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

Introduction: Distance education has significantly expanded access and flexibility in professional training within the health sciences, allowing students from various regions to participate in academic programs without the constraints of in-person attendance. However, this modality also presents major challenges, especially in health-related fields where effective communication, socialization, and the development of interpersonal skills are essential for professional practice. Objective: The objective of this study was to identify the barriers faced by health science students in communication and socialization within distance education contexts, to recognize the most commonly used digital tools for interaction, and to gather teaching strategies or practices that promote communication and socialization in virtual environments. Material and Methods: This systematic review was conducted using the PRISMA methodology. The search was carried out in the Scopus database, selecting studies published between 2023 and 2025 in English and Spanish, resulting in the identification of 107 primary studies. Results: The main barriers in distance education for health science students are academic, social, and emotional in nature, with a notable lack of digital skills and limited interaction. Synchronous tools such as Zoom and Teams are predominant, while other tools are less frequently used. The most effective teaching strategies focus on digital platforms, collaborative work, and active learning methodologies to enhance communication and socialization. Conclusions: In conclusion, communication and socialization in distance education for health science students are affected by various barriers, but can be strengthened through the appropriate use of digital tools and collaborative teaching strategies that promote interaction, mutual support, and meaningful learning.

Introduction: Sexual violence is a serious violation of human rights that causes severe physical and psychological harm. In this context, biomarkers are key tools in forensic and clinical investigation, as they support the diagnosis and obtaining of scientific evidence in cases of sexual assault. Objective: To systematize the use of biological markers in medical-forensic contexts of sexual violence, to evaluate their limitations, and to determine the repercussions on the physical and mental health of the victims. Material and Methods: A systematic review was carried out following the PRISMA methodology, consulting the Scopus and Web of Science databases between 2020 and 2025. After applying eligibility criteria, 48 primary studies were selected. Variables such as type of marker, fluid used, analytical techniques, reported limitations and consequences for the victim were extracted, organized and synthesized through tables and qualitative analysis. Results: Genetic and enzymatic markers were the most used biomarkers, mainly in semen, blood, saliva and vaginal fluids. Several limitations were identified, including molecular degradation, cross-contamination, sparse samples, and high technical requirements. Regarding the impact on the victims, traumatic injuries, gynecological complications and serious psychological sequelae were documented with a high prevalence of post-traumatic stress disorder, anxiety, depression and low self-esteem. Conclusions: Genetic, enzymatic and proteomic methods complement the detection of biological evidence, with semen being the most analyzed fluid. However, their application is limited by molecular degradation, the scarcity and contamination of samples, as well as the need for specialized tools and the technical complexity of the procedures.

Introduction: The COVID-19 pandemic highlighted the need for effective strategies to manage acute respiratory failure. Non-invasive respiratory therapies, such as non-invasive ventilation (CPAP, BiPAP) and high-flow oxygen therapy, emerged as relevant alternatives to invasive mechanical ventilation. Objective: To analyze the clinical efficacy of non-invasive respiratory therapies in patients with acute respiratory failure secondary to COVID-19, with emphasis on their impact on intubation prevention and clinical outcomes. Material and Methods: A narrative review of scientific literature published between January 2020 and May 2025 was conducted. Databases including PubMed, Scopus, SciELO, ScienceDirect, as well as institutional repositories specialized in respiratory care and intensive medicine (SCCM, ESICM, ATS, SEMICYUC, ALAT, PAHO), were consulted. DeCS/MeSH descriptors in Spanish and English were used, including “COVID-19,” “respiratory insufficiency,” “non-invasive ventilation,” “high-flow oxygen therapy,” “CPAP,” “BiPAP,” and “ROX index.” From 43 identified studies, 27 articles were selected based on methodological rigor and clinical relevance. Development: High-flow oxygen therapy and non-invasive respiratory therapies showed benefits in reducing the need for intubation, improving oxygenation, and enhancing patient comfort. Although no conclusive reduction in mortality was demonstrated, early and well-monitored application increased clinical effectiveness. Predictive tools such as the ROX index and respiratory rate proved useful for identifying therapeutic failure. Conclusions: Non-invasive respiratory therapies are safe and effective strategies for managing COVID-19-related acute respiratory failure, provided they are applied early, within structured protocols, and under strict clinical monitoring.

Introduction: Discal hernia is a chronic condition that is difficult to manage, sometimes disabling patients.  It is a wordwide public health problem. Nowadays, the automated and computerized DRX 9000 equipement has been developed to treat this condition and alleviate its symptoms. Objective: To evaluate how rehabilitation therapy and spinal descompression with the DRX 9000 equipment influence pain, as well as to describe the adverse effects in patients with cervical and lumbar disc herniation. Material and Methods: A descriptive study was conducted on 971 patients with cervical disc hernia and lumbar disc hernia treated at the Hospital of the Ecuadorian Social Security Institute (IESS) in Portoviejo, Manabí province, during the period between January 2017 and January 2018. The patients consented to participate in the treatment and recived it duting 30 sessions with intermediate evaluation. Before and after starting the treatment, clinical symptomatology was evaluated. Results: Cervical disc herniations predomined in women, while lumbar disc herniations mostly occurred in men. The fifth decade of life was the most frequent. After the interventions, an improvement in symptomatology was demonstrated (p < 0.01) when comparing them before and after treatment. No adverse effects were evident. Conclusions: Rehabilitation therapy of patients with discal hernia applying descompression with the DRX 9000 equipment, significantly alleviated pain and sensory manifestations, being effective and safe.

