[Performance of medical schools in Mexico: results from the Examen Nacional para Aspirantes a Residencias Médicas]. / Desempeño de las escuelas de medicina en México: resultados del Examen Nacional para Aspirantes a Residencias Médicas.

OBJECTIVE: To assess the performance of medical schools (FEM) by analyzing the results of their applicants in the Examen Nacional para Aspirantes a Residencias Médicas (ENARM). MATERIALS AND METHODS: Five performance criteria, two official and three created on purpose, were calculated from the ENARM-2016 and -2017 official databases to assess FEM performance. RESULTS: In 2016 and 2017, applicants registered from 112 and 115 FEM, respectively. Depending on the performance criteria, the FEM in the first place obtained 5 to 20 points more than the one placed second, and 23 to 98 points more than the FEM in the last place. Approximately 25% applicants were classified as "knowledge-deficient," and about 80% of these originated from less than one third of the FEM. CONCLUSIONS: The ENARM results provide information on the performance of the FEM. Approximately one of every four applicants obtained scores lower than the approval threshold of any specialty.

OBJECTIVE: Evaluar el desempeño de las facultades y escuelas de medicina (FEM) utilizando como subrogado los resultados del Examen Nacional para Aspirantes a Residencias Médicas (ENARM). MATERIALS AND METHODS: Se analizaron las bases de datos oficiales del ENARM 2016 y 2017, empleando cinco criterios de desempeño (CD) por cada FEM: dos oficiales y tres creados exprofeso. RESULTS: En 2016 y 2017 se registraron sustentantes de 112 y 115 FEM, respectivamente. Dependiendo del CD, la FEM que quedó clasificada en el primer lugar obtuvo entre 5 y 20 puntos más que la del segundo lugar, y entre 23 y 98 puntos más que la FEM ubicada en el último lugar. Aproximadamente 25% de los sustentantes fueron calificados como "deficientes en conocimientos" y aproximadamente 80% de éstos provenían de menos de un tercio de las FEM. CONCLUSIONS: El ENARM arroja información sobre el desempeño de las FEM. Aproximadamente uno de cada cuatro sustentantes obtuvo puntajes menores al aprobatorio en cualquier especialidad.

Flaws in the design of the Examen Nacional para Aspirantes a Residencias Médicas produce inequity.

OBJECTIVE: To assess the assumption of 'equity' of Mexico's resident-selection assessment tool, the Examen Nacional para Aspirantes a Residencias Médicas (ENARM). MATERIALS AND METHODS: Official ENARM-2016 and -2017 databases were analyzed. Differences in the absolute number of correct answers (multivariable linear regression) and the number of applicants reaching their specialty minimum score (SMS) per test day (odds ratio [OR]) were calculated. Applicants affected by test-day inequity were estimated. RESULTS: There were 36 114 applicants in 2016, and 38 380 in 2017. In 2016, day-2 applicants had significantly higher scores and more reached the SMS than on days 1-3-4 (OR 1.55), and 5 (OR 3.8); 3 565 non-passing applicants were affected by inequity (equivalent to 44.64% of those selected). In 2017, day-1 and -2 applicants had significantly higher scores and more reached the SMS than on days 3-4 (OR 1.85), and 5 (OR 4.04); 3,155 non-passing applicants were affected by inequity (37.2% of those selected). CONCLUSIONS: Analysis of official ENARM databases does not support the official attribution of equity, suggesting the test should be redesigned.

