ABSTRACT Aging and Alzheimer is a prospective, longitudinal cohort study involving 2944 adults aged ≥65 years from selected areas in Cuba’s Havana and Matanzas Provinces. This door-to-door study, which began in 2003, includes periodic assessments of the cohort based on an interview; physical exam; anthropometric measurements; and diagnosis of dementia and its subtypes, other mental disorders, and other chronic non-communicable diseases and their risk factors. Information was gathered on sociodemographic characteristics; disability, dependency and frailty; use of health services; and characteristics of care and caregiver burden. The first assessment also included blood tests: complete blood count, blood glucose, and liver function, lipid profile and ApoE4 genotype (a susceptibility marker). In 2007–2011, the second assessment was done of 2010 study subjects aged ≥65 years who were still alive. The study provides data on prevalence and incidence of dementia and its risk factors, and of related conditions that affect the health of older adults. It also contributes valuable experiences from field work and interactions with older adults and their families. Building on lessons learned, a third assessment to be done in 2016–2018 will incorporate a community intervention strategy to respond to diseases and conditions that predispose to dementia, frailty and dependency in older adults.

INTRODUCTION Population aging translates into more people with chronic non-communicable diseases, disability, frailty and dependency. The study of frailty-a clinical syndrome associated with an increased risk of falls, disability, hospitalization, institutionalization and death-is important to improve clinical practice and population health indicators. OBJECTIVES In a cohort of older adults in Havana and Matanzas provinces, Cuba, estimate prevalence of frailty and its risk factors; determine incidence of dependency; estimate mortality risk and identify mortality predictors. METHODS A prospective longitudinal study was conducted door to door, from June 2003 through July 2011, in a cohort of 2813 adults aged ≥65 years living in selected municipalities of Havana and Matanzas provinces; mean followup time was 4.1 years. Independent variables included demographics, behavioral risk factors and socioeconomic indicators, chronic non-communicable diseases (hypertension, stroke, dementia, depression, diabetes, anemia), number of comorbidities, and APOE ε4 genotype. Dependent variables were frailty, dependency and mortality. Criteria for frailty were slow walking speed, exhaustion, weight loss, low physical activity and cognitive decline. Prevalence and frailty risk were estimated by Poisson regression, while dependency and mortality risks and their predictors were determined using Cox regression. RESULTS Frailty syndrome prevalence was 21.6% (CI 17.9%-23.8%) at baseline; it was positively associated with advanced age, anemia and presence of comorbidities (stroke, dementia, depression, three or more physically debilitating diseases). Male sex, higher educational level, married or partnered status, and more household amenities were inversely associated with frailty prevalence. In followup, dependency incidence was 33.1 per 1000 person-years (CI 29.1-37.6) and mortality was 55.1 per 1000 person-years. Advanced age, male sex, lower occupational status during productive years, dependency, frailty, dementia, depression, cerebrovascular disease and diabetes were all associated with higher risk of death. CONCLUSIONS Given the challenge for developing countries presented by demographic and epidemiologic transition; the high prevalence in older adults of frailty syndrome, dependency and chronic non-communicable diseases; and the association of all these with higher mortality, attention should be targeted to older adults as a risk group. This should include greater social protection, age-appropriate health services, and modification and control of cardiovascular risk factors.

