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PubMedDate not supplied

[Variations in a 24-year period of colorectal and gastric cancer in Mexico].

OBJECTIVE: Gastric cancer (CG) and colorectal cancer (CCR) are the two most common neoplasms of the digestive system in the world. We performed a study to determine incidence and relation between CG and CCR in five hospitals in Mexico City. METHODS: Patients with admitted diagnosis of CG and CCR at Hospital General de Mexico, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Hospital Español de México, Centro Médico Nacional "20 de Noviembre" from the Instituto de Salud y Seguridad Social para Trabajadores del Estado, and Hospital Central Militar from January 1978 to December 2001 were studied. RESULTS: A total of 7,136 patients were studied. (CG 3,830, CCR 3,306). At Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" CG was the most common digestive neoplasm; from 1999, ratio was inverted to < 1. At Hospital General de México, from the beginning and until 1984, ratio was > 2, and later had an average of 1.31. For Hospital Español, ratio always was < 1 without changes. At Centro Médico Nacional "20 de Noviembre", initially CCR was more frequent, then CG, and finally CCR. At Hospital Central Militar ratio was constant, > CG. At the beginning, was global behavior > CG, ratio seemed to invert, but since 1998 CG/CCR ratio was < 1 and continued that way. CONCLUSIONS: In this study, we found that changes of CG/CCR ratio in a period of 24 years showed elevation of CCR incidence at five Mexican hospitals.

Adolescent↗
PubMed2003

Notes on Elaphoglossum (Lomariopsidaceae) section Polytrichia subsection Hybrida in Mexico and Central America.

In Elaphoglossum sect. Polytrichia subsect. Hybrida six new species are described: E. angustioblongum A. Rojas, E. baquianorum A. Rojas, E. cotoi A. Rojas, E. jinoteganum A. Rojas, E. neeanum A. Rojas and E. silencioanum A. Rojas. New combination is made for Elaphoglossum mexicanum (E. Fourn.) A. Rojas. Two species are reported: E. barbatum (H. Karst.) Hieron. and E. scolopendrifolium (Raddi) J. Sm. Two species are redefined: E. erinaceum (Fée) T. Moore and E. tambillense (Hook.) T. Moore. E. pallidum (Baker ex Jenman) C. Chr. is eliminated for Mexico and Central America. Of the new species only E. neeanum is present outside of the region. A key is given to those species in Mexico and Central America.

Central America↗
PubMed2003

[Morphologic variations in Blackfordia virginica (hydroidomedusae: Blackfordiidae) in coastal lagoons of Chiapas, Mexico].

Blackfordia virginica is an important hydromedusae in the zooplankton of coastal lagoons at Mexico. In order to contribute to their study, morphological variations of these species were analyzed in the system of coastal lagoons of Chiapas, Mexico. A total of 503 jellyfish were studied their sizes varied from 6.1 to 9.9 mm of umbrelar diameter. The number of marginal tentacles varied from 86 to 125. A 67.7% females and 30.2% males were recognized. Only 31 jellyfish (26 females and five males) presented morphological variations of ten different types and affected the number and form of the handles, radial channels and gonads. The size of the jellyfish and the number of tentacles reflected a correlation of 0.74.

Animals↗
PubMedDate not supplied

[Prevalence of allergic rhinitis in Durango, Mexico].

BACKGROUND: Allergic rhinitis has become the most frequent chronic disease of upper airways and its prevalence is increasing importantly in countries with systems of western life. OBJECTIVE: To determine the prevalence of allergic rhinitis and its subtypes in inhabitants of Durango, Mexico. MATERIAL AND METHODS: Through a descriptive, cross-sectional study, 1,320 inhabitants of Durango were studied. They were chosen randomly and accepted voluntarily to participate. A modification of the Middleton diary symptom questionnaire was used as a tool to determine the prevalence. RESULTS: The prevalence of allergic rhinitis in the general population was of 7.6% (95% CI 6.2-9.2). The prevalence of seasonal rhinitis was of 5.5% (95% CI 4.4-6.9), of perennial rhinitis, 2.1% (95% CI 1.4-3.0), for medical diagnosis, 4.3% (95% CI 3.4-5.8), and for survey, 3.3% (95% CI 2.4-4.4). The highest frequency was found in persons of 5-9 years old (12.5%) and in women (5.1%). CONCLUSIONS: The prevalence of allergic rhinitis in Durango, Mexico, is similar to the national mean prevalence, but lower than that reported in developed countries.

