Alfredo de Jesús Celis de la Rosa

Weight, Physical Activity, and Smoking as Determinants of Insulinemia in Adolescents

BACKGROUND It is known that insulinemia is the result of the interaction among several factors, such as weight, body fat pattern distribution, and physical activity as well as ethnicity. There is little information regarding this question among Mexican adolescents. The association among fasting insulin levels, weight, fat distribution, physical activity, and cigarette smoking was studied in Mexican adolescents. METHODS Cross-sectional data were collected from 352 Mexican adolescents aged 14-19 years (response rate 41.5%). Fasting insulin levels were measured by microparticle enzyme immunoassay; body mass index (BMI), waist-to-hip ratio (WHR), and waist circumference (WC) were determined using standardized techniques, while physical activity was determined by 7-day Stanford physical activity inventory. Cigarette smoking was defined as number of cigarettes/year. RESULTS Increased BMI and waist circumference, low physical activity, younger age, and non-smoking were associated with high insulin levels. Non-smokers had higher fasting insulin levels compared to smokers (57.8 pmol +/- 1.84 vs. 49.7 pmol/L +/- 2.8; p = 0.034). However, adjusted odds ratio (OR) between insulin and smoking status was not significant. Multivariate analysis showed the following: insulin increased 1.06 pmol/L for each unit of change in BMI; increased 1.02 pmol/L for each unit of change in waist circumference; increased 1.16 pmol/L for non-smoking, and decreased 1.07 pmol/L for each 250 kcal/day of energy expenditure. CONCLUSIONS Our results support the concept that Mexican adolescents who are overweight have abdominal fat distribution and physical inactivity, and significant hyperinsulinemia. The relationship between smoking and lower insulinemia found in this research warrants further study.

Interaction between mercury (Hg), arsenic (As) and selenium (Se) affects the activity of glutathione S-transferase in breast milk: possible relationship with fish and shellfish intake

Breast milk is regarded as an ideal source of nutrients for the growth and development of neonates, but it can also be a potential source of pollutants. Mothers can be exposed to different contaminants as a result of their lifestyle and environmental pollution. Mercury (Hg) and arsenic (As) could adversely affect the development of fetal and neonatal nervous system. Some fish and shellfish are rich in selenium (Se), an essential trace element that forms part of several enzymes related to the detoxification process, including glutathione S-transferase (GST). The goal of this study was to determine the interaction between Hg, As and Se and analyze its effect on the activity of GST in breast milk. Milk samples were collected from women between day 7 and 10 postpartum. The GST activity was determined spectrophotometrically; total Hg, As and Se concentrations were measured by atomic absorption spectrometry. To explain the possible association of Hg, As and Se concentrations with GST activity in breast milk, generalized linear models were constructed. The model explained 44% of the GST activity measured in breast milk. The GLM suggests that GST activity was positively correlated with Hg, As and Se concentrations. The activity of the enzyme was also explained by the frequency of consumption of marine fish and shellfish in the diet of the breastfeeding women.

Contaminantes atmosféricos y su correlación con infecciones agudas de las vías respiratorias en niños de Guadalajara, Jalisco

Objective: To describe the correlation between the concentration levels of atmospheric air pollutants and the number of medical visits to IMSS, ISSSTE and of SSJ healthcare facilities of the Urban Area of Guadalajara between 20002002 by children under five years suffering from acute respiratory infections. Material and Methods: An ecological study was performed to describe the correlation between the interpolated monthly average modes, monthly mobile average of air pollutants: carbon monoxide, nitrogen dioxide, ozone, and particles with an aerodynamic diameter of less than 10 microns (PM 10 ) and sulfur dioxide, and the number of medical visits per month due to acute respiratory infections in children under five years. Results: The air pollutants: carbon monoxide and nitrogen dioxide show a significant correlation with the incidence of acute respiratory infections in children less than five years of age in the Urban Area of Guadalajara. The correlation coefficients were: CO (r= 0.05) and NO 2 (r= 0.09). Conclusions: Although the concentrations of air pollutants stay below the official limit, carbon monoxide and nitrogen dioxide affect the health of the child population of the Urban Area of Guadalajara. Although the monthly average mode and monthly mobile average does not exceed the established legislation, the registered maximums do exceed it; this indicates that although throughout most of the day there is no latent risk of popu

Incremento de la temperatura ambiental y su posible asociación al suicidio en Baja California Sur (BCS) 1985-2008

