A diagnostic model for overweight and obesity from untargeted urine metabolomics of soldiers.

Soldiers in active military service need optimal physical fitness for successfully carrying out their operations. Therefore, their health status is regularly checked by army doctors. These inspections include physical parameters such as the body-mass index (BMI), functional tests, and biochemical studies. If a medical exam reveals an individual's excess weight, further examinations are made, and corrective actions for weight lowering are initiated. The collection of urine is non-invasive and therefore attractive for frequent metabolic screening. We compared the chemical profiles of urinary samples of 146 normal weight, excess weight, and obese soldiers of the Mexican Army, using untargeted metabolomics with liquid chromatography coupled to high-resolution mass spectrometry (LC-MS). In combination with data mining, statistical and metabolic pathway analyses suggest increased S-adenosyl-L-methionine (SAM) levels and changes of amino acid metabolites as important variables for overfeeding. We will use these potential biomarkers for the ongoing metabolic monitoring of soldiers in active service. In addition, after validation of our results, we will develop biochemical screening tests that are also suitable for civil applications.

Factores de riesgo nutricionales asociados con el desarrollo de obesidad en militares / Nutritional risk factors associated with the development of obesity in military population

Resumen Introducción: La correcta alimentación de los soldados es clave para mantener la salud y el buen rendimiento, actualmente, la obesidad constituye un problema de salud pública calificada como la "epidemia del siglo". Objetivo: Identificar los factores de riesgo nutricionales asociados al sobrepeso y obesidad en una Brigada del Ejército Mexicano. Material y métodos: Se determinó la fuerza de asociación entre los factores de riesgo nutricionales y el desarrollo de sobrepeso y obesidad. La asociación se realizó mediante X2 y OR, y la diferencia de medias con prueba Z. Resultados: Se observó diferencia entre casos y controles en consumo de calorías (z=9.34, P<0.01), proteínas (z=10.22, P<0.01), grasas (z=8.84, P<0.0) y carbohidratos (z=7.04, P<0.01). El consumo de verduras y frutas <1 vez/semana, y el de bebidas azucaradas >1 vez/semana fueron factores de riesgo para desarrollar sobrepeso y obesidad (X2=4.406; p=0.036; OR=2.1), (X2= 5.6; p=0.018; OR=2.25), (X2=7.368; p=0.007; OR=4.5), respectivamente. El no consumir la mayor cantidad de calorías en el comedor y el que la cafetería y la calle sean el sitio de mayor consumo de calorías fueron factores de riesgo (X2=14.44; p=0.000; OR=4.3), (X2=13.74; p=0.000; OR=5.56) y (X2=6.375; p=0.012; OR =4.12), respectivamente. Conclusiones: El consumo menor o igual a una vez a la semana de verduras y frutas, el consumir bebidas azucaradas más de una vez a la semana, el consumir la mayor cantidad de calorías de la cafetería y de la calle y el no consumir la mayor cantidad de calorías en el comedor fueron factores de riesgo para desarrollar sobrepeso-obesidad.

Abstract Introduction: Correctly feeding soldiers is key to maintaining health and good performance. Obesity is currently a public health problem classified as the "epidemic of the century". Objective to identify the nutritional risk factors associated with overweight and obesity in a Mexican Army Brigade. Material and methods: The strength of association between nutritional risk factors and the development of overweight and obesity was determined. The association was made using X2 and OR, and the difference in means with the Z test. Results: Different differences between cases and controls in the consumption of calories (z = 9.34, P <0.01), proteins (z = 10.22, P <0.01), fats (z = 8.84, P <0.0) and carbohydrates (z = 7.04, P <0.01). Consumption of vegetables and fruits <1 time / week and consumption of sugary drinks> 1 time / week were risk factors for developing overweight and obesity (X2 = 4,406; p = 0.036; OR = 2.1), (X2 = 5.6 ; p = 0.018; OR = 2.25), (X2 = 7.368; p = 0.007; OR = 4.5), respectively. Failure to consume the highest amount of calories in the dining room and the fact that the cafeteria and the street are the site of the highest calorie consumption were risk factors (X2 = 14.44; p = 0.000; OR = 4.3), (X2 = 13.74; p = 0.000; OR = 5.56) and (X2 = 6.375; p = 0.012; OR = 4.12), respectively. Conclusions: Consumption less than or equal to once a week of vegetables and fruits, consumption of sugary drinks more than once a week, consumption of the greatest number of calories in the cafeteria and the street and non-consumption of the greatest amount of calories in the dining room were risk factors for developing overweight-obesity.

Diseño, validación y aplicación de un instrumento de evaluación de las competencias profesionales para realizar las funciones esenciales de la salud pública / Design, validation and application of an instrument for the evaluation of the professional competences for making the essential functions of public health

Introducción: Las funciones esenciales de la salud pública se han definido como las condiciones que permiten un mejor desempeño de su práctica. Competencia profesional es un conjunto de conocimientos, habilidades y actitudes necesarias para que un profesional de la salud pública desarrolle adecuadamente las funciones y actividades que le son propias. Objetivo: Diseñar, validar y aplicar un instrumento para evaluar las competencias profesionales necesarias para realizar las funciones esenciales de la salud pública que poseen los graduados de los cursos de posgrado en salud pública de la Escuela Militar de Graduados de Sanidad. Sujetos y métodos: Se realizó un estudio observacional, analítico y transversal, y se analizó estadísticamente. Resultados: Se diseñó un instrumento con excelente validez de contenido (IVC = 0,94) y fiabilidad elevada (alfa de Cronbach = 0,94). El 81,59% de los graduados de la Maestría en Salud Pública tenía las 56 competencias profesionales necesarias para realizar las funciones esenciales de la salud pública. Por otro lado, el 53,21% de graduados del Curso Técnico Especializado en Salud Pública las tenía. Conclusiones: Se diseñó un instrumento válido y fiable para evaluar las competencias profesionales para realizar las funciones esenciales de la salud pública, y se evaluaron dichas competencias en los graduados de los cursos de posgrado en salud pública. Este instrumento, adaptado a circunstancias particulares, puede aplicarse a otros cursos de posgrado en salud pública

