Patrón alimentario de pacientes mexicanas con cáncer de mama y obesidad / Dietary patterns of Mexican patients with breast cancer and obesity

Introducción: La dieta ha sido implicada en muchos mecanismos relacionados con el desarrollo de carcinogénesis, incluyendo apoptosis, diferenciación del ciclo celular, inflamación y angiogénesis. Objetivo: Evaluar la asociación del patrón del consumo de alimentos con el cáncer de mama en pacientes con obesidad. Métodos: Estudio transversal comparativo en 98 mujeres obesas con menopausia y cáncer de mama de reciente diagnóstico y 95 mujeres obesas sin cáncer de mama, con menopausia. Se aplicó un cuestionario semi-cuantitativo de 116 ítems de frecuencia de consumo de alimentos, se evaluó edad, IMC, antecedentes ginecoobstétricos, tabaquismo y alcohol. Se realizó ajuste de modelos multivariados de regresión logística utilizando el software STATA V 11. Resultados: El hallazgo principal fue que las pacientes que tenían un consumo de vitamina B2 por debajo de la recomendación, tuvieron 6,74 veces la posibilidad de presentar cáncer de mama, con un valor de p=0,06 comparada con mujeres que tenían un consumo adecuado de vitamina B2. El modelo de regresión fue ajustado por edad, IMC, glucosa, triglicéridos séricos y dieta. Discusión: Los resultados muestran asociación marginalmente significativa entre el consumo de vitamina B2 por debajo de la recomendación con la presencia de cáncer de mama. Hallazgo similar a lo reportado por otros autores, quienes encontraron evidencia débil de una asociación inversa entre el riesgo de cáncer de mama y la ingestión de riboflavina. La metionina, vitamina B12, vitamina B6, riboflavina están involucradas en el metabolismo de grupos metilo. Conclusiones: Los resultados de este estudio sustentan la necesidad de seguir fortaleciendo los esfuerzos sobre los procesos para comprender la complejidad y los problemas que constituyen el uso de las estimaciones individuales de la ingestión de nutrimentos individuales y potencial papel de las vitaminas del complejo B como protectoras contra este tipo de cáncer (AU)

Introduction: Diet has been implicated in many mechanisms related to the development of carcinogenesis, including apoptosis, cell cycle differentiation, inflammation and angiogenesis. Objective: To evaluate the association of the pattern of food consumption with breast cancer in obese patients. Methods: Comparative cross-sectional study in 98 obese women with menopause and newly diagnosed breast cancer and 95 obese women without breast cancer, with menopause. A semi-quantitative questionnaire of 116 items of food consumption frequency was applied, age, BMI, gyneco- obstetric history history, smoking and alcohol were evaluated. Adjustment of multivariate logistic regression models using the STATA V 11 software. Results: The main finding was that patients who had a vitamin B2 intake below the recommendation had a 6.74-fold chance of developing breast cancer, with a value of p = 0.06 compared to women who had adequate intake Of vitamin B2. The regression model was adjusted for age, BMI, glucose, serum triglycerides and diet. Discussion: The results show a marginally significant association between vitamin B2 intake below the recommendation with the presence of breast cancer. Findings similar to those reported by other authors, who found weak evidence of an inverse association between breast cancer risk and riboflavin intake. Methionine, vitamin B12, vitamin B6, riboflavin are involved in the metabolism of methyl groups. Conclusions: The results of this study support the need to further strengthen efforts on processes to understand the complexity and problems of using individual estimates of individual nutrient intakes and the potential role of B vitamins as protectors against this Type of cancer (AU)

Asociación de factores de riesgo de preeclampsia en mujeres mexiquenses / Association preeclampsia risk factors in mexiquenses women

