Nutritional and food protection against epidemic emerging neuropathy. Epidemiological findings in the unique disease-free urban area of Cuba.

A survey was conducted through the SECUBA (SEguridad alimentaria en CUba y Buena Alimentación) research program in Cuban healthy smokers living in Guantánamo and in Havana. The aim of the survey was to investigate biological and nutritional factors connected with the occurrence of zero epidemic neuropathy (EN) observed in Guantánamo urban area since the disease emerged in Cuba. Blood riboflavin status and carotenoid and selenium concentrations were higher in Guantánamo than in Havana smokers. Food dietary quantities of plantain banana, pepper (Capsicum spp.), bovine meat and milk products were higher in Guantánamo. Inversely, foods rich in cholesterol, especially eggs, were more consumed in Havana. Through riboflavin, carotenoid and selenium contents and specific antioxidants substances (indoleamines, capsaicin), the foods more consumed in Guantánamo could be considered as EN protective factors. Disease protective effects could be exerted via enhancement of defence mechanisms against free radical damage and related mechanisms focused on redox recycling of glutathione and local protection from carotenoids. Finally, the results of the present study should help Cuba, through a better EN control, to improve long-term food safety and define healthier dietary habits.

Relation between serum lipoperoxide concentrations and iron or copper status over one year in Cuban adult men.

The aims of this study were to determine the relations between iron and copper status and lipid peroxidation at different periods over one year in low-income and low-energy intake healthy subjects. The study was conducted in 199 middle-aged healthy Cuban men from March 1995 to February 1996. Iron status was assessed by the determination of serum ferritin, transferrin saturation, whole blood hemoglobin and iron intakes. Copper status was evaluated by the determination of serum copper and copper intakes. Serum thiobarbituric acid substances (TBARS) determination was used as an index of lipid peroxidation. Rank correlations were observed between serum TBARS concentrations and iron or copper status indices at different periods. In period 3 (end of the rainy season), serum TBARS and ferritin concentrations were maximum whereas blood hemoglobin levels and iron intake were minimum. Serum TBARS concentrations were significantly higher than the reference values of the laboratory whereas, iron and copper status were within the reference ranges. These results suggested that iron and copper status may be associated with lipid peroxidation in subjects without metal overloads and that variations over the year needed to be taken in account.

Vitamin B intake and status in healthy Havanan men, 2 years after the Cuban neuropathy epidemic.

A prospective epidemiological study was carried out over 1 year to evaluate vitamin B complex dietary intake and status in Cuba, 2 years after the Cuban neuropathy epidemic of 1993. Of the 199 healthy middle-aged men selected, 141 completed the study. Volunteers were followed up every 3 months for 1 year. Dietary intake and status of thiamin, riboflavin, vitamin B6, folate and vitamin B12 were assessed each time. The dietary intake of vitamin B complex was low, particularly in June and July (folate), and October (thiamin). A deficient status was observed for vitamin B complex, except for vitamin B6. Vitamin B complex intake and status varied over the year. However, dietary intake and status were poorly related. The results prove that healthy Cuban men represent a vulnerable population in terms of vitamin B complex status and stress the necessity to both promote preventive multivitamin supplementation and produce local food rich in vitamin B complex.

Seasonal variations of antioxidant imbalance in Cuban healthy men.

OBJECTIVE: To determine the antioxidant imbalance in healthy Cuban men 2y after the end of the epidemic neuropathy (50 862 cases from 1991 to 1993) and to evaluate its change over 1 y. DESIGN: Prospective study. SETTING: La Lisa health centres (Havana, Cuba). SUBJECTS: One-hundred and ninety-nine healthy middle-aged men were selected and 106 completed the study. Subjects were studied at 3 month intervals over 1 year. INTERVENTIONS: No invervention. MAIN OUTCOME MEASURES: An assessment of dietary intake and the determination of blood lipid peroxides (TBARS), glutathione, diglutathione, glutathione peroxidase, superoxide dismutase, vitamin E, carotenoids, copper, zinc and selenium were performed at each period. RESULTS: While dietary zinc, vitamins C and E, carotenoids and fat dietary intakes and blood concentrations were low for adult men compared to international reference ranges, serum TBARS concentrations were high at every period. Some significant seasonal variations were observed. The lowest carotenoids (P < 0.002) and vitamin C(P = 0.0001) intakes, serum beta-carotene (P = 0.0001) and lutein/zeaxanthin (P < 0.05) concentrations, and the highest blood TBARS (P = 0.0001) and diglutathione (P < 0.001) concentrations were observed at the end of the rainy season (October). This period seemed to pose the greatest risk of antioxidant imbalance. CONCLUSIONS: Cuban men still represent a vulnerable population in terms of antioxidant imbalance. A national program of vegetable growing and increase in fruit and vegetable consumption is now evaluated in Cuba.

Vitamin and nutritional status in Cuban smokers and nonsmokers in the context of an emerging epidemic neuropathy.

