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

Background: one of the main causes of death in hospitals in the first hours after a pelvic trauma therefore, a multidisciplinary and early management is required. Objective: to report a case of severe pelvic fracture and moderate bleeding treated with external fixation. Clinical case: a forty-six-year-old male patient who suffered from severe pelvic traumatism, which provoked a pelvic fracture hemodynamically unstable and posterior urethral rupture, therefore he had to go through surgery since hemodynamic stability was not achieved with regular methods wich are non-invasive. Exploratory laparotomy, urethrostomy and external fixation of the pelvis were indicated. Conclusions: the first procedure to interrupt bleeding is the stabilization of the fracture through external fixation and in most cases it becomes the only necessary procedure. DeCS: PELVIS/injuries; FRACTURE FIXATION; JOINT INSTABILITY; ADULT; CASE REPORTS.

Background: osteomyelitis is an infectious disease causing local and general symptoms. Its diagnosis is based mainly on clinical picture, because imaging and hematologic exams are not useful at early stages. Objective: to update the knowledge of patients who have pyogenic osteomyelitis. Methods: with the obtained information, a search in the databases PubMed, Hinari, SciELO and Medline was conducted in a one-month period (October, 2016) through the information locator EndNote by using the following words: osteomyelitis and bone infections, resulting in a total of 2145 articles from the last five years. From them, 50 quotes were selected for review, and five books were included. Development: incidence and percentages of patients with osteomyelitis were described in regards to anatomic zones, as well as contributing factors to develop the disease. Regarding imaging investigations the most used are pointed according to the time of the disease, being positive and percentages. Treatment was described based on pillars as general measures, antibiotic therapy and surgical modalities. The most important complications were pointed out. Conclusions: osteomyelitis is a local entity affecting patients of any age range. Diagnosis should be always kept in mind, based on clinical exploration, because imaging and hematologic investigations are not specific, especially at early stages of the disease.DeCS:OSTEOMYELITIS/epidemiology; MAGNETIC RESONANCE IMAGING; EXTERNAL FIXATORS; CAUSALITY; REVIEW LITERATURE AS TOPIC.

Background: road accidents cause many lesions affecting significantly bone and joints system; the forearm is one of the most involved structures. Objective: to show a clinical case of a patient with a complex fracture of the right forearm and the used treatment modality to ensure functional recovery. Clinical case: a 23 years-old, white man, without illness record who suffer a traffic accident and was taken to emergency room of Orthopedics and Traumatology complaining of pain, swelling and limitation of movement of the right forearm and left ankle which stopped him from movement in the affected areas. Simple imaging examination showed wrist and proximal shaft right radial fracture and left ankle fracture, based on clinical and imaging elements, immediate surgical treatment was indicated to reduce and fix fractures. Conclusions: segmental and open fractures of the forearm associated to ulnar bone lost is a complex fracture. There is no a standard treatment for this condition so external fixation and AO plates achieve acceptable functional results. DeCS: FOREARM INJURIES; ORTHOPEDIC FIXATION DEVICES; EXTERNAL FIXATORS; YOUNG ADULT; CASE REPORTS.

Background: the diabetes mellitus constitutes one of the most frequent chronic diseases in the worldwide population, causing damages in several organs and the oral cavity is not an exception. Objective: to design a strategy of educative intervention directed to modify the knowledge on oral health in diabetic patients. Methods: an observational, longitudinal and prospective research, with a universe of 27 diabetic patients, belonging to the Medical Doctor's office 27 were assisted in the Ormani Arenado Llonch dentist Clinic in Pinar del Río, in 2016. Theoretical, empirical and statistical methods were used. Results: an educative intervention strategy on health was designed and applied, including four specific strategic operations that was validated theoretically by criterion of experts through Delphi Method. Conclusions: the level of knowledge on oral health in diabetic patients whose majority was evaluated as bad before the development of the strategy and later on it was modified significantly and finally it obtained a good evaluation. DeCS: ORAL HEALTH; DIABETES MELLITUS; ORAL HYGIENE/education; HEALTH PROMOTION; CLINICAL TRIAL.

Background: degenerative changes affect all the tissues inside knee joint, including meniscus. Clinical picture, imaging and treatment are different in regards to traumatic lesions. Objective: to deep about the most important aspects of patients with degenerative meniscal lesions. Methods: a search in the databases PubMed, Hinari, SciELO and Medline was done through the information locator EndNote by using the words meniscal tear, knee osteoarthritis and meniscus, meniscal pathology, meniscal damage and degenerative meniscus, resulting in a total of 371 articles which 50 of them selected for review, 46 of them of the last five years and five books were included. Development: important aspects related to update classifications systems were pointed out. Relationship between arthroscopy and magnetic resonance imaging and histologic features were described. Clinical picture, conservative and surgical treatment were stated. Conclusions: meniscal degenerative lesions are associated to other lesions inside the knee joint, clinical picture, imaging and treatment modalities are different compare to traumatic lesions. DeCS:OSTEOARTHRITIS, KNEE; MENISCUS/injuries; MAGNETIC RESONANCE IMAGING; ARTHROSCOPY; REVIEW LITERATURE AS TOPIC.

