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BACKGROUND & AIMS: The prevalence of precursor lesions for gastric cancer (GC) and the differential burden between countries of varying GC risk is not well-understood. We conducted a systematic review and meta-analysis to estimate the global prevalence of precursor lesions. METHODS: We estimated the prevalence of atrophic gastritis (AG), gastric intestinal metaplasia (IM), and dysplasia in regions with low, medium, and high GC incidence. Because IM is an advanced manifestation of AG, we assessed the prevalence of less advanced precursors, regardless of the presence of more advanced lesions. Prevalence was sub-stratified by Helicobacter pylori infection, symptomatology, and period (<2000, 2000-2010, and >2010). RESULTS: Among the 582 articles that underwent full-text review, 166 studies met inclusion criteria. The global prevalence estimates of AG, IM, and dysplasia were 25.4%, 16.2%, and 2.0%, respectively, on the basis of 126 studies that reported the prevalence of less advanced precursors, regardless of the presence of more advanced lesions. The prevalence of all precursor lesions was higher in high and medium compared with low GC incidence countries (P < .01). Prevalence of AG and IM was significantly higher among H pylori-infected individuals (P < .01) but not statistically different between symptomatic and asymptomatic individuals (P > .17). All precursors demonstrated a secular decrease in prevalence over time. CONCLUSIONS: Gastric precursor lesions have differences in prevalence in regions with differential GC incidence and are associated with H pylori infection. Because of the substantial prevalence of precursor lesions in both symptomatic and asymptomatic individuals, symptomatic evaluation may not be sufficient to identify individuals at risk. These estimates provide important insights for tailoring GC prevention strategies.
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Neoplasias Gástricas , Humanos , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/patología , Prevalencia , Salud Global/estadística & datos numéricos , Infecciones por Helicobacter/epidemiología , Metaplasia/epidemiología , Lesiones Precancerosas/epidemiología , Lesiones Precancerosas/patología , Gastritis Atrófica/epidemiologíaRESUMEN
BACKGROUND: Physical activity (PA) among Hispanic and other minority adolescents in the U.S. lag behind White, non-Hispanic adolescents. Previous studies have examined the beneficial impact of culturally informed, community-based health programs within the Hispanic community on PA levels. There is a need for longer term follow up to determine the impact on family and individual habits over time. Our study aims to explore the aspects of a two-year PA and nutrition program, Families Inspired Together 4 Youth Empowered to Succeed (FIT4YES), that continue to influence family health habits and child development. METHODS: Community-based focus groups were held in Milwaukee, WI with Hispanic parent participants of the FIT4YES program three years after program conclusion. A semi-structured guide of open-ended questions was used to facilitate the discussion of the lasting impact of FIT4YES. Each group was audio recorded, transcribed, and translated from Spanish when necessary. Four student researchers utilized a grounded theory qualitative approach to identify overarching themes. RESULTS: Three focus groups with 16 total parents (N = 16) spoke about the program. Three overarching themes emerged from the transcripts indicating that cultural exposure, relationships, and self-growth were necessary for families to sustain the healthy behaviors promoted in FIT4YES. Specifically, parents discussed increased comfort levels with their children participating in school sports, the impact of shared experiences with community members, and continued skills initially taught and practiced during active programming. CONCLUSIONS: Our group adapted our previously published model to a "post-program" state that incorporated the major themes and sub-themes with levels of the social-ecological model. Although the FIT4YES program ended, multiple ideals instilled by the program continued, we believe, due to the common themes illustrated by our model. This study utilized a community check-in approach to gain insight into the long-term impacts of the FIT4YES program. We propose three recommendations for consideration in the creation of community-based health programs: utilize dynamic, culturally appropriate components based on the intended community; understand the strength of the program as a whole is dependent on the strength of each individual component; and incorporate an anchor institution for consistency and trust within the community.