A prospective survey was conducted in a random sample of smokers (SMO) and non-smokers (NON) men living in Havana. The aim of the survey was to investigate metabolic and dietary parameters discriminating between SMO and NON volunteers, which could explain underlying mechanisms to the higher risk of Epidemic Neuropathy (51,000 reported cases in Cuba from late 1991) previously demonstrated in the Cuban smoker. Forty three blood markers were determined and dietary intakes evaluated during 4 seasonal periods. alpha-carotene, beta-carotene, beta-cryptoxanthin, total carotenoids and riboflavin blood concentrations were lower in SMO vs. NON subjects. Activities of glutathione reductase and butryrylcholinesterase were lower in the SMO group, as did total protein levels. Copper and thiocyanates were higher in SMO subjects. Most of the dietary parameters did not differ between the two groups of volunteers. Low biologically available quantities of carotenoids and riboflavin from low dietary intakes and depletion through smoking would be the main precipitating factors of Epidemic Neuropathy. Protein depletion and copper delivery via tobacco smoke, sunlight exposure, level of physical activity and high consumption of cigarettes, in a context of low dietary supplies concerning especially B vitamins, were probably aggravating factors through oxidative stress and impairment of cyanide detoxification.

Estudio morfológico del acetábulo humano: biometría / Morfological study of the human acetabulum: biometry

Se realizó un estudio biométrico del acetábulo con el fin de aclarar el problema del aflojamiento mecánico en el postoperatorio alejado del reemplazo total de cadera; teniendo en cuenta que el acetábulo está anatómicamente diseñado para soportar y transmitir las cargas. En 150 acetábulos, se midieron (entre otros accidentes): su altura; su diámetro anteroposterior y su profundidad. Se comprobó que el acetábulo no es hemisférico sino ojival, con un predominio de la altura sobre el diámetro anteroposterior de 5,86 mm. promedio. Se observó que la distancia entre el vértice real del acetábulo y el vértice del triángulo isósceles, cuya base es la línea que une los dos cuernos de la cara semilunar, es de 24,3 mm promedio y que constituye la zona de elasticidad en el momento de la transmisión de las cargas

[Trace elements balance in treated phenylketonuria children. Consequences of selenium deficiency on lipid peroxidation]. / Equilibre des oligoelements chez l'enfant phenylcetonurique traite. Consequences de la carence en selenium sur la peroxidation lipidique.

We studied Ca and Mg and trace elements (Zn, Cu, Fe, Mn, Se) in 15 P.K.U. children treated with strict Phe-reduced diet and in a control group. P.K.U. children are significantly lower (p < 0.01) plasma and erythrocyte Se as well as significantly lower (p < 0.01) activities of Glutathione-Peroxidase (GSH-Px), a seleno-dependent enzyme in erythrocytes and in plasma. Concomitantly with defective GSH-Px activities we observe significantly (p < 0.01) increased levels of lipid peroxidation products: malonaldialdehyde (MDA) and organic hydroperoxides (O.H.P.). So, Se supplementation appears to be necessary in low phenylalanine products used in P.K.U. treatment.

[Leprosy in Guadeloupe 1980-1990: development and management in the general hospital]. / La lèpre en Guadeloupe 1980-1990: évolution et prise en charge a l'Hôpital général.

27 leprosy patients (19 adults, 8 children) from Basse Terre (Guadeloupe, FWI) were referred to General Hospital from 1975 to 1989: for diagnostic purpose in half the cases, for starting or modifying treatment regimens, or for complications (ENL). Lepromatous type was predominant (16/27), whereas ENL was the most serious diagnosis and therapeutic problem (7/27). Some epidemiological and psycho-social aspects are discussed.

[Infantile acropustolosis: unusual manifestation of scabies in the infant?]. / Acropustulose infantile: expression inhabituelle de la gale chez le nourrisson?

Three pediatric cases of vesiculopustules persisting for several months or years after eradication of Sarcoptes scabiei are reported. This particular course of scabies in infants is underrecognized although probably common. Its clinical manifestations, natural history and histologic features are identical to those seen in infantile acropustulosis, a recently individualized syndrome whose pathogenesis is unelucidated. In the light of these cases and a review of the literature, the possible relationship between scabies and infantile acropustulosis is discussed.

[Follow-up of HIV-I seropositive children at the Saint-Hyacinthe Hospital in Basse-Terre (Guadeloupe)]. / Suivi des enfants séro-positifs pour le VIH I à l'Hôpital Saint-Hyacinthe de Basse-Terre (Guadeloupe).

Between 1985 and 1989, we have followed twenty (20) newly born babies whose mothers were HIV seropositive. Eight of them were contaminated. Two of them died. We have studied the particular aspects of this infection in Guadeloupe.

[Marshall syndrome. 2 new cases]. / Syndrome de Marshall. Deux nouveaux cas.

Two new familial cases of Marshall syndrome are reported. The main features of this rare syndrome are outlined. Its possible relationship with Stickler syndrome is discussed.

