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1.
An. psicol ; 37(2): 323-333, mayo-sept. 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-202555

RESUMO

Este estudio tiene dos objetivos. Primero, estudiar la validez del modelo de clima motivacional de la familia como indicador de implicación parental, cuando se evalúa con el cuestionario de Clima Motivacional de la Familia para padres (CMF/P). Y, segundo, hacerlo en población española y cubana con el fin de determinar las diferencias en la percepción del CMF de los padres de ambos países. Participaron 892 padres, 400 españoles y 492 cubanos. Se realizaron análisis factoriales confirmatorios, de validez cruzada y multigrupo, y análisis de fiabilidad. Los resultados muestran, tanto en España como en Cuba, la validez del Modelo teórico que subyace al cuestionario. Las ayudas que ofrecen los padres sirviendo como ejemplo a sus hijos y la estructuración del trabajo escolar en casa por parte de los padres son los factores de mayor peso en la definición del CMF. Sin embargo, la cultura moderó la configuración del CMF en varios indicadores del Modelo, mostrando diferentes maneras de actuar entre padres españoles y cubanos en la configuración de un clima familiar motivador


This study has two objectives. First, to study the validity of the family motivational climate model as an indicator of parental involvement, when it is evaluated with the Family Motivational Climate questionnaire for Parents (CMF / P). Second, to do it in the Spanish and Cuban population in order to determine the differences in the CMF perception of the parents of both countries. A total of 892 parents participated in the study, 400 from Spain and 492 from Cuba. Confirmatory factor analyses, cross-validation and multi-group analyses performed, as well as reliability analysis. The results show, both in Spain and in Cuba, the validity of the theoretical model that underlies the questionnaire. The help offered by parents serving as an example to their children, and the way in which parents structure the schoolwork at home are the most important factors in the definition of the CMF. However, culture moderated the configuration of the CMF in several indicators of the Model, showing different ways of acting between Spanish and Cuban parents in the configuration of a family motivating climate


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Comparação Transcultural , Relações Pais-Filho , Motivação , Inquéritos e Questionários/normas , Análise Fatorial , Percepção , Reprodutibilidade dos Testes , Valores de Referência , Cuba , Espanha
2.
Vaccimonitor (La Habana, Print) ; 30(2)mayo.-ago. 2021. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1252327

RESUMO

La gastroenteritis causada por rotavirus constituye un importante problema de salud mundial, por lo que se recomienda incluir la vacunación contra el rotavirus en los programas de inmunización. Para evaluar el impacto de una futura introducción en Cuba de una vacuna contra este patógeno, resulta necesario crear una línea de base pre-vacunación de la carga de la gastroenteritis causada por este virus. Entre noviembre 2017 a abril 2018 se implementó en el Hospital Pediátrico de Centro Habana un sistema de vigilancia para la gastroenteritis causada por rotavirus. Se establecieron las definiciones para las categorías de caso sospechoso, probable y confirmado. Por cada niño captado se recogió una muestra de heces que se analizó con tiras rápidas y se confirmó la presencia de rotavirus por ELISA. Para determinar la severidad de la enfermedad se utilizó la escala de Vesikari. Los resultados fueron expresados en cifras absolutas y relativas, el análisis se realizó a través de la prueba de chi-cuadrado. Del total de ingresos por enfermedad diarreica aguda, el 26 por ciento cumplió los criterios de inclusión y el 46 por ciento resultó confirmado como rotavirus. El hacinamiento en el hogar y asistir al círculo infantil se comportaron como factores de riesgo. El servicio de gastroenterología absorbió la mayor carga de ingresos hospitalarios por esta causa. Los resultados mostrados validan la funcionalidad del sistema de vigilancia implementado y brindan nuevas evidencias sobre la carga de la enfermedad y la utilización de los servicios de un hospital pediátrico cubano, debido a la gastroenteritis provocada por rotavirus, lo que justifica la introducción de la vacuna(AU)


