Frequencies of BCR::ABL1 Transcripts in Patients with Chronic Myeloid Leukemia: A Meta-Analysis

Chronic myeloid leukemia (CML) is associated with the Philadelphia chromosome and distinct BCR::ABL1 gene transcripts. We assessed the frequencies of these transcripts in Mexico, Latin America, and worldwide. We determined the prevalence of BCR::ABL1 transcripts in CML patients and intercontinental or regional variations using specialized databases and keywords. We analyzed 34 studies from 20 countries, encompassing 5795 patients. Keyword-based searches in specialized databases guided data collection. ANOVA was employed for transcript distribution analysis. The b3a2 transcript was most prevalent globally, followed by b2a2, with e1a2 being the least frequent. Interestingly, Mexico City exhibited a higher incidence of b2a2, while b3a2 predominated in the remaining country. Overall, no significant intercontinental or regional variations were observed. b3a2 was the most common BCR::ABL1 transcript worldwide, with b2a2 following closely; e1a2 was infrequent. Notably, this trend remained consistent in Mexico. Evaluating transcript frequencies holds clinical relevance for CML management. Understanding the frequency of transcript informs personalized CML treatments.

Análisis de la presencia de trisomía 8 en las diferentes fases de leucemia mieloide crónica

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Gallbladder stones during pregnancy: are we doing the right thing in Mexico?

OBJECTIVE

To present the treatment of choice and approach in pregnant and postpartum women with a diagnosis of gallstones in Mexico and to compare it with the recommendations of international guidelines.

METHOD

Observational, descriptive, and retrospective study based on information from the 2019 Dynamic Cubes database of pregnant women diagnosed with cholecystitis and/or cholelithiasis who had undergone cholecystectomy.

RESULTS

During 2019, 937 patients with cholelithiasis and cholecystitis were registered, 516 (55%) pregnant and 421 (45%) in puerperium. 91.47% of cases were managed with medical treatment and 8.53% with cholecystectomy, with predominance in the open approach in 63.75% of cases. Mortality was nil in both groups.

CONCLUSIONS

Despite current international guidelines recommending early laparoscopic cholecystectomy in pregnant or puerperal women, in Mexico medical treatment, delayed cholecystectomy and its open approach are still privileged.

COVID-19-Associated Case Fatality Rate in Subjects Under 18 Years Old in Mexico, up to December 31, 2020

Background: The emergence of the SARS-CoV-2 and the COVID-19 have become a global health crisis. The infection has been present in all the social sectors. Subjects under 18 years are one of them. The objective was to analyze the case fatality ratio of COVID-19 cases in the Mexican population under 18 years of age registered in the National Epidemiological Surveillance System from March 2020 to December 31, 2020. Material and Methods: The design is cross-sectional, quantitative, and analytical. All the suspected cases of respiratory viral disease, with a real-time polymerase chain reaction (RT-PCR) test result, aged from 0 to 17 years, were included. Descriptive statistics are presented for all the variables. Epidemiological curves were designed. The chi-squared test and its P-values were obtained to show the relationship between comorbidities and death. The case fatality ratio was computed for each comorbidity, sex, and age group. Multivariable logistic regression models were fitted to study the effect between comorbidities with the fatality of cases, adjusting for sex and age group as potential confounders. The alpha value was fixed to 0.05 to assess significance. Results: The number of records for this study was 167,856. Among them, 48,505 were from SARS-CoV-2-positive patients (28.90%), and 119,351 (71.10%) were negative. Of those who died, males (55.29%) (P < 0.05) and those under 2 years of age (50.35%) (P < 0.05) predominated. Unlike in older populations, from the comorbidities considered risk factors for death by COVID-19, only immunosuppression showed a statistically significant effect on the fatality of cases after adjustment by the other related variables. Sex and age group were not confounders for the models in those under 18 years old. Pneumonia, being younger than 5 years, and immunosuppression are related to death. Conclusion: The case fatality ratio in those under 18 years old is low. Special attention must be paid to those children under 5 years. The development of pneumonia is a warning indicator while treating them. On the other hand, having an open database of cases allows the researchers to analyze the impact of COVID-19 in different population sectors, which has clear benefits for public health.

Forty-Year-Old Man With Abdominal Pain 4 Years Post-Renal Transplant: A Case Report

Tuberculosis (TB) is an opportunistic infection 20 to 74 times more frequent in immunocompromised patients compared to the general population. The prevalence with renal transplant had a 0.5% to 15% incidence. The infection could be pulmonary or extrapulmonary (EPTB). The EPTB accounts for almost 20% of TB cases in immunocompetent people and 50% in positive human immunodeficiency virus cases. In this case report, we present a patient who attended the emergency room because of chronic diarrhea, abdominal pain, loss of weight, nocturne diaphoresis, and intermittent fever. A computed tomography scan showed retroperitoneal ganglionic conglomeration. He got into an exploratory laparotomy for histopathology specimens and paraganglionic fluid culture to a Gene Xpert MTB-RIF Assay G4, positive for rifampicin resistance tuberculosis. After an individualized treatment, trying to protect the graft's remaining function, the patient returned with acute abdominal pain and pancreatic enzymes elevation; the antibiotic management had to be suspended until the return of renal function.

Laparoscopic procedures experience in Mexico during 2015: ¿Where are we?

Background

26 years have passed from the first laparoscopic cholecystectomy in Mexico. Since then the laparoscopy has been adopted of variable way and has extended into different specialties.

Objective

To identify the place that laparoscopic approaches occupy at the present time in Mexico.

Method

We searched the codes that had the word laparoscopy or laparoscopic in the records of the Automated System of Hospitable Discharges in 2015. Based on the obtained information there was realized a descriptive and retrospective study.

Results

We found 55 different procedures in a total of 30,174. Of them, 79.7% in women and 20.3% in men. The most common age was between 25 and 29 years. The ten first ones were cholecystectomy, appendectomy, total abdominal laparoscopic hysterectomy, procedures to create esophago-gastric sphincter competence, unilateral salpingo-oophorectomy, partial cholecystectomy, ovarian resection, umbilical hernia repair, incidental appendectomy and unilateral oophorectomy (94.6%). The States with the major number are Mexico City, State of Mexico, Jalisco, Guanajuato and Sonora.

Conclusions

The laparoscopic procedures have increase in the national health systems and there is concordance of the most common with the international statistics. However, is necessary to diversify them and reduce the times of hospital stay. Its application is in process and it still face challenges in relation to availability of organizational elements, equipment, infrastructure and training, although there are different ways to overcome them.

[Institutional liability and medical research]

On December 14, 2011 an addition to Article 100 of the General Health Law was published in the Federation Official Journal. The added section VII states that: "It is the responsibility of the Health Care Institution to provide medical care to the subject that is injured, if this is directly related to the investigation, without prejudice to the legally appropriate compensation", thus establishing the institution's liability in an precise way when it authorizes research. This is a relevant situation of Fundamental Rights. We will present the spirit of the ordinary legislator from the Law initiative to its enactment.