Feeding Habits in the Cultural Domains of Child Care: Elements for Health Promotion.

Introduction: Family eating behavior is determined by the meaning that the caretaker gives to food and the act of eating in the domestic environment, as well as the beliefs and perceptions around those concepts. Objective: Identify the place that nutrition has within the dimensions of child care, the specific weight that the caregiver gives to it within the range of actions deployed and if there are differences when the child exhibits neurodevelopmental disorders, as a contribution to the design of interventions in health promotion. Methodology: Qualitative, exploratory, two-stage study, with the approach of cognitive anthropology; proposal sampling of maximum differences, 121 informants participated in three groups, caregivers of: (1) healthy children, (2) children who had been hospitalized between 3 and 6 months prior to the time of the interview, and (3) children with a diagnosis of permanent neurological injury and that express some type of neurodevelopmental disorder. Results: Nourishment is the element that reaches the highest values of cultural relevance in the three groups, is located in different domains according to the condition of the care receiver. Conclusion: The common domains are Well-being, Health Maintenance, Coexistence, and Security, in the 3rd group the domain of Socialization emerges, the elements that make up the conceptual dimensions were identified, the comparative design allowed to identify differences. The description of the domains can represent the cognitive spaces of educational intervention and the elements that configure them are the triggers of the interaction, due to the importance they are given in everyday life.

Differential Methylation in Promoter Regions of the Genes NR3C1 and HSP90AA1, Involved in the Regulation, and Bioavailability of Cortisol in Leukocytes of Women With Preeclampsia.

Introduction: Hypertensive disorders are of interest in obstetrics and gynecology because they are the second place among causes of maternal mortality and a source of complications in the short, mid, and long term. Even if the pathophysiological process behind preeclampsia (PE) is still unknown, stress factors have been revealed to play an important role in the genesis of this pathologic process. Methods: A case-control study was designed with the purpose of determining if there is a differential methylation in NR3C1, HSD11B2, CYP11A1, CRHBP, TEAD3, and HSP90AA1 genes, related to signaling of the hypothalamic-pituitary-adrenal axis, and its regulation on early-onset PE (EOPE). Results: A total of 20 cases and 20 controls were studied by DNA methylation analysis, demonstrating differences among groups in the percentage of methylation of the NR3C1 gene. After a contingency analysis, an odds ratio (OR) for PE of 12.25 was identified for NR3C1 and 9.9 for HSP90AA1 genes. NR3C1, TEAD3, and HSP90AA1 genes showed a positive correlation with the systolic and diastolic blood pressure levels with a p ≤ 0.05. Conclusion: This study found a differential methylation in the glucocorticoid receptor (GR) NR3C1 and its co-chaperone HSP90AA1 in women with PE, with a possible regulatory role in the response to stress in pregnancy and is a likely physiopathological mechanism in PE.

Haplotype analysis of TGF-ß1 gene in a preeclamptic population of northern Mexico.

OBJECTIVE: To determine the frequencies of -800G/A (rs1800468), -509C/T (rs1800469) and 869T/C (rs1800470) polymorphisms and their haplotypes in the TGF-ß1 gene and their association with preeclampsia in a population of northern México. DESIGN AND METHODS: This case-control study involved 175 preeclamptic and 253 normoevolutive pregnant women. The polymorphisms were genotyped by real time PCR. RESULTS: The allele and genotype frequencies of polymorphisms showed no significant differences between cases and controls; the -800AA genotype had a very low frequency in cases (1%) and controls (0.4%). The TT genotype of the 869T/C polymorphism is a protective factor of severe preeclampsia (OR 0.56, 95% CI 0.32-0.98). The -509C/T and 869T/C polymorphisms were in linkage disequilibrium (D'=.537, p=.009). The most common haplotypes in case and control groups were -800G/-509C/869C, 34.95% and 37.24%, respectively. We found no increased risk of preeclampsia by haplotype. CONCLUSIONS: Our results suggest that -800G/A, -509C/T and 869T/C polymorphisms of TGF-ß1 gene or their haplotypes are not associated with preeclampsia and that only the TT genotype of 869T/C polymorphism is a protective factor of severe preeclampsia in a population of northern México.

