Pulse oximetry as a screening test for critical congenital heart disease in term newborns.

BACKGROUND: Pulse oximetry has been suggested as a screening test for congenital heart disease (CHD) in asymptomatic newborns. However, most newborns in Mexico are discharged from the hospital without this evaluation. OBJECTIVE: To evaluate pulse oximetry as a screening test for critical congenital heart disease (CCHD) in term newborns. METHODS: We conducted a cross-sectional study in term newborns between July 2010 and April 2011. Pulse oximetry was determined before hospital discharge; in case of post-ductal oxygen saturation < 95%, a Doppler echocardiogram was performed. RESULTS: From 1,037 newborns screened, two had CCHD, one had pulmonary atresia and ventricular septal defect, and one Ebstein´s anomaly. Minor CHD was present in 10 babies. The overall prevalence of CHD was 11.5 per 1000 live births, and the prevalence of CCHD was 3.9 per 1000 live births. For those with critical disease, pulse oximetry had a sensitivity of 100%, specificity 98.8%, positive predictive value 14.2%, negative predictive value 100%, and positive likelihood ratio of 86.2. In regression analysis, oxygen saturation, respiratory frequency, and postnatal age were related with CCHD. CONCLUSIONS: Pulse oximetry had a good sensitivity and specificity for the identification of critical congenital heart disease in term newborns. Low oxygen saturation, higher respiratory frequency, and early postnatal age were related with congenital heart disease.

Parameters of lung inflammation in asthmatic as compared to healthy children in a contaminated city.

BACKGROUND: The impact of air pollution on the respiratory system has been estimated on the basis of respiratory symptoms and lung function. However; few studies have compared lung inflammation in healthy and asthmatics children exposed to high levels of air pollution. The aim of the study was to elucidate the modulatory effect of air pollution on Cysteinyl-leukotrienes (Cys-LTs) levels in exhaled breath condensate (EBC) among healthy and asthmatic children. METHODS: We performed a cross-sectional comparative study. Children between 7-12 years of age, asthmatics and non-asthmatics, residents of a city with high levels of PM10 were included. In all cases, forced spirometry, Cys-LTs levels in EBC, and the International Study of Asthma and Allergies in Childhood questionnaire were evaluated. We also obtained average of PM10, CO, SO2 and O3 levels during the period of the study by the State Institute of Ecology. RESULTS: We studied 103 children (51 asthmatics and 52 non-asthmatics). Cys-LTs levels were higher in asthmatics than in non-asthmatics (77.3 ± 21.6 versus 60.3 ± 26.8 pg/ml; p = 0.0005). Also, Cys-LTs levels in children with intermittent asthma were lower than in children with persistent asthma (60.4 ± 20.4 versus 84.7 ± 19.2 pg/ml; p = 0.0001). In the multiple regression model, factors associated with levels of Cys-LTs were passive smoking (ß = 13.1, p 0.04) and to be asthmatic (ß = 11.5, p 0.03). CONCLUSIONS: Cys-LTs levels are higher in asthmatic children than in healthy children in a contaminated city and its levels are also associated with passive smoking.

Iron overload as cardiovascular risk factor in children and adolescents with renal disease.

BACKGROUND: Iron overload can affect cardiac structure and function by the production of free radicals in addition to iron deposits in heart muscle. The purpose of this study was to compare traditional and non-traditional cardiovascular risk factors (CVRF) in children and adolescents on renal replacement with and without iron overload. Also, we evaluated the relationships between iron overload and left ventricular mass (LVM). METHODS: First, in a cross-sectional study, we evaluated traditional and non-traditional CVRF in 143 children and adolescents, 48 on peritoneal dialysis (PD), 53 on hemodialysis (HD) and 42 after renal transplantation according to iron overload. In a second phase with a case-control study, we measured LVM in 12 case patients and 12 matched controls. RESULTS: Iron overload was identified in 15 patients (10.5%), 11 in HD and 4 in PD (P = 0.002). The group with iron overload had lower body mass index (17 versus 19; P = 0.01), total cholesterol (132 versus 165 mg/dL; P = 0.03) and hemoglobin (8.5 versus 10.6 g/dL; P = 0.003) but higher interleukin (IL)-6 levels (4.8 versus 3.6 ng/L; P = 0.04) and hypertension diagnosis (79 versus 48%; P < 0.001) than those without iron overload. Ferritin showed a positive correlation with C-reactive protein (CRP) and IL-6 levels. In a subgroup of 24 patients (12 with and 12 without iron overload), LVM was not different. However, ferritin levels showed a borderline positive correlation (r = 0.44, P = 0.05) with LVM. CONCLUSION: Children and adolescents with iron overload show more CVRFs, especially if they received replacement therapy with HD. Ferritin is related to CRP and IL-6 levels.

