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1.
Artigo em Espanhol | LILACS | ID: biblio-1119089

RESUMO

La revisión teórica aborda la educación física virtual establecida en México a partir delconfinamiento social por COVID-19, basada en el problema, ya existente en México, de sedentarismo y obesidad infantil en niños de educación primaria, en quienes, derivado del confinamiento social, se estima un aumento de masa cor-poral, lo que conlleva mayores riesgos de salud. Al analizar la bibliografía reciente, que relaciona al COVID-19 con la educación física y la actividad física, se identificala oportunidad del profesorado de educación física, de conducir esquemas virtuales en los contenidos del programa educativo para, de esta manera, coadyuvar en la disminución del sedentarismo en estudiantes de primaria, teniendo como prioridad la alfabetización física.(AU)


The theoretical review addresses the virtual physical education established in Mexico based on social con-finement by COVID-19, based on the problem, already existing in Mexico, of sedentary lifestyle and childhood obesity in primary school children, in whom, derived from social confinement, an increase in body mass is estimated, which carries greater health risks. When analyzing the recent bibliography, which relates COVID-19 with physical education and physical activity, the opportunity for physical education teachers to conduct virtual schemes in the contents of the educational program is identified, in this way, to contribute to the decreasein sedentary lifestyle in primary school students, prioritizing physical literacy.(AU)


Assuntos
Humanos , Educação Física e Treinamento/métodos , Isolamento Social , Infecções por Coronavirus/epidemiologia , Educação a Distância/métodos , Ensino Fundamental e Médio , Comportamento Sedentário , México/epidemiologia
2.
Rev. bioét. derecho ; (50): 239-253, nov. 2020.
Artigo em Espanhol | IBECS | ID: ibc-191356

RESUMO

Las carencias sociales de México empeorarán por la pandemia SARS-COV2. A saber, el acceso a la salud, derechos laborales básicos, y la infructuosa respuesta del gobierno para erradicar la violencia machista contra las mujeres. El desinterés histórico para fomentar una cultura del apoyo mutuo y el autocuidado ha provocado que gran parte de la ciudadanía se haya desconectado de sus derechos sociales y sanitarios. Así, no se sigue una indicación -quédate en casa- por desigualdades estructurales. Propongo que la libertad efectiva puede conseguirse mediante la aprobación de la renta básica universal desde una perspectiva feminista. Concluyo que las secuelas de la pandemia, que definirán la vida cotidiana, ameritan la aprobación de esta medida. Igualmente, las mujeres como clase sexual requieren protección desde una perspectiva feminista


Many of the social deprivations of Mexico will be worsened due to SARS-COV2 pandemic. Namely, the insufficient access to public health, lack of labor rights, and the unsuccessful government's response to eradicate male violence against women. The historical unconcern in promoting a culture rooted in mutual aid and self-care has provoked many citizens are disconnected from their social and health rights. Thus, people's inability to carry through one direction -stay home- is unfulfilled, in part, due to structural inequalities. I affirm that effective liberty could be obtained by approving a Universal Basic Income from a feminist perspective. I conclude that the aftermath of COVID-19, which will define everyday life for a while, require the endorsement of such measure. Likewise, women as a class deserve protection from a feminist critical framework


Les mancances socials de Mèxic empitjoraran per la pandèmia SARS-COV-2. A saber, l'accés a la salut, els drets laborals bàsics I la infructuosa resposta de govern per eradicar la violència masclista contra les dones. El desinterès històric per fomentar una cultura de suport mutu I l'autocura ha provocat que gran part de la ciutadania s'hagi desconnectat dels seus drets socials I sanitaris. Així, no se segueix una indicació -queda't a casa- per desigualtats estructurals. Proposo que la llibertat efectiva pot aconseguir-se mitjançant l'aprovació de la renda bàsica universal des d'una perspectiva feminista. Concloc que les seqüeles de la pandèmia, que definiran la vida quotidiana, mereixen l'aprovació d'aquesta mesura. Igualment, les dones com a classe sexual requereixen protecció des d'una perspectiva feminista


