Search

Dentro de la atención para la salud, se interseca el sistema religioso. Las prácticas religiosas buscan una intervención de actores divinos por medio de prácticas, rezos, ritos y rituales. A su vez, las prácticas mágicas se describen como preceptos simbólicos cotidianos a los que se les atribuye poder para conseguir multas técnicas y utilitarios sin intervención de un rango o ser sagrado. Se buscó caracterizar el tipo ideal de las prácticas mágico-religiosas realizadas por madres de pacientes con enfermedades crónicas, atendidos en un hospital de tercer nivel de atención. Se realizaron entrevistas a profundidad en 12 madres con hijos con diversas enfermedades crónicas.En todas ellas, se destaca el uso de las prácticas mágico-religiosas como auto-cuidado emocional al afrontar la soledad y las crisis de su entorno, con el fin de sentir tranquilidad y paz en busca de este bienestar de ellas y de sus hijos. Por el uso extendido de las prácticas mágico-religiosas es necesario comprender cómo intersecan el proceso de salud-enfermedad, en donde el personal para la salud busque equilibrar la tensión entre el componente biológico de la enfermedad y el aspecto religioso-espiritual, en la búsqueda de bienestar social y espiritual del vínculo madre-hijo.

Biotin supplemented diet (BSD) is known to enhance β-cell replication and insulin secretion in mice. Here, we first describe BSD impact on the islet β-cell membrane potential (Vm) and glucose-induced electrical activity. BALB/c female mice (n ≥ 20) were fed for nine weeks after weaning with a control diet (CD) or a BSD (100X). In both groups, islet area was compared in pancreatic sections incubated with anti-insulin and anti-glucagon antibodies; Vm was recorded in micro dissected islet β-cells during perfusion with saline solutions containing 2.8, 5.0, 7.5-, or 11.0 mM glucose. BSD increased the islet and β-cell area compared with CD. In islet β-cells of the BSD group, a larger ΔVm/Δ[glucose] was found at sub-stimulatory glucose concentrations and the threshold glucose concentration for generation of action potentials (APs) was increased by 1.23 mM. Moreover, at 11.0 mM glucose, a significant decrease was found in AP amplitude, frequency, ascending and descending slopes as well as in the calculated net charge influx and efflux of islet β-cells from BSD compared to the CD group, without changes in slow Vm oscillation parameters. A pharmacological dose of biotin in mice increases islet insulin cell mass, shifts islet β-cell intracellular electrical activity dose response curve toward higher glucose concentrations, very likely by increasing K

Background: Breast milk is irreplaceable for healthy development. In Mexico, by 2019, the prevalence of exclusive breastfeeding (EBF) was low and the use of breastmilk substitutes (BMSs) was high. Objective: The aim of this work was to evaluate the maternal and child characteristics related to breastfeeding (BF) duration and to the introduction of BMSs for residents of Mexico City (CdMX) and an agricultural town in Morelos. Methods: A cross-sectional study was conducted with 160 mother–child binomials (0–15 months of age) from the megacity CdMX and the agricultural town. Outcomes: EBF and total breastfeeding (TBF) duration, age of transition to BMSs, and the introduction of complementary feeding (CF) were assessed. Associations with maternal and infant factors were assessed using Cox models. Results: The prevalence of EBF in the joint samples at 5.9 months was 32.6% and 5.8% at 6 months. EBF was favored under the following conditions: living in CdMX, receiving prenatal care, no newborn hospitalization, and breastmilk provided as first food at birth. TBF was prolonged under the following conditions: older mother, female children, rooming-in care during puerperium, receiving BF upon discharge after birth, cohabiting with extended family, and having no siblings. The introduction of BMSs predominated under the following conditions: living in an agricultural town, BMSs given after birth before discharge, younger mother, worker mother, and lack of prenatal care. The early introduction of CF (before the fourth month) was 2% for CdMX and 14% for the agricultural town. Conclusions: The agricultural population had a higher risk of the premature interruption of EBF/TBF and the early introduction of BMSs and CF. Protective factors were family-friendly environments and being born in a baby-friendly hospital.

Adverse conditions in early life, including environmental, biological and social influences, are risk factors for ill-health during aging and the onset of age-related disorders. In this context, the recent field of social epigenetics offers a valuable method for establishing the relationships among them However, current clinical studies on environmental changes and lifespan disorders are limited. In this sense, the Tlaltizapan (Mexico) cohort, who 52 years ago was exposed to infant malnutrition, low income and poor hygiene conditions, represents a vital source for exploring such factors. Therefore, in the present study, 52 years later, we aimed to explore differences in clinical/biochemical/anthropometric and epigenetic (DNA methylation) variables between individuals from such a cohort, in comparison with an urban-raised sample. Interestingly, only cholesterol levels showed significant differences between the cohorts. On the other hand, individuals from the Tlaltizapan cohort with more years of schooling had a lower epigenetic age in the Horvath (p-value = 0.0225) and PhenoAge (p-value = 0.0353) clocks, compared to those with lower-level schooling. Our analysis indicates 12 differentially methylated sites associated with the PI3-Akt signaling pathway and galactose metabolism in individuals with different durations of schooling. In conclusion, our results suggest that longer durations of schooling could promote DNA methylation changes that may reduce epigenetic age, nevertheless, further studies are needed.

