Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introduction: Oral cancer is a world health problem. It constitutes the sixth leading cause of cancer-related death. Knowledge about and awareness of this disease among the population is important to reduce its high mortality rate.Objective: Determine the level of knowledge about oral cancer among adult patients attending the Dental School at the National University of San Marcos in the year 2017.Methods: A cross-sectional observational descriptive study was conducted. The study population was the patients attending the Dental School clinic. The sample was 223 patients selected by systematic probabilistic random sampling. The evaluation tool was a survey containing 11 closed-ended questions divided into five domains: general knowledge, risk factors, signs and symptoms, repercussions and prevention of oral cancer. The grading scale was low, fair or high.Results: Of the patients surveyed, 56.5% (n= 126) had a low knowledge level, 40.4% (n= 90) a fair level and 3.1% (n= 7) a high level. Average answer level was 12.14 ± 2.90 (CI 95% [10.17-14.89]). Sex and age did not have a significant relationship to knowledge level (p= 0.45 and p= 0.52, respectively). However, educational level did have a significant relationship (p= 0.009).Conclusions: In the study population the level of knowledge about oral cancer is predominantly low. Sex and age do not have an influence on the level of knowledge about oral cancer, but educational level does.

El principio de autonomía y el derecho a decidir libremente, pueden generar una situación en la que potencialmente se compromete la vida de la persona.  ¿Qué posición debe tomar el clínico tratante, ante una decisión que puede poner en riesgo la vida de su paciente?

Introduction:Worldwide, the frequency of malnutrition in intensive care units is high and continues to be a cause of increased morbidity only surpassed by sepsis. This frequency increases hospital costs due to delayed injuries healing, suture dehiscence, septic complications, failure to separate mechanical ventilation, critical patient myopathy, and high mortality.Objective:To assess the nutritional status of patients admitted to an intensive care unit.Methods:A descriptive, prospective, cross-sectional research was carried out during the period from January to December 2017, in the multipurpose intensive care unit of Orlando Pantoja Tamayo General Teaching Hospital. The sample was 85 patients selected by the simple random method. The variables used were biochemical, anthropometric, immunological, age, sex, need for mechanical ventilation, discharge status, and group of diseases.Results:The average age was 57.9 years (min: 20 years, max: 89. DS: 17.9), patients with hospital stay of 1-7 days (70.6%) [min: 1, max: 17 predominated. DS: 3.41]. Mechanical ventilation was used in 37.6%, 11.8% of patients died, and the cardiovascular disease group prevailed in 49.4%.Conclusions:No association between nutritional status was found, based on the nutritional control index, with hospital stay or status at discharge, but with the need for mechanical ventilation.Keywords:  nutritional status; nutritional control index; mechanical ventilation. 

Introduction:The approach to the subarachnoid space was described by Quincke in 1891. It is now a common practice to perform subarachnoid neuroaxial anesthesia in obstetric patients. The complications described, associated with this, are several. Within these, the paralysis of the abducens nerve or sixth pair is not frequent and sometimes is not related to the puncture, since it occurs days after the event.Objective:To review the information related to the complication of paralysis of the sixth pair.Case presentation:A 33-year-old female patient, a physician, with a personal history of migraine, a history of epidural neuroaxial anesthesia without complications, who underwent combined epidural-spinal anesthesia for performing a cranial segment cesarean section and bilateral partial salpingectomy. The transoperative period runs with hemodynamic stability. There was headache three days after surgery, which was attributed to the migraine history and the patient was treated, without evaluation by anesthesiology, with dipyrone. At 10 days after surgery, the eyes are diverted and diplopia is manifested, paralysis of the sixth pair is diagnosed. She was treated by neurology and several differential diagnoses were proposed. Imaging studies are negative. She was treated with vitamins and remission occurred at six weeks.Conclusions:The diagnosis of this complication is necessary, since the relationship with anesthesia may go unnoticed and, therefore, its treatment may be poorly conducted.Keywords: paralysis of the sixth cranial pair; abducens nerve disease; spinal anesthesia; dural puncture. 

Introduction: The increase in life expectancy determines an increase in the incidence of diseases with surgical indication. Advances in surgical techniques, intensive care and deeper understanding of the aging process tend to favor the reduction of perioperative morbidity and mortality among geriatric patients.Objective: To determine the incidence of intraoperative and postoperative complications among geriatric patients during elective major abdominal surgery.Methods: A descriptive, cross-sectional and observational study was carried out with 373 geriatric patients scheduled for major abdominal surgery from January 2017 to December 2019 at Dr. Miguel Enríquez Clinical-Surgical Hospital. The incidence of perioperative complications was recorded, relating them to the study variables.Results: The most frequent complications were the cardiovascular ones. Mortality was low.Conclusions: The perioperative complications identified among the geriatric patients studied are related with previous diseases, with the type and extent of surgery, and with the surgical time.

