Mexico City, Mexico
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Lopez-Valdes J.C.,ISSSTE | Lopez-Valdes J.C.,Autonomous University of Tamaulipas | Escarcega-Servin R.,La Salle University at Cuauhtémoc
Gaceta Medica de Mexico | Year: 2016

Nowadays appendicitis is the leading cause of acute surgical abdomen. It occurs mainly between the first and third decade of life and is very rare in the neonatal period. The pathophysiology and clinical manifestations differ from the typical signs and symptoms, making it difficult to diagnose, which is in mostly cases at the time of surgery, and 74[%] of them appear with perforation and peritonitis. During the first day there were no complications; however, antibiotic therapy was initiated due to the risk of sepsis. On the next day there were changes in vital signs, fresh blood by nasogastric probe, acute abdomen data, cyanosis, and decreased tone. Case description: A newborn male of 34.3 weeks gestation using the Capurro method, Apgar score 8/9, obtained by emergency caesarean section, in which the maternal abdominal cavity was with copious purulent material and perforated appendix with generalized peritonitis. Surgery was determinate, where they found necrotic ileum and appendix with five perforations in total, so resection and ileostomy was performed. Intubation and dopamine support were required, but removed within a short time, beginning oral alimentation. © 2016, Academia Nacional de Medicina. All rights reserved.

Diaz-Olguin L.,ISSSTE | Coral-Vazquez R.M.,Institute Seguridad Y Servicios Sociales Of Los Trabajadores Del Estado | Canto-Cetina T.,National Polytechnic Institute of Mexico | Ramirez Regalado B.,ISSSTE | And 3 more authors.
Disease Markers | Year: 2011

Preeclampsia is a specific disease of pregnancy and believed to have a genetic component. The aim of this study was to investigate if three polymorphisms in eNOS or their haplotypes are associated with preeclampsia in Maya mestizo women. A case-control study was performed where 127 preeclamptic patients and 263 controls were included. Genotyped and haplotypes for the -768T→C, intron 4 variants, Glu298Asp of eNOS were determined by PCR and real-time PCR allelic discrimination. Logistic regression analysis with adjustment for age and body mass index (BMI) was used to test for associations between genotype and preeclampsia under recessive, codominant and dominant models. Pairwise linkage disequilibrium between single nucleotide polymorphisms was calculated by direct correlation r^{2}, and haplotype analysis was conducted. Women homozygous for the Asp298 allele showed an association of preeclampsia. In addition, analysis of the haplotype frequencies revealed that the -786C-4b-Asp298 haplotype was significantly more frequent in preeclamptic patients than in controls (0.143 vs. 0.041, respectively; OR =3.01; 95% CI = 1.74-5.23; P =2.9 × 10^{-4}). Despite the Asp298 genotype in a recessive model associated with the presence of preeclampsia in Maya mestizo women, we believe that in this population the -786C-4b-Asp298 haplotype is a better genetic marker. © 2011 - IOS Press and the authors. All rights reserved.

Cruz Lopez J.C.,ISSSTE | Medina-Santillan R.,National Polytechnic Institute of Mexico | Castillo-Hernandez C.,National Polytechnic Institute of Mexico
Oral Oncology | Year: 2013

