Cubanthonomus, a new genus of Anthonomini (Coleoptera: Curculionidae: Curculioninae) from Cuba.

Cubanthonomus Anderson, new genus (Coleoptera: Curculionidae: Curculioninae: Anthonomini) is here described to accommodate the Cuban species Cleogonus grossulus Suffrian, which was previously placed as incertae sedis within Cleogonini. The genus is characterized by head constricted behind the eyes, globose form, compact antennal funicle of seven antennomeres, base of pronotum strongly produced posteriorly at middle, elytra with rows of punctures (striae effaced), tarsal claws with small basal tooth, profemora with two teeth, meso- and metafemora with single small tooth. Specimens have been collected in tropical semideciduous forest but no host associations are known.

Presence of pharmaceutical contaminants of emerging concerns in two rivers of western Cuba and their relationship with the extracellular enzymatic activity of microbial communities.

In recent years, the concern derived from the presence of emerging contaminants in the environment and the possible effects on the One Health trilogy has increased. This study determined the concentration of pharmaceutical contaminants of emerging concern and their relationship with the extracellular enzymatic activity of microbial communities from two rivers in western Cuba. Two sampling stations were analyzed; one in the Almendares River (urban) and the other in the San Juan River (rural), taking into account the pollution sources that arrive at these stations and previous physicochemical characterizations. Extracellular protease, acid phosphatase, alkaline phosphatase, lipase, and catalase activities in water and sediments were determined and correlated with contaminants of emerging concern determined by liquid chromatography with mass spectrometry. This study evidenced the presence of different pharmaceutical contaminants found in the categories of antihypertensives, stimulants, anti-inflammatories, and antibiotics in both rivers. Concentrations of contaminants of emerging concern were greater in the Almendares River compared to the San Juan River. In addition, through the canonical redundancy analysis, the influence of these contaminants on the extracellular enzymatic activities of microbial communities was documented, where in most cases they inhibit protease, phosphatase, and lipase activities and enhance catalase activity in response to oxidative stress. The present investigation constitutes the first report in Cuba of the presence of pharmaceutical contaminants of emerging concern and one of the few works that exist in the Latin American region.

Polimorfismos de los genes CCR5, IL-6, IFN-γ e IL-10 en pacientes cubanos con VIH/sida / Polymorphisms of CCR5, IL-6, IFN-γ and IL-10 genes in Cuban HIV/AIDS patients

Introducción Los estudios genéticos han demostrado asociaciones de varios polimorfismos de un solo nucleótido (SNP) con diferentes tasas de progresión y variación en la susceptibilidad a la infección por VIH. Este estudio tuvo como objetivo estimar la frecuencia de los polimorfismos ccr5Δ32, IL-6-174G/C, IFN-γ+874T/A e IL-10-1082A/G en pacientes cubanos infectados por VIH y un grupo de parejas serodiscordantes para evaluar su influencia sobre el riesgo y la progresión de la enfermedad. Métodos Se realizó un estudio transversal en 120 sujetos atendidos en el Instituto de Medicina Tropical «Pedro Kour» (IPK) y el Hospital Hermanos Ameijeiras entre junio de 2018 y diciembre de 2019. La amplificación de los fragmentos de los genes ccr5, IL-6, IFN-γ e IL-10 se realizó mediante reacción en cadena de la polimerasa seguida por el análisis del polimorfismo de fragmentos de restricción utilizando la enzima NlaIII para la IL-6. El sistema de mutación refractario a la amplificación por PCR se utilizó en el caso de los genes IFN-γ e IL-10. Resultados Las distribuciones alélicas y genotípicas de los genes ccr5, IL-6, IFN-γ e IL-10 no difirieron significativamente entre los dos grupos. Los recuentos celulares y los valores de carga viral en plasma no difirieron significativamente entre los genotipos de los genes ccr5, IL-6, IFN-γ e IL-10. Solo el genotipo IL-6 GC se asoció con valores más altos de carga viral. La combinación de alelos de los cuatro SNP considerados mostró un aumento muy significativo del riesgo de infección por VIH para uno de ellos, pero con una frecuencia muy baja (<1%). Conclusión Este estudio contribuye a evaluar la frecuencia de estos polimorfismos y su influencia en los biomarcadores de la progresión de la infección por VIH en la población cubana con infección por el VIH. (AU)

