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2.
Rev Colomb Psiquiatr (Engl Ed) ; 50(3): 176-183, 2021.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34544583

RESUMO

INTRODUCTION: The aims of this study were to determine the usefulness of the Modified (10-item) Scale of Perceived Stress related to COVID-19 (EEP-10-C, for its acronym in Spanish) and to identify the levels of stress perceived by students of medical sciences in Cuba due to the COVID-19 pandemic. METHODS: A cross-sectional study was conducted, with self-reported data of students from 14 Cuban universities of medical sciences (n=200), through an online survey. The EEP-10-C was used as an instrument to identify stress. Its validity was determined through a confirmatory factor analysis and its internal consistency and reliability was measured by the Cronbach's alpha. A cluster analysis was performed to establish as the cut-off point the centre of the cluster with the highest values of stress perceived by the scale. RESULTS: The average age of the sample was 23.30± 1.91 years, with observed scores of the EEP-10-C between 0 and 29 points (13.25±5.404). When applying the cut-off point ≥25, only two students had high rates of perceived stress. The confirmatory factor analysis supported the validity of the instrument (α=0.755). The cut-off point ≥20 was proposed as a reference of high stress perceived for the study population, when applying this one, 14% of students presented high rates of stress. CONCLUSIONS: In Cuba, students of the medical sciences have participated in research and healthcare support, despite which they have presented low levels of stress. The main contribution of the research was the validation of the EEP-10-C for its use in assessing levels of stress in Cuban medical students, proposing the cut-off point ≥20 as a reference of high stress perceived.

3.
MEDICC Rev ; 23(3-4): 9-14, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34516531

RESUMO

At the time of this writing, more than 10 million Cubans (nearly 90% of the country's population), had received at least their first dose of Soberana 02 or Abdala, two of five vaccine candidates for SARS-CoV-2 developed and produced on the island. Late-phase clinical trial data revealed that Abdala is 92.28% effective after the full, three-dose cycle and Soberana 02 is 91.2% effective after two doses, when followed by a booster of Soberana Plus.[1] Cuban health authorities have committed to vaccinating the entire population, including children aged 3-18 years old, using these vaccines by the end of 2021. The first pre-clinical, peer-reviewed data are available,[2] with clinical trial results already submitted to various international journals. Building on decades of biotechnology know-how developing, producing and administering 11 preventive vaccines for childhood diseases-used in the nation's universal health system and also marketed elsewhere-Cuba is the first, and to date only, country in Latin America and the Caribbean to develop its own vaccine candidates for COVID-19 (Soberana 01; Soberana 02; Soberana Plus; Abdala and Mambisa; see Box on following page). In a strategy designed to ensure comprehensive and importantly, independent solutions to the global health crisis, research institutes and manufacturing facilities coordinated by BioCubaFarma-the country's biopharmaceutical conglomerate-have also developed COVID-19 treatments and essential medical equipment. To gain a better understanding of the regulatory process involved, MEDICC Review turned to Olga Lidia Jacobo-Casanueva, Director of the Center for State Control of Medicines and Medical Devices (CECMED), Cuba's national regulatory authority (NRA). A clinical microbiologist, Jacobo-Casanueva served as interim director throughout 2020 before becoming director in January 2021. She has spent nearly her entire career at CECMED, working her way up the ranks in a unique trajectory: from her first position in 1992 in the Center's microbiology laboratories, she has since worked in all but one of the six areas required by WHO to qualify as a National Regulatory Authority of Reference (NRAr; CECMED was certified as a Level 4 NRAr in 2011, a qualification it maintains). In short, Jacobo-Casanueva is a regulatory polymath, with hands-on experience in nearly every facet of regulation. She is also an adjunct researcher in the Faculty of Biology at the University of Havana. Cuba's decision to confront the pandemic autonomously by developing preventive vaccines to control COVID-19 is deliberate and fraught with challenges. With dozens of ongoing clinical trials, coupled with the declining epidemiological and economic situation in Cuba-exacerbated by tightened US sanctions affecting all facets of COVID-19 prevention and response-we appreciate the time Jacobo-Casanueva took from her schedule to parse the complex regulatory mechanisms required to introduce Cuban and imported products into the national health system. Editor's note: Just days after this interview was conducted in Havana, CECMED granted Emergency Use Authorization for Abdala, one of five Cuban COVID-19 vaccine candidates undergoing clinical trials since 2020.

