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Aims: To analyze the association between alcohol intake and the severity of injuries sustained from traffic accidents on a Mexican highway., Design: An observational unit evaluated drivers involved in auto accidents., Setting: Mexico-Cuernavaca Highway, Mexico. A 60 km-long road with many altitude variations and sharp curves., Participants: Three hundred and eighty-six drivers involved in traffic accidents between March and September, 1994., Measurements: A questionnaire was applied to the driver, an occupant or witness at the site of the accident to collect information about the driver, vehicle characteristics, type of accident, day-night occurrence, road section (Mexico-Cuernavaca or Cuernavaca-Mexico) and weather conditions. A physical examination was carried out to determine the presence and severity of injuries., Findings: There were 177 injured people, including 12 deaths, with rates of 67.5 injuries and 4.58 deaths per 10,000 km driven. Variables associated with alcohol intake (p < 0.05) included: severity of injuries, non-use of seat belt, vehicle size and occurrence at night. Risk factors for severe injuries were: alcohol intake (adjusted OR 6.1 CI 95% 1.6-24.0); non-use of seat belt (OR 4.9 CI 2.2-10.8), age < 25 years (OR 3.6 CI 1.0-12.7), age > 54 years (OR 6.0 CI 1.4-25.0), speed > 90 km/h (OR 2.6 CI 1.1-6.3) and occurrence at night (OR 2.6 CI 1.3-5.3)., Conclusions: Alcohol intake is a major risk factor for severe injuries from highway traffic accidents. Its association with other risk factors such as non-use of seat belt and excessive speed suggests the importance of designing interventions aimed at reducing alcohol intake among automobile drivers.

A collection of rhizobial isolates from nodules of wild beans, Phaseolus vulgaris var. aborigineus, found growing in virgin lands in 17 geographically separate sites in northwest Argentina was characterized on the basis of host range, growth, hybridization to a nifH probe, analysis of genes coding for 16S rRNA (16S rDNA), DNA fingerprinting, and plasmid profiles. Nodules in field-collected wild bean plants were largely dominated by rhizobia carrying the 16S rDNA allele of Rhizobium etli. A similar prevalence of the R. etli allele was observed among rhizobia trapped from nearby soil. Intragroup diversity of wild bean isolates with either R. etli-like or Rhizobium leguminosarum bv. phaseoli-like alleles was generally found across northwest Argentina. The predominance of the R. etli allele suggests that in this center of origin of P. vulgaris the coevolution of Rhizobium spp. and primitive beans has resulted in this preferential symbiotic association.

Our understanding of violence gains from perspectives contributed by several different disciplines. The differences among goals and points of view are often reflected in their vocabularies and interfere in to integrate the advances by each of them. Three big disciplines have studied violence, those are: Social Sciences, Criminal Justice and most recently Public Health. This paper discusses the theoretical perspectives by discipline and try to dimensionate the violence problem measured by mortality and morbidity by intentional injuries in México.

Traffic accidents are a well-known public health problem worldwide. In Mexico research into risk factors for motor involving vehicles accidents and their consequences has recently been taken into account. The relevant literature does not normally describe the methodological aspects involved in the collection of primary data, since most studies have used secondary data the good quality and validity of which are assumed. The paper presented seeks to discuss and share with researchers in this field, some of the methodological aspects to be considered in the attempt to recreate the scene of the accident and obtain information approximating to reality. The measurements in situ of, such traffic accident variables as injury, use of seat belt, speed and alcohol intake are discussed.

