[Immunoglobulin G4 disease with pancreatic affectation: the mimicker of malignancy].

Background: mmunoglobulin G subclass 4-related disease (IgG4-RD) is characterized by elevated serum IgG4 levels and tissue infiltration by IgG4-positive plasma cells. It has a varied clinical presentation, and definitive diagnosis requires rigorous clinicopathological correlation.

Clinical Case: 47-year-old male patient with a history of weight loss of 35 kg over 2 years, accompanied by the presence of pulmonary nodules and alterations in pancreatic morphology detected by imaging, which was assessed as a probable pancreatic neoplasm; however, IgG4-RD was suspected during the approach, which is why serum IgG4 levels and a biopsy of the submandibular gland were requested, fulfilling the diagnostic criteria, consequently starting treatment with rituximab with an adequate response.

Frequency, risk factors and time to resolution of exposure keratopathy in patients in the Pediatric Intensive Care Unit.

Background And Objective: Exposure keratopathy (EPK) is characterized by punctate erosions of the corneal epithelium, mainly located in the lower third of the cornea. In the Pediatric Intensive Care Unit (PICU), an incidence of 19-25 % has been reported. The objective of this study was to describe the frequency, risk factors, and time to resolution of exposure keratitis in PICU patients.

Extended resection for seizure control of pure motor strip focal cortical dysplasia during awake craniotomy: illustrative case.

Background: Focal cortical dysplasias (FCD) represent highly intrinsically epileptogenic lesions that require complete resection for seizure control. Resection of pure motor strip FCD can be challenging. Effective control of postoperative seizures is crucial and extending the boundaries of resection in an eloquent zone remains controversial.

[Sustained virologic response in patients with hepatitis C and chronic kidney disease].

Background: Patients with chronic kidney disease (CKD) have a higher prevalence of hepatitis C virus (HCV) infection compared to the general population, and they also present higher morbidity and mortality if they are not treated. Current treatment is based on different direct-acting antiviral (DAA) schemes, which are available in the Mexican health system. However, the efficacy and safety of DAA treatment in patients with CKD on hemodialysis and HCV infection are unknown in Mexican population.

Discrimination of residents during neurosurgical training in Mexico: Results of a survey prior to SARS-CoV-2.

Background: Recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic represents an important negative impact on global training of neurosurgery residents. Even before the pandemic, discrimination is a challenge that neurosurgical residents have consistently faced. In the present study, we evaluated discriminatory conditions experienced by residents during their neurosurgical training in Mexico before the SARS-CoV-2 pandemic.

[Mammographic density patterns in women from Torreon, Coahuila].

Background: Breast cancer is the main cause of death by cancer in Mexican women. High mammographic breast density is a well-established breast cancer risk factor that also increases the risk of death. However, there is limited data of breast density patterns among Mexican women and their association with breast cancer incidence and mortality.

Tc-UBI 29-41 bone SPECT/CT scan in craniofacial : Misdiagnosis of cranial bone tumor - A case report.

Background: Actinomycosis is a rare infection, frequently misdiagnosed as a neoplasia. This chronic and granulomatous disease is caused by species. Cervicofacial actinomycosis occurs in 60% of cases and the diagnosis is commonly made by histopathology study.

Update of the Mexican College of Rheumatology Guidelines for the Pharmacological Treatment of Rheumatoid Arthritis, 2018.

Unlabelled: Therapeutic advances in rheumatoid arthritis require periodic review of treatment guidelines.

Objective: To update the Mexican College of Rheumatology guidelines on the pharmacological treatment of rheumatoid arthritis.

Method: Board certified rheumatologists from different health institutions and regions of the country participated.

Validation of the FRAIL scale in Mexican elderly: results from the Mexican Health and Aging Study.

Background: The aging population in Latin America is characterized by not optimal conditions for good health, experiencing high burden of comorbidity, which contribute to increase the frequency of frailty; thus, identification should be a priority, to classify patients at high risk to develop its negative consequences.

Aim: The objective of this analysis was to validate the FRAIL instrument to measure frailty in Mexican elderly population, from the database of the Mexican Health and Aging Study (MHAS).

Materials And Methods: Prospective, population study in Mexico, that included subjects of 60 years and older who were evaluated for the variables of frailty during the year 2001 (first wave of the study).

Guidelines for the diagnosis and treatment of extrahepatic portal vein obstruction (EHPVO) in children.

Introduction: Extrahepatic portal vein obstruction is an important cause of portal hypertension among children. The etiology is heterogeneous and there are few evidences related to the optimal treatment.

Aim And Methods: To establish guidelines for the diagnosis and treatment of EHPVO in children, a group of gastroenterologists and pediatric surgery experts reviewed and analyzed data reported in the literature and issued evidence-based recommendations.

[Therapeutic endoscopy in pancreas].

The role of endoscopic retrograde cholangiopancreatography (ERCP) in the management of pancreatic disease is continuing to evolve. In view of increasingly noninvasive diagnostic imaging modalities for pancreatic disease, ERCP should be mainly restricted to therapeutic indications. This article reviews recent publications spanning a wide range of topics related to therapeutic pancreatic endoscopy: This review article will be focused on the technical and therapeutic aspects of the following topics: 1.

[Self-expandable metallic biliary endoprosthesis in malignant obstructive jaundice].

Background: Implantation of metallic stents for malignant biliary strictures has been recognized to be effective alternatives.

