Daily Dietary Protein Distribution Does Not Influence Changes in Body Composition During Weight Loss in Women of Reproductive Years with Overweight or Obesity: A Randomized Controlled Trial.

BACKGROUND: Preservation of fat-free mass (FFM) during intentional weight loss is challenging yet important to maintain a resting metabolic rate. A balanced protein distribution of 25-30 g per meal improves 24-h muscle protein synthesis, which may promote FFM maintenance and greater reductions in fat mass (FM) during weight loss in women. OBJECTIVES: We aimed to determine whether the daily dietary protein distribution pattern during energy restriction influences changes in body composition in women of reproductive age. We hypothesized that evenly distributing protein across meals compared with the usual intake pattern of consuming most of the protein at the dinner meal would be superior in preserving FFM while reducing FM during weight loss. METHODS: Healthy women (n = 43) aged 20-44 y with a BMI of 28-45 kg/m2 completed a randomized parallel feeding study testing 2 patterns of daily protein intake (even distribution across all meals compared with a skewed distribution with most protein consumed at the evening meal). Participants completed an 8-wk controlled 20% energy restriction (all foods provided), followed by an 8-wk self-choice phase in which participants were asked to maintain a similar diet and dietary pattern when purchasing and consuming their own foods. Body composition was measured at baseline, week 8, and week 16. Data were analyzed using mixed models. Statistical significance was set at P < 0.05. Data are presented as differences in least squares means ± SE. RESULTS: No significant main effects of group or group-by-time interactions were observed. All measures exhibited the main effect of time (P < 0.001). Overall, body weight, FFM, FM, and body fat percentage decreased 5.6 ± 0.4, 1.0 ± 0.2, 4.6 ± 0.4 kg, and 2.3 ± 0.2%, respectively, during this 16-wk study. CONCLUSION: Daily dietary protein distribution at a fixed protein level does not appear to influence changes in body composition during weight loss in women of reproductive age. CLINICAL TRIAL REGISTRY NUMBER AND WEBSITE WHERE IT WAS OBTAINED: NCT03202069 https://classic. CLINICALTRIALS: gov/ct2/show/NCT03202069.

Consumption of Dietary Guidelines for Americans Types and Amounts of Vegetables Increases Mean Subjective Happiness Scale Scores: A Randomized Controlled Trial.

BACKGROUND: The health benefits of diets rich in fruits and vegetables (FV) are well established. Recent observational and intervention research suggests that FV consumption may also exert a positive effect on psychological well-being. OBJECTIVE: This study aimed to assess changes in mean Subjective Happiness Scale (SHS) scores in response to consuming 2010-2015 Dietary Guidelines for Americans (DGA) recommended types and amounts of vegetables. It was hypothesized that increased vegetable consumption would increase mean SHS scores. DESIGN: This study investigated a secondary outcome of a randomized, parallel, nonblinded controlled trial with a 1:1 allocation ratio to a provided vegetable intervention or attention control group. PARTICIPANTS/SETTING: Men and women (n = 75) aged 18 to 65 years, body mass index ≥ 25, with low habitual vegetable consumption were recruited from Grand Forks, North Dakota, December 2016 to January 2018, for this community-based study. INTERVENTION: The vegetable intervention consisted of an 8-week feeding phase during which participants were provided with vegetables in DGA-recommended types and amounts. The attention control group was not provided vegetables but completed the same testing schedule as the vegetable intervention group. MAIN OUTCOME MEASURE: Mean SHS scores were assessed before and after the intervention. STATISTICAL ANALYSES: Mean SHS scores were analyzed using a 2-way factorial mixed linear model analysis of variance. RESULTS: A significant interaction between treatment and visit (P = .015) revealed greater mean SHS scores at week 8 than at baseline in the vegetable intervention group (+0.23 ± 0.11) (mean difference ± SE of the difference) but no change in the attention control group (-0.15 ± 0.11). CONCLUSIONS: Greater mean SHS scores were observed after increasing vegetable consumption to meet DGA recommendations, suggesting that adhering to DGA vegetable guidance may help promote psychological well-being.

Identification of Barriers to Adherence to a Weight Loss Diet in Women Using the Nominal Group Technique.

BACKGROUND: At any given time, a majority of women are engaged in some type of weight loss diet; however, these efforts are difficult to sustain for long-term weight control. Because women are more likely to develop obesity and suffer a greater severity of obesity-related health and economic consequences, we sought to identify the key factors that make adhering to a weight loss diet difficult for overweight/obese women. METHODS: Ten nominal group technique (NGT) sessions aimed at identifying perceived barriers to adherence to a weight loss diet were conducted as part of a weight loss study for overweight/obese women (n = 33) during the controlled feeding weight loss phase. RESULTS: Individual-level barriers to emerge from the sessions included knowing when to stop eating, being able to control cravings and emotional eating, and sustaining healthier dietary habits. Environmental-level barriers included family/social events that bring people together, especially those centered around food and drink, eating out, cost, and busy schedules. CONCLUSIONS: These findings offer a deeper understanding of barriers women find most salient to adhering to a weight loss diet, providing direction for the clinical application of weight loss programs.

Liking and Acceptability of Whole Grains Increases with a 6-Week Exposure but Preferences for Foods Varying in Taste and Fat Content Are Not Altered: A Randomized Controlled Trial.