Intercellular adhesion molecules and mortality for sepsis in infants younger than 1 year of life.

BACKGROUND: Adhesion molecules in sepsis syndrome are correlated with the severity of illness and may be considered as predictors of survival outcome in adults. However, only few studies have been performed in infants and none using international criteria for sepsis. OBJECTIVE: To determine whether adhesion molecules during the first 7 days of the disease could predict sepsis outcome and its severity. MATERIAL AND METHODS: We performed a prospective study in 88 infants with sepsis and 30 controls. Soluble intercellular adhesion molecule (ICAM)-1, vascular cell adhesion molecule (VCAM)-1, and E-selectin levels were determined at days 1, 3 and 7 of follow-up in those patients with sepsis and only one determination in the control group. The main outcome measure was mortality during 10 days of monitoring. RESULTS: Positive hemoculture was reported in 64(72.7%). ICAM-1, VCAM-1, and E-selectin levels were higher in the group of sepsis than in the control group. However, no association was found between ICAM-1, VCAM-1 or E-selectin levels with sepsis severity. Mortality linked to sepsis was observed in 9 patients (10.2%). In the logistic regression analysis, those variables positively associated with mortality were the increase in ICAM-1 levels > 250 ng/mL between day 1 to 3, number of amines and the baseline severity of sepsis. However, we did not identify in those patients who died a specific pattern in adhesion molecules levels during follow up. CONCLUSIONS: ICAM-1 levels, number of amines and severity of sepsis levels predict mortality during 10 days of monitoring in infants younger than 1 year of age with sepsis.

Heart sympathetic activity and pulmonary function in obese pregnant women.

OBJECTIVE: To estimate autonomic balance and pulmonary function in obese women according to their baseline weight and weight gain during pregnancy. DESIGN: A cohort study. SETTING: Hospital of Gynecology and Obstetrics in Leon, Mexico. POPULATION: One hundred and seventy-eight healthy pregnant women (88 obese and 90 non-obese). METHODS: At first visit of pregnancy and in the third trimester blood pressure, anthropometric measurements, glucose, insulin, and leptin levels were evaluated and spirometry, oximetry, and 60 minutes electrocardiograph monitoring were performed. MAIN OUTCOME MEASURES: Heart rate variability and pulmonary function. RESULTS: Blood pressure levels, glucose, insulin, and leptin levels were higher in obese women, whereas total power of heart rate variability was lower in this group than in non-obese women at the beginning of pregnancy. In the third trimester, the standard deviation of all the normal R-R intervals was lower in obese women, whereas blood pressure and glucose levels remain higher. In the multiple regression analysis, the change in forced expiratory volume at 1 second/forced vital capacity (FEV1/FVC) ratio and leptin levels independently of weight gain were associated to low-frequency/high-frequency (LF/HF) index at third trimester (R2=0.21; p<0.001 for the model) only in obese women. CONCLUSIONS: LF/HF index at third trimester of pregnancy is associated with increase in leptin levels and decrease in FEV1/FVC in obese women independently of weight gain.

[Maternal mortality: relation between directive management and opportune clinical care]. / Mortalidad materna: enlace entre gestión directiva y atención clínica oportuna.

The authorities of the High Medical Specialized Units (HMSUs) Obstetric/Gynecology Service (OB/GYN) and Intensive Care Unit (ICU) elaborated a strategy, which included the organization and interrelation of both hospital services and the implementation of an Epidemiologic Monitoring Program for all critical complicated pregnancies. This plan consisted in an assignment of personnel for special care, immediate communication with heads of services to coordinate the attention and to facilitate the resources for medical attention in these patients, as well as daily follow up by the authorities until complete resolution. Through epidemiological monitoring, 274 cases of pregnant women with high risk of mortality were identified during 2005, and 437 during 2006 (increased 59 %). The admittance to ICU for this reason in 2003 was 17; in 2005 was 24 and in 2006 was 42 (147 % from 2003 to 2006). Maternal deaths diminished from: 3/17 (17.6 %) to 1/24 (4.1 %) to 2/42 (4.7 %) during the same years, respectively. The maternal death rate from 2004 to 2006 was: 33.2, 17.4, and 22 per 100,000 newborns, respectively, below the national and institutional average. The coordination between the Headquarters and the HMSUs that take care of obstetrical patients helped diminution maternal death over this period.

