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Brief communication: a case of congenital syphilis during the colonial period in Mexico City.

Congenital syphilis has been diagnosed very seldom in ancient populations. The case that we examined comes from San Jeronimo's Church (17th and 18th centuries AD; Mexico City). Coffin 43 contained an incomplete skeleton of an approximately 2-year-old infant. The pathological lesions of this skeleton include bilateral osteochondritis, diaphyseal osteomyelitis, and osteitis and/or periostitis on the long bones. The radiographic appearance depicts symmetrical osteomyelitic foci, particularly at the proximal extremity of both tibiae (Wimberger's sign). The skull exhibits hydrocephaly and periosteal changes on the vault, and the unerupted upper incisors evince dental hypoplasia and other pathological alterations reminiscent of Hutchinson's incisors. All these features strongly suggest a case of early congenital syphilis.

Bone Diseases↗

Craniofacial dimensions in children in rural Oaxaca, southern Mexico: secular change, 1968-2000.

The objective of this investigation was to analyze the underlying cause(s) of secular changes in craniofacial dimensions among indigenous children in an isolated community in Oaxaca, southern Mexico, between 1968-2000. Subjects were schoolchildren resident in a rural, agrarian, Zapotec-speaking community in the Valley of Oaxaca, previously characterized as mildly-to-moderately undernourished with growth-stunting in 1968 and 1978. In 2000, children had experienced a secular increase in height compared with two prior growth surveys. Four craniofacial dimensions (head length, head breadth, and bizygomatic and bigonial breadths) were measured during anthropometric surveys of schoolchildren aged 6-13 years in 1968, 1978, and 2000. Cephalic and zygomandibular indices were calculated. Samples by survey were: 1968, 151 males and 157 females; 1978, 179 males and 184 females; and 2000, 180 males and 186 females. The analysis was based on a total of 1,037 children. Multivariate analysis of covariance was used to assess secular trend effects, with height, age, and age2 as covariates by sex. Over the interval of 32 years, significant secular changes occurred in craniofacial dimensions and one index: 1) head length was shorter in boys and girls; 2) bizygomatic breadth was narrower in boys and girls; 3) head breadth increased over time only among girls; 4) brachycephalization increased significantly in a linear manner among both sexes; and 5) the zygomandibular index decreased significantly only in boys. Thus, the cranial complex remodeled to a shorter head length, both relatively (brachycephalization) and absolutely. Remodeling over time also resulted in a narrower face, with the midface changing at about the same rate as the lower face (i.e., mandible). Secular changes are generally recognized as multifactorial. Changes in the cephalic index and cranium over time in schoolchildren in an isolated rural agrarian Zapotec-speaking community in the Valley of Oaxaca suggest that the underlying forces for the secular change are associated: 1) decreased food (maize) coarseness or grit content (masticatory stress), and 2) relaxed natural selection, resulting in 3) a greater role for developmental plasticity.

Adolescent↗

Use of alternative therapies by patients with rheumatic disease in Guadalajara, Mexico: prevalence, beliefs, and expectations.

OBJECTIVE: To assess the prevalence, practices, beliefs, and expectations of patients with rheumatic diseases in relation to the use of alternative therapies. METHODS: We conducted a cross-sectional survey of 300 consecutive patients with rheumatic diseases at 3 outpatient rheumatic disease clinics in Guadalajara, Mexico to evaluate the use of alternative therapies. A face-to-face structured interview was administered by a trained assistant to evaluate the prevalence of use and patient beliefs, perceptions, and expectations in relation to alternative therapies. RESULTS: Two hundred fifty patients (83%) had used a total of 1,386 alternative therapies (range 1-19); 203 (68%) patients had used alternative therapy in the previous 12 months. Sixty-one percent received at least one alternative treatment before the first rheumatology consultation, but an additional 18% initiated these therapies after their initial contact with a rheumatologist at our clinics. Only 66 (26%) of the patients using alternative therapy notified their rheumatologist about their use. Thirty-six patients (14%) discontinued formal treatment at least on one occasion in order to receive alternative therapies, and only 8 (22%) notified their rheumatologist. Alternative therapy practitioners recommended discontinuation of conventional therapy on 57% of the occasions when formal treatments were discontinued. Mean expenditures per patient for fees to alternative therapy providers were equivalent to 28 days of the official minimum daily wage, and per patient costs for the remedies themselves were equivalent to 13 days of the official minimum daily wage. Patients who used alternative therapy in the past 12 months had lower education (7 versus 10 years, P < 0.001) and were slightly more disabled (1.7 versus 1.5, modified Health Assessment Questionnaire, P < 0.01). CONCLUSIONS: In this survey most patients used alternative therapies for the treatment of their rheumatic disease. Alternative therapies were costly and appeared to decrease adherence to conventional therapy. Health care providers should openly discuss the use of alternative therapy in patients with rheumatic diseases.

