Luis Pablo Cruz-Hervert - Academia.edu (original) (raw)
Papers by Luis Pablo Cruz-Hervert
Geriatrics & Gerontology International, May 6, 2016
Aim: Oral health in old persons is frequently poor; non-functional prostheses are common and nega... more Aim: Oral health in old persons is frequently poor; non-functional prostheses are common and negatively affect quality of life. The objective of this study was to estimate the impact of oral health problems on oral health related quality of life in a sample of home dwelling Mexican elders. Methods: Household survey in 655 persons 70 years old and over residing in one county in Mexico City. Variables: Oral Health Related Quality of Life (Short version of the Oral Health Impact Profile validated in Mexico-OHIP-14-sp), self-perception of general and oral health, xerostomia, utilization of dental services, utilization and functionality of removable dental prostheses, dental and periodontal conditions, age, gender, marital status, schooling, depression, cognitive impairment and independence in activities of daily living (ADL). A negative binomial regression model was fitted. Results: Mean age was 79.2 ± 7.1 years; 54.2% were women. Mean OHIP-14-Sp score was 6.8 ± 8.7, median was 4. The final model showed that men (RR = 1.30); persons with xerostomia (RR = 1.41); no utilization of removable prostheses (RR = 1.55); utilization of non-functional removable prostheses (RR = 1.69); fair self-perception of general health (RR = 1.34); equal (RR = 1.43) or worse (RR = 2.32) self-perception of oral health compared with persons of the same age; and being dependent for at least one ADL (RR = 1.71) increased the probability of higher scores of the OHIP-14-sp. Age, schooling, depression, cognitive impairment and periodontal conditions showed no association. Conclusions: Oral rehabilitation can improve quality of life, health education and health promotion for the elder and their caregivers may reduce the risk of dental problems. Geriatr Gerontol Int 2016; ••: ••-••.
Gerodontology
ObjectivesTo analyse the relationship between the Frailty Index and 10 oral conditions controllin... more ObjectivesTo analyse the relationship between the Frailty Index and 10 oral conditions controlling for nutritional status among Mexican community‐dwelling older people.BackgroundStudies suggest that the association between frailty and oral conditions are mediated by nutrition.Materials and methodsThis cross‐sectional analysis includes 487 community‐dwelling men and women aged ≥70 years old. Interview and clinical examinations were performed at participants' homes. Objective (number of natural teeth, root remnants, dental condition, utilisation and functionality of removable dental prostheses and periodontitis) and subjective (utilisation of dental services, self‐rated oral health, chewing difficulties and xerostomia) oral variables were collected by trained personnel. The Frailty Index was calculated considering 35 deficits. Nutritional status measured with the Mini‐Nutritional assessment (MNA), age, sex, education, and marital status were included as covariates. We fitted 11 mu...
BMC Oral Health, 2019
Background: Determine the impact of poor oral health on the oral health-related quality of life (... more Background: Determine the impact of poor oral health on the oral health-related quality of life (OHRQoL) in communitydwelling older adults. Methods: Cross-sectional study of community-dwelling older adults in Mexico City. Sociodemographic characteristics were obtained and assessed their OHRQoL according to the Geriatric/General Oral Health Assessment Index (GOHAI). Clinical evaluation of their oral health: painful chewing, use of dentures, dry mouth, xerostomia, plaque, calculus, coronal and root caries, tooth loss and gingival bleeding. Finally, we determined the oral health of participants through Latent Class Analysis (LCA), excluding totally edentulous. The strength of association was determined (Odds Ratio [OR] and 95% confidence interval [95% CI]) through logical regression between the oral health categories (latent classes) and OHRoL in older adults, adjusted with the other variables included in the study: age, sex, marital status, living arrangements (lives alone), educational level, paid work status, comorbidity, cognitive deterioration, depression and use of medical and dental services in the previous 12 months. Results: The mean (SD) GOHAI score for the 228 older adults to 46.5 (8.7), number of classes to characterize oral health through LCA was three (entropy 0.805). The GOHAI mean for Class 3 (57.0%), acceptable oral health was 50.1 (7.1); totally edentulous (9.6%), 47.9 (8.4); for Class 2 (16.7%), regular oral health, 43.8 (9.3); and for Class 1 (16.7%), poor oral health, 42.2 (9.7). Significant differences were observed among means (p < .001). Using Class 3 an as a reference, the strength of association between the GOHAI scores and low OHRQoL (GOHAI 25th percentile = 24.0) was OR = 0.7, 95% CI = 0.2-3.3 for totally edentulous; OR = 3.0, 95% CI = 1.2-7.6 for Class 2 and OR = 5.0, 95% CI = 2.1-12.1 for Class 1. Conclusion: Poor oral health was associated with a negative impact on the OHRQoL of community-dwelling older adults. Clinical relevance: It is essential to design and implement oral health care policies specifically targeted at improving the quality of life in this older adult population.
