Serum lead levels and its association with overweight and obesity.

BACKGROUND: Lead (Pb) exposure has been associated with cardiovascular diseases and metabolic syndrome, nevertheless its association with obesity, type 2 diabetes, and dyslipidemia markers has been little explored in Mexico. Therefore, we evaluated the association of serum Pb levels (Pb-S), with body mass index (BMI), fasting plasma glucose (FPG), total cholesterol (TC), and triglycerides (TG). METHODS: A cross-sectional study was performed on 85 Mexican adults (57 women and 28 men). BMI was calculated, while FPG, TC, and TG were measured by the enzymatic colorimetric method. Total Pb-S levels were measured using inductively coupled plasma mass spectrometry (ICP-MS). RESULTS: The study population was 20.3 ± 1.9 years old, showed an average of Pb-S of 0.0982 ± 0.068 µg dL-1, and presented a frequency of overweight (OW) and obesity (OB) of 50.5% and 18.8%, respectively. Men had higher average FPG than women (Women= 83.930 ± 5.662 vs Men= 84.953 ± 6.495; p = 0.037). When we analyzed anthropometric and clinical variables, Pb-S and frequency of OW and OB were observed to increase within the categories of Pb-S tertiles (<0.001). The averages of Pb-S were 0.051 ± 0.035 µg dL-1, 0.107 ± 0.067 µg dL-1, and 0.151 ± 0.063 µg dL-1 for individuals with normal weight (NW), OW, and OB, respectively. In addition, an analysis adjusted for age and sex shows Pb-S is positively associated with BMI (ß = 2.76 ± 0.498, p = <0.001). CONCLUSION: Our results evidence a significant association between Pb-S and the increase of BMI in Mexican adults and highlight the important health impact that may represent environmental Pb exposure.

Relationship Between Serum Levels of Arsenic, Cadmium, and Mercury and Body Mass Index and Fasting Plasma Glucose in a Mexican Adult Population.

In Mexico, few studies have analyzed the associations between toxic elements and metabolic diseases. In the present study, we analyzed the associations between serum arsenic (As), cadmium (Cd), and mercury (Hg) levels and body mass index (BMI) and fasting plasma glucose (FPG) in a Mexican adult population. Anthropometric data corresponding to 86 Mexican healthy adults (59 females and 27 men) were analyzed. FPG was analyzed by an enzymatic colorimetric method, and serum As, Cd, and Hg levels were analyzed by inductively coupled plasma-mass spectrometry (ICP-MS). The data show that the median serum As, Cd, and Hg levels were relatively higher in females (As = 1.78 ng mL-1, Cd = 1.00 ng mL-1, Hg = 0.96 ng mL-1) than those in males (As = 1.22 ng mL-1, Cd = 0.91 ng mL-1, Hg = 0.95 ng mL-1). However, these differences were not statistically significant (p ≥ 0.097). We also found that the median level of As significantly increased with an increase in the body weight categories (normal weight = 1.08; overweight = 1.50; obesity = 2.75; p < 0.001). In addition, a positive association between serum As levels and FPG before and after adjustment for BMI was demonstrated (RhoUnadjusted = 0.012; (RhoAdjusted = 0.243, p = 0.032). Serum As levels are positively associated with BMI and FPG in the adult population of Mexico. Nevertheless, these results need to be replicated and confirmed with a larger sample size.

Concordancia citocolposcópica con la prueba histopatológica en la identificación de neoplasias intraepiteliales cervicales / Cytocolposcopic concordance with histopathologic testing in the identification of cervical intraepithelial neoplasia

Resumen OBJETIVO: Evaluar la concordancia diagnóstica entre la citología y la colposcopia respecto del diagnóstico histopatológico de cáncer cervicouterino en mujeres del estado de San Luis Potosí que acudieron a un hospital de segundo nivel de atención. MATERIALES Y MÉTODOS: Estudio correlacional efectuado en un hospital de segundo nivel de atención del Municipio de San Luis Potosí, entre 2015 y 2017. Criterios de inclusión: reunir tres reportes de las pruebas de Papanicolaou, colposcopia e histopatología basados en la clasificación de Richart, ser usuarias de la clínica de colposcopia del hospital y haber firmado el consentimiento informado. Para evaluar la concordancia diagnóstica, tomando como referencia el resultado histopatológico, se realizó la prueba de Kappa. RESULTADOS: Se estudiaron 379 pacientes con media de edad de 34.61 años. La sensibilidad, especificidad, valor predictivo positivo y negativo de la prueba de Papanicolaou fueron: 95.60, 6.60, 96.13 y 5.82%, respectivamente. La sensibilidad, especificidad, valor predictivo positivo y negativo de la colposcopia fueron: 95.98, 33.33, 98.90 y 11.76%, respectivamente. Al hacer la prueba de Kappa el desenlace para el Papanicolaou fue: 0.021 (p = 0.677) y para la colposcopia 0.154 (p = 0.001). CONCLUSIONES: La sensibilidad de la prueba diagnóstica de Papanicolaou y la colposcopia fue alta al igual que el valor predictivo positivo. Es importante analizar las variables que pudieran estar ocasionando la discordancia diagnóstica entre Papanicolaou-colposcopia-histopatología.

Abstract OBJECTIVE: To evaluate the diagnostic concordance between cytology and colposcopy with respect to the histopathological diagnosis of cervical cancer in women from the state of San Luis Potosí who attended a second-level care hospital. MATERIALS AND METHODS: Correlational study performed in a second-level care hospital in the municipality of San Luis Potosí, between 2015 and 2017. Inclusion criteria: to gather three reports of Papanicolaou, colposcopy and histopathology tests based on Richart's classification, to be users of the hospital's colposcopy clinic and to have signed the informed consent. To evaluate the diagnostic concordance, taking the histopathological result as a reference, the Kappa test was performed. RESULTS: We studied 379 patients with a mean age of 34.61 years. The sensitivity, specificity, positive and negative predictive value of the Papanicolaou test were: 95.60, 6.60, 96.13 and 5.82%, respectively. The sensitivity, specificity, positive and negative predictive value of colposcopy were: 95.98, 33.33, 98.90 and 11.76%, respectively. When doing the Kappa test the outcome for Papanicolaou was: 0.021 (p = 0.677) and for colposcopy 0.154 (p = 0.001). CONCLUSIONS: The sensitivity of the Papanicolaou diagnostic test and colposcopy was high as was the positive predictive value. It is important to analyze the variables that could be causing the diagnostic discordance between Papanicolaou-colposcopy-histopathology.

