1. Enfermedad renal crónica en el adulto mayor
Chronic renal disease in elder people
Founding principle: Chronic renal insufficiency is defined as the
kidney structural or functional damage, evidenced by markers of
damage (urine, blood or images) for a period of three months or
more. Between 8 and 10 % of the general adult population has some
renal damage.
Objective: To know the incidence and prevalence of the chronic
renal disease in elder people, in the Teaching Clinic Surgical Hospital
Comandante Faustino Pérez Hernández.
Methods. A retrospective descriptive longitudinal study was carried
out. The sample was formed by 274 patients fulfilling the inclusion
criteria. The used variables were: age, sex, skin color, weight,
personal pathological antecedents, entering cause, chronic renal
disease´s progression factors, toxic habits and creatinine value. For
organizing the obtained indicators we applied the descriptive statistic
method, analyzing the information through frequency distribution
tables, graphics resuming measures as average and mode for the
quantitative variables, and absolute numbers and percentage for the
qualitative variables.
Results: high nosocomial prevalence of the chronic renal disease in
elder people, more frequent in the female sex and white people;
coexistence of many risk factors, predominating arterial hypertension,
cardiopathies,
diabetes
mellitus,
age
and
smoking.
The
most
frequently found progression factors were de decompensated arterial
hypertension, renal hypoperfusion and sepsis.
Conclusions: There is high nosocomial prevalence of the chronic
renal disease in elder people
Palabras clave: enfermedad renal crónica, población geriátrica,
epidemiología, incidencia, prevalencia, comorbilidad.
Key
words:
Chronic
renal
disease,
geriatric
population,
epidemiology, incidence, prevalence, co-morbidity.
2. Mortalidad adulta por tumores malignos en el municipio
Jovellanos. 2009-2011
Adult mortality due to malignant tumors in the municipality of
Jovellanos. 2009-2011
A cross-sectional descriptive study was carried out to know the
behavior of mortality caused by cancer in people elder than 18 years
old due to malignant tumors in the municipality of Jovellanos in the
period between 2009-2011. We considered those deceases whose
main cause was cancer, according to the 10th Revision of the Disease
International Classification. We calculate the mortality rate per age
groups and sex, the proportional mortality ratio and potentially lost
years. We found that the proportional mortality ratio was kept over
20 %, that the male sex was 1,5 times more at risk of dying by
cancer, duplicated at the age range from 60 to 74 years old. 73,3 %
of the deceases occurred after being 60 years old. The most common
location of the malignant tumors was lung, trachea and bronchi,
digestive
tract,
prostate,
hemolymphopoietic.
colon
and
rectum,
mamma
and
Female sex showed the greatest quantity
potentially lost life years, with 17,6 life years per 1000 women. We
arrived to the conclusion that cancer is an important health problem
for the population of the municipality of Jovellanos, with increasing
mortality levels, may be becoming the main mortality cause.
Palabras clave: neoplasia, mortalidad, adulto.
Key words: neoplasia, mortality, adult.
3.
Comportamiento
de
los
pacientes
con
enfermedad
cerebrovascular en el Servicio de Rehabilitación del Hospital
Militar de Matanzas
Behavior of the patients with cerebrovascular disease at the
Rehabilitation Service of the Military Hospital of Matanzas
The cerebrovascular disease is the third cause of death in the world
and one of the main disability causes. A descriptive study was
conducted in the Rehabilitation Service of the Military Hospital of
Matanzas, with the objective of describing the behaviour of the
patients with cerebrovascular diseases assisted there from January
2011 to June of 2012.
encephalic
vascular
The variables used were: sex, age, type of
accident,
personal
pathological
history,
complications in the rehabilitation, modalities of the rehabilitative
treatment, time of evolution, grade of disability to carry out the daily
life activities (Barthel Index). The cerebrovascular disease was
predominant in the female sex; the average age was 68,6 years. A
higher incidence of the ischemic encephalic vascular accidents was
proved. The painful shoulder and spasticity were identified as the
most frequent complications. The most used modalities of treatment
were the kinesiotherapy and ambulation. The gain in the Barthel
Index was bigger in patients with less than three months of evolution.
Palabras
clave:
enfermedad
cerebrovascular,
discapacidad,
descriptivo, comportamiento, adulto.
Key
words:
cerebrovascular
disease,
disability,
descriptive,
behavior, adult.
4.
Sistema
de
acciones
para
la
prevención
de
la
neurotoxoplasmosis en personas con VIH y SIDA
System of actions to prevent neurotoxoplasmosis in persons
with HIV and AIDS
Neurotoxoplasmosis
expresses
mainly
is
in
associated
persons
to
with
immunodeficiency
HIV
and
AIDS;
it
and
is
it
the
opportunistic infection that more frequently affects the nervous
system
in
inmunodepressed
persons
so
any
approach
to
its
prevention from the methodology of pairs allows decreasing risks and
damages.
