Consensus on the management of complications of cirrhosis of the liver in pediatrics.

The Asociación Mexicana de Hepatología A.C. carried out the Consensus on the Management of Complications of Cirrhosis of the Liver in Pediatrics to provide physicians with useful information for treating said complications. A group of pediatric gastroenterologists and experts in nutrition, nephrology, and infectious diseases participated and reviewed the medical literature. The Delphi method was applied to obtain the level of agreement on the statements that were formulated. The statements were sent to the participants to be analyzed and voted upon, after which they were discussed in virtual sessions, and the final versions were produced. The aim of the consensus results was to issue indications for the management of pediatric patients with liver cirrhosis, to prevent or control complications.

Pharmacognostical studies of the plant drug Mimosae tenuiflorae cortex.

The bark of the Mimosa tenuiflora (Willd.) Poiret (Leguminoseae) tree, known as tepescohuite in Mexico, is commonly used in this country and in Central America to elaborate different products for the treatment of skin burns and lesions. The cicatrizing properties of extracts obtained from this bark have been scientifically studied, attributing the main biological activity to its tannin and saponin content. Studies include clinical trials of phytodrugs based on Mimosae tenuiflora bark extracts for treatment of venous leg ulcerations. Recent commercialization of the plant drug Mimosae tenuiflorae cortex requires pharmacognostical information to develop quality-control methods for raw materials and extracts produced with this plant drug. The present paper reports a group of ethnobotanical, morphological, chemical, and molecular studies performed with Mimosae tenuiflora materials obtained by collection in the southeastern Mexican state of Chiapas. Macro- and micro-morphological parameters were established to authenticate the genuine drug that allowed detection of adulterants usually found in commercial samples of this plant material. These morphological characteristics can be used for rapid identification of the drug and are particularly useful in the case of powdered materials. The chemical studies performed demonstrated that tannins represent the major component group in the bark. Its content in genuine tepescohuite is 16% and is mainly composed of proanthocyanidins, a condition permitting a tannin-based chemical-control method for fingerprinting the plant drug. Contrariwise, the saponin concentration in Mimosae tenuiflora bark is extremely low, and its isolation and content evaluation represent a complex procedure that is unsuitable for routine control purposes. Finally, random amplified DNA (RAPD) analysis results a useful tool for obtaining DNA specific markers of Mimosae tenuiflora species which should be useful in future studies involving raw material authentication by molecular methods.

Resección de lesiones metastásicas pulmonares / Resection of pulmonary metastasis lesions

The surgical excision of lung metastasis is a procedure with clear indications. Some patients not only survive longer periods, but are actually cured of their malignant disease. We present here the experience at the Hospital Mexico with the surgical treatment of metastatic pulmonary involvement. During the last 6 years 12 patients underwent resection of lung metastasis.There were 5 men and 7 females, with an average age of 42 years. A total of 15 procedures were performed because 3 patient had recurrent disease and were reoperated. A single lobectomy was done in 1 patient and from one to multiple wedge excisions were carried out in the other 14 without surgical mortality. There was only a prolonged air leak(8.3 porcent) that stopped spontaneously. This group is compared to one previously reported, convering from 1969 to 1983. Eleven patient were operated upon, their sex and distribution were just about the same as in the present study. The lesions were unilateral and were treated by lobectomy in 6 cases and wedge excision in 5. There was no mortality and the morbility was 18 porcent.In conclusion, the number of cases has more than doubled. Now we tend to be lesions, even bilaterally, and at the same time sparing more lung tissue.

Archives of Medical Research: an historical and subject coverage overview.

