MSD (Mexico)

The Bangladesh government took an important step towards preventing cervical cancer by initiating a widespread HPV vaccination campaign directed at girls aged 10 to 14. The campaign aims to reach 10 million girls in three phases. Assessing knowledge about HPV and cervical cancer and willingness to get vaccinated is essential for government success. This study examines Bangladeshi girls' knowledge about human papillomavirus (HPV), cervical cancer, and their willingness to receive the HPV vaccine, providing information needed to improve vaccination strategies and programs. We used a communitybased cross-sectional survey of 416 girls aged 10 to 15 years to assess their knowledge of cervical cancer, vaccination against HPV, and factors influencing their willingness to vaccinate. Parental consent was obtained from all participants before data collection, ensuring ethical compliance for the study. Logistic regression models and descriptive statistics were used to find significant predictors of vaccine uptake. The study's findings highlighted that awareness levels regarding cervical cancer and HPV vaccination were low among Bangladeshi girls. Among participants, only 23% identified HPV as the primary cause of cervical cancer. Overall, 45% of the girls expressed a willingness to receive the HPV vaccine. This willingness was significantly associated with discussions with their mothers (aOR = 6.64, 95% CI: 2.65-22.3, p < 0.001) and living in urban areas (aOR = 0.13, 95% CI: 0.04-0.32, p < 0.001). Participants who had heard about the HPV vaccination had 2.28 times the odds of being willing to receive the HPV vaccine (aOR: 2.28, 95% CI: 1.27-4.29, p = 0.007). Despite moderate willingness to vaccinate, substantial knowledge gaps remain among Bangladeshi girls. This study highlights the necessity for comprehensive education and awareness programs. These conversations with mothers and healthcare providers can significantly increase vaccine acceptance, emphasizing the critical role of targeted communication in the success of vaccination campaigns.

Introduction: This study provides a comprehensive assessment of the geographic distribution and accessibility of stroke care resources in Mexico’s public health system. The World Stroke Organization (WSO) roadmap criteria classifies centers offering only intravenous thrombolysis as Essential Stroke Centers (ESCs) and those providing both thrombolysis and mechanical thrombectomy as Advanced Stroke Centers (ASCs). Despite recent progress, substantial disparities in access have persisted, particularly between the remote and underserved areas. Methods: This cross-sectional study evaluated institutional resources for acute stroke care across public hospitals in Mexico. A structured online survey developed by the Deputy Secretariat for Health Policy and Population Well-Being in collaboration with experts was based on the WSO Roadmap and aligned with institutional protocols. The instrument was validated by healthcare professionals and distributed via institutional email to the medical directors of IMSS, ISSSTE, IMSS-Bienestar (including the National Institutes of Health), PEMEX, and SEMAR. Data were collected between December 5, 2024, and January 25, 2025. Duplicate entries, nonhospital responses, and uncertified neurointerventional specialists were excluded. The analysis was restricted to general and regional hospitals, and eligible facilities were identified and validated against the Ministry of Health’s Catalogue of Health Establishments. All hospitals were georeferenced using the CLUES code and classified as ESCs or ASCs according to the WSO Roadmap criteria. Results: In total, 1,032 facilities across 32 federal entities completed the survey. Hospitals without a diagnostic or therapeutic capacity for stroke were excluded from further analysis. Isochrones were generated using national road network data and the estimated average travel speeds for different road types under normal conditions. Eighty-five percent of at-risk individuals reside within 60 min of an ESC, ensuring access to fibrinolytic therapy. In contrast, 14% of the individuals aged ≥40 years (6,312,370 people) lived for more than 60 min from the nearest ESC. Despite advances in acute ischemic stroke care, more than half of the population aged ≥40 years remains over 1 h away from an ASC, highlighting critical “stroke care deserts,” particularly in access to thrombectomy, most notably in Colima, Nayarit, Oaxaca, Guerrero, Veracruz, and Sinaloa. Conclusion: Strengthening universal stroke care through interinstitutional collaboration, standardized protocols, certification programs, and optimization of referral networks could enable up to 85% of the at-risk population to access effective treatment at certified stroke centers. Our analysis highlights the major infrastructural and logistical barriers that impede equitable access to life-saving endovascular therapies. Addressing these gaps is essential to reducing mortality and disability in Mexico’s heterogeneous public health system.

