Pesticide use patterns and their association with cytokine levels in Mexican flower workers.

OBJECTIVE: Occupational exposure to pesticides is a known risk for disrupting cellular immune response in flower workers due to their use of multiple chemical products, poor work conditions, and inadequate protection. Recently, the analysis of pesticide use patterns has emerged as an alternative to studying exposure to mixtures of these products. This study aimed to evaluate the association between exposure to different patterns of pesticide use and the cytokine profile of flower workers in the State of Mexico and Morelos, Mexico. METHODS: A cross-sectional study was carried out on a population of 108 flower workers. Serum levels of IL-4, IL-5, IL-6, IL-8, IL-10 cytokines were analyzed by means of multiplex analysis, and TNF-α and IFN-γ using an ELISA test. Pesticide use patterns were generated by principal components analysis. RESULTS: The analysis revealed that certain patterns of pesticide use, combining insecticides and fungicides, were associated with higher levels of pro-inflammatory cytokines, particularly IL-6 and IFN-γ. CONCLUSION: These findings indicate that pesticides may possess immunotoxic properties, contributing to increased inflammatory response. However, further comprehensive epidemiological studies are needed to establish a causal relationship.

Disparities on prostate cancer survival in Mexico: a retrospective cohort study.

OBJECTIVE: To estimate prostate cancer (PC) survival in Mexico and explore survival disparities according to the marginalization level of residence place. MATERIALS AND METHODS: A nationwide administrative claims database (4 110 men) whose PC treatment was financed by Seguro Popular between 2012-2016, was cross-linked to the National Mortality Registry up to December 2019. Patients were classified according to their oncological risk at diagnosis and the marginalization level of the residence municipality. Cox proportional hazards regression was used to estimate multivariable survival functions. RESULTS: Five-years PC survival (69%; 95%CI: 68,71%) ranged from 72% to 54% at very low and very high marginalization, respectively (p for trend<0.001). The lowest PC survival was observed in men with high-risk PC (47%; 95%CI: 33,66%) residents in very high marginalization municipalities. CONCLUSIONS: Overall, PC survival was lower than that reported in other Latin American countries. The distribution of oncologic risk and survival differences across marginalization levels suggests limited early detection and cancer health disparities.

Tamizaje, prevalencia, diagnóstico previo, tratamiento y control de hipertensión, hipercolesterolemia y diabetes en adultos mexicanos. Ensanut 2022.

OBJETIVO: Describir las estimaciones de tamizaje, prevalencia, diagnóstico previo, tratamiento y control de hipertensión, hipercolesterolemia y diabetes, así como sus factores asociados en los adultos mexicanos. Material y métodos. Se utilizó información de los adultos de 20 años o más participantes de la Encuesta Nacional de Salud y Nutrición 2022 (Ensanut 2022). Se presentan estimaciones de prevalencias con sus intervalos de confianza al 95%, y modelos de regresión logística múltiple para cada padecimiento, con factores asociados al tamizaje, diagnóstico previo, tratamiento y control. RESULTADOS: El tamizaje de estas tres enfermedades es bajo, menor a 15%. La prevalencia de hipercolesterolemia y de diabetes es de 18% y la de hipertensión es 27.8%; cerca de la mitad conoce su diagnóstico. La proporción de pacientes con tratamiento farmacológico ha incrementado, pero menos de la mitad está en control. Conclusión. Es recomendable que la detección de estas enfermedades se haga de manera integrada con otros factores de riesgo cardiovascular. Se necesita aumentar los porcentajes de tamizaje, incrementar la proporción de enfermos con diagnóstico previo, mejorar el porcentaje de tratamiento médico de estas enfermedades y, sobre todo, aumentar la proporción de enfermos con tratamiento en control metabólico.

The Trend in the Prevalence of Diabetes Mellitus in the Mexican Indigenous Population From 2000 to 2018.

