Neonatal Behçet's disease with Raynaud phenomenon.

We report a new clinical manifestation of neonatal Behcet's disease. A newborn from a mother with active Behcet's disease during pregnancy, who develops vasomotor phenomena (Raynaud) with oral ulcerations in the second day of life. Neonatal mucocutaneous lesions have been reported previously in few newborns of pregnant women with active Behçet disease. Although neonatal disease is a very infrequent situation, with a mostly transient and favorable course, clinicians should be aware of serious potential complications associated with this entity.

[Geographical factors in the epidemiology of intoxication with Karwinskia (tullidora) in Mexico]. / Factores geográficos en la epidemiología de la intoxicación por Karwinskia (tullidora) in México.

Consumption of fruits from the genus Karwinskia may cause a flaccid paralysis that can be confused with the Guillan-Barré syndrome or poliomyelitis. Paralysis resulting from consumption of such fruit has emerged as a public health problem in certain regions of Mexico. The purpose of this study was to investigate geographical factors associated with this intoxication in the 72 cases reported in Mexico from 1990 to 1994. Location of cases coincides with the distribution of the 11 reported species of Karwinskia in the country. The majority of reported cases were related to the consumption of K. humboldtiana, with a smaller number involving K. mollis, K. parvifolia, K. johnstonii, and K. rzedowskii. Most cases were located in regions with dry climates (79.2%), arid vegetation (41. 7%), and altitudes under 1,000 meters above sea level (54.1%). The study establishes three different risk areas: the Balsas river region in the southwestern central part of the country; the arid northern area; and the arid and dry central area. Cases were from rural communities with low levels of schooling and poor socioeconomic conditions.

Late infection after total knee arthroplasty caused by Pasteurella multocida.

The authors report a case of Pasteurella multocida infection in a total knee arthroplasty as a result of a dog bite. The patient was treated with one-stage reimplantation of a new prosthesis and with intravenous antibiotics, resulting in complete relief of symptoms with no evidence of recurrence of infection after 24 months.

[Risk factors for antitubercular drug resistance in Chiapas, Mexico]. / Factores de riesgo para resistencia a drogas antifímicas en Chiapas, México.

OBJECTIVES: To determine risk factors for antibiotic resistance in patients with pulmonary tuberculosis in four Health Jurisdictions of the state of Chiapas. MATERIAL AND METHODS: A case-control study was carried out in patients diagnosed by acid fast smear during 1992. A questionnaire was applied which included variables related to the diagnosis, treatment and follow-up of the patients. Sputum samples were collected for culture and sensitivity tests. A case of drug-resistant pulmonary tuberculosis was defined as the presence of culture colonies showing resistance to one or more drugs. The control group was patients with negative smears and cultures or positive cultures for M. tuberculosis sensitive to the specific drugs. RESULTS: Of the total of 18 individuals reported to have positive cultures, 13 (72.2%) were resistant to one or more drugs. Resistance to two or more drugs was found in 10 of them of which three were resistant to five antituberculosis drugs. The most frequent resistance was to isoniazid (77%). Risk factors for resistance encountered in this patient population were monotherapy (OR = 34.2), abandonment of treatment (OR = 6.86), a prolonged period of illness (OR = 6.40), delay in diagnosis and a history of prior therapy (OR = 28.3). CONCLUSIONS: The high proportion of patients resistant to antituberculosis therapy poses a public health problem and is a clear consequence of the problems arising from inadequate treatment.

[Outbreaks of food poisonings of microbial and parasitic origins]. / Brotes de toxiinfecciones alimentarias de origen microbiano y parasitario.

In order to know the agents and foods related more frequently with food-borne disease outbreaks, we reviewed all the outbreaks studied between 1980 and 1989 by the National Laboratory of Public Health. A total of 79 outbreaks of food-borne diseases of microbial origin were reviewed. The causative agent was identified in 50 (73%) outbreaks. Twenty-four per cent of the outbreaks occurred in parties, 10.3 per cent in school or nurseries, 8.6 per cent in restaurants and 8.6 per cent in hospitals. Staphylococcus aureus was the most common agent, causing 48.2 per cent of the outbreaks. Salmonella enterica was involved in 34 per cent of them. The most frequent serovar was typhimurium. Foods involved were: cheese in 29.3 per cent of the cases; cakes in 15.5 per cent; cooked meat in 15.1 per cent; milk in 13.8 per cent; and fish and seafood in 7.0 per cent of the cases. Since the number of studied incidents represents only a small proportion of all the outbreaks occurring in the country, the constant exchange of information among the laboratories which work on the problem and the promotion of the health care team are necessary in order to improve the epidemiologic surveillance systems and the study and prevention of food-borne disease and food poisoning outbreaks.

[Evaluation of the Murless head extractor]. / Valoración del uso del extractor cefálico de Murless.

The Murless head extractor has been used since long time ago as a vector, extractor and head rotator through cesarean section diminishing the injury feto-maternal. From march to june 1991, 50 patients with cesarean section indication and with fetus in head presentation were gotten out using this way, analyzing 12 maternal parameters and 9 fetal. The most frequent indication of cesarean section was severe Preeclampsia 41%, third cesarean section 14.7%, fetal distress 14.7%, low reserve fetal 11.7%, PROM 8.8% and others 9.1%. The height of the head was at the first plane in 59.4%. The Apgar score at the minute was of 9 in 6.0%, of 8 in 60.6%, of 7 in 18.1%, of 6 in 12.1% of 4 in 3.3%. The Apgar score at five minutes was 9 in 84.8% and 8 in 12.1% for a total of 96.9%. An USG transfontanelar was practiced in 40 products from which 37 (92.5%) were normal and in 3 (7.5%) it was found: in one brain light edema and in two hypoxical encephalopathy (caused by severe Preeclampsia, chronic hypertension and superimposed preeclampsia and fetal distress due to cord around the neck. In the other ten cases USG was not used for another reasons. Maternal morbi-mortality and general due to extractor use, was not obtained not either fetal morbi-mortality. It was concluded that the head extractor is useful, does not increase the obstetrical injury and it is easily applied).

