Objetivo. Evaluar el cumplimiento de los límites máximos permisibles de residuos de plaguicidas en alimentos del estado de Veracruz, así como evaluar el riesgo para la salud humana debido a su consumo. Material y métodos. Se midieron las concentraciones de residuos de plaguicidas en productos vegetales y se compararon con los valores esta­blecidos como límites de seguridad en el marco regulatorio del uso de plaguicidas. Se calculó el cociente de peligro y sus posibles efectos a la salud. Resultados. El 14.8% de las muestras excedieron la concentración permitida. Se detec­taron plaguicidas prohibidos (metamidofos, monocrotofos, triazofos y clorpirifos) que superaron las dosis de referencia establecidas, lo que pone en riesgo de sufrir posibles efectos a la salud del tipo neurológico, hepatotóxico y alteraciones endocrinas a la población. Conclusiones. Se encontraron residuos de plaguicidas altamente peligrosos en los alimentos, los cuales están prohibidos por los convenios internacionales ambientales derivado de su potencial para causar efectos a la salud y al medio ambiente, por lo cual es necesario su elimi­nación. El marco regulatorio de México debe actualizarse y ser dinámico conforme se avance en el conocimiento de los efectos adversos de los plaguicidas en la salud.

Acute respiratory infections (ARIs) cause illness. Children under five years of age are highly vulnerable to these infections. Viral coinfection or multiple viral infection is a variable that can have a significant impact on the evolution of these diseases. This cross-sectional study was carried out in Mexican children (under five years of age) who had an ARI and who were treated by an emergency service in a hospital in Guadalajara, Jalisco, Mexico. The viral etiology, as well as the presence of multiple viral infections, was determined. A structured questionnaire was used to obtain demographic and clinical information. Odds ratio (OR) was calculated, and univariate and multivariate analyses using logistic regression were performed. In the study population, metapneumovirus (hMPV) was the most frequent virus (22%), followed by adenovirus (hAD) (16%), respiratory syncytial virus (RSV) (14%), rhinovirus (hRV) (12%), bocavirus (hBoV) (9%), influenza virus (IF) (7%), and parainfluenza (PIF) (4%). The frequency of viral coinfections was 31.62%, and multiple logistic regression analysis revealed that hMPV, RSV, PIF, and hBoV were independently associated with multiple viral infection. No difference was found in the clinical manifestation of children with simple and multiple infections. Simple hMPV infection was associated with patients who presented with severe ARI. Using a multivariate analysis, we found that overcrowding is associated with coinfection when the viral etiology was hRV (OR = 2.56, 95% confidence interval (CI) 1.07 to 6.13), IF (OR = 2.56, 95% CI 1.07 to 6.13), PIF (OR = 2.96, 95% CI 1.15 to 7.65), hAD (OR = 2.56, 95% CI 1.07 to 6.13), and hBoV (OR = 2.9, 95% CI 1.14 to 7.34). Viral coinfections are frequent in children requiring treatment by an emergency service. However, the severity of ARI is similar to that of children with a simple infection. The hMPV is common and may confer a significant disease burden in the Mexican population. Finally, overcrowding is a housing characteristic that favors the development of coinfections.

Metabolic syndrome includes a set of metabolic alterations associated with overweight and obesity. The criteria for its diagnosis are heterogeneous, and there have been few studies about prevalence in the pediatric population. The aim of this study was to describe how the estimated prevalence of metabolic syndrome varies by International Diabetes Federation (IDF) vs. National Cholesterol Education Program—Adult Treatment Panel III (NCEP—ATP) criteria. We conducted a cross-sectional study in which anthropometric information, triglyceride, cholesterol, glycemia, and insulin levels, among others, were collected. We compared the group potentially misclassified by IDF with the group classified without metabolic syndrome by NCEP—ATP with respect to weight status and biomarkers. Statistical analysis included linear regression, Mann–Whitney U test, Fisher´s exact test, and odds ratio calculation. The IDF criteria missed the association with obesity, although the undetected group differed significantly from the nonmetabolic syndrome group in terms of IBM and weight. The associated biomarkers were ultrasensitive C-reactive protein (Hs-CRP), alanine aminotransferase (ALT) enzyme, insulin, triglycerides, and high-density lipoprotein (HDL) cholesterol. Waist circumference was the parameter with the strongest association for presenting metabolic syndrome, with an odds ratio of 18.33. The results of this study showed the estimated prevalence of MS varies by criteria, due to cutoff points, and how the high prevalence of MS strongly associated with obesity.

Objetivo: Determinar la prevalencia del síndrome de burnout y sus factores asociados en el personal de enfermería, médicos y residentes durante la pandemia, en un hospital de alta especialidad reconvertido para la atención a pacientes con el COVID-19. Materiales y métodos: Se realizó un estudio cuantitativo, transversal y analítico a 225 profesionales de la salud. Para ello, se empleó el cuestionario Maslach Burnout Inventory (MBI) y un cuestionario de elaboración propia con el fin de evaluar las variables sociodemográficas, laborales y relacionadas con la pandemia. El grupo de participantes estuvo compuesto por 93 trabajadores de enfermería, 60 médicos y 72 médicos residentes, quienes laboraban en los servicios de cirugía general, medicina interna, ginecología y obstetricia, urgencias, unidad de cuidados intensivos (UCI), pediatría y epidemiología, en los turnos matutino, vespertino, nocturno y jornada acumulada, en un hospital de alta especialidad del estado de Veracruz, México, que se convirtió en hospital para la atención de pacientes con el COVID-19 durante la pandemia. Resultados: La prevalencia global del síndrome de burnout identificada en este trabajo fue de 58,7 %. Se observó que los más afectados por este síndrome fueron los médicos residentes, con 77,8 %, seguido del personal médico, con 55 %, y del personal de enfermería, con 45 %. De las dimensiones que conforman el síndrome de burnout, el desgaste emocional alto se encontró en el 38,2 % de los trabajadores, mientras que la despersonalización alta se observó en el 31,1 % y la baja realización personal (RP) en el 36 %. Las variables más asociadas al síndrome de burnout fueron el número de hijos, la edad, la cantidad de años laborando en la institución, la profesión, las horas laboradas por la semana, el puesto, el tipo de contrato y el turno. Conclusiones: La evidencia indica que la excesiva cantidad de horas laboradas por semana y la gran carga de trabajo asignada a los médicos podrían estar influyendo de manera negativa en la presencia del síndrome de burnout, ya que este grupo fue el más afectado por dicho síndrome.

In Mexico, breast cancer (BC) is the principal cause of death in women over 30 years old, with an annual mortality rate of 14.61 deaths per a 100,000 population. Chemotherapy, in combination with trastuzumab (TTZ), improves the survival of cancer patients; however, cardiotoxicity (CT) is the principal consequence. CT prevalence occurs between 10% and 30% of patients; however, there are no data about the prevalence of CT in the Mexican population. This study aims to establish the prevalence of CT in patients treated with anti-HER-2 therapy among BC women in southeast Mexico. A retrospective cross-sectional study was carried out from January 2015 to July 2019. The records of 46 patients diagnosed with HER-2-positive BC who attended the Mexican Social Security Institute in the Ambulatory Care Medicine Unit were analyzed. The diagnostic criterion for CT was a decrease in LVEF > 10% from baseline or a final LVEF < 53%. CT prevalence was observed in 19 (41.3%) of women with cancer, with an average decrease in LVEF of 13%. In the population, we found an association between weight, surface area, and the loading dose of TTZ with CT. Nutritional follow-up and the administration of cardioprotective drugs are necessary to recover LVEF and avoid cardiovascular failure in women with BC and survivors.