Notes

Extracellular Nampt (eNampt/Visfatin/PBEF) right as well as in a roundabout way stimulates ACTH as well as CCL2 necessary protein release via remote rat corticotropes.
ival rates (hybrid LPD 11.0 months versus TLPD 12.0 months, P=0.373) CONCLUSIONS Hybrid LPD was comparable to TLPD. Hybrid LPD could be performed safely when some surgeons first started LPD (during the operative learning curve), while for skilled surgeons, TLPD could be applied initially.In 1978, the world was put on notice health inequalities exacerbated by lack of access to essential services was a ticking time bomb threatening social and economic development everywhere. That year, over 100 countries signed on to the Declaration of Alma-Ata, which affirmed that "health . . . a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, is a fundamental human right." To guarantee this right, governments were urged to prioritize the provision of quality, continuous, comprehensive and affordable primary care for their entire populations by the year 2000.Cardiovascular diseases are the leading cause of death worldwide, and a health problem in low- and middle-income as well as high-income countries. They also constitute the main cause of death in Latin America, with ischemic heart disease as the principal cause in most countries of the region. In Cuba, heart disease is the first cause of death, followed by cancer and stroke. In its 2030 Agenda for Sustainable Development, the UN recognizes the importance of chronic non-communicable diseases, including cardiovascular diseases. Cuba has participated actively as lead partner in design and implementation of the two regional technical cooperation projects conducted over the last six years by the International Atomic Energy Agency to address cardiovascular diseases in Latin American and Caribbean member states. These projects have generated greater interest among participating countries in the use of myocardial perfusion for dilated cardiomyopathy and coronary artery disease compared to other imaging techniques; disseminated knowledge about nuclear cardiology techniques and clinical applications in heart failure and coronary artery disease; and made important contributions to implementing harmonized, appropriate and safe clinical protocols. Cuba's contribution to the International Atomic Energy Agency's regional cardiology projects has fostered development of human resources and harmonized protocols both nationally and regionally, and demonstrated the importance of region-based scientific cooperation that ensures greater opportunities and more equitable access to resources. This participation has also accrued important benefits to Cuba's own nuclear cardiology program. KEYWORDS Cardiovascular disease, myocardial perfusion imaging, nuclear cardiology, scientific cooperation, low-income populations, Latin America, Caribbean region, Cuba.Health is a universal human right, which should be safeguarded by government responsibility and included in all social policies. Only as such it is possible to ensure effective responses to the health needs of an entire population. The Cuban Constitution recognizes the right to health, and the country's single, free, uni-versal public health system and high-level political commitment promote intersectorality as a strategy to address health problems. Intersectorality is refiected in national regulations that encourage participation by all social sectors in health promotion/disease prevention/treatment/rehabilitation policies and programs. The strategy has increased the response capacity of Cuba's health system to face challenges in the national and international so-cioeconomic context and has helped improve the country's main health indicators. New challenges (sociocultural, economic and environmental), due to their effects on the population's health, well-being and quality of life, now require improved intersectoral coordination in the primary health care framework to sustain achievements made thus far. KEYWORDS Universal coverage, public health, health policy, social planning, intersectoral collaboration, Cuba.Growth and development is considered the best positive indicator of children's quality of life and well-being. Studies have been carried out in Cuba since the early 20th century and large scale, periodic an-thropometric surveys have been regularly conducted by its National Health System to chart modifications in growth patterns of children and adolescents. These surveys have produced national references for the anthropometric indicators most commonly applied in individual assessment of the health and nutritional status of children and ado-lescents in health care settings. These have also provided data for estimating the magnitude and characteristics of secular growth trends, and for comparing growth of Cuban children with that of children in other countries and with WHO's proposed growth standards. read more The data have also served as evidence of persisting social gradients. The most important results include, as positive data, the positive secular trend in school-aged children's growth of 9.7 cm between 1919 and 2005, with an average increase of 1.1 cm per decade, and, in preschool children, 1.9 and 1.8 cm in boys and girls, respectively, between 1972 and 2015. More recent studies have detected unfavorable changes associated with a marked increase in adiposity and, therefore, in the prevalence of excess weight and obesity. Another interesting result is the gradual movement toward WHO height-for-age standards in preschool children in Havana, verified in surveys conducted in 2005 and 2015. KEYWORDS Growth and development, growth, child development, children, adolescents, nutrition, obesity, pediatrics, Cuba.Vaccination is one of the most cost-effective interventions for control of communicable diseases. This health achievement could