Adolescent↗
PubMedDate not supplied

[Historical perspective of smallpox in Mexico: emergence, elimination, and risk of reemergence due to bioterrorism].

Smallpox has been considered a disease of historical interest. However, given the 2001 terrorist events in the U.S. with intentional release of spores of Bacillus anthracis, and the current political worldwide agenda, the risk of bioterrorism has become a global public health concern. The risk of an intentional release of Variola virus as a biological weapon mandates a critical review of the historical impact of the disease in our country and the possible risk of its intentional reemergence. Smallpox was introduced into susceptible Indian populations in the Americas in the 16th century, contributing to the collapse of the Aztec Empire. Francisco Xavier Balmis start a vaccination campaign in the New World, and his efforts are considered the first eradication campaign of vaccine preventable diseases. Due to his efforts, smallpox was eliminated in Mexico in 1951. In the posteradication era, there is small but finite risk of intentional release of Variola virus. In response to this risk, Mexico has developed a comprehensive National preparedness plan. The impact of a new epidemic of smallpox will be considered a catastrophic event from both a historical and public health perspectives.

Bioterrorism↗
PubMedDate not supplied

[Facing the HIV/AIDS epidemic in Mexico: the response of the health sector].

OBJECTIVE: To analyze the challenges and accomplishments of the Mexican health system as it faced the HIV/AIDS epidemic over the 20 years since discovery of the virus. METHODS: A review of the relevant literature was done. The topics revised were: HIV/AIDS epidemiology, the early response of the health system and civil society, prevention and risk behaviors, care and treatment, and financing and resources allocation. DISCUSSION: In Mexico a rapid initial public response surely contributed to containing any early spread of the epidemic to select populations; whether that spread will continue to be contained is an open question. Sexual risk practices remain high not only among traditional risk populations but also among youth. Even though the epidemic remains concentrated in Mexico, principally among MSM and IDU, only 13% of public HIV prevention funds are directed to key populations at especially high risk of becoming infected or infecting others. In recent years antiretroviral coverage has increased rapidly with funding increasing from 30 to 367 million pesos from 2001 to 2003 and coverage now approaching 100%. Of all health spending on HIV/AIDS in the public sector, 82.4% is spent by the social security institutes and 17.6% by the Ministry of Health. The former provides medical care to about half of PLHA while the latter, in addition to caring for the other half, supports the large majority of prevention expenses. One of the challenges faced by the health system which has largely achieved universal antiretroviral coverage is how to provide quality care with appropriate monitoring, promotion of adherence and recognition and treatment of resistance and adverse effects--without dramatically increasing costs.

Acquired Immunodeficiency Syndrome↗
PubMed2004

[Management of the rectovaginal fistula. A review of five years at the Colon and Rectal Unit of the General Hospital of Mexico City].

BACKGROUND: Rectovaginal fistula, although infrequent, produces considerable discomfort to the patients and disables them in their social life. OBJECTIVES: To review and report the experience in the management of rectovaginal fistula in the Colon and Rectal Unit of the General Hospital of Mexico City, from January 1997 to December 2001. MATERIAL AND METHODS: A retrospective, observational and descriptive study was designed including all patients diagnosed with rectovaginal fistula, who had not been previously operated for this condition in the Colon and Rectal Unit of the General Hospital of Mexico City from January 1977 to December 2001. RESULTS: Thirty-eight patients were included, aged between 17 and 70 years with a mean age of 24. The etiology of the rectovaginal fistulas was: obstetric trauma in 21 patients (55.2%), post-surgical in 5 (13.1%), traumatic in 5 (13.1%), after radiotherapy in 5 (13.1%) and malignant in 2 (5.2%). DISCUSSION: Rectovaginal fistula treatment relies on fistula classification (simple or complex), its location, and damage or not to the sphincter mechanisms and prior surgical repair. CONCLUSIONS: The most frequent surgical approach was the creation of a fourth degree perineum laceration and reconstruction (45.7%), followed by the advancement flap (25.7%). Complex fistulas were handled with a stoma. The surgical approach of rectovaginal fistula must rely on etiologic, anatomic and physiologic basis.

Adolescent↗
PubMed2004

[Nutrition intervention actions in relief situations: report on 4 experiences in Mexico].

