Risk Factors of Failure in 228 Periprosthetic Distal Femur Fractures: A Multicenter Study.

OBJECTIVES: To identify risk factors of reoperation to promote union or to address deep surgical-site infection (DSSI) in periprosthetic distal femur fractures treated with lateral distal femoral locking plates (LDFLPs). DESIGN: Multicenter retrospective cohort study. SETTING: Ten level-I trauma centers. PATIENT SELECTION CRITERIA: Patients with Orthopaedic Trauma Association/Association of Osteosynthesis (OTA/AO) 33A or 33C periprosthetic distal femur fractures who underwent surgical fixation between January 2012 and December 2019 exclusively using LDFLPs were eligible for inclusion. Patients with pathologic fractures or with follow-up less than 3 months without an outcome event (unplanned reoperation to promote union or for deep surgical infection) before this time point were excluded. Fracture fixation constructs used medial plates, intramedullary nails, or hybrid fixation constructs were excluded from analysis. OUTCOME MEASURES AND COMPARISONS: To examine the influence of patient demographics, injury characteristics, and features of the fracture fixation construct on the occurrence of unplanned reoperation to promote union or to address a DSSI. RESULTS: There was an 8.3% rate (19/228) of unplanned reoperation to promote union. Predictive factors for the need for reoperation to promote union included increasing body mass index (odds ratio [OR] = 1.09; 95% confidence interval [CI]: 1.02-1.16; P = 0.01), increasing number of screws in the distal fracture segment (OR = 1.73; 95% CI: 1.06-2.95; P = 0.03), and decreasing proportion of proximal segment screws that are locking (OR = 0.17; 95% CI: 0.03-0.70; P = 0.02) There was a 4.8% rate (11/228) of reoperation to address DSSI. There were no statistically significant predictive factors identified as risk factors of the need for reoperation to address DSSI ( P > 0.05). CONCLUSIONS: 8.3% of periprosthetic distal femur fractures treated at 10 centers with LDFLPs underwent unplanned reoperation to promote union. Increasing patient body mass index and increasing number of screws in the distal fracture segment were found to be predictive factors, whereas increased locking screws in the proximal segment were found to be protective. 4.8% of patients in this cohort underwent reoperation to address DSSI. LEVEL OF EVIDENCE: Level III. See Instructions for Authors for a complete description of levels of evidence.

Technical Factors Contributing to Nonunion in Supracondylar Distal Femur Fractures Treated With Lateral Locked Plating: A Risk-Stratified Analysis.

OBJECTIVE: To identify technical factors associated with nonunion after operative treatment with lateral locked plating. DESIGN: Retrospective cohort study. SETTING: Ten Level I trauma centers. PATIENT SELECTION CRITERIA: Adult patients with supracondylar distal femur fractures (OTA/AO type 33A or C) treated with lateral locked plating from 2010 through 2019. OUTCOME MEASURES AND COMPARISONS: Surgery for nonunion stratified by risk for nonunion. RESULTS: The cohort included 615 patients with supracondylar distal femur fractures. The median patient age was 61 years old (interquartile range: 46 -72years) and 375 (61%) were female. Observed were nonunion rates of 2% in a low risk of nonunion group (n = 129), 4% in a medium-risk group (n = 333), and 14% in a high-risk group (n = 153). Varus malreduction with an anatomic lateral distal femoral angle greater than 84 degrees, was associated with double the odds of nonunion compared to those without such varus [odds ratio, 2.1; 95% confidence interval (CI), 1.1-4.2; P = 0.03]. Malreduction by medial translation of the articular block increased the odds of nonunion, with 30% increased odds per 4 mm of medial translation (95% CI, 1.0-1.6; P = 0.03). Working length increased the odds of nonunion in the medium risk group, with an 18% increase in nonunion per 10-mm increase in working length (95% CI, 1.0-1.4; P = 0.01). Increased proximal screw density was protective against nonunion (odds ratio, 0.71; 95% CI, 0.53-0.92; P = 0.02) but yielded lower mRUST scores with each 0.1 increase in screw density associated with a 0.4-point lower mRUST (95% CI, -0.55 to -0.15; P < 0.001). Lateral plate length and type of plate material were not associated with nonunion. ( P > 0.05). CONCLUSIONS: Malreduction is a surgeon-controlled variable associated with nonunion after lateral locked plating of supracondylar distal femur fractures. Longer working lengths were associated with nonunion, suggesting that bridge plating may be less likely to succeed for longer fractures. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Synthesis and Characterization of Bi4Ti3O12 Nanoparticles Obtained via Pulsed Laser Ablation in Liquids.

