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Abstract Background Metabolic dysfunction-associated steatotic liver disease (MASLD) is a predominant chronic liver condition globally and is strongly associated with obesity, diabetes mellitus, and dyslipidemia. Essential phospholipids (EPL) are recommended as supportive treatment for managing liver conditions, including MASLD or metabolic dysfunction-associated steatohepatitis, cirrhosis, and viral hepatitis. While efficacy of EPL as an adjunctive therapy in MASLD treatment has been established earlier, certain aspects of its usage such as the impact of standard-of-care parameters, effect of EPL on quality of life (QoL) and change in symptoms evaluation in patients with MASLD remain unexplored. The proposed trial aims to assess the efficacy and safety of EPL and the subsequent QoL of patients with MASLD associated with type 2 diabetes mellitus (T2DM) and/or hyperlipidemia and/or obesity. Methods This is a multicenter, multinational, double-blind, randomized, two-arm, placebo-controlled, parallel-group, phase IV clinical trial. The trial is being conducted in approximately 190 patients who are randomized on a 1:1 basis either to the EPL arm (Essentiale® 1800 mg/day orally + standard of care) or placebo arm (placebo + standard of care). The primary outcome is to assess the efficacy of EPL on hepatic steatosis, as measured by transient elastography, from baseline to 6 months. The secondary outcomes include change in QoL parameters, as measured by the Chronic Liver Disease Questionnaire–metabolic dysfunction-associated steatotic liver disease/ metabolic dysfunction-associated steatohepatitis and change in symptom evaluation (using the Global Overall Symptom scale) from baseline to 6 months for symptoms, including asthenia, feeling depressed, abdominal pain/discomfort, or fatigue. Discussion The current protocol design will allow to comprehensively explore the efficacy of EPL added to the standard of care on hepatic steatosis and QoL and its safety in patients with MASLD associated with T2DM and/or hyperlipidemia and/or obesity by assessing various outcome measures. Trial registration European Union Clinical Trials Register, EudraCT, 2021–006069-39. Registered on March 13, 2022.

Summary: Background: The clinical relevance of recurrent venous thromboembolism (VTE) after discontinuing anticoagulation in patients with COVID-19-associated VTE remains uncertain. We estimated the incidence rates and mortality of VTE recurrences developing after discontinuing anticoagulation in patients with COVID-19-associated VTE. Methods: A prospective, multicenter, non-interventional study was conducted between March 25, 2020, and July 26, 2023, including patients who had discontinued anticoagulation after at least 3 months of therapy. All patients from the registry were analyzed during the study period to verify inclusion criteria. Patients with superficial vein thrombosis, those who did not receive at least 3 months of anticoagulant therapy, and those who were followed for less than 15 days after discontinuing anticoagulation were excluded. Outcomes were: 1) Incidence rates of symptomatic VTE recurrences, and 2) fatal PE. The rate of VTE recurrences was defined as the number of patients with recurrent VTE divided by the patient-years at risk of recurrent VTE during the period when anticoagulation was discontinued. Findings: Among 1106 patients with COVID-19-associated VTE (age 62.3 ± 14.4 years; 62.9% male) followed-up for 12.5 months (p25-75, 6.3–20.1) after discontinuing anticoagulation, there were 38 VTE recurrences (3.5%, 95% confidence interval [CI]: 2.5–4.7%), with a rate of 3.1 per 100 patient-years (95% CI: 2.2–4.2). No patient died of recurrent PE (0%, 95% CI: 0–7.6%). Subgroup analyses showed that patients with diagnosis in 2021–2022 (vs. 2020) (Hazard ratio [HR] 2.86; 95% CI 1.45–5.68) or those with isolated deep vein thrombosis (vs. pulmonary embolism) (HR 2.31; 95% CI 1.19–4.49) had significantly higher rates of VTE recurrences. Interpretation: In patients with COVID-19-associated VTE who discontinued anticoagulation after at least 3 months of treatment, the incidence rate of recurrent VTE and the case-fatality rate was low. Therefore, it conceivable that long-term anticoagulation may not be required for many patients with COVID-19-associated VTE, although further research is needed to confirm these findings. Funding: Sanofi and Rovi, Sanofi Spain.

Foundation: Postoperative pain is considered time-limited pain, often poorly controlled. Its management represents a great challenge, since postoperative analgesia must provide the mother with adequate control, and at the same time facilitate care for the baby.Objective: to evaluate the effectiveness of subarachnoid anesthesia with morphine as a treatment for postoperative pain in cesarean section.Methods: descriptive and cross-sectional study carried out at the Martín Chang Puga General Teaching Hospital, in the Nuevitas municipality, Camagüey province, between January 2021 and December 2022. 36 patients to whom subarachnoid anesthesia was applied with Hyperbaric lidocaine plus morphine for cesarean section were considered as the sample.Results: the age between 27-31 years predominated. 63.9% of cesarean patients did not report postoperative pain. Almost half of the population (47.2%) studied presented side effects with the use of intrathecal morphine, mainly pruritus. 80.5% expressed satisfaction with postoperative analgesia.Conclusions: the majority of patients were satisfied with the analgesic treatment, despite the presence of adverse effects, so that the use of intrathecal morphine is effective in the management of post-cesarean section pain.

Introduction: Fournier's gangrene is a necrotizing infection of the scrotum and perineum. It has a global incidence of 1.6/100,000 men. Objective: To present a clinical case of Fournier´s gangrene in the course of secondary peritonitis due to a perforated prepyloric ulcer. Clinical Case: White male patient, 67 years old, with a history of being a smoker, who was admitted to the General Surgery Service for abdominal pain and increased volume of the genitals, abdominal pain more localized in the hypogastrium, accompanied by vomiting of contents. food and fever of 38 °C, with chills. Fournier's gangrene secondary to acute peritonitis was diagnosed, which was treated in the emergency services. Conclusions: Fournier's gangrene is one of the urological emergencies that can occur in the course of acute peritonitis due to perforation of a peptic ulcer.

Background: the diagnosis of multiple sclerosis is a challenge for the clinical physician, given its wide variety of symptoms and clinical forms of presentation, therefore a close interrelation between clinical characteristics and spinal fluid analysis is required to make the correct and timely diagnosis. Objective: to determine the clinical and analytical correlation ofimmunoglobulin values in cerebrospinal fluid in patients with suspicion of multiple sclerosis,treated at the Provincial Clinical Surgical Teaching Hospital "Manuel Ascunce Domenech" from 2020 to 2023. Methods: a cross-sectional analytical observational study was performed inpatients and time period defined in the objective. The study population consisted of 17 patients. Descriptive and inferential statistics were used for the data analysis. Results: there was apredominance of the female sex (88.2 %); patients between 30 and 39 years (29.4 %), recurrent multiple sclerosis (58.8 %) and between one and three months the time of evolution at diagnosis (35.3 %). Immunoglobulin G values in cerebrospinal fluid were increased in all patients and immunoglobulin M in 47.1 %, showing stronger correlation with clinical forms. Conclusions:Increased values of G and M immunoglobulins in cerebrospinal fluid increase the suspicion of multiple sclerosis.

