HIV-Related Stigma and Treatment Adherence Among Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Crystal Meth in the Metropolitan Area of Mexico City.

Internationally, HIV-related stigma and crystal methamphetamine (meth) use have been described as barriers to treatment adherence among gay, bisexual, and other men who have sex with men (gbMSM). Crystal meth use has been increasing among gbMSM in the Metropolitan Area of Mexico City (MAMC). Therefore, this study aimed to determine the association between HIV-related stigma and HIV treatment adherence among gbMSM who use crystal meth in the MAMC. This study was undertaken as part of an exploratory study of crystal meth use in the MAMC. The data were collected from September to December 2021 through an encrypted online survey. Participants (n = 89) were gbMSM adults living with HIV who reported crystal meth use in the past month that were recruited through an online snowball sampling. The online survey included questions about HIV treatment adherence, sexual behaviors, the Alcohol, Smoking, and Substance Involved Screening Test, and the HIV-Related Stigma Mechanisms Scale. Logistic regression analyses assessed the association between HIV-related stigma and HIV treatment adherence. The multivariate logistic regression model showed that, controlling for health insurance [adjusted odds ratio (AOR) = 0.13; 95% confidence intervals (CI)  = 0.02-0.59] and educational level (AOR = 0.16; 95% CI = 0.02-0.88), non-adherence to HIV treatment was independently associated with higher HIV-related stigma (AOR = 1.06; 95% CI = 1.01-1.12). Public health policies must include HIV-related stigma and substance use in treating gbMSM with HIV.

Feasibility, acceptability, and perceived usefulness of a community-evidence-based harm reduction intervention for sexualized stimulant use among Mexican gay, bisexual, and other men who have sex with men.

BACKGROUND: The use of stimulants and other substances with the purpose of enhancing, maintaining, and prolonging sexual activity is known as sexualized substance use. Also known as chemsex, this pattern of use has been mainly explored in high-income countries. The aim of this article was to assess the feasibility, acceptability, and usefulness of a community- evidence-based harm reduction intervention among Mexican gay, bisexual, and other men who have sex with men (gbMSM) adults who reported sexualized stimulant use in the past 6 months and who were not enrolled in any psychosocial treatment. METHODS: The in-person intervention was designed in partnership with gbMSM who used substances. It consisted of 39 harm reduction strategies before, during, and after episodes of use. The components of the intervention were health and self-care, safety, and psychopharmacology. The intervention was delivered at a university campus, a public recreational space, and an HIV public clinic. Feasibility to deliver the intervention was assessed based on enrolment and completion rates; acceptability through a 28-item, 5-point Likert scale (140 max.) constructed and validated for the Mexican population with good reliability coefficients; usefulness through a 5-point Likert scale ("not useful"-"very useful") for each of the 39 strategies; and potential behavioral change by subtracting the likelihood of implementing each strategy minus the frequency of use of the technique before the intervention. RESULTS: Participants (n = 19; recruitment rate = 35.2%; completion rate = 84.2%) rated the intervention as acceptable with a mean score of 121.6 (SD = 7.5). The highest potential for behavioral change was regarding the use of information about the half-life of stimulants, polysubstance use, and overdose prevention. CONCLUSIONS: This intervention is feasible when provided within public health services where potential participants are already in contact. Harm reduction strategies need to surpass sexually transmitted infections prevention and HIV care and focus on substance use and mental health strategies.

HIV Stigma Mechanisms Scale: Factor Structure, Reliability, and Validity in Mexican Adults.

We aimed to validate the HIV Stigma Mechanisms Scale (HIV-SMS) in a sample of Mexican adults living with HIV, which differentiates between sources and mechanisms of stigma. Adults (n = 362) with a median age of 32 years old completed a web-based version in Spanish of the HIV-SMS as well as sociodemographic and HIV-related characteristics questionnaire. Exploratory factor analyses with weighted least squares and oblique rotation were performed to assess the construct validity of the scale. The Spanish translation for the Mexican population of the HIV-SMS has adequate internal consistency (Ω = 0.86) and demonstrated a structure similar to the original scale. After excluding the items related to community and social workers, a five-factor solution with internalized, promulgated, and anticipated stigma from family and healthcare workers showed adequate construct validity. The HIV-SMS is a valid and sensitive scale that can be used in a Mexican adult population living with HIV.

