To compare the prevalence of previously diagnosed diabetes in 2016 with previous national surveys and to describe treatment and its complications.
Mexico's national surveys Ensa 2000, Ensanut 2006, ...2012 and 2016 were used. For 2016, logistic regression models and measures of central tendency and dispersion were obtained.
The prevalence of previously diagnosed diabetes in 2016 was 9.4%. The increase of 2.2% relative to 2012 was not significant and only observed in patients older than 60 years. While preventive measures have increased, the access to medical treatment and lifestyle has not changed. The treatment has been modified, with an increase in insulin and decrease in hypoglycaemic agents.
Population aging, lack of screening actions and the increase in diabetes complications will lead to an increase on the burden of disease. Policy measures targeting primary and secondary prevention of diabetes are crucial.
Objetivo. Comparar la prevalencia de diabetes por diagnóstico médico previo en 2016 con encuestas nacionales anteriores y describir su tratamiento y complicaciones. Material y métodos. Se utilizaron ...la Encuesta Nacional de Salud 2000, las Encuestas Nacionales de Salud y Nutrición 2006 y 20012, y la Encuesta Nacional de Salud y Nutrición de Medio Camino 2016. Para 2016 se obtuvieron modelos de regresión logística, así como medidas de tendencia central y dispersión. Resultados. La prevalencia de diabetes por diagnóstico médico en 2016 fue de 9.4%. El incremento de 2.2% respecto a 2012 no fue significativo y se observó únicamente en los mayores de 60 años. Aunque las acciones preventivas han aumentado, el acceso al tratamiento médico y los estilos de vida no han mejorado. Se observó un aumento en insulina y una diminución en hipoglucemiantes. Conclusión. El envejecimiento de la población, la insuficiencia de acciones de tamizaje y el aumento en las complicaciones de diabetes provocarán un aumento en la carga de enfermedad. Invertir en la prevención primaria y secundaria en diabetes es crucial.
Objective. To estimate the prevalence of diabetes (diagnosed and undiagnosed), glycemic control in Mexico, and its associated factors. Materials and methods. We used data from Ensanut 2018 (n=12 648) ...and 2020 (n=2 309). We defined diabetes as fasting glucose ≥126 mg/dl or HbA1c≥6.5% or previously diagnosed; glycemic control was defined as HbA1c<7%. We fitted Poisson regression models to assess the association between diabetes, glycemic control, and potential associated factors. Results. The total prevalence of diabetes was 16.8% in 2018 and 15.7% in 2020. In 2018, 38% of adults with diabetes were unaware of their disease, while in 2020 this figure was 29%. Glycemic control was observed in 42% of participants in 2018 and 39% in 2020. Longer disease duration was associated with lower glycemic control, while older age, having a diet, and being affiliated to IMSS, Pemex, Sedena, or private healthcare were associated with better control. Conclusion. Mexico is among the countries with the highest diabetes prevalence. A high proportion of adults with diabetes did not have a previous diagnosis, and the proportion with glycemic control is low. Strengthening screening to achieve a timely diagnosis, and improving glycemic control, should be key actions in the management of diabetes.
To estimate the prevalence of total, diagnosed and undiagnosed diabetes, and the prevalence of poor glycemic control in Mexico, and its associated factors.
Data from 3 700 adult participants were ...analysed in the 2016 National Health and Nutrition Survey. Diabetes prevalences were estimated with population weights, and the factors associated with total diabetes and poor glycemic control with Poisson regression models.
The total prevalence of diabetes was 13.7% (9.5% diagnosed, 4.1% undiagnosed); 68.2% of people with diagnosed diabetes presented poor glycemic control. Longer disease duration, living in the centre or south of the country and being treated in pharmacies were associated with poor glycemic control. Being treated in a social security system was associated with better glycemic control.
Multisectoral efforts are needed to strengthen screening, timely diagnosis and disease control, considering differences by region and type of health service.
The validity of the CALMA Veterinary Lap-trainer simulator (CVLTS) for training basic veterinary laparoscopic skills was assessed and compared to a simple collapsible mobile box trainer. Ten ...veterinarian surgeons with no experience in laparoscopic surgery and four experts with at least two years of experience in minimally invasive surgery (MIS) were included. The training curriculum included object transfer, non-woven gauze cutting with curved scissors, and interrupted and continuous intracorporeal sutures, which were practiced on the CVLTS. The initial and final assessments were carried out in both the CVLTS and in a collapsible mobile simulator. These were video-recorded and evaluated by external experts using the Objective Structured Assessment of Technical Skills (OSATS) and a specific scale evaluation in a double-blinded schedule. The time, angular displacement, number, and movement smoothness were recorded using a hands movement assessment system (HMAS). Through a survey, the face validity and content were evaluated. The data were analyzed by a Pearson's proportions comparison or Mann Whitney U test and a bilateral Student's
-test. The experimental group OSATS, specific scores, and HMAS values, with the exception of the smoothness of movements, significantly improved after training, with no statistically significant differences compared to the expert group. No differences were found between the two simulators. The experts' and experimental participants' CVLTS mean score was 4.8. Our data support the CVLTS validations for laparoscopic surgery basic skills training.