[Holt-Oram syndrome and portal extrahepatic hypertension. A case report]. / Síndrome de Holt-Oram asociado con hipertensión portal.

BACKGROUND: The Holt-Oram syndrome (HOS) is characterized by skeletal abnormalities, frequently accompanied by congenital cardiac defects. It was first described by Holt and Oram in 1960. It has a prevalence of 0.95/10,000 live newborns. The syndrome shows a dominant autosomic heritance with high penetrance. A mutation in the transcription gene factor TBX5 has been identified. This factor has been shown to be important in the heart and upper extremities development. CLINICAL CASE: A 17 year-old boy with muscle-skeletal abnormalities in forearms and hands, with implantation defects of thumbs and narrow shoulders as well as wide atrial septal defect type osteum secundum. He also showed portal cavernomatosus degeneration which conditioned portal extrahepatic hypertension and esophageal varicose veins. The diagnosis was established by clinical, radiological and auxiliary studies. His parents were also studied, and they did not show abnormalities. CONCLUSIONS: Two previous cases have been reported in the Mexican medical literature, both due to de novo genetic mutation. However, none has been associated with portal cavernomatosus degeneration and portal hypertension.

Asymmetric Septal Hypertrophy in Appropriate for Gestational Age Infants Born to Diabetic Mothers.

OBJECTIVE: To compare the frequency of asymmetric septal hypertrophy in appropriate for gestational age infants born to diabetic mothers with those born to non-diabetic mothers. METHODS: We compared 38 full term infants born to diabetic mothers with 85 full term infants of non-diabetic mothers. 2-D echocardiography was obtained in the first 24 hours after birth. RESULTS: Asymmetric septal hypertrophy was only present in infants born to diabetic mothers (50% vs. 0%; P<0.001). Intraventricular septum thickness and intraventricular septum/posterior wall of the left ventricle ratio was also significantly higher in the first group (P<0.001). We found no correlation between mother´s glycated hemoglobin levels and intraventricular septum thickness in newborns. CONCLUSION: Asymmetric septal hypertrophy is a common finding in infants born to diabetic mothers, even if they are appropriate for gestational age.

Leptin, insulin, and glucose serum levels in large-for-gestational-age infants of diabetic and non-diabetic mothers.

BACKGROUND: It has been suggested that hyperleptinemia could be caused by hyperinsulinemia in infants of diabetic mothers (IDMs). AIM: To compare leptin, insulin, and glucose levels in large-for-gestational-age (LGA) and appropriate-for-gestational-age (AGA) infants. METHODS: A cross-sectional study was conducted in IDMs, infants of non-diabetic mothers (INDM) and AGA infants. RESULTS: Seventy-seven newborns were studied (11 IDM, 16 INDM, and 50 AGA infants). Leptin levels were significantly higher in LGA infants than in the AGA group and a trend for higher levels in IDM than NIDM was observed. Insulin levels and insulin resistance were significantly higher in IDMs. Glucose levels were lower in both groups of LGA infants. CONCLUSIONS: We found insulin resistance, hyperinsulinism and hyperleptinemia in IDMs, and the trend of higher leptin levels in IDMs than INDMs shows that leptin could be related to insulin resistance in these infants.

[Rehabilitation service in a primary care unit]. / Impacto del servicio de rehabilitación en el primer nivel de artención.

