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Cancer has increased in all the countries of the world and Mexico is no exception. The recognised risk factors for the main types of cancer are reviewed and searched through the Mexican government web pages and cancer prevention programmes to tackle the risk factors in the population. The Mexican government, a member of the World Health Organization, shows that the main approach is an early diagnosis rather than prevention, forgetting that an ounce of prevention is better than a pound of cure. Effective public programmes should be promoted to reduce preventable risk factors in the population (smoking, nutrition, obesity, diet, environmental toxicity, sedentary lifestyle) and control the non-preventable factors (genetics) if we really want to control the incidence of different types of cancer.
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INTRODUCTION: Occupational exposure to ionizing radiation can potentially lead to adverse health effects, including cancer and genetic defects. Genetic damage caused by radiation can be detected if micronuclei are observed. The objective of this pilot study was to detect the presence of micronuclei in cells of the oral mucosa in inidividuals occupationally exposed to ionizing radiation. METHODS: We implemented a pilot case-control study in which we compared oral mucosa micronuclei in 30 medical and nursing personnel in radiology centers in Celaya, Mexico, with 30 volunteers not exposed to ionizing radiation recruited from a public University. The oral mucosa was brushed and the amount of micronuclei was quantified. Chi-square test or t-test for two proportions were used to compared ionizing radiation and genetic damage between exposed and non-exposed groups. RESULTS: The exposed group had an average of 5.37 ± 3.49 micronuclei and the non-exposed had 0.37 ± 0.61 (P<0.01). In the exposed group, 90% of participants exhibited genetic damage compared to 6.67% in the unexposed group (P<0.05). CONCLUSION: In this pilot study, medical and nursing staff from radiology centers presented with higher genetic damage compared to control group. Further studies are needed to identify the prevalence of genetic damage due to occupational radiation exposure in Mexico.
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Objetivo. Evaluar los costos médicos directos, gastos de bolsillo y costos indirectos en casos de diarrea aguda hospitalizada en <5 años, en el Hospital de Niños Héctor Quintana de la provincia de Jujuy, durante el período de circulación de rotavirus en la región Noroeste de Argentina. Métodos. Estudio de corte trasversal de costos de enfermedad. Fueron incluidos todos los niños hospitalizados <5 años con diagnóstico de diarrea aguda y deshidratación durante el período de circulación de rotavirus, entre el 1/5/2013 y el 31/10/2013. La evaluación de costos médicos directos se realizó mediante la revisión de historias clínicas, y los gastos de bolsillo y costos indirectos, mediante una encuesta. Para el intervalo de confianza del 95% del costo promedio por paciente, se realizó un análisis probabilístico de 10 000 simulaciones por remuestreo (boostraping). Resultados. Fueron enrolados 105 casos. La edad promedio fue de 18 meses (desvío estándar 12); 62 (59%) fueron varones. El costo médico directo, gasto de bolsillo y pérdida de dinero por lucro cesante promedio por caso fue de AR$ 3413, 6 (2856, 35-3970, 93) (USD 577, 59), AR$ 134, 92 (85, 95-213, 57) (USD 22, 82) y de AR$ 301 (223, 28380, 02) (USD 50, 93), respectivamente. El total del costo por evento hospitalizado fue de AR$ 3849, 52 (3298-4402, 25) (USD 651, 35). Conclusiones. El valor de costo total por evento hospitalizado se encuentra dentro de lo esperado para Latinoamérica. La distribución de costos presenta una proporción importante de costos médicos directos en relación con los gastos de bolsillo (3, 5%) y costos indirectos (7, 8%).