[Acute poisonings in children in Guadeloupe. 10 years' activity at a general pediatric service]. / Intoxications aiguës chez l'enfant en Guadeloupe. Dix années d'activité d'un service de pédiatrie générale.

The authors have studied all the files concerning intoxications admitted in their department throughout ten years. They stress on the epidemiologic aspects particular to this tropical country, in order to plan a program for preventing children intoxications and accidents.

[8 cases of diphtheria observed in Guadeloupe from 1979 to 1984]. / A propos de 8 cas de diphtérie observés en Guadeloupe de 1979 à 1984.

From 1979 to 1984, 8 cases of diphtheria were diagnosed in Basse-Terre, in children aged 11 months to 6 years. All of them were badly or not vaccinated at all. They showed the common clinical features; two patients had only pharyngitis. Corynebacterium diphtheriae was isolated from the throat in 6 patients. All children were successfully treated by early administration of antitoxin and antibiotics.

Haematology and erythrocyte metabolism in man at high altitude: an Aymara-Quechua comparison.

In the course of haematological and biological investigations among Aymara and Quechua populations in Bolivia, an anthropological study of the erythrocytary respiratory function was carried out on the two groups at two altitudes: 3,600 m and 450 m. A difference in the intensity of the biological variations of the two populations is observed at high altitude. In the Quechuas, as in any lowland native, the adaptative phenomena are totally and quickly reversible. In the Aymaras, we detected the existence of more marked haematological and biochemical characters: moderate polycythemia, hyperhaemoglobinemia, microcytosis, metabolical hyperactivity with accumulation of 2-3 di-phosphoglycerate and ATP, and methaemoglobinemia with a drop in the activity of the methaemoglobin reductases. The Aymaras preserve some of those characters (methaemoglobinemia excepted) when they settle in lowlands.

Human red cell glycolysis in high altitude chronic hypoxia.

We have found that glycolysis in human red blood cells under the hypoxic conditions found at high altitudes is connected with changes in enzyme activities and levels of various metabolic intermediates. The sensitivity of the four kinases to hypoxia results in 1) glycolytic hyperactivity leading to a higher intracellular energy state, and 2) accumulation of 2-3 DPG, whose role in the adaptation of red blood cell respiration to high altitude has been shown by previous research. PEP, 3PG , and G6P appear to be the main regulating intermediates in glycolysis in this system. The reason for the very large increase in G1- 6DP is still not clear.

The effect of high altitude on the glycolytic activity of erythrocytes in natives of the Andean Altiplano.

Glucose consumption by anaerobic glycolysis and the pentose pathway were studied in two Aymara populations living at different altitudes (3 600 m and 450 m). The measurements were made both with and without methylene blue. We observed a Pasteur effect for both pathways which may explain the increase in 2-3 DPG and ATP levels found in blood samples from people living at high altitudes. The results in the presence of methylene blue showed a reduced activity of the methaemoglobin reductase system in the high altitude group which may be partly responsible for their increased levels of methaemoglobin.

The effect of high altitude on the glycolytic activity of erythrocytes in natives of the Andean Altiplano.

En este trabajo se miden los consumos de glucosa mediante la glicolisis y la via de las pentosas. La prueba se verifica con o sin azul de metileno en unas muestras de sangre sacadas de dos poblaciones Aymaras residentes en dos alturas diferentes, 3600 m y 450 m. Este estudio permite notar un efecto Pasteur en las dos vias, lo que contribuye al aumento de las concentraciones en 2-3 DPG y ATP en altitud. Las medidas hechas en presencia del azul de metileno comprueban la disminucion de actividad de los sistemas methemoglobina reductasa accesorios en altitud, lo que puede contribuir en parte al aumento de la tasa de methemoglobina

The effect of high altitude on the glycolytic activity of erythrocytes in natives of the Andean Altiplano.

Glucose consumption by anaerobic glycolysis and the pentose pathway were studied in two Aymara populations living at different altitudes (3 600 m and 450 m). The measurements were made both with and without methylene blue. We observed a Pasteur effect for both pathways which may explain the increase in 2-3 DPG and ATP levels found in blood samples from people living at high altitudes. The results in the presence of methylene blue showed a reduced activity of the methaemoglobin reductase system in the high altitude group which may be partly responsible for their increased levels of methaemoglobin.

The effect of high altitude on the glycolytic activity of erythrocytes in natives of the Andean Altiplano.

En este trabajo se miden los consumos de glucosa mediante la glicolisis y la via de las pentosas. La prueba se verifica con o sin azul de metileno en unas muestras de sangre sacadas de dos poblaciones Aymaras residentes en dos alturas diferentes, 3600 m y 450 m. Este estudio permite notar un efecto Pasteur en las dos vias, lo que contribuye al aumento de las concentraciones en 2-3 DPG y ATP en altitud. Las medidas hechas en presencia del azul de metileno comprueban la disminucion de actividad de los sistemas methemoglobina reductasa accesorios en altitud, lo que puede contribuir en parte al aumento de la tasa de methemoglobina