Unplanned pregnancy in adolescents: association with family structure, employed mother, and female friends with health-risk habits and behaviors.

Previous publications have suggested that living in a nonintact family household and socializing with girlfriends who smoke or who consume alcoholic beverages favor the development of health-risk habits and customs in adolescents. However, their relationship with unplanned pregnancy in adolescents has not been determined. We investigated the association between family structure, employed mother, and female friends with health-risk habits and behaviors with unplanned pregnancy in adolescents (n = 3,130). After adjusting for low maternal educational level and low family income, logistic regression analyses showed that having an employed mother and socializing with girlfriends who have health-risk habits or behaviors, rather than living in a nonintact family household, appear to be the most important health-risk factors for unplanned pregnancy in adolescents. It is important for health-care programs for adolescents to be revised and for their strategies be strengthened in order to reach the objectives for which they were created.

Factores de riesgo y consecuencias del cyberbullying en un grupo de adolescentes: Asociación con bullying tradicional / Risk factors and consequences of cyberbullying in teenagers: association with bullying

Introducción. En el cyberbullying se utilizan medios electrónicos para intimidar. El objetivo del presente trabajo fue determinar la prevalencia de cyberbullying, identificar algunas características, explorar asociación con el bullying y analizar factores de riesgo y consecuencias. Métodos. El estudio incluyó alumnos de secundaria. El cyberbullying se utilizó como variable de exposición y de resultado. Se aplicó estadística no paramétrica y regresión logística. Resultados. Se encuestaron 603 alumnos, con media de edad de 13.4 años (DE 0.98 años). Fueron más prevalentes las cibervíctimas. El teléfono celular fue la herramienta más utilizada para intimidar. El factor de riesgo más importante para cibervíctimas fue "sentirse inseguro en la escuela" (X²=6.485 p=0.011 OR=4.1 IC95% 1.30-11.2). Para ciberagresores, "usar la computadora a escondidas de los padres y a altas horas de la noche" (X²=14.584 p<0.05 OR=4.2 IC95% 2.10-16.30); para cibervíctimas-ciberagresores, "ser mujer" (X²=2.891 p>0.05 OR=3.50 IC95% 1.70-16.80). La mayor asociación con bullying fue para varones y entre los roles víctima-agresor tradicional y ciberagresor (X²=28.821 p<0.05 OR=7.37 IC95% 3.78-14.3). Al considerar al ciberbullying como variable de exposición, la principal consecuencia fue la cefalea para el rol de ciberagresor (X²=15.125 p<0.05 OR=7.91 IC95% 2.28-29.6). Conclusiones. La prevalencia de cyberbullying fue menor a otras investigaciones, pero los factores de riesgo y las consecuencias son relevantes.

Background. Cyberbullying uses electronic tools to intimidate. We undertook this study to determine the prevalence of cyberbullying and to identify its characteristics. We explored the association with bullying and analyzed consequences and risk factors. Methods. Junior-high-school students were included. Cyberbullying was used as exposure and outcome variable. Nonparametric statistic and logistic regression were applied. Results. Six hundred three students with a mean age of 13.4 years (SD 0.98 years) were included. Cybervictims were more prevalent. The cell phone was the most common tool used to intimidate. The most important risk factor for cybervictims was "feeling unsafe at school" (c² = 6.485 p = 0.011 OR = 4.1 95% CI 1.30-11.2); for cyberaggressors it was "to use the computer hidden from parents and late at night" (c² = 14.584 p <0.05 OR = 4.2 95% CI 2.10-16.30); for cybervictims-cyberaggressors it was "to be female" (c² = 2.891 p >0.05 OR = 3.50 95% CI 1.70-16.80). The strongest association with bullying was shown for males and between traditional victim-aggressor and cyberaggressor roles (c² = 28.821 p <0.05 OR = 7.37 95% CI 3.78-14.3). When cyberbullying was considered as the exposure variable, the most relevant outcome measure was "to have headaches" for cyberaggressors (c² = 15.125 p <0.05 OR=7.91 95% CI 2.28-29.6). Conclusions. The prevalence of cyberbullying was less than demonstrated in other studies, but the risk factors and consequences are relevant.

