Horizonte Sanitario is a publication published since 2002 by the Universidad Juárez Autónoma de Tabasco. It publishes articles in English, Portuguese and Spanish on topics related to Public Health Sciences and Health Administration in the form of editorials, review articles and originals (scientific research products). The journal is freely accessible and does not charge authors for submission or publication.
Social determinants of pregnancy among school-aged adolescents in two Colombian municipalities
Objective: To determine the influence of social factors on adolescent pregnancy in contexts of regional vulnerability. Materials and Methods: A descriptive cross-sectional study was conducted, which included 354 high school students from public schools in two municipalities located in the Colombian Caribbean. Analyzed factors included sociodemographic data, aspects related to sexual and reproductive health, and interpersonal variables. Data analysis was carried out using univariate and bivariate techniques, determining the odds ratio (OR), 95% confidence intervals, and statistical significance. Results: The analysis identified the following risk variables: being female (OR=1.74; 95% CI: 1.10-2.74), not participating in religious practices (OR=1.78; 95% CI: 1.02-3.10), and being in the 14-to-16-year-old age group (OR=3.24; 95% CI: 1.58-6.60). Notably, male adolescents showed lower attendance at sexual and reproductive health programs (OR= 0.63; 95% CI: 0.40-0.98). Likewise, the non-utilization of these health services was a key predictor of a lack of knowledge about contraceptive methods (OR=3.171; 95% CI: 1.84-5.46). Conclusions: Reproductive vulnerability is closely linked to school dropout, making this group a priority for interventions that extend beyond the traditional educational setting. The need to implement intersectional strategies with a gender and rights-based approach is emphasized, strategies that not only aim to prevent early pregnancy but also guarantee the autonomy and comprehensive protection of adolescent girls' life plans in the Caribbean context of Colombia. Keywords: Social Determinants of Health; Adolescent pregnancy Sexual and Reproductive Health.
Copyright (c) 2026 Horizonte Sanitario https://creativecommons.org/licenses/by-nc-sa/4.0
Common disease prevention habits in schoolchildren from rural communities in Guerrero, Mexico
Objective: To identify the factors associated with the development of preventive behaviours for common diseases in primary schoolchildren from four rural communities. Materials and methods: Mixed study, survey of 236 parents and interview with 14 teachers. Parents reported sociodemographic data and data on prevention of common diseases. Teachers reported on the school context and health habits. Results: Health care based on customs and practices prevails. There was an association between the reporting of diarrheal diseases and lack of piped water (ORa 2.71, 95% CI 1.27-5.77) and lack of a latrine in the home (ORa 2.93, 95% CI 1.26-6.81). Teachers have limited knowledge of curricular content on education and health. Conclusions: Common illnesses are related to the lack of basic services. There is an opportunity to promote habits for the prevention of common diseases through educational work, so it is necessary to encourage community participation in school activities. Keywords: Habits; Schoolar health services; Health education; Health promotion.
Copyright (c) 2025 Horizonte Sanitario https://creativecommons.org/licenses/by-nc-sa/4.0
Characterization of Sexual Behavior in Adolescents from the Northeastern Border of Tamaulipas
Objective: To identify the characteristics of sexual behavior among adolescents from the northeastern border of Tamaulipas. Materials and Methods: A descriptive, cross-sectional study with a quantitative approach was conducted in a population of high school students from the northeastern border of Tamaulipas. A probabilistic random sampling method was used, yielding a final sample of 543 students. The Gamarra-Tenorio & Iannacone (2010) questionnaire was applied, which evaluates sociodemographic profile and sexual behavior. Descriptive statistics were performed, and the Kolmogorov-Smirnov normality test with Lilliefors correction was applied using the SPSS software, version 26. Results: The mean age of participants was 16.89 years (SD = 1.27), with females representing 65.4% of the sample. Most students were born in municipalities of Tamaulipas and Nuevo Laredo. The mean age of menarche was 11.68 years (SD = 2.19) and spermarche 11.38 years (SD = 4.69). Adolescents reported sexual experiences such as hugging (21.8%) and kissing (19.2%). Furthermore, 47.8% had already experienced first sexual intercourse, with a mean age of 15.27 years (SD = 1.29); among them, 35.7% did not use any contraceptive method. Conclusions: Adolescent sexual behavior in this population is characterized by early pubertal maturation and the initiation of sexual life at relatively young ages. These practices are mainly developed within dating relationships, where affective expressions (such as hugging and kissing) play an important role preceding sexual intercourse. However, inconsistent contraceptive use leads a considerable proportion of adolescents toward risky sexual behavior. Keywords: Adolescents; Sexual behavior; Contraception; Border health.