Introduction Genetic studies have shown associations of several single nucleotide polymorphisms (SNP) with different rates of progression and variation in susceptibility to HIV infection. This study aimed to estimate the frequency of ccr5Δ32, IL-6-174G/C, IFN-γ+874T/A and IL-10-1082A/G polymorphisms in Cuban HIV-infected patients and a group of sero-discordant couples to assess their influence on risk and disease progression. Methods A cross-sectional study was carried out on 120 subjects registered at the Institute of Tropical Medicine «Pedro Kour» (IPK) and the Ameijeiras Hospital from June 2018 until December 2019. The amplification of fragments of the ccr5, IL-6, IFN-γ and IL-10 genes was performed by polymerase chain reaction followed by identification of polymorphisms using the restriction fragment length polymorphism analysis for IL-6 with the restriction enzymes Nla III. Amplification refractory mutation system was used for IFN-γ and IL-10 genes. Results The allelic and genotypic distributions of the genes ccr5, IL-6, IFN-γ and IL-10 did not differ significantly between the two groups. Cell counts and plasma viral load values did not differ significantly between genotypes of the ccr5, IL-6, IFN-γ and IL-10 genes. Only the IL-6 GC genotype was associated with higher viral load values. The combination of alleles of the four considered SNPs showed a highly significant increase in the risk of HIV infection for one of them, but with a very low frequency (<1%). Conclusion This study contributes to evaluating the frequency of these polymorphisms and their influence on biomarkers of the progression of HIV infection in the Cuban HIV-population. (AU)

Polimorfismos de los genes CCR5, IL-6, IFN-γ e IL-10 en pacientes cubanos con VIH/sida / Polymorphisms of CCR5, IL-6, IFN-γ and IL-10 genes in Cuban HIV/AIDS patients

Introducción Los estudios genéticos han demostrado asociaciones de varios polimorfismos de un solo nucleótido (SNP) con diferentes tasas de progresión y variación en la susceptibilidad a la infección por VIH. Este estudio tuvo como objetivo estimar la frecuencia de los polimorfismos ccr5Δ32, IL-6-174G/C, IFN-γ+874T/A e IL-10-1082A/G en pacientes cubanos infectados por VIH y un grupo de parejas serodiscordantes para evaluar su influencia sobre el riesgo y la progresión de la enfermedad. Métodos Se realizó un estudio transversal en 120 sujetos atendidos en el Instituto de Medicina Tropical «Pedro Kour» (IPK) y el Hospital Hermanos Ameijeiras entre junio de 2018 y diciembre de 2019. La amplificación de los fragmentos de los genes ccr5, IL-6, IFN-γ e IL-10 se realizó mediante reacción en cadena de la polimerasa seguida por el análisis del polimorfismo de fragmentos de restricción utilizando la enzima NlaIII para la IL-6. El sistema de mutación refractario a la amplificación por PCR se utilizó en el caso de los genes IFN-γ e IL-10. Resultados Las distribuciones alélicas y genotípicas de los genes ccr5, IL-6, IFN-γ e IL-10 no difirieron significativamente entre los dos grupos. Los recuentos celulares y los valores de carga viral en plasma no difirieron significativamente entre los genotipos de los genes ccr5, IL-6, IFN-γ e IL-10. Solo el genotipo IL-6 GC se asoció con valores más altos de carga viral. La combinación de alelos de los cuatro SNP considerados mostró un aumento muy significativo del riesgo de infección por VIH para uno de ellos, pero con una frecuencia muy baja (<1%). Conclusión Este estudio contribuye a evaluar la frecuencia de estos polimorfismos y su influencia en los biomarcadores de la progresión de la infección por VIH en la población cubana con infección por el VIH. (AU)

