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Introduction: Treatment of periodontal disease includes mechanical therapy complemented with antibiotics / antiseptics, which could lead to the occurrence of long-term adverse effects. Objective: Describe the pharmacological potential of the fruit of M. dubia and its use as adjunct in periodontal therapy. Methods: A review was conducted of international high impact journals from the Web of Sciences which dealt with the topic (58 journals). The databases Google Scholar, SciELO, PubMed and EBSCO were consulted, using the descriptors “review”, “phytotherapy”, “Myrtaceae”, “gingivitis”, “periodontitis”, “periodontal diseases”, anti-bacterial agents”, “anti-inflammatory agents”, “dental plaque”, “antioxidants”, “plants, toxic”, “adverse effects”. A total 517 papers were obtained, of which 60 were included in the study. 91.7 % of the papers had been published in the last three years. Data integration: A description was provided of the properties and safety of the use of M. dubia in humans. Conclusions: M. dubia has in vitro antimicrobial activity against dental biofilm microorganisms, particularly S. mutans, S. mitis and P. gingivalis to the seed hydroalcoholic extract, and S. aureus to the leaf and peel hydroalcoholic extract. Anti-inflammatory activity was also observed. Results suggest that M. dubia ethanolic extract could be incorporated into oral antiseptics, given its antibiofilm and anti-inflammatory potential.

Introduction: Hemophilia is a genetic disease scarcely found in dental practice. On occasion it presents as a dental emergency in face of which the professional should relate the general clinical manifestations of the disease to an appropriate semiological, paraclinical and genetic-molecular analysis to diagnose the condition and apply relevant therapies aimed at solving the patient's main concern as well as managing and controlling its complications. Objective: Describe the main general pathophysiological features and aspects of dental interest of hemophilia, as well as the diagnostic tools related to the condition from a clinical, paraclinical and genetic-molecular perspective. Methods: A bibliographic search was conducted in the databases Pubmed, Proquest, Scielo and Elsevier of papers published in English and Spanish in a period of 13 years (2005-2018), using the search terms "hemophilia A", "hemophilia B", "diagnostic criteria", "genetic", "molecular", "oral health", "clinical diagnosis". A total 50 papers were selected. Data analysis and integration: Studies have shown that hemophilia, a genetic systemic condition, may have oral manifestations and complications. This makes it important to dentists, since the disease should be diagnosed from a genetic-molecular point of view and managed in an interdisciplinary manner. Conclusions: Genetic-molecular diagnosis by geneticists implies involvement of hematologists and dentists in the management and control of the condition via interconsultation, when it comes to deciding on procedures for hemophilic patients.

Introduction: Bibliometric studies provide an interesting overview of the topic under analysis, thus attesting to its importance. Objective: To describe the Cuban scientific production ouput indexed in Scopus in the category Dentistry in the period 1995-2016. Methods: A search was conducted to identify publications indexed in Scopus under the category of dentistry in which at least one author was of Cuban professional affiliation. The bibliometric indicators of output, visibility and impact were addressed. Results: 518 papers were published (449 original), which have an h-index of 16 and have received 1 465 citations (207 self-citations). 2015 was the year when the largest number of papers was published (n= 51, 9.85 %). 53.86 % of the papers (n= 279) have been cited, and the average number of citations per document was 2.83. There was a predominance of papers published in Spanish in the Revista Cubana de Estomatología (n= 448, 86.49 %). In 15.64 % of the papers (n= 81) at least one author had been affiliated with the former Higher Institute of Medical Sciences of Havana, currently University of Medical Sciences of Havana. The most productive researcher was Daniele Botticelli, with 47 papers which have received 408 citations and have an h-index of 12. Conclusions: Cuban scientific production about dentistry exhibits a growing tendency characterized by the publication of original papers in Spanish in fourth quartile journals.

Critical reading of scientific papers and publication of letters to the editor are skills to be developed in undergraduate training. Such early command would improve scientific communication when master's degree and PhD programs are undertaken. By then, scientific communication skills should be well formed and in ideal conditions for their broadening. The present communication intends to contribute some considerations about critical reading and submission of letters to the editor as a new section available in the Cuban Journal of Dentistry. In the context of Cuban dentistry, publication of this sort of papers is scarce. Therefore, the Cuban Journal of Dentistry has decided to open this new section with the purpose of contributing to scientific debate for the benefit of the health of the population. The space will be an open, necessary framework for the conduct of debates aimed at improving Cuban and worldwide dental science. Researchers are encouraged to make this new section their own, for the benefit of the health of our populations.

Introduction: Malocclusion is triggered by rupture of the balance between extraoral and intraoral forces as a result of an anomalous function. Such anomalous muscular functions are known as harmful oral habits. Objective: Update knowledge and analyze factors related to dental malocclusions, such as harmful oral habits in children, in terms of the frequency and duration of nutritive and non-nutritive sucking, mouth breathing and atypical tongue thrust. Methods: A bibliographic review was conducted of papers published in the last five years in the digital databases Pubmed, Lilacs, Ibecs and Cumed. The search terms used were malocclusion, habits, finger sucking, pacifiers, bottle feeding, tongue habit and mouth breathing in English, and maloclusión, hábitos, succión del dedo, chupete, biberones, hábitos linguales and respiración por la boca in Spanish. 65 papers were obtained, of which only 39 met the inclusion criteria. Data analysis and integration: 89.5 % of the papers corresponded to studies about non-nutritive sucking habits alone or in combination with other habits, whereas 10.5 % dealt with studies about mouth breathing children. Only 26.31 % of the studies selected took into account the variables duration and frequency of the habits. Nutritive sucking habits were found to be associated with overjet, posterior crossbite and distal step. A relationship was also found between a short breastfeeding period and the prevalence of non-nutritive sucking habits, with the presence of anterior open bite alongside the aforementioned malocclusions. Mouth breathing was related to class II, small retrognathic jaw and a decreased lower third of the face. Conclusions: Numerous studies have been conducted to determine the relationship between malocclusions and the duration of nutritive and non-nutritive sucking habits, without considering the frequency of such habits. On the other hand, the electronic databases consulted contain few studies about mouth breathing and atypical tongue thrust in children.

Peer reviewing scientific journals consists in a critical examination of papers seeking scientific validation of their quality for national and international dissemination, thus contributing to the development of the field of science in question. Therefore, the work of peer reviewers and editors in scientific journals requires systematic comprehensive training, responsibility, honesty and a high level of altruism, among other values, for they are in charge of passing objective and educational judgment on the papers evaluated, a task they often perform after fulfilling their occupational obligations. Perfecting peer reviewing is crucial to improve the performance of the journal and raise its quality. This is the reason why it was decided to develop the present guide to train reviewers of the Cuban Journal of Dentistry in the management of the Open Journal System during the process of scientific paper review.

Introduction: bibliometric studies are tools allowing analysis of the scientific production of institutions. Objective: characterize the bibliometric behavior of the scientific production at the School of Dentistry in the period 2011-2015. Methods: a descriptive bibliometric study was conducted. The study universe was composed of 696 papers published in the study period and included in the corresponding databases. The variables analyzed were publications per year, publication type, topic dealt with, place of publication, teaching category of the first author and productivity per author. Results: a total 696 scientific papers were published in the period, 44.2 % of which dealt with clinical pathology and 18.5 % with teaching. 64.5 % were original papers, 17.5 % were bibliographic reviews, 9.3 % were case reports, 1.2 % were bibliographic sketches and 1.2 % were editorials. 53.4 % of the first authors were Associate Professors. 52.4 % of the papers had been published in scientific journals. Ten professors were the most productive with 101 papers, for 18.0 % of the total number. Conclusions: scientific production has remained at a similar level for years. More than half the papers were published in peer-reviewed journals. There was a prevalence of clinical pathology and teaching subjects. Most of the papers were original. A predominance was found of first authors with the category of Assistant Professor. The most productive professors at the school published almost one fifth of all the papers.

Introduction: Endodontic sealers play a crucial role in sealing, for they not only act at the moment of their application, but continue to do so later, protecting the apical periodontium against microbial organisms. One of the properties desired in endodontic sealers is precisely their antimicrobial action against bacteria remaining after irrigation and instrumentation. Objective: Carry out a systematic review about the antibacterial effect of the endodontic sealers most commonly used in dental practice against Enterococcus faecalis (E. faecalis). Methods: The systematic review was based on PRISMA guidelines. The search was conducted in the databases PubMed and Science Direct. Papers were reviewed which dealt with in vitro antimicrobial studies about endodontic sealers, excluding secondary sources such as literature reviews and papers about cements used for other purposes. Discussion: Cements based on calcium hydroxide, resin or bioceramic are biocompatible and display some percentage of antimicrobial activity. However, variability was observed in the results obtained by the studies in the review, due to the use of different conditions for antibacterial evaluation, except for silicone-based endodontic sealers, which consistently displayed no antibacterial activity against E. faecalis. Conclusion: According to the bibliography reviewed, the sealers AH Plus, AH 26, TotalFill, BC Sealer and MTA Fillapex had an antimicrobial effect. However, some of them displayed scant activity against E. faecalis.

Introduction: Intraoral scanners are devices that emerged as an alternative to conventional impression methods. A variety of studies have been conducted to evaluate the actual effectiveness of this technology and its clinical applicability. Objective: Analyze the results obtained by studies about intraoral scanners in the area of implantology in terms of types, accuracy, working time, and operator and patient preference. Methods: A search was conducted in the databases PubMed and SciELO using the following descriptors: “intraoral AND scanner AND implant”, “digital AND scanner AND implant” and “digital AND impression AND implant” in English, Portuguese and Spanish. The inclusion criteria were the following: clinical or laboratory papers evaluating the use of digital implant scanning technique, full access to the paper, written in Portuguese, English or Spanish and published as of the year 2013. Data analysis and integration: Of the 158 papers obtained and analyzed, 35 were selected: 28 laboratory and 7 clinical. Despite the limitations in the standardization of the studies, we perceive the potential and viability of the digital technique, with favorable clinical and accuracy results, as well as advantages such as a reduction in work time and stages, dynamic communication with laboratories, preference by patients and dental students and ease of technical incorporation by experienced dentists. Conclusions: Laboratory studies indicate that, in addition to the advantages concerning the use of impression materials, communication with laboratories and ease of manipulation, the digital technique may achieve better results than conventional impression techniques. The use of intraoral scanners is therefore a promising technique for the area of implantology. However, further studies should be conducted, especially in vivo, to evaluate the consistency of the clinical results obtained.

