[Epidemiological characteristics of workers with COVID-19 from the Instituto Mexicano del Seguro Social]. / Características epidemiológicas de trabajadores con COVID-19 del Instituto Mexicano del Seguro Social.

Background: ¿In December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused an outbreak of the respiratory disease called COVID-19, in Wuhan, China. At the end of February 2020, it was detected in Mexico the first case of COVID-19. With this disease, chronic degenerative diseases are decisive for comorbidity to continue increasing. Objective: To know the epidemiological characteristics and comorbidity in workers sick with COVID-19 from the Veracruz Norte Regional Deconcentrated Administrative Operation Body, from the Mexican Institute for Social Security (Instituto Mexicano del Seguro Social, IMSS). Material and methods: Descriptive, cross-sectional study, which included 228 COVID-19 patients, who were IMSS workers. Variables such as age, gender, as well as medical unit, contractual category, comorbidities, etc., were analyzed and were taken from April to June 2020 from the Online Notification System for Epidemiological Surveillance (SINOLAVE) database. It was used descriptive statistics, and Pearson's chi-squared, with a p < 0.05. Results: 228 patients were analyzed. The nursing staff was the one with the highest prevalence with 101 patients (44.3%). Comorbidities such as obesity in the foreground, with 27 patients (11.8%), and diabetes mellitus alone with 15 patients (6.6%), and as a group, along with arterial hypertension, obesity and being a chronic smoker in 22 patients (9.6%) were the most frequent. Conclusions: The nursing staff predominated; the prevalent comorbidities were obesity, diabetes mellitus and arterial hypertension.

Introducción: en diciembre de 2019, el coronavirus 2 causante del síndrome respiratorio agudo severo (SARS-CoV-2) provocó un brote en Wuhan, China, de la enfermedad respiratoria denominada COVID-19. A finales de febrero de 2020 se detectó en México el primer caso de COVID-19. Con esta enfermedad, las enfermedades crónicas degenerativas son determinantes para que la comorbilidad continúe en aumento. Objetivo: conocer las características epidemiológicas y la comorbilidad en trabajadores enfermos de COVID-19 del Órgano de Operación Administrativa Desconcentrada Estatal Veracruz Norte, del Instituto Mexicano del Seguro Social (IMSS). Material y métodos: estudio descriptivo y transversal que incluyó a 228 pacientes de COVID-19, trabajadores del IMSS. Se analizaron variables como edad, género, así como unidad médica, categoría contractual, comorbilidades, etcétera, las cuales se tomaron de abril a junio de 2020 de la base del Sistema de Notificación en Línea para la Vigilancia Epidemiológica (SINOLAVE). Se empleó estadística descriptiva y chi cuadrada de Pearson, con una p < 0.05. Resultados: se analizaron 228 pacientes. El personal de enfermería fue el de mayor prevalencia, con 101 pacientes (44.3%). Las comorbilidades más frecuentes fueron la obesidad en primer plano, con 27 pacientes (11.8%), y la diabetes mellitus por sí sola con 15 (6.6%), y en conjunto, con hipertensión arterial, obesidad y ser fumador crónico se presentaron en 22 pacientes (9.6 %). Conclusiones: predominó el personal de enfermería; las comorbilidades prevalentes fueron la obesidad, la diabetes mellitus y la hipertensión arterial.

Características epidemiológicas de trabajadores con COVID-19 del Instituto Mexicano del Seguro Social / Epidemiological characteristics of workers with COVID-19 from the Instituto Mexicano del Seguro Social

