Revista medica del Instituto Mexicano del Seguro Social

Publisher: Instituto Mexicano del Seguro Social

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Website Revista medica del Instituto Mexicano del Seguro Social website
Other titles Revista médica, Revista médica
ISSN 0443-5117
OCLC 10512384
Material type Government publication, National government publication, Periodical
Document type Journal / Magazine / Newspaper

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Squamous carcinoma of conjuctive (SCC) is a rare tumour with different geographic frequency. The ethiology is multifactorial, and included high exposition to UV and also systematic infections (HPV and HIV). Those tumours have low potential of malignity, but occasionally this type of cancer is capable to provoke local recidive and distant metastasis and finally the death of patients. The aim of this work was to investigate the antitumoral response, the tolerable and safe doses of cysplatin preparation in three patients with HIV with recurrent SCC by subconjuctival and topical administration after conservative surgery. Methods: The patients were treated with cysplatin preparation. The treatment was about 3 months in 6 cycles. The patients were clinical follow since the last administration until update. Results: The evolution was favorable. The patients preserved the eyes and their vision without SCC recidive. One patient died about 2 years after he finalized the treatment with conservative vision and without tumoral activity and the cause was HIV infection. Conclusion: Treatment with adjuvant chemotherapy to surgery subconjunctival is effective and tolerable in the population of patients treated.
    Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):564-8.
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    ABSTRACT: Background: The relevance of biliary tract injury patients is not only related to diagnosis and treatment but also to follow-up for the possibility of late complications and medical and legal aspects. Hepatobiliary scintigraphy has played a principal roll in diagnosis of many hepatobiliary diseases. Methods: We carried out a descriptive and retrospective study. Included were all patients with biliary tract injuries who underwent biliary reconstruction and liver biopsy. Clinical, laboratory exams and hepatobiliary scintigraphy follow-up was done. Results: From January 2001 to december 2009 one hundred patients, sixty-five women and thirty-five men were registered. According to Strasberg´s classification we had 13 % type E1, 17 % type E2, 38 % type E3 and 32 % type E4. All of them underwent biliary tract reconstruction, eighty-four Hepp-Couinaud type and sixteen conventional jejunum-hepatic anastomosis (Roux-Y). Liver biopsy demonstrated twelve patients with inflammation, forty-nine with cholestasis, nineteen with ductular proliferation and nineteen with fibrosis. When we compare pathologic results of liver biopsy with pre and postoperatively hepatobiliary scintigraphy we found significance in those patients with cholestasis and ductular proliferation in hepatobiliary scintigraphy elimination step, but none in those with inflamation and fibrosis. Conclusions: Hepatobiliary scintigraphy is an adequate study to the follow-up of patients who underwent hepatobiliary reconstruction been more significative in patients with cholestasis and ductular proliferation.
    Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):538-45.
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    ABSTRACT: Background: To associated mental health factors with tobacco-smoking in the last month in scholastic adolescents. Methods: An analytic transversal study with 1134 students in the first year of senior studies in a government preparatory school. Ten mental health factors were evaluated: self-esteem, impulsiveness, depressive symptoms, suicide ideation, disordered eating, recreation, locus of control, relationship with father, relationship with mother and stress. Results: We found mental health factors differences between men and women. In the risk analysis, the factors which associated with tobacco smoking in men were high self-esteem, impulsiveness, age and tobacco-smoking in friends. For the women suicide ideation, impulsiveness disordered eating, age and tobacco-smoking in friends and brothers. After the logistic regression were associated impulsiveness and tobacco-smoking in friends for both, high self-esteem and age for men, and tobacco-smoking in brothers for women. Conclusions: Mental health factors are different for men and women. However, all of them are a reference that tobacco-smoking is associated with the inner world of teens that are meaning differently for men and women.
    Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):570-7.
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    ABSTRACT: Cardiopulmonary resuscitation of newborns with perinatal hypoxia faces serious ethical, moral, medical and legal problems, particularly in rural areas. Ethical and moral issues have to do with the medical-parents relationship; with values, preferences and priorities of each of these groups; and with the scarce resources situation. Medical-technical problems are related to asphyxia complications, and their prognostic and therapeutic implications. Legal considerations arising from the fact of killing or letting die. In this article is analyzed the real case of a neonate with severe perinatal hypoxia in order to enhance the understanding of the incorporation of ethics in everyday clinical practice.
    Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):638-42.
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    ABSTRACT: Diabetes mellitus is a complex and chronical disease, which represents one of the biggest health issues the world, with alarming numbers and constantly increasing it demands the creation of new diagnostic, therapeutic and preventive techniques. The complete Genome Wide Association (GWA) in type 2 diabetes (T2D) is a useful research tool for the characterization of genetic markers and physiopathogenic pathways, with potential clinical utility either as a T2D risk prediction or its complications. In Mexico is necessary to make a comprehensive dissection of the genetic background of T2D by the complex genetic mosaic of our population and increase the knowledge of the molecular and pathophysiological mechanisms that lead to this condition. There are several genetic studies for the Mexican population, linked to the 1000 genomes project, which have led to define some specific genetic markers for our population which are not described in European populations, until the moment, 78 loci have been associated with T2D. Recently in the global meta-analysis, with the participation of Mexico, we demonstrated at least 7 new variants associated with T2D.
    Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):592-9.
  • Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):536-7.
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    ABSTRACT: Background: Residual renal function (RRF) contributes to the quality of life of patients on dialysis. The preservation of RRF is associated with higher patient survival in peritoneal dialysis (PD), and is now accepted that RRF and peritoneal clearance are not of equal value in patient survival. The aim of this study is to know the factors related to RRF loss in prevalent patients in continuous ambulatory peritoneal dialysis (CAPD). Methods: This is an analysis of secondary outcomes. Forty-three adult patients with type 2 diabetes were included. They had RRF preserved. Clinical and laboratory assessments were done in each visit during a year. Results: The male gender (p = 0.042), systolic (p = 0.009) and diastolic (p = 0.006) blood pressure (BP), hemoglobin (p = 0.008), peritoneal creatinine clearance (p = 0.014), peritoneal ultrafiltration (p = 0.017) and levels of tumor necrosis factor-alpha (TNF-alpha) in plasma (p = 0.022) and dialysate (p = 0.008) were related with RRF loss. Conclusions: It is important to understand the factors associated with RRF loss in our patients to prevent the gradual loss and its implications on the mortality and quality of life.
    Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):578-83.
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    ABSTRACT: Background: In recognition that the availability of resources in the medical facility forms part of the factors that influence the quality of healthcare, it is of vital importance to measure their outcome. The aim of this study was determine the efficiency of the medical facility through the use of beds in a secondary level hospital. Methods: Through the Health Information Management System (HIMS), we examined statistical reports from July 2012 to June 2013 including variables such as expenses, patient days, occupancy rate, average length of stay by specialty and medical division, results were obtained for each strategic indicator, and these results were related assumptions proposing to assess hospital efficiency. Results: Overall, we identified optimal efficiency of the medical facility without analysis of services, leads to deteriorating and low efficiency. The overall outcome of the five indicators applied overlooked saturation of services within the medical unit. However, the overall analysis shows the problem, noting the advantage of evaluating the same scenario from different perspectives. Conclusions: The include indicators measuring hospital efficiency resource based bed, allows considering deficiencies identified, so that decision making is strengthened the decision making health.
    Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):552-7.
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    ABSTRACT: Background: To identify type 2 diabetic patients, the stages of grief and its association with metabolic control. Methods: 186 patients both sexes, without recent loss of a loved one or a terminal illness. We applied a previously validated instrument, which explored the stages of grief (denial, anger/disbelief, bargaining, depression, and acceptance). There was measured BMI, waist circumference, and 6-month averages of glucose, cholesterol and triglycerides. Results: The associations between the stages of grief and clinical variables showed that BMI is greater denial 33.1 ± 6.2 vs 28.9 ± 4.6 33.1 with p = 0.001, in disbelief stage glucose is greater 190 ± 67 vs 167 ± 51 with p < 0.05. The negotiation phase is associated with older age, 65.6 ± 10 vs 59.1 ± 11 years with p = 0.001 and higher cholesterol level against 229.4 ± 39.1 vs 206.6 ± 40 with p < 0.05. The stage of depression was associated with increased diagnostic time vs. 13.3 ± 8.9 vs 9.4 ± 7.1 years with p < 0.05 and the blood glucose level 198.9 ± 60, vs 164 ± 51 mg/dL p = 0.001. Conclusions: There are logical associations between clinical variables and stages of grief. Identify the stages of grief, as an additional element in the evaluation of patients with diabetes will develop strategies to improve adherence to medical management and metabolic control.
    Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):546-51.
  • Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):534.
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    ABSTRACT: Background: Cochlear implant surgery has a low morbidity and mortality. Postoperative complications can be minor and major. Minor complications require conservative management; major complications require reoperation or implant removal. The aim is to determine our complications and compare them with international and Latin American series. Methods: 275 operated cases were retrospectively analyzed from December 2005 to December 2013. Children and adults between 11 months to 82 years old are included. Demographic data, unilateral or bilateral placement, type of surgery and postoperative complications were evaluated. The follow-up was made for 20 months. Results: The 57.46 % are children and adolescents, youth and adults are 33.81 %; and 8.73 % are seniors. The complication rate is 12 % (n = 33), 6.91 % for women and 5.09 % for men. There are more complications among 19 to 60 years old. Minor complications account for 7.6 %: local infection (n = 9), delayed transient facial palsy (n = 7), vertigo (n = 3) and tinnitus (n = 2). These are prevalent in children and adults. Major complications are 4.36 %: postoperative hematoma (n = 8), extrusions (n = 2) and inadequate electrode placement (n = 2). These predominate in adults among 19 to 60 years. No deaths or cases of meningitis occurred. Conclusions: Cochlear implantation has a low incidence of complications. Our results, the only reported at the national level, are comparable with those mentioned in literature.
    Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):644-51.
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    ABSTRACT: In our country there is a report of prevalence of Diabetes Mellitus in the adult population of a 10%, occupying one of the first causes of morbidity-mortality, also visual and labor incapacity. Macular edema is the first cause of lost vision in the diabetic patient. There are classic methods to detect it, as the examination with biomicroscope, indirect ophthalmoscopy, fluorangiography (FAR), and the new and gold standard method for diagnostic and sequence examination, Ocular Coherence Tomography (OCT). With OCT had been possible the study of distinct types of macular edema, that could represent distinct clinical states, with specific treatments. The protocol of treatment of macular edema, continues changing. The traditional methods as metabolic control and fotocoagulation with Laser now have more options as intravitreal injection of triamcinolone, or antiangiogenic substances, even surgical treatment with vitrectomy. There are many prospective and randomized studies evaluating this methods, so until now is difficult to determine wich treatment is the best.
    Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):600-7.
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    ABSTRACT: Background: Gastric carcinoma causes about 700 000 deaths worldwide per year. Is feasible detect it in earlier stages. The aim of this article is to assess the atrophy in the mucosa neighboring an intestinal-type gastric adenocarcinoma by comparing the Sydney vs. OLGA systems. Methods: Twenty-eight individuals with intestinal-type gastric adenocarcinoma (Lauren) were compared with 32 non-neoplastic cases. Both groups had undergone total gastrectomy. Two pathologists made a consensus-based assessment of the atrophy in non-neoplastic corpus and antral epithelium using the Sydney and OLGA Systems. The mean, median, and distribution of the frequencies were obtained using the measuring and distribution scales of the study variables. The sensitivity, specificity, and predictive values, both positive and negative, for gastric cancer were calculated through the dichotomy of advanced atrophy-positive and advanced atrophy-negative scales. Results: Twenty-four of the 28 cases with intestinal-type gastric carcinoma showed an advanced atrophy with the OLGA system, with a sensitivity and specificity of 77 and 85 %, respectively. Conversely, 4 of the 28 individuals showed an advanced atrophy with the Sydney system, with a sensitivity and specificity of 14 and 100 %, respectively. Conclusions: The OLGA system has a high sensitivity and specificity (77 y 85 % respectively) for the recognition of preneoplastic changes in the mucosa neighboring a gastric carcinoma.
    Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):584-90.
  • Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):536.