Propiedades psicométricas de la CES-D/IS en población universitaria de la ciudad de Durango, México / Psychometric properties of CES-D/IS in university population in Durango city, México

Introduction Depression has been frequently related with suicidal behavior. Evidences of depressive symptoms in adolescents and young people with suicidal ideation or suicidal intention have been showed in several studies. For that reason, it is necessary to have an adequate instrument to measure and identify some characteristics associated with self-destructive behavior in university students. Objective To evaluate the psychometric properties of CES-D/IS in students at the University Juarez of the State of Durango (UJED). Material and Methods The universe of study selected for the schooling period of 2008 consisted of 943 students from 13 academic units. CES-D/IS scale was applied. Before the interview informed consent was obtained from all the participants and they were informed about the nature and scope of the study. Exploratory factor analysis was conducted to evaluate the instrument validity, and Cronbach alpha for internal consistency. Further analysis included Student t-test and Mann-Withney U test. A p-value below 0.05 was considered to indicate statistical significance. The data were analyzed with SPSS, version 15 and R v 2.7.2. Results The total scale showed a high value of internal consistency (α=0.89), and similar results for academic areas, for age and sex. Factor analysis showed a four-factor structure that accounted for 45.5% of variance Conclusions CES-D/IS scale has adequate psychometric properties in reliability and in validity.

Introducción La depresión es un aspecto que constantemente se ha relacionado con la conducta suicida. La sintomatología depresiva ha sido evidenciada en varios estudios donde ha estado presente en adolescentes y jóvenes con pensamientos e intentos de suicidio. Por esta razón es de suma prioridad e interés el contar con un instrumento válido y confiable para la identificación y la medición de características relacionadas con la conducta autodestructiva en estudiantes universitarios. Objetivo Evaluar las propiedades psicométricas de la CES-D/IS, mediante su aplicación a estudiantes de nivel licenciatura de la Universidad Juárez del estado de Durango (UJED). Material y métodos El estudio incluyó a 943 estudiantes de 13 unidades académicas durante el periodo escolarizado de 2008. Se aplicó la escala CES-D/ IS. Se solicitó a los participantes el consentimiento informado y se les aseguró el manejo confidencial de los datos. Para medir la validez del instrumento se utilizó el análisis factorial exploratorio, se evaluó la consistencia interna mediante el coeficiente alfa de Cronbach, se emplearon estadísticos descriptivos, t de Student y U de Mann-Whitney para inferencias al 0.05. Los datos se procesaron con los paquetes estadísticos SPSS v15 y R v 2.7.2. Resultados La escala presentó una consistencia interna de α=0.89. El índice resultó homogéneo cuando se analizó por área de estudio, edad y sexo. El análisis factorial mostró cuatro factores con el 45.5% de la varianza explicada. Conclusiones La escala CES-D/IS, presentó buenas propiedades tanto en su confiabilidad como en su validez.

Genesis of preeclampsia: an epidemiological approach.

THERE ARE ANALYZED SOME OF THE MAIN ASPECTS RELATED TO THE CAUSALITY OF PREECLAMPSIA, PRIVILEGING TWO TYPES OF MODELS: the clinic model and the epidemiologic model, first one represented by the hypothesis of the reduced placental perfusion and the second one considering the epidemiologic findings related to the high levels of psychosocial stress and its association with preeclampsia. It is reasoned out the relevance of raising the causality of the disease from an interdisciplinary perspective, integrating the valuable information generated from both types, clinical and epidemiologic, and finally a tentative explanatory model of preeclampsia is proposed, the subclinical and sociocultural aspects that predispose and trigger the disease are emphasized making aspects to stand out: the importance of reduced placental perfusion as an indicator of individual risk, and the high levels of physiological stress, as a result of the unfavorable conditions of the psychosocial surroundings (indicator of population risk) of the pregnant women.