Latin America continues to be severely underrepresented in genomics research, and fine-scale gene... more Latin America continues to be severely underrepresented in genomics research, and fine-scale genetic histories as well as complex trait architectures remain hidden due to the lack of Big Data. To fill this gap, the Mexican Biobank project genotyped 1.8 million markers in 6,057 individuals from 32 states and 898 sampling localities across Mexico with linked complex trait and disease information creating a valuable nationwide genotype-phenotype database. Through a suite of state-of-the-art methods for ancestry deconvolution and inference of identity-by-descent (IBD) segments, we inferred detailed ancestral histories for the last 200 generations in different Mesoamerican regions, unraveling native and colonial/post-colonial demographic dynamics. We observed large variations in runs of homozygosity (ROH) among genomic regions with different ancestral origins reflecting their demographic histories, which also affect the distribution of rare deleterious variants across Mexico. We analyzed...
Salud Pública de México
Objective. To determine the prevalence and factors related to depressive symptoms in older Mexica... more Objective. To determine the prevalence and factors related to depressive symptoms in older Mexican adults in urban and rural areas. Materials and methods. Cross-sectional study. We examined older adults from a sample taken from the Mexican Health and Aging Study (MHAS-2018). 14 230 older Mexicans were screened for self-reported depressive symptoms. Results. The prevalence of depressive symptoms was 29.8% (33.4% rural vs. 28.9% urban). In the rural and urban population, the probability of a high prevalence of depressive symptoms was higher in older adults with multimorbidity ≥3, severe pain, and fair/poor SRH. Only in the urban population the prevalence of depressive symptoms increased with lower schooling. Conclusion. Identification of the factors related to depressive symptoms may help healthcare professionals provide better treatment for specific groups in the population.
In the planning phase of research related to age and aging, the quality of knowledge derived from... more In the planning phase of research related to age and aging, the quality of knowledge derived from epidemiological studies, depends heavily on the solidity of the methodological design and the strategies for collecting data designed to answer the research question. Case–control studies are a cost-effective alternative for providing a valid and reasonably precise estimate for identifying an association force of a hypothetical relationship cause-effect in studies related to older adults population. Recently case–control studies have been related directly to cohort studies, which enabled researchers to design new patterns for their development while obtaining major benefits. The case–control study is the appropriate choice and at times the only alternative for studying diseases of very low incidence in older adults. With this type of study it is possible to explore a broad range of related exposures to illness. Another important advantage is that they require smaller samples and are les...
Revista Mexicana de Ortodoncia
Objetivo: Determinar la prevalencia del ponticulus posticus en radiografías digitales laterales d... more Objetivo: Determinar la prevalencia del ponticulus posticus en radiografías digitales laterales de cráneo. Material y métodos: Se seleccionaron aleatoriamente radiografías digitales laterales de cráneo de la base de datos de un centro de radiología oral y maxilofacial de la ciudad de Cuenca, Ecuador, de pacientes entre nueve y 25 años entre 2013-2015. Se estimó la prevalencia del ponticulus posticus según la clasificación de Cederberg y Stubbs y se estratificó por sexo. Se realizó un análisis de regresión multivariante multinomial para comparar la asociación entre edad y sexo con la clase 2, 3 y 4 frente a la clase 1. Los datos se analizaron en el programa STATA V13.0. Resultados: Se analizaron 1,000 radiografías laterales de cráneo, la edad promedio fue de 15 (± 4.23) años y 57.60% (n = 424) eran mujeres. La prevalencia de clase 1 fue de 71.8% (IC 95% 68.92-74.51), clase 2 fue 16.5% (IC 95% 14.32-18.94), clase 3 fue 5.5% (IC 95% 4.24-7.10) y clase 4 fue 6.20% (IC del 95%: 4.86 a 7....
Frontiers in Genetics
Current Genome-Wide Association Studies (GWAS) rely on genotype imputation to increase statistica... more Current Genome-Wide Association Studies (GWAS) rely on genotype imputation to increase statistical power, improve fine-mapping of association signals, and facilitate meta-analyses. Due to the complex demographic history of Latin America and the lack of balanced representation of Native American genomes in current imputation panels, the discovery of locally relevant disease variants is likely to be missed, limiting the scope and impact of biomedical research in these populations. Therefore, the necessity of better diversity representation in genomic databases is a scientific imperative. Here, we expand the 1,000 Genomes reference panel (1KGP) with 134 Native American genomes (1KGP + NAT) to assess imputation performance in Latin American individuals of mixed ancestry. Our panel increased the number of SNPs above the GWAS quality threshold, thus improving statistical power for association studies in the region. It also increased imputation accuracy, particularly in low-frequency varia...
