[Risk factors in the epidemic neuropathy of Cuba]. / Factores de riesgo en la neuropatía epidémica cubana.

OBJECTIVE: A case control study to find out if Cuba's epidemic neuropathy was a result of one of the following causes: (1) an infectious process, (2) exposure to one or more toxical agents, (3) low intake of one or more nutrients, or (4) more than one of such causes and their interactions. MATERIAL AND METHODS: A total of 311 cases of epidemic neuropathy with optic and peripheral symptoms and 377 controls were studied. A questionnaire with 55 items was employed to document exposure to factors determined by the etiologic hypothesis. Data analysis was done separately for the optical and peripheral types of the disease. RESULTS: No association was found between illness and any deficiency of basic sanitation for both types of neuropathy. Acute stress, irregularities in food intake, body weight loss in the last 12 months and other indicators of nutritional deficiencies were associated to both clinical manifestations, although they were also high in the controls. Low frequency of illness was found for people living with diseased persons. Females had a significant high risk of illness in the peripheral manifestations whereas smoking was the only toxical risk factor in optical neuropathy. Nutritional deficiencies together with unidentified personal factors were the main associations for illness outcome; smoking increased significantly the risk of optical neuropathy. CONCLUSIONS: 1. The infection etiology was unsupported in the study. 2. Smoking appeared as a factor for the optical neuropathy. 3. Stress induced by vital events were significantly associated with the disease. 4. Both types of the neuropathy were associated to body weight loss and other indicators of nutritional deficit.

[Case-control study of epidemic optic neuropathy in Cuba, 1993]. / Estudio de casos y controles de la neuropatía óptica epidémica de Cuba, 1993.

The purpose of this study was to identify the risk factors for epidemic optic neuropathy, which occurred in Cuba in 1992 and 1993, as well as to formulate a hypothesis about its etiology. The study sample consisted of 551 pairs of cases and controls matched for age, sex, and area of residence. The cases were patients aged 15 years and over who were diagnosed in April 1993. Diagnosis was made in accordance with major criteria (diminished visual acuity, alteration in color vision, scotomata, and changes in the papillo-macular tract) and minor criteria (pallor of the optic disk, photophobia, and others). Cases were selected through systematic sampling of all the country's provinces. The controls were selected from the population registers of the primary care districts. By means of a 52-section questionnaire, information was obtained from the cases and controls about their sociodemographic characteristics, drug and food habits, and exposure to toxic environmental substances. The population group most affected was that of persons 25 to 64 years of age who lived in urban areas. No evidence was found to support biological transmission of the disease, nor were any environmental toxins discovered to be causal agents. Construction of logistic models showed an irregular diet (95% confidence interval of the odds ratio [95%CI OR]: 2.43-3.63), smoking (95% CI OR: 2.60-3.13), and elevated ingestion of sugar (95% CI OR: 1.74-2.52) to be risk factors for the disease. Despite the study's limitations, it supports the hypothesis that the epidemic's pathogenesis is toxic-nutritional. According to this hypothesis, nutritional deficiencies could be responsible for a marked alteration in metabolic detoxification mechanisms, which would increase susceptibility to a noxious agent.

Estudio comparativo entre el Asma Bronquial, contaminación atmósferica y algunas variantes meteorológicas

Se presenta un estudio comparativo realizado en tres zonas de la Ciudad de la Habana desde el punto de vista de la contaminación atmósferica, la frecuencia de crisis de asma bronquial en niños de 2 a 14 años de edad, residentes en las áreas durante el período de estudio y algunas variables meteorológicas. Se encontró que en las tres zonas seleccionadas, las mayores concentraciones diarias de polvo en suspensión mostraron asociación con la frecuencia elevada de crisis asmáticas por día y que el área de mayor contaminación atmósferica era la que presentaba la frecuencia más alta de crisis de asma bronquial. Además se comprobó que existía una correlación estadisticamente significativa entre todas las variables estudiadas. (AU)

Estudio comparativo entre el Asma Bronquial, contaminación atmósferica y algunas variantes meteorológicas

Se presenta un estudio comparativo realizado en tres zonas de la Ciudad de la Habana desde el punto de vista de la contaminación atmósferica, la frecuencia de crisis de asma bronquial en niños de 2 a 14 años de edad, residentes en las áreas durante el período de estudio y algunas variables meteorológicas. Se encontró que en las tres zonas seleccionadas, las mayores concentraciones diarias de polvo en suspensión mostraron asociación con la frecuencia elevada de crisis asmáticas por día y que el área de mayor contaminación atmósferica era la que presentaba la frecuencia más alta de crisis de asma bronquial. Además se comprobó que existía una correlación estadisticamente significativa entre todas las variables estudiadas. (AU)

Relación entre contaminación atmosférica y otros factores ambientales con el asma bronquial en la Ciudad de La Habana, julio de 1982 / Relationship between atmospheric contamination and other environmental factors and bronchial asthma at Havana City. July 1982

Presenta los resultados de las investigaciones realizadas sobre la relación entre el nivel de contaminación atmosférica en varias zonas de la ciudad de La Habana y la frecuencia de crisis de asma en la población infantil expuesta. También estudia la influencia de otros factores en la ocurrencia de las crisis, como son condiciones urbanísticas y de la vivienda, variables meteorológicas. Se utilizaron los datos suministrados por la Red de Muestreo de la Contaminación del Aire de la Ciudad de La Habana, por las encuestas higiénico-epidemiológicas en la población y por las estaciones meteorológicas del Instituto Nacional de Meteorología