Unhealthy habits and comorbidities associated with uncontrolled asthma in young people.

INTRODUCTION: Asthma is a chronic inflammatory disease of the lower airways that affects more than 260 million people worldwide and has been related to more than 460,000 deaths a year. It is estimated that in 60% of asthma cases, the symptoms are not adequately controlled. The objective of this study was to determine the association between some comorbidities, habits, and health risk behaviors with uncontrolled asthma in a sample of young people with asthma. METHODS: Through a cross-sectional study, data from 1,078 young people aged 17 to 19 years were analyzed. Information was collected through physical examination, direct questioning, and the application of a self-administered questionnaire. RESULTS: In the group of young people with asthma, the prevalence of uncontrolled asthma was 20.6%, of which 53.8% were women, 76.9% suffered from rhinitis, 46.2% were overweight and 23.1% were obese. In the group of young with uncontrolled asthma, gingivitis was detected in 53.8% and alcohol consumption in 84.6%. Logistic regression analysis showed a significant association between allergic rhinitis, gingivitis, carbohydrate intake, alcohol consumption, overweight, and obesity with uncontrolled asthma. CONCLUSIONS: Parents and members of the health team need to identify on time the risk factors associated with uncontrolled asthma in young people with asthma to limit its development and the negative effects it generates. The results of this study should be used to strengthen programs that promote the comprehensive health of adolescents.

Factors Associated with Early Sexual Activity in Adolescents Residing in an Urban Area of Northeastern Mexico Who Use WhatsApp or Facebook.

Early sexual activity has been associated with unplanned pregnancy and sexually transmitted infections. In recent decades, the prevalence of early sexual activity and social media use has increased. However, the relationship between these variables has been little studied. Consequently, we examined the relationships of some factors present in the family and personal environment with early sexual activity in adolescents who use and do not use the WhatsApp and Facebook platforms. Through a cross-sectional study, data from 1328 adolescents aged 13 to 19 years were analyzed. Data collection was carried out using a self-administered questionnaire. Of the total participants, 35.7% reported early sexual activity, and 37.7% reported using social networks such as WhatsApp and Facebook. The mean age of onset of sexual activity was 15.59 ± 1.56 years. Multivariate logistic regression analysis showed significant associations of not studying (adjusted OR 4.70; CI 95% 1.31-16.78), consuming alcohol (adjusted OR 3.71; CI 95% 2.44-5.65) and having parents who consumed alcoholic beverages in the home (adjusted OR 1.48; 95% CI 1.03-2.12) with ESA. In the family and personal environment, some factors favored early sexual activity in young people who used the WhatsApp and Facebook applications. This information should be used by authorities in the health and education sectors to strengthen preventive programs targeting health risk habits and behaviors in adolescents.

Risk factors of non-adherence to guidelines for the prevention of COVID-19 among young adults with asthma in a region with a high risk of a COVID-19 outbreak.

OBJECTIVE: SARS-CoV-2 disease 2019 (COVID-19) is highly contagious and spreads rapidly. The application of preventive measures has proven to be the best strategy to minimize the number of patients and the dissemination of and deaths from COVID-19. The objective of this study was to determine the risk factors that limit the adherence of asthmatic patients to measures that prevent COVID-19 among residents of a region with a high risk of a COVID-19 outbreak. METHODS: Through a cross-sectional study, data from 2,372 participants aged 16-24 years were analyzed. To collect their information, a questionnaire was constructed using the Google Forms tool. Due to the prevention measures in place for COVID-19, the home quarantine of many people, and the lack of socialization, the questionnaire was distributed through email (Internet) and WhatsApp. A logistic regression analysis was performed to determine the relationship between the variables. RESULTS: The prevalence of asthma was 12.2%, and non-adherence to the guidelines for the prevention of COVID-19 was 53.1%. Approximately 30.8% of asthma patients did not comply with the basic prevention measures for COVID-19. The results of the logistic regression analysis showed that being male, active smoking, and believing that COVID-19 is not a more severe disease for people suffering from asthma than others were associated with non-adherence to the basic protection measures established in the guidelines for the prevention of COVID-19. CONCLUSIONS: It is important for health professionals to advise asthma patients to comply with the basic measures of protection against COVID-19 and timely use medications for asthma control.

[Nutritional status of Mexican school age children, living in the frontier with United States]. / Evaluación nutricional de escolares en una ciudad fronteriza entre Estados Unidos y México.

