[Association between neuropathy and peripheral vascular insufficiency in patients with diabetes mellitus type 2]. / Asociación entre la presencia de enfermedad vascular periférica y neuropatía en pacientes con diabetes mellitus tipo 2.

INTRODUCTION: Diabetes mellitus (DM) can present complications of neuropathy and peripheral arterial disease with high risk for developing foot ulcers and consequent amputations. OBJECTIVE: To identify the association between peripheral vascular disease, and neuropathy in type 2 Diabetes mellitus patients from the Hospital General de Zona No. 1 IMSS in Colima, Mexico. MATERIAL AND METHODS: Cross-sectional study of 80 patients with diabetes mellitus evaluated by means of the Edinburgh Claudication Questionnaire, Michigan Neuropathy Screening Instrument, ankle-arm index, Motor Nerve Conduction Velocity and H-reflex. RESULTS: 51 women and 29 men were studied. Mean age was 53.9 +/- 9.6 years, mean diabetes mellitus progression was 8 +/- 6.6 years and mean glucose level was 283 +/- 110 mg/mL. Neuropathy presented in 65 patients (81.2%). Ankle/arm index revealed 19% of patients presented with moderate peripheral vascular insufficiency. Motor Nerve Conduction Velocity was abnormal in 40% of patients and H-reflex was absent in 70%. DISCUSSION: Grade 2 motor-sensitive polyneuropathy was found in 70-80% of patients and moderate peripheral vascular insufficiency in 19%. It can thus be inferred that the complication of diabetic neuropathy appears before that of peripheral vessel damage.

[New therapeutic alternatives in migraine prophylaxis using histamine H3 receptor agonists]. / Nueva alternativa terapéutica en profilaxis de migraña con histamina como agonista de receptores H3.

BACKGROUND: Subcutaneous histamine at low concentrations interacts with H3-receptors and may constitute a new therapeutic drug in migraine prophylaxis. It acts by limiting the excessive inflammatory response involved in migraine pathophysiology. OBJECTIVE: Describe the results of a 15-year trial administering histamine at low concentrations. METHODS: Different study designs were used with subcutaneous histamine (10 microg/ml in Evan's solution) twice weekly, with an initial administration of microg (0.1 ml) and gradually increasing the dose to 10 microg (1.0 ml) over a 12-week period together with placebo, sodium valproate and topiramate. A Friedman-type rank ANOVA test was used to assess the difference between basal values and different design outcomes. RESULTS: Data recorded during the 12-week period showed a significant reduction in variables from both treatment groups (histamine) compared with basaline stage results (p < 0.001). The histamine group reported a reduction of headache frequency (50%), decrease in pain intensity (51%), length of migraine attacks (45%) and painkiller use (52%). CONCLUSIONS: The present study provides evidence on the safety and efficiency of subcutaneous histamine administered at a dose of 1-10 microg twice weekly. This treatment constitutes a new therapeutic alternative, and provides a clinical and pharmacological basis for the use of H3 histaminergic agonists in migraine prophylaxis.

[Frequency of intestinal helminthiasis and its association with iron deficiency and malnutrition in children from western Mexico]. / Frecuencia de helmintiasis intestinal y su asociación con deficiencia de hierro y desnutrición en niños de la región occidente de México.

OBJECTIVE: To determine intestinal helminthiasis frequency and its association with malnutrition and iron deficiency. MATERIAL AND METHODS: An analytical cross-over study was carried out on children in the municipality of Comala, Colima, Mexico. Coproparasitoscopic exams in series of three using the Kato-Katz technique were performed in all children. To evaluate the degree ofmalnutrition, the following anthropometric indices were determined: means and z-scores for weight/height, height/age, weight/age. Severe, moderate and minimal iron deficiency was considered when ferritin was: < or = 12 ng/ml, 12 to 18 ng/mL and 19 to 24 ng/mL, respectively. RESULTS: 243 children were studied with an average age of 65.3+/-8.7 months. 60.9% (n = 148) of the children showed a decrease in ferritin levels and 2.5% (n = 6) had anemia. 16% (n = 39) had trichuriasis, 6.9% (n = 17) ascariasis and 5.3% (n = 13) had both parasites. Trichiura infection was associated with declining health (OR 11.0, CI 3.9-30.8; p<0.001) and with iron deficiency, with cut-off points of <24 ng (OR 2.0, CI 1.0-3.9, p = 0.02) and <18 ng/ dL (OR 2.2, CI 1.2-4.2, p= 0.009). Ascaris infection was not associated with malnutrition or iron deficiency. CONCLUSIONS: Trichiura infection was associated with declining health and slight and moderate degrees of iron deficiency.