RESUMEN: El objetivo de este estudio fue validar la Escala de Mecanismos de Estigma de VIH (EME-VIH) en una muestra de adultos mexicanos que viven con VIH. Esta escala distingue entre fuentes y mecanismos de estigma. 362 adultos con una edad media de 32 años completaron vía web una versión en español de la EME-VIH así como preguntas acerca de sus características sociodemográficas y cuestiones relacionadas con el VIH. Se realizaron análisis factoriales exploratorios de mínimos cuadrados ponderados con rotación oblicua para evaluar la validez de constructo de la escala. La traducción al español de la EME-VIH para población mexicana tiene consistencia interna adecuada (Ω = 0.86) y muestra una estructura similar a la escala original. Después de excluir los ítems relacionados con trabajadores comunitarios y sociales, se encontró una solución con validez de constructo adecuada de cinco factores: estigma internalizado, promulgado y anticipado ejercido por la familia y personal de salud. La EME-VIH es una escala válida y sensible que puede usarse en población adulta mexicana que vive con VIH.

Bioactive role of vitamins as a key modulator of oxidative stress, cellular damage and comorbidities associated with spinal cord injury (SCI).

Introduction: Spinal cord injury (SCI) cause significant disability and impact the quality of life of those affected by it. The nutritional status and diet are fundamental to diminish the progression of complications; vitamins modulate the inflammatory response and oxidative stress, promote blood-spinal cord barrier preservation and the prompt recovery of homeostasis. A deep knowledge of the benefits achieved from vitamins in patients with SCI are summarized. Information of dosage, time, and effects of vitamins in these patients are also displayed. Vitamins have been extensively investigated; however, more clinical trials are needed to clarify the scope of vitamin supplementation.Objective: The objective of this review was to offer relevant therapeutic information based on vitamins supplementation for SCI patients.Methods: Basic and clinical studies that have implemented the use of vitamins in SCI were considered. They were selected from the year 2000-2022 from three databases: PubMed, Science Direct and Google Scholar.Results: Consistent benefits in clinical trials were shown in those who were supplemented with vitamin D (prevents osteoporosis and improves physical performance variables), B3 (improves lipid profile) and B12 (neurological prophylaxis of chronic SCI damage) mainly. On the other hand, improvement related to neuroprotection, damage modulation (vitamin A) and its prophylaxis were associated to B complex vitamins supplementation; the studies who reported positive results are displayed in this review.Discussion: Physicians should become familiar with relevant information that can support conventional treatment in patients with SCI, such as the use of vitamins, a viable option that can improve outcomes in patients with this condition.

A longitudinal study on the impact of Internet gaming disorder on self-perceived health, academic performance, and social life of first-year college students.

BACKGROUND AND OBJECTIVES: Internet gaming disorder (IGD) is associated with health, social, and academic problems but whether these are consequences of the disorder rather than precursors or correlates is unclear. We aimed to evaluate whether IGD in the 1st year of university predicts health, academic and social problems 1 year later, controlling for baseline health, academic and social problems, demographics, and mental health symptoms. METHODS: In a prospective cohort study, 1741 university students completed both a baseline online survey in their 1st year and a follow-up survey 1 year later. Log-binomial models examined the strength of prospective associations between baseline predictor variables (IGD, baseline health, academic and social problems, sex, age, and mental health symptoms) and occurrence of health, academic and social problems at follow-up. RESULTS: When extensively adjusted by the corresponding outcome at baseline, any mental disorder symptoms, sex, and age, baseline IGD was associated only with severe school impairment and poor social life (risk ratio [RR] = 1.77; 95% confidence interval [CI] = 1.14-2.75, p = .011; RR = 1.22; 95% CI = 1.07-1.38, p = .002, respectively). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: University authorities and counselors should consider that incoming 1st-year students that meet criteria for IGD are likely to have increased academic and social impairments during their 1st year for which they may want to intervene. This study adds to the existing literature by longitudinally examining a greater array of negative outcomes of IGD than previously documented.

