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tony rivera

    tony rivera

    Introducción: La diabetes es la causa más común de la enfermedad renal crónica y constituye más d 44% de los casos nuevos. Objetivo: Analizar la correlación del estado nutricional y el tiempo de tratamiento con hemodiálisis en pacientes... more
    Introducción: La diabetes es la causa más común de la enfermedad renal crónica y constituye más d 44% de los casos nuevos. Objetivo: Analizar la correlación del estado nutricional y el tiempo de tratamiento con hemodiálisis en pacientes con enfermedad renal crónica y diabetes mellitus tipo 2. Material y métodos: Fueron incluidos 56 pacientes de uno u otro género con rango de edad de 45-82 años, todos en tratamiento con hemodiálisis y diagnóstico de diabetes Abstract
    The Mexican Tarahumara are accustomed to running ultra-distance races. No data exist on the acute physiological changes following ultra-distance running and physiological-biomarker associations in this population. Thus, we aimed to... more
    The Mexican Tarahumara are accustomed to running ultra-distance races. No data exist on the acute physiological changes following ultra-distance running and physiological-biomarker associations in this population. Thus, we aimed to investigate the acute impact (≤ 24 h) on functional and biochemical changes of the cardiac muscle and biochemical changes associated with kidney function following a 63-km ultra-distance race with an altitude difference of 1800 m in Mexican Tarahumara athletes. Ten Tarahumara male athletes (mean ± SD age = 29.9 ± 6.6 years) volunteered to participate in the study. VO2max was assessed by a sub-maximal step test individually calibrated combining heart rate and accelerometry. Standard transthoracic echocardiography methodology and venipuncture blood tests were carried out at four time points: pre-race, immediately post-race, 6 h, and 24 h post-race. Estimated mean VO2max was 54.5 (± 8.8) mL O2 min-1 kg-1 and average physiological activity intensity was 746 (...
    Objetivo: Determinar la prevalencia de complicaciones mas frecuentes de la segunda molar inferior, ocasionadas por la posicion anatomica de la tercera molar inferior, en estudiantes entre 17 y 24 anos de edad de la Facultad de Odontologia... more
    Objetivo: Determinar la prevalencia de complicaciones mas frecuentes de la segunda molar inferior, ocasionadas por la posicion anatomica de la tercera molar inferior, en estudiantes entre 17 y 24 anos de edad de la Facultad de Odontologia de la Universidad de El Salvador, de Marzo a Junio del 2014. Materiales y metodos: Estudio descriptivo y correlacional, a 202 estudiantes se les evaluaron las segundas y terceras molares inferiores utilizando dos guias de observacion, una para examen clinico y otra para interpretacion de radiografia panoramica. El analisis de datos se realizo mediante estadisticos descriptivos y prueba X². Resultados: El 61.39% de la poblacion de estudio, es del sexo femenino y el 38.61% del sexo masculino. Segun la clasificacion de Winter la posicion anatomica de la tercera molar de mayor prevalencia fue mesioangulacion con el 59.9%. Segun la clasificacion de Pell y Gregory el espacio disponible, que prevalecio fue la clase IIA con un 29%. Entre las complicaciones de la segunda molar esta la caries en superficie distal con 48.78%, prevaleciendo con un 23.3% la R1, segun clasificacion de Pitts. En cuanto a la reabsorcion de la cresta osea alveolar, un 20.1% en tercio medio; la profundidad de bolsa periodontal de 4 a 6 mm fue de 35.0%. Y la reabsorcion radicular externa de la raiz distal del segundo molar fue de 10 %. La falta de espacio disponible de la tercera molar inferior, genera al menos una complicacion en la segunda molar inferior adyacente con una significancia estadistica de P=0.002 y un X²= 12.916; y la posicion anatomica mesioangulada de la tercera molar inferior, ocasiona complicaciones en la segunda molar adyacente con una significancia estadistica de P=0.000 y un X²=18.603. Conclusion: La mal posicion anatomica mesioangular de la tercera molar inferior y la falta de espacio para su erupcion, provocan afecciones estadisticamente significativas en la segunda molar adyacente como: caries en superficie distal, reabsorcion de cresta osea, enfermedad periodontal y reabsorcion radicular.
