Exploring local perceptions and drivers of engagement in biodiversity monitoring among participants in payments for ecosystem services schemes in southeastern Mexico

Payments for ecosystem services (PES) are widely applied incentive-based instruments with diverse objectives that increasingly include biodiversity conservation. Yet, there is a gap in understanding of how to best assess and monitor programs' biodiversity outcomes. We examined perceptions and drivers of engagement related to biodiversity monitoring through surveys among current PES participants in 7 communities in Mexico's Selva Lacandona. We conducted workshops among survey participants that included training and field deployment of tools used to monitor biodiversity and land cover, including visual transects, camera traps, acoustic recorders, and forest cover satellite images. We conducted pre- and postworkshop surveys in each community to evaluate changes in respondents' perceptions following exposure to biodiversity monitoring training and related field activities. We also reviewed existing research on participatory environmental management and monitoring approaches. One quarter of current PES participants in the study area participated in our surveys and workshops. The majority stated interest in engaging in diverse activities related to the procedural aspects of biodiversity monitoring (e.g., planning, field data collection, results dissemination) and acknowledged multiple benefits of introducing biodiversity monitoring into PES (e.g., knowledge and capacity building, improved natural resource management, and greater support for conservation). Household economic reliance on PES was positively associated with willingness to engage in monitoring. Technical expertise, time, and monetary constraints were deterrents. Respondents were most interested in monitoring mammals, birds, and plants and using visual transects, camera traps, and forest cover satellite images. Exposure to monitoring enhanced subsequent interest in monitoring by providing respondents with new insights from their communities related to deforestation and species' abundance and diversity. Respondents identified key strengths and weaknesses of applying different monitoring tools, which suggests that deploying multiple tools simultaneously can increase local engagement and produce complementary findings and data. Overall, our findings support the relevance and usefulness of incorporating participatory biodiversity monitoring into PES.

Genotyping of Toxoplasma gondii in domestic animals from Campeche, México, reveals virulent genotypes and a recombinant ROP5 allele

Toxoplasma gondii has at least 318 genotypes distributed worldwide, and tropical regions usually have greater genetic diversity. Campeche is a state located in the southeastern region of México and has favourable climate conditions for the replication and dissemination of this protozoan, similar to those in South American countries where broad genetic diversity has been described. Thus, in this study, 4 T. gondii isolates were obtained from tissues of stray dogs and free-range chickens in Campeche, México, and were genotyped by Mn-PCR-RFLP with 10 typing markers (SAG1, altSAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1 and Apico) and 5 virulence markers (CS3, ROP16, ROP17, ROP18 and ROP5) to provide new information about the distribution and virulence prediction of T. gondii genotypes. Two isolates of T. gondii genotype #116 and 2 of genotype #38 were obtained from stray dogs and chickens, respectively. The parasite load found in these species was between <50 and more than 35 000 tachyzoites per mg of tissue. Virulence marker genotyping revealed a recombinant 1&3 ROP5 RFLP pattern in 2 ToxoDB #116 isolates with no prediction of virulence in a murine model, while in the 2 ToxoDB #38 isolates, the ROP18/ROP5 combination predicted high virulence. Considering all the typed markers, there is a predominance of type I and III alleles, as constantly reported for the isolates characterized in various regions of México. It is crucial to determine their phenotype to corroborate the genetic virulence profile of the T. gondii isolates obtained in this study.

[Impact of the COVID-19 pandemic on cardiovascular disease mortality trends in Mexico, 2000-2022]

OBJECTIVE

To estimate the impact of the COVID-19 pandemic on cardiovascular disease (CVD) mortality trends in Mexico.

METHODS

An ecological study was conducted where deaths from CVD reported in Mexico under the ICD-10 classification with codes I10 to I99 for the period 2000-2022 were analyzed. Age-standardized mortality rates were calculated at the national and state levels, then the annual percentage variation was estimated using joinpoint analysis to know the changes in the mortality trend in the period studied.

RESULTS

There was an increase of 27.96 deaths per 100,000 inhabitants from 2000 to 2022 in Mexico. The joinpoint analysis shows in the period 2019-2021 an annual percentage change at the national level of 17,398 and subsequently a negative trend is presented between the years 2021-2022. The states of Guanajuato, Tlaxcala and Querétaro showed the largest increases in CVD mortality trends during the COVID-19 pandemic.

CONCLUSIONS

The trend in CVD mortality in Mexico increased significantly during the COVID-19 pandemic.

Antibiotic resistance of ESKAPE group-microorganisms in health institutions from Hermosillo and Ciudad Obregón, Sonora, México

Introduction

Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. are microorganisms referred as the ESKAPE group pathogens. These microorganisms have generated great concern in health institutions around the world since most of them have resistance to multiple antibiotics and cause most infections associated with healthcare, as well as community infections. The aim of this study was the analysis of antibiotic resistance in microorganisms of the ESKAPE group, recovered from clinical samples in 11 health institutions from Hermosillo and Ciudad Obregón in the State of Sonora, México, during the period from 2019 to 2020.

Methods

A cross-sectional, descriptive, observational, and temporality epidemiological study was carried out. A comparative and statistical analysis of antibiotic resistance was carried out using the chi-square test, and small values were analyzed using Fisher's exact test p ≤ 0.05.

Results and discussion

All the ESKAPE group microorganisms showed significant differences in antibiotic resistance percentages between both cities. High resistance percentages for some antibiotics, like cephalosporins and ciprofloxacin were detected for Klebsiella pneumoniae and Acinetobacter baumannii.

External validation of the 2017 ACR/EULAR classification criteria for inflammatory myopathies in a Mexican cohort: Role of autoantibodies in the diagnosis and classification of patients with inflammatory myopathies

OBJECTIVE

This retrospective study aimed to perform the first external validation of the ACR/EULAR classification criteria for inflammatory myopathy (IIM) in a Mexican dynamic cohort where the patients were evaluated with clinical and laboratory values. As secondary objectives, we presented the clinical characteristics of the patients and included antibodies other than anti Jo1 to evaluate their impact on our population.

METHODOLOGY

This study included 70 patients with IIM and 70 patients with differential diagnoses of IIM, according to the absolute score of the classification criteria. We obtained sensitivity and specificity in the modality without biopsy, and as an exploratory analysis, we added other antibodies from the myositis extended panel. We analyzed the area under the curve (AUC) of three models: score without antibodies, with anti Jo1 and with any antibody.

RESULTS

The ACR/EULAR criteria showed increased specificity and at least similar sensitivity to that of the original cohort (85% sensitivity and 92% specificity), with a cohort point of >55%. When we classified patients into definite, probable, possible, and no IIM categories, by adding the extended myopathy panel, 6 of the 10 patients initially classified as "no IIM" changed their classification to "Probable IIM" and 4 to "Definite IIM"; of the 16 patients classified as "probable IIM," 15 changed their classification to "Definite IIM."

CONCLUSION

Considering the limitations of this study, we concluded that the 2017 EULAR/ACR criteria for IIM classification are sensitive and specific for classifying patients with IIM in the Mexican population. Additionally, the addition of antibodies other than anti-Jo1 may improve performance in certain populations.

Factores socioeconómicos asociados por nivel de inseguridad alimentaria en adultos mexicanos con diabetes mellitus durante la pandemia de la COVID-19

OBJETIVOS

estimar la prevalencia de la inseguridad alimentaria e identificar los factores socioeconómicos asociados en adultos mexicanos con diabetes mellitus, durante la pandemia de la COVID-19.

MÉTODOS

estudio transversal, análisis secundario de los datos de la Encuesta Nacional de Salud y Nutrición 2020 sobre la COVID-19. Se estudió a 1 232 individuos que representan a 9 569 330 adultos con diabetes mellitus. La inseguridad alimentaria se midió utilizando la Escala Latinoamericana y Caribeña de Seguridad Alimentaria adaptada para México. Se realizó un modelo de regresión logístico binario para cada nivel de inseguridad alimentaria. Se calcularon razón de momios e intervalos de confianza al 95 %. Un valor de p < 0.05 fue estadísticamente significativo.

