Evaluación in vitro de la actividad antifúngica de extractos fluidos de Dichrostachys cinerea L. (marabú) frente a Candida albicans

Introducción: La Dichrostachys cinerea L. (marabú) es una planta que crece en Cuba, de la que se estudian propiedades medicinales. La resistencia de levaduras del género Candida a los antifúngicos sintéticos disponibles en la actualidad es cada vez mayor, por lo que se buscan nuevos compuestos de origen vegetal que puedan ser eficaces en el tratamiento de infecciones causadas por este germen. Objetivo: Evaluar la actividad antifúngica in vitro de Dichrostachys cinerea L. contra una cepa de Candida albicans. Métodos: Se realizó un estudio observacional analítico transversal in vitro para evaluar la actividad antifúngica de extractos fluidos de hojas y de tallos de D. cinerea L mediante el método de macrodilución en caldo y como sustancia de referencia el alcohol. Resultados: A través del proceso se mostró la actividad antifúngica del extracto fluido de tallos de D. cinerea L. al 50 % hasta la dilución 1/32, determinada como la concentración mínima inhibitoria; el extracto fluido de hojas al 30 % no logró inhibir el crecimiento de la cepa de Candida albicans ATCC 10231. Conclusiones: La actividad antifúngica del extracto fluido al 50 % de las hojas de Dichrostachys cinerea L. fue efectiva, no así el preparado farmacéutico al 30 %. Se determinó la concentración mínima inhibitoria del extracto fluido de hojas al 50 % y se demostró que ésta superó a la del alcohol al 50 % en tres diluciones contra la Candida albicans.

Introduction: Dichrostachys cinerea L. (marabou) is a plant that grows in Cuba, medicinal properties of this plant are being studied. The resistance of yeasts of the Candida genus to current available synthetic antifungals is increasingly greater. This is why, new compounds of plant origin are being searched for the effective treatment of infections caused by this germ. Objective: To evaluate the in vitro antifungal activity of Dichrostachys cinerea L against a strain of Candida albicans. Methods: An in vitro a cross-sectional analytic observational study was carried out to evaluate the antifungal activity of fluid extracts of D. cinerea L leaves and stems using the broth macro-dilution method and alcohol as the reference substance. Results: Through the process was shown the antifungal activity of the fluid extract of Dichrostachys cinerea L. stems at 50% up to the 1/32 dilution; it was determined as the minimum inhibitory concentration. The leaves fluid extract at 30% failed to inhibit the growth of the Candida albicans ATCC 10231 strain. Conclusions: The antifungal activity of the fluid extract at 50% of the leaves was effective, but not the pharmaceutical preparation at 30%. The minimum inhibitory concentration of the fluid extract of leaves at 50% was determined and it was shown that it exceeded that of alcohol at 50% in three dilutions against Candida albicans.

A rare case of colonic malakoplakia at the bottom of an adenoma mimicking an invasive carcinoma.

We present the case of a 47-year-old man with a history of refractory multiple myeloma who was referred to our hospital for the presence of a colonic lesion suspected of having signs of deep submucosal invasion. After a surgical resection, the histological study revealed that it was a case of malakoplakia that had developed at the base of a tubular adenoma.

Influence of pain on the quality of life in patients with venous ulcers: Cross-sectional association and correlation study in a brazilian primary health care lesions treatment center.

We aimed to verify the association and correlation between pain and QoL in people with VU treated in a Brazilian Primary Health Care (PHC) lesions treatment center. This is an observational, cross-sectional study with a quantitative approach, carried out in a service specialized in the treatment of chronic injuries, linked to 29 PHC units. Sociodemographic and health characterization instruments were used. The Short Form Health Survey-36 (SF-36) and Visual Analogue Pain Scale (VAPS) also were used. The Kruskal-Wallis test verified the association between the scalar variables of QoL and pain intensity. With Spearman's correlation test, we verified the level of correlation between the scales applied. A total of 103 patients participated in the study. Higher QoL scores associated with moderate pain were found, especially in the Physical role functioning, Physical functioning, and Vitality domains. Correlation analysis showed its greatest (moderate) strength in the interaction between the highest scores in the Physical role functioning and Emotional role functioning domains with the lowest pain levels.

