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

Introduction: Patients admitted to the intensivecare unit have different clinical and evolutionary charecteristics between the sexes that may influence the prognosis. Objective: To determine the clinical and evolutionary differences according to sex in the intensive care unit. Methods: Observational, descriptive, cross-sectional study in the intensive care unit with a sample of 5664 patients. The following were studied: age, sex, type of admission, APACHE II score at admission, invasive mechanical ventilation, status upon of dischsrge and direct cause of death. Statistical methods: absolute and relative frequency distributions, measures of central tendency, and the chi-square test and Student's t test. Results: The male gender predominated (56.7%) and their average age was lower (57.7 vs. 61.9 years). The female sex had a higher proportion of deaths (50.6 vs. 47.9%). There was a higher percentage of clinical admissions in women (69.9 vs. 58.8%) and of traumatic admissions in men (18.0 vs. 5.5%). The average APACHE II score was lower in men (15.4 vs. 16.3). Both sexes received a similar proportion of invasive mechanical ventilation. There were no differences in the direct causes of death. Conclusions: Differences associated with the sex of the patients are evident, marked by men having a higher rate of live discharge, lower mean age and lower APACHE II scores, while women have a higher incidence of deaths.

Introduction: Temporomandibular disorders in patients with rheumatoid arthritis are variable. This is a little studied topic and the degree of joint involvement is controversial. It is a relevant problem for public health and evaluating it contributes to improving the quality of life of patients. Objective: To characterize patients with temporomandibular disorders and rheumatoid arthritis. Methods: Descriptive cross-sectional study in a series of 27 patients with rheumatoid arthritis and temporomandibular disorders. The variables studied were age, sex, muscle involvement, degree of temporomandibular dysfunction, time of evolution of rheumatoid arthritis and clinical manifestations in the TMJ. Descriptive statistics were used. Results: Females predominated (59.26%) and patients between 40 and 49 years old (48.15%); the masseter muscle was the most affected (66.67%); 51.86% of patients had severe dysfunction and 40.74% had rheumatoid arthritis for more than 10 years; joint noises were present in 62.96% and joint pain in 59.26%. The most frequent clinical manifestations were joint noises (62.96%), joint pain (59.26%) and deviations in mandibular movements (40.74%). Conclusions: Patients with TMD and rheumatoid arthritis are characterized by being female, around 50 years old, with the masseter muscle being the most affected, having severe dysfunction and more than 10 years of suffering from rheumatoid arthritis. The most frequent clinical manifestations are joint noises and joint pain.

Introduction: Mirror therapy is a physiotherapeutic technique based on visual imagery, which is used as an innovative sensorimotor tool to treat pain-related conditions. Objective: To describe the effectiveness of mirror therapy in various pain patient populations. Methods: A systematic review was conducted including 26 randomized clinical trials obtained from Web of Science, Scopus, Pubmed and Scielo databases. The terms “Mirror Movement Therapy AND Pain” were used; inclusion criteria included studies published in English, Spanish and Portuguese with accessible texts, while duplicate studies were excluded. Methodological quality was assessed with the PEDro scale. Results: The reviewed studies applied mirror therapy in different conditions: amputations (9 articles), stroke (7), median nerve injuries (4), complex regional pain syndrome (3), neck pain (1), shoulder capsulitis (1) and fractures (1). Assessments employed tools such as the Visual Analog Scale and the McGill brief pain questionnaire. Conclusions: Mirror therapy is an effective tool for treating various types of pain, as it promotes activation of the somatosensory cortex and primary motor cortex. Its integration with other physical therapy interventions enhances results and increases its effectiveness. Furthermore, its development alongside augmented reality offers a promising approach, as it improves body image representation through the manipulation of colors and movements.

