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

Type 2 diabetes mellitus results from the combination of insulin resistance along with inadequate secretion of it. Its etiology is heterogeneous, involving genetic and environ-mental factors. Its increase has been significant in recent decades which has been coupled with the increase in obesity. There may be three forms of presentation: asymptomatic, symptomatic and ketosis or ketoacidosis. The accelerated development of complications is due to a more rapid and progressive decrease in the function of the B cells that characterizes this disease in the pediatric age. The treatment includes lifestyle changes, diabetes self-control and drug treatment, being essential to involve the whole family in the management of this group of patients. Only metformin and insulin have been approved for use in this age group. Prevention is the cornerstone to curb the surge of DM2 in children and adolescents internationally. It is based on the identification of individuals at risk, early diagnosis of prediabetic states and education, aimed at the family and the community.

Pulmonary processes in children under two years are mostly caused by viral agents, which are largely resolved without further complications, however there are causal agents that we must keep in mind that can leave important sequelae at the lungs. We present a case of Bronchiolitis Obliterans as sequel of Adenovirus infection.

This is a systematic review of selected articles published in different sources of information up until February 2, 2020, including the different clinical-epidemiological aspects of the epidemic reported after the first confirmed 2019-nCoV case in China. The article also compares the new coronavirus (2019-nCoV) data as of February 2, 2020, with the available evidence and parameters documented for SARS-CoV and MERS-CoV, including its form of transmission, origin, mortality, incubation period and the basic reproductive number (R0), or the speed at which a disease is capable of spreading in a population. The report concludes by recommending the creation of global health units, which could favor the impact of our health system on the health indicators of entities with higher prevalence and endemic behavior, while reinforcing the effective preparedness efforts and containment measures for epidemic outbreaks, at entry ports and strategic points in a particular nation. The impro-vement of interconnections with other units of similar consti-tution and objectives is also recommended, initially, at regional level, but, as the ultimate goal, also globally.

No summary.

Introduction: The body exposes daily to different agents that cause normally controlled oxidative reactions. Overproduction of reactive oxygen species and/or decrease in antioxidants induce oxidative stress (OS) associated with chronic pathologies contribute to a worse prognosis of the disease. One such chronic pathology is diabetes mellitus (DM) in which OS has shown to be highly involved in its pathophysiology and as part of the development of complications. The OS index (OSI) was determined in individuals with DM and in a healthy control group, to assess their possible correlation and degree of oxidative damage, as an initial supportive strategy for a potential antioxidant therapy as an adjunction to conventional treatment Methods: OSI was measured in a population of 110 individuals with DM, consisting of 37 cases of type 1 DM (DMT1) and 73 type 2 (DMT2) at ages between 50 and 70 years chosen at random and compared with the values of a healthy volunteer control group. The main goal of the clinical trial was to define the degree of correlation between OSI levels and oxidative damage severity, weighted from a qualitative formula, through the measurement of nine OS biomarkers in erythrocyte lysate. Discussion: The prevention or detention of DM comorbidities may rest in the future in the precise identification of biomarkers and their regulatory counterpart. The inclusion of a therapy using an antioxidant protocol adjuvant to the standard management of DMT2 could provide more effective results for hyperglycemic control and, therefore, to induce redox balance. The results show that this type of therapy would not be effective in DMT1. The recognition of the extent and type of oxidative damage in specific populations is decisive, through the creation and use of a baseline with the most frequently altered biomarkers. This baseline will help defining the best antioxidant strategy to be applied, because genetic polymorphism, the environment and styles of life act specifically in the type of response to the OS. A beneficial scheme to assess may be the development of new drugs with antioxidant effects or products capable of strengthening the physiological antioxidant system made from natural substrates and the making of effective fixed dose combinations of antioxidants that attack the causes of OS in DM. The final aim is to reverse oxidative damage in order to prevent the appearance of complications or slow them down. Conclusions: The use of OSI with different biomarkers helps to achieve the specificity of OS diagnosis, but for the choice of markers to be correct, these must be defined by the objective and design of the study, as well as by the clinical relevance in the selected subjects, as was the one applied in the actual trial. The results obtained demonstrate the potentiality of the use of antioxidant therapy in DMT2, but not in DMT1. The clinical importance of OS biomarkers in humans should come from a critical marker’s analysis that reflects the overall status of redox under particular conditions and guidance for effective antioxidant therapy.

Introduction: Low visual acuity is an educational problem of global interest, the progression of which is avoidable with early detection methods and active cooperation by parents and the educational institutions. The purpose of this study is to define the number of students of an educational center in El Carretón, Peravia, Dominican Republic, who have some type of condition that merits specialized ophthalmological care and emphasize the lack of importance given to ophthalmological health in that location. Methodology: Prospective, descriptive, cross-sectional and observational study in which the prevalence of visual acuity disorders, dyschromatopsia and associated signs and symptoms in a student population was analyzed. Results: It can be seen that visual acuity in the left eye was normal in 47% of the cases being higher than in the right eye which was 43% of all the cases; The 8-year-old students had a predominance in alterations of visual acuity in the right eye as well as the 12-year-old students had a predominance in alterations in the left eye. 77% of the percentage that presented an alteration in visual acuity had headache as the most common symptom and 10% had no associated signs and symptoms. It was observed that with the pinhole occluder there was greater improvement of vision in the right eye with 7% compared to the left eye that was 5%. Conclusions: Students with VA impairment presented more often a mild visual impairment in both the right eye and the left eye. The symptoms most associated with vision disorders were headache and blurred vision. Of the signs evaluated, none were evident in the population examined. No student presented dyschromatopsia. Recommendations: Conduct public health campaigns that emphasize the importance of eye care. Involve educational and all institutions related to it, as partners in raising awareness about the importance of identifying eye conditions and access to eye care services among students.

