ABSTRACT The objective of this study was to determine the impact of metabolic changes occurring in induced subclinical gestation toxaemia in ewes on metabolic parameters and vigour in the first 72 h of their lambs’ life. Fifty-one adult Corriedale ewes of known gestation date and fed on a natural pasture were randomly divided into four groups at day 145 of gestation. Group A (ewes with single pregnancies) and group C (ewes with twin pregnancies) were fed on a natural pasture throughout the trial; group B (ewes with single pregnancies) and group D (ewes with twin pregnancies) were subjected to 75% feed restriction for three days until they reached glycaemia and β-hydroxybutyrate (BHB) values indicative of subclinical gestational toxaemia. The birth-to-first station and birth-to-first suckling times of the born lambs were studied. Within the first hour after parturition and at 24, 48, and 72 h, glycaemia and BHB concentrations were determined in the blood of lambs, and body temperature and body weight were assessed at the same time. Relative weight gain at 72 h of age was calculated for all lambs. The BHB concentration determined at all times studied showed no difference among the groups. Subclinical gestation toxaemia induced in ewes subjected to feed restriction causes a decrease in the glycaemia of their lambs in the first hour of life; however, it does not cause an increase in ketone bodies. The metabolic changes induced in the mothers do not have negative effects on the vigour of the lambs at birth, as the weight, temperature, and the time it took for lambs to stand and suckle are not affected. However, they have a negative effect on relative weight gain in the critical period of the first 72 h of life.

ABSTRACT The COVID-19 pandemic currently affects millions of people including the pediatric population. The clinical manifestations in children are diverse: respiratory, gastrointestinal, hematological, neurological and systemic. In order to describe the various clinical and neurological manifestations during the evolution of the disease, we documented a series of cases of pediatric patients with COVID-19. Various mechanisms are proposed through which SARS-CoV-2 would cause neurological injury (direct injury, secondary to an immune response, among others) with variable clinical characteristics (seizures, muscle weakness, sensorial disorder). Studies on clinical characteristics and prognostic factors in children and adolescents with SARS-CoV-2 are limited, therefore, this report provides a spectrum of neurological manifestations associated with SARS-CoV-2 in pediatric population.

RESUMEN La pandemia por la COVID-19 afecta actualmente a millones de personas sin exceptuar la población pediátrica. Las manifestaciones clínicas en niños son variables: respiratorias, gastrointestinales, hematológicas, neurológicas y sistémicas. Con el objetivo de describir las diversas presentaciones clínicas y neurológicas durante la evolución de la enfermedad se documentó una serie de casos de pacientes pediátricos con la COVID-19. Se plantean diversos mecanismos a través de los cuales el SARS-CoV-2 causaría daño neurológico (daño directo, secundario a respuesta inmune, entre otras) con características clínicas variables (convulsiones, debilidad muscular, trastorno del sensorio). Los estudios sobre características clínicas y factores pronósticos en niños y adolescentes con SARS-CoV-2 son limitados, por lo cual el presente reporte contribuye con un espectro de manifestaciones neurológicas asociadas al SARS-CoV-2 en población pediátrica.

ABSTRACT The COVID-19 pandemic currently affects millions of people including the pediatric population. The clinical manifestations in children are diverse: respiratory, gastrointestinal, hematological, neurological and systemic. In order to describe the various clinical and neurological manifestations during the evolution of the disease, we documented a series of cases of pediatric patients with COVID-19. Various mechanisms are proposed through which SARS-CoV-2 would cause neurological injury (direct injury, secondary to an immune response, among others) with variable clinical characteristics (seizures, muscle weakness, sensorial disorder). Studies on clinical characteristics and prognostic factors in children and adolescents with SARS-CoV-2 are limited, therefore, this report provides a spectrum of neurological manifestations associated with SARS-CoV-2 in pediatric population.

RESUMEN La pandemia por la COVID-19 afecta actualmente a millones de personas sin exceptuar la población pediátrica. Las manifestaciones clínicas en niños son variables: respiratorias, gastrointestinales, hematológicas, neurológicas y sistémicas. Con el objetivo de describir las diversas presentaciones clínicas y neurológicas durante la evolución de la enfermedad se documentó una serie de casos de pacientes pediátricos con la COVID-19. Se plantean diversos mecanismos a través de los cuales el SARS-CoV-2 causaría daño neurológico (daño directo, secundario a respuesta inmune, entre otras) con características clínicas variables (convulsiones, debilidad muscular, trastorno del sensorio). Los estudios sobre características clínicas y factores pronósticos en niños y adolescentes con SARS-CoV-2 son limitados, por lo cual el presente reporte contribuye con un espectro de manifestaciones neurológicas asociadas al SARS-CoV-2 en población pediátrica.

