Prevalence and disease burden of peripheral neuropathy in the general population in Mexico city: a cross-sectional epidemiological study.

OBJECTIVE: Peripheral neuropathy (PN) is one of the most common diseases of the peripheral nervous system. Symptoms range from mild sensory signs to severe neuropathic pain. Untreated PN is progressive and can lead to complications and impair quality of life (QoL). However, PN prevalence is underestimated in the general population and affected individuals often remain undiagnosed. This study aimed to contribute to the global generation of prevalence data and determine sociodemographic and disease-related characteristics of PN sufferers. METHODS: This cross-sectional study collected information on PN prevalence and associated factors in the adult population (40-65 years) of the Mexico City area. Participants were recruited in public places and screened for PN using the Michigan Neuropathy Screening Instrument (MNSI). Subjects with PN answered the Neuropathy Total Symptom Score-6 (NTSS-6), the Short Form-36 Health Survey (SF-36), and the QoL Pharmacoeconomic Questionnaire. Statistical analysis included descriptive methods and calculation of PN prevalence with 95% confidence intervals. RESULTS: Of 3066 participants, 448 had PN based on the MNSI physical examination. The overall PN prevalence was 14.6%, with the highest (18.9%) seen in subjects aged 61-65 years. PN was undiagnosed in 82.6%, and 62.9% had never heard of PN. Although half of all subjects had only mild PN symptoms, QoL was impacted in 91.8%. CONCLUSIONS: The results confirm that PN prevalence in the general population is high. Despite the disease burden, most affected persons are undiagnosed and unaware of the disease. Almost all felt their QoL was impacted. The data highlight the need to raise awareness and identify undiagnosed individuals to prevent complications.

Network analysis of sleep bruxism in the EPISONO adult general population.

Sleep bruxism (SB) has been associated with biological and psychosocial factors. The assessment of SB includes self-report, clinical evaluation, and polysomnography. This study aimed to investigate the associations of self-reported SB with other sleep disorders and demographic, psychological, and lifestyle factors in the adult general population, and to investigate whether self-reported SB and polysomnographically (PSG) confirmed SB provide similar outcomes in terms of their associated factors. We recruited 915 adults from the general population in Sao Paulo, Brazil. All participants underwent a one-night PSG recording and answered questions about sex, age, BMI, insomnia, OSA risk, anxiety, depression, average caffeine consumption, smoking frequency, and alcohol consumption frequency. We investigated the link between SB and the other variables in univariate, multivariate, and network models, and we repeated each model once with self-reported SB and once with PSG-confirmed SB. Self-reported SB was only significantly associated with sex (p = 0.042), anxiety (p = 0.002), and depression (p = 0.03) in the univariate analysis, and was associated with insomnia in the univariate (p < 0.001) and multivariate (ß = 1.054, 95%CI 1.018-1.092, p = 0.003) analyses. Network analysis showed that self-reported SB had a direct positive edge to insomnia, while PSG-confirmed SB was not significantly associated with any of the other variables. Thus, sleep bruxism was positively associated with insomnia only when self-reported, while PSG-confirmed SB was not associated with any of the included factors.

Use of Antihypertensive Drugs and Arterial Stiffness in the Longitudinal Study of Adult Health (ELSA-Brasil).

OBJECTIVE: Evaluate the longitudinal association between BP control and the use of antihypertensive classes with arterial stiffness (AS) in Brazilian adults. METHODS: This study included 1830 participants with arterial hypertension (1092 participants with controlled BP and 738 participants with uncontrolled BP) from the Longitudinal Study of Adult Health (ELSA-Brasil). AS was assessed by pulse wave velocity (PWV) and pulse pressure (PP) at baseline and repeated after approximately 9 years. Associations between AS and BP control and the use of antihypertensives, diuretics, angiotensin-converting enzyme inhibitors (ACEI), AT1 receptor blockers (ARB), calcium channel blockers (CCB), and beta blockers (in the population with controlled BP), at baseline were investigated using linear mixed-effects models. RESULTS: Uncontrolled BP was associated with worse PWV and PP trajectory, respectively (ß = 0.026 [0.008 to 0.036] / ß = 0.273 [0.216 to 0.330]). Among the participants with controlled BP, using CCB (ß = 0.031 [0.011 to 0.051]) was associated with a worse PWV trajectory, compared to not using this class and this combination, respectively. CONCLUSION: BP control, regardless of the class of antihypertensive used is associated with a better AS trajectory, as assessed by PWV and PP. Among participants with controlled BP, the use of BCC, compared to not using this class, seems to be worse for the trajectory of PWV in individuals with arterial hypertension without cardiovascular disease. Further studies are needed to assess whether this effect results in a better prognosis for patients with arterial hypertension.

