Effects of Renin-Angiotensin System Inhibitors on Atrial Mechanics Parameters in Patients with Metabolic Syndrome.

INTRODUCTION: Metabolic syndrome (MS) is associated with abnormalities in atrial mechanics, atrial remodeling, and an increased risk of heart rhythm disorders. One of the most commonly used approaches to the prevention of cardiac remodeling in arterial hypertension is the administration of renin-angiotensin system (RAS) inhibitors. Therefore, this study aimed to investigate the effects of RAS inhibitors on atrial mechanics parameters in patients with MS. METHODS AND MATERIALS: This longitudinal observational study included 55 patients with hypertension and MS, as defined by the ATP III criteria. The patients were evaluated at the start of antihypertensive treatment with an RAS inhibitor. The patients' clinical characteristics, chosen pharmacological treatment, and transthoracic echocardiography findings were recorded at baseline and 6 months thereafter. A student's dependent sample t-test was used for comparisons between groups. Pearson correlation was used to evaluate the relationships between variables. RESULTS: Patients with MS had higher peak atrial longitudinal strain (PALS) values at 6 months than at baseline. Meanwhile, systolic strain and peak late strain rates were lower at follow-up than at baseline. The different antihypertensive treatments had comparable effects on the PALS changes during the follow-up period. Higher high-density lipoprotein levels at baseline were correlated with changes in PALS. CONCLUSION: The administration of RAS inhibitors improved atrial mechanics parameters in the early stages of antihypertensive management in MS.

Risk Factors of Muscle Wasting in Women with Rheumatoid Arthritis: Relevance of the Persistent Failure of Conventional Combination Therapy.

Background: Muscle wasting, also known as myopenia, is frequent in rheumatoid arthritis (RA). To date, it is still unknown if the failure of pharmacologic therapies increases the risk of myopenia in RA. Objective: To identify if treatment failure with conventional synthetic DMARDs (csDMARDs) constitutes an independent risk factor of muscle wasting in women with RA. Methods: This was a cross-sectional study. We included 277 women with RA. Assessments in RA patients included: clinical, epidemiological, and therapeutic variables. The skeletal muscle index (SMI) was estimated by DXA, and myopenia was diagnosed if they had an SMI < 5.45 kg/m2. Multivariable logistic regression models identified risk factors of myopenia. Results: Muscle wasting was observed in 28.2% of patients with RA. The risk factors of myopenia in RA were menopausal (OR: 4.45, 95% CI: 1.86 to 10.64) and failure of combined therapy with csDMARDs (OR: 2.42, 95% CI: 1.15 to 5.07). The increased body mass index was protective (OR:0.81, 95% CI: 0.75 to 0.87). Conclusions: Around one of four patients with RA presented muscle wasting. Muscle wasting is related to treatment failure of combined csDMARDs; other factors influencing the presence of muscle wasting is being postmenopausal, whereas, the body mass index was a protective factor.

Risk factors associated with permanent disability in neuromyelitis optica spectrum disorders.

BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune inflammatory disease of the central nervous system. In NMOSD, a relapse results in increased disability. OBJECTIVE: To assess risk factors associated with permanent disability (PD) in patients with neuromyelitis optica spectrum disorders (NMOSD). METHODS: We evaluated 34 cases (who developed permanent disability) and 33 controls. The assessment included the following variables: sociodemographic data and characteristics of the disease. Logistic regression analysis was performed to adjust variables associated with PD. RESULTS: fifty-one percent developed PD during follow-up; 15 (22%) developed permanent visual disability, 13 (19%) developed permanent motor disability and 6 (9%) were restricted to wheelchair. Factors associated with PD in the crude analysis were: age at onset ≥ 50 years (OR 3.95, 95% IC 1.12-13.94, p= 0.032), time from onset to diagnosis ≥ 12 months (OR 3.30, 95% IC 1.13-9.64, p= 0.029), time from onset to treatment ≥ 60 months (OR 4.16, 95% IC 1.03-16.85, p= 0.045), EDSS ≥ 4.0 at the first appointment (OR 3.21, 95% IC 1.18-8.76, p= 0.022) and severe relapses during disease evolution (OR 5.72, 95% IC 1.98-16.57, p= 0.001). Factors associated with PD in the adjusted analysis were: age at onset ≥ 50 years (OR 5.82, 95% IC 1.30-26.05, p= 0.021), time from onset to diagnosis ≥ 12 months (OR 5.43, 95% IC 1.47-20.08, p= 0.011) and severe relapses during disease evolution (OR 6.65, 95% IC 1.98-22.31, p= 0.002). CONCLUSION: Half of patients with NMOSD may develop PD during disease evolution. Age of onset ≥ 50 years, delay to diagnosis ≥12 months and initial EDSS ≥ 4.0 constitute the strongest risk factors for PD.