4.
MEDICC Rev ; 23(3-4): 65-73, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34516540

RESUMO

INTRODUCTION: One year after WHO declared COVID-19 a pandemic, we found it useful to carry out a diagnosis of the situation in Latin America. OBJECTIVE: Examine the prevailing epidemiological panorama in mid-March 2021 in 16 countries in Latin America and the performance, over time, in the two countries with the best responses to their respective epidemics. METHODS: Using morbidity and mortality data, we compared the relative performance of each country under review and identified the two countries with the most successful responses to the pandemic. We used five indicators to analyze the course of each country's performance during the pandemic throughout 2020: prevalence of active cases per million population; cumulative incidence rate in 7 days per 100,000 population; positivity rate over a 7-day period; percentage of recovered patients and crude mortality rate per 1,000,000 population. RESULTS: According to the performance indicators, Cuba was ranked highest, followed by Uruguay. Although figures remained within acceptable margins, both nations experienced notable setbacks in the first weeks of 2021, especially sharp in Uruguay. CONCLUSIONS: Any characterization of the situation is condemned to be short-lived due to the emergence of mutational variants; however, this analysis identified favorable sociodemographic characteristics in both nations, and in their health systems, which may offer possible explanations for the results we obtained.

5.
Edumecentro ; 13(3): 309-324, jul.-sept. 2021. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1286268

RESUMO

RESUMEN Fundamento: capacitar a los trabajadores del sistema de salud y otros sectores en temas relacionados con la COVID-19 resulta necesario para enfrentar con éxito la pandemia. Objetivo: describir el comportamiento del proceso de capacitación sobre el nuevo coronavirus en la provincia Villa Clara durante el año 2020. Métodos: se realizó un estudio descriptivo transversal en la Universidad de Ciencias Médicas de Villa Clara entre febrero-octubre 2020 para lo cual se revisó la documentación existente en la Dirección de Posgrado y en la Secretaria General. La información obtenida se analizó a través de la estadística descriptiva. Resultados: se realizaron diversas actividades de superación posgraduada dirigidas al personal de la salud; en una primera etapa se logró capacitar al 98,59 %, en otros momentos resultaron preparados 293 055 personas de varios organismos y organizaciones. Se efectuaron talleres relacionados con los protocolos de actuación, medidas de bioseguridad y otras acciones. Para garantizar la atención efectiva en el cumplimiento de misiones en el territorio nacional e internacional, se graduaron 54 médicos y 287 licenciados en Enfermería en un diplomado sobre Bioseguridad, más 54 técnicos en Enfermería en un entrenamiento sobre riesgo biológico. Conclusiones: la actualización del personal del sistema de salud y de otros sectores ha garantizado un adecuado enfrentamiento a la pandemia, lo cual ha permitido que en el período estudiado, esta provincia se mencione entre las que han logrado un mayor control de la enfermedad en Cuba.


ABSTRACT Background: training workers in the health system and other sectors on issues related to COVID-19 is necessary to successfully face the pandemic. Objective: to describe the behavior of the training process on the new corona virus in Villa Clara province during 2020. Methods: a cross-sectional descriptive study was carried out at Villa Clara University of Medical Sciences from February to October 2020, so the existing documentation in the Postgraduate Department and the General Secretariat was reviewed. The information obtained was analyzed through descriptive statistics. Results: various postgraduate improvement activities were carried out aimed at health personnel; In the first stage, 98.59% were trained, at other times 293,055 people from various agencies and organizations were trained. Workshops related to action protocols, biosafety measures and other actions were held. To guarantee effective care in the fulfillment of missions in the national and international territory, 54 doctors and 287 graduates in Nursing graduated from a diploma course on Biosafety, plus 54 Licensed Practical Nurses graduated from a training course on biological risk. Conclusions: the updating of the health system personnel and of other sectors has guaranteed an adequate confrontation with the pandemic, which has allowed that in the period studied, this province is considered among those that have achieved greater control of the disease in Cuba.

