Simultaneous quantification of human herpesvirus 8 DNA by real time PCR in different tissues of HIV infected cuban patients with Kaposi's sarcoma

In Cuba, previous reports have shown an increase of epidemic KS, reaching a total of 120 cases by the end of 2007, despite the use of HAART. To evaluate and compare the role of human herpes virus 8 (HHV-8) viral loads in different compartments of AIDS-related Kaposi's sarcoma (AIDS-KS) patients real-time polymerase chain reaction (RT-PCR) was used to determine the genome copy number of HHV-8 in plasma, saliva, tissue and peripheral blood mononuclear cells (PBMC) of 49 AIDS-KS patients. Overall, 98% of AIDS-KS patients harbored detectable HHV-8. HHV-8 could be detected in 91.6% of KS tissue lesions showing the highest viral load (median log = 3.14 copies/100 ng DNA) followed by saliva and PBMC which were positive in 78%, and 69.2%; respectively. In contrast, HHV-8 was detected in only 37% of plasma samples, which also showed lower viral loads. Men who had sex with men (MSM) were more likely to have three-times higher HHV-8 genome copies in KS lesions when compared with tissues from heterosexuals individuals (OR 3; 95% CI 1.1 to 12.5). These results emphasize the systemic nature of HHV-8-infection and demonstrate the possible role of saliva in HHV-8 transmission among MSM

Safety and effectiveness of CIMAvax-EGF administered in community polyclinics

In spite of the advances in immunotherapy and targeted therapies, lung cancer continues to be the leading cause of cancer-related death. The epidermal growth factor receptor is an established target for non-small cell lung cancer (NSCLC), and its overactivation by the ligands can induce accelerated proliferation, angiogenesis, and metastasis as well as proinflammatory or immunosuppressive signals. CIMAvax-EGF is an epidermal growth factor (EGF)-depleting immunotherapy that is approved for the treatment of NSCLC patients in Cuba. The study was designed as a phase IV trial to characterize the safety and effectiveness of CIMAvax-EGF in advanced NSCLC patients treated in 119 community polyclinics and 24 hospitals. CIMAvax-EGF treatment consisted of four bi-weekly doses followed by monthly boosters. Overall, 741 NSCLC patients ineligible for further cancer-specific treatment were enrolled. CIMAvax-EGF was safe, and the most common adverse events consisted of mild-to-moderate injection site reactions, fever, chills, tremors, and headache. For patients completing the loading doses, the median survival was 9.9 months. For individuals achieving at least stable disease to the frontline and completing vaccination induction, the median survival was 12 months. Most of the functional activities and symptoms evaluated through the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire improved over time. In conclusion, this real-world trial demonstrated that CIMAvax-EGF was safe and effective in patients who were vaccinated in the maintenance scenario. A larger effect was seen in subjects with poor prognosis like those with squamous tumors and high EGF levels. Remarkably, this community-based intervention was very important because it demonstrated the feasibility of treating advanced lung cancer patients with active immunotherapy in primary care institutions. In addition to CIMAvax-EGF, patients received supportive care at the community clinic. Vaccine administration by the family doctors at the polyclinics reduced the patients’ burden on the medical oncology services that continued providing chemotherapy and other complex therapies. We conclude that community polyclinics constitute the optimal scenario for administering those cancer vaccines that are safe and require prolonged maintenance in patients with advanced cancer, despite the continuous deterioration of their general condition.Clinical trial registrationhttps://rpcec.sld.cu/trials/RPCEC00000205-En, identifier RPCEC00000205

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Estrategia metodológica para contribuir al mejoramiento del trabajo con las personalidades históricas en los docentes de la Educación Técnica y Profesional en Pinar del Río

El trabajo se desarrolla en los centros provinciales de la Educación Técnica y Profesional del municipio de Pinar del Río y consiste en la propuesta de una estrategia metodológica para contribuir al mejoramiento del tratamiento a las personalidades históricas y el papel de estas en el desarrollo socia

Influences of external factors in automotive sales forecasting : a portuguese case study

Dissertation presented as the partial requirement for obtaining a Master's degree in Information Management, specialization in Knowledge Management and Business IntelligenceThis study aims to contribute to a better understanding of the Portuguese automotive market, its behaviour and, additionally, attempt to create better sales prediction models, using linear regression models with ARIMA errors. Through time series analysis, it will be studied how external factors such as socio-economic variables, consumer behaviour as well as market specific factors (e.g. gas prices, car rental services) affects the development of the automotive market. Furthermore, it will be tested if methodologies such as hierarchical forecasting on a bottom-up approach will bring better results compared to forecasting the market as a whole. This understanding and forecasting techniques, if proven successful, can bring higher competitive advantage to companies in this sector, through more accurate planning and strategic management

