Gaceta medica de Mexico最新文献

Background: Front package warning labeling (FWL) was implemented in Mexico in 2020 as part of a strategy to raise food-related knowledge. However, limited media coverage, a lack of awareness among health professionals, and the usage of technical terminology appear to be impediments affecting many groups of the population, particularly older persons.

Objective: Analyze the profile of nutritional label use and understanding among older persons taking into account different factors that might have an effect on it.

Material and method: The use and knowledge of FWL were assessed using a representative sample of 1884 older individuals from the 2021 National Health and Nutrition Survey (ENSANUT). Logistic regression was used to determine the association of knowing or using FWL, adjusted by age, sex, able to read, educational level, living with diabetes, hypertension, and social security status.

Results: The probability of reading and using the FWL was influenced by lower age, being female, higher education level and having social security. There was no discernible effect of living with diabetes or hypertension.

Conclusions: Nutritional education tailored to the circumstances of older persons in Mexico is timely.

The provision of inclusive health services for older adults requires a holistic approach to the health needs of the ageing population and their social environment, to deliver an effective response. To describe the health needs of older adults and their social environment, as a basis for integration of primary health care services. A non-systematic narrative review of the literature was conducted based on an electronic database covering the period 2019-2023 along with a combination of citation references. Information collection followed the principles of the thematic analysis derived from the qualitative approach. Two groups of health needs for older adults were identified: natural aging processes and disease processes. The social environment for these health needs were conceptualized in three interconnected dimensions: socioeconomic conditions, health services, and place of residence. Understanding the elements underlying the health needs which are determined by contextual conditions, supports strategies to improve services for older adults as part of the primary health care approach.

Introduction: The transdermal patch is an effective contraceptive with advantages over other hormonal methods. However, the percentage of patch's users is 2.8 %.

Objective: Determine the factors influencing the use of contraceptive patch.

Material and methods: Review of the literature on contraception in Mexico.

Results: Mexican Health System offers free contraceptive methods, but it is necessary to avoid bureaucratic obstacles guaranteeing a timely supplies distribution and provide continuing medical education to health professionals. In Mexico, the patch is the least known and accessible contraceptive option. Only 20.9 % of women known its correct use. The patch is effective, safe, and convenient contraceptive option. It is proposed that adequate information and counseling on the use of the patch should increase the users' functional knowledge, empowering autonomy and improving therapeutic compliance.

Conclusion: The transdermal patch is an effective and safe alternative; increasing its functional knowledge can help reduce the unmet need.

Cardiovascular disease is the main cause of mortality in Mexico as well as the rest of the world, with dyslipidemia being one of the main risk factors. Despite the importance of its epidemiological impact, there is still -among primary care physicians- a lack of knowledge ranging from the basic concepts for diagnosis to the most recent recommendations for treatment. This document consisting of 10 questions is done by experts in this field. A total of 22 recommendations arise using Delphi methodology. The recommendations include the measurement of the lipid profile starting at 20 years of age, the treatment goals for patients according to their risk, the follow-up of patients with dyslipidemia, and the management approach in primary and secondary prevention.

Background: The follow-up of health sciences graduates is relevant due to the commitment of universities to train professionals who contribute to solve the country's health problems. The National Autonomous University of Mexico (UNAM) has health sciences graduates who join the workforce every year.

Objective: To identify the perception of health sciences graduates regarding the curriculum and their incorporation into the labor market from 1994 to 2015, and compare it according to the degree program and campus.

Material and methods: Observational, cross-sectional, comparative, quantitative study. The sample of 26,866 graduates was obtained from information of three decades of the institutional questionnaire for graduates applied by the General Directorate of Planning of the UNAM.

Results: Most graduates were females (68.4%), with admission to the degree course at between 19 and 20 years of age (65.4%). At least 47% had a job; incorporation into the labor market depended on not having an income, a higher grade point average, not having presented extraordinary exams, or failed subjects, among others.

Conclusions: Adequate job insertion is associated with starting the degree course at age 18, having financial support, having an average of 8.1 or higher and perceiving low academic and teaching training.