Serum chemerin levels: A potential biomarker of joint inflammation in women with rheumatoid arthritis.

BACKGROUND: Chemerin has a potential role in perpetuating inflammation in autoimmune diseases. Nevertheless, to date, there is no conclusive information on whether high chemerin levels increase the severity of rheumatoid arthritis (RA). Therefore, this study evaluated whether serum chemerin is a biomarker of disease activity in RA patients. METHODS: Study design: cross-sectional. The assessment included clinical and laboratory characteristics, body mass index (BMI) and fat mass. The severity of the disease activity was identified according to the DAS28-CRP index as follows: A) RA with a DAS28-CRP≤2.9 (remission/mild activity) and B) RA with a DAS28-CRP>2.9 (moderate/severe activity). Serum chemerin concentrations were measured by ELISA, and ≥103 ng/mL was considered a high level. Logistic regression analysis was applied to determine whether high chemerin levels were associated with disease activity in RA after adjusting for confounders. Multiple regression analysis was performed to identify variables associated with chemerin levels. RESULTS: Of 210 RA patients, 89 (42%) subjects had moderate/severe disease activity and had higher serum chemerin levels than patients with low disease activity or remission (86 ± 34 vs 73± 27; p = 0.003). Serum chemerin correlated with the number of swollen joints (r = 0.15; p = 0.03), DAS28-CRP (r = 0.22; p = 0.002), and C-reactive protein levels (r = 0.14; p = 0.04), but no correlation was observed with BMI and fat mass. In the adjusted logistic regression analysis, high chemerin levels (≥103 ng/mL) were associated with an increased risk of moderate/severe disease activity (OR: 2.76, 95% CI 1.35-5.62; p = 0.005). In the multiple regression analysis, after adjusting for potential confounders, serum chemerin levels were associated with higher DAS28-CRP (p = 0.002). CONCLUSIONS: Higher chemerin levels increased the risk of moderate and severe disease activity in RA. These results support the role of chemerin as a marker of inflammation in RA. Follow-up studies will identify if maintaining low chemerin levels can be used as a therapeutic target.

Genotypic Analyses of the Sclerostin rs851056 and Dickkopf rs1569198 Polymorphisms in Mexican-Mestizo Postmenopausal Osteoporosis: A Case-Control Study.

