Low-intensity daily smoking and mortality risk among Mexican women.

OBJECTIVE: To examine the association between low-intensity smoking (10 or less cigarettes per day) and all-cause and cause-specific mortality risk among women who smoke and by age at cessation among women who previously smoked. METHODS: In this study, 104 717 female participants of the Mexican Teachers' Cohort Study were categorised according to self-reported smoking status at baseline (2006/2008) and were followed for mortality through 2019. We estimated HRs and 95% CIs for all-cause and cause-specific mortality using multivariable Cox proportional hazards regression models with age as the underlying time metric. RESULTS: Smoking as few as one to two cigarettes per day was associated with higher mortality risk for all causes (HR: 1.36; 95% CI 1.10 to 1.67) and all cancers (HR: 1.46; 95% CI 1.05 to 2.02), compared with never smoking. Similarly, slightly higher HRs were observed among participants smoking ≥3 cigarettes per day (all causes HR: 1.43; 95% CI 1.19 to 1.70; all cancers HR: 1.48; 95% CI 1.10 to 1.97; cardiovascular disease HR: 1.58; 95% CI 1.09 to 2.28). CONCLUSIONS: In this large study of Mexican women, low-intensity smoking was associated with higher mortality risk for all causes and all cancers. Interventions are needed to promote cessation among women who smoke at low-intensity in Mexico, regardless of how few cigarettes they smoke per day.

Childhood acute lymphoblastic leukemia in Mexico: mortality trend analysis, 1998-2018.

OBJECTIVE: To determine the magnitude of mortality due to acute lymphoblastic leukemia (ALL) nationally and by age group, sex, state of residence and insurance status, as well as to evaluate time trends during the period 1998-2018 Materials and methods. We obtained ALL mortality data and estimated age-standardized national, state-level and health insurance mortality rates. We conducted a joinpoint regression analysis to describe mortality trends across the study period and estimate the average annual percent change (AAPC). RESULTS: In a 20-year period, age-standardized ALL mortality rates increased from 1.6 per 100 000 in 1998 to 1.7 in 2018. Nationally, a constant annual increase in mortality was observed for both sexes (1998-2002 AAPC 0.6 in boys, and 1998-2002 AAPC 0.3 in girls). We observed heteroge-neity in childhood ALL at a state level. CONCLUSION: Our results reflect the social, economic, geographic diversity of the country. Monitoring and surveillance of this disease is crucial to assess quality of care.

Aflatoxin levels and prevalence of TP53 aflatoxin-mutations in hepatocellular carcinomas in Mexico.

OBJECTIVE: To determine the exposure to aflatoxin B1 (AFB1) in southern Mexico and the presence of the aflatoxin signature mutation in hepatocellular carcinoma (HCC) tissue from patients from a cancer referral center. MATERIALS AND METHODS: We estimated the prevalence and distribution of AFB1 in a representative sample of 100 women and men from Chiapas using the National Health and Nutrition Survey 2018-19. We also examined the presence of the aflatoxin signature mutation in codon 249 (R249S), and other relevant mutations of the TP53 gene in HCC tissue blocks from 24 women and 26 men treated in a national cancer referral center. RESULTS: The prevalence of AFB1 in serum samples was 85.5% (95%CI 72.1-93.1) and the median AFB1 was 0.117 pg/µL (IQR, 0.050-0.350). We detected TP53 R249S in three of the 50 HCCs (6.0%) and observed four other G>T transversions potentially induced by AFB1. CONCLUSION: Our analysis provides evidence that AFB1 may have a relevant role on HCC etiology in Mexico.

Childhood acute lymphoblastic leukemia in Mexico: mortality trend analysis, 1998-2018 / Mortalidad por leucemia linfoblástica aguda en niños y adolescentes mexicanos: análisis de tendencias 1998-2018

Abstract: Objective: To determine the magnitude of mortality due to acute lymphoblastic leukemia (ALL) nationally and by age group, sex, state of residence and insurance status, as well as to evaluate time trends during the period 1998-2018 Materials and methods: We obtained ALL mortality data and estimated age-standardized national, state-level and health insurance mortality rates. We conducted a joinpoint regression analysis to describe mortality trends across the study period and estimate the average annual percent change (AAPC). Results: In a 20-year period, age-standardized ALL mortality rates increased from 1.6 per 100 000 in 1998 to 1.7 in 2018. Nationally, a constant annual increase in mortality was observed for both sexes (1998-2002 AAPC 0.6 in boys, and 1998-2002 AAPC 0.3 in girls). We observed heterogeneity in childhood ALL at a state level. Conclusion: Our results reflect the social, economic, geographic diversity of the country. Monitoring and surveillance of this disease is crucial to assess quality of care.

