[Overview of mortality in Mexico through four indicators from 1990 to 2012]. / Panorama de la mortalidad en México a través de cuatro indicadores de 1990 a 2012.

OBJECTIVE: To describe the behavior of mortality in Mexico through four indicators from 1990 to 2012. MATERIAL AND METHODS: The official mortality and population records of Mexico were used. RESULTS: An advance was achieved for children under five years of age, with a decrease in mortality, although there was an increase in the years of potential life lost (YPLL) from 2008 for this age group. For children under one year of age, there was no advance since 2002 in the index of YPLL and in the productive years of life lost (PYLL). Since 2008 there has been an increase in the rates of mortality, YPLL, and PYLL in the group from 10 to 29 years of age. There has been a sustained increase in YPLL in the age group from 40 to 69. CONCLUSIONS: It is relevant to evaluate the health policies in Mexico for the different age groups; even though there have been positive results in some of them, these are not across all the age groups, which could put some sectors of the population at risk, such as children and young people from 10 to 29 years of age.

[Knowledge and attitudes of teachers at a Medical School and the use of clinical practice guidelines]. / Conocimientos y actitudes de los docentes de una Facultad de Medicina y el uso de las guías de práctica clínica (GPC) nacionales.

INTRODUCTION: The National Center for Health Technology Excellence (CENETEC) has published 539 clinical practice guidelines (CPG) whose area of influence is nationwide. OBJECTIVE: To conduct an assessment of the knowledge and attitudes of teachers at a medical school and the use of CPGs. MATERIALS AND METHODS: We performed a cross-sectional study in 2012 among teachers at one medical school in San Luis Potosí, Mexico. RESULTS: Overall, 97.1% of medical school physicians (MDs) reported knowing the existence of CPGs and 94.9% had consulted them. The 87.6% of the MD knew where they could find the guidelines. However, only 15.9% mentioned the CENETEC website as a source, 30.4% The Ministry of Health website, and 7.3% both pages. CONCLUSIONS: It is necessary to develop programs that facilitate the implementation and adoption of clinical practice guidelines by a multidisciplinary team that specifically establishes the importance of their use.

[Prevalence of unsafe conditions associated to non-intentional needlestick injuries among trainee physicians]. / Prevalencia, condiciones y actos inseguros asociados a punciones accidentales de médicos en formación.

INTRODUCTION: Physicians in training face high-risk clinical situations for needlestick injuries during their training. OBJECTIVE: To determine the prevalence and establish behaviors associated with needlestick injuries. MATERIAL AND METHODS: A cross-sectional study was conducted during the 2012-2013 school year among undergraduate and graduate medical students of a Faculty of Medicine in Mexico. RESULTS: There were a total of 441 questionnaires completed, of which 56.7% of students reported having experienced at least one lesion, of which only 44.5% reported it. The conditions and unsafe acts associated were: female students had a greater risk for the first puncture, whereas male students correlated with three or more punctures; third year students, night shift rounds, the feeling of being rushed by someone else, and the presence of fatigue were risk factors for the first puncture (p < 0.05). CONCLUSIONS: The high prevalence and the underreporting of non-intentional punctures places students at a higher risk of transmissible diseases. Strategies focused on prevention, monitoring, and control of accidental punctures should be implemented by hospitals, schools, and medical schools.

Oseltamivir storage, distribution and dispensing following the 2009 H1N1 influenza outbreak in Mexico.

PROBLEM: During an influenza outbreak or pandemic, timely access to antivirals is essential to reduce disease severity and transmission. Best practices in antiviral procurement, storage, distribution, prescription and dispensing must be followed for prompt drug delivery. APPROACH: Mexico implemented a national pandemic preparedness plan in 2006 and created a strategic antiviral stockpile. Oseltamivir powder was stored centrally in bulk for distribution to all 31 states and the capital district during an influenza outbreak. LOCAL SETTING: San Luis Potosí, in northern Mexico, was one of the states most intensely affected by the 2009 H1N1 influenza outbreak. RELEVANT CHANGES: The oseltamivir powder was meant to be reconstituted locally but had to be reconstituted centrally during the 2009 influenza outbreak. Doubts arose surrounding the shelf-life of the reconstituted product. As a result of these problems, the first supply of the drug reached San Luis Potosí 11 days after the influenza outbreak had begun. Furthermore, dispensing criteria at the state level had to be changed in conformity with the availability of oseltamivir. LESSONS LEARNT: Antiviral demand forecasts should be based on clearly defined distribution and dispensing criteria and decentralization of some of the medication stockpile should be considered. Mexico's national pandemic preparedness plan needs to be updated in accordance with the lessons learnt in 2009 to improve strategic stockpile management and ensure rapid delivery of oseltamivir to the population.

[Costs of serious adverse events in a community teaching hospital, in Mexico]. / Costos de eventos adversos graves en un Hospital Comunitario de Enseñanza en México.

BACKGROUND: Serious adverse events during hospital care are a worldwide reality and threaten the safety of the hospitalised patient. OBJECTIVE: To identify serious adverse events related to healthcare and direct hospital costs in a Teaching Hospital in México. MATERIAL AND METHODS: A study was conducted in a 250-bed Teaching Hospital in San Luis Potosi, Mexico. Data were obtained from the Quality and Patient Safety Department based on 2012 incidents report. Every event was reviewed and analysed by an expert team using the "fish bone" tool. The costs were calculated since the event took place until discharge or death of the patient. RESULTS: A total of 34 serious adverse events were identified. The average cost was $117,440.89 Mexican pesos (approx. €7,000). The great majority (82.35%) were largely preventable and related to the process of care. Undergraduate medical staff were involved in 58.82%, and 14.7% of patients had suffered adverse events in other hospitals. CONCLUSIONS: Serious adverse events in a Teaching Hospital setting need to be analysed to learn and deploy interventions to prevent and improve patient safety. The direct costs of these events are similar to those reported in developed countries.