Evaluación del ángulo de fase por bioimpedancia vectorial eléctrica en mujeres con cáncer cervicouterino / Phase angle assessment by electrical vector bioimpedance in women with cervical cancer

Introducción: el cáncer cervicouterino es el segundo cáncer más común en las mujeres en el mundo. Se asocia a un índice de masa corporal elevado. Sin embargo, no se ha determinado el ángulo de fase en las mujeres con cáncer cervicouterino. La bioimpedancia vectorial eléctrica está validada para evaluar la composición corporal, el estado nutricional y la integridad de la membrana celular en pacientes con cáncer mediante el ángulo de fase. Objetivo: evaluar el ángulo de fase, la composición corporal por bioimpedancia vectorial eléctrica y el consumo dietético en mujeres con diagnóstico de cáncer cervicouterino usuarias de un hospital de segundo nivel de atención en San Luis Potosí, México. Métodos: estudio observacional, transversal y analítico. Se estudiaron 70 mujeres con diagnóstico de cáncer cervicouterino en el servicio de oncología. Se realizó la medición del ángulo de fase y se aplicó la frecuencia de alimentos del Sistema de Evaluación de Hábitos Nutricionales, así como un cuestionario para medir el nivel socioeconómico. Resultados: el ángulo de fase presentó una media de 4,66° ± 0,87° con un rango de 2,9° a 6,2°. El modelo de regresión lineal múltiple formado para el ángulo de fase como variable dependiente y la evolución del cáncer cervicouterino, el índice de masa corporal, la masa de músculo esquelético, el agua extracelular, la fructosa, los ácidos grasos saturados y los ácidos grasos trans como variables independientes, tuvo un valor de R2 de 0,748 con un valor de p de 0,001. Conclusión: las mujeres con cáncer cervicouterino mostraron daños en la integridad de la membrana celular, con un ángulo de fase menor que el de la población de referencia. (AU)

Introduction: cervical cancer is the second most common cancer in women in the world. It is associated with a high body mass index. However, the phase angle has not been determined in women with cervical cancer. Electrical vector bioimpedance has been validated to assess body composition, nutritional status, and cell membrane integrity in cancer patients using phase angle. Objetive: to evaluate phase angle, body composition by electrical vector bioimpedance, and dietary intake in women with cervical diagnosis who are users of a second-level care hospital in San Luis Potosí, Mexico. Methods: an observational, cross-sectional, and analytical study. Seventy women with a diagnosis of cervical cancer were studied in the oncology service. Phase angle was measured, and the frequency of food from the Nutritional Habits Assessment System and a questionnaire to measure socioeconomic level were applied. Results: the data of the phase angle in a mean of 4.66° ± 0.87° with a range of 2.9° to 6.2°. In a multiple linear regression model formed for phase angle as a dependent variable, and evolution of the cervical cancer, body mass index, skeletal muscle mass, extracellular water, fructose, saturated fatty acids, and trans fatty acids as independent variables, had an R2 value of 0.748 with a p-value of 0.001. Conclusion: women with cervical cancer have integrity damage of the cell membrane with a lower phase angle than the reference population. (AU)

[Phase angle assessment by electrical vector bioimpedance in women with cervical cancer]. / Evaluación del ángulo de fase por bioimpedancia vectorial eléctrica en mujeres con cáncer cervicouterino.

INTRODUCTION: Introduction: cervical cancer is the second most common cancer in women in the world. It is associated with a high body mass index. However, the phase angle has not been determined in women with cervical cancer. Electrical vector bioimpedance has been validated to assess body composition, nutritional status, and cell membrane integrity in cancer patients using phase angle. Objetive: to evaluate phase angle, body composition by electrical vector bioimpedance, and dietary intake in women with cervical diagnosis who are users of a second-level care hospital in San Luis Potosí, Mexico. Methods: an observational, cross-sectional, and analytical study. Seventy women with a diagnosis of cervical cancer were studied in the oncology service. Phase angle was measured, and the frequency of food from the Nutritional Habits Assessment System and a questionnaire to measure socioeconomic level were applied. Results: the data of the phase angle in a mean of 4.66 ° ± 0.87 ° with a range of 2.9 ° to 6.2 ° In a multiple linear regression model formed for phase angle as a dependent variable, and evolution of the cervical cancer, body mass index, skeletal muscle mass, extracellular water, fructose, saturated fatty acids, and trans fatty acids as independent variables, had an R2 value of 0.748 with a p-value of 0.001. Conclusion: women with cervical cancer have integrity damage of the cell membrane with a lower phase angle than the reference population.

INTRODUCCIÓN: Introducción: el cáncer cervicouterino es el segundo cáncer más común en las mujeres en el mundo. Se asocia a un índice de masa corporal elevado. Sin embargo, no se ha determinado el ángulo de fase en las mujeres con cáncer cervicouterino. La bioimpedancia vectorial eléctrica está validada para evaluar la composición corporal, el estado nutricional y la integridad de la membrana celular en pacientes con cáncer mediante el ángulo de fase. Objetivo: evaluar el ángulo de fase, la composición corporal por bioimpedancia vectorial eléctrica y el consumo dietético en mujeres con diagnóstico de cáncer cervicouterino usuarias de un hospital de segundo nivel de atención en San Luis Potosí, México. Métodos: estudio observacional, transversal y analítico. Se estudiaron 70 mujeres con diagnóstico de cáncer cervicouterino en el servicio de oncología. Se realizó la medición del ángulo de fase y se aplicó la frecuencia de alimentos del Sistema de Evaluación de Hábitos Nutricionales, así como un cuestionario para medir el nivel socioeconómico. Resultados: el ángulo de fase presentó una media de 4,66 ° ± 0,87 ° con un rango de 2,9 ° a 6,2 °. El modelo de regresión lineal múltiple formado para el ángulo de fase como variable dependiente y la evolución del cáncer cervicouterino, el índice de masa corporal, la masa de músculo esquelético, el agua extracelular, la fructosa, los ácidos grasos saturados y los ácidos grasos trans como variables independientes, tuvo un valor de R2 de 0,748 con un valor de p de 0,001. Conclusión: las mujeres con cáncer cervicouterino mostraron daños en la integridad de la membrana celular, con un ángulo de fase menor que el de la población de referencia.

