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Introduction: Diagnosing and treating human immunodeficiency virus carriers has led to the identification of a higher prevalence of said infection and, therefore, of a higher risk of transmission of the virus., Objective: To find out the trend of new cases of human immunodeficiency virus infection carriers at the Instituto Mexicano del Seguro Social (IMSS) in Mexico within the 2003-2017 period., Methods: Patients affiliated to the IMSS were analyzed. Data from 42,181 newly-diagnosed cases were collected, with variations related to gender and age being observed. Age-standardized rates per 100,000 population were obtained., Results: The highest mean annual percentage change in males was documented in adolescents (13.0, 95% CI = 9.9, 16.1). Heterogeneous trends were recorded for women, with a significant overall decrease (-2.2, 95% CI = -3.4, -1.0), but growing trends were also observed in some groups., Conclusions: Our results suggest that the human immunodeficiency epidemic in patients cared for at the Instituto Mexicano del Seguro Social is concentrated in males, with a growing trend particularly in adolescents., (Copyright: © 2022 Permanyer.)

Background: The immunologic, metabolic and anthropometric disturbances of overweight-obesity phenomena are risk factors to breast cancer (BC), particularly in proliferative benign breast disease women (PBBD)., Objective: To describe the adipocytokine levels, metabolic alteration and anthropometric characteristics in PBBD and its role as risk estimator to BC in a population with high overweight-obesity prevalence., Material and Methods: A cross-sectional study. We realized nutritional diagnosis, anthropometry, and we calculated the waist-height rate (WHR); serum measurement of adipocytokines, insulin and glucose and, HOMA IR determination in 27 PBBD and 27 BC women. We calculated mean, standard deviation, Pearson and Spearman correlation coefficients, Odds Ratio (OR) and confidence intervals through logistic regression as risk estimators of BC; p < 0.05 values were considered significant., Results: Mean age in the PBBD group was minor than BC group, the humeral diameter was greater in BC group women. We did not find differences in anthropometry or adipocytokine levels; in both groups, the predominant somatotype was the endo-mesomorphic. We found higher insulin levels in BC group and a higher percentage of women with WHR > 0.5 too. The WHR > 0.5 + age over 50 were considered risk estimators to develop breast cancer in PBBD women group., Conclusion: The WHR >0.5 in women with PBBD over 50 years old could be considered an anthropometric risk estimator to develop BC., (Copyright: © 2020 Revista Medica del Instituto Mexicano del Seguro Social.)

Background: Protein supplement use is common in bodybuilders because protein supplements are thought to increase muscle mass by preventing protein catabolism during exercise routines. Information on the consequences of protein supplement use is scarce and contradictory. Therefore, the identification of a kidney damage marker, such as microalbuminuria, could be transcendent in preventing probable organ compromise in healthy persons. The aim of this study is to determine the presence of microalbuminuria in gym members and whether there is an associated risk with protein supplement use., Methods: An analytic, descriptive, cross-sectional study was conducted. It included gym members whose clinical and nutritional histories were taken, identifying protein supplement use. Microalbuminuria was then determined through a random urine sample. Descriptive and inferential statistics were used for the data analysis. The objective was to determine the presence of microalbuminuria in gym members and whether there is an associated risk with protein supplement use., Results: A total of 107 gym members, 71 men and 36 women, that met the inclusion criteria of the study were analyzed. Their mean age was 35±13 years, and the prevalence of microalbuminuria was 9.34%. There was active protein supplement use in 58% of the study participants, with a mean consumption duration of 16±22 months. No association with the presence of microalbuminuria was found (P=0.35)., Conclusions: The prevalence of microalbuminuria in gym members was higher than that of the general healthy population and was not associated with protein supplement use.

Objective: To evaluate the performance of an instrument for predicting chronic chikungunya arthritis (CCA) in adult patients., Methods: A diagnostic test study was conducted and data from 217 confirmed cases of chikungunya virus (CHIKV) illness were analyzed. Two chronic chikungunya arthralgia scales (3-item CCAS-3 and 4-item CCAS-4) were constructed., Results: Modest performance of the CCAS-3 scale was documented at the two given cut-off points. A CCAS-4 score ≥3 showed high sensitivity and specificity for predicting the persistence of CCA at 12 months after acute disease., Conclusions: If replicated in other populations, these results could be useful in the medical management of patients with symptomatic CHIKV infection., (Copyright © 2019 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Aim of the Study: We aimed to explore national and regional trends in teen births in Mexico from 1992-2016, ranking the states with the highest rates in 2016., Methods: A cross-sectional analysis was conducted and the data on the total number of live births to teenage mothers were analyzed. The age-standardized rates (ASRs) per 1,000 adolescent girls were obtained and the annual percent changes (APCs) with 95% confidence intervals (CIs) were calculated using the Poisson regression models., Results: The national ASRs during the study period dropped from 2.11-1.74 in girls aged 10-14 years and from 86.04-70.82 in adolescents aged 15-19 years. Higher APC rates were documented for teenage girls under 15 years of age (‒0.6, 95% CI:-1.0, -0.3), when compared with older girls (-0.3, 95% CI:-0.6, -0.04). Heterogeneous APCs were observed in the stratified analysis and the overall declines were higher from 2011-2016. States with significantly increasing trends in teen births were also documented. The highest ASRs (per 1,000 girls aged 10-19 years) in 2016 were registered in the states of Coahuila de Zaragoza (49.45), Chiapas (46.24), and Guerrero (44.94)., Conclusions: Teen birth rates decreased over the period of time analyzed. However, that decline has not been monotonic or homogeneous across Mexico, and recent (2011-2016) increasing rates were observed in some states in girls aged 14 years and younger. Teenage parenthood can negatively affect multiple dimensions of health, and therefore, regionally directed efforts focusing on its reduction must be strengthened., (Copyright © 2019 IMSS. Published by Elsevier Inc. All rights reserved.)

Background: We aimed to screen for depressive mood experienced during acute chikungunya (CHIKV) infection, and to evaluate the association of several exposures with the risk of depressive symptoms. Methods: A cross-sectional analysis of a multicenter cohort study took place and data from 354 adult individuals with confirmed CHIKV infection were analyzed. Participants were recruited in primary health care settings and the Patient Health Questionnaire-2 (PHQ-2) was used. Prevalence odds ratios (OR) and 95% confidence intervals (CIs) estimated by means of logistic models were used. Results: Depressive mood (PHQ-2 score 3 or higher) was reported by 44.1% of individuals. Subjects with articular effusion (OR = 3.37, 95% CI 1.77⁻8.11), gastrointestinal manifestations (diarrhea, vomiting or abdominal pain, OR = 1.97, 95 CI 1.21⁻3.19), and higher length of severe arthralgia (reference ≤ 14 days: 15⁻30 days, OR = 3.38, 95% CI 1.78⁻6.41; ≥ 30 days, OR = 1.69, 95% CI 0.95⁻3.01) were more likely to self-report depressive mood. Increasing age (≥ 40 years old, OR = 0.55, 95% CI 0.31⁻0.95) and rash (OR = 0.54, 95% CI 0.30⁻0.98) were associated with a decreased risk of depressive mood. Conclusions: Depressive mood seemed to be a frequent event among analyzed individuals, and markers associated with its risk were identified.

