How do rheumatic diseases affect the eyes. What are the common inflammatory eye conditions associated with rheumatic disorders. How are these eye conditions diagnosed and treated. What is the impact of eye inflammation on quality of life in rheumatic disease patients. How can early detection and management improve outcomes in ocular inflammation.

Overview of Ocular Inflammation in Rheumatic Diseases

Inflammatory eye conditions are a significant complication of many rheumatic diseases, potentially leading to vision impairment and reduced quality of life. Understanding the causes, symptoms, and treatment options for these ocular manifestations is crucial for both patients and healthcare providers.

Rheumatic diseases such as rheumatoid arthritis, juvenile idiopathic arthritis, and Sjögren’s syndrome can affect various parts of the eye, including the cornea, sclera, and uvea. These inflammatory processes can result in conditions like uveitis, scleritis, and keratoconjunctivitis sicca.

Prevalence and Impact

Studies have shown that ocular inflammation is a common complication in rheumatic diseases. For instance, uveitis occurs in up to 30% of patients with juvenile idiopathic arthritis. The impact on vision can be severe, with some studies reporting blindness rates of up to 10% in patients with intraocular inflammatory diseases.

Common Ocular Manifestations in Rheumatic Diseases

Several eye conditions are frequently associated with rheumatic diseases. Understanding these manifestations is essential for early detection and management.

Anterior Uveitis

Anterior uveitis, inflammation of the front part of the eye, is one of the most common ocular manifestations in rheumatic diseases. It can cause symptoms such as eye pain, redness, and photophobia.

Keratoconjunctivitis Sicca

Also known as dry eye syndrome, keratoconjunctivitis sicca is particularly common in Sjögren’s syndrome. It can lead to eye discomfort, burning sensation, and vision fluctuations.

Scleritis

Inflammation of the sclera (the white part of the eye) can occur in rheumatoid arthritis and other connective tissue diseases. Scleritis can cause severe eye pain and redness.

Diagnosis and Screening of Ocular Inflammation

Early diagnosis of ocular inflammation is crucial for preventing vision loss. Regular screening and proper diagnostic techniques play a vital role in managing these conditions.

Screening Recommendations

Are there specific screening guidelines for ocular inflammation in rheumatic diseases? Yes, particularly for conditions like juvenile idiopathic arthritis. The frequency of screening may depend on the risk factors for developing chronic iridocyclitis.

Diagnostic Techniques

Diagnosis often involves a comprehensive eye examination, including slit-lamp examination, visual acuity testing, and intraocular pressure measurement. In some cases, additional tests like optical coherence tomography or fluorescein angiography may be necessary.

Treatment Approaches for Ocular Inflammation

Managing ocular inflammation in rheumatic diseases often requires a multidisciplinary approach involving rheumatologists and ophthalmologists.

Topical and Systemic Corticosteroids

Corticosteroids are often the first-line treatment for acute ocular inflammation. They can be administered topically, orally, or through local injections, depending on the severity and location of inflammation.

Immunosuppressive Therapy

In cases where corticosteroids are insufficient or contraindicated, immunosuppressive drugs may be necessary. These medications can help control inflammation and prevent long-term complications.

Biological Agents

Newer biological therapies, such as TNF-alpha inhibitors, have shown promise in managing severe or refractory ocular inflammation associated with rheumatic diseases.

Complications and Long-term Outcomes

Ocular inflammation in rheumatic diseases can lead to various complications if not properly managed. Understanding these potential outcomes is crucial for patient care.

Vision Loss and Blindness

Severe or recurrent inflammation can result in permanent vision loss. Studies have shown that blindness can occur in a significant percentage of patients with intraocular inflammatory diseases.

Cataract Formation

Both the inflammatory process itself and long-term corticosteroid use can increase the risk of cataract formation in patients with rheumatic diseases.

Glaucoma

Ocular inflammation and its treatment can lead to increased intraocular pressure, potentially resulting in glaucoma.