Geospatial modelling to estimate the territory at risk of establishment of influenza type A in Mexico - An ecological study.

The aim of this study was to estimate the territory at risk of establishment of influenza type A (EOITA) in Mexico, using geospatial models. A spatial database of 1973 outbreaks of influenza worldwide was used to develop risk models accounting for natural (natural threat), anthropic (man-made) and environmental (combination of the above) transmission. Then, a virus establishment risk model; an introduction model of influenza A developed in another study; and the three models mentioned were utilized using multi-criteria spatial evaluation supported by geographically weighted regression (GWR), receiver operating characteristic analysis and Moran's I. The results show that environmental risk was concentrated along the Gulf and Pacific coasts, the Yucatan Peninsula and southern Baja California. The identified risk for EOITA in Mexico were: 15.6% and 4.8%, by natural and anthropic risk, respectively, while 18.5% presented simultaneous environmental, natural and anthropic risk. Overall, 28.1% of localities in Mexico presented a High/High risk for the establishment of influenza type A (area under the curve=0.923, P<0.001; GWR, r2=0.840, P<0.001; Moran's I =0.79, P<0.001). Hence, these geospatial models were able to robustly estimate those areas susceptible to EOITA, where the results obtained show the relation between the geographical area and the different effects on health. The information obtained should help devising and directing strategies leading to efficient prevention and sound administration of both human and financial resources.

Pulpotomía utilizando extracto de orégano como alternativa en el tratamiento de dientes temporales / Pulpotomy using oregan extract as an alternative in the treatment of temporary teeth

El formocresol es uno de las sustancias más empleadas para la terapia dental de la pulpotomía en la Odontpediatría debido a sus efectos tóxicos, genotóxicos y mutagénicos; por dicha razón es que se está constantemente buscando nuevas alternativas para dicho tratamiento con el uso de distintas sustancias o medicamentos. Este es un estudio experimental básico en donde se recolectaron 20 muestras de órganos dentarios de pacientes con edades que oscilaban entre los tres y nueve años de la Clínica de Odontopediatría de Pregrado de la Facultad de Estomatología de la U. A. S. L. P. que cumplieron con los criterios de inclusión para el tratamiento de pulpotomías. El tratamiento se realizó de acuerdo con los lineamientos de la AAPD, con excepción de que se utilizó extracto hidroalcohólico 70:30 de orégano y se midió en el laboratorio su capacidad para eliminar microorganismos.

Formocresol is one of the most widely used drugs for the treatment of pulpotomy for the reason in Pediatric Dentistry; due to its toxic, genotoxic and mutagenic effects, it is constantly searching for alternatives with other substances or drugs. This is a basic experimental study in twenty samples collected from dental organs of patients with ages ranging from three to nine years of the Pediatric Dentistry Clinic of the Faculty of Stomatology of the UASLP met the inclusion criteria for the treatment of pulpotomies. The treatment was performed according to those established by AAPD with the exception that hydroalcoholic extract 70:30 of oregano was used and its ability to eliminate microorganisms was measured in the laboratory.

Comparison of a Brucella Enzyme Immunoassay and the Standard Agglutination with 2-Mercaptoethanol Test in the Diagnosis and Monitoring of Brucellosis in Mexican Patients.

BACKGROUND: The diagnosis of human brucellosis is difficult based on clinical grounds alone. Thus, the diagnosis is based on microbiological and serological tests. Therefore, the diagnosis relies predominantly on laboratory testing. The objective of this study was to determine the most efficient test for the diagnosis and monitoring of patients treated for brucellosis by comparing the standard agglutination test in a tube with 2-mercaptoethanol (SAT-2Me) to an enzyme-linked immunosorbent assay for the detection of antibodies against Brucella IgM (IgM ELISA). METHODS: A retrospective chart review was performed. A total of 108 patients with brucellosis were analyzed at diagnosis and at the first and second follow-ups after treatment. The data were captured and analyzed using the SPSS 18.0 program. Frequencies, percentages, the Pearson's chi-square test, the kappa coefficient, sensitivity, specificity, predictive values, odds ratio, and conditional odds ratio (OR and COR) were calculated. RESULTS: Diagnostic test: the IgM ELISA showed 96.3% sensitivity vs. 73.1% sensitivity for the SAT-2Me (p < 0.001). First follow-up: the IgM ELISA presented significant differences vs. the SAT-2Me in sensitivity (97.2% vs. 72.2%) and specificity (89.7% vs. 44.1%). Additionally, the second follow-up data showed significant differences in the sensitivity (85.7% vs. 71.4%) and specificity (82.8% vs. 41.4%) for the IgM ELISA vs. the SAT-2Me, re-spectively. In addition, the IgM ELISA showed significant concordance (0.836, p < 0.001 and 0.563, p < 0.001) at the first and second follow-ups, respectively, vs. the SAT-2Me. CONCLUSIONS: The IgM ELISA is a more reliable and useful assay for the diagnosis and monitoring of brucellosis patients than the SAT-2 Me, avoiding up to 45.6% of unnecessary treatments. The SAT-2Me showed lower efficiency for diagnosis than the IgM ELISA and limited relevance for monitoring.