Factores asociados a Alteraciones de las Funciones Cognitivas y Capacidades Adaptativas en Pacientes con VIH
Objective: To evaluate the relationship between risk factors such as type 2 diabetes, high blood pressure, overweight, high viral load, and cognitive impairments and adaptive capacities in patients with HIV. Materials and methods: An observational, cross-sectional, analytical study was conducted in a family medicine unit, with a sample of n=83 patients who met the inclusion criteria. Comorbidities and high viral load were identified; to measure adaptive capacities and cognitive functions, the Vineland and MoCA questionnaires were applied, with prior informed consent. The data collected were analyzed using descriptive and inferential statistics using Pearson's chi-square test and prevalence ratio (PR) with the statistical software SPSS version 25.0. Authorization was obtained from the ethics and research committee with the registration: R-2023-2701-065. Results: Patients aged Ⱦ=34 years ±S=10.4 years, with a median Md=32 years, men 84.3% (70), married 36.1% (30). With BMI Ⱦ≥30 Kg/m2=9.6% (8). Mild cognitive impairment was presented in 14.5% (12), and interpersonal relationship problems were seen in 27.7% (23). High viral load and cognitive impairment were observed in 83.3% (10), compared to those with undetectable viral load, with X2=10.345, df=2, and a statistically significant p value=0.001. An association was observed between high viral load and mild cognitive impairment (RP=18.05, 95%CI: Li 6.521, Ls 49.989 and p value= 0.0001) and alterations in interpersonal adaptive capacities and gross motor skills. Conclusions: This study highlights the need to implement targeted interventions to improve functionality and quality of life in patients with HIV, through a comprehensive approach that considers both physical risk factors and adaptive capacities. Keywords: HIV; Cognitive impairment; Adaptive behavior; Factors associated.
Low-carbohydrate diet improves glycemic control in patients with type 1 diabetes: a systematic review
Objective: This systematic review and meta-analysis aimed to evaluate the effects of LCDs on glycemic control in adults with T1D. Material and Methods: A comprehensive search was conducted in PubMed, Scopus, and Web of Science up to September 2024. Eligible studies included randomised controlled trials, cohort studies, and non-randomised interventions in adults with type 1 diabetes following LCD. Two review authors independently completed study selection, data extraction, and risk of bias assessment. Ninety-three records were discovered, of which eight research studies met the inclusion criteria. The effect of LCD on glycemic control was assessed using the standardised mean difference and 95% confidence intervals (CIs), calculated from pre- and post-intervention values. Publication bias was assessed using funnel plots and the Egger test, and heterogeneity was assessed using Cochran's Q statistic and I² index. Results: Our results revealed significant reductions in HbA1c (point estimate: 0.79 mmol/mol; 95% CI: 0.57 to 1.02; p < 0.001) and total daily insulin dose (point estimate: 0.96 U; 95% CI: 0,67 to 1.25; p < 0.001) in adults with T1D following LCD interventions. Nonetheless, we observed no significant changes in lipid profile, anthropometric parameters, and blood pressure. Conclusions: DBCs may be effective in conjunction with drug therapy to maintain glycemic control in people with T1D. Evidence is limited by sample sizes, variability in diets, and risk of bias. Trials with appropriate methodological designs are required to validate these findings. Keywords: Low-carbohydrate diet; Type 1 diabetes; Glycemic control; HbA1c; Carbohydrate-restricted diets.
Evaluation of an interprofessional training internship in undergraduate: students' experiences
Objective: To evaluate an interprofessional training practice through the experiences of nursing students. Materials and methods: The study was conducted using an exploratory qualitative design. The participants were 25 undergraduate nursing students of both sexes, aged between 22 and 24 years. An interprofessional training experience was conducted between medical and nursing students. Data were collected through three focus groups and one individual interview, which were recorded and transcribed verbatim prior to analysis. The information was processed using axial coding and categorization. Results: Five categories and nine subcategories were obtained: 1) program dissemination, 2) student motivation, 3) clinical cases as a focus for interprofessional practice, and 4) personal skills and institutional support. Conclusions: The interprofessional training program contributed to the development of fundamental positive experiences in the acquisition of disciplinary and transversal competencies, increased safety and autonomy related to the mastery of clinical protocols to strengthen diagnostic capacity. Keywords: Interprofessional Education, Interdisciplinary Placement; Collaborative learning.
Indicadores de evaluación de los registros clínicos de enfermería: Implementación de una herramienta tecnológica
Objetivo: Desarrollar y experimentar un modelo de evaluación de indicadores mediante una herramienta de control de datos, orientado a evaluar la calidad de los registros clínicos de enfermería. Materiales y Métodos: La investigación de tipo cuantitativo, aplicativo, analítico, implicó el desarrollo e implementación de una herramienta de evaluación automatizada a través de seis indicadores de evaluación de los registros clínicos de enfermería para examinar cada fase del proceso de atención sustentada en un modelo teórico, que facilitó el análisis e interpretación de resultados en seis servicios, de enero a diciembre de 2018, en el Hospital de Alta Especialidad Dr. Gustavo A. Rovirosa Pérez, en Villahermosa, Tabasco. El estudio fue autorizado por el comité de bioética institucional. Resultados: Se efectuó el análisis e interpretación de resultados a través de una tecnología con un modelo de evaluación automatizada de los registros clínicos de enfermería, con indicadores propuestos, que permite conocer su calidad, en todos los turnos y servicios, estableciendo parámetros de comparación y de semaforización. Conclusiones: El desarrollo de un modelo de indicadores de los registros clínicos basado en una herramienta de control, demostró su eficacia, eficiencia y estandarización en la evaluación sistematizada para la mejora del cuidado de enfermería.
