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PubMed1998

Isolation of Inoue-Melnick virus from cerebrospinal fluid of patients with epidemic neuropathy in Cuba.

BACKGROUND: A mysterious disease spread over Cuba from 1991 to 1993, the cause of which has not been fully established. Major symptoms were the same in patients with the Cuban disease as in patients with subacute myelo-optico-neuropathy (SMON), which had occurred in Japan nearly 30 years ago and from which Inoue-Melnick virus (IMV) type 1 was first isolated. We investigated the presence of IMV in cerebrospinal fluid samples of patients with this epidemic neuropathy in Cuba. METHODS: The established method for detecting IMV in MRC-5 fibroblasts was used throughout the study, which was conducted in two independent laboratories, one in Buffalo, NY, and the other in Kyoto, Japan. The cerebrospinal fluid samples of 20 patients and four controls were provided by Cuban researchers. RESULTS: All cerebrospinal fluid specimens from 20 Cuban patients tested were positive for IMV type 2 (100%), and four cerebrospinal fluid specimens from Cuban controls were negative for IMV (0%). These clear-cut results were identical in both laboratories. CONCLUSION: Our study indicates an important association of IMV type 2 with patients of this Cuban epidemic. The etiologic role of IMV type 2 in the epidemic neuropathy in Cuba, along with weak cytopathic effect viruses isolated by the Cuban group, remains to be elucidated.

Animals↗

PubMed1997

[Determination of insecticide resistance and its biochemical mechanisms in 2 strains of Culex quinquefasciatus from Santiago de Cuba].

It was analyzed the behavior of the resistance of 3 organophosphated insecticides (malathion, clorpirifos and methyl-pyrimifos), 3 pyrethroids (deltamethrin, lambda-cyhalothrin and cypermethrin), and 1 carbamate (propuxur) in populations of Culex quinquefasciatus from 2 municipalities of the province of Santiago de Cuba. The values of the resistance factor proved that there is resistance to malathion and clorpirifos. However, in spite of the existence of a high frequency of the mechanisms of elevated esterases and altered acetylcholinesterase no resistance to methylpymirifos, was observed which demonstrated that this insecticide is not affected by these mechanisms selected in our populations of Culex quinquefasciatus. There was resistence to deltamethrin, and lambda-cyhalothrin in Santiago de Cuba, whereas it was moderate to cypermethrin in Santiago and San Luis. Resistance to deltamethrin was also found in San Luis, but it was mild to lambda-cyhalothrin. The results obtained from the use of the synergists S,S,S tributyl phosphotritiade (DBF) and piperonyl butoxide (PB) indicated that the mechanisms of resistance of unspecific esterases and oxidases of multiple function are involved in the resistance to pyrethroids in both strains from Santiago de Cuba and San Luis. It was determined by the biochemical tests that there existed a high frequency of the mechanisms of esterases and altered acetylcholinesterase. The results of the polyacrylamide gel electrophoresis (PAGE) showed that esterase B1 appears more frequently associated with esterases A6 and B6. It was inferred that this association could be connected with the resistance to pyrethroids.

Acetylcholinesterase↗

PubMed1998

Can the effects of exercise on bone quality be detected using the CUBA clinical ultrasound system?

OBJECTIVES: To determine whether the CUBA clinical quantitative ultrasound bone analyser was able to distinguish variations in bone quality between groups categorised according to activity level. METHOD: Eighty one white women aged 32 to 89 completed a confidential questionnaire on general health, diet, and exercise participation and underwent ultrasound testing at the right calcaneus utilising a CUBA clinical ultrasound system. RESULTS: The results confirmed the inverse relationship between age and the ultrasound indicators of bone quality: broadband ultrasound attenuation (BUA) (r = -0.52) and velocity of sound (VOS) (r = -0.68). Subject height weakly but significantly correlated with BUA (r = 0.39) and VOS (r = 0.35), and subject weight only correlated significantly with BUA (r = 0.37). Activity level was significantly associated (p < 0.05) with the changes in ultrasound attenuation (BUA). The use of hormone replacement therapy or the contraceptive pill, a family history of osteoporosis, and gross indicators of calcium consumption did not yield significant results. CONCLUSION: Data obtained from the CUBA clinical system were sensitive enough to allow women to be classified into groups according to activity level. These data were within the range of "normal" ultrasound data and hence it is suggested that the machine has research as well as clinical value.

