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

Paciente masculino de 59 años, con antecedentes patológicos personales de tabaquismo, enfermedad pulmonar obstructiva crónica y obesidad mórbida. Un mes antes del ingreso comenzó con tos seca, dolor en punta de costado izquierda y astenia marcada; se interpretó como una neumopatía inflamatoria de la comunidad, que requirió de varios tratamientos antibióticos. No hubo mejoría y acudió al Hospital “Arnaldo Milián Castro” para estudio. El ecocardiograma transtorácico realizado mostró un derrame pericárdico de gran cuantía y una imagen tumoral en la aurícula izquierda que infiltraba al pericardio. Hubo empeoramiento de los síntomas, presentó cuadro de hipotensión arterial y bradicardia, cayó en parada cardiorrespiratoria y lo declararon fallecido con los diagnósticos de neoplasia cardíaca y choque cardiogénico. Los hallazgos en la necropsia permitieron el diagnóstico de pericarditis constrictiva por infiltración de adenocarcinoma moderadamente diferenciado de pulmón con carcinomatosis pleural y pericárdica; falleció por cuadro de choque cardiogénico. Los tumores cardíacos más frecuentes son los de origen metastásico y, dentro de ellos, los carcinomas de pulmón y mama, los melanomas y las leucemias.

Introduction: dental care in the elderly is of high interest and less time is devoted to it.Objective: to design an educational program about oral cancer aimed at the institutionalized geriatric population.Methods: a descriptive, cross-sectional study was carried out in the period from January 2018 to February 2019 in a sample of 76 institutionalized geriatric patients belonging to the “Celia Sánchez Manduley” Stomatological Clinic in the City of Santa Clara. The following variables were studied: risk factors, level of information, level of schooling and evaluation by specialists' criteria; the data were collected in a questionnaire.Results: deficient oral hygiene and the use and condition of prosthesis were identified as main risk factors, as well as an inadequate knowledge about smoking, the negative effects of alcoholism and oral self-examination with regard to oral cancer.Conclusions: patients with an inadequate level of information on oral cancer predominated. An educational program considered relevant, feasible and with quality by the Stomatology Specialists was designed. It was considered that these results were possible due to the strength of the content of the topics offered and the use of innovative participatory techniques; human and material resources were taken into account in each activity implemented in which the promotion and prevention of oral cancer aimed at institutionalized geriatric patients were developed.

Introduction: cerebrovascular disease is the name given to conditions that cause a transient or permanent brain disorder caused by ischemia or hemorrhage secondary to a pathological process of the blood vessels of the brain.Objective: to describe the tomographic findings in patients diagnosed with non-traumatic subarachnoid hemorrhage.Methods: a descriptive, longitudinal, prospective research was conducted at the “Arnaldo Milián Castro” Hospital from January 2019 to March 2021. The population consisted of patients over 18 years of age with a diagnosis of non-traumatic subarachnoid hemorrhage seen in the Imaging Service who underwent simple tomography and angiotomography.  Documentary analysis of the study record book of the Imaging Department and the individual clinical history were used; data were collected in a review guide.Results: the patients studied were predominantly female and over 50 years of age. CT showed a high sensitivity in the diagnosis of the disease and its etiology and the cause was predominantly aneurysmal. Most aneurysms were saccular, medium-sized, with involvement mainly of the segment of the anterior communicating artery and bifurcation of the middle cerebral artery.Conclusions: tomographic findings demonstrate the usefulness of simple tomography as the first study in case of suspected subarachnoid hemorrhage. The usefulness of angiotomography in the etiological diagnosis of subarachnoid hemorrhage is demonstrated.

Introduction: necrotizing fasciitis is a rare, destructive and rapidly progressive bacterial infection of the subcutaneous tissues and superficial fascia that in the most advanced stages involves the skin and is associated with high morbidity and mortality rates.Objectives: to describe cervicofacial necrotizing fasciitis of odontogenic origin and its main causes and predisposing factors.Methods: an observational, descriptive, cross-sectional, descriptive study was carried out in the General Hospital of Benguela, Angola, from April 2014 to April 2016. The entire population was studied, which consisted by 77 patients who were assisted in this center with a diagnosis of cervicofacial odontogenic necrotizing necrotizing cervicofacial fasciitis. The study variables were sex, age groups, predisposing factors, outpatient treatment, hemoglobin on admission, dental infectious focus and clinical characteristics. Descriptive statistics were used. The information was extracted from the medical records. Results: 73% of all cases were male, 12 patients with systemic diseases developed cervicofacial necrotizing fasciitis, non-steroidal anti-inflammatory drugs were used in 94.8% of patients, hemoglobin was low in 88.3% of cases and 80% of patients arrived at the hospital with advanced disease. Conclusions: the main cause of cervicofacial necrotizing fasciitis was septic foci of dental origin. This disease is related to simple processes that were not adequately treated in the community.

Introduction: paragangliomas are very rare extra-adrenal tumors originating from the autonomic nervous system. They are classified in functioning or non-functioning tumors, according to the production of catecholamines.Patient information: 40-year-old woman, with a history of severe arterial hypertension, who had been treated with three hypotensive drugs without obtaining control; she began to suffer diffuse abdominal pain that increased, associated with hyperpolymenorrhea and a periumbilical tumor of approximately 8 cm, painful and mobile. Laboratory tests were normal. Computed tomography and magnetic resonance imaging confirmed the diagnosis of an 8×5 cm retroperitoneal tumor attached to the aorta and displacing the inferior cava. It was necessary to carry out a highly complex surgical intervention. A tumor was found and the histological and immunohistochemical results confirmed the existence of a non-functioning extra-adrenal paraganglioma.Conclusions: retroperitoneal paraganglioma is a rare tumor, as shown by statistics. The diagnosis was made, fundamentally, by imaging, histological and immunohistochemical studies. Treatment is fundamentally surgical, as was performed in this patient.

