ABO blood groups are not associated to gestational diabetes mellitus in Mexican women.

OBJECTIVES: Some studies show an increased risk of gestational diabetes mellitus for ABO blood groups. Others find a lower risk or do not identify any association. Inconsistencies may be due to the heterogeneity in the control for confounding variables. We determined the association between ABO blood groups and gestational diabetes mellitus in Mexican women, controlling for gravidity and age, pre-pregnancy body mass index, fasting glucose at the first trimester, and first-degree relative with diabetes. METHODS: This case-control study was conducted from February 2019 to December 2021 in Monterrey, Mexico, with 185 cases (women with gestational diabetes mellitus) and 530 controls. ABO blood groups and other variables were obtained from the clinical records. A multivariate binary logistic regression was used for estimating association. Two models were run, one for primigravidae and another for non-primigravidae. A p-value < 0.05 was significant. RESULTS: The ABO blood groups were O (69.4%), A (22.2%), B (6.7%), and AB (1.7%), with no differences between cases and controls (p = 0.884). No association was found between ABO blood groups and gestational diabetes mellitus, in primigravidae or non-primigravidae. CONCLUSION: ABO blood groups were not associated with an increased risk of gestational diabetes mellitus in Mexican women, independent of gravidity and well-known risk factors.

Association between ABO blood groups and preeclampsia.

OBJECTIVE: To determine the association between the ABO blood group and preeclampsia. METHODS: This is a case-control study that included patients with (n = 253) and without (n = 457) preeclampsia/eclampsia in Northeastern Mexico. Data were obtained from electronic medical records. Binary multiple logistic regression analysis was used for analyzing the association between the ABO blood group and preeclampsia according to parity status while adjusting for potential confounders. RESULTS: Blood groups A, B, and AB showed adjusted odds ratios of 0.6 (95%CI 0.3-1.0), 1.1 (95%CI 0.6-2.2), and 0.3 (95%CI 0.1-1.1) in multiparous women, respectively. No association was found in nulliparous women either. CONCLUSIONS: ABO blood groups were not associated with preeclampsia in Mexican women. [Figure: see text].

Comparison of the effectiveness of four SARS-COV-2 v accines in Nuevo Leon, Mexico: A test-negative control study / Comparación de la eficacia de 4 vacunas contra SARS-CoV-2 en Nuevo León, México: estudio de casos y controles

Objective: The objective of the present study was to provide statewide estimates of real-world effectiveness in reducing the odds of one primary (symptomatic COVID-19 infection) and two secondary outcomes (hospitalization and severe COVID-19 infection) by four vaccines BNT162b2 (Pfizer-BioNTech), ChAdOx1 (AstraZeneca), Ad5-nCoV (CanSinoBIO), and CoronaVac (Sinovac Life Sciences), used in Northeast Mexico. Design: We conducted a test-negative case-control study and analyzed statewide surveillance data from December 2020 to August 2021. Site: Primary attention and hospitalization. Participants: Two inclusion criteria were applied, age≥18 years and having a real-time reverse-transcriptase-polymerase-chain-reaction assay or a rapid test for antigen detection in postnasal samples (N=164,052). The vaccination was considered complete if at least 14 days had passed since the application of the single or second dose and the beginning of symptomatology. Interventions: Does not apply. Main measurements: Point and 95% confidence intervals (CI) of vaccine effectiveness were calculated per type of vaccine using the formula 1 – odds ratio, adjusted by sex and age. Results: Complete vaccination offered from none (CoronaVac – Sinovac) to 75% (95%CI 71, 77) (BNT162b2 – Pfizer) effectiveness in reducing symptomatic COVID-19 infection, regardless of sex and age. The fully ChAdOx1 (AstraZeneca) scheme reached the maximum effectiveness in hospitalization (80%, 95%CI 69, 87) and the fully BNT162b2 (Pfizer) scheme the maximum effectiveness in severity (81%, 95%CI 64, 90). Conclusions: More studies are needed to compare benefits of different vaccines and guide policy makers select the best option for their population.(AU)

