Introduccion: la fractura de cadera es una de las causas mas frecuentes de cirugia traumatologica. La seleccion del material de osteosintesis constituye el objetivo fundamental en el tratamiento quirurgico, lo que puede influir en el nivel de validismo alcanzado. Objetivo: evaluar el nivel de validismo en los pacientes intervenidos quirurgicamente, con diferentes implantes segun los diferentes tipos de fracturas del extremo proximal de femur. Atendidos en el Hospital Provincial Clinico Quirurgico “Comandante Faustino Perez Hernandez” de la provincia de Matanzas. Material es y m etodo s : se realizo un estudio prospectivo, longitudinal donde se estudiaron todos aquellos pacientes con fractura de cadera. En el periodo comprendido desde el 1er de enero del 2016 al 31 de diciembre del 2017. Resultados: predomino el sexo femenino con un 60 % y el grupo de edades de 70 a 79 anos para ambos sexos. Prevalecio la fractura extracapsular en un 74 %. El material de osteosintesis mas representado fue el clavo intramedular Gt y en las intracapsulares la protesis simple. El tiempo quirurgico se comporto con un tiempo menor a 2 h y el egreso antes de los 5 dias. El 48,2 % de los pacientes fueron evaluados de bueno segun nivel de validismo alcanzado posterior al tratamiento aplicado. Conclusiones: la fractura de cadera es propia de pacientes adultos mayores que sobrepasan los 65 anos. La intervencion quirurgica de urgencia con una adecuada seleccion del metodo de osteosintesis, disminuye un serio problema de salud en el contexto medico, social y epidemiologico cubano.
Introduction: the nurse who works in the primary health care consultations assumes the responsibility of providing comprehensive care to the relative who takes care of oncological patients. Objective: to design a proposal of upgrading to improve the performance of the nurse in the comprehensive care to the family with an oncological patient. Materials and methods: a development research was conducted in the Faculty of Medical Sciences Dr. Juan Guiteras Gener, of Matanzas, during the school year 2018-2019. The sample was 23 nurses from the primary health care offices of the municipality of Matanzas. The documents that support their professional performance were analyzed. A survey was designed to identify learning needs and also an observation guide to characterize the performance of the nursing professional. Interviews were conducted with supervisors and managers. Results: the analysis of the surveys applied to the chosen sample and the observations made to the activities carried out at home, made it possible to determine the learning needs for the improvement of the comprehensive care to the families with oncological patients. Interviews with supervisors and managers confirmed the necessity of the proposal. Conclusions: a postgraduate course was designed for the improvement of nursing professionals’ performance, aimed to the comprehensive care to families with oncological patients in the primary health care.
Introduccion : el cancer cervico uterino constituye un problema de salud para la humanidad. El estudio de sus factores de riesgo representa prioridad para el sistema de salud cubano. Objetivo: conocer el comportamiento de los factores de riesgo del cancer cervico uterino, en estudiantes de las carreras de Higiene-Epidemiologia-Vigilancia y Lucha Antivectorial de la Universidad de Ciencias Medicas de Matanzas. Materiales y metodos: investigacion descriptiva, transversal, retrospectiva que se inserto en el Programa Ramal Enfermedades Cronicas no Transmisibles. Se trabajo con el universo de 50 alumnos de las carreras de Higiene- Epidemiologia-Vigilancia y Lucha Antivectorial de la Universidad de Ciencias Medicas de Matanzas. Resultados: segun edad de inicio de las relaciones sexuales, se observo mayor predominio a los 14 anos de edad. Presencia de multiples companeros sexuales, relaciones sexuales desprotegidas, uso de tabletas anticonceptivas, habito de fumar, manipulaciones ginecologicas, asi como infecciones de transmision sexual. Especial significacion tuvo la evidencia de cifras significativas de multiples companeros sexuales y el uso de tabletas anticonceptivas. Entre la distribucion de motivos que impulsaron al inicio de relaciones sexuales, se destacaron los de experimentar sensaciones nuevas con el 28 %, y busqueda de placer con la pareja en 55 %. El 92 %, desconocian los factores de riesgo de la enfermedad. Conclusiones: los estudiantes presentaron factores de riesgo de considerable magnitud de padecer cancer cervico uterino.
