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Introduction. Non-Alcoholic Fatty Liver disease (NAFLD) can lead to Non Alcoholic steatohepatitis (NASH), cirrhosis, and liver cancer. The treatment for NAFLD involves modification of caloric intake and physical activity. NAFLD has a pro-oxidant nature; therefore, it is logical to suppose that the antioxidant methionine can be used as a treatment for this disease. Aim. This study aimed to evaluate the effect of high-methionine dietary therapy on patients with NAFLD. Materials and methods. A randomized clinical study was conducted over three months. In this study, 121 NAFLD patients participated, and the age of the participants was ≥ 20 years (experimental group included 56 and control group 65), all of whom were randomized and matched by sex, recluted from the ISSSTE hospital in Xalapa, Mexico. The patients were instructed to consume food to cover the recommended methionine daily doses, and the daily amount consumed was calculated. Methionine effect was measured as NAFLD regression and quality of life improvement. Results. Nutritional therapy induced NAFLD regression and diminished central fat accumulation, blood pressure, and the fatty liver index. Some parameters, such as liver enzymes, did not changed. The quality of life of patients improved after treatment. Conclusions. In this study, we show a hepatoprotective effect induced only in three months of chances in the diet, thus, a longer diet may generate more relevant benefits in the resistant parameters of our study.

Antecedentes: La asociación el asma con la COVID-19 continúa siendo controversial. Objetivo: establecer la prevalencia de asma en una muestra de pacientes con neumonía asociada COVID-19; además, describir las características clínicas de los pacientes con asma en comparación con los pacientes sin asma. Métodos: Se analizaron los datos clínicos correspondientes a120 pacientes hospitalizados por neumonía asociada a infección por SARS-CoV-2. Los pacientes con y sin asma fueron comparados en función de la gravedad de la COVID-19. Resultados: La prevalencia de asma en los pacientes con neumonía por COVID-19 fue del 3.5% (IC 95%: 1.5% a 9.6%). Al comparar la gravedad de la COVID-19 entre los pacientes con asma con los pacientes sin asma, ésta no difirió en función de los síntomas, la comorbilidad, la duración de los síntomas, la necesidad de ventilación mecánica asistida, los biomarcadores de inflamación y la ocurrencia de muerte. Los pacientes con asma y COVID-19 mostraron un fenotipo T2 alto, con pobre función respiratoria y sin uso de tratamiento regular para el control del asma. Conclusiones: No se observaron diferencias significativas en la frecuencia de la ventilación mecánica asistida o de la muerte entre los pacientes hospitalizados por neumonía asociada con COVID-19 con y sin historia de asma. Palabras clave: asma; COVID-19; prevalencia; SARS-CoV-2.

Introducción: En individuos con talla baja se ha reportado mayor morbilidad y mortalidad relacionada con diabetes y enfermedades cardiovasculares. En México se desconoce la prevalencia de talla baja y de obesidad en personas con talla baja de acuerdo con criterios nacionales. Objetivo: Estimar, en mexicanos de 20 a 59 años, la prevalencia de talla baja y de obesidad en individuos con talla baja según la NOM-008- SSA3-2017. Métodos: Es un estudio que analiza los datos de las Encuestas Nacionales de Salud y Nutrición (ENSANUT) de 2006, 2012 y 2018. Las mujeres < 150 cm y los hombres < 160 cm se clasificaron con talla baja, se estableció obesidad cuando presentaron índice de masa corporal ≥ 25 kg/m2. La prevalencia nacional de talla baja fue del 27.3, 22.9 y 22.9%, mientras que la de obesidad en individuos con talla baja fue del 73.5, 75.0 y 78.4% en 2006, 2012 y 2018, respectivamente. De 2006 a 2018, la prevalencia de talla baja se redujo un 16.1%, mientras que la de obesidad incrementó un 6.7% en personas con talla baja. Conclusión: Durante el periodo referido se tuvo una reducción en la prevalencia de talla baja, aunque sigue siendo alta. Por otro lado, la prevalencia de obesidad ha incrementado en este grupo poblacional.

Objetivo: Caracterizar la producción científica de la Revista Alergia México desde una perspectiva bibliométrica. Métodos: Estudio descriptivo, llevado a cabo a partir de la información bibliométrica de la Revista Alergia México, alojada en los repositorios PubMed (MEDLINE) y Scopus. Resultados: De acuerdo con Pubmed, la cantidad total de artículos publicados entre 1991 y 2021 fueron 1115 (media anual; 37.2 ± 12.3); por su parte, Scopus registró 1541 artículos durante 1972 y 2021 (media anual: 30.8 ± 14.9). En ambos repositorios, los artículos originales (49 y 78%, respectivamente) y de revisión (21 y 12%, respectivamente) fueron los documentos publicados con mayor frecuencia. La temática más relevante incluyó: asma (32%), rinitis alérgica (16%) y alergia a medicamentos (9%). Las instituciones públicas de México fueron las que publicaron mayor cantidad de artículos. El país con mayor cantidad de documentos publicados fue México (54%), seguido de Colombia (5%) y España (4%). Según Scopus, el índice de citación de 2020 fue de 0.9; índice-H de 15 y factor de impacto de 0.150. Durante el periodo 2016-2020, el índice de rechazo anual fue del 7 al 30%. Conclusiones: Las principales necesidades de Revista Alergia México consisten en promover su internacionalización, publicar artículos en idioma inglés y conseguir un factor de impacto más alto en los próximos años. Palabra clave: Bibliometría; producción científica; índice de citación; índice-H; factor de impacto.