RESULTADOS

el 64.8 % presentó inseguridad alimentaria: 40.7 % leve, 14.2 % moderada y 9.9 % severa. Los factores asociados a inseguridad alimentaria leve fueron: nivel socioeconómico muy bajo (RM 2.6), pérdida del empleo de algún miembro del hogar (RM 2.0) y reducción de gastos en alimentación (RM 5.0); para inseguridad moderada la RM fue de 7.7, 3.4 y 18.6 y en severa la RM 7.1, 3.0 y 46.7, respectivamente.

CONCLUSIONES

la COVID-19 ha tenido efectos inmediatos en la inseguridad alimentaria de la población de adultos mexicanos con diabetes mellitus. Identificar los factores socioeconómicos asociados es prioritario para llevar a cabo políticas públicas que permitan redirigir los recursos y cubrir necesidades básicas como la alimentación.

Trends in Parkinson's mortality in Mexico 2000-2020

OBJECTIVE

To describe the recent trends in Parkinson's disease mortality in Mexico during 2000-2020.

METHOD

The adjusted mortality rate per 100,000 inhabitants was calculated using the direct method and the world standard population. Trend analysis was performed with the Joinpoint software.

RESULTS

The average mortality rate was 1.26/100,000 inhabitants (SD: 0.09), and males showed higher mortality than females (M/F ratio=1.60). Older individuals ≥70 years old showed higher mortality rates than the rest of the age groups. During the period of study, a significant increase in mortality was observed from 2000 to 2005, while from 2005 to 2020 no significant trend was observed in all the studied groups.

CONCLUSIONS

In Mexico, males and older individuals showed the highest mortality rates. The socioeconomic regions with high levels of wellness showed the highest mortality rates levels. Parkinson's mortality rate has remained constant since 2005 in Mexico.

δ13C and δ15N zooplankton isoscapes as trace of water masses and mesoscale activity in the Pacific Tropical-Subtropical Convergence off Mexico during June 2010

This research analyzes for the first time in the Pacific Tropical-Subtropical Convergence off Mexico during June 2010 the relationships among the δ13C and δ15N signal distribution in the bulk zooplankton, water masses, and mesoscale structures. The environmental analysis showed that the California Current Water (CCW) and Transitional Water (TrW) converge where the 22 °C isotherm and 34.6 g kg-1 isohaline were observed (22°N). Two cyclonic eddies were detected: one in CCW at 24°N about 70 km in diameter, the other one located in TrW at 21°N with 150 km in diameter. A cluster analysis defined three zooplankton isoscapes with significant differences. Isoscape 1, immerses in CCW - the lowest δ13C (-22.37 ± 0.89 ‰) and δ15N (9.89 ± 1.32 ‰) - showed temperature (19.86 ± 1.97 °C), salinity (34.08 ± 0.37 g kg-1) values, the deepest thermocline (77.93 ± 25.51 m) and oxygen minimum zone (164.78 ± 44.96 m). The CCW was relatively oligotrophic without important mesoscale features in the sampled time within the sampled area. Isoscape 2, a cyclonic eddy in CCW - relatively enriched zooplankton δ13C values (-16.78 ± 1.95 ‰) due to the entry of enriched coastal biota- reflected in high chlorophyll a and subsequently assimilated into zooplankton tissues. Isoscape 3, a cyclonic eddy immerses in TrW - the highest δ15N (13.14 ± 1.60 ‰), salinity (34.76 ± 0.19 g kg-1) and temperature (19.90 ± 2.27 °C) values and shallowest thermocline (32.27 ± 18.63 m), and oxygen minimum zone (66.82 ± 37.68 m) in depth. Likely, this 15N-enriched recycled nitrate was pumped from the deoxygenated subsurface to the surface, reflected in the zooplankton bulks. The results showed that the isotopic signals in bulk zooplankton may be a good water mass and mesoscale activity tracer.

Safety of helicopter transport in patients with acute coronary syndrome

BACKGROUND

ST-elevation myocardial infarction (STEMI) systems of care have reduced inter-hospital transfer times and facilitated timely reperfusion goals. Helicopters may be an option when land transportation is not feasible; however, the safety of air transport in patients with acute coronary syndrome (ACS) is a factor to consider.

OBJETIVES

The aim of this study was to evaluate the safety of helicopter transport for patients with ACS.

METHODS

Prospective, observational, and descriptive study including patients diagnosed with ACS within the STEMI network of a metropolitan city transferred by helicopter to a large cardiovascular center to undergo percutaneous coronary intervention. The primary outcome of the study was the incidence of air-travel-related complications defined as IV dislodgement, hypoxia, arrhythmia, angina, anxiety, bleeding, and hypothermia. Secondary outcomes included the individual components of the primary outcome.

RESULTS

A total of 106 patients were included in the study; the mean age was 54 years and 84.9% were male. The most frequent diagnosis was STEMI after successful fibrinolysis (51.8%), followed by STEMI with failed fibrinolysis (23.7%) and non-reperfused STEMI (9.4%). Five patients (4.7%) developed at least one complication: IV dislodgement (1.8%) and hypoxemia (1.8%) in two patients and an episode of angina during flight (0.9%). A flight altitude of > 10,000 ft was not associated with complications.

CONCLUSIONS

The results of this study suggest that helicopter transportation is safe in patients undergoing acute coronary syndrome, despite the altitude of a metropolitan area.

Knowledge, experience, and perception of molar incisor hypomineralisation among dentists in the metropolitan area of Mexico City: a cross-sectional study

BACKGROUND

Molar-incisor hypomineralisation (MIH) is the most common developmental abnormality observed in teeth. Being a relatively new condition, its treatment can present a challenge for the dentist. There is currently no study available that has evaluated the knowledge of Mexican dental personnel. This study aimed to evaluate the knowledge, experience, and perceptions of dental surgeons regarding the detection, assessment, and treatment of MIH in the metropolitan area of Mexico City.

METHODS

A cross-sectional study was designed. Dentists from Mexico City and its metropolitan area were invited through social networks to answer a questionnaire of 30 questions related to MIH. Participants were classified into general practice dentists, paediatric dentists, and other speciality dentists. Pearson's chi-square test was used for data analysis.

RESULTS

The questionnaire was answered by 391 dentists. A total of 86% (338 out of 391) of them identified MIH lesions, while 84% of them reported having observed MIH lesions in their practice. The most frequently observed lesions were yellow-brown opacities which accounted for 47% of the lesions, 46% were white opacities, while only 7% were observed as post-eruptive fractures in the enamel as part of the manifestations of MIH. The most frequently reported problem in the management of teeth with MIH was insufficient training for treating children with MIH. A total of 84% of dentists stated that they would like more information on the treatment of MIH lesions.

CONCLUSIONS

Most of the surveyed dentists recognised MIH and reported having observed MIH lesions in their practice. Most of the dentists indicated that the main problem for the management of the MIH is the lack of training.

Trophic transfer mechanisms of potentially toxic elements from sediment and plant leaves (Rhizophora mangle) to fiddler crabs (Minuca rapax) ()

To assess "bottom-up" to "top-down" trophic transfer, we analyze As, Cd, Co, Cr, Cu, Hg, Ni, Se, Zn, Fe, and Mn from two sediment chemical fractions (exchangeable and organic-bound), red mangrove (Rhizophora mangle) leaves, and fiddler crab (M. rapax) soft tissues from Isla del Carmen, Yucatán Peninsula. Both mechanisms were observed indictive that R. mangle and M. rapax indeed bioaccumulated the toxic elements from the different matrices with the latter being a macro-concentrator only for Cu and Zn. Although the modified Geo-accumulation factor (combined exchangeable and organic matter fractions) suggested that the studied sites are practically "uncontaminated", Hg is the only toxic element to be having a "moderately to strongly" impact. Data shows how M. rapax had progressively bioaccumulated Hg, but no biomagnification could be corroborated given that the fiddler crab behaved as a de-concentrator.

