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au:Aguilar-Salinas, Carlos A

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Beliefs concerning non-nutritive sweeteners consumption in consumers, non-consumers, and health professionals: a comparative cross-sectional study
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Romo-Romo, Alonso

; Brito-Córdova, Griselda X

; Aguilar-Salinas, Carlos A

; Cano-García de León, Cynthia

; Farías-Name, Diana E

; Reyes-Lara, Liliana

; Jiménez-Rossainz, Juan M

; del Moral-Vidal, Lupita P

; Gómez-Pérez, Francisco J

; Almeda-Valdés, Paloma

Nutrición Hospitalaria

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oct 2022, Volume 39 N. 5 Pages 1086 - 1092

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Introducción: el consumo de edulcorantes no nutritivos (ENN) se ha incrementado. Estudios recientes han reportado posibles efectos metabólicos de los ENN, por lo que la percepción de su consumo podría haber cambiado en población general y profesionales de la salud. Objetivo: describir y comparar las creencias sobre los ENN en consumidores, no consumidores y profesionales de la salud, así como conocer las principales opiniones de los profesionales de la salud para recomendar o no el consumo de ENN. Métodos: se aplicaron encuestas a 100 consumidores, 100 no consumidores y 100 profesionales de la salud (nutriólogos y médicos) para evaluar actitudes positivas, negativas o neutras en torno a ciertas creencias de los ENN, la información que creen tener, seguridad, precio, efectos secundarios y sabor. Además, se evaluó la opinión de los profesionales de la salud para recomendar o no su consumo y las razones asociadas. Resultados: se encontraron diferencias entre los tres grupos en torno a la seguridad, los efectos secundarios y el sabor de los ENN (p < 0.01). La postura más frecuente de los profesionales de la salud (48 %) es que los ENN deben limitarse, utilizarse transitoriamente y en ciertos pacientes. Se observó una postura más positiva con respecto a los ENN en los consumidores excepto por su precio, más neutral en los no consumidores excepto por su sabor y más negativa en los profesionales de la salud en todos los aspectos. Conclusiones: las creencias sobre los ENN difieren entre los grupos estudiados, lo cual puede influir en su consumo o en la recomendación de su uso.

Abstract Introduction: the consumption of non-nutritive sweeteners (NNS) has increased. Recent studies have reported possible metabolic effects of NNS, and this may influence the perception regarding their consumption in the general population and health professionals. Objective: to describe and compare the beliefs about NNS in consumers, non-consumers, and health professionals; and to explore the reasons and opinions of health professionals for recommending or not their consumption. Methods: surveys were applied to 100 consumers, 100 non-consumers and 100 health professionals (dietitians and physicians) to evaluate a positive, negative, or neutral attitude towards certain beliefs regarding NNS, including the information they have, safety, price, side effects and taste. In addition, the opinion of health professionals for recommending or not the consumption of NNS and the related reasons was evaluated. Results: statistically significant differences regarding the safety, side effects and taste of NNS were found between the three groups (p < 0.01). The most frequent opinion of health professionals (48 %) is that NNS should be limited, used as a transition and in certain patients. Consumers tend to have a more positive opinion about NNS except for the price, non-consumers have a more neutral position except for taste, and health professionals have a more negative perception of NNS in all aspects. Conclusions: the beliefs regarding NNS differed among the studied groups, which might influence their consumption or recommendation of its use.

https://doi.org/10.20960/nh.04046

Identification of Glucose and Insulin Patterns during A 5-H Glucose Tolerance Test and Association with Cardiometabolic Risk Factors
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Crespo-Morfin, Paulina B.

; Aguilar-Salinas, Carlos A.

; Almeda-Valdés, Paloma

; Alfaro-Pastrana, Raúl

; Bello-Chavolla, Omar Y.

; Cano-Castillo, Jhoana

; Gómez-Pérez, Francisco J.

; Cruz-Bautista, Ivette

Revista de investigación clínica

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aug 2022, Volume 74 N. 4 Pages 193 - 201

