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PubMedDate not supplied

[Alagille's syndrome in Cuba. A report of 9 cases].

Alagille's syndrome or arteriohepatic dysplasia has been described in Cuba in nine patients between nine months and 12 years of age (8 males and one female). Among the clinical features we found five major abnormalities: chronic cholestasis with neonatal jaundice (9/9), peculiar facies (9/9), peripheral pulmonary artery hypoplasia associated with cardiac murmur (6/9), butter-fly-like arch defects (4/9), and posterior embryotoxon (6/7). Two children had a severe xanthomatosis. Laparoscopy showed green hepatomegaly depending on the degree of cholestasis, and only one patient had incipient signs of micronodular cirrhosis. Liver histology showed a paucity of interlobular bile ducts. Survival was of 60%. One patient survived more than 30 years. Four patients died of liver carcinoma (unique report in infants), broncho-pneumonia, acute renal failure, and sudden death respectively. Among the minor features were mental retardation (5/9), a peculiar voice (3/9), growth retardation observed in some of our patients. This is the first report on Alagille's syndrome in Latin America, because so far reports have come only from Europe and North America.

Alagille Syndrome↗

PubMed2003

Surgical support of Operation Sea Signal: adaptability of the 59th Air Transportable Hospital in Cuba.

OBJECTIVE: The attempted migration of approximately 50,000 Cubans in the summer of 1994 created a large patient population detained at Guantanamo Bay, Cuba. This study examined the roles and results of the 59th Air Transportable Hospital (ATH) in treating surgical problems within that population during Operation Sea Signal. METHODS: The surgical case log of the 59th ATH was used to identify all patients operated on at the 59th ATH during the interval of August 1994 to April 1995. These case records and the individual records of the three 59th ATH surgeons were used to determine the types of cases performed, complications, and outcomes. RESULTS: A total of 333 operations were performed at the 59th ATH in three types of surgery: (1) elective (267); (2) emergency for nonself-inflicted conditions (46); and (3) emergency for self-inflicted conditions (20). The total perioperative complication rate was 2.4% (8/333), and the wound infection rate for clean surgical cases was 0.87% (2/229). CONCLUSIONS: Elective surgery may be performed in a field environment with acceptable complication and wound infection rates. Humanitarian missions will be faced with considerable pathology from pre-existing conditions within the population cared for. The humanitarian mission may be complicated by political situations that may encourage malingering and self-injurious behavior within the population cared for. The latter events have not been previously encountered in humanitarian missions involving the U.S. military and must be considered by policy makers and mission planners in planning future humanitarian missions.

Cuba↗

PubMed2003

Comparison of four health systems: Cuba, China, Japan and the USA, an approach to reality.

The ultimate responsibility for the overall performance of a country's health system lies with government, which in turn should involve all sectors of society in its stewardship. A comparison in structure, financing and function of the health systems of Japan, the USA, Cuba and China, as well as their main health and social-demographic results, is shown here. Two clear examples of inequalities, between regions in China and between ethnic and social groups in the USA, let us see different health indicators of both countries. To achieve and maintain a healthy population with good health results does not necessarily depend on a big budget or richness in a country. Good governmental policies regarding public health and social security are crucial to achieve good quality of life equally distributed to the whole population. Some suggestions are given.

China↗

PubMedDate not supplied

[Development of Tropical Medicine in Cuba: life and work of its highest exponent].

A brief historical review of Tropical Medicine in Cuba and of the life and work of Pedro Kourí up to the foundation of the institution that bears his name today was made. The achievements attained by this Institute were also included in this paper. With this study we payed a modest homage to the illustrous Dr. Pedro Kourí on the centenary of his birthday and the students and health workers had the opportunity to know part of this Cuban history.

Academies and Institutes↗

PubMedDate not supplied

[Different circulation patterns of subgroups A and B of human respiratory syncytial virus in some provinces of Cuba].