Neurocysticercosis and hydrocephalus: the value of ventriculoperitoneal shunting in its management

BACKGROUND

Hydrocephalus is the main complication of extraparenchymal neurocysticercosis (EP-NC). Its symptomatic management relies mainly on the placement of a ventriculoperitoneal shunt (VPS). Previous studies have shown that this surgical procedure is associated with a poor prognosis, but current information is lacking.

METHODS

We included 108 patients with a definitive diagnosis of EP-NC and hydrocephalus requiring VPS placement. We evaluated their demographic, clinical, and inflammatory characteristics, as well as the frequency of complications related to VPS placement.

RESULTS

Hydrocephalus was present at the time of NC diagnosis in 79.6% of patients. VPS dysfunction occurred in 48 patients (44.4%), mainly within the first year after placement (66.7%). The dysfunctions were not associated with the location of the cyst, the inflammatory characteristics of the cerebrospinal fluid or the administration of cysticidal treatment. They were significantly more frequent in patients in whom the decision to place a VPS was made in the emergency department. Two years after VPS, patients' Karnofsky score averaged 84.6±15 and only one patient died of a cause directly related to VPS.

CONCLUSIONS

This study confirmed the utility of VPS and showed a significant improvement in the prognosis of patients requiring VPS compared with previous studies.

[Analysis of the internal coherence of the Mental Health and Addictions Program of Mexico 2020-2024]

OBJECTIVE

To analyse the internal coherence of the Specific Mental Health and Addictions Program 2020-2024 (PAE-SM20-24) of the Health Secretary of Mexico.

METHOD

Qualitative descriptive analysis of the logic connection and causal articulation between the objectives, the strategies, and the specific actions of the PAE-SM20-24.

RESULTS

PAE-SM20-24 formulates 3 priority objectives, 9 priority strategies, and 49 specific actions. The formulation of the objectives, strategies and actions lacks the necessary structure to define the who, how, where, and when. Neither does it establish financing sources, the mechanisms for resource administration, nor the strategies and actions that are needed to restructure the functions of the participating institutions. It does not define the mechanisms for social participation nor any clear actions for intersectoral work. The actions that are presented are limited to rhetoric proposals to promote, encourage, support, strengthen, and foster, which do not allow us to determine tangible effects due to their implementation. In general terms, the formulation of the program is ambiguous.

CONCLUSIONS

PAE-SM20-24 lacks internal coherence, which means that there is only a medium connection between its objectives, strategies, and specific actions. This jeopardizes its implementation and, therefore, its potential to contribute to the improvement of public policy related to mental health and addictions in the country.

Catastrophic antiphospholipid syndrome in Mexico. Literature review

Catastrophic antiphospholipid syndrome (CAPS) is a rare entity, approximately 600 cases have been reported around the world, and the prevalence in Mexico is unknown.

OBJECTIVE

To determine the estimated prevalence of CAPS in Mexico.

MATERIAL AND METHODS

A literature search of isolated clinical cases or case series was conducted in diverse search engines, using the terms: "Catastrophic Antiphospholipid Syndrome" and "Mexico" in May 2022.

RESULTS

We found a series of retrospective cases in autopsies that included 12 cases, two reports that included 2 cases each, and reports of 11 isolated clinical cases; these publications were generated between 2003 and 2020. In total, we collected data on 27 cases of CAPS, of which 16 correspond to primary antiphospholipid syndrome, 10 are associated with systemic lupus erythematosus, and 1 case corresponds to systemic sclerosis. The estimated prevalence rate in the Mexican population in 2022 is 2 cases per 10,000,000 inhabitants. The estimated mortality was 68% in this case series.

CONCLUSION

Cases of catastrophic antiphospholipid syndrome in Mexico are underreported; identifying them will help improve current diagnostic and therapeutic strategies used in the country, encouraging the implementation of triple therapy and, in refractory cases, the use of eculizumab, to reduce current mortality.

The Mexican consensus on fecal incontinence

Fecal incontinence is the involuntary passage or the incapacity to control the release of fecal matter through the anus. It is a condition that significantly impairs quality of life in those that suffer from it, given that it affects body image, self-esteem, and interferes with everyday activities, in turn, favoring social isolation. There are no guidelines or consensus in Mexico on the topic, and so the Asociación Mexicana de Gastroenterología brought together a multidisciplinary group (gastroenterologists, neurogastroenterologists, and surgeons) to carry out the «Mexican consensus on fecal incontinence» and establish useful recommendations for the medical community. The present document presents the formulated recommendations in 35 statements. Fecal incontinence is known to be a frequent entity whose incidence increases as individuals age, but one that is under-recognized. The pathophysiology of incontinence is complex and multifactorial, and in most cases, there is more than one associated risk factor. Even though there is no diagnostic gold standard, the combination of tests that evaluate structure (endoanal ultrasound) and function (anorectal manometry) should be recommended in all cases. Treatment should also be multidisciplinary and general measures and drugs (lidamidine, loperamide) are recommended, as well as non-pharmacologic interventions, such as biofeedback therapy, in selected cases. Likewise, surgical treatment should be offered to selected patients and performed by experts.

[Classification of caesarean sections by 10 Robson groups in a second level hospital]

Background

In recent years, cesarean section (CS) rates have increased alarmingly. The World Health Organization (WHO) proposes to use the Robson classification system as a global standard, which contributes to a better analysis of CS indications, making it possible to establish strategies to reduce them.

Objective

To analyze the classification of CS by Robson groups from July to September 2020 at the Hospital General de Zona No. 4 (District General Hospital [DGH] No. 4), in Celaya, Guanajuato.

Material and methods

Retrospective study which included 160 records of women undergoing CS. Robson's group classification was used, and descriptive statistics and cluster analysis were performed to better understand the classification groups.

Results

The average age was 27.6 ± 5.6 years. 53.1% had secondary school; 46.9% was a housewife; 46.3% was laborer; 42.8% were cohabitating; 50% had 1 or more births; 42.5% previous CS; 96.9% 1 fetus; 91.9% cephalic presentation; 78.8% 37 weeks of gestational age or more. Robson's group 5 (previous CS) had the highest percentage (42.5%), followed by group 2 (primiparous) with 20.6%, and group 10 (premature) 13.1%. Cluster analysis formed 3 groups, where cluster 1 and 3 contained group 5 of Robson's classification.

Conclusions

DGH No. 4 must carry out the necessary strategies so that women with a previous cesarean section can have a vaginal delivery, without compromising the well-being of the mother-child pair, in addition to interventions to avoid primary CS, because women in group 1 and 2 will potentially belong to group 5, in the next obstetric event.

Food insecurity and levels of marginalization: food accessibility, consumption and concern in Mexico

BACKGROUND

Food insecurity continues to be a problem throughout the world. When estimating food insecurity, few studies analyze the contexts where the phenomenon takes place. By bearing in mind levels of marginalization in four states of Mexico, this paper answers two questions: (I) What problems are experienced with access to food, and how these difficulties affect the amount of food consumed in households? and (II) How do households experience the concern of running out of food?

METHODS

Our qualitative study draws data from urban and semi-urban areas of four Mexican states: Mexico City, Tamaulipas, the State of Mexico, and Oaxaca. Each state presents different levels of well-being. The study's participants are selected using the snowball method. Eligibility criteria are based on demographic characteristics such as education, age, and gender. A thematic analytical approach is conducted to analyze collected data from a total of 212 semi-structured interviews.

RESULTS

The study's findings indicate that concern of food scarcity is a generalized feeling among participants across different levels of marginalization. Individuals with stable jobs living in contexts of low levels of marginalization experience worriedness when their budgets tightened before the end of the payday, a bi-weekly payment format, named the quincena in México. This psychological state of mind changes through the payday cycle, a period when the direct relationship between food accessibility and consumption weakens. In response, individuals develop strategies to cope with the uncertainty of experiencing food insecurity, such as rationing food portions and/or hoarding food supplies. Even when food accessibility exists, interviewees identify insufficient income as the primary issue in contexts of low and very low levels of marginalization.

