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Pacheco-Mendoza B.A.,Institute Seguridad Y Servicios Sociales Of Los Trabajadores Del Estado
Revista Mexicana de Pediatria | Year: 2016

Hypospadias are defects in the clousure of the urethra. Their identifi cation and treatment should be done at the time of birth and be attended by pediatric urologists. Pediatricians should identify their presence, advising parents, and promptly refer patients for surgical treatment. Different answers to frequently asked questions regarding hypospadias are given in this review. It is priority to repair this malformation between 3 and 18 months of age, according to the type of hypospadias.


Daniel L.-H.,Institute Seguridad Y Servicios Sociales Of Los Trabajadores Del Estado
Indian Heart Journal | Year: 2017

There are significant ethnic differences in the metabolism of some drugs that can be explained by cytochrome P450 polymorphisms and, in particular, the CYP2D6 isozyme. In addition, among patients who are not carriers of the CYP2C19 loss-of-function alleles, there is a reduced risk of stroke when clopidogrel is taken with aspirin compared to aspirin alone. These findings demonstrate that there is inter-ethnic variability in the metabolism of some drugs, which results in different responses to cardiovascular drugs in Asian versus non-Asian populations. © 2017.


Gonzalez-Serrano A.,Institute Seguridad Y Servicios Sociales Of Los Trabajadores Del Estado | Lopez-Gallegos M.,Hospital General Of Zona 1 A
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.


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.


Moguel-Ancheita S.,Institute Seguridad Y Servicios Sociales Of Los Trabajadores Del Estado
Cirugia y cirujanos | Year: 2010

Strabismus has been related to different alterations of brain functions and learning in children. Early treatment for visuomotor functions may improve the executive areas of intelligence. We undertook this study to demonstrate changes of visuomotor function and intelligence in children after strabismus treatment. This is a prospective study of patients with strabismus, before and after treatment. We applied the Human Figure Test, Visuomotor Bender Test, and Intelligence Test. We included nine children with an average age of 8.7 years (± 2.4 years). Stereopsis result was 724 arc sec. Visual acuity was 0.16 logMAR ± 0.15. Verbal intelligence was 91.1 ± 11, executive intelligence (EI) was 86.7 ± 8, and global intelligence (GI) was 91 ± 10. Correlation coefficient of EI was significantly related to stereopsis (-0.2), visual acuity (-0.1) and Bender (-0.1). GI results were higher than statistical prognosis (88.16 for x = 90). We demonstrated improvement in binocularity and psychoadaptive areas related to EI after strabismus and amblyopia treatment.


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.


Vilchis F.,Instituto Nacional Of Ciencias Medicas Y Nutricion Salvador Zubiran | Ramos L.,Instituto Nacional Of Ciencias Medicas Y Nutricion Salvador Zubiran | Mendez J.P.,National Autonomous University of Mexico | Benavides S.,Instituto Nacional Of Ciencias Medicas Y Nutricion Salvador Zubiran | And 2 more authors.
Journal of Andrology | Year: 2010

Inactivating mutations of the SRD5A2 gene result in steroid 5α-reductase 2 deficiency, an autosomal recessive disorder expressed as a male-limited disorder of sex development. Herein, genomic DNA was isolated from 11 new patients with apparent steroid 5α-reductase 2 deficiency. Coding sequence abnormalities in SRD5A2 were assessed by exon-specific polymerase chain reaction, single-stranded conformation polymorphism, and direct sequencing. Likewise, enzymatic activity of the P212R gene variant of SRD5A2 was assessed. DNA analysis revealed mutations in all patients (G115D, R171S, N193S, E197D, G203S, P212R). Three individuals were compound heterozygotes, 6 were homozygotes, and 2 more were single heterozygotes for SRD5A2 mutations; remarkably, 40% of the mutant alleles (9/22) contained the gene variant P212R. The results described in this study represent, along with our previous reports, the largest number of patients with steroid 5α-reductase 2 deficiency belonging to nonrelated families. Regarding the frequency of the p.P212R mutation in our population and its presence throughout all of our country, it allows us to hypothesize that the presence of this mutation may constitute a founder gene effect. Copyright © American Society of Andrology.


