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Objective: Scientifically based injury prevention efforts have not been widely implemented in Latin America. This study was undertaken to evaluate the baseline knowledge and practices of childhood safety on the part of parents in Monterrey, Mexico and in so doing provide information on which to base subsequent injury prevention efforts. Methods: Interviews were carried out with parents from three socioeconomic strata (upper, middle, lower). Questionnaires were based on Spanish language materials developed by The Injury Prevention Program (TIPP) of the American Academy of Pediatrics. Results: Data were obtained from parents of 1123 children. Overall safety scores (percent safe responses) increased with increasing socioeconomic status. The differences among the socioeconomic groups were most pronounced for transportation and less pronounced for household and recreational safety. The differences were most notable for activities that required a safety related device such as a car seat, seat belt, helmet, or smoke detector. Appropriate use of such devices declined from 47% (upper socioeconomic group) to 25% (middle) to 15% (lower). Conclusions: Considerable differences in the knowledge and especially the practice of childhood safety exist among parents in different socioeconomic levels in Mexico. Future injury prevention efforts need to address these and especially the availability, cost, and utilization of specific highly effective safety devices. [ABSTRACT FROM AUTHOR]

We examined tick communities on wild felid hosts in three ecoregions of Mexico. We collected 186 ticks of 7 species from 10 pumas (Puma concolor) and 9 jaguars (Panthera onca). Tick community composition varied across the ecoregions, and across host species within each region. Overall, Ixodes affinis, Amblyomma ovale, and Amblyomma tenellum were the most abundant species; however, only the latter two ticks were distributed across all three ecoregions, while I. affinis, along with Ixodes spinipalpis, Amblyomma inornatum, and Amblyomma parvum were restricted to more limited geographical regions. Ixodes affinis occurred strictly in southern tropical rainforest ecoregions and was significantly more abundant in Selva Lacandona compared with the Yucatán Peninsula. Amblyomma ovale was significantly more common in the tropical dry forest in the Pacific coastal ecoregion. Amblyomma tenellum abundance tended to be higher on jaguars, while I. affinis abundance was higher on pumas. Regional distribution patterns of some tick species (e.g., I. affinis and I. spinipalpis) may be determined by off-host environmental conditions rather than host factors. In contrast, at the local scale, occurrence and abundance of some tick species (e.g., A. tenellum, A. ovale and Rhipicephalus microplus) might be driven by ecological-host factors, such as habitat use or predator-prey relationships., (© 2022 Royal Entomological Society.)

The healthcare sector is an important contributor to mercury (Hg) pollution because of the potential presence of mercury in thermometers, blood pressure cuffs, amalgams, etc. There are also other potential sources of mercury in this sector which are used frequently and in high volumes where the presence of the metal is not obvious and which might be collectively contributing to pollution. For instance, some chemicals used for the clinical diagnosis of illness may contain mercury. The goal of this study was to investigate potential sources of mercury pollution, which originate from clinical laboratory discharges, using an exploratory approach. The focus was on the residue generated during automatic analysis of patients' bodily fluids at a medical center in Hermosillo, Sonora, Mexico. This study shows an overview of what might be happening in the region or the country related to non-obvious sources of mercury in the healthcare sector. The results showed measurable levels of mercury in the residues coming from urine sediment analysis. These amounts do not exceed the maximum allowed by Mexican environmental regulations; nevertheless, the frequency and cumulative volume of residues generated, combined with the potential for persistence and the bioaccumulation of mercury in the environment, warrant attention. The work carried out in this study is being taken as a model for future studies for pollution prevention in the healthcare sector with the goal of measuring mercury emissions to the environment from clinical laboratory wastewater, including identifying sources which--while not obvious--could be important given the frequency and volume of their use in the clinical diagnosis.

A survey was conducted in order to dispel misconceptions about natural orifice transvaginal cholecystectomy. Forty-two patients were surveyed after having undergone that procedure. Those patients were asked questions related to 1) patient satisfaction, 2) whether they would recommend the procedure to others, and 3) dyspaurenia. The survey was done after a sexual abstinence period that varied from 30 to 40 days. We encountered no complications, and all patients liked the procedure and would recommend it to family and friends. No patient developed dyspaurenia. The postoperative responses were unanimous and positive for all questions. The result of this postoperative transvaginal cholecystectomy survey will help patients and surgeons ease their fears and social taboos and better communicate, and this will help patients to become aware of the option of transvaginal peritoneoscopy.

