Asociación entre resistencia a la insulina y cáncer de mama en mujeres mexicanas

Tesis (Doctorado en Medicina) UANL, 2014.UANLhttp://www.uanl.mx

Ultrasound-guided umbilical venous catheterisation: A cost-effectiveness analysis

Introduction: Although the use of ultrasound for the insertion of central catheters has proven to be cost-effective in adults, it is not known if this is the case in the neonatal population. This study compared the cost-effectiveness of ultrasound-guided umbilical venous catheterisation with conventional catheterisation in a neonatal intensive care unit of a Public University Hospital. Patients and methods: A retrospective observational study was conducted on newborns that required an umbilical venous catheter before completing their first 24 h of extra-uterine life. Two retrospective cohorts were formed, including one with ultrasound-guided catheterisation and the other with conventional catheterisation. The effectiveness was measured using 2 variables: placement of ideal position and insertion without complications. The cost of human and material resources (consumable and non-consumable), the cost-effectiveness ratio, and the incremental cost-effectiveness ratio were estimated, as well as carrying out a sensitivity analysis. Results: Catheter obstruction was more frequent in guided catheterisation than in conventional catheterisation (7.7% vs. 0%, P = .04) and catheter dysfunction was higher in the latter (79% vs. 3.8%, P < .0001). The cost-effectiveness ratio of the guided catheterisation wa

Cateterización venosa umbilical guiada por ultrasonografía: un análisis de coste-efectividad

Introducción: El uso de ultrasonografía para la inserción de catéteres centrales ha mostrado ser coste-efectivo en adultos; en neonatos se desconoce esta información. El objetivo del estudio fue comparar el coste-efectividad de la cateterización venosa umbilical guiada por ultrasonografía con la cateterización convencional en un servicio de cuidados intensivos neonatales de un hospital universitario y público. Pacientes y métodos: Estudio observacional retrospectivo en recién nacidos que requirieron catéter venoso umbilical antes de cumplir las primeras 24 h de vida extrauterina; se conformaron 2 cohortes históricas, una con cateterización guiada por ultrasonografía y otra con cateterización convencional. La efectividad se midió con 2 variables: colocación de posición ideal e inserción sin complicaciones. Se estimó el coste de recursos humanos y materiales (fungibles y no fungibles), la razón coste-efectividad y la razón coste-efectividad incremental; y se realizó análisis de sensibilidad. Resultados: La obstrucción del catéter fue más frecuente en la cateterización guiada que en la convencional (7,7 vs. 0%, p = 0,04) y la disfunción del catéter fue superior en esta última (79 vs. 3,8%, p < 0,0001). La razón coste-efectividad de la cateterización guiada fue 153,9 euros y de la convencional 484,6 euros; la razón coste-efectividad incremental fue 45,5 euros. El análisis de sensibilidad incrementó 2,6 euros en la razón coste-efectividad de la cateterización guiada y 47 euros, en la convencional. Conclusiones: El uso de la ultrasonografía para guiar la cateterización umbilical es más eficienteya que, a pesar de suponer un mayor consumo de recursos económicos, ofreció una mayorefectividad

Cessation of Face Mask Use after COVID-19 Vaccination in Patients with Diabetes: Prevalence and Determinants

Studies on the cessation of face mask use after a COVID-19 vaccine in patients with diabetes are not available, despite their greater predisposition to complications. We estimated the prevalence of cessation of face mask use after receiving the COVID-19 vaccine in patients with diabetes and identified which factor was most strongly associated with non-use. This was a cross-sectional study in patients with diabetes 18&ndash;70 years with at least one dose of vaccine against COVID-19 (n = 288). Participants were asked to respond face-to-face to a questionnaire in a primary care center. Descriptive statistics, chi-square tests, and multivariate binary logistic regression were used for analyzing the association between vulnerability, benefits, barriers, self-efficacy, vaccine expectations (independent variables), and cessation of use (dependent variable), controlling for sociodemographic, smoking, medical, vaccine, and COVID-19 history. The prevalence of cessation of face masks was 25.3% (95% CI 20.2, 30.5). Not feeling vulnerable to hospitalization increased the odds of non-use (adjusted OR = 3.3, 95% CI 1.2, 8.6), while perceiving benefits did the opposite (adjusted OR = 0.4, 95% CI 0.2, 0.9). The prevalence was low, and only two factors were associated with the cessation of face mask use after COVID-19 vaccination in patients with type 2 diabetes