Assuntos
Humanos , Masculino , Feminino , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Pandemias , Renda per Capita , Apoio Social , Incerteza , Política Pública , Política de Saúde , Fatores Socioeconômicos , México/epidemiologia
3.
PLoS One ; 15(10): e0240394, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33031467

RESUMO

BACKGROUND: The SARS-CoV-2 pandemic compounds Mexico's pre-existing challenges: very high levels of both non-communicable diseases (NCD) and social inequity. METHODS AND FINDINGS: Using data from national reporting of SARS-CoV-2 tested individuals, we estimated odds of hospitalization, intubation, and death based on pre-existing non-communicable diseases and socioeconomic indicators. We found that obesity, diabetes, and hypertension are positively associated with the three outcomes in a synergistic manner. The municipal poverty level is also positively associated with hospitalization and death. CONCLUSIONS: Mexico's response to COVID-19 is complicated by a synergistic double challenge: raging NCDs and extreme social inequity. The response to the current pandemic must take both into account both to be effective and to ensure that the burden of COVID-19 not falls disproportionately on those who are already disadvantaged.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Adulto , Fatores Etários , Betacoronavirus/fisiologia , Comorbidade , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Complicações do Diabetes , Diabetes Mellitus/fisiopatologia , Feminino , Hospitalização , Humanos , Hipertensão/fisiopatologia , Intubação , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Pandemias , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Pobreza , Fatores Sexuais , Fatores Socioeconômicos
4.
Artigo em Inglês | MEDLINE | ID: mdl-33053788

RESUMO

Early information on public health behaviors adopted to prevent the spread of coronavirus (COVID-19) may be useful in controlling the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) transmission. The objective of this study was to assess the role of income level (IL) and the perception of older adults, regarding COVID-19 susceptibility and severity, on adopting stay-at-home preventive behavior during the first week of the outbreak in Mexico. Participants in this cross-sectional study were urban community dwellers, aged ≥ 65 years from Mexico City. A total of 380 interviews were conducted over the phone. The mean respondent age was 72.9 years, and 76.1% were women. Over half (54.2%) of the participants perceived their susceptibility to COVID-19 as very low or low. Similarly, 33.4% perceived COVID-19 severity as being very low or low, and 57.6% had decided to stay at home: this behavior was associated with IL (ß = 1.05, p < 0.001), and its total effect was partially mediated (15.1%) by perceived severity. Educational attainment was also associated with staying at home (ß = 0.10, p = 0.018) and its total effect was partially mediated (15.0%) by perceived susceptibility. Interventions aimed at low income and less educated older adults should be developed to improve preventive behaviors in this vulnerable group during the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Renda/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Isolamento Social/psicologia , Idoso , Cidades/epidemiologia , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , México/epidemiologia , Pneumonia Viral/epidemiologia , Medição de Risco
5.
Medicine (Baltimore) ; 99(40): e22408, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019417

