Gaceta medica de Mexico最新文献

Background: Growth hormone deficiency (GHD), caused by decreased secretion of growth hormone by the pituitary, has clinical repercussions that impact body composition, metabolic parameters, and can have a negative impact on quality of life. The Quality of Life in Adults with Growth Hormone Deficiency (QoL-AGHDA) is a patient-reported outcome measure used to assess the quality of life of adults with GHD.

Objective: The objective of this study was to validate the QoL-AGHDA for use in Mexico.

Materials and methods: First phase: Translation of the QoL-AGHDA into Spanish as spoken in Mexico. Face and content validity were assessed through 10 Cognitive debriefing interviews. Second phase: The Mexican version of the QoL-AGHDA was administered to 40 patients on two occasions for subsequent analysis. The distributional properties of the measure were explored through descriptive statistics. Cronbach's α was calculated for internal consistency, and Spearman's correlation coefficient was used to assess reliability.

Results: The QoL-AGHDA for Mexicans showed high internal consistency, with Cronbach's α coefficients of 0.91 and 0.92. Test-retest reliability was excellent, with a Spearman's correlation coefficient of 0.95.

Conclusion: The Mexican adaptation of the QoL-AGHDA demonstrated good psychometric properties, supporting its use in future studies to assess quality of life in adults with GHD in Mexico.

The high prevalence of obesity in Mexican-American populations in the United States has suggested that the different genetic composition of the Mexican population may be related to the high prevalence of obesity in Mexico. Recently, the genome of 140,000 individuals in the Mexico City Prospective Study (MCPS) cohort was explored, and it was found that the average Amerindian ancestry (AMR) was 66.2%, followed by European (29.2%), African (3.7%), and Asian (0.8%) ancestries. However, the proportions of ancestry vary by geographic region of the country, with an increasing gradient of AMR from north to south. Despite the importance of this relationship, there are few studies that have analyzed the relationship between obesity and AMR, and the results are controversial. The relationship between AMR and central obesity has been more consistent, especially in women. Few genetic variants associated with obesity have been found in Mexico, due to the small number of individuals analyzed. Future analysis of the MCPS cohort will likely clarify the relationship between AMR and obesity, and identify genetic variations and genes associated with obesity and other metabolic diseases, specific to the Amerindian genome.

Background: And new high-cost antihyperglycemic agents have been introduced into the basic medical at primary care level for its management. The cost-effectiveness evaluation allows the economic and epidemiological components to be analysed together.

Objective: To determine the cost-effectiveness of dual therapy with metformin + sitagliptin versus metformin + dapagliflozin in patients with type 2 diabetes.

Material and methods: Economic cost-effectiveness study with two groups of patients with type 2 diabetes aged 30 to 64 years in dual treatment, metformin + sitagliptin versus metformin + dapagliflozin. The fixed and variable unit costs were examined; the average variable cost was estimated using the microcost technique, and the average fixed cost was estimated using the time and motion technique. The average annual cost was integrated with the average variable and fixed costs. The cost-effectiveness ratio was estimated at $4000 and cost-effectiveness projections were made.

Results: Glycaemic control (efficacy) was 42.10% for metformin + dapagliflozin and 26.50% for metformin + sitagliptin. In the intermediate scenario, average annual costs were $3598.52 for metformin + dapagliflozin and $5,746.82 for metformin + sitagliptin. For an investment of $4000, the effectiveness of the metformin + dapagliflozin group was 46.80%, and the effectiveness of the metformin + sitagliptin group was 18.44%.

Conclusions: In patients with type 2 diabetes, metformin + dapagliflozin achieves the best cost-effectiveness ratio.

Tetravalent dengue vaccines have been the subject of study, particularly in the prevention of severe cases of the disease. However, the variability in results and the methodological quality of existing studies raise questions about their effectiveness. The objective is to evaluate the immunogenicity and safety of tetravalent vaccines compared to placebo in the prevention of severe dengue cases through a systematic review of randomized clinical trials. A systematic search was conducted in databases PubMed, Scopus, and Web of Science, including randomized clinical trials published between 2019 and 2024. Inclusion and exclusion criteria were applied to select relevant studies, and methodological quality was assessed using the level of evidence from the Oxford Centre for Evidence-Based Medicine (OCEBM). Six randomized clinical trials were included, with a total of 24,249 participants. The studies evaluated outcomes such as the incidence of severe dengue, seropositivity, and immune response to the vaccines TV003 and TV005. Tetravalent vaccines show a promising outlook in reducing the incidence of severe dengue, although limitations were identified in study designs and heterogeneity in the studied populations. Further research is needed to confirm efficacy and safety in diverse populations.

Background: The incorporation of industrial foods in Indigenous peoples has generated health problems in families, related to the excessive accumulation of adipose tissue, Diabetes mellitus type II, metabolic liver disease, defined as "adiposity in poverty syndrome".

Objective: To analyze the frequency of diseases of the adiposity syndrome in poverty in Indigenous peoples in transition to modernity in the Wixarika region of the state of Jalisco, Mexico.

Material and methods: An epidemiological, cross-sectional analytical design with sampling segmented by community size is applied. 238 cases over 30 years old of 221 families from three communities are studied. Statistical analysis is performed by nonparametric tests, with significant p < 0.05.

Results: There is a significant difference in the frequencies of adiposity syndrome by community size, by locality and between traditional communities and those in the process of westernization.

Conclusions: The study provides a sociohistorical approach to the problems of Indigenous peoples from critical epidemiology. In the Wixaritari populations there are changes in health conditions, determined by the degree of social development and by their incorporation into the processes of Westernization.

This paper addresses the genetic influence on obesity within the Mexican population, highlighting that this condition is the result of a complex interaction between genetic and environmental factors. Specific genetic variants are identified that not only predispose to obesity but may also offer protection against it. This knowledge is crucial for the development of personalized medicine and nutrition strategies that adapt health interventions to the individual genetic characteristics of patients, thus improving the effectiveness in the prevention and treatment of obesity. Despite the promising potential of personalized medicine and nutrition, the study recognizes significant challenges, such as genetic variability within the Mexican population, the infrastructure necessary to integrate genetic data into clinical practice, and ethical considerations in the management of this information. It is important to highlight the need for future research that delves deeper into the relationship between genetics and obesity, also considering environmental factors. Likewise, it is suggested that the integration of these findings into public health policies could offer more specific and effective approaches to combat obesity in Mexico, contributing significantly to improving health in the population.

Prediabetes is a condition that precedes diabetes with similar damage mechanisms but different diagnostic criteria. In prediabetes, there are certain promoting factors that encourage its development and once established, they favor the progression of comorbidity, especially cardiovascular. Excessive body weight is a main risk factor, usually part of prediabetes so it is recommended to implement lifestyle changes to prevent the development of diabetes, or even get to revert to normoglycemia. This may be possible if there is an adequate identification of risk factors and screening to establish individualized modifications and avoid associated complications. Prediabetes should not be underestimated, since it is part of the diabetes spectrum, and in the long term it has repercussions on quality and life expectancy. This document proposes 10 basic guidelines to broaden the vision of this entity, identifying in which cases there is a probability of remission, related damage mechanisms, risk factors, macrovascular complications that it entails, start of screening, diagnostic criteria, recommendations for lifestyle changes, and pharmacological and non-pharmacological treatment options.