Schwannoma are soft tissue tumors that originate in Schwann cells of the nerve sheath in peripheral, cranial or visceral nerves, anywhere in the body. This is an extremely unusual entity. The article describes the case of a 47-years-old black-skinned patient with a history of health who attended a triage consultation, reporting that one month ago he had started having difficulty urinating, leading to acute urinary retention. The physical examination confirmed, through digital rectal examination, a tonic sphincter, an empty rectal ampulla, a grade IV enlarged prostate with a fibromuscular consistency with a smooth and mobile surface; not painful. After carrying out imaging and complementary studies, he received surgical treatment at the María Curie Provincial Oncological Teaching Hospital, in Camagüey, Cuba. He was diagnosed with a retroperitoneal schwannoma, confirmed by the Pathology report. Currently the evolution of the patient is positive, without medical treatment, but with periodic follow-up.

The case of a 35-years-old female patient with a history of presenting a murmur since childhood and who had to undergo surgery for uterine fibroid is presented. The anesthesiologist, during the preoperative consultation, verified the aforementioned murmur, so it was decided to postpone surgery and consult with a cardiologist. The echocardiographic examination showed that the patient had severe aortic stenosis with preserved ejection fraction, stress test: functional class I, without ischemia. Using orotracheal general anesthesia, a total abdominal hysterectomy was performed without complications. The perioperative management of aortic stenosis is of vital importance for the anesthesiologist.

Hernia with loss of the right of domain can be defined as one in which more than 20 % of the abdominal content is found in the hernia sac. Repair, without preoperative maneuvers that increase abdominal capacity, can cause abdominal compartment syndrome. Numerous maneuvers are used to prevent this. We present the case of a 62-year-old patient, who goes to the emergency department referring that approximately 20 years ago he presents a tumor increasing in size in the right inguinal region and interests even the scrotum. After a physical effort he felt pain in the region, without changes in color or temperature, denies vomiting and has kept expelling feces and gases. Upon physical examination, the presence of a tumor in the right inguinoscrotal region, of about 30 x 40 cm, not reductable, painful, without peritoneal reaction, without changes in coloration or temperature. Hydroaerial noises in the right scrotum. Admitted with a diagnosis of right inguinoscrotal hernia with loss of right of domain. Additional preoperative examinations are indicated, Vygon intraperitoneal catheter size 18 is placed in the left iliac fossa to initiate preoperative progressive pneumoperitoneum, which fostered in the surgical act, the reintroduction of the viscera to the abdominal cavity, the hernial plasty and the favorable evolution of the patient. The use of preoperative progressive pneumoperitoneum in the presurgical treatment of inguinoscrotal hernia with loss of right to home is a safe and successful alternative.

Head injuries are defined as anatomo-functional damage of the skull and its structures, produced by direct or indirect trauma of variable energy. Among its complications, intracranial hypertension is one of the factors that favor the appearance of secondary damage; its severity and duration have been correlated with a fatal prognosis, being the main cause of death. We present the case of a white male patient, 57 years old, with a history of chronic ethylism, who after three hours of admission because of a mild cranioencephalic trauma, begins with tonic-clonic convulsion and degradation of the level of consciousness. In the absence of more specific examinations, the diameter of the sheath of the optic nerve was determined by ultrasonography, which was increased (left 7.3 mm; right 8.0 mm, respectively). As an initial behavior and faced with indirect confirmation of traumatic intracranial hypertension, the airway was secured with mechanical respiratory support, 20% mannitol perfusion and cardiovascular support. Finally, the patient was referred to a center with the possibility of providing urgent neurosurgical treatment.

Vaginal evisceration due to dehiscence of the vault is a fearsome and rare complication that can appear after the total abdominal hysterectomy, the time that can occur is variable from days to 30 years after the surgery. The diagnosis is clinical and the surgical treatment associated with the use of broad-spectrum antibiotic therapy should be immediate as it is an emergency with a risk of mortality close to 10% by secondary peritonitis and septic shock. We present the case of a 72-year-old female white patient with a history of total abdominal hysterectomy due to uterine fibroma about 10 years ago, who went to the surgical guard for presenting thin loops out of the vaginal. Emergency exploratory laparotomy was performed finding continuity loss of approximately 7 centimeters in vaginal vault, confirming the diagnosis, where prolapse about 40 centimeters of terminal ileum, managing to reduce it without accident. Exploration of the reincorporated portion showed no perforation or vascular involvement. The vaginal vault is closed through the abdomen and then given a vaginal background. She presented no postoperative complications, discharged from hospital on the eleventh day.

The application of biomaterials on immune regenerative strategies to deal with unsolved pathologies is getting attention in the field of tissue engineering. In this context, graphene oxide (GO) has been proposed as an immune-mimetic material largely used for developing stem cell-based regenerative therapies, since it has shown to influence stem cell behavior and modulate their immune response. Similarly, amniotic epithelial stem cells (AECs) are getting an increasing clinical interest as source of stem cells due to their great plasticity and immunomodulatory paracrine activities, even though GO bio-mimetic effects still remain unknown. To this aim, GO-functionalized glass coverslips have been used for AECs culture. The results demonstrated how GO-coating is able to induce and accelerate the Epithelial-Mesenchymal Transition (EMT), in a process mediated by the intracellular activation of TGFβ1-SMAD2/3 signaling pathway. The trans-differentiation towards mesenchymal phenotype provides AECs of migratory ability and substantially changes the pattern of cytokines secretion upon inflammatory stimulus. Indeed, GO-exposed AECs enhance their pro-inflammatory interleukins production thus inducing a more efficient activation of macrophages and, at the same time, by slightly reducing their inhibitory action on peripheral blood mononuclear cells proliferation.Therefore, the adhesion of AECs on GO-functionalized surfaces might contribute to the generation of a tailored microenvironment useful to face both the phases of the inflammation, thereby fostering the regenerative process.

Summary: Background: COVID-19 in paediatric ages could result in hospitalizations and death. In addition, excluding children from vaccination could turn them into reservoirs of the SARS-COV-2. Safe and effective COVID-19 vaccines are urgently needed for large-scale paediatric vaccination. ISMAELILLO study aimed to evaluate safety and immunogenicity of two strengths of a new recombinant receptor-binding domain (RBD) protein vaccine (Abdala) in paediatric population. Methods: A double-blinded, multicentre, randomised, phase 1/2 clinical trial was conducted in nine polyclinics in the province of Camagüey, Cuba. Healthy children and adolescents were stratified according to age (3–11 years old, or 12–18 years old) and they were randomly assigned (1:1; block size four) in two dosage level groups of vaccine to receive three intramuscular doses of 25 μg or 50 μg of RBD, 14 days apart. Main safety endpoint was analyzed as the percentage of serious adverse reactions during vaccination up to 28 days after the third dose (Day 56) in participants who received at least one dose vaccination. The primary immunogenicity endpoint assessed was seroconversion rate of anti-RBD IgG antibody at day 56. The immunogenicity outcomes were assessed in the per-protocol population. This trial is registered with Cuban Public Registry of Clinical Trials, RPCEC00000381. Findings: Between July 15, 2021, and August 16, 2021, 644 paediatric subjects were screened, of whom 592 were enrolled after verifying that they met the selection criteria: firstly 88 were included in Phase 1 of the study and 504 who completed Phase 2. The vaccine was well tolerated. Injection site pain was the most frequently reported local event (143 [8·4%] of 1707 total doses applied), taking place in 66/851 (7·8%) in the 25 μg group and in 77/856 (9·0%) in the 50 μg. The most common systemic adverse event (AE) was headache: 23/851 (2·7%) in the 25 μg group and 19/856 (2·2%) in the 50 μg. Reactogenicity was mild or moderate in severity, represented in 75% of cases by local symptoms, completely resolved in the first 24–48 h. Twenty-eight days after the third dose, seroconversion anti-RBD IgG were observed in 98·2% of the children and adolescents (231/234) for the 50 μg group and 98·7% (224/228) for the 25 μg group without differences between both strength. The specific IgG antibody geometric mean titres (GMT) showed higher titres between participants who received Abdala 50 μg (231·3; 95% CI 222·6–240·4) compared to those who received 25 μg (126·7; 95% CI 121·9–131·7). The mean ACE2 inhibition %, were 59·4% for 25 μg, and for 50 μg, 72·9% (p

