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PubMed1995

Fleas on gray foxes in New Mexico.

From April 1992 to April 1993, fleas were collected from 15 gray foxes, Urocyon cinereoargenteus Schreber, in New Mexico. Flea species collected were Cediopsylla inaequalis inaequalis Baker (14/15), Echidnophaga gallinacea (Westwood) (1/15), Euhoplopsyllus glacialis affinis Baker (10/15), Foxella ignota Baker (1/15), Pulex irritans (L.) (6/15), and Pulex simulans Baker (15/15). C. i. inaequalis and F. ignota are new host records for gray foxes. The collection of C. i. inaequalis, E. g. affinis, F. ignota, and P. simulans are new host records for New Mexico. Fleas on gray foxes in the Southwest are reviewed.

Animals↗
PubMed1999

Description and morphometric analysis of the eggs of Anopheles (Anopheles) vestitipennis (Diptera: Culcidae) from southern Mexico.

Light and scanning electron microscopy were used to compare the eggs of Anopheles vestitipennis Dyar & Knab females collected from human and animal baits in 9 villages of southern Mexico. An. vestitipennis eggs are boat-shaped, with lateral floats extending the length of the egg. Both the deck and dorsal surface are covered with hexagonal and pentagonal chorionic cells that contain round tubercles in the cell field. Crowns that enclose 3-5 lobed tubercles are present at both egg poles. By light microscopy, the mean length/width ratio of eggs of females caught at human bait were statistically different from those of females caught in horse-baited animal traps. In a regression tree model that included 19 egg attributes, the same egg groups could be separated by their posterior crown length/width ratio and mean anterior cell deck form factor (an index of their roundness). These findings support of the possible existence of 2 An. vestitipennis subpopulations with different host preferences in southern Mexico.

Animals↗
PubMed1997

Temporal trends in diabetes mortality among American Indians and Hispanics in New Mexico: birth cohort and period effects.

Rates of diabetes mortality are disproportionately high among ethnic minorities in the United States. To describe ethnic trends and cohort effects in diabetes mortality in New Mexico, the authors examined the trends in mortality rates for non-Hispanic whites. Hispanics, and American Indians in the state during the period 1958-1994. Age-specific rates were examined graphically to qualitatively describe the contribution of calendar period and birth cohort effects to changes in the rates. The authors also fit age-period-cohort models to these data. Age-adjusted diabetes mortality rates for American Indians and Hispanics surpassed rates for non-Hispanic whites for all but the earliest two time periods. In the 1993-1994 period, the age-adjusted mortality rate for American Indians was 3.8 times higher for men and 5.6 times higher for women than for their non-Hispanic white counterparts. Rates for American Indian men and women increased sharply over the 37-year period, by 565% and 1,105%, respectively. Mortality rates increased among Hispanics over the period of study but less rapidly than did rates among American Indians. Graphical analyses of age-specific rates were consistent with birth cohort effects among both American Indians and Hispanics and also with a period effect among American Indians. Results from age-period-cohort models indicate a birth cohort effect starting with the 1912 cohort in American Indians and the 1902 cohort in Hispanics. A period effect was present during the 1960s in American Indians. American Indians have experienced an epidemic rise in diabetes mortality in New Mexico; if current trends continue, diabetes may become the leading cause of mortality among American Indians in the state.

Adult↗
PubMed1998

Epidemiology of sarcopenia among the elderly in New Mexico.

