Ethnic disparities in COVID-19 mortality in Mexico: A cross-sectional study based on national data.

INTRODUCTION: Across the world, the COVID-19 pandemic has disproportionately affected racial and ethnic minorities. How ethnicity affects Indigenous peoples in Mexico is unclear. The aim of this cross-sectional study was to determine the mortality associated with ethnicity, particularly of Indigenous peoples, in a large sample of patients with COVID-19 in Mexico. METHODS: We used open access data from the Mexican Ministry of Health, which includes data of all confirmed COVID-19 cases in the country. We used descriptive statistics to compare differences among different groups of patients. Logistic regression was used to calculate odds ratios while adjusting for confounders. RESULTS: From February 28 to August 3, 2020, a total of 416546 adult patients were diagnosed with COVID-19. Among these, 4178 were Indigenous peoples. Among all patients with COVID-19, whether hospitalized or not, a higher proportion of Indigenous peoples died compared to non-Indigenous people (16.5% vs 11.1%, respectively). Among hospitalized patients, a higher proportion of Indigenous peoples died (37.1%) compared to non-Indigenous peoples (36.3%). Deaths outside the hospital were also higher among Indigenous peoples (3.7% vs 1.7%). A higher proportion of Indigenous peoples died in both the private and public health care sectors. The adjusted odds ratio for COVID-19 mortality among Indigenous peoples with COVID-19 was 1.13 (95% confidence interval 1.03 to 1.24). The adjusted odds ratio for COVID-19 mortality among Indigenous peoples with COVID-19 was higher among those who received only ambulatory care (1.55, 95% confidence interval 1.24 to 1.92). DISCUSSION: In this large sample of patients with COVID-19, the findings suggest that Indigenous peoples in Mexico have a higher risk of death from COVID-19, especially outside the hospital. These findings suggest Indigenous peoples lack access to care more so than non-Indigenous people during the COVID-19 pandemic in Mexico.

Morphometric assessment of the lumbar pedicle isthmus by reformatted CT: variations according to age and gender

This work aims to determine the morphometric characteristics of the lumbar pedicle isthmus with surgical relevance to transpedicular procedures using reformatted computed tomography (CT) and to determine the possible variations in the diameters between genders and age groups. Observational, cross-sectional, descriptive and comparative anatomical studies were carried out. We analyzed 200 CT studies of Mexican patients of known age and gender. The images were analyzed using specialized software for reformatting that could determine cortical and endosteal diameters and cortical thickness at the level of the pedicle isthmus. The mean and standard deviation for each measurement parameter were determined, and a parametric correlation test was performed to compare the variations between the age groups of the same gender. Significant differences in the pedicle diameters between men and women were evident for most of the age groups (p <0.05). The cortical and endosteal pedicle width showed an increase from L1 to L5; the reverse was observed for cortical and endosteal pedicle height. No significant differences were evident with respect to age in the horizontal and vertical diameters for most of the generated study groups. The lateral cortical bone had the lowest scores of the study. The mean values of the morphometric characteristics of the pedicle isthmus obtained in this study will be helpful to conclusively define the pedicle dimensions and to improve the transpedicular approach to the lumbar spine

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