BACKGROUND: Multicenter early diuretic response (DR) analysis of single furosemide dosing following neonatal cardiac surgery is lacking to inform whether early DR predicts adverse clinical outcomes. METHODS: We performed a retrospective cohort study utilizing data from the NEPHRON registry. Random forest machine learning generated receiver operating characteristic-area under the curve (ROC-AUC) and odds ratios for mechanical ventilation (MV) and respiratory support (RS). Prolonged MV and RS were defined using ≥ 90th percentile of observed/expected ratios. Secondary outcomes were prolonged CICU and hospital length of stay (LOS) and kidney failure (stage III acute kidney injury (AKI), peritoneal dialysis, and/or continuous kidney replacement therapy on postoperative day three) assessed using covariate-adjusted ROC-AUC curves. RESULTS: A total of 782 children were included. Cumulative urine output (UOP) metrics were lower in prolonged MV and RS patients, but DR poorly predicted prolonged MV (highest AUC 0.611, OR 0.98, sensitivity 0.67, specificity 0.53, p = 0.006, 95% OR CI 0.96-0.99 for cumulative 6-h UOP) and RS (highest AUC 0.674, OR 0.94, sensitivity 0.75, specificity 0.54, p < 0.001, 95% CI 0.91-0.97 UOP between 3 and 6 h). Secondary outcome results were similar. DR had fair discrimination for kidney failure (AUC 0.703, OR 0.94, sensitivity 0.63, specificity 0.71, 95% OR CI 0.91-0.98, p < 0.001, cumulative 6-h UOP). CONCLUSIONS: Early DR poorly discriminated patients with prolonged MV, RS, and LOS in this cohort, though it may identify severe postoperative AKI phenotype. Future work is warranted to determine if early DR or late postoperative DR later, in combination with other AKI metrics, may identify a higher-risk phenotype.
We report a case of aseptic cutaneous necrosis from extravasation of calcium chloride at the proximal port of a central venous catheter (CVC). A right internal jugular CVC was placed with ultrasound guidance using contemporary guidelines for size and insertion site. Catheter migration occurred concurrent with development of postoperative anasarca. Four days later, leakage of infusate with skin necrosis was noted at the insertion site. Despite initial proper positioning, catheter ports can migrate out of intravascular structures due to postprocedural subcutaneous edema. Intravascular confirmation should be performed regularly for infants with localized or generalized edema.
Catheterization, Central Venous , Central Venous Catheters , Infant, Newborn , Humans , Central Venous Catheters/adverse effects , Catheterization, Central Venous/adverse effects , Catheters, Indwelling/adverse effects , Edema/etiology , Necrosis , Jugular Veins/diagnostic imaging
Introducción: Las enfermedades periodontales inmunoinflamatorias crónicas, están catalogadas entre las afecciones más comunes del género humano, las que pueden estar asociadas a enfermedades sistémicas como la artritis reumatoidea. Objetivo: Identificar las manifestaciones periodontales más comunes en pacientes con artritis reumatoidea. Métodos: Se realizó un estudio observacional descriptivo de corte transversal. El universo estuvo constituido por 107 pacientes con diagnóstico de artritis reumatoidea, la muestra no probabilística de 50 pacientes que acudieron a consulta estomatológica durante el periodo, que cumplieron con los criterios de inclusión y exclusión previstos en el estudio. Las principales variables estudiadas fueron: edad, sexo, tiempo de diagnóstico de artritis reumatoide, presencia de enfermedad periodontal (gingivitis y periodontitis), factores de riesgo. Resultados: Prevaleció las edades entre 49 a 58 años, seguido de 39 a 48 años para un 34 y 26 % respectivamente, predominó el sexo femenino con un 46 % de afectadas por gingivitis y con más de siete años para un 58 %, la higiene bucal deficiente seguido de la dieta cariogénica prevaleció en un 50 % y 54% respectivamente. Conclusiones: Predominó el sexo femenino de pacientes diagnosticadas con artritis reumatoidea afectadas por gingivitis, ambas enfermedades son inflamatorias sistémicas, por lo que se puede explicar la conexión entre las dos.
