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Patients at tertiary hospitals may find themselves in need of mental health support due to the distress associated with the illness that may or not lead to a psychiatric condition. Here is an overview of the clinical cases treated by the liaison psychiatry service of a public tertiary hospital from Southeast Mexico during its first years of operation (2008-2018), with the purpose of gathering information about the status and needs of this population. A sample of 304 clinical records of patients treated for the first time by the psychiatry service was reviewed, and the distribution by demographic characteristics, diagnosis of mental illness and medical area of reference was analyzed. Anxiety and depression symptoms were the most frequent. Most patients were women, lived in Merida and returned after the first appointment. The neurology service referred most patients, yet most attended directly. General tertiary hospitals should prioritize integrating ad hoc mental and physical health care. Adult women with a profile of anxiety and/or depression would be the first target group. Some areas of opportunity for further research and improvement of mental health services are: preventive services for anxiety and depression, follow-up of patients, attention to relatives of patients at intensive care units, implementation of telehealth alternatives, training on mental health screening and inter- and intra-institutional collaboration.
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OBJECTIVES: To provide an insight of the incidence of congenital developmental dysplasia of the hip in newborns from Yucatan born between 2015 and 2019 and analyze its association with maternal sociodemographic characteristics and neonatal, pregnancy and delivery related aspects. METHODS: Retrospective, population-based study from Birth Registries database in Yucatan, Mexico between 2015 and 2019. Presence of hip dysplasia was described and analyzed considering three aspects (I) Maternal information (II) Pregnancy and birth (III) Neonatal examination. We obtained incidence rates from each year and the complete studied period. Association between hip dysplasia and maternal, neonatal and pregnancy/delivery variables was analyzed using logistic regression, unadjusted odds ratio and an adjusted model. RESULTS: Hip dysplasia occurred in 13 per 10 000 live births. Significant associations were found between hip dysplasia and maternal place of residence in a city <50 000 inhabitants, without a local clinic. Propensity to give birth to a neonate with hip dysplasia increased with maternal age and ethnicity, in female newborns and when total number of pregnancy consultations summed <5. Newborns with hip dysplasia were heavier and less susceptible to be delivered vaginally. Congenital developmental hip dysplasia was comparatively more frequent among offspring of Mayan women and suboptimal access to medical care during pregnancy. Female neonates were affected the most, those first-borns. Neonates with hip dysplasia were heavier and more susceptible to be born by cesarean section. CONCLUSION: Maternal, neonatal, and perinatal factors are associated with DDH in Yucatecan infants born during 2015-2019. Factors that describe living conditions seems to have a more important effect on the presence of this condition.
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Displasia do Desenvolvimento do Quadril , Luxação Congênita de Quadril , Luxação do Quadril , Cesárea , Etnicidade , Feminino , Luxação Congênita de Quadril/diagnóstico , Luxação Congênita de Quadril/epidemiologia , Humanos , Lactente , Recém-Nascido , México/epidemiologia , Gravidez , Estudos Retrospectivos , Fatores de RiscoRESUMO
This study is aimed at identifying the relationship between oral motor treatment and the improvement of abilities for feeding and swallowing in boys and girls with CP residing in the state of Yucatán. The sample consisted of 30 patients with a diagnosis of CP and the presence of ADT, with gross motor function levels from II to V, between 3 and 14 years old, of which 50% received oral motor treatment. The predominant diagnosis was spastic CP and tetraplegia. An interview was carried out with the tutor, the application of the gross motor skills scale, and an assessment of feeding skills. The feeding and swallowing skills that improved significantly with the oral motor treatment were mandibular mobility, tongue activity, abnormal reflexes, control of breathing, and general oral motor skills (p ≤ 0.05). Within the sample that did not receive oral motor treatment, 46% presented low or very low weight and 40% referred recurrent respiratory diseases. In the end, it was concluded that feeding skills improve significantly with oral motor treatment, regardless of the severity of gross motor involvement. Likewise, oral motor treatment was associated with a lower presence of respiratory diseases and nutritional compromise.