Introduccion. Durante las ultimas decadas se ha podido apreciar un cambio en las variables climaticas, en especial en la temperatura ambiental. Hay evidencias que asocian el aumento de la temperatura ambiental con el incremento en las tasas de mortalidad por suicidio. Objetivo. Evaluar la relacion entre la tasa de suicidio y la temperatura ambiental en Baja California Sur (BCS) durante los anos 1985-2008. Metodo. Los datos de suicidio fueron obtenidos de las bases de Mortalidad del INEGI de 1985-2008. Se tabularon los registros con codigos: E950-E959 CIE-9 y X60-X84, Y87.0 CIE-10 para BCS. En el analisis climatico se usaron las temperaturas maximas de 1985 al 2008 para BCS del Extractor Rapido de Informacion Climatologica (ERIC III). Para evaluar la tendencia, se utilizaron modelos de regresion lineal y cuadraticos. Los modelos lineales generalizados (GLM) se utilizaron para evaluar el efecto de las variables ambientales sobre la tasa de suicidios, con una significancia de p=0.05. Resultados. Un total de 582 suicidios ocurrieron en BCS de 1985 a 2008. Las mujeres representaron el 9% (53), con tasa anual promedio de 1.6/100 000. Los hombres 91% (529), con tasa promedio anual de 16.3/100 000. La tendencia de incremento anual se explico con modelos lineales simples y cuadraticos en ambas temporadas. En los meses calidos el modelo cuadratico explico mejor dicho incremento (R2=0.64 p<0.01). La temperatura se correlaciono positivamente con la tasa en ambas temporadas (p<0.01). Se generaron dos modelos GLM predictivos por temporada. Discusion. En este trabajo se observo una posible relacion entre el incremento de la temperatura ambiental y el numero de suicidios registrados durante 24 anos en BCS. Esta relacion se encuentra bien definida en los meses calidos, pero con una tendencia en aumento para los meses frios.

Bacteriemia relacionada con catéter venoso central: incidencia y factores de riesgo en un hospital del occidente de México

BACKGROUND Central venous catheters (CVC) are needed for monitoring and treatment of critically ill patients; however, their use increases the risk of bacteremia. The aim of the study was to quantify the incidence of central venous catheter-related bacteremia (CVCRB) and to identify factors associated with this infection. METHODS A prospective cohort study was conducted in a concentration hospital of western Mexico. The association of CVCRB and study variables was investigated using multivariate Cox regression analysis. RESULTS Two hundred four patients with CVC were studied. The average age was 4.6 years; 66.2% were male. Insertion sites of the catheters were subclavian vein 72.5% (n = 148), jugular vein 20.1% (n = 41) and femoral vein 7.4% (n = 15). CVCRB incidence was 6.5 events/1,000 catheter days; microorganisms identified were gram-positive cocci 37.5% (n = 6), gram-negative bacilli 37.5% (n = 6) and Candida albicans 25% (n = 4). It was observed that the increase in catheter manipulations per day was associated with bacteremia (HR 1.14, 95% CI 1.06 - 1.23), whereas the use of intravenous antibiotics showed a protective effect (HR 0.84, 95% CI 0.76-0.92). CONCLUSIONS In addition to strategies of maximum caution when placing or manipulating the catheter, we recommend decreasing, as much as possible, disconnects between the CVC and infusion line. Antibiotics showed a protective effect, but the outcome is uncertain and promotion of antimicrobial resistance should be considered.

Central venous-catheter related bacteremia: incidence and risk factors in a hospital in western Mexico☆

Abstract Background Central venous catheters (CVC) are needed for monitoring and treatment of critically ill patients; however, their use increases the risk of bacteremia. The aim of the study was to quantify the incidence of central venous catheter-related bacteremia (CVCRB) and to identify factors associated with this infection. Methods A prospective cohort study was conducted in a concentration hospital of western Mexico. The association of CVCRB and study variables was investigated using multivariate Cox regression analysis. Results Two hundred and four patients with CVC were studied. The mean age was 4.6 years; 66.2% were male. Insertion sites of the catheters were subclavian vein 72.5% (n = 148), jugular vein 20.1% (n = 41) and femoral vein 7.4% (n = 15). CVCRB incidence was 6.5 events/1,000 catheter-days; microorganisms identified were gram-positive cocci 37.5% (n = 6), gram-negative bacilli 37.5% (n = 6) and Candida albicans 25% (n = 4). It was observed that the increase in catheter manipulations per day was associated with bacteremia (HR 1.14, 95% CI 1.06–1.23), whereas the use of intravenous antibiotics showed a protective effect (HR 0.84, 95% CI 0.76–0.92). Conclusions In addition to the strategies of maximum caution when placing or manipulating the catheter, we recommend decreasing, as much as possible, disconnects between the CVC and the infusion line. Antibiotics showed a protective effect, but the outcome is uncertain and the promotion of antimicrobial resistance should be considered.

Effect of symbiotic supplementation on fecal calprotectin levels and lactic acid bacteria, Bifidobacteria, Escherichia coli and Salmonella DNA in patients with cervical cancer

BACKGROUND patients with cervical cancer (CC) receiving chemotherapy and radiotherapy have several gastrointestinal adverse effects. OBJECTIVE to evaluate the effect of dietary symbiotic supplementation on fecal calprotectin (FCP), bacterial DNA levels, and gastrointestinal adverse effects in patients with CC. METHODS clinical, controlled, randomized, double-blind trial. Patients consumed symbiotics or placebo three times a day for seven weeks. FCP was assessed by Elisa method. DNA from probiotic and pathogenic bacteria were determined by quantitative real-time polymerase chain reaction. Diarrheal evacuations were evaluated with the Bristol stool form scale and nausea and vomiting were measured using the scale of the National Institute of Cancerology of the United States. RESULTS after a seven-week treatment, FCP concentration was lower in the symbiotic group compared to the control group (p < 0.001). Stool consistency in the placebo and symbiotic groups was similar at baseline. A significant improvement in stool consistency was obtained in both groups at the end of the intervention (p < 0.001). The concentrations and total proportions of the probiotic and pathogenic bacteria were similar in both groups. Nausea significantly diminished in both groups (p < 0.001) at the end of the trial. Furthermore, the symbiotic group had a statistically significant decrease in the frequency and intensity of vomiting when compared to the control group (p < 0.001). CONCLUSIONS the symbiotic treatment decreases significantly the FCP levels and the frequency and intensity of vomiting in patients with CC.