Background: Despite chemotherapy, patients with cured pulmonary tuberculosis may result in lung f... more Background: Despite chemotherapy, patients with cured pulmonary tuberculosis may result in lung functional impairment. Objective: To evaluate a novel scoring system based on the degree of radiographic abnormalities and related spirometric values in patients with cured pulmonary tuberculosis. Methods: One hundred and twenty seven patients with cured pulmonary tuberculosis were prospectively enrolled in a referral hospital specializing in respiratory diseases. Spirometry was performed and the extent of radiographic abnormalities was evaluated twice by each of two readers to generate a novel quantitative score. Scoring reproducibility was analyzed by the intra-class correlation coefficient (ICC) and the Bland-Altman method. Multiple linear regression models were performed to assess the association of the extent of radiographic abnormalities with spirometric values. Results: The intra-observer agreement for scoring of radiographic abnormalities (SRA) showed an ICC of 0.81 (CI: 95%, 0.67...
Revista Mexicana de Ortodoncia, 2019
There are different cephalometric measurements to evaluate the dimensions of the upper airways us... more There are different cephalometric measurements to evaluate the dimensions of the upper airways using a lateral headfilm. It is unknown how many characteristics are possible to study from the available measurements and which are the most useful measurements for this purpose. Objective: To identify factors of measurement of the upper airways and determine their association to craniofacial dimensions. Material and methods: Cross-sectional study. We analyzed lateral headfilms and performed a principal factor analysis for upper airways measurements: N-S-Ba, BaS-PNS, AD1, AD2, PTV to Adenoid (DPTV) and Airway % (A%). Results: We analyzed 151 records, without previous orthodontic treatment or craniofacial syndrome. We identified two principal factors: Factor 1 (F1) includes AD1, AD2, DPTV and A%, and factor 2 (F2) includes Na-S-Ba and Ba-S-PNE. Conclusions: F1 was related to linear dimensions and F2 to structural characteristics.
Salud publica de Mexico, 2013
OBJECTIVE To estimate the prevalence of acute diarrheal diseases (ADD) during the two weeks previ... more OBJECTIVE To estimate the prevalence of acute diarrheal diseases (ADD) during the two weeks previous to the interview among children <5 years of age and to describe alarm signs and feeding practices of parents and caregivers (PCG) during children's ADD. MATERIALS AND METHODS Analysis of data from the National Health and Nutrition Surveys 2012 and 2006 and the National Health Survey 2000. RESULTS ADD prevalence decreased significantly from 2006 (13.1%) to 2012 (11.0%), particularly in the lower socioeconomic status. "Frequent bowel movements" were the main warning sign identified by PCG (66.0%) in contrast to "crying without tears" (4.3%) and "blood in faeces" (0.5%); only 42% PCG reported administering oral rehydration therapy. Factors associated with ADD were child's age <1 year and mother's age <20 years. CONCLUSIONS It is necessary to reinforce appropriate ADD preventive and treatment practices among PCG of children <5 years o...
Revista Mexicana de Ortodoncia, 2018
Existen diferentes medidas cefalometricas para evaluar las dimensiones de las vias aereas superio... more Existen diferentes medidas cefalometricas para evaluar las dimensiones de las vias aereas superiores a partir del uso de la radiografia lateral de craneo. Se desconoce que caracteristicas o factores de las vias aereas son identificables y posibles de estudiar a partir de las mediciones disponibles y cuales son las mediciones mas utiles para dicho fin. Objetivo: Identificar los factores de las mediciones de las vias aereas superiores y determinar su asociacion a las dimensiones craneofaciales. Material y metodos: Estudio transversal. Analizamos las radiografias laterales y realizamos un analisis factorial principal para las mediciones de las vias respiratorias superiores: N-S-Ba, Ba-S-PNS, AD1, AD2, PTV a adenoides (DPTV) y Airway% (A%). Resultados: Analizamos 151 registros, sin tratamiento de ortodoncia previo ni sindrome craneofacial. Identificamos dos factores principales: el factor 1 (F1) incluye AD1, AD2, DPTV y A%, y el factor 2 (F2) incluye N-S-Ba y Ba-S-ENP. Conclusiones: F1 ...
This study describes the achievements of the Mexican Consortium against Tuberculosis, in the Sani... more This study describes the achievements of the Mexican Consortium against Tuberculosis, in the Sanitary District of Orizaba, Veracruz, Mexico between 1995 and 2008. In brief, the main results can be classified as follows: 1) Conventional and molecular epidemiology (measurement of burden of disease, trends, risk factors and vulnerable groups, consequences of drug resistance, identification of factors that favor nosocomial and community transmission); 2) Development of diagnostic techniques to detect drug resistance, description of circulating clones and adaptation of simple techniques to be used in the field; 3) Evaluation of usefulness of tuberculin skin test, immunologic responses to BCG, impact of directly observed therapy for tuberculosis (DOTS), and study of immunological biomarkers and 4) Comments on ethical aspects of tuberculosis research. Additionally, we describe the impact on public policies, transference of technology, capacity building and future perspectives.