Alcohol and cannabis use in traffic-related injuries in Mexico City.

BACTERKGROUND: There is debate on whether cannabis affects road traffic injuries (RTIs) separately from the effects of alcohol. Our goals are to report the possible increase in risk of an RTI among alcohol and cannabis users by type of exposure (biological, self-reported and combined) and the possible interaction of alcohol and cannabis in patients with an RTI in an emergency department in Mexico City. METHODS: A case-crossover study with 433 cases of RTI (as a pedestrian, driver or passenger) during the period January-April 2022. A breath sample, an oral sample for cannabis detection and self-reported alcohol and cannabis use 6 hours prior to the RTI and in two control periods were used. We report ORs and 95% CIs from conditional logistic regressions for the case-crossover estimates. RESULTS: Alcohol alone increased the risk of an RTI (OR=6.02, 95% CI 3.29 to 10.99) for most RTIs, regardless of whether we used information from self-reports or a breath sample in the hazard period. Conversely, cannabis only increased the RTI when we added information in the hazard period from self-reports or oral samples. Nevertheless, this increase in risk disappeared (OR=2.06, 95% CI 0.90 to 4.70) among those who only used cannabis. We also found no evidence of interaction between alcohol and cannabis in the risk of an RTI. CONCLUSIONS: Alcohol is the most commonly used substance in Mexico and a high-risk factor for RTI in Mexico City. Although cannabis alone was not associated with an RTI, continuous monitoring of its effects is required.

Resilience and risk factors associated to depressive symptoms in Mexican healthcare workers during the Covid-19 pandemic.

OBJECTIVE: Report the prevalence of depression, resilience, and risk factors among healthcare workers (HCW) during Co-vid-19. MATERIALS AND METHODS: This is an observational cross-sectional study derived from the ongoing international, prospective multicentric study "The COVID-19 HEalth caRe wOrk-Ers Study" (HEROES). A convenience sample of 2 127 HCW was obtained from Chiapas and Jalisco between May 19th and July 24th 2020. Depression was assessed using the Patient Health Questionnaire, resilience with the Brief Resilience Scale and a Covid risk scale was developed. Model-adjusted prevalence ratios (PRs) and an additive interaction model were performed. RESULTS: Moderate-severe depression was found in 16.6% of HCW. Those from Jalisco, physicians, in hospitals, with chronic illness and mental health history were more depressed. The interaction between resilience and risk showed that, compared to those with no risk and medium/high resilience, HCW at risk with medium/high resilience had a 2.38 PR for depression while those at risk and low resilience had a PR of 5.83. CONCLUSION: This evidence points the need to develop strategies to enhance resilience and reduce the risk in HCW.

Mental disorders in Mexico 1990-2021. Results from the Global Burden of Disease 2021 study.

BACKGROUND: Mental disorders are one of the main causes of years lived with disability, although there is a lack of recent estimates of their magnitude. OBJECTIVE: To report the trends of mental disorders prevalence, years lived with disability and years of healthy life lost by sex, age and state in Mexico. MATERIAL AND METHODS: The Global Burden of Disease database for Mexico was used. RESULTS: There were an estimated 18.1 million persons with some mental disorder in 2021, which represented an increase of 15.4% in comparison with 2019. Depressive and anxiety disorders did significantly increase between 2019 and 2021, which is possibly related to COVID-19, the confinement and the situations of grief experienced during the pandemic. CONCLUSIONS: Mental disorders have considerably increased since the only national mental health survey that used diagnostic criteria to evaluate their prevalence. It is important to invest in epidemiological studies, prevention and care of mental disorders, which are among the leading causes of years lived with disability in the country.

