An evaluation of the present status of quality assurance program implementation in digital mammography facilities in a developing country.

Quality assurance program (QAP) implementation in mammography is a key aspect to guarantee the acquisition of -quality images and, thus, an opportune diagnosis of breast cancer. A QAP involves planned and systematic actions, such as quality control (QC) tests that will produce consistently high-quality images, while considering low radiation exposure for stakeholders. Currently, there is poor evidence of the current QAP implementation status in developing countries, particularly in Latin America. In this work, 47 Mexican digital mammography facilities were evaluated in terms of their QAP implementation's current status during the period October 2021 to April 2022. A survey of three key indicators of compliance/non-compliance with QAPs was carried out. Also, 17 QC test parameters were assessed in all mammography units according to an international framework. The Kruskal-Wallis test, McNemar test, and Spearman correlation were used to identify the significant correlation between the QC tests and QAP indicators. Statistical analysis showed a significant positive correlation between the QAP indicators and QC parameters that were evaluated, especially associated with an increase in image quality. Almost 90% of the facilities evaluated failed in some QAP indicators, and only 44.68% of the facilities had an updated and current QAP implemented. Successful QAP implementation directly impacted on the QC mammography test results, particularly in terms of image quality, thus conditioning a successful mammography acquisition chain. The results obtained in this work suggest that better regulations need to be implemented to guarantee QAP surveillance, which could mean an increase in opportune diagnosis and management of breast cancer, with improved radiological safety for patients and occupational exposure personnel.

Self-reported prevalence and risk factors associated with food hypersensitivity in Mexican young adults.

BACKGROUND: Food hypersensitivity (FH) is defined as any unfavorable reaction after the ingestion, contact, or inhalation of a food. Few FH prevalence studies have been performed in the Mexican adult population. OBJECTIVE: To determine the prevalence of self-reported FH and probable food allergy (FA) among a sample of Mexican young adults and to determine the most commonly involved foods, associated symptoms, and risk factors. METHODS: We designed an observational, cross-sectional study in which 1,253 young adults (aged 18-25 years) born in the State of Mexico answered a questionnaire concerning FH. We obtained information on personal and familial histories of allergic diseases, the involved foods, and the subsequent adverse reactions to their consumption. RESULTS: The prevalence of FH was 30.1% and was significantly higher in women than in men (P < .001). The prevalence of probable FA was 5.9% and was also higher in women (P = .02). Gastrointestinal symptoms were reported in 83.1% of FH cases, whereas cutaneous symptoms and oral allergy syndrome were reported in FA cases. The food groups most associated with FH were dairy products (13.2%), vegetables (10.0%), and fruits (8.0%). The food groups most associated with FA were fruits (3.0%) and seafood (1.8%). Female sex, personal history of allergic diseases, maternal history of atopic dermatitis, and parental history of urticaria were significantly associated (P < .05) with the presence of FH. CONCLUSION: FH in young adults might be more common than previously thought, especially in women. However, further studies are needed to confirm this situation in the Mexican population.

Hydrogels based on poly(ethylene glycol) as scaffolds for tissue engineering application: biocompatibility assessment and effect of the sterilization process.

Hydrogels are suitable materials to promote cell proliferation and tissue support because of their hydrophilic nature, porous structure and sticky properties. However, hydrogel synthesis involves the addition of additives that can increase the risk of inducing cytotoxicity. Sterilization is a critical process for hydrogel clinical use as a proper scaffold for tissue engineering. In this study, poly(ethylene glycol) (PEG), poly(ethylene glycol)-chitosan (PEG-CH) and multi-arm PEG hydrogels were synthesized by free radical polymerization and sterilized by gamma irradiation or disinfected using 70 % ethanol. The biocompatibility assessment in human fibroblasts and hemocompatibility studies (hemolysis, platelet aggregation, morphology of mononuclear cells and viability) in peripheral blood from healthy volunteers (ex vivo), were performed. The sterilization or disinfection effect on hydrogel structures was evaluated by FT-IR spectroscopy. Results indicated that hydrogels do not induce any damage to fibroblasts, erythrocytes, platelets or mononuclear cells. Moreover, there was no significant difference in the biocompatibility after the sterilization or disinfection treatment. However, after gamma irradiation, several IR spectroscopic bands were shifted to higher or lower energies with different intensity in all hydrogels. In particular, several bands associated to carboxyl or hydroxyl groups were slightly shifted, possibly associated to scission reactions. The disinfection treatment (70 % ethanol) and γ-irradiation at 13.83 ± 0.7 kGy did not induce morphological damages and yielded sterile and biocompatible PEG hydrogels potentially useful for clinical applications.

