Gonzalez Calero T.M.,Instituto Nacional Of Endocrinologia
Revista Cubana de Salud Publica | Year: 2013
Type I diabetes mellitus shows long chronic progressive phase that is now predictable in most of individuals. Recent advances in the understanding of autoimmune etiology of this type of diabetes warrant the implementation of novel methods of immunological interventions. This paper was aimed at reviewing the most relevant aspects on the prevention of type I diabetes mellitus and probable strategies. The intervention measures covered the following immunological methods: Deprivation of bovine proteins, plasmapheresis, insulin-based therapy, oral administration of insulin and GAD antigen; use of immunosupressors, immunomodulators and semi-specific immunotherapies. Non-immunological treatments have been used such as use of non-steroidal anti-inflammatory or antioxidant drugs prior to onset of intolerance to glucose, and the presence of vascular complications. Several trials on possible preventive treatments for type I diabetes mellitus are being performed, but none of them has been so far enough safe and efficient in a convincing way; the rational use of new and potent immunosuppresors or immunomodulators is an attractive procedure to prevent the development and progression of the autoimmune process that characterizes this disease in "high risk" individuals.
Cabrera-Rego J.O.,Instituto Nacional Of Cardiologia Y Cirugia Cardiovascular |
Gandarilla-Sarmientos J.C.,Instituto Nacional Of Cardiologia Y Cirugia Cardiovascular |
del Busto-Mesa A.,Instituto Nacional Of Endocrinologia |
Valiente-Mustelier J.,Instituto Nacional Of Cardiologia Y Cirugia Cardiovascular
Revista Argentina de Cardiologia | Year: 2012
Background Epicardial fat is currently considered a real endocrine organ that can be easily determined by echocardiography, emerging as a novel parameter for the estimation of cardiometabolic risk. Objective To determine the association between epicardial fat, insulin resistance and carotid intima-media thickness. Methods The Instituto Nacional de Endocrinología and the Instituto Nacional de Cardiología y Cirugía Cardiovascular conducted a cross-sectional study on 239 patients with suspected disorders of carbohydrate metabolism. Clinical variables (age, gender, smoking habits, systolic and diastolic blood pressure), anthropometric measurements (waist circumference and body mass index), biochemical determinations (blood glucose, total cholesterol, HDL-C, LDL-C, triglycerides, fasting insulin levels and HOMA-IR) and echocardiographic variables (carotid intima-media thickness) were included. Results A significant and independent association was found between blood glucose, epicardial fat and waist circumference, in that order, and HOMA-IR >2.6. Epicardial fat also showed a positive and significant correlation with fasting insulin levels (r=0.536; p=0.0001) and HOMA-IR (r=0.512; p=0.001). The correlation between epicardial fat and carotid intimamedia thickness was greater in insulin resistant patients (r=0,523; p=0.0001), compared to patients with HOMA-IR <2.6 (r=0.173; p=0.029). Epicardial fat thickness ≥4.9 mm had a sensitivity of 85% and a specificity of 75% to predict insulin resistance, with an area under the ROC curve of 0.815 (95% CI 0.759-0.871). Conclusions Epicardial fat had a significant an independent association with insulin resistance and a significant correlation with carotid intima-media thickness in the group of patients with HOMA-IR >2.6.
PubMed | Novametrics, Voltaire, Center for Maternal and Newborn Health, University of Southampton and 3 more.
