RESUMO

In order to describe the changes in the control of arterial hypertension from 2016 to 2021 and the relationship between the progress made and the maturity of implementation of the HEARTS Initiative at the first level of care in Cuba, a prospective implementation study was designed to promote the correct measurement of blood pressure with validated automatic sphygmomanometers, risk-based care, introduction of standardized antihypertensive treatment protocols, secondary prevention, and teamwork. Patient education, active case-finding, and community activities were also encouraged. Data were obtained from implementation logs and were analyzed with SPSS Statistics V21; outcome values and 95% confidence intervals were reported. Population indicators were evaluated: registration coverage, control between treatments, population control, and the HEARTS in the Americas Maturity Index. The number of participating centers increased from a single demonstration center in 2016 to 22 polyclinics in six provinces and seven municipalities in 2021. There was a significant increase in the absolute values for the total population served, number of hypertensive patients registered, controlled patients among those treated, and controlled hypertensive patients among all adults, although with annual variations in percentages of coverage, control between treatments, and population control. The greatest progress occurred in centers with high-performance health teams. Five years after implementation of the HEARTS Initiative in Cuba, the methodology is becoming institutionalized.

A fim de descrever as mudanças no controle da hipertensão arterial de 2016 a 2021 e a relação entre o progresso e a maturidade da implementação da Iniciativa HEARTS no primeiro nível de atenção em Cuba, foi elaborado um estudo prospectivo de implementação que promoveu a aferição correta da pressão arterial com esfigmomanômetros automáticos validados, cuidados baseados em risco, a introdução de protocolos padronizados de tratamento anti-hipertensivo, a prevenção secundária e o trabalho em equipe. A educação dos pacientes, a busca ativa de casos e as atividades comunitárias também foram incentivadas. Os dados foram obtidos a partir dos registros de implementação e foram analisados com o programa de estatística SPSS versão 21. São relatadas medidas de desfecho e seus intervalos de confiança de 95%. Foram avaliados os seguintes indicadores populacionais: cobertura de registro, controle entre os pacientes tratados e controle populacional, bem como o índice de maturidade dos processos da Iniciativa HEARTS nas Américas. Comparativamente, entre 2016 e 2021, o número de centros participantes aumentou de um só centro de demonstração para 22 policlínicas em 6 províncias e 7 municípios. Evidenciou-se um aumento significativo nos valores absolutos da população total atendida, do número de pessoas com hipertensão cadastradas, de pacientes controlados entre os tratados e de pessoas com hipertensão controlada entre todos os adultos, embora com variações anuais nos percentuais de cobertura, no controle entre os tratados e no controle populacional. Os maiores avanços ocorreram nos centros que têm equipes de saúde de alto desempenho. Cinco anos após a implementação da Iniciativa HEARTS em Cuba, avança-se rumo à institucionalização da metodologia.

RESUMO

[RESUMEN]. Con el propósito de describir los cambios en el control de la hipertensión arterial desde 2016 a 2021 y la relación de los progresos con la madurez de implementación de la Iniciativa HEARTS en el primer nivel de atención de Cuba, se diseñó un estudio prospectivo de implementación que promovió la medición correcta de la presión arterial con esfigmomanómetros automáticos validados, la atención basada en riesgo, la intro- ducción de protocolos de tratamiento antihipertensivo estandarizado, la prevención secundaria y el trabajo en equipo. Se fomentó además la educación a pacientes, la búsqueda activa de casos y las actividades comu- nitarias. Los datos se obtuvieron de los registros de implementación y fueron analizados con el programa estadístico SPSS versión 21, se reportan las medidas de resultados y sus intervalos de confianza del 95%. Se evaluaron los indicadores poblacionales: cobertura de registro, control entre tratados, control poblacional, así como el índice de madurez de procesos de HEARTS en Las Américas. Comparativamente, entre los años 2016 y 2021 aumentaron los centros participantes, desde un centro de demostración hasta 22 policlínicos en 6 provincias y 7 municipios. Se evidenció un incremento significativo en los valores absolutos del total de población atendida, el número de hipertensos registrados, de pacientes controlados entre los tratados e hipertensos controlados entre todos los adultos, aunque con variaciones anuales en los porcentajes de cobertura, control entre tratados y control poblacional. Los mayores progresos ocurrieron en los centros con equipos de salud de alto desempeño. Cinco años después de la implementación de la Iniciativa HEARTS en Cuba se transita hacia la institucionalización de la metodología.