Gastroenteritis caused by rotavirus is a major global health problem, therefore it is recommended that vaccination against rotavirus be included in immunization programs. To evaluate the impact of a future introduction in Cuba of a vaccine against this pathogen, it is necessary to have a pre-vaccination baseline of the burden of gastroenteritis caused by rotavirus. Between November 2017 and April 2018, a surveillance system for gastroenteritis caused by rotavirus was implemented in the Paediatric Hospital of Centro Habana. Definitions were established for the categories of suspected, probable and confirmed cases. For each captured child, stool samples were collected, analyzed with rapid strips and confirmated by ELISA. To determine the severity of the disease, the Vesikari score was used. The results were expressed in absolute and relative figures; the analysis was performed through chi-square. Of the total admissions for acute diarrheal disease, 26 percent met the inclusion criteria and 46 percent were confirmed for rotavirus. Overcrowding at home and attending a day care center were risk factors. The gastroenterology service absorbed the greatest burden of hospital admissions for this cause. The results shown validate the role of the implemented surveillance system and provide new evidence on the burden of disease and use of services for rotavirus gastroenteritis in a cuban pediatric hospital(AU)


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Infecções por Rotavirus/prevenção & controle , Fatores de Risco , Vacinas contra Rotavirus , Diarreia/etiologia , Gastroenterite/epidemiologia , Epidemiologia Descritiva , Estudos Prospectivos , Cuba , Estudos Observacionais como Assunto
3.
Vaccimonitor (La Habana, Print) ; 30(2)mayo.-ago. 2021. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1252325

RESUMO

El uso de anticuerpos monoclonales en la lucha contra el cáncer se convierte cada día más en la terapia de elección. Para la introducción de anticuerpos monoclonales en mercados internacionales de alta demanda y con elevados requerimientos de calidad se requiere su producción a gran escala. El incremento de la presencia de dímeros en el producto final afecta su calidad y, por tanto, la eficiencia y eficacia del proceso. El objetivo del presente trabajo fue obtener un modelo matemático que permita relacionar el porcentaje de dímeros con las variables de operación de mayor influencia. Se realizó el ajuste de un modelo de regresión lineal múltiple usando el programa Statgraphics Centurion XVII versión 17.2.00. El modelo se validó con lotes de producción, logrando errores relativos inferiores al 20 por ciento. Las variables significativas obtenidas fueron: masa de IgG en el sobrenadante; masa de IgG en el producto de salida del paso de captura de proteína A; pH en el producto de salida del paso de captura de proteína A; pH del producto ajustado y conductividad de salida en la membrana de intercambio aniónico. El modelo permitió encontrar un intervalo de trabajo de las variables de mayor influencia en la formación de dímeros para reducirlos hasta valores inferiores al 3 por ciento(AU)


The use of monoclonal antibodies in the fight against cancer is becoming more and more the selected therapy. The introduction of monoclonal antibodies highly demanded in international markets, with high quality requirements needs the production of monoclonal antibodies on a large scale. The increase of dimers in the final product affects its quality, therefore, the efficiency and effectiveness of the process. The objective of this work was to obtain a mathematical model to relate the percentage of dimers with the most influential operating variables. A multiple linear regression model was obtained using Statgraphics Centurion XVII version 17.2.00 software. The model was validated with new production data with a mean error of validation below 20 percent. The significant variables were: supernatant IgG mass; IgG mass in the effluent from Protein A capture column; pH of the effluent from Protein A capture column; pH of the adjusted product and conductivity of the effluent from anionic exchange membrane. A working interval for each of the influential variables were established, in order to reduce dimers below 3 percent(AU)


Assuntos
Humanos , Computação Matemática , Análise de Dados , Anticorpos Monoclonais/imunologia , Neoplasias/mortalidade , Cuba
4.
Vaccimonitor (La Habana, Print) ; 30(2)mayo.-ago. 2021. graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1252324

RESUMO

La trazabilidad es la capacidad para rastrear la historia, aplicación o ubicación de un objeto bajo consideración. En el ámbito farmacéutico, el rastreo y seguimiento de los medicamentos, incluyendo las vacunas y otros medicamentos biológicos, a lo largo de la cadena de suministro constituye un requisito obligatorio establecido por las autoridades sanitarias a nivel internacional, que se exige en mayor o menor magnitud en las reglamentaciones vigentes. En este artículo se analiza el sistema de codificación y clasificación en el sector de la salud y su estado actual en la cadena de suministro de medicamentos de Cuba. Se presenta un procedimiento para la implementación de las tecnologías de auto-identificación e intercambio electrónico de datos, mediante el uso de GS1 en el sistema de codificación y clasificación empleado en el sector de salud, que permita la trazabilidad en toda la cadena de suministro en Cuba(AU)


