Introduccion: La tuberculosis persiste como un importante problema de salud mundial. En el 2016 se estimaron 600 000 casos de resistente a rifampicina, y entre estos 490 000 casos multidrogorresistentes. Objetivo : Describir el comportamiento de la resistencia de los aislados de M. tuberculosis de pacientes con tuberculosis pulmonar notificados en Cuba entre los anos 2015-2017. Metodos: Se determino la susceptibilidad a isoniacida y rifampicina mediante el metodo de la nitratasa. A los aislados resistentes a rifampicina/multidrogorresistentes se les determino mediante el metodo proporcional la susceptibilidad a ofloxacina, kanamicina, amikacina y capreomicina. Resultados: El 93,2 % de los aislados fueron sensibles a isoniacida y rifampicina. En 39 se identifico resistencia a isoniacida y 23 fueron resistente a rifampicina. Se identificaron 10 multidrogorresistentes. No se detecto resistencia a farmacos de segunda linea. Conclusiones: Los resultados alertan sobre la necesidad de investigar las causas que han conllevado al incremento de la tuberculosis resistente en Cuba.
As it is a manuscript to be published in the Reflection and Debate section, no abstract is applicable.
Introduction: Human immunodeficiency virus infection is a pandemic with a health, social and economic impact. Antiretroviral therapy is the only effective alternative to treat patients. Supply of such a therapy poses a great economic burden to health systems in low-income countries. Objective: Describe the antiretroviral therapy schemes formulated and their economic impact on the Colombian health system. Methods: A descriptive cross-sectional study and secondary source review were conducted. The study sample was 446 adult patients of both sexes with a confirmed diagnosis who attended control sessions in a specialized clinic in the city of Villavicencio, Colombia, in the year 2018. The variables analyzed were demographic characteristics, laboratory results, antiretroviral therapy formulated and cost of each scheme. Results: The population studied was mostly male, with a mean age of 35.8 years. 56% of the patients were under appropriate virological control. Fifteen different antiretroviral therapy schemes were found. The economic cost of each scheme ranged between 74 dollars / month and 467 dollars / month. Conclusions: The antiretroviral therapy formulation complies with the recommendations contained in the Colombian guide. However, it does not achieve optimal virological control and poses a high economic cost to the Colombian health care system.
Dengue is the vector-borne infection with the greatest impact on disease, economic and social burden worldwide, with more than 3.6 billion people under risk of contagion. Its manifestations are varied, most of them characterized by febrile syndrome with a risk of bleeding, shock and death. Pulmonary involvement is infrequent, and acute respiratory distress syndrome is an unexpected complication, though it has been reported in association to a bad prognosis. A case is presented of a male patient without relevant antecedents of interest, with severe pulmonary focalization associated to dengue virus infection. Bacterial infectious processes and other causative agents of acute respiratory distress syndrome were ruled out. In view of the patient's clinical status at admission, the endemicity of the patient's area of residence, the clinical and paraclinical course, and the obvious positivity of the dengue tests performed and their seroconversion, despite not having conducted molecular tests, it was concluded that the most probable causative agent was dengue virus. Therefore, it is recommended that dengue infection always be considered as a potential causative agent of acute respiratory distress syndrome, thus contributing to optimal diagnosis and management.
With the objective of analyzing the scientific contribution of measles publications and graphing the collaboration networks between countries during the last 20 years. A bibliometric study was conducted between 1999 and 2018 of journals indexed in Scopus. Annual production data were analyzed and a co-occurrence analysis of production and collaboration between countries using VOSviewer was plotted. 587 documents were registered between 1999 and 2018, with a steady trend, the average of annual publications was 29 documents (range 1-44), being 72.4% were original articles. The countries of Brazil (53.3%) and Mexico (17.5%) had greater productivity and collaboration mainly with the United States and the United Kingdom. Measles research in Latin America presents a stationary trend. Brazil and Mexico were the countries with more publications and have greater networks of scientific collaboration with the United States and the United Kingdom.