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Desarrollo Infantil , Padres , Niño , Adolescente , Humanos , Padres/educación , Grupos Focales , Conductas Relacionadas con la Salud , Promoción de la SaludRESUMEN
BACKGROUND: Risk scores (RS) evaluate the likelihood of short-term mortality in patients diagnosed with community-acquired pneumonia (CAP). However, there is a scarcity of evidence to determine the risk of long-term mortality. This article aims to compare the effectiveness of 16 scores in predicting mortality at three, six, and twelve months in adult patients with CAP. METHODS: A retrospective cohort study on individuals diagnosed with CAP was conducted across two hospitals in Colombia. Receiver Operating Characteristic (ROC) curves were constructed at 3, 6, and 12 months to assess the predictive ability of death for the following scoring systems: CURB-65, CRB-65, SCAP, CORB, ADROP, NEWS, Pneumonia Shock, REA-ICU, PSI, SMART-COP, SMRT-CO, SOAR, qSOFA, SIRS, CAPSI, and Charlson Comorbidity Index (CCI). RESULTS: A total of 3688 patients were included in the final analysis. Mortality at 3, 6, and 12 months was 5.2%, 8.3%, and 16.3% respectively. At 3 months, PSI, CCI, and CRB-65 scores showed ROC curves of 0.74 (95% CI: 0.71-0.77), 0.71 (95% CI: 0.67-0.74), and 0.70 (95% CI: 0.66-0.74). At 6 months, PSI and CCI scores showed performances of 0.74 (95% CI: 0.72-0.77) and 0.72 (95% CI: 0.69-0.74), respectively. Finally at 12 months, all evaluated scores showed poor discriminatory capacity, including PSI, which decreased from acceptable to poor with an ROC curve of 0.64 (95% CI: 0.61-0.66). CONCLUSION: When predicting mortality in patients with CAP, at 3 months, PSI, CCI, and CRB-65 showed acceptable predictive performances. At 6 months, only PSI and CCI maintained acceptable levels of accuracy. For the 12-month period, all evaluated scores exhibited very limited discriminatory ability, ranging from poor to almost negligible.
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Infecciones Comunitarias Adquiridas , Neumonía , Curva ROC , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Colombia/epidemiología , Infecciones Comunitarias Adquiridas/mortalidad , Infecciones Comunitarias Adquiridas/diagnóstico , Neumonía/mortalidad , Neumonía/diagnóstico , Pronóstico , Estudios Retrospectivos , Medición de Riesgo/métodos , Índice de Severidad de la Enfermedad , Factores de TiempoRESUMEN
Lectin-like transcript-1 (LLT1) expression is detected in different cancer types and is involved in immune evasion. The present study investigates the clinical relevance of tumoral and stromal LLT1 expression in oral squamous cell carcinoma (OSCC), and relationships with the immune infiltrate into the tumor immune microenvironment (TIME). Immunohistochemical analysis of LLT1 expression was performed in 124 OSCC specimens, together with PD-L1 expression and the infiltration of CD20+, CD4+, and CD8+ lymphocytes and CD68+ and CD163+-macrophages. Associations with clinicopathological variables, prognosis, and immune cell densities were further assessed. A total of 41 (33%) OSCC samples showed positive LLT1 staining in tumor cells and 55 (44%) positive LLT1 in tumor-infiltrating lymphocytes (TILs). Patients harboring tumor-intrinsic LLT1 expression exhibited poorer survival, suggesting an immunosuppressive role. Conversely, positive LLT1 expression in TILs was significantly associated with better disease-specific survival, and also an immune-active tumor microenvironment highly infiltrated by CD8+ T cells and M1/M2 macrophages. Furthermore, the combination of tumoral and stromal LLT1 was found to distinguish three prognostic categories (favorable, intermediate, and adverse; p = 0.029, Log-rank test). Together, these data demonstrate the prognostic relevance of tumoral and stromal LLT1 expression in OSCC, and its potential application to improve prognosis prediction and patient stratification.