Background: The Wnt/ß catenin pathway promotes bone mineralization stimulating proliferation, differentiation, and survival of osteoblasts; it also inhibits osteoclast differentiation and osteocyte activity. Sclerostin (SOST) and Dickkopf 1 (DKK1) are Wnt/ß catenin pathway inhibitors. Genetic variability in the expression of SOST and DKK1 might be involved in the development of postmenopausal osteoporosis (OP). Aim: To determine whether the SOST rs851056 and DKK1 rs1569198 polymorphisms are associated with OP in Mexican-Mestizo postmenopausal women. Materials and Methods: Two hundred and eighty Mexican-Mestizo postmenopausal women were assessed for their bone mineral density by dual-energy X-ray absorptiometry (DXA). Patients were classified as OP or non-OP. Genomic DNA was extracted from peripheral blood leukocytes. Genetic polymorphisms were analyzed by quantitative polymerase chain reaction using TaqMan probes. Results: The frequency of OP was 40% among the study population. Osteoporotic patients were older (p < 0.001), had a higher frequency of smoking (p = 0.01), and lower body mass index (p < 0.001) compared with the non-osteoporotic patients. The genotypic frequencies of the rs851056 locus of the SOST gene were GG 19%, GC 45%, and CC 35%, whereas the genotypic frequencies of the rs1569198 locus of the DKK1 gene were GG 15%, GA 40%, and AA 44%. In relation to rs851056 locus of the SOST gene, no differences were observed between the OP and non-OP cohorts in the frequencies of the GC polymorphism (48.7% vs. 43.1%). Similarly, analyses of the DKK1 rs1569198 does not demonstrate differences in the GA genotypic frequencies between the OP and non-OP cohorts (42.5% vs. 38.9%). Conclusion: Polymorphisms SOST rs851056 and DKK1 rs1569198 polymorphisms are not associated with OP in Mexican-Mestizo postmenopausal women.

Brain Permeable AMP-Activated Protein Kinase Activator R481 Raises Glycaemia by Autonomic Nervous System Activation and Amplifies the Counterregulatory Response to Hypoglycaemia in Rats.

Aim: We evaluated the efficacy of a novel brain permeable "metformin-like" AMP-activated protein kinase activator, R481, in regulating glucose homeostasis. Materials and Methods: We used glucose sensing hypothalamic GT1-7 neuronal cells and pancreatic αTC1.9 α-cells to examine the effect of R481 on AMPK pathway activation and cellular metabolism. Glucose tolerance tests and hyperinsulinemic-euglycemic and hypoglycemic clamps were used in Sprague-Dawley rats to assess insulin sensitivity and hypoglycemia counterregulation, respectively. Results: In vitro, we demonstrate that R481 increased AMPK phosphorylation in GT1-7 and αTC1.9 cells. In Sprague-Dawley rats, R481 increased peak glucose levels during a glucose tolerance test, without altering insulin levels or glucose clearance. The effect of R481 to raise peak glucose levels was attenuated by allosteric brain permeable AMPK inhibitor SBI-0206965. This effect was also completely abolished by blockade of the autonomic nervous system using hexamethonium. During hypoglycemic clamp studies, R481 treated animals had a significantly lower glucose infusion rate compared to vehicle treated controls. Peak plasma glucagon levels were significantly higher in R481 treated rats with no change to plasma adrenaline levels. In vitro, R481 did not alter glucagon release from αTC1.9 cells, but increased glycolysis. Non brain permeable AMPK activator R419 enhanced AMPK activity in vitro in neuronal cells but did not alter glucose excursion in vivo. Conclusions: These data demonstrate that peripheral administration of the brain permeable "metformin-like" AMPK activator R481 increases blood glucose by activation of the autonomic nervous system and amplifies the glucagon response to hypoglycemia in rats. Taken together, our data suggest that R481 amplifies the counterregulatory response to hypoglycemia by a central rather than a direct effect on the pancreatic α-cell. These data provide proof-of-concept that central AMPK could be a target for future drug development for prevention of hypoglycemia in diabetes.

Serum Neuropeptide Y Levels Are Associated with TNF-α Levels and Disease Activity in Rheumatoid Arthritis.

