Search

Copyright of Revista Medica del IMSS is the property of Direccion de Prestaciones Medicas - IMSS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE: The purpose of this study was to evaluate the relationship between certain reproductive and lifestyle factors and the occurrence of early natural menopause. MATERIAL AND METHODS: A case/control study was conducted on a basal population of 2 510 women participating in the "Mexican Institute of Social Security health workers cohort study". Cases were defined as those women for whom natural menopause presented by age 47. Information was obtained through a self-administered questionnaire. RESULTS: The risk of early menopause is associated with short menstrual cycles [< 26 days, OR=3.79 (IC 95%1.37-10.52)], a short period of oral contraceptives use [15 cigarettes/day, OR=2.7 (IC 95% 1.00-7.30)], and birth cohorts [>1950, OR=4.09 (IC 95% 2.62-6.39)]. COCLUSIONS: The findings of this study suggest that both reproductive and lifestyle factors are significant elements in the occurrence of early menopause in Mexican women.

Prenatal exposure to dichlorodiphenyldichloroethylene (p,p´ -DDE) may interfere with fetal development; however, studies evaluating anthropometry and gestational age at birth show inconsistent results. Typically, p,p´ -DDE exposure has been measured during the third trimester and missed the key early pregnancy period. We evaluated the association between p,p´ -DDE exposure before week 18 of pregnancy and anthropometry at birth, as well as gestational length, in 170 mother–child pairs from a cohort study in a flower-growing mexican region. Maternal serum p,p´ -DDE concentrations were determined by gas chromatography. The associations between p,p´ -DDE and z-scores of birth weight, birth length, and gestational age were evaluated by linear multiple regression models. Logistic regression models were used for low birth weight and small size for gestational age. Effect modification by child's sex was explored. The average gestational age at the blood sample extraction was 10.6 weeks. p,p' -DDE was detected in 64.7% of mothers, at a geometric mean of 0.24 ng/mL. Prenatal p,p´ -DDE exposure was not associated with the birth outcomes in the whole sample. However, a high p,p´ -DDE exposure was marginally associated with greater small for gestational age risk in male newborns (OR≥0.076ng/mL vs <0.076 ng/mL = 3.09, 95% CI: 0.61; 15.58), but not in female (p for interaction = 0.08). Even though, we found no reductions in anthropometric measurements or gestational length associated with early prenatal p,p´ -DDE exposure, the potential effect modification by infant's sex in terms of small for the gestational age risk deserves future studies. [ABSTRACT FROM AUTHOR]

OBJETIVO: Conocer la percepción, recursos y prácticas que sobre el aborto tienen las parteras de un área rural mexicana, el Municipio de Yecapixtla, Morelos, situado en la parte central de México. MÉTODOS: Se utilizó método cualitativo, realizándose entrevistas en profundidad, grupos focales y observación participativa. Los tópicos indagados fueron aspectos socioculturales, sexualidad, reproducción y aspectos de salud en relación al aborto. Se entrevistó en profundidad a 9 parteras y se realizó un grupo focal en el que participaron 16 parteras. RESULTADOS: Éstos dan cuenta de una profunda actitud de rechazo ante el aborto, inducido o espontáneo. El primero se conceptúa como un pecado grave y el segundo como un fracaso en la principal función de la mujer en estas comunidades, la reproducción. Las mujeres que abortan son llamadas "puercas", "cochinas" o "perras" y las parteras se muestran reacias a atenderlas. Sin embargo, es común entre las mujeres de la comunidad la práctica de la "regulación de la regla", es decir, la utilización de sustancias que hacen que aparezca la menstruación si ésta se ha retrasado. Dicha práctica no se considera abortiva. CONCLUSIONES: El conocimiento del mundo de significaciones populares en torno al aborto es imprescindible para construir modelos y estrategias efectivas que, desde los servicios institucionales de salud, refuercen los vínculos entre éstos y las parteras tradicionales, de manera que se mejore el acceso a servicios y la calidad de la atención a las mujeres.

El problema de la violencia se ha analizado a través de distintos enfoques caracterizados todos por la fragmentación, pues cada disciplina ha impreso su punto de vista, de acuerdo con propósitos particulares sin que se hayan integrado los avances alcanzados en cada una. Las tres grandes vertientes a través de las cuales se ha hecho un intento por aproximarse al fenómeno son las ciencias sociales, las penales y, recientemente, la salud pública. En este trabajo se discuten, de manera general, las perspectivas teóricas que plantea cada una de esas vertientes y se destaca el impacto que sobre la salud tiene este problema, mediante la revisión de trabajos realizados en México sobre mortalidad y morbilidad debida a hechos violentos.