Adult↗

PubMed1995

Epidemic optic neuropathy in Cuba--clinical characterization and risk factors.

BACKGROUND: From 1991 to 1993, epidemic optic and peripheral neuropathy affected more than 50,000 people in Cuba. The number of new cases decreased after the initiation of vitamin supplementation in the population. In September 1993, Cuban and U.S. investigators conducted a study to characterize and identify risk factors for the optic form of the syndrome. METHODS: We conducted ophthalmologic and neurologic examinations, assessed exposure to potential toxins, administered a semiquantitative food-frequency questionnaire, and assessed serum measures of nutritional status in 123 patients with severe optic neuropathy, matched for sex and age to randomly chosen normal subjects. RESULTS: In the case patients, prominent clinical features were subacute loss of visual acuity with field defects, diminished color vision, optic-nerve pallor, and decreased sensitivity to vibration and temperature in the legs. Tobacco use, particularly cigar smoking, was associated with an increased risk of optic neuropathy. The risk was reduced among subjects with higher dietary intakes of methionine, vitamin B12, riboflavin, and niacin and higher serum concentrations of antioxidant carotenoids. The risk was also reduced among subjects who raised chickens at home or had relatives living overseas--factors that may be indirect measures of increased food availability. CONCLUSIONS: The epidemic of optic and peripheral neuropathy in Cuba between 1991 and 1993 appears to be linked to reduced nutrient intake caused by the country's deteriorating economic situation and the high prevalence of tobacco use.

Adolescent↗

PubMed1999

Pinta in Austria (or Cuba?): import of an extinct disease?

BACKGROUND: Pinta, 1 of the 3 nonvenereal treponematoses, is supposed to be extinct in most areas in South and Central America, where it was once endemic. Only scattered foci may still remain in remote areas in the Brazilian rain forest, and the last case from Cuba was reported in 1975. OBSERVATION: A native Austrian woman, who had lived for 7 years in Cuba and was married to a Cuban native, developed a singular psoriasiform plaque on her trunk and several brownish papulosquamous lesions on her palms and soles during a visit to her home in Austria. Positive serological findings for active syphilis and the detection of spirochetes in the trunk lesion indicated early secondary syphilis, but an extensive case history and the clinical appearance fulfilled all criteria for pinta. CONCLUSION: The acquisition of a distinct clinical entity, pinta, in a country where it was formerly endemic but now is believed to be extinct raises the question of whether the disease is in fact extinct or whether syphilis and pinta are so similar that no definite distinction is possible in certain cases.

Adult↗

PubMed1997

Incidence of childhood cancer in Cuba (1986-1990).

Cancer is an infrequent disease in childhood. However, it is responsible for 13.06% of child deaths between 1 and 14 years in Cuba. The aim of our work was to describe the incidence of childhood cancer in the period 1986 to 1990 using data reported to the National Cancer Registry (NCR) of Cuba. All cancer cases between 0 and 14 years of age reported to the NCR in the period 1986 to 1990, were included. The cases were classified histologically, by age and gender. Average age-specific and age-standardized rates were calculated; 1428 children were registered, an average of 286 each year, with a mean annual rate of 117.8 per million. The world-population standardized rate was 120.7 and the male-to-female ratio was 0.98. Leukaemias, lymphomas and malignant tumours of the central nervous system were the most common childhood neoplasm groups. The majority of leukaemias were acute lymphoblastic leukaemias (ALL), and the incidence peak extended until 6 years of age. The first peak of incidence of Hodgkin's disease is found in older age-groups. Burkitt's lymphoma showed a male-to-female ratio of 0.44. Most of the hepatic tumours were carcinomas, and only one fourth were hepatoblastomas. In bone tumours, similar rates were observed for osteosarcomas and Ewing's sarcoma.

