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    Item type:Publication,
    Development and validation of a questionnaire to assess the health related Social Capital for Chronic Kidney Disease among Mexican adolescents
    (Public Library of Science (PLoS), 2025)
    Quiñones-Villalobos, Carolina
    ;
    Prado-Aguilar, Carlos Alberto
    ;
    ;
    Arreola-Guerra, José Manuel
    ;
    Padilla-López, Jannett
    Background: Social Capital on health has been studied widely, to date there is no valid and reliable questionnaire that measure it in Chronic Kidney Disease (CKD). Objective: To develop, validate and assess the reliability of Social Capital related to CKD questionnaire for Mexican adolescents. Methods: An instrumental study was employed to validate a questionnaire that assesses the cognitive and structural domains of Social Capital related to CKD. The questionnaire was generated by operationalization of the constructs and validated by assessing the content, face validity, criteria and construct validity. Reliability was assessed through the Cronbach´s alpha. Results: The content validity of the questionnaire was confirmed through Kendall’s W of 0.925 (p = 0.01) and its face validity was evaluated by four focus groups. A principal component analysis on a sample of 281 adolescents indicated that 72.78% of the variance was explained by the cognitive domain and 83.20% by the structural domain. A confirmatory analysis returned a chi-squared value of 142.99 (p = 0.05), a CFI of 0.97, a TLI of 0.96, a RMSEA of 0.040 and a SRMR of 0.07 for the cognitive domain. Similarly, a chi-squared of 408.296 (p < 0.001), a CFI of 0.98, a TLI of 0.97, a RMSEA 0.03 and a SRMR of 0.06 were returned for the structural domain. The validity of the criteria was assessed through a Pearson’s correlation for both the cognitive and structural domains. There was a mild-to-strongly significant correlation (p ≤ 0.001) among items and dimensions within each domain, with correlation coefficients ranging from 0.23 to 0.83. As a determinant of the reliability of the questionnaire, the Cronbach’s alpha was 0.84 and 0.94 for the cognitive and structural domain, respectively. Conclusions: A valid and reliable questionnaire has been developed to measure the influence of Social Capital on health in relation to CKD among Mexican adolescents. ©The authors ©Public Library of Science (PLoS) ©PLOS One.
      33  39
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    Virtual reality pain mitigation during elective cesarean surgical delivery
    (Interactive Media Institute, 2019) ;
    Mosso Lara, Dejanira
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    Lara Vaca, Verónica
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    Wiederhold, Brenda K.
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    Miller, Ian
    We present supplemental virtual reality (VR) relaxation to reduce pain and anxiety during elective cesarean delivery in 4 young women under epidural analgesia. Methodology. Four women voluntarily participated in a VR relaxation group (mean age = 28.5 years) and four women in a control group (mean age = 30.5 years). VR relaxation was initiated for the placement of the epidural block and cesarean procedure until the gynecologist extracted the newborn from the uterus. The mothe's vital signs and pain were measured using physiological monitoring and a visual analog scale before, during and after anesthesia placement and during and after cesarean surgery. Participants viewed an ‘Enchanted Forest’ virtual environment. Three of the four patients’ husbands participated by navigating the virtual environment for his wife using a game controller. Results. Patients presented 91.89 % pain reduction in the VR group—a remarkable result under regional anesthesia. Patients in the control group presented 61 % increases in pain. Conclusions. VR supplemented pain mitigation provides high levels of satisfaction to mothers during elective cesarean delivery and carries no risk for the newborns. The current report highlights an innovative contribution to womens’ healthcare. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
      1  17
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    Manual para miembros de comités de ética en investigación
    (Trillas, 2016)
    Pichardo García, Luz María Guadalupe
    ;
    El objetivo de este manual es proporcionar información a los nuevos miembros de los comités de ética en investigación (CEI), con el fin de coadyuvar en su tarea de analizar, comprender y resolver acertadamente los asuntos éticos y metodológicos que les competen al integrarse a uno de estos comités, así como fomentar en ellos una actitud de entrega y compromiso con los valores y principios universales de respeto al ser humano y su dignidad en el ámbito de la investigación científica y biomédica.Es una guía sencilla que permitirá al lector familiarizarse con el lenguaje utilizado en esta ciencia, conocer el proceso de aprobación de un proyecto, aprender los conceptos elementales, así como los principios relevantes para la toma de decisiones; asimismo, conocerá la legislación y normatividades nacionales e internacionales que lo apoyarán en su nueva tarea.Este texto está enfocado particularmente a quienes recientemente han recibido el cargo y comienzan a funcionar como miembros, ya que contiene lo esencial que debe saber el recién ingresado al comité, sin pretender agotar el tema, pero sí resolver las dudas iniciales más frecuentes, para reforzar y agilizar la solución expedita de la deliberación con base en principios y fuentes éticas confiables. © Los autores © Trillas.