Copyright (c) 2021 HORIZONTE SANITARIO https://creativecommons.org/licenses/by-nc-sa/4.0
Validation of a scale on quality of work life in nurses of the Mexican social security
Objective: To validate the Work-Related Quality of Life Scale-2 (WRQLS-2) among nursing staff at the General Hospital of Zone with Family Medicine No. 2 of the Mexican Social Security Institute (IMSS) in Irapuato, Mexico. Materials and Methods: A total of 200 nurses participated voluntarily in the study. The WRQLS-2 scale was administered, and an exploratory factor analysis was conducted to examine the internal structure of the instrument. The reliability of each factor was assessed using Cronbach’s alpha coefficient. Results: The factor analysis revealed seven dimensions: work commitment, job control, working conditions, well-being, stress, career satisfaction, and work-life interface. The scale demonstrated strong construct validity and internal consistency, with Cronbach’s alpha values exceeding 0.70 for most factors. Conclusions: The validation of the WRQLS-2 questionnaire provides us with a valid and reliable tool to assess the quality of work life of nursing staff at the Mexican Institute of Social Security in Irapuato, Mexico. Its application will make it possible to identify areas for improvement in the work environment, contributing to the well-being of the staff and the quality of the medical care offered. Keyboard: Work environment; Nursing; Validation.
Evaluation of therapeutic adherence in childhood asthma and its relationship with parenting practices
Objective: To determine the level of adherence to inhaler use and its relationship with inhalation technique and asthma control in patients aged 6-11 years treated at the outpatient clinic of Hospital General de Zona No. 46 (HGZ-46) IMSS Tabasco, during the period March 2024 to February 2025. Material and method: An observational, analytical, cross-sectional study was conducted in pediatric patients diagnosed with asthma who used inhaled corticosteroids, n=100. The TAI-10 and 12 items were applied, adjusted to a validated list of 10 critical steps in inhalation technique and the Childhood Asthma Control Test (C-ACT). Caregivers answered a KAP-BMQ questionnaire. Descriptive statistics and multivariate logistic regression were estimated. Results: Overall, 68% achieved clinical control (C-ACT>19). Mean TAI was 44±6; good, intermediate and poor adherence were 27%, 31% and 42%, respectively. In adjusted models, good (aOR 9.99; 95%CI 2.64–37.81; p=0.001) and intermediate adherence (aOR 7.71; 95%CI 1.92–30.92; p=0.004), and ≤1 critical error (aOR 3.49; 95%CI 1.12–10.90; p=0.032) were associated with higher odds of control. Conclusions: Adherence and technical competence in inhaler use are modifiable determinants of asthma control in children. Multicomponent interventions focused on parental education and inhaler retraining are required to improve respiratory outcomes in children. Keyword: Adherence; Inhaler; Asthma; Pediatric; Education.
Self-efficacy and sexual attitude to prevent sexually transmitted infections in women experiencing intimate partner violence
Objective: To analyze the relationship between self-efficacy, sexual attitudes, and sexually transmitted infection (STI) prevention behaviors in young women exposed to intimate partner violence. Materials and methods: A correlational and cross-sectional study was conducted with 42 women aged 18 to 24, selected through random sampling at a university center in northwestern Mexico. All participants reported having experienced some form of partner violence. Validated instruments were used to measure the variables. Results: A significant correlation was found between condom use negotiation and health attitudes (r=.930), as well as with knowledge about STIs/HIV (r=.905). In addition, self-efficacy showed a strong relationship with sexual negotiation (r=.742). Regression analysis indicated that self-efficacy, positive health attitudes, and knowledge about STIs/HIV jointly explained 22.8% of the variance in safe sexual practices (R² = 22.8%), confirming their role as relevant determinants in this context. Conclusions: Strengthening self-efficacy, knowledge, and healthy attitudes in women exposed to partner violence is essential to promote safe sexual behaviors, foster sexual autonomy, and reduce vulnerability to STIs. Keywords: Self-efficacy; Attitudes; Prevention; Sexually transmitted infections; Intimate partner violence.
Consumption of complementary and alternative medicine in patients with chronic kidney disease in Mexico
Objective: The aim of this study is to evaluate the association between social determinants of health, diet quality and consumption of ACM in patients with chronic kidney disease. Materials and methods: Cross-sectional analytical study conducted on patients enrolled in four Facebook groups and one Instagram group on social media focused on kidney disease, aged 18-75, both sexes, diagnosed with chronic kidney disease. Socioeconomic, clinical and dietary variables were evaluated, as well as the types of ACM used. Quantitative variables were compared by ANOVA or Kruskal-Wallis test and Chi-square test. Results: A total of 214 subjects were studied. Twenty-six percent of the sample did not use ACM; 52% used 1 to 3 MAC and 22% used more than 3 therapies. Herbal medicine with 111 subjects, followed by botanicals with 74 patients and meditation with 70 were the most used. Patients who consumed more than 3 alternative therapies were those with high purchasing power and schooling. The subjects who consumed 1 to 3 therapies were those who had more comorbidities. Those who consumed more than 3 therapies had less than 10 years with the diagnosis and their etiology was a chronic disease (DM2 - HTA). Conclusions: The study underscores the importance of health professionals actively inquiring about the use of complementary and alternative medicine (CAM) in their patients with chronic kidney disease, considering the high prevalence of its use and potential adverse effects. Key words: Chronic kidney disease, complementary medicine, alternative medicine, social determinants of health.