Objetivo: Proporcionar estimaciones en el ámbito estatal de la efectividad en el mundo real de reducir las probabilidades de un resultado primario (infección sintomática por COVID-19) y 2 resultados secundarios (hospitalización e infección grave por COVID-19) para 4 vacunas: BNT162b2 (Pfizer-BioNTech), ChAdOx1 (AstraZeneca), Ad5-nCoV (CanSinoBIO) y CoronaVac (Sinovac Life Sciences) utilizadas en el noreste de México. Diseño: Realizamos un estudio de casos y controles y analizamos los datos de vigilancia en todo el estado desde diciembre de 2020 hasta agosto de 2021. Emplazamiento: Atención primaria y hospitalización. Participantes: Se aplicaron 2 criterios de inclusión: edad ≥ 18 años y tener prueba de RT-PCR en tiempo real o una prueba rápida para la detección de antígeno en muestras posnasales (N=164.052). La vacunación se consideró completa si habían transcurrido al menos 14 días desde la aplicación de la dosis única o desde la segunda dosis hasta el inicio de la sintomatología. Intervenciones: No aplica. Mediciones principales: Se calcularon los puntos e intervalos de confianza (IC) del 95% de la efectividad de la vacuna por tipo de vacuna utilizando la fórmula 1: razón de probabilidades, ajustada por sexo y edad. Resultados: Vacunación completa que ofrece desde ninguna efectividad (CoronaVac-Sinovac) hasta el 75% de efectividad (IC95%: 71-77 de BNT162b2-Pfizer) en la reducción de la infección sintomática por COVID-19, independientemente del sexo y la edad. El esquema completo con ChAdOx1 (AstraZeneca) alcanzó la máxima efectividad en hospitalización (80%; IC95%: 69-87) y el esquema completo con BNT162b2 (Pfizer) la máxima efectividad en gravedad (81%; IC95%: 64-90). Conclusiones: Se necesitan más estudios para comparar los beneficios de las diferentes vacunas y para guiar a los responsables en la formulación de políticas a seleccionar la mejor opción para su población.(AU)

Comparison of the effectiveness of four SARS-COV-2 v accines in Nuevo Leon, Mexico: A test-negative control study.

OBJECTIVE: The objective of the present study was to provide statewide estimates of real-world effectiveness in reducing the odds of one primary (symptomatic COVID-19 infection) and two secondary outcomes (hospitalization and severe COVID-19 infection) by four vaccines BNT162b2 (Pfizer-BioNTech), ChAdOx1 (AstraZeneca), Ad5-nCoV (CanSinoBIO), and CoronaVac (Sinovac Life Sciences), used in Northeast Mexico. DESIGN: We conducted a test-negative case-control study and analyzed statewide surveillance data from December 2020 to August 2021. SITE: Primary attention and hospitalization. PARTICIPANTS: Two inclusion criteria were applied, age≥18 years and having a real-time reverse-transcriptase-polymerase-chain-reaction assay or a rapid test for antigen detection in postnasal samples (N=164,052). The vaccination was considered complete if at least 14 days had passed since the application of the single or second dose and the beginning of symptomatology. INTERVENTIONS: Does not apply. MAIN MEASUREMENTS: Point and 95% confidence intervals (CI) of vaccine effectiveness were calculated per type of vaccine using the formula 1 - odds ratio, adjusted by sex and age. RESULTS: Complete vaccination offered from none (CoronaVac - Sinovac) to 75% (95%CI 71, 77) (BNT162b2 - Pfizer) effectiveness in reducing symptomatic COVID-19 infection, regardless of sex and age. The fully ChAdOx1 (AstraZeneca) scheme reached the maximum effectiveness in hospitalization (80%, 95%CI 69, 87) and the fully BNT162b2 (Pfizer) scheme the maximum effectiveness in severity (81%, 95%CI 64, 90). CONCLUSIONS: More studies are needed to compare benefits of different vaccines and guide policy makers select the best option for their population.

Idealistic, realistic, and unrealistic expectations of pharmacological treatment in persons with type 2 diabetes in primary care.

Introduction: Information on treatment expectations in diabetes is scarce for Mexican and Latino populations. We determined idealistic, realistic, and unrealistic expectations for metformin, insulin, and glyburide in primary care. We also explored the association between sociodemographic attributes, time since diagnosis, and expectations. Methods: This was a cross-sectional study conducted during 2020-2022 in governmental primary care centers. We consecutively included persons with type 2 diabetes aged 30-70 years under pharmacological medication (n = 907). Questions were developed using information relevant to expectation constructs. Data were collected by interview. We used descriptive statistics, a test of the difference between two proportions, and multivariate ordinal logistic regression. Results: A high percentage of participants would like to have fewer daily pills/injections or the option of temporarily stopping their medication. Realistic expectations ranged from 47% to 70%, and unrealistic expectations from 31 to 65%. More insulin users wished they could take a temporary break (p < 0.05) or would like to be able to change the route of administration (p < 0.001) than metformin users. More persons with diabetes on insulin expected realistic expectations compared to those on metformin or glyburide (p ≤ 0.01). Being able to interrupt medication upon reaching the glucose goal was higher in combined therapy users (p < 0.001). Conclusion: Time since diagnosis, place of residence, sex, and diabetes education were factors associated to expectations. Management of expectations must be reinforced in primary care persons with type 2 diabetes undergoing pharmacological medication.

