ABSTRACT
BACKGROUND: Venous thromboembolic disease is a major cause of morbidity and hospital mortality worldwide. Although exact figures are unknown in Mexico, achieving uniformity of criteria among the specialties involved in the prophylaxis and treatment will offer a clearer picture and contribute to a more rational and interdisciplinary approach in order to improve the quality of care for patients and increase the level of awareness of this entity. DISCUSSION: For the preparation of this document, a total of 11 medical specialists from Mexico City and the interior of the country met along with a highly experienced professional from Chicago, IL, USA with wide experience in the field and knowledge of methodology for the development of a management algorithm for prophylaxis in at-risk patients of venous thromboembolic disease. The expert group met in plenary working sessions, managed uniform criteria and reached consensus agreement by issuing a series of useful recommendations for the care of patients with venous thromboembolism in Mexican hospitals. CONCLUSIONS: In Mexico there is the need to develop and disseminate guidelines on thromboprophylaxis and treatment of venous thromboembolic disease because of the wide disparity of views or simple misinformation, leading to diagnostic and treatment behaviors unique to each institution.
Subject(s)
Quality Assurance, Health Care/organization & administration , Venous Thromboembolism/drug therapy , Venous Thromboembolism/prevention & control , Venous Thrombosis/prevention & control , Algorithms , Anticoagulants/administration & dosage , Anticoagulants/classification , Anticoagulants/therapeutic use , Disease Management , Drug Prescriptions/standards , Evidence-Based Medicine , Fibrinolytic Agents/administration & dosage , Fibrinolytic Agents/classification , Fibrinolytic Agents/therapeutic use , Hospital Records/standards , Humans , Intermittent Pneumatic Compression Devices , Laboratories, Hospital/standards , Mexico/epidemiology , Organizational Policy , Perioperative Care/standards , Postoperative Complications/prevention & control , Pulmonary Embolism/drug therapy , Pulmonary Embolism/epidemiology , Pulmonary Embolism/prevention & control , Quality Indicators, Health Care , Radiology Department, Hospital/standards , Risk Assessment , Stockings, Compression , Vena Cava Filters , Venous Thromboembolism/epidemiology , Venous Thrombosis/drug therapy , Venous Thrombosis/epidemiologyABSTRACT
OBJECTIVE: to know the peripheral arterial disease (PAD) prevalence and its determinants in a nationwide survey in Mexican population. METHODS: baseline ankle brachial index (ABI) measured by Doppler was performed in patients at high vascular risk for PAD. ABI between 1 and 1.3 was regarded as normal. ABI ≤ 0.9 (a low ABI) was considered to be an indicator of PAD. ABI > 1.3 (a high ABI) was also considered abnormal, as an indirect index of artery calcification and stiffness. RESULTS: a total of 5 101 patients were evaluated: 1,212 patients (23.8 %) had ABI ≤ 0.9, and 431 (8.4 %) > 1.3 (including 1 % with incompressible vessels). ABI ≤ 0.9 was associated with age, arterial hypertension, diabetes, current smoking, dyslipidemia and previous vascular events. On the other hand, ABI > 1.3 was associated with male gender, diabetes, previous smoking habit and history of vascular events. A high proportion of patients (62.5 %) with established PAD, identified by a low ABI (≤ 0.9) were asymptomatic or with minimum symptoms at the time of their assessment. CONCLUSION: a significant prevalence of abnormal ABI was identified. ABI measurement by Doppler can help to identify patients who need intense secondary prevention and more aggressive treatment of vascular risk factors.
Subject(s)
Ankle Brachial Index , Peripheral Arterial Disease/diagnosis , Peripheral Arterial Disease/epidemiology , Aged , Aged, 80 and over , Female , Humans , Male , Mexico , Middle Aged , Prevalence , Prospective Studies , Risk Factors , Vascular Diseases/epidemiologyABSTRACT
Worldwide researchers have invested time, effort, and money during the last years to find new genes associated with diabetes susceptibility, such as LOC387761, HHEX, EXT2, and SLC30A8. The aim of the present study was to evaluate whether single-nucleotide polymorphisms (SNPs) of these genes are associated with type 2 diabetes (T2D) and metabolic traits in the Mexican population. We also assessed these SNPs in Mexican indigenous groups to identify a possible inherited susceptibility. Seven SNPs were analyzed in 789 Mexicans (234 control subjects, 455 type 2 diabetic patients, and 100 of indigenous origin), using the KASPar assay (KBioscience Company). Analysis of the data showed an association of the LOC387761 SNP rs7480010 with T2D (p = 0.019). The risk allele A of rs7480010 increased body mass index in diabetic patients (p = 0.01). In addition, there was no association between T2D and the SNPs of HHEX, EXT2, and SLC30A8. Our findings suggest that the SNP rs7480010 (LOC387761) can contribute to a failure in insulin secretion, thus increasing the susceptibility to T2D in Mexicans.
