[Double colonic cancer localization].
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Colonic Neoplasms↗
Biomedical subjects
J Torres
Publications and source records attributed to J Torres.
Studies on the oxidation-reduction systems of the erythrocyte.
1. Starvation for 3 days produces a decrease in methaemoglobin-reductase and glutathione-reductase activities, but it does not alter the glucose 6-phosphate-dehydrogenase activity of the rat erythrocyte. 2. The feeding of a protein-free diet for 11 days causes greater changes in the first two enzymes and also a diminution of the third. Under this experimental condition slight decreases in protein and haemoglobin contents were noted. 3. The experimental animals did not show methaemoglobinaemia, probably because the activity of methaemoglobin diaphorase is preserved. 4. The GSH content was not affected but the stability of the tripeptide in the presence of an oxidizing agent was diminished.
Animals↗
The value of the prognostic nutritional index in the management of patients with advanced carcinoma of the head and neck.
Nutritional status was evaluated in 50 consecutive patients with advanced squamous cell carcinoma of the head and neck. Using a linear equation developed by Busby , the prognostic nutritional index ( PNI ) was calculated from the serum albumin, triceps skin-fold thickness, serum transferrin, and delayed hypersensitivity reaction. The treatment plan was determined by the patient's attending physician and complications were retrospectively evaluated. The patients were divided into three groups by the value of the PNI . The complication rate was not significantly higher in patients with moderate malnutrition ( PNI between 20% and 39%). However, with severe malnutrition ( PNI greater than 39%), the incidence of iatrogenic complications was prohibitive and 12 of 14 patients were dead within 6 months. We conclude that the PNI is a simple, objective measure of nutritional status that will identify patients at high risk for therapy-related complications and early death.
Adult↗
Susceptibility to varicella-zoster infection in individuals 1 to 29 years of age in Mexico.
BACKGROUND: The prevalence of varicella zoster virus (VZV) infection has been poorly studied in Latin America. The aim of this work was to study the seroprevalence of antibody to VZV infection in Mexico. Infection was determined in 3,737 individuals. METHODS: Samples were collected during a national serologic survey performed during 1987-1988 and represented individuals 1- to 29-years-old from all socioeconomic levels and from rural and urban communities throughout the country. Antibodies anti-VZV were measured with a commercially available enzyme-linked immunosorbent assay (VARELISA Merck, Germany). RESULTS: In the population studied, 464 individuals (12.4%) were seronegative or susceptible to infection, whereas about 17.0% of individuals 1- to 19-years-old were susceptible to infection. Between the ages of 20 to 24 years, 8.4% were susceptible and between 25 to 29 years, 5.0% of persons were still susceptible to infection. CONCLUSIONS: Socioeconomic level, density of population, crowding, and gender were not found as risk factors for susceptibility to VZV infection in adolescents and young adults. Low educational level was found as a risk factor for susceptibility. High proportions of adolescents and young adults in Mexico are susceptible to VZV infection and should receive special attention when designing vaccination programs.
Adolescent↗
Serologic evidences suggesting the presence of Borrelia burgdorferi infection in Mexico.
BACKGROUND: Lyme disease is the most common vector-borne human disease in Europe and the United States. In Mexico, clinical cases suggestive of Lyme borreliosis have been reported; however, infection was not confirmed by serologic or microbiologic tests. METHODS: To study the prevalence of IgG antibodies against Borrelia burgdorferi among Mexican persons, a community-based sero-survey including all states of Mexico was done. A sample of 2,890 sera representing individuals of all ages and all socioeconomic levels was studied. Antibodies anti-B. burgdorferi were determined by enzyme-linked immunosorbent assay (ELISA) using a whole-cell sonicated extract of B. burgdorferi strain B31. Serum specimens positive for ELISA were further studied by Western blot (WB). A serum sample was considered positive by WB if at least three of the following protein bands were recognized: 18, 24, 28, 29, 31, 34, 39, 41, 45, 58, 62, 66, and 93 kDa. Some WB positive specimens were further confirmed with an immunodot-blot (IDB) test using recombinant and purified B. burgdorferi proteins. RESULTS: Of the 2,890 specimens, 34 were positive for ELISA; nine of these 34 were confirmed as positive by WB. Four of the nine WB positive sera were tested by IDB and all four were positive. The prevalence of WB confirmed cases in the sample studied was 0.3%. Positive specimens were from residents of the northeastern and central areas of Mexico. CONCLUSIONS: The serological evidences of this study suggest that Borrelia burgdorferi infection is present in the Mexican population. This finding should be confirmed by documenting the infection in clinical cases and in tick vectors.
Adolescent↗
Seroepidemiology of hepatitis E virus infection in Mexican subjects 1 to 29 years of age.
