Expanding active living after cancer to underserved cancer survivors and their caregivers.

BACKGROUND: Physical activity (PA) improves physical and psychological health in cancer survivors. This study evaluated Active Living After Cancer (ALAC), a community-based program to improve PA, physical function, and quality of life (QOL) in minority and medically underserved cancer survivors and their caregivers. METHODS: Participants completed 12 weekly ALAC sessions and assessments of PA, physical functioning, and QOL at baseline and follow-up (week 12). Paired samples t-tests were used to assess changes in outcomes over time. RESULTS: 540 cancer survivors (M age = 61.1 years, SD = 11.3) and 87 caregivers (M age = 62.3 years, SD = 13.1) were enrolled. Most were women (91.4%), Hispanic (61.1%) or non-Hispanic Black (19.3%), and medically underserved (86.4%). The percent of cancer survivors meeting PA recommendations increased from 28.9% to 60.2% (d = 0.75), and the number of sit-to-stand repetitions in a 30-second period increased from 12.3 to 14.3 (d = 0.39) from 0-12 weeks. Cancer survivors reported significant improvements in physical (T-score Δ = 1.7, d = 0.06) and mental (T-score Δ = 2.3, d = 0.31) health-related QOL. Caregivers also improved their PA, physical function, and QOL, and there were no statistically significant differences between breast and other cancer survivors and between cancer survivors and caregivers. CONCLUSIONS: The ALAC program demonstrated increased PA, physical function, and QOL in medically underserved cancer survivors and their caregivers. Furthermore, ALAC was successfully implemented by community partners and serves as a good model for reaching medically underserved cancer survivors and improving survivorship. Additional efforts are warranted to further extend reach, improve cancer survivorship, and reduce cancer health disparities among underserved cancer survivors.

Phenotypic and genetic characterization of an Avena sativa L. germplasm collection of diverse origin: implications for food-oat breeding in Chile.

Oats are known for their nutritional value and also for their beneficial properties on human health, such as the reduction of cholesterol levels and risk of coronary heart disease; they are an important export product for Chile. During the last decade (2010-2022) over 90% of the oat cultivated area in Chile has been covered with Avena sativa L. cv. Supernova INIA. This lack of genetic diversity in a context of climate change could limit the long-term possibility of growing oats in Chile. The present study is a phenotypic and genetic analysis of 132 oat cultivars and pure lines of diverse origin that can be considered as potential breeding material. The germplasm was evaluated for 28 traits and analyzed with 14 SSR markers. The effects of genotypes on phenotype were significant over all traits (P ≤ 0.05). Most traits exhibited moderate to high broad-sense heritability with exceptions such as yield (H2 = 0.27) and hulls staining (H2 = 0.32). Significant undesirable correlations between traits were generally of small biological importance, which is auspicious for achieving breeding objectives. Some of the heritability data and correlations provided here have not been previously reported. The overall phenotypic diversity was high (H' = 0.68 ± 0.18). The germplasm was grouped into three phenotypic clusters, differing in their qualities for breeding. Twenty-six genotypes outperforming Supernova INIA were identified for breeding of conventional food-oats. The genetic diversity of the germplasm was moderate on average (He = 0.58 ± 0.03), varying between 0.32 (AM22) and 0.77 (AME178). Two genetic subpopulations supported by the Structure algorithm exhibited a genetic distance of 0.24, showing low divergence of the germplasm. The diversity and phenotypic values found in this collection of oat genotypes are promising with respect to obtaining genetic gain in the short term in breeding programs. However, the similar genetic diversity, higher phenotypic diversity, and better phenotypic performance of the germplasm created in Chile compared to foreign germplasm suggest that germplasm harboring new genetic diversity will be key to favor yield and quality in new oat cultivars in the long term.

Efectos de la COVID-19 sobre los servicios de salud en Santiago de Cuba, 2020 / Effects of COVID-19 on health services in Santiago de Cuba, 2020

Introducción: En Santiago de Cuba las acciones aplicadas para el control de la epidemia en el 2020 ocasionaron cambios y efectos negativos sobre muchos de los servicios de salud que se brindan de manera habitual en el territorio. Objetivo: Identificar el efecto de la epidemia de COVID-19 sobre los servicios de salud en la provincia Santiago de Cuba durante el año 2020. Métodos: Se realizó un estudio ecológico retrospectivo con series temporales como unidades de análisis comparadas en la provincia de Santiago de Cuba como único territorio geográfico para evaluar los efectos que tuvo la COVID-19 sobre la prestación de los servicios de salud durante el año 2020. Se seleccionaron algunos indicadores de servicios de salud de la serie de tiempo de 2015 a 2019. La fuente de datos fueron las estadísticas oficiales. Se estimó el porcentaje de cambio y se propuso una clasificación de los efectos de la COVID-19 según su magnitud y sentido. Resultados: Se produjeron cambios en la cantidad y tipos de servicios de salud en cuanto a las consultas médicas externas y de urgencia, los ingresos hospitalarios y promedio de estadía de las actividades de cardiología relacionados con ingresos, coronariografías realizadas, marcapasos implantados y operaciones ejecutadas, de las actividades quirúrgicas operaciones electivas y de urgencia, así como las ambulatorias y por mínimo acceso, los tratamientos rehabilitadores, los estudios para el diagnóstico mediante el uso de los laboratorios clínicos y de microbiología, estudios imagenológicos, en general, y los más afectados fueron los relacionados con la Estomatología, trasplantes renales y de córnea. Conclusiones: La epidemia de COVID-19 tuvo un efecto negativo en el funcionamiento de los servicios de salud al producirse cambios desfavorables en la cantidad de servicios prestados en los niveles de atención primario y secundario, lo que puede impactar en la salud de personas vulnerables si no se establecen estrategias alternativas(AU)

