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Lara-Esqueda A, Zaizar-Fregoso SA, Madrigal-Perez VM, Ramirez-Flores M, Montes-Galindo DA, Martinez-Fierro ML, Rodriguez-Sanchez IP, Guzman-Esquivel J, Meza-Robles C, Ceja-Espiritu G, Kuri-Morales PA, Delgado-Enciso J, Barriguete-Melendez A, Galvan-Salazar HR, Barajas-Saucedo CE, Guillermo-Espinosa E, Lara-Basulto AD, Gonzalez-Roldan JF, Delgado-Enciso I. Evaluation of Medical Care for Diabetic and Hypertensive Patients in Primary Care in Mexico: Observational Retrospective Study. J Diabetes Res 2021; 2021:7365075. [PMID: 34426789 PMCID: PMC8380161 DOI: 10.1155/2021/7365075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/22/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The present study evaluated the quality of medical care for patients diagnosed with diabetes mellitus (DM), hypertension (HBP), and both pathologies (DM+HBP) within a public health system in Mexico. METHODS 45,498 patients were included from 2012 to 2015. All information was taken from the electronic medical record database. Each patient record was compared against the standard to test the quality of medical care. RESULTS Glycemia with hypertension goals reached 29.6% in DM+HBP, 48.6% in DM, and 53.2% in HBP. The goals of serum lipids were reached by 3% in DM+HBP, 5% in DM, and 0.2% in HBP. Glycemia, hypertension, and LDL cholesterol reached 0.04%. 15% of patients had an undiagnosed disease. Clinical follow-up examinations reached 20% for foot examination and clinical eye examination. Specialty referrals reached 1% in angiology or cardiology. CONCLUSION Goals for glycemic and hypertension reached 50% in the overall population, while serum lipids, clinical follow-up examinations, and referral to a specialist were deficient. Patients who had both diseases had more consultations, better control for hypertension and lipids, but inferior glycemic control. Overall, quality care for DM and/or HBP has not been met according to the standards.
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Affiliation(s)
- Agustin Lara-Esqueda
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Sergio A. Zaizar-Fregoso
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Violeta M. Madrigal-Perez
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Mario Ramirez-Flores
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico
| | - Daniel A. Montes-Galindo
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Margarita L. Martinez-Fierro
- Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University, Zacatecas 98160, Mexico
| | - Iram P. Rodriguez-Sanchez
- Molecular and Structural Physiology Laboratory, School of Biological Sciences, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico
| | - José Guzman-Esquivel
- Department of Research, Mexican Social Security Institute, Villa de Alvarez, Colima 28983, Mexico
| | - Carmen Meza-Robles
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Gabriel Ceja-Espiritu
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico
| | - Pablo A. Kuri-Morales
- School of Medicine, Universidad Nacional Autonoma de Mexico, Ciudad de Mexico, 04510, Mexico
| | - Josuel Delgado-Enciso
- Fundación para la Etica, Education e Investigación del Cáncer del Instituto Estatal de Cancerologia de Colima, Colima 28085, Mexico
| | | | - Hector R. Galvan-Salazar
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | | | | | - Agustin D. Lara-Basulto
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Jesus F. Gonzalez-Roldan
- Subsecretaria de Prevención y Promoción de la Salud, Secretaria de Salud de Mexico, Ciudad de Mexico, 06600, Mexico
| | - Ivan Delgado-Enciso
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico
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Delgado-Enciso I, Madrigal-Perez VM, Lara-Esqueda A, Diaz-Sanchez MG, Guzman-Esquivel J, Rosas-Vizcaino LE, Virgen-Jimenez OO, Kleiman-Trujillo J, Lagarda-Canales MR, Ceja-Espiritu G, Rangel-Salgado V, Lopez-Lemus UA, Delgado-Enciso J, Lara-Basulto AD, Soriano Hernández AD. Topical 5% potassium permanganate solution accelerates the healing process in chronic diabetic foot ulcers. Biomed Rep 2018; 8:156-159. [PMID: 29435274 PMCID: PMC5778841 DOI: 10.3892/br.2018.1038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 12/01/2017] [Indexed: 12/26/2022] Open
Abstract
Potassium permanganate has been reported to be an effective treatment for certain types of wounds. The aim of the present study was to evaluate the use of potassium permanganate in the treatment of diabetic foot ulcers. A single-blind, randomized, controlled clinical trial was conducted on patients with type 2 diabetes mellitus that presented with a foot ulcer persisting for >3 months. The control group (n=10) was treated with the current standard treatment, which comprises of measures for reducing pressure in the ulcerated area, daily cleansing of the ulcer with potable water and antiseptic wash solution, and the application of a disinfectant solution on the entire surface area of the ulcer; while the intervention group (n=15) received the standard treatment plus 5% topical potassium permanganate solution applied once a day for 21 days. In the intervention group, 1 patient did not tolerate the treatment and was eliminated from the study on the first day. The remaining patients tolerated the interventions well. At the end of the treatment period, ulcers in the control group had decreased by 38% whereas those in the intervention group decreased by 73% (P<0.009). The degree of decrease was also investigated; the ulcer size was ≥50% decreased in 40% of patients in the control group and in 86% of patients in the intervention group (P=0.02). In conclusion, the results of the present study indicate that topical potassium permanganate is well tolerated and significantly accelerates the healing process of diabetic foot ulcers.
