Missed opportunities for prevention of congenital syphilis.

BACKGROUND: The WHO presented the initiative: "Global elimination of congenital syphilis (CS): rationale and strategies for action". It establishes that CS is a preventable disease that can be eliminated. OBJECTIVE: To estimate the proportion of missed opportunities for prevention (MOP) of (CS). MATERIAL AND METHODS: Cross-sectional study. We studied women with children with confirmed diagnosis of CS (NOM-039-SSA2-2002) in the Mexican Social Security Institute in Jalisco from 01/01/2016 to 08/01/2022. The clinical records of the mother, the newborn and the epidemiological study (ES) were reviewed. Each case was classified into one of the MOP categories. RESULTS: 52 cases were reported: 46.2 % (n = 24) were ruled out, 34.6 % (n = 18) confirmed, 15.4 % (n = 8) unknown and 3.8 % (n = 2) probable cases. The HIV test was performed in 61.1 % (n = 11) and syphilis in 72.2 % (n = 13) of the mothers. The MOP in 27.8 % (n = 5) was inadequate treatment or omission of maternal treatment despite a timely diagnosis of syphilis. Treatment was inadequate in 63.6 % (n = 7) of the women who received it. CONCLUSION: The classification of MOP identifies gaps in CS prevention and can guide stakeholders, policy makers and public health prevention programs to reduce the incidence of CS.

ANTECEDENTES: La Organización Mundial de la Salud estableció que la sífilis congénita es una enfermedad prevenible que puede eliminarse. OBJETIVO: Estimar la proporción de oportunidades perdidas en la prevención (OPP) de la sífilis congénita. MATERIAL Y MÉTODOS: Estudio transversal descriptivo. Se eligieron mujeres en cuyos hijos recién nacidos se identificó sífilis congénita entre 2016 y 2022. Se revisaron los expedientes clínicos de la madre, el recién nacido y el estudio epidemiológico. Cada caso se clasificó en una de las categorías de las OPP. RESULTADOS: Se notificaron 52 casos: 46.2 % (n = 24) fue descartado, 34.6 % (n = 18) confirmado, 15.4 % (n = 8) desconocido y 3.8 % (n = 2) probable. Las pruebas para identificar infección por VIH y sífilis se realizaron en 61.1 % (n = 11) y 72.2 % de las madres (n = 13). La OPP en 27.8 % (n = 5) consistió en el tratamiento inadecuado u omisión de tratamiento materno a pesar de diagnóstico oportuno de la sífilis. De quienes recibieron tratamiento, en 63.6 % fue inadecuado (n = 7). CONCLUSIÓN: La clasificación de OPP de sífilis congénita permite identificar brechas en la prevención y dirigir intervenciones de salud pública hacia las principales causas para reducir la incidencia.

What is a migrant death? An operational definition for a more accurate enumeration of migrant mortality along the US-Mexico border.

Over the last forty years an indeterminate number of persons, ranging from thousands to tens of thousands, have died along the US-Mexico border during migration, fleeing poverty, armed conflict, situations of violence, and disasters. An accurate accounting of migrant deaths along the southern US border is the first step toward an understanding of the extent and the contributing factors of these deaths. In this article, we describe a key aspect of our collaborative work aimed at developing a more representative account of migrant mortality along the southwestern US border: the determination of criteria for inclusion of specific forensic cases as "migrant." Our intention is not to propose a definition of "what is a migrant death" applicable to all contexts and situations but rather one specific to the US-Mexico border region. Our main impetus is to build and launch a web portal to track and map migrant deaths at the US-Mexico border. The criteria we have identified are based on an examination of death data collected by various agencies in the four border states (California, Arizona, New Mexico, and Texas) and at the federal level by the National Missing and Unidentified Persons System (NamUs). They include a) context of human remains discovery; b) identification media/documentation; c) geographic setting; and d) personal effects. Taken together, these criteria will facilitate our determination, case by case, of the probability that human remains found along the United States side of the border may be from a person in the context of migration.

Frequency of rs1051338 and rs116928232 Variants in Individuals from Northwest Mexico.

