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

Introduction: The improper disposal of expired medications poses a risk to public health and the environment. Household practices for managing pharmaceutical waste are often inadequate, highlighting the importance of studying and improving final disposal strategies. Objective: To assess the level of knowledge and disposal practices regarding expired medications within the community. Methods: A descriptive, cross-sectional study was conducted using structured surveys applied to a non-probabilistic sample of 234 patients. Three main variables were evaluated: knowledge, attitudes, and practices related to the disposal of expired medications. Data were analyzed using descriptive statistical methods, including frequencies, percentages, and measures of central tendency. Results: Sixty-five percent of respondents reported discarding medications in household trash, while only 15% chose to return them to pharmacies or designated collection centers. The remaining 20% followed other practices, such as pouring them down the drain, which increases the risk of water resource contamination. The main reasons cited were lack of awareness of proper disposal methods and the absence of accessible collection programs. Conclusions: Inadequate medication disposal practices in households in Lima, underscoring the need to implement educational campaigns and public policies that promote safe and sustainable practices. In addition to demonstrating the need for collaboration between health and environmental institutions, it is essential to mitigate risks and foster responsible citizen awareness regarding the management of expired medications.

Introduction: For non-Spanish speaking medical students, limitations in their professional communication skills can affect their performance when developing actions that involve communication. However, in the methodological order, a proposal that addresses these needs has not been conceived. Objective: To design a methodology for managing the development of professional communicative competence in non-Spanish-speaking medical students during work-based education. Methods: An educational research was carried out with a qualitative approach. The design of the methodology was based on philosophical, sociological, psychological, pedagogical, linguistic and medical education foundations, and three integrating “holos”. A socialization workshop was conducted with 45 subjects. The percentage was used as a summary measure of quantitative data. Results:  The structure of the methodology for managing professional communicative competence in non-Spanish-speaking medical students in workplace education was based on the communicative-professional research method and the methodological procedures for its development. The systemic nature of the methodology was recognized in the socialization workshop, evident in the relationships established between its constituent elements. Conclusions: The methodology designed is consistent in scientific and methodological order. It also contributes to the development of professional communicative competence in non-Spanish-speaking students of medicine during education at work, at the Faculty of Medicine number 1 of the University of Medical Sciences of Santiago de Cuba.

Introduction: The relevance of the research is determined by the study of the effectiveness of psychosocial interventions for women’s ability to find new ways to overcome stress caused by violence. Оbjective: To assess the effectiveness of psychosocial training for increasing adaptive coping mechanisms in women who have become victims of violence. Methods: The study employs the Coping Strategy Indicator (CSI), the Lazarus Ways of Coping Questionnaire (WCQ) or Ways of Coping Checklist (WCC) and the Post Traumatic Growth Inventory (PTGI). Descriptive statistics, Student’s t-test and Manny-Whitney U-test were used. The reliability of the methods was assessed using Cronbach’s alpha. Results: It was found that the control group (CG) and experimental group (EG) did not have statistically significant differences before the training. After the training, the EG showed a significant increase in problem-oriented strategies. This includes problem-solving planning (16.1 to 20.3; t=4.12; p<0.01) and active coping behaviour (15.2 to 19.8; t=3.89; p<0.01. Emotionally oriented strategies also improved, particularly self-control (13.5 to 17.2; t=3.55; p<0.01) and positive reappraisal (12.4 to 16.7; t=4.04, p<0.01). Conclusions: The study confirmed the effectiveness of psychosocial training in increasing adaptive coping strategies and posttraumatic growth in women who survived violence, varying the types of training and studying the duration of changes in coping strategies.

