Adverse Childhood Experiences in Mexico: Prevalence and Association with Sociodemographic Variables and Health Status.

Background: Adverse Childhood Experiences (ACEs) refer to a semantic field of negative childhood events that, in conjunction with insufficient personal, family, or contextual coping resources, have the potential of becoming traumatic. Objective: To assess the prevalence of Adverse Childhood Experiences (ACEs) and their association with sociodemographic variables and physical and mental illnesses in a Mexican sample. Design: A cross-sectional design was used. The sample included 917 Mexican adults who responded to the Adverse Childhood Experiences International Questionnaire (ACE-IQ). Most of the participants were female (79.3%) with an average age of 37 years, a monthly income between 500 and 2,500 USD (59.2%), had completed university education (45.6%) and were married or in a common-law marriage (53.1%). Data was collected through Google Forms, and the link to the form was shared through electronic social networks. Results: A total of 48.3% of the participants presented seven to nine types of ACEs. Among their responses, the most prevalent categories were emotional neglect (95.1%), family violence (83.3%), and emotional abuse (78.6%). A significant association was found between the number of ACEs and the mental illness diagnosis (x2(20) = 15.16; p<001). Women were found to report more experiences of sexual abuse (z = -6.62, p<. 001), whereas men reported more experiences of community violence (z= -4.27, p < .001) and collective violence (z = -3.94, p<.001). Conclusions: The prevalence of ACEs in the Mexican population is high. However, men and women reported differences in certain types of ACEs. It was found that people with a diagnosis and family history of mental illnesses presented a higher number of ACE categories.

Aspiration of excess follicles before intrauterine insemination in high response cycles.

Purpose: To assess the outcome of excess follicle aspiration before intrauterine insemination (EFABI) in intrauterine insemination (IUI) cycles with 4-6 follicles ≥14 mm. Methods: A retrospective case-control study with 1559 patients undergoing IUI (donor and husband's sperm), of whom 86 underwent EFABI. We studied also an historical series of 2213 patients before EFABI implementation. For 3.5 years, all women undergoing IUI developing 4-6 follicles ≥14 mm were offered EFABI on the day of hCG administration. Pregnancy rates (PRs), multiple PRs, and adverse effects were measured. Results: EFABI was associated with a similar multiple PR (17.8% vs 17.5% in non-EFABI cases), with no triplets in EFABI patients. Live birth rates were significantly higher in EFABI cycles in IUI overall (25.5% vs 15.2%). When considered separately, the performance of EFABI resulted in significantly increased live birth rates in IUI-donor cycles (32.5% vs 18.5%), whereas the differences in IUI-husband cycles (19.5% vs 12.9%) did not reach statistical significance. The PR was 21.2% during the EFABI implementation period and 19.4% in the pre-EFABI period. Conclusions: EFABI in cycles in which 4-6 follicles reach ≥14 mm is a simple option that reduces cycle cancellation rates, results in higher PRs than cycles with 1-3 follicles, and lowers the risk of multiple pregnancy.

Mammography Stages Adoption and Health Beliefs in Mexican Women / Etapas de Cambio en el Uso de la Mamografía y Creencias de Salud en Mujeres Mexicanas

Abstract Objective. To identify associations between sociodemographic variables and stages of change and evaluate differences between health belief model variables and these stages. Methods. This cross-sectional descriptive study included 612 women aged 40 years and older admitted to a public hospital in the Northeast of Mexico. The participants answered the health belief model scale and selected the statement that best reflected their experience with mammography screening. The association between sociodemographic and clinical variables and the mammography stages of change was assessed using X2, and the groups of stages of change were compared using one-way ANOVA and Games-Howell post-hoc tests. Results. There was a significant association between age and the stages of action and maintenance. Breast cancer screening methods such as breast self-examination and clinical breast examination were more common among women in the stages of maintenance and relapse. There were differences between pre-contemplation and the more advanced stages in all dimensions except in the perceived seriousness p <.001. Self-efficacy and health motivation were different among women at the stage of contemplation, maintenance, and relapse. Conclusions. Perceived self-efficacy and health motivation may increase adherence to mammography screening.