El DSM-V. Luces y sombras de un manual no publicado. Retos y expectativas para el futuro / DSM-V. Lights and shadows of an unpublished manual. Challenges and expectations for the future

Throughout its history, one of the most fascinating topics of psychiatry has been that of the causes and consequences of mental disorders. The desire to strengthen the reliability of diagnosis in this area has led to significant advances in two important fields: psychopathological description and the formulation of an integral diagnosis. Classifications allow the definition of categories and in the case of the two most read taxonomies in the field of mental health, Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD), these provide the most commonly used criteria for diagnosis. The revised fourth edition of the DSM is now insufficient to cover the ever greater clinical challenges and research. For over ten years, work has been carried out on the structure of DSM-V (the fifth edition), but despite the planning, organization, prediction, and the contributions of guest experts, it is feared that all the requirements of modern psychiatry will not be met. The first edition of DSM was published in the 1950s. It was based on the terminology developed by William Meninger. This version of the manual and the following, published several years later, reflected the psychodynamic psychiatry which prevailed at the time. The third edition was published in 1980 and its revised edition seven years later. The emphasis here was on descriptive and syndromatic considerations. The fourth edition appeared several years later. The most striking change in this edition was the inclusion of variables resulting from empirical studies. A later edition was published in the year 2000. The first attempts to put together DSM-V started in 1999. From 1999 until 2007 work was done on the planning of the investigation and technical documentation of DSM-V and the inclusion of the so called investigation schedules. The second phase of the project, known as «the refinement of the research program for DSM-V¼, was carried out between 2004 and 2007. A pilot test was undertaken between January and May 2010, among different segments of the population and different settings, to evaluate the revisions proposed by the working teams. Between March and April 2011, as a result of the field tests, the proposed criteria for diagnosis were reviewed. The dimensional measurements and the criteria for diagnosis will be reviewed again during the rest of 2011. The year 2012 will see the preparation of the final version of the text, and finally, in May 2013, DSM-V will be presented at the annual meeting of the American Psychiatric Association in San Francisco, California. Several external and independent authors have offered numerous proposals on topics related to psychopathology in general to the working groups formed for the preparation of DSM-V. Only some of these are mentioned below. One of the first factors to be taken into consideration in the revision of the manual is the need to distinguish between empirical questions or approaches and those of a more conceptual or philosophical nature, which should, by no means, be excluded. Another point to be evaluated is the advisability of defining phases according to the development of the condition, which would ideally create a schema focused on prevention. One of the expectations of psychiatry is that eventually laboratory criteria of diagnosis could be established, which could be measurable and would lead to clear statistics of psychiatric pathologies. As far as somatomorphic disorders are concerned, many practitioners agree that the current terminology and the systems of classification are inaccurate. One proposal is that this category should be eliminated altogether and that diagnoses should be made using an additional multidimensional description. One of the most interesting features of DSM is that it has had to accommodate changes brought about by new technologies. These advances go hand in hand with a new series of pathologies which need to be classified, as is the addiction to Internet. Undoubtedly, one of the greatest dilemmas facing DSM is how to classify eating disorders, as many people feel that the rather simplistic distinction between nervous anorexia and bulimia is not altogether convincing. There are two interesting proposals to consider in DSM-V: one is known as night eater syndrome and obesity, as in this case there is a compulsive consumption of food and an inability to limit this intake, in spite of a desire to do so. With regard to the compulsive, obsessive disorder, most experts believe that it is necessary to see the disorder as a spectrum, but defining criteria. Undeniably, a grave current problem which makes no distinctions is suicide. Different researchers recommend that suicidal behavior be considered and documented as a separate diagnosis in a sixth axis of the multiaxis schema. Another important aspect concerns the giving of quality attention to patients. This has led to the proposal to expand DSM-V to include indicators for situations which could eventually be a cause for treatment. The proposal is to structure something different from what can be found in axis I V. In the case of paraphilias, it is deemed necessary that DSM-V should deal not only with the strictly descriptive aspect, but also with the semantic and linguistic. The importance of post-traumatic stress has been described, but there exists the doubt whether it is necessary to experience an adverse incident for this to be triggered. There has been a suggestion that the term «pre-traumatic¼ stress disorder be included in DSM-V to diagnose this condition. In the case of anxiety disorders, some authors advise the creation of a category known as «disorders caused by stress and fear¼, which would allow linking the diagnostic classification with etiology and thus define a «true¼ anxiety nosology. It would be advisable that the DSM-V included a category for «seasonal affective disorder¼ as such, and not simply as a variant in the «specification of the seasonal pattern¼ of depression. In the field of substance consumption, it has been argued that it is necessary to establish a classification which is not only categoric but also dimensional so as to improve its taxonomic usefulness. The organization of mental disorders in DSM-IV-TR and ICD-10 (tenth edition) is complex and this has led to exploring the feasibility of developing a meta-structural system of classification based on risk and clinical factors. For disorders originated in infancy, childhood and adolescence, it has been suggested that the disorder known as «temperament disorder by disphoria¼ be included in the forthcoming taxonomy, as well as the use of the terms insensitive/emotionless for behavioral disorders, among others. In the case of attention deficit hyperactivity disorder (ADHD), the current criteria are considered insufficient and it has been suggested that the starting age for this disorder be increased from 7 to 12 years of age. It is suggested that autism be considered autistic spectrum, thus eliminating the other disorders covered in this section, including Asperger syndrome. The question as to whether this taxonomic-diagnostic system, to be implemented world-wide, will be both valid and reliable enough to cover all variations and particular characteristics of different cultures, ethnic groups, social groups and geographical regions in Mexico is another matter of concern, due to the lack of tools available for daily clinical work, except for the International Classification of Diseases of the World Health Organization. There are, at present, a number of doubts and queries which will need to be laid open and evaluated in all seriousness in order to obtain concrete and integral answers, given that the manual will continue to be used for clinical purposes in different parts of the world. The challenge will be to find the best way to apply diagnostic criteria, avoiding omissions and oversimplifications and taking into account the cultural and social context worked in.

