ABSTRACT
OBJECTIVE: The aim of this study was to establish whether there was a histoplasmosis outbreak among a group of residents of Naucalpan (State of Mexico, a non-endemic area for histoplasmosis) and to ascertain the source through which they were infected. MATERIAL AND METHODS: Anyone associated with the Index Case in the same period with a flu-like infection was considered as a suspected case. Diagnosis was confirmed by clinical examination positive, cultures and positive immunological tests. Date and form of potential exposure were obtained through interviews. Material potentially contaminated with bird or bat droppings was sought and analyzed by PCR. RESULTS: The outbreak was associated with a trip to El Tamarindo (Veracruz, near the Gulf of Mexico). Patients got sick after digging a hole in the floor inside a house where a treasure had been supposedly buried by a death relative. The pathogen was detected in soil samples at 10 cm below the surface. CONCLUSIONS: The study showed that patients contracted histoplasmosis in El Tamarindo, a community where there had been no prior cases of this disease.
Subject(s)
Disease Outbreaks , Histoplasmosis/epidemiology , Adult , Female , Humans , Male , Mexico/epidemiology , Middle AgedABSTRACT
BACKGROUND: Anti-viral treatment has been used to treat severe or progressive illness due to pandemic H1N1 2009. A main cause of severe illness in pandemic H1N1 2009 is viral pneumonia; however, it is unclear how effective antiviral treatment is against pneumonia when administered >48 hours after symptom onset. Therefore, we aimed to determine how time from symptom onset to antiviral administration affected the effectiveness of antiviral treatment against pneumonia due to pandemic (H1N1) 2009. METHODS/PRINCIPAL FINDINGS: A retrospective medical chart review of 442 patients was conducted in a hospital in Mexico. Subjects had tested positive for pandemic H1N1 2009 virus by real-time reverse-transcriptase-polymerase-chain-reaction and were administered oseltamivir. Median time from symptom onset to oseltamivir administration was 5.0 days (range, 0-43). 442 subjects, 71 (16.1%) had severe pneumonia which required mechanical ventilation, 191 (43.2%) had mild to moderate pneumonia, and 180 (40%) did not have pneumonia. Subjects were divided into four groups based on time to oseltamivir administration: ≤2, 3-7, 8-14, and >14 days. Severity of respiratory features was associated with time to treatment, and multivariate analysis indicated that time to oseltamivir administration was associated with severity of respiratory features. A proportional odds model indicated that 50% probability for occurrence of pneumonia of any severity and that of severe pneumonia in patients who would develop pneumonia reached at approximately 3.4 and 21 days, respectively, after symptom onset. Patients with a shorter time to oseltamivir administration were discharged earlier from the hospital. CONCLUSIONS: Earlier initiation of oseltamivir administration after symptom onset significantly reduced occurrence and severity of pneumonia and shortened hospitalization due to pandemic H1N1 2009. Even when administered >48 hours after symptom onset, oseltamivir showed considerable potential for reducing pneumonia. Application of these results would benefit patients affected by future influenza pandemics.
Subject(s)
Influenza A Virus, H1N1 Subtype/physiology , Influenza, Human/virology , Oseltamivir/administration & dosage , Oseltamivir/therapeutic use , Pandemics , Pneumonia, Viral/drug therapy , Severity of Illness Index , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Hospitalization , Humans , Infant , Infant, Newborn , Influenza A Virus, H1N1 Subtype/drug effects , Influenza, Human/complications , Influenza, Human/drug therapy , Influenza, Human/epidemiology , Male , Mexico/epidemiology , Middle Aged , Multivariate Analysis , Oseltamivir/pharmacology , Patient Admission , Patient Discharge , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/virology , Probability , Retrospective Studies , Young AdultABSTRACT
OBJECTIVE: [corrected] To estimate the association between passive and active smoking exposures and lung cancer in Mexico City and the corresponding attributable risks. MATERIAL AND METHODS: Data was analyzed from a multicenter population-based case-control study conducted in Mexico City. RESULTS: ORs for lung cancer in ever smokers were 6.2 (95% CI 3.9-10.2) for males and 2.8 (95% CI 1.7-4.4) for females. Passive smoking at home showed an overall OR of 1.8 (95% CI 1.3-2.6), similar in both genders. Attributable risk for active smoking for both genders combined, and for males and females separately, was estimated at 55, 76 and 27%, respectively. Attributable risk for passive smoking at home was 17% for females, 3.9% for males and 12% for the entire population. CONCLUSIONS: In Mexico City smoking is attributable to a smaller proportion of lung cancer cases than in developed countries. This is explained by a lower intensity of smoking in the Mexican population.
Subject(s)
Lung Neoplasms/etiology , Smoking/adverse effects , Tobacco Smoke Pollution/adverse effects , Adolescent , Adult , Age Factors , Aged , Case-Control Studies , Child , Child, Preschool , Epidemiologic Methods , Female , Humans , Lung Neoplasms/epidemiology , Male , Mexico/epidemiology , Middle Aged , Multicenter Studies as Topic , Multivariate Analysis , Odds Ratio , Risk Factors , Sex Factors , Smoking/epidemiology , Time FactorsABSTRACT
OBJETIVO: Estimar la asociación entre tabaquismo pasivo y activo y cáncer pulmonar (CP) en la Ciudad de México (CM), así como los riesgos atribuibles asociados.MATERIAL Y MÉTODOS: Se analiza un estudio multicéntrico de casos-controles con base poblacional, realizado en la CM. RESULTADOS: Las RM para CP en alguna vez fumadores fueron de 6.2 (IC 95% 3.9, 10.2) en hombres y 2.8 (IC 95% 1.7, 4.4) en mujeres. La exposición pasiva al tabaco mostró una RM en ambos sexos de 1.8 (IC 95% 1.3, 2.6), similar en ambos sexos. Los riesgos atribuibles asociados al tabaquismo activo para ambos sexos, hombres y mujeres fueron de 55, 76 y 27%, respectivamente. El riesgo atribuible para tabaquismo fue de 17% en mujeres, 3.9% en hombres y 12% en ambos sexos. CONCLUSIONES: En la CM el tabaquismo explica una fracción menor de casos de CP que el estimado en países desarrollados. Esto se debe a que en México la intensidad del tabaquismo es menor.
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Lung Neoplasms/etiology , Smoking/adverse effects , Tobacco Smoke Pollution/adverse effects , Age Factors , Case-Control Studies , Epidemiologic Methods , Lung Neoplasms/epidemiology , Mexico/epidemiology , Multicenter Studies as Topic , Multivariate Analysis , Odds Ratio , Risk Factors , Sex Factors , Smoking/epidemiology , Time FactorsABSTRACT
En este documento se revisa la hipótesis de la comparasión de la morbilidad, propuesta por James Fries en 1980, como un ejemplo de elaboración teórica en el campo de la epidemiología. Se presentan inicialmente algunos rasgos fundamentales de las teorías científicas y se hace un recuento histórico de los modelos causales más importantes que ha utilizado la epidemiología. Posteriormente, se presentan los fundamentos de la hipótesis de la compresión de la morbilidad, y se examinan sus posibilidades y limitaciones actuales, así como sus implicaciones epistemológicas con base en la teoría estructuralista. Se concluye que si el modelo de la compresión de la morbilidad fuera correcto, tendría una enorme capacidad para describir, explicar y predecir la salud y la enfermedad en las poblaciones humanas; por lo tanto, el desarrollo sistemático de este tipo de propuestas tiene una extraordinaria importancia para la salud pública