Synthesis of N-heterocyclic amides based on (+)-camphoric acid and study of their antiviral activity and pharmacokinetics.

Efficient conditions for the synthesis of nitrogen-containing heterocyclic derivatives of (1R,3S)(+)-camphoric acid were selected. A series of heterocyclic compounds based on (+)-camphoric acid bearing pharmacophoric fragments was synthesized using the developed methodology. The compounds were tested for their antiviral activity against SARS-CoV-2 and H1N1 influenza viruses, and efficient inhibitors were identified that are of significant interest for further studies. The stability of the compounds and pharmaco-kinetics of the leader compound were studied when administered intragastrically and intramuscularly to mice at a dose of 200 mg kg-1 using the HPLC-MS/MS method.

Guidelines on epidemics in Mexico. Historical perspective.

A perspective of epidemics and pandemics in Mexico is offered, focusing on three time periods, namely, end of the 18th century, the 20th century, and the 21st century, in order to analyze how they were approached by health and government authorities, as well as the challenges they have represented. Historical documentary sources were consulted and, in current cases, participation in them was analyzed. Epidemiological and social historical methodologies were combined. The presence of epidemics in Mexico is a constant on its evolution, which highlights the need for the epidemiological surveillance system to be updated, the importance of being prepared to face an epidemic and to develop a contingency plan.

Se ofrece una perspectiva de las epidemias y pandemias en México en tres periodos: fines del siglo XVIII y siglos XX y XXI, con el fin de analizar cómo las autoridades sanitarias y gubernamentales abordaron estos problemas, así como los desafíos que han representado. Se consultaron fuentes históricas documentales y, en los casos actuales, la participación en ellos. Se combinó metodología epidemiológica e histórica social. La presencia de las epidemias en México es una constante, lo cual evidencia la necesidad de actualizar el sistema de vigilancia epidemiológica, de estar preparados para enfrentar una epidemia y de elaborar un plan de contingencia.

Directrices en torno a las epidemias en México. Perspectiva histórica / Guidelines on epidemics in Mexico. Historical perspective

Resumen Se ofrece una perspectiva de las epidemias y pandemias en México en tres periodos: fines del siglo XVIII y siglos XX y XXI, con el fin de analizar cómo las autoridades sanitarias y gubernamentales abordaron estos problemas, así como los desafíos que han representado. Se consultaron fuentes históricas documentales y, en los casos actuales, la participación en ellos. Se combinó metodología epidemiológica e histórica social. La presencia de las epidemias en México es una constante, lo cual evidencia la necesidad de actualizar el sistema de vigilancia epidemiológica, de estar preparados para enfrentar una epidemia y de elaborar un plan de contingencia.

Abstract A perspective of epidemics and pandemics in Mexico is offered, focusing on three time periods, namely, end of the 18th century, the 20th century, and the 21st century, in order to analyze how they were approached by health and government authorities, as well as the challenges they have represented. Historical documentary sources were consulted and, in current cases, participation in them was analyzed. Epidemiological and social historical methodologies were combined. The presence of epidemics in Mexico is a constant on its evolution, which highlights the need for the epidemiological surveillance system to be updated, the importance of being prepared to face an epidemic and to develop a contingency plan.

Neonatology, paediatrics and paediatric virology on a British island: An interview with neonatologist Dr Prakash Thiagarajan (Isle of Man).

Dr Prakash Thiagarajan, consultant neonatologist and clinical director at Women's and Children's Division at Noble's Hospital on the Isle of Man, is one of the most talented neonatologists in the UK with a great experience in newer modes of infant ventilation and the application of technology in neonatal medicine and paediatrics. Under his leadership, the new neonatal intensive care unit (NICU) at Noble's Hospital is a state-of-the-art neonatal unit offering the very highest standards of care for critically ill babies on the island. Dr Thiagarajan highlights the re-emergence of continuous positive airway pressure (CPAP) as a key mode of ventilatory support for preterm infants and describes the current practice relating to the transport of the critically ill newborn and paediatric population. He reports the main milestones of the Isle of Man preparedness plan for influenza during the 2009 A/H1N1 influenza pandemic and he emphasises the role of immunisations and high level infection control measures in preventing future outbreaks of viral illnesses in children. He accepts that paediatric virology is an extremely important, yet underserved area of paediatrics and as with any clinical specialty, it is very important for effective two-way communications between frontline clinicians and academic researchers. He sums up suggesting the formation of the 'European Society for Paediatric Virology' in order to propagate knowledge and training in paediatric virology to health professionals, set standards in training, promote research and development and also raise public awareness. In the context of the '4th Workshop on Paediatric Virology', which will be held in Athens, Greece, on September 22nd, 2018, Dr Thiagarajan's plenary lecture will focus on antiviral drugs in the clinical management of children with influenza.

