Factores asociados a la aceptación de donar órganos entre la población de Querétaro / Factors associated with organ donation acceptance by the population in Queretaro / Fatores associados à aceitação da população à doação de órgãos em Querétaro

La presente investigación busca determinar los factores asociados a la aceptación de donar órganos entre la población de Queré\r\n-\r\ntaro. Se realizó un estudio transversal comparativo en población ubicada en iglesias, parques recreativos, lugares de trabajo, zona \r\ncomercial y agrupaciones sociales de la ciudad de Querétaro, México. Se integraron dos grupos: con y sin aceptación de donar \r\nórganos, conformados por personas de 18 años o mayores, previo consentimiento informado. El tamaño de la muestra (n=117 \r\npersonas por grupo) se calculó mediante la fórmula de porcentajes para dos poblaciones con un nivel de confianza del 95%; se \r\nseleccionó a la población con la técnica muestral no aleatoria por cuota. Para analizar el fenómeno, se establecieron las siguientes \r\nvariables: características sociodemográficas, y factores económicos, sociales, culturales y psicológicos. El análisis estadístico incluyó \r\npromedios, desviación estándar, porcentajes, prueba de chi cuadrado, razón de momios, IC 95%, modelo y proyección. De acuerdo \r\ncon los resultados, los factores psicológicos asociados a la aceptación de donar de órganos fueron servir a una persona (RM=13,94; IC 95%; 1,86-104,19), satisfacción de ayudar (RM=7,39; IC 95%; 2,95-18,55) y alegría de que otra persona viva con algo mío (RM=4,61; \r\nIC 95%; 1,36-15,62). Se concluye que los factores psicosociales se asocian a la aceptación de donar órganos. El miedo en general y \r\nel miedo a una muerte prematura se asocian a la no aceptación de donar órganos.

Objective: to determine the factors associated with organ \r\ndonor status in the population of Queretaro. Method: a \r\ncross-sectional study was conducted in the general popu\r\n-\r\nlation found in churches, recreational parks, workplaces, \r\nshopping centers, and social gatherings in the city of Quere\r\n-\r\ntaro, Mexico. Two groups were created: organ donors, and \r\nnon-organ donors, both made up of people over 18 years old, \r\nwith informed consent. Data sample size (n = 117 people per \r\ngroup) was calculated using the percent formula for two popu\r\n-\r\nlations with a confidence level of 95%, and the population was \r\nselected with the nonrandom sampling technique by quota. \r\nTo analyze the phenomenon, the following variables were \r\nestablished: socio-demographic characteristics; economic, \r\nsocial, cultural and psychological factors. The statistical analysis \r\nincluded mean, standard deviation, percentages, chi square \r\ntest, odds ratio, 95% confidence interval, and projection model. \r\nResults: psychological factors associated with organ donor \r\nstatus are: helping a person (OR = 13.94; 95% CI 1.86 to 104.19), \r\nthe satisfaction of helping a person (OR = 7.39; 95% CI 2.95 to \r\n18.55) and the joy of another person living due to my organ \r\ndonation (OR = 4.61 person; 95% CI 1.36 to 15.62). Conclusions: \r\npsychosocial factors are associated with organ donor status. \r\nFears in general, and fear of premature death, are associated \r\nwith non-organ donors.

Objetivo: determinar fatores associados à aceitação da popu\r\n-\r\nlação à doação de órgãos em Querétaro. Método: um estudo \r\ntransversal comparativo foi realizado em população localizada \r\nem igrejas, parques recreativos, locais de trabalho, lojas e grupos \r\nsociais na cidade de Querétaro, México. Foram formados dois \r\ngrupos: com e sem a aceitação à doação de órgãos feita por \r\npessoas acima de 18, com consentimento prévio informado. O \r\ntamanho da amostra (n=117 pessoas por grupo) foi calculada \r\nutilizando a fórmula de percentagens para duas populações \r\ncom um nível de confiança de 95%, a população foi selecio\r\n-\r\nnada com a técnica de amostragem não aleatória por quota. \r\nPara analisar o fenômeno, estabeleceram-se as seguintes \r\nvariáveis: características sociodemográficas; factor econômico, \r\nsocial, cultural e psicológico. A análise estatística incluiu média, \r\ndesvio padrão, percentagens, teste do qui quadrado, razão \r\nde possibilidades, IC de 95%, modelo e projeção. Resultados: \r\nos fatores psicológicos associados com a aceitação à doação \r\nde órgãos são: servir uma pessoa (OR = 13,94; IC de 95%; 1,86-\r\n104,19), satisfação de ajudar (OR = 7,39; IC de 95%; 2,95-18,55) e \r\nalegria de que outra pessoa viva com algo meu (OR = 4,61; IC \r\nde 95%; 1,36-15,62). Conclusões: os fatores psicossociais asso\r\n-\r\nciados com a aceitação da doação de órgãos. O medo em \r\ngeral e o medo de uma morte prematura se associam à não \r\naceitação de doação de órgãos.

