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BACKGROUND: The association between iron biomarkers and cardiovascular disease risk factors (CVD-RFs) remains unclear. We aimed to (1) evaluate the cross-sectional and longitudinal associations between iron biomarkers (serum ferritin, transferrin saturation (TSAT), transferrin) and CVD-RFs among women, and (2) explore if these associations were modified by menopausal status. METHOD: Cross-sectional and longitudinal analyses including 2542 and 1482 women from CoLaus cohort, respectively. Multiple linear regression and multilevel mixed models were used to analyse the associations between Iron biomarkers and CVD-RFs. Variability of outcomes and iron markers between surveys was accessed using intraclass correlation (ICC). RESULTS: After multivariable adjustment, elevated serum ferritin levels were associated with increased insulin and glucose levels, while higher transferrin levels were linked to elevated glucose, insulin and total cholesterol, and systolic and diastolic blood pressure (p < 0.05). No association was observed between CVD-RFs and TSAT (p > 0.05). Iron biomarkers demonstrated low reliability across reproductive stages but exhibited stronger associations in the perimenopausal group. In longitudinal analysis, we found association only for transferrin with lower glucose levels [ß = - 0.59, 95% CI (- 1.10, - 0.08), p = 0.02] and lower diastolic blood pressure [ß = - 7.81, 95% CI (- 15.9, - 0.56), p = 0.04]. CONCLUSION: In cross-sectional analysis, transferrin was associated with several CVD-RFs, and the associations did not change according to menopausal status. Conversely, in the longitudinal analyses, changes in transferrin were associated only with lower glucose and diastolic blood pressure levels. These differences might stem from the substantial longitudinal variation of iron biomarkers, underscoring the need for multiple iron measurements in longitudinal analyses.
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Biomarcadores , Enfermedades Cardiovasculares , Ferritinas , Factores de Riesgo de Enfermedad Cardiaca , Posmenopausia , Transferrina , Humanos , Femenino , Biomarcadores/sangre , Estudios Transversales , Persona de Mediana Edad , Ferritinas/sangre , Estudios Longitudinales , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/sangre , Transferrina/metabolismo , Transferrina/análisis , Posmenopausia/sangre , Medición de Riesgo , Adulto , Hierro/sangre , Factores de Tiempo , Brasil/epidemiología , Anciano , Glucemia/metabolismo , Reproducibilidad de los Resultados , Factores de EdadRESUMEN
Background: Management of cardiovascular risk factors (high cholesterol, diabetes, and hypertension) should start by implementing a healthy lifestyle. Whereas lifestyle recommendations are provided irrespective of the patient's socio-economic status has not been recently assessed in the Brazilian population. Aims: To assess the preventive measures against cardiovascular risk factors according to educational level and income in the Brazilian population. Methods: Survey data of the 2019 Brazilian National Health Survey (PNS). The PNS is a nationwide household-based survey carried out by the Brazilian Ministry of Health. The PNS included face-to-face interviews and collected information on lifestyle management of high cholesterol, diabetes, and hypertension by a healthy diet, an adequate weight, exercise, and quitting smoking. The participant's educational level and income (in multiples of the basic salary per capita) was collected. Results: Of the 88,052 participants included, 13,151 (14.9%), 6,986 (7.9%) and 22,516 (25.6%) reported being diagnosed with high cholesterol, diabetes, or hypertension, respectively. Dietary recommendations were the most frequently provided (94.5%, 94.6% and 88.1% for high cholesterol diabetes, and hypertension, respectively), while recommendations to quit smoking to current smokers were the least frequently provided (74.9%, 85.8% and 81.1% for high cholesterol, diabetes, and hypertension, respectively). After multivariable adjustment, participants with a higher educational level or a higher income had a higher likelihood of reporting receipt lifestyle recommendations for high cholesterol or hypertension, while no associations were found for most recommendations for diabetes. Conclusion: Better-educated, wealthier Brazilians report receiving more lifestyle recommendations regarding high cholesterol and hypertension management more frequently than lower-educated or with low-income.
