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Background: Intense and persistent exposure to indoor-air biological agents has been associated with the appearance of allergic diseases. Archives and libraries Indoor environments in tropical countries are an important reservoir of fungal propagules., Objective: To evaluate the degree of air pollution with allergenic fungi in a repository of frequently-manipulated documents., Methods: Air sampling was performed by two methods: active (biocollector) and passive (sedimentation plate). Fungi were taxonomically identified, and spores were measured to determine their penetrability in the human respiratory tract, and its impact on episodes of allergy., Results: In terms of concentration and diversity, the local environment behaved as a fungal propagule reservoir, which showed that there is significant health risk for the staff that manipulates the documents. Some spores were shown to be able to reach the lower respiratory tract when inhaled, which increases their allergenic and pathogenic potential. Aspergillus, Cladosporium, Penicillium and Alternaria, which are referred to as highly allergenic fungi, were prevalent., Conclusion: Aerobiological studies are a valuable tool for the treatment of patients with allergy to fungi and other disorders they produce.

Introduction: There has been a significant change in the role of pediatric tracheostomy over the last twenty years. Obstruction of the upper airway caused by infectious agents is no longer the leading cause of tracheostomy in children. Structural anomalies of the upper airway as well as the need for prolonged ventilator assistance have become the most frequent indication for pediatric tracheostomy., Objective: The purpose of this paper is to assess the incidence, indications, complications, and role in mortality of tracheostomy in our pediatric population., Methods: A retrospective descriptive study of pediatric patients who underwent tracheostomy was conducted between 1999 and 2008 in the Pediatric Intensive Care Unit of the José Martí de Sancti Spiritus Pediatric Teaching Hospital in Cuba., Results: Tracheostomy was performed in 14 patients during the period of the study (0.5% of admitted patients). Nine of them (64.2%) were younger than one year. The most frequent indication for the procedure was the need for prolonged mechanical ventilation in patients with neurologic disorders in 10 patients (71.42%). Upper airway malformations and acute infections were infrequent indications for tracheostomy. The most frequent complications were infectious in 10 patients (71.4%) and obstruction in four patients (28.5%). The following germs were found: Pseudomona aeruginosa in six patients (60%), Staphylococcus aureus in three patients (30%), and Enterobacter cloacae in three patients (30%). Furthermore, four patients were successfully decannulated (28.5%), five patients died (35.7%) but only in one (7.14%), death could be attributed to tracheostomy., Conclusion: The need for prolonged mechanical ventilation in patients with neurologic disorders was the main indication for tracheostomy in our pediatric population; most of these children were younger than one year. The procedure had little impact in overall mortality in this group of patients.

Objective: This paper presents the design and application in Cuba of a social construct to identify the social dimensions associated with discrimination attitudes towards people with positive diagnosis to HIV., Materials and Methods: A combination of qualitative and quantitative methodology was used for the measurement and validation of a construct, and also the K-mean procedure and factor analysis techniques. All these techniques were applied to "Survey on HIV prevention indicators" 2005, 2006 and 2009., Results: A tool for the identification of the most frequent discriminatory attitudes in a specific social context was validated. This instrument allows clustering the population into different typologies, by level of discrimination, and also, to distinguish some social dimensions of this phenomenon., Conclusions: The results allow distinguishing frequent discriminatory attitudes in any population, focusing the actions in the direction of gradually reducing them, and to evaluate the temporal behavior of this phenomenon.

Avian postnatal growth has received considerable attention and its ecological implications have been deeply analyzed. In this current paper, I describe the patterns of culmen and tarsus growth, as well as of weight gain patterns in eight species of herons and egrets (Aves: Ardeidae) found in the Birama Swamp in Eastern Cuba. Between 1998 and 2006,714 nestlings of the following species were measured every two days: Butorides virescens, Bubulcus ibis, Egretta thula, E. tricolor, E. caerulea, E. rufescens, Ardea alba and Nycticorax nycticorax. Logistic and Gompertz equations were adjusted to data using non-lineal regression models with adult values as the asymptote. For each species, the following were determined and recorded: growth rate, age at inflexion, instantaneous growth rates at each age interval, and time taken to reach 90% of adult size. Reported hatchling sizes were similar in other localities, with a variation coefficient ranging between 10-19%. At hatch, each species exhibited differing sizes relative to adult values. In all cases, Gompertz equations were best fitted to explain more variance and lesser residuals. Rates of weight change and tarsus growth were alometrically related to the log of adult weight. Two main growth processes were identified: a physical extension in dimensions of each measurement reflecting inter-specific morphometric differences, and a lineal increase of the growth period from Green Heron to Great Egret. The Black-crowned Night Heron, Cattle Egret and Reddish Egret exhibited some unique measurement characteristics in comparison to the remaining members of the family. All results support the hypothesis that hypermorphosis, as the main evolutionary process in the microevolution of Ardeidae, is caused by a delayed final moment of growth.

