Inflammatory bowel disease in Mexico: Epidemiology, burden of disease, and treatment trends. / Epidemiología, carga de la enfermedad y tendencias de tratamiento de la enfermedad inflamatoria intestinal en México.

INTRODUCTION AND AIMS: There is no systematized information for determining/monitoring the burden of inflammatory bowel disease in Mexico. The aim of the present study was to estimate the annual burden of inflammatory bowel disease on the Mexican National Healthcare System, by number of patients seen, hospitalizations, and specific deaths, stratified into age groups. MATERIALS AND METHODS: Utilizing specific databases of the Mexican National Healthcare System registries coded as ICD-10: K50 and K51, we retrieved and analyzed the data corresponding to the patients seen and hospitalized in 2015, stratified by age group, as well as the specific deaths. Treatment trends among physicians were also examined. RESULTS: In 2015, 5,009 women (8.1) and 4,944 men (8.4) with Crohn's disease received medical attention (prevalence of cases seen) and 35.1% of those patients were ≥50years of age. In that same period, 17,177 women (27.7) and 15,883 men (26.9) with ulcerative colitis were seen and 31.6% of those patients were ≥50years of age. The hospitalized cases (prevalence of hospitalized cases) were 1,097 patients (0.91) with Crohn's disease and 43.7% of those patients were ≥50years of age; and 5,345 patients (4.42) with ulcerative colitis and 47.6% of those patients were ≥50years of age. Deaths (specific mortality rate) were: 32 women (0.52) and 36 men (0.50) due to Crohn's disease, and 267 women (4.31) and 186 men (3.15) due to ulcerative colitis. CONCLUSIONS: Inflammatory bowel disease is a burden on the health of Mexican adults and the Mexican National Healthcare System, and it is expected to increase over the next 15years.

[Helicobacter pylori eradication frequency with the conventional triple therapy in adult patients at the Centro Médico Issemym]. / Frecuencia de erradicación del Helicobacter pylori con triple esquema convencional en pacientes adultos del Centro Médico Issemym.

BACKGROUND: In Mexico, the prevalence of Helicobacter pylori (H. pylori) infection is high. The bacterial eradication rate with the administration of antibiotic regimens recommended by international guidelines is not yet clear. AIMS: To determine the eradication frequency of H. pylori infection in the adult Mexican population that underwent treatment with the conventional triple regimen. MATERIAL AND METHODS: A cross-sectional study was carried out that evaluated the effectiveness of the triple regimen in individuals with confirmed infection that received consensual treatment and then underwent tests to corroborate eradication. RESULTS: From a total of 249 potential case records, 26 did not meet the inclusion criteria. Two hundred and twenty-three patients were enrolled for analysis, 64,00% women and 36,00% men, with a mean age of 49,4 years (range 17-86). Comorbidities presented in 55,60% of the patients and 28,60% referred to chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs). Bacterial eradication with the triple regimen was 65,50% (146/223); of the 77 patients with no eradication, 11 received a quadruple regimen as second-line treatment resulting in bacterial eradication in 5/11 (45,45%) patients, for an overall eradication of 67,70%. CONCLUSIONS: The eradication rate in our study population was suboptimal due to the probability of multiple factors that are difficult to identify, given the retrospective design of the study. A prospective and controlled evaluation of the recommended regimens needs to be carried out in order to determine their true effectiveness.

Reconstrucción de lesiones de extremidad inferior con Colgajo de Arteria Sural Superficial, experiencia de 10 años / Reconstruction of lower extremity lesions with superficial sural artery flap: a ten-year experience

La cobertura de heridas complejas en extremidades inferiores es un desafío de difícil manejo. Se realizó un estudio retrospectivo, analizando el resultado y las complicaciones en el uso del colgajo sural a pedículo distal para cobertura de defectos de extremidad inferior. Material y Método: Revisión de fichas clínicas de todos los pacientes sometidos a colgajo sural en los Hospitales Militar y Trabajador de Santiago entre los años 1995 y 2005, analizando características epidemiológicas, técnica quirúrgica y complicaciones del procedimiento. Resultados: Colgajos surales totales: 40 casos. Etiología de lesión: Fracturas: 33 casos (82,5%), heridas complejas (infectadas, inestables) 4 casos (10%), desforrramiento: 2 casos (5%) y quemadura: 1 caso (2,5%). En 20 casos no hubo complicación, y dentro de las complicaciones se encontraron necrosis parcial: 8 casos (20%), infección: 5 casos (12,5%), epidermolísis: 4 casos (10%) y seroma en 3 casos (7,5%). No se reportaron casos de necrosis total. Conclusión: El colgajo sural a pedículo distal es una alternativa válida de cobertura en lesiones complejas de extremo distal de extremidad inferior, con complicaciones de manejo aceptables, y con buen resultado a largo plazo.

Background: The covering of complex wounds of lower extremities is a difficult challenge. Aim: To analyze the results and complications on the use of sural flaps with distal pedicle for the covering of lower extremity defects. Material and Methods: We reviewed the clinical records of all the patients that had sural flaps between 1995 and 2005 at the Military Hospital and Workers Hospital of Santiago, Chile. We analyzed the epidemiologic characteristics, surgical techniques and complications of the procedure. Results: We found 40 cases of sural flaps. The etiology of the lesions were fractures in 33 cases (82.5%), complex wounds: four cases (10%), skin tearing and muscle laceration in 2 cases (5%) and burns 1 case (2.5%). In 20 cases there were no complications. Eight cases had partial necrosis (20%), five had infections (12.5%), four had epidermolysis and three had a seroma (7.5%). There were no reports of total necrosis. Conclusions: Sural flaps with a distal pedicle are a valid alternative for the covering of complex wounds of the distal portion of lower extremities, with a low rate of complications and good long term results.