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Background: consumers of dietary supplements (DS) or vitamin-mineral supplements (VMS) have a better health profile than nonconsumers; whether this also applies to healthier dietary patterns has seldom been assessed. We aimed to assess the dietary intake of subjects according to their consumption of DS or VMS. Methods: Cross-sectional, population-based studies conducted in 2009-2012 (3773 participants, 52.4% women, 57.0 ± 10.0 years) and 2014-2017 (2536 participants, 52.4% women, 60.0 ± 10 years) in Lausanne, Switzerland. Dietary intake was assessed via a 97-item food frequency questionnaire. Nutrients, consumption of specific food groups, dietary scores, and compliance with the Swiss nutritional guidelines were compared between VMS/DS consumers and nonconsumers. Results: In 2009-2012, after multivariable adjustment for gender, age, body mass index, education, smoking, country of birth, sedentariness, diet and total energy intake, VMS/DS consumers had a higher score for the "Fruits & vegetables"(-0.09 ± 0.02 vs. 0.15 ± 0.05) dietary pattern and a lower score for the "Fatty & sugary" dietary pattern (0.02 ± 0.02 vs. -0.14 ± 0.04) and had a lower likelihood to comply with the guideline on total fat [odds ratio and 95 %CI: 0.72 (0.57-0.89)] than nonconsumers. In 2014-2017, after multivariable adjustment, no differences (at p < 0.005) were found between VMS/DS consumers and nonconsumers. Conclusion: VMS/DS consumers tend to have healthier dietary choices than nonconsumers. The beneficial effect of VMS and/or DS consumption is decreased, as it does not target subjects who really need them.
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Dieta , Suplementos Dietéticos , Estudios Transversales , Ingestión de Energía , Femenino , Humanos , Masculino , Minerales , Suiza , VitaminasRESUMEN
BACKGROUND: After quitting smoking, quitters frequently increase their weight and change their dietary intake. Still, most studies on the topic are over 20 years old and focused on few dietary markers. We analysed the changes in weight and dietary intake after quitting smoking using a large panel of dietary markers. METHODS: Prospective study including 5064 participants, 169 of whom (3.3%) quitted during a median follow-up of 5 years. Dietary intake was assessed using a food frequency questionnaire. Participants were excluded if they lacked dietary data or reported extreme total energy intakes (TEI) < 850 or > 4000 kcal/day. RESULTS: Data from 128 participants (43.8% women, aged 56.0 ± 10.0 years) were used. After quitting smoking, mean weight increased 2.1 ± 0.7 kg; the majority (58%) of the participants gained over 1 kg, and only 7.1% were on a diet to reduce their weight. Total protein intake increased from (median [interquartile range]) 14.4 [12.9-16.4] to 15.1 [13.4-17.9] % of total energy intake (TEI), p = 0.008, while animal protein intake increased from 9.7 [8.0-12.1] to 10.8 [8.5-13.5] %TEI, p = 0.011. Fish intake increased from 27 [17-45] to 37 [19-55] g/day, p = 0.016 and dairy intake decreased from 177 [94-288] to 150 [77-243] g/day, p = 0.009. No other changes were found. Among the 68 (53%) participants who reported time since quitting, quitting for <=1 year led to a decreased consumption of fruits, while the opposite was found for participants who quit for longer than one year. No associations were found between weight or dietary changes and time since quitting. CONCLUSIONS: People who quit smoking tend to gain weight, do not significantly change their dietary intake, and seem to make little effort to prevent weight gain. Systematic dietary support should be provided to all smokers wishing to quit.
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BACKGROUND AND AIMS: A healthy diet is the cornerstone of disease prevention, and dietary guidelines have been issued in most countries. We aimed to assess trends in compliance with dietary guidelines in the population of Geneva, Switzerland. METHODS: Multiple cross-sectional, population-based surveys conducted between 1993 and 2016 in the canton of Geneva, Switzerland [20,310 participants (52.3% women, mean age 51.9 ± 10.7 years)]. Trends in compliance with the Swiss dietary guidelines regarding food intake were assessed using logistic regression (a) for each guideline and (b) for at least three guidelines. Compliance before and after the first and second issuing of the guidelines was assessed. RESULTS: After multivariable adjustment, compliance with fruits increased overall [odds ratio and (95% confidence interval) for 1-year increase: 1.007 (1.003-1.012), p < 0.001], in men, participants aged over 45 and with low educational level. Compliance with vegetables increased overall [1.015 (1.008-1.022), p < 0.001], in both genders, age groups [45-54 and 55-64] and participants with low educational level. Compliance with meat increased in women [1.007 (1.001-1.013), p = 0.021] and participants with a university degree. Compliance with fresh fish increased in age group [55-64] [1.009 (1.000-1.018), p = 0.041]. Compliance with dairy products decreased overall [0.979 (0.972-0.986), p < 0.001] and in all groups studied, except for age group [65-74]. Compliance with at least three guidelines increased in age group [55-64] only [1.013 (1.002-1.024), p = 0.019]. No effect of the issuing of the guidelines was found. CONCLUSION: In the Geneva adult population, compliance with the Swiss dietary guidelines improved little. Issuing of dietary guidelines did not impact trends.
