Risk factors for hospitalization and mortality due to dengue fever in a Mexican population: a retrospective cohort study.

OBJECTIVES: Identify risk factors associated with increased hospital admission and mortality due to dengue fever (DF), and estimate the risk magnitude associated with each individual variable. METHODS: Records of patients diagnosed with dengue were obtained from the Mexican National Epidemiological Surveillance System. Descriptive statistics were performed in all variables. Demographic characteristics and comorbidities were compared between patients based on type of care and mortality. Multivariable analysis was done with a logistic regression model, using two different outcomes: hospitalization and mortality. RESULTS: A total of 24,495 patients were included in the analysis, with a DF case fatality rate of 0.58%. Patients younger than 10 and older than 60, were found to have a greater risk of both hospitalization and mortality due to DF. Comorbidities associated with a higher risk for hospital admission include cirrhosis, CKD, immunosuppression, diabetes, and hypertension. For mortality, CKD, diabetes, and hypertension were identified as risk factors, along with pregnancy. CONCLUSION: Identification of risk factors associated with increased hospitalization and mortality due to DF can help categorize patients that require close monitoring and inpatient care. Early identification of warning signs and patients at increased risk is key to avoiding delay of supportive care.

Lessons from the COVID-19 pandemic: knowledge and preventive actions among a mexican population sample / Lecciones de la pandemia de COVID-19: conocimiento y acciones preventivas de una muestra de población mexicana

Objective: to evaluate the knowledge of the general population about the COVID-19 pandemic, including the disease and the preventive measures to reduce spreading of the virus undertaken by participants. Materials and methods: a cross-sectional study on a Mexican population sample was conducted during the period of March 20th to March 27th in Mexico, via a computer-based survey. General knowledge about COVID-19 and the adherence to recommendations were evaluated. Results: a total of 2,577 participants completed the survey. The results revealed an overall proper knowledge about the disease, with 76.2% having the proper knowledge about the disease, which was significantly correlated with age (r=0.15, p<0.001), socioeconomic status (r=0.06, p<0.003) and maximum academic level achieved by the study subjects (r=0.12, p<0.001). Conclusions: overall, people have good knowledge of COVID-19 and know about the specific public health recommendations, but a large proportion of people do not strictly follow these recommendations..Au

Objetivo: evaluar el conocimiento de la población general acerca de la pandemia de COVID-19, incluyendo datos sobre la enfermedad y las medidas preventivas para reducir la propagación del virus. Materiales y métodos: se realizó un estudio transversal en una muestra de la población mexicana durante el periodo del 20 al 27 de marzo del 2020 por medio de una encuesta electrónica. Se evaluó el conocimiento general sobre COVID-19 y el apego a las recomendaciones de salud pública Resultados: 2,577 participantes completaron la encuesta. Los resultados muestran un adecuado conocimiento sobre la enfermedad en la población general (76.2% de la muestra), el cual está levemente correlacionado con la edad (r=0.15, p<0.001), estado socioeconómico (r=0.06, p<0.003) y grado académico (r=0.12, p<0.001). Conclusiones: en general, la población conoce la información acerca del COVID-19 y conoce las recomendaciones de salud pública, pero una gran proporción de la gente no sigue estrictamente estas recomendaciones..Au

The Role of Gram Staining in Staphylococcal Scalded Skin Syndrome.

Staphylococcal scalded skin syndrome (SSSS) is a severe blistering disease common in children. The diagnosis of SSSS is often difficult to distinguish from other blistering diseases in children. Here, we report a case of SSSS with a particular diagnostic step to elucidate the disease, which is the Gram stain. We propose the use of the Gram stain as a cost-effective diagnostic step in SSSS to shorten the time from presentation to treatment, especially in resource-limited areas.

Sudden Unexpected Infant Death: Review and Analysis of Adherence to Recommendations.

