[37.3(Ϯ 12.9) years] were assessed for values of body mass index (BMI) and waist circumference (WC) for predicting DM or HT by receiver operating characteristic curve analyses. Likelihood ratios for DM and HT were calculated, and BMIs or WCs for public-health screening were developed. Subanalyses included regional data. Results: Likelihood ratios of DM and HT increased from BMI values of 22 to 24 kg/m 2 in both sexes and with WC values of 75 to 80 cm in men and 70 to 80 cm in women. The best BMI cutoffs for predicting DM were 26.3 to 27.4 kg/m 2 in men and 27.7 to 28.9 kg/m 2 in women, with similar values for HT, i.e., 26.2 to 27.0 kg/m 2 and 27.7 to 28.5 kg/m 2 , for men and women, respectively; WC cutoffs for DM were 93 to 98 cm in men and 94 to 99 cm in women, and cutoffs for HT were 92 to 96 cm and 93 to 96 cm for men and women, respectively. The WC cutoffs had higher sensitivity and specificity than those of BMI. Discussion: The risk for DM and HT starts at lower levels of BMI and WC than those suggested by WHO. WC is a better discriminator than BMI measures for use in public health.

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OBJECTIVE:To assess the ability of the body mass index (BMI) to detect obesity-associated morbidity in subjects with a normal or short stature. METHODS: Information was obtained on 119 975 subjects from a cardiovascular risk factors detection program. Standardized questionnaires were used. Capillary glucose and cholesterol concentrations were measured. Diabetes, arterial hypertension and hypercholesterolemia were selected as end points. Sensitivity, specificity and the likelihood ratio for several BMI thresholds were calculated. ROC curves were constructed to identify the BMI cutoff points with best diagnostic performance. The area under the curve (AUC) was used to assess the proficiency of BMI. RESULTS: Short stature (height r150 cm for women or r160 cm for men) was found in 24 854 subjects (20.7%). These cases had a higher prevalence of type II diabetes and arterial hypertension even after adjusting for confounding variables. In addition, the frequency of the abnormalities was higher even at the lowest BMI values; the prevalence increased in direct proportion with the BMI, but at a lower rate compared to cases with normal stature. The AUC for every co-morbidity was smaller in short stature subjects. The likelihood ratio for detecting co-morbidities increased at the same BMI value in subjects with or without short stature. CONCLUSIONS: The prevalence of obesity-associated co-morbidities is higher in subjects with short stature compared to those without it. The proficiency of BMI as a diagnostic tool is poor in short stature subjects. This problem is not resolved by decreasing BMI thresholds used to define overweight.

Rabies remains a public health problem in the Americas because of the great diversity of wild reservoirs that maintain the virus in nature. Here we report the antigenic characterization of 254 rabies viruses isolated from 148 nonreservoir and 106 reservoir hosts collected in 27 states of Mexico. Nine out of 11 antigenic variants previously reported in the United States were detected in Mexico by using the limited panel of monoclonal antibodies donated by the Centers for Disease Control and Prevention. Some rabies virus variants were isolated from their natural reservoirs, which were also taxonomically identified. Terrestrial reservoirs included stray dogs with V1, Urocyon cineroargenteus (gray foxes) with V7, and two subspecies of Spilogale putorius (spotted skunks) with different viral variants (V8 and V10). Aerial hosts included Tadarida brasiliensis mexicana and Desmodus rotundus, which harbored V9 and V4 and harbored V11, respectively. All variants, with the exception of V9, were isolated from nonreservoir hosts, while V3, V4, and V5 were not isolated from their natural reservoirs but only from livestock. Rabies virus antigenic typing allowed us to determine rabies reservoirs and their distribution in Mexico, data which will probably improve prevention and control of the illness in humans and in the reservoir hosts.

This population-based study of M tuberculosis demonstrates moderately high levels of drug resistance. Important issues to consider in the national strategy to prevent M tuberculosis resistance in Mexico include consideration of the most appropriate initial therapy in patients with TB, the treatment of patients with multiple drug resistance, and surveillance or periodic surveys of resistance among new TB patients to monitor drug resistance trends.