Volume 41, Number 1 (2016)

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BATIOJA, YELINA ROMERO FUENTES ..... JUANA LUPE MUÑOZ CALLOL, LUCÍA ÁLVAREZ SURIT, INÉS MARÍA MERCED LEN, NOHERIDIS GONZÁLEZ ...
Catalog Abstracts and Links included

2016 Editors Elso Manuel Cruz Cruz Natalia Ivanovna Osorio Curbelo María Elena Cuervo Calviño Yenisleidys Rodríguez Cruz Maura Isabel Molina Raad

Volume 41, Number 1 (2016), January Table of Contents LETTERS TO THE EDITOR

Sharing is an essence of investigation and knowledge ORLANDO RAFAEL SERRANO BARRERA, JENNY DE LA CARIDAD HERNÁNDEZ BETANCOURT PDF (ESPAÑOL) HTML (ESPAÑOL)

Redefining the concept of clinical method: a necessity of contemporary medical practice VLADIMIR MOLINA RAAD, NILVIA NORMA AGÜERO BATISTA PDF (ESPAÑOL) HTML (ESPAÑOL)

ORIGINAL ARTICLES

Characterization of cervicouterine lesions in patients treated in “Ernesto Guevara de la Serna” hospital Background: there has been an increase of the incidence of cervicouterine cancer in patients from Las Tunas province in recent years. Objective: to characterize those patients with cervical lesions, whose biopsies were analyzed in the pathologic anatomy department of Ernesto Guevara de la Serna General Teaching Hospital from January, 2013 to December, 2014. Methods: a descriptive and cross-sectional study was carried out in 1369 patients who were treated at the place and time period mentioned above for cervical lesions; the official model biopsy was used as a secondary source for collecting information. The data were processed using descriptive statistics. Results: out of the total sample, the frequency of positive biopsies for cervical lesions were: 44,4 % in 2013 and 55,6 % in 2014. Females from 26 to 35 old, 47,4 %, prevailed, followed by the group of 36 to 55 years old, 43,46 %; intraepithelial neoplasia grade I was found in 42,73 %. The 33,6 % of the sample showed infection by the human papilloma virus, from which 35,28 % belonged to 2013 and 32,19 % to 2014. Cervical intraepithelial neoplasia grade III reported the largest number of patients with cervicitis, for a 42,95 %, followed by carcinoma in situ, present in 93 % of the sample. Conclusions: cervicouterine lesions were characterized in patients from the province; the age group from 26 to 35 years old prevailed, as well as intraepithelial neoplasia grade I; about a third of the patients were infected with human papilloma virus, and there was a higher incidence of cervicitis in patients with cervical intraepithelial neoplasia grade. ALICIA MARÍA YABOR PALOMO, ALEXANDER MORALES FONTAINE, ODALYS RUFINA PEÑA PÉREZ, VICENTE DE JESÚS ALVAREZ YABOR, LUVIA INÉS VISTORTE VISTORTE PDF (ESPAÑOL) HTML (ESPAÑOL)

Five-year study in patients with non-melanoma skin cancer in Las Tunas Background: non-melanoma skin cancer has shown a gradual increase all over the world. There is a similar behavior in Las Tunas, Cuba. Objective: to characterize the patients diagnosed histopathologically with non-melanoma skin cancer, whose biopsies were analyzed in the pathologic anatomy department of "Ernesto Guevara de la Serna” General Teaching Hospital from January, 2010 to December, 2014. Methods: a descriptive and cross-sectional study was carried out in 3970 patients treated at the aforementioned place and time period, using the official biopsy model as a secondary source of data collection. The data were processed using descriptive statistics. Results: this cancer had a frequency of a 15,6 % in 2010, it increased to a 21,7 % in 2011, and ranged between 20,62 % and 22,5 % in 2012 and 2013, respectively. In 2014 it showed a decrease of positive cases to 19,5 %. The predominant histological type was basal cell carcinoma, above 50 % in all the years and it was present in 65,4 % of the studied sample. Males (51,5 %) and females (48,5 %) showed very similar figures. The age group over 60 years old predominated, with 61,2 % of patients. Most of them came from secondary health care (76,62 %), and dermatology was the specialty with the highest percentage of biopsy indications, with a 42,84 %. Conclusions: the histological variety that predominated in patients with non-melanoma skin cancer was basal cell carcinoma and its frequency was higher in patients of more than 60 years old; primary health care did not constitute the main step in search and treatment of this condition and the patients were mostly attended by dermatologists and maxillofacial surgeons. ODALYS RUFINA PEÑA PÉREZ, VICENTE DE JESÚS ALVAREZ YABOR, ALICIA MARÍA YABOR PALOMO, ALEXANDER MORALES FONTAINE, ARIADNA RICARDO PEÑA PDF (ESPAÑOL) HTML (ESPAÑOL)

