Medicc Review最新文献

{"title":"Prognostic Scale to Stratify Risk of Intrahospital Death in Patients with Acute Myocardial Infarction with ST-Segment Elevation.","authors":"Ailed Elena Rodríguez-Jiménez,&nbsp;Tessa Negrín-Valdés,&nbsp;Hugo Cruz-Inerarity,&nbsp;Luis Alberto Castellano-Gallo,&nbsp;Elibet Chávez-González","doi":"10.37757/MR2020.V22.N3.10","DOIUrl":"https://doi.org/10.37757/MR2020.V22.N3.10","url":null,"abstract":"<p><p>INTRODUCTION The scales available to predict death and complica-tions after acute coronary syndrome include angiographic studies and serum biomarkers that are not within reach of services with limited resources. Such services need specifi c and sensitive instruments to evaluate risk using accessible resources and information. OBJECTIVE Develop a scale to estimate and stratify the risk of intra-hospital death in patients with acute ST-segment elevation myocardial infarction. METHODS An analytical observational study was conducted in a universe of 769 patients with acute ST-segment elevation myocardial infarction who were admitted consecutively to the Camilo Cienfuegos Provincial Hospital in Sancti Spíritus Province, Cuba, from January 2013 to March 2018. The fi nal study cohort included 667 patients, ex-cluding 102 due to branch blocks, atrial fi brillation, drugs that prolong the QT interval, low life expectancy or history of myocardial infarction. The demographic variables of age, sex, skin color, classic cardiovas-cular risk factors, blood pressure, heart rate, blood glucose level, in addition to duration and dispersion of the QT interval with and without correction, left ventricular ejection fraction, and glomerular fi ltration rate were included in the analysis. Patients were categorized according to the Killip-Kimball Classifi cation for degree of heart failure. A risk scale was constructed, the predictive ability of which was evaluated using the detectability index associated with an receiver-operator curve.RESULTS Seventy-seven patients died (11.5%). Mean blood glucose levels were higher among the deceased, while their systolic and dia-stolic blood pressure, left ventricular ejection fraction, and glomerular fi ltration rate were lower than those participants discharged alive. Rel-evant variables included in the scale were systolic blood pressure, Killip-Kimball class, cardiorespiratory arrest, glomerular fi ltration rate, corrected QT interval dispersion, left ventricular ejection fraction, and blood glucose levels. The variable with the best predictive ability was cardiorespiratory arrest, followed by a blood glucose level higher than 11.1 mmol/L. The scale demonstrated a great predictive ability with a detectability index of 0.92. CONCLUSIONS The numeric scale we designed estimates and strati-fi es risk of death during hospitalization for patients with ST-segment elevation myocardial infarction and has good metric properties for predictive ability and calibration. KEYWORDS ST-segment elevation myocardial infarction, mortality, risk assessment, Cuba.</p>","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"22 3","pages":"46-53"},"PeriodicalIF":2.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38277716","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":"Strategies Needed to Ensure Higher Immunization Rates in the Americas.","authors":"","doi":"10.37757/MR2020.V22.N3.2","DOIUrl":"https://doi.org/10.37757/MR2020.V22.N3.2","url":null,"abstract":"<p><p>In their MEDICC Review Perspective, Galindo-Santana and colleagues highlight the challenges presented by anti-vaccination groups, stressing that immunization is an essential cost-effective preventive measure that promotes population health.[1] In 2019, WHO identifi ed vaccine hesitancy, fragile and vulnerable settings and weak primary health care as 3 of 10 main global health threats. Close attention to these threats can detect potential areas of missed opportunities for immunization across populations and mitigate risk of preventable diseases.</p>","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"22 3","pages":"5"},"PeriodicalIF":2.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38279738","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":"Antimicrobial Resistance in Bacteria Isolated from Foods in Cuba.","authors":"Yamila Puig-Peña,&nbsp;Virginia Leyva-Castillo,&nbsp;René Tejedor-Arias,&nbsp;María Teresa Illnait-Zaragozí,&nbsp;Neibys Aportela-López,&nbsp;Ailen Camejo-Jardines,&nbsp;Jesy Ramírez-Areces","doi":"10.37757/MR2020.V22.N3.9","DOIUrl":"https://doi.org/10.37757/MR2020.V22.N3.9","url":null,"abstract":"<p><p>INTRODUCTION Antimicrobial drug resistance constitutes a health risk of increasing concern worldwide. One of the most common av-enues for the acquisition of clinically-relevant antimicrobial resistance can be traced back to the food supply, where resistance is acquired through the ingestion of antimicrobial resistant microorganisms