Un tema de gran interés a lo largo de la historia de la psiquiatría, ha sido el relacionado a los sistemas diagnósticos. El Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM por sus siglas en inglés) y la Clasificación Internacional de Enfermedades (CIE), integran los criterios diagnósticos comúnmente utilizados en la práctica psiquiátrica. El DSM en su cuarta edición revisada, es ya insuficiente para el trabajo clínico actual, por lo que se ha estado trabajando en la configuración de lo que será el DSM-V (quinta edición); no obstante, aún y con toda la planeación, se teme que no se logren cubrir todas las necesidades de la psiquiatría moderna. La primera edición del DSM fue publicada en la década de 1950; esta versión del manual, y la subsiguiente, reflejaban la psiquiatría psicodinámica de esa época. En la década de 1980 se publicó la tercera edición y su versión revisada, en las que predominaban las consideraciones descriptivas y sindromáticas. Años después fue publicada la cuarta versión y una revisión posterior de este manual en el año 2000. Los primeros esfuerzos para iniciar el proceso de integración del DSM-V se iniciaron desde 1999. Desde ese año, hasta el 2007, se planificó la investigación y la documentación técnica por medio de un programa de investigación. Del año 2004 al 2007 se llevó a cabo la segunda fase del proyecto denominada «perfeccionamiento del programa de investigación para el DSM-V¼. De enero a mayo del 2010 se efectuó una prueba piloto con diferentes poblaciones y las revisiones propuestas por los grupos de trabajo. En el 2011 se revisarán los criterios diagnósticos propuestos y las medidas dimensionales. En el año 2012 se preparará el proyecto de texto final, y en mayo del 2013 se planea presentar el DSM-V en la Reunión Anual de la Asociación Psiquiátrica Americana, en San Francisco, California. Han sido numerosas las propuestas de autores externos e independientes para el desarrollo del DSM-V, como es el caso de la conveniencia de definir estadios de acuerdo a la progresión de la enfermedad o bien establecer criterios diagnósticos de laboratorio, e incluso favorecer una estadificación clara de las patologías psiquiátricas. En cuanto a los trastornos somatomorfos, muchos clínicos están de acuerdo en eliminar esta entidad y elaborar los diagnósticos con una descripción multidimensional adicional. Algunos expertos proponen integrar un diagnóstico denominado «adicción al Internet¼. Diferentes investigadores recomiendan que el comportamiento suicida sea considerado como un diagnóstico separado y documentado en un sexto eje del esquema multiaxial. Hay dos propuestas interesantes para el DSM-V, una es el síndrome del comedor nocturno y la otra la obesidad, al existir en estos casos un consumo compulsivo de alimentos y una dificultad para restringirlos, lo que podría tener implicaciones adictivas. En el caso de las parafilias se plantea la necesidad de que se trabaje en el aspecto descriptivo, semántico y lingüístico. Se ha descrito la importancia del estrés postraumático, pero se sugiere también un trastorno de estrés «pre-traumático¼ como diagnóstico en el DSM-V. En los trastornos de inicio en la infancia, niñez y adolescencia, se ha planteado incluir en la próxima taxonomía el denominado «trastorno por disregulación del temperamento con disforia¼. En lo referente al trastorno por déficit de atención e hiperactividad (TDAH) se considera que los criterios actuales son insuficientes, y se propone incrementar la edad de inicio del trastorno. Para el autismo se sugiere considerarlo como espectro autista, eliminando el trastorno de Asperger. Finalmente en opinión de los autores de este trabajo, existe por el momento una diversidad de cuestionamientos que deberá valorarse con seriedad, toda vez que el manual evidentemente seguirá siendo de uso clínico continuo en diferentes latitudes. El desafío será establecer la mejor forma de aplicar los criterios diagnósticos tomando en cuenta el contexto cultural y social en el que se trabaja, lo que, por lo revisado, sigue siendo un punto pendiente para los encargados de revisar la próxima versión del manual.

