Publications by authors named "Fierro N"

Article Synopsis
  • Viral hepatitis (A-E) is a significant global health issue, prompting the WHO to launch a 2015 initiative aimed at drastically reducing infections and deaths by 2030, especially in countries like Mexico which is among the 38 focus nations.
  • In Mexico, while there are established programs for diagnosing and treating hepatitis B and C, there is a lack of routine diagnosis for hepatitis D and E, and the National Hepatitis C Elimination Program started in 2020 has not expanded to cover hepatitis B and E.
  • Efforts to control viral hepatitis in Mexico need more resources, improved diagnosis and vaccination for hepatitis A and B, treatment coverage for hepatitis B and C, and collaboration across different sectors to enhance patient care.
View Article and Find Full Text PDF
Article Synopsis
  • The study examines the impact of illicit substance use during pregnancy, noting a 4-fold increase over two decades and its negative effects on mothers and fetuses.
  • A multicenter retrospective analysis from 2016 to 2021 included 852 pregnant trauma patients (PTPs), with 9.8% testing positive for substances, primarily THC and methamphetamine.
  • Findings showed that PTPs with positive urine toxicology had higher rates of blunt head injuries, extremity injuries, domestic violence incidents, and uterine contractions, but similar maternal complication rates compared to those who tested negative.
View Article and Find Full Text PDF
Article Synopsis
  • Patients with a heart condition called atrial fibrillation (AF) who have strokes can still be at very high risk of having more strokes, even when taking medication to prevent them.
  • Left atrial appendage occlusion (LAAO) is a special procedure aimed at helping these patients avoid future strokes.
  • A study compared two groups – one that had LAAO and one that only continued their usual medication – and found that there was still a risk of strokes in both groups over a two-year period.
View Article and Find Full Text PDF
Article Synopsis
  • Current guidelines suggest that patients with isolated sternal fractures (ISFs) and minor heart-related issues should undergo 24-hour telemetry monitoring, despite a single study indicating they might not need it.
  • A study conducted across 8 trauma centers reviewed ISF patients with minor ECG changes or troponin elevation and found that very few (1.6%) experienced significant blunt cardiac injury (BCI), and none had BCI diagnosed via echocardiogram.
  • The results imply that routine monitoring and echocardiography may not be necessary for ISF patients displaying minor ECG abnormalities and challenge existing medical protocols.
View Article and Find Full Text PDF

The global distribution of hepatitis E virus (HEV) is attributed to its capacity to spread through several routes of transmission; hemodialysis has gained increased amounts of attention in recent years. Although Mexico is considered a hyperendemic region for hepatitis E, no HEV surveillance is performed in the country. The frequency of HEV in hemodialysis (HD) patients has not been determined.

View Article and Find Full Text PDF
Article Synopsis
  • Left atrial appendage occlusion (LAAO) is a treatment for patients with atrial fibrillation (AF) who can't use oral anticoagulation therapy (OAT) and those who face recurring thrombotic events despite OAT.
  • This study compared the efficacy of LAAO in patients experiencing thrombotic events while on OAT against those who had contraindications for OAT, using data from a large registry and propensity score matching for accuracy.
  • Results showed no significant difference in ischemic stroke rates between the two groups, but the LAAO patients on OAT had a higher thromboembolic risk but lower bleeding risk, suggesting LAAO is a viable option for these patients.
View Article and Find Full Text PDF
Article Synopsis
  • Almost 10% of pregnant women experience serious injuries, but how serious injuries affect them and their babies isn’t well understood.
  • A study looked at 950 pregnant women with injuries and found that about 3.4% had severe injuries, which led to more complications and higher risks for both the mother and baby.
  • Severely injured women had more surgeries and a higher chance of losing their baby, so doctors need to be very careful when taking care of them.
View Article and Find Full Text PDF

The combination of signals from the T-cell receptor (TCR) and co-stimulatory molecules triggers transcriptional programs that lead to proliferation, cytokine secretion, and effector functions. We compared the impact of engaging the TCR with CD28 and/or CD43 at different time points relative to TCR engagement on T-cell function. TCR and CD43 simultaneous engagement resulted in higher CD69 and PD-1 expression levels than in TCR and CD28-stimulated cells, with a cytokine signature of mostly effector, inflammatory, and regulatory cytokines, while TCR and CD28-activated cells secreted all categories of cytokines, including stimulatory cytokines.

View Article and Find Full Text PDF

Background: SARS-CoV2 induces flu-like symptoms that can rapidly progress to severe acute lung injury and even death. The virus also invades the central nervous system (CNS), causing neuroinflammation and death from central failure. Intravenous (IV) or oral dexamethasone (DXM) reduced 28 d mortality in patients who required supplemental oxygen compared to those who received conventional care alone.

View Article and Find Full Text PDF
Article Synopsis
  • Doctors often use CT scans to check for injuries after car accidents, but for pregnant women, these scans can be risky for the baby.
  • A study looked at how often pregnant women involved in car crashes got CT scans at 12 different hospitals from 2016 to 2021.
  • The results showed a big difference in the number of scans given at each hospital, suggesting there should be clearer rules to keep both moms and babies safe while still finding any injuries.
View Article and Find Full Text PDF

Hepatitis E virus (HEV) exhibits tropism toward hepatocytes and thus affects the liver; however, HEV may also affect other tissues, including the heart, kidneys, intestines, testicles, and central nervous system. To date, the pathophysiological links between HEV infection and extrahepatic manifestations have not yet been established. Considering that HEV infects multiple types of cells, the direct effects of virus replication in peripheral tissues represent a plausible explanation for extrahepatic manifestations.

