Servicio de información factográfica orientado a los directivos de salud en Cuba / Factographic Information Services Oriented to Cuban Health System Managers

La posibilidad de disponer de datos relevantes en el momento oportuno es actualmente un punto de apoyo muy útil para argumentar científicamente las tareas de proyección y de toma de decisiones. A partir del estudio de la bibliografía y de la observación del funcionamiento de un servicio orientado a los directivos de la salud en Cuba, se proyectó la aplicación de la información factográfica como valor agregado al servicio Información a Directivos de la Salud ( Infodir ), que se brinda actualmente en el Centro Nacional de Información de Ciencias Médicas. Se detallan las características de la información factográfica como servicio y las peculiaridades de la comunidad de usuarios que la utilizará. Se enumeran sus procesos y salidas como sistema y se examinan de modo particular los productos que ofrece. Este servicio se suministra de manera automatizada con un diseño amigable.

The possibility of disposing of relevant data at the right time is currently one of the most useful sources to scientifically support projection tasks and decision making processes. Based on the study of bibliography and the observation of the performance of a service oriented to health system managers, the application of factographic information was implemented as aggregated value to the Health System Manager Service (Infodir), currently available at the Medical Science National Information Centre. The characteristics of the factographic information as a service are described, as well as the peculiarities of the user community who will make use of it. Its processes and outcomes as a system are enumerated, and the offered products are specially analyzed. This service is provided automatically, with a friendly design.

Infodir: la gestión de información para los directivos de salud / Infodir: Information Management for Health Care Directors

Se estudian los requisitos esenciales para la creación de un servicio de información a dirigentes, los antecedentes, así como la evolución histórica y el estado actual de Infodir, el servicio de gestión de información para los directivos de la salud en Cuba, que ofrece el Centro Nacional de Información de Ciencias Médicas desde el año 2001, primero en forma de boletín y después como página Web.

The essential requisites for the creation of an information center for the directors are studied, as well as the background, historic evolution, and the current state of Infodir, the information management system for the health care system directors in Cuba, offered by the Medical Sciences National Information Center since the year 2001, first as a publication and later as a web page.

Association of genetic markers within the KIT and KITLG genes with human male infertility.

BACKGROUND: There is much evidence involving the KIT tyrosine kinase receptor and its ligand KITLG in the survival and proliferation of germ cells. Animal models and functional studies in humans suggest that this signalling pathway plays a role in male infertility. METHODS: We studied three and two single-nucleotide polymorphisms (SNPs) (rs3819392, rs3134885, rs2237012, rs10506957 and rs995030) located within the genomic region of the KIT and KITLG genes, respectively. A total of 167 idiopathic infertile men (sperm counts <5 million spz/ml) and 465 unrelated healthy controls from the same geographical region were genotyped for these SNPs. RESULTS: We found a statistically significant association of the rs3819392 polymorphism, which is located within the KIT gene, with idiopathic male infertility. In addition, a deviation from the Hardy-Weinberg equilibrium (HWE) law was observed for rs10506957 polymorphism within the KITLG gene only in the infertile group. CONCLUSIONS: Our data indicate that the KIT/KITLG system may be involved in a low sperm count trait in humans.

Precipitating/aggravating factors of porphyria cutanea tarda in Spanish patients.

Erythrocyte uroporphyrinogen decarboxylase (UROD) activity was measured to classify 118 Spanish patients with porphyria cutanea tarda (PCT) into three subtypes: sporadic-, familial- and type III-PCT. Seventy-four patients (63%) had eythrocyte UROD activity within the normal range (74% to 126% of the mean activity of 43 healthy controls) and were classified as sporadic-PCT (47%) or as type III-PCT (16%) whenever a family history of PCT was documented. Forty-four patients (37%) had decreased UROD activity and were classified as familial-PCT. The frequency of both familial-PCT and type III-PCT was higher than reported in other countries. The clinical expression of PCT was associated with the coexistence of two or more risk factors in 80% of the sporadic-PCT patients and in 89% of the familial-PCT patients. Hepatitis C virus and alcohol abuse were risk factors frequently found in these patients, being unrelated to age of onset of skin lesions. A heavy alcohol intake was the main risk factor for type III-PCT. Estrogens appeared as a precipitating factor for women with familial-PCT. The H63D mutation in the hemochromatosis type 1 gene was more frequently found than the C282Y mutation. Both mutations appeared to play a role as precipitating factors in sporadic-PCT when associated with hepatitis C virus infection and alcohol abuse.

