Gaceta medica de Mexico最新文献

Background: Chromosomal abnormalities are present in 50 to 60% of miscarriages and in 6 to 19% of stillbirths. Although microarrays are preferred for studying chromosomal abnormalities, many hospitals cannot offer this methodology.

Objective: To present the results of the cytogenetic analysis of 303 products of conception (POC), which included 184 miscarriages, 49 stillbirths and 17 cases of undefined age.

Material and methods: Karyotyping, fluorescence in situ hybridization, short tandem repeats and microarrays were used, depending on the type of loss and available sample.

Results: In 29 POCs we found maternal tissue and were eliminated from the analyses. Informative results were obtained in 250 (91.2 %)/274 cases; the karyotyping success rate was 80.7%; that of single nucleotide polymorphism microarrays, 94.5%; and that of fluorescence in situ hybridization and short tandem repeat, 100%. Cytogenetic abnormalities were observed in 57.6% of miscarriages and in 24.5% of stillbirths; 94% of total anomalies were numerical and 6% were submicroscopic.

Conclusions: Karyotyping with simultaneous short tandem repeat study to rule out contamination of maternal cells is effective for studying miscarriages; in stillbirths, microarrays are recommended.

Cardiovascular disease is the main cause of mortality in Mexico as well as the rest of the world, with dyslipidemia being one of the main risk factors. Despite the importance of its epidemiological impact, there is still -among primary care physicians- a lack of knowledge ranging from the basic concepts for diagnosis to the most recent recommendations for treatment. This document consisting of 10 questions is done by experts in this field. A total of 22 recommendations arise using Delphi methodology. The recommendations include the measurement of the lipid profile starting at 20 years of age, the treatment goals for patients according to their risk, the follow-up of patients with dyslipidemia, and the management approach in primary and secondary prevention.

Background: Between 2019 and 2024, changes were made to Mexico's Public Health System to improve health care for the population with social security, which modified the organization and the leadership.

Objective: Comprehensively analyze the changes made in the public to serve the population without social security and formulate proposals to achieve universal health.

Material and methods: Qualitative research was carried out with a focus group technique to comprehensively analyze the changes made and formulate proposals.

Results: Most of the changes made between 2019 and 2024 created the legal framework for the Health System for Welfare and the IMSS-BIENESTAR agency, in order to improve the care of the population without social security, but at the same time modified the leadership in the Public Health System. Opportunities for improvement were identified and proposals were made to strengthen the organization of services, management, financing and training of health personnel.

Conclusions: Changes to the health system have weaknesses that can be corrected to improve its sustainability and advance in the construction of a universal health system.

Background: In higher education institutions, the analysis of academic trajectories is key to evaluating training, which can generate interventions to promote regularity and improve terminal efficiency.

Objective: To analyze the differences in the academic trajectories of the student body of the 2001 to 2018 generations of the medical degree at the National Autonomous University of Mexico (UNAM).

Material and methods: A longitudinal comparative study was conducted with 18,739 UNAM Faculty of Medicine students, integrated by real cohorts from 2001 to 2018. Survival functions were adjusted with the KaplanMeier method and a Cox proportional hazards model was adjusted to evaluate the effect of sex and high school of origin. Failure in first-year students was also analyzed.

Results: The study demonstrated that sex and baccalaureate history are variables that impact failure and consequently regularity and terminal efficiency.

Conclusions: Due to a lower failure rate, there is a higher regularity and terminal efficiency in men compared to women, and in those that were admitted from external baccalaureates or the National Preparatory School, compared to those from the College of Sciences and Humanities.

Background: Tuberculosis (TB) has been considered a social disease, and the World Health Organization regards it as a severe global public health problem.

Objective: To determine the epidemiological profile of TB in Puebla, Mexico, in 2022 and 2023 and its relationship with the Social Determinants of Health (SDH).

Material and methods: Correlational and retrospective study with 2,002 subjects. Variables: TB profile (anatomical location, comorbidities, and drug resistance) and SDH (marginalization, educational level, and occupation).

Results: Negative correlations were found between educational level and occupation with TB and comorbidities (p = 0.05). No correlation was found between marginalization and TB profile (p = 0.05). The correlation between drug resistance and SDH was low or not significant (p > 0.05).

Conclusions: Our study suggests that, although marginalization did not show a significant association with TB in the region, other determinants, such as educational level and occupation, did exhibit an inversely proportional relationship with the presence of the disease and its comorbidities.