[Cost/benefit and cost/effectiveness study: Anahuac telemedicine]. / Análisis costo-beneficio. Telemedicina Anáhuac.

BACKGROUND: We undertook this study to make an accurate cost/benefit and cost/effectiveness assessment of the "Telemedicina Anáhuac" project, which provides virtual satellite medical care via fixed teleconsultations and movable units in rural/marginal areas. METHODS: The basis of the study was a bibliographical analysis of health areas. RESULTS: When making a monetary analysis and observing fair profits, accessibility and increase in coverage in these populations, it is easier to determine whether or not the project is viable and whether or not it accomplishes cost/benefit and cost/effectiveness conditions. It has not been possible to accurately evaluate epidemiological situations or their changes and impact on health because of the short duration of the project in each community. The most valuable benefit of "Telemedicina Anáhuac" is the appropriate medical referral of surgical patients. CONCLUSIONS: From the results obtained, we are aware that this project offers to our country a great opportunity to resolve health problems in marginalized areas. It offers several benefits to the population, to the Health Ministry, to the personnel and to the social service medical students who operate it. In the surgical area, better diagnoses are obtained, and the project helps to decongest the second level of medical care in Mexico.

[Telemedicine Anáhuac. Educational system and health promotion activities]. / Telemedicina Anáhuac. Sistema de educación y apoyo a la atención de la salud.

Rural telemedicine began in the 1950s in the Papago, Arizona Reservation with the program Starphac. The Anáhuac University began the program in 2002. In the Anáhuac, the project was developed to provide specialty consultations in a virtual way to a highly marginalized population, creating clinical fields of high technology and fulfilling social obligations. The program began in Guerrero and was complemented with video conferences to an open population, courses to general physicians, continuing medical education, activities to promote health, and emergency disaster plans. From May 2002 until the end of 2004, 11,576 general consults have been provided and 2,420 specialty consults. The most frequent diagnoses in surgery were peptic ulcer disease, cholecystitis, diabetic foot and superficial venous insufficiency. The telemedicine program has allowed us to bring high specialty consults with great productivity, efficiency, less wait time and cost-benefit impact, along with a high quality of humane care. Resident physicians do their social service in a positive manner, with a permanent consultation office and a program of continuing medical education.

[Acute intestinal obstruction provoked by intraperitoneal secretion of ovarian tumor. A clinical case]. / Obstrucción intestinal aguda provocada por la secreción intraperitoneal de tumor ovárico. Caso clínico.

We report here of the case of a 53-year-old woman who presented with intestinal obstruction without response to medical treatment. Exploratory laparotomy produced a moderate quantity of yellowish-green liquid and agglutination of semi-dough-like material. Separation of the flaps of intestine and colon was easily done by the fingers. A grayish white mass of 10 x 15 cm was seen in the left annex, with a perforation which released the semi-dough-like material. Wide resection of the corresponding annex was carried out. Anatomopathologic examination revealed malignant thecoma with resected free borders of at least 2 cm which was moderately differentiated. Because endometrial biopsy was normal, we decided against further hysterectomy. The patient was referred to an oncologist who did not recommend chemotherapy. The patient was reviewed one year later and was found to be free of tumor and in good condition although with some evidence of occlusive blocking. There have been only four similar cases in the literature in which intestinal obstruction by the same mechanism appeared, also indicating that the finding of malignant thecoma is rare.

Estado actual de la amibiasis / Actual statement of the amebiasis

Objetivo. Realizar una investigación documental bibliográfica y epidemiológica para valorar la situación actual de la amibiasis, en especial su comportamiento biológico, su morbilidad, mortalidad y modalidades de terapia médico/quirúrgico. Metodología. Inicialmente se realiza una revisión documental bibliográfica, para ubicar la situación epidemiológica nacional en el contexto internacional. Posteriormente se realiza una investigación epidemiológica en base de la revisión de 20 años que permite establecer el canal endémico en el Estado de México; para finalizar, analizando los alcances que ha tenido el grupo de investigadores mexicanos en el Centro de Estudios sobre Amibiasis. Conclusiones: el grupo médico en nuestro país ha logrado grandes avances en el abatimiento de la morbilidad de la amibiasis, sin lograr erradicarla, puesto que corresponde a los grandes planes nacionales y la introducción de medidas drásticas de saneamiento ambiental hecho único que abatiría por completo la presencia de la amibiasis en México

Estado actual de la amibiasis / Present status of amoebiasis

Se realizó una investigación bibliográfica y epidemiológica para establecer el estado actual de la amibiasis, especialmente acerca de su comportamiento biológico, morbilidad y mortalidad, así como su tratamiento médico y quirúrgico. En primer lugar, fue necesario comparar la situación epidemiológica nacional con la internacional; después se hizo una investigación epidemiológica a través de una revisión de un periodo de 20 años para determinar los canales endémicos, y finalmente se analizaron los resulataos de un grupo de investigadores mexicanos del Centro de Estudios sobre Amibiasis