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

Introduction: subarachnoid hemorrhage, a cerebrovascular disease, is usually caused by aneurysms and is associated with significant impact on morbidity and mortality of affected patients. One of the complications derived from this disease are cerebrospinal fluid collections in the subdural space.Case report: a 68-year-old black female patient, inveterate smoker and hypertensive, who was admitted to the center after suffering sudden headache with loss of consciousness and fall to the floor without cranioencephalic trauma, the physical examination revealed manifestations of drowsiness, psychomotor agitation, disorientation in time, space, person and miotic pupils, some signs and symptoms indicative of endocranial hypertension. In the initial imaging study by simple computed axial tomography of the skull, the subarachnoid and subdural spaces were not expanded and a diffuse bleeding pattern corresponding to a subarachnoid hemorrhage was observed, corresponding to a Fisher 4 subarachnoid hemorrhage. After 24 hours of evolution, due to the worsening of the neurological symptoms (nuchal rigidity, non-reactive pupils, right anisocoria and Glasgow 7), an evolution computed axial tomography was performed, which showed a decrease in the width of the III ventricle, interstitial edema, midline displacement and accumulation of cerebrospinal fluid in the fronto parietotemporal-subdural space.Conclusions: the diagnosis of external hydrocephalus was established, a rare condition that compromises the recovery and survival of the patient. It is important to differentiate this type of hydrocephalus from other subdural cerebrospinal fluid collections.

Introduction: Wilms’ tumor is the most common renal neoplasm in childhood, which makes it necessary to be updated in terms of its treatment.Objective: to describe the treatment of Wilms’ tumor.Method: a literature review was carried out in the Web of Science, Scopus, PubMed, ClinicalKey and SciELO databases. The search strategy used was a combination of terms, using the name of the disease and treatments. Twenty-six references were chosen.Development: Wilms’ tumor represents a malignant tumor with a high cure rate; which is possible thanks to the development of surgical techniques, application of chemotherapy and recognition of the role of radiotherapy. These techniques used rationally have a great impact on the survival rate to this neoplasm. A fundamental pillar in the management of this entity is nephrectomy. There are two positions according to the moment of treatment with chemotherapy; before and after the surgical procedure. Radiotherapy is another modality in the treatment of nephroblastoma; it is used in advanced stages or in conditions where there are associated risk factors.Conclusions: the treatment of Wilms’ tumor depends on the histological classification and staging. Its treatment is multidisciplinary and includes the combination of surgery, chemotherapy and radiotherapy. The application of the existing therapeutic protocols, as long as the parameters they establish are maintained, will have successful results in spite of the different sequences in which the therapeutic modalities are used.

Introduction: the active survey medical students carry out plays an essential role in fighting Covid-19.Objective: to characterize the work of the active survey from the perspective of medical students in fighting Covid-19.Method: an observational, descriptive and cross-sectional study was carried out with medical students who conducted surveys in Habana del Este and 10 de Octubre municipalities, in September 2020. The target group included 55 medical students who agreed to participate in the study; the totality of the group was included in the study.Results: female students predominated (60 %), and students of Medicine (87,27 %). The 12,73 % of them described the surveys as an unnecessary activity and 69,09 % expressed it is a slowdown on the development of the teaching-learning process; 96,36 % reported that the work of the active survey was supervised by healthcare professionals and 80 % reported receiving training from healthcare professionals in the health area. Among the difficulties in conducting the active survey, the students reported a negative attitude on the part of the population being surveyed (36,36 %).Conclusions: medical students showed a positive response about the importance of doing surveys; however, many students considered it a slowdown on the development of the educational process without contributions to professional development. The professors play an essential role in the training and supervision of active surveys.

