Pronostic value of the central aortic systolic pressure measured with the analysis of pulse wave in patients with acute coronary syndrome and systemic hypertension [Valor pronóstico de la presión sistólica central de la aorta medida con el análisis de la onda de pulso en pacientes con síndrome isquémico coronario agudo e hipertensión arterial sistémica]
Rodriguez-Steffani E.A.,Umae Hospital Of Cardiologia |
Corona-Tapia A.,Umae Hospital Of Cardiologia |
Borrayo-Sanchez G.,Coordinacion de Investigacion en Salud
Revista Mexicana de Cardiologia | Year: 2015
Introduction: In Mexico, ischemic heart disease is a major cause of death and representing 18[%] of all deaths per year, approximately 45[%] of these patients have arterial hypertension and 20[%] have less control of their figures tension. The CASP measurement by analysis of the pulse wave is associated with more adverse than the single blood pressure measurement events. At present there are no studies on the subject, in patients diagnosed with ACS. Objective: To evaluate the prognosis of measuring the Central Aortic Systolic Pressure by radial CASP as a risk factor in hypertensive patients with ACS. Material and methods: This is a cohort study in patients admitted to the Inpatient Units, diagnosed with ACS according to international criteria (ACC/AHA/ESC) who underwent measurement of CASP by analyzing pulse wave and Augmentation Index (RAI) using BPro device in patients with and without arterial hypertension. CASP and RAI was measured using a scale expected by age and gender two groups according to the normality of the CASP, cardiovascular events (death, re-infarction, cerebrovascular events, functional class and need new hospitalizations were identified) were evaluated during hospitalization and one month follow-up. Results: We included 150 patients in the study, 105 hypertensive patients (group A) and 45 non-hypertensive patients (group B) and 50 controls (group C). The average age of the patients was 62.6 years, 78[%] male gender, other risk factors were distributed as follows: 52[%] smoking, diabetes, dyslipidemia 39.8 and 42[%]. The mean baseline heart rate was 73 bpm. A statistically significant difference in the numbers of diastolic blood pressure (73 with 78 mmHg, p = 0.014) was found. The average value of the CASP for each group was 102.5 ± 10.1 mmHg in controls, 107.8 ± 16.1 mmHg in normotensive and 118 ± 14.7 mmHg in hypertensive, with a significant difference (p < 0.0001). 53[%] of hypertensive patients had an abnormal CASP with respect to age and gender compared to normotensive subjects (35[%]) and healthy controls (22[%]). The incidence of MACE at 7 and 30 days was higher in the hypertensive group (p < 0.0001). Patients with abnormal CASP regardless of whether or not hypertension had a higher rate of adverse events during hospitalization (RR 2.7, 95[%] CI 1.38-5.45, p = 0.003) and at 30 days follow-up (RR 2.11, 95[%] CI 1.1-4.2, p = 0.018). Conclusions: The arterial hypertension is a risk factor for developing a CASP outside the normal range for age and gender compared with non-hypertensive patients and healthy controls. Our findings demonstrate for the first time in Mexico that measuring central aortic systolic pressure calculated by the radial CASP can be used as an independent predictor of major cardiovascular events 7 and 30 days in patients with ACS, which we consider to be assessed in these patients.
Dircio Montes Sergio A.,Instituto Mexicano Del Seguro Social IMSS |
Gonzalez Figueroa E.,Instituto Mexicano Del Seguro Social IMSS |
Maria Saadia V.G.,Coordinacion de Salud Publica |
Elizabeth S.H.,Coordinacion de Investigacion en Salud |
And 3 more authors.