[ABSTRACT]. In order to describe the changes in the control of arterial hypertension from 2016 to 2021 and the relations- hip between the progress made and the maturity of implementation of the HEARTS Initiative at the first level of care in Cuba, a prospective implementation study was designed to promote the correct measurement of blood pressure with validated automatic sphygmomanometers, risk-based care, introduction of standar- dized antihypertensive treatment protocols, secondary prevention, and teamwork. Patient education, active case-finding, and community activities were also encouraged. Data were obtained from implementation logs and were analyzed with SPSS Statistics V21; outcome values and 95% confidence intervals were reported. Population indicators were evaluated: registration coverage, control between treatments, population control, and the HEARTS in the Americas Maturity Index. The number of participating centers increased from a sin- gle demonstration center in 2016 to 22 polyclinics in six provinces and seven municipalities in 2021. There was a significant increase in the absolute values for the total population served, number of hypertensive patients registered, controlled patients among those treated, and controlled hypertensive patients among all adults, although with annual variations in percentages of coverage, control between treatments, and popula- tion control. The greatest progress occurred in centers with high-performance health teams. Five years after implementation of the HEARTS Initiative in Cuba, the methodology is becoming institutionalized.

[RESUMO]. A fim de descrever as mudanças no controle da hipertensão arterial de 2016 a 2021 e a relação entre o progresso e a maturidade da implementação da Iniciativa HEARTS no primeiro nível de atenção em Cuba, foi elaborado um estudo prospectivo de implementação que promoveu a aferição correta da pressão arterial com esfigmomanômetros automáticos validados, cuidados baseados em risco, a introdução de protocolos padronizados de tratamento anti-hipertensivo, a prevenção secundária e o trabalho em equipe. A educação dos pacientes, a busca ativa de casos e as atividades comunitárias também foram incentivadas. Os dados foram obtidos a partir dos registros de implementação e foram analisados com o programa de estatística SPSS versão 21. São relatadas medidas de desfecho e seus intervalos de confiança de 95%. Foram ava- liados os seguintes indicadores populacionais: cobertura de registro, controle entre os pacientes tratados e controle populacional, bem como o índice de maturidade dos processos da Iniciativa HEARTS nas Américas. Comparativamente, entre 2016 e 2021, o número de centros participantes aumentou de um só centro de demonstração para 22 policlínicas em 6 províncias e 7 municípios. Evidenciou-se um aumento significativo nos valores absolutos da população total atendida, do número de pessoas com hipertensão cadastradas, de pacientes controlados entre os tratados e de pessoas com hipertensão controlada entre todos os adultos, embora com variações anuais nos percentuais de cobertura, no controle entre os tratados e no controle populacional. Os maiores avanços ocorreram nos centros que têm equipes de saúde de alto desempenho. Cinco anos após a implementação da Iniciativa HEARTS em Cuba, avança-se rumo à institucionalização da metodologia.

Assuntos

RESUMO

RESUMEN Con el propósito de describir los cambios en el control de la hipertensión arterial desde 2016 a 2021 y la relación de los progresos con la madurez de implementación de la Iniciativa HEARTS en el primer nivel de atención de Cuba, se diseñó un estudio prospectivo de implementación que promovió la medición correcta de la presión arterial con esfigmomanómetros automáticos validados, la atención basada en riesgo, la introducción de protocolos de tratamiento antihipertensivo estandarizado, la prevención secundaria y el trabajo en equipo. Se fomentó además la educación a pacientes, la búsqueda activa de casos y las actividades comunitarias. Los datos se obtuvieron de los registros de implementación y fueron analizados con el programa estadístico SPSS versión 21, se reportan las medidas de resultados y sus intervalos de confianza del 95%. Se evaluaron los indicadores poblacionales: cobertura de registro, control entre tratados, control poblacional, así como el índice de madurez de procesos de HEARTS en Las Américas. Comparativamente, entre los años 2016 y 2021 aumentaron los centros participantes, desde un centro de demostración hasta 22 policlínicos en 6 provincias y 7 municipios. Se evidenció un incremento significativo en los valores absolutos del total de población atendida, el número de hipertensos registrados, de pacientes controlados entre los tratados e hipertensos controlados entre todos los adultos, aunque con variaciones anuales en los porcentajes de cobertura, control entre tratados y control poblacional. Los mayores progresos ocurrieron en los centros con equipos de salud de alto desempeño. Cinco años después de la implementación de la Iniciativa HEARTS en Cuba se transita hacia la institucionalización de la metodología.

