Hospitalization and mortality in Mexico due to breast cancer since its inclusion in the catastrophic expenditures scheme.

OBJECTIVE: To compare trends in hospital discharges and mortality due to breast cancer (BC) in Mexico from 2004 to 2012 by insurance condition before and after incorporating BC comprehensive treatment into the System of Social Protection in Health (Sistema de Protrección Social en Salud, SPSS) in 2007. MATERIALS AND METHODS: Data on BC hospital discharges and mortality reported in women aged 25 years and over were obtained from the National Health Information System. Mortality rates were adjusted by age and state. RESULTS: At the national level, a growing tendency in hospital discharges was observed, mainly for women without social security, while mortality rate remained constant. Mortality rates by state show that lower marginalization index corresponded to higher mortality. CONCLUSIONS: A differential behavior was observed among women according to insurance condition, partly due to the inclusion of BC treatment in the SPSS.

[Injuries in emergency rooms of urban areas in Mexico: prevalence and severity]. / Atención de lesiones por tipo de causa externa en salas de urgencia en tres ciudades de México: composición, frecuencia y gravedad.

OBJECTIVE: To identify frequency and severity of injuries by type of external cause in people attending emergency services for medical attention. MATERIAL AND METHODS: Cross-sectional study held in the cities of Guadalajara, Colima and Mexico City, from September 2007 to February 2008. All people requiring emergency medical attention due to injuries were included. VARIABLES: sex, age, anatomical area of the injury, type of injury, external cause, type of aggressor and severity according to the abbreviated injury scale. Statistical analysis was univariate simple and multivariate. RESULTS: 26.3% of the emergency medical attention was due to injuries, with the main cause being falls (49.3%). Individuals from 15 to 44 years (55.8%) reported a higher frequency, while those over 60 years presented the most serious injuries. Associated variables to severity were interpersonal aggression (OR 6.7, IC 95% 4.20-10.69) and road traffic injuries (OR 3.00, IC 95% 1.72-5.23). Conclusions. Accidental and intentional injuries represent an important demand of emergency medical attention; with interpersonal aggression and road traffic injuries being responsible for the highest number of serious injuries.

Validation of the Post-Covid-19 Functional Status Scale into Mexican-Spanish.

AIM: To translate and validate the Post-COVID-19 Functional Status Scale into Mexican-Spanish. MATERIALS AND METHODS: A cross-sectional study was performed for transcultural validation of the Post-COVID-19 Functional Status Scale in people over 18 years of age, using the international guidelines for validation published by Beaton and Guillemin. Diagnostic and clinimetric validity tests were applied to the scale. Statistical analysis was performed with the statistical program R. RESULTS: The scale was applied to 249 patients, obtaining a Cronbach's alpha of 0.84 for the structured interview, and 0.67 for the self-reported questionnaire. When comparing both tests, and considering the structured interview as the reference test, the self-reported questionnaire had a sensitivity of 86.2%, a specificity of 96.3%, and a negative predictive value of 95.8%. CONCLUSION: A practical and valid scale was obtained, in concordance with that published in the original version, which can be used in daily clinical practice and rehabilitation. The scale can be used to rapidly and adequately identify post-COVID-19 patients with alterations in functionality who could benefit from rehabilitation therapy.

Cross-cultural adaptation and validation of the Gait, Arms, Legs, Spine locomotor screening test for detecting musculoskeletal disorders in Mexican adults.