Nalpha-methyl histamine safety and efficacy in migraine prophylaxis: phase III study.

BACKGROUND: The histamine catabolite, Nalpha-methylhistamine, possesses a selective affinity for H3 receptors. For this reason, we considered evaluating the efficacy of this histaminergic H3 agonist in migraine prophylactic treatment. OBJECTIVE: To study the therapeutic potential of the subcutaneous administration of Nalpha-methylhistamine in migraine prophylaxis, in a Phase III clinical pharmacological study. METHODS: Using a controlled double-blind, placebo controlled clinical trial for 12 weeks, 60 patients with migraine, who fit the criteria established by the International Headache Society, were selected. The efficacy of subcutaneous administration of Nalpha-methylhistamine 1 to 3 ng twice a week against placebo was studied, evaluating the outcome of headache intensity, frequency, duration, and analgesic intake. RESULTS: Comparison between the groups treated with placebo (n=30) and Nalpha-methylhistamine (n=30), on data collected for the 4th, 8th and 12th weeks of treatment, revealed that Nalpha-methylhistamine exerted a significant (p<0.0001) reduction (compared to placebo) in intensity, frequency, and duration of migraine attacks, as well as on the use of analgesic intake. No significant (p>0.05) adverse experiences or side effects developed in either group. CONCLUSIONS: The present study provides evidence of the efficacy of Nalpha-methylhistamine, given subcutaneously at doses of 1 to 3 ng twice a week, offering a new therapeutic alternative and laying the clinical and pharmacological groundwork for the use of histaminergic H3-agonists in migraine prophylaxis, which may specifically inhibit the neurogenic edema response involved in migraine pathophysiology.

Blink reflex, H-reflex and nerve-conduction alterations in leprosy patients.

Peripheral nerve lesions are the most important cause of disability in leprosy patients. Electrophysiological studies are used in the diagnosis and prognosis of neuropathy. Nerve conduction is the most frequently used electrophysiological test method to detect neuropathy, although it evaluates only a part of the peripheral nervous system. Blink reflex and H-reflex are electrophysiological tests which evaluate facial and trigeminal nerve function. This study determined the frequencies of blink reflex, H-reflex and motor and sensory nerve conduction alterations in twenty five heterogeneous, clinic patients with lepromatous leprosy and a control group of 20 healthy subjects. Study results showed a decrease in motor and sensory nerve conduction in 40% and 30%, respectively. In blink reflex (BR), right R1 was altered in latency in 20% of patients, left R1 in 20%, right ipsilateral R2 in 16%, left ipsilateral R2 in 20%, and right and left contralateral R2 were altered in 32% of patients. There was an absence of H-reflex in 16% (n = 4) and prolonged latency in 4% (n = 1).

[Longitudinal study of three families with familial Parkinson's disease]. / Estudio longitudinal de tres familias con parkinsonismo familiar.

BACKGROUND: Familial Parkinson's is a variant of Parkinson's disease (PD) transmitted generationally with an early onset. OBJECTIVE: Describe the clinical disease characteristics and its 18 year evolution among families in Colima presenting familial PD. MATERIALS AND METHODS: We determined disease diagnosis, evolution and hereditary pattern. The UPDRS system was used to follow the longitudinal course of the disease. Descriptive statistics were carried out using means and percentages. RESULTS: Three families were studied, with a total of 51 subjects aged 29 +/- 22 years spanning 4 generations. Thirty-seven percent of studied subjects displayed familial PD, with disease onset at 24 +/- 9 years of age. The highest UPDRS value was 175. Disease transmission with a dominant autosomic heredity pattern was shown. One hundred percent of first and second generation members from family number 1 displayed the disease. CONCLUSIONS: The three families displayed early onset PD and rapid progression, coinciding with described characteristics of type 1 familial Parkinsonism (PARK1). This disease is caused by the Ala53Thr mutation of the alpha-synuclein gene.

