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OBJETIVO: Evaluar el efecto de intervenciones realizadas en la autopista, tanto en la ocurrencia de lesiones por accidentes de tráfico, como en la gravedad de las mismas. MÉTODOS: Se realizó un análisis comparativo de dos estudios transversales realizados en 1994 y 1996 en los que se investigó la ocurrencia de lesiones en los conductores de vehículos a motor que sufrieron accidente en la autopista, Cuernavaca, México. RESULTADOS: Para 1994 la tasa de accidentes fue de 7,96 / 100.000 vehículos y para 1996 fue de 8,49 / 100.000 vehículos, incremento no significativo (p>0,05). Para 1994 la tasa de lesionados fue de 2,10 / 100.000 vehículos y para 1996 de 1,35 / 100.000 vehículos, disminución significativa (p

Os acidentes de trânsito de veículos a motor representam problema de saúde pública, em nível mundial. No México, a pesquisa, nesse campo, é limitada e a metodologia para seu estudo é pouco desenvolvida. Na literatura científica internacional são escassos os artigos que discutem os aspectos metodológicos de pesquisa nesse campo. Assim, realizou-se estudo com o objetivo de apresentar alguns aspectos metodológicos úteis para os interessados em pesquisar lesões por acidentes de trânsito. Foram discutidos aspectos sobre como medir, no local de ocorrência, as variáveis básicas para o estudo dessas lesões, tais como: se o motorista sofreu ou não lesões, uso de cinto de segurança, velocidade e consumo de álcool.

El problema de la violencia se ha analizado a través de distintos enfoques caracterizados todos por la fragmentación, pues cada disciplina ha impreso su punto de vista, de acuerdo con propósitos particulares sin que se hayan integrado los avances alcanzados en cada una. Las tres grandes vertientes a través de las cuales se ha hecho un intento por aproximarse al fenómeno son las ciencias sociales, las penales y, recientemente, la salud pública. En este trabajo se discuten, de manera general, las perspectivas teóricas que plantea cada una de esas vertientes y se destaca el impacto que sobre la salud tiene este problema, mediante la revisión de trabajos realizados en México sobre mortalidad y morbilidad debida a hechos violentos.

El presente artículo tiene que ver con el estudiode adivinanzas y canciones populares que poseenpotencial didáctico en Educación Infantil. Es muyimportante en la formación de maestras y maestrosposeer un conocimiento del género poético y noperder aquellos aspectos culturales que han sidotransmitidos a través de los años por las distintasgeneraciones. En un original estudio Cook (2007) indicaque las adivinanzas desvelan grandes misteriosa partir de cosas muy pequeñas. Ella indica que elmundo se presenta a sí mismo como una adivinanza.¿Son las adivinanzas un género, una forma, unmodo, un guión maestro? Dicha cuestión ayuda areseñar la importancia de las mismas.Todo el planteamiento estará auspiciado por lasdirectrices que nos otorga el Marco Común Europeode Referencia para las Lenguas. Nuestra intenciónes que la formación lingüística y literaria que recibael alumnado esté contextualizada en un espacioeuropeo y de ese modo el niño o la niña puedandesarrollar sus capacidades de un modo deseable, esdecir que esa tradición lírica popular pueda conectarsea través de las sugerencias didácticas con vocabulariode otras Lenguas, al contacto con sonidosen otros idiomas y demás situaciones positivas parala formación del alumnado.

