Introducción: Se informa que la mayoría de los niños afectados por SARS-CoV-2 cursan asintomáticos y que en ellos la mortalidad por COVID-19 es baja; en México se desconoce la información al respecto en este grupo de la población. Objetivo: Evaluar los factores de riesgo asociados a mortalidad en niños mexicanos con

Introduction: Most children affected by SARS-CoV-2 are reported to be asymptomatic, and COVID-19-related mortality in them is low; in Mexico, there is a lack of information on the subject in this population group. Objective: To assess the risk factors associated with mortality in Mexican children with COVID-19. Method: Secondary analysis of the General Directorate of Epidemiology database. Children younger than 19 years, in whom SARS-CoV-2 infection was confirmed by RT-PCR, were included. Results: 1443 children were included. Median age was eight years; 3.3 % were admitted to the intensive care unit, 1.8 % required assisted mechanical ventilation, and mortality was 1.9 %. In multivariate models, the development of pneumonia was the main risk factor for mortality, with an odds ratio (

Los gráficos constituyen una ayuda visual que usan los artículos para resaltar los resultados de una investigación. Estos permiten ilustrar los resultados con el fin de hacerlos más claros. Los gráficos, al igual que las pruebas estadísticas, se seleccionan a partir del objetivo del estudio, de los tipos de variable y de los análisis estadísticos que se desee ilustrar. Algunos de los gráficos más usados en la práctica clínica son los histogramas de frecuencia que ilustran las variables cualitativas o frecuencias, los gráficos de error se usan para variables cuantitativas con distribución normal, el gráfico de cajas o gráfico de violín para variables cuantitativas de libre distribución y las curvas de supervivencia para las variables que incluyen la variable tiempo/persona. Estos mismos gráficos pueden ser usados para ilustrar las comparaciones entre maniobras y desenlace dependiendo del tipo de variable que se analice. Cuando se comparan dos grupos y la variable dependiente es dicotómica se usan gráficos de bosque. Para los modelos multivariados los gráficos dependen del tipo de análisis, en el caso de la regresión logística se utilizan gráficos de árbol y para la regresión lineal de dispersión y para los riesgos proporcionales de Cox, gráficos de supervivencia. Si bien los gráficos son de gran utilidad, mal utilizados pueden mostrar diferencias donde no las hay, provocando una errónea interpretación de los estudios. En este artículo complementaremos con ejemplos los temas abordados con anterioridad en los artículos de esta misma serie.

Introduction:Cardiotoxicity is an adverse reaction associated with the use of anthracyclines. Objective: To estimate the factors associated with the development of anthracycline cardiotoxicity in pediatric patients surviving cancer. Method: Retro-prolective cohort of children diagnosed with cancer and treated with anthracyclines. Baseline echocardiographic determination of ejection fraction (LVEF0) was carried out before the start of treatment and again at 12 months (LVEF1). Demographic characteristics and treatment were obtained from the medical record. A multiple logistic regression (MLR) model was constructed; LVEF1 < 50 % was the dependent variable, which was adjusted for the main confounding variables. Results: Sixty-five patients were included, out of which 36.9 % were females and 56.8 % had a solid tumor. LVEF0 was 74.79 ± 7.3 % and LVEF1, 67.96 ± 6.7 % (p = 0.001); 60 % developed cardiotoxicity. In the MLR, only a cumulative dose > 430 mg was associated with cardiotoxicity (p = 0.001). Conclusions: In Mexican children, an anthracycline cumulative dose > 430 mg should be avoided in order to prevent cardiotoxicity.

BackgroundThe current surgical management of Neovascular Glaucoma (NVG) is with the placement of the Ahmed Valve. However, up to 70% fail and the factors associated with this failure are unknown. Recognizing the factors associated with dysfunction will help to identify patients prone to failure promptly to establish prompt management and improve visual and functional prognosis.ObjectiveTo determine the risk factors associated with Ahmed valve dysfunction in patients with NVG during the first year after surgery.PopulationPatients diagnosed with VNG who have undergone Ahmed valve implantation in the Glaucoma - APEC service, during the 2013 to 2019 period.Methodsambispective cohort. Patients with NVG defined as the Presence of neovessels in the iris or angle of the anterior chamber were included, those who had a history of implantation of a drainage device, and patients with a diagnosis of glaucoma in the terminal phase, worse visual acuity of perception were excluded. of light. The research unit was eyes subjected to Ahmed valve implantation. The demographic characteristics of the patients were evaluated, as well as the characteristics of the eyes.The primary outcome and the secondary outcomes were adverse events, visual acuity, and final intraocular pressure. An unadjusted Cox proportional hazards model was used to determine risk factors such as Hazzard ratios (HR). Those significant factors were included in a Cox proportional hazards model to adjust for the main confounding variables.Results174 eyes were included. Baseline intraocular pressure (IOP) was 46.03 (±11.8) mmHG. Baseline VA in LogMAR was 1.52(0.89-2.3). Risk factors were: Age <50 years with HR 1.54(95% CI 1.04-2.30); HB1Ac >8% HR 1.71 (95% CI 1.12-2.60) and presence hypertensive phase HR 3.13 (95% CI 1.57-6.23). The multivariate model was adjusted for the following variables, baseline IOP less than 40mmHg HR 1.60 (95% CI 1.04-2.47); HB1Ac >8% HR 1.80 (95% CI 1.16-2.78); FP7 valve type HR 1.75(95% CI 1.04-2.94) and presence of hypertensive phase HR 3.24 (95% CI 1.60-6.59).ConclusionBasal IOP less than 40mmHg, HB1Ac >8%, type of FP7 valve, surgery performed by a resident, lack of photocoagulation after implantation, and the presence of a hypertensive phase are the independent risk factors for implant valvular dysfunction.