Objetivo: Determinar la prevalencia de alergia a la proteína de la leche de vaca e intolerancia a la lactosa en una muestra de adolescentes tardíos. Métodos: Estudio transversal con base poblacional, en el que se analizaron los datos de pacientes adolescentes de 15 a 18 años. Resultados: Se registraron 1992 estudiantes. La prevalencia de alergia a la proteína de la leche de vaca fue de 1.4% (IC95%: 0.9% a 2.0%) y de intolerancia a la lactosa de 0.5% (IC95%: 0.2% a 0.8%). Los adolescentes con alergia a la proteína de la leche de vaca tuvieron menos síntomas gastrointestinales (p = 0.036), pero más molestias cutáneas (p < 0.001) y respiratorias (p = 0.028) que los adolescentes con intolerancia a la lactosa. Conclusiones: Las manifestaciones asociadas con el consumo de leche de vaca en adolescentes tardíos corresponden, principalmente, a la alergia de la proteína de la leche de vaca que a la intolerancia a la lactosa.

Objetivo: Determinar la incidencia de reacciones adversas (RA) tras la primera dosis de la vacuna Pfizer-BioNTech e identificar algunos factores asociados con ellas. Método: Se realizó un estudio de cohorte retrospectiva. Los datos fueron obtenidos mediante una encuesta epidemiológica contestada en línea. Se realizaron análisis multivariados para identificar factores asociados con las RA tempranas (< 2 h) y tardías (≥ 2 h). Resultados: Se incluyeron 2295 trabajadores de la salud; en ellos, la incidencia acumulada de RA fue del 18.2% (intervalo de confianza del 95%: 16.6-19.8%) y la mayoría fueron tardías (78.2%). Las RA tempranas más frecuentes fueron dolor local, cefalea y mareo; en las tardías fueron dolor local, cefalea y fatiga. No se documentaron casos de anafilaxia; sin embargo, en el grupo de RA tempranas y tardías hubo un caso y tres casos, respectivamente, con síntomas sistémicos que afectaron a dos órganos diferentes. Los factores asociados que incrementaron el riesgo de RA tempranas fueron ser mujer (odds ratio [OR]: 2.23; p = 0.002) y pertenecer al personal médico (OR: 1.56; p = 0.041). En las RA tardías fue ser mujer (OR: 1.94; p < 0.0001); por su parte, la diabetes (OR: 0.46; p = 0.021), el asma (OR: 0.53; p = 0.040) y el tabaquismo (OR: 0.44; p = 0.002) fueron factores asociados inversamente. Es interesante que la historia de COVID-19 no se asoció con RA tempranas ni tardías. Conclusiones: El riesgo de presentar algún tipo de RA debido a la vacuna Pfizer-BioNTech en trabajadores de la salud es < 20%.

Background: Asthma does not appear to be a risk factor for developing COVID-19. Objective: The objective of the study was to analyze the role of asthma as a factor associated with COVID-19 among healthcare workers (HW). Methods: A crosssectional study was conducted in HW from a Mexican hospital. Data were obtained through an epidemiological survey that included age, sex, and history of COVID-19. Multivariate logistic regression analysis was performed to identify factors associated with COVID-19. Results: In total, 2295 HW were included (63.1% women; mean age 39.1 years); and 1550 (67.5%) were medical personnel. The prevalence of asthma in HW with COVID-19 was 8.3%; for the group without COVID-19, the prevalence was 5.3% (p = 0.011). The multivariate analyses suggested that asthma was associated with COVID-19 (OR 1.59, p = 0.007). Conclusion: Our study suggests that asthma could be a factor associated with COVID-19 in HW.

Objectives: To determine if the place of residence and the level of poverty are associated with prostate cancer survival. Materials and methods: All patients diagnosed with prostate cancer (PC) in the period from 2013 to 2017 in a tertiary healthcare hospital in Veracruz, Mexico were included. Patients resided in rural and urban areas. Variables were collected according to clinical-epidemiological and histopathological characteristics. The Kaplan Meier method and the Log Rank test were used to measure survival. Prognostic factors were determined by calculating the adjusted hazard ratio (HRa) in a multivariate analysis using the Cox proportional risk method. Results: A total of 186 PC cases were analyzed. Overall, after 5 years, 48.3% of the patients survived. Men living in urban areas had a higher probability of survival than those living in rural areas (HRa 1.67, 95% CI 1.16-2.41). Similarly, people living in areas classified as low-poverty zones had a higher probability of survival than those living in areas with high-poverty (HRa 2.32, 95% CI 1.47-3.66). Conclusions: To reside in a rural place was identified as a negative prognostic factor for the survival of patients with PC regardless of other sociodemographic and clinical variables; patients living in places with a high-poverty level had an unfavorable survival prognosis.

Background/Aims Colorectal cancer (CRC) is a public health problem. In Mexico, there have been no recent studies conducted on survival in terms of this pathology or on the influence of prognostic factors. The study aims to determine the probability of survival in patients with CRC presence of low levels of schooling and a rural population, adjusted for clinical stage and type of treatment. Methods A retrospective study was conducted in a cohort of 305 patients with CRC treated at State Cancer Center, located in Veracruz-Mexico; the follow-up period of 60 months (2012–2016). The survival probability was calculated using the Kaplan-Meier estimator and the log-rank test with 95% confidence intervals (CIs). Prognostic factors were determined using hazard ratio (HR) multivariate Cox regression analysis. Results Overall survival was 40% at 60 months. Subjects in the age group ≥ 65 years had a low survival rate of 28% (P=0.026) and an advanced clinical stage of 22% (P

