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INTRODUCTION: In November 2021, omicron-a new SARS-CoV-2 variant-was identified in South Africa and almost immediately, WHO declared it a 'variant of concern'. In view of its rapid worldwide spread and its imminent introduction in Cuba, genomic surveillance was strengthened. OBJECTIVE: Describe cases during the first eight epidemiological weeks (epiweeks) of SARS-CoV-2 infection attributable to omicron variant in Cuba by clinical and epidemiological variables. METHODS: From epiweek 48, 2021 to epiweek 4, 2022, 288 nasopharyngeal swabs were processed for sequencing of a 1836 bp fragment of the S gene. Variants were identified according to GISAID database and confirmed by phylogenetic analysis. Variants' association with clinical and epidemiological outcomes was assessed. RESULTS: The first cases of omicron variant were imported, mostly from African countries and the United States. During the period studied, omicron was detected in 83.0% (239/288) of cases processed, while the delta variant was found in 17.0% (49/288). Most persons infected with omicron were symptomatic (63.2%; 151/239) and fully vaccinated (65.3%; 156/239); severe cases and deaths occurred mainly among patients aged ≥65 years (92.9%; 13/14), and 12 of these deaths occurred in fully vaccinated persons (92.3%; 12/13). Omicron spread rapidly throughout the country (from 10% of cases in epiweek 48, 2021, to 100% by epiweek 4, 2022), displacing the formerly predominant delta variant. CONCLUSIONS: Omicron's rapid expansion in Cuba was associated with increased incidence but not with a higher case fatality rate. The relatively milder disease in those infected with this variant could be influenced by the high vaccination coverage, along with the natural immunity acquired as a consequence of previous virus infection.
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COVID-19 , SARS-CoV-2 , Humanos , SARS-CoV-2/genética , Filogenia , Cuba/epidemiología , COVID-19/epidemiologíaRESUMEN
The SARS CoV-2 D614G variant circulated in Cuba in 2020. New viral variants were detected after the opening of the border in November 2020. We show the results of the genomic surveillance in Cuba from December 28, 2020, to September 28, 2021 and their relationship to the epidemiological situation in the country. A total of 1,406 nasopharyngeal exudates from COVID-19 patients were processed for RNA extraction and the 1836 bp fragment of the spike gene was amplified and sequenced. The mutations present were determined using the GISAID database. Prevalence ratios were estimated by fitting Poisson univariate and multivariate regression models to investigate associations between SARS-CoV-2 variant group (VOC, non-VOC) and disease outcome. Seventeen genetic variants were detected including VOC Alpha, Beta, Gamma and Delta, one variant of interest (VOI) (Lambda) and two previous VOI (A.2.5.1 and Zeta/P.2). Beta (34.77%), Delta (24.89%) and D614G (19%) variants were the most frequently detected. By June, Delta increased in frequency, displacing Beta. Disease severity increased significantly with age and VOC (PR =1.98, IC 95%: 1.33-3.05, p <0.05). Genomic surveillance allowed us to identify the upsurge of novel variants. Coinciding with the higher epidemic period, multiple variants were co-circulating. Although we cannot rule out that failure in the transmission containment measures occurred, the increase in the number of cases associated with the circulation of several variants, particularly the Beta and Delta variants is highly suggestive. A greater association of Beta variant with clinical severity and Delta variant with a greater transmissibility was observed.
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Childhood obesity is associated with stress. However, most treatment strategies include only dietary and physical activity approaches. Mindfulness may assist in weight reduction, but its effectiveness is unclear. We assessed the effect of mindfulness on stress, appetite regulators, and weight of children with obesity and anxiety. A clinical study was conducted in a pediatric hospital. Eligible children were 10-14 years old, BMI ≥95th percentile, Spence anxiety score ≥55, and who were not taking any medication or supplementation. Participants were assigned to receive an 8-week conventional nutritional intervention (CNI) or an 8-week mindfulness-based intervention plus CNI (MND-CNI). Anthropometry, body composition, leptin, insulin, ghrelin, cortisol, and Spence scores were measured at baseline and at the end of the intervention. Anthropometry was analyzed again 8 weeks after concluding interventions. Log-transformed and delta values were calculated for analysis. Thirty-three MND-CNI and 12 CNI children finished interventions; 17 MND-CNI children accomplished 16 weeks. At the end of the intervention, significant reductions in anxiety score (-6.21 ± 1.10), BMI (-0.45 ± 1.2 kg/m2), body fat (-1.28 ± 0.25%), ghrelin (-0.71 ± 0.37 pg/mL), and serum cortisol (-1.42 ± 0.94 µg/dL) were observed in MND-CNI children. Changes in anxiety score, ghrelin, and cortisol were different between groups (P < 0.05). Children who completed 16 weeks decreased BMI after intervention (-0.944 ± 0.20 kg/m2, P < 0.001) and remained lower 8 weeks later (-0.706 ± 0.19 kg/m2, P = 0.001). We concluded that mindfulness is a promising tool as an adjunctive therapy for childhood obesity. However, our findings need confirmation in a larger sample population.
