Clinical Characteristics and Risk Factors For Mortality During the \u27First Wave\u27 of COVID-19 In Reynosa, Tamaulipas

Background: The COVID-19 pandemic has impacted public health in Mexico. As of February 2020, there have been at least four waves of contagion that resulted in 5.82 million positive cases and more than 325 thousand deaths. At the beginning of the COVID-19 pandemic, hospital and population-based information was available, frequently with non-specific symptoms. Little was known about the risk factors for mortality in specific conditions. We described the clinical characteristics of patients with COVID-19 in Reynosa, Tamaulipas during 2020 and identified the risk factors for mortality. Methods: The COVID-19 cases registered from March to November 2020 in Reynosa were divided into survivors and non-survivors. The study had a retrospective cohort design. Data was obtained from the platform of the Respiratory Disease Surveillance System (SISVER), belonging to the National Epidemiological Surveillance System (SINAVE) of the Mexican Ministry of Health (https://sinave.gob.mx/). The variables considered were the age and gender of each patient. Twenty-five symptoms were included (fever, cough, headache, myalgia, arthralgia, among others); the outcome variable was the detection of COVID-19. Associated comorbidities were diabetes, obesity, hypertension, among others. The outcome variable was mortality. Data were analyzed using χ2 tests, Mann-Whitney tests, principal component analysis, and the Cox regression model. Results:The highest number of COVID-19 cases and deaths was observed in July, in men between 36-40 years old. The most frequent symptoms (37-51%) were headache, fever, cough, myalgia, and arthralgia. Clinical characteristics between survivors and non-survivors were significant (P Conclusions: The most frequent symptoms in positive COVID-19 patients in Reynosa during 2020 were headache, fever, cough, myalgia, and arthralgia. Age, gender and diabetes, hypertension, heart disease, COPD, and CKD increase mortality. The factors with the highest risk of death were age over 80 years, admitted to the ICU or intubated

SIE-Climate: A methodological and technological tool for predicting local climate variability in managing socio-ecological systems

ABSTRACT: Climate variability, as an element of uncertainty in water management, affects community, sectoral, and individual decision-making. Long-range prediction models are tools that offer the potential for integration and joint analysis with the hydrological, hydrodynamic, and management response of the socio-ecological systems to which they are linked. The main objective of this article is to present a seasonal climate prediction model, the open-source algorithm SIE-Climate, whose application consists of three phases (exploration, development, and evaluation), and to describe its application to the Lake Sochagota socio-ecological system (Paipa, Boyacá, Colombia). The K-nearest neighbours method is used when defining a target matrix that represents and integrates macro- and micro-climatic phenomena (Oceanic Niño Index, local temperature, and local rainfall) to identify periods of similar climatic behaviour. Considering a 1-year horizon and management purposes the tool is calibrated and validated in periods with and without climatic anomalies (2000?2018), giving reliable adjustment results (RSME:4.86; R2: 0.95; PBIAS: -8.89%; EFF: 0.85). SIE-Climate can be adapted to various contexts, variables of interest, and temporal and spatial scales, with an appropriate technological and computational cost for regional water management

La expresión dramática: un intento de globalización de la educación artística. Fundamentación y propuesta para la formación del maestro de educación primaria

Sin resume

Spatial scales of COVID-19 transmission in Mexico

During outbreaks of emerging infectious diseases, internationally connected cities often experience large and early outbreaks, while rural regions follow after some delay. This hierarchical structure of disease spread is influenced primarily by the multiscale structure of human mobility. However, during the COVID-19 epidemic, public health responses typically did not take into consideration the explicit spatial structure of human mobility when designing nonpharmaceutical interventions (NPIs). NPIs were applied primarily at national or regional scales. Here, we use weekly anonymized and aggregated human mobility data and spatially highly resolved data on COVID-19 cases at the municipality level in Mexico to investigate how behavioral changes in response to the pandemic have altered the spatial scales of transmission and interventions during its first wave (March–June 2020). We find that the epidemic dynamics in Mexico were initially driven by exports of COVID-19 cases from Mexico State and Mexico City, where early outbreaks occurred. The mobility network shifted after the implementation of interventions in late March 2020, and the mobility network communities became more disjointed while epidemics in these communities became increasingly synchronized. Our results provide dynamic insights into how to use network science and epidemiological modeling to inform the spatial scale at which interventions are most impactful in mitigating the spread of COVID-19 and infectious diseases in general

Efectividad del currículo de la carrera de Medicina. Diseño y validación de instrumentos para valorar la función de investigación