Introduction: Alzheimer disease (AD) is the most common cause of dementia and is considered one of the main causes of disability and dependence affecting quality of life in elderly people and their families. Current pharmacological treatment includes acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine) and memantine; however, only one-third of patients respond to treatment. Genetic factors have been shown to play a role in this inter-individual variability in drug response., Development: We review pharmacogenetic reports of AD-modifying drugs, the pharmacogenetic biomarkers included, and the phenotypes evaluated. We also discuss relevant methodological considerations for the design of pharmacogenetic studies into AD. A total of 33 pharmacogenetic reports were found; the majority of these focused on the variability in response to and metabolism of donepezil. Most of the patients included were from Caucasian populations, although some studies also include Korean, Indian, and Brazilian patients. CYP2D6 and APOE are the most frequently studied biomarkers. The associations proposed are controversial., Conclusions: Potential pharmacogenetic biomarkers for AD have been identified; however, it is still necessary to conduct further research into other populations and to identify new biomarkers. This information could assist in predicting patient response to these drugs and contribute to better treatment decision-making in a context as complex as aging., (Copyright © 2018 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Cytokine storm syndrome (CTS) is a serious complication of patients with SARS-CoV-2 infection. Treatment and evolution in octogenarians are not well defined. Our objective is to describe its clinical characteristics, the treatments and its clinical evolution., Patients and Method: Retrospective observational study of consecutive patients admitted in the period between March 23 and April 12, 2020 with confirmed SARS-CoV-2 infection, with pneumonia by radiological study or chest tomography, whith STC criteria and who received treatment. We classified patients as those who received only glucocorticoid (GC) pulses, or GC and tocilizumab pulses. We determined serum levels of ferritin, CRP and D-dimers. The final variable was survival., Results: 21 patients, (80-88 years). The mean ferritin was 1056 microg/L (317-3,553), CRP 115.8mg/dL (22-306) and D-dimers 2.9m/L (0.45-17.5). All patients received GC pulses and in 2 cases simultaneously tocilizumab. The mean follow-up time was 13.7 days (8-21). The overall mortality was 38.1% (8/21 patients). The 2 patients who received tocilizumab died. The deceased had significantly higher levels of ferritin (1,254 vs. 925microg/L; P=.045) and CRP (197.6 vs. 76mg / dL; P=.007). At the end of the follow-up, a decrease in the biochemical parameters was observed with ferritin of 727microg/L, CRP of 27mg/dl and D-dimers of 1.18mg/L. In 13/21 patients (61.9%), the CTS was controlled without the need to add other treatments., Conclusions: STC mortality from SARS-CoV-2 is high despite treatment. A greater inflammatory response was associated with a higher mortality. Although it seems that the early use of GC pulses could control it, and the use of other treatments such as tocilizumab shouldo be, with the study design and its limitations, this conclusion cannot be stablished., (Copyright © 2020 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.)

There are nanoparticles with remarkable antibacterial characteristics and aptamers able to recognize specific pathogenic bacteria with high affinity and specificity. The combination of both systems has been used to design rapid bacterial detection methods with excellent detection limits. Likewise, the synergism between aptamers and nanoparticles have allowed to optimize the antimicrobial activity of antibiotics and other nanostructures providing them with activity bacterium-specific, turning into attractive and promising tools to fight against bacteria resistant to multiple antimicrobials., (Copyright © 2019 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)

Background: To calculate the prevalence of excessive daytime sleepiness (EDS) (through the Epworth Sleepiness Scale, ESE) and to identify the personal and working variables predicting the risk of EDS., Methods: Cross-sectional study performed on 476 civil servants from Murcia (October 2013 - February 2016). Prevalence of EDS and bad sleep hygiene (LSH) were determined from scores on the Epworth Sleepiness Scale and Sleep Hygiene Scale (SHS), respectively, and their association with different variables was obtained from a self-administered questionnaire. Independent predictors of EDS were identified by multivariate logistic regression., Results: EDS was less prevalent (16.7%) than LSH (23.4%). Women scored higher in ESE (7.5 vs 6.3; p=0,001) and suffered twice the EDS of men (23.0 vs 10.7%, p<0.001). Workers with EDS scored higher on SHS (34.3 vs 32.7; p=0.044) and had LSH more frequently (38.7 vs 24.9%, p=0.014). Smokers were predominantly women (57.0%; p=0.087) with LSH (50.0 vs 25.8 and 18.9% amongst ex-smokers and non-smokers, p<0.001). Being a woman OR=2.5, 95%IC: 1.4-4.3; p<0.001) and having bad sleep hygiene (OR=1.8 95%IC: 1.0-3.2, p=0.032) were predictive factors irrespective of suffering from EDS., Conclusions: EDS was present in civil servants in the region of Murcia, and was higher in women than men. Excessive daytime sleepiness is strongly associated with bad sleep hygiene and became a woman.