Introducción: La preeclampsia es aún uno de los mayores problemas obstétricos en países en vías de desarrollo.Objetivo: Identificar los principales factores de riesgo para desarrollar preeclampsia en mujeres mexiquenses atendidas en el Hospital Materno Perinatal "Mónica Pretelini Sáenz".Material y métodos: Estudio de casos y controles, se incluyeron dos grupos, el grupo A casos (n=138) y el grupo B controles (n=276) con relación caso-control de 1:2.Los criterios de definición para los casos fueron: mujeres con diagnóstico inicial de preeclampsia y que cuenten con las siguientes mediciones: Tensión Arterial Sistólica (TAS)=140 ó Tensión Arterial Diastólica (TAD)=90 mmHg más una de las siguientes: concentración de proteínas en orina de 24 h =300 ó Proteinuria =++. El grupo de controles quedó conformado por mujeres que acudieron al hospital para atención del embarazo sin preeclampsia. Resultados: La media de edad fue de 27.5±8.0 para los casos (grupo A) y 25.3±6.7 para los controles (grupo B) (P<0.01). El tener 1 o más óbitos (P<0.045), las cifras iniciales y finales de TAS y TAD, el índice de masa corporal pregestacional (IMCPG), el peso al final del embarazo, y la hipertensión arterial sistémica crónica (P<0.01) así como el haber padecido preeclampsia en algún embarazo previo fueron estadísticamente significativo (P<0.01) para tener preeclampsia. Conclusiones: En nuestra población, además de los factores de riesgo tradicionales para preeclampsia se agrega el antecedente de óbitos como otro factor de riesgo para padecer preeclampsia.

Introduction: Preeclampsia is still a major obstetric problem in developing countries. Objective: To identify the main risk factors to develop preeclampsia in women from the State of Mexico attended at the Maternal Perinatal Hospital "MónicaPreteliniSáenz". Materials and methods: In this case-control study, two groups were included, group A patients (n = 138) and B controls (n = 276) with a case-control ratio of 1: 2. The criteria for defining cases were women initially diagnosed with preeclampsia and who had the following measurements: Systolic Blood Pressure (SBP) =140 or diastolic blood pressure (DBP) =90 mmHg plus one of the following: =300 protein concentration in a 24-h urine sample or proteinuria = ++. The control group was made up of women attended at the hospital who did not develop preeclampsia. Results: The mean age was 27.5 ± 8.0 years for the cases (group A) and 25.3 ± 6.7 years for controls (group B) (P <0.01). Having 1 or more stillbirth (P <0.045), initial and final measures of SBP and DBP, the pre-pregnancy body mass index (IMCPG), weight in late pregnancy, and chronic hypertension (P <0.01) as well as having had preeclampsia in a previous pregnancy were statistically significant (P <0.01) to have preeclampsia. Conclusions: In our population, in addition to the traditional risk factors for preeclampsia, history of stillbirthswas is another risk factor to develop preeclampsia.

Reference values for areal bone mineral density among a healthy Mexican population.

OBJECTIVE: Compare the influence of ethnicity in the prevalence of osteopenia and osteoporosis in various Mexican populations using two normal dual X-ray absorptiometry (DXA) reference databases: manufacturer's incorporating US Hispanic population and a normal mestizo Mexican population. MATERIAL AND METHODS: MMP included 9 946 subjects participating in an ongoing long-term cohort study focusing on lifestyle and chronic diseases, of which 6 487 MMP males and females aged 7 to 80 years were the normal subjects used to determine bone density T- and Z-scores, following WHO criteria, and peak bone mass values. Abnormal bone mass density values estimated by the manufacturer's and peak bone mass reference values were compared. RESULTS AND CONCLUSIONS: Our results show that by using the manufacturer's T-score values in the mestizo Mexican population we are underestimating the number of abnormal bone mass BMD populations.

Reference values for areal bone mineral density among a healthy Mexican population / Valores de referencia para la densidad mineral ósea expresada en área para una población mexicana sana

OBJECTIVE: Compare the influence of ethnicity in the prevalence of osteopenia and osteoporosis in various Mexican populations using two normal dual X-ray absorptiometry (DXA) reference databases: manufacturer's incorporating US Hispanic population and a normal mestizo Mexican population. MATERIAL AND METHODS: MMP included 9 946 subjects participating in an ongoing long-term cohort study focusing on lifestyle and chronic diseases, of which 6 487 MMP males and females aged 7 to 80 years were the normal subjects used to determine bone density T- and Z-scores, following WHO criteria, and peak bone mass values. Abnormal bone mass density values estimated by the manufacturer's and peak bone mass reference values were compared. RESULTS AND CONCLUSIONS: Our results show that by using the manufacturer's T-score values in the mestizo Mexican population we are underestimating the number of abnormal bone mass BMD populations.

