ABSTRACT
The scientific research goals developed and applied beyond their own frontiers, by the National Institutes of Health and High Specialty Hospitals, are presented regarding the specialized medical care of excellence on the field of global health, in benefice of the Mexican population. Maternal mortality as well as malnutrition, and the lack of micronutrients in the pregnant mother and child, put them in disadvantage to face future physical and mental diseases. Low weight at birth, prematurity, and overweight during childhood are factors that can trigger the the development of the metabolic syndrome, with all its consequences on physical and mental health. These challenges are faced with a preventive vision by means of pilot programs like "Towards a new generation of Mexicans" and "Chronic kidney disease stratification in high risk patients", besides the development of new strategies for the prevention and treatment of other chronic diseases such as cancer, hypertension, and diabetes among others by decreasing the number of overweight and obesity people in the Mexican population.
Subject(s)
Delivery of Health Care , Health Care Reform , Medicine , Global Health , Humans , Mexico , Neoplasms/epidemiology , Obesity/epidemiologyABSTRACT
BACKGROUND: Previous studies have documented that various behavioral disturbances accompany Sydenham's chorea, a neurologic variant of rheumatic fever. Further, an immunological marker associated with rheumatic fever (monoclonal antibody D8/17) has been reported to be elevated in several neuropsychiatric disorders, most frequently tics and obsessive-compulsive disorder. We examined this association in a community sample of children previously identified as being D8/17 positive or negative. It was hypothesized that D8/17 positivity would predict increased rates of tics and obsessive-compulsive disorder, even in the absence of Sydenham's chorea. Possible associations with other disorders accompanying Sydenham's chorea--hyperactivity, anxiety, and depression, also were explored. METHOD: From 1991 to 1995, 2631 children (mean age = 9.6 +/- 1.6 years) from a low socioeconomic area of Mexico City were screened for the D8/17 marker. In a 2- to 5-year follow-up of 240 of these children (108 positive and 132 negative), structured psychiatric interviews and rating scales were administered to the child and main caretaker. Assessments were conducted and scored blind to the child's D8/17 status. RESULTS: No association was seen between D8/17 positivity and tics or OCD. CONCLUSION: This study failed to provide support for the generalized use of D8/17 as a marker of susceptibility to tics and OCD in a community sample.
Subject(s)
Antibodies, Monoclonal/immunology , Anxiety/epidemiology , Attention Deficit Disorder with Hyperactivity/epidemiology , Depression/epidemiology , Rheumatic Fever/epidemiology , Rheumatic Fever/immunology , Biomarkers , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Male , Obsessive-Compulsive Disorder/epidemiology , Prospective Studies , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
Introducción. La sobrepoblación de los servicios médicos ha incrementado la necesidad de referir pacientes a otras unidades médicas; en esas situaciones la nota de envío representa frecuentemente la vía de comunicación entre las unidades médicas. Objetivo: evaluar con qué frecuencia las notas de envío incluyen la información requerida así como la asociación entre integridad de éstas y el tipo de formato estructurado para elaborarlas. Material y métodos. Se colectaron y evaluaron las notas de envío de pacientes referidos al Hospital Infantil de México Federico Gómez de acuerdo a las recomendaciones propuestas por la Secretaría de Salud. A cada nota se le evaluó un total de 12 apartados. Se correlacionó la información incluida de cada categoría con la presencia de un espacio especialmente reservado para esa categoría de información en el formato utilizado.Resultados. Se evaluaron 100 notas de envío de pacientes atendidos desde el 15 de noviembre de 1997 al 15 de julio de 1998. En la mayoría de las notas evaluadas no se incluían ni la información ni los apartados para cada uno los puntos relevantes. Ninguna nota incluía toda la información requerida. Sólo en 4 de los 12 puntos evaluados se pudo demostrar asociación entre la inclusión de un espacio en el formato con la inclusión de dicha información.Conclusión. Las notas de envío frecuentemente no incluyen información referente a cada uno de los reactivos que se consideran necesarios. El uso de un formato que incluya apartados para cada tipo de información pudiera mejorar la integridad de las notas de envío.
