Prenatal exposure to phthalates is associated with decreased anogenital distance and penile size in male newborns.

Reproductive effects from phthalate exposure have been documented mostly in animal studies. This study explored the association between prenatal exposure to phthalate metabolites, anogenital distance and penile measurements in male newborns in Toluca, State of Mexico. A total of 174 pregnant women provided urine samples for phthalate analysis during their last prenatal visit, and the 73 who gave birth to male infants were included in the study. The 73 male newborns were weighed and measured using standardized methods after delivery. After adjusting for creatinine and supine length at birth, significant inverse associations were observed between an index of prenatal exposure to total phthalate exposure and the distance from the anus to anterior base of the penis (ß = -0.191 mm per 1 µg/l, P = 0.037), penile width (ß = -0.0414, P = 0.050) and stretched length (ß = -0.2137, P = 0.034); prenatal exposure to mono-2-ethylhexyl phthalate exposure was associated with a reduction in the stretched length of the penis (ß = -0.2604, P = 0.050). Human exposure to phthalates is a public health concern, and the system most vulnerable to its potential effects seems to be the immature male reproductive tract.

Predictors of death from pulmonary tuberculosis: the case of Veracruz, Mexico.

OBJECTIVES: To identify factors (particularly social, economic and cultural), associated with the risk of death from pulmonary tuberculosis in Mexico. METHODS: A case-control study of patients receiving medical attention from the official health services of Veracruz, Mexico. Cases were deaths from pulmonary tuberculosis in 1993. Controls were survivors randomly selected from the State Tuberculosis Case Registry. Next of kin provided information for both cases and controls. RESULTS: Multivariate analysis of 161 cases and 161 controls showed an increased risk of dying for those patients who withdrew from treatment (odds ratio [OR] = 3.52), who were refused medical attention during some period of time in any health center (OR = 4.45), and who had a concomitant disease at the time of diagnosis (OR = 2.62). A linear trend with age was observed (OR = 1.02 per year), as well as a lower risk for those patients who were compliant with treatment and optimistic about surviving the disease (OR = 0.17). The risk of death was not associated with the presence of a health care unit in the town, time spent to get to the health center, or the residence of a patient in an urban area. CONCLUSIONS: These findings indicate that deaths due to tuberculosis in this area are not related to the geographical distribution of health services but to delays in treatment after the onset of disease and to the low adherence of patients to the treatment regimen.

[Sociodemographic characteristics of people who died from pulmonary tuberculosis in Veracruz, Mexico, 1993]. / Características sociodemográficas de personas que murieron por tuberculosis pulmonar en Veracruz, México, 1993.

OBJECTIVE: We describe the socio-demographic and medical care characteristics of people who died of pulmonary tuberculosis in 1993 in the state of Veracruz, Mexico. MATERIAL AND METHODS: Once selected, through death certificate, an interview and verbal autopsy was applied to the closest available relative. RESULTS: A total of 300 interviews were carried out. Half of the deaths were diagnosed with tuberculosis the same year they died. Approximately half of the deceased withdrew from treatment and 40% reported abuse of alcohol consumption. Patients who died of pulmonary tuberculosis belonged to the most vulnerable social groups. 35% were illiterate or had no education, and 67% lacked a regular job. There were no differences found between those who used private medical services and those who used official or public services. CONCLUSIONS: Important findings include the high proportion of patients diagnosed in advanced stages of the disease, alcoholism, adverse reactions to drugs as a cause of withdrawal from treatment, and other current diseases at the time of tuberculosis diagnosis.

[Effects of the application of the years of productive life lost index (investment-production-consumer model) on the sequence of causes of death in Mexico]. / Efectos de la aplicación del indicador de años de vida productivos perdidos (modelo inversion producción consumo) en el ordenamiento de las causas de muerte en México, 1990.

In the search for methods to support the decision making process and to maximize the benefit resulting from the health priorities, this paper discusses the investment-production-consumption model (IPC). This method attempts to quantify the socio-economic impact of mortality. This type of evaluation takes into account age at death and the potential for future productivity and thus assesses the generation of losses or gains to society, depending on the stage of life in which death occurs. The impact of different causes of death estimated by this method is illustrated from the cause of Mexico. These results are compared with the relative importance attributed by the use of mortality rates and years of potential life lost. The ordering by rates shows heart diseases, accidents and tumors as first causes of deaths. On the other hand, the indicator of years of potential life lost shows causes of death at younger ages to occupy the first place. The YPLLipc, however, gives greater importance to infections, accidents and homicides.

[The prevalence of hypertension and associated factors in a political district of Mexico City]. / Prevalencia de hipertensión arterial y factores asociados en una delegación política de la ciudad de México.

A cross-sectional study was conducted in order to know the prevalence of hypertension and some characteristics related as age, sex, obesity, smoking, heredity and exercise, in a mexican population; their possible causal role is discussed. Other variables related with the treatment and control of hypertension were explored as the awareness of personal blood pressure figures and regularity of treatment among hypertensives. The global hypertension prevalence was 26.9% (CI 95% 24.0-29.0), male's prevalence was 33.7% (CI 95% 29.0-38.0) and female's prevalence was 24.3% (CI 95% 22.0-27.0). Age, sex, obesity and heredity were the most associated characteristics on systolic and diastolic mean figures. The Prevalence Odds Ratios (POR) were 1.79 (CI 95% 1.4, 2.29) for obesity; for smoking 1.41 (CI 95% 1.1, 1.82), heredity 1.23 (CI 95% 0.92, 1.64), and sport practice 0.95 (CI 95% 0.64, 1.39). Among population studied only 61.1% knew their habitual blood pressure figures, and among known hypertensives only 27.1% were on regular anti-hypertensive treatment.

[Multiple cause of death in cardio- and cerebrovascular diseases]. / El estudio de causa múltiple de muerte en las enfermedades cardio y cerebrovasculares.

In order to validate mortality studies, we described the role of hypertension at the time of death of people who died during April and May 1985. This analysis take into account all the causes listed in death certificates and not only the underlying cause. A proportional mortality design was used to evaluate the relationship of hypertension, cerebrovascular and cardiovascular disease. The number of deaths associated to hypertension was larger by multiple cause than by underlying cause. The odds ratio for hypertension and ischemic heart disease was 4.1 adjusted by age and sex, and 21.1 for cerebrovascular disease.