ANTECEDENTES: Los trastornos mentales constituyen una de las principales causas de años vividos con discapacidad, si bien no se dispone de estimaciones recientes sobre su magnitud. OBJETIVO: Reportar las tendencias de prevalencia de trastornos mentales, los años vividos con discapacidad y los años de vida saludables perdidos por sexo, edad y entidad federativa de México. MATERIAL Y MÉTODOS: Se utilizó la base de datos para México del Global Burden of Disease. RESULTADOS: Se calcularon 18.1 millones de personas con algún trastorno mental en 2021, que representaron un incremento de 15.4 % respecto a 2019. Los trastornos depresivos y de ansiedad aumentaron de manera notable entre 2019 y 2021, lo cual posiblemente esté relacionado con COVID-19, el confinamiento y los duelos vividos durante la pandemia. CONCLUSIONES: Los trastornos mentales se han incrementado considerablemente desde la única encuesta nacional de salud mental que utilizó criterios diagnósticos para evaluar las prevalencias. Es importante invertir en estudios epidemiológicos, prevención y atención de los trastornos mentales, los cuales se encuentran entre las primeras causas de años vividos con discapacidad en el país.

Serpin-A3 is Associated with Persistent Albuminuria in Adolescents with Secondary Podocytopathy, in a Region with High Prevalence of Chronic Kidney Disease of Unknown Origin.

Background: The state of Aguascalientes, Mexico, has been recognized as a chronic kidney disease hotspot. Screening studies have revealed a high prevalence of persistent albuminuria (pA), histologically characterized by glomerulomegaly, and incomplete podocyte fusion, probably associated with oligonephrony. To date, urinary biomarkers have not been explored in this population. Objective: The aim of the study was to identify the presence of potential biomarkers of early renal injury in patients with pA (pACR) and that correspond with the characteristic nephropathy profile that prevails in this entity. Methods: This is a cross-sectional, analytical, and comparative study. Four groups were recruited: adolescents aged 10-17 years with pACR, isolated albuminuria (iACR), no albuminuria (negative control), and adults with biopsy-confirmed glomerulopathy (positive control). Urinary excretion of SerpinA3, heat-shock protein-72 (HSP-72), podocalyxin (PCX), and nephrin was evaluated in urine samples. SerpinA3 and HSP-72 were analyzed by Western blot, and PCX and nephrin were quantified by enzyme-linked immunosorbent assay. Results: The mean GFR in the pACR group was 113.4 mL/min/1.73m2 and differed significantly only from that of the positive control group (65.1 mL/min/1.73m2). The mean albuminuria value in the pACR group was 48.9 mg/g. SerpinA3 concentration differed between groups (0.08 vs. 0.25 ng/mL, p < 0.001): it was significantly higher in the pACR group compared to the negative controls (p = 0.037). Conclusion: SerpinA3 was significantly associated with pA and could become a biomarker of early kidney injury. Further investigations are required to determine whether SerpinA3 precedes the development of albuminuria and its pathogenic role.

(Internet) Gaming Disorder in DSM-5 and ICD-11: A Case of the Glass Half Empty or Half Full: (Internet) Le trouble du jeu dans le DSM-5 et la CIM-11: Un cas de verre à moitié vide et à moitié plein.

BACKGROUND: Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included in 2013 Internet gaming disorder (IGD) as a condition for further study, and in 2018, the World Health Organization included gaming disorder (GD) as a mental disorder in the International Classification of Disease (ICD-11). We aim to compare disorders of gaming in both diagnostic systems using a sample of young adults in Mexico. METHODS: Self-administered survey to estimate the prevalence of DSM-5 IGD and ICD-11 GD in 5 Mexican universities; 7,022 first-year students who participated in the University Project for Healthy Students, part of the World Health Organization World Mental Health International College Student Initiative. Cross-tabulation, logistic regression, and item response theory were used to inform on 12- month prevalence of DSM-5 IGD and ICD-11 GD, without and with impairment. RESULTS: The 12-month prevalence of DSM-5 IGD was 5.2% (95% CI, 4.7 to 5.8), almost twice as high as the prevalence using the ICD-11 GD criteria (2.7%; 95% CI, 2.4 to 3.1), and while adding an impairment requirement diminishes both estimates, prevalence remains larger in DSM-5. We found that DSM-5 cases detected and undetected by ICD-11 criteria were similar in demographics, comorbid mental disorders, service use, and impairment variables with the exception that cases detected by ICD-11 had a larger number of symptoms and were more likely to have probable drug dependence than undetected DSM-5 cases. CONCLUSION: DSM-5 cases detected by ICD-11 are mostly similar to cases undetected by ICD-11. By using ICD-11 instead of DSM-5, we may be leaving (similarly) affected people underserved. It is unlikely that purely epidemiological studies can solve this discrepancy and clinical validity studies maybe needed.

