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1.
Clin Appl Thromb Hemost ; 27: 10760296211008988, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33813911

RESUMEN

Coagulation abnormalities have been reported in COVID-19 patients, which may lead to an increased risk of Pulmonary Embolism (PE). We aimed to describe the clinical characteristics and outcomes of COVID-19 patients diagnosed with PE during their hospital stay. We analyzed patients with PE and COVID-19 in a tertiary center in Mexico City from April to October of 2020. A total of 26 (100%) patients were diagnosed with Pulmonary Embolism and COVID-19. We observed that 14 (54%) patients were receiving either prophylactic or full anticoagulation therapy, before PE diagnosis. We found a significant difference in mortality between the group with less than 7 days (83%) and the group with more than 7 days (15%) in Intensive Care Unit (P = .004); as well as a mean of 8 days for the mortality group compared with 20 days of hospitalization in the survivor group (P = .003). In conclusion, there is an urgent need to review antithrombotic therapy in these patients in order to improve clinical outcomes and decrease hospital overload.


Asunto(s)
/mortalidad , Hospitalización , Unidades de Cuidados Intensivos , Embolia Pulmonar/mortalidad , Adulto , Anciano , Femenino , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Embolia Pulmonar/terapia , Estudios Retrospectivos , Centros de Atención Terciaria , Factores de Tiempo
2.
Artículo en Inglés | MEDLINE | ID: mdl-33801928

RESUMEN

The coronavirus disease (COVID-19) that broke out in China in December 2019 rapidly became a worldwide pandemic. In Mexico, the conditions requiring the declaration of a sanitary emergency were reached by the last week of March 2020, and health authorities' limited mobility and imposed social isolation were the main strategies to keep the virus from spreading. Thus, daily living conditions changed drastically in a few days, generating a stressful situation characterized by an almost complete lack of mobility, social isolation, and forced full-time interactions with family members. Soon, complaints of sleep disturbances, anxiety, and symptoms of depression were reported. The present study reports the results of an online survey performed during the first two months of isolation. Questionnaires exploring sleep disturbances, anxiety, and depression were sent to people who responded to an open invitation. A total of 1230 participants filled out the sleep questionnaire, 812 responded to the anxiety questionnaire, and 814 responded to the depression questionnaire. Both men and women reported poor sleep quality, but women showed a higher proportion (79%) than men (60%); young women were more likely to be affected by social isolation. Concerning anxiety and depression, both sexes reported high similar symptoms. These data suggest that stressful conditions related to social isolation and the economic uncertainty caused by the pandemic may induce mental health disturbances, which may become worse with sleep restriction.


Asunto(s)
Coronavirus , Ansiedad/epidemiología , China/epidemiología , Depresión/epidemiología , Femenino , Humanos , Masculino , Salud Mental , México/epidemiología , Pandemias , Sueño , Aislamiento Social
3.
Isr Med Assoc J ; 23(3): 153-159, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33734627

RESUMEN

BACKGROUND: Immune cell counts in blood in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection may be useful prognostic biomarkers of disease severity, mortality, and response to treatment. OBJECTIVES: To analyze sub-populations of lymphocytes at hospital admission in survivors and deceased from severe pneumonia due to coronavirus disease-2019 (COVID-19). METHODS: We conducted a cross-sectional study of healthcare workers confirmed with SARS-CoV-2 in convalescents (control group) and healthy controls (HC) diagnosed with severe COVID-19. Serum samples were taken at hospital admission and after recovery. Serum samples ≥ 25 days after onset of symptoms were analyzed for lymphocyte subpopulations through flow cytometry. Descriptive statistics, Kruskall-Wallis test, receiver operating characteristic curve, calculation of sensitivity, specificity, predictive values, and Kaplan-Meier analysis were performed. RESULTS: We included 337 patients: 120 HC, 127 convalescents, and 90 severe COVID-19 disease patients (50 survivors, 40 deceased). For T cells, total lymphocytes ≥ 800/µL, CD3+ ≥ 400/µL, CD4+ ≥ 180/µL, CD8+ ≥ 150/µL, B cells CD19+ ≥ 80/µL, and NK ≥ 34/µL subsets were associated with survival in severe COVID-19 disease patients. All subtypes of lymphocytes had higher concentrations in survivors than deceased, but similar between HC and convalescents. Leukocytes ≥ 10.150/µL or neutrophils ≥ 10,000/µL were associated with increased mortality. The neutrophil-to-lymphocyte ratio (NLR) ≥ 8.5 increased the probability of death in severe COVID-19 (odds ratio 11.68). CONCLUSIONS: Total lymphocytes; NLR; and levels of CD3+, CD4+, CD8+, and NK cells are useful as biomarkers of survival or mortality in severe COVID-19 disease and commonly reach normal levels in convalescents.


