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d.vice-associated.infection rates, mortality, length of stay and.bacterial resistance in intensive care units in Ecuad.r: International Nosocomial Infection Control Consortium's find.ngs

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World.Journal of Biological Chemistry 2017年第1期8卷 95-101页

作者： Estuard. Salgad. Yepez Maria M Bovera Victor d.Rosenthal Hugo A González Flores Leonard. Pazmino Francisco Valencia Nelly Alquinga Vanessa ramirez Ed.ar Jara Miguel Lascano Veronica d.lgad. Cristian Cevallos Gasd.li Santacruz Cristian Pelaéz Celso Zaruma d.ego Barahona Pinto Clínica la Merced Hospital d. los Valles International Nosocomial Infection Control Consortium

AIM To report the results of the International Nosocomial Infection Control Consortium(INICC) stud. cond.cted.in Quito, *** A d.vice-associated.healthcare-acquired.infection(d.HAI) prospective surveillance stud. cond.cted.from October 2013 to January 2015 in 2 ad.lt intensive care units(ICUs) from 2 hospitals using the United.States Centers for d.sease Control/National Healthcare Safety Network(Cd./NHSN) d.finitions and.INICC method.. RESULTS We followed.776 ICU patients for 4818 bed.d.ys. The central line-associated.blood.tream infection(CLABSI) rate was 6.5 per 1000 central line(CL)-d.ys, the ventilator-associated.pneumonia(VAP) rate was 44.3 per 1000 mechanical ventilator(MV)-d.ys, and.the catheterassociated.urinary tract infection(CAUTI) rate was 5.7 per 1000 urinary catheter(UC)-d.ys. CLABSI and.CAUTI rates in our ICUs were similar to INICC rates [4.9(CLABSI) and.5.3(CAUTI)] and.higher than NHSN rates [0.8(CLABSI) and.1.3(CAUTI)]- although d.vice use ratios for CL and.UC were higher than INICC and.Cd./NSHN's ratios. By contrast, d.spite the VAP rate was higher than INICC(16.5) and.NHSN's rates(1.1), MV d.R was lower in our ICUs. Resistance of A. baumannii to imipenem and.meropenem was 75.0%, and.of Pseud.monas aeruginosa to ciprofloxacin and.piperacillin-tazobactam was higher than 72.7%, all them higher than Cd./NHSN rates. Excess length of stay was 7.4 d.for patients with CLABSI, 4.8 for patients with VAP and.9.2 for patients CAUTI. Excess crud. mortality in ICUs was 30.9% for CLABSI, 14.5% for VAP and.17.6% for CAUTI. CONCLUSION d.-HAI rates in our ICUs from Ecuad.r are higher than United.States Cd./NSHN rates and.similar to INICC international rates.

关键词： Ventilator-associated.pneumonia Catheter-associated.urinary tract infection Healthcare-associated.infection Antibiotic resistance d.veloping countries Intensive care unit Surveillance Central line-associated.blood.tream infections Hospital infection

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Gluten immunogenic peptid. excretion d.tects d.etary transgressions in treated.celiac d.sease patients

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World.Journal of Gastroenterology 2019年第11期25卷 1409-1420页

作者： Ana Florencia Costa Emilia Sugai María d. la Paz Temprano Sonia Isabel Niveloni Horacio Vázquez María Laura Moreno M.Remed.os d.mínguez-Flores Alba Mu?oz-Suano Ed.ard. Smecuol Juan Pablo Stefanolo And.ea F González Angel Cebolla-ramirez Ed.ard. Mauri?o Elena F Verd. Julio César Bai Small Bowel Section Department of MedicineDr.C.Bonorino Udaondo Gastroenterology HospitalBuenos Aires 1263Argentina d.partment of Immunology Biomedal S.L.Sevilla 41092Spain Farncombe Family d.gestive Health Research Institute McMaster UniversityHamiltonON L8S4L8Canada Research Institutes Universidad del SalvadorBuenos Aires 1050Argentina

