Survival After Ischemic and Hemorrhagic Stroke: A 4-Year Follow-Up at a Mexican Hospital.

BACKGROUND: Overall, 75.2% of deaths from stroke occur in low- and middle-income countries. Mexico is a middle-income country with little information about the prognosis of early and late postischemic and hemorrhagic stroke. OBJECTIVE: To evaluate the factors associated with post-stroke survival in the Mexican population. METHODS: Observational study of consecutive stroke cases involving a first-ever hemorrhagic or ischemic stroke, with patients who received care at the National Institute of Neurology and Neurosurgery, in Mexico City, between 2009 and 2012. Patients were followed for up to 4 years after the index event. Exploratory analysis of survival was carried out with Kaplan-Meier and log-rank tests. Factors associated with survival time were determined using Cox models. RESULTS: A total of 300 out of 544 (55.15%) patients had a hemorrhagic stroke, 135 of 544 (24.82%) patients died during the entire follow-up period, and 56 of 544 (10.29%) died in the first 30 days post-stroke (early mortality). Early mortality after stroke was associated with age ≥ 65 years (Adjusted Hazard Ratio - AHR = 2.07, P = .02) and ≥ 2 in-hospital medical complications (AHR = 46.13, P < .01). Late mortality was associated with age ≥ 65 years (AHR = 3.43, P < .01), ≥2 in-hospital medical complications (AHR = 2.55, P < .01), high comorbidity (AHR = 5.43, P < .01), and recurrence (AHR = 1.90, P = .01). CONCLUSIONS: Patients with hemorrhagic and ischemic stroke who presented in-hospital medical complications, high comorbidity, and were over 65 years old had higher rates of early and late mortality.

Factores de riesgo para la obesidad en la infancia / Risck factors for childhood obesity

La obesidad infantil constituye un importante problema de salud, debido a su asociación con enfermedades de tipo crónico y/o degenerativo que pueden presentarse desde la infancia hasta la edad adulta. En la actualidad, se conocen los factores de riesgo asociados a este padecimiento en países desarrollados, más poco se conoce de éstos en los países en desarrollo. Este artículo presenta información relevante sobre los determinantes de la obesidad de la infancia. Por su origen, y tomando en cuenta la posibilidada de prevención, estos factores se han dividido en dos grupos. Por un lado, se realiza una síntesis de los estudios sobre los determinantes biológicos de la obesidad infantil, y por el otro, se revisan los aspectos sociales y ambientales asociados con este padecimiento. Además, se señalan aspectos de interés sobre la prevalencia de la enfermedad tanto en países en vías de desarrollo como en desarrollados, y se presentan recomendaciones sobre el tratamiento correspondiente