Histopathological Diagnosis of Cervical Biopsies: Reduction of Sampling Errors with the Evaluation of a Third Histologic Level.

AIM: Cervical cancer (CC) is considered as a major public health problem; this disease affects mainly vulnerable women in poverty, causing a negative effect on a country's workforce. OBJECTIVE: To determine the histopathological diagnosis variation after examining three more levels of cervical biopsy paraffin blocks from patients with HPVI, CIN and CC. MATERIALS AND METHODS: A quantitative, retrospective correlational study was performed in a hospital with a second level of health care. We worked with 152 paraffin blocks of CIN (CIN, I, II and III) and cervical cancer samples. Currently, CIN I is considered as a set of low-grade injuries (low-grade squamous intraepithelial lesions, LSIL), while CIN II, CIN III and cancer in situ are considered as high-grade lesions (high-grade squamous intraepithelial lesions, HSIL). A slab was prepared with the 50micron block, which was subsequently cut into 5 microns; later, the same thing was done at two more levels to reevaluate the histopathological diagnosis and correlate it with the initial diagnosis issued by the institution. RESULTS: During the examination of the additional block levels, a difference was observed from the initial diagnosis: of 32 cases of HPV diagnosis, there were 17 changes to CIN I; of 31 cases of CIN I, there were 4 changes to CIN II; of 30 cases of CIN II, there were 8 changes to CIN III and 1 change to invasive cancer; of 29 cases of CIN III, there were 9 changes to cancer in situ; and finally, of 14 cases of cancer in situ, there was 1 change to invasive cancer. After the statistical analysis, a value of p <0.05 was obtained, which indicated that the differences were statistically significant. CONCLUSION: By modifying the histopathological study technique, guidelines can be given to generate a more accurate diagnosis with a more solid base, and thus, a more appropriate and timely treatment can be offered to avoid the development of cervical cancer.

Necesidad de educación sexual y reproductiva en adolescentes de escuela secundaria / Need for sexual and reproductive education in high school teens

Introducción: los adolescentes enfrentan problemáticas que atentan su salud, entre los que destacan el embrazo y las infecciones de transmisión sexual, ambas prevenibles con educación. Objetivo: identificar el nivel de necesidad de educación sexual y reproductiva en adolescentes de secundaria. Material y métodos: estudio transversal, realizado de agosto 2018 a marzo 2019. Muestra de 227 estudiantes de una secundaria pública del estado de San Luis Potosí, inscritos en el ciclo escolar 2018-2019. Se aplicó una encuesta autoadministrada para medir la necesidad y se diseñó una escala ordinal con base al puntaje obtenido: alta= 73-93, media= 52-72 y baja= 31-51. Se aplicó la prueba X2 para determinar asociación entre variables. Resultados: la mayoría de los alumnos tienen un nivel de necesidad de educación sexual y reproductiva medio. Los estudiantes de segundo grado tienen mayor necesidad de educación (35.2%) que los de primero (16.7%) y tercero (6%) con una diferencia significativa (p<0.001). Quienes tienen menor necesidad de educación sexual son aquellos que platican frecuentemente con sus padres. Conclusión: es necesario que la educación sexual sea integral e impartida desde niveles de educación básica de manera continua; asimismo, capacitar a los padres de familia para que puedan brin-dar más información. De igual forma, fomentar la comunicación entre padres e hijos.

Association of Serum Zinc Levels in Overweight and Obesity.

Low levels of zinc (Zn) have adverse effects on physiological and metabolic functions in humans, especially in processes linked with obesity. In this work, serum Zn levels and their associations with biochemical parameters (glucose, triglycerides, and total cholesterol), sex, and body mass index (BMI) were determined. The distribution of the study sample by sex was homogeneous: 52.6% were women and 47.4% were men. Women had higher BMI and Zn levels (normal weight and obesity) than men, but the differences in BMI and serum Zn levels by sex were not significant (p > 0.05). Nevertheless, the results obtained showed a decrease in serum Zn levels in overweight and obese individuals (p < 0.05) and a negative correlation between BMI and serum Zn levels (r = - 0.663 and p < 0.001); additionally, a significant correlation was identified between cholesterol and triglyceride values (r = 0.493 and p < 0.001). In conclusion, this study demonstrated decreased serum Zn levels in overweight and obese individuals.

Barreras estructurales en la atención nutricia a personas con enfermedad renal crónica en México / Structural barriers in care nutrition for people with chronic kidney disease in Mexico

Resumen Este trabajo se propone describir las barreras estructurales que el personal de salud identifica para brindar atención nutricia a personas con enfermedad renal crónica (ERC). Se llevó a cabo un estudio cualitativo en la ciudad de San Luis Potosí, México. Se entrevistó a 21 profesionales de salud (nutriólogos, enfermeras y nefrólogos) que trabajan en unidades de hemodiálisis. Se realizó un análisis crítico del discurso. Los participantes del estudio señalan diversas barreras estructurales que obstaculizan la inclusión de la terapia nutricional en el tratamiento de la ERC: la falta de cobertura universal de salud en México, lo que genera que no todas las personas con ERC accedan a un tratamiento nutricio; la infraestructura inadecuada en las unidades de hemodiálisis, donde los nutriólogos carecen de un espacio físico para dar consulta o asesoría; la ausencia de normativa y protocolos para la atención nutricia y; la falta de recursos humanos en nutrición especializados en ERC. Como conclusión, se destaca que la atención nutricia para los enfermos renales en México es incipiente y poco sistematizada. Se requiere instituir una atención universal, así como modificar la normativa nacional para incluir al personal de nutrición especializado en el tratamiento interdisciplinar en beneficio de quienes padecen dicha enfermedad.