BACKGROUND: Undernutrition and obesity coexist among Mexican children due to poverty, sedentariness and inadequate food intake. AIM: To assess the nutritional status of school age children in a Mexican city located in the frontier with United States. MATERIAL AND METHODS: Cross sectional assessment of children from 28 basic schools in 2005, 2008 and 2013. Using a cluster sampling methodology, 5 children per course were selected in each school, reaching a final sample 840 children aged 7 to 12 years old. Body mass index z scores were calculated. RESULTS: The pre valence of overweight and obesity among these children was 49, 54 and 45% in the assessments performed in 2005, 2008 and 2013 respectively. CONCLUSIONS: There is a trend towards a decrease in the frequency of obesity in these children from 2005 to 2013.

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.

[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.

[Factors associated with tobacco use in patients with asthma during the confinement due to COVID-19 in an urban region with high numbers of SARS-CoV-2 infections]. / Factores asociados al tabaquismo en pacientes con asma durante el confinamiento por COVID-19 en una región urbana con cifras elevadas de infecciones por SARS-CoV-2.

OBJECTIVE: To determine the prevalence and risk factors associated with tobacco use during the period of confinement in light of the COVID-19 pandemic. METHODS: Through an analytical and cross-sectional study, the data of 2, 372 participants were analyzed. The information was collected through a self-administered questionnaire that was built with the Google Forms tool, which was distributed and applied via email and WhatsApp; the private messaging platform. The relationship between the independent variables and the outcome was determined by multivariate logistic regression analysis. RESULTS: Out of the total population, 69.3 % were women, the median age was 20.11±2.01 years, the prevalence of asthma was 12.2 %, and the active tobacco use was 13.3 %. There was a higher number of patients with asthma who smoked (14.2 vs. 13.2 %) than of those who didn't have asthma. The multivariate logistic regression analysis showed that factors like considering that COVID-19 does not exist and not being confined were related to tobacco use in patients with asthma during the implementation of the contingency plan that the COVID-19 pandemic represents. CONCLUSIONS: During confinement to home for COVID-19, the prevalence of tobacco use is higher in patients with asthma than in individuals without this ailment; the factors that favor the aforementioned are present in the family environment.

Objetivo: Determinar la prevalencia y factores de riesgo asociados al tabaquismo durante el periodo de confinamiento ante la pandemia de COVID-19. Métodos: Mediante un estudio analítico y transversal se analizaron los datos de 2372 participantes. La recolección de la información se realizó con un cuestionario autoadministrado construido con la herramienta Google Forms, el cual se distribuyó y aplicó a través de correo electrónico y de la plataforma de mensajería privada WhatsApp. La relación entre las variables independientes y la resultante fue determinada a través de regresión logística multivariada. Resultados: De la población total, 69.3 % fue del sexo femenino, la edad media de 20.11 ± 2.01 años, la prevalencia de asma de 12.2 % y la de tabaquismo activo, de 13.3 %. Una mayor proporción de pacientes con asma fumaba (14.2 versus 13.2 %), en comparación con quienes no padecían asma. La regresión logística multivariante mostró que considerar que COVID-19 no existe y no cumplir con el confinamiento se relacionaron con el tabaquismo en pacientes con asma durante la aplicación del plan de contingencia que representa la pandemia de COVID-19. Conclusiones: Durante el confinamiento en casa por COVID-19, la prevalencia de tabaquismo es mayor en pacientes con asma comparados con los individuos sin esta enfermedad. Los factores que favorecen lo anterior están presentes en el entorno familiar.

Association between obesity and dental caries in a group of preschool children in Mexico.

OBJECTIVE: The aim of this study was to determine the association between obesity and caries by utilizing the data of a cohort of preschool children aged 4-5 years. METHODS: Data were obtained from a cohort of 1,160 children. Dental caries detection was performed according to the World Health Organization criteria. The caries index was measured as the number of decayed (d), extracted (e), and filled (f) teeth (t) (deft), or surfaces (defs). The body mass index (BMI) in units of kg/m2 was determined, and children were categorized according to age- and gender-specific criteria as normal weight (5th-85th percentile), at-risk overweight (> or = 85th-<95th percentile), and overweight (> or = 95th percentile). Odds ratios were determined for at-risk overweight and overweight children using logistic regression. RESULTS: The prevalence of dental caries was 17.9 percent. A slightly higher percentage of dental caries was found in boys (19.6 percent) than in girls (16.4 percent). From the total sample, the mean BMI was 17.10 +/- 3.83. Approximately 53.7 percent of children were classified as normal weight, 14.2 percent as at-risk overweight, and 32.1 percent as overweight. At-risk overweight children were higher among girls (17.1 percent) than among boys (11.3 percent). When adjusted for covariates, the logistic regression model showed that there was a significant association between at-risk overweight children (P < 0.001), overweight children (P < 0.001), and caries in the primary dentition. Mean (SD) deft value of the sample was 1.08 (2.34), while the corresponding defs value was 1.43 (3.29). CONCLUSION: Obesity appears to be associated with dental caries in the primary dentition of preschool Mexican children.

