Análisis regional de la esperanza de vida al nacer en México, por medio del método de regresión / Regional analysis of life expectancy at birth in Mexico, using the multiple regression method

RESUMEN Objetivo Estimar y analizar para el período 1990 al 2010 los patrones regionales de la esperanza de vida al nacer en México por medio del método de regresión lineal. Materiales y Métodos Se utiliza la regresión lineal para obtener la esperanza de vida a nivel estatal y éste considera variables como la tasa bruta o cruda de mortalidad y la población mayor a 65 años. Esto permite conocer el nivel de convergencia entre los estados. Resultados Existe un patrón de convergencia que sugiere que las diferencias de los niveles de esperanza de vida se han reducido entre los estados durante el período de estudio, esta tendencia se presenta también a nivel regional. Discusión Se puede mencionar que este análisis puede ser útil en la evaluación de las políticas de salud pública de México que se han centrado en la disminución de las desigualdades en salud entre las poblaciones más pobres y vulnerables. Asimismo, este tipo de método permite tener un método alternativo para conocer las condiciones de acceso a los servicios de salud y conocer las expectativas de vida de la población.(AU)

ABSTRACT Objective To estimate and analyze the regional patterns of life expectancy at birth in Mexico for the period 1990-2010 using multiple regression. Materials and Methods Multiple regression analysis is used to obtain life expectancy rates at state level. This method considers variables such as crude death rate and population over 65 years of age to know the level of convergence between states. Results There is a pattern of convergence that suggests that the differences in the life expectancy levels decreased among states during the analyzed period. This trend is also observed at the regional level. Discussion It could be said that this analysis is useful to evaluate the public health policies in Mexico that focus on the reduction of health inequalities among the poorest and most vulnerable populations. Likewise, this type of method allows having an alternative method to know the conditions of access to health services and the life expectancy of the population.(AU)

[Regional analysis of life expectancy at birth in Mexico, using the multiple regression method]. / Análisis regional de la esperanza de vida al nacer en México, por medio del método de regresión.

OBJECTIVE: To estimate and analyze the regional patterns of life expectancy at birth in Mexico for the period 1990-2010 using multiple regression. MATERIALS AND METHODS: Multiple regression analysis is used to obtain life expectancy rates at state level. This method considers variables such as crude death rate and population over 65 years of age to know the level of convergence between states. RESULTS: There is a pattern of convergence that suggests that the differences in the life expectancy levels decreased among states during the analyzed period. This trend is also observed at the regional level. DISCUSSION: It could be said that this analysis is useful to evaluate the public health policies in Mexico that focus on the reduction of health inequalities among the poorest and most vulnerable populations. Likewise, this type of method allows having an alternative method to know the conditions of access to health services and the life expectancy of the population.

OBJETIVO: Estimar y analizar para el período 1990 al 2010 los patrones regionales de la esperanza de vida al nacer en México por medio del método de regresión lineal. MATERIALES Y MÉTODOS: Se utiliza la regresión lineal para obtener la esperanza de vida a nivel estatal y éste considera variables como la tasa bruta o cruda de mortalidad y la población mayor a 65 años. Esto permite conocer el nivel de convergencia entre los estados. RESULTADOS: Existe un patrón de convergencia que sugiere que las diferencias de los niveles de esperanza de vida se han reducido entre los estados durante el período de estudio, esta tendencia se presenta también a nivel regional. DISCUSIÓN: Se puede mencionar que este análisis puede ser útil en la evaluación de las políticas de salud pública de México que se han centrado en la disminución de las desigualdades en salud entre las poblaciones más pobres y vulnerables. Asimismo, este tipo de método permite tener un método alternativo para conocer las condiciones de acceso a los servicios de salud y conocer las expectativas de vida de la población.

Propiedades antioxidantes de extractos de curuba (Passiflora mollisima Bailey) en crema de leche / Antioxidant properties of curuba extracts (Passiflora mollisima Bailey) in milk cream

Antecedentes: la grasa láctea contribuye al sabor y aroma de los productos lácteos y ayuda a absorber las vitaminas liposolubles. Sin embargo es susceptible a reacciones de oxidación, que traen como consecuencia una disminución en la calidad de los productos. Objetivo: evaluar la capacidad antioxidante de la crema de leche suplementada con 0,40 0,60 y 0,80% p/p de extracto de curuba y la estabilidad oxidativa durante 25 días de almacenamiento a 4ºC. Materiales y métodos: para evaluar la oxidación lipídica se determinó el valor TBAR. La capacidad antioxidante se comprobó mediante las técnicas DPPH, ORAC-H, ORAC-L y Folin Ciocalteu. Resultados: los tratamientos mejoraron significativamente la estabilidad oxidativa de la crema de leche (p<0,05) durante los 25 días de almacenamiento, la presencia de 0,40; 0,60 y 0,80% p/p de extracto de curuba redujo la producción de malondialdehido con respecto el blanco en un 6, 15 y 22% respectivamente, el poder antioxidante de las muestras suplementadas fue superior al del blanco. En la evaluación sensorial se encontró diferencia entre la crema de leche con y sin extracto. Conclusiones: el extracto de curuba retrasa el proceso de oxidación de la crema de leche y puede estar asociado a la capacidad antioxidante del producto.