Introduction: Diabetes is a worldwide public health problem. In Mexico, diabetes was the third leading cause of death in the total population in 2020. The indigenous people in Mexico are approximately 6%. This study aims to estimate the trends in diabetes prevalence from 2000 to 2018 in the group of Mexican indigenous language speakers and to analyze the main sociodemographic (e.g., age, educational and socioeconomic level, and the urbanicity of the area of residence) and clinical (e.g., age of diabetes onset, years with diabetes, and BMI) characteristics of this group. Methods: This cross-sectional study included participants aged ≥20 years from 4 National Health Surveys, 2000-2018. We presented the analyses for indigenous and nonindigenous strata. Logistic models adjusted were used to estimate the trend of diabetes in the study period. Results: We found a significant increase in the prevalence of diabetes in the indigenous group. This trend in the ORs was maintained when adjusting for age, sex, waist circumference, and area of residence. For the study period, the prevalence change in diagnosed diabetes in the indigenous group was greater than that in the nonindigenous group (OR=6.4, 95% CI=4.1, 8.8 and OR=3.3, 95% CI=2.5, 4.1, respectively). We also found a significant prevalence change in undiagnosed diabetes for the indigenous group (OR=7.7, 95% CI=1.3, 14.6). Conclusions: In contrast to the results in nonindigenous populations, our main result reveals an increasing probability of being diabetic in the indigenous population from 2006 to 2018. It is necessary to clarify the origin of the accelerated change in diabetes prevalence among the indigenous population in Mexico.

Docosahexaenoic Acid Effect on Prenatal Exposure to Arsenic and Atopic Dermatitis in Mexican Preschoolers.

Childhood atopic dermatitis (AD) is a chronic and recurrent health problem that involves multiple factors, particularly immunological and environmental. We evaluated the impact of docosahexaenoic acid (DHA) supplementation on prenatal arsenic exposure on the risk of atopic dermatitis in preschool children as part of the POSGRAD (Prenatal Omega-3 fatty acid Supplements, GRowth, And Development) clinical trial study in the city of Morelos, Mexico. Our study population included 300 healthy mother-child pairs. Of these, 146 were in the placebo group and 154 in the supplement group. Information on family history, health, and other variables was obtained through standardized questionnaires used during follow-up. Prenatal exposure to arsenic concentrations, which appear in maternal urine, was measured by inductively coupled plasma optical emission spectrometry. To assess the effect of prenatal arsenic exposure on AD risk, we ran a generalized estimating equation model for longitudinal data, adjusting for potential confounders, and testing for interaction by omega-3 fatty acid supplementation during pregnancy. The mean and SD (standard deviation) of arsenic concentration during pregnancy was 0.06 mg/L, SD (0.04 mg/L). We found a marginally significant association between prenatal arsenic exposure and AD (OR = 1.12, 95% CI: 0.99, 1.26); however, DHA supplementation during pregnancy modified the effect of arsenic on AD risk (p < 0.05). The results of this study strengthen the evidence that arsenic exposure during pregnancy increases the risk of atopic dermatitis early in life. However, supplementation with omega-e fatty acids during pregnancy could modify this association.

Seasonal and Spatial Variability of PM2.5 Concentration, and Associated Metal(loid) Content in the Toluca Valley, Mexico.

This study provides evidence of the seasonal and spatial variation of metal(lloid)s in particulate matter minor to 2.5 microns (PM2.5) in the Toluca Valley Metropolitan Area (TVMA), the fifth largest urban center in Mexico. Four sites were sampled between 2013 and 2014, which included urban and industrial areas, in the dry-cold (November-February) and dry-hot (March-May) seasons; PM2.5 was collected using high- and medium-volume samplers. Metal(lloid) concentrations in PM2.5 were analyzed using inductively coupled plasma‒mass spectrometry (ICP‒MS). The highest 24-hour PM2.5 concentration in the northern area was observed, and the PM2.5 concentrations were independent of the season. Five metal(lloid)s with a recovery percentage above 80% were considered to be reported (Co, Cr, Cu, Mn, and Sb). The maximum concentrations of metal(lloid)s were observed during the dry-cold season, and concentrations were up to one hundred or thousand fold with respect to the dry-hot season. The 24-hour PM2.5 and metal(lloid) concentrations exceeded national and international guidelines to protect population health.