OBJETIVO: Comparar la influencia de la etnicidad en la prevalencia de osteopenia y osteoporosis en varias poblaciones mexicanas utilizando dos bases de referencia normal de densitometría de rayos X (DXA): referencia del fabricante que incorpora hispanos en Estados Unidos y datos de una población mestiza mexicana. MATERIAL Y MÉTODOS: Un total de 9 946 sujetos de población mestiza mexicana participantes en una cohorte de largo plazo dirigida al estudio de estilos de vida y ocurrencia de enfermedades crónicas; de los cuales 6 487 sujetos sanos de ambos sexos, con edad entre los 7 y los 80 años, fueron utilizados para determinar los valores T, Z, de acuerdo a los criterios de la OMS, así como a los valores de masa ósea pico. Se compararon los casos de densidad mineral ósea anormal de acuerdo a los valores de referencia del fabricante y los valores de masa ósea pico de la población mestiza. RESULTADOS Y CONCLUSIÓN: Las bases de referencia del fabricante subestima significativamente el número de casos con densidad mineral ósea anormal en la población mestiza mexicana.

[Determinants of partner violence in health workers of IMSS, Morelos]. / Determinantes de violencia de pareja en trabajadoras del IMSS morelos.

OBJECTIVE: To study the prevalence of partner violence, and to identify the associated risk factors in a sample of female workers of IMSS (Mexican Social Security Institute), Morelos State. MATERIAL AND METHODS: Cross-sectional data from 1 173 women participating in the cohort study of IMSS workers are utilized to study these associations. The study provides information on frequency of psychological, physical or sexual violence and perception of severity during the 12 months prior to the time of data collection. It was carried out in Morelos between October 1998 and March 2000. Polytomous logistic regression models were used to obtain odds ratios for different degrees of partner violence. RESULTS: A high prevalence of partner violence is observed in the sample. Main factors associated with higher severity of violence are state of the relationship and alcohol intake, emotional status of the couple at home, work burden of the woman, and a history of violence in childhood. CONCLUSIONS: All these factors are potentially modifiable through interventions aimed at stress reduction. These results should be considered when developing preventive programs against partner violence in Mexico.

Determinantes de violencia de pareja en trabajadoras del IMSS morelos / Determinants of partner violence in health workers of IMSS, Morelos

OBJETIVO: Identificar la ocurrencia de violencia de pareja y evaluar los factores asociados a este fenómeno en una muestra de trabajadoras del Instituto Mexicano del Seguro Social (IMSS) Morelos. MATERIAL Y MÉTODOS: Un total de 1 173 mujeres de la cohorte de trabajadores del IMSS proporcionó información sobre frecuencia y percepción de severidad de violencia psicológica, física o sexual durante los últimos 12 meses. El estudio se realizó en el estado de Morelos, entre octubre de 1998 y marzo de 2000. Se emplearon modelos de regresión logística politómica a fin de estimar razones de momios para distintos grados de violencia. RESULTADOS: Se observó una alta prevalencia de violencia. Los principales factores asociados fueron la relación de pareja y el consumo de alcohol; el estado emocional de la pareja en el hogar; la tensión laboral de la mujer y los antecedentes de violencia en la infancia. CONCLUSIONES: Los principales factores determinantes de violencia de pareja son potencialmente modificables a través de intervenciones que ayuden a manejar el nivel de tensión. Es necesario tomar en cuenta estos hallazgos al planear programas preventivos de violencia de pareja en México.

OBJECTIVE: To study the prevalence of partner violence, and to identify the associated risk factors in a sample of female workers of IMSS (Mexican Social Security Institute), Morelos State. MATERIAL AND METHODS: Cross-sectional data from 1 173 women participating in the cohort study of IMSS workers are utilized to study these associations. The study provides information on frequency of psychological, physical or sexual violence and perception of severity during the 12 months prior to the time of data collection. It was carried out in Morelos between October 1998 and March 2000. Polytomous logistic regression models were used to obtain odds ratios for different degrees of partner violence. RESULTS: A high prevalence of partner violence is observed in the sample. Main factors associated with higher severity of violence are state of the relationship and alcohol intake, emotional status of the couple at home, work burden of the woman, and a history of violence in childhood. CONCLUSIONS: All these factors are potentially modifiable through interventions aimed at stress reduction. These results should be considered when developing preventive programs against partner violence in Mexico.

