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

Introduction: Stargardt´s Disease or fundus flavimaculatus is the most frequent juvenile macular dystrophy that is responsible for 7 % of macular dystrophies. They can be difficult to address because of several reasons.  The differential diagnosis is sometimes difficult to make and some of these diseases can cause legal blindness at a relatively young age. Objective: To describe the diagnostic process of an unusual entity with an infrequent form of presentation. Case presentation:  We present a case of a 21-year-old white female patient with the diagnosis of Stargardt´s Disease with fundus flavimaculatus.  The diagnosis was made taking into account personal pathological antecedents, the physical examination by direct and indirect ophthalmoscopy, assessment of visual acuity with and without correction, color vision test, fluorescein angiography, optical coherence tomography (OCT), and electroretinogram.  Research on the topic was carried out because of the unusual appearance of these two variants of the same disease in the first decade of life. Conclusions:  The majority of retinal dystrophies are similar from the clinical point of view; however, their evolution and prognosis can be different.

Introducción: Las comunidades nativas forman uno de los grupos humanos más olvidados donde se reagudizan las inequidades y desigualdades en salud oral. Objetivo: Determinar el perfil clínico epidemiológico de salud oral en pobladores de las comunidades nativas de Potsoteni, Boca Sanibeni y Unión Puerto Ashaninka del distrito de Mazamari, provincia de Satipo, departamento de Junín, Perú. Material y Métodos: Se realizó un estudio observacional descriptivo de corte transversal. La muestra estuvo integrada por 169 adultos de las comunidades nativas, se tomaron en cuenta criterios de inclusión y exclusión, y se siguieron las normas éticas en investigación científica. Se evaluó la salud oral mediante una ficha epidemiológica con los indicadores: Índice CPOD, índice de significancia de caries dental (SIC), índice de higiene oral simplificado (IHO-S), índice de necesidad de prótesis dentales de la OMS, clasificación de maloclusión de Angle, índice de consecuencias clínicas de caries no tratadas (PUFA), la evaluación fue realizada con luz natural por observadores calibrados. Los datos se analizaron en el programa STATA v 14 mediante tablas de distribución de frecuencias y figura.Resultados: El 100 % de los pacientes estudiados tenía caries dental (CPO-D = 13,23; SIC=19,01), IHO-S: 5,02 (DS=0,51), la mayoría presentó un tipo de maloclusión y consecuencias clínicas de caries no tratadas 116 (68,63%) y 115 (68%) respectivamente, la prótesis dental unitaria fue la que más se necesitó en ambos maxilares.Conclusiones: El estado de salud bucal fue preocupante, es necesario fomentar políticas que permitan un mejor acceso a los servicios de salud a fin de revertir estos indicadores.

El profesor Miguel Ángel Moreno Rodríguez fue un clínico ejemplar, dedicado a la asistencia y docencia en la especialidad de Medicina Interna. Su curriculum Vitae refleja su destacada labor como profesional, internista y revolucionario. Paradigma para las nuevas generaciones de médicos amantes de la clínica médica.Palabras claves: Medicina interna, clínica, valores, medicina militar, historia.

Introduction: Pancreatic pseudocysts represent the most common cystic lesions of the pancreas. They are complications of acute and chronic pancreatitis although there are other less frequent causes such as pancreatic trauma.Objective: To identify the influence of clinical and morphological factors involved in the evolution of patients.Material and Methods: An observational longitudinal analytical cohort study was conducted in patients with pancreatic pseudocysts treated at “Arnaldo Milián Castro” University Hospital from 2013 to 2017.Results: Pancreatic pseudocyst predominated in the male sex and in the age group between 40 and 60 years old (55 %) for both sexes in the sample studied; the median age was 53 years. We identified the following risk factors for the development of complications: acute pancreatitis as a cause (OR = 2,377-CI: 0,566-9,977), time of formation shorter than six weeks (OR = 2,333-CI: 0,373-14,613) and size smaller than six cm (OR = 1,800-IC: 0.259-12.502).Conclusions: Patients over the age of 53 years, male sex, and size less than six cm had a higher relative risk of death. The risk factors for complications identified were acute pancreatitis, formation before six weeks, and size less than six cm. The time of formation and persistence of pseudocysts were longer in patients with complications, unlike the size that registered greater value for patients without complications.