Muscle mass decreases with age, leading to "sarcopenia," or low relative muscle mass, in elderly people. Sarcopenia is believed to be associated with metabolic, physiologic, and functional impairments and disability. Methods of estimating the prevalence of sarcopenia and its associated risks in elderly populations are lacking. Data from a population-based survey of 883 elderly Hispanic and non-Hispanic white men and women living in New Mexico (the New Mexico Elder Health Survey, 1993-1995) were analyzed to develop a method for estimating the prevalence of sarcopenia. An anthropometric equation for predicting appendicular skeletal muscle mass was developed from a random subsample (n = 199) of participants and was extended to the total sample. Sarcopenia was defined as appendicular skeletal muscle mass (kg)/height2 (m2) being less than two standard deviations below the mean of a young reference group. Prevalences increased from 13-24% in persons under 70 years of age to >50% in persons over 80 years of age, and were slightly greater in Hispanics than in non-Hispanic whites. Sarcopenia was significantly associated with self-reported physical disability in both men and women, independent of ethnicity, age, morbidity, obesity, income, and health behaviors. This study provides some of the first estimates of the extent of the public health problem posed by sarcopenia.

Adult↗
PubMedDate not supplied

Population genetics of Mexican Drosophila. I. Chromosomal variation in natural populations of Drosophila pseudoobscura from Central Mexico.

Drosophila pseudoobscura populations of Central Mexico are chromosomally highly polymorphic. Five gene arangements in the third chromosome are endemic, including the two newly described in the present article. The phylogenetic tree of the gene arrangements known in the species is shown in Figure 1. The ones found in Central Mexico all belong to the Santa Cruz "phylad", while in the northern part of the species area both Santa Cruz and Standard phylads are widespread. Some inferences concerning the evolutionary history of the species are presented.

Animals↗
PubMed1992

Trimethoprim/sulfamethoxazole remains active against enterotoxigenic Escherichia coli and Shigella species in Guadalajara, Mexico.

Bacterial isolates obtained from fecal cultures of U.S. adults in Guadalajara, Mexico, with diarrhea developing during the summers of 1987, 1988, and 1989 were tested for in vitro antimicrobial susceptibility. No resistance was seen among 220 enterotoxigenic Escherichia coli isolates nor among 89 Shigella strains to aztreonam, norfloxacin, ciprofloxacin, gentamicin, or furazolidone. High level (greater than 1000 micrograms/ml) resistance to trimethoprim/sulfamethoxazole (TMP/SMX) was found in 7% of E. coli and 3% of Shigella strains. Susceptibility patterns of 27 E. coli strains derived from fecal cultures of Mexican infants in Guadalajara with diarrhea during the same time period showed similar results, possibly reflecting the presence of a common microbial reservoir. The study serves as a baseline for newer antimicrobials (fluoroquinolones and aztreonam) where no resistance is currently seen and provides evidence of the continuing value of TMP/SMX for therapy of diarrhea among travelers to Gudalajara and perhaps other areas of Mexico.

Diarrhea↗
PubMed1996

A survey of graduates in practice from the University of New Mexico's conventional and community-oriented, problem-based tracks.

PURPOSE: To survey graduates in practice from the first four classes of the University of New Mexico School of Medicine's (UNMSOM's) parallel curricular tracks, and compare data about the graduates' practice patterns, learning behaviors, and satisfaction with the profession of medicine. METHOD: Between 1979 and 1993, the UNMSOM had two tracks for the first two years of medical school: a conventional track and the Primary Care Curriculum (PCC), a community-oriented, problem-based track. In 1990, a survey was conducted of the 140 graduates from the first four classes (1983-1986) who had completed their postgraduate training: 40 from the PCC and 100 from the conventional track. Statistical methods included two-way analyses of variance, logistic regression, and chi-square, adjusted by Bonferroni methods. Comparisons between tracks are reported after adjustments were made for specialty effects. RESULTS: Thirty-three graduates (83%) from the PCC and 87 (87%) from the conventional tracks responded. The PCC graduates were much more likely to work in medically underserved areas, practice in publicly funded health care settings, and care for non-paying patients. The PCC graduates more often identified patient problems and curiosity as providing motivation for their learning. They more frequently studied clinical medicine and community health topics and spent time in community activities. The PCC graduates felt better prepared for practice by their undergraduate medical education. There was no difference between the graduates of the two tracks in the sizes of the populations in which they practiced, in the criteria they used for deciding on referrals to other physicians, in the ranges of community resource utilization, or in the degrees of satisfaction within their chosen professions. Large percentages of graduates from both tracks (67% conventional and 79% PCC) considered themselves to be practicing either primary care or a combination of primary care and non-primary care. In addition, 38% of all the graduates practiced in the state of New Mexico. More PCC graduates chose careers in family practice; however, no significant difference was found in a comparison between the proportions of PCC and conventional-track graduates who chose primary care careers. CONCLUSION: Track differences favorable to the PCC were evident in relation to the two major goals established by the program: to attract graduates to careers in primary care in rural and underserved areas and to provide graduates with self-directed, lifelong learning skills. Some expected track effects were not found.

