Intraspinal and Intracranial Neurotuberculosis, Clinical and Imaging Characteristics and Outcomes in Hospitalized Patients: A Cohort Study (2000-2022).

Neurotuberculosis (neuroTB) is a devastating disease, and is difficult to diagnose. The aim of this study was to analyze the clinical and imaging characteristics, and outcomes of a retrospective cohort (2000-2022) of hospitalized patients diagnosed with intraspinal and intracranial neuroTB. This work was designed through clinical, laboratory and imaging findings. Variables included: demographic data, history of tuberculosis, neurological complications, comorbidities and outcomes. Morbi-mortality risk factors were identified by univariate analysis. The cohort included: 103 patients with intraspinal and 82 with intracranial neuroTB. During the study period, in-hospital mortality of 3% for intraspinal and 29.6% for intracranial neuroTB was estimated. Motor deficit was found in all patients with intraspinal neuroTB. Risk factors for the unfavorable outcome of patients with intraspinal neuroTB were: age ≥ 40 years, diabetes mellitus (DM), diagnostic delay, kyphosis and spondylodiscitis ≥ 3 levels of involvement. Among the patients with intracranial neuroTB, 79/82 (96.3%) had meningitis and 22 patients had HIV infection (10 of them died). Risk factors for mortality from intracranial neuroTB were: HIV infection, hydrocephalus, stroke, lymphopenia and disseminated and gastrointestinal TB. Patients with intraspinal neuroTB had a significant number of destroyed vertebrae that determined their neurological deficit status. The mortality burden in intracranial neuroTB was conditioned by HIV infection and renal transplantation patients.

Conocimientos usuales de los pacientes diabéticos en los estudiantes de medicina del occidente de México” / Usual knowledge of medical students form Western Mexico on diabetic patients

Objetivo: Identificar el conocimiento que presentan los estudiantes de Medicina acerca de los conceptos usuales de los pacientes diabéticos sobre su enfermedad. Material y métodos: Estudio descriptivo en 275estudiantes de Medicina del Centro Universitario del Sur de la Universidad de Guadalajara. Se seleccionó la muestra en forma aleatoria a los alumnos inscritos en el calendario 2006 A, para aplicarles el instrumento Diabetes Knowledge Questionnaire (24). Se utilizó el programa de estadística EPI INFO 2000, se tomó una significancia estadística <0.05.Resultados: Edad en los estudiantes: 20.03±1.9 años. El promedio total de contestaciones acertadas fue: estudiantes 17.56± 3.24, los alumnos de 7º y 8º. ciclo presentaron 19.53 ±2.15 y 19.75±1.92 aciertos. En cuanto a conocimientos básicos de la enfermedad solo el 75.82% contesto adecuadamente los reactivos, en el control glucémico 70.7% y en medidas de prevención y complicaciones 71.9% de los estudiantes. Conclusiones: El conocimiento de los estudiantes de Medicina en cuanto a los conceptos que deben detener los pacientes diabéticos sobre su enfermedad se incrementa en forma significativa en cuanto aumenta los semestres de estudio, los primeros ciclos escolares tienen la tendencia a ser semejantes a la población de pacientes diabéticos de la región (AU)

Objective: To identify the knowledge that presents Medicine students about the usual concepts of the diabetic patients on their disease. Material and Methods: Cross sectional study in 275Medicine alumni of the University Center of the South of the University of Guadalajara. Sample was selected in randomized form in the students enrolled in calendar 2006 A, in order to apply them instrument Diabetes Knowledge Questionnaire (24). The statistic program was used EPI INFO 2000, a statistical significance was taken <0.05.Results: Students age: 20.03±1.9 years. The total average of guessed right answers was: 17.56± 3.24,students of 7º and 8º. cycle presented 19.53 ±2.15 and 19.75±1.92 right answers. As far as basic knowledge of the disease 75,82% answered the reagents suitably, in glycemic control 70.7% and prevention measures and complications 71.9%.Conclusions: knowledge in Medicine students as far as the concepts that must have the diabetic patients on their disease increases in significant form as soon as it increases the semesters of study, the first scholastic cycles have the tendency to be similar to the population in regional diabetic patients (AU)

[Utility of adequate values of an occasional fasting and postprandial glycemia in the chronic control of the type-2 diabetic patient]. / Control de la glucemia en diabeticos tipo 2. Utilidad de mediciones en ayuno y posprandiales.

OBJECTIVE: To identify the sensitivity and specificity of occasional fast and postprandial glycemias as for a chronic control of the type-2-diabetic patient. MATERIAL AND METHODS. DESIGN: Descriptive, cross-sectional in 850 type-2-diabetic adults patients from the outpatient clinic of the Zone General Hospital and Family Medicine 9 in Ciudad Guzmán, Jalisco, Mexico, without insulin therapy, with creatinine values lower than 132.6 micromol/L (1.5 mg/ dL), and glycemia over 4.4 mmol/L (80 mg/dL). PROCEDURE: Blood extraction was carried out to determine fasting glycemia, cholesterol, triglycerides and glycosilated haemoglobin (HbA1c). After that, they were given a breakfast of 320 Kcal, and new blood samples were taken for postprandial glycemia. The statistical programs used were Epi-Info 2000, Epi-Dat. RESULTS: Age, 59. +/- 11.2 years old; antiquity in diabetic diagnosis, 4.8 +/- 6.7 years; fasting glycemia average, 9.9 +/- 4.4 mmol/L (178.6 +/- 79.4 mg/ dL); postprandial glycemia, 14 +/- 6.1 mmol/L (251.6 +/- 109.6 mg/dL); HbA1c, 9.3 +/- 3.4 %. An acceptable fasting glycemia presents an adequate chronic control sensitivity of 44.8 %, with a specificity of 82.1 %. On the other hand, a postprandial glycemia presented a sensitivity of 46.5 % and specificity of 77.3 %; both acceptable parameters have a sentivity of 31.4 % and specificity of 83.3 % to identify a good control of HbA1c. CONCLUSIONS: Random parameters present very little sensitivity to the diagnosis of a good chronic control of the patient; however, as screening tests, they show an acceptable specificity for the HbA1c poor values.