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Adhesión a Directriz , Política Nutricional/tendencias , Estudios Transversales , Encuestas sobre Dietas , Humanos , SuizaRESUMEN
Cross-sectional studies have demonstrated that obstructive sleep apnoea (OSA) and metabolic syndrome (MetS) are often associated, but whether a temporal relationship exists is unknown. We aimed to investigate the effect of OSA on the risk of developing MetS in the general population.A prospective study was conducted combining two population-based samples: Episono (Brazil) and HypnoLaus (Switzerland). MetS was assessed according to unified criteria. Polysomnography (PSG) was performed at baseline and follow-up in Episono, and at baseline in HypnoLaus. OSA was defined according to the apnoea-hypopnoea index as mild (≥5-â<15â eventsâ h-1) and moderate-to-severe (≥15â events·h-1). We included 1853 participants (mean±sd age 52±13â years, 56% female) without MetS at baseline.After mean±sd 6±1â years, 318 (17.2%) participants developed MetS. Moderate-to-severe OSA was independently associated with incident MetS (OR 2.58, 95% CI 1.61-4.11) and increased the number of MetS components from baseline to follow-up through mediation of the percentage of time with arterial oxygen saturation <90%. Subset analysis in Episono confirmed that the increase in this parameter between baseline and follow-up PSGs represented a risk factor for incident MetS (OR 1.42, 95% CI 1.04-1.95, for each 10% increase).OSA is independently associated with an increased risk of developing MetS through mediation of nocturnal hypoxaemia in the general population.
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Síndrome Metabólico/complicaciones , Síndrome Metabólico/epidemiología , Apnea Obstructiva del Sueño/complicaciones , Apnea Obstructiva del Sueño/epidemiología , Adulto , Anciano , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Lípidos/sangre , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Polisomnografía , Estudios Prospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Suiza/epidemiologíaRESUMEN
Adherence to dietary guidelines is associated with significantly better health outcomes. Studies across the world shows that compliance with the guidelines was low, but data in Switzerland are lacking. Hence, we aimed to assess the 5-year trends in dietary compliance regarding food guidelines in Switzerland in a prospective, population-based observational study. Data from 2882 participants (1591 women, 35-75â¯years), from the first (2009-2012) and second (2014-2017) follow-up. Dietary intake was assessed using a validated food frequency questionnaire. Compliance with the guidelines of the Swiss society of nutrition was assessed at baseline and 5.5â¯years afterwards. Prevalence rates for compliance were calculated using the exact Poisson method. Factors associated with changes in compliance (never, shifter or maintainer) were assessed by multinomial logistic regression using "Never compliers" as reference. Overall, improvements in compliance to fruits (42.4% to 45.1%) vegetables (6.9% to 8.6%) and fish (66.6% to 60.5%) were found, while compliance to meat decreased (61.1% to 58.5%). The prevalence of participants complying with at least three dietary recommendations did not change (24.1% to 25.2%). During follow-up, only 11.6% of participants maintained compliance to at least three dietary recommendations, and 62.4% never managed to comply. Female gender and older age were associated with maintaining compliance during the two study periods. In conclusion, compliance with dietary guidelines is a dynamic status, and only a small fraction of the population achieves sustained compliance with at least three guidelines. Almost two thirds of the population never achieve compliance with three guidelines.
