Daily respiratory mortality and PM10 pollution in Mexico City: importance of considering place of death.

Significant associations have been reported between particles with a 50% cut-off aerodynamic diameter of 10 mm (PM10) and ozone ambient concentrations, and daily number of deaths from respiratory causes. The aim of the present study was to assess such associations among elderly (> or =65 yrs) residents of Mexico City. Ambient air pollution data were provided by the Metropolitan Monitoring Network. During the study period, the average daily PM10 ranged 23.4-175.3 microg x m(-3), and ozone 1 h daily maximums ranged 39.4-216.7 ppb. Information was compiled on the primary and underlying causes of death. The analyses were conducted separately according to place of death (within or out of a hospital unit) using time-series methodology. The total number of deaths from all respiratory causes and mortality for chronic obstructive pulmonary diseases (COPD) were significantly related to PM10 over different lags: an increase of 10 microg x m(-3) was related to a 2.9% (95% (CI): 0.9-4.9%) increase and to a 4.1% (95% CI: 1.3%-6.9%) increase with a 3-day lag when death occurred out of medical units, respectively. For deaths occurring in medical units, a longer lag and smaller risk estimate was observed. An interactive effect between PM10 and ozone was detected. This study confirms that there is an important impact of PM10 on respiratory morbidity among elderly subjects. It also indicates that accounting for primary and underlying causes of death, and considering place of death may reduce misclassification and provide more accurate estimates of the adverse impact of PM10 on mortality.

[Overweight in 12-49 year-old women and children under 5 years of age in Mexico]. / Sobrepeso en mujeres de 12 a 49 años y niños menores de cinco años en México.

OBJECTIVE: To estimate the association between some sociodemographic characteristics and the risk of obesity among 12-49 year-old women and children aged under five. MATERIAL AND METHODS: We analyzed data from Mexico's 1988 National Nutrition Survey, including information on 15 811 women of child-bearing age and 6 987 children aged under five years. We estimated the obesity prevalence rate ratios and confidence intervals for all the variables of interest. RESULTS: Preschool children living in the north and central regions of Mexico presented higher obesity prevalence rates than those living in the southeast (PR = 1.90, 95% CI 1.41-2.59 and PR = 1.91, 95% CI 1.41-2.59, respectively). The risk of obesity was positively associated to the educational level of the head of the household. The prevalence of obesity was greater among child-bearing age women living in the northern region of Mexico and in Mexico City (PR = 1.21, 95% CI 1.10-1.34 and PR = 1.16, 95% CI 1.05-1.28). The prevalence of obesity was also positively associated with the number of live births and negatively associated with the woman's educational level. CONCLUSIONS: It is necessary to implement obesity prevention programs among high risk groups.

Feeding patterns of Mexican infants recorded in the 1988 National Nutrition Survey.

Infant feeding patterns in Mexico were analyzed using data from the 1988 National Nutrition Survey. The prevalence of breast-feeding among infants declined from 86% at birth to approximately 40% after three months of age. The hazard rate of terminating breast-feeding increased by 38% at the national level and by 87% in the northern region with each increment in household living conditions, decreased 50% in rural municipalities in the south and decreased by 20% in all regions for each month that the introduction of other milks was delayed. The rate of other milk introduction increased by between 16% and 20% at the national level and within the central and southern regions with each household living condition increment but decreased by between 20 to 30% within indigenous or rural. Finally, the probability of solid food introduction increased by between 8 and 15% with each household living condition increment.

PIP: Infant feeding patterns are important determinants of child health and survival. This paper reports findings from an analysis of infant feeding patterns in Mexico using data from the 1988 National Nutrition Survey. Information was obtained on 7426 children younger than five years of age and 19,278 women aged 12-49 years from 13,236 surveyed households. 1518 children under one year old were included in the analysis, 52% of whom were male. At the national level, the prevalence of breastfeeding among infants declined from 86% at birth to approximately 40% after three months of age. The hazard rate of terminating breastfeeding increased by 38% at the national level and by 87% in the northern region with each increment in household living conditions, decreased by 50% in rural municipalities in the south, and decreased by 20% in all regions for each month that the introduction of other milks was delayed. The rate of other milk introduction increased by 16-20% at the national level and within the central and southern regions with each household living condition increment, but decreased by 20-30% within indigenous or rural areas. The probability of solid food introduction increased by 8-15% with each household living condition increment.

