The study objectives were to estimate the standardized incidence and evaluate factors associated with moderate/severe pediatric traumatic brain injury (p-TBI) in children aged 5–15 years in Western, ...Mexico.
The study was cross-sectional in design. We estimated the standardized incidence of moderate/severe p-TBI using the direct methods of the World Health Organization (WHO) standard populations. We utilized the Glasgow Coma Scale (GCS) to identify moderate/severe p-TBI patients (GCS ≤ 13). Logistic regression analysis was applied to evaluate variables associated with moderate/severe p-TBI.
The standardized incidence of patients diagnosed with moderate/severe p-TBI was 31.0/100,000 person-years (95 % CI 28.7–33.4). According to age, the moderate/severe TBI group was included. A total of 254 (38.5 %) patients were aged 5–9 years, 343 (52.0 %) were aged 10–14 years, and 62 (9.5 %) were aged 15 years. Factors associated with moderate/severe TBI in the crude analysis were male sex (OR 5.50, 95 % CI 4.16–7.39, p < 0.001), primary school (OR 2.15, 95 % CI 1.62–2.84, p < 0.001), and falls (OR 1.34, 95 % CI 1.02–1.77, p = 0.035). Factors associated with moderate/severe p-TBI in the adjusted analysis were male sex (OR 6.12, 95 % CI 4.53–8.29, p < 0.001), primary school (OR 3.25, 95 % CI 2.31–4.55, p < 0.001), and falls (OR 1.78, 95 % CI 1.28–2.47, p < 0.001).
The incidence of moderate/severe p-TBI in children aged 5–15 years in western Mexico in this study was higher than that in other studies. One of the biggest factors associated with moderate/severe p-TBI was male sex, specifically those with lower education levels and those who were prone to falls.
•The standardized incidence of moderate TBI diagnoses patients was 24.5 (95 % CI 22.6–26.4).•The standardized incidence of severe TBI diagnoses patients was 5.1 (95 % CI 3.6–7.3).•Falls were the leading cause of moderate/severe TBI.
•Type-1 diabetes (T1D) patients and controls similarly performed a Go/NoGo task with emotional faces.•T1D patients had greater prefrontal and frontoparietal power in theta and alpha bands.•The ...results reflect the early deleterious effect of T1D on neurodevelopment.
Type-1 diabetes (T1D) is a disruptive metabolic disease that has an impact on neurodevelopment through its effects on the structure and function of the brain. One of the cognitive domains affected by T1D is sustained attention. The aim of this study was to analyze this process in children with T1D and compare their results to those of healthy controls.
Seventeen T1D children attending regular primary school and a similar group of healthy children matched by gender, age, handedness, and educational level were evaluated while identifying happy faces in a Go-NoGo task presented visually with simultaneous electrophysiological recording.
Behavioral performance in the two groups was similar but, the T1D children showed greater prefrontal and frontoparietal spectral power in the theta and alpha bands, compared to controls. Distinct patterns of theta lateralization between groups were also observed, with a negative correlation between frontal power magnitudes in delta and theta and glycated hemoglobin levels.
These results seem to reflect the early deleterious effects of T1D on neurodevelopment, which affects mainly attention allocation processes and the neurofunctional substrates that underlie them.
This phenomenon emphasizes the need for studies on neural-specific targets in which T1D affects neurodevelopment.
Objective
A protective function of vitamin D in metabolic syndrome (MetS) has been described. The objective of the present study was to examine the relationship between serum 25‐hydroxyvitamin D ...(25(OH)D) concentrations and MetS in non‐diabetic systemic lupus erythematosus (SLE) women.
Methods
Cross‐sectional analyses of the relationship between concentrations of 25(OH)D, MetS, and its components were made in 160 non‐diabetic SLE women. MetS was defined according to National Cholesterol Education Program Adult Treatment Panel III criteria. Serum 25(OH)D was measured by chemiluminescent immunoassay. Serum 25(OH)D concentrations were categorized into quartiles (<16.6, 16.6‐21.1, 21.2‐26.3, ≥26.4 ng/mL).
