[Considerations concerning medical knowledge inherited in Mexico from 19th century: the diabetes mellitus case]. / Consideraciones sobre el saber médico heredado en México del siglo XIX: el caso de la diabetes mellitus.

In Mexico, as in the entire Western world, during the 19th century and the beginnings of the 20th century, medical knowledge developed in a remarkable way and the case of diabetes mellitus was not the exception. This situation, which arose on the basis of the antique paradigm, and which in turn was overthrown by the positivism as the emergent paradigm (with its clinical and anatomical, as well as physiopathological and etiopathological viewpoints), was reflected during the 19th the century through its actors and the communications that opened the access of Mexican medicine to the modernity.

En México, como en el mundo occidental, durante el siglo XIX y principios del XX, el conocimiento médico presentó un desarrollo notable y el caso de la diabetes mellitus no es la excepción. Esta situación, originada desde el paradigma antiguo, superado por el paradigma moderno emergente, con sus miradas anatomoclínica, fisiopatológica y etiopatogénica, se refleja en el México decimonónico a través de sus actores y de las comunicaciones que inauguran la entrada de la medicina mexicana a la modernidad.

[Maternal metabolic diseases related to pre-pregnancy overweight and obesity in mexican women with high risk pregnancy]. / Enfermedades metabólicas maternas asociadas a sobrepeso y obesidad pregestacional en mujeres mexicanas que cursan con embarazo de alto riesgo.

INTRODUCTION: Pre-pregnancy obesity has been proposed as a risk factor related to gestational diabetes and hypertensive disorders during pregnancy. OBJECTIVES: Identify pregnancy related diseases associated with pre-pregnancy obesity as a risk factor ina high risk preganancy patient population. METHODS: 600 patients whose pre-pregnancy obesity had been assessed as a high risk factor were included in the study. The means, standard deviation, median, interquartile intervals, Pearson and Spearman correlation and logistic regression to estimate risk with the odds ratio and 95% confidence intervals were calculated. RESULTS: The mean pre-pregnancy body mass index was 29.59 ± 6.42 kg/m2. The mean for recommended pregnancy weight gain was 2.31 ± 1.03 kg, but the mean of real weight gain was 8.91 ± 6.84 kg. A significant correlation between pre-pregnancy obesity and family history of diabetes mellitus (p=0.000), systemic hypertension (p=0.003), cardiac diseases (p=0.000), dyslipidemia (p=0.000) and obesity (p=0.000) was identified. Pre-pregnancy obesity was identified as a risk factor for the development of gestational diabetes (OR: 1.95; IC95%: 1.39 to 2.76; p=0.000) in this kind of patient. DISCUSSION AND CONCLUSION: 75% of high risk pregnancy women in a high specialty hospital in West Mexico are overweight or obese when they become pregnant. These are risk factors in the development of gestational diabetes.

Porcentaje de adiposidad y su relación con el índice de inmunorreactividad de los receptores hormonales en mujeres mexicanas con cáncer de mama / Adiposity percentage relationship with hormone receptors immunoreactive score in breast cancer Mexican women

INTRODUCTION: Adipose tissue is an important estrogen resource and they are involved in breast cancer development. OBJECTIVE: To establish the relationship between adiposity percentage and the estrogen and progesterone receptors immunoreactive score in Mexican women with breast cancer. METHODS: This is a transversal and analytical study. We identified breast cancer women with cancer histologic diagnosis. We calculated: adiposity percentage and immunoreactive score. We performed correlation analysis between adiposity percentage, body mass index, diabetes mellitus and arterial hypertension, with estrogen and progesterone receptors in breast cancer samples. We perform logistic regression and Odds Ratio estimations. RESULTS: We studied 43 patients with breast cancer and we observed association between adiposity percentage and estrogen and progesterone immnunoreactive score (rP 0.470; p 0.003 and rP 0.328; p 0.042, respectively). The most important risk factor in breast cancer positive to estrogen receptors was obesity (OR 19.1, IC95% 2.1 a 169.1, p 0.008), and previous obesity in breast cancer positive to progesterone receptors (OR 20.7, IC95% 2.3 a 185.9, p 0.007). DISCUSSION: Adiposity percentage is an important risk factor to develop breast cancer positive to hormone receptors related with the risk of breast cancer positive to hormonal receptors (AU)

