Diagnostic Accuracy of Capillary Blood Glucometer Testing for Gestational Diabetes.

Purpose: Few pregnant women in low-resource settings are screened for gestational diabetes mellitus (GDM) using the gold standard oral glucose tolerance test (OGTT). This study compared capillary blood glucose testing with 2-h plasma glucose measurements obtained using the 75-g OGTT to screen for GDM at primary healthcare clinics in Mexico. Patients and Methods: Pregnant women who participated in a previous prospective multicenter longitudinal cohort study and who had not been previously diagnosed with diabetes were included. Participants were evaluated using the plasmatic 2-h 75-g OGTT with simultaneous capillary blood glucose measurements using a glucometer. The study endpoint was the comparability of the glucometer results to the gold standard OGTT when collected simultaneously. Sensitivity, specificity, and area under the curve of the glucose measurements obtained for capillary blood compared with venous plasma (gold standard) were calculated to determine diagnostic accuracy. Results: The study included 947 pregnant women who had simultaneous glucose measurements available (blood capillary [glucometer] and venous blood OGTT). Overall, capillary blood glucose testing was very sensitive (89.47%); the specificity was 66.58% and the area under the curve (95% confidence interval) was 0.78 (0.74-0.81). The sensitivity, specificity and area under the curve of each capillary measurement were: 89.47%, 66.58% and 0.78 (0.74-0.82) for the fasting measurement, 91.53%, 93.24% and 0.92 (0.88-0.96) for the one-hour measurement, and 89.80%, 93.32%, 0.91 (0.87-0.95) for the second-hour measurement, respectively. No adverse events were reported. Conclusion: Capillary OGTT is a valid alternative to the gold standard OGTT for screening of GDM in low-resource situations or in situations where there are other limitations to performing the OGTT as part of primary healthcare services.

Contaminación del Río Santiago: Un problema epidemiológico ambiental persistente de Salud Pública en Jalisco, México / River pollution in Santiago: A persistent epidemiologic environmental problem of Public Health in Jalisco, Mexico

El Río Santiago es hoy en día uno de los contextos ambientales más contaminados como resultado de la actividad antropogénica e industrial, representa a simple vista la exposición a múltiples sustancias químicas y a agentes biológicos que ahí concurren y que impactan en la salud de los pobladores del Salto y Juanacatlán Jalisco. Objetivo. Establecer el estado del arte en cuanto a la contaminación ambiental y los riesgos asociados por exposición a residuos peligrosos y agentes biológicos con los que convive la población humana en este contexto socio-ambiental. Material y métodos. Se realizó una revisión sistemática de la información presente en la red y se realizó un análisis crítico de la realidad objetiva presente actualmente en este contexto. Resultados. De un total de 15 referencias detectadas, 2 corresponden a videos de Instituto Mexicano de Desarrollo Comunitario [IMDEC], parte 1 y parte 2, además se detectaron fotografías que denotan un contexto socio-ambiental contaminado y una referencia con la manifestación de GREENSPACE. Conclusión. Los títulos de los artículos en su incidente expresión “Veneno” y los casos de cáncer visibles en los videos de IMDEC, los riesgos asociados en la salud humana, subrayan la intervención necesaria ya de las autoridades en búsqueda del control en cuanto a calidad ambiental y una revisión emergente en cuanto a legislación ambiental.(AU)

The Santiago River is today one of the most contaminated environmental contexts as a result of anthropogenic activity and industrial, represents a simple view of the exposure to multiple chemicals and biological agents that there exist and that impact on the health of the inhabitants of the leap and Juanacatlán Jalisco. Objective. Set the state of the art in terms of the environmental pollution and the risks associated with exposure to hazardous waste and biological agents with the living human population in this social and environmental context. Material and methods. We conducted a systematic review of the information present in the network and made a critical analysis of the objective reality currently present in this context. Results. Of a total of 15 references detected, 2 correspond to video of the Mexican Institute for Community Development (IMDEC], part 1 and Part 2, Furthermore it detected photographs that denote a socio-environmental contaminated and a reference to the expression of GREENSPACE. Conclusion. The titles of the items in your incident expression "poison" and cases of cancer visible in videos of IMDEC, the associated risks to human health, underline the intervention necessary because of the authorities in search of control in terms of environmental quality and a pop-up review in regard to environmental legislation.(AU)

[EFFECT OF A BEVERAGE MADE FROM CACTUS PEAR (NOPALEA COCHENILLIFERA (L) SALM-DYCK) IN A RURAL POPULATION OF HIDALGO, MEXICO; A PILOT CLINICAL TRIAL]. / EFECTO DE UNA BEBIDA A BASE DE NOPAL (NOPALEA COCHENILLIFERA (L) SALM-DYCK) EN PACIENTES DE UNA POBLACIÓN RURAL DE HIDALGO, MÉXICO; ENSAYO CLÍNICO PILOTO.