Resumen Uno de los factores de mayor incidencia y amenaza a la biodiversidad, lo constituye la introducción de especies exóticas. Calificada precisamente como especie exótica invasora, Raoiella indica (Acari: Tenuipalpidae) fue registrada en Cuba desde 2008. Esta especie no solo afecta a plantas de importancia económica, su hábitat incluye a especies botánicas de la familia Arecaceae. Esta amenaza real y potencial a la diversidad biológica nativa, a las colecciones de palmas, sumado al limitado conocimiento pero creciente interés de los impactos de especies exóticas son las razones que justifican el presente trabajo. Para su ejecución se realizó una prospección de R. indica en todos los jardines botánicos de Cuba que poseían palmetum, además de las palmáceas de avenidas y jardines de hoteles de Varadero y el vivero que da soporte de estas especies a ese polo turístico. Se encontró que, de los 214 taxones de palmas muestreados, 66 son hospedantes de R. indica y de ellos, 32 constituyen nuevos reportes. Las avenidas y jardines de hoteles de Varadero y el vivero fueron los que tuvieron mayores valores en la proporción de especies infestadas. R. indica mostró características de especie invasora sobre Colpothrinax wrightii Griseb. & H.Wendl. ex Voss, especie endémica y amenazada. Esta prospección permitió confeccionar el inventario más completo de palmas hospedantes que se ha informado para esta especie exótica para Cuba y el mundo, elemento que revela su impacto ecológico potencial sobre la biodiversidad de palmas y de vital importancia para las futuras estrategias de manejo.

Abstract One of the causes of greater incidence and threat to biodiversity is the introduction of exotic species. Raoiella indica Hirst (Acari: Tenuipalpidae) has been reported in Cuba since 2008. This species not only affects plants of economic importance, its habitat also includes botanical species of the family Arecaceae. This real and potential threat to native biological diversity, palm collections, coupled with the limited knowledge of, but growing interest in the impacts of exotic species are the reasons that justify the present work. For its execution, a survey of R. indica was carried out in all the botanical gardens of Cuba that had palmetum, besides the palmaceas of avenues and gardens of Varadero hotels and the nursery that supports these species in this touristic area. It was found that of the 214 taxa of palms sampled, 66 are hosts of R. indica, and of them, 32 constitute new reports. The avenues and gardens of Varadero hotels and the nursery were those that had higher proportion of infested species values. R. indica showed characteristics of invasive species on Colpothrinax wrightii Griseb. & H.Wendl. Ex Voss, an endemic and threatened species. This prospect allowed this study to make the most complete record of host palms that has been reported for this exotic species for Cuba and the world, showing its potential ecological impact on palm biodiversity, as well as the vital importance of future management strategies.

ABSTRACT Dementia is a great challenge to public health in Cuba due to its impact on society and families. Cuba’s National Intervention Strategy for Alzheimer Disease and Dementia Syndromes is designed to address this challenge. The Strategy includes working guidelines for primary and secondary care, education about rights of people with cognitive impairment, professional development, research, and health promotion and dementia prevention. An associated action plan, focused on primary care, includes proposals for creation of memory clinics, day centers and comprehensive rehabilitation services for cognitive stimulation. Short-term measures proposed include increasing early detection; creating a dementia morbidity and mortality registry; promoting professional training; providing support for families; and promoting basic and clinical research on dementia. Medium-term proposals aim to reduce dementia incidence and mortality by controlling risk factors and promoting healthy lifestyles, offering new treatment options and optimizing early detection. A set of indicators has been developed to evaluate strategy implementation. With this strategy, Cuba joins the small number of developing countries that have responded to WHO’s call to improve care for patients with dementia and alleviate its impact on society and families.

