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There is scarce evidence on sociodemographic and lifestyle characteristics that may explain adherence to different dietary patterns (DPs) during pregnancy. Our aims were to identify dietary patterns in a sample of pregnant Mexican women and to describe their association with selected sociodemographic and lifestyle characteristics. This is a secondary cross-sectional analysis of 252 mothers of children that participated as controls in a hospital-based case-control study of childhood leukemia. We obtained parents' information about selected sociodemographic characteristics, as well as alcohol and tobacco consumption. We also obtained dietary information during pregnancy. We identified DPs using cluster and factor analyses and we estimated their association with characteristics of interest. We identified two DPs using cluster analysis, which we called "Prudent" and "Non healthy", as well as three DPs through factor analysis, namely "Prudent", "Processed foods and fish", and "Chicken and vegetables". Characteristics associated with greater adherence to "Prudent" patterns were maternal education, older paternal age, not smoking, and being a government employee and/or uncovered population. Likewise, the "Processed foods and fish" pattern was associated with greater maternal and paternal education, as well as those with less household overcrowding. We did not identify sociodemographic variables related to the "Chicken and Vegetables" pattern. Our results may be useful to identify target populations that may benefit from interventions aimed to improve individual dietary decisions during pregnancy.

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Background: A heterogeneous geographic distribution of childhood acute lymphoblastic leukemia (ALL) cases has been described, possibly, related to the presence of different environmental factors. The aim of the present study was to explore the geographical distribution of childhood ALL cases in Greater Mexico City (GMC). Methods: A population-based case-control study was conducted. Children <18 years old, newly diagnosed with ALL and residents of GMC were included. Controls were patients without leukemia recruited from second-level public hospitals, frequency-matched by sex, age, and health institution with the cases. The residence address where the patients lived during the last year before diagnosis (cases) or the interview (controls) was used for geolocation. Kulldorff's spatial scan statistic was used to detect spatial clusters (SCs). Relative risks (RR), associated p-value and number of cases included for each cluster were obtained. Results: A total of 1054 cases with ALL were analyzed. Of these, 408 (38.7%) were distributed across eight SCs detected. A relative risk of 1.61 (p<0.0001) was observed for the main cluster. Similar results were noted for the remaining seven ones. Additionally, a proximity between SCs, electrical installations and petrochemical facilities was observed. Conclusions: The identification of SCs in certain regions of GMC suggest the possible role of environmental factors in the etiology of childhood ALL.

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Background: Childhood cancer is the leading cause of disease-related mortality among children aged 5-14 years in Mexico, with acute leukemia being the most common cancer among infants. Examining the overall dietary patterns allows for a comprehensive assessment of food and nutrient consumption, providing a more predictive measure of disease risk than individual foods or nutrients. This study aims to evaluate the association between maternal dietary patterns during pregnancy and the risk of acute leukemia in Mexican infants. Methods: A hospital-based case-control study was conducted, comparing 109 confirmed acute leukemia cases with 152 age-matched controls. All participants (≤24 months) were identified at hospitals in Mexico City between 2010 and 2019. Data on a posteriori dietary patterns and other relevant variables were collected through structured interviews and dietary questionnaires. Multivariate logistic regression was employed to estimate the association between maternal dietary patterns during pregnancy and the risk of acute leukemia in infants. Results: The "Balanced & Vegetable-Rich" pattern, characterized by a balanced consumption of various food groups and higher vegetable intake, exhibited a negative association with acute leukemia when compared to the "High Dairy & Cereals" Pattern (adjusted odds ratio [OR] = 0.51; 95% confidence interval [CI]: 0.29, 0.90). We observed that mothers who gave birth to girls and adhered to a healthy dietary pattern during pregnancy exhibited significantly lower odds of their children developing AL compared to those who gave birth to boys [OR = 0.32 (95% CI 0.11, 0.97)]. Our results underscore the significance of maternal nutrition as a modifiable factor in disease prevention and the importance of prenatal health education.