INTRODUCTION: cactus pear has been used in Mexican traditional medicine. However, clinical studies are limited to demonstrate the effectiveness as anti-diabetic. OBJECTIVE: to evaluate the effect of a fresh beverage made from Nopalea cochenillifera (l.) Salm-dyck on glucose levels, glycosylated hemoglobin, weight, waist circumference and blood pressure. METHODS: the beverage (50 g/250 mL) was daily administered in twenty patients for 30 days. RESULTS AND DISCUSSION: differences statistically significant were found in some time of the supplementation for all measured variables excepting for glucose levels, this suggests that values might be significant to a longer administration or bigger doses. CONCLUSIONS: although preliminary data, the results demonstrated that cactus pear used in this study may be an alternative for the management of patients with diabetes type 2. Nevertheless, further trials must be conducted with a bigger sample size and more control groups so that the effectiveness can be fully evaluated.

Introducción: el nopal ha sido usado en la medicina tradicional mexicana. Sin embargo, los estudios clínicos para demostrar la eficacia como antidiabético son limitados. Objetivo: evaluar el efecto de una bebida fresca a base de nopal (Nopalea cochenillifera (l.) Salm-dyck), sobre los niveles de glucosa, hemoglobina glicosilada, peso corporal, circunferencia de cintura y presión sanguínea. Métodos: la bebida (50 g/250 mL) se administró diariamente a 20 pacientes durante 30 días. Resultados y discusión: se encontraron diferencias estadísticamente significativas en algún momento de la suplementación, excepto para la glucosa, sugiriendo que los valores podrían ser significativos en un tiempo mayor de administración a dosis mayores. Conclusiones: aunque preliminares, los resultados demostraron que el nopal usado en este estudio podría ser útil en el manejo de pacientes con diabetes tipo 2. No obstante, deben efectuarse futuros ensayos con un tamaño de muestra más grande y más grupos control, para que la efectividad pueda ser totalmente evaluada.

Efecto de una bebida a base de nopal (Nopalea cochenillifera (l) Salm-dyck) en pacientes de una población rural de Hidalgo, México; ensayo clínico piloto / Effect of a beverage made from cactus pear (nopalea cochenillifera (l) salm-dyck) in a rural population of hidalgo, Mexico; a pilot clinical trial

Introducción: el nopal ha sido usado en la medicina tradicional mexicana. Sin embargo, los estudios clínicos para demostrar la eficacia como antidiabético son limitados. Objetivo: evaluar el efecto de una bebida fresca a base de nopal (Nopalea cochenillifera (l.) Salm-dyck), sobre los niveles de glucosa, hemoglobina glicosilada, peso corporal, circunferencia de cintura y presión sanguínea. Métodos: la bebida (50 g/250 mL) se administró diariamente a 20 pacientes durante 30 días. Resultados y discusión: se encontraron diferencias estadísticamente significativas en algún momento de la suplementación, excepto para la glucosa, sugiriendo que los valores podrían ser significativos en un tiempo mayor de administración a dosis mayores. Conclusiones: aunque preliminares, los resultados demostraron que el nopal usado en este estudio podría ser útil en el manejo de pacientes con diabetes tipo 2. No obstante, deben efectuarse futuros ensayos con un tamaño de muestra más grande y más grupos control, para que la efectividad pueda ser totalmente evaluada (AU)

Introduction: cactus pear has been used in Mexican traditional medicine. However, clinical studies are limited to demonstrate the effectiveness as anti-diabetic. Objective: to evaluate the effect of a fresh beverage made from Nopalea cochenillifera (l.) Salm-dyck on glucose levels, glycosylated hemoglobin, weight, waist circumference and blood pressure. Methods: the beverage (50 g/250 mL) was daily administered in twenty patients for 30 days. Results and discussion: differences statistically significant were found in some time of the supplementation for all measured variables excepting for glucose levels, this suggests that values might be significant to a longer administration or bigger doses. Conclusions: although preliminary data, the results demonstrated that cactus pear used in this study may be an alternative for the management of patients with diabetes type 2. Nevertheless, further trials must be conducted with a bigger sample size and more control groups so that the effectiveness can be fully evaluated (AU)