Background: Cuba is a unique country, and despite limited economic development, has an excellent health system. However, the prevalence of asthma symptoms in children in Havana, Cuba, is unusually high.Aim: As early life exposures are critical to the aetiology of asthma, we have studied environmental influences on the risk of wheezing in Cuban infants.Design: Cross-sectional study.Methods: A random sample of 2032 children aged 12–15 months living in Havana was selected for inclusion in the cohort. Data were collected using questionnaires administered by researchers.Results: Of 2032 infants invited to participate, 1956 (96%) infants provided data. The prevalence of any wheeze was 45%, severe wheeze requiring use of emergency services was 30% and recurrent wheeze on three or more occasions was 20%. The largest adjusted risk factors for any wheeze were presence of eczema [odds ratio (OR) 2.09; 95% confidence interval (CI) 1.48–2.94], family history of asthma (OR 2.05; 95% CI 1.60–2.62), poor ventilation in the house (OR 1.99; 95% CI 1.48–2.67), attendance at nursery (OR 1.78; 95% CI 1.24–2.57), male sex (OR1.52; 95% CI 1.19–1.96) and the number of smokers in the house (P < 0.03 for trend), OR 1.64 (95% CI 1.17–2.31) for three or more smokers in the house compared to no smokers in the household.Conclusion: We have identified several risk factors for any wheeze in young infants living in modern day Cuba. As the prevalence of smoking in the house is high (51%), intervention studies are required to determine effective strategies to improve infant health.

BackgroundThere is a concern that allergic disease in childhood is higher than expected in Cuba. The aim of this study was to determine the risk factors for eczema of infants aged 12–15 months living in Havana.MethodsWe used a cross-sectional epidemiological study design. Data on eczema symptoms and a wide range of lifestyle factors were collected by researcher administered questionnaires.ResultsData were collected on 1956 children (96% response rate), of whom 672 (34%) were reported as having had eczema. Independent risk factors for eczema included young maternal age (adjusted odds ratio (OR) 0.98 per additional year of age; 95% confidence interval (CI) 0.97-0.99), child’s weight (OR 1.13 per additional kg; 95% CI: 1.03-1.25), insect sting allergy (OR 2.11; 95% CI: 1.33-3.35), rodents in the home (OR 1.39; 95% CI: 1.10-1.76), attendance at childcare facilities (OR 1.34: 95% CI: 1.05-1.70) and self-reported mould in the home (OR 1.23; 95% CI: 1.07-1.41). Infant exposure to paracetamol was associated with an increased risk of eczema even after adjustment for wheeze (OR 1.22; 95% CI: 1.03-1.46).ConclusionDespite a very different culture and environment, the consistency of these findings with those from more economically developed countries suggests potential causal associations. The association with paracetamol, even after adjustment for wheeze, suggests that intervention studies are required in young infants, to ascertain if this commonly used anti-pyretic medication increases allergic disease.

ObjectiveImmunoglobulin E (IgE) plays a key role in allergy disease pathogenesis, but little is known about the environmental factors associated with higher IgE levels in infants. The aim of this study was to determine the risk factors for elevated serum total IgE infants living in Havana.MethodsEight hundred and seventy-seven infants provided blood samples. Data on allergic disease symptoms and a wide range of exposures were collected.ResultsThe median IgE was 35IU/ml (interquartile range 13–96). The risk of having an IgE level above the median was higher for children who had been breastfed for 4 months or more (adjusted odds ratio (OR) 1.28; 95% confidence interval (CI): 1.02–1.61) and for children who reported cockroaches in their home (OR 1.30; 95% CI: 1.03–1.63). The risk was lower for children whose mother was in paid employment (OR 0.73; 95% CI: 0.54–0.97 compared with those who did not), for children living in homes where gas and electricity were used for cooking (OR 0.45; 95% CI: 0.32–0.62 compared with electricity only) and for children with domestic pets at birth (OR 0.83; 95% CI: 0.70-1.00). There was no association between paracetamol use and serum IgE levels.ConclusionsAssociations between gas fuel use and maternal employment indicate that IgE levels in early life are lower in children who may be living in relative affluence. The discrepancy in the effect of early exposure to pets or cockroaches may reflect differences in these allergens, or be confounded by relative affluence. Further investigation of this cohort will determine how these effects translate into the expression of allergic disease in later life.ObjectifLes immunoglobulines E (IgE) jouent un rôle clé dans la pathogenèse de la maladie allergique, mais on sait peu sur les facteurs environnementaux associés à des taux plus élevés d'IgE chez les nourrissons. Le but de cette étude était de déterminer les facteurs de risque pour un taux élevé d'IgE sériques totales chez les nourrissons vivant à La Havane.MéthodesDes échantillons de sang ont été collectés chez 877 nourrissons. Les données sur les symptômes de la maladie allergique et sur une large gamme d'expositions ont été recueillies.RésultatsLa médiane des IgE était de 35 UI/ml (gamme interquartile: 13 à 96). Le risque d'avoir un taux d'IgE au-dessus de la médiane était plus élevé pour les enfants qui avaient été allaités pendant au moins quatre mois (odds ratio ajusté (OR): 1,28; intervalle de confiance (IC) à 95%: 1,02 à 1,61) et pour les enfants pour qui des cafards ont été signalés dans la maison (OR: 1,30; IC 95%: 1,03 à 1,63). Le risque était plus faible pour les enfants dont la mère possédait un emploi rémunéré (OR: 0,73; IC 95%: 0,54 à 0,97 par rapport à ceux dont les mères n'avaient pas cet emploi, pour les enfants vivant dans des foyers où le gaz et l’électricité étaient utilisés pour la cuisson (OR: 0,45; IC 95%: 0,32 à 0,62 par rapport à l'utilisation de l’électricité seule) et pour les enfants ayant des animaux domestiques à la naissance (OR: 0,83; IC 95%: 0,70 à 1,00). Il n'...