CONCLUSIONS

Conclusive remarks drawn from our analysis underline the importance of the context of marginalization in influencing households' experiences with food insecurity. At the quincena's end, food insecurity increases, even in contexts of very low marginalization. Our study calls for rethinking the scales employed to measure food insecurity, specifically the questions related to fear of food scarcity. Coping strategies are implemented by surveyed individuals to resolve issues and repercussions that emerge from experiencing food insecurity differ by context of marginalization.

Genotyping of toxoplasma gondii isolates from México reveals non-archetypal and potentially virulent strains for mice

Genotyping and virulence studies of Toxoplasma gondii are essential to investigate the pathogenesis of strains circulating worldwide. In this study, eight T. gondii isolates obtained from a congenitally infected newborn, a calf, two cats, three dogs, and a wallaby from five states of México were genotyped by Mn-PCR-RFLP with 11 typing markers (SAG1, SAG2 5'3', alt. SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1 and Apico), five virulence markers (CS3, ROP16, ROP17, ROP18 and ROP5), 15 microsatellite markers (TUB-2, W35, TgM-A, B18, B17, M33, IV.1, XI.1, M48, M102, N60, N82, AA, N61, N83), and sequencing. A phylogenetic network was built to determine the relationship between Mexican isolates and those reported worldwide. Six different genotypes were identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), ToxoDB #8, #10, #28 (n = 3), #48, #116, and #282. Genotyping by microsatellite analysis differentiated the three PCR-RFLP genotype #28 isolates into two strains, revealing a total of seven microsatellite genotypes. Three different allele combinations of ROP18/ROP5 virulence markers were also found, 3/3, 1/1, and 4/1. The last two combinations are predicted to be highly virulent in the murine model. According to the phylogenetic network, the T. gondii strains studied here are related to archetypal strains I and III, but none are related to the strains previously reported in México. The genotypes identified in this study in different species of animals demonstrate the great genetic diversity of T. gondii in México. The ToxoDB-PCR-RFLP #28 genotype was found in three isolates from different hosts and states. Additionally, four of the isolates are predicted to be highly virulent in mice. The next step will be to perform in vitro and in vivo assays to determine the phenotype of these T. gondii isolates in murine models.

Hereditary angioedema: Patient journey approach in Mexico

Objective

To understand the patient's journey with HAE from symptom initiation to diagnosis, treatment allocation, follow-up, and the impact of the disease on their quality of life in Mexico.

Methods

A survey was administered to the patients with HAE. Participants completed a questionnaire covering five domains: patient journey; effects on productivity, school performance and daily activities; quality of life; anxiety and depression. Responses were analyzed using descriptive statistics.

Results

A total of 17 surveys were analyzed (15 women and 2 men, age range: 23-67 years). Type I HAE was most common (71%), normal C1 inhibitor HAE was 12% and 18% did not know their HAE type. The average disease evolution was 13.7 years and the time from symptom initiation to diagnosis was 20 years. 59% of patients knew of one or two treatments available, 12% knew 3 treatments and 18% were aware of 4 or more, 12% were not aware of any treatments. 53% had a job, 18% referred a severely anxious state, 41% were depressed and all patients referred some social impact due to HAE.

Conclusions

There is a need to reinforce the knowledge of general practitioners on HAE to promote an earlier diagnosis and awareness of rare diseases and their impact on quality of life among the general population and promote the removal of barriers to treatment.

Metal-specific biomagnification and trophic dilution in the coastal foodweb of the California sea lion (Zalophus californianus) off Bahía Magdalena, Mexico: The role of the benthic-pelagic foodweb in the trophic transfer of trace and toxic metals

Trace metals concentrations along with stable isotopes ratios were measured in marine algae, sea grass, sponges, echinoderms, mollusks, crustaceans, fishes, and the California sea lion, to assess the bioaccumulation potential and detect potential risks for top predators off Bahia Magdalena, Mexico. We assessed the trophic magnification factor (TMF) to determine the potential for biomagnification of 11 trace metals. The concentrations of Fe and Zn were one order of magnitude higher than all other metals. Concentrations of As, Cu, Cd, Co, Cr, Fe, Mn and Ni correlated negatively with trophic level, supporting trophic dilution (TMF < 1, p > 0.05), while Zn and Hg had significant trophic magnification (TMF > 1, p < 0.05) when assessing only the benthic-pelagic foodweb. This research provides a baseline concentration of metals in multiple species, metal-specific foodweb bioaccumulation and biomagnification of mercury, underscoring the key role of the macrobenthic community as biovectors for trophic transfer of Hg through the foodweb to the California sea lion.

Sarcoidosis: experience in a Mexican ophthalmological clinic

BACKGROUND

Sarcoidosis is an inflammatory disorder in which patients frequently develop ocular manifestations that precede systemic involvement, sometimes it even presents as an ocular isolated form of the disease. The purpose of this study is to report the ocular and systemic manifestations of sarcoidosis in a series of Mexican patients, as there is a low incidence of the disease in this population.

METHODS

A retrospective case series of patients with positive classification criteria for sarcoidosis who attended Asociacion Para Evitar la Ceguera en Mexico, IAP between 2011 and 2022. Descriptive statistics were used to report the clinical, laboratory, and imaging findings and treatment. Numerical results were presented using median values and first and third quartiles for distribution.

RESULTS

Fourteen patients were included in this study, 10 of them had definite ocular sarcoidosis (biopsy-proven), 4 had presumed ocular sarcoidosis. The median age of onset was 52 (34; 67), with a predominance of female patients (71.4%). Ten patients (71.4%) debuted with ocular manifestations. The most common forms of ocular involvement were bilateral anterior uveitis (50%) and panuveitis (28.6%). Median follow-up was 24 (13-49) months.

CONCLUSIONS

Sarcoidosis is a rare, underdiagnosed condition in Mexico and ocular involvement can be an early manifestation of the disease. Ophthalmologists should be alert to the signs of ocular sarcoidosis and collaborate with a multidisciplinary team to screen for systemic involvement if suspicion is high.

Prevalence and clinical-epidemiologic characteristics of a Mexican population with metabolic (dysfunction) associated fatty liver disease: An open population study

INTRODUCTION AND AIMS

The risk factors for fatty liver disease are frequent in the Mexican population and the available studies appear to underestimate its prevalence. Our aims were to know the prevalence of metabolic (dysfunction) associated fatty liver disease (MAFLD) in an open population and determine the clinical and sociodemographic characteristics, nutritional status, physical activity level, and prevalence of metabolic syndrome, in the affected population.

MATERIALS AND METHODS

Volunteers from the general public were invited to take part in the study. Three separate questionnaires were applied to 1) determine the sociodemographic characteristics and health status of the participants, 2) evaluate the quality of their diet, and 3) to evaluate their level of physical activity. The participants underwent somatometry, laboratory tests, liver ultrasound, and FIB-4 index determination, and transition elastography (FibroScan®) was carried out on all subjects with signs suggestive of liver fibrosis that agreed to undergo the procedure. The statistical analysis was carried out using SPSS for Windows, version 22, software.

RESULTS

A total of 585 volunteers were studied, resulting in a prevalence of MAFLD of 41.3%, a predominance of men above 50 years of age, poor dietary habits, and sedentary lifestyle. Male sex, obesity, metabolic syndrome, and elevated ALT were risk factors for the disease and 40% of those affected had advanced fibrosis.

CONCLUSIONS

The prevalence of MAFLD in our population is one of the highest in the world. The conditioning factors of the disease can be modified. Therefore, public policies that redirect the current trend are required.

