Publications by authors named "Fernando Flores-Silva"

Background: Physical exercise (PE) has been proven to be beneficial in patients with cirrhosis; effects in cognitive function and cerebral hemodynamics, are yet to be explored.

Aim: To evaluate the effects of a PE program (LFN-exercise protocol) in hepatic/cerebral hemodynamics.

Methods: Randomized open clinical trial in patients with cirrhosis; Control: Diet(n = 13),Intervention: Diet + exercise(n = 14) for 12 weeks.

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Background: Despite the high number of vaccines administered against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) worldwide, the information on the psychological/psychiatric adverse events following immunization (AEFI) with these newly developed vaccines remains scarce.

Objective: To describe the frequency of psychological/psychiatric symptoms among recipients of five different anti-SARS-CoV-2 vaccines and to explore the factors associated with their development reported in the nationwide Mexican registry of AEFI against SARS-CoV-2.

Methods: Descriptive study of all the psychological/psychiatric symptoms, including anxiety, panic attacks, insomnia, and agitation reported to the Mexican Epidemiological Surveillance System from 21 December 2020 to 27 April 2021, among adult (≥18 years old) recipients of 7,812,845 doses of BNT162b2, ChAdOx1 nCov-19, rAd26-rAd5, Ad5-nCoV, or CoronaVac.

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Background: Acute stroke care has greatly improved in recent decades. However, the increasing stroke mortality in low-to-middle income countries suggests that progress has not been reached completely by these populations. Here we present the analysis of the hospital phase of the first population-based stroke surveillance study.

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Article Synopsis
  • * The study found 97 cases of GBS with an overall incidence of 1.19 per million doses, noting higher risks associated with specific vaccines like Ad26.COV2-S and BNT162b2.
  • * Despite the low incidence, GBS onset typically occurred about 10 days post-vaccination, with a notable proportion of patients requiring significant medical intervention and experiencing severe disability outcomes.
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Background And Aim: Headaches related to the use of personal protective equipment (PPE) could affect performance at work in healthcare personnel. Our aim was to describe the prevalence and risk factors for headaches related to PPE, in the personnel of a specialized coronavirus disease 2019 (COVID-19) tertiary hospital.

Methods: In this cross-sectional survey study, we invited healthcare workers from COVID-19 referral center in Mexico (May 22-June 19, 2020) to answer a standardized structure questionnaire on characteristics of new-onset PPE-related headache or exacerbation of primary headache disorder.

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Article Synopsis
  • A study analyzed stroke incidents as adverse events following the administration of 79,399,446 doses of six different COVID-19 vaccines in Mexico from December 2020 to August 2021.
  • The research monitored hospitalized adult patients, focusing on types of strokes occurring within 30 days post-vaccination and identified acute ischemic strokes (AIS) as the most common, with a total incidence of 0.71 cases per million doses.
  • Out of 56 stroke cases reported, most occurred shortly after vaccination (median of 2 days), with 48.2% diagnosed within the first 24 hours, highlighting the need for careful monitoring of potential neurological side effects following vaccination.
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Objectives: The antiphospholipid syndrome (APS) is an autoimmune disease associated with thrombotic and non-thrombotic neurologic manifestations. APS is classified as primary (PAPS) or secondary (SAPS) when it co-exists with another autoimmune disease. We aim to describe the spectrum of acute cerebrovascular disease among patients with APS, their differences between stroke subtypes, and long-term functional outcomes.

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Background: A high proportion of coronavirus disease 2019 (COVID-19) survivors may develop long-term cognitive impairment. We aimed to develop a multivariate causal model exposing the links between COVID-19-associated biomarkers, illness-related variables, and their effects on cognitive performance.

Methods: In this prospective study, we assess the potential drivers for the development of cognitive impairment in patients with severe COVID-19 pneumonia aged ≥ 18 years at 6-month follow-up after hospital discharge, using the Montreal Cognitive Assessment (MoCA).

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Background: Intracerebral hemorrhage (ICH) is associated with an ominous outcome influenced by the time to hospital presentation.

Objective: This study aims to identify the factors that influence an early hospital arrival after ICH and the relationship with outcome.

Methods: In this multicenter registry, patients with confirmed ICH on CT scan and well-known time of symptoms onset were studied.

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mRNA-based COVID-19 vaccines are effective; however, persistent vaccine hesitancy is partly due to a misperception of their potential adverse events. Non-specific sensory symptoms (NSSS) following immunization are thought to be mediated by stress-related responses. In this case-control study, we evaluated NSSS from a cohort of 7,812,845 BNT162b2 first-dose recipients, of whom 10,929 reported an adverse event following immunization (AEFI).

