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PubMed1994

The time has come to lift the economic embargo against Cuba.

The United States embargo against Cuba, which makes trade illegal, contributes to that country's death and disease. The policy is obsolete, counterproductive and should be changed to bring peace between the two nations and help restore the health of the Cuban people. Along with the ban on trade is the ban on traveling. The United States' controls contradict the most fundamental values upon which this country stands. Despite current restrictions, physicians can travel to Cuba and they should in order to observe the island's system for themselves.

Aged↗

PubMed1993

[Human leptospirosis behavior in Cuba].

A description is made of the antecedents of human leptospirosis in Cuba and the behavior of the disease from 1981. An analysis with regards lethality and incidence during the five-year period 1986-1990 was carried out; the most affected provinces, the months of highest occurrence, and the most hazardous occupations, are listed. The present situation of human leptospirosis in Cuba is described and recommendations are provided.

Adolescent↗

PubMed1994

Epidemic neuropathy--Cuba, 1991-1994.

From January 1, 1992, through January 14, 1994, the Ministry of Public Health of Cuba (MINSAP) identified 50,862 cases of a neuropathy in residents of Cuba (1993 population: 10.8 million); affected persons had onset beginning July 1, 1991. The neuropathy has included an optic form--characterized by subacute (i.e., 3-30 days) onset, decreased visual acuity, decreased color vision, and/or central or cecocentral scotomata--and a peripheral form; both forms have been characterized by weight loss and easy fatigability. This report presents a preliminary summary of an investigation by MINSAP of this epidemic.

Adolescent↗

PubMed1993

[Characteristics of the introduction of foods into the diets of infants in Cuba].

The purpose of this study was to examine the prevailing pattern of introduction of nonmilk foods into the diets of children in Cuba and to assess the degree to which this pattern deviates from internationally accepted recommendations. A cross-sectional study was carried out using a simple random sample of 6,688 children under 1 year of age from all over Cuba. The data were analyzed through logistic regression. The study was carried out in 1990 using the pyramidal structure of the national public health system for the collection of data. Through the status quo method, information was obtained on consumption of four representative foods--juice, vegetables, meat, and fish--and some data were gathered on the child. Consumption prevalence rates were estimated at the beginning and the end of the age ranges (in days) that WHO considers optimum for the introduction of these foods. A marked divergence was found between recommended and actual practice. The recommendations were followed in 3% of the cases for juice, 9% for vegetables, 4% for meat, and 25% for fish. It is noteworthy that noncompliance with the recommendations basically takes the form of early introduction of these foods. The exception is vegetables, which are introduced considerably later than recommended, a fact that seems to reflect a cultural distaste for this food.

Cross-Sectional Studies↗

PubMed1977

Obstetrics in Cuba, 1974.

In the past 17 years, Cuba has established a system of governmental medical care, and undergraduate and graduate medical education have also been revised and expanded. Special attention has been directed to maternal and pediatric care, but no description of this has been published outside Cuba. Standards of care have been formulated by national committees, with emphasis placed on the training of specialists in obstetrics and neonatology. Prenatal care and identification of high-risk patients has produced an institutional delivery rate of over 97% with much antenatal hospitalization and referral of high-risk gravidas to tertiary care facilities. New laws providing benefits for working women encourage prenatal care, rest, and breastfeeding. In 1974 the maternal mortality rate was 55.6 per 100,000 live births, and perinatal mortality was 28.5 per 1000 live births.

Abortion, Legal↗

PubMed1996

[Some epidemiological aspects of myasthenia gravis in Cuba].

We estimated the rates of prevalence, incidence, mortality and lethality for myasthenia gravis in Cuba based upon previous epidemiological studies carried out in eight of Cuba's fourteen provinces: Pinar del Río, Havana City, Havana, Matanzas, Cienfuegos, Sancti Spíritus, Camagüey and Guantánamo. Rates of incidence, prevalence and mortality were 4.52, 29.22 and 0.72 per million inhabitants respectively. Lethality rate was 10.77%.

Adolescent↗

PubMed1997

Viral isolation from cases of epidemic neuropathy in Cuba.

