Raymundo Rodríguez-Moctezuma

Mexican Institute of Social Security, Ciudad de México, The Federal District, Mexico

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Publications (9)2.59 Total impact

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    ABSTRACT: Objective To evaluate the reliability and validity of the instrument «FANTASTIC», when being applied to a sample of Mexican patients with high blood pressure. Design Observational, prospective, longitudinal, descriptive. Setting Unit of Family Medicine N.° 91 Instituto Mexicano del Seguro Social. Patients 103 patients with hypertension on treatment, adults, non diabetics that knew to read and to write. Interventions Was applied «FANTASTIC» instrument (that consists of 25 closed items on the lifestyle), translated to Spanish in versions of 3 and 5 answers, with an interval test-retest of 14 to 21 days. The average of the systolic arterial tension (SAT), diastolic (DAT) and half arterial tension (HAT) was calculated of the last 3 registrations of the clinical file, mass corporal index (MCI), waist/hip ratio (WHR), and fast glucaemia (FG) was measured. Measurement and results 66% was women. The correlation test-retest, in the version of five answer options was of 0.81 (p = 0.01) and among both versions of 0.91 (p = 0.01). They were not differences in the total qualification according to the sex. To more age, it was bigger qualification and smaller MCI and FG.Weak correlation was observed (not significant) among more total qualification and smaller DAT. There was negative correlation among more qualification in the nutrition domain and smaller MCI (p = 0.01), among more qualification in the domain of tobacco (smaller consumption) with smaller DAT (p = 0.05) and smaller HAT (p = 0.05). Conclusions The consistency of the instrument is very good. Their content doesn't correlate specifically with the control indicators in hypertension.
    Atención Primaria. 07/2013; 26(8):542–549.
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    ABSTRACT: To determine the association between depressive symptoms not identified by the family physician and polypharmacy in patients over 60 years old. A case-control design with non-probabilistic sampling. Inclusion criteria: > or = 60 years old both sexes, without disease or with one disease-balanced illness, and with reliable recording in chart by the last 12 month. Exclusion criteria: cognitive deterioration, obstructive chronic lung disease, cardiopathy, infarct record, alcoholism, smoking addiction and functional dependence's. Elimination criteria: depression's previous diagnoses and hospitalization during a year before the study. The cases were patients who have simultaneously received 4 o more pharmacologic prescriptions in 5 of 6 last medical visits. The controls were patients who have simultaneously received 3 o less pharmacologic prescriptions in 5 of 6 last medical visits. Depressive symptoms: grading > or = 6 (Yesavage and Brink scale). 200 patients per group, aged 69 +/- 6 years agreed to participate. Logistics regression (OR;CI(95%)): hypertension (6.0;3.6-10.3), diabetes mellitus type 2 (3.7;2.3-5.9), depression (2.1;1.2-3.4), and female sex (1.7;1.1-2.7). Hypertension, diabetes mellitus type 2, depressive symptoms not identified by the family physician, and female sex are risk factors for polypharmacy in the elderly.
    Gaceta medica de Mexico 01/2007; 143(4):285-9. · 0.13 Impact Factor
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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: 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: To develop and validate a diagnostic-therapeutic guideline (DTG) for the management of hospitalized diabetic patients, and apply it to a sample of medical files. The DTG was constructed and then validated by a consensus of internist physicians, afterwards it was applied to a sample of 97 randomly selected medical files of diabetic patients discharged from a internal medicine service. Hospitalization time, studies requested, average glycemia, glycemic prior to the discharge, time for to achieve glycemic control and mortality were compared at different percentages of the DTG's application. The results were analyzed by U of Mann-Whitney and ANOVA of Kruskal-Wallis. The intra-class correlation coefficient among the physicians for the guide validation was 0.94, with minimal modifications of content and format. The time, in hours, to achieve glycemic control was minor with a higher application percentage of the complete guide, p < 0.001, and also of the therapeutic domain, p = 0.05. The last glycemic prior to the discharge was lower with a higher application than 75% of the diagnostic domain, p < 0.001. A higher application percentage of the entire guide was found in living subjects more than in deceased subjects, p = 0.001, and also of the therapeutic domain, p = 0.008, and of the diagnostic domain p = 0.05. A higher level of application of the DTG is associated with a shorter time to achieve glycemic control, lower glycemic prior to the discharge and lower mortality.
    Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion 01/2003; 55(6):642-9. · 0.31 Impact Factor
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    ABSTRACT: To evaluate the reliability and validity of the instrument "FANTASTIC", when being applied to a sample of Mexican patients with high blood pressure. Observational, prospective, longitudinal, descriptive. Unit of Family Medicine No. 91 Instituto Mexicano del Seguro Social. 103 patients with hypertension on treatment, adults, non diabetics that knew to read and to write. Was applied "FANTASTIC" instrument (that consists of 25 closed items on the lifestyle), translated to Spanish in versions of 3 and 5 answers, with an interval test-retest of 14 to 21 days. The average of the systolic arterial tension (SAT), diastolic (DAT) and half arterial tension (HAT) was calculated of the last 3 registrations of the clinical file, mass corporal index (MCI), waist/hip ratio (WHR), and fast glucaemia (FG) was measured. 66% was women. The correlation test-retest, in the version of five answer options was of 0.81 (p = 0.01) and among both versions of 0.91 (p = 0.01). They were not differences in the total qualification according to the sex. To more age, it was bigger qualification and smaller MCI and FG. Weak correlation was observed (not significant) among more total qualification and smaller DAT. There was negative correlation among more qualification in the nutrition domain and smaller MCI (p = 0.01), among more qualification in the domain of tobacco (smaller consumption) with smaller DAT (p = 0.05) and smaller HAT (p = 0.05). The consistency of the instrument is very good. Their content doesn't correlate specifically with the control indicators in hypertension.
    Atención Primaria 12/2000; 26(8):542-9. · 0.96 Impact Factor
  • Juan Manuel López-Carmona, Raymundo Rodríguez-Moctezuma
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    ABSTRACT: To adapt and validate the Spanish language version of the Diabetes 39 instrument, which measures quality of life,for Mexican patients with type 2 diabetes mellitus (DM-2). The Spanish language version of the instrument was adapted to make it more comprehensible to Mexican patients. In a cross-sectional survey, the instrument was administered on two different days to 260 patients with type DM-2. Glycated hemoglobin (HbAic), total cholesterol, triglycerides, blood pressure, body mass index and waist/hip ratio were measured. Information about age, sex, time since diagnosis of diabetes, diabetes related complications and comorbidity was obtained. A total of 249 subjects completed the study, 62.7% of which were women. Cronbach's alpha coefficient was > or = 0.80 for the domains and 0.95 for the total score. The test-retest consistency for the total score was r = 0.82, p = 0.01. The median of the total score was 29 (on a scale of 0-100), which was considered the cutoff value for defining "better" (<29) and "worse" > or =29) quality of life.A worse quality of life was associated with diabetes related complications > or =1 (OR = 1.73; IC 95% 1.05-3.06); total cholesterol >240 mg/dL (OR = 4.43; IC 95% 1.23-16.26); comorbidity > or =2 diseases (OR = 2.36; IC 95% 1.31-4.28); diabetes longer than 10 years (OR = 2.19; IC 95% 1.2-3.78), and HbA(IC) >8% (OR = 1.81; IC 95% 1.09-2.99). The last three were identified as predictor variables for worse quality of life by logistic regression (p < 0.05). The adapted Spanish language version of Diabetes 39 is a reliable and valid instrument for measuring the quality of life of Mexican patients with DM-2.
    Salud publica de Mexico 48(3):200-11. · 0.94 Impact Factor
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    ABSTRACT: Metabolic control of patients with diabetes is determined by several factors, among others competence level, performance, and attitudes of primary-care physicians. On objective was to determinate family physician factors associated with glycemic control in subjects with diabetes in two Family Medicine Units (FMU). Cross-sectional comparative study. Two Family Medicine Units of the Mexican Institute Social Security. Family physician demographic factors were measured (age, sex, job seniority, time of university graduation, and had to have studied a specialty residence studied). Two validated instruments were applied to measure attitude level and handling competence of DM 2, and we determined glycemic level in the previous months of five diabetic patients by consulting room. Forty family physicians were evaluated, mean age 43.9 years, 57.5% with a residence in Family Medicine. Better glycemic control was associated with job seniority, OR 2.49 (CI 0.96-6.6), time of university graduation > 10 years with OR 2.11 (CI 1.4-2.9), to have at least one course related with diabetes in the previous year with OR 4.8 (IC 0.39-22), and competence level OR 2.02 (CI 0.36-11.3) There association between better glycemic control and more professional experience and training on diabetes in the previous year.
    Gaceta medica de Mexico 139(2):112-7. · 0.13 Impact Factor