BACKGROUND: Since 2005, the Dietary Guidelines for Americans have recommended consuming at least half of total grains as whole grains (WGs) for optimal health benefits; however, consumption of WGs falls far short of recommended amounts. OBJECTIVE: This study aimed to evaluate the effect of mere exposure to WGs on liking, acceptability, and consumption of WG foods and to determine if exposure to WG would influence liking and wanting for other foods varying in fat content and sweet taste. METHODS: Healthy, self-identified low WG consumers (n = 45) were randomly assigned to either a 6-wk WG intervention or a refined grain (RG) control condition during which they received a weekly market basket of grain products to incorporate into daily meals and snacks. Consumption of grain products was measured by weekly logs and weigh-backs. A sensory evaluation protocol was conducted at baseline and week 6 to evaluate changes in perception of grain products. Computer tasks designed to measure liking and wanting for other foods varying in high/low-fat content and sweet/savory taste were also completed at baseline and week 6. RESULTS: Participants in the WG group significantly increased WG consumption. Exposure to WG products resulted in improved ratings of liking, flavor, texture, and willingness to include WG in the regular diet. No significant changes in liking or wanting for foods representing high-fat sweet (HFSW), low-fat sweet (LFSW), high-fat savory (HFSA), or low-fat savory (LFSA) categories were found in the WG group. In contrast, exposure to RG foods resulted in an increased explicit wanting for HFSW and LFSW and a decreased wanting for HFSA foods. CONCLUSIONS: Mere exposure to WG foods represents a feasible and easily applied behavioral strategy for increasing consumption of WGs. Encouraging consumers to focus on enjoyment of the taste may be more effective than emphasizing the health benefits of WG consumption. This trial was registered at clinicaltrials.gov as NCT01403857.

Significant reduction in heart rate variability is a feature of acute decompensation of cirrhosis and predicts 90-day mortality.

BACKGROUND: Heart rate variability (HRV) is reduced in cirrhosis and in conditions of systemic inflammation. Whether HRV is associated with cirrhosis decompensation and development of acute-on-chronic liver failure (ACLF) is unknown. AIMS: To (a) validate wireless remote HRV monitoring in cirrhosis decompensation; (b) determine if severely reduced HRV is a surrogate for inflammation and progression of cirrhosis decompensation; (c) assess if measuring HRV determines prognosis in cirrhosis decompensation. METHODS: One hundred and eleven patients at risk of cirrhosis decompensation at two clinical sites were monitored for HRV. Standard deviation of all normal beat-beat intervals (SDNN) reflecting HRV was assessed using remote monitoring (Isansys Lifetouch) and/or Holter ECG recording. Clinical outcomes and major prognostic scores were recorded during 90-day follow-up. RESULTS: Reduced HRV denoted by lower baseline SDNN, correlated with severity of decompensation (median 14 (IQR 11-23) vs 33 (25-42); P < 0.001, decompensated patients vs stable outpatient cirrhosis). Furthermore, SDNN was significantly lower in patients developing ACLF compared to those with only decompensation (median 10 (IQR9-12) vs 16 (11-24); P = 0.02), and correlated inversely with MELD and Child-Pugh scores, and C-reactive protein (all P < 0.0001) and white cell count (P < 0.001). SDNN predicted disease progression on repeat measures and appeared an independent predictor of 90-day mortality (12 patients). An SDNN cut-off of 13.25 ms had a 98% negative predictive value. CONCLUSIONS: This study demonstrates that remote wireless HRV monitoring identifies cirrhosis patients at high risk of developing ACLF and death, and suggests such monitoring might guide the need for early intervention in such patients. Clinical Trial number: NIHR clinical research network CPMS ID 4949.

Patrones comportamentales de fóridos (Diptera: Phoridae) parasitoides de Atta colombica (Hymenoptera: Formicidae) / Behavioral patterns of parasitoid phorids (Diptera: Phoridae) of Atta colombica (Hymenoptera: Formicidae)

ResumenEl éxito de las interacciones parasitoide-hospedero está determinado por la conducta de búsqueda, reconocimiento, ataque y defensa que despliegan los participantes en dicha interacción. Para comprender los patrones comportamentales entre los fóridos parasitoides y su hospedero, Atta colombica, se realizaron observaciones en un fragmento de bosque en el departamento de Córdoba, con un esfuerzo muestral de 186 horas en tres nidos de esta. Se recolectaron fóridos, hormigas atacadas y la carga que llevaban. En total se capturaron 52 individuos de Eibesfeldtphora attae y 54 de Apocephalus colombicus. Se observaron diferencias en cuanto a la forma de ataque y el microhábitat preferido por los parasitoides. No hubo preferencia aparente por el tamaño de las hormigas que atacaron los fóridos, pero seleccionaron cargas de mayor tamaño para posarse sobre ellas. Cuando las hormigas respondieron al ataque, emplearon defensas individuales (adoptando posiciones o aumentando su velocidad) o grupales (cuando hormigas vecinas atacaban al parasitoide). Los fóridos parasitoides especializan su conducta con el fin de garantizar un ataque exitoso sobre su hospedero, quien responde modificando su comportamiento según el parasitoide atacante.

AbstractIn ecology, the success of parasitoid-host interactions is determined by the behavior of seeking, recognition, attack and defense deployed by the participants in the interaction. Our study aimed to understand the behavioral patterns between parasitoid phorids and their host Atta colombica from a forest fragment of Córdoba department, Colombia. We observed three nests of Atta colombica, from December 2013 to Januray 2015 (including dry and rainy seasons), for a total effort of 189 hours. We observed Phorids, their attacks to ants and collected their loads; we also considered differences in the way the parasitoids attacked and observed the microhabitat they preferred. A total of 52 individuals of Eibesfeldtphora attae and 54 of Apocephalus colombicus were collected. Apparently there was no preference for the size of the ants that were attacked by phorids, but larger loads were selected to land on them. When the ants responded to the phorid attack, they used individual defenses (adopting positions or increasing their speed) or grupal defenses (closer ants attacking the phorid). Parasitoid phorids have specialized their behavior, in order to ensure a successful attack on their host, who responded by modifying its behavior, according to the attacker (parasitoid).

