Evaluación del desarrollo infantil en niños de 2 a 4 años en el primer nivel de atención / Evaluation of child development in children from 2 to 4 years old in the first level of care

Introducción: actualmente es posible evaluar el desarrollo infantil y, con ello, proporcionar señales de las posibles alteraciones que pueden existir en los niños menores de 5 años. Objetivo: evaluar el desarrollo infantil e identificar las áreas del desarrollo afectadas en los niños de 2 a 4 años en el primer nivel de atención. Metodología: estudio transversal descriptivo en 69 niños de ambos sexos de 2 a 4 años y 11 meses de edad, a quienes se les aplicó en el consultorio la prueba Evaluación del Desarrollo Infantil. Los datos se expresaron como media ± desviación estándar, porcentajes y prueba de ji al cuadrado, considerando como significancia estadística p < 0.05. Resultados: se incluyeron 44 (63.7%) niños y 25 (36.3%) niñas, con una edad media de 2.57 ± 0.63. El desarrollo infantil fue normal en 49 niños (71%), se observó rezago en el desarrollo en 9 niños (13%) y riesgo de retraso en 11 niños (16%). Las áreas que más afectaron el resultado global fueron motor grueso (p = 0.001), motor fino (p = 0.00) y lenguaje (p = 0.00). Conclusiones: es importante evaluar el desarrollo infantil en los niños menores de 5 años, ya que el riesgo de retraso en el desarrollo se sigue detectando en una proporción considerable, lo que a futuro puede aumentar el costo de su atención.

Introduction: Currently it is possible to evaluate child development and with it, provide signs of the possible alterations that may exist in children under 5 years of age. Objective: To evaluate child development and identify affected areas of development in children from 2 to 4 years of age who attended UMF. Method: Descriptive study, we included 69 patients, both sexes from 2 to 4 years 11 months of age who agreed to participate. The Child Development Assessment test was used. The data were expressed + SD, and percentages, Chi square, significance p < 0.05. Results: 44 (63.7%) men and 25 (36.2%) women were included, mean age 2.57 + 0.63; child development was normal in 49 children (71%), developmental delay in 9 children (13%) and risk of delay in 11 children (16%); The areas that most affected the overall result were: gross motor (p = 0.001), fine motor (p = 0.00) and language (p = 0.00). Conclusions: It is important to carry out the Evaluation of Child Development in children under 5 years of age, since the risk of delay in development continues to be detected in a considerable proportion, which in the future may increase the cost of their care.

Evaluación del desarrollo infantil en niños menores de 1 año en una unidad médica / Evaluation of child development in children under 1 year in a medical unita

Introducción: el desarrollo psicomotor es un fenómeno de adquisición continua y progresiva de habilidades a lo largo de la infancia, afectado por la herencia genética y factores psicosociales y biológicos. Objetivo: evaluar el desarrollo infantil en niños menores de 1 año mediante la prueba Evaluación del Desarrollo Infantil en una unidad de medicina familiar. Metodología: estudio descriptivo con 62 niños menores de 1 año, en el módulo de PREVENIMSS, de octubre de 2018 a octubre de 2019. Se realizó un muestreo no probabilístico. Para el análisis de los datos se utilizó estadística descriptiva (media, desviación estándar, frecuencias y porcentajes); el análisis inferencial se realizó mediante la prueba de ji al cuadrado, considerando como significancia estadística p < 0.05. Resultados: el 42% (26) fueron niños y el 58% (36) niñas. En el resultado global, el 68% (42) obtuvieron desarrollo normal, el 29% (18) rezago en el desarrollo y el 3% (2) riesgo de retraso en el desarrollo. Las áreas del desarrollo afectadas fueron motricidad fina y lenguaje. Conclusiones: es necesario implementar estrategias institucionales para que se cumplan las políticas públicas de la primera infancia y que todos los niños derechohabientes del Instituto Mexicano del Seguro Social cuenten con evaluaciones periódicas de su desarrollo.