Introduction: Healthcare-associated pneumonia (HCAP) is the leading cause of infection in a hospital setting and is associated with a high mortality rate. This study aimed to evaluate the performance of the pneumonia severity index (PSI) and confusion, urea, respiratory rate, blood pressure, age≥65 (CURB-65) systems in predicting 30-day mortality in HCAP in adult patients., Patients and Methods: A cross-sectional study took place and data from 109 non-immunocompromised individuals aged>18 years were analyzed. The clinical diagnosis of HCAP included the presence of radiographic infiltrates in patients≥48hours after hospital admission. The PSI and CURB-65 scores were calculated and performance measures were estimated. Summary statistics were used to describe the study sample. The PSI and CURB-65 scores were calculated based on 20 and 5 criteria, respectively, and the performance indicators of the screening tools were estimated., Results: The overall 30-day mortality was 59.6%. At every given threshold, PSI sensitivity was higher, but showed a lower specificity than the CURB-65, and the highest Youden index (0.392) was observed at cut-off V in the PSI. The area under the ROC curve was 0.737 (95% CI: 0.646-0.827) and 0.698 (95% CI: 0.600-0.797) using the PSI and CURB-65 systems, respectively (P=.323)., Conclusion: Our findings suggest that the performance of the PSI and CURB-65 is reasonable for predicting 30-day mortality in adult HCAP patients and may be used in healthcare settings., (Copyright © 2017 Elsevier España, S.L.U. All rights reserved.)

Aim of the Study: To assess the cumulative incidence and clinical markers associated with persistent arthralgia (PA) at 12 months from acute chikungunya virus (CHIKV) infection., Methods: A multicenter retrospective cohort study was conducted in the state of Colima, Mexico, and 217 serologically confirmed cases of CHIKV infection were enrolled. Participants aged 15 years and older were interviewed on 6 months basis from acute illness onset and the main binary outcome was self-reported PA at 12 months. To assess clinical markers associated with PA we used a generalized linear model. The 2-item Patient Health Questionnaire (PHQ-2) was used to screen for depressive symptoms among PA-positive individuals., Results: The cumulative incidence of PA was 31.8%. In the generalized linear model, individuals ≥40 years of age (risk ratio (RR) = 1.68; 95% confidence interval (CI), 1.10-2.55) and those with 8 or more arthralgia sites (RR = 2.91, 95% CI 1.87-4.53) at acute disease had a significantly increased risk of PA at 12 months from CHIKV infection. Self-reported arthralgia (any site) at 3 months post-infection, a sub-chronic clinical marker, was also associated with a significantly increased risk of long-term articular manifestations (RR = 7.06, 95% CI 2.97-16.81). Depressive symptoms (PHQ-2 score ≥3) were reported by 33.3% of PA-positive participants., Conclusions: Our findings suggest that chronic CHKV-related articular manifestations were a frequent event in the study sample and the impact on functional status was potential. These results may be useful in health care settings in the risk-stratification of PA after CHIKV infection., (Copyright © 2018 IMSS. Published by Elsevier Inc. All rights reserved.)

Objective: To determine the frequency of successful aging (SA) and its relationship with frailty in an elderly population., Material and Methods: An analytical cross-sectional study of subjects ≥60 years of age seen as outpatients in a general hospital. Successful aging was defined as scores of ≥ 90 in the Barthel index and ≤ 2 in the Pfeiffer test. Frailty was determined using the Fried criteria., Results: The study included 400 subjects (272 women and 128 men), with a mean age of 71.6±8.2 years. The SA frequency was 40.4%. frail status was statistically higher in non-successful aging subjects than in SA subjects (161.7 versus 7.9%; P<.001). Women were more frequently frail, while being a pensioner/retired and married were associated less frequently with frailty., Conclusions: Successful aging is associated with a lower level of frailty., (Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To evaluate the association of several clinical markers with acute laboratory-positive Dengue Virus infection., Methods: A hospital-based case-control study was conducted in the state of Colima, Mexico, by using information from the National System of Epidemiological Surveillance (Sistema Nacional de Vigilancia Epidemiológica [SINAVE]) for Dengue. Data from 2 732 cases and 2 775 frequency-matched controls were analyzed. Odds Ratio (OR) and the 95 % Confidence Interval (CI), estimated by means of logistic regression models, were used., Results: The presence of skin rash (OR=1,7; 95 % CI 1,5-2,1), persisting vomiting (OR=1,8; 95 % CI 1,5-2,3) and increased capillary fragility (petechiae, ecchymosis, hematoma or positive tourniquet test; OR=1,8; 95 % CI 1,2-2,6) were associated with laboratory-positive infection., Conclusions: Three clinical markers were significantly associated with an increased risk of acute laboratory-confirmed dengue infection. These findings would support accurate and timely diagnosis of dengue in laboratory-limited settings.

Objective: Determinate the frequency and the risk factors for Metabolic Syndrome in adults with diabetes mellitus, Hypertension and without Diabetes- Hypertension., Materials and Methods: We realized a cross-sectional study in patients of both sexes and older than 20 years of the "Hospital General de Zona 1 IMSS" in Colima, Mexico. The variables studied were: age, BMI, waist circumference, cigarette smoking, and family history of diabetes and hypertension, and biochemical parameters, such as glucose, HDL cholesterol and triglycerides., Results: A total of 417 persons were enrolled (170 men and 247 women), with an age average of 53.2 ± 13.4 years (age range, 20 to 86 years). The global frequency of the metabolic syndrome was 52.3 % (56 % in women and 46.4 % in men). While the MS frequency was 50 % in DM2, 42 % in hypertension, 80 % in DM2+hypertension and 28.2 % without DM2 and hypertension. The cigarette smoking frequency was 27.8 %, and it was an important risk factor for the totally of patients with MS, in DM2 and in DM2+hypertension., Conclusions: The frequency of MS in adults was 52.3 %, women were the most affected, and cigarette smoking was the most important risk factor.

Objective: To estimate the cumulative incidence of persistent arthralgia at 6 months from acute Chikungunya virus (CHIKV) infection and to evaluate the association of clinical markers with the risk of long-term arthralgia., Methods: This multicenter retrospective cohort study was conducted in the Mexican state of Colima. A total of 136 individuals aged 15 years and older with serologically confirmed CHIKV infection were enrolled. Participants were interviewed at 6 months from the onset of symptoms, and self-reported persistent arthralgia (PA) was the main binary outcome. A self-report numeric rating scale (NRS) ranging from 0 to 10 was used to estimate the severity of articular pain., Results: The cumulative incidence of PA was 41.9%. Severe pain (NRS ≥ 7) presented in 36.8% of participants with PA. In multiple analysis, individuals aged 40 years and older (risk ratio (RR) = 1.60; 95% confidence interval (CI), 1.03-2.48) and those with articular pain at 3 months post-infection (RR = 3.95; 95% CI, 1.95-8.01) had a significantly increased risk of PA at 6 months from CHIKV infection., Conclusions: To the best of our knowledge, this is first report of a CHIKV-associated long-term outcome in Mexico, where the incidence of the infection has been high. This is also the first study in Latin America evaluating several factors associated with the risk of PA. Our findings may be useful in health care settings to stratify the risk of chronic arthralgia secondary to CHIKV infection and to identify patients who would benefit clinically from early medical intervention.

