Identification of Human Papillomavirus genotypes in juvenile laryngeal papillomatosis. Three-year experience in a concentration hospital in Puebla, Mexico

uvenile laryngeal papillomatosis (JLP) is a chronic benign disease of viral etiology, with an aggressive clinical course. In Mexico, the genotypes of the Human Papilloma Virus (HPV) that cause the disease have been poorly studied. The aim of this study was to identify HPV genotypes in PLJ patients. A descriptive and retrospective study was carried out, the records of patients with PLJ treated in a hospital in Mexico were reviewed, in the period 2018-2021. HPV was identied in all patients for genomes 6, 11, 16, and 18. nine patients were included, 56% women, mean age 9.5 ± 5.7 years; seven patients registered positivity for HPV-11 and 2 for HPV-6. The average age at diagnosis was 2.35 ± 1.77 years, with an average of 12 ± 11.56 surgical procedures. In conclusion, the most frequent genotypes in patients with PLJ were HPV-6 and HPV-11, with the latter predominating

Cardiovascular variability in Mexican patients with Parkinson's disease

Cardiovascular variability (CVV) has been evaluated in patients with Parkinson's disease (PD) in other countries and exhibit ethnic differences. Objective We investigated heart rate variability (HRV) and blood pressure variability (BPV) in Mexican patients with PD. Method We further compared HRV and BPV between this group and young healthy controls (YHC) in order to estimate, for the first time in our country, the magnitude of the difference. Twenty patients were examined. Time- and frequency-domain CVV parameters were studied during supine rest (SR), active standing (AS) and controlled breathing. These measurements were compared to those of 20 YHC. Results In the three conditions tested, our study showed a decrease in almost all HRV parameters in PD patients; on the contrary, decreased BPV parameters were found less frequently and only during SR and AS. Conclusion Our results indicate that HRV is impaired in PD. Some BPV parameters are also diminished

Disautonomía gastrointestinal como manifestación de mielitis transversa: Reporte de caso: Gastrointestinal dysautonomia as a manifestation of transverse myelitis: Case report

Inflammatory transverse myelitis is a rare condition that affects one or more levels of the spinal cord. Its etiology includes multiple sclerosis, infectious causes, or disorders within the spectrum of neuromyelitis optica. It presents acutely with motor, sensory, and/or dysautonomic symptoms, such as those related to the gastrointestinal and urinary systems. Diagnosis is based on symptomatology, evolution, and is confirmed by lumbar puncture, magnetic resonance imaging, and complete blood analysis. We present a clinical case of a patient with transverse myelitis who presented with gastrointestinal symptoms, motor symptoms, and was diagnosed with magnetic resonance imaging.La mielitis transversa, de origen inflamatorio, es una afectación rara de la médula espinal que afecta a uno o varios niveles. La etiología incluye esclerosis múltiple, causas infecciosas o trastornos del espectro de la neuromielitis óptica. Se presenta de forma aguda, con síntomas motores, sensoriales y/o disautonómicos como los gastrointestinales y urinarios. El diagnóstico se basa en la sintomatología, evolución y se confirma por punción lumbar, resonancia magnética nuclear y analítica sanguínea completa. Se presenta el caso clínico de una paciente con mielitis transversa, que debutó con sintomatología gastrointestinal, síntomas motores y confirmación diagnóstica con resonancia magnética nuclear

Identificación de genotipos de Virus del Papiloma Humano en papilomatosis laríngea juvenil. Experiencia de 3 años en un hospital de concentración en Puebla, México: Identification of Human Papillomavirus genotypes in juvenile laryngeal papillomatosis. Three-year experience in a concentration hospital in Puebla, Mexico

