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PubMedDate not supplied

Genotype and allele frequency of PAI-1 promoter polymorphism in healthy subjects from the west of Mexico. Association with biochemical and hematological parameters.

We investigated the genotype and allelic frequency of the -675 bp insertion/deletion polymorphism at the PAI-1 gene promoter, in healthy Mexican subjects. It was compared to the lipid profile and hematological parameters, and to other healthy worldwide populations. A Mexican population sample of 110 individuals was studied. Demographic data and clinical characteristics of the subjects were registered. Fasting lipid profile, serum glucose, fibrinogen, hematological parameters and leukocyte genomic DNA isolation from peripheral blood were performed in all the participants. Screening of the PAI-1 genotype was done by PCR and restriction analysis. Genotype 4G/4G, 4G/5G, 5G/5G frequency in Mexican healthy subjects was: 14.55%, 39.09%, 46.36%, respectively, whereas the allelic frequency for 5G allele was 65.9%. A significant lesser frequency for 4G allele and related genotypes (4G/4G and 4G/5G) was established in healthy subjects from Mexico, respect to all the compared populations. A particular genotype and allelic frequency of this PAI-1 polymorphism was established in Mexico. The clinical parameters were not associated according to each genotype of PAI-1.

Adult↗
PubMedDate not supplied

Ethics and communication between physicians and their patients with cancer, HIV/AIDS, and rheumatoid arthritis in Mexico.

BACKGROUND: Despite evidence that open communication concerning diagnosis of a disease substantially improves the doctor-patient relationship, in developing countries physicians often provide partial information. METHODS: We carried out a cross-sectional study with 379 physicians practicing at 11 hospitals in Mexico City and in the central Mexican state of Morelos to quantify their communication patterns with patients with cancer, HIV/AIDS, and rheumatoid arthritis. Communication patterns were defined as physician self-reported communication with patients with regard to their diagnosis, prognosis, and treatment. Logistic, ordinal, multivariate models were constructed for analysis. RESULTS: Assigning a high level of value to communication (odds ratio [OR] 5.5, 95% confidence interval [95% CI] 2.1-14.8), and bioethics training (OR 1.5, 95% CI 1.0-2.3) were principal predictors of explicit communication with cancer patients. We found a very strong association between explicit communication with HIV/AIDS patients and an accepting attitude of the physician toward death (OR 34.6, 95% CI 8.5-141.0). As for communication with rheumatoid arthritis patients, we observed an association between a very paternalistic attitude on the part of the physician (OR 6.8, 95% CI 1.9-24.1) and complete communication. CONCLUSIONS: In Mexico, physicians exercise power and authority over patients in an effort that they perceive as beneficial or preventing harm. In most cases, physicians do not seem to recognize or respect their patients' autonomy; therefore, communication is generally partial and vague. Our study established the need among physicians for bioethics and communication training. A discussion of this topic is necessary to transform the doctor-patient relationship and to establish a consensus for policies and norms for communication that benefits patients.

Adult↗
PubMedDate not supplied

Predictors of bone mineral density in female workers in Morelos State, Mexico.

BACKGROUND: Although several studies have identified factors associated with bone mineral density (BMD), little research is available on Mexican women. METHODS: A cross-sectional study was conducted in 1,622 female workers between 20 and 80 years of age at the Mexican Social Security Institute (IMSS), an integral part of the Mexican health system. It was carried out in Morelos, a Mexican state that borders Mexico City. Women were recruited to participate in this study from their workplaces. Body mass index (BMI) was measured and BMD was assessed using dual-energy x-ray absorptiometry of dominant forearm. Predictors of BMD (age, reproductive factors, BMI, diet, and physical activity) in pre- and postmenopausal women were assessed by questionnaire and analyzed using generalized additive models. RESULTS: In premenopausal women, older age, higher BMI, younger age at menarche, and greater vitamin D intake were associated with higher BMD (R(2)=0.06, null deviance reduction=6.9%). In postmenopausal women, determinants of BMD were older age, higher BMI, greater height, later initiation of menopause, longer time of use of hormonal replacement therapy (HRT), and greater calcium intake from dairy products (R(2)=0.39, null deviance reduction=40.7%). CONCLUSIONS: As observed in other populations, age, BMI, height, age at menopause, time of use of HRT, and calcium intake derived from dairy products in these Mexican women are factors associated with higher forearm BMD during postmenopausal period. Age, BMI, age at menarche, and vitamin D are associated with higher forearm BMD in premenopausal women. Some of these factors are not linearly associated with BMD. This was a limited population study carried out in a large group of female healthcare workers whose reproductive and lifestyle factors potentially agreed with those of female workers from urban areas of Mexico.