Factores de riesgo para sobrepeso y obesidad en lactantes / Risk factors for overweight and obesity in infants

Introduction: At one year of age, factors that favor the development of obesity and other metabolic disorders in later stages of life are present. Objective: To identify perinatal, societal, and dietary risk factors for excess weight and obesity in 12 months infants. Subjects and methods: Case-control studies with infants under the care of Family Medicine Units. These cases studied were overweight or obese children, and control cases were children at a healthy weight. Each group included 152 infants, who were evaluated based on their responses to a questionnaire, their records, and perinatal, societal, and dietary variables. Results: The variables with statistical significance were high pre-gestational weight, high gestational weight gain (OR 1.79-3.88), absence of breastfeeding and exclusive formula feeding (OR 2.02 and 1.75). Conclusion: In the presence of pre-pregnancy obesity and exclusive formula feeding, there is a 64.4% greater risk of becoming overweight or obese at 12 months old.

Introducción: Al año de vida existen factores que favorecen el desarrollo de obesidad y alteraciones metabólicas en etapas posteriores. Objetivo: Identificar factores de riesgo perinatales, sociales y alimentarios de sobrepeso y obesidad en lactantes de 12 meses de edad. Sujetos y método: Estudio de casos y controles en lactantes, que acuden a Unidades de Medicina Familiar, considerando casos; niños con sobrepeso u obesidad y controles: peso adecuado. Se incluyeron 152 lactantes por grupo, a los cuales se les estudió mediante un cuestionario y revisión de expedientes, variables perinatales, sociales y alimentarias. Resultados: Las variables con significancia estadística fueron: peso pre-gestacional de la madre elevado, incremento de peso gestacional elevado; OR 1,79 y 3,88 ausencia de lactancia materna y alimentación con fórmula láctea exclusiva, OR 2,02 y 1,75. Conclusión: en presencia de obesidad pregestacional y alimentación con formula láctea exclusiva, existe un riesgo 64,38% mayor de desarrollar sobrepeso u obesidad a los 12 meses de edad.

Costo de la polifarmacia en el paciente con diabetes mellitus tipo 2 / The cost of polypharmacy in patients with type 2 diabetes mellitus

Background: Polypharmacy or the concomitant use of three or more medications, may increase the complexity of health care and its costs. Aim: To determine the costs of polypharmacy in patients with Type 2 Diabetes Mellitus in a Mexican population sample. Patients and Methods: Analysis of health care costs in 257 patients with Type 2 Diabetes Mellitus from two family care facilities, who had at least five consultations during one year. The cost of professional care by family physicians, pharmacological care and medications were considered to calculate the total expenses. The price of medications and the number of units consumed in one year were used to determine pharmacological expenses. Medications were grouped to determine costs derived from complications and concomitant diseases. Costs were calculated in US dollars (USD). Results: The mean cost derived from family physician fees was USD 82.32 and from pharmacy fees USD 29.37. The mean cost of medications for diabetes treatment was USD 33.31, for the management of complications USD 13.9 and for management of concomitant diseases USD 23.7, rendering a total cost of USD 70.92. Thus, the total annual care cost of a diabetic patient was USD 182.61. Conclusions: Medications represent less than 50% of total expenses of diabetic patients with polypharmacy.