[Self-reported prevalence of fructan food hypersensitivity in university students from the State of Mexico]. / Prevalencia de hipersensibilidad alimentaria a fructanos en estudiantes universitarios del Estado de México.

OBJECTIVE: To determine the self-reported prevalence of fructans food hypersensitivity in a sample of Mexican university students and to investigate the most frequent symptoms, the related foods involved, risk factors and gastrointestinal function status. METHODS: A cross-sectional, descriptive study was conducted in a convenience sample of 412 university students aged from 18 to 35 years. Data were collected about their personal and family history of gastrointestinal diseases, the presence of symptoms after consumption of certain foods, and the severity of their symptoms. RESULTS: The prevalence of fructans food hypersensitivity was 31.1 %; it was higher in women than in men. The most frequent gastrointestinal symptoms were bloating and flatulence. The most frequent extra-intestinal symptoms were fatigue and stress. The food groups related to the occurrence of symptoms were legumes, vegetables, and fruits. Significant association was found between female sex, personal and family history of gastrointestinal diseases and the presence of fructans food hypersensitivity (p < 0.05). Most individuals with fructans food hypersensitivity had mild gastrointestinal dysfunction (67.2 %). CONCLUSIONS: FFH is a common condition, it was found in one third of university students and occurs mainly in women. More research and diffusion about this pathology is required.

OBJECTIVO: Determinar la prevalencia por autorreporte de hipersensibilidad alimentaria a fructanos en una muestra de estudiantes universitarios e investigar los síntomas más frecuentes, los alimentos relacionados, los factores de riesgo y su función gastrointestinal. MÉTODOS: Se realizó un estudio transversal, descriptivo, en una muestra elegida por conveniencia de 412 estudiantes universitarios, de 18 a 35 años. Se recopilaron datos sobre antecedentes personales y familiares de enfermedades gastrointestinales, síntomas secundarios al consumo de ciertos alimentos y severidad de sus síntomas. RESULTADOS: La prevalencia de hipersensibilidad alimentaria a fructanos fue de 31.1 %, mayor en mujeres que en hombres. Los síntomas gastrointestinales más frecuentes fueron distensión y flatulencias y los extraintestinales, fatiga y estrés. Los grupos de alimentos relacionados con la aparición de síntomas fueron leguminosas, vegetales y frutas. Se encontró asociación significativa entre el sexo femenino, la historia personal y familiar de enfermedades gastrointestinales y la presencia de hipersensibilidad alimentaria a fructanos (p < 0.05). La mayoría de los individuos con hipersensibilidad alimentaria a fructanos tuvieron una disfunción gastrointestinal leve (67.2 %). CONCLUSIONES: La hipersensibilidad alimentaria a fructanos es común; se encontró en un tercio de los estudiantes universitarios, principalmente en mujeres. Se necesita mayor investigación y difusión sobre esta patología.

Normalization of blood clotting characteristics using prothrombin complex concentrate, fibrinogen and FXIII in an albumin based fluid: experimental studies in thromboelastometry.

BACKGROUND: Colloid fluids supplemented with adequate combinations of coagulation factor concentrates with the capability to restore coagulation could be a desirable future treatment component in massive transfusion. METHODS: Starting from a coagulation factor and blood cell-free albumin solution we added Prothrombin Complex Concentrate, Fibrinogen Concentrate and Factor XIII in different combinations and concentrations to analyze their properties to restore thromboelastometry parameters without the use of plasma. Further analysis under the presence of platelets was performed for comparability to whole blood conditions. RESULTS: Albumin solutions enriched with Fibrinogen Concentrate, Factor XIII and Prothrombin Complex Concentrate at optimized concentrations show restoring coagulation potential. Prothrombin Complex Concentrate showed sufficient thrombin formation for inducing fibrinogen polymerization. The combination of Prothrombin Complex Concentrate and Fibrinogen Concentrate led to the formation of a stable in vitro fibrin clot. Fibrinogen and Factor XIII showed excellent capacity to improve fibrin clot firmness expressed as Amplitude at 10 min and Maximal Clot Firmness. Fibrinogen alone, or in combination with Factor XIII, was able to restore normal Amplitude at 10 min and Maximal Clot Firmness values. In the presence of platelets, the thromboelastometry surrogate parameter for thrombin generation (Clotting Time) improves and normalizes when compared to whole blood. CONCLUSIONS: Combinations of coagulation factor concentrates suspended in albumin solutions can restore thromboelastometry parameters in the absence of plasma. This kind of artificial colloid fluids with coagulation-restoring characteristics might offer new treatment alternatives for massive transfusion. TRIAL REGISTRATION: Study registered at the institutional ethic committee "Institut de Recerca, Hospital Santa Creu i Sant Pau, with protocol number IIBSP-CFC-2013-165.