Introduction: Psychomotor development is a phenomenon of continuous and progressive acquirement of skills throughout childhood, affected by genetic inheritance and psychosocial and biological factors. Objective: To evaluate child development to children under 1 year old, through the Child Development Assessment test in a family medicine unit. Methods: Descriptive study in 62 children under 1 year of age, in the PREVENIMSS module, from October 2018 to October 2019. A non-probability sampling was carried out. Descriptive statistics (mean, standard deviation, frequencies and percentages) were used for data analysis, inferential analysis was performed using Chi Square, statistical significance of p < 0.05. Results: 42% (26) were men and 58% (36) women. In the overall result: 68% (42) obtained normal development, 29% (18) lag in development and 3% (2) risk of delay in development. The developmental areas affected were fine motor skills and language. Conclusions: It is necessary to implement institutional strategies so that early childhood public policies are complied with and that all IMSS eligible children have periodic evaluations of their development.

Educational strategy based on the NutrIMSS program in patients with prediabetes. / Estrategia educativa basada en el programa NutrIMSS en pacientes con prediabetes.

BACKGROUND: Prediabetes is an altered metabolic state of glucose; it does not present symptoms, it is considered an intermediate stage in the progression to diabetes; it is possible to detect it early to avoid or delay the disease. NutrIMSS strategy was implemented so that these patients achieve a healthy lifestyle. OBJECTIVE: To evaluate the impact of an educational intervention based on the NutrIMSS strategy on somatometric and biochemical parameters in patients with prediabetes. METHOD: Quasi-experimental study in the Family Medicine Unit No. 80 of Morelia, Michoacán, Mexico, in patients 20 to 59 years of age, with diagnosis of prediabetes (impaired fasting glucose 100-125 mg/dL). The educational intervention included three educational sessions, six consultations with nutrition and inclusion to the social security center, from March to August 2017. Initial anthropometric and biochemical measurements were taken and in the sixth month. The data were presented as median and interquartile range or mean ± standard deviation, and Student's t and Wilcoxon tests, with a significance value of p < 0.05. RESULTS: 45 patients, 66.7% women. Previous and after the intervention parameters were, respectively: weight (kg), 79.9 (56.5-114) and 77.5 (54.6-110) (p = 0.001); body mass index (kg/m2), 30.89 (23.2-39.9) and 29.0 (21.5-39.1) (p < 0.001); glucose (mg/dL), 111 ± 6.3 and 95.8 ± 9.2 (p < 0.001); and total cholesterol (mg/dL): 171 (120-223) and 170 (90-205) (p = 0.01). CONCLUSIONS: The educational intervention based on the NutrIMSS strategy has a positive impact on the metabolic control of patients with prediabetes.

INTRODUCCIÓN: La prediabetes es un estado metabólico alterado de la glucosa, no presenta síntomas, se considera un estadio intermedio en la progresión a diabetes y es posible detectarla tempranamente para evitar o retrasar la enfermedad. La estrategia NutrIMSS se implementó para que estos pacientes alcancen un estilo de vida saludable. OBJETIVO: Evaluar el impacto de una intervención educativa basada en la estrategia NutrIMSS sobre parámetros somatométricos y bioquímicos en pacientes con prediabetes. MÉTODO: Estudio cuasiexperimental en la Unidad de Medicina Familiar No. 80 de Morelia, Michoacán, en el que participaron pacientes de 20-59 años, con diagnóstico de prediabetes (glucosa alterada de ayuno 100-125 mg/dl). La intervención educativa incluyó tres sesiones educativas, seis consultas con nutrición e inclusión al centro de seguridad social de marzo a agosto de 2017. Se realizaron mediciones antropométricas y bioquímicas iniciales y al sexto mes. Los datos se presentaron como mediana (con rangos intercuartílicos) o media ± desviación estándar, pruebas de Wilcoxon y t de Student, con una significación de p < 0.05. RESULTADOS: Fueron 45 pacientes, con un 66.7% de mujeres. Los parámetros previos y posteriores a la intervención fueron los siguientes, respectivamente: peso (kg), 79.9 (56.5-114) y 77.5 (54.6-110) (p = 0.001); índice de masa corporal (kg/m2), 30.89 (23.2-39.9) y 29.0 (21.5-39.1) (p < 0.001); glucosa (mg/dl), 111 ± 6.3 y 95.8 ± 9.2 (p < 0.001); y colesterol total (mg/dl), 171 (120-223) y 170 (90-205) (p = 0.01). CONCLUSIONES: La intervención educativa basada en la estrategia NutrIMSS impacta de manera positiva en el control metabólico de los pacientes con prediabetes.

