Mortality of childhood-onset IDDM patients. A cohort study in Havana City Province, Cuba.

OBJECTIVE: To determine the survival pattern and the underlying cause of death in a cohort of childhood-onset IDDm subjects from Havana City Province, Cuba. RESEARCH DESIGN AND METHODS: This was a descriptive study carried out on a historical cohort of IDDM subjects with disease onset before 15 years of age in Havana City Province, Cuba. The cohort was assembled from several sources. Subjects were diagnosed from 1965 to 1980, and their vital status was assessed at 31 December 1991. Cumulative survival rate was calculated by the Kaplan-Meier method, and a univariate analysis was performed. To test survival differences between groups, the Cox-Mantel test was used. To compare the cohort mortality with the general population, standardized mortality ratios by sex and age were calculated. Specific causes of death were determined by a committee examining death certificates, clinical records, and necropsy reports. RESULTS: A total of 504 subjects were identified, and the mean follow-up time was 17.5 years. Of the subjects, 70 (13.9%) had died at 31 December 1991. Overall, the cohort had a 71% cumulative survival rate at 25 years of IDDM duration. There were no survival differences according to sex or calendar period of IDDM diagnosis. Statistically significant differences were found among age-at-diagnosis groups. The group with a peripubertal age at diagnosis showed the worst prognosis. The cohort experienced 8.5 times the all-causes death rate, compared with the general population. Renal disease accounted for almost half the deaths. CONCLUSIONS: IDDM subjects from Havana City Province, Cuba, showed a better survival pattern than IDDM subjects from other developing countries. However, when compared with IDDM populations from developed countries, there is a survival reserve to be achieved by reducing mortality due to renal disease and infections.

[Prostaglandin E2 (PgE2) in normal and inflamed gingiva. Clinical assay. Literature review]. / Prostaglandina E2 (PgE2) en encia normal e inflamada. Ensayo clinico. Revisión bibliografica.

The role of prostaglandins (Pg) in the pathogeny of periodontal disease is analyzed. For that purpose, 92 samples of gingivae were taken to the same number of patients (48 women and 44 men) aged 17-74 years, and were clinically classified according to Löe gingival index. Presence of prostaglandins was determined by thin layer chromatography. Presence or absence of PgE2 was related to sex, age, Löe gingival index and degree of inflammatory infiltrated. Although correlation between Löe gingival index and degree of inflammatory infiltrate has not an exactly correspondence, the first one offers a useful initial clinical orientation. To patients with higher degree of inflammation corresponded higher PgE2 concentrations. Possibility of using prostaglandin inhibiting drugs in the treatment of periodontal disease is stated.