Introduction: the current research arises motivated by the study of the variables of family functioning and psychological well-being in patresfamilias. Objective: to determine the influence of family functioning on the psychological well-being of patresfamilias who belong to the Ministry of International Compassion of the churches of the Nazarene in Ecuador Materials and method: an observational, cross-sectional and quantitative study was carried out, in 405 patresfamilias from the cities of Riobamba, Guaranda, Puyo and Montalvo, in Ecuador, in the period August-October 2020. An inquiry was applied through Google Forms. Data on family functioning and psychological well-being were processed in Microsoft Excel, and the SPSS 25 software was used for working Spearman correlation out. Results: the prevalence of a moderately functional family (50.9%) and low psychological well-being (61.5%) were evidenced. The correlation between the two study variables was rho=0.215. Families were mostly nuclear and married marital status predominated. Conclusions: it was determined that results were not conclusive, because there was not a correlation between the study variables: family functioning and psychological well-being. The authors inferred that there were other involved variables that need to be analyzed.
Introduction: psychosocial risks physically and mentally affect workers. The working conditions of university teachers involve academic and administrative responsibilities, exposing them to high levels of psychosocial risk. Objective: the objective of the study was to determine the relationship of psychosocial factors in teaching performance at a higher technological institute in Quito, Ecuador. Materials and methods: a quantitative, observational, transversal, prospective and analytical study was conducted in a population of 89 teachers. Because of its high reliability, the Silva Psychosocial Risk Factors survey was applied to assess risk factors in academic work. The teaching performance was measured according to the rating scale of the Ministry of Labor of Ecuador. Inferences and associations were calculated through the Chi squared test and the odds ratio . Results: 47.2 % of the teachers were women and 52.8 % were men. The 31-40 years old age-group predominated. Among the psychosocial risk factors, the parameters of work requirements predominated. 75.3 % showed average psychosocial risk, not reflected with teaching performance. Conclusions: It was stated the existence of psychosocial risk factors in teachers, related to the workload, content and characteristics of the task, among other aspects. We found that teaching performance was not affected by the presence of psychosocial risk factors.
The authors presented the clinical case of a seropositive patient, in advanced symptomatic phase. The patient attended the Internal Medicine Service of the Teaching Clinical Surgical Hospital Leon Cuervo Rubio of Pinar del Rio, presenting dyspnea, asthenia, anorexia and weight loss. On the oral examination, a tumor lesion was found making difficult to chew and swallow. A biopsy showed Kaposi sarcoma associated to HIV/AIDS. The torpid evolution and disease’s advanced stage propitiated the patient’s death.
Introduction: diabetes is a chronic endocrine-metabolic disorder that affects numerous organs and tissues. More than 90 % of those with it suffer from type 2 diabetes. This is accompanied by chronic complications, which can be prevented by adequate control of hyperglycemia and cardiovascular risk factors. Objective: to characterize the risk factors associated with type 2 diabetes mellitus in patients from the Family Physician's Office no. 27 of the Teaching Polyclinic Jose Jacinto Milanes, of the municipality of Matanzas. Materials and methods: a cross-sectional, descriptive study was carried out during the period from January to December 2019. The universe were 50 patients belonging to Family Physician's Office no. 27 of the Teaching Polyclinic Jose Jacinto Milanes, of the municipality of Matanzas, diagnosed with type 2 diabetes mellitus. Results: female sex predominated, and 24 % of patients were aged 55-59 years. According to the nutritional status, obesity was the more frequent. There was a family history of type 2 diabetes mellitus in 52 %. Conclusion: obesity, poor dietary habits, sedentary way of life, and arterial hypertension were the most frequent risk factors found in these patients.
Introduction: the spread of multi-resistant microorganisms in the hospital is a major epidemiological and therapeutic problem that particularly affects critical patients admitted to the Intensive Care Unit. Objective: to describe the behavior of nosocomial infections and antimicrobial resistance in the Intensive Care Unit. Materials and Methods: a descriptive, observational and prospective study was carried out in the Intensive Care Unit of the Teaching Clinic-Surgical Hospital Faustino Perez Hernandez, during the first half of 2020. The universe was formed by 102 patients who entered the Intensive Care Unit during the studied period, to whom microbiological studies were carried out. The analyzed variables were the following: causes of admission, age, nosocomial infections, ventilator-associated pneumonia, germs, antimicrobial resistance and mortality. The results were expressed in tables and percentage charts. Results: Male sex showed the highest number of nosocomial infection compared to the female, at different ages of life. The most common cause of admission was polytrauma. The most common site of nosocomial infection was the airway. Germs like fermentative Gram-negative bacilli and enterobacteria predominated. Antibiotics such as beta-lactamase inhibitors, other kinds of penicillin, quinolones, cephalosporin, aminoglycosides and meropenen have acquired a higher percent of resistance. Conclusions: nosocomial infection caused by bacteria that have developed multi-resistance to strategic antibiotics is a problem within the Intensive Care Unit, associated to mechanical ventilation, and leads to high mortality.
