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Velasco-Hidalgo L, González-Garay A, Segura-Pacheco BA, Esparza-Silva AL, Cuéllar Mendoza ME, Ochoa-Drucker C, Campos-Ugalde S, Bernabé-Gaspar LE, Zapata-Tarrés M. Virtual reality as a non-medical tool in the treatment of anxiety, pain, and perception of time in children in the maintenance phase of acute lymphoblastic leukemia treatment. Front Oncol 2024; 14:1303421. [PMID: 38567149 PMCID: PMC10985350 DOI: 10.3389/fonc.2024.1303421] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/05/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Management of pediatric cancer patients involves invasive procedures such as punctures, injections, catheter placements, and chemotherapy which can generate fatigue, nausea, vomiting, anxiety, and pain. Virtual Reality (VR) is a nonpharmacological intervention classified as a cognitive-behavioral method to relieve symptoms. Methods We designed a crossover protocol and included 20 patients between 9 and 12 years old; ten were male. All patients had acute lymphoblastic leukemia diagnosis and were treatedwith St. Jude's XV protocol in the maintenance phase. Pain and anxiety were measured with validated scales in the pediatric population. Results Although we used a small group of patients, we found statistical difference in the reduction of anxiety and perception of time. Discussion These results open a window to non-pharmacological treatments and show a strategy to improve quality of life in children inside the hospital.
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Affiliation(s)
| | | | | | | | - Miguel Enrique Cuéllar Mendoza
- Research Coordination, Fundación Instituto Mexicano del Seguro Social (IMSS A.C.), Mexico City, Mexico
- Biochemestry Department at Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Cecilia Ochoa-Drucker
- Research Coordination, Fundación Instituto Mexicano del Seguro Social (IMSS A.C.), Mexico City, Mexico
| | | | | | - Marta Zapata-Tarrés
- Research Coordination, Fundación Instituto Mexicano del Seguro Social (IMSS A.C.), Mexico City, Mexico
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Zapata-Tarrés M, Velasco-Hidalgo L, González-Garay A, Cárdenas-Cardos R, Rivera-Luna R. Does the Human Development Index relate with acute lymphoblastic leukemia incidence? Bol Med Hosp Infant Mex 2021; 78:301-305. [PMID: 33498061 DOI: 10.24875/bmhim.20000043] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 09/14/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The association between childhood cancer and socioeconomic status has been widely studied. However, none of the results are conclusive. This study aimed to analyze the association between the Human Development Index (HDI) and the acute lymphoblastic leukemia (ALL) incidence in children under the Popular Medical Insurance Care. METHODS We conducted an observational, descriptive, and population-based study covering 55% of the Mexican population (58 million). RESULTS The most impoverished states were located in the south east region of Mexico, while the north was more homogeneous, with HDIs varying between 0.73 and 0.79. Our findings emphasize that the metropolitan area of Mexico City and the State of Nuevo Leon have the highest levels of HDI. Regions were graded from I to IV according to their HDIs in ascending order. The HDIs varied from 0.667 to 0.830/100,000 children/year, with a national average of 0.746. The leukemia incidence for regions I, II, III, and IV was 6.12, 6.53, 4.96, and 9.95. An analysis of ALL incidence in Mexico showed significant differences for region IV in comparison with the other regions based on the HDI values (p = 0.0001). CONCLUSIONS Further in-depth studies, including the economic aspects of the different geographic regions and their ethnographic characteristics, would give a more comprehensive panorama.