Results
A total of 79 (49.3%) SLE women had MetS. Without adjusting for body mass index (BMI) or smoking, the odds of having MetS decreased according to increasing quartiles of 25(OH)D concentrations (P for trend = .03). The odds ratio (OR) of having MetS was 0.4 (95% confidence interval: 0.2‐0.9, P = .04) for the highest vs the lowest quartile of 25(OH)D concentrations when adjusted by age. The crude OR of having elevated hypertriglyceridemia decreased according to increasing quartiles of 25(OH)D concentrations (P for trend = .036). However, further adjustments for BMI and smoking removed the inverse association between 25(OH)D concentrations and MetS and its individual components.
Conclusion
In non‐diabetic SLE women with mild activity, 25(OH)D concentrations are not associated with MetS and its components.
Abstract
Purpose: This study examined the influence of five types of impairments in individuals with traumatic brain injury (TBI)-and caregiver stress due to these impairments-on the mental health of ...family caregivers in Guadalajara, Mexico.
Method: Ninety caregivers completed measures of TBI impairments and of their own mental health. The majority were female (92.20%) with a mean age of 47.12 years (SD = 12.67). Caregivers dedicated a median of 50 hours weekly to caregiving and had spent a median of 11 months providing care.
Results: Two canonical correlation analyses suggested that these two sets of variables were broadly related, such that more severe impairments in individuals with TBI and more caregiver stress due to those impairments were associated with lower caregiver mental health. Across both analyses, social impairments were most associated with increased caregiver burden. Follow-up analyses also uncovered that caregiver stress due to cognitive impairments was uniquely associated with caregiver burden and anxiety.
Conclusions: These results are the first to provide evidence that social and cognitive impairments in individuals with TBI from Latin America are the impairments most associated with caregiver mental health and highlight the need for interventions that target social and cognitive functioning.
The aim of this study was to examine the influence of three types of social support (appraisal, belonging, and tangible) on caregiver mental health (anxiety, burden, depression, and satisfaction with ...life) among Mexican caregivers of individuals with traumatic brain injury.
This is a cross-sectional study of 90 family caregivers from Hospital Civil Fray Antonio Alcade in Guadalajara, Mexico.
More months spent caregiving was associated with decreases in all three types of social support. Older age and fewer years of education were associated with lower appraisal social support. More hours per week spent caregiving was associated with lower caregiver state anxiety and greater satisfaction with life. Appraisal, belonging, and tangible social support were all significantly correlated with more salubrious caregiver mental health outcomes, except satisfaction with life. Appraisal social support independently predicted lower caregiver depression.
Particularly in Latin America, strong social support networks and family connections seem closely tied to key mental health outcomes such as depression. Rehabilitation interventions aimed at strengthening perceptions of social support of caregivers of individuals with traumatic brain injury that specifically target availability of advice may improve mental health and contribute to more optimal informal care for individuals with traumatic brain injury.
Research has documented the deleterious effects on caregivers of providing care for an individual with traumatic brain injury (TBI). TBI caregivers in Mexico specifically have reduced health-related ...quality of life (HRQOL) across both physical and mental health domains. The purpose of the current study was to uncover the system of connections between Mexican TBI caregivers' HRQOL and their mental health. A cross-sectional survey was conducted at a public medical facility in Guadalajara, México. Ninety family caregivers of individuals with TBI completed measures of HRQOL, satisfaction with life, depression, and burden. A canonical correlation analysis revealed that the better the caregivers' HRQOL, the better their mental health was, with the effect reaching a large-sized effect. A distinct pattern emerged linking caregivers' higher energy levels and better social functioning to lower depression and greater satisfaction with life. A series of multiple regressions similarly uncovered that the most robust independent HRQOL predictors of caregiver mental health were vitality and social functioning. Especially for TBI caregivers with poor health, behavioral health interventions in Latin America that target the HRQOL domains of social functioning and vitality may significantly improve caregiver mental health, and as a result, informal care for TBI.