Prevalencia de caries dental en adolescentes: asociación con género, escolaridad materna y estatus socioeconómico familia / Prevalence of dental caries in adolescents: association with gender, mother´s education level and family socioeconomic status

Introducción y Objetivo: La prevalencia de caries dental parece estar aumentando y los determinantes no están bien establecidos. Determinar la prevalencia de la caries dental en adolescentes y su asociación con el género, escolaridad materna y el estatus socioeconómico familiar. Materiales y Métodos: Es un estudio transversal de 1.893 adolescentes escolares, en edades de 13 a 18 años. La caries se identificó por exploración física directa. Se utilizó modelo de regresión logística para determinar la asociación entre el sexo, escolaridad materna, estatus socioeconómico familiar y la caries. El índice de caries fue medido como el número de dientes con caries (C), obturados (O), perdidos por caries (P), (COP-D) o superficies (COP-S) Resultados: La prevalencia de caries dental fue de 48,2%. El porcentaje de caries fue similar en hombres y en mujeres (48,3 vs. 48,2%). En la población total estudiada, el valor medio de COP-D fue 1,68±0,52 y el correspondiente valor medio de COP-S fue 2,47±1,08. Aproximadamente, 52,2% de las madres de los adolescentes tenían estudios menores a los de secundaria y 44,5% de los adolescentes vivían en el seno de una familia con nivel económico bajo. De acuerdo a los datos, el sexo, la escolaridad materna, el nivel socioeconómico no se encuentran relacionados con la caries dental en adolescentes. Conclusiones: Nuestros datos muestran que no existe asociación entre el sexo, escolaridad materna, nivel socioeconómico bajo y la caries dental en adolescentes. La caries dental afecta a un porcentaje importante de adolescentes.

Introduction and Objetive: Prevalence of dental caries appears to be increasing, and determinants are not well established. To determine the prevalence of dental caries in adolescents and its association with sex, maternal education and family socioeconomic status. Materials and Methods: This a cross-sectional study of 1.893 adolescent students, age 13 to 18 years. Dental caries was assessed by an intra-oral examination. Logistical regression was used to determine the association between sex, maternal schooling, family socioeconomic status and caries. Decay rate was measured as the number of teeth with decay (C), filled (O), extracted (P), (COP-D) or surfaces (COP-S). Results: Dental caries prevalence was 48,2%. Percentage of caries was similar in boys (48,3% vs. 48,2%) and in girls. In the overall population studied, the mean value of COP-D was 1,68±0,52 and the corresponding mean value of COP-S was 2,47±1,08. Approximately 52,2% of mothers of adolescents had completed High School and 44,5% of adolescents lived in a family with low economic status. According to the data, gender, maternal education and socioeconomic status were not related to dental caries in adolescents. Conclusions: Our data show no association between sex, maternal education, family low socioeconomic status and dental caries in adolescents. Dental caries affects a large percentage of adolescents.

Bullying en alumnos de secundaria. Características generales y factores asociados al riesgo / Bullying in junior high school students. General characteristics and associated risk factors

Introducción. El bullying es una conducta de hostigamiento físico y/o psicológico entre los alumnos en un plantel escolar. En México 25% de los alumnos ha sufrido violencia en sus escuelas. El objetivo de este trabajo fue determinar prevalencia del bullying y explorar las variables asociadas con el riesgo de esta conducta. Métodos. Mediante la resolución de un cuestionario autoaplicable se seleccionaron alumnos de entre la población de una misma secundaria pública, hombres y mujeres, con base en la presencia o la ausencia del rol de víctima, agresor o víctima-agresor. Para el análisis estadístico se aplicaron las pruebas X² y regresión logística. Resultados. De un grupo de 688 alumnos con una media de edad de 13.62 ± 0.96 años se identificaron 20.5% víctimas, 13.1% agresores y 27.4% víctimas-agresores. Los factores de riesgo relevantes para las víctimas fueron: tener algún defecto físico (X² = 21.59, p = 0.000, OR 2.86, IC 95% 1.82-4.50), los padres consideran normal el problema (X² = 30.23, p = 0.000, OR 5.79, IC 95% 2.92-11.47); para los agresores: preferir programas televisivos violentos (X² = 10.38, p = 0.001, OR 2.22, IC 95% 1.36-3.62), tener amigos que pertenezcan a pandillas (X² = 31.78, p = 0.000, OR 4.05, IC 95% 2.45-6.71); para las víctimas-agresores destaca la combinación de factores inherentes a ambos grupos por separado. Conclusiones. El bullying en la escuela es una conducta prevalente y los factores asociados al riesgo son diversos.