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Affiliation(s)
- Iván Delgado-Enciso
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico.,Department of Public Health, School of Medicine, University of Colima, Las Víboras, Colima 28040, Mexico
| | - Violeta M Madrigal-Perez
- Department of Public Health, School of Medicine, University of Colima, Las Víboras, Colima 28040, Mexico
| | - Agustin Lara-Esqueda
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Martha G Diaz-Sanchez
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Jose Guzman-Esquivel
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Luis E Rosas-Vizcaino
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Oscar O Virgen-Jimenez
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Juleny Kleiman-Trujillo
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Maria R Lagarda-Canales
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Gabriel Ceja-Espiritu
- Department of Public Health, School of Medicine, University of Colima, Las Víboras, Colima 28040, Mexico
| | - Viridiana Rangel-Salgado
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Uriel A Lopez-Lemus
- Department of Public Health, School of Medicine, University of Colima, Las Víboras, Colima 28040, Mexico
| | - Josuel Delgado-Enciso
- Department of Research, Foundation for Cancer Ethics, Education and Research of the Cancerology State Institute, Colima 28085, Mexico
| | - Agustin D Lara-Basulto
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Alejandro D Soriano Hernández
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico.,Department of Public Health, School of Medicine, University of Colima, Las Víboras, Colima 28040, Mexico
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Delgado-Enciso I, Paz-Garcia J, Rodriguez-Hernandez A, Madrigal-Perez VM, Cabrera-Licona A, Garcia-Rivera A, Soriano-Hernandez AD, Cortes-Bazan JL, Galvan-Salazar HR, Valtierra-Alvarez J, Guzman-Esquivel J, Rodriguez-Sanchez IP, Martinez-Fierro ML, Paz-Michel B. A promising novel formulation for articular cartilage regeneration: Preclinical evaluation of a treatment that produces SOX9 overexpression in human synovial fluid cells. Mol Med Rep 2017; 17:3503-3510. [PMID: 29286152 PMCID: PMC5802147 DOI: 10.3892/mmr.2017.8336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 09/07/2017] [Indexed: 12/13/2022] Open
Abstract
Osteoarthritis (OA) is a chronic disorder of synovial joints, in which there is progressive softening and disintegration of the articular cartilage. OA is the most common form of arthritis, and is the primary cause of disability and impaired quality of life in the elderly. Despite considerable medical necessity, no treatment has yet been proven to act as a disease‑modifying agent that may halt or reverse the structural progression of OA. The replacement of the joint with a prosthesis appears to be the best option in the advanced stages of the disease. A formulation (BIOF2) for cartilage regeneration has been recently developed. The present study evaluated the effects of BIOF2 on gene expression in human cell cultures, followed by efficacy trials in three OA animal models. Human synovial fluid cells that were exposed to the formulation exhibited increased transcription factor SOX‑9 (SOX9; chondrogenic factor) expression, and decreased mimecan (mineralization inducer) and macrophage‑stimulating protein receptor (osteoclastogenic factor) expression. The intra‑articular application of BIOF2 in the animal models significantly increased cartilage thickness from 12 to 31% at 28 days, compared with articular cartilage treated with saline solution. The articular area and number of chondrocytes additionally increased significantly, maintaining an unaltered chondrocyte/mm2 proportion. Evaluation of the histological architecture additionally displayed a decrease in the grade of articular damage in the groups treated with BIOF2. In conclusion, BIOF2 has proven to be effective for treating OA in animal models, most likely due to SOX9 overexpression in articular cells.
