New obstetric systemic inflammatory response syndrome criteria for early identification of high-risk of sepsis in obstetric patients.

OBJECTIVES: We aimed to establish new cut-off values for SIRS (Systemic Inflammatory Response Syndrome) variables in the obstetric population. METHODS: A prospective cohort study in pregnant and postpartum women admitted with systemic infections between December 2017 and January 2019. Patients were divided into three cohorts: Group A, patients with infection but without severe maternal outcomes (SMO); Group B, patients with infection and SMO or admission to the intensive care unit (ICU); and Group C, a control group. Outcome measures were ICU admission and SMO. The relationship between SIRS criteria and SMO was expressed as the area under the receiver operating characteristics curve (AUROC), selecting the best cut-off for each SIRS criterion. RESULTS: A total of 541 obstetric patients were enrolled, including 341 with infections and 200 enrolled as the reference group (Group C). The patients with infections included 313 (91.7%) in Group A and 28 (8.2%) in Group B. There were significant differences for all SIRS variables in Group B, compared with Groups A and C, but there were no significant differences between Groups A and C. The best cut-off values were the following: temperature 38.2 °C, OR 4.1 (1.8-9.0); heart rate 120 bpm, OR 2.9 (1.2-7.4); respiratory rate 22 bpm, OR 4.1 (1.6-10.1); and leukocyte count 16,100 per mcl, OR 3.5 (1.6-7.6). CONCLUSIONS: The cut-off values for SIRS variables did not differ between healthy and infected obstetric patients. However, a higher cut-off may help predict the population with a higher risk of severe maternal outcomes.

A novel dissector device that separates anatomic structures during laparoscopic surgery.

OBJECTIVE: To describe a novel dissector device useful in laparoscopy, better definition of anatomic structures to have a better dissection, separation, and cleaning of the structures. METHOD: The endoscopic dissector DisePad was designed and developed at the experimental surgery department of Centro Médico Nacional 20 de Noviembre, and properly patented at Instituto Mexicano de la Propiedad Industrial (title 3512). RESULTS: The tip of the device is the most important component, by its direct contact with the different tissues, consists of a cotton-polyester black cloth impregnated with a special gel immersed into a hot saline solution. Once soaked the tip maintains the solution temperature on itself. CONCLUSIONS: This device has been used in 364 laparoscopic procedures demonstrating, its utility to visualize, separate and clean anatomical structures without thermal lesion, tear, hemorrhage or visceral perforation.

OBJETIVO: Describir un nuevo dispositivo disector en laparoscopia, con una mejor definición de las estructuras anatómicas para obtener una mejor disección,separación y limpieza de las estructuras. MÉTODO: El disector endoscópico DisePad fue diseñado y desarrollado en el servicio de cirugía experimental del Centro Médico Nacional 20 de Noviembre, y patentado ante el Instituto Mexicano de la Propiedad Industrial (registro n.º 3512). RESULTADOS: El componente más importante del disector es la punta que tiene contacto con los tejidos: es una tela de algodón-poliéster negra impregnada en un gel (patentado) que, al ser sumergido en un termo con solución salina caliente, permite retener la temperatura. CONCLUSIONES: Este dispositivo ha sido utilizado en 364 procedimientos quirúrgicos por vía laparoscópica y ha demostrado ser útil para visualizar, separar y limpiar estructuras anatómicas sin producir daño por lesión térmica, desgarre, hemorragia ni perforación visceral.

Clinical Reasoning: Adult Patient Presenting With Spine Pain Following a Motor Vehicle Accident.