[Assessment of a postural reference frame as a diagnostic test for lumbar lordotic posture]. / Evaluación de un marco de referencia postural como prueba diagnóstica de postura lordótica lumbar.

INTRODUCTION: Studying lumbar lordosis (LL) in large patient populations is not a practical approach due to the technical limitations of the gold standard. OBJECTIVE: Determine the specificity of a postural reference frame (PRF) in the diagnosis of LL. METHODS: A PRF (wooden frame using strings as a reference for measuring the distance between lumbar curvature and the glutei) was used as a diagnostic test to asses LL. The Ferguson angle, a radiologic evaluation, was used as gold standard. Specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV) of the PRF were determined. RESULTS: One hundred and ten subjects were studied (58 women, 52 men). Mean age was 18.8 +/- 3 years, weight 63 +/- 12 kg, height 164 +/- 8 cm and body mass index (BMI) 23.2 +/- 4 kg/m2. With a cut-off point 37 cm, test specificity was 94%, sensitiivity was 17%, PPV was 50%, and NPV was 75%. CONCLUSION: The postural reference frame as an assessment tool is highly specific and can aid in the diagnosis of LL among young asymptomatic patients.

F-wave and H-reflex alterations in recently diagnosed diabetic patients.

OBJECTIVE: To explore the frequency of F-wave and H-reflex alterations in recently diagnosed type 2 diabetes mellitus patients and to determine if the alterations are dependent on the levels of glycemia. METHODS: A cross-sectional study was carried out on 50 asymptomatic patients, with a mean age of 45.4 +/- 9.8 years and a disease evolution of less than 10 years. Patients were classified as either normoglycemic (7 mmol/L; n = 20) or hyperglycemic (7 mmol/L; n = 30). H-reflex (HR), F-wave (FW), and nerve-conduction measurements (NCM) between the diabetic and non-diabetic (control) groups were compared. RESULTS: The H-reflex was absent in 22% of the patients, while the M-component of this reflex was altered in 58% of patients. The F-wave was altered in 12% of the patients. The motor nerve compound action potential showed a diminution in amplitude (26% of patients, n = 13), area (32%, n = 16), and conduction velocity (20%, n = 10). No positive correlation between glycemia levels and the above alterations was found. CONCLUSIONS: This study demonstrated that asymptomatic diabetic patients showed a high incidence of subclinical neurophysiological abnormalities.

[Causes of non-use of postpartum contraceptive method among adolescent mothers]. / Causas de no uso de método anticonceptivo posparto entre madres adolescentes.

OBJECTIVE: To determine the causes of non postpartum contraceptive use among adolescent mothers. PATIENTS AND METHODS: We conducted a cross-section descriptive study. We included women who asked for attention of an obstetric event in 2002, we identified those were in immediate postpartum period, and we selected those that did not began a birth-control method. Data were collected directly with an interview and revision of the file, later on they were coded and processed manually; the causes of non contraceptive use were classified in: attributable causes to patient: personal, religious, moral, familiar, cultural, etc. Reasons, when they received information and advice or when they did not assist to educational actions; attributable causes to hospital: technique administrative factors, insufficient educational communication activities by service provider; and attributable causes to medical indication: presence of risk factors for health women. The statistical analysis was carried out using frequencies and percentages. RESULTS: We found 261 women, we identified 160 (61%) in immediate postpartum period, 52 (32%) they did not began contraceptive use. CONCLUSION: The causes of non postpartum contraceptive use among adolescent mothers were attributable to themselves in 75%, in 21% to the medical unit, and 4% to medical indication.

[Hyperhomocysteinemia in acute cerebral infarction]. / Hiperhomocisteinemia en infarto cerebral agudo.