Background: Juvenile laryngeal papillomatosis (JLP) is a chronic benign disease from viral etiology, whose clinical course can be aggressive. In Mexico, the Human Papillomavirus (HPV) genotypes that cause this disease have been poorly studied. Objective: To identify the HPV genotypes in patients with JLP in a reference Hospital in Puebla, Mexico. Mehods: A retrospective descriptive study was performed in patients with JLP attended in a 3rd level care of the Instituto Mexicano del Seguro Social in Puebla, México, from 2018 to 2021. Medical records were revised. In all patients, HPV identification was performed by polymerase chain reaction for genomes 6, 11, 16 and 18 using specific oligonucleotides. Descriptive statistics were applied. Results: 9 patients were included, 56% women, mean age 9.5 ±5.7 years; 7 patients were HPV-11 positive and 2 HPV-6. The mean age at diagnosis was 2.35 ±1.77 years, with an average of 12 ±11.56 surgical procedures; 5 patients were tracheostomy carriers, 4 had genotype 11; 8 patients were born vaginally, but no patient had maternal genital condylomatous lesions. In the patient born by cesarean section, transmission due to sexual abuse was documented. Conclusions: The most frequent genotypes in patients with JLP in the south-central region of Mexico are HPV-6 and HPV-11, the latter one is predominating.Introducción: La papilomatosis laríngea juvenil (PLJ) es una enfermedad benigna crónica de etiología viral, que tiende a tomar un curso clínico agresivo. En México se han estudiado pobremente los genotipos del Virus del Papiloma Humano (VPH) que causan la enfermedad. Objetivo: Identificar los genotipos del VPH en los pacientes con PLJ en un hospital de concentración en Puebla, México. Métodos: Se realizó un estudio descriptivo y retrospectivo a los pacientes con papilomatosis laríngea juvenil atendidos en un hospital de 3er nivel de atención del Instituto Mexicano del Seguro Social en Puebla, México, en el periodo 2018-2021. Se realizó revisión de expedientes clínicos. En todos los pacientes se identificó el VPH por reacción en cadena de polimerasa para los genomas 6, 11, 16 y 18 utilizando oligonulceótidos específicos. Se aplicó estadística descriptiva. Resultados: Se incluyeron 9 pacientes, 56% mujeres, edad media 9.5 ±5.7 años; 7 pacientes registraron positividad al VPH-11 y 2 al VPH-6. La edad media al diagnóstico fue de 2.35 ±1.77 años, con promedio de procedimientos quirúrgicos de 12 ±11.56; de los 5 pacientes portadores de traqueostomía, 4 fueron positivos a VPH-11; 8 pacientes nacieron por vía vaginal, sin embargo, en ningún caso se reportaron lesiones condilomatosas maternas. En el paciente nacido por cesárea, se documentó transmisión por abuso sexual. Conclusiones: Los genotipos más frecuentes en pacientes con PLJ en la región centro-sur de México son VPH-6 y VPH-11, predominando este último

Apendicitis xantogranulomatosa; un desafío diagnóstico: Caso Clínico : Xanthogranulomatous appendicitis; a diagnostic challenge: Clinical Case

Introduction: Xanthogranulomatous inflammation is a chronic inflammatory process, rarely located in the appendix. A case of xanthogranulomatous appendicitis is presented. Clinical case. A 77-year-old male presents with intermittent pain in the right hemiabdomen and hyperthermia of one month's evolution. Physical examination showed a tumor in the iliac fossa and right abdomen. He underwent surgery for a probable incarcerated right inguinal hernia, acute perforated appendicitis was found, with inflammation and adhesions, purulent fluid in the right hemiabdomen and abdominal wall dissection. The histopathological result was xanthogranulomatous appendicitis. The evolution of the patient was favorable. Conclusion. Xanthogranulomatous appendicitis simulates a typical picture of acute appendicitis. Histopathologically, pathologies such as Crohn's disease, malacoplakia and tuberculous appendicitis were ruled out.Introducción. La inflamación xantogranulomatosa es un proceso inflamatorio crónico, rara vez se localiza en apéndice. Se presenta un caso de apendicitis xantogranulomatosa. Caso clínico. Masculino de 77 años, presenta con dolor intermitente en hemiabdomen derecho e hipertermia de un mes de evolución. La exploración física mostró tumoración en fosa iliaca y abdomen derecho. Se sometió a cirugía por probable hernia inguinal derecha incarcerada, se encontró apendicitis aguda perforada, con inflamación y adherencias, líquido purulento en hemiabdomen derecho y disección en pared abdominal. El resultado histopatológico fue apendicitis xantogranulomatosa.  La evolución del paciente fue favorable. Conclusión. La apendicitis xantogranulomatosa simula un cuadro típico de apendicitis aguda. Histopatológicamente se descartan patologías como enfermedad de Crohn, malacoplaquia y apendicitis tuberculosa