Introduction Sudden Unexpected Infant Death (SUID) is a term that englobes the sudden and unexpected death of an infant less than 12 months, which can be explained by organic or traumatic causes, or that can't be explained such as cases of Sudden Infant Death Syndrome (SIDS). Although many risk factors have been associated with this syndrome, one of the most widely associated and studied are incorrect sleeping techniques and practices. In 2016, the American Academy of Pediatrics (AAP) updated their safe-sleeping guidelines and sleeping environment recommendations and strategies to prevent SIDS. Methods We conducted a cross-sectional study to analyze the sleeping environments in infants that attended both the inpatient and outpatient services at a public pediatric hospital in Mexico City. A 6-item questionnaire was applied to the parent or guardian to assess the sleeping habits of infants in their homes. Results A total of 184 infants were included in the study, with a mean age of 5.87 months. Overall, the number of parents that follow safe sleeping practices was very low, with no parents following all the AAP recommendations, and over 10% not following any. Although there is uncertainty about the pathogenesis of this syndrome, the focus has shifted to prevention, especially regarding the modifiable risk factors. Conclusions It was demonstrated that our population did not know about the proper and safe sleeping techniques. In the nearby future, our goal is for health authorities in our country to implement a strategy to make the AAP recommendations part of government health campaigns.

Brain-Derived Neurotrophic Factor and Its Associations with Metabolism and Physical Activity in a Latino Sample.

BACKGROUND: Brain-derived neurotrophic factor (BDNF) is associated with body weight and other health conditions but remains understudied in the Latino population. The aim of this study was to examine the associations of BDNF serum levels with body mass index (BMI), physical activity, and the rs6265 nonconservative polymorphism among 349 Latinos aged ≥18 years enrolled in the Arizona Insulin Resistance Registry. MATERIALS AND METHODS: Data on physical activity were acquired using a self-reported questionnaire. BDNF serum levels were measured utilizing a modified ELISA method, and the rs6265 polymorphism was genotyped by the Assay-by-Design service. Two sample t-tests or chi-squared tests were employed to compare demographics and outcomes between physically active and nonactive groups as well as between rs6265 CC and CT+TT groups. RESULTS: BDNF levels and rs6265 polymorphism did not differ significantly between the physically active (N = 195) and nonactive group (N = 154). Participants with the rs6265 polymorphism did not show any significant difference in BDNF levels or BMI when compared with those with the normal functional variant. Higher BDNF levels were significantly associated with higher age (r = 0.11, P = 0.04) and higher 2-hr glucose level (r = 0.11, P = 0.04). CONCLUSIONS: In this cross-sectional study, the rs6265 polymorphism was not associated with a higher risk of obesity, or lower circulating levels of BDNF. Thus, the rs6265 polymorphism may have a different impact in Latinos as compared with other previously studied populations.

Conocimiento sobre la diabetes mellitus tipo 2 en estudiantes universitarios: un estudio transversal y observacional en la Universidad Anáhuac México Campus Norte en la Ciudad de México: un estudio para evaluar el conocimiento en alumnos universitarios / Knowledge about type 2 Diabetes Mellitus in universitary students: a transversal and observational study in Anahuac University Mexico North Campus in Mexico City: a study to evaluate the knowledge of the disease in university students

Objective: To assess the lack of knowledge about Type 2 Diabetes Mellitus in the student population of Anahuac University Mexico North Campus (UAMN). Materials and Methods: An observational, transversal study was conducted from February to April 2017. A 19-question survey based on the study by Al-Sararyra and colleagues in Jordan was applied to 300 students aged 18-25. Results: The lack of knowledge about the disease was made evident, especially its signs, symptoms and complications. The majority of students knew the risk factors of the disease. Information about the disease was obtained by the students mostly through family members or school education. Conclusion: The study shows a lack of knowledge in a high education institution about one of the most important diseases in the country. An educational intervention is necessary to increase their knowledge of the disease for students to take part in preventive measures.

