Hepatic steatosis and type 2 diabetes mellitus in health workers.

BACKGROUND: patients with type 2 diabetes mellitus (T2DM) appear to have an increased risk of developing nonalcoholic fatty liver disease (NAFLD) and have higher risk to develop hepatic fibrosis and cirrhosis. The aim was to determine the prevalence of NAFLD in health workers with T2DM by liver ultrasound. METHODS: health workers with T2DM attended at the Family Medicine Unit No. 77, Madero City, Tamaulipas, Mexico, were screened. Risk factors, BMI, % of body fat (% BF), fat mass, waist circumference (WC), blood pressure, HbA1C and lipid profile, were evaluated. The patients were categorized into two groups according to NAFLD status. Differences between groups were assessed by independent t test and χ(2) test. RESULTS: the NAFLD prevalence found in females on ultrasound examination was 40 % and 17.1 % in males. NAFLD patients were more obese (p < 0.001) and they had significantly higher values of % BF (p < 0.001), fat mass (p < 0.01) and WC (p < 0.01). They also had significantly higher values of HbA1C (p < 0.04) and triglycerides (p < 0.03) than patients without NAFLD. CONCLUSIONS: NAFLD is common among health workers with T2DM. It is important to prevent NAFLD progression.

[Elevated liver enzymes, impaired fasting glucose and undiagnosed diabetes]. / Enzimas hepáticas elevadas, glucosa anormal de ayuno y diabetes no diagnosticada en medicina familiar.

BACKGROUND: emerging evidence suggests that elevated liver enzymatic activity is associated with diabetes. The purpose was to investigate the prevalence of elevated liver enzymes and its relationship between impaired fasting glucose (IFG) and undiagnosed diabetes in family medicine practice. METHODS: a cross-sectional prospective analytic study was conducted in a representative sample of 100 patients aged 25 to 60 years who underwent to a screening for diabetes. Risk factors, BMI, waist circumference, blood pressure, fasting glucose, lipid profile, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT) and C-reactive protein were evaluated. The relationships between liver enzymes, undiagnosed diabetes and IFG were analyzed through c(2) and Student's t test to identify differences in continuous variables. RESULTS: the prevalence found in undiagnosed diabetes were ALT 16.9 %, AST 15.8 % and GGT 20.6 % and in IFG were 76.3 %, 68.4 % and 77.8 % respectively. The relationships between elevated ALT (0.001) and GGT (0.000) with undiagnosed diabetes and IFG were statistically significant. CONCLUSION: elevated ALT or GGT raise the possibility of undiagnosed type 2 diabetes mellitus in family practice.

Cervical cancer screening among women who gave birth in the US-Mexico border region, 2005: the Brownsville-Matamoros Sister City Project for Women's Health.

INTRODUCTION: The objective of this study was to examine correlates of ever having had a Papanicolaou (Pap) test among women who recently delivered a live infant and who resided near the US-Mexico border. METHODS: This cross-sectional study included women who delivered a live infant in Matamoros, Mexico (n = 488) and Cameron County, Texas (n = 453). Women were interviewed in the hospital before discharge between August 21 and November 9, 2005. Multivariable logistic regression was used to estimate the odds of ever having had a Pap test. RESULTS: Significantly fewer Matamoros women (62.1%) than Cameron County women (95.7%) reported ever having had a Pap test. Only 12% of Matamoros women said they received their most recent Pap test during prenatal care, compared with nearly 75% of Cameron County women. After adjusting for potential confounders, the odds of ever having had a Pap test were 7.41 times greater in Cameron County than in Matamoros (95% confidence interval, 4.07-13.48). CONCLUSION: The Healthy Border 2010 goals are to cut cervical cancer mortality by 20% to 30% in the border region. The significant difference in Pap test prevalence among our survey respondents may reflect that routine prenatal Pap testing is more common in the United States than in Mexico. Because women who are receiving prenatal care have increased interaction with health care providers, Matamoros providers may need to be educated about the need to screen for cervical cancer during this time.

Characteristics of young women who gave birth in the US-Mexico border region, 2005: the Brownsville-Matamoros Sister City Project for Women's Health.

INTRODUCTION: Childbearing during adolescence and young adulthood is associated with adverse effects on health and quality of life. Lowering birth rates among young women is a binational priority in the US-Mexico border region, yet baseline information about birth rates and pregnancy risk is lacking. Increased understanding of the characteristics of young women who give birth in the region will help target high-risk groups for sexual and reproductive health services. METHODS: We examined data on reproductive health characteristics collected in hospitals from 456 women aged 24 years or younger who gave birth from August 21 through November 9, 2005, in Matamoros, Tamaulipas, Mexico, and Cameron County, Texas. We calculated weighted percentages and 95% confidence intervals (CIs) for each characteristic and adjusted odds ratios (AORs) for Matamoros and Cameron County women by using multiple logistic regression techniques. RESULTS: Numbers of births per 1,000 women aged 15 to 19 years and 20 to 24 years were similar in the 2 communities (110.6 and 190.2 in Matamoros and 97.5 and 213.1 in Cameron County, respectively). Overall, 38.5% of women experienced cesarean birth. Matamoros women reported fewer prior pregnancies than did Cameron County women and were less likely to receive early prenatal care but more likely to initiate breastfeeding. Few women smoked before pregnancy, but the prevalence of alcohol use in Cameron County was more than double that of Matamoros. In both communities combined, 34.0% of women used contraception at first sexual intercourse. CONCLUSION: Despite geographic proximity, similar ethnic origin, and comparable birth outcomes, young Mexican and US women showed different health behavior patterns. Findings suggest possible pregnancy prevention and health promotion interventions.

Epidemiología del cáncer de cérvix en Latinoamérica / Cervical cancer epidemiology in Latin America

El cáncer del cérvix uterino (CaCu) en la mujer de Latinoamérica es un problema grave de salud, que ocupa por incidencia y mortalidad el primer lugar en las mujeres de edad productiva. Las campañas de detección oportuna de cáncer (DOC) no han mejorado la supervivencia, por lo que existe un alto porcentaje de mujeres en etapas avanzadas de la enfermedad. La población hispana que radica en el sur de Estados Unidos y de Centroamérica ha incrementado notablemente las cifras hasta tres veces la incidencia y la mortalidad por CaCu. Las bajas coberturas de la pesquisa del CaCu en la población latinoamericana con nivel económico bajo, la sobrepoblación, la desnutrición y la falta de educación sexual a los grupos de alto riesgo, son las principales causas de falla para mejorar la supervivencia.