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Introduction: The quality of care in health institutions is a constant challenge, mainly in oncology. The literature shows it has partially evaluated in contrast to it proposed by Donabedian; in addition, health personnel's perspective, who has direct contact with the patient, knows and executes the care process, has not been considered. The objective of the present study was to establish a framework to evaluate the quality of healthcare provided to patients with colorectal or ovarian cancer from health personnel's perspective., Material and Methods: Cross-sectional study that included health personnel belonging to nine services of a cancer hospital. A questionnaire was applied to evaluate the quality of healthcare through amenities, the interpersonal and scientific-technical dimension (Donabedian's model). The variables were standardized, compliance with them among services was compared using non-parametric tests (Kruskal-Wallis test and Mann-Whitney U test), and 40 indicators were evaluated., Results: Health personnel's 181 members participated, the evaluated oncology hospital presented regular compliance to the quality of healthcare (bad ≤82, regular 83-109, good ≥110). When comparing this in the nine services, differences were detected between surgery and radiotherapy (higher compliance scores, 132 and 126 respectively) versus the other services P<.05. Both services had more than 25 indicators with compliance ≥80%., Conclusions: It is shown that the established framework is useful for evaluating the quality of healthcare from health personnel's perspective (an approach not used so far for this type of evaluation), by detecting differences in its compliance, specific problems and its causes by service., (Copyright © 2022 FECA. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: The adverse events (AE) in hospitalized patients occur with increasing frequency due to the increase in complexity of medical care, which implies a greater risk of committing a human error inherent to the care, constituting a serious threat to the safety of the patient., Material and Methods: Cross-sectional study, including patients older than 16years, with hospital stay longer than 24h and discharge from the general surgery service, patients treated in emergency observation units or other hospital services were not considered. AE were identified, classified by cause according to the essential actions for patient safety (EAPS), and compliance with the EAPS was verified., Results: 352 clinical records were reviewed, 61 (17%) were positive on screening. Of the positives, 66% resulted in AE (47 cases). The prevalence of AE was 13%. The AE were: 40% related to procedures; 39% with infections; 17% with medication; 4% with patient identification. The EAPS with the best rating was EAPS5 and the lowest rating was EAPS4. The night shifts with the greatest opportunity area, only with 40% and 44% correct procedures., Conclusions: The study shows that the two methodologies used, one to identify AE and the other to establish its causes and classification according to the EAPS, demonstrated usefulness and synergy for patient safety, when detecting AE, as well as determining their causes and evaluate compliance with the EAPS., (Copyright © 2021 FECA. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objectives: To determine the prevalence of the Metabolically Healthy Obesity (MHO), and Metabolically Obese Normal-Weight (MONW) phenotypes in a sample of children and adolescents. To evaluate which clinical and laboratory variables are related to the MONW and MHO phenotypes., Methods: A cross-sectional study was carried out in children and adolescents aged 6-18 years old, presumably healthy. Somatometry, glucose, insulin, triglycerides, HDL-cholesterol, LDL-cholesterol, HOMA-IR, triglycerides/HDL ratio, triglycerides and glucose index, and leptin/adiponectin, were determined., Results: Data from 620 children and adolescents were included (50.65% were males); the median age was 11 years. The prevalence of the MONW phenotype was 22.85% (95%CI 16.85%-29.79%), and the MHO phenotype 27.61% (95%CI 22.60%-33.06%). The variables that significantly explained the possibility of presenting the MONW and MHO phenotype were triglycerides/HDL ratio, and product of triglycerides and glucose. Insulin and HOMA-IR were significantly associated with the MHO phenotype but not with the MONW phenotype., Conclusions: Prevalence of metabolically healthy obese phenotype is lower in the Mexican population compared to European studies; thus, future studies should determine if this difference relies upon genetic profile or lifestyle. The indices to assess the action of insulin based on lipids can help identify children and adolescents with the MHO and MONW phenotypes., (Copyright © 2020. Publicado por Elsevier España, S.L.U.)