Conocimiento sobre autocuidado y riesgo cardiovascular de pacientes con DM2, derechohabientes de seguridad social de Ciudad Altamirano, Guerrero / Knowledge about self-care and cardiovascular risk of patients with T2DM, social security beneficiaries in Ciudad Altamirano, Guerrero

Introducción: es preciso comprender que el conocimiento del paciente con diabetes mellitus 2 (DM2) es la base del autocuidado para el control de la enfermedad y la prevención o control de las complicaciones cardiovasculares. Objetivo: identificar el conocimiento sobre autocuidado y riesgo cardiovascular de los pacientes con DM2, derechohabientes del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE) en Ciudad Altamirano, Guerrero. Métodos: estudio transversal, descriptivo, en el que se incluyeron 30 pacientes del ISSSTE con diagnóstico de DM2. Se aplicó un cuestionario estructurado con 35 reactivos de opción múltiple, sobre los aspectos sociodemográficos, antropométricos, clínicos, bioquímicos, de conocimiento sobre el autocuidado, la enfermedad, complicaciones y factores de riesgo cardiovascular y nutrición alimentaria. Para la confiabilidad de los marcadores bioquímicos se aplicó el programa PACAL Se empleó estadística descriptiva, t de Student y chi cuadrada. Resultados: el rango de edad que predominó en hombres fue de 64 a 78 años (60%) y en mujeres de 48 a 63 años (53.3%). De los hombres, 46.8% tuvo estudios de primaria y de las mujeres 53.4% licenciatura. El 60% refirió tener más de cinco hijos (p = 0.029). El 93% de las mujeres refirió que tuvo conocimiento sobre su autocuidado, pero 13% fueron hospitalizadas por DM2. El 66.7% de hombres y mujeres tuvo conocimiento sobre las complicaciones de la DM2. Conclusión: es relevante la susceptibilidad del riesgo cardiovascular en la población de estudio, que, si bien tiene conocimiento sobre la DM2, también tiene presentes factores de riesgo modificables y no modificables.

Introduction: It is necessary to understand that the knowledge of patients with type 2 diabetes mellitus (T2DM) is the basis of self-care for disease control and prevention or control of cardiovascular complications. Objective: To identify the knowledge of self-care and cardiovascular risk of patients with T2DM who are beneficiaries from the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE) [Institute for Social Security and Services for State Workers] in Ciudad Altamirano, Guerrero, Mexico. Methods: Cross-sectional, descriptive study, which included 30 patients from ISSSTE diagnosed with T2DM. A structured questionnaire was administered with 35 multiple-choice test items on socio-demographic, anthropometric, clinical, and biochemical aspects, as well as knowledge on self-care, disease, complications, cardiovascular risk factors, and food nutrition. The PACAL program was used to measure biochemical markers' reliability. Descriptive statistics. Student's t, and chi-squared tests were used. Results: The age range that prevailed in men was 64-78 years (60%), and in women 48-63 years (53.3%). Of men, 46.8% had primary education, and 53.4% of women had bachelor's degree. 60% had more than five children [p = 0.029). 93% of women had knowledge about their self-care, but 13% have been hospitalized due to T2DM. 66.7% of all participants had knowledge about T2DM complications. Conclusion: It is important the susceptibility to cardiovascular risk in the study population. Yet, even though this population has knowledge about T2DM, modifiable and non-modifiable risk factors are also present in said population.

