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To measure the incidence rate and trend of acute leukemia (AL) in political districts of Mexico City.Descriptive longitudinal study conducted at six hospitals that care for nearly 97.5% of all cancer cases among children in Mexico City. Study data were collected in 1995 and 1996, and were analyzed in 1999, at the National Medical Center "Siglo XXI" Children's Hospital, of the Mexican Institute for Social Security. Calculations of acute leukemia annual incidence rates, standardized rates, and standardized morbidity rates (SMR) with 95% confidence intervals, were obtained for each district. Morbidity trends were assessed through average change rates.In this study we observed an increasing trend of acute lymphoblastic leukemia (ALL) incidence in five districts: Alvaro Obregon, Cuauhtemoc, Gustavo A. Madero, Iztacalco, and Venustiano Carranza. Acute myeloblastic leukemia (AML) showed no significantly statistic increase of incidence in any district. AML did show a significant SMR in Alvaro Obregon district (SMR = 2.91, 95% CI 1.63-4.80). Higher SMRs were found in the south and southwest areas of the city.Increasing incidence of ALL was observed in five districts of Mexico City. AML incidence was the highest in Alvaro Obregon district.

To assess satisfaction of attendants to a National Meeting on Medical Research in relation with the scientific quality and level of discussion of the research work.An anonymous self-applied questionnaire was handed out to gather opinions about the scientific quality, level of discussion of the research work, and overall satisfaction with the meeting. The studied population included 400 physicians, all of them authors or collaborators of the research work presented.The rate of response was 62% (n = 249). Two hundred and twenty-four approved the scientific quality (90%), and 203 were satisfied with the level of discussion of research (88%); 239 were satisfied with the meeting as a whole (96%). The factors associated with dissatisfaction regarding the quality of the scientific meeting were the masculine gender (OR = 2.7, CI 95% = 0.8-9.l, p = 0.06), having an M.Sc. or Ph.D. degree (OR = 2.3, CI 95% = 0.9-5.5, p = 0.03), and having attending prior meetings more than twice (OR = 5.0, CI 95% = 1.5-18.4, p = 0.001).Most of the attendants were satisfied with the scientific quality and discussions of the research work. The masculine gender, having an M.Sc. or Ph.D. degree, and prior assistance were the factors associated with dissatisfaction of the scientific quality of the Meeting.

Cervical cancer is the most important cancer in Mexican women. Early detection is possible by means of the Papanicolaou (Pap) test; however, the coverage in Mexico is low.A cross-sectional survey was carried out in a representative sample of women from the Tlalpan area of Mexico City. Social, reproductive and health care factors associated with the lack of use of the Pap test with respect to adequate use and misuse were identified. Both bivariate and logistic regression analyses were used for the adjustment of variables.Of 1,215 women studied, 22.5% had never had a Pap smear, 42% had misused the test (90% of triennial performance), and 35.5% had adequately used the test (or = 90% of triennial performance). The main factors related to the lack of use were the following: not knowing about the Pap test (ORa = 35.16, 95% C.I. = 17.4-70.9); having fewer than 6 years of education (ORa = 4.5, 95% C.I. = 2.5-8.4); women younger than 30 years of age (ORa = 3.4 95% C.I. = 2.3-5.1); use of contraceptives (ORa = 0.4, 95% C.I. = 0.2-0.8); history of sexually transmitted diseases (ORa = 0.3, 95% C.I. = 0.1-0.8), and the principal informant about the Pap test, i.e., the health services personnel (ORa = 0.02, 95% C.I. = 0.0008-0.05).The lack of use and the misuse of Pap smears vary importantly among the different social and reproductive factors. But the principal reasons for lack of use were not knowing about the Pap test and a low educational level. We propose a greater diffusion on the benefits of the test in the Mexican population, through massive means of communication and health services.

To determine the frequency, time of occurrence and factors associated with the failure of the permanent peritoneal catheter during dialysis in cases of chronic renal failure (CRF).A retrospective cohort under a nested case control design was studied at a second level health care unit of the Instituto Mexicano del Seguro Social. A total of 149 catheters, double cushion straight Tenckhoff type, were evaluated in 74 patients with CRF due to diabetic nephropathy in 36/74 patients (49%). Information concerning functionality time and causes of catheter failure as well as the clinical and technical factors concerning insertion were obtained from the clinical chart.The cumulated time of dialysis was 814 months. Catheter failure occurred in 101 cases (68%): 67 due to obstruction, 24 due to infection, to leakage in 6 and to other causes in 4. Those of non-infectious origin were more frequent (p0.01). In the first month post-insertion there was a higher number of failures than after one month, (p0.0005). The global functionality of the catheter at one month, one and two years was 55%, 31% and 16%, respectively. There was a greater permanence of the catheters in continuous ambulatory peritoneal dialysis than in intermittent peritoneal dialysis (p = 0.02).It is concluded that the frequency of the peritoneal catheter failure was high; that the most frequent cause was due to non-infectious complications during the first month of insertion; and the factor associated to catheter failure was intermittent peritoneal dialysis as compared to continuous ambulatory dialysis.