Objetivo: Establecer la prevalencia de eosinofilia en sangre en adultos con enfermedad pulmonar obstructiva crónica (EPOC) según varios puntos de corte. Métodos: Se realizó un estudio transversal en pacientes con EPOC. La frecuencia de eosinofilia en sangre se determinó a partir de la concentración absoluta (células/µL) y relativa (%) de eosinófilos. Fueron realizados modelos multivariados para identificar factores asociados. Resultados: En 81 pacientes incluidos, la edad promedio fue de 71.9 ± 9.8 años; de los cuales, 46 (57 %) fueron hombres. La prevalencia de eosinofilia para los puntos de corte ≥ 100, ≥ 150, ≥ 200, ≥ 300 y ≥ 400 células/µL fue de 64.2, 43.2, 37.0, 16.1 y 9.9 %, respectivamente. De 81 pacientes, 34 (42 %) tuvieron una concentración ≥ 2 %; 21 (25.9 %) ≥ 3 %; 14 (17.3 %) ≥ 4 %; y 10 (12.3 %) ≥ 5 %. La eosinofilia ≥ 100 células/µL se asoció con la edad ≥ 80 años (RM = 6.04, p = 0.026) y con la exacerbación de la EPOC (RM = 9.40, p = 0.038); en cambio, la eosinofilia ≥ 2 %, lo hizo con solamente la edad ≥ 80 años (RM = 3.73, p = 0.020). Complementariamente, la concentración de eosinófilos ≥ 100 y < 300 células/µL se asoció con la exacerbación de la EPOC (RM = 11.00, p = 0.026). Conclusiones: Nuestros resultados sugieren que la frecuencia de eosinofilia en EPOC muestra variaciones sustanciales según la definición adoptada.

Introduction Young women under 30 years with breast cancer (BC) are an emerging challenge. The purpose is to identify prognostic factors for survival in young women under 30 years of age with BC. Material and methods A retrospective cohort study was conducted among women younger than or equal to 40 years with BC and who were treated at the State Cancer Center during the period 2012–2017. Overall survival was assessed using the Kaplan–Meier method and the log-rank test. Univariate and multivariate analysis assessed survival predictors using Cox proportional hazards regression model. Results 282 young women were included. The >30-year-old subgroup showed a significant association with excess weight ( P = .002) compared to the 5 cm HR = 2.3; 95% CI 1.03 to 5.1), and advanced clinical stages (HR = 6.6 95% CI 1.3 to 35.5) persisted as predictors. Conclusions Being very young (

Antecedentes: El impacto de la obesidad sobre la gravedad del asma contiúa siendo motivo de controversia. Objetivo: Comparar la gravedad y el control del asma entre pacientes con obesidad y sin obesidad. Métodos: Estudio transversal que incluyó a 188 pacientes con asma, con edad ≥ 18 años, seleccionados consecutivamente. Los pacientes fueron categorizados y comparados de acuerdo con la presencia de obesidad o no. Para establecer asociación entre variables se realizó análisis de regresión logística. Resultados: En total, 111 pacientes tenían obesidad; su edad fue mayor que la de los pacientes sin obesidad (35.9 ± 15.3 años versus 44.4 ± 13.8 años, p < 0.001). No se observó diferencia significativa entre los grupos respecto a sexo, concentración sérica total de IgE, número de eosinófilos en sangre periférica, historia personal de enfermedad atópica, frecuencia de sensibilización alérgica, hospitalización por asma y control del asma. En general, la obesidad se asoció significativamente con el asma moderada o grave (RM = 1.82, p = 0.047), pero no lo hizo con el control del asma (p = 0.094). Conclusiones: Nuestros resultados sugieren que los pacientes con asma y obesidad tienen mayor edad y peor función pulmonar, la cual se reflejada en mayor gravedad del asma.

Background: Factors like ethnic origin and geographical area affect the frequency of cow’s milk protein allergy (CMPA) and lactose intolerance (LI). Epidemiological information about the non-pediatric population is still missing. Objective: To determine the prevalence of CMPA and LI in university students. Methods: A cross-sectional study of 1200 students of 18 to 25-year-old. A structured questionnaire was applied in order to identify the clinical manifestations triggered by the intake of cow’s milk (CM), and these were categorized as linked to CMPA or linked to LI. Results: Thirty students met the criteria for CMPA (prevalence of 2.5 %; CI 95 % = 1.7-3.6 %) and 128 for LI (prevalence of 10.7 %, CI 95 % = : 9.0 % - 12.5 %). The frequency of personal history of food allergy and dust mite allergy was higher in students with CMPA than in students with LI. Oral pruritus, skin and respiratory discomforts were predominant in CMPA. Abdominal cramps and flatulence were predominant in LI. Conclusions: IL is more frequent than CMPA; which frequency was one in every 10 students; and the frequency of CMPA was one in 400.

Background: Peanut allergy among adults with respiratory diseases has seldom been studied within Mexico. Objective: To establish the prevalence of peanut allergy among adults that have been diagnosed with either asthma or allergic rhinitis; we will also be describing the symptoms that are associated with peanut allergy. Methods: We carried out a cross-sectional study through which we analyzed the corresponding data of 257 patients with allergic respiratory diseases, asthma or allergic rhinitis, all participants were 16 years of age or older, and were recruited in a consecutive manner. Peanut allergy was established by testing positive to a peanut skin-prick test; we also conducted a standard interview with each patient. Results: From our sample of 257 patients, 18 tested positive to peanut sensitization, (7.0%; 95% CI = 3.9% to 10.1%); among these 18 participants, 7 were considered to be allergic to peanuts (2.7%; 95% IC: 0.7% to 4.7%). Predominant symptoms were oral, primarily affecting the pharynx and the palate, followed by swelling of the lips. When it came to respiratory discomfort, sneezing and rhinorrhea stood out, and lastly there were cutaneous symptoms. We did not detect any systemic reactions to the peanut. Conclusion: In our study, peanut allergy among adults with allergic respiratory diseases is not an uncommon occurrence.

