Pregnancy outcomes and the use of two standards to assess adequacy of maternal body mass index in early gestation.

The maternal weight gain chart proposed by Rosso and Mardones (RM) was subsequently modified by Atalah et al. (AEA). Both charts are widely used in Latin America.

Development of hypertension in a cohort of Cuban adolescents.

Introduction: Primary hypertension has its origins in childhood and is a risk factor for atherosclerosis; it is considered an important health problem because of its high prevalence worldwide.

Objective: Describe the development of hypertension during adolescence, including some factors that influence its persistence and progression in Cuban adolescents.

Methods: A cohort study was conducted in an intentional sample of 252 apparently healthy adolescents from the catchment area of the Héroes del Moncada Polyclinic in Plaza de la Revolución Municipality, Havana.

Socioeconomic factors and vulnerability to outbreaks of leptospirosis in Nicaragua.

Leptospirosis is an epidemic-prone zoonotic disease that occurs worldwide, with more than 500,000 human cases reported annually. It is influenced by environmental and socioeconomic factors that affect the occurrence of outbreaks and the incidence of the disease. Critical areas and potential drivers for leptospirosis outbreaks have been identified in Nicaragua, where several conditions converge and create an appropriate scenario for the development of leptospirosis.

Contextual and individual influences on diabetes and heart disease in Havana primary care catchment areas.

Introduction: A population health profile is a cumulative product of socioenvironmental and political factors that create the contexts in which health problems arise, as well as opportunities and barriers to addressing them. Research on context has focused on demonstrating its effects, direct or indirect, on health indicators, but has made few incursions into assessing its role as a mediator of other factors. While individual risk factors for chronic diseases are well known, the same cannot be said for the complex of contextual factors operating at various levels and over the lifespan.

Leptospirosis outbreaks in Nicaragua: identifying critical areas and exploring drivers for evidence-based planning.

Leptospirosis is an epidemic-prone zoonotic disease that occurs worldwide. In Central America, leptospirosis outbreaks have been reported in almost all countries; Nicaragua in particular has faced several outbreaks. The objective of this study was to stratify the risk and identify "critical areas" for leptospirosis outbreaks in Nicaragua, and to perform an exploratory analysis of potential "drivers".

[Reducing chronic malnutrition among the disadvantaged populations to promote health and development].

This article advances theoretical and conceptual arguments to justify efforts to reduce chronic malnutrition as a basic component of any strategy for promoting health and development in countries with a high malnutrition prevalence. The arguments rest on four cardinal principles of contemporary social epidemiology, in whose framework reducing chronic malnutrition would be a key strategic component: the social determinants approach, the life course as the clinical-epidemiological paradigm, the concept of heredity and population health, and recognition of the family as a social determinant. Added to these are the close association between nutrition, health, and development, on the one hand, and the political significance of any strategy that makes the fight against chronic malnutrition the most visible focus of programmatic action.

[Subpopulations with particular epidemiologic profiles and risks in Havana, Cuba: diabetes, hypertension, and tobacco-related illnesses].

Objective: Identify and describe population groups with greater risk and morbidity profiles for type II diabetes, hypertension, and tobacco-related illnesses.

Methods: A cross-sectional study was carried out of 840 families under the care of 12 family doctors and nurses in Havana, Cuba. A model-based cluster analysis was used to identify subpopulations with specific morbidity and risk profiles.

Detection of markers of cardiovascular and renal risk in Cuba: Isle of Youth Study (ISYS).

Unlabelled: Chronic vascular diseases constitute a growing global health problem.

Objectives: To (a) determine marker positivity for renovascular damage in the total adult population of the Isle of Youth, Cuba; (b) describe marker association with common risk factors for renal and related chronic vascular conditions, and (c) identify best predictors of renovascular damage.

Methods: Previous informed consent was obtained, the population studied was 55,646, and subjects were aged ≥20 years.

Albuminuria as a marker of kidney and cardio-cerebral vascular damage. Isle of Youth Study (ISYS), Cuba.

Introduction: The disease complex comprised of atherosclerosis, chronic kidney disease (CKD) and other associated chronic vascular diseases is the leading cause of mortality worldwide. Microalbuminuria is a marker for vascular damage in the heart, kidney and brain. This paper presents selected findings of the clinical-epidemiological Isle of Youth Study (ISYS) of markers for kidney and vascular damage from chronic vascular diseases and their common risk factors in total population, focusing on Phase 2 reassessment (in 2010) of Phase 1 (2004 to 2006) results.

