Cytokine profile as diagnostic and prognostic factor in neonatal sepsis.

Antecedents: The serum levels of some cytokines can be useful in the diagnosis of neonatal sepsis; the prognostic value of a cytokine profile has not, to our knowledge, been explored in this disease. Objective: The objective of this study is to evaluate the diagnostic value of the serum levels of cytokines IL-1, -2, -4, -5, -6, -7, -8, -10, -12, -13, and -17, TNF, IFNγ, G-CSF, GM-CSF, MCP1, and MIP1ß in neonates with high risk of developing sepsis. Methods: Sepsis was evaluated in 96 high-risk neonates. We assessed cytokine levels on hospital admission and during or not during sepsis. Results: Fifty (52%) presented sepsis (26 early and 24 late). Sepsis was associated with high levels of IL-6, IL-10, G-CSF, and MCP1 and low levels of IFNγ, early sepsis with high levels of IL-6 and G-CSF, severe sepsis with high levels of IL-6 and IL-10, while deaths or sequelae was associated with low levels of IL-4, IL-12, IFNγ, and high levels of GM-CSF. IL-6 values of ≥40.1 pg/mL were associated with the development of any type of sepsis (relative risk [RR]: 1.70; 95% confidence interval [95% CI]: 1.18-2.24; p = .01), while IL-6 values of ≥44.9 pg/mL were associated with early sepsis (RR: 1.29; 95% CI: 1.29-4.56; p = .01). Conclusion: In neonates with high risk for the development of sepsis, there is an association between levels of IL-6, IL-10, and G-SCF and the disease development/outcome.

[High birth weight as a risk factor for childhood obesity]. / El peso elevado al nacer como factor de riesgo para obesidad infantil.

OBJECTIVE: To investigate the association between high birth weight (HBW) and childhood obesity (CO). MATERIALS AND METHODS: A case-control study in 322 children of 1st and 2nd grade elementary school was carried out. Somatometric determinations were effected to document childhood obesity (cases) as established by The Norma Oficial Mexicana, and normal or low weight. The risk factor of HBW (high birth weight more than 3900 g) was assessed. Odds ratio (OR) was determined and variables between cases and controls were assessed by chi 2 and t tests. RESULTS: There were not clinically significative differences between cases (n = 59) and controls (n = 263) concerning sex, age, height, and weight at birth. There were differences as to present weight (35.5 +/- 8 vs 25.2 +/- 5 kg. p < 0.001), Quetelet index (22.1 +/- 4 vs 16.2 +/- 2 kg/m2, p < 0.001) and measurements of cutaneous folding between cases and controls, respectively. History of HBW was present in 20 cases (33%) and 44 controls (17%). History of HBW was associated to CO [OR: 2.55; (Confidence interval [CI] 95% 1.4-4.8); p = 0.003]. No history of HBW was protective against CO [OR: 0.79; (CI 95% 0.7-0.9); p = 0.003]. CONCLUSIONS: HBW is risk factor to CO.

Limitantes en la utilización del servicio de Medicina Preventiva para la DOC / Restrictions in the use of the Preventive Medicine services for the DOC

Introducción: El Cáncer Cervicouterino (CaCu) es un grave problema de salud pública, con diferencias regionales en su ocurrencia, 80% de los casos se presentan en los países en vías de desarrollo. Objetivo: Determinar los factores que limitan a las mujeres para no acudir a la realización de la detección oportuna de CaCu (DOC). Material y métodos: Se realizó un estudio observacional transversal, en la Unidad de Medicina Familiar N° 4 del Instituto Mexicano del Seguro Social en Zacatecas; mediante la aplicación de encuestas. Se incluyeron: mujeres derechohabientes de 12 a 49 años, con vida sexual activa. Resultados: Se realizaron 100 entrevistas; el promedio de edad de las mujeres fue 28 años desviación estándar de 8.5 y un rango de 33 años de edad; 60% se realizó la DOC. El número de embarazos (OR=24.6; 95% IC 5.05-162.6), la edad (OR = 13.35; 95% IC 4.57-40.5), la escolaridad (OR=1.85; 95% IC 0.68-4.87), el inicio de vida sexual activa (OR=1.42: 95% IC 0.59-3.43) mostraron asociación para no acudir a la detección. Discusión: La cobertura en la población blanco (16 a 26 años) no es la deseable ya que la mayor parte de los displasias son diagnosticados en mujeres > 20 años. Conclusiones: Es imperativo promover la importancia de este estudio en la población femenina en general

Introduction: The frequency of cervicouterine cancer (CaCu) widely accordingto the several etnicas forms worldwide, in some countries of continuous Latin American being the first cause in the female population. Objective: To identify factors that influence refusing opportune detection of cancer cervicouterine. Material and methods: Across secctional, observational study in the Familiar Medicine Unit No 4 of the of Social Security Mexican Institute at Zacatecas by the aplication of surveys in medicare women, during 2000. Incluyed in study women rightful claimants of 15 to 49 years whit active sexual life were interviewed with a questionnaire to evaluate their personal attitudes toward DOC. Results: A total of 100 individuals was studied, an average of the women of 28 years with a rank of 33 years and one desviation to estandar 8.5, the 60% made the Opportuned Detection of Cancer (DOC). Risk factors were (OR=24.6; Cl 95% 5.05 to 162.6), the number of pregnancies(OR=24.6; Cl 95% 5.05 to 162.6), the age (OR= 13.35; Cl 95% 4.57-40.5), the school grade (OR=1.85; 095% 0.68-4.87), the beginning of active sexual life (OR=1.42: Cl 95% 0.59-3.43) showed association among the attitudes that influence refusing to attended to DOC. Conclusions: Among women who don't attendat DOC have more weight personal attitude toward DOC have more than knowledge on the subject.