Author: José Meneses Calderón

Complications in pregnant women with autoimmune diseases

José Meneses Calderón Jazmín Meneses Figueroa María Isabel Ospina Alzate Irma Socorro González Sánchez Hugo Mendieta Zerón (2020)

BACKGROUND: Autoimmune diseases complicate pregnancy in several manners. This study aimed at describing the most common complications in pregnant women with autoimmune diseases. METHODS: This was a descriptive and retrospective study. Two groups of pregnant women with autoimmune diseases were included: 1) Those who since the beginning of gestation received obstetrical care at a tertiary-level hospital and 2) Women who were treated first in a medical unit not specialized in rheumatological diseases. Odds ratio, logistic regression and multinomial logistic regression were used to determine risk of complicated pregnancy. RESULTS: The distribution of autoimmune diseases in our sample is as follows: systemic lupus erythematosus (SLE): 6, rheumatoid arthritis (RA): 4, primary anti-phospholipid syndrome (APS): 4, systemic sclerosis (SS): 2, mixed connective tissue disease (MCTD): 1. Eight patients were seen throughout their gestation at a tertiary-level hospital and nine were referred from other non-specialized hospitals. Patients in the first group had four complications, and those of the second group, 28. The Odds Ratio (OR) of having a complication in the hospitals of reference compared to the “Mónica Pretelini Sáenz” Maternal-Perinatal Hospital (HMPMPS) was of 29.8 (95% CI: 1.29-692.46; Z statistic 2.11, p = 0.03). In relation to the logistic regression, this test was not significant neither for the group nor the treatment scheme for the presence of at least one complication. The multinomial logistic regression did not show significant predictive probabilities of the different possible outcomes for the group and drug treatment scheme. CONCLUSION: Pregnant women with autoimmune diseases can have an OR up to 29.8 to develop complications when they are not cared for by specialized personnel.


Complications Pregnant women Autoimmune diseases MEDICINA Y CIENCIAS DE LA SALUD

Phototherapy induces an improvement in clinical and biochemical scores in rheumatoid arthritis

José Meneses Calderón Guillermo Aburto Huacuz Irma Socorro González Sánchez ALAN GUTIERREZ VILCHIS Hugo Mendieta Zerón (2016)

Objective: Rheumatoid arthritis is a common autoimmune disease for which there is no known cure. Ultraviolet light can induce immunosuppressive effects. Our main objective was to ascertain whether a complementary treatment with phototherapy improves changes in functional scales in patients with rheumatoid arthritis. Methods: Seven women with rheumatoid arthritis were enrolled for this study and submitted to phototherapy sessions with a 425 to 650 nm lamp. Results: The Karnofsky scale changed from requiring frequent medical care to being capable of normal activity with few symptoms or signs of disease (p = 0.018), the RaQol questionnaire decreased abruptly from 29 to zero points (p = 0.018), the Steinbrocker Functional Capacity Rating changed from limited to little or none of the duties of usual occupation or self-care to complete ability to carry out all the usual duties without handicaps (p = 0.017). The pain was remitted after the treatment period. The acute inflammation variables showed a significant decrease after the indicated sessions, C-reactive protein (p = 0.042), erythrocyte sedimentation rate (p = 0.018). Conclusion: The evaluated scales clearly show a benefit with the phototherapy in rheumatoid arthritis patients. Thus, phototherapy seems to be a plausible complementary option to reduce the symptoms in rheumatoid arthritis.


C-reactive protein Functional scales Phototherapy Rheumatoid arthritis MEDICINA Y CIENCIAS DE LA SALUD

Nitazoxanide against COVID-19 in three explorative scenarios

José Meneses Calderón María del Rocío Figueroa Flores Leopoldo Paniagua Coria JESÚS CARLOS BRIONES GARDUÑO Jazmín Meneses Figueroa María José Vargas Contreras Lilia de la Cruz Salvador Díaz Meza REYNALDO RAMIREZ CHACON Srivatsan Padmanabhan Hugo Mendieta Zerón (2020)

to describe the results of treating COVID-19 positive patients with nitazoxanide in three clinical settings: pregnancy/puerperium, hospitalized patients in an Internal Medicine Service and in an ambulatory setting. Methodology: This was a prospective follow-up and report of COVID-19 cases in three different situations, pregnant women, hospitalized patients receiving medical attention in an Internal Medicine Service and ambulatory patients residing in Toluca City, and Mexico City. Results: The experience with a first group of 20 women, pregnant (17) or in immediate puerperium (3) was successful in 18 cases with two unfortunate deaths. The five cases treated in an Internal Medicine service showed a positive outcome with two patients weaned from mechanical ventilation. Of the remaining 16 patients treated in an ambulatory setting, all got cured. Nitazoxanide seems to be useful against SARS-CoV-2, not only in an early intervention but also in critical condition as well as in pregnancy without undesired effects for the babies. As an adjunctive therapy budesonide was used that seems to contribute to the clinical improvement. Conclusions: Nitazoxanide could be useful against COVID-19 as a safe and available regimen to be tested in a massive way immediately.


Nitazoxanide Coronavirus Pregnancy Ambulatory Internal medicine MEDICINA Y CIENCIAS DE LA SALUD

Trends of inflammatory markers and cytokines after one month of phototherapy in patients with rheumatoid arthritis

José Meneses Calderón Irma Socorro González Sánchez Guillermo Aburto Huacuz Arely Sarai Alonso Barreto MARIA DEL CARMEN COLIN FERREYRA Hugo Mendieta Zerón (2015)

Objective. to evaluate changes in the expression of tumor necrosis factor-α in patients with rheumatoid arthritis submitted to phototherapy. Materials and methods. This was an open label study, enrolling ten patients. The phototherapy scheme within a range of 425 to 650 nm, 11.33 Joules/cm2, 30 cm above the chest was as follows: a) 45-min daily sessions from Monday to Friday for 2 to 3 months; b) three, 45-min weekly sessions for 1 to 2 months; c) twice weekly 45-min sessions for 1 to 2 months, and d) one weekly session for 1 to 2 months until completion. Erythrocyte sedimentation rate, C-reactive protein and rheumatoid factor were measured in peripheral blood and tumor necrosis factor-α, interleukin-1β, and interleukin-10 in leukocytes by quantitative real-time Reverse transcriptase-Polymerase chain reaction. In all the patients the next indexes: Karnofsky scale, Rheumatoid Arthritis-specific quality of life instrument, Steinbrocker Functional Capacity Rating and the Visual Analog Scale were evaluated. Results. Erythrocyte sedimentation rate, C-reactive protein, and rheumatoid factor declined notoriously after the indicated sessions. In gene expression, there was a tendency in tumor necrosis factor-α to decrease after 1 month, from 24.5±11.4 to 18±9.2 relative units, without reaching a significant statistical difference. The four tested indexes showed improvement. Conclusion. Phototherapy appears to be a plausible complementary option to reduce the inflammatory component in rheumatoid arthritis.


Interleukin Phototherapy Rheumatoid arthritis Tumor necrosis factor-α. MEDICINA Y CIENCIAS DE LA SALUD