Background. Bullying is physical harassment and/or psychological abuse among students at school. In Mexico, up to 25% of the students have experienced violence at school. The objective of this study was to determine the prevalence of bullying and to explore associated risk factors. Methods. Students of both genders from a junior high school were included and selected from the same population, based on the presence of being a victim, aggressor or victim-aggressor role according to self-reported questionnaire responses; X² and logistical regression statistics were applied. Results. Six hundred eighty eight students with a mean age of 13.62 ± 0.96 years were included; 20.5% victims, 13.1% aggressors and 27.4% victims-aggressors were identified. Major risk factors for victims were "have a physical defect" (X² = 21.59, p = 0.000, OR 2.86, 95% CI 1.82-4.50) and "parents considering bullying a normal problem" (X² = 30.23, p = 0.000, OR 5.79, 95% CI 2.92-11.47); for aggressors: "preference for violent television programs" (X² = 10.38, p = 0.001, OR 2.22, 95% CI 1.36-3.62) and "friends who belongs to gangs" (X² = 31.78, p = 0.000, OR 4.05, 95% CI 2.45-6.71); victims-aggressors present a highlighted combination of risks factors from both roles. Conclusions. There is a high prevalence of bullying at school with a variety of associated risk factors.

Association between obesity and asthma in preschool Mexican children.

The elevated prevalence of obesity as well as of asthma in preschool children has prompted investigators to speculate that obesity in childhood might be a causal factor in the development of asthma. The results obtained to date are debatable. We investigated the association between obesity and asthma in 1,160 preschool Mexican children. Diagnosis of asthma was performed using the International Study of Asthma and Allergy in Childhood (ISAAC) questionnaire. The body mass index (BMI) in units of kg/m2 was determined, and children were categorized according to age- and gender-specific criteria, such as normal weight (5th-85th percentile), overweight (> or =85th and <95th percentile), and obesity (> or =95th percentile). Power test for logistic regression model was calculated. We found no association between overweight (adjusted OR = 1.02; 95% CI = 0.66-1.58), obesity (adjusted OR = 0.94; 95% CI = 0.68-1.30), and wheezing during the last year as determined by logistic regression model adjusted. We did not find an association between overweight, obesity, and asthma-associated hospitalizations. Further longitudinal studies are required to provide a better understanding of the relationship between obesity and asthma in preschool children.

Association between family structure, parental smoking, friends who smoke, and smoking behavior in adolescents with asthma.

Recent investigations show that the smoking prevalence among asthmatic adolescents is higher than among healthy adolescents, and the causes that lead these asthmatic adolescents to smoke are unclear. We investigated the association between family structure, parental smoking, smoking friends, and smoking in asthmatic adolescents (n = 6,487). After adjusting for sex and age, logistic regression analyses showed that nonintact family structure, parental smoking, and smoking friends are associated with smoking in adolescents with and without asthma. Asthmatic adolescents who reside in the household of a nonintact family have a 1.90 times greater risk of smoking compared with those who live with both biological parents. It is important that parents who have children with asthma be made aware that the presence of smokers in the home and adolescent fraternization with smoking friends not only favor the worsening of asthma, but also induce the habit of smoking.

Revisión sistemática de la asociación entre sobrepeso, obesidad y enfermedad mental, con énfasis en el trastorno esquizofrénico / Systematic review of the association between overweight, obesity and mental illness with emphasis on the schizophrenic disorder

Introducción: La Organización Mundial de la Salud ha definido la obesidad y el sobrepeso como el “exceso acumulado de grasa corporal, que se presenta por un desequilibrio permanente entre la ingesta alimenticia y el gasto energético” y la Asociación Psiquiátrica de Estados Unidos señala que puede afectar al aparato psíquico. Objetivo: Describir algunas generalidades relacionadas con la obesidad y el sobrepeso y revisar la asociación que puede darse entre estas circunstancias y la enfermedad mental, en general, y la esquizofrenia, en particular, y su influencia en la administración de antipsicóticos atípicos en el peso corporal de estos pacientes. Método: Se efectuó una búsqueda en las bases de datos electrónicas (Pubmed, EBSCOhost y OvidSP), con prioridad en trabajos publicados en la última década y con una estricta metodología científica. Resultado: La incidencia del sobrepeso y la obesidad es mayor en personas con enfermedad mental, en general, y esquizofrenia, en particular, en comparación con la población general. Se señalan como factores de riesgo los polimorfismos genéticos, consumo de antipsicóticos atípicos y una mala y pobre dieta alimenticia. Conclusión: La obesidad, sin lugar a dudas, es un problema de salud pública en varios países, incluido México. Pacientes con trastornos psiquiátricos tienen una tendencia a desarrollar sobrepeso u obesidad...

