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Background: Social determinants have played a role in COVID-19 outcomes and vaccination has improved these and impacted on inflammatory response, we therefore sought to investigate the association between vaccination and inflammatory response with COVID-19 mortality in a Mexican population with high marginalization during the Omicron wave. Methods: Prospective, longitudinal, single-center study in a setting of high marginalization conducted during the Omicron wave, from January to November 2022. Clinical and laboratory data were collected during admission and patients were followed until discharge or death. Patients were grouped according to outcome (survival and non-survival), and by complete (2 or more doses) and incomplete vaccination status for comparison. Results: 118 patients were included, 54% (64/118) male, with a median age 63 years and 86% (102/118) with self-reported comorbidities. Mortality was 42%. 58% (68/118) had complete vaccination. There was a 64% risk reduction for all-cause in-hospital mortality of having complete vaccination, hazard ratio 0.36, (95% CI 0.18-0.71, p = 0.004) in the proportional hazards Cox regression test. Survivor group arrived earlier to medical care and had higher SpO2 on admission, and for inflammatory response, had lower levels of Neutrophil-to-lymphocyte ratio, C-reactive protein, and D-dimer at admission. In the longitudinal measurement, only D-dimer showed significant differences between groups according to survival. Conclusion: In a highly marginalized Mexican population, complete vaccination has a protective effect against COVID-19 all-cause in-hospital mortality compared with incomplete or no vaccination. However, mortality in this population during the Omicron wave is high. Socio-economic inequalities may play an important role in COVID-19 outcomes.
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INTRODUCTION: Fractures in children and adolescents are a public health issue. However, reliable epidemiological descriptions of the South American population must be improved. This study aims to present epidemiological data on fractures from a children's orthopedic hospital in one of the five largest cities in Latin America. PATIENTS AND METHODS: Descriptive epidemiological data from 2015 to 2019 were used to characterize children's fractures. Demographic variables, the number of fractured bones, high-energy trauma findings, fracture characteristics, fingertip injuries, and associated complications discriminated by the type of treatment are presented. Long bone fractures were classified according to the AO classification. All children less than 18 years of age were included. RESULTS: In a population of 3,616 children, 4,596 fractures were identified. More boys than girls sustain a fractured bone, with ratios as high as 6:1 around 15 years old. Distal forearm fractures were the most common (31.9%), followed by distal humerus (20.2%). Most of the complications were related to these two sites of fractures. The OR of complications between surgical and conservative management was 2.86. CONCLUSION: Epidemiological data of fractures from the authors' institution display the usual trending reported in most populations. Gender-related and age-related differences were relevant. Most fractures and complications are related to upper limb low-energy trauma. The most frequent are loss of ROM and loss of reduction. LEVEL OF EVIDENCE: Level III - retrospective cohort study.
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Fracturas Óseas , Masculino , Femenino , Adolescente , Niño , Humanos , Colombia/epidemiología , Estudios Retrospectivos , Fracturas Óseas/epidemiología , Fracturas Óseas/cirugía , Fracturas Óseas/etiología , HospitalesRESUMEN
Este es un artículo de revisión sobre lo que es el hirsutismo. Se expone que la mayor causa está asociada con el ovario poliquístico. Se describe la producción ovárica y suprarrenal de andrógenos en la mujer, las diferentes manifestaciones de hiperandrogenismo, las diversas clasificaciones que hay para el diagnóstico y clasificación clínica del hirsutismo y el papel que juega la 5-alfa-reductasa. Se postulan las principales etiologías, el diagnóstico y el manejo de esta patología.
This es a review article about what is hirsutism. It is exposed that the greatest cause associated is polycystic ovary. Ovarian and adrenal androgen production are described, the different manifestations of hyperandrogenism, the different classification systems for diagnosis and clinical classification of hirsutism and the role of 5-alfa-reductase. The main etiologies are postulated, as well as diagnosis and management of this pathology.