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PubMed1987

The New Mexico Melanoma Registry. A model of a statewide cooperative program.

The prevalence of cutaneous melanoma is high among Anglo residents of New Mexico. In order to achieve consistency in diagnosis and pathologic staging, a melanoma registry was established in 1980 in conjunction with the University of New Mexico Cancer Center. The registry functions through pathology panel review of newly diagnosed melanomas combined with collection of clinical data. Reports are submitted gratis to contributing pathologists and dermatologists. The melanoma registry works closely with the population-based New Mexico Tumor Registry. Acceptance of the melanoma registry has been excellent. We believe that in excess of 90% of new melanoma cases in the state are sent spontaneously to the registry. During 1986 approximately 150 melanomas were reviewed together with 450 atypical, benign pigmented lesions such as dysplastic nevi. In addition to pathology consultations, the registry serves an educational function and has potential for a variety of epidemiologic studies.

Data Display↗
PubMed1997

Outcome of pediatric intensive care at six centers in Mexico and Ecuador.

OBJECTIVE: To improve understanding of the causes of morbidity and mortality among critically ill children in the countries studied. DESIGN: Survey of hospital records between 1992 and 1994. SETTING: Six pediatric intensive care units (ICUs) (four ICUs in Mexico City and two ICUs in Ecuador). PATIENTS: Consecutive patients (n = 1,061) admitted to the units studied. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The mortality rate for low-risk patients (pediatric Risk of Mortality [PRISM] score of < or = 10, n = 701) was more than four times the rate predicted by the PRISM score (8.1% vs. 1.8%, p < .001), with an additional 11.3% of this group incurring major morbidity. The mortality rate for moderate-risk patients (PRISM scores of 11 to 20, n = 232) was more than twice predicted (28% vs. 12%, p < .001). For low-risk patients, death was significantly associated with tracheal intubation, central venous cannulation, pneumonia, age of < 2 months, use of more than two antibiotics, and nonsurgical diagnosis (after controlling for PRISM score). Central venous cannulation and tracheal intubation in the lower-risk groups were performed more commonly in units in Mexico than in one comparison unit in the United States (p < .001). CONCLUSIONS: For six pediatric ICUs in Mexico and Ecuador, mortality was significantly higher than predicted among lower-risk patients. Tracheal intubation, central catheters, pneumonia, sepsis, and nonsurgical status were associated with poor outcome for low-risk groups. We speculate that reducing the use of invasive central catheters and endotracheal intubation for lower-risk patients, coupled with improved infection control, could lower mortality rates in the population studied.

Child, Preschool↗
PubMed1996

Patient-doctor communication in cross-national perspective. A study in Mexico.

The authors assessed the cross-national replicability previously used to study medical encounters in the United States by adapting them to Mexico. The main research questions focused on information-giving, gender and social class differences in communication, and attention to socioemotional concerns in primary encounters. Sixty-two primary care encounters were audiotaped. Questionnaires were translated into Spanish, then translated back into English. Coding and transcription techniques were taught to Spanish-speaking researchers. Measures of communication were treated as dependent variables and were related by nonparametric statistical analyses to characteristics of physicians, patients, and clinical settings. Doctors in Mexico spent an average of 2.1 minutes (+/- 1.7 standard deviation [SD]), or 16.7% (+/- 10.7 SD) of total interaction time, in information-giving. Mexican doctors asked an average of 27.3 questions per encounter (+/- 18.0 SD), whereas patients asked an average of 1.5 questions (+/- 2.0 SD). Substantial interphysician variability was observed in total time of interaction (Kruskal-Wallis analysis of variance, chi-square = 27.2, P = 0.000), physician time in information giving (chi-square = 16.4, P = 0.022), and physician questions (chi-square = 36.7, P = 0.000). Patient characteristics associated with physician information-giving included male gender (chi-square = 4.1, P = 0.04) and age (Kendall's tau-b = .17, P = 0.05) but not education (tau-b = .08, P = 0.41). Information-giving in public clinics did not differ from that in private practices (chi-square = 0.0, P = 0.91). A bootstrap approach to multiple nonlinear regression permitted additional analysis of physicians', patients', and situational characteristics in explaining measures of patient-doctor communication; this analysis further demonstrated the importance of interphysician variability in communicative behavior. Previous methods for studying patient-doctor communication can be adapted and replicated in a non-English-speaking society. With certain exceptions, findings from Mexico were similar to those obtained in the United States.