Quality of Life Considerations

The impact of ocular inflammation on patients’ quality of life is significant and multifaceted.

Visual Function and Daily Activities

How does ocular inflammation affect daily life? Vision impairment can significantly impact a person’s ability to perform routine tasks, read, drive, and work effectively.

Psychological Impact

The chronic nature of ocular inflammation and the fear of vision loss can lead to anxiety and depression in some patients. Addressing these psychological aspects is an important part of comprehensive care.

Advances in Research and Future Directions

Ongoing research in ocular inflammation associated with rheumatic diseases is paving the way for improved diagnostic and treatment options.

Biomarkers and Genetic Studies

Research into biomarkers and genetic factors may help identify patients at higher risk of developing ocular inflammation, allowing for more targeted screening and preventive strategies.

Novel Therapeutic Approaches

Emerging therapies, including new biological agents and targeted small molecules, hold promise for more effective and less toxic treatments for ocular inflammation.

Patient Education and Self-Management

Empowering patients with knowledge about their condition is crucial for optimal management of ocular inflammation in rheumatic diseases.

Recognizing Warning Signs

Patients should be educated about the early symptoms of ocular inflammation, such as eye redness, pain, or vision changes, and instructed to seek prompt medical attention when these occur.

Adherence to Treatment

The importance of adhering to prescribed treatments, including regular use of eye drops and attending follow-up appointments, should be emphasized to patients.

Ocular inflammation in rheumatic diseases presents a complex challenge that requires a collaborative approach between rheumatologists, ophthalmologists, and patients. Early detection, appropriate treatment, and ongoing monitoring are key to preserving vision and maintaining quality of life. As research continues to advance our understanding of these conditions, we can hope for more targeted and effective therapies in the future.

The management of ocular inflammation in rheumatic diseases extends beyond medical treatment. It involves a holistic approach that considers the patient’s overall health, lifestyle, and psychological well-being. Regular follow-ups, patient education, and support systems play crucial roles in achieving optimal outcomes.

Are there specific lifestyle modifications that can help manage ocular inflammation in rheumatic diseases? While not a replacement for medical treatment, certain lifestyle changes can complement therapy. These may include maintaining good eye hygiene, using protective eyewear, avoiding smoking, and managing stress. A balanced diet rich in anti-inflammatory foods may also be beneficial, although more research is needed to establish definitive dietary recommendations.

The relationship between systemic disease activity and ocular inflammation is an area of ongoing research. Some studies suggest that control of the underlying rheumatic disease can help manage ocular symptoms, while others indicate that eye inflammation may occur independently of systemic disease activity. This highlights the need for comprehensive care that addresses both ocular and systemic manifestations of rheumatic diseases.

Pediatric patients with rheumatic diseases and ocular inflammation require special consideration. The impact of chronic eye conditions on a child’s development, education, and social interactions can be significant. Early intervention and close collaboration between pediatric rheumatologists, ophthalmologists, and other healthcare providers are essential for optimal management in this population.

The role of telemedicine in managing ocular inflammation in rheumatic diseases is an emerging area of interest, particularly in light of recent global health challenges. While in-person examinations remain crucial for comprehensive eye care, telemedicine may offer opportunities for remote monitoring, patient education, and follow-up in select cases.

As our understanding of the pathogenesis of ocular inflammation in rheumatic diseases continues to evolve, so too do the therapeutic approaches. The development of more targeted therapies aims to provide effective control of inflammation while minimizing side effects. This personalized medicine approach holds promise for improving outcomes and quality of life for patients with these complex conditions.

The economic impact of ocular inflammation in rheumatic diseases is substantial, encompassing direct medical costs, lost productivity, and long-term care needs. Early diagnosis and effective management not only improve patient outcomes but may also reduce the overall economic burden associated with these conditions.

Patient advocacy groups play an important role in supporting individuals with rheumatic diseases and associated ocular complications. These organizations can provide valuable resources, promote awareness, and advocate for research funding and improved access to care.