Objective Postconcussion syndrome (PCS) is usually underestimated in cases of mild head injury (MHI). It is one of the most common causes of physical, cognitive, and psychomotor disturbances that ...affect the quality of life, work, and social reintegration of individuals. Until now, we did not have evidence of structural abnormalities shown by traditional imaging methods. We describe a series of instruments that confirm PCS with satisfactory evidence. Methods We conducted a clinical prospective study of 19 adult patients selected from a pool of 320 adults who had MHI. The cognitive, executive, and memory functions of subjects were examined within the first 72 hours using neuropsychological tests. These results were analyzed with neurological examination and functional MR/spectroscopy. Results Neurobehavioral alterations were found in 47% of cases, with posttraumatic amnesia. Around 55% of subjects experienced physical disturbances such as headache and postural vertigo due to PCS. The spectroscopy reports revealed neurometabolite disturbances in 54% of cases, particularly N-acetylaspartate (Naa) and the Naa/lactate ratio in the frontal lobe. We observed a relationship between metabolite disturbances in spectroscopy and the digit span backward test ( P = .045). Conclusions This first diagnostic strategy supports with scientific evidence the presence of PCS in MHI. We identified physical and neuropsychological abnormalities from this group, affecting the areas of memory and learning. Evidence of neurometabolite disturbances were found specifically in the frontal lobe. It is necessary to complete comparative follow-up for an extended period of time. The neuropsychological and spectroscopy tests allow us to confirm the diagnosis of a syndrome that is usually neglected.
The Mini-Mental State Examination (MMSE) is a rapid, easy-to-administer test for the assessment of cognition functions. It is widely used in clinical practice and in applied research. In this study, ...we aimed to establish a standard for the Mexican population similar to the ones produced for other relevant populations. We also analysed the effects of demographic variables which regularly induce bias in responses on performance tests, and then, on the basis of the results, implemented a series of corrections to the MMSE to compensate for the usual effects of age and years of formal education. We thus generated a new scale, the adjusted MMSE (AMMSE). We established the maximum sensitivity point to discriminate between the normal population and subjects diagnosed with dementia (vascular and Alzheimer’s). The study provides sensitivity and specificity estimates of this subject-standardized tool in order to reduce the probability of false positives and negatives in the Mexican population.
En el ámbito de la salud, el aprendizaje autodirigido implica que los profesionales asuman un papel activo en su propio desarrollo educativo y profesional. Esto significa que tienen la ...responsabilidad de identificar sus necesidades de aprendizaje, establecer metas educativas y buscar los recursos necesarios para alcanzarlas. Este enfoque es especialmente relevante en un campo tan dinámico como la salud, donde el conocimiento y las prácticas están en constante evolución. Los profesionales de la salud que participan en el aprendizaje autodirigido están capacitados para adaptarse rápidamente a los avances en su campo, actualizar sus habilidades y conocimientos, y mejorar continuamente su práctica clínica. Esto les permite mantenerse al día con los últimos desarrollos científicos, tecnológicos y terapéuticos, y brindar el mejor cuidado posible a sus pacientes. El aprendizaje autodirigido en el área de la salud también fomenta el desarrollo de habilidades como la reflexión crítica, la resolución de problemas y la toma de decisiones basada en evidencia. Estas habilidades son fundamentales para abordar los desafíos complejos que enfrentan los profesionales de la salud en su práctica diaria y para mejorar la calidad y seguridad del cuidado que brindan a los pacientes.
Introducción: La calidad de la formación de los médicos en el programa de residencias médicas demanda de un cuerpo de profesores altamente capacitados en los procesos educativos y fortalecidos en su ...vocación. Objetivo: Determinar las necesidades formativas de los profesores de residencias médicas en un hospital de segundo nivel. Material y métodos: Se realizó un estudio descriptivo y transversal en el Hospital General de Zona No. 20, en médicos especialistas que conforman el cuerpo de profesores de las especialidades. Se aplicó una encuesta a médicos especialistas de cualquier sexo, que estuvieran registrados como profesores en los programas operativos de las especialidades existente. Resultados: Se incluyeron 44 médicos, con edad promedio de 43±6 años, 15.9% eran profesores titulares, 86.4% contaban con nombramiento oficial de profesor, 40.9% con formación docente, dicha formación relacionado con cursos cortos 25% y diplomados 22.7%. El 97.7% de los docentes tienen necesidades de formación en estrategias didácticas 68.2%, metodología de la investigación 59.1% y herramientas de aprendizaje 52.3%. Conclusiones: Los médicos especialistas tienen necesidades de formación educativa sobre estrategias de enseñanza-aprendizaje e investigación, ya que menos de la mitad tienen formación docente.