ANTECEDENTS: Hyperhomocysteinemia has recently been recognized as contributing directly or associatively to the arteriosclerotic process in cerebral infarction. OBJECTIVE: To determine plasmatic homocysteine levels in with patients with acute cerebral infarction and to seek an association between clinical sub-types of cerebral lesion and homocysteine levels and risk factors present. MATERIALS AND METHODS: A descriptive study was carried out on patients diagnosed with acute cerebral infarction. The study included 22 patients of both sexes between the ages of 40 and 85 years. Samples were collected on the second day of hospitalization after 12 h of fasting. RESULTS: In 13 of 22 patients, elevated levels of serum homocysteine were found. The homocysteine average was 20-68 mumol/l +/- 9.6 SD. No association between degree of cerebral lesion and risk factors was found (p > 0.05). CONCLUSION: An increase in homocysteine was found in 59% of cerebral infarction patients. No correlation between hyperhomocysteinemia and known risk factors such as smoking, alcoholism, high blood pressure, and diabetes was found. It is necessary to continue this line of investigation to identify conditioning factors that elevate homocysteine and to implement measures to lower levels of hyperhomocysteinemia, thus helping reduce the incidence of cerebrovascular disease.

[Migraine. Review of physiopathogeny and future alternative therapy]. / Migraña. Una revisión de la fisiopatogenia y alternativa terepéutica futura.

This work examines recent discoveries in physiopathogenesis, focusing on the combination of sequential events involved in migraine origin. Recent facts concerning active intestinal peptide, substance P, histamine, HI and H3 receptors, and H3-receptor agonists, all neuromodulators having an intimate relations ship with migraine were examined. Present-day recommended treatment, with an efficacy of barely 70%, and reasons for its poor performance were described. The authors state that the future of migraine treatment should be directed toward the search for drugs that directly interact with the above-mentioned neuromodulators, thus offering patients a more efficacious treatment and fewer undesirable side-effects.

[White-coat hypertension and risk factors in recently diagnosed hypertensive patients]. / Frecuencia de hipertensión de bata blanca y sus factores de riesgo en pacientes hipertensos recién diagnosticados.

OBJECTIVE: To determine the frequency of white-coat hypertension (WCH) and associated risk factors in recently diagnosed hypertensive patients. MATERIAL AND METHODS: A cross-sectional study was carried out from January 1997 to December 1998. The reference population consisted of 195 patients presenting with systemic arterial hypertension (SAH) of less than 1-month evolution and receiving no medical treatment. According to Joint National Committee (JNCVI) criteria, 100 individuals with Stages I, II, and III SAH underwent the following procedures: clinical history; physical examination; electrocardiogram, serum creatinine; urianalysis, and ambulatory monitoring of arterial pressure (AMAP). RESULTS: A total of 54% of patients were WCH carriers and 46% presented sustained hypertension (SH); 37% of WCH patients and 63% of SH patients had a family history of SAH, while 19.7% of WCH patients and 39.2% of SH patients presented with stage 1 retinopathy. Left ventricular hypertrophy was absent in all WCH patients and present in 21.7% of SH patients. A total of 31% of WCH patients and 50% of SH patients presented electrocardiographic changes. CONCLUSIONS: A total of 54% of patients presented WCH. Clinical/epidemiologic profiles of WCH carriers and SH patients are different.

[Cyanoacrylate compared with traditional surgery in tension-free incision closure]. / Cianoacrilato comparado con cirugía tradicional en el cierre de heridas en zonas libres de tensión.

OBJECTIVE: To investigate the efficiency of cyanoacrylate in closing tension-free incisions in out-patient surgery compared with traditional suturing methods. PATIENT AND METHODS: A single, blind, clinical study was carried out on 60 patients divided into two groups. Group 1 (n = 30) received one or two drops of cyanoacrylate directly on the incision. Control (Group 2) (n = 32) received traditional nylon suturing. Both groups were evaluated after 21 days of incision closing. Statistical differences in baseline characteristics between study treatment groups were assessed with chi 2 and t tests. All p values are two-sided. RESULTS: There was no significant difference between the two groups in age, gender, or incision length. Length of time for surgical incision to close was less in Group I, significant difference p < 0.0001. There was also a significant difference in aesthetics in Group I. There was no significant difference in any remaining variable, such as suture dehiscence and adequate border coaption. CONCLUSION: Our study showed cyanoacrylate to be more efficient and advantageous in closing of incisions in out-patient surgery than traditional suturing methods. Although we do not pretend to substitute these methods, we recommend the use of cyanoacrylate in closing tension-free incisions in certain patients following rules of usage and practiced by experts.

[Physical abuse of women]. / Maltrato físico en mujeres.

