HEALTH NEWS FROM CUBA

Stem Cell Transplant Saves Patient's Leg

A team of Cuban specialists successfully transplanted stem cells which regenerated tissue to save the leg of 72-year old José Ramirez Espino. Diagnosed with a critical circulation problem requiring the amputation of his leg, Ramirez Espino received injections of stem cells taken from his bone marrow and was evidencing positive regenerative progress just 72 hours after the operation. This was the first clinical application of stem cells for tissue regeneration in the western hemisphere, according to Dr. Porfirion Hernández, deputy director of the Hematology and Immunology Institute of the Ministry of Public Health.

Cutting edge and highly complex, auto transplants are just one of the therapeutic applications Cuban scientists have developed from stem cell research (also see the related article "Back-to-Back Cellular Cardiac Transplants," below). In Ramirez Espino's case, some 300 million stem cells were harvested from his bone marrow, processed, and then injected into his leg muscle in an effort to treat an atherosclerosis condition with such serious circulatory problems that amputation of the leg was recommended. This successful auto transplant of stem cells validates recent studies that stem cells are able to develop cells of different tissues including muscles and blood vessels.

Stem cell research, whereby a cloned blastocyst is developed into a tissue culture to form a stem cell line for investigative purposes and therapeutic applications, has been embroiled in the highly controversial debate regarding reproductive and human cloning. The process of reproductive cloning, however, differs significantly in that the cloned blastocyst is implanted in a female's uterus where it develops until birth. See the article below, " Academy of Sciences Bans Reproductive Cloning, Supports Stem Cell Research" for the international scientific community's stand on the controversy.

Back-to-Back Cellular Cardiac Transplants

A double victory for clinical applications of stem cell research was achieved when the Cellular Therapy group led by cardiovascular surgeon Doctor José Hidalgo Díaz of the Havana Cardiology Institute, successfully implanted stem cells into the hearts of two separate patients.

In a procedure similar to the one that saved the leg of José Ramirez Espino (see "Stem Cell Saves Patient's Leg," above), bone marrow taken from Roberto Martínez, 55, was processed and injected into the infarcted area of his heart in order to rehabilitate damaged cells. This cellular cardiac transplant or cellular cardiomioplastia, was the first application of its kind in Cuba, the Caribbean and Central America. Martínez suffered from chest angina and a previous infarction, plus hypertension and obesity. The second application was used along with bypass surgery to treat Denis González, 61, whose life was in danger as a result of an extended infarction of the posterior myocardial area, compounded by a critical pathology of the coronary vessels. The procedure is being further developed and will be implemented in three other coronary centers around Cuba.

Academy Of Sciences Bans Reproductive Cloning, Supports Stem Cell Research

The Academia de Ciencias Cubanas (ACC), along with scores of Academies of Sciences worldwide, called on the United Nations Committee on Cloning to pass a convention banning cloning for reproductive purposes. The statement, issued by the InterAcademy Panel on International Issues (IAP) in September 2003, argued that human cloning should be banned due to the serious health risks it poses to mother and child, and the serious ethical and social implications it embodies. “Reproductive cloning encompasses a series of ethical problems, violating [a] human being’s freedom and autonomy," said Dr. Sergio Arce of Cuba's Nephrology Institute’s Immunology Center.

However, both the Cuban Academy, which sits on the IAP's Executive Council, and the IAP, emphasized their support for stem cell research and cloning for therapeutic research and clinical applications. As a result, cloning for therapeutic and research purposes was specifically excluded from the proposed ban. According to the president of the Third World Academy of Sciences, C.N.R. Rao, " cloning to obtain embryonic stem cells for research and therapeutic purposes holds considerable promise for long-term benefits.”

The cloning ban was ratified by the UN General Assembly in December 2003; click here to view the entire statement.

Two months later, the Cuban Academy of Sciences adopted its own ban on reproductive cloning, while approving stem cell research.

Infant Mortality Rate Drops to 6.3

The infant mortality rate in Cuba dropped to 6.3 for every 1000 live births in 2003, making it the lowest in Latin America and the second-lowest in the hemisphere, after Canada. Rates did not vary wildly between provinces, with Las Tunas posting the lowest rate at 4.2 deaths per 1000 live births, while Isla de la Juventud had the highest at 9.6. Minimal regional fluctuations are largely attributable to Cuba's free, universal health system and the national program that ensures each infant receives 13 vaccinations in the first year of life, free of charge.