RESUMO

The epidemiology of lymphomas has changed since the use of antiretroviral therapy. The incidence of Non-Hodgkin Lymphomas (NHL) has significantly decreased in high income countries but not in low and middle-income countries where AIDS-related events remain high. This observational study describes the characteristics, infectious complications and main outcomes of patients diagnosed with HIV and lymphoma at the Instituto Nacional de Cancerología.All adults >18 years diagnosed with HIV and lymphoma from January 2010 to December 2017 were included. Information on HIV and lymphoma was collected, as well as the occurrence of co-infections at diagnosis and during therapy. Multiple regression was done with NHL patients to evaluate independent variables associated to death.One hundred fifty three patients were included: 127 patients with NHL (83%) and 26 (17%) with Hodgkin lymphoma (HL). Of the NHL, 49 (38%) were diffuse large B cell Lymphomas (DLBCL), 35 (27%) plasmablastic, 28 (23%) Burkitt, 10 (8%) primary DLBCL of Central Nervous system, 3 (2%) T-cell lymphomas, and 2 (2%) pleural effusion lymphoma. Most patients were diagnosed in an advanced stage: 70% of NHL had a high International Prognostic Index (IPI); 68% of patients had <200 cells/mm. Almost 25% of NHL patients had an opportunistic infection at lymphoma diagnosis. During chemotherapy, 60% of all patients presented with at least 1 serious non-opportunistic infectious complication, and 50% presented 2 or more infectious complications, mostly bacterial infections. Thirty six percent of NHL and 23% of HL died. After adjusting for confounders, the variables associated with death were IPI and lymphoma type.HIV positive patients with lymphoma in our institution are diagnosed with an advanced stage and a high burden of infections complications. Death remains high and the variables strongly associated with death are those related to lymphoma prognosis such as lymphoma type and IPI.


Assuntos
Infecções por HIV/epidemiologia , Doença de Hodgkin/epidemiologia , Doença de Hodgkin/patologia , Linfoma não Hodgkin/epidemiologia , Linfoma não Hodgkin/patologia , Infecções Oportunistas/epidemiologia , Adulto , Feminino , Infecções por HIV/patologia , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Infecções Oportunistas/microbiologia , Estudos Retrospectivos
7.
Cir Cir ; 88(5): 569-575, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33064694

RESUMO

Objective: To describe the clinical characteristics and management of severe COVID-19 patients. Method: Observational, descriptive, longitudinal, and retrospective study. Results: 56 patients were admitted, of whom 80.3% (n = 45) were males with a mean age of 58 years [46-67]. The main comorbidities were obesity, high blood pressure, and diabetes. Symptoms onset time at admittance to the ICU was 9 [7-14] days, of which the most frequent were dyspnea, fever, and dry cough. Laboratory data were lymphopenia; elevation of LDH, fibrinogen, D-dimer, ferritin and CRP. 100% of the patients required mechanical ventilation, the median mechanical ventilation time was 12 [6-17] days, and 66% (n= 37) required a prone position. The pharmacological treatment was mainly based on azithromycin, hydroxychloroquine, tocilizumab and steroids. The most frequent complications were acute kidney injury, venous thromboembolism and acute myocardial infarction. Mortality rate was 17.8% (n = 10). Conclusion: The characteristics of the critically ill patients in our hospital were mostly elderly and obese, with the variables of higher SOFA score and acute kidney injury associated with higher mortality.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Cuidados Críticos/métodos , Unidades de Terapia Intensiva , Pandemias , Pneumonia Viral/terapia , Lesão Renal Aguda/epidemiologia , Lesão Renal Aguda/etiologia , Corticosteroides/uso terapêutico , Idoso , Anticorpos Monoclonais Humanizados/uso terapêutico , Antivirais/uso terapêutico , Azitromicina/uso terapêutico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Terapia Combinada , Comorbidade , Infecções por Coronavirus/sangue , Infecções por Coronavirus/complicações , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Feminino , Mortalidade Hospitalar , Hospitais Universitários/organização & administração , Humanos , Hidroxicloroquina/uso terapêutico , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Escores de Disfunção Orgânica , Pneumonia Viral/sangue , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Respiração Artificial , Avaliação de Sintomas
9.
Ann Emerg Med ; 76(4): 413-426, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33012377