Introduction: In Santiago de Cuba province, the actions applied to control the epidemic in 2020 caused changes and negative effects on many of the health services that are usually provided in the territory. Objective: To identify the effect of the COVID-19 epidemic on health services in Santiago de Cuba province during 2020. Methods: A retrospective ecological study was conducted with time series as units of comparative analysis in Santiago de Cuba province as the only geographical territory to evaluate the effects of COVID-19 on the provision of health services during 2020. Some health service indicators from the time series from 2015 to 2019 were selected. The data source was official statistics. The percentage of change was estimated and a classification of the effects of COVID-19 according to its magnitude and meaning was proposed. Results: There were changes in the number and types of health services in terms of outpatient and emergency medical consultations, hospital admissions and average stay of cardiology activities related to admissions, coronary angiographies performed, pacemakers implanted and operations performed, elective surgical activities and emergency operations, as well as outpatient and minimal access ones, rehabilitative treatments, studies for diagnosis through the use of clinical and microbiology laboratories, imaging studies in general, and the most affected were those related to Stomatology, and kidney and corneal transplants. Conclusions: The COVID-19 epidemic had a negative effect on the functioning of health services as there were unfavorable changes in the number of services provided at the primary and secondary care levels, which can impact on the health of vulnerable people if alternative strategies are not established(AU)

Transmisión directa del SARS-CoV-2 entre contactos en Santiago de Cuba / Direct Transmission of SARS-CoV-2 Among Contacts in Santiago de Cuba

Introducción: El virus SARS-CoV-2 se propaga, principalmente, entre personas que están en estrecho contacto, de ahí la importancia de la detección de contactos y conocer las formas de transmisión entre estos. Objetivo: Identificar las principales formas de transmisión directa entre contactos de casos importados y autóctonos. Métodos: Se realizó un estudio descriptivo transversal sobre dos poblaciones: los casos confirmados de COVID-19 en la provincia Santiago de Cuba en el último trimestre de 2020 y los contactos directos declarados por dichos casos. En busca de la mejor representatividad se empleó un diseño de muestreo estratificado en dos etapas. Para la recolección del dato primario se empleó la entrevista; para resumir la información, el número y el porcentaje; para detectar posibles diferencias, las pruebas de hipótesis de una proporción y de comparación de proporciones mediante el Minitab v. 19 y para elaborar los gráficos el Microsoft Excel 2016. Resultados: El promedio de contactos fue mayor entre los casos autóctonos, con predominio de compañeros de trabajo, vecinos e hijos. La relación contacto-caso en los importados fue amigo(a), chofer y suegro(a), mientras que en los autóctonos fue hijo(a). Hubo menor empleo de acciones preventivas y predominio de contactos extradomiciliarios en los importados. Los contactos de los importados fueron hospitalizados con mayor frecuencia y presentaron mayor proporción de asintomáticos que los de los autóctonos, pero no hubo diferencias significativas. Conclusiones: No se obtuvo un patrón diferenciado de transmisión, excepto que la transmisión característica de los autóctonos fue entre padre e hijo y en los importados fue entre amigos(AU)

Introduction: SARS-CoV-2 spreads, mainly, through close contact among people, hence the importance of detecting contacts of confirmed cases and identifying the mode of transmission between them. Objective: To identify the main modes of direct transmission among contacts of imported and autochthonous cases. Methods: A cross-sectional descriptive study was conducted in two populations: the confirmed cases of COVID-19 in Santiago de Cuba in the last quarter of 2020, and their declared direct contacts. In the search of the best representativeness, a two-stage stratified sampling method was used. The interview was used to collect the primary data; numbers and percentage, to summarize the information; the one-sample proportion hypothesis test and the compare proportions test using Minitab v.19, to identify possible differences across groups; and Microsoft Excel 2016, to produce the graphics. Results: The average number of contacts was higher among the autochthonous cases, prevailing the co-workers, neighbors and children. The contact-case relationship in imported cases was friend, driver, and mother or father-in-law; while in the autochthonous cases, it was son or daughter. Preventive actions were less used, and extra-domiciliary contacts of imported cases predominated. Contacts of imported cases were hospitalized more often, and had a higher proportion of asymptomatic than the autochthonous cases, but there was no significant differences. Conclusions: A differentiated pattern of transmission was not obtained; except that, transmission among autochthonous cases was between parent and child; while in imported cases, it was between friends(AU)

CAFS: Cost-Aware Features Selection Method for Multimodal Stress Monitoring on Wearable Devices.

OBJECTIVE: Today, stress monitoring on wearable devices is challenged by the tension between high-detection accuracy and battery lifetime driven by multimodal data acquisition and processing. Limited research has addressed the classification cost on multimodal wearable sensors, particularly when the features are cost-dependent. Thus, we design a Cost-Aware Feature Selection (CAFS) methodology that trades-off between prediction-power and energy-cost for multimodal stress monitoring. METHODS: CAFS selects the most important features under different energy-constraints, which allows us to obtain energy-scalable stress monitoring models. We further propose a self-aware stress monitoring method that intelligently switches among the energy-scalable models, reducing energy consumption. RESULTS: Using CAFS methodology on experimental data and simulation, we reduce the energy-cost of the stress model designed without energy constraints up to 94.37%. We obtain 90.98% and 95.74% as the best accuracy and confidence values, respectively, on unseen data, outperforming state-of-the-art studies. Analyzing our interpretable and energy-scalable models, we showed that simple models using only heart rate (HR) or skin conductance level (SCL), confidently predict acute stress for and non-stress for , but, outside these values, a multimodal model using respiration and pulse wave's features is needed for confident classification. Our self-aware acute stress monitoring proposal saves 10x energy and provides 88.72% of accuracy on unseen data. CONCLUSION: We propose a comprehensive solution for the cost-aware acute stress monitoring design addressing the problem of selecting an optimized feature subset considering their cost-dependency and cost-constraints. Significant: Our design framework enables long-term and confident acute stress monitoring on wearable devices.

