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Background: The COVID-19 fatality rate exhibited significant variations during the first year of the pandemic, and such divergences seem to show different levels of risk of death among populations. Very few studies stratified fatality based on the presence or absence of risk factors., Objective: To identify COVID-19 fatality rates conditioned by risk factors., Material and Methods: Secondary analysis using an open health database from the Secretariat of Health of Mexico (Secretaría de Salud), covering patients studied from January 1, 2020, to January 6, 2021. Patients with confirmed COVID-19 result were included; those with 5 risk factors or more, or with rare combinations of factors were excluded. The final sample consisted of 394,537 patients. The database was segmented into groups based on 0, 1, 2, 3, and 4 risk factors. The fatality rate conditioned by risk factors was estimated (83 combinations)., Results: Among patients with 0 risk factors, the fatality rate was 2.1%. In those aged ≥ 50 years alone or more, the fatality rate was 20.2%. The combination of factors with the highest fatality rate was age ≥ 50 years + diabetes + obesity (57.1%)., Conclusions: COVID-19 fatality rates conditioned by risk factors ranged from 1.7% to 57.1%, according to the presence or absence of specific comorbidities. Studies like this are necessary to address more precisely the risk of death among subpopulations exposed to different risk factors., (Licencia CC 4.0 (BY-NC-ND) © 2024 Revista Médica del Instituto Mexicano del Seguro Social.)

In diabetes, obtaining optimal control is key to reducing chronic complications. Unfortunately, not all patients achieve the recommended goals. Therefore, the challenges to develop and evaluate comprehensive care models are enormous. In October 2008, the Diabetic Patient Care Program (DiabetIMSS) was designed and implemented in family medicine. Its principal component is the multidisciplinary team (doctor, nurse, psychologist, dietitian, dentist, and social worker) that offers coordinated health care; monthly medical consultation and individual, family and group education on self-care and prevention of complications for 12 months. Due to the COVID-19 pandemic, the percentage of attendance at the DiabetIMSS modules decreased significantly. This is how the Medical Director considered it necessary to strengthen them, and the Diabetes Care Centers (CADIMSS) arose. In addition to providing medical care with a comprehensive and multidisciplinary approach, the CADIMSS encourages the co-responsibility of the patient and his family. It consists of monthly medical consultation and nursing staff provides monthly educational sessions for 6 months. Pending tasks remain and there are still areas of opportunity to modernize and reorganize services that contribute to improving the health of the population with diabetes., (© 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

Background: Despite the importance and availability of cardiovascular risk stratification (CVR) systems, few Latin American studies use them in health care workers., Objective: To evaluate the CVR stratification based on type, number of risk factors and current blood pressure category in primary care employees., Material and Methods: Cross-sectional design study (n = 308). Through an interview, CVR, labor, contractual and sociodemographic profiles were collected. Weight, height, abdominal circumference, blood pressure, glucose and cholesterol were also measured. The CVR prevalence and prevalence ratio were estimated according to labor, contractual and sociodemographic characteristics. Difference in proportions tests were applied., Results: Obesity and central obesity were present in 32.4% and 58.5% of participants, respectively. Blood pressure was high normal in 11.8% and grade 1 hypertension was in 7.2%. Nineteen percent had low, moderate or high CVR; and 53.9% registered ≥ 3 risk factors. The highest PR corresponded to have ≥ 7 years of service, followed by age ≥ 38 years, permanent hiring status, male sex and married status., Conclusions: The stratification system was practical and feasible. Planning preventive and corrective actions is of great importance for lowering cardiovascular events and lost productive years., (Copyright: © 2020 Revista Medica del Instituto Mexicano del Seguro Social.)

Background: People with metabolic syndrome (20-25 % of the world population) are three times more likely to suffer a heart attack or stroke and twice as likely to die from this cause. The objective of this study was to assess the prevalence of metabolic syndrome in workers of a second level hospital., Methods: This was a cross-sectional study with 160 healthcare workers in Monterrey, México. Sociodemographic, anthropometric and biochemical data were obtained to assess the prevalence of metabolic syndrome. Bivariate and multiple logistic regression analysis were carried out in order to assess the relationship between metabolic syndrome and sociodemographic and occupational variables., Results: The prevalence of metabolic syndrome among workers was 38.1 %. Nurses were more affected with 32.8 %. Overweight and obesity were prevalent in 78 %. In the logistic regression there was a significant association between metabolic syndrome and not having partner (OR 3.98, 95 % CI [1.54-10.25]) and obesity (OR 4.69, 95 % CI [1.73-12.73])., Conclusions: The prevalence of metabolic syndrome and obesity is alarming. Appropriate and prompt actions must be taken in order to reduce the risk of cardiovascular disease in this population.

Background: Prevalence of overweight and obesity in children under 5 years can be affected by type of anthropometric indicator and selected threshold values. We assessed variation on estimates according to national and international regulations (NOM-031-SSA2-1999, NOM-008-SSA3-2010, GPC-SSA-025-08 and GPC-IMSS-029-08; WHO-2006, CDC-2000 and IOTF, respectively)., Methods: Cross-sectional study in all the daycare centers (100 %) affiliated to Instituto Mexicano del Seguro Social-Nuevo León during June-December, 2010 (n = 11 141 children). Overweight and obesity were defined on the basis of each regulation, and total and stratified prevalences by age and sex were estimated., Results: According to national regulation, overweight/obesity estimates varied from 12 to 22 %, and to international normativity, from 3 to 14 %. The highest prevalence was given by NOM-008-SSA3-2010 and GPC-SSA-025-08; and the lowest by WHO-2006. There were no differences by sex, but they existed by age; the highest discrepancy occurred in the 3.0-3.9 age group with 28 %., Conclusion: Health personnel and health policy makers should be aware of variation on estimates according to the definition employed. We recommend to standardize national regulation for pointing out overweight/obesity in preschoolers.