[Anemia in women of reproductive age. The results of a national probability survey]. / Anemia en mujeres de edad reproductiva. Resultados de una encuesta probabilística nacional.

Iron deficiency is one of the most prevalent forms of malnutrition which is clinically known as anemia. Functional consequences of anemia include impairment of cardiovascular performance, limitation in productivity, higher incidence of low birth weight and premature delivery, and increased maternal mortality. This paper presents a descriptive analysis of anemia in women of reproductive age in Mexico. Data were collected by the Ministry of Health through a National Nutrition Survey in 1988, which draw a representative sample from four regions: North, Center, South and Federal District. Anemia was more prevalent in pregnant (18.17%) than in non-pregnant women (15.38%). Those women living in predominantly indigenous communities had higher prevalence of anemia (24.02%) than non-indigenous women (14.67%). Anemia was more prevalent in urban areas (15.54%) than in rural (13.56%). Mean +/- standard deviation values for hemoglobin were lower in pregnant women (12.5 +/- 1.6 g/dL) than in non-pregnant ones (13.7 +/- 1.6 g/dL). Consistently, the Northern and Southern regions were worse off than the Center and the Federal District. These data indicate that anemia is a public health problem in Mexico. The functional consequences of this deficiency justify interventions to treat and prevent it.

[Stunting and emaciation in children under 5 in distinct regions and strata in Mexico]. / Déficit de talla y emaciación en menores de cinco años en distintas regiones y estratos en México.

Data from a National Nutrition Survey conducted in 1988 in a probability sample of 13,236 households and 17,426 children under five, representative at the national level and for four regions (North, Center, South, and Mexico City), were analyzed. Risks for wasting and stunting and odds ratios were obtained by region, by district according to proportion of indigenous population and by level of urbanization, by level of education of both parents, by gender, and by various combinations of the former strata. A high risk of stunting and a low risk of wasting were found. The risk of stunting is greater in predominantly indigenous and rural districts, in the South and Center, and in families of mothers with low education and poor housing conditions. The results can be used for food and nutrition policy planning and for targeting nutrition intervention programs.

Field test of a rapid assessment technique against a probabilistic community survey: operational implications for neonatal tetanus elimination.

Neonatal tetanus (NNT) is a leading cause of neonatal mortality in developing countries and is frequently called 'the silent epidemic'. It is endemic in over 90 countries throughout the world. Incidence is often not known, obstructing cost-effective resource management for control measures. In many developing countries NNT is responsible for one-half of the neonatal mortality and up to one-quarter of infant mortality. Case-fatality rates (CFR) can, even with treatment, reach 80-90%. Operational tools for the rapid identification of NNT risk areas need to be developed for WHO's programme which calls for the elimination of NNT by 1995. Results of a rapid assessment technique, carried out in 1990, were compared with those found in a household survey, which was independently carried out in Jalisco, Mexico, in 1988. One approach used random sample survey techniques in rural communities, which in previous years had reported NNT. Of 40 neonatal deaths, 8 (20%) were attributable to NNT. The annual incidence rate was 4.6/1000 livebirths. Using this as the 'gold standard', a rapid assessment technique was evaluated. The NNT cases seen at health services were randomly matched with other neonatal illnesses obtained from health records and then mapped. Age-specific catchment areas for hospitals under investigation and risk areas for NNT were obtained. Areas without NNT cases but with other neonatal illnesses have been operationally considered to be at low risk for NNT. The use of health services by neonates with other pathologies supports the hypothesis that an NNT case, if it occurred within the same time period and area under investigation, would most probably have been admitted.(ABSTRACT TRUNCATED AT 250 WORDS)

[Airway involvement in the postoperative period of carotid endarterectomy. Report of a case]. / Compromiso de la vía aérea en el postoperatorio de la endarterectomía carotídea. A propósito de un caso.

We report a case of a fifty-seven year old man that was diagnosed a bilateral carotid disease and a carotid endarterectomy was practiced on him in the left carotid, and afterwards in a 12 day lapsus of time, the same was done in the right carotid. In the course of the immediate post-operative period, the patient presented a neck haematoma which required its removal and afterwards he developed a glottis oedema which called for the realisation of a tracheotomy in order to control the airway.