BACKGROUND: LIPA, situated on chromosome 10q23.2-q23.3, encodes the enzyme lysosomal acid lipase (LAL) (EC 3.1.1.13). Genetic alterations in LIPA lead to lysosomal acid lipase deficiency (LALD), an inborn error causing lipid metabolism anomalies and impairing cholesterol and triacylglyceride degradation. Over 40 LIPA variants have been documented, yet this study focuses on just two. The rs1051338 variant (NM_000235:c.46A>C) affects the signal peptide in Exon 2, whereas rs116928232, located in Exon 8, alters the splice site (NM_000235:c.894G>A), impacting lysosomal acid lipase activity. Considering the diverse clinical manifestations of LALD and the rising hepatic steatosis prevalence in Mexican population, mainly due to diet, these variants were investigated within this demographic to uncover potential contributing factors. This study aimed to reveal the frequency of rs1051338 and rs116928232 among healthy mestizo individuals in Northwest Mexico, marking a significant genetic exploration in this demographic. METHODS: Three hundred ten healthy mestizo individuals underwent PCR-RFLP analysis for both variants, and Sanger sequencing was performed for variant rs116928232. Bioinformatic analysis was also performed to predict protein changes. RESULTS: Allele frequencies for rs1051338 (FA = 0.39, p value = 0.15) and rs116928232 (FA = 0.0016, p value = 0.49) aligned with reported data, while bioinformatic analysis allowed us to identify the protein alteration observed in both variants; finally, the variants showed no linkage between them (normalized D' = 1.03, p value = 0.56). CONCLUSIONS: Allelic frequencies closely matched reported data, and protein structure analysis confirmed variant impacts on LAL enzyme function. Notably, this study marks the first analysis of rs1051338 and rs116928232 in a healthy Mexican mestizo population.

Early clinical effect of cladribine in patients with highly active multiple sclerosis in Mexico.

Background: Cladribine shows efficacy in multiple sclerosis (MS), but Latin American (LATAM) real-world data is limited, despite potential sociodemographic variations. Objective: Investigate baseline characteristics and clinical response in highly active MS patients in Mexico, identifying predictors of early treatment response. Method: A multicenter cohort study analyzed retrospective data from individuals with "highly active" MS in the Cladribine Patient Support Program across 11 Mexican clinics. Criteria included one-year prior treatment with another disease-modifying treatment and recent relapse with specific MRI findings. Primary outcomes focused on achieving NEDA-3 status after 12 months. Results: In the follow-up, 67.5% maintained NEDA-3 status. Baseline EDSS scores decreased significantly from 1.50 to 1.00 (p = 0.011), with no confirmed disability worsening. No significant differences were observed between NEDA-3 achievers and non-achievers in demographic and clinical variables. No severe adverse events were reported. Conclusion: Cladribine showed early and effective control of active MS in Mexican patients, demonstrating a secure profile with minimal adverse events. This study provides valuable real-world evidence in the LATAM context.

Consumers' beef purchasing behavior across countries.

In 2022, the value of United States (US) beef and beef product exports was $11.7 billion, and the US was the world's largest beef producer and second-largest beef exporter by volume. Therefore, we conducted surveys to evaluate beef purchasing behavior among consumers in important and emerging US beef export markets, including Japan, the United Kingdom (UK), Germany, and Mexico. Results reveal differences in consumers' beef purchasing behavior across countries. Most Mexican consumers purchase beef two-to-three times a week, while consumers in other countries typically purchase it once a week. Using ordered probit models, we examined the factors associated with beef purchase frequency in each country. Japanese consumers who consider price to be an important factor when purchasing beef are less likely to purchase it frequently. German consumers, for whom brands are important when buying beef, are more likely to buy it frequently. British consumers, who consider hormone-free production to be important when purchasing beef, are less likely to buy it frequently. Mexican consumers, who consider grass-fed production to be an important factor when purchasing beef, are less likely to buy it frequently. Across all countries, individuals who purchase beef at supermarkets and from butchers are more likely to purchase it more often. Results also indicate that various consumer demographics are associated with beef purchase frequency across countries. The findings provide valuable insights for stakeholders regarding international consumer beef purchasing behavior.

The "Dark Side" of Community Ties: Collective Action and Lynching in Mexico.

