Background: Regional information regarding the characteristics of patients with coronavirus disease (COVID)-19 is needed for a better understanding of the pandemic. Objective: The objective of the study to describe the clinical features of COVID-19 patients diagnosed in a tertiary-care center in Mexico City and to assess differences according to the treatment setting (ambulatory vs. hospital) and to the need of intensive care (IC). Methods: We conducted a prospective cohort, including consecutive
Objective To determine stroke prevalence, mechanisms, and long-term outcome in a cohort of Hispanic patients with systemic lupus erythematosus (SLE). Methods We analyzed demographical data, the timing between SLE diagnosis and stroke onset, stroke type, recurrence, and outcomes from an institutional database of 4451 patients with SLE followed from 1993 to 2018. Results We observed 139 strokes (3.1%), for an incidence rate of 1.25 per 1000 person-years: 81 (58.3%) acute ischemic stroke (AIS), 19 (13.7%) subarachnoid hemorrhage (SAH), 17 (12.2%) cerebral venous thrombosis, 13 (9.4%) intracerebral hemorrhage (ICH), and 9 (6.5%) transient ischemic attack. Median time from SLE diagnosis to acute stroke was 60 months (interquartile range 12–132 months). AIS had a bimodal presentation with 26% occurring within the first year and 30% >10 years after SLE diagnosis. In contrast, 75% of ICH cases occurred >3 years (and 34% >10 years) after SLE diagnosis. The most important cause of AIS was secondary antiphospholipid syndrome (48%). Hypertension was associated with 69% of ICH cases, while aneurysmal rupture was observed in 78% of SAH cases. Excellent recovery at hospital discharge was observed in 65%. Stroke recurrence was observed in 7%. The long-term all-cause fatality rate was 8%. Conclusions The prevalence of stroke in this cohort was 3.1%. Ischemic strokes had a bimodal presentation, occurring either early after SLE diagnosis or after a several-year delay. Half of the hemorrhagic strokes occurred >10 years after the diagnosis of SLE. Clinical outcome was usually good with a relatively low recurrence rate.
Background We evaluated the risk of death of healthcare workers (HCW) with SARS-CoV-2 infection in Mexico City during the COVID-19 pandemic and described the associated factors in hospitalized HCW compared with non-HCW. Methods We analyzed data from laboratory-confirmed SARS-CoV-2 cases registered from February 27-August 31, 2020 in Mexico City’s public database. Individuals were classified as non-HCW and HCW (subcategorized as physicians, nurses and other HCW). In hospitalized individuals, a multivariate logistic regression model was used to analyze potential factors associated with death and compare mortality risk among groups. Results A total of 125,665 patients were included. Of these, 13.1% were HCW (28% physicians, 38% nurses and 34% other HCW). Compared with non-HCW, HCW were more frequently female, younger and free of comorbidities. Overall, 25,771 (20.5%) were treated as inpatients and 11,182 (8.9%) deaths were reported. Deaths in the total population and in hospitalized patients were significantly higher in non-HCW than in HCW (9.9% vs 1.9%, P<.001; and 39.6% vs 19.3%, P<.001, respectively). In hospitalized patients, using a multivariate model, the risk of death in HCW in general was lower (OR 0.53) compared to non-HCW, and by specific occupation, in physicians, nurses and other HCW risk was OR 0.60, 0.29, 0.61, respectively. Conclusions HCW represent an important proportion of individuals with SARS-CoV-2 infection in Mexico City. While the mortality risk in HCW is lower compared with non-HCW, a high mortality rate in hospitalized patients was observed in this study. Among HCW, nurses had lower risk of death compared to physicians and other HCW.
BackgroundQuantitative Sensory Testing (QST) is more often used because of the increasing recognition of small fiber neuropathy.MethodsWe studied QST in a systematic way in an age‐stratified cohort of 83 neurological‐free Hispanic Latinamerican patients. Predefined standardized stimuli were applied using the method of limits.Results WDT range from 2.2 to 3.3°C in hands, and from 4.0°C up to 6.6°C in feet. Cold detection threshold range from 2.2 to 3.6°C in hands, and from 2.6°C to 4.5°C in feet. Heat‐induced pain (HP) was induced at lower temperatures than previously reported, with a range from 41.8°C to 44.5°C in hands and from 43.2 to 45.7°C in feet. Similar to HP, cold pain was also induced at much higher temperatures, between 21.4–17.3°C in hands and 21.5–16.5°C in feet. Vibratory stimuli ranged from 0.8 to 1.7 μ/sec in hands and from 1.4 to 3.5 μ/sec in feet.ConclusionTemperature and vibration thresholds were similar to those previously reported in other populations except for pain thresholds that were lower in this population than in the Caucasian population.
, the number of valid observations per covariate is omitted in tables 1-3. New tables with this information are provided. The authors apologize for this omission.
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