Política Andina de Salud Pública para Fortelecer y Alcanzar el óptimo Desarrollo Infantil Temprano / Andean Public Health Policy to Strengthen and Achieve Optimal Early Childhood Development

La Política Andina en Salud Pública para fortalecer y contribuir en el Óptimo Desarrollo Infantil Temprano, con la finalidad de determinar según las prioridades ya identificadas en la Región Andina y el reconocimiento de los avances y situación actual de los indicadores en la infancia, plantear las Líneas estratégicas con enfoque de curso de vida, derechos e interculturalidad, con acción sobre los determinantes de la salud y que puedan ser ejecutadas de forma sostenida, eficiente, eficaz e integralmente en los países andinos en los próximos años hacia el alcance de la agenda al 2030.

Situación de la salud infantil y el desarrollo infantil temprano en la región andina / Situation of child health and early childhood development in the Andean region

En la primera parte del presente documento se expone la situación de salud y del Desarrollo Infantil Temprano (DIT) de los niños y niñas en sus primeros 5 años de vida, la situación de salud de las madres y las principales barreras para el ejercicio de los derechos de unos y otras, en el marco de la agenda de los Objetivos de Desarrollo Sostenible (ODS). Para la primera parte se privilegió la información obtenida de fuentes secundarias, de instituciones como el Organismo Andino de Salud Convenio Hipólito Unanue (ORAS-CONHU), la OPS/OMS, UNICEF, UNESCO), el Banco Mundial y otras. Con el fin de contar con una referencia más allá de los seis países miembros del ORAS-CONHU, en varios casos se incorporó información del conjunto de países de ALC (Anexo 1). La segunda parte del documento presenta las políticas, programas, planes u otras intervenciones que se vienen implementando o aplicando en los países andinos, que contribuyan a la salud materna e infantil y que se constituyen en avances y acciones hacia el alcance del óptimo DIT

[Myocardial infarction in young mexicans associated to metabolic syndrome]. / Infarto agudo al miocardio en jóvenes mexicanos asociado a síndrome metabólico.

BACKGROUND: Acute coronary diseases are catastrophic, especially in young patients. OBJECTIVE: To determine the risk of metabolic syndrome (MS) for premature acute myocardial infarction (AMI), combined with familial, behavioral, and nutritional factors in the northeast of Mexico. MATERIAL AND METHODS: This is a case control study of patients less than 47 years of age with no personal history of angina, AMI, or cerebrovascular disease. Cases corresponded to patients with AMI (incident and primary cases; n = 55) and controls were blood donors located at the same hospital (n = 55). Behavioral, nutritional, and cardiometabolic risk factors were measured. Multivariate logistic regression was used for estimating odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS: MS increased the risk for premature AMI (95% CI: 1.73-39.5) eightfold, followed by smoking (OR: 7.76; 95% CI: 1.27-47.3), family history of AMI or sudden death (OR: 11.0; 95% CI: 2.03-60.4), and sedentary lifestyle (OR: 2.26; 95% CI: 2.52-9.80), independent of potential confounders. CONCLUSIONS: The study highlights the magnitude of the risk of MS for AMI in Mexican young adults. The phenomenon of coronary diseases among young adults needs essential attention from the health sector.

[Not Available]. / Threshold values of sagittal abdominal diameter for the detection of cardio-metabolic risk factors in Northeastern Mexico: a cross-sectional study.

BACKGROUND: The use of sagittal abdominal diameter (SAD) has been proposed for screening cardio-metabolic risk factors; however, its accuracy can be influenced by the choice of thresholds values. AIM: To determine the SAD threshold values for cardio-metabolic risk factors in Mexican adults; to assess whether parallel and serial SAD testing can improve waist circumference (WC) sensitivity and specificity; and to analyze the effect of considering SAD along with WC and body mass index (BMI) in detecting cardio-metabolic risk. METHODS: This cross-sectional study was conducted during 2012-2014 in Northeast Mexico (n = 269). Data on anthropometric, clinical, and biochemical measurements were collected. Sex-adjusted receiver-operating characteristic curves (ROC) were obtained using hypertension, dysglycemia, dyslipidemia and insulin resistance as individual outcomes and metabolic syndrome as a composite outcome. Age-adjusted odds ratios and 95% confidence intervals (CI) were estimated using logistic regression. RESULTS: The threshold value for SAD with acceptable combination of sensitivity and specificity was 24.6 cm in men and 22.5 cm in women. Parallel SAD testing improved WC sensitivity and serial testing improved WC specificity. The co-occurrence of high WC/high SAD increased the risk for insulin resistance by 2.4-fold (95% CI: 1.1-5.3), high BMI/high SAD by 4.3-fold (95% CI: 1.7-11.9) and SAD alone by 2.2-fold (95% CI: 1.2.-4.2). CONCLUSIONS: The use of SAD together with traditional obesity indices such as WC and BMI has advantages over using either of these indices alone. SAD may be a powerful screening tool for interventions for high-risk individuals.

