Archives of medical research
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Endothelial nitric oxide synthase gene polymorphisms, either independently or through gene environmental interactions, are associated with cardiovascular diseases in multiple ethnic populations. However, no information is available with regard to such associations in a Saudi population despite a high incidence of cardiovascular abnormalities. We studied the associations of 894G>T and -786T>C polymorphisms of endothelial nitric oxide synthase gene with coronary artery disease in Saudi population. ⋯ This study, for the first time, suggests an independent association of 894G>T and -786T>C polymorphisms of endothelial nitric oxide synthase gene with coronary artery disease in a Saudi population.
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Review Historical Article
Lessons from previous influenza pandemics and from the Mexican response to the current influenza pandemic.
Better understanding of the events occurring during prior influenza pandemics, particularly the 1918 pandemic, and the realization that another pandemic was inevitable and likely to occur early in the 21(st) century, have helped in preparedness planning. In Mexico, pandemic flu preparedness was critical and undoubtedly paid off once a new influenza pandemic was identified in April 2009, but it also became apparent that these plans required flexibility and significant adjustments as the epidemic evolved. ⋯ In addition, we highlight various issues that should be addressed among countries and by the international community before the next influenza pandemic occurs. There have been many lessons learned but the one we cannot forget is that complacency is dangerous and not acceptable when confronting the threat of an influenza pandemic.
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The ongoing influenza A (H1N1) pandemic stroked Mexico and posed a huge challenge to the medical care and public health systems. This report analyzes the clinical course and process of care of patients who died due to atypical pneumonia and fulfilled the clinical criteria of suspected case of novel influenza A (H1N1) virus infection. ⋯ An increased number of severe cases of atypical pneumonia in previously healthy adults highlight the importance of the availability of a timely surveillance system able to identify sudden increases in the number of cases or presentation of apparently known diseases.
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The World Health Organization (WHO) has reported, as of September 2009, that the influenza A (H1N1) influenza pandemic has originated >300,000 laboratory-confirmed cases and 3917 deaths in 191 countries. It is recognized that pandemic vaccines have their greatest impact as a preventive strategy when administered before or near the peak incidence of cases in an outbreak. Therefore, vaccination campaigns should be in place when influenza A (H1N1) 2009 vaccines are available. We undertook this study to provide updated information on clinical evaluation of influenza A (H1N1) vaccines and review recommendations for influenza A (H1N1) vaccination campaigns and public health policy. ⋯ The present pandemic of influenza A (H1N1) has shown mild to moderate severity. Vaccination strategies in Mexico will have the objective of decreasing severe outcomes, slowing transmission, protecting groups at increased risk of infection, complications, or death, and preventing overload of health services. Control of the pandemic should include reinforcement of other non-pharmacologic measures of mitigation and, importantly, an adequate strategy of social communication.
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Cervical cancer is one of the main causes of death in women in low- and middle-income countries. Despite technological and scientific advances that allow an early detection of precancerous lesions and curative treatment of cervical cancer, Mexico and other Latin American countries have only been able to obtain a small decrease in the mortality rates for this kind of cancer. How to implement and sustain effective public health strategies for cervical cancer prevention, such as increasing cytology-based screening program coverage and implementing HPV-DNA testing and vaccination, are important questions. The aim of this study is to perform a cost-effectiveness analysis of the introduction of a quadrivalent (HPV 6/11/16/18) HPV vaccine into the public health system and evaluate the epidemiological and economic benefits on prevention of cervical cancer in Mexico. ⋯ The strategy of using only vaccination ($45 USD for three doses) as a preventive measure was a very cost-effective strategy in Mexico ($68USD/LYS). The strategy of vaccination with traditional screening of Pap test every 3 years produced higher cost by a lower performance of cervical cytology in Mexico, at a cost of $15,935 USD per life-year. The cost-effectiveness of the vaccination strategy was highly sensitive to age of vaccination, duration of vaccine efficacy, and cost of vaccination. The Mexican model predicts that a quadrivalent HPV vaccine will reduce the incidence of high- and low-risk-associated cervical cancer. A program of vaccination as a preventive strategy is likely cost effective. The results of this study could be of great value in decision-making for the implementation of an HPV vaccine as a public health policy in Mexico provided that the cost of each dose will be, at most, $15 dollars (USD) dollars, combined with HPV testing, the new strategy of national secondary prevention program.