OBJETIVO: Evaluar el atributo de "equidad" asignado al Examen Nacional para Aspirantes a Residencias Médicas (ENARM). MATERIAL Y MÉTODOS: Se analizaron las bases de datos oficiales del ENARM 2016 y 2017. Se compararon las diferencias inter-día de respuestas correctas (regresión linear multivariable) y de sustentantes que alcanzaron el puntaje mínimo de su especialidad (PME) (razón de momios [RM]). Se estimó a los afectados por la inequidad. RESULTADOS: Hubo 36 114 sustentantes en 2016 y 38 380 en 2017.Los días 2 (ENARM-2016) y 1-2 (ENARM-2017) registraronpuntajes significativamente más altos, y más sustentantes alcanzaron el PME que en los días 1-3-4 (RM .55) y 5 (RM 3.8) en 2016, y los días 3-4 (RM 1.85) y 5 (RM 4.04) en 2017. Se estimó que cuatro de cada diez sustentantes que aprobaron el ENARM no lo hubieran hecho si el examen fuera equitativo. CONCLUSIONES: Los resultados sugieren que el atributo de equidad del ENARM está en duda.

[Impact of different front-of-pack nutrition labels on foods according to their nutritional quality: a comparative study in Mexico]. / Impacto de diferentes etiquetados frontales de alimentos según su calidad nutricional: estudio comparativo en México.

OBJECTIVE: This study aimed to compare consumers' objec- tive understanding of five FoPLs [Health Star Rating system (HSR), Multiple Traffic Lights (MTL), Nutri-Score, Reference Intakes (RIs), Warning Symbol] in Mexico. MATERIALS AND METHODS: 1 001 Mexican consumers were recruited and asked to rank three sets of label-free products according to their nutritional quality, via a survey. Upon completion of this task, participants were randomized to one of five FoPL condi- tions and were again asked to rank the same sets of products, this time with a FoPL displayed on pack. Change in ability to correctly rank products across the two tasks was assessed by FoPL using ordinal logistic regression. RESULTS: Nutri-Score and MTL performed best, followed Warning Symbol, HSR and RIs. CONCLUSIONS: Nutri-Score and MTL appear as efficient schemes to inform consumers on the nutritional quality of foods, in particular in Mexico, where it would be a helpful tool for consumers in purchasing situations.

OBJETIVO: Evaluar la comprensión objetiva de cinco tipos de etiquetados frontales de paquetes (EFP) (Sistema de Clasifi- cación de Estrellas de Salud, Semáforo Múltiple, Nutri-Score, Ingestas de Referencia y Símbolo de Advertencia) en México. MATERIAL Y MÉTODOS: Se reclutaron 1 001 consumidores mexicanos para clasificar tres productos de tres categorías de alimentos sin EFP, según su calidad nutricional. Se les asignó al azar uno de los cinco EFP para clasificar los mismos productos, esta vez con un EFP en el empaque. El cambio en la capacidad para clasificar correctamente los productos en las dos tareas fue evaluado por EFP, utilizando un modelo de regresión logística ordinal. RESULTADOS: Nutri-Score y Semáforo Múltiple obtuvieron un mejor desempeño, seguidos del Símbolo de Advertencia, Sistema de Clasificación de Estrellas de Salud e Ingestas de Referencia. CONCLUSIONES: Nutri-Score y el Semáforo Múltiple surgen como esquemas eficientes para informar a los consumidores sobre la calidad nutricional de los alimentos en México, donde podrían ser una herramienta útil para los consumidores en situación de compra.

Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico.

BACKGROUND: In late March 2009, an outbreak of a respiratory illness later proved to be caused by novel swine-origin influenza A (H1N1) virus (S-OIV) was identified in Mexico. We describe the clinical and epidemiologic characteristics of persons hospitalized for pneumonia at the national tertiary hospital for respiratory illnesses in Mexico City who had laboratory-confirmed S-OIV infection, also known as swine flu. METHODS: We used retrospective medical chart reviews to collect data on the hospitalized patients. S-OIV infection was confirmed in specimens with the use of a real-time reverse-transcriptase-polymerase-chain-reaction assay. RESULTS: From March 24 through April 24, 2009, a total of 18 cases of pneumonia and confirmed S-OIV infection were identified among 98 patients hospitalized for acute respiratory illness at the National Institute of Respiratory Diseases in Mexico City. More than half of the 18 case patients were between 13 and 47 years of age, and only 8 had preexisting medical conditions. For 16 of the 18 patients, this was the first hospitalization for their illness; the other 2 patients were referred from other hospitals. All patients had fever, cough, dyspnea or respiratory distress, increased serum lactate dehydrogenase levels, and bilateral patchy pneumonia. Other common findings were an increased creatine kinase level (in 62% of patients) and lymphopenia (in 61%). Twelve patients required mechanical ventilation, and seven died. Within 7 days after contact with the initial case patients, a mild or moderate influenza-like illness developed in 22 health care workers; they were treated with oseltamivir, and none were hospitalized. CONCLUSIONS: S-OIV infection can cause severe illness, the acute respiratory distress syndrome, and death in previously healthy persons who are young to middle-aged. None of the secondary infections among health care workers were severe.

