Creencias y actitudes hacia la medicina tradicional Mexicana en las poblaciones de Zacualtipán y Pachuca, Hidalgo / Beliefs and attitudes towards traditional Mexican medicine in the towns of Zacualtipán and Pachuca, Hidalgo

La medicina tradicional ha resultado ser una práctica médica importante para la calidad de vida de las personas. No obstante su estudio desde la psicología social y cultural ha visto pocos frutos. A partir del presente ensayo se pretende mostrar el panorama general de la salud, la medicina y la medicina tradicional como una aproximación a tal estudio, de modo que se destaque la relevancia de este estudio por sus consecuencias en la salud, atendiendo a una aproximación sobre la conducta de las personas dirigidas a este tipo de prácticas médicas y el por qué, a pesar de tener al alcance los servicios de salud oficiales, acuden a este tipo de prácticas médicas.

Utilidad del bloqueo paravertebral en cirugía de aorta torácica / Usefulness of the paravertebral block for surgery of the thoracic aorta

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La reglamentación Europea y la autorización de nuevos alimentos: el caso Unilever / No disponible

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Funcionamiento del Servicio de Atención al Consumidor / No disponible

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Accuracy of the clinical diagnosis of recessive X-linked ichthyosis vs ichthyosis vulgaris.

The present study analyzes the accuracy of the clinical diagnosis of X-linked ichthyosis (XLI) vs ichthyosis vulgaris (IV), in a sample of Mexican patients. The study was double blind, using steroid sulfatase (STS) activity as the golden standard. Twenty male patients were included; 16 corresponded to XLI and 4 to IV. The clinical diagnosis was correct in 9 of the 16 XLI cases (56%) and in 2 of the 4 IV cases (50%). Some clinical findings in XLI, such as cryptorchidism in patients and delayed labor in their mothers, were important features for diagnosis. Statistical analysis of the results showed: among physicians (n = 2) Kappa value 0.50, specific concordance 0.40, and absolute concordance 0.75; other values were sensibility 0.56, specificity 0.50, positive predictive value 0.82, negative predictive value 0.22, accuracy 0.55, prevalence 0.80. In conclusion, the differential diagnosis of XLI and IV is very difficult, and we consider that this is not explained either by personal skills or by other conditions. It could be attributed to the similarities in skin manifestations of these two diseases. The performance of the STS assay is imperative in order to correctly diagnose the disease and offer adequate genetic counseling.

Importance of acid-base strategy in reducing myocardial and whole body oxygen consumption during perfusion hypothermia.

During induced hypothermia with cardiopulmonary bypass, acid-base management usually follows one of two strategies: the so-called ectothermic or alpha-stat strategy, in which the pH of the arterial blood increases 0.015 pH units for every degree Celsius decrease in body temperature, or the pH-stat strategy, in which pH remains 7.4 at all temperatures. It has been assumed that oxygen consumption decreases approximately equally during hypothermia with either strategy, although there are biochemical reasons to hypothesize that oxygen consumption would be better maintained with the alpha-stat strategy. We also hypothesized that venous oxygen tension would be lower with the more alkaline alpha-stat strategy than with the pH-stat acid-base strategy, because of the Bohr effect. We tested these hypotheses by placing 10 anesthetized immature domestic pigs on cardiopulmonary bypass. We measured whole body oxygen consumption and myocardial oxygen consumption. Control measurements were made at 37 degrees C. Then the animals were cooled to 27 degrees C and the measurements were repeated. The alpha-stat strategy (pH 7.554 +/- 0.020 at 27 degrees C) was used in five animals and five animals received pH-stat management (pH 7.409 +/- 0.012 at 27 degrees C). Whole body and myocardial oxygen consumption rate decreased in both groups, but more so in the alpha-stat animals than in the pH-stat animals. The unexpectedly high oxygen consumption in the pH-stat animals also resulted in a lower than expected venous oxygen tension. Thus the effect of hypothermia in reducing oxygen consumption was less pronounced with pH-stat acid-base management.

Progressive systemic sclerosis and nephrotic syndrome. An unusual association resulting in postpartum acute renal failure.

A 27-year-old, full-term pregnant woman with progressive systemic sclerosis (PSS) came to the hospital with marked proteinuria and edema. Two days later, she gave birth to a normal baby. After delivery and during the next 48 hours, renal failure developed. A renal biopsy specimen disclosed findings characteristic of PSS, and immunofluorescence studies displayed nonspecific deposits of fibrinogen and complement. The patient's general condition deteriorated, with development of pericarditis and pulmonary failure; after several peritoneal dialysis treatments, a peritoneal infection developed, and the patient died of Gram-negative sepsis. The association of PSS and nephrotic syndrome is unusual.