Introduction: Malignancy of dentigerous cyst into primary intraosseous carcinoma is infrequent and scantily documented in the literature. It represents 1% to 2.5% of the total odontogenic tumors and is exclusive of maxillary bones. It is more common among men aged around 50 years. Its clinical characteristics are edema, tooth mobility and paresthesia, and in most cases an absence of pain. These features hamper its diagnosis and pose a challenge to pathologists. Objective: Review the prevalence of primary intraosseous carcinoma derived from dentigerous cysts as published in PubMed in the last 15 years. Methods: A literature review was conducted of papers published in the last 15 years. The database PubMed was consulted using the following search terms: “dentigerous cyst prevalence”, “primary intraosseous squamous cell carcinoma”, “dentigerous primary intraosseous squamous cell carcinoma”. The papers included were in English or Spanish. Of the 217 papers obtained, 39 were selected for data crossing. Data analysis and integration: Recognition of a condition as aggressive as primary intraosseous carcinoma derived from a dentigerous cyst requires examination of its clinical and radiographic characteristics as well as its symptoms. Its close relationship to dentigerous cyst, the most prevalent of developmental cysts, makes it necessary to gain an accurate and deep understanding of both. Primary intraosseous carcinoma poses a challenge to clinicians due to its low symptomatology and poor survival. Of the total 44 823 odontogenic cysts studied, 9 806 were diagnosed as dentigerous cysts and 22 maligned into primary intraosseous carcinoma, for 0.32% of the total. Conclusions: Malignation of a dentigerous cyst into primary intraosseous carcinoma has a low incidence and a silent presentation, which hampers its early diagnosis. Protocol biopsy is recommended for each case of dentigerous cyst to prevent the poor survival caused by primary intraosseous carcinoma.

Introduction: Oral halitosis or malodor is offensive to the human sense of smell. It is often the result of poor hygiene or lifestyle and affects thousands of people worldwide. Objective: Conduct a literature review about the etiology, diagnosis and treatment of halitosis with the purpose of contributing a broader scientific basis of updated information for professionals in the field. Methods: The study was characterized by a search for papers published in the electronic databases PubMed, Lilacs, Google Scholar and Scielo between 2014 and 2019 in English, Portuguese or Spanish. A total 52 papers were consulted, of which 28 were selected after careful filtering. Data analysis and integration: Halitosis may be due to a variety of oral cavity etiologies. Several complementary tests are available which help diagnose halitosis, e.g. sialometric tests, organoleptic tests and analysis of the presence of saburra for the diagnosis. Several protocols have been implemented for the treatment of halitosis. These range from preventive to healing procedures. Conclusions: The etiology of halitosis may be due to physiological or pathological factors. Although 90% of the cases originate in the oral cavity and may be associated with dental biofilm, caries, tongue saburra, ill-fitted prostheses or tissue scarring, diagnosis should be based on careful clinical examination. Using questionnaires to gather information such as frequency, duration, number of times it appears on the same day, habits and medications will help elucidate the case. Successful treatment depends on the diagnosis and implementation of a cause-and-effect therapy and a rational multidisciplinary approach which is essential to obtain positive outcomes and improve oral health as well as its individual and social effects.

Introduction: midface fractures are a serious medical problem due to their complexity, frequency and socioeconomic impact. Objective: conduct a literature review about the anatomical considerations, diagnosis, classification, treatment and complications of midface fractures. Methods: A literature review was conducted in September 2016. The evaluation included high impact journals from the Web of Science (25 journals) and 2 books. The databases MEDLINE, PubMed and SciELO were consulted, using the descriptors "maxillary fracture", "treatment", " lefort fracture". Papers written in English in the last five years were included. Of the 98 papers obtained, the study considered 40. Data analysis and integration: the middle third of the face is characterized by anatomical weakness, since it is formed by scantily protected spongy bone with multiple sutures. There are many classifications for midface fractures, and diagnosis is based on clinical findings, particularly ophthalmological, which alongside those of auxiliary diagnostic devices, make it possible to choose the most appropriate therapeutic mode and prevent complications. Conclusions: the anatomical characteristics of the facial middle third justify the frequency and impact of these fractures. Diagnosis should be based on interrogation, physical examination and the use of auxiliary diagnostic imaging, mainly tomography. Upon classification of the fracture, a treatment plan may be devised based on individual assessment of each case to prevent future complications.

Introduction: mandibular fractures are often treated by oral and maxillofacial surgery. Objective: conduct a bibliographic review about the anatomical considerations, diagnosis, classification, treatment and complications of mandibular fractures. Methods: a bibliographic review was conducted from July to August 2016. The evaluation included high impact journals from the Web of Sciences (35 journals) and 3 books. The databases MEDLINE, PubMed and SciELO were consulted, using the descriptors "mandibular fracture", " treatment", "epidemiology". Papers written in English were included, preferably if published in the last five years. Of the 120 papers obtained, the study considered 51. Data analysis and integration: anatomical considerations about the mandibular region are a starting point in this topic. Diagnosis is based on interrogation, physical examination and auxiliary diagnostic means. An accurate classification makes it possible to choose the therapy to be used and prevent complications. Conclusions: the bibliographic review permitted to confirm that there exist anatomical reasons for the high incidence of mandibular angle fractures. The first goal of interrogation is to obtain an exact patient history. The regional physical examination should be performed in an orderly, accurate manner. Panoramic radiography is a good choice of diagnostic technique. The first step in developing a treatment plan is to determine the type of lesion so as to provide an appropriate solution based on open and closed techniques, thus avoiding later complications.

Introduction: depletion of the ozone layer has brought about an increase in the incidence of skin lesions, including actinic cheilitis. Objective: describe the histological, clinical and epidemiological characteristics of actinic cheilitis based on a review of recent literature. Methods: a search was conducted in the databases PubMed, SciELO and Google Scholar using the descriptors cheilitis, keratosis, actinic, solar, and their counterparts in Spanish. The search included original papers, review papers, case reports, theses and books about the specialty preferably published from 2005 to 2014. Results: actinic cheilitis is a potentially malignant condition induced by sun exposure and characterized by micro- and macrostructural alterations of the lip. The risk factors interacting with sun exposure are the skin phototype (light skin), smoking, gender (male), age and occupation (outdoor jobs). Histological alterations include epithelial dysplasia and solar elastosis, though their severity does not correlate with the degree of clinical seriousness. Patients with actinic cheilitis present color alterations, desquamation, ulceration and blurring of the vermillion border, among other signs and symptoms. On many occasions patients do not seek care during the early stages of the disease. As a result, diagnosis is made when the condition has already evolved into cancer. The diagnosis is basically clinic, with the support of the biopsy of lesions with moderate to severe characteristics. Current therapy includes surgery and medication, as well as innovative techniques like phototherapy. The most important strategy is no doubt the use of sunscreens, especially by the population at high occupational risk. Conclusions: actinic cheilitis is a condition relevant to South American countries, since its risk factors are present in the daily activities of millions of workers from our region. It is therefore necessary to foster research aimed at improving its prevention, treatment and rehabilitation.

Introduction: minimal intervention treatments for dental caries enrich dental practice by incorporating detection, diagnosis and microscopic techniques into it. Objective: characterize minimal intervention in the treatment of dental caries by means of a bibliographic review about the subject. Methods: a review was conducted of the literature about minimal intervention in dentistry, using the search engines and platforms SciELO, Hinari and Medline. Twenty-five high impact journals were reviewed. The papers included were in English or Spanish. The descriptors used in the search wereminimal intervention, minimally invasive dentistry, cariology, minimal intervention dentistry, current treatments for dental caries and minimal intervention philosophy, as well as combinations thereof and their counterparts in Spanish. 204 papers were obtained. After being filtered, the sample was composed of 32 scientific journals and one book, i.e. the materials that approached the topic in a more comprehensive manner. 97 % of the bibliography reviewed had been published in the last five years. Data integration: an analysis was conducted about prevention, remineralization and minimal intervention techniques for the removal of dental caries. Conclusions: Minimal intervention dentistry is characterized by adopting a position in which intervention or preparation of dental tissue is the last choice of therapy resorted to after applying a whole set of prevention and remineralization techniques.

Introduction: scientific communication materializes through the publication of papers in specialized journals. This is the reason why the quantitative study of journals, known as bibliometry, is a method allowing to evaluate scientific development. Objective: determine the characteristics of scientific production about endodontics in Cuban medical journals until the present moment. Methods: a cross-sectional observational descriptive study was conducted. The study universe was composed of 22 116 papers. The study sample was all the papers about endodontics (25 papers) published by Cuban authors in Cuban medical journals until the year 2014. All papers were included irrespective of the language in which they were written. The search was conducted in SciELO, the Virtual Health Library and the SCAD service. The search terms used were endodontics, root canal treatment, pulp therapy(ies) and combinations thereof. Results: of the 25 papers about endodontics, four had been published in the last five years. The number of authors per paper was three (32 %). Most authors (24 %) were from the School of Dentistry of Havana. 83.3 % of the sample were original papers. There was a predominance of papers about therapeutics (40 %). Conclusions: cuban scientific production on endodontics is scarce. The publication with the largest number of papers on the subject is the Cuban Journal of Dentistry. Therapies are the most common topic. The most productive institution is the School of Dentistry of Havana.