BACKGROUND: Neuropeptide Y (NPY) is a sympathetic neurotransmitter with effects on the regulation of inflammatory cells. The role of NPY on autoimmune inflammatory diseases such as rheumatoid arthritis (RA) is not completely understood. Therefore, we evaluate if NPY levels are markers of disease activity in RA and if there is a correlation between NPY levels and tumor necrosis factor-alpha (TNF-α), leptin, and interleukin 6 (IL-6) levels. METHODS: Cross-sectional design, including 108 women with RA. We assessed disease activity by DAS28-ESR (considering active disease a score of ≥2.6). Serum NPY levels and anti-CCP2 antibody, TNF-α, IL-6, and leptin levels were quantified (ELISA). RESULTS: Sixty-eight RA had an active disease (RA-active), and 40 were in remission (RA-remission). RA-active patients had higher NPY levels vs. RA-remission (22.8 ± 13.6 vs. 17.8 ± 10.3; p = 0.04). NPY levels correlated with increased TNF-α levels (r = 0.32, p = 0.001). Leptin or IL-6 did not correlate with NPY levels. In the logistic regression analysis, NPY increased the risk of disease activity (OR: 1.04, 95% CI 1.006-1.09, and p = 0.03). CONCLUSION: Higher NPY levels are an independent marker of disease activity in RA. This study encourages the quantification of NPY levels as a surrogate marker for RA-active. Future studies evaluating the role of NPY levels interacting with other proinflammatory cytokines are required.

The Impact of Disuse and High-Fat Overfeeding on Forearm Muscle Amino Acid Metabolism in Humans.

CONTEXT: Anabolic resistance is mechanistically implicated in muscle disuse atrophy. OBJECTIVE: The objective of this study is to assess whether anabolic resistance is associated with reduced postprandial amino acid uptake or exacerbated by excess lipid availability. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS: Twenty men underwent 7 days of forearm immobilization while consuming a eucaloric (CON; n = 11) or high-fat overfeeding (HFD; n = 9; 50% excess energy as fat) diet (parallel design) within our Nutritional Physiology Research Unit. MAIN OUTCOME MEASURES: Preimmobilization and postimmobilization we measured forearm muscle cross-sectional area (aCSA), and postabsorptive and postprandial (3-hour postingestion of a liquid, protein-rich, mixed meal) forearm amino acid metabolism using the arterialized venous-deep venous balance method and infusions of L-[ring-2H5]phenylalanine and L-[1-13C]leucine. RESULTS: Immobilization did not affect forearm muscle aCSA in either group, but tended to reduce postabsorptive phenylalanine (P = .07) and leucine (P = .05) net balances equivalently in CON and HFD. Mixed-meal ingestion switched phenylalanine and leucine net balances from negative to positive (P < .05), an effect blunted by immobilization (P < .05) and to a greater extent in HFD than CON (P < .05). Preimmobilization, meal ingestion increased leucine rates of disappearance (Rd; P < .05), with values peaking at 191% (from 87 ± 38 to 254 ± 60 µmol·min-1·100 mL forearm volume-1) and 183% (from 141 ± 24 to 339 ± 51 µmol·min-1·100 mL-1) above postabsorptive rates in CON and HFD, respectively, with meal-induced increases not evident postimmobilization in either group (P > .05). CONCLUSIONS: Disuse impairs the ability of a protein-rich meal to promote positive muscle amino acid balance, which is aggravated by dietary lipid oversupply. Moreover, disuse reduced postprandial forearm amino acid uptake; however, this is not worsened under high-fat conditions.

High-fat Overfeeding Does Not Exacerbate Rapid Changes in Forearm Glucose and Fatty Acid Balance During Immobilization.

