Gaceta medica de Mexico最新文献

Background: Mucormycosis is an infection caused by Mucorales. Management includes surgical treatment and antifungals.

Objective: To describe the surgical and medical complications associated with mucormycosis in a third-level hospital.

Material and methods: Records of patients with mucormycosis treated between 2019 and 2022 were collected.

Results: A total of 25 patients were obtained, 17 (68%) men and 8 (32%) women. Surgical complications occurred on admission in 16% and early in 4% of cases. The most frequent medical complications were soft tissue infection on admission (84%) and late sepsis (52%). Amphotericin B deoxycholate was used in all cases, finding hypokalemia in 20 (80%), hypomagnesemia in 18 (72%), and acute kidney injury in 15 (60%).

Conclusions: The most commonly performed surgery was surgical debridement on admission (76%). Surgical complications occurred mainly on admission (16%). The most frequent medical complications were soft tissue infection on admission (84%) and late sepsis (52%). Due to the high cost of the liposomal and lipid forms of amphotericin, the use of amphotericin B deoxycholate continues to persist in our setting, which leads to a high degree of renal toxicity and hydroelectrolytic alterations.

Background: Based on the challenge of training competent professionals in complex clinical environments and the fundamental role that simulation plays in the education of both physicians and bioethicists, simulation emerges as an effective and evolving method for acquiring bioethical skills and competencies.

Objective: This article proposes the implementation of bioethical scenarios through simulation as a teaching-learning method of identification, analysis and resolving bioethical dilemmas.

Material and methods: A bibliographic review was conducted on the use of simulation to develop bioethical competencies, following the framework proposed by the American Society for Bioethics and Humanities.

Results: Simulation, particularly debriefing, was found to provide an effective space for learning and developing skills in bioethical analysis and discernment. Additionally, challenges were identified in using clinical simulation to develop bioethical competencies in students.

Conclusions: The clinical simulation method facilitates the learning and development of bioethical skills and competencies in students, both in medicine and bioethics, and requires further implementations to identify areas for improvement and optimize competency acquisition.

Background: Medical education is associated with different mental disorders, a growing concern. Additionally, several barriers have been reported that hinder the use of mental health care services among physicians in training.

Objective: To identify the main barriers faced by medical students in seeking professional help and care the mental health.

Material and methods: Cross-sectional observational study of descriptive and analytical type, in medical students (n = 305), in whom the BACE (Barriers to Care Evaluation) instrument was applied and Pearson's correlation coefficient was applied.

Results: Based on mean subscale values of the instrument, the barriers from highest to lowest were: stigma (x- = 0.69, SD = 0.264), attitudinal (x- = 0.67, SD = 0.472) and structural (x- = 0.63, SD = 0.396). The characteristics most correlated with barriers included female gender, identification with gender and sexual diversity, having a mental health disorder, and exhibiting suicidal behavior (p < 0.05).

Conclusions: These findings are key in the creation of approaches to mitigate the impact these barriers have on the mental health care of medical students.

Coronary artery disease (CAD) is a chronic and multifactorial disease, considered a global health problem. Environmental and genetic factors participate in its development. Various studies, including whole genome and candidate gene studies, have suggested the participation of multiple genes in developing this disease. However, most of these studies have been conducted in Caucasian and Eastern populations. Studies conducted on the Mexican population show that Mexicans have a mixture of Caucasian, Indigenous, and African genes, this mixture varies according to the site of the Mexican Republic being analyzed. Given this, studies conducted in other populations cannot be applied to Mexicans. In 2008, at the initiative of Dr. Carlos Posadas Romero, the GEA (Genetics of Atherosclerotic Disease) project was launched, whose objective is to generate knowledge about environmental and genetic factors in patients with premature CAD (pCAD). The present review shows the participation of genetics in the development of pCAD in Mexicans, based on the results obtained in the GEA cohort.

Background: Blood transfusion and its derivatives are an essential therapeutic action in the different hospital services. Despite the strict haemovigilance carried out in blood banks, there is still a residual risk of contracting infectious diseases through blood transfusion.

Objective: To determine the seroprevalence of infectious agents in blood donors.

Material and methods: Retrospective and observational study. The detections were made in blood donors who came to the blood bank of the General Hospital Zone No. 1 of Tapachula, Chiapas, Mexico, during the period from August 2020 to December 2023.

Results: The general seroprevalence was 3.94%, with syphilis being most frequently found (1.37%), followed by brucellosis (1.17%), human immunodeficiency virus (0.55%), hepatitis C (0.34%), hepatitis B (0.19%), and Chagas disease (0.19%), with 0.10% of co-infection cases.

Conclusions: The seroprevalence of infectious agents in blood donors described in this study allows us to know an epidemiological overview of what happened in a city on the Southern border of Mexico, reaffirming syphilis as a re-emerging disease in this zone, with high prevalences of brucellosis and human immunodeficiency virus.

Background: Diabetes, which is caused by environmental and genetic factors, has a high global prevalence (10.5%). Some single nucleotide variants (SNVs) modify the activity of glucose transporters such as GLUT2, which plays a significant role in insulin secretion and glucose metabolism.

Objective: To analyze the SNVs associated with type 2 diabetes (T2D) in the Mexican population.

Material and methods: Reference databases for SNVs registered for SLC2A2 gen associated with T2DM in the Mexican population.

Results: 83 SNVs were analyzed, identifying 3 relevant variants in Mexican population associated with T2D: rs5404, rs5406 and rs5398, a pathogenic variant with RM >1.0 and p value < 0.05.

Conclusions: Detailed genetic analysis and mapping coupled with functional studies are needed to identify the mechanism by which GLUT2 variants influence diabetes development.

Background: Although tropical fruits (TF) are an important part of the diet in many regions worldwide, epidemiological data on hypersensitivity to tropical fruits (HSTF) are scarce globally.

Objectives: This study aims to determine the prevalence of HSTF in adults, identify the most common symptoms and foods associated with it, and identify factors linked to its occurrence.

Materials and methods: A structured questionnaire was administered to a sample of Mexican adults to identify symptoms associated with TF consumption. Two study groups were formed: one without HSTF and another with HSTF.

Results: A total of 930 adults participated in the study; 35 had HSTF (prevalence of 3.8%; 95%CI: 2.7%-5.2%). The kiwi (13/930, 1.4%), pineapple (8/930, 0.9%), and avocado (7/930, 0.8%) had the highest prevalence. The main symptoms caused by TF were pharyngeal tightness (15/35, 44.1%), oral itching (12/35, 34.3%), and lip itching (9/35, 25.7%). Multivariate analyses identified asthma (aOR: 3.46, p = 0.014), atopic dermatitis (aOR: 7.08, p = 0.002), and a family history of urticaria (aOR: 8.15, p < 0.001) as factors associated with HSTF.

Conclusions: This study indicates that approximately 4% of surveyed adults experience symptoms after consuming TF and identifies asthma, atopic dermatitis, and a family history of urticaria as significant factors associated with HSTF.