BACKGROUND: Hepatitis E virus (HEV) infection causes an acute, self-limited hepatitis associated with high mortality in pregnant women. Community-based surveys are scarce and information on HEV infection in populations is needed. The aim of this work was to study seroprevalence to HEV in young adults and children in Mexico, using a community-based survey. METHODS: Serum samples from 3,549 individuals were studied; the population included subjects from 1 to 29 years old from all regions of the country representing all socioeconomic levels. IgG anti-HEV was determined by ELISA. RESULTS: Anti-HEV antibodies were found in 374 (10.5%) individuals. Seroprevalence increased with age from 1.1% in children younger than 5 years to 14.2% in persons 26 to 29 years of age (p = 0.006). Risk factors for infection included living in rural communities and a low educational level. Seroprevalence was not associated with the level of regional development. CONCLUSIONS: HEV infection is endemic in Mexico. Age, type of community, and educational level were identified as risk factors for infection.
Adolescent↗
Comparison of invasive and noninvasive methods for the diagnosis and evaluation of eradication of Helicobacter pylori infection in children.
BACKGROUND: Acquisition of Helicobacter pylori infection occurs mainly during childhood. To study the events associated with H. pylori colonization in children it is important to have reliable diagnostic methods. Our objective was to validate invasive and noninvasive tests for diagnosis of H. pylori infection in children before and after antimicrobial treatment. METHODS: Before treatment, invasive rapid urease test (RUT) culture and histology, as well as the noninvasive carbon-13 urea breath test (13C-UBT) and serology were validated in 59 children. The gold standard for H. pylori infection was any of three positives of the five tests. After antimicrobial treatment culture, histology, and 13C-UBT were validated in 43 children to determine eradication. The gold standard for eradication was negative in all three tests. RESULTS: For primary diagnosis, RUT was the most sensitive and specific test, followed by 13C-UBT, which performed better than serology, culture, and histology. Concordance tests also showed that RUT and 13C-UBT performed better. For determination of eradication, 13C-UBT and histology were better than culture, which showed poor sensitivity. CONCLUSIONS: RUT performed better for primary diagnosis. However, as endoscopy might not be indicated in most children, 13C-UBT could be the test of choice for diagnosis of H. pylori infection both before and after eradication treatment.
Adolescent↗
A comprehensive review of the natural history of Helicobacter pylori infection in children.
Across populations of children, Helicobacter pylori prevalence ranges from under 10% to over 80%. Low prevalence occurs in the U.S., Canada, and northern and western Europe; high prevalence occurs in India, Africa, Latin America, and eastern Europe. Risk factors include socioeconomic status, household crowding, ethnicity, migration from high prevalence regions, and infection status of family members. H. pylori infection is not associated with specific symptoms in children; however, it is consistently associated with antral gastritis, although its clinical significance is unclear. Duodenal ulcers associated with H. pylori are seldom seen in children under 10 years of age. H. pylori-infected children demonstrate a chronic, macrophagic, and monocytic inflammatory cell infiltrate and a lack of neutrophils, as compared with the response observed in adults. The effect of H. pylori infection on acid secretion in children remains poorly defined. The events that occur during H. pylori colonization in children should be studied more thoroughly and should include urease activity, motility, chemotaxis, adherence, and downregulation of the host response. The importance of virulence determinants described as relevant for disease during H. pylori infection has not been extensively studied in children. Highly sensitive and specific methods for the detection of H. pylori in children are needed, especially in younger pediatric populations in which colonization is in its early phases. Criteria for the use of eradication treatment in H. pylori-infected children need to be established. Multicenter pediatric studies should focus on the identification of risk factors, which can be used as prognostic indicators for the development of gastroduodenal disease later in life.
Child↗
Hepatitis C virus RNA (HCV-RNA) in blood donors and family members seropositive for anti-HCV antibodies.
BACKGROUND: Non-A, non-B virus is responsible for 75-90% of all cases of blood transfusion-related hepatitis. The aim of this work was to determine hepatitis C virus RNA (HCV-RNA) in a group of blood donors and their household contacts. Serotype and genotype of the isolates were also studied. METHODS: HCV antibodies were investigated in 44,588 blood donors with a commercial immunoassay. Forty-four seropositive donors and 72 household members were further studied. Quantitative analysis of viral RNA was performed with Amplicor HCV 2.0 test, while genotype was determined by INNO-LiPA test and serotype with Murex HCV test. RESULTS: Among the 44,588 donors studied, 333 (0.74%) were positive for anti-HCV. Viral RNA was found in 35 (80%) of the 44 seropositive cases studied. Among the 72 household members, HCV antibodies were detected in six (8.3%) and HCV-RNA in four of these individuals. Serotype 1 and genotype 1 were the most frequent types detected (48 and 64%, respectively). The genotype in the blood donor matched that of his seropositive family member in four of six cases. CONCLUSIONS: Our results suggest that intrafamilial transmission of HCV may occur and we stress the need to study household members of seropositive blood donors, as they have a high risk of infection. In this community, genotype 1 is the most prevalent type in blood donors and family members.