In the planning phase of research related to age and aging, the quality of knowledge derived from... more In the planning phase of research related to age and aging, the quality of knowledge derived from epidemiological studies, depends heavily on the solidity of the methodological design and the strategies for collecting data designed to answer the research question. The classic design of case-control studies distinguishes between older adults who have a specific outcome or disease (cases) and those who do not (controls) and are determines whether the subjects were exposed or not to one or several factors to try to establish, retrospectively (that is, from the effect to the cause), the relationship of these factors with the disease. Case-control studies are a cost-effective alternative for providing a valid and reasonably precise estimate for identifying an association force of a hypothetical relationship cause-effect in studies related to older adults. Recently case-control studies have been related directly to cohort studies, which enabled researchers to design new patterns for their...
Open Forum Infectious Diseases, 2017
prolongation (7%), and nosocomial infection (4%). Two patients were pregnant at the time of prese... more prolongation (7%), and nosocomial infection (4%). Two patients were pregnant at the time of presentation; one suffered severe malaria and fetal loss. Only 3% of patients reported being prescribed a prophylactic regimen and completing it; 20% reported taking an incomplete course, and the majority took no prophylaxis at all. Of 27 patients who had presented to another United States-based medical provider prior to hospitalization, 11 were initially misdiagnosed and treated for conditions other than malaria, including two who underwent extensive hematologic investigations. Inadequate experience and resources in treating malaria were the primary reasons cited for transfer to the tertiary hospital from community-based providers. Conclusion. Malaria poses a substantial health risk to US travelers, particularly in light of under-utilization of prophylaxis, lack of familiarity with the disease by local providers, and delays to diagnosis. Disclosures. All authors: No reported disclosures. 303.
International Journal of Infectious Diseases, 2010
Scientific Reports
Measles continues to be one of the leading causes of child mortality worldwide, even though a hig... more Measles continues to be one of the leading causes of child mortality worldwide, even though a highly effective vaccine has existed for more than 40 years. We aimed to describe the seroprevalence of measles antibodies in Mexico in 2012 and the risk factors associated with susceptibility. A total of 7,785 serum samples were analyzed from the National Health and Nutrition Survey in Mexico. This national survey is representative of the general population, including noninstitutionalized adult, adolescent, and child populations. Antibody titers were classified into protective (> 120 mIU/mL) or susceptible (≤ 120 mIU/mL) levels. The weighted seroprevalence and susceptibility of the overall population were 99.37% (95% CI 99.07–99.58) and 0.63% (95% CI 0.42–0.93), respectively. Among 1-to-4-year-old children, 2.18% (95% CI 1.36–3.48) were susceptible to measles. Among adolescents and young adults, the prevalence of susceptibility was as follows: those 15–19 years of age had a prevalence o...
Open Forum Infectious Diseases
Background As wild poliovirus is eradicated and countries switch from Oral Polio Vaccine (OPV) to... more Background As wild poliovirus is eradicated and countries switch from Oral Polio Vaccine (OPV) to Inactivated Polio Vaccine (IPV) per WHO recommendations, preventing circulation of vaccine-derived poliovirus is a top priority. However, spatial dynamics of OPV transmission are not well understood. Understanding these trends will improve resource targeting in the event of OPV reintroduction in undervaccinated communities. Mexico provides a natural environment to study OPV as it provides IPV routinely and bi-annual OPV campaigns. Methods Children in three villages near Orizaba, Mexico were randomized to three levels (10%, 30%, 70%) to receive OPV. We measured distance to nearest OPV shedding, and the amount of shedding close to unvaccinated individuals. We used maps to show the proximity and amount of shedding. Distance and density of shedding was analyzed separately using mixed effects logistic regression with random effects for household and time, adjusted for age, gender, area, and ...
Mouth and Teeth
Introduction: Muscle weakness is frequent in patients with rheumatoid arthritis but electromyogra... more Introduction: Muscle weakness is frequent in patients with rheumatoid arthritis but electromyographic activity of masticatory muscles in these patients remains unclear. The aim of this study is to evaluate the differences of Root Mean Square activity in patients with and without rheumatoid arthritis during a 30 seconds period using a longitudinal approach. Material and methods: We performed a cross-sectional study and measured bilateral electromyographic activity (EMG) of masseter muscles for 30 seconds in maximum intercuspation. We measured EMG by using a digital electromyograph, developed by our group (Hardware and software) to determine µV every 0.001 seconds and root medium square (RMS) values were recorded. Patients were treated at the Department and Physiology Laboratory in the UNAM in 2017. We performed a descriptive, bivariate analysis and a random effects linear regression model for repeated measurements adjusted by confounders. Results: We analyzed the information of 60 patients. Mean age was 43.9 years (±15.9), and 33.3% of the participants were males. As result of the multivariate analysis we identified that in patients with rheumatoid arthritis the RMS increased by 52.3 µV (95%CI 11.7; 85.73, p= 0.012) compared to patients without rheumatoid arthritis, but over a 30 second period RMS mean activity decreased at a rate of-0.44 µV per second (95%CI-0.48;-0.38, p< 0.001). Conclusion: EMG in patients with rheumatoid arthritis had higher mean values of RMS but a decreased activity over the evaluated period. More research is needed to clarify the electromyographic activity in patients with rheumatoid arthritis.