Coleopteran insects can produce toxic substances containing multiple components which have so far not been properly described. To report an unusual case of intoxication by excretion from Calosoma alternans Fabricius 1792 (Coleoptera: Carabidae) in a Venezuelan patient from a periurban neighborhood near the mesothermal raining forest. The toxic activity caused a clinical status characterized by digestive symptoms such as nausea, vomiting, epigastralgia, an increase in bowel movements and probable kidney inflammation with intense pain in both lumbar regions, which did not correspond to the classic dermal damage. In conclusion, a unique case is presented of intoxication by a coleopteran species, with a clinical description not previously reported.
Introduction: Geohelminthiases are intestinal parasitic diseases caused by helminths which complete their life cycle in the soil. They are a global public health problem mainly affecting the lowest socioeconomic strata. Objective: Determine the prevalence of geohelminths in native communities from Zulia State, Venezuela. Methods: Analysis was performed of 250 stool samples from individuals of both sexes aged between 1 and 80 years. The samples were processed by direct examination, concentration (Ritchie) and egg count (Kato-Katz). Results: Geohelminth eggs were found in 35.20% of the stool samples studied (88 cases). The most affected age group was schoolchildren (7-12 years: 38.64%), followed by adults (20 years and over: 26.13%). The most common helminth was Ascaris lumbricoides with 25.20%, followed by Trichuris trichiura with 14.80%. The least common genus was Ancylostoma with 4.40%. Infection was mild in most subjects ( A. lumbricoides 74.60%, T. trichiura 81.08% and Ancylostoma 90.91%). Conclusions: A moderate prevalence of geohelminth infection was observed, most of which was mild. The presence of geohelminths is related to poor environmental sanitation in these native communities.
Introduction: As part of the Universal Coverage Campaign implemented in 2017, a new model was applied for the distribution of mosquito nets impregnated with long-lasting insecticide. Coverage had been found to be low in 2015. Objective: Characterize the new model for the distribution of mosquito nets impregnated with long-lasting insecticide applied in the 2017 Campaign in Tete Province, Mozambique. Methods: A cross-sectional observational descriptive quantitative study was conducted. Starting from univariate statistics, estimation was made of percentage and its 95% confidence intervals for correct registry indicators. Pearson's correlation coefficient (r) and the coefficient of determination (R 2 ) were estimated to find the association between registered and possessing households. Results: Of the 3 284 households evaluated during the registration stage, 98% were given stickers and 99% received coupons. The criterion followed for the assignment of mosquito nets impregnated with long-lasting insecticide was correct in 97%, respectively. Of the households registered, 1 086 (97%) had access to at least one mosquito net impregnated with long-lasting insecticide, whereas 1 041 (92%) had slept under these mosquito nets the night before the survey. Conclusions: With the use of the new model for the distribution of mosquito nets impregnated with long-lasting insecticide, the Universal Coverage Campaign ensures the appropriate registration of households, contributing to an increase in their possession and use, and the attainment of universal coverage goals in the community.
At the end of 2019 a new coronavirus caused an epidemic of acute respiratory disease in Wuhan, China. The World Health Organization called this condition "coronavirus disease 2019" and declared it pandemic on 11 March 2020. On that same date the first three COVID-19 cases were diagnosed in Cuba. The Acute Physiology and Chronic Health Evaluation II (APACHE II) is the disease severity scoring system most commonly used in ICUs. An observational descriptive prospective cohort study was carried out with the objective of describing the behavior of 20 SARS-CoV-2 positive cases in an intensive care unit. This was realized from March to July 2020 at the Intensive Care Unit of Dr Salvador Allende Clinical Surgical Hospital in Havana, Cuba. The study population was all the patients admitted for positive SARS-CoV-2 (n=20). Mean age was 64.35±15.21 years. Male sex prevailed. Mean hospital stay was 10.05±5.5 days. Mean APACHE II was 16.6±8.9. The prevailing symptoms were fever (55%), coughing (25%) and dyspnea (20%). Mortality of COVID-19 patients was associated to age, a longer stay in the intensive care unit, high APACHE II scores, reduced erythrosedimentation values and lymphocyte count. Hypertension was the most common pathological antecedent.