Asunto(s)
Linfocitos T CD4-Positivos/patología , Linfocitos T CD8-positivos/patología , Linfopenia , Neutrófilos/patología , Biomarcadores/sangre , /diagnóstico , /terapia , Correlación de Datos , Estudios Transversales , Femenino , Humanos , Estimación de Kaplan-Meier , Células Asesinas Naturales/patología , Recuento de Leucocitos/métodos , Linfopenia/sangre , Linfopenia/diagnóstico , Linfopenia/etiología , Masculino , México/epidemiología , Persona de Mediana Edad , Mortalidad , Valor Predictivo de las Pruebas , Evaluación de Síntomas/métodos
4.
BMJ Open ; 11(3): e042934, 2021 03 10.
Artículo en Inglés | MEDLINE | ID: mdl-33692179

RESUMEN

OBJECTIVES: Following well-established practices in demography, this article discusses several measures based on the number of COVID-19 deaths to facilitate comparisons over time and across populations. SETTINGS: National populations in 186 United Nations countries and territories and populations in first-level subnational administrative entities in Brazil, China, Italy, Mexico, Peru, Spain and the USA. PARTICIPANTS: None (death statistics only). PRIMARY AND SECONDARY OUTCOME MEASURES: An unstandardised occurrence/exposure rate comparable to the Crude Death Rate; an indirectly age-and-sex standardised rate that can be derived even when the breakdown of COVID-19 deaths by age and sex required for direct standardisation is unavailable; the reduction in life expectancy at birth corresponding to the 2020 number of COVID-19 deaths. RESULTS: To date, the highest unstandardised rate has been in New York, at its peak exceeding the state 2017 crude death rate. Populations compare differently after standardisation: while parts of Italy, Spain and the USA have the highest unstandardised rates, parts of Mexico and Peru have the highest standardised rates. For several populations with the necessary data by age and sex for direct standardisation, we show that direct and indirect standardisation yield similar results. US life expectancy is estimated to have declined this year by more than a year (-1.26 years), far more than during the worst year of the HIV epidemic, or the worst 3 years of the opioid crisis, and to reach its lowest level since 2008. Substantially larger reductions, exceeding 2 years, are estimated for Panama, Peru, and parts of Italy, Spain, the USA and especially, Mexico. CONCLUSIONS: With lesser demand on data than direct standardisation, indirect standardisation is a valid alternative to adjust international comparisons for differences in population distribution by sex and age-groups. A number of populations have experienced reductions in 2020 life expectancies that are substantial by recent historical standards.


Asunto(s)
/mortalidad , Brasil/epidemiología , China/epidemiología , Humanos , Italia/epidemiología , México/epidemiología , New York/epidemiología , Panamá/epidemiología , Perú/epidemiología , España/epidemiología , Estados Unidos/epidemiología
5.
PLoS One ; 16(3): e0239168, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33690607

RESUMEN

INTRODUCTION: Across the world, the COVID-19 pandemic has disproportionately affected racial and ethnic minorities. How ethnicity affects Indigenous peoples in Mexico is unclear. The aim of this cross-sectional study was to determine the mortality associated with ethnicity, particularly of Indigenous peoples, in a large sample of patients with COVID-19 in Mexico. METHODS: We used open access data from the Mexican Ministry of Health, which includes data of all confirmed COVID-19 cases in the country. We used descriptive statistics to compare differences among different groups of patients. Logistic regression was used to calculate odds ratios while adjusting for confounders. RESULTS: From February 28 to August 3, 2020, a total of 416546 adult patients were diagnosed with COVID-19. Among these, 4178 were Indigenous peoples. Among all patients with COVID-19, whether hospitalized or not, a higher proportion of Indigenous peoples died compared to non-Indigenous people (16.5% vs 11.1%, respectively). Among hospitalized patients, a higher proportion of Indigenous peoples died (37.1%) compared to non-Indigenous peoples (36.3%). Deaths outside the hospital were also higher among Indigenous peoples (3.7% vs 1.7%). A higher proportion of Indigenous peoples died in both the private and public health care sectors. The adjusted odds ratio for COVID-19 mortality among Indigenous peoples with COVID-19 was 1.13 (95% confidence interval 1.03 to 1.24). The adjusted odds ratio for COVID-19 mortality among Indigenous peoples with COVID-19 was higher among those who received only ambulatory care (1.55, 95% confidence interval 1.24 to 1.92). DISCUSSION: In this large sample of patients with COVID-19, the findings suggest that Indigenous peoples in Mexico have a higher risk of death from COVID-19, especially outside the hospital. These findings suggest Indigenous peoples lack access to care more so than non-Indigenous people during the COVID-19 pandemic in Mexico.