-Introduction: Multiple sclerosis (Ms) is a chronic, inflammatory and progressive disease of the central nervous system in which local inflammatory injuries of the brain white matter appears, being the most outstanding feature the myeline loss (demyelination). Objective: to determine if the complement system might be involved in the Ms immunopathogeny favouring the mechanism intervening in the myelin destruction. Method: samples of sera and csF from twelve patients with a diagnosis of Ms obtained at the moment of the admission to the hospital at the beginning of the break out, were collected. Levels of c3c and albumin in sera and in csF were quantified using radial immunodiffusion plates. Results: High values over 80% of intrathecal synthesis were obtained except in one of the patients. Conclusion: Intrathecal synthesis of c3c and its liberation to the csF means that the activation of the complement system in any of the two ways has taken place, and that once performed its biological functions, has suffered a degradation process Key words: cytotoxicity, complement, multiple sclerosis, hypersensibility, immunopathogenicity, reibergram.evaluación de la síntesis intratecal de C3c en pacientes con esclerosis múltiple resuMeN -Introducción: La esclerosis múltiple (eM) es una enfermedad crónica, inflamatoria y progresiva del sistema nervioso central que cursa con la aparición de lesiones inflamatorias focales en la sustancia blanca cerebral, en las que lo más llamativo es la pérdida de mielina (desmielinización). Objetivo: conocer si el sistema de complemento puede estar involucrado en la inmunopatogenia de la eM favoreciendo los mecanismos que median la destrucción de la mielina. Método: se colectaron muestras de suero y Lcr de doce pacientes con diagnóstico de eM obtenidas en el momento del ingreso al inicio del brote. se cuantificaron los niveles de c3c y albúmina en suero y en Lcr en placas de inmunodifusión radial. Resultados: se obtuvieron altos valores que superan el 80% de síntesis intratecal, menos en uno de los pacientes. Conclusion: La síntesis intratecal de c3c y su liberación al Lcr significa que ha sucedido la activación del sistema de complemento en alguna de las dos vías y que una vez cumplidas sus funciones biológicas, ha sufrido un proceso de degradación y liberación al Lcr en forma de c3c.PALABrAs-cLAve: citotoxicidad, complemento, esclerosis múltiple, hipersensibilidad, inmunopatogenia, reibergrama.

ObjectiveLow birthweight is associated with a decreased risk of childhood leukemia and an increased risk of both cardiovascular disease and all‐cause mortality in adult life. Possible biological mediators include systemic innate immunity and inflammation. We tested the hypothesis that birthweight was inversely associated with serum high sensitivity C reactive protein assay (hsCRP), a measure of both innate immunity and systemic inflammation.MethodsData on birthweight and current anthropometric measures along with a range of exposures were collected at 1 and 3 years of age in a population‐based cohort study of young children living in Havana, Cuba. A total of 986 children aged 3‐years‐old provided blood samples that were analyzed for serum hsCRP levels.ResultsNearly 49% of children had detectable hsCRP levels in their serum. Lower birthweight was linearly associated with the natural log of hsCRP levels (beta coefficient −0.70 mg L−1 per kg increase in birthweight, 95% CI: −1.34 to −0.06). This was attenuated but still present after adjustment for the child's sex and municipality (−0.65 mg L−1 per kg birthweight; 95% CI: −1.38 to +0.08). There were no associations between growth from birth or anthropometric measures at 3 years and systemic inflammation.ConclusionsBirthweight was inversely associated with serum hsCRP levels in children aged 3 years living in Cuba. These observations provide a potential mechanism that is present at the age of 3 years to explain the association between low birthweight and both decreased childhood leukemia and increased cardiovascular disease in adults.