Aspectos demográficos, clínico-epidemiológicos y geoespaciales de la COVID-19 en Santiago de Cuba / Demographic, clinical-epidemiological and geospatial aspects of COVID-19 in Santiago de Cuba

RESUMEN Fundamento: Santiago de Cuba al igual que el resto de las provincias cubanas, fue afectada por la COVID-19, aunque es de los territorios con menor incidencia de la enfermedad. Objetivo: describir los aspectos demográficos, clínico-epidemiológicos y geoespaciales de la COVID-19 en Santiago de Cuba. Métodos: se realizó un estudio observacional analítico en los niveles individual y poblacional. En el nivel individual, la población de estudio se integró por los 49 casos de COVID-19 de la provincia. Se estimó la frecuencia y distribución de casos, así como las pruebas de hipótesis para descubrir las diferencias entre estas. Para analizar el aspecto geoespacial se empleó como dato de área, el número de casos por territorio y como unidades de agregación de la información, los datos georreferenciados de la totalidad de consejos populares en que se encuentra dividida la provincia. Se realizó el análisis exploratorio de los datos espaciales, se estimó la autocorrelación espacial por consejos populares, por medio del índice global I de Moran y se visualizó la formación de conglomerados mediante el estadístico local G* de Getis-Ord. Resultados: se obtuvieron la frecuencia y distribución de las características demográficas, clínicas-epidemiológicas y la formación de agrupaciones espaciales por consejos populares según el número de casos de COVID-19 y su significación. Conclusiones: el municipio Santiago de Cuba marcó las diferencias a nivel poblacional en la epidemia de esta provincia. En cambio, a nivel individual se apreciaron diferencias entre los casos confirmados en algunos aspectos demográficos, no así en los clínicos ni epidemiológicos.

ABSTRACT Background: Santiago de Cuba, like the rest of the Cuban provinces, was affected by COVID-19, although it is one of the territories with the lowest incidence of the disease. Objective: to describe the demographic, clinical-epidemiological and geospatial aspects of COVID-19 in Santiago de Cuba. Methods: an analytical observational study was carried out at the individual and population levels. At the individual level, the 49 confirmed cases of COVID-19 in the province are used as the study population. The frequency and distribution of cases were estimated, as well as hypothesis tests, with a 5% significance, to discover the differences between them. To analyze the geospatial aspect, the geo-referenced data from all the popular councils into which the province is divided were used as area data, the number of cases by territory and as aggregation units of the information. The exploratory analysis of the spatial data was performed, the spatial autocorrelation was estimated by popular councils, using the Moran global index I, and the formation of clusters was visualized using the local G* statistic from Getis-Ord. Results: the frequency and distribution of the demographic, clinical and epidemiological characteristics were obtained, as well as the formation of spatial groupings by popular councils according to the number of COVID-19 cases and their significance. Conclusions: the municipality of Santiago de Cuba marked the differences at the population level in the epidemic of this province. On the other hand, at an individual level, differences were observed between the confirmed cases in some demographic aspects, but not in the clinical or epidemiological ones.

SPARE: A Spectral Peak Recovery Algorithm for PPG Signals Pulsewave Reconstruction in Multimodal Wearable Devices.

The photoplethysmographic (PPG) signal is an unobtrusive blood pulsewave measure that has recently gained popularity in the context of the Internet of Things. Even though it is commonly used for heart rate detection, it has been lately employed on multimodal health and wellness monitoring applications. Unfortunately, this signal is prone to motion artifacts, making it almost useless in all situations where a person is not entirely at rest. To overcome this issue, we propose SPARE, a spectral peak recovery algorithm for PPG signals pulsewave reconstruction. Our solution exploits the local semiperiodicity of the pulsewave signal, together with the information about the cardiac rhythm provided by an available simultaneous ECG, to reconstruct its full waveform, even when affected by strong artifacts. The developed algorithm builds on state-of-the-art signal decomposition methods, and integrates novel techniques for signal reconstruction. Experimental results are reported both in the case of PPG signals acquired during physical activity and at rest, but corrupted in a systematic way by synthetic noise. The full PPG waveform reconstruction enables the identification of several health-related features from the signal, showing an improvement of up to 65% in the detection of different biomarkers from PPG signals affected by noise.