Efficacy of Symbiotics in an Experimental Model of Endotoxic Shock Induced by Lipopolysaccharide from Escherichia Coli

Obsevation: Endotoxic shock is a life-threatening condition and its sequelae represent an array of clinical symptoms that encompass systemic inflammation, coagulopathy, and abnormalities of the renal, hepatic, pulmonary and hematologic systems, followed by multi-organ failure. Furthermore, systemic failure leads to an unfavorable environment in the gut that causes an imbalance in the homeostasis of intestinal microbiota. In the present study, the effect of symbiotics as adjuvant therapy in endotoxic shock was investigated. Adult male Wistar rats were randomized into three groups: Control group received a single intraperitoneal injection of physiological saline solution, and the other two groups received either a symbiotic formulation or a placebo daily, for one week, followed by the administration of a single lethal dose of lipopolysaccharide (LPS) from E. coli (20 mg/Kg, IP). Results: The symbiotic formulation used improved the survival rate of LPS-treated rats, ameliorated the clinical symptomatology, reduced the production of serum proinflammatory cytokines (TNF-α, IL-6, IL-1β), and preserved the mitochondrial membrane fluidity and ATPase activity. Conclusion: The symbiotic formulation used as a pre-treatment in this experimental model, reduced mortality and showed beneficial effects at the systemic and sub-cellular levels. *Corresponding author: Dr. Genaro Gabriel Ortiz, DevelopmentAging Laboratory, Neurodegenerative diseases, Division of Neurosciences, CIBO-IMSS, Sierra Mojada 800 CP 44340. Guadalajara, Jalisco, Mexico, Tel: (0133) 2015 3651; E-mail: genarogabriel@yahoo.com Received Date: April 13, 2016 Accepted Date: June 06, 2016 Published Date: June 09, 2016

Perfil epidemiológico de niños con quemaduras del Hospital Civil de Guadalajara Dr. Juan I. Menchaca, 2009-2011

BACKGROUND Burns are a public health problem, ranking among the 20 principal causes of morbidity in Mexico. Children are a more vulnerable group to suffer from these injuries. For that reason, we analyzed cases in order to gain a better comprehension and to propose preventive measures for this problem. The aim of the study was to determine the epidemiological profile of those injuries to allow us to plan and implement actions for burn prevention. METHODS We conducted a cross-sectional study that included demographic characteristics of the child, the parents and the burn injuries from children treated at this Burn Unit. Statistical analysis was done to calculate amounts, proportions and 95% confidence intervals. RESULTS The epidemiological profile of the injuries included males (63.4%) <5 years of age (65.2%) with educational level according to their age (56.2%). Parents of the included children were <35 years old with basic educational level. Burns were caused by hot water (56.2%) and occurred between noon and midnight (73.0%). The majority of the burns were shallow and deep second-degree or minor (69.2%) and affected <20% of body surface area (74.5%). CONCLUSIONS This epidemiological profile paved the way for preventive actions beginning with scientific research to guide the actions in a progressive direction along with the cooperative actions of public and private institutions in the development of programs and strategies. The end result would be the establishment of a public policy for accidental injuries.

Efecto de la interacción entre Mercurio (Hg), Arsénico (As) y Selenio (Se) en la actividad de glutatión S-Transferasa en leche materna: potencial relación con el consumo de pescados y mariscos

Breast milk is regarded as an ideal source of nutrients for the growth and development of neonates, but it can also be a potential source of pollutants. Mothers can be exposed to different contaminants as a result of their lifestyle and environmental pollution. Mercury (Hg) and arsenic (As) could adversely affect the development of fetal and neonatal nervous system. Some fish and shellfish are rich in selenium (Se), an essential trace element that forms part of several enzymes related to the detoxification process, including glutathione S-transferase (GST). The goal of this study was to determine the interaction between Hg, As and Se and analyze its effect on the activity of GST in breast milk. Milk samples were collected from women between day 7 and 10 postpartum. The GST activity was determined spectrophotometrically; total Hg, As and Se concentrations were measured by atomic absorption spectrometry. To explain the possible association of Hg, As and Se concentrations with GST activity in breast milk, generalized linear models were constructed. The model explained 44% of the GST activity measured in breast milk. The GLM suggests that GST activity was positively correlated with Hg, As and Se concentrations. The activity of the enzyme was also explained by the frequency of consumption of marine fish and shellfish in the diet of the breastfeeding women.