Hip fracture is the most serious consequence of osteoporosis. It carries a high mortality and increases the risk of dependence. Orthogeriatric units have been shown to reduce mortality, increase quality indicators, and reduce costs and length of stay. There is little evidence about orthogeriatric units in Latin America and particularly in Mexico. In Mexico we have isolated efforts in some hospitals but we still need a lot for making this a generalized practice in the care of elderly with hip fracture. Other countries have developed these units, with multidisciplinary interventions and very good results. This is the case of England, Australia and Spain. This model could serve us as an example to traumatologists and geriatricians to establish alliances, clinical and research, in order to review the current status of the hip fracture in Mexico, and eventually that orthogeriatric units become a reality throughout our borders, so that orthogeriatics in Mexico becomes a reality.
{"title":"Ortogeriatría en México: un futuro posible","authors":"J. C. Viveros-García","doi":"10.24245/mim.v35i1.2405","DOIUrl":"https://doi.org/10.24245/mim.v35i1.2405","url":null,"abstract":"Hip fracture is the most serious consequence of osteoporosis. It carries a high mortality and increases the risk of dependence. Orthogeriatric units have been shown to reduce mortality, increase quality indicators, and reduce costs and length of stay. There is little evidence about orthogeriatric units in Latin America and particularly in Mexico. In Mexico we have isolated efforts in some hospitals but we still need a lot for making this a generalized practice in the care of elderly with hip fracture. Other countries have developed these units, with multidisciplinary interventions and very good results. This is the case of England, Australia and Spain. This model could serve us as an example to traumatologists and geriatricians to establish alliances, clinical and research, in order to review the current status of the hip fracture in Mexico, and eventually that orthogeriatric units become a reality throughout our borders, so that orthogeriatics in Mexico becomes a reality.","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":"44846465","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}
Agents with vasodilatory properties are a heterogeneous group of drugs that have been part of the arsenal of the cardiologist for decades, and although their use is broad, it is not optimal. The term has always been ambiguous and prone to confusion with respect to the drugs that should be included. This paper makes a concise review of the current state of these drugs including the new agents developed, emphasizing their precise therapeutic uses demonstrated by evidence, its limitations and contraindications from a practical perspective for the clinical cardiologist. A structured, non-systematic review of the literature was performed by searching the PubMed database with the MeSH term: vasodilator agent. Articles in Spanish and English were included. A narrative review was written, oriented to a clinical perspective, which describes the current role of vasodilators in contemporary cardiovascular medicine. Vasodilators have an active and determining role in modern cardiology and are an essential tool in various clinical scenarios.
{"title":"Vasodilatadores: re-visión de un viejo armamento","authors":"Juan Antonio Vega-Rosales","doi":"10.24245/mim.v35i1.2275","DOIUrl":"https://doi.org/10.24245/mim.v35i1.2275","url":null,"abstract":"Agents with vasodilatory properties are a heterogeneous group of drugs that have been part of the arsenal of the cardiologist for decades, and although their use is broad, it is not optimal. The term has always been ambiguous and prone to confusion with respect to the drugs that should be included. This paper makes a concise review of the current state of these drugs including the new agents developed, emphasizing their precise therapeutic uses demonstrated by evidence, its limitations and contraindications from a practical perspective for the clinical cardiologist. A structured, non-systematic review of the literature was performed by searching the PubMed database with the MeSH term: vasodilator agent. Articles in Spanish and English were included. A narrative review was written, oriented to a clinical perspective, which describes the current role of vasodilators in contemporary cardiovascular medicine. Vasodilators have an active and determining role in modern cardiology and are an essential tool in various clinical scenarios.","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":"45342848","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}
A. Izaguirre-González, Aleida Gisselle Tejada-Valladares, Jaime Jahaziel Cordón-Fajardo, Karla Auxiliadora Matamoros-Vásquez, Pablo David Toro-Amaya
Acute negative pressure pulmonary edema is a form of potentially serious noncardiogenic pulmonary edema that usually occurs in young healthy subjects capable of generating elevated negative intrathoracic pressures by vigorously inhaling a blocked upper airway. In adults, the most frequent cause is postextubation laryngospasm in the immediate postoperative period. It can present in 0.05-0.1% of healthy patients under general anesthesia. This paper reports the case of a 24-year-old male with no pathological history, who was presented to the general surgery service of the Hospital Regional Santa Teresa, Comayagua, Honduras, to perform open cholecystectomy for chronic cholecystitis. The surgical procedure was performed without complications; 15 minutes of the immediate postoperative period, post-extubation, patient presented clinical manifestations of sudden dyspnea, cyanosis and hemoptysis. On physical examination were found hypoxemia, tachypnea (BR = 40 bfm) and bilateral craniocereus on pulmonary auscultation. Complementary tests and image were performed and NPPE was diagnosed. Treatment with oxygen therapy, corticosteroids and diuretics was started, during 72 hours evolving favorably. The clinical findings of the acute negative pressure pulmonary edema can be confused with a wide range of clinical entities, so it is extremely important to carry out an adequate approach and differential diagnosis. The introduction of appropriate therapeutic measures offers a favorable prognosis and generally a wide decrease in mortality.