Costo-efectividad del programa del control del niño sano en el primer nivel de atención / Cost-effectivenesss of the program of control of the healthy child in the first level of care

Objective: To determine the cost-effectiveness of the control program of healthy children at the primary care level. Methodology: Children were divided into two groups, with and without allocation of milk, measured at 8,10 and 12 months of age. We evaluated 200 children with weight for age and heightfor age. Total cost estimate included the unit cost and service utilization in Family Medicine, EMI, Preventive Medicine, Laboratory, Office and Pharmacy. Results: The results of height for age alternative were most cost effective in all three measurements in the group without milk allocation of milk. For $ 3,000 invested in this option you get an effectiveness of85.36% at 12 months, 96.67% at 10 months and 98.05% at 8 months), while the effectiveness for the group without milk allocation was 69.53% at 12 months, 82.46% at 10 months and91.60% at 8 months. Conclusion: The most cost-effective control program for healthy children at the first level of care is the one withoyt allocation of milk.

Objetivo: Determinar la relación costo-efectividad del programa del control del niño sano en el primer nivel de atención. Metodología: Estudio de costo-efectividad de niños. Se definieron dos grupos con y sin dotación de leche. Se midió a los 8, 10 y 12 meses de edad. Se evaluaron 200 niños con el indicador peso para la edad y talla para la edad, la estimación del costo total incluyó el costo unitario y la utilización del servicio en Medicina Familiar, EMI, Medicina Preventiva, Laboratorio, Gabinete y Farmacia. Resultados: Para el indicador talla para la edad la alternativa con mejor relación costo efectividad en las tres mediciones es sin dotación láctea, por $3,000 invertidos en esta alternativa se obtiene una efectividad del 85.36% (12 meses), 96.67% (10 meses) y 98.05% (8 meses), en tanto la efectividad para el grupo con es de 69.53% (12 meses), 82.46% (10 meses) y 91.60% (8 meses).Conclusión: La mejor relación costo-efectividad del programa del control del niño sano en el primer nivel de atención es sin el otorgamiento de dotación láctea.

Evaluación geriátrica integral del adulto mayor / Cross sectional geriatric assessment of Mexican older people

Background: Due to the progressive aging of our population, it is imperative to evaluate the life conditions and health limitations of older people. Aim: To report the results of an integral geriatric evaluation of Mexican older people. Material and Methods: A cross-sectional assessment of 324 older subjects of a median age of 70 years (57 percent females) beneficiaries of the Mexican Institute of Social Security of the city of Querétaro. Social, demographic, medical, functional and cognitive variables were evaluated. Results: Of the studied subjects, 37 percent were illiterate, 61 percent lived with a partner and 47 percent were dedicated to household activities. Thirty three percent had visual impairment, 54 percent had hearing impairment, 39 percent had urinary incontinence, 26 percent reported falls in the last six months, 34 percent had nutritional problems, 38 percent were functionally dependent, 49 percent had sleeping problems, 25 percent had cognitive impairment and 25 percent had depression. Conclusions: The general health outlook of this population is encouraging, considering that more than half are not functionally impaired.

Costo oportunidad de adolescentes en unidades de medicina familiar / Opportunity cost for adolescents at family medicine clinics

Objective: To determine the opportunity cost for adolescents requiring care at Family Medicine Clinics. Material and Methods: Study of cost performed on 624 patients, 10-19 years of age, Family Medicine Clinics, Pharmacy and Laboratory. A conglomerate sample technique was used (Medical Unit), and proportional sampling internally. Several sociodemographic variables were evaluated, including transfer, waiting time and care. Statistical evaluation included averages, percentages, and confidence intervals of 95 percent. Results: The cost-opportunity for Family Medicine and Pharmacy in the situations evaluated was $10.22 for the teenager, $71.43 for the first family member, and $14.28 for the second person accompanying the child. When they attend all three services, the cost is $12.26, $82.71 and $16.54 respectively. A weighted average cost of opportunity IFOR all three services is $93.18. Conclusions: The largest cost of opportunity for adolescents occurs when waiting for care in Family Medicine. It is suggested that strategies be implemented to decrese waiting times in the various services.