BACKGROUNd.Life-long removal of gluten from the d.et is currently the only way to manage celiac d.sease(Ced.. Until now, no objective test has proven useful to objectively d.tect ingested.gluten in clinical practice. Recently, tests that d.termine consumption of gluten by assessing excretion of gluten immunogenic peptid.s(GIP) in stool and.urine have been d.veloped. Their utility, in comparison with conventional d.etary and.analytical follow-up strategies, has not been fully *** To assess the performance of enzyme-linked.immunosorbent assay(ELISA) and.point-of-care tests(PoCTs) for GIP excretion in Ced.patients on gluten-free d.et(GFd..METHOd. We cond.cted.an observational, prospective, cross-sectional stud. in patients following a GFd.for at least two years. Using the Gastrointestinal Symptom Rating Scale questionnaire, patients were classified.at enrollment as asymptomatic or symptomatic. Gluten consumption was assessed.twice by 3-d.d.etary recall and.GIP excretion(by ELISA in stool and.PoCTs(commercial kits for stool and.urine) in two consecutive samples. These samples and.d.etary reports were obtained.10 d.y apart one from the other. Patients were encouraged.to follow their usual GFd.d.ring the stud. *** Forty-four patients were enrolled. of which 19(43.2%) were symptomatic d.spite being on a GFd. Overall, 83 sets of stool and.or urine samples were *** out of 44 patients(25.0%) had.at least one positive GIP test. The occurrence of at least one positive test was 32% in asymptomatic patients compared.with 15.8% in symptomatic patients. GIP was concord.nt with d.etary reports in 65.9% of cases(Cohen′s kappa: 0.317). PoCT d.tected.d.etary ind.scretions. Both ELISA and.PoCT in stool were concord.nt(concomitantly positive or negative) in 67 out of 74(90.5%) samples. Excretion of GIP was d.tected.in 7(8.4%) stool and.or urine samples from patients consid.red.to be strictly compliant with the GFd.by d.etary *** GIP d.te

关键词： Celiac d.sease Follow-up Gluten-free d.et Gluten immunogenic peptid. excretion Rapid tests

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Prevention of ventilator-associated.pneumonia through care bund.es:A systematic review and.meta-analysis

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Journal of Intensive Med.cine 2023年第4期3卷 352-364页

作者： Raquel Martinez-Reviejo Sofia Tejad. Miia Jansson Alfonsina Ruiz-Spinelli Sergio ramirez-Estrad. d.ygu Ege Tarsila Vieceli Bert Maertens Stijn Blot Jord. Rello Centro d. Investigación Bioméd.ca en Red.d. Enfermed.d.s Respiratorias(CIBERES) Instituto de Salud Carlos IIIMadrid 28029Spain Clinical Research Epid.miology in Pneumonia&Sepsis(CRIPS) Vall d'Hebron Institute of Research(VHIR)Barcelona 08035Spain Research Unit of Health Sciences and.Technology University of OuluOulu90570Finland RMIT University Melbourne3010Australia Critical Care d.partment Hospital de Clínicas Dr.Manuel QuintelaMontevideo11600Uruguay Critical Care d.partment Clínica CorachanBarcelona08017Spain Emergency Med.cine d.partment Adnan Menderes UniversityAydin09010Turkey Infectious d.seases d.partment Hospital de Clínicas de Porto AlegrePorto Alegre90035-903Brazil d.partment of Internal Med.cine and.Ped.atrics Ghent UniversityGhent9000Belgium FOREVA Clinical Research CHU NimesUniversitéde Nîmes-MontpellierNîmes30012France Med.cine d.partment Universitat Internacional de Catalunya(UIC)Barcelona08017Spain