Traumatic Experiences and Psychopathological symptoms in Prison Population and General Population

Traumatic events are stressful episodes that exceed an individual's coping resources and have been related to physical and mental health problems, particularly posttraumatic stress disorder. This study aims to compare the prison population and the general population in terms of trauma and psychopathological symptoms derived from exposure to traumatic events in the context of Ecuador. It is a descriptive-comparative and cross-sectional study. The study sample consisted of 99 incarcerated individuals and 84 persons from the general population of Ambato-Ecuador. The results indicate that persons from the prison population have experienced multiple traumas and re-victimization to a greater extent and present a higher percentage of PTSD and psychopathological symptoms than the general population. In that sense, it is a population that requires more significant intervention to reduce symptoms and prevent violent behavior.

Los eventos traumáticos son hechos estresantes que exceden los recursos de afrontamiento de un individuo y han sido relacionados con problemas de salud física y mental, particularmente con el trastorno de estrés postraumàtico. El objetivo de este estudio es comparar las experiencias traumáticas y los síntomas psicopatológicos entre la población penitenciaria y la población general. Es un estudio descriptivo-comparativo de corte transversal. La muestra del estudio estuvo conformada por 99 individuos encarcelados y 84 individuos de la población general de Ambato (Ecuador). Los resultados indican que los participantes de la población penitenciaria han experimentado en mayor medida múltiples traumas y revictimización; presentan un mayor número de síntomas psicopatológicos y un porcentaje más elevado de TEPT que la población general. Las diferencias que se presentan entre la población penitenciaria y la población general pueden deberse a que las personas encarceladas son más vulnerables a estar expuestas a eventos potencialmente traumáticos por su propia situación social. La población penitenciaria requiere una mayor intervención para reducir los síntomas psicopatológicos provocados por el trauma.

Human T Cell Lymphotropic Virus Type 1 Global Prevalence Associated with the Human Development Index: Systematic Review with Meta-Analysis.

In 2012, the number of people infected with human T cell lymphotropic virus type 1 (HTLV-1) was estimated to be 10 million worldwide. Prevalence varies according to geographic location, ethnic factors, sex, age, populations exposed to risk factors, income, and education, reaching countries with the worst socioeconomic scenarios. There is a need to determine the current global prevalence of HTLV-1 and examine its association with countries' human development index (HDI) to provide data for global health policy. Systematic review with meta-analysis is according to PRISMA 2020 recommendations. It was registered at PROSPERO, CRD42021223146. Prevalence or cross-sectional studies of HTLV-1 infection with at least 100 participants, screening, and confirmatory serologic testing were included. Studies with incomplete or unavailable results or with duplicate information were excluded. Data were selected by two independent investigators and analyzed using R software, a metapackage that generated the forest plots [95% confidence interval (CI)]. Heterogeneity was assessed using the I2 statistic, and funnel plot asymmetry was assessed using Egger's test. Countries were compared using an HDI cutoff ≥0.8. Methodological quality was assessed using Joanna Briggs Institute (JBI) criteria. The overall prevalence of HTLV-1 infection was 0.91% (95% CI: 0.80-1.02, p < .0001) and was higher in low HDI countries [1.18% (95% CI: 1.03-1.34)] than in high HDI countries [0.41% (95% CI: 0.27-0.57)]. Prevalence varied according to the populations studied: it was higher in the general population [1.65% (95% CI: 1.08-2.34)] compared to pregnant women [0.34% (95% CI: 0.17-0.57)] and blood donors [0.04% (95% CI: 0.01-0.08)]. Consistently, prevalence for each population group was higher in low HDI countries than in high HDI countries. The worldwide prevalence of HTLV-1 infection is highly heterogeneous, with a global prevalence of 0.91%. In high HDI countries, the observed prevalence is approximately three times lower than in low HDI countries. In the general population, the observed prevalence is about 5 times higher than in pregnant women and 41 times higher than in blood donors.