The field of ocular inflammation in rheumatic diseases continues to evolve, with ongoing research shedding light on new aspects of these conditions. From novel diagnostic techniques to innovative treatment strategies, the landscape of care is constantly changing. Staying informed about these developments is crucial for both healthcare providers and patients.

What is the role of imaging techniques in managing ocular inflammation in rheumatic diseases? Advanced imaging modalities such as optical coherence tomography (OCT) and fluorescein angiography can provide valuable information about the extent and progression of ocular inflammation. These techniques allow for more precise monitoring of disease activity and treatment response.

The concept of treat-to-target, widely applied in rheumatology, is increasingly being considered in the management of ocular inflammation. This approach involves setting specific treatment goals, such as complete resolution of inflammation or preservation of visual acuity, and adjusting therapy accordingly. Implementing treat-to-target strategies in ocular inflammation may lead to improved long-term outcomes.

The potential role of the microbiome in ocular inflammation associated with rheumatic diseases is an emerging area of research. Some studies suggest that alterations in the gut or ocular microbiome may influence inflammatory processes. While this field is still in its early stages, it may open up new avenues for therapeutic interventions in the future.

Patient-reported outcomes are gaining importance in the assessment and management of ocular inflammation in rheumatic diseases. These measures provide valuable insights into the impact of the condition on patients’ daily lives and can help guide treatment decisions. Incorporating patient-reported outcomes into clinical practice and research can lead to more patient-centered care.

The intersection of ocular inflammation and other comorbidities in rheumatic diseases is an important consideration. Patients with rheumatic diseases often have multiple health conditions, and the presence of ocular inflammation can complicate management. A comprehensive approach that addresses all aspects of a patient’s health is essential for optimal outcomes.

As we continue to advance our understanding and management of ocular inflammation in rheumatic diseases, the importance of a multidisciplinary approach cannot be overstated. Collaboration between rheumatologists, ophthalmologists, immunologists, and other specialists is crucial for providing comprehensive care and advancing research in this field.

The future of managing ocular inflammation in rheumatic diseases looks promising, with ongoing research into new therapies, improved diagnostic techniques, and a better understanding of disease mechanisms. However, challenges remain, including the need for more personalized treatment approaches and strategies to prevent long-term complications.

Education and awareness about ocular inflammation in rheumatic diseases are crucial, not only for patients but also for healthcare providers across various specialties. Recognizing the signs and symptoms of ocular involvement can lead to earlier diagnosis and intervention, potentially preventing serious complications.

The global burden of ocular inflammation in rheumatic diseases varies across different populations and healthcare systems. Addressing disparities in access to care and developing strategies for managing these conditions in resource-limited settings are important considerations for improving global eye health.

As we look to the future, the integration of artificial intelligence and machine learning in diagnosing and monitoring ocular inflammation in rheumatic diseases holds promise. These technologies may enhance our ability to detect subtle changes, predict disease progression, and optimize treatment strategies.

The journey of managing ocular inflammation in rheumatic diseases is ongoing, with each advancement bringing us closer to better outcomes for patients. Through continued research, collaboration, and patient-centered care, we can hope to reduce the burden of these conditions and improve the quality of life for those affected.

Inflammatory conditions of the eye associated with rheumatic diseases

Costochondritis: Causes, symptoms, and treatment

Costochondritis is an inflammation of the cartilage connecting the ribs to the breastbone. It can cause a stabbing, burning, or aching pain in the chest wall, especially around the second to fifth ribs. Coughing and a blow to the chest are among the causes.

The ribs are connected to the breastbone by tough, protective tissue called cartilage. When this cartilage becomes inflamed, the condition is known as costochondritis or chest wall pain.

While this condition is usually temporary, it can be alarming, as the pain can become so significant it mimics a heart attack.

Doctors may also refer to costochondritis as costosternal syndrome or costosternal chondrodynia. The condition will usually resolve on its own with home treatments.