Introducción: la incorporación del entrenamiento de resistencia a bajas intensidades en los programas de rehabilitación cardiaca resulta importante para potenciar grupos musculares específicos luego de un síndrome coronario agudo en pacientes en régimen de rehabilitación cardiovascular e impone un reto a los profesionales dedicados a este campo de la cardiología.Objetivo: describir el comportamiento de la rehabilitación cardiovascular con entrenamiento con resistencia para pacientes con Cardiopatía isquémica.Método: se realizó un estudio cuasi experimental de tipo antes-después sin grupo de control con 39 pacientes luego de un síndrome coronario agudo. Se diseñó un programa de entrenamiento y tras seguimiento durante seis meses de implementado los ejercicios de resistencia se compararon los resultados con los del inicio de la investigación.Resultados: predominó el sexo masculino y el diagnóstico principal fue el síndrome coronario agudo con elevación del segmento ST. La media en las mediciones de la tensión arterial nunca superó los rangos de normalidad en reposo ni en esfuerzo. El consumo de oxígeno máximo mejoró de 15,6 ml/kg/min a 24,3 ml/kg/min. No hubo ninguna alteración de las variables electrocardiográficas de seguridad.Conclusiones: la inclusión del ejercicio de resistencia al entrenamiento aeróbico en programas supervisados de entrenamiento para pacientes con cardiopatía isquémica mejora su capacidad funcional y la fuerza muscular perdida con los cambios fisiológicos del envejecimiento.

Introduction: severe trauma has a great impact on both health and economy in present-day society, with great incidence worldwide and in Cuba.Objective: to characterize patients with severe trauma admitted to the intensive care unit at Arnaldo Milián Castro Clinical Surgical Teaching Hospital during 2017.Methods: a descriptive, longitudinal and retrospective observational study was conducted in a population of 97 patients, working with all of them.  Clinical records were reviewed; taken data to a database and analyzed in SSPS 21.0. Descriptive statistics was applied using absolute and relative percentage frequencies.Results: male patients (81,44 %) predominated, as well as the age group 35-44 years (37,11 %). Car accidents (57,73 %) and stabbing injuries (26,8 %) were found to be the main mechanisms of injury. Cranioencephalic (39,18 %) and thoracic traumas (21,65 %) prevailed. The most frequent complications were sepsis (23,71 %), nosocomial pneumonia (17,53 %) and hypovolemic shock (15,47 %); 70,1 % of the patients were discharged alive.Conclusions: male patients in the third decade of life are prone to suffer trauma; mainly caused by car accidents. Cranioencephalic and thoracic traumas are common injuries in these patients. Sepsis and pneumonia associated with mechanical ventilation were frequent complications.

Introduction: due to the diagnostic utility of complementary clinical laboratory tests, it is necessary to learn from undergraduate to achieve better medical care.Objective: to elaborate a teaching support material on reference values of clinical laboratory examinations.Method: A development investigation was carried out at the Teaching Surgical Clinical Hospital “Dr. León Cuervo Rubio ”, during the year 2018. The sample consisted of 60 third-year students of the Medicine career and 15 professional specialists from the Clinical Laboratory and Internal Medicine as evaluators. Reference values for laboratory test results were collected. Microsoft Publisher 2016, from the Office suite, was used for digital editing. For the treatment of the images, Adobe Photoshop 10 was used. A semi-structured survey was applied to evaluate the product.Results: all the indicators received adequate or higher grades from 95 % of the students, where 26,67 % indicated the update as very adequate. Regarding the perception by teachers, all the indicators received adequate or higher marks by 93,33 % of the teachers, where 100 % evaluated the practical value and coherent integration of the contents as adequate or superior.Conclusions: a medium valued as useful was prepared, and which covers the training objectives of the Basic General Physician. The values are collected in tables that contain the complement with its value (or range) specifying the measurement units. 