A 52-year-old woman with a complex medical history, including a history of consanguinity, developed refractory uncontrollable spine pain after a motor vehicle accident 2 years before presentation. There were no well-defined findings on clinical examination. She was found to have mildly elevated serum creatine phosphokinase levels, and spine imaging revealed fatty replacement and atrophy affecting predominantly lumbar paraspinal muscles. Initial EMG sampling of multiple limb muscles was normal. However, a follow-up concentric needle examination sampling paraspinal and trunk muscles showed abundant myotonic discharges, fibrillations and positive sharp waves, and myopathic motor unit action potential changes. This pattern of neurophysiologic abnormalities prompted the search for a myopathic disorder, which was ultimately confirmed with additional studies. This case highlights the critical role of neurophysiologic evaluation of paraspinal and other trunk muscles in the disambiguation of clinical and imaging data, helping to establish the diagnosis of a rare but treatable myopathy at early disease stages.

Autoantibodies Against Trisulfated Heparin Disaccharide and Fibroblast Growth Factor Receptor-3 May Play a Role in the Pathogenesis of Neuropathic Corneal Pain.

PURPOSE: The aim of this study was to describe cases of patients with presumable dysimmune small-fiber neuropathy (SFN)-related neuropathic corneal pain (NCP), presenting with autoantibodies against trisulfated heparin disaccharide (TS-HDS) or fibroblast growth factor receptor-3 (FGFR-3). METHODS: This study was a case series of 3 patients with NCP with positive anti-TS-HDS and/or anti-FGFR-3 autoantibodies and systemic SFN as confirmed by positive skin biopsy results. RESULTS: All 3 patients were women with a mean age of 34.3± 6.1 years. They suffered from moderate to severe persistent chronic ocular discomfort (10/10, 10/10, and 9/10 on a visual analogue scale, respectively). Although 1 patient suffered from ocular pain and photophobia alone, the other 2 patients experienced additional non-ocular pain. One of the patients had pain on her face and head, and 1 patient reported neck and lower back pain. Two patients had high anti-TS-HDS IgM titers, whereas 1 patient had both high anti-TS-HDS IgM and anti-FGFR-3 IgG titers. Skin biopsy confirmed the presence of SFN in all patients by demonstrating decreased intraepidermal nerve fiber density. CONCLUSIONS: The presence of anti-TS-HDS and anti-FGFR-3 autoantibodies in patients with NCP with positive skin biopsy findings for SFN highlights the potential role of dysimmune SFN in the pathogenesis of this disease.

Direct corticospinal control of force derivative.

During simultaneous generation of static and dynamic forces, motor cortical signals only predict the dynamic components, suggesting a key role in the coding of force changes. However, such a role is obscured by uncertainties regarding the representation of dynamic force signals in corticospinal outputs. We used transcranial magnetic stimulation (TMS) of the motor cortex in humans during a task that dissociated the direction of instantaneous net force and that of force derivative. The direction of TMS-evoked force outputs was closely associated with that of the force derivative, and had no relationship with that of the net force generated simultaneously, even though the magnitude of the instantaneous net force largely exceeded that of the force derivative. This observation supports the hypothesis that during dynamic force generation, the motor cortex and the corticospinal system assume a pivotal role in coding the direction of force changes, through selective recruitment of spinal motoneurons.

Developmental exposure to sertraline impaired zebrafish behavioral and neurochemical profiles.

The number of people suffering from mental health problems is rising, with anxiety and depression now the most commonly diagnosed psychiatric conditions. Selective serotonin reuptake inhibitors (SSRIs) are one of the most prescribed pharmaceuticals to treat these conditions, which has led to their common detection in many aquatic ecosystems. As the monoaminergic system shows a high degree of structural conservation across diverse animal phyla, a reasonable assumption is that the environmental levels of SSRIs in surface water can lead to adverse effects on fish and other aquatic wildlife. For instance, Sertraline (SER), a widely prescribed SSRI, has been shown to induce adverse effects in fish, albeit most of the reports used exposure concentrations exceeding those occurring in natural environments. Therefore, there is still a great lack of knowledge regarding SERs effects in fish species, especially during early life stages. This study describes the evaluation of developmental exposure of zebrafish (Danio rerio) to environmentally relevant concentrations of SER (from 0.01 to 10 µg/L), using a battery of key survival behaviors and further relating them with the expression of genes and neurochemical profiles of the monoaminergic system. We found that developmental exposure to SER did not affect embryo morphogenesis and growth. However, concentrations as low as 0.1 µg/L induced hypolocomotion and delayed learning. The observed behavioral impairment was associated with augmented serotonin levels rather than other neurochemicals and molecular markers, highlighting the relationship between serotonin signaling and behavior in zebrafish.