To study temporal changes in the cumulative incidence (CI) of type 2 diabetes mellitus during early and late adolescence from 2003 to 2013.This was an ecologic, analytical study of trends over time. Data were weekly reports of new cases (General Directorate of Epidemiology). Specific CI was calculated and standardized by age using the direct method (WHO). Autoregressive Integrated Moving Average models offering a better fit to the observed series were calculated and controlled by intentional screening. Structural break point analysis was performed.The CI was lower in younger adolescents than in older adolescents. In early adolescence, the incidence was similar in both sexes and stable over time [Autoregressive Integrated Moving Average female: (2,0,2)(0,0,0), male: (1,0,1)(0,0,0); P .001], whereas in late adolescence, the female incidence was higher than the male incidence and showed a linear increase [female: (1,1,2)(1,0,0), male: (1,0,1)(0,0,0); P .001)]. The female series showed two structural break points, in 2010 and 2012. The male early adolescent series showed one break point in 2011.Although there was an increase in the CI of type 2 diabetes mellitus during the study period, only the female late adolescence series showed an epidemiologically significant linear trend. There was also a brief, limited rise between 2010 and 2012 that affected all adolescents. This suggests that the disease may be triggered by specific events.

Academic pediatric surgery in Mexico has many challenges and opportunities. Work life balance, health service delivery and committements to our many students and residents must be tailored to goals and aspirations respecting talent at every opportunity when we encounter it. This article offers a perspective on the landscape and how we can shape the future in our nation to embrace new leadership in academic pediatric surgery.

We describe the evidence of the effects of early life exposures on health and aging during adulthood.A narrative review of cohorts and systematic reviews of studies initiated early in life and followed up to adulthood was conducted.Most studies were carried out in developed countries. The long-term effects of birth weight and, to a lesser extent, height at birth on chronic-degenerative diseases, functionality, bone, renal and respiratory pathology, and mortality have been consistent. Breastfeeding is associated with metabolic and cardiovascular diseases and functionality. Adiposity, bone pathophysiology, functionality in old age, and high blood pressure are associated with socioeconomic status at birth.Several exposures from intrauterine life to adolescence that exert discrete but significant effects on adult health have been consistently described. It is necessary to carry out these studies in developing countries.En este artículo se describe la evidencia acerca de los efectos de las exposiciones tempranas sobre la salud y el envejecimiento en la edad adulta.Revisión narrativa de cohortes y revisiones sistemáticas de estudios iniciados en la vida temprana y seguidos hasta la edad adulta.La mayoría de los estudios se realizaron en países desarrollados. Los efectos a largo plazo del peso al nacer, y en menor medida de la talla al nacer, en las enfermedades crónico-degenerativas, la funcionalidad, la fisiopatología ósea, renal y respiratoria, y la mortalidad, han sido consistentes. La lactancia materna se ha asociado con enfermedades metabólicas y cardiovasculares, y con la funcionalidad. La adiposidad, la fisiopatología ósea, la funcionalidad en la vejez y la hipertensión arterial están asociadas con el nivel socioeconómico al nacer.Diferentes exposiciones desde la vida intrauterina hasta la adolescencia ejercen efectos discretos, pero significativos, sobre la salud de los adultos. Se requiere realizar estos estudios en las poblaciones que viven en países en desarrollo.

Background: Surgical care is an essential component to achieve universal health coverage. An increase in children's surgical burden is recognized worldwide, but changes in the epidemiological profile associated with global geographic heterogeneity are to be expected. The aims of this study are to analyse the prevalence and epidemiological changes of surgical activity in a tertiary center in Mexico. Methods: Ambispective cohort study. Institutional records were reviewed searching for children’s surgeries in the period comprising 2001-2017. The variables analyzed were age, sex, number of surgeries per subject, and mortality rate; regarding the interventions, kind of inward stay, kind of surgery (ICD 9 CM), ward or department responsible, and perioperative mortality rate (POMR). Results: Of the 104,578 institutional admissions, 37% were surgical procedures of preschool-aged children (30.2%), and infants (27.3%). These tended to decrease, while for adolescents to increase. A total of 84,859 surgeries were performed (1.36 per operating room/day), averaging 4.992 per year, with a marginal tendency to increase. 65.8% of procedures required hospitalization. The systems more frequently intervened were: musculoskeletal system (20.1%, tending to increase), digestive system (19.5%), and cardiovascular system (11.3%). The overall mortality rate of surgical admissions was 5.5%, with POMR of 1.54%. Conclusion: The institutional epidemiological profile has changed, and relevant trends were identified. We corroborated the presence of global geographic heterogeneity with analogous hospitals