Adult↗
PubMedDate not supplied

Evaluation of iron overload in healthy adult residents of Mexico City.

BACKGROUND: We described the effects of age, gender and body mass index (BMI) on the prevalence of iron overload (IO) in blood donors from Mexico City. METHODS: A cross-sectional study of clinically healthy adults was performed. We evaluated serum ferritin (SF) concentration to allow us to establish groups with normal iron stores (SF >30 microg/L) and with IO (SF >200 microg/L and >300 microg/L for women and men), in the following ages groups: 18-29 years, 30-49 years, and 50-64 years, divided by gender. RESULTS: The study included 1757 subjects. Prevalence of IO was 12% in men and 4.8% in women, and prevalence increased in parallel with increasing age (15.6, 25.0 and 29.9% and 3.5, 5.2 and 9.6%, for men and women, respectively). Regression analysis showed that in men there was a significant association of SF and IO with age, BMI and recent blood donation (p <0.01). In women, no differences were seen for BMI and recent blood donation. CONCLUSIONS: IO is highly prevalent in blood donors residing in Mexico City, more so in men than in women. Age, gender and BMI had a positive association with iron stores. This report is the initial contribution towards the study of IO in the Mexican population.

Adolescent↗
PubMedDate not supplied

Epidemiology of type 2 diabetes in Mexico.

The epidemiology of diabetes in Mexico is reviewed. In less than four decades, diabetes has become the main health problem in Mexico. It is the principal cause of death in women and the second among men since the year 2000. It is the primary cause of premature retirement, blindness, and kidney failure. By the year 2025, close to 11.7 million Mexicans are expected to be diagnosed with diabetes. In the year 2000, diabetes was the 11th most frequent cause of hospitalization but the second most common cause of hospital mortality. The number of cases reported in children has also increased since 1995. The results of population-based, nationwide surveys have detected a 25% increment over a 7-year period. Fourteen percent of people with diabetes are <40 years of age, and a large proportion of patients have other conditions that determine the appearance of macrovascular complications and kidney failure. In addition, many cases do not reach treatment goals. In conclusion, the growing number of cases and the significant health burden imposed on affected subjects makes diabetes a disease that needs to be prevented. Well-planned strategies are urgently needed to modify the lifestyle of the population and to increase their physical activity. In addition, an enormous effort will be required to educate the population and physicians to improve the diagnosis and treatment of patients with diabetes.

Adult↗
PubMed2004

Psychosocial factors associated with poor diabetes self-care management in a specialized center in Mexico City.

To examine the relationship between demographic, clinical and psychosocial variables and diabetes self-care management in Mexican type 2 diabetic patients. Cross-sectional study of 176 consecutive patients with type 2 diabetes aged 30-75 years, attending a tertiary health-care center in Mexico City. A brief medical history and previously validated questionnaires were completed. The study group consisted of 64 males/112 females, aged 55 +/- 11 years, mean diabetes duration of 12 +/- 8 years and HbA1c of 9.0 +/- 2.0%, 78.4% reported following the correct dose of diabetes pills or insulin, 58% ate the recommended food portions, and 44.3% did exercise three or more times per week. A good adherence to these three recommendations was observed in only 26.1% of the patients. These patients considered as a group were characterized by a greater knowledge about the disease (P < 0.00001), regular home blood glucose monitoring (P < 0.01), an inner perception of better diabetes control (P = 0.007), good health (P = 0.004) and better communication with their physician (P < 0.02). A poor adherence to two or the three main diabetes care recommendations was associated with a depressive state (OR 2.38, 95% CI 1.1-4.9, P < 0.01) and a history of excessive alcohol intake (OR 4.03, 95% CI 1.1-21.0, P = 0.03). Poor adherence to standard diabetes care recommendations is frequently observed in patients with type 2 diabetes attending a specialized health care center in Mexico City. Depression must be identified and treated effectively.