Metal Contents in Feathers from Birds (Rhynchopsitta terrisi, and Columba livia) with Different Ecological Niches

The metal contaminants can be utilized as an ecological tool to analyze niche partition in birds. As environmental contamination biological indicators, essential (Zn, Cu, and Cr) and non-essential (Pb and Cd) metals in the flight feathers of the Maroon-fronted Parrot and Pigeon with different ecological niches were assessed. The feathers of the parrot were gathered at a national park (Parque Nacional Cumbres de Monterrey) and the feathers of pigeons were collected at an urban site, that is, the city of Monterrey, Mexico. An atomic absorption spectrophotometer was used to establish the concentration of metals in the feathers. Zn, Cu, Cr, Pb, and Cd were detected in the two studied samples. The results obtained in this study exhibited an increase in metal concentrations in pigeon feathers with respect to parrot feathers. In conclusion, employing parrot and pigeon feathers comprises an important tool to track trace-metal occurrence in the environment and metal accumulation in birds. This information is crucial to possess in order to minimize exposure to essential metals in species of wild birds with different ecological niches.

Influence of the sociocultural perspective on the sensory perception of wine consumers in Mexico and Spain

The increasing globalization of companies and markets, including the wine market, makes this study important as a cultural comparison between the sensory perception of wine in Mexico and Spain. Eighty consumers were selected with different consumption habits, and hedonic (Acceptance and Simple Preference) and descriptive (Word Association Task and the Check-All-That-Apply (CATA) method) sensory tests were performed. The results revealed that there were differences in the conceptualization of wine in the Word Association Task. Both populations preferred wines of Spanish origin over those of Mexican origin, especially in the case of red wine. Finally, the results of the CATA method showed that the attributes that discriminate the two types of wine are due more to the country origin of the tasters than to the samples. Spanish consumers used cultural and tradition descriptors and were stricter when it came to sensory evaluation. Moreover, Spanish participants demonstrated more ability to differentiating all wines in terms of visual, olfactory and taste aspects.

Presence of the toxigenic fungi Aspergillus spp. and Fusarium spp. in Musca domestica L. (Diptera: Muscidae) collected from dairy farms

The objective of the study was to identify the presence of toxigenic fungi Aspergillus spp. and Fusarium spp. in domestic flies collected from dairy farms. We selected 10 dairy farms distributed in the central valley of the state of Aguascalientes, México. The flies were trapped using entomological traps with an olfactory attractant in 7 sites of the farm (silo-cutting surface, feed store, milking parlor, 3 feeders, and the rearing room). The fungi were cultivated in Sabouraud agar through direct sowing by serial dilutions to obtain the isolates, and a taxonomical identification was carried out under the microscope. The aflatoxins and zearalenone production capacity of the pure isolates were quantified using the ELISA test. The flies were present in all of the capture sites (45.3 flies, 567 mg, trap per day). We obtained 50 isolates of Aspergillus spp. genus, 12 of which produced aflatoxins (327 ± 143 µg/kg), whereas from 56 of the Fusarium spp. isolates, 10 produced large quantities of zearalenone (3,132 ± 665 µg/kg). These results suggest that the presence of domestic flies on dairy farms can constitute a source of dissemination for toxigenic fungi that can eventually contaminate grains and forage that are part of the daily cattle diet.

Comparison of Climate Change Scenarios of Rhipicephalus sanguineus sensu lato (Latreille 1806) from México and the Boarders with Central America and the United States

In America, the presence of Rhipicephalus sanguineus sensu stricto and Rhipicephalus linnaei has been confirmed. Both species are found in sympatry in the southern United States, northern Mexico, southern Brazil, and Argentina. The objective of this work is to evaluate the projection of the potential distribution of the ecological niche of Rhipicephalus sanguineus sensu lato in two climate change scenarios in Mexico and the border with Central America and the United States. Initially, a database of personal collections of the authors, GBIF, Institute of Epidemiological Diagnosis and Reference, and scientific articles was built. The ENMs were projected for the current period and two future scenarios: RCP and SSP used for the kuenm R package, the ecological niche of R. sanguineus s.l. It is distributed throughout the Mexico and Texas (United States), along with the border areas between Central America, Mexico, and the United States. Finally, it is observed that the ecological niche of R. sanguineus s.l. in the current period coincides in three degrees with the routes of human migration. Based on this information, and mainly on the flow of migrants from Central America to the United States, the risk of a greater gene flow in this area increases, so the risk relating to this border is a latent point that must be analyzed.

Major, minor and trace element concentrations in the muscle and liver of a pregnant female Pacific sharpnose shark (Rhizoprionodon longurio) and its embryos

The Pacific sharpnose shark Rhizoprionodon longurio is an abundant shark consumed by human population in Mexico. This study aimed to determine and compare the concentrations of thirteen essential elements (K, S, P, Na, Ca, Mg, Fe, Zn, Se, Cu, Mn, Cr and Co) and eleven non-essential elements (As, Sr, Cd, V, Li, U, Tl, Ag, Sn, Sb and Pb) in the muscle and liver of a pregnant female, fished near the copper mine of Santa Rosalía, and their respective embryos. Major, minor and trace (essential and non-essential) elements were transferred during gestation to embryos. All major elements analyzed had significantly higher concentrations in embryos liver than the pregnant female, except for magnesium. Higher concentrations in embryo tissues than the pregnant female tissues were found for the non-essential trace elements of strontium, lithium, thallium and silver, which indicate an easy maternal transfer of these non-essential elements.

Taenia solium: Socioeconomic changes and prevalence evolution in four endemic communities in northwestern Mexico

In Mexico, for the past 30 years, a continuous decrease in the incidence of clinical taeniosis/cysticercosis has been documented. This work aimed to determine the influence of improvement in socioeconomic conditions on the prevalence of Taenia solium in four endemic communities in northwestern Mexico. This study was carried out in two phases. First, documentary information (1989-2018) was collected about the prevalence of Theridion solium in the federal entity of Sinaloa State. Second, a pilot study was performed in four communities of Sinaloa, which had an endemic history of Taenia transmission. In each community, a risk factor questionnaire was applied, and serum and stool samples were collected for convenience in a non-probabilistic way. Anti-cysticercus antibodies and adult worm coproantigen were determined. The documentary analysis showed the incidence of taeniosis and cysticercosis to have decreased by 98 and 53%, respectively, while the human development index increased by 5% (1992-2017). Our data suggest that the risk of parasitic transmission is low, although female sex was a risk factor for reporting tremors or seizures (prevalence rate 2.1336, CI: 1.1821-3.8508) and background of tapeworm infection (prevalence rate 1.2893, CI: 0.9795-1.6972). No tapeworms or eggs were found while examining stool samples, but protozoa cysts were observed in four samples. Unexpectedly, only one of the 79 stool samples was positive for coproantigens. This positive result was confirmed in a second sample. However, the evaluation of a third sample was negative. No antibodies were found in human (n = 377) or pig (n = 69) samples. These data suggest parasite transmission has been interrupted and could be possibly associated with improving socioeconomic conditions. Further studies are needed to determine the real prevalence of zoonoses in Mexico.

Sustainable Dietary Score: Methodology for Its Assessment in Mexico Based on EAT-Lancet Recommendations

We developed a Sustainable Dietary Score (SDS) based on the EAT-Lancet commission's recommendations and evaluated its adherence in a sample of Mexican adults. We used data on 1908 men and women aged 19 to 59 participating in the Health Workers Cohort Study in 2004. Fourteen of the healthy reference diet components were used to develop the SDS. We computed an individual SDS for each food component with scales from 0 (non-adherence) to 10 (perfect adherence), as well as a total SDS including all components, ranging from 0 to 140, based on a food frequency questionnaire. Our score incorporates characteristics of the context in which the score is applied, such as the high consumption of tortillas and eggs, and cut-off points that consider the nutrient deficiencies that prevail in the Mexican population. We propose a practical methodology to estimate a SDS incorporating a gradual score for a better distinction between the degrees of adherence to the reference diet proposed by the EAT-Lancet Commission.