Introduction: Chronic immunoinflammatory periodontal diseases are classified among the most common affections of the human gender, which may be associated with systemic diseases such as rheumatoid arthritis. Objective: To identify the most common periodontal manifestations in patients with rheumatoid arthritis. Methods: A cross-sectional descriptive observational study was carried out. The universe consisted of 107 patients diagnosed with rheumatoid arthritis, the non-probabilistic sample of 50 patients who attended a dental consultation during the study period, who met the inclusion and exclusion criteria provided for in the study. The main variables studied were: age, sex, time since diagnosis of rheumatoid arthritis, presence of periodontal disease (gingivitis and periodontitis), risk factors. Results: Ages between 49 and 58 years prevailed, followed by 39 to 48 years with 34 and 26% respectively, predominantly female with 46% affected by gingivitis, affected with more than 7 years with 58%, the poor oral hygiene followed by the cariogenic diet prevailed with 54 and 50% respectively. Conclusions: The female sex prevailed in patients diagnosed with rheumatoid arthritis affected by gingivitis, both diseases are systemic inflammatory, so the connection between the two can be explained.
Introducción: Las enfermedades del tiroides son relativamente frecuentes, constituyen un importante grupo dentro de las enfermedades crónicas no transmisibles. Objetivo: Determinar la calidad de vida en pacientes con enfermedades tiroideas. Métodos: Se realizó un estudio observacional, descriptivo y transversal. El universo estuvo constituido por 210 pacientes con diagnóstico de enfermedades tiroideas, que cumplieron con los criterios de inclusión y exclusión previstos en el estudio, previo consentimiento informado y la muestra no probabilística de 198 pacientes. Se utilizaron las variables: edad, sexo, enfermedad tiroidea diagnosticada (hipertiroidismo, hipotiroidismo, bocio difuso eutiroideo) y calidad de vida (facetas según dimensiones, según la clasificación de expertos y enfermedades tiroideas y la calidad de vida integral según enfermedades tiroideas). Se utilizó el cuestionario World Health Organization Quality of Life. Resultados: Predominó el hipotiroidismo como afección tiroidea más frecuente en las féminas entre 50 a 59 años. Las manifestaciones clínicas que puntuaron las medias más bajas fueron el dolor y malestar, seguido de indicaciones médicas y sentimientos negativos; las dimensiones físicas y psicológicas puntuaron con medias bajas, al igual que el ambiente, valores considerados como deficientes. Conclusiones: Predominó una calidad de vida integral media en el mayor por ciento de los pacientes, estas enfermedades deben ser identificadas a tiempo, para evitar otras complicaciones en diferentes sistemas del organismo que pudieran comprometer la vida del paciente.
Introduction: Thyroid diseases are relatively frequent; they constitute an important group within chronic non-communicable diseases. Objective: To determine the quality of life in patients with thyroid diseases. Methods: An observational, descriptive and cross-sectional study was carried out. The universe (210 patients) with a diagnosis of thyroid diseases, who met the inclusion and exclusion criteria provided for in the study, prior informed consent, and the non-probabilistic sample (198 patients). The variables used were: age, sex, diagnosed thyroid disease (hyperthyroidism, hypothyroidism, diffuse euthyroid goiter) and quality of life (facets according to dimensions, according to expert classification and thyroid diseases and comprehensive quality of life according to diseases thyroid). The World Health Organization Quality of Life questionnaire was used. Results: Hypothyroidism predominated as the most frequent thyroid condition in women between 50 and 59 years of age. The clinical manifestations that scored the lowest average were pain and discomfort, followed by medical indications and negative feelings; the physical and psychological dimensions scored with low averages, as well as the environment, values considered deficient. Conclusions: An average comprehensive quality of life prevailed in the highest percentage of patients; these diseases must be identified in time, to avoid other complications in different body systems that could compromise the patient's life.