Background An Amerindian genetic background could play an important role in susceptibility to metabolic diseases, which have alarmingly increased in recent decades. Mexico has one of the highest prevalences of metabolic disease worldwide. The purpose of this study was to determine the prevalence of metabolic syndrome and its components in a population with high Amerindian ancestry. Methods We performed a descriptive, quantitative, and analytical cross-sectional study of 2596 adult indigenous volunteers from 60 different ethnic groups. Metabolic syndrome and its components were evaluated using the American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement criteria. Results The overall prevalence of metabolic syndrome in the indigenous Mexican population was 50.3%. Although females had a higher prevalence than males (55.6% vs. 38.2%), the males presented with combinations of metabolic syndrome components that confer a higher risk of cardiovascular disease. The most frequent metabolic syndrome component in both genders was low HDL-cholesterol levels (75.8%). Central obesity was the second most frequent component in females (61%), though it had a low prevalence in males (16.5%). The overall prevalence of elevated blood pressure was 42.7% and was higher in males than females (48.8 vs. 40%). We found no gender differences in the overall prevalence of elevated triglycerides (56.7%) or fasting glucose (27.9%). Conclusions We documented that individuals with Amerindian ancestry have a high prevalence of metabolic syndrome. Health policies are needed to control the development of metabolic disorders in a population with high genetic risk.

Objetivo. Evaluar el impacto de la vacunación contra rotavirus (RV) a 10 años de su universalización sobre la morbimortalidad por enfermedad diarreica aguda (EDA) en niños mexicanos menores de cinco años. Material y métodos. Se compararon las medianas anuales de casos nuevos, defunciones y hospitalizaciones por EDA del periodo pre y posuniversalización; se calcularon reducciones absolutas y relativas, considerando significativos valores de p

Background Previous studies have found a strong correlation between internet search and public health surveillance data. Less is known about how search data respond to public health interventions, such as vaccination, and the consistency of responses in different countries. In this study, we aimed to study the correlation between internet searches for "rotavirus" and rotavirus disease activity in the United States, United Kingdom, and Mexico before and after introduction of rotavirus vaccine. Methods We compared time series of internet searches for "rotavirus" from Google Trends with rotavirus laboratory reports from the United States and United Kingdom and with hospitalizations for acute gastroenteritis in the United States and Mexico. Using time and location parameters, Google quantifies an internet query share (IQS) to measure the relative search volume for specific terms. We analyzed the correlation between IQS and laboratory and hospitalization data before and after national vaccine introductions. Results There was a strong positive correlation between the rotavirus IQS and laboratory reports in the United States (R2 = 0.79) and United Kingdom (R2 = 0.60) and between the rotavirus IQS and acute gastroenteritis hospitalizations in the United States (R2 = 0.87) and Mexico (R2 = 0.69) (P < .0001 for all correlations). The correlations were stronger in the prevaccine period than in the postvaccine period. After vaccine introduction, the mean rotavirus IQS decreased by 40% (95% confidence interval [CI], 25%-55%) in the United States and by 70% (95% CI, 55%-86%) in Mexico. In the United Kingdom, there was a loss of seasonal variation after vaccine introduction. Conclusions Rotavirus internet search data trends mirrored national rotavirus laboratory trends in the United States and United Kingdom and gastroenteritis-hospitalization data in the United States and Mexico; lower correlations were found after rotavirus vaccine introduction.

OBJECTIVE: In Mexico, declines in childhood diarrhea deaths have been documented during 2008–2010 after rotavirus vaccine introduction in 2007. Because of concerns about variation in rotavirus vaccine efficacy by socioeconomic status, we compared reductions in diarrhea mortality in the lesser developed southern region versus the more developed northern and central regions of Mexico. METHODS: We obtained data from national vital statistics on diarrhea deaths among children aged RESULTS: In northern, central, and southern Mexico, the 2007 Human Development Index was 0.84, 0.82, and 0.77, respectively, and by 2010 an estimated 99%, 84%, and 89% of children aged .8). CONCLUSIONS: After introduction of rotavirus vaccination, marked and sustained declines in diarrhea deaths were seen among children in all regions of Mexico, including in the least developed southern region with the highest baseline diarrhea mortality. This finding indicates equitable vaccine delivery to children with varying risk of mortality and reaffirms the beneficial effects of rotavirus vaccination against fatal diarrheal disease.

