Hydrogen Peroxide as an Adjuvant Therapy for COVID-19: A Case Series of Patients and Caregivers in the Mexico City Metropolitan Area.

Knowledge of the antiseptic effects of hydrogen peroxide (H2O2) dates back to the late 19th century, and its mechanisms of action has been amply described. Globally, many physicians have reported using H2O2 successfully, in different modalities, against COVID-19. Given its anti-infective and oxygenating properties, hydrogen peroxide may offer prophylactic and therapeutic applications for responding to the COVID-19 pandemic. We report a consecutive case series of twenty-three COVID-19 patients (of 36 initially enrolled) who had been diagnosed by their primary care physician (mean age: 39, range: 8 months-70 years; 74% male) and twenty-eight caregivers in the Mexico City Metropolitan Area who received a complementary and alternative medicine (CAM) telemedicine treatment with H2O2 taken by mouth (PO, at a concentration of 0.06%), oral rinse (mouthwash, 1.5%), and/or nebulization (0.2%). We describe the treatment program and report the response of the COVID-19 patients and their caregivers. The patients mainly recovered well, reporting feeling "completely better" at 9.5 days on average. Two (9%) were hospitalized prior to joining the study, and one did not fully recover. Patients frequently reported nausea and sometimes dizziness or vomiting related to the oral treatment. None of the twenty-eight caregivers in close contact with the patients reported contracting COVID-19. Given its low cost and medical potential and considering its relative safety if used properly, we suggest that randomized controlled trials should be conducted. These should include both SARS-CoV-2-positive and SARS-CoV-2-negative participants, with single or combined modes of administration of H2O2, to study the benefits of this simple molecule and offer safe guidance regarding its use by health professionals.

[Vascular microsurgery course: 40 years at the Centro Médico Nacional 20 de Noviembre (ISSSTE) and 33 years at the Faculty of Medicine of the UNAM]. / Curso de microcirugía vascular: 40 años en el Centro Médico Nacional 20 de Noviembre del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado y 33 años en la Facultad de Medicina de la Universidad Nacional Autónoma de México.

On June 1977, "Centro Médico Nacional 20 de Noviembre," in Mexico City, implemented the first vascular microsurgery course. The aim was to develop clinical applications of microsurgery focus on surgical specialties, due to the necessity to develop microsurgical skills. On August 1964 we started the program course at the surgical department of the School of Medicine at Universidad Nacional Autónoma de México (UNAM). Actually, our course is given five times a year at 20 de Noviembre hospital, and four times at the UNAM. One June 2017, the Experimental Surgical Department at "Centro Médico Nacional 20 de Noviembre" reached 40 continuous or uninterrupted years of successfully teaching the microsurgical vascular skills. The aim of this study is to evaluate the satisfaction degree among the students. For that propose, a written survey was applied one year later, after successfully completed the course. These results reveal a satisfaction rate of 80% among these students.

El Curso de Microcirugía Vascular (CMV) inició en el Centro Médico Nacional (CMN) 20 de Noviembre en la Ciudad de México, en junio de 1977, con la idea de poder desarrollar aplicaciones clínicas de microcirugía en todas las especialidades quirúrgicas. En vista de la gran demanda hacia la microcirugía como destreza, en agosto de 1984 iniciamos el programa de Microcirugía Vascular en el Departamento de Cirugía de la Facultad de Medicina de la Universidad Nacional Autónoma de México (UNAM). El CMV se imparte cinco veces al año en el CMN 20 de Noviembre del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado y cuatro en la Facultad de Medicina de la UNAM. En junio de 2017, el Servicio de Cirugía Experimental del CMN 20 de Noviembre cumple 40 años ininterrumpidos de impartir con éxito el CMV. Con el fin de evaluar el CMV de acuerdo con el nivel de satisfacción, a partir de 2016 se implementó el uso de un cuestionario. La finalidad es dar seguimiento repitiendo el cuestionario un año después para valorar las habilidades adquiridas. Los porcentajes demuestran que más del 80% de los alumnos están satisfechos con las destrezas adquiridas en el CMV.