Background: We report on the effectiveness of a standardized perioperative care process for lowering surgical site infection (SSI) rates among children with stoma closure at a tertiary-care public pediatric teaching hospital in Mexico City., Methods: All consecutive children with stoma closure operated on between November 2003 and October 2005 were prospectively followed for 30 days postoperatively. We conducted a before-after study to evaluate standardized perioperative bowel- and abdominal-wall care process results on SSI rates., Results: Seventy-one patients were operated on, and all completed follow-up. SSI rates declined from 42.8% (12/28) before to 13.9% (6/43) after the standardization procedure (relative risk (RR) = 3.1; 95% confidence interval (CI) = 1.3-7.2; p = 0.006). SSI independently associated risk factors comprised peristomal skin inflammation >3 mm (odds ratio (OR) = 9.6; 95% CI = 1.8-49.6; p = 0.007) and intraoperative complications (OR = 13.3; 95% CI = 1.4-127.2; p = 0.02). Being operated on during the after-study period was shown to be a protective factor against SSI (OR = 0.2; 95% CI = 0.4-0.97; p = 0.04)., Conclusion: Standardization was able to reduce SSI rates threefold in children with stoma closure in a short period of time.

Objectives: To evaluate the effectiveness of educational counselling programmes aimed at increasing parents' practice of childhood safety in Monterrey, Mexico, and to provide information aimed at helping to improve the effectiveness of future efforts in this field., Methods: Three different counselling programmes were designed to meet the needs of the upper, middle and lower socioeconomic strata. Evaluation involved the use of baseline questionnaires on parents' existing safety-related practices for intervention and control groups and the administration of corresponding questionnaires after the programmes had been carried out., Findings: Data were obtained on 1124 children before counselling took place and on 625 after it had been given. Overall safety scores (% safe responses) increased from 54% and 65% for the lower and upper socioeconomic strata, respectively, before counselling to 62% and 73% after counselling (P <0.001 for all groups). Improvements occurred both for activities that required caution and for activities that required the use of safety-related devices (e.g. helmets, car seats). However, scores for the use of such devices remained suboptimal even after counselling and there were wide discrepancies between the socioeconomic strata. The post-counselling scores for the use of safety-related devices were 55%, 38% and 19% for the upper, middle and lower socioeconomic strata, respectively., Conclusions: Brief educational interventions targeting parents' practice of childhood safety improved safe behaviours. Increased attention should be given to specific safety-related devices and to the safety of pedestrians. Educational efforts should be combined with other strategies for injury prevention, such as the use of legislation and the improvement of environmental conditions.

Primary immunodeficiency diseases (PIDs) are rare but important conditions found predominantly in children. We studied PIDs in a large pediatric hospital, their association with cutaneous alterations, and the importance of cutaneous alterations as diagnostic markers. Among 382,383 pediatric patients, 130 (0.0003%) had a PID: humoral in 27, cellular and combined in 18, phagocytic in 37, and associated with major defects in 45. An average of two cutaneous alterations were present in 90 (69%) patients: infections in 80, eczema-dermatitis in 38, and miscellaneous in 57. In 71 (79%) patients the cutaneous alterations preceded and were the basis for the clinical immunologic diagnosis. Only two PIDs were not associated with cutaneous lesions.

Objective: To determinate the effect of maternal heart disease on pregnancy outcome., Methods: We reviewed retrospectively 1169 pregnancies in 1093 women with heart disease. 53 women were assisted during 2 pregnancies, ten during 3 and one during 4 pregnancies. All the pregnancies were prenatal and labor assisted at the National Institute of Perinatology, México, D.F., Results: In 705 (60.30%) the heart disease was of rheumatic origin, in 387 (33.10%) congenital and the remaining were a miscellaneous group. Mitral stenosis and mitral regurgitation (42.13%) was the commonest rheumatic cardiac lesion associated with pregnancy. Ventricular septal defect was seen in the 32.81%. 124 women had a heart valve prosthesis (87 mechanical and 40 bioprosthesis [3 women with double heart valve prosthesis]). Intrauterine fetal growth retardation was the commonest complication. (7.52%) in 29 cases were present complications of heart disease in pregnancy. The abortion was present in 30 cases and intrauterine fetal death in 7 cases. There were 977 term pregnancies. The caesarean section rate was 32.5 per cent, most of them were performed for obstetric or fetal indications. The neonatal weight had a average of 2864.4 +/- 526.9 grams. There were eight maternal deaths in this series (five with congenital origin and 3 rheumatic). The incidence of low birth weight was 8.46 per cent. There were two babies born with cardiac congenital malformations.

Extent and determinants of use of alcohol, marijuana, inhalants, and PCP were explored in a group of 339 Mexican American youths from the East Los Angeles Housing projects. Results from this study were compared to those from a similar survey carried out in the same area 2 years ago. Use of inhalants has declined markedly compared with prevalence reported in the previous report. However, use of alcohol and marijuana have increased across all age and sex cohorts. Prevalence of PCP use, explored for the first time in this report, was shown to be extremely high. Use of all drugs was generally predicted by age, sex, and number of peers reporting use. Self-concept factors, especially one's self-evaluation with respect to others, were also significant predictors to use of marijuana, inhalants, and PCP. However, alcohol use was not related to any self-concept factors. Language (Spanish-English) used both in the home and with peers was related to use of all substances studied. Limitations in the generalization of this study as a result of sampling problems are discussed.