OBJECTIVE: to evaluate the impact of rehabilitation service in two primary care units (PCU). METHODS: a comparative cross-sectional study was performed in two PCU (No. 53 and No. 51). The former has a rehabilitation service and the second one refers to a rehabilitation consultant at a specialized hospital. The variables evaluated were: amount of cases, days of disability, average days/cases, and average cost/case according to specific disease considering the five main medical disease required disability for general or risk work disease. We used descriptive statistics for results and Student's t test to evaluate significance. RESULTS: back pain was the first cause of disablement; the average in opportunity care was seven days. The average number of days disability benefit for hand trauma, ankle sprain, and for back pain was lower in PCU No. 53, as well as for cervical sprain, but slightly higher for knee sprain. Evaluating the global incapacity days average and cost for each case, we found a significant difference to PCU No. 53. CONCLUSIONS: recovery time to return work was faster and lower the average cost in patients from to the PCU No. 53 which has its own rehabilitation service.

Split crest con colocación simultánea de implantes en sector anterior: reporte de un caso / Split crest with simultaneous placement of implants in the anterior sector: a case report

La pérdida ósea en el sector anterior, ya sea por un defecto horizontal, vertical o combinado, actualmente es un desafío, no sólo por la integración del implante, sino por la estética involucrada. Entre las técnicas de regeneración ósea que permiten solucionar estos defectos, cabe destacar la técnica de expansión de crestas. Se presenta el caso de una paciente de 58 años con reborde atrófico, que se sometió a la expansión de crestas con colocación simultánea de implantes en sector anterior, con xenoinjerto previo a técnica de expansión de crestas con piezoeléctrico, colocación simultánea de implantes Narrow Connection SLActive Straumann. Se logró ganancia ósea y estabilidad primaria de los implantes, sin complicaciones. En escenarios seleccionados, la técnica de expansión de crestas de manera predecible permite ganancia de hueso horizontal adecuada, el éxito de los implantes con tasa de supervivencia y mínimas complicaciones intra y postoperatorias (AU)

Bone loss in the anterior sector, both a horizontal, vertical or combined defect is a challenge today; not only for the integration of the implant but also the aesthetic involved. There are techniques of bone regeneration that help us to solve this type of defects, among them we should highlight the crest expansion technique. We present the case of a 58-year-old patient with atrophic flange, who underwent the expansion of crests with simultaneous placement of implants in the anterior sector, with xenograft prior to the piezoelectric crest expansion technique, Simultaneous placement of Narrow Connection SLActive Straumann implants, bone gain and primary stability of the implants were obtained, without complications. In selected scenarios, the crest expansion technique could be considered a predictable approach that demonstrates a high implant survival rate, adequate horizontal bone gain, and minimal intra- and postoperative complications (AU)

Correlation between interleukin-1ß and matrix metalloproteinase-1 levels in crevicular fluid with a proposed periodontal disease index in children.

BACKGROUND: The crevicular fluid contains biomarkers that allow the identification of periodontal disease, anticipation of its risk, and prediction of its progression. PURPOSE: The purpose of this study is to correlate interleukin-1ß (IL-1ß) and matrix metalloproteinase-1 (MMP-1) levels in crevicular fluid with periodontal disease severity in schoolchildren. METHODS: A cross-sectional study was conducted in 82 schoolchildren between 9 and 12 years. The biofilm percentage, attachment level, gingival recession, dental calculus, and bleeding on probing were measured in the teeth 16, 26, 36, 41, and 46. These five parameters obtained were considered to propose a disease score between 0 and 10 points. In crevicular fluid from the tooth with the highest score, IL-1ß and MMP-1 levels were measured. RESULTS: According to the proposed score, mild gingivitis was identified in 20 schoolchildren, moderate gingivitis in 30, and severe gingivitis in 32. Biofilm percentage, IL-1ß, and MMP-1 levels increased as the severity of the disease increase. The mean and 95% confidence interval were 23.2 pg/µl (18.6-27.7), 37.3 pg/µl (27.8-46.9), and 44.6 pg/µl (34.4-58.8) (P = 0.01) for IL-1ß and 2.69 mol/min (2.51-2.87), 4.43 mol/min (3.9-4.95), and 5.59 mol/min (4.81-6.38) (P < 0.001) for MMP-1 in each group, respectively. The proposed clinical score correlated with biofilm percentage (r = 0.63), IL-1ß (r = 0.50), and MMP-1 (0.45) levels, P < 0.001 in all cases. CONCLUSIONS: The proposed clinical score for periodontal disease in children correlated with percentage of biofilm, IL-1ß, and MMP-1 levels.

