Cord blood banking and transplantation at the Mexican Institute of Social Security: the first 5 years.

BACKGROUND: In January 2005, the Cord Blood Bank (CBB) at the Mexican Institute of Social Security initiated activities. Herein, we describe the experience generated during this period (January 1, 2005-December 31, 2009). STUDY DESIGN AND METHODS: Good manufacturing practices and standard operating procedures were used to address donor selection, as well as umbilical cord blood (UCB) collection, processing, and cryopreservation. Based mainly on HLA and nucleated cell content, specific UCB units were thawed, processed, and released for transplantation. RESULTS: A total of 589 UCB units were stored, representing 54% of the total number of units collected. Forty-eight units (8.14% of the stored units) were released for transplantation of 36 patients. Twenty-six patients (72% of cases) corresponded to patients with acute leukemia, five (14%) to patients with marrow failure, and the rest (five; 14%) to patients with hemoglobinopathies and other syndromes. The median number of nucleated cells infused per patient was 6.71 × 10(7) /kg and the median number of CD34+ cells was 4.8 × 10(5) /kg. Current engraftment data indicate that engraftment occurred in 56%, and no engraftment in 44%, of cases. Engraftment was more frequent (59%) in patients that received more than 3 × 10(7) total nucleated cells (TNCs)/kg body weight, than in those receiving fewer than 3 × 10(7) TNCs/kg (40%). Myeloid engraftment was observed 7 to 54 days posttransplant (median, 23 days), whereas platelet engraftment was detected on Days 12 to 87 posttransplant (median, 38 days). To date, the disease-free survival rate was 41% and the overall survival was 47%, with survival periods of 126 to 1654 days. CONCLUSION: Although the experience presented herein is still limited and the period of analysis is still short, the results obtained during these 5 years are encouraging.

[Chagas disease and the transfusional safety in Mexico]. / Enfermedad de Chagas y la seguridad transfusional en México.

The World Health Organization considers to the American trypanosomiasis a disease with priority attention that cause 45 000 deaths annually. We are celebrating a century of the disease description and the identification of etiologic agent and the transmitter. The universal screen strategy had diminished the risk of transmission by blood transfusion. In this number, Novelo Garza ET AL. described the national prevalence in Mexico through a screen test that led us watch the first geographical image of the disease in the country.

[Prevalence of hepatitis C virus in the blood bank at Centro Médico Nacional La Raza]. / Prevalencia del virus de hepatitis C en el Banco de Sangre del Centro Médico Nacional La Raza.

INTRODUCTION: There are no records on the prevalence of infection by HCV in Mexican population. The central area of Mexico is a highly dense demographic zone and is the influence area of the second blood bank in Latin America in terms of affluence. MATERIAL AND METHODS: We prospectively studied the prevalence and genotypes of HCV infection in 5105 individuals attending the Central Blood Bank of Centro Médico Nacional La Raza regardless if they were accepted or rejected as donors. We applied a quimiolumiscence assay as a screening test. A recombinant immunoassay (RIBA) and a qualitative polymerase chain reaction (PCR) were performed as confirmatory tests and to detect viremia, respectively. Virus genotype was identified by means of a Line Immuno Probe Assay in PCR positive samples. RESULTS: The overall prevalence of HCV infection was 0.195% (10/5105). Viremia was detected in 90% of the subjects. The prevalence of accepted donors (0.087%) was significantly lower (p = 0.017) than that of the rejected ones (0.421%). Among viremic subjects, 60 % were infected with genotype 2 and 40% with a subtype combination (a/b) of genotype 1. DISCUSSION: The prevalence of HCV infection in our population was significantly lower than the world mean prevalence estimated in 3 %. A higher prevalence of genotype 2 in asymptomatic individuals contrasts with previous studies with a selected population where genotype 1 prevailed.

Estudio de los factores que influyen en la renuncia de los médicos residentes durante su formación / Study of the factor which promote resident's desertion during their formation

Con el objetivo de conocer los factores que influyen en la renuncia de los médicos residentes durante su formación, se realizó un encuesta comparativa retrospectiva. Fueron tomados para el estudio 52 médicos residentes que renunciaron en el periodo de marzo de 1990 a febrero de 1993 y como grupo control 52 médicos residentes que concluyeron satisfactoriamente su residencia. Se analizaron cinco factores de manera compartiva para grupo de médicos que renunción y para el que no renunció: sexo, estado civil, lugar de origen, tipo de contratación y edad, los tres primeros factores no tuvieron un diferencia estadísticamente; sin embargo, en los dos últimos factores se demostró que existe un menor índice de renuncias (p=0.01 y p=0.05, respectivamente) en los médicos que son seleccionados por la Universidad Nacional Autónoma de México (UNAM) y menores de 35 años, por lo que se concluye que los criterios de selección del médico becado debieran ser de mayor rigor