Lynching remains a common form of collective punishment for alleged wrongdoers in Latin America, Africa, and Asia today. Unlike other kinds of collective violence, lynching is usually not carried out by standing organizations. How do lynch mobs overcome the high barriers to violent collective action? I argue that they draw on local community ties to compensate for a lack of centralized organization. Lynch mobs benefit from solidarity and peer pressure, which facilitate collective action. The study focuses on Mexico, where lynching is prevalent and often amounts to the collective beating of thieves. Based on original survey data from Mexico City and a novel lynching event dataset covering the whole of Mexico, I find that individuals with more ties in their communities participate more often in lynching, and municipalities with more highly integrated communities have higher lynching rates. As community ties and lynching may be endogenously related, I also examine the posited mechanisms and the causal direction. Findings reveal that municipalities exposed to a recent major earthquake-an event that tends to increase community ties-subsequently experienced increased levels of lynching. Importantly, I find that interpersonal trust is unrelated to lynching, thus showing that different aspects of social capital have diverging consequences for collective violence, with community ties revealing a "dark side."

Unlocking the power of tobacco taxation to mitigate the social costs of smoking in Mexico: A microsimulation model.

Despite being the most cost-effective tobacco control policy, tobacco taxation is the least implemented of the WHO MPOWER package to reduce smoking worldwide. In Mexico, both smoking prevalence and taxation have remained stable for more than a decade. This study aims to provide evidence about the potential effects of taxation to reduce the burden of tobacco-related diseases and the main attributable social costs in Mexico, including informal (unpaid) care costs, which are frequently ignored. We employ a first-order Monte Carlo microsimulation model that follows hypothetical population cohorts considering the risks of an adverse health event and death. First, we estimate tobacco-attributable morbidity and mortality, direct medical costs, and indirect costs, such as labour productivity losses and informal care costs. Then, we assess the potential effects of a 50% cigarette price increase through taxation and two alternative scenarios of 25% and 75%. The inputs come from several sources, including national surveys and vital statistics. Each year, 63,000 premature deaths and 427,000 disease events are attributable to tobacco in Mexico, while social costs amount to MX$194.6 billion (US$8.5) -MX$116.2 (US$5.1) direct medical costs and MX$78.5 (US$3.4) indirect costs-, representing 0.8% of GDP. Current tobacco tax revenue barely covers 23.3% of these costs. Increasing cigarette prices through taxation by 50% could reduce premature deaths by 49,000 over the next decade, while direct and indirect costs averted would amount to MX$87.9 billion (US$3.8) and MX$67.6 billion (US$2.9), respectively. The benefits would far outweigh any potential loss even in a pessimistic scenario of increased illicit trade. Tobacco use imposes high social costs on the Mexican population, but tobacco taxation is a win-win policy both for gaining population health as well as reducing tobacco societal costs.

[Childhood overweight and obesity: A biomedical challenge in Mexico]. / Sobrepeso y obesidad infantil: un reto biomédico en México.

In Mexico, 1 out of 3 schoolchildren aged 5 to 11 years is overweight or obese, which represents one of the main public health concerns, due to the fact that this condition in the child population is highly associated with the development of metabolic complications in adults. To date, dietary and physical activity interventions to prevent this problem have shown modest results worldwide. Biomedical studies in Mexico have shown that the pathophysiology of childhood overweight and obesity presents different molecular patterns, inflammation and oxidative stress, possibly associated with specific variants in the genome. However, the challenge is to achieve a secure characterization of this evidence so that it can be used in intervention studies aimed to improve the ability to predict and treat childhood overweight and obesity in Mexico. The biomedical challenge is to make knowledge a prevention strategy in families, in society and in the country, in order to fight the serious problem of obesity and its consequences.

En México 1 de cada 3 escolares de 5 a 11 años presenta sobrepeso u obesidad, lo cual representa una de las principales preocupaciones de salud pública, debido a que en la población infantil este padecimiento se asocia altamente con el desarrollo de complicaciones metabólicas en el adulto. Hasta el momento las intervenciones dietéticas y de actividad física para prevenir este problema han mostrado resultados modestos a nivel mundial. Los estudios biomédicos en México han demostrado que la fisiopatología del sobrepeso y la obesidad infantil presenta diferentes patrones moleculares, de inflamación y de estrés oxidativo, posiblemente asociados a variantes específicas en el genoma. Sin embargo, el reto es lograr la caracterización segura de estas evidencias para que sea posible emplearlas en los estudios de intervención encaminados a mejorar la capacidad de predicción y tratamiento del sobrepeso y la obesidad infantil en México. El reto biomédico es hacer del conocimiento una estrategia de prevención en las familias, en la sociedad y en el país, a fin de combatir el grave problema de la obesidad y sus consecuencias.