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Introduction: Maternal dietary consumption during pregnancy has been inconclusively associated with acute leukemia (AL) in infants, probably because epidemiological evidence has emerged mainly from the analysis of one-by-one nutrient, which is not a real-life scenario. Our objective was to evaluate the association between AL in Mexican children under 2 years of age and their mothers' nutrients concomitant intake during pregnancy, as well as to explore whether there are differences between girls and boys. Methods: We conducted a study of 110 cases of AL and 252 hospital-based controls in the Mexico City Metropolitan area from 2010 to 2019. We obtained information on maternal intake of 32 nutrients by a food frequency questionnaire and used weighted quantile sum regression to identify nutrient concomitant intakes. Results: We found a concomitant intake of nutrients negatively associated with AL (OR 0.17; CI95% 0.03,0.88) only among girls; and we did not find a nutrient concomitant intake positively associated with AL. Discussion: This is the first study that suggests nutrients that have been individually associated with AL are not necessarily the same in the presence of other nutrients (concomitant intake); as well as that maternal diet might reduce AL risk only in girls.

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The aim of this study is to determine the phenolic and polysaccharidic composition, texture properties, and gene expression of new seedless table grape cultivars Timco™ and Krissy™ and compare them to the traditional table grape variety Crimson Seedless (Vitis vinifera L.), during ripening and in commercial postharvest conditions. According to the results, phenolic compounds were present in very different proportions. The total anthocyanins responsible for skin color increased during maturation and the majority anthocyanin in the three cultivars was peonidin-3-glucoside, followed by malvidin-3-glucoside. The phenolic compounds presented a different behavior (decreasing or increasing) during postharvest. The total skin soluble polysaccharides decreased during ripening and postharvest in Crimson Seedless and Krissy™ and remained constant from technological maturity to postharvest storage in Timco™. In all cultivars, the majority soluble polysaccharide fraction was that with a molecular mass between 500 and 35 KDa. The skin mechanical properties of table grapes were good parameters for differentiating varieties, with better results for the new cultivars, compared to the traditional Crimson Seedless, especially in postharvest. Genes involved in the flavonoid pathway and cell wall metabolism in skins exhibited an increase in expression from veraison to remaining constant at the end of the berry ripening.

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Based on a V-shaped microactuator with a pair of beams, modifications were made to the length and width of a microactuator to observe the effects. A theoretical approach and numerical characterization of the modified microactuator were performed. Its performance was compared to a similar microactuator with equal beam widths, and a V-shaped microactuator. The proposed microactuator, fed at 2 V, compared to the V-shaped actuator, showed a 370.48% increase in force, but a 29.8% decrease in displacement. The equivalent von Mises stress level increased (until 74.2 MPa), but was below the silicon ultimate stress. When the modified microactuator was applied to the proposed microgripper, compared to the case using a V-shaped actuator, the displacement between the jaws increased from 0.85 µm to 4.85 µm, the force from 42.11 mN to 73.61 mN, and the natural frequency from 11.36 kHz to 37.99 kHz; although the temperature increased, on average, from 42 °C up to 73 °C, it is not a critical value for many microobjects. The maximum equivalent von Mises stress was equal to 68.65 MPa. Therefore, it has been demonstrated that the new modified microactuator with damping elements is useful for the proposed microgripper of novel geometry, while a reduced area is maintained.

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Resumen Las intoxicaciones o las sobredosis de drogas constituyen una fuente importante de morbilidad, mortalidad y gasto en salud en todo el mundo. Especialmente en adultos menores de 35 años, las intoxicaciones vienen a ser la principal causa de paro cardíaco no traumático, siendofármacos más comunes involucrados, analgésicos, antidepresivos, opioides, sin embargo, esto puede variar. Es importante realizar un abordaje rápido, con base en interrogatorio, información de cualquier testigo y evidencia, además la clínica del paciente. El paro cardíaco debido a toxicidad se maneja de acuerdo conlos estándares actuales de reanimación cardiopulmonar básica y avanzada, siguiendo los principios del A, B, C, D, E. Las manifestaciones clínicas y abordaje clínico pueden variar bastante dependiendo de la sustancia involucrada. Las pruebas de laboratorio casi nunca están disponibles en un marco de tiempo que respalde las decisiones de reanimación tempranas, aún así, es recomendable realizarlas. En general los efectos tóxicos pueden reducirse si se limita la absorción del o los fármacos o se aumenta su eliminación. Además, se puede bloquear efectos farmacológicos no deseados con los llamados antídotos. El uso del carbón activado, algunos antídotos específicos, y tratamientos extracorpóreos también se contemplan en la presente revisión.