Understanding differences in prescription drug misuse between two Texas border communities.

Objectives: The misuse of prescription drugs in the U.S. is an alarming public health crisis. Prior research at the U.S.-Mexico border has found high rates of prescription drug misuse, but with rates varying significantly across border communities. We aimed to examine a model of permissive climate measures and stress exposures as potential mediators of community differences in prescription drug misuse at the U.S.-Mexico border.Design: We analyzed data from the U.S.-Mexico Study of Alcohol and Related Conditions (UMSARC). Household, in-person interviews were conducted with Mexican-origin residents of the Texas border cities Laredo (n = 751) and Brownsville/McAllen (n = 814). Interviews assessed past-year misuse of any and pain-reliever prescription drugs. Drug availability, neighborhood safety, exposure to violence/crime, and social support were examined as potential mediators. Analyses were stratified by gender and employed regressions and mediation analysis with Mplus.Results: The past-year prevalence of any prescription drug misuse in Laredo was 26.3% among women and 24.4% among men, and in Brownsville/McAllen was 12.4% among men, and 6.7% among women. Mediation analysis revealed site effects via some of the hypothesized risk factors for men, but not for women. Specifically, for men, site effects on any and pain reliever prescription drug misuse were partially mediated via high drug availability and low family support.Conclusions: Past-year prescription drug misuse was over 3 times the 2015 national prevalence among both men and women in Laredo and calls for immediate attention. Findings regarding the model suggest drug availability and social support may be relevant to understanding community differences in prescription drug misuse among men living at the border, and that additional factors should be investigated to understand misuse among women living at the border.

Suicide ideation and behavior in Mexico: Encodat 2016.

OBJECTIVE: To provide updated information regarding the 12-month prevalence and associated sociodemographic factors for suicide ideation and behavior (plan and attempts) to substantiate preventive programs in Mexico. MATERIALS AND METHODS: Cross-sectional nationally representative survey, conducted during 2016 (n=56 877) among those 12-65 years old living in rural, urban and metropolitan dwellings. RESULTS: The prevalence of suicide ideation in the last 12-months was 2.3%, 0.8% of the sample reported a plan and 0.7% reported a suicide attempt. All three outcomes were about two times more common among females and suicide plan and attempt were less common among the elderly (50-65 years old). Suicide attempts were more common in urban than in rural areas. The state of Tabasco showed an increased prevalence of ideation, plan and attempts when compared to national average rates. CONCLUSIONS: Public health measures to diminish and treat suicidal behavior are urgently needed all over the country.

OBJETIVO: Dar información actualizada sobre la prevalencia de 12 meses y los factores sociodemográficos asociados para la ideación y el comportamiento suicida (plan e intentos) para fundamentar programas preventivos en México. MATERIAL Y MÉTODOS: Encuesta transversal representativa a nivel nacional, por sexo y grupos de edad, realizada durante 2016 (n = 56 877) entre personas de entre12 y 65 años de edad en zonas rurales, urbanas y metropolitanas. RESULTADOS: La prevalencia de ideación suicida en los últimos 12 meses fue de 2.3%, 0.8% de la muestra informó un plan y 0.7% informó un intento de suicidio. Los tres resultados fueron aproximadamente dos veces más comunes entre las mujeres y el intento de suicidio fue menos común entre los más viejos (50 a 65 años). Los intentos de suicidio fueron más comunes en las zonas urbanas que en las rurales. El estado de Tabasco mostró una mayor prevalencia de ideas, planes e intentos en comparación con las tasas promedio nacionales. CONCLUSIONES: Es urgente y necesario que existan medidas de salud pública para disminuir y tratar el comportamiento suicida en todo el país.