[Difficulties in the classification of metabolic syndrome. The example of adolescents in Mexico]. / Dificultades en la clasificación del síndrome metabólico. El ejemplode los adolescentes en México.

OBJECTIVE: Determine the difference between the National Cholesterol Education Program Adult Treatment Panel (ATPIII) definition of the diagnosis of metabolic syndrome (MS) in Mexican adolescents and that by the International Diabetes Federation (IDF). MATERIAL AND METHODS: We conducted a cross-sectional study of 575 adolescents aged 14 to 16 years using the student's t test, chi square and Spearman correlation. RESULTS: The prevalence of MS was higher by ATPIII (18.6%) than by IDF (8.2%) (p <0.001) and there was a concordance of 41.1%. CONCLUSIONS: There is a statistical difference in the prevalence of MS depending on the definition.

Genotyping of Human Papillomavirus in Cervical Squamous Intraepithelial Lesions in Mexican Women.

Approximately 40 genotypes of the human papillomavirus (HPV) have been identified in cervical mucosa. In particular, HPV-16 and HPV-18 have been associated with cervical neoplasia. Squamous intraepithelial lesions (SILs) are precursors of cervical cancer. This study aimed to identify the HPV by genotype in SILs using a linear array genotyping test in a population in Mexico. We performed a cross-sectional study of 129 female patients with or without SILs, as determined by colposcopy, who completed a risk factor questionnaire. Cervical swab samples were obtained and genotyped using a Linear Array HPV Genotyping assay. Forty-nine (37.98%) samples were positive for HPV, and 24 genotypes were identified among these samples. The most common genotype was HPV-16. Twelve genotypes were found in both high- and low-grade SILs (HPV-6, 16, 31, 39, 51, 52, 53, 58, 59, 61, 67, and 84), of which seven were high-risk SILs (HPV-16, 31, 39, 51, 52, 58, and 59). Among the populations studied, the most frequent genotype was HPV-16, multiple infections were found, and four patients without injury tested positive for HPV.

Self-reported prevalence of clinical features of allergy to nuts and seeds, and seafood in university students.

BACKGROUND: In developing countries, there is a lack of epidemiological information related to food hypersensitivity, including nuts and seafood. OBJECTIVE: The aim was to determine the prevalence of allergic reactions and clinical manifestations associated with the consumption of nuts and seeds or seafood in university students. METHODS: We designed an observational cross-sectional study. A structured questionnaire was applied to Mexican university students to identify allergic reactions associated with the consumption of nuts and seeds, and seafood. RESULTS: A sample of 1,200 students was included; mean age of 19.7 ± 1.7 years. Prevalence of symptoms associated with the consumption of nuts and seeds, and seafood were 2.8% (33 of 1,200) and 3.5% (42 of 1,200) respectively. The main clinical manifestations were abdominal pain (63.6% in nuts and seeds), flushing (50% in seafood), and pharyngeal oppression (19% in seafood). Prevalence of perceived, probable and systemic allergy to nuts and seeds was 2.8% (95% confidence interval [CI], 2.5%-3.0%), 0.8% (95% CI, 0.3%-1.3%) and 0.2% (95% CI, 0%-0.4%) respectively. On the other hand, the prevalence (perceived, probable, and systemic) associated with seafood consumption was 3.5% (95% CI, 2.5%-4.5%), 1.8% (95% CI, 1.0%-2.5%), and 0.5% (95% CI, 0.1%-0.9%). Walnut and shrimp were the most frequently reported foods. CONCLUSION: For every 100 Mexican university students, approximately 3 or 4 perceived to have allergy attributed to the consumption of some nuts and seeds or seafood, while 1 or 2 students would have a probable reaction to this same type of food. Walnut and shrimp would be causing the higher quantity of food allergic reactions.

