Objective: To determine the prevalence of anatomical variations of the circle of Willis (CoW) andtheir association with cerebrovascular malformations detected on cerebral computed tomographyangiography (CTA). Materials and methods: A descriptive, observational, cross-sectional studywas conducted at a tertiary-care hospital involving a Mexican population. Patients of all ages andboth sexes, with complete medical histories and a cerebral CTA scan, were included. Patientswith incomplete CTA studies or missing data were excluded. Descriptive statistics and the phicoefficient were used to assess the relationship between cerebrovascular malformations andanatomical variations of the CoW. A p value ≤ 0.05 was considered significant. All personal datawere handled with strict confidentiality and used exclusively for research purposes. Results:The sample consisted of 97 patients, with a mean age ...

Inflammatory transverse myelitis is a rare condition that affects one or more levels of the spinal cord. Its etiology includes multiple sclerosis, infectious causes, or disorders within the spectrum of neuromyelitis optica. It presents acutely with motor, sensory, and/or dysautonomic symptoms, such as those related to the gastrointestinal and urinary systems. Diagnosis is based on symptomatology, evolution, and is confirmed by lumbar puncture, magnetic resonance imaging, and complete blood analysis. We present a clinical case of a patient with transverse myelitis who presented with gastrointestinal symptoms, motor symptoms, and was diagnosed with magnetic resonance imaging.

Systemic Lupus Erythematosus (SLE) is an autoimmune disease caused by an autoreactive B and T cell response with loss of immune tolerance to self-antigens. It manifests with asthenia, fever, myalgias, arthralgias, skin rash and fatal organ damage. Dengue is a zoonotic disease caused by the dengue virus (DENV), transmitted by mosquitoes of the Aedes aegypti species. Diagnostic suspicion is made in the presence of acute febrile syndrome with clinical manifestations and demographic history. Confirmation is by detection of the virus by PCR-RT, or of the structural protein NS1. The present case report is a 58-year-old woman with data of lupus exacerbation and with clinical manifestations suggestive of Dengue fever, with a history of travel to an endemic area. The confirmatory PCR-RT test leads to appropriate medical treatment. The importance of the case lies in differentiating the diagnosis i...

Background: The use of coffee in patients undergoing surgery of the lower gastrointestinal tract promotes the stimulation of peristalsis, favors tolerance to the initiation of the oral route as well as early progression to the soft diet. Objective: To present the clinical effects of starting the oral route with coffee in patients undergoing lower gastrointestinal tract surgery. Methods:  A descriptive study was performed to analyze the clinical effects of coffee in 14 postoperative patients of lower gastrointestinal tract surgery. The variables analyzed were: presentation of bowel sounds, expulsion of flatus, and effective evacuation.  Results: Fourteen patients were included, 9(64.3%) women and 5(35.7%) men, the use of coffee in patients with lower gastrointestinal tract surgery showed early progression to soft diet tolerance. Conclusions: The initiation of coffee in patients ...

Introduction. Liver cancer is the seventh most common neoplasm worldwide and the second cause of mortality directly associated with cancer. In Mexico it has an incidence of 3.9% in the entire population. Although computed tomography (CT) is the imaging study of choice, the final diagnosis is established with the anatomopathological study of the lesion. Objective. Correlate the tomographic findings with the histopathological result in patients with liver lesions with suspicion of malignancy, who underwent USG-guided biopsy. Methods. Descriptive, correlation, retrolective, homodemographic and single-center study. The study period was from September 2021 to February 2022. Patients older than 18 years with liver lesions suspicious of malignancy were selected and underwent Computed Axial Tomography and ultrasound-guided biopsy. Shapiro Wilk tests (for normality) were used and chi-square was u...

Background: COVID-19 is a disease that since its appearance in 2019 has represented a challenge for health services. The sequelae are a consequence of a deterioration in the quality of life, fatigue, dyspnea and joint pain. Objective: Compare physical, respiratory, cognitive and functional independence functional parameters in post-COVID-19 patients, with respiratory sequelae before and after a respiratory physical and occupational therapy program. Methods: A comparative, quasi-experimental, prospective study was conducted in outpatients discharged from hospitalization due to COVID-19 in a 3rd level hospital of the Instituto Mexicano del Seguro Social in Puebla, Mexico during 2020-2021. Scales were applied before and after the rehabilitation program. Descriptive statistics were used. Results: We included 116 patients, 57.7% men, mean age 47.32 years (min. 20, max. 79); 77 (66.3%) patient...

