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

An intervention study was carried out to determine the need for learning about epidermofitosis in workers associated with the assistance of patients at the "Caridad Jaca" Provincial Nursing Home in Guantanamo in April, 2014. A sample of 57 workers as volunteers decided to participate in the study, nursing staff, podiatry technicians and assistants in the nursing services. Initially the participants were given a survey to determine the learning needs on the subject, and on the basis of the results, the proposed intervention was designed. Variables were analyzed such as: prevention, measures, and form of transmission, symptoms and signs, concept, causal agent. The frequency distribution analysis technique was applied on a qualitative scale for all variables. The data were presented in percentage tables.

A therapeutic intervention was performed in 84 patients who were attended in the consultation of prosthetics at "Julio A. Mella" Guidance Dental Stomatologic Clinic, from September 2014 to the same month of 2015, in order to determine the Effectiveness of joint laser treatment and drug therapy, applied to patients with temporomandibular joint dysfunction pain syndrome. Two therapeutic groups were formed: one received laser and drug therapy and the other drug therapy, each group with 42 patients who were evaluated at 5, 10 and 15 days. General and clinical variables were taken into account: age, degree of severity, pain behavior and evaluation criteria. The combinationwith laser therapy and drug therapy proved to be more effective than drug therapy, as symptomatology disappears in a shorter period of time.

Introduction: Lisfranc joint lesions are produced by high energy traumas, but when they present in patients with Hansen´s disease and damage to the peripheral nervous system, the low intensity repeated traumas can lead to this type of lesion.  Objective: To present an interesting case, given a particular association on a patient with Hansen´s disease and a Lisfranc lesion, caused by a low energy trauma. Case presentation: 64 years old Phototype V patient with antecedents of lepromatous Hansen´s disease who presented Lisfranc fracture-dislocation of a divergent type after low intensity repeated traumas, and a septic superadded process. The antecedents, clinical picture, laboratory tests, ultrasounds, radiological study, and the treatment indicated are all analyzed. Conclusions: Disability in hands and feet due to neurological disorders in patients with lepromatous leprosy of more than 5 years of evolution is very frequent, but it is not so frequent when associated to a Lisfranc fracture-dislocation of a divergent type due to low intensity trauma, because this type of lesion is normally caused by high energy traumas.  Keywords: foot, Lisfranc joint, fracture-dislocation, lepromatous leprosy, disability.

Introduction: When carrying out a first approach to the problem of the learning of the Pharmacology for the absence of effective didactic strategies, it has been observed as problem that medical practitioners reduce the prescription process to a practice centered in the medicine, and they leave aside the diagnostic and therapeutic character centered in the patient. Objective: To analyze the different didactic strategies applied in the process teaching-learning of the Pharmacology in the Superior Medical Education. Material and Methods: it was carried out a revision starting from bibliography and academic documentation that contribute to the investigation, by means of specialized databases (PubMed, EMBASE, LILACS and Web of knowledge). Results: The Learning Based in Problems or ABP(in Spanish)  is an active methodology where the student interacts, participates or builds their own knowledge through the critical analysis, search of solutions, of the similar thought, but mainly, of their paper like the center of the teaching-learning process. It was recognized the game like an amusing, creative and dynamic activity as well as the application in the classrooms of educational software classes. Conclusions: as conclusion in taken that a great diversity of strategies and methodologies that can be applied with success for the learning of the Pharmacology exists but that they require a structural and curricular change to support their integration to the subject. Keywords: Teaching of the Pharmacology, Medical Education, Didactic Strategies, Styles of Learning, Superior Education, Methods of Teaching, curricular Strategy.

Introduction:The liposarcoma is a wicked tumor of origin derived mesodermic of the fatty fabric, it is the most frequent in the adult's sarcomas and the abdominal localization is strange, ending up reaching enormous proportions. Objetive: To present the case of a patient with liposarcoma pleomorfo stage IV, of abdominal localization. Presentation of the case:Woman 42 year-old patient, quarter note that she goes for increase of volume and diffuse pain of the abdomen of a month of evolution. The initial diagnosis was gynecological Neoplasia with peritoneal infiltration, with a torpid evolution. The anatomo-pathological conclusion was a Liposarcoma Pleomórfico in stage IV. The decision of presenting this case, it is based in the first place by the patient's age, the uncommon but very aggressive variety of this tumor and the fatal outcome that this had. Conclusions: The reflective presented patient a due late diagnosis fundamentally to the anatomical localization that conditioned the growth tumoral without it was suspected until an advanced stage in stadium IV. The variety very aggressive histological, for its high degree of malignancy and great metastasis incidence, contributed causing the peritoneal infiltration negatively, of the organs of the pelvic floor and finally the death.Keywords: Liposarcoma, Pleomorfic, Desdiferenciado, Mixoide (round cells), Neoplasia, fatty fabric, metastasic.