pres-ent in food. Antimicrobial resistance constitutes a health risk, leading to production losses and negative consequences for livelihood and food safety. OBJECTIVE Determine whether resistant bacteria are present in foods in Cuba. METHODS A descriptive observational study was conducted in theMicrobiology Laboratory of Cuba's National Institute of Hygiene, Epi-demiology and Microbiology from September 2004 through Decem-ber 2018. Researchers analyzed 1178 bacterial isolates from food samples. The isolates were identifi ed as Escherichia coli, Salmonella, Vibrio cholerae and coagulase-positive Staphylococcus. The antimi-crobial susceptibility study was performed using the Bauer-Kirby disk diffusion method, following procedures outlined by the Clinical and Laboratory Standards Institute. The data were analyzed using WHO-NET version 5.6. RESULTS Of the total isolates, 62.1% were resistant to at least one antibiotic. Within each group, >50% of isolates showed some type of resistance. E. coli and V. cholerae exceeded 50% resistance to tetracycline and ampicillin, respectively. Staphylococcus showed the highest resistance to penicillin, and Salmonella to tetracycline, nali-dixic acid and ampicillin. The highest percentages of non-susceptible microorganisms were identifi ed in meats and meat products. CONCLUSIONS These results serve as an alert to the dangers of acquiring antibiotic-resistant bacteria from food and demonstrate the need to establish a surveillance system and institute measures bacte-rial control in food products.KEYWORDS Microbial drug resistance, bacteria, food, foodborne disease, Cuba.</p>","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"22 3","pages":"40-45"},"PeriodicalIF":2.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38277715","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 in the Americas: Strategies that Mark the Difference.","authors":"","doi":"10.37757/MR2020.V22.N3.1","DOIUrl":"https://doi.org/10.37757/MR2020.V22.N3.1","url":null,"abstract":"<p><p>Four months after COVID-19 was declared a pandemic, it has found a new epicenter: the Americas. With over four million cases and nearly half a million deaths at this writing, the United States is providing the best example of a failed response to a crisis in which GDP is not proving the best predictor of success. Zero coordinat-ed national strategy combined with unnecessary delays in testing, confusing and often contradictory messaging, and politicization of even the most elementary measures to combat the virus have led some US states to surpass infection and death rates in even the most hard-hit countries. Brazil, where government fi nally resumed reporting, is second only to the USA, its authorities admitting 2.4 million cases and over 300,000 deaths thus far. And by all counts, as in many countries, numbers are vastly underestimated.</p>","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"22 3","pages":"5"},"PeriodicalIF":2.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38279736","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":"CUBA'S COVID-19 STRATEGY: UPDATED EPIDEMIC CONTROL AND RECOVERY MEASURES.","authors":"","doi":"10.37757/MR2020.V22.N3.3","DOIUrl":"https://doi.org/10.37757/MR2020.V22.N3.3","url":null,"abstract":"<p><p>MEDICC Review continues documentation of Cuba's COVID-19 Prevention and Control Plan and its implementation, begun with our April issue (see https://mediccreview.org/cubas-covid-19-strategy-main-actions-through-april-23-2020). This time, we present two tables: the first refers to measures taken to confront the epidemic, and the second, to the phased recovery process that is expected to lead to changes in many, if not all, sectors of Cuban society. In both cases, we have indicated the source of the information provided.</p>","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"22 3","pages":"5"},"PeriodicalIF":2.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38279739","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":"Science as a Social Good: Iramis Alonso-Porro Director, Juventud Técnica.","authors":"Conner Gorry","doi":"10.37757/MR2020.V22.N3.4","DOIUrl":"https://doi.org/10.37757/MR2020.V22.N3.4","url":null,"abstract":"<p><p>Science journalism was little known in Cuba when Iramis Alonso wrote her the-sis on the specialized fi eld in 1990. That year, journalism degree from the Uni-versity of Havana in hand, she set off to Cuba's eastern countryside to complete two years of social service reporting for local, regional and national print media. Living in the mountains of Holguín, a typical day for the cub reporter took her to caves, forests and fi elds for stories on the intersection of science, culture and the environment. Alonso credits this formative experience with igniting her passion for investigative and sci-ence journalism, setting her on a unique career path as a journalist and editor specializing in the sciences writ large: climate change, astronomy, mathemat-ics and other hard sciences, engineer-ing, information technologies and social sciences, among others.