Frequencies of BCR::ABL1 Transcripts in Patients with Chronic Myeloid Leukemia: A Meta-Analysis.

Chronic myeloid leukemia (CML) is associated with the Philadelphia chromosome and distinct BCR::ABL1 gene transcripts. We assessed the frequencies of these transcripts in Mexico, Latin America, and worldwide. We determined the prevalence of BCR::ABL1 transcripts in CML patients and intercontinental or regional variations using specialized databases and keywords. We analyzed 34 studies from 20 countries, encompassing 5795 patients. Keyword-based searches in specialized databases guided data collection. ANOVA was employed for transcript distribution analysis. The b3a2 transcript was most prevalent globally, followed by b2a2, with e1a2 being the least frequent. Interestingly, Mexico City exhibited a higher incidence of b2a2, while b3a2 predominated in the remaining country. Overall, no significant intercontinental or regional variations were observed. b3a2 was the most common BCR::ABL1 transcript worldwide, with b2a2 following closely; e1a2 was infrequent. Notably, this trend remained consistent in Mexico. Evaluating transcript frequencies holds clinical relevance for CML management. Understanding the frequency of transcript informs personalized CML treatments.

Gallbladder stones during pregnancy: are we doing the right thing in Mexico?

OBJECTIVE: To present the treatment of choice and approach in pregnant and postpartum women with a diagnosis of gallstones in Mexico and to compare it with the recommendations of international guidelines. METHOD: Observational, descriptive, and retrospective study based on information from the 2019 Dynamic Cubes database of pregnant women diagnosed with cholecystitis and/or cholelithiasis who had undergone cholecystectomy. RESULTS: During 2019, 937 patients with cholelithiasis and cholecystitis were registered, 516 (55%) pregnant and 421 (45%) in puerperium. 91.47% of cases were managed with medical treatment and 8.53% with cholecystectomy, with predominance in the open approach in 63.75% of cases. Mortality was nil in both groups. CONCLUSIONS: Despite current international guidelines recommending early laparoscopic cholecystectomy in pregnant or puerperal women, in Mexico medical treatment, delayed cholecystectomy and its open approach are still privileged.

OBJETIVO: Determinar el tratamiento de elección, el abordaje y la mortalidad en mujeres embarazadas y en puerperio con diagnóstico de litiasis vesicular en México, y compararlo con las recomendaciones de las guías internacionales. MÉTODO: Estudio observacional, descriptivo y retrospectivo basado en la información de la base de datos Cubos Dinámicos del año 2019 de mujeres embarazadas con diagnóstico de colecistitis o colelitiasis que se hubieran realizado colecistectomía. RESULTADOS: En 2019 se registraron 937 pacientes con colelitiasis y colecistitis, 516 (55%) embarazadas y 421 (45%) en puerperio. El 91.47% de los casos se manejaron con tratamiento médico y el 8.53% con colecistectomía, con predominio del abordaje abierto en el 63.75% de los casos. La mortalidad fue nula en ambos grupos. CONCLUSIONES: A pesar de que las guías internacionales actuales recomiendan la colecistectomía laparoscópica temprana en embarazadas y puérperas, en México todavía se privilegian el tratamiento médico, el retraso de la colecistectomía y su abordaje abierto.

Universal prenatal screening: a initiative from Guanajuato, Mexico to improve equity in perinatal healthcare.

The prenatal approach from a preventive perspective is necessary to reduce perinatal complications. A perinatal care model with a holistic and horizontal approach is required. Mexico is currently considered an emerging market economy with inequality and an economic gap that impacts the accessibility and distribution of healthcare services. Guanajuato is one of the 32 states of Mexico and represents 1.6% of the country's surface. Strategies during the prenatal approach allow prediction, diagnosis, and anticipation of the principal causes of morbidity and mortality. Combining data from maternal characteristics and history with findings of biophysical and biochemical tests at 11 to 13 weeks of gestation can define the patient-specific risk for a large spectrum of complications that include miscarriage and fetal death, preterm delivery, preeclampsia, congenital disorders, and fetal growth abnormalities. We aim to describe the care model designed and implemented in the State Center for Timely Prenatal Screening of the Maternal and Child Hospital of Leon, Guanajuato, Mexico. Previous research showed there is a lack of information for low and middle-income countries regarding how to integrate prenatal screening strategies in the absence of resources to perform cell-free fetal DNA or biochemical serum markers in countries with emergent economies. This care model is carried out through horizontal processes where the screening is provided by trained and certified general practitioners who identify the population at risk in a timely manner for specialized care, and could help guide other Mexican states, and other countries with emergent economies with limited financial, professional, and infrastructural resources to improve prenatal care with a sense of equity, equality, and social inclusion as well as the timely evaluation of specialized perinatal care of high-risk patients.