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Insulin resistance is key in the pathogenesis of the metabolic syndrome and cardiovascular disease. Objective: We aimed to identify glucose and insulin patterns after a 5-h oral glucose tolerance test (OGTT) in individuals without diabetes and to explore cardiometabolic risk factors, beta-cell function, and insulin sensitivity in each pattern. Methods: We analyzed the 5-h OGTT in a tertiary healthcare center. We identified classes using latent class trajectory analysis and evaluated their association with cardiometabolic risk factors, beta-cell function, and insulin sensitivity surrogates by multinomial logistic regression analysis. Results: We included 1088 5-h OGTT performed between 2013 and 2020 and identified four classes. Class one was associated with normal insulin sensitivity and secretion. Class two showed hyperglycemia, dysinsulinism, and a high-risk cardiometabolic profile (obesity, hypertriglyceridemia, and low high-density lipoprotein [HDL] cholesterol). Class three included older individuals, a higher proportion of males, and a greater prevalence of hypertension, hyperglycemia, hyperinsulinemia, and postprandial hypoglycemia. Finally, class four showed hyperglycemia, dysinsulinism, and hyperinsulinemia; this class had the worst cardiometabolic profile (a high proportion of males, greater age, hypertension, obesity, hypertriglyceridemia, and low HDL cholesterol, p < 0.001 vs. other classes). Conclusions: The latent class analysis approach allows the identification of groups with an adverse cardiometabolic risk factor, and who might benefit from frequent follow-ups and timely multidisciplinary interventions.

https://doi.org/10.24875/ric.22000039 17 downloads

Triglyceride-Rich Lipoproteins: Their Role in Atherosclerosis
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Castillo-Núñez, Yulino

; Morales-Villegas, Enrique

; Aguilar-Salinas, Carlos A.

Revista de investigación clínica

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apr 2022, Volume 74 N. 2 Pages 61 - 70

Abstract: En | Text: En | PDF: En

ABSTRACT The term “triglyceride-rich lipoproteins” (TRLs) includes chylomicrons and their remnants, very low-density lipoproteins (VLDL), and intermediate-density lipoproteins (IDL). In this manuscript, the mechanisms by which atherogenic TRLs contribute to the formation of atheroma plaques are reviewed. Cholesterol from TRLs that can be retained in the subendothelial space (i.e., remnants, IDLs, and small VLDLs) contributes to the genesis of atherosclerosis. Triglycerides of atherogenic TRLs induce inflammation of the arterial wall. Mechanisms that explain the involvement of TRLs in atherosclerosis are the generation of pro-atherogenic changes in high-density lipoproteins and low-density lipoproteins, accumulation of TRLs in plasma, and their passage to the subendothelial space where they cause endothelial dysfunction and inflammation of the vascular wall. Furthermore, plasma accumulation of TRLs causes hyperviscosity and a procoagulant state. Finally, this manuscript summarizes the controversial aspects of the clinical approach and the treatment of cases with dyslipidemia explained by atherogenic TRLs.

https://doi.org/10.24875/ric.21000416 44 downloads

Effect of Tocilizumab in Mortality among Patients with Severe and Critical Covid-19: Experience in a Third-Level Medical Center
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Martínez-Guerra, Bernardo A.

; de-León-Cividanes, Nereyda A.

; Tamez-Torres, Karla M.

; Román-Montes, Carla M.

; Rajme-López, Sandra

; Ortiz-Brizuela, Edgar

; Aguilar-Salinas, Carlos A.

; Sierra-Madero, Juan

; Sifuentes-Osornio, José

; Ponce-de-León, Alfredo

; González-Lara, María F.

Revista de investigación clínica

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feb 2022, Volume 74 N. 1 Pages 40 - 50

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Trials evaluating safety and efficacy of tocilizumab in coronavirus disease 19 (COVID-19) show contradictory results. Objective: The objective of the study was to evaluate the effect of tocilizumab in hospital mortality among patients with severe COVID-19 in a third-level medical center. Methods: This prospective cohort study included patients with severe and critical COVID-19. Primary outcome was death during hospitalization. Secondary outcomes included invasive mechanical ventilation (IMV), days on IMV, ventilator-free days (VFDs), length of hospital stay (LOS), and development of hospital-acquired infections (HAIs). Bivariate, multivariate, and propensity score matching analysis were performed. Results: During the study period, 99/794 (12%) patients received tocilizumab. Male patients, health care workers, and patients with increased inflammatory markers received tocilizumab more frequently. No difference in hospital mortality was observed between groups (34% vs. 34%, p = 0.98). Tocilizumab was not independently associated with mortality. No significant treatment effects were observed in propensity score analysis. IMV was more frequent (46% vs. 11%, p < 0.01) and LOS was longer (12 vs. 7 days, p < 0.01) in the tocilizumab group, reflecting increased severity. Although HAIs were more frequent in the tocilizumab group (22% vs. 10%, p < 0.01), no difference was seen after adjusting for IMV (38% vs. 40%, p = 0.86). Conclusions: In our study, tocilizumab was not associated with decreased hospital mortality among patients with severe COVID-19.

https://doi.org/10.24875/ric.21000404 27 downloads

Guía de práctica clínica para el diagnóstico y el tratamiento de la otitis media aguda en niños
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Mayorga-Butrón, José L.

