Reported are the results of an analysis of mortality trends from diarrhoeal diseases among under-5-year-olds in Mexico between 1978 and 1993 in relation to the impact of education, basic sanitation, and selected medical care practices. The study period was divided into three stages; the first pre-dated the widespread application of oral rehydration therapy (ORT); the second, covered the implementation of a nationwide programme promoting ORT; and the third included additional measures, such as immunization and improvements in basic sanitation. Mortality rates decreased progressively, at an average of 1.8% per year in the first stage, 6.4% in the second, and 17.8% in the third. The importance of literacy campaigns for women and the promotion of ORT was confirmed. Both of these measures reduced mortality; however, a greater reduction resulted from a massive immunization campaign against measles and improvements in sanitation (expansion of the drainage and piped water systems, improved water chlorination procedure, and effective prohibition of the use of sanitary sewage for vegetable irrigation).
Introduction Geriatric emergency department visits are most often for acute abdominal pain. More elderly patients with acute abdominal pain visit the ER as the elderly population grows. However, emergency physicians face more challenges. Elderly abdominal pain symptoms vary. However, disease manifestations, cognitive issues, and communication issues may delay diagnosis in elderly patients, increasing mortality. Indeed, early and accurate acute abdomen diagnosis in elderly patients greatly affects their outcomes.
Compartment syndrome is a critical condition characterized by elevated pressures within constricted myofascial compartments, leading to vascular compromise, hypoxia, and potential irreversible injury. While commonly affecting the forearm and lower leg, compartment syndrome of the hand is rare and poses unique diagnostic and therapeutic challenges. The pathophysiology involves increased intracompartmental pressure from various etiologies, such as trauma, edema, or external compression, culminating in a cycle of ischemia and worsening edema. Rhabdomyolysis, defined by rapid muscle tissue degradation and release of intracellular components into the bloodstream, is intricately linked to compartment syndrome, with each condition potentially exacerbating the other. Elevated serum creatine kinase and myoglobin levels are hallmark diagnostic markers of rhabdomyolysis. Hand compartment syndrome, despite its rarity, necessitates prompt identification and surgical intervention. The hand's complex anatomical structure comprises ten compartments, each at risk for ischemic injury under increased pressure. Clinically, hand compartment syndrome manifests as severe pain disproportionate to injury, edema, and abnormal posturing. Diagnosis relies on clinical suspicion, supported by intracompartmental pressure monitoring. Emergent fasciotomy remains the definitive treatment, requiring multiple incisions to decompress affected compartments. Magnetic resonance imaging (MRI) is valuable for assessing tissue damage and guiding management strategies. This review underscores the importance of early recognition and timely intervention in compartment syndrome and highlights the interdependent relationship between compartment syndrome and rhabdomyolysis.
To study the urban and rural variations of medical care for acute diarrhea among children under five years old.Data from the 1993 Effective Household Treatment National Survey were analyzed. A number of 338 children from urban areas and 300 from rural areas were included in the study. Variables included were: household treatment, health-seeking behavior, mothers' previous training to manage acute diarrhea, use of oral rehydration salts (ORS) and availability of and access to health care.Oral rehydration therapy (ORT) as part of the household treatment and feeding the regular diet were more frequently found in rural areas. Less than 50% of children received medical care in both settings. In urban areas most children were cared for by private physicians. About 30% of children needed medical care but they were not taken to medical facilities. Physicians in rural areas prescribed ORS more frequently, while those from urban areas prescribed medication and restrictive diets in a greater proportion. Physicians working in public facilities prescribed ORT in greater proportions than private ones. Mothers from rural areas had received more training to manage diarrhea but they had restricted access to medical care in comparison to mothers from urban areas.It is necessary to improve health care education of urban populations, to increase access and coverage of health services in rural areas and to strength activities to improve the quality of medical care provided by private physicians and by those working in urban areas.
'%3e%3cpath fill='%23001489' d='M0 0v6h9V0z'/%3e%3cpath fill='%23e03c31' d='M0 0v3h9V0z'/%3e%3cg stroke='%23fff' stroke-width='2'%3e%3cpath id='d' d='m0 0 4.5 3L0 6m4.5-3H9'/%3e%3cuse xlink:href='%23b' stroke='%23ffb81c' clip-path='url(%23c)'/%3e%3c/g%3e%3cuse xlink:href='%23d' fill='none' stroke='%23007749' stroke-width='1.2'/%3e%3c/g%3e%3c/svg%3e)
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)