Dopamine agonist withdrawal syndrome (DAWS) has been introduced to describe the constellation of symptoms resulting from reduction or suspension of dopamine agonist medications. In patients with Parkinson's disease (PD) the impact of DAWS can be significant in terms of distress and disability. Unfortunately, no standard treatment exists other than reintroduce the dopamine agonist even in the presence of adverse effects. Therefore, identification of vulnerable patients would be beneficial. Previous studies have linked DAWS with impulse control disorder behavior (ICD), higher dopamine agonist doses, and milder motor impairment in PD patients. We conducted a retrospective chart review of PD patients treated with dopamine agonist. A total of 313 charts from January 2011 to December 2013 were reviewed, showing 126 patients who were discontinued from dopamine agonist. Twenty-one patients (16.8 %) fulfilled the diagnostic criteria for DAWS. Factors associated with the occurrence of DAWS were: (1) dose of dopamine agonist ≥150 mg expressed in levodopa equivalents daily dose (LEDD) (p = 0.018), (2) impulse control disorder as an adverse effect to dopamine agonist (p = 0.002), and (3) prior deep brain stimulation (DBS) (p = 0.049). The probability of developing DAWS in the presence of all 3 identified factors was 92 %; presence of 2 factors raised the probability up to 70 %; the presence of one factor increased the probability up to 30 %. In the absence of these 3 factors the probability of developing DAWS was 3 %. Prospective studies are warranted to confirm these findings.
Introducción: El bajo peso al nacer constituye una problemática de salud a nivel mundial, existe controversia sobre la asociación de la enfermedad periodontal con los diferentes resultados perinatales adversos. Objetivo: Determinar si la enfermedad periodontal es un factor de riesgo del bajo peso al nacer. Métodos: Se realizó un estudio observacional, descriptivo transversal en gestantes que aportaron recién nacidos vivos con bajo peso pertenecientes al municipio de Pinar del Río, durante el año 2019. El universo lo conformaron 94 gestantes, la muestra no probabilística la integraron 72 que cumplieron con los criterios de inclusión definidos por los autores de la investigación. Las variables fueron: edad materna, edad gestacional al nacimiento, factores de riesgo (hipertensión arterial, asma bronquial, anemia, sepsis vaginal, sepsis urinaria, hábito de fumar), ganancia de peso durante la gestación (adecuada, insuficiente, excesiva), valoración nutricional (normopeso, sobrepeso, desnutrida, obesa) y presencia de enfermedad periodontal (gingivitis y periodontitis). Las fuentes empleadas fueron las historias clínicas de las madres y recién nacidos, la estadística fue descriptiva con distribución de frecuencias absolutas y relativas. Resultados: Predominaron las edades maternas entre 20 a 25 años y la edad gestacional entre 33 y 36 semanas, la sepsis vaginal constituyó la principal enfermedad asociada al embarazo, predominó la ganancia inadecuada de peso y el normopeso. Conclusiones: La enfermedad periodontal no se asoció como factor de riesgo de resultados perinatales adversos como el bajo peso al nacer.
Introduction: Low birth weight is a health problem worldwide, there is controversy about the association of periodontal disease with different adverse perinatal outcomes. Objective: To determine if periodontal disease is a risk factor for low birth weight. Methods: An observational, descriptive, cross-sectional study was carried out in pregnant women who provided live newborns with low weight belonging to the municipality of Pinar del Río, during 2019. The universe (94) pregnant women and the sample (72) through a non-probabilistic sample at the discretion of the authors, according to inclusion criteria. The variables were: maternal age, gestational age at birth, risk factors (hypertension, bronchial asthma, anemia, vaginal sepsis, urinary sepsis, smoking), weight gain during pregnancy (adequate, insufficient, excessive), evaluation nutritional status (normal weight, overweight, malnourished, obese) and presence of periodontal disease (gingivitis and periodontitis). The sources used were the medical records of the mothers and newborns and the statistics were descriptive with distribution of absolute and relative frequencies. Results: Maternal ages between 20 to 25 (33,3 %) and gestational age between 33 and 36 weeks (47,2 %) predominated, vaginal sepsis was the main disease associated with pregnancy (22,2 %), predominated inadequate weight gain (41,7 %) and normal weight with (59,7 %). Conclusions: Periodontal disease was not associated as a risk factor for adverse perinatal outcomes such as low birth weight.