RESUMO

STUDY OBJECTIVE: Emergency medical services (EMS) may serve as a key source of real-time data about the evolving health of coronavirus disease 2019 (COVID-19)-affected populations, especially in low- and middle-income countries with less rapid and reliable vital statistics registration systems. Although official COVID-19 statistics in Mexico report almost exclusively inhospital mortality events, excess out-of-hospital mortality has been identified in other countries, including 1 EMS study in Italy that showed a 58% increase. Additionally, EMS and hospital reports from several countries have suggested that silent hypoxemia-low Spo2 in the absence of dyspnea-is associated with COVID-19. It is unclear, however, how these phenomena can be generalized to low- and middle-income countries. We assess how EMS data can be used in a sentinel capacity in Tijuana, a city on the Mexico-United States border with earlier exposure to COVID-19 than many low- and middle-income country settings. METHODS: In this observational study, we calculated numbers of weekly out-of-hospital deaths and respiratory cases handled by EMS in Tijuana, and estimated the difference between peak epidemic rates and expected trends based on data from 2014 to 2019. Results were compared with official COVID-19 statistics, stratified by neighborhood socioeconomic status, and examined for changing demographic or clinical features, including mean Spo2. RESULTS: An estimated 194.7 excess out-of-hospital deaths (95% confidence interval 135.5 to 253.9 deaths) occurred during the peak window (April 14 to May 11), representing an increase of 145% (95% CI 70% to 338%) compared with expected levels. During the same window, only 5 COVID-19-related out-of-hospital deaths were reported in official statistics. This corresponded with an increase in respiratory cases of 236.5% (95% CI 100.7% to 940.0%) and a decrease in mean Spo2 to 77.7% from 90.2% at baseline. The highest out-of-hospital death rates were observed in low-socioeconomic-status areas, although respiratory cases were more concentrated in high-socioeconomic-status areas. CONCLUSION: EMS systems may play an important sentinel role in monitoring excess out-of-hospital mortality and other trends during the COVID-19 crisis in low- and middle-income countries. Using EMS data, we observed increases in out-of-hospital deaths in Tijuana that were nearly 3-fold greater than increases reported in EMS data in Italy. Increased testing in out-of-hospital settings may be required to determine whether excess mortality is being driven by COVID-19 infection, health system saturation, or patient avoidance of health care. We also found evidence of worsening rates of hypoxemia among respiratory patients treated by EMS, suggesting a possible increase in silent hypoxemia, which should be met with increased detection and clinical management efforts. Finally, we observed social disparities in out-of-hospital death that warrant monitoring and amelioration.


Assuntos
Infecções por Coronavirus/complicações , Infecções por Coronavirus/mortalidade , Serviços Médicos de Emergência/estatística & dados numéricos , Hipóxia/virologia , Pneumonia Viral/complicações , Pneumonia Viral/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Criança , Pré-Escolar , Registros Eletrônicos de Saúde , Feminino , Humanos , Lactente , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Pandemias , Vigilância em Saúde Pública , Classe Social , Adulto Jovem
10.
Medicine (Baltimore) ; 99(40): e22442, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019428

RESUMO

Delivery methods during childbirth and their related gut microbiota profiles have important impacts on health later in life, they can contribute to the development of diseases such as obesity, whose highest prevalence rate is found among the Mexican child population. Coincidentally, Mexico has one of the highest global average annual rate increase in cesarean births (C-section). Since Mexico leads the world in childhood obesity, studying the relationship between childbirth delivery methods and gut microbiota profiles in this vulnerable population may be used to identify early risk factors for obesity in other developed and developing countries. The objective of this study is to determine the association between child delivery method and gut microbiota profiles in healthy Mexican newborns.Fecal samples of 57 term infants who participated in a randomized clinical trial in 2013 to study the safety of Agave fructans in newborns, were used in this study. DNA samples were extracted and used to characterize the microbiota composition using high-throughput 16S rRNA gene sequencing. The samples were further divided based on childbirth delivery method, as well as early diet. Gut microbiota profiles were determined and analyzed using cluster analysis followed by multiple correspondence analysis.An unusual high abundance of Proteobacteria was found in the gut microbiota of all Mexican infants studied, regardless of delivery method. Feces from infants born by C-section had low levels of Bacteroidetes, high levels of Firmicutes, especially Clostridium and Enterococcus, and a strikingly high ratio of Firmicutes/Bacteroidetes (F:B). Profiles enriched in Bacteroidetes and low F:B ratios, were strongly associated with vaginal delivery.The profile of gut microbiota associated with feces from Mexican infants born by C-section, may be added to the list of boosting factors for the worrying obesity epidemic in Mexico.


