Inverse association between plasma cholesterol and gallstone disease.

BACKGROUND: The association between gallstone disease (gallstones or cholecystectomy) and plasma lipids was evaluated in 2,089 subjects who attended a private health care facility in Mexico City from August 1991 to August 1992. METHODS: All participants provided data on their sociodemographic status, non-insulin-dependent diabetes mellitus diagnoses, alcohol consumption, and smoking habits; women also gave data regarding their obstetric-gynecologic histories. Ultrasounds of the liver and biliary tract were performed. Cholesterol levels, high-density lipoproteins cholesterol, and triglyceride plasma concentration were determined. RESULTS: This study shows a strong inverse association between gallstone disease and plasma cholesterol concentration, with OR = 0.61 (95% CI = 0.42-0.89) in the category of 181-239 mg/dL, and OR = 0.49 (95% CI = 0.32-0.77) in the group of 240 mg/dL or more, when compared to 180 mg/dL or less, after adjusting for the following risk factors: gender, age, and body mass index. CONCLUSIONS: These results suggest an increment in the catabolic pool of cholesterol, reflected in lower levels of plasma cholesterol in subjects with gallstone disease.

How people respond to illness in Mexico: self-care or medical care?

OBJECTIVE: To analyse illness factors associated to the form of attention (self-care or medical care) used to resolve health problems in Mexico. METHODS: A total of 5640 individuals who reported sickness within the 2 weeks before the application of the 1994 National Health Survey were analysed. A descriptive analysis was conducted to study demographic and socioeconomic characteristics, access to medical services, perception of seriousness of the illness, treatment received, and reasons why medical care was not sought. Factors associated with the form of attention (self-care or medical care) were identified through logistic regression. RESULTS: Sixty-one percent of the sample was self-attended. Of those who perceived their illness as serious, 52% did not use medical services because they considered them too expensive or did not have the money to pay. In the multivariate analysis, a greater frequency of self-care was observed among males over 5 years old who lacked access to Social Security medical services, or system of private insurance, suffered a mild illness, and lived in poor, rural areas. DISCUSSION: In Mexico, self-care represents the most important response to illness. Socioeconomic conditions, regardless of the perception of seriousness of the symptoms, determine the higher frequency of self-care mainly among those people living in poverty.

Time-trends and causes of infant, neonatal and postneonatal mortality in Mexico, 1980-1990.

OBJECTIVE: This article analyzes the time-trends and causes of infant, neonatal, and postneonatal mortality in Mexico during the 1980's. MATERIAL AND METHODS: Data on infant deaths came from yearly tabulations (1980 to 1990) published by the Mexican government. Time-trends of mortality rates were determined by simple linear regression models. The parallelism test was performed for evaluating similarities in trends in neonatal and postneonatal mortality rates by causes. RESULTS: During the 1980's, infant mortality rates in Mexico declined from 40.4 to 31.1/1000 (beta = -0.791). Postneonatal mortality rates showed a strong decrease (beta = -0.892), while neonatal mortality rates were almost stationary (beta = 0.089). Significant rate decreases were observed for intestinal infections, Pneumonia and influenza and All other causes while Certain perinatal problems, Congenital defects and Nutritional deficiencies increased. No changes were observed in Acute respiratory infections. The neonatal proportional mortality showed an incremental trend accounting for 37.6% in 1980 and ascending to 48.8% in 1990 of the mortality in the first year of life. CONCLUSIONS: This analysis indicates that the reduction in infant mortality in Mexico during the 1980's was due to declining postneonatal mortality while neonatal mortality rates remain almost unchanged.

PIP: This report describes the time-trends and causes of infant, neonatal, and postneonatal mortality in Mexico during 1980-90. Data were obtained from annual data collected by the General Direction of Statistics and Information of the Secretary of Health. The infant mortality rate (IMR) declined during the 1980s due to declines in the postneonatal mortality rate (PMR). The neonatal mortality rate (NMR) remained stable at around 15.2/1000. IMR declined from 40.4/1000 to 31.1/1000. PMR declined from 25.6/1000 to 16.2/1000. Both changes in PMR and IMR were statistically significant. Rates of mortality due to intestinal infections, pneumonia, and influenza declined. Perinatal problems and congenital defects increased. Significant increases occurred for nutritional deficiencies in IMR and PMR. Acute respiratory infections remained about the same. State variation in infant mortality shows that some states have double the IMR. Further analysis is needed to determine the trends in state-specific IMR and PMR. Decreases in pneumonia and influenza are accounted for by increased levels of sanitation, improved literacy of women, promotion of oral rehydration therapy, massive immunization campaigns against measles, and greater access to health care services. The trends are considered reliable based on the assumption that births are underregistered.

[Work conditions, labor fatigue and low birth weight among street vendors]. / Condiciones de trabajo, fatiga laboral y bajo peso al nacer en vendedoras ambulantes.

OBJECTIVE: This study presents the demographic, socioeconomic profile, working conditions and labor fatigue among fertile age street vendors in Mexico City. MATERIAL AND METHODS: 426 female street vendors were interviewed in Mexico City. This population was described and the association between the components labor fatigue and low birth weight (LBW) was analyzed by logistic regression in a subgroup of women who worked as street vendors during their last pregnancy. RESULTS: Of the interviewed group, 56% works more than 48 h per week, 87% had no social security, and 68% only had primary school level. The risk of LBW increased when workers had to cover selling quotes (OR 6.5, CI95% 1.3-31) when the merchandise were seasonal tools such as accessories or spare parts (OR 6.3, CI95% 1.5-26), when women had to exhibit their merchandise on the floor or carry it (OR 7.7 CI95% 1.8-32) and when financial support to initiate vending activities came from someone other than a close relative or friend (OR 7.4 CI95%, 1.2-44). CONCLUSIONS: These results contribute to identify the female vendors with higher risk of having child with LBW and suggest preventive actions.