INTRODUCTION: Chronic non-communicable diseases are the leading cause of death worldwide, except in Sub-Saharan Africa. Nonetheless, one of these conditions, dementia, is the major contributor to disability-adjusted life years in people aged >60 years. Few epidemiological studies exist of the prevalence and impact of dementia and selected chronic diseases in older adults in Latin America. OBJECTIVE: Describe prevalence of dementia, other chronic vascular diseases and cardiovascular risk factors, as well as resulting disabilities and care needs generated in adults aged >65 years in Havana City and Matanzas provinces, Cuba. METHODS: The 10/66 study is a prospective longitudinal study involving a cohort of 3015 adults aged >65 years in municipalities of Havana City and Matanzas provinces, divided into two phases: a cross-sectional door-to-door study conducted in 2003-2006, and a follow-up and assessment phase in 2007-2010. This article reports findings from the first phase. Hypertension diagnosis was based on criteria from the International Society for Hypertension; diabetes mellitus on American Diabetes Association criteria; stroke according to WHO definitions; and dementia according to criteria of the American Psychiatric Society's Diagnostic and Statistical Manual of Mental Disorders DSM-IV and the 10/66 International Dementia Research Group. Ischemic heart disease was defined by self-report of previous physician diagnosis. Study variables included age, sex, educational level, substance use (alcohol, tobacco) and dietary habits. A structured physical and neurological exam, including blood pressure measurement, was performed on all participants. Laboratory tests included complete blood count, fasting blood glucose, total cholesterol and lipoprotein fractions, triglycerides and apolipoprotein E genotype. Prevalence and standardized morbidity ratios (crude and adjusted) were calculated for chronic diseases studied with 95% confidence intervals, using a Poisson regression model and indirect standardization. RESULTS: The study assessed 2944 older adults (response rate 97.6%) and found high prevalence of vascular risk factors and of chronic non-communicable diseases: hypertension 73.0% (95% CI 71.4-74.7), diabetes mellitus 24.8% (95% CI 22.9-26.5), ischemic heart disease 14.1% (95% CI 12.9-15.4), dementia 10.8% (95% CI 9.7-12.0) and stroke 7.8% (95% CI 6.9-8.8). The majority of participants (85%) had more than one cardiovascular risk factor. The main cause of disability and dependency in the study population was dementia. CONCLUSION: The high prevalence of chronic diseases observed in the elderly-with the consequent morbidity, disability and dependency-highlights the need for prevention, early diagnosis and risk factor control, particularly given the demographic and epidemiologic transition faced by Cuba and other developing countries.

Este trabalho investigou os efeitos do tratamento por vinte dias com extrato de Ginkgo biloba (EGb) na osteoporose induzida por glicocorticóides. Foram utilizadas 36 ratas divididas em seis grupos (n=6): Controle, osteoporose, controle positivo, EGb1 (14 mg EGb/mg/kg/dia), EGb2 (28 mg EGb/kg/dia) e EGb3 (56 mg EGb/kg/dia). Os tratamentos foram realizados por vinte dias, após a indução da osteoporose. Após a eutanásia foram removidos o fêmur e a mandíbula de todos os animais. A mandíbula esquerda foi radiografada digitalmente para avaliação da cortical e do suporte ósseo periodontal (SOP). A análise histomorfométrica foi realizada no fêmur e mandíbula direitos. O grupo controle foi comparado ao grupo osteoporose (Teste t de Student) e os demais grupos foram submetidos a ANOVA, seguido do teste post-hoc de Dunnett. Houve redução significava do SOP mesial, percentual ósseo alveolar (POA) mandibular, percentual ósseo trabecular (POT) do fêmur no grupo osteoporose. Houve aumento do SOP mesial no grupo controle positivo, EGb2 e EGb3. O POA da mandíbula e o POT do fêmur aumentaram nos grupos EGb2 e EGb3. O EGb nas doses de 28 mg/kg e 56 mg/kg recuperou de forma significativa o SOP mesial, o POA da mandíbula e o POT do fêmur.

The objective of this study was to investigate the effect of a 20 day treatment with extract of Ginkgo biloba (EGb) in glucocorticoid-induced-osteoporosis. 36 rats were divided into six groups (n=6): control, osteoporosis, positive control, EGb1 (14 mg EGb/kg/day), EGb2 (28 mg EGb/kg/day) and EGb3 (56 mg EGb/kg/day). Treatments were conducted for twenty days, after osteoporosis was induced. Following euthanasia the femur and mandible of all animals were removed. The left mandible was radiographed to evaluate the cortical and the periodontal bone support (PBS). The histomorphometric analysis was performed on the right mandible and the right femur. The control group was compared with the osteoporosis group (Student's t-test). The other groups were analyzed through ANOVA test followed by Dunnett post-hoc test. There was a significantly reduction in the mesial PBS, in the percentage of the alveolar bone (PAB) of the mandible and percentage of the trabecular bone (PTB) of the femur in the osteoporosis group. There was an increase in the mesial PBS in the positive control group, EGb2 and EGb3. The PAB of the mandible and the PTB of the femur increased in the EGb2 and EGb3 groups. The EGb in the 28 mg/kg and 56 mg/kg doses were effective to increase the mesial PBS, the PAB of the mandible and the PTB of the femur.