Introduction: The essential functions of public health have been defined as the conditions that allow a better performance of the practice of public health. Professional competence is a set of knowledge, skills and attitudes necessary for a public health professional to adequately develop the functions and activities that are his own. Aim: To design, validate and apply an instrument to evaluate the professional competences necessary to perform the essential functions of public health, possessed by graduates of postgraduate courses in public health of the Military School of Graduates of Health. Subjects and methods: An observational, analytical and transversal study was carried out. It was analyzed statistically. Results: An instrument with excellent content validity (IVC = 0.94) and high reliability (Cronbach’s alpha = 0.94) was designed. 81.59% of the graduates of the master’s degree in public health had the 56 professional competences necessary to carry out the essential functions of public health. On the other hand, 53.21% of graduates of the technical course specialized in public health had them. Conclusions: A valid and reliable instrument was designed to evaluate the professional competences to carry out the essential functions of public health and those competences were evaluated in the graduates of the postgraduate courses in public health. This instrument, adapted to particular circumstances, can be applied to other postgraduate courses in public health

Determinación de las competencias profesionales del egresado de la Licenciatura en Salud Pública / Determination of the professional competences of the graduates in Public Health

Resumen Introducción En el Ejército y Fuerza Aérea Mexicanos (FAM) no hay estudios sobre las competencias del personal profesional que se dedica a la salud pública. Objetivo Determinar si el egresado de la Escuela Militar de Oficiales de Sanidad (EMOS) posee las competencias para realizar las FESP. Material y métodos Estudio observacional, transversal y analítico. Se determinó si los egresados de la EMOS poseían las competencias necesarias para desempeñar las FESP. Se estableció la diferencia estadística entre el grupo que sí las poseía y los que no (t de Student). La comparación de diferencia estadística entre la Licenciatura en Salud Pública y Urgencias Médicas versus Maestría y Curso Técnico Especializado se realizó con una Z de proporciones. Resultados El 53.52% de los egresados de la EMOS poseían las competencias profesionales para la realización de las FESP, con diferencia estadística entre los que las poseen y los que no (t de Student 0.015). Sí existe diferencia estadística entre la Maestría versus la Licenciatura en Salud Pública (z = -2.9226); no se encontró diferencia versus el Curso Técnico Especializado en Salud Pública (z = 0.01116). Conclusiones Los egresados de la EMOS no poseen las competencias para realizar las FESP.

Abstract Introduction In the Mexican Army and Air Force (FAM) there are no studies on the competences of professional personnel dedicated to public health. Objectives To determine if the graduates of the Military School of Health Officials (EMOS) have the competences to carry out the essential public health functions (EPHF). Material and methods Observational, transversal and analytical study. It was determined if the personnel graduated from the EMOS possessed the necessary competences to perform the EPHF. The statistical difference was established between the group that did possess them and those that did not (Student's t test). The comparison of statistical difference between the degree in Public Health and Medical Emergencies versus the Master's and Specialized Technical Course was made with a Z of proportions. Results 53.52% of the graduates of the EMOS had the professional competences for the realization of the EPHF, existing statistical difference between those who possessed them and those who did not (t Student 0.015). There was a statistical difference between the Master's degree and the Degree in Public Health (z = -2.9226); there was no difference versus the Specialized Technical Course in Public Health (z = 0.01116). Conclusions Graduates of the EMOS do not have the competences to carry out the EPHF.

Pregnancy outcomes and successful rate of nifedipine therapeutic protocol implementation in a hospital of San Juan.

PRIMARY OBJECTIVE: evaluation of Nifedipine protocol success defined as postponement of labor for 48 hours. SECONDARY OBJECTIVE: evaluation of the presence of risk factors in patients that develop preterm labor and delivery outcome. MATERIALS AND METHODS: Chart review retrospective study with patients admitted to the Hospital of the Metropolitan Area of San Juan in the period of January 1,2009 to December 31, 2010 with diagnosis of preterm labor. A total of 382 patient's records were evaluated for inclusion and exclusion criteria. 48 met all the requirements to be included in the study. RESULTS: There were 68.8% patients who successfully completed the 48 hours postponement of labor required to administer corticosteroid therapy for fetal lung maturation. Risk factors for preterm labor commonly observed in the study group were urinary tract infection (60.4%), previous preterm labor (43.8%), multiple gestations (12.5%), and preterm premature rupture of membranes (10.4%). DISCUSSION: The use of Nifedipine therapy in patients with preterm labor between 24-34 weeks of gestational age can be effective in the postponement of labor for 48 hours so that the patient can receive corticosteroid fetal lung maturation therapy. The most common risk factor observed in this group of patients with preterm labor was urinary tract infection.

An unexpected cause of diarrhea in a pregnant patient: a case report.

In 2009 AH1N1, a novel influenza virus was identified. Majority of complications arise in specific group of patient including pregnant women. This report is a description of the first patient encountered in our institution. Such case was a yo woman on the 23rd week of gestation that presented with several episodes of diarrhea. Shortly after admission what appeared to be a common case of gastroenteritis evolved in respiratory distress and hemodynamic instability progressing to respiratory distress syndrome. The diagnosis was delayed by the absence of respiratory symptoms at presentation as well as by the lack of rapid specific laboratories. This case was a fatality that reinforces the need of a high index of suspicion and prompt treatment even in the most atypical presentations of the disease.