Salud Pública de Méxicohttps://www.scielosp.org/feed/spm/2012.v54n1/2021-01-13T00:10:00ZUnknown authorVol. 54 No. 1 - 2012WerkzeugEvaluación de cuatro métodos para la detección de Staphylococcus aureus meticilino-resistente de muestras clínicas en un hospital regionalS0036-363420120001000012021-01-13T00:10:00Z2017-01-20T00:02:00ZAcosta-Pérez, GabrielRodríguez-Ábrego, GabrielaLongoria-Revilla, ErnestoCastro-Mussot, María Eugenia
<em>Acosta-Pérez, Gabriel</em>;
<em>Rodríguez-Ábrego, Gabriela</em>;
<em>Longoria-Revilla, Ernesto</em>;
<em>Castro-Mussot, María Eugenia</em>;
<br/><br/>
OBJETIVO: Investigar la prevalencia de Staphylococcus aureus meticilino-resistente (MRSA) en aislados clínicos y determinar la concordancia entre los métodos de detección de MRSA en un laboratorio con recursos y personal limitado. MATERIAL Y MÉTODOS: Se analizaron 140 cepas de Staphylococcus aureus aisladas de muestras clínicas de diferentes departamentos mediante pruebas convencionales: producción de β-lactamasa, sensibilidad a oxacilina con MIC-Vitek 2-XL, ChromID MRSA, difusión en agar para discos de 30 μg de cefoxitina, detección de PBP2a y PCR para el gen mecA. Se determinó el índice kappa de Cohen, para evaluar la concordancia entre los diferentes métodos utilizados. RESULTADOS: La prevalencia encontrada fue de 90.7%. La sensibilidad y especificidad para los diferentes métodos de detección fue: difusión en disco para cefoxitina 97 y 92% respectivamente, MIC Vitek 2-XL 97 y 69%, ChromoID MRSA 97 y 85% y detección de PBP2a 98 y 100%. CONCLUSIONES: Todos los métodos son muy buenos para la detección de MRSA; la elección en el uso de cada método dependerá de la infraestructura de cada laboratorio.Prevalence of obesity and metabolic syndrome components in Mexican adults without type 2 diabetes or hypertensionS0036-363420120001000022021-01-13T00:10:00Z2017-01-20T00:02:00ZRojas-Martínez, RosalbaAguilar-Salinas, Carlos AJiménez-Corona, AídaGómez-Pérez, Francisco JBarquera, SimónLazcano-Ponce, Eduardo
<em>Rojas-Martínez, Rosalba</em>;
<em>Aguilar-Salinas, Carlos A</em>;
<em>Jiménez-Corona, Aída</em>;
<em>Gómez-Pérez, Francisco J</em>;
<em>Barquera, Simón</em>;
<em>Lazcano-Ponce, Eduardo</em>;
<br/><br/>
OBJECTIVE: To describe the number of Mexican adults with undiagnosed diabetes and arterial hypertension and their association with obesity. MATERIAL AND METHODS: The study included a sub-sample of 6 613 subjects aged 20 years or more who participated in the 2006 National Health and Nutrition Survey (ENSANUT 2006). Subjects with a previous diagnosis of diabetes or hypertension (n=1 861) were excluded. Prevalences and standard errors were estimated, taking into account the complex sample design. RESULTS: 6.4 million adults have obesity and undiagnosed impaired fasting glucose. Almost two million more have fasting glucose levels diagnostic for diabetes. As for arterial blood pressure, 5.4 million adults had prehypertension. Another 5.4 million adults had blood pressure levels suggestive of probable hypertension. A total of 21.4 million Mexican adults with obesity had at least one further component of the metabolic syndrome. CONCLUSIONS: A large proportion of adults with obesity-related metabolic comorbidities remains undiagnosed in Mexico.Optimal cutoff points for the detection of undiagnosed type 2 diabetes, hypertension and metabolic syndrome in Mexican adultsS0036-363420120001000032021-01-13T00:10:00Z2017-01-20T00:02:00ZRojas-Martínez, RosalbaAguilar-Salinas, Carlos AJiménez-Corona, Aída
<em>Rojas-Martínez, Rosalba</em>;
<em>Aguilar-Salinas, Carlos A</em>;
<em>Jiménez-Corona, Aída</em>;
<br/><br/>