Myeloperoxidase is associated with insulin resistance and inflammation in overweight subjects with first-degree relatives with type 2 diabetes mellitus.

BACKGROUND: Family history of type 2 diabetes mellitus (T2DM) is one of risk factors for that in future a subject can develop diabetes. Insulin resistance (IR) is important in the pathogenesis of T2DM. There is evidence that oxidative stress plays an important role in the etiology and/or progression of diabetes. Myeloperoxidase (MPO) participates in developing of inflammation. The objective was to investigate if MPO is associated with IR and inflammation in individuals with first-degree relatives of T2DM. METHODS: Cross-sectional study in 84 overweight individuals with family history of T2DM divided in two groups according to IR, group with IR (homeostasis model assessment [HOMA] ≥2.5; n=43) and control group (CG; HOMA <2.5; n=41). Complete clinical history and a venous blood sample were collected for measuring glucose and lipids profile, insulin, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), MPO, glutathione reductase (GRd), glutathione peroxidase, and superoxide dismutase. RESULTS: MPO, TNF-α, and IL-6 were higher in patients with IR than in CG (MPO: 308.35 [190.85 to 445.42] vs. 177.35 [104.50 to 279.85], P=0.0001; TNF-α: 13.46 [10.58 to 18.88] vs. 9.39 [7.53 to 11.25], P=0.0001; IL-6: 32.93 [24.93 to 38.27] vs. 15.60 [12.93 to 26.27]; P=0.0001, respectively). MPO was associated with IR (rho de Spearman=0.362, P=0.001). In the analysis of lineal regression, MPO predicts IR (ß, 0.263; t, 2.520; P=0.014). In the univariate analysis, MPO had an odds ratio of 9.880 for risk of IR (95% confidence interval, 2.647 to 36.879). CONCLUSION: MPO had relation with IR and inflammation parameters in overweight subjects with first-degree relatives of T2DM. We need studies on a casual relationship and molecular mechanisms among the increased serum MPO levels, inflammation markers, and IR.

No direct association among respiratory function, disease control and family functioning in a sample of Mexican children with intermittent asthma.

Asthma has been linked to family disfunctioning and poor control of the disease.This study was conducted to analyze the interactions between the level of intermittent asthma control, family functioning and respiratory function and between quality of life of asthmatic patients and their caregivers.7 to 15 years old children with intermittent asthma were included. Asthma Control Test Questionnaire, Pediatric Asthma Quality of Life Questionnaire (PAQLQ) test, and flowmetry were applied to children and Pediatric Asthma Caregiver´s Quatily of Life Questionnaire (PAQCLQ) and the Family Functioning Perception Test (FF-SIL) were applied to their parents.The most affected areas of family functioning in dysfunctional families were adaptability and permeability. A medium to high strength of association was founded between the emotional function of parents and the emotional function of children, R2=0.552. The most remarkable associations were among parents' limitation of activities and parents' emotional function (r=0.837), parents' limitation of activities and child's emotional function (r=0.722), parents' emotional role and limitation of activities (r=0.837), parents' emotional role and emotional functioning of children with asthma (r=0.743) and the limitation of activities of children with asthma and the emotional function of children with asthma (r=0.870).No direct associations were founded among respiratory function, disease control and family functioning in Mexican children with intermittent asthma and emotional function of parents and children were associated in both groups.

