RESUMO
In this work, the epidemiology of cancer in children under one year of age in Mexico City is described. A survey (observational, descriptive and prolective study) from 1 January 1996 to 31 December 1999 was conducted at two paediatric hospitals of the Instituto Mexicano de Seguro Social in Mexico City (IMSS-MC). To calculate both the general and the by sex incidence (rates are given per 10) all new cases recorded for children under one year of age (numerator) and Mexico City population served by the IMSS (denominator) were used. When the total of 34 cases that fulfilled the requirements was analysed, an incidence of 194.5 was obtained. Leukaemia occupied first place with a rate of 68.6 and hepatic and germinal cells tumours occupied second place with an incidence of 28.6, whereas peripheral nervous system tumours (neuroblastoma) showed a very low rate (11.4). Overall, the male/female ratio for tumours was 1.4:1, with the ratio varying with different types of tumours. Cancer incidence in this population was shown to be close to that in developed countries, but differed in the distribution of the type of tumour: leukaemia had a very high incidence and that for neuroblastoma was very low.
Assuntos
Neoplasias/epidemiologia , Cidades , Estudos Epidemiológicos , Feminino , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Incidência , Lactente , Recém-Nascido , Leucemia/epidemiologia , Masculino , México/epidemiologia , Neuroblastoma/epidemiologia , Razão de Masculinidade , População UrbanaRESUMO
In the last decades has been a worldwide trend to increase the number of cesarean sections as an alternative of obstetric resolution, phenomenon for which it was proposed a variety of explanation, this fact remains practically unknown in the institutions of the National Health System (NHS) in Mexico. To identify the trend of the pregnancy to end for cesarean sections during the years of 1991-1995 in the 32 states of de country, as well as of all the institutions of the National Health System. Descriptive, cross sectional and retrospective. We use the data of the Bureau of Statistics and Informatics of de Health Ministry of each one of the 32 states of the country, of the years 1991 to 1995, and of the number of cesarean sections made in the hospitals of the different institutions of the NHS. We started off with a data-base, to calculate frequency tables, and the specific rate of the cesarean section for each year, for each one of the states and institutions of the NHS. We calculate the secular trends using the annual rates of cesarean section, for each one of the states and institutions of the NHS. We also made bivariate analysis and estimated the odds ratio (OR) and 95% Confidence Interval (95% IC); and the statistic X2 for trend, setting the two tailed statistic significance level of 0.05. During the study period, there was 7,503,817 births in all hospitals of the NHS, of these births 1,929,865 (25.72%) was resolved by cesarean section. For the whole period it there was a clear trend to increment of the cesarean section, the rate for 1991 was 20.44%, and by 1995 was 28.58%, the raise for the period was 39.82%, with values of the OR for trend of 1.56; 95% IC (1.55-1.57). "P" < 0.05. The rate for institutions attending open population had an increment of 35.08% [OR trend 1.45; 95% IC (1.43-1.46), "p" < 0.05], of them the highest rate was for the State System of Health in 1995 with 29.78%, the rates for the remaining institutions varied from 16.57% for the IMSS/SOLIDARIDAD and 21.7% for the Health Ministry, all trends were statistically significant. In relation to the institutes attending closed population the raise was of 53.27% [OR trend 1.82; 95% IC (1.81-1.83), "p" < 0.05], with the highest rate for the National Defense Ministry which had a rate of 51-15%, the rates for the remaining institutions varied from 33.52% for the Mexican Institute of Social Security (IMSS) to 43.89% for the Institute of Safety and Social Services for the State Workers (ISSSTE), with exception of the Management of the Medical Services of the Mexican Oils (PEMEX) and the Marine Ministry (SECMAR), all trends were statistically significant. When the analysis of the cesarean section rates for the 32 states of the Mexican Republic was carried out, we found that in 1995, the national average rate was 28.58%, the lowest rate corresponded to the state of Zacatecas with 19.82% and the highest to the state of Nuevo León with 42.14%. There was a tendency to increment for all states which varied from 23.55% for the state Chiapas and 67.97% for the states of Querétaro, all increments were statistically significant. We conclude, that rates of cesarean section for both, institutions of NHS and states of the Mexican Republic, are of the highest in the world, no matter what big the interinstitutional and interstate variation are. The highest rates occurred in institutions attending closed population, and the states with a higher degree of socioeconomic development.
Assuntos
Cesárea/tendências , Cesárea/estatística & dados numéricos , Distribuição de Qui-Quadrado , Intervalos de Confiança , Estudos Transversais , Feminino , Humanos , Modelos Lineares , México , Programas Nacionais de Saúde/estatística & dados numéricos , Razão de Chances , Gravidez , Estudos RetrospectivosRESUMO
OBJECTIVE: To identify factors that influence refusing to donating blood. MATERIAL AND METHODS: Prospective case and control study. Hospitalized patients' relatives were interviewed with a questionnaire to evaluate their knowledge of blood and personal attitudes toward blood donation. Cases were all relatives who did not donate blood and controls who did. RESULTS: A total of 121 individuals was studied, 30 cases and 91 controls. Age of the cases was 32.3 +/- 8.1 years and controls was 28.8 +/- 7.9 years (p = 0.04). Risk factors were female sex (OR = 6.3; 95%CI 2.4 to 17.1), being married (OR = 3.7 95%CI 1.3 to 10.5). No differences were present between the two groups in level of knowledge concerning blood. The average of positive attitudes toward blood donation was greater among relatives who donated blood (cases 5.9 +/- 1.6; controls 6.4 +/- 1.2; P = 0.049). Among the attitudes that influence refusing to donate blood were fear of getting dizzy at the sight of blood (OR = 5.2, 95%CI 1.3-21.4), fear of donating blood (OR = 2.2, 95%C, 0.8-6.0), and getting nervous at the sight of blood (OR = 4.1, 95%CI% 1.5-10.9). CONCLUSIONS: Among patient's relatives who donate blood positive personal attitudes toward blood donation have more weight than knowledge on the subject.