Gender-Based Differences by Age Range in Patients Hospitalized with COVID-19: A Spanish Observational Cohort Study

There is some evidence that male gender could have a negative impact on the prognosis and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The aim of the present study was to compare the characteristics of coronavirus disease 2019 (COVID-19) between hospitalized men and women with confirmed SARS-CoV-2 infection. This multicenter, retrospective, observational study is based on the SEMI-COVID-19 Registry. We analyzed the differences between men and women for a wide variety of demographic, clinical, and treatment variables, and the sex distribution of the reported COVID-19 deaths, as well as intensive care unit (ICU) admission by age subgroups. This work analyzed 12,063 patients (56.8% men). The women in our study were older than the men, on average (67.9 vs. 65.7 years; p < 001). Bilateral condensation was more frequent among men than women (31.8% vs. 29.9%; p = 0.007). The men needed non-invasive and invasive mechanical ventilation more frequently (5.6% vs. 3.6%, p < 0.001, and 7.9% vs. 4.8%, p < 0.001, respectively). The most prevalent complication was acute respiratory distress syndrome, with severe cases in 19.9% of men (p < 0.001). In men, intensive care unit admission was more frequent (10% vs. 6.1%; p < 0.001) and the mortality rate was higher (23.1% vs. 18.9%; p < 0.001). Regarding mortality, the differences by gender were statistically significant in the age groups from 55 years to 89 years of age. A multivariate analysis showed that female sex was significantly and independently associated with a lower risk of mortality in our study. Male sex appears to be related to worse progress in COVID-19 patients and is an independent prognostic factor for mortality. In order to fully understand its prognostic impact, other factors associated with sex must be considered

Estructuración del sistema de control de calidad para la empresa Harina del Valle

Tesis (Ingeniero Industrial)-- Corporación Universitaria Autónoma de Occidente, 1990PregradoIngeniero(a) Industria

Estructuración del sistema de control de calidad para la empresa Harina del Valle

Tesis (Ingeniero Industrial)-- Corporación Universitaria Autónoma de Occidente, 199

Knowledge of stroke a study from a sex perspective Neurology

Antecedentes: La salud pública está cada vez más preocupada con el reconocimiento de los factores de riesgos motivados por las diferencias por sexo. Se realizó un estudio para determinar el efecto de los factores de riesgo de ictus y signos de advertencia en base a ser hombre o mujer, y cómo ambos se perciben, en una muestra representativa en los adultos. Métodos: de una muestra representativa de la población de Extremadura, España fue seleccionado mediante un doble técnica de aleatorización. Médicos entrenados previamente los alumnos realizaron entrevistas cara a cara usando un cuestionario estructurado. Resultados: Se entrevistó a 2409 sujetos [59,9 % mujeres; edad media (SD) de 49,0 (18,7) años]. El setenta y tres por ciento de todos los sujetos informaron que al menos tuvieron una señal de advertencia correcta del accidente cerebrovascular (OR: 1,01; IC 95 %: 0,84 a 1,21). Las señales de advertencia más frecuentemente mencionados fueron repentina debilidad, mareos y dolor de cabeza. No hubo diferencias por sexo en cuanto a los tipos de síntomas de advertencia en los encuestados enumerados. Las mujeres muestran un mejor conocimiento de los factores de riesgo que los hombres (OR: 1,23; IC 95 %: 1,05-1,46). Las mujeres tenían más probabilidades nominales por la hipertensión arterial como factor de riesgo para el accidente cerebrovascular, mientras que en el caso de los hombres la de mayor frecuencia es el tabaquismo, el consumo de alcohol y el sedentarismo como factores de riesgo. En respuesta al accidente cerebrovascular, las mujeres fueron significativamente menos propensas que los hombres a llamar a una ambulancia o ir inmediatamente al hospital (OR: 0,69; IC 95 %: 0,60 a 0,85). Conclusiones: El nivel de conocimiento subóptimo es el mismo, tanto en hombres como en mujeres. Hemos detectado un mejor conocimiento de los factores de riesgo de ictus en las mujeres, así como en las diferencias de los factores de riesgo enumerados por hombres y mujeres. Hubo diferencias significativas en función del sexo respecto a la respuesta sobre el accidente cerebrovascular o a sus signos de advertencia.Background: Public health is increasingly concerned with recognising factors that lead to sex differences in stroke. We conducted a study to determine the effect of sex on knowledge of stroke risk factors and warning signs, and how both are perceived, in a representative sample of adults. Methods: A representative sample of the population of Extremadura, Spain was selected using a double randomization technique. Previously trained medical students carried out face-to-face interviews using a structured questionnaire. Results: 2409 subjects were interviewed [59.9 % women; mean age (SD) 49.0 (18.7) years]. Seventy-three percent of all subjects reported at least one correct warning sign of stroke (OR: 1.01; 95 % CI: 0.84–1.21). The most frequently mentioned warning signs were sudden weakness, dizziness, and headache. There were no sex differences regarding the types of warning symptoms that respondents listed. Women displayed better knowledge of risk factors than men (OR: 1.23; 95 % CI: 1.05–1.46). Women were more likely to name hypertension as a risk factor for stroke whereas men more frequently listed smoking, alcohol consumption and a sedentary lifestyle as risk factors. In response to stroke, women were significantly less likely than men to choose to call an ambulance or to go immediately to hospital (OR: 0.69; 95 % CI: 0.60–0.85). Conclusions: Stroke knowledge is suboptimal in both men and women. We detected better knowledge of stroke risk factors in women, as well as differences in the type of risk factors listed by men and women. There were significant sex differences regarding response to stroke or to its warning signs.Trabajo financiado por: FUNDESALUD and Neurology Society of Extremadura (FUNNE0901). Beca Proyecto Investigación en Neurosciencia Sociedad Española de Neurología. Ayuda desde el Área de InvestigaciónpeerReviewe