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.

[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.

Family, personal, and social factors associated with the non-use of contraceptive methods during the first sexual experience in adolescent women.

Unplanned pregnancy and sexually transmitted infections (STIs) in adolescents continue to be major health problems around the world. They are associated with sex that occurs without contraceptive protection. We determined the relationship of family, personal, and social factors with the non-use of any contraceptive method during the first sexual experience in 1409 adolescent women. The most significant risk factors were being less than 15 years of age and lacking knowledge and awareness about contraceptive methods. In the family environment, the risk factors were living in an incomplete family and the existence of a poor relationship among the father, the mother, and the adolescents. Socialization with friends who became sexually active at an early age was also associated with having sex for the first time without protection. This information should be used in sexual and reproductive education programmes to prevent unplanned pregnancy and STIs in adolescent women.

[Asthma-associated oral and dental health repercussions in children aged 6 to 12 years]. / Repercusiones en la salud bucodental asociadas con el asma en niños de 6 a 12 años de edad.

BACKGROUND: Asthma, which is characterized by mouth breathing and by the use of drugs for its treatment, affects between 1 and 30% of children and adolescents. There are only few studies reporting its impact on the oral cavity. OBJECTIVE: To find out the most common asthma-associated repercussions in 6 to 12-year-old children. METHODS: Cross-sectional, comparative, analytical study carried out in 2 primary schools from Coclique, Veracruz, Mexico, in 6 to 12-year-old children. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire for parents was used. RESULTS: In a population of 409 children, a prevalence of asthma of 6.84% (n = 28) was found, which was higher in males (15, 54%); boys aged 6, 7 and 11 years and girls aged 8, 9 and 10 years were most affected. Risk factors for oral manifestations were acidic pH (OR = 170), caries (OR = 4.29), anterior open bite (OR = 66.78), gingivitis (OR = 9.75), atypical swallowing (OR = 15.70) and high-arched palate (OR = 45.60). CONCLUSION: Children with chronic conditions such as asthma require an oral and dental preventive program as part of their interdisciplinary care.

Antecedentes: El asma, caracterizada por respiración bucal y el uso de fármacos para su tratamiento, afecta entre 1 y 30 % de los niños y adolescentes. Son pocos los estudios que reportan las repercusiones en la cavidad bucal. Objetivos: Conocer las repercusiones en la salud bucodental más asociadas con el asma en niños de 6 a 12 años de edad. Métodos: Estudio transversal, analítico y comparativo en 2 escuelas primarias de Cosoleacaque, Veracruz, México, en niños de 6 a 12 años. Se utilizó el cuestionario "Estudio internacional de alergia y asma en niños" (ISAAC) para padres. Resultados: En una población de 409 niños se encontró una prevalencia de asma de 6.84 % (n = 28), mayor en los hombres (54-15 %); los varones de 6, 7 y 11 años fueron los más afectados y las niñas de 8, 9 y 10 años. Las manifestaciones orales con factor de riesgo fueron pH ácido (OR = 170), caries (OR = 4.29), mordida abierta anterior (OR = 66.78), gingivitis (OR = 9.75), deglución atípica (OR =15.70) y paladar ojival (OR = 45.60). Conclusión: Los niños con enfermedades crónicas como el asma requieren un plan de prevención bucodental como por parte de su atención interdisciplinar.