Adult↗

The effect of fever, febrile illnesses, and heat exposures on the risk of neural tube defects in a Texas-Mexico border population.

BACKGROUND: Hyperthermia produces neural tube defects (NTDs) in a variety of animal species. Elevated maternal body temperatures may also place the developing human embryo at risk. We examined the relation between maternal hyperthermia and the development of NTDs in a high-risk Mexican-American population. METHODS: Case-women were Mexican-American women with NTD-affected pregnancies who resided and delivered in any of the 14 Texas counties bordering Mexico, during 1995-2000. Control-women were randomly selected from study area residents delivering normal live births, frequency-matched to cases by hospital and year. Information on maternal fevers, febrile illnesses, exposures to heat generated from external sources, and hyperthermia-inducing activities was gathered through in-person interviews, conducted about six weeks postpartum. RESULTS: The risk effect (OR) associated with maternal fever in the first trimester, compared to no fever, was 2.9 (95% CI, 1.5-5.7). Women taking fever-reducing medications showed a lower risk effect (OR, 2.4; 95% CI, 1.0-5.6) than those who did not (OR, 3.8; 95% CI, 1.4-10.9). First-trimester maternal exposures to heat devices such as hot tubs, saunas, or electric blankets were associated with an OR of 3.6 (95% CI, 1.1-15.9). Small insignificant effects were observed for activities such as cooking in a hot kitchen (OR, 1.6; 95% CI, 1.0-2.6) and working or exercising in the sun (OR, 1.4; 95% CI, 0.9-2.2). CONCLUSIONS: Maternal hyperthermia increases the risk for NTD-affected offspring. Women intending to become pregnant should avoid intense heat exposures, carefully monitor and manage their febrile illnesses, and routinely consume folic acid supplements.

Adult↗

Detection, isolation, and characterization of exopolysaccharide produced by a strain of Phormidium 94a isolated from an arid zone of Mexico.

Phormidium 94a, a cyanobacteria that produces extracellular polymeric substances (EPS), was isolated from arid soils of Mexico. Microscopic localization, using histochemical techniques like the Toluidine blue technique, was done in order to demonstrate the presence of EPS. Acetone was added to precipitate the EPS. In this study we characterized the EPS by GC, HPLC, and IR techniques. The highest fraction of EPS had a molecular weight of 2000 kDa. The sugar composition was galactose, mannose, galacturonic acid, arabinose, and ribose in the three main fractions, and the sugar ratio found was different in each fraction. The low EPS concentrations had a Newtonian behavior, when the concentrations were increased, the behavior changed to pseudoplastic. The EPS rheulogical behavior is similar to low viscosity arabic gum. Also, it was found that an increase in viscosity occurred at longer hydration time. More rheological and toxicological studies are required in order to analyze its possible application in food industries.

Cyanobacteria↗

Cytochrome P4501A1 polymorphisms in the Amerindian and Mestizo populations of Mexico.

Several polymorphisms in the CYP1A1 locus have been identified and their genotypes appear to exhibit population frequencies that depend on ethnicity. We studied two CYP1A1 polymorphic sites (position 4889 and 6235) in a group of 212 unrelated healthy individuals belonging to three different Mexican populations (106 Mexican Mestizos, 52 Teenek and 54 Mayos). Comparison among Mexican populations showed increased frequency of the *Ile allele (A on position 4889) in Mexican Mestizos when compared to Amerindians (p < 0.05). The analysis of position 6235 showed increased frequencies of *m2 (C in this position) allele in Teenek when compared to Mestizos and Mayos (p < 0.05) and of *m2/*m2 genotype when compared to Mestizos (p < 0.05). Amerindian populations (from Mexico and South America) presented the lowest frequencies of *Ile (position 4889) and *m1 (position 6235) alleles, however these frequencies vary according to the ethnic group studied. Mexican Amerindian groups together with other South Amerindian populations showed the highest frequencies for *Val at position 4889 and the *m2 allele at position 6235. The present study corroborates the high frequencies of*Val and *m2 alleles in the Amerindian populations and detects some differences between Mexican populations that correlate with linguistic differences. Our data could be helpful in understanding the distribution of these polymorphisms and in clarifying their roles as genetic and evolution markers in Amerindian populations.

Cytochrome P-450 CYP1A1↗

Changing patterns of gallbladder carcinoma in New Mexico.