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Lectinas Tipo C , Receptores de Superficie Celular , Carcinoma de Células Escamosas de Cabeza y Cuello , Microambiente Tumoral , Adulto , Femenino , Humanos , Masculino , Antígeno B7-H1/metabolismo , Antígeno B7-H1/genética , Biomarcadores de Tumor/metabolismo , Carcinoma de Células Escamosas/inmunología , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/genética , Linfocitos Infiltrantes de Tumor/inmunología , Linfocitos Infiltrantes de Tumor/metabolismo , Macrófagos/metabolismo , Macrófagos/inmunología , Neoplasias de la Boca/patología , Neoplasias de la Boca/inmunología , Neoplasias de la Boca/metabolismo , Neoplasias de la Boca/genética , Neoplasias de la Boca/mortalidad , Pronóstico , Carcinoma de Células Escamosas de Cabeza y Cuello/inmunología , Carcinoma de Células Escamosas de Cabeza y Cuello/metabolismo , Carcinoma de Células Escamosas de Cabeza y Cuello/patología , Carcinoma de Células Escamosas de Cabeza y Cuello/mortalidad , Carcinoma de Células Escamosas de Cabeza y Cuello/genética , Microambiente Tumoral/genética , Microambiente Tumoral/inmunología , Receptores de Superficie Celular/genética , Receptores de Superficie Celular/inmunología , Receptores de Superficie Celular/metabolismo , Lectinas Tipo C/genética , Lectinas Tipo C/inmunologíaRESUMEN
BACKGROUND: Pancreatic cancer is a highly lethal malignancy often presenting with advanced disease and characterized by resistance to standard chemotherapy. Immune-based therapies such checkpoint inhibition have been largely ineffective such that pancreatic cancer is categorized as an immunologically "cold tumor". In the present study, we examine the therapeutic efficacy of a personalized cancer vaccine in which tumor cells are fused with dendritic cells (DC) resulting in the broad induction of antitumor immunity. RESULTS: In the KPC spontaneous pancreatic cancer murine model, we demonstrated that vaccination with DC/KPC fusions led to expansion of pancreatic cancer specific lymphocytes with an activated phenotype. Remarkably, vaccination led to a reduction in tumor bulk and near doubling of median survival in this highly aggressive model. In a second murine pancreatic model (Panc02), vaccination with DC/tumor fusions similarly led to expansion of tumor antigen specific lymphocytes and their infiltration to the tumor site. Having shown efficacy in immunocompetent murine models, we subsequently demonstrated that DC/tumor fusions generated from primary human pancreatic cancer and autologous DCs potently stimulate tumor specific cytotoxic lymphocyte responses. CONCLUSIONS: DC/tumor fusions induce the activation and expansion of tumor reactive lymphocytes with the capacity to infiltrate into the pancreatic cancer tumor bed.
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Vacunas contra el Cáncer , Neoplasias Pancreáticas , Humanos , Ratones , Animales , Activación de Linfocitos , Células Dendríticas , Neoplasias PancreáticasRESUMEN
BACKGROUND: Risk factors for carbapenem resistance in Enterobacterales bloodstream infections among children with cancer or post-HSCT have not been thoroughly explored. METHODS: All children with cancer or post-HSCT who developed Enterobacterales bloodstream infections in two cancer referral centres in major Colombian cities between 2012 and 2021 were retrospectively examined. When the infection episode occurred, carbapenem resistance mechanisms were evaluated according to the available methods. Data were divided in a training set (80%) and a test set (20%). Three internally validated carbapenem-resistant Enterobacterales (CRE) prediction models were created: a multivariate logistic regression model, and two data mining techniques. Model performances were evaluated by calculating the average of the AUC, sensitivity, specificity and predictive values. RESULTS: A total of 285 Enterobacterales bloodstream infection episodes (229 carbapenem susceptible and 56 carbapenem resistant) occurred [median (IQR) age, 9 (3.5-14) years; 57% male]. The risk of CRE was 2.1 times higher when the infection was caused by Klebsiella spp. and 5.8 times higher when a carbapenem had been used for ≥3 days in the previous month. A model including these two predictive variables had a discriminatory performance of 77% in predicting carbapenem resistance. The model had a specificity of 97% and a negative predictive value of 81%, with low sensitivity and positive predictive value. CONCLUSIONS: Even in settings with high CRE prevalence, these two variables can help early identification of patients in whom CRE-active agents are unnecessary and highlight the importance of strengthening antibiotic stewardship strategies directed at preventing carbapenem overuse.
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Gammaproteobacteria , Trasplante de Células Madre Hematopoyéticas , Neoplasias , Sepsis , Humanos , Niño , Masculino , Adolescente , Femenino , Estudios Retrospectivos , Carbapenémicos/farmacología , Carbapenémicos/uso terapéutico , Antibacterianos/farmacología , Antibacterianos/uso terapéuticoRESUMEN
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.
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This work investigates the ability of two Croton spp. essential oils (EO) to enhance chlorhexidine (CHX) activity against oral streptococci. EO's chemical composition of Croton argyrophyllus and C. pluriglandulosus was determined by GC-MS/FID. The microbial growth kinetics and minimum inhibitory concentration (MIC) of EOs and CHX were determined, followed by their synergism against S. mutans UA159 and ATCC 25175, S. salivarius ATCC 7073 and S. sp. ATCC 15300. The microplate-based method was used to determine the EO/CHX activity against 24-h-old biofilms. The major compounds were α-pinene (54.74%) and bicyclogermacrene (16.08%) for EOAr and 1,8-cineole (17.41%), methyleugenol (16.06%) and elemicin (15.99%) for EOPg. Both EO had MIC around 16,000 µg/mL. EOs/CHX presented a synergistic effect against most strains (FICi from 0.133 to 0.375), and OE/CHX-treated biofilms showed a reduction in biomass and cell viability compared to CHX, only (p < 0.01). Thus, the EOs works as natural adjuvants for CHX.