Introduction: The present study was conducted to estimate the incidence of seropositivity to anti-Trypanosoma cruzi antibodies and analyze potential risk factors in Colima, on the western coast of Mexico., Methodology: Longitudinal studies of 209 subjects with negative serology in 1999 for anti-Trypanosoma cruzi antibodies by hemagglutination inhibition test were tested again in 2005. At the same time, 716 children under six years of age were surveyed serologically (total n = 925); the history of Trypanosoma cruzi infection was determined by the same hemagglutination inhibition test. The variables analyzed were age, sex, living in triatomine-infested places, type of community, quality of housing, presence of pets, and number of inhabitants per house., Results: Trypanosoma cruzi seropositivity in the period of six years was 22/925 cases, with a point prevalence of 2.73% and an adjusted rate of 7.3/1,000 person-years. The variable living in triatomine-infested areas showed association with seropositivity anti-Trypanosoma cruzi antibodies (RR: 5.5; 95% CI: 1.28-23.5). The remaining variables showed no significant association., Conclusions: This study confirms the active transmission of Chagas disease in Mexico´s western-central region, which merits greater epidemiological surveillance and vector control, particularly in localities infested with triatomines.

Background: Road traffic injuries (RTIs) are a leading cause of premature mortality, mainly in low- and middle-income countries Objective: To estimate the 2014 burden of RTIs in Mexico calculating years of life lost (YLL) and age-standardized YLL rates (ASYLL), and to evaluate sex, age, and region-related differences in premature mortality., Methods: Mortality data were obtained from the National Institute of Statistics and Geography and 14,637 deaths of individuals 15 years of age and older were analyzed. The YLL and ASYLL were computed., Results: The overall burden of RTIs was 332,922 YLL and 82.4% of the deaths occurred in males. Males from 25 to 34 years of age and females from 15 to 24 years of age showed the highest age-adjusted YLL rates (933 and 158 YLL per 100,000 inhabitants, respectively). The national ASYLL rate was 416 per 100,000 inhabitants and the highest state-stratified mortality rates were observed in Tabasco (851), Sinaloa (709), Durango (656), Zacatecas (642), and Baja California Sur (570)., Conclusions: RTIs contributed to the premature mortality rate in the study population. Our findings may be useful from a health policy perspective for designing and prioritizing interventions focused on the prevention of premature loss of life.

Objectives: The aim of this study was to compare the effectiveness of oral (PO) versus enteral nutrition (EN) medium-chain triglyceride (MCT) containing-formula to prevent malnutrition and growth impairment in infants with biliary atresia (BA) waiting for a liver transplant., Methods: A total of 15 infants, 3 to 9 months old with BA were included. They were randomly assigned to either PO or EN. For 12 weeks, both groups received an MCT formula fortified with glucose polymers and corn oil to reach a caloric density between 0.8 and 1 kcal/mL. The formula given to the PO group was administered ad libitum and that given via EN was infused through a nasogastric tube to reach 140% of the energy intake recommended by the Dietary Recommended Intake guidelines. Protein intake was adjusted to 4 to 5 g/kg present weight. Outcome variables were growth and nutritional status evaluated periodically by anthropometric indicators. Biochemical and hematological variables were evaluated through the study., Results: Baseline clinical, nutritional, biochemical, and hematological variables showed no differences between the study groups. Baseline length/age was <-2 SD in 10 of the 15 patients; in the PO group, it fell <-3 SD, whereas in the EN group, it remained stable. Head circumference z score dropped 0.6 SD in the PO group, whereas in the EN group it remained stable. Triceps skinfold values improved in the infants taking EN, P < 0.001. The frequency of adverse effects--respiratory infection and diarrhea--was higher in the EN group. No biochemical or hematological differences were observed between the study groups throughout the study., Conclusions: A 12-week EN trial with an MCT-fortified formula prevented malnutrition and growth impairment in infants with BA waiting for a liver transplant.

Background: Interstitial lung disease (ILD) is a frequent complication in progressive systemic sclerosis (SSc), being present in 25% to 90% of cases., Objectives: To evaluate whether serum levels of procollagen typei and iii aminoterminal propeptide (PINP and PIIINP) correlate with severity and patterns of ILD in Mexican women with SSc., Methods: Thirty three SSc patients were assessed for disease characteristics and anti-topoisomerase antibodies (topoi), and also underwent pulmonary function tests and high-resolution computed tomography (HRCT). Nineteen patients had ILD+SSc, and 14 had no lung involvement (no ILD-SSc); data were compared with those from 45 healthy controls. PINP and PIIINP were assessed in all 3 groups., Results: Patients with SSc had higher PINP and PIIINP vs controls (P=.001, P<.001, respectively). Compared to no ILD-SSc patients, those with ILD+SSc had longer disease duration in years (P=.005), higher modified Rodnan skin score (P<.001), higher Health Assessment Questionnaire-Disability-Index scores (P<.001), higher topoi U/mL (P<.001), PINP (49.28±28.63 vs. 32.12±18.58μg/L, P=.05), and PIIINP (4.33±1.03 vs. 2.67±1.26μg/L, P<.001) levels. ILD severity based on total HRCT correlated with PINP (r=.388, P=.03) and PIIINP (P=.594, P<.001). On adjusted analysis, ILD severity was associated with disease duration (P=.037), PIIINP (P=.038), and topoi (P=.045)., Conclusions: PINP and PIIINP are useful markers for severe ILD+SSc, suggesting they could play a role in the follow-up of this complication in SSc., (Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.)

Forskolin is a diterpene derived from the plant Coleus forskohlii. Forskolin activates adenylate cyclase, which increases intracellular cAMP levels. The antioxidant and antiinflammatory action of forskolin is due to inhibition of macrophage activation with a subsequent reduction in thromboxane B2 and superoxide levels. These characteristics have made forskolin an effective medication for heart disease, hypertension, diabetes, and asthma. Here, we evaluated the effects of chronic forskolin administration on blood glucose and oxidative stress in 19 male Wistar rats with streptozotocin-induced diabetes compared to 8 healthy male Wistar rats. Rats were treated with forskolin, delivered daily for 8 weeks. Glucose was assessed by measuring fasting blood glucose in diabetic rats and with an oral glucose tolerance test (OGTT) in healthy rats. Oxidative stress was assessed by measuring 8-hydroxydeoxyguanosine (8‑OHdG) in 24-h urine samples. In diabetic rats, without forskolin, fasting blood glucose was significantly higher at the end than at the beginning of the experiment (8 weeks). In both healthy and diabetic rats, forskolin treatment lowered the fasting glucose at the end of the experiment but no effect was found on oral glucose tolerance. The 8-OHdG levels tended to be less elevated in forskolin-treated than in untreated group. Our results showed that chronic administration of forskolin decreased fasting blood glucose levels; however, the reductions of 8-OHdG were not statistically significant.

Background: The changes in recent decades in the training of medical student seem to agree that the educational model for professional skills is most appropriate. The virtual simulator translates skills acquired the operating room, in the Faculty of Medicine of the University of Colima noticed the need to prepare the students of pregrade transferring surgical trainees' skills in basic laparoscopic activities that require a simple cognitive effort., Objective: The hypothesis in this study was to evaluate the acquisition of skills in laparoscopic simulator in students of pregrade., Methods: Educational research, analytical comparison, which was conducted within the activities of the program of Problem Based Learning in the program of Education and Surgical Technique, Faculty of Medicine of the University of Colima., Results: All participants in the simulator achieved a significantly better during the task one after three repetitions (p= 0.001). The evaluation of final students calcification, we observed significant differences in means being lower during the initial assessment (8.60 ± 0.76) compared to the end (8.96 ± 0.58) p= 0.001., Conclusions: The acquisition of skills in the simulator is longer but at the end is better than the acquisition of skills from the traditional method, showing that leads to the acquisition of skills that promote the transfer of skills to the surgical environment.

