Abraham Campos-Romero

Background/Objectives: Obesity is a chronic, multifactorial condition characterized by excessive adipose tissue that adversely affects health and continues to rise worldwide. It is strongly associated with cardiometabolic abnormalities that increase the risk of adverse outcomes, including type 2 diabetes and coronary heart disease. Methods: We conducted a multicenter, clinic-based cross-sectional analysis of electronic health records from 200,022 adults aged ≥20 years, who accessed nutritional and clinical laboratory services at Salud Digna between 1 January 2022 and 31 December 2025. Nutritional status was classified as normal weight or overweight/obesity using body mass index criteria. Metabolic health was assessed using five components of the National Cholesterol Education Program Adult Treatment Panel III criteria. Individuals were defined as metabolically unhealthy if they met three or more metabolic syndrome criteria. Results: Among participants, 78.17% of males and 79.73% of females were classified as overweight or obese. Metabolic unhealthiness was observed in 50.74% of males and 55.42% of females. The prevalences of metabolically healthy normal weight, metabolically healthy overweight/obesity, metabolically unhealthy normal weight, and metabolically unhealthy overweight/obesity were 18.55%, 31.09%, 3.90%, and 44.20%, respectively. Conclusions: These findings highlight a high burden of overweight/obesity and metabolic abnormalities in a large clinic-based sample of Mexican adults. While not nationally representative, this study provides important insights into the distribution of nutritional and metabolic health profiles in individuals accessing healthcare services, supporting the need for targeted prevention, early detection, and management strategies in clinical settings.

Background/Objectives: Astigmatism is one of the most common refractive errors and represents a risk factor for other ocular conditions, including myopia and amblyopia. In Mexico, comprehensive epidemiological data on refractive astigmatism, particularly its axis-related subtypes, remain limited. This study aimed to estimate the prevalence and distribution of axis subtypes of refractive astigmatism in a nationwide, clinic-based cohort of Mexican outpatients. Methods: We conducted a retrospective, cross-sectional, multicenter study using anonymized electronic health records (EHRs) from Salud Digna clinics across all 32 states of Mexico. Individuals aged 5–90 years who underwent routine non-cycloplegic eye examinations between 2021 and 2023 were included. Refractive astigmatism was defined as a cylinder power (Cyl) of ≤−0.75 D. Age-adjusted prevalence and distribution of axis subtypes (with-the-rule [WTR], against-the-rule [ATR], and oblique [OBL]) were determined according to sex, age groups, and geographic locations. Logistic regression models evaluated potential associations between demographic variables and refractive astigmatism. Results: Data from 8,622,191 individuals were analyzed (median age: 45 years; 63.4% females). The age-standardized prevalence of refractive astigmatism was 41.59% (95% CI: 41.54–41.64%) and was higher in males (45.43%) than females (39.32%). WTR astigmatism predominated among younger individuals, peaking at ages 15–19 (48.97%), whereas ATR astigmatism increased with age, reaching 35.36% among those aged 80–90 years. In multivariable analysis, refractive astigmatism was significantly associated with age, sex, and state of residence, showing a non-linear, non-monotonic age pattern with peaks in adolescence (aOR = 1.47; 95% CI, 1.456–1.484) and older (aOR = 1.177; 95% CI, 1.161–1.193) age, higher odds in males (aOR = 1.269; 95% CI, 1.265–1.272), and marked geographic variability, with the highest in Tlaxcala (aOR = 3.581; 95% CI, 3.491–3.675). Conclusions: Refractive astigmatism was more prevalent in males and showed a clear age-related shift in the axis subtype beginning in the early 40s. These findings provide large-scale, real-world evidence that enhances the understanding of astigmatism epidemiology in Mexico and may inform future research and public health planning.

Background: Refractive errors (REs) and amblyopia are the leading causes of visual impairment (VI) in children worldwide; however, national data for Mexico are scarce. Objective: We aim to estimate the clinical prevalence of RE, refractive amblyopia, and associated visual impairment (VI) in Mexican children aged 6–12 years. Methods: We analyzed 784,372 non-cycloplegic eye examinations from Salud Digna outpatient clinics across all 32 Mexican states (2021–2025). REs were classified as myopia (≤−0.50 D), hyperopia (≥+2.00 D), or astigmatism (≤ −1.00 D cylinder). Refractive amblyopia was defined as best-corrected visual acuity ≤ 20/30 in the most affected eye. The VI categories followed the WHO criteria. Results: Myopia was the most frequent (43.86%), followed by astigmatism (38.41%) and hyperopia (1.29%). Refractive amblyopia affected 4.94% of the children, predominantly due to astigmatic isoametropia (72.19%). VI related to refractive amblyopia occurred in 1.20% (mild), 0.37% (moderate), 0.01% (severe), and 0.01% (blindness) of children. Men showed a higher prevalence of RE and refractive amblyopia (p < 0.01). Geographic disparities were evident, with the central and southern states reporting the highest RA rates. Conclusions: Our outpatient-based study underscores REs, refractive amblyopia, and astigmatic ametropia as significant public health concerns in Mexican school-aged children. The high prevalence of uncorrected REs and refractive amblyopia highlights the need for nationwide school-based screening programs and early intervention strategies to mitigate long-term visual and developmental consequences.

Omicron is the most mutated SARS-CoV-2 variant—a factor that can affect transmissibility, disease severity, and immune evasiveness. Its genomic surveillance is important in cities with millions of inhabitants and an economic center, such as Mexico City. Results. From 16 November to 31 December 2021, we observed an increase of 88% in Omicron prevalence in Mexico City. We explored the R346K substitution, prevalent in 42% of Omicron variants, known to be associated with immune escape by monoclonal antibodies. In a phylogenetic analysis, we found several independent exchanges between Mexico and the world, and there was an event followed by local transmission that gave rise to most of the Omicron diversity in Mexico City. A haplotype analysis revealed that there was no association between haplotype and vaccination status. Among the 66% of patients who have been vaccinated, no reported comorbidities were associated with Omicron; the presence of odynophagia and the absence of dysgeusia were significant predictor symptoms for Omicron, and the RT-qPCR Ct values were lower for Omicron. Conclusions. Genomic surveillance is key to detecting the emergence and spread of SARS-CoV-2 variants in a timely manner, even weeks before the onset of an infection wave, and can inform public health decisions and detect the spread of any mutation that may affect therapeutic efficacy.

Few reports have shared the workflows to reduce SARS-CoV-2 infections among risk groups, including healthcare workers (HCWs). This study describes an occupational health program implemented to reduce the incidence of COVID-19 and establishes a back-to-work algorithm in HCWs of 129 Salud Digna outpatient care clinics in Mexico. This program was composed of training plans, screening SARS-CoV-2 infections, the containment of infections, follow-up COVID-19 cases, and continuing supervision in addition to the steady supply and training for the correct use of PPE. From 16 April 2020 to 15 April 2021, 7376 individuals were enrolled, of which 423 were excluded because they did not meet the inclusion criteria or refused the follow-up. In the cohort studied, we found a COVID-19 incidence of 35.4% (2610 individuals), lower hospitalization (0.11%), ICU (0.04%) and lethality rate (0.04%). Additionally, 85.9% of COVID-19 cases tested negative for SARS-CoV-2 after 14 days of the first positive test with an average isolation time of 26–33 days. Finally, 99% of people received personal protective equipment and adequate training to use it. Our results show that the program implemented reduced the hospitalization ICU admission and lethality in HCWs; we consider this workflow to help other workplaces offer safe conditions for HCWs and patients.