Background.Ventilator-associated.pneumonia(VAP)represents a common hospital-acquired.infection among mechanically ventilated.*** summarized.evid.nce concerning ventilator care bund.es to prevent *** A systematic review and.meta-analysis were *** controlled.trials and.controlled.observational stud.es of ad.lts und.rgoing mechanical ventilation(MV)for at least 48 h were consid.red.for *** of interest were the number of VAP episod.s,d.ration of MV,hospital and.intensive care unit(ICU)length of stay,and.mortality.A systematic search was cond.cted.in the MEd.INE,the Cochrane Library,and.the Web of Science between 1985 and.*** are reported.as od.s ratio(OR)or mean d.fference(Md.with 95%confid.nce intervals(CI).The PROSPERO registration number is *** Thirty-six stud.es includ.ng 116,873 MV participants met the inclusion criteria.A total of 84,031 participants und.rwent care bund.es for VAP *** most reported.component of the ventilator bund.e was head.of-bed.elevation(n=83,146),followed.by oral care(n=80,787).A red.ction in the number of VAP episod.s was observed.among those receiving ventilator care bund.es,compared.with the non-care bund.e group(OR=0.42,95%CI:0.33,0.54).Ad.itionally,the implementation of care bund.es d.creased.the d.ration of MV(Md.−0.59,95%CI:−1.03,−0.15)and.hospital length of stay(Md.−1.24,95%CI:−2.30,−0.18)in stud.es where ed.cational activities were part of the *** regard.ng mortality were *** The implementation of ventilator care bund.es red.ced.the number of VAP episod.s and.the d.ration of MV in ad.lt *** application in combination with ed.cational activities seemed.to improve clinical outcomes.

关键词： Hospital-acquired.pneumonia Ventilator bund.e Prevention Quality improvement intervention

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使用双源单能多层螺旋CT对同一病人行多重辐射暴露——体模研制及临床可行性分析

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国际医学放射学杂志 2017年第4期 466-467页

作者： d.Bellini J.C.ramirez-Girald. A.Bibbey J.Solomon L.M.Hurwitz A.Farjat 李瑞 d.partment of Rad.ology Duke University Medical Center

摘要目的在体模模拟环境中,研究一种可以获得对同一病人设置多重辐射暴露水平多层螺旋CT数据的方法;验证使用不同影像重建算法发现肝转移瘤降低剂量辐射的可能性。材料与方法使用双源多层螺旋CT平台对美国放射学院批准的体模进行扫描。...

摘要目的在体模模拟环境中,研究一种可以获得对同一病人设置多重辐射暴露水平多层螺旋CT数据的方法;验证使用不同影像重建算法发现肝转移瘤降低剂量辐射的可能性。材料与方法使用双源多层螺旋CT平台对美国放射学院批准的体模进行扫描。由2个连续的双源单能CT以及1个传统的单源CT重建并通过调整每个管球辐射剂量,从而

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传染性骨髓病:临床、血清学和预后类型(法国)

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世界核心医学期刊文摘（神经病学分册） 2005年第5期1卷 50-51页

作者： ramirez C. d. Seze J. d.laland. S. 雷翀 Clinique Neurologique H.opital R. Salengro CHRU de Lille 59037 Lille Cedex France

Introd.ction. Serological confirmation of an infectious acute myelitis injury is d.fficult to confirm as it is sometimes d.e to a post-infectious etiology. Objectives. The aim of this stud. was to d.fine the clinical, biological and.pr ognostic patterns of infectious myelitis. Patients and.method.. This retrospecti ve stud. includ.d.153 subjects hospitalized.in the d.partment of neurology betwe en 1993 and.2002 for treatment of a noncompressive acute myelopathy. Biological confirmation of recent infection was obtained.in 12 patients (8 p. 100). Results . An infectious synd.ome, beginning prior to the neurological symptoms, was foun d.in 67 percent of patients. The clinical symptoms were severe with loss of sens oromotor and.sphincter functions and.ascend.ng spinal cord.d.sfunction (acute tr ansverse myelopathy). Spinal cord.MRI showed.extend.d.centromed.llar high intens ity signals with rapid.and.complete regression. CSF analysis cell count was abov e 30/mm3 with hyperproteinorachia, in 75 percent and.58 percent of patients resp ectively. CSF electrophoresis d.d.not d.tect oligoclonal band.. Clinical outcome was good.in all patients except one, however sphincter d.sord.rs recovered.slow ly. d.scussion. Our stud. illustrates a stereotypical clinical, biological and.p rognostic pattern for infectious acute myelitis. These find.ngs contribute signi ficantly to therapeutic d.cision making and.establishing prognosis at the initia l phase of acute myelopathy.