Adult↗
PubMedDate not supplied

Attitudes toward physician-nurse collaboration: a cross-cultural study of male and female physicians and nurses in the United States and Mexico.

BACKGROUND: Inter-professional collaboration between physicians and nurses, within and between cultures, can help contain cost and insure better patient outcomes. Attitude toward such collaboration is a function of the roles prescribed in the culture that guide professional behavior. OBJECTIVES: The purpose of the study was to test three research hypotheses concerning attitudes toward physician-nurse collaboration across genders, disciplines, and cultures. METHOD: The Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration was administered to 639 physicians and nurses in the United States (n = 267) and Mexico (n = 372). Attitude scores were compared by gender (men, women), discipline (physicians, nurses), and culture (United States, Mexico) by using a three-way factorial analysis of variance design. RESULTS: Findings confirmed the first research hypothesis by demonstrating that both physicians and nurses in the United States would express more positive attitudes toward physician-nurse collaboration than their counterparts in Mexico. The second research hypothesis, positing that nurses as compared to physicians in both countries would express more positive attitudes toward physician-nurse collaboration, was also supported. The third research hypothesis that female physicians would express more positive attitudes toward physician-nurse collaboration than their male counterparts was not confirmed. CONCLUSIONS: Collaborative education for medical and nursing students, particularly in cultures with a hierarchical model of inter-professional relationship, is needed to promote positive attitudes toward complementary roles of physicians and nurses. Faculty preparation for collaboration is necessary in such cultures before implementing collaborative education.

Analysis of Variance↗
PubMed2003

Prevalence of myopia among 12- to 13-year-old schoolchildren in northern Mexico.

PURPOSE: The aim of this article was to report the prevalence of refractive errors, mainly myopia, among 12- to 13-year-old children in a metropolitan setting in Mexico. METHODS: A total of 1035 schoolchildren were examined in a field study in Monterrey, Mexico. The examination included best-corrected visual acuity and refraction during cycloplegia. A sample of the children was sent to a pediatric eye clinic and underwent cycloplegic refraction with an autorefractor. RESULTS: We found a prevalence of myopia (>/=-0.5 D SE) of 44%, whereas bilateral myopia was present in 37% of the children. In the total sample, high myopia (>/=-5D) was found in 1.4%. The prevalence of myopia was significantly higher in girls. Only 20% of children with bilateral myopia used prescription glasses; 8% had prescribed glasses, but did not use them. Hyperopia (>/=+1 D) was present in 6.0% of the total population, and astigmatism (>/=-1.5 D) was present in 9.5%. CONCLUSIONS: The prevalence of myopia among 12- to 13-year-old children in Mexico is high. The majority of cases are low grade, and a large number of the myopic children do not have, or do not use, prescription glasses.

Adolescent↗
PubMedDate not supplied

Prevalence and risk factors for Chlamydia trachomatis infection in low-income rural and suburban populations of Mexico.

BACKGROUND AND OBJECTIVES: In rural and suburban populations in developing countries, there is a lack of knowledge about the occurrence of Chlamydia trachomatis infection and the risk factors involved. Knowledge of the prevalence of infection is necessary to develop screening policies. GOALS: To estimate the prevalence of C. trachomatis infection in a rural and a suburban area of Oaxaca, Mexico, and to identify behavioral and demographic risk factors, as well as clinical findings, that may be related to this disease. STUDY DESIGN: A cross-sectional survey was conducted among 559 women attending the Rural Hospital of Tlacolula, Oaxaca in 1994. Genitourinary signs and symptoms were recorded using a structured questionnaire and a speculum examination of the cervix. Endocervical specimens were obtained for the direct immunofluorescent diagnosis of chlamydial infection. RESULTS: Results for 41 women (7.3%) were positive for chlamydia. The prevalence was the same in rural and suburban women. In a multiple logistic regression analysis, chlamydial infection was correlated highly with young age (OR, 2.3; 95% CI, 1.2 to 4.6), oral contraceptives (OR, 2.2; 95% CI, 0.7 to 6.9), number of sex partners, and genitourinary signs or symptoms. The simultaneous presence of mucopurulent cervical discharge, cervix friability, inflammatory signs of the cervix, and urinary symptoms had the highest specificity (99.6%) and positive predictive value (86.7%) for chlamydial infection detection. CONCLUSION: C. trachomatis infection is a common sexually transmitted disease in rural and suburban women in Mexico. Nearly 1 of 8 women 15 to 25 years of age may be infected. A risk factor-based screening program should be implemented in rural and urban populations in Mexico. In rural settings, women with mucopurulent cervical discharge should be treated for chlamydial infection, even without a laboratory diagnosis.