Resumen El objetivo de la investigación fue identificar la asociación entre las variables sociodemográficas y las etapas de cambio para el uso de la mamografía y evaluar si existen diferencias entre las dimensiones del modelo de creencias en salud y las etapas de cambio. El diseño de este estudio es transversal descriptivo, se realizó de enero de 2017 a enero de 2018, incluyó a 612 mujeres de 40 años en adelante que asistían a un hospital de atención terciaria en el noreste de México. Las participantes firmaron el consentimiento informado y respondieron a la escala del modelo de creencias en salud y seleccionaron la declaración que mejor reflejaba su experiencia con la mamografía. La asociación entre las variables sociodemográficas y clínicas y las etapas de cambio de la mamografía se evaluó mediante X2, y los grupos de etapas de cambio se compararon mediante pruebas post hoc de ANOVA unidireccional y Games-Howell. Se encontró una asociación significativa entre la edad y las etapas de cambio de acción y mantenimiento. Los métodos de detección del cáncer de mama, como la autoexploración de mama y el examen clínico de mama, fueron más comunes entre las mujeres en las etapas de mantenimiento y recaída. Se obtuvieron diferencias significativas entre las etapas de pre-contemplación y las etapas más avanzadas en todas las dimensiones de creencias de salud, excepto en la seriedad percibida p <.001. La autoeficacia y la motivación para la salud fueron diferentes entre las mujeres en la etapa de contemplación, mantenimiento y recaída. La identificación de las etapas de cambio para la adopción de mamografías puede ayudar a desarrollar e implementar estrategias de intervención más efectivas. Además, la autoeficacia percibida y la motivación para la salud pueden aumentar la adherencia a la mamografía como método de detección del cáncer de mama.

Clinical Hypnosis For Pain Reduction In Breast Cancer Mastectomy: A Randomized Clinical Trial.

Surgical procedures for breast cancer treatment are commonly followed by pain. Clinical hypnosis has been shown to be effective in reducing pain during and after surgery, but most of the studies have used analogical scales, which only measure pain intensity. The aim of this study was to evaluate the effect of clinical hypnosis on pain intensity and its interference in daily activities in patients before and after mastectomy. The patients were evaluated using the Brief Pain Inventory. Forty patients were randomly assigned to an experimental or control group and evaluated 5 times: 1) baseline, 2) after clinical hypnosis session, 3) before surgery, 4) 1 day after surgery, and 5) 1 week after the surgery (follow-up). The results showed that after surgery the hypnosis group had a statistically significant reduction in pain intensity, less interference of pain with daily activities, sleep and life enjoyment compared with a control group. Clinical hypnosis may be recommended as a complementary treatment procedure for postmastectomy pain reduction and improving the quality of life of these patients.

Psychological Distress, Fatigue and Quality of Life in Patients with Gastrointestinal Stromal Tumors.

Background: Gastrointestinal stromal tumors (GIST) represent 1% of all gastrointestinal tumors and are included in the list of rare diseases. Objective: 1) To evaluate levels of psychological distress, fatigue, and quality of life. 2) To identify the variables that most influence distress among Mexican patients with GIST. Design: A cross-sectional study was conducted with a consecutive sample of 100 patients with GIST, who completed the following questionnaires online: Hospital Anxiety and Depression Scale (HADS) as a measure of distress, Multidimensional Fatigue Inventory (MFI), and Quality of Life Questionnaire (QLQ C30). Results: Distress was present in 31% of patients. No association was found between distress and sociodemographic/clinical variables. The patients with distress demonstrated higher scores in all fatigue dimensions and, regarding quality of life, had more symptoms and were lower functioning. Distress was positively associated with all fatigue dimensions and with QLQ C30 symptoms. Negative associations were found between distress and QLQ C30 functioning dimensions. The predictors of psychological distress were general fatigue, reduced motivation, and emotional functioning. Conclusion: The percentage of patients with distress was akin to the levels found in patients with the most common types of cancer. Fatigue in patients with GIST should be evaluated and managed to improve distress levels.

Hypnosis in Women with Breast Cancer: Its Effects on Cytokines.

The aim of the present study was to evaluate the effects of hypnosis on the cytokine levels of women with breast cancer during chemotherapy. Patients with a recent breast cancer diagnosis were assigned to either a control group (n = 20) or to a hypnosis group (n = 20). The control group received standard medical care, while the hypnosis group received 24 sessions of hypnosis over 6 months as an adjuvant therapy to standard medical care. Three blood samples were obtained, one before the initiation of chemotherapy, the second a month after beginning treatment, and the third at the end of treatment. At the end of chemotherapy treatment, the control group showed significantly higher levels of tumor necrosis factor alpha (TNF-α) and granulocyte colony stimulation factor (G-CSF) compared to the hypnosis group. Stabilized G-CSF and TNF-α levels during chemotherapy in the hypnosis group could be considered as beneficial because high levels of these cytokines have been associated with increased levels of tumor growth and metastasis in cancer patients.