Introduction: The World Health Organization has defined obesity and overweight as “cumulative excess body fat, which is presented by an imbalance between food intake and energy expenditure”, and the American Psychiatric Association declares that it may also affect the psychic apparatus. Objective: To describe some generalities related to obesity and overweight and to review the partnership that exists between these circumstances and mental illness in general and schizophrenia in particular, as well as the influence of the administration of atypical antipsychotics on the body weight of these patients. Method: A search of electronic databases (Pubmed, EBSCOhost, and OvidSP) was conducted, focusing on papers published in the last decade with strict scientific methodology. Results: Incidence of overweight and obesity is higher in people with mental illness in general and schizophrenia in particular compared to the general population, and risk factors such as genetic polymorphisms, use of atypical antipsychotics, and a poor diet are identified. Conclusion: Obesity is a major public health problem in several countries, including Mexico. Patients with psychiatric disorders have a tendency to develop overweight or obesity...

[Tobacco consumption among high school students. Preliminary results from a survey in Tampico, Tamaulipas, Mexico]. / Consumo de tabaco en alumnos de secundaria. Resultados preliminares de la aplicación de una encuesta estructurada.

BACKGROUND: Tobacco consumption constitutes a public health problem among adolescents. National addiction surveys in Mexico have documented a growing trend in this habit over the years. OBJECTIVE: Describe the prevalence of tobacco consumption among a sample of high school students sample in Tampico, Tamaulipas and identify socio-demographic variables. METHODS: Students enrolled in the 2006-2007 school year attending 31 schools located in this county were surveyed. The sample was probabilistic, stratified and random. Students were the sampling units. We used a standardized questionnaire. RESULTS: 5,060 students were surveyed, 50.99% were female, mean age was 13.5 +/- 1 range 11-17. 66.7% started tobacco consumption between the ages of 13- 14, 28.5% (CI 27.2-29.8) had smoked once in their lives, 17% (CI 15.9-18.5) in the last twelve months and 9% (CI 18.2-9.8) in the last thirty days. A small percentage (7.2%) believed smoking was not dangerous and 1.6% of smokers meet the criteria for nicotine dependence. CONCLUSIONS: We recommend to increase prevention programs targeted at high-risk groups such as adolescents.

Consumo de tabaco en alumnos de secundaria. Resultados preliminares de la aplicación de una encuesta estructurada / Tobacco consumption among high school students. Preliminary results from a survey in Tampico, Tamaulipas, Mexico

Antecedentes: El consumo de tabaco representa un problema de salud entre adolescentes. Las encuestas nacionales de adicciones en México han documentado una tendencia creciente en este hábito a través de los años. Los objetivos de esta investigación fueron describir las prevalencias del consumo de tabaco en una muestra de estudiantes de secundaria en Tampico, Tamaulipas, y determinar algunas variables sociodemográficas. Métodos: Alumnos del ciclo escolar 2006-2007 de las 31 escuelas localizadas en el municipio de Tampico. La muestra fue seleccionada con un método probabilístico, estratificado y aleatorio simple; las unidades muestrales fueron los alumnos. Se utilizó un cuestionario autoaplicable estandarizado. Resultados: De 5060 alumnos encuestados, 50.99% correspondió al sexo femenino, media de edad 13.5±1 años, rango de 11-17, 66.7% inició el consumo entre los 13 y 14 años, 28.5% (IC=27.2- 29.8) había fumado alguna vez en su vida, 17% (IC=15.9-18.5) en los últimos 12 meses y 9% (IC=8.2-9.8) en los últimos 30 días, 7.2% de la muestra consideró que no es peligroso fumar y 1.6% de los fumadores ya reúne criterios de dependencia a la nicotina. Conclusiones: Es recomendable incrementar los procesos de prevención dirigidos a grupos de alto riesgo como los adolescentes.

BACKGROUND: Tobacco consumption constitutes a public health problem among adolescents. National addiction surveys in Mexico have documented a growing trend in this habit over the years. OBJECTIVE: Describe the prevalence of tobacco consumption among a sample of high school students sample in Tampico, Tamaulipas and identify socio-demographic variables. METHODS: Students enrolled in the 2006-2007 school year attending 31 schools located in this county were surveyed. The sample was probabilistic, stratified and random. Students were the sampling units. We used a standardized questionnaire. RESULTS: 5,060 students were surveyed, 50.99% were female, mean age was 13.5 +/- 1 range 11-17. 66.7% started tobacco consumption between the ages of 13- 14, 28.5% (CI 27.2-29.8) had smoked once in their lives, 17% (CI 15.9-18.5) in the last twelve months and 9% (CI 18.2-9.8) in the last thirty days. A small percentage (7.2%) believed smoking was not dangerous and 1.6% of smokers meet the criteria for nicotine dependence. CONCLUSIONS: We recommend to increase prevention programs targeted at high-risk groups such as adolescents.

