End-stage renal disease (ESRD) patients have an elevated risk of cardiovascular (CV) complication... more End-stage renal disease (ESRD) patients have an elevated risk of cardiovascular (CV) complications including acute myocardial infarction (AMI); endothelial dysfunction and accumulation of uremic toxins have been associated with such CV-events. To explore which molecular pathways are involved in this CV-complication and the effects of the uremic serum on gene expression, an endothelial dysfunction model was studied through microarrays and pathway analysis. mRNA was isolated of human coronary arterial endothelial cells (HCAEC) primary cultures supplemented with 20% uremic serum from two groups of patients, USI: ESRD-patients; UCI: ESRD-AMI-patients. Affymetrix GeneChip® microarray and the LIMMA-package (Linear Models for Microarray Data) of the Bioconductor sofware17 was implemented to identify relevant DEGs between the two groups of uremic patients. Protein-protein interaction networks and pathway analysis were made to analyze the interaction and expression tendency of differentially...
To describe and analyze the general characteristics and methodology of indexed publications by th... more To describe and analyze the general characteristics and methodology of indexed publications by the health staff of the Mexican Social Security Institute in 1997. Original articles were evaluated. The primary sources included Index Medicus, Current Contents and the Mexican National Council of Science and Technology (CONACYT) index. The following information was gathered for each article: affiliation and chief activity of the first author; impact factor of the journal; research type; field of study; topic of study, and methodological conduction. This latter point included congruence between design and objective, reproducibility of methods, applicability of the analysis, and pertinence of the conclusions. A total of 300 original articles was published of which 212 (71%) were available for the present study: full-time investigators (FTI) generated 109 articles and investigators with clinical activities (CAI) wrote 103 articles. The median impact factor of the journals in which FTI publi...
Resumo: Con el objeto de determinar el efecto del control prenatal sobre la morbimortalidad mater... more Resumo: Con el objeto de determinar el efecto del control prenatal sobre la morbimortalidad materna e infantil se revisaron los ingresos obstétricos del Hospital General Regional de Orizaba, Veracruz de 1991 a 1992. Se estudiaron 2595 pacientes quienes se clasificaron ...
Background: Residual renal function (RRF) is an important determinant of mortality and morbidity ... more Background: Residual renal function (RRF) is an important determinant of mortality and morbidity in patients receiving peritoneal dialysis (PD). Recent studies have shown a positive effect of angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) on RRF in PD patients. Objective: To compare enalapril and losartan for RRF preservation in automated peritoneal dialysis (APD) patients. Material and methods: An open label randomized controlled trial (RCT) with a 12 month follow-up period was conducted to compare the effect of enalapril vs. losartan on RRF preservation in 60 APD patients. Measurements were done at the start of the study (baseline), 3, 6, 9, and 12 months. A historical control group (HCG) without treatment was included to assess the natural history of RRF loss. Results: RRF in the enalapril group dropped from 3.65 +/- 1.6 (baseline) to 2.36 +/- 0.38 mL/min/1.73 m2 (12 months). In the losartan group RRF was reduced from 4.1+/- 2.01 (baseline) to 2.54 +/- 0.47 mL/min/ 1.73 m2 (12 months). There were not significant differences between the two groups regarding RRF at 12 months. In the HCG, RRF declined from 3.68 +/- 0.48 to 1.4 +/- 0.29 mL/min/ 1.73 m2 (12 months). RRF in the HCG was significantly lower than RRF in the two treated groups at 12 months (P < 0.05). Conclusions: There was not significant difference on RRF preservation between enalapril and losartan groups. Comparing these results to those of the HCG suggests that the treatment with any of the drugs is useful in preserving RRF.