    Sánchez González JM y cols. Diagnóstico, prevención y tratamiento del cáncer Calimed Mayo-Agosto 2007; Vol. 13 Núm. 2 Diagnóstico prevención y tratamiento del cáncer :Reflexiones básicas para la toma de decisiones Introducción En México... more
    Sánchez González JM y cols. Diagnóstico, prevención y tratamiento del cáncer Calimed Mayo-Agosto 2007; Vol. 13 Núm. 2 Diagnóstico prevención y tratamiento del cáncer :Reflexiones básicas para la toma de decisiones Introducción En México los padecimientos cróni-co-degenerativos se han constituido un problema de salud pública. De acuerdo con la Organización Mundial de la Salud (OMS) en el año 2000 ocurrieron 56 millones de muertes, 6.2 millones (12%) de éstas se debieron al cáncer. En el 2005 se repor-taron 58 millones de muertes, 7.6 millones (13%) se debieron al cáncer. Más de 70% de estas muertes registradas se produjeron en países de bajos y medianos ingresos, cuyos recursos para la prevención, diagnóstico y tratamiento de la enfermedad son limitados o inexistentes. Los cánceres que más contribuyen a la mortalidad a nivel mundial por año son: pulmón (1.3 millones), estómago (casi un millón), hígado (662,000 muertes), colon (655,000) y mama (502 000). Se prevé que el número mundial...
    High intensity physical exercise favors accumulation of lactate in muscles and bloodstream, leading to impaired muscle func-tion and exercise performance. This study evaluated the effect of citrulline malate (CM) on blood lactate... more
    High intensity physical exercise favors accumulation of lactate in muscles and bloodstream, leading to impaired muscle func-tion and exercise performance. This study evaluated the effect of citrulline malate (CM) on blood lactate concentration and perception of fatigue after muscular effort in high performance athletes. Seventy-two high-performance athletes who gave written informed consent were randomly assigned to CM 3 g/day, CM 6 g/day or placebo for 13 days. Blood lactate mea-surements were performed every training day. Fatigue was as-sessed through an auto-administered questionnaire at baseline and after 6 and 13 days. Main criterion was the percentage of blood lactate recovery 30 minutes after training. The mean percentage of lactate recovery 30 minutes after training was 89.3 ± 1.1% in the CM3 and 97.9 ± 1.3% in the CM6 group, becoming significantly greater than placebo at day 5 with CM3 and at day 3 with CM6. Lactate variations were stable or de-creased in the 2 active group...
    it has been demonstrated an association between the increase in physical activity and improvements in the lipid profile. to evaluate changes in the serum lipids caused by spinning practice. nine men and twelve women were studied, they... more
    it has been demonstrated an association between the increase in physical activity and improvements in the lipid profile. to evaluate changes in the serum lipids caused by spinning practice. nine men and twelve women were studied, they underwent to an initial evaluation that included a treadmill effort test, in order to establish the physical fitness level. With the purpose of determine the lipids change, a blood sample was obtained before and after a typical spinning session. The design was prospective, experimental, longitudinal and comparative study. Student's t-test and regression model were used to determine the changes in the lipids concentrations, and its relation with the physical fitness level. A p value < or = 0.05 was required for statistical significance. lipids increase concentrations were observed (p < 0.05), except at triglycerides in men, in which it had a decrease. It was statistically significant relation between the physical fitness level and the percenta...
    defensive medicine, has been recognized as a problem for health services in several countries of the world. It is defined as the application of treatments, tests and procedures with the main intention to defend the doctor of critic's... more
    defensive medicine, has been recognized as a problem for health services in several countries of the world. It is defined as the application of treatments, tests and procedures with the main intention to defend the doctor of critic's and to avoid controversies, regarding diagnosis or patient's treatment. There are multiple causes of the defensive medicine: the fundamental is patient doctor relationship without the necessary trust. the present reports it is a observational, cross-sectional and descriptive study of exploratory nature, with the objective to consider the dimension of the defensive medicine (MD) in Mexico. A survey was designed to pilot an application with Likert scale in a representative sample. 613 doctors participated to national level, with index of confidence of 95% and maximum error of 5% (p < 0.05). The questions explore the level in agreement or disagreement with perceptions, specific attitudes and conducts that are related to the MD practice. categori...
