Efectos de Cinnamomum zeylanicum en niveles glucémicos en pacientes con diabetes tipo 2: ensayo clínico aleatorizado / Effects of Cinnamomum zeylanicum on glycemic levels in patients with type 2 diabetes: Randomized clinical trial

Objetivo: Evaluar el efecto del consumo de suplemento de Cinnamomum zeylanicum (canela) en los niveles glucémicos de adultos mexicanos con diabetes tipo 2. Métodos: Se realizó un ensayo clínico aleatorizado simple ciego con 30 pacientes >18 años con diabetes tipo 2, se aleatorizaron en los grupos: intervención y control; donde consumieron cápsulas con 2 gramos de C. zeylanicum o harina de trigo (placebo) diario por 12 semanas y se midieron variables antropométricas y bioquímicas (HbA1c, GPa, triglicéridos, colesterol total, HDL y LDL). Se utilizó el software IBM SPSS versión 23 y se aplicó la prueba T-Student y U-Mann Withney para muestras independientes (según el comportamiento de la variable) para las diferencias entre grupos, valores p<0.05 fueron considerados estadísticamente significativos. Resultados: No se observaron cambios significativos en HbA1c entre grupos (p>0.05). Sin embargo, post-tratamiento el grupo intervención disminuyó significativamente HbA1c al compararlo con su línea base (-0.41%, p=0.01) mientras que no se encontraron diferencias en el grupo control (+0.03%, p=0.64). No hubo diferencias significativas en variables antropométricas ni bioquímicas. Conclusiones: El consumo de 2 g de C. zeylanicum en mexicanos con diabetes tipo 2 no produjo cambios significativos entre grupos. Se sugieren nuevos estudios donde se evalúe el suplemento de canela con una muestra mayor. ClinicalTrials.gov; NCT04023539. (AU)

Objective: To evaluate the effect of Cinnamomum zeylanicum (cinnamon) supplement use on the glycemic levels of Mexican adults with type 2 diabetes. Methods: A single-blind randomized clinical trial was conducted with 30 patients over 18 years of age with type 2 diabetes. They were randomized into intervention and control groups where they took 2-gram capsules of Cinnamomum zeylanicum or wheat flour (placebo) daily for 12 weeks; then the anthropometric and biochemical variables HbA1c, FPG, triglycerides, total cholesterol, HDL and LDL were measured. IBM SPSS version 23 software was used and the Student's t-test and Mann-Whitney U test for independent samples (according to the behavior of the variable) were applied for differences between groups, p-values <0.05 were considered statistically significant. Results: No significant changes in HbA1c were seen between the two groups (p>0.05). However, post-treatment, the HbA1c value in the intervention group decreased significantly when compared to their baseline (-0.41%, p=0.01), while no differences were found in the control group (+0.03%, p=0.64). There were no significant differences in the anthropometric or biochemical variables. Conclusions: The consumption of 2 g of Cinnamomum zeylanicum in Mexican people with type 2 diabetes did not produce significant changes between the groups. New studies evaluating cinnamon supplementation on a larger sample size are suggested. ClinicalTrials.gov; NCT04023539. (AU)

Estrategias y limitaciones de la consejería en salud de enfermería: una revisión integradora de literatura / Strategies and limitations of applying health counseling in nursing: an integrative literature review

Resumen: Objetivo: Identificar ámbitos de aplicación de consejería en salud de enfermería y sus limitaciones. Materiales y Métodos: Revisión integradora de literatura; la búsqueda de los estudios se realizó en las bases de datos: Web of Science, Scopus, PubMed, ClinicalKey, OVID, CINAHL y Proquest. Se localizaron artículos publicados en el período del 2012 al 2021, en idiomas: español, inglés y portugués, que incluían en el título y/o resumen alguno de los siguientes descriptores: "Nursing health counseling", "Health promotion", "Patient centered care", "Nurse-Patient relationships", con el operador booleano "AND". Resultados: Once artículos cumplieron los criterios de inclusión y fueron analizados. Se identificaron hallazgos clave y se formularon categorías y temas a través de los estudios. En los resultados se presentan dos categorías a) estrategias para brindar consejería de salud en enfermería y b) limitaciones de la consejería de salud en enfermería. Conclusiones: Los ámbitos de aplicación de la consejería de salud en enfermería son amplios dentro de la atención primaria de salud, tanto para la promoción de la salud, como para el autocuidado de personas con diversas patologías; en cuanto a limitaciones es necesario contar con personal de enfermería capacitado.

