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PubMedDate not supplied

[The prevalence of non-insulin-dependent diabetes mellitus and the associated risk factors in a population of Mexico, D. F].

Non-insulin-dependent diabetes mellitus (NIDDM) is a chronic disabling disease, that shortens length of life and implies a high burden for a community. Its prevalence goes from 0 per cent in Papua, New Guinea to 34 per cent in Pima Indians. There are very few prevalence studies in Mexico, and the strength of association of the known risk factors with the occurrence of the disease is not established. A prevalence cross sectional study was carried out with users of a first level medical care unit, with a meter measure of capillary glucose levels. Those with a previous diagnosis of diabetes or whose capillary glucose level were 200 mg or over were considered diabetics. Hyperglycemia was when the levels were recorded between 121 and 199 mg. The crude prevalence of NIDDM was 5.6 per cent (CI 95% 4.5-6.8), With almost no sex difference. Hyperglycemia prevalence was 2.9 per cent (CI 95% 2.0-3.7). Age was the main risk factor for the development of NIDDM. Those between 40 and 59 years showed a high risk (OR 10.8; CI 95% 5.4-22.0; p < 0.0001), and it was greater for the 60 years or elder (OR 20.6; CI 95% 9.8-44.1; p < 0.0001). Weight was also an important risk factor, with a 2.7 fold greater risk for obese persons (CI 95% 1.6-4.6; p < 0.0001). Other, risk factors were familiar history of diabetes (OR 1.5; CI 95% 0.9-2.3; p = 0.096), and overcrowding (OR 1.9; CI 95% 1.0-3.4; p = 0.03). In order to analyze independently each variable, a logistic regression model was applied, and a similar strength of association was observed for the crude model, but for obesity whose effect was modified by age. When only new cases were analyzed in the former model, the association with obesity was maintained. There is a need to develop prevalence studies of NIDDM in Mexico and to measure the strength of association with the known and the not jet well known risk factors of this disease in order to establish health policies according to the Mexican reality.

Adult↗
PubMedDate not supplied

Takayasu's arteritis in Mexico: a clinical review of 44 consecutive cases.

OBJECTIVES: To review our experience in clinical diagnosis of the non-specific arteritis called Takayasu's arteritis (TA), and to assess its possible relationship with previous mycobacterial infections as judged by delayed hypersensitivity skin test. METHODS: We examined 44 consecutive patients in Mexico City. All of them fulfilled the ACR criteria for the classification of TA and had a characteristic panaortogram in the absence of any other arterial or systemic disease. RESULTS: Forty-three of our patients were Mexican mestizos; only one had a Caucasian appearance. 38 were women, and the age at diagnosis ranged from 15 to 64 years with a mean of 32 and a median of 35. Age at onset of the symptoms was under 30 years in most cases. Five patients had type I disease, and 4 had type II. Most had a diffuse arteritis (type III), and in seven cases involvement of the pulmonary artery (type IV) was recognized. All patients showed abnormal peripheral pulses and blood pressure differences, 35 had systemic arterial hypertension and 7 pulmonary hypertension. A noisy vascular auscultation was very common and cardiac ailments were also found in many cases. Systemic complaints such as fever, weight loss and malaise were present in the active stages of the disease. Arthritis did occur in a single case, arthralgia was frequent and inflammatory nodules involving the shin, perimalleolar area, and the antero-external surface of the distal leg were also common. Polyclonal hypergammaglobulinemia was a frequent finding in active and inactive cases; leukocytosis with neutrophilia, accelerated ESR and high fibrinogen, however, did occur when the disease was active. Eight of our patients had a previous diagnosis of tuberculosis, and 81% developed a delayed skin reactivity to PPD (2U old tuberculin). None had a bacteriologic diagnosis of tuberculosis or mycobacterial disease. CONCLUSION: Non-specific arteritis, or Takayasu's disease, frequently affects young women of colored race in Mexico. Late diagnosis is common and cardiovascular features dominate the clinical picture. Arterial compromise is widespread and may involve the pulmonary artery and its branches. Most cases are inactive and morbidity results from systemic arterial hypertension and heart disease; active cases have systemic complaints and laboratory abnormalities suggestive of ongoing inflammation. The close relationship between Takayasu's arteritis and previous contact with Mycobacterium tuberculosis was again confirmed in our series, although further studies are necessary to clarify this probable relationship.

