Pre-COVID-19 Social Determinants of Health Among Mexican Migrants in Los Angeles and New York City and Their Increased Vulnerability to Unfavorable Health Outcomes During the COVID-19 Pandemic

Journal of Immigrant and Minority Health - COVID-19 has disproportionally affected underrepresented minorities (URM) and low-income immigrants in the United States. The aim of the study is to...     

Surgical site infections at the National Cancer Institute in Mexico: a case-control study

OBJECTIVES: To quantify the surgical infection rate and to identify risk factors associated with surgical site infection. METHODS: We conducted a case-control study of all surgical patients between January 1, 1993, and June 30, 1994. The frequency of surgical site infection per 100 surgeries was calculated. The odds ratio (OR) was estimated by using logistic regression analysis. SETTING: A 130-bed tertiary-care teaching hospital for adult patients with cancer. RESULTS: The study followed 3372 surgeries. Three hundred thirteen patients had a surgical site infection (rate per 100 surgeries: 9. 30). The risk factors associated with surgical site infection were diabetes mellitus (OR = 2.5, 95% confidence interval [CI] = 1.27-4. 91), obesity (OR = 1.76, 95% CI = 1.14-2.7), presence of surgical drains for >5 and <16 days (OR = 1.84, 95% CI = 1.02-3.31), and presence of surgical drains for >/=16 days (OR = 2.14, 95% CI = 1. 0-4.6). The bacteria most frequently isolated were Escherichia coli 38 (21.8% of the total of microorganisms found), Pseudomonas sp 22 (12.6%), Staphylococcus aureus 16 (9.2%), and coagulase-negative Staphylococcus 25 (13.6%). The coexistence of other nosocomial infections was greater among the cases (OR = 1.8, 95% CI = 1.1-3.1) than in the control group. CONCLUSIONS: The surgical site infection rate in our hospital is slightly higher than the rates reported for general hospitals. The risk factors associated with surgical site infection are similar to those previously reported. Diabetes mellitus, obesity, and prolonged presence of a surgical drain increased the risk of infection.     

Clinical validation of the EORTC QLQ-OG25 questionnaire for the evaluation of health-related quality of life in Mexican patients with esophagogastric cancers

Background: Quality of life questionnaires (QLQ) QLQ‐STO22 and QLQ‐OES18 are currently available to measure Health‐related quality of life (HRQL) in patients with Esophageal (EC) or Gastric cancer (GC). The QLQ‐OG25 integrates questions from both questionnaires to be useful for EC, Esophagogastric junction carcinoma (EGJC), and GC. Our aim was to validate the Mexican‐Spanish version. Patients and Methods: The translation procedure followed European Organization for Research and Treatment of Cancer (EORTC) guidelines. QLQ‐C30 and QLQ‐OG25 instruments were completed by patients with EC, EGJC, and GC. Patients were divided into three groups: (1) palliative treatment; (2) treatment with curative intent, and (3) survivors. Reliability and validity tests were performed. Results: One‐hundred sixty‐three patients were included: 62 women and 101 men (mean age, 54.9 years; range, 22–82 years). Sixty‐nine, seventy‐three, and twenty‐one patients were allocated into groups 1, 2, and 3, respectively. Questionnaire compliance rates were high and were well accepted. Group 3 patients reported better functional HRQL scores and lower symptom scores than patients in groups 2 and 1. Scales in the QLQ‐C30 and QLQ‐OG25 distinguished among other clinically distinct groups of patients. Cronbach's α coefficients of all multi‐item scales of the QLQ‐OG25 instrument were >0.7 (range, 0.7–0.83). Multitrait scaling analysis demonstrated good convergent and discriminant validity, even adjusting by location. Test–retest scores were consistent. Conclusion: The Mexican‐Spanish version of the EORTC QLQ‐OG25 questionnaire is reliable and valid for HRQL measurement in patients with esophagogastric cancer and can be used in clinical trials in the Mexican community. Copyright © 2011 John Wiley & Sons, Ltd.     

Changing risk factors for HIV infection

BACKGROUND: HIV infection in women is a growing problem in developing countries. Risk factors for HIV infection vary from country to country and may change with time. METHODS: We describe a retrospective review of the epidemiologic characteristics and associated gynecologic diseases of all HIV-infected women seen at two tertiary-care hospitals in Mexico City. RESULTS: One hundred thirty consecutive patients were included in the study from March 1985 to January 1996. Mean age at HIV diagnosis was 36.2 years (range: 16-76). Of the 75 women diagnosed with AIDS prior to 1992, 58 (69%) were infected through blood transfusion and 17 (20%) through sexual contact. After January 1992, 11 (23%) acquired infection through blood transfusion and 28 (60%) through sexual contact; these differences were statistically significant (p <0.0001). Prior to 1992, 66 (90%) women presented in stage IV, whereas after that year only 29 (51%) (p <0.001) presented in stage IV. Of 92 patients on whom a cervico-vaginal smear was carried out, human papillomavirus infection was identified in 22 (24%) women, nine (9.8%) had morphologic evidence of a cervical intraepithelial neoplasia (four with mild or moderate dysplasia and five with in situ cervical carcinoma). Four patients had invasive cervical carcinoma. CONCLUSIONS: The main risk factor for HIV infection in Mexican women with AIDS changed from transfusion acquired to sexually acquired in 1992. As a country, we were successful in providing safe blood but failed to prevent sexual transmission. Our patients had a high frequency of cervical carcinoma and precursor lesions associated with human papilloma virus.