Niveles de cortisol salivario como predictor de preeclampsia en adolescentes / Salivary cortisol levels as a predictor of preeclampsia in adolescentes

Objective: To determine the usefulness of salivary cortisol as a predictor of preeclampsia in adolescents.Methods: We carried out a nested case- control study. Somatometric, clinical, and biochemical data were obtainedfrom 100 healthy pregnant adolescents and salivary cortisol was measured at 8:00, 12:00, and 20:00 hours on twooccasions during pregnancy, before 20 weeks, and after 30 weeks of gestation. The cortisol values between the groupof healthy pregnant women and the group that developed preeclampsia were compared by using the Student’s t, Mann-Whitney, and Wilcoxon tests. Also, the ROC curve of cortisol values and the Positive and Negative Predictive values of cortisol were estimated. Results: Values >14.9 nmol/L of cortisol were observed in the group that developed preeclampsia, providing a positive predictive value of 1 (100%). Values <10.1 nmol/L were observed in the control group, the negative predictive value was 1 (100%). The cutoff point of the ROC curve -before 20 weeks of gestation- in the members of the cohort was 13.9 nmol/L. Conclusions: The salivary cortisol values observed in the two evaluations made to each of the groups showed statistically significant differences between the groups at 8 and 12 hours of the day. The values obtained enable establishing gradients that allow separating the group of healthy women that got ill with preeclampsia from the groupthat did not develop the illness before week 20. After week 30, the cortisol gradients are established more clearly inthe group with preeclampsia and in the control group. The validation of these findings in larger samples would allowimplementing this procedure as a screening test for preeclampsia in groups of pregnant adolescents.

[The biopsychosocial dimension of preeclampsia: a conceptual-empirical approach]. / La dimensión biopsicosocial de la preeclampsia: un abordaje conceptual-empírico.

From the historical point of view, the toxemia of pregnancy have represented one of the most important clinical and epidemiological investigations related to the process of human reproduction. Remains and their significance is due largely to the close relationship that keeps the disease with the figures for maternal mortality, not only in Mexico but throughout the world. Proposes the addition of a guideline to establish a general explanatory principle to link causally the socioepidemiological and psychosocial characteristics of population groups susceptible to the processes clinical, pathophysiological, biochemical and molecular characteristics of disease. This concept refers to the stress, which is operationally defined as a psychobiological process mediator, whose term physiological, biochemical and molecular level is the translation of the organic individual's response to stimuli of various socio-cultural environment they perceive as threatening. Given the relevance of stress, it is considered appropriate to provide conceptual and empirical evidence supporting it as a centerpiece of the proposal. The association between preeclampsia and adverse psychosocial situation does not correspond to a causal relationship, because they correspond to processes located on different levels of organization. The significance of the results to display at the preeclampsia in a broader perspective, in which an adverse psychosocial situation, characteristic of specific contexts socioepidemiological determines the expression of individual risk factors (genetic, constitutional and obstetric), and this individual level in which psychological stress increases the vulnerability of the pregnant teenager.

Prevalancia de violencia doméstica en la ciudad de Durango / Prevalance of domestic violence in the city of Durango, Mexico