    The purpose of this work was to identify changes in some hematic variables in recreational athletes of middle level competition exposed to exhaustive physical exercise, as well as the association among physiologic changes, personal... more
    The purpose of this work was to identify changes in some hematic variables in recreational athletes of middle level competition exposed to exhaustive physical exercise, as well as the association among physiologic changes, personal characteristics, and physical level produced by marathon running. Ten healthy males participated (20-55 years of age). Blood cell count, blood chemistry, lipids, and enzymes were determined. Exercise produced hemoconcentration by reduction in plasma volume (8%; p<0.05). There was significant increment in leukocytes (149%) by neutrophilia (64%) and decrease in lymphocytes (74%). Fibrinogen increased 10.7% (p<0.05). Lipids (CT, C-HDL) did not modify, except C-LDL, which increased significantly (71%), attributing this response to stress of the marathon. Triglyceride decreased 47%. Enzymes increased significantly, particularly CK. Age and physical activity were related with physiologic and metabolic variables, as demonstrated by multivariate analysis. T...
    Frequency an severity of physical and emotional symptoms in young female students from two cities of México (a medium and a large sized city), were studied. An interview was carried out in 447 female adolescents, non seeking treatment, in... more
    Frequency an severity of physical and emotional symptoms in young female students from two cities of México (a medium and a large sized city), were studied. An interview was carried out in 447 female adolescents, non seeking treatment, in a cross sectional design (146 from Guadalajara, and 301 from León). The mean age was 16.7 years (16.5 + SD 1.7 and 17.1 +/- 1.9 respectively). Most frequent symptoms for both groups were abdominal bloating, acne, increased appetite, low back pain, polydipsia, and emotional symptoms related to depression such as fatigue, desire to stay at home, desire to be alone and anxiety. Adolescents from Guadalajara reported increased intensity of diverse symptoms in comparison with adolescents from León: Breast tenderness, polydipsia and symptoms of depression. Difference was maintained after adjustment for covariates. In regards to the phase of the menstrual cycle, significantly different symptoms were: Abdominal bloating, breast tenderness, constipation, pru...
    Medical error is prevalent in the contemporary practice of medicine. Prevention and solution of the majority of medical errors can be focused upon from the early stages of physician formation by improving knowledge and abilities with... more
    Medical error is prevalent in the contemporary practice of medicine. Prevention and solution of the majority of medical errors can be focused upon from the early stages of physician formation by improving knowledge and abilities with regard to human communication. Despite its importance, information systematized with empirical bases on the teaching of human communication in Mexico is non-existent. Our purpose was to highlight the experience of an exploratory nature on the educative intervention on human communication in medicine in medical residents of different medical specialties. A study of educational intervention was presented 216 medical residents of the National Institutes of Health in Mexico City on the topic of human communication in medical practice. Chi square distribution was employed to find associations among variables. Eighty percent of students presented deficiencies in knowledge and thinking abilities for clinical communication. As a result of the educational interv...
    RESUMEN El presente artículo narra la experiencia mexicana con la elaboración de la Carta de los Derechos Generales de los Médicos, que tiene como finalidad recuperar los derechos plasmados en la legislación mexicana en relación con las... more
    RESUMEN El presente artículo narra la experiencia mexicana con la elaboración de la Carta de los Derechos Generales de los Médicos, que tiene como finalidad recuperar los derechos plasmados en la legislación mexicana en relación con las actividades ...
    Resumen Introducción: se ha demostrado una asociación entre el incremento en la actividad física y mejora en el perfil de lípidos. Objetivo: evaluar los cambios en los lípidos séricos causados por la práctica del ciclismo fijo (spinning).... more
    Resumen Introducción: se ha demostrado una asociación entre el incremento en la actividad física y mejora en el perfil de lípidos. Objetivo: evaluar los cambios en los lípidos séricos causados por la práctica del ciclismo fijo (spinning). Material y métodos: se estudiaron nueve ...