A pesar de la prevalencia de enfermedad renal crónica en Guatemala, existen pocos datos sobre los trastornos minerales y del hueso propios de la enfermedad renal crónica. Se diseñó e implementó un estudio transversal observacional en una institución de salud pública de Guatemala. Se incluyeron cincuenta y ocho pacientes con enfermedad renal crónica en estadios III, IV, y V para determinar niveles séricos de creatinina, fósforo, calcio, parathormona (HPT) intacta y albúmina. El objetivo principal del estudio fue determinar si el valor promedio de hormona paratiroidea difiere entre estadios IIIA, IIIB, IV y V, así como estadificar el grado de alteraciones del metabolismo óseo mineral en la población estudiada. Con respecto a los estadios de enfermedad renal crónica, 50% de los pacientes en estadio IIIB; 62% de los estadio IV, y 95% de los estadio V presentaron resultados compatibles con hiperparatiroidismo secundario. En conclusión, se determinó que pacientes en estadio V tenían valores de hormona paratiroidea estadísticamente diferentes, comparado con pacientes en estadios IIIA, IIIB, y IV con un 90% de certeza (p= 6.08 x 10-6)

RESUMEN Introducción: La COVID-19 representa un panorama particularmente estremecedor en los adultos mayores, debido a la alta morbilidad y mortalidad. Diseñar acciones para su atención integral constituye una prioridad de la salud pública en Cuba y un poderoso instrumento para la prevención de esta enfermedad. Objetivo: Diseñar acciones comunitarias e intersectoriales para la COVID-19 en el adulto mayor. Métodos: Se realizó un estudio cuasiexperimental de intervención mediante acciones comunitarias e intersectoriales para prevenir la COVID-19 en los adultos mayores pertenecientes al consultorio 16 del Policlínico “Guillermo Tejas Silva”, en el período de abril a diciembre del 2020. El universo estuvo constituido por 134 gerontes y la muestra de 110. Se desarrolló en tres etapas. Se evaluó el impacto de la intervención. Resultados: Predominaron las gerontes femeninas (50,9 %), las edades de 60-64 años (32,2 %) y los independientes activos (45,5 %). Con la aplicación de la estrategia se aumentó el nivel de conocimiento de los seniles (91,8 %), se controló el 100 % de las enfermedades, se redujeron los trastornos emocionales en un 78,4 % y se diseñaron 185 acciones comunitarias para prevenir la COVID-19 en el adulto mayor. Conclusiones: La sostenibilidad en el control de la COVID -19 en el adulto mayor requiere de la movilización y participación de todos los sectores de la sociedad y la economía, unidos en un esfuerzo conjunto que sustente las acciones comunitarias.

Introduction: Pulmonary carcinoid tumors are rare malignant epithelial neuroendocrine neoplasms. Objective: To describe the clinical case of a patient with a typical lung carcinoid tumor associated with the diagnosis and synchronous treatment of an ovarian teratoma. Clinical Case: Female patient who started studies due to diverticulitis with abdominal pain, dyspepsia and diarrhea. In the evaluation with computerized axial tomography, the diverticular pattern of the sigmoid colon was reported, as well as the incidental diagnosis of a left lung nodule and an ovarian teratoma. The multidisciplinary team decided on a curative therapeutic strategy with different surgical techniques. A lower lobectomy plus oophorectomy was performed, both left, at the same surgery time, without complications. The post-surgical lung biopsy reported a typical carcinoid tumor and the ovarian surgical specimen reported a 7 cm mature teratoma. Conclusions: Surgery with total resection of the tumor in the same surgical act is curative for both tumors. Currently, the patient is cured, asymptomatic, and free of recurrence with a good quality of life.

En Cuba el cáncer gástrico es la octava causa de muerte según el cuadro de mortalidad. El objetivo fue caracterizar la mortalidad por cáncer gástrico en Cuba durante el período 1987- 2015. Se desarrolló un estudio ecológico de series temporales, el universo de estudio fue todos los fallecidos del país cuya causa básica de muerte recogida en el certificado de defunción fue cáncer gástrico. Las variables fueron edad, sexo, estado civil, color de la piel y ocupación. Se calcularon la razón, porcentajes, tasas de mortalidad bruta, ajustada y específica, por edad y sexo, tendencia y pronóstico. Se estratificó el riesgo según provincias de residencia. Se registraron 21 442 defunciones, 78 % adultos mayores de 60 años, el sexo masculino 62,5 %. Las tasas de mortalidad ajustadas por grupos de edad mostraron una tendencia al aumento a partir de los 50-59 años, predominó el color de la piel negra, mayor frecuencia en jubilados y pensionados. Se incrementaron las tendencias y pronósticos del cáncer gástrico, lo que puede estar influenciado por el envejecimiento y otros factores asociados no investigados en este estudio, por lo que se hace necesario incrementar las medidas preventivas en el país, con vista a direccionar con mayor efectividad los planes de acción para disminuir la mortalidad por esta enfermedad.

Background: Interstitial lung sequelae are increasingly being reported in survivors of COVID-19 pneumonia. An early detection of these lesions may help prevent the development of irreversible lung fibrosis. Lung ultrasound (LUS) has shown high diagnostic accuracy in interstitial lung disease (ILD) and could likely be used as a first-line test for post-COVID-19 lung sequelae.Methods: Single-center observational prospective study. Follow-up assessments of consecutive patients hospitalized for COVID-19 pneumonia were conducted 2–5 months after the hospitalization. All patients underwent pulmonary function tests (PFTs), high-resolution computed tomography (HRCT), and LUS. Radiological alterations in HRCT were quantified using the Warrick score. The LUS score was obtained by evaluating the presence of pathological B-lines in 12 thoracic areas (range, 0–12). The correlation between the LUS and Warrick scores was analyzed.Results: Three hundred and fifty-two patients who recovered from COVID-19 pneumonia were recruited between July and September 2020. At follow-up, dyspnea was the most frequent symptom (69.3%). FVC and DLCO alterations were present in 79 (22.4%) and 234 (66.5%) patients, respectively. HRCT showed relevant interstitial lung sequelae (RILS) in 154 (43.8%) patients (Warrick score ≥ 7). The LUS score was strongly correlated with the HRCT Warrick score (r = 0.77) and showed a moderate inverse correlation with DLCO (r = −0.55). The ROC curve analysis revealed that a LUS score ≥ 3 indicated an excellent ability to discriminate patients with RILS (sensitivity, 94.2%; specificity, 81.8%; negative predictive value, 94.7%).Conclusions: LUS could be implemented as a first-line procedure in the evaluation of Post-COVID-19 interstitial lung sequelae. A normal LUS examination rules out the presence of these sequelae in COVID-19 survivors, avoiding the need for additional diagnostic tests such as HRCT.

