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OBJECTIVE: To apply an artificial neural networks analysis (ANN) model to identify variables that predict assigned leadership and academic success in graduates of six generations of medical school. METHOD: Analytical, retrospective, comparative study. A total of 1434 graduates participated. A questionnaire was sent to them by e-mail including a voluntary participation consent. A multivariate statistical analysis using multi-layer perceptron ANN, decision trees and driver analysis was performed. RESULTS: The ANN identified seven independent variables that predicted professional success and eight for leadership in medical graduates. The decision trees identified significant differences in the variables professional performance (p = 0.000), age (p = 0.005) and continuing education activities (p = 0.034) related to professional success, and for leadership the variables gender (p = 0.000), high school grades (p = 0.042), performing clinical practice during the social service year (p = 0.002) and continuing education activities (p = 0.011). CONCLUSIONS: The ANN identified the main independent predictor variables of professional success and leadership of the graduates. This study opens up two new lines of research little studied with the techniques of in the area of medicine.

OBJETIVO: Aplicar un modelo de análisis de redes neuronales artificiales (RNA) para identificar las variables que predicen el liderazgo asignado y el éxito académico en egresados de seis generaciones de la carrera de Medicina. MÉTODO: Estudio analítico, retrospectivo y comparativo. Participaron 1434 egresados. Se envió un cuestionario por correo electrónico que incluyó el consentimiento de participación voluntaria. Se realizó análisis estadístico multivariado mediante RNA del tipo perceptrón multicapa, árboles de decisión y análisis de impulsores. RESULTADOS: Las RNA identificaron siete variables independientes que predijeron el éxito profesional y ocho para el liderazgo en los médicos egresados. Los árboles de decisión identificaron diferencias significativas en las variables desempeño profesional (p = 0.000), edad (p = 0.005) y actividades de educación continua (p = 0.034) relacionadas con el éxito profesional, y para el liderazgo las variables sexo (p = 0.000), promedio en el bachillerato (p = 0.042), realizar práctica clínica en el servicio social (p = 0.002) y actividades de educación continua (p = 0.011). ­. CONCLUSIONES: Las RNA identificaron las principales variables independientes predictoras del éxito profesional y el liderazgo de los egresados. El estudio abre dos líneas de investigación poco estudiadas con las técnicas de RNA en el área de la medicina.

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INTRODUCTION: The World Health Organization considers that migrants who pass through the Mexico-US walkway suffer high levels of violence, compared to other regions of the world, mainly women. This study aims to identify the factors associated with the types of violence suffered by migrants in transit through Mexico to the USA. DESIGN: A cross-sectional, exploratory, retrospective, and observational study was conducted. A questionnaire of 46 variables was applied, divided into four sections: sociodemographic background, leaving the home, transit, and stay at the border. Questions about different types of direct violence were included. The survey was applied to 612 Mexican and Central American migrants who were in the Chaparral customs office and in five shelters in Tijuana City, on the U.S.-Mexico border. The results were analyzed using descriptive techniques and multivariate analysis of main and inferential components, using the statistical program R. RESULTS: The higher vulnerability of Central American migrants compared to Mexicans was documented, specially of women that proportionally were the most negatively affected victims including all types of violence, making it evident that one of each four was violented sexually and among them, only 50% asked for medical assistance. The multivariate analysis determined that the duration of the trip, and the type of transport can generate greater violence. CONCLUSIONS: The results highlight the greater vulnerability of Central American migrants in their transit through Mexico, mainly women and, likewise, the lack of effective public policies that guarantee the protection of the health, safety, and human rights of migrants.

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Medical care must be supported by research that meets reliable, valid, ethical, and reproducible principles. However, an essential fraction of research carried out in the medical field is inadequately reported due to omitting relevant information when it is published. This reduces their impact and the possibility that other researchers can realize critical appraisal, thereby compromising their application within medical practice. Because of this, guidelines have been developed to reduce this problem; their purpose is to increase research reports' methodological quality, transparency, validity, and reliability. Despite their importance, incorporating these guidelines in various journals and the knowledge and use by a significant part of the medical community is limited. In this context, this article aims to synthesize the main guidelines for reporting research in medicine.