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OBJECTIVE: The objective was to determine if calcium intake was associated with resting energy expenditure (REE) and body fat in children after accounting for ancestral genetic background. STUDY DESIGN: Participants included 315 children. REE, body composition, and dietary calcium were assessed by indirect calorimetry, dual-energy x-ray absorptiometry, and 24-hour recalls, respectively. Structural equations modeling assessed the relationships among REE, calcium intake, and body fat. RESULTS: There were positive associations between calcium intake and REE (P<.01) and between REE and total body fat (P<.0001). There was indirect effect of calcium intake on total body fat (P<.01). There were positive associations between calcium intake and REE (P<.01), and a trend toward an association of calcium intake and total body fat (P=.065) among boys only, whereas the only significant relationship among girls was an association of REE on total body fat (P<.0001). CONCLUSIONS: REE was associated with calcium intake and mediated a relationship between calcium intake and total body fat. These findings suggest calcium intake may play a role in fat accumulation and energy balance through its effects on REE, especially in boys.
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Tejido Adiposo , Negro o Afroamericano , Calcio de la Dieta/administración & dosificación , Metabolismo Energético , Hispánicos o Latinos , Descanso/fisiología , Población Blanca , Niño , Femenino , Humanos , MasculinoRESUMEN
OBJECTIVES: To evaluate the contribution of European genetic admixture (EUADM) to insulin resistance syndrome (IRS) in a multiethnic sample of children age 7-12 years, and to explore whether body fat affects this relationship. STUDY DESIGN: Anthropometric measurements and blood pressure were assessed in 243 children. After an overnight fast, an intravenous glucose tolerance test was conducted, and measures of fasting insulin/glucose, lipids, insulin sensitivity (SI), and acute insulin response to glucose (AIRg) were obtained. The proportion of EUADM was determined by maximum likelihood estimation using 140 ancestry informative markers. Subjects were stratified into tertiles according to the proportion of EUADM for analyses. Subjects were categorized as lean or obese using body fat percentage cutpoints (25% in boys, 30% in girls). RESULTS: Among lean subjects (72%), the tertile representing the greatest proportion of EUADM was associated with higher SI (P<.001) and serum glucose (P<.05) and lower insulin (P<.05), AIRg (P<.001), high-density lipoprotein cholesterol (P=.05), and blood pressure (P<.05). However, among obese subjects, EUADM was associated only with SI (P<.05). CONCLUSIONS: Our results suggest that population differences in IRS likely have a genetic component, but that the influence of genetic background may be masked by obesity.
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Tejido Adiposo , Insulina/sangre , Síndrome Metabólico/etnología , Síndrome Metabólico/genética , Obesidad/sangre , Población Blanca/genética , Negro o Afroamericano/genética , Alabama/epidemiología , Glucemia/metabolismo , Presión Sanguínea , Índice de Masa Corporal , Niño , Estudios Transversales , Ayuno/sangre , Femenino , Predisposición Genética a la Enfermedad , Prueba de Tolerancia a la Glucosa/métodos , Hispánicos o Latinos/genética , Humanos , Lipoproteínas HDL/sangre , Masculino , Síndrome Metabólico/etiología , Síndrome Metabólico/metabolismo , Factores de RiesgoRESUMEN
BACKGROUND: We undertook this study to investigate the association of a genetic polymorphism of the insulin-like growth factor, IGF-I(189), on body composition, exercise performance and exercise economy, after controlling for the independent effect of race as assessed by African genetic admixture (AFADM). METHODS: A total of 114 premenopausal sedentary women were genotyped for IGF-I189, obtaining measures of fat mass, lean body mass, VO2 during cycling and stairclimbing, time on treadmill and leg strength. A quantitative value for AFADM was derived from genotypic information of approximately 40 ancestry informative markers and used as covariate in statistical models. RESULTS: After adjusting for AFADM, IGF-I189 was negatively associated with lean body mass (p = 0.029) and lean leg mass (p = 0.050). Leg strength was not associated with the presence/absence of IGF-I189 (p = 0.380), but carriers of the allele demonstrated a longer time on the treadmill (p = 0.015) after adjusting for AFADM. There was also a negative relationship between oxygen uptake during cycling and presence of the IGF-I189 independent of AFADM (p = 0.010). CONCLUSIONS: Independent of AFADM, individuals with IGF-I189 are more likely to have low leg lean mass and to perform better in activities requiring exercise economy and endurance performance.