Introduction: Tobacco consumption becomes an addictive disorder that endangers the health of both smokers and those around them. Its proper evaluation requires an analysis of the psychological and social factors that favor it.Objective: To describe the adaptation process of the questionnaire for classification of cigarette consumers within the Cuban context and characterize the sample of smokers under study.Material and Methods: The research includes two stages: the first stage that is classified as a technological development study, and the second one which consists of a descriptive cross-sectional study with a quantitative design. Five experts and 205 active smokers selected from an intentional sample from the health areas of Havana and Santiago de Cuba participated in the study.Results: A valid version of the questionnaire for the Cuban population was developed, which contains the recommendations made by the experts and obtained an internal consistency of 0.7005. It was observed that 49.7% of the participants classified as strong smokers and 48.3% as moderate smokers (at risk). On the other hand, 60% of them are men, 32.7% are young and 65% are workers. Conclusions: Linguistic and cultural adaptation to the Cuban context of the questionnaire for classification of cigarette consumers was carried out, which has an adequate level of reliability. Most of the subjects studied were classified as strong or moderate smokers. The male sex, young and workers predominated in the study.Keywords: Addiction, cigarettes, nicotine, classification of smokers, validation, linguistic adaptation.

Introduction: Device-associated infection (DAI) in intensive care units have a major impact on morbidity, mortality, and costs.Objective: To describe the incidence and adherence of a DAI and the bundle compliance in an intensive care unit at a community hospital in Western Qatar.Material and Methods: A prospective surveillance was conducted in a 6-beds medical-surgical intensive care unit from Jan 2013 to December 2016. Data about clinical, laboratory, and other diagnostic information were collected to satisfy the criteria for infection. DAI rates, device utilization ratio (UR) and bundle compliance were analyzed, and comparison with 2013 US data was performed.Results: The pooled mean of ventilator-associated pneumonia rates was 2.61 per 1000 ventilator days, and zero for catheter-associated urinary tract and central line bloodstream infections. The ventilator UR was superior (0.32) (p =0.000) than the National Health System Network (NHSN) data (0.24); the use of the central line bundle and the urinary catheter were similar (0.33, 0.54) (p=0.000), respectively. The compliance with bundle elements for ventilator was 99% and 98.2% for 2013 and 2014 respectively, and 100% compliance afterward. The compliance with central line bundle was 100% during the study period, whereas the compliance with urinary catheter bundle had the lowest figure in 2013 (97.9%), 98.3 % in 2015, and 99.6% in 2016, related to bag contact with the floor. Conclusions: The study has shown the low incidence of device-associated infections related to a comprehensive infection control program in the Intensive Care Unit.Keywords: Device-associated infections, bundle, compliance, Intensive Care Unit

José Martí wrote: “Success is not achieved except for grandiose means”.  This way, we describe the work of Dr. Washington Rosell Puig who represents an example for the generations of doctors throughout his professional life. During his life as a student, he actively collaborated with student activities; he founded the university militias; after graduating from the university and finishing the specialty of Surgery, he started working at “Victoria de Girón” Institute of Basic and Pre-Clinical Sciences joining the teaching staff because of the necessity of teachers of Medicine in the country, after the exodus of doctors.  He participated in the battle of Playa Girón, the fight against bandits in Escambray, and several internationalist missions among which the first international mission in Algeria and the foundation of the University of Yemen stand out.  He was the founder of the Communist Party of Cuba in the University of Havana.  He held numerous management positions in the Medical Sciences and obtained many distinctions and awards.  He made his contributions to both national and international scientific events; stood out for his publications, among them, the ones about teaching resources and those of teaching and pedagogic character.He has been member of different boards of examiners of the specialty, and has participated in the development of teaching materials and pedagogical courses for teaching improvement.  He was member of several scientific societies and a Consultant Professor.Keywords: Example for the generations, internationalist missions, teacher training, outstanding worker. 