Computational classifiers for predicting the short-term course of Multiple sclerosis.

BACKGROUND: The aim of this study was to assess the diagnostic accuracy (sensitivity and specificity) of clinical, imaging and motor evoked potentials (MEP) for predicting the short-term prognosis of multiple sclerosis (MS). METHODS: We obtained clinical data, MRI and MEP from a prospective cohort of 51 patients and 20 matched controls followed for two years. Clinical end-points recorded were: 1) expanded disability status scale (EDSS), 2) disability progression, and 3) new relapses. We constructed computational classifiers (Bayesian, random decision-trees, simple logistic-linear regression-and neural networks) and calculated their accuracy by means of a 10-fold cross-validation method. We also validated our findings with a second cohort of 96 MS patients from a second center. RESULTS: We found that disability at baseline, grey matter volume and MEP were the variables that better correlated with clinical end-points, although their diagnostic accuracy was low. However, classifiers combining the most informative variables, namely baseline disability (EDSS), MRI lesion load and central motor conduction time (CMCT), were much more accurate in predicting future disability. Using the most informative variables (especially EDSS and CMCT) we developed a neural network (NNet) that attained a good performance for predicting the EDSS change. The predictive ability of the neural network was validated in an independent cohort obtaining similar accuracy (80%) for predicting the change in the EDSS two years later. CONCLUSIONS: The usefulness of clinical variables for predicting the course of MS on an individual basis is limited, despite being associated with the disease course. By training a NNet with the most informative variables we achieved a good accuracy for predicting short-term disability.

Giant cell myositis associated with concurrent myasthenia gravis: a case-based review of the literature.

The term "giant cell myositis" has been used to refer to muscle diseases characterized histologically by multinucleated giant cells. Myasthenia gravis is an autoimmune neuromuscular junction disorder. The rare concurrence of giant cell myositis with myasthenia gravis has been reported; however, the clinical and histological features have varied widely. Here, we present such a case and a review of the literature. An 82-year-old woman admitted for subacute, progressive, proximal muscle weakness developed acute-onset dysphagia, dysphonia, and respiratory distress 5 days after admission. Laboratory findings were positive for acetylcholine receptor binding antibodies and striational muscle antibodies against titin. Muscle biopsy demonstrated widespread muscle fiber necrosis with multinucleated giant cells, consistent with giant cell myositis. She died despite treatment with pulse methylprednisolone and plasma exchange. A literature review of the PubMed and Scopus databases from 1944 to 2020 identified 15 additional cases of these co-existing diagnoses. We found that giant cell myositis with myasthenia gravis primarily affects female patients, is typically diagnosed in the 6-7th decades, and is characterized by the presence of thymoma. Muscle histology predominantly shows giant cell infiltrate without granulomas. The onset of myasthenia gravis symptoms may precede, follow, or coincide with symptoms of myositis. Treatment with thymectomy, anticholinesterase inhibitors, or immunosuppressive therapy may lead to favorable clinical outcomes.

An efficient retinal blood vessel segmentation in eye fundus images by using optimized top-hat and homomorphic filtering.