Assuntos
Cesárea/estatística & dados numéricos , Microbioma Gastrointestinal , Obesidade/epidemiologia , Cesárea/efeitos adversos , Fezes/microbiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , México/epidemiologia , Fatores de Risco
11.
Rev Alerg Mex ; 67(2): 199-201, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32892535
12.
Phys Biol ; 17(6): 065001, 2020 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-32959788

RESUMO

Epidemiological models usually contain a set of parameters that must be adjusted based on available observations. Once a model has been calibrated, it can be used as a forecasting tool to make predictions and to evaluate contingency plans. It is customary to employ only point estimators of model parameters for such predictions. However, some models may fit the same data reasonably well for a broad range of parameter values, and this flexibility means that predictions stemming from them will vary widely, depending on the particular values employed within the range that gives a good fit. When data are poor or incomplete, model uncertainty widens further. A way to circumvent this problem is to use Bayesian statistics to incorporate observations and use the full range of parameter estimates contained in the posterior distribution to adjust for uncertainties in model predictions. Specifically, given an epidemiological model and a probability distribution for observations, we use the posterior distribution of model parameters to generate all possible epidemic curves, whose information is encapsulated in posterior predictive distributions. From these, one can extract the worst-case scenario and study the impact of implementing contingency plans according to this assessment. We apply this approach to the evolution of COVID-19 in Mexico City and assess whether contingency plans are being successful and whether the epidemiological curve has flattened.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Epidemias , Pneumonia Viral/epidemiologia , Teorema de Bayes , Infecções por Coronavirus/mortalidade , Bases de Dados Factuais , Epidemias/estatística & dados numéricos , Humanos , Conceitos Matemáticos , México/epidemiologia , Modelos Biológicos , Modelos Estatísticos , Pandemias , Pneumonia Viral/mortalidade , Probabilidade , Fatores de Tempo , Incerteza
13.
BMC Infect Dis ; 20(1): 674, 2020 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-32938419

RESUMO

BACKGROUND: To identify factors predicting severe coronavirus disease 2019 (COVID-19) in adolescent and adult patients with laboratory-positive (quantitative reverse-transcription polymerase chain reaction) infection. METHOD: A retrospective cohort study took place, and data from 740 subjects, from all 32 states of Mexico, were analyzed. The association between the studied factors and severe (dyspnea requiring hospital admission) COVID-19 was evaluated through risk ratios (RRs) and 95% confidence intervals (CIs). RESULTS: Severe illness was documented in 28% of participants. In multiple analysis, male gender (RR = 1.13, 95% CI 1.06-1.20), advanced age ([reference: 15-29 years old] 30-44, RR = 1.02, 95% CI 0.94-1.11; 45-59, RR = 1.26, 95% CI 1.15-1.38; 60 years or older, RR = 1.44, 95% CI 1.29-1.60), chronic kidney disease (RR = 1.31, 95% CI 1.04-1.64) and thoracic pain (RR = 1.16, 95% CI 1.10-1.24) were associated with an increased risk of severe disease. CONCLUSIONS: To the best of our knowledge, this is the first study evaluating predictors of COVID-19 severity in a large subset of the Latin-American population. Male gender and kidney illness were independently associated with the risk of severe COVID-19. These results may be useful for health care protocols for the early detection and management of patients that may benefit from opportune and specialized supportive medical treatment.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Insuficiência Renal Crônica/complicações , Fatores Sexuais , Adolescente , Adulto , Idoso , Infecções por Coronavirus/complicações , Dispneia , Feminino , Hospitalização , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Reação em Cadeia da Polimerase , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
15.
Math Biosci Eng ; 17(4): 4165-4183, 2020 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-32987574