We
developed
a
system
of
actions
for
preventing
neurotoxoplasmosis in persons with HIV and AIDS. We describe the
capacitation of trainers which began with the diagnosis of attitudes
based in knowledge and practices indicating the risk perception of the
Toxoplasma gondii infection. Persons with HIV formed as trainers
have positive attitudes for recognizing the risk of neurotoxoplasmosis
as opportunistic disease and being ready to multiply knowledge
because they acted as pair educators.
The implementation of the
three first stages of the action system by volunteers professionalized
in the theme facilitates the health professionals’ actions in the way
for the secondary and tertiary prevention. The purpose of developing
a system of actions for the neurotoxoplasmosis primary prevention,
early detection and opportune treatment in persons with HIV and
AIDS was achieved through representers of the mutual help teams of
the country.
Identifying attitudes toward neurotoxoplasmosis as
opportunistic disease in persons with HIV and AIDS was of great
value, as it makes easy the way to the secondary prevention through
the specific therapeutic.
Palabras
claves:
neurotoxoplasmosis,
sistema
de
acciones,
capacitación de capacitadores.
Key words: neurotoxoplasmosis, system of actions, capacitation of
the trainers
5. Diagnóstico ambiental para agroecosistemas con probables
riesgos a la salud por presencia de contaminación por metales
pesados
Environmental diagnosis for agroecosystems with probably
health risks due to the presence of heavy metal contamination
The environmental management was assessed in 17 agroecosystems
with probable health risks due to the presence of heavy metal
pollution, by selecting variables and supporting on the qualitative
analysis tool support. The development of the environmental analysis
allowed determining the main problems in the studied areas.
It
was
concluded
that
the
management
performed
in
these
agroecosystems is inefficient. There it was evident the deterioration
of the natural resources inserted in the productive dynamic, and also
the incidence of the transmissible and non-transmissible diseases
keeping a close relationship with environmental problems. We made
the proposal of measures to mitigate the main problems identified in
the studied area.
Palabras
clave:
gestión
ambiental,
metales
pesados,
agroecosistemas, riesgos, salud.
Key
words:
environmental
management,
heavy
metals,
agroecosystems, risks, health.
6. Caracterización clínico epidemiológica de pacientes con
infarto agudo del miocardio no trombolizados en el Hospital
General Orlando Pantoja Tamayo, municipio Contramaestre
Clinical-epidemiologic characterization of non thrombolyzed
patients
Hospital
with
acute
Orlando
myocardium
Tamayo
infarct
Pantoja,
at
the
General
municipality
of
Contramaestre
The ischemic cardiopathy has a high morbimortality all around the
world. A cross-sectional descriptive study was carried out with the
objective of clinically and epidemiologically characterizing 43 patients
diagnosed with acute myocardial infarct who did not received
thrombolytic treatment in the General Hospital Orlando Pantoja
Tamayo of the municipality of Contramaestre, from January to
December 2012, with a predominance of the male sex and the age
group from 61 to 70 years old, with 2 or more coronary risk facts,
being significant dyslipidemia, obesity and arterial hypertension. The
arrival time delayed more than 12 hours was the main cause
disqualifying
thrombolysis
application,
mainly
caused
by
the
ignorance of the alarm signs motivating the visit to the doctor from
the part of the patient. There was a predominance of the lower side
infarct and an average hospital staying of more than 12 days.
Palabras clave: cardiopatía isquémica, infarto agudo del miocardio,
trombolisis.
Key words: ischemic cardiopathy, acute myocardial infarction,
thrombolysis.
7.
Evaluación
de
calidad
en
la
colangiopancreatografía
retrógrada endoscópica en el Hospital Universitario Clínico
Quirúrgico Comandante Faustino Pérez Hernández
Quality
assessment
of
the
endoscopic
retrograde
cholangiopancreatography at the Teaching Clinical surgical
Hospital Comandante Faustino Pérez Hernández.
Fundament: It is responsibility of the endoscopists to guarantee
carrying out quality procedures, based on the parameters defined by
the different endoscopic societies around the world.
Objective: To evaluate the quality of health care of patients to whom
an endoscopic retrograde cholangiopancreatography was carried out
in the Hospital Faustino Pérez Hernández.
