Risk factors for wheezing in infants born in Cuba.

BACKGROUND: Cuba is a unique country, and despite limited economic development, has an excellent health system. However, the prevalence of asthma symptoms in children in Havana, Cuba, is unusually high. AIM: As early life exposures are critical to the aetiology of asthma, we have studied environmental influences on the risk of wheezing in Cuban infants. DESIGN: Cross-sectional study. METHODS: A random sample of 2032 children aged 12-15 months living in Havana was selected for inclusion in the cohort. Data were collected using questionnaires administered by researchers. RESULTS: Of 2032 infants invited to participate, 1956 (96%) infants provided data. The prevalence of any wheeze was 45%, severe wheeze requiring use of emergency services was 30% and recurrent wheeze on three or more occasions was 20%. The largest adjusted risk factors for any wheeze were presence of eczema [odds ratio (OR) 2.09; 95% confidence interval (CI) 1.48-2.94], family history of asthma (OR 2.05; 95% CI 1.60-2.62), poor ventilation in the house (OR 1.99; 95% CI 1.48-2.67), attendance at nursery (OR 1.78; 95% CI 1.24-2.57), male sex (OR1.52; 95% CI 1.19-1.96) and the number of smokers in the house (P < 0.03 for trend), OR 1.64 (95% CI 1.17-2.31) for three or more smokers in the house compared to no smokers in the household. CONCLUSION: We have identified several risk factors for any wheeze in young infants living in modern day Cuba. As the prevalence of smoking in the house is high (51%), intervention studies are required to determine effective strategies to improve infant health.

[Clinical relevance of haptoglobin/IgG index and Boyer's score to the differential diagnosis of bacterial and viral meningitis]. / Relevancia clínica del índice haptoglobina/IgG y la escala de Boyer en el diagnóstico diferencial de las meningoencefalitis bacterianas y víricas.

INTRODUCTION: The meningitis is one of the most severe diseases in children due to its mortality or sequels. However, timely knowledge of whether the infection is bacterial or viral in origin and applied a specific therapeutic would be beneficial for the patients and clinician. The haptoglobin/IgG index and Boyer's score have been use in this purpose. PATIENTS AND METHODS: 39 pediatric patients, 14 suffering from viral meningoencephalitis and 25 from bacterial meningoencephalitis were study. Boyer's score and Hp/IgG index were applied in order to evaluate its diagnostic accuracy. The clinical relevance of haptoglobin/IgG index and Boyer's score were compared by the analysis of the receiver-operating characteristic (ROC) curves. RESULTS: There were no association between Boyer's score and the cause of the meningitis. The sensitivity and specificity of haptoglobin/IgG index were de 71.4 and 64%, respectively. The same parametric to Boyer's score were de 28 and 100%. Increased haptoglobin/IgG index presents bigger precision for the differential diagnostic of the bacterial and viral meningitis than the scale of Boyer according to the curves ROC. CONCLUSION: The index haptoglobin/IgG showed its diagnostic superiority with relationship to the scale of Boyer to establish the origin of the meningoencephalitis.

Seasonal distribution and evolving forms of multiple sclerosis patients diagnosed from April 2004 to November 2007

Multiple sclerosis (MS) was first reported in Cuba in 1965. The most frequent appearance is observed in the first six months of the year. Objetive: To determine the seasonal distribution and evolving forms of MS patients diagnosed with the disease between April 2004 and November 2007. Twenty-one patients with suspected MS and 42 outbreaks were studied. Patients were classified according to Lublin and Revingold's criteria for clinical forms and according to McDonald. Most patients were classified in outbreak and remission and only two patients classified as primary-progressive multiple sclerosis. The higher number of outbreaks occurred in the first two quarters of the year. It is recommended to study further weather variables that may be related to the emergence of these outbreaks in our environment(AU)

La esclerosis múltiple (EM) fue reportada en Cuba por primera vez en 1965. Se ha venido observando la aparición más frecuente en los primeros seis meses del año. Objetivo: Determinar la distribución estacional y formas evolutivas de EM en pacientes con diagnóstico de esta enfermedad entre abril 2004 y noviembre 2007. Se estudiaron 21 pacientes con sospecha de EM y un total de 42 brotes. Los pacientes fueron clasificados según los criterios de Lublin y Revingold para las formas evolutivas y según los criterios de McDonald. Solo dos pacientes clasificaron en la forma evolutiva progresiva primaria; los primeros dos trimestres del año fueron los de mayor número de brotes. Se recomienda profundizar en las variables climatológicas que pudieran tener vínculo con la aparición de estos brotes en nuestro medio(AU)

