Rodriguez-Flores M.,Institute Seguridad Y Servicios Sociales Of Los Trabajadores Del Estado
Revista médica del Instituto Mexicano del Seguro Social | Year: 2011
Polycystic ovary syndrome (POS) is a hyperandrogenic state which causes the majority of the fertility and menstrual disorders in premenopausal women. Treatment has focused on gynecologic and endocrine interventions to modify these disorders and the excess androgenic hormone phenotype, which motivates the seeking of treatment for most women. However, there is progressive support for the role of different factors within the disease, such as obesity and insulin resistance. These factors interact with the androgenic hormones and with the ovulatory alterations; but it is yet not known with certainty the fundamental mechanism upon which the disease depends for the manifestation of its symptoms and signs. This association of phenomena has important reflections on the development of cardiovascular diseases. The POS being such a frequent condition, it is often not diagnosed and treated in a multidisciplinary manner. It is important that, apart from looking for improvement in fertility and a decrease of the hyperandrogenic expression, risk factors resulting from this condition are recognized and its treatment include early management of chronic diseases with evidence-based interventions to improve eating and physical activity habits in who, most of the time, are seen to treat other health problems or to improve their reproductive health exclusively.
Gonzalez-Serrano A.,Institute Seguridad Y Servicios Sociales Of Los Trabajadores Del Estado |
Lopez-Gallegos M.,Instituto Mexicano del Seguro Social
Revista Mexicana de Urologia | Year: 2016
Transurethral bladder eversion is extremely rare and very few cases are described in the literature.The aim of this report was to present the management established for this pathology and to analyze its possible predisposing factors.The case of a 72-year-old, multiparous, postmenopausal woman is presented herein. Her past history included numerous pregnancies resulting in births, uterine prolapse, pessary use, and transurethral bladder eversion. Urethral remodeling, colporrhaphy, and cystopexy were performed.The exact mechanisms by which bladder eversion occurs have yet to be established. Management is heterogeneous due to the lack of reported cases and results tend to be variable. © 2015 Sociedad Mexicana de Urología.
Evaristo-Mendez G.,Institute Seguridad Y Servicios Sociales Of Los Trabajadores Del Estado |
Rocha-Calderon C.H.,Institute Seguridad Y Servicios Sociales Of Los Trabajadores Del Estado
Cirugia y Cirujanos | Year: 2016
The risk of post-operative pneumonia is a latent complication. A study was conducted to determine its risk factors in abdominal surgery. Material and methods A cross-sectional study was performed that included analysing the variables of age and gender, chronic obstructive pulmonary disease and smoking, serum albumin, type of surgery and anaesthesia, emergency or elective surgery, incision site, duration of surgery, length of hospital stay, length of stay in the intensive care unit, and time on mechanical ventilation. The adjusted odds ratio for risk factors was obtained using multivariate logistic regression. Results The study included 91 (9.6%) patients with pneumonia and 851 (90.4%) without pneumonia. Age 60 years or over (OR = 2.34), smoking (OR = 9.48), chronic obstructive pulmonary disease (OR = 3.52), emergency surgery (OR = 2.48), general anaesthesia (OR = 3.18), surgical time 120 minutes or over (OR = 5.79), time in intensive care unit 7 days or over (OR = 1.23), time on mechanical ventilation greater than or equal to 4 days (OR = 5.93) and length of post-operative hospital stay of 15 days or over (OR = 1.20), were observed as independent predictors for the development of postoperative pneumonia. Conclusions Identifying risk factors for post-operative pneumonia may prevent their occurrence. The length in the intensive care unit of greater than or equal to 7 days (OR = 1.23; 95% CI 1.07 - 1.42) and a length postoperative hospital stay of 15 days or more (OR = 1.20; 95% CI 1.07 - 1.34) were the predictive factors most strongly associated with lung infection in this study. © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma Mxico S.A.
Ortiz-Mendoza C.M.,Institute Seguridad Y Servicios Sociales Of Los Trabajadores Del Estado
Revista médica del Instituto Mexicano del Seguro Social | Year: 2012
retrieve the largest number of lymph nodes provides information to know the patient prognosis with invasive cervical cancer undergoing radical hysterectomy. The aim was to evaluate the skill of the attending surgeon to identify and recover lymph nodes. pelvic lymphadenectomy specimens obtained from patients with cervical cancer stages IA2-IIA undergoing radical hysterectomy were studied. The surgeon or the pathologist assessed the specimens to determine the number of recovered lymph nodes. The lymph node classification was: right, left, common and total. the surgeon evaluated nine pelvic dissection specimens and pathologist other nine. Right lymph nodes: surgeon 14.8 ± 8, pathology 7.3 ± 3 (p < 0.01). Left lymph nodes: surgeon 14.3 ± 6, pathology 7 ± 2 (p < 0.01). Common lymph nodes: surgeon 6.6 ± 5, pathology 5.8 ± 5 (p ns). Total lymph nodes: surgeon 35.7 ± 17, pathology 20.2 ± 7 (p < 0.01). Specimens with fewer than 20 lymph nodes recovered: surgeon 1, pathologist 6 (p = 0.02). Metastatic lymph nodes: surgery 4, pathologist 2 (p = ns). the surgeon may retrieve a larger number of lymph nodes of pelvic lymphadenectomy specimens.
Vargas-Cruz A.,Institute Seguridad Y Servicios Sociales Of Los Trabajadores Del Estado
Revista médica del Instituto Mexicano del Seguro Social | Year: 2013
Hemoptysis is a sign that can be secondary to various clinical entities. Depending on the amount of bleeding, it may even endanger the patient's life. The presence of a dilated and tortuous bronchial artery may explain the hemoptysis, whose treatment consists in closing the vessel. Our objective is to demonstrate the percutaneous closure of a disrupt of the bronchial artery which causes hemoptysis. A 49-years old woman with mild hemoptysis and the presence of an abnormal bronchial artery bleeding that underwent percutaneous closure device plug. The device was implanted without complications and it was not observed passage of dye into the bronchial artery occluded through the pigtail catheter angiography control. The patient had no further episodes of hemoptysis. Conclusions: pulmonary arteriovenous malformations can be treated successfully by the percutaneous route.