Journal of Tropical Medicine | Year: 2012
Objective. To determine the prevalence of leptospirosis in patients from Veracruz with initial diagnosis of dengue and its association with risk factors. Materials and Methods. Transversal study in patients who sought medical attention under the suspicion of dengue. Backgrounds were researched and blood samples were drawn to determine dengue (NS1, RT-PCR) and leptospirosis (IFI). Simple frequencies, central tendency and dispersion measures, and prevalence and trust intervals at 95 (IC95) were obtained. Prevalence reasons (RP) and IC95 were obtained and a multivariate logistic model was applied, using SPSSV15. Results. 171 patients were included, 56 women (32±14 years) and 44 men (32±17 years). 48 of the cases (IC9540.5-55.4) was positive to dengue, with a cut point of 1:80, seroprevalence for leptospirosis was of 6 (IC952.7-10); 12 (IC957-16.5) was positive to both pathologies and 34 was negative to both tests. Although the largest number of isolations corresponded to serotype 2, the four dengue virus serotypes were identified. In the bivariate analysis, overcrowding RP=1.33, (IC=0.46-3.5), bathing in rivers (RP=1.31, IC=0.13-7.4), and walking barefoot (RP=1.39, IC=0.58-3.3) were the variables associated with leptospirosis, although the relation was not statistically significant. Conclusions. Leptospirosis prevalence in subjects under suspicion of dengue fever is high, as well as the coincidence of both infections. The results show the coexistence of overlapped outbreaks of several diseases sharing the side of transmission. It is necessary the intentional search of other pathologies, such as influenza, rickettsiosis, and brucella, among others. © 2012 A. Dircio Montes Sergio et al.
Prevalence of gastrointestinal symptoms in overweight and obese subjects: An epidemiologic study on a Mexican population [Prevalencia de síntomas gastrointestinales en personas con sobrepeso y obesidad. Estudio epidemiológico en una población mexicana]
Bernal-Reyes R.,Coordinacion de Investigacion en Salud |
Lopez A.M.,Coordinacion de Investigacion en Salud |
Bernal-Serrano M.,Ibero-American University of Mexico
Revista de Gastroenterologia de Mexico | Year: 2013
Background: The prevalence of overweight and obesity is increasing significantly and Mexico is in a top position on a worldwide scale, with more than 70% of the adult population estimated to be affected. Multiple pathologies are associated with obesity and those of the digestive tract are no exception. Aims: To study the prevalence of gastrointestinal symptoms in subjects with overweight and obesity in a representative sample of the Mexican population. Methods: An epidemiologic study was conducted on 1,139 volunteers that were divided into three groups according to their body mass index: A) normal weight, B) overweight, and C) obese. The prevalence, intensity, and recurrence of 14 common gastrointestinal symptoms were studied through a guided survey. A comparative analysis with measures of frequency and association was carried out using the EPIDAT 3.1 statistical package. Results: Symptom prevalence increased with weight gain; eight of the symptoms (bloating, epigastric burning sensation, regurgitations, flatulence, postprandial fullness, early satiety, heartburn and recurrent vomiting) were more prevalent, intense, and frequent in obese individuals than in those with normal weight, with statistically significant differences P=.0001). Conclusions: Overweight and obese individuals have more gastrointestinal symptoms than those with normal weight; when the most frequent symptoms were grouped together, those characteristic of dyspepsia, reflux disease, and increased intestinal gas production predominated. © 2012 Asociación Mexicana de Gastroenterología.
Constantino-Casas P.,Coordinacion de Investigacion en Salud
Revista médica del Instituto Mexicano del Seguro Social | Year: 2010
adequate treatment of anxiety disorders reduces the economic impact, improves functionality in daily life activities and quality of life. Pharmacologic treatment depends on patient's characteristics and doctor's experience. The aim of this study was to determine the use of resources in anxiety disorder and to analyze its cost-effectiveness. use of resources related to chronic treatment of anxiety disorders and cost-effectiveness of drugs were determined, as well as patients' out-of-pocket expenses and productivity loss. A one-year time horizon and decision tree with benzodiazepines, selective inhibitor of serotonin re-intake (SISR) and tricyclic antidepressant drugs were included. benzodiazepines were the treatment that had the lowest total cost ($147,587 MXP), followed by SISR (incremental cost of $2,182 MXP), and the highest cost was tricyclic antidepressant drugs ($155,903 MXP). benzodiazepines are good alternative for anxiety disorder because of their high effectiveness to control symptoms and because they reduce hospital costs.
