Protective effects of Surfacen® in allergen-induced asthma mice model.

Airway obstruction with increased airway resistance in asthma, commonly caused by smooth muscle constriction, mucosal edema and fluid secretion into the airway lumen, may partly be due to a poor function of pulmonary surfactant. Surfacen®, a clinical pulmonary surfactant, has anti-inflammatory action, but its effect on asthma has not been studied. This work aimed to evaluate the effect of Surfacen® in a murine allergen-induced acute asthma model, using house dust mite allergens. In a therapeutic experimental setting, mice were first sensitized by being administered with two doses (sc) of Dermatophagoides siboney allergen in aluminum hydroxide followed by one intranasal administration of the allergen. Then, sensitized mice were administered with aerosol of hypertonic 3% NaCl, Salbutamol 0.15 mg/kg, or Surfacen® 16 mg in a whole-body chamber on days 22, 23, and 24. Further, mice were subjected to aerosol allergen challenge on day 25. Surfacen® showed bronchial dilation and inhibition of Th2 inflammation (lower levels of IL-5 and IL-13 in broncoalveolar lavage) which increased IFN-γ and unchanged IL-10 in BAL. Moreover, Sufacen® administration was associated with a marked inhibition of the serum specific IgE burst upon allergen exposure, as well as, IgG2a antibody increase, suggesting potential anti-allergy effects with inclination towards Th1. These results support also the effectiveness of the aerosol administration method to deliver the drug into lungs. Surfacen® induced a favorable pharmacological effect, with a bronchodilator outcome comparable to Salbutamol, consistent with its action as a lung surfactant, and with an advantageous anti-inflammatory and anti-allergic immunomodulatory effect.

Smoking prevalence in Cienfuegos City, Cuba.

INTRODUCTION Over the last 40 years, high smoking prevalence has been reported throughout Cuba, including in Cienfuegos city in the central part of the island. OBJECTIVES Determine smoking prevalence and potential associated risk factors in Cienfuegos city for 2010-2011. METHODS A descriptive cross-sectional study was conducted in Cienfuegos city in the context of CARMEN (Collaborative Action for Risk Factor Prevention & Effective Management of Non-communicable Diseases), a PAHO multi-country initiative for a multidimensional approach to chronic non-communicable diseases. Participants totaled 2193 (aged 15-74 years), randomly selected through complex probabilistic three-stage sampling. Variables examined in relation to smoking included age, sex, skin color, civil status and educational level. RESULTS Approximately 25% of those surveyed were smokers (30.3% of men and 21.0% of women). For men, prevalence was highest in the groups aged 25-34 and 55-64 years; for women, in the group aged 45-54 years. Concerning skin color, smoking rates were higher among black and mestizo persons (29.5%); and concerning civil status, higher among those who were separated, widowed or divorced (30.0%). Smoking prevalence fell with higher educational level; in keeping with that trend, the university-educated group had the lowest prevalence (16.2%). CONCLUSIONS Although one in four Cienfuegos residents aged ≥15 years smoked in 2010-2011, prevalence there is lower than in previous surveys. Knowledge of differences observed in age, sex, skin color, civil status and educational level can be useful for planning future smoking prevention and control actions.

Population-wide weight loss and regain in relation to diabetes burden and cardiovascular mortality in Cuba 1980-2010: repeated cross sectional surveys and ecological comparison of secular trends.

OBJECTIVE: To evaluate the associations between population-wide loss and gain in weight with diabetes prevalence, incidence, and mortality, as well as cardiovascular and cancer mortality trends, in Cuba over a 30 year interval. DESIGN: Repeated cross sectional surveys and ecological comparison of secular trends. SETTING: Cuba and the province of Cienfuegos, from 1980 to 2010. PARTICIPANTS: Measurements in Cienfuegos included a representative sample of 1657, 1351, 1667, and 1492 adults in 1991, 1995, 2001, and 2010, respectively. National surveys included a representative sample of 14 304, 22 851, and 8031 participants in 1995, 2001, and 2010, respectively. MAIN OUTCOME MEASURES: Changes in smoking, daily energy intake, physical activity, and body weight were tracked from 1980 to 2010 using national and regional surveys. Data for diabetes prevalence and incidence were obtained from national population based registries. Mortality trends were modelled using national vital statistics. RESULTS: Rapid declines in diabetes and heart disease accompanied an average population-wide loss of 5.5 kg in weight, driven by an economic crisis in the mid-1990s. A rebound in population weight followed in 1995 (33.5% prevalence of overweight and obesity) and exceeded pre-crisis levels by 2010 (52.9% prevalence). The population-wide increase in weight was immediately followed by a 116% increase in diabetes prevalence and 140% increase in diabetes incidence. Six years into the weight rebound phase, diabetes mortality increased by 49% (from 9.3 deaths per 10 000 people in 2002 to 13.9 deaths per 10 000 people in 2010). A deceleration in the rate of decline in mortality from coronary heart disease was also observed. CONCLUSIONS: In relation to the Cuban experience in 1980-2010, there is an association at the population level between weight reduction and death from diabetes and cardiovascular disease; the opposite effect on the diabetes and cardiovascular burden was seen on population-wide weight gain.

Blacks and Whites in the Cuba have equal prevalence of hypertension: confirmation from a new population survey.

BACKGROUND: The excess burden of hypertension among blacks has been a prominent feature of the heath disparities literature, and many scientists presume it to be a stable and inevitable phenomenon. The underlying causes of this disparity can only be disentangled in a setting in which the population does not experience racial stratification of socioeconomic opportunities. While such conditions of racial equality remain uncommon, they may be approximated in Cuba, a country with a persistent policy of social inclusion over the last 5 decades. METHODS: We report on a 2010-2011 stratified probability sample of those aged 15-74 years from the urban population of Cienfuegos in central Cuba. A total of 1496 adults (880 women and 616 men) were recruited and assessed for blood pressure and anthropometrics according to standardized protocols, as well as medication use, educational attainment and observed skin tone (dichotomized into "black" and "white"). Weighted tabular and regression analyses were conducted to estimate adjusted prevalences of hypertension (> 140/90 mmHg) and adjusted prevalence odds ratios for contrasts between the two skin color groups. RESULTS: Mean pressures were higher for men than for women, but overall did not differ importantly between racial groups. About half of all diagnosed hypertensive men were on medication, a proportion that did not vary by racial group. For women, however, adjusted prevalence was somewhat higher among blacks, and treatment and control rates were also somewhat advantaged for white women. CONCLUSIONS: Overall, skin color was unrelated to mean blood pressure or hypertensive status in this population, although among women specifically some racial advantage appears evident in adjusted prevalence and control, and should be investigated further. The overall null result suggests that Cuba may exemplify the social conditions in which racial excess in hypertension, characteristic of much of the western world, is not a necessary reality.

An efficient sampling approach to surveillance of non-communicable disease risk factors in Cienfuegos, Cuba.

One of the most common shortcomings in non-communicable disease risk factor surveillance, especially in prevalence studies, is sampling procedures, which can and do compromise accuracy and reliability of derived estimates. Moreover, sampling consumes significant time and resources. Since the early 1990s, risk factor surveys in Cienfuegos province, Cuba have paid particular attention to careful sampling methods. The new survey conducted in 2011 was not only statistically rigorous but introduced an innovative, more efficient method. This article provides a detailed description of the sample design employed to optimize resource use without compromising selection rigor.