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Cortes-Telles A.,Instituto Nacional Of Enfermedades Respiratorias Ismael Cosio Villegas Iner | Hernandez F.J.,INER | Mirabal E.S.P.,INER
Revista del Instituto Nacional de Enfermedades Respiratorias | Year: 2011

Pneumocystis jirovecii pneumonia remains one of the opportunistic infections that most often defines the acquired immunodeficiency syndrome, particularly in countries with low income, low socioeconomic status and without universal access to highly active antiretroviral therapy. It's a clinical condition that occurs usually in an insidious manner and progresses over a period of 2 to 4 weeks. This point can promote, in isolated cases, to develop rapidly progressive acute respiratory failure requiring mechanical ventilatory support and management in the intensive care unit. Advances in technology have allowed us to recognize the organism in a timely manner. Also, biological characteristics have been identified with greater certainty, as well as, the spectrum of clinical and radiological presentation and treatment. Therefore, it is required to maintain a constant awareness of the evolution of this disease. Source


Salazar-Otaola G.F.,Instituto Nacional Of Enfermedades Respiratorias Ismael Cosio Villegas Iner | Ibarra-Celaya J.M.,INER | Vazquez-Minero J.C.,INER
Revista del Instituto Nacional de Enfermedades Respiratorias | Year: 2013

Perforating injuries of the esophagus are separated into four categories: Instrumental injuries, foreign body injuries, non instrumental (barotrauma) injuries, and other rare causes. Injuries due to barotrauma include blunt trauma, Boerhaave's syndrome and pneumatic lesions from compressed air source. The latter occurs rarely and common sources include accidents involving compressed-air hoses and tanks, or rupture of a bicycle tire when a young child bites on an inner tubing. First described in 1724 by M.D. Hermann Boerhaave as a syndrome related to posthemetic esophageal rupture, the fi rst case with successful surgical management was in 1947 by Barret. The clinical manifestations include hemothorax, hemoneumothorax and free perforation in to the abdominal cavity. Important points in surgical and medical management are: control of the septic focus, appropriate antibiotic management and early nutritional support. There are some reports in medical literature of unusual clinical presentation of this syndrome; however, there are no reports of association between esophageal rupture and the use of non-invasive mechanical ventilation with positive pressure. We present the case of a 70 year old male, who came to the hospital with cough and progressive dyspnea, due to an exacerbation of Chronic Obstructive Pulmonary Disease. Non-invasive Positive Pressure Ventilation (NPPV) was initiated. Three days later shock and hemoperitoneum was detected and a perforation of the distal esophagus was found. Primary repair of the perforation was made with good evolution. The aim of this paper is to present an unusual manifestation of an esophageal perforation associated with NPPV and its successful surgical management. Source


Reyes H.J.N.,Instituto Nacional Of Enfermedades Respiratorias Ismael Cosio Villegas Iner | Cortes P.Z.,Instituto Nacional Of Enfermedades Respiratorias Ismael Cosio Villegas Iner | Cruz A.G.,Instituto Nacional Of Enfermedades Respiratorias Ismael Cosio Villegas Iner | Ugalde M.C.N.,Instituto Nacional Of Enfermedades Respiratorias Ismael Cosio Villegas Iner | And 3 more authors.
Revista del Instituto Nacional de Enfermedades Respiratorias | Year: 2011

Obesity is a major problem worldwide whose prevalence is increasing rapidly, with pandemic characteristics. Obesity is fundamentally a problem of energy balance caused by interaction of a series of social, cultural, behavioral and genetic determinants. The etiology or cause of obesity is an imbalance between the energy ingested in food and the energy expended. The excess energy is stored in fat cells that enlarge and/or increase in number. It is this hyperplasia and hypertrophy of fat cells that is the pathological lesion of obesity. Massive development of the adipose tissue leads to the formation of hypoxic areas. The adipose tissue expands and some adipocytes become too distant from the vasculature to be correctly oxygenated. Hypoxia, a deficiency in oxygen (O2), is a major stimulus affecting a number of biological functions, such as angiogenesis, cell proliferation, apoptosis, and infl ammation, and it switches cell metabolism from aerobic respiration to anaerobic glycolysis. Hypoxia in obese adipose tissue mediates its effect through the expression of the key hypoxia regulator, hypoxia-inducible factor (HIF), a basic transcription factor composed of two subunits, HIF-α and-β. Source


Torres-Fraga M.G.,Instituto Nacional Of Enfermedades Respiratorias Ismael Cosio Villegas Iner | Carrillo-Alduenda J.L.,Instituto Nacional Of Enfermedades Respiratorias Ismael Cosio Villegas Iner | Torre-Bouscoulet L.,INER | Reyes-Zuniga M.M.,Instituto Nacional Of Enfermedades Respiratorias Ismael Cosio Villegas Iner | Castorena-Maldonado A.R.,Instituto Nacional Of Enfermedades Respiratorias Ismael Cosio Villegas Iner
Revista del Instituto Nacional de Enfermedades Respiratorias | Year: 2012

Though neuromuscular diseases (NMD) and thoracic cage disorders differ among them in terms of etiology, clinical manifestations and prognoses, in advanced stages those conditions are characterized by the development of respiratory insufficiency that often results in death. Sleep-disordered breathing (SDB) is frequent in patients with NMD, where they may appear independently or in association with an NMD per se. These conditions include obstructive apnea, central apnea, and alveolar hypoventilation. The purpose of this document is to describe the physiopathology of SDB in NMD patients, emphasizing the most common and deleterious of them, which is the sleep-related hypoventilation-hypoxemia syndrome. We believe that this information will be useful to clinical physicians by providing a better understanding of the respiratory complications that NMD patients suffer, and thereby sensitizing specialists to the importance of non-invasive mechanical v entilation. Source


Vargas-Rojas M.I.,Instituto Nacional Of Enfermedades Respiratorias Ismael Cosio Villegas Iner | Solleiro-Villavicencio H.,Instituto Nacional Of Enfermedades Respiratorias Ismael Cosio Villegas Iner | Solleiro-Villavicencio H.,National Autonomous University of Mexico | Soto-Vega E.,UPAEP University | Soto-Vega E.,Laboratorio Of Investigacion
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2016

Introduction: Preeclampsia is one of the major causes of maternal and neonatal mortality. During pregnancy, the immune system must maintain the tolerance to the fetus, thus changes in the cytokine balance may result in a disturbed pregnancy. T helper cells play an important role in modulation of the immune system and are involved in this cytokine balance.Objective: Many studies have been performed to study the T cell composition in different compartments during pregnancy, although this is the first study in which T cells are evaluated in umbilical cord blood.Study design: Intracellular expression of INF-gamma, IL-17, IL-4 and forkhead foxP3 in CD4+ T cells was evaluated in umbilical blood from healthy pregnant and preeclamptic women using a flow cytometer.Results: Th2 and Treg cells levels were significantly diminished in preeclamptic compared to the healthy women, but no difference in Th1 and Th17 levels were found between both groups.Conclusions: Our data suggest that the cytokine balance is broken, encouraging the development of an exacerbated inflammatory response. Our results show that there is a shift, in the Th1/Th2, and the Th17/Treg balance, favoring skewness towards a proinflammatory status in the umbilical cord blood in preeclampsia. © 2015 Informa UK Ltd. Source

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