Adolescent↗

PubMed2003

Mitochondrial DNA from pre-Columbian Ciboneys from Cuba and the prehistoric colonization of the Caribbean.

To assess the genetic affinities of extinct Ciboneys (also called Guanajuatabeys) from Cuba, 47 pre-Columbian skeletal samples belonging to this group were analyzed using ancient DNA techniques. At the time of European contact, the center and east of Cuba were occupied by agriculturalist Taino groups, while the west was mainly inhabited by Ciboneys, hunter-gatherers who have traditionally been considered a relic population descending from the initial colonization of the Caribbean. The mtDNA hypervariable region I (HVR-I) and haplogroup-specific markers were amplified and sequenced in 15 specimens using overlapping fragments; amplification from second extractions from the same sample, independent replication in different laboratories, and cloning of some PCR products support the authenticity of the sequences. Three of the five major mtDNA Amerindian lineages (A, C, and D) are present in the sample analyzed, in frequencies of 0.07, 0.60, and 0.33, respectively. Different phylogenetic analyses seem to suggest that the Caribbean most likely was populated from South America, although the data are still inconclusive, and Central American influences cannot be discarded. Our hypothesis is that the colonization of the Caribbean mainly took place in successive migration movements that emanated from the same area in South America, around the Lower Orinoco Valley: the first wave consisted of hunter-gatherer groups (ancestors of the Ciboneys), a subsequent wave of agriculturalists (ancestors of the Tainos), and a latter one of nomadic Carib warriors. However, further genetic studies are needed to confirm this scenario.

Bone and Bones↗

PubMed1995

An epidemic of optic neuropathy and painful sensory neuropathy in Cuba: clinical aspects.

An epidemic of bilateral optic neuropathy and painful sensory neuropathy occurred in Cuba in 1991-1993. Over 45,000 individuals were stated to have been affected. We report a clinical study on 25 patients seen in Cuba in 1993-1994. Affected patients showed either bilateral optic neuropathy with caecocentral scotomata or a distal predominantly sensory neuropathy sometimes associated with deafness, or a combination of both optic and peripheral sensory neuropathy. The nature of the epidemic is discussed. The clinical features in patients with confirmed neurological deficits were consistent with a diagnosis of Strachan's syndrome, probably related to nutritional deficiency. Other patients with similar symptoms showed no evidence either of optic or peripheral neuropathy and were considered to represent disease mimicry on a psychoneurotic basis.

Adult↗

PubMed2004

Integrated control of Boophilus microplus ticks in Cuba based on vaccination with the anti-tick vaccine Gavac.

Boophilus microplus has developed resistance against a range of chemical acaricides which has stimulated the development of alternative methods such as vaccination against ticks. In Cuba, the Bm86-based recombinant vaccine Gavac has been successfully used in a number of controlled laboratory and field trials in cattle against B. microplus. In this paper, we have evaluated Gavac in a large scale field trial wherein 588,573 dairy cattle were vaccinated with the aim to reduce the number of acaricidal treatments. It was found that the number of acaricidal treatments could be reduced by 87% over a period of 8 years (1995--2003). Prior to the introduction of the vaccine, 54 clinical cases of babesiosis and six fatal cases were reported per 1000 animals. Six years later, the incidence of babesiosis was reduced to 1.9 cases per 1000 cattle and mortality reduced to 0.18 per 1000. The national consumption of acaricides in Cuba could be reduced by 82% after the implementation of the integrated anti-B. microplus control program.

