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

Background: the cerebellar arteries have been described as variable in terms of anatomy; which is quite relevant due to the impact on endovascular therapeutic and surgical complication. Objective: to characterize the common pattern and anatomical variants of the origin of cerebellar arteries. Methods: a descriptive study was conducted on 50 human brains obtained from the Legal Department of Amalia Simoni Teaching Hospita, in Camagüey. The cerebellar arterial system of each brain was further dissected. Results: the back-inferior cerebellar artery arose from the vertebral one in 90 % of samples; variants included five that arose from the basilar artery and five absent; its outer diameter average was 1.6 mm. The anteroinferior cerebellar artery arose from the basilar in all cases, asymmetrical at its origin level and 10 % was double; its outer diameter average was 1.39 mm. The superior cerebellar artery arose from the basilar in 94% of cases and from the posterior cerebral artery in 6%, 17 % was double; and its outer diameter average was 1.73 mm. Conclusions: the anatomical origin of the posteroinferior cerebellar artery is from the vertebral artery as common pattern while the anteroinferior and superior cerebellar arteries arise from basilar artery. Anatomical variants includes the origin of the posteroinferior cerebellar artery from the basilar or being absent; double or asymmetric anteroinferior cerebellar artery and superior cerebellar artery with origin at the posterior cerebral artery and/or double. The average of the outer diameter of each cerebellar arteries is less than two millimeters. DeCS: CEREBRAL ARTERIES/anatomy&histology; ANTERIOR CEREBRAL ARTERY/anatomy&histology; POSTERIOR CEREBRAL ARTERY/anatomy&histology; ANATOMIC VARIATION; EPIDEMIOLOGY, DESCRIPTIVE.

Fundamento: la implementación de un sistema de gestión de la calidad basado en la norma NC: ISO 9001 conlleva el establecimiento de la metrología como garantía de calidad de la confia-bilidad de sus equipos de medición. Objetivo: demostrar la importancia del aseguramiento metrológico para la implementación de un sistema de gestión de la calidad. Métodos: se realizó un estudio descriptivo de corte transversal en el Centro de Inmunología y Productos Biológicos en la Universidad de Ciencias Médicas de Camagüey, en el período enero de 2014 a mayo de 2018. Resultados: en el primer levantamiento metrológico realizado ninguno de los instrumentos estaba verificado, se realizó un subregistro en el 2014, en el 2017 se incrementó el número de instrumentos registrados en la universidad, durante el estudio se actualizó el plan de verificación y se logró la verificación de la mayoría de los instrumentos de medición que posee el centro. Se constató la necesidad de contar con una asignación en el presu-puesto para la adquisición de algunos instrumentos en déficit. Conclusiones: el diagnóstico realizado como parte del aseguramiento metrológico permitió conocer la situación real de los instrumentos de medición en el Centro de Inmunología y Productos Biológicos y lograr la verificación de un número importante de los mismos. DeCS: EQUIPOS DE MEDICIÓN; GESTIÓN DE LA CALIDAD; EQUIPOS Y SUMINISTROS/normas; EPIDEMIOLOGÍA DESCRIPTIVA; ESTUDIOS TRANSVERSALES.

Background: intramuscular myxomas are rare benign mesenchimal tumors of musculoskeletal system. They have a low incidence and affect more frequently women in the fourth to fifth decades of life. Objective: to present a case of intramuscular myxoma of the left forearm diagnosed and treated at Universitary Hospital Manuel Ascunce Domenech with favorable clinical evolution. Case report: a 38 year old male patient with past medical antecedents and volume increase in the left anterolateral forearm without no other symptoms. On physical examination a five centimeters soft, mobile, lax and painless tumor was palpated. The soft tissues echography showed an image of low echogenicity with well-defined margins and a thin and integral capsule, rounded by muscles that sized 53 millimeters long per 35 millimeters wide. Surgical treatment was decided to remove the tumor and biopsy that revealed a hypo-cellular and hypo-vascular lesion, compound by fusiform cells without atypia, split by abundant extracellular myxoid matrix. The patient showed a satisfactory evolution without evidence of recurrence. Conclusions: intramuscular myxomas are a less frequent slow growing and painless tumors. Complete removal is the treatment of choice. Nowadays there are not cases of malignancy and its recurrence is due to incomplete resection. The final diagnosis can only be achieved by histological study. The presented case had a favorable evolution after two years of surgery without recurrence. DeCS: MYXOMA/pathology; MYXOMA/surgery; FOREARM/diagnostic imaging; CASE REPORTS; RECURRENCE.