There are different risk factors which have been related to the presence of leukemia in children. In the past years one of these factors has become relevant, the risk of living in an area near to high electric voltage lines, generators of electromagnetic fields of low frequency (EMF), which can cause development of leukemia in children.To learn whether living in an area close to EMF generator sources, electric transformers, high electric voltage distribution or transmission lines and electric substations, is a risk factor in the development of leukemia in children living in Mexico City.A projective study of case-control was accomplished. The cases were obtained from hospitals of the third level. The diagnosis of leukemia in its different varieties was confirmed through biopsy of bone marrow. The controls were selected in the same hospital from inpatients and outpatients with different problems, except neoplasia. A total sample of 81 cases and 77 controls was analyzed. The residence of the controls and cases were visited using a questionnaire coded with the different study variables. To diminish the memory bias in relation to EMF, the subjects were shown different pictures pointing out the different sources of exposures, which were asked. Having obtained the information, different odds ratios (OR) were calculated for the different associations, as well as the confidence intervals at 95% and an unconditioned logistic regression was accomplished to know the adjusted OR.There were no differences between the cases and controls according to the relative who gave the information, the current age of children, the parents's age, the social class and the parent's occupation. It was found that all the generating sources of EMF, which were involved in the study, had and OR above 1. Being the highest, the ones living near the distribution or transmission wires of high voltage with an OR of 2.63 (1.26-5.36) and 2.5 (0.97-6.67) respectively. When the distance of exposure was controlled, the highest OR was for distribution lines (OR 2.12; 0.79-5.85). When the analysis was applied to persons who have moved from the residence, it was found that the OR was above 1 in all the associations, the highest being the distribution wires and with the distance the highest was the electric substations. Furthermore, the multivariate analysis showed that the risk continued only for the distribution wires.The EMF exposure was found positive, however this is not very precise, that is why it is necessary to carry out other studies to confirm the existence of the association and correct possible biases which could appear during the research.

To identify the mortality prognostic factors from a pediatric intensive care unit.Retrolective cohort study with an analysis of cases and controls (ambidirectional design). PLACE OF STUDY: The intensive care unit at a Pediatric Third Level Hospital.All of the patients admitted into the I.C.U. for a year (August 1989 to August 1990).The patients were identified when admitted into I.C.U., while evaluating their clinical course through their charts. Afterwards, they were placed into two groups, those who died while in I.C.U. (n = 49) and those in the control group which constituted the initial cohort survivors (n = 115). The prognostic factors evaluated were age, sex, diagnosis when admitted, organic failure, changes in diagnosis and treatment.164 patients were studied, with a slight predominance of the male sex (53%). The patient's age fluctuated between 1 day and 17 years of age, with a mean age of 10 months. The diagnosis established when admitted were predominantly dealing with infectious problems (n = 54, 32%). The most important prognostic factors seen during the bivaried analysis were the peritoneal dialysis (RM = 12.71, IC 95% = 2.41-98.29, P less than 0.01); a Glasgow index less than or equal to 10 points (RM = 7.33, IC 95% = 1.25-47.26, P less than 0.01), respiratory organic failure (RM = 6.32, IC 95% = 2.46-16.8, P less than 0.01) and assisted mechanical ventilation (RM = 5.61, IC 95% = 2.52-12.68, P less than 0.01).The mortality rate in I.C.U. was 30%. The most important prognostic factors associated to mortality after adjusting for severity were having a cardiovascular ailment, the need to administer blood products, a Glasgow index less than or equal to 10 points, heart and hematologic organic failure and when respiratory mechanical assistance was provided.

1. To determine the degree of correlation among different physicians concerning their initial diagnosis and 2. identify the degree of correlation between the probability that physicians assing an initial diagnosis and the number of days the patient is hospitalized, laboratory test and X-rays taken of the patient.A comparative questionnaire.Pediatric hospitalization Unit of a third level medical care ward of the Mexican Social Security Institute.All new admissions or non-programmed readmitted patients to the hospital during the months of November and December 1990.The treating physicians (Staff pediatricians (MB) and third (R3) and second (R2) year residents) were each asked to independently assign a probability (0 to 100) to each of the diagnosis emitted on the day the patient was admitted. When the patient was discharged, the number of days hospitalized as well as the number of laboratory tests and X-rays taken of the patient were added.106 patients were evaluated, a correlation was gathered between MBs and R3s of 0.79 (P less than 0.001) and among MBs and R2s of 0.83 (P less than 0.001). The correlation between resident physicians was discretely less 0.60 (P less than 0.01). When relating the probability assigned by the physicians and the number of days the patients were hospitalized, associations were observed of 0.31 (P less than 0.05), 0.15 (P less than 0.05) and 0.19 (P = 0.04) for the MB, R3 and R2s respectively. In the case of laboratory test a correlation of 0.38, 0.06 and 0.04 (MB, R3, R2 respectively) was found. None of these correlations were statistically significant. The X-rays showed a significant correlation in cases of the MBs (0.50, P less than 0.05).The probabilities assigned by the staff physician as well as the resident doctors are closely related and a lesser grade of association is seen when comparing the residents among each other. No tendencies were identified in the correlation of the probability assigned by the residents and the variables analyzed. A consistent relation was seen between the staff physician and high probabilities, longer stays, and greater number of laboratory tests and X-rays.