Cognitive impairment in young adults with post COVID-19 syndrome.

In this study, we aimed to examine different cognitive domains in a large sample of patients with post COVID-19 syndrome. Two hundred and fourteen patients, 85.04% women, ranged 26 to 64 years (mean = 47.48 years) took part in this investigation. Patients' processing speed, attention, executive functions and various language modalities were examined online using a comprehensive task protocol designed for this research. Alteration in some of the tasks was observed in 85% of the participants, being the attention and executive functions tests the ones that show the highest percentage of patients with severe impairment. Positive correlations were observed between the age of the participants in almost all the tasks assessed, implying better performance and milder impairment with increasing age. In the comparisons of patients according to age, the oldest patients were found to maintain their cognitive functions relatively preserved, with only a mild impairment in attention and speed processing, while the youngest showed the most marked and heterogeneous cognitive impairment. These results confirm the subjective complaints in patients with post COVID-19 syndrome and, thanks to the large sample size, allow us to observe the effect of patient age on performance, an effect never reported before in patients with these characteristics.

Reading fluency in Spanish patients with Parkinson's disease: A reading prosody examination.

BACKGROUND: The expressiveness during reading is essential for a fluent reading. Reading prosody has been scarcely studied in an experimental manner, owing to the difficulties in taking objective and direct measures of this reading skill. However, new technologies development has made it possible to analyse reading prosody in an experimental way. Prosodic patterns may vary, not being the same at the beginning of the reading learning process as in adulthood. They may also be altered in disorders such as dyslexia, but little is known about the prosodic characteristics and reading fluency of people with neurodegenerative diseases that cause language impairment, such as Parkinson's disease (PD). AIMS: The aim of this work was to study reading fluency in PD considering the prosodic characteristics of its reading. METHODS & PROCEDURES: The participants were 31 Spanish adults with PD and 31 healthy controls, aged 59-88 years. Two experimental texts were designed that included declarative, interrogative, and exclamatory sentences and experimental verbs and nouns. The manipulability level of the nouns and the motor content of the verbs were considered. The reading of the participants was recorded and analysed with Praat software. OUTCOMES & RESULTS: A longer reading duration and a greater number of pauses, especially in verbs, were found in the PD group, which also showed less pitch variation than the control group in the experimental sentences. The control group showed a big initial rise in declarative and interrogative sentences, as well as a stronger final declination in declarative and exclamatory ones, when compared to the PD group. CONCLUSIONS & IMPLICATIONS: The use of experimental methodologies for the analysis of reading fluency allows learning more about the prosodic characteristics of people with different pathologies, such as PD. Scarce pitch variability found in the analysis, together with the great number of pauses and the longer reading duration, leads to poorly expressive reading, which compromises fluency in PD. The exhaustive evaluation of the reading fluency of PD patients will make it possible to design more complete assessment methods that will favour the diagnosis and early detection of this pathology. WHAT THIS STUDY ADDS: What is already known on this subject • The speech of people with Parkinson's disease (PD) is often impaired by the appearance of hypokinetic dysarthria. The language of people with PD is usually affected with the progression of the disease, with lexico-semantic impairment which mainly affects verbs. Previous literature on reading fluency in PD usually considers reading speed and accuracy, neglecting prosody. Other neurodegenerative diseases with language impairment, such as Alzheimer's disease, commonly cause reading fluency problems. What this paper adds to existing knowledge • This study provides direct and objective measures of the reading fluency (speed, accuracy and prosody) in patients with PD, by the design of experimental texts. Reading fluency characteristics were found to be altered in these patients, especially in pitch variations and reading duration. The reading of Parkinson's patients showed a more flattened pitch. In addition, a greater number of pauses and longer reading durations were also found in the reading of verbs compared to the control group. What are the potential or actual clinical implications of this work? • The use of experimentally created texts makes it possible to analyse the influence of different psycholinguistic variables (frequency, length, motor content, manipulability) on reading fluency, and how the processing of these stimuli could be affected in PD. The objective analysis of the reading fluency characteristics in PD allows the design of more specific evaluation and diagnostic tasks. More complete assessment methods may allow the early detection of the disease. In the same way, it may favour a differential diagnosis with other neurodegenerative diseases.