Adolescent↗
PubMed1994

[Diabetes in Mexico: what does the National Health Survey tell us?].

The purpose of this monograph is to describe the sociodemographic and health characteristics of individuals who identified themselves as diabetics (through self-notification) in a national health survey that was conducted in Mexico in 1988 and in which information about more than 200,000 persons was collected by interviewing an adult member of each household. Of the population surveyed, 1.2% stated being diabetic, and it was noted that the frequency of the disease increased with age and socioeconomic status and that it was 30% higher in women than in men. Diabetics had higher notification rates for hypertension, heart disease, and blindness than the rest of the population. Twenty percent of diabetic patients and 12% of nondiabetic individuals smoked. People with diabetes consulted physicians twice as often as nondiabetics and their chances of being hospitalized were four times higher. At the end we discuss the limitations and possible biases of self-notification as a method for detecting diabetics. Finally we conclude that diabetes is an important health problem in Mexico and that it warrants more attention from epidemiologists and other public health specialists.

Adolescent↗
PubMed1994

[Asthma mortality trends in Mexico].

The objective of this cross-sectional study was to estimate mortality and morbidity from asthma in Mexico by federative entity (state) of residence, age, and sex during the period between 1960 and 1988. Statistics published by the National Institute of Statistics, Geography, and Information Science were reviewed, as were vital statistics and information from other sources. Data were selected on mortality, hospital admissions, and outpatient visits, as well as population by federative entity, age, and sex. Mortality and morbidity rates were adjusted for age using the direct method. From 1960 to 1987, mortality decreased for both sexes. The groups with the highest asthma mortality were those under 4 years of age and those over 50. From 1960 to the present, the state with the highest mortality was Tlaxcala. Hospitalizations increased from 10 to 140 per 100,000 population for the country as a whole. When both outpatient visits and hospitalizations were considered, the morbidity rates rose from 180 to 203.4 per 100,000 between 1960 and 1970. In 1970, hospital morbidity was higher among males than females. From 1960 up to the 1990s, the highest rates of hospitalization and outpatient visits were registered among those under 4 and those over 60. The states with the highest asthma hospitalization rates were Morelos, Baja California Sur, Nuevo León, Durango, and Tamaulipas. It is concluded that asthma mortality in Mexico is showing a downward trend, while morbidity is increasing considerably, especially among adolescents.

Adolescent↗
PubMedDate not supplied

[Epidemiologic setting of the agricultural use of sewage: Valle del Mezquital, Mexico].

Wastewater from Mexico City is used to irrigate over 85,000 hectares mainly of fodder and cereal crops in the Mezquital Valley. A cross-sectional study method is being used to test the impact of exposure to raw wastewater and wastewater from storage reservoirs on diarrheal disease and parasitic infections in farmworkers and their families. The study population in the rainy season survey included 1,900 households: 680 households where the farmworker is exposed to untreated wastewater (exposed group), 520 households exposed to reservoir water (semiexposed group), and 700 households where the farmworker practices rain-fed agriculture (control group). Preliminary analysis of the data from the rainy season study (dry season study in progress) has been carried out. Current information indicates that the risk of Ascaris lumbricoides infection is much higher in the exposed group than in the control group (95% CL = 2.9-10.8). According to the procedures employed Entamoeba histolytica infection was more frequent among subjects aged 5 to 14 years from households exposed to raw wastewater, than among subjects of the same ages belonging to the control group (95% CL = 1.07-1.72). When diarrheal disease rates were analyzed, children under 5 years from exposed households had a significantly higher prevalence than controls (95% CL = 1.03-1.64). The final results of this study are expected to aid decisions within the National Wastewater Reuse Programme in Mexico.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[An opinion survey on abortion in Mexico City].

In view of the lack of information regarding abortion attitudes in Mexico, an abortion opinion survey was conducted in Mexico City among 387 women and 338 men. Respondents were asked if they agreed with a woman's abortion decision under seven different circumstances. Affirmative responses were analyzed by respondents' sociodemographic and reproductive health characteristics and a scale was created to measure respondents' overall attitudes toward abortion. Greatest support was expressed for a woman's right to an abortion, and to abortion in cases of fetal defect, threat to the mother's life, and rape. On the attitudinal scale, however, respondents generally disapproved abortion. Male respondents were more likely than female respondents to support a woman's abortion decision. Males in union, females not in union, respondents over thirty years of age, those with more than primary school education, those with fewer pregnancies, those with no history of child mortality, and those with a history of or experience with abortion, were also more likely to support an abortion decision.

