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Title: Achievement of therapeutic targets in Mexican patients with diabetes mellitus
Author: Mercado-Martinez, F.
Diaz-Medina, B.
Hernandez-Ibarra, E.
Issue Date: 2013
Abstract: Context-Donation coordinators play an important role in the success or failure of organ donation and transplant programs. Nevertheless, these professionals' perspectives and practices have hardly been explored, particularly in low-and middle-income countries.Objective-To examine donation coordinators' discourse on the organ donation process and the barriers they perceive.Design-A critical qualitative study was carried out in Guadalajara, Mexico.Setting and Participants-Twelve donation coordinators from public and private hospitals participated.Data Gathering and Analysis-Data were gathered by using semistructured interviews and critical discourse analysis.Results- Participants indicated that partial results have been achieved in deceased organ donation. Concomitantly, multiple obstacles have adversely affected the process and outcomes: at the structural level, the fragmentation of the health system and the scarcity of financial and material resources; at the relational level, nonegalitarian relationships between coordinators and hospital personnel; at the ideational level, the transplant domain and its specialists overshadow the donation domain and its coordinators. Negative images are associated with donation coordinators.Conclusions-Organ donation faces structural, relational, and ideational barriers; hence, complex interventions should be undertaken. Donation coordinators also should be recognized by the health system. " 2013 NATCO.",,,,,,"10.7182/pit2013410",,,"","",,,,,,"3",,"Progress in Transplantation",,"258
MEDLINE",,,,,,"Nursing Journal;Attitude of Health Personnel;Humans;Interviews as Topic;Mexico;Tissue Donors/sd [Supply & Distribution];Tissue and Organ Procurement",,,,,,"Achievements and barriers in the organ donation process: A critical analysis of donation coordinators' discourse",,"Article" "40976","123456789/35008",,"Sánchez-Corona, J., División de Genética, Unidad de Inv. Biomédica, CMO, IMSS, Guadalajara, Jalisco, México.; Mora-García, H.A., División de Genética, Unidad de Inv. Biomédica, CMO, IMSS, Guadalajara, Jalisco, México.; Contreras-Sánchez, O., División de Genética, Unidad de Inv. Biomédica, CMO, IMSS, Guadalajara, Jalisco, México.",,"Sanchez-Corona, J.
Mora-García, H.A.
Contreras-Sanchez, O.",,"1990",,"Oligosaccharides were isolated by thin layer chromatography from the urine of a patient diagnosed upon clinical and laboratory characteristics as glycogenosis Ia. The oligosaccharides were hydrolyzed with H2SO2 0.5 M at 100 degrees C. The hydrolysis was interrupted at 5, 10 and 20 minutes by the neutralization of the pH at standard temperature. Chromatography of the product of hydrolysis was performed and alpha 1-4 bonds were identified with the addition of ADP developer. The final product of the whole hydrolysis of all the oligosaccharides was glucose.",,,,,,,,,"","",,,,,,"4",,"Archivos de Investigacion Medica",,"349
351",,"21",,"Scopus",,,,,,,,,,,,"Acid hydrolysis of urinary oligosaccharides in type I glycogenosis [Hidrólisis ácida de oligosacáridos urinarios en glucogenosis tipo I.]",,"Article" "40971","123456789/35008",,"Lavalle-González, F.J., Department of Endocrinology, Hospital Universitario Dr. José Eleuterio González, Monterrey, NL, Mexico; Chiquete, E., Instituto Nacional de Ciencias Médicas y de la Nutrición Salvador Zubirán, Mexico; de la Luz, J., Medical Research Area, Sanofi-Aventis, Mexico City, Mexico; Ochoa-Guzmán, A., Instituto Nacional de Ciencias Médicas y de la Nutrición Salvador Zubirán, Mexico; Sánchez-Orozco, L.V., Department of Molecular Biology and Genomics, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Mexico; Godínez-Gutiérrez, S.A., Division of Internal Medicine, Department of Endocrinology, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico",,"Lavalle-Gonzalez, F.J.
Chiquete, E.
de la Luz, J.
Ochoa-Guzman, A.
Sanchez-Orozco, L.V.
Godinez-gutierrez, S.A.",,"2012",,"Background and aim: Complications of diabetes comprise the leading cause of death in Mexico. We aimed to describe the characteristics of management and achievement of therapeutic targets in Mexican patients with diabetes mellitus. Methods: We analyzed data from 2642 Mexican patients with type 1 (T1D, n=203, 7.7%) and type 2 diabetes (T2D, n=2439, 92.3%) included in the third wave of the International Diabetes Management Practices Study. Results: Of T2D patients, 63% were on oral glucose-lowering drugs (OGLD) exclusively (mostly metformin), 11% on insulin, 22% on OGLD plus insulin, and 4% on diet and exercise exclusively. T2D patients on insulin were more likely to be trained on diabetes, but they were older, had worse control, longer disease duration and more chronic complications than patients on OGLD only. Glycated hemoglobin (HbA1c) < 7% was achieved by 21% and 37% of T1D and T2D patients, respectively. Only 5% of T1D and 3% of T2D attained the composite target of HbA1c < 7%, blood pressure < 130/80. mmHg and low-density lipoprotein cholesterol < 100. mg/dl. T1D patients had less macrovascular but more microvascular complications, compared with T2D patients. Late complications increased with disease duration, so that about 80% of patients after 20 years of diagnosis have at least one late complication. Reaching the target HbA1c < 7% was associated with a reduced number of microvascular but not with less macrovascular complications. Conclusion: A great proportion of these Mexican patients with diabetes did not reach therapeutic targets. Insulin was used mostly in complicated cases with advanced disease. " 2011 SEEN.
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