View Article and Find Full Text PDF

In vitro maturation (IVM) system is an alternative method to superovulation protocols to obtain mature oocytes. Epidermal Growth Factor (EGF) and Insulin-like Growth Factor I (IGF-I) have been widely used in IVM medium in different species. Although the guinea pig is a valuable animal model for reproductive studies, IVM is rarely used.

View Article and Find Full Text PDF

Hepatitis E virus (HEV) is the major cause of acute viral hepatitis worldwide. This virus is responsible for waterborne outbreaks in low-income countries and zoonosis transmission in industrialized regions. Initially, considered self-limiting, HEV may also lead to chronic disease, and evidence supports that infection can be considered a systemic disease.

View Article and Find Full Text PDF

In the late 1970s, 52,000 pregnant women died in Kashmir, India [...

View Article and Find Full Text PDF

Background: Pregnant trauma patients (PTPs) undergo observation and fetal monitoring following trauma due to possible fetal delivery (FD) or adverse outcome. There is a paucity of data on PTP outcomes, especially related to risk factors for FD. We aimed to identify predictors of posttraumatic FD in potentially viable pregnancies.

View Article and Find Full Text PDF
Article Synopsis
  • The study looked at the effects of pregnancy in older moms (35 years and older) who had trauma and compared them to younger pregnant moms.
  • It found that older moms had more injuries to certain organs like the pancreas and stomach, but there was no difference in the chance of delivering the baby after trauma.
  • Because of this, they decided that older moms don’t need extra monitoring compared to younger moms after a trauma.
View Article and Find Full Text PDF

Background: Patients with traumatic brain injury (TBI) are at high risk of venous thromboembolism (VTE). Recent guidelines recommend starting TBI patients on enoxaparin 30 mg twice daily and then considering weight-based dosing. Creatinine clearance may be better than weight for patients when considering high and low enoxaparin dose requirements.

View Article and Find Full Text PDF

Introduction: Guidelines encourage higher doses of low molecular weight heparin (LMWH) for prophylaxis in trauma patients. The risks of LMWH must be considered for patients who require an epidural catheter. We compared adequate and inadequate prophylaxis to determine if venous thromboembolism (VTE) and complication rates differed among patients with epidural catheters.

View Article and Find Full Text PDF

Background: The role of left atrial appendage occlusion (LAAO) for atrial fibrillation patients that during oral anticoagulant therapy (OAC) suffer from ischemic events or present LAA sludge, and the best postinterventional anticoagulant regimen, need to be defined. We present our experience with a hybrid approach of LAAO+ lifelong OAC therapy in this cohort of patients.

Methods: Out of 425 patients treated with LAAO, 102 underwent LAAO because, despite OAC, suffered from ischemic events or presented with LAA sludge.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates survival rates of trauma patients who received closed chest compressions, focusing on different age groups from 2015 to 2020 across four trauma centers.
  • Among the 247 patients analyzed, the overall mortality rate was 92%, with patients aged 70 and older showing 100% mortality and no survivors to hospital discharge.
  • Findings suggest that closed chest compressions may have limited effectiveness in older adults, potentially guiding decisions on whether to proceed with such interventions in this population.
View Article and Find Full Text PDF

Introduction And Objectives: Hepatitis E virus (HEV) is not routinely screened in blood banks in low- and middle-income countries, and no specific biomarkers of exposure to this virus have yet been identified. We aimed to identify HEV seropositivity and detect virus RNA among blood donors from Mexico to further correlate risk factors related to infection and levels of interleukin-18 (IL-18) and interferon-gamma (IFN-γ) as potential biomarkers.

Materials And Methods: This cross-sectional, single-center study included 691 serum samples of blood donors obtained in 2019.

View Article and Find Full Text PDF

Background: Guidelines for enoxaparin dosing after trauma recommend an initial dose of 40 mg twice daily for most patients and then adjusting by anti-Xa levels. Previous studies indicated higher enoxaparin doses are necessary with higher levels of creatinine clearance (CrCl). We sought to determine if the goal enoxaparin dose correlates with the admission CrCl to reduce the reliance on measuring anti-Xa levels.

View Article and Find Full Text PDF

Background: Cerebral protection devices (CPD) are designed to prevent cardioembolic stroke and most evidence that exists relates to TAVR procedures. There are missing data on the benefits of CPD in patients that are considered high risk for stroke undergoing cardiac procedures like left atrial appendage (LAA) closure or catheter ablation of ventricular tachycardia (VT) when cardiac thrombus is present.

Purpose: This work aimed to examine the feasibility and safety of the routine use of CPD in patients with cardiac thrombus undergoing interventions in the electrophysiology (EP) lab of a large referral center.

View Article and Find Full Text PDF

Guinea pig in vitro fertilization (IVF) are poorly developed due to the limited accessibility to oocytes and the lack of an efficient method of sperm capacitation. Thus, we aimed to evaluate different capacitation protocols that we validated through sperm analysis and using heterologous (He) IVF with zona-intact bovine oocytes. Spermatozoa of guinea pigs were collected and processed separately by 4 different protocols: A) Spermatozoa were obtained by flushing the lumen of one cauda epididymis and incubated in a minimal culture medium (MCM); B) One epididymis was placed in a prewarmed of M2 medium and gently minced with fine scissors.

View Article and Find Full Text PDF