Attenuation of pro-inflammatory cytokines and oxidative stress by misoprostol in renal ischemia/reperfusion in rats.

The ischemia/reperfusion (I/R) process alters metabolic pathways, releasing reactive oxygen species and pro-inflammatory cytokines that cause tissue necrosis and activate cellular apoptotic pathways. Misoprostol (MSP) is a prostaglandin E1 analog that has demonstrated a cytoprotective role in the I/R process. The study objective was to evaluate the effects of MSP on the regulation of pro-inflammatory and oxidative stress mediators in an I/R-induced acute kidney injury rat model. Wistar rats were divided into 3 groups. Sham and I/R were given 1 mL/day of physiological solution; MSP+I/R was given intragastric MSP (300 µg/kg) for 3 days. For I/R and MSP+IR, the renal hilum was clamped for 45 min, followed by 15 h of reperfusion. Renal function tests, pro-inflammatory cytokines, mediators of oxidative stress, and histological analysis were evaluated. Pro-inflammatory cytokine activity was significantly attenuated in the MSP+I/R group. However, there was no statistically significant difference between Sham and MSP. Regarding antioxidant activity, MSP+I/R showed a significant decrease in these mediators compared with Sham and I/R. Histologically, scarce medullary necrosis was observed with a preserved renal cortex in the MSP group.

[Hemorrhoid Therapy with Doppler Guided Hemorrhoidal Artery Ligation via Proctoscope KM-25. A New Alternative to Hemorrhoidectomy and Rubber Band Ligation?]. / Therapie des Hämorrhoidalleidens mittels Hämorrhoidalarterienligatur mit dem Dopplergerät KM-25. Eine neue Alternative zur Hämorrhoidektomie und Gummibandligatur nach Barron?

The aim of treating patients suffering from hemorrhoids is to eliminate or to relieve their complaints. The method should be performed on an out-patient basis, and should be painless and low rated concerning complications. The Morinaga technique fulfills these conditions, its feasibility and the results in 281 patients are presented.

Coulomb energy differences in t = 1 mirror rotational bands in (50)Fe and (50)Cr.

Gamma rays from the N = Z-2 nucleus (50)Fe have been observed, establishing the rotational ground state band up to the state J(pi) = 11+ at 6.994 MeV excitation energy. The experimental Coulomb energy differences, obtained by comparison with the isobaric analog states in its mirror (50)Cr, confirm the qualitative interpretation of the backbending patterns in terms of successive alignments of proton and neutron pairs. A quantitative agreement with experiment has been achieved by exact shell model calculations, incorporating the differences in radii along the yrast bands, and properly renormalizing the Coulomb matrix elements in the pf model space.

[9 reflexions on health and medical education in Mexico]. / Nueve reflexiones sobre la salud y la educación médica en México.

In Mexico's case, the fields of healthcare and medical education are closely vinculated. On the other hand, contemporary society lives in a deep transformation process. In the present article, some paradoxes and contrasts in relation to health and medical education characterize the reality in Mexico. Particular emphasis is made on the analysis of the profound differences which exist between the two federative entities which present the extreme figures on life expectancy at birth. The thesis which supports the document, recognizes the need for integral analysis of the organizational and administrative processes of healthcare and medical education in Mexico.

An open trial of cefoperazone plus sulbactam for the treatment of fever in cancer patients.

Cancer patients received cefoperazone plus sulbactam for 673 febrile episodes presumed to be caused by infection. Overall, 415 (76%) of the 545 evaluable episodes responded. There were 213 responses (84%) amongst the 254 fevers of unknown origin and 202 responses (69%) amongst the 291 documented infections. Fifty-one (61%) of the 83 episodes pneumonia and 74 (64%) of the 115 episodes of bacteraemia responded. Only 39 (58%) of the 67 infections caused by Gram-positive bacteria responded compared with 55 (86%) of 64 Gram-negative infections which included seven of eight caused by Pseudomonas aeruginosa. Eighteen (67%) of 27 polymicrobial infections responded to the regimen. Response rates were significantly lower amongst the 125 patients whose neutrophil counts decreased during therapy than amongst the 158 patients whose neutrophil counts increased. Adverse events which were possibly or probably related to antibiotic therapy were observed during 73 of the episodes; the most commonly reported side-effects were diarrhoea and skin rash. Six patients developed a coagulopathy without haemorrhage and two experienced anaphylactic reactions. In this open trial cefoperazone plus sulbactam proved to be an effective regimen for initial therapy of fever in cancer patients. It should be combined with a glycopeptide in those institutions where infections caused by methicillin-resistant staphylococci are frequently encountered.

Serious complications of vascular catheter-related Staphylococcus aureus bacteremia in cancer patients.