Background: In Mexico, there are very few studies aimed at establishing the prevalence of allergic rhinitis (AR) and atopic dermatitis (AD) in late adolescents. Objective: To determine the prevalence of allergic rhinitis and atopic dermatitis in late adolescents and compare it according to their gender. Methods: A cross-sectional study that included 1992 15 to 18 year old adolescents who were recruited through a stratified and randomized probabilistic sample by clusters. The prevalence of AR (allergic rhinitis) and AD (atopic dermatitis) was identified with the questionnaire of “The International Study of Asthma and Allergies in Childhood”. Results: 1056 (53%) women and 936 (47%) men were included in the study. The prevalence of AR was 9.0% (95% CI = 7.8% - 10.4%); the frequency was higher in women (6.7% versus 11.1%, p = 0.001). The symptoms of rhinitis plus conjunctivitis predominated in women (16.0% versus 23.1%, p < 0.0001). The prevalence of AD was 5.2% (95% CI = 4.3% - 6.2%) and, once again, it was more frequent in women (7.7% versus 2.4%, p < 0.0001). The main factors associated with AR and AD were the female gender and a history of family atopic allergic diseases (p < 0.001). Conclusions: There was a significant difference in the prevalence of AR and AD according to gender in late adolescents; women were most affected. In addition, a history of family atopic allergic diseases was another risk factor that was linked to both diseases.

Background: Food allergy is considered a typical problem in the pediatric population, however, cases occur in adults more frequently. Objective: To determine the prevalence of food allergy in patients with allergic rhinitis and asthma; as well as the foods and symptoms most related to said problem. Methods: Through a cross-sectional study, the information of 257 adults with asthma or allergic rhinitis was analyzed. The information related to food allergy was obtained through a standardized interview; the confidence intervals (CI) were calculated for 95% proportions. Results: The prevalence of food allergy was 17.5% (95% CI = 13.3% to 22.6%). The main foods that caused symptoms were soy, shrimp, almonds, avocado and peanuts. The majority of patients who were allergic to a single food were 35.6%, two foods were 17.8% and three foods were 17.8%. The most frequent affections of food allergy were oral (62.2%): itching of the pharynx, tongue and palate; respiratory (26.7%), dyspnea and sneezing; and skin (26.7%), itching and hives. Conclusions: Food allergy in adults with asthma or allergic rhinitis is a common problem. Oral symptoms are the main ailments in this type of patients and are mainly caused by soy.

Zika virus (ZIKV) infection in pregnancy is associated with birth and developmental alterations in infants. In this study, clinical records of 47 infants whose mothers had Zika during pregnancy or clinical manifestations compatible with Zika were reviewed. A description of the infants’ anomalies was established, and a neurodevelopmental assessment was performed on 18 infants, using the Evaluation of Infant Development (EDI for its initialism in Spanish) and DDST-II (Denver Developmental Screening Test II) tests. From his sample, 74.5% of the infants evaluated had major anomalies and 51.9% had minor anomalies. The incidence of major anomalies, related to trimester of pregnancy, was 84.2% for the first trimester, 77.8% for the second trimester, and 37.5% in the third trimester. A similar trend was observed in the frequency of infants without anomalies and was less evident in the incidence of minor anomalies (p = 0.016). Through neurodevelopmental assessments, EDI identified 27.8% of infants as having normal development, while 55.5% of affected infants had developmental delay, and 16.7% were at risk for developmental delay. The DDSST-II showed that 77.7% infants had delay in the gross motor and language area, 88.8% in the fine-adaptative motor area, and 72.2% in the personal–social area. In this work, children of mothers with ZIKV infection during pregnancy may have major or minor anomalies regardless of the trimester of pregnancy in which the infection occurred. The neurodevelopmental assessment shows that ZIKV can cause a developmental delay in infants with the fine-adaptative motor area being the most affected.

Background: Late adolescents with asthma are rarely studied, since generally they are not included in children or adult groups; in addition, studies assessing asthma trends are scarce in Mexico, and their results might differ from findings in developed countries. Objective: To determine the trends in asthma prevalence and its symptoms in late adolescents over a period of 7 years. Methods: The prevalence of asthma and its symptoms were compared in two cross-sectional population-based cohorts, one from 2009 and the other from 2016. Results: The presence of wheezing sometime in life and during the previous year was significantly increased between 2009 and 2016 (12.8 % versus 20.1 % and 7.3 % versus 10.3 %, p

Background: Omalizumab, which is a monoclonal anti-IgE antibody, has recently been used as an option in the treatment of inducible urticaria. Case report: We describe the case of a 46-year-old woman who was referred to the Department of Allergy and Immunology of “Hospital Civil de Guadalajara, Dr. Juan I. Menchaca” due to a history of hives, body itching, changes in the color of the skin after exposure to water, and chest tightness after the intake of cold beverages; therefore, she used to limit her outdoor activities and personal hygiene. We conducted challenge tests with heat, soaked towels, treadmill walks, and dermographism; which were negative. The ice cube test was positive. To establish the speed of wheal formation, we established intervals of exposure to cold of one, three, five, and ten minutes; a positive result was obtained from the third minute. Due to the poor response to the drug treatment and to measures to avoid the cold, as well as to the poor quality of life, the high risk of anaphylaxis, and the advent of winter season, omalizumab was administered at monthly doses of 150 mg during the winter season. After the first dose, there were no reports of episodes of hives in areas exposed to cold; the ice cube test was negative before the second dose and in the following months, and the patient was able to ingest cold beverages and cold food. There were no adverse reactions that could be attributable to the use of omalizumab. Three years after the first dose, the patient was still asymptomatic. Conclusion: The described case is one of the first cases of cold urticaria with risk of anaphylaxis with a positive response to omalizumab, which was reflected in symptom control and the improvement in the quality of life.

