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Respiratory diseases and cigarette smoking in a Hispanic population in New Mexico.

We have conducted a cross-sectional study of Hispanic residents of a community in New Mexico. A total of 2,111 subjects were recruited from 733 households; the overall participation rates were 68.1% for males and 78.9% for females. For all subjects, a standardized respiratory symptoms questionnaire was completed, spirometric testing was performed, and saliva and end-tidal breath samples were obtained. As in other populations, chronic respiratory symptoms were uncommon in children, and asthma was more prevalent in boys than in girls. In adults, physician-diagnosed chronic bronchitis and emphysema were less prevalent in this population than in a previously studied sample of non-Hispanic whites in New Mexico. Spirometric testing was confirmatory; less than 1% of the Hispanic males and females had chronic air-flow obstruction. The prevalence of cigarette usage in the Hispanics was comparable to data from non-Hispanic whites in New Mexico and from nationwide surveys. However, daily cigarette consumption by the Hispanics in this sample tended to be low, as found in previous studies in New Mexico and elsewhere.

Adolescent↗

Seroepidemiology of Toxoplasma gondii infection in pregnant women in a public hospital in northern Mexico.

BACKGROUND: Toxoplasma gondii (T. gondii) infection in pregnant women represents a risk for congenital disease. There is scarce information about the epidemiology of T. gondii infection in pregnant women in Mexico. Therefore, we sought to determine the prevalence of T. gondii infection and associated socio-demographic, clinical and behavioural characteristics in a population of pregnant women of Durango City, Mexico. METHODS: Three hundred and forty three women seeking prenatal care in a public hospital of Durango City in Mexico were examined for T. gondii infection. All women were tested for anti-T. gondii IgM and IgG antibodies by using IMx Toxo IgM and IMx Toxo IgG 2.0 kits (Abbott Laboratories, Abbott Park, IL, USA), respectively. Socio-demographic, clinical and behavioural characteristics from each participant were also obtained. RESULTS: Twenty one out of the 343 (6.1%) women had IgG anti-T. gondii antibodies. None of the 343 women had IgM anti-T. gondii antibodies. Multivariate analysis using logic regression showed that T. gondii infection was associated with living in a house with soil floor (adjusted OR = 7.16; 95% CI: 1.39-36.84), residing outside of Durango State (adjusted OR = 4.25; 95% CI: 1.72-10.49), and turkey meat consumption (adjusted OR = 3.85; 95% CI: 1.30-11.44). Other characteristics as cat contact, gardening, and food preferences did not show any association with T. gondii infection. CONCLUSION: The prevalence of T. gondii infection in pregnant women of Durango City is low as compared with those reported in other regions of Mexico and the majority of other countries. Poor housing conditions as soil floors, residing in other Mexican States, and turkey meat consumption might contribute to acquire T. gondii infection.

Adolescent↗

Survey on schizophrenia treatment in Mexico: perception and antipsychotic prescription patterns.

BACKGROUND: Since the introduction of antipsychotics, especially the so called atypicals, the treatment of schizophrenia has shown important improvements. At the present time, it is preferred to label clozapine and other antipsychotics sharing similar profiles as second-generation antipsychotics (SGAs). These medications have been proposed by some experts as a first line treatment for schizophrenia. It is critical to have reliable data about antipsychotic prescription in Mexico and to create management guidelines based on expert meetings and not only on studies carried out by the pharmaceutical industry. Only this approach will help to make the right decisions for the treatment of schizophrenia. METHODS: A translated version of Rabinowitz's survey was used to evaluate antipsychotic prescription preferences and patterns in Mexican psychiatrists. The survey questionnaire was sent by mail to 200 psychiatrists from public institutions and private practice in Mexico City and Guadalajara, Mexico. RESULTS: Recommendations for antipsychotics daily doses at different stages of the treatment of schizophrenia varied widely. Haloperidol was considered as the first choice for the treatment of positive symptoms. On the contrary, risperidone was the first option for negative symptoms. For a patient with a high susceptibility for developing extrapyramidal symptoms (EPS), risperidone was the first choice. It was also considered that SGAs had advantages over typical antipsychotics in the management of negative symptoms, cognitive impairment and fewer EPS.Besides, there was a clear tendency for prescribing typical antipsychotics at higher doses than recommended and inadequate doses for the atypical ones. CONCLUSIONS: Some of the obstacles for the prescription of SGAs include their high cost, deficient knowledge about their indications and dosage, the perception of their being less efficient for the treatment of positive symptoms and the resistance of some Mexican physicians to change their prescription pattern. It is necessary to reach a consensus, in order to establish and standardize the treatment of schizophrenia, based on the information reported in clinical trials and prevailing economic conditions in Mexico.

