HIV Prevalence and Risk Behaviors in Male to Female (MTF) Transgender Persons in Tijuana, Mexico.

Compared to HIV research on men who have sex with men, less is known about the risks and vulnerabilities for HIV among Male to Female (MTF) transgender persons, particularly in different geographic regions like Mexico. In Tijuana, Mexico, a border city experiencing a dynamic HIV epidemic, no precedent data exists on the MTF transgender population. Our aims were to estimate HIV prevalence and examine the behaviors and characteristics of the population. We conducted a cross-sectional study of 100 MTF transgender persons recruited through time location sampling in 2012. Participants underwent interviewer-administered (paper and pen) surveys and rapid tests for HIV. Descriptive univariate analyses were conducted on various factors, including sociodemographics, substance use, accessing social services (requested vs. received), stigma, and sex behaviors. A total of 22% tested positive for HIV, a prevalence higher than other key populations at risk for HIV in Tijuana.

Association between risky behaviors in adolescents and altered psychophysiological emotional responses / Los adolescentes con conductas de riesgo muestran respuesta psicofisiológica alterada

Abstract Introduction: The psychophysiology of emotional response in adolescence is a crucial factor for understanding risk and deviant behaviors. Objective: To compare specific characteristics of psychophysiological emotional response between risk behavior adolescents and controls. Materials and methods: Characterization of risk behaviors (RB), variations in the heart rate (HR), electromyography (EMG), skin conductance (SC) and temperature during the presentation of visual emotional stimuli. The emotional valence parameters, activation and dominance of such stimuli were qualified as well. Results: Significant differences were found among RB adolescents compared to the non-risk group, as well as signs of major psychophysiological response to emotionally loaded stimuli in RB when compared to the control group. The control group was characterized by initial bradycardia, which was more evident than in the risk behavior group. Conclusions: The control group presented more expressive initial bradycardia in comparison to the RB group. Both groups showed more pronounced cardiac deceleration when experiencing unpleasant stimuli, higher levels in EMG to pleasant stimuli in the RB group, and higher CP indicators for the three types of stimulus. A cohort study is required in order to compare current findings in RB versus physiological emotional response among adolescent groups.

Resumen Introducción. La psicofisiología de la respuesta emocional en la adolescencia es un factor clave en la comprensión de conductas de riesgo y desadaptación. Objetivo. Comparar especificidades de la reacción psicofisiológica emocional entre adolescentes con y sin conductas de riesgo. Materiales y métodos. Las medidas consistieron en la caracterización de conductas de riesgo (CR), variaciones en la frecuencia cardiaca (FC) electromiografía (EMG), conductancia de la piel (CP) y temperatura durante la presentación de estímulos emocionales visuales, así como la calificación en parámetros de valencia emocional, activación y dominancia de dichos estímulos. Resultados. Se encontraron diferencias significativas entre los adolescentes con CR comparados con aquellos que no las presentaban: se detectaron signos de mayor reacción psicofisiológica a los estímulos emocionales. Conclusiones. El grupo control se caracterizó por una bradicardia inicial más expresiva en comparación con el grupo con CR, ambos grupos mostraron desaceleración cardíaca más pronunciada ante estímulos desagradables, niveles más altos en EMG ante estímulos agradables en el grupo con RB e indicadores más elevados de CP ante los tres tipos de estímulo. Se requiere un estudio de cohorte a fin de comparar los hallazgos actuales en CR frente a la reacción fisiológica emocional entre los grupos de adolescentes.

[False positive result in mammography and its association with the presence of obesity: a case-control study]. / Resultado falso positivo en la mamografía y su asociación con la presencia de obesidad: un estudio de casos y controles.

OBJECTIVE: To analyze the association between a false positive result in mammography and obesity, inside the breast cancer early detection program in women affiliated to the Institute of Security and Social Services for Government and Municipality workers of the State of Baja California (ISSSTECALI). MATERIAL AND METHODS: A case-control, retrospective study was done in women affiliated to ISSSTECALI to whom a mammography was performed between 2009 and 2012. Women with a false positive result in mammography were included as cases. Controls were women with a true negative result in mammography. Three controls were randomly selected for each case. Obesity was established with the body mass index (BMI) consigned in the woman's clinical file. Age and estrogen replacement therapy were included as co-variables. RESULTS: Seventy nine cases were identified and 237 controls were included. Obesity was observed in 54.4% of cases and in 41.3% of controls (odds ratio: 1.69; 95% confidence interval for odds ratio: 1.01-2.82; p value: 0.043). A logistic regression model including covariables maintained the observed association (p = 0.044). No association was found with analyzed co-variables. CONCLUSIONS: A false positive result in mammography was associated with the presence of obesity.

Dulce Wireless Tijuana: A Randomized Control Trial Evaluating the Impact of Project Dulce and Short-Term Mobile Technology on Glycemic Control in a Family Medicine Clinic in Northern Mexico.

