Alejandro González-Ojeda

Mexican Institute of Social Security | IMSS · Clinical Research Unit

Background Timely and safe elective health care facilitates return to normal activities for patients and prevents emergency admissions. Surgery is a cornerstone of elective care and relies on complex pathways. This study aimed to take a whole-system approach to evaluating access to and quality of elective health care globally, using inguinal hernia...

Introduction: Chronic kidney disease (CKD) has become a pathology with an increase in its prevalence during the last years. Renal transplantation offers a greater survival advantage for patients with end-stage renal disease. Main long-term conditions for kidney donors, as well as their renal function and the development of renal failure is yet to b...

Introduction: Acute otitis media (AOM) causes inflammation and hearing loss. Ventilation tubes are key in treatment. 3D printing improves prostheses in otorhinolaryngology, offering precision and greater adaptability. Material and Methods: An experimental study was conducted with Wistar rats from July to December 2020. 3D tympanostomy tube models w...

Introduction Telemedicine is being adopted for postoperative surveillance but requires evaluation for efficacy. This study tested a telephone Wound Healing Questionnaire (WHQ) to diagnose surgical site infection (SSI) after abdominal surgery in low- and middle-income countries. Method A multi-centre, international, prospective study was embedded i...

Introduction Burnout syndrome is a global burden characterized by exhaustion, work detachment, and a sense of ineffectiveness. It affects millions of individuals worldwide, with a particularly high prevalence among medical students. Factors such as demanding education, exposure to suffering, and the COVID-19 pandemic have contributed to elevated st...

The objective of the study was to describe the frequency of acute myocardial injury (AMI) assessed by high-sensitivity cardiac troponin I (hs-cTnI) levels and to determine the possible initial risk factors (related to the characteristics of the patient, the disease, and the initial management) in a population of adult patients with early sepsis (wi...

Objective: To evaluate the quality of sexual life in men with spinal cord injury. Design: Cross-sectional analytical study. Patients: Males with a history of spinal cord injury who attended an outpatient rehabilitation service. Methods: An analytical study examined adult male patients with complete spinal cord injury in rehabilitation. A modified S...

Introduction: The use of tissue adhesives has been proposed as an anastomosis reinforcement; however, their efficacy has not been evaluated in a contaminated environment. The objective of this study was to determine if the use of sutures reinforced with ethyl-2-cyanoacrylate for colonic anastomoses in the presence of fecal peritonitis, in a murine...

Introduction: Laparoscopic cholecystectomy (LC) is a common procedure used for the treatment of different pathologies caused by gallstones in the gallbladder, and one of the most common indications is acute cholecystitis. The definitive treatment for acute cholecystitis is surgery, and LC is the gold standard. Nevertheless, transoperative complicat...

To compare the diagnostic effectiveness of chest computed tomography (CT) utilizing a single- versus a dual-reviewer approach in patients with pneumonia secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we conducted a retrospective observational study of data from a cross-section of 4809 patients with probable SARS-CoV-2 fr...

El soporte nutricional (SN) en pacientes adultos que reciben terapia de oxigenación por membrana extracorpórea (ECMO, extracorporeal membrane oxygenation) es controvertido. Si bien existen guías para el SN en pacientes pediátricos con ECMO, en adultos no se cuenta con estos lineamientos para el uso, tipo, ruta y momento de la terapia nutricional. E...

En abril de 2016, durante un ultrasonido de rutina, se encontraron masas hepáticas en una mujer de 54 años. La biopsia reveló carcinoma neuroendocrino metastásico (sinaptofisina y cromogranina positivos). Cromogranina sérica elevada y tomografía computarizada con octreótida reveló reforzamiento de las lesiones hepáticas. En septiembre de 2016 inici...

Background and Objectives: Central aortic pressure (CAP) can be measured through noninva-sive methods, and CAP wave analysis can provide information about arterial stiffness. The objective of this study was to compare CAP in women with preeclampsia and normotensive postpartum women from an urban region in western Mexico. Materials and Methods: We r...

Background: Breastfeeding is a characteristic process of mammals that ensures delivery of an adequate nutritional supply to infants. It is the gold standard food source during an infant's first months of life. Since the onset of the COVID-19 pandemic in 2020, people in quarantine have experienced a wide range of feelings, which may make isolation c...

Background Probiotics are effective for treating acute infectious diarrhoea caused by bacteria, but there are inconsistent results for the effectiveness of probiotics for diarrhoea caused by viruses. In this article we want to determine whether Sb supplementation has an effect on acute inflammatory viral diarrhoea diagnosed with the multiplex panel...

