Facultad de Ciencias de la Salud - CampCM

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Ciudad de México

Country

Director

Mario Enrique Rendón Macías

Parent Organisation

Campus Ciudad de México

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Now showing 1 - 10 of 896

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La aptitud clínica: dos estrategias educativas para su desarrollo en residentes de cardiología. Diseño cuasiexperimental
(Publicidad Permanyer, SLU, 2026)
Leyva-González, Félix A.
;
Gómez-Arteaga, Gress M.
;
Lifshitz-Guinzberg, Alberto
;
Gómez-Clavelina, Francisco J. F.
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Degollado-Bardales, Lilia
Introducción: Esta indagación en nuestro medio representa el primer trabajo multicéntrico en cardiología, mediante el que se pretende determinar los efectos de dos estrategias educativas: participativa vs. tradicional, con respecto al desarrollo de la aptitud clínica en residentes de cardiología de tres sedes académicas. Métodos: Diseño cuasiexperimental, multicéntrico. Se estudió toda la matrícula. Se construyó un instrumento que evaluó la variable aptitud clínica mediante ocho indicadores y 170 ítems; la validez conceptual/de contenido y confiabilidad se valoró por cinco cardiólogos con experiencia docente e investigación educativa. Estrategia educativa participativa: cada sesión se desarrolló en tres fases con guías de discusión estructuradas. Estrategia educativa tradicional: cada sesión se efectúo en dos fases. Las sesiones se realizaron una vez por semana (2 horas). Duración total: 20 sesiones. El instrumento de medida se aplicó en la 1.ª y 20.ª sesión. Resultados: Por año de residencia, en la calificación global de los indicadores se estimaron diferencias estadísticas entre medición inicial y final, resultando significativas en las tres sedes. Por indicador se realizó este mismo análisis y el resultado fue el mismo. Conclusiones: Una estrategia educativa participativa vs. estrategia tradicional tiene mayores efectos en el desarrollo de la aptitud clínica en residentes de cardiología en la sede experimental. ©Los autores ©© 2026 Hospital Infantil de México Federico Gómez. Background: This investigation represents the first multicenter study in cardiology in our setting, through which it is intended to determine the effects of two educational strategies: participatory vs. traditional, with respect to the development of clinical aptitude in cardiology residents at three academic sites. Methods: Quasi-experimental, multicenter design.The entire enrollment was studied. An instrument was built that assessed the variable “clinical aptitude” by means of eight indicators and 170 items; conceptual/ content validity and reliability were assessed by five cardiologists with teaching and educational research experience. Participatory educational strategy: each session was developed in three phases with structured discussion guides. Traditional educational strategy: each session was conducted in two phases. Sessions were held once a week (2 hours). Total duration: 20 sessions. The measurement instrument was applied in the 1st and 20th session. Results: By year of residency, statistical differences were estimated in the overall rating of the indicators between the initial and final measurements, were found to be significant at all three sites. By indicator, the same analysis was performed and the result was the same. Conclusions: A participatory vs. traditional educational strategy has greater effects on the development of clinical aptitude in cardiology residents at the experimental site. ©The authors © 2026 Hospital Infantil de México Federico Gómez.
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Steroid-induced diabetes in lupus nephritis patients: Classic risk factors or a different type of diabetes?
(SAGE Publications, 2025)
Dimas-Ramírez, Cristian Alejandro
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Fortanell-Meza, Luis André
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San Agustín-Morales, Diego
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Brenner Muslera, Eduardo
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Mejía-Vilet, Juan Manuel
Background: Glucocorticoids are frequently employed in systemic lupus erythematosus (SLE) patients and play a critical role in the induction therapy of lupus nephritis (LN), despite their many side effects, including steroid-induced diabetes (SID). Information regarding SID in SLE patients is quite scant. Purpose: The aim of this study was to determine risk factors associated with the development of SID in patients with LN. Research Design: A nested case-control study was conducted. Study sample: We included patients with biopsy-proven LN, who received induction treatment with steroids. Data Collection and/or Analysis: Out of the total of 358 patients, 35 (9.7%) developed SID. Results: Patients with SID had more metabolic risk factors, including the metabolic score for insulin resistance (METS-IR); more factors related with lupus activity, with higher SLEDAI and SLICC-DI scores; and lower cumulative pre-induction steroid dose. A higher percentage of patients who developed SID received steroid pulses and a lower percentage received antimalarials. After logistic regression, the variables significantly associated with the development of SID were the SLEDAI index (OR 1.25 [95% CI 1.04–1.50], p 0.01), SLICC-DI (OR 4.93 [95% CI 2.14–11.3], p < 0.001), METS-IR (OR 1.17 [95% CI 1.04–1.32], p 0.009), delta METS-IR at 6 months (OR 1.20 [95% CI 1.03–1.39], p 0.01), and the use of antimalarials (OR 0.14, [95% CI 0.02–0.85], p 0.03). After propensity score matching, METS-IR remained a significant predictor of SID. Patients with METS-IR >36.8 were at higher risk (OR: 2.83, 95% CI: 1.09–7.36, p = 0.034). Conclusions: In conclusion, SDI development in patients receiving induction therapy for LN is associated with both classic metabolic risk factors and SLE-specific factors, and antimalarial use could be associated with a protective effect. Rheumatologists should be aware of this potential complication, in order to implement appropriate management strategies. ©The authors ©Lupus ©SAGE Publications.