Identificación de clústeres de casos de COVID-19 en la provincia Santiago de Cuba / Identification of clusters in COVID-19 cases in the Santiago de Cuba province

Introducción: A partir de la aparición de la epidemia COVID-19 se conforma un equipo multidisciplinario en Santiago de Cuba con participación de varias instituciones y activado por el Consejo de defensa provincial. El análisis integrado epidemiológico, la gestión gubernamental y la respuesta social resultarían determinantes en el control de la enfermedad. Objetivos: Identificar posibles grupos de casos con COVID-19 en la provincia Santiago de Cuba y caracterizar su transmisión según variables epidemiológicas. Métodos: Se desarrolló un estudio ecológico, comparándose los clústeres de transmisión de COVID-19. Se resumieron variables de interés y se realizó análisis de redes sociales desde el punto de vista de las relaciones entre casos y contactos, así como análisis espacial. Resultados: Se identificaron cinco grupos espaciales de transmisión en los municipios, uno en Palma Soriano, uno en Contramaestre y tres en Santiago de Cuba. Los antecedentes patológicos personales (hipertensión y procesos respiratorios), el sexo femenino, los casos sintomáticos y el promedio de 22 a 27 contactos por cada confirmado fueron las variables más relevantes. Se identificó fuente de infección introducida en 51 por ciento (25/49). Además, se identificaron redes sociales complejas en la transmisión de la enfermedad. Conclusiones: La transmisión de COVID-19 en la provincia Santiago de Cuba mostró grupos de casos y contactos con redes sociales epidemiológicas características para cada municipio, así como el modo de transmisión de acuerdo a la fuente de infección, relaciones de familiaridad o cercanía social y la relación de distancia espacial entre contactos, aspectos que influyeron en las bajas tasas de incidencia de la enfermedad, con predominio en su forma sintomática, edades jóvenes y en mujeres(AU)

Introduction: From the onset of COVID-19 epidemic, a multidisciplinary team is formed in Santiago de Cuba with the participation of several institutions and activated by the Provincial Defense Council. Integrated epidemiological analysis, government management and social response would be decisive in controlling the disease. Objectives: To identify possible groups of COVID-19 cases in the Santiago de Cuba province and to describe the transmission according to epidemiological variables. Methods: An ecological study was carried out, comparing COVID-19 transmission clusters. Variables of interest were summarized and analysis of social contact networks was carried out from the point of view of the relationships between cases and contacts, as well as spatial analysis. Results: Five spatial transmission groups were identified in the municipalities, one in Palma Soriano, one in Contramaestre and three in Santiago de Cuba. The personal pathological antecedents (hypertension and respiratory processes), female sex, symptomatic cases and the average of 22 to 27 contacts for each confirmed were the most relevant variables. A source of introduced infection was identified in 51 percent (25/49). In addition, complex social networks were identified in the transmission of the disease. Conclusions: The transmission of COVID-19 in Santiago de Cuba province showed groups of cases and contacts with characteristic epidemiological social networks for each municipality, as well as the mode of transmission according to the source of infection, relationships of familiarity or social closeness and the relationship of spatial distance between contacts, which influenced on the low incidence rates of the disease, with predominance of symptomatic form, young ages and in women(AU)

A lay health worker intervention to improve breast and cervical cancer screening among Latinas in El Paso, Texas: A randomized control trial.

INTRODUCTION: We examined the effectiveness of a lay health worker (promotora)-delivered intervention on increasing breast and cervical cancer screening among low-income, primarily uninsured Latinas living in El Paso, Texas. METHODS: In 2015, Breast and Cervical Cancer Screening (BCCS) program promotoras recruited Latinas overdue for breast and/or cervical cancer screening in community settings. Promotoras consented eligible women and conducted baseline surveys before individually randomizing women into control (n = 313) or intervention (n = 314) groups. Control participants received printed material providing basic information about breast and cervical cancer screening.Intervention participants received promotora-delivered one-on-one breast and cervical cancer screening education followed by navigation calls, providing assistance to address personal and logistic barriers to accessing clinical services. We assessed breast and cervical cancer screening outcomes using a 6-month follow-up survey. Per protocol (PP) and intent to treat (ITT) analyses are reported. RESULTS: At follow-up, among women in need of breast cancer screening, those in the intervention group were significantly more likely to complete a mammogram than those in the control group (PP: 53.4% vs. 40.1%, p = .013; ITT: 47.9% vs. 35.2%, p = .011). Among women in need of Pap screening, only intervention group women 50 years and older were more likely to complete a Pap screening compared with control group women (PP: 64.5% vs. 43.5%, p = .019). CONCLUSIONS: A promotora-delivered behavioral intervention, embedded in a community-based organization, increased mammography uptake in all women and Pap uptake among women 50 years and older in a sample of low-income Latinas. NCT04397744.

Morbilidad por COVID-19: análisis de los aspectos epidemiológicos, clínicos y diagnósticos / COVID-19 morbidity: analysis of epidemiological, clinical and diagnostic aspects

Introducción: En marzo de 2020 la OMS declaró pandemia a la COVID-19, enfermedad causada por el virus denominado SARS-CoV-2. Cuba, hasta el 9 de junio, reportó 2211 casos y 83 fallecidos; de estos 49 casos eran de Santiago de Cuba, con una letalidad de 6,12. Objetivo: Caracterizar la morbilidad por COVID-19 en Santiago de Cuba según aspectos epidemiológicos, clínicos y de diagnóstico seleccionados. Métodos: Estudio descriptivo transversal con los 49 pacientes confirmados en la provincia. Se efectuó la revisión de base de datos, estadísticas, historias epidemiológicas y clínicas. Se calcularon las tasas de incidencia, media aritmética y mediana, diferencia porcentual de tasas y prueba exacta de Fischer. Se utilizó el software EPIDAT con un nivel de confianza 95 por ciento y significancia ≤ 0,05 para determinar asociación estadística. Resultados: La tasa de incidencia fue 4,7 por 1000 habitantes. Los municipios comprometidos fueron Santiago, Contramaestre y Palma Soriano. El mayor riesgo estuvo en el grupo de los mayores de 60 años, con síntomas frecuentes tos, fiebre y rinitis. El 26,53 por ciento se encontró asintomático. Las principales comorbilidades asociadas fueron hipertensión arterial, trastornos neurológicos y respiratorios. Los procedimientos diagnósticos informaron RT-PCR positiva, LDH elevada, proteína C reactiva, hiperglucemia e infiltrado inflamatorio difuso pulmonar. Existió asociación estadística entre el periodo de evolución, 7 y más días desde el inicio de síntomas al ingreso, y el nivel de gravedad. Conclusiones: El mayor riesgo de enfermar y fallecer se constató en edades más avanzadas de la vida. Los síntomas más frecuentes se comportaron de manera similar a lo descrito en la bibliografía consultada, así como los resultados de laboratorio. La demora en acudir a instituciones de salud y comorbilidades asociadas constituyeron un riesgo, de evolucionar hacia la gravedad y muerte(AU)