Fast facts on costochondritis

• In many cases, doctors do not know what causes costochondritis.
• Pain in the chest and breastbone area is the chief symptom of costochondritis.
• The pain may be so severe that the person feels they are having a heart attack.
• Treatment includes anti-inflammatory medications.

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Share on PinterestUsually costochondritis will resolve itself with home treatment, and is a temporary condition.

Though causes are often unknown, in some instances, the condition can be the result of one or more of the following:

• history of an illness that causes a lot of coughing
• heavy lifting or strenuous exercise, involving the upper extremities and chest wall
• carrying heavy bags, such as a heavy backpack on one side or the other
• having large breasts
• history of chest injuries or chest infections
• undergoing surgery that affects the chest wall, such as cardiac bypass

Doctors call costochondritis that has no known causes idiopathic costochondritis.

Chest discomfort and pain may be stabbing, burning, or aching in nature. The ribs most affected are the second to fifth ones.

The condition most commonly affects those older than age 40, according to an article in the journal American Family Physician. An estimated 13-36 percent of those who seek emergency medical attention for chest pain are experiencing costochondritis.

The following activities usually worsened the pain associated with costochondritis:

• significant amount of coughing
• strenuous exercise
• physical activity using the upper arms, such as lifting boxes

The pain associated with costochondritis usually occurs on the left side of the body but can affect both sides.

Tietze syndrome

There is a variation of costochondritis called Tietze syndrome. This condition causes pain associated with costochondritis, as well as swelling of the rib cartilage.

The swelling of Tietze syndrome affects at least one of the upper four ribs, usually the second or third ribs. While the pain associated with costochondritis may subside with time, some people with Tietze syndrome will still experience the swelling.

Although doctors have not defined how prevalent this condition is, they do consider it to be a rare disorder. Other than pain and discomfort, it does not cause any long-term harmful effects.

Share on PinterestThe symptoms of costochondritis can be worsened by certain activities, such as lifting heavy objects, or strenuous coughing.

Doctors usually treat costochondritis conservatively. Resting and avoiding strenuous exercise that affects the chest wall can help. So can over-the-counter pain relievers, such as ibuprofen or acetaminophen.

Children under age 18 should not take aspirin due to the increased risk for Reye’s syndrome.

In rare instances, a doctor may recommend injections of lidocaine or corticosteroids to reduce pain and inflammation. Other treatments that may help to relieve chest pain include:

• Applying moist heat by way of warm compresses.
• Taking cough suppressants to ease coughing and reduce pressure to the cartilage.
• Physical therapy to ease tension in the chest wall.

If these treatments do not reduce a person’s incidence of costochondritis, they should seek a follow-up with their doctor.

If a person is having chest pain, they should not try to determine for themselves if it is a heart-related issue or costochondritis. Instead, they should seek immediate medical attention.

If a younger person who is not at risk of heart attack experiences these symptoms, they should seek emergency attention if their chest pain is sharp and does not improve with rest.

If someone has gone to a doctor for their symptoms and has been diagnosed with costochondritis, there are still some instances when a person should seek immediate medical attention again. These include:

• feeling faint, dizzy, or lightheaded
• feeling as if the heart is beating irregularly or too fast
• pain that worsens over time or cannot be relieved by pain medicine
• having a shortness of breath
• a fever that is higher than 100. 4 °F in an adult
• coughing up dark-colored sputum or blood

If the chest pain is radiating to the arms, neck, shoulder, jaw, or back, a person should seek immediate medical attention.

Share on PinterestSome conditions may seem similar to costochondritis, including an injured shoulder or neck, or arthritis of the surrounding joints.

Doctors often diagnose costochondritis by ruling out other potential causes of the chest pain and discomfort connected with the condition. For example, if a person is older than 35, a doctor may first want to rule out coronary artery disease (CAD), as a potential cause.