Abstract Background Mesenchymal stem cells, including those derived from human adipose tissue (hASCs), are currently being widely investigated for cell therapy. However, when transplanted at the site of injury, the survival and engraftment rates of hASCs are low, mainly due to the harsh microenvironment they encounter, characterized by inflammation and oxidative stress. To overcome these therapeutic limitations, cell preconditioning with low-concentration of hydrogen peroxide (H2O2) has been proposed as a plausible strategy to increase their survival and adaptation to oxidative stress. Nonetheless, the underlying mechanisms of this approach are not yet fully understood. In this study, we analyzed molecular and bioenergetic changes that take place in H2O2 preconditioned hASCs. Methods Long-term exposure to a low concentration of H2O2 was applied to obtain preconditioned hASCs (named HC016), and then, their response to oxidative stress was analyzed. The effect of preconditioning on the expression of Nrf2 and its downstream antioxidant enzymes (HO-1, SOD-1, GPx-1, and CAT), and of NF-κB and its related inflammatory proteins (COX-2 and IL-1β), were examined by Western blot. Finally, the Seahorse XF96 Flux analysis system was used to evaluate the mitochondrial respiration and glycolytic function, along with the total ATP production. Results We found that under oxidative conditions, HC016 cells increased the survival by (i) decreasing intracellular ROS levels through the overexpression of the transcription factor Nrf2 and its related antioxidant enzymes HO-1, SOD-1, GPx-1, and CAT; (ii) reducing the secretion of pro-inflammatory molecules COX-2 and IL-1β through the attenuation of the expression of NF-κB; and (iii) increasing the total ATP production rate through the adaption of their metabolism to meet the energetic demand required to survive. Conclusions H2O2 preconditioning enhances hASC survival under oxidative stress conditions by stimulating their antioxidant response and bioenergetic adaptation. Therefore, this preconditioning strategy might be considered an excellent tool for strengthening the resistance of hASCs to harmful oxidative stress.

Introduction: It is denominated as lung cancer to a group of diseases resulting from the abnormal growth of cells of the breathing tract, in particular of the lung tissue. Objective: To determine the useful bronchoscopic and histologic aspects in the confirmation of the diagnosis of these neoplasms. Methods: A descriptive and cross-sectional investigation of the 346 patients assisted due to lung cancer in the Pulmonology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital was carried out in Santiago de Cuba during 2016 and 2017 to whom a bronchoscopy was carried out. The variables used were age, sex, diagnostic technique used, histopatologic diagnosis and more frequent localization. Results: The patients aged 56 and 75 (66.1 %), as well as the male sex (65.0 %) prevailed. The bronchial biopsy was the procedure that mostly revealed the presence of cancer (61.3 %) and the most frequent histologic type was the squamous cell carcinoma (67.8 %). Conclusions: The importance of bronchoscopy and its diagnostic procedures to confirm the existence of the morbid process was demonstrated.

The objective of this article is to highlight the validity that Paulo Freire's ideas against banking education and indifference for higher education. The methodology used is the conjugation of the bibliographic study and the participant observation of the author. Among the results are: reflection on higher education from Freire's fight against banking education and indifference; Freire's conception of education as a complex relation system between student and educator, focused on the activation of the student in the educational process, dialogue between him and the educator, union of doubt with epistemological curiosity, guiding role of ethics, conjugation of the rational and the affective; importance in this educational level of critical thinking; rejection of indifference linked basically to the student´s active role in his education.

Este artículo pretende recopilar en la profusa pero dispersa obra pedagógica martiana, lo relativo a su enfoque sobre formación integral durante el ejercicio docente, en particular, desde la visión del trabajo educativo en clase. Se analizan los criterios de estudiosos del tema, pero dirigidos hacia los objetivos de este artículo, mediante la agrupación de ideas y acciones, que den sentido práctico al aprovechamiento de las potencialidades educativas en las clases y la mejora constante de la formación de los docentes. Inicialmente se presenta una sinopsis del trayecto corto pero intenso del Martí, maestro en el sentido directo del término. Luego, una mirada a la evolución y profundización en la asimilación, por los pensadores del ideario filosófico y pedagógico del Apóstol y en un tercer momento, se expresan algunos principios y direcciones que puedan desprenderse del análisis de su obra.

Introduction: Coal worker’s pneumoconiosis is caused by the inhalation of coal dust and its accumulation in the lungs after several years of exposure. Objective: To determine the prevalence of pneumoconiosis in underground mining workers exposed to coal dust in Cundinamarca, Colombia, and its association with their spirometry results and respiratory symptoms. Materials and methods: Cross-sectional study conducted on 215 workers who were administered a questionnaire on respiratory symptoms. For each worker a chest radiograph was taken according to the criteria of the International Labor Organization. Information on the workers’ socio-demographic characteristics, smoking habits, and spirometry results was included. Results: The average age was 45.5 ± 9.4 years and the average length of employment was 21.7±10.0 years. Expectoration was the symptom most frequently reported (73.5%). Regarding spirometry results, a normal pattern was observed in 89.8% of the sample, while obstructive and restrictive patterns were found in 5.1% and 3.7% of the subjects, and 0.5% had a peripheral airways dysfunction pattern. The prevalence of pneumoconiosis was 42.33%. FEV1/FVC ratio (81.75 vs. 83.74, p=0.045) and FF25-75% (84.96 vs. 91.95, p

Un diente retenido no erupciona en la arcada dentaria dentro del intervalo de tiempo esperado. El diente queda retenido porque los dientes adyacentes, un hueso demasiado denso, un exceso de tejidos blandos o alteraciones genéticas impiden la erupción. La frecuencia de la retención de incisivos centrales superiores es del 4%, que es relativamente muy baja en comparación con la frecuencia del tercer molar (35%) y de los caninos (34%).A la consulta de Periodoncia del Policlínico Pedro Díaz Coello de Holguín, Cuba, acudió un paciente masculino de 11 años de edad con los dientes 11 y 21 retenidos. Se decide realizar tratamiento quirúrgico para descubrir la corona por el periodoncista, colocar aparatología ortodóncica para tratar de lograr la oclusión adecuada, llevando los dientes a la línea de oclusión y realizar gingivoplastia. En la actualidad se sigue en consulta con resultados satisfactorios. Palabras clave: diente retenido, brote, arcada dentaria.