Methods: A research evaluating the quality of the endoscopic
retrograde cholangiopancreatography was carried out, describing the
results of the procedures performed in patients whom it was indicated
in the Teaching Clinical Surgical Hospital Comandante Faustino Pérez
Hernández, of Matanzas, in the period from February 23th 2010 to
February 23th 2012. Applying the inclusion and exclusion criteria, the
studied population was formed by 159 patients. As variables we
analyzed quality indicators: procedure indications, frequency of
cannulation in intact papilla, technical success in extracting prosthesis
calculi,
and
prostheses.
technical
success
in
putting
distal
and
proximal
Results: the main procedure indication was based on clinical,
enzymatic and imaging criteria. It was achieved an effectiveness of
the desired duct cannulation
of 93, 71 %. The therapeutic
effectiveness in extraction choledocian lithiasis was 80,76 % in the
first attempt. The biliary duct through prosthesis in distal stenosis
was achieved in 90.9 % of the patient and in 40 % of the proximal
stenosis cases. There were complications in 7.45 % of the cases and
mortality was 1.8 %.
Conclusions: During the studied period the patients received health
care with good quality parameters.
Palabras
clave:
calidad,
colangiopancreatografía
retrógrada
endoscópica, complicaciones.
Key
words:
quality,
retrograde
endoscopic
cholangiopancreatography, complications.
8. Utilización inadecuada de los avances científicos técnicos
del laboratorio clínico y del método clínico. Repercusión en los
servicios de salud
Inadequate usage of the scientific-technical advances of
clinical laboratory and clinical method. Repercussion on health
care services.
The clinical laboratory research have been influenced by the
scientific-technical
advances
of
the
last
years,
consequently
nowadays there it is offered a great variety of examinations allowing
a better diseases
prevention, diagnosis, control and prognosis, but
they cannot, and should not surrogate the clinical method. We carried
out a review of the sources available in Infomed and books related
with the theme, and analyzed how the inadequate usage of the
laboratory tests and the clinical method, on non-scientific bases,
affects the quality of the health services in our settings, and identified
that main generated problems are the damage of physician-patient
relationships, the obstruction and delay of the certain diagnosis,
putting up the prices of the health care services, overwork for
laboratory technicians, and the incorrect learning of the usage of
diagnostic means by the students among others.
Palabras clave: laboratorio clínico, método clínico, revolución
científico-técnica.
Key words: Clinical laboratory, clinical method, scientific-technical
revolution.
9. Tiroiditis de Quervain. Informe de caso
De Queravin’s thyroiditis. Inform of a case
This entity probably has a viral origin. The symptoms usually began
after an infection of the upper respiratory ways and are characterized
by general discomfort, mild fever and pain, generally unilateral, on
the thyroid or referred to ears and jawbone. In the exploration, there
is a great sensibility at the touch of the thyroid, nodular and
increased in size. Sometimes there is no pain, being rare the debut
with signs of serious hyperthyroidism. What it is characteristic is the
increase of the sedimentation speed and the decrease of the thyroidal
capture of radioactive iodine. Respecting the hormonal levels, in the
first stage T4 and T3 are increased and TSH eliminated; lately, as the
hormonal gland gets empty, there is a stage of hypothyroidism. The
differential diagnosis should be established with the serious disease
and with the silent thyroiditis. The process evolves during several
months achieving the complete recovering of the thyroidal function.
In those milder cases, it is usual to control the symptoms with anti
inflammatory drugs, being necessary the use of the steroidal ones in
most in the most serious cases. It is not indicated the treatment with
anti thyroids and propranolol may be used to control the symptoms of
hyperthyroidism.
Having a patient with these characteristics we
decided to present the case.
Palabras claves: tiroiditis de Quervain, clínica, diagnóstico
diferencial
Key words: De Quervain´s thyroiditis , clinic, differential diagnosis
10. Tumor de Vanek o pólipo fibroide inflamatorio. Reporte de
un caso
Vanek's tumor or inflammatory fibroid polyp. Report of a
case
The Vanek's tumor or inflammatory fibroid polyp (IFP) is a rare
benign lesion of submucosal location, not encapsulated, that may be
located throughout the digestive tract, being more common in the
gastric antrum (80%), although it has also been described in the
gastroesophageal junction, duodenum, jejunum, ileum and colon. It
is the less frequent benign gastric tumor (1-4%) with slight
predominance in males and a peak incidence after the sixth decade of
life, being its process of getting malignant an exceptional event. This
case report presents a 47-year-old male patient with a Vanek's tumor
of antral localization that was diagnosed at the Teaching Provincial
Hospital Arnaldo Milian Castro, of Santa Clara.
Palabras
clave: pólipo
fibroide
inflamatorio,
tumor de
Vanek,
Vanek´s
tumor,
informe histopatológico.
Key
words:
inflammatory
fibroid
polyp,
histopathologic inform.
11.
Sindactilia
compleja
de
la
mano,
un
reto
difícil.