Academic Medical Centers↗
PubMed1998

Attitudes of physicians practicing in New Mexico toward gay men and lesbians in the profession.

PURPOSE: To examine the attitudes of physicians practicing in New Mexico toward gay and lesbian medical students, house officers, and physician colleagues. METHOD: In May 1996, the authors mailed a questionnaire with demographic and attitude questions to 1,949 non-federally employed physicians practicing in New Mexico. The questionnaire consisted of questions dealing with medical school admission, residency training, and referrals to colleagues. The response rate was 53.6%. RESULTS: Of all the responding physicians, 4.3% would refuse medical school admission to applicants known to be gay or lesbian. Respondents were most opposed to gay and lesbian physicians' seeking residency training in obstetrics and gynecology (10.1%), and least opposed to their seeking residency training in radiology (4.3%). Disclosure of homosexual orientation would also threaten referrals to gay and lesbian obstetrician-gynecologists (11.4%) more than to gay or lesbian physicians in other specialties. CONCLUSION: Physicians' attitudes toward gay and lesbian medical students, house officers, and physician colleagues seem to have improved considerably from those reported previously in the literature. However, gay men and lesbians in medicine continue to face opposition in their medical training and in their pursuit of specialty practice.

Attitude of Health Personnel↗
PubMed1992

The spectrum of clinical and pathological manifestations of AIDS in a consecutive series of autopsied patients in Mexico.

OBJECTIVE: Little is known about the clinical profile of AIDS in Latin American populations. This study characterizes the clinical and pathological manifestations of AIDS in a representative series of Mexican AIDS patients at autopsy. DESIGN: The clinical and pathological findings were abstracted retrospectively for a sequential series of autopsied AIDS patients. SETTING: Autopsies were conducted at the four major tertiary level hospitals that serve the majority of AIDS patients in Mexico City. PATIENTS: Subjects included 177 consecutive patients diagnosed with AIDS between March 1984 and January 1989 who subsequently died and were autopsied in the same period in the study hospitals. MAIN OUTCOME MEASURES: Demographic characteristics, including age, gender, residence, socioeconomic status, and risk group; clinical presentation and autopsy findings, including opportunistic infections and malignancies. RESULTS: Sixty per cent of the AIDS patients presented with wasting syndrome. The most common infections were cytomegalovirus (69%), tuberculosis (25%), and Pneumocystis carinii pneumonia (24%). Central nervous system infections were also common and included toxoplasmosis (19%) and cryptococcoses (10%). Kaposi's sarcoma was present in 30% of cases and non-Hodgkin's lymphoma in 9%. CONCLUSION: Clinical manifestation, and types and frequency of opportunistic infections in our Mexican AIDS patients were more similar to those seen in AIDS patients in Africa and Haiti than in the United States and Europe. These findings suggest that the AIDS epidemic in Mexico has an 'intermediate' pattern and may be a prototype for Latin American countries.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Health implications of radionuclide levels in cattle raised near U mining and milling facilities in Ambrosia Lake, New Mexico.