Oseltamivir-resistant pandemic (H1N1) 2009 virus, Mexico.

During May 2009-April 2010, we analyzed 692 samples of pandemic (H1N1) 2009 virus from patients in Mexico. We detected the H275Y substitution of the neuraminidase gene in a specimen from an infant with pandemic (H1N1) 2009 who was treated with oseltamivir. This virus was susceptible to zanamivir and resistant to adamantanes and oseltamivir.

H1N1 Influenza Pandemic of 2009 Compared With Other Influenza Pandemics: Epidemiology, Diagnosis, Management, Pulmonary Complications, and Outcomes.

Influenza pandemics are complex events that have occurred frequently throughout human history, three during the past century alone. Now the world is facing the first 21st century pandemic, and the comparison among them is essential to identify common epidemiologic patterns, clinical characteristics, and outcomes. The evolution of medicine, including diagnostic and treatment options, the critical care advances, and global responses are new interventions that could modify the general outcome of the pandemic. Learning from past and current events could lead to a plan for prompt and efficient response in future pandemics and may be help us to predict the unpredictable.

[Epidemiological profile of mortality due to human influenza A (H1N1) in Mexico]. / Perfil epidemiológico de la mortalidad por influenza humana A (H1N1) en México.

OBJECTIVE: To carry out the epidemiological analysis of 122 influenza A (H1N1) deaths confirmed by laboratory and help to improve the diagnosis and timely managing of cases. MATERIAL AND METHODS: A total of 122 clinical records were analyzed of patients with confirmed influenza A (H1N1) virus infection who died. RESULTS: Fifty-one percent of patients were female and 49% were male. A total of 45.l% who died were between 20 and 39 years old. Overall fatality was 2.2% and ranged between 0.3% for the l0 to l9 year-old group to 6.3% for the 50 to 59 year-old group. Forty-three percent of deaths were concentrated in only two of the thirty-two states and 5l% received medical attention in social security institutions. Only l7% received hospital attention within 72 hours and 42% died within 72 hours of hospital attention. DISCUSSION: Novel Influenza A (H1N1) virus produces higher mortality in young people whereas seasonal influenza has a greater impact on young children and older people. Delay in medical care and the associated morbidity were relevant factors for death.

Prevalence of alexithymia in eating disorders in a clinical sample of 800 Mexican patients.

INTRODUCTION: The inability to identify, express feelings, and not distinguish between emotions and bodily sensations, is known as alexithymia. In 1988, it developed The Toronto Alexithymia Scale (TAS-20), consists of 20 items and three factors: a) difficulty of identifying feelings and differences between feelings and bodily sensations; b) difficulty of describing feelings; and c) externally oriented thinking. It's considered that people with eating disorders have specific deficits in identify and communicate their feelings. OBJECTIVE: The present study has as purpose to the instrument validation. METHODS: It was a cross-sectional study and psychometric character design of a single sample, formed of 435 persons suffering eating disorder (ED), with an age range of 12-68 years, of which 91% were women and 9% were men. To obtain the reliability of the instrument, applies internal consistency test, which resulted in an alpha of 0.89, then applied a factor analysis of principals components with oblimin rotation. RESULTS: According to statistical analysis, were eliminated six items, so the scale finished with 14 items, and to analyze it observed that these items correspond with the two main factors of the original scale. The ED patients present alexithymia. DISCUSSION: The scale satisfies the criteria of validity necessary for use in this population.