Type: Journal Article | Journal: BMC pregnancy and childbirth | Year: 2016
While the main causes of maternal mortality in low and middle income countries are well understood, less is known about whether patterns for causes of maternal deaths among adolescents are the same as for older women. This study systematically reviews the literature on cause of maternal death in adolescence. Where possible we compare the main causes for adolescents with those for older women to ascertain differences and similarity in mortality patterns.An initial search for papers and grey literature in English, Spanish and Portuguese was carried out using a number of electronic databases based on a pre-determined search strategy. The outcome of interest was the proportion of maternal deaths amongst adolescents by cause of death. A total of 15 papers met the inclusion criteria established in the study protocol.The main causes of maternal mortality in adolescents are similar to those of older women: hypertensive disorders, haemorrhage, abortion and sepsis. However some studies indicated country or regional differences in the relative magnitudes of specific causes of adolescent maternal mortality. When compared with causes of death for older women, hypertensive disorders were found to be a more important cause of mortality for adolescents in a number of studies in a range of settings. In terms of indirect causes of death, there are indications that malaria is a particularly important cause of adolescent maternal mortality in some countries.The main causes of maternal mortality in adolescents are broadly similar to those for older women, although the findings suggest some heterogeneity between countries and regions. However there is evidence that the relative importance of specific causes may differ for this younger age group compared to women over the age of 20years. In particular hypertensive conditions make up a larger share of maternal deaths in adolescents than older women. Further, large scale studies are needed to investigate this question further.
Dominguez-Alonso E.,Instituto Nacional Of Endocrinologia |
Zacca E.,Registros Medicos y Estadisticas de Salud
Salud Publica de Mexico | Year: 2011
This paper describes the health conditions in Cuba and the general characteristics of the Cuban health system, including its structure and coverage, its financial sources, its health expenditure, its physical, material and human resources, and its stewardship functions. It also discusses the increasing importance of its research institutions and the role played by its users in the operation and evaluation of the system. Salient among the social actors involved in the health sector are the Cuban Women Federation and the Committees for the Defense of the Revolution. The paper concludes with the discussion of the most recent innovations implemented in the Cuban health system, including the cardiology networks, the Miracle Mission (Misión Milagro) and the Battle of Ideas (Batalla de Ideas).
Association of the categories body, gender and chronic disease from different experience in health [Articulación entre las categorías cuerpo, género y enfermedad crónica desde diferentes experiencias de salud]
Llanes L.L.,Instituto Nacional Of Endocrinologia
Revista Cubana de Salud Publica | Year: 2011
Chronic diseases are felt as experience with deep impact. This article analyzed the association of the categories body, gender and health-disease on the basis of some dimensions involved in processes of health care given to persons affected by different chronic diseases. The diagnosis of the disease, its multiple manifestations, the chronic condition and some underlying particularities of these processes show, in close relation with meanings and determinants, the complexity of these pieces of experience in health care and its psychosocial sequelae. It is required to maintain equity and participatory perspective in the health processes that support the meanings that the individuals derived from their experience.
The dengue and an assessment of anti-vector fight in "Isidro de Armas" polyclinic from July to November, 2006 [Dengue: Valoración de la lucha antivectorial en el policlínico "Isidro de Armas" (Julio-Noviembre de 2006)]
Dominguez Y.A.,Instituto Nacional Of Endocrinologia
Revista Cubana de Higiene y Epidemiologia | Year: 2011
A descriptive and observational study was conducted in the populations came to "Isidro de Armas" polyclinic from July to November, 2006 to describe the anti-vector fight campaign including the focal treatment, the carrying out and the inspection of at home fumigation and the work quality control together with the inter-sector task and the community involvement. From July to November 66 Aedes Aegypti outbreaks at homes and its surrounding areas were detected. Searching by blocks the relation of confirmed cases of dengue and the Aedes aegypti outbreaks it was possible to demonstrate that in the 83% there was not any relation. Data were collected by Statistic Department and were processed by Epinfo 0,6 in absolute numbers and percentages. We conclude that there was a decrease in the infestation rate with the inter-sector task and community involvement.
