[Prevalence of blood eosinophilia in adults with COPD according to the cut-off point]. / Prevalencia de eosinofilia en sangre en adultos con EPOC según el punto de corte.

OBJECTIVE: To determine the prevalence of blood eosinophilia in adults with chronic obstructive pulmonary disease (COPD) according to different cut-off points. METHODS: A cross-sectional study was carried out in patients with COPD. The frequency of blood eosinophilia was determined by absolute (cells/ µL) and relative (%) eosinophil count. Multivariate methods were used in order to identify the associated factors. RESULTS: 81 patients were included; the mean age was 71.9 ± 9.8 years; 46 (57%) of the patients were men. The prevalence of eosinophilia for the cut-off points of ≥ 100, ≥ 150, ≥ 200, ≥ 300, and ≥ 400 cells/µL was of 64.2%, 37.0%, 16.1%, and 9.9% respectively. Out of 81 patients, 34 (42%) had a relative eosinophil concentration of ≥ 2%; 21 (25.9%) ≥ 3%; 14 patients (17.3%) had ≥ 4%; and 10 patients (12.3%) had ≥ 5%. Eosinophilia of ≥ 100 cells/µL was associated with age of ≥ 80 years (OR = 6.04, p = 0.026), and with the exacerbation of COPD (OR = 9.40, p = 0.038); in contrast, eosinophilia of ≥ 2% was associated only with age of ≥ 80 years (OR = 3.73, p = 0.020). In addition, the eosinophil count of ≥ 100 and < 300 cells/µL was associated with the exacerbation of COPD (OR = 11.00, p = 0.026). CONCLUSIONS: Our results suggest that the frequency of eosinophilia in the context of COPD shows substantial variations according to the used definition.

Objetivo: Establecer la prevalencia de eosinofilia en sangre en adultos con enfermedad pulmonar obstructiva crónica (EPOC) según varios puntos de corte. Métodos: Se realizó un estudio transversal en pacientes con EPOC. La frecuencia de eosinofilia en sangre se determinó a partir de la concentración absoluta (células/µL) y relativa (%) de eosinófilos. Fueron realizados modelos multivariados para identificar factores asociados. Resultados: En 81 pacientes incluidos, la edad promedio fue de 71.9 ± 9.8 años; de los cuales, 46 (57 %) fueron hombres. La prevalencia de eosinofilia para los puntos de corte ≥ 100, ≥ 150, ≥ 200, ≥ 300 y ≥ 400 células/µL fue de 64.2, 43.2, 37.0, 16.1 y 9.9 %, respectivamente. De 81 pacientes, 34 (42 %) tuvieron una concentración ≥ 2 %; 21 (25.9 %) ≥ 3 %; 14 (17.3 %) ≥ 4 %; y 10 (12.3 %) ≥ 5 %. La eosinofilia ≥ 100 células/µL se asoció con la edad ≥ 80 años (RM = 6.04, p = 0.026) y con la exacerbación de la EPOC (RM = 9.40, p = 0.038); en cambio, la eosinofilia ≥ 2 %, lo hizo con solamente la edad ≥ 80 años (RM = 3.73, p = 0.020). Complementariamente, la concentración de eosinófilos ≥ 100 y < 300 células/µL se asoció con la exacerbación de la EPOC (RM = 11.00, p = 0.026). Conclusiones: Nuestros resultados sugieren que la frecuencia de eosinofilia en EPOC muestra variaciones sustanciales según la definición adoptada.

Quantifying the mortality caused by the H1N1 influenza virus during the 2009 pandemic in Mexico.

INTRODUCTION: The frequency and mortality of the pandemic caused by influenza A(H1N1)pdm09 might have been underestimated, especially in developing countries. This study was designed to quantify the possible underestimation of pandemic influenza mortality and evaluate the concordance between the data reported for A(H1N1)pdm09 mortality and the causes of death reported during the pandemic period of April 2009 to February 2010. METHODOLOGY: The death certificates of 754 confirmed cases of A(H1N1)pdm09 infection were included in the study. Data was analyzed using the United States Centers for Disease Control and Prevention's statistical model accounts for the variability in the proportion at each step using the Monte Carlo probabilistic model sampled from a uniform probability distribution. RESULTS: A total of 1,969 deaths were estimated, with an estimated lethality of 5.53 per 100,000 (range, 3.5-8.76 per 100,000) in contrast with the 754 deaths and a lethality of 1.98 per 100,000 infected patients officially reported. In 631 of 754 (83.7%) death certificates from A(H1N1)pdm09 influenza-positive patients, influenza was not mentioned as a cause of death. CONCLUSIONS: It is possible that the mortality of the pandemic was three times higher than officially reported in Mexico. One source of error that could explain this underestimation is in the completion of death certificates, because in > 80% of confirmed cases of infection with influenza virus, it was not reported as the cause of death.

