Clemente Vásquez

Daily intake of 100 mg ascorbic acid as urinary tract infection prophylactic agent during pregnancy

Objective. To evaluate the role a daily intake of 100 mg of ascorbic acid plays in urinary infection prophylaxis during pregnancy. Methods and materials. A single‐blind clinical trial was carried out on pregnant women randomly assigned to the following treatment groups — Group A: oral treatment with ferrous sulphate (200 mg per day), folic acid (5 mg per day) and ascorbic acid (100 mg per day) for 3 months, and Group B: oral treatment with ferrous sulphate (200 mg per day) and folic acid (5 mg per day) for 3 months. All patients were clinically evaluated, and a urine culture was carried out each month for a period of 3 months. The χ2 and odds ratio were used to compare effects with and without ascorbic acid, and statistical significance was considered at p<0.05. Results. Global frequency of urinary infections was 25%. The presence of urinary infections in Group A (12.7%) was significantly lower than in Group B (29.1%), (p = 0.03, OR = 0.35, CI 95% = 0.13–0.91). Conclusions. Daily intake of 100 mg of ascorbic acid played an important role in the reduction of urinary infections, improving the health level of the gestating women. We recommend additional vitamin C intake for pregnant women in populations which have a high incidence of bacteriuria and urinary infections.

Frecuencia y factores de riesgo asociados a sobrepeso y obesidad en universitarios de Colima, México

OBJECTIVE Determining risk factor frequency regarding obesity and being overweight in university students. METHODS A cross-sectional analytic study was carried out on 821 students from the University of Colima. Some variables analysed were age, gender, alcoholism, smoking and weight-control drug use. RESULTS 821 students were included (380 male, 441 female), 20.9±2.5 average age. 27.8 % of males were overweight and 14.7 % suffered from obesity; this was 17 % and 5.2 % in females, respectively. Smoking (2.1 OR; 1.4-3.8 95 % CI; p=0.01) and alcoholism (2.1 OR; 1.2-3.6 95 % CI; p=0.003) were associated with being overweight and being obese. Weight-control drug use was a protective factor in both genders (0.4 OR; 0.2-0.8 95 % CI; p=0.01); diet control was only a protective factor in women (2.2. OR; 1.1-3.4 95 % CI; p=0.01). CONCLUSIONS 31.6 % of university students were overweight and suffered from obesity. Smoking and alcoholism in males were associated with being overweight and suffering from obesity. Weight-control and diet-control drug use were protective factors.

Prevalence of childhood sexual abuse among Mexican adolescents.

BACKGROUND To determine the characteristics and prevalence of previous child sexual abuse among a group of Mexican junior high school students. METHODS A total of 1067 adolescents of both genders were selected to fill out a survey about child sexual abuse. RESULTS The prevalence of child sexual abuse was 18.7% (n = 200). It was more frequent in girls (58%) than in boys (42%). Sexual abuse involved physical contact in 75% of those cases reporting abuse. The aggressors were neighbours (50.3%), relatives (36.8%) and strangers (13.9%). Abuse was committed through deception in 90% of the cases and involved physical mistreatment in 10% of the cases. Of the victims, 14.4% had spoken about the problem and 3.7% had taken legal action. And 9.6% of those surveyed stated that they required psychological counselling. CONCLUSIONS In the population studied, the prevalency of child sexual abuse was greater than that reported in Mexico City (4.3-8.4%), although it was similar to that found in the Spanish child population (15-23%). The risk of sexual abuse is greater for girls and the principal aggressors are male neighbours, family friends and relatives; the abuse is committed in the home of the aggressor or the victim and very few cases are reported to the authorities.