We present a revised catalog of the Chilopoda fossil record based on descriptions and reports published from 1854 to the present. Our compilation reveals 74 fossil occurrences encompassing five orders, 13 families, 26 genera, and 35 species. The fossil record is distributed across three geological eras: the Paleozoic (11 records), the Mesozoic (17 records), and the Cenozoic (46 records). This study provides insights into the diversity and distribution of centipedes across geological time.

Background: Despite extensive evidence of strict blood pressure (BP) control benefits in preventing hypertension (HTN)-related morbidity and mortality, HTN control rates (defined as SBP &lt; 130 mmHg and DBP &lt; 80 mmHg), remain low. Thus, understanding the clinical burden of uncontrolled HTN is crucial. The iCaReMe Global Registry is an opportunity to gain contemporary insights into the socio-demographic, clinical characteristics, management patterns and determinants of uncontrolled HTN in routine care. Research Questions: To describe the real-world clinical burden of uncontrolled HTN and management patterns in patients with cardiovascular-renal-metabolic comorbidities. Methods: The iCaReMe Global Registry (NCT03549754) is a multinational, prospective, observational study assessing the management of HTN, T2DM, CKD, and/or HF. Baseline data of participants with HTN and office BP measures enrolled in 29 countries across six WHO regions between 2018 and 2024 were used for a cross-sectional descriptive analysis of demographic, clinical characteristics and medication. Data were grouped into: Controlled HTN (SBP and DBP&lt;130/80mHg) and uncontrolled HTN (SBP or DBP≥130/80mmHg). Results: We examined 21,837 subjects with HTN and BP measures (mean age: 60.3 years, 52.0% female). Comorbidities included: T2DM in 71.3%, dyslipidemia in 51.3%, CKD in 37.8%, and HF in 15.0%. Overall, 24.6% of patients had SBP and DBP&lt;130/80 mmHg (mean SBP/DBP: 114/67 mmHg), and 75.4% had SBP or DBP ≥130/80 mmHg (mean SBP/DBP: 141/84 mmHg) including 61% with SBP or DBP ≥140/90 mmHg. Patients with uncontrolled HTN, compared to controlled HTN group, were younger (59.8 vs 61.8 years), had higher obesity rates (42.5% vs 34.6%) and had more comorbid CKD (39.3% vs 33.1%). Among those with uncontrolled HTN, 60.2% were prescribed antihypertensive drugs including: 69.0% ACEi/ARB, 38.6% CCB, 17% diuretics, and only 46.2% received two or more antihypertensive drugs. Conclusion: Our findings reveal a significant burden of uncontrolled HTN, affecting 3 out of 4 of the study population, characterized by younger age, obesity, and higher comorbid CKD. Despite established guidelines and readily available medications, adherence to guideline directed medical therapy remains low in this high-risk HTN population. These data highlight the urgent need for improved treatment strategies to better control BP and prevent complications.

Background:Muscle enhancement through autologous fat grafting has become an important aspect of body contouring procedures, targeting several muscle groups, including the rectus abdominis, deltoids, biceps, trapezius, longissimus, hamstrings, and vastus muscles.Methods:Patients who underwent the ultrasound-guided rectus abdominis fat transfer technique were evaluated using preoperative and postoperative magnetic resonance imaging (MRI) scans to assess the anatomy of the rectus abdominis muscles. Preoperative MRI measured the muscle thickness of the middle and lower rectus abdominis segments on both sides, as they were the most representative. Postoperative imaging was performed 6 months after surgery, assessing the total thickness of the rectus abdominis segments (including fat graft and muscle), the muscle thickness alone, and the remaining fat graft thickness.Results:The ultrasound-guided rectus abdominis fat transfer technique was performed on 20 patients between September 2022 and April 2023. Of these, 6 were men and 14 were women, with a mean age of 37.05 years (range: 25–57 y). Postoperative MRI revealed a statistically significant increase in the total thickness of the muscle segments (including muscle and fat) compared with preoperative measurements.Conclusions:Ultrasound-guided fat grafting is a safe and effective procedure currently used in abdominal etching. Long-term MRI assessments showed significant fat retention and rectus abdominis muscle enhancement.