Animals↗

PubMed1989

Dominantly inherited olivopontocerebellar atrophy from eastern Cuba. Clinical, neuropathological, and biochemical findings.

A form of dominantly inherited olivopontocerebellar atrophy (OPCA) occurs commonly in persons of Spanish ancestry in northeastern Cuba. Its prevalence in the Province of Holguin is 41 per 100,000, a figure much higher than that found in western Cuba or in other parts of the world. The high prevalence is probably the result of a founder effect, but might be due to an interaction between a mutant gene and an unidentified environmental neurotoxin. We describe the clinical features of this disorder, and the neuropathological abnormalities in 7 autopsied patients. In addition, we report biochemical findings in plasma, cerebrospinal fluid (CSF) and urine obtained from 10 living OPCA patients. Quantitation of amino acids in fasting plasma showed a number of differences between the Cuban patients and healthy Canadian controls, but these are likely to have been caused by dietary differences. Amino acid concentrations in the CSF of the Cuban OPCA patients were similar to those of healthy Cuban controls, except for a decreased concentration of ethanolamine. Mean concentrations of dopamine metabolites were significantly low in the CSF of the OPCA patients, corresponding to neuronal depletion observed in the substantia nigra of autopsied cases. Examination of the patients' urines provided no evidence that either cyanide or 3-acetylpyridine is involved in causing this form of OPCA.

Adult↗

PubMed1994

Epidemic neuropathy in Cuba: morphological characterization of peripheral nerve lesions in sural nerve biopsies.

More than 50,000 patients were affected in Cuba during an epidemic outbreak of peripheral neuropathy from January 1992 until September 1993. The disease presented as either a retrobulbar optic neuropathy, a predominantly sensory peripheral neuropathy, a dorsolateral myeloneuropathy, or as mixed forms. The morphological findings in sural nerve biopsies from 34 patients with various forms of the disease are presented here. Frozen, paraffin and semi-thin sections were prepared for light and electron microscopy, immunohistochemistry and morphometric analysis. Every case presented morphological alterations ranging from mild axonal dystrophy (9 cases, or 27%) to moderate and severe axonal damage (25 cases, or 73%). In 6 cases (18%), axonal damage was accompanied by perineural fibrosis and vascular abnormalities. Axonal regeneration was noted in 8 cases (23%) and remyelination in 9 (26%). Morphometric analysis showed a predominant loss of myelinated fibers in 92% of the patients. Quantification of myelinated fiber loss in 11 patients revealed a remarkable decrease in large caliber fibers. Scarce mononuclear cells were observed in 17 cases. No virus-like elements were seen. The morphological features found in this study indicate that, regardless of the clinical presentation, peripheral nerve lesions of the epidemic neuropathy in Cuba correspond to an axonal neuropathy. These lesions are compatible with nutritional, toxic, or metabolic etiologies. An inflammatory etiology would be unusual with these lesions.

Adult↗

PubMed2006

Agro-industry sugarcane residues disposal: the trends of their conversion into energy carriers in Cuba.

The goal of the present work was to carry out a review of the disposal practices for the agro-industry's sugarcane residue and the trends of energy use in Cuba. The lack of an alternative energy carrier to electricity with storage capability for use in off-season has to date been an unsolvable question. The improvement of cogeneration capacity via implementation of CEST or BIG/GTCC and the barriers for their implementation, the introduction of a medium size (3 ton/h) fast pyrolysis module (FPM3) as a solution for off-season energy demand in the agro-industry, and an assessment of the energy required to do so, were also analyzed. Bio-oil production from bagasse and sugarcane agriculture residues (SCAR) and their particularities at the sugar mill are treated. The influence of sugar facility production process configuration is analyzed. The fast pyrolysis products and the trends of their end uses in Cuba are presented. The production cost of a ton of Bio-oil for FPM3 conditions was calculated at 155 USD/ton and the payback time as a function of selling price between 160 and 110 USD/ton was estimated to be from 1.5 to 4 years. The economic feasibility of the FPM3 was estimated, comparing the added values for three scenarios: 1st case, currently-used sugar production, 16.5 USD/ton of cane; 2nd case, factoring in the cogeneration improvement, 27 USD/ton of cane; and 3rd case, with cogeneration improvement and Bio-oil production, 40 USD/ton of cane. The energy use of SCAR and the introduction of FPM3 in the sugar mill are promising improvements that could result in a potential surplus of 80 kWh(e)/ton of cane in-season, or 6 x 10(6)ton of Bio-oil (LHV=15 MJ/kg) for use off-season in a milling season of 4 million tons of raw sugar.