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Conducta Alimentaria , Vida Independiente , Política Nutricional/tendencias , Cooperación del Paciente , Adulto , Factores de Edad , Anciano , Índice de Masa Corporal , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estado Nutricional , Estudios Prospectivos , Factores Sexuales , Encuestas y Cuestionarios , Suiza/epidemiologíaRESUMEN
BACKGROUND: Abdominoplasty, with or without liposuction, is among the most frequently performed aesthetic procedures. Its main objective is to improve the body contour by means of excising redundant skin and fat tissue. Although abdominoplasty is considered a safe procedure with high satisfaction rates, intraoperative and postoperative complications can become a challenge for the surgical team. The aim of this article is to offer a synopsis of the most common complications arising after abdominoplasty, along with evidence-based guidelines about how to prevent and treat them. METHODS: A systematic MEDLINE search strategy was designed using appropriate Medical Subject Headings (MeSH) terms, and references were scanned for further relevant articles. RESULTS: According to the published case series, local complications are considerably more common than complications with systemic repercussions. Approximately 10% to 20% of patients suffer a local complication following abdominoplasty, while fewer than 1% suffer a systemic complication. Prevention and management strategies are critically discussed for complications including seroma, haematoma, infection, skin necrosis, suture extrusions, hypertrophic scars, neurological symptoms, umbilical anomalies, deep venous thrombosis and pulmonary thromboembolism, respiratory distress, and death. CONCLUSIONS: The complications of abdominoplasty vary in severity and in the impact they have on the aesthetic outcomes. Recommendations for prevention and management are based on various levels of evidence, with a risk of observer bias. However, most complications can be treated appropriately following the current standards, with satisfactory results.
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Abdominoplastia , Huella de Carbono , Hospitales de Enseñanza , Mamoplastia , Rinoplastia , Cirugía Plástica , Abdominoplastia/economía , Adulto , Huella de Carbono/economía , Chile , Femenino , Hospitales de Enseñanza/economía , Humanos , Masculino , Mamoplastia/economía , Estudios Retrospectivos , Rinoplastia/economía , Cirugía Plástica/economíaRESUMEN
OBJECTIVES: We aimed to assess the associations of socioeconomic factors with dietary patterns in a Guatemalan population. METHODS: Cross-sectional data of 1076 participants (42 % men, mean age 32.6 ± 4.2 years) collected between 2002 and 2004 in four rural villages in Guatemala. Dietary patterns were derived using principal component analysis. Chi-square and Poisson regression models were used to assess associations between socioeconomic factors and dietary patterns. RESULTS: Three dietary patterns were identified: "Western" (high in processed foods), "traditional" (high in traditional foods) and "coffee and sugar", explaining 11, 7 and 6 % of the variance, respectively. Annual expenditures were associated with a higher adherence to the "Western" pattern: prevalence ratios [(PR) (95 % confidence interval)] 1.92 (1.17-3.15) for the highest vs. lowest expenditure group in men and 8.99 (3.57-22.64) in women. A borderline significant (p = 0.06) negative association was found between the "traditional" pattern and higher household expenditures [0.71 (0.49-1.02) in men] and with schooling [0.23 (0.05-1.02)] in women (p = 0.05). CONCLUSIONS: Dietary patterns in Guatemala are predicted by socioeconomic factors. In particular, high annual expenditures are associated with a more westernized, less traditional diet.
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Dieta/estadística & datos numéricos , Factores Socioeconómicos , Adulto , Estudios Transversales , Dieta/economía , Encuestas sobre Dietas , Femenino , Guatemala , Humanos , Masculino , Análisis de Componente Principal , Características de la ResidenciaRESUMEN
Hyperbaric oxygenation consists in exposing patients to increased gas pressures while inhaling pure oxygen. It involves the use of hyperbaric chambers that can double or triple gas pressure inside them. Hyperbaric oxygenation may be useful in different clinical situations, but mostly for the treatment of decompression syndrome. In the last decades, it has been used for the management of different kinds of wounds. Hyperbaric oxygenation not only increases the delivery of oxygen to damaged tissues, but also stimulates angiogenesis, collagen synthesis, stem cell migration and local immune response. Clinical trials that have addressed the use of hyperbaric oxygenation are difficult to compare due to their heterogeneity in terms of experimental design, kind of injuries involved and assessment of outcome. Even though, most studies support the concept that hyperbaric oxygenation accelerates the healing process.