This study was conducted to determine radionuclide tissue levels in cattle raised near U mining and milling facilities. Ambrosia Lake, New Mexico, has been the site of extensive U mining for 30 y and contains several underground U mines, a processing mill, and two large U tailings piles. Ten cows were purchased from two grazing areas in Ambrosia Lake and ten control animals were purchased from Crownpoint, New Mexico. Muscle, liver, kidney, and bone tissue taken from these animals, and environmental samples, including water, grasses and soil collected from the animals' grazing areas, were analyzed for 238U, 234U, 230Th, 226Ra, 210Pb, and 210Po. Mean radionuclide levels in cattle tissue and environmental samples from Ambrosia Lake were higher in almost every comparison than those found in respective controls. Liver and kidney tissues were particularly elevated in 226Ra and 210Po. Radiation dose commitments from eating cattle tissue with these radionuclide concentrations were calculated. We concluded that the health risk to the public from eating exposed cattle is minimal, unless large amounts of this tissue, especially liver and kidney, are ingested.

Animals↗
PubMed1997

Issues in establishing an aerosol radiological baseline for the waste isolation pilot plant near Carlsbad, New Mexico.

The Department of Energy has constructed a deep geologic repository for defense transuranic waste disposal. The Waste Isolation Pilot Plant, located in Southeastern New Mexico, is slated to receive transuranic waste by truck delivery beginning in 1998. The Environmental Evaluation Group (EEG) provides an independent evaluation of the impact on the health and environment in New Mexico of the WIPP project. Since 1985, the EEG has operated a network of air monitoring sites around WIPP and in nearby communities. The radionuclide concentration data from these air samples have been assembled into a useful baseline data base after resolution of a number of methodological and quality assurance issues. Investigation thresholds for the principal radionuclides have been calculated from combined data collected from several sites. These action levels will provide a critical quantitative basis for decisions of whether future airborne radionuclide measurements are attributable to accidental releases.

Air Pollutants, Radioactive↗
PubMed2003

The Changing Clinical Spectrum of Human Immunodeficiency Virus (HIV)-Related Oral Lesions in 1,000 Consecutive Patients: A 12-Year Study in a Referral Center in Mexico.

In developing countries, the variations in the clinical spectrum of human immunodeficiency virus (HIV)-related oral lesions over time, and the possible effects of antiretroviral therapy, have not been described. In this study we evaluate the clinical spectrum of oral lesions in a series of HIV-infected patients when first examined at the acquired immunodeficiency syndrome (AIDS) clinic of a tertiary care institution in Mexico City, Mexico, and the changes observed over 12 years. All HIV-infected adult patients had an oral examination performed by specialists in oral pathology and medicine who used established clinical diagnostic criteria for oral lesions. Four periods were defined according to the evolving pattern of antiretroviral use: the first 2 were before the introduction of highly active antiretroviral therapy (HAART) and the last 2 were during more established use of HAART. For the statistical analysis the chi-square test for contingency tables and the chi-square test for trend were utilized. For dimensional variables, except age, the Kruskal-Wallis or Mann-Whitney rank sum tests were used when applicable and trend was tested with the Spearman correlation coefficient. Age was tested through analysis of variance (ANOVA) and linear regression analysis. Alpha value was set at p = 0.05 for each test. In the 12-year study, 1,000 HIV-infected patients were included (87.9% male). At the baseline examination, oral lesions strongly associated with HIV were present in 47.1% of HIV-infected patients. Oral candidosis (31.6%), hairy leukoplakia (22.6%), erythematous candidosis (21.0%), and pseudomembranous candidosis (15.8%) were the most frequent lesions. Oral Kaposi sarcoma (2.3%), HIV-associated periodontal disease (1.7%), and oral non-Hodgkin lymphoma (0.1%) were less frequent. HIV-related oral lesions decreased systematically-by half during the course of the 4 study periods (p < 0.001). Except for Kaposi sarcoma, all oral lesions strongly associated with HIV showed a trend to decrease significantly during the study period. No apparent variation in the occurrence of salivary gland disease or human papillomavirus-associated oral lesions was found. A significant trend to a lower prevalence was observed in the group of patients who were already taking antiretroviral therapy, non-HAART and HAART (p < 0.001 and p = 0.004, respectively). Only a discrete reduction, barely significant, was noted among untreated patients (p = 0.060). By Period IV (1999-2001), those who received HAART showed the lowest prevalence of oral lesions strongly associated with HIV (p < 0.001). Patients with oral lesions strongly associated with HIV had significantly lower median CD4+ counts and higher viral loads than those without oral lesions strongly associated with HIV (p < 0.001 and p = 0.005, respectively). When CD4+ counts were correlated with prevalence of oral candidosis, a consistently negative association was found; this association prevailed even after the study group was partitioned according to period. In this selected cohort of 1,000 patients with HIV infection, the clinical spectrum of HIV-related oral lesions has changed over the 12-year study, with a decreased prevalence of most oral lesions. Our findings probably represent improvements in medical care of HIV-infected persons, earlier detection of HIV-infected patients at the AIDS clinic, the increasing use of prophylactic drugs to prevent secondary AIDS-related opportunistic infections, and, perhaps most important, the availability of potent antiretroviral therapy in recent years, since the introduction of HAART.