Objective: To assess the cost-effectiveness ratio of ceftriaxone and cefotaxime to treat moderate... more Objective: To assess the cost-effectiveness ratio of ceftriaxone and cefotaxime to treat moderate to severe community acquired pneumonia (CAP). Methods: A clinical trial was done in five hospitals of the Instituto Mexicano del Seguro Social, at the metropolitan area of Mexico City. Ceftriaxone and cefotaxime were compared to treat moderate to severe CAP, and the costs of purchasing, preparation, administration, hospitalization, and therapeutic success were quantified. Cost-effectiveness ratio was calculated, and sensitivity analysis and incremental analysis were done. Results: The main isolated germs were Streptococcus pneumoniae (23.6%) and Staphylococcus aureus (18.5%). Most of the microorganisms were sensitive to ceftriaxone, ceftazidime, and cefotaxime, and were resistant to penicillin, ampicillin, and erythromycin. Therapeutic success was 98% in the ceftriaxone group and 83% in the cefotaxime group (p = 0.0091). Cost-effectiveness ratio for per cent unit of success was $19,458.62 Mexican pesos in the ceftriaxone group and $29,218.08 in the cefotaxime group. Sensitivity analysis showed consistently a lower cost-effectiveness ratio in the ceftriaxone group. Incremental analysis based on the treatment of 55 patients showed that using ceftriaxone instead of cefotaxime resulted in saving $35,170.79 per each additional cured patient. Conclusions: Ceftriaxone has a lower cost-effectiveness ratio than cefotaxime to treat patients with CAP and bad prognosis criteria requiring hospitalization.
Objective: To determine the risk of pediatric end stage renal disease patients undergoing continu... more Objective: To determine the risk of pediatric end stage renal disease patients undergoing continuous ambulatory peritoneal dialysis to develop a subsecuent peritonitis episode caused by an identical Staphylococcus aureus (SA) strain. Methods: Longitudinal survey carried out in a CAPD center at the nephrology department of a tertiary care (reference) pediatric hospital. At recruitment, swabs were collected from the nares, exit site, and hands, respectively from 29 patients who were followed-up for a mean period of 369 +/- 80 days (range 224-516 days), and from the nares and hands of their mothers. Isolated SA strains were kept in BHI glycerol at -20 degrees C for subsequent analysis. Peritonitis episodes were monitored and registered. When a SA strain was isolated from the dialysate effluent it was compared with the preexisting strain by PFGE. Results: We report 7 SA-mediated peritonitis episodes among 6 patients. Only one of these patients was a previous nasal carrier, and 2 were previous exit site carriers of the same SA strain. The relative risk of developing a peritonitis episode caused by a preexistent SA strain colonizing the exit site was 0.948. The relative risk of developing a peritonitis episode caused by a preexistent SA strain colonizing the nares was 0.525. Conclusions: SA carriers do not appear to be at higher risk of developing peritonitis by an SA related strain than non-carriers. Our results do not lend support to the recommendation of monitoring nasal or exit site carrier status in CAPD patients. The need of attempting to eradicate SA from nose or exit site is also questioned.
Due to the participation of intracellular free calcium in the mechanisms of vascular smooth muscl... more Due to the participation of intracellular free calcium in the mechanisms of vascular smooth muscle contraction, and its importance in the physiopathology of essential arterial hypertension, its possible role in pre-eclampsia physiopathology, was investigated as a cellular model, platelets, were use, as they are similar to vascular smooth muscle cells. The study purpose was to investigate if intracellular concentration of ionized calcium is greater in the patients with pre-eclampsia than in normotensive pregnant women, and also, if there exists a correlation between intracellular calcium concentrations and arterial tension, Seven pre-eclamptic patients, diagnosed by the following criteria: arterial tension greater than or equal to 130/90 mmHg, edema and proteinuria, between 20 to 35 years of age, during the third trimester of gestation, without personal nor family antecedents of hypertension; none of them received treatment at the time, were studied. As control group seven normotensi...