BACKGROUND: Mexico implemented routine childhood vaccination against rotavirus in 2007. We describe trends in hospitalization and deaths from diarrhea among children aged

BACKGROUND In January 2010, surveillance detected a rotavirus gastroenteritis outbreak in Chiapas, Mexico. We aimed to identify risk and protective factors for developing rotavirus gastroenteritis of any severity among children in the epidemic setting. METHODS A case-control study was conducted, comparing case patients (defined as children

We examined potential risk factors on vaccine virus shedding and antibody seroresponse to human rotavirus vaccine (Rotarix) in Mexican infants. Two doses of Rotarix were administered to infants during the first two visits for their routine childhood immunization (∼8 and 15weeks of age) in Mexico City. Infant's characteristics and socioeconomic indicators were obtained, including history of long-term feeding practices (exclusively/predominantly breastfed and exclusively/predominantly non-breastfed). Two serum specimens were collected, one during the second rotavirus vaccine visit and one 7weeks later. Stool specimens were collected between days 4-7 after each of the two rotavirus vaccine doses. Rotavirus IgA and IgG titers in serum were determined by enzyme immunoassays (EIA) and rotavirus shedding in stool was assessed by EIA and confirmed by RT-PCR. The overall rotavirus IgA geometric mean titers (GMT) increased significantly post dose 2 from post dose 1 [176 (95%CI: 113-273) to 335 (238-471); p=0.020). Infants who were exclusively/predominantly breastfed were less likely to shed vaccine virus in stool than those who were formula-fed (22% vs. 43%, p=0.016). Infants who were breastfed had lower rotavirus IgA titers than those who were formula-fed after dose 1 [GMT: 145 (84-250) vs. 267 (126-566) p=0.188] and dose 2 [236 (147-378) vs.578 (367-910), p=0.007]. Infants who shed vaccine virus post dose 1 had significantly higher serum IgA GMT than those who did not shed [425 (188-965) vs. 150 (84-266), p=0.038]. Breastfeeding was linked with the reduction of both stool vaccine shedding, and IgA seroresponse. The reduced rotavirus replication in the gut and shedding after dose 1 may explain in part the lower IgA response in serum.

To describe the epidemiologic profile of congenital syphilis in Mexico between 1990 and 2009.The database of the General Direction of Epidemiology at the Ministry of Health in Mexico about congenital syphilis was reviewed. Data corresponding to the period between 1990 and 2009 were analyzed in every state of the Mexican republic.A total of 1717 cases of congenital syphilis were reported during the study period. A 16.6% increase was observed between 2005 and 2009 and the quinquennium between 2000 and 2004. A trend toward increase in the incidence of congenital syphilis was observed with 2.9 new cases for each 100,000 babies born alive. The states that displayed significant positive trends were as follows: Baja California, Colima, Chihuahua, Jalisco, Nayarit, Sinaloa, and Zacatecas.An increase in the number of cases of congenital syphilis is observed; the northern states are the ones that contribute the most to the statistics. There is a real need to refine the epidemiologic operations to detect and treat the cases of maternal and congenital syphilis in the country.

Single-strain rotavirus vaccine was added to the national immunization program in Mexico in May 2007. We assessed the impact of vaccination on the number of diarrhea-related hospitalizations in Mexican children in 2008 and 2009.We obtained data on all-cause diarrhea-related hospitalizations from January 2003 to June 2009 in Mexican children5 years of age. We compared diarrhea-related hospitalizations during the 2008 and 2009 rotavirus seasons with the median number of diarrhea-related hospitalizations at baseline (2003-2006), before rotavirus vaccine introduction, at 306 Ministry of Health hospitals. We estimated vaccine coverage using administrative data.A median number of 10,993 diarrhea-related hospitalizations (range: 9877-11958) occurred each prevaccine rotavirus season from 2003 to 2006 among children5 years of age. Diarrhea-related hospitalizations decreased by 11% (N = 9836) in 2008 and by 40% (N = 6597) in 2009. The greatest declines occurred in infants12 months of age during 2008 (25%) and 2009 (52%), with 1-dose rotavirus vaccination coverage of 74% and 89% during these years, respectively. A 43% decline was also noted among children 12 to 23 months of age during the 2009 season. No declines were noted during either 2008 or 2009 among unvaccinated children24 months of age during the study period.Marked declines in diarrhea-related hospitalizations among vaccine-eligible Mexican children24 months of age have occurred during the first 2 complete rotavirus seasons following rotavirus vaccination. Rotavirus-specific surveillance and epidemiologic studies are necessary for a better understanding of the changes in disease epidemiology and public health impact from rotavirus vaccination.

Resumen Objetivo Revisar sistematicamente en la literatura cientifica las evidencias que evaluan la seguridad de la vacuna por via oral contra rotavirus. Material y metodos Buscamos estrategicamente en la base de datos Medline, Trip Database y SUM Search, sin restriccion en el lenguaje, cualquier ensayo clinico que evaluara la seguridad de las vacunas de rotavirus por via oral disponibles a la fecha en lactantes (RotaTeq® o Rotarix®). El diseno de estudio de los articulos incluidos correspondio a investigaciones aleatorizadas, cegadas y controladas con placebo, publicadas desde el ano 2005 hasta septiembre de 2009. Resultados De 204 titulos encontrados, 16 articulos completos reunieron criterios basicos y se incluyeron 11 de estos. Un total de 88.017 pacientes se inmunizaron con alguna de las dos vacunas contra rotavirus disponibles frente a 75.538 con placebo. Los eventos adversos mas frecuentes fueron: fiebre (16,02%), diarrea (7,8%) y vomitos (5,2%); estadisticamente, no existio diferencia al compararlas con placebo. Conclusion Los efectos adversos graves relacionados con las vacunas orales de rotavirus se presentan en cifras bajas.