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Environmental tobacco smoke (ETS) increases the risk of mortality among nonsmokers. Yet, few studies have examined this association among racial/ethnic minorities or among people with less education or income. We assessed self-reported ETS exposure at home among never smoking participants (n = 110,945) of the 1991-2010 National Health Interview Surveys. Deaths through 2015 were identified by the National Death Index. Hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality were estimated using Cox proportional hazards regression models with age as the underlying time metric and adjusted for sex, race/ethnicity, education, household income, body mass index, region of residence, and survey year. We further stratified all-cause mortality analyses by race/ethnicity, household income, and education. Relative to no ETS at home, every day exposure was associated with higher risk of all-cause mortality (HR = 1.33, 95%CI: 1.23, 1.45), with similar HRs observed across strata of education and income. HRs were similar among non-Hispanic Black (HR = 1.28, 95%CI: 1.08, 1.53) and non-Hispanic White adults (HR = 1.34, 95%CI: 1.21, 1.48) although somewhat higher among Hispanic adults (HR = 1.65, 95%CI: 1.29, 2.10; P for pairwise comparison = 0.04). ETS exposure at home is an important contributor to mortality across strata of race/ethnicity, education, and income in the US.
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Contaminación por Humo de Tabaco , Adulto , Humanos , Contaminación por Humo de Tabaco/efectos adversos , Etnicidad , Fumadores , Renta , FumarRESUMEN
The aim of this work was to evaluate the chemical composition and antibacterial activity of Croton tetradenius Baill. (CTEO) and C. pulegiodorus Baill. (CPEO) essential oils against Staphylococcus aureus, and their synergism with antibiotics. The essential oils (EOs) were extracted by hydrodistillation and chemically characterized by gas chromatography-mass spectrometry (CG-MS) and gas chromatography with flame ionization detection (CG-FID). The antimicrobial action of the EOs was tested against two standard strains and four clinical isolates of S. aureus using the disk-diffusion agar method and the microdilution assay. The bacterial kinetic growth was also determined. The synergistic effect between EOs and antimicrobials was analyzed by the checkerboard test. CTEO and CPEO yielded 0.47 and 0.37% w/w and the most common components were p-cymene (28.24%), camphor (17.76%) and α-phellandrene (8.98%), and trans-chrysanthenyl acetate (27.05%), α-terpinene (19.21%) and p-cymene (12.27%), respectively. The disk-diffusion test showed that the bacteria are sensitive to the agents tested. The MIC in the presence of the CTEO it was 4000 µg/mL, while for the CPEO it was 8000 µg/mL, except for clinical isolate 4B. The MBC for strains treated with CTEO were 8000 µg/mL, with the exception of isolates 8B and 0 A 4000 µg/mL. For the CPEO, all strains showed a concentration above 8000 µg/mL. The growth curve showed that CTEO and CPEO altered growth kinetics, delaying the lag phase and reducing the log phase. In combination with antibiotics, both essential oils showed synergisms effect with oxacillin and ampicillin, and additive effect with benzylpenicillin. CTEO and CPEO showed antibacterial action against S. aureus strains, showing as a promise natural alternative in clinical therapy.
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Antiinfecciosos , Croton , Aceites Volátiles , Antibacterianos/farmacología , Cromatografía de Gases y Espectrometría de Masas , Pruebas de Sensibilidad Microbiana , Aceites Volátiles/farmacología , Staphylococcus aureusRESUMEN
We have developed a personalized vaccine whereby patient derived leukemia cells are fused to autologous dendritic cells, evoking a polyclonal T cell response against shared and neo-antigens. We postulated that the dendritic cell (DC)/AML fusion vaccine would demonstrate synergy with checkpoint blockade by expanding tumor antigen specific lymphocytes that would provide a critical substrate for checkpoint blockade mediated activation. Using an immunocompetent murine leukemia model, we examined the immunologic response and therapeutic efficacy of vaccination in conjunction with checkpoint blockade with respect to leukemia engraftment, disease burden, survival and the induction of tumor specific immunity. Mice treated with checkpoint blockade alone had rapid leukemia progression and demonstrated only a modest extension of survival. Vaccination with DC/AML fusions resulted in the expansion of tumor specific lymphocytes and disease eradication in a subset of animals, while the combination of vaccination and checkpoint blockade induced a fully protective tumor specific immune response in all treated animals. Vaccination followed by checkpoint blockade resulted in upregulation of genes regulating activation and proliferation in memory and effector T cells. Long term survivors exhibited increased T cell clonal diversity and were resistant to subsequent tumor challenge. The combined DC/AML fusion vaccine and checkpoint blockade treatment offers unique synergy inducing the durable activation of leukemia specific immunity, protection from lethal tumor challenge and the selective expansion of tumor reactive clones.
