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BACKGROUND: Diabetes mellitus (DM) is a national public health problem, and increasingly appears at earlier ages. One of the predisposing factors for this is obesity; however, in our environment there are few data on the prevalence of diabetes in overweight and obese adolescents. OBJECTIVE: To determine the prevalence of diabetes in overweight and obese adolescents. MATERIAL AND METHOD: A prospective study was conducted on adolescents between 12 and 16 years of age, overweight or obese in 3 secondary schools of Michoacán, Mexico. There were registered weight, height, body mass index (BMI), blood pressure (BP), waist circumference and capillary glycosylated hemoglobin (HbA1c) by a device DCA Vantage Siemens, also fasting blood glucose and postprandial. RESULTS: There were included 93 subjects, from whom 71 had HbA1c <5.7% (control), 18 with HbA1c between 5.7 and 6.5% (pre-diabetic), of which 14 were women, and 4 with HbA1c >6.5% (diabetes), 3 women and one man. The only significant difference between the three groups was higher postprandial blood glucose levels in diabetics and pre-diabetics compared with controls. CONCLUSIONS: Although this is a screening study, the frequency of diabetes mellitus among overweight and obese adolescents was 4% and 19.5% with prediabetes, which represents that almost a quarter of these adolescents have impaired glucose metabolism. [ABSTRACT FROM AUTHOR]

This is a report on the experimental phase of a two-stage study on the effects of implicit-explicit grammar instruction regarding EFL students’ performance. The purpose of this phase was to investigate whether the methodologies of implicit and explicit EFL instruction account for the improvement of university students’ performance on a test over two grammar topics. Three groups were selected. Students in the implicit language classes had no explicit instruction on these topics which were taught through meaningful and contextualised listening, speaking, reading and writing activities. Students in the explicit language classes were taught the regular course plus additional exercises and drills in order to practise the grammatical features, and a control group was taught the regular course. The results indicate that students in the explicit instruction group achieved significantly higher scores than both the students in the implicit instruction group and the students in the control group on the performance tests. Key words: Grammar-Input, Implicit-Grammar, Explicit-Grammar, Grammar- Teaching, Quantitative-Research Éste es un informe de la fase experimental de un estudio en dos etapas sobre los efectos de la enseñanza implícita y explícita de la gramática en el desempeño de los estudiantes. El propósito de esta etapa era investigar si las metodologías implícita y explícita se relacionaban con el mejoramiento de estudiantes universitarios en una prueba sobre dos temas gramaticales. Se seleccionaron tres grupos: los estudiantes en el grupo de instrucción implícita no tuvieron ninguna instrucción explícita en los dos tópicos que se enseñaron a través de actividades significativas y contextualizadas en escucha, habla, lectura y escritura. El grupo de instrucción explícita tomó el curso regular ofrecido por la institución más actividades y ejercicios extras con el propósito de practicar los temas gramaticales enseñados; y el grupo de control tomó únicamente el curso regular. Los resultados indican que los estudiantes en el grupo de enseñanza explícita lograron resultados significativamente más altos que los estudiantes en el grupo de enseñanza implícita y que los estudiantes del grupo de control. Palabras claves: Input-Gramatical, Gramática-Implícita, Gramática- Explícita, Enseñanza-Gramática, Investigación-Cuantitativa

Background: There was a need for a solid asthma guideline in Mexico to update and unify asthma management. Because high-quality asthma guidelines exist worldwide, in which the latest evidence on asthma management is summarized, the ADAPTE approach allows for the development of a national asthma guideline based on evidence from already existing guidelines, adapted to national needs., Objective: To fuse evidence from the best asthma guidelines and adapt it to local needs with the ADAPTE approach., Methods: The Appraisal of Guidelines for Research and Evaluation (AGREE) II asthma guidelines were evaluated by a core group to select 3 primary guidelines. For each step of asthma management, clinical questions were formulated and replied according to (1) evidence in the primary guidelines, (2) safety, (3) Cost, and (4) patient preference. The Guidelines Development Group, composed of a broad range of experts from medical specialties, primary care physicians, and methodologists, adjusted the draft questions and replies in several rounds of a Delphi process and 3 face-to-face meetings, taking into account the reality of the situation in Mexico. We present the results of the pediatric asthma treatment part., Results: Selected primary guidelines are from the British Thoracic Society and Scottish Intercollegiate Guidelines Network (BTS/SIGN), Global Initiative for Asthma (GINA), and Spanish Guidelines on the Management of Asthma (GEMA) 2015, with 2016 updates. Recommendations or suggestions were made for asthma treatment in Mexico. In this article, the detailed analysis of the evidence present in the BTS/SIGN, GINA, and GEMA sections on the (non) pharmacologic treatment of pediatric asthma, education, and devices are presented for 2 age groups: children 5 years or younger and children 6 to 11 years old with asthma., Conclusion: For the pediatric treatment and patient education sections, applying the AGREE II and Delphi methods is useful to develop a scientifically sustained document, adjusted to the Mexican situation, as is the Mexican Guideline on Asthma., (Copyright © 2018 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)

