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Objetivo: Determinar los predictores de mortalidad, clínicos, bioquímicos y de imagen, en pacientes con COVID-19. Método: Cohorte retrospectiva que incluyó a mayores de 19 años, hospitalizados, con diagnóstico de COVID-19. Se consideraron como predictores de mortalidad: antecedentes clínicos, marcadores bioquímicos y de imagen al momento del ingreso hospitalario. Se calcularon la razón de momios (RM) y su intervalo de confianza del 95% (IC95%) a partir de modelos de regresión logística mútliple. Resultados: Se incluyeron 604 pacientes, con una media de edad de 58.9 años y un tiempo de evolución de 18 días, con una mortalidad del 37.3%. Los predictores de mortalidad fueron la edad > 50 años (RM: 1.9; IC95%: 1.1-2.3), la enfermedad renal crónica (ERC) (RM: 2.4; IC95%: 1.2-4.8), la obesidad (RM: 1.6; IC95%: 1.0-2.5), el índice neutrófilo/linfocito (N/L) > 12 (RM: 2.0; IC95%: 1.3-3.2), la proteína C reactiva (PCR) > 10 (RM: 4.2; IC95%: 2.4-7.1), la deshidrogenasa láctica (DHL) > 250 (RM: 3.4; IC95%: 1.6-7.3), las plaquetas < 150 (RM: 2.8; IC95%: 1.5-5.4) y el puntaje de tomografía computarizada (TC) > 16 (RM: 3.4; IC95%: 2.1-5.4). Conclusiones: La edad > 50 años, la presencia de ERC, la obesidad, el índice N/L, la PCR > 10, la DHL > 250, las plaquetas < 150 y el puntaje de TC > 16 puntos son predictores de mortalidad en pacientes con COVID-19.

Objective. Self-reported body silhouette is an anthropometric instrument that has been utilized as a screening tool for underweight, overweight, obesity, and other abnormal anthropometric variables. Herein, we analyzed the risk associated with the self-reported body silhouette in the scope of dyslipidemias, hyperglycemia, hyperuricemia, and hypertension. Methods. Adult participants of the Health Workers Cohort Study enrolled between March 2004 and April 2006 were included. Then, risk analysis was performed considering dyslipidemias as serum triglycerides, high total cholesterol, high LDL-C, low HDL-C, hyperglycemia, hyperuricemia, and hypertension. Results. A total of 2,297 males and 5,003 females were analyzed. The median ages of the studied population was 39 (30–49) and 41 (31–50) years for males and females, respectively. Overall, there is a stepwise increase in the risk of presenting dyslipidemias, hyperglycemia, hyperuricemia, and hypertension as the self-reported body silhouette number increases, this tendency was observed in both males and females. Conclusion. Self-reported body silhouette is a useful risk assessment tool for dyslipidemias, hyperglycemia, hyperuricemia, and hypertension in Mexican adults. Applications of questioners containing this silhouette might be considered a valuable public health instrument due to their low cost, relative simplicity, and absence of specialized equipment, training, or respondent knowledge.

Las emisiones de gases de efecto invernadero (GEI), son una preocupación latente para todos los países del mundo, por esto, muchos de los países forman parte de la creación de tratados, acuerdos y normas que permitan concientizar y plantearse objetivos por el bien común. Las estimaciones de los factores determinantes dirigido a las emisiones de CO2, se evidencia mediante la descomposición media logarítmica (LMDI) que permite conocer la variación de estas emisiones. El método antes mencionado presenta gran robustez para la estimación de este tipo de análisis, la descomposición de los factores de mix energético (Mix), índice de carbonización (Ic), intensidad energética (Ie), actividad económica (Act) y poblacional (P) aplicado a dos de los sectores más representativos del Ecuador (Transporte e Industrial) en cuanto al consumo de energía, evidencia que entre 2000 – 2020 las emisiones en el sector transporte han aumentado 5,56 Mt de CO2, mientras que en el sector industrial las emisiones muestran una reducción de 1,83 Mt de CO2. El estudio realizado evidencia que los factores determinantes en los sectores del transporte e industrial son el mix energético, índice de carbonización e intensidad energética. El análisis LMDI aplicado, nos permite describir las emisiones de CO2 mediante la descomposición desagregada de factores y la participación de combustibles de origen fósil de cada sector en estudio.