BACKGROUND: American Indians in the U.S. have a high incidence of gallbladder carcinoma (GBC). Furthermore, American Indians in New Mexico (NM) have the highest incidence rate of GBC in the U.S. The epidemiology of GBC in NM has not been studied in the past 3 decades. METHODS: By using the NM Tumor Registry (NMTR) and the Surveillance, Epidemiology, and End Results (SEER) database, age-specific incidence rates, average annual age-adjusted incidence rates, and incidence rate time trends of GBC were compared among the three major ethnic groups in NM: American Indians, Hispanics, and non-Hispanic whites, for the period 1973-2001. RESULTS: A sharp increase in GBC incidence occurred with advanced age and started earlier in American Indians (at age 55) than Hispanics (at age 60) than non-Hispanic whites (at age 65). GBC occurred more frequently in females than in males in all ethnic groups. In females, the incidence of GBC was the highest in American Indians (14.5 per 100,000) followed by Hispanics (6.8 per 100,000) and non-Hispanic whites (1.4 per 100,000). Similarly in males, American Indians had the highest incidence rate of GBC (7.8 per 100,000), followed by Hispanics (2.0 per 100,000), and non-Hispanic whites (1.0 per 100,000). The time trend analysis revealed that there has been a disproportionate decline in the incidence of GBC in the three ethnic groups, with the greatest drop in American Indians and Hispanics followed by non-Hispanic whites. Despite the decline, American Indians continued to have the highest incidence rate of GBC in NM. CONCLUSION: The incidence of GBC has declined disproportionately in the three major ethnic groups, with the greatest decrease in American Indians and Hispanics followed by non-Hispanic whites.

Age Factors↗

Importance of hereditary disease at a Neuropsychiatric Institute in Mexico City.

The objective of this study is to investigate the type, importance, and incidence of hereditary diseases in patients at the National Institute of Neurology and Neurosurgery in Mexico City. A review of 6,258 files indicated that hereditary diseases represent an important problem for the Institute. Of the diseases with the highest incidences, hereditary factors have an important role in seven (epilepsy, depression, facial palsy, schizophrenia, mental retardation, migraine, and Parkinson's disease). Diseases of known monogenic etiology represent 1.5% of all the cases.

Adolescent↗

The economic value of fatal and non-fatal occupational risks in Mexico City using actuarial- and perceived-risk estimates.

Compensating wage differentials are used to estimate marginal rates of substitution between income and both fatal and non-fatal occupational-injury risks in the Mexico City metropolitan area. Data are obtained by in-person survey of almost 600 workers and include workers' perceived risks of fatal and non-fatal occupational injury supplemented by actuarial-risk estimates from government statistics. Results using both actuarial- and perceived-risk estimates are reasonably consistent. Estimates of the value per statistical life are between 235,000 US dollars and 325,000 US dollars and estimates of the value per statistical non-fatal injury are between 3500 US dollars and 11,000 US dollars (2002 US dollars). These values are much smaller than corresponding estimates for higher-income countries but are compatible with the small number of prior estimates for lower-income countries.

Actuarial Analysis↗

Cancer of the larynx in Mexico: review of 357 cases.

Descriptions of the patient population suffering from carcinoma of the larynx are not common in Mexico. This article deals with the clinical features, treatment, and results of 357 cases of cancer of the larynx treated at the Hospital de Oncologia, Centro Medico Nacional, IMSS, during a 10-year period. In this series, 68% of the patients were in advanced stage (T3-T4) at the time of diagnosis; nevertheless, a combination of surgery and radiotherapy achieved an actuarial 5-year survival for the entire group of 77.5%. Metastatic cervical nodes and tracheotomy previous to the treatment were factors that influenced a poor prognosis (p = 0.01). The survival of cases in the early stages (T1-T2) of 95.2% is comparable to that reported by most authors. In 87.5% of the cases that develop recurrence, it appears during the first 24 months of control.

Adolescent↗

Papillary thyroid cancer in Mexico: review of 409 cases.

This is a retrospective review of 409 cases of papillary thyroid cancer treated at the Hospital of Oncologia, National Medical Center, IMSS in Mexico City. The clinical features, histopathologic findings, analysis of recurrences and survivals according to age, sex, tumor size, and modality of treatment are described. The results showed that tumoral diameter > 5 cm, distant metastasis at diagnosis, age > 40 years, and tumoral infiltration beyond the thyroid capsule significantly affect the patient's survival.

Actuarial Analysis↗

Prevalence and determinants of human papillomavirus infection in men attending vasectomy clinics in Mexico.