[Modification of risk factors in the developing of diabetes mellitus type 2 in obese children]. / Modificación de factores de riesgo para desarrollar diabetes mellitus tipo 2 en escolares obesos.

OBJECTIVE: To determine if an educational and dietetic program diminish the risk factors of diabetes mellitus type 2 in obese children. DESIGN: quasi-experimental trial. MATERIAL AND METHODS: We performed a study in 28 obese children. They received instruction in diabetes mellitus, participated in a nutritional education group, and received an individual dietetic treatment during six months. There was used a 24-hour recall about dietary intake, body mass index and blood pressure measure monthly. Glucose, leptin, and insulin levels were measured at baseline and after the six months of treatment. Kruskal-Wallis and Wilcoxon tests were used. RESULTS: We studied 13 female and 15 male obese children with an age average of 9.7 years. Body mass index (29.0 versus 25.6), blood pressure (121/80 versus 118/78 mm Hg), fasting glucose (95 versus 92 mg/dL), total cholesterol (166 versus 155 mg/dL), triglycerides (144 versus 142 mg/dL), insulin resistance index (5.9 versus 4.9), leptin (56.1 versus 57.3 ng/mL), and energy intake (3409 versus 2243 kcal) decreased, at the begin and at the end of the study. Nutriment and sufficiency balance were lower too (p<0.05). CONCLUSIONS: The program diminished the risk factors for diabetes mellitus and cardiovascular disease.

A new challenge for dental education: Generation Z / Un nuevo reto para la educación odontológica: Generación Z

Abstract A new cohort, known as ''Generation Z'', is nowadays studying Health Careers. These students were born between 1996 and 2012, and currently at year 2022, have between 18 and 26 years. It is necessary to comprehend their characteristics and behaviors, for a better understanding of how they learn, what do they expect from education and how to improve their academic development and potential. Generation Z is considered as the most diverse, and it requires a closer mentorship from teachers, who must be ready to help students to manage their time and resources efficiently. It is worth mentioning that Gen Z information about their professional performance is still preliminary, because they are currently studying their University programs. Thus, it will be interesting to further analyze the behavior of Generation Z in Dental Education.

Abstract Una nueva cohorte generacional, conocida como ''Generación Z'', se encuentra estudiando las Licenciaturas en el área de la Salud. Estos estudiantes nacieron entre los años de 1996 y 2012, y actualmente al año 2022, tienen entre 18 y 26 años. Es necesario comprender sus características y sus conductas, para tener un mejor entendimiento de cómo aprenden, qué esperan de la educación, y cómo se podría mejorar su desarrollo académico y su potencial. La Generación Z es conocida como la más diversa, y requiere de una mentoría cercana por parte de los profesores, quienes deben estar listos para ayudar a los estudiantes a manejar el tiempo y los recursos eficientemente. Es importante mencionar que la información referente al desempeño profesional de la Generación Z es aún preliminar, dado que actualmente están cursando sus programas universitarios. Por tanto, será interesante seguir analizando el comportamiento de la Generación Z en la Educación Odontológica.

Adolescencia y consumo de sustancias: Abordaje odontológico / Adolescência e uso de substâncias: Abordagem odontológica / Adolescence and substance use: Dental approach

La adolescencia se caracteriza por ser un periodo de desarrollo en donde se presentan cambios biológicos, fisiológicos y psicológicos que a menudo aumentan la aparición de conductas de riesgo, como el consumo de sustancias. Se han identificado algunos factores que podrían predisponer al desarrollo de esta problemática, entre los cuales están: vulnerabilidad, problemas de autonomía, presión social, eventos traumáticos, trastornos emocionales y psiquiátricos, entre otros. Los profesionales de la salud bucal pueden ayudar a prevenir y detectar casos sospechosos de uso de sustancias, cuando se observan cambios en la apariencia de los pacientes adolescentes. El propósito de este artículo es informar acerca del impacto negativo del consumo de sustancias ilícitas en la salud bucodental de los adolescentes y del reconocimiento de los signos de alerta. Además, se propone una secuencia de atención odontológica para esta población en riesgo