Introducción: en diciembre de 2019, el coronavirus 2 causante del síndrome respiratorio agudo severo (SARS-CoV-2) provocó un brote en Wuhan, China, de la enfermedad respiratoria denominada COVID-19. A finales de febrero de 2020 se detectó en México el primer caso de COVID-19. Con esta enfermedad, las enfermedades crónicas degenerativas son determinantes para que la comorbilidad continúe en aumento. Objetivo: conocer las características epidemiológicas y la comorbilidad en trabajadores enfermos de COVID-19 del Órgano de Operación Administrativa Desconcentrada Estatal Veracruz Norte, del Instituto Mexicano del Seguro Social (IMSS). Material y métodos: estudio descriptivo y transversal que incluyó a 228 pacientes de COVID-19, trabajadores del IMSS. Se analizaron variables como edad, género, así como unidad médica, categoría contractual, comorbilidades, etcétera, las cuales se tomaron de abril a junio de 2020 de la base del Sistema de Notificación en Línea para la Vigilancia Epidemiológica (SINOLAVE). Se empleó estadística descriptiva y chi cuadrada de Pearson, con una p < 0.05. Resultados: se analizaron 228 pacientes. El personal de enfermería fue el de mayor prevalencia, con 101 pacientes (44.3%). Las comorbilidades más frecuentes fueron la obesidad en primer plano, con 27 pacientes (11.8%), y la diabetes mellitus por sí sola con 15 (6.6%), y en conjunto, con hipertensión arterial, obesidad y ser fumador crónico se presentaron en 22 pacientes (9.6 %). Conclusiones: predominó el personal de enfermería; las comorbilidades prevalentes fueron la obesidad, la diabetes mellitus y la hipertensión arterial

Background: In December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused an outbreak of the respiratory disease called COVID-19, in Wuhan, China. At the end of February 2020, it was detected in Mexico the first case of COVID-19. With this disease, chronic degenerative diseases are decisive for comorbidity to continue increasing. Objective: To know the epidemiological characteristics and comorbidity in workers sick with COVID-19 from the Veracruz Norte Regional Deconcentrated Administrative Operation Body, from the Mexican Institute for Social Security (Instituto Mexicano del Seguro Social, IMSS). Material and methods: Descriptive, cross-sectional study, which included 228 COVID-19 patients, who were IMSS workers. Variables such as age, gender, as well as medical unit, contractual category, comorbidities, etc., were analyzed and were taken from April to June 2020 from the Online Notification System for Epidemiological Surveillance (SINOLAVE) database. It was used descriptive statistics, and Pearson's chi-squared, with a p < 0.05. Results: 228 patients were analyzed. The nursing staff was the one with the highest prevalence with 101 patients (44.3%). Comorbidities such as obesity in the foreground, with 27 patients (11.8%), and diabetes mellitus alone with 15 patients (6.6%), and as a group, along with arterial hypertension, obesity and being a chronic smoker in 22 patients (9.6%) were the most frequent. Conclusions: The nursing staff predominated; the prevalent comorbidities were obesity, diabetes mellitus and arterial hypertension

Association of Genetic Polymorphisms in TLR3, TLR4, TLR7, and TLR8 with the Clinical Forms of Dengue in Patients from Veracruz, Mexico.

Dengue manifestations range from a mild form, dengue fever (DF), to more severe forms such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). The ability of the host to present one of these clinical forms could be related to polymorphisms located in genes of the Toll-like receptors (TLRs) which activate the pro-inflammatory response. Therefore, the genotyping of single nucleotide genetic polymorphisms (SNPs) in TLR3 (rs3775291 and rs6552950), TLR4 (rs2737190, rs10759932, rs4986790, rs4986791, rs11536865, and rs10983755), TLR7 (rs179008 and rs3853839), and TLR8 (rs3764880, rs5741883, rs4830805, and rs1548731) was carried out in non-genetically related DHF patients, DF patients, and general population (GP) subjects. The SNPs were analyzed by real-time PCR by genotyping assays from Applied Biosystems®. The codominance model showed that dengue patients had a lower probability of presenting the TLR4-rs2737190-G/G genotype (odds ratio (OR) (95% CI) = 0.34 (0.14-0.8), p = 0.038). Dengue patients showed a lower probability of presenting TLR4-rs11536865-G/C genotype (OR (95% CI) = 0.19 (0.05-0.73), p = 0.0092) and had a high probability of presenting the TACG haplotype, but lower probability of presenting the TGCG haplotype in the TLR4 compared to GP individuals (OR (95% CI) = 0.55 (0.35-0.86), p = 0.0084). In conclusion, the TLR4-rs2737190-G/G and TLR4-rs11536865-G/C genotypes and TGCG haplotype were associated with protection from dengue.