Trends and age-period-cohort effects on hypertension mortality rates from 1998 to 2018 in Mexico.

Arterial hypertension is a major global health problem. It is the main risk factor for preventable death and the leading cause of premature death in the world. This study aims to describe the changes in hypertension-related mortality in Mexico between 1998 and 2018. Using death certificates and national population public data sets, a total of 335,863 deaths due to hypertension were found in Mexico, disaggregated by sex and age, during the time period covered in this study. An age-period-cohort analysis was conducted to show trends in hypertension mortality rates. Mortality due to hypertension in Mexico affects more women than men. In the most recent cohorts, the risk of dying from hypertension is two times higher in men compared to women. Hypertensive kidney disease is found to be the main underlying cause, with an average increase throughout the period studied. Our results indicate that mortality rates due to hypertension continue to grow and point to an alarming trend of mortality shifting towards younger ages, with sex-based disparities in absolute numbers and in changing trends.

Urinary androgens excretion patterns and prostate cancer in Mexican men.

Epidemiological studies related to androgens and prostate cancer (PC) have focused on serum determination of testosterone, androstenedione (A4), and DHEA, with inconsistent results. Herein, we hypothesized that differences in androgen biosynthetic and metabolic pathways, rather than differences in specific androgen concentrations, are associated with prostatic carcinogenesis. Therefore, spot urine samples from 111 incident PC cases with Gleason score at diagnosis and 227 healthy population controls, were analyzed. Urinary androgen concentrations (nanograms/milligrams of creatinine) were determined by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS). Using a factor analysis, we identified three androgen urinary excretion patterns. In a subsample, we evaluated a modification effect of the androgen receptor (AR) CAG polymorphism. Pattern I, characterized by A4 and testosterone hydroxylated metabolites (11ß-OHT; 2ß-OHT; 15ß-OHT; 2α-OHT; 6ß-OHT), was associated with high PC odds among carriers of AR gene (CAG)>19 repeats (OR: 3.67 95% CI: 1.23-11.0; P for interaction= 0.009). Conversely, higher testosterone excretion (pattern III), was marginally associated with lower (OR: 0.35 95% CI: 0.12-1.00, P for trend= 0.08) poorly differentiated PC (Gleason ≥8). No clear association was observed with pattern II (DHEA; 16α and 16ß-OHT). Our results were consistent with the previous evidence which suggests that the C11-oxy backdoor pathway is important for prostatic carcinogenesis. Androgen urine excretion analysis could be useful for PC diagnosis, treatment, and prognosis; however, further studies with a larger number of samples and the urinary determination of 11-ketoandrogens are necessary.

[Trends in the prevalence of ARIs and ADDs in early childhood and associated factors: Ensanut 2012 and 100k.] / Tendencias en la prevalencia de IRA y EDA en la primera infancia y factores asociados: Ensanut 2012 y 100k.

OBJECTIVE: To compare the prevalence of acute respiratory infections (ARI) and acute diarrheal disease (ADD) among children younger than five years of age living in localities with less than 100 000 inhabitants in Encuesta Nacional de Salud y Nutrición (Ensanut) 2012 and Ensanut 100k (2018). In Ensanut 100k, we evaluate the associated factors. MATERIALS AND METHODS: Analysis of both surveys and of the Mexican Meteorological System. RESULTS: The estimated prevalence of ARI was 45.1% in 2012 vs. 32.9% in 2018. The decrease was significant among medium and high-income households. There were no changes in trends for ADD. Among households with lower EC, ARI was associated with roofing material, temperature, and rainy precipitation while ADD was associated with lack of piped water. CONCLUSIONS: The estimated prevalence of ARI has decreased in medium and high income households. Some households and weather conditions are associated with ARI and ADD.