Introduction: Adverse drug reactions (ADRs) are a major public health concern and a leading cause of morbidity and mortality in the world. In the case of antiepileptic drugs (AEDs), ADRs constitute a barrier to successful treatment since they decrease treatment adherence and impact patients' quality of life of patients. Pharmacogenetics aims to identify genetic polymorphisms associated with drug safety. This article presents a review of genes coding for drug metabolising enzymes and drug transporters, and HLA system genes that have been linked to AED-induced ADRs., Development: To date, several genetic variations associated with drug safety have been reported: CYP2C9*2 and *3 alleles, which code for enzymes with decreased activity, have been linked to phenytoin (PHT)-induced neurotoxicity; GSTM1 null alleles with hepatotoxicity induced by carbamazepine (CBZ) and valproic acid (VPA); EPHX1 polymorphisms with teratogenesis; ABCC2 genetic variations with CBZ- and VPA-induced neurological ADRs; and HLA alleles (e.g. HLA-B*15:02, -A*31:01, -B*15:11, -C*08:01) with cutaneous ADRs., Conclusions: Published findings show that there are ADRs with a pharmacogenetic basis and a high interethnic variability, which indicates a need for future studies in different populations to gather more useful results for larger number of patients. The search for biomarkers that would allow predicting ADRs to AEDs could improve pharmacotherapy for epilepsy., (Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To analyse the levels of engagement, resilience and empathy, and the relationship between them, in a sample of nursing assistants working in different private institutions in Huelva., Method: A transversal, descriptive study. The sample comprised 128 nursing assistants working in private health centres of Huelva. They were given the following instruments: resilience scale Wagnild and Young, Interpersonal Reactivity Index and Utrech Work Engagement Scale., Conclusions: There is a relationship between the cognitive and emotional components of engagement and empathy. Certain sociodemographic variables associated with the organisation of work and working conditions are associated with level of engagement., (Copyright © 2017 Elsevier España, S.L.U. All rights reserved.)

Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms. Dementia is a frequent complication of idiopathic Parkinsonism or PD, usually occurring later in the protracted course of the illness. Some risk factors to develop dementia in PD are aging, severe Parkinson´s symptoms, rigid-akinetic form, hallucinations, and mild cognitive impairment documented at the first examinations. It is not yet clear if some genetic factors are either risk or protector for progression to dementia. In a review of the literature, we found that mutations in the alpha-synuclein gene are the most responsible for developing dementia, either from PARK1 or 4 mutations. GBA (glucocerebrosidase) is another accountable factor. However, the vast majority of patients suffer from non-Mendelian or complex forms of PD, which are likely caused by the combined effects of genetic and environmental factors. There is not until now a clear relation between some polymorphisms in candidate genes and cognitive deterioration, as many studies have not clearly identified this phenotype.

Objective: To determine diet and nutrition practices and the economic and social situation in homes with premature infants., Material and Methods: A descriptive cross-sectional study of 100 preterm infants 30 to 36 weeks gestational age, using data obtained on weight, length and head circumference at birth, and whether they were from rural or urban communities. The mothers of premature infants were given a questionnaire to find out the diet and nutrition status, and the economic and social situation in the families. The preterm infants were recruited from Maternal and Child Hospital of Leon, Guanajuato., Results: The mean gestational age was 34 weeks (26 to 36). The mean weight, length, and head circumference at birth were: 2,007 g (659 to 3,750 g), 43.7 cm (30 to 52 cm) and 32.4 cm (28 to 35.5 cm), respectively. Almost all mothers (98%) wished to breastfeed. More than a quarter (26%) of mothers consumed soda drinks twice a week, and preferred processed food instead of preparing it at home. Fresh fruit was consumed on seven, four, and three days per week by 43%, 13%, and 21% of mothers, respectively. These amounts were similar for vegetables, legumes and cereals. Almost all (91%) referred to consuming tortillas every day. The average monthly income was 1,000 to 4,000 pesos (62.5-250 €) in most cases. Drinking water and electricity services were scarce., Conclusions: Most patients did not have drinking water or electricity services, as well as being on a low income. Diets were inadequate both in quality and type of food. The accessibility to foods was limited. These situations will have an impact on the growth and development of preterm infants., (Copyright © 2011 Asociación Española de Pediatría. Published by Elsevier España. All rights reserved.)