Surgical treatment of lumbosacral disk hernia in "Ernesto Guevara de la Serna" hospital Background: lumbosacral disk hernia has a high prevalence in the world and in Cuba. The outcome of surgical treatment has a great individual, family, work, social and economic impact. Objective: to describe the results of the surgical treatment of disk hernia in patients operated at "Dr. Ernesto Guevara de la Serna" General Teaching Hospital from January, 2005 to May, 2015. Methods: a descriptive and retrospective observational study was carried out in the aforementioned hospital in Las Tunas province and during the time period stated above. Sources of secondary data collection were used, such as medical records and operative reports. Records for continuous data collection were prepared. A database was created for processing information, which was analyzed by

descriptive statistics, using the percentage value for reporting results. Results: the disk hernia was more frequent in males and in the age group of 40 to 49 years. The most affected disk level was L4 - L5; S1 root was the most compressed and the posterolateral hernia predominated. Satisfactory results prevailed in surgical treatment and the most frequent complications were discitis and postoperative fibrosis. Conclusions: it was possible to describe the main results of surgical treatment of disk hernia in patients operated in "Dr. Ernesto Guevara de la Serna" General Teaching Hospital during the last ten years. HENRY LÓPEZ JIMENEZ PDF (ESPAÑOL) HTML (ESPAÑOL)

Asthma predictive index and associated risk factors in under five-year-old children with recurrent wheezes Background:children under five years old show frequent bronchial obstruction and many of them have transient wheezes without necessarily being asthmatic. Objective: to identify the predictive index criteria of bronchial asthma with recurrent wheezes and their associated risk factors in children under five years of age who were treated in “Aleida Fernández Chardiet” Teaching General Hospital in Güines, Mayabeque province. Methods: a descriptive and cross-sectional study was carried out to identify the predictive index criteria of bronchial asthma and their associated risk factors in all the children under five years old who were admitted because of recurrent wheezes in the respiratory diseases ward of the mentioned hospital from April, 2014 to April, 2015. Results: wheeze was most frequent in children under one year old (48,8 %), with a slight predominance of males (54,1 %). First line family history of bronchial asthma (48,1 %), atopic dermatitis (42,7 %), three or more episodes of wheezes not related to acute respiratory infections (60,3 %), and eosinophilia upper than 4 % (44,3 %) showed the highest incidence. The most frequent associated risk factors were: nonexclusive breastfeeding up to six months (61 %), recurrent acute respiratory infections (60,3 %), inside home pollutants (90,8 %) and environmental pollution (83,2 %). Conclusions: the predictive index criteria of bronchial asthma and their associated risk factors were identified in the children population studied. That will permit an adequate diagnosis, follow-up, therapeutics, and promoting actions to modify them. MERCEDES SILVA ROJAS, YARISLEIDY MARTÍNEZ MILIÁN PDF (ESPAÑOL) HTML (ESPAÑOL)