Cessation of Face Mask Use after COVID-19 Vaccination in Patients with Diabetes: Prevalence and Determinants.

Studies on the cessation of face mask use after a COVID-19 vaccine in patients with diabetes are not available, despite their greater predisposition to complications. We estimated the prevalence of cessation of face mask use after receiving the COVID-19 vaccine in patients with diabetes and identified which factor was most strongly associated with non-use. This was a cross-sectional study in patients with diabetes 18-70 years with at least one dose of vaccine against COVID-19 (n = 288). Participants were asked to respond face-to-face to a questionnaire in a primary care center. Descriptive statistics, chi-square tests, and multivariate binary logistic regression were used for analyzing the association between vulnerability, benefits, barriers, self-efficacy, vaccine expectations (independent variables), and cessation of use (dependent variable), controlling for sociodemographic, smoking, medical, vaccine, and COVID-19 history. The prevalence of cessation of face masks was 25.3% (95% CI 20.2, 30.5). Not feeling vulnerable to hospitalization increased the odds of non-use (adjusted OR = 3.3, 95% CI 1.2, 8.6), while perceiving benefits did the opposite (adjusted OR = 0.4, 95% CI 0.2, 0.9). The prevalence was low, and only two factors were associated with the cessation of face mask use after COVID-19 vaccination in patients with type 2 diabetes.

Validation of the Spanish Version of the Copenhagen Burnout Inventory in Mexican Medical Residents.

BACKGROUND: Studies on the psychometric properties of the Copenhagen Burnout Inventory (CBI) in medical residents are scarce despite their susceptibility to burnout. Moreover, none of these studies were conducted in Spanish. AIM OF THE STUDY: To analyze the psychometric properties of the Spanish version of the CBI among Mexican medical residents. METHODS: This cross-sectional study was conducted online on medical residents from a public medical institution (n = 525). The English version of the CBI (19 items organized into three domains: personal-related burnout, work-related burnout, and patient-related burnout) was translated into Spanish and again into English. Content, convergent, discriminant, and concurrent validity were assessed, along with reliability. RESULTS: The CBI Spanish version showed acceptable content, convergent and concurrent validity. Exploratory factor analysis showed two factors, but confirmatory factor analysis showed three factors with adequate fit (Root Mean Square Error of Approximation = 0.08, Comparative Fit Index = 0.95, Tucker-Lewis Index = 0.94, and Standardized Root Mean Square Residual = 0.04). There was no good discrimination between personal-related and work-related burnout. Cronbach's alpha coefficients for the personal-related, work-related, and patient-related burnout domains were 0.94, 0.95, and 0.93, respectively. CONCLUSIONS: The Spanish version of the CBI in Mexican medical residents is reliable, and it meets adequate content, convergent and concurrent validity. The construct validity was not consistent. This should not diminish the importance of the CBI.

Yerbamate Tea Consumption: A Protective Factor in Parkinson Disease.

INTRODUCTION: Little is known about the association between Yerbamate (YMT) tea consumption and Parkinson disease (PD). We determined whether there was an association between YMT tea consumption and PD. METHODS: We conducted a multicenter case-control study in 3 countries (Argentina, Paraguay, and Uruguay). We applied a structured questionnaire about YMT tea consumption history. The survey also included information about factors previously associated with a decreased and increased risk of PD, apart from medical and demographic factors. Odds ratios and 95% confidence intervals were calculated using multivariate unconditional binary logistic regression analysis. RESULTS: We included 215 cases and 219 controls. The mean age of the cases was 65.6 ± 10.5 years and that of controls was 63.1 ± 10.5 years (P < 0.02). Years of YMT tea consumption, number of liters drunk per day, and amount of YMT used for preparing the infusion were similar between cases and controls (P > 0.05), but not the number of times the YMT was added into the container (P = 0.003) and the YMT tea concentration per serving (P = 0.02). The multivariate analysis showed that YMT tea concentration per serving lowered the risk for PD, independent of potential confounders (odds ratio, 0.62; 95% confidence interval, 0.47-0.84). CONCLUSIONS: This multicenter study highlights the association between an environmental factor, the YMT tea drinking, and PD. Although more evidence from longitudinal studies is needed, the results obtained here points toward a protective effect of the YMT tea concentration per serving on PD.

Extension and Severity of Self-Reported Side Effects of Seven COVID-19 Vaccines in Mexican Population.