[Mutations in Hemagglutinin and Polymerase Alter the Virulence of Pandemic A(H1N1) Influenza Virus].

To study the pathogenicity factors of the pandemic A(H1N1) influenza virus, a number of mutant variants of the A/Hamburg/5/2009 (H1N1)pdm09 strain were obtained through passage in chicken embryos, mouse lungs, and MDCK cell culture. After 17 lung-to-lung passages of the A/Hamburg/5/2009 in mice, the minimum lethal dose of the derived variant decreased by five orders of magnitude compared to that of the parental virus. This variant differed from the original virus by nine amino acid residues in the following viral proteins: hemagglutinin (HA), neuraminidase (NA), and components of the polymerase complex. Additional passaging of the intermediate variants and cloning made it possible to obtain pairs of strains that differed by a single amino acid substitution. Comparative analysis of replicative activity, receptor specificity, and virulence of these variants revealed two mechanisms responsible for increased pathogenicity of the virus for mice. Thus, (1) substitutions in HA (Asp225Gly or Gln226Arg) and compensatory mutation decreasing the charge of HA (Lys123Asn, Lys157Asn, Gly158Glu, Asn159Asp, or Lys212Met) altered viral receptor-binding specificity and restored the functional balance between HA and NA; (2) Phe35Leu substitution in the PA protein increased viral polymerase activity.

Screening of neuraminidase inhibitory activities of some medicinal plants traditionally used in Lingnan Chinese medicines.

BACKGROUND: Neuraminidase (NA) is one of the key surface protein of the influenza virus, and has been established as a primary drug target for anti-influenza therapies. This study aimed to screen bioactive herbal extracts from some medicinal plants traditionally used in Lingnan Chinese Medicines by NA activity high-throughput screening assay. METHODS: One hundred ninety herbal extracts from 95 medicinal plants collected in Guangzhou were screened for their potential inhibitory activities against A (H1N1) influenza neuraminidase, and the most active extracts were further evaluated for their anti-influenza virus activities using virus-induced cytopathic effect (CPE). RESULTS: Among the tested 190 herbal extracts, 14 extracts inhibited significantly NA activity (IC50 < 40 µg/mL), and the extracts 1-5, which were obtained from Amomurn villosum Lour, Melaphis chinensis (Bell) Baker, Sanguisorba officinalis and Flos Caryophylli, showed potent inhibitory activity against NA with IC50 values ranging from 4.1 to 9.6 µg/mL. Moreover, the most bioactive extracts 1-5 were found to protect MDCK cells from A (H1N1) influenza virus infection with very low cytotoxicity to the host cells (EC50 values ranged from 1.8 to 14.1 µg/mL, CC50 values ranged from 97.0 to 779.2 µg/mL, SI values ranged from 14 to 438). In addition, quantitative RT-PCR analysis showed that the extracts 1-5 inhibited viral RNA synthesis in a dose-dependent manner. CONCLUSION: We performed in vitro screening of anti-neuraminidase activities of herbal extracts from medicinal plants used in Lingnan Chinese Medicines, and the results indicate that some bioactive extracts are worth further studies to identify the bioactive components responsible for anti-influenza virus activities, to elucidate their modes of action and finally determine their clinical potentials.

Perception of the A/H1N1 influenza pandemic and acceptance of influenza vaccination by Université Claude Bernard Lyon 1 staff: A descriptive study.