Self-report prevalence and associated factors to drug hypersensitivity in Mexican young adults.

BACKGROUND: Drug hypersensitivity is defined as any unfavorable reaction that occurs after the administration of any drug. It may or may not be mediated by the involvement of the immune system. Epidemiological data related to drug hypersensitivity reactions in our country are scarce. OBJECTIVE: To determine the prevalence of drug hypersensitivity in a group of young adults, as well as to identify associated factors. METHODS: A structured questionnaire was applied to young people aged 18 to 25 years. The instrument was oriented to identify reactions of drug hypersensitivity, as well as the most prevalent drugs involved. In addition, a personal and family history of atopic diseases was included. Analysis for associations between variables was been done through logistic regression. RESULTS: The prevalence of drug hypersensitivity reactions was 12% (144 of 1,200). The antibiotics were the agents most related to hypersensitivity reactions (9.8%) followed by nonsteroidal anti-inflammatory drugs (1.6%). Factors associated with drug hypersensitivity were a personal history of asthma, odds ratio (OR) 3.15 (95% confidence interval [CI], 1.44-6.91), maternal and paternal history of drug hypersensitivity, OR 2.33 (95% CI, 1.21-4.48) and OR 3.11 (95% CI, 1.22-7.92), respectively. CONCLUSION: The results of this research show that drug hypersensitivity in young adults is a highly prevalent event and it is associated with personal history of asthma and history of drug hypersensitivity in parents.

[Cellular and biochemical mechanisms involved in physiopathogenesis of autoimmune thrombocytopenic purpura]. / Mecanismos celulares y bioquímicos involucrados en la fisiopatogenia de la púrpura trombocitopénica autoinmune.

Autoimmune thrombocytopenic purpura (ATP) is a bleeding disorder caused by excessive destruction of antibody-coated platelets. It is known that platelet destruction takes place in macrophages of reticulo-endothelial system, but immunological mechanisms involved in such destruction are unknown. The objective of this article is to review the literature concerning pathogenesis of ATP: to have controlled experimental conditions some animal laboratory models have been used. The (NZW X BXSB) F1 mice have been studied as autoimmune disease model and Harrington mouse as an immune purpura model. Studies in humans suggest that there are some differences in pathogenesis of acute or chronic ATP, particularly in reactive T cells. For example, in chronic form there are high levels of The (CD4+) activity concomitant with low levels of T suppressor (CD8+) activity, while in acute form there is no dominance of any particular T cell activity or CD4+ is even decreased. Mitogen lymphocyte proliferation is increased in chronic ATP but decreased in acute form.

Peripheral Pathways in the Food-Intake Control towards the Adipose-Intestinal Missing Link.

In the physiological state a multitude of gut hormones are released into the circulation at the same time depending on the quality and quantity of the diet. These hormones interact with receptors at various points in the "gut-brain axis" to affect short-term and intermediate-term feelings of hunger and satiety. The combined effects of macronutrients on the predominant gut hormone secretion are still poorly understood. Besides, adipokines form an important part of an "adipoinsular axis" dysregulation which may contribute to ß -cell failure and hence to type 2 diabetes mellitus (T2DM). Even more, gestational diabetes mellitus (GDM) and T2DM seem to share a genetic basis. In susceptible individuals, chronic exaggerated stimulation of the proximal gut with fat and carbohydrates may induce overproduction of an unknown factor that causes impairment of incretin production and/or action, leading to insufficient or untimely production of insulin, so that glucose intolerance develops. The bypass of the duodenum and jejunum might avoid a putative hormone overproduction in the proximal foregut in diabetic patients that might counteract the action of insulin, while the early presentation of undigested or incompletely digested food to the ileum may anticipate the production of hormones such as GLP1, further improving insulin action.

Pregnancy Weight Gain Limitation by a Supervised Nutritional Program Influences Placental NF-κB/IKK Complex Expression and Oxidative Stress.

