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Background: Weeksella virosa pneumonia is an infection that has been described as a healthcare-associated infection. This is a rare gram-negative anaerobic bacterium associated with the use of mechanical ventilation for a long period of time and is more frequent in immunosuppressed patients. This is the first case reported in the state of Veracruz and the second in Mexico., Case Presentation: We present the case of a 64-year-old female from Veracruz, Mexico who developed an infectious process in the right pelvic limb after a transcatheter aortic valve replacement procedure and subsequently developed sudden cardiorespiratory arrest requiring mechanical ventilation, with subsequent imaging studies demonstrating a pneumonic process associated with a nosocomial infection., Discussion and Conclusions: We should take into consideration that this pathogen affects not only adults with multiple comorbidities but also children with renal, hepatic, or oncological pathologies, as well as immunocompromised patients, who should be considered high-risk populations for W. virosa infection., (© 2023. The Author(s).)

Background and Objective: Diabetic kidney disease (DKD) is the most common microvascular chronic complication of diabetes mellitus. Hyperbaric oxygen (HBO2) therapy will increase the partial pressure of oxygen (PaO2) and may improve cell repair processes, which can lead to better renal function. The objective of this study was to quantify the efficacy of adjuvant HBO2 to increase the glomerular filtration rate and urinary albumin excretion in diabetic patients, as well as determine its effectiveness to modify the clinical course of DKD., Materials and Methods: An experimental study was performed on patients with stage 3 and 4 DKD. Twenty sessions of HBO2 or ambient air in a hyperbaric chamber were administered. Estimated glomerular filtration rate, urine albumin:creatinine ratio calculation and clinical stage stratification were made prior to and after HBO2 administration. A descriptive, inferential and clinical efficacy analysis was performed., Results: Urinary albumin/creatinine (UACR) mean values prior to HBO2 were 1452.9 ± 644.3 mg/g and decreased to 876.1 ± 504.0 mg/g at the end of the study (p=0.06). The patients in the control group showed a UACR mean of 2784.5 ± 2128.6 mg/g and 2861.4 ± 2424.2 mg/g at baseline and at the end of the study, respectively (p=0.82). Patients in the experimental/HBO2 group showed an estimated GFR of 27.3 ± 9.5 mL/min /1.73m2 before HBO2, with a 34.4 ± 6.9 mL/min/1.73m2 after treatment (p=0.017); control group eGFR was 30.1 ± 9.2 mL/min/1.73m2, decreasing to 22.2 ± 6.8 mL/min/1.73m2 (p=0.004). Relative risk 0.00, relative risk reduction -100%, absolute risk reduction -71.4%, 95% CI (-104.9% to -38.0%), NNT 1, 95% CI (1 to 3)., Conclusions: Management with HBO2 for DKD was associated with decreased excretion urinary albumin, improved GFR and clinical stage of patients in stages 3 and 4 of kidney damage unlike those receiving ambient air.., Competing Interests: The authors of this paper declare no conflicts of interest exist with this submission., (Copyright© Undersea and Hyperbaric Medical Society.)

Background: The most common cause of injury is shoulder impingement syndrome. Management includes physical therapy, analgesics, steroids and surgery. The aim of the study was to determine the cost-effectiveness of using steroids combined with therapeutic exercise at home in the chronic impingement syndrome., Methods: Clinical trial randomized in 30 people with subacromial impingement syndrome underwent two treatments: steroid and at home rehabilitation booklet evaluated at the first and fourth week through UCLA Shoulder rating scale., Results: We studied 17 men (56.7 %) and 13 women (43.3 %), mean age was 42.87 years. Group 2 earned greater improvement in UCLA Shoulder rating scale 18.87 at baseline and 27.60 at the end. With 30.27 accumulated disability days for group 1, and 14.80 for group 2., Conclusions: The combination of local steroids with therapeutic exercise is more effective clinically and declining disability compared to conventional physical therapy.

Background: Neonatal Hearing Screening and Early Intervention (NHSEI) is a screening program to evaluate all infants and identify those with hearing impairment. The objective of this work was to determine the factors associated with hearing loss in NHSEI program., Methods: Analytical cross-sectional study was performed. 234 infants were included in the NHSEI program, hearing was evaluated with transitory evoked otoacoustic emissions (TEOE) at frequencies of 1.5 to 4.5 kHz, and intensity of stimuli of 40-60 dB. The variables were: age from one to 28 days, sex, gestational age and perinatal history. Data was analyzed with descriptive statistics and binary logistic regression., Results: The presence of risk factors in newborns resulted in significant omnibus test (p < 0.05) predicted value by Nagelkerke R square model of 77%. The background inherited family acquired infection, craniofacial abnormalities, low birth weight, respiratory distress at birth and genetic syndromes were factors significantly associated (p < 0.05) to hearing loss in infants., Conclusions: The incidence of hearing impairment in infants diagnosed by newborn hearing program was higher (5/234 newborns) than the reported in the literature.