OBJECTIVE: To investigate the possibility of a viral agent in the central nervous system of patients with epidemic neuropathy. DESIGN: Virus isolation attempts, in cell cultures and suckling mice, from cerebrospinal fluid (CSF) of neuropathy patients and controls undergoing lumbar puncture for unrelated reasons. Serologic studies in patients, contacts, and controls. SETTING: An epidemic of optic and peripheral neuropathy affected more than 50,000 people in Cuba in 1991 through 1993. Illness was associated with dietary limitations and increased physical demands accompanying the shortages of food and fuel experienced in Cuba since 1989. Most patients responded to parenteral vitamin therapy, and the epidemic began to subside when oral vitamin supplementation was begun for the entire Cuban population. RESULTS: Coxsackievirus A9 (five isolates) and a similar, less cytopathic virus (100 isolates) were recovered from 105 (84%) of 125 CSF specimens from neuropathy patients. The strains with light cytopathic effect were antigenically related to Coxsackieviruses A9 and B4 by cross-neutralization and immunoblotting assays. Virus persisted in CSF of some patients for 1 to 12 months. Cerebrospinal fluid from patients and both types of virus from cell culture produced illness, including complete posterior flaccid paralysis, in newborn mice, and virus was reisolated from the mice. Mouse tissues and sural nerve biopsy specimens from patients were stained by immunoperoxidase and colloidal gold techniques using hyperimmune rabbit antisera against the virus with light cytopathic effect. CONCLUSIONS: Coxsackievirus A9 or an antigenically related agent with a light cytopathic effect was present in CSF of 84% of 125 patients with epidemic neuropathy. The role of these agents, probably in combination with nutritional factors, in the pathophysiology of the disease requires further investigation.

Adult↗

PubMed1997

[Confirmation of the presence in Cuba of human T-cell lymphotropic virus type I using the polymerase chain reaction].

The first cases diagnoses in Cuba as HTLV-I/II seropositives (human T lymphotropic virus) were studied by polymerase chain reaction aimed at differentiating the type of virus causing the infection. 3 kits of primer oligonucleotides were used and the amplification products were detected by hybridization with specific oligoprobes. 100% of the cases were HTLV-I positives. No HTLV-II positivity was found. It was confirmed the presence in Cuba of this retrovirus, even though the seroprevalence is low if it is taken into consideration that the Caribbean is an endemic zone for HTLV-1.

Cuba↗

PubMedDate not supplied

[Preschool age mortality (1-4-year olds) in Cuba, 1961-1975].

An abstract is made of the preschool age mortality in Cuba through the period of 1961 to 1975. The authors outlight how it has dropped from 2.0 to 1.1 per 1000 population to reach 45% reduction. They establish comparison with a group of American countries, setting of contrast with the low mortality in Cuba. The mortality in children of 1 to 4 years old is considered as indirect index of malnutrition. The percentage of diminution for the different departments in the period stated is as follows: Pinar del Río, 57.6%; Havana, 43.7%; Matanzas, 58.5%; Las Villas, 63.1%; Camagüey, 50.0%; Oriente, 39.0%. The 10 most important causes of death are analyzed and the percentages in drop of mortality are reported as follows: (A 43), 80.0%; (A65) and (A105-106), 66.7%; (A5), 61.5%; (A93), 50.0%; (A89, 90, 91 and 92), 46.5%; (A21), 42.8%; (AE 138-146), 34.6%; (A126-130), 31.2%; (A25), 25.0%. Finally, stress is placed on the elements responsible for the drop in preschool age children's mortality.

Child, Preschool↗

PubMed1997

Growth assessment in school-children of Villa Cubas, Catamarca Argentine.

An anthropometric study of the growth in schoolchildren aged 5 to 14 years, belonging to the Villa Cubas district of the capital of the province of Catamarca, has been carried out. Villa Cubas presents average/low socioeconomic characteristics and is situated in a peripheral sector to the Center of the Capital. Male and female students have been evaluated. The measurements were turned to "Z" scores. The aims of this work were: 1) To determinate the state of growth in comparison with the national reference standards and 2) To analyze the competence of the use of such standards in the clinical and nutrition assessment in the province of Catamarca. The results showed that the body weight and height had no difference with the standards, while the sitting presented higher values than the standards. The results are interpreted as a consequence of the food deficit that affected the height and the inferior height part. The standards of reference are considered to be out-of-date and inappropriate for the clinic assessment in the province of Catamarca, inasmuch as they do not show the changes that have taken place in the population in the last 20 years.

Adolescent↗

PubMedDate not supplied

[Resistance to insecticides in Blattella germanica species strains from Santiago de Cuba].