Geriatrics & Gerontology International, May 6, 2016
Aim: Oral health in old persons is frequently poor; non-functional prostheses are common and nega... more Aim: Oral health in old persons is frequently poor; non-functional prostheses are common and negatively affect quality of life. The objective of this study was to estimate the impact of oral health problems on oral health related quality of life in a sample of home dwelling Mexican elders. Methods: Household survey in 655 persons 70 years old and over residing in one county in Mexico City. Variables: Oral Health Related Quality of Life (Short version of the Oral Health Impact Profile validated in Mexico-OHIP-14-sp), self-perception of general and oral health, xerostomia, utilization of dental services, utilization and functionality of removable dental prostheses, dental and periodontal conditions, age, gender, marital status, schooling, depression, cognitive impairment and independence in activities of daily living (ADL). A negative binomial regression model was fitted. Results: Mean age was 79.2 ± 7.1 years; 54.2% were women. Mean OHIP-14-Sp score was 6.8 ± 8.7, median was 4. The final model showed that men (RR = 1.30); persons with xerostomia (RR = 1.41); no utilization of removable prostheses (RR = 1.55); utilization of non-functional removable prostheses (RR = 1.69); fair self-perception of general health (RR = 1.34); equal (RR = 1.43) or worse (RR = 2.32) self-perception of oral health compared with persons of the same age; and being dependent for at least one ADL (RR = 1.71) increased the probability of higher scores of the OHIP-14-sp. Age, schooling, depression, cognitive impairment and periodontal conditions showed no association. Conclusions: Oral rehabilitation can improve quality of life, health education and health promotion for the elder and their caregivers may reduce the risk of dental problems. Geriatr Gerontol Int 2016; ••: ••-••.
Gerodontology
ObjectivesTo analyse the relationship between the Frailty Index and 10 oral conditions controllin... more ObjectivesTo analyse the relationship between the Frailty Index and 10 oral conditions controlling for nutritional status among Mexican community‐dwelling older people.BackgroundStudies suggest that the association between frailty and oral conditions are mediated by nutrition.Materials and methodsThis cross‐sectional analysis includes 487 community‐dwelling men and women aged ≥70 years old. Interview and clinical examinations were performed at participants' homes. Objective (number of natural teeth, root remnants, dental condition, utilisation and functionality of removable dental prostheses and periodontitis) and subjective (utilisation of dental services, self‐rated oral health, chewing difficulties and xerostomia) oral variables were collected by trained personnel. The Frailty Index was calculated considering 35 deficits. Nutritional status measured with the Mini‐Nutritional assessment (MNA), age, sex, education, and marital status were included as covariates. We fitted 11 mu...
BMC Oral Health, 2019
Background: Determine the impact of poor oral health on the oral health-related quality of life (... more Background: Determine the impact of poor oral health on the oral health-related quality of life (OHRQoL) in communitydwelling older adults. Methods: Cross-sectional study of community-dwelling older adults in Mexico City. Sociodemographic characteristics were obtained and assessed their OHRQoL according to the Geriatric/General Oral Health Assessment Index (GOHAI). Clinical evaluation of their oral health: painful chewing, use of dentures, dry mouth, xerostomia, plaque, calculus, coronal and root caries, tooth loss and gingival bleeding. Finally, we determined the oral health of participants through Latent Class Analysis (LCA), excluding totally edentulous. The strength of association was determined (Odds Ratio [OR] and 95% confidence interval [95% CI]) through logical regression between the oral health categories (latent classes) and OHRoL in older adults, adjusted with the other variables included in the study: age, sex, marital status, living arrangements (lives alone), educational level, paid work status, comorbidity, cognitive deterioration, depression and use of medical and dental services in the previous 12 months. Results: The mean (SD) GOHAI score for the 228 older adults to 46.5 (8.7), number of classes to characterize oral health through LCA was three (entropy 0.805). The GOHAI mean for Class 3 (57.0%), acceptable oral health was 50.1 (7.1); totally edentulous (9.6%), 47.9 (8.4); for Class 2 (16.7%), regular oral health, 43.8 (9.3); and for Class 1 (16.7%), poor oral health, 42.2 (9.7). Significant differences were observed among means (p < .001). Using Class 3 an as a reference, the strength of association between the GOHAI scores and low OHRQoL (GOHAI 25th percentile = 24.0) was OR = 0.7, 95% CI = 0.2-3.3 for totally edentulous; OR = 3.0, 95% CI = 1.2-7.6 for Class 2 and OR = 5.0, 95% CI = 2.1-12.1 for Class 1. Conclusion: Poor oral health was associated with a negative impact on the OHRQoL of community-dwelling older adults. Clinical relevance: It is essential to design and implement oral health care policies specifically targeted at improving the quality of life in this older adult population.
