Psychosocial Factors Associated with Self-Management in Patients with Diabetes.

Despite the significant advances in research on diabetes, relatively few researchers have examined the theoretical and empirical usefulness of explanatory models that contribute to self-management of the disease. In response to the theoretical and empirical approaches related to this topic, the objective of this research was to assess a hypothetical model to explain self-management behavior in patients with type II diabetes through structural equation modeling in a population of users of the services of the State Health Department of Tamaulipas, Mexico. The study used a cross-sectional and explanatory design. The sample was intentional. A total of 183 patients with a diabetes diagnosis completed a sociodemographic data questionnaire, the Partners in Health Scale, the Duke-UNC-11, the Family Apgar, the Self-Efficacy Scale, the Personal Health Questionnaire and the Physical Activity Scale. The results indicated that the hypothetical model was improved by excluding the exercise variable. The appropriate model was used to determine the effects of depression, social support, self-efficacy, family functioning, years of formal education and years with a diagnosis on self-management. The goodness-of-fit indices (GFIs) were good, i.e., χ2/gl = 0.89 (p = 0.529), root mean square error of approximation (RMSEA) = 0.000, and comparative fit index (CFI) = 1.000, with an acceptable degree of parsimony (PNFI = 0.409 and PGFI = 317). The model explained 33.6% of the variance. Therefore, this model represents an important advance in knowledge concerning self-management and provides empirical and theoretical evidence, particularly for the Mexican or Latino population.

[Physical inactivity in young people during home confinement due to COVID-19]. / Inactividad física en jóvenes durante el confinamiento en casa debido a la COVID-19.

Background: Physical inactivity is a highly prevalent condition in the world and has been associated with increased susceptibility to develop comorbidities and present with severe respiratory distress syndrome due to COVID-19. Objective: To identify the factors present in the family environment and the personal reasons associated with physical inactivity in young people during confinement at home due to COVID-19. Material and methods: A cross-sectional study analyzed data from 1,326 young people, ages 15 - 18. To collect information, a questionnaire was constructed using the Google Forms tool and distributed through the WhatsApp application and email to collect the information. Results: The prevalence of physical inactivity was 43.4%. Approximately 24.4% were overweight, and 8.8% were obese. Near 43.0% of young people reported living in an environment with a dysfunctional family. The multivariate logistic regression analysis showed that suffering from obesity, does not have space at home, or devices to exercise and present a change in emotions, are related to the physical inactivity of young people during confinement at home due to the COVID-19 pandemic. Conclusions: It is important to promote a harmonious environment within the family and the personal development of a healthy lifestyle, during the period of application of the contingency plan due to the presence of a pandemic, in order to maintain a better healthy physical and mental state.

Introducción: la inactividad física es una condición altamente prevalente en el mundo y ha sido asociada con una mayor susceptibilidad para desarrollar comorbilidades y presentar síndrome de distrés respiratorio agudo por COVID-19. Objetivo: identificar los factores presentes en el entorno familiar y los motivos personales asociados a la inactividad física en jóvenes durante el confinamiento en casa debido a la COVID-19. Material y métodos: mediante un estudio transversal se analizaron los datos de 1326 jóvenes de 15 a 18 años. Para la recogida de la información se construyó un cuestionario mediante la herramienta de Google Forms y se distribuyó a través de la aplicación de WhatsApp y por correo electrónico. Resultados: la prevalencia de inactividad física fue del 43.4%. Aproximadamente, el 24.4% sufría de sobrepeso y el 8.8% de obesidad. El 42.8% de los jóvenes declaró vivir en el ambiente de una familia disfuncional. El análisis de regresión logística multivariado mostró que tener obesidad, no contar con espacio en casa, ni aparatos para realizar ejercicio y presentar un cambio en las emociones, se relaciona con la inactividad física de los jóvenes durante el confinamiento en casa. Conclusión: es importante promover un ambiente armónico en el seno familiar, así como el desarrollo personal de un estilo de vida saludable durante el periodo de aplicación del plan de contingencia debido a la presencia de una pandemia, con la finalidad de mantener un mejor estado físico y mental saludable.

Cost to ambulatory care for schizophrenia in Family Medicine / Costo de la atención ambulatoria para esquizofrenia en Medicina Familiar

Background: The groups related to ambulatory care (GRAA, according to its initials in Spanish) are a classification of clinical diagnoses performed on patients receiving medical care in primary care; it is a comprehensive treatment for one year. Objective: To determine the costs of ambulatory care and sociodemographic characteristics of patients with schizophrenia attended in Family Medicine (FM). Material and methods: Cross-sectional study which included adult patients with complete electronic clinical record, who had confirmed diagnosis of schizophrenia and received medical attention in a FM unit from January to December 2017. The variables were: age, sex, sociodemographic data, drug addiction and employment status. To determine the annual cost of schizophrenia based on GRAA, the economic medical card was applied, which includes family medicine consultations, inter-consultations, medications, medical supplies, and the time of use of installed capacity for one year. Results: Out of all patients, 56.2% were men (n = 172). Age was 48.42 ± 14.4 years. Of women, 21.2% were married and 21.2% homemakers, 4.2% smokers, and 1.3% alcohol drinkers. Of men, 30.4% were unmarried, 15% unemployed, 13.1% smokers, and 6.9% alcohol drinkers. The total annual cost of schizophrenia for FGRAA-MH for men was $ 7 613 236.00. Conclusions: The use of FGRAA-MH revealed the total annual cost for the care of schizophrenia in the medical unit, which provides important information for better understanding the magnitude of this health problem in that area, and will improve planning and economic medical management.