[Health-related quality of life in Mexican women with obesity]. / Calidad de vida relacionada con la salud en mujeres mexicanas con obesidad.

Background: Obesity creates a burden of disease that affects the health-related quality of life (HRQoL) of women and in those between 20 to 59 years of age it implies greater morbidity and mortality compared to men or other age groups. Objective: To evaluate the HRQoL of Mexican women aged 20 to 59 years with obesity. Material and methods: Observational, cross-sectional, prospective, and retrospective study. It was obtained a sample of 104 women from 20 to 59 years of age diagnosed with obesity according to the NOM-008-SSA3-2017 Standard. The participants' main clinical and sociodemographic characteristics were collected, and their HRQoL was evaluated with the SF-36 questionnaire. For the analysis of the collected variables, descriptive statistics were used. To identify the association of these variables with HRQoL, the Kruskal-Wallis test was used. Results: 104 women with a median age of 40.0 years participated. Of these, 66.3% had grade I obesity, 21.2% grade II, and 12.5% grade III. In the overall sample, general health and vitality were the lowest dimensions. In the comparison by groups, the physical role and the emotional role had statistically significant differences (p = 0.007 and p = 0.009, respectively), with the most affected group being obesity grade II. Conclusions: Obesity mainly affected the perception of general health and vitality; likewise, those with grade II had a greater impact on the physical role and the emotional role.

Introducción: la obesidad crea una carga de enfermedad que afecta la calidad de vida relacionada con la salud (CVRS) de las mujeres y en aquellas de 20 a 59 años implica una mayor morbilidad y mortalidad respecto a los hombres u otros grupos etarios. Objetivo: evaluar la CVRS de mujeres mexicanas de 20 a 59 años con obesidad. Material y métodos: estudio observacional, transversal, prospectivo y retrolectivo. Se obtuvo una muestra de 104 mujeres de 20 a 59 años, diagnosticadas con obesidad según la NOM-008-SSA3-2017. Se recabaron las principales características clínicas y sociodemográficas de las participantes y se evaluó su CVRS con el cuestionario SF-36. Para analizar las variables recogidas, se usó estadística descriptiva. Para identificar la asociación de estas variables con la CVRS, se usó la prueba Kruskal-Wallis. Resultados: participaron 104 mujeres con una mediana de edad de 40.0 años. De estas, 66.3% tuvieron obesidad grado I, 21.2% grado II y 12.5% grado III. En la muestra general, la salud general y la vitalidad fueron las dimensiones más bajas. En la comparación por grupos, el rol físico y el rol emocional tuvieron diferencias estadísticamente significativas (p = 0.007 y p = 0.009, respectivamente), y el grupo más afectado fue el de obesidad grado II. Conclusiones: la obesidad afectó principalmente la percepción de la salud general y de la vitalidad; asimismo, aquellas con grado II tuvieron una mayor repercusión en los roles físico y emocional.

[Epidemiological, clinical, and biochemical characteristics of patients in the LUPUS-IMMex cohort]. / Características epidemiológicas, clínicas y bioquímicas de los pacientes en la cohorte LUPUS-IMMex.

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect multiple organs and body systems. Objective: To describe the sociodemographic, clinical, and biochemical characteristics of the Lupus-IMMS-Mexico (LUPUS-IMMex) patient cohort from a tertiary-level center. Material and methods: Observational descriptive study of 160 patients with diagnosis of SLE belonging to the aforementioned cohort. Various variables were analyzed at the time of diagnosis. For quantitative variables, normality tests were applied, followed by measures of central tendency and dispersion according to their distribution. For categorical variables, frequencies and percentages were calculated. Results: 81.87% of the patients were female, with a median age at diagnosis of 28 years. 18.12% had a family history of SLE, and concurrently with SLE, 32.50% had hypertension, and 11.25% had antiphospholipid syndrome. The most common clinical manifestation was joint involvement (68.12%), renal (49.37%) and hematological (43.75%) manifestations. Conclusions: SLE affects millions globally. Lack of awareness leads to delayed diagnoses, suboptimal management, and diminished quality of life. After analyzing 160 patients with SLE, their clinical, socioeconomic, and therapeutic characteristics are largely like other cohorts, with differences attributable to ethnic and geographical influences. Informing patients about SLE and providing reliable resources are essential for self-care. Awareness promotes research, therapies, and enhances medical care and the lives of patients globally.