Antipsychotic Agents↗

Environmental urban lead exposure and blood lead levels in children of Mexico City.

Lead contamination is now a leading public health problem in Mexico. However, there are few data on the lead content of various environmental sources, and little is known about the contribution of these sources to the total lead exposure in the population of children residing in Mexico City. We conducted a cross-sectional study in a random sample of 200 children younger than 5 years of age who lived in one of two areas of Mexico City. Environmental samples of floor, window, and street dust, paint, soil, water, and glazed ceramics were obtained from the participants' households, as well as blood samples and dirt from the hands of the children. Blood lead levels ranged from 1 to 31 micrograms/dl with a mean of 9.9 micrograms/dl (SD 5.8 micrograms/dl). Forty-four percent of the children 18 months of age or older had blood lead levels exceeding 10 micrograms/dl. The lead content of environmental samples was low, except in glazed ceramic. The major predictors of blood lead levels were the lead content of the glazed ceramics used to prepare children's food, exposure to airborne lead due to vehicular emission, and the lead content of the dirt from the children's hands. We conclude that the major sources of lead exposure in Mexico City could be controlled by adequate public health programs to reinforce the use of unleaded gasoline and to encourage production and use of unleaded cookware instead of lead-glazed ceramics.

Adult↗

Utilization of physician health care services in Mexico by U.S. Hispanic border residents.

One of the most controversial topics in the U.S. is the issue of accessibility to health services by U.S. residents. This issue is most critical to U.S. Hispanic residents living along the U.S.-Mexico border who have been identified as having low health standards and low socio-economic conditions when compared to the rest of the state and the country. The availability of lower cost health services across the U.S. border in Mexico is, therefore, perceived as a viable economic alternative source of health care. This study is derived from a health needs assessment survey of 1,100 households residing in Laredo, Texas, the largest land port along the 2,000-miles long U.S.-Mexico border. The major result of this study indicates that about 41.2 percent of the Laredo U.S. Hispanic residents are utilizing cross border physician health care services in Mexico.

Adult↗

New Mexico pharmacists' knowledge, attitudes, and beliefs toward prescribing oral emergency contraception.

OBJECTIVE: To describe New Mexico pharmacists' knowledge, attitudes, and beliefs toward the prescribing of oral emergency contraception (EC) in their practices. DESIGN: Cross-sectional study. SETTING: New Mexico in January through March 2004. POTENTIAL PARTICIPANTS: New Mexico pharmacists. INTERVENTIONS: Questionnaire containing 74 items. MAIN OUTCOME MEASURE(S): Mean scores were calculated for individual knowledge items, overall knowledge scores, and attitude/belief items. Knowledge and attitude/belief scores were compared across demographic variables using t tests, ANOVA, and chi-square analyses. RESULTS: Of 1392 deliverable questionnaires, 555 (40%) were returned and 523 (38%) were usable; 136 contained written comments. Pharmacists had overall knowledge scores of 71.2% +/- 11.3%. Pharmacists who had participated in a state-approved EC prescribing training program and had time in their practice setting to prescribe EC had significantly higher knowledge scores. Mean scores indicated that pharmacists have positive attitudes and beliefs toward prescribing EC. Overall, 40% of respondents indicated that they would like to become certified to prescribe EC. Pharmacists who agreed that they would like to be certified to prescribe EC were significantly more likely to be male, non-Hispanic, non-Christian, to have liberal or moderate political views, and to indicate that they had employer/manager approval, time, and privacy in their practice setting to prescribe EC. CONCLUSION: New Mexico pharmacists have positive attitudes/beliefs toward EC prescribing; however, their knowledge in this area is average. Although religious, moral, and political views influence pharmacists' willingness to prescribe EC, factors such as education and practice environment must be addressed if more pharmacists are to accept this EC prescriptive authority.