A few studies examined the comparative side effects of Coronavirus Disease-19 (COVID-19) vaccines. We compared the extension and severity of self-reported side effects of seven COVID-19 vaccines [BNT162b2 (Pfizer-BioNTech), ChAdOx1 (AstraZeneca), mRNA-1273 (Moderna), CoronaVac (Sinovac Life Sciences), Gam-COVID-Vac (Gamaleya's Sputnik V), Ad5-nCoV (CanSinoBIO), and Ad26.CoV2.S (Johnson & Johnson/Janssen)] in the Mexican population. We also evaluated the association of type of vaccine, sex, age, comorbidity, and history of allergies to the extent and severity of side effects. This was a cross-sectional study carried out online between August 12 and September 3, 2021 in Mexico. The first inclusion criterion was to receive a COVID-19 vaccine and the second, being at least 18 years old. The survey link was distributed via multiple social media platforms. We questioned about the type of vaccine and symptoms based on short-term side effects reported in the literature. Side effect extension was classified as local, systemic, or both. We asked about the need to take medicine, stop activities/miss work, or seek medical attention. Then, a severity index was constructed based on responses. Descriptive and stepwise multivariate logistic ordinal regression analyses were used to calculate odds ratio (OR) and 95% CI for each outcome adjusted by potential confounders. The mean age was 38.9 ± 11.0 years (n = 4,024). Prevalence of at least one side effect varied between vaccines and by a number of doses. At dose 1, ChAdOx1 was the vaccine with the highest rate of at least one side effect (85%) followed by Gam-COVID-Vac (80%). Both were associated to greater extension (adjusted OR 2.53, 95% CI 2.16, 2.96 and adjusted OR 2.41, 95% CI 1.76, 3.29, respectively) and severity of side effects (adjusted OR 4.32, 95% CI 3.73, 5.00 and adjusted OR 3.00, 95% CI 2.28, 3.94, respectively). Young age (<50 years), female sex, comorbidity, and history of allergies were associated with greater extension and severity, independent of the type of vaccine and potential confounders. At dose 2, mRNA-1273 was the vaccine with the highest rate of side effects (88%) and the only vaccine associated to greater extension (adjusted OR 2.88, 95% CI 1.59, 5.21) and severity of symptoms (adjusted OR 3.14, 95% CI 1.82, 5.43). Continuous studies are necessary to acknowledge more post-vaccine symptoms in different populations.

Severe COVID-19 patients have severe vitamin D deficiency in Northeast Mexico.

Introduction: Objective: the association between vitamin D and COVID-19 severity is not consistent. We compared prevalences and analyzed the association between vitamin D deficiency and COVID-19 severity in Northeast Mexico. Methods: this was a cross-sectional study with individuals consecutively included at a referral diagnostic center during March-September 2020 (n = 181). Concurrently, every patient admitted to intensive care was also consecutively included (n = 116). Serum 25(OH)D < 20 ng/mL was considered vitamin D deficiency. Descriptive, ANOVA, and multivariate ordinal regression analyses were performed. Results: vitamin D deficiency prevalence was 63.8 % (95 % CI, 54.7, 72.0) in severe COVID-19; 25.6 % (95 % CI, 17.4, 36.0) in mild COVID-19; and 42.4 % (95 % CI, 33.2, 52.3) in non-diseased individuals. Vitamin D deficiency increased 5 times the odds of severe COVID-19 (95 % CI, 1.1, 24.3), independently of sex, age, body mass index, and inflammatory markers. Conclusions: this study is the first report of vitamin D deficiency in Northeast Mexico. Vitamin D deficiency was associated with COVID-19 severity.

Introducción: Objetivo: la asociación entre la vitamina D y la gravedad de la COVID-19 no es consistente. Se comparó la prevalencia y se analizó la asociación de la deficiencia de vitamina D con la gravedad de los pacientes con COVID-19 en el noreste de México. Métodos: este fue un estudio transversal. Se incluyó consecutivamente a individuos de un centro de diagnóstico de referencia durante marzo-septiembre de 2020 (n = 181). Paralelamente, se reclutó a todos los pacientes que ingresaron a cuidados intensivos en ese mismo periodo (n = 116). Se consideró que había deficiencia de vitamina D ante cifras de 25(OH)D sérica < 20 ng/ml. Se realizaron un análisis descriptivo, un ANOVA y una regresión ordinal multivariante. Resultados: la prevalencia de la deficiencia de vitamina D fue del 63,8 % (IC del 95 %: 54,7; 72,0) en la COVID-19 grave, del 25,6 % (IC del 95 %: 17,4; 36,0) en la COVID-19 leve y del 42,4 % (IC del 95 %: 33,2; 52,3) sin COVID-19. La deficiencia aumentó 5 veces las probabilidades de una COVID-19 grave (IC del 95 %: 1,1; 23,9) independientemente del sexo, la edad, el índice de masa corporal y los marcadores inflamatorios. Conclusiones: este estudio es el primer informe de la deficiencia de vitamina D en el noreste de México. La deficiencia de vitamina D se asoció con la gravedad de la COVID-19.