Llanes L.L.,Instituto Nacional Of Endocrinologia
Revista Cubana de Salud Publica | Year: 2011
People suffering from chronic diseases have to deal with them in the physical, psyquical and symbolic spaces of their individuality. However, the human being is a reconstruction of the social and personal image of subjects. Paid or non-paid occupations can be restricted and restructured on account of the need of systematic health care; this may bring about economic instability having an impact on the family structure and dynamics. The family is the source of support par excellence, particularly the couple. Living experience of restricted sexuality might be more the result of how the disease and the experience are built and approached rather than the direct consequence of the process of disease. It is important to explore the life dynamics in persons with chronic diseases within their different areas of expression, and to understand how the actors are involved in their health processes as a way of potentiating well-being, health and quality of life.
Seuc A.H.,Institute Higiene |
Dominguez E.,Instituto Nacional Of Endocrinologia
Cadernos de Saude Publica | Year: 2010
The objective of this study was to estimate the evolution of the burden of disease in Cuba for 20 major causes at five year intervals from 1990 to 2005, in terms of mortality and years of life lost due to premature death (YLL), using national mortality registries. Six summary measures were computed for each of the 20 major causes of death which characterized the evolution of the disease burden over the period studied. The 20 causes were then grouped according to their behaviour in these summary measures; hierarchical cluster analysis was used to support this grouping process. We compute YLL results with and without age-weighting and time discounting (3%). The 20 major causes were grouped into 12 subgroups, each with a particular pattern. The burden of disease in Cuba during the period 1990-2005 has a peculiar pattern that does not reproduce the one characteristic of other low- and middle-income countries. The approach used in this study supports a better description of mortality and YLL trends for major causes, for identifying possible explanations, and for supporting public health policy making. It seems convenient to reproduce this analysis using shorter time intervals, e.g. annually.
Usefulness of integration and convergence of qualitative and quantitative methods in health research [Utilidad de la integración y convergencia de los métodos cualitativos y cuantitativos en las investigaciones en salud]
Gonzalez R.G.,Instituto Nacional Of Endocrinologia
Revista Cubana de Salud Publica | Year: 2010
The objective of this paper is to comment on the possibility of integration and convergence of the quantitative and qualitative methods in health research. It also intends to characterize both methods and to illustrate them with concrete researches in the health field. The information offered is based on the bibliographic review, the theoretical exposition and the presentation of results obtained in social and educational research in the diabetes field. Both methods have different research aims and different ways of approaching the phenomenon to be studied, its advantages and limitations. The quantitative method is useful to measure the magnitude of a phenomenon, whereas the qualitative method serves to interpret how and why this phenomenon occurs. It also allows to get closer to the phenomenon from the perspective of the meanings that the actors give to the process in which they are immersed. The health researches were not foreign to the controversial debate caused by the introduction of the qualitative method into scientific research, but starting from the basis that the set of qualitative and quatitative data do not oppose or exclude each other, the integration of both methods may potentiate scientific research instead of making it difficult. The integration and convergence of both methods may contribute to a better understanding of the phenomenon under study. The application of social sciences to the study and understanding of the health/disease processes facilitate the transfer of the bio-medical to the bio-social approach and leads to the use of qualitative methodology for research.
PubMed | Instituto Nacional Of Endocrinologia
Type: | Journal: BMJ clinical evidence | Year: 2015
Heartburn is a common complaint during pregnancy; the incidence is reported to be between 17% and 45%.We conducted a systematic overview and aimed to answer the following clinical question: What are the effects of interventions to prevent or treat heartburn in pregnancy? We searched Medline, Embase, The Cochrane Library, and other important databases up to December 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review).At this update, searching of electronic databases retrieved 80 studies. After deduplication and removal of conference abstracts, 59 records were screened for inclusion in the review. Appraisal of titles and abstracts led to the exclusion of 58 studies and the further review of one full publication. The full article evaluated did not meet our reporting criteria, and thus no new evidence was added at this update. We performed a GRADE evaluation for two PICO combinations.In this systematic overview, we categorised the efficacy for six interventions, based on information about the effectiveness and safety of acid-suppressing drugs, antacids with or without alginates, raising the head of the bed, reducing caffeine intake, reducing intake of fatty foods, and reducing the size and frequency of meals.