Clave ilustrada y comentada para la identificación de moluscos gastrópodos fluviales de Cuba / An illustrated and annotated key to the freshwater snails of Cuba

Introducción: el reconocimiento de las especies de moluscos hospederos intermediarios es fundamental en el control de enfermedades transmitidas por estas especies. Los estudios morfológicos permiten identificar especies diferentes de una forma sencilla y asequible que en ocasiones no necesitan el uso de técnicas moleculares avanzadas. Objetivo: presentar una clave de identificación de moluscos fluviales gastrópodos de Cuba ilustrada y comentada sobre el papel de cada especie en la transmisión de enfermedades. Métodos: se confeccionó una clave de tipo dicotómica dividida en las tres subclases de moluscos gastrópodos existentes en Cuba. Se utilizaron los especímenes localizados en la colección de referencia del Laboratorio de Malacología del Instituto de Medicina Tropical Pedro Kourí. La base de datos de la colección cuenta con 1147 registros de especies distribuidos en 676 localidades. Se utilizaron hasta 30 ejemplares por población siempre que fue posible. Resultados: la clave agrupa 36 especies de moluscos gastrópodos fluviales distribuidas en diez familias. La descripción de cada especie se basa fundamentalmente en características morfológicas y anatómicas y se tiene en cuenta las variaciones de coloración y ornamentación de las conchas. Conclusiones: aunque la identificación de una especie pueda realizarse por medio de caracteres taxonómicos limitados a varias características de la concha o partes de la anatomía de estos moluscos, se recomienda siempre un estudio detallado de su ecología (patrones de distribución y relaciones interespecíficas)(AU)

Introduction: The recognition of intermediary host snails is capital to control snail-borne diseases. Morphological studies allow the identification of species in a simple and accessible way which may not require the use of advanced molecular techniques. Since specialized readings regarding medical malacology are not broadly available in Cuba, the confection of an easy-to-use and practical key to these species would be of huge utility to manage and control snail populations. Objective: to present an illustrated and annotated key to the freshwater gastropod snails of Cuba and their role in the transmission of parasitic diseases. Methods: a dichotomous key divided into the three subclasses of gastropods snails occurring in Cuba was made. Specimens from the Collection of the Laboratory of Malacology at the Institute of Tropical Medicine were used. The database contains 1147 registries of species from 676 localities in Cuba. Up to 30 individuals from each populations were used whenever possible. Results: the key gathers 36 species of freshwater gastropods belonging to ten families. The description of each species is based on morphological and anatomical features. Color variations and different ornaments patters in the shell are considered. Conclusions: Although the identification of a species may be relied on taxonomical characters limited to several shell and anatomy features, it is strongly recommended a detailed study of its ecology (distribution patterns and interspecific relations)(AU)

Del método holmesiano a la gesta clínico-epidemiológica del maestro Félix Pifano / From the holmesian method to the magister Felix Pifano`s clinical epidemiological exploit

El método holmesiano o sherlockiano según se le quiera designar, se advierte en la obra de Pifano y se sostiene en los siguientes enunciados: 1 Ciudadosa observación mediante el empleo combinado de los sentidos, asociada a un conocimiento intiutivo y razonamiento deductivo. 2 Prestar atención a los detalles y mantener alerta a las discrepancias. 3 Considerar las diversas opciones presentes en un caso. 4 Aprender a diferenciar y conocer lo que es importante de lo que no lo es. El Maestro Pifano dio a conocer a sus alumnos lo que consideraba importante al fusionar el método clínico condicente a formular un diagnóstico (historia clínica y anamnesis cuidadosa, examen físico integral e integrado, e investigaciones complementarias) con el método epidemiológico que situaba al paciente en un espacio geográfico, en un tiempo determinado e insertado en una comunidad donde concurrían los diferentes elementos que determinaban su condición de enfermo. En suma, en su concepción, el estudio integral del enfermo era indisoluble de su ambiente, del biotopo donde se desarrollaban los fenómenos de la ecología asociada al grupo a la cual pertenecía-soma, psiquis y mundo externo

The Holmesian or Skerlockian methodology considered four important steps, 1 Careful observation by use of the senses combined with intuitive knowledge and deductive reasoning. 2 Attention to details and alertness to discrepancies. 3 Considering the many options present in a case 4 Knowing what is important and what is not. Through the discussion we will show how these elements were present in the work of Félix Pifano, M.D. Master Pifano unveiled their students what was considered important to merge the leading clinical method to make a diagnosis (medical history and careful anamnesis, physical examination, integral and integrated and complementary procedures) with the epidemiological method that placed the patient in a geographic area, at a time determined and inserted in a community where the various elements that determined their condition of ill person. In short, in its conception, the comprehensive study of the patient was indissoluble of its environment, the biotope where unfolded the phenomena of ecology associated to the group to which he belonged-soma, psyche and world external