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Humanos , Oxigenoterapia Hiperbárica/métodos , Cicatrización de Heridas , Heridas y Lesiones/terapia , Medicina Basada en la Evidencia , Oxigenoterapia Hiperbárica/efectos adversosRESUMEN
BACKGROUND: In high-income countries, high socioeconomic status (SES) is generally associated with a healthier diet, but whether social differences in dietary intake are also present in low- and middle-income countries (LMICs) remains to be established. OBJECTIVE: We performed a systematic review of studies that assessed the relation between SES and dietary intake in LMICs. DESIGN: We carried out a systematic review of cohort and cross-sectional studies in adults in LMICs and published between 1996 and 2013. We assessed associations between markers of SES or urban and rural settings and dietary intake. RESULTS: A total of 33 studies from 17 LMICs were included (5 low-income countries and 12 middle-income countries; 31 cross-sectional and 2 longitudinal studies). A majority of studies were conducted in Brazil (8), China (6), and Iran (4). High SES or living in urban areas was associated with higher intakes of calories; protein; total fat; cholesterol; polyunsaturated, saturated, and monounsaturated fatty acids; iron; and vitamins A and C and with lower intakes of carbohydrates and fiber. High SES was also associated with higher fruit and/or vegetable consumption, diet quality, and diversity. Although very few studies were performed in low-income countries, similar patterns were generally observed in both LMICs except for fruit intake, which was lower in urban than in rural areas in low-income countries. CONCLUSIONS: In LMICs, high SES or living in urban areas is associated with overall healthier dietary patterns. However, it is also related to higher energy, cholesterol, and saturated fat intakes. Social inequalities in dietary intake should be considered in the prevention and control of noncommunicable diseases in LMICs.
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Dieta , Conducta Alimentaria , Factores Socioeconómicos , Brasil , China , Fibras de la Dieta/administración & dosificación , Proteínas en la Dieta/administración & dosificación , Ingestión de Energía , Ácidos Grasos/administración & dosificación , Ácidos Grasos Monoinsaturados/administración & dosificación , Ácidos Grasos Insaturados/administración & dosificación , Alimentos Orgánicos , Frutas , Conductas Relacionadas con la Salud , Humanos , Irán , Micronutrientes/administración & dosificación , Población Rural , Población Urbana , VerdurasRESUMEN
BACKGROUND: Cardiovascular diseases (CVD) mortality has been shown to follow a seasonal pattern. Several studies suggested several possible determinants of this pattern, including misclassification of causes of deaths. We aimed at assessing seasonality in overall, CVD, cancer and non-CVD/non-cancer mortality using data from 19 countries from different latitudes. METHODS AND FINDINGS: Monthly mortality data were compiled from 19 countries, amounting to over 54 million deaths. We calculated ratios of the observed to the expected numbers of deaths in the absence of a seasonal pattern. Seasonal variation (peak to nadir difference) for overall and cause-specific (CVD, cancer or non-CVD/non-cancer) mortality was analyzed using the cosinor function model. Mortality from overall, CVD and non-CVD/non-cancer showed a consistent seasonal pattern. In both hemispheres, the number of deaths was higher than expected in winter. In countries close to the Equator the seasonal pattern was considerably lower for mortality from any cause. For CVD mortality, the peak to nadir differences ranged from 0.185 to 0.466 in the Northern Hemisphere, from 0.087 to 0.108 near the Equator, and from 0.219 to 0.409 in the Southern Hemisphere. For cancer mortality, the seasonal variation was nonexistent in most countries. CONCLUSIONS: In countries with seasonal variation, mortality from overall, CVD and non-CVD/non-cancer show a seasonal pattern with mortality being higher in winter than in summer. Conversely, cancer mortality shows no substantial seasonality.
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Enfermedades Cardiovasculares/mortalidad , Mortalidad/tendencias , Neoplasias/mortalidad , Estaciones del Año , Asia/epidemiología , Australia/epidemiología , Chile/epidemiología , Europa (Continente)/epidemiología , Encuestas Epidemiológicas/estadística & datos numéricos , Humanos , Nueva Zelanda/epidemiología , Vigilancia de la Población , Seychelles/epidemiología , Sudáfrica/epidemiología , Tasa de Supervivencia , Estados Unidos/epidemiologíaRESUMEN
Hyperbaric oxygenation consists in exposing patients to increased gas pressures while inhaling pure oxygen. It involves the use of hyperbaric chambers that can double or triple gas pressure inside them. Hyperbaric oxygenation may be useful in different clinical situations, but mostly for the treatment of decompression syndrome. In the last decades, it has been used for the management of different kinds of wounds. Hyperbaric oxygenation not only increases the delivery of oxygen to damaged tissues, but also stimulates angiogenesis, collagen synthesis, stem cell migration and local immune response. Clinical trials that have addressed the use of hyperbaric oxygenation are difficult to compare due to their heterogeneity in terms of experimental design, kind of injuries involved and assessment of outcome. Even though, most studies support the concept that hyperbaric oxygenation accelerates the healing process.