Introduction: COVID-19, a disease caused by the virus named SARS-CoV-2, was declared pandemic by the WHO in March 2020. Until 9 June Cuba had reported 2 211 cases and 83 deaths. Forty-nine of these cases were from Santiago de Cuba, for a lethality of 6.12. Objective: Characterize COVID-19 morbidity in Santiago de Cuba based on the analysis of selected epidemiological, clinical and diagnostic aspects. Method: A descriptive cross-sectional study was conducted of the 49 patients confirmed in the province. A review was performed of databases, statistics, and clinical and epidemiological records. Estimation was made of incidence rates, arithmetic mean and median, percentage difference between the rates, and Fischer's exact test. Statistical association was determined with the software EPIDAT, using a confidence level of 95 percent and a significance level of ≤ 0.05. Results: The incidence rate was 4.7 per 1 000 inhabitants. The municipalities involved were Santiago, Contramaestre and Palma Soriano. The greatest risk lay in patients aged over 60 years, among whom coughing, fever and rhinitis were common symptoms. Of the patients studied, 26.53 percent were asymptomatic. The main associated comorbidities were hypertension and neurological and respiratory disorders. The results of the diagnostic procedures applied were positive RT-PCR, high LDH, C-reactive protein, hyperglycemia and diffuse inflammatory pulmonary infiltrate. A statistical association was found between the evolution period, 7 and more days from symptom onset to admission, and the degree of severity. Conclusions: The highest risk of becoming ill and dying was found in the most advanced ages of life. The most common symptoms behaved in a manner similar to the one described in the bibliography consulted, and so did the laboratory results obtained. Delay in reporting to health institutions and associated comorbidities were risks for progression to severity and death(AU)

La COVID-19 en Santiago de Cuba desde un análisis estadístico implicativo / COVID-19 in Santiago de Cuba province from an implicative statistical analysis

Introducción: La COVID-19 se ha convertido en una terrible pandemia, de ahí el interés de investigadores y decisores en estudiar las características de los casos confirmados en cada territorio, lo que es útil como patrón de comparación con las demás regiones y para crear las bases de la investigación de las causas de tal comportamiento. Objetivo: Describir el comportamiento de los casos confirmados con COVID-19 de la provincia Santiago de Cuba entre marzo y abril de 2020. Métodos: Se realizó un estudio observacional descriptivo transversal tomando como población de estudio los 49 casos confirmados con COVID-19 en la provincia de Santiago de Cuba, entre marzo y abril de 2020. Se seleccionaron variables clínicas y epidemiológicas. Se aplicó como técnica estadística el análisis estadístico implicativo, con sus tres formas de análisis: de similaridad, cohesitivo e implicativo. Resultados: Se obtuvo el conjunto de todas las relaciones entre las variables estudiadas de manera gráfica, destacándose entre estas, las diferencias entre ambos sexos, al asociarse las femeninas con la categoría asintomático y los masculinos con sintomático, grave y fallecido, los adultos mayores se relacionaron con la mayor cantidad de antecedentes personales patológicos y los fallecidos, los adultos jóvenes con los antecedentes y los síntomas del aparato respiratorio. Conclusiones: El estudio permite visualizar, como rasgo distintivo del comportamiento de los casos con COVID-19 en la provincia Santiago de Cuba, que el subgrupo de mayor riesgo es el adulto mayor del sexo masculino con enfermedades de base, fundamentalmente, la hipertensión arterial, lo cual está en concordancia con lo ocurrido en otras regiones del planeta(AU)

Objective: To describe the behaviour of COVID-19 confirmed cases from Santiago de Cuba province between March and April, 2020. Methods: It was carried out a cross-sectional, observational descriptive study taking as studied population 49 COVID-19 positive cases in Santiago de Cuba province between March and April, 2020. There were selected clinic and epidemiologic variables. As statistical technique it was applied the implicative statistical analysis with its three forms: similarity, cohesive, and implicative. Results: It was obtained a set of all the relations among the studied variables in a graphic way, being highlighted the differences among both sexes since the females were related to the asymptomatic category and the males to symptomatic, seriously ill and deceased categories; while older adults were related with the higher amount of personal pathological background and the deceased ones, and young adults were related to the backgrounds and respiratory system's symptoms. Conclusions: This study allows to visualize, as a distinctive feature of COVID-19 cases´ behaviour in Santiago de Cuba province, that the highest risk sub-group is the one of male older adults with underlying diseases, mainly arterial hypertension, which is similar to what is happening in other regions of the world(AU)

Effectiveness of patient empowerment over stress related to knee arthroplasty surgery / Efectividad del empoderamiento del paciente sobre el estrés relacionado con la cirugía de artroplastia de rodilla