Aim: To show our experience in metallic stents for palliation of malignant biliary strictures.

Patients And Methods: Seventy three patients (38 males, 35 females, mean age 64.

[Transpapillary and transmural drainage of pancreatic pseudocysts].

Background: Endoscopic treatment of pancreatic pseudocysts via cystoenterostomy or transpapillary stenting has been recognized as a successful treatment options in carefully selected patients. Transpapillary stenting is an option in patients with pancreatic pseudocysts directly communicating with the main duct.

Aim: The aim of this study was to assess the safety and usefulness of transpapillary pancreatic endoprosthesis and transmural drainage in the treatment of symptomatic pancreatic pseudocysts.

[Endoscopic mechanical lithotripsy in choledocholithiasis of difficult extraction handling].

Background: Large stones are difficult to remove in block through a small papillotomy, a relative narrowed distal bile duct, periampular diverticula or in those who have undergone only balloon sphincteroplasty prior to stone extraction. Extending the papillotomy is not always possible, and may carry, an increased risk of bleeding and perforation. Lithotripsy facilitates stone extraction and clearance of the common bile duct.

[Postoperative biliary stenosis: long-term results of endoscopic treatment].

Background: Endoscopic stent placement is often the initial therapy in symptomatic patients with postoperative strictures because patients are usually diagnosed at the time of ERCP. Although stent insertion rapidly relieves symptoms of biliary obstruction and can even be live-saving in patients with cholangitis, all stents eventually clog, necessitating regular stent changes every 3 to 4 months. Results from several groups suggested that placing multiple stents for months to years could dilate the stricture permanently and thus also treat patients with postoperative biliary strictures palliatively.

[Endoscopic sphincterotomy as an out-patient procedure: is it safe?].

Background: Patients have been routinely admitted for observation for potential complications after therapeutic ERCP; however, in this era of cost containment it may be more cost-effective to perform these procedures on an out-patient basis.

Aim: The purpose of this study was to determine safety and complication rates of endoscopic sphincterotomy in out-patients.

Materials And Patients: Over an 11-month period, 124 consecutive patient undergoing endoscopic sphincterotomy for biliary and pancreatic disease were enrolled in a prospective and randomized manner.

[Endoscopic management of choledocholithiasis during pregnancy].

Background: Gallstones and extrahepatic biliary obstruction is a difficult management problem during pregnancy. Choledocholithiasis may cause cholangitis or pancreatitis, potentially life-threatening conditions. As surgery may result in significant fetal mortality when performed on these patients.

[Conservative management of duodenal perforation following endoscopic sphincterotomy of papilla of Vater].

Background: Endoscopic sphincterotomy (ES) is an established procedure in treatment of diseases of the biliary tract; management of serious complications such as duodenal perforation remains controversial. Because mortality is high if sepsis is inadequately treated by no use of operative means, many surgeons advocate routine operative repair and drainage upon diagnosis. In surveys of large experiences, however, the majority patients initially were treated non-surgically, and the majority recovered.

[Endoscopic diagnosis and treatment of non-traumatic bilhemia. A case report].

Biliovascular fistulas are abnormal communications with two types of clinical manifestations depending on type of flow in fistulous tract: 1) hemorrhage into biliary tract known as hemobilia, or 2) bile into bloodstream, known as bilhemia. Historically, this complication has been treated with surgery; however, technological progress at present allows treatment with intervention techniques without surgery being mandatory. In 1975, Clemens and Wittrin introduced the term bilhemia, a rare complication of hepatic damage producing excessively high levels of serum bilirubin and moderate rise of hepatic enzymes secondary to post-traumatic intrahepatic biliovenous fistula.

[Selection criteria for endoscopic cholangiopancreatography before laparoscopic cholecystectomy].

Background: The unexpected detection of stones in common bile duct during laparoscopic cholecystectomy is a concern for laparoscopic surgeons. Immediate laparoscopic removal may not always be feasible due to inadequate operating facilities, surgeons, and assistants. Attempts have been made to identify clinical and biochemical predictor of common bile duct stones, the results of which have not been consistent.

[Insertion of biliary endoprosthesis as ambulatory procedure].

Background: Because of possible complications, it has been common practice to admit to the hospital most if not all patients undergoing therapeutic ERCP. Therefore, little descriptive data exist on the safety of out-patient therapeutic ERCP for endobiliary stent placement.

Objective: To assure quality patient care and patient safety, we reviewed our experience with out-patient therapeutic ERCP for palliation of benign and malignant common bile duct obstruction by means of endobiliary stent insertion.

[Diagnostic and therapeutic endoscopic cholangiopancreatography in biliary leak after liver transplantation. Report of 2 cases].

Background: The most common biliary tract complications after orthotopic liver transplantation are anastomotic strictures and bile leaks. These remain important causes of morbidity, frequently prompting surgical approach and/or biliary drainage.

Objective: To report our experience using endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis and management of biliary tract complications in patients with hepatic transplantation.

[Proximal migration of biliary prosthesis. Endoscopic extraction techniques].

Background: Proximal migration of a biliary stent is an uncommon event, but its management can present a technical challenge to the therapeutic endoscopist.

Objective: We reviewed the methods that have been used for retrieval of proximally migrated biliary stents in a referral endoscopic center. PATIENTS-METHOD, AND RESULTS: From January 1995 to December 1998, there were 410 procedures for insertion of biliary stents.