Individuals who are at risk of CAD, such as those with a family history, those who are obese, or those with a history of smoking, should usually have an electrocardiogram (ECG or EKG) and chest X-ray to check for CAD.

Other medical conditions that may closely resemble costochondritis include:

• arthritis of the shoulder or nearby joints
• chest wall infections or cancer
• fibromyalgia, a condition that causes nerve pain
• slipping rib syndrome, when there is too much mobility in the cartilage supporting the ribs
• injuries to the shoulder or neck that causes pain to refer or travel to the chest wall

A physical examination to detect tenderness of the cartilage to the touch may also be performed. If a person is having a heart attack or has another type of heart condition, the cartilage in the chest is not usually sensitive to the touch.

A doctor will also listen to the heart and lungs, as well as examine the skin for any signs of infection. An X-ray or other imaging studies will not show signs of costochondritis.

Doctors can usually diagnose a child, adolescent, or young adult by asking questions about their medical history and by conducting a physical exam. The doctor will often check for tenderness in the chest cartilage, as part of this.

According to American Family Physician, costochondritis can last anywhere from a few weeks to months. It may also recur if it has been caused by physical exercise or strain.

The condition does not usually last longer than one year. However, adolescents with costochondritis can sometimes have a longer period of symptoms.

90,000 legendary commandant: Life and death of Fidel Castro

https://ria.ru/20210813/kastro-7455572100. html

Legendary Castille Castro

Legendary Kastel – RIA Novosti, RIA Novosti, RIA Novosti, RIA Novosti 08/13/2021

The legendary Comandante: the life and death of Fidel Castro

Cuban revolutionary Fidel Castro would have turned 95 on August 13. Five years ago, the world saw off the legendary Comandante on his last journey.

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He died a natural death at an advanced age despite numerous attempts on his life. According to the leadership of Cuba’s counterintelligence service, there were more than 600 attempts to assassinate Castro. They tried to shoot the revolutionary, poison him with toxic substances and poisons.

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The legendary Comandante: the life and death of Fidel Castro

Cuban revolutionary Fidel Castro would have turned 9 on August 135 years. Five years ago, the world saw off the legendary Comandante on his last journey. He died a natural death at an advanced age despite numerous attempts on his life. According to the leadership of Cuba’s counterintelligence service, there were more than 600 attempts to assassinate Castro. They tried to shoot the revolutionary, poison him with toxic substances and poisons.

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Video, Cuba, Fidel Castro

The legendary Comandante: the life and death of Fidel Castro

Cuban revolutionary Fidel Castro would have turned 95 on August 13. Five years ago, the world saw off the legendary Comandante on his last journey.

2021-08-13T07:47

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Fidel Castro: Biography, education, family

Former President of the Council of State of Cuba

Leader of Cuba from 1959 to 2008. Formerly Prime Minister of Cuba (1959-1976), Chairman of the Council of State of Cuba (1976-2008). In 1953, he led an unsuccessful coup attempt against Cuban dictator Fulgencio Batista, after which he spent two years in prison. Came to power after the overthrow of Batista at 1959 year. Acted as an opponent of the United States and established allied relations with the USSR. Since 1965, he headed the Communist Party of Cuba, actually relinquished these functions in 2006 due to illness and hospitalization, and temporarily transferred power to his brother Raul Castro. In 2008, Raúl Castro was elected as the new President of the Council of State and Commander-in-Chief of the Cuban Armed Forces, and in 2011 as General Secretary of the Cuban Communist Party.