Fundamento: Florence Nightingale fue una enfermera, escritora y estadística británica, considerada pionera de la enfermería moderna y creadora del primer modelo conceptual de enfermería. Objetivo: analizar a Florence Nightingale como la primera enfermera investigadora. Métodos: se realizó una revisión bibliográfica con el método de análisis bibliográfico a través de una búsqueda realizada entre los años 1994 al 2017, donde se consultaron bases de datos especializadas y se seleccionaron 28 publicaciones científicas sobre el tema. Resultados: se insistió en algunos tópicos dentro del tema, como los conocimientos de Florence Nigthingale en cuanto a la filosofía, historia, artes, matemáticas, estadísticas, religión que le permitieron desarrollar innovaciones de técnicas en los análisis estadísticos con lo cual mostró, como un fenómeno social que podía ser medido de manera objetiva y analizado matemáticamente. Conclusiones: Florence Nightingale fue la primera enfermera investigadora, su experiencia ha ejercido una gran influencia en el mundo de las matemáticas, las estadísticas y la Enfermería. DeCS: DOCENTES DE ENFERMERÍA; EDUCACIÓN EN ENFERMERÍA; INVESTIGACIÓN EN ENFERMERÍA; MODELOS DE ENFERMERÍA; HISTORIA DE LA ENFERMERÍA.

Background: degenerative joint diseases of the lower limb have a high prevalence especially those that affect the knee joint. To evaluate the treatment modalities used, scales are used that are originated in other countries. Objective: to validate an evaluation instrument with modifications adapted to the national context. Methods: a development investigation was carried out to address the modification and validation of the The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale in the evaluation of patients with primary gonarthrosis; at the Manuel Ascunce Domenech University Hospital in the city of Camagüey in the period from September 2018 to January 2019. Results: the validation was carried out through an initial process that included the translation into Spanish language and cultural translation, experts consultation, techniques and procedures broken down into five steps such as: definition and characterization of the object of study, selection of indicators, definition of the scale, construction of items and evaluative form of the instrument. To explore the validity the following components were defined: appearance, content based on Moriyama criteria, construct and criterion validity. For the modification and validation of the scale, the data was obtained from primary sources, which produced a database; in statistical processing, summary measures (average and standard deviation), Pearson's linear correlation, Cronbach's alpha coefficient and factor analysis were used with the help of the SPSS 25.0 statistical package for Windows. Conclusions: the reliability and validity of the demonstrated modified scale makes it very useful for the evaluation of patients with primary gonarthrosis. DeCS: OSTEOARTHRITIS, KNEE/classification; OSTEOARTHRITIS, KNEE/epidemiology; OSTEOARTHRITIS, KNEE/therapy; Knee Joint; Validation Studies.

Background: the indices of discrepancy and coincidence of the causes of death between the clinical and morphological diagnosis constitute, indirectly, an indicator of the quality of medical care. Objective: to determine the relationship between clinical and pathological diagnoses based on the results of necropsies of the dead patients in the 2015-2017 period; with emphasis on hospital care indicators. Methods: an observational, descriptive, longitudinal prospective study was conducted with a sample of 1 164 autopsies; 89.1 % of the population. Socio-demographic variables and others referred to the clinical and pathological diagnoses of the causes of death and their degree of agreement related to hospital stay, hospitalization service and diagnosed diseases were selected. Results: in the direct cause of death the coincidence was greater than the non-coincidence. In the basic cause of death the non-coincidence was similar to the coincidence. The coincidence for the direct cause of death according to sex was greater in men and the age group, with greater coincidence was that of 81-90. There was a predominance of coincidence in patients with incomes of less than 24 hours and 1 to 3 days; as well as those who died in the therapy service, followed by clinical specialties. Conclusions: there was a greater number of diagnostic matches for the direct cause of death; and in the basic cause of death the discrepancies predominate. DeCS: CLINICAL DIAGNOSIS; AUTOPSY; CAUSE OF DEATH; UNDERLYING CAUSE OF DEATH; EPIDEMIOLOGY, DESCRIPTIVE.