Dopamine agonists are one of the main stay of treatment option for Parkinson disease (PD). Side effects that develop from their use are generally categorized into behavioral and non-behavioral. Behavioral side effects include: impulse control behavior disorder (ICD), psychosis and cognitive impairment. Non-behavioral side effects include: nausea/vomiting, "sleep attacks", leg swelling, weight gain and orthostasis. The aim of this study is to evaluate the clinicians' response to PD patients who developed behavioral side effects from dopamine agonists, in comparison to those patients who developed only non-behavioral side effects. We performed a retrospective chart review of all patients diagnosed with PD over a two year period. Among 313 patients who were on a dopamine agonist, 156 reported side effects. Sixty-five patients reported behavioral (with or without non-behavioral) side effects, while 91 experienced only non-behavioral side effects. Forty-nine out of the 65 patients (75.3%) who experienced behavioral side effects had their dopamine agonist dose decreased compared to 53 out of 91patients (58.2%) who experienced only non-behavioral side effects (Chi square = 4.92, p < 0.05). Patients with behavioral side effects were 3 times more likely have their dose decreased (OR = 3.3; 95%CI = 1.442-7.551; P = 0.005). However, neither taper speed nor the occurrence of dopamine agonist withdrawal syndrome (DAWS) differed between the two groups. Amongst PD patients treated with dopamine agonists, the presence of behavioral side effects independently increased the chance of dopamine agonist dose reduction. Prospective studies are needed to confirm these findings.
RESUMEN Introducción: el bajo peso al nacer es el índice más importante para determinar las posibilidades del recién nacido de sobrevivir, tener un crecimiento y desarrollo normal. Constituye uno de los principales problemas obstétricos actuales, relacionado con más del 75 % de la morbimortalidad perinatal. Objetivo: identificar los principales factores de riesgo asociados al bajo peso al nacer en el municipio Pinar del Río, durante el año 2018. Métodos: se realizó un estudio descriptivo, transversal. El universo constituido por 95 recién nacidos vivos bajo peso en el período estudiado y la muestra fue de 75 % que cumplieron con los criterios de inclusión establecidos en la investigación. Las variables empleadas fueron: edad materna, edad gestacional al nacimiento, factores de riesgo (hipertensión arterial, diabetes mellitus, asma bronquial, anemia, sepsis vaginal, sepsis urinaria, hábito de fumar) y ganancia de peso durante la gestación. Las fuentes empleadas fueron las historias clínicas de las madres y recién nacidos. Los datos se presentaron en frecuencias absolutas y relativas. Resultados: la incidencia del bajo peso al nacer fue de 4,4 %, donde la edad materna de 27 a 34 años (48 %) fue la más representada, el 52 % de ellos nacieron antes de la semana 37 de gestación. La sepsis vaginal estuvo presente en el 42,6 %, la ganancia de peso durante la gestación fue mayor de 8 kilogramos en el 54,7 %. Conclusiones: tanto la modificación como el conocimiento de los factores de riesgo asociados al bajo peso al nacer, serán impactos favorables para su disminución.
ABSTRACT Introduction: low birth weight is the most important index to determine the survival possibilities of newborn having a normal growth and development; it currently constitutes one of the main obstetric problems, associated with more than 75 % of perinatal morbidity and mortality rate. Objective: to identify the main risk factors associated with low birth weight in Pinar del Rio municipality during 2018. Methods: a descriptive and cross-sectional study was carried out. The target group comprised 95 low birth weight newborn babies in the period studied and the sample included 75 meeting the inclusion criteria established in the research. The variables applied were: maternal age, gestational age at birth, risk factors (hypertension, diabetes mellitus, bronchial asthma, anemia, vaginal sepsis, urinary sepsis and smoking habit), and weight gain during pregnancy. The sources used were clinical histories of the mothers and newborn babies. Data were summarized in absolute and relative frequencies. Results: the incidence of low birth weight was 4,4 %, the most represented maternal age from 27 to 34 years old (48 %), 52 % of babies were born at 37 weeks of gestation. Vaginal sepsis was present in 42,6 %, weight gain during gestation behaved greater than 8 kilograms in the 54,7 %. Conclusions: both the modification of knowledge and the risk factors associated with low birth weight will be of favorable impact for its decrease.