Indigenous migrant workers (IMWs) have a high vulnerability to HIV and STDs due to poverty and marginalization. This study examined factors associated with sexual risk behavior (SRB) according to type of partner in transnational young male IMWs at a sugar cane agro-industrial complex in western Mexico. A total of 192 sexually active IMWs were recruited from four laborer shelters to participate in a sexual partner survey. The IMWs were interviewed about their sexual partners and practices over the last 12 months during which it emerged that they had had a total of 360 sexual partners. Multiple linear regression analyses were performed to identify factors related to SRB in 222 main (spouse, mistress and girlfriend) and 138 casual partners (colleague, friend, casual encounter and sex worker). Results showed a significantly higher SRB score with casual partners. For the main partner regression model, prior exposure to HIV- and STD-preventive information and sexual intercourse with higher employment status partners (formal workers vs. self-employed in informal activities and unemployed) were associated with lower SRB scores, but if the sexual relations occurred in Mexico (vs. the U.S.), the SRB scores increased. For the casual partner model, the practice of survival sex (sex in exchange for basic needs), sexual relations in Mexico (vs. the U.S.), and being a circular migrant (person traveling for temporary work to return home when the contract is over) were related to higher SRB scores. Findings support the implementation of preventive interventions using different messages depending on the type of partners, main or casual, within the labor migrant context.

Introduction: Diseases of the musculoskeletal system are often accompanied by postural deformity or malalignment. Genu varo or genu valgo can be found in the knees. It is necessary to have a diagnostic support test for diagnosis as well as for follow-up of cases since these diseases are frequently progressive and over time have serious repercussions on patient quality of life. Objective. To evaluate a software program that processes digitalized photographs as a diagnostic test for measuring the mechanical axis in patients with genu varo and genu valgo., Materials and Methods: The mechanical axis in both knees was measured by means of radiography (golden standard) and by means of a software program (proposed diagnostic test) in one hundred patients. Mechanical axis was considered to be abnormal when the angle was equal to or greater than four degrees. Sensitivity, specificity, positive predictive value, and negative predictive value were determined. Interobserver variation was evaluated with kappa statistics., Results: In relation to right knee genu varo, sensitivity, specificity, positive predictive value, and negative predictivie value were 0.84, 0.87, 0.84, and 0.87, respectively, and for the left knee values were 0.86, 0.87, 0.84, and 0.89, respectively. For genu valgo in the right knee, sensitivity, specificity, positive predictive value, and negative predictive value were 0.78, 0.98, 0.95, and 0.92, respectively, and in the left knee were 0.88, 0.95, 0.88, and 0.95, respectively. Kappa value was 0.9 in the right knee and 0.8 in the left knee., Conclusion: The software program (diagnostic test) was useful for diagnosing genu varo or genu valgo, representing a safe and low-cost study.

Background: Surgical management of umbilical hernias is proposed in the vast majority of cases. The typical approaches make a semilunar incision above the umbilicus. The aim of this study is evaluate the surgical approach with two different incisions, the transumbilical approach and the infra-umbilical approach., Methods: Included in the study were 82 consecutive patients with diagnosis of umbilical hernia. Variables related to demographic characteristics, surgical operation, and cosmetic results were evaluated. Patients were randomized into two groups; transumbilical or infra-umbilical approach. Statistical analysis was carried out to evaluate complications, recurrences and aspects of the surgical scar., Results: The study included group A (42 patients) and group B (40 patients). The most frequent symptom was pain in both groups. Complications were similar in both groups with four (9.5%) in group A and eight (19%) in group B (RR 0.53, 95% CI 0.17-1.61, p = 0.24). Cosmetic results were classified as good in the vast majority of patients in group A (p 0.001). No recurrences or mortality have been reported so far in both studied groups., Conclusion: We described an uncommon technique of incision with the aim of improving cosmetic results. Our results are in concordance with randomized clinical trials with the same technique with no recurrence or mortality to date. Cosmetic results in our patients using the transumbilical approach were clearly superior.

Purpose: To identify the presence of HPV DNA in cervical as well as in placental tissue of pregnant Mexican women and to determine which type is more frequent., Methods: In a cross-sectional study, 56 placental samples were obtained from 72 pregnant women. HPV DNA was extracted and amplified with polymerase chain reaction using a consensus primer and then identified by type using RsaI endonuclease. The main outcome measures were placenta with/without HPV relation and HPV types in placenta., Results: HPV DNA was identified in 75% of cervical tissue samples and 47.2% of placental tissue samples. Type 18 was the most frequently identified HPV type., Conclusions: There was a higher frequency of HPV DNA found in the cervix of Mexican women during pregnancy than reported in the previous studies. Its identification in full-term placental tissue has no relation to the type of delivery in childbirth.

The objective of the study was to evaluate tamsulosin (TAM) efficacy in distal ureteral stone expulsion in Mexican patients. A double-blind clinical trial was carried out for a period of 4 weeks on 65 patients assigned to the following treatment groups: Group A, 32 patients receiving conventional treatment + TAM; and Group B, 33 patients receiving conventional treatment + placebo. Patients of both groups were checked every 14 days to evaluate treatment adherence and clinical progression through plain abdominal film and abdominal ultrasonogram. There was no significant difference in stone expulsion percentage between groups: Group A 69% (n = 22) versus Group B 70% (n = 23), P = 0.9. There was no significant difference in mean expulsion time comparison between groups: Group A 22 ± 6.7 days (11-30 days interval) versus Group B 23 ± 6.3 days (11-30 days interval), P = 0.3. Tamsulosin did not demonstrate greater efficacy in distal ureteral stone expulsion in Mexican patients.

Introduction: Diabetes mellitus (DM) can present complications of neuropathy and peripheral arterial disease with high risk for developing foot ulcers and consequent amputations., Objective: To identify the association between peripheral vascular disease, and neuropathy in type 2 Diabetes mellitus patients from the Hospital General de Zona No. 1 IMSS in Colima, Mexico., Material and Methods: Cross-sectional study of 80 patients with diabetes mellitus evaluated by means of the Edinburgh Claudication Questionnaire, Michigan Neuropathy Screening Instrument, ankle-arm index, Motor Nerve Conduction Velocity and H-reflex., Results: 51 women and 29 men were studied. Mean age was 53.9 +/- 9.6 years, mean diabetes mellitus progression was 8 +/- 6.6 years and mean glucose level was 283 +/- 110 mg/mL. Neuropathy presented in 65 patients (81.2%). Ankle/arm index revealed 19% of patients presented with moderate peripheral vascular insufficiency. Motor Nerve Conduction Velocity was abnormal in 40% of patients and H-reflex was absent in 70%., Discussion: Grade 2 motor-sensitive polyneuropathy was found in 70-80% of patients and moderate peripheral vascular insufficiency in 19%. It can thus be inferred that the complication of diabetic neuropathy appears before that of peripheral vessel damage.

Background and Aims: Activation of histamine H3 receptors blocks the release of peptides responsible for headache. Our objective was to investigate the association between the genotypes of A280V polymorphism in the H3 receptor and migraine risk., Methods: We evaluated the frequency of the genotypes of A280V, polymorphism A280V and allelic variants of H3 receptor in 147 migraine patients and 186 healthy controls using a PCR-RLFP method., Results: V allele frequency was 6.46% and 2.68% for the cases and controls, respectively (p = 0.02) (OR 2.67; 95% CI 1.20-5.93). The frequency of V/V + V/A genotypes was 12.92% in migraine patients, significantly higher when compared to the 3.22% frequency in the control group (p = 0.001) (OR 4.45; 95% CI 1.7-11.46)., Conclusions: The results of this study suggest that V-allele genotypes in the H3 receptor gene are related to migraine risk in the Mexican population. We propose the hypothesis that the V-allele genotypes in the H3 receptor gene increase the population of inactive receptors, enhancing the inhibition of the negative feedback mechanism on the H3 receptor and increasing histamine release, which correlates with migraine attacks in susceptible patients. The case-control study reinforces the role of histamine in migraine pathogenesis., (Copyright © 2011 IMSS. Published by Elsevier Inc. All rights reserved.)