Background: Milk fat contributes to flavors of dairy products and contributes to fat-soluble vitamins absorption. However, it is susceptible to oxidation reactions that result in a decrease in the quality of products. Objective: To evaluate the antioxidant capacity of the milk cream supplemented with 0.40, 0.60 and 0.80 % w/w of Banana Passion Fruit extracts and oxidative stability during 25 days of storage at 4ºC. Materials and Methods: Lipid peroxidation was evaluated by the TBARS method. The antioxidant capacity was determined by DPPH, ORAC-H, ORAC-L and Folin-Ciocalteu assays. Results: Treatments improved significantly (p<0.05) the oxidative stability of the cream during 25 days of storage, the presence of 0.40, 0.60 and 0.80% w/w curuba extract reduced production of malondialdehyde by 6, 15 and 22% respectively compared to control, the antioxidant power of the supplemented samples was higher than control. In the sensory evaluation was found difference between the cream with and without extract. Conclusions: Banana Passion Fruit extract retards the oxidation process of the cream and may be associated with the antioxidant capacity of the product.

Características nutricionales y antioxidantes de la fruta curuba larga (Passiflora mollissima Bailey) / Nutritional and antioxidant characteristics of banana passion fruit (Passiflora mollissima Bailey)

Antecedentes: la curuba larga es una fruta tropical poco reconocida y poco estudiada sobre su valor nutricional y sus componentes bioactivos. Objetivo: describir las características nutricionales y antioxidantes de la curuba larga. Metodología: descripción de las características del fruto y producción de la curuba larga. Análisis de la composición proximal de la fruta. Se conoció a partir de referencias científicas el contenido de micronutrientes de la curuba larga. Se determinó el contenido de carotenoides, fenoles y flavonoides totales. La capacidad antioxidante se analizó por los métodos DPPH, FRAP y ORAC. Resultados: esta fruta es fuente de vitaminas A, C y niacina, minerales como potasio, fósforo, magnesio, sodio, cloro, hierro; aporta cantidades moderadas de carbohidratos y calóricas. El contenido de carotenoides, fenoles y flavonoides totales fue 118,8 mg βcaroteno 460,1 mg ácido gálico y 1.907,6 mg catequina/100 g, respectivamente. El valor DPPH, FRAP y ORAC fue 60.843,1 µmol, 8.520,3 µmol y 20.754,9 µmol de equivalentes Trolox/100 g de fruta seca, respectivamente. Conclusión: el valor nutricional y antioxidante de la curuba larga debe aprovecharse por la población en general y como materia prima por la agroindustria para favorecer su cadena productiva.

Background: banana passion fruit is a tropical fruit whose nutritional value and bioactive compounds are little known and have not been studied enough. Objective: based on the nutritional and antioxidant characteristics of banana passion fruit we show the nutritional value and the impact to human health. Methodology: characteristics of fruit and production were described. Proximal composition of the fruit was analyzed. Micronutrients were known by scientific references related to banana passion fruit. Antioxidant capacity was analyzed by DPPH, FRAP and ORAC methods. Results: this is a source of vitamins A, C and niacin, minerals such as potassium, phosphorus, magnesium, sodium, chlorine, iron; provides moderate amounts of carbohydrates and calories. The content of total carotenoids, phenols and flavonoids was 118,8 mg βcarotene 460,1 mg galic acid galic and, 1.907,6 mg catechine/100 g respectively. The DPPH, FRAP and ORAC value was 60.843,1 µmol, 8.520,3 µmol and, 20.754,9 µmol trolox equivalents/100 g dehydrated fruit respectively. Conclusion: people in general and the food industry should take advantange of the nutritional and antioxidant value of banana passion fruit as well as raw material to improve the productive chain.

The role that graduate medical education must play in ensuring health equity and eliminating health care disparities.