Bismuth titanate (BTO) nanoparticles were obtained by pulsed laser ablation in liquid media (PLAL). Distilled water, ethanol, isopropanol, and acetone were used as media for laser ablation experiments, in which the colloidal solutions were obtained. Laser ablation was carried out using the second harmonic and fundamental wavelength of a pulsed Nd:YAG laser (532 nm and 1064 nm, respectively) with laser fluences of 25 and 12 mJ/cm2, respectively. Transmission electron microscopy was utilized for morphological characterization. BTO nanoparticles obtained have spherical shapes with orthorhombic structure and the average size distribution depended on the liquid media nature. In alcohols, BTO NPs were spherical with a carbon layer around them. X-ray diffraction, UV-Vis absorption spectra, and X-ray photoelectron spectroscopy were used to confirm the structural, optical, and elemental properties of the ablated products. The presented results show that PLAL is a viable technique for the synthesis of high-quality BTO nanoparticles with enhanced optical properties for possible applications in photocatalysis.

Nail Plate Combination Fixation Versus Lateral Locked Plating for Distal Femur Fractures: A Multicenter Experience.

OBJECTIVES: To (1) report on clinical, radiographic, and functional outcomes after nail-plate fixation (NPF) of distal femur fractures and (2) compare outcomes after NPF with a propensity matched cohort of fractures treated with single precontoured lateral locking plates. DESIGN: Multicenter retrospective cohort study. SETTING: Ten Level 1 trauma centers. PATIENTS/PARTICIPANTS: Patients with OTA/AO 33A or 33C fractures. INTERVENTION: Fixation with (1) retrograde intramedullary nail combined with lateral locking plate (n = 33) or (2) single precontoured lateral locking plate alone (n = 867). MAIN OUTCOME MEASUREMENTS: The main outcomes of interest were all-cause unplanned reoperation and presence of varus collapse at final follow-up. RESULTS: One nail-plate patient underwent unplanned reoperation excluding infection and 2 underwent reoperation for infection at an average of 57 weeks after surgery. No nail-plate patients required unplanned reoperation to promote union and none exhibited varus collapse. More than 90% were ambulatory with no or minimal pain at final follow-up. In comparison, 7 of the 30 matched lateral locked plating patients underwent all-cause unplanned reoperation excluding infection (23% vs. 3%, P = 0.023), and an additional 3 lateral locked plating patients were found to have varus collapse on final radiographs (10% vs. 0%, P = 0.069). CONCLUSIONS: Despite a high proportion of high-energy, open, and comminuted fractures, no NPF patients underwent unplanned reoperation to promote union or demonstrated varus collapse. Propensity score matched analysis revealed significantly lower rates of nonunion for NPF compared with lateral locked plating alone. Larger studies are needed to identify which distal femur fracture patients would most benefit from NPF. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cognitive-Behavioral Profile in Pediatric Patients with Syndrome 5p-; Genotype-Phenotype Correlationships.

(1) Background: 5p minus Syndrome (S5p-) is a neurodevelopmental disorder caused by a deletion in the short arm of chromosome 5. Among the phenotypic characteristics of S5p-, the most characteristic and representative element is a monochromatic cry with a high-pitched tone reminiscent of a cat's meow. Individuals may also show great phenotypic heterogeneity and great genetic variability. Regarding cognitive-behavioral aspects of the syndrome, the studies are scarce and do not establish a general profile of the main cognitive-behavioral particularities that this syndrome presents. The main objective of this work was to describe the development profile of a cohort of 45 children with 5p minus Syndrome, concerning the biomedical, genetic, cognitive, and behavioral aspects. Establishing putative genotype-phenotype (cognitive-behavioral profiles) relationships in our cohort, from an interdisciplinary approach. (2) Methods: A selection of instruments of measures was selected for neuropsychological assessment (3) Results: In general, children with S5p- have a higher cognitive level than a communicative and motor level. Language difficulties, especially expressive ones, influence the frequency and severity of the most frequent behavioral problems in S5p. The most significant problem behavior of children with S5p-, especially girls, is self-harm. Compulsive behavior, limited preferences, and interest in monotony are significantly more frequent in subjects with better cognitive levels. We also find a significant correlation between the size of the loss of genetic material on 5p and the cognitive level of the subjects. (4) Conclusions: We described for the first time, the cognitive-behavioral profile of a cohort of minors with S5p-. Remarkably, it was found that language, especially of an expressive nature, modulates the most frequent behavioral aspects in subjects with lower cognitive levels, so it is essential to develop verbal or alternative communication strategies adjusted to these individuals.