Antecedentes: Recientemente, el síndrome de alergia oral (SAO) ha sido clasificado de acuerdo con los alimentos que lo inducen: fenotipo I, relacionado con alimentos derivados de plantas; fenotipo II, provocado por alimentos de origen vegetal y animal. Objetivo: Determinar la prevalencia del síndrome de alergia oral en adolescentes tardíos según la nueva clasificación. Métodos: Estudio transversal en el que se analizaron los datos de 1992 adolescentes de 15 a 18 años; la información se obtuvo a través de un cuestionario estructurado, en el que se interrogó acerca de síntomas orales según el tipo de alimento consumido. Resultados: La prevalencia global de síndrome de alergia oral fue de 1.7 % (IC 95 % = 1.2-2.4): fenotipo I, 0.85 % y fenotipo II, 0.85 %. Según el fenotipo no hubo diferencia por sexo e historia personal de enfermedad atópica; el tiempo de inicio de los síntomas sí mostró asociación (p = 0.048). La frecuencia de los síntomas respiratorios, en piel y mucosas no difirieron entre los grupos; respecto a los síntomas gastrointestinales, la diarrea fue notoriamente más frecuente en el fenotipo II (p = 0.044). Conclusión: Se identificaron claramente los dos fenotipos del síndrome de alergia oral: uno asociado a alimentos de origen vegetal y otro a alimentos tanto de origen vegetal como animal.

Background: Prevalence of latex allergy in medical students is not known. Objective: To determine the prevalence of self-reported latex allergy and associated factors in medical students. Methods: Cross-sectional, analytical study of students with or without self-reported latex allergy. By means of a structured questionnaire, past personal and family history of allergic disease, time and frequency of exposure to latex gloves and symptoms after exposure to products or foods associated with latex allergy were inquired. Logistic regression models were carried out. Results: Out of 854 subjects, 431 (50.5%) were females. Median age was 21 years. Overall prevalence of latex allergy was 4.3% (95% CI = 3.1 to 5.9). Associated risk factors were age (OR = 1.37; 95% CI = 1.05 to 1.79), personal history of atopic dermatitis (OR = 7.32; 95% CI = 3.14 to 17.08), use of gloves ≥ 15/week (OR = 2.59; 95% CI = 1.17 to 5.76), use of latex products (OR = 5.76; 95% CI = 2.15 to 15.49) and fruit allergy (OR = 3.24; 95% CI = 1.27 t o8.27). Conclusion: Four out of a hundred students reported latex allergy. Age, personal history of atopic dermatitis, higher frequency of exposure to latex gloves and history of fruit allergy were risk factors for self-report latex allergy.

Background: In our country, the prevalence of latex allergy in health personnel has rarely been studied. Objective: To determine the prevalence and associated factors to self-reported latex allergy in health care workers. Methods: A cross-sectional study was conducted among 1,292 health care workers of a second level hospital. All workers were included and they were required to answer a structured questionnaire aimed at identifying latex allergy, atopic personal and family history, exposure to latex gloves and surgical background. Odds ratio (OR) and 95 % confidence interval (95 % CI) were estimated using regression logistic to investigate factors associated to latex allergy. Results: The female to male ratio was 2.4:1. The men age 38.4 ± 11.6 years. The prevalence of latex allergy auto-reported was 9.7 %, with a confidence interval of 95 % (95 % CI) 8.1 %-11.3 %. There was no statistical difference by workplace (p = 0.508). Factors associated with latex allergy included female gender (OR = 1.68; 95 % CI, 1.03-2.73, p = 0.037), personal history of atopy (OR = 4.82; 95 % CI, 3.19-7.26, p < 0.0001), family history of atopic dermatitis (OR = 4.33, 95 % CI, 1.20-4.41) and history of allergy to fruits (OR = 4.33; 95 % CI, 2.62-7.14, p < 0.0001). Conclusions: Up to 10 out to 100 health workers may have latex allergy. The main factors associated with latex allergy in this study were: being a female, personal or familiar atopy and allergy to fruits.

En este estudio se obtuvo evidencia de validez y confiabilidad de la escala de Locus de Control de la Salud en Dios (GLHC) en una muestra de 539 adultos mexicanos con diabetes mellitus tipo 2. El análisis de validez se basó en el análisis del contenido de los ítems y de la estructura interna del GLHC. El primer procedimiento estuvo a cargo de seis expertos, quienes evaluaron la pertinencia de la adaptación de los ítems. El segundo procedimiento fue un análisis factorial confirmatorio de grupo múltiple, de acuerdo al sexo y edad, a fin de evaluar la invarianza de medición del GLHC. Finalmente, la confiabilidad fue calculada mediante los coeficientes ω y H. El análisis factorial confirmatorio demostró una estructura de un solo factor con seis ítems, interpretable para la población de estudio con invarianza de medición por sexo, aunque deben tomarse precauciones al interpretar comparaciones por grupos de edad. La confiabilidad del constructo obtuvo magnitudes elevadas (>.90). Los resultados indican que la GLHC puede brindar información válida y confiable para valorar el locus de control de la salud en Dios para mexicanos con diabetes mellitus tipo 2.

Background: Hypovitaminosis D has been associated with various chronic diseases such as infections, autoimmune diseases, chronic obstructive pulmonary disease, cancer and asthma Objective: The objective at hand is to determine the prevalence of vitamin D (VD) insufficiency and deficiency in adults with allergic asthma. Methods: Through a cross-sectional study, we analyzed corresponding data amongst 135 patients. VD concentration was categorized as sufficient (≥ 30 ng/mL), insufficient (21-29 ng/mL), and deficient (≤ 20 ng/mL). The level of VD deficiency was measured through chemo-luminescence. We estimated the prevalence of VD alterations and their respective confidence intervals at 95 % (CI 95 %). Results: Within the analyzed population, there were 99/135 women (73.3 %); the mean age was 34.5 ± 10.3 years. The mean concentration of VD was 17.9 ± 6.9 ng/mL and the median was 17 ng/mL. The prevalence of VD insufficiency and deficiency was 25.2 % (CI 95 %, 18.6-33.2 %) and 71.1 % (CI 95 %, 62.9-78.1 %), respectively; VD concentrations ≤ 10 ng/mL had 13.3 % (CI 95 %, 8.5-20.2 %) and ≥ 30 ng/mL at 3.7 % (CI 95 %: 1.4-8.6 %). When we contrasted the men to the women, the median concentration of VD did not differ significantly (16 ng/mL vs. 18 ng/mL, p = 0.71). Conclusions: In this study, patients with allergic asthma had distinctively reduced VD concentration levels; future research will determine if and how VD affects the severity of asthma.

