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Quito, Ecuador

Sexual and reproductive health concerns man in its individual, economic and social dimensions. Pregnancy and child delivery in adolescents generate high costs. The fertility rate of adolescents decreased in Cuba until 2006, but in the last few years, there has been an increase that represents a warning about the health of this group of young people. Cuba is developing projects aimed at improving the health status of adolescents such as the National Program of Integrated Care to the Health of Adolescents. Making economic analysis of the pregnancy at adolescence in Cuba is a pending task. Methodological tools providing timely information on the economic consequences of pregnancy at adolescence are required. The objective of this paper was to submit a methodological proposal in order to identify the economic effects of pregnancy at adolescence in Cuba. A literature and document review was made with Big 6 model as the information management pattern, with a view to identifying the studies on sexual and reproductive health, emphasizing the economic consequences of pregnancy at adolescence. This information was supplemented with interviews to experts in sexual and reproductive health and in economic analysis, who contributed several elements for the design of the final methodological proposal for this type of study from the macroeconomic and the microeconomic perspectives. Both provide the necessary useful economic information to allocate resources and to make decisions.

Luis Alvarez M.C.,Hospital Pediatrico William Soler | Alonso Castillo A.,Hospital Pediatrico William Soler | Gonzalez Aleman M.,Hospital Pediatrico William Soler | Arana Rosainz M.,Institute Endocrinologia | Sarmiento Perez L.,Institute Medicina Tropical Pedro Kouri
Revista Cubana de Pediatria | Year: 2014

Introduction: viral meningoencephalitis affecting the child is caused mainly by enteroviruses and have generally self-limited benign course. Objective: to estimate the interleukin-6 and tumor necrosis factor-? present in the serum and the cerebrospinal fluid of children suffering viral meningoencephalitis.Method: cross-sectional descriptive study of 61 patients aged one month to 17 years and diagnosed with viral meningoencephalitis. The diagnosis was based on their clinical picture, the cytochemical study of their cerebrospinal fluid and the detection of enterovirus viral genome through the reverse transcriptase polymerase chain reaction. Forty eight serum samples and 35 cerebrospinal fluid samples served to determine the interleukin-6 and tumor necrosis factor-? concentrations. The statistical analysis included Wilcoxon's test for 2 related samples and the Spearman's test for correlating cytokine concentrations.Results: viral genome was detected in 3 cerebrospinal fluid samples with increased cellularity and predominant polymorphonuclear neutrophils and in other 3 samples with normal cellularity. The quantitation of serum interleukin-6 and of tumor necrosis factor-alpha were 91.6 ± 39.0 pg/mL and 106.5 ± 54.6 pg/mL, respectively. The interleukin-6 and tumor necrosis factor-alpha levels in the cerebrospinal fluid amounted to 109.65 ± 49.6 pg/mL, and 75.28 ± 29.9 pg/mL, respectively.Conclusions: high interleukin-6 and tumor necrosis factor-alpha levels were found in all the studied samples. The factor concentrations were higher in the serum whereas those of interleukin-6 were higher in the cerebrospinal fluid; there was positive correlation between interleukin-6 values in the serum and those of the tumor necrosis factor-alpha. © 2014 Editorial Ciencias Medicas. All rights reserved.

Guevara-Aguirre J.,San Francisco de Quito University | Rosenbloom A.L.,San Francisco de Quito University | Balasubramanian P.,University of Southern California | Teran E.,San Francisco de Quito University | And 9 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2015

