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World Journal of Vaccines 2011年第1期1卷 1-4页

作者： Reyna Jesus Herbas Ilse gómez misael Vidal Patricia Richardson Vesta Cruz Edith Cruz Edith National Center for the Health of the Childhood and the Adolescence Ministery of Health Mexico

Objective: To investigate maternal and neonatal complications resulting from inadvertent immunization against rubella-measles during the first trimester of pregnancy. Methods: A prospective and descriptive study was carried out, including a total of 1,924 pregnant women, 175 (9.1%) of which were classified as non responding to infection by the rubella virus. They underwent clinical and ultrasonographic follow-up to dismiss maternal or fetal complications and complications at the time of delivery. The infant was checked to determine demographic, anthropometric, serological and clinical features at the time of birth. Results: No women had complications during the pregnancy, including exanthematic symptoms. 174/175 newborns were studied;one pregnancy was interrupted based on non-medical arguments. The findings in terms of the analyzed patients suggest a benign evolution after inadvertently immunizing the pregnant women, which support studies with similar results. No complications during the course of the pregnancy or phenotypic alterations of the infant at the time of birth are suggested.

关键词： Congenital Rubella Pregnancy Perinatal Repercussion

Implementation of a New Solution for the Preservation of Anatomical Specimens Made of Non-Toxic Substances

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Open Journal of Veterinary Medicine 2024年第3期14卷 56-67页

作者： Ma Reyes Pichardo-Molinero Samantha Jardon-Xicotencatl misael R. Oliver-gonzález Carlos g. garcía-Tovar Laboratorio de Apoyo Técnico a la Anatomía Facultad de Estudios Superiores Cuautitlán Universidad Nacional Autónoma de México Estado de México Mexico Unidad de Investigación Multidisciplinaria L4 (Morfología Veterinaria y Biología Celular) Facultad de Estudios Superiores Cuautitlán Universidad Nacional Autónoma de México Estado de México Mexico

The preservation of anatomical pieces in Veterinary Anatomy is essential since it is not possible to dissect all domestic species. Most techniques use reagents with high levels of toxicity such as formaldehyde. The objective of this work was to develop a new preservation technique that uses reagents with zero toxicity and that allows obtaining preserved pieces suitable for anatomical studies. The alcohol propylene glycol technique was developed, the method of which uses a fixation step with alcohol, sodium chloride, commercial vinegar and subsequently the impregnation of the preservation solution made from propylene glycol and commercial vinegar, which are non-toxic. As a result of this work, adequately preserved sheep hearts were obtained that preserved their morphology with slight changes in size and weight, which did not affect their external and internal anatomical structure. Its coloration was not substantially affected, remaining a little lighter. The pieces obtained showed flexibility which allowed dissections to be carried out. The time to develop the technique was 20 days. A comparative study was carried out with the phenolated glycerin technique that uses toxic reagents (formaldehyde and phenol) and the pieces obtained with the alcohol propylene glycol technique were of better quality, observing that the pieces with phenolated glycerin tend to darken and are more rigid. And the time to develop the technique is 24 days. In conclusion, a preservation technique for anatomical pieces was developed that allowed the preservation of the organs under study, which allow their use for anatomical studies, and which have been preserved without changes until the time of this publication (8 months) and there are pieces preserved with this technique for 2 years.

关键词： Veterinary Anatomy Heart Preservation Techniques Alcohol Propylene glycol Technique Fixation Necropsy Toxic Chemicals

Clinical heterogeneity in autoimmune acute liver failure

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World Journal of gastroenterology 2007年第12期13卷 1824-1827页

作者： Norberto C Chavez-Tapia Julio Martinez-Salgado Julio granados misael Uribe Felix I Tellez-Avila Department of gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Mexico City MexicoJulio Granados Department of Immunology and Rheumatology Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Mexico City Mexico Department of Immunology and Rheumatology Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Mexico City Mexico

AIM: To describe the outcome and prognosis in a cohort of patients with acute liver failure due to autoimmune hepatitis without liver transplantation. METHODS: A retrospective trial was conducted in 11 patients with acute liver failure due to autoimmune hepatitis who attended the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran. Demographic, biochemical and severity indexes, and treatment and outcome were assessed. RESULTS: Among the 11 patients, with a median age of 31 years, 72% had inflammatory response syndrome, and six patients received corticosteroids. The mortality rate within four weeks was 56%, and the one-year survival was 27%. In the survivors, severity indexes were lower and 83% received corticosteroids. CONCLUSION: We observed a relatively high survival rate in patients with acute liver failure due to autoimmune hepatitis. This survival rate could be influenced by severity of the disease and/or use of corticosteroids.