Background: oligohydramnio frequently blocks a successful pregnancy and it is necessary to found therapeutics options that reduce its damages over the fetus. Objective: to characterize the use of maternal intravenous hydration on the management of oligohydramnio. Methods: an observational descriptive cross-sectional study was carried out. The universe was constituted by 1 272 pregnant women with gestational age ≥ 34 weeks who suffered from oligohydramnio. They were divided into 2 groups depending on the use or not of maternal intravenous hydration. A descriptive statistic with absolute and relative frequencies was used. Results: the average of amniotic liquid index at the admission was 3.9 cm in group 1 and 4.1 cm in group 2, in which it increased until 6.2 cm after maternal intravenous hydration. 49.58 % of women in group 1 were cesarean and 63.29 % of women in group 2 have a eutocic labor. Fetal distress was the indication of cesarean in 182 and 139 pregnant women of group 1 and 2 respectively. 29 and 26 newborn of group 1 and 2 respectively have low birth weight. Conclusions: maternal intravenous hydration increases the average of amniotic liquid index. The majority of hydrated maternal women have a eutocic labor, newborn complications were less in that group too. DeCS: OLIGOHYDRAMNIOS/diagnosis; QUALITY OF LIFE; FETAL DEVELOPMENT; MORBIDITY; EPIDEMIOLOGY, DESCRIPTIVE.

El cáncer gástrico afecta principalmente a las personas de edad avanzada. Con el objetivo de caracterizar la evolución de la mortalidad por cáncer gástrico en el adulto mayor en Cuba durante los años 1987-2015, según variables sociodemográficas seleccionadas, se realizó un estudio ecológico de series temporales. El universo estuvo conformado por 16713 fallecidos mayores de 60 años en Cuba, cuya causa de muerte registrada en el certificado de defunción fue el cáncer gástrico. Se analizaron tasas anuales crudas y ajustadas por grupos de edad y sexo. Predominó el sexo masculino con 62,3 % y el grupo de edad de 70-79 años con 37,1 %, mayor frecuencia de morir en hombre 1,6:1. El 38,6 % de los fallecidos tenía color de la piel blanca, más frecuente en el sexo masculino. Fue evidente que a la hora de la muerte predominó la condición de fallecidos sin parejas estables en 57,4 %. Las tasas de mortalidad ajustadas por grupos de edad aumentan después de la octava década de la vida. La evolución de la mortalidad por cáncer gástrico durante los últimos 28 años muestra una tendencia ascendente a predominio del sexo masculino, se hace necesario diseñar e implementar programas de detección precoz que vayan dirigidos a la disminución de la mortalidad en los adultos mayores.

Background: The associations of cause-specific mortality with alcohol consumption have been studied mainly in higher-income countries. We relate alcohol consumption to mortality in Cuba. Methods: In 1996-2002, 146 556 adults were recruited into a prospective study from the general population in five areas of Cuba. Participants were interviewed, measured and followed up by electronic linkage to national death registries until January 1, 2017. After excluding all with missing data or chronic disease at recruitment, Cox regression (adjusted for age, sex, province, education, and smoking) was used to relate mortality rate ratios (RRs) at ages 35–79 years to alcohol consumption. RRs were corrected for long-term variability in alcohol consumption using repeat measures among 20 593 participants resurveyed in 2006-08. Findings: After exclusions, there were 120 623 participants aged 35-79 years (mean age 52 [SD 12]; 67 694 [56%] women). At recruitment, 22 670 (43%) men and 9490 (14%) women were current alcohol drinkers, with 15 433 (29%) men and 3054 (5%) women drinking at least weekly; most alcohol consumption was from rum. All-cause mortality was positively and continuously associated with weekly alcohol consumption: each additional 35cl bottle of rum per week (110g of pure alcohol) was associated with ∼10% higher risk of all-cause mortality (RR 1.08 [95%CI 1.05-1.11]). The major causes of excess mortality in weekly drinkers were cancer, vascular disease, and external causes. Non-drinkers had ∼10% higher risk (RR 1.11 [1.09-1.14]) of all-cause mortality than those in the lowest category of weekly alcohol consumption (

Primary retroperitoneal tumors are rare. Schwannoma or neurilemmoma is a benign tumor formed from the Schwann cells, which rarely has a retroperitoneal location. The article describes the diagnosis of a retroperitoneal schwannoma in a patient who received surgical treatment at the “Manuel Ascunce Domenech” Hospital of Camagüey, Cuba. This is a 33-year-old white female patient with a past medical history. She visited the department of surgery complaining of an increase in volume in the right hemiabdomen, of six months of progress, accompanied by moderate pain, radiating to the lumbar region and right iliac fossa, which was not relieved with analgesics or at rest. There was also inflammation of the lower limbs. Physical examination revealed: asymmetric abdomen, painful on deep palpation of the hypochondrium and right iliac fossa, 12 cm tumor, with firm and irregular consistency, adhered to deep planes, and decreased hydro-aerial noises in this region. She was admitted with the diagnosis of a right abdominal tumor for study. The abdominal echography reported: a right kidney with a marked dilation, of hydronephrotic appearance due to compression of another large right structure, with cystic appearance, heterogeneous content and echogenic elements that suggested a cystic teratoma. She received a satisfactory surgical treatment and was discharged eight days after surgery. By the histopathologic study a benign schwannoma-type mesenchymal tumor with cystic degeneration was diagnosed.

no procede

Introducción: el monitoreo de la calidad de la atención médica es una exigencia social. Objetivo: evaluar la calidad de la atención médica al paciente con hemorragia digestiva alta en un centro hospitalario. Método: se realizó un estudio observacional, prospectivo y longitudinal de 98 pacientes seleccionados aleatoriamente en el Hospital Dr. Agostinho Neto, Guantánamo, Cuba, durante el trienio 2015-2017. Se exploraron criterios de la estructura, el proceso y los resultados de esta atención médica. Resultados: el 21,4% de los indicadores de estructura (6 de un total de 28) y el 18,54 % de los indicadores del proceso (5 de un total de 27) fueron evaluados como poco adecuados y el 18,5 % de los indicadores de resultados se evaluaron en esta categoría (5 de un total de 27). Conclusiones: el 52,1% del total de los indicadores se evaluaron como adecuados, por lo que la calidad de la atención a estos pacientes no satisfizo las aspiraciones, sobre todo por limitaciones en la estructura para el desarrollo de este proceso atencional. Palabras clave: hemorragia digestiva alta, calidad de la atención médica, atención secundaria a la salud.

Malignant transformation of a mature cystic teratoma located in the ovary is rare. Its diagnosis should be suspected when there are rapidly growing adnexal tumors in patients between 40 and 60 years of age and with mixed component imaging studies, larger than 10 cm in diameter. This study presents the case of a 48-year-old female patient with a personal pathological history of a gynecological tumor, diagnosed a year earlier. She comes to consultation due to abdominal growth, moderate diffuse abdominal pain with a progressive increase in intensity, accompanied by a feeling of fullness, malaise, weight loss and difficulty defecating and urinating. On physical examination, a painful tumor mass of approximately 20 cm, and of firm and regular consistency, is palpated in the lower hemiabdomen, left flank and mesogastrium. CT scan shows an image consistent with a solid cystic tumor lesion in relation to the left adnexus, consistent with a teratoma. Panhysterectomy, omentectomy and ganglionic resection are performed due to a mixed tumor of the left ovary. Histopathologic study confirms the diagnosis of a malignant infiltrating epithelial tumor of the epidermoid carcinoma type which is characterized by being moderately differentiated and originating in a mature cystic teratoma of the ovary. Infiltration of the fallopian tube and vascular congestion of the wall of said structure is observed. The patient died 75 days after the surgical treatment.