Enhanced expression of Fc alpha receptor I on blood phagocytes of patients with gram-negative bacteremia is associated with tyrosine phosphorylation of the FcR-gamma subunit.

Sepsis caused by gram-negative bacteria is a common finding having high incidence and mortality. Fc alpha RI (CD89), a receptor for immunoglobulin A (IgA), has been shown to mediate bacterial phagocytosis, which might play a role in the pathogenesis of sepsis. In this study the expression and function of Fc alpha RI were analyzed on blood monocytes and neutrophils of patients with bacteremia. We found a marked increased in expression of the alpha- and gamma-subunits of the Fc alpha RI on both types of cells in patients with gram-negative bacteremia, but not in patients with gram-positive bacteremia. This increase was independent of serum IgA levels. Fc alpha RI M(r) was lower on cells from gram-negative patients than on cells from controls (50-65 kDa versus 55-75 kDa), despite a similar 32-kDa backbone, indicating altered glycosylation. Increased levels of Fc alpha RI on blood phagocytes correlated with enhanced serum IL-6 levels, but not with IFN gamma or TNF-alpha. FcR-gamma chain associated with Fc alpha RI was phosphorylated in patients neutrophils, indicating functional engagement of this receptor during gram-negative sepsis. Increased expression and activation of Fc alpha RI-gamma 2 complexes following gram-negative infections suggests its involvement in host defense against bacteria.

Peripheral iron metabolism in patients with focal cerebral ischemia.

To ascertain the possible role of iron as a risk factor for cerebral ischemia, we studied the serum levels of iron, transferrin and ferritin in 42 patients between the third and seventh days after a cerebral ischemic event (transient ischemic attack, reversible ischemic neurological deficit or cerebral infarction) and in 62 matched controls. The serum levels of iron did not differ significantly between cerebral ischemic patient and control groups. Serum transferrin levels were lower and ferritin higher in stroke patients than in controls. These values were not influenced by age, blood pressure, or smoking and alcohol drinking habits. These results suggest that iron stores could be related to the risk for cerebral ischemia.

Epidermotropic metastatic melanoma. Are the current histologic criteria adequate to differentiate primary from metastatic melanoma?

A case is reported of a patient with a lentiginous acral melanoma of the heel that was excised and recurred 3 years later at the margin of the previous scar. After another 3 years, a group of five small lesions appeared in the thigh that were considered to be junctional and epidermotropic metastases. The authors question the current histologic criteria for differentiating junctional and epidermotropic metastases of previous melanomas from multiple primary melanomas. It is concluded that the clinical history is of primary importance in reaching a correct diagnosis; histologic studies are not sufficient.

Intestinal zinc absorption in cirrhotic patients.

We studied intestinal zinc absorption and daily urinary zinc excretion in 13 healthy controls and 27 cirrhotic patients (14 alcoholics, 13 non-alcoholics) with normal serum creatinine levels. Intestinal zinc absorption was determined by the oral zinc tolerance test. Serum levels were significantly lower in cirrhotics, whether alcoholic or non-alcoholic, than in healthy controls (6.2 +/- 2.1 mumol/L vs. 11.6 +/- 2.1 mumol/L; p less than 0.001). Daily urinary zinc excretion was significantly higher in alcoholic cirrhotics (17.6 +/- 9.4 mumol/d vs. 11.4 +/- 4.1 mumol/d; p less than 0.05). Intestinal zinc absorption was significantly reduced in cirrhotics and correlated with the degree of liver dysfunction. During the oral tolerance test, urinary zinc excretion was not significantly higher in cirrhotics than in controls. We conclude that the low serum zinc levels in cirrhotics are of multifactorial origin. Impaired intestinal absorption seems to play a role, particularly in patients with more severe liver dysfunction, but increased urinary excretion may contribute to zinc deficiency in alcoholics.