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

Introduction: Complications related to biliary anastomosis are recognized as the first cause of post-liver transplantation morbidity and can negatively affect patient survival. Objective: To evaluate the behavior of long-term survival in patients with post-transplant biliary complications. Methods: An observational, longitudinal, and retrospective study was carried out in 152 patients with liver transplantation between 1999-2019, the following were excluded: patients with survival less than 72 hours, retransplants and patients with hepatic artery thrombosis. The variables studied were age and sex of the recipients, pre-transplant etiology, MELD index (Model for End Stage Liver Desease), biliary anastomosis technique, type of biliary complication, time of onset and treatment used. The categorical variables were related using the Chi square statistical test and Fisher's exact test, with significant differences when p Results: They were significantly related to the presence of biliary complication, a higher MELD index score (p = 0.008) and the end-to-end anastomosis technique (p = 0.039). Early biliary complications (66.7%) and anastomotic stenosis (58.7%) predominated. Treatment by endoscopic retrograde cholangiopancreatography (ERCP) was the most used (68.2%). Patients with biliary complications had a mean survival of 10.9 years (95% CI 8.75-13.19), while patients without it had a mean of 9 years (95% CI 7.03 -10.98); there was no significant difference (p = 0.24). Conclusions: Biliary complications were an important cause of post-transplant morbidity, but without affecting patient survival. DeCS: LIVER TRANSPLANT; BILIARY TRACT DISEASES/complications; SURVIVAL; SURGICAL ANASTOMOSIS; MORBIDITY.

Introduction: Therapeutic adherence constitutes one of the main problems of health interventions. One of the populations in which difficulties in adherence to treatment are evidenced is burn patients. Objective: To determine the validity and reliability of two instruments for the evaluation of adherence to treatment and their influential dimensions in hospitalized burn patients. Methods: From the quantitative approach, a cross-sectional study was conducted, in the period from January 2017 to December 2019. Adherence to treatment and influencing adherence to treatment were established as research variables. Expert judgment was used, the pilot test and finally the two questionnaires were applied to 90 burn patients. Results: Both instruments proved to have content validity. The test-retest reliability of the instrument to evaluate therapeutic adherence was considerable and significant, while the internal consistency was acceptable. Reliability was very strong and consistency good in the instrument that evaluates the influencing dimensions in therapeutic adherence. Conclusions: The two instruments developed for the evaluation of therapeutic adherence in hospitalized burn patients present content validity and reliability. DeCS: TREATMENT ADHERENCE AND COMPLIANCE; VALIDATION STUDIES AS TOPIC; BURNS; PRECIPITATING FACTORS; TECHNIQUES, MEASURES, MEASUREMENT EQUIPMENT.

Introduction: For adequate sexual and reproductive health, people need to have access to all the information required in this regard, access to safe contraceptive methods to avoid unwanted pregnancies and not acquire sexually transmitted infections. Objective: To validate the software on sexual and reproductive health in students of the Faculty of Nursing-Health Technology. Methods: A research of technological innovation investigation was carried out with the CrheaSoft version 3.3.3 program; the universe was made up of all the first-year students and the sample was represented by 150 students, 10 for each group; all expressed their willingness to participate in the study. Theoretical and empirical methods were used. Results: It was structured with the modules: start, agenda, exercises, glossary, media library and accessories, related to each other. 100% of the teachers and students surveyed gave the rating of very adequate to the proposed indicators. Conclusions: The software obtained positive evaluations by the respondents, being considered a highly relevant, current, easily acquired tool, allowing self-learning, with the necessary and preventive information to achieve adequate sexual and reproductive health in young people. DeCS: SEXUAL AND REPRODUCTIVE HEALTH; SOFTWARE; INVENTIONS; TEACHING MATERIALS; EDUCATION, MEDICAL.

Introduction: Paraphilic disorder are non tradicional sexual behaviors like the sexual activity with the boys/girls, to exhibit the genital to an unaware person or others. Objective: To systematize the theoretical bases that sustain the clinical characterization and the treatment of the paraphilic disorder in the world and in Cuba. Methods: The bibliographical search was made in the electronic databases ClinicalKey and PubMed, Cuban investigations were used. Results: Paraphilia is any intense and persistent sexual interest that is not the interest in the genital stimulation or preparatory caresses with a human normal, mature physically, with consenting persons; they are paraphilics disorders when the paraphilia causes distress or deterioration in the social, labor or others. Excellent clinical characteristics: they prevail in the masculine sex, cognitive distortions exist, comorbidities among different types of paraphilics disorders, dysfunctions for use of substances and disorders personality. The pharmacological treatment embraces the selective serotonin reuptake inhibitors, in Cuba the Sertraline is used (100-200 mg/day); analogues of the hormone Gonadotropin-Releasing Hormone Agonists and antiandrogens used in the country Androcur (50-100 mg/day). Technical of cognitive and behavioral psychotherapy: covered sensitization, empathy development toward the victims and cognitive restructuring. Conclusions: Clinically it is indispensable to differentiate the paraphilia of the paraphilics disorders, considered mental illnesses, with generally chronic course and generally comorbid psychiatric. In Cuba, for their treatment it is used the Sertraline or Androcur and technical of cognitive and behavioral psychotherapy. DeCS: PARAPHILIC DISORDERS/etiology; PARAPHILIC DISORDERS/drug therapy; PARAPHILIC DISORDERS/psychology; MENTAL DISORDERS; COGNITIVE BEHAVIORAL THERAPY.