Risk factors associated with COVID-19 during the pandemic in Puerto Vallarta, Mexico
Objective: To analyze the risk factors associated with SARS-CoV-2 infection, as well as the dynamics of viral variants in the Puerto Vallarta region, Jalisco, during the COVID-19 pandemic. Materials and methods: A cross-sectional observational study was conducted to identify infection by SARS-CoV-2 and the variants present in infected individuals were carried out by Real-time Polymerase Chain Reaction between April 2020 and April 2022. Results: A total of 5,646 individuals were analyzed, of which 3,336 people obtained a negative result for SARS-CoV-2, while 2,310 tested positive. The presence of several SARS-CoV-2 variants was detected, with a predominance of the wild variant. Statistically significant associations were found between symptoms such as cough (p=0.000), fever (p=0.000), loss of smell (p=0.000) and taste (p=0.000), as well as with morbidities such as obesity (p=0.000) and diabetes (p=0.000) concerning SARS-CoV-2 infection. These conditions, reported more frequently in positive cases, highlight their relevance in clinical management. Additionally, the dynamics of virus variants during this period were investigated. Conclusions. SARS-CoV-2 detection contributed to identifying positive cases, a requirement for prevention strategies, while variant identification allowed contextualizing changes in local epidemiology. Keywords: COVID-19; RT-PCR; Comorbidities.
Design and validation of a questionnaire on the perception of persuasive food marketing among young Mexicans
Objective: To design and validate a questionnaire that evaluates the influence of food marketing on young Mexicans. Materials and method: An observational, cross-sectional and quantitative study was carried out. The sample consisted of 346 university students from different states in Mexico. A questionnaire based on theoretical models of consumer behavior was developed. Content validity was determined by expert judgment and construct validity through exploratory factor analysis (EFA) using principal axes and oblique rotation. Internal consistency was assessed using the omega coefficient (ω). Results: The EFA revealed a four-factor structure that explained 56.72% of the total variance. The factors identified were: (1) product exposure and advertising on social networks, (2) social and environmental responsibility, (3) product exposure and packaging, (4) brand experience and loyalty. The total scale showed adequate internal consistency (ω= .85) and a KMO measure of sampling adequacy of .84. Conclusions: The questionnaire developed proved valid and reliable for evaluating food marketing and its relationship to the purchasing decisions of young Mexicans, providing a useful tool for future research and intervention strategies. Keywords: Questionnaires; Evaluation studies; Marketing; Food; Adolescents.
Effects of acceptance and commitment therapy on mothers of children with chronic illnesses
Objective: To describe the effects of Acceptance and Commitment Therapy (ACT) on experiential avoidance (EA) and perceived health-related quality of life (HRQoL) in mothers of children with chronic illnesses. Materials and methods: A single-case, repeated-measures A-B-A experimental design was used. An ACT-based intervention was administered to six mothers of children with chronic illnesses. Acceptance and Action Questionnaire (AAQ-II) and the Pediatric Quality of Life Questionnaire (PedsQl) were administered. Results: In the Tau-U analysis, statistical significance (0.03) was identified in the decrease in experiential avoidance in baseline vs. treatment comparisons in three participants, and in mothers who presented a clinical baseline score of EE they showed a statistically significant score (0.04) when comparing baseline and follow-up. Statistical evidence was identified in the same participants in the increase in HRQoL of their children, when comparing baseline and treatment (0.03) and in the comparison baseline and follow-up (0.04). Conclusions: Thit mothers showed a decrease in experiential avoidance and an increase in their children's perceived quality of life. This identifies the relevance of core processes for increasing psychological flexibility, which contributes to the management of chronic childhood illnesses and influences essential areas of children's lives. Keywords: Chronic illness; Quality of life; Acceptance and commitment therapy.
Efficacy of a methodology for the scientific development of future physiotherapists
Objective: To evaluate the efficacy of a methodology for scientific development in students of the Bachelor's Degree in Health Rehabilitation at the University of Medical Sciences Sancti Spíritus, Cuba. Materials and methods: Pre-experimental study with 45 third-year students of Rehabilitation in Health (Sancti Spíritus University of Medical Sciences, Cuba, during the 2023-2024 school year). A pedagogical methodology validated by the Delphi method was designed, implementing a guide to academic-work-research tasks. Seven indicators of pre- and post-intervention research skills were evaluated, with statistical analysis using the McNemar-Bowker test. Results: After the application of the methodology, a substantial improvement was observed in the mastery of the investigative skill. Initially, only 4.44% (n=2) of the students were at the "quite adequate" level. After the intervention, this percentage increased significantly to 88.88% (n=40), which demonstrates the effectiveness of the strategy to develop the ability to argue based on the rehabilitation area. The results of the McNemar-Bowker test, with chi-square values between 76.8 and 92.1 (all with p < 0.001), showed significant changes in the distribution of response categories for all indicators. Conclusion: The pre-experiment validates an original methodology that systemically integrates the academic, work, and research dimensions. The results confirm its scientific contribution and practical effectiveness to develop essential research competencies, closing the gap between theoretical training and the demands of professional performance. Keywords: Physical therapy; University students; Professional competence; Rehabilitation Research.