Introducción: el lupus eritematoso sistémico (LES) es una enfermedad autoinmunitaria crónica que puede afectar a múltiples órganos y sistemas del cuerpo. Objetivo: describir las características sociodemográficas, clínicas y bioquímicas de la cohorte de pacientes Lupus-IMMS-México (LUPUS-IMMex) de un hospital de tercer nivel. Material y métodos: estudio descriptivo observacional de 160 pacientes con diagnóstico de LES de la cohorte mencionada. Se analizaron diversas variables al momento del diagnóstico. Para variables cuantitativas se aplicaron pruebas de normalidad y posteriormente medidas de tendencia central y dispersión de acuerdo con su distribución. Para variables categóricas se calcularon frecuencias y porcentajes. Resultados: 81.87% de los pacientes fueron del sexo femenino, con mediana de edad al diagnóstico de 28 años. El 18.12% tenían antecedentes familiares de LES y concomitante al LES, hipertensión (32.50%) y síndromes antifosfolípidos (11.25%). Las afecciones clínicas más frecuentes fueron la articular (68.12%), la renal (49.37%) y la hematológica (43.75%). Conclusiones: el LES afecta a millones de personas globalmente. La falta de conciencia lleva a diagnósticos tardíos, manejo deficiente y baja calidad de vida. Tras analizar 160 pacientes con LES, sus características clínicas, socioeconómicas y terapéuticas son mayormente similares a otras cohortes, con diferencias atribuibles a influencias étnicas y geográficas. Informar a los pacientes sobre el LES y brindar recursos confiables es esencial para el autocuidado. La sensibilización fomenta la investigación, las terapias y mejora la atención médica y la vida de pacientes a nivel global.

Experience of a novel lung transplant program in Mexico.

Lung transplantation is the gold standard therapy for patients in the end stages of pulmonary disease. However, in numerous countries, candidates for lung transplants often die on the waiting list due to a shortage of donors and limited access to transplant centers. This article delves into the experience of our hospital, Christus Muguerza in Monterrey, Mexico, as the sole active lung transplant program in the country, having conducted 35 transplants from August 2017 to March 2023. We discuss the actual situation of lung transplantation in Mexico and the challenges we have faced over time, such as late patient referrals for evaluation and eventual transplantation. In addition, we outline the challenges we anticipate as more transplant programs emerge in the country.

[Dietary inflammatory index related to knee osteoarthritis symptomatology]. / Índice inflamatorio dietético relacionado con la sintomatología de osteoartritis de rodilla.

Background: Proinflammatory diet contributes to greater symptomatology in patients with knee osteoarthritis (KOA); however, in Mexico there seems to be no evidence of the dietary inflammatory role, being a country with high prevalence of overweight and obesity with an inclination towards a Western diet. Objective: To analyze the relationship between dietary inflammatory index (DII) and KOA symptomatology in Mexican patients. Material and methods: Analytical cross-sectional study in 100 patients aged 40 to 70 years. Pain, stiffness, and functionality were evaluated with the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the DII was calculated from the semi-quantitative food consumption frequency questionnaire (QFCFQ). For its analysis, linear regression was calculated. Results: DII was significantly associated with pain (p = 0.001, R² = 0.118), functionality (p = 0.003, R² = 0.087) and WOMAC score (p = 0.001, R² = 0.099). In the second linear regression model with the dependent variable functionality, waist circumference (WC) was adjusted obtaining an R² = 0.144 and higher significance p = 0.001. Conclusions: Proinflammatory DII was related to greater pain, lower functionality and a high WOMAC score, which is why the anti-inflammatory diet could be considered as a support for the treatment of the patient with KOA.

Introducción: la dieta proinflamatoria contribuye a una mayor sintomatología en pacientes con osteoartritis de rodilla (OAR); sin embargo, en México parece no existir evidencia del papel inflamatorio dietético, pues es un país con alta prevalencia de sobrepeso y obesidad con inclinación hacia una dieta occidental. Objetivo: analizar la relación del índice inflamatorio dietético (IID) con la sintomatología de OAR en pacientes mexicanos. Material y métodos: estudio transversal, analítico en 100 pacientes de 40 a 70 años. Se evaluó el dolor, la rigidez y la funcionalidad con el Western Ontario and McMaster Universities Arthritis Index (WOMAC) y el IID se calculó a partir del cuestionario semicuantitativo de frecuencia de consumo de alimentos (CSFC). Para su análisis, se calculó regresión lineal. Resultados: el IID se asoció significativamente con dolor (p = 0.001, R² = 0.118), funcionalidad (p = 0.003, R² = 0.087) y puntaje del WOMAC (p = 0.001, R² = 0.099). En el segundo modelo de regresión lineal con la variable dependiente funcionalidad, se ajustó la circunferencia de cintura (CC) y se obtuvo una R² = 0.144 y una mayor significación: p = 0.001. Conclusiones: el IID proinflamatorio se relacionó con un mayor dolor, una menor funcionalidad y un puntaje alto del WOMAC, por lo cual la dieta antiinflamatoria podría considerarse como un apoyo para el tratamiento del paciente con OAR.