Asunto(s)
/epidemiología , Disparidades en Atención de Salud/etnología , Adulto , Estudios Transversales , Grupos Étnicos/estadística & datos numéricos , Femenino , Disparidades en el Estado de Salud , Humanos , Pueblos Indígenas/estadística & datos numéricos , Masculino , México/epidemiología , Persona de Mediana Edad , Grupos Minoritarios/estadística & datos numéricos , Pandemias , Grupos de Población/estadística & datos numéricos , /patogenicidad
6.
Artículo en Inglés | MEDLINE | ID: mdl-33670181

RESUMEN

Background: on 7 January 2020, a new type of coronavirus was isolated, the Severe Acute Respiratory Syndrome Coronavirus2 (SARS-CoV-2), the organism causing the outbreak that has affected the lives of all humans and has modified the rules of coexistence around the world. In Mexico, from 3 January 2020 to 9 January 2021, there have been 1439, 569 confirmed cases of COVID-19 with 131,031 deaths. The World Health Organization reported that Mexico was ranked twelfth, in terms of confirmed cases of COVID-19 by country. Aim: the objective of this study was to determine what modifications dentists from the Mexican Republic have made to their dental practice during theCOVID-19 pandemic. Methods: the study was conducted based on a questionnaire to evaluate the dentists' response and knowledge on the modifications in their dental practice to combat the new coronavirus's cross-transmission. The questionnaire was piloted before it was distributed. The questionnaire was disseminated through the social network Facebook. The questionnaire was distributed to groups of dentists on Facebook, in each of the Mexican Republic states. The survey was carried out during June 2020. Results and Conclusions: from the 32 states of the Mexican Republic, 29 participated with at least one respondent. The results of the applied survey suggest that dentists, at least the population of surveyed ones, have proper knowledge of detection methods of patients suspected of COVID-19, preventive measures that must be applied in the dental office to decrease the risk of infection, and the appropriate procedures and solutions for dental office disinfection.


Asunto(s)
/diagnóstico , Odontólogos , Conocimientos, Actitudes y Práctica en Salud , Control de Infecciones , Estudios Transversales , Femenino , Humanos , Masculino , México/epidemiología , Competencia Profesional , Encuestas y Cuestionarios
7.
Artículo en Inglés | MEDLINE | ID: mdl-33670888

RESUMEN

Background. The doubling time is the best indicator of the course of the current COVID-19 pandemic. The aim of the present investigation was to determine the impact of policies and several sociodemographic factors on the COVID-19 doubling time in Mexico. Methods. A retrospective longitudinal study was carried out across March-August, 2020. Policies issued by each of the 32 Mexican states during each week of this period were classified according to the University of Oxford Coronavirus Government Response Tracker (OxCGRT), and the doubling time of COVID-19 cases was calculated. Additionally, variables such as population size and density, poverty and mobility were included. A panel data model was applied to measure the effect of these variables on doubling time. Results. States with larger population sizes issued a larger number of policies. Delay in the issuance of policies was associated with accelerated propagation. The policy index (coefficient 0.60, p < 0.01) and the income per capita (coefficient 3.36, p < 0.01) had a positive effect on doubling time; by contrast, the population density (coefficient -0.012, p < 0.05), the mobility in parks (coefficient -1.10, p < 0.01) and the residential mobility (coefficient -4.14, p < 0.01) had a negative effect. Conclusions. Health policies had an effect on slowing the pandemic's propagation, but population density and mobility played a fundamental role. Therefore, it is necessary to implement policies that consider these variables.


Asunto(s)
/epidemiología , Política de Salud , Pandemias , Factores Socioeconómicos , /transmisión , Humanos , Estudios Longitudinales , México/epidemiología , Densidad de Población , Estudios Retrospectivos
8.
J Parasitol ; 107(1): 29-38, 2021 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-33535232

RESUMEN

This study was carried out to identify the ectoparasites that infest owned dogs in the state of Tabasco, Mexico. In total, 1,302 dogs were sampled in the 5 ecological regions of Tabasco. The dog owners were surveyed to identify the factors associated with infestations. Ectoparasites were identified using taxonomic keys. Eleven species of ectoparasites were observed. General prevalence was 26.65%. Rhipicephalus sanguineus and Ctenocephalides felis were the most prevalent and abundant ectoparasites. The most important factors associated with ectoparasite infestations in the studied dogs were living outdoors, being a non-purebred, having short hair, being dark-haired, and having a body condition <3. Ectoparasite studies such as the one presented herein generate important information to create control programs focused on decreasing infestations in companion animals and thus the likelihood of zoonotic transmission of pathogens.