ABSTRACT In order to describe the changes in the control of arterial hypertension from 2016 to 2021 and the relationship between the progress made and the maturity of implementation of the HEARTS Initiative at the first level of care in Cuba, a prospective implementation study was designed to promote the correct measurement of blood pressure with validated automatic sphygmomanometers, risk-based care, introduction of standardized antihypertensive treatment protocols, secondary prevention, and teamwork. Patient education, active case-finding, and community activities were also encouraged. Data were obtained from implementation logs and were analyzed with SPSS Statistics V21; outcome values and 95% confidence intervals were reported. Population indicators were evaluated: registration coverage, control between treatments, population control, and the HEARTS in the Americas Maturity Index. The number of participating centers increased from a single demonstration center in 2016 to 22 polyclinics in six provinces and seven municipalities in 2021. There was a significant increase in the absolute values for the total population served, number of hypertensive patients registered, controlled patients among those treated, and controlled hypertensive patients among all adults, although with annual variations in percentages of coverage, control between treatments, and population control. The greatest progress occurred in centers with high-performance health teams. Five years after implementation of the HEARTS Initiative in Cuba, the methodology is becoming institutionalized.

RESUMO A fim de descrever as mudanças no controle da hipertensão arterial de 2016 a 2021 e a relação entre o progresso e a maturidade da implementação da Iniciativa HEARTS no primeiro nível de atenção em Cuba, foi elaborado um estudo prospectivo de implementação que promoveu a aferição correta da pressão arterial com esfigmomanômetros automáticos validados, cuidados baseados em risco, a introdução de protocolos padronizados de tratamento anti-hipertensivo, a prevenção secundária e o trabalho em equipe. A educação dos pacientes, a busca ativa de casos e as atividades comunitárias também foram incentivadas. Os dados foram obtidos a partir dos registros de implementação e foram analisados com o programa de estatística SPSS versão 21. São relatadas medidas de desfecho e seus intervalos de confiança de 95%. Foram avaliados os seguintes indicadores populacionais: cobertura de registro, controle entre os pacientes tratados e controle populacional, bem como o índice de maturidade dos processos da Iniciativa HEARTS nas Américas. Comparativamente, entre 2016 e 2021, o número de centros participantes aumentou de um só centro de demonstração para 22 policlínicas em 6 províncias e 7 municípios. Evidenciou-se um aumento significativo nos valores absolutos da população total atendida, do número de pessoas com hipertensão cadastradas, de pacientes controlados entre os tratados e de pessoas com hipertensão controlada entre todos os adultos, embora com variações anuais nos percentuais de cobertura, no controle entre os tratados e no controle populacional. Os maiores avanços ocorreram nos centros que têm equipes de saúde de alto desempenho. Cinco anos após a implementação da Iniciativa HEARTS em Cuba, avança-se rumo à institucionalização da metodologia.

RESUMO

Increased blood pressure is a leading risk factor for death worldwide, and improving the control of hypertension is a major health goal to reduce non-communicable disease. Thus, in 2016, as part of a regional effort between the Pan American Health Organization and Cuban Ministry of Public Health to reduce cardiovascular risk and disease, a community demonstration project was implemented to enhance hypertension control. The intervention project was in a population of 25 868 people served by the Carlos Verdugo Martínez Polyclinic in Matanzas, Cuba. The project implemented interventions currently recommended in the World Health Organization HEARTS modules, including a standardized clinical training program with certification for blood pressure measurement, routine screening for hypertension in clinics and in the community, a simple directive pharmacologic treatment algorithm, and a registry with performance reporting and feedback. Qualitative and quantitative program monitoring and evaluation was established. In a 2010 national survey, the prevalence of hypertension and the rate of hypertension control were estimated to be 31% and 36%, respectively. Following less than one year of the full implementation of the program, the prevalence of hypertension, proportion of the hypertensive population registered as having hypertension, proportion of those drug-treated who were controlled, and estimated population rate of control were 30%, 90%, 68%, and 58%, respectively. Based on these positive results, the program has been expanded to include another demonstration program initiated in a second region. In addition, preliminary efforts to disseminate and scale-up aspects of the program to the full Cuban population have started.

