Foundation: the Healthy Municipalities, Cities, and Communities Movement seeks to improve health and well-being through public policies. It promotes sustainable development and local planning with community participation. Objective: to describe the results of a community project for improving health and well-being in the Camarones People's Council of the Palmira municipality in Cienfuegos. Methods: the study included the active participation of the population, institutions, and local entities to identify and address health problems related to the prevalence of non-communicable diseases, their social determinants, and risk factors, through the promotion of coordinated intersectoral work. In the first stage, a health situation assessment was conducted in the Francisco del Sol Díaz Health Area of San Fernando de Camarones, Palmira municipality, focusing on the prevalence of NCDs and their risk factors. In the second stage, under the guidance of the health department, the leaders of the local council and informal community leaders were involved in carrying out the following relevant actions. Results: non-communicable diseases were identified as the most prevalent. Among these, hypertension and smoking stand out, along with high rates of obesity, alcoholism, and hypercholesterolemia. Conclusions: the implementation of this project in the community council will strengthen the work of community organizations and the functioning of health councils, all of which will contribute to the well-being and satisfaction of the population.
Foundation: women of reproductive age have a protective factor against cardiovascular disease due to the effect of estrogen on the vascular endothelium. However, during perimenopause and postmenopause, states of hypoestrogenemia occur, leading to an increased risk of cardiovascular disease and death. Objective: to determine the frequency of the main cardiovascular risk factors in perimenopausal and postmenopausal women. Method: a cross-sectional study was conducted on 332 women who attended the menopause and perimenopause clinic at the 19 de Abril University Polyclinic in the Plaza de la Revolución municipality between 2018 and 2020. The variables studied were: hypertension, type 2 diabetes mellitus, overweight and obesity, abdominal obesity, hypercholesterolemia, smoking, sedentary lifestyle, perimenopause, and postmenopause. The mean and standard deviation were determined for the variables that required and the typical measures of association (Odds Ratios and contingency coefficients) to evaluate the binary associations between the variables. Results: cardiovascular risk factors are more frequent in the postmenopausal stage compared to the perimenopausal stage, with sedentary lifestyle being the most prevalent in 214 patients (78.7 %), followed by excess weight in 179 patients (65.8 %). Patients with 3 risk factors represented 82.1 % of the postmenopausal patients, while those with 7 represented 94.7 %. Conclusion: the high prevalence of atherosclerotic risk factors in the postmenopausal stage highlights the need for specific preventive strategies to reduce the cardiovascular burden in menopausal women.
Foundation: the Healthy Municipalities initiative seeks to develop democratic forms of exchange that lead to reflection and the definition of creative proposals for the development of healthy environments and the solution of problems that constitute negative factors in the health of individuals and the community. Objective: to describe the experience of the Healthy Municipalities, Cities, and Communities Movement in the San Fernando de Camarones People's Council, in the Palmira municipality, highlighting its achievements, challenges, and lessons learned. Methods: a qualitative, descriptive study was conducted, and a focus group was formed with government leaders, the local historian, delegates, and representatives from various sectors. Additionally, a review of documents was carried out, including minutes from the People's Council assemblies, the polyclinic's board of directors, and statements from representatives of the districts and formal and informal community leaders. Results: there was a commitment to improving the population's health through a social pact among local authorities, community entities, and public and private institutions. The local public library, educational centers, the cultural center, and a sports complex undertook actions to achieve overall well-being in conjunction with the disease prevention and control programs led by health institutions. The enthusiastic contribution of individuals, families, organizations, groups, and the community at large proved vital in the comprehensive approach to the factors that influence health, with the aim of optimizing it and fostering supportive environments within the community. Conclusions: the declaration of San Fernando de Camarones as a Community for Health was the product of political will, intersectoral collaboration, and community participation, which made visible the fulfillment of the requirements demanded by this movement at the international level. This experience constitutes a replicable model of community intersectoral collaboration in Cuba, the main challenge lies in maintaining it, given the current complex and multifaceted context.
Fundamento: las enfermedades crónicas afectan a gran parte de los niños en el mundo. Esto ha llevado a un mayor uso de servicios de salud, tanto en la Atención Primaria como en los hospitales. Objetivo: diseñar de un plan de acción para mejorar la atención de pacientes con enfermedades crónicas en el Hospital Pediátrico Universitario Paquito González Cueto de Cienfuegos. Método: se realizó una investigación en sistemas y servicios de salud entre 2023 y 2024 en la que se involucraron a directivos de hospitales, personal de servicios médicos, familias de pacientes y representantes de organizaciones. Se utilizó la guía para desarrollar planes de humanización en Iberoamérica, se identificaron los problemas en la humanización del cuidado y las amenazas, oportunidades, debilidades y fortalezas para la implementación de un plan de acción estratégico diseñado a partir del ciclo de humanización en cuatro ejes, con objetivos y acciones concretos. Resultados: el plan de acción se organizó en cuatro áreas: organizacional, relacional, asistencial y estructural, con objetivos estratégicos y operativos. Persigue mejorar la atención médica centrado en crear procesos personalizados y en establecer relaciones respetuosas entre pacientes, familiares y profesionales de salud. Incluye objetivos para combatir enfermedades, promover estilos de vida saludables y fomentar la autonomía de los pacientes. También refuerza la relación entre el nivel primario y secundario de atención a estos pacientes al favorecer la continuidad en los cuidados. Se propone un programa de formación para profesionales adaptado a las necesidades de los pacientes y un sistema de educación continua. También destaca la importancia de involucrar a la comunidad en adoptar estilos de vida saludables y garantizar el acceso a información relevante. Además, tiene en cuenta la mejora de la infraestructura para ofrecer atención digna y humanizada. Conclusión: el plan fomenta la humanización en la atención a pacientes crónicos con un enfoque que combina evaluación, educación y reconocimiento para mejorar la calidad de la atención.
Foundation: heart failure is one of the most prevalent cardiovascular complications in patients with type 2 diabetes mellitus. This condition leads to recurrent hospitalizations and high mortality. Objective: to clinically and echocardiographically characterize type 2 diabetic patients with heart failure. Methods: a descriptive, cross-sectional study was conducted in the Internal Medicine Department of the Guillermo Domínguez López General Teaching Hospital between January 2023 and January 2025. The study population consisted of 52 type 2 diabetic patients with heart failure. The following variables were analyzed: age, sex, comorbidities, clinical manifestations, functional class, left ventricular ejection fraction, complications, and pharmacological group. Descriptive statistics were used.Results: male patients predominated (55.77 %; 95 % CI: 41.31-70.23), with ages ranging from 75 to 84 years (34.62 %; 95 % CI: 20.72-48.51) and hypertension (75 %; 95 % CI: 62.27-87.73) as the main comorbidity. Dyspnea (84.62 %; 95 % CI: 73.85-95.38) was the predominant clinical manifestation, as was functional class III (44.23 %; 95 % CI: 29.77-58.69). Patients with intermediate left ventricular ejection fraction predominated (40.39 %; 95 % CI: 26.09-54.68). Respiratory infections (19.23 %; 95 % CI: 7.56–30.90) were the main complication. The most frequently used drug classes were loop diuretics (100 %) and aldosterone antagonists (92.31 %; 95 % CI: 81.46–97.86). Conclusions: heart failure in type 2 diabetic patients is more prevalent in older adults with associated hypertension, who require loop diuretics for disease control.