Abstract: Objective: Identify the areas of application of nursing health counseling, and its limitations. Materials and Methods: Integrative literature review; the search of the studies was performed in the following databases: Web of Science, Scopus, PubMed, ClinicalKey, OVID, CINAHL, and Proquest. Articles that were published in the period from 2012 to 2021 were located in the following languages: Spanish, English, and Portuguese, which included in the title and/or abstract any of the following descriptors: "Nursing health counseling", "Health promotion", "Patient-Centered care", "Nurse-patient relationships", with the Boolean operator "AND". Results: Eleven articles met the inclusion criteria and were assessed. Key findings were identified and categorized into topics. In the results, two categories are shown: a) strategies to provide nursing health counseling and b) limitations of nursing health counseling. Conclusions: The application scope of nursing health counseling is broad within primary health care, both for the promotion of health and for the self-care of people with various pathologies; with respect to limitations, it is necessary to have trained nursing personnel.

Massive splenic pseudochist in pregnancy. A rare condition.

BACKGROUND: Splenic cystic lesions are rare. They are classified as type 1 with an epithelial component and type 2 (pseudocysts) without an epithelial component. Pseudocysts are the result of trauma, heart attacks, or infection. In Mexico there are no cases reported in pregnancy. CASE REPORT: 26-year-old woman, pregnant, asymptomatic. With a spleen-dependent cystic intraparenchymal lesion measuring 25 × 18 × 10 cm. Undergoing open splenectomy in the second trimester of pregnancy with satisfactory evolution. Histological analysis demonstrated a splenic pseudocyst. We describe the first case of splenic pseudocyst in a pregnant patient in Mexico.

ANTECEDENTES: Las lesiones quísticas esplénicas son infrecuentes. Se clasifican en tipo 1, con componente epitelial, y en tipo 2 (pseudoquistes), sin componente epitelial. Los pseudoquistes son resultado de traumatismos, infartos o infección. En México no existe ningún caso reportado en el embarazo. CASO CLÍNICO: Mujer de 26 años, embarazada, asintomática. Presenta una lesión intraparenquimatosa quística dependiente del bazo, de 25 × 18 × 10 cm. Es sometida a esplenectomía abierta en el segundo trimestre del embarazo, con evolución satisfactoria. El análisis histológico demostró un pseudoquiste esplénico. Describimos el primer caso de pseudoquiste esplénico en una paciente embarazada en México.

Establishing a program for individuals at high risk for breast cancer.

Our need to create a program for individuals at high risk for breast cancer development led us to research the available data on such programs. In this paper, we summarize our findings and our thinking process as we developed our own program. Breast cancer incidence is increasing worldwide. Even though there are known risk factors for breast cancer development, approximately 60% of patients with breast cancer have no known risk factor, although this situation will probably change with further research, especially in genetics. For patients with risk factors based on personal or family history, different models are available for assessing and quantifying risk. Assignment of risk levels permits tailored screening and risk reduction strategies. Potential benefits of specialized programs for women with high breast cancer risk include more cost -effective interventions as a result of patient stratification on the basis of risk; generation of valuable data to advance science; and differentiation of breast programs from other breast cancer units, which can result in increased revenue that can be directed to further improvements in patient care. Guidelines for care of patients at high risk for breast cancer are available from various groups. However, running a high-risk breast program involves much more than applying a guideline. Each high-risk program needs to be designed by its institution with consideration of local resources and country legislation, especially related to genetic issues. Development of a successful high-risk program includes identifying strengths, weaknesses, opportunities, and threats; developing a promotion plan; choosing a risk assessment tool; defining "high risk"; and planning screening and risk reduction strategies for the specific population served by the program. The information in this article may be useful for other institutions considering creation of programs for patients with high breast cancer risk.

Cáncer de mama y embarazo / Breast cancer and pregnancy

Se revisa la casuística de cáncer de mama y embarazo. - Es un problema poco frecuente: 2,5% de todos los Ca de mama. - Los motivos de consulta más frecuentes son tumor y dolor, siendo la demora en la primera consulta mayor que 6 meses en la mitad de los casos. - Un número importante de los casos (20%) se presenta en una "poussée" evolutiva. - La supervivencia acturial a 5 y 10 años es algo menor en las pacientes que presentan Ca coexistente con embarazo que en las premenopáusicas no embarazadas. - El tratamiento debe enfocarse independientemente del embarazo. - La interrupción del embarazo no mejora el pronóstico. - Si el tratamiento adecuado significa usar medidas que ponen en peligro la seguridad y bienestar del feto, debe plantearse la indicación de interrumpir el embarazo - Después de tratado un Ca de mama, debe aconsejarse un lapso de tres años sin embarazo. - En pacientes en quienes se ha hecho un tratamiento conservador, no parecería adecuado permitir un embarazo