A medicina no Brasil imperial: clima, parasitas e patologia tropical

O livro guia o leitor pelos caminhos do pensamento médico brasileiro no século XIX e as origens da medicina tropical no país. Mais especificamente, fala da gênese da parasitologia helmintológica (estudo de vermes parasitas) e mostra como esse novo saber se legitimou e foi incorporado às práticas de diagnóstico, tratamento e profilaxia de doenças. Analisa as disputas em torno dessa legitimação, onde a helmintologia médica se confrontava com a climatologia - que associava as doenças às peculiaridades do clima e às características naturais do Brasil. Mostra como a helmintologia médica contribuiu para a corrosão da climatologia, embora esse processo tenha sido marcado tanto por rupturas como por continuidades, na medida em que, a princípio, não se tratava de saberes incomensuráveis. Como se lê desde o prefácio, "os inovadores não queriam vencer, mas convencer"

Setting research priorities by applying the combined approach matrix.

Background & objectives: Priority setting in health research is a dynamic process. Different organizations and institutes have been working in the field of research priority setting for many years. In 1999 the Global Forum for Health Research presented a research priority setting tool called the Combined Approach Matrix or CAM. Since its development, the CAM has been successfully applied to set research priorities for diseases, conditions and programmes at global, regional and national levels. This paper briefly explains the CAM methodology and how it could be applied in different settings, giving examples and describing challenges encountered in the process of setting research priorities and providing recommendations for further work in this field. Methods: The construct and design of the CAM is explained along with different steps needed, including planning and organization of a priority-setting exercise and how it could be applied in different settings. Results: The application of the CAM are described by using three examples. The first concerns setting research priorities for a global programme, the second describes application at the country level and the third setting research priorities for diseases. Interpretation & conclusions: Effective application of the CAM in different and diverse environments proves its utility as a tool for setting research priorities. Potential challenges encountered in the process of research priority setting are discussed and some recommendations for further work in this field are provided.

Evaluación retrospectiva de fiebre amarilla selvática en Venezuela período 2003-2005 / Retrospective evaluation of jungle yellow fever in Venezuela during the years 2003-2005

La fiebre amarilla es una enfermedad viral, propia de algunas regiones tropicales de América del Sur y Africa, causando numerosas epidemias con elevadas tasas de mortalidad. Con el objetivo de caracterizar retrospectivamente el brote de fiebre amarilla selvática en Venezuela en el año 2003, a través de la determinación del número de casos confirmados y defunciones en los estados afectados, según grupos etarios, sexo, ocupación y procedencia y la identificación de factores desencadenantes del brote, así como también el estudio de los casos reportados en los años 2004 y 2005, se estudiaron los casos registrados oficialmente en el estado Zulia, durante el periodo de estudio. El Zulia fue el estado más afectado en el período evaluado con 25 casos (p<0,001), reportando mayor tasa de ataque durante el año 2003, Mérida y Monagas en el año 2004, y Portuguesa en el 2005. El grupo etario más afectado fue 25-44 años, predominando el sexo masculino, afectando mayormente al trabajador agrícola. Los resultados evidencian la alta letalidad de la fiebre amarilla al arrojar un 46,51 por ciento en el año 2003, 60 por ciento en el 2004 y 66,67 por ciento en el 2005. Se recomienda la implementación de medidas que permitan establecer una vigilancia mínima en las zonas con actividad demostradas.

Yellow fever is a viral disease, typical of some tropical regions in South America and Africa, causing numerous epidemics with high mortality rates. In order to characterize retrospectively the jungle yellow fever outbreak in Venezuela in the year 2003, by determining the number of cases and deaths confirmed in the affected states according to age, sex, occupation and origin and by identifying factors that triggered the outbreak, as well as the study of cases reported in 2004 and 2005, cases officially registered in the State of Zulia were studied for the period in question. Zulia was the state most affected during the period evaluated, with 25 cases (p <0.001), reporting the highest attack rate during 2003; Merida and Monagas had the highest rates in 2004, Portuguesa in 2005. The most affected age group was 25-44 years, predominantly male farm workers. Results showed the high lethality of yellow fever: 46.51 percent in 2003, 60 percent in 2004 and 66.67 percent in 2005. The implementation of measures to establish a minimum surveillance in areas with proven activity is recommended.