Over the period 1986 to 1989, 53 cancer patients were identified with catheter-related Staphylococcus aureus bacteremia at the University of Texas M.D. Anderson Cancer Center. Septic thrombosis was diagnosed in 12 (23%) patients and was suspected in another 3 (6%). Of the 12 patients, five developed deep-seated infections (septic emboli, endocarditis, meningitis, abscess), compared with 2 of the 38 other patients with no septic thrombosis (p < 0.01). Fever persisted for more than three days after antibiotic initiation in 52% of the patients with complications (septic thrombosis and/or deep-seated infections), compared with 19% of those without complications (p < 0.02). Of the three patients with complications who were treated for 14 days with intravenous antistaphylococcal antibiotics, two relapsed; in contrast, all of the nine patients with complications who were treated for more than 14 days (mean 4 weeks) were cured, and none relapsed (p < 0.05). Of the nine patients with complications who were treated with a long course of therapy, only one required surgery. The possibility of septic thrombosis and/or deep-seated infections should be considered in all cancer patients with catheter-related Staphylococcus aureus bacteremia, and if present, the condition should be treated with appropriate intravenous antibiotics for at least four weeks.

Cobertura y calidad del registro de las defunciones en una comunidad rural / Coverage and quality of the registries of deaths in a rural community

En Mexico, en la mayoria de las areas rurales, la informacion sobre la salud en la que se incluye a las estadisticas vitales, es incompleta y de pobre calidad. Este estudio confirma que el metodo de encuesta es util para conocer la cobertura de las oficinas locales de registro sobre las defunciones y que el adiestramiento del personal encargado de efectuarlo mejora la calidad de los datos. El empleo de medicos durante su servicio social para supervisar y adiestrar al personal responsable del registro puede ser altamente satisfactorio

El registro de defunciones en una comundial rural. / Death registers in a rural community

En el presente estudio se analiza la información sobre defunciones en un municipio del estado de Tlaxcala con población de 4.946 habitantes (Censo de 1970), durante los años 1972 a 1976 y se compara la información correspondiente a tres años de este periodo con la publicada oficialmente por la Dirección General de Estadística correspondiente a este mismo municipio. De 449 defunciones 96% fueron certificadas médicamente, Al revisar los certificados de defunción, se encontró que de 391 solo 57% corresponde a defunciones en las Que el médico certificante atendi6 al fallecido durante su última enfermedad, en 56% de los casos la causa de muerte se anota con un solo diagnóstico y sólo en 2% de los certificados se utiliza el apartado Il. Al comparar 389 pares de certificados con las respectivas hojas de concentración mensual de los datos referentes a sexo, edad y causa de la defunción, se encontraron diferencias importantes. Una comparación similar se realizó entre los datos consignados en las actas y los datos obtenidos de la Dirección General de Estadística, encontrándose que el total de defunciones no coincide con las dos fuentes (257 vs. 253); de la misma manera que la distribución por sexo tampoco es concordante. Al analizar las causas de defunción de acuerdo a la lista de 150 causas de la Clasificación Internacional de Enfermedades las diferencias son aún más evidentes

La mortalidad en la atencion medica primaria en la jurisdiccion de Huamantla, Tlaxcala. / The morbidity in primary medical care in Huamantla, Tlaxacala

RESUMEN El artículo señala la falta de conocimiento de la morbilidad que se presenta en los servicios médicos de primer contacto, particularmente el caso del medio rural mexicano. Este problema se ve complicado por la falta de clasificaciones adecuadas para catalogar las enfermedades que se presentan en este medio. Con el fin de contribuir al conocimiento de la morbilidad en estos sitios. en el presente trabajo se comunican los datos de la consulta a enfermos en las unidades rurales de una jurisdicción sanitaria de la Secretaría de Salubridad y Asistencia (Huamantla, Tlaxcala). Durante el año 1978. La información se recolectó a través del registro diario de las actividades en los Centros de Salud "C", como parte de un programa de investigación de la atención médica desarrollado conjuntamente por la Facultad de Medicina de la Universidad Nacional Autónoma de México (UNAM) y la Secretaría de Salubridad y Asistencia (SSA). se incluyeron tanto los diagnósticos correspondientes al motivo de consulta de primera vez o subsecuente, como los diagnósticos adicionales elaborados durante la consulta. Asimismo, se captó información demográfica básica. En el estudio se utilizó una clasificación de morbilidad de 98 causas, diseñada por el Departamento de Medicina General. Familiar y Comunitaria de la Facultad de Medicina de la UNAM. Durante el periodo estudiado se registraron 14,801 consultas a pacientes enfermos, la mayoría en niños menores de 15 años (52%) y en mujeres (55%). Del total de consultas, en 90% se notificó un sólo diagnóstico. Además, aproximadamente 90% de los diagnósticos fueron codificados como de primera vez, hecho que sugiere falta de continuidad en los servicios. Los padecimientos infecciosos del aparato respiratorio y de las vías digestivas comprendieron 35% de la demanda de consulta. Otro motivo importante de consulta fue ocasionado por sintomatología vaga a la que no se pudo dar un diagnóstico preciso. Los datos mostraron la característica presencia de los padecimientos infecciosos agudos en to-- dos los grupos de edad, especialmente en los niños; así como la aparición de las enfermedades crónico-degenerativas entre los individuos de edad avanzada. Otro problema atendido con mucha frecuencia fueron los padecimientos ginecológicos entre las mujeres en edad fértil. 183