Lara M.A.,Instituto Nacional Of Psiquiatria Ramon Of La Fuente Muniz | Navarrete L.,Instituto Nacional Of Psiquiatria Ramon Of La Fuente Muniz | Nieto L.,Instituto Nacional Of Psiquiatria Ramon Of La Fuente Muniz | Barba Martin J.P.,Hospital Regional Lic Adolfo Lopez Mateos | And 2 more authors.
Journal of Affective Disorders | Year: 2015

Background The aim of this study was to assess point and period prevalence and incidence of perinatal depression in Mexican women. Methods The Structured Clinical Interview for DSM-IV and the Patient Health Questionnaire (PHQ-9) were administered at three points in time to 210 women: during the third trimester of pregnancy, at six weeks and at six months after delivery. Results Prevalence of prenatal depression was 9.0%, and 13.8% at six weeks and 13.3% at six months postpartum. Incidence of postpartum depression (PPD) was 10.0% at six weeks and 8.2% at six months. Prevalence of prenatal depressive symptoms was 16.6%; and 17.1% at six weeks and 20.0% at six months postpartum. Incidence of postpartum depressive symptoms (PPDS) was 11.4% at six weeks and 9.0% at six months. At six months postpartum, women with depression were younger (OR=2.45, p=0.02), had fewer years' schooling (OR=5.61, p=0.00), were unpartnered (OR=3.03, p=0.01), unemployed (OR=3.48, p=0.00) and poorer (OR=4.00, p=0.00) than women without depression. Limitations 25% of the initial sample was not retained to complete the three assessments. Non completers were younger, less educated and reported more depressive symptoms. This may have resulted in an underestimation of prevalence. Conclusions This is the first longitudinal study in Latin America to assess perinatal depression at three different points in times, reporting point and period prevalence and incidence of clinical depression and depressive symptoms. Most LA countries have yet to recognize the importance of providing mental health care for expectant and postpartum mothers to reduce disability in mothers and infants. © 2014 Elsevier B.V. All rights reserved.


Orozco-Gomez L.P.,Institute Seguridad Y Servicios Sociales Of Los Trabajadores Del Estado
Cirugia y cirujanos | Year: 2011

The "Early Treatment for Retinopathy of Prematurity Cooperative" reported a failure rate of 55.2% using laser in zone 1 for treatment of retinopathy of prematurity (ROP). We need to offer better alternatives for those patients. We undertook this study to evaluate the efficacy of combined laser-ranibizumab therapy for ROP with threshold-prethreshold and "plus disease" and to study development of the newborn. This is a prospective, experimental, longitudinal and open study including newborns of either <32 weeks of gestation or with a birth weight <1500 g, with threshold-prethreshold retinopathy or "plus disease." The effect of treatment was analyzed and development of the newborn was determined. We studied 34 eyes of 17 patients. Age at birth was 29.9 ± 2.6 weeks. Birth weight was 1,120 ± 253 g. The statistics demonstrated an important relationship between severity of retinopathy and early birth age, along with a high probability of threshold-prethreshold disease at 29.4 weeks of age or 1204 g birth weight. The Bayley scale reported normal development in 23.5% of cases, global retardation in 23.5%, psychomotor retardation but normal mental behavior in 29.4%, and mental retardation but normal psychomotor development in 23.5%. We demonstrated regression of retinopathy in all cases. Persistence of vascular tortuosity was present in 17.6% of cases without vascular dilatation, and vitreous membrane development was demonstrated in 11.7% of patients. Laser-ranibizumab treatment has allowed a better control of retinopathy for threshold-prethreshold and "plus disease" in this group of patients.


In abdominal sepsis, when the initial surgery fails to control infection, a good choice may be to leave the abdomen open. This is a descriptive study of a series of cases using the vacuum pack system for temporary abdominal closure. We studied 19 patients. Demographic data were obtained, as well as those related to the vacuum pack, and the final fascial closure. We describe the technique of temporary abdominal closure. Values are presented as mean ± standard deviation (SD). The average length of the hospital stay was 24.7 days. Fourteen (73.7%) patients survived and five patients (26.3%) died. The mean treatment time with the vacuum pack was 12.7 days, with an average of 3.9 changes. Early fascial closing was achieved in seven patients with an average of 14.6 days. In seven patients a planned ventral hernia formed, which was repaired by separation of components on an average of 261 days or by polypropylene mesh on an average of 228 days. In our series, early fascial closing was achieved using the vacuum pack at a lower frequency than reported by other authors. Other parameters analyzed were similar to those reported in the literature. The vacuum pack system demonstrated to be effective, although the final selection for temporary abdominal closure will depend on the experience of the institution as well as surgeon preference. The vacuum pack system for temporary abdominal closure of the open abdomen is an effective alternative in patients with abdominal sepsis.

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