Normal 0 21 false false false ES X-NONE X-NONE MicrosoftInternetExplorer4 Normal 0 21 false false false ES X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} Introducción: La formación actual de médicos en Cuba responde a las necesidades de salud de la población del nuestro país y de otros lugares necesitados del mundo. El Área de Docencia e Investigación del Ministerio de Salud Pública creó un grupo de investigación, el cual diseñó el proyecto Efectividad del Currículo de Medicina. Uno de los cortes de valoración del currículo evalúa la correspondencia entre el modelo del profesional declarado para las cinco funciones descritas en el currículo y el profesional en formación. Una de las cinco funciones que se describe en el modelo es la función de investigación. Objetivo: Diseñar un instrumento para evaluar la correspondencia entre el modelo del profesional declarado para la función de investigación en el currículo y el profesional en formación. Material y métodos: Se realizó una investigación de desarrollo tecnológico en tres etapas: primera: diseño del instrumento evaluativo; segunda: ejecución de los ejercicios teóricos y prácticos; tercera: valoración del instrumento. Resultados: Mediante el instrumento diseñado se demostró que con el actual currículo la función de investigación se cumple en 80.8%. La totalidad de los profesores y la mayor parte de los estudiantes se proyectaro

A tool for curricular evaluation of the management function of Medicine career

Introduction: Current medical training in Cuba responds to the health needs of the population of our country and others worldwide. The Teaching and Research Department belonging to the Ministry of Public Health created a research group, which designed the project "Medicine Curriculum Effectiveness". One of the partial curriculum assessments evaluates the correspondence between the professional model declared for the five functions described in the curriculum and professional training. One of the five functions described in the model is the management function. Objective: To design a tool to assess the correspondence between the management function declared and modeled in the curriculum and the actual results showed by professionalist on training. Material and Methods: An investigation of technological development was performed in three stages: First: design an assessment instrument; Second: implementation of the survey and of theoretical - practical exercise; Third: valuation of the instrument.  Results: The designed instrument demonstrated that, with the current educational curriculum, management function is fulfilled in a 77.07%. All the teachers and mostly of students disclosed correctly, focusing their opinions on the required aspects for validation. Conclusions: Was designed a tool for assessing the correspondence between the management function declared and modeled in the curriculum and the actual results showed by the training professionalist. The applied validation actions support the instrument’s tenability in terms of their operativeness and content.Keywords: Management function, assessment instrument, validation, career, Medicine, design.</p

Efectividad del currículo de la carrera de Medicina. Diseño y validación de instrumentos para valorar la función docente educativa

Introducción: La formación actual de médicos en Cuba responde a las necesidades de salud de la población de nuestro país y otros lugares necesitados del mundo. El Área de Docencia e Investigación del Ministerio de Salud Pública creó un grupo de investigación, el cual diseñó el proyecto Efectividad del Currículo de Medicina. Uno de los cortes de valoración del currículo evalúa la correspondencia entre el modelo del profesional declarado para las cinco funciones descritas en el currículo y el profesional en formación. Una de las cinco funciones que se describe es la función docente educativa. Objetivo: Diseñar un instrumento para evaluar la correspondencia entre el modelo del profesional declarado para la función docente-educativa en el currículo de la carrera de Medicina y el profesional en formación. Material y Métodos: Se realizó una investigación de desarrollo tecnológico en tres etapas: primera, diseño del instrumento evaluativo; segunda, aplicación de la encuesta y ejecución del ejercicio teórico-práctico; tercera, valoración del instrumento. Resultados: El instrumento diseñado demostró que con el actual currículo la función docente educativa se cumple en 75.6%. La totalidad de los profesores y la mayor parte de los estudiantes se proyectaron correctamente, al focalizar sus opiniones en los aspectos requeridos para la validación. Conclusiones: El instrumento permite evaluar la correspondencia entre el modelo del profesional declarado para la función docente-educativa en el currículo y el profesional en formación. Las acciones de validación aplicadas apoyan la validez del instrumento en cuanto a su contenido y operatividad en la práctica. Palabras clave: Función docente educativa, instrumento evaluativo, medicina, currículo, diseño, validación.ABSTRACTIntroduction: Current medical training in Cuba responds to the health needs of the population of our country and others in need around the world. The Department of Teaching and Research of the Ministry of Health created a research group, which designed the project Curriculum Effectiveness of Medicine. One of the cuts curriculum assessments evaluates the correspondence between the professional model declared for the five functions described in the curriculum and professional training. One of the five functions described in the model is the educational teaching function. Objective: To design a tool to assess the correspondence between the professional models declared for educational teaching role in the curriculum and professional training. Material and methods: An investigation of technological development was performed in three stages: first: design assessment instrument; Second: implementation of the survey and implementation of theoretical exercise - practical; Third: assessment instrument. Results: Using the designed instrument was demonstrated that with the current educational curriculum teaching function is fulfilled in 75.6%. All the teachers and most students were projected correctly, to focus their opinions on the aspects required for validation. Conclusions: The instrument allows evaluating the correspondence between the professional model declared for education teaching role in the curriculum and professional training Shares applied validation support the validity of the instrument in terms of content and functionality in practice. Keywords: Educational teaching function, assessment instrument, medicine, curriculum, design, validation.</p

La expresión dramática: un intento de globalización de la educación artística. Fundamentación y propuesta para la formación del maestro de educación primaria

Sin resume

Prevalence of rheumatic disease in a cohort of patients with human immunodeficiency virus infection

