Comorbilidades y características clínicas asociadas a la mortalidad hospitalaria por COVID-19 en el estado de Hidalgo, México / Comorbidities and clinical characteristics associated with hospital mortality, due to COVID-19, in the state of Hidalgo, Mexico / Comorbidades e características clínicas associadas à mortalidade hospitalar por COVID-19, no estado de Hidalgo, México

Resumen: Introducción: La enfermedad por COVID-19 ha tenido gran impacto en nuestro país; aunque se han documentado diversas variables que contribuyen al pronóstico sobre la mortalidad y/o enfermedad grave en pacientes, es necesario generar información que dé cuenta de las especificidades estatales para contribuir a la toma de decisiones ante una inminente saturación hospitalaria. Objetivo: Identificar las comorbilidades y características clínicas asociadas a la mortalidad por COVID-19, en pacientes hospitalizados en el estado de Hidalgo, México. Material y métodos: Se realizó un estudio descriptivo y retrospectivo. Como fuente de información se utilizó la base de datos abiertos COVID-19 de la Dirección General de Epidemiología de la Secretaría de Salud de México para realizar tres tipos de regresión: probit, logit y Gauss. El modelo gaussiano fue el de mejor ajuste. Resultados: Se analizaron 3,880 casos (1,696 defunciones y 2,184 recuperados) y se identificaron cuatro comorbilidades asociadas a la mortalidad por COVID-19: obesidad, hipertensión, diabetes e insuficiencia renal crónica (IRC) así como dos características clínicas: sexo y edad. Conclusiones: La hipertensión, obesidad, diabetes e IRC aumentan la probabilidad de defunción. Entre las comorbilidades la IRC es la de mayor peso. De las características clínicas analizadas, se encontró asociación con el sexo y la edad, donde la edad es la variable de mayor peso en el modelo.

Abstract: Introduction: The COVID-19 disease has had a great impact on our country; Although various variables that contribute to the prognosis of mortality and/or serious illness in patients have been documented, it is necessary to generate information that accounts for state specificities to contribute to decision-making in the face of imminent hospital saturation. Objective: To identify the comorbidities and clinical characteristics associated with mortality from COVID-19, in hospitalized patients in the state of Hidalgo, Mexico. Material and method: A descriptive and retrospective study was carried out. As a source of information, the COVID-19 open database of the General Directorate of Epidemiology of the Mexican Ministry of Health was used to perform three types of regression: probit, logit and Gaussian. The Gaussian model was the one with the best fit. Results: 3,880 cases (1,696 deaths and 2,184 recovered) were analyzed and 4 comorbidities associated with mortality from COVID-19 were identified: obesity, hypertension, diabetes, and chronic kidney failure (CRF), as well as 2 clinical characteristics: sex and age. Conclusions: Hypertension, obesity, diabetes and CRF increase the probability of death. Among the comorbidities, CRF is the one with the greatest weight. Of the clinical characteristics analyzed, an association was found with sex and age, where age is the variable with the greatest weight in the model.

Resumo: Introdução: A doença COVID-19 teve um grande impacto no nosso país; Embora tenham sido documentadas diversas variáveis ​​que contribuem para o prognóstico de mortalidade e/ou doença grave em pacientes, é necessário gerar informações que contemplem as especificidades estaduais para contribuir na tomada de decisão diante da iminente saturação hospitalar. Objetivo: Identificar as comorbidades e características clínicas associadas à mortalidade por COVID-19, em pacientes hospitalizados no estado de Hidalgo, México. Material e métodos: Foi realizado um estudo descritivo e retrospectivo. Como fonte de informação, o banco de dados aberto COVID-19 da Direção Geral de Epidemiologia do Ministério da Saúde do México foi usado para realizar três tipos de regressão: probit, logit e gaussiana. O modelo gaussiano foi o que melhor se ajustou. Resultados: foram analisados 3,880 casos (1,696 óbitos e 2,184 recuperados) e identificadas 4 comorbidades associadas à mortalidade por COVID-19: obesidade, hipertensão, diabetes e insuficiência renal crônica (IRC), além de 2 características clínicas: sexo e idade. Conclusões: Hipertensão, obesidade, diabetes e IRC aumentam a probabilidade de morte. Dentre as comorbidades, a IRC é a de maior peso. Das características clínicas analisadas, foi encontrada associação com sexo e idade, sendo a idade a variável com maior peso no modelo.