Prevalencia de factores de riesgo cardiometabólico en estudiantes universitarios de la región centro-occidente, en la Universidad Michoacana de San Nicolás de Hidalgo, México / Prevalence of cardiometabolics factors of risk in university students of the region the center west of Mexico, in Universidad Michoacana de San Nicolas de Hidalgo México

Introducción: Las enfermedades cardiometabólicas son causa de 30% de las muertes en el mundo, siete de cada 10 mexicanos tienen sobrepeso u obesidad, condicionantes de diabetes mellitus, hipertensión arterial y enfermedades cardiovasculares. Objetivo: Estudiar la prevalencia de factores de riesgo cardiometabólico en estudiantes de la Facultad de Ciencias Médicas y Biológicas ''Dr. Ignacio Chávez'' de la Universidad Michoacana de San Nicolás de Hidalgo en Morelia, Michoacán. Material y métodos: se realizó un estudio epidemiológico, transversal, descriptivo, aleatorio y voluntario. Se evaluaron factores de riesgo cardiovascular como edad, sexo, antecedentes heredofamiliares, hipertensión arterial, diabetes mellitus, tabaquismo, obesidad, cardiopatía isquémica prematura y actividad física. Resultados: De 141 estudiantes, 67 (47.5%) fueron hombres y 74 (52.5%) mujeres, el promedio de edad (homogéneo 22.66 ± 0.18 varones y 22.23 ± 0.10 mujeres). Fumadores mujeres 9 (6.38%) y hombres 15 (10.63%); el perímetro abdominal en 5 hombres (3.5 %) fue > 102 cm, y en 13 mujeres (9.20%) > 88 cm. El valor de colesterol total normal en mujeres fue de 73 (51.80%) y en hombres de 64 (45.40%). Conclusiones: Un porcentaje elevado de universitarios presentaron sobrepeso, obesidad, tabaquismo, hipertensión arterial y alteración del perfil lipídico. Algunos factores de riesgo son modificables con cambios de estilo de vida. Es necesario que autoridades en salud y educación tomen medidas para establecer estilos de vida saludables.

Introduction: The cardiometabolics diseases cause 30% of deaths in the world, seven of ten Mexicans have overweight or obesity, conditioners of diabetes mellitus, arterial hypertension and cardiovascular diseases. Objective: To study prevalence of cardiometabolics factors of risk in students of the Faculty of Medical Sciences and Biological ''Dr. Ignacio Chávez'', in Morelia, Michoacán. Material and Methods: Study cross-sectional, descriptive, random and voluntary epidemiologist, familiars here to factors of cardiometabolics risk like the age, sex, antecedents, arterial hypertension, diabetes mellitus, tobacco addiction, obesity, premature ischemic cardiopathy and physical activity were evaluated. Results: Of 141 students 67 (47.5%) men and 74 (52.5%) women, homogenous average of age men 22.66 ± 0.10 women, 22.23 ± 0.18 women 9 (6.38%) and men 15 (10.63%) are smokers. The abdominal risk in man 5 (3.50) of ( > 102 cm), and women 13 (9.20%) ( > 88 cm). The value of normal total cholesterol was in women 73 (51.80%) and in men 64 (45.40%). Conclusions: A lifted percentage of college students presented/displayed overweight, obesity, tobacco addiction, arterial hypertension and alteration of the lipoid profile. Some factors of risk are modifiable with changes of life style, is necessary that authorities in health and education take measures to establish healthful styles of life.

Prevalencia de factores de riesgo cardiovascular en poblaciones: Rural, suburbana y urbana de los estados de Guanajuato y Michoacán / Prevalence of cardiovascular risk factors in rural, suburban and urban areas of the states of Guanajuato and Michoacan, Mexico

