RESUMEN
The SARS CoV-2 D614G variant circulated in Cuba in 2020. New viral variants were detected after the opening of the border in November 2020. We show the results of the genomic surveillance in Cuba from December 28, 2020, to September 28, 2021 and their relationship to the epidemiological situation in the country. A total of 1,406 nasopharyngeal exudates from COVID-19 patients were processed for RNA extraction and the 1836 bp fragment of the spike gene was amplified and sequenced. The mutations present were determined using the GISAID database. Prevalence ratios were estimated by fitting Poisson univariate and multivariate regression models to investigate associations between SARS-CoV-2 variant group (VOC, non-VOC) and disease outcome. Seventeen genetic variants were detected including VOC Alpha, Beta, Gamma and Delta, one variant of interest (VOI) (Lambda) and two previous VOI (A.2.5.1 and Zeta/P.2). Beta (34.77%), Delta (24.89%) and D614G (19%) variants were the most frequently detected. By June, Delta increased in frequency, displacing Beta. Disease severity increased significantly with age and VOC (PR =1.98, IC 95%: 1.33-3.05, p <0.05). Genomic surveillance allowed us to identify the upsurge of novel variants. Coinciding with the higher epidemic period, multiple variants were co-circulating. Although we cannot rule out that failure in the transmission containment measures occurred, the increase in the number of cases associated with the circulation of several variants, particularly the Beta and Delta variants is highly suggestive. A greater association of Beta variant with clinical severity and Delta variant with a greater transmissibility was observed.
RESUMEN
Se realiza una investigación partiendo de la insuficiencia que presentan en la formación pedagógica los docentes de la Facultad de Ciencias Médicas Dr Ernesto Che Guevara de la Serna, con el propósito de contribuir al perfeccionamiento de la Educación Médica Superior, específicamente en el postgrado, al determinar la fundamentación teórica pedagógica y didáctica para el proceso docente - educativo postgraduado de los profesionales de la Salud que ejercen función docente, que tome en cuenta su estructura y dinámica, el sistema de leyes que lo rigen y las regularidades que se manifiesten en este proceso en particular, a través del diseño de un programa de Diplomado en Ciencias de la Educación Médica Superior que tiende a eliminar todo carácter empírico. Se tomarán en consideración los métodos científicos de investigación: histórico, lógico, dialéctico, análisis documental, empíricos y sistémico estructural entre otros. Se arriban a conclusiones y recomendaciones...(AU)