      19  15
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    Vínculo materno-filial. Neurociencia, cultura y bioética
    (Editores De Textos Mexicanos, 2021)
    No es de desconocimiento el conflicto infinito del ser humano, sobre su existencia y su expectativa, entre lo que somos y lo que se espera a llegar a ser, la fragmentación de su personalidad, en malos entendidos metonímicos, en confundir la parte por el todo e imponer el inmanentismo sobre su biología o viceversa, situaciones que complican más el camino y fines del ser humano. Actualmente, nos encontramos ante una expansión de libertades y voluntariedad, de los cual esa nueva libertad se trueque en nuevas coerciones, sin conciencia de los daños y efectos que nos afectan, la mala atención y decisiones durante todo el desarrollo de la vida humana, empezando desde su inicio y su corresponsabilidad. Los académicos que integran la presente obra nos dimos a la tarea, desde el ámbito interdisciplinar y transdisciplinar, de exponer un camino donde se zanje la personalidad humana a través de la ciencia basada en evidencia (biología, psíquica), ética, políticas públicas, antropología filosófica y el derecho, brindando herramientas y estructuras para que el cauce del desarrollo humano sea el más acorde durante toda la existencia. © Los autores © Editores de Textos Mexicanos.
      6  14
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    Prediction of preeclampsia before 11th week of gestation: a secondary analysis of the ASPIRIN trial
    (Elsevier BV, 2025)
    Capdeville, Gabriela
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    Godinez-Medina, Andrea
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    Copado-Mendoza, Diana Y.
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    Acevedo-Gallegos, Sandra
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    Rodriguez-Bosch, Mario R.
    Background: Early screening for preeclampsia is crucial for preventing adverse maternal and fetal events. Current first-trimester algorithms for predicting preeclampsia are designed to evaluate individual risk between 11.0 and 13.6 weeks of gestation based on various maternal characteristics while integrating biophysical and biochemical features. However, there is limited information regarding risk assessment during earlier stages of pregnancy (i.e., <11.0 weeks gestation). Objective: To develop a prediction model for preeclampsia/eclampsia before 11.0 weeks of gestation as a proof-of-concept in a secondary analysis of the ASPIRIN trial. Study design: This study is a secondary analysis of the ASPIRIN trial, a multinational, randomized, double-blind, placebo-controlled trial. The ASPIRIN trial database, obtained from NICHD DASH, included 11,976 nulliparous pregnant women aged 18–40 with gestational ages of 6.0–13.6 weeks at randomization. Participants were assigned to receive either aspirin (81 mg/day) or placebo until 36.0 weeks or delivery. This secondary analysis included pregnancies delivered at ≥20.0 weeks, excluding those in the aspirin group or with gestational ages ≥11.0 weeks at enrollment. The composite outcome was preeclampsia/eclampsia, as reported in the ASPIRIN trial. Predictor variables available in the dataset included maternal age, education (4 levels), body mass index (BMI kg/m2), gravidity, baseline hemoglobin, baseline systolic blood pressure, and baseline diastolic blood pressure. Logistic regression, with logarithmic transformation for continuous variables, was used to develop the model. The area under the ROC curve with a 95% confidence interval (CI) estimated via bootstrap resampling (1,000 iterations) and the P-value of the Hosmer-Lemeshow statistical test are reported as discrimination and calibration measures. This study used the entire available sample using a complete case approach. Results: A total of 3421 participants met the inclusion criteria, with a cumulative incidence of preeclampsia/eclampsia of 2.9% (99/3,421). Maternal age (21.96 ± 4.13 vs 20.86 ± 3.21, P<.001) and BMI (22.49 ± 4.77 vs 20.79 ± 3.55, P<.001) were significantly higher in the preeclampsia/eclampsia group. Gravidity was lower (P=.023), and hemoglobin levels were slightly elevated (11.88 ± 1.52 g/dL vs 11.50 ± 1.61 g/dL, P=.019) in the preeclampsia/eclampsia group. Educational level (P=.070), systolic blood pressure (P=.720), and diastolic blood pressure (P=.390) showed no significant differences between groups. The logistic regression model yielded an AUC of 0.69 (95% CI 0.63–0.74), and the Hosmer-Lemeshow test P-value was 0.094, indicating acceptable discrimination and calibration. Conclusions: This proof-of-concept logistic regression model using first-trimester maternal characteristics demonstrated acceptable predictive performance for preeclampsia/eclampsia before 11.0 weeks of gestation. During this critical period, several interventions could be proposed to reduce preeclampsia risk, including medication adjustments, lifestyle changes, and appropriate referral if needed. Further studies are required to validate these findings and assess their clinical utility in different settings. © The authors © Elsevier.