6.
Diabetes Metab Syndr ; 15(5): 102245, 2021 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-34416467

RESUMO

AIMS: It is important to have valid and reliable measures to determine the psychological impact of COVID-19 in patients with diabetes; however, few instruments have been developed and validated for this population. Therefore, the aim of this study was to validate the Scale of Worry for Contagion of COVID-19 (PRE-COVID-19) in a sample of patients with diabetes mellitus (DM). MATERIALS AND METHODS: A total of 219 patients (66.2% female, mean age 58.5 SD = 18.2) participated, selected through non-probabilistic sampling. The PRE-COVID-19 and the Generalized Anxiety Disorder Scale-2 were applied. Reliability analysis was performed for internal consistency, structural equation modeling and item response theory modeling. RESULTS: The results show that a unidimensional 5-item model presents satisfactory goodness-of-fit indices and excellent reliability values. Likewise, convergent validity between the PRE-COVID-19 and a measure of anxiety is evident. All items present adequate discrimination parameters, allowing for discerning between those patients with critical concern about COVID-19 contagion from those with severe concern. CONCLUSION: It is concluded that the PRE-COVID-19 is an instrument with adequate psychometric properties to measure concern about COVID-19 infection and the emotional impact in patients with DM.

7.
Artigo em Espanhol | MEDLINE | ID: mdl-34346996

RESUMO

Cuba has a long tradition of controlling epidemics. In Cuba, this occurred with covid-19 six months after it started. Different measures were taken to control the pandemic: various community interventions, the isolation of suspected cases and of people returning from overseas, the application of therapeutic strategies. The first phase of the epidemic peaked in late April and the highest number of cases was seen in May. The epidemic was under control in June and July. Cases began to de-escalate in mid-June. There was a rise in cases in the month of August, which was interpreted as another outbreak.

8.
Artigo em Espanhol | PAHO-IRIS | ID: phr2-54704

RESUMO

“Andar la salud” es un boletín elaborado en la Oficina de la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS) en Cuba. Su propósito fundamental es compartir lo más relevante de la cooperación técnica de esta Representación con el Ministerio de Salud Pública (MINSAP) y otras instituciones en el país. Desde marzo de 2020, cuando comenzó la pandemia provocada por el SARS-CoV-2 en la isla, cada edición de esta publicación se ha dedicado a compilar y dar a conocer aspectos destacados de la respuesta en el territorio nacional. Con la colaboración de autoridades y especialistas de Salud Pública, así como de otras ramas de la ciencia, se han elaborado interesantes artículos sobre la situación epidemiológica; los protocolos para el diagnóstico y la atención; los productos biotecnológicos utilizados; entre otros temas. Con el presente número se desea resaltar, fundamentalmente, lo relacionado con los avances de los candidatos vacunales cubanos contra la COVID-19 y la inmunización en el país, hasta el 30 de junio de 2021. De ahí que se ofrezcan detalles acerca de los ensayos clínicos, la intervención sanitaria en grupos y territorios de riesgo, la vacunación como parte del seguimiento a las personas convalecientes, así como la participación en estos procesos del Centro Nacional Coordinador de Ensayos Clínicos (CENCEC), que llega a su XXX Aniversario en el actual contexto.