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Affiliation(s)
- Ivan Delgado-Enciso
- Cancerology State Institute, Colima State Health Services, Colima 28000, Mexico
| | - Juan Paz-Garcia
- Centro Hospitalario Union, Villa de Álvarez, Colima 28950, Mexico
| | | | | | | | | | | | - Jose L Cortes-Bazan
- Cancerology State Institute, Colima State Health Services, Colima 28000, Mexico
| | | | | | | | - Iram P Rodriguez-Sanchez
- Department of Genetics, School of Medicine, Nuevo Leon Autonomous University, Monterrey, Nuevo León 64460, Mexico
| | - Margarita L Martinez-Fierro
- Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Universidad Autónoma de Zacatecas, Zacatecas 98160, México
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Madrigal-Perez VM, García-Rivera A, Rodriguez-Hernandez A, Ceja-Espiritu G, Briseño-Gomez XG, Galvan-Salazar HR, Soriano-Hernandez AD, Guzman-Esquivel J, Martinez-Fierro ML, Newton-Sanchez OA, Buenrostro BAO, Rodriguez-Sanchez IP, López-Lemus UA, Lara-Esqueda A, Delgado-Enciso I. Preclinical analysis of nonsteroidal anti-inflammatory drug usefulness for the simultaneous prevention of steatohepatitis, atherosclerosis and hyperlipidemia. Int J Clin Exp Med 2015; 8:22477-22483. [PMID: 26885230 PMCID: PMC4730016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 11/21/2015] [Indexed: 06/05/2023]
Abstract
Nonalcoholic steatohepatitis (NASH) is currently one of the primary liver diseases. Recent studies have shown a clinical relation between NASH and atherosclerosis. There is much interest in these two diseases because they are both associated with great morbidity and mortality. Inflammation and the overexpression of COX-2 participate in the pathophysiology of the two diseases, and therefore simultaneous treatment is feasible. The role of the four NSAIDs, meclofenamate, mefenamate, flufenamate, and aspirin, was analyzed in a mouse model of NASH, as well as preclinical atherosclerosis induced by a high-fat diet (HFD). Six mouse groups were formed. Five of the groups were fed a high-fat diet for 6 months and one group was fed a standard diet, acting as the normality reference. Of the five groups fed a high-fat diet, four received a NSAID, each of them identified by the specific drug administered. One group received no treatment. Serum markers (cholesterol, triglycerides, ALT, and AST) and histologic changes in the aorta and liver were analyzed for the study. Aspirin significantly reduced the hepaticsteatosis. All the drugs significantly reduced the hepatic inflammatory infiltrate. In relation to atherosclerosis, there were significant reductions in all the study variables with the use of aspirin and flufenamate. The four medications were able to stop steatosis from progressing into steatohepatitis by reducing inflammation. However, aspirin was the most beneficial, simultaneously reducing steatosis, atherosclerosis, and serum cholesterol levels.
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Affiliation(s)
- Violeta M Madrigal-Perez
- School of Medicine, University of Colima Av. Universidad 333, Col. Las Víboras. Colima 28030, Mexico
| | - Alejandro García-Rivera
- School of Medicine, University of Colima Av. Universidad 333, Col. Las Víboras. Colima 28030, Mexico
| | | | - Gabriel Ceja-Espiritu
- School of Medicine, University of Colima Av. Universidad 333, Col. Las Víboras. Colima 28030, Mexico
| | - Xochitl G Briseño-Gomez
- Cancerology State Institute, Colima State Health Services Av. Liceo de Varones 401. Col. La Esperanza, Colima 28000, México
| | - Hector R Galvan-Salazar
- School of Medicine, University of ColimaAv. Universidad 333, Col. Las Víboras. Colima 28030, Mexico; Cancerology State Institute, Colima State Health ServicesAv. Liceo de Varones 401. Col. La Esperanza, Colima 28000, México
| | - Alejandro D Soriano-Hernandez
- School of Medicine, University of ColimaAv. Universidad 333, Col. Las Víboras. Colima 28030, Mexico; Cancerology State Institute, Colima State Health ServicesAv. Liceo de Varones 401. Col. La Esperanza, Colima 28000, México
| | - Jose Guzman-Esquivel
- Hospital General de Zona No1. IMSS Av. De los Maestros 149. Col. Centro. Colima 28000, México
| | - Margarita L Martinez-Fierro
- Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Universidad Autónoma de Zacatecas Km 6 Carr. Zacatecas-Guadalajara s/n. Ejido La Escondida, Zacatecas 98160, Mexico
| | - Oscar A Newton-Sanchez
- School of Medicine, University of Colima Av. Universidad 333, Col. Las Víboras. Colima 28030, Mexico
| | | | - Iram P Rodriguez-Sanchez
- Department of Genetics, School of Medicine, Nuevo Leon Autonomous University Ave. Madero s/n con Dr. Eduardo Aguirre Pequeño. Col. Mitras Centro, Monterrey, Nuevo León 64460, México
| | - Uriel A López-Lemus
- School of Medicine, University of Colima Av. Universidad 333, Col. Las Víboras. Colima 28030, Mexico
| | - Agustin Lara-Esqueda
- Cancerology State Institute, Colima State Health Services Av. Liceo de Varones 401. Col. La Esperanza, Colima 28000, México
| | - Ivan Delgado-Enciso
- School of Medicine, University of ColimaAv. Universidad 333, Col. Las Víboras. Colima 28030, Mexico; Cancerology State Institute, Colima State Health ServicesAv. Liceo de Varones 401. Col. La Esperanza, Colima 28000, México
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