The Ultrasound-Assisted Extraction of Polyphenols from Mexican Firecracker (Hamelia patens Jacq.): Evaluation of Bioactivities and Identification of Phytochemicals by HPLC-ESI-MS.

The objective of the present work was to optimize the extraction of phytochemicals from Hamelia patens Jacq. by ultrasound-assisted extraction. Taguchi L9 orthogonal array was used to evaluate the factors solid/liquid ratio (1:8, 1:12, and 1:16), extraction time (10, 20, and 30 min), and ethanol concentration (0, 35, and 70%). Total polyphenols were the response variable. Chromatographic fractionation using Amberlite XAD-16 was carried out and the total polyphenols, flavonoids, and condensed tannins were quantified. The redox potential, the reduction of the 2,2-diphenyl-1-picrylhydrazyl (DPPH), and the lipid oxidation inhibition were determined. Anti-bacterial activity was evaluated. The phytochemicals were identified by liquid chromatography coupled to mass spectrometry. Optimal extraction conditions were a solid/liquid ratio of 1:16, ethanol of 35%, and 10 min of ultrasound-assisted extraction. Maximum polyphenol content in the crude extract was 1689.976 ± 86.430 mg of gallic acid equivalents (GAE)/100 g of dried plant material. The purified fraction showed a total polyphenols content of 3552.84 ± 7.25 mg of GAE, flavonoids 1316.17 ± 0.27 mg of catechin equivalents, and condensed tannins 1694.87 ± 22.21 mg of procyanidin B1 equivalents, all per 100 g of purified fraction. Its redox potential was 553.93 ± 1.22 mV, reducing 63.08 ± 0.42% of DPPH radical and inhibiting 77.78 ± 2.78% of lipid oxidation. The polyphenols demonstrated antibacterial activity against Escherichia coli, Klebsiella pneumonia, and Enterococcus faecalis. The HPLC-ESI-MS analysis revealed the presence of coumarins, hydroxycinnamic acids, and flavonoids.

Análisis crítico del programa curso propio Terapéutica Razonada para la carrera de Medicina en Cuba / Critical analysis of the Reasoned Therapeutic course program for the Medicine career in Cuba

RESUMEN Fundamento: el análisis de los programas de estudio para identificar potencialidades e insuficiencias, formular propuestas para su gestión o rediseño curricular, constituye una necesidad en las universidades médicas cubanas. Objetivo: analizar el programa analítico del curso de contenido propio Terapéutica Razonada para la carrera de Medicina en Cuba. Métodos: estudio cualitativo realizado en el tercer trimestre del año 2021. Se realizaron búsquedas en internet mediante buscadores especializados y los descriptores en ciencias de salud. Se utilizaron métodos teóricos como el analítico sintético y el inductivo deductivo y como método empírico, el análisis documental, los cuales permitieron establecer los criterios para el análisis y realizar el análisis del programa propiamente dicho. Resultados: se identifican las fortalezas y debilidades en torno a la justificación, pertinencia social, aspectos generales que lo caracterizan, nexos con el currículo formal, secuencia lógica en el currículo, organización de los temas, equilibrio entre las horas teóricas, prácticas y de trabajo independiente, análisis de los componentes no personales, orientaciones metodológicas, así como el análisis de la bibliografía. Las insuficiencias de mayor relevancia se orientan hacia la necesidad de reformular los objetivos, declarar métodos de enseñanza, incluir horas para la educación en el trabajo, explicitar las orientaciones metodológicas y actualizar la bibliografía. Conclusiones: el programa responde al encargo social de las universidades cubanas y su diseño se ajusta a las exigencias curriculares contemporáneas, pero se identifican aspectos que requieren atención en aras de su perfeccionamiento.