BACKGROUND AND OBJECTIVE: Automatic segmentation of retinal blood vessels makes a major contribution in CADx of various ophthalmic and cardiovascular diseases. A procedure to segment thin and thick retinal vessels is essential for medical analysis and diagnosis of related diseases. In this article, a novel methodology for robust vessel segmentation is proposed, handling the existing challenges presented in the literature. METHODS: The proposed methodology consists of three stages, pre-processing, main processing, and post-processing. The first stage consists of applying filters for image smoothing. The main processing stage is divided into two configurations, the first to segment thick vessels through the new optimized top-hat, homomorphic filtering, and median filter. Then, the second configuration is used to segment thin vessels using the proposed optimized top-hat, homomorphic filtering, matched filter, and segmentation using the MCET-HHO multilevel algorithm. Finally, morphological image operations are carried out in the post-processing stage. RESULTS: The proposed approach was assessed by using two publicly available databases (DRIVE and STARE) through three performance metrics: specificity, sensitivity, and accuracy. Analyzing the obtained results, an average of 0.9860, 0.7578 and 0.9667 were respectively achieved for DRIVE dataset and 0.9836, 0.7474 and 0.9580 for STARE dataset. CONCLUSIONS: The numerical results obtained by the proposed technique, achieve competitive average values with the up-to-date techniques. The proposed approach outperform all leading unsupervised methods discussed in terms of specificity and accuracy. In addition, it outperforms most of the state-of-the-art supervised methods without the computational cost associated with these algorithms. Detailed visual analysis has shown that a more precise segmentation of thin vessels was possible with the proposed approach when compared with other procedures.

Lumbar ligamentum flavum burden: Evaluating the role of ATTRwt amyloid deposition in ligamentum flavum thickness at all lumbar levels.

BACKGROUND: Wild-type transthyretin (ATTRwt) amyloid deposition has been found in the ligamentum flavum (LF) of patients undergoing spinal stenosis surgery. Our group previously reported that ATTRwt amyloid is associated with an increased lumbar ligamentum flavum thickness at symptomatic levels that required surgery. A comprehensive evaluation of LF thickness at asymptomatic levels in addition to symptomatic, treated levels has never been performed in ATTRwt patients. In this study, we compare the total LF thickness of all lumbar levels (lumbar LF burden) in ATTRwt and non-ATTRwt patients. METHODS: We retrospectively identified 177 patients who underwent lumbar spine surgery. Ligamentum flavum thickness of 885 lumbar levels was measured on T2-weighted axial MRI. Amyloid presence was confirmed through Congo red staining of specimens, and subtype of ATTRwt was confirmed using mass-spectrometry and gene sequencing. RESULTS: Of the 177 patients, 30 (16.9%) were found to have ATTRwt in the ligamentum flavum. One hundred and fifty ATTRwt levels and 735 non-ATTRwt levels were measured by four different reviewers, with an intraclass coefficient (ICC) of 0.79. Mean ligamentum flavum thickness was 4.64 (±1.31) mm in the ATTRwt group and 3.99 (±1.45) mm in the non-ATTRwt group (p < 0.001). The lumbar LF burden (sum of ligamentum flavum thickness at all lumbar levels) for ATTRwt patients was 23.22 (±4.48) mm, and for non-ATTRwt patients was 19.96 (±5.49) mm (p = 0.003) CONCLUSION: The lumbar LF burden is greater in patients with ATTRwt amyloid compared to non-ATTRwt patients. This supports prior evidence that ATTRwt amyloid deposition might be associated with increased LF thickness and lumbar stenosis. This potential association requires more research and could be an important finding, as medications have recently become available that can treat patients with ATTRwt amyloid deposition.

Increased thickness of lumbar spine ligamentum flavum in wild-type transthyretin amyloidosis.