Objective: To analyze the association between the severity of car accident injuries and the use of safety belts., Material and Methods: The unit of observation and analysis was car drivers in the Mexico-Cuernavaca toll highway. Variables included were those of car drivers, the vehicles and the physical environment at the accident site. Statistical analysis was carried out by means of chi square, odds ratios, 95% confidence intervals and logistic regression. Data was collected in 422 questionnaires for 324 accident events., Results: There were 177 injured people, including 12 deaths, with rates of 67.5 injuries and 4.58 deaths per 10 000 kilometers driven. Variables associated with not using a safety belt (p < 0.05) were: alcohol drinking, vehicle size, night-time and road section. Risk factors for severe injuries were: not using a safety belt (raw OR 4.9, 95% CI 2.2-10.8, adjusted OR 2.94, 95% CI 1.13-7.66); age < 25 years (OR 3.6, 95% CI 1.0-12.7) and > 54 (OR 6.0, 95% CI 1.4-25.0); alcohol drinking (OR 10.8, 95% CI 3.8-30.4); and night time (OR 2.8, 95% CI 1.4-5.8)., Conclusions: Theses findings suggest the need to formulate interventions aimed at enforcing the use of safety belts and prevention of related factors.

Unlabelled: A study of homicide in the population of Mexico, was undertaken for the purpose of discovering the mortality panorama by this cause during 1979-1992. Homicide mortality trends were analyzed, as well as the main causes by age and sex. Rate by cause and sex were also analyzed using a Poisson Regression model. The variables were: age, sex, year, external cause of intentional injuries ICD 9th. E960-E969., Results: The total number of deaths due to homicide was 198,485. Each day 35 persons die in Mexico as a result of homicide. Men were more affected than women with a RR of 10.1 and CI (95%) 14.9-16.0, adjusted for age. The main cause 56% was homicide by fire-arms and explosives. The high relative risk was for those aged from 35 to 39 with an RR of 15.4 CI 14.9-16.0. To the cause assault by other and unspecified means, the elderly population has a RR of 21.2 IC 19.7-22.9. Further research in the area and prevention should make use of a multidisciplinary approach in considering the multiple causes and solutions to this problem.

When the death causes are understood as a result of morbility process that may have been avoided with different kinds of economic, social and welfare services policies and the advance of scientific and technologic knowledges, there is clearly a structural determinism so that many population social sectors can't reach the "modern epidemiological patterns". This study used annual data bases of register death 1979-1991 brought by INEGI/DGE-SSA from five Mexican federal border entities. It were adjusted by Preston-Coale method and Life Tables were generated in 1980 and 1990. The percentage contributions of avoidable causes' groups by sex and age of the increases in the Expectation of Life (Ex) were calculated in the same years following Pollard's method. As result of this research, limited increments of Ex were found because of the permanence of high contribution of deaths, that may have been avoided (50%). Contrary to popular beliefs, Ex male diminished the difference compared with Ex female. Highest male mortality is explained even for this kind of causes, where accidents and violence deaths are bringing high percentages of total mortality.

A study was conducted in children under five years old, in order to establish the association between the mother's work and the severity of unintentional injuries. The study was carried out at the emergency room of six pediatric hospitals in Mexico City. Cases were children with major injuries that required hospitalization, intensive care, surgery, or who died as a result of the injury. Controls were children of similar age, with minor injuries resolved at the emergency room. Sample size was 350 cases and 350 controls. Variables were grouped according to: mother's occupation; characteristics of the child, socioeconomic status, child care, and those related with home risk factors. Results showed a protective effect on severity of injuries when the mother worked outside home in comparison to mothers who do not work, (or 0.79, 95%CI 0.57-1.07). No differences were found with respect to sex and age of children. Mother age under 24 years old and low schooling (< 3 years of elementary school) were statistically significant with a risk of major injuries (or 2.30, 95%CI 1.5-3.4). Delay of demand of medical care after 60 minutes of injury occurrence is related with a risk of major injury (or 1.68, 95% CI 1.2-2.3). No differences related with household risk factors were found. Results provide valuable information about risk factors related with injury severity and the association with mother's work.