We assessed the perception and attitudes of university staff, including medical school and other science specialties, toward the 2009 A/H1N1 influenza pandemic and influenza vaccination program. A cross-sectional online survey was conducted among 4,529 university personnel on October 19-20, 2009. Seven hundred (15%) employees participated in the study. Only 18% were willing to be vaccinated, men more than women (29% versus 9%, P < 0.001), and professors/researchers more than administrative/technical staff (30% vs. 6%, P < 0.001). Intention to be vaccinated was insufficient. Additional efforts are needed to improve information dissemination among university staff. Medical university personnel should receive more information to increase vaccine coverage and protect them as well as patients.

Intense seasonal A/H1N1 influenza in Mexico, winter 2013-2014.

BACKGROUND AND AIMS: A recrudescent wave of pandemic influenza A/H1N1 affected Mexico during the winter of 2013-2014 following a mild 2012-2013 A/H3N2 influenza season. METHODS: We compared the demographic and geographic characteristics of hospitalizations and inpatient deaths for severe acute respiratory infection (SARI) and laboratory-confirmed influenza during the 2013-2014 influenza season compared to previous influenza seasons, based on a large prospective surveillance system maintained by the Mexican Social Security health care system. RESULTS: A total of 14,236 SARI hospitalizations and 1,163 inpatient deaths (8.2%) were reported between October 1, 2013 and March 31, 2014. Rates of laboratory-confirmed A/H1N1 hospitalizations and deaths were significantly higher among individuals aged 30-59 years and lower among younger age groups for the 2013-2014 A/H1N1 season compared to the previous A/H1N1 season in 2011-2012 (χ(2) test, p <0.001). The reproduction number for the winter 2013-2014 influenza season in central Mexico was estimated at 1.3-1.4, in line with that reported for the 2011-2012 A/H1N1 season but lower than during the initial waves of pandemic A/H1N1 activity in 2009. CONCLUSIONS: We documented a substantial increase in the number of A/H1N1-related hospitalizations and deaths during the period from October 2013-March 2014 in Mexico and a proportionate shift of severe disease to middle-aged adults, relative to the preceding A/H1N1 2011-2012 season. In the absence of clear antigenic drift in globally circulating A/H1N1 viruses in the post-2009 pandemic period, the gradual change in the age distribution of A/H1N1 infections observed in Mexico suggests a slow build-up of immunity among younger populations, reminiscent of the age profile of past pandemics.

The global condition of epidemics: Panoramas in A (H1N1) influenza and their consequences for One World One Health programme.

Among the most relevant elements contributing to define the One World One Health programme we find epidemics. The reason is that in recent decades, infectious diseases such as HIV/SIDA, SARS and Influenza have shown that we need new approaches and concepts in order to understand how biological emergencies and health alerts deploy new scales of action. Especially relevant has been the case of A(H1N1) influenza. This reached the status of global threat virtually from its onset, triggering an international response with a diffusion, visibility and rapidity unparalleled in previous health alerts. This article maintains that this global condition cannot be explained solely by the epidemiologic characteristics of the disease, such as mortality rate, severe cases, propagation capacity, etc. Resorting to the approach proposed by the Actor-Network Theory (ANT), this paper suggests that the action of certain socio-technical operators was what built a heterogeneous network of ideas, concepts and materials that turned the A (H1N1) influenza into a global-scale phenomenon with unprecedented speed. Among these operators, the most important ones were: the speaking position, a discourse about threat, the protocols and guidelines that were used and, lastly, the maps that allowed a real-time monitoring of the influenza. The paper ends with the notion of panorama, as defined by Bruno Latour: a suggestion to describe the common denominator of the aforementioned operators, and a means to foresee the development of global scales for certain health alerts. The paper will conclude by proposing that this type of analysis would allow the One World One Health to understand with greater precision the dynamic of epidemics and thus make its principles of action much more specific as well as its definition of what global health should be.

Should expectant mothers be vaccinated against flu? A safety review.

