María de Jesús Orozco-Valerio

Validation of a Mexican food photograph album as a tool to visually estimate food amounts in adolescents

The aim of the present study was to validate a food photograph album (FPA) as a tool to visually estimate food amounts, and to compare this estimation with that attained through the use of measuring cups (MC) and food models (FM). We tested 163 foods over fifteen sessions (thirty subjects/session; 10-12 foods presented in two portion sizes, 20-24 plates/session). In each session, subjects estimated food amounts with the assistance of FPA, MC and FM. We compared (by portion and method) the mean estimated weight and the mean real weight. We also compared the percentage error estimation for each portion, and the mean food percentage error estimation between methods. In addition, we determined the percentage error estimation of each method. We included 463 adolescents from three public high schools (mean age 17·1 (sd 1·2) years, 61·8 % females). All foods were assessed using FPA, 53·4 % of foods were assessed using MC, and FM was used for 18·4 % of foods. The mean estimated weight with all methods was statistically different compared with the mean real weight for almost all foods. However, a lower percentage error estimation was observed using FPA (2·3 v. 56·9 % for MC and 325 % for FM, P< 0·001). Also, when analysing error rate ranges between methods, there were more observations (P< 0·001) with estimation errors higher than 40 % with the MC (56·1 %), than with the FPA (27·5 %) and FM (44·9 %). In conclusion, although differences between estimated and real weight were statistically significant for almost all foods, comparisons between methods showed FPA to be the most accurate tool for estimating food amounts.

Tendencia de la mortalidad a consecuencia de asfixia por inmersión en México, 1979-2005

OBJECTIVE To examine the trends in mortality from drowning in Mexico and each of its federal states during the period from 1979-2005. METHODS Mortality rates and trends were estimated for the study period from Mexicos official data based on the International Classification of Diseases, 9th and 10th revisions. Results were analyzed by age group, sex, and year registered, as well as by state and size of city or town of residence. RESULTS From 1979-2005, there were 107 319 deaths by drowning registered. The mortality from drowning rate decreased 65.31% (from 6.58 per 100 000 inhabitants in 1979-1981 to 2.28 per 100 000 inhabitants in 2003-2005). This decrease was evident in all the age groups (ranging from 68.10% among 5-9 year olds to 54.30% among 1-4 years) and by state (ranging from 87.19% in Colima to 36.58% in Nayarit). During the three-year period from 2003-2005, drowning mortality was relatively greater among men and boys than among women and girls (rate: 5.46 (95%CI: 5.15-5.80); among the age groups 1-4 years (4.27 per 100 000) and 60 years or older (3.37 per 100 000 inhabitants); in the Tabasco state (5.92 per 100 000 inhabitants); and among towns with fewer than 2 499 inhabitants (4.03% per 100 000 inhabitants). CONCLUSIONS In Mexico, the drowning mortality drowning rate is on a downward trend, although it remains a serious public health problem. Intensified efforts are needed to harness information regarding accidentals death from this cause, both from the epidemiological surveillance angle as well as through the implementation of eradicating interventions.

Competencia clínica de médicos mexicanos de atención primaria para manejar osteoporosis

aDepartamento de Salud Pública, División de Disciplinas para el Desarrollo, Promoción y Preservación de la Salud, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México. Recibido: 13-febrero-2017. Aceptado: 8-agosto-2017. *Autor para correspondencia: Marco Antonio Zavala González. Sierra Mojada 950, Puerta 1, Edificio N, Planta Alta, Colonia Lomas de Independencia, Guadalajara, Jalisco, México, C.P. 44240. Resumen Introducción: Al menos 21 millones de personas tienen osteoporosis en México, donde se ha evidenciado desconocimiento de los médicos de atención primaria sobre esta enfermedad, pero no se han evaluado mediante instrumentos apropiados las competencias clínicas para el manejo de esta. Objetivo: Evaluar la competencia clínica de una muestra de médicos mexicanos de atención primaria para el diagnóstico y tratamiento de la osteoporosis. Método: Estudio transversal en una muestra de 5 de 23 unidades médicas familiares del Instituto Mexicano del Seguro Social en Jalisco, México. Se diseñó y validó un instrumento que evalúa la competencia clínica en cinco dimensiones: identificación de factores de riesgo, identificación de datos clínicos, interpretación de pruebas

100 years of weight loss surgery: Voluntary weight loss, involuntary bone loss

Methods: A sample of 100 participants with a body mass index (BMI) above 25kg/m2 was asked to complete a questionnaire which included socio-demographic data and perceptions about their weight. The study was approved by the Biomedical Research Ethics Committee at the University of KwaZulu-Natal, South Africa. The participants were recruited from a peri-urban general practice situated in the north of Durban, South Africa.L sleeve gastrectomy (LSG) is gaining acceptance among bariatric surgeons as a viable option for treating morbidly obese patients. We describe results of a single surgeon’s experience with LSG, its intra-operative, early and late complications and their management. We retrospectively reviewed the data of patients who underwent LSG from 2006 to 2015. Patients underwent LSG as a primary procedure or as revisional bariatric surgery. The short-term morbidity and mortality were examined. All patients entering our practice, requesting bariatric surgery, were offered three procedure options: laparoscopic gastric bypass, adjustable gastric banding, and LSG. After a one-on-one consultation with the surgeon, the patients made an informed decision to undergo LSG, and an informed consent was obtained. All patients were required to undergo a psychological screening, routine labs, electrocardiogram, upper gastrointestinal X-rays, pulmonary function studies, and a medical evaluation. All patients were scheduled for LSG as a primary definitive procedure. All patients received intravenous antibiotics, subcutaneous unfractionated heparin and sequential compression devices preoperatively. One-stage LSG was performed. The major complications were late leakage after 4 weeks, with hemorrhaging. Two patients required reoperation & one patient was treated conservatively. Furthermore, one patient had complete Dysphagia, and was treated conservatively. Moreover, one patient who had an injury to the lower esophagus was re-operated, intra-operatively. One patient had mesenteric injury; another patient had an NG tube stapled, while a third patient’s GE junction blew up because the balloon was inflated while doing the leak test. In addition, the serosal layer of ten patients came off while firing the first stapler. However, in spite of the presence of many such complications, only one case was aborted. In conclusion, LSG is a relatively safe surgical option for weight loss as a primary procedure.

