Joaquin Maria Albarran Y Dominguez: Microbiologist, histologist, and urologist–a lifetime from orphan in Cuba to Nobel nominee

Joaquin Albarran was an extraordinary late 19th century urologist. His early career was in the field of microbiology and histopathology in Paris at a time of great medical developments and innovations. His later contributions to urology included the Albarran lever, Albarrans sign, Albarran-Ormond syndrome and seminal works on testicular and renal tumors. He also wrote treatizes on the pathophysiology of acute urinary retention, nephritis and calculus ureteric obstruction. He died at the young age of 52 from the effects of tuberculosis and in this same year was nominated for the Nobel prize in medicine.     

Genetic relatedness and antimicrobial resistance determinants among clinical isolates of enterococci from Cuba

This study describes the genetic relationships and antimicrobial resistance determinants found among 99 clinical isolates of enterococci from 15 different hospitals in Cuba. Pulsed-field gel electrophoresis SmaI analysis demonstrated a high degree of genetic diversity. A limited number of multiresistant Enterococcus faecalis clones, showing resistance to three or more families of antimicrobial agents, were detected simultaneously in different institutions, suggesting inter-hospital circulation of selected clones, and/or selection of particular clones following their introduction into the hospital environment. Antimicrobial resistance determinants, including erm(B), aac(6')-aph(2'), aph(3'), ant(6), vanB (E. faecalis) and vanA (Enterococcus faecium) were detected by PCR in various isolates.     

Frequency of antibodies to Toxocara in Cuban schoolchildren

Objective The aim of the study was to determine the frequency of antibodies to Toxocara in Cuban schoolchildren. Methods The frequency of antibodies to Toxocara canis was assessed with a commercial enzyme‐linked immunosorbent assays kit in school‐aged children from two municipalities of Cuba. Univariate analysis and a multivariable logistic regression analysis adjusted for age, sex, municipality and co‐infection with helminth and/or protozoa were conducted. Results The percentage of children with antibodies to Toxocara was 38.8% (392/1011; 95% CI = 36.8–42.8). Antibody positivity was significantly associated with gender and co‐infections with intestinal parasites, but not with age or municipality. Conclusion Cuban children are highly exposed to the Toxocara parasite, corresponding well with reported environmental contamination with Toxocara parasite eggs and T. canis prevalences in dogs in Cuba. Relevant policy makers and the Cuban population need to be better informed about this preventable infection.     

Movimiento de alumnos ayudantes: experiencia de una institución cubana

The teaching-support student movement arose out of the necessity to cover the lack of teachers caused by the massive exodus of professionals at the beginning of the Cuban Revolution. Five decades later it is still alive and continuously perfects and adjusts itself according to the dynamic social requirements of the country. This article intends to describe the experience acquired at the University Hospital “Arnaldo Milián Castro” based on the work of teaching-support students in the period from 2011 to 2016, emphasising its achievements and challenges in the fulfilment of its main objectives in Cuban higher medical education such as: to support the development of the instructional and educational process, to address the professional orientation towards specialities deficient in professionals and to quickly acquire skills for teaching, research, and those related to specialities.     

Herbal mixtures in the traditional medicine of eastern Cuba

Herbal mixtures in the traditional medicine of Eastern Cuba. Traditional herbal mixtures in Eastern Cuba are investigated through interviews with 130 knowledgeable people and traditional healers of the provinces of Santiago de Cuba and Guantánamo. One hundred seventy plant species and other products are used in 199 formulas, galones being the more complex. Cocos nucifera L. (Arecaceae), Bidens pilosa L. (Asteraceae), Cissus sicyoides L. (Vitaceae), Erythroxylum havanense Jacq. (Erythroxylaceae) and Stachytarpheta jamaicensis (L.) Vahl. (Verbenaceae) are the species most frequently cited. The ecological distribution of the taxa and cultural and anthropological aspects of mixtures are highlighted; particularly American and African influences that have shaped local knowledge about plant combinations are discussed.     