Resumen: Objetivo: Determinar la magnitud de mortalidad por leucemia linfoblástica aguda (LLA) infantil a nivel nacional, por grupo de edad, sexo, estado y derechohabiencia, así como evaluar las tendencias en el tiempo. Material y métodos: Se estimaron las tasas de mortalidad estandarizadas por edad y estratificadas. Se realizó un análisis de regresión joinpoint para estimar el cambio porcentual anual promedio (AAPC). Resultados: En un periodo de 20 años, las tasas de mortalidad por LLA aumentaron de 1.6 por 100 000 en 1998 a 1.7 en 2018. A nivel nacional, se observó un aumento anual constante para ambos sexos (1998-2002 AAPC 0.6 en niños, y 1998-2002 AAPC 0.3 en niñas). Existe heterogeneidad en la LLA infantil a nivel estatal. Conclusión: Los resultados reflejan la diversidad social, económica y geográfica del país. El seguimiento y la vigilancia de esta enfermedad es fundamental para evaluar la calidad de atención e implementar medidas para su control.

Aflatoxin levels and prevalence of TP53 aflatoxin-mutations in hepatocellular carcinomas in Mexico / Niveles de aflatoxina y prevalencia de mutaciones del gen TP53 por aflatoxina en carcinoma hepatocelular en México

Abstract: Objective: To determine the exposure to aflatoxin B1 (AFB1) in southern Mexico and the presence of the aflatoxin signature mutation in hepatocellular carcinoma (HCC) tissue from patients from a cancer referral center. Materials and methods: We estimated the prevalence and distribution of AFB1 in a representative sample of 100 women and men from Chiapas using the National Health and Nutrition Survey 2018-19. We also examined the presence of the aflatoxin signature mutation in codon 249 (R249S), and other relevant mutations of the TP53 gene in HCC tissue blocks from 24 women and 26 men treated in a national cancer referral center. Results: The prevalence of AFB1 in serum samples was 85.5% (95%CI 72.1-93.1) and the median AFB1 was 0.117 pg/µL (IQR, 0.050-0.350). We detected TP53 R249S in three of the 50 HCCs (6.0%) and observed four other G>T transversions potentially induced by AFB1. Conclusion: Our analysis provides evidence that AFB1 may have a relevant role on HCC etiology in Mexico.

Resumen: Objetivo: Determinar la exposición a aflatoxina_B1 (AFB1) en el sur de México y la presencia de la mutación característica de AFB1 en tejido de carcinoma hepatocelular (CHC) de pacientes de un centro oncológico. Material y métodos: Se estimó la prevalencia y distribución de AFB1 en una muestra representativa de 100 mujeres y hombres de Chiapas a partir de la Encuesta Nacional de Salud y Nutrición 2018-19. También se observó la presencia de la mutación característica de AFB1 en el codón 249 (R249S), y otras mutaciones relevantes del gen TP53 en bloques de tejido de CHC de 24 mujeres y 26 hombres estudiados en un centro de referencia nacional de oncología. Resultados: La prevalencia de AFB1 en las muestras de suero fue de 85.5% (IC95% 72.1-93.1) y la mediana de la concentración 0.117 pg/µL (IQR, 0.050-0.350). Se detectó TP53 R249S en tres de 50 casos de CHC (6.0%) y se observaron cuatro transversiones G>T potencialmente inducidas por AFB1. Conclusión: El presente análisis proporciona evidencia de que la AFB1 puede tener un papel relevante en la etiología del CHC en México.

Prevalence and Correlates of Mental Health Outcomes During the SARS-Cov-2 Epidemic in Mexico City and Their Association With Non-adherence to Stay-At-Home Directives, June 2020.

Objectives: To describe the prevalence and correlates of depressive symptoms, generalized anxiety disorder (GAD), and perceived negative mental health impact during the SARS-Cov-2 pandemic in Mexico City and evaluate their association with adherence to stay-at-home directives. Methods: Baseline data from a cohort study of 2,016 Mexico City government employees were analyzed using multivariable logistic regression models. Results: Among participants, 17.2% had clinically significant depressive symptoms, 21.6% had probable GAD, and 15.2% reported that the pandemic has had a major impact on their mental health. Factors including the presence of COVID-19 symptoms, self-isolation, and economic difficulties were associated with poor mental health. The presence of depressive symptoms and general anxiety were associated with non-adherence to public health directives, particularly among those who might have experienced these symptoms for the first time during the pandemic. Conclusion: Our study is one of the first to document the population mental health burden during the SARS-CoV-2 pandemic in Mexico and to provide evidence of the potential role of mental health in the adherence to public health measures.