Contraception, Postcoital↗

Age at menopause in Puebla, Mexico.

Comparisons of age at menopause are made difficult by the different methodologies applied across populations. This study extended an opportunity to apply different methodologies to the same data to draw some preliminary conclusions about age at menopause in Puebla, Mexico. Among 755 women aged 28 to 70 interviewed in the capital city of Puebla, Mexico, 447 (59.6%) were naturally or surgically postmenopausal. Mean recalled age at natural menopause in Puebla (46.7 years) appears to be similar to mean recalled age at menopause in Mexico City (46.5 years), suggesting that age at menopause is similar in urban Mexican populations. However, median age at menopause computed by probit analysis was later in the city of Puebla (49.6 years) compared to the median age computed by the same method in the capital city of León, Guanajuato, Mexico (48.2 years). Median age at menopause computed by Kaplan-Meier survival analysis suggests that age at menopause in Puebla (50.0 years) is older still, and close to that of the United States (51.1 years). The differences in median ages at menopause in Puebla are solely due to methodological choices and highlight the difficulty inherent in making inferences across studies of age at menopause between biological and/or cultural groups. Factors associated with age at menopause offer another avenue for comparing and understanding variation in this basic biological process. In Puebla, smoking, low levels of education, and nulliparity are associated with an earlier age at menopause.

Adult↗

[Influenza vaccination in the elderly population in Mexico: economic considerations].

OBJECTIVE: To estimate costs and health outcomes that could be attained by an influenza vaccination program in adults 65 years of age and older in Mexico. MATERIAL AND METHODS: Between June and October 2004, a model was constructed to estimate the number of life years lost due to influenza and the fraction that could be prevented by vaccination among adults 65 years of age and older. The model also allowed the estimation of the net cost of a vaccination program, including both the cost of delivering the vaccine and savings from prevented infections and their treatment costs. RESULTS: Using two scenarios of vaccine effectiveness, between 7 454 and 11 169 life years could saved by the vaccine if given to all adults 65 years and older in Mexico, with a net cost per life year saved between 13 301 and 21 037 Mexican pesos (about dollar 1 210 and dollar 1 910 US dollars). DISCUSSION: Influenza vaccination among the elderly in Mexico would result in savings per life year saved well below the Mexican gross domestic product (GDP) per capita, suggesting, even without examining alternative uses for these resources, that this is a cost effective intervention in Mexico and probably also in other middle-income developing countries.

Aged↗

A review of the prevalence of dental fluorosis in Mexico.

OBJECTIVE: There has been a worrisome increase in the prevalence of dental fluorosis worldwide. The objective of this study was to review research on dental fluorosis prevalence in Mexico in order to assess if that prevalence is rising and if dental fluorosis constitutes a public health problem for the country. METHODS: Clinical, experimental, and review reports were searched for in a number of bibliographic databases for scientific literature, using the search phrase "fluorosis and Mexico." All the materials that were initially identified had to satisfy eight specific criteria in order to be included in our study. RESULTS: Of the 24 publications that the literature search yielded, 14 satisfied all the inclusion criteria. The prevalence of dental fluorosis reported in Mexico ranged from 30% to 100% in areas where water is naturally fluoridated and from 52% to 82% in areas where fluoridated salt is used. Most of the 14 studies were conducted in areas where water fluoride levels were above optimal, and the fluorosis cases reported in these publications ranged from "mild" to "severe." There have been only a small number of reports on dental fluorosis since the introduction of fluoridated salt in the country in 1991. However, some of those studies have shown that the prevalence of fluorosis was higher than what would be expected given the historical data from communities with optimal fluoridation in other countries. CONCLUSION: Due to the limited amount of information, it is not possible to determine if the prevalence of dental fluorosis in Mexico is rising or if it constitutes a public health problem. To objectively answer these questions more controlled studies are needed in areas where fluoridated salt is distributed, where water fluoride is above optimal, and where residents live at a high altitude.

