Cancer mortality in the Mexican Social Security Institute, 1989-2013.

UNLABELLED: Objetive: To analyze cancer mortality in affiliates of the Mexican Social Security Institute (Instituto Mexicano del Seguro Social - IMSS) and time trends in the risk of death due to cancer from 1989 to 2013. MATERIALS AND METHODS: A descriptive analysis of cancer mortality trends in beneficiaries of the IMSS was performed. Age- and sex-adjusted mortality rates were obtained using direct standardization with the WHO population. Changes in the risk of death due to cancer over time were evaluated using Poisson regression. RESULTS: The absolute number of deaths due to cancer doubled from 1989 to 2013 due to increasing age of the affiliate population. The risk of death among affiliates decreased for the majority of cancers except for colon and rectal cancer. CONCLUSION: The risk of dying from cancer among IMSS affiliates showed a marked decrease, which may be due to an increase in detection and opportune treatment.

Cancer mortality in the Mexican Social Security Institute, 1989-2013 / Mortalidad por cáncer en el Instituto Mexicano del Seguro Social, 1989-2013

Abstract Objetive: To analyze cancer mortality in affiliates of the Mexican Social Security Institute (Instituto Mexicano del Seguro Social - IMSS) and time trends in the risk of death due to cancer from 1989 to 2013. Materials and Methods: A descriptive analysis of cancer mortality trends in beneficiaries of the IMSS was performed. Age- and sex-adjusted mortality rates were obtained using direct standardization with the WHO population. Changes in the risk of death due to cancer over time were evaluated using Poisson regression. Results: The absolute number of deaths due to cancer doubled from 1989 to 2013 due to increasing age of the affiliate population. The risk of death among affiliates decreased for the majority of cancers except for colon and rectal cancer. Conclusion: The risk of dying from cancer among IMSS affiliates showed a marked decrease, which may be due to an increase in detection and opportune treatment.

Resumen Objetivo: Analizar la frecuencia de las defunciones por cáncer en la población derechohabiente (DH) del Instituto Mexicano del Seguro Social, así como la tendencia temporal en el riesgo de muerte por esta causa de 1989 a 2013. Material y métodos: Se realizó análisis descriptivo del comportamiento de la mortalidad por cáncer en población derechohabiente del IMSS. Las tasas de mortalidad ajustadas por edad y sexo se obtuvieron con el método directo utilizando la población mundial estándar de la OMS. Los cambios en el riesgo de morir por cáncer a través del tiempo se evaluaron mediante regresión de Poisson. Resultados: El número absoluto de defunciones por cáncer se duplicó de1989 a 2013 debido a un aumento y al envejecimiento de la población derechohabiente. El riesgo de muerte en los DH disminuyó para la mayoría de los diferentes tipos de cáncer, excepto para el cáncer de colon y recto. Conclusión: El riesgo de morir por cáncer en DH del IMSS muestra una discreta disminución, posiblemente debido a la mejora en la detección y tratamiento oportuno.

[Rapid Response obstetrics Team at Instituto Mexicano del Seguro Social,enabling factors]. / Equipo de Respuesta Inmediata obstétrico en el Instituto Mexicano del Seguro Social, factores facilitadores.

BACKGROUND: There are barriers and enablers for the implementation of Rapid Response Teams in obstetric hospitals. The enabling factors were determined at Instituto Mexicano del Seguro Social (IMSS) MATERIAL AND METHODS: An observational, retrospective study was conducted by analysing the emergency obstetric reports sent by mobile technology and e-mail to the Medical Care Unit of the IMSS in 2013. Frequency and mean was obtained using the Excel 2010 program for descriptive statistics. RESULTS: A total of 164,250 emergency obstetric cases were reported, and there was a mean of 425 messages per day, of which 32.2% were true obstetric emergencies and required the Rapid Response team. By e-mail, there were 73,452 life threatening cases (a mean of 6 cases per day). A monthly simulation was performed in hospitals (480 in total). Enabling factors were messagés synchronisation among the participating personnel,the accurate record of the obstetrics, as well as the simulations performed by the operational staff. The most common emergency was pre-eclampsia-eclampsia with 3,351 reports, followed by obstetric haemorrhage with 2,982 cases. DISCUSSION: The enabling factors for the implementation of a rapid response team at IMSS were properly timed communication between the central delegation teams, as they allowed faster medical and administrative management and participation of hospital medical teams in the process. CONCLUSION: Mobile technology has increased the speed of medical and administrative management in emergency obstetric care. However, comparative studies are needed to determine the statistical significance.