RESUMO

In this paper we develop a compartmental epidemic model to study the transmission dynamics of the COVID-19 epidemic outbreak, with Mexico as a practical example. In particular, we evaluate the theoretical impact of plausible control interventions such as home quarantine, social distancing, cautious behavior and other self-imposed measures. We also investigate the impact of environmental cleaning and disinfection, and government-imposed isolation of infected individuals. We use a Bayesian approach and officially published data to estimate some of the model parameters, including the basic reproduction number. Our findings suggest that social distancing and quarantine are the winning strategies to reduce the impact of the outbreak. Environmental cleaning can also be relevant, but its cost and effort required to bring the maximum of the outbreak under control indicate that its cost-efficacy is low.


Assuntos
Betacoronavirus , Infecções por Coronavirus/transmissão , Modelos Biológicos , Pandemias , Pneumonia Viral/transmissão , Número Básico de Reprodução/estatística & dados numéricos , Teorema de Bayes , Simulação por Computador , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Desinfecção/estatística & dados numéricos , Epidemias/prevenção & controle , Epidemias/estatística & dados numéricos , Humanos , Controle de Infecções/métodos , Controle de Infecções/estatística & dados numéricos , Conceitos Matemáticos , México/epidemiologia , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Isolamento de Pacientes/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Quarentena/estatística & dados numéricos
16.
Medicine (Baltimore) ; 99(36): e21622, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32898997

RESUMO

The objective of the study was to characterize self-reported oral hygiene practices among Mexican older adults aged ≥60 years, and to measure the association between frequency of tooth brushing and a set of sociodemographic, socioeconomic, and dental variables.We conducted a cross-sectional study of 139 older adults aged ≥60 years in Pachuca, Mexico. A questionnaire and a clinical dental examination were administered to identify specific variables. We determined frequency of tooth brushing (or cleaning of dentures or prostheses) and use of toothpaste, mouthwash, and dental floss among respondents. Non-parametric testing was performed for statistical analysis and a multivariate logistic regression model was generated with Stata 11 software to determine frequency of tooth brushing.In our study sample, 53.2% of participants reported brushing their teeth at least once a day, 50.4% always using toothpaste, 16.5% using mouthwash and 3.6% using floss for their oral hygiene. In general, younger and female respondents used oral hygiene aids more than the others. Our multivariate model yielded an association (P < .05) between tooth brushing at least once daily and the following variables: having functional dentition (OR = 12.60), lacking health insurance (OR = 3.72), being retired/pensioned (OR = 4.50), and suffering from a chronic disease (OR = 0.43).The older adults in our sample exhibited deficient oral hygiene behaviors. The results suggest certain socioeconomic inequalities in oral health. The findings of this study should be considered when designing dental care instructions for older adults.


Assuntos
Escovação Dentária/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Dispositivos para o Cuidado Bucal Domiciliar , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Antissépticos Bucais/administração & dosagem , Autorrelato , Fatores Socioeconômicos , Cremes Dentais/administração & dosagem
17.
J Prev Med Public Health ; 53(4): 211-219, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32752589