Introduction: Dengue is the fastest spreading mosquito-borne viral disease worldwide. Despite its high incidence, no effective antiviral treatment or vaccine has been approved for use against this infection. The plant Ageratina havanensis has been widely used in our folk culture and in other countries due to its various biological properties. Objective: Evaluate the antiviral activity of four extracts from Ageratina havanensis and two flavonoids isolated from that plant against the dengue 2 virus. Methods: Primary screening of the antiviral activity of each extract and flavonoid was conducted by viral productivity detection assay, and an evaluation was carried out of the virucidal action of the stem ethanolic extract and the leaf butanolic extract. Results: All the extracts inhibited viral replication by a reduction in the number of lysis plates. However, no evidence was found of a reduced viral infective titer in the virucidal assay. Treatment with sakuranetin achieved viral productivity inhibition values of 61%-91%, whereas 7-methoxyaromadendrin obtained viral reduction values of 64%-86%. Conclusions: The extracts and flavonoids isolated from Ageratina havanensis displayed antiviral activity. The stem ethanolic extract and the leaf butanolic extract do not have a virucidal action against the viral strain used. The paper is the first report about the effect of extracts and compounds isolated from A. havanensis against the dengue virus.
Introduccion: El colera es una infeccion intestinal aguda causada por cepas toxigenicas de Vibrio choleare . La rapida diseminacion y emergencia de la multirresistencia que caracteriza a este patogeno, podria interferir en el exito de la terapia antimicrobiana, por lo que constituye una prioridad monitorear los cambios en los patrones de susceptibilidad, como parte trascendental de la politica de control de la resistencia antimicrobiana. Objetivos: Determinar el comportamiento de la resistencia antimicrobiana frente a los antimicrobianos de interes empleados en el tratamiento, la presencia de factores de virulencia enzimaticos y si existe relacion entre ambos. Metodos: Se realizo un estudio descriptivo de corte transversal durante julio de 2012 a diciembre de 2015. Donde se estudiaron 500 aislamientos pertenecientes al cepario del Laboratorio Nacional de Referencia de Enfermedades Diarreicas Agudas del Instituto de Medicina Tropical “Pedro Kouri”, procedentes de brotes de EDA de la red nacional de laboratorios de Microbiologia de Cuba. Se aplicaron metodos convencionales fenotipicos para, determinar el comportamiento de la resistencia antimicrobiana, la presencia de factores enzimaticos y la relacion de estos con la resistencia antimicrobiana. Resultados: Los mayores porcentajes de sensibilidad se obtuvieron frente azitromicina (98%), doxiciclina (96 %) y ciprofloxacina (93%) y de resistencia frente a ampicilina (100 %) y trimetoprim-sulfametoxazol (99.4%). Se encontraron 44 aislados (8.8%) multirresistente. Todos los aislamientos poseian al menos dos enzimas extracelulares como factores de virulencia, las mas frecuentes: gelatinasa (96 %) y lecitinasa (95%). Conclusiones: Se evidencia una relacion directa y proporcional entre la presencia de los factores de virulencia y resistencia antimicrobiana, sinergismo que surgiere mayor patogenicidad de los aislados estudiados procedentes de brotes epidemicos.