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The Pan American Health Organization (PAHO)-World Hypertension League (WHL) Hypertension Monitoring and Evaluation Framework is summarized. Standardized indicators are provided for monitoring and evaluating national or subnational hypertension control programs. Five core indicators from the World Health Organization hearts initiative and a single PAHO-WHL core indicator are recommended to be used in all hypertension control programs. In addition, hypertension control programs are encouraged to select from 14 optional qualitative and 33 quantitative indicators to facilitate progress towards enhanced hypertension control. The intention is for hypertension programs to select quantitative indicators based on the current surveillance mechanisms that are available and what is feasible and to use the framework process indicators as a guide to program management. Programs may wish to increase or refine the number of indicators they use over time. With adaption the indicators can also be implemented at a community or clinic level. The standardized indicators are being pilot tested in Cuba, Colombia, Chile, and Barbados.

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BACKGROUND: In Central America, chronic interstitial nephritis of agricultural communities (CINAC) has reached epidemic proportions. Clusters of cases have been described in several farming communities. Its aetiology remains uncertain and a controversy exists on its key triggers, among them the heat stress-dehydration mechanism and the toxic exposure to agrochemicals. METHODS: This study analysed the mortality pattern and trend of chronic kidney disease code N18 (CKD-N18) according to the International Statistical Classification of Diseases and Related Health Problems-10th Revision, the proxy and the underlying cause of death, in four selected Central American countries from 1997 to 2013. In addition, we used exponential regression to retrospectively model the likely onset and prior trajectory of the epidemic. RESULTS: Between 1997 and 2013, CKD-N18 mortality accounting 47 885 deaths (31% were female), 19 533 of which occurred below 60 years of age (26% female). The excess of mortality starts as early as 10-14 years of age for both boys and girls. El Salvador and Nicaragua, with mortality rates between 9-fold and 12-fold higher than reference countries, were the most affected. Statistical modelling suggests that the epidemic commenced around the mid-1970s, coinciding with important changes in modes of agricultural production. CONCLUSIONS: This study provides the most comprehensive mortality analysis of this epidemic published to date and confirms an excess of CKD-N18 mortality and its relation with the epidemic of CINAC. The overall trends and the mortality pattern among women, children and adolescents suggest that the heat stress-dehydration hypothesis cannot fully explain this epidemic and that other environmental factors, more likely agricultural practices and agrochemicals, may be causally involved.

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Armed conflict in Colombia has played an important role in the missing people phenomenon, in which the Government has the duty to identify, recover and investigate the crime in the process of the victims' reparation. However, identifying missing people is a complex process because of the huge amount of time it consumes and the lack of information regarding the identity of the missing people, which is the norm in most of the cases. In such cases in which there is little information on the identity of missing people (including data of their relatives), DNA analysis and databases are of key importance in the identification process. This is why we present two cases that exemplify the role of DNA databases in the successful identification of missing people.

En el marco del conflicto armado que se ha presentado durante los últimos años en el territorio colombiano, el Estado ha llevado a cabo la labor de investigar, recuperar e identificar los cuerpos de personas desaparecidas en el proceso de reparación a las víctimas. La identificación de personas fallecidas y desaparecidas en la mayoría de los casos es un proceso largo y complejo, en el que es frecuente contar con muy escasa información sobre la posible identidad del individuo y sin ninguna información sobre los familiares. Es aquí donde el análisis de ADN y las bases de datos relacionadas juegan un papel importante en este proceso. Se presentan dos casos en los que se logra la identificación de dos individuos previamente reportados en condición de no identificados (individuos CNI); esto se da años después mediante la búsqueda y comparación de perfiles genéticos en la Base Nacional de Perfiles Genéticos de Aplicación en Investigación Judicial CODIS (Combined DNA Index System por sus siglas en inglés) y haciendo una ampliación del análisis genético en ambos casos para su confirmación.

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En este trabajo se presenta un estudio sistemático sobre el efecto del incremento en el número de grupos OH de alcoholes y polioles de cuatro carbonos sobre las propiedades conformacionales de la β-lactoglobulina. Los cambios en el comportamiento de las soluciones acuosas de la proteína por la adición de 1-butanol, 1,2-butanodiol, 1,2,4-butano-triol y 1,2,3,4-butanotetrol fueron determinados por espectroscopia UV, de fluorescencia y DC en el UV lejano, y en el UV cercano a 298,15 K. Los resultados muestran que el butanol ejerce una mayor modificación en la estructura de la proteína y el efecto va disminuyendo a medida que se incrementa el número de grupos OH.

