Abortion, social inequity, and women's health: obstetrician-gynecologists as agents of change.

Unsafe abortion persists as a serious health problem for women. It is rooted in poverty, social inequity, and denial of women's basic human rights. As experience from Latin America and other regions demonstrates, obstetrician-gynecologists can be leaders in supporting reproductive rights and access to safe abortion, through their professional societies and also by way of their roles as providers, academicians, and advocates. Ob-gyns are often most effective when working in partnership with women's organizations, lawyers, and other stakeholders.

Comparative demographic and autopsy findings in acquired immune deficiency syndrome in two Mexican populations.

In order to identify the characteristics of the acquired immune deficiency syndrome (AIDS) as it occurs in Mexico, a comparative study of the demographic and pathological findings of the first 58 patients who died of AIDS and were autopsied at two Mexican hospitals, Hospital General de Mexico (HG) and Instituto Nacional de la Nutricion (INN), was performed. The patient population consisted of 52 men and 6 women. Their socioeconomic status (SES) was estimated using the occupational prestige and level of education as indicators. As in the U.S.A., most patients (72%) were male homosexuals/bisexuals (HMS/BSX). However, nine patients (31%) at the HG could not be assigned to any of the currently known risk groups. Comparison of the SES of the two series revealed a significantly higher number of poor patients at HG (81 vs. 17%). For the whole group, the most frequent infections were caused by cytomegalovirus (CMV) (65%), Mycobacterium tuberculosis (28%), Pneumocystis carinii (24%), and Toxoplasma gondii (17%). Kaposi's sarcoma (KS) was found in 41% of the cases. The frequency of toxoplasmosis was higher in poor patients (30 vs. 8%, odds ratio of 5.5, 95% confidence limits of 0.83, 39.34, p = 0.04) while the reverse situation was true for KS (18 vs. 61%, odds ratio of 0.14, 95% confidence limits of 0.04, 0.55, p = 0.001). For KS, this difference persisted when only HMS/BSX patients were compared. In conclusion, dissimilarities observed in the frequency of some AIDS-associated diseases in different institutions appear to be mainly influenced by the SES of the patients.

Medical drug utilization patterns for febrile patients in rural areas of Mexico.

The objective of this study was to evaluate the medication pattern of febrile patients and determine what proportion of these drugs were included in the Mexican Essential Drugs List. A cross-sectional study was conducted in 32 rural communities located in malarial endemic areas near the Mexico-Guatemala border. Of 817 febrile patients interviewed, 55% self-medicated, while 16% consulted a physician. The most frequently used drugs were antipyretics (68%), antibiotics (25%), and antimalarial drugs (37%), despite the fact that only 2% of all febrile patients were diagnosed with malaria. Antipyrine, acetylsalicylic acid, and acetaminophen represented 84% of antipyretics, and ampicillin, penicillin, and sulfadiazine-trimethoprim represented 51% of total antibiotics. Public health service and self-medicating patients used essential drugs (antipyretics and antibiotics) significantly more than those consulting private physicians. These findings demonstrate the need to foster access to primary health care (PHC) facilities, rational drug prescription by private physicians, and to review guidelines for prescription of antimalarial drugs for febrile patients.