As of April 6, 2022, almost 500 million confirmed cases of COVID-19, including more than 6.1 million deaths have been reported to the World Health Organization (WHO)1. Obesity, hypertension (HT), and type 2 diabetes have all been identified as predictors of poor outcomes in COVID-19 infection (T2DM). Thrombotic events were identified as a contribut...

Objective: We aimed to evaluate the efficacy of the combination of atorvastatin and N-acetyl cysteine in increasing platelet counts in patients with immune thrombocytopenia who were resistant to steroid therapy or had a relapse after treatment. Material and Methods: The patients included in this study received oral treatment of atorvastatin at a do...

Background and Objectives: Our primary objective was to study the clinical and biochemical characteristics associated with acute kidney injury (AKI) remission in a group of Mexican patients. Materials and methods: We retrospectively enrolled 75 patients who were diagnosed with AKI and separated the sample into two groups: nonremitting patients (n =...

strategies of minimizing errors during a trial

The targeting of transforming growth factor β (TGF-β) has been shown to reduce complications related to ischemia-reperfusion injury (IRI) post-surgically. Pirfenidone (PFD) specifically inhibits TGF-β expression and has been demonstrated to provide protection from IRI in short-term allograft models, though not yet in long-term models. A chronic uni...

The prevalence of colonization by Pneumocystis jirovecii (P. jirovecii) has not been studied in Mexico. We aimed to determine the prevalence of colonization by P. jirovecii using molecular detection in a population of Mexican patients with chronic obstructive pulmonary disease (COPD) and describe their clinical and sociodemographic profiles. We enr...

A polytraumatized patient is defined as one who has multiple lesions involving different organs and systems, which are usually serious and lead to life-threatening respiratory or circulatory dysfunction. Traumatic stress in the polytraumatized patient results in many metabolic changes that are evident from the first days, but usually persist for we...

The one-anastomosis gastric bypass (OAGB) is one of the most popular performed bariatric surgeries and has good long-term success for treating obesity and metabolic diseases. However, some patients can develop severe complications such as malnutrition and hepatic steatosis, which can be corrected with a reversal procedure, as seen in this case. A 2...

Background: Surgical site infection (SSI) is a major complication of surgical procedures and contributes to morbidity, mortality, and healthcare costs. It is commonly caused by Gram-negative bacteria and should be monitored in hospital units. Objective: To identify critical points to implement an antibiotic form for surgical wound infection mana...

Objectives: This observational cross-sectional study examined changes in substance use during the coronavirus disease 2019 (COVID-19) pandemic in the Mexican population and evaluated whether depression or anxiety was associated with these new consumption patterns. Methods: An online survey was distributed to the general population. Participants...

Takotsubo cardiopathy is a specific type of heart attack commonly linked with sudden emotional stress and usually presenting in postmenopausal women. It is thought to occur through direct catecholamine-associated myocardial toxicity. The case report described herein outlines an instance of the syndrome arising during a liposuction on a 24-year-old...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Social isolation and school closure may predispose adolescents to higher prevalence rates of depression, anxiety, and stress. In this cross-sectional observational study, the validated Spanish version of the Depression, Anxiety, and Stress Scale was administered to 3112 students aged 14–22 years old. We also collected data on participant gender, ag...

This is an observational cross-sectional study designed to ascertain the prevalence and severity of dysexecutive symptoms in high school students during the COVID-19 pandemic. The validated Spanish version of the Dysexecutive Questionnaire (DEX) was used. A total of 2396 participants aged 14-22 years were included. Our sample yielded a mean DEX sca...

Confinement and a lack of social interaction are associated with depressive symptoms, low self-esteem, and suicidal thoughts. We report the results of a cross-sectional survey of 1414 junior high school students. The aim was to evaluate the prevalence of depression, anxiety, and stress in Guadalajara, Mexico, during the COVID-19 pandemic. Mean scor...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background Surgical site infection (SSI) remains the most common complication of surgery around the world. WHO does not make recommendations for changing gloves and instruments before wound closure owing to a lack of evidence. This study aimed to test whether a routine change of gloves and instruments before wound closure reduced abdominal SSI.

Background Surgical site infection (SSI) remains the most common complication of surgery around the world. WHO does not make recommendations for changing gloves and instruments before wound closure owing to a lack of evidence. This study aimed to test whether a routine change of gloves and instruments before wound closure reduced abdominal SSI. Met...