关键词： Autoimmune hepatitis Acute liver failure Corticosteroids

Smoking is not associated with nonalcoholic fatty liver disease

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World Journal of gastroenterology 2006年第32期12卷 5196-5200页

作者： Norberto C Chavez-Tapia Javier Lizardi-Cervera Oliver Perez-Bautista Martha H Ramos-Ostos misael Uribe Departments of gastroenterology and Internal Medicine. Medica Sur Clinic and Foundation Mexico City Mexico

AIM： To analyze the relationship between smoking and nonalcoholic fatty liver disease （NAFLD）. METHODS： This is a cross-sectional study of a healthy population, carried out in a check-up unit of a university hospital in Mexico City. We enrolled 933 subjects, 368 current smokers （cases） and 565 persons who had never smoked （controls）. Demographic, metabolic and biochemical variables were measured in the two groups. NAFLD was determined by ultrasound and metabolic syndrome according to ATPⅢ. RESULTS： A total of 548 men （205 cases and 343 controls） and 337 women （114 cases and 223 controls） were included in the analysis. Statistical differences between cases and controls were observed only in high blood pressure prevalence （6.6% vs 11.3%, P〈0.05; cases and controls respectively）, high-density lipoproteins （1.00±0.26 vs 1.06±0.28 mmol/L, P 〈 0.005）, triglycerides （2.18±1.49 vs 1.84±1.1 mmol/L, P〈0.001）, and erythrocyte sedimentation rate （11.3±9.3 vs 13.5±11.9 mm/h, P〈0.001）. No differences were observed in the prevalence of NAFLD （22.27% vs 29.68%, P = NS） and metabolic syndrome （41.69% vs 36.74%, P = NS）. Univariate analysis showed that smoking was not a risk factor for NAFLD （OR = 0.89, 95% CI 0.65-1.21）. CONCLUSION： No differences in NAFLD prevalence were observed between current smokers and nonsmokers, and furthermore, no differences were observed in heavy smokers （more than 20 packs/year）, indicating that there js no relationship between smoking and NAFLD.

关键词： Smoking Nonalcoholic fatty liver disease Metabolic syndrome

gallbladder plication as a rare complication of endoscopic sleeve gastroplasty:A case report

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World Journal of gastrointestinal Endoscopy 2023年第10期15卷 629-633页

作者： Cesar D Quiroz guadarrama Luis Andres Saenz Romero Eric misael Saucedo Moreno Martín E Rojano Rodríguez Obesity Clinic and Bariatric Surgery Dr.Manuel Gea González General HospitalMéxico 14080Mexico

Endoscopic sleeve gastroplasty(ESg)is a minimally invasive procedure used in the treatment of obesity,with a complication rate of less than 2%of *** have been only two reported cases worldwide of gallbladder injuries as a major complication of *** SUMMARY We present the case of a 34-year-old patient who developed a complication after *** patient experienced epigastric and right hypochondrium pain 12 h after the procedure,and a positive Murphy’s sign was identified on physical *** results showed a leukocyte count of 17×10^(3)/μL,and computed tomography indicated the presence of free fluid in the pelvic cavity and perihepatic recesses as well as a possible suture in the wall of the Hartmann’s pouch toward the anterior surface of the stomach.A diagnostic laparoscopy was performed,revealing plication of the Hartmann’s pouch wall to the anterior stomach *** cholecystectomy and lavage were carried *** patient had a stable recovery and was discharged 72 h after surgery,tolerating oral *** gallbladder plication should be suspected if signs and symptoms consistent with acute cholecystitis occur after ESg.

关键词： gastroplasty Bariatric surgery Complication Endoscopy Case report

Factors that influence outcome in non-invasive and invasive treatment in polycystic liver disease patients

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World Journal of gastroenterology 2008年第20期14卷 3195-3200页

作者： Josué Barahona-garrido Jesús Camacho-Escobedo Eduardo Cerda-Contreras Jorge Hernández-Calleros Jesús K Yamamoto-Furusho Aldo Torre misael Uribe Department of gastroenterology National Institute of Health Sciences and Nutrition "Salvador Zubirán" Mexico City 14000 Mexico