      12  2
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    Sarcoma histiocítico. Criterios diagnósticos histopatológicos e inmunohistoquímicos y sus diagnósticos diferenciales
    (2011)
    García-Gutiérrez, Mónica
    ;
    Histiocytic sarcoma (HS) is a rare malignant tumor, originating from bone marrow-derived myeloid stem cells, showing morphologic and immunophenotipic evidence of mature tissue histiocytes (macrophages). HS arises in lymph nodes and extranodal sites such as skin, soft tissues and particularly the gastrointestinal tract, often presenting with clinically advanced disease and pursuing and aggressive clinical course. The diagnosis of HS relies predominantly on the immunohistochemical features of the histiocytic lineage, and the exclusion of large cell lymphoma and other poorly differentiated large cell malignancies such as, carcinomas and melanomas.© Gaceta Mexicana de Oncología
      1  8
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    Encuesta en población abierta respecto a términos relacionados con decisiones al final de la vida
    (Academia Nacional de Medicina, 2019)
    Pichardo García, Luz María Guadalupe
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    Jaimes-Palomera, Mónica
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    Sotelo-Méndez, Alma Guadalupe
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    Sosa-Delgado, Ana Paula
    Introducción: Conceptos relacionados con las decisiones que se toman al final de la vida, como eutanasia, cuidados paliativos, voluntad anticipada y obstinación terapéutica son poco comprendidos por la población en general, que en el momento de enfrentar una situación terminal no está preparada para elegir la mejor opción. Objetivo: Estudio piloto (n = 544) para conocer lo que la población abierta entiende acerca de términos utilizados al final de la vida en cuatro ciudades de la república mexicana. Método: Encuesta vía internet de 18 preguntas sobre los distintos términos. Se trató de un estudio descriptivo, transversal, con análisis estadístico. Resultados: Se eligieron personas mayores de 18 años que no trabajaran en profesiones relacionadas con la salud. Conclusiones: La mayoría de los términos del final de la vida no interesaron ni fueron entendidos por parte de la población. El término menos reconocido fue la obstinación terapéutica (62.8 %) y el más conocido, cuidados paliativos (91 %); se confunden los términos eutanasia y suicidio asistido (47.8 %). La edad y escolaridad resultaron de mayor influencia en los resultados, que las otras variables demográficas. © Los autores © Academia Nacional de Medicina © Gaceta Médica de México.
      13  44
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    The ASCEND-NHQ randomized trial found positive effects of daprodustat on hemoglobin and quality of life in patients with non-dialysis chronic kidney disease
    (2023)
    Johansen, Kirsten L.
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    Cobitz, Alexander R.
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    Singh, Ajay K.
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    Macdougall, Iain C.
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    Lopes, Renato D.