Latin America continues to be severely underrepresented in genomics research, and fine-scale gene... more Latin America continues to be severely underrepresented in genomics research, and fine-scale genetic histories as well as complex trait architectures remain hidden due to the lack of Big Data. To fill this gap, the Mexican Biobank project genotyped 1.8 million markers in 6,057 individuals from 32 states and 898 sampling localities across Mexico with linked complex trait and disease information creating a valuable nationwide genotype-phenotype database. Through a suite of state-of-the-art methods for ancestry deconvolution and inference of identity-by-descent (IBD) segments, we inferred detailed ancestral histories for the last 200 generations in different Mesoamerican regions, unraveling native and colonial/post-colonial demographic dynamics. We observed large variations in runs of homozygosity (ROH) among genomic regions with different ancestral origins reflecting their demographic histories, which also affect the distribution of rare deleterious variants across Mexico. We analyzed...
Salud Pública de México
Objective. To determine the prevalence and factors related to depressive symptoms in older Mexica... more Objective. To determine the prevalence and factors related to depressive symptoms in older Mexican adults in urban and rural areas. Materials and methods. Cross-sectional study. We examined older adults from a sample taken from the Mexican Health and Aging Study (MHAS-2018). 14 230 older Mexicans were screened for self-reported depressive symptoms. Results. The prevalence of depressive symptoms was 29.8% (33.4% rural vs. 28.9% urban). In the rural and urban population, the probability of a high prevalence of depressive symptoms was higher in older adults with multimorbidity ≥3, severe pain, and fair/poor SRH. Only in the urban population the prevalence of depressive symptoms increased with lower schooling. Conclusion. Identification of the factors related to depressive symptoms may help healthcare professionals provide better treatment for specific groups in the population.
In the planning phase of research related to age and aging, the quality of knowledge derived from... more In the planning phase of research related to age and aging, the quality of knowledge derived from epidemiological studies, depends heavily on the solidity of the methodological design and the strategies for collecting data designed to answer the research question. Case–control studies are a cost-effective alternative for providing a valid and reasonably precise estimate for identifying an association force of a hypothetical relationship cause-effect in studies related to older adults population. Recently case–control studies have been related directly to cohort studies, which enabled researchers to design new patterns for their development while obtaining major benefits. The case–control study is the appropriate choice and at times the only alternative for studying diseases of very low incidence in older adults. With this type of study it is possible to explore a broad range of related exposures to illness. Another important advantage is that they require smaller samples and are les...
Revista Mexicana de Ortodoncia
Objetivo: Determinar la prevalencia del ponticulus posticus en radiografías digitales laterales d... more Objetivo: Determinar la prevalencia del ponticulus posticus en radiografías digitales laterales de cráneo. Material y métodos: Se seleccionaron aleatoriamente radiografías digitales laterales de cráneo de la base de datos de un centro de radiología oral y maxilofacial de la ciudad de Cuenca, Ecuador, de pacientes entre nueve y 25 años entre 2013-2015. Se estimó la prevalencia del ponticulus posticus según la clasificación de Cederberg y Stubbs y se estratificó por sexo. Se realizó un análisis de regresión multivariante multinomial para comparar la asociación entre edad y sexo con la clase 2, 3 y 4 frente a la clase 1. Los datos se analizaron en el programa STATA V13.0. Resultados: Se analizaron 1,000 radiografías laterales de cráneo, la edad promedio fue de 15 (± 4.23) años y 57.60% (n = 424) eran mujeres. La prevalencia de clase 1 fue de 71.8% (IC 95% 68.92-74.51), clase 2 fue 16.5% (IC 95% 14.32-18.94), clase 3 fue 5.5% (IC 95% 4.24-7.10) y clase 4 fue 6.20% (IC del 95%: 4.86 a 7....
Frontiers in Genetics
Current Genome-Wide Association Studies (GWAS) rely on genotype imputation to increase statistica... more Current Genome-Wide Association Studies (GWAS) rely on genotype imputation to increase statistical power, improve fine-mapping of association signals, and facilitate meta-analyses. Due to the complex demographic history of Latin America and the lack of balanced representation of Native American genomes in current imputation panels, the discovery of locally relevant disease variants is likely to be missed, limiting the scope and impact of biomedical research in these populations. Therefore, the necessity of better diversity representation in genomic databases is a scientific imperative. Here, we expand the 1,000 Genomes reference panel (1KGP) with 134 Native American genomes (1KGP + NAT) to assess imputation performance in Latin American individuals of mixed ancestry. Our panel increased the number of SNPs above the GWAS quality threshold, thus improving statistical power for association studies in the region. It also increased imputation accuracy, particularly in low-frequency varia...
