Atherogenic indices in pediatric population in South-Southeast region of Mexico.

BACKGROUND: Atherosclerosis is a cardiovascular disease, highly predictable, and associated with different atherogenic indices (AI) in adults. However, such indexes in the pediatric population are far less explored. The objective of this study was to evaluate the AI and the cardiovascular factors in the pediatric population in the South-Southeast of México. METHODS: A total of 481 children between 2 and 17 years old were recruited. Anthropometric evaluation, blood pressure (BP), lipid profile, apolipoprotein A-I (ApoA-I) and apolipoprotein B (ApoB) were measured, and AI were calculated. The population was grouped by age, binary logistic regression analysis was performed to analysis for associations of AI and cardiovascular risk factors. Sensibility and specificity of AI to detect metabolic alteration were evaluated for curve ROC. RESULTS: The atherogenic risk presented a high prevalence in the pediatric population, such as LDL-c/ApoB (86.9%), AIP (78%) and AC (36.6%). Preschoolers showed a higher risk of ApoB/ApoA-I and ApoB/LDL-c, while adolescents have a high risk of AIP. CRI-I and AC were associated with elements of lipid profile and body mass index (BMI). ROC curves analysis shows that AIP is the best index evaluating metabolic syndrome (MS) (0.87) and dyslipidemia (0.91). CONCLUSION: Such pediatric population showed a high risk of AI, mainly by LDL-c/ApoB and AIP. The BMI was the cardiovascular risk factors most frequently related to AI, AIP is the best index for detecting cases of MS and dyslipidemia. This is the first study carried out in the pediatric population from the South-Southeast of Mexico that evaluated the AI.

[Construction and validation of an instrument to assess primary care level patient satisfaction]. / Construcción y validación de un instrumento para medir la satisfacción de los pacientes del primer nivel de atención médica en la Ciudad de México.

OBJECTIVE: To develop an instrument to assess the satisfaction of patients using health services at the first care level of the city of Mexico (SSA), adapted to the socio-cultural characteristics of the population, and to examine its reliability and validity. METHODS: The instrument reagents were designed using the natural semantic networks technique. The dimensions used have been determined from the literature. Participants included 230 adults with type 2 diabetes attending eight SSA health centers. Subsequently, intelligibility was determined by conducting a pilot, then the construct validity of the instrument by means of exploratory factor analysis was evaluated and its internal consistency was determined by calculating Cronbach's alpha. RESULTS: The questionnaire is composed of six factors with a Likert-type scale. Its consistency showed a Crombach´s alpha of 0.94. The factor structure included 29 reagents that correlated with the six dimensions with factorial loads>0.581 that explained 66.8% of the total variance. CONCLUSIONS: The patient satisfaction questionnaire incorporates the sociocultural characteristics of the target population and has an adequate level of validity and reliability and is quick and easy in application.

Social inequalities and health in rural Chiapas, México: agricultural economy, nutrition, and child health in La Fraylesca Region

Investiga la relación entre las condiciones socioeconómicas de los productores agrícolas y la salud de sus hijos en La Fraylesca, Chiapas, México. Los datos se recopilaron mediante una encuesta transversal de una muestra de 1046 hogares (5546 indivíduos) de dos municípios del área de estudio. La encuesta incluyó mediciones antropométricas, recordatorio alimentario de 24 horas, exámenes coprológicos y datos sobre mortalidad infantil. Los hijos de productores privados y campesinos "ricos" presentaron mejor estado nutricio, mejor dieta, prevalencias más bajas de parásitos intestinales y menor riesgo de morir que los hijos de ejidatarios/comuneros o campesinos "pobres". Estos resultados sugieren que el volumen de producción de maíz es mejor indicador que la tenencia de la tierra para analizar desigualdades en salud y nutrición. Los principales determinantes de dichas disparidades pueden encontrarse en las inequididades en la distribución de los recurso. De modo que el impacto de intervenciones médicas en las desigualdades será limitado, a menos que se acompañen de una redistribución de recursos.