Mortality in residents of the urban and rural areas of Mexico, 2002-2019.

INTRODUCTION: Mortality is affected by several factors, including the place of residence. Several studies have found a gap in mortality between urban and rural residents. This study aimed to describe adjusted mortality rates in urban and rural areas of Mexico. METHODS: Adjusted mortality rate per 100 000 inhabitants was estimated in urban and rural areas of Mexico, were grouped by sex, age, and main cause of death. Trend analysis was performed with a logarithmic regression of adjusted rates. RESULTS: Mortality was higher in urban (622.1/100 000 inhabitants) than rural (549.5/100 000 inhabitants) areas of Mexico. Males showed the highest mortality rate in both studied areas, urban and rural (737.8 and 634.4/100 000 inhabitants respectively). A significant annual decrease of 0.5% in mortality rates was observed in both areas. CONCLUSION: In Mexico, there is a gap in mortality rates based on individuals' place of residence. Those who live in urban areas present the highest mortality rates.

A Retrospective Chart Review of Patients Who Underwent Cardiac Evaluation Before Bariatric Surgery.

BACKGROUND: Overweight and obesity are considered to be a global pandemic. Its associations with hypertension, diabetes and hyperlipidemia are important risk factors for cardiovascular diseases. METHODS: This was a retrospective, observational chart review of obese patients who were seen in our outpatient clinic for cardiovascular clearance prior to an intended bariatric surgery between 2004 and 2020. Data from patient's demographics, risk factors, presence of coronary artery disease (CAD) and other cardiovascular diseases were collected from medical charts. They underwent clinical evaluation, non-invasive workup including electrocardiograms, echocardiograms, treadmill exercise tests and some of them myocardial perfusion studies and coronary angiograms when indicated, based on their symptoms and/or risk factors for CAD. RESULTS: From 761 patients studied, 7.6% (58 patients) underwent coronary angiograms, based on their non-invasive workup and their history. Among them, we found that 17 patients had significant CAD. It should be mentioned that this is a selected group of patients with the intention to undergo a bariatric surgical procedure, which this makes them somewhat different from the general population, and this could be considered among the limitations of our study. CONCLUSIONS: Data from our selected population chart review showed that in this specific population, there was no high prevalence of cardiovascular disease, specifically coronary atherosclerosis, dilated cardiomyopathy, left ventricular hypertrophy, heart failure, atrial fibrillation, stroke, venous thrombosis and obstructive sleep apnea.

Detection of enteric parasite DNA in household and bed dust samples: potential for infection transmission.

BACKGROUND: Enteric parasites are transmitted in households but few studies have sampled inside households for parasites and none have used sensitive molecular methods. METHODS: We collected bed and living room dust samples from households of children participating in a clinical trial of anthelmintic treatment in rural coastal Ecuador. Dust was examined for presence of DNA specific for 11 enteric parasites (Ascaris lumbricoides, Trichuris trichiura, Ancylostoma duodenale, Necator americanus, Strongyloides stercoralis, Toxocara canis and T. cati, Giardia lamblia, Blastocystis hominis, Cryptosporidium spp., and Entamoeba histolytica) by quantitative PCR (qPCR). RESULTS: Of the 38 households sampled, 37 had positive dust for at least one parasite and up to 8 parasites were detected in single samples. Positivity was greatest for B. hominis (79% of household samples) indicating a high level of environmental fecal contamination. Dust positivity rates for individual pathogens were: S. stercoralis (52%), A. lumbricoides (39%), G. lamblia (39%), Toxocara spp. (42%), hookworm (18%) and T. trichiura (8%). DNA for Cryptosporidium spp. and E. histolytica was not detected. Bed dust was more frequently positive than floor samples for all parasites detected. Positivity for A. lumbricoides DNA in bed (adjusted OR: 10.0, 95% CI: 2.0-50.1) but not floor dust (adjusted OR: 3.6, 95% CI: 0.3-37.9) was significantly associated with active infections in children. CONCLUSIONS: To our knowledge, this is the first use of qPCR on environmental samples to detect a wide range of enteric pathogen DNA. Our results indicate widespread contamination of households with parasite DNA and raise the possibility that beds, under conditions of overcrowding in a humid tropical setting, may be a source of transmission.