Costo-efectividad de una alternativa para la prestación de servicios de atención primaria en salud para los beneficiarios del Seguro Popular de México / Cost-effectiveness analysis of an alternative for the provision of primary health care for beneficiaries of Seguro Popular in Mexico

Resumen: Objetivo: Calcular la razón costo-efectividad de servicios públicos y privados contratados por el Seguro Popular en primer nivel de atención. Material y métodos: Se evaluó una experiencia piloto de contratación de servicios de primer nivel de atención a la salud en el estado de Hidalgo, México, midiendo, con base en una encuesta poblacional, la calidad general y la detección de disminución de visión. Se analizó la sensibilidad mediante simulaciones de Monte Carlo. Resultados: El prestador privado es dominante en calidad y costo-efectivo para la detección de disminución de visión. Conclusiones: La compra estratégica de prestadores privados de atención primaria es promisoria para mejorar los servicios de salud y reducir los costos.

Abstract: Objective: To estimate the cost-effectiveness ratio of public and private health care providers funded by Seguro Popular. Materials and methods: A pilot contracting primary care health care scheme in the state of Hidalgo, Mexico, was evaluated through a population survey to assess quality of care and detection decreased of vision. Costs were assessed from the payer perspective using institutional sources.The alternatives analyzed were a private provider with capitated and performance-based payment modalities, and a public provider funded through budget subsidies. Sensitivity analysis was performed using Monte Carlo simulations. Results: The private provider is dominant in the quality and cost-effective detection of decreased vision. Conclusions: Strategic purchasing of private providers of primary care has shown promising results as an alternative to improving quality of health services and reducing costs.

Observations on the biology and distribution of Uresiphita reversalis (Lepidoptera, Crambidae), a defoliator of the native tree Calia secundiflora in México

Observations on the biology and distribution of Uresiphita reversalis (Lepidoptera, Crambidae), a defoliator of the native tree Calia secundiflora in México. Uresiphita reversalis (Guenée, 1854) feeding on Calia secundiflora (Ortega) Yakovlev is recorded for the first time in the state of Hidalgo, Mexico. New aspects regarding the life cycle, feeding behaviour, geographical distribution and host plant damage by U. reversalis on C. secundiflora are here presented and discussed.

Conductas alimentarias de riesgo, interiorización del ideal estético de delgadez e índice de masa corporal en estudiantes hidalguenses de preparatoria y licenciatura de una institución privada / Disordered eating, internalization of the body thin-ideal and body mass index in high school and college students from a private institution in Hidalgo, Mexico