INTRODUCCIÓN: La incapacidad para identificar y expresar sentimientos, y no distinguir entre las emociones y las sensaciones corporales, se conoce como alexitimia. En 1988 se desarrolló la Escala de Alexitimia de Toronto (TAS-20), que está conformada por 20 reactivos y tres factores: a) dificultad para identificar los sentimientos y las diferencias entre sentimientos y sensaciones corporales; b) dificultad para describir sentimientos; y c) pensamiento orientado externamente. Se considera que las personas con trastornos de la conducta alimentaria (TCA) tienen déficits específicos en la identificación y la comunicación de sus sentimientos. OBJETIVO: Realizar la validación de dicho instrumento. MÉTODO: Estudio de tipo transversal y de carácter psicométrico con diseño de una sola muestra, conformada por 435 personas con diagnóstico de TCA, con un rango de edad de 12 a 68 años, de las cuales el 91% eran mujeres y el 9% eran hombres. Para obtener la confiabilidad del instrumento se aplicó una prueba de consistencia interna, que dio como resultado un alfa de 0.89; posteriormente se hizo un análisis factorial de componentes principales con rotación oblimin. RESULTADOS: De acuerdo con el análisis estadístico, se eliminaron seis reactivos, de tal forma que la escala finalizó con 14 reactivos, y al analizarlos se observó que concordaban con los dos factores principales de la escala original. Las pacientes con TCA presentan alexitimia. DISCUSIÓN: La escala satisface los criterios de validez necesarios para ser utilizada en dicha población.

[The age of public goods in health, a national perspective]. / La etapa de los bienes globales en salud, una perspectiva nacional.

Adverse health effects from smoking have been widely known for a long time. Nevertheless, tobacco use does not appear to decrease, and with it the inevitable consequences on morbidity and mortality for millions of people continue. This year alone, the WHO calculates that five million people will die from tobacco use. In Mexico, 26.2% of the population between the ages of 15 and 65 smoke regularly and consumption increases among youth and women. The WHO adopted the Framework Convention on Tobacco Control, ratified by Mexico, which brought about the General Law for Tobacco Control, an important milestone in Mexican sanitary policy. This law will soon be in force and is expected to have a notable effect on containing the smoking epidemic in the country.

[Chronic non-communicable diseases in Mexico: epidemiologic synopsis and integral prevention]. / Las enfermedades crónicas no transmisibles en México: sinopsis epidemiológica y prevención integral.

The federal government has implemented several strategies to reduce mortality caused by chronic non-communicable diseases (CNTD). One example is the development of medical units specialized in the care of CNTD (i.e. overweight, obesity, cardiovascular risk and diabetes), named UNEMES (from its Spanish initials). These units--consisting of an ad-hoc, trained, multi-disciplinary team--will provide patient education, help in the resolution of obstacles limiting treatment adherence, and involve the family in patient care. Treatment will be provided using standardized protocols. The efficacy of the intervention will be regularly measured using pre-specified outcomes. We expect that these UNEMES will result in significant savings. In summary, our health care system is developing better treatment strategies for CNTD. Evaluating the performance of the UNEMES will generate valuable information for the design of future preventive actions.