Adolescent↗

Peer and sibling substance use: predictors of substance use among adolescents in Mexico.

OBJECTIVE: To examine the extent to which peer drug use and sibling drug use predict alcohol abuse/dependence disorder status and the use of drugs other than alcohol among school-based youth in Mexico. METHODS: Data were collected on 1 203 middle and high school students in northern Mexico in May 1998. Participation was voluntary, and responses were confidential. Logistic regression analyses estimated the association that peer drug use and that sibling drug use had with alcohol abuse/dependence diagnosis and the lifetime use of drugs other than alcohol. RESULTS: Students who had siblings or peers who used alcohol and other drugs were more likely to meet the standard alcohol abuse/dependence criteria defined by the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV), and were more likely to have used drugs other than alcohol. Controlling for potentially important confounders, we found that adolescents with the highest level of peer substance use were eight times as likely to meet alcohol abuse/dependence criteria and four times as likely to use other drugs. Youth who had siblings who used drugs were about twice as likely to meet alcohol abuse/dependence criteria and about 2.5 times as likely to use drugs other than alcohol when compared to youth with no sibling substance use. CONCLUSIONS: Consistent with extant findings among youth in the United States of America, peer and sibling substance use are major risk factors for substance use among school-based youth in Mexico. Students in Mexico may benefit from prevention strategies found to be effective among students in the United States.

Adolescent↗

[Trends in mortality from lung cancer in Mexico, 1980-2000].

OBJECTIVE: To analyze trends in age-adjusted lung cancer mortality rates in Mexico for the period of 1980 through 2000. METHOD: The trends were assessed using the adjusted rates of mortality from lung cancer, year of death, year of birth, age at death, state, and standard population. The standardized mortality rate and the index of potential years of life lost were used to compare incidence and premature deaths. The standardized mortality rate was analyzed by age groups according to the age at death (30-74 years), five-year observation period (1980-1999), and birth cohort (1910-1950). Nonparametric Spearman correlations were calculated for per capita tobacco consumption, social marginalization, and emigration. RESULTS: The adjusted mortality rate from lung cancer declined from 7.91 per 100 000 in 1989 to 5.96 per 100 000 in 2000. This pattern correlated with the reduction in per capita tobacco consumption, from 2.145 kg in 1959 to 0.451 kg in 1982. The latent period for the appearance of lung cancer in Mexico was 30 years. The male:female ratio was 2.4:1. The highest adjusted mortality rate was found in men who were 70-74 years old at the time of death. The adjusted mortality rates were low among the cohorts of persons born in 1945 or later, and those rates declined over the 1980-2000 period. The index of potential years of life lost and the incidence of premature death were greater among men. The mortality rates for the cohorts of men born between 1915 and 1940 showed a slight decline over the 1980-2000 period; beginning with men born in 1944 the rates increased slightly, mainly among men 30-34 and 35-39 years old at the time of death. For women the adjusted mortality rates were highest among those 75 or older; the rates gradually declined among the women born between 1945 and 1960, with the largest decrease among women 30-34 years old. The adjusted mortality rates varied according to the five-year observation period, the year of death, and birth cohort and gender. The correlation coefficient for the adjusted mortality rate by state and social marginalization was -0.70 (P = 0.00). There was no statistically significant correlation with the index of emigration (P = 0.56). CONCLUSIONS: Mortality from lung cancer has declined in Mexico. Morbidity and premature death due to lung cancer are greater in the states of northern Mexico.

Adult↗

[Women's empowerment and life expectancy at birth in Mexico].

