Medicc Review最新文献

{"title":"Cuba-US Collaboration: The Pandemic Imperative.","authors":"Roberto Cañete, Kenneth W Goodman","doi":"10.37757/MR2021.V23.N1.3","DOIUrl":"https://doi.org/10.37757/MR2021.V23.N1.3","url":null,"abstract":"","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 1","pages":"89"},"PeriodicalIF":2.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25542091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypoxic Ischemic Encephalopathy in Units Reporting to the Ibero-American Society of Neonatology Network: Prevalence and Mortality.","authors":"Fernando Domínguez-Dieppa,&nbsp;Marcelo Cardetti,&nbsp;Susana Rodríguez,&nbsp;Alfredo García-Alix,&nbsp;Augusto Sola","doi":"10.37757/MR2021.V23.N1.7","DOIUrl":"https://doi.org/10.37757/MR2021.V23.N1.7","url":null,"abstract":"<p><strong>Introduction: </strong>Hypoxic ischemic encephalopathy is a neurological condition occurring immediately after birth following a perinatal asphytic episode. Therapeutic hypothermia is a safe and effective intervention to reduce mortality and major disability in survivors. In Latin America, perinatal asphyxia is a major problem, but no data are available characterizing its current situation in the region or the impact of hypoxic ischemic encephalopathy on its management.</p><p><strong>Objective: </strong>Understand the prevalence, mortality and use of therapeutic hypothermia in newborns at ≥36 weeks gestational age with hypoxic ischemic encephalopathy admitted to neonatal units reporting to the Ibero-American Society of Neonatology Network.</p><p><strong>Methods: </strong>The Ibero-American Society of Neonatology Network groups various neonatology centers in Latin America that share information and collaborate on research and medical care. We evaluated data on newborns with ≥36 weeks gestational age reported during 2019. Each unit received a guide with definitions and questions based on the Society's 7th Clinical Consensus. Evaluated were encephalopathy frequency and severity, Apgar score, need for resuscitation at birth, use of therapeutic hypothermia and clinical evolution at discharge. Our analysis includes descriptive statistics and comparisons made using the chi-square test.</p><p><strong>Results: </strong>We examined reports of 2876 newborns from 33 units and 6 countries. In 2849 newborns with available data, hypoxic encephalopathy prevalence was 5.1% (146 newborns): 27 (19%) mild, 36 (25%) moderate, 43 (29%) severe, and 40 (27%) of unknown intensity. In those with moderate and severe encephalopathy, frequencies of Apgar scores ≤3 at the first minute (p = 0.001), Apgar scores ≤3 at the fifth minute (p ⟨0.001) and advanced resuscitation (p = 0.007) were higher. Therapeutic hypothermia was performed in only 13% of newborns (19). Neonatal mortality from encephalopathy was 42% (61).</p><p><strong>Conclusions: </strong>Hypoxic ischemic encephalopathy is a neonatal condition that results in high mortality and severe neurological sequelae. In this study, the overall prevalence was 5.1% with a mortality rate of 42%. Although encephalopathy was moderate or severe in 54% of reported cases, treatment with hypothermia was not performed in 87% of newborns. These data reflect a regional situation that requires urgent action.</p>","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 1","pages":"30-34"},"PeriodicalIF":2.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25527944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Control in a Havana Surgical Hospital.","authors":"Julián Francisco Ruiz-Torres,&nbsp;Tania González-León","doi":"10.37757/MR2021.V23.N1.16","DOIUrl":"https://doi.org/10.37757/MR2021.V23.N1.16","url":null,"abstract":"","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 1","pages":"10"},"PeriodicalIF":2.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25527939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dangers and Management of Obstructive Sleep Apnea Syndrome in COVID-19 Patients.","authors":"Calixto Machado-Curbelo","doi":"10.37757/MR2021.V23.N1.17","DOIUrl":"https://doi.org/10.37757/MR2021.V23.N1.17","url":null,"abstract":"","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 1","pages":"10"},"PeriodicalIF":2.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25527940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Build Back Better: Leadership for US–Cuba Health Cooperation","authors":"","doi":"10.37757/mr2021.v23.n1.4","DOIUrl":"https://doi.org/10.37757/mr2021.v23.n1.4","url":null,"abstract":"","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"42 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76481310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Build Back Better: Leadership for US-Cuba Health Cooperation.","authors":"","doi":"10.37757/MR2020.V23.N1.4","DOIUrl":"https://doi.org/10.37757/MR2020.V23.N1.4","url":null,"abstract":"","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 1","pages":"4-5"},"PeriodicalIF":2.