Objective: To determine the incidence of paresthesia during lumbar puncture performed with the patient in different positions., Material and Methods: A single-blind prospective study of patients scheduled for elective cesarean section, randomized to 3 groups. In group 1 patients were seated in the direction of the long axis of the table, with heels resting on the table. In group 2 they were seated perpendicular to the long axis of the table, with legs hanging from the table. In group 3 they were in left lateral decubitus position. Lumbar punctures were performed with a 27-gauge Whitacre needle., Results: One hundred sixty-eight patients (56 per group) were enrolled. Paresthesia occurred most often in group 3 (P = .009). We observed no differences in blood pressure after patients moved from decubitus position to the assigned position. Nor did we observe between-group differences in blood pressure according to position taken during puncture., Conclusion: Puncture undertaken with the patient seated, heels on the table and knees slightly bent, is associated with a lower incidence of paresthesia than puncture performed with the patient seated, legs hanging from the table. Placing the patient's heels on the table requires hip flexion and leads to anterior displacement of nerve roots in the dural sac. Such displacement would increase the nerve-free zone on the posterior side of the sac, thereby decreasing the likelihood of paresthesia during lumbar puncture. A left lateral decubitus position would increase the likelihood of paresthesia, possibly because the anesthetist may inadvertently not follow the medial line when inserting the needle.

Aim: Different patients exhibit wide variability in the way they respond to medications. Individual differences in drug response can result from environmental factors, as well as genetic determinants. In particular, inherited differences in the metabolism and disposition of drugs can have a great influence on the efficacy and toxicity of medications, so herein we focus on the pharmacogenetics of drug metabolism., Development: Clinical observations of inherited differences in drug effects were first documented in the 1950s, giving rise to the field of pharmacogenetics. These observations were then followed by population studies of drug disposition phenotype, then biochemical, and eventually molecular elucidation of the genetic defect associated with the inherited trait. Genetic polymorphisms have been described for many phase I and phase II drug-metabolizing enzymes including several cytochromes P450, N-acetyltransferases, and thiopurine S-methyltransferase. Rapid advances in human genomics gave birth to pharmacogenomics, an emerging discipline that uses genome-wide approaches to study the entire spectrum of genes involved in drug response. High-through-put genomic technologies will serve as the foundation of personalized therapies., Conclusions: Knowledge of an individual's genetic variability in drug response may be clinically and economically important and could provide the basis for a rational approach to drug prescription in neuropsychiatric disorders.

We report the cases of 2 women with epilepsy who suffered generalized postpartum seizures on the first day after giving birth. The first had a history of febrile convulsions in childhood and had a seizure in the 36th week of gestation due to sleep deprivation. She had received epidural analgesia for labor pain. The second patient had had her most recent crisis at the beginning of the third trimester of pregnancy. Both patients had low serum levels of antiepileptic drugs. The pharmacokinetics of antiepileptic drugs can change during pregnancy, making seizures more difficult to control. Serum levels of these drugs should therefore be monitored more often, given that a generalized maternal seizure can have devastating consequences for the fetus. More careful planning and management of pregnancy is necessary for epileptic patients to ensure successful outcomes for both mother and fetus.

We describe the case of a woman with a functioning orthotopic liver transplant who was receiving cyclosporine treatment. An emergency cesarean section was performed, with epidural analgesia, for prolonged pregnancy and an unfavorable cervix. No complications were recorded either during or after surgery. She gave birth to a healthy boy and both were discharged on the fifth day after delivery. Organ transplantation is an increasingly common procedure, and Spain, which has a large number of organ donors, is the country where the largest number of transplants in Europe is performed. Immunosuppressive therapy has advanced greatly, allowing patients to survive longer and enjoy good quality of life. Many transplanted women in their childbearing years consider pregnancy, which can lead to medical problems, a worsened clinical picture or complications related to pregnancy, putting the lives of both mother and fetus at risk. Perioperative management by an anesthesiologist is necessary, whether delivery is vaginal or cesarean. Whenever immunosuppressive therapy is involved, the use of general or regional anesthetics carries risk, as do pregnancy and delivery themselves.

Introduction: Zolpidem is derived from imidazopiridine. In recent years it has been used as a non benzodiazepine hypnotic. It is a short acting inducer of sleep of similar efficacy to the benzodiazepines or zopiclone, but well tolerated and does not lead to drug abuse, rebound effects or abstinence syndromes. In this clinical note we wish to show that in spite of the descriptions in the medical literature, complications may follow long term use of zolpidem., Clinical Case: We report the case of a 50 year old woman with no clinical history of interest apart from chronic insomnia and anxiety. She had been treated with zolpidem for the previous five years, at the usual dosage. However, since this seemed to be insufficient, the dose was progressively increased until in the months before she was seen by us she was taking a total of 450 mg per day in divided doses. She had drug tolerance, abuse and dependence. After a period of 12 hours without taking zolpidem she developed an abstinence syndrome, with generalized tonic clonic seizures and a prolonged post convulsion period which improved on symptomatic anticonvulsant treatment., Conclusions: In view of our case, and others described, we should be sceptical of the claim that zolpidem has no side effects, since it may give rise to tolerance, abuse and an abstinence syndrome. We consider that its indiscriminate use should be modified. Patients should be carefully followed up and medical prescription necessary to obtain zolpidem, as opposed to its current unrestricted availability.