In this work we present a systematic study of the effect of the increase of OH groups in alcohols and polyols of four carbon atoms on the conformational properties of β-lactoglobulin. The changes in the behavior of the aqueous solution of the protein by the addition of 1-butanol, 1,2-butanediol, 1,2,4-butanetriol y 1,2,3,4-butano-tetrol were determined by UV, far and near UV CD spectra and fluorescence spectroscopy at 298.15K. The results show that the largest modification ofprotein structure is due to butanol and the effect decreases as the number of OH groups increase.

Neste trabalho apresenta-se um estudo sistemático sob o efeito do acréscimo do número de grupos OH de alcoóis e polióis de quatro carbonos nas propriedades conformacionais da β-lactoglobulina. As mudanças no comportamento das soluções aquosas da proteína, pela adição de 1-butanol, 1,2 butanodiol, 1,2,4 e 1,2,3,4 butanotetrol butanotriol, foram determinados por espectroscopia UV, fluorescência e DC no UV distante, e no UV próximo a 298,15 K. Os resultados mostraram que o butanol tem uma maior influencia na estrutura da proteína, e o seu efeito diminui com o aumento do número de grupos OH.

RESUMO

During the twentieth century, life expectancy rose significantly across the globe due to improvements in public health and overall living conditions.[1] By 1950, life expectancy in most of today's developed countries had increased by an average of 20 years. In 1900, Japan's life expectancy was 43 years; today that country boasts the highest in the world at 83. The United States entered the last century with a life expectancy of 47 years, today reaching 78,[2] the same as in Cuba, where life expectancy in the early 1900s was only 38 years.[3,4].

RESUMO

In Cuba, breast cancer is the most common cancer in women (excluding skin cancer) and the second cause of cancer death in women. The Ministry of Public Health recognizes breast cancer as a major public health problem, and aims to reduce mortality 15% by 2015-from the 2004 adjusted mortality rate of 14.1 per 100,000 population to 11.9.[1,2] Programs are underway to lower mortality and improve survival through improved screening, research on risk factors and new therapies, and broader public education about the importance of early detection. Women in breast cancer support groups are also beginning to play a key role in raising awareness about the disease and about life-after-mastectomy, as well as providing emotional and practical support for each other and their families. The first, and now largest, breast cancer support group was started in Havana in 2003 by a few surgeons and their patients who had undergone a radical or partial mastectomies. For these women and the majority diagnosed with breast cancer in Cuba, surgery is the most common shared experience with the disease, and they refer to themselves as 'operadas' (operated on) or 'mastectomizadas' (mastectomized), rather than 'survivors'. However, the group's name, Alas por la Vida (Wings for Life), symbolizes the spirit of hope and determination uniting these women. Today, over 300 women, family members and doctors participate in bimonthly meetings at the Manuel Fajardo Clinical-Surgical Teaching Hospital in Havana. Inspired by this group's experience, breast cancer survivors in other communities are forming their own, supported by the Federation of Cuban Women. MEDICC Review talked with members, physicians and families involved with three groups-in urban Havana, the semi-urban Cotorro municipality on the outskirts of the city, and the rural town of Batabanó, two hours south of the capital-about their experiences with cancer and what the group has meant for them.

RESUMO

Since 1995, the Cuban Sports Medicine Institute has integrated natural and traditional medicine (NTM, also known in the United States as Complementary and Alternative Medicine or CAM) into its array of prevention techniques and rehabilitation therapies for Cuban athletes. Incorporating NTM into conventional medical practice-both for the Institute and the public health system as a whole-has been a sometimes prickly process, confronting prejudice among some in the medical profession and among patients themselves. The Sports Medicine Institute's NTM Unit is headed by medical director Anisio Le�n and technical director Pedro Carmona, who spoke with MEDICC Review about the history, philosophy, results and challenges of their work.

RESUMO

Dr Yamila de Armas has occupied an array of posts since finishing her residency in family medicine in her home province of Cienfuegos in 1992. She has served as a family doctor; polyclinic, municipal and provincial health director; medical school dean; and twice vice minister of public health. But few would doubt her toughest job is the one she has now: deputy director of the Havana City Provincial Health Department, in charge of medical services for the 2.2 million people living in Cuba's complex, sprawling capital. It was here in 2002-2003 that the program was launched to repair, refurbish and expand the country's nearly 500 community polyclinics. Key to the effort was equipping these facilities with a broader range of new and upgraded medical technology. Dr de Armas offers MEDICC Review her reflections on the results five years later.