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25527938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Surveillance Needed to Contain COVID-19.","authors":"Saurabh RamBihariLal Shrivastava,&nbsp;Prateek Saurabh Shrivastava","doi":"10.37757/MR2021.V23.N1.1","DOIUrl":"https://doi.org/10.37757/MR2021.V23.N1.1","url":null,"abstract":"","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 1","pages":"92"},"PeriodicalIF":2.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25542093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cuban Prophylactic and Therapeutic Vaccines for Controlling Hepatitis B.","authors":"Eduardo Pentón-Arias,&nbsp;Julio César Aguilar-Rubido","doi":"10.37757/MR2021.V23.N1.6","DOIUrl":"https://doi.org/10.37757/MR2021.V23.N1.6","url":null,"abstract":"<p><p>Hepatitis B causes liver failure, cirrhosis and cancer. It has an estimated global prevalence of 6%, and 700,000 to 1 million persons die every year of hepatitis B-related causes. In 1989, hepatitis B incidence in Cuba was 14.9 per 100,000 population. To control infection, the Genetic Engineering and Biotechnology Center and the Ministry of Public Health, both in Havana, collaborated on a joint project that first produced natural interferon and recombinant interferon alpha-2b, and later a polyethylene glycolconjugated interferon. As part of the Cuban biotechnology development strategy, the project produced a vaccine against hepatitis B in 1985. At that time, hepatitis B vaccines available elsewhere in the world were costly and inaccessible to Cubans due to the US economic and trade embargo. The Heberbiovac HB preventive vaccine was approved by the Cuban regulatory authority and added to the Cuban newborn vaccination program in 1992 after phase 1-3 clinical trials demonstrated its safety and immunogenicity. From 2001 to 2003, PAHO/WHO qualified and requalified the vaccine four times. When associated with other antigens or molecules, Heberbiovac HB provides a common platform of virus-like particles that can be used in different ways, such as in the pentavalent vaccine containing Bordetella pertussis and Haemophilus infl uenzae type b antigens and tetanus and diptheria toxoids. Thanks to this vaccine, annual incidence of acute hepatitis in Cuba has dropped from more than 2000 cases to fewer than 100, and no infections in children aged 0-15 years have been reported since 2007. It is now used in more than 30 countries, providing protective, long-lasting antibody levels with no reports of serious adverse events. Yet, hepatitis B cannot be eliminated until there are no chronic patients. The comprehensive hepatitis B control project therefore included development of a therapeutic vaccine based on Heberbiovac HB. Using its platform, researchers designed an innovative version of the vaccine that was the precursor of a therapeutic nasal/subcutaneous vaccine for chronic hepatitis B, HeberNasvac. This precursor vaccine, which combines Heberbiovac HB with a recombinant antigen from the virus nucleocapsid (rHBcAg), was patented and licensed in 2015 by the Cuban regulatory authority. This article provides an overview of the progress-to-date on the development of this therapeutic vaccine, including clinical trials (some completed and others ongoing) to determine safety, efficacy and therapeutic benefits.</p>","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 1","pages":"21-29"},"PeriodicalIF":2.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25527943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary Metabolic Disorders Associated with Urolithiasis in Cuban Pediatric Patients.","authors":"Raymed Antonio Bacallao-Méndez,&nbsp;Reynaldo Mañalich-Comas,&nbsp;Francisco Gutiérrez-García,&nbsp;Carlos Fernando Madrid-Mancia,&nbsp;Catalina Lucero-Méndez,&nbsp;Magaly Julieta Smith-González","doi":"10.37757/MR2021.V23.N1.9","DOIUrl":"https://doi.org/10.37757/MR2021.V23.N1.9","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric urinary lithiasis (urolithiasis) is an important health issue linked to urinary metabolic disorders. In the United States alone, annual costs associated with urolithiasis are $229 million for hospital admissions and $146 million for emergency care.</p><p><strong>Objective: </strong>Identify urinary metabolic disorders in Cuban pediatric patients with urolithiasis and better understand the relationship of age, demographic and anthropometric variables to urinary metabolic disorders strongly associated with urolithiasis.