Definition of normal blood pressure at 11 to 14 weeks' gestation according to risk

OBJECTIVE

To define normal blood pressure at first trimester of pregnancy by performance for pre-eclampsia prediction.

METHOD

A cohort study in singleton pregnancies, according to the competing risks model for pre-eclampsia. Blood pressure was measured according to a standardized method at 11 to 14 weeks' gestation.

RESULTS

Among 797 pregnancies included, there were 40 (5.0%, IC95 3.6; 6.4) deliveries with pre-eclampsia. The systolic, diastolic, and mean arterial blood pressures were respectively of 101(9), 68(8) and 79(8) mmHg in pregnant women who did not develop pre-eclampsia, against 109(10), 75(8) and 86(8) in those who did (p < 0.001, t-test). The areas under the curves were 0.707 (0.637; 0.777), 0.728 (0.661; 0.795), and 0.738 (0.673; 0.803). At a 3% of false positive rate, the cut-off points were 119, 83 and 94 mmHg with predictive values of negative of 95.6%.

CONCLUSIONS

It is feasible to define the normal values for blood pressure in pregnancy on biostatistic and clinical basis.

Identifying socioeconomic and biophysical factors driving forest loss in protected areas

Protected areas (PAs) are a commonly used strategy to confront forest conversion and biodiversity loss. Although determining drivers of forest loss is central to conservation success, understanding of them is limited by conventional modeling assumptions. We used random forest regression to evaluate potential drivers of deforestation in PAs in Mexico, while accounting for nonlinear relationships and higher order interactions underlying deforestation processes. Socioeconomic drivers (e.g., road density, human population density) and underlying biophysical conditions (e.g., precipitation, distance to water, elevation, slope) were stronger predictors of forest loss than PA characteristics, such as age, type, and management effectiveness. Within PA characteristics, variables reflecting collaborative and equitable management and PA size were the strongest predictors of forest loss, albeit with less explanatory power than socioeconomic and biophysical variables. In contrast to previously used methods, which typically have been based on the assumption of linear relationships, we found that the associations between most predictors and forest loss are nonlinear. Our results can inform decisions on the allocation of PA resources by strengthening management in PAs with the highest risk of deforestation and help preemptively protect key biodiversity areas that may be vulnerable to deforestation in the future.

Colorectal cancer. Genetic variants in BMP signaling pathway and ancestry in the Mexican population

INTRODUCTION

Genetic variants related to bone morphogenetic proteins (BMP2, BMP4, GREM1, SMAD7) signaling pathway have been associated with colorectal cancer, mainly in Caucasian populations.

OBJECTIVE

To describe the association of variants in members of the BMP signaling pathway in a Mexican population, characterized by its indigenous American and Caucasian ancestry.

METHODS

Genotyping of 1,000 colorectal cancer cases and 1,043 control individuals recruited in Mexico City, Monterrey, and Torreón was carried out using the Sequenom platform. Associations between colorectal cancer and variants were studied with univariate and multivariate analyses.

RESULTS

Variants rs4444235, rs12953717 and rs4939827 replicated the association with the neoplasm (p ≤ 0.05). Caucasian ancestry showed association with the tumor.

CONCLUSIONS

The study replicated the associations between colorectal cancer and SMAD7 and BMP4 variants, with an association being observed with the Caucasian component of the ethnic mix.

Inequalities in diabetes mortality in Mexico: 2010-2019

BACKGROUND

The impact of diabetes mellitus has been shown to be differentially expressed between social groups.

OBJECTIVE

To estimate inequality gaps in diabetes mellitus mortality through absolute and relative measures according to geographic distribution and social conditions.

MATERIAL AND METHODS

Diabetes mellitus-related deaths recorded in Mexico between 2010 and 2019 were analyzed, and inequality measurements at the state level were calculated by gender.

RESULTS

National age-adjusted diabetes mellitus mortality rate showed an increase during the study period.

CONCLUSION

The inequalities present in diabetes mortality should be considered for the design of health strategies.

Use of subcutaneous cardioverter-defibrillator. First cases reported from National Institute of Cardiology Ignacio Chávez-Mexico

INTRODUCTION

The transvenous implantable cardioverter defibrillator (ICD) is the treatment of choice for the prevention of sudden cardiac death (SCD). Its use could be restricted when device-related infections occurs or in the pediatric population. In the later, an ICD represents a challenge, due to the minimal dimensions of the venous system in children, the length of the electrodes, the size of the generator, as well as the anatomical complexity in cases with associated congenital heart disease.

OBJECTIVE

This article presents the first Mexican patients with a subcutaneous ICD (SC-ICD) implant as a therapy for the prevention of SCD.

METHODS

The first four cases were implanted at the Ignacio Chávez National Institute of Cardiology with a SC-ICD (Emblem, Boston Scientific, USA), three of them were pediatric patients, including the first implant of this type of device in a pediatric patient in Latin America. The 3-incision and 2-incision techniques were used under general anesthesia.

RESULTS

A successful implantation was obtained with the 3-incision technique in the first 2 cases and the last 2 with the 2-incision technique. Proper functioning of the device was corroborated in the operating room with proof of appropriate therapy (65 J) for ventricular fibrillation induced with 50 Hz stimulation. No immediate complications were observed. One patient had appropriate shocks two months after the implant. During follow-up, one child developed skin erosion at the level of the curve of the electrode on the sternum, with no signs of infection. In the operating room, the damaged skin was resected, the barrel and the fixation silk were removed, surgical lavage was performed, and the skin was closed again, thus avoiding removal of the system.

CONCLUSIONS

The SC-ICD is an alternative therapy to the transvenous ICD. It can be considered first choice in subjects who do not require ventricular pacing, including pediatric patients. Skin complications can occur but do not pose a threat as venous complications of conventional ICDs.

Burden of overweight and obesity in Mexico from 1990 to 2021

BACKGROUND

Overweight and obesity (OW/OB) represent a serious challenge in Mexico, with effects on health, society and economy. Demographic, epidemiological, nutritional, social and economic factors have exacerbated this problem.

OBJECTIVE

To analyze mortality and years of healthy life lost in Mexico due to OW/OB in the 1990-2021 period.

MATERIAL AND METHODS

The Global Burden of Disease and Risk Factors 2021 study was used to analyze data on elevated body mass index (BMI) as a risk factor and its evolution in Mexico.

RESULTS

In 2021, 118 thousand deaths attributable to high BMI were recorded, which accounted for 10.6% of total deaths and more than 4.2 million disability-adjusted life years lost.

CONCLUSIONS

The obesogenic environment, influenced by social determinants of health, has had a significant impact on mortality, burden of disease, and economic costs. Addressing OW/OB requires multisector interventions to strengthen the Mexican health system.

Celiac disease seroprevalence in patients with infertility. A case-control study

BACKGROUND

Although most patients with celiac disease (CD) have digestive manifestations, in some of them they may be of extraintestinal (atypical) nature, such as chronic anemia, ataxia, and fertility disorders.

OBJECTIVE

To determine the prevalence of CD-related antibodies in Mexican women with fertility disorders.

MATERIAL AND METHODS

Case-control study of women who attended evaluation for fertility disorders in a specialized center. h-tTG-IgA, gliadin IgA II and gliadin IgG II were quantified; titers > 30 IU were considered positive.

RESULTS

One-hundred and seventy-one cases and 171 controls were included; 137 patients (80.1%) had infertility, and 34 (19.9%), sterility. Eight patients (4.6%, 95% CI = 2.3-8.9) had at least one positive marker for CD in comparison with one woman in the control group (0.5%, 95% CI = 0.01-3, p = 0.04, odds ratio = 8.3). Six of the eight patients had unexplained infertility.

CONCLUSIONS

Up to 4.6% of women with infertility had at least one positive marker for CD. As in other parts of the world, screening for CD could be recommended in women with infertility, especially in those with unexplained infertility.