Efecto de una intervención nutricional en el consumo de alimentos en escolares de educación básica de Reynosa, Tamaulipas, México / Effect of a nutritional intervention on food consumption in basic education schoolchildren in Reynosa, Tamaulipas, Mexico

Introducción: en los últimos años se ha incrementado el consumo de alimentos ultraprocesados en escolares y esto se ha relacionado con un aumento en la prevalencia de obesidad infantil. Objetivo: calcular el tamaño del efecto de una intervención nutricional en el consumo alimentario en escolares de educación básica de Reynosa, Tamaulipas, México. Materiales y métodos: estudio longitudinal, con una muestra de 309 escolares de 12 escuelas primarias públicas; se formaron dos grupos: intervención (GI) y control (GC) con seguimiento de un año. Se realizaron mediciones antropométricas. Para evaluar los alimentos incluidos en los refrigerios escolares se utilizó un registro de alimentos antes y después de la intervención y se caracterizaron como recomendables y no recomendables. Se calculó el tamaño del efecto (TE) utilizando el estadístico "g" de Hedges. Resultados: al final del estudio en ambos grupos se incrementó el consumo de agua, sin embargo, él TE fue grande en el GI (TE=0,84), mientras que en el GC fue moderado (TE=0,50). En el GI se encontró una reducción pequeña en el consumo de carnes procesadas (p=0,004; TE=0,28), cereales dulces (p=0,001; TE=0,36) y bebidas no lácteas endulzadas (p=0,001; TE=0,49); mientras que el GC mostró un incremento pequeño en el consumo de comida rápida y antojitos mexicanos (p=0,001; TE=0,46). Conclusiones: en el GI se observó una disminución y un TE pequeño en el consumo de carnes procesadas, cereales dulces y bebidas no lácteas endulzadas. Es necesario diseñar estrategias que promuevan el consumo de alimentos recomendables(AU)

Introduction: In recent years, the consumption of ultraprocessed foods in schoolchildren has increased and this has been linked to an increase in the prevalence of childhood obesity. Objective: To calculate the size of the effect of a nutritional intervention on food consumption in basic education schoolchildren in Reynosa, Tamaulipas, Mexico. Materials and methods: Longitudinal study, with a sample of 309 schoolchildren from 12 public elementary schools; two groups were formed: intervention (IG) and control (CG) with a follow-up of one year. Measurements of weight, height and waist circumference were made. To evaluate the foods included in school lunch, a food registry was used before and after the intervention and they were characterized as recommended and not recommended. The effect size (ES) was calculated using the Hedges'g statistic. Results: At the end of the study in both groups, water consumption increased, however the ES was big in the IG (ES=0.84); while in the CG it was moderate (ES=0.50). In the IG, a small reduction in the consumption of processed meats was observed (p=0.004; ES=0.28), sweet cereals (p=0.001; ES=0.36) and sweetened nondairy beverages decreased (p=0.001; ES=0.49); while the CG showed a small increase in the consumption of fast food and Mexican appetizers (p=0.001; ES=0.46). Conclusions: In the IG showed a TE small decrease in consumption of processed meats, sweet cereals, and sweetened non-dairy beverages. It is necessary to design strategies that promote the consumption of recommended foods(AU)

[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.

[Clinical experience with omalizumab in patients with severe asthma. Real-world data]. / Experiencia clínica con omalizumab en pacientes con asma severa. Datos del mundo real.

BACKGROUND: Omalizumab is a monoclonal antibody that is prescribed in a stepwise addition regimen for the treatment of severe asthma. OBJECTIVE: To report the experience of patients with severe asthma who were given omalizumab in accordance with international guides, in a context of real-world data. METHODS: Open, analytical, cross-sectional, retrospective, observational clinical study with real-world data. GINA 2006 Asthma Control Scheme was used to evaluate patients, and a questionnaire was used to evaluate patient characteristics, effectiveness, safety, and tolerance to omalizumab. RESULTS: 48 patients were studied, 34 women and 14 men with an average age of 39 years. The average disease duration was 26 years. Average serum IgE was 522 IU. At the beginning of treatment, all patients had uncontrolled asthma; at the end, 69% asthma control was obtained, 19% was partially controlled and 12% unchanged. The changes were observed at seven months on average. CONCLUSION: Omalizumab is effective and safe for treating severe asthma when applied in accordance with international guidelines for the management of bronchial asthma.