Introduction: the infection by Helicobacter pylori is the chronic bacterial disease that affects the human being with greater prevalence Objective: to identify the frequency of the infection by Helicobacter pylori and its relationship with variables considered risk factors for this infection. Materials and methods: a cross-sectional study was carried out in the teaching Polyclinic Camilo Cienfuegos, municipality Habana del Este, during 2018. In a universe of 42 patients aged 18 years and over, with clinical suspicion and endoscopic diagnosis of duodenal ulcer and histological study report for the diagnosis of the infection. A data collection form was made, which included variables such as: overcrowding, consumption water, place of birth, staying in an institution, contact with animals, and family history. The relationship within variables was found using the chi-square test (X 2 ) with statistical significance ɒ = 0.05, and there were identified variables significantly different from 0 (p < 0.05). The association strength was determined through odds ratio. Results: the prevalence was 59.5%. Statistical association was found and overcrowding (X 2 = 4.37, OR = 3.89), consumption water (X 2 = 4.92; OR = 3.43), contact with animals (X 2 = 7.41, OR = 6.17) and family history (X 2 = 13.18, OR = 13) were found risk factors for Helicobacter pylori infection. Conclusions: The study allowed to determine the prevalence of Helicobacter pylori infection and the main associated variables, coinciding with other reviewed studies dealing with the subject.
La atencion primaria de salud es el area de actuacion fundamental de la medicina familiar y una herramienta clave para su desarrollo. Al ser declarada como pandemia por la Organizacion Mundial de la Salud, la COVID-19 ha hecho que los sistemas de salud consideren los solidos servicios de atencion primaria como base de la respuesta ante esta emergencia. El objetivo del presente trabajo fue describir los desafios a los que se enfrentan los medicos de familia en la atencion a pacientes sospechosos o confirmados por la COVID-19. Es necesario que el personal de salud y toda la poblacion conozcan las caracteristicas del nuevo coronavirus. En Cuba, existe un Protocolo Nacional contra la COVID-19, en constante actualizacion, donde se definen los criterios de casos, las principales medidas preventivas y el tratamiento para combatir la enfermedad. El medico familiar debe establecer consultas de clasificacion para atender los pacientes con enfermedades respiratorias agudas; de esta manera se evita el contacto con los demas pacientes que acuden con otros problemas de salud. Asimismo, debe insistir en las medidas preventivas y tratar los casos sospechosos y confirmados, mantenerse actualizado, realizar pesquisa activa de los casos, garantizar la atencion de las personas que se encuentran en los centros de aislamiento, e investigar cada una de las caracteristicas de la enfermedad. A modo de conclusion, se plantea que la medicina familiar es necesaria para prevenir la enfermedad por coronavirus 2019. Son varios los retos y desafios que deben enfrentar los medicos de familia ante la pandemia.
Una pandemia ocurre cuando la epidemia traspasa las fronteras internacionales y generalmente, afecta un gran numero de personas. Varias son las pandemias que han afectado a la humanidad a traves de la historia. La enfermedad por coronavirus 2019, (COVID-19) causada por el virus SARS-CoV-2, fue catalogada como pandemia por la Organizacion Mundial de la Salud, en marzo del 2020. Se realizo una revision bibliografica sobre esta, otras enfermedades transmisibles y no transmisibles, asi como problemas de salud, que han azotado la humanidad durante los ultimos 100 anos. Estas enfermedades y problemas de salud afectan en pleno siglo XXI a todo el planeta y son igualmente, consideradas verdaderas pandemias. Las guerras, la contaminacion ambiental, la pobreza, el hambre, la infodemia, entre otras, junto a la COVID-19, deben igualmente levantar las alarmas sanitarias, cientificas, sociales, ambientales y politicas para evitarlas, controlarlas y erradicarlas.