Asunto(s)
Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/parasitología , Perros/clasificación , Infestaciones Ectoparasitarias/veterinaria , Animales , Animales Domésticos , Enfermedades de los Perros/transmisión , Infestaciones Ectoparasitarias/epidemiología , Infestaciones Ectoparasitarias/parasitología , Infestaciones Ectoparasitarias/transmisión , Femenino , Masculino , México/epidemiología , Propiedad , Phthiraptera/clasificación , Prevalencia , Siphonaptera/clasificación , Encuestas y Cuestionarios , Garrapatas/clasificación
9.
Artículo en Inglés | MEDLINE | ID: mdl-33573228

RESUMEN

Previous research connecting health-related quality of life (HRQoL) in people with traumatic brain injury (TBI) and caregiver mental health has primarily been conducted cross-sectionally in the U.S. and Western Europe. This study, therefore, examined how HRQoL in individuals immediately after their TBI predicts longitudinal caregiver depression symptom trajectories in Latin America. A sample of 109 patients with an acute TBI and 109 caregivers (total n = 218) was recruited from three hospitals in Mexico City, Mexico, and in Cali and Neiva, Colombia. TBI patients reported their HRQoL while they were still in hospital, and caregivers reported their depression symptoms at the same time and at 2 and 4 months later. Hierarchal linear models (HLM) found that caregiver depression symptom scores decreased over time, and lower patient mental health and pain-related quality of life at baseline (higher pain) predicted higher overall caregiver depression symptom trajectories across the three time points. These findings suggest that in Latin America, there is an identifiable relationship between psychological and pain-related symptoms after TBI and caregiver depression symptom outcomes. The results highlight the importance of early detection of caregiver mental health needs based in part upon patient HRQoL and a culturally informed approach to rehabilitation services for Latin American TBI caregivers.


Asunto(s)
Lesiones Traumáticas del Encéfalo , Calidad de Vida , Cuidadores , Colombia/epidemiología , Depresión/epidemiología , Europa (Continente) , Humanos , América Latina/epidemiología , México/epidemiología
10.
BMC Infect Dis ; 21(1): 235, 2021 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-33639886

RESUMEN

BACKGROUND: This study aimed to determine the epidemiological, microbiological, and molecular characteristics of an outbreak of carbapenem-resistant Leclercia adecarboxylata in three hospitals associated with the unintended use of contaminated total parental nutrition (TPN). METHODS: For 10 days, 25 patients who received intravenous TPN from the same batch of a formula developed sepsis and had blood cultures positive for L. adecarboxylata. Antimicrobial susceptibility and carbapenemase production were performed in 31 isolates, including one from an unopened bottle of TPN. Carbapenemase-encoding genes, extended-spectrum ß-lactamase-encoding genes were screened by PCR, and plasmid profiles were determined. Horizontal transfer of carbapenem resistance was performed by solid mating. Clonal diversity was performed by pulsed-field gel electrophoresis. The resistome was explored by whole-genome sequencing on two selected strains, and comparative genomics was performed using Roary. RESULTS: All 31 isolates were resistant to aztreonam, cephalosporins, carbapenems, trimethoprim/sulfamethoxazole, and susceptible to gentamicin, tetracycline, and colistin. Lower susceptibility to levofloxacin (51.6%) and ciprofloxacin (22.6%) was observed. All the isolates were carbapenemase producers and positive for blaNDM-1, blaTEM-1B, and blaSHV-12 genes. One main lineage was detected (clone A, 83.9%; A1, 12.9%; A2, 3.2%). The blaNDM-1 gene is embedded in a Tn125-like element. Genome analysis showed genes encoding resistance for aminoglycosides, quinolones, trimethoprim, colistin, phenicols, and sulphonamides and the presence of IncFII (Yp), IncHI2, and IncHI2A incompatibility groups. Comparative genomics showed a major phylogenetic relationship among L. adecarboxylata I1 and USDA-ARS-USMARC-60222 genomes, followed by our two selected strains. CONCLUSION: We present epidemiological, microbiological, and molecular evidence of an outbreak of carbapenem-resistant L. adecarboxylata in three hospitals in western Mexico associated with the use of contaminated TPN.