Introduction: One of the causes of low back pain is lumbar hyperlordosis. There are different protocols of therapeutic exercises for its correction, which do not involve all of corporal segments. A modified protocol is proposed, which involves all such segments., Objective: To evaluate the efficacy of proposed protocol with two established protocols for correction of lumbar hyperlordosis., Materials and Methods: Simple-blind clinical trial on 42 students of the Faculty of Medicine at University of Colima. The three protocols: A) Pérez-Olmedo (proposed, n = 14), B) Williams (n = 15) and C) Jeffrey Saal (n = 13) were randomly assigned. Clinical and radiological evaluations were performed. Lumbar hyperlordosis was considered when Ferguson's angle was > or = 30 degrees, measured on lateral spine x-ray pictures. During two months they underwent supervised and directed exercise sessions. The improvement in lumbar hyperlordosis correction of each protocol was compared through paired Student t-test and ANOVA., Results: Average age was 18 +/- 0.9 years. Lumbar hyperlordosis frequency was 31% (n = 15). There was not significative difference on Ferguson's angle average comparation between three treatment groups. There was lumbar hyperlordosis improvement with following percentages: group A = 60%, Group B = 16% and group C = 0%., Conclusion: Protocol of therapeutic exercises proposed (Pérez-Olmedo) could be an alternative to lumbar hyperlordosis improvement in asyntomatic youhts.

Objective: To identify clinical characteristics and prognosis in patients with cranial trauma., Methods: A longitudinal design was used to study 302 patients between the years 2003 and 2006. Variables were mechanism and type of lesion, localization, clinical condition, Glasgow Coma Scale and prognosis. Descriptive statistics, correlation analysis and odds ratio were applied., Results: Motor vehicle accidents were in the first place (47%). The Glasgow mean score was 13. Half of the patients presented with loss of consciousness and the most common symptom, in 34% of them, was cephalgia. There was a proportionately inverse correlation (r-53, < 0.00001) between the Glasgow score and the number of hospitalization days. A two percent mortality was equally distributed in the period studied. Odds ratio for the motorcycle as mechanism was 2.02 (95% CI, 0.8- 4.2) and the OR for the frontoparietal region was 2.6 (95% CI, 0.6-2.3)., Conclusions: The variables associated with unfavourable prognosis in cranial trauma were motorcycle accidents and damage to the frontoparietal region of the brain.

Objective: Determining risk factor frequency regarding obesity and being overweight in university students., Methods: A cross-sectional analytic study was carried out on 821 students from the University of Colima. Some variables analysed were age, gender, alcoholism, smoking and weight-control drug use., Results: 821 students were included (380 male, 441 female), 20.9±2.5 average age. 27.8 % of males were overweight and 14.7 % suffered from obesity; this was 17 % and 5.2 % in females, respectively. Smoking (2.1 OR; 1.4-3.8 95 % CI; p=0.01) and alcoholism (2.1 OR; 1.2-3.6 95 % CI; p=0.003) were associated with being overweight and being obese. Weight-control drug use was a protective factor in both genders (0.4 OR; 0.2-0.8 95 % CI; p=0.01); diet control was only a protective factor in women (2.2. OR; 1.1-3.4 95 % CI; p=0.01)., Conclusions: 31.6 % of university students were overweight and suffered from obesity. Smoking and alcoholism in males were associated with being overweight and suffering from obesity. Weight-control and diet-control drug use were protective factors.

Objective: Combined spinal and general anesthesia block (CSGAB) and combined epidural and general anesthesia block (CEGAB) in laparoscopic cholecystectomy were compared., Material and Methods: Forty patients were randomly selected (ASA physical status I-II) to receive sevoflurane plus 10 to 15 mg of bupivacaine weighed at 0.5% and 20 microg of fentanyl (CSGAB) or sevoflurane plus 150 mg of ropivacaine and 1 microg/kg of fentanyl (CEGAB). Blood pressure, heart rate, oxygen and carbon dioxide saturation, drug doses and sevoflurane MAC (minimum alveolar concentration) were evaluated during surgery. Anesthesia recovery time and pain intensity and duration were evaluated during the first two postoperative hours. Frequency of incisional or referred pain, dyspnea, headache, cramping, nausea and vomiting were evaluated 24 hours after surgery. Statistical analysis was carried out using the Chi-square test and Student t test. Relative risk, absolute risk reduction and number needed to treat (NNT) for adverse reactions were determined., Results: Systolic and diastolic arterial pressures posterior to semi-Fowler's position were lower in the CSGAB group than in the CEGAB group. (94 +/- 16 vs. 110 +/- 18 mmHg; p < 0.01 and 59 +/- 8 vs. 69 +/- 12, mmHg; p < 0.01, respectively). Anesthesia recovery time (32 +/- 17 vs. 61 +/- 29 minutes; p < 0.01) and pain duration (26 +/- 42 vs. 83 +/- 46 minutes; p < 0.01) were shorter in the CSGAB group. NNT was 8 for postoperative pain, 8 for nausea, and 95 for vomiting., Conclusions: CSGAB was more efficacious for rapid anesthesia recovery and had a shorter post-operative pain duration than CEGAB.

Background: Exposure of renal grafting to prolonged cold ischemia time (CIT) and the association with acute rejection (AR) are known. However, there is no evidence in Mexico about this topic. Thus, the objective of this study was to evaluate prolonged CIT as a risk factor for AR in renal grafting of cadaveric kidney transplantation in a Mexican population., Methods: A cross-sectional study was carried out. Clinical files of patients undergoing renal grafting using cadaveric kidneys were reviewed from July 1994-June 2004. Prolonged CIT (=12 h) as a risk factor for AR was evaluated. Other related variables were also examined., Results: From 425 kidney transplantations, only 33 cases were cadaveric. Ten patients had AR. Prolonged CIT (OR 8.4; CI 1.5-44.2, p = 0.02) and azathioprine (AZA)-prednisone (PDN)-cyclosporine (CSA) combination (OR 9.1; CI 1.5-49.4, p = 0.02) were risk factors for AR. Anti-CD25 use (OR 0.6; CI 0.009-0.37, p = 0.001) and mycofenolate mofetil (MMF)-PDN-CSA combination (OR 0.1; CI 0.02-0.65, p = 0.02) were protective factors for AR., Conclusions: In a Mexican population, prolonged CIT and AZA-PDN-CSA combination were risk factors for AR. Meanwhile, anti- CD25 use and MMF-PDN-CSA combination were protective factors for AR in cadaveric kidney transplantations.

Objective: To determine the relationship between fasting blood glucose (FBG) values and gustatory sensitivity alterations in type 2 diabetic patients (DM2) without peripheral neuropathy (PNP)., Methods: Assessment of the strength of association between FBG and detection and recognition taste thresholds for the four primary tastes measured by chemical gustometry were performed in 140 DM2 without PNP with evolution < 10 years., Results: FBG values above 7.77 mmol/L (140 mg/dL) induce in a dependent manner, the increase in the detection and recognition taste thresholds only to sweetness; whereas, values above 16.65 mmol/L (300 mg/dL) did not cause further decreasing in taste acuity to sweet flavor. Statistically significant differences where found for detection and recognition, taste thresholds for sucrose between well controlled (HbA1c < or = 7 %) normoglycemic and hyperglycemic diabetics, as well as between alarming uncontrolled (HbA1c > 10 %) normoglycemic and hyperglycemic patients., Conclusions: Hyperglycemia induces a concentration-dependent impairment of sweet taste perception in DM2 patients as the result of an adaptation of the sensory cell to elevated circulating concentrations of glucose.