Adult↗
PubMed2005

The effect of EDTA on Helianthus annuus uptake, selectivity, and translocation of heavy metals when grown in Ohio, New Mexico and Colombia soils.

The use of two EDTA concentrations for enhancing the bioavailability of cadmium, chromium, and nickel in three natural soils (Ohio, New Mexico and Colombia) was investigated. The resulting uptake, translocation and selectivity with Helianthus annuus after mobilization were also examined. In general, plants grown in the sandy-loam Ohio soil had a higher uptake that resulted in a selectivity and total metal content of Cd>Cr>>Ni and 0.73 mg and Cr>Cd>>Ni and 0.32 mg for 0.1 and 0.3 g kg-1 EDTA, respectively. With the silty-loam New Mexico soil, although the total metal uptake was not statistically different the EDTA level did alter the selectivity; Cd>Cr>>Ni (0.1 g kg-1 EDTA) and Cd>>Cr>Ni (0.3 g kg-1 EDTA). Conversely, with the Colombian (sandy clay loam) soil increasing the EDTA level resulted in a higher total metal uptake (0.62 mg) than the 0.1 g kg-1 (0.59 mg) treatment. For all three soils, the translocation of Cd was limited. Evaluating the mobile metal fraction with and without EDTA determined that the chelator was capable of overcoming mass transfer limitations associated with the expandable clay fraction in the soils. Root wash results and root biomass concentrations indicated that Cd sorption was occurring. Therefore limited Cd translocation was attributed to insufficient phytochelatin levels.

Biodegradation, Environmental↗
PubMed2005

Chemical characterization of extractable water soluble matter associated with PM10 from Mexico City during 2000.

We report the chemical composition of PM10-associated water-soluble species in Mexico City during the second semester of 2000. PM10 samples were collected at four ambient air quality monitoring sites in Mexico City. We determined soluble ions (chloride, nitrate, sulfate, ammonium, sodium, potassium), ionizable transition metals (Zn, Fe, Ti, Pb, Mn, V, Ni, Cr, Cu) and soluble protein. The higher PM(10) levels were observed in Xalostoc (45-174 microg m(-3)) and the lowest in Pedregal (19-54 microg m(-3)). The highest SO2 average concentrations were observed in Tlalnepantla, NO2 in Merced and O3 and NO(x) in Pedregal. The concentration range of soluble sulfate was 6.7-7.9 and 19-25.5 microg m(-3) for ammonium, and 14.8-29.19 for soluble V and 3.2-7.7 ng m(-3) for Ni, suggesting a higher contribution of combustion sources. PM-associated soluble protein levels varied between 0.038 and 0.169 mg m(-3), representing a readily inhalable constituent that could contribute to adverse outcomes. The higher levels for most parameters studied were observed during the cold dry season, particularly in December. A richer content of soluble metals was observed when they were expressed by mass/mass units rather than by air volume units. Significant correlations between Ni-V, Ni-SO4(-2), V-SO4(-2), V-SO2, Ni-SO2 suggest the same type of emission source. The variable soluble metal and ion concentrations were strongly influenced by the seasonal meteoclimatic conditions and the differential contribution of emission sources. Our data support the idea that PM10 mass concentration by itself does not provide a clear understanding of a local PM air pollution problem.

Air Pollutants↗
PubMed2005

Subsoil TPH and other petroleum fractions-contamination levels in an oil storage and distribution station in north-central Mexico.