OBJETIVO: Analizar la mortalidad por diarrea en menores de cinco anos en Mexico, antes y despues de la vacunacion contra el rotavirus. MATERIAL Y METODOS: Se compararon defunciones y mortalidad por diarrea mediante diferencias porcentuales anuales por grupo etario, antes (2000-2005) y despues (2006-2007) de la vacunacion. RESULTADOS: Entre 2000 y 2007 la mortalidad por diarrea disminuyo 42%. En los estados con vacunacion, la mortalidad se redujo 15.8 y 27.7% en menores de uno y de uno a cuatro anos, respectivamente, en el periodo de 2006 a 2007. DISCUSION: La reduccion observada en la mortalidad por diarrea en menores de cinco anos despues de 2005 puede atribuirse en parte a la vacunacion contra el rotavirus.

To assess, by socioeconomic setting, the effect of nationwide vaccination against species A rotavirus (RVA) on childhood diarrhoea-related hospitalizations in Mexico.Data on children younger than 5 years who were hospitalized for diarrhoea in health ministry hospitals between 1 January 2003 and 31 December 2011 were collected from monthly discharge reports. Human development indexes were used to categorize the states where hospitals were located as having generally high, intermediate or low socioeconomic status. Annual rates of hospitalization for diarrhoea--per 10,000 hospitalizations for any cause--were calculated. Administrative data were used to estimate vaccine coverage.In the states with high, intermediate and low socioeconomic status, coverage with a two-dose monovalent RVA vaccine--among children younger than 5 years--had reached 93%, 86% and 71%, respectively, by 2010. The corresponding median annual rates of hospitalization for diarrhoea--per 10,000 admissions--fell from 1001, 834 and 1033 in the "prevaccine" period of 2003-2006, to 597, 497 and 705 in the "postvaccine" period from 2008 to 2011, respectively. These decreases correspond to rate reductions of 40% (95% confidence interval, CI: 38-43), 41% (95% CI: 38-43) and 32% (95% CI: 29-34), respectively. Nationwide, RVA vaccination appeared to have averted approximately 16,500 hospitalizations for childhood diarrhoea in each year of the postvaccine period.Monovalent RVA vaccination has substantially reduced childhood diarrhoea-related hospitalizations for four continuous years in discretely different socioeconomic populations across Mexico.Évaluer, par contexte socio-économique, les effets de la vaccination nationale contre le rotavirus A (RVA) sur les hospitalisations liées à la diarrhée infantile au Mexique.Les données chez les enfants de moins de 5 ans qui ont été hospitalisés pour cause de diarrhée dans les hôpitaux du ministère de la santé entre le 1Dans les états présentant des statuts socio-économiques élevés, intermédiaires et bas, la couverture avec un vaccin monovalent contre le RVA administré en 2 doses – parmi les enfants de moins de 5 ans – a atteint 93%, 86% et 71%, respectivement, en 2010. Les taux annuels médians d'hospitalisation correspondants pour cause de diarrhée – par 10 000 admissions – ont chuté de 1001, 834 et 1033 dans la période «pré-vaccinale» de 2003 à 2006, à 597, 497 et 705 dans la période «post-vaccinale» de 2008 à 2011, respectivement. Ces diminutions correspondent à des réductions de taux de 40% (Intervalle de Confiance (IC) à 95%: 38–43), 41% (IC à 95%: 38–43) et 32% (IC à 95%: 29–34), respectivement. Dans tout le pays, la vaccination contre le RVA semble avoir évité environ 16 500 hospitalisations pour cause de diarrhée infantile chaque année au cours de la période post-vaccinale.La vaccination monovalente contre le RVA a substantiellement réduit les hospitalisations liées à la diarrhée infantile pendant quatre ans de suite dans des populations socio-économiques différentes et distinctes dans tout le Mexique.Evaluar, por el contexto socioeconómico, el efecto de la vacunación a escala nacional contra el rotavirus de tipo A (RVA) en las hospitalizaciones vinculadas a la diarrea infantil en México.Se recopilaron datos sobre niños menores de 5 años hospitalizados por diarrea en hospitales del Ministerio de Salud entre el 1 de enero de 2003 y el 31 de diciembre de 2011 a partir de los informes de altas hospitalarias mensuales. Se usaron índices de desarrollo humano para clasificar los estados donde los hospitales estaban situados según un nivel socioeconómico generalmente alto, intermedio o bajo. Se calcularon las tasas anuales de hospitalización por diarrea, por 10 000 hospitalizaciones por cualquier causa. Se emplearon datos administrativos para estimar la cobertura de la vacuna.En los estados con nivel socioeconómico alto, intermedio y bajo, la cobertura de la vacuna monovalente contra el rotavirus de tipo A de dos dosis había alcanzado entre los niños menores de 5 años el 93 %, 86 % y 71 %, respectivamente, en el año 2010. Las tasas anuales medias correspondientes de hospitalización por diarrea (por 10 000 ingresos) cayeron, respectivamente, de 1001, 834 y 1033 en el periodo «prevacuna» entre 2003 y 2006, a 597, 497 y 705 en el periodo «posvacuna» entre 2008 y 2011. Estas disminuciones se corresponden con reducciones de las tasas del 40 % (intervalo de confianza del 95 %, IC: 38–43), 41 % (IC del 95 %: 38–43) y el 32 % (IC del 95 %: 29–34), respectivamente. A nivel nacional, la vacunación contra el rotavirus de tipo A parece haber evitado unas 16 500 hospitalizaciones por diarrea infantil cada año del periodo «posvacuna».La vacunación monovalente contra el RVA ha reducido sustancialmente las hospitalizaciones relacionadas con la diarrea infantil durante cuatro años seguidos en poblaciones socioeconómicas ligeramente distintas de todo México.