Background: The prevalence of food sensitization in adults shows differences owing to geographic, regional and cultural circumstances. Objective: To identify the prevalence and factors associated with food sensitization in adults with allergic diseases. Methods: Cross-sectional study, where medical records of adult patients with any allergic disease and who tested positive to airborne allergens on at least one skin test were reviewed. Age, sex, underlying allergic disease and skin test result were recorded. Statistical analyses included food sensitization prevalence with the corresponding confidence intervals (CI), as well as a multivariate analysis to determine associated factors. Results: We included 258 patients with a mean of 36 years of age; 75 % were of the female sex. The most common underlying condition was allergic rhinitis (59 %). The prevalence of food sensitization was 37 % (95 % CI, 31.5-43.3) and it did not vary significantly according to sex or allergic disease in question. The most sensitizing food was soybeans (44.8 %), and associated factors were sensitization to cat dander (OR = 1.8; 95 % CI, 1.03-3.2) and 5 or more positive skin tests (OR = 4.3, 95 % CI 2.3-8.1). Conclusions: The prevalence of food sensitization in people with allergic disease was 40 %. Further studies are required to determine its prevalence in the general population.

Background Diabetic kidney disease is the most common cause of chronic kidney disease (CKD). An early event in diabetic kidney disease is alteration of the glomerular basement membrane and the mesangial expansion. Matrix metalloproteinases (MMP) are a family of endopeptidases responsible for controlling the pathophysiological remodeling of tissues, including renal tissues. MMP-9 in human urine has been proposed as a marker of diabetic nephropathy and urinary tract infections (UTI). Methods A cross-sectional study was conducted in type 2 diabetes mellitus (T2DM) patients who receive first level medical attention in Mexico. We used ELISA to measure MMP-9 levels in the urine of subjects with T2DM ≥ 18 years of age, who fulfilled the clinical requirements for calculation of glomerular filtration rate (GFR), according to the K/DOQI guide, in an attempt to identify whether MMP-9 levels in T2DM differ in patients with and without renal impairment. Univariate and multivariable analyses were performed in order to identify the association between MMP-9 and renal impairment. Results Included in the study were 34 (45%) subjects with renal impairment and 42 (55%) without. In the group with renal impairment, 10 subjects corresponded to stages 1–2 and 24 subjects corresponded to stage 3, according to their values of GFR and urinary albumin, following that proposed by the K/DOQI. No differences were found relating to sex, age, having or not having a partner, education, being able to read and write a message and duration of T2DM. Moreover, no differences were found between the groups in terms of weight, height, body mass index, waist size in general and frequency of UTI. In contrast, serum creatinine and urinary albumin were higher in the group with renal impairment, while GFR was greater in the group without renal impairment. Levels of MMP-9 were greater in women compared to men. Through univariate analysis in the general population, the presence of MMP-9 and that of its percentile 90 (P90) P90 were associated with the renal impairment group; however, in patients without UTI, only the presence of MMP-9 was associated with the renal impairment group, and no association was found with its P90. Multivariate analysis revealed an association between MMP-9 and its P90 with renal impairment. Discussion It is necessary to validate sensitive and non-invasive biological markers of CKD. We demonstrate that the presence and P90 of urinary MMP-9 are associated with renal impairment in Mexican patients with T2DM. While high levels of MMP-9 were associated to females and UTI, the presence of UTI was not associated with the incidence of renal impairment.

Objetivo: Realizar la adaptación transcultural de SmokefreeTXT, intervención que envía mensajes de texto para dejar de fumar en población hispana que vive en Estados Unidos de América al contexto cultural y lingüístico de México. Métodos: Utilizando un abordaje cualitativo, se efectuó la adaptación transcultural considerando aspectos teóricos, culturales y gramaticales para lo cual se realizaron grupos focales y entrevistas semiestructuradas en las que participaron fumadores y profesionales de la salud. La información recopilada permitió crear dominios y categorías, a partir de los cuales se integró la biblioteca adaptada de mensajes de texto. Resultados: Este proceso permitió identificar tres dominios, modificar 96 mensajes y crear nueve. La mayor parte de los cambios se realizaron en el dominio lingüístico y la biblioteca de mensajes quedó integrada por 182 mensajes de texto. Conclusiones: La intervención SmokefreeTXT se enriqueció con la precisión y generación de nuevos mensajes.

Background: Studies related to the patterns of sensitization to rare species of aeroallergens are uncommon. Objective: To determine the frequency of sensitization to pollens clinically relevant in Allergology, corresponding to subclass Rosidae in patients with respiratory allergy. Patients and method: A cross-sectional study was done with patients included in a group with allergic rhinitis or asthma, respectively. We studied the clinical history, physical examination and reactivity to a panel of allergens, including the species Prosopis, Schinus, Acacia and Eucalyptus. Frequency of sensitization and confidence intervals at 95% (95%CI) were calculated. Results: A total of 104 allergic rhinitis patients and 99 patients with asthma diagnosis were included. In both groups, the mean age corresponded to fourth decade of life. Women had greater frequency. In patients with allergic rhinitis, frequencies of sensitization were: mesquite tree 26.2% (95%CI: 17.7% to 34.6%), American pepper tree 11.5% (95%CI: 5.4% to 17.6%), eucalypt tree 6.7% (95%CI: 1.9% to 11.5%) and acacia tree 3% (95%CI: 0.3% to 6.3%). In subjects with asthma the results were as follows: mesquite tree 13.1% (95%CI: 6.5% to 19.7%), American pepper tree 7.1% (95%CI: 2% to 12.2%), eucalypt tree 4% (95%CI: 0.1% to 7.9%) and acacia tree 3% (95%CI: 0.4% to 6.4%). Both groups had a high frequency of sensitization to ash tree and oak tree followed by eucalypt, pine and acacia tree. Conclusions: Studied capacity of sensitization to tree pollens for this population is low, except for mesquite tree.