Adult↗
PubMedDate not supplied

Prevalence, incidence, and determinants of syphilis in female commercial sex workers in Mexico City.

GOAL: To determine the prevalence and the incidence of serologic markers for syphilis, and the characteristics associated with the risk of infection in female commercial sex workers in Mexico City. To identify female commercial sex workers at greater risk of infection with syphilis. STUDY DESIGN: The authors performed a cross-sectional study of 3,100 female commercial sex workers who sought human immunodeficiency virus testing at a National Council on AIDS clinic between January 1992 and April 1993. The authors collected information about socioeconomic and demographic characteristics, history of sexually transmitted diseases, sexual practices, and preventive measures against such diseases. All of the women provided a blood sample for identification of infection markers and in a subgroup of 1,802 women, repeat samples were obtained to estimate the rate of seroconversion to syphilis. RESULTS: Prevalence of syphilis was 8.2%, with an incidence of 2.4 per 100 person years. A positive linear relation between age and time working in commercial sex and prevalence of infection markers was observed. Women with less education, born in states other than Mexico City, and who worked on the street had significantly greater risks of infection with syphilis. CONCLUSIONS: Frequency of infection by both estimators is relatively low in the women studied. Characteristics related with periods of exposure such as age and time working in commercial sex, as well as socioeconomic and demographic characteristics, such as place of birth, education, and type of work site, were significantly related to the frequency of infection.

Adult↗
PubMed2001

Human papillomavirus: a highly prevalent sexually transmitted disease agent among female sex workers from Mexico City.

BACKGROUND: Cervical cancer, a human papillomavirus (HPV)-caused neoplasia, is highly prevalent in Mexico. GOAL: To determine the prevalence of HPV infection in female sex workers (FSW) from Mexico City and to assess the association between HPV infection and the characteristics of these women. STUDY DESIGN: A questionnaire was applied to 495 FSW. Cervical cell specimens were obtained for DNA amplification and hybridization to detect 27 HPV types. A risk factor analysis was performed. RESULTS: The overall prevalence of HPV infection was 48.9%. The prevalence of high-risk HPV types was 43%, whereas that of low-risk types was 24.6%. A total of 18.8% of study participants was infected with both high-risk and low-risk HPV types, and 28.5% were infected with two or more HPV types. Younger age and failure to use a condom were independently associated HPV risks (odds ratio, 7.3 and 2.3; 95% CI, 3.5-15.0 and 1.2-4.4, respectively). CONCLUSIONS: Infection with high-risk and multiple HPV types is high among Mexican FSW. This study corroborated a higher infection rate in younger women. A higher risk of HPV infection is also observed in women who have been involved with sex work for less than 1 year. However, condom use showed a protective effect against HPV infection.

Adolescent↗
PubMedDate not supplied

The disparity change score: a new methodology to examine health disparities in New Mexico.

