Complicaciones al uso de Implantes Subdérmico con Etonogestrel en usuarias adscritas al Programa de Planificación Familiar en el C.S.R.D San Pedro Tenayac en los años 2011 - 2013

Objetivo: Analizar las complicaciones al uso de implante subdérmico de Etonogestrel en las usuarias del C.S.R.D San pedro Tenayac adscritas al programa de planificación familiar en los años 2011-2013 Material y método: Se analizaron los expedientes de 178 usuarias de implante subdérmico de Etonogestrel en la unidad, registradas en el tarjetero del programa de planificación familiar en el Centro de Salud. De dichas usuarias por diversas razones fue imposible localizar a 13 quedando un total de 165 mujeres a estudiar. Fueron excluidas al momento del estudio 9, 7 de ellas por que no contaban con el criterio de haber portado el implante por más 6 meses y 2 por deseo de embarazo, quedando como tamaño de la muestra 156 mujeres. Resultados: Se registró ganancia de peso e incremento en el Índice de Masa Corporal en la mayor parte de las usuarias (80%). En cuanto a las alteraciones del patrón de sangrado menstrual, encontramos que la amenorrea fue la alteración que se presentó con más frecuencia (69.6%), seguida en orden decreciente por polimenorrea (56.5%), opsomenorrea (37.0%), hipomenorrea (32.6%), oligomenorrea (28.3%), hipermenorrea (28.3%), sangrado intermenstrual (21.7%) y proiomenorrea (13.0%). De las otras complicaciones referidas, la cefalea se presentó con mayor frecuencia (56.5%), seguida de la mastalgia (47.8%), y las alteraciones de la libido (43.5%). Conclusiones: La información obtenida en nuestro estudio demostró, que como se esperaba, tanto el sobrepeso y obesidad; así como las alteraciones del patrón del sangrado menstrual, son más frecuentes de lo que reporta la literatura

Un mundo mejor es posible : educación humanista hacia la búsqueda del ser humano en la atención farmacéutica y en la ciudadanía

RESUMEN: El reto importante de la educación en forma transdisciplinaria del estudiante y profesional Farmacéutico o de cualquier disciplina, es la práctica reflexiva crítica interactiva que propicie capacidades integrales como un Ser humano biopolítico en el marco de su disciplina en diálogo de saberes. Esta consiste en ensayar la experiencia profunda de asumirse como Ser social, pensante, comunicador, transformador, creador, realizador de sueños, capaz de expresar sentimientos, considerar y reconocer al otro. Para desarrollar un portafolio de servicio de Atención Farmacéutica desde el área que les corresponda e interactuar en forma transdisdiplinar multicultural en equipo, desde sus diversas labores humanas hacia la sociedad de manera progresiva, con una excelente planificación y evaluación de calidad de su servicio. Un motivador y realizador de sueños, que encamina lo utópico, ligado a la reflexión pedagógica social del autocuidado y el cuidado de los recursos naturales.CONTENIDO: Presentación. -- Introducción. -- Planteamiento reflexivo de un viejo y nuevo problema global. -- Referentes conceptuales para la construcción de otro modelo educativo biopolítico posible para el desarrollo sostenible. -- Primera unidad: Sistema educativo integrado que eduque-forme con base ontológica en perspectiva de derechos humanos y derechos fundamentales. El desarrolllo a escala humana para cambiar paradigmas de desarrollo. Las esferas de desarrollo del ser humano para el desarrollo social sostenible. El plan de vida del ser humano desde la familia y el plan curricular. -- Segunda unidad: La responsabilidad social de todos los implicados con un modelo biopolítico y la construcción de un sistema educativo integral. -- Tercera unidad: Sistema educativo integral biopolítico en derecho superior del ser humano para ejercer autoridad, no autoritarismo. Sistema educativo integral biopolítico en perspectiva de deberes derivados del ejercicio de los derechos y libertades. -- Objetivo general de las intervenciones educativas IAP. -- Metodología. -- Hallazgos y variables de discusión. -- Discusión de los resultados. -- Conclusiones. -- Recomendaciones