Guidelines on epidemics in Mexico. Historical perspective

A perspective of epidemics and pandemics in Mexico is offered, focusing on three time periods, namely, end of the 18^th century, the 20^th century, and the 21^st century, in order to analyze how they were approached by health and government authorities, as well as the challenges they have represented. Historical documentary sources were consulted and, in current cases, participation in them was analyzed. Epidemiological and social historical methodologies were combined. The presence of epidemics in Mexico is a constant on its evolution, which highlights the need for the epidemiological surveillance system to be updated, the importance of being prepared to face an epidemic and to develop a contingency plan.

Analysis of cancer mortality in Mexico using the results of the Global Burden of Disease 2021 study

BACKGROUND

In Mexico, cancer mortality rates have undergone changes over the past decades.

OBJECTIVE

To analyze the evolution of cancer mortality rates in Mexico between 1990 and 2021.

MATERIALS AND METHODS

Based on the Global Burden of Disease study, the mortality rates for the 10 most prevalent types of cancer in Mexico were obtained, at the national and regional level and by states, considering different age groups and gender. Global Burden of Disease reassigns misclassified causes and distributes them among different types of cancer; subsequently, it models and adjusts the causes to the total number of deaths with a model of a set of causes of death and a cause corrector, which corrects INEGI's mortality records.

RESULTS

The cancer mortality rate went from 117.87 in 1990 to 84.18 in 2021. In women, breast, cervical, stomach and lung cancers were the most frequent. In men, the most common were prostate, stomach, lung, and colon and rectum cancer. The decrease in cancer mortality for men and women stood out, particularly from lung and cervical cancer.

CONCLUSIONS

The results provide information for the development of health policies and specific prevention and control strategies to address the impact of cancer in Mexico.

Salivary gland tumor incidence in adult patients in a tertiary hospital in Mexico from 2008 to 2019

OBJECTIVE

To determine the incidence of salivary gland tumors in a population of a tertiary hospital in the State of Mexico, and to describe demographic variables.

METHOD

An observational, cross-sectional and retrospective study of salivary gland tumors reported in a tertiary hospital in the State of Mexico in the period 2008-2019 is presented.

RESULTS

A prevalence of 0.049% was found. There was no difference between sex in the studied population. Benign salivary gland tumors were the most frequent (86.7%). The age range most affected was 51-60 years. The most frequently found tumor was the pleomorphic adenoma, followed by Warthin's tumor. There was 13.33% of sialolipomas, and one myoepithelioma. There were no cases of sublingual gland tumors or minor salivary glands.

CONCLUSION

Tumors of the major salivary glands are infrequent tumors; population cases from a central Mexican state and their demographic characteristics are presented to contribute to the information found in local and international literature.

Prevalence of methanogens and associated factors in patients with irritable bowel syndrome and healthy controls in a Southeastern Mexican population

INTRODUCTION

Methane (CH₄) is an inert gas produced by colonic anaerobes and has been associated with different intestinal diseases, including irritable bowel syndrome (IBS). According to geographic region, the prevalence of methanogens varies, being higher in Africa (80%) and lower in the United States (35-40%). In Mexico, the prevalence of methanogens is unknown.

AIM

To evaluate the prevalence of CH₄ producers and associated factors in a group of patients with IBS and controls in a Mexican population.

MATERIALS AND METHODS

A baseline fasting measurement of alveolar H₂ and CH₄ gas was carried out, by gas chromatography (stationary phase), in consecutive patients diagnosed with IBS and a control group. Subjects with baseline levels of H₂ of 0 ppm and CH₄ ≥ 5 ppm were classified as methanogenic.

RESULTS

A total of 132 controls (53.8% women) and 67 patients with IBS (76% women) were included. The overall prevalence (n = 199) of methanogenic subjects was 38% (n = 76) (95% CI: 0.31-0.45) and they had a greater prevalence of overweight/obesity (56.5 vs 39.8%, P = .028). The prevalence of methanogens in the healthy controls was 41.6% (95% CI: 0.33-0.49), whereas, in the patients with IBS, it was 31.4% (n = 21, 71% IBS-C and 29% IBS-M).

CONCLUSIONS

The prevalence of methanogens in our study on a Mexican population was comparable to that reported in other populations and was associated with overweight/obesity. One-third of the patients with IBS presented with methanogens. Said microorganisms were particularlyassociated with the constipation-predominant IBS subtype.

Mental disorders in Mexico 1990-2021. Results from the Global Burden of Disease 2021 study

BACKGROUND

Mental disorders are one of the main causes of years lived with disability, although there is a lack of recent estimates of their magnitude.

OBJECTIVE

To report the trends of mental disorders prevalence, years lived with disability and years of healthy life lost by sex, age and state in Mexico.

MATERIAL AND METHODS

The Global Burden of Disease database for Mexico was used.

RESULTS

There were an estimated 18.1 million persons with some mental disorder in 2021, which represented an increase of 15.4% in comparison with 2019. Depressive and anxiety disorders did significantly increase between 2019 and 2021, which is possibly related to COVID-19, the confinement and the situations of grief experienced during the pandemic.

CONCLUSIONS

Mental disorders have considerably increased since the only national mental health survey that used diagnostic criteria to evaluate their prevalence. It is important to invest in epidemiological studies, prevention and care of mental disorders, which are among the leading causes of years lived with disability in the country.

Abdominal aortic aneurysm characteristics and outcomes: a single-center retrospective cross-sectional study

OBJECTIVE

The objective of the study is to evaluate the characteristics and outcomes of patients with abdominal aortic aneurysm (AAA) and its correlation with mortality in the first 30 days after the procedure was performed.

METHODS

Demographic information, clinical and radiological characteristics, as well as outcomes 30 days after the procedure was performed were assessed and compared. Continuous variables were analyzed with Student's t-test and categorical with Chi-square and Fisher's exact test.

RESULTS

Duration of the procedure (p = 0.001), blood loss (p < 0.001), age > 75 years (p = 0.027), aneurysm size > 65 mm (p = 0.01), open surgery (p = 0.001), presence of pain (p = 0.005), chronic kidney disease (p = 0.03), and rupture of the aneurysm (p < 0.001) were the factors significantly associated with mortality.

CONCLUSION

It is essential that patient characteristics and comorbidities are assessed, as well as factors that may affect the outcomes to predict the prognosis in patients with AAA. At present, no mortality predictive model is universally applicable and highly variable performance across different populations might need a model that adapts to the population of interest.

Effect of COVID-19 mortality on life expectancy in municipalities of Mexico. Comparison between 2019 and 2020

BACKGROUND

Life expectancy (LE) is an indicator related to medical, demographic, social and geographic conditions.

OBJECTIVES

To analyze the effect of the COVID-19 pandemic on LE and of its distribution according to sociodemographic variables in municipalities of Mexico.

METHODS

Information on mortality was collected from data published by the Ministry of Health, and demographic information, from the 2020 Population and Housing Census. LE was calculated according to the standard actuarial method. A risk analysis was carried out between expected years of life lost and the size of the economically active population, years of education and indigenous-speaking population.

RESULTS

In 2020, there was a nation-wide average drop of 4.7 years in LE, but its distribution was heterogeneous at the municipal level, with extreme values of -2.8 years and 12.6 years. The risk analysis showed an inverse relationship between sociodemographic variables and expected years of life lost, except for the indigenous-speaking population.

CONCLUSIONS

The impact of the COVID-19 pandemic on LE in Mexico was significant and was influenced by the analyzed sociodemographic variables, particularly by the municipalities' population size.

Impact of accidental and intentional injuries in Mexico. Findings of the Global Burden of Disease study for 1990 and 2021

BACKGROUND

Previous analyses on the burden of disease in Mexico identified that injuries differentially affect young people, males and working-age people.

OBJECTIVE

To analyze the burden of disease due to intentional and unintentional injuries in Mexico during 1990 and 2021, at the national and state levels.