The Effects of Moderate Whole Grain Consumption on Fasting Glucose and Lipids, Gastrointestinal Symptoms, and Microbiota.

This study was designed to determine if providing wheat, corn, and rice as whole (WG) or refined grains (RG) under free-living conditions will change parameters of health over a six-week intervention in healthy, habitual non-WG consumers. Measurements of body composition, fecal microbiota, fasting blood glucose, total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), and triglycerides were made at baseline and post intervention. Subjects were given adequate servings of either WG or RG products based on their caloric need and asked to keep records of grain consumption, bowel movements, and GI symptoms weekly. After six weeks, subjects repeated baseline testing. Significant decreases in total, LDL, and non-HDL cholesterol were seen after the WG treatments but were not observed in the RG treatment. During Week 6, bowel movement frequency increased with increased WG consumption. No significant differences in microbiota were seen between baseline and post intervention, although, abundance of order Erysipelotrichales increased in RG subjects who ate more than 50% of the RG market basket products. Increasing consumption of WGs can alter parameters of health, but more research is needed to better elucidate the relationship between the amount consumed and the health-related outcome.

Comportamiento de la lepra en la provincia de Las Tunas 2003-2012 / Behavior of Leprosy in Las Tunas province 2003-2012

Se realizó un estudio descriptivo de corte transversal, para determinar algunas características epidemiológicas de la incidencia de la lepra, que es una enfermedad transmisible, tan antigua como el hombre mismo. El universo estuvo constituido por los 103 casos notificados con lepra en la provincia de Las Tunas, en el período de enero de 2003 a diciembre de 2012. La información se obtuvo por las encuestas epidemiológicas existentes en el Departamento de Estadística de la Dirección Provincial de Salud y en el Centro Provincial de Higiene, Epidemiología y Microbiología. Se creó una base de datos en Epinfo versión 3.3.3, donde se tabularon los datos de las encuestas. El análisis de los resultados se expresó en números absolutos, tasas y porcentajes para su mejor interpretación, obteniéndose como resultado que la tasa de detección de casos tiene un comportamiento irregular, el año de mayor incidencia fue el 2009, con 20 casos. Se notificaron tres casos de lepra infantil; las formas paucibacilares representaron el 51,5 por ciento; el modo de detección más frecuente fue el espontáneo. Existe transmisión activa y todo ello puede ser reflejo de la ausencia de un trabajo consolidado en el programa de control de la enfermedad (AU)

A descriptive, cross sectional study was carried out to determine some of the epidemiological characteristics of the incidence of leprosy, which is a transmissible disease, as old as humankind. The universe was made up of the 103 notified leprosy cases in Las Tunas province from January, 2003 to December, 2012. The information was obtained from the epidemiological surveys in the Statistic Department of the Provincial Direction of Health in Las Tunas, and in the Provincial Epidemiology and Microbiology Hygiene Center. A data base was created in Epinfo version 3.3.3, where the information from the surveys was arranged in tables. The analysis of the results were expressed in absolute numbers, rates and percentages for its better interpretation, getting as results that the rate detection of the cases has an irregular behavior, and 2009 was the year with a greater incidence, with 20 cases. Three cases of infantile leprosy were notified; the paucibacillary forms represented the 51,5 percent; the most frequent way of detection was the spontaneous one. There is active transmission of the disease, which can be because of lack of a consolidated work in the program for control of the disease (AU)

Intraspecific variation in body size and shape in an andean highland anole species, Anolis ventrimaculatus (Squamata: Dactyloidae).

Variation in body characteristics related to lizard locomotion has been poorly studied at the intraspecific level in Anolis species. Local adaptation due to habitat heterogeneity has been reported in some island species. However, studies of mainland species are particularly scarce and suggest different patterns: high variability among highland lizards and poorly differentiated populations in one Amazonian species. We characterized inter population variation of body size and shape in the highland Andean Anolis ventrimaculatus, an endemic species from Western Colombia. A total of 15 morphometric variables were measured in specimens from the reptile collection of the Instituto de Ciencias Naturales, Universidad Nacional, Colombia. The study included individuals from seven different highland localities. We found size and shape sexual dimorphism, both of which varied among localities. Patterns of variation in body proportions among populations were different in both males and females, suggesting that either sexual or natural selective factors are different in each locality and between sexes. Since this species exhibits a fragmented distribution in highlands, genetic divergence may also be a causal factor of the observed variation. Ecological, behavioral, additional morphological as well as phylogenetic data, may help to understand the evolutionary processes behind the geographic patterns found in this species.

Breeding, growth and exploitation of brachyplatystoma rousseauxii castelnau, 1855 in the caqueta river, Colombia

The main life history traits of the large Amazonian migratory catfish Brachyplatystoma rousseauxii were determined in the Caqueta River, Colombia. The breeding season occurred during the rising and falling water periods. The size at first sexual maturity was significantly larger for females (88.5 cm Ls) than males (81.7 cm). Both males and females reproduce for the first time between their third and fourth year. The growth characteristics were estimated using length frequency analyses. Females grew systematically larger than males, the difference being about 9% after the first year and increasing to 12% for ten years old individuals. Mortality estimates, calculated from different models, some taking into account the effect of body size, ranged from 0.32 to 0.42 year-1 for natural mortality and from 0.72 to 0.82 year-1 for fishing mortality, indicating high fishing pressure in the Caqueta River, higher than in the Peruvian Amazon. Resulting exploitation rates (0.63 to 0.72) pointed towards overexploitation of the species in the Caqueta. The situation calls for a concerted management between the countries sharing this resource (Brazil, Colombia, and Peru) and potential solutions are proposed.