Pentoxifylline is a drug with hemorheological actions used in the management of microcirculatory ... more Pentoxifylline is a drug with hemorheological actions used in the management of microcirculatory abnormalities, such as those usually seen in diabetic patients. The drug has been successfully used in improving peripheral and central circulation, as well as proteinuria of long-term diabetes. With the hypothesis that pentoxifylline reduces proteinuria in patients with IDDM and NIDDM, with a wide range of urinary protein excretion, 86 diabetic patients were studied. Forty-one patients with IDDM were stratified in 2 subgroups: one of 18 patients with microalbuminuria, and the other of 23 patients with overt proteinuria. In the same way, 45 patients with NIDDM were divided in 2 subgroups: one of 23 patients with microalbuminuria, and the other of 22 patients with proteinuria. Patients in each subgroup were randomized to receive either placebo or pentoxifylline 1,200 mg/d, during 4 months, using a double blind design. At the beginning of the study and after treatment, 24-hour urinary albu...
Revista de investigación clínica; organo del Hospital de Enfermedades de la Nutrición
To test the acute effects of the intake of a phosphoric acid containing soft drink on acid-base b... more To test the acute effects of the intake of a phosphoric acid containing soft drink on acid-base balance and on calcium and phosphate metabolism. We studied 14 young adult male Sprague-Dawley rats aged 90 days, and 14 immature animals aged 30 days. Half of the animals in each group were randomly assigned to receive either tap water (controls), or Coca-Cola ad libitum for seven days. After this period, the rats were individually placed in metabolic cages to collect 24 hours urine, and they were exsanguinated by aortic puncture. Immediately, pH and ionized calcium were measured in whole blood. Creatinine, phosphate and total calcium were determined in the urine and plasma. Plasma levels of PTH, 1 alpha, 25 (OH)2 D3 and 25 OH D3 were measured by IRMA and RIA commercial kits. The animals receiving the soft drink, both adults and immature, developed significant hypercalciuria and hyperphosphaturia. In immature animals, the plasma pH dropped from 7.45 +/- 0.04 to 7.33 +/- 0.02 (p < 0.05...
El objetivo del trabajo es identificar lo que significa la practica interprofesional en atencion ... more El objetivo del trabajo es identificar lo que significa la practica interprofesional en atencion a la salud para para alumnos y docentes de las carreras de enfermeria, medicina, odontologia, optometria y psicologia de la FES Iztacala y lo que piensan que se requiere para llevarla a cabo. Se aplico un cuestionario sobre trabajo en equipos interprofesionales. Se elaboraron categorias de analisis y se establecieron unidades de significado respecto a situaciones en las que se considera necesario el trabajo interprofesional, conocimientos, habilidades y actitudes que consideran importantes para el trabajo en equipos interprofesionales. Hubo 154 participantes: 58 estudiantes de los primeros semestres, 59 de los ultimos y 37 profesores de las cinco carreras. La mayoria considero necesario el trabajo interprofesional principalmente en enfermedades cronicas no transmisibles. Los docentes y los estudiantes de ultimos semestres ya habian tenido experiencia de trabajo en equipos interprofesiona...
El objetivo de este trabajo es resaltar la importancia de incluir la educacion interprofesional (... more El objetivo de este trabajo es resaltar la importancia de incluir la educacion interprofesional (EI) en los planes de estudios de las profesiones de atencion de la salud y dar a conocer algunas acciones que se han llevado a cabo en ese sentido. La colaboracion interprofesional consiste en que los profesionales de la salud trabajen juntos y con los usuarios para lograr atencion de alta calidad que beneficie a pacientes, familias, comunidades, prestadores de atencion y sistemas de salud. La Organizacion Mundial de la Salud ha destacado la importancia de que los planes de estudios promuevan la formacion de equipos interprofesionales. Se han identificado diversos obstaculos para el desarrollo de la EI, entre los que destacan la escasa difusion y comprension del concepto de interprofesionalidad, las diferencias culturales entre las profesiones para la atencion de la salud, el diseno curricular de los planes de estudios y problemas logisticos y de organizacion. Incorporar actividades de E...
Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, 1996
Objective To assess some epidemiological and demographic aspects of peritoneal dialysis (PD) at t... more Objective To assess some epidemiological and demographic aspects of peritoneal dialysis (PD) at the Instituto Mexicano del Seguro Social (IMSS), the major institution of social security in Mexico, that provides health care services for 57% of the Mexican population at the time of the study. Study Design A cross-sectional analysis of data about patients under peritoneal dialysis in 1992. Data Sources A national survey containing demographic data, dialysis modality, type of catheter, peritonitis and death rates, and questions on costs, medical staff, and physical facilities for PD in all of the hospitals of the IMSS. Results All hospitals returned the information re quested. Intermittent peritoneal dialysis (IPD) was performed in 19 hospitals, continuous ambulatory peritoneal dialysis (CAPD) in 11, and both modalities in 90. In 61 hospitals, a special area was designed for PD; in the rest of them, beds from general internal medicine departments were used. All hospitals had a head for ...
Boletín médico del Hospital Infantil de México, 1991
In order to evaluate the usefulness of certain clinical and paraclinical characteristics to be ab... more In order to evaluate the usefulness of certain clinical and paraclinical characteristics to be able to discriminate the minimal change disease (MCD) from other histopathological lesions associated with the nephrotic syndrome (NS), the clinical charts of 31 patients were reviewed and relevant data were analyzed. Those patients with no history of biopsy and those with documented MCD through biopsy, were placed in one group (MCD = 25) and the rest as others (others = 6). None of the clinical or paraclinical indicators analyzed showed significant differences between either group. In the MCD group, 76% of the patients entered remission after receiving steroid treatment, while none of the others entered remission. The magnitude of the proteinuria, hypoalbuminemia, hypercholesterolemia, and the presence of hematuria, hypertension or hyperazoemia, were not useful to discriminate those with MCD from other lesions. The response to treatment with prednisone was the most useful data to differen...
End-stage renal disease (ESRD) patients have an elevated risk of cardiovascular (CV) complication... more End-stage renal disease (ESRD) patients have an elevated risk of cardiovascular (CV) complications including acute myocardial infarction (AMI); endothelial dysfunction and accumulation of uremic toxins have been associated with such CV-events. To explore which molecular pathways are involved in this CV-complication and the effects of the uremic serum on gene expression, an endothelial dysfunction model was studied through microarrays and pathway analysis. mRNA was isolated of human coronary arterial endothelial cells (HCAEC) primary cultures supplemented with 20% uremic serum from two groups of patients, USI: ESRD-patients; UCI: ESRD-AMI-patients. Affymetrix GeneChip® microarray and the LIMMA-package (Linear Models for Microarray Data) of the Bioconductor sofware17 was implemented to identify relevant DEGs between the two groups of uremic patients. Protein-protein interaction networks and pathway analysis were made to analyze the interaction and expression tendency of differentially...
To describe and analyze the general characteristics and methodology of indexed publications by th... more To describe and analyze the general characteristics and methodology of indexed publications by the health staff of the Mexican Social Security Institute in 1997. Original articles were evaluated. The primary sources included Index Medicus, Current Contents and the Mexican National Council of Science and Technology (CONACYT) index. The following information was gathered for each article: affiliation and chief activity of the first author; impact factor of the journal; research type; field of study; topic of study, and methodological conduction. This latter point included congruence between design and objective, reproducibility of methods, applicability of the analysis, and pertinence of the conclusions. A total of 300 original articles was published of which 212 (71%) were available for the present study: full-time investigators (FTI) generated 109 articles and investigators with clinical activities (CAI) wrote 103 articles. The median impact factor of the journals in which FTI publi...
Resumo: Con el objeto de determinar el efecto del control prenatal sobre la morbimortalidad mater... more Resumo: Con el objeto de determinar el efecto del control prenatal sobre la morbimortalidad materna e infantil se revisaron los ingresos obstétricos del Hospital General Regional de Orizaba, Veracruz de 1991 a 1992. Se estudiaron 2595 pacientes quienes se clasificaron ...