INTRODUCTION: Pregnant women have a higher risk of serious complications from influenza than non-pregnant women of reproductive age. This increased risk has been noted both during pandemic and inter-pandemic influenza seasons. However, although vaccination against flu is recommended at any trimesters by international and national policies, vaccine coverage remains low in pregnant women, possibly due to patient and healthcare providers' concern about the safety of the vaccine. AREAS COVERED: This review addresses the effectiveness and safety of seasonal and adjuvanted and non-adjuvanted pandemic 2009 A/H1N1 influenza vaccine. EXPERT OPINION: Available data suggest no evidence of an increased risk for any adverse event for both mothers and fetuses after vaccination against flu during pregnancy. These results are important when considering the potential of maternal immunization against flu as a public health intervention to protect both the mother and her infant against serious infectious disease.

Obesity and pro-inflammatory mediators are associated with acute kidney injury in patients with A/H1N1 influenza and acute respiratory distress syndrome.

BACKGROUND: The obesity has been shown to increase the severity of A/H1N1 infection and the development of acute respiratory distress syndrome (ARDS) and organ involvement. METHODS: Circulating levels of C-peptide, insulin, glucagon, leptin, acute phase reactants (procalcitonin, C-reactive protein, tissue plasminogen activator, and serum amyloids A and P), were measured in samples from 32 critically ill patients with A/H1N1 virus infection, 17 of whom had ARDS complicated by acute kidney injury (AKI) and 15 of whom had ARDS but did not develop AKI. RESULTS: Patients with ARDS and AKI (ARDS/AKI) had higher BMI and higher levels of C-peptide, insulin, leptin, procalcitonin and serum amyloid A compared to those ARDS patient who did not develop AKI. Adjusting for confounding variables using logistic regression analysis, higher levels of C-peptide (>0.75 ng/mL) (OR=64.8, 95% CI = 2.1-1980, p = 0.0006) and BMI>30 Kg/m(2) (OR = 42.0, 95% CI = 1.2-1478, p = 0.04) were significantly associated with the development of AKI in ARDS patients. CONCLUSION: High levels of C-peptide and BMI>30 kg/m(2) were associated with the development of AKI in ARDS patients due to A/H1N1 infection. These metabolic/obesity indicators, together with the profiles of pro-inflammatory acute phase proteins, may be important links between obesity and poor outcomes in A/H1N1 09 infection.

2009 A/H1N1 influenza vaccination in pregnancy: uptake and pregnancy outcomes - a historical cohort study.

OBJECTIVES: To describe the uptake of 2009 A/H1N1 influenza vaccination among pregnant women and determine if vaccination was associated with adverse pregnancy outcomes. STUDY DESIGN: A historical cohort study was performed using booking, delivery suite and neonatal unit discharge records from the Coombe Women and Infants University Hospital, Dublin, Ireland. Singleton deliveries to women pregnant before (December 2008-September 2009) and during the pandemic (December 2009-September 2010) were included. Information on vaccination status and type of vaccine was collected on admission to the delivery suite. Logistic regression analyses were used to determine maternal characteristics associated with vaccination. Pregnancy outcomes were compared for vaccinated and unvaccinated women, with adjustment for differing maternal characteristics. Outcomes included vaccination status, preterm birth, size for gestational age, neonatal intensive care admission, congenital anomalies and perinatal death. RESULTS: Of 6894 women pregnant during the pandemic, 2996 [43.5%] reported vaccination at delivery. In the early weeks of the vaccination programme rates of over 70% were achieved. Of those vaccinated, 246 [8.2%], 1709 [57.0%] and 1034 [34.5%] were vaccinated in the first, second and third trimesters respectively. Vaccination was less likely in younger age groups, those who were not in the professional/manager/employer socioeconomic group, women from Eastern Europe, Africa and Asia/Middle East, those who reported an unplanned pregnancy, women who booked late for antenatal care and recipients of publicly-funded obstetric care. Irish nationality was associated with reporting vaccination. There was no association between vaccination during pregnancy and adverse pregnancy outcomes. Women who were vaccinated were less likely to have a preterm delivery than unvaccinated women. CONCLUSION: 2009 A/H1N1 influenza vaccination uptake was influenced by maternal sociodemographic factors. High vaccination uptake can be achieved in a pandemic situation. Future public health campaigns should provide clear information on vaccination safety in pregnancy, ensure consistent vaccination recommendations from healthcare professionals and provide easy access to vaccination in order to optimise uptake rates in subgroups of the population who less likely to be vaccinated. There was no association between vaccination and adverse pregnancy outcomes.