Objective: Determining antimicrobial indication and frequency of use in hospitalised patients., Materials and Methods: Date and place of work: May 1st to June 30th 2006, Colima, Mexico. An analytical cross-sectional study was carried out; it involved 400 patients from both sexes hospitalised in different second level hospital departments. The variables analysed were: age, gender and the department from which each patient was referred. Antibiotics were evaluated according to type, frequency of use, whether use was prophylactic or therapeutic, whether treatment design was monotherapeutic or mixed, the amount of time taken from being admitted to hospital to beginning treatment, the number of days of treatment, the motive for changing or suspending therapeutic design, the number of patients receiving complete design and the number of patients for whom cultures were or were not done., Results: 63% of the patients received antibiotic therapy, antibiotic use being prophylactic in 46 % of them. The General Surgery Department presented statistically significant antibiotic use association (3.9 OR; 1.7-8.9 CI; p<0.01) and the Internal Medicine Department presented a protector factor (0.5 OR, 0.3-0.8 CI, p<0.01). Betalactamic antibiotics were most frequently used (47%). Mean antibacterial treatment lasted 3.8+/-3.3 days and the amount of time taken from hospital admittance to beginning antibiotic treatment was 13.6+/-47.4 hours. Cultures were done for 2.8% of the patients., Conclusion: 63% of hospitalised patients received antibiotic therapy. The prophylactic impact of antibiotics on intrahospital infection frequency and characteristics should be evaluated and their cost-benefit calculated.

Objective: To identify the existence of significant differences in the degrees of mal-alignment of the mechanical axis of the knee between a traditional measuring method and an alternative method. MATERIALS AND METHODS. One hundred mechanical axes of the knee were determined in patients of both sexes. The degree of axis mal-alignment was obtained first using the traditional measuring method and subsequently using the alternative method. The results obtained from the two methods were then compared. The measurement variable control was standardised by positioning the patients in the same place during radiography when beginning mechanical axis determination. A wooden ruler on which each centimetre was indicated by a metal strip and numbered at every 10-centimeter interval was used to evaluate the degree of pelvic mal-alignment. The ruler was then used as a mechanical axis correction reference in accordance with the characteristics of each patient., Results: The following results were obtained from 100 mechanical axes evaluated by the traditional method and by the alternative method, respectively: varus deformity of the right pelvic segment was 21 degrees +/- 16 degreesuv. 7 ++/-6. degrees varus deformity of the left pelvic segment was 22 &#95;+/-170 degreesvs. 8 ++/-50 degrees valgus deformity of the right pelvic segment was 21 - /-150 degreess. 8 + +/-; and valgus deformity of the left pelvic segment was 16 +/- 11 vs. 6 +/- 5 degrees., Conclusions: Our results suggest that the proposed method provides more accurate mechanical axis measurement and that the correction is exponential: the greater the angle measured traditionally, the greater the correction with our proposed method.

Background: Therapeutic pain is one of the most important outcome measures in surgery. Comparative studies investigating ketorolac efficiency in ambulatory surgery have generally been restricted to IV administration. We compared analgesic effectiveness of sublingual ketorolac and metamizole in short stay surgery., Methods: This was a randomized single-blind clinical trial. All patients received either a three-dose (30 mg) of sublingual ketorolac or 1 g of IV metamizole, respectively. We evaluated pain with a visual/analog scale (VAS). Side effects were also recorded. Statistical analysis included t-test or Mann-Whitney U test and Fisher exact test or chi(2). Absolute risk reduction (ARR), odds ratio (OR), confidence interval (CI), relative risk ratio (RRR) and numbers needed to treat (NNT) were also evaluated., Results: Rescue doses of analgesics were greater in patients receiving metamizole although the difference was not significant (p = 0.286). Mean VAS score was lower in the ketorolac group at 8 h after surgery, with no statistical difference (p = 0.06). ARR for severe pain score was almost 5% (OR = 1.78). Adverse effects did not show differences between groups (p = 0.642)., Conclusions: Ketorolac and metamizole have comparable effects and can be safely used in ambulatory settings.

Background: Nevertheless its association with cervicouterine cancer, there is no information about cervical human papillomavirus infection prevalence in patients with rheumatoid arthritis., Objective: To evaluate human papillomavirus infection prevalence through molecular biology tests, and to analyze this infection related factors in patients with rheumatoid arthritis., Material and Method: Analytic, transversal study to 250 patients: 61 women with rheumatoid arthritis selected from a rheumatologic external consult of a second level hospital, and 189 healthy women, with cervical cytology, of a first level hospital. They were polled to find infection risk factors. They were exfoliated to get cervix cells to extract its DNA and detect human papillomavirus (chain reaction of polymerase with specific consensus markers), and identification of restriction enzyme in high and low risks viruses. Prevalence was calculated, and adjusted factors analysis was performed through logistic regression with odds ratio and confidence intervals of 95%., Results: Prevalence of papillomavirus infection in patients with rheumatoid arthritis was 30%, and in control group was 24%, with an odds ratio of 0.8 (CI 95% 0.42-1.6, p = 0.5). Ninety-four percent of the most frequent viral types in women with rheumatoid arthritis were high risk (mainly types 16, 58, and 18). Factors associated with higher human papillomavirus adjusted to rheumatoid arthritis were: more than one sexual partner (OR = 5.8 CI 95% 1.1-31.1, p = 0.04), more than one sexual intercourse weekly (OR = 6.7, CI 95% 0.9-51.6, p = 0.06), circumcised sexual partner (OR = 9.0, CI 95% 1.2-64.4, p = 0.02). Patients and controls had same values of marital status. Seventy-four percent of controls worked, compared to 44% of women with rheumatoid arthritis (p < 0.01)., Conclusion: One out of three women with rheumatoid arthritis has human papillomavirus infection and 94% has the high-risk viral type. Infection associated factors mainly includes sexual partner ones; due to high risk of cervical dysplasia, it is necessary the early detection of the infection and surveillance.

Objective: To determine intestinal helminthiasis frequency and its association with malnutrition and iron deficiency., Material and Methods: An analytical cross-over study was carried out on children in the municipality of Comala, Colima, Mexico. Coproparasitoscopic exams in series of three using the Kato-Katz technique were performed in all children. To evaluate the degree ofmalnutrition, the following anthropometric indices were determined: means and z-scores for weight/height, height/age, weight/age. Severe, moderate and minimal iron deficiency was considered when ferritin was: < or = 12 ng/ml, 12 to 18 ng/mL and 19 to 24 ng/mL, respectively., Results: 243 children were studied with an average age of 65.3+/-8.7 months. 60.9% (n = 148) of the children showed a decrease in ferritin levels and 2.5% (n = 6) had anemia. 16% (n = 39) had trichuriasis, 6.9% (n = 17) ascariasis and 5.3% (n = 13) had both parasites. Trichiura infection was associated with declining health (OR 11.0, CI 3.9-30.8; p<0.001) and with iron deficiency, with cut-off points of <24 ng (OR 2.0, CI 1.0-3.9, p = 0.02) and <18 ng/ dL (OR 2.2, CI 1.2-4.2, p= 0.009). Ascaris infection was not associated with malnutrition or iron deficiency., Conclusions: Trichiura infection was associated with declining health and slight and moderate degrees of iron deficiency.