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Paralisia Cerebral , Adolescente , Paralisia Cerebral/complicações , Paralisia Cerebral/terapia , Criança , Pré-Escolar , Deglutição , Feminino , Humanos , Masculino , Destreza MotoraRESUMO
Objective: To provide a brief and comprehensive summary of the recent evidence from clinical trials testing psychotherapeutic interventions in patients with fibromyalgia with particular interest in their possible effect on physical pain. Methods: Bibliographical search was performed in PubMed, PsycInfo, Web of Science, Scopus, and Cochrane Library databases. Content of the manuscripts was studied to obtain, if available, the following information: year of publication, location of the research team, design, type of psychotherapeutic intervention tested, pain measures, and a brief description of the psychotherapy, groups, and outcomes regarding physical pain. Results: Initial search eliciting 475 citations got reduced to 13 relevant papers. Most research studies from Spain (n = 8) are randomized control trials (n = 10) and used guided imagery (n = 5) or cognitive behavioral therapy (n = 4). The Visual Analogue Scale (n = 4) and the Fibromyalgia Impact Questionnaire (n = 4) were the physical pain measures mostly used. Improvements on physical pain were reported on all studies with published results; nevertheless, only in five cases, differences were significant. Conclusions: Evidence on the effect of psychotherapy on physical pain in patients with FS was divergent; though most studies report a reduction in pain, this was not always lasting and/or significant. Diversity of the results might be due to the selected psychotherapeutic approaches, assessment tools, and other internal (e.g., personality traits, (sub)clinical psychiatric symptoms, and treatment adherence) and external (e.g., family environment and social support) variables worth to be considered in the future research.
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Fibromialgia/psicologia , Fibromialgia/terapia , Psicoterapia/métodos , Dor Crônica/etiologia , Dor Crônica/psicologia , Dor Crônica/terapia , Humanos , EspanhaRESUMO
Breast cancer is the most frequent malignancy in women around the world. Its diagnosis and treatment may be accompanied by depressive symptoms. The frequency of depression in women with breast cancer may vary, ranging from < 10% to > 70%, depending on the questionnaire, type of population studied and geographic area. Depression is associated with genetic and environmental factors; the imbalance between the central nervous, endocrine and immune systems; the patient's age at diagnosis of cancer; metastasis; chemotherapy, and physical rehabilitation. Depression treatment is based on different types of approaches, such as hypnosis, meditation, music therapy and stress management. In Mexico, there are few studies about this topic. The objective of this work is to make a critical review on the scientific evidence of the relation between depression and breast cancer.
El cáncer de mama es la neoplasia maligna más frecuente en mujeres en todo en el mundo. Su diagnóstico y tratamiento puede estar acompañado de síntomas depresivos. La frecuencia de depresión en mujeres con cáncer de mama puede ser tan variada que va desde < 10% a > 70%, dependiendo del instrumento de evaluación, el tipo de población estudiada y el área geográfica. Se ha descrito que la depresión se asocia a factores genético-ambientales; desequilibrio entre los sistemas nervioso central, endócrino e inmunitario; edad de la paciente; presencia de metastasis; quimioterapia, y rehabilitación física. Su tratamiento está basado en diversos tipos de abordajes, como hipnosis, meditación, musicoterapia y manejo del estrés. En México se ha estudiado poco esta relación. El objetivo de este trabajo es realizar una revisión crítica sobre la evidencia científica de la relación entre depresión y cáncer de mama.
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BACKGROUND: World population is living longer, demanding adjustments in public health policies. Body mass index (BMI) is widely known and used as a parameter and predictor of health status although an adapted criterion for older adults is usually overlooked. BMI has been extensively analysed in relation to mortality but fewer studies address its association with cognition, functioning and depression in older adults. The present study aimed at 1) comparing BMI distribution according to the ranges proposed by the World Health Organization (WHO) and the United States National Research Council Committee on Diet and Health (CDH), 2) analysing their association with cognitive functioning, physical functioning and depression and 3) analysing a possible, interaction of BMI criteria with sex on the outcome measures. METHODS: This cross-sectional study included 395 participants recruited by convenience sampling; 283 (71.6%) women and 112 (24.58%) men. Mean age was 74.68 (SD = 8.50, range: 60-98). Outcome measures included the Short Portable Mental State Questionnaire for cognitive status, the Barthel's Index of Activities of Daily Living for physical functioning, and the Geriatric Depression Scale. RESULTS: WHO criterion classified most cases (65.3%) as overweight, followed by normal weight (32.2%) and underweight (2.5%) whereas CDH criterion considered most (48.1%) as normal weight, and followed by overweight (31.4%) and underweight (20.5%). Analysing cognitive status, independent physical functioning and depression mean scores, significant differences (p ≤ .001) were found when comparing the three weight groups (underweight, normal weight and overweight) using either the WHO- or the CDH criterion. Post-hoc tests revealed that in all comparisons the underweight group scored the lowest in all three outcome measures. According to the CDH criterion, overweight was favourable for females but unfavourable for males regarding cognitive status (interaction F(2,389) = 4.52, p ≤ .01) and independent functioning (interaction F(2,389) = 3.86, p ≤ .05). CONCLUSIONS: BMI and its associations to relevant outcome measures in the older adults must rely on criteria that take into account the particular features of this population, such as the CDH criterion. Underweight was associated with decremented cognition, less independent physical functioning and more depression. Overweight seemed favourable for women but unfavourable for men.