Asunto(s)
Brotes de Enfermedades , Infecciones por Enterobacteriaceae/etiología , Enterobacteriaceae/metabolismo , Nutrición Parenteral Total/efectos adversos , beta-Lactamasas/metabolismo , Antibacterianos/farmacología , Bacteriemia/epidemiología , Bacteriemia/etiología , Bacteriemia/microbiología , Enterobacteriaceae Resistentes a los Carbapenémicos/efectos de los fármacos , Enterobacteriaceae Resistentes a los Carbapenémicos/genética , Enterobacteriaceae Resistentes a los Carbapenémicos/aislamiento & purificación , Enterobacteriaceae Resistentes a los Carbapenémicos/metabolismo , Niño , Enterobacteriaceae/efectos de los fármacos , Enterobacteriaceae/genética , Enterobacteriaceae/aislamiento & purificación , Infecciones por Enterobacteriaceae/epidemiología , Infecciones por Enterobacteriaceae/microbiología , Genoma Bacteriano/genética , Hospitales , Humanos , México/epidemiología , Pruebas de Sensibilidad Microbiana , Tipificación de Secuencias Multilocus , Filogenia , beta-Lactamasas/genética
11.
Public Health ; 191: 68-77, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33540186

RESUMEN

OBJECTIVES: The goal of care at the end-of-life has changed in recent years to encompass not only the relief of suffering but also improve the quality of death. Palliative care offers a coordinated and multidisciplinary approach to improving the quality of life and quality of care of individuals and their families facing illness at the end-of-life. This manuscript examines the end-of-life of older adults in Mexico and the factors associated with pain in this period of their life. STUDY DESIGN: We used data from the Mexican Health and Aging Study (MHAS), a longitudinal panel study of adults 50 years and older in Mexico that is nationally representative of urban and rural areas and includes a next-of-kin questionnaire that captures the conditions during the last year of life of those who died. We used all four waves of data to construct a group of deceased individuals between 2001 and 2015, including information in the wave immediately before death and a complete next-of-kin questionnaire. We studied factors associated with pain at the end-of-life in this group. METHODS: The dependent variable was pain reported over time among deceased individuals. We constructed pain categories based on whether the pain was reported in one or two waves (occasional and persistent), and the pain intensity reported (mild, moderate, or severe). We included independent variables previously reported to be related to pain, including sociodemographic, functional, and health characteristics. We used descriptive statistics and a multinomial regression model to examine the factors associated with pain in this group. RESULTS: Pain was reported by 71.5% of older adults who died between 2001 and 2015. The prevalence of pain differed significantly by sociodemographic characteristics. Women had 1.69 higher odds of reporting severe pain than men. Compared to those with zero years of education, the odds of reporting severe pain were 0.72 for those with 1-6 years of education (P < 0.05) and 0.55 for those with more than 7 years (P < 0.001). Poor self-reported health, arthritis, taking more medications, depression, and functional limitations in the wave prior to death were associated with higher odds of persistent pain at the end-of-life (P < 0.05). Conversely, older age, more years of education, and diabetes were associated with lower odds of persistent pain (P < 0.001). CONCLUSIONS: The prevalence of pain among older Mexican adults is high at the end-of-life. Sociodemographic factors, some chronic diseases, number of medications, psychosocial factors, and functional status impact the odds of reporting pain in this group at the end-of-life. Providing education to families on psychosocial interventions to improve the quality of care at the end-of-life is a pressing need in Mexico. These findings provide information to help policymakers and healthcare providers in Mexico improve the quality of care at the end-of-life.


Asunto(s)
Envejecimiento , Muerte , Dolor/epidemiología , Calidad de Vida/psicología , Anciano , Enfermedad Crónica , Femenino , Humanos , Estudios Longitudinales , Masculino , México/epidemiología , Persona de Mediana Edad , Dolor/psicología , Prevalencia , Autoinforme
12.
Nutr. hosp ; 38(1): 67-72, ene.-feb. 2021. tab
Artículo en Inglés | IBECS | ID: ibc-198842

RESUMEN

INTRODUCTION: obesity often leads to deregulation and disrupting of the function of adipokines, which leads to various altered conditions, including metabolic syndrome (MetS). Adiponectin is one of the main adipokines secreted by adipocytes. The ADIPQ gene polymorphism rs266729 (-11377 C>G) is significantly associated with metabolic alterations related to obesity in different populations. Mexico has a high prevalence of obesity and risk factors associated with MetS. We investigated the association of the ADIPQ gene polymorphism rs266729 (-11377 C>G) with MetS in a Mexican population of western Mexico. METHODS: a total of 101 MetS patients and 70 unrelated healthy subjects were genotyped for ADIPQ polymorphism rs266729 using the restriction fragment length polymorphism method. RESULTS: we found a higher frequency of the minor allele G in MetS patients, as compared to that observed in the control group (OR = 2.17; 95 % CI, 1.26-3.70; p = 0.003). Also, the GG genotype was significantly associated with MetS risk under codominant (OR = 4.0; 95 % CI, 1.32-11.71; p = 0.014), dominant (OR = 2.16; 95 % CI, 1.12-4.03; p = 0.018), and recessive (OR = 3.33; 95 % CI, 1.14-9.45; p = 0.033) genetic models. CONCLUSION: our findings suggest that the minor allele G in the ADIPQ gene polymorphism rs266729 constitutes a risk factor for the development of MetS in a Mexican population of western Mexico


