Oral ivermectin for the treatment of red scrotum syndrome.

Red scrotum syndrome is an infrequently reported dermatosis characterized by scrotal erythema accompanied by burning, pain, or dysesthesia. It has been increasingly associated with prolonged use of topical corticosteroids. Treatment is challenging and symptoms may persist for months or years after discontinuation of the topical corticosteroids. We report three cases successfully treated with oral ivermectin.

A case of lichen aureus successfully treated with 595 nm wavelength pulsed-dye laser.

BACKGROUND: Lichen aureus (LA) is a variant of pigmented purpuric dermatosis (PPDs) that typically presents with the acute onset of a solitary, unilateral, purple to rust-yellow colored lichenoid patch or plaque on lower extremities. Treatment remains challenging and is based on anecdotal case reports often with poor results. AIMS: Describe a case of LA successfully treated with 595 nm wavelength pulsed-dye laser (PDL). PATIENT/METHOD: A 46-year-old woman with segmental LA was treated using a 595 nm PDL at a uniform spot size of 10 mm, with pulse durations of 10 milliseconds and fluence of 6 J/cm2. The patient had received previous treatments with no improvement. RESULTS: Clearance was archived after three sessions with PDL. Sessions were performed at intervals of 4 weeks, with no serious adverse events nor recurrence. CONCLUSION: We hypothesize the favorable clinical outcome with PDL is due to the affinity of the wavelength for oxyhemoglobin (allowing uniform vessel penetration and energy delivery to fragile capillaries and intraluminal blood) and to its anti-inflammatory profile. PDL seems to be an alternative for patients with progressive LA that have failed other therapies.

Prevalence of skin diseases among hospitals in the public healthcare system of a developing country.

BACKGROUND: Skin diseases in the population are universal, common, and can cause significant economic burden. The impact of skin diseases in the national public healthcare system is complex and poorly studied. This study analyzes the prevalence of skin diseases in a hospital setting within the National Public Health System of Mexico and describes the main associated characteristics. METHODS: Information was obtained from the 2015 hospital discharge database of the public healthcare system of Mexico. Pathologies that result in a direct dermatological condition were included according to chapter XII of the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD - 10) and grouped according to the classification of the report, The burden of skin diseases in the United States. RESULTS: In 2015, a total of 9,230,968 hospital discharges were registered nationwide, of which 170,917 discharges (1.85%) reported a dermatological disease as the main diagnosis; five states account for 40.79% of the cases reported in Mexico. Half of all the cases corresponded to skin infections (32.08%, n = 54,843) and non-cancerous skin growths (27.80%, n = 47,515), and 59.71% were adult patients between 18 and 65 years of age. CONCLUSIONS: Understanding of the configuration of skin diseases in a hospital setting and public healthcare system is warranted to develop effective public policies and research for the development of effective, safe, high-quality care processes for the main groups of identified diseases.

Prevalencia mundial de la diabetes mellitus tipo 2 y su relación con el índice de desarrollo humano

Objetivo. Evaluar la relación entre la prevalencia de diabetes mellitus tipo 2 (DM2) y el índice de desarrollo humano (IDH) por región del mundo en el período 2010–2015. Método. Se utilizaron los datos de la Federación Internacional de Diabetes para la prevalencia de DM2 (2010–2015) y el IDH del Programa de las Naciones Unidas para el Desarrollo. Se analizaron correlaciones lineales de Spearman entre el IDH y la prevalencia de DM2 y se hicieron regresiones lineales para estimar la relación entre ambos. Resultados. Se observó que a menor IDH menores son las prevalencias de DM2, y a mayor IDH, mayores son las prevalencias de DM2. A nivel mundial, el IDH explica 8,6% de la varianza de la prevalencia de DM2 (P < 0,0001) y que este comportamiento fue diferente en cada región del mundo. Conclusiones. El IDH puede influir en la prevalencia de DM2, aunque la relación depende de cada país, región y año analizado.

Objective. To evaluate the relationship between the prevalence of type 2 diabetes mellitus (DM2) and the Human Development Index (HDI), by region of the world in the period 2010-2015. Method. International Diabetes Federation data were used for DM2 prevalence (2010-2015), together with HDI data (United Nations Development Program). Spearman linear correlations between HDI data and DM2 prevalence were analyzed, and linear regressions were done to estimate the relationship between the two. Results. It was observed that lower HDI scores corresponded to lower DM2 prevalence rates, and higher HDI scores to higher DM2 prevalence. At the global level, the HDI explains the 8.6% variance of DM2 prevalence (P < 0.0001) and shows that the situation was different in each region of the world. Conclusions. While HDI score may be associated with DM2 prevalence, the relationship between them differs from region to region and from country to country, and depends on the particular year analyzed.

Objetivo. Avaliar a relação entre a prevalência de diabetes mellitus tipo 2 (DM2) e o índice de desenvolvimento humano (IDH) por região do mundo no período de 2010 a 2015. Métodos. Foram utilizados dados da Federação Internacional de Diabetes para a prevalência da DM2 (2010–2015) e o IDH do Programa das Nações Unidas para o Desenvolvimento. Foram analisadas as correlações lineares de Spearman entre o IDH e a prevalência de DM2 e feitas regressões lineares para estimar a relação entre ambos. Resultados. Observou-se que quanto mais baixo o IDH, menores são as prevalências de DM2, e quanto mais alto o IDH, maiores são prevalências de DM2. Ao nível mundial, o IDH explica 8,6% da variança da prevalência de DM2 (P < 0,0001) e este comportamento difere em cada região do mundo. Conclusões. O IDH pode influir na prevalência de DM2, embora a relação dependa de cada país, região e ano analisados.