    The pediatric outweigh within countries with high infant population, problems of sanitation, hygiene, nutrition and education are due to the predominance of poverty�s pathology as well as a rate increases in the industrialize illnesses... more
    The pediatric outweigh within countries with high infant population, problems of sanitation, hygiene, nutrition and education are due to the predominance of poverty�s pathology as well as a rate increases in the industrialize illnesses and high infant mortality rates. The study�s objective was the emission of Recommendations on the analysis base of the pediatric complains interposed in the Commission from 1997 to 2001. The Database was done from the SAQMED and VMI. The data was computationally processed and analyzed by a statistic package. During the period a total of 200 complains. A high percentage was in children minor of one year of age, mainly male, 61.5%. The predominantly causes were due to infection diarrhea and gastroenteritis. The Social security with 57%. Mainly in the Metropolitan area, 71%. The 50% was due to disagreement with the medical treatment. In 50% was medical malpractice. 23% ended in death. Finally in 51% conciliation agreement was determined. The results in general are related with the Pediatric regular practice and the national morbidity and mortality. Nevertheless, from the medical malpractice case�s analysis, discussion and agreement with the External Validation Group were emitted nine Pediatric Recommendations mainly to the problems which more commonly the specialty faces.
    RESUMEN En la actualidad, la Anestesiología se reconoce como una disci-plina médica y las actividades del anestesiólogo son amplias, ya que se involucra en todos los procesos que ocurren durante el acto anestésico-quirúrgico. La causa más... more
    RESUMEN En la actualidad, la Anestesiología se reconoce como una disci-plina médica y las actividades del anestesiólogo son amplias, ya que se involucra en todos los procesos que ocurren durante el acto anestésico-quirúrgico. La causa más común de daños o complica-ciones serias están asociadas con fallas en la ventilación adecuada del paciente. El objetivo del presente trabajo es emitir recomenda-ciones generales y específicas, dirigidas a los especialistas de Anestesiología, a partir del análisis de las quejas recibidas en la CONAMED. Se analizaron todas las quejas recibidas en la CONAMED para la especialidad de anestesiología de junio de 1996 a mayo de 2001. Se incluyeron variables sociodemográficas, de la institución de salud y motivo de queja entre otras. Se incluyó información de la Valoración Médica Integral, para obtener el tipo de anestesia utilizada. Para el análisis se empleó estadística descriptiva, para este propósito se utilizó el paquete estadístico SPSS 10.1. Resultad...
    Research Interests:
    El perfil de la mortalidad en México se ha modificado: de un perfil con predominio de enfermedades infecciosas a uno donde predominan las enfermedades crónico degenerativas, Entre este último grupo, destacan los tumores malignos, que... more
    El perfil de la mortalidad en México se ha modificado: de un perfil con predominio de enfermedades infecciosas a uno donde predominan las enfermedades crónico degenerativas, Entre este último grupo, destacan los tumores malignos, que ocupan el segundo lugar en la mortalidad general en nuestro país. Por otra parte se han identificado problemas de calidad de la atención médica en éstos pacientes, destacando los relacio-nados con la comunicación médico-paciente y/o sus familiares, retraso en el diagnóstico y diagnósticos erróneos, entre otros. El objetivo del trabajo es identificar los principales problemas referidos en las quejas de Oncología que se han recibido en la CONAMED y brindar recomendaciones generales para el manejo del paciente con cáncer. A partir del Sistema de Atención de Quejas Médicas (SAQMED), se se-leccionaron las quejas sobre los servicios de Oncología que fueron recibi-das en la Institución, entre junio de 1996 y noviembre del 2000. Incluyó información sociodemográ...