OBJECTIVE: Nuclear factor kappa B (NF-κB) pathway and oxidative stress participate in endothelial dysfunction, which is one of the causes of pre-eclampsia. Among the human antioxidant mechanisms, there are the enzymes catalase (CAT), glutathione peroxidase (GPx) and superoxide dismutase (SOD). Our aim was to measure NF-κB, its inhibitor (IKK) and oxidative stress in placenta and umbilical cord of pregnant women submitted to a supervised nutritional program. METHODS: TWO GROUPS WERE CONFORMED: A) 14 pregnant women with individualized nutritional counseling, and B) 12 pregnant women without nutritional guidance. NF-κB and IKK were assessed by real time PCR (RT-PCR). Enzymatic activity of CAT, GPx, lipoperoxidation (LPO) and SOD were also evaluated. RESULTS: Pregnant women that followed a supervised nutritional program had lower levels of systolic (p=0.03) and diastolic pressure (p=0.043) although they were heavier than the control group (p=0.048). Among all the women, the Spearman correlation was positive between weight gain and placental NF-κB expression (1, p≤0.01). In the placenta, women with nutritional advice had lower enzymatic activity of GPx (p≤0.038) and showed a tendency of IKK to be higher than in women without a nutritional supervised program. CONCLUSION: A supervised nutritional program in pregnancy offers a proven option to control weight gain, hypertension, NF-κB/IKK complex expression and oxidative stress reactions in the placenta.

Effects of a physical activity program on markers of endothelial dysfunction, oxidative stress, and metabolic status in adolescents with metabolic syndrome.

The metabolic syndrome (MetS) is a precursor of diabetes. Physical activity (PA) improves endothelial dysfunction and may benefit patients with MetS. Aims. To evaluate the effect of a physical activity (PA) program on markers of endothelial dysfunction and oxidative stress in adolescents with (MetS). Methods. We carried out a cohort study of 38 adolescents with and without MetS (18 females and 20 males). All participants completed a 3-month PA program. All variables of the MetS as well as markers of endothelial dysfunction and oxidative stress tests were evaluated. Results. Females with and without MetS showed significant differences for almost all components of the MetS, whereas males were significantly different in half of the components. After the PA program, components of the MetS were not different from baseline values except for HDL-C levels. Some baseline endothelial dysfunction markers were significantly different among adolescents with and without MetS; however, after the PA program, most of these markers significantly improved in subjects with and without MetS. Conclusion. PA improves the markers of endothelial dysfunction in adolescents with MetS although other changes in the components of the MetS were not observed. Perhaps the benefits of PA on all components of MetS would appear after a PA program with a longer duration.

Urocultivos en infección clínica de vías urinarias / RESULTS OF URINE CULTURE IN PATIENTS WITH CLINICAL URINARY TRACT INFECTION

Introducción: Las infecciones de vías urinarias (IVU) constituyen un problema de salud mundial. El aumento de la resistencia bacteriana a los antimicrobianos limita la administración de antibióticos económicos y de espectro limitado, lo que afecta el costo y el acceso a la atención. El objetivo de este trabajo es determinar la sensibilidad, resistencia y germen causal en urocultivos realizados en pacientes con infección clínica de vías urinarias. Métodos: Estudio transversal. Se analizaron urocultivos de pacientes con infección clínica de vías urinarias, cada urocultivo correspondió a un paciente. Las variables fueron edad, género, microorganismo causal, resistencia y sensibilidad a los antimicrobianos. Se realizó en la Unidad de Medicina Familiar No. 222 del Instituto Mexicano del Seguro Social en Toluca Estado de México. Se evaluaron urocultivos con más de 100000 Unidades formadoras de colonias. Se realizó mediciones descriptivas, frecuencias y porcentajes en el programa SPSS v. 17 para Windows. Resultados: se incluyeron urocultivos de pacientes con infección clínica de vías urinarias. La edad promedio de los pacientes fue de 50.09 ± 19.43 años, con predominio del género femenino (211 pacientes). Los agentes causales más frecuentes fueron: Escherichia Coli (51.91%), Proteus mirabilis (14.70%) y Staphylococcus (11.11 %). Los antibióticos con mayor sensibilidad fueron: imipenem, cefotetan y meropenem (34%). Los antimicrobianos con mayor resistencia fueron: ampicilina (24%), ciprofloxacino (22%) y ampicilina con sulbactam (20%). Conclusiones: los microorganismos más frecuentemente fueron: Escherichia coli y Proteus; y los antimicrobianos a los que mostraron más resistencia bacteriana fueron: ampicilina y quinolonas.

