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Mendez-Hernandez P.,University of Lyon | Mendez-Hernandez P.,Autonomous University of Tlaxcala | Dosamantes-Carrasco D.,University of Lyon | Dosamantes-Carrasco D.,Instituto Mexicano del Seguro Social | And 11 more authors.
Salud Publica de Mexico | Year: 2012

Objective: To assess the impact of a workplace leisure physical activity program on healthcare expenditures for type 2 diabetes and hypertension treatment. Material and Methods: We assessed a workplace program's potential to reduce costs by multiplying the annual healthcare costs of patients with type 2 diabetes and hypertension by the population attributable risk fraction of non-recommended physical activity levels. Feasibility of a physical activity program was assessed among 425 employees of a public university in Mexico. Results: If 400 sedentary employees engaged in a physical activity program to decrease their risk of diabetes and hypertension, the potential annual healthcare cost reduction would be 138 880 US dollars. Each dollar invested in physical activity could reduce treatment costs of both diseases by 5.3 dollars. Conclusions: This research meets the call to use health economics methods to re-appraise health priorities, and devise strategies for optimal allocation of financial resources in the health sector. Source

Goniewicz M.L.,University of California at San Francisco | Goniewicz M.L.,University of Silesia | Eisner M.D.,University of California at San Francisco | Lazcano-ponce E.,Research Center en Salud Poblacional | And 6 more authors.
Nicotine and Tobacco Research | Year: 2011

Objectives: Cotinine is the most widely useds an overlap in cotinine levels when comparing light or occasional smokers versus heavily ex biomarker to distinguish active versus passive smoking. However, there iposed passive smokers. 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) is a tobacco-specific nitrosamine measurable in urine with a much longer half-life than cotinine. The aim of the study was to determine optimal cutoff points to discriminate active versus passive smokers and to compare sensitivity and specificity for the use of cotinine, NNAL, and the ratio of the NNAL/cotinine in urine. Methods: Cotinine and NNAL were measured in urine of 373 active smokers and 228 passive smokers. Results: Geometric mean cotinine levels were 2.03 ng/ml (interquartile interval: 0.43-8.60) and 1,043 ng/ml (658-2,251) and NNAL levels were 5.80 pg/ml (2.28-15.4) and 165 pg/ml (90.8-360) pg/ml in passive and active smokers, respectively. NNAL/cotinine ratio in urine was significantly higher for passive smokers when compared with active smokers (2.85 vs. 0.16, p < .01). The receiver operating characteristics analysis determined optimal cutoff points to discriminate passive versus active smokers: 31.5 ng/ml for cotinine (sensitivity: 97.1% and specificity: 93.9%), 47.3 pg/ml for NNAL (87.4% and 96.5%), and 0.74 × 10 -3 for NNAL/cotinine ratio (97.3% and 87.3%). Conclusions: Both urine cotinine and NNAL are sensitive and specific biomarkers for discriminating the source of tobacco smoke exposure. Cotinine is the best overall discriminator when biomarkers are measured while a person has ongoing exposure to tobacco smoke. NNAL because of its long half-life would be particularly useful when there is a delay between exposure and biomarker measurement. The NNAL/cotinine ratio provides similar sensitivity but poorer specificity at discriminating passive versus active smokers when compared with NNAL alone. © The Author 2011. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. Source

Blanc E.,Cesar Milstein Hospital | Ponce C.,Cesar Milstein Hospital | Brodschi D.,Cesar Milstein Hospital | Nepote A.,Cesar Milstein Hospital | And 8 more authors.
Metabolic Syndrome and Related Disorders | Year: 2015

Background: Metabolic syndrome has been associated with nodular goiter. Our aim was to evaluate which metabolic parameters in elderly patients with metabolic syndrome are associated with thyroid enlargement or increased prevalence of thyroid nodules. Methods: In this cross-sectional study, 77 patients >65 years of age with metabolic syndrome were included. We evaluated the presence of thyroid nodules and thyroid volume by ultrasonography and several biochemical, metabolic and anthropometric parameters. Only patients with thyrotropin (thyroid-stimulating hormone, TSH) levels between 0.3 and 6 mU/L were included. We further divided subjects into two groups - type 2 diabetes mellitus (T2DM) and non-T2DM and established comparisons between them. Results: Among all parameters analyzed we found a significant correlation between glycated hemoglobin (HbA1c) and volume (r=0.261, P=0.027) or number of nodules (r=0.266, P=0.023). Neither sex, age, body mass index (BMI), metformin, nor levothyroxine use were associated with thyroid volume or nodularity. Within the whole cohort, those patients with T2DM had larger thyroid volumes compared to non-T2DM [median (confidence interval, CI) 6.976 (5.220-10.789) vs. 5.034 (3.796-6.034) mL, P<0.008). Furthermore, a larger proportion of T2DM patients presented thyroid volumes >5.8 mL [69 vs. 23%, P<0.001; odds ratio=7.25 (CI 2.04-25.56)]. Conclusions: In elderly patients with metabolic syndrome, worse metabolic control, represented by higher HbA1c levels, was found associated to increased prevalence of thyroid nodules and larger thyroid volume. Moreover, within the whole metabolic syndrome group, patients with T2DM had the largest thyroid volumes © Copyright 2015, Mary Ann Liebert, Inc. 2015. Source