CONTEXT: Physical inactivity and high-fat overfeeding have been shown to independently induce insulin resistance. OBJECTIVE: Establish the contribution of muscle disuse and lipid availability to the development of inactivity-induced insulin resistance. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS: 20 healthy males underwent 7 days of forearm cast immobilization combined with a fully controlled eucaloric diet (n = 10, age 23 ± 2 yr, body mass index [BMI] 23.8 ± 1.0 kg·m-2) or a high-fat diet (HFD) providing 50% excess energy from fat (high-fat diet, n = 10, age 23 ± 2 yr, BMI 22.4 ± 0.8 kg·m-2). MAIN OUTCOME MEASURES: Prior to casting and following 2 and 7 days of immobilization, forearm glucose uptake (FGU) and nonesterified fatty acid (NEFA) balance were assessed using the arterialized venous-deep venous (AV-V) forearm balance method following ingestion of a mixed macronutrient drink. RESULTS: 7 days of HFD increased body weight by 0.9 ± 0.2 kg (P = 0.002), but did not alter fasting, arterialized whole-blood glucose and serum insulin concentrations or the associated homeostatic model assessment of insulin resistance or Matsuda indices. Two and 7 days of forearm immobilization led to a 40 ± 7% and 52 ± 7% decrease in FGU, respectively (P < 0.001), with no difference between day 2 and 7 and no effect of HFD. Forearm NEFA balance tended to increase following 2 and 7 days of immobilization (P = 0.095). CONCLUSIONS: Forearm immobilization leads to a rapid and substantial decrease in FGU, which is accompanied by an increase in forearm NEFA balance but is not exacerbated by excess dietary fat intake. Altogether, our data suggest that disuse-induced insulin resistance of glucose metabolism occurs as a physiological adaptation in response to the removal of muscle contraction.

Gestational diabetes mellitus, pre-pregnancy body mass index, and gestational weight gain as risk factors for increased fat mass in Brazilian newborns.

BACKGROUND: Gestational diabetes mellitus (GDM) is a common complication of pregnancy. It may predispose offspring to increased fat mass (FM) and the development of obesity, however few data from Latin America exist. OBJECTIVE: To investigate the influence of GDM on newborn FM in mother-newborn pairs recruited from a public maternity care center in São Paulo, Brazil. METHODS: Data were collected cross-sectionally in 2013-2014 from 72 mothers diagnosed with GDM, and 211 mothers with normal glucose tolerance (NGT). Newborn FM was evaluated by air-displacement plethysmography (PEA POD), and relevant demographic and obstetric data were collected from hospital records. Associations between maternal GDM status and newborn FM were investigated by multiple linear regression analysis, with adjustment for maternal age, pre-pregnancy BMI, gestational weight gain, type of delivery, sex of the child, and gestational age. RESULTS: FM was greater in GDM versus NGT newborns in a bivariable model (Median (IQR), GDM: 0.35 (0.3) kg vs. NGT: 0.27 (0.2) kg, p = 0.02), however GDM status was not a significant predictor of FM with adjustment for other variables. Rather, pre-pregnancy BMI (coefficient (ß) 1.46; 95% confidence interval (CI) 0.66, 2.27), gestational weight gain (ß 1.32; 95% CI 0.49, 2.15), and male sex (ß -17.8; 95% CI -27.2, -8.29) predicted newborn FM. Analyzing GDM and NGT groups separately, pre-pregnancy BMI (ß 6.75; 95% CI 2.36, 11.1) and gestational weight gain (ß 5.64; 95% CI 1.16, 10.1) predicted FM in the GDM group, while male sex alone predicted FM in the NGT group (ß -12.3; 95% CI -18.3, -6.34). CONCLUSIONS: Combined model results suggest that in our cohort, pre-pregnancy BMI and gestational weight gain are more important risk factors for increased neonatal FM than GDM. However, group-specific model results suggest that GDM status may contribute to variation in the relationship between maternal/offspring factors and FM. Our use of a binary GDM variable in the combined model may have precluded clearer results on this point. Prospective cohort studies including data on maternal pre-pregnancy BMI, GWG, and glycemic profile are needed to better understand associations among these variables and their relative influence on offspring FM.

Controlling Nerve Growth with an Electric Field Induced Indirectly in Transparent Conductive Substrate Materials.