OBJECTIVE: To compare the waist circumference cutoff points established by the American Heart Association and the National Heart, Lung and Blood Institute (AHA/NHLBI) with those of the International Diabetes Federation (IDF) for the screening of diabetes, hypertension, and metabolic syndrome in Mexican adults. MATERIAL AND METHODS: This study comprised a subsample of the ENSANUT 2006. Subjects without diabetes and hypertension and non-pregnant women were included. Sensitivity, specificity, and predictive values were compared using AUC and the positive likelihood ratio test [LR(+)]. RESULTS: In subjects aged ≥40 years, sensitivity for detection of diabetes and hypertension was higher for the IDF thresholds (85.34 and 86.87%, respectively) compared with those of the AHA/NHLBI (59.49 and 52.41%, respectively). LR(+) were higher for IDF thresholds compared with AHA/NHLBI. Similar results in subjects aged ≥65 years were observed. CONCLUSIONS: The measurement of abdominal obesity defined by the IDF was a better screening tool for diabetes and hypertension, considering that initially a high sensitivity and low cost tool at population level is required.A workplace physical activity program at a public university in Mexico can reduce medical costs associated with type 2 diabetes and hypertensionS0036-363420120001000042021-01-13T00:10:00Z2017-01-20T00:02:00ZMéndez-Hernández, PabloDosamantes-Carrasco, DarinaSiani, CaroleFlores, Yvonne NArredondo, ArmandoLumbreras-Delgado, IrmaGranados-García, Víctor MDenova-Gutiérrez, EdgarGallegos-Carrillo, KatiaSalmerón, Jorge
<em>Méndez-Hernández, Pablo</em>;
<em>Dosamantes-Carrasco, Darina</em>;
<em>Siani, Carole</em>;
<em>Flores, Yvonne N</em>;
<em>Arredondo, Armando</em>;
<em>Lumbreras-Delgado, Irma</em>;
<em>Granados-García, Víctor M</em>;
<em>Denova-Gutiérrez, Edgar</em>;
<em>Gallegos-Carrillo, Katia</em>;
<em>Salmerón, Jorge</em>;
<br/><br/>
OBJECTIVE: To assess the impact of a workplace leisure physical activity program on healthcare expenditures for type 2 diabetes and hypertension treatment. MATERIAL AND METHODS: We assessed a workplace program's potential to reduce costs by multiplying the annual healthcare costs of patients with type 2 diabetes and hypertension by the population attributable risk fraction of non-recommended physical activity levels. Feasibility of a physical activity program was assessed among 425 employees of a public university in Mexico. RESULTS: If 400 sedentary employees engaged in a physical activity program to decrease their risk of diabetes and hypertension, the potential annual healthcare cost reduction would be 138 880 US dollars. Each dollar invested in physical activity could reduce treatment costs of both diseases by 5.3 dollars. CONCLUSIONS: This research meets the call to use health economics methods to re-appraise health priorities, and devise strategies for optimal allocation of financial resources in the health sector.Tobacco industry success in Costa Rica: the importance of FCTC article 5.3S0036-363420120001000052021-01-13T00:10:00Z2017-01-20T00:02:00ZCrosbie, EricSebrié, Ernesto MGlantz, Stanton A
<em>Crosbie, Eric</em>;
<em>Sebrié, Ernesto M</em>;
<em>Glantz, Stanton A</em>;
<br/><br/>
OBJECTIVE: To analyze how the tobacco industry influenced tobacco control policymaking in Costa Rica. MATERIALS AND METHODS: Review of tobacco industry documents, tobacco control legislation, newspaper articles, and interviewing of key informants. RESULTS: During the mid-to-late 1980s, Health Ministry issued several advanced (for their time) smoking restriction decrees causing British American Tobacco (BAT) and Philip Morris International (PMI) to strengthen their political presence there, resulting in passage of a weak 1995 law, which, as of August 2011, remained in effect. Since 1995 the industry has used Costa Rica as a pilot site for Latin American programs and has dominated policymaking by influencing the Health Ministry, including direct private negotiations with the tobacco industry which violate Article 5.3's implementing guidelines of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). CONCLUSIONS: The Costa Rica experience demonstrates the importance of vigorous implementation of FCTC Article 5.3 which insulates public health policymaking from industry interference.Encuesta Nacional de Cobertura de Vacunación (influenza, neumococo y tétanos) en adultos mayores de 60 años en MéxicoS0036-363420120001000062021-01-13T00:10:00Z2017-01-20T00:02:00ZTrejo-Valdivia, BelemMendoza-Alvarado, Laura RPalma-Coca, OswaldoHernández-Ávila, MauricioTéllez-Rojo Solís, Martha María
<em>Trejo-Valdivia, Belem</em>;
<em>Mendoza-Alvarado, Laura R</em>;
<em>Palma-Coca, Oswaldo</em>;
<em>Hernández-Ávila, Mauricio</em>;
<em>Téllez-Rojo Solís, Martha María</em>;