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Vacunas contra el Cáncer , Leucemia Mieloide Aguda , Animales , Antígenos de Neoplasias , Células Dendríticas , Humanos , Leucemia Mieloide Aguda/terapia , Ratones , Linfocitos T , VacunaciónRESUMEN
Azospirillum is one of the most successful plant growth-promoting bacteria (PGPB) genera and it is considered a study model for plant-bacteria interactions. Because of that, a wide broad of topics has been boarded and discussed in a significant number of publications in the last four decades. Using the Scopus® database, we conducted a bibliographic search in order to analyze the number and type of publications, the authors responsible of these contributions, and the origin of the researchers, as well as the keywords and journals selected by the authors, among other related characteristics, with the aim to understand some less addressed details about the work done with Azospirillum worldwide since its discovery in 1925. Despite that the largest numbers of publications about this bacterium were obtained between the 1970 and 1980s, there is still a linear increase tendency in the number of published works. Understanding the mechanisms involved in the ability of these bacteria to promote growth in a wide broad of plant species under both laboratory and field conditions has been a preferential target for these published articles. This tendency could be considered a cause or consequence of the current increase in the number of commercial products formulated with Azospirillum around the world and a catalyzer for the increase of published articles along time.
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Azospirillum/metabolismo , Interacciones Microbiota-Huesped/fisiología , Reguladores del Crecimiento de las Plantas , Plantas/microbiología , Azospirillum/clasificación , Desarrollo de la Planta , Raíces de Plantas/microbiologíaRESUMEN
OBJECTIVE: To analyse trends in cigarette brand preference among Mexican smokers during the implementation period of key WHO's Framework Convention on Tobacco Control recommendations. METHODS: Data came from two nationally representative, comparable surveys, namely the Global Adult Tobacco Survey 2009 and 2015 and the National Survey on Addictions 2011 and 2016. Logistic models were used to estimate the adjusted prevalence of each brand purchased, as well as individual correlates of purchasing the single brand with a large growth over the study period. Multiple linear regressions were also employed to analyse cigarette prices across brands. RESULTS: Six brand families accounted for about 90% of the cigarette market, with Marlboro clearly dominating all brands at 54%-61%. Only the share of Pall Mall brand, however, registered a rapid increase over the period-from 1% in 2009 to 14% in 2016. Women and younger smokers (15-24 years) were more likely to prefer Pall Mall over other brands. While the typical price segmentation between international (premium) brands and national (discount) brands was observed, the price of Pall Mall is within the range of the latter. Importantly, most varieties of this brand include flavour capsule varieties (FCVs). CONCLUSIONS: This study suggests that the strong campaign of brand migration, the pricing strategy and the aggressive introduction of FCVs expanded Pall Mall in the Mexican cigarette market. Therefore, better control policies of cigarette contents and taxes that reduce price differentials across brands should be encouraged to promote public health.
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Fumadores , Productos de Tabaco , Adulto , Comercio , Comportamiento del Consumidor , Femenino , Humanos , Fumar/epidemiología , ImpuestosRESUMEN
INTRODUCTION: Mexico was the first Latin American country to ratify the Framework Convention on Tobacco Control (FCTC) in 2004, after which it implemented some key FCTC policies (e.g., taxes, smoke-free, pictorial warnings and ad bans). This study assessed trends in the prevalence of current, daily and non-daily smoking in Mexico before and after the implementation of key FCTC policies. METHODS: Data were analysed from two comparable, nationally representative surveys (i.e., the National Survey on Addictions 2002, 2011 and 2016, and the Global Adult Tobacco Survey 2009 and 2015). The pooled sample comprised 100 302 persons aged 15-65 years. Changes in the prevalence of current, daily and non-daily smoking were assessed. RESULTS: From 2002 to 2016, the prevalence of current smoking fell 11% in relative terms (from 21.5% to 19.0%). The decrease was registered between 2002 and 2009, and after that, a slight increase was observed (from 16.5% in 2009 to 19% in 2016). The prevalence of daily smoking decreased by about 50% between 2002 and 2016 (from 13.5% to 7.0%) with most of the decrease occurring by 2009. Conversely, the prevalence of non-daily smoking increased by 35% between 2009 and 2016 (from 8.8% to 11.9%). CONCLUSIONS: Full implementation of the FCTC is necessary to further reduce smoking. Specific interventions may be needed to target non-daily smokers, who now comprise more than half of current smokers in Mexico.
