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1.
Int J Vitam Nutr Res ; 91(5-6): 451-460, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32091321

RESUMO

Nowadays, glycine is used in nutritional supplements and to attenuate chronic complications of diabetes and obesity; however, its use has side effects as insulin resistance. Our aim was to evaluate the effect of chronic glycine supplementation on insulin, glucose and triglyceride levels in healthy Wistar rats. Groups were: Control (C), that received sterilized water only, glycine (GG), that received 1% glycine and taurine (TG), that received 0.5% taurine during 6 months (n = 10). Our results showed no differences in plasma insulin levels after six months of supplementation (C: 13.22 ± 2.0; GG: 11.4 ± 2.0; TG: 11.13 ± 2.0 ng/ml; p = 0.64). Likewise, neither glucose plasma concentration (C: 99.9 ± 3.9 mg/dl; GG: 104.3 ± 4.3 mg/dl; TG: 104.5 ± 4.8 mg/dl) (p = 0.88) nor triglyceride levels (C: 58.4 ± 5.6 mg/dl; GG: 46.9 ± 2.3 mg/dl; TG: 50.68 ± 3.3 mg/dl), showed differences after six months supplementation (p = 0.22). Furthermore, the analysis of glycine (C: 80 ± 24.6; GG: 83.9 ± 25.9; TG: 90.7 ± 13.5 nmol/ml) (p = 0.19) and taurine (C: 169 ± 15.17; GG: 148.7 ± 23.9; TG: 165.8 ± 22.5 nmol/ml) (p = 0.4) in the plasma of animals with supplementation showed no significant changes. Additionally, general urine tests and histological analysis of liver or kidneys showed no alterations. In conclusion, chronic supplementation with 1% glycine did not have any significant detrimental side effects in our model. However, more studies are still necessary to evaluate the effect of 1% glycine supplementation in humans.


Assuntos
Resistência à Insulina , Insulina , Animais , Glicemia , Suplementos Nutricionais , Glucose , Glicina , Ratos , Ratos Wistar , Triglicerídeos
2.
Int J Vitam Nutr Res ; 91(5-6): 491-499, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32228174

RESUMO

Although thiamine pyrophosphate (TPP) is considered a protective agent for endothelial cells, it is still unknown if this is associated with nitric oxide (NO) synthesis. Our aim was to evaluate the synthesis of NO in endothelial cells incubated with TPP and high glucose concentrations. Endothelial cells from the umbilical cord vein from newborns (n = 20), were incubated with 5, 15 or 30 mmol/L glucose, in absence or presence of 0.625 mg/ml of TPP. Our results showed a significant increase in cell proliferation (> 40%; P < 0.05), and cell viability (> 90%; P < 0.001) after 48 h in endothelial cells cultured with glucose plus TPP. Likewise, in the presence of glucose and TPP an important rise in the consumption of glucose by the endothelial cells was observed after 24 h (> 7%; P < 0.001) and 48 h (> 10%; P < 0.05). Additionally, the levels of lactate after incubation with glucose and TPP showed only slight variations after 48 h (P < 0.05). However, these changes were clearly different from those observed in the absence of TPP. Interestingly, we found that the changes mentioned were linked with reduced levels of nitrites both at 24 h (< 171 pmol/µg protein; P < 0.001), and 48 h (< 250 pmol/µg protein; P < 0.05), which was associated with a reduced expression of mRNA of eNOS in endothelial cells incubated with TPP and high glucose. In conclusion, the presence of TPP regulates the consumption of glucose and the synthesis of NO, which would explain its protective effect in the endothelium of diabetic patients.