Abstract This study describes the structural barriers that the health personnel identifies to provide nutritional care to people with chronic kidney disease. A qualitative study was carried out in San Luis Potosí, Mexico. We interviewed 21 health professionals (nutritionists, nurses and nephrologists) who work in hemodialysis units. Critical discourse analysis was performed. The study participants point out various structural barriers that hinder the inclusion of diet therapy in the treatment of CKD: the lack of universal health coverage in Mexico, which means that not all people with CKD have access to nutritional treatment; inadequate infrastructure in hemodialysis units, where nutritionists lack a physical space to provide appointment or advice; absence of regulations and protocols for nutritional care; lack of human resources in nutrition, specialized in CKD. In conclusion, it is highlighted that nutritional care for kidney patients in Mexico is incipient and little systematized. It is necessary to institute universal care, as well as modify the national regulations to include specialized nutrition personnel to interdisciplinary treatment for the benefit of those who suffer from the disease.

Coleta de amostra para identificação de DNA do papilomavírus: conhecimento e habilidades / Toma de muestra para identificación de ADN del papilomavirus: conocimiento y habilidades / Sample taking for identification of papilomavirus DNA: skills and knowledge

Resumo Objetivo Estabelecer a relação entre o conhecimento e as habilidades dos profissionais da saúde em coletar amostras para a identificação do DNA do papilomavírus. Métodos Estudo transversal, realizado entre março e junho de 2017, com uma população de 313 pessoas. A amostra probabilística foi calculada considerando um r=0,306, 95% de confiança e poder de 90%, equivalente a 90 trabalhadores de 23 centros de saúde. Um teste de conhecimento e um checklist foram administrados para avaliar as habilidades na coleta de amostra utilizando o teste de Captura Híbrida 2 (teste HPV-CH2). Para análise dos dados, foi utilizada a correlação de Pearson e ANOVA. Resultados Foi encontrada uma correlação entre conhecimento e habilidades (r=0,438) (p<0,001). Quanto ao conhecimento, não houve diferença significativa nas médias obtidas nos três grupos de participantes (enfermeiros versus estagiários 3,27 p=0,557, médicos vs. enfermeiros 2,17 p=0,852, e médicos vs. estagiários 5,45 p=0,441). Quanto às habilidades, não houve diferença entre as médias obtidas entre médicos e enfermeiros (4,27 p=0,388), nem entre enfermeiros e estagiários (4,54 p=0,179), mas houve diferença entre médicos e estagiários (8,81 p=0,041). Conclusão Houve correlação entre o conhecimento e as habilidades em coletar amostras para a identificação do DNA do papilomavírus. Não houve diferenças significativas no conhecimento entre os grupos estudados, mas uma diferença em relação às habilidades foi encontrada entre médicos e estagiários.

Resumen Objetivo establecer la relación entre el conocimiento y las habilidades de los profesionales de la salud para tomar muestras para identificación del ADN del papilomavirus. Métodos estudio transversal realizado entre marzo y junio de 2017, con una población de 313 personas. El muestreo probabilístico fue calculado considerando un r=0,306, 95% de confianza y poder de 90%, equivalente a 90 trabajadores de 23 centros de salud. Se aplicó una prueba de conocimiento y una checklist para evaluar las habilidades de toma de muestra utilizando la prueba de captura de híbridos 2 (prueba HPV-CH2). Para el análisis de datos se utilizó la correlación de Pearson y ANOVA. Resultados se encontró una correlación entre conocimiento y habilidades (r=0,438) (p<0,001). Con relación al conocimiento, no hubo diferencia significativa en los promedios obtenidos en los tres grupos de participantes (enfermeros vs. practicantes 3,27 p=0,557, médicos vs. enfermeros 2,17 p=0,852 y médicos vs. practicantes 5,45 p=0,441). Respecto a las habilidades, no hubo diferencia en los promedios obtenidos entre médicos y enfermeros (4,27 p=0,388), ni entre enfermeros y practicantes (4,54 p=0,179), pero hubo diferencia entre médicos y practicantes (8,81 p=0,041). Conclusión hubo correlación entre el conocimiento y las habilidades para tomar muestras para identificar el ADN del papilomavirus. No hubo diferencias significativas en el conocimiento entre los grupos estudiados, pero se encontró una diferencia con relación a las habilidades entre médicos y practicantes.

Abstract Objective To establish the relationship between the knowledge and skills of health personnel in taking samples for the identification of papillomavirus DNA. Methods Cross-sectional study, conducted between March and June of 2017. Population of 313 people, the probabilistic sample was calculated considering a r = 0.306 expected, 95% confidence, and power of 90%, which equated to 90 workers from 23 health centers. A knowledge test and checklist were administered to evaluate sampling skills, with the hybrid capture method (HPV-CH2 test). For data analysis, Pearson's and the ANOVA correlation were used. Results A correlation between knowledge and skills was found (r=0.438) (p<0.001). Regarding knowledge, there was no significant difference in the means obtained from the three groups of participants (nurses vs. interns 3.27 p=0.557, physicians vs. nurses 2.17 p=0.852, physicians vs. interns 5.45 p=0.441). Regarding skills, there was no difference between the means obtained between physicians and nurses (4.27 p=0.388), nor between nurses and interns (4.54 p=0.179), but there was a difference between physicians and interns (8.81 p=0.041). Conclusion There was a correlation between the knowledge and skills in taking samples for the identification of papillomavirus DNA. There were no significant differences in knowledge between the groups studied; but a difference in means for skills was found between physicians and interns.

[Using geo-intelligence to estimate risk of introduction of influenza type A in MexicoCenário de risco de introdução do vírus da influenza A no México estimado com o uso de inteligência geográfica]. / Escenario de riesgo de introducción de la influenza tipo A en México estimado mediante geointeligencia.