The term <> is immediately related to food consumption. However, eating is a complex behavior mediated by external factors. Eating is not exclusively related to satisfying individual's needs or nutritional requirements. Eating behavior alteration has originated disordered eating (DE) and eating disorders (ED), such as anorexia nervosa, bulimia nervosa and binge eating syndrome, where patterns of food ingestion are altered and people forget the importance of maintaining a balance between caloric ingestion and caloric expenditure, with repercussions in the nutritional status and in the individual's health. Recent studies carried out in Mexican population have confirmed the presence of DE, particularly among adolescents and young adults, and predominantly in females. Data from a representative sample of students with a mean age of 14.5 years reported an increase in the proportion of DE between the 1997 and the 2003 assessments (1.3% in males and 3.4% in females) compared to the 3.8% in males and 9.6% in females registered in 2003. More recent data from the National Nutrition and Health Survey 2006, in a representative sample of adolescents 10 to 19 years of age, indicated a prevalence of 0.8% (1% in females and 0.4% in males), with higher scores in the north and center-west areas of the country, followed by the central and south-south-east areas, with almost two-fold percentages in the urban settings compared to the rural ones. The multifactorial origin of ED is well known and among the most studied risk factors are: eating behaviors, high body mass index (BMI) and body thin-ideal internalization. Research findings indicate that overweight and obese adolescents are at more risk for body dissatisfaction, as their physical appearance is farther away from being as the one promoted by society and the media. The sociocultural pressure to be thin has promoted the internalization of the idea that being thin is synonymous to success, greater social acceptance, femininity (among females), self-control, and self-esteem. Based on the above, the main purpose of this paper was to evaluate the prevalence of DE and its relationship to body thin-ideal internalization and BMI in high school and college male and female students from an urban setting. An additional objective was to provide data on reliability and validity of the scales used in a sample of males, as well as additional validity data in females. Data analyzed in this research come from a larger study on risky factors associated to ED carried out in high-school and college students in the city of Pachuca, Hidalgo, during the 2007-2008 school years. After censing the school, a sample of 845 students was selected (381 males, 464 females), 45.1% was from high school, with a range of 15 to 17 years(× =15.82; D.E.=0.78), and 54.9% from college with a range of 18 to 23 years(× =19.81; D.E.=1.41) and that completed the questionnaires adequately. Two previously validated questionnaires in Mexican samples were used to assess DE and body thin-ideal internalization: the Brief Questionnaire for Risky Eating Behaviors and the Attitudes toward Body Figure Questionnaire. Cutoff points for these questionnaires were used to determine the prevalence rates. BMI was obtained by measuring each subject's weight and height by standardized experts and divided in categories according to NCHS those under 18 years old, and to the World Health Organization Experts Committee for those above 18. Self-reported questionnaires were applied to students after verbal consent was received from the school authorities and students, who were previously informed about the voluntary, anonymous, and confidential nature in the study. The protocol was revised by the Ethics Committee of the institution were the field work was carried out. Descriptive analyses were held, as well as Student t tests for comparisons between groups, and a logistic regression analysis to estimate the risk for DE. Results showed that 70% of the women had a normal weight, and there were fewer students in the very underweight and underweight categories (high-school 2.9% and 8.7% college) than those in the overweight and obese categories (high-school 15.2% and 8.3% vs. 18.6% and 6.6% in college). Among the males, a similar distribution was found, 71.3% of the high-school and 58.2% of college students have normal weight, 2.7% and 4.8% low weight, 19.1% and 26.1% were overweight, and 6.9% and 10.9% were obese, respectively. The prevalence of DE was 8.4% in females (9.0% in high school and 7.9% in college), and 2.9% in males (1.6% in high school and 4.2% in college). DE was more prevalent among females, with the exception of binge eating and lack of control while eating. The analysis by BMI showed that neither females nor males with very low or low weight scored high on DE. The higher percentages were obtained for the overweight students of both sexes, and obese males obtained the higher percentages of all. From the total of females with DE, the 84.2% of high-school and 80% of college students also scored high on body thin-ideal internalization, while in males the results were 33.3% and 62.5%, respectively. The regression analysis indicated that the two variables associated with DE were body thin-ideal internalization (OR=27.27) and sex <> (OR=2.33). The model correctly classified 94.5% of the cases and explained 35% of the DE occurrence. The DE scale yielded a reliability score of 0.72 in females and of 0.63 in males. For both males and females, the scale yielded 3 factors with a congruent conceptual structure. The Attitudes toward Body Figure Questionnaire had a reliability of 0.94 in females and of 0.89 in males. In the case of females, the structure obtained nearly replicated the one obtained in Mexico City's students, but in the case of the male's questionnaire, three questions were eliminated leaving a two-factor structure. From the present data, it can be concluded that DE is present in the sample studied, mainly in females. It was also found that the preoccupation with gaining weight, dieting, and excessive exercising with the purpose of losing weight are also present in a high percentages in Mexican youths not only from the largest metropolis, but also in other urban settings such as Pachuca, Hidalgo. The prevalence found was similar to the one from the Student Survey from Mexico City in adolescents. A positive relationship between DE, educational status, and age was also found; overweight women and obese men were the ones that obtained the higher percentages of DE. The fact that obese men displayed the higher percentages is an important finding regarding the development of future preventive interventions, as it has been so far a neglected population in relation to this topic. The psychometric properties of the validated questionnaires in females were adequate and factorial structures were conceptually congruent. Nevertheless, in the case of males, it is important to continue working in the development of screening questionnaires sensible to their conceptions, beliefs, and attitudes regarding eating, weight control, and beauty ideal, in a way to count with reliable and valid instruments for the detection of DE and body thin-ideal internalization, so we recommend to use caution in interpreting the use of these scales in male populations.