Objective: To know the proportion of people older than 74, who are not institutionalized and not immobilized with cognitive alteration and to analyze if there is any association with social demographic characteristics and health factors., Design: Cross-sectional descriptive study, made by interview., Location: In an urban environment: Getafe, Parla, Pinto and rural environment: Griñón., Participants: The study population included all the people older than 74, that was registered in data base of individual health card, INSALUD. The sample, consisted by 704 elderly, who compliment including criterion, accuracy +/- 3.4%, p < 0.05 It's evaluated 615 persons., Measurements and Main Results: It's made by questionnaire that included social demographic variables, information about the necessity of help for basic activities in daily life (ADLs), perceived health status, illness, sensorial alterations, falls, stay in hospital, social support, rotation, architectonics obstacles. For evaluating the likely cognitive deterioration, it was used the Short Potable Mental Questionnaire (SPSMQ) with 2 cutting points: 2-4 errors and > 4 errors. The proportion of elderly people with cognitive deterioration (SPSMQ > 2) was 19% (95% CI, 16.2-22.4). This proportion grew with age, the same as men as in women (p < 0.0001), 11% (95% CI, 8-15) in < 80 years, 29% (95% CI, 23.8-34.8) in > 79 years. It's proved a significant statistically association between cognitive deficit (SPSMQ > 4), in age > 84 years OR = 4.1 (95% CI, 1.7-9.7), dependence degree for ADLs OR = 4.4 (95% CI, 2.2-8.8), and low cultural level, OR = 6.2 (95% CI, 2-18)., Conclusion: The prevalence of cognitive deficit in elderly population who lives in community environment, it's associated with the degree of functional damage, advanced age and the absence of studies, without any difference between urban and rural environment.

Objective: To evaluate the effect of interventions at a highway, in the occurrence and severity of injuries by traffic accidents., Method: It was made a comparative analysis of two cross-sectional studies in 1994 and 1996., Results: In 1994 the rate was 7.96 accidents/ 100,000 vehicles and in 1996 8.49 / 100,000 vehicles. The increase was not significant (p>0.05). The rate of injured drivers in 1994 was of 2.10 / 100,000 vehicles and of 1.35 / 100,000 vehicles in 1996, which was a significant decrease (p<0.000). The self-report of use of seat belt (63.46% versus 76.6%), the small vehicles involved in accidents (7.9% versus 37.7%), nocturnal schedule (23.7% versus 31.8%) and in Mexico-Cuernavaca direction (45% versus 66.7%), were more frequent in 1996 (p<0.05). The risk of injury, using a logistic regression model, between drivers exposed to the interventions (1996) and those that were not exposed (1994) adjusted by: age, speed, use of seat belt, alcohol intake and external cause, showed a protective effect of the interventions at the highway (OR 0.42 CI95% 0.27-0.66)., Conclusion: There is an evident need of multisectorial approaches in the study and evaluation of the interventions in the field of the traffic accidents. The present research is a clear example of the repercussions over health of interventions developed by the transportation sector at the highway.

Objective: To analyze the incidence of pathoanatomical lesions seen in systematic prostate biopsies and to evaluate their influence on PSA serum levels., Material and Methods: 495 consecutive prostate biopsies, indicated by a suspicion digital rectal examination in 194 patients (39.2%) and raised serum PSA in 301 (60.8%), were evaluated. Biopsy was performed by sextant and hypoechoic nodes, and PSA serum measurements by dual monoclonal antibody radioimmunoassay, Tandem PSA., Results: Cancer was diagnosed in 42.6% biopsies and BPH in 67.4%; additionally, other associated lesions were detected in 74.6% cases, the most frequent ones being chronic prostatitis (47.3%), glandular atrophy (35.9%) and acute prostatitis (23%). All lesions were significantly related to the primary BPH diagnosis in 74.2% to 85% cases. High grade PIN (14.1%) was related to primary cancer diagnosis in 87.1% cases. The multivariate analysis showed that the main diagnosis (BPH vs cancer) was the only variable that had a significant influence on PSA serum levels. When BPH patients were considered separately, the only variable with significant influence on PSA serum levels was the prostatic volume. The univariate analysis showed a nonsignificant increase in association with acute prostatitis and high grade PIN, and a decrease in association with chronic prostatitis., Conclusions: BPH or cancer associated damage is very frequent in prostatic biopsies. However, the only factors showing a significant contribution to PSA serum levels appear to be the presence or absence of cancer, or the prostatic volume when the main diagnosis is BPH.