Clinical Hypnosis and Music In Breast Biopsy:A Randomized Clinical Trial.

A randomized clinical study was conducted to evaluate the effects on anxiety, depression, stress and optimism levels of an audio-recorded clinical hypnosis intervention and a music session and compare them with a control group in women scheduled for breast biopsy. We analyzed the data of 170 patients with an average age of 47 years, who were randomly assigned to each of the groups. The psychosocial variables were measured in three moments: baseline, which corresponds to the period before the intervention with hypnosis, music or waiting in the room before biopsy; a second measurement after the interventions and a third measurement after the breast biopsy procedure was finished. The results showed a statistically significant reduction in the stress (p < .001, η2p = .06); pain, (p < .01, η2p = .04); anxiety, (p < .001, ƞ2p = .07) and depression, (p < .001, ƞ2p = .05) in hypnosis and music groups compared with the control group. Before biopsy, hypnosis decrease significantly pain and depression levels compared with music, but after biopsy there were no differences between both groups. It is recommended to use audio-recorded hypnosis and music interventions to reduce physical and emotional discomfort during the biopsy procedure and to improve the quality of life of patients with suspected breast cancer.

Infertile Couples Prefer Twins: Analysis of Their Reasons and Clinical Characteristics Related to This Preference.

BACKGROUND: The number of multiple pregnancies has been significantly increased in the last decades due to assisted reproduction techniques development. Compared to singleton, twins and multiple pregnancies are associated to more complications and risks for both mother and children. The objective of this study was to examine the proportion of patients preferring a multiple birth over a singleton after an IVF/ICSI attempt, their reasons and the influence of socio-demographic and clinical parameters on their preference. METHODS: A prospective study was conducted in two different Spanish centers in 2014; a public university hospital and a private clinic, with different populations and embryo transfer policies. In order to evaluate patients and partners attitudes towards twins and singletons, an anonymous 10-question survey was conducted and 399 were invited to participate. RESULTS: 58.2% of participants preferred having twins to having one child at a time and 4.8% preferred triplets. Primary reasons for preferring twins were "avoiding a new IVF/ICSI attempt" (61.6%), "I like the idea of having twins" (27.3%), "avoiding the waiting list" (5.8%), and "in my opinion with the latest technology, the rate and severity of complications in multiple pregnancies are low" (5.2%). The multivariate analysis showed that the only significant parameter related to a preference for multiplets was the transfer of women's own fresh embryos (OR=3.31). CONCLUSION: Twin pregnancy risks are not perceived as important by the majority of IVF/ICSI couples, and many of them specifically prefer twins. In our opinion, much more information is needed highlighting the multiple pregnancy risks and that information should come from medical sources besides general media.

Breast Biopsy: The Effects of Hypnosis and Music.

The authors evaluated the efficacies of audio-recorded hypnosis with background music and music without hypnosis in the reduction of emotional and physical disturbances in patients scheduled for breast biopsy in comparison with a control group. A total of 75 patients were randomly assigned to 3 different groups and evaluated at baseline and before and after breast biopsy using visual analog scales of stress, pain, depression, anxiety, fatigue, optimism, and general well-being. The results showed that, before breast biopsy, the music group presented less stress and anxiety, whereas the hypnosis with music group presented reduced stress, anxiety, and depression and increased optimism and general well-being. After the biopsy, the music group presented less anxiety and pain, whereas the hypnosis group showed less anxiety and increased optimism.

Repercusión de la rehabilitación con prótesis obturatriz en pacientes tratados en el Centro de Prótesis Bucomaxilofacial / Repercussion of rehabilitation with opturator prosthesis in patients treated on the Buccal and Maxillofacial Prosthetics Center