Objective: To evaluate the role a daily intake of 100 mg of ascorbic acid plays in urinary infection prophylaxis during pregnancy., Methods and Materials: A single-blind clinical trial was carried out on pregnant women randomly assigned to the following treatment groups - Group A: oral treatment with ferrous sulphate (200 mg per day), folic acid (5 mg per day) and ascorbic acid (100 mg per day) for 3 months, and Group B: oral treatment with ferrous sulphate (200 mg per day) and folic acid (5 mg per day) for 3 months. All patients were clinically evaluated, and a urine culture was carried out each month for a period of 3 months. The chi(2) and odds ratio were used to compare effects with and without ascorbic acid, and statistical significance was considered at p<0.05., Results: Global frequency of urinary infections was 25%. The presence of urinary infections in Group A (12.7%) was significantly lower than in Group B (29.1%), (p=0.03, OR =0.35, CI 95% =0.13-0.91)., Conclusions: Daily intake of 100 mg of ascorbic acid played an important role in the reduction of urinary infections, improving the health level of the gestating women. We recommend additional vitamin C intake for pregnant women in populations which have a high incidence of bacteriuria and urinary infections.

Peripheral nerve lesions are the most important cause of disability in leprosy patients. Electrophysiological studies are used in the diagnosis and prognosis of neuropathy. Nerve conduction is the most frequently used electrophysiological test method to detect neuropathy, although it evaluates only a part of the peripheral nervous system. Blink reflex and H-reflex are electrophysiological tests which evaluate facial and trigeminal nerve function. This study determined the frequencies of blink reflex, H-reflex and motor and sensory nerve conduction alterations in twenty five heterogeneous, clinic patients with lepromatous leprosy and a control group of 20 healthy subjects. Study results showed a decrease in motor and sensory nerve conduction in 40% and 30%, respectively. In blink reflex (BR), right R1 was altered in latency in 20% of patients, left R1 in 20%, right ipsilateral R2 in 16%, left ipsilateral R2 in 20%, and right and left contralateral R2 were altered in 32% of patients. There was an absence of H-reflex in 16% (n = 4) and prolonged latency in 4% (n = 1).

Objective: To compare clinical improvement between treatment with metilprednisolone aceponate vs. betamethasone dipropionate among children with nonretractable prepuce., Material and Methods: Between August 2001 and November 2002, we carried out a double blind and controlled clinical trial in 34 children with a diagnosis of nonretracable prepuce. Children were randomly assigned to one of the following groups and topical treatment was administered: Group A; metilprednisolone aceponate 0. I 1% and Group B; betamethasone dipropionate 0.05%., Results: Improvement was noted in 88.2% of our sample studied; (n= 15) children from group A and 76.4% (n= 13) childrenfrom group B; however, we did not observe a significant difference when comparing percentages between the two groups (chi2 = 0.2; p = 0.6)., Conclusions: The percentage of clinical improvement was similar between the two groups of topical steroid treatment administered.

Introduction: Histamine may prove to be effective in migraine prophylaxis, as an specific treatment aimed to limit excessive inflammatory responses involved in the pathophysiology of migraine., Methods: One hundred and ten migraine patients were selected. The variables analyzed were: a) frequency; b) intensity; c) duration, and d) number of analgesic tablets. Treatment consisted of a regimen of subcutaneous histamine (10 ng/ml of Evan's solution) twice a week, with an administration volume of 1 ng (0.1 ml) of histamine, which was consecutively increased until reaching 10 ng (1 ml); during twelve month. At the end of treatment, the patients remained under observation for 8 years. A Friedman repeated measures ANOVA on ranks test was used to evaluate the statistical significance of differences between basal values and values found., Results: The statistical analysis showed significant differences between basal values and values found for the 3, 6 and 12 months of treatment with histamine (p < 0.0001). The beginning of the 4th week there was a significant decrease in the magnitude of all variables studied (p < 0.0001). During the first and second year after treatment there were no headache attacks. In the third year migraine appeared again same to basal values., Conclusions: The present study provides evidence of the safety and efficacy of histamine, applied subcutaneously at doses of 1 to 10 ng twice a week, bringing about a new therapeutic alternative and laying the clinical and pharmacological groundwork for the use of histaminergic H3-agonists in migraine prophylaxis.

Introduction: Studying lumbar lordosis (LL) in large patient populations is not a practical approach due to the technical limitations of the gold standard., Objective: Determine the specificity of a postural reference frame (PRF) in the diagnosis of LL., Methods: A PRF (wooden frame using strings as a reference for measuring the distance between lumbar curvature and the glutei) was used as a diagnostic test to asses LL. The Ferguson angle, a radiologic evaluation, was used as gold standard. Specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV) of the PRF were determined., Results: One hundred and ten subjects were studied (58 women, 52 men). Mean age was 18.8 +/- 3 years, weight 63 +/- 12 kg, height 164 +/- 8 cm and body mass index (BMI) 23.2 +/- 4 kg/m2. With a cut-off point 37 cm, test specificity was 94%, sensitiivity was 17%, PPV was 50%, and NPV was 75%., Conclusion: The postural reference frame as an assessment tool is highly specific and can aid in the diagnosis of LL among young asymptomatic patients.

Objective: To explore the frequency of F-wave and H-reflex alterations in recently diagnosed type 2 diabetes mellitus patients and to determine if the alterations are dependent on the levels of glycemia., Methods: A cross-sectional study was carried out on 50 asymptomatic patients, with a mean age of 45.4 +/- 9.8 years and a disease evolution of less than 10 years. Patients were classified as either normoglycemic (7 mmol/L; n = 20) or hyperglycemic (7 mmol/L; n = 30). H-reflex (HR), F-wave (FW), and nerve-conduction measurements (NCM) between the diabetic and non-diabetic (control) groups were compared., Results: The H-reflex was absent in 22% of the patients, while the M-component of this reflex was altered in 58% of patients. The F-wave was altered in 12% of the patients. The motor nerve compound action potential showed a diminution in amplitude (26% of patients, n = 13), area (32%, n = 16), and conduction velocity (20%, n = 10). No positive correlation between glycemia levels and the above alterations was found., Conclusions: This study demonstrated that asymptomatic diabetic patients showed a high incidence of subclinical neurophysiological abnormalities.

Objective: To determine the causes of non postpartum contraceptive use among adolescent mothers., Patients and Methods: We conducted a cross-section descriptive study. We included women who asked for attention of an obstetric event in 2002, we identified those were in immediate postpartum period, and we selected those that did not began a birth-control method. Data were collected directly with an interview and revision of the file, later on they were coded and processed manually; the causes of non contraceptive use were classified in: attributable causes to patient: personal, religious, moral, familiar, cultural, etc. Reasons, when they received information and advice or when they did not assist to educational actions; attributable causes to hospital: technique administrative factors, insufficient educational communication activities by service provider; and attributable causes to medical indication: presence of risk factors for health women. The statistical analysis was carried out using frequencies and percentages., Results: We found 261 women, we identified 160 (61%) in immediate postpartum period, 52 (32%) they did not began contraceptive use., Conclusion: The causes of non postpartum contraceptive use among adolescent mothers were attributable to themselves in 75%, in 21% to the medical unit, and 4% to medical indication.

