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Introduction: renal lithiasis is very common, the predominant symptom is pain, generally intense, which must be alleviated, and homeopathic treatment is an option accessible to everybody. Objective: to evaluate the results of homeopathic treatment with calcareous carbonic 30CH indicated in patients diagnosed with renal lithiasis. Methods: a prospective longitudinal descriptive study was carried out in adult patients with a diagnosis of renal lithiasis attended at the Urology Service of the "Arnaldo Milián Castro" Hospital of Villa Clara Province during the years from 2017 to 2020. They were included 220 patients willing to cooperate with the study and were indicated treatment with calcareous carbonic 30CH. Results: female sex (115, 52.3%), age between 30 and 44 years (78, 35.5%), rural origin (129, 58.6%), consumption of well water (168, 76.4%), presentation with pain, nausea and vomiting, left lithiasis - in most cases (115, 52, 37 patients expelled the calculus in less than 30 days and 140 in the second month of treatment, 210 patients were cured, with 213 negative ultrasound scans, in the remaining patients the symptoms were relieved and the size of the lithiasis was reduced, there were few complications. Conclusions: the results of cure in more than three quarters of the patients treated confirm the use of 30CH carbonic calcarea as another option in the treatment of renal lithiasis.

Introduction: the Medical-Dental-Pharmaceutical Corps, founded on December 11, 1892 in Santa Clara, was one of the oldest and most enduring scientific societies in Cuba. Objective: to specify the origin and development of the Medical-Dental-Pharmaceutical Corps of Santa Clara and to demonstrate that it was one of the oldest and most enduring societies of its kind in Cuba. Methods: a historical documentary research was carried out during 2019, using theoretical methods that allowed the analysis of the study objective, based on the interaction of the historical and the logical and from the temporal and spatial dimensions, and empirical: the documentary analysis and interviews to important informants. A methodological triangulation was carried out to arrive at integrative considerations. Results: some historical antecedents of the development of Public Health in Santa Clara and the emergence of important personalities of Medical Sciences in the territory at the end of the XIX century and beginning of the XX century were addressed. These personalities allowed the creation of a scientific society that organized and supported the development of those professions in Santa Clara and exerted its influence in the province. Conclusions: the foundation of the Medical-Dental Pharmaceutical Corps of Santa Clara represented a step forward for the development of Medical Sciences in the territory and particularly in Villa Clara and was, after the Society of Clinical Studies of Havana, one of the most stable in the country in the field of Medical Sciences.

Introducción: en los años 60 en la Provincia de Villa Clara quedó constituido el Servicio de Urología en el Hospital “Celestino Hernández Robau”; en la actualidad está difundido por toda la provincia y tiene su eje fundamental en el Hospital “Arnaldo Milián Castro”. Objetivo: dar a conocer con más profundidad los diferentes acontecimientos relacionados con la Urología en Villa Clara. Método: se realizó una revisión de los expedientes y se entrevistó a los profesionales de más años de experiencias. Desarrollo: en los años 60 el Dr. Julio César Vigil Quiñones desempeñó su servicio social verticalizado en esta Especialidad. El desarrollo científico-tecnológico ha estado presente en todos los momentos de la Urología y ha hecho posible el surgimiento de nuevos medios, así como la implementación de nuevas técnicas quirúrgicas para mejorar la calidad de vida. Conclusiones: los avances alcanzados han repercutido favorablemente en la población cubana y villaclareña específicamente porque han mejorado la calidad de vida de los pacientes atendidos.

Urethrovaginal fistula is uncommon and its surgical treatment can be very challenging because of poor local tissue quality; two or more procedures may often be required, making it discouraging for many who use vaginal procedures with favorable results: urethro-compression, urethrosuspension, and urethroplasty. It is presented a female patient of 64 years old operated of rectocistocele and uterine prolapse with diagnosis of urethrovaginal fistula. Due to the history of urinary incontinence of stress presented by the patient before surgery of the uterine prolapse since the fistula located in the proximal urethra or bladder neck the mechanism of continence may be compromised, it was decided to perform the repair of the urethrovaginal fistula with a technique successfully used in another patient who presented a fistulous trajectory between bladder trine and vagina and support this procedure with a urethrosuspension with mesh free of suburetral transobturator tension. The patient evolved satisfactorily, which supports the use of this surgical technique that was performed for the first time in this hospital.

