Achievements and challenges in the health of Mexican women, 1990 and 2019: ecological analysis based on the global burden of disease data.

OBJECTIVES: To describe the burden and causes of disease in Mexican women in 1990 and 2019, based on the data disaggregation by age groups and states. Also, to evaluate the relationship of years of healthy life lost with the Socio-demographic Index (SDI) and with the Healthcare Access and Quality (HAQ) Index. STUDY DESIGN: This was an ecological descriptive study. METHODS: Based on the Global Burden of Disease, Injuries, and Risk Factors Study study, the age-standardized and age-specific rates for mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) were reported. RESULTS: At the national level, the all-cause age-standardized rates for Mexican women decreased in mortality -28.8%; YLLs -39.8%; YLDs -1.3%; and DALYs -26.2%. For 2019, the indicators analyzed had the worst performances in Chiapas and Chihuahua, while women in Sinaloa had the lowest age-standardized rates. In 1990, it is worth noting that there was a remarkable presence of CDs, mainly in YLLs. In all age groups, diabetes mellitus was the leading cause of DALYs in Mexico's 32 states, followed by CKD (in 24 states), and ischemic heart disease (in 18 states). In both 1990 and 2019, a negative and statistically significant correlation between DALYs and the HAQ Index was evident. The correlation between DALYs and the SDI was only significant in 1990. CONCLUSION: In the last 30 years, the burden of disease on Mexican women has undergone substantial changes that reflect progress in the improvement of their health conditions. However, the current scenario is complex because the convergence of communicable diseases, non-communicable diseases, and injuries is evident, which implies important challenges that must be addressed as soon as possible.

Coledocoduodenostomía laterolateral: Indicaciones y técnicas / A side to choledochoduodenostomy: Indications and technique

Se revisan las indicaciones y técnica de la coledocoduodenostomía laterolateral y se señala la experiencia acumulada en el hospital docente "Enrique Cabrera", adquirida mediante la práctica de esa derivación biliodigestiva en 41 pacientes. La indicación para efectuarla en 18 enfermos fue la litiasis coledociana asociada a un colédoco muy dilatado. Comprobaron que la edad avanzada no aumentó la estadía posoperatoria de los pacientes; que la mortalidad fue de 4,8 porciento por causas ajenas al tipo de operación efectuada, y que la morbilidad no aumentó en los pacientes portadores de íctero obstructivo o en los edad avanzada. La variante de la técnica quirúrgica descrita por Juraz, con la modificación propuesta por el profesor Emilio Camayd fue la más utilizada, y tiene probada calidad para obtener posoperatorio óptimo (AU)