CONTEXTUALIZAÇÃO: Diversos estudos têm avaliado a função motora de crianças com Paralisia Cerebral (PC), entretanto pouco se sabe sobre as inter-relações entre comprometimentos da mobilidade, autocuidado e função social relacionadas às habilidades funcionais da criança e à assistência do cuidador. OBJETIVOS: Identificar diferenças funcionais de crianças com PC em diferentes níveis de disfunção motora e correlacioná-las com os domínios mobilidade, autocuidado e função social na habilidade funcional e na assistência do cuidador. MÉTODOS: Realizou-se uma pesquisa analítica de corte transversal com 70 crianças/famílias, com idades de 4 a 7,5 anos, atendidas no Centro de Reabilitação Infantil, por meio do Pediatric Evaluation Disability Inventory (PEDI) e do Gross Motor Function Classification System (GMFCS). A análise dos dados foi realizada por meio da ANOVA e teste de correlação de Pearson. RESULTADOS: Os resultados indicaram importante variabilidade funcional das crianças com PC em diferentes níveis de severidade da disfunção motora. Essa variação foi observada nos domínios mobilidade, autocuidado e função social. Os resultados apresentaram, também, forte correlação entre os domínios mobilidade e autocuidado e mobilidade e função social. CONCLUSÕES: Diante da variabilidade apresentada pelas crianças, percebe-se a necessidade de aplicação do PEDI e GMFCS, o que parece aumentar o entendimento sobre a relação entre funções motoras grossas e atividades da vida diária. Essa correlação demonstra o quanto a mobilidade é determinante para avaliar o desempenho funcional e orientar a prática terapêutica no sentido de desenvolver as potencialidades das crianças, bem como orientar o cuidador na estimulação.

BACKGROUND: Several studies have evaluated motor function among children with cerebral palsy (CP), but little is known about how mobility impairment, self-care and social function interrelate with their functional skills and caregiver assistance. OBJECTIVES: To identify functional differences among children with CP at different levels of motor dysfunction, and to investigate the relationship between these differences and the domains of mobility, self-care and social function in functional skills and caregiver assistance. METHODS: An analytical cross-sectional study was conducted among 70 children and their families. The children were aged 4 to 7.5 years and received care at the Children's Rehabilitation Center. The instruments used were the Pediatric Evaluation Disability Inventory (PEDI) and the Gross Motor Function Classification System (GMFCS). Data analysis was performed by means of ANOVA and Pearson's correlation. RESULTS: The results showed significant functional variability among the children with CP at different levels of motor dysfunction severity. This variation was observed in the domains of mobility, self-care and social function. The results also showed a strong correlation between mobility and self-care and between mobility and social function. CONCLUSIONS: In view of the variability shown by the children, it was necessary to apply PEDI and GMFCS, which appears to increase the understanding of how gross motor function relates to activities of daily living. This correlation demonstrates the extent to which mobility is a determinant for evaluating functional performance and guiding therapeutic practice to develop children's potentials and instruct caregivers in stimulation.

Os objetivos deste estudo foram conhecer a guilda de parasitóides associados a pupas de Methona themisto (Hübner, 1818), avaliando a abundância relativa de cada espécie de parasitóide e o efeito do parasitoidismo na mortalidade do hospedeiro. Foram coletadas 160 pupas de M. themisto, 80 em outubro de 2001 e 80 em outubro de 2002. Essas foram mantidas em temperatura de 25 ± 2,0ºC e fotofase de 14 horas, sendo diariamente observadas, até a emergência de parasitóides ou borboletas. Os seguintes parasitóides foram obtidos das pupas de M. themisto: Brachymeria annulata (Fabricius, 1793), B. mnestor (Walker, 1841) (Chalcididae), Neotheronia sp. (Ichneumonidae), Palmistichus elaeisis Delvare & LaSalle, 1996 e Tetrastichus sp. (Eulophidae). Somente os gêneros Brachymeria e Neotheronia ocorreram nos dois anos de estudo, sendo que o primeiro foi mais abundante em 2001 e o último, em 2002. As outras espécies de parasitóides ocorreram somente no segundo ano de estudo. Este é o primeiro relato da associação de B. annulata, B. mnestor, Neotheronia sp. e P. elaeisis com M. themisto.