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Índice de Massa Corporal , Transtornos Cognitivos/epidemiologia , Depressão/epidemiologia , Fragilidade/psicologia , Sobrepeso/psicologia , Magreza/psicologia , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Fragilidade/epidemiologia , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To provide a brief and comprehensive summary of recent research regarding psychological interventions for patients surviving a traumatic brain injury. METHODS: A bibliographical search was performed in PubMed, Cochrane Library, PsycNET, Scopus, ResearchGate, and Google Scholar online databases. Analysis included distribution by year of publication, age stage of participants (paediatric, adult), location of the research team, study design, type of intervention, and main outcome variables. RESULTS: The initial search eliciting 1541 citations was reduced to 62 relevant papers. Most publications had adult samples (88.7%). The United States outstands as the country with more research (58.1%); Latin America countries provided no results. Cognitive behavioural therapy (CBT) was the most widely used approach for treatment of (sub)clinical mental disturbances (41.9%). Neuropsychological interventions were scarce (4.8%). Outcome measures included psychiatric disorders (e.g., posttraumatic stress disorder (PTSD), depression, and anxiety) (37.1%), postconcussive symptoms (16.1%), cognitive and functional deficits (48.1%), and social and psychological dimensions (62.9%). CONCLUSIONS: CBT outstands as the preferred therapeutic approach for treating behavioural and emotional disturbances. Also, other related therapies such as dialectical behaviour, mindfulness, and acceptance and commitment therapies have been proposed, and probably in the years to come, more literature regarding their effectiveness will be available. On the other hand, evidence showed that interventions from the field of neuropsychology are minimal if compared with its contribution to assessment. Future research should be aimed at performing studies on more diverse populations (e.g., nonmilitary communities and paediatric and Latin American populations) and at controlling designs to examine the therapeutic efficacy of psychotherapeutic and neurocognitive rehabilitation interventions and compare amelioration by injury severity, age of patients, and clinical profile, in the hopes of creating better guidelines for practitioners.
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Lesões Encefálicas Traumáticas/psicologia , Lesões Encefálicas Traumáticas/terapia , Psicoterapia/métodos , Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Terapia Cognitivo-Comportamental/tendências , Depressão/terapia , Transtorno Depressivo/terapia , Humanos , Transtornos de Estresse Pós-Traumáticos/terapiaRESUMO
Resumen Introducción La obesidad, el sobrepeso y la carcinogénesis son de origen multifactorial y resultado de procesos crónicos donde el ambiente y la genética tienen un papel fundamental. Por lo que su magnitud tiene variaciones regionales, nacionales e internacionales. En Yucatán la prevalencia de obesidad es muy alta, por lo que su implicación en el cáncer podría ser mayor que en otras poblaciones. Material y Métodos Estudio de casos y controles, Muestra probabilística de 400 mujeres de 20 a 65 atendidas en el hospital regional del ISSSTE en Mérida, Yucatán en 2013-2014; los casos: 200 mujeres con diagnóstico histopatológico de tumor mamario y los controles: 200 mujeres sin mastopatía, pareadas por edad. Exceso de peso IMC > 25. Análisis Chi2, ANOVA, t-Student y diferencia de proporciones. Resultados 64% de los tumores mamarios fueron de tipo maligno y 36% de tipo benigno. 91.5% de las mujeres con tumores malignos, 65% de las mujeres con tumores benignos y 59% de las mujeres sin tumores de mama, tenían exceso de peso. El exceso de peso relacionó con los tumores malignos, OR 5.65 (IC95% 2.57-12.4, p<0.001). Las neoplasias más prevalentes fueron de tipo carcinoma ductal (65%) y lobulillar (19%). Conclusiones El exceso de peso se asocia con la presencia de tumores mamarios especialmente de tipo maligno en mujeres yucatecas, por lo que el control del peso en mujeres con factores de riesgo para cáncer de mama puede ser un factor preventivo para el proceso de carcinogénesis.