[Poisoning by paralytic molluscan toxins in Oaxaca]. / Intoxicaciones por toxina paralizante de molusco en Oaxaca.

Toxic Red Tides are caused by marine dinoflagellates which synthesize neurotoxins that accumulate in bivalve mollusks. Upon ingestion, these shellfish can cause paralysis and death. During the month of December, 1989, 99 cases of Paralytic Shellfish Poisoning in the areas of Salina Cruz and Huatulco, Oaxaca, were reported; three of which died. The majority of the cases involved the ingestion of oysters and clams. A short time later, the Red Tide was reported appearing. One hundred and fifteen seafood samples were analyzed through a biologic test in mice to determine the quantity of saxitoxin. Oysters and clams showed levels reaching 4 000 U.R. Laboratory analysis of seawater found very high quantities of Gimnodinium catenatum and Gonyaulax catenella. The control measures consisted of the prohibition of the harvest and sale of all bivalve mollusks as well as a public warning to avoid the consumption of such shellfish.

[Coffee tree cultivation and the social history of onchocerciasis in Soconusco, Chiapas state, Mexico]. / Cafeticultura e historia social de la oncocercosis en el Soconusco, estado de Chiapas, México.

Due to the social and ecological changes that have taken place in the region of Soconusco, Chiapas, Mexico, the coffee tree growth economy (established in the latter part of the last century) has been an important factor in the transmission of onchocerciasis. The optimum ecological conditions for the growth of the coffee tree coincide with those of the disease's growth rate vector; the mobilization of migrant workers for the cultivation and gathering of coffee beans, plus changes in the natural environment, are elements which explain the disease's distribution in the different regions. The origin of the disease in Chiapas may be due to the migration of coffee plantation workers from Guatemala in search of land in which to settle. Social changes occurring after the Agrarian Distribution (land distributions that occurred in 1918 and 1940) caused an intensification and modernization in the areas of cultivation which in turn caused a decline in the disease's growth rate vector. This, together with standard of living improvements and control measures against the disease, explain why the problem in these regions has decreased considerably. The use of ivermectin as a new therapy paves the way for better disease control in the future. Nevertheless, in the smaller locations occupied by middle and poor class farmers, where coffee bean cultivation is just commencing and still in a rudimentary form, onchocerciasis and other diseases continue to present serious health problems.

[Lesions of the oral mucosa. Epidemiological study of 7,297 patients]. / Lesiones de la mucosa bucal. Estudio epidemiológico en 7,297 pacientes.

To our Knowledge, this is the first work in a number population (higher than 500 sample WHO) that is carried out in our country about lesions in the Oral Mucosa. The advantages in this Kind of studies are recognized particularly in the fields of academic, research and services. This work presents the first view of a permanent research project of Oral Mucosa Lesions at the admission clinic, School of Dentistry, Universidad del Bajío. The findings are from the evaluation of 7,297 patients, 15 years or older, that seek dental services between January 1982 and June 1989 (7.5 years). The lack of national data and the oldest population samples in other countries studies stopped wider evaluations, even though the study purpose was not affected, it was possible to offer qualitative data in the respect of prevalecence, variety and etiopathogenesis of those type of pathosis in the Oral Mucosa. The general prevalecence in the group was approximately 13%, identifying lesions more frequently in males, but higher variety in females. Report on 40 different entities, presented in general according to a descent order of prevalencece and reagrouped by sex and pathology. In half the lesions was possible to identify as the cause, acute and cronic traumatic agents; The infectious associations were also very frequent. Those last observations are of high relevance concerning the prevention of Oral Mucosa lesions.

[Functional, involutional and pathological oral changes with age. 6. Systemic disease]. / Cambios funcionales, involutivos y patológicos estomatológicos con la edad. VI. Enfermedades sistémicas.

The present study was realized to determine the frequency variety and concentration of old and new health disease in patients attending a school of Dentistry, classification to an age variable. This paper ends a series of articles about estomatological changes associated to an aging process. The main findings indicate that when patients grow older an increment in variety and number of pathological personal background. The results suggest a very well defined difference in the prevalence and concentration among subjects over and under 50 years. The risk factor was 1:1 in patients older than that. The importance of considering the Clinical history in patients as a determining factor in the global dental evaluation, for the decision. making in treatment planning.

[Xerostomia and hyposalivation: clinical aspects]. / Xerostomía e hiposalivación: aspeoctos clínicos.

In stomatology, salivary function and dysfunction are seldom discussed in their biological and psychological aspects; too often, the terms are mistakenly used as synonyms. The importance of identifying these conditions not only involves direct therapeutic implications, as it can additionally influence global and systemic buccal conditions, as well as modify tissue response and psychological adaptation to dental, periodontal and prothesis therapy as currently performed in daily practice. The physiopathogenesis, etiology, the local and general clinical repercussions, as well as those on behavior, the methods of clinical evaluation and treatment/handling of hyposalivation and xerostoma, are presented and discussed.

[2. Occluso-articular aspects. Functional, involutional and pathologic dental changes with aging]. / II. Aspectos ocluso-articulares. Cambios functionales, involutivos y patológicos estomatológicos con la edad.

A description is made of occlusal, articular and craniomandibular alterations that become present in the advance adult and old age and in some way they induce to the implementation of preventive and curative aspects from early stages or specific in posterior ages.