The discordance between the chromosomic and the gonadal-phenotypic sex is known as sex reversal (XX males and XY females). We review the XY pure gonadal dysgenesis characterized by female phenotype, primary amenorrhea and absence of secondary sexual development. Bilateral streak gonads are always present in the complete form of this syndrome, while variable degrees of virilization are found in the partial forms, depending on the severity of the testicular damage. A plausible explanation for this pathology are SRY mutations that interfere with the testicular differentiation. However, only 10-15% of the patients with the complete form show SRY mutations, particularly in the HMG box. The remaining cases are probably due to mutations in different autosomal or X-linked genes which are also involved in the sex differentiation cascade. Recently, it has been shown that mutations in several genes responsible of well known genetic entities as WT1, SOX9, DSS and SF1, result in sex reversal. These findings reveal the genetic heterogeneity and clinical variability of XY sex reversal and provide the basis establishing a hierarchy of genes and their participation in the sex determination pathway.

Our understanding of violence gains from perspectives contributed by several different disciplines. The differences among goals and points of view are often reflected in their vocabularies and interfere in to integrate the advances by each of them. Three big disciplines have studied violence, those are: Social Sciences, Criminal Justice and most recently Public Health. This paper discusses the theoretical perspectives by discipline and try to dimensionate the violence problem measured by mortality and morbidity by intentional injuries in México.

Traffic accidents are a well-known public health problem worldwide. In Mexico research into risk factors for motor involving vehicles accidents and their consequences has recently been taken into account. The relevant literature does not normally describe the methodological aspects involved in the collection of primary data, since most studies have used secondary data the good quality and validity of which are assumed. The paper presented seeks to discuss and share with researchers in this field, some of the methodological aspects to be considered in the attempt to recreate the scene of the accident and obtain information approximating to reality. The measurements in situ of, such traffic accident variables as injury, use of seat belt, speed and alcohol intake are discussed.

In humans, the first stage of sex differentiation is determined by the sex chromosomal constitution and the genes required in the pathway leading gonadal organogenesis. The interaction of SRY, ZFY and several autosomic and X-linked genes in this process is analyzed. It has been suggested that sex-differences are present immediately after fertilization. Sex differentiation depends on a cascade of complex molecular and morphological events that occur at the appropriate time and in the correct sequence during ontogeny.

Objective: To analyze the association between the severity of car accident injuries and the use of safety belts., Material and Methods: The unit of observation and analysis was car drivers in the Mexico-Cuernavaca toll highway. Variables included were those of car drivers, the vehicles and the physical environment at the accident site. Statistical analysis was carried out by means of chi square, odds ratios, 95% confidence intervals and logistic regression. Data was collected in 422 questionnaires for 324 accident events., Results: There were 177 injured people, including 12 deaths, with rates of 67.5 injuries and 4.58 deaths per 10 000 kilometers driven. Variables associated with not using a safety belt (p < 0.05) were: alcohol drinking, vehicle size, night-time and road section. Risk factors for severe injuries were: not using a safety belt (raw OR 4.9, 95% CI 2.2-10.8, adjusted OR 2.94, 95% CI 1.13-7.66); age < 25 years (OR 3.6, 95% CI 1.0-12.7) and > 54 (OR 6.0, 95% CI 1.4-25.0); alcohol drinking (OR 10.8, 95% CI 3.8-30.4); and night time (OR 2.8, 95% CI 1.4-5.8)., Conclusions: Theses findings suggest the need to formulate interventions aimed at enforcing the use of safety belts and prevention of related factors.