Introduction: Urinary tract infections (UTIs) are a global health problem. Increased bacterial resistance to antimicrobials limits the administration of low-spectrum antibiotics, which affect cost and access to care. The objective of this work is to determine the sensitivity, resistance and causal germ in urine cultures in patients with clinical urinary tract infection Methods: Transversal study. Urine cultures of patients with clinical urinary tract infection were analyzed, each urine culture corresponded to one patient. The variables were age, gender, causal microorganism, resistance and sensitivity to antimicrobials. It was performed at the Family Medicine Unit No. 222 of the Mexican Institute of Social Security in Toluca State of Mexico. Urocultures were evaluated with more than 100,000 colony forming units. Measurements were made frequencies and percentages in the SPSS program version 17 for Windows. Results: there were included 558 urine cultures; the average age was 50.09 ± 19.43 years, female predominance (211 patients). The most common causative microorganisms were Escherichia coli (51.91%), Proteus mirabilis (14.70%) and Staphylococcus (11.11%). Most sensitive antibiotics were: imipenem, meropenem and cefotetan (34%). Most resistance antimicrobial were: ampicillin (24%), ciprofloxacin (22%) and ampicillin with sulbactam (20%). Conclusions: Escherichia coli and Proteus were the most commonly isolated microorganisms; Ampicillin and quinolones showed more bacterial resistence.

In vitro susceptibilities of bloodstream isolates of Candida spp.: results from a multicenter active surveillance program in Andalusia.

OBJECTIVES: The aim of this study was to determine the antifungal drug susceptibilities of Candida bloodstream isolates in Andalusia, obtained through a multicenter active laboratory-based surveillance between October 2005 and September 2006. METHODS: One hundred and ninety-seven Candida isolates were collected. The MICs of amphotericin B, fluconazole, itraconazole and voriconazole were established using the Sensititre YeastOne panel. The MICs of posaconazole and caspofungin were determined by Etest. RESULTS: C. albicans was the most frequently isolated species (49.2%), followed by C. parapsilosis (17.3%), C. tropicalis (15.2%), C. glabrata (13.7%) and C. krusei (3.6%). All strains were inhibited at MICs of or = 64 mg/L) and 7 (3.6%) were considered resistant to itraconazole (MIC > or = 1 mg/L). All the isolates were susceptible to voriconazole and caspofungin. CONCLUSION: In our study C. krusei and C. glabrata were identified in over 18% of cases of candidemia. Most clinical isolates of these species are resistant or susceptible-dose-dependent to fluconazole but susceptible to voriconazole and caspofungin. These agents must be used in the empiric treatment of candidemia rather than fluconazole.

Adolescent adjustment in at-risk families: The role of psychosocial stress and parental socialization / Ajuste adolescente en familias en situación de riesgo: El rol del estrés psicosocial y de la socialización parental

Introduction The study of factors associated with internalizing and externalizing problems in adolescents living in at-risk families is a subject of recent interest in mental health in Spain. The presence of mental health problems in children and adolescents is too frequent in these families due to their high exposure to a variety of risk factors and the lack of protection factors. However, few studies have examined the contribution of specific factors to each type of mental health problem in adolescents from at-risk Spanish families. This study strives to contribute to knowledge in this field, by analyzing the role of two important dimensions frequently linked to adolescents' adjustment: psychosocial stress and parental socialization. Likewise, this study seeks to identify whether both dimensions predict differently for two types of mental health problems in adolescents from at-risk families. Methodology The sample was composed by 134 Spanish adolescents (56 girls and 78 boys) with an average age of 13.52 (SD = 1.57). These adolescents grew up in families who were receiving psychosocial intervention from Social Services in Spain for family preservation reasons. This research is considered to be a cross-sectional descriptive study and the instruments administered allowed the collection of data about mental health problems, psychosocial stress, parental socialization and intervention data by Social Services. Results The hierarchical multiple regression models showed that both domains (psychosocial stress and parental socialization) were significantly related to mental health problems, but a different pattern of findings emerged for each type of problem. When co-morbidity between both problems was controlled, psychosocial stress was mainly related to internalizing problems, whereas parental socialization predicted the externalizing ones. Discussion and conclusions This study underscores the importance of distinguishing between two types of mental health problems analyzed (internalizing and externalizing) and emphasizes that both, the enhancement in parental socialization as well as the training of adolescents in positive social skills to cope better with stressful life events, should be part of at-risk family programs.