Cessation of Face Mask Use after COVID-19 Vaccination in Patients with Diabetes: Prevalence and Determinants

Studies on the cessation of face mask use after a COVID-19 vaccine in patients with diabetes are not available, despite their greater predisposition to complications. We estimated the prevalence of cessation of face mask use after receiving the COVID-19 vaccine in patients with diabetes and identified which factor was most strongly associated with non-use. This was a cross-sectional study in patients with diabetes 18–70 years with at least one dose of vaccine against COVID-19 (n = 288). Participants were asked to respond face-to-face to a questionnaire in a primary care center. Descriptive statistics, chi-square tests, and multivariate binary logistic regression were used for analyzing the association between vulnerability, benefits, barriers, self-efficacy, vaccine expectations (independent variables), and cessation of use (dependent variable), controlling for sociodemographic, smoking, medical, vaccine, and COVID-19 history. The prevalence of cessation of face masks was 25.3% (95% CI 20.2, 30.5). Not feeling vulnerable to hospitalization increased the odds of non-use (adjusted OR = 3.3, 95% CI 1.2, 8.6), while perceiving benefits did the opposite (adjusted OR = 0.4, 95% CI 0.2, 0.9). The prevalence was low, and only two factors were associated with the cessation of face mask use after COVID-19 vaccination in patients with type 2 diabetes

Association between ABO blood groups and preeclampsia

Objective To determine the association between the ABO blood group and preeclampsia. Methods This is a case-control study that included patients with (n = 253) and without (n = 457) preeclampsia/eclampsia in Northeastern Mexico. Data were obtained from electronic medical records. Binary multiple logistic regression analysis was used for analyzing the association between the ABO blood group and preeclampsia according to parity status while adjusting for potential confounders. Results Blood groups A, B, and AB showed adjusted odds ratios of 0.6 (95%CI 0.3-1.0), 1.1 (95%CI 0.6-2.2), and 0.3 (95%CI 0.1-1.1) in multiparous women, respectively. No association was found in nulliparous women either. Conclusions ABO blood groups were not associated with preeclampsia in Mexican women

Multiple Unhealthy Behaviors Share Equivalent Profiles of Readiness for Change in Patients with Type 2 Diabetes

Few studies have considered more than one behavior, despite the tendency towards multiple behaviors, and there are none that have focused on a Latino population. We determined the concurrence of four unhealthy behaviors related to glycemic control and identified common cognitive factors at advanced stages of readiness for change in patients with type 2 diabetes treated in primary care. A cross-sectional study was carried out during August–December 2018 in northeastern Mexico. We consecutively included patients between 20 and 70 years who were without medical contraindication, physical impediment against exercise, pregnancy and edentulism, among other selection criteria (n = 407). Stages of behavior were measured according to the Transtheoretical Model. Pros, cons, self-efficacy, susceptibility, and severity data were collected by interview. Statistical analysis consisted of descriptive statistics and multiple logistic regression. A total of 36.7% exhibited more than one unhealthy behavior in precontemplation or contemplation (no interest or some interest in changing consumption of refined sugars and saturated fats, exercise, or oral hygiene behavior). Cons (p &lt; 0.05) and self-efficacy (p &lt; 0.001) were common to all four unhealthy behaviors, independent of potential confounders. Studies like ours facilitate the recognition of individuals with multiple unhealthy behaviors who share equivalent profiles of readiness for change before implementing public health programs