Predictors of Deep Infection After Distal Femur Fracture: A Multicenter Study.

OBJECTIVES: To identify potentially modifiable risk factors for deep surgical site infection after distal femur fracture. DESIGN: Multicenter retrospective cohort study. SETTING: Ten Level-I trauma centers. PATIENTS/PARTICIPANTS: Patients with OTA/AO 33A or C distal femur fractures (n = 1107). INTERVENTION: Surgical fixation of distal femur fracture. MAIN OUTCOME MEASUREMENT: The outcome of interest was deep surgical site infection. RESULTS: There was a 7% rate (79/1107) of deep surgical site infection. In the multivariate analysis, predictive factors included alcohol abuse [odds ratio (OR) = 2.36; 95% confidence interval (CI), 1.17-4.46; P = 0.01], intra-articular injury (OR = 1.73; 95% CI, 1.01-3.00; P = 0.05), vascular injury (OR = 3.90; 95% CI, 1.63-8.61; P < 0.01), the use of topical antibiotics (OR = 0.50; 95% CI, 0.25-0.92; P = 0.03), and the duration of the surgery (OR = 1.15 per hour; 95% CI, 1.01-1.30; P = 0.04). There was a nonsignificant trend toward an association between infection and type III open fracture (OR = 1.73; 95% CI, 0.94-3.13; P = 0.07) and lateral approach (OR = 1.60; 95% CI, 0.95-2.69; P = 0.07). The most frequently cultured organisms were methicillin-resistant Staphylococcus aureus (22%), methicillin-sensitive Staphylococcus aureus (20%), and Enterobacter cloacae (11%). CONCLUSIONS: Seven percent of distal femur fractures developed deep surgical site infections. Alcohol abuse, intra-articular fracture, vascular injury, and increased surgical duration were risk factors, while the use of topical antibiotics was protective. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Risk Factors for Reoperation to Promote Union in 1111 Distal Femur Fractures.

OBJECTIVES: To identify modifiable and nonmodifiable risk factors for reoperation to promote union after distal femur fracture. DESIGN: Multicenter retrospective cohort study. SETTING: Ten Level-I trauma centers. PATIENTS/PARTICIPANTS: Patients with OTA/AO 33A or C distal femur fractures (n = 1111). INTERVENTION: Surgical fixation of distal femur fracture. Fixation constructs were classified as lateral plate, dual plate, nail, or nail plate combination. MAIN OUTCOME MEASUREMENTS: The outcome of interest was unplanned reoperation to promote union. RESULTS: There was an 11% (121/1111) rate of unplanned reoperation to promote union. In the multivariate analysis, predictive factors included body mass index [odds ratio (OR) = 1.18; 95% confidence interval (CI), 1.06-1.32; P < 0.01], intra-articular fracture (OR = 1.57; 95% CI, 1.01-2.45; P = 0.04), type III open injury (OR = 2.29; 95% CI, 1.41-3.72; P < 0.01), the presence of medial comminution (OR = 1.85; 95% CI, 1.14-3.06; P = 0.01), and medial translation on postoperative radiographs (OR = 1.23 per one 10th of condylar width; 95% CI, 1.01-1.48; P = 0.03). Construct type was not significantly predictive. CONCLUSIONS: Eleven percent of distal femur fractures underwent unplanned reoperation to promote union. Body mass index, intra-articular fracture, type III open injury, medial comminution, and medial translation on postoperative radiographs were predictive factors. Construct type was not associated with unplanned reoperation; however, this conclusion was limited by small numbers in the dual plate and nail plate groups. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Deep Phenotyping and Genetic Characterization of a Cohort of 70 Individuals With 5p Minus Syndrome.