Frequency of, indications for and clinical epidemiological characteristics of first time cesarean section, compared with repeated cesarean section

Abstract The aim of this study was to determine the frequency of, indications for and clinical epidemiological characteristics in patients having their first cesarean section (FCS) and then to compare the data with that found in patients with repeated cesarean section (RCS). Patients and methods. A cross-sectional study was carried out. 493 pregnant patients who gave birth by cesarean section or vaginal delivery were seen. Some of the variables analyzed were: age, prenatal care consultations, gyneco-obstetric antecedents, cesarean section indication and neonate weight. Statistical analysis included ANOVA, χ2 and OR, with a 95% CI. Significance was p<0.05. Results. 66% of the patients had vaginal births (VB) and 33.4% had cesarean sections, with a FCS frequency of 61%. The three most frequent indications for FCS were dystocias and cephalopelvic disproportion (45%), fetal distress (12.8%), and pelvic presentation (9.9%). Meanwhile, those for RCS were previous cesarean section (51%), dystocias (20%) and pelvic presentation (6.2%). The variables significantly associated with FCS were: first pregnancy, antecedent of labor room induction and a neonate weight above 3500 g. The remaining variables were not associated with FCS. Percentages of nulliparity, secondgravidity and multigravidity were greater in RCS patients. Conclusion. The frequency of FCS is still high in Mexico. Adequate following of programs to diminish the percentage of FCS and increase the number of VB, would significantly reduce the prevalence of cesarean section.

Forskolin versus sodium cromoglycate for prevention of asthma attacks : a single-blinded clinical trial

To determine the efficacy of forskolin in preventing asthma attacks, we performed a single-blinded clinical study in children and adult out-patients at a public hospital in Mexico. Forty patients of either sex with mild persistent or moderate persistent asthma were assigned randomly to 6 months of treatment with forskolin at 10 mg/day orally (capsules) or with two inhalations of sodium cromoglycate every 8 h, i.e. three times a day. The number of patients who had asthma attacks during the treatment period was significantly lower among those receiving forskolin (8/20, 40%) than among those receiving sodium cromoglycate (17/20, 85%). Values of forced expiratory volume in 1 s and forced expiratory flow, mid-phase, were similar in the two groups during the treatment period. We conclude that forskolin is more effective than sodium cromoglycate in preventing asthma attacks in patients with mild persistent or moderate persistent asthma.

Direct trocar insertion without pneumoperitoneum and the veress needle in laparoscopic cholecystectomy : a comparative study

Abstract Purpose: The purpose of this study is to compare the safety and complications of direct trocar insertion without pneumoperitoneum (DTI) with Veress needle (VN) in laparoscopic cholecystectomy (LC). Methods: We studied 84 patients admitted to our hospital for LC, in a random simple blind design, 42 patients were assigned to DTI and 42 to VN. The variables analysed were: procedure complications, laparoscope insertion time and duration of surgery. Results: Complication percentages between the groups were significantly different (DTI 2.3% versus VN 23.8%, p = 0.009). The duration of surgery between the two groups was also significantly different (DTI 56 ±31 versus VN 71 ± 28 minutes, p < 0.02). Finally, laparoscope insertion time between the two techniques was significantly different (DTI 1.5 ± 0.5 versus VN 3.0 ± 0.4 minutes p < 0.001). Conclusions: Our results show DTI to be a safe, efficient, rapid and easily-learned alternative technique, reducing the number of procedure-related complications.

Presence of HPV DNA in placenta and cervix of pregnant Mexican women.

PurposeTo identify the presence of HPV DNA in cervical as well as in placental tissue of pregnant Mexican women and to determine which type is more frequent.MethodsIn a cross-sectional study, 56 placental samples were obtained from 72 pregnant women. HPV DNA was extracted and amplified with polymerase chain reaction using a consensus primer and then identified by type using RsaI endonuclease. The main outcome measures were placenta with/without HPV relation and HPV types in placenta.ResultsHPV DNA was identified in 75% of cervical tissue samples and 47.2% of placental tissue samples. Type 18 was the most frequently identified HPV type.ConclusionsThere was a higher frequency of HPV DNA found in the cervix of Mexican women during pregnancy than reported in the previous studies. Its identification in full-term placental tissue has no relation to the type of delivery in childbirth.