; Torre-González, Carlos de la

; Boronat-Echeverría, Nuria

; Aguirre-Mariscal, Héctor

; Montaño-Velázquez, Bertha B.

; Figueroa-Morales, Marco A.

; Aguilar-Gómez, Nancy E.

; Flores-Ruiz, Eric M.

; Solórzano-Santos, Fortino

; Gómez-Barreto, Demóstenes

; Moreno-Espinosa, Sarbelio

; González-Zamora, José F.

; Arredondo-García, José L.

; Xóchihua-Díaz, Luis

; Hernández-Porras, Marte

; Chavolla-Magaña, Rogelio

; Sánchez-Reyes, Blas

; Rodríguez-Carrasco, Carlos A.

; Greenawalt-Rodríguez, Sydney

; Cristerna-Tarrasa, Hernán

; Olvera-Salinas, Jorge

; Ávila-Iglesias, María C.

; Tinajero-Iriarte, Mónica G.

; Ramos-Zúñiga, José A.

; Montes-Narváez, Gabriel

Boletín médico del Hospital Infantil de México

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2022, Volume 79 Suppl. 1 Pages 1 - 31

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Background: Acute otitis media (AOM) is one of the most prevalent acute conditions in the pediatric population worldwide. This work aimed to elaborate a Clinical Practice Guideline with clinical recommendations systematically developed to assist decision-making of specialists, patients, caregivers, and public policymakers involved in managing patients with AOM in children. Methods: This document was developed by the College of Pediatric Otorhinolaryngology and Head, and Neck Surgery of Mexico (COPEME) in compliance with international standards. The SIGN quality of evidence classification was used. On behalf of the COPEME, the Guideline Development Group (GDG) was integrated, including otolaryngologists, infectologists, pediatricians, general practitioners, and methodologists with experience in systematic literature reviews and the development of clinical practice guidelines. Results: A consensus was reached on 18 clinical questions, covering what was previously established by the GDG in the scope document of the guidelines. Scientific evidence answering each of these clinical questions was identified and critically evaluated. The GDG agreed on the final wording of the clinical recommendations using the modified Delphi panel technique. Specialists and patient representatives conducted an external validation. Conclusions: This Clinical Practice Guideline presents clinical recommendations for the prevention, diagnosis, and management of AOM to assist shared decision-making among physicians, patients, and caregivers and improve the quality of clinical care.

Resumen Introducción: La otitis media aguda (OMA) es uno de los padecimientos agudos más prevalentes en la población pediátrica a escala global. El objetivo de este trabajo fue elaborar una guía de práctica clínica con recomendaciones para asistir la toma de decisiones de médicos especialistas, pacientes, cuidadores de pacientes y elaboradores de políticas públicas involucrados en el manejo de la OMA en niños. Métodos: El documento ha sido desarrollado por parte del Colegio de Otorrinolaringología y Cirugía de Cabeza y Cuello Pediátricas de México (COPEME) en cumplimiento con los estándares internacionales. Se empleó la clasificación de calidad de la evidencia de SIGN. En representación del COPEME, se integró el Grupo de Desarrollo de la Guía (GDG), que incluyó otorrinolaringólogos, infectólogos, pediatras, médicos generales y metodólogos con experiencia en revisiones sistemáticas de la literatura y el desarrollo de guías de práctica clínica. Resultados: Se consensuaron 18 preguntas clínicas que abarcaron lo establecido previamente por el GDG en el documento de alcances de la Guía. Se identificó la evidencia científica que responde a cada una de estas preguntas clínicas y se evaluó críticamente. El GDG acordó la redacción final de las recomendaciones clínicas mediante la técnica Delphi de panel. Se llevó a cabo una validación externa por colegas especialistas y representantes de pacientes. Conclusiones: En esta Guía de Práctica Clínica se presentan recomendaciones clínicas para la prevención, el diagnóstico y el manejo de la OMA, con el fin de asistir la toma de decisiones compartidas entre médicos, pacientes y cuidadores con la intención de contribuir a mejorar la calidad de la atención clínica.

https://doi.org/10.24875/bmhim.21000168

Guía de práctica clínica mexicana para el diagnóstico y tratamiento de las dislipidemias y enfermedad cardiovascular aterosclerótica
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Pavía-López, Abel A.

; Alcocer-Gamba, Marco A.

; Ruiz-Gastelum, Edith D.

; Mayorga-Butrón, José L.

; Mehta, Roopa

; Díaz-Aragón, Filiberto A.

; Aldrete-Velasco, Jorge A.

; López-Juárez, Nitzia

; Cruz-Bautista, Ivette

; Chávez-Mendoza, Adolfo

; Secchi-Nicolás, Nikos C.

; Guerrero-Martínez, Francisco J.