Innovative neurostimulation therapies require improved electrode materials, such as poly(3,4-ethylenedioxythiophene) (PEDOT) polymers or IrOx mixed ionic-electronic conductors and better understanding of how their electrochemistry influences nerve growth. Amphibian neurons growing on transparent films of electronic (metal) conductors and electronic-ionic conductors (polymers and semiconducting oxides) are monitored. Materials are not connected directly to the power supply, but a dipole is created wirelessly within them by electrodes connected to the culture medium in which they are immersed. Without electrical stimulation neurons grow on gold, platinum, PEDOT-polystyrene sulfonate (PEDOT-PSS), IrOx , and mixed oxide (Ir-Ti)Ox , but growth is not related to surface texture or hydrophilicity. Stimulation induces a dipole in all conductive materials, but neurons grow differently on electronic conductors and mixed-valence mixed-ionic conductors. Stimulation slows, but steers neurite extension on gold but not on platinum. The rate and direction of neurite growth on PEDOT-PSS resemble that on glass, but on IrOx and (Ir-Ti)Ox neurites grow faster and in random directions. This suggests electrochemical changes induced in these materials control growth speed and direction selectively. Evidence that the electric dipole induced in conductive material controls nerve growth will impact electrotherapies exploiting wireless stimulation of implanted material arrays, even where transparency is required.

Eliminación de la tuberculosis en Cuba: contribuciones recientes, resultados y desafíos / Elimination of tuberculosis in Cuba: recent contributions, results and challenges

Desde el 70 al 80 Aniversario de la fundación del Instituto de Medicina Tropical "Pedro Kourí", los investigadores, profesionales y técnicos de este centro, han laborado en cooperación con diversas instituciones académicas y de los servicios de salud de Cuba (en equipos multidisciplinarios) en las tareas de desarrollo científico, innovación tecnológica y construcción de capacidades. Este artículo resume las principales investigaciones realizadas sobre la tuberculosis desde 2008-2017; como contribuciones al Programa Nacional de Control y Eliminación de la Tuberculosis con la perspectiva de aumentar la calidad, efectividad y eficiencia de las acciones y acelerar la solución de la incidencia y la mortalidad por tuberculosis, para la investigación, la vigilancia y control de la tuberculosis. Se presentan evidencias que fundamentan las innovaciones en el manejo clínico terapéutico de pacientes inmunocompetentes e inmunocomprometidos, en niños y adolescentes, sobre las indicaciones para el control de la infección tuberculosa latente, la vigilancia de los desenlaces del tratamiento anti-tuberculosis, la investigación de contactos de casos, los cambios en el sistema de registro e información, el monitoreo y evaluación de la calidad de la detección de casos de tuberculosis, el impacto sobre la morbilidad y la mortalidad.

During the period extending from the 70th to the 80th anniversary of the founding of Pedro Kouri Tropical Medicine Institute, researchers, professionals and technicians from the center, in joint cooperation with a variety of Cuban academic and health care institutions, have integrated into multidisciplinary teams engaged in tasks related to scientific development, technological innovation and capacity building. The paper summarizes the main research studies about tuberculosis conducted from 2008 to 2017 as contributions to the National Tuberculosis Control and Elimination Program, with a view to enhancing the quality, effectiveness and efficiency of actions, swiftly finding a solution to tuberculosis incidence and mortality, and fostering tuberculosis research, surveillance and control. Evidence is presented which substantiates innovations in the clinical therapeutic management of both immunocompetent and immunocompromised patients, children and adolescents, and indications are provided for latent tuberculosis infection control, surveillance of anti-tuberculosis treatment outcomes, investigation of case contacts, changes in the record and information system, quality monitoring and evaluation of the detection of tuberculosis cases, and impact on morbidity and mortality.

AMP-activated protein kinase (AMPK) activator A-769662 increases intracellular calcium and ATP release from astrocytes in an AMPK-independent manner.

