G. Lugo-Zamudio, L. B. Navarrete-Martínez, C. Salazar, F. G. Reyes-Rodríguez, L. Guerrero-Beltrán, D. Arellano-Álvarez
OBJECTIVE: To establish whether there is clinical improvement with the administration of chloroquine as outpatient treatment in patients suspected of COVID-19 assessed by the reduction of clinical manifestations associated with viral infection. MATERIALS AND METHODS: An experimental study was made in patients suspected of COVID-19 who were attended in the respiratory emergency service of the Hospital Juarez de Mexico from June 1st to July 30th, 2020, who received outpatient treatment with chloroquine. The patients were followed up by telephone to find out their health condition. RESULTS: Fifty patients were included, of which 36 were female. The mean age was 41.1 year;the most frequent symptoms were fever, cough and odynophagia;the most persistent symptom was cough (31 out of 50). Also, 24 patients were positive for SARS-CoV-2 and completed their treatment with chloroquine, with persistent descricough;diarrhea, dysgeusia, and symptoms such as nausea, hypogeusia and headache were documented. No patient required a second evaluation in the emergency room or hospital admissions. CONCLUSIONS: Clinical evidence suggests that chloroquine may be useful in reducing the symptoms associated with SARS-CoV-2 if it is administered in the first five days of the onset of the disease;controlled studies are required to confirm this possibility.
{"title":"Ambulatory treatment with chloroquine in patients with suspicion of COVID-19 for the reduction of symptoms associated to the infection","authors":"G. Lugo-Zamudio, L. B. Navarrete-Martínez, C. Salazar, F. G. Reyes-Rodríguez, L. Guerrero-Beltrán, D. Arellano-Álvarez","doi":"10.24245/mim.v37i3.4798","DOIUrl":"https://doi.org/10.24245/mim.v37i3.4798","url":null,"abstract":"OBJECTIVE: To establish whether there is clinical improvement with the administration of chloroquine as outpatient treatment in patients suspected of COVID-19 assessed by the reduction of clinical manifestations associated with viral infection. MATERIALS AND METHODS: An experimental study was made in patients suspected of COVID-19 who were attended in the respiratory emergency service of the Hospital Juarez de Mexico from June 1st to July 30th, 2020, who received outpatient treatment with chloroquine. The patients were followed up by telephone to find out their health condition. RESULTS: Fifty patients were included, of which 36 were female. The mean age was 41.1 year;the most frequent symptoms were fever, cough and odynophagia;the most persistent symptom was cough (31 out of 50). Also, 24 patients were positive for SARS-CoV-2 and completed their treatment with chloroquine, with persistent descricough;diarrhea, dysgeusia, and symptoms such as nausea, hypogeusia and headache were documented. No patient required a second evaluation in the emergency room or hospital admissions. CONCLUSIONS: Clinical evidence suggests that chloroquine may be useful in reducing the symptoms associated with SARS-CoV-2 if it is administered in the first five days of the onset of the disease;controlled studies are required to confirm this possibility.","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47691927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The evolution of the response of anti-SARSCoV-2 antibodies in infected subjects","authors":"C. Ximénez-García, M. Ramiro","doi":"10.24245/mim.v37i3.5756","DOIUrl":"https://doi.org/10.24245/mim.v37i3.5756","url":null,"abstract":"","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44616916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: The SARS-CoV-2 outbreak is a significant challenge to the healthcare system in Mexico;some regions are already struggling to fight the virus. OBJECTIVE: To identify comorbidities of adult patients with COVID-19 treated in hospitals in Jalisco and to assess their associations with the risk of death. MATERIALS AND METHODS: An observational, analytical, retrospective study in which we obtained data of confirmed COVID-19 cases and their characteristics from epidemiological surveillance system of the Mexican Health Secretary through Feb 27, 2020 to November 30, 2020. RESULTS: We included 5590 patients with a mean age of 58 years, 62% were men;overall mortality was 38%. The most common concomitant conditions were hypertension, diabetes and obesity. The multivariate analysis found that chronic kidney disease (OR = 2.71), obesity (OR = 1.24), chronic obstructive pulmonary disease (OR = 1.21), diabetes mellitus (OR = 1.15) and hypertension (OR = 1.13) were independent risk factors associated with mortality. CONCLUSIONS: The risk of dying was clearly higher in individuals with comorbidities, particularly among people with chronic kidney disease or obesity.