Assuntos
Promoção da Saúde , Coronavirus , Liderança , Vacinação , Cooperação Internacional , Recursos Humanos , Ensaios Clínicos como Assunto
10.
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
11.
Rev. cuba. med ; 60(2): e1660, tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1280349

RESUMO

Introducción: La pesquisa activa realizada por estudiantes de medicina en Cuba tiene la finalidad de descubrir tempranamente la morbilidad oculta. Esta permite un diagnóstico precoz y la garantía de una atención continuada. Objetivos: Conocer la valoración de los estudiantes en relación con la calidad de la capacitación recibida, la comunicación con el médico de la familia y la pesquisa de personas mayores en riesgo, así como sobre los aspectos positivos, negativos, interesantes e interrogantes en relación con la pesquisa. Identificar propuestas de mejoras en retroalimentación de la pesquisa. Métodos: Se realizó un estudio descriptivo de corte transversal en el cual fueron encuestados 164 estudiantes que participaron en la pesquisa de casos sospechosos de enfermedad por coronavirus COVID 19, en tres policlínicos de dos municipios de la provincia La Habana, Cuba, en el periodo de tiempo entre mayo y junio del año 2020. Resultados: En los tres policlínicos predominó el sexo femenino entre los estudiantes. La edad promedio de los pesquisadores fue de 20,7 años, es decir, adolescentes casi adultos. La mayor cantidad de estudiantes eran de la carrera de medicina, seguido estomatología, en ambos casos entre los años primero a quinto y uno de cada cinco correspondió a tecnología de la salud de primero y segundo año. Conclusiones: Los estudiantes reconocen la importancia de la pesquisa al mismo tiempo que expresan preocupaciones que, aunque no son expresadas por todos ni en mayoría, cada una contribuye a retroalimentar esta tarea con mejoras en la actividad de capacitación. Además, debe tener en cuenta los pronósticos para los próximos meses sobre otras entidades que se pueden beneficiar con esta actividad(AU)


ABSTRACT Introduction: The active investigation carried out by medical students in Cuba aims to early discover hidden morbidity. This allows prompt diagnosis and the guarantee of continuous care. Objectives: To be acquainted with the assessment of the students in relation to the quality of the training received, the communication with the family doctor and the investigation of elderly people at risk, as well as the positive, negative, interesting aspects and questions in relation to the investigation, in addition to identify proposals for improvements in research feedback. Method: A descriptive cross-sectional study was carried out in 164 students, who participated in the investigation of suspected cases of COVID 19 coronavirus disease. They were surveyed in three polyclinics from two municipalities in Havana, Cuba, from May to June, 2020. Results: In the three polyclinics, the female sex predominated among the students. The average age of the researchers was 20.7 years, that is, almost adult adolescent. The largest number of students were from the medical career, followed by stomatology, in both cases between the first to fifth years and one in five corresponded to the first corresponded to the first and second year. Conclusions: The students recognize the importance of the research at the same time that they express concerns, which is not expressed by all or the majority, though. Each concern contributes to provide feedback on this task with improvements in the training activity. In addition, future forecasts on other entities that can benefit from this activity(AU)


Assuntos
Humanos , Atenção Primária à Saúde , Pesquisa , Estudantes de Medicina , COVID-19/epidemiologia , Epidemiologia Descritiva , Estudos Transversais , Cuba
12.
Rev. cuba. med ; 60(2): e2117, tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1280340