Arterial hypertension is a major global health problem. It is the main risk factor for preventable death and the leading cause of premature death in the world. This study aims to describe the changes ...in hypertension-related mortality in Mexico between 1998 and 2018. Using death certificates and national population public data sets, a total of 335,863 deaths due to hypertension were found in Mexico, disaggregated by sex and age, during the time period covered in this study. An age-period-cohort analysis was conducted to show trends in hypertension mortality rates. Mortality due to hypertension in Mexico affects more women than men. In the most recent cohorts, the risk of dying from hypertension is two times higher in men compared to women. Hypertensive kidney disease is found to be the main underlying cause, with an average increase throughout the period studied. Our results indicate that mortality rates due to hypertension continue to grow and point to an alarming trend of mortality shifting towards younger ages, with sex-based disparities in absolute numbers and in changing trends.
Background
The body mass index (BMI) is the most commonly used anthropometric indicator. However, it does not discern among the different body components. The body fat content, expressed as fat mass ...index (FMI), is an accurate way to estimate adiposity. Since most metabolic diseases are associated with excess fat tissue, our aims were to comparatively analyze the frequency of associated metabolic abnormalities in patients with different obesity degrees based on BMI and FMI and to determine the best cut-off value of both indicators to predict metabolic abnormalities.
Methods
From a cohort of 2007 patients, BMI and FMI were calculated using DXA. Individuals were classified into the different obesity degrees according to the reference ranges from the World Health Organization (WHO) and the National Health and Nutrition Examination Survey (NHANES). A comparative analysis between BMI, FMI, and their correlation to the presence of metabolic alterations was performed.
Results
BMI underestimated the degree of obesity when compared with FMI. Spearman’s rank-order correlation for both indexes resulted in very high coefficients (rho Spearman’s = 0.857;
p
= 0.0001). The prevalence of metabolic alterations increased as BMI and FMI also increased. Despite the high positive statistical correlation between BMI and FMI, it was seen that some comorbidities were more specifically related to one particular index.
Conclusions
There were no significant differences between the BMI and the FMI for predicting the degree of obesity. Likewise, there were no significant differences between them for the prediction of metabolic alterations.
Objetivo. Estimar la prevalencia de diabetes (total, diagnosticada y no diagnosticada), de descontrol glucémico en México y sus factores asociados. Material y métodos. Se analizaron 3 700 adultos ...participantes en la Encuesta Nacional de Salud y Nutrición de 2016. Se estimaron las prevalencias con ponderadores poblacionales y los factores asociados con diabetes total y descontrol glucémico con modelos de regresión de Poisson. Resultados. La prevalencia total de diabetes fue de 13.7% (9.5% diagnosticada, 4.1% no diagnosticada); 68.2% de los diagnosticados presentó descontrol glucémico. Mayor tiempo de diagnóstico, vivir en el centro/ sur del país y ser atendido en farmacias se asoció con descontrol glucémico, mientras que ser atendido en los servicios de seguridad social se asoció con mejor control glucémico. Conclusión. Se requieren esfuerzos multisectoriales para fortalecer el tamizaje, diagnóstico oportuno y control de la enfermedad, considerando las diferencias por región y tipo de servicio de salud.
We investigated whether excessive retroperitoneal adipose tissue (AT) expansion programmed by maternal obesity (MO) affects adipocyte size distribution and gene expression in relation to adipocyte ...proliferation and differentiation in male and female offspring (F1) from control (F1C) and obese (F1MO) mothers. Female Wistar rats (F0) ate a control or high-fat diet from weaning through pregnancy and lactation. F1 were weaned onto a control diet and euthanized at 110 postnatal days. Fat depots were weighed to estimate the total AT. Serum glucose, triglyceride, leptin, insulin, and the insulin resistance index (HOMA-IR) were determined. Adipocyte size and adipogenic gene expression were examined in retroperitoneal fat. Body weight, retroperitoneal AT and adipogenesis differed between male and female F1Cs. Retroperitoneal AT, glucose, triglyceride, insulin, HOMA-IR and leptin were higher in male and female F1MO vs. F1C. Small adipocytes were reduced in F1MO females and absent in F1MO males; large adipocytes were increased in F1MO males and females vs. F1C. Wnt, PI3K-Akt, and insulin signaling pathways in F1MO males and
in F1MO females were downregulated vs. F1C. MO induced metabolic dysfunction in F1 through different sex dimorphism mechanisms, including the decreased expression of pro-adipogenic genes and reduced insulin signaling in males and lipid mobilization-related genes in females.
Transmission power control constitutes a core feature required to achieve a desired quality of service in wireless networks. A practical implementation calls on the intuition of using limited ...resources, only when are strictly required. Thus, the appeal of an event-triggered scheme arises naturally over more traditional, but less efficient, periodic time-triggered control solutions. Motivated by these ideas, the authors present here a power allocation strategy based on an event-triggered transmission (ETT) to reduce the feedback signalling in the network. The power allocation under ETT is based on a nominal control that guarantees internal stability and performance. Hence, if the feedback signalling does not change significantly from the previous sample, no feedback transmission is assigned to reduce bandwidth usage. Two schemes are employed to define the ETT while preserving closed-loop stability: a piecewise quadratic Lyapunov argument and a perturbed linear system approach. These two approaches establish a trade-off between complexity and conservativeness. The power allocation under ETT was thoroughly evaluated under two nominal control schemes to establish a relation between performance and feedback reduction.
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