In the last years Mexico faced several natural and human provoked disasters. We choose the Mexico City earthquake, the Chichonal volcano eruption, the Guatemala war and its refugees and the Chiapas armed movement. In all of them the INCMNSZ surveillance system proposal has been applied. To establish the intervention we classified the emergencies according to its magnitude and localization. The intervention consisted in: immediate attention of serious cases, immunizations, quimioprofilaxis, personal hygiene, environment control, nutritional assessment and diet definition. The affected population attended were: in the eruption 4.500, in the earthquake 1.000, in the Guatemala war 19.000 and in the Chiapas movement 6.940. Population damaged by the eruption and the war received mass feeding; complementary feeding (vulnerable groups) and therapeutic feeding (people with tuberculosis and serious undernutrition). In the earthquake people received first, prepared food and later they were organized to bring, plan, prepare and distribute their food. In the Chiapas armed movement people received only special baby food. In all cases, population also receive nutritional information and only with the refugees and the Chiapas damaged people the local food production was promoted. We suggest evaluating every emergency program and share experiences to afford this type of situations in a better way.

Disasters↗
PubMedDate not supplied

[Risk factors associated with work-related accidents in the construction industry in the Valley of Mexico].

OBJECTIVE: Our aim was to describe construction-industry, work-related accident prevalence in, associated factors in, and potential impact on affiliated workers of the Mexican Institute of Social Security (Instituto Mexicano del Seguro Social, IMSS) in the Valley of Mexico. MATERIALS AND METHODS: Prevalent cases in a retrospective case-control design. CASES: These include 385 construction-industry workers who were found to have construction work-related accidents in 2001. Controls comprised 385 active construction-industry workers without work-related accident background paired by gender, workplace, and worksite. RESULTS: Work-related accident prevalence in construction workers was 5.5%; most important risk factors and etiology fraction (Ef) included the following: age 16-20 years odds ratio, OR = 1.58, 95% confidence interval (95% CI) 1.40-10.7, p = 0.001, Ef 0.36; eventual insurance, OR = 3.7, 95% CI, 2.16-26.45, p = 0.001), Ef, 0.72, and no training for job, OR = 5.3, 95% CI, 4.9-69.2, p = 0.01), Ef: 0.81. Variables not showing significance were included salary, work shift, and workday. CONCLUSIONS: Work-related accident prevalence maintains its preponderance in the Valley of Mexico construction industry; identified risk factors are potentially modifiable, among which job training acquires unquestionable relevance.

Accidents, Occupational↗
PubMedDate not supplied

[Estimates and trends of obesity prevalence through mortality rates associated of chronic diseases in Mexico].

The pandemy of obesity is affecting more than 300 millions of adults in the world. The trend is increasing. Diabetes, coronary hearth disease, hypertension, cerebrovascular disease and dyslipidemia are chronic diseases associated with obesity. The methodology of this paper is proposed as an alternative resource based in mortality data to quantify the magnitude of chronic diseases in developing countries. Deaths for Mexico registered in 2000, according to selected causes, were taken to derive indirectly the prevalence of obesity in years 2000, 2005, and 2010, both males and females > or = 35 years-old. In 2010, an estimation of 8 million of Mexican with obesity is made. This methodology is referred to be probed in the quantification and projection of chronic diseases. According with our estimation, we hope in Mexico at 2010 to have between 8 and 14 millions of people > or = 35 years-old with obesity.

Adolescent↗
PubMed2005

Evaluation of new external quality assessment guidelines involving random blinded rechecking of acid-fast bacilli smears in a pilot project setting in Mexico.

SETTING: Laboratories in Mexico that support the national tuberculosis (TB) control program have been involved in an acid-fast bacilli (AFB) microscopy external quality assurance program which includes rechecking 100% of smears identified as AFB-positive by the local laboratories and 10% of smears identified as AFB-negative. Very few errors have been detected in Mexico using non-random selection and unblinded rechecking of the slides. OBJECTIVE: To evaluate the results from a 1-year pilot program involving blinded rechecking of randomly selected AFB slides from local TB laboratories in two Mexican states and determine its feasibility for future implementation. DESIGN: To reduce potential bias, laboratory staff from the National TB Laboratory, Institute for Epidemiological Diagnosis and Reference (InDRE), performed quarterly statistical sampling of AFB smears and on-site evaluations in local laboratories in each state. AFB smears were rechecked at the respective state laboratories with discordant results resolved at InDRE. RESULTS: A significantly greater percentage of errors was detected on the randomly selected, blinded AFB smears than on the non-randomly selected, unblinded smears. CONCLUSION: Random blinded rechecking provides more accurate estimates of AFB microscopy results, resulting in improved diagnosis and monitoring of treatment response.