RESUMO

Introducción: Las comorbilidades se han relacionado con mayor riesgo de contraer COVID-19, de tener mala evolución y de mortalidad. Objetivo: Identificar factores de riesgo asociados a la mortalidad al final de la estadía hospitalaria de los pacientes con diagnóstico de COVID-19 en Cuba. Métodos: Investigación retrospectiva, de la totalidad de pacientes confirmados con COVID-19 en Cuba, con 18 años o más, diagnosticados entre el 11 de marzo al 15 de octubre de 2020. La fuente de información fue la base de datos nacional del Ministerio de Salud Pública. Se recopilaron edad, sexo y comorbilidades. Clasificados en recuperados y fallecidos. Estudio analítico de factores y comorbilidades asociadas a la mortalidad. Resultados: Se analizaron 5 490 pacientes (97,7 por ciento recuperados vs 2,3 por ciento fallecidos). Los fallecidos tenían significativamente más edad (72,8 vs 44,5 años). Las comorbilidades más frecuentes en fallecidos fueron hipertensión (47,6 por ciento vs 7,8 por ciento), diabetes (27,4 por ciento vs 2,6 por ciento), cardiopatía isquémica (14,5 por ciento vs 0,9 por ciento), enfermedad renal crónica (11,3 por ciento vs 0,3 por ciento) y EPOC (11,3 por ciento vs 0,5 por ciento). Se encontró riesgo independiente de mortalidad a la edad de 60 años o más (OR:10,090, IC 95 por ciento : 6,247-16,299), enfermedad renal crónica (OR:8,434, IC 95 por ciento: 3,400-20,919), cáncer (OR:7,169, IC 95 por ciento: 2,920-17,601), enfermedad pulmonar obstructiva crónica (OR:5,300, IC95 por ciento: 2,376-11,822), obesidad (OR:4,230, IC 95 por ciento: 1,362-13,139), insuficiencia cardiaca (OR:4,197, IC 95 por ciento: 1,085-16,244), diabetes (OR:2,360, IC 95 por ciento: 1,339-4,159), hipertensión (OR:2,264, IC 95 por ciento: 1,398-3,668) y cardiopatía isquémica (OR:2,321, IC 95 por ciento: 1,168-4,610). Se encontró asociación significativa de comorbilidades, con dos, tres y más de tres (OR: 22,9, IC 95 por ciento: 13,4-39.2), (OR:72,5, IC 95 por ciento: 39,8-132,1) y (OR:88,9, IC 95 por ciento: 36,2-217,8), respectivamente. La combinación de comorbilidades más frecuente entre los fallecidos fue: hipertensión con diabetes (17,7 por ciento vs 1,9 por ciento) e hipertensión con enfermedad renal crónica (8,1 por ciento vs 0,2 por ciento). Conclusiones: La edad avanzada, la enfermedad renal crónica, cardiopatía isquémica, insuficiencia cardiaca, hipertensión, diabetes, cáncer, enfermedad pulmonar obstructiva crónica, obesidad y el número de comorbilidades se relacionaron significativamente con la mortalidad y podrían ayudar a identificar a los pacientes con mayor riesgo(AU)


Introduction: Comorbidities have been related to highrisk of contracting COVID-19, and of having poor evolution and mortality. Objective: To identify risk factors associated with mortality at the end of the hospital stay in patients diagnosed with COVID-19 in Cuba. Methods: A retrospective cohort of all patients confirmed COVID-19 in Cuba, aged 18 years or older, diagnosed from March 11 to October 15, 2020. The source of information was the national database of the Ministry of Public health. Age, sex and comorbidities were collected, and classified as recovered and deceased. This is an analytical study of factors and comorbidities associated with mortality. Results: This study analyzed 5,490 patients (97.7 percent recovered vs 2.3 percent deceased). The deceased were significantly older (72.8 vs 44.5 years). The most frequent comorbidities in the deceased were hypertension (47.6 percent vs 7.8 percent), diabetes (27.4 percent vs 2.6 percent), ischemic heart disease (14.5 percent vs 0.9 percent), chronic kidney disease (11.3 percent vs 0.3 percent) and COPD (11.3 percent vs 0.5 percent). An independent risk of mortality was found at the age of 60 years or more (OR: 10,090, 95 percent CI: 6,247-16,299), chronic kidney disease (OR: 8,434, 95 percent CI: 3,400-20,919), cancer (OR: 7,169 , 95 percent CI: 2,920-17,601), chronic obstructive pulmonary disease (OR: 5,300, 95 percent CI: 2,376-11,822), obesity (OR: 4,230, 95 percent CI: 1,362-13,139), heart failure (OR: 4,197, CI 95 percent: 1,085-16,244), diabetes (OR: 2,360, 95 percent CI: 1,339-4,159), hypertension (OR: 2,264, 95 percent CI: 1,398-3,668) and ischemic heart disease (OR: 2,321, 95 percent CI: 1,168 -4,610). A significant association of comorbidities was found, with two, three and more than three (OR: 22.9, 95 percent CI: 13.4-39.2), (OR: 72.5, 95 percent CI: 39.8-132, 1) and (OR: 88.9, 95 percent CI: 36.2-217.8) respectively. The most frequent combination of comorbidities among the deceased subjects was hypertension with diabetes (17.7 percent vs 1.9 percent) and hypertension with chronic kidney disease (8.1 percent vs 0.2 percent). Conclusions: Advanced age, chronic kidney disease, ischemic heart disease, heart failure, hypertension, diabetes, cancer, chronic obstructive pulmonary disease, obesity and the number of comorbidities were significantly related to mortality and could help to identify patients with higher risk(AU)