RESUMEN Introducción: la nefropatía hipertensiva es una de las lesiones a órganos diana por hipertensión arterial con mayor morbilidad y mortalidad. Objetivo: evaluar la influencia de los diferentes factores de riesgo para el desarrollo de la nefropatía hipertensiva. Métodos: realizamos un estudio observacional analítico de casos y testigos en pacientes de la consulta de hipertensión de la policlínica de especialidades del hospital general universitario Carlos M. de Céspedes, de Bayamo, en el período comprendido desde el primero de enero de 2014 hasta el 31 de diciembre de 2016. Resultados: el análisis multivariado demostró que él no control de hipertensión arterial fue el factor más relevante al incrementar el riesgo de nefropatía hipertensiva en 22,46 veces (IC: 11,915-42,341; p: 0,000) seguido en orden de importancia la hipertrofia ventricular izquierda (OR: 12,95; IC: 7,005-23,968; p: 0,000). El análisis de la curva ROC (área: 0,898; IC: 0,873-0,922; p: 0,000) demostró una adecuada capacidad discriminativa del modelo, cuya calibración fue aceptable (p: 0,176). Conclusiones: los factores propios de la hipertensión arterial así como algunos marcadores biológicos de riesgo cardiovascular, son capaces de predecir con exactitud la probabilidad de desarrollar la nefropatía hipertensiva; de ellos se estimó un modelo con un área bajo la curva con una capacidad de discriminación y calibración adecuada. ABSTRACT Introduction: hypertensive nephropathy is one of the lesions to target organs due to arterial hypertension with higher morbidity and mortality. Objective: to evaluate the influence of different risk factors for the development of hypertensive nephropathy. Methods: we performed an observational and observational study of cases and witnesses in patients from hypertension consultation of the polyclinic specialties of the general university hospital Carlos M. de Céspedes, Bayamo, from January 1, 2014 to the December 31, 2016. Results: multivariate analysis showed that a patient without control of their hypertension was the most relevant factor in increasing the risk of hypertensive nephropathy in 22.46-fold (CI: 11.915-42.341; p: 0.000) followed by left ventricular hypertrophy OR: 12.95, IC: 7.005-23.968, w: 0.000). Analysis of the ROC curve (area: 0.898; IC: 0.873-0.922; p: 0.000) showed adequate model discriminatory ability, whose calibration was acceptable (p: 0.176). Conclusions: factors associated to hypertension, as well as some biological markers of cardiovascular risk are capable of accurately predicting the probability of developing hypertensive nephropathy; of them a model with an area under the curve with a capacity of discrimination and adequate calibration was estimated.

Se diseñó una estrategia educativa antitabáquica en la Residencia Estudiantil de Ciencias Médicas en Camagüey que fue valorada por criterio de especialistas y actualmente se encuentra en fase de implementación. En el artículo se evalúa su impacto. La misma se caracteriza por ser sistémica, dinámica, flexible, factible, participativa y dinamizadora de la esfera afectiva. Se ha empleado en la impartición de posgrado, capacitaciones a profesores guías e instructoras educativas; ha contribuido a incrementar los conocimientos en el orden teórico, metodológico, educativo y salubrista en relación con la educación antitabáquica en estudiantes, profesores e instructoras educativas y ha favorecido el fomento de estilos de vida saludables.

RESUMEN El cáncer de mama es la neoplasia más frecuente en el sexo femenino y una de las principales causas de muerte en este grupo. Se realizó un estudio descriptivo retrospectivo, de mujeres fallecidas por cáncer de mama en el período 2014 al 2015, con el objetivo de describir la mortalidad de esta enfermedad, se tuvo en cuenta la zona de residencia, promedio de edad de las fallecidas y años de vida potencialmente perdidos según consejos populares. Las medidas estadísticas utilizadas fueron tasa de mortalidad, valores absolutos, valores promedios, números absolutos y años de vidas potencialmente perdidos, observándose un incremento de la tasa de mortalidad, con predominio en la zona urbana, el promedio de edad de los fallecidos se encuentra por encima de los 50 años y el consejo popular San Juan – El Cristo aportó las mayores tasa de años de vida potencialmente perdidos. ABSTRACT Breast cancer is the most common neoplasm in females and one of the main causes of death in this group. It was performed a descriptive retrospective study of deceased women for breast cancer during the period of 2014 to 2015, with the aim of describing the mortality rate of this disease, taking into account the residence area, the average age of the deceased women and the potentially lost years according to popular councils in Bayamo. The statistical methods used were the mortality rate, absolute values, average values, absolute numbers and the potentially lost years. Results showed an increase in the mortality rate, prevailing in urban areas, average age of the deceased women is over 50years and the San Juan-El Cristo popular council contributed with the greater rates the potentially lost years.

Fundamento:la rubeosis del iris se asocia generalmente con diferentes enfermedades que producenfalta de oxígeno en la retina. La falta de oxígeno hace que se liberen sustancias que estimulan la formación de nuevos vasos sanguíneos (angiogénesis) en un intento del organismo por solucionar la isquemia. La rubeosis de iris es la complicación más frecuente y precoz de muchas enfermedades vasculares del segmento posterior, que conlleva a una pérdida irreversible de la visión si no se diagnostica y se trata oportunamente.Objetivo:describir el comportamiento de la rubeosis de iris luego deltratamiento con triamcinolona intravítrea.Método:se realizó un estudio descriptivo de corte longitudinal, en pacientes con rubeosis de iris que acudieron a la consulta de retina del Centro Oftalmológico Carlos J Finlay, desde junio 2013 a junio 2014. El universo de estudio estuvo constituido por 25 pacientes y la muestra no probabilística estuvo for-mada por 30 ojos que cumplieron los criterios de inclusión, se les aplicó un formulario para recoger los da-tos. Los resultados se relacionaron con las siguientes variables: tensión ocular, síntomas, enfermedades que provocaron rubeosis de iris, grados de rubeosis.Resultado: la tensión ocular se estabilizó con el tratamiento empleado, el síntoma más frecuente fue el dolor. La retinopatía diabética proliferativa fue la afección más frecuente en el 40 % de los pacientes, seguido de la trombosis de la vena central de la retina. El estado de la rubeosis mejoró en más de la mitad de los pacientes, algunos con regresión completa.Conclusiones: La tensión intraocular mejoró después del tratamiento con triamcinolona intraví-trea. Los síntomas desaparecieron en más de la mitad de los pacientes. La retinopatía diabética proliferativa fue la enfermedad más frecuente que provocó rubeosis de iris. Este signo desapareció en más de la mitad de los pacientes después del tratamiento.

