CARACTERIZACIÓN CLÍNICA DE LOS PACIENTES CON DIABETES MELLITUS DEL REGISTRO ESTATAL DE DIABETES EN UN ESTADO DE MÉXICO / CLINICAL CHARACTERIZATION OF PATIENTS WITH DIABETES MELLITUS FROM THE STATE REGISTER OF DIABETES IN A STATE OF MEXICO

Introducción: La diabetes mellitus representa un reto para los sistemas de salud debido a la complejidad de la atención, la calidad y el acceso a tratamientos. Objetivo: Describir las características clínicas de los pacientes con diabetes mellitus del registro estatal de diabetes del Estado de Hidalgo en México de los años 2007 a 2012. Material y Métodos: Estudio transversal descriptivo del Registro Estatal de Diabetes (RED) durante 2007 al 2012. Se realizó descripción estadística simple para caracterizar a la población del estudio, proporciones y razones para variables cualitativas y para variables cuantitativas medidas de tendencia central y de dispersión (media, mediana, moda, desviación estándar y varianza). Para el análisis de las variables continuas se hizo la prueba de t de Student. Resultados: Se identificaron 10.198 pacientes del RED, el 66,4% fueron mujeres y el 33,52% hombres. La media de edad fue 52,2 ±12,8 años. Respecto a la glucosa en ayuno, la media fue de 239,1±95,3 mg/dl; la media de glucosa postprandial 293,6±122,7 mg/dl y la de glucosa casual 247,9±102,3 mg/dl. Las actividades del RED incluyeron a 5.795 personas que fueron detectadas en ese momento, lo que corresponde al 56,8%. De las cuales, 11,9% manifestó tener visión borrosa, 48,5% poliuria, 4,7% infecciones, 44,07% polidipsia, 13,19% polifagia, 26,9% pérdida de peso y 35,2% fatiga. Al comparar las que estaban en tratamiento con las que ingresaban no encontramos diferencias estadísticas. Mientras que las que se encontraban en tratamiento, quienes mencionaron solo tener dieta fueron el 33,5%, metformina 72,58%, sulfonilureas 62,9%, acarbosa 3,59%, insulina 9,4%, rosiglitazona 0,66%. Discusión: El RED tiene estándares de control glicémico bajo. Se sugiere la elaboración de indicadores internos para que estos les permitan realizar la toma de decisiones desde el interior de la unidad y ofrecer una mejor calidad de atención, el cumplimiento y oportunidad.

Introduction: Diabetes mellitus is a challenge for health systems due to the complexity of care, and the quality and access to treatment. Objective: To describe the clinical characteristics of patients in the Diabetes Mellitus State Register in the state of Hidalgo in Mexico from 2007 to 2012. Methods: Cross-sectional descriptive study of the Diabetes State Register (DSR) between 2007 and 2012. Simple statistics description to characterize the studied population, proportions and reasons for qualitative variables and for quantitative measures of central tendency and continuous and dispersion variables (media, median, mode, deviation, standard and variance) were carried out. The t student test was used for the analysis of continuous variables. Results: 10,198 patients from the Diabetes State Register were identified; 66.4% were women and 33.52% men. The mean age was 52.2±12.8. Regarding fasting glucose, the mean was 239.1±95.3 mg/dl; the post-prandial glucose mean was 293.6±122.7 mg/dl and casual glucose was 247.9±102.3 mg/dl. The DSR activities included 5,795 people that were detected at that time which correspond to 56.8% from which 11.9% reported having blurred vision, polyuria 48.5%, infections 4.7%, polydipsia 44.07%, polyphagia 13.19%, weight loss 26.9% and fatigue 35.2%. When comparing people under treatment with those admitted, no statistical difference was found While those who were under treatment, who mentioned only having diet were 33.5%, metformin72.58%, sulfonylureas 62.9%, acarbose 3.59%, insulin 9.4%, and rosiglitazone 0.66%. Discussion: The Diabetes State Register has low glycemic control standards. Development of internal indicators is suggested to allow medical staff to make decisions from inside the unit and provide a better quality of care, compliance and opportunity.

[Risk factors associated to preclampsia]. / Factores de riesgo asociados con preeclampsia.

BACKGROUND: preeclampsia constitutes one of the main causes of maternal and perinatal morbidity and mortality. The aim was to identify the risk factors associated to the developmental of preeclampsia mild-moderate and severe, as well as the force of association of these factors in a hospital of second-level medical care. METHODOLOGY: study of cases and controls, a relation 1:1, in women withdrawn of the Service of Gynecology and Obstetrics during 2004 to 2007. Pregnant women with more than 20 weeks gestation were included. In the cases group we included patients with diagnosis of preeclampsia mild-moderate or severe (corroborated clinical and laboratory). In the controls group that had a normal childbirth without pathology during the pregnancy. RESULTS: 42 cases and 42 controls. The average age was of 27 years. The associated risk factors were overweight, obesity, irregular prenatal control, short or long intergenesic period, history of caesarean or preeclampsia in previous pregnancies. CONCLUSIONS: the knowledge of the risk factors will allow the accomplishment of preventive measures and decrease the fetal and maternal morbidity and mortality due to preeclampsia.

[Intervention of the family physician in alcoholism: a review of operative strategies]. / Intervención del médico familiar en alcoholismo. Revisión de estrategias operativas.

The actions of secondary prevention of alcohol abuse and alcoholism in the primary medical attention confront barriers that difficult their attention, beginning with those of the patient him or herself, those of the family physician and the multidisciplinary staff, and finally, those corresponding to the system of attention itself. The objective of this study is to show a review of international literature and experiences in Mexico, which present secondary prevention strategies that facilitate the family physician his or her performance in the containment of alcoholism through early detection and brief intervention. In this paper, we present an operative model that the World Health Organization made in 2001 as an advice of its experts on the problem, combining early detection through the application of the "Identification test of disorders due to alcohol addiction, abuse and/or dependence" (AUDIT) and based on the score obtained, it applies an intervention strategy that goes from the simple piece of advice to the brief therapy and if it is necessary, the derivation.