Se analizaron las muertes registradas como homicidio en México de 1979-1992. El estudio se basó en fuente secundaria, siendo las variables analizadas: año, edad, sexo y causa externa de traumatismos y envenenamientos según CIE IX Rev.(E960-E969). Se utilizó un modelo de regresión Poisson para las causas más frecuentes, obteniendo riesgos relativos según edad y sexo. El grupo de referencia fue el de 10-14 años y el sexo femenino. Se registraron 198,485 muertes por Homicidio, con un promedio anual de 14,177 y diario de 39. La principal causa fue ataque con arma de fuego y explosivos(56%). El riesgo relativo más alto fue para el grupo de 35-39 años, con RR 15,4 IC(95%) 14,9-16,0, en comparación al de referencia. El sexo masculino presentó un riesgo relativo 10,1 veces mayor que el femenino, ajustado por edad IC10.0-10.3. Los resultados llaman la atención sobre la necesidad de profundizar y analizar el problema de los homicidios bajo una perspectiva multidisciplinaria.

Flavonoids are a broad group of bioactive compounds with anticarcinogenic effects on the prostate that have been scarcely evaluated in Latin American populations. Our objective was to evaluate the association between dietary patterns of flavonoid intake and prostate cancer (PC) in a population-based case–control study carried out in Mexico City. Based on a semi-quantitative FFQ with a frame reference of 3 years before diagnosis or interview, we used an updated database for estimating the daily intake (mg/d) of flavones, flavonols and flavanols for 395 confirmed incident PC cases and 797 population controls matched by age (± 5 years). Histological PC differentiation was evaluated using the Gleason score at diagnosis. Flavonoid dietary intake patterns (FDIP) were determined through principal component analysis, and their association with PC was estimated using logistic regression models. Three FDIP were identified: gallate pattern (GP) characterised by (–)-epicatechin-3-O-gallate, (–)-epigallocatechin-3-O-gallate and (+)-gallocatechin; luteolin pattern (LP) characterised by luteolin and (–)-epigallocatechin-3-O-gallate; and a mixed pattern (MP) that included (+)-catechin, (–)-epicatechin and quercetin. A higher GP (ORT3 v.T1 = 0·47; 95 % CI 0·33, 0·66) and LP intake (ORT3 v. T1 = 0·39; 95 % CI 0·27, 0·59) were associated with a decreased PC likelihood. In contrast, a higher MP intake (ORT3 v. T1 = 2·32; 95 % CI 1·67, 3·23) increased PC likelihood. The possible differential and synergistic anticarcinogenic role of flavonoid compounds in PC deserves further study. [ABSTRACT FROM AUTHOR]

Copyright of Salud Pública de México is the property of Instituto Nacional de Salud Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this study, we evaluated the effects of dietary intake of vitamin B and folate during pregnancy and their interactions with maternal polymorphism of MTHFR ( 677C> T; 1298A> C) on intrauterine development. Anthropometric parameters were obtained from 231 newborns that belong to a prospective birth cohort in Morelos, Mexico. Maternal dietary intake of vitamin B and folate was assessed using a semi-quantitative questionnaire administered during the first and third trimesters of the pregnancy. Maternal MTHFR 677C> T and 1298 A> C genotypes were determined by PCR-RFLP. The associations between deficient dietary intake of vitamin B (<2.0 μg/d) and folate (<400 μg/d) in the first and third trimesters and maternal polymorphisms of MTHFR on anthropometric parameters at birth were estimated using a multivariate linear regression model. During pregnancy, the deficient dietary intake was roughly 60 % for folate and 19 % for vitamin B. Allelic frequencies of 677T and 1298C were 59 and 10 %, respectively. After adjusting for confounders, deficiency in maternal dietary intake of vitamin B (<2.0 μg/d) was associated with a significant reduction in length (β ~ −2.4; 95 % CI −4.3; −0.6) and length-for-age at birth (β ~ −1.2; 95 % CI −2.3; −0.1) among infants whose mothers were carriers of the 677TT genotype ( p for interaction = 0.02). In contrast, no association was observed between deficiency in maternal dietary intake of folate (<400 μg/d) and any anthropometric parameter of newborns. These results suggest that supplementation with vitamin B during pregnancy could have a favorable impact on intrauterine fetal development mainly in populations that are genetically susceptible. [ABSTRACT FROM AUTHOR]