</p>","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"22 3","pages":"12-15"},"PeriodicalIF":2.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38279740","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":"Economic Packages for COVID-19 Recovery Must Invest in More Resilient Health SystemsCristian Morales MS MPHPAHO/WHO Permanent Representative, Mexico.","authors":"Gail Reed","doi":"10.37757/MR2020.V22.N3.5","DOIUrl":"https://doi.org/10.37757/MR2020.V22.N3.5","url":null,"abstract":"<p><p>Cristian Morales, an economist by training, has dedicated his career to improving health and health equity in the Americas through his work with PAHO/WHO. This has taken him from hurricanes, earthquakes and epidemics in Haiti to PAHO's Washington DC offi ces, where he was instrumental in achieving consensus on a resolution aiming for universal health-coverage plus access-approved by all governments in the Americas. In 2015, he was appointed PAHO/WHO Permanent Representative in Cuba, and in 2018 to the same post in Mexico.</p>","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"22 3","pages":"16-19"},"PeriodicalIF":2.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38279741","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 Forecasts for Cuba Using Logistic Regression and Gompertz Curves.","authors":"Juan Felipe Medina-Mendieta,&nbsp;Manuel Cortés-Cortés,&nbsp;Manuel Cortés-Iglesias","doi":"10.37757/MR2020.V22.N3.8","DOIUrl":"https://doi.org/10.37757/MR2020.V22.N3.8","url":null,"abstract":"<p><p>INTRODUCTION On March 11, 2020, WHO declared COVID-19 a pandemic and called on governments to impose drastic measures to fi ght it. It is vitally important for government health authorities and leaders to have reliable estimates of infected cases and deaths in order to apply the necessary measures with the resources at their disposal. OBJECTIVE Test the validity of the logistic regression and Gompertz curve to forecast peaks of confi rmed cases and deaths in Cuba, as well as total number of cases. METHODS An inferential, predictive study was conducted using lo-gistic and Gompertz growth curves, adjusted with the least squares method and informatics tools for analysis and prediction of growth in COVID-19 cases and deaths. Italy and Spain-countries that have passed the initial peak of infection rates-were studied, and it was inferred from the results of these countries that their models were ap-plicable to Cuba. This hypothesis was tested by applying goodness-of-fi t and signifi cance tests on its parameters.RESULTS Both models showed good fi t, low mean square errors, and all parameters were highly signifi cant. CONCLUSIONS The validity of models was confi rmed based on logis-tic regression and the Gompertz curve to forecast the dates of peak infections and deaths, as well as total number of cases in Cuba. KEYWORDS COVID-19, SARS-CoV-2, logistic models, pandemic, mortality, Cuba.</p>","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"22 3","pages":"32-39"},"PeriodicalIF":2.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38277714","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 in East and Southern Africa: Rebuilding Differently and Better Must Start Now.","authors":"Rene Loewenson","doi":"10.37757/MR2020.V22.N3.13","DOIUrl":"https://doi.org/10.37757/MR2020.V22.N3.13","url":null,"abstract":"<p><p>By June 2020, the cumulative cases and deaths related to COVID-19 in 16 East and Southern African (ESA) countries were still rising, with an average case fatality rate of 1.46%.[1] From its initial presence in cities and regional transport hubs, cases are spreading, including to rural areas, among health workers and as migrants cross borders to return home.[2].</p>","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"22 3","pages":"59-60"},"PeriodicalIF":2.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38277719","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":"A Cuban Physician on the Front Lines in Barcelona Reflects on COVID-19 Responses in Europe and Cuba.","authors":"Marià de Delàs","doi":"10.37757/MR2020.V22.N3.14","DOIUrl":"https://doi.org/10.37757/MR2020.V22.N3.14","url":null,"abstract":"<p><p>Several territorial governments in Spain are considering inviting Cuban doctors to participate in the fi ght against the coronavirus epidemic, just as they have done in Italy and Andorra...Cuba's healthcare culture is different from Europe's, and the response to the epidemic likely would have been different if criteria were used similar to those followed in Cuba.</p>","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"22 3","pages":"61-63"},"PeriodicalIF":2.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38277720","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}