Background: Currently, there are a few studies on the clinical characteristics of the pediatric population with COVID-19 and pneumonia. This study aimed to analyze data associated with the development of pneumonia in children and adolescents with SARS-CoV-2 infection throughout Mexico. Methods: We conducted a secondary analysis of the database of the Dirección General de Epidemiología of the Mexican Government. We included children under the age of 19 who were confirmed with SARS-CoV-2 infection by reverse transcription-polymerase chain reaction (RT-PCR) test. The dependent variable was the diagnosis of pneumonia. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated. Multiple logistic regression models were performed to adjust factors associated with pneumonia. Results: A total of 1443 children with a COVID-19 diagnosis were included. The median age of the participants was 12 years (interquartile range 25, 75: 5, 16). Pneumonia occurred in 141 children (9.8%). The main risk factors were age < 3 years (OR, 3.5; 95%CI, 2.45-5.03); diabetes or obesity (OR, 12.6; 95%CI, 4.62-34.91); and immunocompromise (OR, 7.03; 95%CI, 3.97-13.61). Conclusions: Children < 3 years with COVID-19 and comorbidities, especially diabetes or obesity, and immunocompromised patients have a higher risk of developing pneumonia.

The ethical principles of a research proposal are not contained only in a paragraph or in the informed consent form; actually, they are an essential part of the whole protocol from the beginning to the end. In a complementary manner to the regulatory and educative documents, our objective in this article is to propose a checklist of questions so researches can ensure they have included the necessary information and precautions to meet the ethical considerations that are required for every research with human beings, which shall be called List of Ethical Principles for Medical Research Involving Human Subjects. We propose questions that researchers must ask themselves when they compose the background, justification, objectives, research question, hypothesis, selection criteria, sample size calculation, sampling, research design, statistical analysis plan, ethical aspects, publication plan, and references.

The concept of correlation entails having a couple of observations (X and Y), that is to say, the value that Y acquires for a determined value of X; the correlation makes it possible to examine the trend of two variables to be grouped together. We know that, with increasing age, blood pressure figures also increase, therefore, if we want to answer a research question like “what is the connection between age and blood pressure?” the relevant statistical test is a correlation test. This test makes it possible to quantify the magnitude of the correlation between two variables, but it is also helpful for predicting values. If these variables had a perfect correlation, the value of the variable Y could be deduced by knowing the value of X. Because of these advantages, the correlation is one of the most frequently used tests in the clinical setting since, in addition to measuring the direction and magnitude of the association of two variables, it is one of the foundations for prediction models, such as linear regression model, logistic regression model and Cox proportional hazards model.

Los gráficos constituyen una ayuda visual que usan los artículos para resaltar los resultados de una investigación. Estos permiten ilustrar los resultados con el fin de hacerlos más claros. Los gráficos, al igual que las pruebas estadísticas, se seleccionan a partir del objetivo del estudio, de los tipos de variable y de los análisis estadísticos que se desee ilustrar. Algunos de los gráficos más usados en la práctica clínica son los histogramas de frecuencia que ilustran las variables cualitativas o frecuencias, los gráficos de error se usan para variables cuantitativas con distribución normal, el gráfico de cajas o gráfico de violín para variables cuantitativas de libre distribución y las curvas de supervivencia para las variables que incluyen la variable tiempo/persona. Estos mismos gráficos pueden ser usados para ilustrar las comparaciones entre maniobras y desenlace dependiendo del tipo de variable que se analice. Cuando se comparan dos grupos y la variable dependiente es dicotómica se usan gráficos de bosque. Para los modelos multivariados los gráficos dependen del tipo de análisis, en el caso de la regresión logística se utilizan gráficos de árbol y para la regresión lineal de dispersión y para los riesgos proporcionales de Cox, gráficos de supervivencia. Si bien los gráficos son de gran utilidad, mal utilizados pueden mostrar diferencias donde no las hay, provocando una errónea interpretación de los estudios. En este artículo complementaremos con ejemplos los temas abordados con anterioridad en los artículos de esta misma serie.