Background: The need for a national guideline, with a broad basis among specialists and primary care physicians was felt in Mexico, to try unifying asthma management. As several high-quality asthma guidelines exist worldwide, it was decided to select the best three for transculturation., Methods: Following the internationally recommended methodology for guideline transculturation, ADAPTE, a literature search for asthma guidelines, published 1-1-2007 through 31-12-2015 was conducted. AGREE-II evaluations yielded 3/40 most suitable for transculturation. Their compound evidence was fused with local reality, patient preference, cost and safety considerations to draft the guideline document. Subsequently, this was adjusted by physicians from 12 national medical societies in several rounds of a Delphi process and 3 face-to-face meetings to reach the final version., Results: Evidence was fused from British Thoracic Society Asthma Guideline 2014, Global Initiative on Asthma 2015, and Guía Española del Manejo del Asma 2015 (2016 updates included). After 3 Delphi-rounds we developed an evidence-based document taking into account patient characteristics, including age, treatment costs and safety and best locally available medication., Conclusions: In cooperation pulmonologists, allergists, ENT physicians, paediatricians and GPs were able to develop an evidence-based document for the prevention, diagnosis and treatment of asthma and its exacerbations in Mexico.

There are four types of histamine receptors. Allergic symptoms, especially those in rhinoconjunctivitis and urticaria, are mainly caused by activation of histamine receptor 1 (H1). Consequently, oral H1-antihistamines form and integral part of the treatment of these diseases. Antihistamines are inverse agonists that stabilize the non-active configuration of the histamine receptor. First generation H1-antihistamines cause a variety of adverse effects via several mechanisms: sedation (accumulation in the central nervous system), dry mouth, urinary retention, weight gain (low selectivity: stimulation of serotonin/muscarinic/alpha-adrenergic receptors) and drug interactions (substrate of CYP450-3A4). Generally second generation H1-antihistamines have a better safety profile. New guidelines on allergic rhinitis and urticaria recommend second generation H1-antihistamines as first line drugs, with -if necessary- four-times updosing to obtain control in urticaria. The enhanced efficacy of quadruple doses in urticaria, while maintaining a good safety profile, has been shown for bilastine, desloratadine and levocetirizine (rupatadine). For ebastine and fexofenadine only the safety of quadruple doses has been shown till now. Extreme precaution should be taken with astemizol and terfenadine that never should be up-dosed, as high serum concentrations can cause potentially fatal ventricular tachycardia. First generation antihistamines are not recommended as first line treatment and updosing is not safe.

Background: Urticaria is a disease that a fifth of the population shallsuffer once in a lifetime. Recent clinical guidelines have proposed some fundamental changes in the diagnosis and treatment of urticaria, making the development of a national, multidisciplinary guideline, with wide acceptability among different professional groups -both specialists and primary health care workers-, necessary in Mexico., Material and Method: Internationally recognized tools for guidelinedevelopment were used. An interdisciplinary group of clinical experts (some of them knowledgeable in methodology of guideline development) determined the objectives and scope of the Evidence Based Clinical Practice Guideline with SCOPE. It was decided to adapt and transculturize international guidelines on the diagnosis and treatment of urticaria. With AGREE-II three high-quality guidelines (Zuberbier 2014, Sánchez-Borges 2012, Powell 2007) were selected to function as basic guidelines (BG). A set of Clinical Questions was formulated that lead to recommendations/suggestions, based on these BG, taking into account the cultural and economic background of Mexico, according to GRADE recommendation development., Results: By a formal process of discussion and voting during several working-sessions, experts and first level healthcare physicians determined the wording of the final guideline, taking particularly care of developing a document, adjusted to the reality, values and preferences of the Mexican patients. The use of oral second generation, non-sedating antihistamines as first line treatment is emphasized., Conclusion: This document is an Evidence Based Clinical Practice Guideline for the diagnosis and treatment of acute and chronic urticaria, based on three, high quality, international guidelines. It was developed by a multidisciplinary group. Tables and algorithms make the guideline user-friendly for both, first line health care physicians and specialists.