Introducción: Desconocemos la prevalencia de la enfermedad cardiovascular y factores de riesgo cardiovasculares en poblaciones: rurales, suburbanas y urbanas de los estados de Guanajuato y Michoacán, tienen en común al medio rural exportador de mano de obra a los Estados Unidos de Norte América y a las ciudades urbanas, hábitos como: actividad física inadecuada, consumo de grasas saturadas, inestabilidad laboral; pueden generar tensión emocional, y posible hipertensión arterial sistémica, dislipidemias, sobrepeso, obesidad, estados disglucémicos e incluso tabaquismo, factores de riesgo que varían de acuerdo a costumbres, cultura, y educación en salud de cada población. Objetivo: Determinar prevalencia de factores de riesgo cardiometabólico y su asociación con los diferentes tipos de dislipidemias, entre poblaciones: rural, suburbana y urbana de Guanajuato y Michoacán. Material y métodos: Estudio epidemiológico, transversal, descriptivo, observacional aplicado a 721 individuos de poblaciones rurales, suburbanas y urbanas de Guanajuato y Michoacán. Se registró: edad, género, antecedentes de enfermedad cardiovascular prematura, tensión arterial sistémica, tabaquismo, mediciones antropométricas, porcentaje de grasa corporal, glucemia y perfil de lípidos. Se obtuvo prevalencia de factores de riesgo y su asociación con diferentes tipos de dislipidemias determinando el riesgo relativo. Resultados: Las prevalencias de factores de riesgo fueron: para el medio rural de Michoacán, la circunferencia abdominal y porcentaje de grasa corporal. Medio urbano únicamente porcentaje de grasa corporal; para Guanajuato medio suburbano índice de masa corporal, porcentaje de grasa corporal y talla. El medio urbano de Michoacán resulto desfavorable contra el rural y suburbano de Guanajuato y Michoacán en porcentaje de grasa corporal. El colesterol HDL resultó inferior en la población suburbana, desfavorable clínicamente para Michoacán, aunque estadísticamente homogéneo. Los triglicéridos clínicamente resultaron elevados y estadísticamente homogéneos para el medio rural, suburbano y urbano en los dos estados. 1.- La dislipidemia aterogénica en el medio urbano se asoció con obesidad, hipertensión arterial y síndrome metabólico; en el medio suburbano con sobrepeso, hipertensión arterial y síndrome metabólico y en el medio rural con sobrepeso y síndrome metabólico. 2.- La dislipidemia mixta con prehipertensión y diabetes mellitus en el medio rural; con tabaquismo en el medio suburbano. 3.- La hipertrigliceridemia aislada con sobrepeso en el medio suburbano y urbano, con obesidad y síndrome metabólico en el suburbano y se asoció con tabaquismo en el medio suburbano. Conclusiones: Con los resultados obtenidos se puede sugerir: 1.- En las poblaciones rurales se retome la alimentación tradicional propia de cada región con alimentos naturales, en su mayoría sin la presencia de grasas saturadas y con carbohidratos simples, así como la implementación de planes de actividad física que permitan disminuir la incidencia de factores de riesgo cardiovascular para disminuir la circunferencia abdominal, y tensión arterial sistólica en Michoacán. 2.- La población suburbana se encuentra expuesta a estilos de vida diferentes a las poblaciones urbanas y rurales, así como a factores sociales como carencia de recursos económicos para hacer frente a sus necesidades básicas, presencia de estrés laboral o falta de trabajo, alimentación inadecuada con un elevado consumo de carbohidratos simples y grasas saturadas, falta de actividad física, presencia de tabaquismo, falta de acceso o carencia de servicios médicos preventivos y asistenciales, públicos o privados por lo que se requiere favorecer las propuestas educativas en: salud, alimentación, compensación económica y oferta de trabajo para llegar a cambios sustentables en el estilo de vida para aumentar la talla y disminuir el índice de masa corporal en Guanajuato. 3.- La población urbana tiene algunas necesidades satisfechas y de esta manera apreciamos que con menos factores de riesgo, tienen consecuencias más avanzadas como obesidad, hipertensión arterial sistémica, y síndrome metabólico.