OBJECTIVE: Our aim was determine prevalence of intrafamily violence of the type physical-abuse, toward female claimants aged 18 years and older at the HGZ MF No. 1 in Colima. MATERIAL AND METHOD: A transversal study was conducted in 288 females aged 18 years and older who were seen at the Family Medicine Unit for external consultation. RESULTS: Average age was 33.86 years (+/- 11.6), the highest level of schooling was primary for 33% of subjects and secondary for 26%, 75% of our female claimants were divorced, 53.5% of monthly family incomes in each household was between 1,000 and 3,000 thousand Mexican pesos, and 27.8% of physical abuse consisted of shoving. CONCLUSIONS: Our research revealed that there is indeed physical violence toward 63.45% of female claimants at our hospital, especially toward those with low level of schooling, low socioeconomic status, and monthly income below minimum wage. These conditions only contribute toward making women fall prey to physical violence. Our study is only a first step for better understanding of domestic violence. Risk factors associated with physical abuse need to be controlled to decrease rate of interfamily violence against our claimants.

A280V polymorphism in the histamine H3 receptor as a risk factor for migraine.

BACKGROUND AND AIMS: Activation of histamine H3 receptors blocks the release of peptides responsible for headache. Our objective was to investigate the association between the genotypes of A280V polymorphism in the H3 receptor and migraine risk. METHODS: We evaluated the frequency of the genotypes of A280V, polymorphism A280V and allelic variants of H3 receptor in 147 migraine patients and 186 healthy controls using a PCR-RLFP method. RESULTS: V allele frequency was 6.46% and 2.68% for the cases and controls, respectively (p = 0.02) (OR 2.67; 95% CI 1.20-5.93). The frequency of V/V + V/A genotypes was 12.92% in migraine patients, significantly higher when compared to the 3.22% frequency in the control group (p = 0.001) (OR 4.45; 95% CI 1.7-11.46). CONCLUSIONS: The results of this study suggest that V-allele genotypes in the H3 receptor gene are related to migraine risk in the Mexican population. We propose the hypothesis that the V-allele genotypes in the H3 receptor gene increase the population of inactive receptors, enhancing the inhibition of the negative feedback mechanism on the H3 receptor and increasing histamine release, which correlates with migraine attacks in susceptible patients. The case-control study reinforces the role of histamine in migraine pathogenesis.

[The frequency of risk factors associated with obesity and being overweight in university students from Colima, Mexico]. / Frecuencia y factores de riesgo asociados a sobrepeso y obesidad en universitarios de Colima, México.

OBJECTIVE: Determining risk factor frequency regarding obesity and being overweight in university students. METHODS: A cross-sectional analytic study was carried out on 821 students from the University of Colima. Some variables analysed were age, gender, alcoholism, smoking and weight-control drug use. RESULTS: 821 students were included (380 male, 441 female), 20.9±2.5 average age. 27.8 % of males were overweight and 14.7 % suffered from obesity; this was 17 % and 5.2 % in females, respectively. Smoking (2.1 OR; 1.4-3.8 95 % CI; p=0.01) and alcoholism (2.1 OR; 1.2-3.6 95 % CI; p=0.003) were associated with being overweight and being obese. Weight-control drug use was a protective factor in both genders (0.4 OR; 0.2-0.8 95 % CI; p=0.01); diet control was only a protective factor in women (2.2. OR; 1.1-3.4 95 % CI; p=0.01). CONCLUSIONS: 31.6 % of university students were overweight and suffered from obesity. Smoking and alcoholism in males were associated with being overweight and suffering from obesity. Weight-control and diet-control drug use were protective factors.

[Antibiotic therapy frequency in hospitalised patients and associated risk factors]. / Frecuencia de antibioticoterapia en pacientes hospitalizados y factores de riesgo asociados.