Introducción: cultivar el pensamiento positivo en el ser humano es una necesidad y está relacionado estrechamente con su calidad de vida. Los estudiantes universitarios transitan por una etapa del ciclo vital individual importante, una de sus metas es lograr una profesión; tener una actitud mental optimista puede ser de gran ayuda para el alcance de sus propósitos. Métodos: se realizó una investigación de tipo descriptiva y transversal con el objetivo de determinar un sistema de acciones para alcanzar un pensamiento positivo en los estudiantes universitarios desde diciembre de 2012 a julio de 2014. Se emplearon encuestas en el diagnóstico para identificar las necesidades sentidas de aprendizaje, el nivel de conocimientos sobre el tema y el estado actual de la población objeto de estudio, constituida por los 167 estudiantes del plan D de la Facultad Tecnología de la Salud de Camagüey. Se analizó la información a través del procesamiento de los datos. Se utilizaron también métodos del nivel teórico: análisis-síntesis, inducción-deducción y análisis documental. Se aplicó el consentimiento educado. Resultados: se mostró la necesidad de conocer sobre el tema y la certeza de que no muchos aplican el pensamiento positivo. Conclusiones: se reveló la necesidad de lograr una cultura de salud con la aplicación de acciones para el logro en los estudiantes del pensamiento positivo.

Background: diabetes mellitus occupies the eighth place of the first causes of death in the country. There is consensus that their morbidity will continue to rise. Diabetological education of patients promotes a better quality of life, decreasing the risk of developing complications.Objective: to describe the influence of educational work on the behavior of patients with type 2 diabetic, belonging to five family doctor's offices of "Manuel Fajardo Rivero" polyclinic, Las Tunas municipality, during 2016.Methods: an educational intervention study was conducted. The sample consisted of 86 patients diagnosed with diabetes mellitus type 2, belonging to the health area mentioned. A questionnaire was applied before and after the intervention to explore knowledge, behavior, metabolic control and presence of complications. The intervention was carried out by means of a basic course. The data was processed by descriptive statistics.Results: at the beginning 37, 2 % of the patients had knowledge about the disease, 78,1 % of them with more than 10 years of evolution; after the intervention only 21,9 % did not reach the knowledge. The number of patients with poor metabolic control decreased with the intervention: 40 less for fasting blood glucose and 33 less for postprandial glycaemia. The number of patients who do not practice physical exercises also decreased in 37. The 70,9 % of the patients reported improve their diet, self-care and adherence to treatment. No new complications were reported.Conclusions: the results described support the positive influence of the educational intervention carried out that allowed a remarkable improvement in the metabolic control of these patients and positive changes in their lifestyle.

Introducción: la caries dental es el problema de salud pública que más aqueja a la sociedad, desde los grandes faraones egipcios hasta los actuales presidentes, casi todos, en algún momento de su vida, han padecido esta enfermedad. Objetivo: evaluar la efectividad de una intervención educativa referente a la caries dental en escolares de sexto grado. Métodos: se realizó un estudio de intervención educativa, en escolares de sexto grado de la escuela primaria Dalquis Sánchez, de Holguín, en el período septiembre de 2015-abril de 2016. El universo de la investigación fue de 138 escolares, la muestra conformada por 58 pacientes diagnosticados con caries dental. Se estudiaron variables, como sexo y nivel de conocimiento sobre la enfermedad. Resultados: de los escolares afectados con caries dental 31 (53,4%) pertenecían al sexo masculino, con predominio sobre el femenino. Antes de aplicar el programa educativo, 43 escolares (74,1%) presentaban conocimientos inadecuados sobre generalidades de caries y algunos factores de riesgo; luego el 52 (89,7%) de los escolares tuvieron un conocimiento adecuado. Previo a la labor educativa, el 84,5% de los participantes poseían conocimiento inadecuado en lo que respecta al correcto cepillado y su frecuencia; al realizarla, el 91,4% logró un conocimiento adecuado. Al analizar lo referente a la dieta cariogénica y dieta protectora, observamos que al inicio de la intervención sólo 11 estudiantes presentaban un conocimiento adecuado del tema en cuestión, al aplicar el programa 48 escolares (82,8%) tuvieron una apreciación correcta del tema. Conclusiones: el nivel de conocimiento referente a caries dental era inadecuado antes de aplicar el programa educativo, luego de aplicado, la intervención educativa demostró ser un método certero, lo cual comprobó la efectividad del programa implementado. Palabras clave: caries dental, nivel de conocimiento, dieta cariogénica, cepillado, factores de riesgo.

Actualmente, los traumatismos faciales en la población joven, producto de: agresiones físicas, accidentes de tráfico, y laborales, adquieren protagonismo. Los huesos faciales sufren, debido a su ubicación prominente, cerca de los ojos. El paciente con fractura del complejo cigomático maxilar presenta: dolor regional, diplopía al mirar hacia arriba, y disminución de la agudeza visual. Cuando cumple con el tratamiento, dentro de los 10 días siguientes al trauma, se obtienen los mejores resultados. Se presentó un paciente masculino, de 50añosdeedad, que acudió a consulta de estomatología del Policlínico Pedro Díaz Coello, luego de haber sufrido un accidente de tránsito que le provocó: edema facial, hematoma, dificultad para ingerir alimentos, y debilidad visual en el ojo de la zona comprometida. Al observar sus características clínicas y radiográficas, se le diagnosticó fractura de malar. Se remitió, inmediatamente, a los servicios de Cirugía máxilo- facial, y se trató quirúrgicamente para reducir la fractura, sin complicación. Palabrasclave: fractura, malar, tratamiento.

El artículo que se presenta tiene como objetivo diseñar una estrategia educativa antitabáquica para estudiantes del plan D de la Facultadde Tecnología de la Saludde Camagüey en el período de septiembre del 2014 y febrero del 2015. Su novedad radica en que revela su enfoque educativo y salubrista que dinamiza la esfera afectiva y tiene como rasgo esencial el predominio de la tarea como recurso técnico. Se concluyó que la misma contribuye al fomento de estilos de vida saludables de los estudiantes.

Objective: To define the performance characteristics of the LOCI® method for cardiac troponin I on the Dimension EXL system. Designs and methods: Three different levels of commercial control (mean concentrations 0.426, 1.42, and 18.64 µg/L) were used for the imprecision study, quantifying separately within-run and between-run over 20 days. The limit of blank (LoB) and limit of detection (LoD) were assessed with 20 replicates of a sample without troponin I. Linearity was assessed by regression analysis. In addition, we studied inaccuracy, carry-over and limit of quantitation and conducted a method comparison with the Stratus CS (n=69). The reference interval was determined in 146 healthy blood donors using non-parametric method. Results: The within-run imprecision (coefficient of variation [CV], %) obtained at each level was 2.4, 1.4% and 2.2%, while the between-run imprecision (CV,%) was 3.3%, 2.9% and 2.5%. Total imprecision was 4.06%, 3.3% and 3.4% for each control level. The limit of quantitation which corresponds to the troponin I concentration at which CV=10% was 0.05 µg/L. Method comparison with the Stratus CS assay produced the equation: Dimension EXL=â0.002698+1.0233â(Stratus CS) with a confidence interval from â0.01562 to 0.00626 for the intercept and (0.979 to 1.0875) for the slope. The 99th percentile obtained for the reference population was 0.047 µg/L. Conclusions: The LOCI method for cardiac troponin I on the Dimension EXL meets all guidelines recommended criteria referring to limit of quantitation, imprecision and shows excellent transferability with the Stratus CS method. Keywords: Cardiac troponin, LOCI, Dimension EXL