Prevalence of alexithymia in eating disorders in a clinical sample of 800 Mexican patients. / Prevalencia de alexitimia en los trastornos de la conducta alimentaria en una muestra clínica de 800 pacientes mexicanas

Introduction: The inability to identify, express feelings, and not distinguish between emotions and bodily sensations, is known as alexithymia. In 1988, it developed The Toronto Alexithymia Scale (TAS-20), consists of 20 items and three factors: a) difficulty of identifying feelings and differences between feelings and bodily sensations; b) difficulty of describing feelings; and c) externally oriented thinking. It's considered that people with eating disorders have specific deficits in identify and communicate their feelings. Objective: The present study has as purpose to the instrument validation. Methods: It was a cross-sectional study and psychometric character design of a single sample, formed of 435 persons suffering eating disorder (ED), with an age range of 12-68 years, of which 91% were women and 9% were men. To obtain the reliability of the instrument, applies internal consistency test, which resulted in an alpha of 0.89, then applied a factor analysis of principals components with oblimin rotation. Results: According to statistical analysis, were eliminated six items, so the scale finished with 14 items, and to analyze it observed that these items correspond with the two main factors of the original scale. The ED patients present alexithymia. Discussion: The scale satisfies the criteria of validity necessary for use in this population.

Introducción: La incapacidad para identificar y expresar sentimientos, y no distinguir entre las emociones y las sensaciones corporales, se conoce como alexitimia. En 1988 se desarrolló la Escala de Alexitimia de Toronto (TAS-20), que está conformada por 20 reactivos y tres factores: a) dificultad para identificar los sentimientos y las diferencias entre sentimientos y sensaciones corporales; b) dificultad para describir sentimientos; y c) pensamiento orientado externamente. Se considera que las personas con trastornos de la conducta alimentaria (TCA) tienen déficits específicos en la identificación y la comunicación de sus sentimientos. Objetivo: Realizar la validación de dicho instrumento. Método: Estudio de tipo transversal y de carácter psicométrico con diseño de una sola muestra, conformada por 435 personas con diagnóstico de TCA, con un rango de edad de 12 a 68 años, de las cuales el 91% eran mujeres y el 9% eran hombres. Para obtener la confiabilidad del instrumento se aplicó una prueba de consistencia interna, que dio como resultado un alfa de 0.89; posteriormente se hizo un análisis factorial de componentes principales con rotación oblimin. Resultados: De acuerdo con el análisis estadístico, se eliminaron seis reactivos, de tal forma que la escala finalizó con 14 reactivos, y al analizarlos se observó que concordaban con los dos factores principales de la escala original. Las pacientes con TCA presentan alexitimia. Discusión: La escala satisface los criterios de validez necesarios para ser utilizada en dicha población.

Desempeño de las escuelas de medicina en México: resultados del Examen Nacional para Aspirantes a Residencias Médicas / Performance of medical schools in Mexico: Results from the Examen Nacional para Aspirantes a Residencias Médicas

Resumen: Objetivo: Evaluar el desempeño de las facultades y escuelas de medicina (FEM) utilizando como subrogado los resultados del Examen Nacional para Aspirantes a Residencias Médicas (ENARM). Material y métodos: Se analizaron las bases de datos oficiales del ENARM 2016 y 2017, empleando cinco criterios de desempeño (CD) por cada FEM: dos oficiales y tres creados exprofeso. Resultados. En 2016 y 2017 se registraron sustentantes de 112 y 115 FEM, respectivamente. Dependiendo del CD, la FEM que quedó clasificada en el primer lugar obtuvo entre 5 y 20 puntos más que la del segundo lugar, y entre 23 y 98 puntos más que la FEM ubicada en el último lugar. Aproximadamente 25% de los sustentantes fueron calificados como "deficientes en conocimientos" y aproximadamente 80% de éstos provenían de menos de un tercio de las FEM. Conclusiones: El ENARM arroja información sobre el desempeño de las FEM. Aproximadamente uno de cada cuatro sustentantes obtuvo puntajes menores al aprobatorio en cualquier especialidad.