Background: Residual renal function (RRF) is an important determinant of mortality and morbidity ... more Background: Residual renal function (RRF) is an important determinant of mortality and morbidity in patients receiving peritoneal dialysis (PD). Recent studies have shown a positive effect of angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) on RRF in PD patients. Objective: To compare enalapril and losartan for RRF preservation in automated peritoneal dialysis (APD) patients. Material and methods: An open label randomized controlled trial (RCT) with a 12 month follow-up period was conducted to compare the effect of enalapril vs. losartan on RRF preservation in 60 APD patients. Measurements were done at the start of the study (baseline), 3, 6, 9, and 12 months. A historical control group (HCG) without treatment was included to assess the natural history of RRF loss. Results: RRF in the enalapril group dropped from 3.65 +/- 1.6 (baseline) to 2.36 +/- 0.38 mL/min/1.73 m2 (12 months). In the losartan group RRF was reduced from 4.1+/- 2.01 (baseline) to 2.54 +/- 0.47 mL/min/ 1.73 m2 (12 months). There were not significant differences between the two groups regarding RRF at 12 months. In the HCG, RRF declined from 3.68 +/- 0.48 to 1.4 +/- 0.29 mL/min/ 1.73 m2 (12 months). RRF in the HCG was significantly lower than RRF in the two treated groups at 12 months (P < 0.05). Conclusions: There was not significant difference on RRF preservation between enalapril and losartan groups. Comparing these results to those of the HCG suggests that the treatment with any of the drugs is useful in preserving RRF.
Objective: To assess the cost-effectiveness ratio of ceftriaxone and cefotaxime to treat moderate... more Objective: To assess the cost-effectiveness ratio of ceftriaxone and cefotaxime to treat moderate to severe community acquired pneumonia (CAP). Methods: A clinical trial was done in five hospitals of the Instituto Mexicano del Seguro Social, at the metropolitan area of Mexico City. Ceftriaxone and cefotaxime were compared to treat moderate to severe CAP, and the costs of purchasing, preparation, administration, hospitalization, and therapeutic success were quantified. Cost-effectiveness ratio was calculated, and sensitivity analysis and incremental analysis were done. Results: The main isolated germs were Streptococcus pneumoniae (23.6%) and Staphylococcus aureus (18.5%). Most of the microorganisms were sensitive to ceftriaxone, ceftazidime, and cefotaxime, and were resistant to penicillin, ampicillin, and erythromycin. Therapeutic success was 98% in the ceftriaxone group and 83% in the cefotaxime group (p = 0.0091). Cost-effectiveness ratio for per cent unit of success was $19,458.62 Mexican pesos in the ceftriaxone group and $29,218.08 in the cefotaxime group. Sensitivity analysis showed consistently a lower cost-effectiveness ratio in the ceftriaxone group. Incremental analysis based on the treatment of 55 patients showed that using ceftriaxone instead of cefotaxime resulted in saving $35,170.79 per each additional cured patient. Conclusions: Ceftriaxone has a lower cost-effectiveness ratio than cefotaxime to treat patients with CAP and bad prognosis criteria requiring hospitalization.