Relevancia clínica del índice haptoglobina/IgG y la escala de Boyer en el diagnóstico diferencialde las meningoencefalitis bacterianas y víricas / Clinical relevance of haptoglobin/IgG index and Boyer's score to the differential diagnosis of bacterial and viral meningitis

ntroducción. Las meningoencefalitis son una de las enfermedades más temidas en la infancia, tanto por su mortalidadcomo por sus posibles secuelas. Sin embargo, conocer tempranamente si su origen es bacteriano o vírico e instauraruna terapéutica adecuada resulta muy beneficioso para el paciente y el médico de asistencia. El índice haptoglobina/IgG y la escala de Boyer se han utilizado con estos fines. Pacientes y métodos. Se estudiaron 39 pacientes en edad pediátrica con eldiagnóstico de meningoencefalitis: 14 que sufrían meningoencefalitis bacterianas y 25 meningoencefalitis víricas. Se calculó el índice haptoglobina/IgG y se le aplicó la escala de Boyer para conocer su utilidad en el diagnóstico diferencial de las meningoencefalitis. La relevancia clínica del índice haptoglobina/IgG y la escala de Boyer se compararon a través de las curvas ROC. Resultados. La escala de Boyer no presentó asociación estadísticamente significativa con el origen de las meningoencefalitis.La sensibilidad y especificidad del índice haptoglobina/IgG fueron del 71,4 y el 64 por ciento, respectivamente, para iguales parámetros en la escala de Boyer del 28 y el 100 por ciento. El índice haptoglobina/IgG presentó mayor precisión para el diagnósticodiferencial de las meningitis bacterianas y víricas que la escala de Boyer a través del área bajo la curvas ROC. Conclusiones. El índice haptoglobina/IgG mostró su superioridad diagnóstica con relación a la escala de Boyer para establecer el origen de las meningoencefalitis(AU)

INTRODUCTION: The meningitis is one of the most severe diseases in children due to its mortality or sequels. However, timely knowledge of whether the infection is bacterial or viral in origin and applied a specific therapeutic would be beneficial for the patients and clinician. The haptoglobin/IgG index and Boyer's score have been use in this purpose. PATIENTS AND METHODS: 39 pediatric patients, 14 suffering from viral meningoencephalitis and 25 from bacterial meningoencephalitis were study. Boyer's score and Hp/IgG index were applied in order to evaluate its diagnostic accuracy. The clinical relevance of haptoglobin/IgG index and Boyer's score were compared by the analysis of the receiver-operating characteristic (ROC) curves. RESULTS: There were no association between Boyer's score and the cause of the meningitis. The sensitivity and specificity of haptoglobin/IgG index were de 71.4 and 64 percent, respectively. The same parametric to Boyer's score were de 28 and 100 percent. Increased haptoglobin/IgG index presents bigger precision for the differential diagnostic of the bacterial and viral meningitis than the scale of Boyer according to the curves ROC. CONCLUSION: The index haptoglobin/IgG showed its diagnostic superiority with relationship to the scale of Boyer to establish the origin of the meningoencephalitis(AU)

Relevancia clínica del índice haptoglobina/IgG y la escala de Boyer en el diagnóstico diferencial de las meningoencefalitis bacterianas y víricas / Clinical relevance of haptoglobin/IgG Index and boyer's score to the differential diagnosis of baterial and viral meningitis

Introducción. Las meningoencefalitis son una de las enfermedades más temidas en la infancia, tanto por su mortalidad como por sus posibles secuelas. Sin embargo, conocer tempranamente si su origen es bacteriano o vírico e instaurar una terapéutica adecuada resulta muy beneficioso para el paciente y el médico de asistencia. El índice haptoglobina/IgG y la escala de Boyer se han utilizado con estos fines. Pacientes y métodos. Se estudiaron 39 pacientes en edad pediátrica con el diagnóstico de meningoencefalitis: 14 que sufrían meningoencefalitis bacterianas y 25 meningoencefalitis víricas. Se calculó el índice haptoglobina/IgG y se le aplicó la escala de Boyer para conocer su utilidad en el diagnóstico diferencial de las meningoencefalitis. La relevancia clínica del índice haptoglobina/IgG y la escala de Boyer se compararon a través de las curvas ROC. Resultados. La escala de Boyer no presentó asociación estadísticamente significativa con el origen de las meningoencefalitis. La sensibilidad y especificidad del índice haptoglobina/IgG fueron del 71,4 y el 64%, respectivamente, para iguales parámetros en la escala de Boyer del 28 y el 100%. El índice haptoglobina/IgG presentó mayor precisión para el diagnósticodiferencial de las meningitis bacterianas y víricas que la escala de Boyer a través del área bajo la curvas ROC. Conclusiones. El índice haptoglobina/IgG mostró su superioridad diagnóstica con relación a la escala de Boyer para establecer el origen de las meningoencefalitis

Introduction. The meningitis is one of the most severe diseases in children due to its mortality or sequels. However, timely knowledge of whether the infection is bacterial or viral in origin and applied a specific therapeutic would be beneficial for the patients and clinician. The haptoglobin/IgG index and Boyer’s score have been use in this purpose. Patients and methods. 39 pediatric patients, 14 suffering from viral meningoencephalitis and 25 from bacterial meningoencephalitis were study. Boyer’s score and Hp/IgG index were applied in order to evaluate its diagnostic accuracy. The clinical relevance ofhaptoglobin/IgG index and Boyer’s score were compared by the analysis of the receiver-operating characteristic (ROC) curves.Results. There were no association between Boyer’s score and the cause of the meningitis. The sensitivity and specificity of haptoglobin/IgG index were de 71.4 and 64%, respectively. The same parametric to Boyer’s score were de 28 and 100%. Increased haptoglobin/IgG index presents bigger precision for the differential diagnostic of the bacterial and viral meningitisthan the scale of Boyer according to the curves ROC. Conclusion. The index haptoglobin/IgG showed its diagnostic superiority with relationship to the scale of Boyer to establish the origin of the meningoencephalitis