Factors contributing to the low mortality rate include well coordinated and designed prenatal care, early detection of congenital deformities, specialized care when cardiovascular, arterial hypertension, diabetes or other complications are identified and well equipped hospitals and homes for expectant mothers. Furthermore, every pregnant woman is guaranteed personal, professional medical attention, a fact reinforced by the United Nations Development Program's (UNDP) Human Development Index (2002), which reported that 100% of Cuban women are attended by skilled medical workers upon the birth of their babies.

Major causes of death in the first year include perinatal conditions, congenital anomalies (particularly cardiovascular), flu and pneumonia, sepsis, and accidents, primarily those in the home.

Cuba Develops Major Vaccine for Children

Cuban scientists have successfully produced the first human vaccine made from a chemically-produced antigen, adding to a long list of achievements in the field of biotechnology. The vaccine, which combats haemophilus influenzae type b, signals a breakthrough with the potential to help hundreds of thousands of children worldwide.

The bacteria haemophilus influenzae type b causes upper respiratory infections, mainly in children five years old and younger and is a leading cause of meningitis, a brain and spinal cord disease that can lead to brain damage, deafness or death. Incredibly, nearly half of all infections worldwide in children in this age group are caused by this bacteria; UNICEF estimates that it kills 500,000 children a year.

While haemophilus influenzae type b has largely been stamped out in the United States, conventional vaccines using bacterial-grown antigens have heretofore been prohibitively expensive (US$3 a dose). The new chemically-grown antigens in the Cuban vaccine mean immunizations may be within reach of developing nations where the disease strikes hardest. “Poor nations that depend on multinational pharmaceutical companies for the vaccine...will now have a less expensive alternative”, said Dr. Vicente Verez, head of the University of Havana's Synthetic Antigens Laboratory.

The vaccine, which showed 99.7% success rate in cultivating the necessary antibodies in clinical trials, is already being produced in Cuba. A leader in the industry, Cuba also developed a recombinant vaccine for meningitis B now sold all over the world, including in Europe under license by GalxoSmithKline and a vaccine for hepatitis B now available in more than 30 countries.

Cuban Medical Brigade Receives Guatemala's Order of the Quetzal

Outgoing President Alfonso Portillo bestowed his country's highest honor on the 1700 Cuban medical professionals working in Guatemala since Hurricane Mitch struck in 1998.

Heaping praise on Cuba's visiting medical professionals, Portillo stated “I didn’t want to end my term as president without giving the highest distinction of honor Guatemala grants to this heroic group of Cuban doctors; they are the expression of the solidarity and love of Cuban people.” Indeed, they are also an expression of the efficacy of the Cuban health and education system: the humanitarian work of the 527 doctors working in 16 of Guatemala's 22 provinces has contributed to a drop in both the infant mortality and morbidity rates in some of the poorest regions of that Central American country. Recent reports state that the infant mortality rate in remote areas of Guatemala dropped from 40.3 to 13.8 for every 1000 live births.

Cuba's medical brigade professionals have more than the healing touch, they also apply their many talents towards resolving even the most mundane daily problems. They have "undertaken all tasks here, they have been doctors, mechanics, they have repaired engines, ambulances, they have been bricklayers, electricians, because they are the doctors of the future, they can do anything,” enthused Portillo. Cuban doctors will continue working in Guatemala, saving lives and improving the health of the poor majority in that country.

Cuba currently has 15,000 health professionals doing similar humanitarian work in 65 countries worldwide. Watch future editions of MEDICC Review for special coverage on Cuba's international medical-solidarity work like that in Guatemala.

Viva! 120 Years Club Holds First Scientific Conference

It's fitting that the first Scientific Conference of the 120 Years Club was held in Cuba, where the life expectancy rate is a hardy 76.8, with goals of reaching 80 in the near future. The club, which endeavors to help people reach 120 years of age with a high quality of life, explored longevity, and its challenges and realities, during this debut conference entitled "120 Years Old with Satisfactory Activity."