Assuntos
Diabetes Mellitus , Tiamina Pirofosfato , Células Cultivadas , Células Endoteliais , Glucose , Humanos , Recém-Nascido , Óxido Nítrico , Tiamina
3.
Gac Med Mex ; 155(Suppl 1): S28-S34, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31638615

RESUMO

BACKGROUND: The promotion of health is carried out in preventive services of medical units, in educational programs and textbooks from the general perspective of the population. OBJECTIVE: To determine baseline characteristics of health education for pre-school children, their parents and teachers, by means of specialist doctors. METHOD: Cross-sectional study of an educational program for preschool children. Life skills and health competencies were evaluated. RESULTS: The preschoolers developed resilience (84.12%), empathy (92.23%), assertive communication (93.5%), interpersonal relationships (91.0%), correct decision making (92.56%), problem solving (81.05%), creative thinking (98%), critical thinking (86.08%), emotion management (80.76%), physical activation (97.94%), self-knowledge (98.96%), hygienic habits (94.90%) and co-responsibility (86.25%); 95.59% liked the workshop and 95.75% chose the correct option in the problems described. 63.04% of parents generated changes in their habits and those of their children. CONCLUSION: The educational program implemented can promote empowerment in health from childhood.


Assuntos
Creches , Educação em Saúde/métodos , Pais/educação , Escolas Maternais , Capacitação de Professores , Pré-Escolar , Comunicação , Estudos Transversais , Currículo , Tomada de Decisões , Empatia , Feminino , Humanos , Relações Interpessoais , Masculino , Resolução de Problemas , Resiliência Psicológica , Pensamento
4.
Gac Med Mex ; 155(Suppl 1): S38-S44, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31182875

RESUMO

BACKGROUND: The promotion of health is carried out in preventive services of medical units, in educational programs and textbooks from the general perspective of the population. OBJECTIVE: To determine baseline characteristics of health education for pre-school children, their parents and teachers, by means of specialist doctors. METHOD: Cross-sectional study of an educational program for preschool children. Life skills and health competencies were evaluated. RESULTS: The preschoolers developed resilience (84.12%), empathy (92.23%), assertive communication (93.5%), interpersonal relationships (91.0%), correct decision making (92.56%), problem solving (81.05%), creative thinking (98%), critical thinking (86.08%), emotion management (80.76%), physical activation (97.94%), self-knowledge (98.96%), hygienic habits (94.90%) and co-responsibility (86.25%); 95.59% liked the workshop and 95.75% chose the correct option in the problems described. 63.04% of parents generated changes in their habits and those of their children. CONCLUSION: The educational program implemented can promote empowerment in health from childhood.


ANTECEDENTES: La promoción de la salud se realiza en servicios preventivos de unidades médicas, en programas educativos y libros de texto desde la perspectiva general de la población. OBJETIVO: Determinar características basales de educación en salud a preescolares, sus padres y maestros, mediante médicos especialistas. MÉTODO: Estudio transversal de un programa educativo para preescolares en estancias infantiles. Se evaluaron habilidades para la vida y competencias para la salud. RESULTADOS: Los preescolares desarrollaron resiliencia (84.12%), empatía (92.23%), comunicación asertiva (93.5%), relaciones interpersonales (91.0%), toma correcta de decisiones correctas (92.56%), solución de problemas (81.05%), pensamiento creativo (98%), pensamiento crítico (86.08%), manejo de emociones (80.76%), activación física (97.94%), autoconocimiento (98.96%), hábitos higiénicos (94.90%) y corresponsabilidad (86.25%); al 95.59% les agradó el taller y el 95.75% eligió la opción correcta en los problemas descritos. El 63.04% de los padres generaron cambios en sus hábitos y en los de sus hijos. CONCLUSIÓN: El programa educativo implementado puede favorecer el empoderamiento en salud desde la infancia.


