Scielo RSS <![CDATA[Revista médica del Hospital General de México]]> vol. 84 num. 1 lang. en <![CDATA[SciELO Logo]]> <![CDATA[Pathological findings coronavirus disease-19]]> <![CDATA[Impact of obesity on the thyroid profile, long-term experience at the General Hospital of Mexico, "Dr. Eduardo Liceaga"]]> Introduction: The main alterations reported in the thyroid profile of patients with obesity show an increase in TSH and T3 levels and a decrease in T4 levels. These alterations have been reported in 25% of obese patients and are considered more as a consequence rather than stemming from obesity itself. However, these alterations have not been evidenced in the Mexican population. Objective: The objective of the study was to determine the association between TSH, T3, T4 levels, and obesity grade. Material and methods: This is a retrospective analytical cross-sectional study conducted between the years 2015 and 2019. Obese patients who had altered TSH, free T4 and total T3, and free T3 levels were included in the study. Patients diagnosed with diabetes, thyroid diseases, undergoing treatment with levothyroxine, or taking drugs that alter thyroid function tests were excluded. Spearman's rank correlation coefficient was used to establish a correlation between obesity grade and thyroid hormones levels. Results: A positive correlation was found between TSH levels and obesity grade (r = 0.13; p = 0.049). A negative correlation was found between obesity grade and free T4 (r = −0.26; p = 0.000275) and total T4 levels (r = −0.18; p = 0.029). While analyzing free T3 and total T3 levels and T4/T3 ratio, the descriptive analysis showed an increase in T3 values as the obesity grade increased, with no correlation found. Conclusions: Obesity grade is associated with alterations in thyroid function that can affect the normal range of thyroid hormones levels. <![CDATA[Association between subclinical hypothyroidism and dyslipidemia in the obesity population]]> Introduction: Subclinical hypothyroidism (SCH) is defined as the increase in thyroid-stimulating hormone (TSH) levels, with triiodothyronine (T3) and tetraiodothyronine (T4) values within the population reference range. The prevalence in patients with obesity varies between 10.5% and 25%. This has been related to alterations in serum concentrations of total cholesterol (TC), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), and triglycerides (TG). Objective: The objective of the study was to identify the association between SCH and dyslipidemia in patients with obesity. Materials and methods: A case-control study was carried out in 128 patients with obesity and SCH, assessed at the Clinic for Comprehensive Care of patients with Diabetes and Obesity (CAIDO) from 2015 to 2019. The Mantel-Haenszel Chi-Square Test was used to verify the association between SCH and dyslipidemias (hypertriglyceridemia, total hypercholesterolemia, LDL hypercholesterolemia, and HDL hypocholesterolemia). Odds ratio of the different dyslipidemias was calculated for the group of patients with SCH and obesity, using logistic regression models, adjusted for possible confounding factors (age, sex, and BMI). Results: Dyslipidemias were identified in 96.1% of the patients with SCH compared to 87.3% in relation to the control group (OR 3.56. 95% CI = 1.29-9.84, p = 0.01), the most frequent being HDL hypocholesterolemia, and hypertriglyceridemia. Conclusion: The relationship between SCH and dyslipidemia has been analyzed with controversial results at an international level. In the Mexican population with obesity, SCH is deemed a risk factor for the development of dyslipidemia. <![CDATA[Physical activity, eating habits, and nutritional status of school children in Tepic Nayarit Mexico]]> Background: Obesity (Ob) is a chronic problem that causes health problems mainly in infants. Objective: The objective of the study was to assess the nutritional status (NS), eating habits (EH), and physical activity of elementary school children. Materials and methods: Two hundred and twenty-six school children participated, all of whom were fourth grade (78 students), fifth grade (93 students), and sixth grade (55 students) school children of both sexes, aged 9-13 years. Questionnaires were conducted asking about parents' availability to prepare lunch for their children before taking them to school, food preferences at breakfast, children's food preferences within the school, and children's physical activities during and after school. The questionnaire of EH was made to the children expressing itself as the frequency of consumption of the food groups. The food consumption preference index (PI) was determined. The International Physical Activity Questionnaire for Children's was used to estimate the level