Body mass index and the prevalence of metabolic syndrome among children and adolescents in two Mexican populations.

PURPOSE: To report the prevalence of metabolic syndrome (MS) among children and adolescents living in central Mexico, and its association with body mass index (BMI). METHODS: In a sample of 1366 subjects from 7 to 24-years-old, a self-administered questionnaire was used to determined demographic characteristics. The definition of pediatric MS was determined using analogous criteria to Adult Treatment Panel III (ATPIII) as > or = 3 of the following: concentration of triglycerides > or = 100 mg/dL, HDL cholesterol < 45 mg/dL for males and < 50 mg/dL for females, waist circumference > or = 75th percentile (sex specific), glucose concentration > or = 110 to < 126 mg/dL, and systolic or diastolic blood pressure > or = 90th percentile (age, height, and sex specific). RESULTS: Most of the sample was in the 10-14- (32.4%) and the 15-19-year (35.4%) age groups, mostly females (57%), and 31% of this young sample was overweight (mean BMI = 21.6 kg/m2). About 1 in every 5 participants had full criteria for MS (19.2%, 95% confidence interval [CI]: 16.4-22.1 among females, and 20.2%, 95% CI: 17.1-23.7 among males), and only 1 in every 10 was free of any MS component. The most common component was a low HDL level, observed in 85.4% of the sample. Unfavorable fat distribution, as indicated by a large waist circumference, was present in 27.9% of the sample. About 66% of those 10-14-year-olds with a large BMI were positive for MS. CONCLUSIONS: MS and overweight are major problems for youth in Mexico. Immediate and comprehensive actions at home and schools are needed if Mexico wants to avoid the heavy burden that this disorder will have for its population in the near future.

Depression among health workers: The role of social characteristics, work stress, and chronic diseases

Abstract: Antecedents A substantial number of Mexican adults (9-13%) experience psychological distress and a significant minority suffers from severe mental impairment. Most people suffering from depression do not seek treatment, even though they can be helped and treated. In some families, depression may occur across generations, but it may also affect those without any family history. Low self-esteem, stressful life changes and chronic stress may provoke a depressive episode. In recent years, it has been demonstrated that medical conditions, such as cardiovascular diseases, cancer, Parkinson's disease and hormonal disorders, may lead to depression, making a sick individual apathetic, incapable of taking care of his/her physical needs. In turn, such apathy increases the recovery period. Most probably, a combination of genetic, psychological, and social factors work together in the development of a depressive disorder. However, very little is known about the principal causes of depression in Mexico. It is possible that, due to cultural and social differences, these factors and their impact are distributed differently on the Mexican population as compared to those from the US population. Objectives The first objective from this study is to estímate the frequency and distribution of depression by social characteristics on a population of health workers in Mexico. The second objective is to study the effect of stress and chronic diseases on depression. Methods To study the effects of stress and chronic diseases on depression we used a cross-sectional data obtained from a total of 4048 workers. These workers participated in the "IMSS Health Worker Cohort Study in Morelos" through the years 1998 to 2000. Their age varied from 18 to 89 years. A self-reported questionnaire was administered to obtain information on life-style factors, social characteristics, work stress, and chronic diseases. Data were analyzed using politomic regressions to study the effects of social characteristics on moderate and high levels of depressive symptomatology and on risk factors, such as work stress and chronic diseases. The analysis is stratified by gender as it is expected that effects of such characteristics vary by gender. Results Our results show that the workers' socioeconomic characteristics are significantly associated with their depression level. Being female, being separated from the spouse, having lower education, and working in non-professional jobs with lower income is significantly and positively associated with depression. Similarly, having a less satisfying job and having more than one chronic disease is significantly and positively associated with depression. Workers from a lower socioeconomic status report higher levels of stress and suffer more chronic diseases compared to those from higher socioeconomic levels. Hence, some of the effects of social characteristics seem to be mediated by stress and chronic diseases. Conclusion Our results are consistent with previous research demonstrating systematic variations among groups of people who are at a higher risk for depression. In our study, we find that depression is higher among selected groups, such as women, young and old workers, those without a partner, and those with lower economic resources. We also find that stress and chronic diseases are among the reasons for which groups, which are socially and economically vulnerable, tend to become depressed. To be effective in the long run, any intervention directed to these groups of people must take into account associations highlighted in this paper.

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