Assuntos
Humanos , Comorbidade , COVID-19/mortalidade , Estudos Retrospectivos , Cuba
14.
Arch. méd. Camaguey ; 25(3): e7979, 2021. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1285175

RESUMO

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


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

15.
Medisan ; 25(3): 762-770, 2021.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1287308

RESUMO

RESUMEN Ante la situación que existe actualmente a escala mundial, a partir del brote de la COVID - 19, las organizaciones Mundial y Panamericana de la Salud han trabajado en el control de este virus. El sistema de salud cubano labora para disminuir los riesgos, teniendo en cuenta la prioridad que tiene la salud de las personas, la anticipación al riesgo, la prevención y el control de esta enfermedad, a través del actuar comunitario de estudiantes y profesores, donde la facultad de Enfermería - Tecnología ha tenido una labor destacada. En tal sentido, se comenta brevemente sobre el trabajo desarrollado por los directivos, docentes y estudiantes de dicha institución en el combate activo contra esta pandemia.


ABSTRACT Before the situation that exists worldwide at the moment, taking the COVID - 19 outbreak as a starting point, the World and Pan-American Health Organizations have worked in the control of this virus. The Cuban health system works to diminish the risks, taking into account the priority that people health has, in anticipation to the risk, prevention and control of this disease, through the community performance of students and professors, where the Nursing - Technology Faculty has had an outstanding work. In such a sense, it is briefly commented on the work developed by the directors, teaching staff and students from this institution in the active fight against this pandemic.

16.
Medisur ; 19(3): 377-391, 2021. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1287320

RESUMO

RESUMEN La epidemiología y los métodos estadístico-matemáticos asociados a ella son campos que adquieren relevancia a la luz del enfrentamiento a la epidemia por el SARS-CoV-2 en Cuba. Para optimizar los esfuerzos en futuras batallas, que al parecer se avecinan, es necesario analizar críticamente lo que se ha hecho en ese sentido. El objetivo de este trabajo es identificar las insuficiencias en el enfoque epidemiológico y de las técnicas estadístico-matemáticas asociadas, en el tratamiento estadístico del curso de la epidemia de COVID-19. Se realizó una revisión documental, fundamentalmente de revistas médicas cubanas, y en la base de datos Pubmed. Se seleccionaron artículos y reportes que trataron el tema de la COVID-19 desde una perspectiva epidemiológica y/o estadístico-matemática. El uso de técnicas estadístico-matemáticas sin un fundamento epidemiológico adecuado, puede generar falsas expectativas y dificultar la toma de decisiones adecuadas. Esto ocurre, en particular, con modelos que pretenden describir, analizar y predecir, el comportamiento de las curvas de casos activos. Los aspectos discutidos, de corte estadístico-epidemiológico, pueden contribuir modestamente a los necesarios debates, sin los cuales es imposible hacer un balance objetivo de la situación.


