Hypertension Awareness, Treatment, and Control in Mexico: An Opportunistic Medical Student-led Blood Pressure Screening Campaign – A Cross-Sectional Study

Background: Hypertension is still a growing public health problem in Mexico. An estimated 151% increase in the number of individuals with hypertension is expected for 2050 if actions are not taken in the country. The aim of this study is to describe hypertension awareness, treatment, control and its associated factors in participants of an opportunistic medical student-led blood pressure screening campaign in Mexico. Methods: A cross-sectional study, using convenience sampling was performed, including participants aged 18 years and older from 15 Mexican states. Each participant completed a questionnaire about risk factors and had three BP measurements taken. Hypertension was defined as ?140/90 mmHg. Multiple imputation with linear regression was performed where data was missing. Results: From a population of 2 545 participants, 623 (24.5%) participants had hypertension. Of those with hypertension, 81.9% had a previous diagnosis of hypertension and only 16.1% were not on medication at the time of screening; 61% were controlled, 121% were uncontrolled patients and 18% were not aware they had hypertension. High marginalization was found to have the biggest proportion of uncontrolled cases (33%), while the number of unaware hypertensives in very low marginalization states doubled the national figure. More than half the participants taking antihypertensive agents were on a single medication, achieving control in almost 8 in 10 patients. Conclusion: It is important to continue making and supporting awareness raising campaigns in different settings across the country to generate more evidence and lead to better programs for improving hypertension detection in Mexico

SARS-CoV-2 Infection Among Healthcare Workers in Tijuana, Mexico: A Cross-Sectional Study

Background: Healthcare workers (HCW) are a high-risk group for contraction of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The aim of this study was to estimate the effect size of being a HCW and acquiring coronavirus disease 2019 (COVID-19) at the Mexican Institute of Social Security (IMSS) in Tijuana, Mexico. Methods: A cross-sectional study of the Epidemiologic Surveillance Online Notification System database was conducted, including entries from Tijuana City between March 11, 2020 to May 1, 2020. Multiple imputation was performed for SARS-CoV-2 RT-PCR result where data was missing. Prevalence odds ratios (POR) were calculated to estimate the effect size of HCWs contracting COVID-19 compared to the general population (GP). Results: From a total of 10,216 entries, 6,256 patients were included for analysis. HCW status was significantly associated with higher odds of acquiring COVID-19, (POR=1.730, 95% Confidence Interval [95%CI]=1.459;2.050). Nurses had double odds (POR=2.339, 95%CI=1.804;3.032) than the GP. Physicians had a POR=1.828 (95%CI=0.766;1.380). Resident physician status was double the likelihood of the GP (POR=2.166, 95%CI=0.933;5.025). Meanwhile, being an intern had a protective factor (POR=0.253, 95%CI=0.085;0.758). Among medical specialties, emergency medicine had the highest exposure-effect association, followed by anesthesiologists. Conclusion: HCW had up to 73% increased odds of acquiring COVID-19 than the GP in Tijuana, Mexico. Nurses were the group with the highest likelihood out of all HCW, as a result of prolonged and close contact with patients. Emergency medicine and anesthesiology were the medical specialties with the highest odds of infection because they frequently perform aerosol-generating procedures

Bile duct injury in an anatomical variant of the posterior right hepatic duct draining in the cystic duct: case report

During laparoscopic cholecystectomy, several factors increase the likelihood of bile duct injury (BDI). The most common cause of BDI during laparoscopic cholecystectomy is an inappropriate identification of the critical view of safety associated with acute and chronic inflammation, obesity, haemorrhage, and anatomical variants. Of all anatomic variants of the biliary tree, Blumgart type F has been reported as the least common, but allegedly it carries the biggest risk of BDI. We present the case of a 45-year-old woman with acute cholecystitis subjected to laparoscopic cholecystectomy with Strasberg type C injury in association with a Blumgart F variation confirmed by magnetic resonance cholangiopancreatography. The anatomical variant was identified during the surgical procedure but the BDI was diagnosed postoperatively. Intraoperative identification and treatment of the injury confers a better prognosis to the patient. Management of a BDI on a Blumgart F variant can be challenging and must be targeted to the individual case. Safety measures to prevent such injuries must be promoted by institutions