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Affiliation(s)
- Marta Zapata-Tarrés
- Department of Oncology, Instituto Nacional de Pediatría, Mexico City, Mexico
| | | | | | | | - Roberto Rivera-Luna
- Division of Hematology/Oncology. Instituto Nacional de Pediatría, Mexico City, Mexico
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González-Garay A, Velasco-Hidalgo L, Ochoa-Hein E, Rivera-Luna R. Efficacy and safety of quinolones for the treatment of uncomplicated urinary tract infections in women: a network meta-analysis. Int Urogynecol J 2020; 32:3-15. [PMID: 32095956 DOI: 10.1007/s00192-020-04255-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 02/04/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Uncomplicated urinary tract infection (uUTI) is defined as the presence of pathogenic organisms in the urinary tract without anatomical and functional abnormalities, is accompanied by inflammatory leukocytes and cytokines and may or may not develop clinical symptoms. The frequency of uncomplicated urinary tract infection is higher in young women. Several quinolone treatment regimens are available; however, since we do not know which is the best antibiotic regimen for the treatment of this urinary infection, we analyzed the published evidence and conducted a systematic review with network meta-analysis. The aim was to compare and hierarchize quinolones according to their efficacy and safety and to identify the best treatment for uncomplicated urinary tract infection in women through a systematic review with network meta-analysis. METHODS Medline, Embase, LILACS, Cochrane CENTRAL and other databases were searched for trials. Bias in the trials was assessed using the Cochrane Collaboration tool. To analyze efficacy and adverse events, for direct comparisons, we obtained risk ratios and 95% confidence intervals by applying a fixed-effects model using tau2 and Q2 tests to calculate the heterogeneity. For the network meta-analysis, we analyzed the indirect comparisons by Bucher's method. RESULTS We included 18 trials (8765 women). For premenopausal women, ofloxacin had a 57% probability of achieving remission but an 83% frequency of adverse events. For postmenopausal women, ofloxacin was 82% more effective for remission, with a 49% frequency of adverse events, compared with other types of quinolones. CONCLUSIONS Compared with other quinolones, ofloxacin 200 mg once daily for a treatment duration < 3 days provides the highest clinical and bacteriological remission rates with the lowest relapse and resistance rates for the treatment of women with uUTIs. However, additional trials are needed to confirm our findings, especially when the treatment duration exceeds 3 days.
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Affiliation(s)
- Alejandro González-Garay
- Methodology Research Unit, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Col. Insurgentes Cuicuilco, Coyoacán, zip 04530, Mexico City, Mexico.
| | - Liliana Velasco-Hidalgo
- Medical Research Unit, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Col. Insurgentes Cuicuilco, Coyoacán, zip 04530, Mexico City, Mexico
| | - Eric Ochoa-Hein
- Hospital Epidemiology Department, Instituto Nacional en Ciencias Médicas y Nutrición Salvador Zubirán, Avenida Vaco de Quiroga No. 15, Col. Belisario Domínguez Sección XVI, Tlalpan, zip 14080, Mexico City, Mexico
| | - Roberto Rivera-Luna
- Medical Research Unit, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Col. Insurgentes Cuicuilco, Coyoacán, zip 04530, Mexico City, Mexico
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Díaz-García L, Medina-Vera I, García-de la Puente S, González-Garay A, Murata C. Estudios de exactitud diagnóstica. Acta Pediatr Mex 2019. [DOI: 10.18233/apm40no6pp342-3571933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
ANTECEDENTES: En los estudios de prueba diagnóstica puede hacerse la distinción en cinco fases que corresponden a diferentes objetivos. La fase III se denomina: estudio de exactitud diagnóstica.OBJETIVO: Ofrecer a los médicos y a otros profesionales de la salud una introducción actualizada de los conceptos y herramientas estadísticas de estudio de exactitud diagnóstica.DESCRIPCIÓN: El estudio de exactitud diagnóstica tiene como propósito determinar si la prueba de interés distingue a los sujetos con y sin la enfermedad de entre quienes se sospecha la enfermedad en una situación clínica cotidiana. Para cumplir este objetivo son decisivas: la selección del estándar de referencia válido, evitar los sesgos característicos de esta fase, identificar los parámetros que cuantifican la bondad de la exactitud diagnóstica y efectuar análisis estadísticos adecuados.CONCLUSIONES: Tanto para el uso de la información como para la realización del estudio de exactitud diagnóstica es necesario distinguir claramente esta fase de estudio como parte de los ensayos diagnósticos. Es importante conocer que la utilidad de la información de las fases II y III es muy diferente. Los usuarios de la prueba diagnóstica deben saber aplicar correctamente los datos locales para que la utilidad diagnóstica generada por la prueba sea adecuada al contexto clínico.
