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The combination of molecular and conventional epidemiological methods has improved the knowledge about the transmission of tuberculosis in urban populations. To examine transmission of tuberculosis in Havana, Cuba, with DNA fingerprinting, we studied 51 out of 92 Mycobacterium tuberculosis strains isolated from tuberculosis patients who resided in Havana and whose infection was culture-confirmed in the period from September 1997 to March 1998. Isolates from 28 patients (55%) had unique IS6110 restriction fragment length polymorphism (RFLP) patterns, while isolates from 23 others (45%) had identical patterns and belonged to 7 clusters. Three clusters consisting of six, five and two cases were each related to small outbreaks that occurred in a closed setting. Three other clustered cases were linked to a large outbreak that occurred in another institution. Younger patients were more correlated to clustering than older ones. The finding that 45% of the isolates had clustered RFLP patterns suggests that recent transmission is a key factor in the tuberculosis cases in Havana. The IS6110 RFLP typing made it possible to define the occurrence of outbreaks in two closed institutions.

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The combination of molecular and conventional epidemiological methods has improved the knowledge about the transmission of tuberculosis in urban populations. To examine transmission of tuberculosis in Havana, Cuba, with DNA fingerprinting, we studied 51 out of 92 Mycobacterium tuberculosis strains isolated from tuberculosis patients who resided in Havana and whose infection was culture-confirmed in the period from September 1997 to March 1998. Isolates from 28 patients (55 percent) had unique IS6110 restriction fragment length polymorphism (RFLP) patterns, while isolates from 23 others (45 percent) had identical patterns and belonged to 7 clusters. Three clusters consisting of six, five and two cases were each related to small outbreaks that occurred in a closed setting. Three other clustered cases were linked to a large outbreak that occurred in another institution. Younger patients were more correlated to clustering than older ones. The finding that 45 percent of the isolates had clustered RFLP patterns suggests that recent transmission is a key factor in the tuberculosis cases in Havana. The IS6110 RFLP typing made it possible to define the occurrence of outbreaks in two closed institutions

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BACKGROUND: The province of Havana City, the capital and most densely populated city in Cuba, totals around 27% of the new cases of tuberculosis. This article is for the purpose of describing the distribution and trend of the tuberculosis cases rates from 1986 to 1998, by municipalities and age groups in this province. METHOD: A calculation was made of the rates and of the total percentage of deviation of these rates, in addition to the annual average deviation both throughout two time periods and between the two (1986-1993 and 1994-1998). The trends were calculated by simple linear regression. RESULTS: Throughout the 1986-1993 period, the case rate for this province underwent a 6% increase. Throughout the 1994-1998 period, it dropped by 7.3%. The three most densely-populated cities showed a higher rate increase. Of the 15 municipalities, only La Lisa showed a drop in the rates throughout the entire period in question. The rates by ages were similar throughout all of the municipalities, being higher for individuals > 65 years of age. Six tenths (0.6%) of the cases reported involved people under 15 years of age. The infantile tuberculosis rates were very low for the time period under analysis. CONCLUSIONS: The differences among the municipalities in question make it necessary for different measures to be taken to achieve a greater impact and repercussion in Cuba. The drop in the rates detected over the last three years is indicative of the epidemic being brought under control and the national tuberculosis control program being reinstated.

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The efficacy of eight benzimidazole anthelmintics has been examined against Trichostrongylus colubriformis in gerbils and Nippostrongylus brasiliensis in rats, when the parasites were entering into the fourth and final moult. The dose--response slopes obtained from the data for both host--parasite systems did not deviate significantly from a non-parallel model, and were used for relative potency determinations. The T. colubriformis assay ranked the benzimidazoles in order of potency as follows: albendazole, oxfendazole, fenbendazole, cambendazole, mebendazole, oxibendazole, parbendazole and thiabendazole. This compares favourably with the expected relative efficacies against trichostrongyles in sheep. N. brasiliensis was found to be far less useful in this respect. All compounds tested, with the exception of thiabendazole, were highly effective against both parasites. The T. colubriformis/gerbil assay could be a very useful tool for preliminary in vivo evaluation and possibly in the early selective optimisation of chemical series.

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La migrana puede asociarse a enfermedades vasculares encefalicas a traves de diversos mecanismos. En algunos casos puede asociarse a un infarto cerebral dejando un deficit neurologico permanente.En otros se presenta en relacion a una malformacion vascular intracraneana. Por ultimo, puede simular un accidente isquemico transitorio al presentarse solo los prodromos y no ser seguidos de la cefalea caracteristica. Se analiza la controversia existente en la literatura al respecto, considerando tanto aquellos estudios exclusivamente clinicos como las escasas publicaciones con descripciones anatomopatologicas y otras mas recientes que incluyen evaluaciones con tomografia axial computada de craneo

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En los ultimos anos ha ido adquiriendo creciente importancia el registro de las respuestas evocadas visuales, auditivas y somatosentitivas. Mediante este metodo es posible pesquisar lesiones en el Sistema Nervioso Central que aun no han dado manifestaciones clinicas. Entre las diversas aplicaciones que tiene destaca su contribucion al diagnostico de Esclerosis Multiple donde estan alteradas aproximadamente en un 90% de los casos

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Sleep characteristics are studied in 7 patients with sequelae of manganese intoxication and in 8 controls. A reduction in the length of the REM stage was observed, which could be prolonged by L Dopa administration, but without achieving values comparable to the controls. No changes were noted in the non-REM stage of sleep. These results are similar to the ones obtained in Parkinson's disease, suggesting clinical and probably biochemical similarities between the 2 conditions. The blood concentrations of growth hormone during sleep in the manganic patients was lower than in the control group, and no significant variations were noted after L Dopa administration.

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Lipid studies were performed on fasting plasma samples in 214 healthy adolescent boys, 11-19 years of age. Ranges of normal values for plasma cholesterol and triglyceride concentrations, and normal lipoprotein patterns were established for this age group. The boys were grouped according to puberty rating. A significant increase in triglyceride values was obtained with adolescent maturity. Plasma cholesterol values did not change with age or puberty rating. One boy had hypercholesterolemia and a lipoprotein pattern consistent with Type II hyperlipoproteinemia (Fredrickson). Seventeen boys, all of whom had reached adolescent maturity, had elevated triglyceride values and a marked increase in pre-beta-lipoprotein. It appears from this study that increased concentrations of triglyceride and Type IV hyperlipoproteinemia of Fredrickson may be detected as boys reach maturity at adolescence.

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Se expuso el resultado del seguimiento de 94 casos de tuberculosis pulmonar en dos áreas de verificación del Programa Nacional de Control. En este grupo de pacientes no hubo pérdidas en el tratamiento. La proporción de cepas resistentes en 37 casos investigados, alcanzó el 43 por ciento aunque no pueden establecerse concluciones definitivas al respecto. La conversión de los esputos alcanzó el 84 por ciento. En el grupo de pacientes resistentes fue el 62 por ciento. Se exponen planteamientos alrededor de estos hallazgos y se señala que tal ves la modificación de la fase inicial de tratamiento, añadiendo la thiocetazona y prolongando la administración diaria hasta 8 semanas, se obtengan ersultados aún más favorables(AU)

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