A adolescência caracteriza-se como um período do desenvolvimento em que ocorrem mudanças biológicas, fisiológicas e psicológicas que muitas vezes aumentam o aparecimento de comportamentos de risco, como o uso de substâncias. Foram identificados alguns fatores que podem predispor ao desenvolvimento desse problema, dentre eles: vulnerabilidade, problemas de autonomia, pressão social, eventos traumáticos, transtornos emocionais e psiquiátricos, entre outros. Profissionais de saúde bucal podem ajudar a prevenir e detectar casos suspeitos de uso de substâncias quando são observadas alterações na aparência de pacientes adolescentes. O objetivo deste artigo é relatar o impacto negativo do uso de substâncias ilícitas na saúde bucal de adolescentes e o reconhecimento de sinais de alerta. Além disso, é proposta uma sequência de atendimento odontológico para essa população de risco

Adolescence is characterized as a period of development in which biological, physiological and psychological changes occur that often increase the appearance of risk behaviors, such as substance use. Some factors have been identified that could predispose to the development of this problem: vulnerability, autonomy issues, social pressure, traumatic events, emotional and psychiatric disorders, among others. Oral health professionals can help prevent and detect suspected cases of substance use when changes in the appearance of adolescent patients are observed. The aim of this article is to inform about the negative impact of illicit substance use on the oral health of adolescents and the recognition of warning signs. In addition, a sequence of dental care is proposed for this population at risk.

Materiales bioactivos para restauraciones directas en dientes posteriores / Bioactive materials for direct restorations in posterior teeth

Se trata de paciente femenino de 22 años de edad, en quien se realizó una restauración en un molar siguiendo la filosofía de mínima intervención desde el diagnóstico hasta la obturación con un material bioactivo. Los objetivos del tratamiento fueron devolver la funcionalidad y estética de dicho molar, pero sobre todo brindar una protección a largo plazo mediante la liberación y recarga de iones de calcio, fosfato y flúor proporcionado por el material bioactivo (AU)

t is about a female patient of twenty-two years, in which a restoration was made in a molar following the philosophy of minimal intervention from diagnosis to filling with a bioactive material. The objectives of the treatment were to restore the functionality and aesthetics, but mainly to provide long-term protection through the release and recharge of calcium, phosphate and fluoride ions provided by the bioactive material used (AU)

Efecto de la desprogramación neuromuscular en la calidad de vida y sueño en pacientes con disfunción temporomandibular / Effect of neuromuscular deprogramming on quality of life and sleep in patients with temporomandibular dysfunction

Introduction: Neuromuscular deprogramming reduces the main symptoms such as pain by 70 to 90 percent in patients with temporomandibular dysfunction, but little information is available on the effect on quality of life and sleep. Objective: Determine the effect of neuromuscular deprogramming on quality of life and sleep in patients with temporomandibular dysfunction. Methods: 55 patients with temporomandibular dysfunction were included who were neuromuscularly deprogrammed (29 women and 26 men), with an average age of 34.9 ± 16.5 years. At the beginning and end of neuromuscular deprogramming, surveys were applied to assess the level of chronic pain, perception of quality of life related to oral health, perceived stress, quantity and quality of life, anxiety and depression. Results: In 37 patients (68 percent) pain was identified on examination, and it was confirmed in the chronic pain survey. The quality of life perception score was correlated with low sleep quality (r = 0.39; p = 0.008); pain score (r = 0.48; p = 0.003); anxiety (r = 0.55; p = 0.003) and depression (r = 0.41; p = 0.006). Neuromuscular deprogramming reduced patient-reported pain levels from 9.9 to 2.9 (p = 0.001), the percentage of patients with poor sleep quality from 60 percent to 29 percent (p < 0.0001), the quality of life score from 40.7 to 23.8 (p = 0.03), and perceived stress levels from 22.1 to 19.1 (p = 0.002). Conclusions: In patients with temporomandibular dysfunction, neuromuscular deprogramming reduces the level of pain. It is related to better perception in quality of life, higher quality of sleep and decreases perceived stress.