Introduction: Unknown prevalence of cardiovascular disease in cardio metabolic risk factors in rural, suburban and urban areas of the states of Guanajuato and Michoacán, which are common to rural work exporter to the United States of America and urbanized cities, habits such as inadequate physical activity, consumption of saturated fats, job instability, which can lead to emotional stress, consequently hypertension, dyslipidemia, overweight, obesity, smoking and even disglycemics states, risk factors that vary according to customs, culture, health and education in each population. Objective: Determine prevalence of cardio metabolic risk factors and their association with different types of dyslipidemia, among populations: rural, suburban and urban areas of Guanajuato and Michoacán. Material and methods: Epidemiologic, cross-sectional, descriptive and observational study applied to 721 individuals of rural, suburban and urban populations of Guanajuato and Michoacán, what was registered: age, short, antecedents of premature cardiovascular disease, systemic blood pressure, smoking, anthropometric measurements, percentage of corporal fat, glucose and lipid profile. Results obtained the prevalence of risk factors and his association with different types of dyslipidemia determining the relative risk. Results: The prevalence of risk factors were: for rural population in Michoacán, the abdominal circumference and percentage of corporal fat. Urban population solely percentage of corporal fat; for Guanajuato suburban population the index of corporal mass, percentage of corporal fat and Stature. The results in the urban population of Michoacán are unfavorable against the rural and suburban population of Guanajuato and Michoacán in percentage of corporal fat. Cholesterol HDL was inferior in the suburban, clinically unfavorable for Michoacán, although statistically homogenous. The triglycerides were clinically high and statistically homogenous for rural, suburban and urban population in both states. 1.- Atherogenic dislipidemia in urban population are associated with obesity, arterial hypertension and metabolic syndrome; in suburban population with overweight, arterial hypertension and metabolic syndrome and in rural population with overweight and metabolic syndrome. 2.- Dislipidemia mixed with prehypertension and diabetes in rural population; and with smoking addiction in suburban population. 3.- Hypercholesterolemia are associated with smoking addiction in suburban population. Conclusions: With these results the suggestion is that rural populations return to traditional foods of each region with natural foods, mostly without the presence of saturated fats and simple carbohydrates, as well as the implementation of physical activity plans that would reduce the incidence of cardiovascular risk factors to reduce abdominal circumference, and systolic blood pressure in Michoacán. The suburban population is exposed to different lifestyles to urban and rural populations, as well as determining risk factors such as lack of financial resources to satisfy their basic needs, presence of work stress or lack of work, inadequate food with a high intake of simple carbohydrates and saturated fats, lack of physical activity, smoking status, lack of access or lack of preventive health services and welfare, public or private, requiring new proposals to promote education of health, food, economic compensation and labor opportunities to reach sustainable changes in lifestyles to increase the height and to lower body mass index in Guanajuato. Finally the urban population has more needs satisfied, with fewer risk factors but advanced consequences as obesity, hypertension, and metabolic syndrome.

[Incidence of cesarean section in a regional general hospital]. / Incidencia de cesáreas en un hospital general de zona.

BACKGROUND: the high incidence of cesarean section is a world health problem, and Mexico is not the exception. The purpose of the clinical practice guidelines is to establish accurate directions on delivery by cesarean section, diminishing its unjustified practice. The Regional General Hospital and Medical Family Unit 2 of the Instituto Mexicano del Seguro Social in Zacapu, Michoacán has 70 % of cesarean section rate, it is the double of the country average. The aim was to know causes of cesarean section. METHODS: a retrospective, non-probabilistic analysis of 127 patients attended along two months. The incidence of cesarean section and causes were recorded. A statical descriptive analysis was done. RESULTS: ninety cesareans (70.9) % were performed in 127 patients; 44.4 % of these were performed in primiparous women. The most frequent reason was repeated cesarean in 27.8 %, cephalopelvic disproportion in 25.6 %, and fetal distress in 14.4 %. CONCLUSIONS: the high incidence of cesarean section in primiparous women suggests a careful review of its indications, mainly the cephalopelvic disproportion diagnosis.

[Validation of the PRIDE Scale (Primary Immunodeficiency Disease Evaluation) to Determine High Level of Suspicion for Primary Immunodeficiency Disease in Mexican Population]. / Validación de la escala PRIDE (Primary Immunodeficiency Disease Evaluation) para determinar nivel alto de sospecha de inmunodeficiencia primaria en población mexicana.