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Recomendaciones bioéticas en el manejo de límite de esfuerzo terapéutico en neonatología
(2019)
Ruiz Macías, Hilda
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Ruiz Macías, Hilda
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Casas Martínez, María de la Luz Lina
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Caballero Velarde, María Cristina
Se debe reconocer los límites en la práctica médica cuando la muerte es inevitable o las posibilidades de recuperación son nulas. A través de la Limitación de Esfuerzo Terapéutico se busca evitar la obstinación terapéutica en las salas de atención de recién nacidos gravemente enfermos; la aplicación en el actuar médico de los principios bioéticos; y que la toma de decisiones siempre corresponda con el beneficio del paciente en su mejor interés, con uso de los recursos disponibles para una atención en justa proporción.
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Persistent Vitamin D Deficiency in Pediatric Patients with Cystic Fibrosis
(MDPI AG, 2025)
Reyes-Apodaca, Magali
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Lezana-Fernández, José L.
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Vázquez Frias, Rodrigo
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Rendón-Macías, Mario Enrique
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González-Molina, Aline
Background/Objectives: Cystic fibrosis (CF) is a multisystem disease caused by CFTR gene variants, with a high prevalence of vitamin D (VitD) deficiency despite the supplementation and schedules specifically developed for this population. Lower VitD levels have been associated with an increased risk of respiratory infections and pulmonary exacerbations in CF, with some pilot studies indicating the potential benefits of supplementation during acute episodes. This study aimed to describe the occurrence of VitD deficiency according to the supplemented dose in pediatric patients with CF. Methods: A cross-sectional analytical study was conducted to assess serum VitD levels in a pediatric population with cystic fibrosis. Clinical and biochemical data were collected, along with information on VitD intake and pancreatic enzyme dosage at the time of evaluation. Results: A total of 48 patients were included in the study. Normal VitD levels were observed in 41.7% of the patients, insufficiency in 31.3%, and deficiency in 27%. The median VitD intake was 2050 IU. A statistically significant difference was observed in patients with a daily intake exceeding 2000 IU. Only 10% of patients achieved levels above 30 ng/mL with a lower dose. No statistically significant association was identified between the pancreatic enzyme dosage and vitamin D levels. Conclusions: Vitamin D deficiency/insufficiency is a persistent problem in the pediatric CF population; the interventions targeting factors associated with this condition are required to refine supplementation schedules. These findings underscore the need for personalized strategies to optimize vitamin D status in PwCF. Ideally, these strategies should consider all associated factors, including genetic variants; however, with limited resources, our results suggest that a daily dose of 2000 IU of vitamin D may represent a reasonable and effective starting point for supplementation. © The authors © MDPI .
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Revisión narrativa de la eficacia de los tratamientos enzimáticos en la cicatrización de la úlcera de pie diabetico con tejido necrótico
(2022)
Lima Buendia, Ana Karen
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Martínez Mejía, Emma Paola
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Chico Barba, Gabriela
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Bonilla de Jesús, María Alejandra
Presentar pie diabético con tejido necrótico es una complicación frecuente en los pacientes con Diabetes Mellitus, con la cual se ve afectada la sobrevida y la calidad de la vida de la persona. Es posible una curación completa en aproximadamente el 90 % de todas las úlceras mediante una atención adecuada. La experiencia clínica sugiere que la terapia combinada, con el desbridamiento quirúrgico inicial, seguido de un desbridamiento enzimático o un desbridamiento enzimático junto con desbridamiento cortante son eficaces en pacientes diabéticos con heridas crónicas, indolentes o que no cicatrizan. El objetivo del presente estudio es revisar la evidencia de la eficacia en los tratamientos enzimáticos para las úlceras de pie diabético con tejido necrótico, considerando la gran importancia que tiene para los procesos de cicatrización de este tipo de heridas. Para ello se llevó a cabo una revisión sistemática, incluyendo artículos originales, en inglés y español que se encontraban en Pubmed, EbscoHost Research y Scielo. Se incluyeron un total de 12 artículos concluyendo