Introduction: Healthcare provision to vulnerable populations such as the uninsured, older adults, migrants, and ethnic minorities, faces significant ethical, administrative, and legal challenges. These groups often experience economic, cultural, geographic, and administrative barriers that limit their access to quality healthcare services. Objective: To analyze the main ethical challenges and barriers faced by vulnerable populations in accessing healthcare, based on recent studies. Material and Methods: Studies were reviewed that address topics such as access to expensive treatments for uninsured patients, administrative barriers for older adults in nursing homes, the implementation of telemedicine in rural areas, cultural tensions in medical decision-making, and inequalities in care for ethnic minorities. Results: The studies analyzed highlight the need to address the structural and cultural barriers that limit access to healthcare for vulnerable populations. Conclusions:  The results of these studies provide a clear view of the systemic and cultural obstacles that affect the quality and access to the care for vulnerable populations. Only through a comprehensive and committed approach will it be possible to reduce health disparities and respect fundamental bioethical principles.

Introduction: Research instruments for diagnosing the current state of a process contribute to identifying the problems of health processes and the action plan.Objective: To validate instruments for diagnosing the current state of nursing care for postpartum women with suspected thromboembolism.Material and Methods: An instrument validation study was carried out from January to September 2023 at the Juan Bruno Zayas Alfonso Hospital in Santiago de Cuba. Two random samples were consulted (one was composed of specialists (n1=13) and the other was made up of experts (n2=7)).  The instruments submitted to validation were two guides (one for observation and another for documentary review), as well as a questionnaire. These were validated through a pilot survey and Moriyama's basic criteria; for the latter, Cronbach's alpha was calculated.Results: The three instruments were classified as adequate in terms of general design structure (100%); the majority of respondents classified the guide for documentary review as appropriate (number of items, 69.2%; structure and content, 84.6%; and interpretation,76.9%). Cronbach’s alphas were 0.86 for the guides and 0.94 for the questionnaire.Conclusions: The three instruments were validated as appropriate for the diagnosis of the current state of nursing care for postpartum women with suspected thromboembolism, which showed high acceptance and reliability.

Introduction: Amblyopia is a decrease in best-corrected visual acuity and constitutes a public health problem that, if not treated on time and adequately, can lead to permanent visual disability. Objective: To determine the visual characteristics in children with anisometropic amblyopia before and after optical correction. Material and Methods: A pre-experimental, longitudinal, prospective study was performed between November 2021 and October 2022 in the Pediatric Ophthalmology and Strabismus Clinic of the “Ramón Pando Ferrer” Cuban Institute of Ophthalmology. Results: There was predominance of the male sex (62.5%), as well as the age group between 5 and 9 years (70.8%). There were significant differences in the initial best-corrected visual acuity compared to the final one in the 5-9 (p=0.001) and 10-14 (p=0.042) groups. The highest peak of visual acuity was reached in week 12 where significant differences in visual acuity were found according to the established time periods (p= 0.001), as well as in stereopsis. (p=0.001). Conclusions: Early and adequate optical correction of anisometropic amblyopia during childhood allows a significant improvement in visual acuity from the sixth week of refractive adaptation, with a maximum peak at 12 weeks and an increase in stereopsis at 18 weeks.

Introduction: Multivessel disease is present in approximately 50% of patients experiencing acute myocardial infarction. Initially, revascularization of the culprit lesion during primary PCI was exclusively recommended for patients in cardiogenic shock. Objective: The aim of this study was to assess whether complete revascularization is associated with reduced cardiovascular mortality and adverse cardiovascular events. Material and Methods: A search was conducted in the following bibliographic databases: MEDLINE, Cochrane, Embase, ISI Web of Science, and CENTRAL (Cochrane Central Register of Controlled Trials), SciELO. The search was performed in February 2024, without a time limit, and was updated monthly until June 2024. Randomized controlled trials or meta-analyses of randomized controlled trials were selected, with no restrictions on publication year or language that included the following terms: myocardial revascularization, ST-segment elevation myocardial infarction, coronary artery disease, and coronary stenosis. Results: The systematic review and meta-analysis included seven randomized controlled trials involving 6597 patients, comparing complete revascularization with culprit-only percutaneous coronary intervention. The complete revascularization strategy was associated with a significantly lower risk of major adverse cardiovascular events (RR= 0.50, 95% CI: 0.56-0.74; p<0.001, I2= 0%) and repeated revascularizations (RR=0.32, 95% CI: 0.24-0.42; p<0.001, I2= 42%). Conclusions: Our findings demonstrate that revascularization of non-culprit lesions in patients with STEMI is associated with a significant reduction in major adverse cardiovascular events, repeated revascularizations, and the composite outcome of cardiac death and non-fatal myocardial infarction.