; Cossio-Aranda, Jorge E.

; Mendoza-Zubieta, Victoria

; Fanghänel-Salmon, Guillermo

; Valdivia-Proa, Martha

; Olmos-Domínguez, Luis

; Aguilar-Salinas, Carlos A.

; Dávila-Maldonado, Luis

; Vázquez-Rangel, Armando

; Pavia-Aubry, Vanina

; Nava-Hernández, María de los A.

; Hinojosa-Becerril, Carlos A.

; Anda-Garay, Juan C.

; Ríos-Ibarra, Manuel O. de los

; Berni-Betancourt, Ana C.

; López-Cuellar, Julio

; Araiza-Garaygordobil, Diego

; Rivera-Reyes, Romina

; Borrayo-Sánchez, Gabriela

; Tapia-Hernández, Mónica

; Cano-Nigenda, Claudia V.

; Guerra-López, Arturo

; Elías-López, Josué

; Figueroa-Morales, Marco A.

; Montaño-Velázquez, Bertha B.

; Velasco-Hidalgo, Liliana

; Rodríguez-Lozano, Ana L.

; Pimentel-Hernández, Claudia

; Baquero-Hoyos, María M.

; Romero-Moreno, Felipe

; Rodríguez-Vega, Mario

Archivos de cardiología de México

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2022, Volume 92 Suppl. 1 Pages 1 - 62

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

resumen está disponible en el texto completo

Abstract Background: Cardiovascular diseases are the leading cause of mortality worldwide and Mexico is no exception. The epidemiological data obtained in 1990 showed that cardiovascular diseases represented 19.8% of all causes of death in our country. This figure increased significantly to 25.5% for 2015. Some national surveys suggest that more than 60% of the adult population has at least one risk factor for cardiovascular disease (obesity or overweight, hypertension, smoking, diabetes, dyslipidemias). On the other hand, data from the Pan American Health Organization have linked the process of atherosclerosis as the first cause of premature death, significantly reducing life expectancy, which has enormous social repercussions. Objective: This document constitutes the Clinical Practice Guide (CPG) prepared at the initiative of the Mexican Society of Cardiology in collaboration with the Mexican Society of Nutrition and Endocrinology, AC, National Association of Cardiologists of Mexico, AC, Mexican Association for the Prevention of Atherosclerosis and its Complications, AC, National Normative Committee of General Medicine, AC, National College of Geriatric Medicine, AC, College of Internal Medicine of Mexico, AC, Mexican Society of Angiology and Vascular and Endovenous Surgery, AC, Mexican Institute of Research Nephrological, AC and the Mexican Academy of Neurology, A.C.; with the methodological support of the Ibero-American Agency for the Development and Evaluation of Health Technologies, in order to establish recommendations based on the best available evidence and agreed upon by an interdisciplinary group of experts. The objective of this document is to provide evidence-based recommendations to help decision makers in the diagnosis and treatment of dyslipidemias in our country. Material and methods: This document complies with international quality standards, such as those described by the Institute of Medicine of the USA, the Institute of Clinical Excellence of Great Britain, the Scottish Intercollegiate Guideline Network and the Guidelines International Network. A multidisciplinary group of clinical experts and methodologists with experience in systematic reviews of the literature and the development of clinical practice guidelines was formed. A scope document was agreed upon, relevant clinical questions were established, the best available evidence critically evaluated in systematic literature reviews was exhaustively identified, and clinical recommendations were developed. The modified Delphi Panel methodology was used to achieve an adequate level of consensus in each of the recommendations contained in this CPG. Results: 23 clinical questions were agreed upon which gave rise to their respective clinical recommendations. Conclusions: We consider that this document contributes to better clinical decision-making and becomes a point of reference for clinicians and patients in the management of dyslipidemias and this contributes to reducing the morbidity and mortality derived from atherosclerotic cardiovascular events in our country.

https://doi.org/10.24875/acm.m22000081 1458 downloads

Prevalence of diabetes and glycemic control in Mexico: national results from 2018 and 2020
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Basto-Abreu, Ana

; López-Olmedo, Nancy

; Rojas-Martínez, Rosalba

; Aguilar-Salinas, Carlos A

; Cruz-Góngora, Vanessa De la

; Rivera-Dommarco, Juan

; Shamah-Levy, Teresa

; Romero-Martínez, Martín

; Barquera, Simón

; Villalpando, Salvador

; Barrientos-Gutiérrez, Tonatiuh

Salud Pública de México

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dec 2021, Volume 63 N. 6 Pages 725 - 733

