Evaluación global del panorama epidemiológico de las mordeduras de serpiente en México

Introduction. Envenomation caused by snakebites is a health issue, globally unattended. Like in other countries, this situation is severe in Mexico. Even though Dirección General de Epidemiología de la Secretaría de Salud reports the annual number of cases, it is necessary to analyze in-depth such data to identify these events’ geographical distribution. Objective. This research aims to analyze the new cases and the incidence of the snakebites reported during 2017-2019 to identify the country’s most vulnerable states. Material and Methods. This research is based on the collection and detailed comparison of the smakesbites data taken from Sistema Nacional de Vigilancia Epidemiológica between 2017 and 2019. Results. In 2017, 3,712 new cases were reported; 3,882 in 2018, and 4,095 with an incidence of 3.235 cases per 100,000 inhabitants. Conclusions. Snakebite epidemiological surveillance requires more data (like the type and place of attention) and must derive in formulating dynamic plans to take care of the most vulnerable regions.

Snakebite: Global Evaluation of Current Epidemiology in Mexico

Introduction. Envenomation caused by snakebites is a health issue, globally unattended. Like in other countries, this situation is severe in Mexico. Even though Dirección General de Epidemiología de la Secretaría de Salud reports the annual number of cases, it is necessary to analyze in-depth such data to identify these events’ geographical distribution. Objective. This research aims to analyze the new cases and the incidence of the snakebites reported during 2017-2019 to identify the country’s most vulnerable states. Material and Methods. This research is based on the collection and detailed comparison of the smakesbites data taken from Sistema Nacional de Vigilancia Epidemiológica between 2017 and 2019. Results. In 2017, 3,712 new cases were reported; 3,882 in 2018, and 4,095 with an incidence of 3.235 cases per 100,000 inhabitants. Conclusions. Snakebite epidemiological surveillance requires more data (like the type and place of attention) and must derive in formulating dynamic plans to take care of the most vulnerable regions.

Microbiota intestinal: su importancia en la salud y los factores que la modifican

A vast number of microorganisms inhabit the human body and coexist peacefully with their hosts, under specific conditions. The complex ecosystem of microbial communities found in the intestine fulfills numerous metabolic, physiological, and protective functions of the human body. Recent studies show that an imbalance in these communities (dysbiosis) maintains a close relationship with the health of the host. The change in eating habits, lifestyle, and different compounds of exogenous origin are some of the main factors causing that alteration, which represent new challenges for medical practice. Therefore, the objective of this document is to provide information about the intestinal microbiota concept, the factors altering it, some of the diseases associated with dysbiosis, and the evidence of some foods that may induce the modulation of the intestinal microbiota. Knowing the relationship between food, microbiota, and health is relevant to have more elements in the treatment of diseases in modern society.

Recomendaciones de oncólogos que trabajan en el ISSSTE para el tratamiento sistémico del cáncer de pulmón avanzado 2020

Based on the GRADE system, a group of specialists in Medical Oncology from ISSSTE produced a set of recommendations for the systemic treatment of advanced lung cancer —specifically non-small cell lung cancer and small-cell lung cancer— with immunotherapy, chemotherapy with or without antiangiogenic agents. Regarding the diagnosis, extension studies and lung grades are analyzed. Likewise, basic pathology, molecular biology, and imaging features are described to determine the treatment protocols for advanced lung cancer with actionable mutations or biomarkers related to domains such as actionable mutations, anaplastic lymphoma kinase, and reactive oxygen species (ROS1). The recommendations comprise the most important clinical issues: immunotherapy in lung cancer, first-line treatment for non-small cell lung cancer, non-squamous (wild-type) metastatic cancer, second-line immunotherapy regimes, chemotherapy without first-line immunotherapy for adenocarcinoma, firstline chemotherapy with antiangiogenic agents, as well as the characteristics a patient should present to be a candidate to receive immunotherapy. Dosages are stated in the different treatment protocols; the chemotherapy regimes for unresectable, locally-advanced lung cancer are being reviewed, as well as for ECOG 0-1 until ECOG 2, limited and extended stages. Even though there is no consensus on certain topics, this document includes clear guidelines whose aim is standardizing the criteria, and that will be subject to be reviewed and updated.

Seguridad del paciente y uso de medicamentos, perspectiva del profesional farmacéutico en México enfocado en el macroproceso de la medicación

Patient’s safety in Mexico regarding the use of medications is a vital and very neglected topic since the community, and the hospital population is at serious risk of suffering from any medication-related problem. Nowadays, the health institutions and the Federal Government have been made isolated efforts to contextualize the issue of safety in the use of medications. Still, the risk for the population that consumes drugs is latent throughout the medication macroprocess, from selection to the monitoring of therapies prescribed to patients. Therefore, we present real examples of events that occurred lately in Mexico and other countries because they were classified and analyzed according to the medication macro-processes and because this group of authors suggests a possible solution to them, which could be adapted to the conditions of each particular situation.