A study was conducted in children under five years old, in order to establish the association between the mother's work and the severity of unintentional injuries. The study was carried out at the emergency room of six pediatric hospitals in Mexico City. Cases were children with major injuries that required hospitalization, intensive care, surgery, or who died as a result of the injury. Controls were children of similar age, with minor injuries resolved at the emergency room. Sample size was 350 cases and 350 controls. Variables were grouped according to: mother's occupation; characteristics of the child, socioeconomic status, child care, and those related with home risk factors. Results showed a protective effect on severity of injuries when the mother worked outside home in comparison to mothers who do not work, (or 0.79, 95%CI 0.57-1.07). No differences were found with respect to sex and age of children. Mother age under 24 years old and low schooling (< 3 years of elementary school) were statistically significant with a risk of major injuries (or 2.30, 95%CI 1.5-3.4). Delay of demand of medical care after 60 minutes of injury occurrence is related with a risk of major injury (or 1.68, 95% CI 1.2-2.3). No differences related with household risk factors were found. Results provide valuable information about risk factors related with injury severity and the association with mother's work.

Introduction: The main objective was to determine the risk factors involved in unintentional injuries in children under 10 years old occurring at home., Material and Methods: A Case Control study was conducted in the emergency room of three pediatrics hospitals in Mexico City. The sample size was 160 cases and 320 controls., Results: Boys were more affected than girls (OR) 1.7, C.I. (95%) 1.2-2.5. The age group more affected was two-three years old (OR) 1.6, C.I.1.1-2.2. When children play outside home (roof, stairs, patio) the risk was OR 2.48, C.I. 1.63-3.76. If mother is not encharged of children care (OR) 2.9, C.I. 1.8-4.8. The age > 40 years old of the person encharged of children care (OR) 2.2, C.I. 1.4-3.5., Conclusions: The results showed us how necessary is to develop injury prevention programs especially to implement passive measures, with target populations people encharged of children care.

The presence of Y-chromosome material in the genome of phenotypic females has been associated with an increased risk of developing gonadal tumors. To assess whether DNA sequences of the Y-chromosome are present in the genome of individuals with gonadal dysgenesis and clinical features of Turner's syndrome, we have studied three patients with 45, X/46, X, + mar chromosome complement, and two Turner patients with 45, X/46, XY and 45, X karyotypes who served as positive and negative controls, respectively. Molecular detection of Y-DNA sequences was done by DNA-DNA hybridization using the specific probes pY97 and pDP1007 as well as by polimerase chain reaction. The results revealed that the marker chromosome of one of the patients contained DNA sequences from the centromeric region of the Y-chromosome in a manner similar to that found in the 45, X/46, XY patient and in the male control; the gene ZFY was negative in this patient, and was probably lost when the ring chromosome was formed. In contrast, the ring chromosomes of the other two patients did not exhibit the presence of Y-chromosome material. The results were interpreted as demonstrating the Y-chromosome origin of the ring marker in one patient with gonadal dysgenesis, and suggest an X-chromosome origin of the ring markers in the other two patients. These data further underline the relevance of practicing molecular studies in these disorders which may help to determine appropriate therapeutic strategies.

A case-control study was carried out, aimed at identifying and defining the individual, family, household and childcare social support network characteristics, more likely to be associated with the occurrence of accidental home injuries in 0-9 year-old children. This study was carried out in the emergency units of three pediatric hospitals in the Federal District. In this article we report the results of the descriptive analysis only of the cases. The results were as follows: male children (62%) and the one and two year-old children group (37%) were the most affected. Contusions, head injuries and fractures occupied the first three places, the main three causes being falls from one level to another (mainly in stairways and off the bed) falls on the same level (sliding, tripping or stumbling) and burns with boiling liquids (most frequently boiling water for bathing). A history of injuries was documented in only 15% of cases. Thirty nine percent of cases requested medical attention after one hour of the accident; 51% of these were hospitalized. In 25% of cases, the mother worked outside the home, being absent from 6 to 12 hours. Risk factors occurring most frequently were: unprotected electricity inlets (40%); products within reach of children: cleaning products (38%), makeup products (34%), plastic bags (30%) and tools (30%); lack of protection rails for cradles (30%) and for staircases (48%), and free access to roofs (44%). In 62 percent of cases some care was provided in the house of the injured child; twenty six percent counted on a support network, and 3 percent were by themselves. We present some proposals for epidemiologic and health services research, and stress the necessity to implement health education, social security and health services policies to favorably influence the solution of these problems.

This paper is about the possible influence that the use of two different face archs on the transference of the upper model, should have in the later regulation of the semiadjustable articulator Arcon type.