[Cross sectional geriatric assessment of Mexican older people]. / Evaluación geriátrica integral del adulto mayor.

BACKGROUND: Due to the progressive aging of our population, it is imperative to evaluate the life conditions and health limitations of older people. AIM: To report the results of an integral geriatric evaluation of Mexican older people. MATERIAL AND METHODS: A cross-sectional assessment of 324 older subjects of a median age of 70 years (57% females) beneficiaries of the Mexican Institute of Social Security of the city of Querétaro. Social, demographic, medical, functional and cognitive variables were evaluated. RESULTS: Of the studied subjects, 37% were illiterate, 61% lived with a partner and 47% were dedicated to household activities. Thirty three percent had visual impairment, 54% had hearing impairment, 39% had urinary incontinence, 26% reported falls in the last six months, 34% had nutritional problems, 38% were functionally dependent, 49% had sleeping problems, 25% had cognitive impairment and 25% had depression. CONCLUSIONS: The general health outlook of this population is encouraging, considering that more than half are not functionally impaired.

Target repositioning optimization in prostate cancer: is intensity-modulated radiotherapy under stereotactic conditions feasible?

PURPOSE: To assess repositioning reproducibility of the prostate when treatment setup conditions before radiotherapy (RT) are optimized and internal organ motion is reduced with an endorectal inflatable balloon. METHODS AND MATERIALS: Thirty-two patients were treated with 64 Gy to the prostate and seminal vesicles using a three-dimensional conformal radiotherapy technique, followed by a boost (two fractions of 5-8 Gy, 3-5 days apart) delivered to a reduced prostate volume (the peripheral tumor bearing zone with 3-mm margins) using intensity-modulated RT. A commercially available infrared-guided stereotactic repositioning system and a rectal balloon were used. Further improvement in repositioning could be obtained with a stereoscopic X-ray registration device matching the pelvic bones during treatment with the corresponding bones in the planning computed tomography (CT). To simulate repositioning reproducibility, CT resimulation was performed before the last boost fraction. Prostate repositioning was reassessed, first after CT-to-CT fusion with the stereotactic metallic body markers of the infrared-guided system, and second after CT-to-CT registration of the pelvic bony structures. RESULTS: Standard deviations of the prostate (CTV) center of mass shifts in the three axes ranged from 2.2 to 3.6 mm with body marker registration and from 0.9 to 2.5 mm with pelvic bone registration. The latter improvement was significant, particularly in the right-to-left axis (3.5-fold improvement). In 10 patients, systematic rectal probe repositioning errors (i.e., >20-mL probe volume variations or >8-mm probe shifts in the perpendicular axes) were detected. Target repositioning was reassessed excluding these 10 patients. An additional improvement was observed in the anteroposterior axis with 1.7 times and 1.5 times reduction of the standard deviation with body markers and pelvic bone registrations, respectively. CONCLUSIONS: Infrared-guided target repositioning for prostate cancer can be optimized with a stereoscopic X-ray positioning device mostly in the right-to-left axis. An optimally positioned inflatable rectal probe further optimizes target repositioning mostly along the anteroposterior axis. Thus a planning target volume with a margin of 2 (right-to-left), 4 (anteroposteriorly), and 6 (craniocaudally) mm around the CTV can be recommended under optimal setup conditions with pelvic bone registration and optimal repositioning of an inflated rectal balloon.

Artritis séptica: estudio de 40 casos / Septic arthritis: a study of 40 cases

Estudio retrospectivo realizado en la Unidad de Pediatría del Hospital General de México, SSA, de 1979 a 1984, de pacientes ingresados con el diagnóstico de artritis séptica. Se estudiaron 40 casos entre los que predominaron los menores de dos años de edad; el límite de edad fue de 23 días a 15 años y el tiempo de evolución previo al diagnóstico varió de dos a 365 días. Los gérmenes indentificados en el cultivo del líquido sinovial fueron: S. aureus, Micrococus sp, E, coli, Klebisiella, Salmonella y Pseudomonas. El tratamiento antimicrobiano y quirúrgico simultáneo es el que ofrece menores posibilidades de complicaciones y/o secuelas