Gac Med Mex
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This work was done to determine the mortality and morbidity rates secondary to asthma in Mexico, for age, gender, state of the country and time. Data were obtained from the Instituto Nacional de Estadística. Geografía e Informática. ⋯ From 1960 to the present time, the state with highest mortality is Tlaxcala. The states with highest hospitalization rates were Morelos, Baja California Sur, Nuevo León, Durango and Tamaulipas. In conclusion, mortality rates secondary to asthma in Mexico show a decreasing trend, with a considerable rise in morbidity, especially in the adolescent group.
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Comparative Study
[Primary or of unknown etiology pulmonary hypertension: survival and its determinants].
The main objective of the present study is to characterize mortality in PPH and the factors associated with survival. Our series comprises 61 patients diagnosed of PPH and prospectively followed at the Cardiopulmonary Department between the years of 1977 and 1992. Univariate and multivariate analysis were used to examine relations between survival and selected demographic, medical-history, pulmonary-function, laboratory, and hemodynamic variables. We used the date of initial diagnostic catheterization as an index for determining survival. The method of Kaplan-Meir was used to estimate overall survival distribution. ⋯ the mean age of the group was 22.6 +/- 11 years with a female to male ratio of 3.06:1. Pulmonary hemodynamics at entry were: mean pulmonary artery pressure (PAP) = 65.5 +/- 17.5 mmHg; right atrial pressure (RAP) = 7.5 +/- 5 mmHg; cardiac index (CI) = 3.15 +/- 1.31.mi.m2; pulmonary vascular resistance (RP) = 24 +/- 11 U. The pulmonary to systemic resistance ratio (Rp/Rs) was 0.8 +/- 0.2. The median survival (MS) of the whole group 4.04 years. There was a significant difference in MS between the groups with and without vasodilator treatment (5.04 and 2.12 years respectively), however, the hemodynamic profile at entry was also different, with higher RAP, PAP, PVR, and higher Rp/Rs in the group without treatment (p < 0.05). Factors associated with poor survival (univariate) were: increased RAP, RP, and Rp/Rs and decreased forced vital capacity (FVC), decreased CI, and stroke volume index and decreased mixed venous PO2. The absence of vasodilator treatment was also associated with an increased risk of death. On the multivariate analysis, survival was associated mainly to FVC and to pulmonary hemodynamic variables. We conclude that survival in PPH is related to pulmonary hemodynamic factors at diagnosis.
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Randomized Controlled Trial Comparative Study Clinical Trial
[A comparative study of insulin and glyburide versus glyburide or insulin in the chronic control of patients with type-2 diabetes].
In order to know the usefulness of a combined treatment with gliburide and NPH insulin 25 patients with well controlled type II diabetes mellitus were studied. The patients were randomly divided in to three groups: Group I just received gliburide, Group II only insulin and Group III gliburide and insulin. Glucose in fast, glycosylated haemoglobin and C peptide levels were determined over five months. ⋯ The initial and final glucose determinations were: Group I, 169.3 mg% and 139.0 mg% respectively (p > 0.05); Group II, 202.1 mg% and 177 mg% (p > 0.05); Group III, 157.8 mg% and 158.8 mg% (p > 0.1) for the glycosylated haemoglobin the determinations were: Group I, 7.2% and 5.1% (p > 0.05); Group II, 6.2% and 5.1% (p > 0.05) and Group III, 5.7% and 4.7% (p > 0.05). For the C peptide were 2.5 and 4.5 for Group I (p > 0.05), 2 and 4.1 for Group II (p > 0.05) and 3.2 and 5.3 for Group III (p > 0.05) with no significant statistical differences. It is concluded that the combined treatment showed to be effective, but not superior, in order to control diabetic patients and it can be a useful therapeutic alternative in well selected patients.