Introducción: la infección por el virus de hepatitis C es frecuente en pacientes con insuficiencia renal crónica con o sin tratamiento hemodialítico; en ellos este agente patógeno es la principal causa de enfermedad hepática. Objetivos: describir aspectos epidemiológicos, clínicos, endoscópicos e histológicos del hígado en un grupo de pacientes con insuficiencia renal crónica en régimen de hemodiálisis que padecen el virus de hepatitis C. Método: se realizó un estudio descriptivo y transversal entre abril de 2015 y marzo de 2016. El universo estuvo formado por todos los pacientes de 18 años y más, de ambos sexos, con insuficiencia renal crónica en régimen de hemodiálisis que padecen virus de hepatitis C, tratados en el Hospital “Arnaldo Milián Castro”; la muestra fue de 34 pacientes. Resultados: el mayor número de afectados correspondió al rango de 40 a 59 años de edad (61,8%) y predominó el sexo masculino (61,8%). Un total de 23 pacientes (67,6%) tenían más de seis años de evolución de la infección y la alaninoaminotransferasa estuvo elevada en 26 (76,5%). Fue la hepatomegalia el hallazgo clínico que predominó (20, 58,8%) y por examen laparoscópico (67,6%) e histológico (83,3%) destacó la hepatitis crónica. Conclusiones: la infección por el virus de hepatitis C fue más frecuente en el grupo de edades entre 40 y 59 años y predominó en hombres. El parámetro bioquímico de mayor relevancia fue la elevación de alaninoaminotransferasa y en la clínica predominó la hepatomegalia. A mayor tiempo de infección correspondió mayor afectación hepática, tanto endoscópica como histológicamente.

Introducción: el tratamiento conservador es la opción más utilizada en el tratamiento del trauma renal porque la mayoría de estas lesiones evolucionan satisfactoriamente. Objetivo: describir los resultados obtenidos con el tratamiento conservador en los pacientes con trauma renal. Método: se realizó un estudio descriptivo, retrospectivo con 89 pacientes con diagnóstico de trauma renal tratados en el Servicio de Urgencia del Hospital “Arnaldo Milián Castro” desde el año 2005 hasta 2014. Resultados: el diagnóstico fue más frecuente en pacientes masculinos de 30-49 años de edad, las caídas se presentaron con mayor frecuencia y afectaron al 52,80%, el 76,86% fueron observados y el 14,60% intervenidos quirúrgicamente, la mayoría de los pacientes evolucionaron satisfactoriamente y no se presentó ningún fallecido. Conclusiones: la conducta conservadora en el trauma renal es conveniente y justificada en la mayoría de los casos.

Introduction: non-alcoholic fatty liver is the third cause of chronic liver disease in the world and is associated with obesity, diabetes mellitus type 2 and hyperlipidemia, among others. Objective: to describe some clinical, biochemical, echographic and histological aspects in a group of patients with liver disease by non-alcoholic fat deposition. Method: a descriptive cross-sectional study was carried out from September 2014 to February 2016, the sample was 41 patients who underwent an analytical evaluation and the histological and hepatic ultrasound findings were compared. Results: the sex most affected was female (33, 80,5%); the most altered biochemical parameters were alaninoaminotransferase (34, 82,9%) and glycemia (33, 80,5%); 20 of 26 patients older than 45 years presented steatohepatitis with fibrosis and 22 of the total severe steatosis according to ultrasonography (53,6%). Conclusions: female gender and age over 45 years predominated, the alaninoaminotransferase and the glycemia were the biochemical parameters that showed the highest elevation, the most relevant ultrasonographic finding was the severe hepatic steatosis and the existence of steatohepatitis with fibrosis prevailed since the anatomopathological point of view.