Crenças sobre a violência conjugal: uma explicação a partir dos valores humanos / Beliefs about Conjugal Violence: An Explanation from Human Values

Objetivo. O presente trabalho objetivou conhecer a relação entre valores humanos e crenças sobre a violência conjugal. Método. Contou com uma amostra composta por 202 sujeitos da população geral da cidade de Parnaíba-PI, com uma média de idade de 28,52 anos (DP = 10,33). Estes responderam as seguintes escalas: Escala de Crenças sobre a Violência Conjugal (ECVC), Questionário de Valores Básicos (QVB-18) e um Questionário Sociodemográfico. O software SPSS (versão 22) auxiliou na execução das análises descritivas, correlação (r de Pearson), e regressão (Métodos Stepwise). Resultados. Os resultados apontaram que as subfunções Interativa, Suprapessoal, e Existência apresentam correlações significativas e inversas com todas as dimensões da ECVC; ou seja, ratificam a capacidade dos valores humanos de explicarem construtos sociais, como a violência conjugal.

Objective. The The present work aimed to discover the relationship between human values and beliefs about marital violence. Method. The sample was composed by 202 subjects from the general population of the city of Parnaíba-PI. The average age was 28.52 years (SD = 10.33). They were administered the following instruments: Belief on Marital Violence Scale (BMVS), Basic Values ​​Questionnaire (BVQ-18), and a Socio-demographic Questionnaire. The SPSS software (version 22) assisted in the execution of descriptive analysis, Pearson's correlation (r), and regression (Stepwise Methods). Results. The results showed that the Interactive, Suprapersonal, and Existence subfunctions present significant and inverse correlations with all dimensions of BMVS; they ratify the ability of human values to explain social constructs such as marital violence.

Longitudinal changes in depression and anxiety during COVID-19 crisis in Uruguay.

Longitudinal studies have reported decreased mental health symptoms throughout the COVID-19 crisis, while others have found improvements or no changes across time. However, most research was carried out in developed countries, with a high incidence of COVID-19 and, in several cases, mandatory lockdowns. Considering that Uruguay (a developing country) had a low COVID-19 incidence at the moment of this study and has implemented a mild lockdown, we aimed to evaluate the effect of time and mobility (using Google mobility data) on symptoms of anxiety and depression. A longitudinal panel study with six repeated measures was carried out to evaluate depressive (BDI-II) and anxiety (STAI-S) symptoms during the pandemic. A decline in symptoms of anxiety and depression was found across time. Interestingly, this effect was modulated by age; a greater difference in the symptomatology between age groups was found at the beginning of the measurements than at the end, with the youngest reporting the most severe symptoms. Finally, we found that depressive symptoms decreased as mobility increased. Overall, our findings indicate an improvement in mental health as quarantine passed and mobility increased but following a different pattern depending on age. Monitoring these trajectories is imperative moving forward, especially in vulnerable groups. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-022-03460-w.

Actitudes hacia la vacuna contra la COVID-19 en la población general paraguaya / Attitudes towards the COVID-19 vaccine in the general paraguayan population

Introducción: La pandemia de COVID-19 ha provocado cambios que afectan los sistemas de salud y el abordaje de las enfermedades infecciosas a nivel mundial. La esperanza de recuperar un cierto nivel de "normalidad" se basa en el desarrollo de vacunas. Objetivos: El objetivo de este estudio fue describir las actitudes hacia la vacuna COVID-19 en la población paraguaya, explorando factores que podrían ser abordados para apoyar la campaña de vacunación contra el SARS-CoV-2. Materiales y métodos: Estudio transversal y descriptivo. Los participantes fueron reclutados a través de una encuesta basada en Internet, difundida a través de las redes sociales, durante el mes de marzo de 2021. Todos los participantes recibieron información completa sobre el objetivo del estudio, la privacidad y el procesamiento de datos. Resultados: De los 2297 participantes, el 67,9% (n=1559) eran mujeres, el 49,9% (n=1147) estaban empleados, el 89,1% (n=2046) reportaron educación universitaria y el 96,6% (n=2218) eran de áreas urbanas. En general, el 81,8 % (n=1879) de los participantes afirmó que estarían dispuestos a vacunarse contra el COVID-19 si hubiera una vacuna disponible. Se ha encontrado una relación significativa entre haber solicitado la vacuna antigripal y la intención de vacunarse frente al COVID-19 (p<0,0001), con un OR: 3,09 (IC 95% 2,1-4,5). Conclusión: El porcentaje de participantes inclinados a vacunarse contra el COVID-19 es similar al de aquellos que esperan una inmunización adecuada de la vacuna. Las agencias gubernamentales y de salud deben hacer un esfuerzo para brindar información precisa que responda a las inquietudes de las personas sobre la vacunación, en cualquier nivel de la sociedad.