OBJECTIVE: This study aims to show evidence of the Empowerment Session's effectiveness through measurements of surgery related emotional stress before and after this session. Method: The study was performed on 41 patients with knee arthroplasty surgery prescription by measuring the evolution of their emotional stress generated by surgery expectative, during the empowerment session. Two sets of measurements per patient were performed, before and after the empowerment session. Each set consisted of recording an electrocardiogram for 10min while the patients were seated and then applying two standard psychometric tests: State-Trait Anxiety Inventory test and Visual Analog Stress test. Differences in emotional stress were analyzed using psychometric tests and heart rate variability (HRV) analysis as stress biomarkers. RESULTS: Psychometric stress measurement shows a 17.8% reduction in stress according to the total stress scale value, and a 41.9% reduction in stress between test results before and after the session. Mean heart rate values increased by 7.4% with respect to the initial values, very low frequency power and total power also change in value suggesting more sympathetic and less parasympathetic activity. CONCLUSIONS: Both psychological and physiological measurements suggest the effectiveness of the empowerment session due to a significant increase in the wellness state of PATIENTS: Additionally, the correlation between psychometric tests and HRV indices demonstrates that both emotional stress indicators could be used as feedback on the empowerment sessions or as a reference to enhance surgical outcomes

OBJETIVO: Este estudio tiene como objetivo dar evidencias de la eficacia de la sesión de empoderamiento a través de mediciones del estrés emocional relacionado con la cirugía antes y después de esta sesión. MÉTODO: El estudio se realizó en 41 pacientes con prescripción de cirugía de artroplastia de rodilla durante la sesión de empoderamiento. Se realizaron 2 conjuntos de medidas por paciente, antes y después de la sesión. Cada conjunto consistió en registrar el electrocardiograma durante 10min mientras los pacientes estaban sentados y luego aplicando 2 test psicométricos estándar: test State-Trait Anxiety Inventory y escala análoga visual. Las diferencias en el estrés emocional se analizaron mediante test psicométricos y el análisis de la variabilidad del ritmo cardíaco (HRV) como biomarcadores de estrés. RESULTADOS: Los puntajes en los test psicométricos muestran una reducción del 17,8% en el estrés según el valor de la escala de estrés total, y una reducción del 41,9% en el estrés entre los resultados de las pruebas antes y después de la sesión. Los valores medios de ritmo cardíaco aumentaron un 7,4%. Las variaciones en la potencia ultra baja frecuencia y la potencia total sugieren una mayor actividad simpática y menor parasimpática. CONCLUSIONES: Tanto las mediciones psicológicas como fisiológicas sugieren la efectividad de la sesión de empoderamiento debido a un aumento significativo en el estado de bienestar de los pacientes. Además, la correlación entre las pruebas psicométricas y los índices de HRV demuestra que ambos indicadores de estrés emocional podrían utilizarse como retroalimentación en las sesiones de empoderamiento o como una referencia para mejorar los resultados quirúrgicos

Effectiveness of patient empowerment over stress related to knee arthroplasty surgery.

OBJECTIVE: This study aims to show evidence of the Empowerment Session's effectiveness through measurements of surgery related emotional stress before and after this session. METHOD: The study was performed on 41 patients with knee arthroplasty surgery prescription by measuring the evolution of their emotional stress generated by surgery expectative, during the empowerment session. Two sets of measurements per patient were performed, before and after the empowerment session. Each set consisted of recording an electrocardiogram for 10min while the patients were seated and then applying two standard psychometric tests: State-Trait Anxiety Inventory test and Visual Analog Stress test. Differences in emotional stress were analyzed using psychometric tests and heart rate variability (HRV) analysis as stress biomarkers. RESULTS: Psychometric stress measurement shows a 17.8% reduction in stress according to the total stress scale value, and a 41.9% reduction in stress between test results before and after the session. Mean heart rate values increased by 7.4% with respect to the initial values, very low frequency power and total power also change in value suggesting more sympathetic and less parasympathetic activity. CONCLUSIONS: Both psychological and physiological measurements suggest the effectiveness of the empowerment session due to a significant increase in the wellness state of patients. Additionally, the correlation between psychometric tests and HRV indices demonstrates that both emotional stress indicators could be used as feedback on the empowerment sessions or as a reference to enhance surgical outcomes.

Cuantificación del estrés: información incompleta más un exceso de triunfalismo. Réplica / Quantification of stress: incomplete information plus excessive triumphalism. Reply

No disponible

Proyecto ES3: intentando la cuantificación y medida del nivel de estrés / Project ES3: attempting to quantify and measure the level of stress

Introducción. La Organización Mundial de la Salud ha calificado al estrés de ‘epidemia mundial’, debido a su cada vez mayor incidencia en la salud. El trabajo que se presenta en este artículo representa un intento de cuantificar objetivamente el nivel de estrés. Objetivo. La metodología desarrollada tiene como objetivo medir cuán lejos o cuán cerca se encuentra un sujeto de una situación considerada médica y socialmente como ‘normal’. Sujetos y métodos. Se ha realizado un estudio bibliográfico de la fisiopatología del estrés y sus métodos de estudio, en experimentación animal y en humanos. Se han puesto en marcha nueve estudios prospectivos observacionales con distintas tipologías de sujetos y estresores que cubren las diferentes tipologías de estrés. Resultados. Como resultado del estudio bibliográfico, se han identificado las distintas tipologías de estrés, los indicadores que describen resultados significativos, los tests psicométricos y los ‘agentes estresantes’ bien documentados. Este material ha permitido diseñar la metodología general y el detalle de los nueve ensayos clínicos. Los resultados preliminares obtenidos en algunos de los estudios han servido para validar los indicadores, así como la eficacia de las técnicas utilizadas experimentalmente para disminuir el estrés o para producirlo. Conclusiones. Los resultados preliminares obtenidos en los ensayos experimentales muestran que se está en el camino correcto hacia la definición y validación de marcadores multivariable para la cuantificación de los niveles de estrés, y sugieren que la metodología puede ser aplicada de forma similar al estudio de trastornos mentales (AU)