AIM: To evaluate the factors that influence outcome of both non-invasive and invasive treatment of polycystic liver disease. METHODS: Analysis of clinical files of patients with complete follow-up from July 1986 to June 2006. RESULTS: Forty-one patients (male, 7; female, 34), 47.8 ± 11.9 years age, and 5.7 ± 6.7 years follow-up, were studied. Alkaline phosphatase (AP) elevation (15% of patients) was associated with the requirement of invasive treatment (IT, P = 0.005). IT rate was higher in symptomatic than non-symptomatic patients (65.4% vs 14.3%, P = 0.002), and in women taking hormonal replacement therapy (HRT) (P = 0.001). Cysts complications (CC) were more frequent (22%) in the symptomatic patients group (P = 0.023). Patients with body mass index (BMI) > 25 (59%) had a trend to complications after IT (P = 0.075). Abdominal pain was the most common symptom (56%) and indication for IT (78%). Nineteen patients (46%) required a first IT: 12 open fenestration (OF), 4 laparoscopic fenestration (LF) and 3 fenestration with hepatic resection (FHR). Three required a second IT, and one required a third procedure. Complications due to first IT were found in 32% (OF 16.7%, LF 25%, FHR 66.7%), and in thesecond IT in 66.7% (OF 100%). Follow-up mortality rate was 0. CONCLUSION: Presence of symptoms, elevated AP, and CC are associated with IT requirement. HRT is associated with presence of symptoms and IT requirement. Patients with BMI > 25 have a trend be susceptible to IT complications. The proportions of complications are higher in FHR and second IT groups. RS is more frequent after OF.

关键词： Hepatic cysts Open fenestration Laparoscopic fenestration Hepatic resection Recurrenceof symptoms Hormonal replacement therapy

Insulin sensitizers in treatment of nonalcoholic fatty liver disease:Systematic review

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World Journal of gastroenterology 2006年第48期12卷 7826-7831页

作者： Norberto C Chavez-Tapia Tonatiuh Barrientos-gutierrez Felix I Tellez-ávila Francisco Sánchez-ávila Maria Antonieta Montao-Reyes misael Uribe Department of gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Zalvador Zubirán Mexico City Mexico The University of Texas School of Public Health Houston United States Instituto de Educación Media Superior Mexico City Mexico

AIM: To summarize the evidence available for the clinical effectiveness of insulin sensitizers in the treatment of nonalcoholic fatty liver disease (NAFLD) systematically. METHODS: Relevant articles were located using computer-assisted searches of Medline (1966-March 2006), EMBASE (1988-March 2006), CINAHL (1982-March 2003), Educational Resource Information Center (1966-March 2006), Library, Information Science & Technology Abstracts (1967-March 2006), Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (1994-2006), dissertations in ProQuest and FirstSearch databases. Manual searches were made in the abstracts from meetings of the American gastroenterological Association (1999-2006), and the American Association for the Study of Liver Diseases (2003-2005). Studies were retrieved using the following selection criteria: (1) clinical trials using insulin sensitizers in subjects with NAFLD, (2) adult patients, (3) published as full manuscripts or abstracts, and (4) English, Spanish, german, and French languages only. Data were abstracted independently by two reviewers following standardized procedures. A face-to- face comparison of data was conducted to ensure the completeness and reliability of the abstraction process. RESULTS: Nine studies were included, six using metformin and three using thiazolidinediones. Only two studies were placebo-controlled trials. The mediansample size for all studies was 18 subjects. In the placebo-controlled trials, metformin improved insulin resistance markers and liver function tests, but not histological scores. In the single-arm trials, metformin and thiazolidinediones improved insulin resistance markers and liver function tests, and beneficial histological changes were reported. There is limited high-quality information available from which to draw categorical conclusions about the clinical use of insulin sensitizers in ***: Current information indicates that the use of insulin sensitizers

关键词： Steatohepatitis Evidence based medicine Systematic review

Endoscopic submucosal dissection in dogs in a World gastroenterology Organisation training center

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World Journal of gastroenterology 2010年第14期16卷 1759-1764页

作者： Miguel A Tanimoto gonzalo Torres-Villalobos Rikiya Fujita Patricio Santillan-Doherty Jorge Albores-Saavedra german gutierrez Luis A Martin-del-Campo Carlos Bravo-Reyna Octavio Villanueva Jose J Villalobos misael Uribe Miguel A Valdovinos Department of gastroenterology and World gastroenterology Organisation Training Center National Institute of Medical Sciences and Nutrition Salvador Zubiran Mexico City 14000 Mexico Department of Surgery and Experimental Surgery National Institute of Medical Sciences and Nutrition Salvador Zubiran Mexico City 14000 Mexico The Cancer Institute Hospital of JFCR Tokyo Tokyo 135-8550 Japan Department of Pathology National Institute of Medical Sciences and Nutrition Salvador Zubiran Mexico City 14000 Mexico Department of Experimental Surgery National Institute of Medical Sciences and Nutrition Salvador Zu- biran Mexico City 14000 Mexico Animal lab and Department of Experimental Research National Institute of Medical Sciences and Nutrition Salvador Zubiran Mexico City 14000 Mexico