Biopharmaceuticals at the Frontier of Medical Therapeutics: Monoclonal antibodies, RNAs and Gene editing
In recent years, new medical treatments have been developed using biological molecules that are part of the defense mechanisms of living organisms. These molecules target specific components involved in disease processes, such as those associated with cancer. One example of such strategies are monoclonal antibodies, immune system molecules designed to neutralize specific targets. The in vitro production of these humanized antibodies has permitted homogeneity, industrial-scale production, and similarity to human proteins, which prevents their rapid degradation. These treatments are currently successfully applied to various diseases, including cancer, hypersensitivity, autoimmune, degenerative, and metabolic disorders. Another class of emerging therapeutic molecules are ribonucleic acids (RNA) in their various forms, such as aptamers, antisense oligonucleotides (ASOs), messenger RNAs (mRNAs), small interfering RNAs (siRNAs), and microRNAs (miRNAs). The market entry of these therapies has been so rapid that, to date, approximately 700 RNA products have been approved for human use in the United States, compared to the 125 authorized humanized monoclonal antibodies. While antibodies and RNA products are administered periodically, gene editing is being researched with the aim of correcting mutated genes that cause disease. Although this field has made significant advancements, it poses the greatest ethical dilemmas and challenges. Keywords: Biological Products; Monoclonal antibody; RNAi Therapeutics; Genetic Therapy; Gene Editing.
Influence of gender on the eating behavior phenotype of university students
Objective: To analyze eating behavior phenotypes in university students, with an emphasis on gender-related differences. Materials and methods: A quantitative, non-experimental, cross-sectional, descriptive correlational study was conducted to analyze the relationship between gender and eating behavior phenotype in nutrition students at a higher education institution in southeastern Mexico. The sample was purposive and voluntary. A sociodemographic form and the Eating Behavior Phenotype Scale (EFCA) were applied, with high reliability (α = 0.86). Anonymity and informed consent were guaranteed. The analysis was performed with nonparametric tests (Chi-square and Mann-Whitney), organizing the data in Excel. Correlations between eating phenotypes and BMI were identified, highlighting the usefulness of the EFCA in assessing eating patterns. Results: The study included 89 university students (37.08% men and 62.92% women), with an average age of 21.52 years. Different levels of eating phenotype were observed, with hyperphagia (50.56%) and the hedonic component (48.31%) predominating. Although the Mann-Whitney test did not reveal significant discrepancies in total scores between men and women (p = 0.379), the Chi-square test showed a significant relationship between gender and eating behavior classification (p = 0.000). This suggests that, although scores did not differ significantly, there were gender-differentiated eating patterns within the sample analyzed. Conclusions: The study shows gender differences in eating phenotypes, highlighting more frequent emotional and compulsive behaviors in women. Keywords: Phenotype; Feeding behavior; Gender.
Program to reduce anxiety in women with breast cancer: a pilot study
Objective: To explore the feasibility of the intervention “Mindfulness to Reduce Anxiety in Women with Breast Cancer.” Materials and methods: A pilot study with a quasi-experimental design (pre- and post-test) was conducted. The sample consisted of women aged 30 to 69 years diagnosed with breast cancer who could read and write, had an electronic device with internet access, and had mild or higher levels of anxiety as determined by the Generalized Anxiety Scale. The intervention program lasted eight weeks and consisted of twelve sessions, eight in person and four virtual. Data were collected using a field diary, checklists, and Fabricio's (2013) Acceptability and Feasibility Scale. The study complied with the General Health Law on Research Involving Human Beings (2024). Results: Participants had a mean age of 52.71 years and an average of 13.86 years of schooling. Regarding feasibility, participants reported that the sessions, program duration, procedures used, and program content were sufficient, as was the program's ability to reduce anxiety. They also reported good acceptance and satisfaction with the program. However, although benefits were observed in the participants, the preliminary effect did not show significant differences in pre- and post-intervention measurements using the Wilcoxon test (p=156). Conclusions: The results of the pilot study allow us to conclude that the intervention program showed feasibility and offered benefits to its participants after eight weekly sessions. Therefore, it is recommended to test its delivery with a larger number of participants to begin exploring its effect. Keywords: Feasibility; Breast cancer; Mindfulness; Anxiety.