Introduction Genetic studies have shown associations of several single nucleotide polymorphisms (SNP) with different rates of progression and variation in susceptibility to HIV infection. This study aimed to estimate the frequency of ccr5Δ32, IL-6-174G/C, IFN-γ+874T/A and IL-10-1082A/G polymorphisms in Cuban HIV-infected patients and a group of sero-discordant couples to assess their influence on risk and disease progression. Methods A cross-sectional study was carried out on 120 subjects registered at the Institute of Tropical Medicine «Pedro Kour» (IPK) and the Ameijeiras Hospital from June 2018 until December 2019. The amplification of fragments of the ccr5, IL-6, IFN-γ and IL-10 genes was performed by polymerase chain reaction followed by identification of polymorphisms using the restriction fragment length polymorphism analysis for IL-6 with the restriction enzymes Nla III. Amplification refractory mutation system was used for IFN-γ and IL-10 genes. Results The allelic and genotypic distributions of the genes ccr5, IL-6, IFN-γ and IL-10 did not differ significantly between the two groups. Cell counts and plasma viral load values did not differ significantly between genotypes of the ccr5, IL-6, IFN-γ and IL-10 genes. Only the IL-6 GC genotype was associated with higher viral load values. The combination of alleles of the four considered SNPs showed a highly significant increase in the risk of HIV infection for one of them, but with a very low frequency (<1%). Conclusion This study contributes to evaluating the frequency of these polymorphisms and their influence on biomarkers of the progression of HIV infection in the Cuban HIV-population. (AU)

Cine debate y racialidad en la facultad de medicina n 1 de Santiago de Cuba / Cinema debate and raciality at the No. 1 medical school in Santiago de Cuba

La educación a través del cine constituye un exponente de concientización contra la discriminación racial y sus efectos. En la Facultad de Medicina No.1 de Santiago de Cuba se facilita el debate de filmes que abordan este asunto, partiendo del intercambio creativo y reflexivo con estudiantes y docentes según las situaciones complejas de diversas épocas que se reflejan en los materiales exhibidos y su paralelismo en la actualidad mundial, y en las complejas situaciones que prevalecen en la sociedad cubana.(AU)

Education through cinema is an exponent of awareness against racial discrimination and its effects. In the Faculty of Medicine No.1 of Santiago de Cuba the debate of films that promotes activity based on the creative and reflective exchange with students and teachers according to the complex situations of different times that are reflected in the exhibited materials and their parallelism in world news and the complex situations that prevail in Cuban society.(AU)

Seventeen-year study reveals fluctuations in key ecological indicators on two reef crests in Cuba.

Reef crests in the Caribbean have lost approximately 80% of the foundational habitat-forming coral Acropora palmata (Lamarck, 1816), with declines registered as early as the 1950s mainly from anthropogenic causes. We studied two reef crests in the northwestern region of Cuba over 17 years (2005 to 2021) to evaluate temporal changes in coral cover, dominated by A. palmata, and their potential drivers. The density of A. palmata generally showed a negative trend at both reefs, with the lowest density recorded in 2021 at 0.2 ± 0.05 col. m-2 at Playa Baracoa and 1.0 ± 0.1 col. m-2 at Rincon de Guanabo. The mean size of the colonies in the two reefs also decreased over time. In Playa Baracoa, the mean diameter of A. palmata colonies decreased from 2012 at 67 ± 5.9 cm to 2013 at 34 ± 2.2 cm, whereas in Rincon de Guanabo, a change in diameter was evident from 2015 at 44.3 ± 2.3 to 2021 at 21.6 ± 0.9 cm. Adult colonies (10 cm-50 cm diameter) predominated in most years on both reefs. The populations of A. palmata on both reefs were healthy, with an average of 70% colonies in good condition during the study period. However, A. palmata cover decreased by almost half by 2021, to 8.6% in Playa Baracoa and 16.8% in Rincon de Guanabo. By contrast, macroalgal cover increased two-fold to 87.1% in Playa Baracoa and four-fold to 77.2% in Rincon de Guanabo. The density of the sea urchin Diadema antillarum was higher in Playa Baracoa than in Rincon de Guanabo. The highest densities were 2.8 ± 0.2 ind. m-2 in Playa Baracoa in 2005 and 0.1 ± 0.03 ind. m-2 in Rincon de Guanabo in 2008. Although our results show an overall decline of A. palmata (density and percent cover) and an increase in macroalgae, these two reef crests are in better condition than most reefs in the Caribbean in terms of the density and health of A. palmata populations, and the density of D. antillarum at Playa Baracoa. Our results are important in establishing a management plan to ensure the condition of these reef crests does not degrade further.