Reduction of Peritoneal Adhesion to Polypropylene Mesh with the Application of Fibrin Glue

Abstract Purpose: The purpose of our study was to evaluate the possibility of the reduction of peritoneal adhesions to a polypropylene mesh with fibrin glue. Methods: Forty Wistar rats were assigned to two treatment groups: Group 1) hernioplasty with polypropylene mesh plus fibrin glue sealant, and Group 2) hernioplasty with polypropylene mesh without fibrin glue sealant. The variables evaluated were: presence and density of adhesion, organs or abdominal structures adhered to the polypropylene mesh, inflammatory tissular reaction and cell recount. Results: Group 1 presented a statistically lower adhesion percentage than Group 2 (40% versus 100%, P = 0.0003). The mean areas of mesh patch surfaces covered with adhesions were statistically different between Groups 1 and 2 (0.67 ± 0.65 cm2 versus 1.60 ± 0.51 cm2; P = 0.00001). Twelve rats presented with adhesions in Group 1; eleven were adhesions to the epiploon and one to the colon. In Group 2 there were 16 adhesions to the epiploon, 2 to the colon, 1 to the small intestine and 1 to the stomach. Tissular reaction comparison showed a significant difference (21 ± 4.9 versus 17 ± 4.1; P = 0.006). Conclusions: Fibrin glue sealant significantly reduced the frequency and severity of intra-abdominal adhesions.

F-wave and H-reflex alterations in recently diagnosed diabetic patients

OBJECTIVE To explore the frequency of F-wave and H-reflex alterations in recently diagnosed type 2 diabetes mellitus patients and to determine if the alterations are dependent on the levels of glycemia. METHODS A cross-sectional study was carried out on 50 asymptomatic patients, with a mean age of 45.4 +/- 9.8 years and a disease evolution of less than 10 years. Patients were classified as either normoglycemic (7 mmol/L; n = 20) or hyperglycemic (7 mmol/L; n = 30). H-reflex (HR), F-wave (FW), and nerve-conduction measurements (NCM) between the diabetic and non-diabetic (control) groups were compared. RESULTS The H-reflex was absent in 22% of the patients, while the M-component of this reflex was altered in 58% of patients. The F-wave was altered in 12% of the patients. The motor nerve compound action potential showed a diminution in amplitude (26% of patients, n = 13), area (32%, n = 16), and conduction velocity (20%, n = 10). No positive correlation between glycemia levels and the above alterations was found. CONCLUSIONS This study demonstrated that asymptomatic diabetic patients showed a high incidence of subclinical neurophysiological abnormalities.

Spinal—General Anaesthesia Decreases Neuroendocrine Stress Response in Laparoscopic Cholecystectomy

OBJECTIVE: A randomized clinical study to compare the stress response to laparoscopic cholecystectomy during spinal—general anaesthesia and epidural—general anaesthesia. METHODS: Women undergoing elective laparoscopic cholecystectomy were assigned to receive either spinal anaesthesia (SA group; n = 12) or epidural anaesthesia (EA group; n = 12), in addition to general anaesthesia. Plasma concentrations of cortisol, adrenocortico trophic hormone (ACTH), noradrenaline, adrenaline and total catecholamines were measured pre- and intraoperatively. RESULTS: Intraoperative cortisol, noradrenaline and total catecholamine levels were significantly lower in the SA group compared with the EA group. When pre- and intraoperative values were compared, the SA group showed a decrease in adrenaline, noradrenaline and total catecholamine levels, and the EA group showed an increase in ACTH and noradrenaline levels. CONCLUSIONS: The type of regional anaesthesia significantly affected the stress response: spinal anaesthesia produced a more favourable endocrine response than epidural anaesthesia. Spinal—general anaesthesia may reduce postoperative morbidity in laparoscopic cholecystectomy.