{"title":"Epidemiologic factors associated with mortality among hospitalized adult patients with COVID-19 in the state of Jalisco, Mexico","authors":"C. A. Andrade-Castellanos, L. Colunga-Lozano","doi":"10.24245/mim.v37i3.5107","DOIUrl":"https://doi.org/10.24245/mim.v37i3.5107","url":null,"abstract":"BACKGROUND: The SARS-CoV-2 outbreak is a significant challenge to the healthcare system in Mexico;some regions are already struggling to fight the virus. OBJECTIVE: To identify comorbidities of adult patients with COVID-19 treated in hospitals in Jalisco and to assess their associations with the risk of death. MATERIALS AND METHODS: An observational, analytical, retrospective study in which we obtained data of confirmed COVID-19 cases and their characteristics from epidemiological surveillance system of the Mexican Health Secretary through Feb 27, 2020 to November 30, 2020. RESULTS: We included 5590 patients with a mean age of 58 years, 62% were men;overall mortality was 38%. The most common concomitant conditions were hypertension, diabetes and obesity. The multivariate analysis found that chronic kidney disease (OR = 2.71), obesity (OR = 1.24), chronic obstructive pulmonary disease (OR = 1.21), diabetes mellitus (OR = 1.15) and hypertension (OR = 1.13) were independent risk factors associated with mortality. CONCLUSIONS: The risk of dying was clearly higher in individuals with comorbidities, particularly among people with chronic kidney disease or obesity.","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68825753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Response to the letter to the coeditors","authors":"A. Villagómez-Ortiz, J. E. Cruz-Aranda","doi":"10.24245/mim.v37i3.5759","DOIUrl":"https://doi.org/10.24245/mim.v37i3.5759","url":null,"abstract":"","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68825800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"From 2019-nCoV to COVID-19, characterizing the disease","authors":"L. Carpio-Orantes","doi":"10.24245/mim.v36i3.4009","DOIUrl":"https://doi.org/10.24245/mim.v36i3.4009","url":null,"abstract":"","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44467820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. H. Medina-Chávez, J. Colin-Luna, P. Mendoza-Martínez, D. L. Santoyo-Gómez, J. E. Cruz-Aranda
The current COVID-19 pandemic, caused by the SARS-CoV-2, has reached Mexico and has brought serious consequences for the general population;a large number of sick people and a considerable number of deaths Every day, a large number of academic writings are produced that bring case reports and treatment proposals;however, despite these great efforts, from the experience acquired in other countries, the information is still uncertain regarding any treatment that is effective to stop the advance of the pandemic From these reports we have very valuable data, one of the most relevant is that the most affected people and in greater magnitude in terms of severity are older adults, and even more so if these people have comorbidity with chronic diseases of higher prevalence in our country: hypertension, diabetes mellitus and obesity, conditions that are particularly frequent among older Mexican adults It is known that this age group has its own changes of aging and atypical forms of manifestation of the disease, as well as in the case of hospitalization, they require finer and constant care for the recovery of health;so, a review and consensus of existing information to offer these recommendations was made for the comprehensive care of older adults with COVID-19
{"title":"Recommendations for the integral treatment of older adults with COVID-19","authors":"J. H. Medina-Chávez, J. Colin-Luna, P. Mendoza-Martínez, D. L. Santoyo-Gómez, J. E. Cruz-Aranda","doi":"10.24245/mim.v36i3.4215","DOIUrl":"https://doi.org/10.24245/mim.v36i3.4215","url":null,"abstract":"The current COVID-19 pandemic, caused by the SARS-CoV-2, has reached Mexico and has brought serious consequences for the general population;a large number of sick people and a considerable number of deaths Every day, a large number of academic writings are produced that bring case reports and treatment proposals;however, despite these great efforts, from the experience acquired in other countries, the information is still uncertain regarding any treatment that is effective to stop the advance of the pandemic From these reports we have very valuable data, one of the most relevant is that the most affected people and in greater magnitude in terms of severity are older adults, and even more so if these people have comorbidity with chronic diseases of higher prevalence in our country: hypertension, diabetes mellitus and obesity, conditions that are particularly frequent among older Mexican adults It is known that this age group has its own changes of aging and atypical forms of manifestation of the disease, as well as in the case of hospitalization, they require finer and constant care for the recovery of health;so, a review and consensus of existing information to offer these recommendations was made for the comprehensive care of older adults with COVID-19","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43107675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Blanca Estela Herrera-Morales, Juan Lara-Cruz, Alfredo Arellano-Ramírez
Pregnancy is a state that imposes a real challenge for the maternal cardiovascular system. There is a cardiac remodeling, which along with an increase in myocardial mass, in left ventricular size and decreased myocardial contractility aggravated by changes in pregnancy, can condition acute heart failure during the peripartum period. Peripartum cardiomyopathy is when the systolic function of the left ventricle and the symptoms of heart failure occur in the last month of pregnancy and in the five months after delivery with an incidence ranging from 1/1300 to 1/15,000 pregnancies. This paper reports the case of a 26-year-old female patient, who had a history of congenital cataract, with normal pregnancy and eutocic delivery; during the puerperium patient showed dyspnea, hypoperfusion data and pulmonary and cardiac ultrasonographic evaluation of peripartum dilated cardiomyopathy, being transferred at a third level, where despite intensive multidisciplinary treatment, the patient died. Peripartum cardiomyopathy is an undervalued disease that has a high maternal and perinatal mortality; however, a timely detection can improve treatment and prognosis. The purpose of this case report is to demonstrate the importance of early detection of a poorly diagnosed entity, such as peripartum cardiomyopathy.