Presentación de dos casos
Complex hand syndactyly, a difficult challenge. Presentation
of two cases
We present two cases of complex hand syndactyly that were
surgically treated in early ages. In the first case a boy aged two years
was operated, with atrophy of the left upper member, total
syndactyly of the fingers and agenesis of the first phalanx of the third
finger. In the second case a girl aged one year was operated, with
syndactyly of the second-to-fourth fingers of the right hand, and the
particularity that between the second and the third finger she
presented the common proximal phalanx in the proximal half,
bifurcated in the distal half. In the first case we carried out a surgical
treatment
in
two
times
with
time
intervals
of
three
weeks,
satisfactorily obtaining the separation of the fingers, and in the
second case we got the separation of the second and the third finger,
lacking still one more operation.
The dissemination of this study
benefits
human
the
society,
promotes
health
and
establishes
principles for a multidisciplinary treatment.
Palabras clave: sindactilia de la mano, operación precoz.
Key words: Syndactyly of the hand, precocious operation.
12. Quiste renal gigante. Presentación de caso
Giant renal cyst. Presentation of a case
Frequently, cysts develop in the kidney. Among the diversity of renal
cysts, the simple one could be located inside the kidney or in its
surface and may be single or multiple, unilateral or bilateral, and
more frequent in the left kidney. Generally they are asymptomatic
and can reach a great size, called giant cysts. We present a patient
aged 66 years, entering the hospital with lumbar pain of one year
that gets worse despite the medical treatment for a presumed
sacrolumbal pain. It was found a remarked increase of the abdomen
volume, mainly in the direction of the upper hemiabdomen and it
feels a big tumoral mass filling the totality of the upper abdomen,
renitent and no painful. An abdominal computer tomography was
carried out, finding a multi partitioned hypodense image filling all the
left hemiabdomen with displacement of loops, left kidney and psoas
muscle. We arrived to the conclusion that it was a giant multi
partitioned cyst of the left kidney. A left paramedian supra and infra
umbilical laparotomy was carried out finding a renal cyst of the upper
pole of the left kidney surpassing media line and displacing aortal
artery to the right of the spinal column. A left nephrectomy was
carried out. It is rare a simple renal giant cyst surpassing the media
line and compressing so many intra abdominal organs; this is a fact
scarcely described in the medical literature. The surface physical
examination restricted to the organ producing the symptoms that
motivate the consultation, interferes the precocious diagnosis of
many diseases as it is shown in this patient. This is one of the most
frequent mistakes committed when applying the clinical method.
Palabras clave: quistes renales, riñón, enfermedad quística.
Key words: renal cysts, kidney, cystic disease.
13. Vigencia del pensamiento de Fidel Castro Ruz en la salud
pública cubana
Validity of Fidel Castro Ruz´ thoughts in Cuban public health
The current article allowed us to deal with thoughts of Fidel Castro
where the essential aspects conforming the organization of the public
health system in Cuban are highlighted, taking into account the
situation of public health before 1959 until current days. We
emphasized those aspects we think are important for the significance
the thoughts of the Cuban Revolution leader have for the Cuban
society.
Palabras claves: salud pública, Cuba, Fidel Castro Ruz
Key words: Public health, Cuba, Fidel Castro Ruz.
1. Video endoscopía de magnificación e imagen de banda
estrecha en la vigilancia del esófago de Barrett
Video endoscopic magnification and narrow band imaging in
the surveillance of Barrett´s esophagus
Introduction: Magnification high resolution video endoscopy, and
narrow band imaging (NBI) make possible the identification of
suspicious dysplasia´s areas in Barrett´s esophagus (BE), entity
considered
as
the
most
important
risk
factor
in
esophagus
adenocarcinoma.
Objective: To determinate the utility of the narrow band imaging in
the surveillance of the Barrett´s esophagus.
Methods: It was carried out a descriptive, prospective study at the
Gastroenterology Service of the Clinic- Surgical Teaching Hospital
Faustino Perez, from May 2010 to May 2011. Twenty-three patients
with previous diagnosis of Barrett´s esophagus were enrolled in it.
Results: The mean age was 57.6 years, with a predominance of the
male sex (73, 9%) were males. The mean Barrett’s esophagus length
was 2, 4 cm. The sensibility and specificity of ridge/villous pattern to
detect the specialized intestinal metaplasia (SIM) was 93, 6% and
90%, respectively. The sensibility and specificity of the irregular
mucous pattern to detect the high grade dysplasia was 100% and 98,
4%.
Conclusions: The magnifying video endoscopy and the narrow band
imaging showed a high precision for detecting the specialized
intestinal metaplasia and for identifying focuses of high grade
dysplasia in Barrett’s esophagus on the basis of mucosal and vascular
endoscopic patterns.
Palabras clave: esófago de Barrett, displasia, imagen de banda
estrecha.
Key words: Barrett´s esophagus, dysplasia, narrow band imaging.