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Nicotiana , Prevención del Hábito de Fumar , Adulto , Humanos , México/epidemiología , Prevalencia , Fumar/epidemiología , Organización Mundial de la SaludRESUMEN
OBJECTIVE: To estimate the prevalence of flavor capsule cigarette, use among Mexicans who are 10 years and older, to determine the proportion of smokers who use flavor capsules, and to characterize the sociodemographic correlates of flavor capsule cigarette use. MATERIALS AND METHODS: Data came from the National Health and Nutrition Survey 2018-19. The prevalence and proportion of flavor capsule cigarette use were estimated by sex, age, education, and wealth. Poisson models were used to evaluate sociodemographic factors as-sociated with flavor capsule cigarette use. RESULTS: Among Mexicans,the prevalence of flavor capsule cigarettes use was 6.6%, which is 43% of all smokers. Women, adolescents, and young adults were more likely than other groups to use flavor capsule cigarettes. CONCLUSIONS: Mexicans report a high prevalence of flavor capsule cigarette use. Banning cigarettes with flavors may reduce the appeal of smoking, particularly for youth and women.
OBJETIVO: Calcular la prevalencia de consumo de cigarros con cápsula de sabor, la proporción de uso entre los usuarios de tabaco en la población mexicana de 10 años o más, y los factores asociados a su consumo. MATERIAL Y MÉTODOS: Se utilizó la Encuesta Nacional de Salud y Nutrición 2018-19. Se utilizó un modelo Poisson para obtener la razón de prevalen-cias del uso de cigarros con cápsulas de sabor ajustando por sexo, edad, educación e índice de bienestar. RESULTADOS: El 6.6% de los mexicanos fuma cigarros con cápsulas de sabor, lo que corresponde a 43% del total de usuarios de tabaco. Las mujeres, adolescentes y adultos jóvenes son los grupos con la mayor proporción de consumo. CONCLUSIONES: México tiene una alta prevalencia de consumo de cigarros con cápsula de sabor. Para reducirla, se deben implementar políticas para prohibir la venta de cigarros con saborizantes y eliminar los diseños atractivos en las cajetillas de los cigarros.
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Sistemas Electrónicos de Liberación de Nicotina , Aromatizantes , Productos de Tabaco , Adolescente , Femenino , Humanos , Masculino , México/epidemiología , Prevalencia , Fumadores , Adulto JovenRESUMEN
OBJECTIVE: To evaluate the physical and psychological dependence to tobacco of Mexican smokers and its association with physical, psychological and social factors. MATERIALS AND METHODS: The 2016 National Alcohol and Tobacco Drug Consumption Survey (n=7 331) was analyzed using the Fagerström nicotine physical dependence scale (FTND) and the short scale of psychological dependence on tobacco (TAPDSc). Bivariate analyzes and generalized ordinal logistic regressions were performed to evaluate the associated factors. RESULTS: 82.3% of daily smokers and 98.8% of occasional smokers reported mild physical dependence, while 47.9 and 37.9% respectively reported moderate psychological dependence. The age of initiation of tobacco use, drug use, high alcohol consumption and high emotional distress were associated with high levels of psychological dependence in all smokers. CONCLUSIONS: The exclusive use of FTND does not allow to adequately evaluate Mexican smokers. The physical and psychological dependence on tobacco should be assessed with independent and validated scales in this population.
OBJETIVO: Evaluar la dependencia física y psicológica de los fumadores mexicanos y su asociación con factores físicos, psicológicos y sociales. MATERIAL Y MÉTODOS: . A partir de la Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2016 (n=7 331), se analizó la escala de dependencia física a la nicotina de Fagerström (FTND) y la escala corta de dependencia psicológica al tabaco (TAPDSc). Se realizaron análisis bivariados y regresiones logísticas ordinales generalizadas para evaluar los factores asociados. RESULTADOS: 82.3% de fumadores diarios y 98.8% de ocasionales reportaron dependencia física leve, mientras que 47.9 y 37.9%, respectivamente, presentaron dependencia psicológica moderada. La edad de inicio temprana de consumo de tabaco, uso de drogas, consumo alto de alcohol y malestar emocional se asociaron con niveles altos de dependencia psicológica en todos los fumadores. CONCLUSIONES: El uso exclusivo de FNTD no permite evaluar adecuadamente a los fumadores mexicanos. La dependencia física y psicológica al tabaco debe ser diagnosticada con escalas independientes y validadas en esta población.