OBJETIVO: Estimar y comparar las prevalencias de infec- ciones respiratorias agudas (IRA) y enfermedades diarreicas agudas (EDA) en menores de cinco años, residentes en localidades con menos de 100 000 habitantes, mediante análisis de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2012 y la Ensanut 100k (2018). En la Ensanut 100k se evaluaron los factores asociados con IRA y EDA. MATERIAL Y MÉTODOS: Análisis de ambas encuestas e información meteorológica de la Comisión Nacional del Agua. RESULTADOS: La prevalencia global estimada de IRA fue de 45.1% en 2012 vs. 32.9% en 2018. La disminución fue significativa en hogares de medianas y mayores capacidades económicas (CE). No se observaron cambios significativos para las EDA. En hogares con menores CE, las IRA se asociaron con material del techo y temperatura y las EDA con privación de agua entubada. CONCLUSIONES: Entre 2012 y 2018, la prevalencia de IRA disminuyó en hogares de medianas y mayores CE. Algunas condiciones de vivienda y meteorológicas se asocian con IRA y EDA.

Tendencias en la prevalencia de IRA y EDA en la primera infancia y factores asociados: Ensanut 2012 y 100k / Trends in the prevalence of ARIs and ADDs in early childhood and associated factors: Ensanut 2012 and 100k

Resumen: Objetivo: Estimar y comparar las prevalencias de infecciones respiratorias agudas (IRA) y enfermedades diarreicas agudas (EDA) en menores de cinco años, residentes en localidades con menos de 100 000 habitantes, mediante análisis de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2012 y la Ensanut 100k (2018). En la Ensanut 100k se evaluaron los factores asociados con IRA y EDA. Material y métodos: Análisis de ambas encuestas e información meteorológica de la Comisión Nacional del Agua. Resultados: La prevalencia global estimada de IRA fue de 45.1% en 2012 vs. 32.9% en 2018. La disminución fue significativa en hogares de medianas y mayores capacidades económicas (CE). No se observaron cambios significativos para las EDA. En hogares con menores CE, las IRA se asociaron con material del techo y temperatura y las EDA con privación de agua entubada. Conclusiones: Entre 2012 y 2018, la prevalencia de IRA disminuyó en hogares de medianas y mayores CE. Algunas condiciones de vivienda y meteorológicas se asocian con IRA y EDA.

Abstract: Objective: To compare the prevalence of acute respiratory infections (ARI) and acute diarrheal disease (ADD) among children younger than five years of age living in localities with less than 100 000 inhabitants in Encuesta Nacional de Salud y Nutrición (Ensanut) 2012 and Ensanut 100k (2018). In Ensanut 100k, we evaluate the associated factors. Materials and methods: Analysis of both surveys and of the Mexican Meteorological System. Results: The estimated prevalence of ARI was 45.1% in 2012 vs. 32.9% in 2018. The decrease was significant among medium and high-income households. There were no changes in trends for ADD. Among households with lower EC, ARI was associated with roofing material, temperature, and rainy precipitation while ADD was associated with lack of piped water. Conclusions: The estimated prevalence of ARI has decreased in medium and high income households. Some households and weather conditions are associated with ARI and ADD.

[Lung cancer mortality in Mexico, 1990-2016: age-period-cohort effect]. / Mortalidad por cáncer de pulmón en México de 1990 a 2016: efecto edad-periodo-cohorte.

OBJECTIVE: To update information on the mortality trend due to lung cancer in Mexico from 1990 to 2016. MATERIALS AND METHODS: Age-adjusted rates were obtained using the direct method. The percentage of annual change in the mortality of lung cancer was obtained through joinpoint analysis at the national level, by region, sex and rural-urban stratum, and in the last two the age-cohort-period effect. RESULTS: There was an annual decrease in mortality rates due to this neoplasm in the last 10 years, significantly higher in men (-3.5% CI95% -4.0,-2.9) than in women (-1.9% CI95% -2.1,-1.7), and a generational gap between men and women and urban-rural stratum with a decreasing trend in the risk of death. CONCLUSIONS: Mortality trends due to lung cancer from 1993 to 2016 show a decrease in different magnitudes and specific periods.