Introduction: opposition to the use of animals in biomedical research is based on a variety of scientific and ethical arguments. Objective: carry out a bibliographic review about the bioethics of preclinical research in biomedical sciences. Data collection procedures: an online search was conducted for papers preferably published in the last five years. An evaluation was performed of international high impact journals from the Web of Sciences which dealt with the subject (38 journals). Databases from reference systems such as MEDLINE, PubMed and SciELO were consulted with the aid of search terms like "animal research" "ethical", "animal welfare", " animal ethics committee", "animal pain", "alternatives to laboratory animals" and their Spanish counterparts. The papers included were in English, Portuguese or Spanish. Of the 141 papers obtained, the reviewers selected the 53 which approached the study topic in a more comprehensive manner. Analysis and integration of information: an analysis of the representativeness of papers in the scientific journals where they were published showed that 5.9 % corresponded to the journal Alternatives to Laboratory Animals: ATLA, and an equal percentage to the journal Cambridge Quarterly of Healthcare Ethics. The remaining papers were evenly distributed among the other journals. Conclusions: awareness of and compliance with the bioethical principles governing the behavior of human beings and their relationship to the environment and fields of knowledge, enable a generalizing approach to and comprehensive management of significant aspects of animal research.

Introduction: bacterial dental plaque and biofilms are formed in hard and soft dental tissue alike. They are the main cause of dental caries and periodontal disease in the patients affected. Objective: identify the effect of the materials most commonly used in dental practice against the formation of bacterial dental plaque. Methods: a bibliographic review was conducted about the antibiofilm properties of the main materials used in dental practice. The inclusion criteria were the following: inhibitory properties, formation and/or development of bacterial dental plaque on the surface of dental cements used in endodontics, commonly used dental cements such as zinc oxide, polycarboxylate and glass ionomer, permanent restoration materials such as composite resins and silver amalgam. Data were obtained from the search engines and platforms SciELO, HINARI and MEDLINE. A review was conducted of 21 high impact journals dealing with the topic. About 899 papers were obtained, of which only 39 were included in the study. 52.6 % of the papers had been published in the last five years. Integration of results: a description is provided of the effect of several dental cements, materials used in endodontics and permanent restoration materials against the formation of bacterial dental plaque. Conclusions: according to the bibliographic review conducted, the materials that most commonly enable the formation of bacterial dental plaque are composite resins, followed by silver amalgam. Cements used in endodontic treatment were found to have antifilm properties, whereas cements with zinc compounds, high pH and fluoride releasing capacity exhibited optimal inhibitory and antifilm properties.

Introduction: To do research into our history is a need, since somebody has said: “…there is not possible national history without local history”. This reason and the authors’ commitment with the place where they were born are strong motivations to carry out this study. Objective: Contribute to recover the Quemado de Güines dentistry’s history. Methods: The investigation started with a documental search which confirmed there was not any official publication concerning events, people and development of dentistry in this municipality of Villa Clara province. Historical methods were used. Data´s sources were testimonies and information given by people and documents in archives, using different techniques to collect them. Results: Preliminary outcomes from documental revision, personal interviews and request are shown in this paper. There is not any official publication concerning events, important persons and evolution of dentistry in Quemado de Güines; it is proposed a division into three periods or ages to write the local dentistry´s history and it´s been proved that the first professional of dentistry who settled in this municipality was Dr. Graciela Roura Pulido, in 1928. Final considerations: So, this paper has contributed with the first notes to recover the Quemado de Güines dentistry’s history.

Introduction: maxillofacial fractures require emergency treatment by highly qualified personnel. Complications may occur which may cause the death of the patient. Objective: carry out a bibliographic review about the care of maxillofacial polytrauma patients, highlighting the following aspects of advanced trauma life support: management of neurological deficit, exposure and temperature control, annexes to primary assessment, secondary assessment, definitive treatment, associated injuries, multidisciplinary trauma team, maxillofacial traumas with distinctive characteristics, conditions influencing trauma management and prevention. Methods: a bibliographic review was conducted from December 2014 to January 2015. The evaluation included high impact journals from the Web of Sciences (39 journals), as well as one Cuban journal and five books. The databases MEDLINE, PubMed and SciELO were consulted, using the search terms "maxillofacial trauma", "advanced trauma life support", "secondary survey", "associated injuries", "multidisciplinary trauma team", "prevention", and their Spanish counterparts. The review included papers in English and Spanish, preferably published the last five years. Of the 141 papers obtained, the reviewers selected the 51 which approached the study topics in a more comprehensive manner. Data analysis and integration: analysis of the representativeness of papers in scientific journals revealed that 5.9 % corresponded to the Journal of Craniomaxillofacial Surgery. Conclusions: it is indispensable for emergency maxillofacial surgeons to be able to recognize, diagnose and determine the basic management of maxillofacial trauma. Lack of a diagnosis or inappropriate management may lead to the loss of functions and the development of secondary deformities difficult to correct in the future. Such correction could also lead to disappointing results which may risk the patient's life.

Introduction: facial traumatology is a branch of maxillofacial surgery requiring deep knowledge about disciplines such as anatomy, physiology and pathology, as well as their close relationship to other specialties, either surgical or not. Objective: carry out a bibliographic review about the care of maxillofacial polytrauma patients, highlighting aspects related to advanced trauma life support, particularly management of the airway with cervical spine stabilization, ventilation and circulation. Methods: a bibliographic review was performed which covered the period from December 2014 to January 2015. The evaluation included high impact journals from theWeb of Sciences (41 journals) and 6 books. The databases MEDLINE, PubMed and SciELO were consulted, using the search terms " maxillofacial trauma", "maxillofacial emergency", "emergency management" and "critical care", and their Spanish counterparts. The review included papers in English and Spanish, preferably published the last five years. Of the 147 papers obtained, the reviewers selected the 50 which approached the study topics in a more comprehensive manner. Data analysis and integration: Analysis of the representativeness of papers in scientific journals revealed that 6 % corresponded to the Journal of Oral and Maxillofacial Surgery. Conclusions: effective care of maxillofacial polytrauma patients ensures satisfactory results, both in the preservation of life as from an esthetic and functional point of view. It is indispensable to have a good command of advanced trauma life support guidelines, particularly the management of the airway with stabilization of the cervical spine, ventilation and circulation.

Introduction: the professional work of Dr. Pablo Valdés has a very wide spectrum and it was always being shade by his sense of responsibility, dedication and professionalism. Objective: to divulgate the educational, investigative and administrative work among other important aspect in the professional life of Dr. Pablo Valdés García. Results: in this paper, we make a brief overview of the main task assumed as a professor of under graduate and postgraduate education, chief of Conservative Department during many years and other activities that his time, commitment and his intellectual capacity allowed him. We dig in his research work in the hands of some research papers performed by him and published in some Cuban Review and in some chapters of different books used until today in the process of teaching of dentistry. We also make a brief description of his work as a member and directive of different dental societies in our country or abroad and his participation in many dental congress where his presence honor the Cuban dental school. Conclusion: Dr. Pablo Valdés García, beloved and respected professor of Comprehensive Dentistry Department had leagued his footprint in some generations of dentist, being an example of university professor and chief of department.

Introduction: bibliometric indicators allow characterizing the scientific production of a journal. Objective: describe the scientific production of the Cuban Journal of Dentistry from 2009 to 2013. Method: a descriptive, transversal study was conducted. All articles published in the Cuban Journal of Dentistry from 2009 to 2013 were selected. The type and number of papers, thematic, authors and their country of origin, bibliographyc updating, and the impact factor were variables studied. SciELO Cuba was used to obtain the information. The absolute frequencies and the percentage from the descriptive statistics were used. The results obtained were presented in tables and graphs for their better interpretation. Results: 226 papers were published, 114 were original articles, 20 were bibliographic reviews, 60 were report of clinical case, 14 were on pedagogy and history, and 18 on others. There were 758 authors: 161 Cuban authors, 43 Brazilian, 11 Colombian, 4 Mexicans, 3 Chileans, 2 Venezuelans, 1 Argentines and 1 Peruvian. 93 articles were on oral surgery, 87 on epidemiology of oral diseases, 14 on history and pedagogy, 11 on community health, 7 on natural and traditional medicine, 14 on other topics. The 2009 impact factor was 0.1795 and 0.3394 in 2013. Conclusions: a significant number of items have been published from 2009 to 2013; there was predominance of original articles and case presentations, the Cuban and Brazilian authors were highlighted; updated references and impact factor discreetly showed a upward trend.

Introduction: a historical analysis would reveal that the use of animals as test subjects has been both effective and essential. Such a practice has served both to save lives and to answer a variety of biomedical questions. Objective: carry out a bibliographic review about preclinical biomedical research. Methods: abibliographic review was conducted about preclinical biomedical research on the Internet. Most of the papers included in the search have been published in the last five years. An evaluation was performed of international high impact journals from the Web of Sciences dealing with the subject (32 journals), as well as two Cuban journals. Databases from reference systems such as MEDLINE, PubMed and SciELO were consulted with the aid of search terms like " animal research", "preclinical investigation", "biomodels", "laboratory animals", "translational medicine" and their Spanish counterparts. The papers included were in English, Portuguese or Spanish. Of the 136 papers obtained, the reviewers selected the 53 which approached the study subject in a more comprehensive manner. One book was also reviewed. Data analysis and integration: an analysis of the representativeness of papers in the scientific journals where they were published showed that 9.4 % corresponded to the Journal of Clinical Periodontology, and the same percentage to PloS Biology. The remaining papers were evenly distributed among the other journals. Most studies suggest that biomodels are an effective tool in scientific research, but they should be correctly designed, for it is common to find bias in the internal and external validity of the research, leading to errors in scientific publications. Conclusions: lack of knowledge about characteristics inherent to biomodels, preclinical research, methodological design and the very development of the research may lead to errors in the analysis and publication of results, affecting the quality of the research and contributing to the frequent scarcity of reliable animal studies.

