Salud Publica De Mexico最新文献

Objective: To analyze the association between the addition of micronutrients and the use of health and nutrition claims (HNC) in processed and ultra-processed products, and to evaluate whether this association differs according to the nutritional quality.

Materials and methods: This cross-sectional study utilized data from 17 264 packaged foods and beverages available in major supermarket chains in Mexico City in 2017. Information was obtained from the front-of-packages (for HNC), nutrition facts table (energy and nutrients of concern), and ingredient lists (sources of micronutrients).

Results: 25% (95%CI: 26.8,28.3%) of products reported added micronutrients. In this group, the use of HNC was higher compared to those without added micronutrients (55.1 vs. 27.5%). Finally, the proportion of products classified as excess energy (PR 1.11, 95%CI: 1.07,1.16), free sugars (PR 1.09, 95%CI: 1.04,1.15), and with non-sugar sweeteners (PR 4.05, 95%CI: 3.64,4.50) were higher in products that displayed HNC and with micronutrients added compared to products without HNC and micronutrients.

Conclusion: The addition of micronutrients was more frequent in ultra-processed products that displayed HNC and products excessive in energy, free sugars or those containing non-sugar sweeteners.

Objetivo: Evaluar la eficacia de una estrategia innovadora en el control del Aedes aegypti que emplea tecnologías de la información y la comunicación (TIC) con estudiantes de primaria. Material y métodos. Se realizó un ensayo comunitario aleatorizado en cuatro escuelas primarias de Cuernavaca, Morelos, México. Se adaptó un curso educativo por medio de diversas TIC como videos y juegos interactivos. La evaluación se realizó mediante la administración de un cuestionario de Conocimientos, Actitudes y Prácticas (CAP) basal, posinmediato y posfinal (12 semanas). Se aplicó el modelo estadístico de Diferencias en Diferencias (DID).

Resultados: El Índice CAP (ICAP) del modelo multivariado reveló una diferencia significativa de 16.3% a favor del grupo intervenido (t= 8.9, IC95%: 10.5,22.1, p= 0.003). Conclusión. La estrategia basada en TIC demostró ser efectiva para mejorar el ICAP de los escolares. Estos resultados respaldan la utilidad de las TIC en la educación para la salud y contribuyen como evidencia de su aplicación en la prevención de enfermedades transmitidas por mosquitos.

Objective: To assess the association between hypertension (HTA) prevalence and the urinary levels of inorganic arsenic (iAs) and its metabolites in north Mexican women without type 2 diabetes mellitus (T2DM).

Materials and methods: We included 150 self-reported hypertensive women without T2DM, matched by age with 300 women without diagnosis of HTA and T2DM. Women were interviewed regarding lifestyle, sociodemographic, and clinical characteristics. Urinary iAs metabolites were measured by high performance liquid chromatography inductively coupled plasma mass spectrometry, and methylation efficiency parameters were estimated. Unconditional logistic regression models were used to evaluate the associations.

Results: Total arsenic minus arsenobetaine concentrations in urine varied from 0.57 to 303.29 μg/L, with a median of 12.90 μg/L. The adjusted model showed a significant negative association between HTA prevalence and monomethylarsonic acid (MMA) percentage (OR T3 vs. T1: 0.52; 95%CI: 0.31,0.86; p for trend: 0.03) and a significant positive association with the secondary methylation index (OR T3 vs.T1: 1.94; 95%CI: 1.17,3.22; p for trend: <0.01).

Conclusions: We suggest that arsenic metabolism played an essential part in these associations and recognize the need to elucidate underlying mechanisms.

Objective: To estimate survival outcomes in a population living with diabetes, screened for chronic kidney disease (CKD) and to describe characteristics associated with premature mortality using data from an administrative cohort in Jalisco, Mexico.

Materials and methods: Using an administrative cohort design, we investigated the 8-year cumulative mortality associated with CKD. We linked screening with mortality data and described population characteristics by CKD stage, computed years of life lost (YLL), and performed Kaplan-Meier curves and Cox proportional hazard models to analyze survival and mortality risk factors.

Results: At screening, 44% of the cohort exhibited impaired renal function. The mortality rate stood at 14%, 2.5% linked to CKD; 8.7% were premature deaths, accumulating 8 036 YLL. Eight-year survival was 93% for individuals with normal renal function at screening, decreasing to 41% for those with glomerular filtration rate below 30 mL/min/1.73m², albumin-creatinine ratio >300 mg/dl, increased years since diabetes diagnosis, hypertension, amputations, retinopathy, and smoking were associated with higher mortality risk; female sex and obesity with a lower risk.

Conclusion: The high prevalence of renal impairment in this cohort and its association with high mortality underscores the critical importance of timely detection and protocolized intervention for CKD to mitigate this burden.

El uso de estudios observacionales para inferencia causal es una necesidad, ya que no siempre se cuenta con ensayos clínicos aleatorizados. Para reducir las fuentes de sesgo presentes en estudios observacionales "clásicos" se ha propuesto utilizar el marco de referencia del ensayo diana. Esto es, primero definir los siguientes componentes del protocolo del ensayo clínico pragmático (el ensayo diana) que respondería nuestra pregunta de investigación: criterios de elegibilidad, estrategias de tratamiento, métodos de asignación, periodo de seguimiento, desenlace, contrastes causales y plan de análisis. Posteriormente, estos componentes se modifican con base en los datos observacionales disponibles y se utilizan para emular al ensayo diana lo más de cerca posible. Esto resulta en estudios observacionales con menos sesgo y resultados más confiables. Sin embargo, siguen tratándose de estudios observacionales y no de experimentos aleatorizados, lo cual les confiere algunas limitaciones.