Nonalcoholic fatty liver is frequently associated to diabetes mellitus not insulin-dependent. In order to describe its biochemical, sonographic and histological aspects in a group of diabetic patients non-insulin dependent it was realized a cross-sectional descriptive study at “Arnaldo Milián Castro” Hospital in the period between September 2013 and January 2016. The sample was consisted of 22 patients who were underwent to determination of waist/hip index, analytical evaluation and the findings were pointed out histopathological of the liver. The relationships between some risk factors of progression of the disease and the results of liver biopsy were described. The glycemia was the most altered biochemical parameter (81.8%), followed by alanine aminotransferase and lipid profile (77.3% each one); 68.2% of patients had steatohepatitis with fibrosis; the alanine aminotransferase rose by 77.3% of patients with steatohepatitis and a significant association between the last and the increase of waist/hip index was found. Advanced stages should be suspected in nonalcoholic fatty liver in patients with diabetes non-insulin dependent.

Urinary incontinence is a common problem that increases with age. The incidence is variable, with a prevalence of 11%-72%; the procedure of transobturator suburethral tape, because of the simplicity, the easy learning, to effectiveness, to minimum invasion, to low morbidity, to limited surgical time, to short hospital stay and to faster recovery of patients has become in the treatment of choice in the treatment of urinary incontinence of effort. A cross-sectional study was performed to 23 patients diagnosed with urinary incontinence who were treated at the Urology Service of "Dr. Daniel Codorniu Pruna" University Hospital of Placetas and at "Arnaldo Milián Castro" University Provincial Hospital of Santa Clara during the period between September 2013 and July 2015 with the aim of describing the results of the implementation of the transobturator suburethral tape. The average age of the patients was 54.04 years; all were multiparous, with an average of 2.5 births, 4.04 pregnancies, 1.39 abortions (spontaneous or induced) and 11 (47.82%) had been previously operated by urinary incontinence of effort; all, except two fulfilled the criteria for healing. The use of transobturator suburethral tape in the treatment of genuine stress urinary incontinence for effort can give prompt solution, economical and effective to patients with this technique solutions recover quickly, they reduce hospitalization time and achieve a return to productive activity form earlier.

In order to characterize the gastrointestinal manifestations in patients with American trypanosomiasis a descriptive cross-sectional study was conducted in a population consisting of 130 patients with positive IgG antibodies to Trypanosoma cruzi treated at the " Victoria South"Medical Center of integral diagnostic from José F. Ribas, municipality, Aragua State, Bolivarian Republic of Venezuela , from March 2012 to February 2013. The most affected age group was 61 years and over and not predominantly found in sex ; asymptomatic patients predominated , followed by those with digestive symptoms ; gingivostomatitis was the clinical finding was found , followed dyspeptic disorders and hepatomegaly , megacolon with chronic constipation, esophageal achalasia and megaesophagus . Hepatitis B was detected in four patients and C in two.

The The case of a male patient who attended the Gastroenterology Consultation due to discomfort in the mouth, as well as difficulty in swallowing solids, is reported. The patient had no other symptoms. It was decided to perform an esophagogastroduodenoscopy, which showed the presence of two mirror ulcers near the gastroesophageal junction. It was determined that the cause was the ingestion of drugs. Sucralfate treatment was started and symptoms improved within seven days.

Renal nephroblastoma is a solid tumor common in childhood that has an annual incidence of 7.8 per million children under 15 years of age, with a peak age of onset in the third year of life. Its incidence in adults is extremely rare and is estimated in 1% of the total number of nephroblastomas –about 250 cases reported in the literature. Its prognosis is more unfavorable than in children because it usually has a more malignant histological type and a higher clinical stage. In addition, the low number case prevents a proper assessment of treatment. The case of a 37-year-old patient is reported. Seventeen years ago, in studies conducted due to vision loss and hypertension, it was determined that he suffered from a kidney tumor, the pathological result showed it was a Wilms tumor. He has had a survival free of recurrence, and a full recovery from the symptoms that led to the diagnosis.