Assuntos
Educação em Saúde , Creches , Pré-Escolar , Estudos Transversais , Feminino , Educação em Saúde/métodos , Educação em Saúde/organização & administração , Promoção da Saúde/métodos , Humanos , Masculino
5.
J Nutr ; 142(2): 278-83, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22190032

RESUMO

The R230C variant of the ATP-binding cassette transporter A1 (ABCA1) gene has been consistently associated with decreased HDL-cholesterol (HDL-C) concentrations in several studies in the Mexican mestizo population. However, information on how diet composition modifies the effect of the ABCA1-R230C variant on HDL-C concentrations is very scarce. The aim of the present study was to analyze whether the effect of ABCA1-R230C on HDL-C concentrations is modulated by dietary factors in a nationwide population sample of 3591 adults from the National Health and Nutrition Survey conducted by the State's Employees' Social Security and Social Services Institute. All participants answered a validated questionnaire to assess health status and weekly food consumption. Fasting blood samples were drawn for biochemical analysis and DNA extraction, and the ABCA1-R230C variant was genotyped using TaqMan assays. Statistical analyses consisted of simple linear and multiple regression modeling adjusting for age, BMI, smoking, and alcohol consumption. The overall C risk allele frequency was 9.3% and the variant was significantly associated with low HDL-C concentrations in both sexes. A significant negative correlation between carbohydrate consumption and HDL-C concentrations was observed in women bearing the R230C variant (P = 0.021) and a significant gene-diet interaction was found only in premenopausal women (P = 0.037). In conclusion, the effect of the ABCA1-R230C gene variant on HDL-C concentrations is modulated by carbohydrate intake in premenopausal women. This finding may help design optimized dietary interventions according to sex and ABCA1-R230C genotype.


Assuntos
Transportadores de Cassetes de Ligação de ATP/genética , Transportadores de Cassetes de Ligação de ATP/metabolismo , HDL-Colesterol/sangue , Carboidratos da Dieta/administração & dosagem , Variação Genética , Pré-Menopausa , Transportador 1 de Cassete de Ligação de ATP , Adulto , Alelos , Estudos Transversais , Inquéritos sobre Dietas , Carboidratos da Dieta/farmacologia , Feminino , Genótipo , Humanos , Masculino , México , Pessoa de Meia-Idade , Pré-Menopausa/sangue , Pré-Menopausa/genética , Fatores de Risco , Caracteres Sexuais , Inquéritos e Questionários
6.
Clin Nutr ; 39(10): 3019-3023, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32093879

RESUMO

BACKGROUND & AIMS: Adequate nutrition from which amino acids are part gives us protection against infectious or metabolic diseases. In particular, glycine has immunomodulatory properties and is a secretagogue of insulin. However, its absorption rate or plasma levels are impaired in bacterial infection or high glucose levels. The aim of this study was to evaluate the association between glycine and insulin plasma levels in patients with pulmonary tuberculosis (PTB) and type 2 diabetes mellitus (DM2). METHODS: Plasma levels of insulin and glycine were determined in four groups: 1) patients with PTB; 2) patients with PTB-DM2; 3) household contacts with DM2 (C-DM2), and 4) healthy household contacts (H-C). Likewise, we analyzed the plasma levels of glucose, serine, arginine, lysine, taurine, and glutamic acid. RESULTS: We observed significant differences in the glycine levels between PTB and PTB-DM2 vs C-DM2 and H-C groups (P < 0.05). We observed also important differences in insulin and glucose levels after comparisons between PTB, PTB-DM2, and C-DM2 vs. H-C groups (P < 0.05). A correlation between glycine and insulin levels in the PTB (r = 0.326) and PTB-DM2 (r = 0.318) groups was found. CONCLUSION: Our results showed a significant association between glycine and insulin plasma levels in patients with PTB and PTB-DM2, which suggests that the determination of glycine levels could be used as a reference test to evaluate both pathologic conditions. An additional support to the above is that significant changes in the glucose levels in these groups were observed, too.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Glicina/sangue , Insulina/sangue , Tuberculose Pulmonar/sangue , Adulto , Biomarcadores/sangue , Glicemia/análise , Estudos de Casos e Controles , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/diagnóstico
7.
Tuberculosis (Edinb) ; 111: 114-120, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-30029895