La atención médica debe estar sustentada en investigaciones que cumplan principios confiables, válidos, éticos y reproducibles; sin embargo, una parte importante de las investigaciones realizadas en el campo médico son reportadas de manera inadecuada debido a que omiten información de trascendencia cuando son publicadas, lo cual disminuye su impacto y la posibilidad de que otros investigadores puedan evaluarlas de manera crítica y objetiva, comprometiendo con ello su aplicación dentro de la práctica médica. En un esfuerzo por atenuar este problema se han desarrollado guías cuya finalidad es incrementar la calidad metodológica, la transparencia, la validez y la fiabilidad de los reportes de investigación. No obstante su importancia, la incorporación de estas guías en diversas revistas, así como su conocimiento y utilización por una parte importante de la comunidad médica, son limitados. Dado este contexto, el objetivo del presente artículo es sintetizar las principales guías que existen para reportar investigaciones en medicina.

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BACKGROUND: Covid symptoms reflect its multisystem nature, in addition to its positive relationship between the severity of the condition and the severity of the long COVID. OBJECTIVE: To identify the factors associated with the prevalence of SEQUELAE DUE TO COVID-19 one year after their hospital discharge due to severe pneumonia. METHOD: Longitudinal, analytical, prospective and comparative study. 71 covid-19 pneumonia survivors were followed. Two telephone interviews were conducted to each patient; the first at 5 months of discharge and the second at 12 months from the mentioned date. We included questions of 40 symptoms, in addition to the questioning of diabetes mellitus and/or systemic hypertension with a mentioned onset during the hospitalization or after hospital discharge due to COVID-19. RESULTS: Of the 37 patients without complications and without comorbidities prior to hospitalization, 11 (29.7%) developed arterial hypertension during or after discharge and 17 (45.9%) developed diabetes mellitus before five months. Short-term memory loss was an upward sequel in the two measurements, 24.3% and 41.9% respectively. CONCLUSIONS: Type 2 diabetes mellitus and high blood pressure detected at five months was temporary and reversed in many cases at twelve months. It will be important to deepen the study of brain damage and cognitive dysfunction, characterized by memory loss.

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The use of different guides to report types of study in the medical field has been widely disseminated for decades, however, their adherence and use by an important part of researchers is still limited, this has negatively impacted the dissemination of new findings, which has generated criticism regarding how medical research is designed, conducted and reported. Parallel to this, there are extensions to these guidelines which are little known and used by the personnel involved in research work, they focus on more specific approaches to report different types of studies, among which are: meta-analysis, systematic reviews, clinical trials randomized, diagnostic accuracy studies, observational studies, among others; for this reason, its promotion, knowledge, and use is of vital importance. The objective of this review is to synthesize the main extensions of the guidelines used in medical research; for this purpose, its main characteristics were reviewed, as well as application scenarios according to the level of evidence; Its adequate adherence will allow health personnel involved in research work to increase the transparency and quality of their findings, contemplate potential sources of bias, as well as the development of good practices for the presentation of their results according to the type of study selected.

El uso de diferentes guías para reportar tipos de estudio en el campo médico ha sido ampliamente difundido desde hace décadas; sin embargo, su adherencia y utilización por una parte importante de investigadores aún es limitada. Esto ha impactado de manera negativa en la difusión de nuevos hallazgos, lo cual ha generado críticas en relación a cómo se diseñan, realizan y reportan investigaciones médicas. Paralelo a ello, existen extensiones a dichas guías, las cuales son poco conocidas y utilizadas por el personal involucrado en labores de investigación, estas se enfocan en aproximaciones más específicas para reportar diferentes tipos de estudios entre los que destacan: metaanálisis, revisiones sistemáticas, ensayos clínicos aleatorizados, estudios de precisión diagnóstica, estudios observacionales, entre otros. Por tal motivo, es de vital importancia su promoción, conocimiento y utilización. El objetivo de la presente revisión es sintetizar las principales extensiones de las guías utilizadas en investigación médica. Para tal efecto se revisaron sus principales características, así como escenarios de aplicación de acuerdo con el nivel de evidencia; su adecuada adhesión permitirá al personal de salud involucrado en labores de investigación incrementar la transparencia y calidad de sus hallazgos, contemplar fuentes potenciales de sesgos, así como el desarrollo de buenas prácticas para la presentación de sus resultados de acuerdo al tipo de estudio seleccionado.