Actividades físico recreativas para contribuir a la educación sexual comunitaria en los adolescentes del consejo popular Cuba Libre del municipio Pinar del Río

El trabajo titulado " Actividades físico recreativas para contribuir a la educación sexual comunitaria en los adolescentes del consejo popular Cuba Libre de municipio Pinar del Río." Constituye una Extensión del Proyecto Investigativo Medio Ambiente y Deportes; el mismo tiene como finalidad contribuir a la Educación Sexual Comunitaria, en los adolescentes del Consejo Popular “Cuba Libre” del Municipio Pinar del Río. Este proyecto de intervención comunitaria propicia un desarrollo sociocultural y educativo ya que promueve un progreso en la comunidad y que los alumnos participen como agentes transformadores de cambio al modificar roles, actuaciones y conductas lográndose una mejoría en la Educación Sexual en los mismos y que se irradie al resto de la comunidad. Empleamos métodos teóricos y empíricos, dentro de los teóricos: el análisis-síntesis, inductivo-deductivo, el histórico-lógico y el enfoque del sistema. Dentro de los empíricos nos auxiliamos de la entrevista a profesores, la encuesta a estudiante, el trabajo con documentos. Nos auxiliamos además del procedimiento investigación-acción. Se empleó el método matemático de análisis porcentual. Arribamos a conclusiones y recomendaciones de fácil aplicación en aras de lograr el cumplimiento de nuestros objetivos

Enfermedad pulmonar obstructiva crónica

La enfermedad pulmonar obstructiva cr&oacute;nica se ha convertido en una de las enfermedades cr&oacute;nicas atendidas con mayor frecuencia en la atenci&oacute;n primaria de salud. Produce altas tasas de morbilidad y mortalidad en todo el mundo, con una evoluci&oacute;n lenta aunque progresivamente mortal, a pesar de tratarse de una enfermedad prevenible, que depende en gran medida, del h&aacute;bito de fumar. La prevalencia variar&aacute; seg&uacute;n el consumo de tabaco, y se espera que siga aumentando en los pr&oacute;ximos 25 a&ntilde;os. La mortalidad y morbilidad son cada vez mayores, lo que supone un enorme gasto sanitario, social y personal, pero es una enfermedad potencialmente modificable, motivo por el que requiere de un abordaje multifactorial.Chronic Obstructive Pulmonary Disease has become one of the most frequently treated chronic diseases in primary health care. High rates of morbidity and mortality are worldwide related to this disease. Although it is a preventable disease closely related to smoking, its evolution is slow but progressively fatal. Prevalence varies according to tobacco consumption and is expected to increase in the next 25 years. Even when it is a potentially modifiable disease, mortality and morbidity are also increasing, causing a major health, social and personal spending. For all these reasons, a multifactorial approach is needed both, for health and social issues.</p

Antimicrobial Susceptibility Patterns of Recent Cuban Mycoplasma genitalium Isolates Determined by a Modified Cell-Culture-Based Method.

Isolation of Mycoplasma genitalium from clinical specimens remains difficult and few strains are available for antimicrobial susceptibility testing. We describe the antimicrobial susceptibility of M. genitalium strains grown in Vero cell culture with first- and second- line antibiotics, using a modified cell-culture-based method. Macrolide- and -fluoroquinolone resistance determinants were detected by sequencing of the 23S and parC genes, respectively. Seven strains were examined, including three new, genetically distinct M. genitalium strains isolated from endocervical and urethral swab specimens from Cuban patients together with four reference strains isolated from specimens collected from men in Denmark, Sweden and Australia. Azithromycin was the most active drug against two of the Cuban M. genitalium strains with MICs values of 0.008 mg/liter, however, one strain was macrolide resistant with an MIC of >8 mg/liter, and the A2059G resistant genotype. Ciprofloxacin was the least active antimicrobial drug and moxifloxacin was the most active fluoroquinolone against the new clinical strains, although an MIC of 1 mg/l was found for two strains. However, no relevant parC mutations were detected. MICs for tetracyclines were 0.5-4 mg/liter. Although the number of Cuban strains was low, the results suggest that a single-dose azithromycin treatment could be ineffective, and that a second-line treatment with moxifloxacin, should become an option in Cuba. To our knowledge, this is the first report of isolation and antibiotic susceptibility testing of M. genitalium strains from the Latin-American region, and the first detection of macrolide resistance in such strains