Objective. To identify the degree of association between anthropometric indices and components of metabolic syndrome (MS) and to determine optimal cut-off points of these indices for predicting MS in obese adolescents.Methods. A cross-sectional study with a sample of (n=110) Mexican obese adolescents grouped by sex and the presence/absence of MS. BMI percentile, waist circumference (WC), and waist-to-height ratio (WHtR) were tested. ROC curves of the anthropometric indices were created to identify whether an index was a significant predictor of MS.Results. BMI percentile, WC, and WHtR were significantly correlated with systolic and diastolic blood pressure. As predictors of MS overall patients, the BMI percentile generated an area under curve (AUC) of 0.651 (P=0.008), cut-off point above the 99th percentile. WC generated an AUC of 0.704 (P<0.001), cut-off point of ≥90 cm. WHtR demonstrated an AUC of 0.652 (P=0.008), cut-off point of 0.60. WHtR ≥0.62 and WHtR ≥0.61 generate AUC of 0.737 (P=0.006) and AUC of 0.717 (P=0.014) for predicting hypertension and insulin resistance, respectively, in females.Conclusion. WHtR is a better tool than WC and BMI for identifying cardiometabolic risk. The overall criterion (WHtR ≥ 0.6) could be appropriate for predicting MS in obese Mexican adolescents.

To compare serum concentrations of inflammatory cytokines, interleukin 6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), adiponectin, and tumor necrosis factor alpha (TNFalpha), before and after 3 months treatment with metformin in obese adolescents with insulin resistance (IR). This was a randomized, double-blinded, clinical trial of two groups of obese adolescents with IR, aged 9-18 years: a placebo group (n=14) and a metformin group (n=12) who received 500 mg metformin every 12 h for 3 months. Anthropometric and biochemical (metabolic and inflammatory cytokines) assessments were compared at the beginning and end of treatment. After 3 months of treatment, body mass index (kg/m2) was reduced in both groups: placebo group (32.82 +/- 6.37-32.10 +/- 6.52; p=0.011) and metformin group (33.44 +/- 5.82-32.71 +/- 5.77; p=0.015). Serum fasting insulin concentrations (pmol/L) increased in the placebo group (189.45 +/- 112.64-266.06 +/- 167.79; p=0.01) and showed a slight decrease in the metformin group (256.82 +/- 113.89-229.25 +/- 86.53; p=0.64). Adiponectin concentrations (microg/mL) decreased in the placebo group (13.17 +/- 7.31-5.65 +/- 6.69; p=0.02), while these remained stable in the metformin group (8.57 +/- 3.98-7.86 +/- 6.23; p=0.64). In the metformin group, significant reductions were found in the variances of serum TNFalpha concentrations (p=0.006; Levene test). These results suggest that treating obese adolescents with IR using metformin for 3 months is an option for patients without response to traditional lifestyle change because metformin improves inflammatory activity, which is an etiological factor in cardiovascular disease development.

The aim of this study was to estimate the prevalence of metabolic syndrome (MS) and its components in obese Mexican adolescents and to compare the clinical, anthropometric, and biochemical characteristics between patients with and without MS by sex. We conducted a cross-sectional study with a sample of 110 obese adolescents (boys and girls) from 8 to 16 years old (BMI ≥95th percentile), who were recruited in the pediatric obesity clinic of a third-level care hospital. A frequency analysis was used to estimate the prevalence of MS and its components, and the assessments were compared between the sexes and between the groups with and without MS using the Kruskal–Wallis test. The prevalence of MS was 62%. In order of prevalence, the following components of MS were observed in the sample: abdominal obesity (88%), high triglycerides (TG) (85%), low HDL-C (60%), hypertension (35%), and hyperglycemia (5%). In the groups with MS, hypertension (P<0.001), waist circumference (P=0.003), and TG (P=0.012) were significantly higher, and HDL-C (P<0.001) was significantly lower. In conclusion the prevalence of MS and its components is high among obese Mexican-Hispanic children. These findings show the importance of preventing and treating obesity in the early stages of life in order to decrease the incidence rates of cardiovascular disease and type 2 diabetes mellitus.

