Prevalence and characterization of undiagnosed arterial hypertension in the eastern zone of Mexico.

Arterial hypertension is considered a public health problem with severe consequences at an individual and public health levels. However, there is a lack of information regarding its characterization in Mexico. The objective of this study is to estimate the proportion of undiagnosed arterial hypertension (UAH) and the overall prevalence and clinical management of arterial hypertension within the Eastern Zone of Mexico. Additionally, we explore associated factors related with both UAH and uncontrolled arterial hypertension. We obtained information from the May Measure Month (MMM) 2019 study. People were asked for cardiovascular risk factors and blood pressure was measured according to the protocols of the European Society of Hypertension (ESH). Data from 5901 subjects were extracted: 76.04% from the Eastern Zone of the State of Mexico. The overall prevalence of hypertension was 32.4% (95% CI 31.2-33.6). From all subjects living with hypertension, 28.3% had UAH, 22.1% had previous diagnosis but were untreated; 29.3% were treated but had uncontrolled hypertension. Younger men adults living in the State of Michoacán had increased proportion of UAH and untreated hypertension. We observed that male sex, age, obesity, living at Michoacán were risk factors for UAH. Finally, male sex, diabetes, and living at Michoacán were related risk conditions for having uncontrolled arterial hypertension. In summary, there is a high proportion of UAH in Easter Zone of Mexico. Younger adults had higher proportion of UAH and untreated hypertension profiles. Efficient actions are required to make a timely diagnosis in the young adult population to prevent long-term complications.

Educational strategy based on the NutrIMSS program in patients with prediabetes. / Estrategia educativa basada en el programa NutrIMSS en pacientes con prediabetes.

BACKGROUND: Prediabetes is an altered metabolic state of glucose; it does not present symptoms, it is considered an intermediate stage in the progression to diabetes; it is possible to detect it early to avoid or delay the disease. NutrIMSS strategy was implemented so that these patients achieve a healthy lifestyle. OBJECTIVE: To evaluate the impact of an educational intervention based on the NutrIMSS strategy on somatometric and biochemical parameters in patients with prediabetes. METHOD: Quasi-experimental study in the Family Medicine Unit No. 80 of Morelia, Michoacán, Mexico, in patients 20 to 59 years of age, with diagnosis of prediabetes (impaired fasting glucose 100-125 mg/dL). The educational intervention included three educational sessions, six consultations with nutrition and inclusion to the social security center, from March to August 2017. Initial anthropometric and biochemical measurements were taken and in the sixth month. The data were presented as median and interquartile range or mean ± standard deviation, and Student's t and Wilcoxon tests, with a significance value of p < 0.05. RESULTS: 45 patients, 66.7% women. Previous and after the intervention parameters were, respectively: weight (kg), 79.9 (56.5-114) and 77.5 (54.6-110) (p = 0.001); body mass index (kg/m2), 30.89 (23.2-39.9) and 29.0 (21.5-39.1) (p < 0.001); glucose (mg/dL), 111 ± 6.3 and 95.8 ± 9.2 (p < 0.001); and total cholesterol (mg/dL): 171 (120-223) and 170 (90-205) (p = 0.01). CONCLUSIONS: The educational intervention based on the NutrIMSS strategy has a positive impact on the metabolic control of patients with prediabetes.

INTRODUCCIÓN: La prediabetes es un estado metabólico alterado de la glucosa, no presenta síntomas, se considera un estadio intermedio en la progresión a diabetes y es posible detectarla tempranamente para evitar o retrasar la enfermedad. La estrategia NutrIMSS se implementó para que estos pacientes alcancen un estilo de vida saludable. OBJETIVO: Evaluar el impacto de una intervención educativa basada en la estrategia NutrIMSS sobre parámetros somatométricos y bioquímicos en pacientes con prediabetes. MÉTODO: Estudio cuasiexperimental en la Unidad de Medicina Familiar No. 80 de Morelia, Michoacán, en el que participaron pacientes de 20-59 años, con diagnóstico de prediabetes (glucosa alterada de ayuno 100-125 mg/dl). La intervención educativa incluyó tres sesiones educativas, seis consultas con nutrición e inclusión al centro de seguridad social de marzo a agosto de 2017. Se realizaron mediciones antropométricas y bioquímicas iniciales y al sexto mes. Los datos se presentaron como mediana (con rangos intercuartílicos) o media ± desviación estándar, pruebas de Wilcoxon y t de Student, con una significación de p < 0.05. RESULTADOS: Fueron 45 pacientes, con un 66.7% de mujeres. Los parámetros previos y posteriores a la intervención fueron los siguientes, respectivamente: peso (kg), 79.9 (56.5-114) y 77.5 (54.6-110) (p = 0.001); índice de masa corporal (kg/m2), 30.89 (23.2-39.9) y 29.0 (21.5-39.1) (p < 0.001); glucosa (mg/dl), 111 ± 6.3 y 95.8 ± 9.2 (p < 0.001); y colesterol total (mg/dl), 171 (120-223) y 170 (90-205) (p = 0.01). CONCLUSIONES: La intervención educativa basada en la estrategia NutrIMSS impacta de manera positiva en el control metabólico de los pacientes con prediabetes.