Funcionalidad antes y después de fisioterapia en pacientes post COVID-19: Functionality before and after physiotherapy in post COVID-19 patients

Background: COVID-19 is a disease that since its appearance in 2019 has represented a challenge for health services. The sequelae are a consequence of a deterioration in the quality of life, fatigue, dyspnea and joint pain. Objective: Compare physical, respiratory, cognitive and functional independence functional parameters in post-COVID-19 patients, with respiratory sequelae before and after a respiratory physical and occupational therapy program. Methods: A comparative, quasi-experimental, prospective study was conducted in outpatients discharged from hospitalization due to COVID-19 in a 3rd level hospital of the Instituto Mexicano del Seguro Social in Puebla, Mexico during 2020-2021. Scales were applied before and after the rehabilitation program. Descriptive statistics were used. Results: We included 116 patients, 57.7% men, mean age 47.32 years (min. 20, max. 79); 77 (66.3%) patients had moderate symptoms in hospitalization. A significant p value was obtained (p <0.000) Conclusions: Significant improvement is observed in post-COVID-19 patients after receiving respiratory physical and occupational therapy.Introducción: El COVID-19 es una enfermedad que desde su aparición en 2019 ha representado un reto para los servicios sanitarios. Las secuelas son consecuencia de un deterioro de la calidad de vida, fatiga, disnea y dolor articular. Objetivo: Comparar parámetros funcionales físicos, respiratorios, cognitivos y de independencia funcional en pacientes post COVID-19, con secuelas respiratorias antes y después de un programa de terapia física y ocupacional respiratoria. Métodos: Se realizó un estudio comparativo, cuasiexperimental, prospectivo en pacientes ambulatorios egresados de hospitalización por COVID-19 en un Hospital de 3er nivel de atención del Instituto Mexicano del Seguro Social en Puebla, México durante 2020-2021. Se aplicaron escalas antes y después del programa de rehabilitación. Se utilizó estadística descriptiva. Resultados: Se incluyeron 116 pacientes, 57.7% hombres, edad media de 47.32 años (min. 20, máx. 79); 77 (66.3%) pacientes presentaron síntomas moderados en hospitalización. Se obtuvo un valor de p significativa (p <0.000). Conclusión: Se observa una mejoría significativa en los pacientes post COVID-19 tras recibir terapia física y ocupacional respiratoria

Cognitive characteristics and quality of life in attention deficit hyperactivity disorder

Background: Attention deficit hyperactivity disorder (ADHD) is the most frequent pediatric neurodevelopmental disorder. Studies in Mexico about health-related quality of life (QOL) and cognitive characteristics in these patients are scarce. Objectives: The objective of this study is to describe the relationship between cognitive characteristics and health-related QOL in children with ADHD in Puebla, Mexico. Method: A cross-sectional, analytical study was carried out in a second-level care hospital in Puebla, Mexico. Both genders, from 6 to 12 years old patients with ADHD were included. Those with visual/hearing disabilities and/or severe language delays were excluded. Patients who did not complete the information were eliminated. The Wechsler Intelligence Scale for Children IV (WISC-IV), The Neuropsi and Brief Multidimensional Life Satisfaction Scale for Students (as health-related QOL indicator) scales were applied. Spearman test was used; p ≤ 0.05 was considered significant. Results: 104 children were recruited, 71 male (68.26%), medium age was 8.94 years old (SD = 1.83, min = 6, max = 12). Work memory and processing speed (WISC-IV), and memory and attention (Neuropsi) were the most affected domains. Health-related QOL was low at 60%. WISC-IVs intellectual quotient (r = 0.3962, p = 0.000), and Neuropsi’s memory and attention (r = 0.451, p = 0.018) reported a significant moderated correlation with health-related QOL. Conclusion: Attention, memory, and processing speed were the most affected cognitive characteristics in children with attention deficit/hyperactivity disorder. Health-related QOL resulted low. Intellectual coefficient, as well as memory and attention, reported a significant moderated correlation with health-related QOL