Anthropometric parameters to estimate body frame size in children and adolescents: A systematic review.

OBJECTIVE: To determine the most frequently body frame size (BFS) measurement and to compare the cut-off values used for classifying body size in children and adolescents. METHODS: This systematic review focused on primary studies and scientific reports published in Medline Ovid, EMBASE, Web of Science, or Scopus between January 1, 2007 and March 31, 2021. Eligible studies must have included at least one BFS parameter measured in healthy children or adolescents. A descriptive analysis and graphic comparison were performed when values of the body frame were available. RESULTS: A total of 26 studies involving 317 202 children and adolescents from all over the world were included. The report of Frame index predominated (46%). It was followed by the biacromial diameter single or combined with the bitrochanteric and biiliocristal diameter (27%), the wrist circumference (19%), and the grant index (12%). Fourteen studies reported percentile values of the BFS measurement, but only four presented cut-off values. CONCLUSIONS: There was no unified BFS measurement in children and adolescents neither reference cut-off values for categorization. The Frame index was the most frequently used. It is difficult to compare BFS statistics due to the diversity of measurements. It is necessary to standardize the use of the methods for measuring BFS.

[Comprehensive care in type 2 diabetes: from DiabeIMSS to CADIMSS]. / Atención integral en diabetes tipo 2: transición del modelo DiabetIMSS a CADIMSS.

In diabetes, obtaining optimal control is key to reducing chronic complications. Unfortunately, not all patients achieve the recommended goals. Therefore, the challenges to develop and evaluate comprehensive care models are enormous. In October 2008, the Diabetic Patient Care Program (DiabetIMSS) was designed and implemented in family medicine. Its principal component is the multidisciplinary team (doctor, nurse, psychologist, dietitian, dentist, and social worker) that offers coordinated health care; monthly medical consultation and individual, family and group education on self-care and prevention of complications for 12 months. Due to the COVID-19 pandemic, the percentage of attendance at the DiabetIMSS modules decreased significantly. This is how the Medical Director considered it necessary to strengthen them, and the Diabetes Care Centers (CADIMSS) arose. In addition to providing medical care with a comprehensive and multidisciplinary approach, the CADIMSS encourages the co-responsibility of the patient and his family. It consists of monthly medical consultation and nursing staff provides monthly educational sessions for 6 months. Pending tasks remain and there are still areas of opportunity to modernize and reorganize services that contribute to improving the health of the population with diabetes.

En un paciente con diabetes, la obtención de un control óptimo es clave para reducir las complicaciones crónicas. Desafortunadamente, no todos los pacientes logran las metas recomendadas. Por ello, son substanciales los desafíos para desarrollar y evaluar modelos de atención integral. En octubre del 2008, se diseñó e implementó el Programa de Atención al Paciente Diabético (DiabetIMSS) en medicina familiar. Su componente básico es el equipo multidisciplinario (médico, enfermera, psicólogo, dietista, dentista y trabajador social) que ofrece asistencia sanitaria coordinada, consulta médica mensual y educación individual, familiar y grupal sobre autocuidado y prevención de complicaciones durante 12 meses. Debido a la pandemia de COVID-19, el porcentaje de asistencia a los módulos DiabetIMSS disminuyó importantemente. Es así como la Dirección de Prestaciones Médicas consideró necesario su fortalecimiento, por lo que surgen los Centros de Atención a la Diabetes (CADIMSS). Además de proporcionar atención médico-asistencial con enfoque integral y multidisciplinario, en los CADIMSS se fomenta la corresponsabilidad del paciente y su familia, y se otorga consulta médica mensual y sesiones educativas a cargo de personal de enfermería durante 6 meses. Sin embargo, siguen tareas pendientes, y aún hay áreas de oportunidad para modernizar y reorganizar los servicios que contribuyan a mejorar la salud de la población con diabetes.

Differences in Social Determinants of Health between Urban Indigenous Migrants and Non-Indigenous People in North-Eastern Mexico: An Analysis to Prioritize.

The degree to which social determinants of health differ between indigenous migrants and non-indigenous people born and raised locally is currently unknown. We compared social determinants of health between indigenous migrants and non-indigenous people from urban north-eastern Mexico. Additionally, we ranked priorities for addressing the negative social determinants of health. This was a population-based comparative cross-sectional study (n = 235 indigenous migrants and 168 non-indigenous people). A two-stage non-random sampling was carried out from June to August of 2019. Heads of households ≥18 years and those with the ability to communicate in Spanish were recruited house by house. Structural and intermediary determinants of health were identified according to the World Health Organization Conceptual Framework and priorities were ranked using Z-scores. Being a migrant indigenous increased 1.6 times the odds of low education (95% CI = 1.1, 2.4). In addition, the migrant indigenous status increased the odds of poor housing, unhealthy behaviour and low social cohesion (p < 0.05). Housing, behaviours and health service accessibility were top priorities for indigenous migrants and structural determinants for non-indigenous people. The findings show that the right to access the social determinants of health has not yet been guaranteed for indigenous communities.