Traceability is the capability to track the history, application or location of an object under consideration. In the pharmaceutical field, the tracking and monitoring of medicines, including vaccines and other biological medicines, along the supply chain constitutes a mandatory requirement established by the sanitary authorities at an international level, which is demanded to a greater or lesser extent in the regulations in force. This research was carried out involving different links in the drug supply chain in Cuba, ranging from drug suppliers, drug distribution company, to healthcare centers and pharmacies. An analysis is carried out on the current coding and classification system, detecting the ineffectiveness of the identification of the drugs as the main deficiency. A procedure is proposed for the implementation of the auto-identification and electronic data interchange technologies using GS1 in the coding and classification system used in the health sector that allows traceability throughout the supply chain in Cuba(AU)


Assuntos
Humanos , Produtos Biológicos , Rotulagem de Medicamentos/métodos , Política Nacional de Medicamentos , Codificação Clínica/métodos , Vacinas , Cuba
5.
Artigo em Inglês | PAHO-IRIS | ID: phr-54420

RESUMO

[ABSTRACT]. Cuba’s National Health System has managed to guarantee an effective and equitable response to COVID-19. Universal and free health coverage, based on primary care, follows the principle of equity and the greatest resources are allocated to areas of the lowest socioeconomic stratum (where higher risk is concentrated), followed by those of medium and high strata, in that order. This allowed for similar mortality rates in the three strata, and Cuban national mortality rate was one of the lowest in the Region of the Americas. Before the first case was identified in Cuba, a Plan for Coronavirus Prevention and Control was elaborated with multisectoral participation, and when the first case was confirmed the Temporary National Working Group to Fight COVID-19 was created as an advisory body of the government. The actions to face the pandemic began with preventive measures in the community, continued in the isolation centers and ended again in the community with actions of surveillance and follow up of recovered patients. Following the principle of territoriality, molecular diagnosis laboratories were created in the provinces that did not have one. Free medical care and treatment; the preparation of a single national intersectoral government plan; the use of particular strategies for research, diagnosis and case tracing; and the implementation of a universal protocol for disease prevention and treatment of confirmed cases made it possible to control the disease with a health equity perspective.


[RESUMEN]. El Sistema Nacional de Salud de Cuba ha logrado garantizar una respuesta eficaz y con equidad en el enfrentamiento a la COVID-19. La cobertura de salud universal y gratuita, basada en la atención primaria, sigue el principio de equidad, por lo que los mayores recursos se asignan a los territorios del estrato socioeconómico más bajo, que concentra mayores riesgos de salud, seguidos de los de estratos medio y alto, en ese orden. Esto permitió tener tasas de letalidad similares en los tres estratos, y a nivel nacional la de Cuba es una de las tasas más bajas de la Región de las Américas. Antes de identificar el primer caso en Cuba, se elaboró el Plan para la Prevención y Control del Coronavirus, con participación multisectorial, y al confirmarse el primer caso se creó el Grupo Temporal de Trabajo para Enfrentar la COVID-19 como órgano asesor del Gobierno. Las acciones de enfrentamiento a la pandemia comienzan en la comunidad con medidas preventivas, continúan en los centros de aislamiento y terminan nuevamente en la comunidad, con acciones de vigilancia y acompañamiento a los enfermos recuperados. Siguiendo el principio de territorialidad, se crearon laboratorios de diagnóstico molecular en las provincias que no lo tenían. La atención médica y los tratamientos gratuitos; la preparación de un plan de gobierno intersectorial nacional único; la utilización de estrategias particulares para la pesquisa, diagnóstico y rastreo de casos; y la implementación de un protocolo universal para la prevención de la enfermedad y el tratamiento de los casos confirmados permitieron el control de la enfermedad con una perspectiva de equidad en salud.