[Global prevalence of type 2 diabetes mellitus and its relationship with the Human Development IndexPrevalência mundial da diabetes mellitus tipo 2 e sua relação com o índice de desenvolvimento humano]. / Prevalencia mundial de la diabetes mellitus tipo 2 y su relación con el índice de desarrollo humano.

OBJECTIVE: To evaluate the relationship between the prevalence of type 2 diabetes mellitus (DM2) and the Human Development Index (HDI), by region of the world in the period 2010-2015. METHOD: International Diabetes Federation data were used for DM2 prevalence (2010-2015), together with HDI data (United Nations Development Program). Spearman linear correlations between HDI data and DM2 prevalence were analyzed, and linear regressions were done to estimate the relationship between the two. RESULTS: It was observed that lower HDI scores corresponded to lower DM2 prevalence rates, and higher HDI scores to higher DM2 prevalence. At the global level, the HDI explains the 8.6% variance of DM2 prevalence (P < 0.0001) and shows that the situation was different in each region of the world. CONCLUSIONS: While HDI score may be associated with DM2 prevalence, the relationship between them differs from region to region and from country to country, and depends on the particular year analyzed.

OBJETIVO: Avaliar a relação entre a prevalência de diabetes mellitus tipo 2 (DM2) e o índice de desenvolvimento humano (IDH) por região do mundo no período de 2010 a 2015. MÉTODOS: Foram utilizados dados da Federação Internacional de Diabetes para a prevalência da DM2 (2010­2015) e o IDH do Programa das Nações Unidas para o Desenvolvimento. Foram analisadas as correlações lineares de Spearman entre o IDH e a prevalência de DM2 e feitas regressões lineares para estimar a relação entre ambos. RESULTADOS: Observou-se que quanto mais baixo o IDH, menores são as prevalências de DM2, e quanto mais alto o IDH, maiores são prevalências de DM2. Ao nível mundial, o IDH explica 8,6% da variança da prevalência de DM2 (P < 0,0001) e este comportamento difere em cada região do mundo. CONCLUSÕES: O IDH pode influir na prevalência de DM2, embora a relação dependa de cada país, região e ano analisados.

[Costs of serious adverse events in a community teaching hospital, in Mexico]. / Costos de eventos adversos graves en un Hospital Comunitario de Enseñanza en México.

BACKGROUND: Serious adverse events during hospital care are a worldwide reality and threaten the safety of the hospitalised patient. OBJECTIVE: To identify serious adverse events related to healthcare and direct hospital costs in a Teaching Hospital in México. MATERIAL AND METHODS: A study was conducted in a 250-bed Teaching Hospital in San Luis Potosi, Mexico. Data were obtained from the Quality and Patient Safety Department based on 2012 incidents report. Every event was reviewed and analysed by an expert team using the "fish bone" tool. The costs were calculated since the event took place until discharge or death of the patient. RESULTS: A total of 34 serious adverse events were identified. The average cost was $117,440.89 Mexican pesos (approx. €7,000). The great majority (82.35%) were largely preventable and related to the process of care. Undergraduate medical staff were involved in 58.82%, and 14.7% of patients had suffered adverse events in other hospitals. CONCLUSIONS: Serious adverse events in a Teaching Hospital setting need to be analysed to learn and deploy interventions to prevent and improve patient safety. The direct costs of these events are similar to those reported in developed countries.

[Knowledge and attitudes of teachers at a Medical School and the use of clinical practice guidelines]. / Conocimientos y actitudes de los docentes de una Facultad de Medicina y el uso de las guías de práctica clínica (GPC) nacionales.

INTRODUCTION: The National Center for Health Technology Excellence (CENETEC) has published 539 clinical practice guidelines (CPG) whose area of influence is nationwide. OBJECTIVE: To conduct an assessment of the knowledge and attitudes of teachers at a medical school and the use of CPGs. MATERIALS AND METHODS: We performed a cross-sectional study in 2012 among teachers at one medical school in San Luis Potosí, Mexico. RESULTS: Overall, 97.1% of medical school physicians (MDs) reported knowing the existence of CPGs and 94.9% had consulted them. The 87.6% of the MD knew where they could find the guidelines. However, only 15.9% mentioned the CENETEC website as a source, 30.4% The Ministry of Health website, and 7.3% both pages. CONCLUSIONS: It is necessary to develop programs that facilitate the implementation and adoption of clinical practice guidelines by a multidisciplinary team that specifically establishes the importance of their use.

[Prevalence of unsafe conditions associated to non-intentional needlestick injuries among trainee physicians]. / Prevalencia, condiciones y actos inseguros asociados a punciones accidentales de médicos en formación.

INTRODUCTION: Physicians in training face high-risk clinical situations for needlestick injuries during their training. OBJECTIVE: To determine the prevalence and establish behaviors associated with needlestick injuries. MATERIAL AND METHODS: A cross-sectional study was conducted during the 2012-2013 school year among undergraduate and graduate medical students of a Faculty of Medicine in Mexico. RESULTS: There were a total of 441 questionnaires completed, of which 56.7% of students reported having experienced at least one lesion, of which only 44.5% reported it. The conditions and unsafe acts associated were: female students had a greater risk for the first puncture, whereas male students correlated with three or more punctures; third year students, night shift rounds, the feeling of being rushed by someone else, and the presence of fatigue were risk factors for the first puncture (p < 0.05). CONCLUSIONS: The high prevalence and the underreporting of non-intentional punctures places students at a higher risk of transmissible diseases. Strategies focused on prevention, monitoring, and control of accidental punctures should be implemented by hospitals, schools, and medical schools.