que el área de la herida disminuyo (68%) del valor inicial para el grupo que usó tratamiento enzimático, en relación al grupo que solo utilizó desbridamiento cortante (36%), otros mostraban que la experiencia clínica sugiere firmemente que la terapia combinada como el desbridamiento quirúrgico inicial seguido por un desbridamiento enzimático es eficaz para muchos pacientes diabéticos con heridas crónicas, indolentes o que no cicatrizan . De los enzimáticos, la colagenasa mostró ser las más eficaz y las más utilizada para elesbridamiento de tejido necrótico; hay evidencia limitada del enzimático papaína-urea, se ha visto que elimina el tejido necrótico en un 50% (90 días) más rápido que la pomada colagenasa, sin embargo, el proceso de cicatrización con este enzimático parece ser más ambiguo. Otros artículos mostraban que elmomento más doloroso para los pacientes con heridas de pie diabético era el momento de su curación, cuando se realiza cambio de apósito y el desbridamiento cortante. El desbridamiento enzimático fue una alternativa útil en pacientes que no necesitaban desbridamiento rápido, pues no había infección y la escara adherida fuertemente impedía la cicatrización. En relación a los enzimáticos uroquinasa y estreptoquinasa, se vio que, debido a que su mecanismo de acción promueve el sangrado, su uso no es adecuado para pacientes con pie diabético. Del enzimático tripsina no se encontraron estudios de su uso en heridas de pie diabético. Se vio que los costos del uso de enzimáticos, en especial colagenasa, era más rentable que las curaciones estándar en úlceras de pacientes diabéticos y es una alternativa eficaz al desbridamiento agudo. Por lo cual se puede concluir que la colagenasa parece ser beneficiosa para la cicatrización de heridas de pie diabético con tejido necrótico.
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Relationship between Healthcare Access and Deceased Donor Quality for Kidney Transplant
(2020)
Yuan, Qing
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Jiménez Collado, David
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Elias, Nahel
Introduction: The Kidney Donor Prolife Index (KDPI) is a percentile combining clinical parameters and demographics to summarize the quality of deceased donor kidneys (DDK) relative to the past year recovered organs. Lower KDPI values are associated with higher donor quality and expected organ function post-transplant. Under the Kidney Allocation System retrieved DDK with best KDPI (0%-20%) are matched to recipients with the greatest Estimated Post-Transplant Survival (0%-20%). However, the prevalence of best KDPI (0%-20%) DDK across transplant regions is not 20% as the percentile would suggest. We hypothesize that this difference stems from favorable health care quality. © 2020 by Lippincott Williams & Wilkins, Inc.
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Prediction of preeclampsia before 11th week of gestation: a secondary analysis of the ASPIRIN trial
(Elsevier BV, 2025)
Capdeville, Gabriela
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Godinez-Medina, Andrea
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Copado-Mendoza, Diana Y.
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Acevedo-Gallegos, Sandra
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Rodriguez-Bosch, Mario R.
Background: Early screening for preeclampsia is crucial for preventing adverse maternal and fetal events. Current first-trimester algorithms for predicting preeclampsia are designed to evaluate individual risk between 11.0 and 13.6 weeks of gestation based on various maternal characteristics while integrating biophysical and biochemical features. However, there is limited information regarding risk assessment during earlier stages of pregnancy (i.e., <11.0 weeks gestation). Objective: To develop a prediction model for preeclampsia/eclampsia before 11.0 weeks of gestation as a proof-of-concept in a secondary analysis of the ASPIRIN trial. Study design: This study is a secondary analysis of the ASPIRIN trial, a multinational, randomized, double-blind, placebo-controlled trial. The ASPIRIN trial database, obtained from NICHD DASH, included 11,976 nulliparous pregnant women aged 18–40 with gestational ages of 6.0–13.6 weeks at randomization. Participants were assigned to receive either aspirin (81 mg/day) or placebo until 36.0 weeks or delivery. This secondary analysis included pregnancies delivered at ≥20.0 weeks, excluding those in the aspirin group or with gestational ages ≥11.0 weeks at enrollment. The composite outcome was preeclampsia/eclampsia, as reported in the ASPIRIN trial. Predictor variables available in the dataset included maternal age, education (4 levels), body mass index (BMI kg/m2), gravidity, baseline hemoglobin, baseline systolic blood pressure, and baseline diastolic blood pressure. Logistic regression, with logarithmic transformation for continuous variables, was used to develop the model. The area under the ROC curve with a 95% confidence interval (CI) estimated via bootstrap resampling (1,000 iterations) and the P-value of the Hosmer-Lemeshow statistical test are reported as discrimination and calibration measures. This study used the entire available sample using a complete case approach. Results: A total of 3421 participants met the inclusion criteria, with a cumulative incidence of preeclampsia/eclampsia of 2.9% (99/3,421). Maternal age (21.96 ± 4.13 vs 20.86 ± 3.21, P<.001) and BMI (22.49 ± 4.77 vs 20.79 ± 3.55, P<.001) were significantly higher in the preeclampsia/eclampsia