Se determinaron las principales características del ciclo biológico de dorado Brachyplatystoma rousseauxii en el río Caquetá, Colombia. La época reproductiva ocurre durante la transición del período de aguas altas a aguas en descenso. La talla de primera madurez sexual fue significativamente mayor en hembras (88,5 cm Ls) que en machos (81,7 cm). Tanto hembras como machos se reproducen por primera vez entre su tercer y cuarto año de vida. Los parámetros de crecimiento fueron estimados mediante el análisis de frecuencia de tallas. Las hembras alcanzan un mayor tamaño que los machos, con una diferencia de cerca del 9% en el primer año que luego aumenta hasta un 12% en el décimo año de edad. La estimación de mortalidad, calculada a partir de diferentes modelos, variaron entre 0,32 a 0,42 años-1 para la mortalidad natural y 0,72 a 0,82 años-1 para la mortalidad por pesca, lo que indica una alta presión de la pesca en el río Caquetá, mucho más elevada que en la Amazonía peruana. Las tasas de explotación resultantes (0,63 a 0,72) para el río Caquetá, señalan una sobre-utilización del recurso. La situación exige una gestión concertada entre los países que comparten y utilizan con elevada frecuencia este recurso amazónico (Brasil, Colombia y Perú), por lo que se proponen posibles estrategias de solución.

Intraspecific variation in body size and shape in an Andean highland anole species, Anolis ventrimaculatus (Squamata: Dactyloidae)

Variation in body characteristics related to lizard locomotion has been poorly studied at the intraspecific level in Anolis species. Local adaptation due to habitat heterogeneity has been reported in some island species. However, studies of mainland species are particularly scarce and suggest different patterns: high variability among highland lizards and poorly differentiated populations in one Amazonian species. We characterized inter population variation of body size and shape in the highland Andean Anolis ventrimaculatus, an endemic species from Western Colombia. A total of 15 morphometric variables were measured in specimens from the reptile collection of the Instituto de Ciencias Naturales, Universidad Nacional, Colombia. The study included individuals from seven different highland localities. We found size and shape sexual dimorphism, both of which varied among localities. Patterns of variation in body proportions among populations were different in both males and females, suggesting that either sexual or natural selective factors are different in each locality and between sexes. Since this species exhibits a fragmented distribution in highlands, genetic divergence may also be a causal factor of the observed variation. Ecological, behavioral, additional morphological as well as phylogenetic data, may help to understand the evolutionary processes behind the geographic patterns found in this species.

La diversificación fenotípica al interior de una especie en características de dimensiones corporales relacionadas con la locomoción de los lagartos, se ha estudiado poco en especies de Anolis. Los datos de algunas especies de isla revelan patrones distintos de variación geográfica y sugieren que la adaptación local, debida a la heterogeneidad del hábitat, ocurre a este nivel. Los estudios de especies de continente son particularmente escasos y sugieren patrones distintos: un lagarto altoandino altamente variable y poblaciones poco diferenciadas en una especie amazónica. Caracterizamos la variación inter poblacional en el tamaño y forma del cuerpo del lagarto altoandino Anolis ventrimaculatus, especie endémica del Oeste de Colombia. Encontramos variación geográfica en el dimorfismo sexual en tamaño y forma. El patrón de variación en las proporciones corporales entre poblaciones fue distinto en machos y en hembras, sugiriendo que las presiones de selección sexual o natural son diferentes en cada localidad. Dado que la especie exhibe una distribución fragmentada en alta montaña, la divergencia genética entre poblaciones puede ser otro factor causal de la variación observada. Datos ecológicos, etológicos y morfológicos adicionales, así como información filogenética puede contribuir al entendimiento de los procesos evolutivos responsables del patrón de variación geográfica encontrado en esta especie.

Caracterización de las enfermedades profesionales en Las Tunas en el período 1998 a 2009 / Characterization of occupational diseases in Las Tunas from 1998 to 2009

Las enfermedades profesionales son una importante causa de morbilidad, discapacidad e incluso muerte en la población adulta laboralmente activa. La identificación de las principales entidades etiológicas, los factores de riesgo causales y los grupos y poblaciones expuestas se ubican entre las principales acciones para la reducción y prevención de estas enfermedades. Se realizó una investigación observacional descriptiva sobre la incidencia de enfermedades profesionales en la provincia de Las Tunas, en el período comprendido desde enero de 1998 hasta diciembre de 2009. El universo estuvo constituido por los 331 casos, diagnosticados durante la mencionada etapa. Predominó la laringitis nodular crónica, con el 50,4 por ciento de los casos, la hipoacusia neurosensorial bilateral, con el 23,2 por ciento y las dermatitis por contacto, con el 8,2 por ciento, en segundo y tercer lugares, respectivamente. El mayor número de casos lo aportaron los grupos de edades, comprendidos entre 45 y 49 años; 50 y 54 años y 40 y 44 años. En el 46,2 por ciento de los trabajadores afectados en la serie se constató un periodo de exposición entre 15 y 29 años. Los municipios de Manatí, Puerto Padre y Las Tunas aportaron 62, 71 y 128 casos, respectivamente. No hubo un franco predominio de sexo ni de categoría ocupacional entre los afectados (AU)

Occupational diseases are an important cause of morbidity, disability and even death in active working adult population. The identification of the main etiological entities, causal risk factors and the groups and populations exposed are among the main actions taken for the reduction and prevention of such illnesses. An observacional, descriptive investigation on the incidence of occupational diseases in the province of Las Tunas was carried out from January, 1998 to December, 2009. The universe was constituted by 331 cases diagnosed during the above mentioned stage. Nodular chronic laryngitis showed a predominance in 50,4 percent of the cases, followed by bilateral neurosensorial hypoacusis with 23,2 percent and contact dermatitis with 8,2 percent, in the second and third places, respectively. Most cases were in the age groups between 45- 49, 50- 54 and 40- 44 years old. 46,2 percent of the workers affected in the series were exposed for a period between 15 and 29 years. The municipalities of Manatí, Puerto Padre and Las Tunas reported 62, 71 and 128 cases, respectively. There was no predominance concerning the sex and occupational category among the people affected (AU)