Prevalence of IgG antibodies induced by the SARS-COV-2 virus in asymptomatic adults in Nuevo Leon, Mexico.

Population-based immunoglobulin G (IgG) seroprevalence studies in asymptomatic individuals in Latin America are scarce. The objective of the study was to estimate the prevalence and geographic distribution of IgG antibodies induced by natural SARS-CoV-2 infection in asymptomatic adults, 5-8 months after the first case was reported in a northeastern state of Mexico. This was a population-based cross-sectional study carried out in Nuevo Leon during August-November 2020. Individuals ≥18 years with no previous diagnosis or symptoms suggestive of COVID-19 were consecutively screened in one of the busiest subway stations. Also, a search for eligible individuals was done from house-to-house, after selecting densely populated geographic sectors of each of the municipalities of the metropolitan area (n = 4495). The IgG antibodies to SARS-CoV-2 nucleocapsid protein were analyzed. The IgG antibody positivity rate was 27.1% (95% confidence interval [CI]: 25.8, 28.4); there were no differences by sex or age (p > 0.05). Analysis by month showed a gradual increase from 11.9% (August) to 31.9% (November); Week 39 had the highest positivity rate (42.2%, 95% CI: 34.2, 50.7). Most people did not have evidence of previous SARS-CoV-2 infection. Preventive measures and promotion of the COVID-19 vaccine should be strengthened.

Multiple Unhealthy Behaviors Share Equivalent Profiles of Readiness for Change in Patients with Type 2 Diabetes.

Few studies have considered more than one behavior, despite the tendency towards multiple behaviors, and there are none that have focused on a Latino population. We determined the concurrence of four unhealthy behaviors related to glycemic control and identified common cognitive factors at advanced stages of readiness for change in patients with type 2 diabetes treated in primary care. A cross-sectional study was carried out during August-December 2018 in northeastern Mexico. We consecutively included patients between 20 and 70 years who were without medical contraindication, physical impediment against exercise, pregnancy and edentulism, among other selection criteria (n = 407). Stages of behavior were measured according to the Transtheoretical Model. Pros, cons, self-efficacy, susceptibility, and severity data were collected by interview. Statistical analysis consisted of descriptive statistics and multiple logistic regression. A total of 36.7% exhibited more than one unhealthy behavior in precontemplation or contemplation (no interest or some interest in changing consumption of refined sugars and saturated fats, exercise, or oral hygiene behavior). Cons (p < 0.05) and self-efficacy (p < 0.001) were common to all four unhealthy behaviors, independent of potential confounders. Studies like ours facilitate the recognition of individuals with multiple unhealthy behaviors who share equivalent profiles of readiness for change before implementing public health programs.

Lifestyle, Quality of Life, and Health Promotion Needs in Mexican University Students: Important Differences by Sex and Academic Discipline.

Few studies have evaluated and contrasted the lifestyles and quality of life of university students by academic discipline. We compared university students' lifestyle and quality of life, and schools' compliance with health promotion guidelines. Then, needs were ranked and prioritized. This was a cross-sectional study carried out in a public university in Northeastern Mexico. Higher education students with no visual or hearing impairment from six different academic disciplines were included (N = 5443). A self-administered and anonymous questionnaire was applied that included the HPLP (Health-Promoting Lifestyle Profile) and SF-12 scales. A check list was employed for measuring 26 on-site schools' compliance with health promotion guidelines, and needs were ranked using Z-scores. The mean lifestyle was 53.9 ± 14.8 and the mean quality of life was 69.7 ± 5. Men had healthier lifestyles with more exercise and better stress management. The mean compliance with health promotion guidelines was 58.7%. Agricultural Sciences students had the highest need for improving both lifestyle and quality of life. Arts, Education, and Humanities, Engineering and Technology, and Social and Administrative Sciences schools ranked first in need for health promotion actions. The methodology used allowed hierarchization of areas requiring planning and implementation of specific actions, and the results indicated that healthy lifestyles and quality of life should be a priority.