Unidad de Microcirugía: 30 años de experiencia clínica, entrenamiento continuo e investigación / Microsurgery unit: 30 years of clinical experience, continuous training and research

Se describen 30 años de actividades clínicas, entrenamiento e investigación en dos Unidades de Microcirugía. El Servicio de Cirugía Experimental del Centro Médico Nacional (CMN) ''20 de Noviembre'' del ISSSTE y el Departamento de Cirugía de la Facultad de Medicina de la UNAM, ambos de la Ciudad de México; participando en 121 casos clínicos resueltos con técnicas microquirúrgicas en 7 diferentes especialidades. En el ISSSTE, de 1977 a 2007, se han impartido 104 cursos de ''Microcirugía vascular'' y entrenado a 453 cirujanos y residentes de especialidades quirúrgicas. En la UNAM, de 1984 a 2007 se han entrenado 364 alumnos en 67 cursos. Desde 1979 hemos estudiado experimentalmente microprótesis vasculares de origen biológico o sintético de 1 y 2 mm de diámetro, en sustitución de segmentos de aorta y vena cava en rata, generando seis publicaciones. Desde 1996 estamos trabajando el fenómeno de ''angiogénesis'' como tratamiento de miembros inferiores con isquemia crítica. Con base en los trabajos previos, el Comité de Investigación y Ética del CMN aprobó un protocolo de investigación en pacientes con dicha patología, acumulando a la fecha 26 extremidades con trasplante de células endoteliales progenitoras, derivadas de la médula ósea, aplicadas por inyección intramuscular y por vía venosa distal a nivel de vena safena. Del 2004 al 2009 se han amputado 5 extremidades y salvamento de 21; los resultados del estudio se encuentran en evaluación para su publicación. Los hospitales con programas de formación de residentes en especialidades quirúrgicas, deben contar con laboratorio de microcirugía para entrenamiento básico, continuo y diseño de protocolos de investigación, ofreciendo a los pacientes soluciones con técnicas microquirúrgicas.

We describe 30 years of clinical, training and research activities in two Microsurgery Units. The Experimental Surgery Service of the National Medical Center ''20 de Noviembre'' from the ISSSTE (Mexican Health and Welfare Institute for government employees) and the Department of Surgery of the School of Medicine, UNAM (National Autonomous University of Mexico), both located in Mexico City, participating in 121 clinical cases resolved with microsurgical techniques in seven different specialties. At the ISSSTE, from 1977 to 2007, 104 courses on ''Vascular Microsurgery'' have been given and 453 surgeons and residents have been trained in surgical techniques. At the UNAM, from 1984 to 2007, 364 students have been trained in 67 courses. Since 1979, we have experimentally studied vascular microprostheses of biological or synthetic origin of 1 to 2 mm in diameter in substitution of aorta and cava vein segments in rats, giving rise to six publications. Since 1996, we have been studying the ''angiogenesis'' phenomenon as treatment for lower extremities with critical ischemia. Based on previous studies, the Ethics and Research Committee of the ISSSTE-Medical Center approved a research protocol in patients with that pathology, accumulating, until this date, 26 extremities with bone marrow-derived stem cells, applied through intramuscular injection and through distal venous route at the level of the saphenous vein. From 2004 to 2009, five extremities have been amputated and 21 have been saved; the results of the study are being evaluated for publication. Hospitals with programs for the training of residents in surgical specialties must have a laboratory of microsurgery for the basic and continuous training and for the design of research protocols, to be able to offer solutions to the patients with microsurgical techniques.

Hepatocellular carcinoma: epidemiological profile from a cohort of federal employees in Mexico.