Introduction: in dental practice it is common to find professionals who do not know or are unable to apply Mount & Hume's cavity preparation classification. Information about the subject is scarce in the literature published in Spanish, despite the fact that leading dental institutions worldwide consider it to have current validity. Objective: compare Mount & Hume's classification of dental cavity preparations as modified by Lasfargues and colleagues, with Black's. Methods: a bibliographic review was conducted of papers about Mount & Hume's classification of cavity preparations published from 2006 to 2014. The review included high impact online journals from the databases Google Scholar, Scopus, Scielo, Hinari and Medline. The search terms used were "new cavity classification", "cavity design", "preservation and restoration of tooth structure", "enamel remineralization", "Mount Hume Lasfargues Classification". The 163 papers obtained were scanned, but the study was restricted to the 52 which dealt with the topic in a more comprehensive manner. Data analysis and integration: black's classification was considered to be insufficient in the light of the new technologies and current concepts about minimally invasive therapies. Mount & Hume's classification shows the limitations of Black's preparations. Final considerations: black's classification had limitations with relation to Mount & Hume's and Lasfargues'. Both classifications should coexist and it is feasible to apply them in current conservative dental practice.

Introduction: Mouthwashes contribute to the inhibition of bacterial plaque formation and, therefore, may help to maintain salivary pH close to neutral. Objective: To identify changes in salivary pH in patients with fixed orthodontics after using a Stevia rebaudiana Bertoni solution and a commercial essential oil mouthwash. Methods: A clinical experiment with a mixed factorial design was carried out in patients with fixed orthodontic appliances. Once informed consent was signed, thirty-two patients were randomly assigned to one of 2 groups: 2 % S. rebaudiana B. solution or a commercial essential oil mouthwash. Fifteen ml of mouthwash was used for 60 s in all patients. Salivary pH was measured by two independent calibrated observers using pH-measuring paper before rinsing (basal measurement) and after rinsing, after 5 and 20 min. The data were analyzed by mixed ANOVA. Results: A statistically significant interaction was found between the type of treatment and the time of pH measurement. The medium pH of the S. rebaudiana and essential oil groups were respectively as per basal measurement: 6.61 and 6.52 (p = 0.72); after 5 min: 7.61 and 7.77 (p = 0.40); and after 20 min: 7.72 and 6.82 (p < 0.001). Conclusions: Both mouthwashes had the effect of increasing salivary pH to alkaline levels after 5 min, but only the 2 % S. rebaudiana B. mouthwash maintained the basic pH after 20 min.

Introducción: las clasificaciones sobre las alteraciones cefalogénicas presentan una gran dispersión debido a la multiplicidad de especialidades médicas que intervienen en la región de la cabeza. Objetivo: describir las clasificaciones más relevantes de las malformaciones craneofaciales y proponer una nueva clasificación. Métodos: se realizó un estudio mixto, hermenéutico y cuantitativo descriptivo, durante el cual se analizó la producción de clasificaciones sobre este tema en la Web of Sciences en el periodo comprendido desde 1992 hasta 2012. Luego de seleccionar 263 artículos que trataban este tema se estudiaron 22 de ellos en los que proponían clasificaciones o modificaciones al respecto. Se estudió la región anatómica, el tipo de clasificación, el tipo de malformación que describe y la revista de publicación. Resultados: hubo predominio del tipo de clasificación morfogénica en el 60 %, el tipo de malformación mayormente clasificada fue por defecto (fisuras e hipoplasias) en 72 % y la revista con mayor representación de publicaciones sobre clasificaciones de alteraciones cefalogénicas fue TheJournal of CraniofacialSurgery donde se publicaron el 44 % de ellas. Se propuso una clasificación integradora morfo-fisiopatológica y se analizó su validación interna y externa. Conclusiones: se demostró la ausencia de una clasificación que agrupara todas las malformaciones cefalogénicas, que incluyera a todas sus regiones anatómicas y tipos de malformaciones. La clasificación propuesta podría ser de utilidad para las especialidades médicas y estomatológicas afines a esta región anatómica.Introduction: classifications on cephalic alterations have great dispersion secondary to diversity of medical specialties involved in head region. Objective: to describe relevant classifications in craniofacial malformations and recommend a new classification. Method: was carried out a mixed study: hermeneutic and quantitative descriptive, to analyze the production of this kind of classifications on the Web of Sciences during the years 1992 to 2012. As result 263 papers was find on this topic and 22 papers were selected because provided classifications or modifications in this respect. This research analyzed the anatomical region, the classification type, the type of malformation and the magazine of publication. Results: there was a prevalence of the type of morphogenic classification in 60 %, the mostly classified malformation type of by defect (fissures and hypoplasia) in 72 % and the representative magazine of cephalic alterations classifications was the Journal of Craniofacial Surgery where 44 % of them were published. An integrative morpho-physiopathologic classification was suggested and internal and external validation was analyzed. Conclusions: was demonstrated the absence of any classification that joined all the cephalic malformations of all the anatomical cephalic regions. The recommended classification would being of utility for medical and dentistry specialties related to this anatomical region.

Introducción: un estudio preliminar realizado por el autor sobre hernia umbilical recidivante demostró que los defectos múltiples de la línea media la predisponen, si no se tratan al unísono. El presente trabajo tiene como objetivo demostrar que al aplicar una técnica de mínimo acceso no videolaparoscópica se logra una cura integral para la hernia umbilical y los defectos múltiples de la línea media. Métodos: para su realización, en la etapa del 2006 al 2011, se seleccionaron todos los pacientes herniados (72 en total) que acudieron a la consulta especializada del Hospital Universitario General “Calixto García”, con hernia umbilical y que además presentaron defectos de la línea media, como diastasia o hernia epigástrica. Se realizó un estudio de intervención para demostrar la utilidad de la técnica quirúrgica, inscrita por el autor en el Centro Nacional de Derecho de Autor, (CENDA), registro: 856-2007. Se colocó una prótesis de polipropileno preperitoneal por incisión transumbilical que protege toda la zona afectada. Se evaluaron complicaciones y grado de satisfacción del paciente. Resultados: predominaron los hombres y los pacientes con hernia umbilical y diastasia, seguidos de los casos con hernia umbilical y epigástrica y por último, los tres defectos. La media del tiempo quirúrgico fue de 45 minutos. La complicación posoperatoria predominante fue el seroma, no hubo infección, rechazo ni muerte. El grado de satisfacción fue excelente en la mayoría de los casos y solo hubo una recidiva. Conclusiones: el método es factible y útil.Introduction: apreliminary study conducted by the author of this paper on relapsing umbilical hernia showed that the multiple midline defects may predispose a patient to it, if not treated at the same time. The present paper was aimed at demonstrating that the application of a non-videolaparoscopic technique manages to comprehensively cure the umbilical hernia and the multiple midline defects. Methods: from 2006 through 2011, all the herniated patients (72) who went to the specialized service of “Calixto García” general university hospital and presented with umbilical hernia and midline defects such as dyasthasia or epigastric hernia were selected. An intervention study was conducted to demonstrate the advantages of the surgical technique registered by the author in the National Center of Copyright (CENDA) under the register no. 856-2007. Through a transumbilical incision, a preperitoneal polypropylene prosthesis that protects the affected area was placed. The complications and the level of satisfaction of the patient were evaluated Results: males and patients with umbilical hernia and diasthasia prevailed, followed by cases with umbilical and epigastric hernia and finally the three defects together. The surgical time mean was 45 minutes. The predominant postoperative complication was serome, but there was no infection, rejection or death. The level of satisfaction was considered excellent in most of cases, and just one relapse. Conclusions: this method is feasible and useful.