Drug use on both sides of the US-Mexico border.

OBJECTIVE: To compare drug use for cities along the USMexico border. MATERIALS AND METHODS: Data are from the US-Mexico Study on Alcohol and Related Conditions (UMSARC, 2011-2013), a survey of 4 796 randomly selected BMexican and of Mexican origin individuals on both sides of the border. RESULTS: Higher rates of any past-year drug use and symptoms of drug use disorders were found only in the border city of Laredo, when compared to the non-border city of San Antonio. Nuevo Laredo and Reynosa/Matamoros showed higher rates of drug use than the non-border city of Monterrey. Much higher rates (OR's in the range of 4-11) were found in the US cities when compared to their acrossthe-border Mexican counterparts. CONCLUSIONS: Drug use is high on the border for the selected Mexican cities. Misuse of prescription drugs is nevertheless a concern in the south Texas border cities in our study.

Alcohol and Road Traffic Injuries in Latin America and the Caribbean: A Case-Crossover Study.

BACKGROUND: This study reports dose-response estimates for the odds ratio (OR) and population attributable risk of acute alcohol use and road traffic injury (RTI). METHODS: Data were analyzed on 1,119 RTI patients arriving at 16 emergency departments (EDs) in Argentina, Brazil, Costa Rica, Dominican Republic, Guatemala, Guyana, Mexico, Nicaragua, Panama, and Trinidad and Tobago. Case-crossover analysis, pair-matching the number of standard drinks consumed within the 6 hours prior to the RTI with 2 control periods (prior d/wk), was performed using fractional polynomial analysis for dose-response. RESULTS: About 1 in 6 RTI patients in EDs were positive for self-reported alcohol 6 hours prior to the injury (country range 8.6 to 24.1%). The likelihood of an RTI with any drinking prior (compared to not drinking) was 5 times higher (country range OR 2.50 to 15.00) and the more a person drinks the higher the risk. Every drink (12.8 g alcohol) increased the risk of an RTI by 13%, even 1 to 2 drinks were associated with a sizable increase in risk of an RTI and a dose-response was found. Differences in ORs for drivers (OR = 3.51; 95% CI = 2.25 to 5.45), passengers (OR = 8.12; 95% CI = 4.22 to 15.61), and pedestrians (OR = 6.30; 95% CI = 3.14 to 12.64) and attributable fractions were noted. Acute use of alcohol was attributable to 14% of all RTIs, varying from 7% for females to 19% for being injured as a passenger. CONCLUSIONS: The finding that the presence of alcohol increases risk among drivers and nondrivers alike may further help to urge interventions targeting passengers and pedestrians. Routine screening and brief interventions in all health services could also have a beneficial impact in decreasing rates of RTIs. Higher priority should be given to alcohol as a risk factor for RTIs, particularly in Latin America and the Caribbean.

A dose-response estimate for acute alcohol use and risk of suicide attempt.

This study reports dose-response estimates for the relative risk and population attributable risk (PAR) between acute alcohol use and serious suicide attempt. Data were analyzed on 272 suicide attempters arriving at 38 emergency departments within 6 hours of the event in 17 countries. Case-crossover analysis, pair-matching the number of standard drinks consumed within the 6 hours prior to the suicide attempt with that consumed during the same 6-hour period of the previous week, was performed using fractional polynomial analysis for dose-response. Every drink increased the risk of a suicide attempt by 30 percent; even one-two drinks was associated with a sizable increase in the risk of a serious suicide attempt, and a dose-response was found for the relationship between drinking 6 hours prior and the risk of a suicide attempt up to 20 drinks. Acute use of alcohol was responsible for 35 percent PAR of all suicide attempts. While very high levels of drinking were associated with larger relative risk s of suicide attempt, the control and reduction of smaller quantities of acute alcohol use also had an impact on population levels of suicide attempt, as showed here for the first time with our PAR estimates. Interventions to stop drinking or at least decrease levels of consumption could reduce the risk of suicide attempt. Screening people more at risk to suffer these acute effects of ethanol and offering interventions that work to these high-risk groups are a matter of urgent new research in the area.