Abstract Introduction Obesity, overweight and carcinogenesis are of multifactorial origin and result of chronic processes where the environment and genetics play a fundamental role. So its magnitude has regional, national and international variations. In Yucatan the prevalence of obesity is very high, so that its implication in cancer could be higher than in other populations. Material and methods Case-control study, Probabilistic sample of 400 women aged 20 to 65 attended at the ISSSTE regional hospital in Merida, Yucatan in 2013-2014; The cases: 200 women with histopathological diagnosis of breast tumor and controls: 200 women without mastopathy, matched by age. Excess weight BMI> 25. Chi2, ANOVA, t-Student and difference in proportions. Results 64% of the mammary tumors were of the malignant type and 36% of the benign type. 91.5% of women with malignant tumors, 65% of women with benign tumors, and 59% of women without breast tumors were overweight or obesity. Excess weight was associated with malignant tumors, OR 5.65 (95% CI 2.57-12.4, p <0.001). The most prevalent neoplasms were ductal (65%) and lobular (19%) carcinomas. Conclusions Excess weight is associated with the presence of breast tumors especially of malignant type in Yucatecan women, so that weight control in women with risk factors for breast cancer may be a preventive factor for the process of carcinogenesis.
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BACKGROUND: As the population with a disability increases both in number and life expectancy, so does its demand for health services. Very little original research has been done in Mexican populations regarding the effect of disability on quality of life. OBJECTIVES: 1) Assessing the subjective quality of life of patients with neuromusculoskeletal and movement-related function disabilities and, 2) Analyzing the possible effect of the medical condition (diseases of the nervous system vs. diseases of the musculoskeletal system and connective tissue) and its interaction with sex and age. METHODS: In a cross-sectional design 330 participants were recruited from a public institution in Mexico providing specialized outpatient rehabilitation. After signing informed consent they responded a brief sociodemographic questionnaire and the WHOQOL-BREF scale. RESULTS: In general quality of life levels were satisfactory. Female and elderly patients with diseases of the nervous system were particularly affected in the physical and psychological dimensions. Women with diseases of the nervous system also showed a negatively affected social quality of life. Elderly with diseases of the musculoskeletal system and connective tissue scored the lowest in general health perception. CONCLUSIONS: Even though most patients were quite satisfied with their quality of life, not all aspects or cases have such positive perceptions; both the physical and psychological dimensions were particularly negative in female and elderly patients with nervous system diseases. Clinicians would do well to thoughtfully assess patients in these groups and adjust treatment to achieve the greatest possible rehabilitation.
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Atividades Cotidianas , Atitude , Doenças do Tecido Conjuntivo , Pessoas com Deficiência , Doenças Musculoesqueléticas , Doenças Neuromusculares , Qualidade de Vida , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças do Tecido Conjuntivo/psicologia , Doenças do Tecido Conjuntivo/reabilitação , Pessoas com Deficiência/psicologia , Feminino , Serviços de Saúde , Humanos , Relações Interpessoais , Masculino , México , Pessoa de Meia-Idade , Movimento , Doenças Musculoesqueléticas/psicologia , Doenças Musculoesqueléticas/reabilitação , Doenças Neuromusculares/psicologia , Doenças Neuromusculares/reabilitação , Satisfação Pessoal , Fatores Sexuais , Inquéritos e Questionários , Adulto JovemRESUMO
Los medios de comunicación, el ambiente social y los factores personales desempeñan un papel importante como factores de riesgo de los TCA. El objetivo del presente trabajo fue conocer la relación entre las influencias socioculturales del modelo estético corporal con las cogniciones que son características de los TCA, en estudiantes de licenciatura en nutrición. Se contó con 112 participantes (88 mujeres y 24 hombres) estudiantes de la licenciatura en nutrición. 15.9% de las mujeres y el 20.8% de los hombres presentaron insatisfacción corporal. Los hombres presentaron significativamente mayor malestar patológico, influencia de la publicidad y perfeccionismo que las mujeres. Tanto en hombres y mujeres se muestra una correlación significativa entre la interiorización de un cuerpo delgado y la insatisfacción corporal. Casi la mitad de los participantes (48%) presenta una interiorización del modelo estético de delgadez. Se encontraron correlaciones significativas entre la interiorización de un modelo estético delgado y la insatisfacción corporal, lo cual indica que dicha insatisfacción está mediada por aquellos estándares provenientes de los medios de comunicación.
The media, the social environment and personal factors play an important role as risk factors for eating disorders. The aim of this study was to determine the relationship between sociocultural influences body shape model with cognitions that are characteristic of eating disorders in undergraduate nutrition. Participated 112 students (88 women and 24 men) undergraduate students in nutrition. 15.9% of women and 20.8% of the men had body dissatisfaction. Men showed significantly greater pathological distress advertising influence and perfectionism than women. Both men and women shows a significant correlation between the internalization of a thin body and body dissatisfaction. Almost half of the participants (48%) had an internalization body thin model. Significant correlations were found between the internalization of a thin aesthetic model and body dissatisfaction, which indicates that this dissatisfaction is mediated by those standards from the media.