The global, regional, and national burden of foreign bodies from 1990 to 2019: a systematic analysis of the global burden of disease study 2019.

BACKGROUND: Foreign bodies (FBs) are a common emergency in medical institutions, that can occur in any area and among people of any age, which are common public health problems. Understanding the epidemiological characteristics of FBs is crucial for their prevention and control. The purpose of this study was to analyze the epidemiological characteristics of FBs worldwide through the data from the Global Burden of Disease Study 2019 (GBD 2019). METHODS: We obtained data from the GBD 2019, which is an important public database to understand the disease burden of FBs. Joinpoint was used to analyze temporal trends in the incidence and death trends of FBs, which is widely used to study the long-term temporal trend of the burden of diseases. SaTScan was used to detect spatial-temporal clusters of pulmonary aspiration and foreign body in the airway (PAFBA), which is based on a Poisson model, scanning the number of people and diseases in the study area to obtain the spatial-temporal clusters of diseases. RESULTS: Globally, the age-standardized incidence rate (ASIR) and the age-standardized death rate (ASDR) of FBs in 2019 were 869.23/100,000 (679.92/100,000-1120.69/100,000) and 1.55/100,000 (1.41/100,000-1.67/100,000), respectively. The ASIR and ASDR showed downtrends with average annual percent changes (AAPCs) of -0.31% and - 1.47% from 1990 to 2019. Of note, the ASIR showed an uptrend during 2010-2019, especially in high, high-middle, and middle SDI regions. Stratified analysis by age group showed that ASIR increased in each age group in recent years. From 1990 to 2019, the ASDR in the over-70 age group showed an uptrend worldwide, especially in high and high-middle SDI regions. In different types of FBs, the ASDR of PAFBA was the highest. The death burden of PAFBA was mainly clustered in 82 countries during 1993-2007, such as Canada, Cuba, and Mexico. CONCLUSION: The most important goal is to improve public awareness and emergency knowledge of FBs through publicity methods, such as the internet or offline activities, and to improve laws and regulations. Additionally, different age groups need different targeted measures, such as strengthening the care of children, caring for elderly individuals, improving necessary monitoring programs and reporting systems, conducting effective hazard assessments, and publicity and education activities.

The association of maternal country/region of origin and nativity with infant mortality rate among Hispanic preterm infants.

OBJECTIVES: Among US-born preterm infants of Hispanic mothers, we analyzed the unadjusted and adjusted infant mortality rate (IMR) by country/region of origin and maternal nativity status. STUDY DESIGN: Using linked national US birth and death certificate data (2005-2014), we examined preterm infants of Hispanic mothers by subgroup and nativity. Clinical and sociodemographic covariates were included and the main outcome was death in the first year of life. RESULTS: In our cohort of 891,216 preterm Hispanic infants, we demonstrated different rates of infant mortality by country and region of origin, but no difference between infants of Hispanic mothers who were US vs. foreign-born. CONCLUSION: These findings highlight the need to disaggregate the heterogenous Hispanic birthing population into regional and national origin groups to better understand unique factors associated with adverse perinatal outcomes in order to develop more targeted interventions for these subgroups.