The hepatitis B virus (HBV) represents a worldwide public health problem; the virus is present in one third of the global population. However, this rate may in fact be higher due to occult hepatitis B virus infection (OBI). This condition is characterized by the presence of the viral genome in the liver of individuals sero-negative for the virus surface antigen (HBsAg). The causes of the absence of HBsAg in serum are unknown, however, mutations have been identified that produce variants not recognized by current immunoassays. Epigenetic and immunological host mechanisms also appear to be involved in HBsAg suppression. Current evidence suggests that OBI maintains its carcinogenic potential, favoring the progression of fibrosis and cirrhosis of the liver. In common with open HBV infection, OBI can contribute to the establishment of hepatocellular carcinoma. Epidemiological data regarding the global prevalence of OBI vary due to the use of detection methods of different sensitivity and specificity. In Latin America, which is considered an area of low prevalence for HBV, diagnostic screening methods using gene amplification tests for confirmation of OBI are not conducted. This prevents determination of the actual prevalence of OBI, highlighting the need for the implementation of cutting edge technology in epidemiological surveillance systems.

Human rhinovirus (HRV) is a leading cause of acute respiratory infection (ARI) in young children and infants worldwide and has a high impact on morbidity and mortality in this population. Initially, HRV was classified into two species: HRV-A and HRV-B. Recently, a species called HRV-C and possibly another species, HRV-D, were identified. In Mexico, there is little information about the role of HRV as a cause of ARI, and the presence and importance of species such as HRV-C are not known. The aim of this study was to determine the clinical characteristics and genetic variability of HRV in Mexican children. Genetic characterization was carried out by phylogenetic analysis of the 5′-nontranslated region (5′-NTR) of the HRV genome. The results show that the newly identified HRV-C is circulating in Mexican children more frequently than HRV-B but not as frequently as HRV-A, which was the most frequent species. Most of the cases of the three species of HRV were in children under 2 years of age, and all species were associated with very mild and moderate ARI.

INTRODUCTION: The situation of tuberculosis (TB) is being modified by the human immunodeficiency virus (HIV), which is increasing the occurrence of new cases and the generation of drug resistant strains, affecting not only the people infected with HIV, but also their close contacts and the general population, conforming a serious public health concern. However, the magnitudes of the factors associated to this co-infection differ considerably in relation to the population groups and geographical areas. METHODS: In order to evaluate the prevalence and risk factors for the co-infection of tuberculosis (TB) in a population with human immunodeficiency virus (HIV+) in the Southeast of Mexico, we made the analysis of clinical and epidemiological variables and the diagnosis of tuberculosis by isolation of mycobacteria from respiratory samples. RESULTS: From the 147 HIV+ individuals analyzed, 12 were culture positive; this shows a prevalence of 8% for the co-infection. The only variable found with statistical significance for the co-infection was the number of CD4-T < 200 cells/mm³, OR 13 (95%, CI 2-106 vs 12-109). CONCLUSIONS: To our knowledge this is the first report describing the factors associated with tuberculosis co -infection with HIV in a population from Southern Mexico. The low number of CD4 T-cells was the only variable associated with the TB co-infection and the rest of the variables provide scenarios that require specific and particular interventions for this population group.INTRODUÇÃO: A situação da tuberculose (TB) foi modificada pelo vírus da imunodeficiência humana (HIV). Com isso, aumentou-se a ocorrência de novos casos de TB e a geração de cepas resistentes à droga, afetando não só as pessoas infectadas com HIV, mas também seus contatos próximos e da população em geral, gerando um sério problema de saúde pública. No entanto, a magnitude dos fatores associados à esta coinfecção diferem consideravelmente em relação aos grupos populacionais e áreas geográficas. MÉTODOS: Para avaliar a prevalência da comorbilidade e fatores de risco da coinfecção de tuberculose (TB) em uma população com o vírus da imunodeficiência humana (VIH+) no sudeste do México, nós fizemos a análise das variáveis clínicas e epidemiológicas e de isolamento da micobactérias através de cultura de amostras respiratórias. RESULTADOS: A partir de 147 indivíduos HIV+ analisados, 12 foram positivos na cultura, o que mostra uma prevalência de 8% para a coinfecção. A única variável com significância estatística encontrada para a coinfecção foi o número de células CD4-T

The clinical behavior of asthma varies with age at onset. This study was undertaken to identify associated markers of adult-onset allergic asthma (age ≥20 years).This cross-sectional study compared two groups: 58 patients with asthma onset at