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract: Objective: To estimate the prevalence of diabetes (diagnosed and undiagnosed), glycemic control in Mexico, and its associated factors. Materials and methods: We used data from Ensanut 2018 (n=12 648) and 2020 (n=2 309). We defined diabetes as fasting glucose ≥126 mg/dl or HbA1c≥6.5% or previously diagnosed; glycemic control was defined as HbA1c<7%. We fitted Poisson regression models to assess the association between diabetes, glycemic control, and potential associated factors. Results: The total prevalence of diabetes was 16.8% in 2018 and 15.7% in 2020. In 2018, 38% of adults with diabetes were unaware of their disease, while in 2020 this figure was 29%. Glycemic control was observed in 42% of participants in 2018 and 39% in 2020. Longer disease duration was associated with lower glycemic control, while older age, having a diet, and being affiliated to IMSS, Pemex, Sedena, or private healthcare were associated with better control. Conclusion: Mexico is among the countries with the highest diabetes prevalence. A high proportion of adults with diabetes did not have a previous diagnosis, and the proportion with glycemic control is low. Strengthening screening to achieve a timely diagnosis, and improving glycemic control, should be key actions in the management of diabetes.

Resumen: Objetivo: Estimar la prevalencia de diabetes total (diagnosticada y no diagnosticada), control glucémico en México y sus factores asociados. Material y métodos: Se analizó información de la Ensanut 2018 (n=12 648) y 2020 (n=2 309). Se definió diabetes como glucosa en ayunas ≥126 mg/dl o HbA1c≥6.5% o diagnóstico previo; se consideró control glucémico si HbA1c<7%. Usando modelos de regresión de Poisson, se estimaron los factores asociados con diabetes y control glucémico. Resultados: La prevalencia de diabetes fue de 16.8% en 2018 y 15.7% en 2020. En 2018, 38% de los adultos con diabetes desconocían su enfermedad, en 2020 fue 29%. El control glucémico se observó en 42% de los participantes en 2018 y en 39% en 2020. Mayor tiempo de diagnóstico se asoció con descontrol glucémico mientras que mayor edad, seguir una dieta y estar afiliado al IMSS, Pemex/Sedena o privados se asoció con control glucémico. Conclusión: México se encuentra entre los países con mayor prevalencia de diabetes. Una alta proporción de adultos con diabetes no tenía un diagnóstico previo y la proporción con control glucémico es baja. Fortalecer la detección, el diagnóstico oportuno y el control glucémico es clave para el manejo de la diabetes.

https://doi.org/10.21149/12842

Trends in the prevalence of metabolic syndrome and its components in Mexican adults, 2006-2018
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Rojas-Martínez, Rosalba

; Aguilar-Salinas, Carlos A

; Romero-Martínez, Martín

; Castro-Porras, Lilia

; Gómez-Velasco, Donaji

; Mehta, Roopa

Salud Pública de México

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dec 2021, Volume 63 N. 6 Pages 713 - 724

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract: Objective: To examine trends in the prevalence of metabolic syndrome (MS) and its components. Materials and methods: Data from 27 800 Mexican adults who participated in Ensanut 2006, 2012, 2016 and 2018 were analyzed. Linear regression was used across each Ensanut period to assess temporal linear trends in the prevalence of MS. Logistic regression models were obtained to calculate the percentage change, p-value for the trend and the association between the presence of MS and the risk of developing type 2 diabetes mellitus (T2DM) over 10 years using the Finnish Diabetes Risk Score (FINDRISC) and cardiovascular disease (CVD) using Globorisk. Results: The prevalence of MS in Mexican adults according to the harmonized definition was: 40.2, 57.3, 59.99 and 56.31%, in 2006, 2012, 2016 and 2018 respectively (p for trend <0.0001). In 2018, 7.62% of metabolic syndrome cases had a significant risk for incident DM2 and 11.6% for CVD. Conclusion: It is estimated that there are 36.5 million Mexican adults living with metabolic syndrome, of which 2 million and 2.5 million have a high risk of developing T2DM or cardiovascular disease respectively, over the next 10 years.

Resumen: Objetivo: Examinar las tendencias en la prevalencia del síndrome metabólico (SM) y de sus componentes. Material y métodos: Se analizaron datos de 27 800 adultos mexicanos que participaron en las Ensanut 2006, 2012, 2016 y 2018. Se utilizó regresión lineal en cada periodo de Ensanut para evaluar las tendencias lineales temporales en la prevalencia del SM. Se obtuvieron modelos de regresión logística para calcular el cambio porcentual, P para la tendencia y las asociaciones entre la SM con el riesgo de desarrollar en 10 años diabetes mellitus tipo 2 utilizando la Finnish Diabetes Risk Score (FINDRISC) y enfermedad cardiovascular utilizando Globorisk. Resultados: La prevalencia de SM en adultos mexicanos según la definición armonizada fue: 40.2, 57.3, 59.99 y 56.31%, en 2006, 2012, 2016 y 2018 respectivamente (p para tendencia <0.0001). En 2018, 7.62% de los casos de síndrome metabólico tenían un riesgo significativo de DM2 incidente y 11.6% de ECV. Conclusión: Se estima que los adultos mexicanos con síndrome metabólico son 36.5 millones; de ellos, dos millones tienen un alto riesgo de desarrollar DMT2 en los próximos 10 años y 2.5 millones enfermedades cardiovasculares.