Rinitis alérgica: actualización y opciones de tratamiento por Medicina Natural y Tradicional / Allergic rhinitis: update and treatment options by Natural and Traditional Medicine

La rinitis alérgica es un problema de salud muy común y una de las principales causas de consulta médica en el mundo. En Cuba se afirma que es una enfermedad subdiagnosticada y subtratada, motivo que llevó a realizar la presente revisión bibliográfica, donde se tienen en cuenta sus características clínicas, los elementos del diagnóstico y las opciones de tratamiento; con énfasis en el uso de la medicina natural y tradicional. Se definió una estrategia de búsqueda mediante palabras clave y descriptores relacionados, la que fue empleada en la gestión de información en los recursos disponibles en Infomed, tales como PubMed, HINARI, EBSCO y LILACS. Considerando que la enfermedad es un complejo de síntomas con un trasfondo genético, asociado a las reacciones de hipersensibilidad frente a alérgenos comunes, incluyendo los ácaros caseros, la caspa animal y el polen de hierbas, árboles y semillas; que la respuesta inflamatoria conduce a síntomas diversos, locales y sistémicos, que suelen ser molestos para el paciente y afectar su calidad de vida; que para su control se emplean numerosos fármacos como antihistamínicos, esteroides, antileucotrienos e inmunoterapia; que la aplicación de la acupuntura y otros métodos de la medicina tradicional y alternativa es un tema de debate en la actualidad, hasta 24 diferentes puntos de acupuntura han sido empleados en ensayos clínicos sobre la rinitis. Se puede concluir que la acupuntura se considera una alternativa muy segura en el tratamiento de la rinitis alérgica; los diferentes esquemas de tratamiento alivian o resuelven los síntomas y modifican algunos de los mediadores moleculares de la enfermedad, como las interleucinas(AU)

Allergic rhinitis is a very common health problem and one of the main causes of medical consultation all over the world. In Cuba, it is a subdiagnosed and subtreated illness, a reason that led to the present bibliographical review that takes into account its clinical characteristics, elements of diagnosis and options of treatment, emphasizing the use of natural and traditional medicine. A search strategy, using key words and related descriptors, was defined and used for the information management in the resources available on Infomed, such as PubMed, HINARI, EBSCO and LILACS. Considering that this illness is a symptoms´ complex with a genetic background, associated with reactions of hypersensitivity to common allergens- including home-bred acarus, animal dandruff and grass, trees and seeds pollen-; that the inflammatory response leads to diverse, local and systemic symptoms which usually annoy the patient and affect the quality of life; that there are numerous medicines like antihistamines, steroids, antileukotrienes and immunotherapy for the control of the illness; that the application of acupuncture and other methods of traditional and alternative medicine is a debate topic at present, up to 24 different acupunctural points have been used in clinical essays on the rhinitis. It is possible, then, to conclude that acupuncture is considered a very safe alternative for the treatment of allergic rhinitis. The different treatment schemes relieve or solve the symptoms and modify some of the molecular mediators of the illness, like interleukins(AU)

Conocimientos sobre leptospirosis en trabajadores agrícolas de Guaro Holguín / Knowledge about leptospirosis of agricultural workers from Guaro Holguín

Se realizó un estudio descriptivo transversal para determinar el nivel de conocimientos sobre los factores de riesgo favorecedores de la leptospirosis, presentes en los trabajadores de la Casa de Cultivo de Guaro 2, perteneciente al área de salud de Guaro, durante el periodo comprendido de marzo a junio de 2010. El universo coincidió con la muestra y estuvo conformado por 41 trabajadores, el 100 por ciento de los expuestos a riesgo por las labores agrícolas que desarrollan. El grupo de estudio se caracterizó según las variables demográficas y se les aplicó una encuesta para conocer la información que poseían sobre leptospirosis. La información se presentó en tablas de distribución de frecuencia y se utilizó el porciento. Predominó en la muestra el sexo masculino, el grupo de edad entre 35 y 44 años y el 12 grado como nivel escolar vencido. El 43,9 por ciento identificó erróneamente la transmisión de la enfermedad por picadura de insectos. El 63,4 por ciento relacionó la diarrea entre los síntomas de la infección. El uso del preservativo fue mencionado por el 53,6 por ciento de los participantes como medida de prevención. El perro, el cerdo y el caballo son los animales que con mayor frecuencia conviven con los trabajadores. La infestación por roedores fue frecuente en las casas y sus alrededores. Se recomienda realizar una intervención educativa para elevar el nivel de conocimientos sobre los factores de riesgo de la leptospirosis (AU)

A descriptive, cross-sectional study was carried out to determine the level of knowledge of the workers of Guaro 2 Greenhouse- belonging to the Guaro health area- on the favoring risk factors of leptospirosis, during the period from March to June, 2010. The universe matched the sample and was formed by 41 workers, 100 per cent of those exposed to risk due to the agricultural works they do. The group of study was characterized according to the demographic variables and a survey was applied to know the information these people have on leptospirosis. The information was organized with percents and in frequency distribution charts. The sample showed prevalence for the masculine sex, the 35-44 age group and 12th grade as a completed school level. A group of 43,9 per cent mistakenly identified the transmission of the illness as coming from insects´ bites and 63,4 per cent mentioned diarrhea among the symptoms of the infection. The use of the condom was mentioned by 53,6 per cent of the participants as a prevention measure. Dogs, pigs and horses are the animals which frequently lived with the people and rodents infestation was frequent in the houses and surroundings. An educational intervention to increase the level of knowledge on the risk factors of leptospirosis is recommended (AU)