Introducción: La desprogramación neuromuscular reduce los síntomas principales como el dolor de 70 a 90 por ciento en los pacientes con disfunción temporomandibular, pero se dispone de escasa información sobre el efecto en la calidad de vida y sueño. Objetivo: Determinar el efecto de la desprogramación neuromuscular en la calidad de vida y sueño en pacientes con disfunción temporomandibular. Métodos: Se incluyeron 55 pacientes con disfunción temporomandibular que fueron desprogramados neuromuscularmente (29 mujeres y 26 hombres), con edad promedio de 34,9 ± 16,5 años. Al inicio y final de la desprogramación neuromuscular, se aplicaron las encuestas para evaluar el nivel de dolor crónico, percepción de calidad de vida relacionada con la salud oral, estrés percibido, cantidad y calidad de vida, ansiedad y depresión. Resultados: En 37 pacientes (68 por ciento) se identificó dolor a la exploración confirmado en la encuesta de dolor crónico. El puntaje de percepción de calidad de vida se correlacionó con baja calidad de sueño (r = 0,39; p = 0,008); el puntaje de dolor (r = 0,48; p = 0,003); ansiedad (r = 0,55; p = 0,003) y depresión (r = 0,41; p = 0,006). La desprogramación neuromuscular redujo los niveles de dolor referidos por el paciente de 9,9 a 2,9 (p = 0,001), el porcentaje de pacientes con pobre calidad de sueño de 60 por ciento a 29 por ciento (p < 0,0001), el puntaje de la calidad de vida de 40,7 a 23,8 (p = 0,03) y los niveles de estrés percibido de 22,1 a 19,1 (p = 0,002). Conclusiones: En pacientes con disfunción temporomandibular, la desprogramación neuromuscular reduce el nivel de dolor, se relaciona con mejor percepción en la calidad de vida, mayor calidad de sueño y disminuye el estrés percibido(AU)

Body fat at birth and cord blood levels of insulin, adiponectin, leptin, and insulin-like growth factor-I in small-for-gestational-age infants.

BACKGROUND: Low birthweight has been associated with an increased risk of obesity, insulin resistance, and diabetes in adulthood. The aim of this study was to evaluate IGF-I, adiponectin, insulin levels, and body fat in small-for-gestational-age (SGA) infants at birth. METHODS: We performed a transverse comparative study in SGA and appropriate-for-gestational-age (AGA) infants. The study was conducted at the Hospital of Gynecology and Obstetrics in Leon, Mexico. Weight, length, and percent of body fat were evaluated during the first 48 h of birth. Glucose, insulin, leptin, adiponectin, and IGF-I levels in cord blood were measured. RESULTS: We studied 100 infants (50 SGA and 50 AGA). A history of diabetes in a second-degree relative was higher in SGA infants than in AGA infants (48.0 vs. 30.0%, respectively; p = 0.03). Glucose, adiponectin, insulin and IGF-I levels were similar between the groups. Leptin levels and percentage of body fat were lower in SGA than AGA (15.3 vs. 23.4 ng/mL; p = 0.003, 11.1 vs. 12.7%; p <0.001, respectively). Logistic regression analysis showed that length, percentage of body fat, and leptin levels were positively associated with birthweight. However, leptin levels were not independent of percentage of body fat. CONCLUSIONS: Low body fat and leptin levels, but no evidence of increased metabolic risk at birth, were found in SGA infants.

[Maternal and fetal morbidity related to delayed antenatal work incapacity]. / Morbilidad materno fetal relacionada con el aplazamiento de la incapacidad laboral prenatal.

OBJECTIVE: To determine if there is higher maternal fetal morbidity associated to delayed antenatal work incapacity. PATIENTS AND METHOD: A case-control study was carried out, including 220 pregnant workers. They were divided into 110 women who delayed their antenatal work incapacity (cases) and 110 women who took it on time (controls). Sociodemographic and clinical data, which included maternal fetal morbidity, were registered. Results were analyzed by percentage values and arithmetic mean. Differences between groups were evaluated with Student's t test, chi square test, or exact test of Fisher. An alpha value was set at 0.05. RESULTS: There were 48 (43.6%) women who had antenatal complications in the group of cases and 27 (24.5%) in the controls, p= 0.004. The most common complication in the cases was preterm labor (29.1%), and in the controls was threatening of spontaneous abortion (55.5%). Other significant variables were: higher maternal age in the cases group (32.2 vs 22.5 years, p < 0.001), and lower number of antenatal visits (8.2 vs 9.5, p < 0.001). CONCLUSIONS: We conclude that there is higher maternal morbidity in women who delayed their antenatal work incapacity. It is recommended to give this incapacity according to present normative.