Characterization of the risk for diabetic foot in people with type 2 diabetes mellitus
Objective: This study aimed to analyze the factors associated with the risk of diabetic foot in individuals with type 2 diabetes mellitus enrolled in a Primary Health Care (APS) program. Materials and Methods: Observational, analytical, cross-sectional study based on multivariate analysis using binary logistic regression. Population composed of individuals diagnosed with type II diabetes mellitus enrolled in the Primary Health Care Program. Data were collected through home visits. A podiatric assessment was conducted to evaluate clinical risk factors for diabetic foot, including vascular, neurological, and dermatological evaluations, assessment of bone structure, examination of skin characteristics, identification of deformities, and detection of neuropathic symptoms. Results: This study analyzed the sociodemographic and clinical characteristics of 120 patients with type 2 diabetes mellitus, identifying factors associated with their complications. Logistic regression analysis revealed that the duration of diabetes was the main risk factor for ulcers, necrosis, metatarsal overload, and infections (p < 0.05). Age showed a significant association with anhidrosis and edema, while sex was linked to varicose veins and neuromuscular reflex alterations. Conclusion: The findings differ from those of previous studies regarding variables such as bone and vascular changes and disease duration. The results emphasize the risk faced by the working-age population, highlighting the need for preventive interventions to avoid complications that could impair their quality of life. Keywords: Diabetes Mellitus; Diabetic Foot; Risk Factors.
María Verónica de los Ángeles Pacheco Chan
Genes associated with virulence and pathogenicity of Rickettsia rickettsii: A systematic review
Objective: To review recent literature on the function of genes associated with virulence and pathogenicity in Rickettsia rickettsii. Materials and Methods: This systematic review followed the PRISMA 2020 guidelines for systematic reviews. Searches were conducted in Google Scholar and PubMed (2015–2025) using keywords and Boolean operators related to the topic. Results: A total of 5,026 articles were identified. Ultimately, 50 were selected for the preparation of this review. From these, information was obtained regarding the relevance of virulence-associated genes (Adr1, Adr2, RARP2, RapL). Concerning genes associated with bacterial pathogenicity, OmpA, OmpB, Sca2, Sca4, tlyA, tlyC, pld, RLip, and RickA were reported. These genes are necessary for cell interaction, adhesion, and invasion, as well as immune system evasion. Conclusions: Rickettsia rickettsii is a pathogen of public health importance globally and in Mexico. Therefore, key bacterial genes such as Sca2, Sca4, tlyA, tlyC, RARP2, RapL, Adr1, Adr2, pld, OmpA, and OmpB that influence host interaction and immune evasion were analyzed. However, the strains present in Mexico still require in depth study, and strategies for the prevention, control, and treatment of the disease need to be improved. Keywords: Rickettsia rickettsii; outer membrane proteins; genes; virulence; pathogenicity; surface cell antigens (Sca).
Positioning of healthcare institutions in the city of Rioverde, San Luis Potosí, Mexico
Objective: The purpose of this study is to establish the positioning of health institutions and which of these is the leading brand in the municipality of Rioverde, San Luis Potosi. Materials and methods: We worked under a quantitative methodology, descriptive and correlational in scope, with a cross-sectional design. The sample corresponds to 267 participants where a multistage sampling was carried out in two phases, where first sampling was carried out in the areas where the health institutions are located, and the second part consisted of sampling the users of the service. The technique used was the survey and the instrument was a questionnaire composed of seven items that were measured by means of a 5-point Likert scale, where one indicated strongly disagree and five indicated strongly agree. The reliability of this instrument was very good because a Cronbach's alpha value of 0.887. Results: The main results showed that the leading brand in the municipality is the CMR, which is positioned by attributes such as warmth, attention, personnel, facilities and reputation, while the General Hospital of Rioverde has a great disadvantage in the market because users cannot clearly associate it with any attribute. Conclusions: The positioning of health institutions in the municipality of Rioverde, S.L.P. plays a great role due to the intense competition in this field. Therefore, it is essential to understand how users value different institutions and their respective attributes. It was observed that there is a significant difference between health institutions, both public and private, which causes some to be considered superior to others. Keywords: Positioning; Image; Health Institutions.
Educational Strategy for Training Adolescents as Peer Educators for HIV Prevention
Objective: To evaluate the effectiveness of an educational strategy based on risk communication in adolescents as peer educators for the prevention of human insufficiency virus (HIV) infection. Materials and methods: A quasi-experimental mixed-process non-randomized intervention trial with pre-test (before the intervention) and post-test (after). 40 students from six middle and high schools participated, three rural and three urban. Based on a previous diagnosis, the educational strategy and didactic resources were designed. The training lasted 20 hours and addressed issues related to HIV and AIDS, sexuality, relationships, other sexually transmitted infections, gender and equity. The participants' level of knowledge was assessed through a questionnaire and the development of drawings in response to two slogans: How can you become infected with HIV? and draw the behaviors that can protect you from contracting HIV. Results: After the training, the participants integrated knowledge related to the topics addressed and the average increased to 2.06 points (p <0.00001). Through the development of drawings (after training), the number of participants who drew elements related to blood, sexual and maternal transmission of HIV was increased. Regarding protective behaviors, most drew the use of condoms, although no significant changes were observed. At the end of the training, the participants proposed strategies and teaching materials for peer education later carried out in their schools. Conclusion: The evidence based educational strategy is a useful strategy for educating and training adolescents as peer educators. It could be replicated to other schools, adapting it to each context. Keywords: Disease prevention; Human immunodeficiency virus; Acquired immunodeficiency syndrome; Health education; Sex education.