RESUMO

OBJECTIVES: The goal of this study was to identify chronic conditions and multimorbidity patterns in patients with coronavirus disease 2019 (COVID-19) and to examine their associations with pneumonia and death. METHODS: This cross-sectional study analyzed the official data of COVID-19 patients in Mexico through May 18, 2020 (released by the Secretaría de Salud de México). Adjusted logistic regression models were applied to assess the associations of comorbidities with pneumonia and death. The marginal effects were estimated, and the probability of pneumonia or death according to the number of comorbidities was graphed for each year of age. RESULTS: Of the 51 053 COVID-19 patients enrolled in the final analysis, 27 667 (54.2%) had no chronic conditions, while 13 652 (26.7%), 6518 (12.8%) and 3216 (6.3%) were reported to have 1, 2, and 3 or more simultaneous conditions, respectively. Overall, a significant incremental gradient was observed for the association between multimorbidity and pneumonia (p<0.001); for 2 chronic conditions, the adjusted odds ratio (aOR) was 2.07 (95% confidence interval [CI], 1.95 to 2.20), and for ≥3 conditions, the aOR was 2.40 (95% CI, 2.22 to 2.60). A significant incremental gradient was also found for the relationship between multimorbidity and death (p<0.001); an aOR of 2.51 (95% CI, 2.30 to 2.73) was found for 2 chronic conditions and an aOR of 3.49 (95% CI, 3.15 to 3.86) for ≥3 conditions. CONCLUSIONS: Underlying chronic conditions and multimorbidity are associated with pneumonia and death in Mexican COVID-19 patients. Future investigation is necessary to clarify the pathophysiological processes behind this association, given the high burden of chronic diseases in various countries, including Mexico.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia/epidemiologia , Doença Crônica , Comorbidade , Infecções por Coronavirus/mortalidade , Estudos Transversais , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Pandemias , Pneumonia/mortalidade , Pneumonia Viral/mortalidade , Fatores de Risco
18.
Womens Health (Lond) ; 16: 1745506520949416, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32811351

RESUMO

OBJECTIVE: To compare the sociodemographic, diagnostic, clinical, and treatment-related characteristics and outcomes of patients with breast cancer in two hospitals in Mexico according to type of healthcare coverage. METHODS: A retrospective cohort study of women with breast cancer according to public or private healthcare coverage in two hospitals was done. Patients were treated by the same group of physicians and healthcare infrastructure. Groups were compared using the chi-square test for categorical variables, Mann-Whitney U-test and Student's t-test for quantitative variables, and Kaplan-Meier estimator and log-rank test for time dependent outcomes (including recurrence-free and overall survival). A value of p < 0.05 was considered statistically significant. RESULTS: A total of 282 women were included. Mean age at diagnosis was 52 years. Women with public healthcare coverage were diagnosed more frequently with self-detected tumors (82.8% vs 47.9%, p < 0.001) and advanced clinical stage (III and IV) (31.1% vs 17.8%, p = 0.014). More women with public healthcare insurance underwent initial systemic treatment (41.1% vs 17.8%, p < 0.001) and mastectomy (70.1% vs 54.9%, p = 0.020), and received more chemotherapy (79.4% vs 43.8%, p < 0.001) and adjuvant radiotherapy (68.9% vs 53.4%, p = 0.017). Overall, no differences were found in survival outcomes according to healthcare coverage. Trends suggesting worse recurrence-free and overall survival were observed in patients with public coverage at 3 years follow-up in stage III (85.7% vs 67.3% and 100% vs 84.6%, respectively) and triple negative disease (83.3% vs 74.5% and 100% vs 74.1%, respectively). CONCLUSION: Strategies to promote preventive medicine, diagnostic mammograms, and prompt diagnosis of breast cancer in Mexican women with public health coverage are needed. Access to the main treatment modalities by Seguro Popular and good quality care by an experienced group of physicians likely explains the similar outcomes between patients with private and public healthcare coverage. However, trends suggesting worse survival for patients with public medical coverage with stage III and triple-negative disease should encourage close follow-up.


Assuntos
Neoplasias da Mama/epidemiologia , Cobertura do Seguro/estatística & dados numéricos , Adulto , Neoplasias da Mama/terapia , Quimioterapia Adjuvante/estatística & dados numéricos , Estudos de Coortes , Intervalo Livre de Doença , Feminino , Disparidades em Assistência à Saúde/estatística & dados numéricos , Hospitais , Humanos , Mastectomia/estatística & dados numéricos , México/epidemiologia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/epidemiologia , Radioterapia Adjuvante/estatística & dados numéricos , Estudos Retrospectivos , Fatores Socioeconômicos
19.
MEDICC Rev ; 22(3): 16-19, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32812894

RESUMO

Cristian Morales, an economist by training, has dedicated his career to improving health and health equity in the Americas through his work with PAHO/WHO. This has taken him from hurricanes, earthquakes and epidemics in Haiti to PAHO's Washington DC offi ces, where he was instrumental in achieving consensus on a resolution aiming for universal health-coverage plus access-approved by all governments in the Americas. In 2015, he was appointed PAHO/WHO Permanent Representative in Cuba, and in 2018 to the same post in Mexico.