    The ASCEND-NHQ trial evaluated the effects of daprodustat on hemoglobin and the Medical Outcomes Study 36-item Short Form Survey (SF-36) Vitality score (fatigue) in a multicenter, randomized, double-blind, placebo-controlled trial. Adults with chronic kidney disease (CKD) stages 3-5, hemoglobin 8.5-10.0 g/dl, transferrin saturation 15% or more, and ferritin 50 ng/ml or more without recent erythropoiesis-stimulating agent use were randomized (1:1) to oral daprodustat or placebo to achieve and maintain target hemoglobin of 11-12 g/dl over 28 weeks. The primary endpoint was the mean change in hemoglobin between baseline and the evaluation period (Weeks 24-28). Principal secondary endpoints were proportion of participants with a 1 g/dl or more increase in hemoglobin and mean change in the Vitality score between baseline and Week 28. Outcome superiority was tested (1-sided alpha level of 0.025). Overall, 614 participants with non-dialysis-dependent CKD were randomized. The adjusted mean change in hemoglobin from baseline to the evaluation period was greater with daprodustat (1.58 vs 0.19 g/dl). The adjusted mean treatment difference (AMD) was significant at 1.40 g/dl (95% confidence interval 1.23, 1.56). A significantly greater proportion of participants receiving daprodustat showed a 1 g/dl or greater increase in hemoglobin from baseline (77% vs 18%). The mean SF-36 Vitality score increased by 7.3 and 1.9 points with daprodustat and placebo, respectively; a clinically and statistically significant 5.4 point Week 28 AMD increase. Adverse event rates were similar (69% vs 71%); relative risk 0.98, (95% confidence interval 0.88, 1.09). Thus, in participants with CKD stages 3-5, daprodustat resulted in a significant increase in hemoglobin and improvement in fatigue without an increase in the overall frequency of adverse events. Copyright © 2023 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.
    Scopus© Citations 16  1  17
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    Personal attitudes and denialist views about the COVID-19 pandemic in Italy: a national survey
    (2022)
    Sisto, Antonella
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    Quintiliani, Livia
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    Vicinanza, Flavia
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    Fabris, Silvia
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    Campanozzi, Laura Leondina
    Since COVID-19 began to spread, hypotheses about the possible causes of the disease and its treatment have increased worldwide, engenedering fears and concerns. This context of uncertainty, as well as the great changes that people were forced to accept in their daily lives, have challenged the general population, affecting public opinion and collective imagination inevitably, with also a negative impact on compliance with public health policies. This study explored the personal attitudes towards the COVID-19 pandemic and their association with denial stances in the Italian context. The aim was to address the relevance of these phenomena and in what guise they are present in relation to the grounds supporting them, as an avenue to be more effective in public health under different domains. An online questionnaires was set out to survey the general population over 18 throughout the Italian country, including students and health professionals, to offer geographic and professional diversity. General population was also stratified based on their direct or indirect experience of COVID-19, whilst health participants were recruited with regard to their involvement in a COVID centre. A total of 2110 questionnaire were filled out between December 2020 and April 2021. Of the participants, 85.45% completely disagree with the possibility that COVID-19 is not real and that the cultural, social and economic system wanted us to believe otherwise, whereas 69% had doubts about what has been claimed to date about the existence of COVID-19. Trust in institutions and types of COVID-19 experience affected these beliefs. The results also show that stress, anxiety, sadness, and vulnerability increased as compared to the pre-COVID- 19 pandemic timeframe. The fundings of this national survey revealed how much behaviors based on social responsibility and rational prudence are important for defensing human life. ©Medicina e Morale
      2  23Scopus© Citations 1
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    Un enfoque sistémico de la bioética del medioambiente y la complejidad
    <jats:p>La teoría general de sistemas ofrece un marco conceptual y metodológico para integrar consideraciones bioéticas en la toma de decisiones ambientales y ecológicas, enmarcando clara y eficazmente muchos problemas y situaciones que suelen presentarse utilizando el lenguaje ordinario. Un sistema es una entidad estructurada internamente que se caracteriza por algunas propiedades y funciones específicas. Esta unidad se relaciona con varias de sus partes que también son sistemas y son, por tanto, sus subsistemas. A su vez, cada sistema es parte (es decir, subsistema) de sistemas de orden superior. Todos estos sistemas y subsistemas están relacionados entre sí de tal manera que cada uno se caracteriza por sus propiedades específicas, que, además, resultan de las correlaciones que los unen a sus subsistemas y sistemas de orden superior. Dentro de esta arquitectura general se inscriben fácilmente conceptos como entorno y complejidad, así como emergencia, con todos los problemas relativos a los límites de las posibilidades de predicción mostrando que los enfoques deterministas tradicionales en la ciencia son insuficientes para manejar tal complejidad. El artículo aborda los desafíos que plantea la impredecibilidad en los sistemas complejos, criticando las visiones fatalistas que aceptan de manera optimista o pesimista la naturaleza incontrolable de los desarrollos tecnológicos y ecológicos. Es precisamente la impredecibilidad de un sistema complejo como el entorno lo que requiere una dimensión bioética para guiar los valores que subyacen a nuestra toma de decisiones respecto a la vida misma.</jats:p>
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