Objective: Estimating whether adolescents' sedentary behaviour and their lack of physical activity is determined by family characteristics or socio-cultural aspects and their impact on health and adiposity level., Material and Methods: 932 adolescents were surveyed. Information regarding physical activity, sedentary behaviour, anthropometric index and family characteristics (structure, dynamics and functioning) was estimated by adolescents answering a questionnaire., Results: The sample's average age was 16.07±1.09 years old, 56.3 % were female, 66.3 % had a low level of physical activity and 51.9 % were sedentary. A lack of physical activity occurred more frequently in females (56.8 % cf 41.5 %: p=0.000); family characteristics did not influence such risk behaviour. A relationship between physical activity and sedentary lifestyle with BMI could not be demonstrated, whilst waist circumference was associated with risky behaviour patterns. Teenagers in good health were more active (36.1 % cf 27 %) and less sedentary (49.3 % cf 59.4 %) than those for whom an unhealthy state was reported., Conclusion: Sedentary behaviour and a lack of physical activity were more determined by socio-demographic factors than family aspects, such behaviour pattern having a direct influence on the adolescents' health.

Objective: To assess risk sexual behaviour in adolescents and its relationship with family characteristics., Methods: In a representative and random sample of 909 teenagers, their sex life, structure, satisfaction and family dynamics were evaluated. It was used chi-squared test, in order to compare the frequency of family negative characteristics between the groups of adolescents with and without risky sexual behaviors., Results: The early onset of sexual life was more frequent in adolescents with dysfunctional expression of affection in their families, and single-parent or nuclear family structure. The lack of condom use was associated with a lack of affection, and a poor comunication within the family. Having more than three partners was related to the expression of affection and the degree of satisfaction of the teenager with his family. Unplanned pregnancies and sex transmission diseases were most frequent in adolescents belonging to extended families with a poor expression of affection., Conclusions: The level of communication, the monitoring of conduct, the warmth and proximity play a very important role as protectors of sexual risk behaviour in teens.

Objective: To estimate the prevalence of maternal and neonatal syphilis, to assess the usefulness of a rapid treponemic diagnostic test, and to evaluate the frequency of screening for syphilis during prenatal care in Mexican women., Material and Methods: This was a cross-sectional study that included 1,322 women interviewed in two hospitals (Hospital General in Cuernavaca, Morelos, and Hospital de la Mujer in Mexico City). Women answered a questionnaire on reproductive background, exposure to sexually transmitted infections and prenatal care. In order to diagnose syphilis, a rapid Determine TP test and a latex-VDRL test were used among all participating women. Positive cases were confirmed using FTA-ABS test., Results: Prevalence of serologically active syphilis was 0.3% (4/1322). Using as comparison standard a combination of VDRL and FTA-ABS tests, the Determine TP test had a sensitivity and specificity of 100%. Two newborns with positive FTA-ABS IgM, one negative with FTA-ABS IgM and one first-trimester abortion were found from seropositive women. Prenatal serum screening for syphilis was conducted in only 6.9% of women included in the study., Conclusions: Although the prevalence of maternal syphilis is relatively low, results show that if the situation found in the hospitals studied is shared by other hospitals in Mexico, a systematic screening for maternal syphilis would help to diagnose more cases of this infection than the number reported in official figures. Screening of syphilis in pregnant women using rapid tests may help in the prevention of congenital syphilis.

Objective: To determine the prevalence of group B Streptococcus (GBS) colonization in two anatomical sites in Mexican women of childbearing age, as well as the associated risk factors., Patients and Method: A retrospective cohort analysis was made with two groups of women between 14 and 44 years old. We formed two groups of 72 women; one had a recent positive group B Streptococcus culture and the other, paired by age and culture date, had a negative culture of the same bacterium. All of them answered a validated questionnaire and two rectal swabs were obtained and cultured for isolation of group B Streptococcus., Results: Prevalence of GBS colonization was 18% for two anatomical sites (heavy colonization), and 37% for one anatomical site; the overall prevalence was 54.9%. Three or more sexual partners increased by 4-fold the risk of heavy GBS colonization (p < 0.01). In this study 49 (34%) women were pregnant, 26 (53%) of them were colonized by GBS and 7 (14.3%) were heavy colonized., Conclusions: Prevalence of GBS during pregnancy in Mexican women was higher than the reported previously, even in developed countries. Risk of colonization increased by 4-fold with a history of three or more sexual partners.