Introduction: Insufficient physical activity is one of the main public health problems globally. Teen behavior patterns and lifestyle may affect their physical and mental health. Objectives: The objective of this study was to know the patterns of physical activity and sedentary behaviors in the adolescent population nationwide. Materials and methods: A quantitative, observational, descriptive cross-sectional study, the questionnaire of the Global School Health Survey was applied in school adolescents of the eighth and ninth grades of the 3rd cycle of Basic School Education and the 1st, 2nd and 3rd year of Secondary Education in 49 schools and colleges in the country. 1,803 students aged 13 to 15 years were included in this study. Results. 27% of adolescents between the ages of 13 and 15 in Paraguay are active, being significantly higher in men than in women (p-value 0.000) and 22% are inactive more frequently in women than in men (p-value 0.000). It was observed that 33.5% of the adolescents had sedentary behavior, 43.4% of the adolescents did not use active displacement to attend school. Adolescents who did not participate in physical education classes at school accounted for 15.6%. Conclusion: Although 27% of adolescents between the ages of 13 and 15 are active, the large percentage of inactive adolescents with sedentary behavior is worrying.

Prevalence of infection by human T Cell lymphotropic viruses (HTLV-1/2) in adult population in Vitória-ES.

INTRODUCTION: Brazil has a high number of HTLV-1/2 infections which are unequally distributed in the country. Most prevalence studies have focused on specific populations, such as blood donors and pregnant women. Some areas, for example the state of Bahia, have robust information about HTLV-1/2 infection, however there is no information available about this infection in the general population of Vitória, Espírito Santo, Brazil. OBJECTIVE: To determine the prevalence of HTLV-1/2 infection in adults from the municipality of Vitoria, ES. METHODS: A cross sectional study was performed from September 2010 to December 2011, in individuals of both sexes, aged 18 or older living in Vitória-ES. Venous blood samples were collected and tested for anti-HTLV-1/2 antibodies by chemiluminescent immunoassay (CMIA). Individuals with CMIA reactive results were submitted to a new blood collection for retesting by CMIA, followed by PCR to confirm infection and discriminate the viral type. RESULTS: From 1502 tested samples, eight were reactive in CMIA and all were confirmed by PCR. Therefore, the prevalence of HTLV-1/2 was 0.53% (8/1502, 95% CI: 0.2-1.0%). The infection rate was 0.7% in men (5/711, 95% CI: 0.17-1.51%), and 0.38% in women (3/791, 95% CI: 0-0.81%). CONCLUSIONS: The prevalence of HTLV-1/2 infection was 0.53% (8/1502; 95% CI: 0.2-0.9%). Confirmatory test using real-time PCR (qPCR) identified seven individuals positive for HTLV-1 and one for HTLV-2. Considering the risk of infected individuals to develop high morbidity and mortality diseases, it would be important to implement public health policies aimed at stopping transmission of these viruses in this municipality.

Explanatory Model of Perceived Stress in the General Population: A Cross-Sectional Study in Peru During the COVID-19 Context.

BACKGROUND: The COVID-19 pandemic had negatively impact mental health worldwide. High prevalence of stress had been previously reported in populations during this context. Many theoretical frameworks had been proposed for explaining the stress process, we aim to proposed and explanatory model for the genesis of perceived stress in Peruvian general population. METHOD: We conducted an online survey in Peruvian general population assessing sociodemographic variables and evaluating mental health conditions by using The Perceived Stress Scale (PSS-10), Positive Affect and Negative Affect Scale (PANAS), Generalized Anxiety Disorder scale (GAD-7), Patient Health Questionnaire (PHQ-9), and a numerical rating scale (NRS) for fear of COVID-19. Correlation analysis was conducted for the variables of interest. Two regression models were constructed to explore related factor to the dimensions of perceived stress. Finally, a structural regression model was performed with the independent variables. RESULTS: Data of 210 individuals was analyzed. Ages ranged from 15 to 74 years and 39% were women. Additionally, 65.2% of the participants had at least one mental health conditions (depression, anxiety, or stress symptoms). Perceived self-efficacy and positive affect (PA) were correlated, as perceived helplessness with anxious symptoms and negative affect (NA). Regression analysis showed that sex, anxiety symptoms, and NA explained perceived helplessness while positive and NA explained self-efficacy. The structural regression model analysis identified that fear of COVID-19 (composed of fear of infecting others and fear of contagion), predicted mental health conditions (i.e., depressive or anxiety symptoms); also, mental health conditions were predicted by PA and NA. Perceived helplessness and Perceived self-efficacy were interrelated and represented the perceived stress variable. CONCLUSION: We proposed an explanatory model of perceived stress based on two correlated dimensions (self-efficacy and helplessness) in the Peruvian general population during the context of the COVID-19 pandemic, with two out of three individuals surveyed having at least one mental health condition.