A queilite actínica é uma lesão cancerizável por conseqüência da exposição prolongada e contínua ao sol, afetando preferencialmente o lábio inferior. Objetivo: traçar o perfil da pesquisa odontológica desenvolvida no Brasil durante os últimos 10 anos, no que diz respeito à queilite actínica. Métodos: realizou-se um estudo transversal, por meio da observação indireta dos resumos dos trabalhos apresentados nas reuniões da Sociedade Brasileira de Pesquisa em Odontologia- SBPqO, no período de 2001 a 2011, resultando 42 resumos, os quais continham as palavras queilite actínica, ceratose actínica do lábio, queilose actínica e/ou actinic cheilitis. Os dados foram organizados e analisados com o software Epi Info versão 3.5.1 e apresentados por meio da estatística descritiva e analítica. Nas análises bivariadas, utilizou-se o teste do Qui-quadrado (p < 0,05). Resultados: obteve-se um pico de trabalhos apresentados no ano de 2006 e 2008; concentração da produção científica na região sul e sudeste, porém, com singela contribuição do estado da Bahia; predomínio de estudos de natureza observacional com corte transversal. Observou-se que 35,7 % receberam apoio de órgãos governamentais, sendo o CNPq responsável pela maioria do financiamento (16,7 %). Não foi verificada diferença significativa quanto à distribuição do fomento entre as instituições públicas e particulares (p = 0,103), assim como entre as federais e estaduais (p= 0,225). Conclusão: embora escassos, alguns estudos demonstram a importância de pesquisas que esclareçam os mecanismos moleculares que influenciam no comportamento biológico da queilite actínica. Assim, pode desenvolver uma terapêutica segura e eficaz que não permita o avanço da doença a quadros mais graves. Para isso é necessário uma maior participação das universidades e agências financiadoras para possibilitar a execução de pesquisas com maior potencial de evidência científica.Queilitis actínica es una lesión cancerígena como consecuencia de la exposición prolongada y continua a la luz solar, que afecta principalmente el labio inferior. Objetivo: rastrear el perfil de investigación bucal desarrollado en Brasil en los últimos 10 años con respecto a la queilitis actínica. Métodos: se realizó un estudio transversal a través de la observación indirecta de los resúmenes de los trabajos presentados en las reuniones de la Sociedad Brasileña para la Investigación Dental-SBPqO en el período de 2001 a 2011, y se apreció que 42 resúmenes contenían las palabras queilitis actínica, queratosis actínica de los labios y/o actinic cheilitis. Los datos fueron organizados y analizados mediante Epi Info versión 3.5.1 y se presentó la estadística descriptiva y analítica. En variados análisis, se utilizó la prueba de qui-cuadrado (p < 0,05). Resultados: se observó un pico de los trabajos presentados en 2006 y 2008, la concentración de la producción científica en el sur y sureste, pero con un sencillo aporte de Bahía; predominio de estudios de carácter observacional. Se observó que el 35,7 % recibió el apoyo de los organismos gubernamentales, CNPq fue responsable de la mayoría de los fondos (16,7 %). No se encontraron diferencias significativas en cuanto a la distribución del desarrollo entre las instituciones públicas y privadas (p= 0,103), y entre las autoridades federales y estatales (p= 0,225). Conclusión: Sin mucha frecuencia algunos estudios muestran la importancia que tiene la investigación para aclarar los mecanismos moleculares que influyen en el comportamiento biológico de la queilitis actínica. Por lo tanto, se puede desarrollar un tratamiento seguro y eficaz que no permita la progresión de la enfermedad. Esto requiere una mayor participación de las universidades y organismos de financiación que permitan la aplicación de la investigación con el mayor potencial de la evidencia científica.The actinic cheilitis is a carcinogenic injury resulting from extended and continuous exposure to the sun, mainly affecting the lower lip. Objective: To describe the profile of dental research about actinic chelitis conducted in Brazil in the last 10 years. Methods: A cross-sectional study through indirect observation of the paper abstracts, which had been submitted in the Brazilian Society for Dental Research-SBPqO meetings held from 2001 to 2011. It was observed that 42 abstracts contained the words actinic cheilitis and actinic keratosis of the lip. The data were organized and analyzed using Epi Info version 3.5.1 and presented using descriptive and analytical statistics. In the bivariate analyzes, the chi-square test (p < 0.05) was used. Results: A peak of papers was presented in 2006 and 2008; the scientific production was concentrated in the south and the southeast areas, with simple contribution by the state of Bahia and predominance of the observational studies. It was observed that 35.7 % received support from the governmental agencies, and the CNPq contributed most of the funding (16.7 %). There were no significant differences in the distribution of dental research works between the public and the private institutions (p= 0.103), as well as between the federal and the state authorities (p= 0.225). Conclusions: Although uncommon, some studies showed the importance of research to clarify the molecular mechanisms that influence the biological behavior of actinic cheilitis. Hence, a safe and effective treatment may be provided to prevent the advance of disease. This requires greater involvement of universities and of funding agencies to allow applying the results of research with the greatest potential for scientific evidence.

Este trabajo expone consideraciones acerca de la situación social y de salud en América Latina, seleccionado por ser un continente afectado e imposibilitado de alcanzar niveles de desarrollo necesarios para erradicar la pobreza y la desigualdad, en el que se utiliza como referencia a la mujer, por la vulnerabilidad que este grupo representa, con énfasis en la mujer cubana. Objetivo: destacar los indicadores de impacto positivos y negativos en el panorama social y de salud de la mujer en las Américas. Métodos: se realizó la revisión documental de los informes publicados de salud, con criterios de estratificación de la América por regiones, entre las que fueron escogidos países representativos, y se seleccionaron algunos indicadores de la situación social y de salud. Resultados: los indicadores positivos más destacados son: esperanza de vida al nacer, empleo remunerado, desempleo, paridad y la mortalidad materna en Canadá. Los indicadores negativos han sido principalmente: incremento de la paridad en adolescentes, prevalencia de anemia y mortalidad materna e infectada por VIH (para Argentina). Cuba, por su parte, tiene marcados contrastes porque a pesar de ser un país en vías de desarrollo ofrece indicadores positivos, como la mortalidad infantil y la esperanza de vida al nacer, a diferencia de la prevalencia de anemia y la mortalidad materna que se comportaron como indicadores negativos. Conclusiones: los resultados muestran un mejor balance con mayores indicadores positivos sobre los negativos en Canadá y Cuba; no sucedió así con Argentina, que exhibe mayores indicadores negativos sobre los positivos.This paper presents considerations on the social and health situation in Latin America. This continent is selected since it is affected and unable to reach levels of development to eradicate poverty and inequality. In this paper, women are used as a reference due to their vulnerability, focusing on Cuban women. Objective: Positive and negative indicators are highlighted as objective of impact on the health and social landscape of women in America. Methods: the literature review of published health reports was used, stratifying America by regions; representative countries were chosen, and social status and health indicators were selected. Results: The outstanding results providing positive indicators are: life expectancy at birth, paid employment, unemployment, parity and maternal mortality in Canada. The main negative indicators have been: increased parity in adolescents, prevalence of anemia and maternal mortality, and HIV-infected (in Argentina). Cuba, meanwhile, has marked contrasts because despite being a developing country, positive indicators are shown, such as infant mortality and life expectancy at birth, but the prevalence of anemia and maternal mortality which behaved as negative indicators. Conclusions: Results of better balance with more positive over negative indicators are shown in Canada and Cuba. However, Argentina exhibits more negative over positive indicators.

Los adultos mayores constituyen un grupo poblacional que cada día va en aumento, y son ellos los que requieren mayor atención médica y los que consumen un número elevado de fármacos. Este trabajo intenta hacer una revisión sobre la prescripción de fármacos con fines preventivos en el adulto mayor según las evidencias científicas. La polifarmacia en el anciano incrementa las posibilidades de reacciones adversas a los medicamentos, interacciones entre ellos potencialmente deletéreas, aumento de los ingresos hospitalarios por esta causa y aumento de los gastos en salud. Los fármacos constituyen la primera fuente de trastornos yatrogénicos en los ancianos, atribuible a que muchas veces se indican de forma irracional y se aplican malas prácticas de prescripción sin un sustento científico sólido. Se espera contribuir a que el médico desarrolle la habilidad de prescribir el fármaco de manera eficaz, conveniente, con prudencia clínica y distancie las recomendaciones sesgadas del mercado en términos de terapéutica. Es importante mejorar la prescripción farmacológica en aras de una mejor calidad de vida en el adulto mayor.The older adults are a population group that increases every day and they require more medical care and consume a large number of drugs. This paper was intended to make a review on drug prescription for preventive purposes in the elderly on the basis of scientific evidence. The multiple drug consumption by the elderly increases the possibilities of suffering adverse reactions to drugs, potentially deleterious interactions, rise of admissions at hospital due to this problem and higher health expenses. The drugs are the first source of iatrogenic disorders in the aged people, often attributable to irrational and wrong practices of prescription without any sound scientific support. This paper was expected to contribute to developing the skill of prescribing a drug in an effective, convenient and prudent way, thus paying little attention to the market-biased recommendations in terms of therapeutics. It is important to improve drug prescription towards a better quality of life for the older people.

Objetivo: incrementar la adquisición de competencias profesionales en los estudiantes de médicina familiar ubicados mayoritariamente en sedes académicas cuya supervisión y asesoría resulta difícil, por distancia, ubicación geográfica y turno laboral. Métodos: se creó un grupo de expertos integrado por nueve profesores que incluyó a tres especialistas en medicina familiar, dos terapeutas familiares, un subespecialista en orientación familiar, un maestro en educación médica, un psiquiatra y una psicóloga. Su misión fue desarrollar un instrumento piloto, que permitiera apreciar la práctica profesional de los médicos a través de los videos. Finalmente, se decidió valorar cinco dimensiones: 1. Imagen personal y profesional, 2. Imagen del consultorio, 3. Comunicación verbal y no verbal, 4. Práctica clínica y 5. Abordaje familiar. Se describen cada una de las dimensiones valoradas. Resultados: se obtuvo una herramienta valiosa para el proceso de enseñanza aprendizaje en medicina familiar, que permitió mejorar las habilidades y destrezas del médico en el abordaje del paciente y la familia así como el asesoramiento del profesor al alumno en el desarrollo de las habilidades clínicas y las actitudes en la consulta cotidiana. Conclusiones: la herramienta presentada es una estrategia educativa que busca finalmente, incrementar las capacidades del médico familiar para que pueda otorgar una mejor atención al paciente y su familia.Objective: to increase the acquisition of professional competences in those family medicine students who are mostly located in academic institutions and are difficult to be supervised and advised, due to distance, geographic location and work shifts. Methods: a group of experts made up of nine professors including three family medicine specialists, two family therapists, a family counseling specialist, a medical education professor, a psychiatrist and a psychologist was created. The mission of this group was to develop a pilot instrument that allows observing the professional practice of the physicians through videos. Finally, five dimensions were chosen to be assessed: 1- personal and professional image, 2- the physician's office image, 3- verbal and non-verbal communication, 4-Clinical practice and 5-Family approach. All these assessed dimensions were described in the paper. Results: a valuable tool for the teaching/learning process was obtained. It allowed improving the abilities and dexterities of the physician in dealing with the patient and the family, as well as the possibilities of the professor for giving advice to the student in terms of development of clinical abilities and individual attitudes in the daily medical work. Conclusions: the tool described in this paper is an educational strategy aimed at increasing the capacities of the family physicians to provide better care to their patients and families.