Childhood acute leukemias are frequent in Mexico City: descriptive epidemiology

<p>Abstract</p> <p>Background</p> <p>Worldwide, acute leukemia is the most common type of childhood cancer. It is particularly common in the Hispanic populations residing in the United States, Costa Rica, and Mexico City. The objective of this study was to determine the incidence of acute leukemia in children who were diagnosed and treated in public hospitals in Mexico City.</p> <p>Methods</p> <p>Included in this study were those children, under 15 years of age and residents of Mexico City, who were diagnosed in 2006 and 2007 with leukemia, as determined by using the International Classification of Childhood Cancer. The average annual incidence rates (AAIR), and the standardized average annual incidence rates (SAAIR) per million children were calculated. We calculated crude, age- and sex-specific incidence rates and adjusted for age by the direct method with the world population as standard. We determined if there were a correlation between the incidence of acute leukemias in the various boroughs of Mexico City and either the number of agricultural hectares, the average number of persons per household, or the municipal human development index for Mexico (used as a reference of socio-economic level).</p> <p>Results</p> <p>Although a total of 610 new cases of leukemia were registered during 2006-2007, only 228 fit the criteria for inclusion in this study. The overall SAAIR was 57.6 per million children (95% CI, 46.9-68.3); acute lymphoblastic leukemia (ALL) was the most frequent type of leukemia, constituting 85.1% of the cases (SAAIR: 49.5 per million), followed by acute myeloblastic leukemia at 12.3% (SAAIR: 6.9 per million), and chronic myeloid leukemia at 1.7% (SAAIR: 0.9 per million). The 1-4 years age group had the highest SAAIR for ALL (77.7 per million). For cases of ALL, 73.2% had precursor B-cell immunophenotype (SAAIR: 35.8 per million) and 12.4% had T-cell immunophenotype (SAAIR 6.3 per million). The peak ages for ALL were 2-6 years and 8-10 years. More than half the children (58.8%) were classified as high risk. There was a positive correlation between the average number of persons per household and the incidence of the pre-B immunophenotype (Pearson's r, 0.789; P = 0.02).</p> <p>Conclusions</p> <p>The frequency of ALL in Mexico City is among the highest in the world, similar to those found for Hispanics in the United States and in Costa Rica.</p

A qualitative analysis of environmental policy and children's health in Mexico

<p>Abstract</p> <p>Background</p> <p>Since Mexico's joining the North American Free Trade Agreement (NAFTA) and the Organization for Economic Cooperation and Development (OECD) in 1994, it has witnessed rapid industrialization. A byproduct of this industrialization is increasing population exposure to environmental pollutants, of which some have been associated with childhood disease. We therefore identified and assessed the adequacy of existing international and Mexican governance instruments and policy tools to protect children from environmental hazards.</p> <p>Methods</p> <p>We first systematically reviewed PubMed, the Mexican legal code and the websites of the United Nations, World Health Organization, NAFTA and OECD as of July 2007 to identify the relevant governance instruments, and analyzed the approach these instruments took to preventing childhood diseases of environmental origin. Secondly, we interviewed a purposive sample of high-level government officials, researchers and non-governmental organization representatives, to identify their opinions and attitudes towards children's environmental health and potential barriers to child-specific protective legislation and implementation.</p> <p>Results</p> <p>We identified only one policy tool describing specific measures to reduce developmental neurotoxicity and other children's health effects from lead. Other governance instruments mention children's unique vulnerability to ozone, particulate matter and carbon monoxide, but do not provide further details. Most interviewees were aware of Mexican environmental policy tools addressing children's health needs, but agreed that, with few exceptions, environmental policies do not address the specific health needs of children and pregnant women. Interviewees also cited state centralization of power, communication barriers and political resistance as reasons for the absence of a strong regulatory platform.</p> <p>Conclusions</p> <p>The Mexican government has not sufficiently accounted for children's unique vulnerability to environmental contaminants. If regulation and legislation are not updated and implemented to protect children, increases in preventable exposures to toxic chemicals in the environment may ensue.</p

Consenso colombiano de atención, diagnóstico y manejo de la infección por SARS-COV-2/COVID-19 en establecimientos de atención de la salud Recomendaciones basadas en consenso de expertos e informadas en la evidencia

The “Asociación Colombiana de Infectología” (ACIN) and the “Instituto de Evaluación de Nuevas Tecnologías de la Salud” (IETS) created a task force to develop recommendations for Covid 19 health care diagnosis, management and treatment informed, and based, on evidence. Theses reccomendations are addressed to the health personnel on the Colombian context of health services. © 2020 Asociacion Colombiana de Infectologia. All rights reserved

Aggregation tests identify new gene associations with breast cancer in populations with diverse ancestry

Low-frequency variants play an important role in breast cancer (BC) susceptibility. Gene-based methods can increase power by combining multiple variants in the same gene and help identify target genes. We evaluated the potential of gene-based aggregation in the Breast Cancer Association Consortium cohorts including 83,471 cases and 59,199 controls. Low-frequency variants were aggregated for individual genes' coding and regulatory regions. Association results in European ancestry samples were compared to single-marker association results in the same cohort. Gene-based associations were also combined in meta-analysis across individuals with European, Asian, African, and Latin American and Hispanic ancestry. In European ancestry samples, 14 genes were significantly associated (q < 0.05) with BC. Of those, two genes, FMNL3 (P = 6.11 × 10 ) and AC058822.1 (P = 1.47 × 10 ), represent new associations. High FMNL3 expression has previously been linked to poor prognosis in several other cancers. Meta-analysis of samples with diverse ancestry discovered further associations including established candidate genes ESR1 and CBLB. Furthermore, literature review and database query found further support for a biologically plausible link with cancer for genes CBLB, FMNL3, FGFR2, LSP1, MAP3K1, and SRGAP2C. Using extended gene-based aggregation tests including coding and regulatory variation, we report identification of plausible target genes for previously identified single-marker associations with BC as well as the discovery of novel genes implicated in BC development. Including multi ancestral cohorts in this study enabled the identification of otherwise missed disease associations as ESR1 (P = 1.31 × 10 ), demonstrating the importance of diversifying study cohorts. [Abstract copyright: © 2023. The Author(s).