AIM: To test the hypothesis that, given the role of AMP-activated protein kinase (AMPK) in regulating intracellular ATP levels, AMPK may alter ATP release from astrocytes, the main sources of extracellular ATP (eATP) within the brain. MATERIALS AND METHODS: Measurements of ATP release were made from human U373 astrocytoma cells, primary mouse hypothalamic (HTAS) and cortical astrocytes (CRTAS) and wild-type and AMPK α1/α2 null mouse embryonic fibroblasts (MEFs). Cells were treated with drugs known to modulate AMPK activity: A-769662, AICAR and metformin, for up to 3 hours. Intracellular calcium was measured using Fluo4 and Fura-2 calcium-sensitive fluorescent dyes. RESULTS: In U373 cells, A-769662 (100 µM) increased AMPK phosphorylation, whereas AICAR and metformin (1 mM) induced a modest increase or had no effect, respectively. Only A-769662 increased eATP levels, and this was partially blocked by AMPK inhibitor Compound C. A-769662-induced increases in eATP were preserved in AMPK α1/α2 null MEF cells. A-769662 increased intracellular calcium in U373, HTAS and CRTAS cells and chelation of intracellular calcium using BAPTA-AM reduced A-769662-induced eATP levels. A-769662 also increased ATP release from a number of other central and peripheral endocrine cell types. CONCLUSIONS: AMPK is required to maintain basal eATP levels but is not required for A-769662-induced increases in eATP. A-769662 (>50 µM) enhanced intracellular calcium levels leading to ATP release in an AMPK and purinergic receptor independent pathway.

La comunidad y el control de Aedes aegypti: percepción y comportamiento respecto al larvicida abate / The community and the control of Aedes aegypti: ideas and behaviours regarding temephos larvicide

Dada la persistencia de focos de Aedes aegypti en el municipio Santiago de Cuba en el año 1998 se realizó una encuesta en las viviendas, con el objetivo de conocer la aceptación y el comportamiento de los moradores respecto al abate, precisar los motivos por los que este no se mantenía en los recipientes y conocer aspectos asociados con la presencia de los focos y su control. Se encontró que se mantenían tanques con agua, en viviendas en la que esta no faltaba, para que la suciedad se sedimentara; 72,2 porciento lavaba todos sus depósitos de agua antes de rellenarlos cada 4 d aproximadamente. Se concluyó que la suciedad del agua constituía un factor adicional para el mantenimiento de agua depositada, la abatización de los recipientes con agua para el consumo doméstico no cumplía su objetivo, se sobrevaloraba el papel de la fumigación y existían desconocimientos que podían influir en el comportamiento de estas personas

La comunidad y el control de Aedes aegypti: percepción y comportamiento respecto al larvicida abate / The community and the control of Aedes aegypti: perception and behavior regarding the larvicida knock down

Dada la persistencia de focos de Aedes aegypti en el municipio Santiago de Cuba en el año 1998 se realizó una encuesta en las viviendas, con el objetivo de conocer la aceptación y el comportamiento de los moradores respecto al abate, precisar los motivos por los que este no se mantenía en los recipientes y conocer aspectos asociados con la presencia de los focos y su control. Se encontró que se mantenían tanques con agua, en viviendas en la que esta no faltaba, para que la suciedad se sedimentara; 72,2 por ciento lavaba todos sus depósitos de agua antes de rellenarlos cada 4 d aproximadamente. Se concluyó que la suciedad del agua constituía un factor adicional para el mantenimiento de agua depositada, la abatización de los recipientes con agua para el consumo doméstico no cumplía su objetivo, se sobrevaloraba el papel de la fumigación y existían desconocimientos que podían influir en el comportamiento de estas personas(AU)

Conocimientos y prácticas sobre la pediculosis en un área de salud / Knowledge and practice concerning pediculosis in a health district

Pediculosis is an endemics that has recently intensified world wide and also in Cuba as of 1970. A study was performed in the schools located in the health area of the Vedado Polyclinics in the City of Havana to find out the level of knowledge acquired and the practices followed that may have an effect on the control of this disease. Two qualitative techniques i.e. group analysis and non-participatory observation allowed to gather information. Wrong pieces of knowledge and ill practices were detected such as the belief that nits can fly, the use of a drug called Lindano 1 to treat children as a preventive method while they are in class, application of products in a wrong way, use of harmful products and no taking out of nits in a systematic way. These mistaken concepts and practices affect the analysis of cases and thus, they should be taken into consideration to increase the efficiency of the control program.