Pregnancy outcome following maternal use of zanamivir or oseltamivir during the 2009 influenza A/H1N1 pandemic: a national prospective surveillance study.

OBJECTIVE: To conduct enhanced surveillance for signals of teratogenesis following use of the neuraminidase inhibitors zanamivir and oseltamivir in the treatment or post-exposure prophylaxis of 2009 A/H1N1 influenza during pregnancy. DESIGN: Prospective cohort study, using national surveillance data collected by the UK Teratology Information Service (UKTIS) during the 2009 A/H1N1 pandemic. SETTING: United Kingdom. POPULATION: Pregnant women who were reported to UKTIS by healthcare professionals seeking advice about exposure to zanamivir and oseltamivir or to other non-teratogenic drugs. METHODS: Pregnancy outcomes were collected for prospectively reported pregnancies exposed to zanamivir (n = 180) or oseltamivir (n = 27), and compared with a reference group of 575 prospectively reported pregnancies exposed to non-teratogenic drugs over the same period. MAIN OUTCOME MEASURES: Rates of major congenital malformation, preterm delivery and low birth weight. RESULTS: No significant differences in overall rates of major malformation in live-born infants [adjusted odds ratios (aOR): zanamivir 0.37 (95% confidence interval 0.02-2.70); oseltamivir aOR 0.81 (0.05, 14.15)], preterm delivery [aOR: zanamivir 0.95 (0.45, 1.89); oseltamivir aOR 1.68 (0.38, 5.38)] or low birth weight [aOR: zanamivir 0.94 (0.25, 2.90); oseltamivir aOR 4.12 (0.59, 17.99)] were observed following exposure at any gestation. No major malformations were reported in 37 zanamivir or eight oseltamivir first trimester exposures. CONCLUSION: These surveillance data do not provide a signal that use of zanamivir or oseltamivir in pregnancy is associated with an increased risk of the adverse pregnancy outcomes studied but the data are too limited to state conclusively that there is no increase in risk.

Genetic diversity of hemagglutinin gene of A(H1N1)pdm09 influenza strains isolated in Taiwan and its potential impact on HA-neutralizing epitope interaction.

Pandemic influenza A(H1N1)pdm09 virus is a global health threat and between 2009-2011 it became the predominant influenza virus subtype circulating in the world. The research describes the MSSCP (Multitemperature Single Strand Conformation Polymorphism) analysis of the hemagglutinin (HA) region encompassing major neutralizing epitope in pandemic influenza isolates from Taiwan. Several genetically distinct changes appeared in isolates obtained in 2010 and 2011. The majority of changes in HA protein did not result in significant modifications, however three modifications were localized in epitope E of H1 and one was part of the interface binding antibodies BH151 and HC45 possibly making the current vaccine less effective.-Taking into account the possibility of the emergence of influenza A with antibody evading potential, the MSSCP method provides an alternative approach for detection of minor variants which escape detection by conventional Sanger sequencing.

Change s of haemagglutination inhibitionan tibody level within one month after in fluenza A (H1N 1) vaccination / 中华微生物学和免疫学杂志

