Clinical profile of the first 1000 fatalities for influenza A (H1N1) in Mexico.

Background: Influenza is an acute respiratory disease responsible for several episodes of high mortality throughout human history. In 2009, Mexico experienced an atypical influenza outbreak caused by a mutant strain of the influenza A (H1N1) subtype, which generated significant mortality. The aim of this paper was to analyze the clinical and sociodemographic conditions of the first 1000 fatalities recorded during this outbreak. Methods: We conducted a study based on an analysis of the clinical files of patients positive for influenza A (H1N1) using Real-Time-Polymerase Chain Reaction (RT-PCR) to conduct an analysis of deaths compared to deaths in the general population. Results: The majority of deaths occurred in patients aged 35-84 years (65.8%). Average time between symptom onset and death was 13.8 days, with an average of 7.8 days from time of hospitalization until death. Ca. 25% of deaths occurred in residents from Mexico City and from the nearby State of Mexico. In the majority of cases, we found that patients who died had a low educational and socioeconomic status along with co-morbidities such as metabolic syndrome and its individual components, as well as respiratory illnesses. In 80% of cases, patients received mechanical ventilation, and a similar percentage received antiviral therapy (oseltamivir, zanamivir). Conclusions: The primary-care level was not utilized by patients who died from influenza. The higher prevalence of chronic degenerative diseases among deaths compared with the general population indicates that these groups of patients should be considered and prioritized in the event of future outbreaks.

Comparación de frecuencia de factores de riesgo cardiovascular tradicionales en mujeres con distinto nivel educativo / Comparison of traditional cardiovascular risk factors frequency among women of different education levels

INTRODUCTION: Ischemic heart disease is the first cause of death in the world in both genders between 30 and 40 years of age. It has been proposed that socioeconomic status could affect the prevalence of cardiovascular risk factors (CVRF), as well as cardiovascular disease incidence and mortality. The purpose of this work was to compare the frequency of CVRF in two groups of women with different educational level. RESULTS: A higher frequency of visceral obesity was identified in the women with lower educational level and hypo-HDL-C in the group of women with higher educational level. Correlation between age and modifiable CVRF was different between the studied groups. A larger proportion of women with higher educational level than those with lower educational level drank alcoholic beverages and smoked cigarettes. DISCUSSION: Frequency of identified modifiable CVRF was similar to that found in other Hispanic-American populations. The inverse relationship between CVRF and educational level, a commonly used measure of socioeconomic status, and prevalence of CVRF informed in English and American studies was not observed in this investigation; probably because social and cultural conditions could affect the educational level in a different manner. Health education programs must take into account the cultural processes of each country, city, or community, regardless of the socioeconomic status, based on social and cultural backgrounds of each group.