Introducción: los grupos relacionados con la atención ambulatoria (GRAA) son una clasificación de diagnósticos clínicos que reciben los pacientes atendidos en consultorios de primer nivel; se trata de un tratamiento integral por un año. Objetivo: determinar los costos de atención ambulatoria y las características sociodemográficas de pacientes con esquizofrenia atendidos en Medicina Familiar (MF). Material y métodos: estudio transversal que incluyó pacientes adultos con expediente clínico electrónico completo y vigente, los cuales tuvieron diagnóstico de esquizofrenia y fueron atendidos en una unidad de MF de enero a diciembre de 2017. Las variables fueron: edad, sexo, datos sociodemográficos, toxicomanías y situación laboral. Para determinar el costo anual de la esquizofrenia con base en los GRAA se aplicó la cédula médico-económica, que incluye consultas de MF, interconsultas, medicamentos, insumos médicos y tiempos de uso de capacidad instalada durante un año. Resultados: 56.2% de los pacientes fueron hombres (n = 172). La edad fue 48.42 ± 14.4 años. De las mujeres, 21.2% eran casadas y 21.2% dedicadas al hogar; 4.2% fumaba y 1.3% consumía alcohol. De los hombres, 30.4% eran solteros, 15% desempleados, 13.1% fumadores y 6.9% consumían alcohol. El costo anual total de la esquizofrenia por FGRAA-SM para los hombres fue de $7 613 236.00. Conclusiones: el uso de los FGRAA-SM reveló el costo anual total para la atención de la esquizofrenia en la unidad médica, lo cual brinda información importante para conocer mejor la magnitud del problema de salud en la zona y permitirá mejorar la planeación y la gestión médico-económica.

The Frequency and Type of K-RAS Mutations in Mexican Patients With Colorectal Cancer: A National Study.

BACKGROUND: Current metastatic colorectal cancer (mCRC) therapy uses monoclonal antibodies against the epidermal growth factor receptor. This treatment is only useful in the absence of K-RAS gene mutations; therefore the study of such mutations is part of a personalized treatment. The aim of this work is to determine the frequency and type of the most common K-RAS mutations in Mexican patients with metastatic disease by nucleotide sequencing. PATIENTS AND METHODS: We studied 888 patients with mCRC from different regions of Mexico. The presence of mutations in exon 2, codons 12 and 13, of the K-RAS gene was determined by nucleotide sequencing. RESULTS: Patients exhibited K-RAS gene mutations in 35% (310/888) of cases. Mutation frequency of codons 12 and 13 was 71% (221/310) and 29% (89/310), respectively. The most common mutation (45.7%) in codon 12 was c.35G>A (p.G12D), whereas the one in codon 13 was c.38G>A (p.G13D) (78.7%). DISCUSSION: Given the frequency of K-RAS mutations in Mexicans, making a genetic study before deciding to treat mCRC patients with monoclonal antibodies is indispensable.

Human papillomavirus infection is principally found with cervical intra-epithelial neoplasia-III in Toluca, State of Mexico.

INTRODUCTION: To describe the prevalence of human papillomavirus infection (HPV) in cases of cervical intra-epithelial neoplasia (CIN), micro-invasive carcinoma and invasive carcinoma in Toluca, State of Mexico. MATERIALS AND METHODS: Cross-sectional study analysing slides with the diagnosis of CIN I to invasive carcinoma for one year and reporting the presence of HPV; also identifying these cervical-uterine cancer stages noted during one semester in the registery of histopathological studies, at the Department of Pathology, General Regional Hospital 220, Instituto Mexicano del Seguro Social (IMSS). RESULTS: In one year, from a total of 5755 studies, 731 (13%) were of cervical-uterine cancer, 112 (16%) of these were positive for some stage of cervical cancer and 46.43% had HPV infection. In one semester, 2918 histopathological studies were done, 341 (11.68%) of these were cervix uterine biopsies, colposcopies and hysterectomies. 62 women (18.18%) diagnosed with CIN II-III, carcinoma in situ (CIS), micro-invasive carcinoma or invasive carcinoma and finding HPV infection in 51.92% of total cases. CONCLUSIONS: The prevalence of HPV was higher than that reported in developed world and CIN II-III are the most common stages in Toluca, State of Mexico.

Manejo conservador de la enfermedad periodontal crónica en presencia de lesiones vesiculobulosas: reporte de dos casos de pénfigo vulgar / Conservative management of chronic periodontal disease in the presence of vesiculobullous lesions: report of two cases of pemphigus vulgaris

Se reportan dos casos clínicos de pénfigo vulgar, confirmados a través del examen histopatológico, con localización en la región mucogingival de cavidad bucal, en pacientes con presencia de enfermedad periodontal crónica moderada avanzada. El tratamiento periodontal a emplearse en pacientes con lesiones bucales vesiculobullosas como el pénfigo vulgar, puede ser considerado conservador, evitando así la consecuente descamación epitelial de la superficie mucosa y la posterior ulceración de la misma al realizarse tratamientos orientados a las periodontopatías