Introduction. The WHO has qualified stress as a ‘world epidemic’ due to its increasingly greater incidence on health. The work described in this paper represents an attempt to objectively quantify the level of stress. Aim. The aim of the method developed here is to measure how close or how far a subject is from a situation that can be considered ‘normal’ in medical and social terms. Subjects and methods. The literature on the pathophysiology of stress and its methods of study in experiments on both animals and humans was reviewed. Nine prospective observational studies were undertaken with different types of subjects and stressors covering the different types of stress. Results. The results of the literature review made it possible to identify the different types of stress, the indicators that yield significant results, the psychometric tests and the well-documented ‘stressors’. This material was then used to design the general method and the details of the nine clinical trials. The preliminary results obtained in some of the studies were used to validate the indicators as well as the efficacy of the techniques used experimentally to diminish stress or to produce it. Conclusions. The early results obtained in the experimental trials show that we are on the right path towards defining and validating multivariable markers for quantifying levels of stress and also suggest that the method can be applied in a similar way to the study of mental disorders (AU)

Project ES3: attempting to quantify and measure the level of stress.

INTRODUCTION: The WHO has qualified stress as a 'world epidemic' due to its increasingly greater incidence on health. The work described in this paper represents an attempt to objectively quantify the level of stress. AIM: The aim of the method developed here is to measure how close or how far a subject is from a situation that can be considered 'normal' in medical and social terms. SUBJECTS AND METHODS: The literature on the pathophysiology of stress and its methods of study in experiments on both animals and humans was reviewed. Nine prospective observational studies were undertaken with different types of subjects and stressors covering the different types of stress. RESULTS: The results of the literature review made it possible to identify the different types of stress, the indicators that yield significant results, the psychometric tests and the well-documented 'stressors'. This material was then used to design the general method and the details of the nine clinical trials. The preliminary results obtained in some of the studies were used to validate the indicators as well as the efficacy of the techniques used experimentally to diminish stress or to produce it. CONCLUSIONS: The early results obtained in the experimental trials show that we are on the right path towards defining and validating multivariable markers for quantifying levels of stress and also suggest that the method can be applied in a similar way to the study of mental disorders.

TITLE: Proyecto ES3: intentando la cuantificacion y medida del nivel de estres.Introduccion. La Organizacion Mundial de la Salud ha calificado al estres de 'epidemia mundial', debido a su cada vez mayor incidencia en la salud. El trabajo que se presenta en este articulo representa un intento de cuantificar objetivamente el nivel de estres. Objetivo. La metodologia desarrollada tiene como objetivo medir cuan lejos o cuan cerca se encuentra un sujeto de una situacion considerada medica y socialmente como 'normal'. Sujetos y metodos. Se ha realizado un estudio bibliografico de la fisiopatologia del estres y sus metodos de estudio, en experimentacion animal y en humanos. Se han puesto en marcha nueve estudios prospectivos observacionales con distintas tipologias de sujetos y estresores que cubren las diferentes tipologias de estres. Resultados. Como resultado del estudio bibliografico, se han identificado las distintas tipologias de estres, los indicadores que describen resultados significativos, los tests psicometricos y los 'agentes estresantes' bien documentados. Este material ha permitido diseñar la metodologia general y el detalle de los nueve ensayos clinicos. Los resultados preliminares obtenidos en algunos de los estudios han servido para validar los indicadores, asi como la eficacia de las tecnicas utilizadas experimentalmente para disminuir el estres o para producirlo. Conclusiones. Los resultados preliminares obtenidos en los ensayos experimentales muestran que se esta en el camino correcto hacia la definicion y validacion de marcadores multivariable para la cuantificacion de los niveles de estres, y sugieren que la metodologia puede ser aplicada de forma similar al estudio de trastornos mentales.

Características clínicas y epidemiológicas de la epidemia de dengue en el municipio de Santiago de Cuba / Clinical and epidemiological characteristics of dengue epidemic in Santiago de Cuba municipality

Se realizó un estudio descriptivo y transversal de 13 147 pacientes del municipio Santiago de Cuba, a fin de caracterizar desde el punto de vista clinicoepidemiológico la epidemia de dengue que afectó a dicho municipio desde 2006 hasta 2007, para lo cual se constituyó un equipo multidisciplinario formado por epidemiólogos, clínicos, pediatras y ginecoobstetras. Se caracterizaron los casos según variables de interés clinicoepidemiológico. Predominaron el sexo femenino (50,6 %) en los mayores de 15 años (92,3 %), la forma clínica de dengue clásico (98,6 %) y julio-agosto-septiembre como los meses de mayor notificación de casos. Se conoció la morbimortalidad en una población susceptible a un nuevo serotipo no identificado anteriormente y se demostró que la infección secundaria en menores no fue suficiente para producir las formas hemorrágicas de esta enfermedad; por tanto, se recomendó mantener estrecha vigilancia sobre los viajeros procedentes de áreas endémicas y con altos índices vectoriales.