[RESUMO]. O Sistema Nacional de Saúde de Cuba tem assegurado uma resposta eficaz e com equidade ao enfrentar a pandemia de COVID-19. A cobertura de saúde universal e gratuita baseada na atenção primária se pauta no princípio da equidade. Mais recursos são destinados às áreas de nível socioeconômico mais baixo que concentram risco de saúde maior e a seguir, nesta ordem, às áreas de nível socioeconômico médio e alto. Assim, a taxas de letalidade tem sido semelhante nos três níveis e a taxa nacional é uma das mais baixas da Região. Antes de o primeiro caso de COVID-19 ter sido detectado em Cuba, preparou-se o Plano para prevenção e controle do coronavírus com participação multissetorial. Quando o primeiro caso da doença foi confirmado, instituiu-se o Grupo de trabalho temporário para combater a COVID-19 como um órgão assessor do governo. As ações de combate à pandemia começam na comunidade com medidas preventi-vas, prosseguem nos centros de isolamento e retornam à comunidade com medidas de vigilância sanitária e o acompanhamento dos pacientes recuperados. E, seguindo o princípio de territorialidade, laboratórios de diagnóstico molecular foram instituídos nas províncias onde eles inexistiam. A atenção médica, o trata-mento gratuito, a preparação de um plano de governo único intersetorial nacional, o emprego de estratégias próprias para pesquisa, diagnóstico e rastreio de casos e a implementação de um protocolo universal para prevenção da doença e tratamento dos casos confirmados possibilitaram controlar a doença de uma per-spectiva de equidade em saúde.


Assuntos
Infecções por Coronavirus , Equidade em Saúde , Cobertura Universal de Saúde , Atenção Primária à Saúde , Cuba , Infecções por Coronavirus , Equidade em Saúde , Cobertura Universal de Saúde , Atenção Primária à Saúde , Infecções por Coronavirus , Equidade em Saúde , Cobertura Universal de Saúde , Atenção Primária à Saúde , COVID-19
6.
Rev Bras Parasitol Vet ; 30(2): e001921, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34133615

RESUMO

Toxoplasma gondii is a zoonotic parasite of worldwide distribution that can infect several species of homeothermic animals. Few studies have evaluated the exposure of captive wild animals to T. gondii. This study involved a serological survey of anti-T. gondii antibodies in mammals kept in Cuba's National Zoo (PZN) and in the Rio de Janeiro Zoo (RIOZOO) in Brazil. The study consisted of a total of 231 serum samples from mammals, 108 from PZN and 123 from RIOZOO. All the samples were subjected to IgG anti-T. gondii testing by means of the inhibition ELISA method and the modified agglutination test, respectively. T. gondii antibodies were detected in 85.2% samples from PZN and 32.5% samples from RIOZOO. At the PZN, Perissodactyla (92.3%) was the order with the highest serological prevalence rate, whereas at the RIOZOO, the order Primates (46.7%) stood out (p<0.05). In addition to this association, the origin of the PZN animals was also associated with T. gondii infection. This finding demonstrates the need for constant veterinary monitoring of captive wild mammals in order to link the serological diagnosis with clinical alterations indicative of toxoplasmosis.


Assuntos
Toxoplasma , Toxoplasmose Animal , Animais , Animais de Zoológico , Anticorpos Antiprotozoários , Brasil/epidemiologia , Cuba/epidemiologia , Mamíferos , Fatores de Risco , Estudos Soroepidemiológicos , Toxoplasmose Animal/diagnóstico , Toxoplasmose Animal/epidemiologia
8.
BMC Med Educ ; 21(1): 337, 2021 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-34107919

RESUMO

BACKGROUND: In the French West-Indies, few studies have been performed on fertility and sexual problems in cancer survivors, which are frequent and recurring issues reported by surveys on unmet needs. Additionally, mutualizing human and material resources and promoting cooperation through a collaborative platform are the most appropriate response to complex health pathways in the Caribbean territories. Implementation of such a collaborative platform will help to launch a strategic Caribbean partnership to transfer theoretical and technical skills and care standards in oncofertility and oncosexuality. METHODS: We propose to set up a collaborative digital platform to strengthen, from the French expertise, Cuban health professionals' knowledge, know-how, and skills in oncofertility and oncosexuality. The project will be coordinated by a coordinating, scientific, and supervisory committee, and the main activities will include: 1. Theoretical training in e-learning adapted to low-speed Internet. 2. Practical training in fertility preservation and sexual rehabilitation. 3. Digital multidisciplinary consultation meetings for medical decisions to be taken for complex clinical cases. The platform will benefit from a recurrent evaluation, by the two cancer registries of Martinique and Cuba, with the following performance indicators: number of Cuban professionals trained, number of professionals sensitized, hourly volumes (or number of training courses provided), satisfaction of trained professionals, number of e-RCPs carried out online and number of missionaries supported. These indicators will be set up and analyzed by the registers. This project meets the Cuban and French health policies (cancer plans and national sexual health strategies) and will be implemented in liaison with the Health Agencies of both countries and the Embassy of France in Cuba. DISCUSSION: This project aims to provide support through bilateral exchanges to improve reproductive and sexual health in Cuba's cancer patients. This collaboration will be based on a long-lasting French expertise and a solid Cuban health system. Consequently, this collaborative digital platform will contribute to data collection for cancer surveillance, and the two participating countries will ultimately be identified in the Caribbean as having centers of competence and excellence in oncofertility and oncosexuality with care standards.