INTRODUCCIÓN: la obesidad frecuentemente tiene como consecuencia una desregulación y disrupción de la función de las adipocinas, que dan lugar a varias alteraciones, incluyendo el síndrome metabólico (SM). La adiponectina es una de las principales adipocinas secretadas por los adipocitos. El polimorfismo rs266729 (-11377 C>G) del gen ADIPOQ se ha asociado significativamente con alteraciones metabólicas relacionadas con la obesidad en diferentes poblaciones. México tiene una alta prevalencia de obesidad y de factores de riesgo asociados al SM. En el presente estudio investigamos la asociación del polimorfismo rs266729 (-11377 C>G) del gen ADIPOQ con el SM en una población mexicana del occidente de México. Metodos: a un total de 101 pacientes con SM y 70 sujetos sanos no relacionados se les identificó el polimorfismo rs266729 por el método de la PCR-RFLP. RESULTADOS: encontramos una mayor frecuencia del alelo menor G en los pacientes con SM, en comparación con la frecuencia observada en el grupo de control (OR = 2,17; IC 95 %: 1,26-3,70; p = 0,003). Asimismo, el genotipo GG se asoció significativamente con el SM bajo los modelos genéticos codominante (OR = 4,0; IC 95 %: 1,32-11,71; p = 0,014), dominante (OR = 2,16; IC 95 %: 1,12-4,03; p = 0,018) y recesivo (OR = 3,33; IC 95 %: 1,14-9,45; p = 0,033). CONCLUSIÓN: nuestros resultados sugieren que el alelo menor G del polimorfismo rs266729 (-11377 C>G) del gen ADIPOQ representa un factor de riesgo para el desarrollo de SM en la población mexicana del occidente de México


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Polimorfismo Genético , Síndrome Metabólico/epidemiología , Síndrome Metabólico/genética , Obesidad/epidemiología , Protocolos Clínicos , Adipoquinas/sangre , Adiponectina/sangre , México/epidemiología , Adipoquinas/análisis , Adipoquinas/genética , Adiponectina/genética , Estudios Transversales , Antropometría
13.
Allergol. immunopatol ; 49(1): 1-10, ene.-feb. 2021. tab, graf
Artículo en Inglés | IBECS | ID: ibc-199219

RESUMEN

BACKGROUND: The Global Asthma Network (GAN) builds on the International Study of Asthma and Allergies in Childhood (ISAAC). OBJECTIVE: To compare asthma prevalence time trends in primary and secondary school children in four Mexican centers participating in ISAAC and GAN. METHODS: GAN is a cross-sectional, multicenter, epidemiological methodology carried out in groups of primary school children aged 6-7 and adolescents aged 13-14 following the ISAAC Phase Three protocol, with additional questions on risk factors and asthma management. RESULTS: Overall, the prevalence of asthma symptoms and diagnosis in primary school children was higher in males than in females both in ISAAC (p < 0.05) and in GAN (p < 0.01), while adolescent females had a higher prevalence, also both in ISAAC (p < 0.001) and in GAN (p < 0.001). CONCLUSION: The prevalence of asthma and its symptoms has increased from ISAAC Phase Three since 2003 to GAN Phase I in Mexico in 2019. These findings are in line with the increases observed in the centers with low asthma baseline prevalence in ISAAC Phase One in comparison with ISAAC Phase Three


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Asma/epidemiología , Asma/diagnóstico , Hipersensibilidad/epidemiología , Monitoreo Epidemiológico , Cooperación Internacional , México/epidemiología , Estudios Transversales , Encuestas y Cuestionarios
15.
Sci Rep ; 11(1): 3354, 2021 02 08.
Artículo en Inglés | MEDLINE | ID: mdl-33558571