ABSTRACT Epidemiology and the statistical-mathematical methods associated with it are fields that acquire relevance in light of the confrontation with the SARS-CoV-2 epidemic in Cuba. To optimize efforts in future battles, it is necessary to critically analyze what has been done in this regard. The objective of this work is to identify the shortcomings in the epidemiological approach and associated statistical-mathematical techniques, in the statistical treatment of the course of the COVID-19 epidemic. A documentary review was carried out, mainly of Cuban medical journals, and in the Pubmed database. Articles and reports were selected that dealt with the subject of COVID-19 from an epidemiological and/or statistical-mathematical perspective. The use of statistical-mathematical techniques without an adequate epidemiological basis can generate false expectations and make it difficult to make adequate decisions. This occurs, in particular, with models that aim to describe, analyze and predict the behavior of the curves of active cases. The issues discussed, of a statistical-epidemiological nature, can contribute modestly to the necessary debates, without which it is impossible to make an objective assessment of the situation.

17.
Rev Colomb Psiquiatr ; 50(3): 176-183, 2021.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33985764

RESUMO

INTRODUCTION: The aims of this study were to determine the usefulness of the Modified (10-item) Scale of Perceived Stress related to COVID-19 (EEP-10-C, for its acronym in Spanish) and to identify the levels of stress perceived by students of medical sciences in Cuba due to the COVID-19 pandemic. METHODS: A cross-sectional study was conducted, with self-reported data of students from 14 Cuban universities of medical sciences (n=200), through an online survey. The EEP-10-C was used as an instrument to identify stress. Its validity was determined through a confirmatory factor analysis and its internal consistency and reliability was measured by the Cronbach's alpha. A cluster analysis was performed to establish as the cut-off point the centre of the cluster with the highest values of stress perceived by the scale. RESULTS: The average age of the sample was 23.30± 1.91 years, with observed scores of the EEP-10-C between 0 and 29 points (13.25±5.404). When applying the cut-off point ≥25, only two students had high rates of perceived stress. The confirmatory factor analysis supported the validity of the instrument (α=0.755). The cut-off point ≥20 was proposed as a reference of high stress perceived for the study population, when applying this one, 14% of students presented high rates of stress. CONCLUSIONS: In Cuba, students of the medical sciences have participated in research and healthcare support, despite which they have presented low levels of stress. The main contribution of the research was the validation of the EEP-10-C for its use in assessing levels of stress in Cuban medical students, proposing the cut-off point ≥20 as a reference of high stress perceived.


Assuntos
COVID-19/psicologia , Inquéritos Epidemiológicos , Testes Psicológicos , Estresse Psicológico/diagnóstico , Estresse Psicológico/etiologia , Estudantes de Medicina/psicologia , Adulto , COVID-19/epidemiologia , Estudos Transversais , Cuba/epidemiologia , Análise Fatorial , Feminino , Humanos , Internet , Masculino , Pandemias , Percepção , Reprodutibilidade dos Testes , Autorrelato , Estresse Psicológico/epidemiologia , Adulto Jovem
18.
Ther Innov Regul Sci ; 55(5): 1014-1018, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33939173

RESUMO

The authors aim to familiarize the reader with the Center for the State Control of Medicines, Medical Equipment and Devices (CECMED) and the agency's perspective regarding the development and implementation of regulatory sciences as an interactive tool to promote cooperation and scientific thinking. The authors share their viewpoint on the preparedness of Latin American regulatory agencies by assessing innovation (i.e. novel biopharmaceuticals, vaccines, etc.), analyzing the challenges which are impacting healthcare and patients, and posing suggestions for a collaborative regional and international approach. To conclude, the authors' share recommendations for the implementation of regional initiatives aimed at supporting regulatory science, with the goal to promote the exchange of scientific cooperation as a vital element to maximize regulatory skills and competencies.


Assuntos
COVID-19 , Vacinas , Órgãos Governamentais , Humanos , SARS-CoV-2
20.
MEDICC Rev ; 23(2): 9, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33974607

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
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