Introducción: La infección respiratoria aguda es una causa importante de morbimortalidad en menores de cinco años en los municipios de las provincias de Santander. La etiología viral en esos municipios no es bien conocida. Objetivo: El objetivo del estudio fue determinar la etiología viral de la infección respiratoria aguda en menores de cinco años en las provincias Comunera y García Rovira del departamento de Santander entre diciembre de 2012 y diciembre de 2013. Materiales y métodos: Estudio descriptivo en población usuaria de servicios de urgencias. Se obtuvieron muestras por hisopado nasofaríngeo y se realizó amplificación por reacción en cadena de polimerasa con el test Seeplex® RV15 OneStep ACE Detection, multiplex para 15 virus. Resultados: Participaron 64 niños, 57,8% niños de sexo masculino. El 26,6%, de los niños eran menores de un año. La positividad para virus fue del 37,5% de las muestras. El 75% de las muestras positivas fueron de la provincia Comunera y 25% de la provincia de García Rovira. Hubo co-infección por dos virus en 8,3% de las muestras positivas. Los virus más identificados fueron Rhinovirus (29%), Parainfluenza 4 (20,8%) e Influenza (12,5%). También se identificó Coronavirus, Adenovirus, Virus Sincitial Respiratorio, Metapneumovirus y otros virus Parainfluenza. Conclusiones: En las dos provincias de Santander evaluadas circula una amplia cantidad de virus respiratorios en menores de cinco años. El Rhinovirus fue identificado como el más frecuente. Se encontró presencia de Metapneumovirus y Coronavirus humano.

Introduction: Acute respiratory infection is a major cause of morbidity and mortality in children under 5 years in Santander (Colombia). Viral etiology in municipalities from this department is not well known. Objective: To determine the viral etiology of acute respiratory infection in children under five years in the provinces Comunera and García Rovira (Santander) from December 2012 to December 2013. Methodology: Descriptive study in pediatric population who attended the emergency services studied. Nasopharyngeal swab samples were obtained and a polymerase chain reaction was performed with Seeplex® OneStep RV15 ACE Detection, which is a multiplex test for 15 virus. Results: 64 children were enrolled, 57,8% being boys. 26.6% of participants were under one year. Virus positivity was present in 37.5% of the samples and 75% of the positive samples were from the province Comunera. Besides, 8.3% from positive samples were co-infected with two viruses. The most common virus were Rhinovirus (29%), Parainfluenza 4 (20.8%) and influenza (12.5%). Coronavirus, Adenovirus, respiratory syncytial virus, Metapneumovirus and other Parainfluenza virus were also identified. Conclusions: There is a wide circulation of respiratory virus in children under five in these two provinces of Santander (Colombia). Rhinovirus was the most frequent. Human Metapneumovirus and Coronavirus were also found.

Gender identity is a sociocultural construct based (in nearly every society) on a binary norm: female and male. Transsexual individuals suffer from intense family and social discrimination because they express a dissident sexuality incongruent with this norm. They assert they feel trapped in a body that does not belong to them, so they seek help from health professionals to modify their bodies, to "adapt their bodies to their minds." This essay discusses health care for transsexual persons in Cuba from a human rights perspective that does not pathologize their gender identification.

The red palm mite, Raoiella indica Hirst (Acari: Tenuipalpidae) is a serious pest for coconut, date and areca palms in many countries in the tropics of the Eastern and Western hemispheres. It was described on coconut leaves from India in 1924, being disseminated in several countries including Pakistan, Sri Lanka, Malaysia, Mauritius, Egypt, Sudan, Iran, Oman, Israel, Reunion, Saudi Arabia, United Arab Emirates and Philippine. This mite was recently reported in the Caribbean region, in Martinique, in 2004. It has spread rapidly throughout this region and has been found in Dominica, Guadeloupe, St. Martin, Saint Lucia, Trinidad and Tobago, Puerto Rico, St. Thomas, Dominican Republic and Jamaica, where it has been observed also affecting other plant species not belonging to Arecaceae family such as Musa spp. (Musaceae), Heliconia rostrata (Heliconaceae), Alpinia purpurata (Zingiberaceae) and Eucayiptus spp. (Myrtaceae). Considering the risk of introduction of this invasive species, the present review was carried out to provide updated technical information about the biology, geographic distribution, detection, damage and management of R. indica. The incidence of this pest in Cuba might have serious consequences for coconut and plantain crops and to the tourism industry for the damage on the attractive gardens surrounding the hotels and to the Real Palm, national tree, with social and cultural implications. For this reason, the development of a management strategy to mitigate the possible impact of red palm mite and of a comprehensive public awareness programme for farmers and the public in general is very important.