Introduction: Diabetes mellitus is a cardiovascular risk factor. Menopause, associated with decreased estrogen levels, also increases this risk. Both conditions, along with other risk factors, elevate cardiovascular risk in postmenopausal women with type 2 diabetes. Objective: To implement a smartphone application that allows primary and secondary healthcare providers to reliably estimate cardiovascular risk in postmenopausal women with type 2 diabetes. Methods: A mobile application was developed using Visual Studio Code as the development environment and Flutter as the framework, employing the Dart programming language. Presentation: An application was implemented that estimates cardiovascular risk and offers additional functionalities. The integration of multimedia resources facilitated the verification of diagnoses related to cardiovascular risk factors. Conclusions: The developed application is a valuable tool for estimating cardiovascular risk in postmenopausal women with type 2 diabetes, supporting healthcare professionals in diagnosis and treatment.

Introduction: Primary pancreatic lymphoma is a rare entity that represents approximately less than 0.5% of all pancreatic neoplasms. Objective: To illustrate the diagnostic complexity of primary pancreatic lymphoma. Case Report: A 73-year-old male patient with no history of comorbidities, surgical interventions, or drug use presented with a clinical picture characterized by jaundice and intermittent abdominal pain. A CT scan revealed a solid lesion in the head of the pancreas and the ampullary region, encasing the hepatic artery and partially the gastroduodenal artery. A biopsy confirmed the presence of a B-cell non-Hodgkin lymphoma. Chemotherapy was effective, and the patient is currently in recovery. Conclusions: Primary pancreatic lymphoma should be considered as a differential diagnosis for pancreatic masses, especially when the clinical presentation is nonspecific, since its early detection allows for less invasive treatment with a better prognosis than pancreatic adenocarcinoma.

Introduction: Early diagnosis of postoperative complications in colorectal surgery poses a challenge for the surgeon. C-reactive protein is a circulating plasma protein that is part of the acute phase reactants, whose levels in the blood increase during the inflammatory response. Objective: To evaluate the usefulness of C-reactive protein as a predictor of postoperative complications in laparoscopic colorectal surgery. Method: Prospective case series study conducted during the period between January 2021 and December 2022. A total of 97 patients who underwent laparoscopic surgery due to colorectal disease were included. Serum levels of C-reactive protein were recorded on the third day post-surgery. The studied variables included sex, age, ASA classification, nutritional status, comorbidities, surgical intervention, surgical time, and complications. The Mann-Whitney U test was used to detect significant differences between the reactant levels on the third day and the frequency of complications. The Kruskal-Wallis test was employed to detect significant differences between the reactant levels and the observed complications. Results: In complicated patients, the median reached a value of 186.4 mg/L, exceeding the values of the non-complicated patients (104.3 mg/L). The most identified complications were anastomosis leakage and surgical site infection. Conclusions: This protein has a high negative predictive value for complications (close to 90%). It proved to be a useful element for the timely prediction of complications following laparoscopic colorectal surgery.

Introduction: Lung ultrasound is presented as an alternative diagnostic technique used in decision making at the point of care. Objective: To identify pulmonary ultrasound findings that constitute prognostic factors for mortality in patients diagnosed with severe community-acquired pneumonia treated with invasive ventilation. Methods: An analytical, observational, case-control study was conducted from January 1, 2019, to October 30, 2023, at the Orlando Pantoja Tamayo General Teaching Hospital. A sample of 240 patients (80 cases and 160 controls) was selected by simple random sampling. A multivariate analysis was performed with a binary logistic regression model, with backward stepwise selection with likelihood ratio to assess whether independent variables contribute to mortality. Discharge status was considered as the dependent variable, and bilateral pleural effusion, bilateral thickened pleura, and pulmonary aeration scale were considered as independent variables. Results: bilateral pleura effusion and bilateral thickened pleura was present in 18.3 % and 35.4 % of patients; with a median for the pulmonary aeration scale of 18 points. The identified prognostic factors for mortality were the presence of bilateral pleural effusion with an odds ratio (OR)=5.1 and the pulmonary aeration scale ≥20 points with an OR=3.6. Conclusions: It is concluded that the presence of bilateral pleural effusion and a pulmonary aeration score ≥20 points are prognostic factors for mortality.