[Association among familial atopy, smoking (passive and active), allergic rhinitis, labor environment and adult asthma]. / Asociación entre atopia familiar, tabaquismo (pasivo o activo), rinitis alérgica, ambiente laboral y asma del adulto.

BACKGROUND: Studies of association among parental atopy, tobacco exposure (passive or active) and adult asthma have provided conflicting results. OBJECTIVE: To determine the relationship among parental atopy, smoking, exposure to tobacco smoke, allergic rhinitis, work environment and asthma in adults. MATERIAL AND METHODS: In a population of 329,219 inhabitants of a geographically defined area in Northeastern of Mexico, we identified 791 cases of asthma. The patients were 20 to 54 years old, and were divided in three groups: with asthma in remission (263 patients), with symptoms since childhood (270 patients), and with asthma onset in adult age (258 patients). We included 793 randomly selected control subjects. Information on family atopy, passive and active smoking, allergic rhinitis and workplace conditions were collected by using a questionnaire. RESULTS: Parental atopy history, active smoking, allergic rhinitis and pollution in the workplace induce asthma symptoms. Exposure to smoking is a risk factor of persistence of asthma symptoms in adults (OR = 1.33; IC 95%, 1.07-1.66), but no of their development (OR = 1.10; IC 95%, 0.87-1.39). Working in a polluted environment had not significance in remission of asthma (OR =1.32; IC 95%, 0.95-1.85). CONCLUSIONS: Results support hypothesis that family atopy, active smoke, allergic rhinitis and pollution favor the persistence of asthma symptoms and increase the risk of asthma in adults.

Effect of allergic rhinitis, asthma and rhinobronchitis on dental malocclusion in adolescents.

OBJECTIVE: To determine the effect of allergic rhinitis (AR), asthma, rhinobronchitis (ARB) on dental malocclusion in adolescents. METHOD: This is a cross-sectional, observational, retrospective and sample descriptive study of 2556 adolescents aged 14-20 years. AR, asthma and ARB were defined by self-reported. Malocclusion was identified by direct physical examination. Data were analyzed by the SPSS 10.0 version statistical program, adjusted OR value (Odds Ratio) using a logistic regression model was determined, ji square was calculated, an 95% Confidence Intervals was used. Equal or smaller values of p < 0.05 were considered statistically significant. RESULTS: Percentage of male sex was 42.7% and female 57.3%. Prevalence of AR was 39.3%, asthma 6.9%, ARB 4.5%, and malocclusion, 37.2%. A higher percentage of malocclusion was found in adolescents with asthma (48.3% vs 36.3%). For the groups of asthma (adjusted OR = 1.78; p = 0.017) and RA (fit OR = 1.20, p = 0.032) were inferred that these pathologies to favor the malocclusion in adolescents, this did not happen with the group of RBA (OR fit = 0.81; p = 0.511). The prevalence of open bite was greater in adolescents with asthma (44.3% vs. 31.3%). For the asthma group (OR fit = 1.66; p = 0.037) we deduced that the development of anterior open bite is favored, this was not thus for the groups of RBA (OR fit = 1.01; p = 0.956) and RA (OR fit = 1.17; p = 0.071). Nor AR, asthma orARB have any effect on posterior open bite. CONCLUSIONS: Asthma is related to malocclusion in adolescents, particularly to anterior open bite. AR and ARB do not favor the development of malocclusion.

Meconium aspiration syndrome, parental atopy and asthma symptoms in children under two years old.

OBJECTIVE: To determine the association among meconium aspiration syndrome, parental atopy and asthma symptoms in children younger than two years. MATERIAL AND METHODS: One hundred thirty six children who had suffered meconium aspiration syndrome were followed from birth to they were two years old. CONTROL GROUP included 136 healthy children without meconium aspiration syndrome. RESULTS: Group of children with meconium aspiration syndrome: The average hospital stay in neonatal intensive care unit was of 5.91 +/- 4.44 days and were given 65.5 +/- 16.6 hours of oxygen. Prevalence of asthma symptoms during the last year was of 41.2%; 35.7% had family history of allergies (p = NS). The average age at the beginning of asthma symptoms was of 12.64 +/- 6.96 months; 78.6% of children were male. CONTROL GROUP: 30.9% had wheezing episodes during the last 12 months; 28.6% were male; 38.1% had family history of allergies (p = NS). The average age at the beginning of asthma symptoms was of 15.57 +/- 6.05 months. CONCLUSION: Aspiration of meconium seems to be an important risk factor of the early beginning of asthma symptoms in children younger than two years. Data shows that the prevalence of asthma symptoms was higher in case group than in control group. Asthma symptoms risk increases in children with aspiration meconium syndrome and family background of allergies.