Many oil industry related sites have become contaminated due to the activities characteristic of this industry, such as oil exploration and production, refining, and petro-chemistry. In Mexico, reported hydrocarbon spills for the year 2000 amounted to 185203, equivalent to 6252 tons (PEMEX, 2000). The first step for the remediation of these polluted sites is to assess the size and intensity of the oil contamination affecting the subsoil and groundwater, followed by a health risk assessment to establish clean up levels. The aim of this work was to characterize the soil and water in a north-central Mexico Oil Storage and Distribution Station (ODSS), in terms of TPHs, gasoline and diesel fractions, BTEX, PAHs, MTBE, and some metals. Besides, measurements of the explosivity index along the ODSS were made and we describe and discuss the risk health assessment analysis performed at the ODSS, as well as the recommendations arising from it. Considering soils with TPH concentrations higher than 2000 mg kg(-1), the contaminated areas corresponding to the railway zone is about 12776.5 m2, to the south of the storage tanks is about 6558 m2, and to the south of the filling tanks is about 783 m2. Total area to be treated is about 20107 m2 (volume of 20107 m3), considering 1m depth.

Environmental Exposure↗
PubMed2004

Do Mexico City pharmacy workers screen women for health risks when they sell oral contraceptive pills over-the-counter?

CONTEXT: In Mexico, oral contraceptives (OCs) are available to women over-the-counter in pharmacies. While past research has suggested that nonmedical providers, such as pharmacy workers, are capable of screening women for contraindications to OCs, little is known about their practices. METHODS: After selecting a 10% random sample of all pharmacies in Mexico City (n = 108), we surveyed the first available pharmacy worker to learn more about pharmacy workers' screening practices when selling OCs over-the-counter to women. RESULTS: While nearly all of the pharmacy workers surveyed had sold OCs without a prescription, only 31% reported asking women any questions before selling pills. Among those who asked questions, the most commonly asked questions were about other medications a woman was taking, about blood pressure and about alcohol intake. Pharmacy workers did not ask these questions consistently to all clients. CONCLUSION: Training pharmacy workers might be one strategy to improve screening of women for pill contraindications. However, pharmacy workers may lack the time and motivation to carry out such screening. An alternative strategy might be to better inform women to self-screen for pill contraindications.

Adolescent↗
PubMed2005

Early alcohol or tobacco onset and transition to other drug use among students in the state of Morelos, Mexico.

UNLABELLED: In this study, we explored if patterns in the transition from alcohol/tobacco in the Mexican State of Morelos, Mexico are similar to those observed in other countries. METHODS: The data were from a representative sample of youth age 11-21 years (n = 13,105), who participated in a paper-and-pencil survey in middle schools, high schools, and colleges in the State of Morelos, Mexico. Drug use was assessed via the standardized instrument mostly used in Mexican student surveys. Cox's models for discrete time-survival analyses, stratified by school and age group were used to estimate the risk of drug use in relation to age of alcohol and tobacco use initiation by gender, while accommodating the complex survey design. RESULTS: About 5% of the students were estimated to have used drugs in their life. Male early users of alcohol or tobacco were more likely to use other drugs, compared to students who did not have an early alcohol or tobacco onset. COMMENT: Further studies on social mechanisms might help to account for observed similarities in patterns of drug involvement in different countries, even in the context of important differences in rates of drug use.

Adolescent↗
PubMed2005

Methylenetetrahydrofolate reductase 677C>T polymorphism and gastric cancer susceptibility in Mexico.

This study investigated whether methylenetetrahydrofolate reductase MTHFR 677C>T polymorphism modified gastric cancer (GC) risk independently as well as in combination with folate intake and alcohol consumption. A hospital-based case-control study of 201 cases and 427 controls was conducted in three geographical areas of Mexico, between 1994 and 1996. The MTHFR 677T allele frequency was 51.0% in cases compared with 45.3% in controls. After controlling for dietary sources of folate, alcohol intake and other selected variables, a significant increase in GC risk was found among carriers of the 677TT genotype compared with those with the 677CC genotype (odds ratio (OR) 1.62, 95% confidence interval (CI) 1.00-2.59), with a significant trend (P = 0.048). There were no significant interactions between the MTHFR polymorphism and consumption of folate and alcohol. Our results suggest that the high prevalence of MTHFR 677T allele may be a contributor to the high rate of morbidity and mortality in GC in Mexico.