Fidel Alejandro Castro Ruz was born on August 13, 1926 years old in the town of Biran in Cuba, in the family of the owner of a sugar plantation [15], [21], [14], [23], [17]. From 1945 he studied at the Faculty of Law of the University of Havana. After graduating in 1950, he took up private legal practice [15], [21], [14], [22], [23], [17]. In his student years, Castro was a political activist, joined the reformist Party of the Cuban People (Partido del Pueblo Cubano), also known as the Party of the Orthodox (Partido Ortodoxo) [22], [23]. Participated in an unsuccessful attempt to overthrow the dictator of the Dominican Republic Rafael Trujillo (Rafael Trujillo) [23], [17]. Castro’s plans included winning a seat in the Cuban parliament, but at 19Fulgencio Batista returned to power in 1952 after an eight-year hiatus. The elections were cancelled, and Castro took up revolutionary activities [15], [22], [23], [17].

On July 26, 1953, Castro led the attack of one and a half hundred young revolutionaries on the Moncada barracks near Santiago – Batista’s largest military garrison [15], [21], [14], [22], [23]. The uprising was unsuccessful, many of Castro’s associates died, he himself was arrested and in October 1953 was sentenced to 15 years in prison [15], [21], [14], [22], [23], [17]. At the trial, he delivered a speech that became known as “History will justify me” and contained accusations against the Batista regime and a call for democratic reforms [23], [21], [17]. May 19For 55 years, under pressure from public opinion, the Cuban authorities pardoned Castro, and he emigrated to Mexico, where he organized the “26 July Movement” (Movimiento 26 de Julio), named in memory of the 1953 uprising [15], [21], [14], [22], [23]. In 1956, a group of revolutionaries, including Fidel, his brother Raul Castro, and the Argentine Ernesto “Che” Guevara, arrived in Cuba on the yacht Granma. Only a few managed to escape from the persecution of Batista’s forces, but the guerrilla movement started by them in the Sierra Maestra mountains quickly grew and gained popularity [15], [14], [22], [23], [17]. At first, the United States helped Batista’s forces in the fight against partisans [23], but in 19In 58, American military assistance to the dictator ceased [15], [23]. On January 1, 1959, Castro’s rebel forces occupied Havana, Batista fled to the Dominican Republic [15], [21], [14], [22], [23]. In the following week, a new government was formed. Castro became commander-in-chief of the armed forces, and in February took over as prime minister [15], [21], [23], [17]. Later, in 1976, a new Cuban constitution was adopted, and Fidel took over as chairman of the Council of State [15], [23].

From May 1959, the Castro government began expropriating American property in Cuba [15], [23]. In June 1960, after US President Dwight Eisenhower imposed a quota on imports of Cuban sugar, the Cuban authorities nationalized the property of American enterprises worth about $850 million [15]. Tension in relations with the United States prompted Fidel to move closer to the USSR [22], [23]. April 14 (according to other sources, April 16 [17]), 1961, Castro proclaimed the Cuban revolution socialist [15], [23] (previously it was only about moderate politics, national representative democracy and a well-organized economy [14], [22] ).

On April 15, 1961, the United States bombed Cuban airfields [15], and on April 17, about 1,400 Cuban emigrants, trained and organized by the CIA, landed in Playa Giron (Bay of Pigs, Playa Giron). Their goal was to initiate a mass uprising against the Castro government [15], [14], [22], [23]. US President John F. Kennedy only at the last moment abandoned the idea of ​​supporting this enterprise with the help of the US military [15]. On April 21, 1961, Castro’s troops successfully repelled the attack and captured about a thousand prisoners [15], [14], [23]. February 7 19For 62 years, in connection with the ongoing nationalization of American property in Cuba, the United States imposed a trade embargo against the country [15].

In October 1962, the Cuban Missile Crisis occurred, bringing the world to the brink of nuclear war. On October 14, a US reconnaissance aircraft spotted Soviet intercontinental ballistic missiles in Cuba. On October 22, Kennedy announced this in a public address. On October 27, an American U-2 reconnaissance aircraft was shot down over Cuba. On October 28, after tense negotiations, Kennedy and Soviet leader Nikita Khrushchev were able to reach a resolution to the crisis: the USSR withdrew missiles from Cuba, the United States, in response, abandoned plans for a military invasion of the island and withdrew nuclear weapons from Turkey [15], [14], [22], [23].