Detection, Characterization and Sequencing of BTV Serotypes Circulating in Cuba in 2022.

In Cuba, despite a high sero-prevalence of bluetongue virus (BTV), circulating serotypes remain unknown. The aim of this study was to identify circulating BTV serotypes in farms throughout the western region of Cuba. Blood samples were collected from 200 young cattle and sheep between May and July 2022 for virological analyses (PCR, viral isolation and virus neutralization) and genome sequencing. The results confirmed viral circulation, with viro-prevalence of 25% for BTV. The virus was isolated from 18 blood samples and twelve BTV serotypes were identified by sequencing RT-PCR products targeting the segment 2 of the BTV genome (BTV-1, 2, 3, 6, 10, 12, 13, 17, 18, 19, 22 and 24). Finally, the full genome sequences of 17 Cuban BTV isolates were recovered using a Sequence Independent Single Primer Amplification (SISPA) approach combined to MinION Oxford Nanopore sequencing technology. All together, these results highlight the co-circulation of a wide diversity of BTV serotypes in a quite restricted area and emphasize the need for entomological and livestock surveillance, particularly in light of recent changes in the global distribution and nature of BTV infections.

LAENALS: epidemiological and clinical features of amyotrophic lateral sclerosis in Latin America.

OBJECTIVE: The Latin American Epidemiologic study of ALS (LAENALS) aims to gather data on ALS epidemiology, phenotype, and risk factors in Cuba, Chile, and Uruguay, to understand the impact of genetic and environmental factors on ALS. METHODS: A harmonized data collection protocol was generated, and a Latin-American Spanish language Register was constructed. Patient data were collected in Uruguay in 2018, in Chile from 2017 to 2019, and in Cuba between 2017 and 2018. Statistical analysis was performed using SPSS 25.0.0 software. Crude cumulative incidence, standardized incidence, and prevalence were calculated in the population aged 15 years and older. RESULTS: During 2017-2019, 90 people with ALS from Uruguay (55.6% men), 219 from Chile (54.6% men), and 49 from Cuba (55.1% men) were included. The cumulative crude incidence in 2018 was 1.73/100,000 persons in Uruguay, 1.08 in Chile and 0.195 in Cuba. Crude prevalence in 2018 was 2.19 per 100,000 persons in Uruguay, 1.39 in Chile and 0.55 in Cuba. Mean age at onset was 61.8 ± 11.96 SD years in Uruguay, 61.9 ± 10.4 SD years in Chile, and 60.21 ± 12.45 SD years in Cuba (p = 0.75). Median survival from onset was 32.43 months (21.93 - 42.36) in Uruguay, 24 months (13.5 - 33.5) in Chile, and 29 months (15 - 42.5) in Cuba (p = 0.006). CONCLUSIONS: These preliminary data from LAENALS confirm the lower incidence and prevalence of ALS in counties with admixed populations. The LAENALS database is now open to other Latin American countries for harmonized prospective data collection.

An island 'endemic' born out of hybridization between introduced lineages.