Background: the control of transmittable diseases contributes to the illegitimate use of biological agents, initially for war or criminal purposes and currently for terrorist purposes. Objective: to describe the problem of the use of biological weapons, its different edges and in its current form for terrorist purposes and the aspects that prohibit its use according to current international regulations. Methods: a bibliographic review was made with the bibliographic analysis method with a search conducted between 2000 and 2017, where specialized databases were consulted and 31 scientific publications on the subject were selected. Development: an analysis on the issue of biological warfare was made based on the agents used and the threat that constitutes their use, since they cause diseases and cause death by affecting the health of living beings and the environment. They are harmful and include knowledge of science, technology, engineering and involve other areas, such as economics, law, the legal framework that limits or not the obtaining of materials and the psychological aspects of such attacks. The technological advances in Biology and Genetic engineering of recent decades make it possible to modify and create new microorganisms that are more resistant to treatment and in particular in the search for the inoculation of diseases such as cancer. The biodefense is the set of measures for the prevention and action facing a sanitary alert where the use of the biological agents with war aims is implied. Conclusions: biological agents are used as weapons to cause damage in circumstances of biological warfare and bioterrorism, as it is potentially the most destructive weapon known to humanity that involves political, economic, scientific-technological, legal and psychological aspects, which is why biodefense protects people and the environment with the use of sanitary measures against above-mentioned agents. DeCS: BIOLOGICAL WARFARE, NOXAE, ENVIRONMENT, BIOLOGICAL WARFARE AGENTS, BIOTERRORISM.

Background: the quality system is defined as a set of policies, objectives, processes, documents and resources that lead to quality assurance, not only of the product but of the organization as a whole, seeking the maximum satisfaction of the clients or the users. Objective: to spread theoretical elements on the importance of the implementation of a management system to ensure quality in teaching, research and medical assistance. Methods: with the descriptors health quality and quality management system, a bibliographic search was carried out in the access platforms to databases of the Cuban health information network Infomed, within them in EBSCOhost, PubMed/Medline and SciELO, and a documents’ review of the normative bases that establish the requirements to be met for the implementation of the system. Development: it is addressed the importance of the implementation of a Quality Management System at the University of Medical Sciences and the many advantages it offers; the most indicated are a greater optimization of resources, and improvement of internal communication and the external image of the organization. Conclusions: the system of evaluation and accreditation of university institutions and programs is the driving force of the University Quality Management, demonstrating the importance of implementing a quality management system in the medical university to achieve superior results in the process of training and development of health professionals. DeCS:QUALITY MANAGEMENT; UNIVERSITIES; HEALTH FACILITY ACCREDITATION; EDUCATIONAL PERSONNEL; PROGRAMS OF STUDY.

Background: cutaneous metastasis occur between 0.7 % and 9 % of cancer patients. They tend to be a late sign in the evolution of most neoplasms, although at times they may be their presentation. Neoplasms of lung, breast, melanoma, oral cavity, colon, liver, ovary and stomach are responsible for 80-90 % of cutaneous metastasis in adults. Objective: to present the case of a patient with a metastasis of an epidermoid carcinoma of the lung, the liver and on the skin of the nose, constituting the clown's nose sign. Clinical case: a 72-year-old black patient, smoker of more than 50 years, with a history of arterial hypertension, who comes to the hospital because he presented an inflamed and ulcerated lesion of the skin of the nose which had been treated as a superficial soft tissue infection. In the clinical study, as well as histopathological, an epidermoid carcinoma of the lung with little differentiation, with liver metastasis and the skin of the nose was demonstrated. The patient died two months after diagnosis. Conclusions: the presence of skin lesions and, in the case of the nose particularly, sometimes indicate more specific studies to search oncological diseases such as the case of the clown nose sign. DeCS: LUNG NEOPLASMS; NOSE; NEOPLASM METASTASIS; AGED; CASE REPORTS.

Fundamento: es alta la frecuencia de pacientes con afecciones pulpares y periapicales en la Clínica Estomatológica del Policlínico Este de Camagüey. Se desconocían todos los factores de riesgo a los que estaban expuestos los pacientes de esta área de salud. Era necesario precisar el nivel de información de los pacientes en cuanto a cómo actuar ante estas afecciones. Objetivo: caracterizar urgencias pulpares y periapicales agudas en los pacientes atendidos. Métodos: se realizó un estudio descriptivo y transversal en el policlínico Este de la ciudad de Camagüey. El universo quedó conformado por 580 pacientes a los que se les llenó un formulario que recogía las variables sociodemográficas, las afecciones presentadas, sus causas y las vías por las que se informaron sobre estas enfermedades. Se aplicó estadística descriptiva. Resultados: predominaron las féminas entre las edades de 19-59 años. Las urgencias pulpares y periapicales que más se presentaron fueron pulpitis aguda supurada y el absceso alveolar agudo. La caries dental representó un 58,6 % de los factores etiológicos. Solo el 18,8 % de los pacientes acudieron a consulta antes de las 24 horas. Conclusiones: la mayoría de los pacientes demoraron en buscar alivio por miedo al tratamiento. Un pequeño porciento había recibido información sobre lo que debían hacer. El odontólogo constituyó el principal promotor de salud. Es necesaria una intervención educativa para prevenir urgencias pulpares y periapicales. DeCS: CAVIDAD PULPAR; ENFERMEDADES PERIAPICALES; FACTORES DE RIESGO; SERVICIOS MÉDICOS DE URGENCIA; EPIDEMIOLOGÍA DESCRIPTIVA.