The goals of this study were to know the parasitoid guild associated to pupae of Methona themisto (Hübner, 1818), evaluate the relative abundance of each species of parasitoid and the effect of parasitism on the host mortality. A total of 160 pupae of M. themisto were collected, 80 in October 2001 and 80 in October 2002. They were maintained at 25 ± 2,0ºC and photophase of 14 hours, daily observed until parasitoid or butterfly emergence. Five parasitoid species were obtained from M. themisto pupae: Brachymeria annulata (Fabricius, 1793), B. mnestor (Walker, 1841) (Chalcididae), Neotheronia sp. (Ichneumonidae), Palmistichus elaeisis Delvare & LaSalle, 1993, and Tetrastichus sp. (Eulophidae). Only the genera Brachymeria and Neotheronia occurred in both years of the study, the former was more abundant in 2001 and the latter in 2002. The other species of parasitoids occurred only in the second year of the study. These are the first records of B. annulata, B. mnestor, Neotheronia sp. and P. elaeisis as parasitoids of M. themisto.

Alecrim (Rosmarinus officinalis L. - Lamiaceae) é uma planta utilizada no tratamento de afecções hepática, intestinal, renal e respiratória. Sua toxicidade foi investigada em ratas e seu efeito antiimplantação foi relatado em estudos prévios. Este trabalho analisa o efeito da administração aguda do extrato de R. officinalis em órgãos vitais, em órgãos do sistema reprodutor e na produção de espermatozóides de ratos Wistar adultos. Ratos Wistar foram tratados com 1 mL do extrato aquoso de R. officinalis na dose de 291,2 mg e 582,4 mg/kg de peso corporal por cinco dias. O peso corporal e de órgãos, a produção de espermatozóides e o consumo de ração foram avaliados. Os resultados mostraram que a administração da dose menor do extrato de R. officinalis não alterou significativamente o peso corporal e de órgãos e nem interferiu com a produção de gametas. Entretanto, os animais tratados com a maior dose evidenciaram aumento significativo de peso de vesícula seminal, mas nenhuma outra alteração significativa das outras variáveis. O consumo de ração não foi afetado pelos tratamentos.

Rosemary (Rosmarinus officinalis L. - Lamiaceae) is a shrub used in the treatment of hepatic, intestinal, renal and respiratory affections. Its toxicity was assessed in female rats and an anti-implantation effect was reported after treatment with this plant. This work analyzes the effect of the short-term administration of R. officinalis extract on vital organs, on the organs of the reproductive system and sperm production of mature male Wistar rats. Adult Wistar rats were treated with 1 mL of R. officinalis aqueous extract at a dose level of 291.2 mg and 582.4 mg/kg of body weight for five days. Body and organs weights, sperm production and food consumption were evaluated. The results showed that the lower dose administration of R. officinalis extract did not significantly alter body and organs weight nor did it interfere with gamete production. However, animals treated with the higher dose showed significant weight increase of the seminal vesicle but no significant alteration of the other variables. Food intake was not affected by the treatments.

O melão-de-são-caetano é uma espécie monóica e ruderal de interesse econômico. O conhecimento de seus mecanismos reprodutivos é fundamental para a sua conservação e manejo. Foram estudados a biologia floral, a fenologia reprodutiva, a polinização e o sistema de reprodução da espécie. A espécie possui flores diclinas, com antese diurna. O período de floração dura em torno de 100 dias e seu pico ocorre em outubro. No início da floração a espécie apresenta dicogamia do tipo protandria. As flores femininas não produzem néctar, tendo sido identificado mimetismo das flores masculinas pelas femininas. As flores masculinas produziram néctar durante todo o período de antese. Houve formação de frutos por fecundação cruzada e autopolinização. O número de sementes presentes nos frutos não diferiu (H = 1,13; P > 0,05). A relação sementes/óvulos foi da ordem de 80%. Todos os visitantes florais coletados e observados pertencem à Classe Insecta. Diabrotica speciosa (Coleoptera, Chrysomelidae) foi a espécie mais abundante (40%) e o principal polinizador de Momordica charantia na área de estudo. Outros insetos, como abelhas (Apoidea) e lepidópteros (Hesperiidae e Pieridae), também visitaram as flores e podem contribuir na polinização.