تقييم تأثير التطعيم على الصعيد الوطني ضد الفيروس العجلي من النوع أ (RVA)، حسب البيئة الاقتصادية الاجتماعية، على حالات الإدخال إلى المستشفيات ذات الصلة بالإسهال لدى الأطفال في المكسيك.تم جمع البيانات بشأن الأطفال الأقل من 5 سنوات الذين تم إدخالهم إلى المستشفيات إثر إصابتهم بالإسهال في مستشفيات وزارة الصحة في الفترة من 1 كانون الثاني/ يناير 2003 إلى 31 كانون الأول/ ديسمبر 2011 من تقارير الخروج الشهرية. وتم استخدام أدلة التنمية البشرية لتصنيف الولايات التي تقع بها المستشفيات من حيث الوضع الاقتصادي والاجتماعي المرتفع أو المتوسط أو المنخفض بشكل عام. وتم حساب معدلات الإدخال السنوية إلى المستشفيات إثر الإصابة بالإسهال لكل 10 آلاف حالة إدخال لأي سبب. وتم استخدام البيانات الإدارية لتقدير التغطية باللقاح.في الولايات ذات الوضع الاقتصادي والاجتماعي المرتفع والمتوسط والمنخفض، وصلت التغطية بلقاح الفيروس العجلي من النوع أ أحادي التكافؤ ثنائي الجرعة – بين الأطفال الأقل من 5 سنوات – 93 % و86 % و71 %، على التوالي بحلول 2010. وانخفض متوسط المعدلات السنوية المقابلة لحالات الإدخال إلى المستشفى إثر الإصابة بالإسهال – لكل 10 آلاف حالة إدخال – من 1001 و834 و1033 حالة في فترة "ما قبل التطعيم" من 2003 إلى 2006، إلى 597 و497 و705 في فترة "ما بعد التطعيم" من 2008 إلى 2011، على التوالي. وتتوافق هذه الانخفاضات مع الانخفاضات في المعدل التي تبلغ 40 % (فاصل الثقة 95 %، فاصل الثقة: من 38 إلى 43) و41 % (فاصل الثقة 95 %، فاصل الثقة: من 38 إلى 43) و32 % (فاصل الثقة 95 %، فاصل الثقة: من 29 إلى 34)، على التوالي. وبدا أن التطعيم بلقاح الفيروس العجلي من النوع أ قد حال دون إدخال 16500 حالة تقريباً إلى المستشفيات إثر الإصابة بالإسهال لدى الأطفال في كل سنة من سنوات فترة "ما بعد التطعيم".أدى التطعيم بلقاح الفيروس العجلي من النوع أ أحادي التكافؤ إلى تقليل حالات الإدخال إلى المستشفيات ذات الصلة بالإسهال لدى الأطفال بشكل كبير لأربع سنوات متواصلة في فئات سكانية ذات وضع اقتصادي واجتماعي مختلف على نحو متمايز في أنحاء المكسيك.按照社会经济背景，评估墨西哥全国A群轮状病毒疫苗接种（RVA）对儿童腹泻相关住院治疗的影响。从每月出院报告中收集2003 年1 月1 日至2011 年12 月31 日因腹泻在卫生部医院接受住院治疗的五岁以下儿童的数据。使用人类发展指数将医院所在的各个州分为一般性的高、中或低级三类社会经济地位。计算年腹泻住院率（占万例所有原因住院病例比例）。使用行政数据来估计疫苗覆盖率。在具有高、中和低级社会经济地位的州中，到2010 年五岁以下两剂量单价RVA疫苗覆盖率分别达到93%、86%和71%。相应的平均每年腹泻住院率（每万例住院病例数）从2003-2006 年接种前期间的1001、834 和1033 分别降低为2008 至 2011 年接种后期间的597、497 和705 例。这些降低分别对应40%（95%置信区间，CI：38-43）、41%（95% CI：38-43）和32%（95% CI：29-34）的住院率降低。RVA疫苗接种看来在后期间避免了全国范围内每年大约16500 例儿童腹泻住院。单价RVA疫苗接种连续四年显著减少了墨西哥不同社会经济群体儿童腹泻相关住院。Оценить с социально-экономической точки зрения воздействие общенациональной кампании по вакцинации от ротавируса типа A на госпитализацию детей в связи с диареей в Мексике.Были собраны данные ежемесячных отчетов о выписках детей в возрасте до 5 лет, которые находились на стационарном лечении в больницах министерства здравоохранения в связи с диареей, за период с 1 января 2003 г. по 31 декабря 2011 г. Для определения категорий штатов, в которых были расположены больницы, использовались индексы человеческого развития; штаты были распределены по категориям с высоким, средним и низким общим социально-экономическим статусом. Были рассчитаны годовые уровни госпитализации в связи с диареей на 10 000 госпитализаций по любым причинам. Для оценки покрытия вакцинации использовались административные данные.В штатах с высоким, средним и высоким социально-экономическим статусом покрытие двухфазной вакцинацией с применением моновалентной ротавирусной вакцины против вируса типа A среди детей младше 5 лет к 2010 г. составило 93%, 86% и 71% соответственно. Соответствующие средние годовые уровни госпитализации в связи с диареей на 10 000 случаев госпитализации сократились от 1001, 834 и 1033 в период до вакцинации (с 2003 по 2006 г.) до 597, 497 и 705 в период после вакцинации (с 2008 по 2011 г.) соответственно. Такое сокращение соотносится с сокращением уровней в 40% (доверительный интервал 95%, CI: 38–43), 41% (95 %, CI: 38–43) и 32% (95 %, CI: 29–34) соответственно. На общенациональном уровне ротавирусная вакцинация против вируса типа A позволила предотвратить приблизительно 16 500 госпитализаций детей в связи с диареей ежегодно за период после вакцинации.Проведение вакцинации с применением моновалентной ротавирусной вакцины против вируса типа A существенно сократило число госпитализаций детей в связи с диареей за четыре последовательных года в разграниченных по социально-экономическому статусу популяциях по всей Мексике.