Indices of anti-dengue immunoglobulin G subclasses in adult Mexican patients with febrile and hemorrhagic dengue in the acute phase.

Heterologous secondary infections are at increased risk of developing dengue hemorrhagic fever (DHF) because of antibody-dependent enhancement (ADE). IgG subclasses can fix and activate complement and bind to Fcɣ receptors. These factors may also play an important role in the development of ADE and thus in the pathogenesis of DHF. The aim of this study was to analyze the indices of anti-dengue IgG subclasses in adult patients with febrile and hemorrhagic dengue in the acute phase. In 2013, 129 patients with dengue fever (DF) and 57 with DHF in Veracruz, Mexico were recruited for this study and anti-dengue IgM and IgG determined by capture ELISA. Anti-dengue IgG subclasses were detected by indirect ELISA. Anti-dengue IgG2 and IgG3 subclasses were detected in patients with dengue. IgG1 increased significantly in the sera of patients with both primary and secondary infections and DHF, but was higher in patients with secondary infections. The IgG4 subclass index was significantly higher in the sera of patients with DHF than in that of those with DF, who were in the early and late acute phase of both primary and secondary infection. In conclusion, indices of subclasses IgG1 and IgG4 were higher in patients with DHF.

Health care utilization of mexican patients with medically unexplained physical symptoms.

OBJECTIVE: To determine the prevalence of medically unexplained physical symptoms and the characteristics and use of health services in a group of patients with medically unexplained physical symptoms and a group of patients with other illnesses. METHODS: This was a cross-sectional, retrospective and multicenter study. We included 1,043 patients over 18 years of age from 30 primary care units of a government health institution, in 11 states of Mexico, attended by 39 family physicians. The prevalence of medically unexplained physical symptoms was determined and both groups with or without symptoms were compared with regard to drug use, laboratory and other studies, leaves of absence, and referrals in the last six months. The group with medically unexplained physical symptoms was diagnosed using the Patient Health Questionnaire and the diagnostic criteria of Reid et al. Emergency or terminal illnesses were excluded. The chi square test was used with a statistical significance of p < 0.05. RESULTS: Medically unexplained physical symptoms was diagnosed in 73 patients (7.0%). The majority were women (91.8%); their predominant symptom was from the gastrointestinal system in 56 (76.7%). This group had a greater use of clinical studies and referrals to other services (mean 1.1 vs. 0.5; p <0.0001 and 0.6 vs. 0.8; p < 0.01, respectively). CONCLUSIONS: The prevalence of medically unexplained physical symptoms was low, but with a greater impact on some health services. This could represent an overload in medical costs. OBJETIVO: Determinar la prevalencia de Síntomas Físicos Medicamente No Explicables y las características y uso de los servicios de salud entre el grupo de pacientes con Síntomas Físicos Medicamente No Explicables, y el grupo con otras enfermedades. MÉTODOS: Estudio transversal, retroprospectivo y multicéntrico. Se incluyeron a 1,043 pacientes mayores de 18 años, en 30 unidades de atención primaria de una institución gubernamental en salud, en 11 estados de la República Mexicana, atendidos por 39 médicos familiares. Se estimó la prevalencia de Síntomas Físicos Medicamente No Explicables y se compararon los dos grupos con y sin estos síntomas, en cuanto al uso de medicamentos, estudios de laboratorio, de gabinete, incapacidades y referencias en los últimos seis meses. El grupo de Síntomas Físicos Medicamente No Explicables fue diagnosticado por el Patient Health Questionnaire (son los síntomas físicos más comúnmente referidos por estos pacientes en el primer nivel de atención), además de criterios diagnósticos de Reid et al. Se excluyeron urgencias o con enfermedad terminal. Se utilizó prueba Chi cuadrada con p <0.05 para significancia estadística. RESULTADOS: El 7.0% (73) se diagnosticó como Síntomas Físicos Medicamente No Explicables, la mayoría mujeres (91.8%); el síntoma predominante pertenece al sistema gastrointestinal con 76.7% (56). Este grupo demandó mayor uso de estudios de gabinete y referencias a otros servicios (media 1.1 vs. 0.5; p <0.0001 y 0.8 vs 0.6; p <0.01, respectivamente). CONCLUSIONES: La prevalencia de Síntomas Físicos Medicamente No Explicables fue baja, pero con impacto significativo en el uso de algunos servicios de salud. Esto pudiera representar un mayor costo comparado con otro grupo de pacientes.