Background: Juvenile laryngeal papillomatosis (JLP) is a chronic benign disease from viral etiology, whose clinical course can be aggressive. In Mexico, the Human Papillomavirus (HPV) genotypes that cause this disease have been poorly studied. Objective: To identify the HPV genotypes in patients with JLP in a reference Hospital in Puebla, Mexico. Mehods: A retrospective descriptive study was performed in patients with JLP attended in a 3rd level care of the Instituto Mexicano del Seguro Social in Puebla, México, from 2018 to 2021. Medical records were revised. In all patients, HPV identification was performed by polymerase chain reaction for genomes 6, 11, 16 and 18 using specific oligonucleotides. Descriptive statistics were applied. Results: 9 patients were included, 56% women, mean age 9.5 ±5.7 years; 7 patients were HPV-11 positive and 2 HPV-6. The mean age at diagnosis was 2.35 ±...

Introduction: Colorectal cancer (CRC) is the third most common cancer and the second leading cause of death worldwide, with an incidence of 10.2%. The treatment of CRC has evolved over the past 25 years. Two surgical procedures are used: abdominoperineal resection (APR) and low anterior resection (LAR) and ultra-low anterior resection (ULAR). The recurrence rate and quality of life are similar between these approaches. Objective: To compare the quality of life of rectal cancer patients treated with abdominoperineal resection versus conservative sphincter-preserving surgeries: low anterior resection (LAR) and ultra-low anterior resection (ULAR) at UMAE of Puebla. Methods: A comparative, observational, cross-sectional study was conducted on CRC patients treated between 2015 and 2019 at a tertiary-level hospital in Puebla. Two groups were formed: those managed with APR and those manage...

Introduction: Ectopic pregnancy is any gestation in which the implantation site of the fertilized egg is located outside the endometrial cavity. Abdominal ectopic pregnancy represents 1.4% of these. Case report: 28-year-old patient with two previous cesarean sections; bilateral tubal obstruction during the last operation. The patient was admitted to the hospital with blood pressure of 180/130 mm Hg that did not respond to medical treatment and not progression to labor so it was decided to interrupt the pregnancy by cesarean section. During surgery, a small uterus with extrauterine pregnancy was observed adhered to the serosa of the cecum, ascending colon, and appendix. A live preterm female product was obtained; the mother had a favorable evolution and no postoperative complications. Conclusion: Ectopic pregnancies are rera. An adequate prenatal control by well trained personnel is essen...

Introduction: Transplantation is the treatment of choice in patients with chronic kidney disease (CKD). It requires immunosuppression, which predisposes to the development of complications. Chronic rhinosinusitis (CRS) is one of the most important. Objective: To compare the characteristics of patients with CKD with and without CRS undergoing renal transplantation protocol in a concentration Hospital in Puebla, Mexico. Methods: Comparative, cross-sectional, retrospective study in patients in a tertiary care hospital with CKD and undergoing renal transplantation protocol. The SNOT-22 and Lund-Mackay scales were applied. Descriptive statistics and Mann-Whitney U test, Fisher's exact test and Phi coefficient were used; p<0.05 was considered significant. Results: 360 patients were recruited, 49 presented CRS, prevalence: 13.61%. Means: age: 39.22 ±12.09 years and evolution time: 17.73 ±5...

Vascular malformations represent a heterogeneous spectrum of lesions that often present a diagnostic and therapeutic challenge, thus requiring a high index of clinical suspicion to reach a definitive diagnosis. Cloves syndrome is a rare overgrowth disorder of genetic etiology associated with a somatic activating mutation in PIK3CA, which is part of the PI3KAkt-mTOR intracellular signaling pathway. Clinically, it is characterized by congenital lipomatous overgrowth of any part of the body (mainly the thorax), accompanied by vascular and lymphatic malformations, epidermal nevi and structural abnormalities of the skeletal system such as scoliosis and alterations in the spine. The current therapeutic cornerstone for this syndrome is therapy with rapamycin, an mTOR pathway inhibitor. On the other hand, Klippel-Trenaunay syndrome is a complex vascular condition associated with overgrowth due t...