OBJECTIVE: Determining antimicrobial indication and frequency of use in hospitalised patients. MATERIALS AND METHODS: Date and place of work: May 1st to June 30th 2006, Colima, Mexico. An analytical cross-sectional study was carried out; it involved 400 patients from both sexes hospitalised in different second level hospital departments. The variables analysed were: age, gender and the department from which each patient was referred. Antibiotics were evaluated according to type, frequency of use, whether use was prophylactic or therapeutic, whether treatment design was monotherapeutic or mixed, the amount of time taken from being admitted to hospital to beginning treatment, the number of days of treatment, the motive for changing or suspending therapeutic design, the number of patients receiving complete design and the number of patients for whom cultures were or were not done. RESULTS: 63% of the patients received antibiotic therapy, antibiotic use being prophylactic in 46 % of them. The General Surgery Department presented statistically significant antibiotic use association (3.9 OR; 1.7-8.9 CI; p<0.01) and the Internal Medicine Department presented a protector factor (0.5 OR, 0.3-0.8 CI, p<0.01). Betalactamic antibiotics were most frequently used (47%). Mean antibacterial treatment lasted 3.8+/-3.3 days and the amount of time taken from hospital admittance to beginning antibiotic treatment was 13.6+/-47.4 hours. Cultures were done for 2.8% of the patients. CONCLUSION: 63% of hospitalised patients received antibiotic therapy. The prophylactic impact of antibiotics on intrahospital infection frequency and characteristics should be evaluated and their cost-benefit calculated.

Frecuencia y factores de riesgo asociados a sobrepeso y obesidad en universitarios de Colima, México / The frequency of risk factors associated with obesity and being overweight in university students from Colima, Mexico

Objetivo Determinar la frecuencia y factores de riesgo para sobrepeso y obesidad en jóvenes universitarios. Métodos Se realizó un estudio transversal analítico en 821 alumnos inscritos de la Universidad de Colima. Entre las variables analizadas se encuentran: edad, género, alcoholismo, tabaquismo y utilización de medicamentos o sustancias para control de peso. Resultados Se estudiaron 821 alumnos (380 hombres y 441 mujeres) con una edad promedio de 20,9±2,5 años. Las frecuencias de sobrepeso y obesidad en hombres fueron de 27,8 por ciento y 14,7 por ciento y en mujeres de 17 por ciento y 5,2 por ciento. En hombres el tabaquismo (OR 2,1, IC 95 por ciento 1,4-3,8;p=0,01) y etilismo (OR 2,1, IC 95 por ciento 1,2-3,6;p=0,003), estuvieron asociados a sobrepeso y obesidad. Fueron factores protectores en ambos géneros el uso de sustancias para control de peso (OR 0,4, IC 95 por ciento 0,2-0,8;p=0,01); mientras que el control dietético fue un factor protector sólo en las mujeres (OR 2,2, IC 95 por ciento 1,1- 3,4;p=0,01). Conclusiones En estudiantes universitarios, el 31,6 por ciento presentó sobrepeso y obesidad. En hombres, el tabaquismo y etilismo se asociaron a sobrepeso y obesidad. El uso de sustancias para bajar de peso y control dietético fueron factores protectores.

Objective Determining risk factor frequency regarding obesity and being overweight in university students. Methods A cross-sectional analytic study was carried out on 821 students from the University of Colima. Some variables analysed were age, gender, alcoholism, smoking and weight-control drug use. Results 821 students were included (380 male, 441 female), 20.9±2.5 average age. 27.8 percent of males were overweight and 14.7 percent suffered from obesity; this was 17 percent and 5.2 percent in females, respectively. Smoking (2.1 OR; 1.4-3.8 95 percent CI; p=0.01) and alcoholism (2.1 OR; 1.2-3.6 95 percent CI; p=0.003) were associated with being overweight and being obese. Weight-control drug use was a protective factor in both genders (0.4 OR; 0.2-0.8 95 percent CI; p=0.01); diet control was only a protective factor in women (2.2. OR; 1.1-3.4 95 percent CI; p=0.01). Conclusions 31.6 percent of university students were overweight and suffered from obesity. Smoking and alcoholism in males were associated with being overweight and suffering from obesity. Weight-control and diet-control drug use were protective factors.

Nalpha-methylhistamine safety and efficacy in migraine prophylaxis: phase I and phase II studies.