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Introducción: La Organización Internacional para las Migraciones (OIM), reportó en 2018 244 millones de migrantes en el mundo, el 3,3 por ciento de la población mundial. De ellos, México es el segundo país expulsor con 13 000 000. El fenómeno migratorio y la salud guardan estrecha relación, debido a diversos factores de riesgo que influyen en lo personal y familiar. Objetivo: Identificar los factores de riesgo relacionados con la salud de las personas migrantes durante el proceso migratorio. Métodos: Estudio de investigación transversal, prospectivo, no comparativo. Se desarrolló de marzo de 2017 a diciembre de 2018, en la ciudad de Tijuana, Baja California, en seis instituciones de apoyo al migrante. El instrumento contó con 62 ítems. La muestra fue de 392 migrantes mexicanos de ambos sexos, mayores de 18 años, que migraron y vivieron en Estados Unidos y regresaron a México. Resultados: De los 392 migrantes, resultaron 96,3 por ciento hombres y 3,8 por ciento mujeres, el principal factor de migración fue el económico (76,3 por ciento); 92 por ciento salió sano de México; 31,4 por ciento adquirió una nueva adicción, principalmente cristal (9,4 por ciento) y marihuana (6,6 por ciento). El 11,2 por ciento regresó con alguna enfermedad crónica: 4,1 por ciento con hipertensión; 3,1 por ciento con diabetes mellitus tipo 2 y 1,8 por ciento con epilepsia. Conclusiones: Las etapas del proceso migratorio de tránsito y vivir en los Estados Unidos fueron las que generaron mayores riesgos a la salud, la primera por los accidentes y agresiones de terceras personas y la segunda vinculada a la adquisición de nuevas adicciones a sustancias ilegales(AU)

Introduction: The International Organization for Migration (IOM) reported, in 2018, 244 million migrants worldwide, 3.3 percent of the world population. Of these, Mexico is the second country of origin, accounting for 13 000 000. The migration phenomenon and health are closely related, due to various risk factors that influence the personal and familial aspects. Objective: To identify risk factors related to the health of migrants during the migration process. Methods: Cross-sectional, prospective and noncomparative research study carried out from March 2017 to December 2018, in the city of Tijuana, Baja California, at six institutions that support migrants. The instrument had 62 items. The sample consisted of 392 Mexican migrants of both sexes, over 18 years of age, who migrated to and lived in the United States, and returned to Mexico. Results: Of the 392 migrants, 96.3 percent were men and 3.8 percent were women. The main migration factor was the economic (76.3 percent). 92 percent left Mexico healthy, while 31.4 percent acquired a new addiction, mainly crystal meth[amphetamine] (9.4 percent) and marijuana (6.6 percent). 11.2 percent returned with any chronic disease: 4.1 percent, with hypertension; 3.1 percent, with type 2 diabetes mellitus; and 1.8 percent, with epilepsy. Conclusions: The stages of the immigration process of transit and living in the United States were those that generated the greatest health risks; the first, due to accidents and assaults by third parties and the second in association with the uptake of new addictions to illegal substances(AU)

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Objetivos: determinar la prevalencia de infección de vías urinarias, la sensibilidad antimicrobiana y los factores de riesgo asociados en pacientes con diabetes mellitus tipo 2. Métodos: estudio descriptivo, transversal y prospectivo, a 300 pacientes con diagnóstico de diabetes mellitus tipo 2, seleccionados mediante muestreo no probabilístico. Se aplicó ficha de identificación, y se realizó diagnóstico clínico y microbiológico de infección de vías urinarias. El análisis estadístico se realizó a través de razón de momios, intervalos de confianza y chi cuadrado, con el programa estadístico SPSS versión 17. Resultados: el porcentaje total de infección de vías urinarias fue de 17 por ciento, y se presentó 12,5 por ciento de bacteriuria asintomática y 38,4 por ciento de bacteriuria sintomática (p= 0,000; OR= 4,38; IC 95 por ciento 2,09-8,99). Se obtuvo una prevalencia de infección de vías urinarias de 6,5 por ciento para hombres y 22,8 por ciento para mujeres (p= 0,000; OR= 4,22; IC 95 por ciento 1,78-11,51). Escherichia coli se aisló en 68,6 por ciento, seguido de Klebsiella spp. en 13,7 por ciento. En relación con la sensibilidad a los antibióticos, E. coli presentó 74,3 por ciento de resistencia a la ciprofloxacina y 68,6 por ciento a la ampicilina. Conclusiones: E. coli y Klebsiella spp. fueron las bacterias de mayor prevalencia, con porcentajes altos de resistencia a la ampicilina y la cefalosporina, 2 de los antimicrobianos mayormente utilizados en estos procesos. De los factores de riesgo analizados, solo el sexo se asoció a infección de vías urinarias en el paciente diabético(AU)