Introducción: El tejido adiposo es una importante fuente de estrógenos, los cuales se encuentran implicados en el desarrollo de cáncer de mama. Objetivo: Establecer la relación entre el porcentaje de adiposidad y el índice de inmunorreactividad de los receptores a estrógenos y a progesterona en mujeres mexicanas con cáncer de mama. Métodos: Estudio transversal analítico en pacientes con cáncer de mama confirmado con estudio histopatológico. Se estimó el % de adiposidad, y el índice de inmunorreactividad. Se realizó el análisis de correlación entre el porcentaje de adiposidad, el IMC, la presencia de DM2 e hipertensión arterial con la expresión de receptores a estrógeno y progesterona y regresión logística con cálculo de Odds Ratio. Resultados: Se estudiaron 43 pacientes con cáncer de mama y se observó asociación entre el porcentaje de adiposidad y el índice de inmunoreactividad para los RE y RP (rP 0,470; p 0,003 y rP 0,328; p 0,042 respectivamente). El factor de riesgo más importante en cáncer positivo a receptores estrogénicos fue la obesidad (OR 19,1, IC 95% 2,1 a 169,1, p 0,008) y obesidad previa en cáncer positivo a receptores a progesterona (OR 20,7, IC 95% 2,3 a 185,9, p 0,007). Conclusión: El porcentaje de adiposidad es un factor de riesgo importante para desarrollar cáncer de mama positivo a receptores hormonales (AU)

[Adiposity percentage relationship with hormone receptors immunoreactive score in breast cancer mexican women]. / Porcentaje de adiposidad y su relación con el índice de inmunorreactividad de los receptores hormonales en mujeres mexicanas con cáncer de mama.

INTRODUCTION: Adipose tissue is an important estrogen resource and they are involved in breast cancer development. OBJECTIVE: To establish the relationship between adiposity percentage and the estrogen and progesterone receptors immunoreactive score in Mexican women with breast cancer. METHODS: This is a transversal and analytical study. We identified breast cancer women with cancer histologic diagnosis. We calculated: adiposity percentage and immunoreactive score. We performed correlation analysis between adiposity percentage, body mass index, diabetes mellitus and arterial hypertension, with estrogen and progesterone receptors in breast cancer samples. We perform logistic regression and Odds Ratio estimations. RESULTS: We studied 43 patients with breast cancer and we observed association between adiposity percentage and estrogen and progesterone immnunoreactive score (rP 0.470; p 0.003 and rP 0.328; p 0.042, respectively). The most important risk factor in breast cancer positive to estrogen receptors was obesity (OR 19.1, IC95% 2.1 a 169.1, p 0.008), and previous obesity in breast cancer positive to progesterone receptors (OR 20.7, IC95% 2.3 a 185.9, p 0.007). DISCUSSION: Adiposity percentage is an important risk factor to develop breast cancer positive to hormone receptors related with the risk of breast cancer positive to hormonal receptors.

Introducción: El tejido adiposo es una importante fuente de estrógenos, los cuales se encuentran implicados en el desarrollo de cáncer de mama. Objetivo: Establecer la relación entre el porcentaje de adiposidad y el índice de inmunorreactividad de los receptores a estrógenos y a progesterona en mujeres mexicanas con cáncer de mama. Métodos: Estudio transversal analítico en pacientes con cáncer de mama confirmado con estudio histopatológico. Se estimó el % de adiposidad, y el índice de inmunorreactividad. Se realizó el análisis de correlación entre el porcentaje de adiposidad, el IMC, la presencia de DM2 e hipertensión arterial con la expresión de receptores a estrógeno y progesterona y regresión logística con cálculo de Odds Ratio. Resultados: Se estudiaron 43 pacientes con cáncer de mama y se observó asociación entre el porcentaje de adiposidad y el índice de inmunoreactividad para los RE y RP (rP 0,470; p 0,003 y rP 0,328; p 0,042 respectivamente). El factor de riesgo más importante en cáncer positivo a receptores estrogénicos fue la obesidad (OR 19,1, IC 95% 2,1 a 169,1, p 0,008) y obesidad previa en cáncer positivo a receptores a progesterona (OR 20,7, IC 95% 2,3 a 185,9, p 0,007). Conclusión: El porcentaje de adiposidad es un factor de riesgo importante para desarrollar cáncer de mama positivo a receptores hormonales.