Adolescent↗
PubMed2003

Prevalence of Chlamydia trachomatis infection in registered female sex workers in northern Mexico.

BACKGROUND: Little is known about the epidemiology of Chlamydia trachomatis infection in female sex workers (FSWs) in Mexico. GOAL: The goal of the study was to determine the prevalence of C trachomatis infection in registered FSWs from northern Mexico and to determine the sociodemographic characteristics associated with the infection. STUDY DESIGN: An enzyme immunoassay was used to test 354 FSWs in three northern Mexican cities for cervical C trachomatis infection. All participants were registered in a government health office. Recruitment was consecutive and voluntary. The association between clinical and sociodemographic characteristics of FSWs and infection was evaluated. RESULTS: The overall prevalence of C trachomatis infection among participants in the three cities was 12.4%. Women of low socioeconomic level and those younger than 25 years were the most frequently infected. Among FSWs in Durango, a higher frequency of C trachomatis infection was found for those who did not use condoms. CONCLUSION: C trachomatis is an important pathogen in the sexually transmitted diseases of registered FSWs in northern Mexico.

Adult↗
PubMed1985

Health precautions for travelers to Mexico.

After Canada, Mexico is the most popular destination for Americans traveling outside the United States. As a developing country, Mexico presents numerous health hazards to American visitors, including the prevalent travelers' diarrhea (turista), from which 40% will suffer, and the less common typhoid, dengue, rabies, malaria, taeniasis, cysticercosis, and trichinosis. Environmental hazards, including sun, heat, high altitude, motion sickness, and accidents, also threaten the unwary traveler. In the event of illness or injury, Americans may find medical facilities unfamiliar and less well equipped than those in the United States. Utilizing both an individualized risk assessment for each traveler and readily available references, physicians, in partnership with local public health agencies, can develop comprehensive preventive health plans for their patients traveling to Mexico.

Diarrhea↗
PubMed2005

Epidemiology of cancer in children under one year of age in Mexico City.

In this work, the epidemiology of cancer in children under one year of age in Mexico City is described. A survey (observational, descriptive and prolective study) from 1 January 1996 to 31 December 1999 was conducted at two paediatric hospitals of the Instituto Mexicano de Seguro Social in Mexico City (IMSS-MC). To calculate both the general and the by sex incidence (rates are given per 10) all new cases recorded for children under one year of age (numerator) and Mexico City population served by the IMSS (denominator) were used. When the total of 34 cases that fulfilled the requirements was analysed, an incidence of 194.5 was obtained. Leukaemia occupied first place with a rate of 68.6 and hepatic and germinal cells tumours occupied second place with an incidence of 28.6, whereas peripheral nervous system tumours (neuroblastoma) showed a very low rate (11.4). Overall, the male/female ratio for tumours was 1.4:1, with the ratio varying with different types of tumours. Cancer incidence in this population was shown to be close to that in developed countries, but differed in the distribution of the type of tumour: leukaemia had a very high incidence and that for neuroblastoma was very low.

Cities↗
PubMed2004

Direct health care costs of 4 common skin ulcers in New Mexico Medicaid fee-for-service patients.