Large studies of genital human papillomavirus (HPV) infection in men are few and mainly include high-risk groups. We interviewed 779 men who requested a vasectomy in 27 public clinics in 14 states of Mexico. Exfoliated cells were obtained from the scrotum, the shaft of the penis, the top of the penis including the coronal sulcus, the glans and the opening of the meatus. HPV testing was performed using biotinylated L1 consensus primers and reverse line blot. Unconditional logistic regression was used to estimate odds ratios (ORs) of being HPV-positive and corresponding 95% confidence intervals (CIs). The prevalence of any type of HPV was 8.7%. HPV positivity was highest among men below age 25 (13.6%), and lowest among men aged 40 years or older (6.0%). The most commonly found HPV types were, in decreasing order, HPV59, 51, 6, 16 and 58. Lifetime number of sexual partners was associated with HPV positivity (OR for > or = 4 vs. 1 partner = 3.7, 95% CI: 2.0-6.8), mainly on account of the strong association with number of occasional and sex-worker partners. Condom use with both regular (OR = 0.4, 95% CI: 0.1-1.0) and sex-worker (OR = 0.1, 95% CI: 0.0-0.3) partners and circumcision (OR = 0.2, 95% CI: 0.1-0.4) were inversely associated with HPV positivity. HPV prevalence in Mexican men was similar to the prevalence found in Mexican women of the same age groups. The association between HPV positivity and lifetime number of sexual partners in the present low-risk male population is one of the strongest ever reported in studies in men. Condom use and circumcision were associated with a strong reduction in HPV prevalence.

Adult↗

Use of complementary and alternative medicine in children with cancer in Occidental, Mexico.

PURPOSE: To describe the types of complementary and alternative medicine (CAM) used by pediatric cancer patients attending a tertiary care hospital in Western Mexico. PATIENTS AND METHODS: In a cross-sectional survey, parents were interviewed and types of CAM employed as well as factors related to their use and their perceived effectiveness were determined. RESULTS: One hundred ten parents of pediatric cancer patients completed the survey. Seventy-seven patients (70%) received CAM. Of CAM used, herbal remedies (69%) and orally administered products (26%) were most common. Mean number of therapies was 2 +/- 1.1 (95% CI 1.59-2.12). Prior CAM use by the family was associated with use in patients (P = 0.006) (OR 4.6, CI 95% 1.7-12.9). Perceived usefulness was reported in 79% of CAM users. CONCLUSION: CAM use in Mexican children is common, most frequently with herbal therapies. The majority perceived benefits with its usage but in most cases, the treating physician was not informed about this practice.

Administration, Oral↗

The emotional response of families to children with leukemia at the lower socio-economic level in central Mexico: a preliminary report.

Little research has been done in developing countries on the emotional impact experienced by families who have a child diagnosed with leukemia. This preliminary study looked at parents in Mexico who had to cope with their child's leukemia in the face of meager financial and social resources. The 51 children in the study were under 15 years and being treated for leukemia in hospitals affiliated with the Mexican Social Security Institute (IMSS) where their parents were interviewed using a questionnaire to ascertain their emotional responses to the illness. The data are analyzed and reported in five domains: perceived illness; psychological impact; coping strategies; family relationships; socio-economic impact. A strengthening of family bonds was found the most common response (82.4%). The second most common responses were concern for the expenses incurred by the illness and the time dedicated to caring for the sick child (both 78.4%). It is especially important to assess families with meager social and financial resources as to their emotional responses to life-threatening illness because these limitations impose greater burdens and make coping more difficult. Psychosocial interventions are key to ensuring adequate treatment of the child in these circumstances.

Adaptation, Psychological↗

Spirometric function in children of Mexico City compared to Mexican-American children.

We set out to describe the pattern of lung function growth in Mexican students from 8-20 years of age, using internationally accepted equipment and methodology, and to compare it to values reported for Mexican-American children. Out of a total of 6,803 students from primary school to high school studied cross-sectionally in the Mexico City metropolitan area, we selected 4,009 asymptomatic, nonobese, nonsmoker subjects to generate spirometric prediction equations. We describe regression equations for the main spirometric variables (log transformed) based on age, height, and weight, and separated for males and females. Spirometric function in the population studied was above that predicted for European (Quanjer et al. [1987] Pediatr Pulmonol 19:135-142) or Mexican-American children, for the same age, height, and gender. On average, forced expiratory volume in 1 sec (FEV(1)) in Mexican children was 9.5% above that of Europeans (Quanjer et al. [1987] Pediatr Pulmonol 19:135-142), 14% and 5% above Hispanics reported by (Coultas et al. [1988] Am Rev Respir Dis 138:1386-1392) and (Hsu et al. [1979] J Pediatr 95:14-23), respectively, and 5% above Mexican-Americans from the third National Health and Nutrition Examination Survey study. Similarly, FVC was 8%, 14%, 8%, and 5.6% above the figures predicted by the same authors. The largest errors of prediction of foreign equations occurred in extremely tall or short subjects, and therefore a single proportional adjustment is unfeasible.