BACKGROUND: Primary immunodeficiencies have a low prevalence, but their severity and high risk of mortality require a clinical approach based in diagnostic instruments that allow their early detection. OBJECTIVE: To validate the PRIDE scale to determine a high level of suspicion for primary immunodeficiency diseases in Mexican population. METHODS: Seventy five patients with suspicion of primary immunodeficiencies (13.9 ±11.8 years-old) were evaluated with the PRIDE scale by specialists in Allergy and Immunology in this cross-sectional study, and their results were compared with the confirmed diagnosis of primary immunodeficiency. RESULTS: Kappa concordance coefficient with clinical diagnosis was 0.872, with an standard error of 0.072; CI 95% [0.73-1.013]. The scale showed sensitivity 98.3%, specificity 86.6%, positive predictive value 96.7%, negative predictive value 92.8%, positive odds ratio 7.3358 and negative odds ratio 0.0196. CONCLUSIONS: PRIDE scale was concordant with the diagnosis of primary immunodeficiency in the majority of patients with a previous confirmed diagnosis. The characteristics of diagnostic accuracy provide reliability to this instrument in the scrutiny of patients with probable immunodeficiency.

Conocimiento y criterios de enfermería para evitar flebitis en neonatos con catéter venoso periférico / Knowledge and nursing criteria to avoid phebitis in neonates with peripheral venous catheter

Introducción: el proceso cotidiano en la atención y cuidado de los neonatos brinda la oportunidad de conocer, observar e implementar procedimientos que contribuyan al bienestar del neonato. Objetivo: analizar el conocimiento y el criterio de enfermería para evitar se presente flebitis en el neonato con catéter venoso periférico. Metodología: estudio descriptivo, transversal a 17 enfermeras y 43 neonatos ingresados al servicio de infectología pediátrica. Se aplicó un instrumento con 37 reactivos, se evaluaron tres dimensiones: conocimiento, criterio y técnica. Una lista de cotejo para medir la flebitis de acuerdo a los indicadores de calidad de la Norma Oficial en la Vigilancia y Control de Venoclisis Instaladas de la SSA. 2001. Resultados: se identificó la evidencia que la flebitis es uno de los principales problemas del uso de catéteres intravenosos cortos. En el grupo de edad entre 20 a 25 años aportó significancia estadística, en la técnica (F = 4.663, gl = 3, sig: = 0.020) es quien mejor lo realiza con un promedio de ejecución de 2.25, con respecto a conocimiento y criterio no hay cifras estadísticamente significativas. Discusión: los resultados encontrados muestran que el riesgo de flebitis se incrementa con el tiempo de permanencia de los dispositivos intravasculares periféricos, al presentar flebitis en las primeras 24 a 48 horas de instalado un catéter venoso periférico.

Background: the daily care of the newborn offers the opportunity to know, to observe and to implement procedures that contribute to the well-being of them. Objective: to analyze the knowledge and the criteria in the nursery to avoid phlebitis in the newborn with a peripheral venous catheter. Methodology: the design was cross-sectional, descriptive and observational. Seventeen nurses and 43 newborns from a pediatrics infectious hospital. An instrument was applied where three dimensions were evaluated: knowledge, criterion and technique. Another instrument was a matching list to measure the phlebitis according to Official Norm for the monitoring and control of intravenous treatment. Results: this study showed that the phlebitis is one of the main problems in the use of intravenous catheters. In the group of age 20 to 25 years statistical significance, in the technique (F = 4.663, gl = 3, sig: = 0.020) is the highest average of performance was 2.25, With regard to knowledge and criterion there were not statistically significant values. Discussion: the results found in this study reveal that the risk phlebitis is proportional to the inawelling time of the devices. This complication presents with in the first 24 to 48 hours after the placement of an intravenous catheter. Conclusions: the flebitis in the neoborn one with hospitalized peripheral venous catheter appears in a one hundred percent.