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Fumadores/psicología , Tabaquismo/psicología , Adolescente , Adulto , Edad de Inicio , Anciano , Consumo de Bebidas Alcohólicas/psicología , Encuestas Epidemiológicas/estadística & datos numéricos , Humanos , Modelos Logísticos , México/epidemiología , Persona de Mediana Edad , Nicotina , Agonistas Nicotínicos , Fumadores/estadística & datos numéricos , Fumar/epidemiología , Fumar/psicología , Trastornos Relacionados con Sustancias/psicología , Tabaquismo/epidemiología , Adulto JovenRESUMEN
OBJECTIVE: To assess the correlates of secondhand smoke exposure (SHS) in public and private settings. MATERIALS AND METHODS: Data came from the 2016 National Survey of Drug, Alcohol and Tobacco use. Multilevel Poisson models were conducted to evaluate factors associated with SHS. RESULTS: Having a higher education, being male and being a young adult were associated with higher SHS in bars and restaurants. Men had greater SHS at work, while women and adolescents had greater exposure at home. Adults older than 45 years had higher SHS on public transportation compared to adolescents between 12-17 years old. CONCLUSIONS: Exposure to SHS remains high and affects the population differentially. To reduce SHS, it is necessary to apply Article 8 of the Framework Convention on Tobacco Control.
OBJETIVO: Determinar los factores asociados con la exposición al humo de tabaco de segunda mano (HTSM) en lugares públicos y privados. MATERIAL Y MÉTODOS: Se analizó la Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2016. La exposición al HTSM se evaluó mediante modelos Poisson multinivel. La muestra del estudio incluye únicamente no fumadores. RESULTADOS: La exposición al HTSM fue similar en los estados que tienen prohibición total para fumar en espacios cerrados en comparación con estados con prohibición parcial. Adultos jóvenes, hombres y personas con nivel educativo alto tienen mayor exposición al HTSM en bares y restaurantes. Los hombres tienen mayor exposición al HTSM en el trabajo, los adultos de mayor edad en el transporte público, mientras las mujeres y adolescentes en el hogar. CONCLUSIONES: La exposición al HTSM continúa elevada y afecta diferencialmente a la población mexicana. Para reducirla, se requiere aplicar totalmente el artículo octavo del Convenio Marco para el Control del Tabaco.
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Exposición a Riesgos Ambientales/estadística & datos numéricos , Contaminación por Humo de Tabaco/estadística & datos numéricos , Adolescente , Adulto , Anciano , Niño , Correlación de Datos , Estudios Transversales , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Instalaciones Privadas , Instalaciones Públicas , Adulto JovenRESUMEN
There is strong epidemiologic evidence linking chronic exposure to inorganic arsenic (iAs) to myriad adverse health effects, including cancer of the bladder. We set out to identify DNA methylation patterns associated with arsenic and its metabolites in exfoliated urothelial cells (EUCs) that originate primarily from the urinary bladder, one of the targets of arsenic-induced carcinogenesis. Genome-wide, gene-specific promoter DNA methylation levels were assessed in EUCs from 46 residents of Chihuahua, Mexico, and the relationship was examined between promoter methylation profiles and the intracellular concentrations of total arsenic and arsenic species. A set of 49 differentially methylated genes was identified with increased promoter methylation associated with EUC tAs, iAs, and/or monomethylated As (MMAs) enriched for their roles in metabolic disease and cancer. Notably, no genes had differential methylation associated with EUC dimethylated As (DMAs), suggesting that DMAs may influence DNA methylation-mediated urothelial cell responses to a lesser extent than iAs or MMAs. Further analysis showed that 22 of the 49 arsenic-associated genes (45%) are also differentially methylated in bladder cancer tissue identified using The Cancer Genome Atlas repository. Both the arsenic- and cancer-associated genes are enriched for the binding sites of common transcription factors known to play roles in carcinogenesis, demonstrating a novel potential mechanistic link between iAs exposure and bladder cancer.