Abstract Poisoning or drug overdose is a major source of morbidity, mortality and health expenditure worldwide, especially in adults under 35, where it is the leading cause of non-traumatic cardiac arrest, being more common drugs involved, analgesics, antidepressants, opioids, however, this may vary. It is important to make a quick approach, based on questioning, information from any witness and evidence, and the patient's clinic. Cardiac arrest due to toxicity is managed according to current Basic and Advanced life support standards, following the principles of A, B, C, D, E. Clinical manifestations and clinical approach can vary considerably depending on the substance involved. Laboratory tests are almost never available in a time frame that supports early resuscitation decisions, yet it is advisable to perform them. In general, the toxic effects can be reduced if the absorption of the drugs is limited or their elimination increased. In addition, you can block unwanted pharmacological effects with so-called antidotes. The use of activated charcoal, specific antidotes, and extracorporeal treatments are also covered in this review.

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BACKGROUND: The parental age at conception has been reported to be a risk factor for childhood acute leukaemia (AL); however, the relationship is controversial. The aim of the present study was to investigate the association between parental age at conception and the risk of AL in Mexican children, a population with a high incidence of the disease and a high prevalence of pregnancies in adolescents and young adults. METHODS: A multicentre case-control study was conducted. Incident AL cases younger than 17 years of age diagnosed between 2010 and 2015 were included. Controls were matched with cases according to age, sex, and health institution. Using logistic regression analysis, adjusted odds ratios (aOR) and 95 % confidence intervals (95 % CI) were calculated for each maternal stratum after adjusting for paternal age at conception of index child. The maternal age between 25 and 29.99 years was selected as the reference category. RESULTS: In most strata where maternal and paternal ages were assessed, no association was found with the risk of developing acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML) in their offspring. An increased risk for AML was observed when the mother was between 20 and 24.99 years of age and the father aged 25-29.99 years (aOR, 1.94; 95 % CI, 1.03-3.67). In addition, there was a positive association for ALL when the mother´s age was between 20 and 24.99 years and the father was <20 years of age, however, a very wide confidence interval was noted (aOR, 12.26; 95 % CI, 1.41-106.83). CONCLUSION: In the present study, maternal and paternal ages assessed in different strata showed little association with risk of developing ALL and AML in children. Positive associations between risk of both types of childhood AL were observed with younger paternal and maternal ages.

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In Mexico, due to the high rates of diabetes, overweight, and obesity, there has also been noted an increased newborn weight, which may be contributing to the elevated incidence rate of childhood acute leukemia (AL). We conducted a case-control study in public hospitals of Mexico City aimed to know whether a greater weight at birth is associated with a higher risk of developing leukemia. We included incident cases with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) diagnosed between 2010 and 2015. Controls were frequency-matched to the cases by age, sex, and health institution. Logistic regression analysis was performed adjusting risks by child's sex, overcrowding index, birth order, and mother's age at the time of pregnancy. Adjusted odds ratios (aORs) and 95% confidence intervals were calculated. A total of 1455 cases and 1455 controls were included. An evident association between ALL and child's birthweight ≥2500 g was found (aOR 2.06; 95% CI: 1.59, 2.66) and also, in those with birthweight ≥3500 g (aOR 1.19; 95% CI: 1.00, 1.41). In AML patients with birthweight ≥2500 g and ≥3500 g, an aOR of 1.77 (95% CI: 1.07, 2.94) and 1.42 (95% CI: 1.03-1.95) was observed, respectively. No association was noticed with either type of AL and a birthweight ≥4000 g. To sum up, we found a moderate association between not having a low birthweight and an increased risk of acute leukemias. Birthweight ≥3500 g was also a risk factor for both types of leukemia. This suggests that a greater birthweight may increase the risk of acute leukemias in Mexican children.