The nucleotide sequencing of the protein G C-terminal region of 37 samples taken from nasopharyngeal washings of under one-year old children from some Cuban provinces was made for 5 epidemic periods (1995-2000) to find out the circulation patterns of strains of human respiratory syncytial virus that is classified in two antigenic subgroups known as A and B; each of them contains multiple variants. Subgroup A has circulated during all these years but subgroup B was detected only in the year 2000. The presence of strains with two different sizes of protein G (297 aa and 298 aa) was observed whereas subgroup B showed only one size (295 aa). Phylogenetic analysis allowed identifying 5 and 2 genotypes within subgroups A and B respectively. Viruses present in Cuba were phylogenetically related to the strains of other parts of the world. Subgroup A comprised two strains very similar to Long prototype strain. Almost all the strains of both subgroups in the year 2000 phylogenetically related with strains that circulated in South Africa during the same period.

Base Sequence↗

PubMedDate not supplied

[Antiretroviral therapy in HIV/AIDS seropositive pregnant women in Cuba].

It was assessed that the number of HIV infected children due to vertical transmission increases every day and that is why the early diagnosis in the HIV+ pregnat women and the administration of antivirals in the prenatal stage to reduce the transmission is so important. Taking these factors into account, from 1997 on, it was decided in Cuba to administer AZT to all HIV+ pregnant women and to the newborn infant, as it is established in the protocol 076, which considerably reduced the number of infected children.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

[Mortality from tuberculosis in Cuba. 1902-1997].

The behavior of mortality from tuberculosis in Cuba from 1902 to 1997 was described. During the xx century, tuberculosis has been studied in various stages, but no papers reflecting its behavior in a comprehensive way have been published so far. To this end, the notifications of tuberculosis and the populations by sex, age and provinces available since 1902 in the archives of the National Statistics Division of the Ministry of Public Health were taken into consideration. The trend and the percentages of variation of the gross and specific rates were analyzed. A descending trend of mortality from tuberculosis with rates from 230.9 x 10(5), in 1902, to 0.7, in 1997, was observed. It decreased 71.7% between 1902 and 1940, 74% between 1943 and 1959, 85% between 1960 and 1978, and 0.16% between 1985 to 1991. It increased 40% from 1991 to 1994 and it decreased 30% from 1994 to 1997. Pulmonary and extrapulmonary tuberculoses descended in the same way. They were higher among females until 1940, but from 1943 on it was observed a predominance in males. The highest rates were observed in the group aged 45 and over. They have been insignificant among individuals under 15 for the last 30 years. The highest rates were reported in the capital of the country. It was concluded that the mortality rates from tuberculosis have decreased remarkably during the present century and that it should disappear as a health problem in the next 10 years.

Adolescent↗

PubMedDate not supplied

[Diagnosis of coccidia and microspores in specimens of diarrheal feces from Cuban HIV seropositive patients: first report of microspores in Cuba].

The numerous specimens of liquid diarrheas received at the clinical parasitology laboratory of "Pedro Kouri" Institute of Tropical Medicine were studied searching for the presence of pathogenic agents of Coccidium subclass and of the microspore family. The conditions to diagnose microsporidia were created on July 13, 2000, and the method was incorporated to the battery of diagnostic techniques used in the laboratory. A cut-off was made after 4 months to analyze the positivity found. A frequency distribution study was conducted and it was observed that of the 170 studied samples, 51 proved to be positive for some protozoon, which represents 30% of positivity. The most frequently found species were Cryptosporidium parvum and microsporidium. Association of various species in a same sample was found in 13.1% of the positive samples. The most frequent associations were: Cryptosporidium parvum and Cyclospora cayetanensis, Cryptosporidium parvum and microsporidium, and Cyclospora cayetanensis and microsporidium, each with 2 patients. Association of 3 different species in a same sample was also found. All the individuals in the series were HIV seropositive and the most affected had less than 200 TCD4+ lymphocytes/mL. This was the first report of microsporidia in feces in Cuba. It was possible after applying and interpreting the technique previously described to identify this phylum. As there is a trend towards the increase of cases with HIV/AIDS infection, it is necessary that the laboratories have the indispendable reagents to perform the modified Didier's trichromic staining and that the professionals and technicians of the parasitology laboratories of the country be trained in the procedures for identifying and recognizing these opportunistic protozoa.