Assuntos
Saúde Sexual , Região do Caribe , Cuba , França , Humanos , Índias Ocidentais
10.
Rev. cuba. inform. méd ; 13(1): e407, ene.-jun. 2021. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1251732

RESUMO

La Unidad Central de Cooperación Médica (UCCM) es un centro de excelencia del Ministerio de Salud Pública (MINSAP). Este centro se encarga de garantizar el cumplimiento de los compromisos internacionales contraídos por el MINSAP y el Gobierno de la República de Cuba, en el área de la cooperación médica a través de la asistencia técnica y docente. El objetivo de este desarrollo es implementar un módulo para el Sistema Integral para la Gestión de Información en la Colaboración Médica Cubana (Colpadi), que optimice el proceso de gestión de cartas avales que se generan en la UCCM. El trabajo que se desarrolla contribuye de forma positiva al concepto de excelencia de la institución. El proyecto tiene un enfoque cualitativo, con alcance descriptivo, de tipo retrospectivo y diseño no experimental, de corte transversal. Se emplean los métodos científicos de observación y análisis documental. Además, la implementación utilizando el Lenguaje Unificado de Modelado (UML) y la metodología RUP de desarrollo de software. Como resultado se obtiene un módulo, como parte del sistema informático Colpadi, que optimiza el proceso de gestión de cartas avales. Las cartas avales se entregan a los cooperantes internacionalistas del MINSAP en sus vacaciones y al finalizar su misión en el exterior. Con la implementación de la aplicación informática se obtienen varias ventajas como la automatización de los vuelos de entrada, las solicitudes automáticas para el procesamiento de las cartas avales, los reportes estadísticos y el tratamiento de la información(AU)


Central Unit for Medical Cooperation (UCCM) is a center of excellence of the Ministry of Public Health (MINSAP). This center is in charge for guaranteeing compliance with the international commitments made by MINSAP and the Government of the Republic of Cuba, in the area of ​​medical cooperation through technical and educational assistance. This research contributes positively to the institution's concept of excellence. Its objective is to implement a module for the Colpadi computer system, which it optimizes the process for managing the guarantee letters generated at the UCCM. The research has a qualitative approach, with a descriptive scope, of a retrospective type and a non-experimental, cross-sectional design. Scientific observation and documentary analysis methods are used; as well as UML, and RUP software development methodology in its implementation. As a result, a module is obtained, as part of the Colpadi computer system, which it optimizes the guarantee letter management process. The letters of guarantee are delivered to the internationalist aid workers of the MINSAP, on their vacations and at the end of their mission abroad. With the implementation of the computer application, several advantages are obtained, such as the automation of the incoming flights, the automatic requests for the processing of the letters of guarantee, the statistical reports and the treatment of the information(AU)


Assuntos
Humanos , Correspondência como Assunto , Atos Internacionais/políticas , Otimização de Processos/métodos , Cuba
11.
Zootaxa ; 4965(2): 385395, 2021 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-34187037

RESUMO

Buzionema lutgardae n. sp. (Nematoda: Oxyuridomorpha: Thelastomatidae) is described from the cockroach Byrsotria sp. (Blattaria: Blaberidae), endemic to Cuba. Females of B. lutgardae n. sp. are shorter than those of B. validum Kloss, 1966 (16002150 µm vs. 31313378 µm), but the oesophagus is comparatively longer (b = 2.963.77 vs. 4.654.87). The lateral alae of the new species extend from ca. the midpoint of the cylindrical part of the procorpus to the level of the anus in contrast to the base of the basal bulb to the level of the anus in B. validum. The males of B. lutgardae n. sp. are shorter than those of B. validum (780940 µm vs. 11771423 µm) and their lateral alae end at some distance before the cloaca instead the level of the cloaca in B. validum. The phylogeny of B. lutgardae n. sp. is inferred by the D2-D3 domains of the 28S rDNA. B. lutgardae n. sp. and B. validum form a monophyletic clade with strong nodal support, as sister-group of the genus Leidynema Schwenck in Travassos, 1929.