BACKGROUND: Wild-type transthyretin (ATTRwt) amyloid deposits have been found in the ligamentum flavum of patients undergoing surgery for spinal stenosis. The relationship between ATTRwt and ligamentum flavum thickness is unclear. We used pre-operative magnetic resonance imaging (MRI) to analyze ligamentum flavum thickness in lumbar spinal stenosis patients with and without ATTRwt amyloid. METHODS: We retrospectively identified 178 patients who underwent lumbar spine surgery. Ligamentum flavum thickness of 253 specimens was measured on T2-weighted axial MRI. Amyloid presence was confirmed through Congo red staining of specimens, and ATTRwt was confirmed using mass-spectrometry and gene sequencing. RESULTS: Twenty four of the 178 patients (13.5%) were found to have ATTRwt in the ligamentum flavum. Forty ATTRwt specimens and 213 non-ATTRwt specimens were measured. Mean ligamentum flavum thickness was 4.92 (±1.27) mm in the ATTRwt group and 4.00 (±1.21) mm in the non-ATTRwt group (p < 0.01). The ligamentum flavum was thickest at L4-L5, with a thickness of 5.15 (±1.27) mm and 4.23 (±1.29) mm in the ATTRwt and non-ATTRwt group, respectively (p = 0.007). There was a significant difference in ligamentum flavum thickness between ATTRwt and non-ATTRwt case for both patients younger than 70 years (p = 0.016) and those older than 70 years (p = 0.004). ATTRwt patients had greater ligamentum flavum thickness by 0.83 mm (95% confidence interval (CI): 0.41-1.25 mm, p < 0.001) when controlled for age and lumbar level. CONCLUSION: Patients with ATTRwt had thicker ligamentum flavum compared to patients without ATTRwt. Further studies are needed to investigate the pathophysiology of ATTRwt in ligamentum flavum thickening.

Paired-pulse transcranial magnetic stimulation during preparation for simple and choice reaction time tasks.

Motor preparation for execution of both simple and choice reaction time tasks (SRT and CRT) involves enhancement of corticospinal excitability (CE). However, motor preparation also implies changes in inhibitory control that have thus far been much less studied. Short-interval intracortical inhibition (SICI) has been shown to decrease before CE increases. Therefore we reasoned that, if SICI contributes to inhibitory control of voluntary movement during the preparatory phase, it would be larger in CRT than in SRT because of the need to keep the movement unreleased until the uncertainty resolves on which task is required. We measured changes in SICI and in CE at different time points preceding motor reaction in normal subjects. Single-pulse transcranial magnetic stimulation (spTMS) and paired-pulse transcranial magnetic stimulation (ppTMS) produced time-dependent changes in both SRT and CRT, with shortening when applied close to the presentation of the imperative signal ("early") and lengthening when applied near the expected reaction ("late"). In addition, at all stimulation time points, reaction time was shorter with ppTMS than that with spTMS, but there was no consistent association between the amount of SICI and reaction time changes. At early stimulation time points, CE was reduced in CRT but not in SRT. However, SICI in CRT was not different from SICI in SRT. At late stimulation time points, SICI decreased just before enhancement of CE. Our findings indicate that inhibitory circuits other than SICI are responsible for setting the level of CE at earlier parts of the reaction time period. Although the decrease in SICI may contribute to the increase in CE at the last part of the premotor period, the two phenomena are not dependent on each other.

Where Neurosurgery Meets Heart Failure: A Case Report of a Patient with Amyloid Transthyretin Wild Type in the Ligamentum Flavum and Cardiac Tissue with Bilateral Carpal Tunnel Syndrome.

BACKGROUND: Transthyretin wild-type (ATTRwt) amyloidosis is a systemic process resulting in deposition of misfolded transthyretin protein in several different tissues throughout the body. It is known to be a cause of progressive, life-threatening cardiomyopathy and lumbar spinal stenosis and carpal tunnel syndrome. CASE DESCRIPTION: Here we present the case of a 71-year-old man who has clinical manifestations of all 3 entities over several years, providing a picture of the natural history of ATTRwt amyloidosis. This patient eventually underwent a heart transplant because of progressive cardiac amyloidosis (CA) resulting in end-stage heart failure. However, symptoms in carpal tunnel and lumbar spine manifested years before the symptoms of heart failure. ATTRwt amyloidosis may present as a clinical triad of lumbar stenosis, carpal tunnel syndrome, and heart failure. Recently developed medications have shown efficacy in slowing the progress of systemic and cardiac amyloidosis. CONCLUSIONS: Knowing that extracardiac symptoms may occur first, we propose that sending ligamentum flavum and flexor tenosynovium for pathologic evaluation may be a unique opportunity to screen and treat a population of patients at risk for developing CA and heart failure.