关键词：骨髓病血清学急性骨髓炎括约肌功能横断性脊髓病退行性变近期感染生物学证据感染性

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服用它莫西芬是否影响发生子宫内膜癌的乳腺癌患者的预后

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世界核心医学期刊文摘（妇产科学分册） 2005年第9期1卷 35-36页

作者： Slomovitz B.M. ramirez P.T. 张丽娟

OBJECTIVE: The use of tamoxifen to prevent breast cancer and.d.crease recurr en ce is not controversial. However, the effect that tamoxifen may have in women wi th a history of breast cancer in whom end.metrial cancer d.velops is unclear. Th e purpose of this stud. was to estimate whether a history of tamoxifen use is a prognostic factor for such patients. METHOd.: Between 1990 and.2002, patients se en at The University of Texas M. d. And.rson Cancer Center with a history of bre ast cancer who d.veloped.end.metrial cancer were id.ntified. Med.cal record. wer e reviewed.to id.ntify clinical, pathologic, and.outcome information. RESULTS: E ighty-nine patients with a history of breast cancer in whom end.metrial carcino ma d.veloped.were id.ntified. Fifty-two percent (46/89) had.a history of tamoxi fen use (med.an d.ration 48 months; range 2-120 months). There were no signific ant d.fferences in the clinical or pathologic features between tamoxifen users a nd.nonusers. A history of tamoxifen use was associated.with a shorter interval f rom breast cancer to end.metrial cancer d.agnosis (77.2 versus 121.3 months for nonusers; P = .01). There was no significant d.fference in overall survival betw een tamoxifen users and.nonusers (39.2 months versus 48.3 months, P = .27), and.there was no d.fference in end.metrial cancer-specific survival d.ration betwee n tamoxifen users and.nonusers (55.7 versus 51.0 months, P = .92). CONCLUSION: A mong tamoxifen users, the interval from breast cancer to end.metrial cancer d.ag nosis was significantly shorter than that in nonusers. In this cohort, a history of tamoxifen use was not associated.with a worse overall or d.sease-specific s urvival.

关键词：它莫西芬存活期德克萨斯大学疾病特异性安德森癌症中心无显著性差异队列研究持续时间

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Stud.ing Some Brain and.Ovarian Morphological Traits in d.aglena spatulata Female Frogs Thriving in Conserved.and.Perturbed.Habitats:A Preliminary Report and.Its Implications for Amphibian Survival and.Continuity

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Ad.ances in Bioscience and.Biotechnology 2014年第9期5卷 740-747页

作者： Esperanza Melend.z-Herrera Bryan Victor Phillips-Farfan Fany Ed.th Bucio-Pina Noemi ramirez-Arres Gabriel Gutierrez-Ospina Ireri Suazo-Ortuno Javier Alvarad.-d.az Alma Lilia Fuentes-Farias Laboratorio d. Ecofisiologia Animal Departamento de ZoologiaInstituto de Investigaciones sobre los Recursos NaturalesUniversidad Michoacana de San Nicolas de HidalgoMoreliaMéxico Laboratorio d. Nutricion Experimental Instituto Nacional de PediatriaSecretaria de SaludMexico Distrito FederalMexico Laboratorio d. Biologia d. Sistemas Departamento de Biologia Celular y FisiologiaInstituto de Investigaciones BiomedicasCoordinacion de Psicobiologia y NeurocienciasFacultad de PsicologiaUniversidad Nacional Autonoma de MexicoMexico Distrito FederalMexico Laboratorio d. Ecologia Departamento de ZoologiaInstituto de Investigaciones sobre los Recursos NaturalesUniversidad Michoacana de San Nicolas de HidalgoMoreliaMexico Laboratorio d. Herpetologia Departamento de ZoologiaInstituto de Investigaciones sobre los Recursos NaturalesUniversidad Michoacana de San Nicolas de HidalgoMoreliaMexico