Context: Ecuadorian subjects with GH receptor deficiency (GHRD) have not developed diabetes, despite obesity. Objective: We sought to determine the metabolic associations for this phenomenon. Design: Four studies were carried out: 1) glucose, lipid, adipocytokine concentrations; 2) metabolomics evaluation; 3) metabolic responses to a high-calorie meal; and 4) oral glucose tolerance tests. Setting: Clinical Research Institute in Quito, Ecuador. Subjects: Adults homozygous for the E180 splice mutation of the GH receptor (GHRD) were matched for age, gender, and body mass index with unaffected control relatives (C) as follows: study 1, 27 GHRD and 35 C; study 2, 10 GHRD and 10 C; study 3, seven GHRD and 11 C; and study 4, seven GHRD and seven C. Results:AlthoughGHRDsubjectshadgreatermeanpercentagebodyfatthancontrols,theirfastinginsulin, 2-hour blood glucose, and triglyceride levels were lower. The indicator of insulin sensitivity, homeostasis model of assessment 2%S, was greater (P .0001), and the indicator of insulin resistance, homeostasis model of assessment 2-IR, was lower (P .0025). Metabolomic differences between GHRD and control subjects were consistent with their differing insulin sensitivity, including postprandial decreases of branched-chain amino acids that were more pronounced in controls. High molecular weight and total adiponectin concentrations were greater inGHRD(P .0004 and P .0128, respectively), and leptin levels were lower (P .02). Although approximately 65% the weight of controls, GHRD subjects consumed an identical high-calorie meal; nonetheless, theirmeanglucose concentrationswerelower, withmeaninsulin levels one-third those of controls. Results of the 2-hour oral glucose tolerance test were similar. Main Outcome Measures: Measures of insulin sensitivity, adipocytokines, and energy metabolites. Conclusions:WithoutGHcounter-regulation,GHRDisassociatedwithinsulinefficiencyandobesity.Lower leptin levels, despite higher percentage body fat, suggest that obesity-associated leptin resistance is GH dependent.Elevatedadiponectinlevelsnotcorrelatedwithpercentagebodyfat indicate thatGHsignaling is necessary for their typical suppression with obesity. Copyright © 2015 by the Endocrine Society.

Yanes Quesada M.A.,Hospital Clinicoquirurgico Hermanos Ameijeiras | Yanes Quesada M.,Institute Endocrinologia | Calderin Bouza R.,Hospital Clinicoquirurgico Hermanos Ameijeiras | Gutierrez Rojas A.R.,Hospital Clinicoquirurgico Hermanos Ameijeiras | Leon Alvares J.L.,Hospital Clinicoquirurgico Hermanos Ameijeiras
Revista Cubana de Medicina | Year: 2015

Introduction: lung cancer is a health problem that significantly affects how mankind. Objective: describe the clinical features and its association with histological subtype in patients with lung cancer. Methods: across-sectional study was conducted in 107 patients with lung cancer hospitalized in the services of internal medicine and pneumology at Hermanos Ameijeiras Hospital from March 2012 to February 2013. Results: 66.4% of the patients were men with a mean age of 65.9 years and 61.7% had smoking habits. Broncho-pneumonia was the most common clinical form of presentation in 20.6% and symptom, cough in 63.6%. In lung adenocarcinoma, 30.4% had the broncho-pneumonic form. Conclusions: atelectasis and pleural clinical form of presentation were associated with squamous cell carcinoma and adeno-carcinoma, respectively. © 2015, Editorial Ciencias Medicas. All rights reserved.

Amador L.V.,Hospital docente Ginecoobstetrico Ramon Gonzalez Coro | Bacallao O.S.,Hospital docente Ginecoobstetrico Ramon Gonzalez Coro | Anzardo B.R.,Institute Endocrinologia | Gil A.S.,Hospital docente Ginecoobstetrico Ramon Gonzalez Coro | Guillen A.M.,Institute Endocrinologia
Revista Cubana de Obstetricia y Ginecologia | Year: 2011

INTRODUCTION: Pregnancy in adolescence has been associated with adverse health problems. OBJECTIVE: To identify the maternal and perinatal morbidity and mortality in adolescents presenting with diabetes. METHODS: A retrospective study was conducted in 138 adolescent pregnant patients (< 20 years) with diabetes. From them, 101 were pregestional diabetics (B2, C64, D30, F1, R3 and F-R 1 of Priscilla White) and 37 gestational diabetics (A1 24, A2 8 and A3-5 of Freinkel and Metzger). The maternal and perinatal results were compared to that of 242 non-diabetic adolescents and 482 non-adolescents pregnant and non-diabetics from the same institution at random. For variables' analysis the Fisher X2 test was used and Z for the ratios with a statistical significance of p< 0.05. RESULTS: The level of metabolic control was qualified as non-optimal in the 42.0 % of the diabetics which may be contributed to the significant greater frequency of pre-term labor, morbidity and mortality and of newborns weighing = o > 4 000 g, it was probably the responsible of the greater frequency of cesarean section. The frequency of the eleven congenital malformations (8.0% was higher than the reported in our country for the general population and even for pregnants and to the non-attendance to pre-conception control consultation. CONCLUSION: The adverse perinatal results in diabetic adolescents could be in relation, according our results, to hyperglycemia of difficult control in these pregnants and to non-attendance to preconception control consultation.

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