Blanca Elsa Rivera-García

Mexican Institute of Social Security, Ciudad de México, The Federal District, Mexico

Are you Blanca Elsa Rivera-García?

Claim your profile

Publications (6)4.16 Total impact

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: It has been identified that platelet glycoprotein IIIa PIA1/A2 polymorphism plays an important role in atherothrombotic disease such as myocardial infarction and stroke, but results remain controversial. Here, we investigated whether the PIA2 allele is associated with ST myocardial infarction or idiopathic ischemic stroke in young individuals in two independent studies. In a case-control study 275 patients with ST elevation myocardial infarction ≤45 years of age and 278 controls were recruited. In a second study, 200 patients with idiopathic ischemic stroke ≤45 years of age and 200 controls were enrolled. In both studies cases and controls were matched by age and gender. The PIA1/A2 polymorphism was determined in all participants by a polymerase chain reaction-restriction fragment length polymorphism assay. There was a significant difference in the PIA1/A2 genotype distribution (P = 0.001) and allele frequency (P = 0.001), between ST elevation myocardial infarction and control groups, but not in the PIA1/A2 genotype distribution (P = 0.61) and allele frequency (P = 0.80), between idiopathic ischemic stroke. The allele PIA2 represented an independent risk for ST elevation myocardial infarction but not for idiopathic ischemic stroke. Hypertension, smoking, and family history of atherothrombotic disease were also associated with ST elevation myocardial infarction and idiopathic ischemic stroke. Our results suggest that PA2 allele represents a risk factor for ST elevation myocardial infarction in young Mexican individuals but not for idiopathic ischemic stroke.
    Molecular and Cellular Biochemistry 09/2013; · 2.33 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Individuals older than 60 years of age have multiple simultaneous diseases, for which the average number of medications is greater than five, leading up to 3% possibility of having an adverse reaction event. To detect potential drug-drug interactions (PDDIs) and report the average hospital stay for severity potential PPIs, in adults 60 years of age and older in an Internal Medicine Service. This was a retrospective analysis with a review of the clinical records of patients 60 years of age and older. The length of stay, number and type of prescribed daily medications, PDDIs, and number of admission diagnoses for each patient, were reviewed. This study included 342 patients with an average and standard deviation of 6 ± 3.0 medications per day. The PDDI levels were 27 (7.9%) severe, 94 (27.5%) moderate, and 61 (17.8%) had both types of interactions. Severe interactions, presented a hospital stay of 10 days, and moderate interaction a 13-day stay. The most common interactions and their average length of stay may be utilized for quality evaluation of the medication process of such a major patient population as that of the older adult in the hospital setting.
    International journal of clinical pharmacology and therapeutics 04/2012; 50(6):426-30. · 1.20 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Nosocomial surgical-site infection (NSSI) after craniotomy is responsible for an increase in deaths and/or disabilities that affect quality of life. It is necessary to identify factors to be included in an index for their control. The aim of this study was to a) identify intrinsic and extrinsic factors associated with NSSI after craniotomy and b) obtain the infection risk attributed to both intrinsic and extrinsic factors as well as to compare their predictive capability with the NNISS (National Nosocomial Infection Surveillance System) index. A case-control study was conducted during a 2-year period in patients who underwent craniotomy in hospitals affiliated with the Instituto Mexicano del Seguro Social. Patients were selected according to the Centers for Disease Control and Prevention criteria for NSSI. During the study period 737 craniotomies were performed, 41 of which presented with NSSI. Intrinsic factors associated with NSSI were the presence of chronic diseases (OR = 2.18) and craniotomy due to nontraumatic causes (OR = 1.87), whereas extrinsic factors were procedures performed during the late shift (OR = 2.6) and another surgery at the same surgical site (OR = 5.2). These factors comprised the index with intrinsic and extrinsic factors. Extrinsic factors were 1.7 times higher than intrinsic factors, in addition to having a larger area under the ROC curve (0.731). The risk obtained with the NNISS index for patients who had one factor was 1.5, whereas that for patients who had two or three factors was 4.7. In the studied population, patients who underwent a craniotomy with extrinsic factors showed a higher association with NSSI.
    Cirugia y cirujanos 78(1):5-13. · 0.32 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Stroke is considered a big public health problem in adults and older adults. Increased life expectancy is one of the greatest achievements of development; however it is also a great challenge because of the implications with regard to increasing chronic disease that it will lead complications such as stroke. Stroke is the leading cause of disability worldwide in adulthood and the second leading cause of dementia. In developing countries, it is estimated that the costs of care for stroke are from 6000 to 8000 euros, as well as the social costs of informal care and changes in family dynamics around patients. So the purpose of this clinical practice guideline is to define recommendations based on the best available evidence for the standardization of health care of patients with stroke.