RESUMO

IL-15 is part of the immune response in pulmonary tuberculosis (PTB) but amazingly, it may also induce physiological effects similar to those of insulin. We evaluated the IL-15 and insulin plasmatic levels in adults with PTB and with or without type 2 diabetes mellitus (DM2), who received previous antituberculosis therapy for at least 2 months. We analyzed the concentrations of glucose, glycated hemoglobin, insulin, as well as levels of IL-15, IL-2, IFN-γ, and TNF-α in patients with PTB, patients with PTB-DM2, household contacts with DM2 (C-DM2), and healthy household contacts (H-C). Our results showed unexpected high levels of glucose, insulin, and IL-15 in the PTB and C-DM2 groups. In comparison, low levels of these same indicators were observed in the PTB-DM2 and H-C groups. Interestingly, our analysis showed a positive correlation of IL-15 with insulin in the PTB group (r = 0.73) and in the C-DM2 group (r = 0.66). In comparison, a weak correlation between IL-15 and insulin was observed in the PTB-DM group (r = 0.10) and in the H-C group (ρ = 0.26). Our results suggest an association between IL-15 and insulin levels in the patient with PTB. Intriguingly, this association was weaker in the patient with PTB-DM2.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Insulina/sangue , Interleucina-15/sangue , Tuberculose Pulmonar/sangue , Adulto , Idoso , Antituberculosos/uso terapêutico , Biomarcadores/sangue , Glicemia/efeitos dos fármacos , Glicemia/metabolismo , Estudos de Casos e Controles , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Hipoglicemiantes/uso terapêutico , Resistência à Insulina , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/tratamento farmacológico
8.
Hypertens Pregnancy ; 26(4): 423-31, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-18066961

RESUMO

BACKGROUND: Hypertensive disorders of pregnancy (HDP), which affect 8% to 15% of pregnancies, are associated with nitric oxide dysfunction and hyperlipidemia, but their precise role in HDP remains controversial. In order to gain more insight into the mechanisms underlying HDP, we evaluated some indicators common to the diseases associated with endothelial dysfunction. METHODS: Plasma samples were obtained from 47 normotensive women (control group) and from 27 women with HDP (experimental group). All women were 7 months pregnant. Body mass index as well as triglycerides, nitrite concentrations, total cholesterol, LDL-cholesterol, HDL-cholesterol, glucose, and glycated hemoglobin were determined. RESULTS: Our results showed significant differences in body mass index (30.4 +/- 1.3 vs 28.3 +/- 0.6 kg/m(2), p < 0.05), triglycerides (363 +/- 137 vs. 263 +/- 80 mg/dL, p < 0.01), nitrites (19.6 +/- 5.2 vs. 15.2 +/- 5.0 micromol/L, p < 0.01), and glucose (92 +/- 25 vs. 81 +/- 10.8 mg/dL, p < 0.05) in women from the experimental group compared with the control group. Interestingly, nitric oxide synthesis was significantly reduced when triglycerides and cholesterol concentrations were increased (p < 0.018 and p < 0.002, respectively). Moreover, there was a strong association (odds ratio, 3.5) between a family history of type 2 diabetes mellitus and the development of HDP, especially preeclampsia. CONCLUSIONS: It may be useful to screen pregnant women for plasma nitrites and serum triglycerides to identify those at risk of developing HDP, especially in women with a family history of type 2 diabetes mellitus.


Assuntos
Hipertensão Induzida pela Gravidez/sangue , Hipertrigliceridemia/sangue , Óxido Nítrico/biossíntese , Adulto , Glicemia/análise , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Colesterol/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/genética , Feminino , Hemoglobinas Glicadas/análise , Humanos , Nitritos/sangue , Pré-Eclâmpsia/sangue , Gravidez/sangue , Fatores de Risco , Triglicerídeos/sangue
9.
Gac. méd. Méx ; 155(supl.1): 38-44, dic. 2019. tab
Artigo em Espanhol | LILACS | ID: biblio-1286563