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Several national health systems in Latin America initiated health reforms to counter widespread criticisms of low equity and efficiency. For public purchasing agencies, these reforms often consisted in contracting external providers for primary care provision. This paper intends to clarify both the complex and intertwined issues characterizing such contracting as well as health system performances within the context of four Central American countries. It results from a European Commission financed project lead between 2002 and 2005, involving participants from Costa Rica, Guatemala, Nicaragua, Salvador, United Kingdom, Netherlands and Belgium, whose aim was to promote exchanges between these participants. The findings presented in this paper are the results of a two stage process: (a) the design of an initial analytical framework, built upon findings from the literature, interlinking characteristics of contractual relation with health systems performances criteria and (b) the use of that framework in four case studies to identify cross-cutting issues. This paper reinforces two pivotal findings: (a) contracting requires not only technical, but also political choices and (b) it cannot be considered as a mechanical process. The unpredictability of its evolution requires a flexible and reactive approach. This should be better assimilated by national and international organizations involved in health services provision, so as to progressively come out of dogmatic approaches in deciding to initiate contractual relation with external providers for primary care provision.

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El dolor lumbar constituye una patología de alta incidencia y costos, transformándose en un problema de salud pública. Cuando la causa es secundaria a compresión de estructuras neurales la indicación quirúrgica es clara; sin embargo, cuando a ésta se asocian características biomecánicas del dolor no es claro el manejo que se debe seguir y las medidas terapéuticas no siempre tienen buenos resultados. Durante mucho tiempo se ha manejado el concepto de inestabilidad como causal del componente biomecánico de la lumbalgia crónica; de tal manera, la fusión del segmento espinal se ha convertido en la medida terapéutica de elección. Sin embargo, a pesar de una depuración de la técnica, y de tasas de fusión cercanas al 100%, el resultado clínico no se correlaciona y, por el contrario, aparecen complicaciones como la enfermedad del segmento adyacente a la fusión. Se han propuesto entonces formas de estabilización que conserven el movimiento, prefiriéndose los sistemas basados en tornillos transpediculares por su larga durabilidad y mejor control del movimiento. Reportamos tres casos de enfermedad degenerativa lumbar asociada a compresión de estructuras nerviosas que requerían estabilización adicional y en los que se prefirió, por la edad de los pacientes y otros factores a favor, la colocación del sistema dinámico de estabilización posterior COSMIC. Presentamos un reporte preliminar de casos con resultados alentadores de una técnica de fijación transpedicular dinámica como una opción al tratamiento tradicional de fusión estático y rígido, para el manejo de la enfermedad degenerativa de la columna lumbar y el dolor lumbar crónico.

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Presenta informe parte de una serie de consideraciones relacionadas con la problemática en la gestión delos recursos humanos en salud de Paraguay, resaltando a los personales del Ministerio de Salud Pública yBienestar Social

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Hoy en día el cambio constituye una labor cotidiana. El mundo, los países y sus instituciones buscan la forma de hacerse más competitivas y eficientes. El problema económico agobia a las organizaciones del sector privado y del sector público, las cuales requieren de transformaciones que les permitan subsistir en el tiempo. La Caja está en un momento importante para replantear sus objetivos, y la forma en quelos va a alcanzar en el largo plazo. Se ha iniciado con el cambio del actual modelo de atención y en el sistema de pensiones, por uno que en el largo plazo, proporcione una mejor condición de vida a la población costarricense. Por otro lado, se ha visto la ncesidad de mejorar la forma en que recaudamos los ingresos, con el fin de hacer posible esa meta. Un eficiente modelo de recaudación, acorde a las necesidades actuales es una condición necesaria para lograr un mejor nivel de salud de la población costarricense