Objective. To assess direct medical costs, out-of-pocket expenses, and indirect costs in cases of hospitalizations for acute diarrhea among children <5 years of age at Hospital de Niños "Héctor Quintana" in the province of Jujuy during the period of rotavirus circulation in the Northwest region of Argentina. Methods. Cross-sectional study on disease-related costs. All children <5 years of age, hospitalized with the diagnosis of acute diarrhea and dehydration during the period of rotavirus circulation between May 1st and October 31st of 2013, were included. The assessment of direct medical costs was done by reviewing medical records whereas out-of-pocket expenses and indirect costs were determined using a survey. For the 95% confidence interval of the average cost per patient, a probabilistic bootstrapping analysis of 10 000 simulations by resampling was done. Results. One hundred and five patients were enrolled. Their average age was 18 months (standard deviation: 12); 62 (59%) were boys. The average direct medical cost, out-of-pocket expense, and lost income per case was ARS 3413.6 (2856.35-3970.93) (USD 577.59), ARS 134.92 (85.95-213.57) (USD 22.82), and ARS 301 (223.28380.02) (USD 50.93), respectively. The total cost per hospitalization event was ARS 3849.52 (32984402.25) (USD 651.35). Conclusions. The total cost per hospitalization event was within what is expected for Latin America. Costs are broken down into direct medical costs (significant share), compared to out-of-pocket expenses (3.5%) and indirect costs (7.8%).
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Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Infecções por Rotavirus/economia , Custos Diretos de Serviços , Efeitos Psicossociais da Doença , Diarreia/economia , Hospitalização/economia , Argentina , Infecções por Rotavirus/virologia , Estudos Transversais , Rotavirus , Desidratação/economia , Desidratação/virologia , Diarreia/virologia , Financiamento Pessoal/economiaRESUMO
OBJETIVE: To assess direct medical costs, outof-pocket expenses, and indirect costs in cases of hospitalizations for acute diarrhea among children <5 years of age at Hospital de Niños "Héctor Quintana" in the province of Jujuy during the period of rotavirus circulation in the Northwest region of Argentina. METHODS: Cross-sectional study on diseaserelated costs. All children <5 years of age, hospitalized with the diagnosis of acute diarrhea and dehydration during the period of rotavirus circulation between May 1st and October 31st of 2013, were included. The assessment of direct medical costs was done by reviewing medical records whereas out-of-pocket expenses and indirect costs were determined using a survey. For the 95% confidence interval of the average cost per patient, a probabilistic bootstrapping analysis of 10 000 simulations by resampling was done. RESULTS: One hundred and five patients were enrolled. Their average age was 18 months (standard deviation: 12); 62 (59%) were boys. The average direct medical cost, out-of-pocket expense, and lost income per case was ARS 3413.6 (2856.35-3970.93) (USD 577.59), ARS 134.92 (85.95-213.57) (USD 22.82), and ARS 301 (223.28-380.02) (USD 50.93), respectively. The total cost per hospitalization event was ARS 3849.52 (3298-4402.25) (USD 651.35). CONCLUSIONS: The total cost per hospitalization event was within what is expected for Latin America. Costs are broken down into direct medical costs (significant share), compared to out-of-pocket expenses (3.5%) and indirect costs (7.8%).
OBJETIVO: Evaluar los costos médicos directos, gastos de bolsillo y costos indirectos en casos de diarrea aguda hospitalizada en <5 años, en el Hospital de Niños Héctor Quintana de la provincia de Jujuy, durante el período de circulación de rotavirus en la región Noroeste de Argentina. MÉTODOS: Estudio de corte trasversal de costos de enfermedad. Fueron incluidos todos los niños hospitalizados <5 años con diagnóstico de diarrea aguda y deshidratación durante el período de circulación de rotavirus, entre el 1/5/2013 y el 31/10/2013. La evaluación de costos médicos directos se realizó mediante la revisión de historias clínicas, y los gastos de bolsillo y costos indirectos, mediante una encuesta. Para el intervalo de confianza del 95% del costo promedio por paciente, se realizó un análisis probabilístico de 10 000 simulaciones por remuestreo (boostraping). RESULTADOS: Fueron enrolados 105 casos. La edad promedio fue de 18 meses (desvío estándar 12); 62 (59%) fueron varones. El costo médico directo, gasto de bolsillo y pérdida de dinero por lucro cesante promedio por caso fue de AR$ 3413,6 (2856,35-3970,93) (USD 577,59), AR$ 134,92 (85,95-213,57) (USD 22,82) y de AR$ 301 (223,28-380,02) (USD 50,93), respectivamente. El total del costo por evento hospitalizado fue de AR$ 3849,52 (3298-4402,25) (USD 651,35). CONCLUSIONES: El valor de costo total por evento hospitalizado se encuentra dentro de lo esperado para Latinoamérica. La distribución de costos presenta una proporción importante de costos médicos directos en relación con los gastos de bolsillo (3,5%) y costos indirectos (7,8%).