https://doi.org/10.21149/12835

Precision Medicine for Metabolic Disorders in Low - and Middle - Income Countries: Areas of Opportunity and Challenges for the Future
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Tusié-Luna, María T.

; Aguilar-Salinas, Carlos A.

Revista de investigación clínica

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oct 2021, Volume 73 N. 5 Pages 316 - 320

Abstract: En | Text: En | PDF: En

The purpose of this perspective is to analyze the use of precision medicine and its potential for the next few decades with a special focus on the low- and middle-income countries, using diabetes as a paradigm. Precision medicine has improved the diagnosis, prevention, treatment, and prognosis of several malignant neoplasia. Furthermore, this approach is useful in the management of monogenic diabetes. However, its impact in the current practice for the majority of the cases of diabetes is quite limited. Precision medicine has not fulfilled the expectations because it implies a long-term process composed by several feedback loops, and a number of internal and external validations and calibrations to target specific populations. If we want to obtain the expected benefits, the academic community and science agencies should work together to create the budgets and infrastructure that warrant the transfer of knowledge to the whole of society.

https://doi.org/10.24875/ric.21000344 8 downloads

10.

La asociación entre la resistencia a la insulina y la rigidez arterial en pacientes mexicanos sin diabetes mellitus tipo 2
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Mehta, Roopa

; Antonio-Villa, Neftali E.

; Bello-Chavolla, Omar Y.

; Martagón, Alexandro J.

; Elias-López, Daniel

; Vargas-Vàzquez, Arsenio

; Gómez-Velasco, Donaji V.

; Almeda-Valdés, Paloma

; Muñoz-Hernández, Liliana

; Cruz-Bautista, Ivette

; Aguilar-Salinas, Carlos A.

Gaceta médica de México

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oct 2021, Volume 157 N. 5 Pages 539 - 547

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Introduction: Central aortic arterial stiffness (CAAS) is an independent cardiovascular risk factor. Insulin resistance (IR) contributes to CAAS-associated risk. Objective: To evaluate the association between IR and CAAS in a Mexican population without diabetes. Methods: IR was estimated with Homeostatic Model Assessment 2-Insulin Resistance (HOMA2-IR) and other surrogate markers (Metabolic score for IR [METS-IR], Quantitative Insulin Sensitivity Check Index [QUICKI], triglycerides/glucose index [TyG], TyG*body mass index [TyG*BMI] and triglycerides/high-density lipoprotein cholesterol ratio [TG/HDL-C]). CAAS was evaluated using carotid-femoral pulse wave velocity analysis (PWVcf) and the standardized augmentation index (AI-75). Bivariate correlations were made between surrogate markers and PWVcf. Increased CAAS was defined as PWVcf above the 90th percentile. Thresholds and area under the curve (AUC) were obtained for each surrogate marker in order evaluate their performance in estimating increased CAAS. Results: Three hundred and fifty-eight patients were included. A correlation was found between HOMA2-IR and PWVcf; this correlation was replicated with other surrogate markers. METS-IR and TyG*IMC had the highest degree correlation with PWVcf. When adjustments were made for covariables, the correlations with TyG*IMC, METS-IR, HOMA2-IR and QUICKI maintained significance. HOMA2-IR showed the strongest correlation with AI-75. METS-IR and TyG showed the best AUC. Patients with prediabetes had the highest PWVcf. Conclusions: The relationship between IR and CAAS is present before the onset of diabetes; this association may entail higher cardiovascular risk.