Abortion, Legal↗
PubMed1994

Experimental infection of Contracaecum multipapillatum (Nematoda: Anisakinae) from Mexico in the domestic cat.

Juveniles of Contracaecum multipapillatum infected the Mayan cichlid (Cichlasoma urophthalmus) and adults infected the olivaceous cormorant (Phalacrocorax olivaceus) and the great egret (Casmerodius albus) in the coastal lagoon at Celestun, State of Yucatan, Mexico. All are new host records, and, even though the geographic locality record of Mexico for the species has not been published, unidentified but presumably conspecific specimens have been reported from there. When juveniles of C. multipapillatum were fed to a kitten, but not rats, ducks, or chickens, they developed into adults. Measurements and morphological data are provided on the specimens from the kitten. Development of an avian ascaridoid in the intestine of a mammal increases the potential of this widespread species to infect other mammals, including humans.

Animals↗
PubMedDate not supplied

[The utilization of Arizona medical services by residents of Mexico].

Arizona physicians practicing in the four counties bordering Mexico were surveyed regarding the use of their services by residents of Mexico. One hundred eighty-eight (79%) of the 239 respondents to the mail survey reported seeing at least one Mexican resident per week during 1988. Ninety-nine of these physicians (53%) practiced in Tucson; 89 (47%) practiced elsewhere in the four border counties. The mean number of Mexican resident patients seen per week was nine (9% of total) for border physicians and 5 (6% of total) for Tucson physicians. The most frequent responses from border physicians asked to list the most common health conditions of their Mexican resident patients were injury and poisoning (21%) and circulatory diseases (11%), while the most frequent responses of Tucson physicians were circulatory diseases (10%) and digestive diseases (9%). Problems and solutions in the border care health system are mainly related to quality of care and health care financing.

Adult↗
PubMedDate not supplied

[The reproductive characteristics of adolescents and young adults in Mexico City].

This article presents the preliminary findings of the Survey on Teenagers and Youth Reproductive Behavior in the Metropolitan Area of Mexico City, which contains information on 1,010 teenagers and young adults from 10 to 25 years of age interviewed in 1987. The average age was 17 years; 51.7 per cent of those interviewed were male and 48.3 per cent were female. A total of 14.6 per cent were married, being the average age at marriage 19.2 years for males and 17.8 years for females. Menarche occurred at an average age of 12.4 years, and spermarche at 14. Of those interviewed, 32.7 per cent have had sexual intercourse at least once in their lives. The average age at which sexual activity had begun, in the case of males, was 16 years and for females, 17 years. Of this group, 33.8 per cent stated that they had used some form of contraception during the first sexual intercourse; the contraceptive methods used most often were rhythm and withdrawal. The main source of supply of other methods is the pharmacy, in 67 per cent. 18.4 per cent of women had been pregnant, and 20.4 per cent of men's partners had presented this same condition. The first pregnancy occurred at 17.8 years for women and 18.7 for men. Of those men and women with a pregnancy experience 66.1 per cent and 57.3 per cent, respectively, stated that their first pregnancy was an unplanned one. Also, first pregnancy was related to their first marriage in 48.1 per cent of women and 82.4 per cent of male. The data presented here will reinforce current knowledge and will enable us to obtain a profile of the reproductive behavior of teenagers and young adults in the metropolitan area of Mexico City.

Adolescent↗
PubMed1993

[Medical equipment companies and their ties with technology development centers in Mexico].

The purpose of this study was to determine the characteristics of the companies that produce, distribute, and service medical equipment in Mexico and the factors related to whether or not they had established ties with research and technology development centers. The data analyzed came from a survey of such companies carried out in Mexico City and environs in 1989. The information was updated in 1991. Multivariate analyses were carried out in order to identify the characteristics of companies that had established ties or wished to do so and the areas of interest of those companies. Of 208 companies surveyed, only 23% had ties with research centers. The companies that had such ties or were interested in establishing them tended to invest in research and to have made plans for expansion. The establishment of ties appeared to be a two-way process, with positive consequences for the companies involved, the research centers, and the health sector. It was concluded that it would be advantageous to design programs to promote ties with companies having the characteristics mentioned.