Objective To find the changes of haemagglutination inhibition ( HI ) antibody level against A/California/07/2009 (H1N1) within one month after pandemic A/H1N1 influenza vaccine (A/H1N1InfV) vaccination, and to provide data for drawing up immunization protocols against novel influenza . Methods The HI antibodies against A/California/07/2009 (H1N1) in sera from the inoculated subjects were tested by HI test .The geometric mean titer ( GMT) , geometric mean increase ( GMI) , seroconversion (SC) rate, seroprotection (SP) rate of HI antibodies were compared among the sera collected on day 3, 7, 14, 30 post vaccination .Results 961 participants were injected with A/H1N1InfV.In subjects aged 3 to 11 years, the antibody level peaked on day 14 post vaccination, but neither on day 14 nor on day 30, the lower bound of the two -sided 95%CI for the SP rate could fulfill the criteria of the FDA for influenza vac-cine.In subjects aged 12 to 60 years, the antibody level peaked on day 14 post vaccination and the SC rate , SP rate and GMI fulfilled the criteria of the European Medicines Agency ( EMEA) and the FDA for influenza vaccine. In subjects aged more than 60 years, the antibody level peaked on day 30 post vaccination , and the SC rate, SP rate and GMI on day 30 fulfilled the criteria of the EMEA and the FDA .Conclusion One dose A/H1N1InfV vaccination was able to induce enough protection on day 14 for subjects aged 12 to 60 years, on day 30 for subjects aged more than 60 years;however , for subjects aged 3 to 11 years who were antibody-negative at baseline , the lower bound of the two-sided 95%CI for the SP rate on day 14 and day 30 couldn′t fulfill the criteria of the FDA for influenza vaccine .

Profile of Brazilian scientific production on A/H1N1 pandemic influenza / Perfil da produção científica brasileira sobre a gripe pandemica de influenza A/H1N1

In the last few years, bibliometric studies have proliferated, seeking to provide data on world research. This study analyzes the profile of the Brazilian scientific production in the A (H1N1) influenza field between 2009 and 2011. The research was conducted in MEDLINE, SciELO and LILACS databases, selecting papers in which the term "H1N1" and "Brazil" were defined as the main topics. The data were analyzed taking into consideration the Brazilian state and institution in which the articles were produced, the impact factor of the journal and the language. The research revealed 40 documents (27 from MEDLINE, 16 from SciELO and 24 from LILACS). The journal impact factor ranged from 0.0977 to 8.1230. A similar amount of articles were written in English and Portuguese and São Paulo was the most productive state in the country, with 95% of the Brazilian production originating from the Southern and Southeastern regions. Linguistic data indicate that previous efforts made in order to improve the scientific production of Brazilian researchers making their observations attain a broader scientific audience produced results. It is necessary to assess the scientific studies, especially those conducted with public funds, in order to ensure that the results will benefit society.

Nos últimos anos, estudos bibliométricos proliferaram, procurando prover dados sobre a pesquisa mundial. O presente estudo analisou o perfil da produção científica brasileira no campo da influenza A (H1N1) durante o período de 2009 a 2011. A pesquisa foi conduzida através das bases de dados Medline, SciELO e Lilacs, selecionando artigos onde os termos "H1N1" e "Brazil" foram definidos como tópicos principais. Os dados foram analisados considerando-se: o estado brasileiro e a institutição onde o trabalho foi produzido, o fator de impacto de periódico e a língua. A pesquisa revelou 40 documentos (27 provenientes do Medline, 16 do SciELO e 24 do Lilacs). O fator de impacto do periódico variou de 0.0977 a 8.1230. Uma quantidade similar de artigos foi escrita em inglês e em português. São Paulo foi o estado mais produtivo no país e 95% da produção eram provenientes das regiões Sul e Sudeste. Os dados linguísticos indicam que esforços anteriores para melhorar a produção científica dos pesquisadores brasileiros, fazendo com que suas observações atingissem um público científico mais amplo, foram alcançados. É necessário avaliar os estudos científicos, especialmente os realizados com fundos públicos, a fim de assegurar que os resultados beneficiem a sociedade.

Knowledge, attitudes and perceptions of health professionals in relation to A/H1N1 influenza and its vaccine.

OBJECTIVE: To determine the intention of health professionals, doctors and nurses, concerning whether or not to be vaccinated against A/H1N1 influenza virus, and their perception of the severity of this pandemic compared with seasonal flu. MATERIAL AND METHODS: A cross-sectional study was carried out based on an questionnaire e-mailed to health professionals in public healthcare centres in Vitoria between 6 and 16 November 2009; the percentage of respondents who wanted to be vaccinated and who perceived the pandemic flu to carry a high risk of death were calculated. RESULTS: A total of 115 people completed the questionnaire of whom 61.7% (n=71) were doctors and 38.3% (n=44) were nurses. Of these, 33.3% (n=23) of doctors and 13.6% (n=6) of nurses intended to be vaccinated (p=0.019). Even among those who considered themselves to be at a high risk, 70.6% (n=48) of doctors and 31.7% (n=13) of nurses participating in the study (p=0.001) planned to have the vaccination. CONCLUSIONS: Most health professionals, and in particular nurses, had no intention to be vaccinated against A/H1N1 influenza virus at the beginning of the vaccination campaign.

