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PubMed1992

Cervical cancer incidence and mortality in New Mexico's Hispanics, American Indians, and non-Hispanic whites.

High rates of cervical cancer were reported in New Mexico in the early 1970s, with especially high rates for minority women. We examined data collected from 1970 to 1987 for invasive cervical cancer and cervical carcinoma in situ for New Mexico's Hispanic, American Indian, and non-Hispanic white women to determine whether changes had occurred in cervical cancer rates since earlier reports. To further characterize the epidemiology of cervical cancer in New Mexico, we reviewed state vital statistics for cervical cancer deaths occurring between 1958 and 1987. From 1970 to 1987, the incidence for invasive cervical cancer among Hispanic (18.9 per 100,000 person-years) and American Indian women (22.0 per 100,000 person-years) was about double that for non-Hispanic white women (10.3 per 100,000). The incidence in each ethnic group decreased over time for both invasive cancer and carcinoma in situ when the data were examined by 2 time periods (1970 to 1978 and 1979 to 1987). These decreases were most dramatic for invasive cervical cancer. Cervical cancer-related death rates for Hispanics and non-Hispanic whites also decreased from 1958 to 1987. Although our data reflect declines in cervical cancer rates during the study period, further rate decreases, especially for minority women, remain an important public health goal in New Mexico.

Adult↗
PubMed1989

Injury mortality in New Mexico's American Indians, Hispanics, and non-Hispanic whites, 1958 to 1982.

New Mexico has extraordinarily high injury mortality rates. To better characterize the injury problem in New Mexico, we calculated proportionate injury mortality and age-adjusted and age-specific injury mortality rates for the state's 3 major ethnic groups--American Indians, Hispanics, and non-Hispanic whites. According to death certificate data collected from 1958 to 1982 and US population census figures, age-adjusted mortality rates for total external causes varied widely between the sexes and among the ethnic groups. Males in each ethnic group consistently had higher average annual age-adjusted external mortality rates than females. Injury mortality rates for American Indians of both sexes were 2 to 3 times higher than those for the other New Mexico ethnic groups. Motor vehicle crashes were the leading cause of death from injury for all 3 groups. Homicide accounted for twice the proportion of injury death in Hispanic compared with non-Hispanic white males (12.5% and 6.1%, respectively), while the proportion of males dying of suicide was highest in non-Hispanic whites. Deaths from excessive cold and exposure were leading causes of injury mortality for American Indians, but these causes were not among the leading causes of injury mortality for Hispanics or non-Hispanic whites. We conclude that the minority populations in New Mexico are at high risk for injury-related death and that the major causes of injury mortality vary substantially in the state's predominant ethnic populations.

Adolescent↗
PubMedDate not supplied

Maternal and child mortality along the U.S.-Mexico border.

This paper examines the maternal mortality and the age-specific mortality rates for the under 25 year olds in six border regions on the U.S. side of the U.S.-Mexico border and compares them with those of adjoining regions in Mexico. On the U.S. side of the border, the improvement in the general mortality status of maternal and child health from 1970 to 1980 was equal to or better than that of the nation as a whole. Despite this improvement, in 1980 five of the six border regions showed higher mortality rates due to external causes for the 1-4 age-group. On the Mexican side, maternal and child mortality was lower in the border region than in other parts of Mexico but much higher than in the United States. The 1-4 year olds in Mexico had the highest mortality rates among the three age-groups over 1 year of age.

Age Factors↗
PubMed1996

Decreasing rates of cervical cancer among American Indians and Hispanics in New Mexico (United States).