OBJECTIVE: To study the therapeutic potential of the subcutaneous administration of Nalpha-methylhistamine in migraine prophylaxis. BACKGROUND: The histamine catabolite, Nalpha-methylhistamine, possesses a selective affinity for H3 receptors. We consequently considered it viable to conduct a clinical pharmacological study to evaluate the safety and efficacy of this histaminergic H3 agonist in migraine prophylactic treatment, which specifically may inhibit the neurogenic edema response involved in migraine pathophysiology. METHODS: Phase I.-In a clinical trial of 30 healthy volunteers, the effects of the subcutaneous administration of Nalpha-methylhistamine and placebo were studied to assess undesirable symptomatic effects. Phase II.-In a clinical open study, we evaluated the efficacy of Nalpha-methylhistamine in reducing headache intensity, frequency, and duration; and in decreasing analgesic intake in 18 patients with migraine. RESULTS: Phase I.-None of the variables studied showed significant differences (P>.05), and no secondary effects were observed at doses below 10 ng. Phase II.-Nalpha-methylhistamine, at doses of 1 to 3 ng, significantly reduced (P<.0001) the frequency, intensity, and duration of migraine attacks, as well as the need for rescue analgesics. However, at doses greater than 3 ng, patients experienced intense headache. CONCLUSIONS: The present study provides evidence of the safety and efficacy of Nalpha-methylhistamine applied subcutaneously at doses of 1 to 3 ng twice a week.

Frecuencia de antibioticoterapia en pacientes hospitalizados y factores de riesgo asociados / Antibiotic therapy frequency in hospitalised patients and associated risk factors

Objetivo Determinar la frecuencia del uso e indicaciones de antimicrobianos en pacientes hospitalizados. Métodos Fecha y lugar de ejecución: Del 1º de mayo al 30 de junio de 2006. Colima, México. Se realizó un estudio transversal analítico. Se incluyeron 400 pacientes de ambos sexos hospitalizados en cualquier servicio de un hospital de segundo nivel. Las variables estudiadas fueron: edad, género, servicio de procedencia; de los antibióticos se evalúo su frecuencia, tipo de antibiótico, si se utilizó en forma profiláctica o terapéutica, como monoterapia o terapia mixta, tiempo de inicio posterior al ingreso, días de tratamiento, motivo de cambio o suspensión del esquema terapéutico, cuantos tuvieron esquema completo, si hubo o no cultivo. Resultados El 63 por ciento de los pacientes estudiados recibieron antibioticoterapia y en 46 por ciento su uso fue profiláctico. Cirugía general fue el servicio que presentó una asociación estadística significativa para uso de antibióticos (OR 3,9, IC 1,7-8,9; p < 0,01); mientras que el servicio de medicina interna presentó un factor protector (OR 0,5, IC 0,3-0,8, p < 0,01) Los betalactámicos fueron el grupo más frecuentemente utilizado (47 por ciento). El promedio de días de tratamiento antibacteriano fue 3,8 ± 3,3 días y el tiempo desde su ingreso a la aplicación de antibiótico fue de 13,6± 47,4 horas. El 2,8 por ciento de pacientes tenían cultivo. Conclusiones El 63 por ciento de los pacientes hospitalizados recibieron antibioticoterapia. Es necesario evaluar el impacto profiláctico de los antibióticos sobre la frecuencia y características de las infecciones intrahospitalarias y determinar su costo beneficio.

Objective Determining antimicrobial indication and frequency of use in hospitalised patients. Materials and methods Date and place of work: May 1st to June 30th 2006, Colima, Mexico. An analytical cross-sectional study was carried out; it involved 400 patients from both sexes hospitalised in different second level hospital departments. The variables analysed were: age, gender and the department from which each patient was referred. Antibiotics were evaluated according to type, frequency of use, whether use was prophylactic or therapeutic, whether treatment design was monotherapeutic or mixed, the amount of time taken from being admitted to hospital to beginning treatment, the number of days of treatment, the motive for changing or suspending therapeutic design, the number of patients receiving complete design and the number of patients for whom cultures were or were not done. Results 63 percent of the patients received antibiotic therapy, antibiotic use being prophylactic in 46 percent of them. The General Surgery Department presented statistically significant antibiotic use association (3.9 OR; 1.7-8.9 CI; p<0.01) and the Internal Medicine Department presented a protector factor (0.5 OR, 0.3-0.8 CI, p<0.01). Betalactamic antibiotics were most frequently used (47 percent). Mean antibacterial treatment lasted 3.8±3.3 days and the amount of time taken from hospital admittance to beginning antibiotic treatment was 13.6±47.4 hours. Cultures were done for 2.8 percent of the patients. Conclusion 63 percent of hospitalised patients received antibiotic therapy. The prophylactic impact of antibiotics on intrahospital infection frequency and characteristics should be evaluated and their cost-benefit calculated.