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.
Intoxicación por barbitúricos, una mirada toxicológica.
Introducción: Los barbitúricos son depresores no selectivos del sistema nervioso central desplazados como hipnosedantes por el mejor índice riesgo- beneficio de las benzodiacepinas. En la actualidad sus principales usos son en la anestesia y para el tratamiento de la epilepsia. Su consumo con fines suicidas continúa, y debido a lo inespecífico del inicio de su sintomatología, las intoxicaciones pueden resultar fatales. Objetivos: Actualizar los conocimientos acerca de las características desde el punto de vista toxicológico de las intoxicaciones por barbitúricos. Materiales y métodos: Se realizó un estudio donde se aplicó el método cualitativo, mediante una revisión bibliográfica y documental sobre el tema en fuentes de datos digitales. Se usaron los descriptores DeCs-MeSH: intoxicaciones, barbitúricos, tratamientos, hemoperfusión, toxicología. Se revisaron artículos publicados sobre el tema, a través de los buscadores habituales (Google, PubMed, Cochrane, Scielo, entre otros), teniendo en cuenta la calidad y la actualidad de ellos. Resultados: Tanto las dosis tóxicas como el comportamiento toxicocinético de estos fármacos son variables y dependen sobre todo del grupo al cual pertenezcan. Las intoxicaciones más frecuenten están relacionadas con los barbitúricos de acción prolongada. Debido a su alta liposolubilidad, los de acción ultracorta, pueden quedar acumulados en el tejido adiposo y al movilizarse estas reservas pueden ser fuente de toxicidad. Aunque no son comunes también hay que tener en cuenta la posible existencia de metabolitos activos. Conclusiones: Estos son fármacos en desuso debido a su estrecho margen terapéutico, la elevada dependencia y posterior tolerancia que provoca un aumento potencial de su toxicidad. Aun así, acompañados de una debida monitorización, pueden emplearse en situaciones concretas. Desafortunadamente todavía se producen numerosas muertes por sobredosis accidentales o con fines suicidas.
Effect of health warnings and cigarette advertising on Cuban university students and workers
Objective: To identify differences in prevalence and addiction to tobacco use among University students and staff in Pinar del Río and Havana, in health sciences and other disciplines; to describe the effectiveness of health warnings and to characterize the advertising tactics directed at the studied populations. Material and Methods: Cross-sectional descriptive study, using bibliographic, documentary, and social media review; survey and observation. Quantitative data were systematized in SPSS version 25 and descriptive statistics were used. Results: Risk and addiction severity profiles vary between institutions. Health sciences students in Havana show an earlier onset of addiction than those in other disciplines, and workers from other disciplines in Pinar del Río exhibit greater chronicity and severity. Contextual and gender differences are observed. The ineffectiveness of textual health warnings is present across the entire population, although comprehension and credibility are high. Tobacco industry marketing tactics target vulnerable youth populations. Conclusions: Cuba's adherence to the Framework Convention on Tobacco Control is insufficient in its practical implementation (Articles 11 and 13). The effectiveness of textual warnings is limited or nonexistent for cessation. Marketing bans are easily circumvented through free distribution and digital channels. A differentiated approach by territory, adoption of graphic health warnings, and control of advertising are required. Keywords: Duty to Warn; Cigarettes; Smoking Prevention; Economy; Workers; University.
Copyright (c) 2026 Horizonte Sanitario https://creativecommons.org/licenses/by-nc-sa/4.0
Health literacy and prenatal empowerment as predictors of Prenatal Care Adherence
Objective: To evaluate the predictive power of prenatal empowerment and maternal health literacy variables on adherence to prenatal care. Materials and methods: The study used a predictive design for the dependent variable adherence to prenatal care. The population consisted of pregnant adult women in their third trimester of pregnancy. The sample included 233 participants who were selected at convenience in public health institutions offering prenatal care services in the city of Chihuahua, Chihuahua. The measurement instruments used were the Maternal Health Literacy in Pregnancy inventory (MHELIP); the Pregnancy Empowerment Scale (PRES); and an activity compliance index to measure adherence to prenatal care. SPSS version 22 was used to analyze the information. This study respected the human rights of the participants, ensuring data reliability, anonymity, and preservation of dignity and freedom to withdraw at any time. Results: 233 pregnant women participated in the study. 81.1% of the women in the study presented strong prenatal empowerment, while 37.8% had a sufficient level of maternal health literacy. The mean adherence to prenatal care was 11.24 (SD= 2.14), on a maximum of 16 points. The model was significant (F (2,230) =10.66, R2=.07, p=.00). Predictor variables for adherence to prenatal care were maternal health literacy (B=.21, p=.00) and prenatal empowerment (B=.15, p=.01). Conclusions: Pregnant women who presented higher maternal health literacy and prenatal empowerment presented higher adherence to prenatal care. Key words: Health literacy; Empowerment; Pregnancy; Prenatal care.