Resumen Antecedentes: La rigidez arterial central aórtica (RACA) es un factor de riesgo cardiovascular independiente. La resistencia a la insulina (RI) contribuye al riesgo asociado a RACA. Objetivo: Evaluar la asociación entre RI y RACA en una población mexicana sin diabetes. Métodos: La RI se estimó con HOMA2-IR y (Homeostatic Model Assessment 2-Insulin Resistance) otros subrogados (METS-IR [Metabolic score for IR], QUICKI [Quantitative Insulin Sensitivity Check Index], TyG [ratio triglicéridos/glucosa], TyG*IMC [TyG*índice de masa corporal] y TG/HDL [ratio TG/lipoproteínas de alta densidad]). Se evaluó la RACA mediante el análisis de velocidad de onda del pulso carotídeo-femoral (VOPcf) y el índice de aumentación estandarizado (AI-75). Se realizaron correlaciones bivariante entre los subrogados y la VOPcf. RACA aumentada se definió como VOPcf arriba del percentil 90. Se obtuvieron puntos de corte y área bajo la curva (ABC) para cada subrogado para estimar RACA aumentada. Resultados: Se incluyó 358 pacientes. Se encontró una correlación entre HOMA2-IR y VOPcf; esta correlación se replicó con los subrogados. METS-IR y TyG*IMC tuvieron el mayor grado de correlación con VOPcf. Al ajustar, las correlaciones con TyG*IMC, METS-IR, HOMA2-IR y QUICKI mantuvieron significancia. La correlación con AI-75 fue mayor para HOMA2-IR. METS-IR y TyG mostraron la mejor ABC. Los pacientes con prediabetes tuvieron mayor VOPcf. Conclusiones: La relación entre la RI y la RACA está presente desde etapas no diabéticas; esta asociación puede conllevar mayor riesgo cardiovascular.

https://doi.org/10.24875/gmm.21000177 44 downloads

11.

Bioethics in Medical Care Rationing During the Coronavirus Disease-19 Pandemic
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González-Duarte, Alejandra

; Kaufer-Horwitz, Martha

; Gamba, Gerardo

; Rivera-Moscoso, Raúl

; Aguilar-Salinas, Carlos A.

Revista de investigación clínica

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feb 2021, Volume 73 N. 1 Pages 1 - 5

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Coronavirus (CoV) disease (COVID)-19 poses difficult situations in which the ethical course of action is not clear, or choices are made between equally unacceptable responses. Methods: A web search was performed using the terms “bioethics; COVID-19; ethics; severe acute respiratory syndrome CoV-2; emergent care; pandemic; and public health emergencies.” Results: Protection from COVID-19 has resulted in the cancellation of necessary medical interventions, lengthened suffering, and potential non-COVID-19 deaths. Prolonged lockdown reduced well-being, triggering or aggravating mental illnesses and violence, and escalated medical risks. Collateral damage includes restrictions on visitations to hospitals, alienation from the deceased relative, or lack of warm caring of patients. Finally, in a public health crisis, public health interest overrides individual rights if it results in severe harm to the community. Conclusion: Balancing ethical dilemmas are one more challenge in the COVID-19 pandemic. (REV INVEST CLIN. 2021;73(1):1-5)

https://doi.org/10.24875/ric.20000385 258 downloads

12.

Implicaciones clínicas del retorno al trabajo durante la pandemia
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Aguilar Salinas, Carlos A

Salud Pública de México

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feb 2021, Volume 63 N. 1 Pages 147 - 148

Abstract: Es | Text: Es | PDF: Es

https://doi.org/10.21149/12368 6 downloads

13.

Sustratos alternativos para la producción de plántulas de tomate de cáscara (Physalis ixocarpa Brot.) en Chiapas
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Caballero-Salinas, Juan Carlos

; Ovando-Salinas, Sindy Guadalupe

; Núñez-Ramos, Erasmo

; Aguilar-Cruz, Fabián

Siembra

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dec 2020, Volume 7 N. 2 Pages 14 - 21

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract The present project aimed to evaluate the effect of different alternative substrates during the emergence and growth of Physalis ixocarpa Brot. obtained in root trays, under shadow mesh conditions. The research took place in Cintalapa, Chiapas. The substrates employed were T1 cosmopeat as master sample, T2 earthworm humus, T3 sawdust of Pinus Oocarpa and T4 compost. The treatments were stablished with a completely random design with four repetitions, sowing 50 seeds for each repetition in unicel trays. The variables of this study were analyzed by median comparison (𝑝 ≤ 0.05), with statistics software MENU® version 5.1. The treatments with a higher percentage of emergence were those where cosmopeat, earthworm compost and sawdust were used. According to the morphological parameters, the control was the one that presented the maximum values in most of the evaluated variables. Nevertheless, from the alternative substrates, the earthworm humus was above the general median in 8 of the 9 studied variables and in four cases was statistically equal to cosmopeat, thus making it possible to be considered as an alternative substrate for tomato plants production. Regarding the other two substrata, it is important to consider porosity of the compost and the amount of macro and micronutrients in sawdust to obtain better results in future research.