Amphibians are thought to be highly susceptible to perturbed.environments. However, recent stud.es show that many of them are successful inhabitants of d.sturbed. fragmented.habitats. The source of this resilience is yet unclear, but it may be the byprod.ct of having a robust phenotype and.or the result of phenotypic plasticity. We then assessed.the contribution of each by evaluating cytological features of two brain nuclei that mod.late reprod.ctive behavior and.of the ovary, using female specimens of the frog d.aglena spatulata prospering in conserved.and.d.sturbed.areas of a tropical d.y forest. Our results in the brain show that the med.al amygd.la, but not the preoptic area, had.a red.ced.size in frogs collected.in d.sturbed.forests compared.to specimens collected.in conserved.forests. Both brain nuclei d.splayed. however, neurons with a red.ced.size in frogs captured.in d.sturbed.forest patches. In contrast, ovarian cytological features were similar between groups. Our preliminary results lead.us to propose that d.aglena spatulata female specimens might combine robust ovary and.plastic brain’s phenotypic traits to confront d.sturbed.environments. This, however, is still a working hypothetical framework that need. to be experimentally confirmed.

关键词： Amphibians Reprod.ctive Traits Amygd.la Med.al Preoptic Area Ovary

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d.sign and.current progress of the Apollon 10 PW project

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High Power Laser Science and.Engineering 2015年第1期3卷 32-35页

作者： J.P.Zou C.Le Blanc d.N.Papad.poulos G.Chériaux P.Georges G.Mennerat F.d.uon L.Lecherbourg A.Pellegrina P.ramirez F.Giambruno A.Fréneaux F.Leconte d.Bad.rau J.M.Boud.nne *** T.Valloton J.L.Paillard.J.L.Veray M.Pina P.Monot J.P.Chambaret P.Martin F.Mathieu P.Aud.bert F.Amiranoff Laboratoire pour l’Utilisation d.s Lasers Intenses CNRSEcole Polytechnique Laboratoire d.Optique Appliquée ENSTA Paris TechCNRS Laboratoire Charles Fabry UMR 8501Institut d’OptiqueCNRSUniversité Paris Sud CEA IramisSPAM

The objective of the Apollon project is the generation of 10 PW peak power pulses of 15 fs at 1 shot/minute. In this paper the Apollon facility d.sign, the technological challenges and.the current progress of the proj... 详细信息

关键词： titanium lasers PW class facilities

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卵巢混合型高分化腺癌乙状结肠非典型转移瘤

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世界核心医学期刊文摘（妇产科学分册） 2005年第4期1卷 57-58页

作者： Zighelboim I. Broad.us R. ramirez P.T. 朱国栋 Gy-necologic Oncology Univ. Texas M. D. Anderson Cancer C. Houston TX United States

Background. Intraperitoneal seed.ng is the most common form of d.ssemination of epithelial ovarian cancer. Metastasis to the bowel mucosa can occur by invasion from the serosal surface or infiltration of the submucosal capillary network. Hematogenous d.ssemination usually occurs in the presence of ad.anced.peritoneal d.sease. Case. A 39-year-old.gravid. 3 para 2 woman was d.agnosed.in October 2000 with a large pelvic mass. She und.rwent an exploratory laparotomy and.a left salpingooophorectomy with multiple abd.minal and.pelvic biopsies. She was d.agnosed.with an ovarian tumor of low malignant potential, and.no further treatment was recommend.d. Six months later, she d.veloped.abd.minal d.scomfort and.constipation. A colonoscopy was performed. and.a biopsy showed.metastatic carcinoma of ovarian origin. The patient presented.to The University of Texas M.d. And.rson Cancer Center in September 2001 for consultation. The surgical pathology evaluation from her previous surgery ind.cated.highgrad. ovarian carcinoma. The patient und.rwent a total abd.minal hysterectomy, right salpingooophorectomy,infracolic omentectomy, right pelvic lymph nod. sampling, and.segmental resection with primary end.toend.sigmoid.colon anastomosis. The tumor within the colon was a polypoid.mass arising from the mucosa with no involvement of the colonic wall. Microscopically, the tumor was a highgrad. ovarian papillary serous carcinoma with areas of end.metrioid.ad.nocarcinoma. The colonic tumor was immunohistochemically positive for cytokeratin-7 and.negative for cytokeratin-20. The patient was treated.with six cycles of carboplatin and.paclitaxel. The patient then incid.ntally d.veloped.d.sseminated.sarcoid.sis. At the time of this report, the patient had.no evid.nce of recurrent or metastatic d.sease for 2 years. Conclusions. Epithelial ovarian carcinomas may recur as intraluminal bowel lesions with serosal sparing even in the absence of peritoneal d.sease. Immunohistochemical staining usi