RESUMEN La esquistosomiasis es una enfermedad parasitaria causada por helmintos del género Schistosoma. La neuroesquistosomiasis es la afectación del sistema nervioso central (SNQ en la esquistosomiasis. Se trata de una afectación grave, infradiagnosticada y potencialmente letal. La verdadera prevalencia de la neuroesquistosomiasis se desconoce y las cifras obtenidas de los diferentes estudios son muy dispares. Los esquistosomas son trema-todos cuyo hábitat principal se ubica en los vasos sanguíneos de los vertebrados. El sistema nervioso central (SNC) puede afectarse en todas las fases de la esquistosomiasis, incluyendo la fase postinfecciosa precoz, el estadio intermedio paucisintomático y los estadios crónicos avanzados. A la fecha no existe consenso respecto al tratamiento de la neuroesquistosomiasis, pero se cuenta con algunas opciones orales y, en algunos casos, el abordaje quirúrgico.
SUMMARY Schistosomiasis is a parasitic disease caused by helminths of the genus Schistosoma. Neuroschistosomiasis is the involvement of the central nervous system (CNS) in the schistosomiasis. It is a serious, underdiagnosed, and potentially fatal condition. The true prevalence of neuroschistosomiasis is unknown and the figures obtained from the different studies are very disparate. Schistosomes are trematodes whose main habitat is located in the blood vessels of vertebrates. The central nervous system (CNS) can be affected in all phases of schistosomiasis including the early postinfectious phase, the paucisymptomatic intermediate stage and advanced chronic stages. To date, there is no consensus regarding the treatment of neuroschistosomiasis, but there are some oral options and, in some cases, the surgical approach.
Transit-Oriented Development
BACKGROUND AND OBJECTIVES: Acute severe neurologic involvement is the most threatening complication in children with hemolytic-uremic syndrome (HUS). Our primary study objectives were to describe the association between acute neurologic manifestations (ANMs) and in-hospital mortality among children with HUS. METHODS: Using the Pediatric Health Information System database, in this retrospective multicenter cohort study, we identified the first HUS-related inpatient visit among children ≤18 years (years 2004-2018). Frequency of selected ANMs and combinations of ANMs, as well as the rate of mortality, was calculated. Multivariate logistic regression was used to identify the association of ANMs and the risk of in-hospital mortality. RESULTS: Among 3915 patients included in the analysis, an ANM was noted in 10.4% (n = 409) patients. Encephalopathy was the most common ANM (n = 245). Mortality was significantly higher among patients with an ANM compared with patients without an ANM (13.9% vs 1.8%; P < .001). Individuals with any ANM had increased odds of mortality (odds ratio [OR]: 2.25; 95% confidence interval [CI]: 1.29-3.93; P = .004), with greater risk (OR: 2.60; 95% CI: 1.34-5.06; P = .005) among patients with ≥2 manifestations. Brain hemorrhage (OR: 3.09; 95% CI: 1.40-6.82; P = .005), brain infarction (OR: 2.64; 95% CI: 1.10-6.34; P = .03), anoxic brain injury (OR: 3.92; 95% CI: 1.49-10.31; P = .006), and brain edema (OR: 4.81; 95% CI: 1.82-12.71; P = .002) were independently associated with mortality. CONCLUSIONS: In this study, the largest systematic assessment of ANMs among children with HUS to date, we identify differences in in-hospital mortality based on the type of ANM, with increased risk observed for patients with multiple ANMs.
Brain Diseases/mortality , Hemolytic-Uremic Syndrome/mortality , Hospital Mortality , Adolescent , Brain Diseases/complications , Brain Edema/complications , Brain Edema/mortality , Brain Edema/pathology , Cerebral Hemorrhage/complications , Cerebral Hemorrhage/mortality , Cerebral Infarction/complications , Cerebral Infarction/mortality , Child , Child, Preschool , Confidence Intervals , Female , Hemolytic-Uremic Syndrome/complications , Humans , Hypoxia, Brain/complications , Hypoxia, Brain/mortality , Infant , Infant, Newborn , Logistic Models , Male , Odds Ratio , Retrospective Studies
OBJECTIVE: To present our center's experience with terminal extubation in 3 palliative critical care home transports from the Pediatric Cardiac Intensive Unit. DESIGN: All cases were identified from our Cardiovascular intensive care unit ( CVICU). Patients were terminally ill children with no other surgical or medical option who were transported home between 2014 and 2018, for terminal extubation and end-of-life care according to their families' wishes. INTERVENTIONS: The patients were 7, 9 months, and 19 years; and they had very complex and chronic conditions. The families were approached by the CVICU staff during multidisciplinary meetings, where goals of care were established. Parental expectations were clarified, and palliative care team was involved, as well as home hospice was arranged pre transfer. The transfer process was discussed and all the needs were established. All patients had unstable medical conditions, with needs for transport for withdrawal of life support and death at home. Each case needed a highly trained team to support life while in transport. The need of these patients required coordination with home palliative care services, as well as community resources due to difficulty to get in their homes. CONCLUSIONS: Transportation of pediatric cardiac critical care patients for terminal extubation at home is a relatively infrequent practice. It is a feasible alternative for families seeking out of the hospital end-of-life care for their critically ill and technology dependent children. Our single-center experience supports the need for development of formal programs for end-of-life critical care transports.