El término <> se asocia de manera inmediata con el hecho de ingerir alimentos; sin embargo, es una conducta compleja mediada por factores externos a la persona y no exclusivamente porque los individuos quieran satisfacer sus necesidades alimentarias y sus requerimientos nutricios. La alteración de esta conducta ha dado origen a lo que se conoce como trastornos de la conducta alimentaria (TCA) tales como la anorexia nervosa, la bulimia nervosa y <>, en los cuales se ven distorsionados los patrones de la ingestión de alimentos, olvidándose la importancia de mantener un balance entre ingestión y gasto de energía, lo que repercute de manera importante en el estado nutricio y por ende en la salud del individuo. Es bien sabido el origen multifactorial de los TCA, y dentro de los factores de riesgo más estudiados están: las conductas alimentarias, el Índice de Masa Corporal (IMC) y las actitudes hacia el cuerpo provenientes de la interiorización de una figura corporal delgada. El objetivo principal de este estudio fue conocer la prevalencia de las conductas alimentarias de riesgo (CAR) y su relación con la interiorización del ideal estético de delgadez y con el IMC, en estudiantes de ambos sexos de nivel preparatoria y licenciatura en una escuela privada de la ciudad de Pachuca, Hidalgo. Un objetivo adicional fue el de proporcionar datos de confiabilidad y validez de las escalas utilizadas en una muestra de hombres, así como datos adicionales de validez en las mujeres. Se trabajó con una muestra de 845 sujetos (381 hombres y 464 mujeres) de los cuales 45.1% eran de nivel preparatoria con un rango de edad de 15 a 17 años (× =15.82; D.E.=.78) y 54.9% de nivel licenciatura en un rango de edad de 18 a 23 años (× =19.81; D.E.=1.41). Se aplicaron el Cuestionario Breve de Conductas Alimentarias (CBCAR) y el Cuestionario de Actitudes hacia la Figura Corpora l. El IMC se obtuvo partir de la medición del peso y la estatura de cada sujeto. La distribución por categorías del IMC por nivel escolar mostró que el 70% de las mujeres tiene peso normal, y que el porcentaje de las que se encuentran en las categorías de peso muy bajo y bajo (preparatoria 2.9% y licenciatura 8.7%) es mucho menor que las que se hallan en sobrepeso y obesidad (preparatoria 15.2% y 8.3% vs. licenciatura 18.6% y 6.6%). En los hombres se encontró una distribución similar: 71.3% de los de preparatoria y 58.2% de los de licenciatura tienen peso normal, 2.7% y 4.8% bajo peso, 19.1% y 26.1% sobrepeso, y 6.9% y 10.9% obesidad, respectivamente. La prevalencia de CAR en mujeres fue de 8.4% (9.0% en preparatoria; 7.9% en licenciatura) y de 2.9% en hombres (1.6% en preparatoria; 4.2% en licenciatura). <>. Del total de mujeres con CAR elevadas, el 84.2% de preparatoria y el 80% de licenciatura también obtuvo puntuaciones altas en el cuestionario sobre interiorización del ideal estético de delgadez, en tanto que en los hombres fue el 33.3% y el 62.5%, respectivamente. La escala CBCAR en mujeres arrojó un alfa de Cronbach de 0.72 y de 0.63 en hombres. El instrumento de actitudes alcanzó valores de confiabilidad de 0.94 para mujeres y de 0.89 para hombres. Se puede concluir que en la población estudiada están presentes las CAR características de los TCA, y que a mayor interiorización de una figura delgada mayor aparición de dichas conductas, principalmente entre las mujeres. Igualmente se comprobó que la práctica de dietas y de ejercicio para bajar de peso, aunadas a la preocupación por engordar, se presentan en porcentajes importantes en estudiantes del Estado de Hidalgo, lo que confirma que esta problemática no es exclusiva de las grandes urbes.

Luis Hidalgo y Carpio, editor de Gaceta Médica de México (1818-1879) / Luis Hidalgo y Carpio, editor of Gaceta Médica de México (1818-1879)

Luis Hidalgo y Carpio (1818-1879) fue un insigne médico mexicano especializado en aspectos forenses, que hizo interesantes aportaciones a la medicina de su tiempo; sin embargo, para el perfil que interesa destacar, el de editor, las fuentes no son abundantes, pues precisamente en 1867, cuando Hidalgo y Carpio ocupó la presidencia de la Sociedad Médica de México, conocida posteriormente como Academia Nacional de Medicina, se interrumpió la publicación de Gaceta Médica de México, medio informativo de la Sociedad Médica. El papel de nuestro personaje como editor fue de gran trascendencia debido a que la comunidad médica requería un medio de comunicación donde externara sus logros científicos y se retroalimentara con las lecturas de la publicación en cuestión, que tuvo un gran alcance no solo por el carácter periódico que la caracterizó sino también por el organismo que representaba.

Luis Hidalgo y Carpio (1818-1879) was a notable physician who made important contributions to the field of medicine during his time. Nevertheless, reference sources on the aspect from Hidalgo y Carpio that we would like to emphasize (i.e. as an editor of a medical journal) are scarce since precisely when Hidalgo y Carpio was named President of the Medical Society (later the Academia Nacional de Medicina), in 1987, the publication of the Gaceta Médica de México was temporarily interrupted. Hidalgo y Carpio played a key role as an editor at a time when the medical community of Mexico required a means whereby the scientific achievements could be published and discussed among peers and colleagues. Under Hidalgo y Carpio, the Gaceta Médica de México soon reached a wide audience, not only as a periodical publication but also for the prestige of the Academy that represented.