Social disadvantages that start during childhood and continue into the later stages in life may be linked to the presence of diabetes during adulthood.
To analyze whether the presence of social ...disadvantages in childhood and in the present affects the presence of diabetes in older adults.
The present study was based on longitudinal data from the third and fourth Mexican Health and Aging Study (MHAS) waves (2012 and 2015). Data on diabetes diagnosis, past (e.g. "no shoes during childhood") and present (e.g. self-perception of economic status) social disparities, and other covariables were analyzed.
From 8,848 older adults, 21.5% (n = 1903) were classified as prevalent cases (PG), 5.2% (n = 459) as incident cases (IG) and 77.4% (n = 6,486) were free of disease (NDG). The predictor variable "no shoes during childhood" was statistically significant in the model incident versus no diabetes group. Hypertension and body mass index (BMI) were the most relevant covariates as they were statistically significant in the three groups (PG, IG and NDG).
Not having shoes during childhood, an indicator of social disadvantages, is associated with the incidence and prevalence of diabetes in older adults. This suggests that social disadvantages can be a determinant for the presence of chronic diseases in adulthood.
Objective. Polymerized-type I collagen (polymerized-collagen) is a downregulator of inflammation and a tissue regenerator. The aim was to evaluate the effect of intra-articular injections (IAIs) of ...polymerized-collagen among patients with symptomatic knee osteoarthritis (OA) in delaying or preventing joint replacement surgery. Patients and Methods. This was a cohort study of 309 patients with knee OA. Patients with mild-to-moderate disease were treated weekly with IAIs of 2 mL of polymerized-collagen for six weeks (n = 309). Follow-up was for 6–60 months. The primary endpoints included the following determinations: (1) therapeutic effect; (2) survival from total knee replacement surgery (TKR); (3) Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and pain (visual analogue scale, VAS). Clinical improvement was defined as a decrease in pain exceeding 20 mm on the VAS and the achievement of at least 20% improvement from baseline with respect to the WOMAC score. Radiographic analysis was performed at baseline and 60 months. The joint space width in the medial, lateral, and patellofemoral compartments was calculated. Results. Patients who received IAIs of polymerized-collagen had a statistically significant improvement in the primary criteria (p<0.05). Kaplan–Meier survival analysis of the therapeutic effect demonstrated 98.8% survival at 60 months with TKR as the endpoint. There was no significant reduction in joint space in any compartment based on the analyzed radiographs. No serious adverse events were recorded. Conclusion. Polymerized-collagen increased the time to TKR by at least 60 months, modifying the disease course, improving functional disability, and decreasing pain.
Introducción: datos de varios países del mundo sugieren que los niños con COVID-19 podrían presentar síntomas diferentes y menos graves que los adultos. Sin embargo, los patrones epidemiológicos y ...clínicos en este grupo poblacional son poco claros. Métodos: el presente es un estudio observacional, con una caracterización inicial transversal-analítica, y con un componente longitudinal o de seguimiento a un grupo de menores con sospecha y/o diagnóstico confirmado de COVID-19, que presentaron desenlaces como mejoría, traslado a un nivel superior de atención o defunción por sintomatología respiratoria. Los niños recibieron atención médica en el Hospital General Regional con Medicina Familiar N.o 1 (HGR C/MF N.o 1), y se les realizó prueba de reacción en cadena de la polimerasa en tiempo real (RT-PCR). Resultados: se estudiaron 98 niños como casos sospechosos para COVID-19, a quienes se les realizó RT-PCR. Del total, 24 resultaron positivos y 74 fueron negativos. La mediana de edad de los participantes fue 64,4 meses (0 a 203 meses), 55 menores eran de sexo masculino, 59 niños tuvieron manejo ambulatorio, y de estos 14 presentaron resultado positivo. Entre los que requirieron manejo hospitalario (39), 10 niños dieron positivo para SARS-CoV-2, y, de estos, 84,7% alcanzaron mejoría y fueron dados de alta; 4 fueron trasladados a hospitales de nivel superior de atención. De los 98 niños en estudio, 11 fallecieron, 7 con resultado negativo y 4 con resultado positivo para SARS-CoV-2.
In Mexico, regular participation in mammography screening is low, despite higher survival rates. The objective of our research is to highlight healthcare procedures to be optimized and target areas ...to encourage investment and to raise awareness about the benefits of early diagnosis. Those socio-ecological factors (community, interpersonal and individual) were collected through a review of literature and based on the spatial interaction model of mammography use developed by Mobley et al. The opinion of diverse groups of experts on the importance of those factors was collected by survey. The Fuzzy Delphi Method helped to solve the inherent uncertainty of the survey process. Our findings suggest that population health behaviors, proximity-density to facilities/ physicians and predisposing factors are needed to increase the screening rate. Variations in expert group size could affect the accuracy of the conclusions. However, the application of the enhanced aggregation method provided a group consensus that is less susceptible to misinterpretation and that weighs the opinion of each expert according to their clinical experience in mammography research.
Introduction: anthropometric indicators (AIs) such as waist circumference (WC), body mass index (BMI), waist/hip index (WHpI), waist/height index (WHtI) and body fat percentage (BFP) are useful tools ...for the diagnosis of nutritional status (NS) in adolescents. Each of these parameters has advantages and disadvantages. The purpose of the present study was to analyze the association of these AIs (WC, BMI, WHpI, WHtI, and BFP) to evaluate nutritional status and estimate the cardiometabolic risk (CMR) in Mexican adolescents. Material and method: in a cross-sectional descriptive study, the NS was analyzed through various AIs and CMR with the WHtI criteria. Nine hundred and seventeen adolescents between 15 and 17 years old participated in the study, of whom 488 (52.9%) were female and 429 (47.1%) male, all students of middle school in Tuxtla Gutiérrez, Chiapas, Mexico. Results and conclusion: women presented a higher prevalence of obesity according to most indicators. The WHtI was the parameter that detected the highest prevalence of obesity (31%), correlating with the BMI and the BFP. Moreover, there was evidence of a significant relation between NS (assessed by all the anthropometric indicators) and CMR. The WHtI could be considered as an adequate tool for the diagnosis of obesity associated with CMR in adolescents.