Chromosome-5p minus syndrome (5p-Sd, OMIM #123450) formerly known as Cri du Chat syndrome results from the loss of genetic material at the distal region of the short arm of chromosome 5. It is a neurodevelopmental disorder of genetic cause. So far, about 400 patients have been reported worldwide. Individuals affected by this syndrome have large phenotypic heterogeneity. However, a specific phenotype has emerged including global developmental delay, microcephaly, delayed speech, some dysmorphic features, and a characteristic and monochromatic high-pitch voice, resembling a cat's cry. We here describe a cohort of 70 patients with clinical features of 5p- Sd characterized by means of deep phenotyping, SNP arrays, and other genetic approaches. Individuals have a great clinical and molecular heterogeneity, which can be partially explained by the existence of additional significant genomic rearrangements in around 39% of cases. Thus, our data showed significant statistical differences between subpopulations (simple 5p deletions versus 5p deletions plus additional rearrangements) of the cohort. We also determined significant "functional" differences between male and female individuals.

UNDERSTANDING triggering skills for ENTREPRENEURS: The case of ESIC.

The aim of this paper is to present the methodology and results of a study on the role played by an institution in higher education, the ESIC Business & Marketing School, in teaching different master's degree programmes to examine whether they respond to the demands of potential entrepreneurs who are seeking to acquire the tools and develop the skills necessary to eventually become successful. The main conclusions were that the students with the intention of achieving a higher level of entrepreneurial skills were enroled in the Executive Master of Business Administration (EMBA) programme without omitting other master's degree programmes also chosen by students with entrepreneurial concerns. It was also found that the variable with the highest impact on entrepreneurial motivation was family environment. Our data lead us to maintain that these students were not always going to start up a new business. The originality of this paper comes from our survey with 1,135 responses from the master's degree programmes taught in five cities in Spain with the inclusion of an analysis for LATAM students.

Stability and visual outcomes yielded by three intraocular trifocal lenses with same optical zone design but differing material or toricity.

PURPOSE: To compare rotational stability, centration and visual outcomes provided by three trifocal lens models that have the same optical zone design but different material, composition, and/or toricity. METHODS: The study included 78 patients with symmetric bilateral intraocular lens implantation. The lenses under evaluation were trifocal intraocular lenses made of hydrophilic acrylic material: a spherical lens 26% hydrophilic acrylic (POD FineVision), a similar lens but having a toric design (POD Toric FineVision), and a trifocal lens 25% hydrophilic acrylic material (FineVision/MicroF). Moreover, the lenses share the same optical zone design. The lenses' rotational stability and centration were measured by means of the PIOLET software, which relies on recording and image processing techniques to determine lens rotation and centration based on slit-lamp images. We also assessed patients' visual quality by means of 25, 40, and 80 cm VA tests. RESULTS: The best centration results were achieved with the POD Toric FineVision model, although the differences were not statistically significant. As for lens rotation, it was below 5° in all cases under study. Regarding VA, all subjects attained at least 0.3 logMAR for far distance uncorrected VA, at 80 cm VA was about 0.2 logMAR, at 40 cm it was above 0.15 logMAR, and at 25 cm it was about 0.3 logMAR for both lens types. CONCLUSION: All three intraocular lens models yield excellent visual results at far, near as well as intermediate distances. The POD FineVision and POD Toric FineVision models, with double C-loop design, yielded the best results centration-wise and rotation-wise. Differences had no clinical relevance.

Active Living Logan Square: joining together to create opportunities for physical activity.

BACKGROUND: The Active Living Logan Square target audience is the community of the southwest corner of Logan Square, an urban Chicago community of 84,466 residents, mostly Latinos. Through the Active Living by Design (ALbD) initiative, the Logan Square Neighborhood Association leveraged its 48 years of existence in the neighborhood to create opportunities and build partnerships. INTERVENTION: Activities addressed three primary goals: (1) enhance school environments and practices to support physical activity before, during, and after the school day; (2) encourage individuals and families to enjoy outdoor activities in their own communities; and (3) create safe, inviting places for activity that connect to surrounding communities. The partnership's participatory approach involved a variety of community stakeholders in developing and implementing affordable, accessible, culturally acceptable, and sustainable physical activities for children and their families. RESULTS: The partnership successfully piloted Open Streets (temporary street closures) and advocated for development of the Bloomingdale Trail, an elevated rails-to-trails project. In schools, the partnership changed the culture at McAuliffe Elementary to support healthy behaviors through new policies, physical projects, and programs. LESSONS LEARNED: Vital components of the project's success included a full-time coordinator with strong community ties; time to build healthy relationships within the partnership and community; the use of culturally relevant strategies; and flexibility to welcome complementary opportunities. CONCLUSIONS: The partnership intentionally did not produce a single community-recognized campaign; instead, it chose to use limited resources to promote tangible programs and projects that led to sustainable and replicable changes that promote physical activity.