Introduction: The clinical method represents the guide that every physician should follow in the search for the definitive diagnosis. In recent years, it has been stated that it is not correctly applied, with negative effects both for the physician and for the patient and his family. Objective: To evaluate the application of the clinical method in the Internal Medicine service of the Martín Chang Puga General Teaching Hospital in the municipality of Nuevitas. Methods: An observational descriptive cross-sectional study was conducted. The universe was made up of 2,402 patients discharged from the Internal Medicine service and 240 were selected by simple random probabilistic sampling.Results: Errors were found in the application of the clinical method in all its stages. The physical examination was affected in 53.7% of the medical records reviewed, the diagnostic discussion in 52.9% and the medical evolution in 50.4%. In 78.3 % of the medical records there was correspondence between the proposed diagnoses. The evaluation was poor and fair in 52.9 % of the medical records. Conclusions: The application of the Clinical Method is still deficient, and there is an urgent need to train health professionals who know and adequately master the objectively structured Clinical Method. DeCS: CRITICAL PATHWAYS; PHYSICAL EXAMINATION; EVALUATION STUDY; CLINICAL DIAGNOSIS; INTERNAL MEDICINE.

Introduction: Appearance, size, form and symmetry of the mammary gland play an important role in the sexuality of the woman and have a deep effect in her biopsychosocial well-being. Objective: To characterize breast augmentation using prosthetic implants. Methods: A descriptive, prospective longitudinal study was carried out to determine the behavior of breast augmentation through prosthetic implants in patients with breast disorders that attended to the consultation of Plastic Surgery of the Universitary Hospital Manuel Ascunce Domenech in Camagüey's province, from September, 2017 to June, 2020. 35 patients were studied and the following variableswere analyzed: age, breast disease to be corrected with implants, implant volume, access route for implant placement, location of the breast pocket and complications with the procedure. Results: Of all the patients studied, mammary hypotrophy was present in 25 females, predominating in the ages between 30 and 49 years in 68.56% of them. In twelve of the patients who used the subareolar route for implant placement, they presented volumes between 351 and 400 milliliters. The least used access route for implant placement was the axillary route, in one patient and this in turn used a retromuscular breast pocket. Wound dehiscence was the predominant complication. Conclusions: Breast augmentation surgery using alloplastic material is a frequent procedure that is used to correct different breast defects in the specialty of Plastic Surgery, with a variety of techniques and few complications. DeCS: BREAST DISEASES; BREAST IMPLANTS/adverse effects; PROSTHESIS IMPLANTATION; COSMETIC TECHNIQUES; SELF CONCEPT.

Introduction: Mondor's disease is a superficial thrombophlebitis that affects the thoracoabdominal subcutaneous veins mainly unilaterally, with a peak incidence in the fifth decade of life affecting mainly women. Objective: To describe the presentation of a superficial thrombophlebitis of the thoracoepigastric vein, also called Mondor's disease, in a male adult. Case report: A 43-year-old male patient with no relevant history who consulted for presenting constant pain of three days of evolution located in the right anterolateral thoracic region of moderate intensity not associated with other symptoms. The clinical findings highlighted during the examination include elevated blood pressure levels and the presence of an indurated subcutaneous cord that extends from the lower third of the upper outer quadrant of the right breast to the right subcostal region. Ultrasonography is performed, which reports the absence of collapse of the vessel studied by compression of the transducer. A diagnosis of Mondor's disease is established and non-steroidal anti-inflammatory drugs are prescribed for one week, with gradual improvement in symptoms and complete resolution at six weeks of follow-up. Conclusions: This disease, despite being a rare entity, especially in male patients, should be taken into account within the differential diagnoses of pain or superficial longitudinal induration in the anterolateral chest wall, even in the absence of risk factors for its appearance, the use of ultrasonography corresponds to a good complementary diagnostic tool to reach the diagnosis. DeCS: THROMBOPHLEBITIS/therapy; THROMBOPHLEBITIS/diagnostic imaging; THROMBOPHLEBITIS/complications; THROMBOPHLEBITIS/drug therapy; CASE REPORTS.