A descriptive and cross-sectional study of 13 147 patients from Santiago de Cuba municipality was carried out, in order to characterize the dengue epidemic from the clinical and epidemiological point of view, which affected this municipality from 2006 to 2007, for this purpose a multidisciplinary team was formed by epidemiologists, clinical doctors, pediatricians and gyneco-obstetricians. Cases were characterized according to variables of clinical and epidemiological interest. Female sex (50.6%) in those under 15 years (92.3%), the clinical classical form of dengue (98.6%) and July-August-September as the months of higher notification of cases. Morbimortality was known in a population susceptible to a previously non identified new serotype and it was shown that the secondary infection in the younger population was not enough to produce the hemorrhagic forms of this disease; therefore, it was recommended to maintain close control on the travellers coming from endemic areas and with high vectorial indexes.

Características clínicas y epidemiológicas de la epidemia de dengue en el municipio de Santiago de Cuba / Clinical and epidemiological characteristics of dengue epidemic in Santiago de Cuba municipality

Se realizó un estudio descriptivo y transversal de 13 147 pacientes del municipio Santiago de Cuba, a fin de caracterizar desde el punto de vista clinicoepidemiológico la epidemia de dengue que afectó a dicho municipio desde 2006 hasta 2007, para lo cual se constituyó un equipo multidisciplinario formado por epidemiólogos, clínicos, pediatras y ginecoobstetras. Se caracterizaron los casos según variables de interés clinicoepidemiológico. Predominaron el sexo femenino (50,6 por ciento) en los mayores de 15 años (92,3 por ciento), la forma clínica de dengue clásico (98,6 por ciento) y julio-agosto-septiembre como los meses de mayor notificación de casos. Se conoció la morbimortalidad en una población susceptible a un nuevo serotipo no identificado anteriormente y se demostró que la infección secundaria en menores no fue suficiente para producir las formas hemorrágicas de esta enfermedad; por tanto, se recomendó mantener estrecha vigilancia sobre los viajeros procedentes de áreas endémicas y con altos índices vectoriales(AU)

A descriptive and cross-sectional study of 13 147 patients from Santiago de Cuba municipality was carried out, in order to characterize the dengue epidemic from the clinical and epidemiological point of view, which affected this municipality from 2006 to 2007, for this purpose a multidisciplinary team was formed by epidemiologists, clinical doctors, pediatricians and gyneco-obstetricians. Cases were characterized according to variables of clinical and epidemiological interest. Female sex (50.6 percent) in those under 15 years (92.3 percent), the clinical classical form of dengue (98.6 percent) and July-August-September as the months of higher notification of cases. Morbimortality was known in a population susceptible to a previously non identified new serotype and it was shown that the secondary infection in the younger population was not enough to produce the hemorrhagic forms of this disease; therefore, it was recommended to maintain close control on the travellers coming from endemic areas and with high vectorial indexes(AU)

Caracterización clinicoquirúrgica y anatomopatológica de la enfermedad nodular tiroidea / Clinical surgical and pathological characterization of nodular thyroid disease

Introducción: La enfermedad nodular tiroidea constituye un preocupante problema endocrino debido a su asociación con el cáncer. Objetivos: Caracterizar a los pacientes hospitalizados con dicha afección según aspectos clinicoquirúrgicos y anatomopatológicos, así como determinar la eficacia del estudio citológico mediante punción-aspiración con aguja fina para su diagnóstico. Método: Se realizó una investigación descriptiva, transversal y prospectiva de 154 afectados con esta enfermedad, operados en el Servicio de Cirugía General del Hospital Clinicoquirúrgico Docente Dr Ambrosio Grillo Portuondo de Santiago de Cuba, durante el trienio 2007-2010. Resultados: Predominaron las féminas de 30-59 años. Los índices de confiabilidad para el estudio citológico fueron: sensibilidad (81,2 por ciento), especificidad (97,9 por ciento) y certeza diagnóstica (93,9 por ciento). Entre los nódulos benignos preponderó el adenoma folicular y entre los malignos el carcinoma papilar. La hemitiroidectomía fue la intervención más frecuente; no obstante, en todos los nódulos malignos se realizó tiroidectomía total. La disfonía resultó ser la complicación posoperatoria más común, asociada significativamente con la cirugía radical. Conclusiones: La citología mediante punción-aspiración con aguja fina permite un diagnóstico confiable de las enfermedades nodulares de tiroides. Ante la presencia de cáncer tiroideo, la tendencia debe ser la cirugía radical, aunque a ella se asocian el mayor número de complicaciones posquirúrgicas.

Introduction: Nodular thyroid disease is a worrisome endocrine problem due to its association with cancer. Objectives: To characterize patients hospitalized with this condition according to clinical surgical and pathological aspects, as well as to determine the effectiveness of the cytology by fine-needle aspiration biopsy for diagnosis. Method: A descriptive, cross-sectional and prospective study was carried out in 154 patients with this disease, operated at the General Surgery Department of Dr Ambrosio Grillo Portuondo Clinical Surgical Teaching Hospital in Santiago de Cuba during the period 2007-2010.Results: There was a predominance of 30-59 year-old females. Rates of reliability for cytology were: sensitivity (81.2 percent), specificity (97.9 percent) and diagnostic accuracy (93.9 percent). Among benign nodules was the follicular adenoma, and among malignant ones was the papillary carcinoma. Hemithyroidectomy was the most frequent operation; however, in all malignant nodules total thyroidectomy was performed. Dysphonia was the most commonly postoperative complication significantly associated with radical surgery.Conclusions: Cytology by fine-needle aspiration biopsy allows a reliable diagnosis of nodular thyroid diseases. In the presence of thyroid cancer the trend should be radical surgery, although it is associated with many postoperative complications.