Comparación de la calidad de vida en cirugía conservadora vs no conservadora de esfínteres por cáncer de recto: Comparison of quality of life in sphincter-conserving vs non-conservative surgery for rectal cancer

Introduction: Colorectal cancer (CRC) is the third most common cancer and the second leading cause of death worldwide with an incidence of 10.2%. The treatment of CRC has changed over the past 25 years. Two surgical procedures are used: abdominoperineal resection (AR) and low anterior resection (LAR) and ultra-low (ULAR). The recurrence rate and quality of life are similar.  Objective: To compare quality of life for rectal cancer (CRC) patients treated with abdominoperineal resection vs conservative resections: low anterior (LAR) and ultra-low (ULAR) in UMAE Puebla.  Methods: A comparative, observational, cross-sectional study was conducted in CRC patients treated during 2015-2019 in a 3rd level hospital in Puebla. Two groups were formed: those managed with RA, and those managed with LAR/ULAR. The EORT QLQ CR-29 and EuroQol scale was applied. Descriptive statistics and Man-Whitney U were applied for comparisons.  Results: A total of 26 patients were recruited, 18with AR and 18 with LAR/ULAR. A mean QoL was recorded in the RAP group of 73.72 (SD 16.92, minimum 31.46, maximum 95.09) and in the RAB/RAUB group of 56.22 (SD 6.29, minimum 47.51, maximum 68.96), with a value of p=0.005.  Conclusions: There is no significant difference in the quality of life of patients of CRC patients operated by AR, LAR and ULAR (non-conservative and conservative approach).Introducción: El cáncer colorrectal (CCR) es el tercer cáncer más frecuente y la segunda causa principal de muerte a nivel mundial con una incidencia 10,2%. El tratamiento del CCR ha cambiado durante los últimos 25 años. Se utilizan dos manejos quirúrgicos: la resección abdominoperineal (RAP) y la resección anterior baja (RAB) y la ultra baja (RAUB). La tasa de recidiva y la calidad de vida son similares.  Objetivo: Comparar la calidad de vida de los pacientes con cáncer de recto tratados con resección abdominoperineal vs resecciones conservadoras de esfínteres: anterior baja y ultra baja en la UMAE Puebla.  Métodos: Se realizó un estudio comparativo, observacional, transversal en pacientes con CCR atendidos durante 2015-2019 en un hospital de 3er nivel en Puebla. Se formaron dos grupos: los manejados con RAP y los manejados con RAB/RAUB. Se aplicó la escala EORT QLQ CR-29 y EuroQol. Se aplicó estadística descriptiva y U de Man-Whitney para comparaciones.  Resultados: Se reclutaron 26 pacientes, 18 manejados con RAP y 8 con RAB/RAUB. Se registró una CV media en el grupo RAP de 73,72 (DE 16,92, mínimo 31,46, máximo 95,09) y en el grupo RAB/RAUB de 56,22 (DE 6,29, mínimo 47,51, máximo 68,96), con un valor de p=0,005.  Conclusiones: No hay diferencia significativa en la calidad de vida de los pacientes con CCR operados por RAP, RAB y RAUB (abordaje no conservador y conservador)