Objetivo: Evaluar la falta de conocimiento sobre la Diabetes Mellitus tipo 2 en una población estudiantil de alto nivel de la Universidad Anáhuac México Campus Norte (UAMN). Material y Métodos: Estudio transversal y observacional, realizado de febrero a abril de 2017. Se realizaron encuestas de 19 preguntas a 300 alumnos de 18 a 25 años, basada en el trabajo de Al-Sarayra y colaboradores en la Universidad Al-Balqa en Jordania. Resultados: Se evidenció la falta de conocimiento sobre la enfermedad, especialmente sobre signos, síntomas y complicaciones. Los mayoría de los alumnos conocía los factores predisponentes. La educación escolar y los familiares fueron las principales fuentes de información para la enfermedad. Conclusión: Se refleja la carencia de conocimiento, entre alumnos con educación básica completa y aspirando a licenciaturas, sobre una de las enfermedades más importantes a nivel internacional. Una intervención educativa es necesaria para que tengan más información sobre la enfermedad y así tomen las medidas preventivas necesarias.

El consumo de drogas como sostén narcisista en la adolescencia / The consumption of drugs as a narcissistic support in the adolescence / O consumo de drogas como suporte narcisista na adolescência / La consommation de drogues comme soutien narcissique dans l'adolescence)

La tradición científica ha encontrado, en la transformación endocrina y en las condiciones ambientales, una explicación al consumo de drogas en la adolescencia, abriendo con ello la puerta a un tratamiento donde la subjetividad difícilmente ha sido leída como tal. La siguiente investigación propone comprender el periodo de la adolescencia como un proceso que, iniciándose en la pubertad, reactualiza los conflictos infantiles del sujeto, exigiendo de este, una reorganización psíquica que conduce a su subjetivación; situando desde esta visión al consumo de drogas como una posibilidad de sopesar o no, dicho advenimiento.

A tradição científica encontrou uma explicação para o consumo de drogas na adolescência, na transformação endócrina e nas condições ambientais, abrindo as portas para um tratamento em que a subjetividade dificilmente tem sido lida como tal. A pesquisa a seguir propõe compreender a adolescência como o processo que se inicia na puberdade e reativa os conflitos infantis do sujeito, demandando, dessa forma, uma reorganização psíquica que conduza à sua subjetivação; situando a partir desta visão o consumo de drogas como uma possibilidade de ponderar ou não dito advento.

The scientific tradition has found an explanation for the drug consumption in the adolescence, in the endocrine transformation and in the environmental conditions, opening the door to a treatment where the subjectivity has hardly been read as such. The following research proposes to understand adolescence as the process that begins at puberty, reactivates the infantile conflicts of the subject, thus demanding a psychic reorganization leading to its subjectivation; situating from this viewpoint, the consumption of drugs as a possibility to mourn or not that kind of situation.

La tradition scientifique a trouvé une explication pour la consommation des drogues pendant l'adolescence, dans la transformation endocrine et dans les conditions environnementales, ouvrant les portes à un traitement où la subjectivité difficilement a été lue comme telle. L'étude suivante propose de comprendre l'adolescence comme le processus qui commence à la puberté, déclenche les conflits de l'enfance du sujet, exigeant, ainsi, une réorganisation psychique qui mène à sa subjectivation; situant à partir de cette vision la consommation de drogues comme une possibilité de tristesse ou pas, dit l'avènement.

Die wissenschaftliche Tradition erklärt den Drogenkonsum bei Jugendlichen aufgrund der endokrinen Transformation und den Umweltbedingungen, was zu einer Behandlung führt, in der die Subjektivität kaum als solche gelesen wird. Die folgende Arbeit schlägt vor, die Adoleszenz als einen Prozess zu verstehen, der in der Pubertät beginnt, die kindlichen Konflikte des Subjekts reaktiviert und von diesem eine psychische Reorganisation verlangt, die zu seiner Subjektivierung führt. Aus dieser Sicht kann man den Drogenkonsum als einen Versuch betrachten, mit diesem Phänomen umzugehen.

A randomized controlled trial of a brief intervention for alcohol and drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in primary health care in Chile.