Oncoguía de cáncer de próstata 2020

In Mexico, prostate cancer is the first cause of death in men. Instituto Nacional de Cancerología has developed health-care protocols for the main neoplasms. Members of its Urology Department framed Oncoguía de cáncer de próstata 2020, based on a bibliographic revision and a consensus they conducted. It includes the analysis of the risk factors and the central diagnostic elements: specific prostatic antigen (SPA), digital rectal examination (DRE), imaging diagnosis, biopsy, and Gleason grading system. Oncoguía also contains the role of the clinical assessment and life expectancy as treatment guidelines, which, according to the case, are radical prostatectomy, lymph-node treatment, hormone blockade, and treatment monitoring.

Oncoguía de cáncer de mama 2020

Breast cancer is a world health problem, and in our country is generally diagnosed in advanced stages. Departamento de Tumores Mamarios from Instituto Nacional de Cancerología developed Oncoguía de cáncer de mama 2020 based on a consensus methodology conducted among its members: clinical oncologists, surgical oncologists, radiation therapists, nurses, and social workers. Such specialists carry out multidisciplinary management (detailed in this Oncoguía) through a clinical assessment performed by Unidad Funcional, and it is based on surgery, radiotherapy, and systemic treatment, either adjuvant, neoadjuvant or palliative. The systemic management also includes chemotherapy, hormone blockade, and biological therapy. These guidelines also include algorithms to make decisions in every clinical stage

Actualización en terapia biológica para psoriasis y artritis psoriática (parte I): moléculas pequeñas, inhibidores de JAK y agentes biológicos (inhibidores IL-17)

Psoriasis is a chronic, inflammatory skin disease associated with cardiovascular comorbidities, metabolic syndrome, neoplasms, psychiatric impairment, and arthritis, among others, which affect patients’ quality of life, as well as their life expectancy. Even though it is a multifactorial process of unknown causes, its relationship to class 1 HLA alleles and their polymorphisms has been described. Its physiopathology involves a dysregulation of the systemic inflammatory response —mediated by T Helper lymphocytes, dermal cells, cytokines, and interleukins—, as well as their interactions with keratinocytes and synovial cells. This triggers differentiation of lymphocytes towards a Th 17 phenotype, which activates inflammatory processes mediated mainly by interleukin 17 (IL-17), with the subsequent proliferation of keratinocytes and inflammatory and angiogenic mediators, resulting in the typical cutaneous and osteoarticular clinical features. Biological agents are recombinant proteins produced in different cell lines aimed at interrupting inflammatory pathways in psoriasis and psoriatic arthritis, specifically, immune or genetic mediators involved in the progression of these diseases, ultimately targeting the IL-23 / IL-17 axis. This review aims to discuss the most recent literature regarding the use of small molecules, JAK inhibitors, and biological agents (IL-17 inhibitors) in the treatment of psoriasis and psoriatic arthritis, mainly referring to their efficacy and safety. Using these molecules means a fundamental change in the approach to patients with psoriasis and psoriatic arthritis. As a specific mediator-targeted therapy, it enhances effectiveness, and at the same time, reduces the associated adverse effects. Therefore, it is essential to know how they work from a physiopathological point of view, as well as assessing their effectiveness in humans through randomized clinical trials. Current knowledge allows us to conclude that despite biological agents being the best treatment option in psoriasis as well as in psoriatic arthritis, comparative studies —among drugs of the same group and groups— are still required. Besides, their high price is another problem to solve before they can be massively used in these patients.

Mecanismos neurobiológicos del dolor de origen no maligno asociado a estructuras óseas

Introduction. Despite the high prevalence of musculoskeletal diseases, the neurobiological mechanisms underlying bone-related pain are not fully known. Objective. To summarize the information on neurobiological mechanisms of bone structures-related pain that has been reported in the last two decades. Material and Methods. A scientific search was performed on the PubMed platform in the last 20 years using the keywords pain, bone, skeletal, non-malignant, aging, periosteum, and nerve fibers. Results and Discussion. Significant advances in biochemical, immunohistochemical and imaging techniques have helped to characterize sensory and sympathetic innervation of different natural compartments in healthy tissue. Likewise, several preclinical models of acute and chronic musculoskeletal pain —providing a clearer understanding of the mechanisms underlying bone-related pain— have been established.