Humans have profoundly impacted the distribution of plant and animal species over thousands of years. The most direct example of these effects is human-mediated movement of individuals, either through translocation of individuals within their range or through the introduction of species to new habitats. While human involvement may be suspected in species with obvious range disjunctions, it can be difficult to detect natural versus human-mediated dispersal events for populations at the edge of a species' range, and this uncertainty muddles how we understand the evolutionary history of populations and broad biogeographical patterns. Studies combining genetic data with archaeological, linguistic and historical evidence have confirmed prehistoric examples of human-mediated dispersal; however, it is unclear whether these methods can disentangle recent dispersal events, such as species translocated by European colonizers during the past 500 years. We use genomic DNA from historical museum specimens and historical records to evaluate three hypotheses regarding the timing and origin of Northern Bobwhites (Colinus virginianus) in Cuba, whose status as an endemic or introduced population has long been debated. We discovered that bobwhites from southern Mexico arrived in Cuba between the 12th and 16th centuries, followed by the subsequent introduction of bobwhites from the southeastern USA to Cuba between the 18th and 20th centuries. These dates suggest the introduction of bobwhites to Cuba was human-mediated and concomitant with Spanish colonial shipping routes between Veracruz, Mexico and Havana, Cuba during this period. Our results identify endemic Cuban bobwhites as a genetically distinct population born of hybridization between divergent, introduced lineages.

Prevalence of intestinal parasites and associated risk factors among schoolchildren from Unión de Reyes municipality, Matanzas Province, Cuba.

Intestinal parasites are widely distributed around the world and children are the most common affected group. The prevalence of intestinal parasites and associated risk factors by a cross-sectional study among children at a primary school in the Union de Reyes municipality, Matanzas province, Cuba, was carried out during April-May, 2022. Blastocystis spp. and Giardia intestinalis were the most common parasites found.

Acciones impostergables sobre las enfermedades cardiovasculares en Cuba / Imperative Actions on Cardiovascular Diseases in Cuba

Las enfermedades cardiovasculares afectan el corazón y los vasos sanguíneos producto de la interacción combinada de factores de riesgos metabólicos, conductuales, socioeconómicos y ambientales como son: la presión arterial elevada, dieta no saludable, colesterol alto, diabetes, obesidad, hábito de fumar, enfermedad renal, estrés, consumo de alcohol y la poca actividad física entre otros. El número de muertes por enfermedades cardiovasculares en 2019 representó el 33 por ciento de las muertes globales, por la cardiopatía isquémica con 9,1 millones y el accidente vascular cerebral con 6,6 millones representaron el 85 por ciento de las muertes cardiovasculares mundialmente. A pesar de que las tasas estandarizadas de mortalidad ajustadas por edad se han reducido entre los años 2000-2019, el número total de fallecidos se ha incrementado en un 25 por ciento debido a el envejecimiento poblacional, el incremento de la población y la mayor incidencia de eventos fatales en pacientes con diabetes mellitus.1,2 Este envejecimiento poblacional es de particular importancia, la Organización Mundial de la Salud (OMS) estima que para el 2030 el número de personas mayores de 60 años estará en un 34 por ciento mayor con 1,4 mil millones y para el 2050 se duplicaría a 2,2 mil millones.3 El Atlas de Obesidad Mundial del 2023 estima que para el 2035 los niveles de sobrepeso y obesidad alcanzarán los 4 mil millones de personas comparados con los 2,6 mil millones en el 2020. El Diabetes Collaborators 2021estima que el número de pacientes que viven con diabetes puede llegar a 1,3 mil millones de personas comparado con los 529 millones existentes en el 2021.4,5 Estos datos demuestran la necesidad de incrementar...(AU)

"Havana Syndrome": A post mortem.

BACKGROUND: Since 2016, an array of claims and public discourse have circulated in the medical community over the origin and nature of a mysterious condition dubbed "Havana Syndrome," so named as it was first identified in Cuba. In March 2023, the United States intelligence community concluded that the condition was a socially constructed catch-all category for an array of health conditions and stress reactions that were lumped under a single label. AIMS: To examine the history of "Havana Syndrome" and the many factors that led to its erroneous categorization as a novel clinical entity. METHOD: A review of the literature. RESULTS/CONCLUSIONS: Several factors led to the erroneous classification of "Havana Syndrome" as a novel entity including the failure to stay within the limitations of the data; the withholding of information by intelligence agencies, the prevalence of popular misconceptions about psychogenic illness, the inability to identify historical parallels; the role of the media, and the mixing of politics with science.