Clinical and epidemiological characterization of hypodontia in “Guillermo Tejas” polyclinic Background: oligodontia, anodontia and hypodontia are terms used interchangeably to refer to the absence of one or more teeth. It is important to consider that it can bring clinical damages, whether functional, psychological and aesthetic. Objective: to characterize clinically and epidemiologically patients suffering from hypodontia treated at the dental clinic of "Guillermo Tejas" polyclinic in Las Tunas, from October, 2013 to July, 2015. Method: a descriptive study was carried out in patients suffering from hypodontia who went to the dental clinic during the aforementioned time period. The universe consisted of 180 patients who entered the service and the sample was composed of the 27 ones who were between 9 and 20 years old. Results: the prevalence of hypodontia was higher in white females; past health history showed prevalence of respiratory disease, inheritance factor and embryological cause. Hypodontia was more common in the maxillar; the most affected teeth were the third molar, the lateral incisor and bicuspids, in order of frequency. Conclusions: it was possible to characterize the patients of the sample by means of this study. DELARAYS OSSANI PÉREZ ALFONSO, YULIANNI PEREIRA DURÁN, YAIMA DE LOS ÁNGELES HIDALGO TORRES, ALINA DEL MONTE NONELL PDF (ESPAÑOL) HTML (ESPAÑOL)

Combined use of focalized meditation and group psychological intervention in patients with terminal chronic renal failure Background: chronic renal failure is within the first 35 death causes in the country within the last five years. Objective: to determine the effectiveness of the combined use of the group psychological intervention with the focalized meditation (FM) in the psychological rehabilitation of patients suffering from terminal chronic renal failure who underwent hemodialysis treatment in “Juan Bruno Zayas” General Hospital in Santiago de Cuba from January to June, 2014. Methods: a pre-test, post-test and control group intervention was carried out. The study sample was divided into three groups: one for the group psychological intervention (GPI), another one for the focalized meditation FM) and the other one for the combined use of them both. The research process had three stages: the diagnostic phase with the use of: interview, observation, state-trait anxiety inventory (STAI), Beck Diagnostic Inventory (BDI), and coping ways questionnaire; the intervention, where treatment was imposed with six sessions of group psychological intervention to a group, eight sessions of focalized meditation to another one and the combination of them both to the other one; and the last phase, which was the post-intervention one, was carried out to evaluate the changes of the impaired adjustment and coping with emotional states, applying the same diagnostic techniques. Results: after the application of the therapeutic modalities, the results were: in the groups treated with the GPI and FM separately, the 80 % of the subjects reduced their anxiety levels; meanwhile, with the combination of the techniques, improvement was for the 100 % of the patients. The variable depression had a similar behavior. As for the coping styles: in the GPI group, 80 % of the subjects got active coping styles and the 20 % got mixed ones; in the FM group, the 40 % showed active styles, another 40 % passive styles, and 20 % got mixed ones; in the group with the combined treatment, the results were the same as in the GPI group. Conclusions: there was no significant evidence that the group psychological intervention combined with the focalized meditation was more effective than the group psychological intervention by itself. ENMA TAIMARA CISNEROS ACOSTA, AYMARA REYES SABORIT PDF (ESPAÑOL) HTML (ESPAÑOL)

CASE REPORTS

Rash: the only one clinical manifestation of dengue This is an unusual case of dengue without fever. This is a 23-year-old, white male patient who went to his family doctor in August, 2013 complaining of of a reddish exanthematous eruption in his upper chest, who despite of having measured his temperature several times at home, he did not have hyperthermia. He was referred to "Dr. Ernesto Guevara de la Serna" General Teaching Hospital, from where he was moved to "60 Anniversario del Moncada" field hospital for suspecting dengue. Throughout his hospital stay vital, his signs were measured every 3 hours, and fever was never detected. On the fourth day of his follow-up, loop test was positive. On sixth day, IgM for dengue was made and resulted positive. In situations of increasing the incidence of dengue, at the onset of rash without fever, this disease should be considered as a possible diagnosis, which is of paramount importance that has incidence on its transmission. SARAH MARÍA REGUEIRA BETANCOURT, MANUEL DE JESÚS DÍAZ PÉREZ, LISBETH ORIVE PACHECO PDF (ESPAÑOL) HTML (ESPAÑOL)