Equipment and Supplies↗
PubMed1994

mtDNA and Y-chromosome polymorphisms in four Native American populations from southern Mexico.

mtDNA sequence variation was examined in 60 Native Americans (Mixtecs from the Alta, Mixtecs from the Baja, Valley Zapotecs, and Highland Mixe) from southern Mexico by PCR amplification and high-resolution restriction endonuclease analysis. Four groups of mtDNA haplotypes (haplogroups A, B, C, and D) characterize Amerind populations, but only three (haplogroups A, B, and C) were observed in these Mexican populations. The comparison of their mtDNA variation with that observed in other populations from Mexico and Central America permits a clear distinction among the different Middle American tribes and raises questions about some of their linguistic affiliations. The males of these population samples were also analyzed for Y-chromosome RFLPs with the probes 49a, 49f, and 12f2. This analysis suggests that certain Y-chromosome haplotypes were brought from Asia during the colonization of the Americas, and a differential gene flow was introduced into Native American populations from European males and females.

DNA, Mitochondrial↗
PubMedDate not supplied

Non-insulin-dependent diabetes mellitus in Mexico.

Previous experience throughout the world has suggested that certain populations have a genetic predisposition to the development of non-insulin dependent diabetes mellitus (NIDDM) in response to a changing environment. In particular, Native American admixture presents a genetic risk for NIDDM and modernization represents an environmental change which amplifies the risk. This review discusses these factors with respect to the situation in Mexico, where a significant portion of the population is Native American and industrialization is producing rapid environmental changes. Perhaps, with foresight, the epidemic of NIDDM which has struck Native Americans in the United States and indigenous groups in the South Pacific may be averted in Mexico. Specific aspects of the traditional Mexican lifestyle which could be retained to protect against NIDDM are presented.

Arizona↗
PubMed1993

Capnocytophaga canimorsus sepsis misdiagnosed as plague--New Mexico, 1992.

Since 1961, 200 human isolates of Capnocytophaga canimorsus--a gram-negative bacterium--have been sent to CDC for identification. Infections with this organism may result in a spectrum of manifestations ranging from self-limiting cellulitis to fatal septicemia; most fatal infections have occurred in persons with a history of asplenia, alcoholism, or hematologic malignancy. In most (77%) cases, infection is preceded by a bite or other exposure to dogs. This report summarizes the investigation by the New Mexico Health and Environment departments and CDC of a fatal case of C. canimorsus infection in a resident of New Mexico. This case was initially misdiagnosed as human plague.

Capnocytophaga↗
PubMedDate not supplied

[2 cases of neutropenic enteropathy and bone marrow hypoplasia. An association not reported in Mexico].

Neutropenic enterocolitis (NE) is a serious complication in neutropenic patients; it often affects the cecum and the ascending colon. Most cases have been reported in neutropenic patients after chemotherapy for hematologic neoplasms, and some in association with conditions such as rheumatoid arthritis, benign cyclic neutropenia, and solid neoplasms. As far as we know, four cases of NE associated to AA (aplastic anemia, hypoplastic bone marrow) have been previously reported, two of them with autopsy studies. The macroscopic findings in the enterocolonic lesions were not illustrated. We report the first two cases in Mexico. The NE was neither clinically nor radiographically suspected initially, i.e. the morphologic diagnosis of their colonic lesions were amebic colitis in one and edematous ulcerated colitis in the other. Medical treatment without surgery was instituted. Both died. The macroscopic aspect of the enterocolonic lesions in NE associated to aplastic anemia in our two patients was similar to that in NE associated to hematologic neoplasms. In Mexico there is little experience in the clinical, radiographic or morphologic diagnosis of this rare association.

Adult↗
PubMed1995

Hypothermia-related deaths--New Mexico, October 1993-March 1994.

Hypothermia is an unintentional lowering of the body temperature to < or = 95 F (< or = 35 C) (1). From 1979 through 1992, 10,550 persons in the United States died from hypothermia, an average of 754 deaths per year (range: 557-1021). Most of these deaths occurred during winter months in three distinct climatic areas: northern states characterized by moderate to severe cold temperatures during winter (e.g., Illinois and New York); southern states where rapid changes in temperature occur because of the effects of weather systems (e.g., North Carolina, South Carolina, and Virginia); and western states in areas of high elevations and profound declines in temperatures at night (e.g., New Mexico and Arizona). From October 1993 through March 1994, a total of 23 deaths attributed to hypothermia were reported to the New Mexico Office of the Medical Investigator. This report summarizes the investigations of four of these deaths and the epidemiology for all 23 cases.