</p><p><strong>Methods: </strong>We carried out a descriptive, cross-sectional study. The study universe was comprised of Cuban patients aged 2 to 19 years with urinary lithiasis who underwent renal metabolic studies at the Dr Abelardo Buch López Nephrology Institute in Havana, Cuba, from 2008 through 2019. All data were obtained from reports of the aforementioned metabolic studies. We collected the following variables: age, sex, nutritional status, urinary volume, plasma and urinary creatine concentrations; and calcium, uric acid, oxalate and citrate urinary excretions collected during a 24-hour period. We included results of urinary cystine tests and urine mini-cultures. We obtained frequency distributions for categorical and qualitative variables and calculated means and standard deviations for quantitative variables. We also evaluated homogeneity of metabolic disorders between children and adolescents.</p><p><strong>Results: </strong>We studied 1592 pediatric patients, of whom 67.7% (1078/1592) were adolescents. The main metabolic disorders included hypercalciuria (39.1%; 622/1592), decreased urinary flow (22.4%; 357/1592) and hypocitraturia (18.2%; 289/1592). Hypercalciuria, hypocitraturia and hyperoxaluria were more common in children, while decreased urinary flow and hyperuricosuria were more common in adolescents. Hyperuricosuria was more frequent in male patients (6.3%; 40/639 vs. 1.8%; 8/439) and had the greatest impact on lithogenesis. Hypercalciuria was more frequent in undernourished children (62.5%; 30/48) than in overweight children (21.7%; 10/46), or those with obesity (33.3%; 15/45).</p><p><strong>Conclusions: </strong>The main metabolic disorders among Cuban pediatric patients with urinary lithiasis are: hypercalciuria, decreased urinary flow and hypocitraturia. Hypercalciuria, hypocitraturia and hyperoxaluria are more common in children, and decreased urinary flow and hyperuricosuria are more common in adolescents. Identifying urinary metabolic disorders facilitates formulation of treatment plans tailored to decreasing the likelihood of urolithiasis.</p>","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 1","pages":"43-48"},"PeriodicalIF":2.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25527946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Adverse Events Following Childhood Immunizations in Pinar del Río, Cuba.","authors":"Elba Cruz-Rodríguez,&nbsp;Belkys María Galindo-Santana,&nbsp;Waldemar Baldoquín-Rodríguez,&nbsp;Damarys Concepción-Díaz,&nbsp;Miriam Caridad Luis-Martínez","doi":"10.37757/MR2021.V23.N1.8","DOIUrl":"https://doi.org/10.37757/MR2021.V23.N1.8","url":null,"abstract":"<p><strong>Introduction: </strong>The Cuban national program for childhood immunizations began in 1962 and has included a surveillance system for monitoring adverse events following immunization since 1999. The expected rate of adverse events following childhood immunization in Cuba is 50 per 100,000 vaccine doses administered. In 2017, Pinar del Río Province reported higher-than-expected rates of adverse events, which motivated this study on their frequency and types.</p><p><strong>Objective: </strong>Characterize adverse events following immunization reported in children in Pinar del Río Province in 2017.</p><p><strong>Methods: </strong>We examined reports of adverse events following immunization in children from 2 months through 14 years of age in Pinar del Río Province, Cuba, from January 1, 2017 through December 31, 2017. We found 487 adverse events that met the criteria established by the national surveillance system. Information was obtained from epidemiological surveys of adverse events following immunization in Pinar del Río Province municipalities. Recorded were age, municipality, signs and symptoms, vaccine type, number of doses, anatomical site and route of vaccine administration, and the institution where the child was vaccinated. We estimated proportions for intensity and frequency related to vaccination, and calculated rates for 100,000 vaccine doses administered. We then compared the rates of observed adverse events with those of expected events.</p><p><strong>Results: </strong>The overall rate of adverse events was 305.6 per 100,000 doses administered. Highest rates were reported in children aged ⟨1 year (580.9 per 100,000 doses administered); in Guane Municipality (610 per 100,000 doses), for the pentavalent (DTwP-HB-Hib) vaccine (1567.7 per 100,000 doses), and in applications to the anterolateral quadrant of the thigh (772.5 per 100,000 doses). Symptoms classifi ed as moderate, common, and general occurred more often, with fever being the most frequent. Severe induration, hypotonic and hyporesponsive episodes, persisten crying and rashes were observed more frequently than expected.</p><p><strong>Conclusions: </strong>The rate of adverse events following childhood immunization is similar to that reported in other provinces and elsewhere in the world. Of all childhood vaccines, the pentavalent vaccine is the most reactogenic. The absence of serious adverse events demonstrates the safety of childhood immunization in Cuba.</p>","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 1","pages":"35-42"},"PeriodicalIF":2.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25527945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}