AIM: To evaluate if canine models are appropriate for teaching endoscopy fellows the techniques of endoscopic submucosal dissection (ESD). METHODS: ESD was performed in 10 canine models under general anesthesia, on artificial lesions of the esophagus or stomach marked with coagulation points. After ESD, each canine model was euthanized and surgical resection of the esophagus or stomach was carried out according to "The Principles of Humane Experimental Technique, Russel and Burch". The ESD specimens were fixed with needles on cork submerged in a formol solution with the esophagus or stomach, and delivered to the pathology department to be analyzed. RESULTS: ESD was completed without complications using the Hook-knife in five esophageal areas, with a procedural duration of 124 ± 19 min, a length of 27.4 ± 2.6 mm and a width of 21 ± 2.4 mm. ESD was also completed without complications using the IT-knife2 in five gastric areas, with a procedural duration of 92.6 ± 19 min, a length of 32 ± 2.5 mm and a width of 18 ± 3.7 mm. CONCLUSION: ESD is feasible in the normal esopha- gus and stomach of canine models, which are appropriate for teaching this technique.

关键词： Endoscopic mucosal resection Endoscopic submucosal dissection Stomach neoplasms Training

Metabolic syndrome as a risk factor for gallstone disease

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World Journal of gastroenterology 2005年第11期11卷 1653-1657页

作者： Nahum Méndez-Sánchez Norberto C. Chavez-Tapia Daniel Motola-Kuba Karla Sanchez-Lara guadalupe Ponciano-Rodríguez Héctor Baptista Martha H. Ramos misael Uribe Departments of Biomedical Research and gastroenterology and Liver Unit

AIM: To establish an association between the presence of metabolic syndrome and the development of gallstone disease. METHODS: We carried out a cross-sectional study in a check-up unit in a university hospital in Mexico City. We enrolled 245 subjects, comprising 65 subjects with gallstones (36 women, 29 men) and 180 controls (79 women and 101 men without gallstones). Body mass index, waist circumference, blood pressure, plasma insulin, and serum lipids and lipoproteins levels were measured. Insulin resistance was calculated by homeostasis model assessment. Unconditional logistic regression analysis (univariate and multivariate) was used to calculate the risk of gallstone disease associated with the presence of at least three of the criteria (Adult Treatment Panel Ⅲ). Analyses were adjusted for age and sex. RESULTS: Among 245 subjects, metabolic syndrome was present in 40% of gallstone disease subjects, compared with 17.2% of the controls, adjusted by age and gender (odds ratio (OR) = 2.79; 95%CI, 1.46-5.33; P= 0.002), a dose-dependent effect was observed with each component of metabolic syndrome (OR=2.36, 95%CI, 0.72-7.71; P= 0.16 with one component and OR = 5.54, 95%CI, 1.35-22.74; P = 0.02 with four components of metabolic syndrome). Homeostasis model assessment was significantly associated with gallstone disease (adjusted OR = 2.25; 95%CI, 1.08-4.69; P= 0.03). CONCLUSION: We conclude that as for cardiovascular disease and diabetes mellitus, gallstone disease appears to be strongly associated with metabolic syndrome.

关键词： Obesity Metabolic syndrome gallstones Insulin resistance

Prevalence of metabolic syndrome, obesity and diabetes type 2 in cryptogenic cirrhosis

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World Journal of gastroenterology 2008年第30期14卷 4771-4775页

作者： Felix I Tellez-Avila Francisco Sanchez-Avila Mauricio garcía-Saenz-de-Sicilia Norberto C Chavez-Tapia Ada M Franco-guzman gustavo Lopez-Arce Eduardo Cerda-Contreras misael Uribe Department of gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

AIM: To evaluate the prevalence of metabolic syndrome (MS), obesity and type 2 diabetes mellitus (T2DM) in a group of Mexican Mestizo patients with cryptogenic cirrhosis (CC) and to compare this group with patients with cirrhosis secondary to other causes (disease controls). METHODS: Patients with CC, diagnosed between January, 1990 and April, 2005, were included in a retrospective study. Patients with cirrhosis caused by chronic hepatitis C, alcohol abuse or autoimmune hepatitis (AIH) served as disease controls. RESULTS: A total of 134 patients with CC were analyzed. Disease controls consisted of 81 patients with chronic hepatitis C, 33 with alcohol abuse and 20 with AIH. The median age of patients with CC was 57 years (range, 16-87); 83 (61.9%) patients were female; 53 (39.6%) were Child A, 65 (48.5%) Child B, and 16 (11.9%) were Child C cirrhosis. The prevalence of MS (29.1% vs 6%; P gher in CC patients than in disease controls. There were no differences in sex, age or liver function tests between the two groups. CONCLUSION: The prevalence of MS, obesityand T2DM were higher in patients with CC than in patients with cirrhosis secondary to others causes. Our findings support the hypothesis that non-alcoholic steatohepatitis (NASH) plays an under-recognized role in CC.

关键词： Cryptogenic chronic hepatitis Metabolic syndrome Obesity Diabetes mellitus