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

Resumen en español Introducción: Los beneficios que los CP aportan a los pacientes con enfermedad oncológica, están claramente establecido desde hace años, no así los beneficios que podrían recibir los pacientes con IC.  Objetivos: Evidenciar los beneficios de la inclusión de los CP a los servicios de Cardiología y determinar el manejo de los pacientes con IC avanzada/terminal.  Métodos: Se realizó una búsqueda de estudios relacionados con el tema en diferentes bases de datos: Cochrane Medline, Medscape, PubMed Scielo y Tripdatabase en el mes de Setiembre del 2018 utilizando las palabras claves.  Resultados y conclusiones: La inclusión temprana de los pacientes con IC avanzada o terminal en los programas de CP trae importantes beneficios para el pacientes su familia/cuidador y al sistema de salud.     Abstract Introduction: The benefits that palliative care provides to patients with oncological disease are clearly established for years, but not the benefits that patients with heart failure could receive. Objectives: To demonstrate the benefits of the inclusion of palliative care to Cardiology services and to determine the management of patients with advanced/terminal heart failure. Methods: A search of related studies was carried out in different databases: Cochrane Medline, Medscape, PubMed Scielo and Tripdatabase in the month of September 2018 using the key words. Results and conclusions: The early inclusion of patients with advanced or terminal heart failure in palliative care programs brings important benefits for patients, their family / caregiver and the health system.

Lung cancer is one of the leading causes of cancer death in the world, being the main cause in 93 countries (1-6), this pathology has a survival of 15% in 5 year and at the beginning of the diagnosis 70 % of patients are non-operable (5). It is described that surgical treatment is the curative treatment of choice for this pathology (2,3,12,13), but not all patients are surgical at the time of diagnosis. Pulmonary rehabilitation is a multidisciplinary intervention that is based on evidence, is cost-effective (1,10), and for patients with lung cancer it has been seen that it can be based on the rehabilitation programs in COPD (20), this is safe and feasible in patients with advanced stages of the disease; another characteristic is that it can increase the number of operable cases (10). It takes 6 weeks to obtain substantial effects but from the 2-4 week physiological changes are seen (11,17,19,21)

We present the clinical case of a 36-year-old male patient, who was taken to the operating room with the diagnosis of intestinal occlusion and eosinophilia. The intraoperative findings were nonspecific, so a positive test for Morera was performed for Angiostrongylus costaricensis. This parasitosis causes intestinal occlusion with low frequency. In our country, it must be included in the list of abdominal pain, both acute and chronic, moreover, if it associates marked eosinophilia.

The term amyloidosis refers to a series of pathologies with abnormal folding of proteins, that have in common the formation of extracellular deposits of insoluble protein fibrils in organs and soft tissues. The fibrils present green apple birefringence after being dye with red Congo and observed with electronic microscopy. Up to 60 types of proteins have been identified in the amyloid deposits, that is why it is so important to perform immunohistochemical studies to identify the protein present in an amyloid fibril. The amyloidosis that occurs in the context of inflammatory or infectious chronic disease presents a protein called serum amyloid A. The case of a patient with chronic osteomyelitis that presents serum amyloid A amyloidosis is discussed.

This article covers the result of a set of theoretical- practical considerations about the communicative and social needs of children with multiple disabilities in classrooms. This, taking in account that disability is constantly changing concept and that the Statutory Law 1618 uses the concept of disability to ensure this population’s good treatment, needs and guarantees. In this context, it is important to address how the speech therapist has started to occupy a relevant role in the classroom, contributing to the communicative development, analyzing and seeking to improve deficiencies, looking for solutions and making activities to increase the social and interpersonal development of the student population. With the teachers help, this population is projected from the classroom, under an inclusive and dynamic perspective, towards a society where all children have the power to communicate and participate. This article proposes a reflection on the speech therapist’s actions to favor the interactive classroom communication with the child’s population with multiple disabilities.

Introduction: A series of short periods of distant ischemia, prior to the major ischemic event, can limit the myocardial damage produced by ischemia or reperfusion. Objective: To evaluate the usefulness of remote ischemic conditioning in patients scheduled for surgical procedures of coronary revascularization. Methods: A quasi-experimental, explanatory, comparative study with historical control was conducted in two groups of 247 patients proposed for coronary revascularization. A tourniquet was placed in the right arm in the study group, alternating 3 insufflations with 3 dessufflations with a pressure of 200 mmHg, keeping each for 5 minutes. This procedure was performed before, during and after the major ischemic event, caused by the impingement of the coronary artery. Results: A significant decrease in enzymatic parameters was achieved. No significant differences were found (p> 0.05) according to a set of variables that represent the initial state of the patients.

Introduction: One of the most feared emergencies during the instrumentation of the respiratory tract is bronchospasm. Magnesium sulfate, administered intravenously, has a bronchodilation effect by antagonizing calcium channels, inhibiting muscle contraction mediated by calcium and promoting bronchial smooth muscle relaxation. Objective: To evaluate the efficacy of magnesium sulfate administered intravenously in patients with bronchospasm during bronchoscopy. Methods: Observational, descriptive and cross-sectional study carried out with 20 patients, with bronchospasm, triggered by airway manipulation with flexible bronchoscope, treated with 50 mg/kg of magnesium sulfate, (maximum 2 g), administered intravenously for 5 min. Results: Men between 50-59 years (75 %) predominated. All patients were smokers. 15 patients were classified with physical state ASA III. They suffered bronchospasm of mild intensity 60 %, classified according to the clinic and monitoring of oxygen saturation. In 75 % of the patients, the bronchospasm ceased after the treatment without administering any other medication. No adverse effects were recorded. No patient needed orotracheal intubation for ventilation or required hospitalization for more than 8 hours. Conclusions: Magnesium sulfate is a good pharmacological option for the emergency treatment of bronchospasm triggered by manipulation of the respiratory tract.

Introduction:Surgical-patient safety is nowadays a public health concern for its high and growing usage in healthcare, the high potential for associated damage, and the demonstration that most of the adverse effects associated with anesthetic-surgical procedures are preventable.Objective:To analyze the deficient elements in the current anesthetic practice in terms of patient safety and to provide possible solutions for improving the quality of care.Development:Safety culture is defined as an integrated pattern of individual and organizational behavior, based on shared beliefs and values, which continuously aims at minimizing the harm the patient could suffer as a consequence of the processes and general provision of healthcare.Conclusions:The anesthesiologist is a key part within the surgical team in terms of patient safety, so a reflective practice, one that is adjusted to current treatment standards, within the framework of a care system capable of learning from its mistakes, will result in better quality of care and decrease in the incidence of adverse events.Keywords:   anesthetic safety; surgical patient; quality of care. 

Introduction: Virtual education is the training process developed through the usage of information and communication technologies, through the Internet. For an adequate development of this new pedagogical method, teachers are needed who are qualified and motivated in that respect. Objectives: To describe the main aspects related to the development of teaching competences in virtual learning environments. Method: A summary was made of the information extracted from different bibliographic sources. Development: The level of teaching competences in virtual learning environments is affected by poor knowledge and mastery of technological tools, as well as by low motivation. Conclusions: This review provides elements to design a strategy aimed at maintaining the continuous improvement of professors including the use of information communication technologies.