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Recibe el nombre de "neuropsicología dinámica" el enfoque actual dentro de la neuropsicología que sostiene que la relación cerebro-comducta debe ser entendida en términos de su interfase dinámica y no como dimensiones separadas, casualmente relacionadas de manera estática. La neuropsicología dinámica intenta comprender y estudiar el proceso de interacción entre los factores neurológicos, y psicológicos, y los procesos cognoscitivos, considerando también el desarrollo del cerebro y el proceso de evolución del individuo en torno a los procesos de aprendizaje, dentro de un momento sociohistórico-cultural. La neuropsicología dinámica se desarrolló alrededor de los años 80, a partir de la imperiosa necesidad de tomar en cuenta las variables medioambientales y del entorno, tanto para elaborar técnicas de evaluación, como para implementar estrategias de rehabilitación. El foco de estudio se centra en el análisis de la relación entre el conocimiento neuropsicológico y las tareas del quehacer cotidiano, que conduce al individuo hacia la adaptación o desadaptación dentro de la sociedad. Este enfoque está fuertemente influenciado por los conceptos y principios metodológicos propios de la psicología cognoscitiva y experimental, condición que ha dado lugar a que el estudio de la relación cerebro-conducta se dirija hacia la búsqueda de las alteraciones cognoscitivas subyacentes a los trastornos observador enel comportamiento de los pacientes. La neuropsicología, como una rama de las neurociencias, se incorpora con rapidez a la investigación es psiquiatría, enfrentando retos metodológicos particulares puesto que su objeto de estudio ha cambiado de la evaluación y rehabilitación del paciente "con daño o padecimiento neurológico" al estudio del "paciente psiquiátrico". En la bibliografía neuropsicológica vinculada con la psiquiatría hay ya un sinnúmero de publicaciones relacionadas con la esquizofrenia, padecimiento considerado por muchos como el prototipo de la enfermedad mental. Sin embargo, a pesar de la gran cantidad de información generada, todavia no hay modelos de procesamiento de información que permitan comprender, dentro de una teoría neuropsicológica, los trastornos cognoscitivos que sabyacen en la incapacidad de estos pacientes para contender con las demandas de su entorno. Por otra parte, la aproximación a la población psiquiátrica demanda aún más del estudio del entorno: los valores, creencias y tradiciones juegan un papel muy importante en la expresión particular de la psicopatología y determinan, en gran medida, el pronóstico del tratamiento. De esta manera, y tomando en consideración que desde siempre la neuropsicología ha sido definida como una ciencia "interdisciplinaria", desde un enfoque neuropsicológico dinámico se propone considerar a la antropología social como una más de las disciplinas de apoyo a la ciencia neuropsicológica

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La enfermedad de chagas, endemia parasitaria de América, de crácter metaxénica, es una patología sobre la cual existe una extensa bibliografía lo cual demuestra el interés de los investigadores por conocer diferentes apectos que conduzcan a generar soluciones para su control, dada su distribución y el gran número de habitantes expuestos al riesgo. Desde hace más de cinco siglos fueron iniciados los estudios, en principio, expresados como relatos de vivencias experimentadas por cronistas, en relación a la existencia de los triatominos responsables de transmitir el agente causal, luego como investigaciones, que basadas en el descubrimiento del Dr. Carlos Chagas permiten conocer el comportamiento vectorial y formas clínicas de expresión, que llevaron a generar soluciones inmediatas para proteger a la población expuesta al riesgo. En Venezuela y otros paises de América, el programa de control basado en la lucha antivectorial, tiene inicio a finales de la década de los años cincuenta para cumplir objetivos y metas concretas que se expresan actualmente en indicadores cuantitativos que reflejan que la transmisión ha sido casi interrumpida en el área rural. El propósito de este trabajo documental es analizar como se ha intensificado el estudio de una enfermedad de carácter social, a través de las variables epidemiológicas de tiempo, espacio y persona, conocimientos que han permitido conocer en detalle la transmisión vectorial en el área rural

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Se efectuaron encuestas de carácter epidemiológico, tratamiento de los sujetos afectados. En los primeros 1.600 sujetos examinados se encontraron 228 con serologia positiva para la T. Cruzi la encuesta permitió comprobar una disminución acentuada en cuanto a la transmisión de la enfermedad debido a la campaña de control de sectores efectuada

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