During the same period, active party building took place in Cuba. In 1961, several political parties formed the United Revolutionary Organizations (Organizaciones Revolucionarias Integradas) movement, on the basis of which the United Party of the Cuban Socialist Revolution (Partido Unido de la Revolucion Socialista de Cuba; PURSC) was created in 1962 [24]. Castro became the general secretary of the party [17]. In the fall of 1965, PURSC was transformed into the Communist Party of Cuba (Partido Comunista de Cuba), and Castro became the first secretary of the party’s Politburo [17], [24].

In November 1966, US President Lyndon Johnson announced an amnesty for illegal immigrants from Cuba who left the country after the 1959 revolution. About 125 thousand people took advantage of the amnesty [15]. In addition, from December 1965 to April 1973, the United States conducted an air evacuation of Cubans wishing to leave the country: their number was more than 260 thousand people [15].

On November 11, 1975, rebels from the Popular Movement for the Liberation of Angola (Movimento Popular de Libertacao de Angola, MPLA), with intense support from Cuba, captured the Angolan capital of Luanda and proclaimed the independence of their country from Portugal [15], [22], [23]. The military presence of Cuba in Angola remained until 1988 years old [15]. In addition, the Cubans provided assistance to the rebels in other countries – Ghana, Algeria, Mozambique, Nicaragua and El Salvador [14], [23]. At the same time, under the leadership of Castro, Cuba became a key participant in the international non-aligned movement [14], [23].

On November 20, 1975, the United States released information about eight unsuccessful attempts on the life of Castro, undertaken by the CIA from 1960 to 1965 [15]. According to Cuban authorities, during the years of Fidel’s rule, the CIA made more than 600 attempts to kill him [14].

Under the leadership of Fidel, Cuba achieved significant success in the social sphere. Cubans enjoy free healthcare, the literacy rate reaches 98 percent, and the infant mortality rate in Cuba is lower than in many Western countries [14]. At the same time, the Cuban economy was dependent on the country’s alliance with the USSR. During the Cold War, the Soviet Union bought most of the sugar produced by Cuba and supplied various goods to the island, which helped to overcome the consequences of the American blockade [14]. With the beginning of the Soviet “perestroika”, sugar purchases ceased [14], and after the collapse of the USSR in 19In 1991, advisers from the USSR who worked in Cuba left the island [15]. The cessation of Soviet economic aid led to a recession in the Cuban economy, an increase in the shortage of food and consumer goods, and, as a result, to the flourishing of the black market [15], [14], [22], [23]. The Castro government was forced to make significant concessions, allowing foreign investment in certain sectors of the economy, in particular tourism, and then allowing foreign currencies to circulate in the country [23].

Economic difficulties caused an increase in the number of refugees, many of whom died trying to reach the US coast on boats and other improvised watercraft [14], [15], [23]. 9September 1994, Cuba and the United States entered into an agreement under which the number of Cuban immigrants accepted by the United States was limited to 20 thousand people per year [15]. In January 1996, Miami-based Cuban dissident Brothers to the Rescue (Hermanos al Rescate) dropped leaflets over Havana calling for the overthrow of Castro. One of the two American aircraft used for this was shot down by Cuban air defenses, after which, on February 24, the United States made the trade embargo against Cuba permanent [15].

In January 1998, Pope John Paul II visited Cuba and met with Fidel [23], [15], who was excommunicated in 1962 by Pope John XXIII [21]. Since the revolution, the Cuban authorities have emphasized the atheistic nature of their state, but in the mid-1990s they began rapprochement with the Catholic Church, hoping to use it to enlist international support and persuade the United States to lift the economic embargo against the country [20]. The Pope celebrated several masses in different parts of the island, each of which gathered several hundred thousand people, and during the last and largest of them, held on January 25 at the Revolution Square in Havana (Castro personally attended it), John Paul II called on the United States ease economic pressure on Cuba [19].