{"title":"Miocardiopatía periparto: afección subvalorada","authors":"Blanca Estela Herrera-Morales, Juan Lara-Cruz, Alfredo Arellano-Ramírez","doi":"10.24245/mim.v35i5.2661","DOIUrl":"https://doi.org/10.24245/mim.v35i5.2661","url":null,"abstract":"Pregnancy is a state that imposes a real challenge for the maternal cardiovascular system. There is a cardiac remodeling, which along with an increase in myocardial mass, in left ventricular size and decreased myocardial contractility aggravated by changes in pregnancy, can condition acute heart failure during the peripartum period. Peripartum cardiomyopathy is when the systolic function of the left ventricle and the symptoms of heart failure occur in the last month of pregnancy and in the five months after delivery with an incidence ranging from 1/1300 to 1/15,000 pregnancies. This paper reports the case of a 26-year-old female patient, who had a history of congenital cataract, with normal pregnancy and eutocic delivery; during the puerperium patient showed dyspnea, hypoperfusion data and pulmonary and cardiac ultrasonographic evaluation of peripartum dilated cardiomyopathy, being transferred at a third level, where despite intensive multidisciplinary treatment, the patient died. Peripartum cardiomyopathy is an undervalued disease that has a high maternal and perinatal mortality; however, a timely detection can improve treatment and prognosis. The purpose of this case report is to demonstrate the importance of early detection of a poorly diagnosed entity, such as peripartum cardiomyopathy.","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42493488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
José Carlos os Herrera-García, Ek Ixel Arellano-Montellano, Luis Enrique Jaramillo-Arellano, Andrea Espinoza-Arellano
{"title":"Administración exitosa de omalizumab en pacientes con síndrome de sobreposición asma-EPOC en un hospital universitario de Puebla","authors":"José Carlos os Herrera-García, Ek Ixel Arellano-Montellano, Luis Enrique Jaramillo-Arellano, Andrea Espinoza-Arellano","doi":"10.24245/mim.v35i2.2090","DOIUrl":"https://doi.org/10.24245/mim.v35i2.2090","url":null,"abstract":"","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48846125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. A. Choreño-Parra, Martha Carnalla-Cortés, Parménides Guadarrama-Ortíz
Vascular cerebral ischemic disease constitutes a leading cause of morbidity and mortality as well as of disability worldwide. Its incidence has risen in developing countries in which it is estimated that two thirds of all cases occur annually. Risk factors for ischemic stroke are related with obesity and sedentary lifestyle; nonetheless, hypertension is the main factor involved in the occurrence of the disease. The prognosis depends directly on the time since the onset of the symptoms and the establishment of an optimal treatment. In recent years, important advances in the medical and interventionist treatment of ischemic stroke has been made which has resulted in a lower rate of deaths and an improvement in functionality at the short term; however, some of the therapeutic options are not available in most of the hospital centers and many patients are not eligible for endovascular procedures as they attend late or there is a delay in the identification and diagnosis of the disease. Therefore, it is of major importance that physicians and specialists taking care of patients with neurological impairment know diagnostic and therapeutic tools useful in the approach and management of ischemic stroke to improve the prognosis of the affected individuals. In this article we review the clinical approach to patients with vascular cerebral ischemic disease and make an update of the treatment with a focus on the practice of evidence-based medicine.
{"title":"Enfermedad vascular cerebral isquémica: revisión extensa de la bibliografía para el médico de primer contacto","authors":"J. A. Choreño-Parra, Martha Carnalla-Cortés, Parménides Guadarrama-Ortíz","doi":"10.24245/mim.v35i1.2212","DOIUrl":"https://doi.org/10.24245/mim.v35i1.2212","url":null,"abstract":"Vascular cerebral ischemic disease constitutes a leading cause of morbidity and mortality as well as of disability worldwide. Its incidence has risen in developing countries in which it is estimated that two thirds of all cases occur annually. Risk factors for ischemic stroke are related with obesity and sedentary lifestyle; nonetheless, hypertension is the main factor involved in the occurrence of the disease. The prognosis depends directly on the time since the onset of the symptoms and the establishment of an optimal treatment. In recent years, important advances in the medical and interventionist treatment of ischemic stroke has been made which has resulted in a lower rate of deaths and an improvement in functionality at the short term; however, some of the therapeutic options are not available in most of the hospital centers and many patients are not eligible for endovascular procedures as they attend late or there is a delay in the identification and diagnosis of the disease. Therefore, it is of major importance that physicians and specialists taking care of patients with neurological impairment know diagnostic and therapeutic tools useful in the approach and management of ischemic stroke to improve the prognosis of the affected individuals. In this article we review the clinical approach to patients with vascular cerebral ischemic disease and make an update of the treatment with a focus on the practice of evidence-based medicine.","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45406182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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