ABSTRACT
Genetic counseling is the process of advising indivduals, partners and families affected by or at risk of genetic disorders to help them understand and adapt to the medical, psychological, social, family and reproductive implications of a genetic condition. Given the expansion of precision medicine and the recent increase in the use of molecular diagnostic tests, it is necessary to have duly certified personnel in our environment to perform it. In Mexico, unlike other countries, the figure of the genetic counselor is not formally recognized, which is why geneticists doctors give this advice within the healthcare context (as part of the outpatient consultation). The number of these health professionals is below the internationally proposed requirement standard of one medical geneticist per 100,000 inhabitants, which is only met in Mexico City, making it of utmost importance to increase the training of medical geneticists as well such as the inclusion of these in the different health institutions of the country.
El asesoramiento genético es el proceso de comunicación que tiene como objetivo ayudar al individuo, la pareja o la familia a comprender y adaptarse a las implicaciones médicas, psicológicas, sociales, familiares y reproductivas de una condición genética. Dada la expansión de la medicina de precisión y el reciente incremento del uso de pruebas diagnósticas moleculares, es necesario contar en nuestro medio con personal debidamente certificado para realizarlo. En México, a diferencia de otros países, la figura del asesor en genética no está formalmente reconocida; por lo que médicos genetistas otorgan este asesoramiento dentro del contexto asistencial (formando parte de la consulta externa). El número de estos profesionales de la salud está por debajo del estándar de requerimiento propuesto internacionalmente, de un genetista por cada 100,000 habitantes, el cual únicamente se cumple en la Ciudad de México, por lo que resulta de suma importancia incrementar la formación de médicos genetistas, así como la inclusión de estos en las distintas instituciones de salud del país.
Subject(s)
Genetic Counseling/statistics & numerical data , Referral and Consultation , Delivery of Health Care , Health Personnel , Humans , MexicoABSTRACT
BACKGROUND: Prevalence of latex allergy in medical students is not known. OBJECTIVE: To determine the prevalence of self-reported latex allergy and associated factors in medical students. METHODS: Cross-sectional, analytical study of students with or without self-reported latex allergy. By means of a structured questionnaire, past personal and family history of allergic disease, time and frequency of exposure to latex gloves and symptoms after exposure to products or foods associated with latex allergy were inquired. Logistic regression models were carried out. RESULTS: Out of 854 subjects, 431 (50.5%) were females. Median age was 21 years. Overall prevalence of latex allergy was 4.3% (95% CI = 3.1 to 5.9). Associated risk factors were age (OR = 1.37; 95% CI = 1.05 to 1.79), personal history of atopic dermatitis (OR = 7.32; 95% CI = 3.14 to 17.08), use of gloves ≥ 15/week (OR = 2.59; 95% CI = 1.17 to 5.76), use of latex products (OR = 5.76; 95% CI = 2.15 to 15.49) and fruit allergy (OR = 3.24; 95% CI = 1.27 t o8.27). CONCLUSION: Four out of a hundred students reported latex allergy. Age, personal history of atopic dermatitis, higher frequency of exposure to latex gloves and history of fruit allergy were risk factors for self-report latex allergy.
Antecedentes: La prevalencia de la alergia al látex se desconoce en los estudiantes de medicina. Objetivo: Determinar prevalencia y factores asociados con autorreporte de alergia al látex en estudiantes de medicina. Métodos: Estudio transversal de estudiantes con o sin autorreporte de alergia al látex. Mediante cuestionario estructurado se indagó historia personal y familiar de enfermedad alérgica; tiempo y frecuencia de exposición a guantes de látex y síntomas tras la exposición a productos o alimentos relacionados con alergia al látex. Se realizaron modelos de regresión logística. Resultados: De 854 sujetos, 431 (50.5 %) fueron mujeres. La mediana de edad fue de 21 años. La prevalencia global de alergia al látex fue 4.3 % (IC 95 % = 3.1 a 5.9). Los factores de riesgo relacionados fueron edad (RM = 1.37; IC 95 % = 1.05 a 1.79), historia personal de dermatitis atópica (RM = 7.32; IC 95 % = 3.14 a 17.08), uso de guantes ≥ 15/semana (RM = 2.59; IC 95 % = 1.17 a 5.76), uso de productos con látex (RM = 5.76; IC 95 % = 2.15 a 15.49) y alergia a frutas (RM = 3.24; IC 95 % = 1.27 a 8.27). Conclusión: Cuatro de cada 100 estudiantes reportaron alergia al látex. La edad, la historia personal de dermatitis atópica, la mayor frecuencia de exposición a guantes de látex y antecedente de alergia a frutos fueron factores de riesgo.
Subject(s)
Latex Hypersensitivity/diagnosis , Latex Hypersensitivity/epidemiology , Self Report , Cross-Sectional Studies , Female , Humans , Male , Prevalence , Risk Factors , Students, Medical , Young AdultABSTRACT
BACKGROUND: An estimated 800,000 people worldwide are occupationally exposed to welding-fumes. Previous studies show that the exposure to such fumes is associated with damage to genetic material and increased cancer risk. In this study, we evaluate the genotoxic effect of welding-fumes using the Micronucleus Test on oral mucosa cells of Mexican welders. MATERIAL AND METHODS: We conducted a cross-sectional, matched case-control study of n = 66 (33 exposed welders, and 33 healthy controls). Buccal mucosa smears were collected and stained with acridine orange, observed under 100x optical amplification with a fluorescence lamp, and a single-blinded observer counted the number of micronuclei and other nuclear abnormalities per 2,000 observed cells. We compared the frequencies of micronuclei and other nuclear abnormalities, and fitted generalised linear models to investigate the interactions between nuclear abnormalities and the exposure to welding-fumes, while controlling for smoking and age. RESULTS: Binucleated cells and condensed-chromatin cells showed statistically significant differences between cases and controls. The frequency of micronuclei and the rest of nuclear abnormalities (lobed-nuclei, pyknosis, karyolysis, and karyorrhexis) did not differ significantly between the groups. After adjusting for smoking, the regression results showed that the occurrence of binucleated cells could be predicted by the exposure to welding-fumes plus the presence of tobacco consumption; for the condensed-chromatin cells, our model showed that the exposure to welding-fumes is the only reliable predictor. CONCLUSIONS: Our findings suggest that Mexican welders who are occupationally exposed to welding-fumes have increased counts of binucleated and condensed-chromatin cells. Nevertheless, the frequencies of micronuclei and the rest of nuclear abnormalities did not differ between cases and controls. Further studies should shed more light on this subject.