Los determinantes de la salud en la provincia de Las Tunas 2002 2006 / Determinants of health in the province of Las Tunas 2002 2006

El estado de salud de la población es el resultado de una compleja interacción entre factores de diversa naturaleza: individuales, sociales, económicos, físicos, biológicos y otros, agrupados bajo el término de determinantes de salud. Como parte de un proyecto para estimar los elementos condicionantes del estado sanitario de la población cubana se describen 15 indicadores, agrupados en cuatro dimensiones de la realidad social y de salud de los ocho municipios de la provincia de Las Tunas, entre los años 2002 y 2006. A pesar de contar con limitada infraestructura económica de base agrícola y producción mercantil, junto a una escasa cobertura de sistemas para el manejo de residuales y de agua potable, la provincia dispone de unidades de salud en todos los municipios, con una cobertura de 26,4 médicos de familia por cada 10 mil habitantes. La mortalidad infantil en el 2006 fue de 4,7 por mil nacidos vivos, en tanto predominaron las enfermedades crónicas en el cuadro de salud, ocupando nueve de las primeras diez causas de muerte. Se hace énfasis en la importancia de la voluntad política, la intersectorialidad y el empleo del capital humano en la producción social de la salud (AU)

The state of the population´s health is the result of a complex interaction between factors of diverse nature: individual, social, economic, physical, biological and others, grouped under the term of health determinants. Fifteen indicators grouped in four dimensions of the social reality and health of the eight municipalities of the province of Las Tunas between the years 2002 and 2006 are described here as part of a project to estimate the determining elements of the sanitary state of the Cuban population. Despite having a limited economic infrastructure of agricultural and mercantile production base, along with a scarce system coverage for the handling of sewage and drinking water, the province has health units in all the municipalities, with a coverage of 26,4 family doctors per every 10 thousand inhabitants. Infant mortality in 2006 was represented by the figure of 4, 7/ 1 000 born alive, while there was a predominance of chronic illnesses in the health profile, occupying nine of the first ten causes of death. There is strong emphasis on the importance of the political will, interdepartmentality and the use of the human capital on the social production of health (AU)

Diferenciales de salud y una aproximación mediante el empleo del coeficiente de Gini y el índice de concentración en las provincias cubanas, 2002-2008 / Health's differentials and a approaching to use of Gini's coefficient and the rate of concentration in the Cuban provinces, 2002-2008

INTRODUCCIÓN: No existen muchas publicaciones científicas que aborden los diferenciales de salud entre las provincias de Cuba, ni que documenten los principales factores que impactaron en los resultados de salud de la población durante el período 1989 - 2000. En el año 2002 Fidel Castro destacó la existencia de una serie de errores de conducción y organización durante ese periodo, que a su criterio debilitaron el sistema de salud cubano y propiciaron la aparición de "determinadas desigualdades". OBJETIVO: Describir los principales diferenciales de salud existentes entre los distintos territorios de Cuba (factores determinantes de la salud de los cubanos) durante el período estudiado (2002-2008). MÉTODOS: Se utilizó como unidad geográfica a la provincia. Las catorce provincias cubanas fueron estratificadas sobre la base de tres ejes fundamentales: demográfico, económico y condiciones de vida, con vista a identificar posibles diferenciales de salud (inequidades en salud y en servicios de salud) mediante el empleo de la técnica del coeficiente de Gini y del índice de concentración. RESULTADOS: Se muestran los principales factores o variables con diferenciales de salud presentes en el país por provincias durante el período estudiado, se identificaron los factores o variables que mayores diferenciales exhibieron por cada uno de los ejes demográfico (densidad poblacional), económico (producción mercantil) y condiciones de vida (cobertura sanitaria). Se definen las diferencias existentes entre cada una de las provincias y por regiones y las características muy particulares de la capital cubana como provincia. CONCLUSIONES: Se confirma la hipótesis de que a pesar de la férrea voluntad política del estado de evitar inequidades en salud, aún se observan diferenciales no importantes en el comportamiento de las variables estudiadas por cada uno de los ejes de análisis entre provincias. No obstante, existen diferencias entre el comportamiento de esos diferenciales de acuerdo con los ejes de análisis, aspectos que deben ser y fueron considerados durante el proceso de diseño de políticas sanitarias, de reorganización de los servicios de salud, de formación de capital humano y de abordaje intersectorial de los determinantes no médicos de la salud durante los años más duros del período especial, lo que viene a confirmar el modelo teórico desarrollado previamente por los autores.

INTRODUCTION: There is a lack of scientific publications approaching the health differentials among the Cuban provinces and of to document the leading factors with impact on the health results in the population during the period 1989-2000. In 2002 Fidel Castro Rus emphasized on the existence of errors in the management and organization during above mentioned period, that according to his criterion to weaken the Cuban health system and led to appearance of "determined inequalities". OBJECTIVE: To describe the leading health differentials present among the different Cuban territories (determinant health factors for Cubans) during the study period (2002-2008). METHODS: The province was used as geographical unit. The fourteen Cuban provinces were stratified on the base of the three fundamental bases: demographic, economic and life conditions to identify the potential health differentials (inequalities in health and in its services) using the Gini's coefficient technique and the concentration's index. RESULTS: The leading factors or variables with health differentials present in our country by provinces during the study period are showed, identifying the factors or variables with greater differentials by each of the demographic bases (population density), economic (commercial production) and life conditions (health coverage). The differences present among each of the provinces and regions are defined as well as the very particular characteristics of the Cuban capital as province. CONCLUSIONS: The hypothesis that despite the strong political and state will to avoid health inequalities, still there are no-significant differences in the behavior of study variables by each of the bases of analysis among provinces. Nevertheless, there differences among the behavior of such differentials according to analysis's bases, features that be and were considered during the process of health politics design, of reorganization of health services, of human resource training and the intersectorial approach of non-health physicians determinants during the more hard year of special period, confirming the theoretical model previously developed by the authors.