    Research Interests:
    Although it has been pointed out that the main cardiovascular risk factors in diabetic are dyslipidemias, hypertension, and cigarette smoking, very few studies have analyzed other risk factors, such as sedentarism and maximal aerobic... more
    Although it has been pointed out that the main cardiovascular risk factors in diabetic are dyslipidemias, hypertension, and cigarette smoking, very few studies have analyzed other risk factors, such as sedentarism and maximal aerobic capacity (VO2 max). The purpose of this study was to evaluate VO2 max and blood lipids (total cholesterol = TC, high density lipoproteins cholesterol = HDL; low density lipoproteins cholesterol = LDL; triglycerides = TG), in 19 diabetics subjects, 19 sedentary and 19 long distance runners. The diabetics of 5-10 years of evolution were non obese (body fat < 28%), and in regular metabolic control (Hb A1 < 12%). The athletes had more than five years of uninterrupted training. The diabetics had significantly lower VO2 max, than the other groups. The mean +/- SEM (mL/kg/min) in diabetics was 30.5 +/- 1.6 versus 41.3 +/- 2.3 in the controls and 54.2 +/- 2.5 in the athletes. There were significant group differences in TG (218 +/- 44 in diabetics vs 106 +...
    Influence of the autonomic nervous system on the heart rate response to active and passive orthostatism. The purposes of this study were twofold. First, to compare heart rate responses as measured by R-R interval under two conditions of... more
    Influence of the autonomic nervous system on the heart rate response to active and passive orthostatism. The purposes of this study were twofold. First, to compare heart rate responses as measured by R-R interval under two conditions of orthostatic stress, i.e. a change from supine to an active free standing-up position (active orthostatism, AO), and from supine to a passive 70 head-up tilt posture (passive orthostatism, PO) second, to utilize a standard pharmacological model to study the participation of the autonomic nervous system upon heart rate responses evoked by AO. In the first part of the research, eight healthy subjects (seven men, one woman) were evaluated for AO and PO. In both occasions, subjects were supine for 5 minutes and then adopted an upright or a tilted position in 3-5 seconds and remained motionless during 5 minutes. In the second part, eight men participated twice in the pharmacological studies. In day one, they stood up for control (AOC), after IV administrat...
    Heart rate (HR), Systolic (SBP), Diastolic (DBP), and Mean Blood Pressures (MBP), were evaluated during a resting sitting and during upright moveless positions, in fifty seven highly trained runners with a maximal oxygen consumption equal... more
    Heart rate (HR), Systolic (SBP), Diastolic (DBP), and Mean Blood Pressures (MBP), were evaluated during a resting sitting and during upright moveless positions, in fifty seven highly trained runners with a maximal oxygen consumption equal or superior to 55 ml/kg. min. (VO2 max greater than or equal to 55 ml/kg . min., group I), and in fifty seven sedentary untrained men (group II). During sitting position the members of group I, had a significantly lower DBP and MBP than the members of group II. In the members of group II the assumption of upright posture did not produce significant changes in blood pressure, whereas subjects of group I showed a significantly drop in SBP, DBP and MBP. The results of this investigation indicated that in human, vigorous physical activity produce lower values of arterial blood pressure, and might be of value in the prevention of high blood pressure. On the other hand, the observed responses in group I during orthostatism, reveal a different regulation ...
    The purpose of this study was to determine the effect of a combination of aerobic exercise and hypocaloric diet on body composition, cardiovascular function and some cardiovascular risk factors in obese patients. Ten subjects, (8 women 2... more
    The purpose of this study was to determine the effect of a combination of aerobic exercise and hypocaloric diet on body composition, cardiovascular function and some cardiovascular risk factors in obese patients. Ten subjects, (8 women 2 men X age 30 years and 138% of ideal body weight) volunteered as participants. The program lasted 12 weeks and consisted of a hypocaloric diet (1257 kcal/day) and 3-5 days/week supervised sessions of aerobic exercise (65-90% maximal heart rate and/or 50-80% of maximal oxygen uptake). The program resulted in a significant mean decrease in body weight of 7.7 kg. for the group (P less than or equal to 0.05). Mean (+/- EE) relative body fat significantly decreased from 35.9 +/- 2 to 31.6 +/- 2%. Interestingly, the decrease in relative body fat was solely accounted for by a significant decrease in fat weight, as body free of fat remained constant. Cardiovascular function as evidenced by oxygen uptake, increased 11.3%. Resting systolic and diastolic blood...