Cateterización venosa umbilical guiada por ultrasonografía: un análisis de coste-efectividad / Ultrasound-guided umbilical venous catheterisation: A cost-effectiveness análisis

INTRODUCCIÓN: El uso de ultrasonografía para la inserción de catéteres centrales ha mostrado ser coste-efectivo en adultos; en neonatos se desconoce esta información. El objetivo del estudio fue comparar el coste-efectividad de la cateterización venosa umbilical guiada por ultrasonografía con la cateterización convencional en un servicio de cuidados intensivos neonatales de un hospital universitario y público. PACIENTES Y MÉTODOS: Estudio observacional retrospectivo en recién nacidos que requirieron catéter venoso umbilical antes de cumplir las primeras 24 h de vida extrauterina; se conformaron 2 cohortes históricas, una con cateterización guiada por ultrasonografía y otra con cateterización convencional. La efectividad se midió con 2 variables: colocación de posición ideal e inserción sin complicaciones. Se estimó el coste de recursos humanos y materiales (fungibles y no fungibles), la razón coste-efectividad y la razón coste-efectividad incremental; y se realizó análisis de sensibilidad. RESULTADOS: La obstrucción del catéter fue más frecuente en la cateterización guiada que en la convencional (7,7 vs. 0%, p = 0,04) y la disfunción del catéter fue superior en esta última (79 vs. 3,8%, p < 0,0001). La razón coste-efectividad de la cateterización guiada fue 153,9 euros y de la convencional 484,6 euros; la razón coste-efectividad incremental fue 45,5 euros. El análisis de sensibilidad incrementó 2,6 euros en la razón coste-efectividad de la cateterización guiada y 47 euros, en la convencional. CONCLUSIONES: El uso de la ultrasonografiacute;a para guiar la cateterización umbilical es más eficiente ya que, a pesar de suponer un mayor consumo de recursos económicos, ofreció una mayor efectividad

INTRODUCTION: Although the use of ultrasound for the insertion of central catheters has proven to be cost-effective in adults, it is not known if this is the case in the neonatal population. This study compared the cost-effectiveness of ultrasound-guided umbilical venous catheterisation with conventional catheterisation in a neonatal intensive care unit of a Public University Hospital. PATIENTS AND METHODS: A retrospective observational study was conducted on newborns that required an umbilical venous catheter before completing their first 24hours of extra-uterine life. Two retrospective cohorts were formed, including one with ultrasound-guided catheterisation and the other with conventional catheterisation. The effectiveness was measured using 2 variables: placement of ideal position and insertion without complications. The cost of human and material resources (consumable and non-consumable), the cost-effectiveness ratio, and the incremental cost-effectiveness ratio were estimated, as well as carrying out a sensitivity analysis. RESULTS: Catheter obstruction was more frequent in guided catheterisation than in conventional catheterisation (7.7% vs. 0%, p = .04) and catheter dysfunction was higher in the latter (79% vs. 3.8%, p < .0001). The cost-effectiveness ratio of the guided catheterisation was € 153.9, and €484.6 for the conventional one. The incremental cost-effectiveness ratio was € 45.5. The sensitivity analysis showed a € 2.6 increase in the cost-effectiveness ratio of the guided catheterisation and € 47 in the conventional one. CONCLUSIONS: The use of ultrasound to guide umbilical catheterisation is more efficient than conventional catheterisation since, despite using more economic resources, it offers greater effectiveness

Association study of genetic polymorphisms in proteins involved in oseltamivir transport, metabolism, and interactions with adverse reactions in Mexican patients with acute respiratory diseases.

Oseltamivir, a pro-drug, is the best option for treatment and chemoprophylaxis for influenza outbreaks. However, many patients treated with oseltamivir developed adverse reactions, including hypersensitivity, gastritis, and neurological symptoms. The aim of this study was to determine the adverse drug reactions (ADRs) in Mexican patients treated with oseltamivir and whether these ADRs are associated with SNPs of the genes involved in the metabolism, transport, and interactions of oseltamivir. This study recruited 310 Mexican patients with acute respiratory diseases and treated them with oseltamivir (75 mg/day for 5 days) because they were suspected to have influenza A/H1N1 virus infection. Clinical data were obtained from medical records and interviews. Genotyping was performed using real-time polymerase chain reaction and TaqMan probes. The association was assessed under genetic models with contingency tables and logistic regression analysis. Out of 310 patients, only 38 (12.25%) presented ADRs to oseltamivir: hypersensitivity (1.9%), gastritis (10%), and depression and anxiety (0.9%). The polymorphism ABCB1-rs1045642 was associated with adverse drug reactions under the recessive model (P = 0.017); allele C was associated with no adverse drug reactions, while allele T was associated with adverse drug reactions. The polymorphisms SLC15A1-rs2297322, ABCB1-rs2032582, and CES1-rs2307243 were not consistent with Hardy-Weinberg equilibrium, and no other associations were found for the remaining polymorphisms. In conclusion, the polymorphism rs1045642 in the transporter encoded by the ABCB1 gene is a potential predictive biomarker of ADRs in oseltamivir treatment.