OBJECTIVE: Estimate the probabilistic potential of introduction of the causative agent of influenza type A in Mexico, using geo-intelligence applied to health. METHODS: Ecological study of 1,973 influenza outbreaks with a high degree of pathogenicity, worldwide during the period 2014-2016. Geospatial modeling was developed with geo-intelligence tools such as spatial representation, a relational model, spatial characterization of the inoculum source with the maximum entropy model and the receiver operating characteristic (ROC) curve, using multicriteria spatial analysis. This was validated with the Moran index and geographically weighted regression. RESULTS: Isochrones (at an initial distance of 548 km) were estimated for health risks and their exponential growth; at the fourth isochrone, the east and west coasts of the United States of America and a part of Central America were identified as possible areas that favor the introduction of the pathogen. Also, a COR curve = 0.923 was obtained; two risk periods for introduction were identified (September-March and April-August, with north-south and south-north trajectories, respectively) with high positive autocorrelation for geospatial modeling; and in one scenario, more than half of Mexico was found to be at high risk of introduction, with an estimated 78 million people exposed. A positive association was identified between significant risk areas (p < 0.001). CONCLUSION: More than 50% of Mexican territory was found to be at risk of introduction of the causative agent of influenza type A, with approximately 70% of the population exposed.

OBJETIVO: Estimar o cenário probabilístico em potencial de introdução do vírus da influenza A no México com o uso de inteligência geográfica em saúde. MÉTODOS: Estudo ecológico de 1.973 surtos mundiais de influenza de alta patogenicidade ocorridos no período 2014­2016. Foi desenvolvido um modelo geoespacial com ferramentas de inteligência geográfica, como representação espacial, modelo de conexidade, caracterização espacial da fonte de inóculo com o modelo de máxima entropia e curva ROC (receiver operating characteristic) com avaliação espacial por múltiplos critérios e validação com o índice de Moran e regressão geograficamente ponderada. RESULTADOS: Foram estimadas isócronas do risco de saúde com uma distância de 548 km e o crescimento exponencial destes linhas; até a quarta isócrona, foram identificadas as costas leste e oeste dos Estados Unidos (EUA) e parte da América Central como possível superfície que favorece a introdução do vírus. Foi também estimada uma curva ROC de 0,923, sendo identificados dois períodos de risco de introdução do vírus (setembro­março e abril­agosto) com trajetórias de norte-sul e sul-norte, respectivamente, com elevada autocorrelação positiva para o modelo geoespacial. Foi estimado um cenário em que mais da metade do México apresenta alto risco de introdução do vírus da influenza, com 78 milhões de pessoas expostas. E foi observada uma associação positiva entre as áreas de risco significativo (P < 0,001). CONCLUSÃO: Observa-se que mais de 50% do território mexicano está sob risco de introdução do vírus da influenza A, com cerca de 70% da população exposta.

Escenario de riesgo de introducción de la influenza tipo A en México estimado mediante geointeligencia

[RESUMEN]. Objetivo. Estimar el escenario potencial probabilístico de introducción del agente causal de la influenza tipo A en México mediante geointeligencia sanitaria. Métodos. Estudio ecológico en el que consideran 1 973 brotes de influenza con alto grado de patogenicidad en el mundo durante el período 2014-2016. Se desarrolló un modelado geoespacial con herramientas de la geointeligencia, como la representación espacial, modelo de conexidad, caracterización espacial de la fuente de inoculo con el modelo de máxima entropía y la curva característica de operación receptora (COR) mediante la evaluación espacial multicriterio y se validó con el índice de Moran y la regresión geográficamente ponderada. Resultados. Se estimaron las isocronas de riesgo sanitario con una distancia de 548 km y su crecimiento exponencial; hasta la cuarta isócrona se identificaron las costas este y oeste de Estados Unidos de América (EEUU) y una porción de América Central como posible superficie que favorece la introducción del patógeno. Se obtuvo, también, una curva COR = 0,923, se identificaron dos períodos de riesgo de introducción (setiembre-marzo) y (abril-agosto) con trayectorias de norte-sur y sur-norte respectivamente, con alta autocorrelación positiva para el modelado geoespacial, y se estimó un escenario donde más de la mitad de México se encuentra en un riesgo alto de introducción, con 78 millones de personas expuestas. Se identificó una asociación positiva entre las áreas de riesgo significativo (P < 0,001). Conclusión. Se evidencia que más de 50% del territorio mexicano se encuentra en riesgo de introducción del agente causal de la influenza tipo A, con aproximadamente 70% de la población expuesta.

[ABSTRACT]. Objective. Estimate the probabilistic potential of introduction of the causative agent of influenza type A in Mexico, using geo-intelligence applied to health. Methods. Ecological study of 1,973 influenza outbreaks with a high degree of pathogenicity, worldwide during the period 2014-2016. Geospatial modeling was developed with geo-intelligence tools such as spatial representation, a relational model, spatial characterization of the inoculum source with the maximum entropy model and the receiver operating characteristic (ROC) curve, using multicriteria spatial analysis. This was validated with the Moran index and geographically weighted regression. Results. Isochrones (at an initial distance of 548 km) were estimated for health risks and their exponential growth; at the fourth isochrone, the east and west coasts of the United States of America and a part of Central America were identified as possible areas that favor the introduction of the pathogen. Also, a COR curve = 0.923 was obtained; two risk periods for introduction were identified (September-March and April-August, with north-south and south-north trajectories, respectively) with high positive autocorrelation for geospatial modeling; and in one scenario, more than half of Mexico was found to be at high risk of introduction, with an estimated 78 million people exposed. A positive association was identified between significant risk areas (p < 0.001). Conclusion. More than 50% of Mexican territory was found to be at risk of introduction of the causative agent of influenza type A, with approximately 70% of the population exposed.