A comprehensive update of the status of hepatitis C virus (HCV) infection in Mexico-A systematic review and meta-analysis (2008-2019).

INTRODUCTION AND OBJECTIVES: HCV infection is targeted by the WHO's Global Health Sector Strategy on Viral Hepatitis to be reduced notably by 2030. However, renovated epidemiological data is needed to line up with such goals. Herein, we provide an updated review of incidence, prevalence, genotypes (GTs), and risk factors (RFs) of HCV infection in Mexico to build elimination strategies. MATERIAL AND METHODS: HCV incidence was charted using the cumulative new cases/year at week 52. Prevalence, GTs, and RFs data from low-risk (LR-G) and high-risk (HR-Gs) groups were searched in PubMed/MEDLINE/Medigraphic/Scielo databases from January 2008 to December 2019 as per PRISMA guidelines. Weighted mean prevalence (WMP) was estimated; GTs and RFs were registered. RESULTS: In this study, 25,247 new cases were reported. Ten states accumulated 76.32% of HCV incidence that peaked in men at 50-59 years and women at 60-64 years. Thirty-four studies revealed a WMP between 0.774%-2.5% in LR-Gs and 11.8%-39.6% in HR-Gs that included mainly prison inmates, drug users, and dialyzed patients. GT1 and GT2 were predominant; GT3a emerged. Subtypes 1a and 1b circulate differentially, whereas novel GT2 subtypes appeared. Unsafe blood transfusion was infrequent in younger groups, but parenteral/intravenous transmission through drug-related risk behaviors has arisen. CONCLUSIONS: HCV transmission increased notably among LR-Gs and HR-Gs in Mexico. Novel genotypes/subtypes emerged as well as risky behavioral routes of transmission. A national elimination strategy will require pro-active screening in designated risk groups, research in molecular epidemiology, medical training, robust epidemiological databases, and antiviral treatment available to all eligible HCV-infected patients.

Prevalence of infection by human T Cell lymphotropic viruses (HTLV-1/2) in adult population in Vitoria-ES

ABSTRACT Introduction: Brazil has a high number of HTLV-1/2 infections which are unequally distributed in the country. Most prevalence studies have focused on specific populations, such as blood donors and pregnant women. Some areas, for example the state of Bahia, have robust information about HTLV-1/2 infection, however there is no information available about this infection in the general population of Vitoria, Espírito Santo, Brazil. Objective: To determine the prevalence of HTLV-1/2 infection in adults from the municipality of Vitoria, ES. Methods: A cross sectional study was performed from September 2010 to December 2011, in individuals of both sexes, aged 18 or older living in Vitoria-ES. Venous blood samples were collected and tested for anti-HTLV-1/2 antibodies by chemiluminescent immunoassay (CMIA). Individuals with CMIA reactive results were submitted to a new blood collection for retesting by CMIA, followed by PCR to confirm infection and discriminate the viral type. Results: From 1502 tested samples, eight were reactive in CMIA and all were confirmed by PCR. Therefore, the prevalence of HTLV-1/2 was 0.53% (8/1502, 95% CI: 0.2-1.0%). The infection rate was 0.7% in men (5/711, 95% CI: 0.17-1.51%), and 0.38% in women (3/791, 95% CI: 0 -0.81%). Conclusions: The prevalence of HTLV-1/2 infection was 0.53% (8/1502; 95% CI: 0.2 -0.9%). Confirmatory test using real-time PCR (qPCR) identified seven individuals positive for HTLV-1 and one for HTLV-2. Considering the risk of infected individuals to develop high morbidity and mortality diseases, it would be important to implement public health policies aimed at stopping transmission of these viruses in this municipality. 2021 Sociedade Brasileira de Infectologia. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license

Validation of the Portuguese version of the Community Assessment of Psychic Experiences and characterization of psychotic experiences in a Brazilian sample