Cardiovascular risk assessment in primary care employees / Evaluación del riesgo cardiovascular en trabajadores de atención primaria

BACKGROUND: Despite the importance and availability of cardiovascular risk stratification (CVR) systems, few Latin American studies use them in health care workers. OBJECTIVE: To evaluate the CVR stratification based on type, number of risk factors and current blood pressure category in primary care employees. MATERIAL AND METHODS: Cross-sectional design study (n = 308). Through an interview, CVR, labor, contractual and sociodemographic profiles were collected. Weight, height, abdominal circumference, blood pressure, glucose and cholesterol were also measured. The CVR prevalence and prevalence ratio were estimated according to labor, contractual and sociodemographic characteristics. Difference in proportions tests were applied. RESULTS: Obesity and central obesity were present in 32.4% and 58.5% of participants, respectively. Blood pressure was high normal in 11.8% and grade 1 hypertension was in 7.2%. Nineteen percent had low, moderate or high CVR; and 53.9% registered ≥ 3 risk factors. The highest PR corresponded to have ≥ 7 years of service, followed by age ≥ 38 years, permanent hiring status, male sex and married status. CONCLUSIONS: The stratification system was practical and feasible. Planning preventive and corrective actions is of great importance for lowering cardiovascular events and lost productive years.

INTRODUCCIÓN: A pesar de la importancia y la disponibilidad de los sistemas de estratificación de riesgo cardiovascular (RCV), hay pocos estudios latinoamericanos que los utilicen en trabajadores de la salud. OBJETIVO: Evaluar el RCV estratificado según el tipo, el número de factores de riesgo y la categoría de presión arterial actual en trabajadores de atención primaria. MATERIAL Y MÉTODOS: Estudio de diseño transversal (n = 308). Mediante entrevista se colectó el perfil de RCV, laboral, contractual y sociodemográfico. Se midieron peso, talla, circunferencia abdominal, presión arterial, glucosa y colesterol. Se estimaron la prevalencia y la razón de prevalencia de RCV según las características laborales, contractuales y sociodemográficas. Se aplicaron pruebas de diferencia de proporciones. RESULTADOS: El 32.4% presentaba obesidad y el 58.5% obesidad central. El 11.8% estaba en categoría de presión arterial normal-alta y el 7.2% en hipertensión de grado 1. El 19% presentó RCV bajo, moderado o alto, y el 53.9% registró tres o más factores de riesgo. La razón de prevalencia más alta fue en antigüedad laboral ≥ 7 años; le siguieron la edad ≥ 38 años, la contratación definitiva, el sexo masculino y el estado civil con pareja. CONCLUSIONES: El sistema de estratificación fue práctico y factible. Es de gran trascendencia para planear acciones preventivas y correctivas para reducir la incidencia de eventos cardiovasculares y la pérdida de años de vida potencialmente productivos.

[Ultrasound-guided umbilical venous catheterisation: A cost-effectiveness analysis]. / Cateterización venosa umbilical guiada por ultrasonografía: un análisis de coste-efectividad.

INTRODUCTION: Although the use of ultrasound for the insertion of central catheters has proven to be cost-effective in adults, it is not known if this is the case in the neonatal population. This study compared the cost-effectiveness of ultrasound-guided umbilical venous catheterisation with conventional catheterisation in a neonatal intensive care unit of a Public University Hospital. PATIENTS AND METHODS: A retrospective observational study was conducted on newborns that required an umbilical venous catheter before completing their first 24hours of extra-uterine life. Two retrospective cohorts were formed, including one with ultrasound-guided catheterisation and the other with conventional catheterisation. The effectiveness was measured using 2 variables: placement of ideal position and insertion without complications. The cost of human and material resources (consumable and non-consumable), the cost-effectiveness ratio, and the incremental cost-effectiveness ratio were estimated, as well as carrying out a sensitivity analysis. RESULTS: Catheter obstruction was more frequent in guided catheterisation than in conventional catheterisation (7.7% vs. 0%, p=.04) and catheter dysfunction was higher in the latter (79% vs. 3.8%, p<.0001). The cost-effectiveness ratio of the guided catheterisation was €153.9, and €484.6 for the conventional one. The incremental cost-effectiveness ratio was €45.5. The sensitivity analysis showed a €2.6 increase in the cost-effectiveness ratio of the guided catheterisation and €47 in the conventional one. CONCLUSIONS: The use of ultrasound to guide umbilical catheterisation is more efficient than conventional catheterisation since, despite using more economic resources, it offers greater effectiveness.