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Fundamento: en los pacientes con drepanocitosis las alteraciones de la función pulmonar son frecuentes y pueden detectarse por la espirometría. Objetivo: describir las alteraciones de la función ventilatoria en los pacientes con drepanocitosis seguidos en consulta provincial de hemoglobinopatías. Métodos: estudio observacional, descriptivo, de corte transversal. Se incluyeron 76 pacientes, seleccionados por muestreo no probabilístico accidental, de 88 adultos seguidos en el Hospital Dr. Gustavo Aldereguía Lima. Las variables estudiadas fueron: edad, sexo, tipo de hemoglobinopatía, síntomas respiratorios, antecedentes de síndrome torácico agudo, (formas clínicas y número de eventos), comorbilidades y patrón ventilatorio. Las pruebas funcionales ventilatorias se realizaron con Microspiro digital Hellige. Resultados: el grupo de edad entre 20-29 años fue el más frecuente (34,2 %). Hubo discreto predominio del sexo femenino (56,1 %) y del genotipo SS (67,1 %). El más frecuente de los síntomas respiratorios fue la disnea y entre las comorbilidades la insuficiencia cardíaca en 9,2 % de los enfermos. En 42,1 % se registró antecedentes de síndrome torácico agudo, neumonía en la mayoría de los casos. Nueve enfermos (11,8 %) presentaron trastornos obstructivos y 43 enfermos (56,6 %) un patrón restrictivo. En el genotipo SS el riesgo de tener alteraciones en la espirometría resultó tres veces mayor que el resto [OR=3,2 IC (1,7-5,9)] Conclusiones: resultó común el hallazgo de prueba funcional ventilatoria alterada con predominio del patrón restrictivo. Estas modificaciones se observaron con mayor frecuencia en pacientes con el genotipo SS.

Foundation: University students do not consciously assimilate that the system of knowledge of the discipline Society and Philosophy may help them solving new problems and situations using its concepts and logical operations. Objective: describe the student´s perception about the conscious assimilation of the content of the discipline Society and Philosophy, taught with an increment of the productive level. Methods: pedagogical research realized at the University of Medical Sciences, Cienfuegos, from February to July 2018, in four first year groups of the medical career at their Philosophy lessons. There was an increase of the productive assimilation level in the seminar guidelines and practical lessons, on the bases of designing integrating questions. The number of questions decreased. It was applied a survey to the students to confirm the predominance of the assimilation productive method over the reproductive one in the seminaries may strengthen the conscious assimilation of the subject. The measurement was done at concluding the topic related to Marxist-Leninist nosology since it is considered essential to develop the logical thinking of the future health professional. Results: 95% of the students validated the transformation applied to the guidelines of the practical lessons and seminaries, as a way for a better assimilation of knowledge. They acknowledge the importance of the subject for a better understanding of the world and their future profession. Conclusion: it was demonstrated that the level of productive assimilation in frequent evaluation of the discipline Philosophy and Society the university student assumes consciously that the discipline may help them in the solution to many problems and situations using its concepts and logical operations.

El modelo clásico de la coagulación, propuesto hace más de 40 años, separa las fases celular y humoral de la coagulación. Considera que el proceso de hemostasia se consigue a través de la activación secuencial de enzimas efectoras en dos vías independientes: la extrínseca y la intrínseca. Una nueva teoría, conocida como modelo celular de la coagulación, reemplaza la tradicional hipótesis de las cascadas y enfatiza en las células como elementos esenciales capaces de dirigir el proceso hemostático, mediante la interacción de superficies celulares, factor tisular y factor VII, en tres fases simultáneas: iniciación, amplificación y propagación. En la presente revisión bibliográfica se abunda con detalle sobre la nueva teoría celular de la coagulación, para lo cual se consultaron 33 artículos, con el objetivo de describir los aspectos más importantes de la nueva teoría y sus ventajas respecto a la vieja.

Recombinant human erythropoietin has been used for more than two decades in clinical practice with promising results in the treatment of anemia associated with chronic renal insufficiency and in patients with cancer. Recent evidence has uncovered new nonhematopoietic functions of this protein and have brought new hope in the treatment of diseases with ischemic component. In the present review is rife with detail about these new features in the light of new discoveries and explores the therapeutic opportunities offered by these new scientific evidence.

Bakground: Neutropenia and infections are the most restrictive side effects in chemotherapy application. The granulocytic colonies stimulating factor activates the neutrophils, shortens the neutropenic period and can be effective against the potential risk of infection. There is a need of studies for its commercialization to endorse their effectiveness and security. Objective: To evaluate the impact of the G-CSF in primary and secondary prevention and neutropenia episodes, in onco-haematological patients in Cienfuegos. Method: 95 neutropenic episodes were studied, picked up in clinical histories and data collection notebooks belonging to 47 patients treated in the University Hospital ¨Dr. Gustavo Aldereguía Lima¨ in Cienfuegos and happened during one year (2005-2006). It was analyzed: demographic data, absolute neutrophils count values, number of administered doses, treatment regime and possible treatment interruptions Results: 50, 5% received treatment in an ambulatory way. There was treatment interruption in 9 episodes, 9,5% and the mean dose number administered to obtain the recovery of neutrophils absolute count was 6,69. Conclusions: The product was effective, sine the decrease of neutropenic episodes could be verified, as the elevation of neutrophil values in approximately one week, what allowed a better pursuit of chemotherapy to patients of the studied series.AbstractTo demonstrate the effectiveness of Leukocim an open, phase IV clinical trial was designed, 39 patients from Cienfuegos were evaluated with 73 neutropenic episodes in primary or secondary prophylaxis or treatment, the demographic parameters behaved with an age 49.86 year old average, the predominant sex was the feminine 64.38%, 73.97% belonged to the white race, when the effectiveness was analyzed we obtained that 46.5% received the treatment in an ambulatory way, whereas 52.1% was hospitalized; one patient abandoned before beginning the treatment, the 12,3% of patients abandoned the study, the dose number received in order to correction CAN was between 3 and 7, behaving with a stocking of 1.26 before receiving the treatment and of 5.82 after the same one receiving the next cycle chemo y/o radiotherapy in time demonstrating this way the effectiveness of the product.

Background: The survival of patients with multiple myeloma varies. Frequently we don’t identify the patients that could be cured with advanced therapies, nor even recognize those, in which we expect a long survival with the classic treatment measures. That’s why it is necessary the study of prognosis factors to achieve an optimum stratification and to individualize the pattern to follow. Objectives: To determine the 3 years survival of the patients with multiple mieloma and the factors that influence it. Methods: A descriptive study of a series of cases of 50 patients with multiple mieloma. The socio-demographic characteristics were studied, as well as the clinic-humoral state, type of treatment and response to it, the over life curves were calculated by the estimates of Kaplan-Meier. A uni-varied analysis was made for which the patients were stratified in groups, that were compared through the long-rank method. A trust interval of 95% was accepted. Results:The total 3 years survival was of 37%. The 58% of the cases used the combination of Melfalan with Prednisona as initial therapeutic scheme. The 47,1% of the treated patients had a positive response to the chemotherapy. There were no alarming differences in response percentage and in survival among those who received Melfalan-prednisona and those who were treated with schemes that combined both drugs. The functional capacity reduction, the association to renal insufficiency, and not having response to treatment were the factors associated to an early mortality. Conclusions: The identification by means of this study of the factors related with the illness, would allow us to stratify the sick persons and to individualize its cares to improve the survival.