La Literatura Universal, fuente de información y conocimiento, medio para enriquecer el acervo cognoscitivo y cultural de los profesionales de la estomatología; recoge en sus páginas las raíces de esta profesión, manifestada en la labor que realizaron los charlatanes, sacamuelas y barberos, así como el papel que jugaron en su construcción y desarrollo. El objetivo de este trabajo es identificar la presencia, en estas creaciones, de la actividad desarrollada por ellos. Se realizó la búsqueda bibliográfica en libros impresos y automatizados en Internet, Google Académico, para lo cual se usaron los descriptores charlatanes, sacamuelas, barberos, dientes, boca. Se consultaron quince obras y seleccionaron ocho en cuyas páginas se recogen referencias al tema que nos ocupó. La información se organizó sobre la base del orden cronológico de los autores. El estudio de las obras de la Literatura Universal consultadas nos permitió reconocer excelentes descripciones de la actividad de los charlatanes, sacamuelas y barberos, los cuales constituyen raíces históricas de la labor de los profesionales de la estomatología.The world literature is a source of information and knowledge and a means of enhancing the cognitive and cultural stock of the dental professionals. Its pages collect the roots of this profession expressed in the work of quacks, tooth-pullers and barbers and their role in the creation and development of this discipline. The objective of this paper was to identify the presence of the activities carried out by them in these creations. Literature search was made in printed and computerized books and in the academic google on Internet, for which we used subject headings as quacks, tooth-pullers, barbers, teeth, mouth. Fifteen works were consulted; eight of them were selected for this paper since they made reference to this topic. The gathered information was organized by the chronological order of the authors. The study of these documents from the world literature allowed us to be aware of the excellent descriptions of the activities performed by quacks, tooth-pullers and barbers as part of the historical roots of the work of dental professionals.

El presente trabajo trata acerca de algunos factores biosicosociales que inciden en la salud del adulto mayor, se parte del concepto de que el envejecimiento no es un proceso de causa única, sino el resultado de una compleja asociación de interacciones y modificaciones estructurales y funcionales, entre lo biológico, lo psicológico y lo socio-ambiental. Teniendo en cuenta estos elementos el objetivo de este trabajo es exponer algunos aspectos que inciden en la salud del adulto mayor, para que los profesionales de la atención primaria de salud, comprendan la importancia de abordar el proceso de salud-enfermedad en el anciano, con una concepción holística.This paper is a bibliographical revision of bio-psycho social factors, which have incidence on the elderly health, from the notion that aging is not a process of only one cause, but the result of a complex combination of interactions and structural and functional modifications, including biological, psychological and socio-environmental aspects. Given these elements, the objective of this paper is that practitioners of primary health care, address the health-disease process in the elderly, with a comprehensive and holistic conception.

Introducción: La mayoría de las investigaciones epidemiológicas, más específicamente estudios no enteramente limitados a la mera descripción, implican comparaciones entre grupos, a través del tiempo o entre estudios. Incluso cuando la estadística es correctamente aplicada, los resultados pueden ser difícilmente interpretados por un inexperto. Se realizó este estudio con el fin de describir el uso de los procedimientos estadísticos en los artículos originales de la Revista Cubana de Higiene y Epidemiología, cuantificando la accesibilidad estadística para el lector. Métodos: Se analizaron los trabajos publicados en la sección artículos originales durante el período de 1996 a 2009, excluyendo investigaciones metodológicas, estudios cualitativos, revisiones bibliográficas y noticias en un total de 180 originales. Fueron estudiadas detalladamente las secciones de métodos y resultados, en las que se identificaron los análisis efectuados para clasificarlos en 14 categorías jerárquicas con tres niveles de accesibilidad (Emerson-Colditz): estadística descriptiva, análisis bivariados y análisis complejos, incluidos los multivariados. La accesibilidad se definió como la proporción de artículos accesibles para lectores con diferentes niveles de conocimiento estadístico. Resultados: Los procedimientos estadísticos más frecuentes fueron: estadística descriptiva (88,7 %), chi cuadrado (17,3 %), medidas de riesgo (18,7 %), prueba t de Student (7,3 %) y regresión logística (7,3 %). Globalmente, el 79 % de los artículos fueron accesibles para un lector con conocimientos básicos (análisis bivariables), cifras similares a las de otras revistas biomédicas. Conclusiones: Un porcentaje considerable de los artículos originales de la Revista Cubana de Higiene y Epidemiología incorpora actualmente análisis complejos en su desarrollo. Parece así aconsejable que los lectores profundicemos en nuestros conocimientos estadísticos.Introduction: Most of epidemiological researches, specifically, those studies not totally limited to the simple description; involve comparisons among groups by time of among studies. Even when the statistics is appropriately applied, results may be interpreted with difficulty by an inexperienced. This study was conducted to describe the use of statistic procedures in the original papers of the Cuban Journal of Hygiene and Epidemiology, quantifying the statistic accessibility for the readers. Methods: The papers published were analyzed in the section of Original Papers from 1996 to 2009, excluding the methodological researches, qualitative studies, bibliographic reviews and news selecting 180 original papers. The sections Methods and Results were studied in detail where we identified the analyses carried out to be classified in 14 hierarchic categories with three levels of accessibility (Emerson-Colditiz): descriptive statistic, bi-varied analyses and complex analyses including the multi-varied. Accessibility was defined like the ratio of accessible articles for readers with different levels of statistic knowledge. Results: The more frequent statistic procedures were: descriptive statistics (88.7 %), Chi2 (17.3 %), risk measures (18.7 %), t-Student test (7.3 %) and logistic regression (7.3 %). Overall, the 79 % of papers were accessible to a reader with basic knowledges (bi-variable analysis), figures similar to those of other biomedical journals. Conclusions: A significant percentage of original papers of the Cuban Journal of Hygiene and Epidemiology nowadays incorporate complicated analyses in its development. It is advisable that readers must to deepen in our statistic knowledges.

Motiva la redacción de este artículo el pobre control de la hipertensión arterial que se reporta en la mayoría de los países del mundo. Se aclararon los criterios que se siguen para considerar a un paciente hipertenso como controlado y se revisaron varios trabajos de investigación sobre prevalencia de hipertensión arterial y porcentaje de control en distintas poblaciones. Se expusieron las experiencias de los autores en la atención protocolizada de la hipertensión arterial refractaria como expresión de inadecuado control de esta afección y se señalaron las principales situaciones o causas que inciden en el pobre control de la enfermedad, tanto por parte del paciente como por parte del médico. Se insistió en la necesidad de que los sistemas de salud de los países den prioridad a la atención de la hipertensión arterial con la participación del propio paciente y la mayor preocupación por médicos e instituciones en garantizar la mejor y más efectiva atención a los casos con dificultades en el control de su afección.The aim of present paper is to analyze the poor control of high blood pressure reported in many countries at world scale. The criteria followed to consider that a patient be hypertensive and under control were clarified and some papers related to a research on the high blood pressure prevalence and the control percentage in different populations were reviewed. Author's experiences with the formalized care of refractory high blood pressure as expression of a inappropriate control of this affection designating the main situations or causes falling into the poor control of this disease by patient on the one hand and by physician by the other. We emphasize on the need that the health systems of the countries give priority to high blood pressure care with the involvement of patient and a greater preoccupation by the physicians and institutions to guarantee a better and more effective care to those cases with difficulties in the control of its affection.

La identificación correcta de los problemas de salud del paciente constituye la base en que descansa la actuación profesional de los médicos y la clave para una atención de calidad. El propósito de este trabajo es describir el método hipotético-deductivo y su utilización en el proceso del diagnóstico, mostrando ejemplos prácticos de casos clínicos que pueden ser similares a los vistos en la atención primaria. Se realizó un trabajo de revisión de artículos nacionales y algunos extranjeros que abordan el diagnóstico médico y la aplicación del método hipotético-deductivo en el proceso del diagnóstico. Los médicos a medida que ganan en conocimientos y experiencias simplifican el proceso del diagnóstico y con pocos datos elaboran sus hipótesis diagnósticas (método hipotético-deductivo), dirigiendo el interrogatorio, el examen físico y las exploraciones complementarias hacia la comprobación o rechazo de los diagnósticos iniciales. Si se rechaza el diagnóstico inicial hay que comenzar de nuevo el proceso. El método hipotético-deductivo es muy eficiente siempre que se aplique correctamente, por un personal experimentado y con las condiciones necesarias. Este método no está exento de errores si se violan sus principios.ABSTRACT The proper identification of health problems of patient is the basis supporting the professional performance of physicians and the key for a quality care. The purpose of present paper is to describe the deductive-hypothetical method and its use in the diagnostic process, showing practical examples of clinical cases that could be similar to that observed in the primary care. A review work was made of national and foreign papers approaching the medical diagnosis y the implementation of the above mentioned method in the process of diagnosis. The physicians according to a increase in knowledges and experiences may to simplify the process of diagnosis and with a few data they made its diagnostic hypotheses (deductive-hypothetic method), directing the questioning, the physical examination and the complementary screenings towards the verification or the rejection of initial diagnoses. If initial diagnosis is rejected it is necessary to start again the process. The deductive-hypothetical method is very effective whenever it be properly applied by a experimented staff and with the necessary conditions. The method is not extent of errors if its principles are infringed.

La estadística es una herramienta elemental en la investigación biomédica; sin embargo, se ha demostrado que no siempre su uso se corresponde con los adelantos científicos y los logros alcanzados en la salud. Se realiza un estudio descriptivo con el fin de describir el uso de las técnicas estadísticas y los softwares, paquetes o programas de cálculo estadístico, en los artículos originales de la Revista Cubana de Higiene y Epidemiología. Se analizaron los trabajos publicados en la sección Artículos Originales durante el período de 1996 al 2009, excluyendo investigaciones metodológicas, estudios cualitativos, revisiones bibliográficas y noticias, y se recogieron 180 originales. Fueron estudiadas detalladamente las secciones de Métodos y Resultados. Las técnicas estadísticas más frecuentes fueron: estadística descriptiva (88,7 %), chi cuadrado (17,3 %), medidas de riesgo (18,7 %), prueba t de Student (7,3 %) y regresión logística (7,3 %). Constituyó una gran dificultad en los artículos originales publicados en la Revista Cubana de Higiene y Epidemiología la falta de información importante para la reproductibilidad de la investigación, dada por no precisarse el diseño muestral aplicado y el programa estadístico. Los procedimientos estadísticos no se emplearon en un número importante de artículos.Statistics is an elemental tool in biomedical research; however it has been demonstrated that not always its use is in correspondence with scientific advances and achievement reached in the health field. A descriptive study was conducted with the objetive to describe the use of statistic techniques and the software, packages or programs of statistic calculation in the Original Papers of the Cuban Journal of Hygiene and Epidemiology. The published papers in the section of Original Papers from 1996 to 2009 were analyzed, excluding methodological researches, qualitative studies, bibliographic reviews and news, for a total of 180 original papers. The Methods and Results were carefully studied. The more frequent statistic techniques were: descriptive statistics (88.76 %), chi² (17.3 %), risk measures (18.7 %), t Student test (7.3 %) and logistic regression analysis (7.3 %). The great difficulty of the original papers published in the above mentioned Journal was the lack of significant information for reproducibility of the research, due to the no precise of the applied sampling design and the statistic program. The statistic procedures were not used in an important number of papers.

