Newborn Screening Program for Cystic Fibrosis in Cuba: Three Years' Experience

ABSTRACT In Cuba, newborn screening (NBS) for cystic fibrosis (CF) was introduced in January 2019. The results from the first three years of the CF NBS program are presented. An IRT/IRT protocol was followed using a cut-off value of 50 ng/mL. In this period 281,717 neonates were screened, 2,197 samples had increased IRT values, and a second sample was necessary (recall rate=0.78%). In 686 (0.24%) neonates, IRT was still elevated, and they were referred for clinical evaluation. Twenty-one children were confirmed by sweat test and molecular biology. Eighteen newborns presented variant F508del. A false negative case was reported. Demographic data of 32,764 neonates were collected. The average age of sampling was six days with results available at 11 days of life, but 1.7% of the samples were collected 20 days after birth. The mean IRT value was 12.7±11.7 ng/mL (ranging 0-283 ng/mL) with a calculated 98.5 percentile value of 42.4 ng/mL. On average, the samples were processed five days after collection and two days after they were received at the laboratory. Although CF NBS program in Cuba is just beginning, it can be predicted that CF will be one of the most frequent inherited-metabolic diseases in the Cuban population.

Caracterización de los cuidadores de pacientes terminales / Characterization of Caregivers of Terminally ill Patients

Introducción: Resultan alarmantes las cifras de pacientes terminales tanto a nivel mundial como en Cuba, por lo que es necesario estudiar la preparación de los cuidadores de estos pacientes. Objetivo: Caracterizar al cuidador del paciente con enfermedad terminal, su preparación, experiencia, conocimientos sobre los cuidados y sobrecarga emocional en el municipio de San Luis. Métodos: Se realizó un estudio descriptivo y transversal en el periodo 2017-2019, en un universo de 47 cuidadores, a los que se les aplicó un muestreo no probabilístico. La muestra quedó conformada por 20 cuidadores que cumplieron los criterios de inclusión establecidos y dieron su consentimiento informado. Los instrumentos usados fueron la entrevista individual y la escala de carga del cuidador de Zarit. Se utilizó el método empírico y el estadístico y los textos se procesaron con Word XP, las tablas y gráficos se realizaron con Excel XP. Resultados: Prevaleció el nivel de escolaridad preuniversitaria y el estado civil casado. El grado de parentesco más frecuente en la muestra fue los hijos que no poseían experiencia previa de cuidado. Las causas más frecuentes de las enfermedades terminales fueron las demencias. Conclusiones: Predominaron los mayores de 60 años, el sexo femenino con escasos conocimientos sobre los cuidados, lo que influyó en la alta sobrecarga emocional presente en ellos(AU)

Introduction: The figures corresponding to terminally ill patients, both worldwide and in Cuba, are alarming, a reason why it is necessary to study the preparation of the caregivers of these patients. Objective: To characterize the caregiver of the terminally ill patient, their preparation, experience, knowledge about care and emotional overload in San Luis Municipality. Methods: A descriptive and cross-sectional study was carried out in the period 2017-2019, with a universe of 47 caregivers, to whom a nonprobabilistic sampling was applied. The sample was made up of twenty caregivers who met the established inclusion criteria and gave their informed consent. The instruments used were the individual interview and the Zarit Caregiver Load Scale. Empirical and statistical methods were used. The texts were processed with Word XP. The tables and graphs were made with Excel XP. Results: There was a prevalence of pre-university education level and married as marital status. The most frequent degree of kinship in the sample was made up of children who had no previous caregiving experience. The most frequent causes of terminal illnesses were dementias. Conclusions: Those over sixty years of age predominated, as well as the female sex with little knowledge about care, which influenced the high emotional overload present in them(AU)

Intento suicida en la adolescencia: un abordaje desde la Atención Primaria Salud / Suicide attempt in the adolescence: an approach from primary health care