A cross-sectional descriptive study was conducted with all patients who presented with stress urinary incontinence at the Arnaldo Milian Castro Clinical-Surgical Hospital from January 2010 to January 2012 in order to characterize aspects of incontinence as a economic problem and social problem. Once the diagnosis was made, a survey was conducted in each patient, which was completed after surgery and after returning to their daily activities. According to the results obtained it was concluded that stress urinary incontinence is more common in women of the rural area, between 50-59 years of age and multiparous women. Most sought medical help between the first and fifth years of evolution of the disease. Cough was the key element that triggers it, and it causes profound alterations in the quality of life of women (psychological health, economic and social areas), which improves significantly after surgical treatment.

The red lionfish (Pteroirs volitans) belongs to the family Scorpaenidae (scorpion fish). It is native to coral reefs in the Indian Ocean and western Pacific Ocean. Its poison consists of toxins that are water-soluble thermolabile polypeptides. The case of a 78-year-old white male is reported. He was a fisherman with a history of good health, normal body weight, who was conducting his normal fishing activities and was attacked by the lionfish. A necrotic tissue debridement was performed at the level of the left lower limb to the upper third. Surgery was decided, with a diagnosis of Fournier's gangrene, and a necrectomy was performed in a wide area. During his hospital stay, he underwent antibiotic treatment with crystalline penicillin, amikacin, metronidazole, meropenem, cefepime, sulfaprim, piperacillin. He was discharged alive on April 2, 2012.

Fournier's gangrene is a fast and progressive synergistic necrotizing fasciitis of multibacterial origin which is rare but very serious. This study was conducted in order to characterize the main causes of its high lethality. A retrospective and descriptive study was conducted in 16 patients with Fournier's gangrene admitted by the emergency service of the Arnaldo Milian Castro Provincial University Hospital during the period from January 2007 to December 2011. The information about variables of interest for the study was collected. The disease was more common in patients over 60 years of age and predominantly male. The group suffering from with diabetes mellitus and cancer prevailed, which was only significantly associated with patient outcome at the beginning of the disease. The analysis of the most frequently isolated germs and the antibiotic combination most widely used showed no significant difference when compared with patient outcomes. Scrotal location was the most frequent one, and as the spread of infection increased the unfavorable outcomes also increased as well as mortality. The time elapsed since the onset of the disease and surgical treatment is the most important variable in the outcome of patients affected by this disease. Fournier's gangrene is a disease of high mortality, especially in patients over 60 years of age with predisposing factors such as diabetes and cancer, so early diagnosis and early aggressive therapy are essential.

Sarcomatiodes carcinomas that originate in the renal pelvis are uncommon neoplasms. All previously published cases have been isolated cases and were characterized by poor prognosis. The case of a 60 year-old patient is reported and the clinical, radiological and histological aspects are described. In the medical literature in English, some 127 cases of carcinosarcoma located in the urogenital tract have been described in the last fifty years; considering that only nine originated in the pelvis, it is possible to understand the importance of this case.

Prostatic cancer is one of the most common malignant tumors, and represents the second cause of death in males. There are several therapeutic methods to treat this illness and the prognosis and the biochemical relapse depend on the stage and the behavior.

The case of a patient with a history of arterial hypertension, who presents an episode of hematuria, is reported here. After some tests, it was decided to perform a surgical intervention due to the presumptive diagnosis of a renal tumor. During the intervention the existence of a renal artery aneurysm was determined and a nephrectomy was carried out. During the postoperative period the patient showed a favorable evolution; the symptoms disappeared and the arterial tension returned to normal without medications. The patient is currently followed-up at The Urology Consulting Room.

