RESUMO
BACKGROUND: Demographic and epidemiological dynamics characterized by lower fertility rates and longer life expectancy, as well as higher prevalence of non-communicable diseases such as diabetes, represent important challenges for policy makers around the World. We investigate the risk factors that influence the diagnosis of diabetes in the Mexican population aged 50 years and over, including childhood poverty. RESULTS: This work employs a probabilistic regression model with information from the Mexican Health and Aging Study (MHAS) of 2012 and 2018. Our results are consistent with the existing literature and should raise strong concerns. The findings suggest that risk factors that favor the diagnosis of diabetes in adulthood are: age, family antecedents of diabetes, obesity, and socioeconomic conditions during both adulthood and childhood. CONCLUSIONS: Poverty conditions before the age 10, with inter-temporal poverty implications, are associated with a higher probability of being diagnosed with diabetes when older and pose extraordinary policy challenges.
Assuntos
Diabetes Mellitus , Fatores Socioeconômicos , Humanos , México/epidemiologia , Pessoa de Meia-Idade , Diabetes Mellitus/epidemiologia , Feminino , Masculino , Idoso , Fatores de Risco , Criança , Pobreza/estatística & dados numéricos , Idoso de 80 Anos ou maisRESUMO
To consolidate an effective and efficient universal health care coverage requires a deep understanding of the challenges faced by the health care system in providing services demanded by population in need. This study analyses the dynamics of health insurance coverage and effective access coverage to some health interventions in Mexico. It examines the evolution of inequalities and heterogeneous performance of the insurance subsystems incorporated under the Mexican health care system. Two types of coverage indicators were selected: health insurance and effective access to preventive health interventions intended for normative population. Data were drawn from National Health and Nutrition Surveys 2006 and 2012. The economic inequality was estimated using the Standardized Concentration Index by household per capita consumption expenditure as socioeconomic-status indicator. Approximately 75% of the population reported being covered by one of the existing insurance schemes, representing a huge step forward from 2006, when as much as 51.62% of the population had no health insurance. About 87% of this growth was attributable to the expansion of Non Contributory Health Insurance whereas 7% emanated from the Social Security subsystem. The results revealed that inequality in access to health insurance was virtually eradicated; however, traces of unequal access persisted in some subpopulations groups. Coverage indicators of effective access showed a slight improvement in the period analysed, but prenatal care and interventions to prevent chronic disease still presented a serious shortage. Furthermore, there was no evidence that inequities in coverage of these interventions have decreased in recent years. The results provided a mixed picture, generalizable to the system as a whole, expansion of insurance status represents one of the most remarkable advances that have not been accompanied by a significant improvement in effective access. In addition, existing inequalities are part of the most important challenges to be faced by the Mexican health system.
Assuntos
Acessibilidade aos Serviços de Saúde/tendências , Cobertura do Seguro/tendências , Seguro Saúde , Adolescente , Adulto , Criança , Pré-Escolar , Atenção à Saúde , Feminino , Disparidades em Assistência à Saúde/economia , Humanos , Lactente , Masculino , México , Pessoa de Meia-Idade , Adulto JovemRESUMO
Se presentaron historias clínicas de pacientes con lesiones intraventriculares. Un pacientes de 3 años y el segundo de 49 años. En ambos, la tomografía computada mostró la lesión intraventricular. En el segundo, se practicó un estudio de resonancia magnética y la localización y extensión de la lesión se define mejor. La evolución postquirúrgica de los dos pacientes fue satisfactoria. Se efectuan algunas consideraciones sobre los métodos de imagen empleados.
Assuntos
Humanos , Pré-Escolar , Pessoa de Meia-Idade , Masculino , Feminino , Neoplasias do Ventrículo Cerebral/diagnóstico , Ependimoma/diagnóstico , Meningioma/diagnóstico , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Diagnóstico Diferencial , Ventrículos Cerebrais/patologiaRESUMO
Durante los últimos nueve años estudiamos cincuenta casos de intoxicación por talio. Veintiocho casos fueron mujeres y vientidos fueron hombres. Uno de los casos fue un recién nacido, cuya madre sufrió este tipo de intoxicación durante el tercer trimestre de su embarazo. Las edades variaron de un día hasta 84 años de edad y en todos los casos la fuente de talio fue una solución raticida administrada oralmente, excepto en el recién nacido en quien la vía de acceso fue a través de la placenta y en una paciente en que fue transdérmica. En veintitrés casos la intoxicación fue accidental, con fines suicidas en veintiuno y con fines homicidas en cinco. En un caso la fuente de intoxicación fue desconocida. En todos los casos los niveles de talio se midieron en la orina, en algunos en la sangre y en el líquido cefalorraquídeo. Las principales manifestaciones clínicas fueron las de una neuropatía periférica severa de tipo mixto, con dolor abdominal, náusea, vómito y alopecia y en algunos casos manifestaciones psiquíatricas. En varios casos se practicaron estudios electrofisológicos, biopsia de nervio con examen de microscopía electrónica en tres pacientes, resonancia nuclear magnética y tomografía axial computarizada de abdomen y de cráneo en dos pacientes. Sólo uno de los pacientes murió y el resto se recuperó prácticamente en forma completa. Se revisan la patofisiología y las bases farmacológicas del manejo de este tipo de neurointoxicación