Gac Med Mex
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COVID-19 is characterized by acute respiratory distress syndrome progression, which ranges from mild to severe. A percentage of critically ill patients will require endotracheal intubation and mechanical ventilation; therefore, Mexican engineers from different places have had the initiative of creating mechanical ventilators. ⋯ Intubation per se induces lung damage, increases the risk of superinfection, and the number of days of ICU stay. Furthermore, non-selective use of artificial ventilators decreases the opportunity for patients who require a ventilator to survive and increases institutional care costs of both human and material resources.
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Double or triple combination therapy in systemic arterial hypertension: to whom, when and with what?
Systemic arterial hypertension (SAH) is the main risk factor for premature death in the world and in Mexico. Around 15.2 million Mexicans have been estimated to be diagnosed with SAH, out of which 7.48 million are affiliated to IMSS (evaluation of the financial risks considered in the Institutional Risk Management Program, ENSANUT, 2018). SAH is a complex, chronic disease that requires continuous medical attention with multifactorial risk reduction strategies, which go beyond numerical control in mm Hg of blood pressure and have been shown to be effective in reducing the vascular, cardiac and renal complications of the disease, as well as its impact on premature death. Continuous education and support in SAH self-management are essential to overcome the main challenges: treatment adherence and self-monitoring by the patient for the rest of his/her life.
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Review Practice Guideline
Expert recommendations for biological treatment in patients with psoriasis.
In recent years, the introduction of a series of biological drugs for the treatment of psoriasis has considerably increased the therapeutic armamentarium of doctors, and thus a strongly positive impact on the control of this condition has been achieved. With the purpose to provide the best recommendations for the use of these biological agents in patients with psoriasis, the Mexican group of psoriasis experts, PSOMEX, has developed recommendations in order to improve the understanding and therapeutic positioning of this type of medications.
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Observational Study
Clinical experience with Tolvaptan outpatient use. Cost and effectiveness in 9 cases.
Tolvaptan introduction has constituted the main therapeutic novelty in the management of hyponatremia in recent years. ⋯ Long-term use of tolvaptan appears to be safe and is associated with a decrease in days of hospitalization.
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Acquired hemophilia (AH) is an autoimmune hemostatic disorder mediated by autoantibodies directed against factor VIII: C. In 52% of cases, the cause is unknown or is not associated with other pathological entities; in the rest, there are concomitant factors: lupus, rheumatoid arthritis, cancer, pregnancy, and medications. In Mexico, there is not a registry of AH, and awareness of the disease among health personnel is low. ⋯ Most cases of AH are not diagnosed, which translates into a high mortality rate. Given that awareness about the disease among physicians is low, it is not suspected, neither diagnosed, and nor is it treated. This document reviews the most recent data on AH and expands on its diagnosis and treatment.