A study was conducted on the level of resistance to seven insecticides, namely, 3 organophosphate compounds (malathion, chlorpyrifos and pirimiphos-methyl), one carbamate (propoxur) and 1 pyrethroid (cypermethrin, deltamethrin and lambdacialotrine) of three field-collected strains of Blattella germanica (Linnaeus, 1767) from Santiago de Cuba. These strains showed high resistance levels to malathion, cypermethrin, deltamethrin and lambdacialotrine and low resistance to pirimiphos-methyl, and also they were susceptible to chlorpyrifos and propoxur. The levels of resistance to tested organophosphate insecticides such as malathion and pirimiphos-methyl and to pyrethroid compounds like cypermethrin, deltamethrin and lambdacialotrine may be related to the increased production of esterases as a mechanism of resistance. The value of frequency of the resistant genes for enzyme acetylcholinesterase was very low, therefore, the modified acetylcholinesterase is not involved in resistance to insecticides tested in the studied strains from Santiago de Cuba.

Animals↗

PubMed1997

Results of 12 years' combined maternal serum alpha-fetoprotein screening and ultrasound fetal monitoring for prenatal detection of fetal malformations in Havana City, Cuba.

Progressively since 1982 and as part of a nationwide programme for the diagnosis and prevention of genetic diseases, maternal serum alpha-fetoprotein (MS-AFP) screening and ultrasound fetal monitoring has been implemented in all pregnant women in Cuba. In Havana City, 328,983 pregnant women underwent MS-AFP screening between 15 and 19 weeks of gestational age. With a cut-off level of > or = 2 multiples of the normal median (MOM), 1767 amniocenteses were carried out to determine the levels of amniotic fluid AFP and 685 malformed fetuses were diagnosed. By ultrasound fetal monitoring, an additional 686 malformed fetuses were detected. As a result of the programme, the birth prevalence of neural tube defects has fallen by 90 per cent.

Amniotic Fluid↗

PubMed1985

Psychology and human services in Cuba: personal perspectives.

Through a series of meetings with Cuban social scientists, an analysis of the development and practices of psychology and related human services was attempted. Interviews were held at a medical school, at a local community health clinic, at a residential treatment facility and at one of the two universities in Cuba offering a degree program in psychology. The interviews revealed a network of interrelationships between: (a) work performance and a complex material and moral incentive system, where the workers played an active role in evaluating and modulating the system; (b) the health delivery system and its targeted community members, where services are adapted to the needs of the community; and (c) individuals and their neighborhoods, where local organizations are the mechanisms for community participation. It was concluded that a prime characteristic of Cuban society is to change the very nature of the relationships between people and their social institutions. Since community participation in social services is a growing concern within our own country, the Cuban system may provide reference points to note.

Community Mental Health Services↗

PubMed1985

Community medicine in Cuba.

The 25 years of revolution in Cuba have brought about great changes in the health care system. The health status of the population has been transformed from that of a developing country to one approximating the developed countries. The delivery of primary care at the community level has evolved over the past 15 years as a result of critical evaluations of the new implementations. The community polyclinic has been the basis for all health planning since 1975. This model has the health of the community as its main concern and the mechanism for involving the community in healthcare decisions has been established. The history of the community polyclinic and the evolution of the guidelines by which it functions are reviewed. In practice, many problems persist and the strategy for resolution of current conflicts will provide for interesting developments in the near future.

Community Health Centers↗

PubMed1995

Sickle cell anemia and beta-gene cluster haplotypes in Cuba.

We have studied 91 patients with SS genotype, 44 children and 47 adults. Excluding the Cameroon and atypical haplotypes, the distribution in the children's sample exhibited 43% Benin, 38% Bantu, and 3% Senegal. In adults, the sample exhibited 46% Benin, 30% Bantu, and 9% Senegal (chi 2: 13.511, 2 df, P = 0.001). When the whole sample of 198 chromosomes (SS, SC, and S/beta thal) is considered, we find that the beta s chromosome is linked 51% to the Benin haplotype, 41% with the Bantu, and 8% with the Senegal. After adjusting for the different frequencies of beta s in Africa, these numbers would predict the port of origin to be 16% from Atlantic West Africa, 37.3% from Central West Africa, and 46% from Bantu-speaking Africa. This is in direct contradiction with the historical record that establishes a higher percentage from Bantu-speaking Africa (55%) and a much lower percentage from Senegal (3.4%). The overall conclusions from these findings is that there is a loss of Bantu haplotypes in sickle cell syndromes in Cuba, particularly among adults, and that there is an excess of Senegal haplotype, also among adults. These differences might reflect the differential survival and severity of the sickle cell disease linked to these haplotypes.