INTRODUCTION: Hepatocellular carcinoma (HCC) has become a frequent type of cancer in Mexico. At the present time it represents the 19th cause of death in the population. OBJECTIVE: To recognize the epidemiological profile and the treatment results in a cohort of federal employees with HCC. MATERIAL AND METHODS: We analyzed 47 consecutive cases with HCC diagnosis from January 2004 till December 2007. Twenty four demographic data, tumor staging, clinical, and biochemical variables were analyzed to identify parameters predicting survival by computing Kaplan-Mier and Mantel-Cox survival curves. RESULTS: Patient reference increased 5% each year. The mean age was 60.4 years, 63.8% female sex, and 72.3% had cirrhosis, 44.7% had Hepatitis C infection. Most patients presented with advanced disease: 55.3% were AJCC stage 3 and 21.3% stage 4, 51.1% were BCLC class D. Mean tumor size was 8.09 cm. Median survival time from diagnosis was 122 days. Patients that did not receive treatment had a median survival of 70 days; the longest survival of patients was of those that received transarterial chemoembolization with a median of 707 days, followed by surgery with 683 days. Univariate analysis showed survival was associated to MELD score, AJCC and BCLC staging, creatinine level and ascites. Multivariate analysis showed tumor differentiation, AJCC staging and the choice of treatment to be related to the risk of death. CONCLUSION: An increase in the referral of HCC was demonstrated. Most patients had cirrhosis and HCV infection. Due to advance disease staging, TACE was the treatment that offered longest survival.

[Optical coherence tomography applications in otolaryngology]. / Aplicaciones de la tomografía de coherencia óptica en otorrinolaringología.

Optical coherence tomography is a novel imaging technique providing high-resolution bidimensional images of tissue microstructures. Several studies have been published on the use of this technique in different fields of medicine, particularly ophthalmology. There are very few studies in the field of otolaryngology. This paper presents various applications of optical coherence tomography in the different sub-specialties of otolaryngology, as well as the benefits of this technique over traditional diagnostic methods.

Bone marrow mononuclear cells stimulate angiogenesis when transplanted into surgically induced fibrocollagenous tunnels: results from a canine ischemic hindlimb model.

Progenitor cell transplantation has been considered as a potential angiogenesis therapy for the ischemic hindlimb. In this work we performed an ischemic hindlimb model in dogs. We ligated the middle sacra and the external right iliac arteries. After 7 days, the femoral artery was ligated and removed, and three Silastic tubes were inserted into the gracilis muscle to create fibrocollagenous tunnels. After Silastic implantation, we administered saline or granulocyte colony stimulating factor (G-CSF) subcutaneously daily during 5 days. Fourteen days after device positioning we transplanted bone marrow mononuclear cells (BMMC) into the tunnels previously formed by Silastic tube reaction. Twenty-eight days later, contrasted angiographies were performed and angiographic scores were calculated. Also, vessels and endothelial cells and proliferating cells were identified by immunochemistry of muscle sections. Results demonstrated that BMMC transplantation enriched by G-CSF administration significantly stimulates angiogenesis in the ischemic hindlimb, and more than BMMC transplantation alone. Transplantation of progenitor cells in an appropriate extracellular matrix is a potential therapy for hindlimb ischemia.

Fibrin glue: an alternative technique for nerve coaptation--Part I. Wave amplitude, conduction velocity, and plantar-length factors.

The search for better surgical repair of nerve injuries should be aimed at uncovering alternatives that not only are efficient, but also enhance nerve growth. The purpose of this study was to compare functional nerve responses following repair with either a traditional microsuture technique or Quixil human fibrin sealant. Thirty female Lewis rats received transection of the right sciatic nerve. Nerve repair was achieved with either epineurial microsuture (n = 15) or Quixil fibrin glue (n = 15). Functional results were assessed at 2, 6, and 12 weeks postoperatively with walking-track analysis. Electrophysiologic nerve recordings were also performed 12 weeks postoperatively. Rats receiving Quixil nerve repair returned to baseline performance on the walking-track analysis significantly faster than those with microsuture repairs (6 and 12 weeks postoperatively; p < 0.0001). Recovery of nerve conduction velocities and wave amplitudes was also significantly better in the nerves repaired with Quixil than in those repaired with microsuture (p's < 0.0001). Quixil human fibrin sealant is a good alternative to traditional microsuture nerve repair techniques.

Fibrin glue: an alternative technique for nerve coaptation--Part II. Nerve regeneration and histomorphometric assessment.