RESUMEN

The application, timing, and duration of lockdown strategies during a pandemic remain poorly quantified with regards to expected public health outcomes. Previous projection models have reached conflicting conclusions about the effect of complete lockdowns on COVID-19 outcomes. We developed a stochastic continuous-time Markov chain (CTMC) model with eight states including the environment (SEAMHQRD-V), and derived a formula for the basic reproduction number, R0, for that model. Applying the [Formula: see text] formula as a function in previously-published social contact matrices from 152 countries, we produced the distribution and four categories of possible [Formula: see text] for the 152 countries and chose one country from each quarter as a representative for four social contact categories (Canada, China, Mexico, and Niger). The model was then used to predict the effects of lockdown timing in those four categories through the representative countries. The analysis for the effect of a lockdown was performed without the influence of the other control measures, like social distancing and mask wearing, to quantify its absolute effect. Hypothetical lockdown timing was shown to be the critical parameter in ameliorating pandemic peak incidence. More importantly, we found that well-timed lockdowns can split the peak of hospitalizations into two smaller distant peaks while extending the overall pandemic duration. The timing of lockdowns reveals that a "tunneling" effect on incidence can be achieved to bypass the peak and prevent pandemic caseloads from exceeding hospital capacity.


Asunto(s)
/epidemiología , Modelos Estadísticos , Pandemias , Cuarentena/métodos , Adolescente , Adulto , Anciano , Número Básico de Reproducción , /virología , Canadá/epidemiología , Niño , Preescolar , China/epidemiología , Hospitalización , Humanos , Incidencia , Lactante , Recién Nacido , Cadenas de Markov , México/epidemiología , Persona de Mediana Edad , Niger/epidemiología , Salud Pública , Factores de Tiempo , Adulto Joven
17.
PLoS One ; 16(2): e0246595, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33556150

RESUMEN

INTRODUCTION: Some patients with COVID-19 pneumonia present systemic disease involving multiple systems. There is limited information about the clinical characteristics and events leading to acute kidney injury (AKI). We described the factors associated with the development of AKI and explored the relation of AKI and mortality in Mexican population with severe COVID-19. METHODS: We retrospectively reviewed the medical records of individuals with severe pneumonia caused by SARS-CoV-2 hospitalized at the largest third-level reference institution for COVID-19 care in Mexico between March and April 2020. Demographic information, comorbidities, clinical and laboratory data, dates of invasive mechanical ventilation (IMV) and hospitalization, mechanical-ventilator settings and use of vasoactive drugs were recorded. RESULTS: Of 99 patients studied, 58 developed AKI (58.6%). The risk factors for AKI were older age (OR = 1.07, 95% CI = 1.01-1.13, p = 0.024); obesity (OR = 6.58, 95% CI = 1.8-24.05, p = 0.040); and the need for IMV (OR = 6.18, CI = 1.29-29.58, p = 0.023). The risk factors for mortality were obesity (OR = 5.57, 95% CI = 1.48-20.93, p = 0.011); requirement of vasoactive drugs on admission (OR = 5.35, 95% CI = 1.16-24.61, p = 0.031); and AKI (OR = 8.61, 95% CI = 2.24-33.1, p = 0.002). In-hospital mortality was significantly higher in patients with AKI stage 3 (79.3%) and AKI stage 2 (68.7%) compared with those with AKI stage 1 (25%; p = 0.004). Fifty-three patients underwent the furosemide stress test (FST) to predict progression to AKI stage 3. Of those, 12 progressed to AKI stage 3 (22%). The ROC curve for the FST had an AUC of 0.681 (p = 0.009); a sensitivity of 81.6% and a specificity of 54.5%. CONCLUSIONS: AKI was common in our cohort of patients with severe pneumonia caused by SARS-CoV-2 infection. The risk factors for AKI were older age, obesity and the need for of IMV on admission. The risk factors for mortality were obesity, requirement of vasoactive drugs on admission and AKI. Mortality was more frequent in patients with AKI stages 2-3. The FST had an acceptable predictive capacity to identify patients progressing to AKI stage 3.


Asunto(s)
Lesión Renal Aguda/virología , /complicaciones , Lesión Renal Aguda/epidemiología , Lesión Renal Aguda/mortalidad , Biomarcadores/metabolismo , Femenino , Furosemida , Humanos , Inflamación/complicaciones , Estimación de Kaplan-Meier , Masculino , México/epidemiología , Persona de Mediana Edad , Curva ROC , Factores de Riesgo , /fisiología
18.
Sci Rep ; 11(1): 4327, 2021 02 22.
Artículo en Inglés | MEDLINE | ID: mdl-33619337

RESUMEN

COVID-19, the first pandemic of this decade and the second in less than 15 years, has harshly taught us that viral diseases do not recognize boundaries; however, they truly do discriminate between aggressive and mediocre containment responses. We present a simple epidemiological model that is amenable to implementation in Excel spreadsheets and sufficiently accurate to reproduce observed data on the evolution of the COVID-19 pandemics in different regions [i.e., New York City (NYC), South Korea, Mexico City]. We show that the model can be adapted to closely follow the evolution of COVID-19 in any large city by simply adjusting parameters related to demographic conditions and aggressiveness of the response from a society/government to epidemics. Moreover, we show that this simple epidemiological simulator can be used to assess the efficacy of the response of a government/society to an outbreak. The simplicity and accuracy of this model will greatly contribute to democratizing the availability of knowledge in societies regarding the extent of an epidemic event and the efficacy of a governmental response.