Análisis de la presencia de trisomía 8 en las diferentes fases de leucemia mieloide crónica.

No disponible.

COVID-19-Associated Case Fatality Rate in Subjects Under 18 Years Old in Mexico, up to December 31, 2020.

Background: The emergence of the SARS-CoV-2 and the COVID-19 have become a global health crisis. The infection has been present in all the social sectors. Subjects under 18 years are one of them. The objective was to analyze the case fatality ratio of COVID-19 cases in the Mexican population under 18 years of age registered in the National Epidemiological Surveillance System from March 2020 to December 31, 2020. Material and Methods: The design is cross-sectional, quantitative, and analytical. All the suspected cases of respiratory viral disease, with a real-time polymerase chain reaction (RT-PCR) test result, aged from 0 to 17 years, were included. Descriptive statistics are presented for all the variables. Epidemiological curves were designed. The chi-squared test and its P-values were obtained to show the relationship between comorbidities and death. The case fatality ratio was computed for each comorbidity, sex, and age group. Multivariable logistic regression models were fitted to study the effect between comorbidities with the fatality of cases, adjusting for sex and age group as potential confounders. The alpha value was fixed to 0.05 to assess significance. Results: The number of records for this study was 167,856. Among them, 48,505 were from SARS-CoV-2-positive patients (28.90%), and 119,351 (71.10%) were negative. Of those who died, males (55.29%) (P < 0.05) and those under 2 years of age (50.35%) (P < 0.05) predominated. Unlike in older populations, from the comorbidities considered risk factors for death by COVID-19, only immunosuppression showed a statistically significant effect on the fatality of cases after adjustment by the other related variables. Sex and age group were not confounders for the models in those under 18 years old. Pneumonia, being younger than 5 years, and immunosuppression are related to death. Conclusion: The case fatality ratio in those under 18 years old is low. Special attention must be paid to those children under 5 years. The development of pneumonia is a warning indicator while treating them. On the other hand, having an open database of cases allows the researchers to analyze the impact of COVID-19 in different population sectors, which has clear benefits for public health.

Forty-Year-Old Man With Abdominal Pain 4 Years Post-Renal Transplant: A Case Report.

Tuberculosis (TB) is an opportunistic infection 20 to 74 times more frequent in immunocompromised patients compared to the general population. The prevalence with renal transplant had a 0.5% to 15% incidence. The infection could be pulmonary or extrapulmonary (EPTB). The EPTB accounts for almost 20% of TB cases in immunocompetent people and 50% in positive human immunodeficiency virus cases. In this case report, we present a patient who attended the emergency room because of chronic diarrhea, abdominal pain, loss of weight, nocturne diaphoresis, and intermittent fever. A computed tomography scan showed retroperitoneal ganglionic conglomeration. He got into an exploratory laparotomy for histopathology specimens and paraganglionic fluid culture to a Gene Xpert MTB-RIF Assay G4, positive for rifampicin resistance tuberculosis. After an individualized treatment, trying to protect the graft's remaining function, the patient returned with acute abdominal pain and pancreatic enzymes elevation; the antibiotic management had to be suspended until the return of renal function.

Laparoscopic procedures experience in Mexico during 2015: ¿Where are we?