To determine the efficacy of zymodemes of E. histolytica technique in an epidemiologic study. To report the zymodemes for the first time described in Mexico. To report the main difficulties in the correct classification of zymodemes in this study. To describe the zymodemes identified in two evaluations done in 100 healthy individuals.A cross-sectional survey and a cohort of healthy persons.We analyze the results of 1730 Robinson cultures performed in a cross-sectional survey done in the Municipality of Cadereyta, Queretaro, Mexico from October 1986 to August 1987. From positive cultures properly growth a Iysate was done and preserved in liquid nitrogen until the electrophoretic determination of 4 isoenzymes was done: EC 5.3.1.9. glucophosphate isomerase (GPI); EC 1.1.1.40 L-malate: NADP oxidoreductase (oxaloacetate decarboxylating) (ME); Ec 2.7.5.1 phosphoglucomutase (PGM); and EC 2.7.1.1 hexokinase (HK).Of 1730 cultures 289 (16.7%) developed trophozoites, in 100 (34.6%) was possible to make lysate and zymodeme. There were 67 ZNP, 3 mixtures (ZP and ZNP) and 30 ZP. There were two patterns for the first time described in Mexico (XVII and XVIII) and 30 strains had a pattern different from the 20 already described by Sargeaunt. Results observed in 100 individuals measured twice. [table: see text] There were 9 subjects in which zymodemes were isolated twice: at the first time 5 PZ and 4 NPZ, at the second time 1 PZ and 8 NPZ. At first time all 9 had negative serology and the second time one carrier of NPZ became positive.In our study one tirth of Robinson cultures positive to trophozoites reached lysate. Efficacy of zymodemes and CPS is similar. We report for the first time in Mexico two non-pathogenic zymodemes (XVII and XVIII). We also report 30 zymodemes non-classified according to the standard proposed by Sargeaunt, one explanation for this feature is the possibility of zymodemes variability or new patterns. In endemic populations zymodeme pattern varies with time in asymptomatic carriers.

This paper shows the results of a study of acute diarrhoea (AD) in 137 rural communities in Mexico. We studied 51 communities with 1000 inhabitants or less, 45 communities with 1001 to 5000 inhabitants and, 41 with 5001 to 15000 inhabitants. All in all we observed 4,796.9 persons year during a period comprised from March 1982 to February 1983. In communities with more than 5000 inhabitants there occurred 0.85 episodes of AD per person-year, whereas in the smaller ones the incidence was only 0.58 episodes per person-year p less than 0.01). In small communities the frequency was higher in families with poor water supply and inadequate excreta disposal, whereas in large communities the frequency was not affected by such services. In 95.6 percent of the cases the episodes were self-limited within the first 14 days. There were seven deaths, five occurring in children under one year of age, six in children living in small communities and, five associated with dehydration. These results suggest that the size of the community constitutes a risk factor for AD in rural areas, which deserves to be explored in further studies. The lethality observed in small communities stresses the need of programs for better treatment of this frequent disease.

This study describes the epidemiology of acute respiratory infections (ARI) in a sample of rural population of México. The study includes 137 communities from all over the country: 51 with 5001 to 15000. In each community ten families with one child under one year of age were followed. Each family was child under one year of age were followed. Each family was visited weekly by one physician from the local IMSS-COPLAMAR clinic in order to register frequency and characteristics of ARI in each family member. We followed 1359 families and observed 4796.9 persons-year. Eight thousand and two episodes of ARI were observed. The relative risk of getting ARI in children below two years of age was 2.8 and in severe malnourished was 1.8. The frequency of ARI was higher in large communities than in small ones. Eight six point eight percent of the episodes were upper respiratory infections, 95.3 percent of the cases cured, 4.6 became chronic and there were four deaths. Mortality rate was 0.8 per 1000 persons-year. Sixty nine point eight percent of the cases received antithermics, 49.3 percent antihistaminics and, 48.6 percent antibiotics.