OBJECTIVES: One overarching goal of Healthy People 2010 is to eliminate health disparities. Reducing disparities improves the overall health status of a population but is a lengthy process. The disparity change score (DCS) is a method for tracking health disparities over time. METHODS: Rates, rate ratios, and DCSs were calculated to track disparities during two time periods by sex, race/ethnicity, education, and income for key health indicators. Time periods were 10 years apart for all death indicators; length between time periods varied for other indicators depending on data collection systems. RESULTS: Sex-, race/ethnicity-, education-, and income-based disparities and disparity changes for New Mexico were identified. In general, males, American Indians, and those with the lowest income and education experienced the greatest health disparities. Five disparities that are worsening were identified for targeted interventions, mainly for males (firearm-related death and suicide) and American Indians (diabetes death and influenza/pneumonia death), but also for white non-Hispanics (drug-related death). CONCLUSIONS: Examining disparities at one point in time discounts disparity change over time. The DCS can help identify large disparities that are worsening and toward which resources for targeted interventions can be redirected. New Mexico should consider interventions for the five key disparities identified in this study.

Ethnicity↗
PubMed2006

Economic impact of antiretroviral therapy prescription decisions in the context of rapid scaling-up of access to treatment: lessons from Mexico.

BACKGROUND: Mexico started scaling-up access to antiretroviral treatment in the late 1990s. Even though the Mexican Health System enrolled patients at impressive speed, in the initial years important aspects of the quality of care were overlooked. OBJECTIVE: To describe antiretroviral prescribing and adherence practices in Mexico during initial scaling-up of antiretroviral treatment in comparison to national treatment guidelines and to estimate the associated economic cost. METHODS: Eleven public sector hospitals provided detailed patient chart data. Monthly observations formed the basis of scenarios aligned by calendar month and by month before and after initiation of triple therapy. The scenarios varied by extent of prescription refill, adherence levels, and compliance with national treatment guidelines. RESULTS: Antiretroviral therapy prescription practices were largely inconsistent with published guidelines. Non-recommended combinations were prescribed to between 54 and 79% patients-months per year. Additionally, more than 50% of patients experienced four to 13 changes in treatment. Modeling of the economic impact of treatment practices showed that it would have been possible to effectively treat the same number of patients at the same or lower cost per patient. CONCLUSIONS: In addition to dispensing drugs, countries scaling-up antiretroviral therapy must find ways to ensure consistent drug supply, appropriate prescription practices and effective levels of adherence. Failing to do so will seriously reduce treatment effectiveness, greatly increasing the cost per unit of health benefit. With very low levels of effective adherence patients may even be harmed and the spread of multi-drug resistant virus facilitated.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Air pollution and heart rate variability among the elderly in Mexico City.

BACKGROUND: Suspended particles and ozone have been associated with varying degrees of cardiac autonomic dysfunction. METHODS: In Mexico City, residents from a nursing home underwent heart rate variability analysis every other day for 3 months. Indoor and outdoor PM2.5 (particulate matter less than 2.5 mm in diameter) were measured daily at the nursing home. Levels of ozone and other atmospheric pollutants were obtained from a nearby automated monitoring station. RESULTS: Of the initial 42 screened participants, 34 (81%) were followed during the study period. The 24-hour average levels of indoor PM2.5 ranged from 15 to 67 micro g/m3, and outdoor PM2.5 ranged from 9 to 87 micro g/m3. Daily 1-hour maximum ozone levels ranged from 47 to 228 ppb. After adjusting for age and heart rate, we observed a strong decrease in the high frequency component of heart rate variability and the average 24-hour concentrations of PM2.5. Participants with hypertension had considerably larger reductions in their HF-HRV (high frequency-heart rate variability) component in relation to both ozone and PM2.5 exposure. CONCLUSIONS: Our results suggest that ambient levels of PM2.5 and ozone can reduce the high-frequency component of heart rate variability in elderly subjects living in Mexico City and that subjects with underlying hypertension are particularly susceptible to this effect.

Aged↗