Conocimientos y prácticas sobre la pediculosis en un área de salud / Knowledge and practices on the pediculosis in an area of health

La pediculosis es una endemia que se ha recrudecido en el mundo y también en Cuba a partir de 1970. Se realizó un estudio en los centros escolares ubicados en el área de salud del Policlínico Vedado de la ciudad de La Habana con el propósito de indagar sobre los conocimientos y las prácticas que pudieran incidir en el control de esta infestación. La información se obtuvo por medio de 2 técnicas cualitativas: discusiones grupales y observación no participante. Se encontraron conocimientos y prácticas erróneos como son que el piojo vuela, uso del lindano 1 por ciento en los niños como preventivo mientras se encuentran en la escuela, incorrecta aplicación de los productos, utilización de productos nocivos, y el no retiro de las liendres mecánicamente. Estas concepciones y prácticas erróneas afectan el estudio de los casos por lo que deben tomarse en cuenta para incrementar la eficiencia del programa de control(AU)

Conocimientos, creencias y práticas respecto a las infecciones respiratorias agudas en adultos mayores de 65 años / Knowledge, beliefs, and pratices related to acute respiratory infections in the elderly

Las Infeciones Respiratorias Agudas (IRA) se encuentran entre las primeras 5 causas de muerte en adultos mayores de 65 años. Para contribuir a disminuir la mortalidad debe lograrse un diagnóstico temprano y un tratamiento adecuado para lo cual en el hogar se deben tener conocimientos elementales sobre sus manifestaciones, las medidas de apoyo y el uso apropiado de medicamentos. Nos propusimos evaluar los conocimientos y prácticas sobre las IRA de los que atienden a ancianos por medio de una encuesta a 245 personas, 136 residentes en zona urbana y 109 en zona rural. La media de las edades fue 62 años. Todos estaban alfabetizados. El 52 por ciento se cuidaban ellos mismos. El 33 por ciento fumaba. Se encontró desconocimiento acerca de las IRA, sobre todo de las manifestaciones de gravedad ya que el 37 por ciento no pudo señalar alguno de sus signos. Un 47 por ciento no cumplía las indicaciones del médico. Existían prácticas inadecuadas como automedicación de antibióticos y antitusígenos. El 28 por ciento no aumentaba la ingestión de líquidos, el 30 por ciento sobreabrigaba al enfermo y el 9 por ciento consideraba que debía evitarse toda actividad. Ésto demostró desconocimiento en el manejo de las IRA y para mejorarlo se propuso una intervención basada en estos resultados.

Conocimientos de la población sobre el cólera / Knowledge of the population about cholera

Con el objetivo de determinar el impacto de la campaña educativa sobre el cólera en los conocimientos y creencias de la población, se realizó en 1993 una encuesta a 1 324 personas de 14 provincias y el municipio especial Isla de la Juventud. El 85 por ciento tenía entre 20 y 59 años y el nivel escolar del 89 por ciento era de secundaria básica o superior. El 69 por ciento tenía los conocimientos mínimos para enfrentar la enfermedad, el 90 por ciento acudiría al médico si la sospechara, el 72 por ciento conocía que la diarrea es el síntoma principal del cólera, el 54 por ciento sabía cómo se transmite, el 89 por ciento creía que se puede contagiar por medio del agua de beber, el 54 por ciento entendía la importancia de suministrarle líquidos al enfermo y el 78 por ciento comparendía la importancia de lavarse las manos anted de comer y cocinar. Se concluye que, si bien la población tiene conocimientos generales sobre la enfermedad, por encontrarse nuestro país en una zona endémica debe reforzarse la educación para la salud, específicamente en los aspectos relacionados con la transmisión y con el incremento de la ingestión de líquido a los enfermos(AU)