[Acute apical abscess and associated factors in patients during the covid-19 pandemic in a health center in Acapulco, Mexico.] / Absceso apical agudo y factores asociados en pacientes durante la pandemia de covid-19 en un centro de salud de acapulco, méxico.

Objective: To estimate the prevalence of acute apical abscess and identify associated factors in patients of a health center from Acapulco, Mexico. Material and methods: Epidemiological study that collected clinical records of patients during the period of october 2021. Sociodemographic and housing information was collected, as well as personal pathological and non-pathological history and a record of the diagnosis of the periapical lesion based on its clinical characteristics issued by the operator on duty. Through multivariate analysis, a factor associated with acute apical abscess was identified with the odds ratio and its 95% confidence interval as estimators of the strength of association with CIETmap statistical software. Results: The 37% (32/87) of patients were diagnosed with the infection. In terms of gender, females were the most affected with a proportion of 56% (18/32). The most common cause was caries with 72% (23/32). The right upper second premolar was the most affected tooth with 25% (8/32). One associated factor was identified, age 36 to 62 years (ORa=3.54; CI95%a=1.27 -16.62). Conclusion: The morbidity rate of the infection was moderate, and it is a common pathology in stomatological emergency consultations, so it is important for the professional in charge of the area to manage it clinically. It will be important to implement oral health education strategies aimed at different age groups to raise awareness of the cariogenic process and its consequences.

Microhabitat selection by the Oscura Mountains Colorado Chipmunk (Neotamias quadrivittatus oscuraensis): an old-growth pinyon-juniper woodland specialist.

Habitat specialists have been largely overlooked in old-growth pinyon-juniper woodlands, despite specialists exhibiting heightened sensitivity to anthropogenic habitat loss. Furthermore, small mammal relationships within pinyon-juniper woodlands have most commonly been investigated via species abundance or habitat use, rather than habitat selection, thereby providing limited management metrics. We used the Oscura Mountains Colorado Chipmunk (Neotamias quadrivittatus oscuraensis) as a model organism to evaluate whether old-growth conditions drive resource selection by small mammals associated with pinyon-juniper woodlands. The goal of our study was to determine resources important to the chipmunk to inform management decisions. We evaluated microhabitat selection by testing a priori predictions based on natural history characteristics of the chipmunk and the woodlands. We grouped predictions into habitat characteristics affiliated with or not affiliated with old growth. We tested predictions under a multistage modeling framework using generalized linear mixed models with a binomial response variable of use versus availability. Probability of selection by chipmunks increased with increasing mean juniper diameter and increasing variation of pinyon diameter and decreased with increased distance to rocky escape terrain and increased mean percent grass cover. Our findings support the classification of the Oscura Mountains Colorado chipmunk as an old-growth pinyon-juniper specialist, as the chipmunk displayed disproportionate preference for old-growth microhabitat conditions. We recommend management policies that conserve old-growth multiage stands of pinyons and junipers. Old-growth conditions near outcroppings, escarpments, and large boulders are of particular conservation concern. Further, thinning resulting in increased grass cover may be detrimental to this old-growth pinyon-juniper specialist.

Prevalence of Umbilical Hernias by Computed Tomography.