RESUMO

Resumen Antecedentes: La promoción de la salud se realiza en servicios preventivos de unidades médicas, en programas educativos y libros de texto desde la perspectiva general de la población. Objetivo: Determinar características basales de educación en salud a preescolares, sus padres y maestros, mediante médicos especialistas. Método: Estudio transversal de un programa educativo para preescolares en estancias infantiles. Se evaluaron habilidades para la vida y competencias para la salud. Resultados: Los preescolares desarrollaron resiliencia (84.12%), empatía (92.23%), comunicación asertiva (93.5%), relaciones interpersonales (91.0%), toma correcta de decisiones correctas (92.56%), solución de problemas (81.05%), pensamiento creativo (98%), pensamiento crítico (86.08%), manejo de emociones (80.76%), activación física (97.94%), autoconocimiento (98.96%), hábitos higiénicos (94.90%) y corresponsabilidad (86.25%); al 95.59% les agradó el taller y el 95.75% eligió la opción correcta en los problemas descritos. El 63.04% de los padres generaron cambios en sus hábitos y en los de sus hijos. Conclusión: El programa educativo implementado puede favorecer el empoderamiento en salud desde la infancia.


Abstract Background: The promotion of health is carried out in preventive services of medical units, in educational programs and textbooks from the general perspective of the population. Objective: To determine baseline characteristics of health education for pre-school children, their parents and teachers, by means of specialist doctors. Method: Cross-sectional study of an educational program for preschool children. Life skills and health competencies were evaluated. Results: The preschoolers developed resilience (84.12%), empathy (92.23%), assertive communication (93.5%), interpersonal relationships (91.0%), correct decision making (92.56%), problem solving (81.05%), creative thinking (98%), critical thinking (86.08%), emotion management (80.76%), physical activation (97.94%), self-knowledge (98.96%), hygienic habits (94.90%) and co-responsibility (86.25%); 95.59% liked the workshop and 95.75% chose the correct option in the problems described. 63.04% of parents generated changes in their habits and those of their children. Conclusion: The educational program implemented can promote empowerment in health from childhood.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Educação em Saúde/métodos , Educação em Saúde/organização & administração , Creches , Estudos Transversais , Promoção da Saúde/métodos
10.
Pediatr Allergy Immunol ; 15(5): 415-20, 2004 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-15482516

RESUMO

Recent studies have explored the effect of Bacilli Calmette-Guerin (BCG) or Mycobacterium vaccae vaccination in asthmatic patients, yielding conflicting results. We investigated the effect of BCG vaccination in asthmatic schoolchildren, especially focusing on the cytokine pattern released by mononuclear cells. After a 1-yr run-in period, 67 asthmatic schoolchildren received intradermal immunization with BCG (33 patients) or placebo (34 patients). Both groups were followed during 1 yr. Serum immunoglobulin E (IgE) levels did not change after BCG (407.1 +/- 86.6 vs. 415.1 +/- 86.7 IU/ml, mean +/- s.e.m.), but increased after placebo (406.7 +/- 67.0 vs. 619.7 +/- 90.7 IU/ml, p = 0.001) administration. Interleukin (IL)-4 and interferon (IFN)-gamma measured in the supernatant of stimulated cultured blood mononuclear cells did not change in the BCG group (10.8 +/- 2.3 vs. 17.9 +/- 5.7 pg/ml, and 348.6 +/- 118.0 vs. 354.8 +/- 139.0 pg/ml, respectively), while in the control group IL-4 increased (from 6.7 +/- 1.3 to 16.1 +/- 6.0 pg/ml, p < 0.05), and IFN-gamma decreased (from 279.9 +/- 82.1 to 232.1 +/- 109.6 pg/ml, p = 0.01). In comparison with their initial status, most patients maintained the same asthma severity and the same proportion of emergency room visits at the end of the study. The proportion of those in whom asthma improved or worsened was the same in both groups. We concluded that, contrary to the common hypothesis, BCG vaccination in asthmatic children was unable to cause a long-term reinforcement of Th(1) response, although it could avoid the increased Th(2) response observed in control patients.