Minority women in New Mexico (United States)--including American Indian and Hispanic women--have shown disproportionately high incidence rates of invasive cervical cancer during the 1960s and 1970s. Several public health programs in New Mexico were directed toward early detection of cervical cellular abnormalities, particularly targeting the state's minority women. To evaluate the effectiveness of these programs, we examined the New Mexico Surveillance, Epidemiology, and End Results (SEER) data collected from 1969-92, and calculated average annual, age-specific, and age-adjusted incidence rates by ethnic group (American Indian, Hispanic, and non-Hispanic White) for five-year time intervals. We also calculated age-adjusted mortality rates for cervical cancer in the same ethnic groups using state vital records. Age-adjusted incidence rates for invasive cervical cancer show substantial temporal decreases, especially for minority women in the state. The age-adjusted incidence rate decreased by 66 percent, from 30.3 to 10.3 per 100,000 for American Indian women, and by 61 percent, from 26.1 to 10.2 per 100,000 for Hispanic women. A stage shift to earlier stages of cervical neoplasia occurred over the study period, with a substantially higher proportion of in situ compared with invasive cancers diagnosed in the most recent cf the most remote time period. The ratio of incidence rates of in situ to invasive cancers changed dramatically for both American Indian and Hispanic women. Cervical cancer mortality rates decreased steadily among Hispanic women from 1958 to 1992; the decrease among American Indian women was less stable and fluctuated due to small numbers. Ongoing targeted screening programs should help to reduce cervical cancer incidence and mortality further in New Mexico.

Adult↗
PubMed1996

Age of natural menopause among women in Mexico City.

OBJECTIVES: The average age of menopause among women in Mexico City was calculated, considering their reproductive and socio-demographic characteristics. The information was obtained from a population-based control group from a case-controlled study of gynecologic cancer. METHODS: Interviews were carried out with 1005 women resident in Mexico City chosen at random from a sample using the housing sample framework of the Mexico General Directorate of Epidemiology, 472 of whom had undergone a natural menopause. RESULTS: The most important results include an average age for menopause in this population of 46.5 +/- 5 years (95% C.I. 46-48) with a median of 47. Groups of women with an average early menopause were those with no formal education (1.6 years), low socio-economic level (1.3 years, P < 0.05), nulliparas (2.6 years, P < 0.05), those who had never breastfed (2.2 years, P < 0.05) and those who had not used contraceptive hormones (1.7 years, P < 0.05). CONCLUSION: This phenomenon must be documented in Mexico because of its strong links with the morbidity and mortality of the growing number of women who are reaching advanced ages and whose survival is calculated at 30 years after menopause.

Age Factors↗
PubMedDate not supplied

Clues to positive birth outcomes in New Mexico.

Childbearing women in New Mexico possess several characteristics known to be associated with poor pregnancy outcomes: late entry into prenatal care and few visits, a high rate of teen pregnancy, low family income, and ethnic and minority group membership. Despite these, rates of low birth weight and infant mortality in New Mexico remain at or below those for all American women. Data from the 1988 National Maternal and Infant Health Survey were used to compare characteristics of New Mexico women with women in the southwest and with all American women to identify factors that may contribute to favorable pregnancy outcomes in New Mexico. Observed differences that warrant further study were: a high proportion of births for Hispanic women, greater gestational weight gain, and a high rate of participation in the Special Supplemental Food Program for Women, Infants, and Children.

Adolescent↗
PubMed1992

Genotype-specific in vitro amplification of sequences of the wild type 3 polioviruses from Mexico and Guatemala.

The extensive nucleotide sequence heterogeneity among independent genotypes of wild polioviruses permits the systematic design of genotype-specific molecular reagents. We have prepared two sets of polymerase chain reaction (PCR) primer pairs specific for the genotype of wild poliovirus type 3 recently endemic to Mexico and Guatemala. Nucleotide sequences of a representative wild type 3 virus isolated in Mexico in 1989 differed from the corresponding Sabin 3 (Leon 12 a1b) sequences at 167 of 900 positions within the VP1 region. From the sequence data, wild virus-specific primer pairs were designed to complement regions of high mismatch (greater than 33%) with Sabin 3 templates. Primer binding sites were spaced along the genome so that the predicted amplification products (142 bp and 163 bp) could be easily resolved electrophoretically from the products generated with our Sabin strain-specific primers (Sabin 1: 97 bp; Sabin 2: 71 bp; Sabin 3: 53 bp). RNAs of all wild type 3 poliovirus isolates from Mexico and Guatemala obtained over a 13-year period (1977-1990) served as efficient templates for amplification of the 142-bp and 163-bp products. Genomic templates derived from vaccine-related polioviruses and most heterologous wild polioviruses were inactive under equivalent reaction conditions. Amplifications generating a 114-bp product with a broadly reacting primer pair, matching highly conserved sequences in the 5'-noncoding region, provided a positive control for the presence in samples of poliovirus (or enterovirus) RNAs. Selective amplification of wild Mexico-Guatemala type 3 poliovirus sequences was obtained with either primer set in reactions containing large stoichiometric excesses (up to 10(6)-fold) of vaccine-related RNAs. We have used wild genotype-specific PCR primer sets to facilitate identification of wild polioviruses present in both clinical and environmental samples.