BACKGROUND: 26 years have passed from the first laparoscopic cholecystectomy in Mexico. Since then the laparoscopy has been adopted of variable way and has extended into different specialties. OBJECTIVE: To identify the place that laparoscopic approaches occupy at the present time in Mexico. METHOD: We searched the codes that had the word laparoscopy or laparoscopic in the records of the Automated System of Hospitable Discharges in 2015. Based on the obtained information there was realized a descriptive and retrospective study. RESULTS: We found 55 different procedures in a total of 30,174. Of them, 79.7% in women and 20.3% in men. The most common age was between 25 and 29 years. The ten first ones were cholecystectomy, appendectomy, total abdominal laparoscopic hysterectomy, procedures to create esophago-gastric sphincter competence, unilateral salpingo-oophorectomy, partial cholecystectomy, ovarian resection, umbilical hernia repair, incidental appendectomy and unilateral oophorectomy (94.6%). The States with the major number are Mexico City, State of Mexico, Jalisco, Guanajuato and Sonora. CONCLUSIONS: The laparoscopic procedures have increase in the national health systems and there is concordance of the most common with the international statistics. However, is necessary to diversify them and reduce the times of hospital stay. Its application is in process and it still face challenges in relation to availability of organizational elements, equipment, infrastructure and training, although there are different ways to overcome them.

ANTECEDENTES: Han pasado 26 años desde la primera colecistectomía laparoscópica en México. Desde entonces, la laparoscopía se ha adoptado de forma variable y se ha extendido a diferentes especialidades. OBJETIVO: Identificar el sitio que ocupan los abordajes laparoscópicos en México. MÉTODO: Se buscaron los códigos que tuvieran la palabra laparoscopia o laparoscópica en los registros del Sistema Automatizado de Egresos Hospitalarios en 2015. Con los datos obtenidos se realizó un estudio descriptivo y retrospectivo. RESULTADOS: Se encontraron 55 procedimientos diferentes en un total de 30,174. De ellos, el 79.7% en mujeres y el 20.3% en hombres. La edad más común fue entre los 25 y 29 años. Los diez primeros fueron colecistectomía, apendicectomía, histerectomía total abdominal laparoscópica, procedimientos para creación de competencia esfinteriana esofagogástrica, salpingo-ooforectomía unilateral, colecistectomía parcial, escisión local o destrucción de ovario, plastia umbilical, apendicectomía incidental y ooforectomía unilateral (94.6% del total). Los Estados con el mayor número reportado fueron Ciudad de México, Estado de México, Jalisco, Guanajuato y Sonora. CONCLUSIONES: Los procedimientos laparoscópicos han ido en aumento en los sistemas de salud nacionales y hay concordancia de los más comunes con las estadísticas internacionales. Sin embargo, es necesario diversificarlos y disminuir los tiempos de estancia hospitalaria. Su aplicación está en proceso y aún enfrentan retos en relación con la disponibilidad de elementos organizacionales, equipo, infraestructura y entrenamiento, aunque existen diferentes alternativas para vencerlos.

[Institutional liability and medical research]. / Responsabilidad institucional e investigación médica.

On December 14, 2011 an addition to Article 100 of the General Health Law was published in the Federation Official Journal. The added section VII states that: "It is the responsibility of the Health Care Institution to provide medical care to the subject that is injured, if this is directly related to the investigation, without prejudice to the legally appropriate compensation", thus establishing the institution's liability in an precise way when it authorizes research. This is a relevant situation of Fundamental Rights. We will present the spirit of the ordinary legislator from the Law initiative to its enactment.

Low birthweight in Mexico: a systematic review.

There is abundant literature on the birth outcomes of women of Mexican origin living in the United States, but in most cases it does not refer to data available in Mexico. We conducted a systematic review of available data regarding low birthweight (LBW) rates in Mexico. We searched official online Mexican administrative data bases and four literature databases: OVID (Global Health), EMBASE, PubMed, and Bireme. The following inclusion criteria were used: (1) study is in English, Spanish, or Portuguese; (2) study presents data regarding LBW or birthweight distribution in Mexico; (3) study defines LBW as either < or ≤2,500 g; (4) study population includes newborn children; and, (5) LBW was a primary interest of the study. Because altitude influences birthweight, it was taken into account when comparing regions. Birth certificate data showed LBW rates of 8.2% in 2008 and 8.5% in 2009 among live births with known birthweights. In 2009, high altitude (≥2,000 m) federal entities (states and Mexico City) had LBW rates higher than the median (>7.9%). States at low altitudes (<50 m) had LBW rates lower than the median, with the exception of Yucatán state. The systematic literature review identified 22 hospital-based studies and three household interview surveys that met our inclusion criteria. The hospital-based LBW rates were relatively similar to the birth certificate data and slightly lower than survey data. Data on LBW rates are available in Mexico. They should be analyzed further and used for comparative studies.