Lockdown, relaxation, and acme period in COVID-19: A study of disease dynamics in Hermosillo, Sonora, Mexico.

Lockdown and social distancing measures have been implemented for many countries to mitigate the impacts of the COVID-19 pandemic and prevent overwhelming of health services. However, success on this strategy depends not only on the timing of its implementation, but also on the relaxation measures adopted within each community. We developed a mathematical model to evaluate the impacts of the lockdown implemented in Hermosillo, Mexico. We compared this intervention with some hypothetical ones, varying the starting date and also the population proportion that is released, breaking the confinement. A Monte Carlo study was performed by considering three scenarios to define our baseline dynamics. Results showed that a hypothetical delay of two weeks, on the lockdown measures, would result in an early acme around May 9 for hospitalization prevalence and an increase on cumulative deaths, 42 times higher by May 31, when compared to baseline. On the other hand, results concerning relaxation dynamics showed that the acme levels depend on the proportion of people who gets back to daily activities as well as the individual behavior with respect to prevention measures. Analysis regarding different relaxing mitigation measures were provided to the Sonoran Health Ministry, as requested. It is important to stress that, according to information provided by health authorities, the acme occurring time was closed to the one given by our model. Hence, we considered that our model resulted useful for the decision-making assessment, and that an extension of it can be used for the study of a potential second wave.

[Early menarche as a risk factor of breast cancer]. / Menarquia temprana como factor de riesgo de cáncer de mama.

BACKGROUND: Most of the information in medical literature report diverse factors of breast cancer, which are related to the reproductive life of the woman. It is mentioned that menarche before the 12 years elevates the relative risk of this disease, in comparison with its appearance after the 13 years. OBJECTIVE: To determine if early menarche is a risk factor associated to breast cancer. MATERIAL AND METHODS: This retrospective, observational and descriptive study included 162 women with breast cancer from a 3 years period (2002-2004), in the Juarez Hospital of Mexico. In addition other well known risk factors for breast cancer were evaluated. The statistical analysis was made with the software program SPSS; the descriptive analysis was made by means of summary of statistics, histograms, box and bar charts. RESULTS: Early menarche doesn't have correlation with breast cancer nor with the appearance of the disease in early ages; it was present in the 12.3% (n = 20) of the patients; the menarche initiated between 12 and 13 years in 64.4% (n = 104.3) of the cases. The average age at the time of the diagnosis of breast cancer in the early menarche group was of 55 years and for the group in general of 47.6 years. The factor that seems to be related to breast cancer is overweight and obesity with 54.26 and 17.11% respectively, with an average body mass index of 27.7 kg/m2. CONCLUSIONS: There was not a correlation between early menarche as risk factor for breast cancer neither between the reproductive risk factors considered habitual and increased risk of breast cancer. Overweight and obesity seem to be related to the appearance of the disease, reason why it is required to investigate this with different random control groups in the country. We propose to study other factors that may be implicated in the genesis of breast cancer such as inflammatory factors, similar insulin growth factors and hyperinsulinism.

[Prevalence of postmenopausal simple ovarian cyst diagnosed by ultrasound]. / Prevalencia de quistes simples de ovario diagnosticados por ultrasonido en mujeres posmenopáusicas.

INTRODUCTION: The high-resolution ultrasound has taken to discover small ovary cysts in postmenopausal asymptomatic women who in another situation would not been detected; these cysts frequently disappear spontaneously and rarely develop cancer; however, they are treated aggressively. OBJECTIVE: To know the prevalence, evolution and treatment of ovary simple cysts in the postmenopausal women in our department, since in our country there are not studies that had analyzed these data. MATERIAL AND METHODS: We made a retrospective and descriptive study in the Service of Biology of the Human Reproduction of the Hospital Juarez de Mexico, in a four-year period (2000-2003) that included 1,010 postmenopausal women. The statistical analysis was made using the SPSS software program with which we obtained descriptive measurements in localization, dispersion and by a graphic analysis. RESULTS: We found a simple cysts prevalence of 8.2% (n = 83); the average of age at the diagnosis time was 50.76 years with a standard deviation of 5.55; the cysts diameter was between 0.614 to 12,883 cm with a mean and standard deviation of 2.542 and 1.91 cm respectively; in 27.71% of the cases (n = 23), the cysts disappear spontaneously in the follow up of 3 to 36 month (mean of 14.1). Surgery was indicated in 16.46% (n = 13), by increase in the size of the cyst in 9 patients (11.64%) and by changes in morphology from simple to complex in 4 (4.82%). Tumor like markers were made only to 37 patients (44.57%), which were in normal ranks; no carcinoma was found in this group. CONCLUSIONS: The prevalence of ovary simple cysts was similar to the reported in literature. Risk of cancer of these cysts is extremely low when a suitable evaluation is made, a reason why the conservative treatment is suggested when these are simple cysts lesser than 5cm with Ca-125 levels within normal ranks. We recommend a follow up every 3-6 months by Doppler color ultrasound and tumor like markers for five years.