Robot-assisted surgery and endoscopic management of gastrocolic fistula: A rare complication of acute pancreatitis in a patient who had undergone sleeve gastrectomy.

Ten years after undergoing sleeve gastrectomy, a 39-year-old man developed pancreatitis and, after recovery, presented with severe diarrhea. An image study showed barium contrast passing from the stomach to the colon. Before surgery, initial treatment consisted of parenteral nutrition and antibiotics. The patient then underwent robot-assisted resection of a gastrocolic fistula and omentoplasty. However, 72 h after surgery, the amount of suction drainage suggested that the fistulous track repair was leaking. Therefore, we decided to perform endoscopy to place a self-expanding covered stent at the gastroesophageal junction as well as a nasojejunal tube to continue nutritional supplementation. After the patient had fasted for 2 weeks, there was no evidence of leakage in the image studies. The patient was discharged after he had clinically improved, and the stent was removed at the end of 8 weeks. The combination of robot-assisted surgery and endoscopic management is effective for treating gastrocolic fistula.

Motor cortex excitability changes during imagery of simple reaction time.

Imagining motor actions is enough to enhance cortical motor excitability. However, the fact that execution of the motor task has to be inhibited should have a correlate on the extent of cortical excitability enhancement. Therefore, we examined the possible differences between real and motor imagery of simple reaction time tasks (SRT) in the facilitation of the motor-evoked potential (MEP) to transcranial magnetic stimulation (TMS) and in the reduction of short-interval intracortical inhibition (SICI) taking place before the movement onset. Thirteen healthy volunteers were requested to perform visual real or imaginary SRT tasks (rSRT and iSRT) with their dominant hand. For rSRT, subjects had to perform a rapid isometric squeeze as soon as possible after the imperative signal. For iSRT they had to imagine the same movement without actually doing it. Electromyographic (EMG) signals were recorded from the first dorsal interosseus (FDI) muscle. The mean EMG onset was calculated for each subject in rSRT trials. Single-and paired-pulse TMS (at an interstimulus interval of 2.5 ms) were applied at rest and at time intervals of -25, -50, -75, -100 and -125 ms before the expected real (rSRT) mean EMG onset. In rSRT there was a significant increase of MEP to single-pulseTMS at the intervals of -50 and -25 ms, and in iSRT at -50 ms in comparison to the rest condition. % SICI changes were significantly reduced at the intervals of -75, -50 and -25 ms, before EMG the onset in rSRT and at -50 and -25 in iSRT (P < 0.05) in comparison to % SICI changes at rest. The differences between MEPs to spTMS and MEP to ppTMS were significantly larger at rest, -125 and -100 ms intervals in rSRT, and at all intervals in iSRT. Imagining to move causes an increase in corticospinal excitability and a decrease in intracortical inhibition that follow a temporal profile similar to those observed with real movements. However, complete removal of SICI happened only in rSRT at the shortest intervals before the EMG onset. Such action may delineate new tool in motor rehabilitation of patients who have limitation to move.

Análisis de la producción científica de la Universidad de Ciencias Médicas de Granma en Scopus

Introducción: la evaluación científica y los estudios bibliométricos han devenido en procesos de gran interés e importancia debido a que la investigación científica es un indicador de calidad para las instituciones científicas y académicas. La Universidad de Ciencias Médicas de Granma es una institución de Educación Médica Superior cuya finalidad es la formación y desarrollo de las Ciencias Médicas en la región basada en la integración docencia-asistencia-investigación. Es por esto que se hace necesario comprender el impacto y el comportamiento de su producción científica desde una perspectiva internacional. Objetivo: analizar la producción científica de la Universidad de Ciencias Médicas de Granma en la base de datos bibliográfica Scopus. Métodos: se realizó un estudio bibliométrico retrospectivo y de carácter descriptivo de toda la producción científica de la Universidad de Ciencias Médicas de Granma, usando como fuente de información la base de datos Scopus. Resultados: se identificó una alta concentración de trabajos en idioma español y en revistas cubanas de Q4 aunque predominaron las investigaciones originales. La colaboración internacional se comportó favorable. Por último, el posicionamiento internacional de la universidad es todavía insustancial. Conclusiones: la producción científica de la UCMG presenta valores moderados en cuanto a los indicadores de productividad, visibilidad e impacto. Este comportamiento presenta una marcada tendencia al aumento para los últimos años y se prevé un mejoramiento de estos patrones en años futuros.