Introduction: Ovarian tumors are not as frequent as those of the uterus and breast. They constitute the third group of benign and malignant tumors in women. Border cystadenoma has clinicopathologic intermediate features between those of benign and malignant tumors. Objective: To describe the successful therapeutic management of a case of a postmenopausal woman with borderline mucus cystadenoma of ovary. Case report: A hypertensive and diabetic patient, operated in the Lucia Iñiguez Landín Clinical Surgical Hospital in Holguin province, 54-year-old postmenopausal, with a giant tumor of the left ovary and satisfactory clinical-surgical evolution. Conclusions: Border mucinous cystadenoma is usually limited to the ovary at the time of diagnosis, without capsular or peritoneal invasion. The risk of malignant degeneration is highly variable and is related to age. For its treatment, oophorectomy, omentectomy and biopsy of the contralateral ovary, retroperitoneal nodes, visible peritoneal nodules and cytology of peritoneal fluid are recommended. DeCS: CYSTADENOMA, MUCINOUS/therapy; OVARY; POSTMENOPAUSE; NEOPLASMS/surgery; CASE REPORTS.

Introduction: Fuchs endothelial corneal dystrophy is a specific, bilateral and progressive degenerative disorder of the corneal endothelium, it is the most frequent but it is not always diagnosed in its initial stages in general ophthalmology consultations. Objective: To describe the clinical behavior of patients with Fuchs endothelial corneal dystrophy in Camagüey province. Methods: A cross-sectional descriptive observational study was carried out at the Ophthalmological Center of the Manuel Ascunce Domenech University Hospital in Camagüey in the period from November 2019 to June 2021. The study universe consisted of all the patients who attended during the study period and the sample was made up of 19 patients (38 eyes) who met the inclusion and exclusion criteria. The variables studied were age, sex, skin color, corrected visual acuity, association with glaucoma, pachymetry, anterior segment biomicroscopy, endothelial microscopy, confocal microscopy, disease stage, and type of treatment applied. Results: Patients between 40 and 59 years of age, female sex, and white skin color predominated. Useful vision stood out, high pachymetry values and associated with glaucoma, the presence of guttas, corneal edema, low cell count with polymorphism, and polymegatism was confirmed. Stage 2 was 47.4% and medical treatment was applied in 97.4%. Conclusions: Dystrophy appears more frequently after 40 years of age, in females and white skin persons. Useful vision, high pachymetry values, and association with glaucoma prevailed. In the biomicroscopy of the anterior segment, guttas and stromal edema predominated, and endothelial and confocal microscopy were mostly characterized by low cell count, guttas, polymorphism, and polymegatism. Stage 2 and medical treatment prevailed. DeCS: FUCHS' ENDOTHELIAL DYSTROPHY/therapy; EYE DISEASES, HEREDITARY; DESCEMET STRIPPING ENDOTHELIAL KERATOPLASTY; SALINE SOLUTION, HYPERTONIC/therapeutic use; EYE ABNORMALITIES.

Introduction: A procedural systemic educational strategy model was based on oral health of the elderly, to achieve the impact of this in the Cuban prison context; considering the importance of their knowledge and understanding in the development and evolution of daily tasks. Objective: To carry out the theoretical and methodological foundation of a procedural systemic educational model, with emphasis on the prison context. Methods: A bibliographic review was carried out in the period between June and July 2020. A search was made on theories and models consistent with health promotion in 624 articles published in biomedical databases (SciELO, PubMed, Cumed, Lilacs, ClinicalKey) through the search manager and reference manager EndNote, of these, 53 selected citations were used to carry out the review, of which; 28 of the last five years, 38 original articles and opinion articles, 3 books, 6 programs, 2 manuals, 4 documents between guidelines and resolutions. Document analysis was used as a method. Document analysis was used as a method. Results: This model acquires a particular significance due to the fact that it is constituted on a highly vulnerable population, taking into account the characteristics of life in prison and the need to achieve social reintegration and rehabilitation through management policies based on ethics and human dignity. Conclusions: This model was a fundamental tool for the development of oral health promotion in the prison environment, which recognizes the need to implement updated and effective strategies to benefit the elderly inmate, their families and the personnel involved in their care. DeCS: HEALTHCARE MODELS; HEALTH EDUCATION, DENTAL; PRISONS; HEALTH OF INSTITUTIONALIZED ELDERLY; REVIEW LITERATURE AS TOPIC.