[Cognitive anthropology applied to the study of the causes of arterial hypertension in Guadalajara, Jalisco, México]. / La antropología cognitiva aplicada al estudio de las causas de la hipertensión arterial en Guadalajara, Jalisco. México.

BACKGROUND: In medical anthropology, culture is shared knowledge and it can be used to study cultural consensus for development of preventive and control actions in chronic diseases such as high blood pressure. The aim of this study was to characterize the semantic structure and level of cultural consensus regarding the causes of arterial hypertension in persons >15 years of age belonging to families of laborers from "Colonia Fabrica de Atemajac." METHODS: Using a propositive sample of 36 persons >15 year of age of both genders and divided into three age groups, we conducted an anthropological study. A structured questionnaire and semi-structured interviews were applied in order to obtain the semantic model and cultural consensus regarding the causes of arterial hypertension. RESULTS: The semantic structure of the model links the causes of arterial hypertension to emotions and certain risk conditions that vary in relation to their arrangement as elements of related semantics nuclei according to age group. CONCLUSIONS: Our results show evidence of one semantic model in regard to the causes of arterial hypertension and different from the biomedical cognitive pattern. These types of models must be taken into account for establishing cultural comprehensive health policies.

Oral Health: Validation of a questionnaire of self-perceptionand self-care habits in Diabetes Mellitus 2, hypertensive andobese patients. The UISESS-B scale

Objectives: To develop and to evaluate a questionnaire of self-perception and self-care habits on oral health on afirst level population.Methods: A descriptive, observational study was performed to validate a questionnaire on oral health self-perception(UISESS-B). After non-probabilistic sampling, 94 users, 30-59 years of age, with either diabetes mellitus 2,hypertension or obesity were included. Duration of disease was lesser than 10 years. Pearson’s r, Cornbach’s á,factorial analysis, chi-square and Snedecor’s F tests were employed.Results: A Pearson’s r of 0.7 and Cronbach’s á of 0.82 was observed on the pre-post values of the global question-naire. In the factorial analysis, the variance explained more than 60% for a first factor. A punctuation of very highrisk for the three groups with the scale UISESSS-B that coincides with the index CPO-D and the index UISESS-Fwas observed.Conclusions: The UISESS-B scale shows significant validity and reliability, sugg esting its use as a sensitive instrumentfor the measurement of oral health in people with chronic illnesses such as diabetes, hypertension andobesity (AU)

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[Gender and metabolic control of type 2 diabetes among primary care patients]. / Género y control de diabetes mellitus 2 en pacientes de primer nivel de atención.

INTRODUCTION: removing the biological perspective of the sexual differences and understanding the asymmetries related to diabetes, lead to define situations of benefit or deterioration of the population's health. OBJECTIVE: to analyze gender situations related to self-care and control of type 2 diabetes in primary care patients. METHODS: we conducted a descriptive observational study in 620 patients with diabetes at the family medicine clinic number 3 of Instituto Mexicano del Seguro Social in Guadalajara, Mexico. Three groups each with 79 women and 54 men were integrated. Gender situation was valued by means of questionnaires. Data were tested using the multiple correspondences analysis in seven situations of susceptibility. The comparison included the analysis with Snedecor's F distribution and chi2. RESULTS: women have several social disadvantages, deterioration of healthy life, poor self-care and lack of solidarity that increases their vulnerability to reach glycemic control successfully to avert complications. CONCLUSIONS: continuing investigating about the gender situation as the main driver to design specific actions to provide integrated care, should focus to supporting women's self care in general and glycemic control of diabetic women in particular.

[Oral signs in patients with type-2 diabetes, hypertension and obesity]. / Manifestaciones bucales en pacientes con diabetes mellitus tipo 2, hipertensión y obesidad.