Colombian consensus recommendations for diagnosis, management and treatment of the infection by SARS-COV-2/ COVID-19 in health care facilities - Recommendations from expert´s group based and informed on evidence

La Asociación Colombiana de Infectología (ACIN) y el Instituto de Evaluación de Nuevas Tecnologías de la Salud (IETS) conformó un grupo de trabajo para desarrollar recomendaciones informadas y basadas en evidencia, por consenso de expertos para la atención, diagnóstico y manejo de casos de Covid 19. Estas guías son dirigidas al personal de salud y buscar dar recomendaciones en los ámbitos de la atención en salud de los casos de Covid-19, en el contexto nacional de Colombia

Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

© 2018 The Author(s). Background: Assessments of age-specifc mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Afairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specifc mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in diferent components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings: Globally, 18·7% (95% uncertainty interval 18·4-19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2-59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5-49·6) to 70·5 years (70·1-70·8) for men and from 52·9 years (51·7-54·0) to 75·6 years (75·3-75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5-51·7) for men in the Central African Republic to 87·6 years (86·9-88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3-238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6-42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2-5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation: This analysis of age-sex-specifc mortality shows that there are remarkably complex patterns in population mortality across countries. The fndings of this study highlight global successes, such as the large decline in under-5 mortality, which refects signifcant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing

Estudio espectrofotométrico de la hidrólisis del hierro III

Se utiliza el término "estudio teórico" en el sentido de que despues de conocer las sustancias químicas que conforman la Calcopirita se estudiará la reacción que se presenta cuando cada una de ellas se disuelve en ácido sulfúrico; tomando como sustancia para disolver el reactivo puro correspondiente y no tal como se presenta realmente en el mineral impura y además asociado a otras sustancia

Ejercicio tradicional de la partería frente a su profesionalización: estudio de caso en Jalisco, México

Objective: to analyze the status of midwifery in Jalisco,Mexico and its professionalization process. Methodology: acase study conducted from June 2011 to July 2013 in threestages: I. in-depth interviews with 20 midwives, II. fourregional assemblies with 44 midwives, and III. a state assemblywith 136 midwives, health care staff and other social actors.The three stages employed popular educational techniques.In addition, qualitative data were analyzed using the actantialsemiotic model, and the midwives’ sociodemographic datawere processed in Epi Info 7. Finally, a meta-inference wasperformed with the findings from both datasets. Results: atotal of 180 midwives participated in the study, 89% of whichoperate in rural areas. The average age was 56, and 73% ofthe midwives had secondary education or less. Moreover,95% of them were traditional midwives who adopted thispractice since their adolescence and received training fromhealth care providing institutions and from other midwives. Inaddition, 16.7% studied nursing in order to obtain positionsin institutions while remaining midwives. They currentlyprovide care for mothers and children as well as for patientswith traditional nosologies. They also mention that theysuffer institutional neglect. Among doctors and nurses,there are positions of rejection and acceptance regardingtheir inclusion in the health sector, while other social actorsrequest their acknowledgement. Conclusions: midwiferyin Jalisco, Mexico, is a traditional and vital practice with orwithout institutional recognition. It is an answer to the needfor health care. Likewise, it is necessary to consider the sociodemographicprofile of midwives, their current role, the viewsof the health care staff and other social actors and the closecultural and economic relationship of the Country regardingits professionalization.Objetivo: analizar el estado de la partería en Jalisco, México, frente al proceso de profesionalización. Metodología: Estudio de caso, realizado desde junio de 2011 a julio de 2013 en tres momentos: I. Entrevistas a profundidad con 20 parteras, II. Cuatro asambleas regionales con 44 parteras, III. Una asamblea estatal con 136 parteras, personal de salud y otros actores sociales, retomando técnicas educativas populares. Los datos cualitativos fueron analizados bajo el modelo actancial semiótico y los datos sociodemográficos de parteras en Epi Info 7, realizando una meta-inferencia con ambos hallazgos. Resultados: 180 parteras informantes, 89% de zona rural, media de edad 56 años, 73% con estudios de secundaria o menos, 95% son parteras tradicionales, adoptando esta práctica desde la adolescencia, capacitándose en instituciones de salud y entre las mismas parteras; 16,7% estudiaron enfermería buscando posicionamiento institucional, sin dejar de ser parteras. Actualmente otorgan atención materno-infantil y a nosologías tradicionales, aludiendo abandono institucional. Existen posturas de rechazo y aceptación de su incorporación al sector salud en médicos y enfermeras, mientras que otros actores sociales, piden su reconocimiento. Conclusiones: la partería en Jalisco, México, es una práctica tradicional vital, con o sin reconocimiento institucional, transformándose en respuesta a necesidades de atención, teniendo que considerar el perfil sociodemográfico de las parteras, su papel actual, la perspectiva del personal de salud y otros actores sociales, junto con la estrecha relación sociocultural y económica del país, frente a su profesionalización.