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


  • No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social
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    ABSTRACT: In order to improve the position of the Revista Médica del Instituto Mexicano del Seguro Social among the different journals, in this editorial we enumerate a series of recommendations to ameliorate the practices of the different actors who participate in the scientific communication process of this journal.
    No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social
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    ABSTRACT: Background: Diabetes is a serious health problem for pediatrics. In pediatric patients control depends on correct insulin administration. The most usual is subcutaneous administration according to the glycemic control. The aim was to analyze the indications for continuous subcutaneous insulin infusion (CSII) in type 1 diabetes mellitus (T1DM) children and adolescents. Methods: It was carried out a descriptive study in patients from 1 to 16 years with T1DM who underwent CSII therapy. The main cause to use this therapy was analyzed, and also if that cause was different regarding age, sex and disease progression. Results: 61 patients underwent CSII therapy. The median age at the beginning of treatment was 9 years old; 43 patients (71.6 %) had more than one year of diagnosis. The main reasons to use CSII were: 42.6 % had to improve their quality of life, 34.4 % had to reduce the high glycemic variability, 13.1 % had to control severe recurrent hypoglycemia, and 9.8 % had to control their HbA1c. For children under 6 years of age (n = 14) the more frequent indication were recurrent hypoglycemia and to improve their quality of life; children from 6 to 12 years of age (n = 27) had to improve their quality of life, and in children over 12 years CSII was indicated for high glycemic variability and severe recurrent hypoglycemia. There was no different indication related between sexes. Conclusion: Improve their quality of life and reach a better glycemic control were the main reasons to start CSII in our patients.
    No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social
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    ABSTRACT: Background: Coverage for HIV in our country through the rapid test has increased, from 8.2 % in 2006 to 59.8 % in 2012; however, it is still insufficient. The objective is to determine the prevalence of HIV screening through rapid testing to pregnant women in the Unidad de Medicina Familiar (UMF) 171. Methods: It was carried out a descriptive cross-sectional study with non-probability sampling that included pregnant women of any age who came to birth control in the UMF 171 of the Instituto Mexicano del Seguro Social. Review of medical records was applied as a tool to gather information on the rapid test. A sample of 85 patients was calculated and descriptive statistical analysis was performed. Results: 85 patient records were reviewed in control pregnancy. Rapid testing for detection of antibodies to HIV was performed in 79 patients (93 %). In nine (10 %) of the patients who underwent the test, the result was not reported in their file. In six patients (7 %) of the total sample the rapid test was not requested or performed. The result of all rapid tests reported was HIV negative. Conclusion: There is an increase in the coverage of rapid HIV testing in pregnant women; however, not reporting and not requesting the test are still common problems in the early detection of HIV infection in pregnant women.
    No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social
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    ABSTRACT: Background: Community-acquired pneumonia is an important cause of mortality and morbidity worldwide. Therefore, our aim was to assess the efficacy and safety of outpatient treatment of community-acquired pneumonia. Methods: We systematically reviewed randomized clinical trials evaluating efficacy and safety of outpatient treatment (OPT) compared with inpatient treatment (IPT) of community-acquired pneumonia in patients without added co-morbidity. Relative Risk (RR) and 95 % confidence interval (95 % CI) were calculated. Results: From 4088 reviewed articles, two articles were included for meta-analysis, including 2324 patients. One study was conducted in adults, and the other was carried out in pediatric patients. Treatment setting was not significantly associated with treatment failure (RR 0.84 [95% CI 0.68, 1.02]). Death occurred in 6 of 2324 with no difference between the two groups (RR 0.56 [95 % CI 0.12-2.61]). Finally, no differences were seen in hospital readmission between groups (RR 0.82 [95 % CI 0.52-1.30]). Conclusion: Evidence shows that treatment setting of community-acquired pneumonia is not statistically associated with treatment failure or mortality.
    No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social
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    ABSTRACT: Background: Maternal depression entails cognitive, behavioral, affective and relational disorders with a great impact on the life quality of individuals, society and family. Our objective was to determine the prevalence and factors associated in women with children in paedopsychiatry treatment in a children's hospital. Methods: Descriptive, prospective and prevalence study with a sample of 194 women. We used Beck scale. We calculated the prevalence rate. We analyzed the association of risk factors with the maternal depression by using chi square and a relative risk with a 95 % confidence interval (p = 0.5). Results: There was a maternal prevalence depression of 66 %: 45 % had a mild depression (58), 35 % moderate (45) and 20 % severe (25). According to the chi square analysis, married female variable was statistically significant (8.7408, p = 0.0031, Odds Ratio [OR] 2.48). Having five children had an OR of 2.09, and the diagnosis of delay in the development an OR of 1.75. Conclusion: There was a higher prevalence than expected with a percentage difference of 6 points. Mild depression was more common; women from 31 to 40 years of age, married, and with five children were the most affected groups.