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    ABSTRACT: The situs inversus totalis is a rare condition associated with multiple congenital malformations, the most common heart defects and is associated with more complex syndromes such as Kartagener. Most of the time, the defect is found after a physical examination for other reason. We reported the case of a patient diagnosed on the first day of extra uterine life. It has been the first case reported in the state of Guerrero, with several prenatal history of interest. Our aim is to emphasize that early diagnosis completely changes the future healthcare. Reviewing the literature, it does not have any algorithm on searching protocol of congenital malformations and management attention on common pathologies.
    Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):652-5.
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    ABSTRACT: Background: The reorganization of the national health system (SNS), enforces reflection and transformation on medical education in clinical contexts. The study presents an educational model to develop entrusted professionals activities (MEDAPROC) to train human resources in health with reliable knowledge, skills and attitudes to work in the shifting scenario of the SNS. Methods: The paper discusses international and national documents on skills in medicine. Based on the analysis of 8 domains, 50 skills and 13 entrusted professional activities (RPA) proposed by the Association of the American Medical College (AAMC) we propose a curriculum design, with the example of the undergraduate program of Gynecology and Obstetrics, with the intention to advance to internship and residency in a continuum that marks milestones and clinical practices. Results: The pedagogical design of MEDAPROC was developed within three areas: 1) proposal of the AAMC; 2) curricular content of programs in pre and postgraduate education 3) organization of the daily agenda with academic mechanisms to develop the competencies, cover program items and develop clinical practice in deliberate learning activities, as well as milestones. Conclusion: The MEDAPROC offers versatility, student mobility and curricular flexibility in a system planed by academic units in diverse clinical settings.
    Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):616-29.
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    ABSTRACT: Of all the animals, the human being is the only one capable of making processes leading to the development of new tools and methodologies changing the course of nature for their own and others' benefit. These improvements have been also given, of course, in the field of medicine, where the research made by thousands of people have been favored by the advance of new technologies, procedures and substances, that while intended to achieve the welfare of patients also seek to achieve a higher profit margin.
    Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):532-3.
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    ABSTRACT: This document presents four stages in the history of the Centro Médico Nacional Siglo XXI (Centro Médico Nacional XXI Century) of the Instituto Mexicano del Seguro Social. The first stage started at the end of the third decade of the twentieth century and ended in 1961, it corresponded to the conception, planning and construction of what was to be the Centro Médico del Distrito Federal (Centro Médico of the Distrito Federal) belonging to the Secretaría de Salubridad y Asistencia (Ministry of Health and Assistance). The second stage began when the Center was acquired by the Institute, then was known like Centro Médico Nacional (Centro Médico Nacional ), being put into full operation in 1963, more than twenty-two years later, in 1985, an earthquake virtually ended it, immediately began its reconstruction, finishing the second stage. In 1989 began the third stage, different and new buildings complemented or replaced the structures damaged or destroyed by the earthquake which formed the now Centro Médico Nacional Siglo XXI (Centro Médico Nacional XXI Century). In 2004 the fourth stage opened when the four hospitals of the Center were categorized like Unidades Médicas de Alta Especialidad (High Specialized Medical Units).
    Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):656-63.
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    ABSTRACT: Background: Psychosocial profile disturbances are the basis of personality disorders, which are frequent in México. Thus, the objective of this study was to determine if the family support perception is associated with the psychosocial profile in adults. Methods: A total of 450 men and non-pregnant women aged 18 to 60 years were enrolled in a population-based cross-sectional study. According psychosocial profile individuals were allocated into groups altered and unaltered. The presences of psychiatric illness, renal, hepatic, and cardiovascular disease, malignancy or any kind of disability were exclusion criteria. The family support perception was determined by family APGAR and the psychosocial profile using the Dr. Víctor Chávez test. A logistic regression analysis was used to compute the association between family support perception and psychosocial profile. Results: A total of 344 (76.4 %) and 106 (23.5 %) subjects were included into the groups with altered and unaltered psychosocial profile, respectively. Both, moderate family dysfunction (OR = 1.80 95 % CI 1.01-3.23 p = 0.04), and high family dysfunction (OR = 3.88 95 % CI 1.09-12.09 p = 0.02) were significantly associated with altered psychosocial profile. Conclusions: Both, moderate and high family dysfunctions are associated with altered psychosocial profile in adults.
    Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):558-63.
  • Revista medica del Instituto Mexicano del Seguro Social 09/2015; 53(5):534-5.