Antecedentes: El omalizumab es un anticuerpo monoclonal que se prescribe en esquema de adición por pasos para el tratamiento del asma severa. Objetivos: Informar la experiencia en pacientes con asma severa a quienes se aplicó omalizumab conforme a las guías internaciones, en un contexto de datos de mundo real. Métodos: Estudio retrospectivo, clínico, observacional, abierto, analítico y transversal a partir de datos de la vida real. Se utilizó el esquema de Control del Asma de GINA 2006 para evaluar a los pacientes y con un cuestionario se calificaron las características del paciente, efectividad, seguridad y tolerancia al omalizumab. Resultados: Se estudiaron 48 pacientes, 34 mujeres y 14 hombres, con edad promedio de 39 años. La duración promedio de la enfermedad fue de 26 años. La concentración sérica promedio de la IgE fue de 522 UI. Al inicio del tratamiento, todos los pacientes estaban sin control del asma; al final, en 69% se obtuvo control del asma, 19% estaba parcialmente controlado y 12% sin modificaciones. Los cambios se observaron en promedio a los siete meses. Conclusión: El omalizumab es efectivo y seguro para tratar el asma severa cuando se aplica conforme las guías internacionales para el manejo del asma bronquial.

Asociación de la violencia obstétrica, control prenatal y embarazo no planeado con la prematurez / Association of obstetric violence, prenatal control, and unplanned pregnancy with prematurity

Resumen La prematurez (PM) neonatal es un problema mayor de salud pública en el mundo, debido a su frecuencia de presentación y los años de vida potencialmente perdidos; además, es la principal causa de muerte en menores de cinco años. Entre las consecuencias negativas de la PM están las discapacidades del aprendizaje, visual y auditiva. Múltiples son los factores asociados a la PM; algunos pueden ser detectados y modificados de forma oportuna en las consultas prenatales y también, en las preconcepcionales. Por otro lado, la PM no es solamente responsabilidad del prestador de los servicios de salud, sino también del sistema de salud, el cual, debe otorgar los recursos mínimos necesarios para monitorear y mantener a la embarazada en un estado óptimo de salud para evitarla, y en caso de presentarse, debe contar con la infraestructura hospitalaria básica que permita la viabilidad del producto y evitar su muerte. Aunado a lo anterior, se debe de considerar la responsabilidad de la paciente y su pareja, debido a que en ellos recae la obligación de llevar un estilo de vida saludable y acudir a las consultas preconcepcionales y control prenatal.

Abstract Neonatal prematurity (MP) is a major public health problem in the world, due to its presentation frequency and the years of life potentially lost; In addition, it is the main cause of death in children under five years of age. Among the negative consequences of MP are learning, visual and hearing disabilities. There are multiple factors associated with MP; some can be detected and modified in a timely manner in prenatal consultations and in preconception. On the other hand, MP is not only responsibility of the health service provider, but also of the health system, which must grant the minimum resources necessary to monitor and maintain the pregnant woman in an optimal state of health to avoid it, and if it occurs, the hospital must have the basic infrastructure that allows the viability of the product and prevents its death. In addition, the responsibility of the patient and her partner must be considered since they are obliged to lead a healthy lifestyle and attend preconception consultations and prenatal care.

[Impact of the prenatal care in the neonatal morbidity and mortality]. / Impacto del control prenatal en la morbilidad y mortalidad neonatal.

OBJECTIVE: To analyze the prenatal care impact in the neonatal morbidity and mortality. MATERIALS AND METHODS: Case-control cohort-nested study, among hospitalized and healthy newborns. The variables studied were: prenatal care, neonatal morbidity (respiratory distress syndrome, prematurity, low weight at birth, congenital malformations and asphyxia) and mortality, as well as mother's age, weight, height, gestation, and level of education. The statistical analysis was made through percentage, rates and standard deviation, odds ratio and chi2. RESULTS: We analyzed 407 mother and newborn files divided in 2 groups: 118 hospitalized newborns (cases) and 289 healthy newborns (controls). Respiratory distress syndrome (OR 3.559, IC 1.865-6.794), low weight at birth (OR 3.504, IC 1.861-6.597) and prematurity (OR 5.044, IC 2.624-9.698) were significant, but not asphyxia. Other variables were similar in both mother groups. CONCLUSION: Prenatal care produces low incidence of respiratory distress, low weight at birth and prematurity in the newborn. Neonatal mortality rate (6%), was lower than in other studies.

Association between family structure, maternal education level, and maternal employment with sedentary lifestyle in primary school-age children.