Factors related to contraceptive behavior among socially disadvantaged adolescents in southwestern Mexico
Objective: To determine the direct and indirect effects between individual background (sex, gender violence), social background (occupation), information background (contraceptive knowledge), attitudes toward contraceptive use, peer norms toward sexuality, contraceptive self-efficacy, and intention toward contraceptive use with contraceptive behavior of socially disadvantaged adolescents. Materials and methods: A cross-sectional correlational-predictive study was conducted in 247 sexually active adolescents, residents of socially underprivileged communities in the states of Oaxaca and Guerrero, Mexico. A structural equation model was developed using AMOS version 23 statistical software. Results: The adjusted model explained 19% of the variance, where positive attitudes towards contraceptive use (β=.22, p<.01), intention to use contraception (β=.22, p<.001), contraceptive self-efficacy (β=.13, p<.05) and occupation (β=.15, p<.01) were directly and positively related to increased contraceptive behavior, while gender-based violence (β=-.19, p<.01) was negatively related. Conclusions: Intention towards contraceptive use, positive attitudes towards contraceptive use, contraceptive self-efficacy and occupation were direct and positive predictors of contraceptive behavior of socially disadvantaged adolescents, while gender-based violence was directly and negatively related to this outcome variable. Understanding the factors that influence contraceptive behavior in adolescents living in poverty is essential for the design of programs aimed at preventing unwanted pregnancies. Keywords: Contraceptives; Adolescents; Social Disadvantage in Health; Poverty.
Managerial skills in mental health and teaching performance in an Educational Management
Objective: To determine the influence of managerial skills on mental health and teacher performance in public educational institutions (UGEL) in Lima. Materials and methods: The methodology used is quantitative, basic, with a non-experimental design. A structured questionnaire was applied to a non-probabilistic sample of 102 teachers from public educational institutions belonging to a UGEL in Lima-Peru, using validated scales for managerial skills, burnout risk (mental health) and teacher performance according to the Peruvian Good Teacher Performance Framework. Results: 39.2% reported poor managerial skills and 38.2% good. Regarding the “mental health” dimension, the majority (61.7%) presented moderate-high burnout risk. In addition, for “teacher performance” only 44.1% reached an efficient level; in the dimensions “preparation for student learning” 54.9%, “teaching for student learning” 38.2%, “participation in school management” 52.0% and “professional development” 54.9%. Conclusions: Managerial skills influence managerial competencies, mental health, and teaching performance in public educational institutions of a UGEL in the post-pandemic context, reducing the negative impact of COVID-19 sequelae on mental health and significantly enhancing teachers’ professional performance. Keywords: Managerial skills; Teacher mental health; Teacher performance; Post-COVID-19 pandemic.
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.
Copyright (c) 2025 Horizonte Sanitario https://creativecommons.org/licenses/by-nc-sa/4.0
Influence of hybrid immunity and host factors on the concentration of neutralizing antibodies against SARS-CoV-2
Objectives: To analyze the influence of hybrid immunity and host-dependent factors on the baseline concentration of neutralizing antibodies against SARS-CoV-2. Materials and methods: Observational study of an analytical type, cross-sectional. A sample of 169 participants, over 18 years of age, of both sexes; distributed in two groups. Group A: 84 participants with previous infection + vaccination. Group B: 85 participants without previous infection + vaccination. Baseline concentrations of total anti-RBD antibodies were measured. In all cases, a significance level α 5% was used (p= <0.05). Results: A positive result was considered from a mean fluorescence index equal to or greater than 1.3 (MIF≥ 1.3). All participants have titles above the cut-off point. Group A: 6.8 ± 2.23 MIF, Group B: 7.39 ± 2.78 MIF. There was no statistically significant difference between them (p= 0.145). Significant differences were evidenced with males (p= 0.049), overweight (p= 0.037) and the Moderna vaccine (mRNA-1273) (p= 0.003). A statistically significant, weak, and direct correlation was evidenced between the number of booster doses and the concentration of antibodies in group A (p= 0.013). The simple linear regression model predicts in group A that a fifth booster dose would generate antibody levels of 8.81 MIF, values much higher than the average (6.80 MIF). Conclusions: Hybrid immunity influences the humoral response induced by vaccines, favouring increased antibody production with each booster dose received. In our population, overweight is a host-dependent factor that negatively influences the baseline concentration of antibodies in individuals with previous infections. Keywords: Infection; SARS-CoV-2; COVID-19; Vaccines; Hybrid immunity.
Influence of anthropometric indicators on blood pressure levels in adult Mexican women
Objective: To determine the influence of anthropometric indicators on blood pressure levels in adult Mexican women. Materials and methods: An observational, analytical, cross-sectional study was conducted in a sample of 342 adult women aged 18 years and older. General, anthropometric, and blood pressure data were collected in accordance with international guidelines. Multiple linear regression models and multinomial logistic regression models were analyzed. Results: Body mass index and neck circumference were statistically significant predictors of systolic and diastolic blood pressure (p < .05), explaining 14.4% of the variance in each model. Neck circumference was associated with high-normal blood pressure and grade I hypertension, while BMI was associated with isolated diastolic hypertension. Conclusions: The findings of the present study show that BMI and CC are significantly associated with systolic and diastolic blood pressure levels in Mexican adult women. Its integration into primary care screening for young women is recommended, in order to facilitate early detection and evidence-based prevention. Keywords: Hypertension; Anthropometry; Women; Social Determinants of Health.