Adult↗
PubMed2005

Nutrient status and plant growth effects of forest soils in the Basin of Mexico.

The nutrient status of forest soils in the Mexico City Air Basin was evaluated by observing plant growth responses to fertilization with N, P or both nutrients combined. P deficiency was the most frequent condition for soil from two high pollution sites and N deficiency was greatest at a low N deposition site. Concentrations of Pb and Ni, and to a lesser extent Zn and Co, were higher at the high pollution sites. However, positive plant growth responses to P and sometimes to N, and results of wheat root elongation bioassays, suggest that heavy metal concentrations were not directly phytotoxic. Further studies are needed to determine if heavy metal toxicity to mycorrhizal symbionts of eucalyptus (Eucalyptus camaldulensis Dehnh.) from high pollution sites may explain the P deficiency and stunted growth. P deficiency is expected to limit the capacity for biotic N retention in N saturated forested watersheds in the Basin of Mexico dominated by Andisols.

Cobalt↗
PubMed2005

Organochlorine pesticides in the ambient air of Chiapas, Mexico.

Organochlorine (OC) pesticides were measured in the ambient air of Chiapas, Mexico during 2000-2001. Concentrations of some OC pesticides (DDTs, chlordanes, toxaphene) were elevated compared with levels in the Great Lakes region, while those of other pesticides were not (hexachlorocyclohexanes, dieldrin). While this suggests southern Mexico as a source region for the former group of chemicals, comparably high levels have also been reported in parts of the southern United States, where their suspected sources are soil emissions (DDTs, toxaphene) and termiticide usage (chlordane). Ratios of p,p'-DDT/p,p'-DDE and trans-chlordane/cis-chlordane/trans-nonachlor (TC/CC/TN) in Chiapas suggest a mixture of fresh and weathered sources, while congener profiles of toxaphene suggest emission of old residues from soils. This is supported by air parcel back trajectory analysis, which indicated that air masses over Chiapas at the time of sampling had previously passed over areas of continuing or recent use of some OC pesticides as well as areas of past use.

Air Pollutants↗
PubMed2006

Effect of acid rain on building material of the El Tajín archaeological zone in Veracruz, Mexico.

Three limestone slabs (approx. 20 cm2 each) were extracted from the El Tajin archaeological zone in Veracruz, Mexico. X-ray diffraction analysis revealed three components: calcite (81.2%), quartz (17.9%) and feldspar (0.9%). Calcite content by x-ray diffraction analysis was slightly higher than that determined by chemical reaction between the limestone sample and nitric acid. The latter analysis, carried out in triplicate, yielded a calcite content of 77.1%. Mean water absorption, density and porosity of the limestone samples were also determined. Dissolution of limestone samples was investigated using an experimental rainfall simulation chamber, in which the stone samples were irrigated with artificial rain matching the pH and the ionic composition with 40 rainfall samples collected at El Tajin from August 18, 2002, to April 9, 2003. According to calcium and bicarbonate net concentrations found in the effluent of the chamber, a chemical mechanism by which limestone at El Tajin is dissolved by acid rain is proposed. A model used to investigate the air transport pathways corresponding to precipitation events at El Tajin shows that air parcels come mainly from the Gulf of Mexico, although no directional preference is evident for acidic vs. non-acidic events.

Acid Rain↗
PubMed2004

Ozone, area social conditions, and mortality in Mexico City.