Los defectos en la canalizacion de la membrana himeneal causan obstruccion del tracto genital femenino. Como consecuencia aparece hematocolpos, resultante de la acumulacion y retencion de secreciones cervicovaginales —sangre en utero y vagina—, ante la imposibilidad de su evacuacion por la presencia de un himen imperforado. Clinicamente aparece masa abdominal, asociada con malformaciones vaginales congenitas. Se presento el caso de una adolescente de 13 anos que refirio retencion urinaria, disuria, dolor y masa en hipogastrio, y ausencia de la menarquia a pesar de un desarrollo puberal en estadio Tanner III. Al realizar ultrasonido se constato sangre en el utero, debido a imperforacion himeneal que se resolvio mediante himenotomia. La patologia de himen imperforado con hematocolpos debe estar entre los posibles planteamientos sindromicos de aquellas pacientes con cuadros similares; puede diagnosticarse en la Atencion Primaria de Salud a partir de una detallada anamnesis y exploracion fisica, aunque la comprobacion requiere ecografia.
The Unit of Science, Technology and Innovation of the Territorial Delegation of the Ministry of Science, Technology and Environment in Matanzas promotes, since January 19 2018, the revival of the Productive Scientific Pole as a form of giving a better use to science done in Matanzas province and integrating the research centers and enterprises efforts in pursuit of the socioeconomic development of the territory. Currently, the province is involved in an effort for ensuring that every organization assumes its responsibility in setting in motion the Productive Scientific Pole with the delegation of the Ministry of Sciences, Technology and Environment as the coordinating entity. This paper is written with the aim of assessing the importance of the Productive Scientific Pole in increasing the impact of science and technique in solving the productive problems of the Matanzas territory. The current paper assesses the importance of the Productive Scientific Pole in increasing the impact of science and technique in solving the productive problems of the Matanzas territory.
Metabolic syndrome includes a set of cardiovascular risk factors associated with resistance to insulin, favoring the appearance of cardiovascular disease and diabetes mellitus type 2. Its etiology is attributed to the combination of genetic and environmental factors, associated to lifestyle, and favoring a proinflammatory and prothrombotic status that worsens the clinical characteristics of the patients with COVID-19. The objective of the review was to analyze the current state of the scientific knowledge in research on the interrelationship between glucide metabolism disorder s and metabolic syndrome, associated with the exacerbated proinflammatory condition in COVID-19 patients. Searches were conducted in PubMed, SciELO , CinicalKey , and LILACS databases. A relevant role in the metabolic syndrome pathogenesis is attributed to the inflammatory process generated by poor eating habits, high caloric overfeeding, and to sedentary lifestyle, and also to possible complications with associated comorbidities in COVID-19 patients. It is possible to reduce the metabolic syndrome inflammatory condition through life style and alimentary habits changes that prevent obesity and its effects on insulin resistance and propitiate the reduction of the disease severity associated with the inherent inflammatory processes.
Introduccion: en enero de 2000, comenzo la cirugia videolaparoscopica en el Hospital Militar Docente Dr. Mario Munoz Monroy, de la ciudad de Matanzas. El equipo quirurgico, en esa epoca, lo constituian cirujanos con varios anos de experiencia y con una solida formacion en cirugia convencional. Tambien poseian habilidades demostradas en la realizacion de colecistectomia a cielo abierto. A partir de 2011, una nueva generacion de cirujanos desarrollo la cirugia minimamente invasiva, con poca experiencia en cirugia a cielo abierto. Por lo tanto, se presento la contradiccion de que cada vez menos cirujanos tenian la experiencia tecnica que requieren los casos mas dificiles. Objetivo: determinar la seguridad en la realizacion de la colecistectomia laparoscopica. Materiales y metodos: Investigacion observacional, descriptiva y retrospectiva de los pacientes intervenidos de afecciones biliares benignas, por la tecnica de colecistectomia laparoscopica, entre enero de 2014 y diciembre de 2017. Resultados: fueron colecistectomizados 2 016 pacientes. De ellos, 1 759 (87 %) correspondieron al sexo femenino, y 257 (13 %) al masculino. Comorbilidades presentes en el 46,3 %. Cirugias: electivas, 1 801; urgentes, 215. Eventos adversos, 38 (1,88 %). Conversiones, 28 (1,3 %). Mortalidad operatoria, 5 (0,24 %). Conclusiones: resultan seguras las colecistectomias laparoscopicas por el bajo indice de eventos adversos, conversiones y mortalidad operatoria.