Blood Donors↗
[Waterborne outbreak of gastroenteritis transmitted through the public water supply].
INTRODUCTION: The chlorination of public water supplies has led researchers to largely discard drinking water as a potential source of gastroenteritis outbreaks. The aim of this study was to investigate an outbreak of waterborne disease associated with drinking water from public supplies. METHODS: A historical cohort study was carried out following notification of a gastroenteritis outbreak in Baqueira (Valle de Arán, Spain). We used systematic sampling to select 87 individuals staying at hotels and 67 staying in apartments in the target area. Information was gathered on four factors (consumption of water from the public water supply, sandwiches, water and food in the ski resorts) as well as on symptoms. We assessed residual chlorine in drinking water, analyzed samples of drinking water, and studied stool cultures from 4 patients. The risk associated with each water source and food type was assessed by means of relative risk (RR) and 95% confidence intervals (CI). RESULTS: The overall attack rate was 51.0% (76/149). The main symptoms were diarrhea 87.5%, abdominal pain 80.0%, nausea 50.7%, vomiting 30.3%, and fever 27.0%. The only factor associated with a statistically significant risk of disease was consumption of drinking water (RR = 11.0; 95% CI, 1.6-74.7). No residual chlorine was detected in the drinking water, which was judged acceptable. A problem associated with the location of the chlorinator was observed and corrected. We also recommended an increase in chlorine levels, which was followed by a reduction in the number of cases. The results of stool cultures of the four patients were negative for enterobacteria. CONCLUSIONS: This study highlights the potential importance of waterborne outbreaks of gastroenteritis transmitted through drinking water considered acceptable and suggests the need to improve microbiological research into these outbreaks (viruses and protozoa detection).
Disease Outbreaks↗
[Bilateral trans-sternal thoracotomy in the treatment of complicated bilateral pneumothorax].
Transsternal bilateral thoracotomy ("clam shell" incision) is an approach that allows wide access to both sides of the thorax. Its use dates from the earliest period of cardiac surgery, and it fell into disuse in the face of the advantages of a mid-level sternal approach. The "clam shell" incision was revived, however, with the introduction of lung transplantation. We describe 2 cases of bilateral pneumothorax treated by this surgical route.
Adult↗
Evaluation of paediatric tolerance to an extract of Alternaria alternata under two treatment regimes. A multicentre study.
In order to evaluate the efficacy and safety of an extract of Alternaria alternata in a paediatric population, a two phase study plan has been elaborated that in the first place consists of a retrospective analysis of tolerance under the standard treatment regimes used by the clinical groups involved. This was achieved by analysing the records of 94 patients that have been treated with this extract, these being consecutive patients included at 7 clinics over a period of 6 months. Two regimes were used: a conventional short regime of 7 doses and a cluster regime. Under neither of these two regimes were any serious reactions registered. The percentage of local reactions was significantly greater using the short conventional regime than with the cluster regime (1.9% and 0.4% respectively, p = .035). In contrast, no significant differences were observed with respect to the systemic reactions (0.5% and 1.2%), these percentages also being similar to those registered with other extracts in which identical regimes have been used. In conclusion, we can confirm that a very satisfactory tolerance profile was observed, with the advantage that through using shorter regimes than the conventional regime of 13 doses, a considerable saving is made both in the number of visits and the doses necessary to reach the maintenance dose.
Adolescent↗
[Primary thymic lymphomas].
INTRODUCTION: Primary thymic lymphomas (PTLs) are uncommon, and their prognosis is linked with early treatment. A review is carried out of this disease in our hospital in order to determine the best diagnostic-therapeutic management for these patients. MATERIAL AND METHODS: Ten LPTs--four Hodgkin's and six non-Hodgkin's (4 primary mediastinal B lymphomas [PMBLs] and 2 lymphoblastic T lymphomas [LTLs]--were reviewed. Most of the patients were females, with a mean age of 23 +/- 10 years. RESULTS: The initial diagnostic suspicion in the Hodgkin's lymphomas was thymoma in two cases and lymphoma in the other 2. All of them underwent surgery, including an intra-operative biopsy, which was completed with a thymectomy in the two in which thymoma was reported. They were treated with radio and chemotherapy. The response was partial in two cases, and treatment was completed with a bone marrow transplant (BMT) (one died and the other had active disease). The non-Hodgkin's lymphomas had large tumors and short evolution. All of them received surgery, with an intra-operative biopsy in four and a thymectomy in two. They were treated with chemotherapy, with associated radiotherapy in two. The response was total in three, with two recurring, who are in complete remission after a BMT. In the other three the response was partial. CONCLUSIONS: In a patient with thymic tumour with a preoperative or intraoperative study suspected of having a lymphoma, it is necessary to do a biopsy and not resective surgery, to avoid unnecessary resections and morbidity. PTLs are uncommon but aggressive, principally the non-Hodgkin's lymphomas. The main treatment is radio and chemotherapy, with associated bone marrow transplantation in selected cases.