{"title":"Edema agudo de pulmón por presión negativa secundario a laringoespasmo","authors":"A. Izaguirre-González, Aleida Gisselle Tejada-Valladares, Jaime Jahaziel Cordón-Fajardo, Karla Auxiliadora Matamoros-Vásquez, Pablo David Toro-Amaya","doi":"10.24245/mim.v35i1.2002","DOIUrl":"https://doi.org/10.24245/mim.v35i1.2002","url":null,"abstract":"Acute negative pressure pulmonary edema is a form of potentially serious noncardiogenic pulmonary edema that usually occurs in young healthy subjects capable of generating elevated negative intrathoracic pressures by vigorously inhaling a blocked upper airway. In adults, the most frequent cause is postextubation laryngospasm in the immediate postoperative period. It can present in 0.05-0.1% of healthy patients under general anesthesia. This paper reports the case of a 24-year-old male with no pathological history, who was presented to the general surgery service of the Hospital Regional Santa Teresa, Comayagua, Honduras, to perform open cholecystectomy for chronic cholecystitis. The surgical procedure was performed without complications; 15 minutes of the immediate postoperative period, post-extubation, patient presented clinical manifestations of sudden dyspnea, cyanosis and hemoptysis. On physical examination were found hypoxemia, tachypnea (BR = 40 bfm) and bilateral craniocereus on pulmonary auscultation. Complementary tests and image were performed and NPPE was diagnosed. Treatment with oxygen therapy, corticosteroids and diuretics was started, during 72 hours evolving favorably. The clinical findings of the acute negative pressure pulmonary edema can be confused with a wide range of clinical entities, so it is extremely important to carry out an adequate approach and differential diagnosis. The introduction of appropriate therapeutic measures offers a favorable prognosis and generally a wide decrease in mortality.","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":"42202699","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}
Carlos d´Hyver de las Deses, María del Pilar Alonso-Reyes, Alejandro Herrera-Landero, J. Aldrete-Velasco
{"title":"Envejecimiento exitoso. Una visión entre médicos","authors":"Carlos d´Hyver de las Deses, María del Pilar Alonso-Reyes, Alejandro Herrera-Landero, J. Aldrete-Velasco","doi":"10.24245/mim.v35i1.2451","DOIUrl":"https://doi.org/10.24245/mim.v35i1.2451","url":null,"abstract":"","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":"44456961","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}
Miriam Marcela Hernández-Sánchez, José Juan Lozano-Nuevo, J. A. Suárez-Cuenca, E. Mendoza-Portillo, Fernando Iván Vergara-Orduña, Elizabeth Palacios-Pérez, F. González-Moreno, Jonathan Villanueva-Domínguez
{"title":"Índice leuco-glucémico asociado con complicaciones en isquemia cerebral aterotrombótica","authors":"Miriam Marcela Hernández-Sánchez, José Juan Lozano-Nuevo, J. A. Suárez-Cuenca, E. Mendoza-Portillo, Fernando Iván Vergara-Orduña, Elizabeth Palacios-Pérez, F. González-Moreno, Jonathan Villanueva-Domínguez","doi":"10.24245/mim.v35i1.2180","DOIUrl":"https://doi.org/10.24245/mim.v35i1.2180","url":null,"abstract":"","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":"45735562","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}
Loel Ayala-Castro, Kelly A. Yuncar-Rojas, Alonso Soto, Gino Patrón-Ordóñez
An important complication that occurs between 5 and 10% of patients with cancer is spinal cord compression syndrome that represents an oncological emergency. There is a relationship between lung cancer and spinal cord compression syndrome, because cancer can infiltrate the spine. However, it is not common to occur as an initial manifestation. We report the case of a 40-year-old patient diagnosed with pulmonary adenocarcinoma who had paraplegia as an initial manifestation.