RESUMEN Introducción: el intento suicida es una manifestación extrema de violencia, por ser violencia contra sí mismo, situación que, tanto en el mundo como en Cuba, se encuentra en ascenso; por ello el objetivo del presente trabajo es caracterizar el intento suicida en la adolescencia, a partir de los aspectos sociodemográficos, los factores de riesgo asociados al intento y por la existencia de antecedentes personales y familiares de intento suicida previos. Métodos: se realizó un estudio descriptivo, transversal, donde el universo fueron 81 adolescentes con intento suicida y la muestra no probabilística, de sujetos tipos de 46 adolescentes. Se aplicaron la encuesta para el control y la tipificación de la conducta suicida, entrevista individual y entrevista familiar. Resultados: Se constató el predominio de los individuos comprendidos entre los 15 y los 19 años con vínculo escolar, el nivel de escolaridad preuniversitario, el estado civil soltero. La presencia de alcoholismo y patrones imitativos fueron los factores de riesgos comunitarios más frecuentes y como factores de riesgo individuales la ruptura de pareja, la depresión y las características personológicas. Discusión: Se constató que la coincidencia de criterios con otros estudios en los que se también se corroboró que las personas que planearon el intento de suicidio y usaron un método duro tenían el deseo de morir; en tanto que aquellos que emplearon métodos blandos, los movía la intención de llamar la atención, de ahí la relación entre los medios y la intención.

ABSTRACT Introduction: Suicide attempt is an extreme demonstration of violence, for being against oneself, it is in expansion around the world and in Cuba. Objective: To characterize suicide attempt in adolescence, socio-demographic aspects, risk factors associated to attempt, personals and family antecedent of precedent suicide attempt. Methods: It was descriptive and cross sectional study, the target group was comprised by 81 adolescents, the sample was not probabilistic and consisted of 46 adolescents. The tests used were inquiry for the control and type of the suicide behavior, individual interview and family interview. Apply empiric and statistic method and data was process with Word XP, table and graph make with Excel XP. Results: Among the main results were that the most frequent ages were between 15 and 19 years, school level high school, marital status single and they weren't working. Alcoholism and imitation were the community risk factors and the individual risk factors were couple breaking, depression and self-characteristic. Discussion: Criteria coincidences with other studies related to the way of committing suicide and its purpose were found.

SUMA Technology and Newborn Screening Tests for Inherited Metabolic Diseases in Cuba: An Overview of the First 30 Years

Abstract The ultramicroanalytic system (SUMA), created in the 1980s, is a complete system of reagents and instrumentation to perform ultramicroassays combining the sensitivity of the micro-enzyme-linked immunosorbent assay (ELISA) tests with the use of ultramicrovolumes. This technology permitted establishing large-scale newborn screening programs (NSPs) for metabolic and endocrine disorders in Cuba. This article summarizes the main results of the implementation during the 30 years of SUMA technology in NSP for 5 inherited metabolic diseases, using ultramicroassays developed at the Department of Newborn Screening at the Immunoassay Center. Since 1986, SUMA technology has been used in the Cuban NSP for congenital hypothyroidism, initially studying thyroid hormone in cord serum samples. In 2000, a decentralized program for the detection of hyperphenylalaninemias using heel dried blood samples was initiated. These successful experiences permitted including protocols for screening congenital adrenal hyperplasia, galactosemia, and biotinidase deficiency in 2005. A program for the newborn screening of CH using the thyroid-stimulating hormone Neonatal ultramicro-ELISA was fully implemented in 2010. Nowadays, the NSP is supported by a network of 175 SUMA laboratories. After 30 years, more than 3.8 million Cuban newborns have been screened, and 1002 affected children have been detected. Moreover, SUMA technology has been presented in Latin America for over 2 decades and has contributed to screen around 17 million newborns. These results prove that developing countries can develop appropriate diagnostic technologies for making health care accessible to all.

Propuesta de un sistema de vigilancia de las reacciones adversas en la terapeutica antituberculosa / sss

De todos los datos analizados y obtenidos podemos concluir: el grupo etareo mas vulnerable fue entre los 25 a 34 años es decir en la edad productiva. Es evidente que los casos manifestados por los pacientes se encuentran en proporcion directa entre las fases especificamente en las primeras cuatro semanas del tiempo de tratamiento entre los nuevos casos, reingreso y tratamiento sobre el total de estos grupos mencionados. Los niveles de infeccion que han presentado nuestros pacientes tienen una variabilidad de sintomatologia y signos en algunos de ellos se han presentado 1,2,3 molestias simultaneamente mencionaremos los mas relevantes region abdominal 69 por ciento, musculo 64 por ciento al ingerir 73 por ciento. Existe una contraversia entre algunos autores si esta ultima es no una reaccion adversa...

La salud bucal y las políticas preventivas en Venezuela / The bucal health and the preventive political in Venezuela

After a bibliographic review around the conceptualization about Health and Prevention been used until the moment, from the original documents of the Health and Social Assistence Ministry memories and acounts of the same ministry and studies about the development of the Venezuela State. We made the present study, with the purpose of analizing the economic dinamic of the country, the preventive politcs of health and specifically its effects on the development of preventive actions of Dental Health in Venezuela between 1920 and 1986