Abstract: Objective: To assess the performance of medical schools (FEM) by analyzing the results of their applicants in the Examen Nacional para Aspirantes a Residencias Médicas (ENARM). Materials and methods: Five performance criteria, two official and three created on purpose, were calculated from the ENARM-2016 and -2017 official databases to assess FEM performance. Results: In 2016 and 2017, applicants registered from 112 and 115 FEM, respectively. Depending on the performance criteria, the FEM in the first place obtained 5 to 20 points more than the one placed second, and 23 to 98 points more than the FEM in the last place. Approximately 25% applicants were classified as "knowledge-deficient," and about 80% of these originated from less than one third of the FEM. Conclusion: The ENARM results provide information on the performance of the FEM. Approximately one of every four applicants obtained scores lower than the approval threshold of any specialty.

Flaws in the design of the Examen Nacional para Aspirantes a Residencias Médicas produce inequity / Fallas en el diseño del Examen Nacional para Aspirantes a Residencias Médicas generan inequidad

Abstract: Objective: To assess the assumption of 'equity' of Mexico's resident-selection assessment tool, the Examen Nacional para Aspirantes a Residencias Médicas (ENARM). Materials and methods: Official ENARM-2016 and -2017 databases were analyzed. Differences in the absolute number of correct answers (multivariable linear regression) and the number of applicants reaching their specialty minimum score (SMS) per test day (odds ratio [OR]) were calculated. Applicants affected by test-day inequity were estimated. Results: There were 36 114 applicants in 2016, and 38 380 in 2017. In 2016, day-2 applicants had significantly higher scores and more reached the SMS than on days 1-3-4 (OR 1.55), and 5 (OR 3.8); 3 565 non-passing applicants were affected by inequity (equivalent to 44.64% of those selected). In 2017, day-1 and -2 applicants had significantly higher scores and more reached the SMS than on days 3-4 (OR 1.85), and 5 (OR 4.04); 3,155 non-passing applicants were affected by inequity (37.2% of those selected). Conclusion: Analysis of official ENARM databases does not support the official attribution of equity, suggesting the test should be redesigned.

Resumen_ Objetivo: Evaluar el atributo de "equidad" asignado al Examen Nacional para Aspirantes a Residencias Médicas (ENARM). Material y métodos: Se analizaron las bases de datos oficiales del ENARM 2016 y 2017. Se compararon las diferencias inter-día de respuestas correctas (regresión linear multivariable) y de sustentantes que alcanzaron el puntaje mínimo de su especialidad (PME) (razón de momios [RM]). Se estimó a los afectados por la inequidad. Resultados: Hubo 36 114 sustentantes en 2016 y 38 380 en 2017. Los días 2 (ENARM-2016) y 1-2 (ENARM-2017) registraron puntajes significativamente más altos, y más sustentantes alcanzaron el PME que en los días 1-3-4 (RM 1.55) y 5 (RM 3.8) en 2016, y los días 3-4 (RM 1.85) y 5 (RM 4.04) en 2017. Se estimó que cuatro de cada diez sustentantes que aprobaron el ENARM no lo hubieran hecho si el examen fuera equitativo. Conclusión: Los resultados sugieren que el atributo de equidad del ENARM está en duda.

Impacto de diferentes etiquetados frontales de alimentos según su calidad nutricional: estudio comparativo en México / Impact of different front-of-pack nutrition labels on foods according to their nutritional quality: a comparative study in Mexico

Resumen: Objetivo: Evaluar la comprensión objetiva de cinco tipos de etiquetados frontales de paquetes (EFP) (Sistema de Clasificación de Estrellas de Salud, Semáforo Múltiple, Nutri-Score, Ingestas de Referencia y Símbolo de Advertencia) en México. Material y métodos: Se reclutaron 1 001 consumidores mexicanos para clasificar tres productos de tres categorías de alimentos sin EFP, según su calidad nutricional. Se les asignó al azar uno de los cinco EFP para clasificar los mismos productos, esta vez con un EFP en el empaque. El cambio en la capacidad para clasificar correctamente los productos en las dos tareas fue evaluado por EFP, utilizando un modelo de regresión logística ordinal. Resultados: Nutri-Score y Semáforo Múltiple obtuvieron un mejor desempeño, seguidos del Símbolo de Advertencia, Sistema de Clasificación de Estrellas de Salud e Ingestas de Referencia. Conclusión: Nutri-Score y el Semáforo Múltiple surgen como esquemas eficientes para informar a los consumidores sobre la calidad nutricional de los alimentos en México, donde podrían ser una herramienta útil para los consumidores en situación de compra.