ABSTRACT Background: the analysis of the study programs to identify potentialities and insufficiencies, formulate proposals for their management or curricular redesign, constitutes a necessity in Cuban medical universities. Objective: to analyze the analytical program of the Reasoned Therapeutics course with its own content for the Medicine career in Cuba. Methods: qualitative study carried out in the third quarter of 2021. Internet searches were carried out using specialized search engines and descriptors in health sciences. Theoretical methods were used, such as synthetic analytical and inductive-deductive, and documentary analysis as an empirical method, which allowed establishing the criteria for the analysis and carrying out the analysis of the program itself. Results: the strengths and weaknesses around the justification, social relevance, general aspects that characterize it, links with the formal curriculum, logical sequence in the curriculum, organization of topics, balance between theoretical, practical and independent work hours, analysis of the non-personal components, methodological orientations, as well as the analysis of the bibliography are identified. The most relevant insufficiencies are oriented towards the need to reformulate the objectives, declare teaching methods, include hours for education at work, explain the methodological orientations and update the bibliography. Conclusions: the program responds to the social assignment of Cuban universities and its design is adjusted to contemporary curricular demands, but aspects that require attention for the sake of its improvement are identified.

Risk Factors Associated With Inadequate Brain Relaxation in Craniotomy for Surgery of Supratentorial Tumors.

INTRODUCTION: Cerebral swelling often occurs during craniotomy for cerebral tumors. Poor brain relaxation can increase the risk of cerebral ischemia, possibly worsening the outcome. The surgical team should identify any risk factors that could cause perioperative brain swelling and decide which therapies are indicated for improving it. The present investigation aimed to elucidate the risk factors associated with brain swelling during elective craniotomy for supratentorial brain tumors. METHODS: This prospective, nonrandomized, observational study included 52 patients scheduled for elective supratentorial tumor surgery. The degree of brain relaxation was classified upon the opening of the dura according to a four-point scale (brain relaxation score: 1, perfectly relaxed; 2, satisfactorily relaxed; 3, firm brain; and 4, bulging brain). Moreover, hemodynamic and respiratory parameters, arterial blood gas, and plasma osmolality were recorded after the removal of the bone flap. RESULTS: This study showed that the use of preoperative dexamethasone was associated with a brain relaxation score of ≤2 (p = 0.005). The median midline shift of 6 (3-0) mm and median hemoglobin level of >13 g/dL were associated with a brain relaxation score of ≥3 (p = 0.02 and p = 0.01, respectively). The dosage of mannitol (0.25 g/kg versus 0.5 g/kg), physical status, intraoperative position, tumor diameter and volume, peritumoral edema and mass effect, World Health Organization (WHO) grading, mean arterial pressure, PaCO2, osmolality, and core temperature were not identified as risk factors associated with poor relaxation. CONCLUSION: The use of preoperative dexamethasone was associated with improved brain relaxation, whereas the presence of a preoperative midline shift and a higher level of hemoglobin were associated with poor brain relaxation.

Mikros, aplicación androide para Microbiología y Parasitología en la Universidad de Ciencias Médicas de Camagüey / Mikros, an Android Application for the Microbiology and Parasitology Subject in the University of Medical Sciences of Camagüey