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Valdovinos M, Montijo E, Abreu A, Heller S, González-Garay A, Bacarreza D, Bielsa-Fernández M, Bojórquez-Ramos M, Bosques-Padilla F, Burguete-García A, Carmona-Sánchez R, Consuelo-Sánchez A, Coss-Adame E, Chávez-Barrera J, de Ariño M, Flores-Calderón J, Gómez-Escudero O, González-Huezo M, Icaza-Chávez M, Larrosa-Haro A, Morales-Arámbula M, Murata C, Ramírez-Mayans J, Remes-Troche J, Rizo-Robles T, Peláez-Luna M, Toro-Monjaraz E, Torre A, Urquidi-Rivera M, Vázquez R, Yamamoto-Furusho J, Guarner F. The Mexican consensus on probiotics in gastroenterology. Revista de Gastroenterología de México (English Edition) 2017. [DOI: 10.1016/j.rgmxen.2017.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Valdovinos MA, Montijo E, Abreu AT, Heller S, González-Garay A, Bacarreza D, Bielsa-Fernández M, Bojórquez-Ramos MC, Bosques-Padilla F, Burguete-García AI, Carmona-Sánchez R, Consuelo-Sánchez A, Coss-Adame E, Chávez-Barrera JA, de Ariño M, Flores-Calderón J, Gómez-Escudero O, González-Huezo MS, Icaza-Chávez ME, Larrosa-Haro A, Morales-Arámbula M, Murata C, Ramírez-Mayans JA, Remes-Troche JM, Rizo-Robles T, Peláez-Luna M, Toro-Monjaraz EM, Torre A, Urquidi-Rivera ME, Vázquez R, Yamamoto-Furusho JK, Guarner F. The Mexican consensus on probiotics in gastroenterology. Rev Gastroenterol Mex 2017; 82:156-178. [PMID: 28104319 DOI: 10.1016/j.rgmx.2016.08.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/17/2016] [Accepted: 08/26/2016] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Probiotics are frequently prescribed in clinical practice. Their efficacy in treating gastrointestinal disorders is supported by a significant number of clinical trials. However, the correct prescription of these agents is hampered due to a lack of knowledge of the scientific evidence and to the different presentations and microbial compositions of the probiotics that are currently available. AIM To provide the clinician with a consensus review of probiotics and recommendations for their use in gastroenterology. MATERIALS AND METHODS Controlled clinical trials, meta-analyses, and systematic reviews published up to 2015 were selected, using the MESH terms: probiotics, gastrointestinal diseases, humans, adults, AND children. The Delphi method was employed. Eighteen gastroenterologists treating adult patients and 14 pediatric gastroenterologists formulated statements that were voted on until agreement>70% was reached. The level of evidence based on the GRADE system was evaluated for each statement. RESULTS AND CONCLUSIONS Eleven statements on the general concepts of probiotics and 27 statements on the use of probiotics in gastrointestinal diseases in both adults and children were formulated. The consensus group recommends the use of probiotics under the following clinical conditions: the prevention of diarrhea associated with antibiotics, the treatment of acute infectious diarrhea, the prevention of Clostridium difficile infection and necrotizing enterocolitis, the reduction of adverse events from Helicobacter pylori eradication therapy, relief from irritable bowel syndrome symptoms, the treatment of functional constipation in the adult, and the induction and maintenance of remission in patients with ulcerative colitis and pouchitis, and the treatment of covert and overt hepatic encephalopathy.