Ovary fibroma The ovary fibroma is a solid tumor of very low frequency, scarcely from 1 to 4 % of all benign neoplasms in that gonad. The condition can be asymptomatic or with scarce manifestations, at the time it has been confused with malignant lesions. This is the case of a postmenopausal woman with an increase of volume of her lower right abdomen; at palpation, an immotile and hard tumoral mass of about 10 cm in diameter was found. To the vaginal touch, the volume increase, predominantly solid, was located in the right annex. The ultrasound reported a bladder slightly out of its place. The abdominal computed tomography showed that the colon and the bladder were compressed and moved up to the left by the lesion. The patient underwent surgery and the biopsy informed an ovary fibroma, as well as other disorders of that side of the uterus and the ovary. MARÍA DEL PILAR ESTRADA PÉREZ, ODELCIS KELLYS MASTRONA, YUNIESKA PUIG SÁNCHEZ PDF (ESPAÑOL) HTML (ESPAÑOL)

Acquired epidermolysis bullosa Epidermolysis bullosa is a group of diseases or skin disorders genetically transmitted and it is characterized by the appearance of bullae, ulcers and skin wounds. It usually appears at birth or in the first months of life. This is a case of a 72-year-old female patient who comes to the dermatology department with skin lesions of 6 months of evolution. A skin biopsy was performed, taking a sample for direct and indirect immunofluorescence. Acquired epidermolysis bullosa of unknown etiology was diagnosed. Treatment was started with low-dose colchicine to increase it later, according to the patient’s tolerance and disease progression. MARICEL SUCAR BATISTA, YANIER SERRANO GARCÍA, TAIMÍ MIRANDA VERGARA PDF (ESPAÑOL) HTML (ESPAÑOL)

LITERATURE REVIEWS

Achievements and perspectives of nanotechnology in stomatology The development of nanotechnologies has begun a new period, mainly in scientific investigations. It is reflected in the specialty of stomatology giving place to the emergence of a specific area of knowledge, which has putting forward a new term: nanodentistry. Because of its importance, a bibliographical review was carried out using the services available in Infomed and the specialized databases: Scielo, Mediclatina, Medline and PubMed were reviewed with the objective of updating the information about the advances obtained and the investigations that are developed about the use of nanotechnologies in dentistry. Its use is extended to all the specialties, mainly to the dental operations with the creation of dental materials with nanoparticles increasing the resistance, quality and aesthetics of restorations, as well as the implants with bio-compatible materials that favor the self-repair, avoiding the rejection. These advances revolutionize the way of diagnosing and treating the different buccal diseases and improving the life quality of the population. TOMÁS DE LA PAZ SUÁREZ, CARMEN DE LOS MILAGROS GARCIA ALGUASIL, YOLEXIS PÉREZ ESPINOSA PDF (ESPAÑOL) HTML (ESPAÑOL)

Volume 41, Number 2 (2016), February Table of Contents EDITORIAL

Scientific research projects on health ELSO MANUEL CRUZ CRUZ PDF (ESPAÑOL) HTML (ESPAÑOL)

ORIGINAL ARTICLES

Impact of the early decompressing craniectomy in the results of the treatment of severe crani-encephalic trauma Background: crani-encephalic trauma is the first cause of death and morbidity in young people. At present, it is difficult to know the real benefit of the decompressing craniectomy and the right time is not clearly defined, especially in patients who have suffered crani-encephalic trauma. Objective: to assess the impact of the early decompressing craniectomy to control intracranial pressure (ICP), quality of life, and mortality in patients with severe crani-encephalic trauma, treated at "Dr. Ernesto Guevara de la Serna” General Teaching Hospital in Las Tunas province from January, 2008 to December, 2013. Methods: an analytical, longitudinal and prospective study was carried out in the hospital and time period mentioned above. The investigation had two phases: the first one, from 2008 to 2011, with 202 patients and the second one, from 2012 to 2013, with 38 patients. Group I, of study, consisted of 120 cases, which was offered as initial treatment the decompressing craniectomy. Group II, of control, comprised 120 patients who initially received the conventional treatment. Results: in the study group, the intracranial pressure figures below 20 mmHg (72,5 %), deaths (17,5 %), moderate sequelae (40,83 %) and good functional recovery (18,3 %) predominated. In the control group, intracranial pressure values above 20 mmHg, deaths (35 %) and serious sequelae (41,6 %) predominated. Early surgical treatment had no significant impact on patients’ mortality. Conclusions: early decompressing craniectomy was effective in the control of intracranial pressure, patients’ quality of life improved, and the surgical technique at an early stage did not influence on the mortality of patients. HENRY LOPEZ JIMENEZ PDF (ESPAÑOL) HTML (ESPAÑOL)