Introduction: People with incomplete spinal cord injury present balance disorders that affect their functional capacity and require physical therapy. Virtual reality-based interventions are considered promising therapies for restoring balance in these patients. Objective: To describe the physiotherapeutic principles and benefits of virtual reality that promote balance recovery in people with incomplete spinal cord injury. Methods: A bibliographic review was conducted of updated information published in journals indexed in regional databases (Scielo, Latindex, and Redalyc) and high-impact databases (Scopus, PubMed, and Medline) over the last 5 years. Health descriptors in English, Spanish, and Portuguese were used, along with Boolean operators (OR, NOT, and AND) to increase and optimize search results. Google Scholar was used as the search engine to locate information. A total of 89 documents were identified, of which 30 contributed information to the study. Development: The main results of the research include a synthesis of balance characteristics in people with incomplete spinal cord injury, as well as a summary of interventions that have reported improvement. Conclusions: Virtual reality training includes single or combined therapies that can be effective in restoring balance. These trainings involve varied movements and provide multimodal feedback that activates and reorganizes neurophysiological processes, networks, and cortical areas, leading to improved balance and mobility.

Introduction: In older adults, postural balance and muscle strength are affected by the degenerative process. The use of virtual reality and kayaking exercises can improve these abilities. Objective: To identify the benefits of virtual kayaking training on postural balance and muscle strength in older adults. Methods: A literature review was conducted to search for updated information in the databases PubMed, Scopus, Medline, Dialnet, Scielo, Redalyc, and Latindex. The search engine used was Google Scholar. 71 documents were identified, and 29 articles were selected for the study. Health descriptors (elderly; postural balance; muscle strength and rehabilitation) in Spanish, English, and Portuguese were used, along with Boolean operators (AND, OR, and NOT) to optimize the information search results. Development: The main results include a synthesis of the characteristics of postural balance and muscle strength in older adults secondary to the physiological changes of the aging process; Likewise, the benefits of virtual exercises and kayak paddling for the improvement of these diminished capacities are summarized. Development: The main results include a synthesis of the characteristics of postural balance and muscle strength in older adults secondary to physiological changes associated with aging; The benefits of virtual exercises and kayaking for improving these diminished abilities are also summarized. Conclusions: Virtual reality training has proven effective in improving postural balance and muscle strength thanks to its characteristics. Virtual training with kayak paddling reports benefits in maintaining static and dynamic balance, as well as upper extremity muscle strength, grip strength, and core stability.

Introduction: Timely diagnosis of thyroid cancer requires greater homogeneity, consistency, uniformity, and precision compared to the multiple guidelines that evaluate the risk stratification of malignancy in thyroid nodules. Objective: To evaluate the feasibility of an algorithm for the timely diagnosis of thyroid cancer during the course of thyroid nodular disease. Methods: Quasi-experimental study in patients with thyroid nodular disease. Two groups were formed and compared: group I (n = 42) not subjected to the algorithm, and group II  (n = 31) treated with the algorithm. Clinical, epidemiological, diagnostic, and therapeutic variables were evaluated. Inferential and survival statistical analyses were performed. Results: Statistically significant differences were found in group II undergoing the algorithm with respect to: reduction in immediate surgeries (6.4% vs. 95.2%; p < 0.05); increase in active surveillance (93.6% vs. 4.8%; p < 0.05); increase in nodule evaluation time (56.5 vs. 7.6 months; p < 0.05); decrease in the percentage of patients with thyroid cancer (6.4% vs. 37.5%; p < 0.05), increase in event-free survival up to 41 months and surgery-free survival up to 56.5 months (p < 0.05). Conclusion: The application of the algorithm allows for improved personalized timely diagnosis of TC during the course of NCDs by reducing the percentage of patients operated on for this condition, with the benefits of active surveillance.