Objective: We investigated: i) the reliability and validity of a Brazilian version of the Community Assessment of Psychic Experiences (CAPE), developed to detect and characterize psychotic experiences in the general population; and ii) the association between psychotic experiences, childhood adversity, and cannabis use in a population-based sample. Methods: We performed factorial analyses and generalized linear models with CAPE scores as the dependent variable in a sample composed of 217 first-episode psychosis patients, 104 unaffected biological siblings, and 319 non-psychotic population-based participants. Results: After removing seven items from its positive dimension and two items from its negative dimension, a 33-item Brazilian version of the CAPE showed acceptable adjustment indices (confirmatory fit index = 0.895; goodness of fit index = 0.822; parsimony goodness of fit index = 0.761; root mean square error of approximation [RMSEA] = 0.055, p [RMSEA ≤ 0.05] = 0.04) and internal consistency in all its dimensions (> 0.70). Childhood adversity was associated with higher scores in all three dimensions, as well as with total score. Lifetime cannabis use was associated with higher scores only in the positive dimension. Conclusion: The proposed Brazilian version of the CAPE corroborates the tridimensional approach for assessing psychosis-proneness, and the frequency and severity of psychotic manifestations are distributed as a spectrum in the general population.

Blood cadmium levels and sources of exposure in an adult urban population in southern Brazil.

BACKGROUND: Cadmium (Cd) is a toxic metal that is widely present in the environment due to geologic and anthropogenic sources. Exposures to high Cd levels may cause nephrotoxicity, carcinogenicity, pulmonary and cardiovascular disease, among others. The goal of this study was to investigate in an adult urban population whether an association exists between sources and levels of Cd exposure and blood Cd concentrations. METHODS: Using a census-based design, a total of 959 adults, aged 40 years or older, were randomly selected. Information on socio-demographics, dietary, and lifestyle background was obtained by household interviews. Blood Cd levels were measured by inductively coupled-plasma mass spectrometry. Geometric means (GM) (95% CI) and the 50th percentile were determined, stratified by sex, age, race, education, income class, smoking status, consumption of vegetables, red meat and milk, occupation and blood pressure. To assess the association between Cd exposure and the aforementioned variables, we estimated the geometric mean ratio (GMR) (95%CI) of blood Cd concentrations. RESULTS AND CONCLUSION: The geometric mean (95%CI) of blood Cd levels in the total population was 0.25 (0.22, 0.27) ug/dL. In a univariate analysis, significantly higher blood Cd levels were found in men (p < 0.001), current and former smokers (p < 0.001), alcohol drinkers (p < 0.001), those who never or almost never consumed milk (p < 0.001), and in subjects with higher diastolic blood pressure (p = 0.03). Significant correlations were found between the number of cigarettes consumed daily and blood Cd levels. Multivariate analysis confirmed higher blood Cd concentrations were associated with alcohol consumption (GMR 95%CI = 1.28, 1.04-1.59) and in former and current smokers (GMR 95% IC = 1.33, 1.06-1.67 and 4.23, 3.24-5.52, respectively). Our results shed novel information on variables associated with blood Cd levels in an urban Brazilian population, and should encourage additional research to prevent environmental Cd exposure, both in Brazil and globally.

Prevalence of liver fibrosis in an unselected general population with high prevalence of obesity and diabetes mellitus. Time for screening?

INTRODUCTION: Cirrhosis and liver cancer are currently common causes of death worldwide. The global epidemic of obesity has increased the incidence of nonalcoholic fatty liver disease (NAFLD) and cirrhosis in recent years. Advanced fibrosis increases the morbimortality rate in NAFLD. The Mexican population has one of the highest prevalence of obesity and diabetes mellitus (DM) worldwide. AIM: To determine the prevalence of advanced liver fibrosis in Mexican general population. METHODS: Adult individuals, without a history of liver disease nor heavy alcohol consumption were randomly sampled from 20,919 participants of a health and nutrition survey applied to the general population. Clinical and laboratory evaluations were performed to calculate the NAFLD fibrosis score (NFS) (an extensively validated non-invasive method). Two cut-off points were used. Advanced fibrosis was defined as a result >0.676. RESULTS: In total 695 individuals were included. The mean age was 47.8±16.4. The majority were between 20 and 50 years (59%), 70.2% were female, 35.5% showed obesity and 15.8% DM. The 93% had normal serum ALT. Based on the NFS results, 56 individuals (8.1%) had a high probability of fibrosis. Most patients from this subgroup showed normal serum ALT (92.9%), 89.3% were >45yr. old, 52% were obese and 27% suffered from DM. CONCLUSIONS: Based on these results, 8.1% of Mexican general population without a history of liver disease is at high risk of having advanced liver fibrosis and complications and death derived from cardiovascular disease and cirrhosis. Most of them showed normal ALT serum levels.