Health care utilization of mexican patients with medically unexplained physical symptoms / Uso de los servicios de salud de pacientes mexicanos con síntomas físicos medicamente inexplicables

Abstract Objective: To determine the prevalence of medically unexplained physical symptoms and the characteristics and use of health services in a group of patients with medically unexplained physical symptoms and a group of patients with other illnesses. Methods: This was a cross-sectional, retrospective and multicenter study. We included 1,043 patients over 18 years of age from 30 primary care units of a government health institution, in 11 states of Mexico, attended by 39 family physicians. The prevalence of medically unexplained physical symptoms was determined and both groups with or without symptoms were compared with regard to drug use, laboratory and other studies, leaves of absence, and referrals in the last six months. The group with medically unexplained physical symptoms was diagnosed using the Patient Health Questionnaire and the diagnostic criteria of Reid et al. Emergency or terminal illnesses were excluded. The chi square test was used with a statistical significance of p < 0.05. Results: Medically unexplained physical symptoms was diagnosed in 73 patients (7.0%). The majority were women (91.8%); their predominant symptom was from the gastrointestinal system in 56 (76.7%). This group had a greater use of clinical studies and referrals to other services (mean 1.1 vs. 0.5; p <0.0001 and 0.6 vs. 0.8; p < 0.01, respectively). Conclusions: The prevalence of medically unexplained physical symptoms was low, but with a greater impact on some health services. This could represent an overload in medical costs....au

Resumen Objetivo: Determinar la prevalencia de Síntomas Físicos Medicamente No Explicables y las características y uso de los servicios de salud entre el grupo de pacientes con Síntomas Físicos Medicamente No Explicables, y el grupo con otras enfermedades. Métodos: Estudio transversal, retroprospectivo y multicéntrico. Se incluyeron a 1,043 pacientes mayores de 18 años, en 30 unidades de atención primaria de una institución gubernamental en salud, en 11 estados de la República Mexicana, atendidos por 39 médicos familiares. Se estimó la prevalencia de Síntomas Físicos Medicamente No Explicables y se compararon los dos grupos con y sin estos síntomas, en cuanto al uso de medicamentos, estudios de laboratorio, de gabinete, incapacidades y referencias en los últimos seis meses. El grupo de Síntomas Físicos Medicamente No Explicables fue diagnosticado por el Patient Health Questionnaire (son los síntomas físicos más comúnmente referidos por estos pacientes en el primer nivel de atención), además de criterios diagnósticos de Reid et al. Se excluyeron urgencias o con enfermedad terminal. Se utilizó prueba Chi cuadrada con p <0.05 para significancia estadística. Resultados: El 7.0% (73) se diagnosticó como Síntomas Físicos Medicamente No Explicables, la mayoría mujeres (91.8%); el síntoma predominante pertenece al sistema gastrointestinal con 76.7% (56). Este grupo demandó mayor uso de estudios de gabinete y referencias a otros servicios (media 1.1 vs. 0.5; p <0.0001 y 0.8 vs 0.6; p <0.01, respectivamente). Conclusiones: La prevalencia de Síntomas Físicos Medicamente No Explicables fue baja, pero con impacto significativo en el uso de algunos servicios de salud. Esto pudiera representar un mayor costo comparado con otro grupo de pacientes...au