OBJECTIVE: To determine health care costs associated with pressure ulcers, ulcers of the lower limbs, other chronic ulcers, and venous leg ulcers from the New Mexico Medicaid fee-for-service program perspective. DESIGN: Retrospective analysis of claims database MAIN OUTCOME MEASURES: Physician visit, hospital, and prescription costs were determined for New Mexico Medicaid patients with a primary and/or secondary diagnosis of 1 of 4 identified categories of skin ulcers from January 1, 1994, through December 31, 1998. Costs were determined in terms of mean and median annual cost per patient and total costs per year. Zero dollar claims were included within the cost calculations. All costs are expressed in 2000-dollar values. MAIN RESULTS: Mean annual physician visit costs per patient ranged from $71 (standard deviation [SD] = $60) for venous leg ulcers in 1998 to $520 (SD = $1228) for pressure ulcers in 1996. Mean annual hospital costs per patient ranged from $266 (SD = $348) for other chronic ulcers in 1998 to $15,760 (SD = $30,706) for pressure ulcers in 1998. Mean annual prescription costs per patient ranged from $145 (SD = $282) for other chronic ulcers in 1998 to $654 (SD = $1488) for pressure ulcers in 1994. CONCLUSION: The New Mexico Medicaid fee-for-service system incurred a total cost of approximately $11.6 million (in 2000 dollars) from 1994 through 1998 for the treatment of the 4 categories of skin ulcers studied. The data showed that the majority of wounds were coded as pressure ulcers, which had the highest associated costs.

Chronic Disease↗
PubMed2004

The epidemiology of HIV among Mexican migrants and recent immigrants in California and Mexico.

For Mexican migrants and recent immigrants, the impact of migration from Mexico to California has the potential to lead to an increased risk for HIV infection. Until recently, the prevalence of HIV in Mexico and among Mexican migrants in California appeared to be stable and relatively low. Recent studies have raised new concerns, however, that the HIV epidemic may expand more aggressively among this population in the coming years. Unfortunately, the insufficient amount of data available within recent years makes it difficult to fully assess the potential for rapid spread of the HIV epidemic among this population. Consequently, there is a critical need for an ongoing binational surveillance system to assess prevalence and trends in HIV/STD/TB disease and related risk behaviors among this population both in Calfornia and within this population's states of origin in Mexico. This enhanced epidemiologic surveillance system should provide improved data on the subpopulations at the highest risk for HIV/STD/TB, such as men who have sex with men, and should provide the opportunity to evaluate the impact of migration on the transmission dynamics, risk behaviors, and determinants of behavior on each side of the border. It is essential that this potential threat be assessed and that intervention programs are developed and implemented to combat this possible escalation in the HIV epidemic.

Agriculture↗
PubMed2002

Shorebird use of coastal wetland and barrier island habitat in the Gulf of Mexico.

The Gulf Coast contains some of the most important shorebird habitats in North America. This area encompasses a diverse mixture of estuarine and barrier island habitats with varying amounts of freshwater swamps and marshes, bottomland hardwood forests, and coastal prairie that has been largely altered for rice and crawfish production, temporary ponds, and river floodplain habitat. For the purposes of this review, discussion is confined to general patterns of shorebird abundance, distribution, and macro- and microhabitat use in natural coastal, estuarine, and barrier island habitats on the Gulf of Mexico Coast. The following geographic regions are considered: Northwestern Gulf (Rio Grande to Louisiana-Mississippi border), Northeastern Gulf (Mississippi to Florida Keys), and Mexico (Rio Grande to Cabo Catoche [Yucatan Strait]). Wintering and migrating shorebirds are most abundant along the Gulf Coast in Texas and Tamaulipas, particularly the Laguna Madre ecosystem. Other important areas are the Southwest Coast region of Florida and the area between Laguna Terminos and Puerto Progresso in Mexico. In general, relative abundances of shorebirds increase from north to south, and decrease south of the Tropic of Cancer (23 degrees 27' N). Based on bimonthly maximum counts within 5 latitudinal bands, the region between 25-30 degrees N is used most heavily by wintering and spring migrating birds. Non-vegetated coastal wetland habitats associated with bays, inlets and lagoons, particularly tidal flats, and sandy beaches are the habitats that appear to be favored by wintering and migrating shorebirds. In general, these habitats tend to occur as habitat complexes that allow for movement between them in relation to tidal flooding of bay-shore habitats. This relationship is particularly important to Piping Plover and may be important to others. Although vegetated habitats are used by some species, they do not appear to attract large numbers of birds. This habitat is most widespread between the Texas-Louisiana border and the Florida Panhandle region, but it has not been studied extensively. Shorebird abundance and habitat use in this area need to be addressed.