Despite the 2002 Institute of Medicine report that described the moral and financial impact of health care disparities and the need to address them, it is evident that health care disparities persist. Recommendations for addressing disparities include collecting and reporting data on patient race and ethnicity, supporting language interpretation services, increasing awareness of health care disparities through education, requiring cultural competency training for all health care professionals, and increasing diversity among those delivering health care. The Accreditation Council on Graduate Medical Education places strong emphasis on graduate medical education's role in eliminating health care disparities by asking medical educators to objectively evaluate and report on their trainees' ability to practice patient-centered, culturally competent care. Moreover, one of the objectives of the Accreditation Council on Graduate Medical Education Clinical Learning Environment Review visits as part of the Next Accreditation System is to identify how sponsoring institutions engage residents and fellows in the use of data to improve systems of care, reduce health care disparities, and improve patient outcomes. Residency and fellowship programs should ensure the delivery of meaningful curricula on cultural competency and health care disparities, for which there are numerous resources, and ensure resident assessment of culturally competent care. Moreover, training programs and institutional leadership need to collaborate on ensuring data collection on patient satisfaction, outcomes, and quality measures that are broken down by patient race, cultural identification, and language. A diverse physician workforce is another strategy for mitigating health care disparities, and using strategies to enhance faculty diversity should also be a priority of graduate medical education. Transparent data about institutional diversity efforts should be provided to interested medical students, residents, and faculty. Graduate medical education has a clear charge to ensure a generation of physicians who are firmly grounded in the principles of practicing culturally competent care and committed to the reduction of health care disparities.

Aflibercept treatment for patients with exudative age-related macular degeneration who were incomplete responders to multiple ranibizumab injections (TURF trial).

AIM: To determine the efficacy of 2.0 mg aflibercept in the management of patients with recalcitrant exudative age-related macular degeneration (AMD). METHODS: In this prospective, open-label, single-arm clinical trial, patients were seen monthly and given mandatory 2.0 mg aflibercept at baseline, months 1, 2 and 4. Pro re nata (PRN) retreatment at months 3 and 5 was performed upon evidence of disease on spectral domain-optical coherence tomography (SD-OCT). End point at month 6: mean change in Early Treatment Diabetic Retinopathy Study best corrected visual acuity (ETDRS BCVA) and central subfield thickness (CST), mean number of aflibercept injections, percentage of PRN injections required, patients with no fluid on SD-OCT and patients losing >15 letters. RESULTS: At baseline, 46 patients with a mean of 42 prior antivascular endothelial growth factor-A (anti-VEGF) intravitreal treatments had a mean of 74.2 letters (Snellen equivalent 20/32) and mean CST of 347 µm. ETDRS letters remained stable throughout the trial; at month 6, mean BCVA change was +0.2 letters (range -10 to +13, p=0.71). Anatomically, mean CST improved significantly from baseline at each study visit including -23.6 µm at month 1 and -27.3 µm at month 6 (p=0.018). Seventy-one of 90 (79%) possible PRN injections were required and a mean of 5.6 aflibercept injections out of the maximum six were administered. Ten of 45 (22%) patients had no retinal fluid on SD-OCT at month 6. No patient lost >15 letters. CONCLUSIONS: Aflibercept 2.0 mg treatment maintained mean visual acuity improvements previously achieved with high-dose 2.0-mg ranibizumab injections in recalcitrant wet AMD patients. Aflibercept 2.0 mg treatment led to significant anatomic improvement and was required monthly in most patients. CLINICAL TRIALS REGISTRATION: FDA IND#12462. NCT 01543568. TRIAL DETAILS: IND 12462, NCT 01543568 http://clinicaltrials.gov/show/NCT01543568.

Bioactivities of Piper aduncum L. and Piper obliquum Ruiz & Pavon (Piperaceae) essential oils from Eastern Ecuador.

Essential oils from aerial parts of Piper aduncum (Matico) and Piper obliquum (Anis del Oriente) of ecuadorian origin were analyzed by GC-FID, GC-MS, (13)C NMR and their biological and pharmacological activities were assessed. Chemical composition proved to be unusually different from previous reports for safrole-rich P. obliquum (45.8%), while P. aduncum main constituent was dillapiol (45.9%). No genotoxic activity was found in the Ames/Salmonella typhimurium (TA98 and TA100) assay, either with or without S9 activation. Mutagen-protective properties, evaluated using sodium azide, 2-nitrofluorene and 2-aminoanthracene as mutagens/promutagens, was observed against promutagen 2-aminoanthracene, likely in consequence of microsomial deactivation. Antimicrobial assays have been performed on Gram+/Gram- bacteria, dermatophyte and phytopathogenic fungi and best results were provided by P. aduncum against fungal strains with complete inhibition at 500µg/ml. Preliminary analgesic and antithrombotic activities evidenced the absence of the former in hot plate and edema assays and a limited antiplatelet action against three different agonists (ADP, AA and U46619). Both oils have a very limited antioxidant capacity.