Background: Despite chemotherapy, patients with cured pulmonary tuberculosis may result in lung f... more Background: Despite chemotherapy, patients with cured pulmonary tuberculosis may result in lung functional impairment. Objective: To evaluate a novel scoring system based on the degree of radiographic abnormalities and related spirometric values in patients with cured pulmonary tuberculosis. Methods: One hundred and twenty seven patients with cured pulmonary tuberculosis were prospectively enrolled in a referral hospital specializing in respiratory diseases. Spirometry was performed and the extent of radiographic abnormalities was evaluated twice by each of two readers to generate a novel quantitative score. Scoring reproducibility was analyzed by the intra-class correlation coefficient (ICC) and the Bland-Altman method. Multiple linear regression models were performed to assess the association of the extent of radiographic abnormalities with spirometric values. Results: The intra-observer agreement for scoring of radiographic abnormalities (SRA) showed an ICC of 0.81 (CI: 95%, 0.67...
Revista Mexicana de Ortodoncia, 2019
There are different cephalometric measurements to evaluate the dimensions of the upper airways us... more There are different cephalometric measurements to evaluate the dimensions of the upper airways using a lateral headfilm. It is unknown how many characteristics are possible to study from the available measurements and which are the most useful measurements for this purpose. Objective: To identify factors of measurement of the upper airways and determine their association to craniofacial dimensions. Material and methods: Cross-sectional study. We analyzed lateral headfilms and performed a principal factor analysis for upper airways measurements: N-S-Ba, BaS-PNS, AD1, AD2, PTV to Adenoid (DPTV) and Airway % (A%). Results: We analyzed 151 records, without previous orthodontic treatment or craniofacial syndrome. We identified two principal factors: Factor 1 (F1) includes AD1, AD2, DPTV and A%, and factor 2 (F2) includes Na-S-Ba and Ba-S-PNE. Conclusions: F1 was related to linear dimensions and F2 to structural characteristics.
Salud publica de Mexico, 2013
OBJECTIVE To estimate the prevalence of acute diarrheal diseases (ADD) during the two weeks previ... more OBJECTIVE To estimate the prevalence of acute diarrheal diseases (ADD) during the two weeks previous to the interview among children <5 years of age and to describe alarm signs and feeding practices of parents and caregivers (PCG) during children's ADD. MATERIALS AND METHODS Analysis of data from the National Health and Nutrition Surveys 2012 and 2006 and the National Health Survey 2000. RESULTS ADD prevalence decreased significantly from 2006 (13.1%) to 2012 (11.0%), particularly in the lower socioeconomic status. "Frequent bowel movements" were the main warning sign identified by PCG (66.0%) in contrast to "crying without tears" (4.3%) and "blood in faeces" (0.5%); only 42% PCG reported administering oral rehydration therapy. Factors associated with ADD were child's age <1 year and mother's age <20 years. CONCLUSIONS It is necessary to reinforce appropriate ADD preventive and treatment practices among PCG of children <5 years o...
Revista Mexicana de Ortodoncia, 2018
Existen diferentes medidas cefalometricas para evaluar las dimensiones de las vias aereas superio... more Existen diferentes medidas cefalometricas para evaluar las dimensiones de las vias aereas superiores a partir del uso de la radiografia lateral de craneo. Se desconoce que caracteristicas o factores de las vias aereas son identificables y posibles de estudiar a partir de las mediciones disponibles y cuales son las mediciones mas utiles para dicho fin. Objetivo: Identificar los factores de las mediciones de las vias aereas superiores y determinar su asociacion a las dimensiones craneofaciales. Material y metodos: Estudio transversal. Analizamos las radiografias laterales y realizamos un analisis factorial principal para las mediciones de las vias respiratorias superiores: N-S-Ba, Ba-S-PNS, AD1, AD2, PTV a adenoides (DPTV) y Airway% (A%). Resultados: Analizamos 151 registros, sin tratamiento de ortodoncia previo ni sindrome craneofacial. Identificamos dos factores principales: el factor 1 (F1) incluye AD1, AD2, DPTV y A%, y el factor 2 (F2) incluye N-S-Ba y Ba-S-ENP. Conclusiones: F1 ...
This study describes the achievements of the Mexican Consortium against Tuberculosis, in the Sani... more This study describes the achievements of the Mexican Consortium against Tuberculosis, in the Sanitary District of Orizaba, Veracruz, Mexico between 1995 and 2008. In brief, the main results can be classified as follows: 1) Conventional and molecular epidemiology (measurement of burden of disease, trends, risk factors and vulnerable groups, consequences of drug resistance, identification of factors that favor nosocomial and community transmission); 2) Development of diagnostic techniques to detect drug resistance, description of circulating clones and adaptation of simple techniques to be used in the field; 3) Evaluation of usefulness of tuberculin skin test, immunologic responses to BCG, impact of directly observed therapy for tuberculosis (DOTS), and study of immunological biomarkers and 4) Comments on ethical aspects of tuberculosis research. Additionally, we describe the impact on public policies, transference of technology, capacity building and future perspectives.