Animal Migration↗
PubMed2004

New Mexico's 1998 drive-up liquor window closure. Study II: economic impact on owners.

AIMS: This study examined the economic impact of the New Mexico legislative action closing drive-up liquor windows on the retail establishments that operated them. DESIGN: A telephone survey was conducted 20 months after the closure seeking information and owners' opinions about how their outlets had changed since the closure and how this affected their business. In addition, 2 years of aggregated pre- and post-closure total gross receipts revenues were obtained from the New Mexico Taxation and Revenue Department, with convenience stores as a comparison group. FINDINGS: Interviews were completed for 149 of 220 establishments. Over one-quarter of former drive-up liquor windows (28%) had been converted to 'step-in' sales, defined as an outside door where customers can stop and enter the premises while their car is running. Almost two-thirds (61%) of owners reported decreased annual gross revenues following closure, with a reported average 15% reduction in alcohol sales. This is consistent with findings of decreased gross receipts for operators of non-urban, but not urban, drive-up liquor windows compared to convenience store gross receipts. Almost three-quarters (72%) of those surveyed would re-open the drive-up window if the law were rescinded. CONCLUSION: Over one-quarter of the drive-up owners converted to step-in alcohol sales that still allow a form of drive-up liquor sales. Despite this, the forced closure of New Mexico's drive-up liquor windows negatively impacted total sales and liquor sales revenues of establishments that operated them.

Alcoholic Beverages↗
PubMed2004

Lead levels in primary teeth of children living in Mexico City.

OBJECTIVE: The aim of this study was to discover the lead concentration in primary teeth extracted in the peripheral clinics of the Faculty of Dentistry, UNAM (Mexico City). DESIGN: One hundred healthy primary teeth were collected from 2 to 13-year-old children (52 girls and 48 boys). Sixty-six were maxillary teeth and 34 were mandibular teeth. Lead concentrations were measured by Graphite Furnace Atomic Absorption Spectrophotometry. RESULTS: Our results indicate that lead concentration in the 10-13-year-old group (7.7 micro g/g(-1)) was higher than in the other groups. Geometric mean lead concentration was higher in girls than in boys (7.3 micro g/g(-1) and 6.3 micro g/g(-1), respectively). Maxillary teeth had higher lead concentrations than mandibular teeth and primary canines showed the highest mean lead concentration followed by incisors and molars. Teeth from children living in the south-east area (which according to the Mexico City's Pollution Center data is the more polluted area), presented the highest lead concentration but no statistically significant difference was found among teeth from the different areas. CONCLUSIONS: Our results suggest that age, gender and place of residence are not related to the lead concentration in human primary teeth. This fact seems to indicate the ubiquitous presence of lead in the whole atmosphere of Mexico City and suggests that zones of residence do not appear to influence tooth lead concentration.

Adolescent↗
PubMed1998

An outbreak of equine leukoencephalomalacia at Oaxaca, Mexico, associated with fumonisin B1.

Equine leukoencephalomalacia (ELEM), swine pulmonary oedema and human oesophageal cancer have been associated with fumonisine B1 (FB1) ingestion. For the first time in this study it is reported that FB1 was identified as being associated with an outbreak of ELEM at Oaxaca, Mexico. Symptoms of ELEM and Equine Venezuelan Encephalitis (EVE) are similar and a different diagnosis is obligatory. In the geographical area (Oaxaca, Mexico) where donkeys died showing a neurological syndrome, 14 corn samples were collected. With the use of TLC (Thin layer chromatography) and HPLC (High performance liquid chromatography) all collected samples resulted positive to FB1. In the area of study, this syndrome was reported to be the cause of death of 100 donkeys, after 3 postmortem examinations in which macroscopic and microscopic cerebral white manner liquefactive necrosis were observed, when FB1 concentration was determined in the samples collected, using HPLC and TLC. It was concluded that HPLC is a highly sensitive method for the detection of FB1 through the formation of an OPA derivative. However, the reverse phase TLC plate and the visualisation of the coloured reaction with the vanillin acidic solution is more objective. FB1 concentration in the studied samples ranged from 0.67 to 13.3 ppm. It was concluded that FB1 was the cause of leukoencephalomalacia reported in donkeys in the state of Oaxaca, Mexico.