[Associations between family history of allergy, exposure to tobacco smoke, active smoking, obesity, and asthma in adolescents]. / Asociación entre atopia familiar, exposición a humo de tabaco, tabaquismo activo, obesidad y asma en adolescentes.

OBJECTIVE: The relationships between asthma in adolescents and various environmental and social exposures needs to be clarified. The aim of this study was to determine the association between family history of allergy, passive or active tobacco smoking, obesity, and asthma in adolescents. SUBJECTS AND METHODS: A population-based case-control study was carried out. A random sample of 4003 students aged 13 to 18 years old was selected from secondary and preparatory schools in an urban area in northeastern Mexico. Data was gathered in physical examinations and with a questionnaire administered by trained staff. Two study groups were formed: a group of 253 adolescents with asthma and a control group of students without asthma. RESULTS: Variables associated with asthma were family history of allergy (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.28-2.06), passive smoking (OR, 1.53; 95% CI, 1.18-1.99), and obesity (OR, 1.96; 95% CI, 1.45-2.65). Female gender and active smoking were unrelated to asthma. The percentage of obese adolescents was higher in the group of asthmatics (18.2%) than in the control group (12.8%). CONCLUSIONS: Family history of allergy, passive tobacco smoking, and obesity seem to be the main risk factors for the development of asthma in adolescents. The relationship of active smoking and asthma requires further study.

Asociación entre atopia familiar, exposición a humo de tabaco, tabaquismo activo, obesidad y asma en adolescentes / Associations between family history of allergy, exposure to tobacco smoke, active smoking, obesity, and asthma in adolescents

Objetivo: Es necesario aclarar la relación entre varias exposiciones ambientales y sociales y el asma en la población adolescente. El objetivo de este estudio ha sido determinar la asociación entre la atopia familiar, la inhalación pasiva o activa de humo de tabaco, la obesidad y el asma en adolescentes. Sujetos y métodos: Se ha realizado un estudio de casos y controles basado en un estudio de población. Se encuestó a 4.003 estudiantes de 13 a 18 años de edad, seleccionados aleatoriamente, que acudían a escuelas de secundaria y preparatoria de un área urbana del nordeste de México. La información sobre las variables estudiadas se recabó a través de la exploración física y de la aplicación de un cuestionario por parte de personal capacitado. Se formaron 2 grupos de estudio: uno compuesto por 253 adolescentes con asma, y un grupo control formado por estudiantes sin asma. Resultados: De los resultados se desprende que la atopia familiar (odds ratio [OR] = 1,62; intervalo de confianza [IC] del 95%, 1,28-2,06), la exposición involuntaria al humo de tabaco (OR = 1,53; IC del 95%, 1,18-1,99) y la obesidad (OR = 1,96; IC del 95%, 1,45-2,65) se encuentran asociadas con el asma en adolescentes. El sexo femenino y el tabaquismo activo no se relacionan con dicha enfermedad. El porcentaje de obesos fue mayor en el grupo de adolescentes con asma (18,2%) que en el grupo control (12,8%). Conclusiones: La atopia familiar, la inhalación involuntaria de humo de tabaco y la obesidad parecen ser los factores de riesgo más importantes para el desarrollo de asma en adolescentes. La relación entre tabaquismo activo y asma requiere una mejor evaluación

Objective: The relationships between asthma in adolescents and various environmental and social exposures needs to be clarified. The aim of this study was to determine the association between family history of allergy, passive or active tobacco smoking, obesity, and asthma in adolescents. Subjects and methods: A population­based case­control study was carried out. A random sample of 4003 students aged 13 to 18 years old was selected from secondary and preparatory schools in an urban area in northeastern Mexico. Data was gathered in physical examinations and with a questionnaire administered by trained staff. Two study groups were formed: a group of 253 adolescents with asthma and a control group of students without asthma. Results: Variables associated with asthma were family history of allergy (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.28-2.06), passive smoking (OR, 1.53; 95% CI, 1.18-1.99), and obesity (OR, 1.96; 95% CI, 1.45-2.65). Female gender and active smoking were unrelated to asthma. The percentage of obese adolescents was higher in the group of asthmatics (18.2%) than in the control group (12.8%). Conclusions: Family history of allergy, passive tobacco smoking, and obesity seem to be the main risk factors for the development of asthma in adolescents. The relationship of active smoking and asthma requires further study