Introduction: scientific evaluation and bibliometric studies have become processes of great interest and importance because scientific research is a quality indicator for scientific and academic institutions. The University of Medical Sciences of Granma is an institution of Higher Medical Education whose purpose is the training and development of Medical Sciences in the region based on teaching-assistance-research integration. This is why it is necessary to understand the impact and behavior of its scientific production from an international perspective. Objective: to analyze the scientific production of the Granma University of Medical Sciences in the Scopus bibliographic database. Methods: a retrospective and descriptive bibliometric study of all the scientific production of the University of Medical Sciences of Granma was carried out, using the Scopus database as a source of information. Results: a high concentration of works in the Spanish language and in Cuban Q4 journals was identified, although original research predominated. International collaboration behaved favourably. Finally, the international positioning of the university is still insubstantial. Conclusions: the scientific production of the UCMG presents moderate values ​​in terms of indicators of productivity, visibility and impact. This behavior shows a marked upward trend in recent years and an improvement in these patterns is expected in future years.

Introdução: a avaliação científica e os estudos bibliométricos tornaram-se processos de grande interesse e importância, pois a pesquisa científica é um indicador de qualidade para as instituições científicas e acadêmicas. A Universidade de Ciências Médicas do Granma é uma instituição de Ensino Superior Médico cuja finalidade é a formação e o desenvolvimento das Ciências Médicas na região com base na integração ensino-assistência-pesquisa. Por isso, é necessário compreender o impacto e o comportamento de sua produção científica a partir de uma perspectiva internacional. Objetivo: analisar a produção científica da Universidade de Ciências Médicas do Granma na base de dados bibliográfica Scopus. Resultados: identificou-se alta concentração de artigos em periódicos Q4 espanhóis e cubanos, emboratenha predominado pesquisas originais. A colaboração internacional foi favorável. Por fim, o posicionamento internacional da universidade aindaé insubstancial. Conclusões: a produção científica da UCMG apresenta valores moderados em termos de indicadores de produtividade, visibilidade e impacto. Esse comportamento mostra uma acentuada tendência de aumento nos últimos anos e espera-se uma melhora nesses padrões nos próximos anos.

Herramienta para evaluar la comprensión de la Gestión de Información y del Conocimiento en Infomed / A Tool for Assessing the Understanding of Information and Knowledge Management at Infomed

Introducción: La información y el conocimiento constituyen recursos estratégicos en las organizaciones ya que garantizan una efectiva toma de decisiones y mayor adaptabilidad a contextos cada vez más dinámicos y cambiantes. Objetivo: Proponer una herramienta diagnóstica para evaluar la comprensión de la Gestión de Información y el Conocimiento en el Centro Nacional de Información de Ciencias Médicas/Infomed. Métodos: Se realizó un análisis de las particularidades de la Gestión de Información y el Conocimiento en las organizaciones. Se caracterizó el Centro Nacional de Información de Ciencias Médicas/Infomed, teniendo en cuenta su objeto social, estructura y actividad informacional. Resultados: Se propone una herramienta ajustada a las características de dicha entidad para el diagnóstico de la comprensión de la Gestión de Información y el Conocimiento. Esta herramienta diagnóstica esboza cuatro divisiones estructurales para la recogida de información. Su concepción y diseño valoran, entre otros aspectos de interés, los elementos cognitivos y de comportamiento de los trabajadores de cara a los procesos de Gestión de Información y el Conocimiento. Conclusiones: Esta herramienta permite diagnosticar el estado de la comprensión de la Gestión de Información y el Conocimiento en el Centro Nacional de Información de Ciencias Médicas/Infomed, sobre la base de la importancia de la identificación y el desarrollo de estos procesos en la organización. También tiene en cuenta la necesidad de articular aquellos componentes de la gestión desde todos los niveles de la organización con el propósito de fomentar una cultura informacional(AU)