Conocimiento y práctica sobre lactancia materna de mujeres primigestas derechohabientes de una Unidad de Medicina Familiar / Knowledge and practice about breastfeeding of primigravid women entitled to a Family Medicine Unit

Introducción: la promoción e información a la mujer primigesta sobre la lactancia materna, los beneficios de esta y cómo amamantar correctamente al bebé, mejoran el conocimiento y disminuyen el abandono de la misma. Objetivo: analizar el conocimiento y práctica sobre lactancia materna de mujeres primigestas derechohabientes de una unidad de medicina familiar. Material y métodos: estudio transversal, descriptivo con una muestra de 75 mujeres primigestas de entre 14 y 34 años de edad. Se utilizó el "Cuestionario sobre conocimientos, actitudes y prácticas de la lactancia materna". Se llevó a cabo el análisis con frecuencias simples y porcentajes, medidas de tendencia central (X ± DE), asociación chi cuadrada y prueba exacta de Fisher. Resultados: la edad de las mujeres primigestas fue de 24.88 ± 4.64 años, con predominio de mujeres en el segundo trimestre de embarazo, casadas, con grado de licenciatura, católicas y amas de casa. El nivel de conocimiento fue suficiente en 61.3%, se encontró asociación no significativa entre el nivel de conocimiento, grado académico y ocupación. Conclusión: las mujeres primigestas tienen conocimiento suficiente sobre lactancia materna y sus beneficios. Dicha información es proporcionada principalmente por el personal de enfermería.

Introduction: The promotion and information to the primigravid woman on breastfeeding, the benefits of it and how to breastfeed correctly, improve the knowledge and decreases the abandonment of it. Objective: To analyze knowledge and practice about breastfeeding of primigravid women entitled to a family medicine unit. Methods: A cross-sectional, descriptive study with a sample of 75 primigravid women between 14 and 34 years of age. The "Questionnaire on knowledge, attitudes and practices of breastfeeding" was used. The analysis was carried out with simple frequencies and percentages, measures of central tendency, Chi square association and Fisher's exact test (p < 0.05). Results: The age of the primigravid women was 24.88 ± 4.64 years old, with predominance of women in the second trimester of pregnancy. The level of knowledge was sufficient in 61.3%, a non-significant association was found between the level of knowledge, academic degree and occupation. Conclusion: Primigravid women have sufficient knowledge about breastfeeding and its benefits. This information is provided mainly by the nursing staff.

[Influenza-like illness. Therapeutic experience in family medicine]. / Enfermedad tipo influenza. Experiencia terapéutica en medicina familiar.

BACKGROUND: influenza is a highly contagious respiratory disease. Surveillance in Mexico is based on the detection of Influenza-Like Illness (ILI) and antiviral treatment should begin within 48 hours to avoid the main complication, pneumonia. The aim was to describe the experience of treatment of ILI in a family medicine unit. METHODS: a descriptive study included patients presented to the emergency room with ILI (38°C fever, headache and cough accompanied by other symptoms). We reviewed the reporting formats of Influenza. To follow up, we contacted them by telephone. Data are expressed as mean ± standard deviation. RESULTS: there were 537 patients attended with diagnosis of upper airway infection, 1.3 % met criteria for ILI. 85.7 % were men. The mean age was 18 ± 24.21 years. The patients were seen in a mean time of 19.14 hours after the symptoms have started; 100 % of the patients received treatment with oseltamivir and zanamivir; 14.3 % developed pneumonia. All the patients recovered without concomitant disease or complications. CONCLUSIONS: The use of a protocol in patients with influenza in a family medicine unit led an early diagnosis and treatment that favored the patients' health restoration.

Introducción: la influenza es una enfermedad respiratoria muy contagiosa. Se debe iniciar el tratamiento antiviral en las primeras 48 horas para evitar la neumonía. El objetivo de este informe es describir la experiencia en el tratamiento de la enfermedad tipo influenza en una unidad de medicina familiar. Métodos: estudio descriptivo de pacientes que acudieron a urgencias con enfermedad tipo influenza (fiebre de 38 °C, cefalea y tos, acompañadas de otro síntoma) y que fueron contactados por vía telefónica. Los datos se expresan en media ± desviación estándar. Resultados: de 537 consultas por infecciones respiratorias agudas, 1.3 % reunió los criterios de enfermedad tipo influenza; 85.7 % era del sexo masculino. El promedio de la edad fue de 18 ± 24.21 años. La atención inicial ocurrió a las 19.14 horas después de que se iniciaron los síntomas. Todos los pacientes recibieron oseltamivir y zanamivir; 14.3 % presentó neumonía. El 100 % se restableció. No hubo enfermedades concomitantes. Conclusiones: existe un protocolo para el manejo de la enfermedad tipo influenza que hace posible el diagnóstico y el tratamiento oportunos de los pacientes.