AIM: Developed in the United Kingdom, the Gait, Arms, Legs and Spine (GALS) sensitive screening test enables doctors to examine joints and positions at rest and during motion. Therefore, patients with an early diagnosis for musculoskeletal (MSK) disorders, can enjoy a better quality of life than those diagnosed at a later stage. The objective was to adapt and validate a Mexican-Spanish version of the GALS measurement instrument for MSK disorders in Mexican adults. MATERIALS AND METHODS: We conducted a cross-sectional diagnostic test study among 18- 60-year-old adults in a hospital in the city of Guadalajara, Mexico. Based on international guidelines, we divided our work into 2 phases: first, we developed and adapted a cross-cultural, Mexican-Spanish version of the GALS; second, we validated the instrument as a diagnostic test among Mexican patients. RESULTS: The adapted version yielded the following scores as a measurement instrument: 0.92 under Cronbach's alpha, 0.695 (95% CI, 0.592-0.797) in the kappa index, 98.2% (95% CI, 90.3%-100%) in sensitivity, 80.6% (95% CI, 72.9%-86.9%) in specificity, and 5.06 for positive likelihood ratio. It also covered an area of 0.89 (95% CI, 0.85-0.93) under the receiver operating characteristic curve. CONCLUSIONS: The GALS diagnostic test proved valid for detecting MSK disorders among Mexican adults. It can be used by specialized physicians, family doctors, general practitioners and even physicians in training.

Underreporting trends of occupational illnesses in Mexico.

OBJECTIVE: To report trends underreporting levels of occupational illnesses (OI) in Mexico from 2000 to 2015. METHODS: An ecological study was conducted. Data on OI was obtained from the Statistical Memories of the Mexican Institute of Social Security. We used univariate sensitivity analysis to estimate the average value and range. RESULTS: During the 2000-2015 period, the estimated average OI underreporting in the Mexican population was 89.1%; the minimum was 81.8% in 2015 and the maximum 95% in 2007, with an annual decrement rate of 1% (p<0.05) was observed from 2007 to 2015. CONCLUSIONS: Important changes to improve reporting of OI have taken place since 2007, most likely due to the implementation of new policies in this matter. Even though the OI report in Mexico is higher than what the World Health Organization estimates for Latin America (18% in 2015), activities to address this problem remain insufficient. Furthermore, it is important to evaluate the current process of identification and registration of OI in order to identify those that need reinforcement, to guarantee adherence to regulations, to consolidate training systems, and importantly, to develop the governing capacity of the sanitation and labor authorities to exercise their coordinating and regulatory functions.

Hospitalization and mortality in Mexico due to breast cancer since its inclusion in the catastrophic expenditures scheme / Hospitalización y mortalidad en México por cáncer de mama a partir de su inclusión en el esquema de gastos catastróficos

Abstract Objective: To compare trends in hospital discharges and mortality due to breast cancer (BC) in Mexico from 2004 to 2012 by insurance condition before and after incorporating BC comprehensive treatment into the System of Social Protection in Health (Sistema de Protrección Social en Salud, SPSS) in 2007. Materials and methods: Data on BC hospital discharges and mortality reported in women aged 25 years and over were obtained from the National Health Information System. Mortality rates were adjusted by age and state. Results: At the national level, a growing tendency in hospital discharges was observed, mainly for women without social security, while mortality rate remained constant. Mortality rates by state show that lower marginalization index corresponded to higher mortality. Conclusions: A differential behavior was observed among women according to insurance condition, partly due to the inclusion of BC treatment in the SPSS.

Resumen Objetivo: Comparar las tendencias de egresos hospitalarios y mortalidad por cáncer de mama (CaMa) en México de 2004 a 2012, según esquema de aseguramiento, antes y después de la incorporación del tratamiento integral del CaMa al Sistema de Protección Social en Salud (SPSS) en 2007. Material y métodos: Los egresos hospitalarios y de mortalidad por CaMa en mujeres de 25 años o más se obtuvieron del Sistema Nacional de Información en Salud. Las tasas de mortalidad se ajustaron por edad y entidad federativa. Resultados: A nivel nacional, hubo una tendencia creciente de los egresos hospitalarios, principalmente para mujeres sin seguridad social, mientras que la tasa de mortalidad se mantuvo constante. Las tasas de mortalidad fueron mayores en estados con menor índice de marginación. Conclusiones: Se observó un comportamiento diferencial entre las mujeres según esquema de aseguramiento en salud debido, en parte, a la inclusión del tratamiento de CaMa al SPSS.