Brigada 17 de la Cruz Roja en Santa Clara, paradigma de humanismo

The Red Cross is an independent relief society, serving the humanitarian community and acting in different contexts. The Red Cross of Santa Clara, through the sanitary work of the 17th Brigade, deployed active participation in the military health during the taking of the city. Its brigade showed signs of humanism and respect in compliance with the principles and rules of International Humanitarian Law; also participated in the Literacy Campaign in the fight against bandits and farming, among other activities. Serve this material as a modest tribute to the dedicated work of the Red Cross and contribute to the formation of professional values ​​in the Cuban Public Health.La Cruz Roja es una sociedad de socorro independiente, al servicio de la comunidad y de carácter humanitario que actúa en diversos contextos. La Cruz Roja de Santa Clara, a través de la labor sanitaria de la Brigada 17, desplegó una activa participación en la sanidad militar durante la toma de dicha ciudad. Sus brigadistas dieron muestra de humanismo y respeto en el cumplimiento de los principios y las normas del Derecho Internacional Humanitario; además, participaron en la Campaña de Alfabetización, en la lucha contra bandidos y en labores agrícolas, entre otras actividades. Sirva este material como modesto homenaje a la abnegada labor de la Cruz Roja y contribuya a la formación de valores en los profesionales de la Salud Pública cubana

Caracterización de las enfermedades neoplásicas en los pacientes con trasplante renal funcional

Introduction: renal transplantation is the therapy of choice for the majority of patients with chronic renal failure. Immunosuppressive treatment shows associations with neoplastic diseases. Objective: to characterize neoplastic diseases in patients with functional renal transplantation. Method: an observational, descriptive, transverse study was carried out at "Arnaldo Milián Castro" Hospital. An intentional sample of 16 patients with neoplastic diseases was selected. Information was obtained from the renal transplant Consultation, from the clinical file and database of the Department of Pathological Anatomy. Results: male sex predominated (81%), mean age higher than female sex, and white skin color (93.7%). The most commonly used renal replacement therapy was hemodialysis (nine, 56%). Squamous cell carcinoma (six) and basal cell (three) prevailed. The frequency of viral diseases such as hepatitis C and cytomegalovirus was evidenced. Immunosuppressive treatment with prednisone, immuran, and cyclosporin was more than half of the patients (62%), and seven died after three years of neoplastic disease treatment for each patient. Conclusions: squamous cell carcinoma and basal cellular carcinoma were the most prevalent neoplastic diseases and after the treatment received, the survival was the expected.Introducción: el trasplante renal es la terapia de elección para la mayoría de los pacientes con insuficiencia renal crónica. El tratamiento inmunosupresor muestra asociaciones con enfermedades neoplásicas. Objetivo: caracterizar las enfermedades neoplásicas en los pacientes con trasplante renal funcional. Método: se realizó una investigación observacional, descriptiva, transversal en el Hospital “Arnaldo Milián Castro”. Se seleccionó una muestra intencional de 16 pacientes con enfermedades neoplásicas. Se obtuvo la información de la pancarta de la Consulta de trasplante renal, del expediente clínico y de la base de datos del Departamento de Anatomía Patológica. Resultados: predominaron el sexo masculino (81%), con edad media superior a la del femenino, y el color de piel blanca (93,7%). El tratamiento renal de reemplazo más utilizado fue la hemodiálisis (nueve, 56%). Prevalecieron el carcinoma espinocelular (seis) y el basocelular (tres). Se evidenció la frecuencia de enfermedades virales como hepatitis C y citomegalovirus. Recibieron tratamiento inmunosupresor con prednisona, inmurán y ciclosporina más de la mitad de los pacientes (62%) y por cada fallecido sobrevivieron siete a los tres años de tratamiento de la enfermedad neoplásica. Conclusiones: el carcinoma espinocelular y el basocelular fueron las enfermedades neoplásicas que más prevalecieron y la supervivencia, después del tratamiento recibido, fue la esperada

Caracterización de pacientes que padecen hepatitis C en un Servicio de hemodiálisis