The results of nerve repair with fibrin glue and microsuture were evaluated in rat nerve transection models. Ninety Wistar-Furth rat median nerves were exposed, transected, and repaired in an end-to-end fashion with one of four substances/techniques: 1) human fibrin sealant (Quixil); 2) autologous graft and human fibrin sealant (Quixil); 3) bovine fibrin sealant (Tissucol); and 4) nylon microsuture, epineurial technique. Histologic analyses were performed at 3-, 6-, and 9-month postoperative intervals, and factors evaluated included: presence of inflammatory cells (i.e., macrophages and T cells); number of Schwann cells at the repair site; number of blood vessels; fibrosis; axonal regeneration; and fiber alignment. An additional group underwent histologic analysis at 3 weeks following repair with Quixil. Surgical time of repair was also measured. Nerve repairs performed with fibrin sealants produced less inflammatory response and fibrosis, and better axonal regeneration and fiber alignment than nerve repairs performed with microsuture. In addition, the fibrin sealant techniques were quicker and easier to use. The authors conclude that fibrin sealant represents a good alternative technique to microsuture for peripheral-nerve repair.

[Evaluation of the symptomatology and quality of life in functional dyspepsia before and after Helicobacter pylori eradication treatment]. / Evaluación de la sintomatología y calidad de vida en la dispepsia funcional antes y después de tratamiento de erradicación de H. pylori.

BACKGROUND: Whether H. pylori infection plays a role in FD is ill defined; however, it is recommended to prescribe eradication treatment in patients with dyspepsia without alarm symptoms. Results of this advice are controversial, principally due to absence of instruments that provide an objective measure of changes in symptoms and quality of life. OBJECTIVE: Our aim was to evaluate significant changes in symptom severity and quality of life in patients with functional dyspepsia (FD) following Helicobacter pylori (H. pylori) eradication treatment. METHODS: We conducted an open clinical trial in adult patients with FD who were H. pylori-positive by means of 14C breath test. Treatment consisted of 2 weeks on lanzoprazole, amoxicillin, and clarithromycin. Score change on the severity of dyspepsia assessment (SODA) test instrument was used to evaluate modifications in symptom severity and quality of life. RESULTS: One hundred patients were included in this trial; treatment compliance was observed in 77% of these, while cure of H. pylori infection was obtained in 82.7% of patients. Only 11.7% displayed absence of dyspepsia symptoms and improvement in quality of life. No significant changes were obtained in global assessment nor in pain, or symptoms in health perception quality of life when initial SODA scores were compared with after-treatment results. CONCLUSIONS: There was no improvement of FD symptoms or quality of life after H. pylori eradication treatment.

[Comparative study between rapid urease test, imprint and histopathological study for Helicobacter pylori diagnosis]. / Estudio comparativo entre las pruebas de ureasa rápida, la impronta y el estudio histopatológico para el diagnóstico de Helicobacter pylori.

Helicobacter pylori infection is relevant, due to its role in different gastric pathologies; there are several diagnostic methods, which are divided into invasive and non-invasive. In the first category histology has been considered the gold standard, while other methods include imprint with Gram stain and rapid urease test, which can produce dependable results. The aim of this study is to compare several available techniques for H. pylori diagnosis to know their sensitivity and specificity. We studied 88 patients, 50 women and 38 men, with age range from 17 to 83 years (48.8+/-14.3) from the Endoscopy Department of the 20 de Noviembre Medical Center; in all five to eight biopsies were taken from gastric mucosa to perform rapid urease test, Gram-stained imprint and histology. Endoscopic findings included gastritis (87.50%), pangastritis (2.30%) and another diagnoses (10.22%). Rapid urease test was positive in 40 patients and negative in 48, while imprint was 34 and 54, respectively. Sensitivity and specificity were as follows: rapid urease test, 84.8 and 78.5%, and imprint 75.8 and 83.6%, respectively. In conclusion, H. pylori diagnosis by rapid urease test is a dependable and quick method. On the other hand, imprint is useful but depends on the ability of the personnel who perform the test.

Administration of bone marrow cells into surgically induced fibrocollagenous tunnels induces angiogenesis in ischemic rat hindlimb model.