OBJECTIVE: To identify and describe 1) progress achieved thus far in meeting the commitments of the Fourth Millennium Development Goal (MDG 4) in Mexico, mainly the contribution of the Universal Immunization Program (UIP) over the last 20 years, and 2) new opportunities for further reducing mortality among children under 5 years old. METHODS: An observational, descriptive, retrospective study was carried out to examine registered causes of death in children under 5 between 1990 and 2010. Indicators were built according to the recommendations of the United Nations. RESULTS: In 2010, deaths among children under 5 decreased 64.3% compared to the baseline (1990) figure. Of the total deaths of the children under 5, the neonatal period was the most affected (52.8%), followed by the 1 to 11 months (30.9%), and the 12 to 59 months (16.2%) groups. A 34% overall mortality reduction was observed after the universalization of immunization against influenza, rotavirus, and pneumococcus in children under 5. CONCLUSIONS: Despite a significant reduction in under-5 mortality in Mexico over the last 20 years, largely due to the successes of the UIP, several challenges remain, particularly in improving preventive and curative services during pre- and postnatal care.

During the last decades, the incidence of whopping cough, has been rising worldwide, despite the high coverage of the immunization programs. The highest mortality is found among children under 6 month of age, who are too young to have completed a primary vaccination series with three doses the pertussis vaccine, nevertheless this disease also affects adolescents and adults, who may only manifest mild symptomatology. Hence they do not get diagnosed or treated, becoming a potential community source of infection for young children. In order to prevent this transmission, the recommendation of vaccinating adolescents and adults, including of women in child bearing age, was issued. Nevertheless the immunization coverage among these populations was low. Postpartum vaccination was also recommended, but recent evidence have shown that the antibody levels in breast milk are detectable at least a week after immunization, allowing a window of opportunity for the infection in the newborn. Finally, it has been suggested that a booster dose against Bordetella pertussis, given to pregnant women is safe and immunogenic. Therefore, the antibody transferred across the placenta and through breast milk, could protect the product in the early stages of life.