FRAX^®, a risk calculator that provides individualized 10-year probabilities of hip and major osteoporotic fracture, has been widely used for fracture risk assessment since its launch in 2008. It is now incorporated into very many guidelines worldwide to inform osteoporosis management. In this review, we explore the development of FRAX and how it enhances fracture risk prediction as compared to use of bone mineral density alone, as well as approaches to utilizing FRAX in determining intervention and assessment thresholds. We also discuss the limitations of FRAX and the arithmetic adjustments that have been proposed to address these. The introduction of FRAXplus^® includes these adjustments on a web-based platform for ease of application to enhance treatment decisions in osteoporosis.

Background: Type 2 diabetes has economic implications involving family income and out-of-pocket spending.

Objective: Determine family out-of-pocket expenditure for type 2 diabetes mellitus care and percentage of family income.

Material and methods: Study of family out-of-pocket spending in families with patients with type 2 diabetes treated at primary care level. Out-of-pocket expenses included expenses for transportation, food-drinks, and external medications. Family income corresponded to the total economic income contributed by family members. The percentage of out-of-pocket spending in relation to family income was identified with the relationship between these two variables. Statistical analysis included averages and percentages.

Results: The annual family out-of-pocket expenditure on transportation was $2,621.24, the family out-of-pocket expenditure on food and beverages was $1,075.67, and the family out-of-pocket expenditure on external medications was $722.08. The total annual family out-of-pocket expense was $4,418.89 and corresponds to 4.73% of family income.

Conclusion: The family out-of-pocket expense in the family with a patient with diabetes mellitus 2 was $4,418.89 and represents 4.73% of the family income.

Background: Infertility increases stress and affects life quality. Mindfulness reduces stress and improves life quality, but its role in infertility remains unclear.

Objective: To evaluate the effect of mindfulness on stress and quality of life of women with infertility.

Material and methods: An exploratory clinical study was conducted in women under infertility treatment, together with an 8-week mindfulness intervention (MND) or only infertility treatment (CTRL). Anxiety and quality of life were assessed at baseline and at the end of intervention with IDARE and FertiQoL questionnaires respectively, as well as salivary alpha-amylase and cortisol concentrations. Non-parametric statistics was used for analysis using an alpha value of 0.10.

Results: 14 MND and 15 CTRL completed follow-up. At baseline, CTRL patients exhibited better quality of life than MND; anxiety scores correlated negatively with quality of life. At the end of intervention, cortisol concentrations (p = 0.097), and the increments of amylase (p = 0.039), were higher in CTRL than in MND. Increases in quality of life were associated with basal anxiety score (p = 0.002), improvements in tolerability (p < 0.001), and mindfulness intervention (p = 0.014).

Conclusion: Our results suggest that mindfulness reduces stress and improves quality of life in women under infertility treatment.

Background: Endothelial dysfunction (ED) suspicion will allow to prevent accelerated atherosclerosis and premature death.

Objective: To establish the usefulness of thermography for endothelial function screening in adults with cardiovascular risk factors.

Material and methods: Cross-sectional, analytical diagnostic test. A brachial arterial diameter (BAD) increase < 11% at one-minute post-ischemia meant probable ED and was confirmed if BAD was ≥ 11% post-sublingual nitroglycerin. Thermographic photographs of the palmar region were obtained at one minute. Descriptive statistics, ROC curve, Mann-Whitney's U-test, chi-square test, or Fisher's exact test were used.

Results: Thirty-eight subjects with a median age of 50 years, and with 624 thermographic measurements were included. Nine had ED (flow-mediated vasodilation [FMV]: 2.5%). The best cutoff point for normal endothelial function in subjects with cardiovascular risk factors was ≥ 36 °C at one minute of ischemia, with 85% sensitivity, 70% specificity, positive and negative predictive values of 78 and 77%, area under the curve of 0.796, LR+ 2.82, LR- 0.22.

Conclusion: An infrared thermography-measured temperature in the palmar region greater than or equal to 36 °C after one minute of ischemia is practical, non-invasive, and inexpensive for normal endothelial function screening in adults with cardiovascular risk factors.