Background: Although primary treatment of localized prostate cancer provides excellent oncologic control, some men who chose radiotherapy experience a recurrence of disease. There is no consensus on the most appropriate management of these patients after radiotherapy failure. In this single-institution review, we compare our oncologic outcome and toxicity between salvage prostatectomy and cryotherapy treatments. Methods: From January 2004 to June 2013, a total of 23 salvage procedures were performed. Six of those patients underwent salvage prostatectomy while 17 underwent salvage cryotherapy by two high-volume fellowship-trained urologists. Patients being considered for salvage therapy had localized disease at presentation, a prostate-specific antigen (PSA) 10 years at recurrence, and a negative metastatic workup. Patients were followed to observe cancer progression and toxicity of treatment. Results: Patients who underwent salvage cryotherapy were statistically older with a higher incidence of hypertension than our salvage prostatectomy cohort. With a mean follow up of 14.1 months and 7.2 months, the incidence of disease progression was 23.5% and 16.7% after salvage cryotherapy and prostatectomy, respectively. The overall complication rate was also 23.5% versus 16.7%, with the most frequent complication after salvage cryotherapy being urethral stricture and after salvage prostatectomy being severe urinary incontinence. There were no rectal injuries with salvage prostatectomy and one rectourethral fistula in the cohort after salvage cryotherapy. Conclusion: While recurrences from primary radiotherapy for prostate cancer do occur, there is no consensus on its management. In our experience, salvage procedures were generally safe and effective. Both salvage cryotherapy and salvage prostatectomy allow for adequate cancer control with minimal toxicity.

Introducción: Se sabe que la vitamina D (25(OH) D) tiene un efecto directo sobre la salud del hueso y músculo. Se ha relacionado también con enfermedades reumatológicas de origen autoinmune. Los estudios en niños con este tipo de enfermedades son escasos, sobre todo en artritis idiopática juvenil. El objetivo de este trabajo fue determinar las concentraciones de 25(OH) D en pacientes con lupus eritematoso sistémico (LES) y artritis idiopática juvenil (AIJ), y compararlas con las concentraciones en individuos sanos. Métodos: Se determinaron las concentraciones de 25(OH) D por medio de espectrometría de masas con cromatografía liquida por tándem (ID-LC-MS/MS), las concentraciones de la hormona paratiroidea por análisis inmunorradiométrico (IRMA), y las concentraciones de calcio, fósforo y fosfatasa alcalina por métodos colorimétricos en 37 pacientes con LES, 37 pacientes con AIJ y 79 controles sanos. Resultados: Las concentraciones séricas de 25(OH) D fueron de 18.9 ±7.92 ng/ml en LES, 21.97 ± 5.55 ng/ml en AIJ y 23.6 ± 3.07 ng/ml en controles sanos. Hubo una diferencia significativa al comparar las concentraciones de 25 (OH) D entre los pacientes con LES y los controles sanos (p

Introduction: Nutrition research has traditionally promoted a nutrient-based approach; however, to evaluate population compliance with dietary recommendations, researchers have increasingly used dietary pattern analysis. Objective: To assess the relationship between dietary patterns and vitamin D and calcium intake in an adult Mexican population. Methods: We characterized the dietary patterns of 8,456 men and women aged 20-80 years who were participating in the Health Workers Cohort Study. Information on participants' sociodemographic conditions and physical activity was collected via self-administered questionnaires. A food frequency questionnaire was used to assess diet. In a cross-sectional analysis, we examined dietary patterns in relation to vitamin D and calcium consumption. Results: Factor analysis revealed 3 major dietary patterns. Pattern 1, labeled as "prudent pattern", was characterized by high positive loads for the consumption of fresh vegetables, fresh fruits, whole grains, oils, and legumes. The second dietary pattern, named as "dairy and fish pattern", was positively correlated with intake of dairy foods, fish and other seafood, milk and whole grains. Finally, dietary pattern 3 was associated with higher intake of red meat, soft drinks, fats, eggs, white meat and alcoholic beverages. Of these, the "dairy and fish pattern" was positively and significantly associated with vitamin D and calcium consumption (r = 0.42, p < 0.001; and r = 0.20, p < 0.001 respectively). Conversely, the third dietary pattern was negatively associated with vitamin D and calcium intake (r = -0.28, p < 0.001; and r = -0.41, p < 0.001, respectively). Conclusions: In summary, our findings show that dietary patterns represented by high consumption of milk, dairy products, whole grains, fish are associated with higher consumption of vitamin D and calcium in Mexican adult population. Additionally, our results highlight the importance of following an appropriate dietary pattern to achieve adequate consumption of nutrients.