Introducción: El aprendizaje móvil (m-learning) es la inclusión de dispositivos móviles en las actividades de aprendizaje. En la enseñanza de Microbiología y Parasitología médica estos ofrecen un alto poder de ilustración y contribuyen al aprendizaje de la asignatura de los estudiantes de la carrera de medicina; además, sirven de apoyo a otros perfiles como Tecnología de la Salud. Objetivo: Exponer la actualización del curso de Microbiología y Parasitología en la Universidad de Ciencias Médicas de Camagüey mediante una aplicación androide. Métodos: Se realizó una aplicación optimizada para androide 4.4 o superior con el lenguaje de programación Java. Esta investigación se desarrolló en la Universidad de Ciencias Médicas Carlos J. Finlay y se aplicó a estudiantes de la carrera de medicina en los cursos 2018-2019 y 2019-2020. El universo del estudio fueron 1446 estudiantes de los cursos de 2016-2020. Se realizó una encuesta validada por expertos a una muestra probabilística de 88 estudiantes de la Universidad de Ciencias Médicas de Camagüey, en el período comprendido entre noviembre y diciembre de 2020. Se calculó el coeficiente concordancia general W de Kendall en cuanto a las respuestas a las preguntas. Resultados: Mikros fue una herramienta de apoyo a la docencia, fruto de un proyecto de colaboración entre el Centro de Inmunología y Productos Biológicos de la Universidad de Ciencias Médicas y la Facultad de Ingeniería Informática de la Universidad Ignacio Agramonte, de Camagüey, que permitió introducir al profesor en una modalidad de enseñanza muy a tono con estos tiempos. Conclusiones: La aplicación Mikros incluyó conceptos básicos y un alto nivel de actualización. También contribuyó a elevar el índice académico y a una mayor satisfacción del alumno en el aprendizaje, y resultó una herramienta de consulta práctica para estudiantes de años posteriores de la carrera en rotación por el área clínica y útil para el aprendizaje a distancia en tiempos de COVID-19(AU)

Introduction: Mobile learning (m-learning) consists in the inclusion of mobile devices into learning activities. In the teaching of medical parasitology and microbiology, such devices offer a high power of illustration and contribute to medical students' learning of the subject; in addition, they serve as support to other profiles such as health technology. Objective: To present the update, by means of an android application, of the Microbiology and Parasitology course at the University of Medical Sciences of Camagüey. Methods: An optimized application for android 4.4 or higher was created with the Java programming language. This research was carried out at Carlos J. Finlay University of Medical Sciences and applied to medical students in the 2018-2019 and 2019-2020 academic years. The study universe was made up of 1446 students from the academic years from 2016 to 2020. A survey validated by experts was carried out, in the period between November and December 2020, with a probabilistic sample of 88 students from the University of Medical Sciences of Camagüey. Kendall's coefficient of general concordance (W) was calculated for the answers to the questions. Results: Mikros was a teaching support tool, the result of a collaborative project between the Center of Immunology and Biological Products at the University of Medical Sciences and the School of Computer Engineering at Ignacio Agramonte University, in Camagüey, which allowed to present the professor in a teaching modality much in tune with the current times. Conclusions: The Mikros application included basic concepts and a high update level. It also contributed to raising the student's academic index and satisfaction with learning. It turned out to be a practical consultation tool for students of higher academic years of the major who are rotating through the clinical area, as well as a useful tool for distance learning in COVID-19 times(AU)

[National survey on the treatment of acute appendicitis in Spain during the initial period of the COVID-19 pandemic]. / Encuesta nacional sobre el tratamiento de la apendicitis aguda en España durante la fase inicial de la pandemia por COVID-19.

INTRODUCTION: The COVID-19 pandemic has had a significant impact on Spanish hospitals, which have had to allocate all available resources to treat these patients, reducing the ability to attend other common pathologies. The aim of this study is to analyze how the treatment of acute appendicitis has been affected. METHODS: A national descriptive study was carried out by a online voluntary distribution of a specific questionnaire with Google Drive™ distributed by email by the Spanish Association of Surgeons (AEC) to all affiliated surgeons actually working in Spain (5203) opened from April 14th to April 24th. RESULTS: We received 337 responses from 170 centers. During the first month of the pandemic the incidence of acute appendicitis has decreased. Although conservative management has increased, surgical option has been the most used in both simple and complicated appendicitis. Despite the fact that the laparoscopic approach continues to be the most widely used in our services, the open approach has increased during this pandemic period. CONCLUSION: Highlight the contribution of this study in terms of knowledge of the status of the treatment of acute appendicitis during this first month of the pandemic, being able to serve for a better possible organization in future waves of the pandemic and a reorganization of current protocols and management of acute appendicitis in a pandemic situation.