BioHabana 2022: Preventive and Immunotherapeutic Strategies Against COVID-19 and Cancer in Cuba.

The convergence of life sciences with neurosciences, nanotechnology, data management, and engineering has caused a technological diversification of the biotechnology, pharmaceutical, and medical technology industries, including the phenomenon of digital transformation, which has given rise to the so-called Fourth Industrial Revolution (Industry 4.0). Confronting the COVID-19 pandemic revealed the outstanding response capacity of the scientific community and the biopharmaceutical industry, based on a multidisciplinary and interinstitutional approach that has achieved an unprecedented integration in the history of biomedical science. Cuba, a small country, with scarce material resources, has had remarkable success in controlling the disease, which also highlights the impact of social factors. This report presents a summary of the most relevant presentations of selected topics during the scientific meeting, "BioHabana 2022: Cancer Immunotherapy and the COVID-19 Pandemic," which was held in Havana Cuba in April 2022.

Interpretación psiquiátrica forense de la fórmula de inimputabilidad del nuevo Código Penal cubano de 2022 / Psychiatric forensic interpretation of non-imputability formula in the new 2022 Cuban Penal Code

Resumen: En 2022 el Código Penal cubano incorporó una nueva fórmula de inimputabilidad. Este artículo aborda el problema de cómo interpretarla y aplicarla durante las pericias psiquiátricas a imputados. Es su objetivo analizar desde la Psiquiatría dicha fórmula penal para su interpretación forense. Se muestran las críticas que, en publicaciones y ámbitos académicos, fueron hechas a la anterior fórmula; así como la norma complementaria del organismo rector para su interpretación pericial. Se expone y analiza la actual fórmula, elaborada con asesoría de psiquiatras al proceso legislativo, para superar aquellas críticas, pero que, precisamente por diferente, demanda actualizar su interpretación y los métodos periciales para calificar casos acertadamente, detectar simulación y ser controlable como prueba por los jueces. Un criterio de interpretación fue elaborado por el autor y se le sometió a grupos de expertos para consensuar una propuesta final normativa, consistente en considerar pericialmente pretenso inimputable a quién actuó ilícitamente por un trastorno psicótico diagnosticado que se manifestó directamente en el delito, lo que debe quedar demostrado en el informe. En su generalidad, estos criterios pueden aplicarse a valoración de inimputabilidad según otros códigos penales.

Introduction: In 2022 a new Cuban Penal Code incorporated a new requirement of non-imputability. This article approaches to the problem of how to interpret and apply this new non-imputability formula to the psychiatric examination of defendants and has the objective of analyzing it in forensic interpretation. It shows the academic and publisher's criticism made of the previous Cuban non-imputability formula and the complementary precept of the health ministry for forensic interpretation. The new non-imputability formula, elaborated with psychiatrists' assistance during a legislative process to surpass those previous criticisms, is exposed and analyzed. This new different penal requirement put under obligation to change in forensic interpretations and methods to identify criminal non-imputability, pretenders and to be a clue controlled by judges. A new forensic interpretation criterion was elaborated and submitted to groups of psychiatrist experts, to obtain a normative proposition that considered in possible non-imputability of the person who committed the crime during a diagnosed psychotic disorder that was the certain direct determinant of the fact. The psychiatric report may show all mentioned below and, in general view, according to other penal codes, these criteria can be applied in the forensic expertise relative to non-imputability.

