A.L. Salcedo-Rocha

Enfermedades metabólicas maternas asociadas a sobrepeso y obesidad pregestacional en mujeres mexicanas que cursan con embarazo de alto riesgo

INTRODUCTIONnPre-pregnancy obesity has been proposed as a risk factor related to gestational diabetes and hypertensive disorders during pregnancy.nnnOBJECTIVESnIdentify pregnancy related diseases associated with pre-pregnancy obesity as a risk factor ina high risk preganancy patient population.nnnMETHODSn600 patients whose pre-pregnancy obesity had been assessed as a high risk factor were included in the study. The means, standard deviation, median, interquartile intervals, Pearson and Spearman correlation and logistic regression to estimate risk with the odds ratio and 95% confidence intervals were calculated.nnnRESULTSnThe mean pre-pregnancy body mass index was 29.59 ± 6.42 kg/m2. The mean for recommended pregnancy weight gain was 2.31 ± 1.03 kg, but the mean of real weight gain was 8.91 ± 6.84 kg. A significant correlation between pre-pregnancy obesity and family history of diabetes mellitus (p=0.000), systemic hypertension (p=0.003), cardiac diseases (p=0.000), dyslipidemia (p=0.000) and obesity (p=0.000) was identified. Pre-pregnancy obesity was identified as a risk factor for the development of gestational diabetes (OR: 1.95; IC95%: 1.39 to 2.76; p=0.000) in this kind of patient.nnnDISCUSSION AND CONCLUSIONn75% of high risk pregnancy women in a high specialty hospital in West Mexico are overweight or obese when they become pregnant. These are risk factors in the development of gestational diabetes.

The seasonality variation plays an important role for increasing the uncontrolled type 2 diabetes

Dear Sir For México, type 2 diabetes mellitus (T2DM) represents a growing health problem. In 2000, adult’s prevalence was 5.7 and 9.1 % in 2012 [1], a situation that alters the finances of our medical institutions [2]. In other hand, the seasonal variations is well known to exist within components of metabolic syndrome such as glycemias [1], which were significantly higher in winter, attributed by multiple causes: season checkups, low temperature, affective disorder, etc. Evolution explains elude fluctuating patterns of food availability and physical activity. Adults gain weight for holiday periods or specific seasons, due to increased calories intake or decrease calories expenditure or both. In Mexico, holidays are accumulated in the “winter season,” beginning with the Day of the faithful dead persons (November 2), Mexican Revolution (November 20), Our Lady Guadalupe (December 12), “Posadas” period (December10-23), Christmas (December 25), New Year, Epiphany (January 6), and the three wise men day (February 2), periods that co-exist with food. We collected during 2011–2012, from the largest social security family clinic in Guadalajara. City, 9017 routinely control glycaemias of all T2DM patients (2319 people) solicited by a physician at a laboratory and the temperature monthly data from the Institute of Meteorology from the University of Guadalajara. We applied a curvilinear regression, for glycaemias and temperatures (r=0.567, p=0.023) and a non parametric rank sum criterion of Hewitt [3] that show significant seasonality for the winter period (∑=55: p=0.004). But, Guadalajara has not a true cold season (24.4–15.3 °C) We believe that in this significant variation, the role that the socio-cultural factors play in our developing countries has more weight, than physical factors, and are linked principally at traditional and modern holidays that integrate and give meaning at the social identity, when more food availability exist [4]. In low-income populations, the holiday-food require special focus and consideration due to the vulnerability of these populations and the specific aspects of each setting [4]. In result of this seasonality, we suggest to establish surveillance, educational programs, holistic preventive attention, and extra-institutional support, depending on the culture of population, for reversing eating habits as a problem of gastroanomie An integrative approach to the study of the mechanisms underlying responses is required for provide effective tools with which to control of diabetes during Holliday periods.

Impact of Early Microbiologic Culture in the Economic Burden of Care for Patients With Infected Diabetic Foot Ulcers At A Model Of Secondary Level Imss' Hospitals in Mexico

1 Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social; 2 Unidad Médica de Alta Especialidad Hospital de Gineco-Obstetricia, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social; 3 Departamento de Morfología, División de Disciplinas Básicas para la Salud, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara; 4 Programa de Posgrado de la Maestría en Administración de Negocios, Centro Universitario de Ciencias Económico Administrativas, Universidad de Guadalajara; 5 Unidad de Investigación Social Epidemiológica y en Servicios de Salud, Delegación Estatal Jalisco, Instituto Mexicano del Seguro Social; 6 Admisión Médica Continua, Hospital General de Zona No. 42, Delegación Estatal Jalisco, Instituto Mexicano del Seguro Social; 7 Laboratorio de Biología Molecular, Departamento de Farmacobiología, División de Ciencias Básicas, Centro Universitario de Ciencias Exactas e Ingenierías, Universidad de Guadalajara; 8 División de Educación e Investigación en Salud, Hospital General Regional No. 46, Delegación Estatal Jalisco, Instituto Mexicano del Seguro Social.

Health Related Quality of Life and Patient Satisfaction in Colorectal Cancer Patients Treated Through Radical Surgery in Curative Intent in a Colo-Proctology Clinical Department

1 UMAE Hospital de Especialidades Centro Medico Nacional de Occidente IMSS, Guadalajara, Jalisco, Mexico, 2 UMAE Hospital de Gineco-Obstetricia Centro Medico Nacional de Occidente IMSS, Guadalajara, Jalisco, Mexico, 3 UMAE HE Centro Medico Nacional de Occidente Instituto Mexicano del Seguro Social, Guadalajara, Mexico, 4 Universidad de Guadalajara, Guadalajara, Jalisco, Mexico, 5 Delegacion Jalisco IMSS, Guadalajara, Jalisco, Mexico

EORTC QLQ-C30 questionnaire role as predictor for malnutrition risk in head and neck cancer Mexican patients

INTRODUCTIONnHead and neck cancer treatment restricts oral intake and conditioning malnutrition. Adequate nutritional support during treatment can limit the impact of side effects.nnnOBJECTIVEnTo describe EORTC QLQ-C30 role for malnutrition risk screening in head and neck cancer patients.nnnMETHODSnAnalytical and cross-sectional, diagnostic test study in head and neck cancer patients. We correlated malnutrition diagnosis with subjective global assessment (SGA) and score for the EORTC QLQ-C30 scales with Pearson and Spearman correlation. We realized COR (Receiver Operating Characteristic) curves to calculate cut point in the score for the EORTC QLQ-C30 scales; we calculated sensitivity, specificity, positive predictive value, negative predictive value and Odds Ratio through logistic regression.nnnRESULTSnFunctional scales (role, physic, global health status/QoL) showed limited utility to malnutrition risk estimation in people with head and neck cancer. Symptoms scales with strong association were: pain (sensitivity 76.47%, specificity 69.23%), insomnia (sensitivity 88.24%, specificity 53.85%), fatigue (sensitivity 70.59%, specificity 76.92%).nnnCONCLUSIONSnEORTC QLQ-C30 questionnaire is a useful tool to early malnutrition diagnosis in head and neck cancer patients with short term results in nutritional condition, treatment response and a better QoL in this kind of patients.