Severe maternal morbidity in the intensive care unit of a havana teaching hospital,1998 to 2004.

Introduction In recent years, several reports have appeared in the international literature concerning evolution and prognosis for obstetric patients whose illnesses have led to admission to intensive care units (ICUs). The term severe maternal morbidity has been proposed to refer to life-threatening complications that occur during pregnancy, delivery or postpartum. Objective Characterize severe maternal morbidity in obstetric patients admitted to the ICU of the Enrique Cabrera General Teaching Hospital in Havana from 1998 to 2004.

Prevalence of Obesity and its Association with Chronic Kidney Disease, Hypertension and Diabetes Mellitus. Isle of Youth Study (ISYS), Cuba.

Introduction: Obesity is a social disease constituting a global pandemic. It is present in 90% of diabetic and 65% of hypertensive patients. It is associated with cardiometabolic syndrome and with damaging physiopathological mechanisms, particularly for the vascular system and the kidneys.

Design & Methodology of the Isle of Youth Community-Based Epidemiological Study of CKD, Cardio-cerebral Vascular Disease, Hypertension, and Diabetes Mellitus (ISYS).

Unlabelled: The methodology is described in detail for the population-based Isle of Youth Study (ISYS) for epidemiological evaluation of CKD associated with cardio-cerebral vascular disease, arterial hypertension, diabetes mellitus, and other risk factors.

Background: Chronic kidney disease emerges as an important and growing global health problem associated with an increase in the incidence and prevalence of the above mentioned diseases. ISYS Objectives: Ascertain CKD morbidity and its relation to chronic vascular diseases and other risk factors in whole population of Cuba's Isle of Youth special municipality.

Effects of a dairy product fortified with multiple micronutrients and omega-3 fatty acids on birth weight and gestation duration in pregnant Chilean women.

Objective: To test the hypothesis that maternal food fortification with omega-3 fatty acids and multiple micronutrients increases birth weight and gestation duration, as primary outcomes.

Design: Non-blinded, randomised controlled study.

Setting: Pregnant women received powdered milk during their health check-ups at 19 antenatal clinics and delivered at two maternity hospitals in Santiago, Chile.

[Indices based on entropy for measuring social inequalities in health].

As described in the scientific literature, indices used to measure social inequalities in health have positive features, but they also have shortcomings, depending on how they are applied. The objective of this article is to put forward and to demonstrate, in both theoretical and practical terms, the advantages of measurements of inequality based on the notion of entropy, which is well known in physics and in information theory. The article defines and presents the main properties of indices based on the notions of entropy and redundancy.

[Methods for measuring inequalities in health].

Measuring health inequalities is indispensable for progress in improving the health situation in the Region of the Americas, where the analysis of average values is no longer sufficient. Analyzing health inequalities is a fundamental tool for action that seeks greater equity in health. There are various measurement methods, with differing levels of complexity, and choosing one rather than another depends on the objective of the study.

Trends in infant mortality inequalities in the Americas: 1955-1995.

Study Objective: s: To describe overall and income related trends in infant mortality inequalities in the Region of the Americas from 1955 to 1995.

Design: Infant mortality rates (IMRs) were computed and their trends assessed by ordinary least squares. Overall trends in IMR inequalities among countries were analysed by comparing 10 year period IMRs, Gini coefficients, and Lorenz curves.

Malnutrition and poverty.

This paper is an attempt to discuss the problem of malnutrition within the framework of the global need for development and the challenges posed by the trends of neoliberalism and globalization. We argue that there is a two-way link between poverty and health in which nutrition plays an important role both as an active and as a mediating factor. Key concepts are exposed and expanded: (a) Development per se does not ensure better health; (b) unequal distribution of income has an independent effect on health indicators after adjusting for total income; (c) improving health can make an important contribution to reducing poverty; (d ) improving nutrition throughout the whole life course is an indispensable strategy for better health; (e) obesity has to be included amongst the most critical health problems, has different traits, and presents with different challenges in the developing world and in the industrialized countries.

[Anthropometric characteristics of obese women before and after weight reduction].

Anthropometric changes in 53 premenopausal obese women, 25-45 year-old, after an obesity treatment, were analyzed. Before and immediately after treatment, midarm, abdomen, waist, hip, midthigh and midcalf circumferences, as well as tricipital, bicipital, suprailiac, subscapular, abdominal and calf skinfold thickness were measured. The later averaged over percentil 75th.