Migraine trigger factors in non-clinical Mexican-American population in San Diego county: implications for etiology.

We conducted an investigation of migraine headache in a general population of Mexican-Americans living in San Diego county. Specific headache triggers were reported and analyzed, the most frequently reported for females with migraine being missing meals (58.9%), weather changes (54.4%), menstruation (53.6%), post-crisis letdown (52.7%), and fatigue (51.8%). The most frequently reported trigger factors for migraines reported by males were fatigue (58.8%), sleep (as a precipitating factor) (56.3%), post-crisis letdown (41.2%), and weather changes (37.5%). Trigger factors were further evaluated using stratification by presence or absence of Raynaud's phenomenon (RP), menstrual migraine, family history of migraine, and by migraine type. Odds ratios and 95% confidence intervals were calculated. These results suggest that subjects with migraine and RP (perhaps indicative of a systematic vascular tone disorder) and those with menstrual migraine (indicative of sensitivity to hormonal changes) may overall be more sensitive to certain environmental stimuli, particularly those involving change in the internal environment.

[The effectiveness of a program of smoking prevention among Mexican schoolchildren]. / Efectividad de un programa de prevención de tabaquismo en escolares mexicanos.

The main objective of this study was to determine if a program emphasizing training for coping with the social pressures to smoke cigarettes is effective in preventing initial experimentation in the same population. Six elementary schools in Tijuana, Mexico, were included in this prospective study with the participation of 168 sixth-graders. After a baseline survey students were randomly assigned to an intervention and a control group. A program that emphasizes peer-pressure resistance skills to avoid smoking was applied to the intervention group. The control group received no intervention. After 10 months a second survey was carried out in both groups. A significantly smaller proportion of subjects in the intervention group experimented with tobacco during the follow-up period when compared with controls (8.1% vs 20%; p < 0.05). Although designed as a prevention tool, the program also had a therapeutic effect. The proportion of subjects in the intervention group that quit smoking was significantly higher than that of the control group (72% vs 34.78%; p < 0.01). We conclude that this peer pressure resistance skill program was effective in preventing experimentation with tobacco among sixth graders in Tijuana, Mexico.

The social epidemiology of smoking during pregnancy among Mexican women.

The association between maternal tobacco smoke exposure and hazards to reproduction has been investigated since the turn of the century. Numerous studies have demonstrated an increased risk to the developing fetus as a result of maternal smoking. This risk continues to manifest itself postnatally into childhood. The present study examined both risk factors for and consequences of smoking behavior among a sample of 50 pregnant women consecutively admitted to the obstetrics ward of the Tijuana General Hospital, Tijuana, Mexico. A questionnaire completed postpartum examined social, cultural, and economic variables for the mother, and physical variables of the newborn. Twenty-one subjects were smokers and 29 were nonsmokers. The number of previous pregnancies per subject was significantly higher in the group of smoking mothers. Overall, 86.2% of the nonsmoking mothers had three or fewer pregnancies versus 52.4% of the smoking mothers (p less than or equal to 0.005). It was also noted that the smoking subjects tended to be light smokers (90% reported smoking ten or fewer cigarettes a day, with an average of 4.27 years of smoking history). No difference in knowledge of the harmful effects of smoking during pregnancy was observed between the two groups; however, the proportion of subjects whose mothers and siblings also smoked was significantly higher (p less than or equal to 0.005 and p less than or equal to 0.01, respectively) in the smoking groups. The results are discussed in terms of antismoking prevention and health promotion programs for the developing world.

Neuroepidemiology of human T-lymphotrophic virus type-I-associated tropical spastic paraparesis.

Tropical spastic paraparesis (TSP) is a chronic neurological syndrome of gradual onset involving the pyramidal tracts and upper motor neurons, resulting in weakness and stiffness of the lower extremities, hyperactive tendon reflexes, spasticity, low back pain, and urinary disturbances. Clusters of endemic TSP have been noted in Africa, the Seychelles Islands, Colombia, and the Caribbean. Recently, studies have linked human T-lymphotrophic virus type-I (HTLV-I) with the endemic form of the disease. In Japan a very similar clinical syndrome has been identified as HTLV-I-associated myelopathy and may be a non-tropical version of the same disease. The purpose of the present review is to examine the role HTLV-I may play in the pathogenesis of these myelopathies from a neuroepidemiological point of view.

Use of the CES-D among a community sample of older Mexican-Americans.

This study is a descriptive and comparative analysis of the Center for Epidemiologic Studies Depression (CES-D) scale as administered to a sample of Mexican-Americans (n = 455) age 45 years and older. This sample was part of a cross-sectional survey (Health and Lifestyles After 45) carried out in 1985-1987 by the University Center on Aging at San Diego State University. Results indicate that CES-D mean scores (overall = 11.3) and caseness rates (overall = 25.9%) are comparable with depression data reported from other studies among samples of Mexican-Americans. Factor analysis provided evidence indicating cultural response preferences among Mexican-Americans, particularly immigrants, who tend to somatize dysphoric complaints. A re-examination of an often cited CES-D ethnic validation study is included. Implications for construct validity of the CES-D among older Mexican-Americans are discussed.

Predictors of chewing tobacco and cigarette use in a multiethnic public school population.

Smoking and tobacco-chewing habits of sixth and seventh graders were investigated. Four hundred thirty-three white, black, Mexican-American, and Oriental students in San Diego public schools self-reported their tobacco use as well as perceptions of use among their peers and friends, parental socio-economic status, and other variables. One-third of the respondents had used some form of tobacco at least once, with cigarette smoking more common than chewing. Norm perceptions and best friend's habits predicted both smoking and chewing experimentation and prevalence. White males were more frequent "chewers," while blacks and Mexican-Americans were more frequent smokers. Significant associations between the two types of tobacco use were also found.

Patterns and Predictors of Cigarette use Among Public School Children in Tijuana, Mexico.

The use of cigarettes and other forms of tobacco poses a major and growing health threat to populations of developing countries. The present study examined the onset of cigarette use among public school students in Tijuana, Mexico. Fifty-four percent of the males and 34 percent of the females had experimented with smoking. Maternal smoking was more strongly associated with smoking among girls, while peer smoking had a relatively stronger association with future intentions to smoke among boys. Rates of smoking behavior among Mexican-American school children in nearby San Diego more closely resembled the higher rates of their Tijuana than those of their Anglo-American counterparts.

A review of the antituberculosis campaign in Mexico.

Tuberculosis, a major cause of death in the nineteenth century, has consistently and steadily declined in industrialized countries. Such decline antedates the introduction of specific treatment or immunization programs. In the United States of America, the tuberculosis problem is almost exclusively confined to ethnic minorities, socially marginal groups, and migratory workers. All the countries of Latin America have adopted the programs for tuberculosis control recommended by the World Health Organization and the Pan American Health Association. The degree to which these programs are followed in Mexico is critically discussed. A number of suggestions are offered to improve a program that appears to be insufficient in terms of controlling this disease.