Amino Acid Sequence↗
PubMed2006

Dengue virus circulation and evolution in Mexico: a phylogenetic perspective.

BACKGROUND: Dengue is the most important arthropod-borne viral infection in the Americas. In the last decades a progressive increment in dengue severity has been observed in Mexico and other countries of the region. METHODS: Molecular epidemiological studies were conducted to investigate the viral determinants of the emergence of epidemic dengue, dengue hemorrhagic fever and dengue shock syndrome as major public health problems in Mexico. Bayesian phylogenetic analyses were conducted to determine the origin, persistence and geographical dispersion of the four serotypes of dengue virus (DENV) isolated in Mexico between 1980 and 2002. Tests for natural selection were also conducted. RESULTS: The origin of some, but not all, strains circulating in Mexico could be inferred. Frequent lineage replacements were observed and were likely due to stochastic events. In situ evolution was detected but not associated with natural selection. Recent changes in the incidence and severity of dengue were temporally associated with the introduction and circulation of different serotypes and genotypes of DENV. CONCLUSIONS: Introduction of new DENV genotypes and serotypes is a major risk factor for epidemic dengue and severe disease. Increased surveillance for such introductions is critical to allow public health authorities to intervene in impending epidemics.

Aedes↗
PubMed2004

Prostate cancer mortality in Connecticut, Iowa and New Mexico African American men.

We sought to assess trends in prostate cancer incidence, treatment and mortality in African American men by means of analysis of prostate cancer data from three states, Connecticut, Iowa and New Mexico, all participants in the Surveillance, Epidemiology, and End Results (SEER) Program. Compared with levels before prostate specific antigen (PSA) testing, prostate cancer incidence increased in all three states after widespread testing. For men diagnosed with localized or regional prostate cancer, the respective increases in radical prostatectomy in Connecticut, Iowa, and New Mexico were 3.2, 2.3, and 4.9 times pre-test levels. Age-standardized mortality in Connecticut and Iowa increased slightly; in New Mexico the 104.7 deaths per 100,000 in 1979-1986, 62.1 in 1987-1990, dropped to 47.6 in 1991-1998, an amount of decline that was statistically significant. Introduction of PSA testing influenced early detection and treatment of prostate cancer in all three states. Although decline in prostate cancer mortality in New Mexico over time may be linked with use of the PSA test and definitive therapy, the relationship among these factors, and thus the proper treatment for the early stages of this condition, is unclear on the basis of these data.

Black or African American↗
PubMed2005

Comparison of actual and stated concentrations of pharmaceuticals manufactured in Mexico.

BACKGROUND: During the past 5 years, there has been much concern about the safety of and ease of access to drugs that are unavailable without a prescription in the United States but are manufactured and can be purchased over the counter (OTC) in Mexico. However, based on a literature search, studies have not been performed to determine whether such drugs meet the US Pharmacopoeia (USP) standards for percent of labeled amount. OBJECTIVE: The aim of this study was to determine whether 5 drugs commonly prescribed in the United States and manufactured and purchased in Mexico met USP standards for stated concentration, were properly packaged and sealed, and had properly labeled expiration dates and lot numbers. METHODS: For the study, we purchased acetaminophen, carbamazepine, diazepam, digoxin, and phenytoin from 2 to 4 pharmacies in Ciudad Acuna, Mexico. Samples of each drug, each with a different lot number, were purchased OTC or with a prescription. None of the pharmacists had knowledge of the study. Brand-name or generic drugs manufactured and obtained in the United States were also analyzed for comparative purposes. Each drug was analyzed by high-performance liquid chromatography using USP guidelines established for the analysis of each drug. In addition, we visually examined the packaging, seals, color, and appearance of the drugs, and observed whether the packages contained lot numbers and whether the drugs were within the stated expiration dates. RESULTS: For all 5 drugs, the 95% CIs fell within the USP-defined acceptable ranges for percent of labeled amount. This was found to be true for drugs obtained at different pharmacies, for different drug manufacturers, and for drugs with different lot numbers. All of the drugs were found to be properly packaged and sealed, had lot numbers listed on the packages, and were sold before the stated expiration dates. CONCLUSION: Although health care practitioners should be aware that patients might be using drugs manufactured and purchased in Mexico, the results of this study of a small sample of such drugs suggest they meet the USP standards for percent of labeled amount.