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Oxigenoterapia Hiperbárica/métodos , Cicatrización de Heridas , Heridas y Lesiones/terapia , Medicina Basada en la Evidencia , Humanos , Oxigenoterapia Hiperbárica/efectos adversosRESUMEN
For years, the gold standard in facial rejuvenation has been the face lift. However, exploring new, less complex procedures for achieving the same goal is currently drawing interest. Rejuvenation of the perioral area is a difficult task for plastic surgeons because of the minimal effect that face lift procedures have over this region and the lack of published material on the subject. In this article, the descended mouth corner anguloplasty technique is presented. It is a 20-minutes lift technique that can correct this typical feature of the ageing mouth. The authors have treated 71 patients using the technique with consistently good results, with just one requiring revision. They conclude that this procedure by itself and in combination with other small operations or even a full face lift can rejuvenate the ageing face.
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PURPOSE: To compare the quality-of-life (QoL) and psychosocial changes in a group of patients with early breast cancer who underwent conservative surgery (BCS) or modified radical mastectomy(MRM). METHODS: Self-administered questionnaire assessing body image perception, social habits, sexual attraction and self-consciousness with relatives/friends, was randomly assigned to 125 patients (61 BCS, 64 MRM; aged 53 +/- 8 and 50 + 9 years, respectively, p = NS). RESULTS: MRM patients reported a significantly higher frequency of changes in body image perception and other related social behaviour such as avoiding going to the beach or using low-cut clothes, and reticence with friends. Conversely, no differences were found regarding sexuality, denial of the disease by the husband/partner, or concealing the disease from family members. Also, no significant differences were found between patients above and below the age of 50 years, for all variables studied after adjustment for surgical procedure. CONCLUSIONS: Modified radical mastectomy has a negative effect on body image perception and in social behaviour patterns of patients and with a concomitant decrease in QoL. The sexuality of the patient is not significantly affected.
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Neoplasias de la Mama/psicología , Mastectomía Radical Modificada/psicología , Mastectomía Segmentaria/psicología , Adulto , Factores de Edad , Anciano , Antineoplásicos/uso terapéutico , Antineoplásicos Hormonales/uso terapéutico , Imagen Corporal , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/radioterapia , Neoplasias de la Mama/cirugía , Vestuario , Terapia Combinada , Negación en Psicología , Relaciones Familiares , Femenino , Humanos , Metástasis Linfática , Persona de Mediana Edad , Neoplasias Hormono-Dependientes/tratamiento farmacológico , Neoplasias Hormono-Dependientes/radioterapia , Neoplasias Hormono-Dependientes/cirugía , Portugal , Psicología , Radioterapia Adyuvante , Autoimagen , Sexualidad , Conducta Social , Apoyo Social , Esposos/psicología , Revelación de la VerdadRESUMEN
Describe las causas de la contaminación del medio ambiente rural en función a los factores que han ido innovando los métodos de explotación; resalta el uso, las ventajas y desventajas de los plaguicidas. Evalúa y clasifica los efectos nocivos que causan los plaguicidas a todos los componentes del medio ambiente y especialmente al hombre. Proporciona normas básicas de seguridad para aminorar y/o evitar dichos efectos
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Impactos de la Polución en la Salud , Monitoreo del Ambiente , Plaguicidas , Medio RuralRESUMEN
Describe las causas de la contaminación del medio ambiente rural en función a los factores que han ido innovando los métodos de explotación; resalta el uso, las ventajas y desventajas de los plaguicidas. Evalúa y clasifica los efectos nocivos que causan los plaguicidas a todos los componentes del medio ambiente y especialmente al hombre. Proporciona normas básicas de seguridad para aminorar y/o evitar dichos efectos