[RESUMO]. Objetivo. Estimar o cenário probabilístico em potencial de introdução do vírus da influenza A no México com o uso de inteligência geográfica em saúde. Métodos. Estudo ecológico de 1.973 surtos mundiais de influenza de alta patogenicidade ocorridos no período 2014–2016. Foi desenvolvido um modelo geoespacial com ferramentas de inteligência geográfica, como representação espacial, modelo de conexidade, caracterização espacial da fonte de inóculo com o modelo de máxima entropia e curva ROC (receiver operating characteristic) com avaliação espacial por múltiplos critérios e validação com o índice de Moran e regressão geograficamente ponderada. Resultados. Foram estimadas isócronas do risco de saúde com uma distância de 548 km e o crescimento exponencial destes linhas; até a quarta isócrona, foram identificadas as costas leste e oeste dos Estados Unidos (EUA) e parte da América Central como possível superfície que favorece a introdução do vírus. Foi também estimada uma curva ROC de 0,923, sendo identificados dois períodos de risco de introdução do vírus (setembro–março e abril–agosto) com trajetórias de norte-sul e sul-norte, respectivamente, com elevada autocorrelação positiva para o modelo geoespacial. Foi estimado um cenário em que mais da metade do México apresenta alto risco de introdução do vírus da influenza, com 78 milhões de pessoas expostas. E foi observada uma associação positiva entre as áreas de risco significativo (P < 0,001). Conclusão. Observa-se que mais de 50% do território mexicano está sob risco de introdução do vírus da influenza A, com cerca de 70% da população exposta.

Situación futura de la cardiopatía isquémica en el estado de San Luis Potosí: un modelo dinámico predictivo / Future status of ischaemic heart disease in the state of San Luis Potosí: A predictive dynamic model

Resumen Objetivo: Desarrollar un modelo dinámico predictivo para generar y analizar la situación futura de la tasa de incidencia de la enfermedad isquémica del corazón en población de 25 años y mayores en México, en función de la variación en el tiempo de algunos factores de riesgo. Método: Estudio ecológico retrospectivo durante el periodo 2013-2015, en la ciudad de San Luis Potosí (México). Se utilizaron bases de datos secundarias con indicadores oficiales de los 58 municipios que conforman el estado de San Luis Potosí, los cuales corresponden a los años 2000, 2005 y 2010. Se analizaron 8 indicadores a nivel municipio, por medio de los métodos de análisis de componentes principales, modelos de ecuaciones estructurales, modelaje dinámico y software de simulación. Resultados: Fueron extraídos 3 componentes que en conjunto explican el 80.43% de la varianza total de los indicadores oficiales utilizados; el segundo componente tiene un peso de 16.36 unidades que favorecen el incremento de la enfermedad analizada; este componente está integrado solo por el indicador EDAD 60-64 y el escenario esperado del mismo va en aumento. El modelo estructural confirma que los indicadores explican el 42% de la variación de esta enfermedad; los posibles escenarios para los años 2015, 2020 y 2025 son de 195.7, 240.7 y 298, respectivamente, por cada 100,000 habitantes de 25 años y mayores. Conclusiones: Se espera un incremento exponencial en la tasa de incidencia de la enfermedad isquémica del corazón; la edad de 60-64 años se identificó como el factor de riesgo de más peso. © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. Este es un artículo Open Access bajo la licencia CC BY-NC-ND (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Abstract Objective: To develop a predictive dynamic model to generate and analyse the future status of the incidence rate of ischaemic heart disease in a population of 25 years and over in Mexico, according to the variation in time of some risk factors. Method: Retrospective ecological study performed during the period 2013-2015, in San Luis Potosí City, Mexico. Secondary databases that corresponded to the years 2000, 2005, and 2010, were used along with official indicators of the 58 municipalities of the state of San Luis Potosí. Eight indicators were analysed at municipality level, using principal components analysis, structural equation modelling, dynamic modelling, and simulation software methods. Results: Three components were extracted, which together explained 80.43% of the total variance of the official indicators used. The second component had a weight of 16.36 units that favoured an increase of the disease analysed. This component was integrated only by the indicator AGE 60-64 and the expected stage of it increasing. The structural model confirmed that the indicators explain 42% of the variation of this disease. The possible stages for the years 2015, 2020, and 2025 are 195.7, 240.7, and 298.0, respectively for every 100,000 inhabitants aged 25 and over. Conclusions: An exponential increase in the incidence rate of ischaemic heart disease is expected, with the age of 60-64 years being identified as the highest risk factor. © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/).

[Future type 2 diabetes mellitus scenario estimated with a predictive dynamic simulation model]. / Escenario futuro de la diabetes mellitus tipo 2 estimado con un modelo de simulación dinámico predictivo.

OBJECTIVE: Develop a predictive dynamic model to estimate future scenarios for the incidence rate of type 2 diabetes mellitus (T2DM). METHODS: A retrospective ecological study was conducted in 2013-2015 in the city of San Luis Potosí, Mexico. Secondary official data from the 58 municipalities making up the state of San Luis Potosí were analyzed. Linear correlation, multiple linear regression, and structural equations were carried out, and four predictive dynamic submodels were developed: T2DM, urban population, inhabited private dwellings that have television, and population aged 45-49 years. A holistic model was also developed. RESULTS: The structural model explains 27.2% of total variance in type 2 diabetes mellitus. Percentage of inhabited dwellings that have television weighs 4.46 non-standard units on diabetes; that of urban population, 2.84; and that of population aged 45-49 years, 156.69. Estimated scenarios for T2DM per 100 000 population for the years 2015, 2020, 2025, and 2030 were 1,052.4, 1,413.7, 1,850.1, and 2,351.1 respectively. CONCLUSION: The T2DM scenario shows exponential growth from 2000 to 2030. Risk factors according to the weight they represent in occurrence of the disease were: population aged 45-49 years, inhabited private dwellings that have television, and urban population.

[Future status of ischaemic heart disease in the state of San Luis Potosí: A predictive dynamic model]. / Situación futura de la cardiopatía isquémica en el estado de San Luis Potosí: un modelo dinámico predictivo.

OBJECTIVE: To develop a predictive dynamic model to generate and analyse the future status of the incidence rate of ischaemic heart disease in a population of 25 years and over in Mexico, according to the variation in time of some risk factors. METHOD: Retrospective ecological study performed during the period 2013-2015, in San Luis Potosí City, Mexico. Secondary databases that corresponded to the years 2000, 2005, and 2010, were used along with official indicators of the 58 municipalities of the state of San Luis Potosí. Eight indicators were analysed at municipality level, using principal components analysis, structural equation modelling, dynamic modelling, and simulation software methods. RESULTS: Three components were extracted, which together explained 80.43% of the total variance of the official indicators used. The second component had a weight of 16.36 units that favoured an increase of the disease analysed. This component was integrated only by the indicator AGE 60-64 and the expected stage of it increasing. The structural model confirmed that the indicators explain 42% of the variation of this disease. The possible stages for the years 2015, 2020, and 2025 are 195.7, 240.7, and 298.0, respectively for every 100,000 inhabitants aged 25 and over. CONCLUSIONS: An exponential increase in the incidence rate of ischaemic heart disease is expected, with the age of 60-64 years being identified as the highest risk factor.