Adult↗
PubMed1995

Unintentional deaths from carbon monoxide poisoning in New Mexico, 1980 to 1988. A comparison of medical examiner and national mortality data.

Carbon monoxide was the number 1 cause of poisoning deaths in the United States from 1980 through 1988, with the highest rates reported in the western states. We studied unintentional deaths from carbon monoxide poisoning in New Mexico during this period using the multiple-cause mortality files from the National Center for Health Statistics (NCHS) and data from the New Mexico Office of the Medical Investigator (OMI). We compared the nationally available NCHS data with the more detailed OMI data to determine the sensitivity of NCHS data for the surveillance of this preventable cause of death. The NCHS data were 88% sensitive in identifying deaths from unintentional carbon monoxide poisoning and had a positive predictive value of 81% when compared with OMI data. Half of the unintentional carbon monoxide-related deaths were attributable to a home heating mechanism of some sort, 46% involved motor vehicle exhaust, and at least 42% were associated with alcohol use. We conclude that available NCHS data are a sensitive source of surveillance information about unintentional deaths from carbon monoxide poisoning. Additional details about specific deaths can be obtained from medical examiner files when needed.

Accidents↗
PubMed1995

[The evaluation of a monoclonal antibody panel for Lyssavirus typing in Mexico].

The purpose of this study was to evaluate the ability of a panel of eight antinucleocapsid monoclonal antibodies developed in Europe to identify different strains of rabies virus isolated from a variety of animal species from diverse geographic areas in Mexico. Fifty-one virus-positive samples of brain tissue from various animal species and humans were studied. Material from these samples was used to infect mice, whose brains were later tested by indirect immunofluorescence, using the monoclonal antibodies described above. Strains of the virus that showed antigenic variations were sent to the Pasteur Institute in Paris for confirmation of the results. No mouse brain sample showed a pattern of antigenic reactivity that indicated the presence of a Lyssavirus other than the classic rabies virus. However, four antigenic variations from serotype 1 of classic rabies were found. The panel of antibodies was judged to be useful for the rapid classification of rabies virus in Mexico. It is possible that autochthonous antigenic variations are appearing among strains circulating in that country, a scenario that could explain some of the failures observed with certain vaccines. For this reason, there is a need to produce antinucleocapsid monoclonal antibodies with strains of rabies virus indigenous to the area.

Animals↗
PubMedDate not supplied

[The epidemiology of AIDS/HIV in Mexico: from 1983 to March 1995].

The purpose of this study is to analyze the HIV/AIDS magnitude, distribution, frequency, patterns, trends, risk factors, risk groups, estimation and evaluation of interventions in Mexico during the last twelve years. Results of a summary of statistics and results from several sources are presented including the National Registry of AIDS cases, HIV sentinel surveillance in 18 cities of the country, analysis of death certificates, cross-sectional, longitudinal, observational, and intervention studies. As of March 1995, 34,230 AIDS cases, 120,000 HIV infections and 21,000 AIDS deaths are estimated. A damaged exponential growth with duplication of AIDS cases every 18 months can be seen. Epidemiological patterns of transmission are found primarily among men with homosexual and bisexual practices. The male:female ratio is 6 to 1. In 1992 AIDS was the 19th cause of death among the general population. At least two patterns of transmission have been identified: one is the western-urban pattern which contributes with more than 90% of cases and the other, more recent, has been described as Caribbean-rural. Blood transmission of AIDS shows a downward trend, and heterosexual and perinatal transmission is slightly increasing. Seroprevalence among adults is 0.06%: however, among groups with risk practices, rates up to 50% have been found. Risk factors are similar to those described in the literature in other countries, and have been used for designing interventions. Evaluation of interventions has been accomplished by demonstrating positive results in the prevention of blood transmission and sexual transmission among female commercial sex workers; prevention efforts directed to men with homosexual practices have not been successful. Between 77,000 and 88,000 cumulated AIDS cases are estimated in Mexico for the year 2000.

Acquired Immunodeficiency Syndrome↗