Preventive medication saves lives: Reyes Terán

All of us love Dr. Gustavo Reyes Terán. Seeing him smile on the Nationwide Institute of Respiratory Illnesses is a aid in itself. Carlos Monsiváis cherished him and admired him, though he didn’t obey him. If he had carried out it, he would nonetheless be amongst us.

In recent times, his sufferers have gone to seek the advice of him and we keep for a very long time past the session as a result of he at all times has one thing new to indicate us with delight, whether or not it’s the enchancment within the hospitalization heart or the information in every of the Institute’s pavilions. Nationwide Respiratory Illnesses. He does it with such enthusiasm and delight that we’re moved not solely by the medical go to, however by the standard of basic medication that’s taught in Mexico, a rustic of extraordinary medical doctors acknowledged worldwide and instructing hospitals to which college students from throughout America come. Latin and even from the US and Europe.

–Preventive medication will at all times be a pillar of any well being system, however in my view it shouldn’t be unique, as a result of after we say that we inherit a very destroyed well being system, we’re referring not solely to the infrastructure, however to the shortage of preventive medication. Certainly you already know that coronary heart assault, acute myocardial infarction, is the main reason behind dying within the nation. About 200,000 individuals die a 12 months from coronary heart assaults alone, however coronary heart assaults are the ultimate results of the shortage of management of a sequence of ailments that may be prevented…

–Do not we Mexicans know when one thing is critical?

–It can take a few years to stop them, Elena. For instance, one of many causes of coronary heart assaults is diabetes and nothing is completed towards the sale of soppy drinks and sweet to which kids are addicted. The incidence of diabetes is rising, simply because the quantity of people that die annually from an acute coronary heart assault has elevated. Now it’s extra widespread in younger individuals…

–Within the fats ones?

–Largely it is because of chubby and weight problems, which has additionally elevated in current a long time, at the least within the final 30 or 40 years.

–Is that the place the campaigns towards gentle drinks and sweets come from?

–Sure, however they haven’t labored as a result of the consumption of soppy drinks has elevated… Possibly there have been campaigns towards junk meals, however in actuality there was by no means a lower in a single a kind of merchandise and unequivocal proof, a Conclusive proof of its dimension is that we’re the primary or two nation in childhood weight problems and that’s very critical. Mexico is among the many first two locations for weight problems in adults.

–At college dismissal time the sweet makers seem like vultures…

–It’s catastrophic and it’s a drawback that has been happening for a lot of a long time regardless of the good medical doctors who have been public well being officers in our nation, regardless of the preventive campaigns, regardless of the promotion of sports activities, regardless of the video games at recess time…

–Is that why you say that at present the well being system is destroyed?

–Sure, after we medical doctors report it with alarm, we actually imply the absence of management and in addition detection. These days, there’s a idea in medication known as the 50 p.c rule: 50 p.c and 50 p.c. In Mexico there’s an estimated variety of individuals with hypertension or diabetes or with lipid issues (excessive ldl cholesterol and excessive triglycerides) which have been detected for a number of a long time, however it is just 50 p.c of the full of these individuals with hypertension or with diabetes or lipid issues. One other 50 p.c has not been detected and that’s the greatest drawback now we have to face.

–However 50 p.c have already been detected.

–About 75 p.c or 80 p.c of the full detected obtain remedy and of that complete solely half of them are managed. Briefly, of the thousands and thousands of sufferers with hypertension –that are between 25 and 30 million individuals in Mexico–, it has been recognized solely half, and of this, lower than half is managed, that’s, we’re treating between 15 p.c and 25 p.c of the full variety of individuals with hypertension.

–I do not perceive why it’s so critical…

–It is loopy, it truly is a really major problem. There are 14 to 16 million individuals with diabetes in Mexico in complete, however now we have recognized roughly half and now we have managed the opposite half. In different phrases, roughly talking solely two out of each 10 individuals with diabetes are managed in Mexico. It is vitally critical. In preventive medication it might be preferrred if there have been no diabetes, that there was weight loss plan, train, gymnastics, cardio workout routines and every thing else, that there have been no chubby individuals. For that now we have to work exactly, however we’ll see the leads to a few years and within the meantime diabetes will proceed, which is lethal…

-What are we going to do?

–We should attempt to establish all individuals with diabetes, with hypertension, with dyslipidemia, and that our aim shouldn’t be solely 50 p.c, however that every 12 months we improve detection by 5 to 10 p.c, in order that within the following In 5 or 6 years now we have detected 80 or 90 p.c of the full variety of individuals with weight problems and diabetes. And never solely detect them, however deal with them and deal with them nicely.

–The enemy was not solely the covid?

–Clearly, the covid pandemic had a number of affect in delaying these applications that had been in place for 4 and a half years. I feel that the brand new authorities goes to face it and that’s when we’re going to see higher detection and higher management of those ailments. The tip result’s that the variety of individuals with coronary heart assaults will probably be lowered. The implications of those persistent ailments and their care will improve the life expectancy of Mexicans. In Mexico, in 1960, life expectancy at start was round 50 years. In the US and Canada it was a bit of extra, 55 to 60 years, and since 1960 in Mexico it elevated with an upward development. Yearly years of life expectancy have been gained. Mexico even approached the US and Canada till 2005; A plateau was created that few individuals speak about and the development of accelerating life expectancy at start was misplaced. In 2005 he was 75 years outdated. There was a one-year decline in 2011, attributed partially to the struggle on narcosince earlier than – since Fox and the six-year time period of Felipe Calderón – as a result of many younger individuals died within the struggle towards the narco. In 2011 there was a lower of 75-74 years that was recovered later. However a lot of this plateau shouldn’t be solely defined by the struggle towards narco, but in addition because of the lack of management of those three ailments which are just like the scourges of humanity and that end in an rising variety of coronary heart assaults: diabetes, hypertension and dyslipidemias that come from ldl cholesterol and triglycerides. Taken collectively, it explains the plateau till the pandemic arrives in 2019. That one-year decline in 2011 was most likely because of the 2009 influenza pandemic, which though not extremely deadly, in comparison with covid it did have last implications. By the way, that was the very best alternative that would have been had as a result of the chance components have been recognized: diabetes, hypertension, weight problems of the individuals who died (many younger individuals). And in 2009, 2010, 2011 and 2012 there was the chance to develop a technique to face future pandemics that principally consisted of strengthening the primary stage of care, rising the variety of specialist medical doctors, particularly in Pulmonology, Intensive Care, and Medical Emergencies. , in Inside Medication, Pediatrics, Neonatology, and so on.

What was carried out within the final 4 a long time, till earlier than this authorities, was to more and more prohibit medical specialties, which prompted many medical doctors to hunt their specialty in non-public universities, in non-public hospitals. What the nation wanted was deserted, which was not solely the first-level infrastructure of well being facilities within the cities, and clinics adjoining to pharmacies started to flourish. The usage of antibiotics that may solely be prescribed by a health care provider was additionally restricted. There was an abuse of self-medication and as a substitute of regulating prescriptions for antibiotics, the pharmacies arrange adjoining places of work at a minimal value and a major problem was prompted: the abuse of antibiotics. The answer is to strengthen main care, strengthen second-level hospitals, particularly working rooms, which instructor Zoé Robledo has been doing within the final 18 months, who’s doing an ideal job as coordinator and as director of the IMSS whose construction IMSS Bienestar, previously known as IMSS Coplamar, IMSS Solidaridad, was used to rehabilitate the Mexican well being facilities which have agreed to stick to the federalization of the system.