Objective COVID-19 progression to severe or critical illness may be related to initial clinical presentation. Main objective was to identify initial symptoms related to highest risk of disease progression, in mild or moderate suspected or confirmed COVID-19 patients or in asymptomatic subjects in contact with a recently diagnosed patient. Design and methods Historic cohort study of Mexican patients with suspected or confirmed mild or moderate COVID-19 or asymptomatic subjects in recent contact with positive patients. They sought medical attention in Centro Medico ABC or claimed for remote attention, and daily telemedicine follow up until recovery or illness progression, from April 17th to October 08th 2020. Data excerpted for analysis were sex, age, body mass index, comorbidities, and signs, and symptoms presented in first day of disease manifestations and during follow up. We used logistic regression to identify initial symptoms associated with progression disease and through a conjunctive consolidation analysis a symptom index was created. Results 120 of 1635 patients (7.2%) had clinical progression disease. By logistic regression we found as initial symptoms related to progression: fever OR 3 (1.89-4.77, p<0.001), cough OR 2.34 (1.56-3.52, p<0.001), myalgias or arthralgias OR 1.69 (1.09-2.63, p=0.018), and fatigue OR 1.65 (1.08-2.53, p=0.019). Conjunctive consolidation was processed with the previous symptoms, and a 3 groups score resulted C-19PAIS Index: 1) Fever with cough or fever with fatigue, with a probability of progression disease of 29% (31/106 patients), 2) Fever or cough or fatigue or cough with fatigue, 10.7% (66/615 patients) and 3) No fever, no cough, no fatigue, 2% (23/914). Conclusions Initial symptoms predict clinical progression in COVID-19 patients.

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Quantose MR -Resistencia a la insulina es un nuevo análisis metabolómico que consiste en una sola toma de muestra sanguínea para evaluar resistencia a la insulina. Objetivo: analizar la fiabilidad de Quantose MR -Resistencia a la insulina (Quantose MR -RI) para el diagnóstico de prediabetes en pacientes del primer nivel de atención y compararla con HOMA-IR (Homeostatic Model Assessment-Insulin Resistance), hemoglobina glucosilada y glucosa de ayuno. Material y métodos: estudio observacional, transversal-analítico, llevado a cabo en las Clínicas de Salud Incluyente y Educación, Centro Médico ABC, México. Se estudiaron 135 pacientes, edad promedio de 46 años, 77% mujeres, índice de masa corporal promedio de 30.7, con diagnóstico de prediabetes de acuerdo

Entorno de mujeres embarazadas mexicanas y sus conocimientos y actitudes sobre la atención prenatalMexican pregnant women's environment, knowledge and attitudes on prenatal care RESUMEN Objetivos Explorar barreras y facilitadores para contar con atención prenatal, conocimientos sobre embarazo saludable y; actitudes frente al embarazo.Métodos Estudio cuali-cuantitativo, en embarazadas con vulnerabilidad socio-económica. Se examinaron barreras y facilitadores para recibir atención prenatal y entrevistas estructuradas y semi-estructuradas para evaluar conocimientos y actitudes frente al embarazo. En el análisis cualitativo se categorizaron datos y en el cuantitativo, se estimaron frecuencias y proporciones y promedio y D.E. Resultados Se entrevistaron 10 mujeres entre 18 y 33 años de edad, 50% acudieron al cuidado prenatal durante el primer trimestre. Los facilitadores para atención prenatal: roles en la pareja y apoyo familiar. Las barreras: entorno inseguro, al interior y el exterior del hogar y falta de recursos para transportarse. La mayoría no recibió información para aumentar de peso durante el embarazo. Casi ninguna conocía sobre depresión ni maltrato. La mitad desconocía riesgos del tabaco, alcohol y otras sustancias adictivas, así como de prevención de enfermedades infecto-contagiosas. Las actitudes en torno al embarazo: con estresores de su entorno; viven en ambientes caóticos; con miedos por el embarazo; e interés por adquirir conocimientos sobre su embarazo. Conclusión Las mujeres tienen disposición para adquirir conocimientos sobre el embarazo y cuentan con apoyo familiar y de pareja. Su atención debe fortalecer temas de salud mental, violencia familiar, ganancia saludable de peso, riesgos de sustancias adictivas y prevención de enfermedades infecto-contagiosas; contemplando afrontamiento de entornos inseguros, manejo del tiempo y de la economía familiar.Palabras Clave: Salud materno-infantil; atención prenatal; poblaciones vulnerables (fuente: DeCS, BIREME). ABSTRACTObjectives To explore the barriers and facilitators to prenatal care, as well as the knowledge about healthy pregnancy and the attitude towards pregnancy. Materials and MethodsMixed-methods study in pregnant women with social and economic vulnerability. Barriers and facilitators for prenatal care were examined using ethnographic methods, while structured and semi-structured interviews were used to assess knowledge and attitudes. Data were categorized during the qualitative analysis, and frequencies, ratios, average and standard deviation were calculated in the quantitative analysis. Results Ten women aged between 18 and 33 years were interviewed; 50% sought prenatal care during their first trimester. Facilitators included partner role and family support, and barriers were unsafe neighborhood and home, and lack of funds to cover transportation to the clinic. Most women did not receive information related to weight gain. Almost none knew about depression or abuse. Half of them did not know about risks of addictive