Agriculture↗

PubMed1996

Role of the USA in shortage of food and medicine in Cuba.

For over 30 years an embargo by the USA has restricted Cuba's ability to purchase foods and medicines. In 1992, the USA enacted the Cuban Democracy Act (CDA), which "exempted" the sale of medicines from the embargo. However, the implementation of the CDA's requirements and the intensification of the embargo as a result of the passage of the Helms-Burton Act in March, 1996, have undermined the purpose of the medicine exemption. The resultant lack of food and medicine to Cuba contributed to the worst epidemic of neurological disease this century. The Inter-American Commission on Human Rights of the Organization of American States has informed the US Government that such activities violate international law and has requested that the US take immediate steps to exempt food and medicine from the embargo.

Commerce↗

PubMed2002

Visual inspection in oral cancer screening in Cuba: a case-control study.

A case-control study was conducted to evaluate the efficacy of an on-going oral cancer screening programme in Cuba in preventing advanced oral cancer in Cuba. The cases for the study consisted of 200 oral cancer patients with stage III and IV disease. Three apparently healthy subjects per case, matched for sex, age (plus or minus 5 years) and residing within a perimeter of 200 m of the house with the case, and willing to be interviewed, were recruited as the controls. Information on socio-economic indicators, smoking, drinking, diet and screening history in the form of visits to the dentist were collected by personal interview with the subjects. Odds ratio (OR), with 95% confidence intervals (CI), of being diagnosed with an advanced oral cancer, in relation to the screening experience at the date of diagnosis of case, 1, 2, 3, 6, and 12 months prior to the date of diagnosis of case were estimated by conditional logistic regression for matched data. The odds ratio of advanced oral cancer associated with screening in relation to screening experience 3 months prior to the diagnosis of the case was 0.67 (95% CI: 0.46-0.95). The odds ratio was 0.91 (95% CI: 0.60-1.37) for a single screening test and 0.41 (95% CI: 0.24-0.68) for two or more tests. The protection offered by screening persisted up to 3 years since the last test. The results of a descriptive evaluation of the programme also revealed limited evidence towards a shift from advanced to early stages after the introduction of the programme. Nonetheless, the results should be interpreted with caution in view of the several limitations in the study, particularly the fact that screening history was established indirectly by interviews and advanced oral cancers constituted the cases, rather than those who died from the disease.

Case-Control Studies↗

PubMed1996

The fertility transition in Cuba and the Federal Republic of Korea: the impact of organised family planning.

South Korea and Cuba are dissimilar in religion, economy, culture and attitudes toward premarital sexual relations. In 1960, Korea instituted a national family planning programme to combat rapid population growth. Cuba explicitly rejected Malthusian policies, but made family planning universally available in 1974 in response to health needs. Both countries have undergone rapid fertility declines and today have less than replacement level fertility. Both countries have also used a similar mixture of methods, including a high prevalence of female sterilisation. Abortion has played a major role in the fertility decline of both countries, rising in the first half of the fertility transition and then falling, although remaining a significant variable in the second half. It is concluded that access to contraception, voluntary sterilisation, and safe abortion has a direct impact on fertility and has been associated with a rapid fall in family size in two very different countries.