[Preventable diseases by vaccination. Coverage and impact]. / Enfermedades inmunoprevenibles. Coberturas e impactos de la vacunación.

OBJECTIVE: to evaluate the coverage and impacts of the vaccination component in Integrated Health Programs. MATERIAL AND METHODS: a descriptive study of secondary data analysis was carried out. We analyzed data generated by the Universal Vaccination Program (PROVAC) since 1991, the data compiled in the 2000 National Health Survey (ENSA) and the 2005 National Survey of Coverage of Integrated Health Programs (ENCOPREVENIMSS), as well as the IMSS Annual Epidemiological Gazettes since 1973. RESULTS: the coverage of the basic schemes of the Extended Immunization Program (PAI) in children from one to four years old increased from 46.0% in 1990 to 92.5% in 1992 and 98.2% in 2005. The coverage with booster doses was substantially lower, ranging between 57.0% and 97.3% depending on the type of vaccine and the number of doses. The coverage also varied, although to a lesser extent, among public healthcare institutions. In relation to the impact of the Universal Vaccination Program and the PREVENIMSS strategy among IMSS affiliates, we distinguished at least three situations: (1) illnesses in which a drop in incidence predates the Universal Vaccination Program: tuberculous meningitis, diphtheria, whooping cough, and tetanus; (2) illnesses in which the drop in incidence is clearly related to the program: measles, rubella, mumps, and meningitis due to H. influenzae b. (3) illnesses for which the impact has not yet been assessed: hepatitis B. In addition to a drop in the incidence of immunopreventable diseases, we observed changes in the age distribution of cases. CONCLUSIONS: the PREVENIMSS strategy has not interfered with, and in some case has helped to consolidate the achievements of the Universal Vaccination Program. The results of this investigation point to the need to modernize the current system of evaluating coverage and expanding vaccination schemes with booster doses.

Seroepidemiology and risk factors for sporadic norovirus/Mexico strain.

Risk factors associated with transmission of sporadic norovirus (NV; formerly Norwalk-like virus)/Mexico strain were identified in a seroepidemiological study conducted in rural Mexico. Acquisition of Mexico strain IgA antibodies was age-related; 34% of 1-4-year-olds were seropositive, compared with 81% of adults (P<.001). After 12 months, 42% of 1-4-year-olds showed a seroresponse to Mexico strain, compared with 27% of adults (P<.01). Personal and domestic hygiene measures, such as hand washing, general cleanliness of the mother's clothing, and the type of room assigned for cooking were significantly associated with odds of a seroresponse. For infants, having a dog in or near the home was a risk factor for seroresponse (P<.01), whereas, for older children, the mother's involvement in agricultural activities was a risk factor (P<.001). This study provides initial evidence of risk factors associated with sporadic NV infection. Data indicate some similarities to risk factors associated with outbreaks of NV infection.

Correlación de la citología de moco fecal con el coprocultivo en niños con diarrea aguda / Correlation of fecal mucus citology with coproculture in children with acute diarrhea

Se realizó un estudio retrospectivo en el Hospital Infantil Privado de la Ciudad de México del 1 de enero al 31 de diciembre de 1997, con el objetivo de determinar la utilidad de la citología de moco fecal en el diagnóstico de diarrea aguda en niños y su relación con el germen identificado en el coprocultivo. Se incluyeron 170 niños con diagnóstico de diarrea aguda en niños y su relación con el germen identificado en el coprocultivo. Se incluyeron 170 niños con diagnóstico de diarrea aguda con una mediana de edad entre 12 y 120 meses. A todos los pacientes se les realizó citología de moco fecal y coprocultivo, encontrándose 11 casos de citología de moco fecal positivo (6.5 por ciento) y 159 negativos (87.6 por ciento); en el coprocultivo el agente etiológico se identificó en 21 casos (12.3 por ciento), de los cuales ocho correspondieron a E. coli (4.7 por ciento), ocho a Salmonella (4.7 por ciento) y cinco a Shigella (2.9 por ciento). La relación de la citología de moco fecal y el agente identificado en el coprocultivo no fue significativo, ya que mostró p=0.13 mediante la prueba de Fisher