Assuntos
Asma/imunologia , Vacina BCG/efeitos adversos , Criança , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunoglobulina E/sangue , Interferon gama/imunologia , Interferon gama/metabolismo , Interleucina-4/imunologia , Interleucina-4/metabolismo , Masculino , Células Th1/imunologia , Células Th2/imunologia
11.
Rev. Inst. Nac. Enfermedades Respir ; 12(4): 250-61, oct.-dic. 1999. tab
Artigo em Espanhol | LILACS | ID: lil-266897

RESUMO

Introducción. En México se ha logrado disminuir la mortalidad por infecciones respiratorias agudas, en un 41.5 por ciento de 1990 a 1997. El descenso no ha sido mayor, porque los grupos indígenas y marginados siguen manteniendo altas tasas de mortalidad. Material y métodos. Estudio etnográfico, realizado en dos comunidades indígenas una mixteca y otra zapoteca de diferentes regiones del estado de Oaxaca. Población de estudio: 24 madres mixtecas y 15 zapotecas entre 15 y 65 años, con uno o más niños menores de cinco años. Se les aplicaron dos cuestionarios: uno, semi-abierto y otro socioeconómico, traducidos oralmente por personas de las comunidades. Objetivo. Conocer ¿cómo las madres de dos comunidades indígenas de diferentes regiones del estado de Oaxaca perciben e identifican a las infecciones respiratorias agudas y a qué prácticas médicas recurren? Resultados. En la comunidad mixteca, ninguna madre reconoció la neumonía, y en la zapoteca sólo un tercio. De las infecciones respiratorias agudas superiores, la mayoría de ambas comunidades, reconoce principalmente al resfriado común. Para la atención de las enfermedades, recurren a tres acciones: tradicional, doméstica y automedicación. Ninguna madre mencionó el uso de antibióticos. Sólo cuando sus hijos tienen una infección respiratoria aguda grave, acuden a la clínica oficial. Conclusión. El desconocimiento de las percepciones maternas del proceso salud-enfermedad-atención de las infecciones respiratorias agudas, puede hacer que las actividades de capacitación, para su prevención y control, planeadas bajo la concepción occidental del modelo biomédico les resulten ajenas, contribuyendo a mantener la morbilidad y mortalidad en sus comunidades


Assuntos
Humanos , Feminino , Adulto , Atitude Frente a Saúde/etnologia , Medicina Tradicional , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/etnologia , Características Culturais , Áreas de Pobreza , População Rural , Fatores Socioeconômicos
12.
Rev. Inst. Nac. Enfermedades Respir ; 12(2): 120-8, abr.-jun. 1999. tab, mapas
Artigo em Espanhol | LILACS | ID: lil-254661

RESUMO

Introducción. En el contexto de la transición epidemiológica, las infecciones respiratorias agudas han disminuido su importancia como causa de muerte en la población general, aunque todavía representan un problema importante de salud pública debido a la incapacidad, secuela y muerte que producen en los grupos etarios extremos de la vida. Esta característica es compartida con países latinoamericanos en condiciones de desarrollo similares al de México. Objetivo. El propósito de este ensayo es decribir la epidemiología de las infecciones respiratorias agudas en México y en cinco países del continente americano para destacar su magnitud actual y la necesidad de mejorar estrategias para su control y prevención. Conclusión. El análisis de la situación existente en los países de América Latina muestra la heterogenidad epidemiológica que existe entre estas naciones. En nuestro país el perfil epidemiológico de las infecciones respiratorias agudas ha mostrado mejoría con respecto a la mortalidad. Para poder abatir las tasas de morbilidad y mortalidad por infecciones respiratorias agudas es necesario conocer con mayor detalle las características que se encuentran asociadas a la enfermedad en las áreas y grupos de mayor riesgo y así proponer alternativas preventivas adecuadas a los niveles local, regional y nacional


Assuntos
Humanos , Lactente , Pré-Escolar , Epidemiologia/estatística & dados numéricos , Epidemiologia/tendências , Mortalidade , Doenças Respiratórias/epidemiologia , Doenças Respiratórias/prevenção & controle , México/epidemiologia
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