flounder if measures are not taken by health systems to prioritize immunization, increase vaccination rates and educate health professionals to address public concerns about vaccine safety and efficacy. Parents' refusal to vaccinate their children directly affects public health, because it puts both individual and group immunity in danger; immunization coverage is effective only when high population coverage is attained. The growing number of antivaccination (antivaxxer) groups around the world is alarming, contributing to falling vaccination rates. Troubling consequences include disease outbreaks in several countries globally and in our hemisphere. This article looks at the history and features of antivaxxer movements around the world and proposes ways the Cuban health system, through its National Immunization Program, can address dangers for the population associated with potentially negative infiuences of social-network antivaxxer campaigns. The paper underscores the role of mass and social media, health professional training and sustained competence, and the importance of a vaccine-related adverse events surveillance system. KEYWORDS Vaccination, immunization, antivaccination move-ment, antivaccine groups, primary health care, society, communi-cations media, social media, Cuba.WHO's 2015 End Tuberculosis Strategy can succeed only through universal health coverage, social protection, poverty alleviation and effective multisector actions to tackle social determinants in general. The pediatric age group is particularly vulnerable to tuberculosis and historically neglected worldwide. However, this group is a priority within Cuba's National Tuberculosis Control Pro-gram that has functioned since 1970, and Cuba is considered a low-incidence country with rates less then 7 per 100,000 population since 2011. Tuberculosis incidence in children aged less then 15 years is less then 1 per 100,000, similar to that reported in high-income countries and rep-resenting less than 2% of total cases in Cuba. Since 1999, no deaths from tuberculosis, coinfection with HIV or resistance to the two first-line TB drugs have been reported in affected children, and most diagnosed cases correspond to early, primary forms of the disease. These results place Cuba among the countries on track to eliminate TB by 2050. This article reviews the pillars and components of the 2015 End TB Strategy and the strategies devel-oped by the National Tuberculosis Control Program that enabled Cuba to bring incidence below the 2035 targets of WHO's End TB strategy. The article also proposes other actions Cuba can take, despite limited resources, to eliminate TB, particularly in the pedi-atric age group.KEYWORDS Tuberculosis, communicable disease control, disease control programs, preventive health services, child health, World Health Organization, Cuba.The Ebola virus is a pathogen that causes high morbidity and mortality in epidemic events during which health personnel are frequently infected. Such an epidemic occurred in West Africa, prompting WHO to issue a call in 2014 for health personnel to be dispatched to affected countries. Cuba responded and signed an assistance agreement under which 265 Cuban health professionals, members of the Henry Reeve Emergency Medical Contingent, volunteered their services in the Republic of Guinea, Sierra Leone and Liberia. This article presents Cuba's strategy of medical aid and organization of the three medical teams formed; refers to the teams' contribution to epidemic control in treatment centers where they worked alongside other personnel; and describes measures taken in Cuba to prevent the virus from entering the country through returning volunteers or other means. In the centers where Cuban medical teams worked with other health professionals in West Africa, case fatality decreased from 80%-90% to 24%, contributing to control of the epidemic; no Ebola outbreaks occurred in Cuba. During the epidemic, two Cuban health professionals died of malaria and one physician fell ill with Ebola. This paper includes an overview of the treatment and evolution of the latter case, a doctor who contracted the disease in Sierra Leone and was treated in Geneva and Havana. KEYWORDS Ebola virus, treatment, strategy, followup, medical collaboration, Republic of Guinea, Sierra Leone, Liberia, Cuba.In El Salvador, chronic kidney disease had reached epidemic propor-tions towards the end of this century's first decade. In 2011-2012, the Ministry of Health reported it was the leading cause of hospital deaths in men, the fifth in women, and the third overall in adult hospital fa-talities. Farming was the most common occupation among men in dialysis (50.7%). By 2017, chronic kidney disease admissions had overwhelmed hospital capacity.In 2009, El Salvador's Ministry of Health, Cuba's Ministry of Public Health and PAHO launched a cooperative effort to comprehensively tackle the epidemic. The joint investigations revealed a total prevalence of chronic kidney disease in the adult population of farming communities higher than that reported internationally (18% vs.11%-14.8%), higher in men than in women (23.9% vs 13.9%) and higher in men who were farmers/farmworkers than in men who were not (31.3% vs. 14.8%). The disease was also detected in children. An association was found between chronic kidney disease and expbecome dehydrated in the fields) are most exposed. The research thus also laid the foundations for design of comprehensive intersectoral government actions to reduce cases and put an end to the epidemic. KEYWORDS Chronic kidney disease; chronic renal failure; tubuloint-erstitial nephritis; epidemiology; histopathology; international coopera-tion; agrochemicals; environmental pollutants, noxae, and pesticides; occupational health; PAHO; El Salvador; Cuba.
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