El propósito de este trabajo es reflexionar sobre la relación existente entre la bioética y la salud ambiental, exponiendo algunos ejemplos del trabajo desarrollado en el área de la Salud Ambiental en Cuba. Se intenta explicar la interacción entre el medio ambiente y la salud de la población, así como los valores morales y éticos que debe tener cada ciudadano frente a la naturaleza, para contribuir a mejorar su salud y garantizar así la supervivencia de las presentes y futuras generaciones.The purpose of present paper is to reflect on the relation between the Bioethics and the Environmental Health showing some examples from the paper developed in the Environmental Health area in Cuba. Authors tried to explain the interaction between the environment and the health of the population, as well as the moral and ethical values indispensable in each citizen in face of nature to contribute to improve its health and to thus guarantee the survival of present and future generations.

La atención estomatológica a las gestantes se hace imprescindible por diferentes factores que pueden acelerar la progresión de enfermedades iniciales o ya establecidas, por ello se les ha dado prioridad como grupo del Programa Nacional de Atención Estomatológica Integral, insertado dentro del Programa Materno Infantil del MINSAP. Por la importancia que reporta mantener a la gestante siempre sana, así como prevenir alteraciones en ella y en el futuro bebé, nos propusimos exponer algunas consideraciones para la atención estomatológica integral y sistemática durante el embarazo, según el riesgo, severidad de la enfermedad y trimestre de gestación. Fueron realizadas revisiones bibliográficas, se valoraron trabajos anteriores en esa localidad, criterios de estomatólogos, médicos de la familia, ginecoobstetras y de la propia embarazada. Este trabajo concluyó que es importante lograr un cambio de conducta en los estomatólogos, que involucre una comunicación fluida y directa con los médicos de la familia y las gestantes, de manera que un trabajo comunitario de promoción, permita garantizar una adecuada atención preventiva y curativa en este sentido.The stomatologic care to pregnants is essential due to different factors that in a way or in another may to accelerate the progression of initial diseases or already established, considered as a priority group by the National Group of Integral Stomatologic Care, included in the maternal-child program of Public Health Ministry. Due to significance to maintain the pregnant always healthy, thus preventing the alterations in them and in their babies, our aim was to show some considerations for the integral and systematic stomatologic care during pregnant, taking into account the risk and disease severity according to the pregnancy trimester. For its design authors made bibliographic reviews, assessing previous papers, stomatologists criteria, family physicians, gynecologists-obstetricians and from the pregnant. Present paper concludes alerting stomatologists for a change in behavior in the profession involving a fluent and direct communication with family physicians and the pregnants, so a promotion community work allows to guarantee a curative and preventive appropriate care in that sense.

OBJETIVO: Los bifosfonatos constituyen una piedra angular en el tratamiento de las metástasis óseas. En este trabajo se evalúa la eficacia y seguridad del uso del ácido zoledrónico (AZ) en pacientes con cáncer de mama metastásico (CMM) a hueso. MÉTODOS: Se realizó un estudio retrospectivo y descriptivo de pacientes tratadas en el Servicio de Oncología del Hospital "Hermanos Ameijeiras" (HHA), desde octubre del 2006 hasta diciembre del 2007, con confirmación histológica de CMM óseo y tratadas con AZ. La supervivencia (SV) global y el tiempo para la aparición de nuevos eventos esqueléticos (EER) fue estimada usando el método de Kaplan-Meier. Para la comparación de las medias se utilizó el test de comparación (Wilcoxon) para muestras relacionadas. Para la evaluación de la respuesta al dolor se utilizó la escala visual analgésica (EVA). RESULTADOS: Las medianas de SV y del tiempo para la aparición de algún EER fueron de 33,82 meses y de 27,82 meses, respectivamente. El 50 % de las pacientes presentaban dolor severo (EVA ³ 7), al inicio del tratamiento, y a los 12 meses, el 66,6 % obtuvieron EVA=0 (p=0,021). En el 42,3 % se reportó un síndrome pseudogripal luego de la primera infusión. No hubo toxicidad hematológica, ni variaciones significativas de los valores de fosfatasa alcalina, LDH, y creatinina. No se reportó ningún caso de insuficiencia renal. CONCLUSIONES: Este estudio constituye el primer reporte en Cuba de la utilización del AZ en cáncer. Se demostró la eficacia del AZ en reducir los EER, el tiempo de aparición de estos, incremento de la SV, así como la reducción del dolor e incremento de la calidad de vida. El AZ tiene un buen perfil de seguridad.OBJECTIVE: the biphosphonates are the cornerstone in the bone metastases treatment. In present paper the effectiveness and safety of the zoledronic acid (ZA) use in patients with bone metastatic breast cancer (MBC). METHODS: a descriptive and retrospective study was conducted in patients seen in Oncology Service of the «Hermanos Ameijeiras» Clinical Surgical Hospital from October, 2006 to December, 2007 with histological confirmation of MBC treated with ZA. Global survival and appearance time of new skeletal events (SE) was estimated using the Kaplan-Meier method. For means comparison we used the comparison test (Wilcoxon) in related samples. To assessment of pain response the analgesic visual scale (AVS). RESULTS: the survival means and the appearance time of some SE were of 33.82 months and of 27.72 months, respectively. The 50 % of patients showed AVS ³ 7 at treatment onset, and at 12 months, the 66.6 % had AVS =0 (p=0.021). In the 42.3 % was present a flu-like syndrome after the first infusion. There was not hematologic toxicity or significant variations of alkaline phosphatase values, LDH and creatinine. No case of renal failure. CONCLUSIONS: present paper is the first report in Cuba on use of ZA in cancer cases. The ZA effectiveness to reduce the SEs was demonstrated, as well as the appearance time of such events, the survival rise, the pain decrease and the quality of life increase. ZA has a good safety profile.

Este trabajo refleja el sentido de lo bello en la práctica médica, especialmente en el paciente con estrabismo disociado y la importancia de la formación de adecuados valores estéticos en consonancia con el alto valor humanista que la sociedad promueve. En tal sentido los valores estéticos tienen también un razonable lugar en la vida del ser humano, cómo colaborar en la formación y comprensión de estos es una tarea que toca también a los profesionales de la salud. Pretendemos acercarnos a las diferentes interpretaciones y a la identificación de esta categoría filosófica relacionándolo con la corrección quirúrgica de esta patología que favorece una mejora no sólo la apariencia estética, sino también la función psicosocial y la calidad de vida.This paper deals with the concept of beauty in relation to the medical practice, especially in patients with dissociated strabismus, as well as the importance to develop the right aesthetics values pursuant to the high humanistic values of the society that promotes them. In this regard, the esthetic values also have an important place in the life of human beings, so how to cooperate in the formation and understanding of these values should be a mission of every health professional. This paper was intended to approach different interpretations, as well as the identification of this philosophical category by relating it to the surgical correction of this pathology that favors improvement not only in the esthetic appearance but also in the psychosocial function and the quality of life of the patients.

Se expone el Plan Temático que el Instituto de Medicina Tropical "Pedro Kourí" se propone para los próximos años y los grandes retos a enfrentar, así como la experiencia que ya acumulan sus profesionales como aval de éxito para estas intervenciones. El trabajo fundamenta la necesidad muy importante de continuar el perfeccionamiento de nuestro sistema de atención primaria de salud (APS). Se reconoce a nuestra APS como un modelo único en el mundo, y al mismo tiempo novedoso y complejo. Se plantea que la aplicación del enfoque epidemiológico a la APS puede ayudar mucho a mejorar la ejecución de los actores sociales que en ella intervienen, y por ende, mejorar el rendimiento del modelo en beneficio de la salud de la comunidad.The Thematic Plan proposed by "Pedro Kouri" Institute of Tropical Medicine for the next years, as well as the great challenges to be faced are explained in this paper. Emphasis is made on the experience accumulated by its professionals as a guarantee for the success of these interventions. The paper establishes that it is very necessary to continue improving our primary health care (PHC) system, which is recognized as a novel, complex and unique model in the world. It is stated that the application of the epidemiological approach to PHC may help to enhance the performance of the social actors that take part in it, and to make better the efficiency of the model for the benefit of community health.