Animal Feed↗
PubMed2005

Prevalance of proteinuria in Mexico: a conjunctive consolidation approach with other cardiovascular risk factors: the Mexican Health Survey 2000.

BACKGROUND: A number of cross-sectional or serial studies have demonstrated the clinical impact of microproteinuria and macroproteinuria by identifying individuals at risk of both end-stage renal disease and major cardiovascular events. This study focused on the prevalence of proteinuria in Mexico and its relationship with other cardiovascular risk factors such as hypertension, type 2 diabetes mellitus, body mass index, smoking, age, and gender. METHODS: The prevalence of proteinuria in Mexico was obtained from the probabilistic cross-sectional national health survey performed in the year 2000. The proportion of urine dipstick samples that tested positive for protein (defined as > or =1+) in adults from 20 to 69 years of age was determined. The analysis was performed using both algebraic and multicategorical models. Potential interactions between proteinuria and other major cardiovascular risk factors were investigated. RESULTS: A total of 46,523 adult survey participants were included in the analysis. In the general population, 9.2% had proteinuria. By univariate, multivariate, and multicategorical analysis, hypertension, diabetes, obesity, and age were strongly associated with the prevalence of proteinuria (P < 0.001). However, in Mexico, the specific distribution of age groups demonstrated that the absolute number of patients without hypertension that had proteinuria is not irrelevant. To identify 1 case of proteinuria, one would need to screen 3 persons with diabetes mellitus, 5 patients with hypertension without diabetes, or 6 persons over the age of 55 years. When proteinuria is present, the probability of having a noncommunicable chronic disease or other major cardiovascular risk factor is more than 85%. CONCLUSION: Proteinuria is prevalent. When considered together, dipstick-positive proteinuria, blood pressure level, body mass index > or =30 m(2)/kg, and abnormal fasting blood glucose measured on a single occasion identifies different segments of the population. Studies such as this may be a suitable initial clinical approach to general population screening for renal and cardiovascular risk stratification.

Adult↗
PubMed1997

A state-based immunization campaign: the New Mexico experience.

Hepatitis B prophylaxis in the form of immunization has become an increasingly effective protective measure across the United States. Various cohorts have been targeted and methodologies used by public health officials to attain optimal coverage of the population. New Mexico is in its third year of school-based hepatitis B immunization programs. New Mexico's approach to this issue is characterized by significant rates of participation (66% in middle schools and 56% in high schools), high vaccination series completion (88% in middle schools and 89% in high schools), and minimal financial investment (cost of vaccine). The "Roll Up Your Sleeves" campaign was piloted, modified, and adapted to New Mexico's multi-lingual and multi-cultural environment, resulting in these successes.

Adolescent↗
PubMed2005

Fluoride concentration of bottled water, tap water, and fluoridated salt from two communities in Mexico.

AIM: To determine fluoride levels in bottled water, tap water, and fluoridated salt from two communities in Mexico. DESIGN: Stratified random collection of water and salt samples from Mexico City and Veracruz, Mexico for fluoride analysis. METHODS: Samples were analysed using a combination fluoride ion-specific electrode. Results were compared using Student's t-test and mixed-model ANOVA. Water fluoride values were compared by type, community and collection area; salt fluoride values were compared by community and collection area. RESULTS: 197 tap water samples, 133 bottled water samples and 20 fluoridated salt samples were collected. The mean (+/- SD) fluoride content for all tap water was 0.20 +/- 0.17 microg F/g (ranging from 0.01 to 0.88 microg F/g) and 0.24 +/- 0.24 microg F/g for all bottled water (ranging from 0.01 to 2.80 microg F/g). This difference was not statistically significant. When results were analysed by city, the difference between tap water samples was statistically significant. Ten bottled water samples contained more than negligible fluoride (ranging from 0.7-2.8 microg F/g). Mean salt fluoride content was 230.0 +/- 49.8 microg F/g, which was within governmental regulation levels. CONCLUSION: Some water samples had amounts of fluoride exceeding the maximum recommended levels. Salt fluoride levels were within regulation limits. Monitoring of fluoride content of both bottled and tap water is strongly advised.

Analysis of Variance↗