Introduction: Brain tumors pose a significant challenge in oncology due to their variability and diagnostic complexity. Cytological diagnosis has emerged as a valuable tool for the rapid evaluation of samples, enabling early intervention and treatment planning. Objective: To synthesize advances in the cytological diagnosis of brain tumors over the past two decades, identifying the main technological, methodological, and clinical innovations that have enhanced its accuracy, accessibility, and application in neurooncology management. Methodology: A narrative review was conducted, based on a search between January 2024 and February 2025. Databases such as Cochrane Library and Scielo were used, with keywords: "cytological diagnosis," "brain tumors," "neurooncology," "stereotactic biopsy”, and "biomarkers". Out of 634 retrieved documents, 73 were reviewed, and 24 were selected, and 8.34% were selected to include in the article. Development: Cytological diagnosis offers a rapid and less invasive alternative to histological diagnosis, with particular effectiveness in differentiating high- and low-grade tumors. However, it faces challenges such as interobserver variability and the need for adequate samples. Advances in immunocytochemistry and the introduction of molecular biomarkers have increased diagnostic accuracy.Conclusions: While cytological diagnosis is a promising tool, its full integration into clinical practice requires further standardization, expert training, and technological improvements. Future research should focus on optimizing biopsy methods and developing new biomarkers.

Introduction: Head and neck cancer is a global health problem. Recurrence or relapse increases mortality, leading to the identification of new prognostic factors, such as tumor relapse. Objective: To describe the development and significance of tumor budding as a prognostic factor in head and neck cancer. Methods: The EMBASE, Cochrane, and Scopus databases were consulted, as well as the PubMed platform. Medical Subject Headings (MeSH) terms were used, and articles published between January 2010 and December 2024, in both Spanish and English, were considered. A total of 193 articles were reviewed, and 63 were selected: review articles (8), original research articles (47), textbooks (3), websites (2), and diagnostic and treatment guidelines (3). Development: Tumor budding, defined as clusters of tumor cells at the invasive front, may represent a marker of tumor aggressiveness in head and neck cancer. Tumor buds are graded and associated with features such as lymph node dissemination and vascular invasion. They are considered key prognostic and predictive factors, as they are linked to an increased risk of recurrence and metastasis, thus proving useful in prognosis assessment and therapeutic decision-making. Conclusions: Survival in head and neck cancer depends on clinical and histopathological factors, such as the presence of tumor budding, which is associated with a poor prognosis.

Introduction: Approximately, between 23 % and 61 % of cases of pheochromocytomas are diagnosed as incidentalomas and their annual incidence varies from 2-8 cases per million people. Objective: To address the atypical presentation of an adrenal incidentaloma caused by a pheochromocytoma. Clinical Case: A 55-year-old patient with a history of difficult-to-manage high blood pressure and diabetes mellitus presented with dyspeptic symptoms and recurrent abdominal pain of one month's duration. Abdominal ultrasound revealed a 5 cm image in the region corresponding to the left adrenal gland. A laparoscopic left adrenalectomy was performed. At follow-up, the patient remained asymptomatic, without hypertension, and with normal blood glucose levels. Conclusions: Pheochromocytomas are a diagnostic possibility in patients with adrenal gland tumors, although they present with few symptoms.

Objective: To investigate the correlation between intolerance to non-steroidal anti-inflammatory drugs (NSAIDs), bronchial asthma, and nasal polyps, and to develop an effective treatment strategy for patients suffering from these conditions simultaneously. Methods: The study was conducted across several clinical centres and included 200 patients diagnosed with bronchial asthma and nasal polyps, as well as intolerance to NSAIDs. Data were collected on the clinical manifestations of the pathology, including disease symptoms, frequency, and severity of exacerbations, along with their allergic history and tolerance to various drugs. Additionally, laboratory tests were performed, including blood tests to determine eosinophil levels, immunoglobulin E, and other inflammatory markers. Results: Based on the collected data, individualized treatment regimens were developed, combining pharmacotherapy and methods of desensitization to NSAIDs. Pharmacotherapy included the use of inhaled corticosteroids to reduce airway inflammation, antihistamines to control allergic symptoms, and monoclonal antibodies to modify the immune response. Desensitization methods involved the gradual introduction of NSAIDs under strict medical supervision, which helped to increase tolerance to these drugs. Conclusions: This comprehensive and individualized approach significantly improved patients’ quality of life, reducing the frequency and severity of exacerbations, improving lung function, and overall well-being. This study emphasizes the importance of a comprehensive approach to the diagnosis and treatment of patients with intolerance to NSAIDs, bronchial asthma, and nasal polyps, and the need for further research in this area.