El ácaro rojo de las palmeras, Raoiella indica Hirst (Acari: Tenuipalpidae) es una plaga importante para el cocotero, la palma dátil y en arecas ornamentales de numerosos países tropicales del hemisferio oriental y occidental. Esta especie fue descrita en 1924 sobre hojas de cocotero en la India, diseminándose por varios países donde se incluyen: Pakistán, Sri Lanka, Malasia, Mauricio, Egipto, Sudán, Irán, Omán, Israel, Isla Reunión, Arabia Saudita, Emiratos Árabes Unidos y Filipinas. Recientemente fue informado en la cuenca del Caribe en Martinica, en el 2004. En esta región se ha dispersado rápidamente, y se señala su presencia en Dominica, Guadalupe, San Martín, Santa Lucía, Trinidad y Tobago, Puerto Rico, Santo Tomás (Islas Vírgenes Estadounidenses), República Dominicana y Jamaica. En el Caribe ha afectado otras especies de plantas que no pertenecen a la familia Arecaceae, tales como Musa spp. (Musaceae), Heliconia rostrata (Heliconaceae), Alpinia purpurata (Zingiberaceae) y Eucayiptus spp. (Myrtaceae). Considerando el riesgo de introducción de esta especie invasora se elaboró la presente reseña con el objetivo de ofrecer información técnica actualizada sobre la biología, distribución geográfica, identificación, daños y el manejo de R. indica. La incidencia de esta plaga en Cuba podría tener serias consecuencias para los cultivos del cocotero, plátano, y en la industria del turismo, debido a que los jardines que rodean los hoteles pueden ser dañados, así como afectar a la Palma Real, árbol nacional, con implicaciones sociales y culturales. Por ello, es importante elaborar una estrategia de manejo para mitigar el posible impacto del ácaro rojo de las palmeras, así como desarrollar un programa de información para productores y el público en general.

An analytical-observational case-control study was carried out to assess the impact of some atherogenic risk factors on morbidity and mortality from cardiovascular disease and to set a synthetic indicator for stratifying risk groups of vasculovisceral damage on the basis of such factors. The sample was made up of 200 patients randomly selected from patients admitted at "Dr Luis Díaz Soto" Higher Institute of Military Medicine throughout the year 2000. Patients with unequivocal diagnosis of cardiovascular disease were classified as sick people whereas patients with similar characteristics without vasculo-visceral damage were taken as controls. When making the statistical significance analysis, the risk factors related with morbidity and mortality from cardiovascular disease, with independent predictive power, were the following (in decreasing order of odd ratios (OR): blood hypertension, hypercholesterolemia, diabetes mellitus, lack of physical exercising and smoking. Stress, body mass index and personal and family pathological history did not show significant differences. These variables integrated into a synthetic scoring were stratified and compared, and cases showed significant differences with respect to controls. The estimated probabilities of getting sick was 6.9 times higher in the group of exposed people (strata 2 and 3). This was a preliminary proof of the discriminating value of the prognostic index for the stratification of population by risk groups since such an index may be an adequate alternative due to its simplicity, cost-benefit relation and advantages for the implementation of intervention strategies at primary health care level against non-communicable chronic diseases.

Se realizó un estudio observacional analítico de casos y controles, para evaluar la influencia de algunos factores de riesgos aterogénicos en la morbilidad y mortalidad por enfermedad cardiovascular y establecer a partir de estos un índice sintético para estratificar los grupos de riesgo del daño vasculovisceral. La muestra integrada por 200 pacientes fue seleccionada de forma aleatoria en pacientes ingresados en el Instituto Superior de Medicina Militar "Dr. Luis Díaz Soto" durante el año 2000. Se definieron como enfermos a pacientes con diagnóstico inequívoco de enfermedad cardiovascular y controles, a pacientes con características similares a los casos anteriores, excepto no presentar daño vasculovisceral. Al efectuar el análisis de significación estadística, los factores de riesgo aterogénico que permanecieron asociados con la morbilidad y mortalidad por enfermedad cardiovascular, con un poder predictor independiente, fueron en orden decreciente de razones cruzadas (OR), la hipertensión arterial, la hipercolesterolemia, la diabetes mellitus, el sedentarismo y el hábito de fumar. No mostraron diferencias significativas el estrés, el índice de masa corporal y los antecedentes patológicos personales y familiares. Estas variables integradas en una puntuación sintética fueron estratificadas y comparadas, y mostraron diferencias significativas los casos en relación con los controles, con estimaciones de la probabilidad de enfermar 6,9 veces superiores en el grupo expuesto (estratos 2 y 3), como demostración preliminar del valor discriminativo del índice para la estratificación de la población por grupos de riesgo, el cual puede constituir una alternativa apropiada por su simplicidad, relación costo-beneficio y utilidad para la implementación de estrategias de intervención contra las enfermedades crónicas no transmisibles en el nivel primario de salud.