Health Behavior Education, e-research and a (H1N1) Influenza (Swine Flu): Bridging the Gap between Intentions and Health Behavior Change.

This study examined relations between risk perception/self-efficacy and handwashing intentions/behaviors during the A (H1N1) pandemic influenza. Data were collected from a longitudinal sample of Costa Ricans (NT1/T2 = 449/97). Results revealed that males and females presented a different social cognitive pattern in reaction to A (H1N1) pandemic. In females, the effects of risk perception/self-efficacy on handwashing behaviors were fully mediated by handwashing intentions. In males, self-efficacy influenced both directly and indirectly on handwashing behaviors, and risk perceptions showed no significant effect on handwashing behaviors. These results suggest that gender oriented protocols should be adopted by public health authorities in order to educate males and females in preventing both A (H1N1) and seasonal influenza.

Comportamiento de la morbilidad materna por enfermedad tipo Influenza A H1N1 en cuidados intensivos / Behavior of maternal mortality due to Influenza A H1N1 disease in the intensive care unit

Se realizó un estudio observacional analítico, de corte transversal, en el Hospital General Docente Enrique Cabrera, con el objetivo de caracterizar la morbilidad materna por enfermedad tipo influenza A H1N1 en las pacientes obstétricas ingresadas en la unidad de cuidados intensivos respiratorios, en el marco de la pandemia 2009 de influenza. Se compararon los ingresos en gestantes y puérperas que se produjeron entre el 1 de septiembre y el 31 de diciembre de 2009, en cuanto a variables sociodemográficas, obstétricas, epidemiológicas y clínicas, utilizando el sistema SPSS 11.5 para Windows como procesador estadístico. Durante el periodo de estudio ingresaron 103 pacientes en cuidados intensivos, 86 (83,5 por ciento) gestantes y 17 (16,5 por ciento) puérperas; el 87, por ciento de las gestantes estaban en el 2do y 3er trimestre del embarazo. El 55,8 por ciento de las gestantes y 47,1 por ciento de las puérperas tenían un antecedente patológico, el asma bronquial fue el más frecuente. El 69,9 por ciento de las pacientes iniciaron el tratamiento antiviral con más de 48 h de síntomas. La tos fue el síntoma más frecuente presente, significativamente, en mayor número de gestantes, 79 (91,9 por ciento) que de puérperas, 11 (61,7 por ciento), le siguieron en orden la disnea (69,9 por ciento) y la fiebre (50,5 por ciento). Los principales diagnósticos de ingreso fueron neumonía (36 por ciento gestantes y 58,8 por ciento puérperas) y bronconeumonía (33,7 por ciento gestantes y 23,5 por ciento puérperas). Las complicaciones fueron más frecuentes en las puérperas, 9 (52,9 por ciento). Concluimos que el trabajo multidisciplinario y en equipo contribuyó a los resultados obtenidos(AU)

A cross-sectional, analytical and observational study was conducted in the Enrique Cabrera Teaching Hospital to characterize the maternal morbidity due to A H1Ni influenza in the pregnant patients admitted in the respiratory intensive care unit during the influenza pandemic in 2009. The admissions of pregnants and puerperants from September 1, 2009 to December 31, 2009 as regards the sociodemographic, obstetric, epidemiological and clinical variables, using the SPSS 11.5 system for Windows as the statistic processor. During the study period 103 patients were admitted in intensive care unit, 86 (83.5 percent) pregnants and 17 (16.5 percent) puerperants; the 87 percent of pregnants were in the second and the third trimester of pregnancy. The 55.8 percent of pregnants and the 47.1 percent of puerperants had a pathologic background, the bronchial asthma was the more frequent one. The 69.9 percent of patients started the antiviral treatment with more than 48 hours from the symptoms. Cough was the more prevalent symptom, in a significant way in the greater number of pregnants, 79 (91.9 percent) than puerperants, 11 (61.7 percent), followed in order the dyspnea (69.9 percent) and fever (50.5 percent). The major diagnoses for admission were pneumonia (36 percent of pregnants and the 58.8 percent or puerperants) and bronchopneumonia (33.7 percent of pregnants and the 23.5 percent of puerperants). The complications were more frequent in the puerperants, 9 (52.9 percent). We conclude the multidisciplinary work and by teams contributed to the results obtained(AU)