Purpose: To show the effectiveness of tension-free hernioplasty for inguinal hernia repair., Methods: We studied 106 patients who underwent inguinal hernia repair, as conventional hernioplasty in 52 and as tension-free hernioplasty in 54. We analyzed the operation time, postoperative complications, pain, time to resume daily activities, and frequency of recurrence in the short and long term., Results: The average age of the patients was 46.2 years. The operation time was significantly shorter in the tension-free group than in the conventional group, at 33 +/- 11.1 versus 49 +/- 8.8 min, respectively (P < 0.05). The overall complication rate was 10%, being 1.5% in the tension-free group and 13% in the conventional group (P = 0.4). The visual-analogue pain scores after surgery were lower in the tension-free group than in the conventional group (P = 0.01). Patients in the tension-free group returned to their normal activities sooner than those in the conventional group (P < 0.05)., Conclusions: Tension-free hernioplasty resulted in less pain and allowed patients to return to their daily activities sooner than conventional hernioplasty.

Objective: To evaluate the possible association that age, sex, excess weight, family history of hypertension, alcoholism, and sedentary lifestyle have with hypertension in the adult population of the city of Colima, Mexico., Methods: This was a population-based analytic cross-sectional study. A structured survey was used with 280 adults older than 30 years of age who were living in the city of Colima in 2001 and 2002. The variables studied were sex, age, weight, height, family history of hypertension, engaging in physical exercise, smoking, and consuming alcohol. Blood pressure (BP) was measured with the auscultatory method. Borderline or doubtful measurements were checked again four or five days later. Hypertension was defined as systolic BP > or = 140 mm Hg and diastolic blood pressure > or = 90 mm Hg, or as the person being under antihypertensive treatment. The odds ratios (ORs) of the variables studied were calculated, along with their 95% confidence intervals (95% CIs). The association between the variables and hypertension was estimated through logistic regression, and their interaction through the coefficient of the interaction products., Results: The overall prevalence of hypertension was 28.6%. The prevalence was higher in men than in women (42.1% vs. 19.2%; OR = 3.04, 95% CI: 1.8 to 5.2) and in people older than 49 years than in people 30 to 49 years old (36.8% vs. 21.9%; OR = 2.07, 95% CI: 1.22 to 3.50). A family history of hypertension and excess weight were associated with hypertension, while physical exercise had a protective effect (OR = 0.45; 95% CI: 0.23 to 0.86). There was interaction between hypertension and age > or = 50 years, a family history of hypertension, overweight, and physical exercise, especially among women., Conclusions: The prevalence of hypertension in Colima is very similar to that for Mexico as a whole. The strong association that hypertension had with male gender, regardless of the other variables, emphasizes the need for promoting prevention campaigns that focus more on men.

The purpose of this study was to evaluate the efficacy of a modified mattress suture technique in septal anterior deviation correction and to compare it with the Hinderer technique. This was a randomized, controlled, single-blind clinical trial. Fifty patients with anterior septal deviation were assigned to one of two surgery treatment groups: in group A, 25 patients underwent anterior septoplasty with modified mattress suture technique; and in group B, 25 patients underwent anterior septoplasty with the Hinderer technique. Subjective (oral respiration, epistaxis, rhinorrhea, and nasal obstruction) and objective (anterior rhinomanometry) parameters were analyzed and compared between groups. Better results in obstructive deflections were achieved with the modified mattress suture technique. Unilateral and total nasal resistances improved during the 6-month follow-up in patients who underwent anterior septoplasty with the modified mattress suture technique, and there was a significant difference in the values when compared with patients who underwent anterior septoplasty with rhinoplasty using the Hinderer technique (p = 0.003). The modified mattress suture technique had better subjective and objective results than rhinoplasty with the Hinderer technique and therefore could be considered as an alternative technique in anterior septal surgery.

Objective: Our aim was determine prevalence of intrafamily violence of the type physical-abuse, toward female claimants aged 18 years and older at the HGZ MF No. 1 in Colima., Material and Method: A transversal study was conducted in 288 females aged 18 years and older who were seen at the Family Medicine Unit for external consultation., Results: Average age was 33.86 years (+/- 11.6), the highest level of schooling was primary for 33% of subjects and secondary for 26%, 75% of our female claimants were divorced, 53.5% of monthly family incomes in each household was between 1,000 and 3,000 thousand Mexican pesos, and 27.8% of physical abuse consisted of shoving., Conclusions: Our research revealed that there is indeed physical violence toward 63.45% of female claimants at our hospital, especially toward those with low level of schooling, low socioeconomic status, and monthly income below minimum wage. These conditions only contribute toward making women fall prey to physical violence. Our study is only a first step for better understanding of domestic violence. Risk factors associated with physical abuse need to be controlled to decrease rate of interfamily violence against our claimants.

A case-control study to determine the causes of accidents in children aged 0-14 years and to analyse family environment risk factors was carried out. The variables analysed in the children were age, gender, mechanism and type of accidental injury, number of siblings, birth order of the injured child, history of sibling injury and family type. Variables analysed in the parents were mother's age, history of alcoholism, maternal and paternal education level, time mother spent at home with the child, presence or absence of parents at the time of the accident and parents' occupations. The most important risk factors were gender, time mother spends at home, level of maternal education, paternal alcoholism, birth order, more than five siblings and previous injury to a sibling.

To evaluate the suitability of dimethyl sulfoxide (DMSO) as a solvent for muscle-contraction studies in the chicken, its effect on the slow muscle contracture induced by high-K(+) solution was explored using the anterior latissimus dorsi (ALD) muscle from one-week-old chicks. Measurements were made of isometric tension and various characteristics of the contractures [peak tension, total tension (area under the curve), duration of contraction, drop in tension from peak to plateau, and resting tension], in the presence and absence of DMSO (20 mM). Exposure to DMSO led to a concentration-dependent reduction in resting tension of up to 9 +/- 1.8% (n = 4) with respect to the control. The threshold concentration was 10 mM, and the maximum effect was reached between 20 and 30 mM. The drop in tension from peak to plateau was three times larger in the presence of DMSO (20 mM) than in its absence. At the same concentration, there was a 10 +/- 2.3% increase in the time constant of activation. No significant changes were observed in peak tension or in total tension in the presence of 20 mM DMSO. As a consequence, this type of biological preparation is not suitable for research on muscle contractures involving drugs that must be dissolved in DMSO (at the DMSO concentrations tested here).

Antecedents: Hyperhomocysteinemia has recently been recognized as contributing directly or associatively to the arteriosclerotic process in cerebral infarction., Objective: To determine plasmatic homocysteine levels in with patients with acute cerebral infarction and to seek an association between clinical sub-types of cerebral lesion and homocysteine levels and risk factors present., Materials and Methods: A descriptive study was carried out on patients diagnosed with acute cerebral infarction. The study included 22 patients of both sexes between the ages of 40 and 85 years. Samples were collected on the second day of hospitalization after 12 h of fasting., Results: In 13 of 22 patients, elevated levels of serum homocysteine were found. The homocysteine average was 20-68 mumol/l +/- 9.6 SD. No association between degree of cerebral lesion and risk factors was found (p > 0.05)., Conclusion: An increase in homocysteine was found in 59% of cerebral infarction patients. No correlation between hyperhomocysteinemia and known risk factors such as smoking, alcoholism, high blood pressure, and diabetes was found. It is necessary to continue this line of investigation to identify conditioning factors that elevate homocysteine and to implement measures to lower levels of hyperhomocysteinemia, thus helping reduce the incidence of cerebrovascular disease.