We established a comparative model of angiogenic induction in previously formed fibrocollagenous tunnels in rat inner thigh muscles. A unilateral hindlimb chronic ischemia model was performed in male Sprague-Dawley rats. A device was then inserted in the central portion of the inner thigh muscles. Vascularity in the ischemic limb was determined by means of an angiographic score, capillary/fiber ratio, and endothelial proliferation by histochemistry and immunohistochemistry. Autologous transplant of bone marrow, vascular endothelial growth factor (VEGF), or collagen-polyvinylpyrrolidone plus heparin induced significant vascularization of the ischemic hindlimb when compared to saline solution. However, the bone marrow group presented a higher angiographic score than the other two. No differences among groups were observed in capillary/fiber ratio or proliferation, except for the VEGF group, where capillary proliferating cells were significantly higher than in controls. Based on these results, bone marrow-derived progenitor cells may constitute a safe and viable alternative for the induction of therapeutic angiogenesis.

[Prevalence of and risk factors for hepatitis C in blood donors]. / Prevalencia y factores de riesgo para hepatitis C en donadores de sangre.

OBJECTIVE: Determine hepatitis C prevalence and risk factors in blood donors from the Blood Bank at the Centro Médico Nacional 20 de Noviembre ISSSTE, in Mexico City. METHODS: A total of 41,957 blood donors were included in the study was done from January 1996 to August 2000. To study risk factors, a case-control study cases were defined as blood donors with repeatedly positive anti-hepatitis C virus (HCV) ELISA test. Controls were defined as blood donors with negative anti-HCV ELISA test. All cases were interviewed a second time on HCV infection-associated risk factors. Odd ratio (OR) and confidence interval 95% (CI 95%) were calculated for each risk factoring in a univariate analysis. Multivariate analysis was performed subsequents to determine the independent contribution or each risk factor. RESULTS: HCV crude total prevalence was 0.84%. Risk factors were found in 36.16% anti-HCV-positive blood donors. During the second interview, 30% of sero-positive blood donors recalled one or more risk factors they previously denied. The most important risk factors, found were as follows sexual relations with prostitutes (OR 7.48, CI 95% 1.43-38.92) transfusion (OR 6, CI 95% 2.62-13.72); nasal cocaine use (OR 8.89, CI 95%, 1.01-86.89); dental surgery (OR 8.89, CI 95% 1.01-86.89) and contact with hepatitis-infected subject (OR 3.01, CI 95% 1.17-7.70). Other risk factors did not show a significant association. DISCUSSION: In this study, we found a crude total prevalence of 0.84%, very close to the prevalence reported in Mexican population by the National Center for Blood Transfusion.

El simulador ®Harvey¼ de paciente cardiológico: la utilización de simuladores, computadoras y equipo multimedia en el aprendizaje de la cardiología / Cardiologic Harvey simulator: utilizing simulators, computers and multimedia equipment in the learning of cardiology

A través de un maniquí y un programa multimedia es posible adquirir conocimientos y destrezas necesarios para la evaluación y tratamiento de múltiples situaciones clínicas en el área de cardiología. Desde 1968, en la Escuela de Medicina de la Universidad de Miami, se viene utilizando un simulador de paciente cardiológico conocido como Harvey con una gran aceptación por parte de paramédicos, estudiantes de medicina, residentes, adscritos y enfermeras. El maniquí está programado para simular 27 situaciones cardiológicas que representan el mínimo necesario que debe de conocer y manejar un estudiante de medicina en el cuarto año, durante su periodo de aprendizaje en la materia clínica de cardiología.