PubMed | Hospital General Of Zona No 3, Hospital General Of Zona No 1, Hospital Of Cardiologia, Medicina Familiar and 2 more.
Type: Journal Article | Journal: Gaceta medica de Mexico | Year: 2016
Identify factors related to preclinical depression in healthy adults, their risk factors and concordance with family doctor diagnostic.Case-control study in adult from family medicine consulting room. Beck inventory for depression was applied. The correlation between depression and the diagnosis by the family physician was evaluated. Odds ratio (OR) was determined.Involved 138 patients randomly from four family medicine units (FMU) in the Northern Region of Quintana Roo, Mexico. The mean age 34.9 11.4 years, 55.8% women, prevalence for depression was 26.1%. Being male OR: 3.76; 95% CI: 1.69-8.36, under 30 years OR: 2.76; 95% CI: 1.27-5.99, low socioeconomic status (SES) OR: 2.11; 95% CI: 0.97-4.59 and be married OR: 3.22; 95% CI: 1.41.-7.36 had depression risk. Diagnosis by the family physician and inventory Beck. Kappa Index 0.2, 95% CI: -0057-0176; p = 0.05.Almost a third of young adults have some depression degree in family medicine consulting room, it is necessary a depression screening for male patients, low SES, married, and under 30 years old, attending medical consultation familiar, for a early diagnosis and improve prognosis.
PubMed | Medical Science Research Center Cicmed Cuerpo Academico Of Salud Del Universitario, Coordinacion de Investigacion en Salud, Medical Science Research Center Cicmed Cuerpo Academico Of Biomedicina and High school Licenciado Adolfo Lopez Mateos
Type: | Journal: Diabetology & metabolic syndrome | Year: 2015
The prevalence of obesity and Type 2 diabetes mellitus (T2DM) among children and adolescents is rising. Thyroid function has been associated with insulin resistance. There is scarce information about how thyroid function could be related with cardiovascular risk or glucose homeostasis in adolescent.To analyze how thyroid function is associated with insulin resistance and another cardiovascular risk factors in healthy adolescents with risk factors to develop diabetes.A prospective cross-sectional analysis was carried out on euthyroid, adolescents. considered at high risk to develop Type 2 diabetes. Fasting blood samples were obtained. Thyroid function test and another cardiometabolic parameters were assessed. A 75 grams oral glucose tolerance test was performed to calculate insulin resistance.One hundred adolescents were evaluated. The mean age was 15.90.8years, There is a negative correlation between Fasting insulin, post glucose load insulin and HOMA IR. There were no correlation with Matsuda index. We could not found any correlation with TSH values.We found a correlation between fasting insulin, HOMA IR and serum thyroid hormones, we did not find any relation with serum TSH. In euthyroid adolescents with risk factors to develop diabetes.
PubMed | Coordinacion de Investigacion en Salud and Northern University of Mexico
Type: Journal Article | Journal: Salud publica de Mexico | Year: 2016
To estimate the cost-effectiveness ratio of public and private health care providers funded by Seguro Popular.A pilot contracting primary care health care scheme in the state of Hidalgo, Mexico, was evaluated through a population survey to assess quality of care and detection decreased of vision. Costs were assessed from the payer perspective using institutional sources.The alternatives analyzed were a private provider with capitated and performance-based payment modalities, and a public provider funded through budget subsidies. Sensitivity analysis was performed using Monte Carlo simulations.The private provider is dominant in the quality and cost-effective detection of decreased vision.Strategic purchasing of private providers of primary care has shown promising results as an alternative to improving quality of health services and reducing costs.