AIM: To study the effectiveness of a brief intervention (BI) associated with the ASSIST (Alcohol Smoking and Substance Involvement Screening Test) for alcohol and illicit drug use as part of a systematic screening program implemented in primary care. DESIGN: A multi-center randomized open-label trial stratified using the ASSIST-specific substance involvement score (for alcohol, scores ranged from 11 to 15 and 16 to 20; and for the other substances from 4 to 12 and 13 to 20). SETTING: A total of 19 primary care centers (n = 520), eight emergency rooms (n = 195) and five police stations (n = 91) were evaluated. PARTICIPANTS: A total of 12 217 people aged between 19 and 55 years were screened for moderate alcohol and drug use risk as defined by the ASSIST Chilean version. A total of 806 non-treatment-seekers were randomized. INTERVENTION AND COMPARISON: ASSIST-linked BI (n = 400) compared with an informational pamphlet on risk associated with substance use (n = 406). MEASUREMENTS: Total ASSIST alcohol and illicit involvement score (ASSIST-AI), and ASSIST-specific score for alcohol, cannabis and cocaine at baseline and at 3-month follow-up. FINDINGS: Sixty-two per cent of participants completed follow-up. An intention-to-treat analysis showed no difference between the two groups for the ASSIST-AI score [mean difference (MD) = - 0.17, confidence interval (CI) = -1.87, 2.20], either for specific scores alcohol (MD = 0.18, CI = -1.45, 1.10), cannabis (MD = -0.62, CI = -0.89, 2.14) or cocaine (MD = -0.79, CI = -2.89, 4.47). CONCLUSION: It is not clear whether a brief intervention associated with the Alcohol Smoking and Substance Involvement Screening Test is more effective than an informational pamphlet in reducing alcohol and illicit substance consumption in non-treatment-seeking, primary care users with moderate risk.

Temporalidad psiquica y subjetivación en la adolescencia / Temporalidade psíquica e subjetivação na adolescência / Psychic temporality and subjectivation in adolescence / Temporalité psychique et subjectivation dans l’adolescence

La crisis de la adolescencia encuentra su explicación en la actualización del conflicto edípico, demostrando por primera vez una ritmicidad y una estructura temporal en retroactividad que deshace los modelos del tiempo lineal, ubicando así a la adolescencia como el paradigma de la temporalidad de los procesos psíquicos en el sujeto.

A crise da adolescência é explicada pela atualização do conflito edípico, demonstrando pela primeira vez uma ritmicidade e uma estrutura temporal em retroatividade que desfaz os modelos do tempo linear, colocando assim a adolescência como o paradigma da temporalidade dos processos psíquicos no sujeito.

The crisis of adolescence is explained by an updated Oedipus conflict, showing for the first time rhythmicity and a temporal retroactive structure that undoes the linear time models. This article proposes to think adolescence as the paradigm of the temporality of psychic processes in subjects.

La crise de l’adolescence trouve son explication dans la réactualisation du conflit œdipien, en mettant en scène pour la première fois une rythmicité et une structure temporelle de façon rétroactive, défaisant les modèles du temps linéaire. Cet article propose de penser l’adolescence comme le paradigme de la temporalité des processus psychiques du sujet.

Temporalidad psiquica y subjetivación en la adolescencia / Temporalidade psíquica e subjetivação na adolescência / Psychic temporality and subjectivation in adolescence / Temporalité psychique et subjectivation dans l’adolescence

La crisis de la adolescencia encuentra su explicación en la actualización del conflicto edípico, demostrando por primera vez una ritmicidad y una estructura temporal en retroactividad que deshace los modelos del tiempo lineal, ubicando así a la adolescencia como el paradigma de la temporalidad de los procesos psíquicos en el sujeto.(AU)

A crise da adolescência é explicada pela atualização do conflito edípico, demonstrando pela primeira vez uma ritmicidade e uma estrutura temporal em retroatividade que desfaz os modelos do tempo linear, colocando assim a adolescência como o paradigma da temporalidade dos processos psíquicos no sujeito.(AU)

The crisis of adolescence is explained by an updated Oedipus conflict, showing for the first time rhythmicity and a temporal retroactive structure that undoes the linear time models. This article proposes to think adolescence as the paradigm of the temporality of psychic processes in subjects.(AU)

La crise de l’adolescence trouve son explication dans la réactualisation du conflit œdipien, en mettant en scène pour la première fois une rythmicité et une structure temporelle de façon rétroactive, défaisant les modèles du temps linéaire. Cet article propose de penser l’adolescence comme le paradigme de la temporalité des processus psychiques du sujet.(AU)