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Efeitos Psicossociais da Doença , Diarreia/economia , Custos Diretos de Serviços , Hospitalização/economia , Infecções por Rotavirus/economia , Argentina , Estudos Transversais , Desidratação/economia , Desidratação/virologia , Diarreia/virologia , Feminino , Financiamento Pessoal/economia , Humanos , Lactente , Masculino , Rotavirus , Infecções por Rotavirus/virologiaRESUMO
BACKGROUND: Type 2 diabetes is a chronic disease that presents a significant burden on health care systems in many countries. With the rise of obesity, the incidence of Type 2 diabetes has also been steadily increasing. A healthy lifestyle and understanding of diabetes management are important factors for delaying the onset of comorbidities associated with Type 2 diabetes. The objective of this study was to evaluate the self-perception of health in individuals with Type 2 diabetes as it relates to BMI status, which has important implications for the implementation of preventive programs. METHODS: A cross-sectional lifestyle survey was implemented in the region of Celaya, Guanajuato, Mexico, targeting 100 participants diagnosed with Type 2 diabetes. Anthropometric measurements and participant characteristics were also obtained. Fisher's exact test was used to determine if the proportions of lifestyles perceptions differed by BMI status. RESULTS: Participants had a mean age of 56.12 ± 10.26, a mean BMI of 29.13 ± 5.48 kg/m2, were mostly married (67.0%), and female (70.0%). None of the normal weight participants perceived themselves as unhealthy. 95% of overweight/obese participants perceived themselves to be healthy, despite a diagnosis of diabetes and being overweight/obese, while only 5% perceived themselves to be unhealthy. However, these differences in the perceptions of health classified by BMI status were not statistically significant (p = 0.42). CONCLUSION: Our findings indicate that overweight and obese persons with Type 2 diabetes in Celaya, Mexico may have misperceptions about their own health, even though these findings were not statistically significant. These preliminary data highlight the importance of implementing prevention and educational programs among those with diabetes, in order to combat health misperceptions and raise awareness about the dangers of diabetes and obesity. Furthermore, more research with larger sample sizes is needed in order to fully understand the effects of perception of health on actual health.
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Agave tequilana is a monocarpic perennial species that flowers after 5-8 years of vegetative growth signaling the end of the plant's life cycle. When fertilization is unsuccessful, vegetative bulbils are induced on the umbels of the inflorescence near the bracteoles from newly formed meristems. Although the regulation of inflorescence and flower development has been described in detail for monocarpic annuals and polycarpic species, little is known at the molecular level for these processes in monocarpic perennials, and few studies have been carried out on bulbils. Histological samples revealed the early induction of umbel meristems soon after the initiation of the vegetative to inflorescence transition in A. tequilana. To identify candidate genes involved in the regulation of floral induction, a search for MADS-box transcription factor ESTs was conducted using an A. tequilana transcriptome database. Seven different MIKC MADS genes classified into 6 different types were identified based on previously characterized A. thaliana and O. sativa MADS genes and sequences from non-grass monocotyledons. Quantitative real-time PCR analysis of the seven candidate MADS genes in vegetative, inflorescence, bulbil and floral tissues uncovered novel patterns of expression for some of the genes in comparison with orthologous genes characterized in other species. In situ hybridization studies using two different genes showed expression in specific tissues of vegetative meristems and floral buds. Distinct MADS gene regulatory patterns in A. tequilana may be related to the specific reproductive strategies employed by this species.