Impact of Zika Virus Emergence in French Guiana: A Large General Population Seroprevalence Survey.

BACKGROUND: Since the identification of Zika virus (ZIKV) in Brazil in May 2015, the virus has spread throughout the Americas. However, ZIKV burden in the general population in affected countries remains unknown. METHODS: We conducted a general population survey in the different communities of French Guiana through individual interviews and serologic survey during June-October 2017. All serum samples were tested for anti-ZIKV immunoglobulin G antibodies using a recombinant antigen-based SGERPAxMap microsphere immunoassay, and some of them were further evaluated through anti-ZIKV microneutralization tests. RESULTS: The overall seroprevalence was estimated at 23.3% (95% confidence interval [CI], 20.9%-25.9%) among 2697 participants, varying from 0% to 45.6% according to municipalities. ZIKV circulated in a large majority of French Guiana but not in the most isolated forest areas. The proportion of reported symptomatic Zika infection was estimated at 25.5% (95% CI, 20.3%-31.4%) in individuals who tested positive for ZIKV. CONCLUSIONS: This study described a large-scale representative ZIKV seroprevalence study in South America from the recent 2015-2016 Zika epidemic. Our findings reveal that the majority of the population remains susceptible to ZIKV, which could potentially allow future reintroductions of the virus.

Encuesta en población abierta respecto a términos relacionados con decisiones al final de la vida.

INTRODUCTION: Concepts related to end-of-life decisions, such as euthanasia, palliative care, advance directives and therapeutic obstinacy, are poorly understood by the general population, which, when facing a terminal situation, is not prepared to choose the best option. OBJECTIVE: Pilot study (n = 544) to find out what the open population understands about terms used in end-of-life situations in four cities of the Mexican Republic. METHOD: Survey via Internet with 18 questions about different terms. It was a descriptive, cross-sectional study. Statistical analysis was carried out. RESULTS: People older than 18 years who were not engaged in health-related professional activities were selected. CONCLUSIONS: Most terms related to end-of-life decisions were found not to be interesting to or understood by a part of the population. The least recognized term was therapeutic obstinacy (62.8%), and the most widely known, palliative care (91%); there was confusion between the terms euthanasia and assisted suicide (47.8%). Age and education level had more influence in the results, than other demographic variables.

INTRODUCCIÓN: Conceptos relacionados con las decisiones que se toman al final de la vida, como eutanasia, cuidados paliativos, voluntad anticipada y obstinación terapéutica son poco comprendidos por la población en general, que en el momento de enfrentar una situación terminal no está preparada para elegir la mejor opción. OBJETIVO: Estudio piloto (n = 544) para conocer lo que la población abierta entiende acerca de términos utilizados al final de la vida en cuatro ciudades de la república mexicana. MÉTODO: Encuesta vía internet de 18 preguntas sobre los distintos términos. Se trató de un estudio descriptivo, transversal, con análisis estadístico. RESULTADOS: Se eligieron personas mayores de 18 años que no trabajaran en profesiones relacionadas con la salud. CONCLUSIONES: La mayoría de los términos del final de la vida no interesaron ni fueron entendidos por parte de la población. El término menos reconocido fue la obstinación terapéutica (62.8 %) y el más conocido, cuidados paliativos (91 %); se confunden los términos eutanasia y suicidio asistido (47.8 %). La edad y escolaridad resultaron de mayor influencia en los resultados, que las otras variables demográficas.

Encuesta en población abierta respecto a términos relacionados con decisiones al final de la vida / Open population survey regarding terms related to decisions at the end of life

Resumen Introducción: Conceptos relacionados con las decisiones que se toman al final de la vida, como eutanasia, cuidados paliativos, voluntad anticipada y obstinación terapéutica son poco comprendidos por la población en general, que en el momento de enfrentar una situación terminal no está preparada para elegir la mejor opción. Objetivo: Estudio piloto (n = 544) para conocer lo que la población abierta entiende acerca de términos utilizados al final de la vida en cuatro ciudades de la república mexicana. Método: Encuesta vía internet de 18 preguntas sobre los distintos términos. Se trató de un estudio descriptivo, transversal, con análisis estadístico. Resultados: Se eligieron personas mayores de 18 años que no trabajaran en profesiones relacionadas con la salud. Conclusiones: La mayoría de los términos del final de la vida no interesaron ni fueron entendidos por parte de la población. El término menos reconocido fue la obstinación terapéutica (62.8 %) y el más conocido, cuidados paliativos (91 %); se confunden los términos eutanasia y suicidio asistido (47.8 %). La edad y escolaridad resultaron de mayor influencia en los resultados, que las otras variables demográficas.