La prueba de aliento como método diagnóstico no invasico en la infección por Helicobacter pylori / Urea breath test as a non-invasive diagnostic method in Helicobacter pylori infection

Existen varios métodos para la detección de la infección por Helicobacter pylori, algunos de ellos (invasivos) requieren de un procedimiento endoscópico y biopsia como la prueba rápida de ureasa, el cultivo y la histología. Recientemente se han desarrollado y aprobado métodos no invasivos, sensibles, específicos, fáciles de realizar y bien aceptados por los pacientes como la prueba de aliento, basada en la hidrólisis de la urea marcada por la ureasa del Helicobacter pylori formando amonio y bicarbonato. El CO2 marcado pasa, a través de la circulación, a los pulmones y es espirado en el aliento de donde puede ser recolectado. La urea puede ser marcada en su átomo de carbono existiendo dos opciones: 13C estable, no radioactivo y 14 C inestable y radioactivo. La prueba de aliento con 13C se basa en la diferencia de masa atómica entre el 12C y 13C y requiere para su cuantificación de un espectómetro de masas y aproximadamente 40 minutos para su realización. La prueba de aliento con 14C contiene 1 uCi (un micro-curie) de radioactividad que corresponde a 1/300 de la radiación recibida en un año del medio ambiente; su realización toma 10 minutos y la lectura se realiza en un contador de centello. Ambas pruebas, no invasivas, han demostrado sensibilidad y especificidad comparables con los ®estándares de oro¼ establecido para el diagnóstico de infección por Helicobacter pylori

Comparación de dos esquemas basados en pantoprazol para erradicación de Helicobacter pylori en pacientes con úlcera duodenal activa / Comparison between two therapies based on pantoprazol for the eradication of Helicobacter pylori in patients with active duodenal ulcers

Objetivo. Comparar la eficacia y tolerabilidad de una terapia triple contra una doble basadas en pantoprazol para erradicar Helicobacter pylori (H. pylori) en pacientes mexicanos con úlcera duodenal activa. Antecedentes. El tratamiento de la enfermedad ulcerosa péptica ha sido revolucionada con el hecho de que H. pylori generalmente induce grastritis crónica y se asocia con enfermedad ulcerosa péptica y la curación de la infección previene la recaída de la úlcera. Material y métodos. 74 pacientes H. pylori positivos con diagnóstico de úlcera duodenal activa recibieron ya sea pantoprazol 40 mg dos veces al día en combinación con claritromicina 500 mg tres veces al día en combinación con claritromicina 500 mg tres veces al día y amoxicilina 1 g dos veces al día (esquema triple = PAC) o bien pantoprazol en combinación con claritromicina y placebo (esquema doble = PC) durante 14 días. Con el fin de asegurar la completa cicatrización de la úlcera, todos los pacientes recibieron 2 semanas adicionales de pantoprazol 40 mg una vez al día. La prueba de aliento con urea marcada con 14C fue el criterio principal para determinar el índice de erradicación con < 150 desintegraciones por minuto (DPM) para considerar a un paciente erradicado. En todos los pacientes se realizaron cultivos y pruebas de susceptibilidad a antibioticos (E-test) así como estudio histológico. Resultados. En el análisis protocolo correcto (n=66) los índices de erradicación fueron: PAC 93.5 por ciento vs 54.3 por ciento (p<0.001); el 76 por ciento de cepas de H. pylori fueron resistentes al metronizadol. La tolerancia y apego al tratamiento fue excelente en ambos grupos. Conclusiones. La triple terapia (PAC) demostró ser superior a la doble (PC) para la erradicación de H. pylori en pacientes mexicanos con úlcera duodenal activa

Superioridad clínical del pantoprazol sobre la ranitidina en la curación de la esofagitis por reflujo grado II y III. Estudio prospectivo, doble ciego, doble pacebo. Experiencia clínica mexicana / Clinical superiority of pantoprazol over ranitidine in the treatment of reflux esophagitis grade II and III. Prospective, double blind and double placebo study. Mexican clinical experience