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Agave/metabolismo , Proteínas de Domínio MADS/metabolismo , Agave/genética , Agave/crescimento & desenvolvimento , Sequência de Aminoácidos , DNA Complementar/classificação , Flores/metabolismo , Expressão Gênica , Genes de Plantas , Proteínas de Domínio MADS/genética , Meristema/metabolismo , Dados de Sequência Molecular , Homologia de Sequência de AminoácidosRESUMO
OBJECTIVE: To describe the patterns of antimicrobial resistance of organisms isolated from urine cultures at a teaching oncological hospital for adult patients. MATERIAL AND METHODS: All strains obtained from urine cultures from 1998 to 2005 were included. Mean susceptibilities were obtained for each antimicrobial tested; nosocomial and community-acquired isolates were analyzed separately. RESULTS: A total of 9,232 positive urine cultures were obtained (20.7%) from 44,447 samples taken. Gram negative bacteria were reported in 78.8%, Gram-positive in 13.8% and yeasts in 7.4%. Escherichia coli was the most frequently isolated bacterium (41.3%); antimicrobial resistance was higher in nosocomial isolates than in community strains (amikacin 92.4 vs. 97%, ceftazidime 83.1 vs. 95.1% and ciprofloxacin 46.2 vs. 58.6%). Pseudomonas aeruginosa showed a greater resistance to amikacin and ceftazidime in nosocomial cultures compared to community-acquired bacterial cultures (55.7 vs. 66.6% and 65.5 vs. 84.8% respectively). Vancomycin-resistant enterococci were found in only 2.5% (3 of 119 E. faecium isolates). CONCLUSIONS: Higher bacterial resistance was observed in nosocomial cultures than in community ones. Antimicrobial resistance was found to be progressively increasing for E. coli, the most frequent pathogen isolated both in nosocomial and community infections. We consider imperative the establishment of an intense educational campaign for the use and control of antibiotics.
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Institutos de Câncer/estatística & dados numéricos , Farmacorresistência Bacteriana , Farmacorresistência Fúngica , Neoplasias/urina , Urina/microbiologia , Bactérias/efeitos dos fármacos , Bactérias/isolamento & purificação , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , Infecções Bacterianas/urina , Candida/efeitos dos fármacos , Candida/isolamento & purificação , Candidíase/epidemiologia , Candidíase/microbiologia , Candidíase/urina , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/urina , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Infecção Hospitalar/urina , Enterococcus faecium/efeitos dos fármacos , Enterococcus faecium/isolamento & purificação , Humanos , México/epidemiologia , Neoplasias/epidemiologia , Neoplasias/microbiologia , Estudos Retrospectivos , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Infecções Urinárias/urinaRESUMO
OBJETIVOS: Describir los patrones de resistencia bacteriana en cultivos de orina en un hospital oncológico. MATERIAL Y MÉTODOS: Se incluyeron las cepas obtenidas de cultivos de orina de 1998 a 2005. Se obtuvo el porcentaje de sensibilidad para diferentes antibióticos, tras analizar por separado cepas nosocomiales y compararlas con las de la comunidad. RESULTADOS: Se detectaron 9 232 cultivos positivos (20.7 por ciento) de 44 447 muestras: gramnegativos, 78.8 por ciento; grampositivos, 13.8 por ciento; y levaduras, 7.4 por ciento. Escherichia coli fue el principal microorganismo identificado (41.3 por ciento); la resistencia en aislados nosocomiales fue mayor que en la comunidad para amikacina (92.4 y 97 por ciento), ceftazidima (83.1 y 95.1 por ciento) y ciprofloxacina (46.2 y 58.6 por ciento). De igual manera, Pseudomonas aeruginosa presentó mayor resistencia para amikacina y ceftazidima en las cepas nosocomiales (55.7 y 66.6 por ciento; y 65.5 y 84.8 por ciento, respectivamente). Enterococcus resistente a vancomicina se encontró sólo en 2.5 por ciento (3/119 aislados de E. faecium). CONCLUSIONES: Existe una mayor resistencia bacteriana en las cepas de origen nosocomial en comparación con las cepas comunitarias. Se encontró un incremento progresivo de la resistencia para E. coli, el patógeno aislado con más frecuencia de infecciones nosocomiales y comunitarias. Es prioritario intensificar una campaña educativa para el control y uso racional de los antibióticos.