    No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social
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    ABSTRACT: Background: The prevention and control of the nosocomial infections involve the knowledge of the most frequent type of microorganism isolated. In Mexico there are not national statistics to identify the main microorganisms that cause a nosocomial infection. Methods: It was conducted an analysis of all the culture results of the nosocomial infections reported by the Sistema de Vigilancia Epidemiológica Hospitalaria (Epidemiological Surveillance System) of the Instituto Mexicano del Seguro Social during the year 2013. The most frequent and relevant microorganisms were reported. Results: 48 377 results from cultures of nosocomial infections were studied. Of these 13 207 (27.3 %) were from 25 high specialty medical units and 35 170 (72.6 %) from 197 second level medical units. The most frequently isolated microorganism was Escherichia coli with 8192 results (16.9 %), followed by the group of Coagulase-negative Staphylococci with 6771 cultures (14 %) and Pseudomonas aeruginosa with 5275 results (19.9 %). Slight differences between levels of care and specialized hospitals were observed. Conclusion: This study identifies the Escherichia coli, the group of Coagulase-negative Staphylococci and the Pseudomonas aeruginosa as the main microorganisms to prevent.
    No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social
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    ABSTRACT: Neuhauser syndrome is an extremely rare genetic disease, most cases are sporadic by spontaneous mutation, but there are cases of autosomal recessive genetic transmission; the specific cause is unknown and has no diagnostic test. The disease is clinically characterized by primary megalocornea, congenital hypotonia, mental retardation of varying degree and delayed psychomotor development. The diagnosis in childhood is usually performed by oculo-neurological criteria. The patients have a peculiar face by specific craniofacial anomalies: round face, wide prominent forehead, hypertelorism, broad nasal bridge, bulbous nose, wide philtrum nasolabial wide, thin elongated mouth, big and protuded ear "cup", jaw undersized (micrognathia) and abnormal posterior positioning of the mandible (retrognathia).The use of facial dysmorphism helps to delineate the phenotype and achieve the punctuation required for the diagnosis, allowing early management and prevention of complications.
    No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social
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    ABSTRACT: Background: Lactate is one of the most useful biomarkers to screen patients with shock; therefore, the aim of this study was to establish the levels of lactate regarding the pulse pressure in that sort of patients. Methods: Observational, retrospective, cross-sectional and descriptive study of patients over 18 years diagnosed with shock from an emergency room of a tertiary care hospital. Lactate levels and pulse pressure were used as biomarkers. We used descriptive statistics, Student's t test and Pearson correlation coefficient. Results: We obtained 46 patients. The average age was 39.52 (SD 15.22), media initial lactate level was 5.88 mmol/L (SD 3.89) and media final lactate level 3.31 mmol/L (SD = 3.12); initial pulse pressure was 19.78 mmHg (SD 7.45) and final pulse pressure 31.52 mmHg (SD 31.52). The relation of secundary diagnosis did show predominance in chest trauma with 13 patients. There was a statistical significance in initial lactate and final lactate of r = 0.83 (p = 0.00), and initial pulse pressure and final pulse pressure: r = 0.57 (p = 0.001). There was not a significant correlation between final lactate and final pulse pressure (r: -0.184, p = 0.222). Conclusion: Even when several studies emphasize the clinical significance of biomarkers in the diagnosis and management of patients with hypovolemic shock, it is necessary to do more studies in order to find the efficacy of the non-invasive screening in this type of pathology.