{"title":"Síndrome de compresión medular como manifestación de un carcinoma de células no pequeñas","authors":"Loel Ayala-Castro, Kelly A. Yuncar-Rojas, Alonso Soto, Gino Patrón-Ordóñez","doi":"10.24245/mim.v35i1.1987","DOIUrl":"https://doi.org/10.24245/mim.v35i1.1987","url":null,"abstract":"An important complication that occurs between 5 and 10% of patients with cancer is spinal cord compression syndrome that represents an oncological emergency. There is a relationship between lung cancer and spinal cord compression syndrome, because cancer can infiltrate the spine. However, it is not common to occur as an initial manifestation. We report the case of a 40-year-old patient diagnosed with pulmonary adenocarcinoma who had paraplegia as an initial manifestation.","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":"43424632","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}
M. D. J. Sánchez-Zúñiga, R. Carrillo-Esper, M. Garnica-Escamilla, Nikolette Iren Medveczky-Ordoñes, D. M. Carrillo-Córdova
OBJECTIVE: To identify if there are changes in the stratification of acute respiratory distress syndrome severity at hospitalization and 24 hours later. MATERIAL AND METHOD: A retrospective observational study was done describing patients studied over a 4-month period during 2017, who met Berlin criteria for acute respiratory distress syndrome (ARDS) of any origin and who re-stratified at 24 hours, with the same scale. The data of inflammatory biomarkers and ventilatory mechanics were collected. RESULTS: There were included 17 patients, from which 11 patients (64%) died and 6 (35%) were discharged to home. The initial stratification of patients according to the severity of the hypoxemia (PaO2/FiO2) showed 2 (11%) without ARDS, 3 (17%) mild, 10 (58%) moderate, and 2 (11%) severe. At 24 hours after conventional treatment, gravity stratification (PaO2/FiO2) showed: 9 (52%) without ARDS, 6 (35.2%) with mild hypoxemia, in one (5.8%) moderate and in one (5.8%) severe. CONCLUSIONS: It is necessary to stratify at the time of admission and at 24 hours the severity of the ARDS, although no difference was shown in the pattern of inflammatory response through the measurement of serum markers of usual clinical use.
{"title":"Estratificación de la gravedad del síndrome de insuficiencia respiratoria aguda a las 24 horas de su diagnóstico","authors":"M. D. J. Sánchez-Zúñiga, R. Carrillo-Esper, M. Garnica-Escamilla, Nikolette Iren Medveczky-Ordoñes, D. M. Carrillo-Córdova","doi":"10.24245/mim.v35i1.2120","DOIUrl":"https://doi.org/10.24245/mim.v35i1.2120","url":null,"abstract":"OBJECTIVE: To identify if there are changes in the stratification of acute respiratory distress syndrome severity at hospitalization and 24 hours later. MATERIAL AND METHOD: A retrospective observational study was done describing patients studied over a 4-month period during 2017, who met Berlin criteria for acute respiratory distress syndrome (ARDS) of any origin and who re-stratified at 24 hours, with the same scale. The data of inflammatory biomarkers and ventilatory mechanics were collected. RESULTS: There were included 17 patients, from which 11 patients (64%) died and 6 (35%) were discharged to home. The initial stratification of patients according to the severity of the hypoxemia (PaO2/FiO2) showed 2 (11%) without ARDS, 3 (17%) mild, 10 (58%) moderate, and 2 (11%) severe. At 24 hours after conventional treatment, gravity stratification (PaO2/FiO2) showed: 9 (52%) without ARDS, 6 (35.2%) with mild hypoxemia, in one (5.8%) moderate and in one (5.8%) severe. CONCLUSIONS: It is necessary to stratify at the time of admission and at 24 hours the severity of the ARDS, although no difference was shown in the pattern of inflammatory response through the measurement of serum markers of usual clinical use.","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":"47663389","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}
M. González-Ortiz, E. Alexanderson-Rosas, M. Castro-Martínez, M. Duarte-Vega, Juan C. Garnica-Cuéllar, Eduardo Márquez-Rodríguez, E. Martínez-Abundis, L. E. Morales-Buenrostro, Enrique C Morales-Villegas, Al Servín-Caamaño
Three diseases with a high prevalence in the adult population, especially in Mexico, are type 2 diabetes mellitus, arterial hypertension and hyperuricemia-gout; they share among them pathophysiological characteristics that favor their appearance as a group in the patients and whose treatments are frequently in the same way, the above-mentioned has allowed that in the following lines can be described such diseases as the three unfortunate enemies of the health of the population.
{"title":"Tres desafortunados enemigos de la salud de la población","authors":"M. González-Ortiz, E. Alexanderson-Rosas, M. Castro-Martínez, M. Duarte-Vega, Juan C. Garnica-Cuéllar, Eduardo Márquez-Rodríguez, E. Martínez-Abundis, L. E. Morales-Buenrostro, Enrique C Morales-Villegas, Al Servín-Caamaño","doi":"10.24245/mim.v35i4.3251","DOIUrl":"https://doi.org/10.24245/mim.v35i4.3251","url":null,"abstract":"Three diseases with a high prevalence in the adult population, especially in Mexico, are type 2 diabetes mellitus, arterial hypertension and hyperuricemia-gout; they share among them pathophysiological characteristics that favor their appearance as a group in the patients and whose treatments are frequently in the same way, the above-mentioned has allowed that in the following lines can be described such diseases as the three unfortunate enemies of the health of the population.","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68825739","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}
Miguel Ángel Nares-Torices, Armando González-Martínez, Francisco Agustín Martínez-Ayuso, Manuel Orlando Morales-Fernández
{"title":"Hipoglucemia: el tiempo es cerebro. ¿Qué estamos haciendo mal?","authors":"Miguel Ángel Nares-Torices, Armando González-Martínez, Francisco Agustín Martínez-Ayuso, Manuel Orlando Morales-Fernández","doi":"10.24245/mim.v34i6.2040","DOIUrl":"https://doi.org/10.24245/mim.v34i6.2040","url":null,"abstract":"","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46308650","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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