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PURPOSE: To develop Mexico's first methodologically rigorous clinical practice guideline for the management of adult overweight and obesity. The target audiences are interdisciplinary healthcare professionals across healthcare systems who are the first point of contact for patients with obesity in Mexico, patients, and health system decision makers. RECENT FINDINGS: A review of recent international obesity clinical practice guidelines and an expert consensus process identified: i) common recommendations appropriate for implementation in Mexico and ii) knowledge gaps requiring the formulation of new recommendations. In all, 20 new recommendations and 20 good practice statements were developed using the GRADE Evidence-to-Decision Framework and expert consensus. Overweight and obesity negatively impact the health and well-being of individuals and populations in Mexico. This guideline aims to establish a new evidence-based, patient-centered, non-stigmatizing, and practical treatment and management framework, based on the fundamental principles of chronic disease prevention and management.
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Hemochromatosis (HC) is a disorder that alters the body's ability to metabolize iron, increasing its absorption, causing iron overload, and consequently an accumulation of the mineral in multiple organs such as the liver, heart, and pancreas. The amount of total iron in the body is 2-4 g in healthy individuals and remains within these limits throughout life thanks to the control of intestinal absorption. In patients with CH, this amount is increased by at least 10 times, which translates into body deposits of 20-40 grams of iron on average. Factors that increase the risk of having HC: having two copies of the mutated HFE gene, family history, ethnicity or ancestry from Northern Europe (less common in blacks, Hispanics, and Asians), and male gender.
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Humanos , Pessoa de Meia-Idade , Hemocromatose/diagnóstico , Hemocromatose/fisiopatologia , Sinais e Sintomas , Transplante de Fígado , Insuficiência Cardíaca , Hemocromatose/terapia , Hemossiderose , FerroRESUMO
INTRODUCTION: Vascular trauma is a low frequency event and is related to a high burden of morbidity and mortality. Vascular trauma of the upper limb is of different etiology. More frequent, secondary to closed trauma. It is usually associated with other lesions, soft tissue and nerves. OBJECTIVES: To present a case of complex vascular trauma of the upper limb and its multidisciplinary management. METHOD: Description of the clinical case and literature review. The information was obtained from the patient's clinical record, review and analysis of the published literature was performed using search engines. CASE REPORT: Young man, fall with upper limb in extension, results in elbow dislocation associated with acute ischemia. AngioTAC confirms stop in brachial. Emergency surgery: brachio-radial saphenous bridge. It evolves with absence of pulses. It is reexplored finding incomplete fasciotomy, brachial artery bridge to cephalic vein with inverted saphenous. Elbow dislocated, unstable. Arterial bridge, external fixation and fasciotomy is completed. Coming out with radial pulse. He undergoes multiple surgeries and surgical toilets, achieving skin closure at 45 days. Then traumatology removes external tutors. Electromyography confirms incomplete lesion of median, radial and ulnar. Currently in the process of rehabilitation. DISCUSSION AND CONCLUSION: Vascular trauma of the upper limb is of low incidence. However, they are associated with a high burden of morbidity and mortality, generally occurring in young men. The diagnostic pillar is through the medical history and physical examination. its surgical management.
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Humanos , Masculino , Artérias/cirurgia , Extremidade Superior/cirurgia , Lesões do Sistema Vascular/cirurgia , Artéria Braquial , Prontuários Médicos , Veias Braquiocefálicas , Resultado do Tratamento , FasciotomiaRESUMO
INTRODUCTION: Femoral hernias have a high risk of strangulation or obstruction, and their acute presentations are associated with a high risk of mortality, occurring in up to 60% of cases with complications. The presence of the appendix within the femoral sac has been described in a maximum of 1% of cases, which has been called Garengeot hernia, but only 0.08% with concomitant appendicitis. CASE REPORT: Woman 56 years old, cholecystectomized, with no other relevant history, 5 months of evolution, right femoral region volume increase, consultation for 24 hours of evolution of habitual pain exacerbation, CT scan showing complicated hernia, with appendix inside of the hernial sac. The right inguinal approach is performed, the cecal appendix is the only content within the hernial sac, with signs of acute appendicitis, appendectomy and hernia repair with Prolene mesh. Diagnosis is confirmed with biopsy. DISCUSSION AND CONCLUSION: Acute appendicitis within De Garengeot's hernia is extremely rare and often difficult to diagnose. The diagnosis of a femoral hernia appendicitis is often obscured by nonspecific clinical findings that indicate a complicated hernia. Computed tomography may be useful to definitively diagnose acute appendicitis contained within a femoral hernia. It is important to always consider De Garengeot hernia as a differential diagnosis in patients with inguinal mass of acute pain, so as not to delay its detection and management.
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Humanos , Feminino , Pessoa de Meia-Idade , Apêndice/diagnóstico por imagem , Hérnia Femoral/diagnóstico por imagem , Apendicite/diagnóstico , Apêndice/cirurgia , Apêndice/irrigação sanguínea , Prontuários Médicos , Hérnia Femoral/cirurgia , Hérnia Femoral/complicaçõesRESUMO
We investigated the extent to which a complex finger sequence impacts on hand switching costs in a sequential action. Response component latencies (premotor, motor, and movement) were compared in no-switch (same finger performed the action of pressing and reaching) and switch conditions (pressing with one finger and completing the reaching action with the homologous finger from the other hand). Results showed that the switch condition presented longer latency for premotor and movement components. For the motor component, however, switch condition was faster. This expands the previous literature investigating switching costs using simple finger movements in more complex tasks. A mechanical explanation of the interplay between response subcomponents is provided to explain the inversion of response pattern for the motor component.