Bacteriological Techniques↗
PubMedDate not supplied

[Inconsistency in sun protection factor (SPF) index in Mexico. The case of sunscreens for oily skin].

BACKGROUND: In Mexico, information regardiing sunscreen protection is not widely accessible from sources other than manufacturers. OBJECTIVE: To assess the Sun Protection Factor (SPF) of 12, over the counter sunscreens for oily or acne-prone skin available in the Mexican market. SETTING: Dermatology Department. Autonomous University of San Luis Potosí, Mexico. SUBJECTS AND METHODS: Twenty healthy volunteers ofskin type III and IV were tested. Sunscreen SPFs were measured using solar simulated radiation according to FDA final monograph. RESULTS: SPFs ranged between 7.8 and 26.9. Overall SPFs determined by solar simulator showed values between 22% to 74% less than the one advertised in their labels. CONCLUSIONS: We warn about the potenital risk of SPF overestimation as many of'the sunscreens tested did not comply with their offered protection. A proper regulation is needed because sunscreens are considered cosmetic products and do not require clinical tests to verify their efficacy before marketing.

Adult↗
PubMedDate not supplied

[Acute pancreatitis: five year experience at the Hospital General de Mexico].

INTRODUCTION: In Mexico acute pancreatitis is an important cause of morbility and mortality. We here describe the characteristics of patients managed with that diagnosis at the Hospital General de Mexico. MATERIAL AND METHODS: Retrospective, descriptive and observational study. Patients with acute panrcreatitis were seen between January 1996 to December 2000. RESULTS: The acute pancreatitis prevalence found in the hospital setting was 5%. We identified 104 patients, 62% men, with mean age 37 yrs. In 74% ofcases seen, we made a correct early diagnosis upon admission. The biliary (49%) and the alcoholic (37%) were the most frequent causes. Abdominal pain was the most common symptom at onset (94%). High leukocyte count (78%), followed by serum lipase (74%) was the most sensitive laboratory test. Only 34% of patients studied had an adequate nutritional status. 54% of' patients presented severe pancreatitis. The mean number of hospital days was 17 and 44% required ICU management. Thirty five percent required surgery where necrosectomy was performed and a mortality of 67% was found. The total mortality rate was 21%. CONCLUSIONS: The correct clinical diagnosis of acute pancreatitis is frequent. It is a more common finding than severe pancreatitis, but it does not increase the morbility and mortality in our patient population.

Acute Disease↗
PubMedDate not supplied

[Intracerebral haemorrhage in a referral hospital in the central-western region of Mexico].

INTRODUCTION: Intracerebral haemorrhage (ICH) has received little attention in studies in Mexico. Isolated reports talk of high frequency, its importance as a disorder among young people, its being mainly located in the lobar regions and a high rate of recurrence. AIMS: The objective of this study was to characterise the clinical, radiological, therapeutic and prognostic spectrum of ICH in a general hospital in the central-western region of Mexico. PATIENTS AND METHODS: The study involved 270 consecutive patients over the age of 15 years with spontaneous ICH who were hospitalised in the Neurology and Neurosurgical Service in the Antiguo Hospital Civil de Guadalajara between the years 2000 and 2002. Their clinical history and progression was known at least on discharge from the hospital. RESULTS: The mean age was 63 years (12% under 40 years old) with no predominance according to gender (53% males). Arterial hypertension was the main risk factor in 69%, followed by obesity in 38%. There were no differences in the Glasgow administered on admission in three pre-established subgroups. The ICH was ganglionic in 64% of cases and lobar in 24%. Arterial hypertension was the principal cause of ICH in 76%. Ventricular aperture was noted in 53%. All the patients were treated in a general ward. Mortality in the acute phase occurred in 49%, although a poor progression was observed in 83%. Overall recurrence was 13%. Outpatient follow-up was poor. CONCLUSIONS: ICH shares most of the features reported in Anglo-Saxon series including aetiology and location. In our population, mortality and recurrence are high with important sequelae. The high frequency of ICH (40%) may represent a bias in the selection of hospitals.

Adolescent↗
PubMedDate not supplied

Hepatocellular carcinoma and hepatitis C in Mexico.

BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) has increased in many countries as a result of an increased frequency of hepatitis C virus (HCV) infection. In Mexico, the association of HCC to HCV infection has not been evaluated. This study aims to evaluate the epidemiological factors related to HCC in Mexican patients as well as the results of treatment. METHODOLOGY: A retrospective review of clinical files of patients with HCC diagnosed between May 1992 to July 2002 was performed. RESULTS: There were 63 males and 64 females with a median age of 57 years (range 17-82). Seventy-one patients were evaluated for hepatitis status. In 43 (60%) HCV was the etiological factor. Isolated HCV infection was present in 32 (45%), HCV infection and ethanol abuse was observed in 11 (15.5%). In six (8.4%) patients hepatitis B was the etiological factor. HCV and HBV infection were found in 9 (12.6%). HCV and HBV infection associated to ethanol abuse was present in one patient. Ethanol abuse alone was observed in six (8.4%) patients. The median size of the lesion was 8cm (range 3-20cm). Alpha-fetoprotein was measured in 113 patients and was higher than 500ng/dL in 60 (53%). Sixty-five patients received supportive measures. Sixty-two were treated. Eighteen were resected. Thirteen were treated with intraoperative large volume ethanol injection (ILVEI), 12 with chemotherapy and 19 with tamoxifen-talidomide. Patients without treatment had a median survival time of 11 months and patients who received treatment had a median survival time of 25.3 months. The median survival time in patients who received surgery was 26 months, the ILVEI group survival time was 18 months, the chemotherapy survival was 8.8 months, and the tamoxifen-talidomide survival time was 7 months. CONCLUSIONS: HCC is a rare neoplasm in Mexico and HCV infection is the main etiological factor. Surgical resection is the best form of treatment of HCC in our country. However, only 14% of the patients were candidates. For non-resectable lesions, ILVEI offers the best palliative results in our center.

Adolescent↗
PubMedDate not supplied

[Prevalence and risk factors for periodontal disease among preschool children in Mexico City].

UNLABELLED: Periodontal disease is one of the most frequent oral cavity diseases. Its main characteristic among pediatric patients is gingivitis. The aim of the present study was to determine the prevalence and severity of periodontal disease among preschool children living in an eastern suburb of Mexico City. STUDY DESIGN: We carried out a descriptive/observational study of 382 school age children. The following indexes were administered: IHOS, IPMA and IP. Risk factors for periodontal disease were analyzed. RESULTS: 70% of the children studied had periodontal disease. The index averages were: IHOS of 1.38+0.51; IPMA of 0.62+0.72 and IP of 0.51+0.42. Cervical cavities, restorations with cervical interference and eruption-exfoliation processes were associated with periodontal disease. Mild chronic gingivitis was the most prevalent. We must strengthen preventive programs aimed at improving oral health, hygienic and dietary habits among preschool children in Mexico.

Child↗
PubMed2005

[Medical insurance coverage in Mexico].

OBJECTIVE: To present estimates of health insurance coverage in Mexico and discuss the differences among some sources of information. MATERIAL AND METHODS: Based on a national survey performed in 2002, the percentage of insurance coverage was estimated by state, rural condition, and expenditure level. RESULTS: The percentage of the population without medical insurance is 59.9%. The main insurance institution is the Mexican Institute for Social Security (Instituto Mexicano del Seguro Social, IMSS), with a coverage of 29.5%. Private insurance agencies cover 1.5% of the total population. There are huge differences in insurance coverage by state, expenditure level and social exclusion level. CONCLUSIONS: Data on insurance coverage provided by Mexico's main social security institution differ from that obtained through population-based studies. Some of these differences may be due to probabilistic reasons and others to macroeconomic changes. However, these reasons had not been sufficiently explored. In depth studies are needed in order to explain the observed differences.

Data Collection↗
PubMed2005

[Catastrophic health expenditures in Mexico: magnitude, distribution and determinants].

OBJECTIVE: To describe the magnitude, distribution, and determinants of catastrophic health expenditures in Mexico. MATERIAL AND METHODS: The information source was the National Performance Assessment Survey and the methodology, the one developed by the World Health Organization for assessing fair financing. Households with catastrophic expenditures were defined as those with health expenditures over 30% of their ability to pay. Multivariate analysis by logistic and linear regression were used to identify the determinants of catastrophic expenditures. RESULTS: A total of 3.8% of the households incurred in catastrophic health expenditures. There were huge differences by state. The uninsured, poor, and rural households showed a higher impoverishment risk. Sixty percent of the catastrophic expenditures were attributable to outpatient care and medication. A 10% increase of insured households could result in a 9.6% decrease in catastrophic expenditures. Disability, adults 60 years of age and older, and pregnancy increased the probability of catastrophic expenditures. CONCLUSIONS: The insurance of older adults, pregnant women, and persons with disabilities could reduce catastrophic health expenditures in Mexico.

Adult↗