Confident interpretation of Bayesian decision tree ensembles for clinical applications.

Bayesian averaging (BA) over ensembles of decision models allows evaluation of the uncertainty of decisions that is of crucial importance for safety-critical applications such as medical diagnostics. The interpretability of the ensemble can also give useful information for experts responsible for making reliable decisions. For this reason, decision trees (DTs) are attractive decision models for experts. However, BA over such models makes an ensemble of DTs uninterpretable. In this paper, we present a new approach to probabilistic interpretation of Bayesian DT ensembles. This approach is based on the quantitative evaluation of uncertainty of the DTs, and allows experts to find a DT that provides a high predictive accuracy and confident outcomes. To make the BA over DTs feasible in our experiments, we use a Markov Chain Monte Carlo technique with a reversible jump extension. The results obtained from clinical data show that in terms of predictive accuracy, the proposed method outperforms the maximum a posteriori (MAP) method that has been suggested for interpretation of DT ensembles.

Identification and Small Sample Estimation of Thurstone's Unrestricted Model for Paired Comparisons Data.

The interpretation of a Thurstonian model for paired comparisons where the utilities' covariance matrix is unrestricted proved to be difficult due to the comparative nature of the data. We show that under a suitable constraint the utilities' correlation matrix can be estimated, yielding a readily interpretable solution. This set of identification constraints can recover any true utilities' covariance matrix, but it is not unique. Indeed, we show how to transform the estimated correlation matrix into alternative correlation matrices that are equally consistent with the data but may be more consistent with substantive theory. Also, we show how researchers can investigate the sample size needed to estimate a particular model by exploiting the simulation capabilities of a popular structural equation modeling statistical package.

A Multidimensional Ideal Point Item Response Theory Model for Binary Data.

We introduce a multidimensional item response theory (IRT) model for binary data based on a proximity response mechanism. Under the model, a respondent at the mode of the item response function (IRF) endorses the item with probability one. The mode of the IRF is the ideal point, or in the multidimensional case, an ideal hyperplane. The model yields closed form expressions for the cell probabilities. We estimate and test the goodness of fit of the model using only information contained in the univariate and bivariate moments of the data. Also, we pit the new model against the multidimensional normal ogive model estimated using NOHARM in four applications involving (a) attitudes toward censorship, (b) satisfaction with life, (c) attitudes of morality and equality, and (d) political efficacy. The normal PDF model is not invariant to simple operations such as reverse scoring. Thus, when there is no natural category to be modeled, as in many personality applications, it should be fit separately with and without reverse scoring for comparisons.

Factores de riesgo cardiovascular / Cardiovascular risk factors

Los objetivos de este trabajo son: 1) establecer el riesgo cardiovascular como parámetro basal para un programa de atención médica preventiva, 2) medir el riesgo cardíaco y su modificación mediante intervenciones preventivas y terapéuticas. Los factores de riesgo fijos son: edad mayor de 45 años, sexo masculino, antecedentes familiares. Los factores de riesgo modificables son: hipertensión arterial, obesidad (cofactor), dislipidemias, tabaquismo, hábito sedentario, diabetes mellitus. Actuando sobre los factores modificables se puede reducir hasta 2,5 veces el riesgo individual de infarto de miocardio, no obstante la existencia de los factores fijos. Al respecto se propone efectuar un plan de acción con objetivos poco numerosos pero prioritarios, con las correspondientes medidas, estrategias, plazos y criterios de éxito

Factores de riesgo cardiovascular / Cardiovascular risk factors

Los objetivos de este trabajo son: 1) establecer el riesgo cardiovascular como parámetro basal para un programa de atención médica preventiva, 2) medir el riesgo cardíaco y su modificación mediante intervenciones preventivas y terapéuticas. Los factores de riesgo fijos son: edad mayor de 45 años, sexo masculino, antecedentes familiares. Los factores de riesgo modificables son: hipertensión arterial, obesidad (cofactor), dislipidemias, tabaquismo, hábito sedentario, diabetes mellitus. Actuando sobre los factores modificables se puede reducir hasta 2,5 veces el riesgo individual de infarto de miocardio, no obstante la existencia de los factores fijos. Al respecto se propone efectuar un plan de acción con objetivos poco numerosos pero prioritarios, con las correspondientes medidas, estrategias, plazos y criterios de éxito (AU)