In the spur-and-groove reefs of the Ecological Reserve Siboney-Juticí (Southeast Cuba) octocorals are one of the predominant components of the sessile fauna. Main objectives of the present paper are characterizing the composition, structure and conservation status of the octocoral communities and assessing on the prevailing environmental conditions in the study area. For data collection, six sampling sites were located every 2-3 km ranging from 12 m to 17 m depth along the spur-and-groove reefs. In each site, 22-26 lm2 quadrants were zigzag arranged every 2 m. The density of colonies was determined per site. The severity degree and predictability of environmental conditions were inferred by using the Heterogeneity and Equitability indexes, respectively. Hydrodynamic stress and the Comparative Pollution Index were also assessed. Current affectations of the octocoral communities were also determined and classified into four main categories: mechanical damage, diseases, predation and invertebrate and macroalgae overgrowth. As a result, 25 species represented by 752 colonies were recorded and Eunicea flexuosa and Gorgonia ventalina were the most abundant. The occurrence of Eunicea succinea forma succinea constituted the first report for Eastern Cuba. Site densities ranged from 3.58 +/- 1.84 to 7.58 +/- 2.16 colonies/m2 and considered from moderate to low. The biggest densities were reported at both sides of the San Juan River mouth. Despite of the composition and structure of the octocoral communities, low to high hydrodynamic stress and low and moderate levels of contamination were inferred, it is likely that these indexes could have been overestimated due to the sensitivity of the indicator species to other factors such as sedimentation. The environmental conditions were mostly favorable and stable. In general, the number of dead colonies was low and mostly caused by the detachment of the substrate and overgrowth of Millepora alcicornis. Injuries were mainly brought about by mechanical damage, followed by coenenchyme loss, predation by Cyphoma gibbosum and macroalgae overgrowth. On the other hand, negative effects by Hermodice carunculata predation, bleaching, Red Band and Black Band Disease were not observed. Among sampled species, G. ventalina colonies were the most severely damaged within the community. As a whole, octocoral communities of spur-and-groove reefs in the Ecological Reserve Siboney-Juticí showed a good conservation status.

Objective: To identify the relationship between emergency visits for acute respiratory illnesses, acute bronchial asthma crisis (ABAC) and acute respiratory infections (ARI), in children less than 14 years of age, and the daily changes of air pollutant levels, in two central hospitals of Havana City, between October 1st 1996 and March 16 1998., Material and Methods: An ecological time series study was conducted. We assessed the relationship between the presence of acute respiratory illnesses, ABAC, and IRA, and exposure to levels of particles less than 10 microg/m3 (PM10), smoke, and sulfur dioxide (SO2); negative binomial regression models were used to assess latency periods of one to five days as well as the cumulative effect of seven days before the emergency visit., Results: The levels of atmospheric pollutants were low, in general. The 24-hour mean values for PM10 levels, smoke, and SO2, were 59.2 microg/m3 (SD=29.2), 27.7 microg/m3 (SD=21.2), and 21.1 microg/m3 (SD=20.1), respectively. An increase of 20 microg/m3 in the daily average of black smoke was associated with a 2.2% increase (95% CI 0.9-3.6) in the number of emergency visits for ABAC. A 20 microg/m3 increase in the daily average of black smoke and SO was associated with an increase in ARI of 2.4% (95% CI 1.2-3.6), and 5% (95% CI 1.3-5.3), respectively, with a 5-day lag. We also observed a cumulative effect for all the contaminants studied., Conclusions: These results suggest that air pollution levels in Havana City affect children's respiratory health; therefore implementation of control measures is necessary, especially those aimed at decreasing motor vehicle exhaust fumes. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

The percentiles (3,10,25,50,75,90 and 97) of the subscapular/triceps Index (SS/TR), obtained in a sample of 7286 subjects (3721 males and 3765 females) aged 5 to 20 years, were calculated. Median values of SS/TR are generally higher in females up to the age of 13 years approximately, and show a pattern of peripheral distribution of fat during all the period of study. In males, a pattern of central distribution of fat develops starting from age fourteen and becomes more central as age increases. Values obtained were higher than those reported in the literature at all ages and in both sexes. The results reported in this paper show that SS/TR is useful for assessing changes in the pattern of fat distribution during childhood and adolescence.

In Cuba, the infant mortality rate (IMR) dropped by 65% between 1970 and 1986. The 1986 IMR - 13.6% - has put the country in the lead in Latin American mother and child health care. However, the behavior of the IMR is not homogeneous throughout the country. This paper seeks to identify by multiple regression techniques, those sociodemographic or health care factors which have determined the decline in the IMR and those variables which best explain the inter-regional differences in this indicator. Sociodemographic factors fundamentally explain the evolution of the IMR in Cuba; on the other hand, although in the first instance the proportion of live births of low weight and the crude birth rate explain the inter-regional differences in IMR levels every year, it can be seen that other socioeconomic variables really lie behind these differences.