OBJETIVO: Actualizar información sobre la tendencia de mortalidad por cáncer de pulmón en México de 1990 a 2016. MATERIAL Y MÉTODOS: Se obtuvieron tasas ajustadas por edad mediante el método directo. Se obtuvo el porcentaje de cambio anual de la mortalidad por cáncer de pulmón, mediante análisis joinpoint a nivel nacional, por región, sexo y estrato rural-urbano y, en estos dos últimos, el efecto de edad-periodo-cohorte. RESULTADOS: Se observó un decremento anual en las tasas de mortalidad por esta neoplasia en los últimos 10 años, significativamente mayor en los hombres (-3.5% IC95% -4.0,-2.9) que en las mujeres (-1.9% IC95% -2.1,-1.7), una brecha generacional entre hombres y mujeres y estrato urbano-rural con tendencia decreciente en el riesgo de muerte. CONCLUSIONES: Las tendencias de mortalidad por cáncer de pulmón de 1993 a 2016 presentan una disminución en diferentes magnitudes y periodos específicos.

Mortalidad por cáncer de pulmón en México de 1990 a 2016: efecto edad-periodo-cohorte / Lung cancer mortality in Mexico, 1990-2016: age-period-cohort effect

Resumen: Objetivo: Actualizar información sobre la tendencia de mortalidad por cáncer de pulmón en México de 1990 a 2016. Material y métodos: Se obtuvieron tasas ajustadas por edad mediante el método directo. Se obtuvo el porcentaje de cambio anual de la mortalidad por cáncer de pulmón, mediante análisis joinpoint a nivel nacional, por región, sexo y estrato rural-urbano y, en estos dos últimos, el efecto de edad-periodo-cohorte. Resultados: Se observó un decremento anual en las tasas de mortalidad por esta neoplasia en los últimos 10 años, significativamente mayor en los hombres (-3.5% IC95% -4.0,-2.9) que en las mujeres (-1.9% IC95% -2.1,-1.7), una brecha generacional entre hombres y mujeres y estrato urbano-rural con tendencia decreciente en el riesgo de muerte. Conclusión: Las tendencias de mortalidad por cáncer de pulmón de 1993 a 2016 presentan una disminución en diferentes magnitudes y periodos específicos.

Abstract: Objective: To update information on the mortality trend due to lung cancer in Mexico from 1990 to 2016. Materials and methods: Age-adjusted rates were obtained using the direct method. The percentage of annual change in the mortality of lung cancer was obtained through joinpoint analysis at the national level, by region, sex and rural-urban stratum, and in the last two the age-cohort-period effect. Results: There was an annual decrease in mortality rates due to this neoplasm in the last 10 years, significantly higher in men (-3.5% CI95% -4.0,-2.9) than in women (-1.9% CI95% -2.1,-1.7), and a generational gap between men and women and urban-rural stratum with a decreasing trend in the risk of death. Conclusion: Mortality trends due to lung cancer from 1993 to 2016 show a decrease in different magnitudes and specific periods.

[Development and validation of a screening score for prediabetes and undiagnosed diabetes.] / Diseño y validación de un score para detectar adultos con prediabetes y diabetes no diagnosticada.

OBJECTIVE: To develop and validate an easy-to-use risk score to detect prediabetes and undiagnosed diabetes in Mexican population. MATERIALS AND METHODS: Using information from the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán's cohort study of 10 234 adults, risk factors were identified and included in multiple logistic regression models stratified by sex. The beta coefficients of the final model were multiplied by 10, thus obtaining the weights of each variable in the score. RESULTS: The proposed score correctly classifies 55.4% of women with undiagnosed diabetes and 57.2% of women with prediabetes or diabetes. While for men it correctly classifies them at 68.6% and 69.9%, respectively. CONCLUSIONS: We present the design and validation of a risk score stratified by sex, to determine if an adult could have prediabetes or diabetes, in which case laboratory studies should be performed to confirm or not the diagnosis.