Background: Many studies have shown gemcitabine and cisplatin are radiosensitizers. Concurrent chemoradiation seems to be an efficient approach for treatment of advanced head and neck cancer (HNC), but toxicity is significant. Objective: To evaluate safety and explore efficacy of alternating chemotherapy with gemcitabine and cisplatin concurrent with radiotherapy in patients with advanced non-metastatic HNC. Patients and Methods: Twenty-eight patients diagnosed with advanced Squamous Cell Carcinomas of the Head and Neck (SCCHN) in stages III (28%), IVa (36%), and IVb (36%) were treated with gemcitabine: 100 mg/m2 alternating with cisplatin: 50 mg/m 2 concurrent with radiotherapy at doses of 2 Gy/day until completing 70 Gy. While awaiting for concurrent treatment, eleven patients received induction chemotherapy with cisplatin: 100 mg/m2 and 5-FU: 1000 mg/m2. Toxicity, especially in relation to mucositis, xerostomy, dysphagia, leucopenia and radiodermitis was evaluated. Results: 5-year progression-free survival was 27.8 ± 17.2% (CI-95: 0-61.5) and overall survival was 55.9 ± 11% (CI: 34.4-77.5). Overall response rate was 93%; complete response was 64.3% and partial response was 28.6%. Extensive surgery for primary site was avoided in 19 patients (70.4%). Grade 3-4 adverse events were mucositis (46.4%), leucopenia (14.2%), dysphagia (25%), xerostomy (10.7%) and radiodermitis (3.6%). Response rates and toxicity were not significantly different among those patients with and without induction chemotherapy, but survival was higher in patients receiving induction. Conclusions: Gemcitabine alternating with cisplatin concurrent with radiotherapy is an active and safe treatment that deserves further study. © 2012 Elsevier Ltd. All rights reserved.

Garcia-Alcala H.,UPAEP University | Meaney-Mendiolea E.,ISSSTE | Vargas-Ayala G.,Nivel II del Sistema Nacional de Investigadores CONACyT | Vargas-Ayala G.,Colegio de Mexico | And 5 more authors.
Medicina Interna de Mexico | Year: 2011

Diabetes mellitus is a chronic disease characterized, among other cardiometabolic anomalies, by hyperglycemia and the development of micro and macrovascular outcomes in the long range. Treatment of Diabetes mellitus has to reduce fast and postprandial glycemia to near to normal values in order to diminish the frecuency and progression of micro and macrovascular complications. This paper reviews the mechanisms of carbohydrate intestinal absorption, and it is discussed the role of several hypoglucemic and antidiabetic drugs, mainly acarbose, an inhibitor of α-glucosidades, which has proved to reverse glucose intolerance and to delay the development of DM, reducing significatively both, fasting and postprandial glycemia, as well as improving insulin resistance, independently of age and gender. It is concluded that acarbose is among the first choice drugs used in the management of glucose intolerance and in the prevention of Diabetes mellitus, as well as one of the main drugs, used in monotherapy or in combination with other pharmacology agents, in the treatment of the established disease.

Roman-Guzman E.,ISSEMYM | Ruiz-Mercado H.,Hospital Regional Dr Valentin Gomez Farias | Quero-Sandoval F.,ISSEMYM | Nolasco-De La Rosa A.L.,ISSEMYM | And 4 more authors.
Revista Mexicana de Angiologia | Year: 2014

Introduction. Deep vein thrombosis of the lower limbs, often coupled with anticoagulant management, surgery or interruption of the vena cava, to prevent associated complications such as; pulmonary embolism and post-thrombotic syndrome, should be taken into account possible vein anatomical variants of the lower limbs. Objective. The present study determinate that venous anatomical variant that exist in a group of patients. Material and methods. A retrospective cohort study (2011-2013) was conduced in 890 clinical and radiological records of venography to detect type of femoro-popliteal vein anatomical variants. The study only patients whith normal renal function and creatinine clearance. In all patients was used non ionic contrast (60-70 mL iopamidol 300 g/dL). Excluding patients with acute venous thrombosis and post-thrombotic syndrome. Results. Included 74 patients (84 cases) of 890 records reviewed with inclusion criteria. The common age was 47.1 years old ± 5 years, 55 women (74%), 19 male (26%). Anatomic variations: femoral unilateral in 54 patient (73%), femoral bilateral in 10 patient (13.5%), duplication of popliteal vein in 10 patient (13.5%), the most frequent duplication was the left femoral vein in 44 cases (52%). Conclusions. In the present study found 8.3% incidence, comparable only to the series of Francois (France) which was 12%. We believe that de problem exist and its detection is important to prevent complications from diagnosis and not undesirable treatment.

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