In October 2000, the US House of Representatives revised the trade embargo against Cuba and allowed limited supplies of food and medicine to that country [15]. Castro condemned the September 11, 2001 terrorist attacks in the United States [23]. At the same time, he spoke out against the US-led war in Afghanistan [23]. Against this background, there was a rapprochement between Cuba and Venezuela, which in 1998 was headed by anti-globalist President Hugo Chavez [14], [23], [12], [13].

In April 2004, the UN Commission on Human Rights condemned the Cuban authorities for violating human rights, including the detention of 78 members of the political opposition [15], [23].

In 2005, Forbes magazine named Castro one of the world’s richest people and estimated his personal fortune at $550 million. In 2006, it was already about 900 million. Castro was outraged by these reports and categorically denied that he received income from state-owned enterprises [15], [18].

In recent years, the world has closely followed Castro’s deteriorating health. In 2004, during a public speech, he fell, injuring his leg and arm [23]. On March 30, 2006, the Spanish-language press erroneously reported Castro’s death [15]. On July 31, 2006, an official statement from the Cuban authorities was released, announcing that Castro had undergone surgery due to gastrointestinal bleeding. He temporarily handed over power to the Minister of Defense and Vice President – his brother Raul. After that, Fidel did not participate in any public event. Although official Cuban sources claimed that the leader was on the mend, many observers questioned this information [16], [15], [14], [23].

On January 16, 2007, the Spanish newspaper El Pais reported that Fidel had survived at least three unsuccessful surgeries and was in critical condition. Cuban officials called this message false [11]. In March, official Cuban sources reported that Castro would certainly return to office in the run-up to the general elections scheduled for April 2008 [10].

On February 18, 2008, Fidel announced that he was going to step down as Chairman of the Council of State and Commander-in-Chief of the armed forces of Cuba [8], [9]. On February 24, his brother Raul Castro was elected as the new chairman of the State Council [7].

In March 2011, Castro published an article in which he, in particular, said that back in 2006, due to illness, he actually resigned from all state and party posts [6], [5]. In April of the same year, at the congress of the Communist Party of Cuba, Raul Castro was elected its general secretary instead of Fidel [3], [4].

In early February 2012, Castro presented two volumes of his memoirs under the general title “Fidel Castro Ruz: Partisan of Time”, which described the life of a politician from early childhood to December 1958 years [2], [1].

Materials used

[1] Fidel Castro presented a book of his memoirs. – BBC News, Russian Service , 02/05/2012

[2] Fidel Castro unveils 1,000-page memoir. — CNN , 02/04/2012

[3] Raul Castro Elected First Secretary of the Cuban Communist Party. — Cuban News Agency , 04/19/2011

[4] Cuban communists opt for old guard to lead party. — Reuters , 04/19/2011

[5] Fidel Castro’s announcement retirement ends of an era, spurs Cuba succession buzz. — The Associated Press , 03/22/2011

[6] Fidel Castro Ruz . Los zapaticos me aprietan. — CubaDebate , 03/21/2011

[7] Raul Castro elected president of the councils of State and Ministers. — Granma International , 02/24/2008

[8] Castro resigns as Cuban president: official media. – Agence France-Presse , 02/19/2008

[9] Fidel Castro Ruz . Reflexiones del companero Fidel. — El Mundo , 02/18/2008

[10] As Cuba prepares for 2008 vote, officials say Castro could be back. — Agence France-Presse , 03/16/2007

[11] Mar Roman . Castro reportedly in ‘grave’ condition. — The Associated Press , 01/16/2007

[12] Kirill Zubkov . Hugo Chavez goes to a new term “in the name of love.” – Newspaper (gzt.ru) , 04.12.2006. — №222

[13] Eugene Bay . Hugo Chavez casts out the devil. – Izvestia , 12/04/2006

[14] Castro: Profile of the great survivor. — BBC News , 02.12.2006

[15] Ben Brudevold-Newman .