Comportamiento de la morbilidad materna por enfermedad tipo Influenza A H1N1 en cuidados intensivos / Behavior of maternal mortality due to Influenza A H1N1 disease in the intensive care unit

Se realizó un estudio observacional analítico, de corte transversal, en el Hospital General Docente Enrique Cabrera, con el objetivo de caracterizar la morbilidad materna por enfermedad tipo influenza A H1N1 en las pacientes obstétricas ingresadas en la unidad de cuidados intensivos respiratorios, en el marco de la pandemia 2009 de influenza. Se compararon los ingresos en gestantes y puérperas que se produjeron entre el 1 de septiembre y el 31 de diciembre de 2009, en cuanto a variables sociodemográficas, obstétricas, epidemiológicas y clínicas, utilizando el sistema SPSS 11.5 para Windows como procesador estadístico. Durante el periodo de estudio ingresaron 103 pacientes en cuidados intensivos, 86 (83,5 por ciento) gestantes y 17 (16,5 por ciento) puérperas; el 87, por ciento de las gestantes estaban en el 2do y 3er trimestre del embarazo. El 55,8 por ciento de las gestantes y 47,1 por ciento de las puérperas tenían un antecedente patológico, el asma bronquial fue el más frecuente. El 69,9 por ciento de las pacientes iniciaron el tratamiento antiviral con más de 48 h de síntomas. La tos fue el síntoma más frecuente presente, significativamente, en mayor número de gestantes, 79 (91,9 por ciento) que de puérperas, 11 (61,7 por ciento), le siguieron en orden la disnea (69,9 por ciento) y la fiebre (50,5 por ciento). Los principales diagnósticos de ingreso fueron neumonía (36 por ciento gestantes y 58,8 por ciento puérperas) y bronconeumonía (33,7 por ciento gestantes y 23,5 por ciento puérperas). Las complicaciones fueron más frecuentes en las puérperas, 9 (52,9 por ciento). Concluimos que el trabajo multidisciplinario y en equipo contribuyó a los resultados obtenidos

A cross-sectional, analytical and observational study was conducted in the Enrique Cabrera Teaching Hospital to characterize the maternal morbidity due to A H1Ni influenza in the pregnant patients admitted in the respiratory intensive care unit during the influenza pandemic in 2009. The admissions of pregnants and puerperants from September 1, 2009 to December 31, 2009 as regards the sociodemographic, obstetric, epidemiological and clinical variables, using the SPSS 11.5 system for Windows as the statistic processor. During the study period 103 patients were admitted in intensive care unit, 86 (83.5 percent) pregnants and 17 (16.5 percent) puerperants; the 87 percent of pregnants were in the second and the third trimester of pregnancy. The 55.8 percent of pregnants and the 47.1 percent of puerperants had a pathologic background, the bronchial asthma was the more frequent one. The 69.9 percent of patients started the antiviral treatment with more than 48 hours from the symptoms. Cough was the more prevalent symptom, in a significant way in the greater number of pregnants, 79 (91.9 percent) than puerperants, 11 (61.7 percent), followed in order the dyspnea (69.9 percent) and fever (50.5 percent). The major diagnoses for admission were pneumonia (36 percent of pregnants and the 58.8 percent or puerperants) and bronchopneumonia (33.7 percent of pregnants and the 23.5 percent of puerperants). The complications were more frequent in the puerperants, 9 (52.9 percent). We conclude the multidisciplinary work and by teams contributed to the results obtained