Introduction Understanding how Mexicans behave during the pandemic could present a complete picture of the phenomenon in our country and provide better management of it. Objective This study aimed to analyze the Mexican population's behavior and preventive measures. Methods This was a cross-sectional study in which a total of 4,004 participants f...

Acute pancreatitis (AP) is a frequent abdominal acute inflammatory disorder and the leading cause of hospital admissions in gastrointestinal units. Clinical manifestations of AP vary from a mild edematous form to severe fulminant pancreatitis with major devastating complications. To date, experimental therapeutic agents remain scarce for the treatm...

Background: Melasma is a common circumscribed hypermelanosis of sun-exposed areas of the skin. Platelet-Rich Plasma therapy has been evidenced to inhibit melanin synthesis in animals and humans OBJECTIVE: To determine the effectiveness of platelet-rich plasma as a treatment for melasma. Materials and methods: Twenty female patient with melasma w...

Malnutrition is associated with several complications during hospital stay, including patients who will undergo major surgery. Therefore, it is important to optimize nutritional status in the preoperative period being the main objective restoring metabolic and immunological abnormalities. Preoperative fasting is a common practice in clinical settin...

Depression and anxiety are common after months of social isolation, and they can have a negative impact on anyone's quality of life if they are not treated promptly and appropriately. The aim of this study was to determine if the change to online modality courses and the presence of depression or anxiety symptoms during the COVID-19 pandemic was as...

IntroductionIn Mexico, sexually transmitted diseases (STDs) are the fifth-leading reason to seek medical guidance. Among people aged 15–44 years, STDs are ranked among the top 10 causes of general morbidity.Methods This was a descriptive cross-sectional study conducted at a private university in Mexico from December 2019 to January 2020. A total of...

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and proces...

Las enfermedades mentales y los tras-tornos neurológicos se encuentran entre las principales causas de discapacidad a nivel mundial. En los últimos años, múltiples estudios epidemiológicos han investigado la relación existente entre los patrones dietéticos y el estado mental, con énfasis en la influencia de factores genéticos y ambientales en el de...

Background: The COVID-19 pandemic has prompted the increasing popularity of several emerging therapies or preventives that lack scientific evidence or go against medical directives. One such therapy involves the consumption of chlorine dioxide, which is commonly used in the cleaning industry and is available commercially as a mineral solution. This...

Depression and anxiety are common after months of social isolation, and they can have a negative impact on anyone's quality of life if they are not treated promptly and appropriately. The purpose of this study was to determine whether undergraduate and graduate students preferred classroom or online classes and to determine whether the existence of...

Introduction: Many experimental studies have examined multiple drugs or treatments to improve the healing of intestinal anastomoses. Synthetic prostacyclin analogues, immunosuppressants, erythropoietin, growth hormone, insulin-like growth factor type 1, synthetic metalloproteinases inhibitors, and hyperbaric oxygen therapy have produced promising...

Mental as well as neurological disorders are among the leading causes of disability worldwide. In recent years, multiple epide-miological studies have investigated the relationship between dietary patterns and mental status, emphasizing the influence of genetic and environmental factors on the development of such disorders. It has also been recogni...

Introduction: Intra-abdominal adhesions' main etiology is surgical procedures that commonly require reintervention. Oral treatments with Sildenafil, Zafirlukast, and Pirfenidone have yielded decreased severity of fibrotic phenomena secondary to the introduction of foreign material. This study aimed to evaluate the efficacy of oral Zafirlukast, Sil...

SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients.Since surgical patients are already at higher risk of venous thromboembolism than general populations, thisstudy aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk ofvenous thromboembolism. We...

Background: Postoperative symptoms and pain after laparoscopic cholecystectomy (LC) are common in women. However, there is no evidence of differences in incidence and severity among different age groups. We evaluated whether adverse postoperative symptoms were more common in younger than in older women after LC. Methods: One hundred and fifty pr...

Background Surgical site infection (SSI) is the most common postoperative complication worldwide. WHO guidelines to prevent SSI recommend alcoholic chlorhexidine skin preparation and fascial closure using triclosan-coated sutures, but called for assessment of both interventions in low-resource settings. This study aimed to test both interventions i...

Background & Aims Mexico has one of the highest mortality rates by COVID-19 worldwide. This may be partially explained by the high prevalence of overweight/obesity found in general population; however, there is limited information in this regard. Furthermore, acute kidney injury (AKI) and need for renal replacement therapy (RRT) associated to obesi...