Objetivo. Comparar y contrastar la eficacia y tolerabilidad de un inhibidor de bomba de protones, pantoprazol, con un antagonista de los receptores H2, ranitidina, en el tratamiento de pacientes con esofagitis por reflujo moderada y severa. Antecedentes. La esofagitis por reflujo es una enfermedad común que afecta del 5 al 10 por ciento de la población mundial. El reflujo ácido juega un papel importante en el desarrollo de la enfermedad, así como las alteraciones en la motilidad del esófago y estómago. Pacientes y métodos. 315 pacientes (intento de tratamiento) con esofagitis por reflujo (Savary-Miller (SM) grados II y III) confirmada endoscópicamente fueron reclutados en este estudio por 46 investigadores mexicanos en nueve centros. Los pacientes recibieron ya sea pantoprazol 40 mg una vez al día o 150 mg de ranitidina dos veces al día en este estudio doble ciego, aleatorizado, con comparación de grupos paralelos. Los pacientes que no alcanzaron una cicatrización endoscópica completa después de cuatro semanas de tratamiento recibieron cuatro semanas adicionales. La tolerabilidad a los medicamentos fue valorada a través del informe de eventos adversos durante el estudio. Resultados. Después de cuatro semanas de tratamiento con pantoprazol el 81 por ciento de los pacientes con SMII y 67 por ciento de los pacientes con SM III habían cicatrizado; en contraste en el grupo tratado con ranitidina cicatrizaron solamente 67 y 30 por ciento respectivamente, todos los resultados están expresados en pacientes protocolo correcto. Después de ocho semanas de tratamiento los índices de cicatrización para el grupo pantoprazol se incrementaron a 94 por ciento y en el grupo de ranitidina 74 por ciento (p=0.001). La incidencia de eventos adversos fue menor del 2 por ciento en ambos grupos de tratamiento, por lo tanto encontramos que ambas terapias fueron bien toleradas. Conclusiones. El pantoprazol es superior a la ranitidina en el tratamiento de esofagitis por reflujo moderada y severa y ambos tratamientos son igualmente bien tolerados

Simposio: cirugía experimental en México (parte I): producción in vivo e in vitro de óxido nítrico por hepatocitos / Symposium: experimental surgery in Mexico (part l): in vivo and in vitro production of nitric oxide by hepatocytes

Objetivo: Demostrar que el óxido nítrico producido por el hígado juega un papel protector en este órgano durante episodios de sepsis. Diseño: Estudio experimental en animales, prospectivo con grupo control. Material y métodos: Se utilizaron ratas Sprague-Dawley machos con peso entre 200 y 250 g. Para experimento in vivo, los animales recibieron una sola inyección de 28 mg/kg/IV de Corynebacterium parvum; ratas normales se emplearon como controles y donadores de hepatocitos para los estudios in vitro. Los hepatocitos normales y estimulados con C. parvum fueron aislados utilizando una modificación a la técnica de perfusión de colagenasa in situ; fueron colocados en platos de Petri con una capa de gelatina de 100 mm en 6 ml de medio de cultivo que contenía: L-arginina, insulina, L-glutaminam, penicilina, streptomicina y 10 por ciento de suero bajo en endotoxina. Después e 24 h en cultivo los hepatocitos recibieron medio frasco adicionado de citoquinas (INF+TNF+IL-1) y endotoxina (LPS para estimular la producción de óxido nítrico in vitro. Los sobrenadantes fueron colectados, almacenados y sujetos a medición de NO2 + NO3 empleando un método automático colorimétrico

Injertos vasculares biológicos para microcirurgía / Biological vascular grafts for microsurgery

En este estudio se revisó el comportamiento de la arteria umbilical humana (AUH), tratada con glutaraldehído, en un calibre de 1.5 mm de diâmetro, substituyendo un segmento de 20 mm de longitud de la aorta abdominal de la rata. Se utilizaron 48 ratas Wistar machos de 250 a 300 g de peso, las cuales fueron divididas en grupos. Fuerojn sacrificadas a diferentes intervalos de tiempo, entre los 12 a 315 días. En el Grupo I (AUH lisa) se observó una permeabilidad del 75%. En el grupo II (AUH corrugada) se obtuvo una permeabilidad del 50%. En el grupo III (AUH lisa + glutaraldehído) se encontró una permeabilidad del 75%. Finalmente, en el grupo IV (AUH corrugada + glutaraldehído se observó una permeabilidad del 66.6%. Aunque la permeabilidad del Grupo III es del 75%, las dilataciones aneurismáticas y clacificaciones importantes (25% y 41.6% respectivamente) que se presentaron no permiten recomendar este tipo de microinjertos para substituir segmentos vasculares en el humano