Asunto(s)
/epidemiología , Brotes de Enfermedades/estadística & datos numéricos , Pandemias/estadística & datos numéricos , /patogenicidad , Epidemias/estadística & datos numéricos , Humanos , México/epidemiología , Ciudad de Nueva York/epidemiología , República de Corea/epidemiología
19.
Artículo en Inglés | MEDLINE | ID: mdl-33593750

RESUMEN

INTRODUCTION: Diabetes and hyperglycemia are risk factors for critical COVID-19 outcomes; however, the impact of pre-diabetes and previously unidentified cases of diabetes remains undefined. Here, we profiled hospitalized patients with undiagnosed type 2 diabetes and pre-diabetes to evaluate its impact on adverse COVID-19 outcomes. We also explored the role of de novo and intrahospital hyperglycemia in mediating critical COVID-19 outcomes. RESEARCH DESIGN AND METHODS: Prospective cohort of 317 hospitalized COVID-19 cases from a Mexico City reference center. Type 2 diabetes was defined as previous diagnosis or treatment with diabetes medication, undiagnosed diabetes and pre-diabetes using glycosylated hemoglobin (HbA1c) American Diabetes Association (ADA) criteria and de novo or intrahospital hyperglycemia as fasting plasma glucose (FPG) ≥140 mg/dL. Logistic and Cox proportional regression models were used to model risk for COVID-19 outcomes. RESULTS: Overall, 159 cases (50.2%) had type 2 diabetes and 125 had pre-diabetes (39.4%), while 31.4% of patients with type 2 diabetes were previously undiagnosed. Among 20.0% of pre-diabetes cases and 6.1% of normal-range HbA1c had de novo hyperglycemia. FPG was the better predictor for critical COVID-19 compared with HbA1c. Undiagnosed type 2 diabetes (OR: 5.76, 95% CI 1.46 to 27.11) and pre-diabetes (OR: 4.15, 95% CI 1.29 to 16.75) conferred increased risk of severe COVID-19. De novo/intrahospital hyperglycemia predicted critical COVID-19 outcomes independent of diabetes status. CONCLUSIONS: Undiagnosed type 2 diabetes, pre-diabetes and de novo hyperglycemia are risk factors for critical COVID-19. HbA1c must be measured early to adequately assess individual risk considering the large rates of undiagnosed type 2 diabetes in Mexico.


Asunto(s)
/mortalidad , Diabetes Mellitus Tipo 2/sangre , Estado Prediabético/sangre , Enfermedades no Diagnosticadas/complicaciones , Adulto , Glucemia/análisis , /diagnóstico , Estudios de Cohortes , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/mortalidad , Ayuno/sangre , Femenino , Hemoglobina A Glucada/análisis , Hospitalización/estadística & datos numéricos , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Estado Prediabético/epidemiología , Estado Prediabético/mortalidad , Estudios Prospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Enfermedades no Diagnosticadas/epidemiología
20.
Sci Rep ; 11(1): 4659, 2021 02 25.
Artículo en Inglés | MEDLINE | ID: mdl-33633229

RESUMEN

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a newly emerged coronavirus responsible for coronavirus disease 2019 (COVID-19); it become a pandemic since March 2020. To date, there have been described three lineages of SARS-CoV-2 circulating worldwide, two of them are found among Mexican population, within these, we observed three mutations of spike (S) protein located at amino acids H49Y, D614G, and T573I. To understand if these mutations could affect the structural behavior of S protein of SARS-CoV-2, as well as the binding with S protein inhibitors (cepharanthine, nelfinavir, and hydroxychloroquine), molecular dynamic simulations and molecular docking were employed. It was found that these punctual mutations affect considerably the structural behavior of the S protein compared to wild type, which also affect the binding of its inhibitors into their respective binding site. Thus, further experimental studies are needed to explore if these affectations have an impact on drug-S protein binding and its possible clinical effect.


Asunto(s)
/virología , Mutación Puntual , Glicoproteína de la Espiga del Coronavirus/genética , Secuencia de Aminoácidos , Descubrimiento de Drogas , Humanos , Ligandos , México/epidemiología , Simulación del Acoplamiento Molecular , Simulación de Dinámica Molecular , Conformación Proteica , Alineación de Secuencia , Glicoproteína de la Espiga del Coronavirus/química
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