Satisfaction and quality provided by students in dental clinics at private universities in northwestern Peru
Objective: To analyze the relationship between patient satisfaction and the quality of care provided by undergraduate students in dental clinics at two private universities in northwestern Peru. Materials and methods: This was a basic, quantitative study with a non-experimental, correlational, descriptive, and cross-sectional design. The non-probability sample consisted of 134 patients. The data collection instruments were a Patient Satisfaction Questionnaire, previously submitted to expert review for content validation, and the Peruvian Ministry of Health (MINSA) Quality of Care Assessment Scale, both using a Likert-type scale. Results: The results indicated that the level of satisfaction was high, with an approval rating of over 98%, and that the quality of care was also positively valued by all participants. A significant correlation was observed in the 6th (Rho = 0.437; p = 0.042) and 7th (Rho = 0.514; p = 0.009) cycles in Chiclayo, as well as in the 6th (Rho = 0.567; p = 0.005), 7th (Rho = 0.450; p = 0.016) and 8th (Rho = 0.518; p = 0.040) cycles in Piura, indicating a progressive improvement in the perception of quality as the students' clinical training progresses. Conclusions: A significant association was found between satisfaction and quality of care among patients treated by dental students (p=.000; rho=.513). These findings suggest that the higher the perceived quality of care, the higher the levels of patient satisfaction, which reaffirms the importance of strengthening training and clinical processes in the university setting. Keywords: Attention; Quality; Satisfaction.
Characterization of storage and distribution logistics in the Metropolitan Health Region’s warehouses, El Salvador, 2024-2025
Objective: To characterize the environmental, organizational, and operational conditions under which storage and distribution operations are carried out in the Warehouses of the Metropolitan Health Region. Materials and Methods: A descriptive observational cross-sectional, field study with a mixed-methods approach was conducted. Data collection was based on direct participatory observation of processes performed by administrative and operational staff during user service, using a structured observation guide to systematize data for analysis. Results: It was found that medical supplies and equipment are stored under inadequate conditions, marked by a lack of control and stability in temperature and humidity. Additionally, there is no systematic method for prioritizing supplies based on expiration dates. The physical space of the warehouses is insufficient, and the internal product distribution hinders agile and safe access to the supplies. Furthermore, there is an absence of regular supervision of storage and dispatch operations, limiting process efficiency and control. Conclusion: The environmental, organizational, and operational conditions of the regional warehouses were characterized, revealing significant deficiencies in the storage and distribution logistics system. These conditions reflect a logistics system that does not incorporate Good Storage Practices, negatively impacting the efficiency and quality of service provided to users. Therefore, improvements are necessary to ensure environmental, organizational, and operational standards that optimize management and guarantee the availability and quality of supplies. Keywords: Logistics, Drug Storage, Drugs, Good Storage and Distribution Practices.
Satisfaction, dignified treatment of the user of health services in a hospital in Mexico
Objective: Determine the satisfaction and dignified treatment of medical care in the user user of a hospital in northeastern Mexico. Materials and Methods: An observational, descriptive, longitudinal, and retrospective study was conducted. Users who sought medical care between September 2023 and June 2024 were included. Results: Regarding the Dignified Treatment component, a positive perception was observed: 99.4% of users considered the care received respectful, while 0.6% did not. Regarding consultation time, 98.5% of users perceived that the doctor dedicated sufficient time to their visit, while 1.5% felt the opposite. Regarding overall perceived quality, satisfaction predominated: 92.5% of users declared themselves satisfied, 7.36% declared themselves fairly satisfied, and only 0.1% declared themselves not at all satisfied. Conclusions: The study conducted at the Regional High Specialty Hospital of Ciudad Victoria “Bicentenario 2010” shows a high level of user satisfaction regarding the medical care received. Most patients highlighted effective communication with the physician, clarity in treatment explanations, and respectful behavior from the healthcare staff. These results reflect the human and professional quality of the medical team, as well as adherence to the principles of patient-centered care. Key words: User satisfaction; Quality; Health services.
Vaccination coverage against COVID-19 and associated factors in university students in Southern Mexico
Objetive: The purpose of this study was to assess COVID-19 vaccination coverage among university students in Guerrero, Mexico, and to analyze the factors associated with their acceptance or refusal of the vaccine. Materials and methods: A cross-sectional survey was used to collect demographic data, vaccination status, perceptions of vaccine efficacy and safety, and postvaccination experiences. Results: Of the 1052 students surveyed, 97.1% reported having been vaccinated. A higher likelihood of vaccination was associated with having access to medical services (adjusted odds ratio [ORa] = 4.27; 95% CI: 2.06–8.85), perceiving the vaccine as effective (ORa = 2.33; 95% CI: 1.00–5.43), knowing someone who had contracted COVID-19 (ORa = 2.16; 95% CI: 1.04–4.49), and regularly receiving influenza vaccines (ORa = 1.89; 95% CI: 0.92–3.90). Conclusions: These findings underscore the importance of healthcare access, risk perception, and positive vaccination habits in promoting vaccine uptake. High vaccination coverage in this population reflects positive attitudes toward immunization. Key words: Vaccination; COVID-19; Coverage; SARS-CoV-2; Hesitancy.