The viral infections affect the morbidity and mortality of patients in substitute treatment of renal function; the infection for the virus of hepatitis C is a flagellum of public health in this century and a serious health problem in adult hemodialysis centers of Villa Clara. A descriptive, longitudinal and retrospective study was realized in “Arnaldo Milián Castro” Hospital in the period between January 2012 and December 2014; only 41 patients constituted the hemodialysis population. It was aimed to characterize patients with hepatitis C and it was an updated review of the topic to show the progress made in prevention with the use of the new room of purifying methods. To compile information it was used a form of data collection and the hospitable records were consulted. In the study the male patients predominated aged between 50 and 69, with the highest incidence in 2012, the time between six months and one year was the period of greatest infestation and the route of infection most preponderant was for catheter of hemodialysis. In the prevention of viral infection is essential the fulfillment universal standards compliance of biosafety; the restructuring of the unit of purifying methods is a pioneer in this effort.Las infecciones virales inciden en la morbilidad y la mortalidad de los pacientes en tratamientos sustitutivos de la función renal; la infección por el virus de la hepatitis C es un flagelo de la salud pública en el presente siglo y un serio problema de salud en los centros de hemodiálisis de adultos de Villa Clara. Se realizó una investigación de desarrollo, descriptiva, longitudinal y retrospectiva en el Hospital “Arnaldo Milián Castro” en el período comprendido entre enero de 2012 y diciembre de 2014; constituyeron la población 41 enfermos hemodializados. Se tuvo como objetivo caracterizar a los pacientes con hepatitis C y se hizo una revisión actualizada del tema para demostrar los avances obtenidos en materia preventiva con el uso de la nueva sala de métodos depuradores. Para la recopilación de la información se utilizó un formulario de recogida de datos y se consultaron las historias clínicas hospitalarias. Predominaron los pacientes del sexo masculino en edades comprendidas entre 50 y 69 años, con mayor incidencia en el año 2012, el tiempo comprendido entre seis meses y un año constituyó el período de mayor infestación y la vía de contagio más preponderante fue por catéter de hemodiálisis. En la prevención del contagio viral es imprescindible el cumplimiento de las normas universales de bioseguridad; la reestructuración de la unidad de métodos depuradores es pionera en este empeño

Microangiopatía trombótica

A female patient of 26 years old, with personal pathological history of congenital glaucoma and blindness in the right eye that three days before his admission to “Arnaldo Milian Castro” Hospital began with chills, fever of 39-410°C, universal headache, nausea, projectile vomiting and fetid dark urine, fot those reasons she was admitted in the “Celestino Hernández Robau” Hospital with the presumptive diagnosis of dengue; she evolved bad, so she was sent to “Arnaldo Milian Castro” Hospital with the same symptoms and taking consciousness. On physical examination of the central nervous system, It was appreciated nuchal rigidity ++, bilateral Babinsky, somnolence, disorientation and Glasgow 13/15. An axial computerized tomography was realized that showed hypodense of both thalamuses badly definite, in the midline of both cerebellar hemispheres an image of similar characteristics and III ventricle collapsed. It raised vasculitis with multiple several cerebral infarctions and possible meningoencephalitis and died 26 days admitted. Pathologic findings allowed the diagnosis of damage and multiple organ failure in patient suffering thrombotic microangiopathy.Se trata de una paciente femenina de 26 años de edad, con antecedentes patológicos personales de glaucoma congénito y ceguera del ojo derecho que tres días antes de su ingreso en el Hospital “Arnaldo Milián Castro” comenzó con escalofríos, fiebre de 39-410°C, cefalea universal, náuseas, vómitos en proyectil y orinas oscuras fétidas, razones por las que fue ingresada en el Hospital “Celestino Hernández Robau” con el diagnóstico presuntivo de dengue; evolucionó mal, por lo que fue remitida al Hospital “Arnaldo Milián Castro”, con iguales síntomas y toma de la conciencia. En el examen físico del sistema nervioso central se apreció rigidez nucal ++, Babinsky bilateral, somnolencia, desorientación y Glasgow 13/15. Se le realizó una tomografía axial computadorizada que mostró hipodensidad de ambos tálamos mal definida, en línea media de ambos hemisferios cerebelosos una imagen de similares características y III ventrículo colapsado. Se planteó vasculitis con infartos cerebrales múltiples y posible meningoencefalitis y falleció a los 26 días de ingresada. Los hallazgos anatomopatológicos permitieron el diagnóstico de daño y fallo multiorgánico en paciente que padecía microangiopatía trombótica

Risk of COVID-19 after natural infection or vaccinationResearch in context

Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health

Risk of COVID-19 after natural infection or vaccinationResearch in context

Summary: Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health