municipios | Galar-Martinez M.,National Polytechnic Institute of Mexico | And 4 more authors.
Oxidative Medicine and Cellular Longevity | Year: 2014

The impact of involuntary exposure to antineoplastic drugs (AD) was studied in a group of nurses in diverse hospitals in Mexico. The results were compared with a group of unexposed nurses. Anthropometric characteristics and the biochemical analysis were analyzed in both groups. Also, lipid peroxidation level (LPX), protein carbonyl content (PCC), and activity of the antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) were evaluated in blood of study participants as oxidative stress (OS) biomarkers. The group of occupationally exposed (OE) nurses consisted of 30 individuals ranging in age from 25 to 35 years. The control group included 30 nurses who were not occupationally exposed to the preparation and handling of AD and whose anthropometric and biochemical characteristics were similar to those of the OE group. All biomarkers evaluated were significantly increased (P < 0.5) in OE nurses compared to the control group. Results show that the assessment of OS biomarkers is advisable in order to evaluate exposure to AD in nurses. © 2014 Leobardo Manuel Gómez-Oliván et al. Source

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