Objectives: to determine the prevalence of urinary tract infection, antimicrobial resistance and associated risk factors in type 2 diabetes mellitus patients. Methods: prospective, descriptive and cross-sectional study conducted in 300 patients diagnosed with type 2 diabetes mellitus and selected by non-probabilistic sampling. The identification card was used and the clinical and microbiological diagnosis of urinary tract infection was performed. The statistical analysis used the SPSS statistical program version 17 through the odds ratio, the confidence intervals and the chi square test. Results: total percentage of urinary tract infection was 17 percent, asymptomatic bacteriuria reached 12.5 percent and symptomatic 38.4 percent (p= 0.000; OR= 4.38; IC 95 percent 2.09-8.99). The prevalence of urinary tract infection was 6.5 percent for men and 22.8 percent for women (p= 0.000; OR= 4.22; IC 95 percent 1.78-11.51). Escherichia coli was isolated in 68.6 percent of cases, followed by Klebsiella spp. in 13.7 percent. Regarding the antimicrobial resistance, E. coli exhibited 74.3 percent resistance to ciprofloxacin and 68.6 percent to ampicillin. Conclusions: E. coli and Klebsiella spp. were the preponderant bacteria with high percentages of resistance to ampicillin and to cephalosporin, two of the mostly used antimicrobials to control these processes. Sex was the only risk factor associated to urinary tract infection in the diabetic patient(AU)

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Objetivos: Determinar la prevalencia de infecciones de vías urinarias en pacientes de una clínica de primer nivel de atención y asociar la presencia de los diferentes microorganismos aislados con alguno de los factores de riesgo, así como determinar la sensibilidad y la especificidad de los principales síntomas asociados a infección de vías urinarias, y de los principales parámetros utilizados en la tira reactiva para su diagnóstico. Material y métodos: Estudio longitudinal, descriptivo y observacional, realizado en la Clínica de Medicina Familiar ®Dr. Ignacio Chávez¼ en México DF. Se incluyeron 237 pacientes de ambos sexos, con edades entre 28 y 82 años. Se realizó un cuestionario confidencial y se tomó muestra de orina para examen general y urocultivo. Resultados: La prevalencia total de bacteriuria fue de 28.7%. Se encontraron diferencias estadísticas significativas entre pacientes sintomáticos y asintomáticos para Candida, ente-robacterias, G. vaginalis y el total de casos positivos. Para el total de los microorganismos, se encontró asociación con el sexo, con infecciones urinarias y tratamientos previos. Los datos de sensibilidad y especificidad más altos se hallaron en presencia de polaquiuria con 88.2% y 92.9%, respectivamente. Conclusiones: La diversidad de los resultados obtenidos tanto en la prevalencia de microorganismos aislados, como en la utilidad de las pruebas diagnósticas, y que es confirmada en este trabajo, depende en buena medida de las características de la población de estudio, y de los medios de cultivo utilizados para la búsqueda y aislamiento de los microorganismos.

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OBJECTIVES: To determine the frequency and characteristics of urinary tract infection (UTI) by Candida in diabetic patients (with and without symptoms) and to compare them with non-diabetic patients (with and without symptoms). DESIGN: Longitudinal, descriptive, and observational study. SETTING: Study conducted at the "Dr Ignacio Chavez" Clinic of family medicine, ISSSTE: Mexico. PARTICIPANTS: There were 2 kinds of patients; 1 with diabetes mellitus diagnosis (DM) with and without clinical picture of probable urinary tract infection (UTI), and 1 without DM and with and without clinical picture of probable UTI. MAIN MEASUREMENTS: A urine culture and a confidential questionnaire were administered to find the presence of urinary symptoms and likely risk factors associated with the infection. To associate these risks, the chi2 statistical method was used, with significance at 95% and Fisher's Exact Test for small frequencies, using the EpiInfo V.6.0 program. RESULTS: Two hundred thirty seven patients between 28 and 82 years old were included. The prevalence of urinary infection by Candida was 5.1%, but only 33% of these had C albicans. There was no association between candidiasis and factors like age, sex, or presence of DM, but it was related to previous treatments, previous UTI and the evolution time of DM. CONCLUSIONS: The conscious search by both doctor and laboratory for Candida micro-organisms as factors causing UTI is important. This is especially so in those patients with factors of risk that may condition Candida's presence.