Resumen Se estudiaron 234 pacientes aparentemente sanos, de 2 consultorios del Médico de Familia pertenecientes al policlínico "Héroes del Moncada" para detectar la presencia de deterioro cognoscitivo en la población mayor de 60 años de esos consultorios. El elevado número de consultas por trastornos de memoria y pérdida de la capacidad cognoscitiva en general fue lo que motivó este trabajo. A todos los pacientes se les realizó un examen neurológico completo y se les aplicaron pruebas en forma de encuestas para medir el tipo y el grado de deterioro, además de su relación con la edad. Se detectó que un 19,66 % de ellos presentaban alguna forma de deterioro cognoscitivo, correspondiendo los mayores porcentajes a la memoria (36,9 %), seguido de la orientación, las formas mixtas, el pensamiento y el juicio respectivamente. De los 46 pacientes con deterioro, 36 se encontraban por encima de los 70 años. El mayor número de casos correspondió a las formas comenzantes o ligeras (50 %), mientras que a diferencia de otros trabajos similares presentamos mayores cifras de deterioro severo (28,2 %) sobre el deterioro moderado (21,7 %), probablemente dependiendo de las características de nuestra muestra. En nuestro país se señalan cifras similares de prevalencia a las presentadas en este trabajo (16,5 y 19,3 %). Los resultados obtenidos demuestran la tendencia creciente del síndrome y el papel de la edad como factor de riesgo para la aparición de estos síndromesSUMMARY 234 apparently sound patients, who receive medical attention at 2 family physician’s offices of the "Héroes del Moncada" Polyclinic were studied to detect the presence of cognition deterioration in the population over 60 from these places. The high number of consultations due to memory disorders and to the lost of the cognition capacity in general led the authors to write this paper. A complete neurological examination was made to all patients and some tests were applied in the form of surveys to measure the time and degree of deterioration and their relation to age. It was observed that 19.66 % of them had some form of cognition deterioration. The highest percentages corresponded to memory (36.9 %), followed by orientation, mixed forms, thought and judgement, respectively. Of the 46 patients with deterioration, 36 were over 70. Most of the cases were in an initial or mild stage (50 %), but unlike other similar papers the figures of severe deterioration (28.2 %) were higher than those of moderate deterioration (21.7 %), probably depending on the characteristics of our sample. Figures of prevalence similar to those presented in this paper (16.5 and 19.3 %) have been registered in our country. The results attained showed the increasing trend of the syndrome and the role of age as a risk factor for the appareance of these syndromes

Joaquín M. Albarrán, fue un médico y cirujano reconocido en el ámbito mundial en el desarrollo de la Urología moderna. Cubano por nacimiento, e hijo de la Francia ilustrada, país donde hizo su segunda graduación como médico, donde realizó el desarrollo de su intelecto científico y cultural, realizó aportes al conocimiento médico en la Histología, la Anatomía, la Bacteriología, a la Clínica y Cirugía Urológica. Son poco conocidos sus aportes al conocimiento morfológico del desarrollo de los dientes y sus estructuras de soportes y a las tumoraciones desarrolladas a partir de los restos paradentarios. En este trabajo se realiza una información sintética de los trabajos presentados y publicados por este eminente médico.Joaquín M. Albarrán was a well-known physician and surgeon worldwide in the development of the modern Urology. Cuban by birth and son of the educated France where he graduated as a physician for the second time and developed his scientific and cultural intellect, Albarrán made contributions to the medical learning in Histology, Anatomy, Bacteriology and Urological Clinics and Surgery. His contributions to the morphological knowledge on the development of teeth and their supporting structures and on the tumors from the paradental remains are barely known. This paper presents and abridged information on the papers which were submitted and published by this remarkable physician.

Se fundamenta la importancia de conocer las necesidades informativas de los Médicos de Familia, para lo cual se confeccionó una encuesta que se distribuyó entre 55 galenos de los policlínicos de las áreas norte y sur del municipio de Güines, provincia La Habana, con el objetivo de conocer el nivel de conocimientos que poseían en relación con los servicios de información brindados por la bibliotecaria de su unidad en 1999. Se determinó que sólo el 41 % de los encuestados asiste frecuentemente a la biblioteca de su unidad, y que el 80 % no sabe redactar un artículo para publicar. Se concluye que el nivel de conocimientos en cuanto a fuentes y servicios informativos de los Médicos de Familia de las unidades antes mencionadas se puede calificar de insuficienteThe importance of knowing the needs of information of the family physicians is explained in this paper. 55 female family physicians working in the polyclinics located in the north and south areas of the Güines municipality, in Havana province, were surveyed in order to determine their level of kwnoledge as regards the information services rendered by the librarian of their units in 1999. It was observed that only 41% of them visited the library of their units frequently and that 80% did not know how to write a paper to be published. It was concluded that the level of knowledge of the family physicians from the above mentioned units in relation to the information sources and services was poor

La mortalidad general tiene una tendencia al decrecimiento en los últimos decenios, ello se traduce por un incremento en las esperanzas de vida al nacer. Sin embargo, la modificación del patrón epidemiológico de las defunciones y el envejecimiento poblacional han provocado que las enfermedades no transmisibles se hayan adueñado de las primeras causas de muerte, lo cual implica un mayor despliegue de recursos en las intervenciones. Las enfermedades del corazón y las enfermedades cerebrovasculares (ECV) están entre las 3 primeras causas de muerte en nuestro país y el control de la hipertensión arterial, factor de riesgo para ambas, pudiera disminuir la mortalidad por estas causas e incrementar la esperanza de vida. Este artículo tuvo como objetivos la descripción de la mortalidad general y la determinación de la magnitud del impacto que produciría la reducción de las defunciones por enfermedades del corazón y ECV en un 20 %, sobre la esperanza de vida de la población, lo cual se espera obtener al aplicar el nuevo programa de control de la HTA. Para ello, se emplearon las funciones de las tablas de vida, fundamentalmente las esperanzas de vida al nacer, las esperanzas de vida en edades exactas y las esperanzas de vida temporarias, estas últimas según la metodología ofrecida por Eduardo Arriaga. Se obtuvo como resultado un incremento apreciable en la vida promedio de los cubanos de ambos sexos al reducir en un 20 % la mortalidad por las citadas causas para todas las edades.General mortality tends to decrease in the last few decades, which is translated into an increrase of life expectancy at birth. However, the changes in the epidemiological pattern of deaths and the population aging have brought about that non-communicable diseases turn into the first causes of dealth, which implies a higher use of resources in the interventions. Heart and cerebrovascular diseases are among the first three causes of death in our country and the control of arterial hypertension, a risk factor for both illnesses, could reduce mortality from both causes and increase life expectancy. This paper was aimed at describing general mortality and determining the impact of the reduction of deaths from heart and cerebrovascular diseases by 20% on the population´s life expectancy. This is expected to be achieve thanks to the implementation of the new program of blood pressure control. For this paper, functions of life tables, basically life expectancy at birth, life expectancy at exact ages and temporary life expectancies were used, being the two latter employed according to Eduardo Arriaga´s methodology. The result was an notable increase in average lifetime of Cuban of both sexes by a 20% reduction of mortality from the above-mentioned diseases for all age groups.

Entre los aspectos que contempla el Programa Nacional de Medicamentos, se establece la entrega de medicamentos a los pacientes (sobre todo para tratamiento de enfermedades crónicas no transmisibles) mediante una tarjeta control. Para abrir una inscripción de tarjeta control en la farmacia, el prescriptor expide un certificado con los datos que exige el programa; para ello se utiliza hoy, el modelo 53-63, originalmente concebido para la expedición de certificados médicos. Con vistas a diseñar un modelo que se ajustara a los requerimientos actuales para la prescripción, estudiamos el Programa Nacional de Medicamentos (1998), el Programa para el Uso Racional de Medicamentos (1999) y otros documentos relacionados con el control de los medicamentos. Se elaboró una propuesta de modelo que además de responder estrictamente a las necesidades de información del Programa Nacional de Medicamentos, está diseñada de forma tal que por su tamaño, solo requiere la mitad del papel que se utiliza en el modelo de certificado médico usado hasta ahora para este fin. Existen aproximadamente 1 500 000 pacientes a los cuales, este año, se les ha prescrito algún medicamento de los que se expenden por el sistema de tarjeta control. De utilizar el modelo propuesto, solo por concepto de papel, en 1 año el ahorro sería de 3 300 USD, a los 5 años de 16 500 USD, y a los 10 años se ahorrarían unos 33 000 USD. Además de uniformar la información que se intercambia en relación con este programa nacional, facilita la investigación científica relacionada con la prescripción de estos medicamentosThe delivery of drugs to patients (mainly for the treatment of non-communicable chronic diseases) is among the aspects included in the National Drug Program. To register a control card in the pharmacy, the prescriber issues a certificate with the necessary data required by the program. At present it is used the form 53-63, which was originally utilized for medical certificates. In order to design a form that adapts to the current requirements for prescription, we studied the National Drug Program (1998), the Program for the Rational Use of Drugs (1999) and other documents related to drug control. A proposal was made that besides meeting the needs of information of the National Drug Program strictly, is designed in such a way that only requires half of the paper that was used up to now in the medical certificate. Approximately 1 500 000 patients have been prescribed this year some of the drugs sold under the control card system. The use of the proposed form just on account of paper will cause a saving of USD 3 300 in the first year, USD 16 500 in the fifth year and USD 33 000 in the tenth year. In addition to standardize the information that is exchanged in connection with this national program, the use of this form makes easy the scientific research related to the prescription of these drugs

El presente trabajo se realizó teniendo en cuenta la insuficiente bibliografía sobre el tema y la necesidad de sistematizar el uso de las técnicas con recursos artísticos, en la atención primaria. Tuvo por objetivos mostrar su utilidad, cómo insertarlas en las principales tareas de salud y orientar metodológicamente su implementación en la atención primaria de salud (APS). Se realizó una extensa revisión bibliográfica y se analizaron experiencias en el trabajo en este nivel de atención, se expusieron las principales características de las terapias con recursos artísticos, y se estructuraron orientaciones metodológicas para una implementación eficiente. Se concluyó que la creatividad es el principal elemento integrador y de crecimiento que posibilita la efectividad de estas técnicas, y que una adecuada aplicación de las orientaciones metodológicas posibilita la obtención de éxitos en torno al crecimiento de la salud en las tareas de la APSThe present paper was made taking into account the insufficient bibliography on this topic and the need to systematize the use of techniques with artistic resources in primary health care. The objective of this paper was to demonstrate the usefulness of these techniques, the way to insert them in the main health tasks and to methodologically regulate their implementation at the primary health care level (PHC). An extensive bibliographic review was made and some working experiences at this care level were analyzed. The main characteristics of the therapies with artistic resources were shown and methodological instructions were structured for an efficient implementation. It was concluded that creativity is the main integrating and growth element that makes possible the effectiveness of these techniques and that an adequate application of the methodological instructions allows to succeed in the growth of health in the PHC tasks