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Hernández-Higareda S, Pérez-Pérez OA, Balderas-Peña LMA, Martínez-Herrera BE, Salcedo-Rocha AL, Ramírez-Conchas RE. [Maternal metabolic diseases related to pre-pregnancy overweight and obesity in mexican women with high risk pregnancy]. CIR CIR 2016; 85:292-298. [PMID: 27955851 DOI: 10.1016/j.circir.2016.10.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 10/07/2016] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Pre-pregnancy obesity has been proposed as a risk factor related to gestational diabetes and hypertensive disorders during pregnancy. OBJECTIVES Identify pregnancy related diseases associated with pre-pregnancy obesity as a risk factor ina high risk preganancy patient population. METHODS 600 patients whose pre-pregnancy obesity had been assessed as a high risk factor were included in the study. The means, standard deviation, median, interquartile intervals, Pearson and Spearman correlation and logistic regression to estimate risk with the odds ratio and 95% confidence intervals were calculated. RESULTS The mean pre-pregnancy body mass index was 29.59 ± 6.42 kg/m2. The mean for recommended pregnancy weight gain was 2.31 ± 1.03 kg, but the mean of real weight gain was 8.91 ± 6.84 kg. A significant correlation between pre-pregnancy obesity and family history of diabetes mellitus (p=0.000), systemic hypertension (p=0.003), cardiac diseases (p=0.000), dyslipidemia (p=0.000) and obesity (p=0.000) was identified. Pre-pregnancy obesity was identified as a risk factor for the development of gestational diabetes (OR: 1.95; IC95%: 1.39 to 2.76; p=0.000) in this kind of patient. DISCUSSION AND CONCLUSION 75% of high risk pregnancy women in a high specialty hospital in West Mexico are overweight or obese when they become pregnant. These are risk factors in the development of gestational diabetes.
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Affiliation(s)
- Salvador Hernández-Higareda
- División de Medicina Perinatal, Unidad Médica de Alta Especialidad (UMAE), Hospital de Gineco-Obstetricia, Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Jalisco, México
| | - Omar-Alejandro Pérez-Pérez
- División de Medicina Perinatal, Unidad Médica de Alta Especialidad (UMAE), Hospital de Gineco-Obstetricia, Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Jalisco, México
| | - Luz-Ma-Adriana Balderas-Peña
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE), Hospital de Especialidades (HE), Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México.
| | - Brenda-Eugenia Martínez-Herrera
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE), Hospital de Especialidades (HE), Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México
| | - Ana-Leticia Salcedo-Rocha
- Unidad de Investigación Social, Epidemiológica y en Servicios de Salud, Delegación Estatal Jalisco, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México
| | - Rosa-Emilia Ramírez-Conchas
- Unidad de Investigación Social, Epidemiológica y en Servicios de Salud, Delegación Estatal Jalisco, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México
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Balderas-Peña LMA, Sat-Muñoz D, Ramírez-Conchas RE, Alvarado-Iñiguez MR, García-de-Alba-García JE, Cruz-Corona E, Chávez-Hurtado JL, Chagollán-Ramírez JM. Descriptive, Longitudinal Study Results Applied to Statistical Models to Assess the Impact of Early Microbiological Cultures on the Economic Burden of Treatment for Infected Diabetic Foot Ulcers at a Mexican Public Health Facility. Ostomy Wound Manage 2016; 62:14-28. [PMID: 28054923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Infection plays a critical role in health care and impacts the cost of the treatment of diabetic foot ulcers (DFU). To examine the cost reduction associated with the multidisciplinary treatment of infected DFU (IDFU) by obtaining early (ie, within 48 hours of admission) microbiological culture results, a descriptive, longitudinal study was conducted. Data were collected prospectively from patient medical charts of a cohort of 67 patients (mean age, 56.14 ± 12.3 years; mean duration of diabetes, 14.95 ± 8 years) with IDFU treated at a Mexican public health facility from January 1 to April 30, 2010. Information included demographic data (age, gender, marital status, time elapsed since first diagnosis of diabetes mellitus type 2 [DM2]), and the following clinical records: Wagner classification, bacterium type, antimicrobial resistance, length of hospital stay, and the antibiotic schedule utilized, as well as number and type of laboratory tests, medications, intravenous therapy, surgical and supportive treatment, type and number of specialists, and clinical outcome. Microcosting was used to calculate the unit cost of each medical treatment element. Using the Monte Carlo and Markov predictive simulation economical models, cost reduction associated with early identification of the specific microorganism through bacterial culture in IDFU was estimated. Based on the statistical results, differences between real and estimated costs when including early microbiological culture were identified and the number and type of most common species of infectious bacteria were detected. The total cost observed in the patient cohort was $502 438.04 USD, mean cost per patient was $7177.69 ± $5043.51 USD, and 72.75% of the total cost was associated with the hospital stay length. The cost of the entire treatment including antibiotics was $359 196.16 USD; based on the simulation of early microbiological culture, the model results showed cost could be reduced by 10% to 25% (in this study, the cost could be as low as $304 624.63 USD). The use of early microbiological cultures on IDFU to determine the appropriate antibiotic can reduce treatment costs by >30% if hospital stay is part of the consideration.