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Objetivo. Determinar la frecuencia y las características de la candidiasis urinaria en pacientes diabéticos (con y sin sintomatología urinaria) y compararla con un grupo de pacientes sin dicha afección (con y sin sintomatología). Diseño. Estudio longitudinal, descriptivo y observacional. Emplazamiento. Trabajo realizado en la Clínica de Medicina Familiar Dr. Ignacio Chávez ISSSTE. Participantes. Se incluyó a 2 tipos de pacientes: a) pacientes con diagnóstico de diabetes mellitus (DM) con y sin cuadros clínicos de probable infección de vías urinarias (IVU), y b) un segundo tipo sin DM y con o sin cuadro clínico de probable IVU. Mediciones principales. Se realizaron un urocultivo y un cuestionario confidencial para reconocer la sintomatología urinaria y los probables factores de riesgo del paciente asociados con el proceso infeccioso. Para asociar estos últimos se utilizó el método estadístico de la *2, con significanción del 95%, y la prueba exacta de Fisher para frecuencias pequeñas; se utilizó el programa EpiInfo versión 6.0. Resultados. Se incluyó a 237 pacientes de 28-82 años; la prevalencia de candidiasis urinaria fue del 5,1%, pero sólo el 33% fue C. albicans. No se encontró ninguna asociación entre la candidiasis y factores como la edad, el sexo o la presencia de DM, pero sí con tratamientos previos, IVU previas y el tiempo de evolución de la DM. Conclusiones. Se considera importante la búsqueda intencionada, tanto por el médico como por el laboratorio, de estos microorganismos como causales de IVU, principalmente en los pacientes con factores de riesgo que parecen condicionar su presencia

Objectives. To determine the frequency and characteristics of urinary tract infection (UTI) by Candida in diabetic patients (with and without symptoms) and to compare them with non-diabetic patients (with and without symptoms). Design. Longitudinal, descriptive, and observational study. Setting. Study conducted at the "Dr Ignacio Chavez" Clinic of family medicine, ISSSTE. Mexico. Participants. There were 2 kinds of patients; 1 with diabetes mellitus diagnosis (DM) with and without clinical picture of probable urinary tract infection (UTI), and 1 without DM and with and without clinical picture of probable UTI. Main measurements. A urine culture and a confidential questionnaire were administered to find the presence of urinary symptoms and likely risk factors associated with the infection. To associate these risks, the *2 statistical method was used, with significance at 95% and Fisher's Exact Test for small frequencies, using the EpiInfo V.6.0 program. Results. Two hundred thirty seven patients between 28 and 82 years old were included. The prevalence of urinary infection by Candida was 5.1%, but only 33% of these had C albicans. There was no association between candidiasis and factors like age, sex, or presence of DM, but it was related to previous treatments, previous UTI and the evolution time of DM. Conclusions. The conscious search by both doctor and laboratory for Candida micro-organisms as factors causing UTI is important. This is especially so in those patients with factors of risk that may condition Candida's presence

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OBJECTIVE: To evaluate the in vitro activities of 13 antimicrobial agents against 47 group A Streptococcus pyogenes (GAS) strains, and to determine the presence of genes encoding streptococcal pyrogenic exotoxin A (SpeA) and the M-protein serotypes. MATERIALS AND METHODS: A cross-sectional study was conducted at Centro de Salud Dr. José Castro Villagrana, during a scarlet fever outbreak occurring between December 1999 and January 2000, among 137 children at Colegio Espíritu de América. Minimum Inhibitory Concentrations (MICs) were obtained by the semiautomated microdilution method. Automated DNA sequencing was used for analysis of sequence variation in genes encoding the M protein, and SpeA. RESULTS: All strains were sensitive to betalactams and clindamycin. Six (12.7%) were resistant to erythromycin. The M2 type was the most frequently isolated GAS (27); almost all (96%) bacteria with the SpeA gene had the gene encoding the M2 protein. CONCLUSIONS: The recent resurgence of GAS infections calls for molecular epidemiology research and studies on the sensitivity to macrolides and beta-lactams.

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OBJECTIVE: To evaluate the in vitro activities of 13 antimicrobial agents against 47 group A Streptococcus pyogenes (GAS) strains, and to determine the presence of genes encoding streptococcal pyrogenic exotoxin A (SpeA) and the M-protein serotypes. MATERIALS AND METHODS: A cross-sectional study was conducted at Centro de Salud Dr. JosÚ Castro Villagrana, during a scarlet fever outbreak occurring between December 1999 and January 2000, among 137 children at Colegio EspÝritu de AmÚrica. Minimum Inhibitory Concentrations (MICs) were obtained by the semiautomated microdilution method. Automated DNA sequencing was used for analysis of sequence variation in genes encoding the M protein, and SpeA. RESULTS: All strains were sensitive to betalactams and clindamycin. Six (12.7) were resistant to erythromycin. The M2 type was the most frequently isolated GAS (27); almost all (96) bacteria with the SpeA gene had the gene encoding the M2 protein. CONCLUSIONS: The recent resurgence of GAS infections calls for molecular epidemiology research and studies on the sensitivity to macrolides and beta-lactams.

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