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Composición Corporal/genética , Factor I del Crecimiento Similar a la Insulina/genética , Aptitud Física , Polimorfismo Genético , Adulto , Negro o Afroamericano/genética , Ejercicio Físico , Femenino , Humanos , Pierna/anatomía & histología , Persona de Mediana Edad , Tamaño de los Órganos , Consumo de Oxígeno/genética , Premenopausia , Población Blanca/genéticaRESUMEN
OBJECTIVE: To describe and provide estimates of the distribution of waist circumference (WC) according to percentiles in African-, European-, and Mexican-American children, and to test for group differences at different percentiles. STUDY DESIGN: Cross-sectional data from the Third National Health and Nutrition Examination Survey (NHANES III) were examined. The sample evaluated included 9713 nonpregnant persons 2 to 18 years of age with measured values of WCs. Age-, sex-, and ethnicity-specific percentiles were estimated via percentile regression. RESULTS: WC measurements increased in a monotonic fashion across ages but at nonconstant rates and in a manner that varied across age and sex. At higher percentiles of the distribution, estimates of WC differ between Mexican-American (MA) and European-American (EA) and between African-American (AA) and European-American (EA), and, in some cases, exceeded the adult cutoff value for obesity-related disease risk at as early as 13 years of age. CONCLUSION: Age-, sex-, and ethnicity-specific WC percentiles are available for US children and adolescents and can be used as an assessment tool that could impact public health recommendations. Results suggest concern with respect to high WC values among certain ethnic groups.
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Negro o Afroamericano , Americanos Mexicanos , Relación Cintura-Cadera , Población Blanca , Adolescente , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Encuestas Nutricionales , Análisis de Regresión , Estados UnidosRESUMEN
Se realizó un estudio descriptivo transversal del comportamiento de la lepra en el municipio de Camagüey durante los últimos quince años 1984-1998), el universo de estudio estuvo representado por 260 casos diagnosticados como tal en las historias clínicas familiares e individuales. Como registro primario se utilizaron los informes anuales del Departamento Municipal de EStadísticas de Camagüey y el modelo de encuesta epidemiológica del enfermos de lepra, con los datos obtenidos se confeccionó una encuesta según bibliografia revisada la cual una vez llenada pasó a ser el registro primario de datos. Los aspectos analizados fueron: la incidencia de la enfermedad, su tasa x 100.00 hab., la distribución según grupo etáreo, sexo, color de la peil, nivel de escolaridad, ocupación, condiciones de la vivienda, formas clínicas, primeros síntomas y signos referidos de la enfermedad, localización de los mismos,. modo de detección, grado de incapacidad, fuente de infección, tiempo de diagnóstico y los resultados de la situacion del enfermos copn relación al foco. Entre los resultados obtenidos se observó una tendencia hacia la disminución de la incidencia y su tasa, ligero predominio del sexo femenino, bajo nivel escolar, mayor número de desocupación y de pacientes mayores de 35 años, porcentaje superior de las formas multibacilares y predominio de la LD y LL. En los casos LL predominan los nódulos cutáneos y en la LD. LI y LT las manchas anestésicas. El modo de detección espontáneo y el diagnóstico tardío aportaron el mayor porcentaje, la fuente de infección fue desconocida en el mayor número de enfermos. Predominaron los casos sin incapacidades en el momento del diagnóstico y en los casos discapacitados predominó el grado I.
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Cuba , Lepra , Lepra/clasificación , Lepra/etnologíaRESUMEN
En el mes de diciembre de 1995 la Dirección del Hospital "Celia Sánchez Manduley" decidió rescatar la actividad del control de la terapia transfusional y subordinar la misma a un Comité de Expertos que rinde mensualmente un informe detallado del comportamiento de la política transfusional y además desarrolla una intensa labor educativa con todo el personal involucrado en esta práctica. A la vuelta de dos años el Comité de Sangre exhibe resultados alentadores al lograr normalizar los índices de transfusión de componentes e incluso disminuirlos por debajo de lo que establece el Programa de Sangre para la nación y coadyuvar a que la provincia Gramma se ubique entre las mejores del país en este sentido. (AU)
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Humanos , Transfusión Sanguínea/métodos , Política Organizacional , Auditoría Médica , Comité de Profesionales , Bancos de Sangre/métodos , Responsabilidad LegalRESUMEN
En el mes de diciembre de 1995 la Dirección del Hospital "Celia Sánchez Manduley" decidió rescatar la actividad del control de la terapia transfusional y subordinar la misma a un Comité de Expertos que rinde mensualmente un informe detallado del comportamiento de la política transfusional y además desarrolla una intensa labor educativa con todo el personal involucrado en esta práctica. A la vuelta de dos años el Comité de Sangre exhibe resultados alentadores al lograr normalizar los índices de transfusión de componentes e incluso disminuirlos por debajo de lo que establece el Programa de Sangre para la nación y coadyuvar a que la provincia Gramma se ubique entre las mejores del país en este sentido.
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Humanos , Bancos de Sangre , Comité de Profesionales , Auditoría Médica , Política Organizacional , Transfusión Sanguínea/métodos , Responsabilidad LegalRESUMEN
Se reporta un caso de mioblastoma a celulas granulares con lesiones múltiples nodulares cútaneas. Se señala su difícil interpretación clínica y la importancia de la histopatología para su diagnóstico. Aunque la localización en piel y TCS. no es muy frecuente, los dermatólogos deben pensar en esa posibilidad ante cualquier tumoración con las características señaladas(AU)