    No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social
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    ABSTRACT: From the second half of the 19th century, health disciplines went through an institutional and professional restructuring, which progressively altered the guild order that had characterized them to that point. In the case of Pharmacy, this process implied the generation of officially recognized spaces, as the chairs of Pharmacy and Medical Substance, founded during the Establecimiento de Ciencias Médicas (Establishment of Medical Sciences) (1833). In those spaces it was sought to institutionalize knowledge and modern practices related to Pharmacy. In this work we look over the first academic experience of the pharmaceutical community in that new space of instruction, based on the records belonging to the students enrolled in the Establecimiento de Ciencias Médicas from 1833 to 1865, year of the enrollment of the last generation. The information contained in those 163 records displays the way the pharmaceutical field was transformed, after the aforementioned restructuring. The reader will notice the diverse normativity, which regulated the joining of pharmacists to academic life (of which, until then, they were excluded). He will also realize how, among the first students enrolled in the Establecimiento de Ciencias Médicas, said normativity was broke in order to adapt it to the known ways of students and professors. Progressively, the guild instruction would be ousted by the institutional instruction (for example, the years of practice in the drugstores were rejected), so that the guild ways of teaching were changing to turn the pharmacist into an individual of institutional instruction.
    No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social

  • No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social
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    ABSTRACT: Background: Staphylococcus aureus is capable of acquiring resistance against all antimicrobial agents. Vancomycin has been the cornerstone therapy for serious methicillin-resistant S. aureus infections. However, vancomycin treatment failures have been reported. Methods: From March to August 2010, S. aureus blood isolates were included to determine methicillin-resistance and the vancomycin susceptibility by using a standard microdilution method. To detect methicillin-resistance, a Mueller-Hinton agar plate added with oxacillin 4 µg/mL and 2 % NaCl, and an agglutination test were used. Growth of S. aureus on the agar plate and/or reactive agglutination defined a methicillin-resistant organism. Vancomycin susceptibility was assessed by determining the minimal inhibitory concentration (MIC) in Muelller-Hinton agar plates prepared with dilutions ranging from 16 to 0.5 µg/mL. Results: A total of 25 blood-isolates of S. aureus were included. A 60 % was methicillin-resistant. All isolates were vancomycin-susceptible (MIC ≤ 2 µg/mL) showing the next MICs distribution: 48 % ≤ 0.5 µg/mL; 44 % 1 µg/mL, and 8 % 2 µg/mL. Conclusion: The high proportion of methicillin-resistance among S. aureus and the presence of vancomycin susceptible phenotypes (MIC of 2 µg/mL) not only claim for an enforcement of standard precautions and antimicrobial control, but also for a regular surveillance of vancomycin susceptibility pattern using a reference method.
    No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social
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    ABSTRACT: Background: The objective was to evaluate the prevalence of urinary tract symptoms and the impact in the quality of life in women with diabetes, the association with DM and neuropathy evolution time and glycemic control. Methods: A cohort of women from the DiabetIMSS program was evaluated from January 2011 to 2013. The personal history, time of DM diagnosis, neuropathy, urinary symptoms, glycemic control and quality of life impact were noted. Results: A total of 169 women were evaluated. The median age was 58 years (29-85) and DM main evolution time was 9 years (0.5-31). Urinary tract symptoms were present in 128 (75.7 %) patients. Stress and urge incontinence were predominantly present (45.3 and 40.6 % respectively), followed by obstructive and irritative symptoms (25 and 10.1 % respectively). The impact in the quality of life was mild-moderate in 91.1 % of the patients. At least one criteria for neuropathy was noted in 154 (91.1 %) patients. Neuropathy evolution time was longer in the symptomatic group (12 vs 4.8 months). Symptoms were mainly present in patients with more than one year of neuropathy; p < 0.05. Conclusion: There is a high prevalence of urinary tract symptoms in diabetic women. The only associated risk factor was neuropathy. No significative association was found between the rest of the factors.
    No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social
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    ABSTRACT: Background: The incidence of skin cancer has increased in Mexico in recent years. Ultraviolet radiation is the main risk factor associated. Due to the need to develop strategies to prevent skin cancer, the aim of the study was to estimate the UV intensity in several representative regions of Mexico, the average annual UV dose of these populations, and the potential benefit of applying sunscreen at different ages. Methods: The intensity of UV radiation was quantified by remote and terrestrial radiometry. The dose of UV exposure was measured in minimal erythema doses using validated models for face and arms. The benefit of using a sunscreen was calculated with the use of a sunscreen with SPF 15 from birth to age 70. Results: The UV radiation is lower in December and greater in the period from May to July. The region with a lower annual dose is Tijuana; and the higher annual dose is in the Mexico City area. The annual difference between these regions was 58 %. Through life, a low SPF sunscreen can reduce up to 66 % of the received UV dose. Conclusions: The geographical location is a risk factor for accumulation of UV radiation in Mexico. Since childhood, people receive high amounts of it; however, most of this dose can be reduced using any commercially available sunscreen, if applied strategically.