Introduction: Prostate cancer is considered a predominant type of neoplasia and aging is a factor for chemotherapeutic toxicity, which can increase due to chronic diseases, particularly diabetes. Despite all this knowledge, there are no studies to evaluate the association between diabetes and the risk of chemotherapeutic toxicity in these patients.Objective: To determine the association between Type 2 Diabetes Mellitus and the risk of chemotherapy toxicity in in older adults with prostate cancer in the Geriatric Service of the Peruvian Naval Medical Center.Material and methods: Analytical retrospective cohort study and secondary database analysis.  The adverse effects of chemotherapy and the associated factors of 161 retired sailors with prostate cancer were evaluated between 2013 and 2015. Cox Regression Model for Adjusted Toxicity was constructed for antecedents of diabetes, age, pathological antecedents, smoking antecedents, calf circumference, physical activity, dependence on ABVD, falls, polypharmacy, fragility, and vulnerability.Results: The 23.6% of patients had diabetes. The prevalence of fragility was 39.7% and the one of vulnerability was 24.2% (G8) and 26.71% (VES-13). The frequent adverse effects were: gastrointestinal (13.04%) and hematological (8.07%). The most significant associations by adjusted regression model were the antecedent of Type 2 Diabetes Mellitus, 3 or more pathological antecedents, smoking antecedents, calf circumference, physical activity, dependence on ABVD, falls, polypharmacy, fragility, and vulnerability.Conclusions: The antecedent of Type 2 Diabetes Mellitus is a predictive factor for the risk of chemotherapy toxicity in older adults with prostate cancer.Keywords: Diabetes Mellitus, toxicity, chemotherapy, older adults, cancer, prostate, cohort.

Introduction: Experts of the Faculty of Psychology of the University of Havana proposed the Personal, Labor and Social Human Well-being questionnaire (BHPLS, in Spanish), that was applied to 135 Cuban workers of three social and occupational groups. Given the variety of responses, a content analysis (CA) was used for Question 1 of the mentioned questionnaire.Objective: To present and implement a software that allows a semi-automatic categorization in a CA used for this question.Material and Methods: The Kappa index test was used to evaluate experts´ agreement with respect to category schemes. We implemented a software with the Python programming language to achieve our objective, considering other similar software functionalities.Results: We implemented, validated and registered the software BHPLS data processing-UH® that allows to set up a categories system, load the collected data, categorize associations in a semi-automatic way, and save the results, among other functionalities. This software was validated by Psychology students and, when they performed the manual categorization, a negative Kappa agreement index (low categorization agreement between experts) was obtained whereas using the proposed software, a global Kappa index of 0.7871 with p=0.00 (high and statistically significant categorization agreement between experts) was obtained. Besides, we proposed a unified algorithm for expert’s categorizations, and carried out a Correspondence Analysis (ANACOR) on the basis of the categorizations achieved.Conclusions: According to the high concordance attained, we recommend the software due to its adaptability, ease of use, and “humanization'' of the process. The CA allowed us to observe similarities in social and occupational groups. The software functionalities can be applied for processing free associations in other scenarios. Keywords: content analysis, qualitative data analysis, text mining, human welfare, free associations, Kappa index test.

Introduction: The effectiveness of the national immunization program has impacted on the reduction of the incidence of hepatitis B virus (HBV) infection in Cuba; however, the number of chronically infected patients is not negligible.  These patients are diagnosed in the clinical practice, although the epidemiological studies that indicate the presence of the disease are insufficient. Objective: To describe the main clinical, biomolecular and immunological characteristics of patients with chronic hepatitis B virus infection treated at the National Institute of Gastroenterology, Havana, Cuba.Materials and methods: A total of 97 patients who had at least a 6-month history of chronic HBV infection were recruited at the above mentioned institution from January 2016 to January 2018. Descriptive statistical analyzes were performed to identify the clinical characteristics.  Biochemical and virological studies, analysis of both liver stiffness values measured by transient elastography and use of antiviral therapy were also carried out.Results: All patients completed the follow-up.  It was observed that 61,9 % of them were male and the median (range) age was 46 (18-84) years. The mean time since the diagnosis of the infection was 11.7 ± 8,9 years. Inactive disease without liver fibrosis or light fibrosis was present in 61,9 %. Only 2 % were negative for hepatitis B surface antigen with quantitative analysis of HBV DNA; also, 81,4 % of patients had detectable viral load and 85,5 % received one or more antiviral treatments, mainly nucleotide analogues. Conclusions: The patients with chronic HBV infection studied are mostly in the inactive phase of their disease, without significant evidence of liver damage and detectable levels of viremia.  All of them have received some antiviral treatment.