Behavior of small cell lung carcinoma in “Hermanos Ameijeiras” hospital Background: small cell lung carcinoma is approximately in a 15 % of bronchogenic carcinomas. At diagnosis, between 70 and 80 % of patients often show the disease disseminated, so most of the patients die, even with the best treatment available. Objective: to describe the behavior of small cell lung carcinoma in patients registered in "Hermanos Ameijeiras" hospital in Havana during the years 2010 to 2013. Methods: a descriptive and retrospective study was carried out in patients diagnosed with small cell lung cancer treated at the oncology department of that hospital from January, 2010 to December, 2013. The universe of study consisted of 1013 patients diagnosed with lung cancer and the sample comprised 104 patients diagnosed with small cell lung carcinoma. Results: the frequency of small cell lung carcinoma was of a 10,3 % and the predominant age group was 60 to 69 years and in males. The 50 % showed some associated co-morbidity, being hypertension the most frequent one, followed by diabetes mellitus and ischemic heart disease. As the primary site, the right lung prevailed, diagnosed mostly in stage IV, being the liver the most common site of metastasis, followed by the contralateral lung and pleura. The most used treatment was chemotherapy as a single modality or with radiation therapy, reaching a median survival of 7 months. Conclusions: small-cell lung carcinoma is the less frequent histological variant; most of the patients had the disease disseminated at diagnosis. Chemotherapy improves survival but it is curative in only a minority of patients. HASLEN HASSIUL CÁCERES LAVERNIA, ELIA NENÍNGER VINAGERAS PDF (ESPAÑOL) HTML (ESPAÑOL)

Genotype identification of the Human Papilloma Virus in cervicouterine lesions carrier patients Background: during the last years there has been a high prevalence of women infected with genotypes of the human papilloma virus, considered as a high risk because of its high oncogenicity. Objective: to identify the genotypes of the human papilloma virus in cervical lesions carrier patients whose biopsies were analyzed in the pathologic anatomy department of “Dr. Ernesto Guevara de la Serna” General Teaching Hospital from January 2013, to December, 2014. Methods: a descriptive and cross-sectional study was carried out in 45 patients whose biopsies were taken at random from a total of 456 cases in which histopathological evidence of infection by the human papilloma virus was found, in the study period of time mentioned above. The biopsies were sent to the molecular biology laboratory of the virology department of ''Pedro Kourí” Tropical Medicine Institute in order to isolate and identify the types of this virus involved in the pathogenesis of the premalignant lesions studied. Secondary sources, given by the results of the identification of the genotype of the isolated virus sent from that institution, were used. Data were processed according to descriptive statistics, by means of percentage analysis. Results: in the 88,8 % of the sample, infection by the human papilloma virus was obtained, with high risk of oncogenicity, from which there

was a predominance of genotype 16, with 26 cases (57,7 %), followed by 31, with 12 isolations (26,6 %), and 2 patients had genotype 52, for a 4,4 %. The 6,6 % of the sample was found to be infected with the genotype 11, which is considered to be of low risk, and in 2 cases it was not possible to type. Conclusions: there was a great predominance of patients affected by the human papilloma virus with a high risk of oncogenicity. ALEXANDER MORALES FONTAINE, ODALYS RUFINA PEÑA PÉREZ, ALICIA MARÍA YABOR PALOMO, VICENTE DE JESÚS ALVAREZ YABOR PDF (ESPAÑOL) HTML (ESPAÑOL)