[Angiofibrolipoma of the greater omentum: case report and literature review]. / Angiofibrolipoma de omento mayor. Informe de un caso y revisión de la literatura.

BACKGROUND: Primary solid tumors of the greater omentum are extremely rare. Lipomas, leiomyomas, fibromas, and neurofibromas have been described as benign tumors of the greater omentum, but angiofibrolipomas have not. CLINICAL CASE: We present the case of a 39-year-old male with a 3-day evolution of right lower quadrant abdominal pain associated with nausea and vomiting. McBurney, Psoas, Obturator and Markle signs were all positive. Laboratory analysis revealed leukocytosis and bandemia. Abdominal ultrasound showed free fluid and an undefined mass suggestive of complicated acute appendicitis. Emergency midline laparotomy demonstrated a tumor of the greater omentum with areas of ischemia, necrosis and hemorrhage. Histological exam revealed angiofibrolipoma of the greater omentum. CONCLUSIONS: Angiofibrolipoma of the greater omentum may present as a surgical emergency due to torsion. When a tumor of the omentum is found during surgery, complete excision is the treatment of choice when a definitive histology result is received.

Angiofibrolipoma de omento mayor: informe de un caso y revisión de la literatura / Angiofibrolipoma of the greater omentum: case report and literature review

Introducción: Los tumores sólidos primarios del omento son extremadamente raros. Como tumores benignos del omento se han descrito los lipomas, leiomiomas, fibromas, y neurofibromas, pero no el angiofibrolipoma. Caso clínico: Varón de 39 años de edad, con dolor abdominal de tres días de evolución localizado en cuadrante inferior derecho del abdomen, acompañado de náusea y vómito, así como dolor en fosa iliaca derecha, signo de McBurney, psoas, obturador y Markle positivos. El laboratorio documentó leucocitosis y bandemia; el ultrasonido abdominal, líquido libre en cavidad y masa no bien definida sugestiva de apendicitis aguda complicada; la laparotomía de urgencia, tumoración de omento mayor con zonas de isquemia, necrosis y hemorragia; el examen histológico, angiofibrolipoma de omento mayor. Conclusiones: El angiofibrolipoma del omento mayor se puede presentar como una urgencia quirúrgica debido a la torsión sobre su propio eje. Ante el hallazgo transoperatorio de una tumoración del omento, la escisión completa con omentectomía es el tratamiento de elección, en tanto se recibe el examen histológico definitivo.

BACKGROUND: Primary solid tumors of the greater omentum are extremely rare. Lipomas, leiomyomas, fibromas, and neurofibromas have been described as benign tumors of the greater omentum, but angiofibrolipomas have not. CLINICAL CASE: We present the case of a 39-year-old male with a 3-day evolution of right lower quadrant abdominal pain associated with nausea and vomiting. McBurney, Psoas, Obturator and Markle signs were all positive. Laboratory analysis revealed leukocytosis and bandemia. Abdominal ultrasound showed free fluid and an undefined mass suggestive of complicated acute appendicitis. Emergency midline laparotomy demonstrated a tumor of the greater omentum with areas of ischemia, necrosis and hemorrhage. Histological exam revealed angiofibrolipoma of the greater omentum. CONCLUSIONS: Angiofibrolipoma of the greater omentum may present as a surgical emergency due to torsion. When a tumor of the omentum is found during surgery, complete excision is the treatment of choice when a definitive histology result is received.