A bibliometric study about the subject content of the articles published in the Mexican scientific journal Archives of Medical Research is reported. The journal, published by the Mexican Institute of Social Security (IMSS), is comprised of 100 regular issues and 12 special supplements giving a total amount of 1,424 reports on medical research performed in Mexico during the last 25 years. According to the type of studies published during this period, we found that there is a similar percent of biomedical and clinical reports in the journal (47 and 42%, respectively) and a low proportion of epidemiological and medical educational reports (8 and 3%, respectively). Six thematic areas of research have been permanently published in this journal: investigations on infectious and neurological diseases being the areas mainly represented (34% of the total, corresponding to 17% in each area), followed by studies in reproductive biology (10%) and endocrine (7%), oncological (5%) and cardiovascular (3%) diseases. The tendency of the subjects covered by the journal during this period shows an increment in reports on infectious and parasitic disorders together with an increase in publications related to medicinal plant pharmacology; reproductive biology and endocrine studies show also an increasing tendency. On the other hand, a moderate decrease in studies related to neurological, oncological and cardiovascular diseases is observed. The origin of contributions during the last five years has balanced the proportion of papers published from IMSS scientists, other Mexican biomedical researchers and foreign contributions, thus reflecting favorably the recent changes in the journal's policies. This journal represents a clear example of a scientific publication edited in a developing country, originating as a national publication that evolved progressively into an international biomedical journal.

Prevalencia de marcadores serologicos de hepatitis en diversos grupos de poblacion del Perú / Prevalence of viral hepatitis serologic markers in different population groups of Perú

Review was undertaken of 5 521 serum samples that had been tested to detect or confirm the presence of different hepatitis A, B, and delta serologic markers. The sources of the samples included a national reference laboratory, several outbreaks of viral hepatitis in civilian and military populations, and a serologic survey. They were examined using the enzyme linked immunosorbent assay (ELISA). The prevalence of antibody to hepatitis A virus was very high (x=92.2 percent) and it was uniform. Prevalence of hepatitis B markers was more variable and inconsistent; it was high in samples from the Jungle region of Perú, where the average prevalence of hepatitis B surface antigen (HBsAg) was 4.9 percent. Antibodies to delta hepatitis were present in 28.6 percent of the carriers of HBsAg identified in the outbreaks. All the outbreaks had similarities, including a high, ciclic case-fatality rate associate with the delta virus. Hepatitis B is highly endemic in Perú, while hepatitis B has average endemicity. It will be necessary to do more research in order to better understand the epidemiology of viral hepatitis in this country

Utilidad de la ultrasonografia en el diagnostico de la enfermedad hepato-biliar / Utility of ultrasonics in the diagnosis of hepatic and biliary disease

La U.S., metodo no invasivo, ha demostrado ya su gran utilidad en el estudio de las enfermedades hepato-biliares y pancreaticas.Los autores analizan en el presente trabajo 40 casos de esta patologia estudiados por ultrasonografia. En 29 casos se establecio la certificacion diagnostica mediante cirugia. En base a estos datos, la U.S. ha demostrado en la presente serie una eficacia global en el diagnostico de patologia quirurgica hepato-biliar del orden del 96%, con un indice de diagnosticos correctos del 65.5%. El estudio de la litiasis biliar ha demostrado para la litiasis vesicular un acierto del 88% y para la coledociana del 25%. En cuanto a la obstruccion subhepatica su acierto fue el 68.75% Su eficacia en cuanto al diagnostico etiologico de la obstruccion es del 74%. Se saca en conclusion que la ultrasonografia es un metodo de altisimo valor en el estudio de la patologia hepato-biliar, no solo por su apreciable eficacia, sino tambien por su sensillez, rapidez e inocuidad

Prevalencia de marcadores serologicos de hepatitis en diversos grupos de poblacion del Peru / Prevalence of viral hepatitis serologic markers in different population groups of Peru

A review was undertaken of 5 521 serum samples that had been tested to detect or confirm the presence of different hepatitis A, B, and delta serologic markers. The sources of the samples included a national reference laboratory, several outbreaks of viral hepatitis in civilian and military populations, and a serologic survey. They were examined using the enzyme linked immunosorbent assay (ELISA). The prevalence of antibody to hepatitis A virus was very high (x=92.2 percent) and it was uniform. Prevalence of hepatitis B markers was more variable and inconsistent; it was high in samples from the Jungle region of Peru, where the average prevalence of hepatitis B surface antigen (HBsAg) was 4.9 percent. Antibodies to delta hepatitis were present in 28.6 percent of the carriers of HBsAg identified in the outbreaks. All the outbreaks had similarities, including a high, ciclic case-fatality rate associate with the delta virus. Hepatitis B is highly endemic in Peru, while hepatitis B has average endemicity. It will be necessary to do more research in order to better understand the epidemiology of viral hepatitis in this country