INTRODUCTION: Umbilical hernias (UHs) are commonly underdiagnosed due to their asymptomatic presentation. The aim was to determine the prevalence of UHs by computed tomography (CT) in a trauma center, to assess the magnitude of their underdiagnosis. METHODS: A cross-sectional study was designed, using CT studies to evaluate the integrity of the abdominal wall. The images were obtained from consecutive cases of adult patients (≥18 y) from the database of the radiology and imaging service during a 4-mo period. The sociodemographic features, type of CT scan, and description of the abdominal wall were obtained and compared with the radiology report. In the case of UH presence, the transversal, cephalocaudal, and anteroposterior lengths, as well as its content, were registered. RESULTS: A total of 472 CT scans were included with a 67.6% (n = 319) prevalence of UH. These were most common in men (58.9%, n = 188/319), but women were more likely to have UH ≥ 10 mm (55%, n = 72/131). Of those with UH, 63.6% were unreported by radiology. The most common content was peritoneal fat (87.5%). UH had medians (interquartile range) of 9.1 mm (6.8, 12.5), 8.3 mm (6, 11.5), and 12.8 mm (8.6, 18.2) in its transversal, cephalocaudal, and anteroposterior lengths, respectively. Transversal length had a high positive correlation with cephalocaudal length (r = 0.877). This datum relationship can be explained by at least 76% due to this factor. Interobserver reliability analyses resulted in substantial reliability (ICC>0.85 and k > 0.85). CONCLUSIONS: CT is an effective imaging tool for diagnosing UH. There is a high prevalence among the general adult population, with a high radiologic underreporting.

[Hegemonies, subalternities, and possible counter-hegemonies: The case of traditional medicine of Indigenous peoples in Mexico]. / De hegemonías, subalternidades y posibles contrahegemonías: El caso de la medicina tradicional de los pueblos indígenas de México.

A whole series of processes lead to the decrease in the use of traditional medicine by the indigenous peoples of Mexico, including the reduction in the number of traditional healers and the direct and indirect expansion of biomedicine. This essay addresses the central role these processes play in the relations of hegemony/subalternity that occur in different fields of reality, and especially in the health-illness-care-prevention processes, given that counter-hegemonic processes are not generated, or those that do arise have been ineffective in confronting social hegemony in general and biomedical hegemony in particular.

Toda una serie de procesos conducen a la disminución del uso de la medicina tradicional por los pueblos indígenas de México, incluyendo la reducción del número de curadores tradicionales y la expansión directa e indirecta de la biomedicina. En este ensayo se aborda el papel nuclear que tienen estos procesos en las relaciones de hegemonía/subaltenidad que se dan en los diferentes campos de la realidad y, especialmente, en los procesos de salud-enfermedad-atención-prevención, dado que no se generan procesos contrahegemónicos o, los que surgen, han sido ineficaces para enfrentar la hegemonía social en general y biomédica en particular.

METAZOAN PARASITE COMMUNITY OF THE YELLOW SNAPPER LUTJANUS ARGENTIVENTRIS: FACTORS THAT INFLUENCING SPECIES COMPOSITION AND RICHNESS.

A total of 366 individuals of Lutjanus argentiventris (Peters, 1869) were collected over a 5-yr period (October 2018 to June 2022) from Acapulco Bay, Mexico. Parasite communities in Lutjanus argentiventris were quantified and analyzed to determine the main factors that generate changes in species richness and/or species composition over time. The digeneans and copepods were the best-represented parasite groups. The parasite communities were characterized by a high numerical dominance of ectoparasites, mainly isopod larvae. Species richness at the component community level (9-23 species) was similar to the reported richness in other Lutjanus spp. The parasite communities of Lutjanus argentiventris exhibited high variability in species composition, suggesting that each parasite species may respond differently to environmental changes. However, the species richness and diversity were fairly stable over time; therefore, a clear pattern of interannual variation was not observed. Variations in the community structure probably were due to factors such as host traits (e.g., feeding behavior and body size), and possible interannual differences in environmental factors amplified by the occurrence of the anomalous event of La Niña.

Sodium and potassium excretion and its association with cardiovascular disorders in Mexican adults.