In the planning phase of research related to age and aging, the quality of knowledge derived from... more In the planning phase of research related to age and aging, the quality of knowledge derived from epidemiological studies, depends heavily on the solidity of the methodological design and the strategies for collecting data designed to answer the research question. The classic design of case-control studies distinguishes between older adults who have a specific outcome or disease (cases) and those who do not (controls) and are determines whether the subjects were exposed or not to one or several factors to try to establish, retrospectively (that is, from the effect to the cause), the relationship of these factors with the disease. Case-control studies are a cost-effective alternative for providing a valid and reasonably precise estimate for identifying an association force of a hypothetical relationship cause-effect in studies related to older adults. Recently case-control studies have been related directly to cohort studies, which enabled researchers to design new patterns for their...
Open Forum Infectious Diseases, 2017
prolongation (7%), and nosocomial infection (4%). Two patients were pregnant at the time of prese... more prolongation (7%), and nosocomial infection (4%). Two patients were pregnant at the time of presentation; one suffered severe malaria and fetal loss. Only 3% of patients reported being prescribed a prophylactic regimen and completing it; 20% reported taking an incomplete course, and the majority took no prophylaxis at all. Of 27 patients who had presented to another United States-based medical provider prior to hospitalization, 11 were initially misdiagnosed and treated for conditions other than malaria, including two who underwent extensive hematologic investigations. Inadequate experience and resources in treating malaria were the primary reasons cited for transfer to the tertiary hospital from community-based providers. Conclusion. Malaria poses a substantial health risk to US travelers, particularly in light of under-utilization of prophylaxis, lack of familiarity with the disease by local providers, and delays to diagnosis. Disclosures. All authors: No reported disclosures. 303.
International Journal of Infectious Diseases, 2010
Scientific Reports
Measles continues to be one of the leading causes of child mortality worldwide, even though a hig... more Measles continues to be one of the leading causes of child mortality worldwide, even though a highly effective vaccine has existed for more than 40 years. We aimed to describe the seroprevalence of measles antibodies in Mexico in 2012 and the risk factors associated with susceptibility. A total of 7,785 serum samples were analyzed from the National Health and Nutrition Survey in Mexico. This national survey is representative of the general population, including noninstitutionalized adult, adolescent, and child populations. Antibody titers were classified into protective (> 120 mIU/mL) or susceptible (≤ 120 mIU/mL) levels. The weighted seroprevalence and susceptibility of the overall population were 99.37% (95% CI 99.07–99.58) and 0.63% (95% CI 0.42–0.93), respectively. Among 1-to-4-year-old children, 2.18% (95% CI 1.36–3.48) were susceptible to measles. Among adolescents and young adults, the prevalence of susceptibility was as follows: those 15–19 years of age had a prevalence o...
Open Forum Infectious Diseases
Background As wild poliovirus is eradicated and countries switch from Oral Polio Vaccine (OPV) to... more Background As wild poliovirus is eradicated and countries switch from Oral Polio Vaccine (OPV) to Inactivated Polio Vaccine (IPV) per WHO recommendations, preventing circulation of vaccine-derived poliovirus is a top priority. However, spatial dynamics of OPV transmission are not well understood. Understanding these trends will improve resource targeting in the event of OPV reintroduction in undervaccinated communities. Mexico provides a natural environment to study OPV as it provides IPV routinely and bi-annual OPV campaigns. Methods Children in three villages near Orizaba, Mexico were randomized to three levels (10%, 30%, 70%) to receive OPV. We measured distance to nearest OPV shedding, and the amount of shedding close to unvaccinated individuals. We used maps to show the proximity and amount of shedding. Distance and density of shedding was analyzed separately using mixed effects logistic regression with random effects for household and time, adjusted for age, gender, area, and ...
Mouth and Teeth
Introduction: Muscle weakness is frequent in patients with rheumatoid arthritis but electromyogra... more Introduction: Muscle weakness is frequent in patients with rheumatoid arthritis but electromyographic activity of masticatory muscles in these patients remains unclear. The aim of this study is to evaluate the differences of Root Mean Square activity in patients with and without rheumatoid arthritis during a 30 seconds period using a longitudinal approach. Material and methods: We performed a cross-sectional study and measured bilateral electromyographic activity (EMG) of masseter muscles for 30 seconds in maximum intercuspation. We measured EMG by using a digital electromyograph, developed by our group (Hardware and software) to determine µV every 0.001 seconds and root medium square (RMS) values were recorded. Patients were treated at the Department and Physiology Laboratory in the UNAM in 2017. We performed a descriptive, bivariate analysis and a random effects linear regression model for repeated measurements adjusted by confounders. Results: We analyzed the information of 60 patients. Mean age was 43.9 years (±15.9), and 33.3% of the participants were males. As result of the multivariate analysis we identified that in patients with rheumatoid arthritis the RMS increased by 52.3 µV (95%CI 11.7; 85.73, p= 0.012) compared to patients without rheumatoid arthritis, but over a 30 second period RMS mean activity decreased at a rate of-0.44 µV per second (95%CI-0.48;-0.38, p< 0.001). Conclusion: EMG in patients with rheumatoid arthritis had higher mean values of RMS but a decreased activity over the evaluated period. More research is needed to clarify the electromyographic activity in patients with rheumatoid arthritis.