Evaluación del profesorado de Medicina en Práctica Clínica

Fac. de MedicinaFALSEsubmitte

Diabetes: Guía para personas afectadas y cuidadoras. 2ª ed

YesLa diabetes es una de las enfermedades de tipo crónico más frecuentes en el mundo, que tiene importancia tanto por las repercusiones que provoca en el estado de salud de la persona que la padece, como por los trastornos que origina en su calidad de vida. Esta monografía además de indicarle cómo actuar de manera coordinada con el personal sanitario que le atiende habitualmente, pretende dar a las personas que tienen la enfermedad y a sus cuidadores, información útil para que puedan controlarla y conseguir una mejora en su calidad de vida, hasta hacerla lo más satisfactoria posible

WHO Ordinal Scale and Inflammation Risk Categories in COVID-19

Background: The WHO ordinal severity scale has been used to predict mortality and guide trials in COVID-19. However, it has its limitations. Objective The present study aims to compare three classificatory and predictive models: the WHO ordinal severity scale, the model based on inflammation grades, and the hybrid model. Design Retrospective cohort study with patient data collected and followed up from March 1, 2020, to May 1, 2021, from the nationwide SEMI-COVID-19 Registry. The primary study outcome was in-hospital mortality. As this was a hospital-based study, the patients included corresponded to categories 3 to 7 of the WHO ordinal scale. Categories 6 and 7 were grouped in the same category. Key Results A total of 17,225 patients were included in the study. Patients classified as high risk in each of the WHO categories according to the degree of inflammation were as follows: 63.8% vs. 79.9% vs. 90.2% vs. 95.1% (p<0.001). In-hospital mortality for WHO ordinal scale categories 3 to 6/7 was as follows: 0.8% vs. 24.3% vs. 45.3% vs. 34% (p<0.001). In-hospital mortality for the combined categories of ordinal scale 3a to 5b was as follows: 0.4% vs. 1.1% vs. 11.2% vs. 27.5% vs. 35.5% vs. 41.1% (p<0.001). The predictive regression model for in-hospital mortality with our proposed combined ordinal scale reached an AUC=0.871, superior to the two models separately. Conclusions The present study proposes a new severity grading scale for COVID-19 hospitalized patients. In our opinion, it is the most informative, representative, and predictive scale in COVID-19 patients to date