[Heterologous allogeneic blood transfusion as a risk factor associated with the adverse course of the surgical wound in primary hip surgery]. / Hemotransfusión alogénica heteróloga como factor de riesgo asociado con la evolución adversa de la herida quirúrgica en cirugía primaria de cadera.

BACKGROUND: Due to its immunomodulating effects mediated by leukocytes and interleukins, heterologous allogeneic blood transfusion has been considered as a risk factor for both morbidity and mortality in patients undergoing orthopedic surgery, including hip surgery. This research analyzed whether heterologous allogeneic blood transfusion is a risk factor associated with the adverse course or complication of the surgical wound in patients undergoing primary hip surgery due to fracture at a general hospital in 2008-2009. MATERIAL AND METHODS: Forty-nine patients who had a complication (cases) and 207 with no complications (controls) were identified and both groups were compared with a bivariate and multivariate analysis, and demographic and clinical data, including having undergone blood transfusion or not. RESULTS: Not having received a blood transfusion was identified as a variable that reduced the risk of surgical wound complications (OR = 0.05, 95% confidence interval [CI 95%] 0.0067 to 0.16; chi2 with p < 0.001). The multivariate model excluded as clinically significant variables the duration of surgery (OR = 1.01, CI 95% 0.99 to 1.02; p = 0.12) and certain chronic conditions (OR = 0.54, CI 95% 0.13 to 2.24 for diabetes mellitus, OR = 1.16, CI 95% 0.29 to 4.60 for chronic hypertension, OR = 1.21, CI 95% 0.19 to 7.51 for various heart diseases). CONCLUSIONS: Not having received a blood transfusion reduced 95% the risk of surgi- cal wound complications. Neither the duration of surgery nor a specific comorbid condition were associated with the former event.

[Epidemiologic features of tetanus in adults form Yucatan, Mexico]. / Características epidemiológicas del tétanos en adultos en Yucatán, México.

OBJECTIVE: To describe epidemiologic features from tetanus in adult patients (TIAP) treated at hospital general O'Horan in Merida, Yucatan, Mexico and compare them with another Mexican series analyzed 25 years ago. MATERIAL AND METHODS: From 1985 to 1999, 121 TIAP cases aged 13 years or older were identified from which 112 were analyzed. Diagnosis of TIAP was made just in a clinical basis. To analyze information inferencial statistics were used. RESULTS: People affected by tetanus averaged 43 +/- 21, 95% CI 39 to 47. A 3:1 male to female ratio was documented. Eighty two (73%) patients come from the rural area; 43 (38%) did work as peasants. Sixty two cases (55%) were diagnosed during the Fall and Winter seasons. In 91 patients (81%) no anti-tetanus vaccination was documented. In 89 cases (79%) incubation period averaged 5.4 +/- 4 days, 95% CI 5 to 6. According to this 89 cases (79%) with incubation period < 10 days were graded as severe tetanus and 23 (21%) with incubation period > or = 10 days were graded as non-severe tetanus. Tetanus-prone wounds were documented in 95 (85%) cases, 59 (62%) of which (62%) were localized in the lower extremities. Final outcome dichotomized either as death patient (group one) or surviving patient (group two) was documented in 103 cases of whom 67 (65%) were in group one and 36 (35%) were in group two. By comparing them, differences were seen in mean age (P = 0.004, 95% CI 3.9 to 19.8), age categories (< 50 vs. > or = 50) (chi 2 P = 0.001, 95% CI 0.6 to 0.60), severity of tetanus (Fisher exact test P = 0.0009, 95% CI 2 to 53) and mean hospitalization time (mean difference 14.8, P = 0.0001, 95% CI 11 to 18) but not in sex (chi 2 0.69, P = 0.40). CONCLUSIONS: In the State of Yucatan, Peninsula de Yucatan, Mexico, TIAP is still an endemic process with high mortality rate specially among young productive people. Secondary preventive measures as routinely tetanus toxoid booster vaccination are still not enough, at least in adulthood.

[Acute pesticide poisoning]. / Intoxicación aguda por plaguicidas.

OBJECTIVE: To describe the epidemiologic pattern of acute pesticide poisoning (APP) in a general hospital in Merida, Yucatan, Mexico. MATERIAL AND METHODS: From 1994 to 1998, 33 patients 13 years of age or older with diagnosis of APP were studied. Descriptive statistics were used to analyze information. RESULTS: Males were frequently affected (82%), specially those coming from rural areas (60%). The mean age of the group was 34 +/- 15.8 years. In 79% of the cases, pesticides were used to commit suicide and 33% of poisoning cases were due to organophospate pesticides. The mortality rate was 12%. CONCLUSIONS: In this small sample, acute poisoning from pesticides in the agricultural setting may be underestimated, since it was less frequent than in the general population. APP was more commonly used by indigent people to commit suicide.

[Epidemiology of preeclampsia-eclampsia at the General Hospital O'Horán. (Epidemiology of preeclampsia-eclampsia of a sample, in Yucatan)]. / Epidemiología de la preeclampsia-eclampsia en el Hospital General O'Horán. (Epidemiología de la preeclampsia-eclampsia de una muestra, en Yucatán).

The objective was to describe the epidemiology of preeclampsia-eclampsia (P-E) at the Hospital General O'Horán (HGOH) in Mérida, Yucatán, México, from 1995 to 1998. Patients with a discharge diagnosis of P-E were included. Their demographic and clinical data were ascertained. To analyze information, descriptive statistics were used. There were 143 patients. Preeclampsia was documented in 41% and eclampsia in 59%. The mean age of the group was 24.4 +/- 7.3 years. It was found that 76% came from rural area. In 79% schooling was no more than elementary education. Seventy five per cent were married. Sexual life began at a mean age of 18.8 +/- 4.3 years. There was no prenatal care in 27% of the cases. Fifty five per cent were primigravida and 43% multigravida. Nuliparity was documented in 52%. Two o more parities were documented in 48%. Complications were seen in 30%. Overall mortality rate was 5%, more frequent eclamptic patients. At the HGOH, P-E was frequently documented in women with both low socioeconomic status and fewer years of schooling. Prenatal care was also irregular. Clinical evolution was satisfactory in most of them, and the mortality rate was low, although it usually occurred in young eclamptic women.