Introducción El estudio de factores asociados con problemas internalizantes y externalizantes en adolescentes que viven en familias en riesgo es objeto de interés reciente en salud mental en España. La presencia de problemas de salud mental en menores y adolescentes es demasiado frecuente en estas familias debido a la alta y variada exposición a factores de riesgo, así como a la falta de elementos de protección que les rodean. Sin embargo, pocos estudios han examinado la contribución que factores específicos hacen a cada tipo de problemas de salud mental en adolescentes de familias españolas en riesgo. Este estudio intenta contribuir al conocimiento en este campo, analizando el papel de dos dimensiones frecuentemente relacionadas con el ajuste adolescente: estrés psicosocial y socialización parental. Asimismo, este estudio trata de identificar si ambas dimensiones predicen de forma diferente los dos tipos (internalizantes y externalizantes) de problemas de salud mental en adolescentes de familias en situación de riesgo. Metodología La muestra se compone de 134 adolescentes españoles (56 chicas y 78 chicos) con una media de edad de 13.52 (DT=1.57). Estos adolescentes crecieron en familias que estaban recibiendo una intervención psicosocial por parte de los Servicios Sociales españoles por razones de preservación familiar. El diseño de esta investigación es de carácter transversal y descriptivo. Los instrumentos administrados permitieron recabar datos sobre problemas de salud mental, estrés psicosocial, socialización parental y la intervención recibida por los Servicios Sociales. Resultados Los modelos de regresión múltiple jerárquica mostraron que ambos dominios (estrés psicosocial y socialización parental) estuvieron significativamente relacionados con los problemas de salud mental, pero emergió un patrón de resultados diferentes para cada tipo de problemas. Cuando la comorbilidad entre ambos problemas fue controlada, el estrés psicosocial estuvo significativamente relacionado con los problemas internalizantes, mientras que la socialización parental se asoció con los problemas externalizantes. Discusión y conclusiones Este estudio subraya la importancia de distinguir entre los dos problemas de salud mental analizados y hace hincapié en que, tanto la mejora en la socialización de los progenitores como el entrenamiento de los adolescentes en habilidades sociales positivas que permitan afrontar adecuadamente acontecimientos estresantes, deben ser contenidos fundamentales en los programas de intervención destinados a familias en situación de riesgo psicosocial.

Dificultades en la clasificación del síndrome metabólico: El ejemplode los adolescentes en México / Difficulties in the classification of metabolic syndrome: The example of adolescents in Mexico

OBJETIVO. Determinar la diferencia entre las definiciones del National Cholesterol Education Program Adult Treatment Panel (ATPIII) y de la International Diabetes Federation (IDF) para síndrome metabólico (SM) en adolescentes mexicanos. MATERIAL Y MÉTODOS. Estudio transversal en 575 adolescentes de 14 a 16 años. Se utilizaron pruebas t de Student, ji cuadrada y correlación de Spearman. RESULTADOS. La prevalencia de SM fue mayor por ATPIII (18.6 por ciento) versus IDF (8.2 por ciento) (p<0.001), con 41.1 por ciento de concordancia. CONCLUSIONES. Existe una diferencia estadística de la prevalencia del SM en adolescentes mexicanos entre las dos definiciones.

OBJECTIVE. Determine the difference between the National Cholesterol Education Program Adult Treatment Panel (ATPIII) definition of the diagnosis of metabolic syndrome (MS) in Mexican adolescents and that by the International Diabetes Federation (IDF). MATERIAL AND METHODS. We conducted a cross-sectional study of 575 adolescents aged 14 to 16 years using the student's t test, chi square and Spearman correlation. RESULTS. The prevalence of MS was higher by ATPIII (18.6 percent) than by IDF (8.2 percent) (p <0.001) and there was a concordance of 41.1 percent. CONCLUSIONS. There is a statistical difference in the prevalence of MS depending on the definition.