PubMed | Umae Hospital Of Ginecologia Y Obstetricia Cmno, Coordinacion de Investigacion en Salud, Hospital Materno Infantil Esperanza Lopez Mateos SSJ and Umae Hospital Of Pediatria Cmno
Type: | Journal: Gaceta medica de Mexico | Year: 2015
Objective. To compare the clinical profiles in newborns of adolescent and non-adolescent mothers. Materials and Methods. Comparative cross-sectional study. Newborns selected by cluster sampling registered in the hospital. Two groups were formed according to the mothers age: adolescent and non-adolescent. The clinical profile was evaluated with: weight, length, Apgar score, gestational age, and presence of neonatal pathology. For the comparison between proportions, we used chi-squared test and students t-test between the mean. Results. Of the 2,155 clinical profiles of newborns analyzed, 819 (38%) were newborns of adolescent mothers and 1,336 (62%) of non-adolescent mothers. Differences between birth weight groups 2,859 459 vs. 3,265 486 grams (p = 0.000), male gender 518 (63%) vs. 725 (54%) female (p = 0.000); intrauterine growth restriction in full-term newborns 62 (7.5%) vs. 66 (4.9%) (p = 0.012); prematurity 171 (21%) vs. 213 (16%) (p = 0.003). Factors that favor the alteration of clinical profiles in newborns: adolescent mother OR: 1.58 (1.99-2.99), male gender OR: 1.80 (1.50-2.17), neonatal pathology OR: 3.73 (2.50-5.30), association of low birth weight in newborns of adolescent mothers OR: 2.4 (1.72-3.42). Conclusion. We found a high frequency of observing in newborns of adolescent mothers greater risk of prematurity, intrauterine growth restriction, and neonatal pathology. No differences were seen in length and Apgar score.
PubMed | Coordinacion de Investigacion en Salud
Type: Journal Article | Journal: Revista medica del Instituto Mexicano del Seguro Social | Year: 2011
adequate treatment of anxiety disorders reduces the economic impact, improves functionality in daily life activities and quality of life. Pharmacologic treatment depends on patients characteristics and doctors experience. The aim of this study was to determine the use of resources in anxiety disorder and to analyze its cost-effectiveness.use of resources related to chronic treatment of anxiety disorders and cost-effectiveness of drugs were determined, as well as patients out-of-pocket expenses and productivity loss. A one-year time horizon and decision tree with benzodiazepines, selective inhibitor of serotonin re-intake (SISR) and tricyclic antidepressant drugs were included.benzodiazepines were the treatment that had the lowest total cost ($147,587 MXP), followed by SISR (incremental cost of $2,182 MXP), and the highest cost was tricyclic antidepressant drugs ($155,903 MXP).benzodiazepines are good alternative for anxiety disorder because of their high effectiveness to control symptoms and because they reduce hospital costs.
PubMed | Coordinacion de Investigacion en Salud
Type: Journal Article | Journal: Revista medica del Instituto Mexicano del Seguro Social | Year: 2015
To identify type 2 diabetic patients, the stages of grief and its association with metabolic control.186 patients both sexes, without recent loss of a loved one or a terminal illness. We applied a previously validated instrument, which explored the stages of grief (denial, anger/disbelief, bargaining, depression, and acceptance). There was measured BMI, waist circumference, and 6-month averages of glucose, cholesterol and triglycerides.The associations between the stages of grief and clinical variables showed that BMI is greater denial 33.1 6.2 vs 28.9 4.6 33.1 with p = 0.001, in disbelief stage glucose is greater 190 67 vs 167 51 with p < 0.05. The negotiation phase is associated with older age, 65.6 10 vs 59.1 11 years with p = 0.001 and higher cholesterol level against 229.4 39.1 vs 206.6 40 with p < 0.05. The stage of depression was associated with increased diagnostic time vs. 13.3 8.9 vs 9.4 7.1 years with p < 0.05 and the blood glucose level 198.9 60, vs 164 51 mg/dL p = 0.001.There are logical associations between clinical variables and stages of grief. Identify the stages of grief, as an additional element in the evaluation of patients with diabetes will develop strategies to improve adherence to medical management and metabolic control.