of physical activity during the school day. Anthropometric parameters were determined to diagnose their NS. Results: About 55% of parents of 4th graders buy food for their children. About 44% of 6th graders are given money to buy them at school. Hamburgers (PI = 6 in 6th), fried foods (PI = 9 in 4th; PI = 6 in 5th and 6th), pizza (PI = 9 in 5th y 6th), cookies (PI = 9 in 4th y 5th), and soft drinks (PI = 9 in 4th and 6th; PI = 6 in 5th) are foods most often eaten inside the school. Physical activity decreases as the school grade increases. Fourth prefer to play bring it (41%) and have fun in some kind of sport (35%); while 5th prefer to sit (26%) or to talk and walk (28%). There is a high prevalence of Ob in all three grades assessed (71% 4°, 69% 5°, and 78% 6°). Conclusions: School children have moderate and low levels of physical activity during school hours and junk food is prevalent in school schedules. <![CDATA[Arteriovenous subclavian artery fistula with aneurysm secondary to firearm trauma: Case report]]> We present the case of a 25-year-old male patient with a history of gunshot wound in the chest 3 years before, who developed symptoms in the arm for 1 year. The patient was assessed by the outpatient clinic, presenting left subclavian murmur, and development of venous network. Three-dimensional rotational angiography revealed left subclavian arteriovenous fistula with aneurysmal dilatation. Patient was operated and received a polytetrafluorethylene graft with excellent evolution. The case is presented due to the complexity of a late vascular injury in a region that is difficult to approach with very high morbidity and mortality rates. <![CDATA[Rhinofacial conidiobolomycosis, two cases in Mexican patients from rural and urban backgrounds]]> Conidiobolomycosis is a relatively uncommon disease in humans, caused by Conidiobolus spp fungi. It manifests itself in rural environments with tropical climate. It is frequently associated with certain degree of immunosuppression such as hematologic malignancies, diabetes mellitus, and/or chronic use of steroids. Treatment of the localized disease is simple, although diagnosis, due to its low incidence, can represent a challenge to many doctors. The objective of this case series is to help identify, diagnose, and treat this disease in a timely manner. <![CDATA[Characterization of two children with tetrasomy 18p syndrome through multiplex ligation-dependent probe amplification and single nucleotide polymorphism-array: expanding phenotype?]]> Tetrasomy 18p is characterized by intellectual disability and systemic alterations. The aim of this study is to describe two patients with tetrasomy 18p, one of them with clinical data not previously reported. Genomic DNA was analyzed by multiplex ligation-dependent probe amplification and single nucleotide polymorphism-array. The final molecular result for each of the patients was arr (hg19) 18p11.32-p11.21 (136.226-15,157.836) × 4 dn and arr (hg19) 18p11.32-p11.21 (134,878, −15,149,748) × 4 dn. The results of both parents were normal. Both patients showed data compatible with tetrasomy 18p. However, one patient presented atopic dermatitis, café-au-lait spots, and thyroglossal cysts. This data have not been reported in patients with tetrasomy 18p before. <![CDATA[Oncology at general hospital of Mexico. Its origins]]> Objective: The objective of the study was to carry out a review of the birth and evolution of Oncology at the General Hospital of México (GHM), cradle of Oncology in our country. Background: In 1922, GHM acquired 50 mg of radiobromide, which begins the fight against cancer in Mexico. In 1937, the Oncology Unit (OU) was inaugurated in pavilion 13 and Dr. Ignacio Millán was the first head of service. A decade later, with radiotherapy oncologists Dr. Guillermo Montaño Islas and Dr. José Noriega Limón, surgery oncologists Dr. José Manuel Velasco Arce and Dr. Horacio Zalce Torres, and pathologist Dr. José de Jesús Curiel, the OU becomes the first center dedicated to the treatment of cancer patients and the first Human Resources Training Institution for this purpose. Evolution: Dr. Montaño and Dr. Rodolfo Díaz Perchez restructure the Radiotherapy Unit and create the Oncology University Specialty. Dr. Héctor Rodríguez Cuevas joined the Service and consolidated the cancer surgery school. Dr. Irma Nora Hidalgo and Dr. Raquel Gerson Cwilich were members of the first generation of clinical oncologists in the OU. Since 2011, comprehensive care for cancer patients has been carried out in a modern building equipped for this purpose. Conclusions: The GHM begins the diagnostic and therapeutic approach for cancer patients in Mexico. Comprehensive care is, currently, carried out in the latest state-of-the-art facilities.