OBJECTIVES: To assess the effect of women's empowerment (WE) on life expectancy at birth (LEB) in the federative states of Mexico and to compare the results of measuring WE with various compound indicators that reflect, to a greater or lesser degree, an individual or population focus. METHODS: This was an ecological study conducted in Mexico's 32 federative states. We estimated the correlations between overall and sex-specific LEB on the one hand, and a measure of gender empowerment (MGE), the index of women's ability to make decisions within the household (WADH), the index of women's autonomy (IWA), income inequality, certain aspects of the physical environment, the proportion of the population who spoke an indigenous language, and the net migratory rate on the other. By using robust regressions, we studied the effect on LEB of MGE, IWA, and WADH, after mutually adjusting for other independent variables. RESULTS: A very strong inverse correlation (-0.93) was found between overall LEB and factors of the physical environment linked to population vulnerability and biodiversity. Significant direct and inverse correlations were also found between LEB on the one hand and WADH, IWA, net migratory rate, the percentage of the population that spoke an indigenous language, and the Gini coefficient on the other. Multiple robust regressions showed inverse associations between MGE and LEB in women (beta: -1.44; 95% confidence interval [95% CI]: -2.71 to -0.17). WAI was positively associated with LEB in men (beta: 0.88; 95% CI: 0.01 to 1.75) and women (beta: 0.66; 95% CI: 0.03 to 1.30). CONCLUSION: The use of MGE as a surrogate for WE failed to reveal a positive effect of WE on LEB in Mexico. It is necessary to review the components that make up MGE and the relevance of using such a measure in different contexts. WAI showed a greater association with LEB and its effect was greater among men. This indicator made it possible to measure WE in Mexico and its use is recommended, as long as there are no other indicators available for capturing more effectively all the components that affect WE.

Female↗

Three new Procamallanus (Spirocamallanus) species from freshwater fishes in Mexico.

The following 3 new species of Procamallanus (Spirocamallanus) are described from the intestines of freshwater fishes in Mexico, all belonging to the morphological group characterized by the presence of wide caudal alae, 3 pairs of subventral preanal papillae, and unequal spicules in the male: Procamallanus (Spirocamallanus) jaliscensis n. sp. (type host: Agonostomus monticola) and Procamallanus (Spirocamallanus) gobiomori n. sp. (hosts: Gobiomorus maculatus [type host], Gobiomorus polylepis and Eleotris picta) from 2 rivers in Jalisco State, western Mexico, and Procamallanus (Spirocamallanus) mexicanus n. sp. (type host: Cichlasoma geddesi) from Xalapa District, Veracruz State (Gulf of Mexico region), southeastern Mexico. Procamallanus jaliscensis is characterized by the length of the spicules (606-900 microm and 282-354 microm), number (15-16) of spiral ridges in the buccal capsule, and the digit-like protrusion with 1 terminal cuticular spike on the female tail; P. mexicanus by the length of the spicules (456-480 microm and 231-233 microm), number (10-12) of spiral ridges in the capsule, and the shape of the female tail (conical with a suddenly narrowed distal part, without any terminal spikes); and P. gobiomori by the length of spicules (318-348 microm and 156-192 microm), number (8-10) of spiral ridges and by the digit-like protrusion with 2 terminal cuticular spikes on the female tail.

Animals↗

Helminths of the Virginia opossum Didelphis virginiana (Mammalia: Didelphidae) in Mexico.

The goal of this study was to provide further information about helminth parasites of Virginia opossum Didelphis virginiana Kerr, 1792 from Mexico. During routine faunal investigations between 1958 and 2001, 101 opossum were necropsied. Nineteen taxa of helminths were collected, representing 13 genera from hosts in 27 localities from Mexico. There are 58 new locality records, with 6 species recorded in Mexico for the first time: Brachylaima virginiana Dickerson, 1930; Cruzia americana Mapleston, 1930; Didelphonema longispiculata (Hill, 1939); Didelphostrongylus hayesi Prestwood, 1976; Viannaia didelphis Travassos, 1914; and Viannaia viannai Travassos, 1914. This increases the number of helminth taxa previously known for this host in Mexico to 28.

Animals↗

The University of New Mexico Visiting Physicians Program: helping older New Mexicans stay at home.

New Mexico is a rural state with unique barriers to health service delivery to homebound elderly. The University of New Mexico's Visiting Physicians Program allows these patients to stay in their homes by bringing physicians to them. The physicians use community agencies to provide nursing, lab, X-ray, and physical therapy services. The University of New Mexico has also integrated home visits into the medical students, residents and geriatric fellows' educational programs. By involving medical students, residents and fellows in home care, future physicians who practice in New Mexico will incorporate this valuable service into care for the homebound elderly in their practice communities.