Diferenciales de salud y una aproximación mediante el empleo del coeficiente de Gini y el índice de concentración en las provincias cubanas, 2002-2008 / Health's differentials and a approaching to use of Gini's coefficient and the rate of concentration in the Cuban provinces, 2002-2008

INTRODUCCIÓN: No existen muchas publicaciones científicas que aborden los diferenciales de salud entre las provincias de Cuba, ni que documenten los principales factores que impactaron en los resultados de salud de la población durante el período 1989-2000. En el año 2002 Fidel Castro destacó la existencia de una serie de errores de conducción y organización durante ese periodo, que a su criterio debilitaron el sistema de salud cubano y propiciaron la aparición de determinadas desigualdades. OBJETIVO: Describir los principales diferenciales de salud existentes entre los distintos territorios de Cuba (factores determinantes de la salud de los cubanos) durante el período estudiado (2002-2008). MÉTODOS: Se utilizó como unidad geográfica a la provincia. Las catorce provincias cubanas fueron estratificadas sobre la base de tres ejes fundamentales: demográfico, económico y condiciones de vida, con vista a identificar posibles diferenciales de salud (inequidades en salud y en servicios de salud) mediante el empleo de la técnica del coeficiente de Gini y del índice de concentración. RESULTADOS: Se muestran los principales factores o variables con diferenciales de salud presentes en el país por provincias durante el período estudiado, se identificaron los factores o variables que mayores diferenciales exhibieron por cada uno de los ejes demográfico (densidad poblacional), económico (producción mercantil) y condiciones de vida (cobertura sanitaria). Se definen las diferencias existentes entre cada una de las provincias y por regiones y las características muy particulares de la capital cubana como provincia. CONCLUSIONES: Se confirma la hipótesis de que a pesar de la férrea voluntad política del estado de evitar inequidades en salud, aún se observan diferenciales no importantes en el comportamiento de las variables estudiadas por cada uno de los ejes de análisis entre provincias. No obstante, existen diferencias entre el comportamiento de esos ...(AU)

INTRODUCTION: There is a lack of scientific publications approaching the health differentials among the Cuban provinces and of to document the leading factors with impact on the health results in the population during the period 1989-2000. In 2002 Fidel Castro Rus emphasized on the existence of errors in the management and organization during above mentioned period, that according to his criterion to weaken the Cuban health system and led to appearance of determined inequalities. OBJECTIVE: To describe the leading health differentials present among the different Cuban territories (determinant health factors for Cubans) during the study period (2002-2008). METHODS: The province was used as geographical unit. The fourteen Cuban provinces were stratified on the base of the three fundamental bases: demographic, economic and life conditions to identify the potential health differentials (inequalities in health and in its services) using the Gini's coefficient technique and the concentration's index. RESULTS: The leading factors or variables with health differentials present in our country by provinces during the study period are showed, identifying the factors or variables with greater differentials by each of the demographic bases (population density), economic (commercial production) and life conditions (health coverage). The differences present among each of the provinces and regions are defined as well as the very particular characteristics of the Cuban capital as province. CONCLUSIONS: The hypothesis that despite the strong political and state will to avoid health inequalities, still there are no-significant differences in the behavior of study variables by each of the bases of analysis among provinces. Nevertheless, there differences among the behavior of such differentials according to analysis's bases, features that be and were considered during the process of health politics design, of reorganization of health services, of human ...(AU)

Pronóstico y estacionalidad de la leptospirosis en Las Tunas año 2008 / Prediction and seasonal nature of the leptospirosis in Las Tunas year 2008

La capacidad de predicción constituye un aspecto primordial para evaluar el comportamiento futuro de determinados problemas a corto, mediano o largo plazo, relacionados con el estado de salud de la población. En el caso particular del presente trabajo, se estimó el pronóstico de los posibles casos de Leptospirosis por constituir un problema de salud para nuestro territorio. A partir del análisis de sus series cronológicas desde el año 2001 al 2007 se realizó un estudio descriptivo, con el objetivo de determinar los pronósticos y la estacionalidad de la leptospirosis en Las Tunas en esta etapa. Se determinó la estacionalidad, la curva de expectativa y se construyó un canal endémico. Se confeccionó el pronóstico para este año por el método de Alisamiento Exponencial de Tres Parámetros. Se obtuvo un alza probable en los meses de agosto y octubre diciembre, lo cual guarda relación con la estacionalidad histórica encontrada para esta enfermedad, según sus principales factores de riesgo. El establecimiento de límites para la acción facilita la toma de decisiones de manera precoz, en tanto los cambios en el número de casos evidencien un incremento hacia la alerta o la emergencia. De igual modo, permite dar seguimiento y determinar la eficacia de las medidas implementadas como parte de la vigilancia, con lo que se convierte en un instrumento para la evaluación de este sistema, en busca de su perfeccionamiento y la detección de errores, incumplimientos o desviaciones de los procedimientos establecidos(AU)