Birth Rate↗

PubMed1998

Quality of life, gender and schizophrenia: a cross-national survey in Canada, Cuba, and U.S.A.

Although gender differences in schizophrenic symptom expression have been widely established, no systematic studies have documented if these differences extend to the perception of quality of life. This survey gathered international data on the perception of quality of life among 102 outpatient men and women with schizophrenia from Canada, Cuba, and the United States. Using portions of Lehman's Quality of Life Interview, quality of life was assessed on the domains of social relationships, health, living situation, leisure, finances and general quality of life. Gender differences were tested with ANOVA where site was treated as a nested variable and separate t-tests comparing men and women within each country. Although no differences were found for the combined sample, differences were observed between men and women in Canada and Cuba on the social relationship domain. In Canada, women with schizophrenia reported a higher quality of life for social relationships. In contrast, Cuban men with schizophrenia reported higher quality of life for social relationships than Cuban women. Findings from the three sites show no differences for the other domains. With the possible exception of social relationships, these findings suggest no discernable differences in the perception of quality of life for men and women with schizophrenia. Overall, men and women with schizophrenia were only somewhat satisfied with some aspects of life. These findings have implications for developing comprehensive community care that includes quality of life promotion.

Adult↗

PubMed2000

Childhood cancer survival in Cuba.

Reports dealing with childhood cancer population-based survival have not yet been published in Cuba. A survival study including cases reported to the National Cancer Registry in the period 1988-1989 have been accomplished in the National Cancer Registry of Cuba. A comprehensive view of its results in childhood cancer is intended to be shown in this paper. All sites childhood cancer cases aged below 15 years (400) and reported in this period were included derived from a total of 578 incident cases. Vital status of cases was checked-up to December of 1994 by a mixed follow-up. Survival analysis was achieved by the life-table method using the SPSS for Windows software. Relative survival rates were not included because no differences were appreciated with the observed ones. Cases between 0-4 years and females account for the highest frequencies. Leukaemia accounts for 27% of the cases, followed by lymphomas and tumours of the central nervous system. Lymphoid and non-lymphoid acute leukaemia had 41 and 9% 5-year survival rate respectively being the latter comparable with Bangalore, India (10%). For lymphomas, Hodgkin's disease present better prognosis compared with non-Hodgkin lymphoma with 73 and 35% 5-year survival rates, respectively. Figures are comparable to the corresponding to Bangalore, India (72 and 33%, respectively). For time trends survival distribution were compared by period of diagnosis (1982/1988-1989). In all cases differences resulted statistically non-significant with lower rates for 1988-1989 except for lymphomas. International reports show increasing time trends for childhood cancer. Nevertheless, these results may serve as a milestone for future comparisons, corresponding with the creation of the National Program for Childhood Cancer Control and future studies will confirm the success of its measures.

Adolescent↗

PubMed1998

Low levels of urinary iodine excretion in schoolchildren of rural areas in Cuba.

OBJECTIVE: We set up a baseline data on urinary iodine excretion from a nationwide representative sample of rural schoolchildren before instituting iodine supplementation. DESIGN: Stratified multistage cluster sampling in three different strata: lowlands, foothills and mountainous areas. Early morning urine samples were collected for evaluation of iodine status. SETTING: Field study in 25 municipalities in 11 out of 14 provinces. The study was carried out from October to December 1995. SUBJECTS: Three thousand and twenty-seven schoolchildren of either sex, 6 to < 12 y from 87 primary schools. RESULTS: The median urinary iodine excretion was 95 microg/L for the whole sample. The situation in a few foothills and all mountainous areas showed a moderate to severe deficiency. In the mountainous stratum, the median urinary iodine excretion values was less than 20 microg/L. CONCLUSIONS: Cuba has a mild iodine deficiency public health problem with respect to WHO criteria, which in the mountainous areas is severe. The Government of Cuba has started a national Plan of Action and funds are being mobilized to introduce nationwide iodized salt.

Altitude↗