Actividad antimicrobiana de la peroxiadenosina en cultivos in vitro de Staphylococcus aureus resistente a meticilina / Antimicrobial activity of peroxyadenosine in vitro culture of resistant methicillin Staphylococcus aureus

RESUMEN Fundamento : las infecciones asociadas a la asistencia sanitaria y de la comunidad causadas por Staphylococcus aureus resistente a la meticilina, constituyen un problema de salud en el mundo. Esta situación se asocia al uso indiscriminado de antimicrobianos y a la mutagénesis bacteriana, por tanto, el desarrollo de nuevos productos con actividad antimicrobiana constituye una prioridad para Cuba. Objetivo : evaluar la actividad antimicrobiana de la peroxiadenosina en cultivo in vitro de Staphylococcus aureus resistente a la meticilina. Métodos : se realizó un estudio experimental de laboratorio en un modelo biológico (cultivo microbiano) en el Hospital Universitario Amalia Simoni de la provincia Camagüey, desde enero de 2016 hasta julio de 2020. La muestra se conformó con 60 cultivos biológicos de Staphylococcus aureus resistentes a la meticilina, mediante un muestreo aleatorio simple, distribuidos en dos grupos, cada uno con 30 cultivos. Un grupo correspondió a una cepa salvaje de Staphylococcus aureus resistentes a la meticilina, obtenida de la colección de cultivos del hospital y el otro a la cepa de referencia (ATCC 25923) de la American Type Culture Collection. Se estudiaron las variables: formación y concentración de la peroxiadenosina, preservación de la estructura aromática de la adenosina y el patrón de susceptibilidad a la meticilina. Resultados : la peroxiadenosina se formó a partir de la interacción del peróxido de hidrógeno con la adenosina. Los cultivos de Staphylococcus aureus resistentes a la meticilina se mostraron sensibles a las concentraciones de peroxiadenosina sin diluir y 1:2, demostrado por la presencia de halos de inhibición en el cultivo. Conclusiones : la inhibición del crecimiento de Staphylococcus aureus resistentes a la meticilina por la peroxiadenosina sugiere su evaluación como un nuevo producto antibacteriano eficaz contra este microorganismo.

ABSTRACT Background: infections associated with healthcare and the community caused by methicillin-resistant Staphylococcus aureus (MRSA) constitutes a health problem in the world. This situation is associated with the indiscriminate use of antimicrobials and bacterial mutagenesis, therefore, the development of new products with antimicrobial activity is a priority for Cuba. Objective: to evaluate the antimicrobial activity of peroxyadenosine in vitro culture of MRSA. Methods: an experimental laboratory study was carried out in a biological model (microbial culture) at the Amalia Simoni Hospital in Camagüey province, from January 2016 to July 2020. The sample consisted of 60 biological cultures through simple random sampling, distributed in two groups with 30 crops of each investigated layer. One group corresponded to a wild MRSA strain, obtained from the hospital culture collection and the other to the reference strain (ATCC 25923) from the American Type Culture Collection. The studied variables were: formation and concentration of peroxyadenosine, preservation of the aromatic structure of adenosine and the pattern of susceptibility to methicillin. Results: peroxyadenosine was formed from the interaction of hydrogen peroxide with adenosine. The MRSA cultures were sensitive to 1: 2 undiluted peroxyadenosine concentrations, demonstrated by the presence of inhibition halos in the culture. Conclusions: the inhibition of MRSA growth by peroxyadenosine suggests its evaluation as a new antibacterial product effective against this microorganism.

National survey on the treatment of acute appendicitis in Spain during the initial period of the COVID-19 pandemic.