To evaluate the associations between six single-nucleotide polymorphisms (SNPs) in intron 1 of FTO and body mass index (BMI), a case-control association study of 2314 unrelated Mexican-Mestizo adult subjects was performed. The association between each SNP and BMI was tested using logistic and linear regression adjusted for age, gender, and ancestry and assuming additive, recessive, and dominant effects of the minor allele. Association analysis after BMI stratification showed that all five FTO SNPs (rs1121980, rs17817449, rs3751812, rs9930506, and rs17817449), were significantly associated with obesity class II/III under an additive model (P

Because postlicensure surveillance determined that a previous rotavirus vaccine, RotaShield, caused intussusception in 1 of every 10,000 recipients, we assessed the association of the new monovalent rotavirus vaccine (RV1) with intussusception after routine immunization of infants in Mexico and Brazil.We used case-series and case-control methods to assess the association between RV1 and intussusception. Infants with intussusception were identified through active surveillance at 69 hospitals (16 in Mexico and 53 in Brazil), and age-matched infants from the same neighborhood were enrolled as controls. Vaccination dates were verified by a review of vaccination cards or clinic records.We enrolled 615 case patients (285 in Mexico and 330 in Brazil) and 2050 controls. An increased risk of intussusception 1 to 7 days after the first dose of RV1 was identified among infants in Mexico with the use of both the case-series method (incidence ratio, 5.3; 95% confidence interval [CI], 3.0 to 9.3) and the case-control method (odds ratio, 5.8; 95% CI, 2.6 to 13.0). No significant risk was found after the first dose among infants in Brazil, but an increased risk, albeit smaller than that seen after the first dose in Mexico--an increase by a factor of 1.9 to 2.6 - was seen 1 to 7 days after the second dose. A combined annual excess of 96 cases of intussusception in Mexico (approximately 1 per 51,000 infants) and in Brazil (approximately 1 per 68,000 infants) and of 5 deaths due to intussusception was attributable to RV1. However, RV1 prevented approximately 80,000 hospitalizations and 1300 deaths from diarrhea each year in these two countries.RV1 was associated with a short-term risk of intussusception in approximately 1 of every 51,000 to 68,000 vaccinated infants. The absolute number of deaths and hospitalizations averted because of vaccination far exceeded the number of intussusception cases that may have been associated with vaccination. (Funded in part by the GAVI Alliance and the U.S. Department of Health and Human Services.).

To identify when during fetal development connexins (Cxs) 26 (Cx26) 32 (Cx32), and 36 (Cx36) begin to be expressed, as well as to characterize their spatial distribution, real time polymerase chain reaction and immunolabeling studies were performed. Total RNA from mouse pancreases at 13 and 18 days postcoitum (dpc) and 3 days postpartum (dpp) was analyzed. In addition, pancreatic sections of mouse at 13, 14, 15, 16, 18 dpc and 3 dpp and of rat at term were double labeled with either anti-insulin or anti-α-amylase and anti-Cx26 or -Cx32 or -Cx36 antibodies and studied with confocal microscopy. From day 13 dpc, Cxs 26, 32, and 36 transcripts were identified and their levels increased with age. At 13-14 dpc, Cxs 26 and 32 were localized in few acinar cells, whereas Cx36 was distributed in small beta cell clumps. From day 14 dpc onwards, the number of labeled cells and relative immunofluorescent reactivity of all three Cxs at junctional membranes of the respective cell types increased. Cxs 26 and 32 colocalized in fetal acinar cells. In rat pancreas at term, a similar connexin distribution was found. Relative Cxs levels evaluated by immunoblotting also increased (two-fold) in pancreas homogenates from day 18 dpc to 3 dpp. The early cell specific, wide distribution, and age dependent expression of Cxs 26, 32, and 36 during fetal pancreas ontogeny suggests their possible involvement in pancreas differentiation and prenatal maturation.

BACKGROUND A phased introduction of a monovalent rotavirus vaccine occurred in Mexico from February 2006 through May 2007. We assessed the effect of vaccination on deaths from diarrhea in Mexican children in 2008 and 2009. METHODS We obtained data on deaths from diarrhea, regardless of cause, from January 2003 through May 2009 in Mexican children under 5 years of age. We compared diarrhea-related mortality in 2008 and during the 2008 and 2009 rotavirus seasons with the mortality at baseline (2003-2006), before the introduction of the rotavirus vaccine. Vaccine coverage was estimated from administrative data. RESULTS By December 2007, an estimated 74% of children who were 11 months of age or younger had received one dose of rotavirus vaccine. In 2008, there were 1118 diarrhea-related deaths among children younger than 5 years of age, a reduction of 675 from the annual median of 1793 deaths during the 2003-2006 period. Diarrhea-related mortality fell from an annual median of 18.1 deaths per 100,000 children at baseline to 11.8 per 100,000 children in 2008 (rate reduction, 35%; 95% confidence interval [CI], 29 to 39; P

To analyze the mortality due to acute diarrhea in children younger than five years old, before and after the introduction of rotavirus vaccine in Mexico.Number of deaths and mortality rates due to acute diarrhea were compared by children's age and states' vaccine status using annual percentage differences before (2000-2005) and after (2006-2007) the introduction of the HRV.From 2000-2007, deaths due to acute diarrhea in children under five years of age dropped 42%. In those states that received the HRV early in 2006, diarrhea mortality decreased between 2006-2007 15.8% in children younger than one year old and 22.7% in children 1-4 years old.The observed reduction in mortality due to acute diarrhea in children under five years of age after 2005 can be, in part, attributed to the HRV.