BACKGROUND: The global epidemic of diabetes calls for innovative interventions. This study evaluated the effectiveness of the Project Dulce model, with and without wireless technology, on glycemic control and other clinical and self-reported outcomes in patients with poorly controlled type 2 diabetes in Mexico. SUBJECTS AND METHODS: Adults with type 2 diabetes and a glycated hemoglobin A1c (HbA1c) level of ≥8% were recruited from Family Medical Unit #27 of the Instituto Mexicano del Seguro Social (IMSS) in Tijuana, México, and randomly assigned to one of three groups: Project Dulce-only (PD); Project Dulce technology-enhanced with mobile tools (PD-TE); or IMSS standard of care/control group (CG). Clinical and self-reported outcomes were assessed at baseline, Month 4, and Month 10. Time-by-group interactions and within-group changes were analyzed. RESULTS: HbA1c reductions from baseline to Month 10 were significantly greater in PD-TE (-3.0% [-33 mmol/mol]) and PD (-2.6% [-28.7 mmol/mol]) compared with CG (-1.3% [-14.2 mmol/mol]) (P = 0.009 and 0.001, respectively). PD-TE and PD also exhibited significant improvement in diabetes knowledge when compared with CG (P < 0.05 for both). No statistically significant differences were detected between PD and PD-TE on these indicators (P = 0.54 and 0.86, respectively). Several within-group improvements were observed on other clinical and self-report indicators but did not vary significantly across groups. CONCLUSIONS: Project Dulce with and without wireless technology substantially improved glycemic control and diabetes knowledge in high-risk patients with type 2 diabetes in a Mexican family medical unit, suggesting that integrating peer-led education, nurse coordination, and 3G wireless technology is an effective approach for improving diabetes outcomes in high-risk populations.

[Deficient prevention and late treatment of diabetic retinopathy in Mexico]. / Prevención deficiente y tratamiento tardío de las complicaciones retinianas de la diabetes en México.

INTRODUCTION: Retinopathy is a frequent complication of diabetes, causing visual impairment in 10% and blindness in 2% of diabetic patients. The aim of this study is to describe the clinical profile of diabetic patients in an ophthalmologic unit in Tijuana, México. METHODS: Retrospective study of a random sample of 500 clinical charts of patients with diabetes who attended the Retina Service of "Fundación CODET para la Prevención de la Ceguera IBP" Ophthalmologic Center between 2006 and 2010. RESULTS: The main complaint of 58% of patients was decreased visual acuity in first evaluation. Only 6.2% of patients were referred by a health professional. Forty-six percent of the patients had a history of diabetes of at least 15 years. Thirty percent had clinically significant visual impairment at first visit, which was associated with a long history of diabetes and previous eye surgery. Twenty-five percent of these patients who were treated at our clinic experienced visual deterioration due to advanced retinopathy. CONCLUSION: Patients with diabetic retinopathy are referred to ophthalmological service tardily, when visual loss is usually severe and irreversible.

[Severe periodontitis, edentulism and neuropathy in patients with type 2 diabetes mellitus]. / Periodontitis severa, edentulismo y neuropatía en pacientes con diabetes mellitus tipo 2.

UNLABELLED: Periodontitis is a frequent pathologic condition in diabetic patient, and has been associated with chronic complications like nephropathy, cardiovascular disease, peripheral artery disease or death. OBJECTIVE: To document the association between severe periodontitis and edentulism with the presence of sensory-motor neuropathy in diabetic patients. MATERIAL AND METHOD: Cross-sectional study in type 2 diabetic patients from the family medicine unit no. 27 of the IMSS in Tijuana, México. Patients were evaluated to identify periodontitis and sensory-motor neuropathy. Information was also obtained about sex, age, duration of diabetes, glycemic control, smoking and alcohol use. RESULTS: Four hundred and thirty-six patients completed all measurements. In 180 (41.3%) neuropathy was identified, and associated with age (p < 0.001); duration of diabetes (p < 0.001); fasting glucose (p < 0.001); severe periodontitis (OR: 2.7; IC 95%: 1.5-4.8);and with edentulism (OR: 4.4; IC 95%: 2.0-9.4). Logistic regression multivariable analysis kept as significative the association between severe periodontitis and edentulism with neuropathy (adjusted OR: 1.7; IC 95%: 1.1-2.6). CONCLUSIONS: Periodontitis and edentulism are associated with the presence of neuropathy in diabetic patients.

[Teen pregnancy in migrants: socioeconomic, gynecobstetric, and neonatal variables]. / Embarazo en adolescentes migrantes: características sociodemográficas, ginecoobstétricas y neonatales.

OBJECTIVE: Identify and correlate characteristics of adolescent mothers in a border city of Mexico with their migratory status. METHODS: We surveyed post partum adolescent mothers in the discharge rooms of two public hospitals in Tijuana, Mexico. We assessed obstetric, gynecologic, socioeconomic and neonatal variables. Mothers living fewer than 5 years in the area were designated as 'migrant.' RESULTS: 324 adolescent mothers were identified; 86% had healthy babies; 27% had previous pregnancies; age of onset of sexual activity was 15.5 +/- 1.4 years. 115 (36%) were identified as 'migrant,' among whom we found they had interrupted their studies (24% vs. 33%; OR 2.62: CI 95% 1.39-4.94), had a higher incidence of failure to use contraception (74% vs. 62%; OR 1.79: C.I. 95% 1.07-3.01) and a lower incidence of prenatal care (28% vs. 38%; OR 1.8: C.I. 95% 1.04-3.15). A larger percentage of migrant adolescents already lived with their partner (39% vs. 24%; OR 2.00: C.I. 95% 1.21-3.30) and expressed a desire to become pregnant (55% vs. 37%; OR 2.10: C.I. 95% 1.31-3.37). The observed association persisted in multivariate analysis. We did not observe differences between other ob-gyn and neonatal variables. CONCLUSIONS: Being a female migrant should be considered a risk factor in the reproductive health of adolescent mothers.