We present the case of a 38-years-old tertipara at full term with a diagnosis by ultrasound of placenta previa who underwent elective cesarean under spinal anesthesia. After a difficult birth, anomalous adhesion of the placenta prevented its removal and caused massive hemorrhage of the placental bed and hypovolemic shock. Blood volume was restored and emergency hysterectomy under general anesthesia was effected, as bleeding and hemodynamic state were brought under control. Abnormal heart rhythm appearing after the operation responded to treatment; postoperative recovery was unremarkable. Placenta accreta is a rare complication of placenta previa. Given that massive obstetric hemorrhage is associated with significant mortality and morbidity, both maternal and fetal, the anesthesiologist must be aware of potential problems that might arise in cases of placental accreta so that readiness can keep risk to a minimum.

Introduction: The main objective was to determine the risk factors involved in unintentional injuries in children under 10 years old occurring at home., Material and Methods: A Case Control study was conducted in the emergency room of three pediatrics hospitals in Mexico City. The sample size was 160 cases and 320 controls., Results: Boys were more affected than girls (OR) 1.7, C.I. (95%) 1.2-2.5. The age group more affected was two-three years old (OR) 1.6, C.I.1.1-2.2. When children play outside home (roof, stairs, patio) the risk was OR 2.48, C.I. 1.63-3.76. If mother is not encharged of children care (OR) 2.9, C.I. 1.8-4.8. The age > 40 years old of the person encharged of children care (OR) 2.2, C.I. 1.4-3.5., Conclusions: The results showed us how necessary is to develop injury prevention programs especially to implement passive measures, with target populations people encharged of children care.

A case-control study was carried out, aimed at identifying and defining the individual, family, household and childcare social support network characteristics, more likely to be associated with the occurrence of accidental home injuries in 0-9 year-old children. This study was carried out in the emergency units of three pediatric hospitals in the Federal District. In this article we report the results of the descriptive analysis only of the cases. The results were as follows: male children (62%) and the one and two year-old children group (37%) were the most affected. Contusions, head injuries and fractures occupied the first three places, the main three causes being falls from one level to another (mainly in stairways and off the bed) falls on the same level (sliding, tripping or stumbling) and burns with boiling liquids (most frequently boiling water for bathing). A history of injuries was documented in only 15% of cases. Thirty nine percent of cases requested medical attention after one hour of the accident; 51% of these were hospitalized. In 25% of cases, the mother worked outside the home, being absent from 6 to 12 hours. Risk factors occurring most frequently were: unprotected electricity inlets (40%); products within reach of children: cleaning products (38%), makeup products (34%), plastic bags (30%) and tools (30%); lack of protection rails for cradles (30%) and for staircases (48%), and free access to roofs (44%). In 62 percent of cases some care was provided in the house of the injured child; twenty six percent counted on a support network, and 3 percent were by themselves. We present some proposals for epidemiologic and health services research, and stress the necessity to implement health education, social security and health services policies to favorably influence the solution of these problems.

The optimal treatment, surgical or conservative, for multicystic dysplastic kidney (MDK) is still undetermined. We analyzed prospectively the evolution of 12 children with MDK who were managed conservatively. After a mean follow-up of 32 months, the only complication found was an episode of urinary tract infection in 3 patients. Complete involution of MDK was observed in 9 patients (75%), the mean period for sonographical disappearance being 16 months. Infants with MDK should be closely monitored and nephrectomy performed when MDK compresses neighbor organs or hypertension develops. There is no agreement on the best therapeutic approach in patients in whom MDK involution has not occurred after a prudential waiting time still not determined.

We report the case of a 37 year old male from rural area who presented as an emergency with symptoms compatible with the existence of a retropharyngeal tumoration. By the clinic it suggested an abscess but the CT scan as compatible with a carcinoma. On complementary examinations it appeared in a chest X ray an image which strongly suggested the possibility of a hydatidic cyst of the lung. Specific serologic reactions supported this and post-surgical pathological study lately confirmed the diagnosis. We believe of interest reporting this case because of it's unusual localization and difficulty in diagnosis.