    No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social

  • No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social
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    ABSTRACT: The current scenario of health services in Mexico reveals as a priority the implementation of strategies that allow us to better respond to the needs and expectations of individuals and society as a whole, through the provision of efficient and effective alternatives for the prevention, diagnosis and treatment of diseases. In this context, clinical practice guidelines constitute an element of management in the health care system, whose objective is to establish a national bechmark for encouraging clinical and management decision making, based on recommendations from the best available evidence, in order to contribute to the quality and effectiveness of health care. The purpose of this document is to show the methodology used for the development and updating of clinical practice guidelines that the Instituto Mexicano del Seguro Social has developed in line with the sectorial model in order to serve the user of these guidelines.
    No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social
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    ABSTRACT: In order to diagnose TB infection, tuberculin skin test and interferon gamma release assay are available. The tuberculin test has a sensitivity of 99 % and a specificity of 95 %. For the detection of interferon gamma in blood there are currently two tests available: TBGold QuantiFERON-In-Tube (with a sensitivity of 0.70 and a specificity of 0.90), and T-SPOT-TB (sensitivity 0.90 and specificity 0.93). To diagnose the disease, a microscopy of direct smears for acid-fast bacilli is used if the physician is facing an extensive cavitary lung disease due to M. tuberculosis (this test has a high sensitivity: 80-90 %). The most common staining techniques used are Ziehl-Neelsen and Kinyoun, and the fluorescent technique, auramine-rhodamine. The culture is the gold standard and it has a sensitivity of 80 % and a specificity over 90 %, but the results take weeks. The nucleic acid amplification test has an overall sensitivity and specificity of 0.85 and 0.97, respectively. In the presence of a pleural effusion is necessary to perform a pleural biopsy for culture with a sensitivity of 85 % if it is percutaneous and 98 % if it was taken by thoracoscopy. The adenosine deaminase can be determined in pleural fluid with a sensitivity and specificity of 95 %.
    No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social
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    ABSTRACT: Hyperprolactinemia is a frequent neuroendocrinological condition that should be approached in an orderly and integral fashion, starting with a complete clinical history. Once physiological causes such as pregnancy, systemic disorders such as primary hypothyroidism and the use of drugs with dopamine antagonistic actions such as metochlopramide have been ruled out, the most common cause of hyperprolactinemia is a PRL-secreting pituitary adenoma or prolactinoma. Prolactinomas are usually classified as microprolactinomas (less than 1 cm) or macroprolactinomas (larger than 1 cm), which can either be confined or invasive. The hormonal consequence of hypeprolactinemia is hypogonadism; in women, this is manifested as amenorrhea/oligomenorreha, anovulation and galactorrhea, whereas in men the main complaints are a diminished libido and erectile dysfunction. Macroprolactinomas can also present with symptoms and signs resulting form mass effect of the tumor, such as headaches and visual field defects. Other structural causes of hyperprolactinemia include non-functioning pituitary adenomas and infiltrative disorders, which can interrupt the inhibitory, descending dopaminergic tone. The primary treatment of prolactinomas is pharmacological with dopamine agonists such as cabergoline.
    No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social
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    ABSTRACT: Background: Nosocomial infections in intensive care units are a health problem worldwide due to their incidence, prevalence and clinical impact. The objective of this article was to describe the trend of antimicrobial susceptibility during a 10-years period in both a pediatric and a neonatal intensive care unit. Methods: This is a follow-up cohort study. In 10 years of follow-up, the antimicrobial used was considered the independent variable, and the antimicrobial susceptibility as the dependent variable. By using chi squared with Fisher exact test, the initial and final susceptibilities were compared, and also the most prevalent diagnoses and the antimicrobials. A two-tailed p value < 0.05 was considered statistically significant. SPSS 8 and Epi-Info 0.6 were used for statistical analysis. Results: Antimicrobial susceptibility decreased from 66 to 45 % in 10 years, representing a global loss of 13 % (p = 0.002). The most affected antimicrobials were first-generation cephalosporin (p = 0.02), ciprofloxacin (p = 0.05), erythromycin (p = 0.001), imipenem (p = 0.001), and trimethoprim/sulfamethoxazole (p = 0.05). Conclusion: There is an alarming loss of effectiveness in antimicrobial agents.
    No preview · Article · Jan 2016 · Revista medica del Instituto Mexicano del Seguro Social