Inequalities in medical specialization in Mexico: Analysis of the National Residency Examination and accreditation
Objective: To evaluate the likelihood of admission to a medical specialty through the National Medical Residency Examination (ENARM), with quality assurance from the Mexican Council for the Accreditation of Medical Education (COMAEM), comparing public and private medical schools. Materials and methods: A study was carried out with a quantitative, documentary, observational and cross-sectional approach, based on the secondary analysis of public and open access information. The probabilities of physicians gaining admission to a specialty were analyzed based on qualification quartiles from the national evaluation and the type of medical school (public or private). Comparisons were made between public and private schools, considering their accreditation status. Results: A select group of prestigious, high-tuition private schools consistently ranked higher for admission to medical specialties. In contrast, many private schools achieved the lowest scores in the national ranking. Public schools demonstrated greater consistency, with those holding satisfactory accreditation status achieving the highest overall ratings across the cohort. The distribution of state-level educational offerings revealed inequities, reflecting known economic, social, and cultural disparities in Mexico. Conclusions: Inequities in access to quality medical education during undergraduate training in Mexico require urgent analysis and action. These disparities can negatively impact the fundamental right to health and hinder the development of a high-quality national health system. Key words: Education, Medical; Right to Health; Health Inequities; Schools, Medical; Mexico.
Epidemiology of chronic venous disease in health personnel
Objective. To determine the prevalence of chronic venous disease (CVD) in hospital health staff. Materials and Method. Cross-sectional study on health workers of a general hospital in Tuxtla Gutierrez, Chiapas. The sample was 282 peoples using a probabilistic selection. The interview was conducted with a validated questionnarie. All patients underwent detailed clinical examination. Data were analyzed obteining descriptive measures, with SPSS versión 26. Results. Included 282 patients, 69% women. The prevalence of CVD was 51.4%, the range age of the sample from 18 to 45 and over years old; with regard to characteristics with statistic significance by the chi-square test were : to be women, 69% (p:0.00), with familiar antecedent of CVD 75.2% (p:0.00), sedentary life style 71.3% (p:0.00), women with one or more children 50% (p:0.00). The nurse workers had the higest prevalence of CVD, 63.4%. Regarding clinical symptoms 81% (p:0.01) refer lower leg pain, swelling 78.6 % (p:0.00), heaviness of legs 76.3% (p:0.00), night cramps, 80%(p:0.00) and plantar pain 76.2% (p:0.00). Conclusion. The prevalence of chronic venous diseases is higher in women, specifically nurses, it is similar as reported in the literature. It is recommended implement diagnosis and early treatment in hospital workers. Keywords: Venous insufficiency; Health personnel; Prevalence.
Nutritional status in Mexican young adults who consume marijuana: an analysis by sex
Objective: To know the association between marijuana use and nutritional status in young Mexicans aged 18 to 34, according to sex. Materials and methods: Analytical cross-sectional study, in which 32 women and 35 men who used marijuana, recruited on social networks with the snowball technique, participated. The instrument used was a nutritional clinical history that included self-report of anthropometric measurements and dietary practices; the ASSIST questionnaire on the consumption of alcohol, tobacco and other drugs; as well as the International Physical Activity and Lifestyle Questionnaire, known as IPAQ (International Physical Activity Questionnaire). Results: The average age of the participants was 24 years for women and 25 for men. Regarding anthropometric measurements, the statistically significant results were lower body mass index and waist circumference in women than in men. The dietary indicator also showed lower caloric intake in women; however, both groups were classified as having hypercaloric diets. Conclusions: Despite the limitations of the study due to SARS-CoV-2 which prevented the implementation of the biochemical and clinical indicators, significant body and eating changes were found in marijuana users of both sexes. Keywords: Nutrition; Adults; Marijuana Abuse.
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.
Narratives on Barriers to Mental Health Care for Medical Students
Objective: To explore the main barriers faced by medical students in seeking help and the use of addressing mental health services. Materials and Methods: Qualitative study conducted through semi-structured interviews with medical students (N = 17). The data were analyzed and coded in accordance with Grounded Theory methodology; a central category was constructed, along with subcategories, their properties, and dimensions, using ATLAS.ti version 24 software. Results: A total of 23 distinct barriers were identified and categorized into three main groups: nine related to health services (GR = 75), addressing issues of quality, organization, accessibility, and dissemination; another nine linked to perceptions and attitudes (GR = 66), reflecting how students conceptualize and interpret mental health in themselves; and those associated with stigma (GR = 29), which describe the internalized system of negative beliefs prevalent within the medical profession. Conclusions: To address mental health among future physicians, it is essential to integrate socio-emotional education, promote a culture of empathy and support, and ensure accessible high-quality health services. This underscores the need for a comprehensive approach that transcends the biomedical model by incorporating sociocultural dimensions and fostering cross-cutting, collaborative interventions among students, institutions, and society to overcome barriers that hinder mental health care and well-being in medical training. Keywords: Medical Students; Mental Health; Mental Health Assistance; Help-Seeking Behavior; Social Stigma.
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.
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
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