OBJECTIVE: To evaluate oral health in patients with type-2 diabetes, hypertension and obesity. MATERIAL AND METHODS: Comparative cross-sectional study with a random conglomerate sample, constituted by 363 patients of primary care units in Guadalajara, with records of glycemia, blood pressure and body mass index. A questionnaire was applied to know sociodemographic data, as well as medical and oral state. It included CPO-D and functionality index. For the intergroup comparison, the chi2 and t of Student were applied, considering significant p < 0.05. RESULTS: In the sample, the average age was 50 years old, 74% were women, 75 % showed overweight-obesity, arterial hypertension or diabetes mellitus; the rest had different combinations of these pathologies. In diabetic patients, glucose was of 184 +/- 74.9 mg/dL; in hypertensive ones, blood pressure was of 132/83 mm Hg, and in patients with overweight-obesity, the BMI was 34 +/- 5.33. The CPO and the functionality indexes were inadequate in all the patients. The hypertensive group showed the most deteriorated oral state; the periodontal disease prevailed. CONCLUSIONS: We propose to emphasize clinical-preventive programs in stomatologic attention of chronic patients, and to consider them a high priority. We also suggest to train the health staff and patients in the interaction between systemic illness and oral state. Finally, we propose to integrate stomatology to the research of chronic degenerative pathologies.

Defunciones masculinas de 1786, en el Hospital Real de San Miguel Belén de la ciudad de Guadalajara / Male deaths in 1786 at the Royal Hospital of San Miguel of Guadalajara city, Jalisco, Mexico

Se presentan los registros sobre defunciones masculinas acaecidas en 1786, durante el periodo de hambruna que sufrió el país, en el Hospital Real de San Miguel de Belén de la ciudad de Guadalajara, México. Éstas se calcularon en razón de 50 por 1000 habitantes, de ellas ocurrieron en 41 por ciento en indios, 25 por ciento españoles, 17 por ciento de mulatos y 7 por ciento de mestizos. El grupo de edad mayoritariamente afectado fue el de 25 a 34 años. Se discute su paralelismo con otros reportes del centro del país, así como la importancia de dicha epidemia para fundar el actual Hospital Civil de Guadalajara.

Defunciones masculinas de 1786, en el Hospital Real de San Miguel Belén de la ciudad de Guadalajara / Male deaths in 1786 at the Hospital Real de San Miguel de Belén in Guadalajara

Se presentan los registros sobre defunciones masculinas acaecidas en 1786, durante el periodo de hambruna que sufrió el país, en el Hospital Real de San Miguel de Belén de la ciudad de Guadalajara, México. Éstas se calcularon en razón de 50 por 1000 habitantes, de ellas ocurrieron en 41 por ciento en indios, 25 por ciento españoles, 17 por ciento de mulatos y 7 por ciento de mestizos. El grupo de edad mayoritariamente afectado fue el de 25 a 34 años. Se discute su paralelismo con otros reportes del centro del país, así como la importancia de dicha epidemia para fundar el actual Hospital Civil de Guadalajara. (AU)

Factores asociados a la desnutrición aguda en preescolares migrantes de la zona cañera de Jalisco / Factors associated with acute malnutrition in migrating preschool children from the Jalisco sugar cane area

Con el propósito de identificar la asociación de factores socioeconómicos, ambientales, alimentarios e individuales en la desnutrición aguda del preescolar migrante, se realizó un estudio observacional comparativo transversal, en 511 niños de uno a cinco años de edad en los albergues de la zona cañera de Jalisco. Mediante indicadores antropométricos, clasificados de acuerdo con Waterlow se evaluó el estado de nutrición. La prevalencia de desnutrición fue de 79.0 por 100 preescolares (68.1%adaptados y 21.5%crónico agudizados y 10.4%agudos). Se asociaron a la desnutrición aguda: ingreso familiar menor a un salario mínimo (R.M= 6.32, P= 0.00), menores con patología aguda (R.M. = 3.34, P =0.00) y tener un año de edad (R.M. =2.22, P=0.01). Existieron diferencias significativas en hijos de padres: sin escolaridad (P = 0.04) y ser cortador de caña (P = 0.05). Los hallazgos identifican factores de riesgo en la desnutrición aguda, modificables probablemente mediante estrategias de vigilancia epidemiológica nutricional