Substance Use and Cumulative Exposure to American Society: Findings From Both Sides of the US-Mexico Border Region.

OBJECTIVES: We investigated whether Mexican immigration to the United States exerts transnational effects on substance use in Mexico and the United States. METHODS: We performed a cross-sectional survey of 2336 Mexican Americans and 2460 Mexicans in 3 Texas border metropolitan areas and their sister cities in Mexico (the US-Mexico Study on Alcohol and Related Conditions, 2011-2013). We collected prevalence and risk factors for alcohol and drug use; Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, alcohol-use disorders; and 2 symptoms (hazardous use and quit or control) of drug use disorder across a continuum of migration experiences in the Mexican and Mexican American populations. RESULTS: Compared with Mexicans with no migrant experience, the adjusted odds ratios for this continuum of migration experiences ranged from 1.10 to 8.85 for 12-month drug use, 1.09 to 5.07 for 12-month alcohol use disorder, and 1.13 to 9.95 for 12-month drug-use disorder. Odds ratios increased with longer exposure to US society. These findings are consistent with those of 3 previous studies. CONCLUSIONS: People of Mexican origin have increased prevalence of substance use and disorders with cumulative exposure to US society.

Eight-year incidence of psychiatric disorders and service use from adolescence to early adulthood: longitudinal follow-up of the Mexican Adolescent Mental Health Survey.

Half of mental disorders have their first onset before adulthood when the presence of a disorder may be particularly disruptive to developmental milestones. Retrospective prevalence estimates have been shown to underestimate the burden of mental illness and scarce data are available on the incidence of disorders throughout the adolescent period, especially in developing countries. Thus, the objective was to determine the incidence of mental disorders in an 8-year period from adolescence to young adulthood, onset of service use and their predictors in a Mexican cohort. 1071 respondents from a representative two-wave panel sample participated in the Mexican Adolescent Mental Health Survey in 2005 and in the follow-up survey in 2013. Disorders were evaluated with the World Mental Health Composite International Diagnostic Interview. 37.9% experienced the onset of a psychiatric disorder and 28.4% sought services for the first time. Substance use disorders had the greatest incidence, followed by mood and behavior disorders, anxiety disorders and lastly eating disorders. Sex, age, school dropout, childhood adversities and prior mental disorders predicted the onset of new disorders. Being female, having more educated parents and most classes of disorder predicted first time service use. These findings contribute to a paradigm shift in conceptions of mental disorder similar to how we think of common physical afflictions as near universal experiences across the life course, but less frequent at any given moment. Adolescents are particularly vulnerable. Therefore, public health policy should focus on early universal promotion of positive mental health and structural determinants of mental health.

Co-occurrence of alcohol, drug use, DSM-5 alcohol use disorder, and symptoms of drug use disorder on both sides of the U.S.-Mexico border.

