[Outpatient medical attention demand due to diabetes mellitus in the health primary care]. / Demanda de atención médica por diabetes mellitus en el primer nivel de atención.

Outpatient visits for medical attention because of Diabetes mellitus in the Instituto Mexicano del Seguro Social became very important for the magnitude that it represents. There is a clear increasing tendency for the coming years. The available data indicates a higher frequency and increased demand of women. Higher number of patients is observed between 40 and 59 years old. However, earlier age groups present considerable amount of cases. Having the number of patients allows knowing the average of consultations per patient, this parameter allows having an estimate of the follow up by the physician and it must be part of the evaluation of the medical attention programs. Diabetes mellitus is strongly associated with obesity, this condition affects a high percentage of diabetic patients in the Institution and weight loss must be encouraged.

[Mortality from the HIV/AIDS in the Instituto Mexicano del Seguro Social]. / Mortalidad por VIH/SIDA en el Instituto Mexicano del Seguro Social.

Mortality is an indicator that allow us to evaluate HIV infection control programs. From the middle of the last decade, mortality presents a tendency to decrease in the population covered by the Instituto Mexicano del Seguro Social). In relation to gender and age group the most affected are men between 25 to 44 years of age with mortality rates ranging from 30 to 12 by 100,000 men (1995 to 2009 respectively). In 2009, at least half of the Delegaciones (administrative units by State) present larger mortality rates than the institutional average, particularly Campeche with 14.9 by 100,000 men. It is clear that introduction of control measures against the disease from infected people represents a modification in the course of the illness in the population covered by IMSS.

[Smoking habits in beneficiaries of the social security]. / Consumo de tabaco en derechohabientes del IMSS.

OBJECTIVE: To determine the prevalence of tobacco consumption (TC) and frequency according to demographics and health aspects. METHODS: A cross-sectional study from the Mexican Family Life Survey Project was conducted. The past and present TC according to sociodemo-graphic variables and the presence of chronic diseases (CD) were achieved. RESULTS: The prevalence of TC in the past was 21.4 % with a male/female ratio of 2.5. Nowadays TC was 15.2 % and the ratio between male/female was 2.6 (23.0: 8.9); exposure levels by age decreased at present. Out of the total smokers in the past 71 % continue with the habit, 75 % began TC before the age of 20. In the 15 to 19 years group, 50 % of them started before the age of 14. The highest cigarette pack consumption mean was 2.5 per week and for the present smokers was 1.8; the prevalence for CD in the smoking population was above 20 %; present smoking diminished in those with a history of CD, especially cancer and heart disease. CONCLUSIONS: The prevalence of past and present TC is lower than that reported in other studies in the Mexican population, because of how the exposure to TC was measure.

Clinical profile of dengue hemorrhagic fever cases in Mexico.

OBJECTIVE: Dengue hemorrhagic fever is a public health problem in Mexico since 1994. With four serotypes circulating the risk of epidemic dengue hemorrhagic fever is increasing. MATERIAL AND METHODS: We describe the clinical features of confirmed cases in the social security health system (IMSS) from 1995 to 2003. Clinical picture and epidemiological features were compared and a multivariate model was fitted to evaluate associations. RESULTS: Cases were divided into two groups: 438 patients with dengue fever, including 109 cases with hemorrhagic manifestations without thrombocytopenia, and 977 cases with dengue hemorrhagic fever, including 79 deaths. The main risk factors associated with mortality were hematemesis (RR 2.6; CI 95% 1.4-4.6) and melena (RR 2.2; Cl 95% 1.2-3.7). CONCLUSIONS: Our results characterize the clinical profile of dengue hemorrhagic fever cases in Mexico and identify prognostic factors to alert clinician for the prevention of a fatal evolution.