group. Gravidity was lower (P=.023), and hemoglobin levels were slightly elevated (11.88 ± 1.52 g/dL vs 11.50 ± 1.61 g/dL, P=.019) in the preeclampsia/eclampsia group. Educational level (P=.070), systolic blood pressure (P=.720), and diastolic blood pressure (P=.390) showed no significant differences between groups. The logistic regression model yielded an AUC of 0.69 (95% CI 0.63–0.74), and the Hosmer-Lemeshow test P-value was 0.094, indicating acceptable discrimination and calibration. Conclusions: This proof-of-concept logistic regression model using first-trimester maternal characteristics demonstrated acceptable predictive performance for preeclampsia/eclampsia before 11.0 weeks of gestation. During this critical period, several interventions could be proposed to reduce preeclampsia risk, including medication adjustments, lifestyle changes, and appropriate referral if needed. Further studies are required to validate these findings and assess their clinical utility in different settings. © The authors © Elsevier.
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Vínculo materno-filial. Neurociencia, cultura y bioética
(Editores De Textos Mexicanos, 2021)
Casas-Martínez, María-de-la-Luz
No es de desconocimiento el conflicto infinito del ser humano, sobre su existencia y su expectativa, entre lo que somos y lo que se espera a llegar a ser, la fragmentación de su personalidad, en malos entendidos metonímicos, en confundir la parte por el todo e imponer el inmanentismo sobre su biología o viceversa, situaciones que complican más el camino y fines del ser humano. Actualmente, nos encontramos ante una expansión de libertades y voluntariedad, de los cual esa nueva libertad se trueque en nuevas coerciones, sin conciencia de los daños y efectos que nos afectan, la mala atención y decisiones durante todo el desarrollo de la vida humana, empezando desde su inicio y su corresponsabilidad. Los académicos que integran la presente obra nos dimos a la tarea, desde el ámbito interdisciplinar y transdisciplinar, de exponer un camino donde se zanje la personalidad humana a través de la ciencia basada en evidencia (biología, psíquica), ética, políticas públicas, antropología filosófica y el derecho, brindando herramientas y estructuras para que el cauce del desarrollo humano sea el más acorde durante toda la existencia. © Los autores © Editores de Textos Mexicanos.
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Aproximación hacia la evaluación de la aptitud clínica en residentes de cardiología. Diseño multicéntrico
(2022)
Leyva-González, Félix A.
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Gómez-Arteaga, Gress M.
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Lifshitz, Alberto
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Gómez-Clavelina, Francisco J. F.
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Valencia-Chávez, Jesús S.
Introduction: To the best of our knowledge, the research herein presented is the first multicenter study in Mexico to analyze the development of clinical aptitude in medical units that train cardiologists. Objective: To determine the degree of development of clinical aptitude in cardiology residents at three High Specialty Medical Units. Methods: Multicenter, cross-sectional design. All students of the 2019-2020 academic year were included in the study. An instrument was constructed that evaluated clinical aptitude based on eight indicators and 170 items; conceptual/content validity and reliability were assessed by five cardiologists with teaching and educational research experience. © Gaceta Médica de México
Scopus© Citations 1 1 9
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Virtual reality pain mitigation during elective cesarean surgical delivery
(Interactive Media Institute, 2019)
Mosso Vázquez, José Luis
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Mosso Lara, Dejanira
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Lara Vaca, Verónica
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Wiederhold, Brenda K.
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Miller, Ian
We present supplemental virtual reality (VR) relaxation to reduce pain and anxiety during elective cesarean delivery in 4 young women under epidural analgesia. Methodology. Four women voluntarily participated in a VR relaxation group (mean age = 28.5 years) and four women in a control group (mean age = 30.5 years). VR relaxation was initiated for the placement of the epidural block and cesarean procedure until the gynecologist extracted the newborn from the uterus. The mothe's vital signs and pain were measured using physiological monitoring and a visual analog scale before, during and after anesthesia placement and during and after cesarean surgery. Participants viewed an ‘Enchanted Forest’ virtual environment. Three of the four patients’ husbands participated by navigating the virtual environment for his wife using a game controller. Results. Patients presented 91.89 % pain reduction in the VR group—a remarkable result under regional anesthesia. Patients in the control group presented 61 % increases in pain. Conclusions. VR supplemented pain mitigation provides high levels of satisfaction to mothers during elective cesarean delivery and carries no risk for the newborns. The current report highlights an innovative contribution to womens’ healthcare. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
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Facultad de Ciencias de la Salud - CampCM

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