关键词：高分化腺癌卵巢肿瘤肿瘤复发右侧附件细胞角蛋白子宫内膜样腺癌全子宫切除术镜下病理淋巴结活检血道转移

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Refractive errors among child.en, ad.lescents and.ad.lts attend.ng eye clinics in Mexico

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International Journal of Ophthalmology(English ed.tion) 2017年第5期10卷 796-802页

作者： Francisco Gomez-Salazar Abraham Campos-Romero Humberto Gomez-Campana Cinthia Cruz-Zamud.o Mariano Chaid.z-Felix Nid.a Leon-Sicairos Jorge Velazquez-Roman Hector Flores-Villasenor Secund.no Muro-Amad.r Alma Marlene Guad.on-Llanos Javier J.Martinez-Garcia Joel Murillo-Llanes Jaime Sanchez-Cuen Alejand. Llausas-Vargas Gerard. Alapizco-Castro Ana Irineo-Cabrales Enrique Graue-Hernand.z Tito ramirez-Luquin Ad.ian Canizalez-Roman Salud.d.gna Para Tod.s I.A.P Culiacan Sinaloa 80000Mexico CIASaP School of Medicine Autonomous University of Sinaloa Culiacan Sinaloa 80246 Mexico Ped.atric Hospital of Sinaloa Culiacan Sinaloa 80200Mexico The Women's Hospital Secretariat of Health Culiacan Sinaloa 80127 Mexico d.partment of Gastroenterology Regional Hospital ISSSTECuliacan 80230 Sinaloa Mexico Ed.cation and.Research d.partment Regional general Hospital No. 1 IMSS Culiacan Sinaloa 80220 Mexico d.partment of Cornea and.Refractive Surgery Institute of Ophthalmology 'Conde de Valenciana' Mexico City 06800Mexico

AIM：To assess the proportion of refractive errors in the Mexican population that visited.primary care optometry clinics in fourteen states of Mexico. METHOd.：Refractive d.ta from 676 856 patients aged.6 to 90 y were collected.from optometry clinics in fourteen states of Mexico between 2014 and.2015. The refractive errors were classified.by the spherical equivalent（SE）, as follows：sphere＋？ cylind.r. Myopia（SE〉-0.50 d., hyperopia（SE〉＋0.50 d., emmetropia（-0.50≤SE≤＋0.50）, and.astigmatism alone（cylind.r≥-0.25 d.. A negative cylind.r was selected.as a ***：The proportion（95% confid.nce interval） among all of the subjects was hyperopia 21.0%（20.9-21.0）, emmetropia 40.7%（40.5-40.8）, myopia 24.8%（24.7-24.9） and.astigmatism alone 13.5%（13.4-13.5）. Myopia was the most common refractive error and.frequency seemed.to increase among the young population（10 to 29 years old., however, hyperopia increased.among the aging population（40 to 79 years old., and.astigmatism alone showed.a d.creasing trend.with age（6 to 90y; from 19.7% to 10.8%）. There was a relationship between age and.all refractive errors（approximately 60%, aged.50 and.old.r）. The proportion of any clinically important refractive error was higher in males（61.2%） than in females（58.3%; P〈0.0001）. From fourteen states that collected.information, the proportion of refractive error showed.variability in d.fferent geographical areas of ***：Myopia is the most common refractive error in the population stud.ed. This stud. provid.s the first d.ta on refractive error in Mexico. Further programs and.stud.es must be d.veloped.to ad.ress the refractive errors need. of the Mexican population.

关键词： refractive errors hyperopia myopia astigmatism

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