Introduction: The quality criteria in radical oncological surgery are based on complete tumor removal, with free margins, without residual macroscopic disease, with adequate lymphadenectomy and minimal possible tumor manipulation. Despite achieving these objectives, non-visible residual disease or micrometastasis may remain, likely to grow and spread depending on tumor capacity and the host's defenses.Objectives: To evaluate the influence of perioperative factors on the immunity of cancer patients operated on and the potential effect of anesthetic drugs on recurrence, as well as other perioperative factors that may affect long-term tumor spread.Methods: An electronic bibliographic search was carried out of the articles published in the last ten years and that fulfilled the established objective.Development: During the perioperative period, activation of the response to surgical stress triggers a series of complex neuroendocrine, humoral and immune reactions. Surgery, with unquestionable curative potential, is related to a state of immunosuppression due to activation of the hypothalamic-pituitary-adrenal axis and inflammation. On the other hand, anesthesia produces biomolecular changes that affect cellular immunity and the number of natural killers, which can influence cancer recurrence in the long term.Conclusions: To reduce surgical and psychological stress, to control surgical pain, to maintain normothermia, and a judicious blood transfusion, in addition to an anesthetic technique with reduced opiates usage, can be beneficial to protect the body's antimetastatic immune response and can have a beneficial effect on oncological disease.

Introduction: The decision to perform anesthetic induction with propofol or thiopental in obstetric patients for cesarean section is a controversial issue, with contradictory oncomes among investigations.Objective: To present the results published in the national and international literature about the use of propofol as an anesthetic agent in the induction of general anesthesia in elective cesarean section.Methods: A nonsystematic review of the bibliography was carried out, with a focus on articles in Spanish and English published, during the last ten years, in databases indexed in Infomed, such as Hinari, Ebsco, Scielo, Pubmed, Cubmed, Cocrhane, using keywords such as (inducción anestésica [anesthetic induction] OR anestesia general [general anesthesia] OR) AND (propofol OR) AND (operación cesárea [ cesarean section] OR cesárea [cesarean] OR).Development: Articles were highlighted if they compared the results of propofol usage against thiopental and other barbiturates during anesthetic induction in terms of hemodynamic variables, adverse effects, anesthetic quality and neonatal outcomes such as physical state, neurological adaptation capacity and arterial gases.Conclusions: Propofol is the commonest agent for anesthetic induction in obstetric patients requiring elective caesarean section. This presents adequate maternal and fetal outcomes, as well as a lower incidence of adverse effects. Keywords: obstetric patient; propofol; caesarian section; neonatal depression.

Introduction: Thrombophilia is a congenital or acquired hemostasis disorder that predisposes to thrombosis development. The commonest congenital thrombophilias are deficiencies of antithrombin III, protein C and protein S, factor V Leiden, prothrombin gene mutation (G20210A), and methylenetetrahydrofolate reductase (MTHFR) mutations.Objective: To describe the anesthetic management in a patient with congenital thrombophilia.Case presentation: The case is reported of a 19-year-old patient with a family and personal history of deep-vein thrombosis, treatment with double antiplatelet therapy and association of three mutations for congenital thrombophilia (G20210A, A1298C MTHFR and C677T MTHFR), who receives spinal anesthesia for an inguinal herniorrhaphy. Aspirin treatment is maintained. Clopidogrel is suspended seven days before surgery. During this time, fraxiparin is administered subcutaneously in 0.6-mL units daily, up to twelve hours before surgery. Elastic stockings are used, early ambulation is allowed, and clopidogrel is restarted 24 hours after surgery, with satisfactory evolution.Conclusions: Thromboprophylaxis in patients with congenital thrombophilia is mandatory, a reason why the use of low-molecular-weight heparin, together with the rest of the prevention measures against deep-vein thrombosis, is decisive. Keywords: deep-vein thrombosis; congenital thrombophilia; spinal anesthesia; thromboprophylaxis. 

Introduction: Takayasu arteritis is an inflammatory disease that affects the aorta and its branches, and shows a predilection for the Asian population.Objective: To describe anesthetic management in an obstetric patient with Takayasu arteritis.Case presentation: Female patient, 20 years old, 39 weeks of pregnancy, a history of Takayasu arteritis. At six months of gestation, the first symptoms of the disease appeared. Diagnosis is confirmed through CT angiography of the supra-aortic trunk and neck vessels, in addition to carotid Doppler. Occlusive vascular disorders, as well as concentric stenosis of both carotids and the main branches of the aortic arch are observed. Finally, the diagnosis of type I Takayasu arteritis was confirmed. At the end of her pregnancy, an elective cesarean section was decided to avoid labor.Conclusions: Obstetric anesthesia for patients with this disease is highly complicated due to its complex management, observation and interpretation of multiparametric and imaging monitoring. During anesthetic conduction, strict hemodynamic control is essential, avoiding low blood flow syndrome and maternal or fetal ischemic damage.