Adolescent↗

PubMed2006

A genome-wide linkage search for bipolar disorder susceptibility loci in a large and complex pedigree from the eastern part of Cuba.

We present results from a genome-wide scan of a six generation pedigree with 28 affected members with apparently dominant bipolar I disorder from eastern Cuba. Genotypes were obtained using the early access version of the Genechip Mapping 10K Xba array from AFFYMETRIX. Parametric and non-parametric linkage analyses under dominant and recessive models were performed using GENEHUNTER v2.1r5. Two phenotypic models were included in the analyses: bipolar I disorder and recurrent depressive disorder, or bipolar I disorder only. LOD scores were calculated for the entire family combined, and for four subdivisions of the family. For the entire family a suggestive parametric LOD score was obtained under the dominant model and the broader phenotype at 14q11.2-12 (LOD = 2.05). In the same region, a non-parametric LOD score close to genome-wide significance was also obtained, based on the entire family (NPL = 7.31, P-value = 0.07). For two individual branches of the pedigree, genome-wide significance (P < 0.005) was obtained with NPL scores of 8.71 and 12.99, respectively, also in the same region on chromosome 14. Chromosome 5q21.3-22.3 also showed close to genome-wide significant linkage for the complete pedigree (NPL = 7.26, P = 0.07), also supported by significant linkage in one individual branch (NPL = 9.86, P < 0.005). In addition, genome-wide significant nonparametric results (P-values <0.005) were obtained for individual branches at 5p13.1-q12.3, 6p22.3, 8q13.3-21.13, and 10q22.3-23.32. Finally, 2p25.1-25.3, 2p13.3-14, 3p14.2, 6p22.3-24.1, 7p14.1-14.2, 8q12.2-12.3, 10q21.1-21.2, 14q13.1-21.1, 15q15.1-21.2, and 22q12.3-13.32 showed suggestive linkage in the complete family. Most of these potential susceptibility loci overlap with, or are close, to previous linkage findings. The locus on 5q may, however, represent a novel susceptibility locus.

Bipolar Disorder↗

PubMed2004

IL-10 levels in Dengue patients: some findings from the exceptional epidemiological conditions in Cuba.

The pathogenesis associated with Dengue haemorrhagic fever, has yet to be fully elucidated, with no definitive in vivo evidence. The exceptional epidemiological circumstances in Cuba allow the evaluation of different mediators in a well-defined situation. In the present study, we describe the determination of levels of IL-12, IL-10 and RANTES in the sera of Cuban patients hospitalised with Dengue fever or Dengue haemorrhagic fever. The results showed that levels of serum IL-10 were higher in patients than controls, and those patients with secondary infections had consistently higher levels. All the Dengue haemorrhagic fever patients had increased levels of IL-10. In contrast, levels of IL-12 did not differ between patients and controls. Finally, RANTES serum levels detected in patients were lower than those observed in the controls. The association of increased levels of IL-10 in Dengue patients with a sequential infection suggests a possible role of this cytokine in the pathogenesis of Dengue disease.

Adolescent↗

PubMed1995

Fate in humans of dietary intake of cyanogenic glycosides from roots of sweet cassava consumed in Cuba.

We studied if consumption of boiled fresh roots from sweet cassava varieties grown in Cuba resulted in exposure to cyanogenic glycosides and their final breakdown product, cyanide. When adult, nonsmoking subjects consumed 1-4 kg cassava over 2 days, their urinary levels of the main cyanide metabolite, thiocyanate, only increased from a mean +/- SEM of 12 +/- 2 to 22 +/- 2 mumol/l, indicating a negligible cyanide exposure. Their mean urinary linamarin, the main cyanogenic glucoside in cassava, increased from 2 +/- 1 to 68 +/- 16 mumol/l. In a second experiment 5 subjects consumed one meal of 0.5 kg boiled cassava that contained 105 mumol linamarin and 8 mumol hydrogen cyanide (HCN). Quantitative urine collections prior to and after intake showed that 28% of linamarin was excreted during the following 24 hours, whereas a modest increase of urinary thiocyanate (SCN) only corresponded to the small amount of free HCN ingested. These results indicate that the dominant cyanogen in boiled cassava is glycosides that pass through the human body without causing cyanide exposure. It remains to be studied whether humans occasionally possess intestinal or tissue beta-glucosidases that can hydrolyse cyanogenic glycosides from cassava.

Adult↗