Assuntos
Baratas/parasitologia , Oxyurida/anatomia & histologia , Oxyurida/classificação , Animais , Cuba , DNA Ribossômico , Feminino , Masculino , Filogenia
12.
Rev. cuba. inform. méd ; 13(1): e385, ene.-jun. 2021. graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1251725

RESUMO

Introducción: El cáncer de mama es el tumor maligno más frecuente en el mundo, en Cuba, es la segunda causa de muerte en mujeres. La insuficiencia en el diagnóstico precoz y la existencia de novedosas estrategias de tratamiento plantean la necesidad de establecer formas eficaces para identificar el riesgo en personas sanas, sin embargo en nuestro país no se cuenta con un método eficaz para predecir el riesgo y direccionar las acciones preventivas y terapéuticas. Objetivo: Crear un estándar nacional orientado a la identificación del cáncer de mama como soporte a la práctica médica y como herramienta de apoyo en la evaluación del riesgo. Método: Se combinaron 28 variables (determinadas por los factores de riesgo de cáncer de mama) a las cuales se les atribuyeron parámetros de ponderación asociados al nivel de incidencia registrado en la literatura médica, utilizando un algoritmo de votación como elemento matemático central. Resultados: Se desarrolló un sistema computarizado para la evaluación del riesgo de cáncer de mama en personas sanas. Conclusiones: BRCAR es una herramienta de soporte para objetivar el riesgo del cáncer de mama, al determinar el impacto de determinados factores de riesgo, con el fin de direccionar los métodos de estudio para la detección precoz(AU)


Introduction: Breast cancer is the most frequent malignant tumour in the world; it is the second cause of women death in Cuba. The insufficiency in early diagnosis and the existence of novel treatment strategies raise the need to establish effective ways to identify risk in healthy people, however in our country there is no effective method to predict risk and direct preventive actions and therapeutic. Objective: To create a national standard aimed at identifying breast cancer as a support to medical practice and support tool in risk assessment. Method: 28 variables (determined by risk factors for breast cancer) were combined; assigning to those variables weighting parameters associated with the level of incidence recorded in the medical literature, using a voting algorithm as the central mathematical element. Results: A computerized system was developed to assess the risk of breast cancer in healthy people. Conclusions: BRCAR is a support tool to objectify the risk of breast cancer, by determining the impact of certain risk factors, in order to direct study methods for early detection(AU)


Assuntos
Humanos , Feminino , Algoritmos , Software , Neoplasias da Mama/epidemiologia , Autoexame de Mama/métodos , Cuba
13.
MEDICC Rev ; 23(2): 12, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: covidwho-1224449

RESUMO

Cuba has five COVID-19 vaccines in clinical trials and is on track to receive emergency use authorization from the country's regulatory agency to begin mass vaccination with two of those candidates: Abdala and SOBERANA 02. Results from phase 1 and 2 trials of these vaccines, the first developed and produced in Latin America, have been encouraging, both in terms of safety and immunogenicity. The ongoing phase 3 trials will continue to look at safety, together with efficacy; parallel intervention studies involving over a million people in Havana will begin generating data on effectiveness. Coordination between Cuba's biotechnology sector and its public health system-particularly throughout the different levels of primary care-to control and treat COVID-19 is a cornerstone of the Cuban strategy and one that could serve as a blueprint for future pandemics. Another Cuban product, itolizumab, is showing positive results mitigating cytokine release syndrome (CRS) in COVID-19 patients with moderate-to-severe acute respiratory distress syndrome (ARDS). Developed in collaboration with Biocon (India), itolizumab is administered under an expanded access program to treat vulnerable populations in Cuba. Marshaling complementary capacities of dozens of institutions belonging to BioCubaFarma-the country's biotech conglomerate-and developing therapies, vaccines and medical technologies together, is another cornerstone of Cuba's strategy to combat COVID-19 and improve population health. The Molecular Immunology Center (CIM) is a key player in this strategy. Founded in 1992, CIM is a powerhouse in monoclonal antibody research and production, with 6 registered products and 22 in the pipeline. Known for several novel therapeutic cancer treatments, CIM has over two decades' experience producing complex recombinant proteins in mammalian cells on an industrial scale. Once Cuba's Innovation Committee (convened in January 2020 as part of the National COVID-19 Prevention & Control Plan) determined Cuban researchers would pursue protein subunit vaccine candidates, they turned to CIM to produce the required receptor-binding domain (RBD) of the SARS-CoV-2 spike protein, among other responsibilities. CIM's General Director, Dr Eduardo Ojito-Magaz, is a chemical engineer and holds a master's degree in biotechnology. He spoke with MEDICC Review just days before 1.7 million Havana residents began participating in the country's largest intervention study with the COVID-19 vaccines his center helped make possible.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Pneumonia Viral/prevenção & controle , Anticorpos Monoclonais , Pesquisa Biomédica , Biotecnologia , COVID-19/epidemiologia , Cuba/epidemiologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , SARS-CoV-2
14.
MEDICC Rev ; 23(2): 9, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: covidwho-1224448