Threshold values of sagittal abdominal diameter for the detection of cardio-metabolic risk factors in Northeastern Mexico: a cross-sectional study / Valores de corte del diámetro sagital del abdomen para la detección de factores de riesgo cardiovascular en el noreste mexicano: estudio transversal

Background: The use of sagittal abdominal diameter (SAD) has been proposed for screening cardio-metabolic risk factors; however, its accuracy can be influenced by the choice of thresholds values. Aim: To determine the SAD threshold values for cardio-metabolic risk factors in Mexican adults; to assess whether parallel and serial SAD testing can improve waist circumference (WC) sensitivity and specificity; and to analyze the effect of considering SAD along with WC and body mass index (BMI) in detecting cardio-metabolic risk. Methods: This cross-sectional study was conducted during 2012-2014 in Northeast Mexico (n = 269). Data on anthropometric, clinical, and biochemical measurements were collected. Sex-adjusted receiver-operating characteristic curves (ROC) were obtained using hypertension, dysglycemia, dyslipidemia and insulin resistance as individual outcomes and metabolic syndrome as a composite outcome. Age-adjusted odds ratios and 95% confidence intervals (CI) were estimated using logistic regression. Results: The threshold value for SAD with acceptable combination of sensitivity and specificity was 24.6 cm in men and 22.5 cm in women. Parallel SAD testing improved WC sensitivity and serial testing improved WC specificity. The co-occurrence of high WC/high SAD increased the risk for insulin resistance by 2.4-fold (95% CI: 1.1-5.3), high BMI/high SAD by 4.3-fold (95% CI: 1.7-11.9) and SAD alone by 2.2-fold (95% CI: 1.2.-4.2). Conclusions: The use of SAD together with traditional obesity indices such as WC and BMI has advantages over using either of these indices alone. SAD may be a powerful screening tool for interventions for high-risk individuals (AU)

Introducción: el diámetro sagital del abdomen (SAD) se ha usado para detectar factores de riesgo cardiometabólicos; su precisión se ve afectada por los valores de corte. Objetivo: determinar valores de corte para factores de riesgo cardiometabólicos en mexicanos adultos; evaluar la sensibilidad y especificidad cuando se utiliza en serie o en paralelo con la circunferencia de la cintura (WC); y analizar el uso del SAD individualmente o junto a WC o el índice de masa corporal (IMC) para detectar factores de riesgo cardiometabólicos. Métodos: en forma transversal, de 2012 a 2014 se estudiaron 209 sujetos provenientes del noreste mexicano. Se recopilaron datos antropométricos, clínicos y bioquímicos. Se construyeron curvas ROC ajustadas por sexo utilizando como resultado individual hipertensión, disglicemia y resistencia a la insulina y como resultado compuesto, el síndrome metabólico. Se calcularon razón de momios e intervalos de confianza (IC 95%) mediante regresión logística. Resultados: los valores de corte fueron 24,6 cm en hombres y 22,5 cm en mujeres. El SAD en paralelo con la WC mejoró sensibilidad y en forma seriada, la especificidad de WC. La coocurrencia de WC y SAD por encima de los rangos incrementó el riesgo para resistencia a la insulina 2,4 veces (95% CI: 1,1-5,3); BMI y SAD elevados, 4,3 veces (95% CI: 1,7-11,9) y SAD individualmente, 2,2 veces (95% CI: 1,2-4,2). Conclusiones: utilizar el SAD junto a índices tradicionales de obesidad (WC y BMI) tiene ventajas sobre su uso individual. El SAD puede ser una poderosa herramienta de tamizaje para intervenciones en individuos de alto riesgo (AU)