Background: Multidetector computer tomography (CT) has been used to diagnose pathologies such as osteoporosis via opportunistic screening, where the assessment of the bone structure and the measurement of bone mineral density (BMD) are of great relevance. Purpose: To construct reference BMD values based on the measurement of the attenuation of the L1 vertebral body by multidetector CT scan (in the soft tissue and bone windows) in adult patients and to establish normative ranges by sex and age of BMD values. Materials and Methods: A retrospective cross-sectional study of 5080 patients who underwent multidetector CT scan between January and December 2021. Adult patients (≥18 years) with non-contrast multidetector CT scan of the abdomen or thorax–abdomen at a voltage 120 kV. The attenuation of the L1 vertebral body in Hounsfield units (HU) in both windows were compared using the Mann—Whitney U-test with α = 0.05. Additionally, the quartiles of the BMD were constructed (in both windows) grouped by sex and age. Results: Only 454 (51.30 ± 15.89 years, 243 women) patients met the inclusion criteria. There is no difference in BMD values between windows (soft tissue: 163.90 ± 57.13, bone: 161.86 ± 55.80, p = 0.625), mean L1 attenuation decreased linearly with age at a rate of 2 HU per year, and the presence of BMD deficit among patients was high; 152 of 454 (33.48%) patients presented BMD values suggestive of osteoporosis, and of these, approximately half 70 of 454 (15.42%) corresponded to patients with BMD values suggestive of a high risk of osteoporotic fracture. Conclusions: From clinical practice, the bone mineral density (BMD) of a patient in either window below the first quartile for age- and sex-matched peers suggests a deficit in BMD that cannot be ignored and requires clinical management that enables identification of the etiology, its evolution, and the consequences of this alteration.

Background: Data on hospital discharges can be used as a valuable instrument for hospital planning and management. The quantification of deaths can be considered a measure of the effectiveness of hospital intervention, and a high percentage of hospital discharges due to death can be associated with deficiencies in the quality of hospital care. Objective: To determine the overall percentage of hospital discharges due to death in a Mexican tertiary care hospital from its opening, to describe the characteristics of the time series generated from the monthly percentage of hospital discharges due to death and to make and evaluate predictions. Methods: This was a retrospective study involving the medical records of 81,083 patients who were discharged from a tertiary care hospital from April 2007 to December 2019 (first 153 months of operation). The records of the first 129 months (April 2007 to December 2017) were used for the analysis and construction of the models (training dataset). In addition, the records of the last 24 months (January 2018 to December 2019) were used to evaluate the predictions made (test dataset). Structural change was identified (Chow test), ARIMA models were adjusted, predictions were estimated with and without considering the structural change, and predictions were evaluated using error indices (MAE, RMSE, MAPE, and MASE). Results: The total percentage of discharges due to death was 3.41%. A structural change was observed in the time series (March 2009, p>0.001), and ARIMA(0,0,0)(1,1,2)₁₂ with drift models were adjusted with and without consideration of the structural change. The error metrics favored the model that did not consider the structural change (MAE = 0.63, RMSE = 0.81, MAPE = 25.89%, and MASE = 0.65). Conclusion: Our study suggests that the ARIMA models are an adequate tool for future monitoring of the monthly percentage of hospital discharges due to death, allowing us to detect observations that depart from the described trend and identify future structural changes.

Introduction: Nocturnal enuresis is a common problem affecting 20% of 5-year-old children; its prevalence decreases with age. Nocturnal bedwetting in children younger than 5 is generally accepted by parents and society, but the expectation of parents is that children will achieve a higher degree of responsibility and increased control with age. Some studies have identified maternal distress as a factor associated with childhood urinary incontinence; specifically, maternal stress, maternal depression, and maternal anxiety. The aim of this study was to compare the degree of anxiety (trait and state) among mothers of children with nocturnal enuresis and mothers of healthy children. Methods: This was a prospective, cross-sectional, comparative study including two groups: a control group of 25 mothers of healthy children from open population, and an enuresis group of 25 mothers of children with nocturnal enuresis of the pediatric urology clinic of a third-level Mexican Hospital. STAI-T and STAI-S tests were performed and assessed blindly. Quantitative variables were compared using the Mann–Whitney U test, and qualitative determinations using a chi-square test or Fischer’s exact test. Results: The STAI-S and STAI-T tests results identified 14 (56%) mothers of enuretic children with moderate-to-severe trait anxiety versus 4 (16%) mothers from the control group and moderate-to-severe state anxiety in 23 (92%) of the mothers of enuretic children compared to 7 (28%) control-group mothers. The anxiety scores were significantly higher for the enuresis group for both tests: STAI-T: 53.00 ± 8.39 versus 41.52 ± 9.61 (p < 0.001) and STAI-S: 56.48 ± 6.83 versus 43.84 ± 10.57 (p < 0.001). Conclusion: Mothers of children with nocturnal enuresis present state anxiety ranging from moderate to severe. In clinical practice, our results indicate that the transitory emotion experienced by mothers of enuretic children cannot be neglected in an enuresis treatment program, state anxiety needs to be evaluated, and psychological interventions need to be implemented.