RESUMO

The effects and implications of COVID-19 are global, comprehensive and long-term. The pandemic has exposed inequities, the fragility of economic and political systems, and in many cases, skewed priorities. Population health, not to mention planetary health, is suffering as a result. Nevertheless, the global health crisis in which we are embroiled has provided opportunities for effective collaboration, scientific innovation and real dialog around health and equity. Dr Amaylid Arteaga-García, director of Cuba's National Clinical Trials Coordinating Center (CENCEC), emphasized these opportunities when discussing Cuba's clinical trials in times of COVID-19. Founded in 1991 in response to the groundbreaking research emerging from the country's biopharmaceutical sector-including the first safe, effective vaccine against serogroup B meningococcal disease, VA-MENGOC-BC in 1989 and a recombinant vaccine against hepatitis B, Heberbiovac in 1990-CENCEC now coordinates some 100 clinical trials annually, many of them multi-site trials involving thousands of volunteers. Little did Dr Arteaga García know what problems lurked when she became CENCEC director in 2019. In February 2020, Cuba implemented its National COVID-19 Prevention & Control Plan. This included a scientific Innovation Committee tasked with evaluating promising projects, products and research that might be used in the health system to control and treat COVID-19. This approach taps into two of Cuba's strengths: biotechnology and primary health care. Given the volume and complexity of COVID-19 clinical trials, Dr Arteaga.


Assuntos
COVID-19/epidemiologia , COVID-19/prevenção & controle , Ensaios Clínicos como Assunto , Controle de Doenças Transmissíveis/organização & administração , Cuba/epidemiologia , Humanos , Pandemias , SARS-CoV-2
16.
MEDICC Rev ; 23(2): 15, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: covidwho-1224444