Assuntos
Controle de Doenças Transmissíveis/economia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , América/epidemiologia , Betacoronavirus , Humanos , México/epidemiologia
20.
Eur Rev Med Pharmacol Sci ; 24(15): 8232-8238, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32767355

RESUMO

OBJECTIVE: The COVID-19 pandemic has caused a global public health crisis with social, psychological and long-lasting economical damages. Weather-related dynamics have an impact on the pattern of human health and disease. The present study aimed to investigate the impact of heat and humidity on daily basis incidence and mortality due to COVID-19 pandemic in ten of the world's hottest countries compared to ten of the coldest ones. MATERIALS AND METHODS: Worldwide, we selected 20 countries; 10 hottest countries with the highest temperatures and 10 coldest countries with the lowest temperature. The selection of the countries was based on the daily basis mean temperature from the date of appearance of the initial cases of COVID-19, Dec 29, 2019 to May 12, 2020. In the world's 10 hottest countries, the mean temperature was (26.31±1.51) and humidity (44.67±4.97). However, in the world's 10 coldest countries the mean temperature was (6.19±1.61) and humidity (57.26±2.35). The data on the global outbreak of COVID-19, daily new cases and deaths were recorded from World Health Organization, and daily information on temperature and humidity was obtained from metrological web "Time and Date". RESULTS: In countries with high temperatures and low humidity, the mean daily cases incidence were (407.12±24.33); cumulative cases (9094.34±708.29); and cumulative deaths (452.84±43.30) were significantly low compared to countries with low temperatures and high humidity: daily cases (1876.72±207.37); cumulative cases (44232.38±5875.11); and cumulative deaths (2008.29±310.13). Moreover, COVID-19 cases and deaths per million population were significantly low in countries with high temperatures (cases 711.23, and deaths 16.27) compared to countries with low temperatures (cases 1685.99; and deaths 86.40). Furthermore, in hottest countries, a 1% increase in humidity reduced number of cases and deaths by (ß = -5.40, p<0.001) and (ß = -0.187, p=0.004) respectively. A similar trend was seen with a 1°C increase in temperature, reducing the number of deaths by (ß = -1.35. p<0.001). CONCLUSIONS: The results revealed a significant decrease in incidence of daily cases and deaths in countries with high temperatures and low humidity (warmest countries), compared to those countries with low temperatures and high humidity (coldest countries). The findings could be of interest to the policymakers and the health officials on the epidemiological trends of COVID-19 pandemic and weather changes.


Assuntos
Clima , Infecções por Coronavirus/epidemiologia , Temperatura Alta , Umidade , Pneumonia Viral/epidemiologia , Argélia/epidemiologia , Áustria/epidemiologia , Betacoronavirus , Canadá/epidemiologia , Infecções por Coronavirus/mortalidade , Estônia/epidemiologia , Finlândia/epidemiologia , Gana/epidemiologia , Humanos , Incidência , Índia/epidemiologia , Irã (Geográfico)/epidemiologia , Cazaquistão/epidemiologia , Kuweit/epidemiologia , México/epidemiologia , Mortalidade , Noruega/epidemiologia , Omã/epidemiologia , Paquistão/epidemiologia , Pandemias , Pneumonia Viral/mortalidade , Análise de Regressão , República de Belarus/epidemiologia , Federação Russa/epidemiologia , Arábia Saudita/epidemiologia , Suécia/epidemiologia , Emirados Árabes Unidos/epidemiologia , Estados Unidos/epidemiologia
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