MATERIAL AND METHODS

The results of the Global Burden of Disease study for the 1990-2021 period were used to describe the burden of disease attributed to injuries in Mexico. The life years lost (YLL) due to premature mortality, years lived with disability (YLD) and disability-adjusted life years (DALY) were analyzed.

RESULTS

The burden of disease related to intentional injuries has increased, as also have YLDs and DALYs associated with unintentional injuries. Men continue to have higher mortality and DALY rates compared to women. Interpersonal violence and suicide have steadily increased. The analysis by state showed patterns with important variations.

CONCLUSIONS

Injuries generate catastrophic consequences in terms of mortality and disability in Mexico. It is necessary to promote and strengthen programs and policies in order to improve the data system and injury prevention.

Blood pressure in healthy term and late preterm newborns in Mexico City

OBJECTIVE

Describe the measurements of systolic, diastolic and mean blood pressure in healthy term and late preterm newborns to establish normal values.

METHODS

Cross-sectional study carried out in the nursery of the Hospital Español, located in Mexico City. A sample of 551 healthy newborns were included in the study. Blood pressure (BP) measurements were taken within the first 48 hours of life with the oscillometric method. After the evaluation of normality, a descriptive analysis of the population and calculation of percentiles (25, 50 and 75) specific for each week of gestation was performed. All analyzes were performed in STATA v14.2.

RESULTS

Male newborns had a mean SBP value of 64.6 mmHg at week 35 of gestation, this value increased to 69.8 mmHg at week 40; the systolic blood pressure (SBP) value was 42.6 mmHg at week 35 of gestation, which decreased to 40.8 mmHg at week 40. The mean SBP values in female newborns were 65.5 mmHg at week 35, increasing to 73.5 mmHg at week 40; the diastolic blood pressure (DBP) value at week 35 of gestation was 38 mmHg, increasing to 41.3 mmHg at week 40.

CONCLUSIONS

The BP values in healthy newborns are modified by the gestational age and sex of the patients. These results can serve as a reference for other physicians located in countries or cities with a similar altitude than the one in Mexico City.

Cardiometabolic risk factors and antithrombotic treatment in a Mexican population with atrial fibrillation and heart failure with reduced ejection fraction

INTRODUCTION

Heart failure in patients with non-valvular atrial fibrillation (NVAF) is two to three times more common than in individuals without NVAF.

OBJECTIVE

To identify cardiometabolic risk factors (CMRF) and antithrombotic treatment in patients with NVAF and heart failure with reduced ejection fraction (HFrEF), and to determine if there were differences according to gender.

METHODS

CMRF, pro-thrombotic risk, bleeding risk, and antithrombotic therapy were globally analyzed and according to gender.

RESULTS

Out of 1,423 patients with NVAF, 336 had HFrEF. On average, females were older than males. There was no difference between genders with regard to the type of NVAF or direct oral anticoagulants use. Hypertension was more common in women. History of transient ischemic attack was reported in 3.6% of the patients and cerebrovascular event in 10%, without differences in terms of gender. The percentage of men with elevated embolic risk was higher, but without antithrombotic treatment, in comparison with women.

CONCLUSIONS

Significant differences were found according to gender in patients with NVAF and HFrEF, both in CMRF and some comorbidities, as well as in antithrombotic treatment according to embolic and bleeding risk.

Analysis of the burden of disease attributable to environmental risk factors in Mexico in the 1990-2021 period. Identification of advances, lags and emergencies

BACKGROUND

It is estimated that environmental risk factors (ERF) were responsible for nine million deaths worldwide in 2019.

OBJECTIVE

Using data from the Global Burden of Disease study, indicators of health loss associated with exposure to ERF in Mexico were analyzed.

MATERIAL AND METHODS

Absolute numbers and population percentages of deaths and disability-adjusted life years (DALY) lost attributed to selected ERFs were analyzed at the national and state level and by sex, as well as age-standardized trends from 1990 to 2021.

RESULTS

In 2021, ambient particulate matter pollution showed the highest mortality and DALYs lost attributed to selected ERFs (42.2 and 38.1% respectively), followed by lead exposure (20.6 and 13.4%) and low temperature (19.8 and 12.3%). Both indicators have decreased for all selected ERAs by different magnitudes between 1991 and 2021, except for high temperature.

CONCLUSIONS

Despite decreases in the last 32 years, outdoor environment particulate matter showed the highest mortality and DALYs lost, followed by lead exposure. It is essential to strengthen air quality and lead exposure policies in Mexico.

The burden of cardiovascular disease in Mexico 1990-2021. Summary of the Global Burden of Disease 2021 study

BACKGROUND

Cardiovascular disease (CVD) is a major cause of mortality, with economic implications for the health system.

OBJECTIVE

To characterize the burden of CVD in Mexico from 1990 to 2021 based on the Global Burden of Disease (GBD) study, to address the burden of health and disease, its implications for public health and for the development of the health care system.

MATERIAL AND METHODS

CVD mortality in Mexico is described, and the extent to which population growth and aging explain the observed trends, sex differences, and geographic patterns is examined.

RESULTS

CVD is the leading cause of mortality, mainly due to hypertensive heart disease, intracerebral hemorrhage, subarachnoid hemorrhage, ischemic heart disease and ischemic stroke. A change of trend was observed in men and women, with higher mortality in people older than 80 years and in the northern states of the country.

CONCLUSIONS

Mexico must invest in public health programs to address modifiable risks, promote healthy aging, and reduce premature death due to CVD.

Respiratory diseases in Mexico: analysis from the Global Burden of Disease study 2021

BACKGROUND

Respiratory diseases (RD) are often analyzed separately rather than collectively, possibly leading to an underestimation of their total burden.

OBJECTIVE

To analyze the burden of RD in Mexico for population aged 20 or older from 1990 to 2021.

MATERIAL AND METHODS

We present the burden of RD in Mexico based on estimates of the Global Burden of Disease study for mortality and disability-adjusted life years (DALYs), comprising counts, rates per 100,000, as well as age-standardized rates. RDs were categorized into three key groups: chronic respiratory diseases (CRD), respiratory infections (RI), and respiratory cancers.

RESULTS

In 2021, among those aged 20+, RDs were responsible for 336,728 deaths, which accounts for 30.5% of total deaths -a nearly threefold increase since 2019, primarily due to the COVID-19 pandemic. CRDs contributed with 3.4% of total deaths; RIs, with 25.9%; and respiratory cancers, with 1.2%. CRDs showed a continuous rise in deaths, crude mortality, and DALY rates across genders, with no signs of leveling. RD burden varied widely across Mexican states. Age-standardized CRD mortality rates have generally declined since 1990, except for interstitial lung diseases, which have consistently increased.

CONCLUSION

The significant burden of mortality and disability due to RDs in Mexico underscores the n|ecessity for enhanced prevention, research, and for addressing risk factors such as smoking and pollution. Ongoing healthcare training can help reduce RD burden.

Gender and age-related variations in human immunodeficiency virus infection trends at the Mexican Institute of Social Security: 2003-2017

INTRODUCTION

Diagnosing and treating human immunodeficiency virus carriers has led to the identification of a higher prevalence of said infection and, therefore, of a higher risk of transmission of the virus.

OBJECTIVE

To find out the trend of new cases of human immunodeficiency virus infection carriers at the Instituto Mexicano del Seguro Social (IMSS) in Mexico within the 2003-2017 period.

METHODS

Patients affiliated to the IMSS were analyzed. Data from 42,181 newly-diagnosed cases were collected, with variations related to gender and age being observed. Age-standardized rates per 100,000 population were obtained.

RESULTS

The highest mean annual percentage change in males was documented in adolescents (13.0, 95% CI = 9.9, 16.1). Heterogeneous trends were recorded for women, with a significant overall decrease (-2.2, 95% CI = -3.4, -1.0), but growing trends were also observed in some groups.

CONCLUSIONS

Our results suggest that the human immunodeficiency epidemic in patients cared for at the Instituto Mexicano del Seguro Social is concentrated in males, with a growing trend particularly in adolescents.