What the Cuban context provides health researchers: the feasibility of a longitudinal multi-method study of the impact of housing improvements on health in Havana, Cuba

BACKGROUND: From extensive participatory research in inner city communities in Central Havana, Cuba, we found housing to be the largest perceived source of health risk. The objective of this study, therefore, was to ascertain the feasibility of conducting a multi-method longitudinal evaluation of the impact of housing improvements on health. METHODS: Meetings with community and governmental stakeholders were held; housing policy documents were reviewed; key informants were interviewed; decisions were made by a collaborative interdisciplinary team regarding measurement instruments for health as well as housing quality; training was conducted for use of new measurement tools; and a 3 month multi-method trial with repeated measures was conducted on individuals in good housing and poor housing in the inner city of Central Havana. Questionnaires were administered at monthly intervals for 3 months to 25 adults living in good housing and 25 in poor housing. RESULTS: Cuba's housing policies made it easy to identify a suitable cohort and control group for possible longitudinal study. Consent to participate was enthusiastically obtained, and no difficulties were encountered in collecting or analysing the data. Housing quality measurements were conducted using validated instruments with minimal difficulties. There was strong community involvement and support for a comprehensive longitudinal study. CONCLUSION: Cuba, although a poor country, has the necessary infrastructural support and capacity to make it an excellent site for health and housing intervention studies.     

THE ELIÁN GONZÁLEZ DISCURSIVE TEMPLATE

In this essay we return to the Elián González custody battle of 1999/2000 in order to investigate the lessons the case poses for understanding the conflicted mediation of childhood, and to ask why Elián's particular childhood continues to resonate widely years after his return to Cuba. Detailing how the Elián case ruptured the myth of Cuban exile exceptionalism, thereby ensuring that US Cubans became prey to the nativist discourses that historically targeted other US Latina/o groups, we also attend to the media, popular‐cultural, and international cooptions of the Elián story. Those cooptions indicate that the enduring and evolving Elián icon has come to provide an adaptable, differentially applied, and contradictory template by which numerous children have been pressed into symbolic service as “other Eliáns.” With this focus, we track the evolution of the Elián discursive template and its applications in cognate custody conflicts centred on the border‐crossing child as potential citizen.     

Breteau Index threshold levels indicating risk for dengue transmission in areas with low Aedes infestation

We used Breteau Indices to – retrospectively – predict dengue transmission. The presence of one house block (on average about 50 houses) with a Breteau Index ≥4 in a neighbourhood (a block plus the surrounding blocks in a radius of 100 m) predicted transmission at the latter level with 81.8% sensitivity and 73.3% specificity during the first month of the Havana 2001 dengue outbreak. This result corroborates the external validity of this threshold, at least in situations with low infestations levels.     

Diagnostic validity of an expert tuberculosis commission that assists the diagnosis of bacteriologically negative suspected TB cases in Havana, Cuba

The Provincial Tuberculosis Commission of Havana, Cuba, a multi-speciality committee, assists clinicians in diagnosing bacteriologically negative tuberculosis (TB). At its weekly meetings, clinicians present the files of suspected TB cases for discussion, diagnosis and recommendations. This prospective study assessed the validity of the diagnoses made by the Commission by comparing the diagnoses made with diagnoses ascertained after one year of follow-up. Between October 2002 and December 2003, 126 patients suspected to have TB but who were bacteriologically negative completed diagnostic work at the Commission. Fifty-three (42%) were diagnosed as TB cases. The definite diagnosis of 116 patients (92%) was ascertained after one year of follow-up. Six patients diagnosed by the Commission as TB cases were suffering from other diseases, while one patient diagnosed with pneumonia had a definite diagnosis of pulmonary TB. The diagnostic sensitivity and specificity of the Commission were 98% (95% CI 93-100) and 92% (95% CI 85-98), respectively. The Provincial Tuberculosis Commission of Havana can be considered a valuable tool for the diagnosis of TB in patients suspected of TB but who are bacteriologically negative. A comparable approach, adapted to the local conditions, could prove useful in other epidemiological and healthcare settings.