RESUMO

INTRODUCTION: COVID-19 is caused by the novel coronavirus SARS-CoV-2 and was declared a pandemic on March 11, 2020, the same day that the first cases in Cuba were diagnosed. In Cuba, all confirmed cases of COVID-19 were hospitalized from this point forward. OBJECTIVE: Characterize the first patients diagnosed with COVID-19 in Cuba. INTRODUCTION: METHODS We carried out a descriptive, cross-sectional study of 415 suspected cases of COVID-19 admitted to the Pedro Kourí Tropical Medicine Institute in Havana, Cuba, from March 11, 2020 through April 10, 2020. (In Cuba, all patients suspected of being COVID-19-positive were admitted to hospitals or isolation centers for observation and treatment.) Of these 415 individuals, 63 (15.2%) tested positive for SARS-CoV-2. Information was obtained from the Institute's databases as well as a standardized interview form for cases confirmed or suspected as infected with the novel coronavirus. We considered the following variables: age, sex, occupation at the time of interview, national origin, personal health history, time elapsed between symptom onset and hospital admission, signs and symptoms, diagnosis and status at discharge. We based our analysis on frequency distributions and double-entry contingency tables. RESULTS: The mean age was 50 years (range: 16-94 years). The 45-54 age group represented the largest share of cases (25.4%; 16/63); persons aged ≥65 years were 20.6% (13/63); there were more men than women (55.6% vs. 44.4%). Cubans represented 52.4% (33/63) of patients while 47.6% (30/63) were from 14 countries where COVID-19 had already been identified. All foreigners and Cubans who arrived from abroad were considered imported cases (54.0%; 34/63). Health personnel (10 doctors and 1 nurse) represented 17.5% (11/63) of cases. Cough (50.8%), fever (46.0%), sore throat (22.2%) and headache (19.0%) were the most frequently reported symptoms. Asymptomatic patients represented 25.4% (16/63) of cases. Hypertension was the most frequently associated chronic disease (28.6%), followed by asthma (25.0%) and diabetes (17.9%). Patients who were admitted to hospital ≥3 days after symptom onset represented 66.7% (42/63) of cases. Mean hospital stay was 13.7 days (range: 1-27 days). Factors associated with a higher risk of contracting the disease included occupation as a healthcare worker (OR: 1.85; 95%, CI: 0.88-3.87) and aged ≥65 years (OR: 1.68; 95% CI: 0.85-3.34). Five individuals died, for a fatality rate of 7.9% (three foreigners and two Cubans; four men and one woman). Four of these patients were infected outside of Cuba and one was identified as a contact of a confirmed case. All patients who died had significant comorbidities (diabetes, asthma and hypertension). Age of deceased patients ranged from 54 to 87 years. CONCLUSION: The first patients diagnosed with COVID-19 in Cuba were admitted to the Pedro Kourí Tropical Medicine Institute in Havana. They share characteristics with those reported by other countries: more men than women were affected, and comorbidities including hypertension, diabetes and asthma were all important risk factors, as was age ≥65 years. More than half of all cases were imported, and autochthonous patients were all contacts of confirmed cases.


Assuntos
COVID-19/epidemiologia , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Cuba/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , SARS-CoV-2
17.
MEDICC Rev ; 23(2): 55, 2021 04.
Artigo em Inglês | MEDLINE | ID: covidwho-1224443

RESUMO

Cuba implemented policies mandating social distancing on March 11, 2020, which were still in place at the time of this study. During such periods of isolation, people with psychoactive substance-related disorders and other addictions may be tempted to reduce tension, stress, uncertainty and possible distress by increasing the use of substances or practices they have abused. This can mean relapses and setbacks for patients undergoing treatment. A multidisciplinary team of health professionals specializing in addiction at the Center for Academic Development in Drug Addiction, in Havana, Cuba, cares for people with these disorders and followed their evolution during the initial period of COVID-19 social isolation. With the aim of characterizing strategies employed by patients undergoing treatment for substance abuse and addictions, we conducted a qualitative study from April 2020 through May 2020, using a convenience sample of 37 patients (all students) who had been progressing towards recovery from addictive behaviors when face-to-face encounters were suspended due to COVID-19 restrictions. Contact was maintained through information and communication technologies. The research used telepsychology and focused on understanding patient life experiences. Patients were interviewed using a semi-structured survey, which was then transcribed and coded thematically using a grounded-theory approach. We found that patients' ability to cope successfully with challenges presented by COVID-19 were influenced by: 1) the individual's own methods for maintaining self-control (commitment to studies, projects, and work with therapists) that aided them in their goals concerning abstinence; 2) difficulties faced in addressing specific events and situations (doubts, uncertainties, disagreements, isolation and time use); 3) perpetuation and revivification of myths related to substances and addictive activities (exacerbation of supposed benefits of tobacco, alcohol, marijuana, overuse of social networks); and 4) tendencies toward irrationality and lack of emotional control (fear, sadness, anger, constant worry and self-imposed demands). Our findings suggest that despite the potential negative psychological impact of preventive social isolation during the COVID-19 pandemic, individual coping mechanisms developed by these patients, aiming at improved self-control, allowed most to avoid setbacks that could have affected their recovery. Nevertheless, patients faced challenges to their recovery that were compounded by difficulties in specific situations, myths related to substances and addictive activities, and tendencies toward irrationality or lack of emotional control.


Assuntos
Adaptação Psicológica , Comportamento Aditivo/psicologia , COVID-19/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto , Comportamento Aditivo/epidemiologia , Comportamento Aditivo/reabilitação , COVID-19/epidemiologia , Cuba/epidemiologia , Feminino , Teoria Fundamentada , Humanos , Masculino , Pandemias , Pesquisa Qualitativa , SARS-CoV-2 , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/reabilitação
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