<br/><br/>
OBJETIVO: Determinar la cobertura de vacunación (CV) para influenza, neumococo y tétanos, en adultos mayores (AM) de 60 años y más, heterogeneidad por entidad federativa y relación con características sociodemográficas. MATERIAL Y MÉTODOS: Análisis transversal basado en una encuesta nacional en 18 015 hogares. Se captó información general y sobre vacunación (autorreporte) en un AM por cada uno de los hogares seleccionado aleatoriamente. RESULTADOS: La prevalencia nacional de vacunación fue 56.5% (±0.97) para influenza, 44.3% (±0.98) para neumococo y 61.8% (±0.96) para tétanos. Las CV analizadas fueron significativamente menores para AM sin seguro médico y mayores en las mujeres. Casi 20% de AM reconoció no tener vacuna alguna, argumentando principalmente el hecho de desconocer la necesidad de vacunarse. CONCLUSIONES: Se muestra un avance importante en las coberturas de vacunación en AM en México; se identifican diferenciales que sugieren la necesidad de impulsar campañas de información y acciones que mejoren la accesibilidad a la vacuna por este grupo poblacional.Cost-effectiveness analysis of the use of palivizumab in the prophylaxis of preterm patients in MexicoS0036-363420120001000072021-01-13T00:10:00Z2017-01-20T00:02:00ZSalinas-Escudero, GuillermoMartínez-Valverde, SilviaReyes-López, AlfonsoGarduño-Espinosa, JuanMuñoz-Hernández, OnofreGranados-García, VíctorRely, Kely
<em>Salinas-Escudero, Guillermo</em>;
<em>Martínez-Valverde, Silvia</em>;
<em>Reyes-López, Alfonso</em>;
<em>Garduño-Espinosa, Juan</em>;
<em>Muñoz-Hernández, Onofre</em>;
<em>Granados-García, Víctor</em>;
<em>Rely, Kely</em>;
<br/><br/>
OBJECTIVE: The study evaluated the incremental cost-effectiveness ratio (ICER) of the prophylaxis of palivizumab, for the reduction of complications associated to the respiratory syncytial virus in preterm patients in Mexico. MATERIAL AND METHODS: A decision tree was developed in preterm groups [<29 and 29-32 weeks of gestational age (wGA)], by using epidemiological and cost local data; the effectiveness was obtained with a systematic review. Patients were evaluated according to their life expectancy. Mexican Health System perspective was used. Effectiveness measures employed were LYG and QALYs. The costs are reported in USD 2009. RESULTS: ICERs per LYG resulted on values of USD $25,029 and USD $29,637 for <29 wGA and 29-32 wGA respectively, whereas ICERs per QALYs obtained in the model accounted for USD $17,532 and USD $20,760. CONCLUSIONS: Palivizumab prophylaxis for preterm newborn patients ≤32 weeks of age resulted in a cost-effective alternative.Análisis de la inclusión de la policía en la respuesta de emergencias al paro cardiorrespiratorio extrahospitalarioS0036-363420120001000082021-01-13T00:10:00Z2017-01-20T00:02:00ZAguilera-Campos, AndreaAsensio-Lafuente, EnriqueFraga-Sastrías, Juan Manuel
<em>Aguilera-Campos, Andrea</em>;
<em>Asensio-Lafuente, Enrique</em>;
<em>Fraga-Sastrías, Juan Manuel</em>;
<br/><br/>
OBJETIVO: El presente estudio busca analizar una alternativa al pronóstico de paro cardiorrespiratorio extrahospitalario (PCE) como problema de salud pública al involucrar a los cuerpos policiacos en la respuesta de emergencias. MATERIAL Y MÉTODOS: Se analizó retrospectivamente un registro de PCE iniciado en junio de 2009. Se contrastó un modelo basado en un número limitado de ambulancias con primera respuesta por la policía. RESULTADOS: La mortalidad fue de 100%, tiempos de respuesta elevados y 10.8% recibió reanimación cardiopulmonar (RCP) por testigos presenciales. En 63.7% de los eventos la policía llegaba antes que la ambulancia y en 1.5% el policía dio RCP. El costo por vida salvada fue 5.8-60 millones de pesos en un modelo sólo con ambulancias vs. 0.5-5.5 millones de pesos en un modelo con primera respuesta policiaca. CONCLUSIONES: La intervención de la policía en la ciudad de Querétaro facilitaría la disminución de la mortalidad por PCE a un menor costo.Normas para la publicación de manuscritos en Salud Pública de MéxicoS0036-363420120001000092021-01-13T00:10:00Z2017-01-20T00:02:00ZNanopartículas modificadas en productos de consumoS0036-363420120001000102021-01-13T00:10:00Z2017-01-20T00:02:00Z