The capacity to predict constitutes a paramount aspect to evaluate the future behavior of certain problems AT short, medium or long terms, related to the state of the population's health. In the case of the present work, the prediction of the possible cases of leptospirosis was done because they constitute a problem of health in our territory. A descriptive study starting from the analysis of the chronological series from the year 2001 to 2007 was carried out, with the objective of determining the prediction and the seasonal nature of leptospirosis in Las Tunas. The seasonal nature and the expectation curve were determined and an endemic channel was built. The prediction was done for this year by the Three- Parameter exponential isolation method . It was found out that leptospirosis is more likely in the months of August and October - December, what keeps the relationship with the historical seasonal nature for this illness according to their main risk factors. The setting up of limits for action facilitates the decision- making in a precocious way, as long as the changes in the number of cases evidence an increment towards the alert or the emergency. In a same way, it allows for follow-up and to determine the effectiveness of the measures implemented as part of the surveillance, with which it becomes an instrument for the evaluation of this system, in search of their improvement and the detection of errors, non- fulfilments or deviations of the established procedures(AU)

Estratificación epidemiológica y tendencia de la Tuberculosis en el siglo XXI Las Tunas: 2000 2006 / Epidemiological Stratification and Tendency of Tuberculosis in the XXI Century Las Tunas, 2000 - 2006

Se realizó un estudio descriptivo del comportamiento de la tuberculosis en la provincia de Las Tunas en el siglo XXI (2000 al 2006), con el propósito de encaminar este trabajo a la posible eliminación de dicha enfermedad en el territorio después del 2015. Se revisaron las series cronológicas y las historias epidemiológicas de los casos diagnosticados, según los criterios del Programa Nacional de Prevención y Control, y se consultaron los anuarios estadísticos nacionales y provinciales en la Estadística Provincial y del Centro Provincial de Higiene, Epidemiología y Microbiología. Se realizaron las tasas de incidencia por 100 mil habitantes, para establecer las tendencias por años, grupos de edades, y municipios. Las estratificaciones epidemiológicas se trabajaron por el riesgo absoluto con escalas de alto, mediano y bajo riesgos. Los principales resultados encontrados fueron: la incidencia se comportó desde la superior con 13,2 por un millón de habitantes (2000) hasta la inferior de 6,5 por un millón de habitantes (2006); se observó una tendencia descendente. Los grupo de edades de mayor riesgo de enfermar fueron los de 35 a 44 años, con tasa de 11,7 x 100 mil habitantes, seguido de los de 55 a 64 años, con una tendencia ligeramente ascendente desde los 55 años. En el alto riesgo de enfermar se encuentran los municipios Tunas y Majibacoa. En el diagnóstico por categorías la mayor media porcentual fue en el examen directo con 54,9 por ciento. No se cumplió el indicador establecido en el Programa y las categorías clínico-radiológicas y extrapulmonares con 17,2 por ciento, respectivamente, están por encima de los parámetros establecidos. El diagnóstico se realizó en la Atención Primaria de Salud en el 72,6 por ciento(AU)

A descriptive study about the behaviour of Tuberculosis in Las Tunas province in the XXI century (2000 to 2006) was carried out with the purpose of guiding our work to the possible elimination of this illness in the territory after 2010. The chronological series and the epidemic histories of the diagnosed cases were reviewed, according to the approaches of the National Program for Prevention and Control and the national and provincial statistical annuals were consulted in the Provincial Statistics Department and in the Provincial Center of Hygiene, Epidemiology and Microbiology. The rates of incidence x 100 000 inhabitants was done to establish the tendencies by years, groups of ages and municipalities. The epidemic stratifications were worked out by the absolute risk with scales of High, Medium and Low Risk. The main results were: incidence which behaved from the superior with 13.2 x 1000 000 hbs (2000) until the inferior 6,5 x 100 000 hbs (2006), a descending tendency being observed. The group of age at more risk of getting sick were those who went from 35 to 44 years, with a rate of 11,7 x 100 000 hbs, followed by those of 55 to 64 years, with a slight upward tendency from the 55 years. At the high risk of getting sick according to the epidemic stratification are the municipalities of Tunas and Majibacoa. In the diagnosis according to categories, the highest percentage was the direct exam, with 54,9 per cent. The indicator settled down in the Program was not completed. The radiological -clinical categories and extrapulmonar with 17,2 per cent, respectively, they are above the established parameters. The diagnosis was carried out in the Primary Attention of Health in 72,6 per cent (AU)

Evaluación de la historia clínica de pacientes hipertensos de acuerdo a indicadores de calidad del programa de hipertensión arterial, Clínica Assbasalud La Enea (ESE) 2004-2007 / Medical records evaluation pf hypertensive patients according to indicators of quality of the hipertension program, ASSBASALUD Enea (ESE) clinic 2004-2007

Objetivo: Evaluar la calidad de la historia clínica del programa de hipertensión arterial en los pacientes inscritos en la clínica la ENEA de ASSBASALUD ESE (Centros urbanos de Atención en Seguridad Social, Bienestar y Salud, Empresa Social del Estado, Manizales, Colombia) entre los años 2005-2007. Materiales y métodos: El estudio aplicado fue de corte transversal y se ejecutó revisando las historias clínicas de los pacientes hipertensos que asisten al programa de seguimiento de la hipertensión arterial en la clínica mencionada. Se estudiaron variables como: edad, escolaridad, seguridad social, sexo, tarjetas elaboradas, asistencia al programa, asistencia al control, historia clínica, órgano blanco, guías de atención. Resultados: En las historias clínicas no aparece registrado el dato de escolaridad (94,5 porciento), en la revisión del órgano blanco, se encontró solo en 177 (77 por ciento), valorado el órgano blanco riñón, el corazón en 116 (53,5 por ciento) pacientes, y la retina en 64(29,5 por ciento). Además 92,6 por ciento de los pacientes tenían diligenciadas sus tarjetas de control, solo el 39,6 por ciento asisten a los controles. Conclusiones: La mayor falencia en la evaluación del paciente hipertenso es cómo se enfocan a estos pacientes en los niveles de atención básica que lleva a un seguimiento erróneo...