Animals↗

PubMedDate not supplied

[Pathogenic effect of the parasite nematode Strelkovimermmis spiculatus (Nematoda Mermithidae) in larvae of mosquito Culex quinquesfasciatus (Diptera Culicidae) under laboratory conditions in Cuba].

The infective capacity of Strelkovimermis spiculatus Poinar and Camino, 1986, was evaluated under laboratory conditions for the first time in Cuba in order to introduce it as a new agent of biological control of mosquitoes of medical and epidemiological importance. The second stage larvae of Culex quinquefasciatus Say, 1823, were used and exposed to the infective juvenile parasites at different doses. It was observed a rise in the mean values of infestation and in the mortality percentage with the dose increase. Culex quinquefasciatus Say proved to be a good host and a dose of 7:1 will be optimum to attain high percentages of mortality and to obtain this parasite massively for its further evaluation under field conditions.

Animals↗

PubMed1992

Presence of Aedes (Gymnometopa) mediovittatus in Cuba: a new factor to be considered in the national campaign to eradicate dengue.

To assess the presence of the potential dengue vector Aedes mediovittatus relative to other mosquito species, data were examined from 44,199 larvitraps operating between January 1984 and December 1987 in the town of Mariel, Cuba. Of 1,068 larvitraps containing mosquitoes, 626 (58.6%) were positive for Ae. mediovittatus. Its relative presence increased each year except 1986, going from 37.9% of the positive traps in 1984 to 70.2% in 1987. More larvitraps were positive for Ae. mediovittatus than for Culex quinquefasciatus, which typically dominated breeding sites at the end of the intensive phase of the national campaign against Ae. aegypti in the early 1980s. The results appear to reflect Ae. mediovittatus' gradual infiltration into areas covered by the campaign, a factor that may need to be considered in efforts to control dengue in the Americas.

Aedes↗

PubMedDate not supplied

[Prenatal diagnosis of congenital heart disease by echocardiography in Matanzas Province, Cuba, from 1990 to 1995].

We analyze the intra-uterine diagnoses of congenital cardiopathies performed by means of fetal echocardiographies from 1990 to 1995 in Matanzas, Cuba. All patients were examined in search of risk factors and indicators; 39 complex cardiopathies were detected, the most frequent ones were univentricular heart, hypoplasia of the left ventricle, and pulmonary atresia. Significant references were an abnormal image of the four cavities and the associated fetal anomalies; 66% of the malformations were diagnosed before week 24 of gestation. It was observed that the group of patients not diagnosed prenatally had a significant perinatal mortality. Although 32% of the newborns' complex cardiopathies in that period were diagnosed prenatally, it is necessary to improve this result aimed at reducing the morbidity and mortality due to these anomalies, offering the best survival conditions at the time of birth.

Cuba↗

PubMedDate not supplied

[Microbiological quality of spices consumed in Cuba].

The microbiological quality of some widely consumed spices in Cuba was evaluated by means of aerobic mesophilic microorganisms count, filamentous fungi, yeasts, coliforms, thermophilic and thermoresistant microorganisms. Salmonella spp was looked for too. Black pepper and cumin resulted the most contaminated spices with values of total count and thermoresistant microorganisms at levels of 10(6) per gram, and coliform values up to 10(5) per gram. Oregano and cinnamon showed satisfactory microbiological quality; the contamination detected in these spices was lower than 10(4) per gram. Salmonella spp and yeasts were not detected.

Bacteria↗

PubMedDate not supplied

[The characterization of Biomphalaria orbignyi Paraense, 1974, a mollusk of medico-epidemiological importance recently reported for Cuba].

The conchological, anatomical and radular characteristics of Biomphalaria orbignyi are described, as well as the morphometric ratio between maximal height and maximal diameter, in which the regression coefficient value is 0.9. The life tables of Biomphalaria orbignyi shows a life range (L phi = 10.37) much higher than in the rest of the species available in Cuba; the value of k = 0.17 is similar to that of Biomphalaria havanensis. It has 2 reproductive peaks at middle age. Differently from other species of the genus, it has lower mortality at early ages and the highest peak is seen when it reaches the adult stage, which means it is a strong species. The zymograms that have been obtained confirm this species is different from B. havanensis. Since there are no marked differences on an individual basis, its correct identification requires to take into consideration every biological and ecological evidence available.