Los hábitos alimentarios saludables promueven el bienestar y previenen enfermedades, sin embargo, pese a la intencionalidad de cambio de hábitos nocivos, las personas con frecuencia fracasan en sus intentos. Lo anterior debido a que el cambio, además de conocimientos sobre una adecuada alimentación, requiere capacidades de autorregulación que permitan observarse, evaluarse y emprender acciones con una constante motivación durante el proceso. El objetivo de este estudio fue diseñar y validar un instrumento para evaluarel nivel de autorregulación de hábitos alimentarios en estudiantes universitarios.Fueron redactados 62 ítems, posteriormente sometidos a evaluación por cuatro jueces expertos. Se efectuaron dos aplicaciones del instrumento con un total de 487 participantes. Se realizó un análisis factorial de mínimos cuadrados no ponderados con rotación a través del método Oblimin directo. Se descartaron los ítems que tuvieron carga factorial inferior a 0.40 o comunalidad inferior a 0.30.Se obtuvo un instrumento de 14 ítems agrupados en tres factores que explicaron 46.9% de la varianza: autorreación, autoobservación y autoevaluación. A través del alfa de Cronbach se obtuvo un coeficiente de confiabilidad muy alto (α = 0.874).Los resultados muestran que la escala constituye una herramienta válida y confiable para medir la autorregulación de hábitos alimentarios en estudiantes universitarios. Sus aplicaciones incluyen la obtención de diagnósticos y la evaluación de intervenciones enfocadas a la mejora de la alimentación, partiendo del supuesto de que los procesos de cambio sostenido requieren de capacidades de autorregulación en las personas.

Abstract Introduction: Anxiety and depression are frequent disorders of chronic diseases, yet there is no conclusive information to their association with rhinitis. Objective: The objective is to determine the frequency of anxiety and depression and its possible association to allergic rhinitis (AR) and non-allergic rhinitis (NAR). Methods: This is a cross-sectional study in which procured subjects with AR (n = 111), NAR (n = 34) and a control group (n = 96) from the university hospital. The presence of anxiety and depression was considered when it reached a score > 13 based on The Beck Anxiety Inventory Test and The Beck Depression Inventory II Test, respectively. The association between AR and NAR with anxiety and depression was adjusted with the Mantel-Haenszel Method and logistic regression. Results: The frequency for anxiety in AR, NAR and the control group was 45.9%, 52.9%, 10.4%, respectively (p < 0.001); depression frequency was 38.7%, 47.1%, 16.6% (p = 0.0003), respectively. Both AR and NAR were associated to anxiety and depression in women, but not to men. After adjusting the sex: AR was associated to anxiety (OR = 5.7, p < 0.001) and depression (OR = 2.5, p = 0.015), while NAR was also associated to anxiety (OR = 7.8, p < 0.001) and depression (OR = 3.3, p < 0.014). In multivariate analysis it was identified that AR, NAR and the individual's sex (women) were factors associated to anxiety and depression. Results showed that age was only associated to anxiety. Conclusion: AR and NAR are diseases associated to anxiety and depression, at least in women.

ABSTRACT Objective: To investigate whether there is an association between suicidal ideation (SI) and allergic diseases in adults. Methods: This was a comparative cross-sectional study involving individuals ranging from 20 to 50 years of age recruited from a university hospital in the city of Guadalajara, Mexico. We included patients with a confirmed diagnosis of allergic asthma, those with a confirmed diagnosis of allergic rhinitis, and healthy controls. All subjects completed the Beck Depression Inventory-II (BDI-II), which includes an item that evaluates the presence of suicidal thoughts or desires within the last two weeks, in order to identify SI. Results: The sample comprised 115 patients with allergic asthma, 111 patients with allergic rhinitis, and 96 healthy controls. The number of individuals identified with SI in the three groups were, respectively, 17 (14.8%), 13 (11.7%), and 8 (8.3%). Regarding the presence of SI, no statistically significant association was found in the allergic asthma group (OR = 1.98; 95% CI: 0.78-4.64; p = 0.154) or in the allergic rhinitis group (OR = 1.46; 95% CI: 0.58-3.68; p = 0.424) when they were compared with the control group. However, the presence of depression was associated with SI in the three groups: allergic asthma (OR = 12.36; 95% CI: 2.67-57.15; p = 0.001); allergic rhinitis (OR = 6.20; 95% CI: 1.66-23.14; p = 0.006); and control (OR = 21.0; 95% CI: 3.75-117.36; p < 0,001). Conclusions: In comparison with the control group, no association was found between SI and the groups with allergic diseases. In contrast, there was association between SI and depression in the three groups.

ABSTRACT Background and aim: the aim of the study was to use a validated questionnaire to identify factors associated with the development of gastric cancer (GC) in the Mexican population. Methods: the study included cases and controls that were paired by sex and ± 10 years of age at diagnosis. In relation to cases, 46 patients with a confirmed histopathological diagnosis of adenocarcinoma-type GC, as reported in the hospital records, were selected, and 46 blood bank donors from the same hospital were included as controls. The previously validated Questionnaire to Find Factors Associated with Gastric Cancer (QUFA-GC(c)) was used to collect data. Odds ratio (OR) and 95% confidence interval (IC) were estimated via univariate analysis (paired OR). Multivariate analysis was performed by logistic regression. A decision tree was constructed using the J48 algorithm. Results: an association was found by univariate analysis between GC risk and a lack of formal education, having smoked for ≥ 10 years, eating rapidly, consuming very hot food and drinks, a non-suitable breakfast within two hours of waking, pickled food and capsaicin. In contrast, a protective association against GC was found with taking recreational exercise and consuming fresh fruit and vegetables. No association was found between the development of GC and having an income that reflected poverty, using a refrigerator, perception of the omission of breakfast and time period of alcoholism. In the final multivariate analysis model, having no formal education (OR = 17.47, 95% CI = 5.17-76.69), consuming a non-suitable breakfast within two hours of waking (OR = 8.99, 95% CI = 2.85-35.50) and the consumption of capsaicin ˃ 29.9 mg capsaicin per day (OR = 3.77, 95% CI = 1.21-13.11) were factors associated with GC. Conclusions: an association was found by multivariate analysis between the presence of GC and education, type of breakfast and the consumption of capsaicin. These variables are susceptible to intervention and can be identified via the QUFA-GC(c).