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Affiliation(s)
- M A Valdovinos
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
| | - E Montijo
- Departamento de Gastroenterología y Nutrición, Instituto Nacional de Pediatría, Ciudad de México, México
| | - A T Abreu
- Servicio de Gastroendoscopia, Hospital Regional n.(o) 2 con Unidad de Medicina de Atención Ambulatoria, IMSS, Ciudad de México, México
| | - S Heller
- Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México, México
| | - A González-Garay
- Metodología de la Investigación, Instituto Nacional de Pediatría, Ciudad de México, México
| | - D Bacarreza
- Hospital Infantil de las Californias, Tijuana, BC, México
| | - M Bielsa-Fernández
- Unidad de Pacientes en Estudio, Universidad Autónoma de Guadalajara, Zapopan, Jalisco, México
| | - M C Bojórquez-Ramos
- UMAE Hospital de Pediatría, Centro Médico Nacional de Occidente, IMSS, , Guadalajara, Jalisco, México
| | - F Bosques-Padilla
- Departamento de Medicina Interna, División de Gastroenterología, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, N.L., México
| | - A I Burguete-García
- Departamento de Epidemiología Genética e Infecciones, CISEI, INSP, Cuernavaca, Mor., México
| | | | - A Consuelo-Sánchez
- Departamento de Gastroenterología y Nutrición, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - E Coss-Adame
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - J A Chávez-Barrera
- Departamento de Gastroenterología Pediátrica, UMAE Hospital General Dr. Gaudencio González Garza, Centro Médico Nacional La Raza, IMSS, Ciudad de México, México
| | - M de Ariño
- Servicio de Gastroenterología, Hospital Español, Ciudad de México, México
| | - J Flores-Calderón
- Departamento de Gastroenterología y Endoscopia, UMAE Hospital de Pediatría Dr. Silvestre Frenk Freund, Centro Médico Nacional Siglo XXI, Ciudad de México, México
| | - O Gómez-Escudero
- Clínica de Gastroenterología, Endoscopia Digestiva y Motilidad Gastrointestinal, Hospital Ángeles Puebla, Puebla, México
| | - M S González-Huezo
- Departamento de Gastroenterología, Centro Médico Issemym, Metepec, Estado de México, México
| | | | - A Larrosa-Haro
- Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | | | - C Murata
- Metodología de la Investigación, Instituto Nacional de Pediatría, Ciudad de México, México
| | - J A Ramírez-Mayans
- Departamento de Gastroenterología y Nutrición, Instituto Nacional de Pediatría, Ciudad de México, México
| | - J M Remes-Troche
- Laboratorio de Motilidad y Fisiología Digestiva, Instituto de Investigaciones Médico Biológicas, Universidad Veracruzana (UV), Veracruz, México
| | - T Rizo-Robles
- Servicio de Gastroenterología, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, IMSS, Ciudad de México, México
| | - M Peláez-Luna
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - E M Toro-Monjaraz
- Departamento de Gastroenterología y Nutrición, Instituto Nacional de Pediatría, Ciudad de México, México
| | - A Torre
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - M E Urquidi-Rivera
- Servicio de Gastroenterología Pediátrica y Endoscopia, Hospital Regional ISSSTE, Monterrey, N.L., México
| | - R Vázquez
- Departamento de Gastroenterología y Nutrición, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - J K Yamamoto-Furusho
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - F Guarner
- Servicio de Aparato Digestivo, Hospital Vall d'Hebrón, Barcelona, España
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Keil-Ríos D, Terrazas-Solís H, González-Garay A, Sánchez-Ávila JF, García-Juárez I. Pocket ultrasound device as a complement to physical examination for ascites evaluation and guided paracentesis. Intern Emerg Med 2016; 11:461-6. [PMID: 26895032 DOI: 10.1007/s11739-016-1406-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 02/04/2016] [Indexed: 12/14/2022]
Abstract