Animals↗

PubMed1991

Vaccine against group B Neisseria meningitidis: protection trial and mass vaccination results in Cuba.

The Cuban vaccine, first in the world with proven efficacy against group B-caused disease, is based on outer membrane proteins from B meningococci capable of inducing long-lasting and high-titered bactericidal antibodies in humans. This bactericidal activity has a wide spectrum against all pathogenic group B Neisseria meningitidis tested. A randomized, double-blind controlled trial of the vaccine efficacy was performed during 1987-1989 with 106,000 10-14 years old students from 197 boarding schools in seven provinces. The efficacy obtained was 83% (chi 2, p less than 0.002; Fischer exact, p less than 0.001). In a second field trial including 133,600 persons from 5 months to 24 years of age in Ciego de Avila province (30 cases/10(5) inhabitants, the highest incidence rate in Cuba) by comparing vaccinated and non-vaccinated population after 2.5 years of observation and careful follow-up, the efficacy and safety was confirmed. Because of these results and because of the very low reactogenicity of the vaccine, the Ministry of Public Health took the advice of the Scientific Council to vaccinate all children between 3 months and 6 years of age in the most affected provinces. No severe or long lasting reactions to the vaccine were observed after the millions of doses administered. The efficacy of vaccination varied in the provinces between 83% and 94%, among age groups ranging from 3 months and 20 years. After 3 years of massive application no severe reactions occurred and one of the most severe epidemics has been practically eradicated.

Adolescent↗

PubMedDate not supplied

[Automated data processing for the epidemiological surveillance of schistosomiasis in Cuba].

Schistosomiasis is one of the parasitical infections with widest world distribution and its epidemiological surveillance proves vital for Cuba. A pack of programs is presented for processing data of the surveillance system for this disease. It may provide information on the state of the screening of international travellers, both Cuban and foreign, who may be at risk.

Africa↗

PubMed1991

[Acquired ichthyosis caused by bladder neoplasia. Presentation of the 1st case in Cuba].

Ichthyosiform dermatoses comprise a heterogeneous group of cutaneous disease characterized by keratin disorder that clinically manifests as dry, rough and scaly skin. The acquired form of ichthyosis has principally been associated with neoplastic disease. It has also been described in association with other disorders and as drug-induced cutaneous manifestations. We report on a patient with a bladder tumor who developed acquired ichthyosis, a complication and presenting feature of the underlying neoplastic condition. The clinical manifestations and associated conditions are described. To our knowledge, this is the first case of acquired ichthyosis from a bladder tumor reported in Cuba.

Aged↗

PubMed1991

[Daily variations in health care in a health area of Cuba].

The daily variations of several medical care activities in a health area of Cuba were evaluated during the first semester of 1990. To this end, chronological series of the different activities were set up, and seasonal indexes were calculated from them. The selected method was the mobile mean, using a multiplicative model as a basis. The occurrence of seasonal changes in the behaviour of evaluated activities was found to be higher in the visits of family physicians in their clinics and in the home visits than in on duty staff. Monday was identified as the least used day. The possible reasons for these results are relate with the schedules of medical tasks and also with population habits. These results may be useful to improve the quality of the health area services.

Adolescent↗

PubMedDate not supplied

[Relationship of the levels of cholesterol and triglycerides in blood plasma in racial groups in Cuba].

Content of cholesterol and total triglycerides was studied in blood plasma of 397 healthy volunteers, 299 of which belonged to white race and 99 persons--to negroid race (mulatto and negroes). Distinct variations were not found in content of total triglycerides in these both groups. However, statistically significant dissimilarity was detected in distribution of hypercholesterolemia as compared with normocholesterolemia and normotriglyceridemia, hypocholesterolemia--with hypertriglyceridemia and hypercholesterolemia--with normotriglyceridemia in race groups. The same analysis should be performed in "mixed race group" which constitutes the main population of Cuba.

Cholesterol↗