ObjectiveTo evaluate the effects on anencephaly risk of the interaction between the maternal profile of folate, vitamin B12 and homocysteine and the 677C→T polymorphism in the gene encoding methylenetetrahydrofolate reductase (MTHFR).DesignCase–control study paired (1:1) on maternity clinic, date of birth and state of residence. Cases of anencephaly were identified using the Registry of the Mexican Neural Tube Defect Epidemiological Surveillance System. Case and control mothers were selected from the same maternity departments. All mothers completed a structured questionnaire and blood samples were obtained to determine the MTHFR 677C→T polymorphism and biochemical profile.SettingMexico, Puebla and Guerrero states, Mexico.SubjectsA total of 151 mothers of cases and controls were enrolled from March 2000 to February 2001. We had complete information on biochemical profile and MTHFR C677T polymorphism for ninety-eight mothers of cases and ninety-one mothers of controls.ResultsThe adjusted models show that the risk of anencephaly in mothers with 677TT genotype was reduced by 18 % (OR = 0·82; 95 % CI 0·72, 0·94) for each 1 ng/ml increment in serum folate. In terms of tertiles, mothers with 677TT genotype with serum folate levels in the upper tertile (>14·1 ng/ml) had a 95 % lower risk to have a child with anencephaly than mothers with serum folate levels in the first and second tertiles (P trend = 0·012).ConclusionsOur data agree with the hypothesis of a gene–nutrient interaction between MTHFR 677C→T polymorphism and folate status. We observed a protective effect on anencephaly risk only in mothers with 677TT genotype as serum folate levels increased. [ABSTRACT FROM AUTHOR]

Background: The NutrIMSS program is granted to populations with chronic conditions to improve basic health indicators and its effectiveness in this population is unknown., Objective: To analyze the change in the basic health indicators of patients who attended the NutrIMSS Program, at the UMF No. 2 of the IMSS in Mexico City, during the period 2018 to 2019., Material and Methods: From 105 files of IMSS beneficiaries, a retrospective cohort study was carried out considering two measurements, before and after the NutrIMSS program. To evaluate the average change over time of health indicators, GEE models (Generalized Estimation Equations) and multiple linear regression models were used. Statistical analysis was used using the statistical program StataCorp 2015., Results: Patients who attended the Program showed changes between the beginning and end of the period with an average of three months of follow-up. They presented a decrease in the following health indicators: body weight of 1 kg, body mass index: 0.8 kg/m2, glucose of 13 mg/dL, triglycerides of 57 mg/dL and cholesterol of 17 mg/dL (p < 0.005 in all cases). There was no difference in the level of blood pressure., Conclusions: The NutrIMSS program influenced the improvement of the health indicators of the population of the program and is an ally to improve the health of the IMSS beneficiary population., (Licencia CC 4.0 (BY-NC-ND) © 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

Objective: Identify the characteristics associated with correct utilization of self examination (SE), clinical exam (CE) and mammography (MA) for breast cancer (BC) early detection., Materials and Methods: Interviews were undertaken with 1 030 Mexican women (n=1 030), 20 to 88 years of age, regarding their reproductive and sociodemographic characteristics. An index of correct utilization was constructed based on the form and frequency practice of those techniques., Results: The prevalence of correct utilization of SE was 11% and 5.4% for CE. Further, 7.6% of women 40-49 years of age with 2 or more BC risk factors had MA during the two years prior to the interview, and for 31.6% among women ≥50 years of age the MA was annually. The main determinant of MA utilization was having financial protection from either IMSS, ISSSTE or Seguro Popular., Conclusions: It is necessary to improve the correct utilization of BC detection techniques in Mexico.

Objective: To identify risk factors associated with severity of injuries occurring in public streets of an urban area., Material and Methods: Between February and April 2001, a cross-sectional survey was conducted among injured people seeking emergency care at three hospitals in Cuernavaca, Morelos, Mexico. Information was also obtained for those who died on accident sites. Data on the following variables were collected: age, sex, alcohol intake, day and time of injury, prehospital care, external cause and nature of injury. The Abbreviated Injury Scale (AIS) was used to define severity of injuries. Data analysis consisted of descriptive, bivariate, and multivariate regression models., Results: A total of 492 injured people were included in the study; 23 of them died on site. The main cause of injuries was road traffic accidents (52%); 72% of injuries were not severe. Variables associated with the severity of injuries were: Road traffic accidents (odds ratio [OR] 6.59, 95% confidence interval [CI] 2.52, 17.23), adjusted for age and schooling., Conclusion: Road traffic injuries are the main cause of severe injuries. TheAIS is useful to assess the frequency and distribution of injury severity.