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With an ever-increasing population of patients recovering form severe coronavirus disease 2019 (COVID-19), recognizing long-standing and delayed neurologic manifestations is crucial. Here, we present a patient developing posterior reversible encephalopathy syndrome (PRES) in the convalescence form severe coronavirus disease 2019 (COVID-19). A 61-year-old woman with severe (COVID-19) confirmed by nasopharyngeal real-time reverse transcription-polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) required invasive mechanical ventilation 24-hours after admission.

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Article Synopsis
  • The study investigates "silent hypoxemia" in COVID-19 patients, where individuals experience low oxygen levels without feeling short of breath.
  • Researchers analyzed 470 hospitalized adults with severe hypoxia, finding that only 4.9% presented without dyspnea.
  • Key predictors of silent hypoxemia included new-onset headaches and seeking medical help within eight days of symptom onset, indicating a potential underestimation of disease severity due to lower physiological responses.
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Background: The coronavirus disease 2019 (COVID-19) pandemic dramatically increased the number of patients requiring treatment in an intensive care unit or invasive mechanical ventilation worldwide. Delirium is a well-known neuropsychiatric complication of patients with acute respiratory diseases, representing the most frequent clinical expression of acute brain dysfunction in critically ill patients, especially in those undergoing invasive mechanical ventilation. Among hospitalized patients with COVID-19, delirium incidence ranges from 11% to 80%, depending on the studied population and hospital setting.

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Background: The coronavirus disease 2019 (COVID-19) is a systemic entity that frequently implies neurologic features at presentation and complications during the disease course. We aimed to describe the characteristics and predictors for developing in-hospital neurologic manifestations in a large cohort of hospitalized patients with COVID-19 in Mexico City.

Methods: We analyzed records from consecutive adult patients hospitalized from March 15 to June 30, 2020, with moderate to severe COVID-19 confirmed by reverse transcription real-time polymerase chain reaction (rtRT-PCR) for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

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In severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated disease coronavirus disease 2019 (COVID-19), hypoxemia mechanisms differ from those observed in acute respiratory distress syndrome. Hypoxemia and respiratory failure in COVID- 19 are attributed to pulmonary angiopathy, increasing physiological pulmonary shunting1-3.

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Background: The complications of coronavirus disease 2019 (COVID-19), the clinical entity caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are not limited to the respiratory system. Leukoencephalopathy with microbleeds is increasingly seen in patients with COVID-19. New information is needed to delineate better the clinical implications of this infectious disease.

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Background: The prompt recognition of an acute neurovascular syndrome by the patient or a bystander witnessing the event can directly influence outcome. We aimed to study the predictive value of the medical history and clinical features recognized by the patients' bystanders to preclassify acute stroke syndromes in prehospital settings.

Methods: We analyzed 369 patients: 209 (56.

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Background: The recognition of stroke symptoms by patients or bystanders directly affects the outcomes of patients with acute cerebrovascular disease.

Objective: The objective of the study was to assess the predictive value of the medical his- tory and clinical features recognized by the patients' bystanders to classify neurovascular syndromes in pre-hospital settings.

Methods: We included 150 stroke patients of two Mexican referral centers: 50 with acute ischemic stroke (AIS), 50 with intracerebral hemorrhage (ICH), and 50 with subarachnoid hemorrhage (SAH).

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Background: Transcranial color-coded sonography (TCCS) allows direct observation of arteries and the possibility of correcting the insonation angle for reliable evaluation of hemodynamics. We obtained TCCS reference values of the cerebral hemodynamics after correction of insonation angles.

Methods: We studied 195 healthy adults equally allocated into 3 age groups: 18-40, 41-60, and greater than or equal to 61 years.

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Introduction: Atherosclerotic carotid artery disease (CAD) is a major risk factor for cerebrovascular disease.

Objective: To analyze the association of major vascular risk factors with atherosclerotic CAD and white matter disease (WMD) in patients without a history of ischemic stroke.

Method: Risk factors were assessed with carotid examination using Doppler duplex ultrasound.

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Diffuse cerebral angiomatosis is a rare disorder of the brain and only 5 cases have been reported to date. We report a 16-year-old female patient who presented to the emergency department with seizures. The patient had no hereditary syndromes, no epistaxis, no skin lesions and no telangiectasia.

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Introduction: Epidemiological studies on myasthenia gravis (MG) in Mexico is mainly derived from experiences in referral centers.

Objective: To describe the epidemiological characteristics of hospital discharges during 2010 with the diagnosis of MG in adults hospitalized in the Mexican public health system.

Methods: We consulted the database of hospital discharges during 2010 of the National Health Information System (Ministry of Health, IMSS, IMSS oportunidades, ISSSTE, PEMEX, and the Ministry of Defense).

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