The pocket ultrasound device (PUD) is a new tool that may be of use in the early detection of ascites. Abdominal ultrasound-guided paracentesis has been reported to decrease the rate of complications due to the procedure, but must be performed in a healthcare setting; this new tool may be a useful on an ambulatory basis. The aim of this study was to determine the diagnostic usefulness of the PUD in the diagnosis of ascites and the safety of guided paracentesis. We conducted a retrospective study that included adult patients suspected of having ascites and in whom an evaluation was performed with the PUD to identify it. Concordance with abdominal ultrasound (AUS) was determined with the Kappa coefficient. Sensitivity (Se), specificity (Sp) and likelihood ratios (LR) were determined and compared with physical examination, AUS, computed tomography and procurement of fluid by paracentesis. Complications resulting from the guided paracentesis were analyzed. 89 participants were included and 40 underwent a paracentesis. The PUD for ascites detection had 95.8 % Se, 81.8 % Sp, 5.27 +LR and 0.05 -LR. It had a concordance with AUS of 0.781 (p < 0.001). Technical problems during the guided paracentesis were present in only two participants (5 %) and three patients (7.5 %) developed minor complications that required no further intervention. There were no severe complications or deaths. This study suggests that the PUD is a reliable tool for ascites detection as a complement to physical examination and appears to be a safe method to perform guided paracentesis.
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Affiliation(s)
- Daniel Keil-Ríos
- Department of Gastroenterology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga 15, Sección XVI, Tlalpan, 14000, Mexico City, Mexico
| | - Hiram Terrazas-Solís
- Department of Internal Medicine, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Alejandro González-Garay
- Department of Research Methodology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Juan Francisco Sánchez-Ávila
- Department of Gastroenterology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga 15, Sección XVI, Tlalpan, 14000, Mexico City, Mexico
| | - Ignacio García-Juárez
- Department of Gastroenterology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga 15, Sección XVI, Tlalpan, 14000, Mexico City, Mexico.
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González-Serrano ME, Estrada-García I, Mogica-Martínez D, González-Garay A, López-Herrera G, Berrón-Ruiz L, Espinosa-Padilla SE, Yamazaki-Nakashimada MA, Vargas-Hernández A, Santos-Argumedo L, Estrada-Parra SA, Espinosa-Rosales FJ. Increased pro-inflammatory cytokine production after lipopolysaccharide stimulation in patients with X-linked agammaglobulinemia. J Clin Immunol 2012; 32:967-74. [PMID: 22665224 DOI: 10.1007/s10875-012-9706-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Accepted: 05/11/2012] [Indexed: 12/26/2022]
Abstract
PURPOSE To evaluate the lipopolysaccharide (LPS)-induced pro-inflammatory cytokine response by peripheral blood mononuclear cells (PBMCs) from XLA patients. METHODS Thirteen patients with XLA were included in the study. LPS-induced TNF-α, IL-1β, IL-6, and IL-10 production was determined in PBMCs from patients and matched healthy controls by ELISA. Cytokine production was correlated with the severity of mutation, affected domain and clinical characteristics. RESULTS In response to LPS, PBMCs from XLA patients produced significantly higher amounts of pro-inflammatory cytokines and IL-10 compared to controls, and this production was influenced neither by the severity of the mutation nor the affected domain. PBMCs from patients with a history of more hospital admissions before their diagnosis produced higher levels of TNF-α. PBMCs from patients with lower serum IgA levels showed a higher production of TNF-α and IL-1β. Less severe (punctual) mutations in the Btk gene were associated with higher serum IgG levels at diagnosis. CONCLUSIONS Our results demonstrate a predominantly inflammatory response in XLA patients after LPS stimulation and suggest a deregulation of TLR signaling in the absence of Btk. This response may be influenced by environmental factors.
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Affiliation(s)
- María Edith González-Serrano
- Immunodeficiency Research Unit, National Institute of Pediatrics (INP), Av. Imán # 1, Col. Insurgentes Cuicuilco, Deleg. Coyoacán, Mexico City, ZP 04530, Mexico
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