Objetivo. Determinar el costo oportunidad de los adolescentes que demandan atención en las Unidades de Medicina Familiar. Material y Métodos. Estudio de costo oportunidad realizado en 624 usuarios de 10 a 19 años de edad atendidos en tres Unidades de Medicina Familiar, en los servicios de Medicina Familiar, Farmacia y Laboratorio. Se empleó la técnica muestral por conglomerados (Unidad Médica) y al interior por cuota. Se estudiaron variables sociodemográficas y número de acompañantes; se estimó el costo oportunidad para el traslado, espera y atención. El análisis estadístico incluyó promedios, porcentajes e intervalos de confianza del 95 por ciento. Resultados: El costo oportunidad promedio para Medicina Familiar y Farmacia es de $10.22 para el adolescente, de S 71.43 para el acompañante 1 y de $14.28 para el acompañante 2; cuando acuden a los tres servicios es de $12.26, $82.71 y $16.54 respectivamente. El costo oportunidad promedio ponderado cuando acuden a los tres servicios es de $93.18. Conclusión: El mayor costo oportunidad para los adolescentes corresponde a la espera en el servicio de Medicina Familiar. Por lo que se sugiere implementar estrategias que disminuyan el tiempo de espera en los diferentes servicios.

Estereotipos negativos de la vejez en personal de salud de un Hospital de la Ciudad de Querétaro, México / Prevalence of negative stereotypes towards old age among personnel of a general hospital

Background: Social representations are value systems. Social stereotypes are a social consensus of traits associated with a specific group. Stereotypes about older subjects, generally have negative connotations. Aim: To assess the prevalence of negative stereotypes towards older subjects among health care personnel. Material and Methods: A questionnaire about stereotypes towards old age, with Likert type questions that included health, social motivations and personality-character domains, was applied to 52 doctors, 12 residents, 80 general nurses, 36 auxiliary nurses, four social workers and 10 medical assistants, working at a general hospital. Results: The mean age of the professionals who answered the questionnaire was 38 years (95 percent confidence intervals (CI) 37-39 years) and 78 percent were women. The prevalence of a Global negative stereotype was 65.0 percent(95 percent CI: 59.5-70.5). The figure for the health domain was 64.5 percent (IC95 percent; 59.0-70.0), for the social motivation domain was 60 percent(5 percentCI: 54.3-65.7) and for the character personality domain was 64 percent (95 percentCI: 58.4-69.6). Conclusions: There is a high prevalence of a negative stereotype towards old age among health care personnel.

Efectos de una intervención en la utilización del servicio de nutrición en México / Effect of an intervention in the use of the service of nutrition in Mexico

Se aplicó una estrategia de comunicación para mejorar la utilización del servicio de nutrición previa identificación de las barreras de acceso. La intervención consistió en establecer libre demanda al servicio y se utilizaron carteles, volantes y mensajes por altavoz para motivar a la población en el uso del servicio. El 40 por ciento de la población que utilizó el servicio después de la estrategia de medios, lo hizo de manera espontánea. El análisis por tipo de medio de comunicación, mostró diferencias intragrupos en todos los indicadores de uso. En conclusión, todas las estrategias fueron buenas; sin embargo, comparaciones post hoc señalaron un mayor impacto del volante en incremento en la demanda espontánea de consultas.

Evolución a un año de los efectos adversos, en una cohorte de pacientes con implante subdérmico de Desogestrel / Adverse effects of subdermal Desogestrel implants: one year evolution

Objetivo: El propósito de la investigación fue evaluar la evolución a un año los efectos adversos en una cohorte de pacientes con implante subdérmico de desogestrel. Método: Se incluyeron pacientes portadoras de implante que tenían como mínimo tres meses de uso, previo consentimiento informado. Se realizaron 4 mediciones en forma trimestral, registrándose los efectos más frecuentes referidos por la paciente. El análisis incluyó porcentajes, promedios e intervalos de confianza al 95 por ciento. Resultados: Se estudiaron 50 pacientes, los efectos adversos presentados con mayor frecuencia en el primer trimestre fueron alteraciones del ciclo 48 por ciento, mastalgia 46 por ciento, amenorrea 40 por ciento, mareo 40 por ciento, cefalea 40 por ciento, náuseas 30 por ciento, acné 28 por ciento, aumento de peso 26 por ciento y dolor local 10 por ciento. Se observó al final del tercer trimestre reducción de la cefalea, mastalgia y mareo (p<0,05); para el cuarto trimestre las náuseas y las alteraciones del ciclo (p<0,05). El 11,1 por ciento de las pacientes desertaron del método al final del estudio. Se observó que el uso del desogestrel tuvo un valor estadísticamente significativo para el control de la dismenorrea (p<0,05) al final del cuarto trimestre de uso. Conclusión: Los implantes de desogestrel tienen efectos adversos importantes en los primeros meses de uso para disminuir la mayoría de ellos al final del primer año.