Chromatography, High Pressure Liquid↗
PubMed2005

Efficient antioxidant capacity against lipid peroxide levels in healthy elderly of Mexico City.

We evaluated antioxidant activity against lipid peroxide levels (LPO) in healthy elderly and adults of Mexico City in comparison with a population of a rural area. The study included free-living subjects: 38 adults aged <60 years and 129 older subjects aged > or = 60 years of urban Mexico City in addition to 37 adults aged <60 years and 88 older subjects aged > or = 60 years of rural area (Actopan, Hidalgo State, Mexico). LPO were observed as higher in adults and elderly of the urban area than among rural subjects (P<0.01), although LPO levels were similar in rural adults and elderly (P>0.05); conversely, in urban area levels were higher in the elderly than in adults (P<0.01). On the other hand, the superoxide dismutase in urban elderly was higher than that in rural elderly (P<0.05) but similar between urban adults and urban elderly (P>0.05). Total oxidant status in urban elderly was higher than that in rural elderly (P<0.01). Our findings allow us to conclude that the urban elderly (residents of Mexico City) have higher oxidative stress than the rural-dwelling elderly, though the urban elderly have efficient antioxidant capacity as a response to elevated LPO.

Adult↗
PubMed2007

Obesity increases metabolic syndrome risk factors in school-aged children from an urban school in Mexico city.

OBJECTIVE: To characterize the nutritional status of school-aged children from an urban public school in Mexico City, Mexico, and to assess the influence of obesity on health status in a subgroup of these children. DESIGN: Cross-sectional descriptive study. A nutrition screening was done for all children, including anthropometric (ie, weight, height, and waist circumference) and blood pressure assessment. In the subgroup of children, complementary dietary and biochemical assessment (ie, glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, insulin, albumin, hemoglobin, and hematocrit levels) was done. SUBJECTS: Children from an urban school in Mexico City (N=561) aged 6 to 13 years. The representative subgroup (n=88) was selected based on age (9 to 12 years) and weight status (ie, normal, overweight, or obese). STATISTICAL ANALYSIS: Descriptive statistics, correlations, mean differences tests (analysis of variance, Kruskal-Wallis and Mann-Whitney U), and chi(2) tests (categorical variables) were done with SPSS version 13 (2005, SPSS Inc, Chicago, IL). RESULTS: In the whole school, overweight and obesity prevalence were 27.1% and 21.4%, respectively. High systolic blood pressure was seen in 8.4% of children and 6.2% of children had prehypertension. Higher hypertension risk was seen in children with body mass index > or =95th percentile and waist circumference > or =90th percentile (88 cm). Significantly higher waist circumference, systolic blood pressure, insulin resistance indexes, and triglyceride levels were found among the obese when compared with normal-weight children. CONCLUSIONS: Childhood obesity prevalence is high in Mexico and it is having an influence on children's health. It is urgent to design, implement, and evaluate specific childhood obesity prevention programs.

Analysis of Variance↗
PubMed2006

Consumption and costs of antihypertensive drugs in Mexico: are diuretic agents a standing technological trajectory?