Objetivo: Describir la prevalencia de enfermedades reumáticas en una cohorte de pacientes con infección por VIH y sus características demográficas y clínicas. Pacientes y métodos: Estudio descriptivo de corte transversal de una cohorte de 1.712 pacientes con infección por VIH, en un hospital universitario, seguidos desde enero del 2005 hasta septiembre del 2013. Resultados: Se encontró una prevalencia de enfermedades reumáticas del 5,2% (n= 89 casos), el 24% de sexo femenino y el 76% de sexo masculino. Edad promedio ± desviación estándar 45 ± 11 anos. ˜ Las enfermedades encontradas fueron: artritis reactiva 15% (n= 14), artrosis 15% (n= 14), púrpura trombocitopénica inmune 11% (n= 10), otras 59% (n= 53). El tiempo promedio entre el diagnóstico de VIH y la condición reumática fue de 73 ± 66 meses. Dentro de las comorbilidades se encontraron: dislipidemia 39% (n= 43), hepatitis B 17% (n= 19), lipodistrofia 11% (n= 12), herpes zóster 10% (n= 11) e hipotiroidismo 9% (n= 10). Conclusiones: Se presenta información respecto a las comorbilidades reumáticas en una cohorte de pacientes con infección por VIH. Como se ha documentado en otras series, la artritis reactiva fue la enfermedad reumática más frecuente junto con osteoartrosis. Nuestro estudio evidencia una tendencia hacia el envejecimiento de los pacientes con VIH gracias a un mejor control de la enfermedad, con el uso de terapia antirretroviral, lo cual aumenta la prevalencia de osteoartrosis. © 2014 Asociación Colombiana de Reumatología. Publicado por Elsevier España, S.L.U. Todos los derechos reservados.Artículo original79-83Objective: To describe the prevalence of rheumatic diseases in a cohort of patients with HIV infection attending a university hospital, along with their demographic and clinicalfeatures. Patients and methods: Cross-sectional study of 1712 outpatients with HIV infection treated at a university hospital between January 2005 and September 2013. Results: There was a prevalence of rheumatic diseases of 5.2% (n=89) in the patients studies, with 76% being male patients. The mean age of onset was 45 ± 11 years. Fourteen patients had reactive arthritis (15%), 14 had osteoarthritis (15%), 10 had immune thrombocytopenic purpura (11%), and 53 had other conditions (59%). The mean time between HIV diagnosis and rheumatic condition onset was 73 ± 66 months. The most prevalent comorbidities were dyslipidemia in 12 patients (11%), hepatitis B in 19 (17%), lipodystrophy in 12 (11%), herpes zoster in 11 (10%) and hypothyroidism in 10 (9%). Conclusions: A description is presented on the rheumatic diseases found in a cohort of patients with HIV infection. As reported in previous series, reactive arthritis is the most frequent rheumatic condition along with osteoarthritis. This study shows a trend towards successful aging of HIV patients due to a better control of the disease with the use of antiretroviral therapy, but with an increasing prevalence of osteoarthritis. © 2014 Asociación Colombiana de Reumatología. Published by Elsevier España, S.L.U. All rights reserved

Effect of Immunosuppressive Treatments on Kidney Outcomes After Gross Hematuria-Related Acute Kidney Injury in Older Patients With IgA Nephropathy

Macroscopic hematuria (MH) bouts, frequently accompanied by acute kidney injury (AKI-MH) are one of the most common presentations of IgA nephropathy (IgAN) in the elderly. Immunosuppressive therapies are used in clinical practice; however, no studies have analyzed their efficacy on kidney outcomes. This is a retrospective, multicenter study of a cohort of patients aged ≥50 years with biopsy-proven IgAN presenting with AKI-MH. Outcomes were complete, partial, or no recovery of kidney function at 1 year after AKI-MH, and kidney survival at 1, 2, and 5 years. Propensity score matching (PSM) analysis was applied to balance baseline differences between patients treated with immunosuppression and those not treated with immunosuppression. The study group consisted of 91 patients with a mean age of 65 ± 15 years, with a mean follow-up of 59 ± 36 months. Intratubular red blood cell (RBC) casts and acute tubular necrosis were found in all kidney biopsies. The frequency of endocapillary hypercellularity and crescents were low. Immunosuppressive therapies (corticosteroids alone or combined with mycophenolate mofetil or cyclophosphamide) were prescribed in 52 (57%) patients, whereas 39 (43%) received conservative treatment. There were no significant differences in the proportion of patients with complete, partial, or no recovery of kidney function at 1 year between patients treated with immunosuppression and those not treated with immunosuppression (29% vs. 36%, 30.8% vs. 20.5% and 40.4 % vs. 43.6%, respectively). Kidney survival at 1, 3, and 5 years was similar among treated and untreated patients (85% vs. 81%, 77% vs. 76% and 72% vs. 66%, respectively). Despite the PSM analysis, no significant differences were observed in kidney survival between the two groups. Fourteen patients (27%) treated with immunosuppression had serious adverse events. Conclusions: Immunosuppressive treatments do not modify the unfavorable prognosis of patients with IgAN who are aged ≥50 years presenting with AKI-MH, and are frequently associated with severe complications