    Revista medica del Instituto Mexicano del Seguro Social 50(3):335-46.
  • [Show abstract] [Hide abstract]
    ABSTRACT: We undertook this study to determine the incidence of nosocomial surgical-site infections, apply the National Nosocomial Infections Surveillance (NNIS) index, and describe the clinical and biochemical characteristics of patients prior to a first-time ventriculoperitoneal shunt (VPS). We conducted a cohort study for 1 year with patients aged 18 years or older who underwent VPS. Patients were followed up for 30 days to identify the presence of an infection. Infection diagnosis was made according to the criteria established by the Centers for Disease Control (Atlanta, GA). A questionnaire was developed to obtain the data regarding the factors contained in the NNIS and the clinical and biochemical characteristics prior to surgery. The annual incidence of nosocomial surgical-site infections was 12.3% (9/73). Distribution of factors according to the NNIS index was as follows: 55% without any factor, 38% with one factor, 7% with two factors, and no patients with three factors. ASA RR = 2.0, 95% CI 0.4-11.4, wound type RR = 5.1, 95% CI 0.5-48.9 and surgical time RR = 0.6, 95% CI 0.1-4.2. No differences were found in the frequency of concomitant diseases. Even though the clinical and biochemical characteristics of patients who underwent first-time VPS were normal and no associated NNIS factors were identified, 12.3% of the patients developed a nosocomial surgical-site infection. These results suggest the existence of factors other than those contained in the NNIS, which are possibly extrinsic to the individual and may influence the development of infections.
    Cirugia y cirujanos 77(1):13-9. · 0.32 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: resumen introducción: La infección nosocomial en sitio quirúrgico (INSQ) en craneotomía puede ocasionar la muerte o discapa-cidad que modifica la calidad de vida, por lo que se requiere encontrar factores que puedan ser utilizados para incluir en los índices de control. Por ello es necesario identificar facto-res asociados a esta infección y obtener el riesgo de infección atribuible y comparar su capacidad predictiva con el índice del NNISS (Sistema de Vigilancia Nacional de Infecciones Noso-comiales de Estados Unidos). material y métodos: Se realizó un estudio de casos y controles durante dos años, en pacientes con craneotomía en hospitales del Instituto Mexicano del Seguro Social. Los pacientes cum-plieron los criterios de los Centros de Control de Enfermedades de Atlanta para INSQ. resultados: Se practicaron 737 craneotomías durante el es-tudio, 41 pacientes presentaron INSQ. Factores intrínsecos asociados: presencia de enfermedades crónicas (OR = 2.18) y craneotomía debida a causas no traumáticas (OR = 1.87); fac-tores extrínsecos: turno vespertino (OR = 2.6) y la práctica de otra cirugía en el mismo sitio quirúrgico (OR = 5.2). Estos facto-res conformaron los índices de factores intrínsecos y extrínse-cos. Con factores extrínseco se presentó 1.7 veces más riesgo en comparación con los factores intrínsecos, así como mayor área bajo la curva ROC (0.731). El riesgo con el índice NNISS con un factor fue de 1.5 y con dos a tres factores, de 4.7. Conclusiones: En esta población en estudio, los pacientes sometidos a una craneotomía tuvieron mayor asociación a INSQ con los factores extrínsecos. Palabras clave: Craneotomía, infección hospitalaria, índice NNISS. summary Background: Nosocomial surgical-site infection (NSSI) after craniotomy is responsible for an increase in deaths and/or di-sabilities that affect quality of life. It is necessary to identify factors to be included in an index for their control. The aim of this study was to a) identify intrinsic and extrinsic factors asso-ciated with NSSI after craniotomy and b) obtain the infection risk attributed to both intrinsic and extrinsic factors as well as to compare their predictive capability with the NNISS (Natio-nal Nosocomial Infection Surveillance System) index. methods: A case-control study was conducted during a 2-year period in patients who underwent craniotomy in hospitals affi-liated with the Instituto Mexicano del Seguro Social. Patients were selected according to the Centers for Disease Control and Prevention criteria for NSSI. results: During the study period 737 craniotomies were per-formed, 41 of which presented with NSSI. Intrinsic factors associated with NSSI were the presence of chronic diseases (OR = 2.18) and craniotomy due to nontraumatic causes (OR = 1.87), whereas extrinsic factors were procedures performed during the late shift (OR = 2.6) and another surgery at the same surgical site (OR = 5.2). These factors comprised the index with intrinsic and extrinsic factors. Extrinsic factors were 1.7 times higher than intrinsic factors, in addition to having a larger area under the ROC curve (0.731). The risk obtained with the NNISS index for patients who had one factor was 1.5, whereas that for patients who had two or three factors was 4.7. Conclusions: In the studied population, patients who un-derwent a craniotomy with extrinsic factors showed a higher association with NSSI.