Abstract Introduction: Concepts related to end-of-life decisions, such as euthanasia, palliative care, advance directives and therapeutic obstinacy, are poorly understood by the general population, which, when facing a terminal situation, is not prepared to choose the best option. Objective: Pilot study (n = 544) to find out what the open population understands about terms used in end-of-life situations in four cities of the Mexican Republic. Method: Survey via Internet with 18 questions about different terms. It was a descriptive, cross-sectional study. Statistical analysis was carried out. Results: People older than 18 years who were not engaged in health-related professional activities were selected. Conclusions: Most terms related to end-of-life decisions were found not to be interesting to or understood by a part of the population. The least recognized term was therapeutic obstinacy (62.8%), and the most widely known, palliative care (91%); there was confusion between the terms euthanasia and assisted suicide (47.8%). Age and education level had more influence in the results, than other demographic variables.

National trends in alcohol consumption in Mexico: results of the National Survey on Drug, Alcohol and Tobacco Consumption 2016-2017 / Tendencias nacionales del consumo de alcohol en México: resultados de la Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2016-2017

Abstract: Introduction: Worldwide, binge drinking of alcohol has increased, especially among young people. In Mexico, various epidemiological sources allow us to account for the growth this pattern of consumption has had. Given this context, the Encuesta Nacional de Consumo de Drogas 2016-2017 (ENCODAT) shows the evolution in alcohol consumption. Objective: To determine the prevalence and national and regional trends, as well as state variations of alcohol consumption in the population aged 12 to 65. Method: The ENCODAT 2016-2017 is a random, probabilistic, and multi-stage study with national and state representation. The sample consisted of 56 877 people who answered a standardized questionnaire through ACASI (self-administered computer interviews) that collects information about the use of tobacco, alcohol, and medical and illegal drugs. Results: Binge drinking past month increased from 12.3% to 19.8% from 2011 to 2016. A similar situation occurs in daily use (from .8% to 2.9%) and weekly binge drinking (from 5.4% to 8.5%). The age of onset has remained stable since 2011 (16.6 years for men, 19.2 years for women in 2016). Meanwhile, 2.2% reported alcohol dependence. The states with the highest prevalence of binge drinking are Nuevo León (30.3%), Jalisco (27.7%) and, Coahuila (27.5%). Discussion and conclusion: The results show that alcohol use increased with respect to 2011, especially in women; data on treatment seeking indicate that women who use alcohol are also the least likely to seek help. Given this context, it is necessary to have specialized spaces that provide treatment in keeping with use-based needs and gender condition.

Resumen: Introducción: A nivel internacional, el consumo excesivo de alcohol ha aumentado, principalmente entre la población joven. En México, diversas fuentes epidemiológicas dan cuenta del crecimiento de este patrón de consumo. Dado este contexto, la Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2016-2017 (ENCODAT) muestra la evolución en el consumo de alcohol. Objetivo: Conocer las prevalencias y tendencias nacionales y regionales, así como las variaciones estatales del consumo de alcohol en la población de 12 a 65 años. Método: La ENCODAT 2016-2017 es un estudio aleatorio, probabilístico y polietápico con representatividad nacional y estatal. En la muestra participaron 56 877 personas que contestaron un cuestionario estandarizado mediante ACASI (entrevistas auto-administradas por computadoras), que recaba información sobre consumo de tabaco, alcohol y drogas médicas e ilegales. Resultados: El consumo excesivo en el último mes se incrementó de 12.3% a 19.8% de 2011 a 2016. Una situación similar ocurre en el consumo diario (de .8% a 2.9%) y consuetudinario (de 5.4% a 8.5%). La edad de inicio se ha mantenido estable desde 2011 (16.6 años hombres; 19.2 años mujeres en 2016). En tanto, el 2.2% reportó dependencia al consumo de alcohol. Las entidades con las prevalencias más altas en consumo excesivo son Nuevo León (30.3%), Jalisco (27.7%) y Coahuila (27.5%). Discusión y conclusión: Los resultados muestran que el consumo de alcohol creció con respecto a 2011, especialmente en mujeres. Datos sobre la asistencia a tratamiento, indican que éstas son también quienes menos acuden. Dado este contexto, es necesario contar con espacios especializados que brinden atención conforme a las necesidades de consumo y de condición de género.