Abstract: Objective: This study aimed to compare consumers' objective understanding of five FoPLs [Health Star Rating system (HSR), Multiple Traffic Lights (MTL), Nutri-Score, Reference Intakes (RIs), Warning Symbol] in Mexico. Materials and methods: 1 001 Mexican consumers were recruited and asked to rank three sets of label-free products according to their nutritional quality, via a survey. Upon completion of this task, participants were randomized to one of five FoPL conditions and were again asked to rank the same sets of products, this time with a FoPL displayed on pack. Change in ability to correctly rank products across the two tasks was assessed by FoPL using ordinal logistic regression. Results: Nutri-Score and MTL performed best, followed Warning Symbol, HSR and RIs. Conclusion: Nutri-Score and MTL appear as efficient schemes to inform consumers on the nutritional quality of foods, in particular in Mexico, where it would be a helpful tool for consumers in purchasing situations.

Perfil epidemiológico de la mortalidad por influenza humana A (H1N1) en México / Epidemiological profile of mortality due to human influenza A (H1N1) in Mexico

OBJETIVO: Efectuar el análisis epidemiológico de 122 defunciones por influenza A (H1N1) confirmadas por laboratorio y contribuir a mejorar el diagnóstico y atención oportuna de casos. MATERIAL Y MÉTODOS: Se Analizaron 122 expedientes de pacientes fallecidos por influenza A (H1N1). RESULTADOS: Una proporción de 51 por ciento correspondió a mujeres y 49 por ciento a varones. Hasta 45.1 por ciento ocurrió entre los 20 y 39 años. La letalidad general fue de 2.2 por ciento y varió entre 0.3 por ciento en el grupo de 10 a 19 años y 6.3 por ciento en el de 50 a 59. Una cifra de 43 por ciento de las defunciones se concentró en dos de las 32 entidades federativas y 5l por ciento se atendió en instituciones de seguridad social. Sólo 17 por ciento recibió atención hospitalaria en las primeras 72 horas y 42 por ciento falleció en las primeras 72 horas de hospitalización. En 58.2 por ciento de los fallecidos había algún padecimiento asociado. DISCUSIÓN: El Nuevo virus A (H1N1) produce mayor mortalidad en personas jóvenes, al contrario de lo que sucede con la influenza estacional que muestra un mayor impacto en niños pequeños y personas de edad avanzada. El retraso de la atención médica y la morbilidad asociada fueron factores relevantes del fallecimiento.

OBJECTIVE: To carry out the epidemiological analysis of 122 influenza A (H1N1) deaths confirmed by laboratory and help to improve the diagnosis and timely managing of cases. MATERIAL AND METHODS: A total of 122 clinical records were analyzed of patients with confirmed influenza A (H1N1) virus infection who died. RESULTS: Fifty-one percent of patients were female and 49 percent were male. A total of 45.l percent who died were between 20 and 39 years old. Overall fatality was 2.2 percent and ranged between 0.3 percent for the l0 to l9 year-old group to 6.3 percent for the 50 to 59 year-old group. Forty-three percent of deaths were concentrated in only two of the thirty-two states and 5l percent received medical attention in social security institutions. Only l7 percent received hospital attention within 72 hours and 42 percent died within 72 hours of hospital attention. DISCUSSION: Novel Influenza A (H1N1) virus produces higher mortality in young people whereas seasonal influenza has a greater impact on young children and older people. Delay in medical care and the associated morbidity were relevant factors for death.