Heart failure (HF) is one of the most important global public health problems, as there is an increase in its prevalence and an estimated 23 million of the world’s population live with this problem. HF is defined by the presence of structural and functional abnormalities of the cardiac muscle leading to an impairment of ventricular filling and ejec...

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the s...

Objective To describe mortality of in-hospital patients with COVID-19 and compare risk factors between survivors and non-survivors. Design Prospective cohort of adult inpatients. Setting Tertiary healthcare teaching hospital in Guadalajara, Mexico. Participants All patients with confirmed COVID-19 hospitalised from 25 March to 7 September 2020 w...

The world is social distancing, and compulsory confinement has caused stress, psychological instability, stigmatization, fear, and discrimination in the general population. In this cross-sectional survey study, we administered the Fear of COVID-19 Scale (FCV-19S) to hospital medical and nonmedical personnel. A total of 1216 participants were survey...

The world is facing the worst health crisis in modern history. In addition to general concerns about the effects of COVID-19 on health, hospital personnel are developing numerous mental health conditions. This cross-sectional survey study evaluated the prevalence and severity of anxiety caused by the COVID-19 pandemic using the Coronavirus Anxiety...

Introduction Urethral stricture caused by fibrosis is a common medical condition, but top-line therapy for this pathology has a high recurrence rate. This study aimed to determine the efficacy of hyaluronic acid (HA) treatment in preventing the development of fibrosis in a rabbit model of urethral anastomosis. Materials and Methods This experiment...

BACKGROUND The COVID-19 pandemic triggered the appearance of several emerging therapies or preventives that lack scientific evidence. Chlorine dioxide is commonly used in the cleaning industry and is available commercially as a mineral solution. This substance has been promoted as a preventive or treatment agent for several diseases, including SARS...

Background The COVID-19 pandemic has prompted the increasing popularity of several emerging therapies or preventives that lack scientific evidence or go against medical directives. One such therapy involves the consumption of chlorine dioxide, which is commonly used in the cleaning industry and is available commercially as a mineral solution. This...

Background: Human papillomavirus (HPV) is recognized as the most important cofactor in the etiology of cancers of the cervix, esophagus, larynx, and nasopharynx. Experimental evidence suggests that HPV could have an oncogenic influence on thyroid follicular cells; however, to the best of our knowledge, there is no record of its role in human thyro...

Background The incidence of mental disorders during major events is higher in prenatal and postnatal women than in the general population. The COVID-19 pandemic, subsequent lockdown, and social distancing may have caused changes in newborn mothers’ mental health, postpartum depression (PPD), and breastfeeding practices. There is no information abou...

Background: In December 2019, the World Health Organization announced a new viral pneumonia due to SARS-CoV-2, which originated in Wuhan, China. In Mexico, the official announcement regarding the first coronavirus disease 2019 (COVID-19) case was made on February 29, 2020. Understanding how Mexicans behave during the pandemic could present a comple...

Heart failure (HF) is one of the most important global public health problems, as there is an increase in its prevalence and an estimated 23 million of the world's population live with this problem. HF is defined by the presence of structural and functional abnormalities of the cardiac muscle leading to an impairment of ventricular filling and ejec...

Background After almost nine months of social isolation, the high incidence of depression and anxiety is understandable. However, depression and anxiety can adversely affect the quality of life. One of the biggest challenges in this global pandemic is providing education within public and private academic institutes. Methods This study was a cross-...

Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Su...

Objetivo: Identificar los factores asociados a dehiscencia de anastomosis de intestino delgado y grueso. Método: Se incluyeron 92 anastomosis de intestino delgado y grueso, en mayores de 18 años, realizadas en 2012-2016. Se evaluaron factores asociados en el preoperatorio, el transoperatorio y el posoperatorio. Resultados: Se presentó dehiscen...

Background 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on...

p>Background: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications...

A Correction to this paper has been published: https://doi.org/10.1007/s11469-021-00487-1

A finales de 2019, en Wuhan, China, se reportaron numerosos casos de neumonía comunitaria causada por un virus, llamado coronavirus tipo 2 asociado a síndrome respiratorio agudo grave (SARS-CoV-2). En octubre de 2020 rebasamos la preocupante cifra de 34 millones de casos en todo el mundo, con más de 1 millón de decesos. Se han hecho múltiples compa...