INTRODUCTION: The COVID-19 pandemic has had a significant impact on Spanish hospitals, which have had to allocate all available resources to treat these patients, reducing the ability to attend other common pathologies. The aim of this study is to analyze how the treatment of acute appendicitis has been affected. METHOD: A national descriptive study was carried out by an online voluntary specific questionnaire with Google Drive™ distributed by email by the Spanish Association of Surgeons (AEC) to all affiliated surgeons currently working in Spain (5203), opened from April 14th to April 24th. RESULTS: We received 337 responses from 170 centers. During the first month of the pandemic, the incidence of acute appendicitis decreased. Although conservative management increased, the surgical option has been the most used in both simple and complicated appendicitis. Despite the fact that the laparoscopic approach continues to be the most widely used in our services, the open approach has increased during this pandemic period. CONCLUSION: Highlight the contribution of this study in terms of knowledge of the status of the treatment of acute appendicitis during this first month of the pandemic, being able to serve for a better possible organization in future waves of the pandemic and a reorganization of current protocols and management of acute appendicitis in a pandemic situation.

Mastitis Quística Granulomatosa Neutrofílica, Reporte De Caso / Granulomatous Neutrophilic Cystic Mastitis, Case Report

La mastitis granulomatosa neutrofílica quística (MGNQ) es una entidad recientemente caracterizada, con detalles histopatológicos específicos que la diferencian de otros tipos de mastitis crónicas idiopáticas. La presencia de bacilos grampositivos dentro de espacios de apariencia quística rodeados de neutrófilos, en un contexto de inflamación granulomatosa supurativa, definen esta entidad. La importancia de su reconocimiento en el reporte diagnóstico recae en su asociación a la infección por especies de corinebacterias, de esa manera se puede direccionar el tratamiento con antibióticos, más allá del tratamiento antiinflamatorio que suele administrarse en mastitis idiopáticas. Se describe el caso de una paciente de sexo femenino, de 35 años de edad, sin antecedentes relacionados, con dolor mamario intermitente, asociado a la presencia de múltiples nodulaciones palpables, duras, en ambas mamas, con resultados de múltiples biopsias particulares previas que describieron mastitis crónica granulomatosa con reacción de tipo tuberculoso, por lo cual recibió tratamiento antituberculoso. Pese a ello, las tumoraciones cedieron sólo parcialmente. Se revisó las láminas histológicas en la institución y se estableció el diagnóstico de MGNQ. Se consideró importante la presentación de este caso debido a su escaso reconocimiento entre patólogos, pese a presentar características ya definidas en estudios previos.

Cystic neutrophilic granulomatous mastitis (CNGM) is a recently characterized entity, with specific histopathological details that differentiate it from other types of chronic idiopathic mastitis. The presence of gram-positive bacilli within cystic-like spaces surrounded by neutrophils, in a context of suppurative granulomatous inflammation, define this entity. The importance of its recognition in the diagnostic report lies in its association with infection by corynebacterial species, so that treatment with antibiotics can be targeted, beyond the anti-inflammatory treatment that is usually administered to idiopathic mastitis. We describe the case of a 35-year-old female patient with no related history, with intermittent breast pain, associated with the presence of multiple hard, palpable nodules in both breasts, with results from multiple previous private biopsies that described chronic granulomatous mastitis with a tubercular reaction, for which she received treatment for tuberculosis. Despite this, the clinical response was partial. Histological slides were reviewed at the institution and the diagnosis of CNGM was then established. The presentation of this case was considered important due to its low recognition among pathologists, despite presenting characteristics already defined by previous studies.

Mastitis quística granulomatosa neutrofílica asociada a corinebacterias: Reporte de caso