OBJECTIVE: To describe the patterns of antimicrobial resistance of organisms isolated from urine cultures at a teaching oncological hospital for adult patients. MATERIAL AND METHODS: All strains obtained from urine cultures from 1998 to 2005 were included. Mean susceptibilities were obtained for each antimicrobial tested; nosocomial and community-acquired isolates were analyzed separately. RESULTS: A total of 9 232 positive urine cultures were obtained (20.7 percent) from 44 447 samples taken. Gram negative bacteria were reported in 78.8 percent, Gram-positive in 13.8 percent and yeasts in 7.4 percent. Escherichia coli was the most frequently isolated bacterium (41.3 percent); antimicrobial resistance was higher in nosocomial isolates than in community strains (amikacin 92.4 vs. 97 percent, ceftazidime 83.1 vs. 95.1 percent and ciprofloxacin 46.2 vs. 58.6 percent). Pseudomonas aeruginosa showed a greater resistance to amikacin and ceftazidime in nosocomial cultures compared to community-acquired bacterial cultures (55.7 vs. 66.6 percent and 65.5 vs. 84.8 percent respectively). Vancomycin-resistant enterococci were found in only 2.5 percent (3 of 119 E. faecium isolates). CONCLUSIONS: Higher bacterial resistance was observed in nosocomial cultures than in community ones. Antimicrobial resistance was found to be progressively increasing for E. coli, the most frequent pathogen isolated both in nosocomial and community infections. We consider imperative the establishment of an intense educational campaign for the use and control of antibiotics.
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Humanos , Institutos de Câncer/estatística & dados numéricos , Farmacorresistência Bacteriana , Farmacorresistência Fúngica , Neoplasias/urina , Urina/microbiologia , Bactérias/efeitos dos fármacos , Bactérias/isolamento & purificação , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , Infecções Bacterianas/urina , Candida/efeitos dos fármacos , Candida/isolamento & purificação , Candidíase/epidemiologia , Candidíase/microbiologia , Candidíase/urina , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/urina , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Infecção Hospitalar/urina , Enterococcus faecium/efeitos dos fármacos , Enterococcus faecium/isolamento & purificação , México/epidemiologia , Neoplasias/epidemiologia , Neoplasias/microbiologia , Estudos Retrospectivos , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Infecções Urinárias/urinaRESUMO
The introduction of low-cost competitive antiseptic products may offer savings, but, unfortunately, their quality control is poor in many developing countries. The use of a new brand of idopovidone solution, used routinely for catheter insertion-site cleaning, was associated with a 55% increase in catheter insertion-site infection per 100 active catheters, returning to usual after the product was recalled. The new brand of iodopovidone solution had less free iodine (.76%) and lower pH (2.7) than required by local standards (pH 3-6.5). Use of substandard antiseptics in developing countries, because of poor quality control, is a risk for patients and results in increased health services expenses and burden of work.
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Anti-Infecciosos Locais , Cateteres de Demora/efeitos adversos , Infecção Hospitalar/etiologia , Povidona-Iodo , Anti-Infecciosos Locais/normas , Cateteres de Demora/microbiologia , Estudos de Coortes , Humanos , Controle de Infecções/métodos , Povidona-Iodo/normasRESUMO
Objetivo. Describir los resultados de diez años de vigilancia de infecciones intrahospiralarias (II) en un centro oncológico. Material y métodos. Es un estudio descriptivo, retrospectivo, del programa de vigilancia del Comité de Vigilancia y Control de Infecciones Intrahospitalarias del Instituto Nacional de Cancerología, realizado en 1997. Se utilizaron los criterios de infección intrahospitararia por sitio propuestos por el Centro para la Prevención y el Control de Enfermedades de Atlanta, Georgia, de Estados Unidos de América, en 1972. De junio de 1986 a diciembre de 1996, se estudiaron 62 733 egresos. La vigilancia se realizó mediante la revisión de los expedientes de pacientes con fiebre, de aquellos que reciben antibióticos y de posoperados en los pisos de hospitalización y revisión de cultivos. Se calcularon las tasas de II por episodios/100 egresos. Resultados. La tasa de infecciones intrahospitalarias por 100 egresos fue de 4.4 en 1986; 7.7, en 1987; 8.1; 5.9, en 1989; 4.6, en 1990; 5.1, en 1991; 4.3 en 1992; 5.4, en 1993; 7.6, en 1994; 7.1 en 1995, y 8.5 en 1996. El germen más frecuentemente aislado en las II fue Escherichia coli. Los aislamientos de hongos y los de enterococo se incrementaron en casi siete veces desde 1987. Conclusiones. Se observó un incremento en la tas de infecciones hospitalarias en los últimos cuatro años. Al menos dos factores contribuyeron a esta tendencia: la aplicación de un sistema de vigilancia más experiemntando, el cual hizo que diminuyera el subregistro, y el aumento real en la frecuencias de tales infecciones.