Encuesta de salud de refugiados guatemaltecos en la frontera sur de México / Health surveys of Guatemalan refugees along the Southern border of Mexico

En noviembre de 1983, se llevó a cabo una investigación sobre las condiciones de vida y la frecuencia de enfermedades transmisibles y de desnutrición en ocho campamentos de refugiados guatemaltecos y en tres comunidades rurales mexicanas en la frontera sur de México, con objeto de valorar si ha habido cambios en el perfil epidemiológico de la población mexicana de esa zona, debidos al impacto de la migración. Por muestreo aleatorio se seleccionaron 158 familias de refugiados guatemaltecos (955 individuos) y 125 familias de la población rural mexicana (718 individuos). Se aplicó un cuestionario, en el cual se registraron la composición de la familia y las características de las viviendas y se investigaron las enfermedades infecciosas mediante interrogatorio y exploración física detallada, registro de peso y talla, y toma de muestras de sangre y heces para búsqueda de Plasmodium y de parásitos intestinales. En ambos grupos de población las condiciones de vida eran deficientes, la mayoría de las viviendas carecían de agua entubada y las familias vivían en condiciones de hacinamiento. Se encontró una alta prevalencia de enfermedades infecciosas, en especial las transmitidas por contacto directo; 2,3% de los frotis de sangre fueron positivos para Plasmodium y la cobertura de vacunación de los niños menores de cinco años fue muy baja. Más del 80% de los individuos presentaron parasitosis intestinal y aproximadamente 75% de la población tenía algún grado de desnutrición. Se concluye que no ha habido un impacto importante de un grupo sobre otro, sino que las enfermedades que aquejan tanto a los refugiados guatemaltecos como a la población rural mexicana son las que prevalecen en la zona geográfica y están subordinadas a las condiciones socioeconómicas; por consiguiente, las medidas de control que se apliquen deberán incluir a ambos grupos de población

Evaluación nutricional de refugiados guatemaltecos y población mexicana del área rural de Chiapas / Nutritional evaluation of Guatemalian refuges and Mexican population of the rural area of Chipas

Para conocer sus condiciones de salud, se evaluó el estado nutricional de los refugiados guatemaltecos de ocho campamentos asentados en la frontera sur de México (Chiapas) y tres comunidades mexicanas del área, así como algunas prácticas de alimentación de los niños menores de cinco años. No se encontró en los campamentos, ni en las comunidades mexicanas estudiadas, ninguna situación dramática de urgencia nutricional. Prevalecieron altas cifras de desnutrición aguda y crónica: la aguda de 39 y 43% y la crónica de 81 a 73% para guatemaltecos y mexicanos, respectivamente. Llama la atención el elevado número de niños con retardo severo de la talla, debido probablemente a carencia crónica de nutrientes energético-proteínicos. Se encontró en ambas poblaciones que los niños aún son alimentados con leche materna por tiempo prolongado, con inapropiado apoyo de otros alimentos tomados de la dieta familiar. Se identificó la necessidad que entre los refugiados se asegure la producción local de alimentos y que en ambas poblaciones, se establezcan programas de atención primaria de la salud, con énfasis en el adiestramiento materno para apoyar apropriada y oportunamente la alimentación con leche materna

Encuesta de salud de refugiados guatemaltecos en la frontera sur de Mexico / Health surveys of Guatemalan refugees along the Southern border of Mexico

In november 1983 a study was done of living conditions and the frequency of communicable diseases and malnutrition in eight camps for Guatemalan refugees and three rural Mexican communities along the southern border of Mexico. The purpose of the study was to determine what changes the influx of refugees might have brought about in the epidemiological profile of the Mexican population in that border zone. A study group of 158 Guatemalan refugee families (955 individuals) and 125 rural Mexican families (718 individuals) was selected by random sampling. A questionnaire was used to record the composition of the family and the characteristics of the dwellings, and the presence of infectious diseases was investigated by interviews, thorough physical examinations, recording of weights and heights, and examination of blood and feces for the presence of Plasmodium and intestinal parasites. In both population groups, living conditions were poor: most of the dwellings lacked running water and were overcrowed. The prevalence of infectious diseases, especially those transmitted by direct contact,was found to be high; 2.3 per cent of all blood smears tested positive for Plasmodium, and the vaccination coverage of children under 5 was very low. Intestinal parasitosis was found in more than 80 per cent of the individuals, and about 75 per cent of them suffered from some degree of malnutrition