Bitter melon is a monoecious and ruderal species of economic interest. The knowledge of its reproductive mechanisms is important for its conservation and management. The species floral biology, reproductive phenology, pollination, and breeding system were studied. The species has diclinous flowers, with diurnal anthesis. The period of flowering lasted around 100 days and its peak occurred in October. In the beginning of the flowering the species presents dicogamy of the protandry type. The female flowers do not produce nectar, while the male flowers produce nectar during the entire period of anthesis. There was identified a mimicry of the male flowers by the female flowers. Fruit formation occurred through crossed-pollination and self-pollination. The number of seeds in the fruits did not differ (H = 1.13; P > 0.05) among the type of pollination. The relation seed/egg was in the order of 80%. All floral visitors collected and observed on the flowers belong to the class Insecta. Diabrotica speciosa (Coleoptera, Chrysomelidae) was the most abundant species (40%) and the main pollinator of Momordica charantia in the study area. Other insects, however, as bees (Apoidea) and butterflies (Hesperiidae and Pieridae), were also observed in the flowers and can contribute as pollinators.

Analisamos as características clínicas e moleculares de 205 pacientes portadores das diferentes formas clínicas da deficiência da 21-hidroxilase, com diagnóstico hormonal e molecular definidos. As mutações mais freqüentes foram a I2 splice na forma perdedora de sal, a I172N na forma virilizante simples e a V281L na forma não clássica, com freqüências semelhantes às de outros estudos. Obtivemos baixa freqüência de deleção do gene da 21-hidroxilase, de forma semelhante ao identificado nas populações argentina e mexicana. Cinco mutações novas foram descritas em nossa população: G424S, H28+C, Ins 1003^1004 A, R408C e IVS2-2A>G. A severidade do genótipo também se correlacionou diretamente com níveis mais elevados de 17OH-progesterona e de testosterona. As mutações foram classificadas em três grupos, de acordo com o comprometimento da atividade enzimática observado in vitro: Grupo A: atividade de 0-2%; Grupo B: atividade de 3-7% e Grupo C: atividade >20%. Houve forte correlação do grupo A com a forma perdedora de sal, do grupo B com a forma virilizante simples e do grupo C com a forma não clássica. A mutação I2 splice (Grupo A) em homo ou hemizigose conferiu o fenótipo de forma clássica, embora tanto a forma perdedora de sal quanto a forma virilizante simples tenham sido identificadas. A boa correlação do genótipo com o fenótipo na HAC-21OH permite sua aplicação na prática clínica, para o aconselhamento genético, diagnóstico e tratamento pré-natal das gestações de risco para a forma clássica da HAC-21OH e para confirmação diagnóstica após screening neonatal da HAC-21OH, exceto na presença da mutação I2splice.

We analyzed the clinical and molecular data of 205 patients with the three different clinical forms of 21-hydroxylase deficiency, in whom the clinical and molecular diagnosis were already defined. The most frequent mutations were I2 splice in the salt wasting form, I172N in the simple virilizing and V281L in the nonclassical form, presenting similar frequencies as those observed in other populations. We found a lower frequency of 21-hydroxylase gene deletion, similar to that previously identified in Argentinean and Mexican populations. Five new mutations were described in our population: G424S, H28+C, Ins 1003^1004 A, R408C and IVS2-2A>G. The genotype was classified in three groups according to the impairment of enzymatic activity observed in vitro, Group A: 0-2%, Group B: 3-7% and Group C: >20%. Group A mutations correlated with the salt wasting form, the Group B with simple virilizing form and Group C with the non classical form. The severity of genotype showed a positive correlation with higher 17OH-progesterone and testosterone levels. The I2 splice mutation in homo or hemizygosis confers classical form phenotype with both salt wasting and simple virilizing forms, precluding the prediction of the clinical form through genotype in pre and neonatal diagnosis. The good genotype-phenotype correlation in patients with 21-hydroxylase deficiency shows the usefulness of genotype to predict the clinical form for genetic counseling, prenatal diagnosis and to confirm neonatal screening diagnosis, except in cases with I2 splice mutation.