We investigated whether the association of daily mortality and ambient ozone differs by age and area social conditions of the region of residence using a time-series analysis. The study setting was metropolitan Mexico City, a high altitude city situated in a valley, with an estimated 20 million inhabitants, large socioeconomic gradients, and ozone levels frequently exceeding international standards. We stratified daily deaths by six census-derived socioeconomic indicators, based on characteristics of the county where decedents lived. We used Poisson regression to model the association between daily mortality and ozone levels (on the day of death and the previous day) in separate models, stratified by area socioeconomic level and age, and controlling for time trends and temperature. Ozone was positively associated with total mortality [0.65% increase per 10 ppb increment, 95% confidence interval (CI): 0.02%, 1.28%] and for mortality among those over age 65 [1.39% increase per 10 ppb increment, 95% CI: 0.51%, 2.28%]. Associations between ozone and all-age mortality did not show any consistent patterns according to socioeconomic gradients. We conclude that elderly people are at higher risk for ozone-associated mortality. Though county-level social indicators in Mexico City were not strong markers of vulnerability to ozone-associated acute mortality in this analysis, complex associations between individual and area-level factors may exist that would require additional data and further analyses to elucidate.

Age Factors↗
PubMed2004

Arsenic drinking water exposure and urinary excretion among adults in the Yaqui Valley, Sonora, Mexico.

The objective of this study was to determine arsenic exposure via drinking water and to characterize urinary arsenic excretion among adults in the Yaqui Valley, Sonora, Mexico. A cross-sectional study was conducted from July 2001 to May 2002. Study subjects were from the Yaqui Valley, Sonora, Mexico, residents of four towns with different arsenic concentrations in their drinking water. Arsenic exposure was estimated through water intake over 24 h. Arsenic excretion was assessed in the first morning void urine. Total arsenic concentrations and their species arsenate (As V), arsenite (As III), monomethyl arsenic (MMA), and dimethyl arsenic (DMA) were determined by HPLC/ICP-MS. The town of Esperanza with the highest arsenic concentration in water had the highest daily mean intake of arsenic through drinking water, the mean value was 65.5 microg/day. Positive correlation between total arsenic intake by drinking water/day and the total arsenic concentration in urine (r = 0.50, P < 0.001) was found. Arsenic excreted in urine ranged from 18.9 to 93.8 microg/L. The people from Esperanza had the highest geometric mean value of arsenic in urine, 65.1 microg/L, and it was statistically significantly different from those of the other towns (P < 0.005). DMA was the major arsenic species in urine (47.7-67.1%), followed by inorganic arsenic (16.4-25.4%), and MMA (7.5-15%). In comparison with other reports the DMA and MMA distribution was low, 47.7-55.6% and 7.5-9.7%, respectively, in the urine from the Yaqui Valley population (except the town of Cocorit). The difference in the proportion of urinary arsenic metabolites in those towns may be due to genetic polymorphisms in the As methylating enzymes of these populations.

Adolescent↗
PubMed2005

The avoidable health effects of air pollution in three Latin American cities: Santiago, São Paulo, and Mexico City.

Urban centers in Latin American often face high levels of air pollution as a result of economic and industrial growth. Decisions with regard to industry, transportation, and development will affect air pollution and health both in the short term and in the far future through climate change. We investigated the pollution health consequences of modest changes in fossil fuel use for three case study cities in Latin American: Mexico City, Mexico; Santiago, Chile; and São Paulo, Brazil. Annual levels of ozone and particulate matter were estimated from 2000 to 2020 for two emissions scenarios: (1) business-as-usual based on current emissions patterns and regulatory trends and (2) a control policy aimed at lowering air pollution emissions. The resulting air pollution levels were linked to health endpoints through concentration-response functions derived from epidemiological studies, using local studies where available. Results indicate that the air pollution control policy would have vast health benefits for each of the three cities, averting numerous adverse health outcomes including over 156,000 deaths, 4 million asthma attacks, 300,000 children's medical visits, and almost 48,000 cases of chronic bronchitis in the three cities over the 20-year period. The economic value of the avoided health impacts is roughly 21 to 165 billion Dollars (US). Sensitivity analysis shows that the control policy yields significant health and economic benefits even with relaxed assumptions with regard to population growth, pollutant concentrations for the control policy, concentration-response functions, and economic value of health outcomes. This research demonstrates the health and economic burden from air pollution in Latin American urban centers and the magnitude of health benefits from control policies.

Adolescent↗