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Affiliation(s)
- Luz-Ma-Adriana Balderas-Peña
- Unidad de Investigación Médica en Epidemiología Clínica (UIMEC) of Unidad Médica de Alta Especialidad Hospital de Especialidades Centro Médico Nacional de Occidente (UMAE HE CMNO), Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Jalisco, México
| | - Daniel Sat-Muñoz
- UMAE HE CMNO, IMSS and Departamento de Morfología, Centro Universitario de Ciencias de la Salud, UdG
| | | | - Moisés-Roberto Alvarado-Iñiguez
- Unidad de Investigación Social, Epidemiológica y en Servicios de Salud, Delegación Jalisco, Instituto Mexicano del Seguro Social
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Balderas-Peña LMA, Sat-Muñoz D, Palomares-Chacon UR, Flores-Larios EA, Ramírez-Conchas RE, Salcedo-Rocha AL, García de Alba-García JE. Health Related Quality of Life and Patient Satisfaction in Colorectal Cancer Patients Treated Through Radical Surgery in Curative Intent in a Colo-Proctology Clinical Department. Value Health 2014; 17:A647-A648. [PMID: 27202326 DOI: 10.1016/j.jval.2014.08.2348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- L M A Balderas-Peña
- UMAE Hospital de Especialidades Centro Médico Nacional de Occidente IMSS, Guadalajara, Jalisco, Mexico
| | - D Sat-Muñoz
- UMAE Hospital de Gineco-Obstetricia Centro Médico Nacional de Occidente IMSS, Guadalajara, Jalisco, Mexico
| | - U R Palomares-Chacon
- UMAE HE Centro Medico Nacional de Occidente Instituto Mexicano del Seguro Social, Guadalajara, Mexico
| | | | - R E Ramírez-Conchas
- UMAE Hospital de Especialidades Centro Médico Nacional de Occidente IMSS, Guadalajara, Jalisco, Mexico
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Balderas-Peña LMA, Sat-Muñoz D, Alvarado-Iñiguez MR, Salcedo-Rocha AL, Ramírez-Conchas RE, Sánchez-Sandoval FH, Macías-López GG, Ruíz-Quezada SL, Chagollán-Ramírez JM, Prieto-Miranda SE, García DAGJE. Impact of Early Microbiologic Culture in the Economic Burden of Care for Patients With Infected Diabetic Foot Ulcers At A Model Of Secondary Level Imss' Hospitals in Mexico. Value Health 2014; 17:A342. [PMID: 27200631 DOI: 10.1016/j.jval.2014.08.681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- L M A Balderas-Peña
- UMAE Hospital de Especialidades Centro Médico Nacional de Occidente IMSS, Guadalajara, Jalisco, Mexico
| | - D Sat-Muñoz
- UMAE Hospital de Gineco-Obstetricia Centro Médico Nacional de Occidente IMSS, Guadalajara, Jalisco, Mexico
| | - M R Alvarado-Iñiguez
- Centro Universitario de Ciencias Económico Administrativas. Universidad de Guadalajara, Zapopan, Jalisco, Mexico
| | | | - R E Ramírez-Conchas
- UMAE Hospital de Especialidades Centro Médico Nacional de Occidente IMSS, Guadalajara, Jalisco, Mexico
| | - F H Sánchez-Sandoval
- Instituto Mexicano del Seguro Social, Hospital General Regional N° 46, Guadalajara,, Mexico
| | - G G Macías-López
- Universidad de Guadalajara, Centro Universitario de Ciencias Exactas e Ingenierias, Guadalajara, Mexico
| | - S L Ruíz-Quezada
- Universidad de Guadalajara, Centro Universitario de Ciencias Exactas e Ingenierias, Guadalajara, Mexico
| | - J M Chagollán-Ramírez
- Centro Universitario de Ciencias Económico Administrativas. Universidad de Guadalajara, Zapopan, Jalisco, Mexico
| | - S E Prieto-Miranda
- Instituto Mexicano del Seguro Social, Hospital General Regional N° 46, Guadalajara,, Mexico
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Solano-Moreno H, Ramirez-Muñoz OR, Balderas-Peña LMA, Flores-Larios EA, Ramírez-Conchas RE, Sat-Muñoz D, Salcedo-Rocha AL, García de Alba-García JE. Health Related Quality of Life and Patient Satisfaction in Prostate Cancer Patients Treated Through Radical Prostatectomy. Value Health 2014; 17:A647. [PMID: 27202330 DOI: 10.1016/j.jval.2014.08.2346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- H Solano-Moreno
- (1)UMAE HE Centro Medico Nacional de Occidente Instituto Mexicano del Seguro Social, Guadalajara, Mexico
| | - O R Ramirez-Muñoz
- (1)UMAE HE Centro Medico Nacional de Occidente Instituto Mexicano del Seguro Social, Guadalajara, Mexico
| | - L M A Balderas-Peña
- (2)UMAE Hospital de Especialidades Centro Médico Nacional de Occidente IMSS, Guadalajara, Jalisco, Mexico
| | | | - R E Ramírez-Conchas
- (2)UMAE Hospital de Especialidades Centro Médico Nacional de Occidente IMSS, Guadalajara, Jalisco, Mexico
| | - D Sat-Muñoz
- (4)UMAE Hospital de Gineco-Obstetricia Centro Médico Nacional de Occidente IMSS, Guadalajara, Jalisco, Mexico
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