The object of this study was to evaluate the changes in fibrinolysis and clotting inhibitors in patients with preeclampsia and to describe the connection between preeclampsia and blood pressure values. Two groups of pregnant women were prospectively studied at delivery: group 1 women without preeclampsia and group 2 patients with preeclampsia. The variables that were registered are: diastolic blood pressure (DBP), systolic blood pressure (SBP), mean blood pressure (MBP), hemoglobin (Hb), platelet count (Plt), lupus like inhibitor, anticardiolipin antibodies (ACA), antinuclear antibodies (ANA), fibronectina, D dimer, protein S (PS), protein C (PC) and vo Willebrand factor (vWF). 62 pregnant women were included. The patients of group 2 presented high values of Hb (p 0.01), fibronectin (p 0.0001), D-dimer (p 0.01) and lower PC (p 0.04). We found an association between fibronectin and higher values of SBP, DBP, MBP and Hb (p 0.0007) versus lower values of VFW and PC (p 0.002). The low values of total PS were associated with high D-dimer and SBP results (p 0.04 and 0.002 respectively). All patients were ACA/ANA negative. In preclampsia there is a increased hemoconcentration and drop in clotting inhibitors (PC), without fibrinolytic compensatory response (lower D-dimer) and remarked vasopressive effect (hig fibronectin). This changes depend on the stratification of blood pressure. Th SBP and MBP values depend on the haemodynamic changes (Hb, fibronectin), while the increase in DBP expresses a non compensated thrombophilic state.

To describe the situation of perinatal mortality during 1994 year in General Hospitals with Family Medicine number 16 and 18 of IMSS (Social Security Mexican Institut) National Medical Center in Torreón Coah. It was realized a retrospective study, were included 199 files of perinatal deaths occurred from January 1st to December 31 of 1994. The variables obtained were number of death for step, period, age, sex, weight and the cause of the cause of the death. Were eliminated the files without data of interest. For the analysis our utilized descriptive statistics. The rate of perinatal mortality was 20.17 per 1000 live birth, fetal death rate 9.58 by 1000 and the rate of neonatal death 12.97 per 1,000 live birth, fetal death rate 8.68 and neonatal death rate 12.30. The majority were in the perinatal period one with a rate of 16.71 by 1,000 live birth. Were most common in a male sex (53%) in pregnancies from 28 to 32 weeks (33.91%) and in babies with less of 1000 gr of weight (33.86%). The causes more frequents of deaths were the respiratory difficult syndrome (41.77%), the anomalies (19.62%) and hypoxia (9.49%). The perinatal mortality in our study was similar that in the rest of the country and is acorde with the literature. The perinatal mortality were in the perinatal period one. Is important to conduce a prospective studies.

Near 70 per cent of Mexican women infected by the Human Immunodeficiency virus (HIV) are between 15 and 44 years old, in this women sexual transmission are the most frequent route of infection. The objective of this article was to describe the obstetric course and perinatal repercussion of the HIV-Positive pregnant women with medical care at the Instituto Nacional de Perinatología, Mexico city between January 1994 to December 1996. Nineteen women were studied, sexual transmission was the route of infection in 16 of them. One had diagnostic criteria for AIDS, the others 18 had HIV asymptomatic infection. At delivery 18 a term products were born. The mean of the newborn weight was 3159 g. At moment of this report 4 children (22%) have been diagnosed as HIV infected, all of them dead during their first year of life.

Objective: To find what vital events middle-aged women in our society most often experience and their influence as stress factors on physical health and subjective psychological well-being., Design: A multivariant transversal study., Setting: 5 primary care centres in Valencia and Alicante., Participants: 306 women chosen at random among those seen at these health centres., Measurements and Main Results: Frequency analysis of vital events. Correlation analysis with questionnaires on physical symptoms and diseases, psychological well-being, work situation, emotional behaviour, sexuality and relationships with their partner. ANOVA: dividing the sample into 2 groups based on mean adaptive effort. The most common events numbered 23. The ANOVA showed a significant association between greater adaptive effort and negative emotional behaviour, personal control, material well-being, relationship with the partner, and physical and psychological symptoms., Conclusions: The relevance of daily events as generators of stress was confirmed, as was the impact of these and major events on these women's physical and psychological health. The importance of attending women at this stage of their lives from an integrated and interdisciplinary perspective, which tackles the physiological, psychological and cultural features together, was shown.