RESUMO

Jacinto Duverger received his Bachelor's Degree in Economic Cybernetics from the University of Donetsk, Ukraine in 1988 and his Master's Degree in Information and Communications in 2007 from a joint program between the University of Las Villas and Guantánamo University. Since 1994 he has worked almost exclusively on the development of the Health Trends Analysis Units (Unidad de Análisis de Tendencias en la Salud, UATS) throughout Cuba, participating in their conceptual design, installing their first computer network, and more. Born in the country's easternmost province, Guantánamo, his fascination with programming and Prospective Methodology led him to create health software that helps provincial UATS track and forecast health events and to engage in proactive strategic health planning. Most recently, Duverger developed a software package to study the financial sustainability of Mexico's new catastrophic illness coverage program. Duverger sat down with MEDICC Review to talk about software development, strategic health planning methodologies, and training the new generation of Cuban public health leaders.

RESUMO

Dr Pedro Ordúñez, a leading public health expert and internist, is Director of the Cienfuegos Provincial Teaching Hospital and Associate Professor at the National School of Public Health in Havana. Dr Ordúñez has published extensively in Cuban and international peer-reviewed journals, most recently in the American Journal of Epidemiology, as co-author of Impact of Energy Intake, Physical Activity, and Population-wide Weight Loss on Cardiovascular Disease and Diabetes Mortality in Cuba, 1980-2005.[1] In 1994, he was selected as a Pan American Health Organization (PAHO) post-graduate fellow at Johns Hopkins University School of Public Health. Thereafter, he obtained a Doctorate in Health Sciences from Cuba's National School of Public Health. Dr Ordúñez has traveled throughout the Americas as a chronic disease consultant for PAHO and has served locally in the PAHO-coordinated CARMEN Network, which focuses on the integrated prevention of chronic non-communicable diseases and their risk factors. He is a member of the Cuban Academy of Sciences and has received the nationalhealth award on several occasions. Dr Ordúñez sat down with MEDICC Review for an exclusive interview to discuss his insights into the complex relation between poverty, development, and chronic disease.

RESUMO

In December 2007, Cuba's National Health Science Prizes were awarded for outstanding contributions to basic science, clinical medicine, and population health. The prizes, first bestowed in 1976, are sponsored by Cuba's Ministry of Public Health and the National Council of Scientific Societies. Works are selected based on excellence, scientific rigor, and relevance. In 2007, one Grand Prize, 13 additional prizes, and 11 special mentions were awarded from among 244 entries forwarded from the provincial level.

RESUMO

In 2004, the final death toll in Haiti from Tropical Storm Jeanne was recorded at 3,006; of these, 2,826 in Gonaïves, a city floating in ruins. The road to Gonaïves was washed out, leaving the city and the department of Artibonite cut off for days from the rest of the country. Dr Juan Carlos Ch�vez, who headed the Cuban medical team in Haiti at the time, recalls that 17 Cuban health professionals were working in the area when the storm barrelled through, among the 400 already serving in the country. They were later joined by another 72 doctors, nurses, technicians and engineers sent directly from Cuba.

RESUMO

A systematic study concerning the effect of aqueous solution of alcohols and polyols with four carbon atoms on beta-lactoglobulin stability is presented. The protein was chosen due to its functional properties and applications in food and pharmaceutical industries and because its structure and properties in aqueous solution have been widely described. The alcohols having a four carbon chain were selected to examine the effect of the gradual increase in the number of OH groups on protein stability. Protein thermal stability in water, buffers and dilute aqueous solutions of 1-butanol, 1,2-butanediol, 1,2,4-butanetriol and 1,2,3,4-butanetetrol was evaluated by fluorescence spectroscopy. The results were used to determine the temperature range in which the unfolding process is reversible and the protein denaturation temperature in acetate buffer pH 5.5 and in the aqueous mixed solvents. Thermodynamic results show that alcohol denaturating effect diminishes gradually as the number of OH groups increase.

Assuntos

RESUMO

The world's 1,691 medical schools and 5,492 nursing schools are not producing enough graduates to cover the massive global deficit of doctors, nurses, and midwives, reports the World Health Organization (WHO).[1] One scaling-up initiative addressing these critical shortages is Cuba's Latin American Medical School (ELAM).