OBJETIVO: Diseñar y validar un score de riesgo de fácil aplicación para detectar prediabetes y diabetes no diagnosticada en población mexicana. MATERIAL Y MÉTODOS: Empleando la información del estudio de cohorte de 10 234 adultos del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), se identificaron factores de riesgo incluidos en modelos de regresión logística múltiple estratificados por sexo. Los coeficientes beta fueron multiplicados por 10 para obtener el peso de cada variable en el score. Una submuestra de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2012 se usó para validar el score. RESULTADOS: El score propuesto clasificó correctamente 55.4% a las mujeres con diabetes no diagnosticada y 57.2% a las mujeres con prediabetes o diabetes. Por su parte, clasificó correctamente a los hombres en 68.6 y 69.9%, respectivamente. CONCLUSIONES: Presentamos el diseño y validación de un score de riesgo estratificado por sexo para determinar si un adulto podría tener prediabetes o diabetes, en cuyo caso deberán realizarse estudios de laboratorio para confirmar o descartar el diagnóstico.

Diseño y validación de un score para detectar adultos con prediabetes y diabetes no diagnosticada / Development and validation of a screening score for prediabetes and undiagnosed diabetes

Resumen: Objetivo: Diseñar y validar un score de riesgo de fácil aplicación para detectar prediabetes y diabetes no diagnosticada en población mexicana. Material y métodos: Empleando la información del estudio de cohorte de 10 234 adultos del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), se identificaron factores de riesgo incluidos en modelos de regresión logística múltiple estratificados por sexo. Los coeficientes beta fueron multiplicados por 10 para obtener el peso de cada variable en el score. Una submuestra de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2012 se usó para validar el score. Resultados: El score propuesto clasificó correctamente 55.4% a las mujeres con diabetes no diagnosticada y 57.2% a las mujeres con prediabetes o diabetes. Por su parte, clasificó correctamente a los hombres en 68.6 y 69.9%, respectivamente. Conclusiones: Presentamos el diseño y validación de un score de riesgo estratificado por sexo para determinar si un adulto podría tener prediabetes o diabetes, en cuyo caso deberán realizarse estudios de laboratorio para confirmar o descartar el diagnóstico.

Abstract: Objective: To develop and validate an easy-to-use risk score to detect prediabetes and undiagnosed diabetes in Mexican population. Materials and methods: Using information from the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán's cohort study of 10 234 adults, risk factors were identified and included in multiple logistic regression models stratified by sex. The beta coefficients of the final model were multiplied by 10, thus obtaining the weights of each variable in the score. Results: The proposed score correctly classifies 55.4% of women with undiagnosed diabetes and 57.2% of women with prediabetes or diabetes. While for men it correctly classifies them at 68.6% and 69.9%, respectively. Conclusions: We present the design and validation of a risk score stratified by sex, to determine if an adult could have prediabetes or diabetes, in which case laboratory studies should be performed to confirm or not the diagnosis.

Prenatal Exposure to Nitrogen Oxides and its Association with Birth Weight in a Cohort of Mexican Newborns from Morelos, Mexico.

BACKGROUND: The Child-Mother binomial is potentially susceptible to the toxic effects of pollutants because some chemicals interfere with placental transfer of nutrients, thus affecting fetal development, and create an increased the risk of low birth weight, prematurity and intrauterine growth restriction. OBJECTIVE: To evaluate the impact of prenatal exposure to nitrogen oxides (NOx) on birth weight in a cohort of Mexican newborns. METHODOLOGY: We included 745 mother-child pair participants of the POSGRAD cohort study. Information on socio-demographic characteristics, obstetric history, health history and environmental exposure during pregnancy were readily available and the newborns' anthropometric measurements were obtained at delivery. Prenatal NOx exposure assessment was evaluated using a Land-Use Regression predictive models considering local monitoring from 60 sites on the State of Morelos. The association between prenatal exposure to NOx and birth weight was estimated using a multivariate linear regression models. RESULTS: The average birth weight was 3217 ± 439 g and the mean of NOx concentration was 21 ppb (Interquartile range, IQR = 6.95 ppb). After adjusting for maternal age and other confounders, a significant birthweight reduction was observed for each IQR of NOx increase (ß = -39.61 g, 95% CI: -77.00; -2.21; p = 0.04). CONCLUSIONS: Our results provides evidence that prenatal NOx exposure has a negative effect on birth weight, which may influence the growth and future development of the newborn.