Nursing education in humanized care / Educação em enfermagem no cuidado humanizado / Educación de enfermería en el cuidado humanizado

Abstract Objective: To evaluate the effect of an educational intervention for the adequate use of the Dignified Treatment indicator by the nursing staff before the care of hospitalized patients. Methods: Pre-experimental analysis performed from February to March of 2017 in a public hospital in San Luis Potosí Mexico, with 37 nurses. In the first stage, a diagnostic evaluation of knowledge was elaborated. In the second, an education program was implemented for the proper use of the decent treatment indicator. In the third, nursing knowledge was evaluated and the before and after tests were compared by the t-Student parametric test. Results: For the diagnostic stage, 97% of nursing staff had a low level of knowledge. After implementing the program, 80% of the team increased their level. Conclusions: The educational intervention increased the knowledge about the use of the Dignified Treatment indicator.

Resumo Objetivo: Avaliar o efeito de uma intervenção educacional para o uso adequado do indicador digno de tratamento na equipe de enfermagem antes do atendimento de pacientes hospitalizados. Métodos: Análise pré-experimental realizada de fevereiro a março de 2017 em um hospital público em San Luis Potosí, México, para 37 enfermeiros. Na primeira etapa, foi elaborada uma avaliação diagnóstica do conhecimento. Na segunda, um programa de equação foi implementado para o uso adequado do indicador de tratamento decente. Na terceira, o conhecimento em enfermagem foi avaliado após a implementação do programa e o teste anterior e posterior foi comparado através do teste paramétrico t-Student. Resultados: Na etapa diagnóstico, 97% da equipe de enfermagem apresentou baixo nível de conhecimento. Após a implementação do programa, 80% da equipe de enfermagem aumentou seu nível de conhecimento. Conclusões: A intervenção educacional aumentou o conhecimento sobre o uso do indicador Dignified Treatment.

Resumen Objetivo: Evaluar el efecto de una intervención educativa para el adecuado uso del indicador Trato digno en el personal de enfermería ante el cuidado del paciente hospitalizado. Métodos: Analítico pre-experimental realizado de febrero a marzo del 2017 en un hospital público en San Luis Potosí, México, con 37 enfermeras. En la primera etapa, se elaboró una evaluación diagnóstica de conocimientos. En la segunda, se implementó un programa de educación para el adecuado uso del indicador Trato digno. En la tercera, se evaluaron los conocimientos de enfermería posterior a implementar el programa y se contrastó el antes y después por la prueba paramétrica t-Student. Resultados: Para la etapa diagnóstica, el 97% del personal de enfermería presentó un nivel bajo de conocimientos. Después de implementar el programa, el 80% del personal incrementó su nivel. Conclusiones: La intervención educativa incrementó los conocimientos sobre el buen uso del indicador Trato digno.

Atole de amaranto y su efecto potencial sobre la composición corporal de adultas mayores / Amaranth drink and its potential effect on the body composition of older adults

Introducción: El envejecimiento implica disminución de las capacidades físicas asociado a un deficit nutricional por un bajo aporte de calorías y/o proteínas que disminuyen la masa muscular. El desarrollo de dietas que incorporen alimentos funcionales como el amaranto, cuyo contenido de proteína es muy similar y comparable a la caseína, podrían mejorar el estado nutricio de este grupo de población. Objetivo: Evaluar el efecto de una bebida "atole" a base de amaranto sobre la composición corporal de mujeres mayores utilizando bioimpedancia. Métodos: Se incluyeron 26 mujeres mayores de 60 años suplementadas por 90 días con atole estandarizado con 22.5g de amaranto. Se aplicó la prueba estadística t de Student para muestras relacionadas con un intervalo de confianza del 95%. La evaluación se realizó basal, intermedia día 30 y final día 90. Resultados: En 90 días mostraron disminución de peso »0.97 ± 1.9kg, masa grasa »2 ± 2.0kg (p £ 0.05) y aumento de masa magra »1.20 ±1.8 Kg (p £ 0.05). Discusión: El Amaranto tiene gran potencial como cultivo sostenible con alta incidencia en la seguridad alimentaria, particularmente en grupos vulnerables donde la desnutrición es causa primordial de la fragilidad en el adulto mayor. Conclusiones: Se sugiere que el atole de amaranto favorece la ganancia de masa muscular en adultos mayores. Son necesarias futuras investigaciones sobre los efectos del consumo de amaranto en el desarrollo y mantenimiento de la masa muscular

Background: Aging implies a decrease in physical abilities associated with a nutritional deficit due to a low consumption of calories and / or proteins that decrease muscle mass. The development of diets that incorporate functional foods such as amaranth, whose protein content is very similar and comparable to casein, could improve the nutritional status of this population group. Objetive: in this work was to assess the nutritional effect of consumption of a drink made of amaranth in antropometric parameters of older adults. Materials and methods: Twenty-six adults older over 60 years were supplemented with "Atole" amaranth. Body composition was assessed by impedance at 0, 30 and 90 days before, during and after of supplementation. Results: After 90 days, the weight and fat mass decreased » 0.97 ± 1.9kg and » 2 ± 2.0kg (p£0.05), respectively. However, lean mass increased »1.20 ±1.8 Kg (p£0.005). Conclusions: Se sugiere que el atole de amaranto favorece la ganancia de masa muscular en adultos mayores. Future research is needed on the effects of amaranth consumption on the development and maintenance of muscle mass