Introduction: hypomelanosis of Ito is a neurocutaneous syndrome and a multisystem disorder, described by Japanese dermatologist Minor Ito in 1951. This disease is characterized by hypopigmented lesions of linear or annular distribution on the skin, associated or not with neurological and ocular manifestations, as well as dental and musculoskeletal malformations.Case report: 12-year-old male patient, son of young non-blood parents with a family history of vagal crises, personality disorders and epileptic seizures in childhood. Personal pathological history included right unilateral appendageal since birth, spasms during sleep at 3 months, joint hyperlaxity and hypotonia at one year, delayed psychomotor development, focal temporal lobe and tonic-clonic epilepsy seizures at 10 years old, diagnosis of right pectoral agenesis at 1 year old and bilateral pyelectasis. He attended the Provincial Clinical Genetics Service referred by the Dermatology Clinic for presenting hypopigmented macules in the upper right limb, accompanied by the neurological, musculoskeletal and genitourinary signs described above. Taking into account the international criteria based on cutaneous and extra cutaneous manifestations, hypomelanosis of Ito was diagnosed.Conclusions: hypomelanosis of Ito is a rare, multisystem disorder, with a fundamental clinical diagnosis. Early diagnosis is essential in order to provide a timely treatment, as well as knowing the forms of presentation and manifestations, achieving a better quality of life for the patient.

Basic knowledge for the care of patients with acute myocardial infarction

Abstract: Objective: Compare in cucumber cultivation a commercial pest control program vs a biological pest control program evaluating quality and production parameters. Design/methodology/approach: The study was carried out in glass greenhouses classified as high technology, under a cooling system consisting of wet walls and extractors, heating that works by irradiation, automated irrigation. Two treatments were evaluated: biological control of pests in area A and the second, a commercial control program in area B, both in Persian cucumber (Cucumis sativus) of the Jawell variety. Each area of 160 m², in separate areas. One plant was considered as an experimental unit, the total of experimental units were 41, 600 plants for each area, 80 grooves were considered within each area with a length of 100 meters with 52 pillows of coconut fiber, whose pillows contain five cubes of rockwool with a plant two heads each cube, giving a total of 10 plants per pillow and 520 plants per groove. The average planting density was 3.42 plants / m². The biological control program consisted of releasing the mite (Amblyseius swirskii) for the control of thrips; the release of the wasp (Aphidius colemani) for aphid control; mites (Phytoseiulus persimilis) and (Amblyseius californicus) for the control of red spider mites and the application of the entomopathogenic nematode (Steinernema fetiae). The commercial-chemical control was in accordance with COFEPRIS (2019). The chemical products Actara (Thiametoxam), Beleaf (Flonicamid), Confidor 350 sc (Imidacloprid), Plenum 50 gs (Pymetrozine) and Talstar 100 CE (Biphentrine) were applied to control aphids. Tracer (Spinosad), Exalt (Spinetoram) and Beleaf (Flonicamid) for thrips control. Agirmec (Abamectina) and Talstar (Bifentrina) for the control of red spider, and finally Trigard (Cyromazina) for the control of fungus gnat larvae. The evaluated variables were fruit quality, total production and incidence of pests. A completely randomized experimental design was applied. To analyze the total number of boxes produced, the statistical T-Student test was used for normal data between two independent samples and the Mann-Whitney test was used to compare the variables weight quality and weight loss with the data obtained, with a level of significance of P³0.05 to determine differences. A correlation (r) was made between the incidence of thrips (Thrips tabaci) and the incidence of the biological control Amblyseius swirskii, to compare the biological control (A) and the commercial control (B). Results: The results show that the production method using a biological pest control system was just as efficient as the chemical control program, in variables such as fruit weight, number of quality cucumber boxes obtained and incidence of pests. and its biological control. Limitations on study/implications: It is important to carry out further studies under open-air conditions where biotic and abiotic factors are different and in other regions, in addition to testing other registered biological products. Findings/conclusions: Biological and chemical control are complementary, an integrated control would help to slowly adapt a company for a subsequent application of only biological pest control, facilitating regularization and certification procedures involving the use of chemicals. In this biological control program, a more continuous and distributed release of A. swirskii is proposed during the weeks of cultivation, which will maintain more uniform and constant populations, this to avoid development of high populations of thrips and allow better control of this plague. It is necessary to evaluate both control programs during the spring-summer season to be able to compare the efficiency of these for each season and annually.