Introduction: COVID-19 most frequently affects adults with comorbidities and risk factors that promote a proinflammatory state. Hyperglycemia is among the factors most frequently associated with severity. Objective: To epidemiologically and humorally characterize the deaths of diabetic and non-diabetic patients with COVID-19 who had abnormalities in baseline blood glucose levels upon admission. Methods: A cross-sectional, analytical study was conducted from March 2020 to January 2022, including 309 deceased patients. The following variables were included: age, sex, previous diagnosis of diabetes mellitus, presence of other comorbidities, clinical presentation, hospital stay, and clinical laboratory variables. Descriptive statistics and chi-square tests were applied. Results: Altered baseline blood glucose levels were primarily associated with age over 60 years (55.5% vs. 62.5%), respiratory symptoms (90.5% vs. 65.1%), and having three or more comorbidities (61.5% vs. 56.7%). In diabetic patients, a personal medical history and abnormal laboratory parameters predominated, while in non-diabetic patients, prolonged hospital stays and delays in seeking medical care were more common. Conclusions: Patients who died from COVID-19 and had abnormal baseline blood glucose levels on admission were characterized by older age, respiratory symptoms, and multiple comorbidities.

Introduction: Acute kidney injury can lead to respiratory dysfunction, yet no specific index currently exists to assess it comprehensively. Objective: To develop and evaluate the performance of the Respiratory Dysfunction Index in Acute Kidney Injury for predicting short-term mortality. Methods: A retrospective cohort study using secondary data from 5,060 hospitalized Acute Kidney Injury (AKI) patients. Clinical and biochemical variables were analyzed, including respiratory rate, oxygen saturation, creatinine, anion gap, bicarbonate, hemoglobin, blood pressure, and hemodynamic parameters. Principal component analysis (PCA) was applied, with model adequacy assessed using the Kaiser-Meyer-Olkin index and Bartlett’s test of sphericity. Based on PCA, the Respiratory Dysfunction Index in AKI was constructed and evaluated using the area under the curve (AUC), Cox regression for 14-day mortality, and Kaplan-Meier survival analysis. Results: PCA showed moderate adequacy (Kaiser-Meyer-Olkin = 0.522; p< 0.001) and identified seven components. The Respiratory Dysfunction Index in AKI was developed based on respiratory rate and oxygen saturation (AUC = 0.735; 95% CI: 0.710–0.760) to predict 14-day mortality. In Kaplan-Meier analysis, patients with a high index had lower survival (161.5 vs. 275.9 days; p< 0.001). In Cox regression, a high index was associated with increased mortality risk (HR = 2.323; 95% CI: 1.895–2.848; p< 0.001). Conclusions: The Respiratory Dysfunction Index in Acute Kidney Injury proved to be a useful tool for predicting mortality in patients with AKI.

Introduction: Posterior reversible encephalopathy syndrome is a transient clinical-radiological disorder that can occur in pregnant or postpartum women. Its incidence and prevalence are unknown due to the transient course of the clinical picture and the limitations of imaging studies in this population. Objective: To describe the characteristics and clinical course of a postpartum woman diagnosed with posterior reversible encephalopathy syndrome. Clinical case: A 36-year-old postpartum woman with a history of bronchial asthma and a previous cesarean section developed elevated blood pressure and headache 24 hours after surgery. She later presented with vision loss and tonic-clonic seizures, impaired consciousness, and respiratory depression, necessitating mechanical ventilation. A simple cranial computed tomography and magnetic resonance imaging (MRI) were performed; reversible posterior encephalopathy was diagnosed. With intensive treatment, the patient progressed favorably until discharge. Conclusions: Posterior reversible encephalopathy syndrome is an underdiagnosed disease that should be considered when seizures, persistent headache, and vision loss occur in patients with severe hypertensive disease of pregnancy or in the early postpartum period.