OBJECTIVE: To determine the association between family structure, maternal education level, and maternal employment with sedentary lifestyle in primary school-age children. METHOD: Data were obtained from 897 children aged 6 to 12 years. A questionnaire was used to collect information. Body mass index (BMI) was determined using the age- and gender-specific Centers for Disease Control and Prevention definition. Children were categorized as: normal weight (5(th) percentile≤BMI<85(th) percentile), at risk for overweight (85(th)≤BMI<95(th) percentile), overweight (≥ 95(th) percentile). For the analysis, overweight was defined as BMI at or above the 85(th) percentile for each gender. Adjusted odds ratios (adjusted ORs) for physical inactivity were determined using a logistic regression model. RESULTS: The prevalence of overweight was 40.7%, and of sedentary lifestyle, 57.2%. The percentage of non-intact families was 23.5%. Approximately 48.7% of the mothers had a non-acceptable educational level, and 38.8% of the mothers worked outside of the home. The logistic regression model showed that living in a non-intact family household (adjusted OR=1.67; 95% CI=1.04-2.66) is associated with sedentary lifestyle in overweight children. In the group of normal weight children, logistic regression analysis show that living in a non-intact family, having a mother with a non-acceptable education level, and having a mother who works outside of the home were not associated with sedentary lifestyle. CONCLUSION: Living in a non-intact family, more than low maternal educational level and having a working mother, appears to be associated with sedentary lifestyle in overweight primary school-age children.

[Association between unplanned pregnancy and adolescence onset asthma]. / Asociación entre embarazo no planeado y asma de inicio en la adolescencia.

BACKGROUND: The association between asthma and pregnancy has been documented previously. The relationship between unplanned pregnancy and onset asthma in adolescence has not been studied. OBJECTIVE: To determine the association between unplanned pregnancy and adolescence onset asthma. MATERIAL AND METHODS: A cross-sectional study was done gathering information about asthma, unplanned pregnancy, family atopy and active or passive smoking in 3,130 adolescents aged 13-19 years. Asthma diagnosis was established through a selfquestionnaire based on the International Study of Asthma and Allergy in Childhood. Odds ratios for asthma were determined using logistic regression model and chi-squared test. RESULTS: Mean age of the participants was 16.37 ± 1.93 years. The prevalence of active smoking was 16.1%, of passive smoking 40% and of family atopy 9.8%. From the pregnant adolescents (785), 59.5% reported had planned not to have a child before pregnancy. Prevalence of wheezing during the year prior to the study was 9.3% and of wheezing during the pregnancy 2%. The prevalence of adolescence onset asthma was 5.4%. The age of initiation of asthma in the adolescence was 14.75 ± 1.60 years. The analysis showed that unplanned pregnancy has a slight risk for the development of asthma during adolescence. (Crude OR=1.03; CI 95% 1.02-1.05; p=0.000). CONCLUSION: Unplanned pregnancy, family atopy, active smoking and smoking friends are associated with the onset-asthma in the adolescence.

ANTECEDENTES: la asociación entre embarazo y asma se ha documentado previamente. La relación entre embarazo no planeado y asma de inicio en la adolescencia no se ha estudiado. OBJETIVO: determinar la asociación entre embarazo no planeado y asma de inicio en la adolescencia. MATERIAL Y MÉTODOS: estudio transversal en el que se recogió información de asma, embarazo no planeado, atopia familiar y tabaquismo activo o pasivo en 3,130 adolescentes de 13-19 años de edad. El asma se diagnosticó mediante un cuestionario autoadministrado basado en el utilizado en el Estudio Internacional de Asma y Alergia en Niños (ISAAC por sus siglas en inglés). Se determinó la razón de momios para asma mediante regresión logística y chi cuadrada. RESULTADOS: la edad media de las participantes fue 16.37 ± 1.93 años. La prevalencia del tabaquismo activo fue 16.1%, del pasivo 40% y la atopia familiar 9.8%. De las adolescentes embarazadas (785), 59.5% anotó que no había planeado tener un hijo antes del embarazo. La prevalencia de sibilancias durante el último año fue 9.3% y de sibilancias durante el embarazo 2%. La prevalencia de asma de inicio en la adolescencia fue 5.4%. La edad de inicio de asma en la adolescencia fue 14.75 ± 1.60 años. El análisis muestra que el embarazo no planeado tiene un ligero riesgo de padecer asma de inicio en la adolescencia (RM cruda=1.03; IC 95% 1.02-1.05). CONCLUSIONES: el embarazo no planeado, la atopia familiar, el tabaquismo activo y el tabaquismo de las amigas se asocian con el asma de inicio en la adolescencia.