Prenatal Exposure to Endocrine Disruptors and Cardiometabolic Risk in Preschoolers: A Systematic Review Based on Cohort Studies.

BACKGROUND: Follow-up studies have reported both positive and negative associations between prenatal exposure to endocrine disrupting chemicals (EDCs) and some anthropometric indicators of overweight and obesity in children. However, few studies have evaluated the effect of this exposure on cardiometabolic risk factors in preschool-age children. The health and disease development paradigm (DOHaD) proposes that the physiological and metabolic adaptations triggered by the exposure to these compounds, coupled with postnatal conditions, can modify the risk of disease. In this context, cardiometabolic risk factors in children are not only an important outcome derived from prenatal exposure but a predictor/mediator of the children's future health. OBJECTIVE: To conduct a systematic review of the evidence published in the last 10 years from cohort studies on the association between prenatal exposure to EDCs and cardiometabolic risk factors in preschoolers. DESIGN: Studies published from January 1, 2007 to May 1, 2017 in PubMed were analyzed. The research strategy was based on specified keywords and following the application of strict inclusion/exclusion criteria, 16 studies were identified and reviewed. Data were extracted and aspects of quality were assessed using an adapted Newcastle-Ottawa scale for cohort studies. RESULTS: Only 5 of the 16 studies reviewed analyzed cardiometabolic risk factors in addition to anthropometric measures in children. The cohort studies included in this review suggest that prenatal exposure to low concentrations of EDCs has an impact on anthropometric variables and biochemical parameters in preschool-age children. Positive associations between prenatal exposure to EDCs and percentage of fat mass, body mass index, waist circumference, skinfolds and risk of overweight persisted after adjustment for important confounding variables. No association was found with lipid profile and glucose levels. CONCLUSIONS: Evidence was found to suggest that prenatal exposure to EDCs is positively associated with cardiometabolic risk factors in preschool children.

Influence of genetic variants of CYP2D6, CYP2C9, CYP2C19 and CYP3A4 on antiepileptic drug metabolism in pediatric patients with refractory epilepsy.

BACKGROUND: Identified the polymorphisms of CYP2D6, CYP2C9, CYP2C19 and CYP3A4, within a rigorously selected population of pediatric patients with drug-resistant epilepsy. METHOD: The genomic DNA of 23 drug-resistant epilepsy patients and 7 patients with good responses were analyzed. Ten exons in these four genes were genotyped, and the drug concentrations in saliva and plasma were determined. RESULTS: The relevant SNPs with pharmacogenomics relations were CYP2D6*2 (rs16947) decreased your activity and CYP2D6*4 (rs1065852), CYP2C19*2 (rs4244285) and CYP3A4*1B (rs2740574) by association with poor metabolizer. The strongest risk factors were found in the AA genotype and allele of SNP rs3892097 from the CYP2D6 gene, followed by the alleles A and T of SNPs rs2740574 and rs2687116, respectively from CYP3A4. The most important concomitance was between homozygous genotype AA of rs3892097 and genotype AA of rs2740574 with 78.3% in drug-resistant epilepsy patients as compared to 14.3% in control patients. CONCLUSION: The results demonstrated the important role of the CYP 3A4*1B allelic variant as risk factor for developing drug resistance and CYP2D6, CYP2C19 SNPs and haplotypes may affect the response to antiepileptic drugs.

Occupational predictors of urinary dialkyl phosphate concentrations in Mexican flower growers.