Organized by Dr. Eugenio Selman, President of the Caribbean Medical Association (AMECA), an NGO with special consultant status to the United Nations Economic and Social Council (UNESCO), the conference tackled topics such as the skills and factors people need to reach 120 years of age, how life expectancies have evolved over time and the problems of advanced aged, including disabilities and dysfunctions that can convert into a social burden. Capacities that people can develop in order to increase their chances of reaching 120 years of age include not setting limits for themselves, staying motivated mentally and physically, including getting exercise daily, practicing good nutrition, having good health care, pursuing cultural activities and living in a amenable environment.

On the likelihood that humans can attain 120 years of age, Dr Selman observed, " Life expectancy in the world by [the] early 20th century was 40 years of age. By mid-20th century it was 54, and at the closing, 75 years. But some countries are more advanced than others like Japan, with a life expectancy of 80 years for men and 81 years for women...More people are reaching the age of 100 years, and others 120 and more.” Dr Selman is not alone in his quest for longevity: the 120 Years Club has more than 1700 members in 18 countries, including Guatemala, Venezuela, Nigeria and the United States.

Cuba-US Biologic Psychiatry Workshop

Over one hundred specialists participated in a Biologic Psychiatry workshop in Havana this past January in another example of collaboration between the Cuban and US scientific communities.

Cooperation and exchange between psychiatrists and researchers from the two countries in the areas of biologic psychiatry (particularly genome mapping and the neurological bases for mental diseases) were focuses of the workshop. Participants included North American psychiatrists and representatives from pharmaceutical companies who aim to increase collaboration and bolster existing relationships with Cuban specialists.

Developments in Neurological Restoration

Cuban scientists presented their latest findings during the Second International Conference on Neurological Restoration hosted in Havana in February 2004. Gene and cell therapy, molecular genetics and biology, neurological rehabilitation and epilepsy surgery were among the specialties discussed. Other disciplines on the agenda included movement disorders like Parkinson's disease and biomedical studies on the molecular level. Among the presentations featured were neurological restoration of motor functions applied to brain aging, dementia, degeneration of the central nerve system, tumors and vascular malformations. Emerging support technologies presented included stereotaxic systems, surgical planning, neuroimaging and various computer software.

Scientists from all over the world attended the conference, which concurred with the 15th anniversary of the International Center for Neurological Restoration.

In Brief...

Cuban Elected President of the Latin American Union of the Blind and Visually Impaired; Focuses on Women

Cuban doctor José Monteagudo was recently elected to a four-year term as president of the Latin American Union of the Blind and Visually Impaired (UNLAC). During his acceptance speech, Dr Monteagudo promised to focus on developing rehabilitation services and finding employment for his constituents. Above all, he said the Union needs to pay special attention to the needs of blind women, who in his opinion, are extremely discriminated against and should be given the opportunity to assume their rightful place in the world, including occupying executive positions.

In Cuba, opportunities for the visually impaired are maximized through specialized learning centers which teach how to read in Braille, move through physical spaces, how to do house work, create artwork and other skills. With the help of their colleagues and the Cuban Association for the Blind & Visually Impaired (ANCI), many of these people go onto regular higher learning institutions.

Horses Make Good Therapy

Innovative therapies using horses have been netting positive results among deaf and blind and other differently-abled children, Cuban doctors have found. While not curative, the nine month program works to win the confidence of the children while helping them develop social and language skills through contact with horses. Once they're familiar and comfortable with the animal, they're introduced to their movements and their reactions are monitored. At a trot, for instance, children have shown higher spirits and improved balance, articular movement and muscular control. The therapy, administered free of charge, has shown results among quadriplegics and children with neurological disorders or autism.

Jardines del Rey: Where Vacation is Healthier

Relaxing on a powdery beach while sapphire waters lap at your ankles is intrinsically healing, but a new health center in Cayo Coco, Cuba's premier beach destination, caters to your mind, body and spirit. Specializing in massage, sun, air and algae treatments, the center boasts a high marine biological content that flourishes in temperate waters of perfect salinity and chemical composition. Such environmental conditions put this center at the forefront of talasoterapia in the region. These therapeutic applications promise to beautify the body while fine tuning it to work at peak performance.