Introduction: The diagnosis of TB can be particularly difficult in children infected with HIV because clinical overlap with another HIV-related disease , making it difficult and delaying a correct diagnosis. Objective: To know the clinical and epidemiological characteristics of HIV / AIDS patients diagnosed with Tuberculosis in Dr. Robert Reid Cabral Children’s Hospital during the period 2010-2016. Methods: Descriptive study, the information was obtained from the records of HIV / AIDS patients diagnosed with Tuberculosis in Dr. Robert Reid Cabral Children’s Hospital during the period 2010-2016. The study variables were collected in a instrument designed for these purposes. The data were processed using the SPSS 2007 statistical package and the analysis was carried out using descriptive statistics. Results: 13.2% of HIV patients developed TB, 72.3% had severe immunosuppression at the time of TB diagnosis, 45% reported a history of TB contact, and 90.5% were intradomiciliary. 53% were not receiving ART before establishing the TB diagnosis. Cough (65.9%), fever (61.7%) and weight loss or poor progress (40.4%) were the main clinical manifestations. 76.6% completed 6 months of treatment, 17% was lost to follow-up, and 4.3% died during treatment. Conclusion: 13.2% of HIV patients developed tuberculosis, with a significant deterioration in their immunity at the time of making this diagnosis, more than half did not receive antiretroviral therapy; a high percentage of these patients had a history of intradomiciliary contact with a TB case, 17% abandoned antituberculosis treatment after it was started.

Objective: Determine the frequency and different causes of postoperative complications of laparoscopic cholecystectomy, in the Hospital Traumatológico Doctor Ney Arias Lora, june 2018-june 2019. Methods: The study was descriptive, cross-sectional and retrospective with a population of 617 patients but only 19 showed postoperative complications, which was the sample number we use. The data was processed using Epi-Info 7.0. Results: Of the 617 laparoscopic cholecystectomies perform in the hospital, 19 presented with postoperative complications, which put the postoperative complication rate at 3.1%; the study showed that the feminine sex was the most affected and the most common age range was between 26-30 years old. The most common postoperative complication was hemorrhages, representing 33% of all the complications, follow by nausea and/or vomits with 21% of the complications. Conclusion: The study shows that within the main postoperative complications of laparoscopic cholecystectomies, the hemorrhages constituted the #1 cause with a 33%, meanwhile nausea and/or vomits represented the 21% and in third place there was a tide between jaundice and shoulder pain with 17%.

Introduction: Colorectal cancer represents the third in incidence in both sexes worldwide. For this reason, it is essential to carry out epidemiological studies of it. Objective: To characterize clinically, endoscopically and histologically colorectal cancer in patients treated at the Surgical Medical Research Center, Cuba. Methods: An observational, descriptive, and retrospective study of 52 patients (31 men and 21 women) with colorectal cancer diagnosed between 2012 and 2014 was carried out. Data from clinical histories, endoscopic imaging, and pathological studies were collected. The average age was 66.7 years. Results: The antecedent and presence of polyps in the colon predominated with 55.8%. Enterorrhagia occurred in 38.5% of patients, intestinal occlusion, and abdominal pain in 17.3%. During the colonoscopy, 47.7% of patients were found with an ulcerated lesion, and the most compromised place was the descending colon (38.5%). Adenocarcinoma was found in 90.4% of patients. Conclusions: Personal history of colorectal polyps, smoking, type 2 diabetes mellitus, and obesity were the most common risk factors. The most common form of presentation was enterorrhagia, followed by intestinal occlusion, and the most affected regions of the colon were descending and ascending. The histological diagnosis was, in most cases, an adenocarcinoma. There was a higher frequency of diagnosis in advanced stages of the disease.

Introduction: Medical relationships with the pharmaceutical industry are increasingly complex and the ethical challenges it poses are real. Objective: To know the relationship that exists between the pharmaceutical industry and the resident doctors of the country and the impact that this relationship could have. Material and Methods: Cross-sectional descriptive study, through anonymous electronic survey participation was considered if they confirmed the completion of the survey that was available during April and May 2019. A descriptive analysis was conducted and the confidentiality and anonymity of the data was ensured. Results: 77 resident physicians of the country were surveyed; 55.8% receive a weekly visit from the pharmaceutical representative. At least 5 times a year they received a gift (49.4%), participated in a meal, dinner or other social event (48.1%), participated in a talk funded by a pharmaceutical company (57.1%). 40.3% received once a year the payment by the FI, of registration / trip to an event (congress, day, etc.). They agree that the gifts / proposals of the pharmaceutical industry influence the prescription of the medicines (20.8%), consider accepting payment of events (45.4%), they said that in their residence they usually accept gifts and offers of the pharmaceutical industry and has not had a training space on relations with the pharmaceutical industry (89.6%). Conclusion: There is a high level of contact of resident physicians with the Pharmaceutical Industry, it is necessary more and better training in handling conflicts of interest in professional practice.