    The purpose of this study was to evaluate the effects of body postural changes (supine-upright), upon the serum concentration of cholesterol (CT), triglycerides (TG), high density lipoproteins (HDL), low density (LDL) and very low density... more
    The purpose of this study was to evaluate the effects of body postural changes (supine-upright), upon the serum concentration of cholesterol (CT), triglycerides (TG), high density lipoproteins (HDL), low density (LDL) and very low density lipoproteins (VLDL) and hemoglobin, hematocrit, and plasma proteins (to calculate delta% change in plasma y volume). Nine healthy men participated as subjects. Their age ranged from 32 +/- 3 years old, and 16 +/- 4% body fat (X +/- SD). After 10-12 hours post absorptive and appropriate rest, they performed a standard orthostatic maneuver: subjects remained supine for 30 minutes, then assumed the standing position (unsupported and with minimal movement) for additional 30 minutes. Blood samples were obtained after 30 minutes supine and at 10, 20 and 30 minutes of standing. At 10 minutes of orthostatism, CT, TG, HDL and VLDL had a significant increase as compared to supine values; these changes were associated with a reduction of 8.9% on plasma volume...
    The purpose of this study was to examine the trends in selected physical cardiovascular and metabolic variables in 248 first division professional soccer players within a period of 27 years (1973-2000). In a cross sectional study (panel)... more
    The purpose of this study was to examine the trends in selected physical cardiovascular and metabolic variables in 248 first division professional soccer players within a period of 27 years (1973-2000). In a cross sectional study (panel) 198 Mexican players and 50 mainly from Brazil and Argentina were evaluated for physical examination, body composition, blood samples, EKG and maximal oxygen uptake on a treadmill. Data were categorized by decade (70's n = 66, 80's n = 84 and…
    The objective of this study was to examine epinephrine and norepinephrine plasma levels in patients with clinical type 2 diabetes mellitus, at different stages of autonomic neuropathy. Eighteen patients were classified in groups without... more
    The objective of this study was to examine epinephrine and norepinephrine plasma levels in patients with clinical type 2 diabetes mellitus, at different stages of autonomic neuropathy. Eighteen patients were classified in groups without (n = 6) and with early (n = 6), definite (n = 3) and severe (n = 3) neuropathy. Blood catecholamine levels were measured after the Valsalva maneuver, cold exposure and orthostatic tests. The norepinephrine basal levels were lower in patients with severe neuropathy (0.4 +/- 0.2 nmol/l), compared with the group with no neuropathy (1.3 +/- 0.5 nm/l, p = 0.034), or with early neuropathy (1.3 +/- 0.7 nm/l, p = 0.035). After the Valsalva maneuver, no increase was found in the group with severe alteration. In patients without neuropathy, cold exposure induced a peak of norepinephrine at 5 min (delta = 1.9 +/- 1.6 nmol/l). The increase was lower in groups with definite and severe damage. In patients with definite or moderate neuropathy, the orthostatic test induced minimal or no response. The epinephrine response to the maneuvers was not significant, and no differences were found among the groups. Norepinephrine basal levels and cold responses are diminished in patients with definite and severe autonomic neuropathy. This provides further evidence on their impaired response to stress. The comparable epinephrine levels in patients with or without autonomic neuropathy indicates that adrenal medullar function is not significantly altered.
    During exercise, water loss frequently occurs in the intracellular spaces and there is a decrease in the plasmatic volume, with a blood concentration as a secondary characteristic. Plasmatic volume losses provoke a decrease in the blood... more
    During exercise, water loss frequently occurs in the intracellular spaces and there is a decrease in the plasmatic volume, with a blood concentration as a secondary characteristic. Plasmatic volume losses provoke a decrease in the blood flow, which directly affects cardiac function. Physical performance decreases and aerobic capacity deteriorates. An observational, prospective, longitudinal, and comparative study was carried out to evaluate gender influence and the aerobic capacity level upon hydration and the plasmatic volume produced by maximal physical exercise. Twenty four individuals between 18 and 35 years old were included. All participated in aerobic physical exercise and changes in hemoglobin, hematocrit, plasmatic volume, and hydration state were evaluated. Gender showed a significant influence on plasmatic volume but not on the hydration state. The aerobic capacity presented a relationship with plasmatic volume, and the plasmatic volume with the hydration state. Women pre...