Introduction: Nursing observations are a source of information that ensures continuity in the care of patients. Objective: Characterize the nursing observations at admission of AIDS patients to the Hospital Center at Pedro Kouri Institute. Methods: A cross-sectional study was conducted of nursing observations about all the AIDS patients admitted in January 2015. An analysis was carried out of the structure indicators record, the content and layout of the current Cuban regulations, and the application of Orem's Self-Care Theory. Results: A total 64 nursing observations were reviewed. In terms of structure, 39% of the observations omitted the subjective data section. The content indicators least often recorded in the header at admission were the reason for admission (20.3%) and the health status report (39%). Subjective data about self-care activities were not recorded. Similar behavior was observed concerning health deviation self-care requisites and self-care activities in the objective data section. Information about the nursing personnel in charge of observations was recorded in 76.5% of the cases. Layout indicators were complied with in 18.7% of the cases. Conclusions: Difficulties were found in nursing observations which point to the need for continuous training about current Cuban regulations for such observations. Application of Orem's theory to the characterization of observations made it possible to identify the limited registration of self-care deficiencies and activities aimed at solving that deficit, an area of vital importance for AIDS patients.
Introduccion: A finales del 2019, un nuevo coronavirus provoco una epidemia de enfermedad respiratoria aguda en Wuhan, China. La Organizacion Mundial de la Salud nombro a esta enfermedad “coronavirus disease 2019”, el 11 de marzo de 2020 la declaro como pandemia, y se diagnosticaban los tres primeros casos de COVID-19 en Cuba. Objetivo: Describir el comportamiento de 20 casos positivos a SARS CoV-2 en una unidad de cuidados intensivos. Metodo s : Estudio observacional, descriptivo, de cohorte y prospectivo, aplicado entre marzo y julio del 2020, en la Unidad de Cuidados Intensivos del Hospital Clinico-Quirurgico “Dr. Salvador Allende”, La Habana, Cuba. La poblacion estuvo conformada por la totalidad de pacientes ingresados positivos a SARS CoV-2 ( n = 20). Resultados: La edad promedio fue de 64,35 ± 15,21 anos. El sexo masculino sobresalio. La estadia media fue 10,05 ± 5,5 dias. El APACHE II medio fue de 16,6 ± 8,9. Los sintomas predominantes fueron la fiebre (55 %), la tos (25 %) y la disnea (20 %). Conclusiones: La mortalidad en pacientes con COVID-19 se asocio con la edad, con el aumento de la estadia en Unidad de Cuidados Intensivos, elevados puntajes APACHE II, disminucion de los valores de eritrosedimentacion y del recuento linfocitario. La hipertension fue el antecedente patologico mas recurrente.
La leptospirosis es una enfermedad zoonotica endemica de potencial epidemico, que afecta al hombre y minimo a 160 especies animales. Estos aspectos evidencian la importancia de estudiarla de manera integral desde la salud humana y veterinaria con un abordaje interdisciplinar para entenderla y asi orientar las medidas de prevencion y control; sin embargo, una de las dificultades en estos aspectos es la existencia de mas de 300 serovares, la posibilidad de la bacteria de vivir en el ambiente por mas de 180 dias y que el agua sea un vehiculo importante de transmision. Esto asociado a la problematica del uso prolongado de los antibioticos, la multirresistencia e inmunosupresion hace que se evaluen nuevas alternativas antimicrobianas a partir del conocimiento y utilidad de la biodiversidad vegetal. Por lo tanto, el proposito de este articulo es revisar la leptospirosis y su diagnostico enfatizando en el control convencional de la infeccion y las alternativas de tratamiento a partir del uso de plantas medicinales. Para esto se realizo una revision de articulos en bases de datos como scopus, science direct y pubmed entre otras, que permitieran explorar los aspectos mas relevantes de la enfermedad, su diagnostico y tratamiento; tanto con antimicrobianos convencionales como frente a nuevas alternativas de origen natural. En este sentido, es importante realizar investigaciones orientadas hacia la busqueda de principios activos que puedan contribuir al control de Leptospira spp, agente etiologico de la leptospirosis, una de las zoonosis mas importantes por su impacto en salud humana, veterinaria y del ecosistema.
