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Publications (5)0.26 Total impact

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    ABSTRACT: To ascertain the prevalence of gastroesophageal reflux disease (GERD) in elderly people attending to family medicine clinics. the study was conducted by using a prospective design in which participants were randomly selected from a family medicine clinic located in Mexico City. The study was run from August to September 2003, and included patients aged sixty years or older, regardless of gender. They should not have cognitive damage, which was ascertained by the Folstein Mini Mental State Examination. Those patients that did not accept to participate and those having incomplete or illegible medical records were excluded. The socio-demographic characteristics test and Carlsson-Dent test were applied. The information about diagnosis, drugs prescriptions, and pharmacological and no pharmacological gastroesophageal protection was obtained from the medical charts and prescriptions. 400 elderly patients were evaluated by using the Carlsson-Dent test. GERD prevalence was 25% (CI 95% 21-29) the average age of patients with and without GERD was 68 +/- 7 years and 70 +/- 7 years respectively (p = .002). Women suffered GERD more frequently than men (p = 0.001). GERD diagnosis was not found in any of the reviewed medical charts. Antacids, histamine-2 receptor antagonists (H2 As) and prokinetics were prescribed in 39% (CI 95% 34-44) of patients with GERD and in 18% (CI 95% 15-21) without GERD. Elderly patients attending to primary care facilities often have GERD symptoms, but they are not properly diagnosed or followed up. The Carlsson-Dent questionnaire is an alternative to identify GERD patients.
    Revista medica del Instituto Mexicano del Seguro Social 01/2007; 45(5):447-52.
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    ABSTRACT: SUMMARY Objective. Determine prescription characteristics of non-steroidal anti-inflammatory drugs among the elderly attending primary medical care. Material and methods. Setting, Family Health Unit 52, Mexican Institute of Social Security. Design: Prospective, cross-sectional, descriptive, with randomized sampling. Participants: 400 patients; aged 60 and older, male and female, without cognitive impairment. Those without clinical records were excluded. Every patient was interviewed and examined and their clinical record and prescription were assesed. Results. NSAIDs were prescribed in 312 patients (78% 95% CI 74- 82), one type of NSAIDs was prescribed in 188 (60% 95%CI 55-65), two types in 117 (38% 95%CI 33-43) and three types in 7 (2% 95%CI 0.0-4). Of the 443 prescriptions, Acetylsalicylic acid was prescribed in 200 cases (45% 95%CI 40-50) and Naproxen in 100 (23% IC95%19-26). Reasons for prescribing included cardiovascular prophylaxis in 46% (IC95% 7-13) pain management in 40% (95%CI 31-49), anti-inflammatory cases 4%(95%CI 2-6), and non-specified in 10% of cases (95%CI 7-13). Treatment duration was not specified for 253 patients (81% 95%CI 77-85). We noted drug-drug interaction in 228 cases (73% 95%CI 67-77) and a potential drug-disease interaction in 247 (79% 95%CI 77-81). The gastro-esophageal prescription was not more frequent among patients taking NSAIDs compared with non-users OR = 1 (95%CI 0.53-1.75; p=0.89). Conclusions. NSAIDs prescription prevalence is high: although diagnoses do not justify their use and gastro-esophageal protection is often not sufficient. Prostaglandins inhibitors are favored without taking into account drug-disease interaction.
    01/2007;
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    ABSTRACT: Determine prescription characteristics of non-steroidal anti-inflammatory drugs among the elderly attending primary medical care. Setting, Family Health Unit 52, Mexican Institute of Social Security. Prospective, cross-sectional, descriptive, with randomized sampling. 400 patients; aged 60 and older, male and female, without cognitive impairment. Those without clinical records were excluded. Every patient was interviewed and examined and their clinical record and prescription were assesed. NSAIDs were prescribed in 312 patients (78% 95% CI 74-82), one type of NSAIDs was prescribed in 188 (60% 95% CI 55-65), two types in 117 (38% 95% CI 33-43) and three types in 7 (2% 95% CI 0.0-4). Of the 443 prescriptions, Acetylsalicylic acid was prescribed in 200 cases (45% 95% CI 40-50) and Naproxen in 100 (23% IC 95% 19-26). Reasons for prescribing included cardiovascularprophylaxis in 46% (IC 95% 7-13)pain management in 40% (95% CI 31-49), anti-inflammatory cases 4% (95% CI 2-6), and non-specified in 10% of cases (95% CI 7-13). Treatment duration was not specified for 253 patients (81% 95% CI 77-85). We noted drug-drug interaction in 228 cases (73% 95% CI 67-77) and a potential drug-disease interaction in 247 (79% 95% CI 77-81). The gastro-esophageal prescription was not more frequent among patients taking NSAIDs compared with non-users OR = 1 (95% CI 0.53-1.75; p = 0.89). NSAIDs prescription prevalence is high: although diagnoses do not justify their use and gastro-esophageal protection is often not sufficient. Prostaglandins inhibitors are favored without taking into account drug-disease interaction.
    Gaceta medica de Mexico 01/2007; 143(1):5-9. · 0.13 Impact Factor
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    ABSTRACT: Hypertensive disorders in pregnancy (HDP) are the main complication and cause of maternal and perinatal death. Pre-eclampsia represents a 34%, according to the Secretaría de Salud de México. To offer the family physicians tools for the opportune detection and diagnosis of HDP a clinical guideline was developmented. Clinical questions were formulated and structured. A standardized sequence to search for Practice Guidelines, based on the key words: hypertensive disorders in pregnancy, pre-eclampsia. Tripdatabase, MDConsult, National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, National Institute for Health and Clinical Excellence were used. In addition, Cochrane Library Plus, Science Direct and OVID were used. Most of the recommendations were taken from guidelines selected and supplemented with the remaining material. The information is expressed in levels of evidence and grade of recommendation according to the characteristics of the study design and type of publications. To reduce morbidity and mortality from HDP health professionals should identify risk factors; conduct a close monitoring and early diagnosis. It is essential to provide information to the pregnant patient on alarm data and behavior to follow. This clinical practice guide offers current evidence for screening and diagnosis of HDP in primary care.
    Revista medica del Instituto Mexicano del Seguro Social 49(2):213-24.
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    ABSTRACT: Objective: To compare the lifestyle and metabolic control of diabetes patients included and not included in the DiabetIMSS program. Methods: Subjects with diabetes in the DiabetIMSS program and the general clinic were divided into three groups: group 1 first attended the program, group 2 were enrolled during the study, and group 3 had not been included the program. Demographic and clinical aspects were measured and the IMEVID instrument was applied. Results: We included 539 type-2 diabetes patients, predominantly females (73.3%), mainly of primary school level, and more frequently on double-drug therapy. There were clinical differences between the three groups for program leavers in terms of weight, waist, blood pressure, fasting glucose, HbA1c, triglycerides, and IMEVID qualification, all p < 0.05; correlation analysis of the variables with the qualification of IMEVID was significant at p < 0.05. The higher number of variable control targets was for leavers (71% of group); those who were enrolled in the study was 32%, and who had not was 17.2%. Conclusions: There are significant differences in lifestyle and control target parameters in subjects who completed the DiabetIMSS program.
    Gaceta medica de Mexico 150(1):29-34. · 0.13 Impact Factor