Background: thyroid is where malignant endocrine tumor diseases originate more frequently. This entity possesses multiple histological variants added to this antecedent, which are usually the cause of important diagnostic doubts. For this reason, studies in which more and more morphometric procedures are added have been developed. The success of an individualized treatment depends on an accurate diagnosis, in which morphometry is recognized by ruling out subjectivity in diagnosis, becomes a valuable tool. Objective: morphometric characterization of papillary thyroid carcinoma diagnosed by excisional biopsies. Morphometric. Methods: a morphometric study of a series of cases was carried out with 12 patients with this histopathological diagnosis, attended at the Vladimir Ilich Lenin University Provincial Hospital. 340 fields were selected and 10 465 cell nuclei were measured, which was our sample. Nuclear morphometric indicators were characterized, such as area, volume and shape factor. Results: nuclear area and volume showed increased values compared to benign nodular disease values from other studies. The value of the nuclear form factor approached one, so the nuclei tend to be round and it was observed that the higher the values of the nuclear area, the higher the values of the nuclear form factor. Conclusions: morphometric indicators of papillary thyroid carcinoma were characterized in the studied cases that may contribute to histopathological diagnosis. DeCS: THYROID CANCER, PAPILLARY/diagnosis; THYROID CANCER, PAPILLARY/pathology; THYROID CANCER, PAPILLARY/therapy; THYROID GLAND/pathology; THYROID GLAND/anatomy&histology.

Fundamento: el carcinoma escamoso del pene es uno de los tumores menos frecuentes del aparato urogenital, que por su localización trae como consecuencias serias afectaciones de la calidad de vida de los pacientes, ocasiona daños tanto físicos, psíquicos como sexuales, por lo que su prevención resulta muy importante. Objetivo: exponer un caso de cuerno cutáneo peneano por lo poco frecuente de su aparición y de su potencial relacionado con la enfermedad neoplásica, en especial el carcinoma escamoso. Presentación del caso: se presenta el caso de un paciente de 74 años de edad, blanco, jubilado con antecedentes de ser fumador de dos cajetillas de cigarros desde la juventud diariamente, además de presentar hipertensión arterial controlada con tratamiento, que desde hace un año presenta lesión en el glande, indurada no dolorosa que ha ido en aumento, además de secreción con mal olor, la lesión hace relieve, paciente no circuncidado. Conclusiones: la presentación clínica de este tipo de tumores ha variado de manera sustancial al asemejarse en ocasiones lesiones benignas, por ello el diagnóstico y tratamiento de esta enfermedad suelen retrasarse implicando un menor tiempo en la supervivencia de los pacientes. DeCS: NEOPLASIAS DEL PENE/cirugía; NEOPLASIAS DEL PENE/terapia; NEOPLASIAS DEL PENE/diagnóstico; CARCINOMA DE CÉLULAS ESCAMOSAS; CALIDAD DE VIDA.

Background: the general surgeon needs to know about the techniques and frequent surgical procedure actions on the small intestine; other relation surgeons should have basic necessary knowledge. This segment of the digestive tract is the place where the intestinal Ilium appears most, but not the cancer; however, the procedures in malnutrition due to excess or defect and the plasties are currently increasing. Objective: to update this important surgical procedure technique. Methods: aspects of the subject in question are reviewed by conducting a search through the web site SciELO, LILACS, MEDLINE, PubMed, as well as institutional libraries. The results were criticall y analyzed before writing the manuscript. Results: all procedures are conceptualized. It is exposed how to extract a foreign body from the intestine insisting on the types of bezoar. It refers to the enterorrafias, their technique, suture materials and needles; in ostomies, we provide information about jejunum and ileostomy and enteroanastomosis, how to do them and their precepts. It is reviewed on enterectomies, enteroptiquia, enteroplastias and ilioentectropia. Conclusions: all procedures are listed in detail corresponding to the objectives of the review. DeCS: INTESTINE, SMALL /surgery; SURGICAL PROCEDURES, OPERATIVE; REVIEW LITERATURE AS TOPIC; ILEOSTOMY; ENTEROSTOMY/methods.

Cave of Guantes, located in Palencia, near the village called Guardo, is a site known for its Middle Paleolithic deposits, as well as for indefinite subsequent occupations. The present study discloses a set of Late Antiquity material, highlighting, among them, a “tremís” that belonged to Visigothic King Égica, which was recovered on the surface levels of the cave, during the last archeological interventions. Because the coins from the Visigothic period are not too numerous, it seems interesting to make them known within this archeological context. As it has been mentioned, along with the coin, some other material appeared which allowed us to make some assumptions about the characteristics of the finding and the deposit. The work includes an extensive analysis on the occupation of the cave during the late times of the Roman Empire and Late Antiquity, as well as on the possible role played by the Roman communication channels during the late occupation of the Cave of Guantes. Our conclusion, after the study, is that the cave must have been the result of exceptional occupations, although continuous over the time, due to its fine location and accessibility, and also probably in relation to agricultural work. The discovery of the “tremís” could be by chance, but also due to an occultation caused by a violent event, in which case we propose, as the reason, the military operations carried out by the Muslims, between year 712 and 713, to get control over the North of the Península.