Objetivo. Caracterizar y determinar, desde un enfoque de género, la prevalencia de los diferentes tipos de violencia que se presentan en la ciudad de Durango., México. Material y métodos. Con un diseñó transversal se entrevistaron 384 mujeres casadas, o bien, unidas al momento del estudio o alguna vez, residentes de la ciudad de Durango. El tamaño de la muestra se distribuyó en forma proporcional en seis sectores de la ciudad, seleccionados al azar y representativos de los niveles socioeconómicos alto, medio y bajo. En cada sector se realizaron 64 entrevistas. El instrumento de medición fue un cuestionario con 184 preguntas cerradas y 22 abiertas, que incluía datos de identificación, sociodemográficos y reproductivos, así como reactivos específicos para la violencia física, emocional y sexual. Resultados. La mediana de edad del grupo estudiado fue de 41.5 años, con un rango de 12 a 48 años. La prevalencia de violencia doméstica fue: alguna forma de violencia sexual 42 por ciento; física, 40 por ciento, y emocional, 39 por ciento. Conclusiones. Se reconoce que el problema de la violencia, en sus diferentes formas, es un hecho altamente prevalente que pone en peligro el bienestar del núcleo familiar. Se observó una mayor prevalencia de violencia doméstica en presencia de factores tales como: antecedentes de violencia, alcoholismo y/o consumo de drogas en algún miembro de la familia

Epidemiología de las infecciones nosocomiales en un hospital de segundo nivel / Epidemiology of nosocomial infections at a secon level hospital

Objetivo. Conocer la incidecia, tasas específicas, áreas de mayor riesgo y los agentes causales de infecciones nosocomiales en el Hospital General de Durango, México, de la Secretaría de Salud. Material y métodos. Estudio prospectivo de vigilancia de infecciones nosocomiales, a lo largo de un año, que incluyó a todos los pacientes egresados durante ese periodo. Resultados. S encontró un tasa cruda de nueve infecciones por 100 egresos, las tasas específicas más altas correspondieron a la unidad de terapia intensiva pediátrica y neonatología y las más bajas a cirugía, pediatría y ginecobstetricia. Las infecciones de vías urinarias, neumonía y de heridas quirúrgicas fueron las más frecuentes en los servicios de adultos, mientras que las bacteremias mostraron una alta incidencia en las áreas pediátricas en donde se observó un brote epidémico donde predominó el germen Serratia marscecens. La mayoría de los pacientes presentaron un solo proceso infeccioso y E. coli, Klebsiella y Enterobacter spp. fueron los microrganismos más frecuentemente aislados. Conclusiones. La tasa de infecciones nosocomiales observada en este estudio es más alta que la informada en instituciones similares en México, y las áreas más afectadas fueron las de atención a pacientes en estado crítico y las de atención a recién nacidos, predominando la infección de vías urinarias, neumonía y de heridas quirúrgicas y como agentes causales los bacilos entéricos gram negativos. Los hallazgos anteriores sugieren pautas para el diseño e instrumentación de un programa de control de infecciones nosocomiales, ajustado a las características de este tipo de instituciones.

Critica de la validez de los metodos de detección y confirmación de la tuberculosis pulmonar como un problema de salud pública / Critique of the validity of the methods for detection and confirmation of pulmonary tuberculosis as a public health problem

Se discute la eficiencia de la estrategia que se sigue para detectar personas con tuberculosis pulmonar activa. Se considera que las cifras de morbilidad que son generadas a partir de dicha estrategia subestiman la verdadera magnitud de la enfermedad como problema de salud pública. Se analiza cada una de las características que un enfermo de tuberculosis pulmonar debe reunir para la confirmación de la enfermedad, características que debido a la complejidad de los procesos que involucran determinan que unicamente dos de cada diez enfermos (en forma aproximada) sean diagnosticados; considerándose que el factor limitante más importante para esta pérdida de enfermos en el aspecto diagnóstico es la detección poblaciónal pasiva de tosedores. Se concluye que un conocimiento más real del problema, lo que significa un mejor planteamiento del mismo, se lograría por medio de la búsqueda activa de tosedores casa por casa en aquellos estratos de la población más expuestos a padecerla. La eficiencia de esta pesquisa aumentaría si se tomaran en cuenta los processos psicosociales y culturales que limitan la aceptación de los servicios de salud y que condicionan la autopercepción de los sujetos como portadores de una enfermedad estigmatizante