Background Flower growers have high potential for exposures to pesticides. Occupational factors, such as tasks performed, the production method (organic or conventional), the use of personal protective equipment (PPE), and workplace characteristics influence the intensity of pesticide exposure. Objective To evaluate occupational characteristics affecting urinary concentration of dialkylphosphate (DAP) metabolites of organophosphate pesticides among a group of Mexican floricultural workers. Methods A questionnaire was administered to 117 workers who also provided a first morning urine sample. According to tasks performed and the production methods, pesticide contact was defined as low, medium, or high. PPE use was categorized as acceptable, fairly acceptable, and unacceptable. Urinary concentration of DAP metabolites were determined using gas-liquid chromatography. Association between occupational characteristics and DAP urinary concentrations was assessed by means of linear regression models. Results After adjusting for potential confounders, the workers in the medium and high contact categories had significantly higher DAP concentrations than those in the low contact category (ß: 0.3, CI 95%: 0.1-0.5). Greenhouse workers had greater DAP concentrations than outdoors workers (ß: 0.3, CI 95%: 0.1-0.5). Compared with non-acceptable use of PPE, acceptable use of PPE was associated with lower DAP concentrations (ß: -0.4, CI 95% -0.6 to -0.1). Conclusion Improved safety training is needed for correct PPE usage, especially among flower growers who use conventional pest control methods and who work in a greenhouse environment.

Prostate cancer mortality according to marginalization status in Mexican states from 1980 to 2013.

OBJECTIVE: To assess prostate cancer (PC) mortality in Mexico from 1980 to 2013, according to the state marginalization level. MATERIALS AND METHODS: Using age-adjusted rates in men ≥ 40 years old, we estimated trends and age-cohort-period effects of PC mortality from 1980-2013 according to state marginalization status by using a joinpoint regression model and a Poisson regression model proposed by Holford. RESULTS: The PC mortality risk has increased nationwide at a constant rate (2% annually) during the past 13 years. The highest annual increase was observed among states with very high (4.4%) and high (7.7%) marginalization rates. In contrast, states with very low levels of marginalization showed a significant reduction of 1.5% per year. The main changes were observed in the 1945-1950 birth year cohorts. CONCLUSIONS: Differences in PC mortality across regions of Mexico may reflect differences in the timing of the diagnosis and treatment of PC.

Prostate cancer mortality according to marginalization status in Mexican states from 1980 to 2013 / Comportamiento de la mortalidad por cáncer de próstata en México de acuerdo al índice de marginación estatal, de 1980 a 2013

Abstract Objective: To assess prostate cancer (PC) mortality in Mexico from 1980 to 2013, according to the state marginalization level. Materials and methods: Using age-adjusted rates in men ≥ 40 years old, we estimated trends and age-cohort-period effects of PC mortality from 1980-2013 according to state marginalization status by using a joinpoint regression model and a Poisson regression model proposed by Holford. Results: The PC mortality risk has increased nationwide at a constant rate (2% annually) during the past 13 years. The highest annual increase was observed among states with very high (4.4%) and high (7.7%) marginalization rates. In contrast, states with very low levels of marginalization showed a significant reduction of 1.5% per year. The main changes were observed in the 1945-1950 birth year cohorts. Conclusions: Differences in PC mortality across regions of Mexico may reflect differences in the timing of the diagnosis and treatment of PC.

Resumen Objetivo: Evaluar la mortalidad por cáncer de próstata (CP) en México de acuerdo con la marginación estatal de 1980 a 2013. Material y métodos: Mediante el método directo se estimaron las tasas de mortalidad por CP ajustadas por edad en hombres ≥ 40 años; se analizaron las tendencias y el efecto de edad-cohorte-periodo de la mortalidad por esta causa a nivel nacional y por nivel de marginación estatal, utilizando modelos joinpoint y de regresión de Poisson propuesto por Holford. Resultados: En los últimos 13 años, la mortalidad por CP a nivel nacional mostró un incremento constante (2% anual), principalmente en los estados de muy alta (4.4%) y alta marginación (7.7%), mientras que en los de muy baja hubo una reducción de 5% anual. Los principales cambios se observaron en las cohortes de nacimiento de 1945-1950. Conclusiones: Los resultados posiblemente reflejan las diferencias regionales, en la oportunidad del diagnóstico y tratamiento del CP.