BACKGROUND: Little is known about hypertension medication consumption and costs in Mexico. Hypertension control is a pharmacological challenge and a public health issue. OBJECTIVE: (a) To compare drug sales, number of written prescriptions, and monthly treatment costs among 5 classes of antihypertensive drugs and (b) to analyze diuretic drug sales and prescriptions to determine whether these antihypertensive agents represent an established technological trajectory. METHODS: A retrospective time series data study from 1999 to 2003. Data sources used were International Marketing Services of Mexico drug sales and the Mexico Prescription Audit databases. The 5 different classes of antihypertensive drugs were accommodated into 4 main technological trajectories according to their main biological mechanisms of action. Each technological trajectory was assessed using consumption and prescription data. Daily defined dose was used to calculate drug treatment costs. RESULTS: The market for cardiovascular agents is one of the largest, and in 2003 accounted for a value market share of 59 billion US dollar and a unit share of 40.7 million. Among cardiovascular agents, antihypertensive drugs made up a large percentage of market shares. Calcium channel blockers and angiotensin-converting enzyme inhibitors I had the biggest share value of the total cardiovascular market. Amlodipine had the highest share among calcium channel blockers, and enalapril and captopril had the largest share among angiotensin-converting enzyme inhibitors I. The top-selling diuretic drug was furosemide. The trend in number of prescriptions was parallel to that in sales. The diuretic spironolactone was the most expensive drug treatment (59 US dollar). Treatment with spironolactone might represent 47% of the income of a Mexican family if their household income was close to minimum wage (124 US dollar). CONCLUSIONS: The most effective and least expensive drugs-diuretics-had the smallest market share of all antihypertensive agents in Mexico. Nevertheless, diuretic agents are still in use and kept over time a steady market share both in value and in units.

Adrenergic beta-Antagonists↗
PubMed1999

Emergency contraception in Mexico City: what do health care providers and potential users know and think about it?

Emergency contraception promises to reduce Mexico's high unwanted pregnancy and unsafe abortion rates. Because oral contraceptives are sold over-the-counter, several emergency contraceptive regimens are already potentially available to those women who know about the method. Soon, specially packaged emergency contraceptives may also arrive in Mexico. To initiate campaigns promoting emergency contraception, we interviewed health care providers and clients at health clinics in Mexico City, ascertaining knowledge, attitudes, and practices concerning the method. We found limited knowledge, but nevertheless cautious support for emergency contraception in Mexico. Health care providers and clients greatly overestimated the negative health effects of emergency contraception, although clients overwhelmingly reported that they would use or recommend it if needed. Although providers typically advocated medically controlled distribution, clients believed emergency contraception should be more widely available, including in schools and vending machines with information prevalent in the mass media and elsewhere.

Adolescent↗
PubMed2001

Analysis of fatal pedestrian injuries in Mexico City, 1994-1997.

Currently, in Mexico City, 57% of deaths from traffic crashes are pedestrian injuries. The purpose of this study was to identify and analyse the magnitude, trends, risks, and geographic distribution of fatal pedestrian injuries during the period 1994-1997. A cross-sectional study design was used, based on the death certificates of persons who were in Mexico City during 1994-1997 and died due to pedestrian injuries. Mortality rates, trend analysis, standard mortality ratios (SMRs), and potential years of life lost index (PYLLI) were calculated by gender, age groups and region (these correspond to "delegations", which are political divisions of the city). Rates were derived according to place of occurrence and place of residence. A total of 3687 pedestrian fatalities were reported, and 71% of these were to Mexico City residents. The rate for males was 10.6/100000 with a slight decrease in rate from 1994 to 1997. For females, the rate was 4.0/100000, with an increase in rate during the same years. The present study allowed identification of the target population as well as regions with a high risk of fatal pedestrian injuries. From these data we have developed or recommended specific interventions for prevention and control of fatal pedestrian injuries in Mexico City.

Accidents, Traffic↗
PubMed2003

Population genetic structure of Taenia solium from Madagascar and Mexico: implications for clinical profile diversity and immunological technology.