Aged↗

United States male students who heavily consume alcohol in Mexico are at greater risk of travelers' diarrhea than their female counterparts.

BACKGROUND: The relationship between alcohol consumption and travelers' diarrhea has not been well studied. METHODS: A cohort of US college students (n=171), who attended 2001 or 2002 summer educational sessions in Guadalajara, Mexico, were followed prospectively to examine the frequency of alcohol consumption and the development of travelers' diarrhea. RESULTS: More male students reported consuming >5 drinks/day of drinking while in Mexico compared to female students (p <.001). Males who consumed >5 drinks/day of drinking while in Mexico were more likely to develop diarrhea than their female counterparts who drank the same amount (79% vs. 46%; p=.035). No association was found between the development of travelers' diarrhea and the consumption of fewer than 5 drinks per day in Mexico. Non-drinkers accounted for only 8% of the population and had a relatively high attack rate of diarrhea (69%). CONCLUSIONS: This study suggests that males who drink heavily are at high risk for developing travelers' diarrhea and may be a group of people to target for education about the moderation of use of alcohol while traveling. Nondrinkers also deserve further study in larger numbers to confirm an apparently high attack rate of diarrhea and to explore what risk factors might be involved.

Adult↗

Diabetes mortality among New Mexico's American Indian, Hispanic, and non-Hispanic white populations, 1958-1987.

OBJECTIVE: To determine the diabetes-related mortality rates among New Mexico's American Indians, Hispanics, and non-Hispanic whites over a 30-yr period. RESEARCH DESIGN AND METHODS: Death certificates were used to identify diabetes as an underlying cause of death by ethnic group in New Mexico during each 5-yr period from 1958 through 1987. The age-adjusted rates were calculated by ethnic group and sex, and temporal trends were examined. Comparison was made to U.S. white age-adjusted rates during the same time period. RESULTS: Age-adjusted diabetes mortality rates for American Indians and Hispanics increased throughout the 30-yr period, and far exceeded rates for New Mexico non-Hispanic whites and U.S. whites by the 1983-1987 time period. The rates increased most dramatically among the state's American Indians, increasing 550% among women and 249% among men. Hispanic women and men experienced increases of 112 and 140%, respectively. CONCLUSIONS: New Mexico's American Indian and Hispanic populations have higher diabetes mortality rates than non-Hispanic whites, and American Indian mortality rates have risen dramatically over the 30-yr period included in our study. Although the high prevalence of diabetes in American Indians and Hispanics is a major contributor to these rates, other factors may also influence the reported mortality rates.

Age Factors↗

The prevalence of NIDDM and associated coronary risk factors in Mexico City.

OBJECTIVE: To determine the prevalence of diabetes and associated coronary risk factors in the Mexico City population. RESEARCH DESIGN AND METHODS: A sample of 805 adults was selected from Mexico City. The participants, 20-90 years of age and living in the city, were selected by the method of multistage cluster sampling with proportional allocation. Diabetes was diagnosed by previous history or if fasting blood glucose was > or = 7.8 mmol/l ( > or = 7.8 mmol/l ( > or = 140 mg/dl). RESULTS: The crude rate prevalence of NIDDM was 8.7%, with an age-adjusted rate of 10.6% for women and 6.0% for men. Age strongly influenced diabetes prevalence, with a chi 2 of risk tendency of 39.1 (P < 0.00005). A significant proportion (5.9%) of younger individuals (35-44 years of age) was affected by the disease. Diabetes was associated with advanced age, had a greater impact in the low-income group, and showed increased odds ratio for hypertension, dyslipidemias, and myocardial infarction in men and women and for obesity only in women. CONCLUSION: There is a high prevalence of NIDDM in Mexico City that also strikes a significant group of younger individuals. Associated coronary risk factors are also common and more prevalent in diabetic individuals. Current epidemiological data in Mexico and Mexican-Americans in the U.S. suggest that we may be on the ascending limb for diabetes and cardiovascular disease. There is a critical need for resources to be allocated to programs for primary and secondary prevention, which must be well structured and organized so that proper standards of care are followed to prevent progression of the disease.

Adult↗