Asunto(s)
Arsénico/toxicidad , Metilación de ADN/efectos de los fármacos , Neoplasias de la Vejiga Urinaria/inducido químicamente , Neoplasias de la Vejiga Urinaria/genética , Urotelio/citología , Urotelio/efectos de los fármacos , Adulto , Anciano , Arsénico/metabolismo , Transformación Celular Neoplásica/inducido químicamente , Metilación de ADN/genética , Femenino , Humanos , Persona de Mediana Edad , Neoplasias de la Vejiga Urinaria/patología , Adulto JovenRESUMEN
Background: We evaluated the comparative effectiveness of all intra-articular injection corticosteroids for treating internal temporomandibular joint (TMJ) disorders. Methods: We searched MEDLINE, CENTRAL, EMBASE, SCOPUS, and LILACS through December 2023. We included randomized clinical trials (RCTs) enrolling patients with symptomatic internal disorders of the TMJ comparing any type of intra-articular corticosteroid therapy against another or to another minimally invasive therapy. The outcomes of interest were pain, range of mandibular motion (RoM), quality of life (QoL) and adverse effects at 1, 3, 6, and 12 months. We assessed the risk of bias using the Cochrane Collaboration's tool. We conducted a frequentist network meta-analysis and assessed the certainty of the evidence (CoE) using GRADE. Results: We included 20 RCTs enrolling 810 participants, which assessed five corticosteroids alone or combined with arthrocentesis or hyaluronic acid. Based on moderate CoE, betamethasone is among the most effective corticosteroids for reducing pain at one (mean difference compared to arthrocentesis [MD], -3.80; 95% confidence interval [CI], -4.55 to -3.05) and three months (MD, -2.74; 95%CI, -3.42 to -2.06), and arthrocentesis plus dexamethasone at six months (MD, -0.80; 95%CI, -1.57 to -0.03). There was no convincing evidence that any intervention was better than arthrocentesis for improving the RoM and QoL at any follow-up time. Methylprednisolone may be more harmful than arthrocentesis for adverse effects. Discussion: Betamethasone and arthrocentesis plus dexamethasone are the most effective in managing pain in the short and medium term compared to arthrocentesis (moderate CoE). Decisions about their use should consider other factors, such as costs, feasibility, and acceptability. Future research should consider QoL as an outcome and assess participants at longer follow-up periods.
RESUMEN
Introduction: The following bibliographic review was carried out with the purpose of recognizing the clinical and radiographic characteristics that must be considered in the diagnosis of external root resorption, including treatments. Methods: A bibliographic search was carried out in PubMed/Medline, Cochrane Library and Google Scholar databases under the term "external root resorption", from 2010 to 2022 in Spanish and English. Experimental studies and bibliographic reviews were selected, and finally 17 articles were included. Results: The results obtained indicated that each type of resorption presents specific clinical characteristics that differentiate them, these are: for external inflammatory resorption a negative pulp vitality; for replacement external resorption the absence of mobility and metallic percussion; for cervical external resorption a pink coloration of the crown; superficial external resorption does not present any type of clinical symptoms and transient apical collapse presents a transient change in color. Conclusion: External root resorptions require accurate and early diagnosis. A clinical examination should be performed with emphasis on the following: probing, coloration, mobility, and vitality tests.
Introducción: La siguiente revisión bibliográfica se realizó con el propósito de reconocer las características clínicas y radiográficas que deben ser evaluadas para el diagnóstico de las reabsorciones radiculares externas incluyendo también sus tratamientos. Metodología: Se llevó a cabo una búsqueda en las bases de datos MEDLINE/PubMed, Cochrane Library y Google Scholar bajo el término , incluyendo estudios experimentales y revisiones bibliográficas desde 2010 a 2022 en español e inglés, incluyendo finalmente 17 artículos. Resultados: Los resultados obtenidos señalaron que cada tipo de reabsorción radicular externa presenta características clínicas específicas que las diferencian. Estas diferencias son: para la reabsorción externa inflamatoria la vitalidad pulpar negativa; para la reabsorción externa de reemplazo la ausencia de movilidad y percusión metálica; para la reabsorción externa cervical una coloración rosada de la corona; la reabsorción externa superficial no presenta ningún tipo de sintomatología clínica y la reabsorción de colapso apical transitorio presenta un cambio de coloración transitorio. Conclusión: Las reabsorciones radiculares externas requieren un diagnóstico preciso y temprano. Se debe realizar un examen clínico con énfasis en sondaje, coloración, movilidad y pruebas de vitalidad.