Adolescent↗

Modelling the transmission dynamics of acute haemorrhagic conjunctivitis: application to the 2003 outbreak in Mexico.

We model an outbreak of acute haemorrhagic conjunctivitis (AHC) using a simple epidemic model that includes susceptible, infectious, reported, and recovered classes. The model's framework considers the impact of underreporting and behaviour changes on the transmission rate and is applied to a recent epidemic of AHC in Mexico, using a fit to the cumulative number of cases to estimate model parameters, which agree with those derived from clinical studies. The model predicts a 'mean time from symptomatic onset to diagnosis' of 1.43 days (95 per cent CI: 1-2.5) and that the final size of the Mexican epidemic was underreported by 39 per cent. We estimate that a primary infectious case generates approximately 3 secondary cases (R0* = 2.64, SD 0.65). We explore the impact of interventions on the final epidemic size, and estimate a 36 per cent reduction in the transmission rate due to behaviour changes. The effectiveness of the behaviour changes in slowing the epidemic is evident at 21.90 (SD 0.19) days after the first reported case. Results therefore support current public health policy including expeditious announcement of the outbreak and public health information press releases that instruct individuals on avoiding contagion and encourage them to seek diagnosis in hospital clinics.

Adenoviridae↗

Hazard evaluation of inorganics, singly and in mixtures, to flannelmouth sucker Catostomus latipinnis in the San Juan River, New Mexico.

Larval flannelmouth sucker (Catostomus latipinnis) were exposed to arsenate, boron, copper, molybdenum, selenate, selenite, uranium, vanadium, and zinc singly, and to five mixtures of five to nine inorganics. The exposures were conducted in reconstituted water representative of the San Juan River near Shiprock, New Mexico. The mixtures simulated environmental ratios reported for sites along the San Juan River (San Juan River backwater, Fruitland marsh, Hogback East Drain, Mancos River, and McElmo Creek). The rank order of the individual inorganics, from most to least toxic, was: copper > zinc > vanadium > selenite > selenate > arsenate > uranium > boron > molybdenum. All five mixtures exhibited additive toxicity to flannelmouth sucker. In a limited number of tests, 44-day-old and 13-day-old larvae exhibited no difference in sensitivity to three mixtures. Copper was the major toxic component in four mixtures (San Juan backwater, Hogback East Drain, Mancos River, and McElmo Creek), whereas zinc was the major toxic component in the Fruitland marsh mixture, which did not contain copper. The Hogback East Drain was the most toxic mixture tested. Comparison of 96-h LC50 values with reported environmental water concentrations from the San Juan River revealed low hazard ratios for arsenic, boron, molybdenum, selenate, selenite, uranium, and vanadium, moderate hazard ratios for zinc and the Fruitland marsh mixture, and high hazard ratios for copper at three sites and four environmental mixtures representing a San Juan backwater, Hogback East Drain, Mancos River, and McElmo Creek. The high hazard ratios suggest that inorganic contaminants could adversely affect larval flannelmouth sucker in the San Juan River at four sites receiving elevated inorganics.

Animals↗

Environmental conditions and pesticide pollution of two coastal ecosystems in the Gulf of California, Mexico.

In December 1997 and April and September 1998, water temperature, salinity, dissolved oxygen, nutrients, chlorophyll, and pesticide residues were determined in two coastal ecosystems of Sinaloa, NW Mexico: Ensenada del Pabellón and Bahía de Santa María. These two are considered to be among the greatest shrimp producers in the region. Temperature, salinity, and dissolved oxygen were similar to those of other ecosystems of this region: high temperatures and salinity in spring and summer (dry season) and lower in winter and the rainy season. Levels of nitrites and phosphates and chlorophyll concentration were relatively higher than those of other ecosystems nearby, probably due to fertilizers used in the agricultural lands surrounding the water bodies studied. The pesticides more frequently detected were BHCalpha, aldrin, endosulfan and parathion. In some cases, pesticides forbidden by Mexican regulations were detected. These results indicate that the ecosystems studied are in a warning condition, because severe biochemical and physiological alterations have been reported in crustaceans exposed to pesticides. Therefore these pesticides could be one cause of the slow growth, diverse pathologies, and mortality in shrimp that have been reported in recent years.

Animals↗