Characterization of the sub-denture stomatitis in patients from "Julio Antonio Mella" polyclinic Background: sub-denture stomatitis is a lesion that constitutes a risk factor for the occurrence of premalignant and malignant diseases of the oral cavity. Objective: to characterize those patients suffering from sub-denture stomatitis who were treated at "Julio Antonio Mella" polyclinic in Camagüey. Methods: an observational and descriptive study was carried out in patients treated at the referred polyclinic from January to November, 2014. The universe was composed of 643 patients over 20 years of age, of both sexes, who came to be assessed by the dental prosthesis specialty. The selection of the sample was non-probabilistic and was made up of 296 patients who had sub-denture stomatitis. Results: out of the 296 patients, females predominated, with 70,94 %. Those who used the dentures for over 10 years were the most affected ones (60,47 %), mainly due to lesions grade II (59,45 %). The 81,41 % were users of full dentures and the 18,58 % suffered from the disease using partial dentures. The continuous use of the dentures got the most important place in the study, with 195 patients, for 65,87 %. Conclusions: patients older than 20 years old with sub-denture stomatitis, objects of research, were characterized. ISIDRO NÁPOLES GONZÁLEZ, SILVIA MARÍA DÍAZ GÓMEZ, CARIDAD INÉS GARCÍA NÁPOLES, DAINIER PÉREZ SARDUY, ANA MARÍA NÁPOLES SALAS PDF (ESPAÑOL) HTML (ESPAÑOL)

Modification of the oral health state of patients suffering from VHI/AIDS in a health area Background: the poor oral health state affects patients’ health in general; this situation has greater negative influences in patients suffering from VHI/AIDS, besides having an effect on the evolution of their illness. Objective: to modify the oral health state in patients suffering from VHI/AIDS belonging to "Romárico Oro" teaching polyclinic, by means of an intervention study carried out during two years. Methods: an intervention study was carried out from January, 2013 to January, 2015 in a sample of 11 patients diagnosed with VHI/AIDS to modify their oral health state. The patients were examined to detect risk factors associated to oral diseases and to classify them epidemiologically. They were given healing attention, follow-up assessment of their oral health state after two years of having initiated the intervention. Results: patients were between 19 and 59 years of age; there was a slight prevalence of males, with 63,3 %. Before the intervention all the patients showed bacterial plaque; toward the end, it persisted in only one patient. Caries and tartar were the associated risk factors that showed the highest incidence, with 90,9 % in both cases; after the intervention they were eliminated in all the patients. Peri-odontopathies were present in 63,3 % of the cases and it was possible to reduce them to 9,1 %. Smoking and occlusal dysfunction were those less modified. Conclusions: it was possible to modify the oral health state in all the patients who were object of intervention, improving the oral health state of most of them, even the healthy ones at risk. ROSARIO ABRAHAM IGLESIAS, KENIA CASANOVA SALES, NIRIA YUSIMI REYES DESDIN, SARA ELENA PANIZO BRUZÓN, ELVA SAYAS SÁNCHEZ PDF (ESPAÑOL) HTML (ESPAÑOL)

BRIEF COMMUNICATIONS

Cost of treatment in hypertensive patients who include ear acupuncture / phyto-therapy into their drug treatment Background: control of hypertension reduces the occurrence of complications. However, in difficult-to-control patients costs are increased as a result of the need to use more than one drug. Objective: to determine the consumption of drugs and the cost of treatment in hypertensive patients who include auricular therapy / phytotherapy into their drug treatment and who belong to the health area of "Romárico Oro" teaching polyclinic in Puerto Padre, treated between April, 2013 and April, 2014. Methods: an intervention in 68 hypertensive patients was carried out in the health area and during the time period mentioned above. The patients were divided into two equal groups, at random sampling. In the first group of study, the auricular therapy / phyto-therapy treatment was added to the medication, and the second, the control one, received only drugs. The statistical analysis was made using the Statistic system; the Chi-square test was used, considering p