Teran-Figueroa Y.,Autonomous University of San Luis Potosi | Muniz-Carreon P.,Autonomous University of San Luis Potosi | Moya M.F.,Hospital Regional del Suroeste | Galan-Cuevas S.,Autonomous University of San Luis Potosi | And 3 more authors.
Ginecologia y Obstetricia de Mexico | Year: 2015

Background: Cervical cancer is caused by high-risk HPV, a sexually transmitted virus. In Mexico, this disease represents a public health problem. San Luis Potosi is located within ten states with the highest rates in the country. Indigenous women of Mexico will likely to develop cervical cancer due to inequality in access to health services and their determinants. Epidemiological studies can be supported by investigations of diverse geographical nature to undertake the identification and analysis of spatial patterns of disease. Objective: To locate by geographical distribution of Huasteca Potosina women high-risk HPV positive to observe the burden of disease in patients with limited access to health services and propose specific primary prevention activities was made with a sample of 605 women. Cervico-vaginal specimens were taken. High-risk HPV infection was determined by hybrid capture. Age and date of the last Papanicolaou were obtained through a structured poll. It was use descriptive statistics and georeference was made in a map using the software ILWIS 3.3. Results: Countyes with the highest and lowest percentages of infection were found. The prevalence of infection with high-risk HPV was 9.9% and age groups with the highest percentages of infection were in 51- 60 and 41-50 years. Most women had been made the Papanicolaou at time of the present study. Conclusions: Georeferenceas like epidemiological tool for generating risk profiles allowed suggest strategies for improve prevention, early detection and control of the cervical cancer. © 2015, Asociacion Mexicana de Ginecologia y Obstetricia. All rights reserved. Source

Martinez De Tejada B.,University of Geneva | Karolinski A.,Research Center en Salud Poblacional | Ocampo M.C.,Research Center en Salud Poblacional | Laterra C.,Hospital Materno Infantil Ramon Sarda | And 29 more authors.
BJOG: An International Journal of Obstetrics and Gynaecology | Year: 2015

Objective To evaluate the effectiveness of 200 mg of daily vaginal natural progesterone to prevent preterm birth in women with preterm labour. Design Multicentre, randomised, double-blind, placebo-controlled trial. Setting Twenty-nine centres in Switzerland and Argentina. Population A total of 385 women with preterm labour (240/7 to 336/7 weeks of gestation) treated with acute tocolysis. Methods Participants were randomly allocated to either 200 mg daily of self-administered vaginal progesterone or placebo within 48 hours of starting acute tocolysis. Main outcome measures Primary outcome was delivery before 37 weeks of gestation. Secondary outcomes were delivery before 32 and 34 weeks, adverse effects, duration of tocolysis, re-admissions for preterm labour, length of hospital stay, and neonatal morbidity and mortality. The study was ended prematurely based on results of the intermediate analysis. Results Preterm birth occurred in 42.5% of women in the progesterone group versus 35.5% in the placebo group (relative risk [RR] 1.2; 95% confidence interval [95% CI] 0.93-1.5). Delivery at <32 and <34 weeks did not differ between the two groups (12.9 versus 9.7%; [RR 1.3; 95% CI 0.7-2.5] and 19.7 versus 12.9% [RR 1.5; 95% CI 0.9-2.4], respectively). The duration of tocolysis, hospitalisation, and recurrence of preterm labour were comparable between groups. Neonatal morbidity occurred in 44 (22.8%) cases on progesterone versus 35 (18.8%) cases on placebo (RR: 1.2; 95% CI 0.82-1.8), whereas there were 4 (2%) neonatal deaths in each study group. Conclusion There is no evidence that the daily administration of 200 mg vaginal progesterone decreases preterm birth or improves neonatal outcome in women with preterm labour. © 2014 Royal College of Obstetricians and Gynaecologists. Source

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