Expanding healthcare: The role of Farmacias Similares clinics in the State of Mexico
Objetive: To analyze the social impact of pharmacy-based clinics (CAF) on healthcare services, with the aim of identifying their role in access to medical services in Region 1 of the State of Mexico. Materials and Methods: A descriptive observational study was conducted, which gathered the opinions of 334 users of medical consultation services offered by pharmacies, using an online survey on the Microsoft Forms platform. Results: With a heterogeneous sample, the majority of participants were women (221) engaged in primary economic activities with a monthly income of less than 5,000 pesos. They stated that the medical consultation services offered by pharmacies positively impact at least three aspects of their social lives, with healthcare costs and accessibility being the areas where they rated this service most highly. Conclusions: The factors that have made medical consultation services at pharmacies such a significant service in the region are accompanied by ongoing complaints about the public health system, including wait times of around 40 minutes, travel times to the medical center of over 2 hours, and a healthcare system that excludes people engaged in informal economic activities from public coverage. Keywords: Office adjacent to pharmacy; social impact; health coverage; public health services; quality of medical service.
Pharmacy offices, actors in the cluster and inadequate disposal of medications: A Systematic Review
Objective: To analyze, through a systematic review of the literature, the association between pharmacy-adjacent medical offices and the accumulation and improper disposal of medicines, as well as the implications of this phenomenon for public health and the environment. Materials and methods: A structured search was conducted in PubMed for articles published in English and Spanish during the last ten years, following the PRISMA 2020 guidelines and applying the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Eligible studies included original research and reviews addressing practices of medication storage and disposal in households, the role of pharmacy offices in prescription patterns and drug accumulation, and the social, health, and environmental effects derived from these practices. Results: Out of 16 studies initially identified, 14 met the inclusion criteria. The findings were grouped into three main themes: (1) disposal practices of expired medications in households and health services, predominantly through household waste and sewage systems; (2) the influence of pharmacy-adjacent medical offices on overprescription and the growth of household medicine cabinets, linked to labor and market incentives; and (3) the socio-environmental consequences of improper disposal, including bacterial resistance, household poisonings, and contamination of water and soil. Conclusions: The review highlights that pharmaceutical marketing models and the working conditions of physicians in pharmacy-adjacent medical offices indirectly contribute to the accumulation and inadequate disposal of medicines. This scenario constitutes an emerging issue of public health and environmental justice. Priority areas identified include the promotion of eco-pharmacovigilance programs, the development of specific regulations for the final disposal of medicines, and the implementation of health education campaigns aimed at responsible use and the donation of medicines with remaining shelf life.
Teaching methodologies to acquire theoretical, procedural and attitudinal knowledge in nursing
Objective: To assess the theoretical, procedural, and attitudinal knowledge of nursing students through teaching with clinical simulation versus audiovisual media and role-playing. Materials and methods: A quasi-experimental, cross-sectional study. The study population consisted of first-year students of the FESZ Nursing Program. The sample was determined by calculating finite populations, with a total of 120 students, divided into three subgroups: "A" trained with clinical simulation (anatomical model); "B" trained with audiovisual media; and "C" trained with the role-playing technique. Data analysis was performed using SPSS.V23, and analysis of variance (ANOVA) and post hoc tests were performed for three categories. Results: 82.5% were women in the simulation group, 55% in the audiovisual media group, and 72.5% in the role-playing group. The age ranged from 18 to 22 years. For theoretical knowledge, the audiovisual media group obtained a mean of x̅=49.740 (SD=9.305); for procedural knowledge, role-playing, x̅=62.470 (SD=8.782); and for attitudinal knowledge, audiovisual media, x̅=52 (SD=30.315). A statistically significant difference was identified between the simulation group and the audiovisual media group (p=.003), but not with the audiovisual media group. Conclusions: The use of audiovisual media is a methodology that favors theoretical knowledge compared to other methodologies such as simulation and role-playing. Regarding procedural and attitudinal knowledge, there are no differences between the three methodologies. Keywords: Knowledge, Attitudes and Practice in Health; Simulated Training; Audiovisual Resources; Paper Performance.
Benefit-risk use of transfer factor (Hebertrans®) in usual medical practice
Objetive:Analyze the benefit-risk ratio of FT (Hebertrans®) in medical practice. Materials and methods: The Bayesian approach was used to compare the likelihood of benefit (satisfactory evolution of patients) with risk (presence of adverse reactions during or after treatment). The information was obtained from publications investigating adverse reactions and the clinical evolution of patients treated with Hebertrans® Results. A higher percentage of adverse reactions was observed with patients who evolved in an unsatisfactory way (24.5%), than among those who progressed correctly (12.2%). The difference between benefit and risk favored the first (Bayes Factor = 2.3). Conclusions. The benefit-risk balance for the use of the transfer factor (Hebertrans®) was in favor of the benefit, despite the fact that the clinical evolution of patients is not satisfactory, this drug causes few adverse reactions; the most frequent are related to the administration site and are mild. However, controlled epidemiological studies are necessary to verify these results. Keywords: Transfer factor; adverse reactions; benefit-risk; pharmacoepidemiology.
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