Worldwide, as well as in Mexico, the leading cause of death is cardiovascular disease (CVD). Hypertension is the main risk factor for CVD; about 50% of the adult population suffers from this condition. High sodium (Na) intake combined with low potassium (K) intake can trigger cardiovascular disorders such as high blood pressure (BP). The aim of this study was to estimate the mean excretion of Na and K in Mexican adults using a spot urine sample, and its association with cardiovascular disorders. Information on 2,778 adults, 20-59 years of age, who participated in ENSANUT-2016 was analyzed. Na and K were estimated using Tanaka formulae. Biomarkers such as glucose, total cholesterol, triglycerides, HDL cholesterol and LDL cholesterol, and anthropometry were measured. Mean Na was 3,354 mg/day (95%CI: 3,278, 3,429), 1,440 mg/day of K (95%CI: 1,412, 1,469), and the Na-K ratio was 2.4. The excretion of Na was greater in adults with high BP (3,542 mg/day) compared to those with normal BP (3,296 mg/day). In adults with hypertension, excretion of K was 10% greater (1,534 mg/day) than in adults with normal BP (1,357 mg/day). In adults with moderate reduction of renal function, Na excretion was 22% less (2,772 mg/day) than in adults with normal kidney function (3,382 mg/day). The results of this study show that the cardiovascular health of Mexican adults is at risk, as they showed high Na excretion and low K excretion.

Predictors of persistent moderate and severe food insecurity in a longitudinal survey in Mexico during the COVID-19 pandemic.

Background: Household food insecurity (HFI) increased in Latin America by 9% between 2019 and 2020. Scant evidence shows who was unable to recover from the COVID-19 pandemic. Our aim was to use a Machine Learning (ML) approach to identify consistent and influential predictors of persistent moderate or severe HFI over 2 years. Methods: We use a three-wave longitudinal telephone survey with a probabilistic sample representative of the Mexican population. With a response rate of 51.3 and 60.8% for the second and third waves, the final sample size consisted of 1,074 individuals. The primary outcome was persistent HFI, i.e., respondents who reported moderate or severe HFI in 2021 and 2022. Twelve income-related predictors were measured in 2020, including baseline HFI. We employed 6 supervised ML algorithms to cross-validate findings in models, examined its precision with 4 standard performance indicators to assess precision, and used SHAP values (Shapley Additive exPlanations) to identify influential predictors in each model. Results: Prevalence of persistent moderate/severe HFI in 2021 and 2022 was 8.8%. Models with only a HFI 2020 baseline measure were used as a reference for comparisons; they had an accuracy of 0.79, a Cohen's Kappa of 0.57, a sensitivity of 0.68, and a specificity of 0.88. When HFI was substituted by the suite of socioeconomic indicators, accuracy ranged from 0.70 to 0.84, Cohen's Kappa from 0.40 to 0.67, sensitivity from 0.86 to 0.90, and specificity from 0.75 to 0.82. The best performing models included baseline HFI and socioeconomic indicators; they had an accuracy between 0.81 and 0.92, a Cohen's Kappa between 0.61 and 0.85, a sensitivity from 0.74 to 0.95, and a specificity from 0.85 to 0.92. Influential and consistent predictors across the algorithms were baseline HFI, socioeconomic status (SES), adoption of financial coping strategies, and receiving government support. Discussion: Persistent HFI can be a relevant indicator to identify households that are less responsive to food security policies. These households should be prioritized for innovative government support and monitored to assess changes. Forecasting systems of HFI can be improved with longitudinal designs including baseline measures of HFI and socioeconomic predictors.

Life history data of four populations of Triatoma mexicana (Hemiptera: Reduviidae) from Central Mexico.

Triatomine bugs are vectors for the Trypanosoma cruzi Chagas parasites, the etiological agent for Chagas disease. This study evaluated 6 epidemiologically significant behaviors (development time, number of blood meals required for molting to the next instar, mortality rate, aggressiveness, feeding duration, and defecation delay) across 4 populations of Triatoma mexicana Herrich-Schaeffer (Heteroptera: Reduviidae), a major T. cruzi vector in Central Mexico. We collected triatomines from areas characterized by high (HP), medium (MP), medium-high (MHP), and low (LP) prevalence of human T. cruzi infection. The MHP population had the shortest development time, <290 days. Both the HP and MP populations required the most blood meals to molt to the next instar, with a median of 13. Mortality rates varied across all populations, ranging from 44% to 52%. All of the tested populations showed aggressive behavior during feeding. All populations shared similar feeding durations, with most exceeding 13 min and increasing with each instar. Quick defecation, during feeding, immediately after or less than 1 min after feeding, was observed in most nymphs (78%-90%) from the MP and MHP populations and adults (74%-92%) from HP, MP, and MHP populations. Though most parameters suggest a low potential for T. mexicana to transmit T. cruzi, unique feeding and defecation behaviors in 3 populations (excluding the LP group) could elevate their epidemiological importance. These population-specific differences may contribute to the varying prevalence rates of T. cruzi infection in areas where T. mexicana is found.