 ABSTRACTIntroduction: Low weight and obesity are risk factors for osteoporosis in postmenopausal women; however, the influence of its change on a therapeutic response to biophosphonates for the prevention of fractures has not been defined yet. Objective:To describe the association between the body mass index (BMI) and bone mass in postmenopausal women, as well as to identify changes in weight and BMI during the treatment with biophosphonates. Material and methods: Weight, height, and BMI was determined in 296 women who came consecutively to the Climateric and Osteoporosis Clinic (ClimOS) in Havana from 2009 to 2014 (n=103), and to the Department of Metabolic Bone Diseases, Jiménez Díaz Foundation, Madrid (n=193); also, bone mineral density in lumbar spine and hip was measured by DXA.  The influence of initial body weight and its temporal variation with the use of biophosphonates (BPS) was evaluated in 80 of them. Statistical analysis: standard statistical average for qualitative variables, frequencies for the qualitative variables, Student´s t-Tests, and X2 test for differences among them.  Pearson´s correlation to specify the influence of the initial weight and BMI, and their differences in the response to biophosphonates. Besides, p<0,05 value was used for statistical significance. Results: Low weight was identified 4/296; more than half of them were overweight or obese. Women who were evaluated in ClimOs, presented a worse bone status on the hip. Neither association of body weight nor BMI was found on the response to treatment with (BPS). Conclusions: The influence of body weight on a new fracture was controversial; it is suggested to include ponderal variation as part of the treatment for osteoporosis.Keywords:  menopause, osteoporosis, body mass index, biophosphonates, body composition.

Introduction: Antimicrobials are one of the most pharmacological groups used in the clinical practice, and its relation to microbial resistance is demonstrated. The rational use of antibiotics can be beneficial from the social and medical point of view, but occasionally, their use is not the most correct one and there should be a systematic and special surveillance. A rational antimicrobial policy is necessary in the health care centers. Objective: To review national and international consensuses and criteria on antimicrobial policy to try to unify criteria and apply them the most uniform way possible in health care centers.Material and method: A bibliographic review on antimicrobial policy, antibiotics commission, and antibiotics policy was made in different databases; some of them were: Clinical Evidence, The Cochrane Library, PUBMED, Academic Google, MEDLINE, LIS, Scielo, Medscape, LILACS, Latindex, HINARI, MEDIGRAPHIC-NEWS, NIH Reporter, Scholar Google, and the Web sites of the PAHO/ WHO.Development: Concepts on different Cuban publications, international consensuses, human components, objectives, functions, resources, methods, strategies, and controls were considered. Conclusions: The implementation of any therapeutic modification in the medical attention has to be analyzed correctly in all its dimensions: scientific, technological, and social ones.  When the microbiological study is not possible or there is no antibiogram, the selection of the antibiotic should be made on the local epidemiological and clinical basis. The creation of an Antimicrobial Policy with all its components, resources, and methodology is needed now more than ever. It can be submitted to modifications with new evidences, but it has to be fulfilled to reduce both microbial resistance and the costs, and obtain better results.Keywords: Antimicrobial policy, antibiotics policy, antibiotics commission, microbial resistance, health actions.

Introduction: Epilepsy is as old as mankind, and for some people, the second neurological disease.  It has gone through different cultures and epochs, following different treatments until the 19th century when the scientific and modern therapy began, which currently maintains in absolute development. Objective: To present and reflect on the use of antiepileptic drugs described up to the present, the ones which are under investigation, and the future development trends. Material and Method:  A bibliographic review was performed by searching different online databases, related to antiepileptic therapy.  The reports of original prospective or retrospective researches, and review works were included in the information search.  The 79 period reviewed extended from 1937 to 2016. Results: The importance of the positive diagnosis of epilepsy for a correct management of the patient is described. The antiepileptic treatment is approached, with a specificity on the drugs described up to the present time, the ones that are under complete development, and the general principles of treatment and worries in the field of neurosciences, with a view to achieve an efficient therapy. Conclusions: The current antiepileptic therapy is symptomatic and not curative, being necessary to keep in mind the general aspects in the management of the epileptic patient, in an integral and individualized way.Keywords: epilepsy, scientific therapy, antiepileptic drugs.

The unorganized growth in urban planning in Spain in the last decade of the 20 century and the beginning of the 21st century has provoked diverse negative consequences for the public interest and specially for the large number of foreigners that have been affected by the serious problem of having declared void and null, building licenses for their properties which were bought in good faith, only to discover that they are obliged to demolish such properties.Our planning laws contemplate a possible compensation for the cancelation of a building license, except in the case of fraud, error or negligence on behalf of the injured party. But along with this demand for the replacement of the integral property of the injured party, it raises the constitutional demand to carry out the decisions of the Courts in its full terms, which corresponds exclusively to the judicial power, as well as to proceed to its execution.To reconcile all the parties involved, we will show the various legal initiatives which have been taken by the different autonomous regions, which have been declared void and null by the Constitutional Court, basically due to the fact that regional parliaments have not got legal powers to regulate process law and additionally, because such initiatives would limit the exclusive faculties of the judges to execute their own decisions. The State also has adopted legal measures which are relevant in criminal and public process laws, so as to try and give a response to this problem. We will demonstrate and show the difficulties in applying such measures, specially the public process law area.

This paper examines how European and Spanish public procurement rules tackle agreements between entities within the public sector. In Spain these agreemets were initially above those rules, but now they cannot have the same object as a contract. Spanish law is not in line with European law, since under European law agreements are valid even if their object could be attained with a contract, provided that they meet some requirements. On the other hand, attention is paid to these requisites, laid down by Eurepean law, in order to ascertain if agreements are asked to comply with harder rules than «in house providing», and if it has to be so. Public entities are not obliged to «buy» if they can fulfill their needs with their own resources. And «their own resources» include the resources of entities or bodies closely related, or even any entity within the public sector. Otherwise decentralized States, in which there are many autonomous entities whose cooperation involves agreements between independent bodies, would be impaired.