Introduction: Information and knowledge are strategic resources in organizations, since they guarantee effective decision making and greater adaptability to increasingly dynamic and changing contexts. Objective: To propose a diagnostic tool for assessing the understanding of information and knowledge management at the Centro Nacional de Información de Ciencias Médicas/Infomed. Methods: An analysis was carried out of the particularities of information and knowledge management in organizations. Centro Nacional de Información de Ciencias Médicas/Infomed was characterized, taking into account its social purpose, structure and informational activity. Results: A tool adjusted to the characteristics of this entity is proposed for diagnosing the understanding of information and knowledge management. This diagnostic tool outlines four structural divisions for collecting the information. Its conception and design assess, among other aspects of interest, the cognitive and behavioral elements of the workers in the face of the information and knowledge management processes. Conclusions: This tool makes it possible to diagnose the state of understanding of information and knowledge management at Centro Nacional de Información de Ciencias Médicas/Infomed, based on the importance of identifying and developing these processes in the organization. It also takes into account the need to articulate those management components from all organizational levels and with the purpose of fostering an informational culture(AU)

Impacto de instituciones cubanas en la producción científica acerca de las Ciencias de la Salud

En el año 2021 se desarrollan investigaciones en el Centro Nacional de Información de Ciencias Médicas para analizar el comportamiento de la producción científica cubana en salud en varias bases de datos. Como resultado de estos procesos se generó una serie de informes bibliométricos enfocados en el apoyo a la toma de decisiones de los directivos del sistema. Uno de los componentes analizados fueron las instituciones cubanas que contribuyen a la producción científica del país en temas relacionados con la salud. Este trabajo tuvo como objetivo identificar las principales instituciones cubanas que más impacto tienen en la producción científica cubana relacionada con las Ciencias de la Salud. Se realizó un análisis bibliométrico descriptivo en múltiples fuentes de información. Los datos fueron extraídos durante los primeros meses del año 2021. Las instituciones investigativas de salud y centros de biotecnología son los que más aportan a las publicaciones. También contribuyen de forma elevada varios centros de enseñanza superior. Es la Universidad de La Habana la entidad que mayor cantidad de artículos tributa en todas las bases de datos, seguida por la Universidad de Ciencias Médicas de La Habana y la Universidad Central "Marta Abreu" de Las Villas. Esto destaca la importancia de las universidades y su rol para el desarrollo de la ciencia y la investigación en el país. Se detectaron problemas en los procesos de declaración de metadatos y errores en los nombres de las instituciones en las bases de datos, lo cual influye directamente en el comportamiento de la producción científica cubana en salud.

In the year 2021, research is being developed at the National Center for Medical Sciences Information to analyze the behavior of Cuban scientific production in health in several databases. As a result of these processes, a series of bibliometric reports were generated to support decision making by the system's managers. One of the components analyzed were the Cuban institutions that contribute to the country's scientific production in health-related topics. The objective of this work was to identify the main Cuban institutions that have the greatest impact on Cuban scientific production related to Health Sciences. A descriptive bibliometric analysis was carried out in multiple sources of information. The data were extracted during the first months of the year 2021. Health research institutions and biotechnology centers are the main contributors to publications. Several higher education centers also contribute a high number of publications. The University of Havana is the entity that contributes the largest number of articles in all the databases, followed by the University of Medical Sciences of Havana and the Central University "Marta Abreu" of Las Villas. This highlights the importance of universities and their role in the development of science and research in the country. Problems were detected in the processes of metadata declaration and errors in the names of the institutions in the databases, which directly influence the behavior of Cuban scientific production in health.