Objective: To determine the risk of pediatric end stage renal disease patients undergoing continu... more Objective: To determine the risk of pediatric end stage renal disease patients undergoing continuous ambulatory peritoneal dialysis to develop a subsecuent peritonitis episode caused by an identical Staphylococcus aureus (SA) strain. Methods: Longitudinal survey carried out in a CAPD center at the nephrology department of a tertiary care (reference) pediatric hospital. At recruitment, swabs were collected from the nares, exit site, and hands, respectively from 29 patients who were followed-up for a mean period of 369 +/- 80 days (range 224-516 days), and from the nares and hands of their mothers. Isolated SA strains were kept in BHI glycerol at -20 degrees C for subsequent analysis. Peritonitis episodes were monitored and registered. When a SA strain was isolated from the dialysate effluent it was compared with the preexisting strain by PFGE. Results: We report 7 SA-mediated peritonitis episodes among 6 patients. Only one of these patients was a previous nasal carrier, and 2 were previous exit site carriers of the same SA strain. The relative risk of developing a peritonitis episode caused by a preexistent SA strain colonizing the exit site was 0.948. The relative risk of developing a peritonitis episode caused by a preexistent SA strain colonizing the nares was 0.525. Conclusions: SA carriers do not appear to be at higher risk of developing peritonitis by an SA related strain than non-carriers. Our results do not lend support to the recommendation of monitoring nasal or exit site carrier status in CAPD patients. The need of attempting to eradicate SA from nose or exit site is also questioned.
Due to the participation of intracellular free calcium in the mechanisms of vascular smooth muscl... more Due to the participation of intracellular free calcium in the mechanisms of vascular smooth muscle contraction, and its importance in the physiopathology of essential arterial hypertension, its possible role in pre-eclampsia physiopathology, was investigated as a cellular model, platelets, were use, as they are similar to vascular smooth muscle cells. The study purpose was to investigate if intracellular concentration of ionized calcium is greater in the patients with pre-eclampsia than in normotensive pregnant women, and also, if there exists a correlation between intracellular calcium concentrations and arterial tension, Seven pre-eclamptic patients, diagnosed by the following criteria: arterial tension greater than or equal to 130/90 mmHg, edema and proteinuria, between 20 to 35 years of age, during the third trimester of gestation, without personal nor family antecedents of hypertension; none of them received treatment at the time, were studied. As control group seven normotensi...
Pentoxifylline is a drug with hemorheological actions used in the management of microcirculatory ... more Pentoxifylline is a drug with hemorheological actions used in the management of microcirculatory abnormalities, such as those usually seen in diabetic patients. The drug has been successfully used in improving peripheral and central circulation, as well as proteinuria of long-term diabetes. With the hypothesis that pentoxifylline reduces proteinuria in patients with IDDM and NIDDM, with a wide range of urinary protein excretion, 86 diabetic patients were studied. Forty-one patients with IDDM were stratified in 2 subgroups: one of 18 patients with microalbuminuria, and the other of 23 patients with overt proteinuria. In the same way, 45 patients with NIDDM were divided in 2 subgroups: one of 23 patients with microalbuminuria, and the other of 22 patients with proteinuria. Patients in each subgroup were randomized to receive either placebo or pentoxifylline 1,200 mg/d, during 4 months, using a double blind design. At the beginning of the study and after treatment, 24-hour urinary albu...
Revista de investigación clínica; organo del Hospital de Enfermedades de la Nutrición
To test the acute effects of the intake of a phosphoric acid containing soft drink on acid-base b... more To test the acute effects of the intake of a phosphoric acid containing soft drink on acid-base balance and on calcium and phosphate metabolism. We studied 14 young adult male Sprague-Dawley rats aged 90 days, and 14 immature animals aged 30 days. Half of the animals in each group were randomly assigned to receive either tap water (controls), or Coca-Cola ad libitum for seven days. After this period, the rats were individually placed in metabolic cages to collect 24 hours urine, and they were exsanguinated by aortic puncture. Immediately, pH and ionized calcium were measured in whole blood. Creatinine, phosphate and total calcium were determined in the urine and plasma. Plasma levels of PTH, 1 alpha, 25 (OH)2 D3 and 25 OH D3 were measured by IRMA and RIA commercial kits. The animals receiving the soft drink, both adults and immature, developed significant hypercalciuria and hyperphosphaturia. In immature animals, the plasma pH dropped from 7.45 +/- 0.04 to 7.33 +/- 0.02 (p < 0.05...