BACKGROUND: The U.S.-Mexico border displays elevated rates of hazardous alcohol and drug use. Whether the co-occurrence of alcohol and drug use and disorders is also high in the border area is unknown. METHODS: Data are from the U.S.-Mexico Study on Alcohol and Related Conditions, a cross-sectional survey of randomly selected respondents interviewed from 2011 to 2013. Participants included 1,690 Mexican Americans from Texas (572 in an off-border city and 1,118 from 3 border cities) and 1,293 Mexicans from Nuevo Leon and Tamaulipas (415 in an off-border city and 878 from 3 Mexican cities bordering Texas) who reported drinking in the last 12 months. Participants were interviewed regarding the prevalence of and risk factors for: (i) co-occurring hazardous alcohol use (5+/4+ at least monthly) and drug use (medical and illicit) and (ii) co-occurring presence of a DSM-5 alcohol use disorder (AUD) and 2 symptoms (hazardous use and quit/control) of drug use disorder (DUD symptoms). RESULTS: Co-occurring hazardous alcohol and drug use was more common in the U.S. border cities (14.7%) than off-border (7.2%), but similar for Mexican border (1.2%) and off-border (1.4%) cities. Co-occurrence of AUD and DUD symptoms was likewise more common at the U.S. border (6.8%) than off-border (3.3%), as well as at the Mexican border (1.3%), compared to off-border (0.6%), but not statistically significant for Mexico. In models adjusting for demographics, mobility factors and exposure to the U.S. culture, border residence in both countries related to a nearly twofold increase in prevalence ratios (PRs) of co-occurring AUD and DUD symptoms (PR = 1.97, 95% CI = 1.36 to 2.85). CONCLUSIONS: Increased rates of co-occurring AUDs and DUDs suggest an added negative impact on already difficult conditions of the border population.

The 2021 Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) guidelines and the outpatient management: Examining physician adherence and its effects on patient outcome.

Background: Chronic obstructive pulmonary disease (COPD) is a common preventable illness that carries a large global economic and social burden. The global initiative for chronic obstructive lung disease (GOLD) guidelines has been utilized as a global strategy for the continued COPD diagnosis, assessment, and treatment. We aimed to determine if the adherence to the 2021 GOLD guideline directed management influenced outcomes. Materials and Methods: Retrospective medical records review of adult patients with COPD, who received care in our office during the entire year of 2021. Patients managed as per the 2021 GOLD guidelines were compared with those who received usual care. Results: Among 242 patients, 171 (70.7%) were GOLD management adherent (GA) and 71 (29.3%) were GOLD non-adherent (GNA). Certain comorbidities were associated with higher frequencies in the GA group, such as allergic rhinitis (63.2 vs. 18.3%; P < 0.001), coronary artery disease (55.9 vs. 38.0%; P = 0.011), GERD (63.2 vs. 32.4%; P < 0.001), anemia (38.6 vs. 19.7%; P = 0.004), malignancy (34.5 vs. 19.7%; P = 0.023), and immunodeficiency (12.3 vs. 1.4%; P = 0.007). There was no significant difference in the mortality between the GA and GNA groups (5.3 vs. 9.9%; P = 0.254). Although the frequency of number of exacerbations was greater in the GA group, the difference in the mean number of exacerbations was not statistically significant (0.39 ± 1.08 vs. 0.39 ± 1.14; P = 0.984). Conclusion: We found no significant difference in the patient outcomes, such as number of exacerbations of COPD and mortality, when comparing the 2021 GOLD guideline adherent versus GOLD guideline non-adherent management of COPD.

Substance use and type of Road Traffic Injury in Mexico City.

Limited data are available in Mexico on the prevalence of alcohol and drug use and the possible differences in their effects on types of road traffic injury (RTI), such as those involving pedestrians, drivers or passengers of motorcycles or other motor vehicles, and the association between substance use and driving behaviors, for preventive purposes. The sample comprised 433 adult RTI patients, admitted to the emergency department (ED) of a public hospital in Mexico City (January to April 2022). Breath Alcohol Concentration (BAC) was measured using a breath tester, and six types of drugs (amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, and methamphetamine) were assessed using a saliva screen test. RTI patients also self-reported their alcohol and drug use in the six hours prior to the accident. Approximately 62% of respondents had been involved in a motorcycle crash. One in three patients self-reported or had traces of a substance in their saliva or breath. The most common substance was alcohol (23.6%), followed by cannabis and stimulants (10.9%). One in five patients reported having used a cell phone ten minutes before the injury. One in three had not been using any safety device, the only behavior exacerbated by substance use. We found a high prevalence of substance use in the sample of RTI patients admitted to the ED, regardless of the type of the RTI, together with high cell phone rates. Motorcycle passengers under the influence were particularly likely not to have been wearing a helmet.