Objective: to assess the specificity and sensibility of the O'Sullivan test for gestational diabetes in early pregnancy., Methods: a pilot study in 50 women with low-risk of pregnancy, without history of alteration of glucose was done. The O'Sullivan test consisted in the administration of 50 g of glucose; glycemia was measured 60 minutes after, between weeks 14 and 23 and between weeks 24 and 28 of pregnancy. Value was considered positive with a glycemia = 140 mg/dL. We calculated sensitivity, specificity and predictive values., Results: O'Sullivan test performed between weeks 14 and 23 was positive in three pregnant women (6 %), and between weeks 24 and 28, in four (8 %); there was no statistical difference in both measurements (p > 0.05). The sensitivity was 75 % (95 %, CI 30.1 % to 95.4 %), and the specificity 100.0 % (95 %, CI 92.3 % to 100 %)., Conclusions: the O'Sullivan test performed between weeks 14 and 23 of gestation showed good sensitivity and specificity in the diagnosis of early gestational pregnancy.

Background: prehypertension is the category established in JNC-7, which designates the individuals that present diastolic blood pressure of 80-89 mm Hg and systolic blood pressure of 120-139 mm Hg, and it is associated to high rates of cardiovascular disease. The purpose of the study was to identify prevalence rates and their correlation with sociodemographic factors and comorbidity in a sample of a population of Veracruz, Mexico., Methods: a cross-sectional and representative survey was chosen by means of probability sampling. Sociodemographic factors, lifestyle and anthropometric characteristics were assessed. Odds ratios and 95 % confidence intervals were obtained., Results: the prehypertension prevalence found was 33.8 %, with an average age of 40.9 ± 14.2 years in prehypertensive subjects, and 50.6 ± 12.7 in hypertension subjects (p < 0.05). In relation with prehypertension, males presented a 1.48 (1.18-1.86) OR. Also, those who had more than 40 years had an OR of 1.9 (1.51-2.38); the ones with basic schooling, an OR of 1.73 (1.38-2.17); subjects with hyperglycemia, OR 3.0 (1.5-3.75); with overweight, OR 1.41 (1.01-1.68); and those with other comorbidities an OR of 1.61 (1.09-2.36)., Conclusions: a high prevalence of prehypertension was found in the sample, and it was associated to male gender subjects, aged above 40 years, with basic schooling and relevant comorbidities, such as diabetes and cardiovascular disease.

Objective: To validate an instrument to evaluate the clinic aptitude of the pregraduate intern in the integral attention of the diabetic patient with chronic complications at home., Methods: A comparative cross-sectional study; 114 pregraduate interns from five medical units were included to determine the clinic aptitude by an instrument with five real clinical cases of diabetic patients. Seven clinical indicators and 175 statements were used. The instrument was validated with two rounds of experts and the trustworthiness with a pilot group. Nonparametric statistics were used., Results: The consistency of the instrument was of 0.91. The clinic aptitude of the pregraduate interns was low and very low, except in a medical units that resulted intermediate. When comparing the five medical units, there were significant differences in the global qualification in six of the seven indicators., Conclusions: The instrument fulfilled the requirements of validity.

The objective was to determine the effect of lifestyle modification on cardiovascular risk in individuals with prehypertension, which is defined as a systolic blood pressure between 120 mmHg and 139 mmHg and a diastolic pressure between 80 mmHg and 89 mmHg. A randomized clinical trial was carried out in prehypertensives to compare those who took part in a program involving dietary modification, physical activity and educational sessions with those who followed normal recommendations. Cardiovascular risk was evaluated using the Framingham risk score and the chi-squared test, the Mann-Whitney U-test and the Friedman test. The mean Framingham score in the intervention group decreased from 5 (rank, -10 to 12) to 3.5 (rank, -11 to 10; P< .05) and the probability of a cardiovascular event at 10 years decreased from 5.29+/-3.88 to 4.24+/-2.86 (P< .05). This improvement was associated with a relative risk of 0.30 (95% confidence interval, 0.11 to 0.83) and a relative risk reduction of -69.8% (95% confidence interval -89% to -16.9%). There was no change in control subjects. Lifestyle modification decreased cardiovascular risk in individuals with prehypertension.

Objective: To compare quality of life in climacterical women with and without hormone replacement therapy., Material and Methods: A cross-sectional analytical study was carried out in the Family Medicine Unit number 61 in Veracruz, Veracruz. There were chosen 102 women between 40 and 60 years old. There were two groups: the first one with 51 patients with hormone replacement therapy during the last year; the second one with 51 patients who are not in hormone replacement therapy. Coop/wonca charts were used to measure quality of life. A complementary questionnaire related to climacteric period and menopause was answered by both groups. Statistical test with chi2 was carried out., Results: Health condition and satisfactory sexual life were improved in patients with hormone replacement therapy (30 versus 19, p = 0.007; and 40 cases versus 30, p = 0.04, respectively). No significantly differences were found in six from seven coop/wonca charts., Conclusions: There were no impact results in climacteric and menopause women. However, a better health condition and satisfactory sexual life were observed in patients with hormonal replacement therapy.