Adolescent↗
[Comparison of 2 schedules based on pantoprazole for eradication of Helicobacter pylori in patients with active duodenal ulcer].
OBJECTIVE: To compare the efficacy and tolerability of a triple vs dual pantoprazole based therapy to eradicate Helicobacter pylori (H. pylori) in mexican patients with florid duodenal ulcer. BACKGROUND: The treatment of peptic ulcer disease was revolutionized by the fact that H. pylori generally induces chronic gastritis and peptic ulcer disease and that the cure of the infection prevents ulcer relapses. MATERIAL AND METHODS: 74 H. pylori positive patients with florid duodenal ulcer were randomized to receive either pantoprazole 40 mg bid in combination with clarithromycin 500 mg tid and amoxicillin 1 g bid (triple regimen PAC) or pantoprazole in combination with clarithromycin and placebo (dual regimen PC) during 14 days. To ensure complete ulcer healing all patients received an additional 2 weeks treatment with pantoprazole 40 mg od. 14C Urea Breath test (UBT) was the main criteria used to determine eradication rate with < 150 disintegrations per minute (DPM) to consider a patient eradicated. In all patients culture, antibiotic susceptibility (E-test) and histology were performed. RESULTS: In the per protocol analysis (n = 66) the eradication rate was: PAC 93.5% vs PC 54.3% (p < 0.001). 76% of H. pylori strains were resistant to metronidazole. Tolerance and compliance were excellent in both groups. CONCLUSIONS: Triple therapy (PAC) was shown to be superior to dual therapy (PC) for H. pylori eradication in mexican patients with florid duodenal ulcer.
2-Pyridinylmethylsulfinylbenzimidazoles↗
Proportion of mortality caused by severe hospital-acquired infection in open-heart surgery.
OBJECTIVE: To investigate severe hospital-acquired infection as an independent risk factor for in-hospital mortality and the proportion of mortality caused by severe hospital-acquired infections in patients under going open-heart surgery. SETTING: A 1,300-bed teaching hospital in Spain. METHODS: A retrospective cohort study of 702 patients who underwent open-heart surgery procedures between January 1989 and December 1991. The mean age was 57 years, and 68% of the subjects were men. Of the 702 patients, 42% underwent a valve operation, 41% had coronary artery bypass grafting, 4% had both a valve operation and coronary artery bypass grafting, 5% underwent repair of congenital heart disease, and 8% had other surgical procedures. RESULTS: The cumulative incidence of severe hospital infection was 16.8%. The overall mortality rate was 5.4%. The mortality risk was 5.15 times higher in nosocomially infected patients than in uninfected patients. In addition, univariate analysis revealed up to 18 perioperative variables associated with in-hospital mortality. By multiple logistic regression, we identified four factors that independently predicted increased risk of mortality: preoperative New York Heart Association functional class level IV; long duration of cardiopulmonary bypass; low cardiac output syndrome; and severe hospital-acquired infection. The proportion of mortality caused by severe hospital-acquired infection in the cohort was 31.1%. CONCLUSIONS: Severe hospital-acquired infection is a principal factor in in-hospital mortality. One third of all deaths are caused by infection. Major efforts should be devoted to the prevention and control of severe nosocomial infections in open-heart surgery patients to prevent mortality.
Adolescent↗
[Acute unilateral cerebellar ataxia: a case report].
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Acute Disease↗
[Incidence of Helicobacter pylori infection in a cohort of infants in the State of Morelos].
OBJECTIVE: To study the incidence of Helicobacter pylori infection in infants from the State of Morelos, Mexico. MATERIAL AND METHODS: A cohort of 110 healthy infants was studied between 1997 and 1999. Serum samples were collected from mothers and their infants at 2, 6, 18, and 24 months of life. All serum samples were tested for antibodies against Helicobacter pylori with the ELISA test. A questionnaire was used to collect socio-economic and clinical data. Associations among selected variables and Helicobacter pylori infection were determined using Fisher's exact test. RESULTS: Two thirds of mothers and six (5.5%) infants tested positive. Two of the six positive infants were born to positive mothers; both of them became negative before age two. The other four infants remained positive. Although not statistically significant, a vaginal birth and more than five people living in the household are possible risk factors for infant H. pylori infection. CONCLUSIONS: Despite the previously reported high prevalence of infection by H. pylori in Mexican children, in this population we found a low incidence of infection in infants up to two years of age. The English version of this paper is available at: http://www.insp.mx/salud/index.html.
Adolescent↗