La mastitis granulomatosa neutrofílica quística (MGNQ) es una entidad recientemente caracterizada, con detalles histopatológicos específicos que la diferencian de otros tipos de mastitis crónicas idiopáticas. La presencia de bacilos grampositivos dentro de espacios de apariencia quística rodeados de neutrófilos, en un contexto de inflamación granulomatosa supurativa, definen esta entidad. La importancia de su reconocimiento en el reporte diagnóstico recae en su asociación a la infección por especies de corinebacterias, de esa manera se puede direccionar el tratamiento con antibióticos, más allá del tratamiento antiinflamatorio que suele administrarse en mastitis idiopáticas. Se describe el caso de una paciente de sexo femenino, de 35 años de edad, sin antecedentes relacionados, con dolor mamario intermitente, asociado a la presencia de múltiples nodulaciones palpables, duras, en ambas mamas, con resultados de múltiples biopsias particulares previas que describieron mastitis crónica granulomatosa con reacción de tipo tuberculoso, por lo cual recibió tratamiento antituberculoso. Pese a ello, las tumoraciones cedieron sólo parcialmente. Se revisó las láminas histológicas en la institución y se estableció el diagnóstico de MGNQ. Se consideró importante la presentación de este caso debido a su escaso reconocimiento entre patólogos, pese a presentar características ya definidas en estudios previos.

Cystic neutrophilic granulomatous mastitis (CNGM) is a recently characterized entity, with specific histopathological details that differentiate it from other types of chronic idiopathic mastitis. The presence of gram-positive bacilli within cystic-like spaces surrounded by neutrophils, in a context of suppurative granulomatous inflammation, define this entity. The importance of its recognition in the diagnostic report lies in its association with infection by corynebacterial species, so that treatment with antibiotics can be targeted, beyond the anti-inflammatory treatment that is usually administered to idiopathic mastitis. We describe the case of a 35-year-old female patient with no related history, with intermittent breast pain, associated with the presence of multiple hard, palpable nodules in both breasts, with results from multiple previous private biopsies that described chronic granulomatous mastitis with a tubercular reaction, for which she received treatment for tuberculosis. Despite this, the clinical response was partial. Histological slides were reviewed at the institution and the diagnosis of CNGM was then established. The presentation of this case was considered important due to its low recognition among pathologists, despite presenting characteristics already defined by previous studies.

Contribuciones de la Universidad de las Ciencias de la Salud en Venezuela a la Educación Médica / Venezuela Health Sciences University contributions to Medical Education

RESUMEN La Universidad de las Ciencias de la Salud de Venezuela se establece de forma legal, como centro formador, años después de la gestión del Programa Nacional de Formación en Medicina Integral Comunitaria y el Programa Nacional de Formación Avanzada en Medicina General Integral. Las bases legales, teóricas y metodológicas de esta se sustentan en el proyecto Alma Mater y, de manera particular, en las experiencias normativas, metodológicas, didácticas e instrumentales de estos dos programas. Como universidad médica inmersa en la generación de modelos de formación que garanticen egresados transformadores de los problemas sociales, ha contribuido -a consideración de los autores de este artículo- con la Educación Médica en lo siguiente: enseñanza en el servicio asistencial y educación en el colectivo laboral, desarrollo de nuevas formas de organización de la enseñanza, trabajo metodológico desde una visión integradora de los niveles organizativos del proceso docente educativo y concepción del Servicio Comunitario Estudiantil como actividad de investigación, integración de saberes y transformación comunitaria permanente. La Universidad de las Ciencias de la Salud ha enriquecido las concepciones formativas que regulan el proceso docente educativo en las universidades encargadas de egresar profesionales para los Sistemas Públicos de Salud.

ABSTRACT The University of Health Sciences of Venezuela is legally established, as a training center, years after the management of the National Training Program in Integral Community Medicine and the National Advanced Training Program in Integral General Medicine. Its legal, theoretical and methodological bases are based on the conceptions of the Alma Mater project and, in particular, on the normative, methodological, didactic and instrumental experiences of these programs. As a medical university, immersed in the generation of training models that guarantee transformative graduates of social problems, it has contributed - to the authors of this article - with the Medical Education in the following contributions: education of students in and by the work team, teaching of the profession from the assistance service, development of new forms of organization of teaching, methodological work from an integrative vision of the organizational levels of the educational teaching process and the conception of the Student Community Service as a research activity, integration of knowledge and permanent community transformation. This University has enriched the training conceptions that regulate the teaching learning process in the university that train professionals for Public Health Systems.