Objective: To assess the safety of botulinum toxin type A for children with cerebral palsy using data from randomized clinical trials.
Data sources: A search was conducted of MEDLINE database for the ...period January 1990 to February 2008. A complementary search was carried out of references from previous reviews. From 122 articles, 20 randomized clinical trials were selected for the review.
Review methods: Two authors independently assessed eligibility of the studies and methodological quality of those according to CONSORT guidelines. For each adverse effect, relative risk was calculated, and when more than one study reported adverse effects, a meta-analysis was carried out. Sensitivity analyses with different continuity corrections factors were performed when zero cases were reported in a study arm.
Results: There were 882 participants in the 20 studies included in the meta-analysis. Six studies reported zero adverse effects. Thirty-five different adverse events were reported. Botulinum toxin type A use was related to respiratory tract infection, bronchitis, pharyngytis, asthma, muscle weakness, urinary incontinence, falls, seizures, fever and unspecified pain. Two deaths were reported in the study with higher person-time follow-up (relative risk (RR) 4.69, 95% confidence interval (CI) 0.23—95).
Conclusions: Botulinum toxin type A has a good safety profile during the first months of use. However the occurrence of adverse events is more frequent among children with cerebral palsy than individuals with other conditions. Severe adverse events are potentially related with the use of botulinum toxin type A, but data are sparse and additional study is required to clarify the causal relation.
El 24 de julio de 2020 el estadio nacional de Tokio, en Japón, se convertiría en el epicentro de los Juegos Olímpicos donde un tumulto de atletas de diversas disciplinas deportivas y de muchos ...lugares del mundo se darían cita para disputar los logros que desde 776 a. C. se realizaban en la Villa Griega de Olimpia, dentro del Santuario del dios Zeus (aunque en 1896 se iniciaron las de la era moderna); sin embargo, estos eventos deportivos de Tokio fueron pospuestos para el siguiente año (23 de julio de 2021). En 124 años nunca antes habían sido postergados, sólo en 1916, 1940 y 1944 fueron cancelados debido a los conflictos bélicos de las dos guerras mundiales, pero ahora la aparición de un nuevo virus (SARSCoV-2) de la familia de los coronavirus y causante de la enfermedad COVID-19 que surgió en Wuhan, China, en el año 2019, se extendió por todo el mundo y ocasionó una pandemia que condicionó este aplazamiento, haciendo que esta justa deportiva pasara a la historia no sólo por la espera de romper marcas atléticas
RESUMEN: Asociar grupos de alimentos con “atención dental por caries” y “por gingivitis” en adolescentes de entre 12 y 24 años de edad de escuelas públicas en Morelos, México. Las variables ...dependientes: “atención dental por caries” y “por gingivitis” se definieron por auto-reporte. Los grupos de alimentos se obtuvieron de un cuestionario de consumo en el último año. La ingesta diaria se estimó calculando cada peso correspondiente a la frecuencia de consumo del alimento ajustado al tamaño de la porción utilizando tablas de alimentos y después fueron sumados según al grupo que pertenecían (lácteos, frutas, verduras, leguminosas, cereales, carne y huevo, pescados y mariscos, comida rápida, bebidas carbonatadas y jugos embotellados y golosinas). Para el análisis se utilizaron modelos logísticos multinivel para mediciones repetidas para identificar as ociaciones (RM) entre ingesta de cada grupo de alimentos con cada variable dependiente por separado. En el análisis ajustado “atención dental por caries” se asoció con: frutas (RM 1.70), bebidas carbonatadas y jugos embotellados (RM 1.38) y golosinas (RM 1.44), mientras que cereales se mantuvo en el nivel marginal (RM 1.34). No se encontró asociación con “por gingivitis”. Los alimentos con altos contenidos de hidratos de carbono refinados son determinantes para acudir a servicios dentales por caries.
Objetivo: estimar la asociación entre deterioro cognitivo y obesidad en adultos. Métodos: estudio transversal analítico con una muestra no probabilística de casos consecutivos. Se incluyeron 112 ...participantes de 20 a 64 años de edad, con peso normal y con obesidad, que acudieron a la consulta externa del Hospital General Regional con Medicina Familiar No. 1, en Cuernavaca, Morelos, México. Se utilizó la escala de Evaluación Cognitiva de Montreal y se evaluaron covariables como actividad física, consumo calórico, sexo, edad, circunferencia de cintura y porcentaje de grasa corporal. Los datos se analizaron con el programa estadístico stata 11.1. Resultados: de los 112 participantes, 23 eran hombres y 89, mujeres; el rango de edad fue de 20 a 64 años (mediana 30 años). Se encontraron diferencias estadísticamente significativas (p<0.05) entre los grupos con y sin deterioro cognitivo en las variables: escolaridad, edad, nivel de grasa visceral, porcentaje de grasa corporal, circunferencia de cintura y calidad muscular. Después de ajustar por edad, sexo, nivel de educación, actividad física y consumo de calorías diarias, la obesidad se asoció significativamente con un incremento de la posibilidad de presentar deterioro cognitivo (rm = 3.77, ic 95% = 1.004-14.190, p <0,04). Conclusión: la obesidad se asoció con mayor posibilidad de presentar deterioro cognitivo, mientras que la escolaridad superior se asoció con una menor posibilidad de presentarlo.
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