El objetivo del trabajo es identificar lo que significa la practica interprofesional en atencion ... more El objetivo del trabajo es identificar lo que significa la practica interprofesional en atencion a la salud para para alumnos y docentes de las carreras de enfermeria, medicina, odontologia, optometria y psicologia de la FES Iztacala y lo que piensan que se requiere para llevarla a cabo. Se aplico un cuestionario sobre trabajo en equipos interprofesionales. Se elaboraron categorias de analisis y se establecieron unidades de significado respecto a situaciones en las que se considera necesario el trabajo interprofesional, conocimientos, habilidades y actitudes que consideran importantes para el trabajo en equipos interprofesionales. Hubo 154 participantes: 58 estudiantes de los primeros semestres, 59 de los ultimos y 37 profesores de las cinco carreras. La mayoria considero necesario el trabajo interprofesional principalmente en enfermedades cronicas no transmisibles. Los docentes y los estudiantes de ultimos semestres ya habian tenido experiencia de trabajo en equipos interprofesiona...
El objetivo de este trabajo es resaltar la importancia de incluir la educacion interprofesional (... more El objetivo de este trabajo es resaltar la importancia de incluir la educacion interprofesional (EI) en los planes de estudios de las profesiones de atencion de la salud y dar a conocer algunas acciones que se han llevado a cabo en ese sentido. La colaboracion interprofesional consiste en que los profesionales de la salud trabajen juntos y con los usuarios para lograr atencion de alta calidad que beneficie a pacientes, familias, comunidades, prestadores de atencion y sistemas de salud. La Organizacion Mundial de la Salud ha destacado la importancia de que los planes de estudios promuevan la formacion de equipos interprofesionales. Se han identificado diversos obstaculos para el desarrollo de la EI, entre los que destacan la escasa difusion y comprension del concepto de interprofesionalidad, las diferencias culturales entre las profesiones para la atencion de la salud, el diseno curricular de los planes de estudios y problemas logisticos y de organizacion. Incorporar actividades de E...
Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, 1996
Objective To assess some epidemiological and demographic aspects of peritoneal dialysis (PD) at t... more Objective To assess some epidemiological and demographic aspects of peritoneal dialysis (PD) at the Instituto Mexicano del Seguro Social (IMSS), the major institution of social security in Mexico, that provides health care services for 57% of the Mexican population at the time of the study. Study Design A cross-sectional analysis of data about patients under peritoneal dialysis in 1992. Data Sources A national survey containing demographic data, dialysis modality, type of catheter, peritonitis and death rates, and questions on costs, medical staff, and physical facilities for PD in all of the hospitals of the IMSS. Results All hospitals returned the information re quested. Intermittent peritoneal dialysis (IPD) was performed in 19 hospitals, continuous ambulatory peritoneal dialysis (CAPD) in 11, and both modalities in 90. In 61 hospitals, a special area was designed for PD; in the rest of them, beds from general internal medicine departments were used. All hospitals had a head for ...
Boletín médico del Hospital Infantil de México, 1991
In order to evaluate the usefulness of certain clinical and paraclinical characteristics to be ab... more In order to evaluate the usefulness of certain clinical and paraclinical characteristics to be able to discriminate the minimal change disease (MCD) from other histopathological lesions associated with the nephrotic syndrome (NS), the clinical charts of 31 patients were reviewed and relevant data were analyzed. Those patients with no history of biopsy and those with documented MCD through biopsy, were placed in one group (MCD = 25) and the rest as others (others = 6). None of the clinical or paraclinical indicators analyzed showed significant differences between either group. In the MCD group, 76% of the patients entered remission after receiving steroid treatment, while none of the others entered remission. The magnitude of the proteinuria, hypoalbuminemia, hypercholesterolemia, and the presence of hematuria, hypertension or hyperazoemia, were not useful to discriminate those with MCD from other lesions. The response to treatment with prednisone was the most useful data to differen...
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