Taenia solium is a cestode parasitic of humans and pigs that strongly impacts on public health in developing countries. Its larvae (cysticercus) lodge in the brain, causing neurocysticercosis, and in other tissues, like skeletal muscle and subcutaneous space, causing extraneuronal cysticercosis. Prevalences of these two clinical manifestations vary greatly among continents. Also, neurocysticercosis may be clinically heterogeneous, ranging from asymptomatic forms to severely incapacitating and even fatal presentation. Further, vaccine design and diagnosis technology have met with difficulties in sensitivity, specificity and reproducibility. Parasite diversity underlying clinical heterogeneity and technological difficulties is little explored. Here, T. solium genetic population structure and diversity was studied by way of random amplified polymorphic DNA in individual cysticerci collected from pigs in Madagascar and two regions in Mexico. The amplification profiles of T. solium were also compared with those of the murine cysticercus Taenia crassiceps (ORF strain). We show significant genetic differentiation between Madagascar and Mexico and between regions in Mexico, but less so between cysticerci from different localities in Mexico and none between cysticerci from different tissues from the same pig. We also found restricted genetic variability within populations and gene flow was estimated to be low between populations. Thus, genetic differentiation of T. solium suggests that different evolutionary paths have been taken and provides support for its involvement in the differential tissue distribution of cysticerci and varying degrees of severity of the disease. It may also explain difficulties in the development of vaccines and tools for immunodiagnosis.

Animals↗
PubMed1990

Venom characteristics as an indicator of hybridization between Crotalus viridis viridis and Crotalus scutulatus scutulatus in New Mexico.

One hundred and thirteen venoms from 46 populations of Crotalus viridis viridis were screened by immunodiffusion for protein toxins antigenically similar to the phospholipase A2 (PLA) toxin 'Mojave toxin', using a polyclonal antibody to it's basic PLA subunit. Venom i.p. LD50 values in mice were recorded from 22 of the 46 populations. The venoms of three of 14 specimens from southwest (S.W.) New Mexico and one specimen from northern Arizona were immunologically positive by the immunodiffusion tests and produced low LD50 values (0.38-0.65 mg/kg) compared to all immunologically negative venoms (0.9-5.5 mg/kg). These four specimens were morphologically typical for C. v. viridis and their venoms were the only samples of 15 southern New Mexico specimens examined by reverse phase HPLC to exhibit peaks corresponding to the acidic and basic subunits of Mojave toxin. Alkaline polyacrylamide gel electrophoresis (PAGE) analysis of the recombined subunit peaks from the C.v. viridis venom from the S.W. New Mexico specimens showed more similarity to Mojave toxin from C.s. scutulatus venom than to similar toxins in C.v. concolor venom. The combined results of the immunodiffusion, lethal toxicity tests, HPLC profiles and PAGE analysis strongly suggest that the venoms of the three New Mexico specimens contain Mojave toxin(s), as a result of some previous hybridization with C.s. scutulatus. The northern Arizona specimen likely contains 'concolor toxin' through integration with C.v. concolor in its' genetic background.

Animals↗
PubMed2001

Potential particulate impacts at the Grand Canyon from northwestern Mexico.

Project MOHAVE was a major air quality and visibility research program conducted from 1990 to 1999 to investigate the causes of visibility impairment in the Grand Canyon National Park region. At Meadview, a remote monitoring site just west of the Grand Canyon National Park, on September 1 and 2, 1992, the concentrations of sulfate (3.1 and 4.3 microg sulfate/m3) were the highest seen in 6 years of monitoring at this site. During this period, the concentrations of SO2 at Meadview were also abnormally high and approximately three times the sulfate concentrations, on a nmol/m3 basis. High concentrations of sulfate and SO2 extended south into southern Arizona and northwestern Mexico. Based on ambient atmospheric conditions, emissions from the Mohave Power Project (MPP) 110 km upwind of Meadview could not have been responsible for the majority of the regionally observed sulfur oxides. The geographical distribution of SO2 and sulfate, and available source information suggest that northwestern Mexico was a significant source of the unusually high observed sulfur oxides. A CMB model developed during Project MOHAVE was used to apportion sulfur oxides at Meadview and other sampling sites throughout the study region for August 31-September 2, 1992. The results indicate that the contribution of MPP to sulfate at Meadview was typical. However, the transport of SOx from northwestern Mexico was elevated throughout much of the region during this time period. This led to the large increase in sulfate concentrations at Meadview on September 1 and 2. These results indicate that emissions from Mexico can be a significant source of particulate material in the Grand Canyon.

Air Movements↗