INTRODUCTION:Over the last 40 years, high smoking prevalence has been reported throughout Cuba, including in Cienfuegos city in the central part of the island. OBJECTIVE: Determine smoking prevalence and potential associated risk factors in Cienfuegos city for 2010-2011. METHODS: A descriptive cross-sectional study was conducted in Cienfuegos city in the context of CARMEN (Collaborative Action for Risk Factor Prevention & Effective Management of Non-communicable Diseases), a PAHO multi-country initiative for a multidimensional approach to chronic non-communicable diseases. Participants totaled 2193 (aged 15-74 years), randomly selected through complex probabilistic three-stage sampling. Variables examined in relation to smoking included age, sex, skin color, civil status and educational level. RESULTS: Approximately 25% of those surveyed were smokers (30.3% of men and 21.0% of women). For men, prevalence was highest in the groups aged 25-34 and 55-64 years; for women, in the group aged 45-54 years. Concerning skin color, smoking rates were higher among black and mestizo persons (29.5%); and concerning civil status, higher among those who were separated, widowed or divorced (30.0%). Smoking prevalence fell with higher educational level; in keeping with that trend, the university-educated group had the lowest prevalence (16.2%). CONCLUSIONS: Although one in four Cienfuegos residents aged > 15 years smoked in 2010-2011, prevalence there is lower than in previous surveys. Knowledge of differences observed in age, sex, skin color, civil status and educational level can be useful for planning future smoking prevention and control actions.

Between 1994 and 2009, the Dr Gustavo Aldereguía University Hospital of Cienfuegos, Cuba implemented a series of interventions that reduced acute myocardial infarction case fatality rate from 47% to 15%. These interventions were part of an institutional plan for myocardial infarction included in the hospital's overall quality assurance strategy. Outcomes resulted primarily from organizational changes (from upgrading of the hospital emergency department and provincial emergency system to creation of a comprehensive coronary care unit and a chest pain center); optimizing use of effective drugs (streptokinase, aspirin, ACE inhibitors and beta blockers); adherence to clinical practice guidelines; and continual and participatory evaluation and adjustment.

One of the most important consequences of the epidemiological transition that the populations have undergone in the last decades is the progressive and geometric increase in the number of persons suffering chronic diseases; particularly around 80% of people who die from these diseases do not live in developed countries. Growing population aging is added to a setting full of new conditions and "unhealthy" lifestyles. This paper emphasized that for the health services to be successful in the prevention and control of chronic diseases and the care of those affected by them, it is required to clearly define and identify this problem with its specificities, to re-direct the services and to re-design the formation of integral health professionals. All these actions should be carried out in a coordinated way by both public health specialists, epidemiologists and clinicians, within an unprecedented demographic and epidemiological setting in the history of mankind.

Como una de las consecuencias más importantes de la transición epidemiológica que han sufrido las poblaciones en las últimas décadas, ha estado el incremento progresivo y geométrico de las personas que padecen enfermedades crónicas, con la particularidad de que alrededor del 80 % de todos los que mueren de estas enfermedades, no residen en los países desarrollados. A un escenario con nuevas condiciones y estilos de vida "no saludables", se une un envejecimiento poblacional creciente. En este artículo se insiste en que para un enfrentamiento exitoso de los servicios de salud en la prevención y el control de las enfermedades crónicas y en la atención de quienes las padecen, se requiere de una clara definición e identificación de este problema con sus particularidades, de una reorientación de los servicios y del rediseño de una formación de profesionales de la salud integrales; acciones que deberían llevarse a cabo de manera coordinada, tanto por salubristas y epidemiólogos, como por clínicos, en un contexto demográfico y epidemiológico sin precedentes en la historia de la humanidad.

One of the most important consequences of the epidemiological transition that the populations have undergone in the last decades is the progressive and geometric increase in the number of persons suffering chronic diseases; particularly around 80% of people who die from these diseases do not live in developed countries. Growing population aging is added to a setting full of new conditions and "unhealthy" lifestyles. This paper emphasized that for the health services to be successful in the prevention and control of chronic diseases and the care of those affected by them, it is required to clearly define and identify this problem with its specificities, to re-direct the services and to re-design the formation of integral health professionals. All these actions should be carried out in a coordinated way by both public health specialists, epidemiologists and clinicians, within an unprecedented demographic and epidemiological setting in the history of mankind.

Como una de las consecuencias más importantes de la transición epidemiológica que han sufrido las poblaciones en las últimas décadas, ha estado el incremento progresivo y geométrico de las personas que padecen enfermedades crónicas, con la particularidad de que alrededor del 80 % de todos los que mueren de estas enfermedades, no residen en los países desarrollados. A un escenario con nuevas condiciones y estilos de vida "no saludables", se une un envejecimiento poblacional creciente. En este artículo se insiste en que para un enfrentamiento exitoso de los servicios de salud en la prevención y el control de las enfermedades crónicas y en la atención de quienes las padecen, se requiere de una clara definición e identificación de este problema con sus particularidades, de una reorientación de los servicios y del rediseño de una formación de profesionales de la salud integrales; acciones que deberían llevarse a cabo de manera coordinada, tanto por salubristas y epidemiólogos, como por clínicos, en un contexto demográfico y epidemiológico sin precedentes en la historia de la humanidad.

A 64 years-old male patient presented with a confirmed histopathological diagnosis of sporadic Creutzfeld-Jakob disease. His clinical manifestations were initially interpreted and treated as if it were Parkisonism plus since extrapiramidal manifestations prevailed in his clinical picture. The occurrence and rapid development of his demential picture and his death seven months later suggested the presence of Creutzfeld-Jakob disease. Postmortem studies revealed the neuropathological features of this disease. It was confirmed that until that moment no other cases had been reported in Cuba.

Se presentó un paciente de 64 años de edad con diagnóstico histopatológico comprobado de enfermedad de Creutzfeld-Jakob a forma esporádica. Sus manifestaciones clínicas se interpretaron y trataron inicialmente como un parkisonismo plus, pues predominaban en su cuadro clínico manifestaciones extrapiramidales. La instalación y evolución rápida de su cuadro demencial, con fallecimiento posterior, aproximadamente 7 meses después, sugirió la presencia de enfermedad de Creutzfeld-Jakob. Se demostraron en estudios postmorten características neuropatológicas de dicha enfermedad. Se comprobó que no existían otros casos reportados en Cuba hasta este momento.