A descriptive and retrospective study was carried out at the Gastroenterology Services of the Arnaldo Milian Castro University Hospital in Santa Clara, Villa Clara. It included all the patients who were considered as having symptoms of obstructive disease of the main bile duct, with the indication of an endoscopic retrograde cholangiopancreatography, since February 2004 to March 2007. The universe of study was formed by the total amount of procedures carried out, and the sample was formed by the concluding reports of benign disease of the main bile duct. The information was obtained by a review of the reports of cholangiopancreatographies. In the series, the patients from the age group between 51 and 60 years of age (31.1%) were prevalent; being the female sex the most frequent one (67.9%). The suspicion of gallbladder lithiasis and choledocal lithiasis was the most frequent indication (39.9 %), being the choledocal lithiasis (44.4%) and odditis (29.9%) the most diagnosed conditions. The most used therapeutic procedure was the endoscopic sphincterotomy with extraction of calculus (52.6%); the complications represented 3.9 percent, with prevalence of discrete bleeding.

A case of urinary schistosomiasis produced by a schistosoma haematobium detected in Villa Clara Province in a 19 year old student from the South African Republic is presented. A detailed review of this disease was carried out. The case was treated in the Urological Services of the Arnaldo Milian Castro Provincial University Hospital with the previous coordination with the Provincial Centre of Hygiene and Epidemiology. The treatment used was praziquantel and the disease evolved to the cure. The patient is currently under the follow up in the outpatient department of urological services with the objective of preventing or detecting in time the appearance of a relapse or the appearance of vesical neoplasias, or both.

Se estudiaron mediante ecocardiografía 18 pacientes con antecedentes de leucemia aguda promielocítica y tratamiento con antraciclinas. Como indicadores de la función sistólica se utilizaron la fracción de eyección y la de acortamiento, y para la función diastólica, la relación eyección/acortamiento y los tiempos de desaceleración y de relajación isovolumétrico. Según el tiempo transcurrido desde la última dosis de antraciclinas recibida hasta el momento del estudio se dividieron los pacientes en 2 grupos: el grupo 1 con 12 meses o menos y el grupo 2 con más de 12 meses, para determinar cardiotoxicidad crónica y tardía, respectivamente. La edad promedio en ambos grupos fue de 31 años. Las dosis acumulativas de antraciclinas (DAA) expresadas en milígramos por metro cuadrado de superficie corporal (mg/m2) fueron de 593.42 en el grupo 1 y de 497.27 en el grupo 2. En el grupo 1, 2 pacientes (28,5 %) presentaron alteraciones de la función ventricular como reflejo de cardiotoxicidad crónica; en el grupo 2, 5 pacientes (45,4 %) mostraron alteraciones de esa función como reflejo de cardiotoxicidad tardía. De estos 7 pacientes, 6 habían recibido DAA mayores de 400 mg/m2. De Los 11 pacientes que no la presentaron, 10 habían recibido también DAA mayores de 400 mg/m2Cardiotoxicity in patients with acute promyelocytic leukemia treated with doses of anthracyclines 18 patients with history of acute promyelocytic leukemia and treatment with anthracyclines were studied by echocardiography The fraction of ejection and that of shortening were used as indicators of the systolic function, whereas the ejection/shortening relation and the times of deceleration and of isovolumetric relaxation were utilized for the diastolic function. According to the time elapsed from the last dose of anthracyclines to the moment of the study, the patients were divided into 2 groups (group 1 with 12 or less months and group 2 with 12 or more months) to determine chronic and late cardiotoxicity, respectively. Average age in both groups was 31 years old. The accumulative doses of anthracyclines (ADA) expressed in milligrams per square meter of body surface (mg/m2) were 593.42 in group 1 and 497.27 in group 2. In group 1, 2 patients (28.5 %) presented alterations of the ventricular function as a reflex of chronic cardiotoxicity. In group 2, 2.5 patients (45.4 %) showed alterations of that function as a reflex of late cardiotoxicity. Of these 7 patients, 6 had received ADA over 400 mg/m2 . Of the 11 patients that did no have it, 10 had also received ADA over 400 mg/m2