Introducción: la fractura abierta de tibia es una de las urgencias más frecuentes en pacientes que sufren accidentes automovilísticos y su tratamiento generalmente es muy complejo.Información del paciente: paciente masculino de 40 años que luego de accidente automovilístico sufrió fractura abierta de tibia que llevó tratamiento con fijador externo, colgajo y antibióticos.Conclusiones: el adecuado manejo del paciente con fractura abierta permite una evolución satisfactoria y la colocación de fijadores externos permite aplicar otras opciones terapéuticas y estabilizar la fractura.

Introducción: en el año 1900 Paul Sudeck describió la enfermedad como una inflamación de curación trastornada y la bautizó con su nombre. En 1994 la Asociación Internacional para el estudio del dolor la definió como síndrome doloroso regional complejo tipo I o enfermedad de Sudeck y determinó los criterios diagnósticos y los pilares de su tratamiento.Objetivo: evaluar la efectividad de la sonoforesis y la iontoforesis en el tratamiento de los pacientes con síndrome de dolor regional complejo tipo I.Métodos: se realizó un estudio cuasiexperimental en 38 pacientes con diagnóstico de síndrome de dolor regional complejo tipo I en las manos atendidos en la Consulta de Fisiatría del Hospital “Arnaldo Milián Castro” de abril de 2018 a diciembre de 2019; los métodos empírico rectores fueron el análisis documental y la experimentación. Se conformaron dos grupos mediante un muestreo no probabilístico por criterios.Resultados: los resultados obtenidos revelan que el mayor número de pacientes con síndrome de dolor regional complejo tipo I se encontraron entre los 50 y 69 años respectivamente, con un predominio del sexo femenino. Las fracturas resultaron el factor desencadenante de mayor frecuencia y la manifestación clínica más frecuente fue el edema. El Grupo B que se aplicó sonoforesis presentó mejores resultados en el alivio del dolor y mejoría de la amplitud articular y de la funcionalidad de la mano.Conclusiones: ambos métodos son efectivos, pero la sonoforesis mostró superioridad.

Introduction: worldwide, cerebrovascular accidents constitute a health problem with a growing tendency. Due to the impact of the high socioeconomic cost of this disease on the health system of any nation because of its high mortality and its colossal disabling sequel, it is particularly important to establish immediate preventive actions.Objective: to describe the level of knowledge about cerebrovascular accident and its risk factors in older adults.Methods: a descriptive, cross-sectional study was conducted in patients of the Polyclinic “Marta Abreu” from January to December 2019, the study population consisted of 120 patients dispensed with stroke risk factor, all constituted the study sample. They were administered a questionnaire on knowledge of cerebrovascular accidents and their risk factors. Descriptive statistical techniques were applied, absolute and relative frequencies were calculated and simple statistical tables were constructed to describe the behavior of the variables under study.Results: patients between 60 and 69 years of age, female (36, 30%), hypertension among the well-documented modifiable risk factors (114, 95%) and diabetes (54, 45%) among the well-documented potentially modifiable risk factors predominated.Conclusions: older adults between 60 and 69 years of age were more frequent, of female sex and with ignorance about the types of cerebrovascular accidents, complications and their risk factors.

Introduction: diabetes mellitus has increased considerably in recent times and constitutes an important health problem. A high number of patients are diagnosed late, even with risk factors, which are not properly identified.Objective: to identify the hidden morbidity of diabetes mellitus in a population of 20 years old and over with risk factors.Methods: an observational, descriptive study was carried out in 102 patients 20 years old and older with risk factors for diabetes mellitus belonging to the “Ramón López Peña” Polyclinic between June and October 2020, who underwent fasting glucose measurement and glucose tolerance test when necessary. Age, sex, risk factors and the presence of symptoms and signs of the disease were studied. Descriptive and health statistics techniques were used.Results: 70.6% were women and 49% were 60 years of age or older. Among the risk factors, excess body weight (84.3%), arterial hypertension (52.9%) and family history of the disease (22.5%) predominated. Metabolic alteration was found in 26 patients, 19 (18.6%) were diagnosed as diabetic, for an incidence of 1.97%.Conclusions: the existence of hidden morbidity of diabetes mellitus in the population at risk was demonstrated, in addition, other people with disorders in glucose metabolism should be closely monitored, which shows the importance of active screening to achieve an early diagnosis and avoid complications of the disease.

Introduction: Hansen's disease or leprosy is an infectious and contagious disease of chronic evolution caused by a bacillus, Mycobacterium leprae. Pure, or primary, neural leprosy presents as peripheral neuropathy without the presence of skin lesions.Patient information: a young man, 19 years old, was presented with a history of sensory alterations in both legs of approximately two months of evolution. Physical examination revealed hypoesthesia in patches in both lower limbs. Diagnostic confirmation was established by biopsy of the sural nerve. Antileprosy treatment was started and clinical improvement was achieved with few weeks of evolution.Conclusions: clinical diagnosis is difficult and the disease may go unnoticed for years, with neural damage with increasing disability, so an exhaustive clinical approach is required to achieve accurate diagnoses. Multidisciplinary management improves the prognosis and quality of life of patients with this disease.