Resumen El presente trabajo tuvo como objetivo evaluar el efecto de distintos sustratos alternativos en la emergencia y crecimiento de Physalis ixocarpa Brot. obtenidos en cepellón, bajo condiciones de malla sombra. La investigación se llevó a cabo en el municipio de Cintalapa, Chiapas. Los sustratos empleados fueron T1 cosmopeat usado como testigo, T2 humus de lombriz, T3 aserrín de Pinus oocarpa y T4 composta. Los tratamientos se establecieron bajo un diseño completamente al azar con cuatro repeticiones, sembrándose 50 semillas por cada repetición en bandejas de unicel. Las variables de estudio fueron sometidas a un análisis de comparación de medias (𝑝 ≤ 0,05), con el paquete estadístico MENU® versión 5.1. Los tratamientos con mayor porcentaje de emergencia fueron aquellos donde se empleó cosmopeat, lombricomposta y aserrín. De acuerdo con los parámetros morfológicos, el testigo presentó los valores máximos en la mayoría de las variables evaluadas. No obstante, de los sustratos alternativos el humus de lombriz obtuvo resultados por encima de la media general en ocho de las nueve variables y en cuatro fue estadísticamente igual al cosmopeat (capacidad de emergencia, número de hojas, peso fresco y seco de la plúmula), por lo que puede ser considerado como un sustrato alternativo para la producción de plántulas de tomate. En cuanto a los otros dos sustratos es importante considerar el efecto de la porosidad en la composta y la cantidad de macro y micronutrientes en el aserrín para obtener mejores resultados en investigaciones futuras.

https://doi.org/10.29166/siembra.v7i2.1916 42 downloads

14.

Perfiles poblacionales asociados con la asistencia a servicios preventivos para tamizaje de diabetes e hipertensión. Ensanut 2018-19
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Villalobos, Aremis

; Aguilar-Salinas, Carlos A

; Romero-Martínez, Martín

; Rojas-Martínez, Rosalba

Salud Pública de México

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dec 2020, Volume 62 N. 6 Pages 754 - 766

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract: Objective: We describe the profile of the population aged 20 years and over, who go for a diabetes and hypertension screening test. Materials and methods: Based on the information from Ensanut 2018-19, two multiple logistic regression models were obtained with variables associated with the detection of diabetes and hypertension. Profiles were generated based on combinations of the variables included in the model. Increases in probabilities were plotted according to profiles. Results: Individuals with a family history of the disease, comorbidities or unhealthy lifestyles composed the group that seek for diabetes and hypertension screening. Conclusions: The health system should look for those with the highest risk of developing or having undiagnosed diabetes and hypertension, using risk questionnaires, type score. This population should undergo screening studies and, where appropriate, diagnoses.

Resumen: Objetivo: Presentar el perfil de la población de 20 años o más que acude a realizarse una prueba de detección de diabetes y de hipertensión. Material y métodos: Con información de la Encuesta Nacional de Salud y Nutrición 2018-19, se obtuvieron dos modelos de regresión logística múltiple con variables asociadas con la detección de diabetes e hipertensión. Se generaron perfiles basados en combinaciones de las variables incluidas en el modelo. Se graficaron los incrementos de las probabilidades de acuerdo con los perfiles. Resultados: La población cuyas probabilidades predichas son las más altas para acudir a detección corresponde a adultos con antecedente familiar de la enfermedad, con comorbilidad asociada y estilos de vida poco saludables. Conclusiones: El sistema de salud debe buscar personas con el mayor riesgo de desarrollar o tener diabetes e hipertensión sin diagnóstico, mediante cuestionarios de riesgo tipo score. A esta población se les deberán hacer estudios de tamizaje y, en su caso, diagnósticos.

https://doi.org/10.21149/11556 31 downloads

15.

Bioethics in the COVID-19 Pandemic Research: Challenges and Strategies
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González-Duarte, Alejandra

; Kaufer-Horwitz, Martha

; Aguilar-Salinas, Carlos A.

Revista de investigación clínica

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oct 2020, Volume 72 N. 5 Pages 265 - 270

Abstract: En | Text: En | PDF: En

As all other aspects in times of the coronavirus disease (COVID)-19 pandemic, carrying-out quality clinical research has been challenging. Many well-established paradigms have shifted as a consequence of the rapid demand for new knowledge. New treatments are fast-moving, informed consent forms are difficult to obtain, a competitive invitation from researchers to participate in different studies is common, and non-COVID-19 research protocols are suffering continuity. However, these challenges should not imply taking shortcuts or accepting deficiencies in bioethical standards, but rather enhance the alertness for rigorous ethical approaches despite these less than ideal circumstances. In this manuscript, we point out some interrogates in COVID-19 research and outline possible strategies to overcome the difficult task to continue with high-quality research without violating the ethical principles. (REV INVEST CLIN. 2020;72(5):265-70)

https://doi.org/10.24875/ric.20000258 343 downloads

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