737 Associated factors to severe injuries of Motorcyclists, Guadalajara Metropolitan Area and Zapotlanejo

Background Traffic events where motorcyclists are involved are a phenomenon increasingly frequent in Mexico. The use of less fuel and the practical to drive this vehicle makes the motorcycle a convenient mean of transport for a large sector of the population. For this reason, the objective is to analyse the associated factors to severe injuries of motorcyclists involved in traffic events in the Guadalajara metropolitan area and the municipality of Zapotlanejo in Jalisco, Mexico. Methods This is a cross-sectional study made to injured motorcyclists in the Guadalajara metropolitan area and the municipality of Zapotlanejo who were care in the Antiguo Hospital Civil de Guadalajara “Fray Antonio Alcalde”. The people selected were drivers or occupants of the motorcycle crashed, of any sex and age and the traffic event in what they were involved. A model of logistic regression was performed, which included the above variables with a p = <0.25. Results The risk factors for severe injuries were: the motorcycle does not work correctly before the accident (OR 76.89, 2.08–2839.25), the motorcyclist deemed to have committed a traffic violation at the time of the event (OR 6.88, 1.30–36.26), the injured resident in the Guadalajara metropolitan area (OR 7.58, 1.15–50.17), drive a motorcycle unknowing if was “salvage” or not (OR 6.88, 1.30–36.26). The factors that reduce the risk were: drive other motorcycle except Italika (OR 0.06, 0.008–0.41) and have had the crash in a straight road or in a crossroad (OR 0.10, 0.02–0.61). Conclusions There are elements of the motorcyclist, the motorcycle and the physical environment that increase or decrease injury severity of motorcyclists without health insurance. For this public health problem could be necessary promote and create more awareness about road safety in motorcyclists. Not only promote the use of helmet, require support other recommendations about motorcycle and physical environment.

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.

La invisibilidad de las condiciones laborales y de salud de niños del mercado Felipe Angeles

Objetivo Identificar las condiciones de trabajo y salud de los menores que trabajan en el mercado Felipe Angeles de la Ciudad de Guadalajara. Metodologia Se realizo un estudio descriptivo a 198 menores de 18 anos de edad que desempenaban alguna actividad laboral en dicho mercado. Se aplico una encuesta que incluia variables sociodemograficas de los menores, de condiciones del trabajo y de salud. Resultados Los menores de que laboran en este mercado son principalmente hombres (89,9 %) con edades de entre 6 a 17 anos, residentes de Guadalajara, 71 % asiste a la escuela. El 83 % de los ninos iniciaron sus actividades laborales en el mercado entre los 7 y 10 anos y 75 % de ellos llevan 1 ano o mas trabajando. La jornada laboral va de lunes a domingo en el 50 % de los casos. Los riesgos a la salud percibidos y presentados por los menores son lesiones durante la jornada laboral tales como abrasion, contusion, fracturas, atropellamiento; y las relacionadas con el aspecto psicosocial como son ser victimas de robo o ser sujetos vulnerables para iniciarse en la drogadiccion. Conclusiones Las condiciones de trabajo y salud en que laboran los menores no son adecuadas para su edad y afectan su desarrollo fisico y psicosocial, ya que el sitio donde trabajan tiene deficiencias en la estructura arquitectonica, les impide la realizacion de actividades propias de su edad y los somete a riesgos laborales para los que no existe prevencion.

Epidemiology of burns in children and adolescents in the Burns' Unit of Civil Hospital of Guadalajara

Introduction Burns are a problem in public health that occupies the third leading cause of injury in children worldwide. Objective Analyse the epidemiology of burns in children and adolescents in the Burns Unit of the Guadalajara Civil Hospital Dr Juan I Menchaca. Methodology This research is descriptive. Data were obtained through 118 patient clinical records and interviews with their family members from 1 November 2008 to 31 October 2009. The variables studied were: gender, age, injury mechanism, injury agent, degree of burn, place where it happened, place where first medical care was received and time to first medical care after injury. Results Male gender was three times as frequent as female gender in burns patients (70 vs 48), and also suffered the most severe injuries. The largest age group was the 0–2 years old (48.3% of cases). In the majority, the mechanism of injury was non-intentional. The most common agents were hot liquids (55.9%) and fire (28.0%). The most frequent locations were injury occurred was home, mainly in the kitchen. In 11.0% of patients receive their first medical care after 3:00. Conclusions The groups at highest risk were children under 3 years old and males; the most frequent burning agent were hot liquids; and the events occurred at home.