Combinación de interferones en pacientes con tumores cerebrales de alto grado de malignidad sin opciones terapéuticas / Combination of interferons in patients with high-grade brain tumors without therapeutic options

Introducción: La escasa supervivencia de pacientes con tumores cerebrales de alto grado de malignidad, pese a la existencia de algunas opciones de tratamiento, conduce a la búsqueda de nuevas modalidades terapéuticas. La combinación cubana de interferones alfa y gamma es novedosa y existen evidencias de que aumenta la supervivencia de pacientes con tumores sólidos. Método: Se realizó una investigación clínica para determinar la eficiencia de la combinación en pacientes con tumores cerebrales de alto grado sin opciones terapéuticas. Se incluyeron 40 pacientes tratados en el Hospital “Arnaldo Milián Castro” en el período 2009-2020, se evaluó seguridad y eficacia. Resultados: No se produjeron efectos adversos graves, fueron leves o moderados, y los pacientes se recuperaron. Al año habían fallecido el 8,7 % de los casos del grupo experimental, frente al 70,6 % en el grupo control. La supervivencia global en estadio III fue similar en ambos escenarios y en estadio IV fue superior para el grupo experimental. La posibilidad de sobrevivir para los pacientes que se trataron con la combinación de interferones fue 0,887 veces superior a los casos control. Se produjeron diferencias significativas en la capacidad funcional entre ambos grupos de pacientes. Conclusiones: Se evidenció que la combinación cubana de interferones es segura y eficaz para el tratamiento de tumores cerebrales de alto grado de malignidad sin opciones terapéuticas, lo que la convierte en una opción eficiente en este escenario clínico. (AU)

Introduction: The poor survival of patients with high-grade malignancy brain tumors, despite the existence of some treatment options, leads to the search for new therapeutic modalities. The cuban combination of alpha and gamma interferons is novel and there is evidence that it increases the survival of patients with solid tumors. Method: A clinical investigation was conducted to determine the efficiency of the combination in patients with high-grade brain tumors without therapeutic options. 40 patients treated at the “Arnaldo Milián Castro” Hospital in the period 2009-2020 were included, safety and efficacy were evaluated. Results: No serious adverse events occurred, events were mild or moderate, expected, and patients recovered. After one year, 8.7 % of the cases in the experimental group had died, compared to 70.6 % in the control group. Overall survival in stage III was similar in both scenarios and in stage IV it was higher for the experimental group. The chance of survival for the patients who were treated with the combination of interferons was 0.887 times higher than the control cases. There were significant differences in functional capacity between both groups of patients. Conclusions: It was evidenced that the Cuban combination of interferons is safe and effective for the treatment of high-grade malignancy brain tumors without therapeutic options, which makes it an efficient option in this clinical scenario. (AU)

The Development of Cuba's Biotechnology: Mechanisms and Challenges.

Cuba faces a dilemma between continuing its current portfolio of biotechnology drugs and vaccines with lower profitability or renewing its product portfolio with the associated costs and risks.

Quality of care for patients with ST-segment Elevation Myocardial Infarction before COVID-19 pandemic in Cuba: review of 17 reports with 7823 patients

BACKGROUND: In Cuba, there is neither a registry of ST Elevation Myocardial Infarction (STEMI), nor are analysis of performance measures widely reported. OBJECTIVE: A review of Cuban studies of patients with STEMI was carried out to describe quality of medical care. METHODS: Cochrane Library, EMBASE, PubMed, Scopus and SciELO, as well as archives of national journals, were all searched for articles on STEMI in Cuba, from 2000 to March 2020. They were included if they reported number or percentage of application of reperfusion therapy; administration of aspirin, enalapril-captopril (ACEI) or beta-blockers; status of patients at discharge; and patient or system delay times. Finally, 17 reports with 7823 patients were included. RESULTS: Thrombolytic therapy was administered to 3991 patients (51%), and 695 patients (8.9%) died. Only four studies, with 880 patients, presented data about prescription of ACEI, aspirin, and beta-blockers, which were administered to 381 (45.3%), 824 (93.6%), 464 (52.7%) patients, respectively. Coronary intervention was reported in 5 studies with 3422 patients, being performed in 661 (19.3%).  Conclusions: Quality of care of patients with STEMI seems to be poorer than reported in similar scenarios. Thrombolytic administration is still low, although mortality decreases in this period. Other pharmacological treatments were insufficiently fulfilled.