Introducción: los hábitos bucales deformantes tienen su origen dentro del sistema neuromuscular; constituyendo patrones reflejos de naturaleza compleja que se aprenden. Objetivo: identificar los factores de riesgo asociados a hábitos bucales deformantes en niños. Método: se realizó un estudio transversal en el período comprendido de septiembre de 2014 a febrero de 2015. Se escogieron 180 niños en las edades comprendidas entre 8 y 11 años, pertenecientes al área de salud del Policlínico Docente Pedro Díaz Coello de Holguín, que visitaron voluntariamente la consulta para participar en la investigación. Los resultados se presentaron en tablas estadísticas. Resultados: hubo predominio de niños con hábitos bucales deformantes en el sexo femenino (57,2%) y en la edad de 10 años (37,2%), predominó como hábito deformante la lengua protráctil (39,2%) y se consideran condiciones de riesgo en la presencia de hábitos bucales deformantes variables socio biológicas de las madres y los niños, la no experiencia de lactancia materna exclusiva (57,2%) y el mal funcionamiento familiar (61,1%). El nivel de escolaridad de la madre que predominó fue el preuniversitario o técnico medio (60,6%). Conclusiones: se identificaron como factores de riesgo asociados a los hábitos bucales deformantes el mal funcionamiento familiar y la no lactancia materna. Palabras clave: factores de riesgo, hábitos bucales deformantes, niños.

Introducción: la celulitis odontógena es una inflamación difusa del tejido celular subcutáneo que se extiende por los espacios entre el tejido celular a más de una región anatómica a causa de la infección de uno o varios dientes o de enfermedades asociadas al tejido dentario o de sostén. Es una de las infecciones más frecuente y la urgencia más grave que puede presentarse en la práctica esto­matológica. Objetivo: caracterizar el comportamiento de la celulitis facial odontógena en los pacientes atendidos en el Hospital Vladímir Ilich Lenin, Holguín. Métodos: se realizó un estudio descriptivo de serie de casos durante los años 2014 y 2015. El universo estuvo constituido por 54 pacientes con celulitis facial odontógena, la muestra quedó conformada por 51 pacientes. Las variables estudiadas fueron: sexo, grupos de edad, etiología, grupo dentario, regiones anatómicas y clasificación clínica. Resultados: existió un predominio del sexo masculino y el grupo de edad de 35-59 años representado por el 62,75% y el 60,78% respectivamente. La principal etiología fue la caries dental con el 68,63%. El grupo dentario de los molares inferiores fue el más afectado con un 41,18%. La región submandibular fue la más afectada en el 25,49%. La celulitis moderada resultó ser la más frecuente representando el 74,51%. Conclusiones: la etiología de la infección fue variada al igual que las regiones anatómicas afectadas. Palabras clave: celulitis facial, infecciones odontógena.

Fundamento: la diabetes gestacional y pregestacional son consideradas enfermedades propias y asociadas al embarazo respectivamente, con graves consecuencias para la madre y el feto. Objetivo: determinar los resultados médicos con las nuevas formas terapéuticas de la diabetes mellitus durante la gravidez. Método: se realizó un estudio observacional descriptivo en 929 gestantes, en el Hospital Universitario Gineco-Obstétrico Provincial Ana Betancourt de Mora en Camagüey en el período 2009-2012. El universo estuvo constituido por las embarazadas diagnosticadas con diabetes mellitus en el embarazo, los datos se extrajeron de las historias clínicas, en el análisis estadístico se aplicó relación de variables y se halló probabilidad estadística para lo cual se utilizó el software Microsoft Word y Microsoft Excell para Windows 98. Resultados: para la diabetes pregestacional y gestacional, la media de la edad fue de 18±6 y 34-5 años, el número de partos de 0, 2±1, 3 y 2±1, 7; el antecedente de abortos inducidos de 0, 1±0, 7 y 1±1, 1 y el de abortos espontáneos de 0, 2±1, 1 y 3±1, 8 respectivamente. Mientras que el tiempo de gestación al diagnóstico fue de 10±1, 2 en las pregestacionales y 18±3 semanas en las gestacionales, el tiempo de gestación al parto de 35, 2±2 para el primer subgrupo y 40, 4±0, 6 semanas para el segundo y el peso del recién nacido de 2 920±212 y 3 500±232 gramos en cada grupo. La insulina simple fraccionada a dosis con más de 30 unidades diarias se utilizó en 80 y en 35 el empleo de la mezcla en la pregestacionales y las gestacionales en 135 simple fraccionada con más de 30 unidades e incluso, en 11 se necesitó la combinación de las insulinas. Conclusiones: la diabetes pregestacional es más frecuente en adolescentes sin experiencia de parto, el tiempo de embarazo al diagnóstico y al parto fue más precoz en las pregestacionales, mientras que la ganancia de peso y el peso del neonato se comportó con valores permisibles para ambos grupos.

Introducción: el embarazo constituye un proceso natural que provoca una serie de cambios fisiológicos, patológicos y psicológicos que las convierten en pacientes especiales que demandan cuidados exclusivos. Objetivo: determinar las principales enfermedades bucodentales que afectan a las embarazadas del Policlínico Pedro Díaz Coello. Métodos: Se realizó un estudio transversal de enero de 2014 a enero de 2015 en el Policlínico Pedro Díaz Coello de Holguín a un total de 395 embarazadas que acudieron a la consulta en el período de estudio. Las variables estudiadas fueron: edad, nivel educacional, área de residencia, clasificación epidemiológica, factores de riesgo y principales enfermedades bucales. Resultados: predominó como área de residencia la zona rural, el grupo de edad de 25 a 29 años, el nivel educacional preuniversitario con 53,9%, 35,2% y 53,7% respectivamente. El mayor número de las pacientes se encontraban enfermas (grupo III) con el 52,9%. El factor de riesgo que más incidió fue la higiene bucal deficiente representado por el 94,2%. La caries dental se identificó como la enfermedad que más afectó a las gestantes con el 47,8%. Conclusiones: la realización de trabajos educativos dirigidos a mejorar el estado de salud bucal en este grupo priorizado constituye una necesidad del momento actual. La caries dental es la afección más frecuente en las gestantes y el factor de riesgo la higiene bucal deficiente. Palabras clave: embarazadas, enfermedades bucodentales, caries dental, higiene bucal.

El trabajo aborda el rol que juega la gestión de información en relación con la infotecnología para los profesionales en formación, así como los elementos esenciales de una propuesta de estrategia didáctica que contribuye al desarrollo de la habilidad profesional gestionar información contentiva de las habilidades investigativas. Por su importancia y universalidad constituye una propuesta válida para la formación profesional en cualquiera de sus dimensiones, en el que se incluye, las Ciencias Médicas que bien pudiera ser aplicada como alternativa para favorecer y perfeccionar el aprendizaje de los futuros egresados.This work deals with the relation between information management and infotechnology, and its influence on incoming professionals; as well as with the essential elements for a didactic strategy that could contribute to the development of a professional skill that is to manage contentious information of the researching skills. Due to its importance and universal values, it constitutes a valid proposal for the formation of professionals and its different venues in which could be included the Medical Sciences. This proposal could be used to favor and improve the learning process of the incoming graduates.