INTRODUCCIÓN: el tratamiento protético con obturadores en pacientes con defectos maxilares, ya sea por causa oncológica o por defectos congénitos, debe devolver las funciones importantes, como deglución, fonación, masticación, además de una estética aceptable, ya que la apariencia personal puede hallarse tan afectada, que la rehabilitación estética resulta más necesaria y urgente que la misma rehabilitación funcional. OBJETIVO: valorar la repercusión de la rehabilitación con prótesis obturatriz en pacientes adultos atendidos en el Centro de Rehabilitación de la Cara y Prótesis Bucomaxilofacial entre los años 2004 y 2009. MÉTODOS: se desarrolló la investigación en servicios de salud sobre la base de un estudio descriptivo, transversal con enfoque cuantitativo. El universo estuvo constituido por 215 pacientes; la muestra se conformó al azar con 31 pacientes encuestados durante el 2011. RESULTADOS: predominaron el sexo femenino, el grupo de 35-59 años de edad y los defectos grandes de causa oncológica. Se restableció la estética en la mayoría de los pacientes, tanto de causa oncológica como congénita. Los factores funcionales analizados se comportaron de manera adecuada. La mayor parte de los pacientes se encontraban satisfechos con relación al uso de la prótesis obturatriz y al servicio recibido, pues lograron sus expectativas. CONCLUSIÓN: la repercusión de la rehabilitación con prótesis obturatriz se valoró de medianamente positiva en los pacientes estudiados.

IINTRODUCTION: prosthetic treatment by means of obturators in patients with maxillary defects, due to oncologic reason or congenital defects, should restore the most important functions like deglutition, phonation, mastication, as well as, an acceptable aesthetics, because personal appearance can be affected in a sense that, aesthetic rehabilitation is more necessary and urgent than functional rehabilitation in itself.Objective: to evaluate the repercussion of rehabilitation with opturator prosthesis in adult patients treated on the Buccal and Maxillofacial Prosthetics Center from 2004 to 2009. METHODS: a descriptive and transversal research with a quantitative approach was carried out in health services. The universe was constituted by 215 patients; 31 patients interviewed during 2011 were randomly taken as sample. RESULTS: female sex, people in the age range 35-59 years and large defects of oncologic cause predominated. Aesthetics was reestablished in the majority of patients, as much as, oncologic cause, as congenital one. The analyzed functional factors manifested adequately. Most of the patients felt satisfied and achieved their expectations in relation to the use of the obturator prosthesis and the service received. CONCLUSION: repercussion of the rehabilitation with obturator prosthesis was evaluated of moderately positive in the studied patients.

Repercusión de la rehabilitación con prótesis obturatriz en pacientes tratados en el Centro de Prótesis Bucomaxilofacial / Repercussion of rehabilitation with opturator prosthesis in patients treated on the Buccal and Maxillofacial Prosthetics Center

Introducción: el tratamiento protético con obturadores en pacientes con defectos maxilares, ya sea por causa oncológica o por defectos congénitos, debe devolver las funciones importantes, como deglución, fonación, masticación, además de una estética aceptable, ya que la apariencia personal puede hallarse tan afectada, que la rehabilitación estética resulta más necesaria y urgente que la misma rehabilitación funcional. Objetivo: valorar la repercusión de la rehabilitación con prótesis obturatriz en pacientes adultos atendidos en el Centro de Rehabilitación de la Cara y Prótesis Bucomaxilofacial entre los años 2004 y 2009. Métodos: se desarrolló la investigación en servicios de salud sobre la base de un estudio descriptivo, transversal con enfoque cuantitativo. El universo estuvo constituido por 215 pacientes; la muestra se conformó al azar con 31 pacientes encuestados durante el 2011. Resultados: predominaron el sexo femenino, el grupo de 35-59 años de edad y los defectos grandes de causa oncológica. Se restableció la estética en la mayoría de los pacientes, tanto de causa oncológica como congénita. Los factores funcionales analizados se comportaron de manera adecuada. La mayor parte de los pacientes se encontraban satisfechos con relación al uso de la prótesis obturatriz y al servicio recibido, pues lograron sus expectativas.Conclusión: la repercusión de la rehabilitación con prótesis obturatriz se valoró de medianamente positiva en los pacientes estudiados(AU)

Disfunción temporomandibular asociada al desdentamiento / Temporomandibular dysfunction associated with tooth loss

La articulación temporomandibular es como una bisagra que permite el movimiento del maxilar inferior hacia abajo, arriba, delante, detrás, derecha e izquierda. Estos movimientos son posibilitados por los músculos y tienen como tope los dientes, de ahí la importancia de su presencia, de su posición y de la salud de los tejidos que los protegen y los sostienen. Es importante conservar la mayor cantidad de dientes. Los trastornos temporomandibulares constituyen un grupo complejo y heterogéneo de condiciones y alteraciones clínicas que afectan la musculatura masticatoria y los dientes y su aparato de sostén, por lo que representa un reto importante para los profesionales de la Estomatología no solamente que la población identifique como problemas fundamentales el dolor y la disfunción, sino que además interiorice el cuidado de este aparato y que la atención estomatológica constituye una necesidad real(AU)