Home Care Services , Hospice Care , Terminal Care , Child , Critical Care , Humans , Palliative Care , Terminally Ill
RESUMEN Fundamentación: padecer de enfermedades crónicas no trasmisibles como hipertensión y diabetes aumenta el riesgo de contraer enfermedades oculares. Objetivo: determinar defectos refractivos en estudiantes, profesores y trabajadores hipertensos y/o diabéticos de la Universidad de Ciencias Médicas de Cienfuegos. Métodos: estudio descriptivo realizado entre enero de 2017 e igual mes del 2018, que incluyó a los 64 pacientes que presentaron antecedentes patológicos personales de hipertensión arterial y/o diabetes mellitus, en los cuales se determinó la presencia o no de defectos refractivos. Los datos fueron obtenidos mediante examen oftalmológico. Resultados: el grupo etario más afectado fue de 50 años y más; predominó el sexo femenino, los defectos refractivos de mayor prevalencia fueron el astigmatismo hipermetrópico compuesto y presbicia; prevalecieron los pacientes hipertensos. La corrección óptica más indicada fue los lentes progresivos, los pacientes que más asistieron a consulta fueron profesores. Conclusiones: la detección y caracterización de los pacientes diagnosticados con diabetes e hipertensión en consulta es necesaria para un mayor control del estado de salud ocular.
ABSTRACT Background: suffering from non-communicable chronic diseases such as hypertension and diabetes increases the risk of contracting eye diseases. Objective: to determine refractive errors in hypertensive and / or diabetic students, teachers and workers at the University of Medical Sciences of Cienfuegos. Methods: descriptive study carried out between January 2017 and the same month of 2018, which included 64 patients who presented a personal pathological history of arterial hypertension and / or diabetes mellitus, in which the presence or absence of refractive errors was determined. The data were obtained by ophthalmological examination. Results: the most affected age group was 50 years and over; the female sex predominated, the most prevalent refractive errors were compound hyperopic astigmatism and presbyopia; hypertensive patients prevailed. The most indicated optical correction was progressive lenses; the patients who attended the consultation the most were teachers. Conclusions: the detection and characterization of patients diagnosed with diabetes and hypertension in consultation is necessary for a better control of the ocular health status.
RESUMEN Introducción: la Organización Mundial de la Salud declara pandemia a la enfermedad provocada por el nuevo coronavirus SARS-CoV-2, el conocimiento que posean los estudiantes de esta enfermedad es significativo para su prevención y control. Objetivo: describir el nivel de conocimientos sobre prevención y control de la COVID-19 en estudiantes de quinto año de la carrera de Medicina pertenecientes a un área de salud del municipio Pinar del Río. Métodos: se realizó un estudio descriptivo y transversal en el Policlínico Universitario Raúl Sánchez Rodríguez entre el 27 de marzo al 27 de abril del 2020. El universo coincidió con la muestra, constituido por 94 estudiantes asignados a la institución a los cuales se les aplicó un cuestionario diseñado a los efectos del estudio y evaluada sobre 100 puntos, con variables cualitativas que se resumieron mediante la Estadística Descriptiva. Resultados: se identificaron escasas deficiencias sobre la prevención y control de la COVID-19 en los estudiantes, prevaleció la evaluación general de 90 a 100 puntos en el 93,6 % de los sujetos participantes con predominio del nivel Muy Bien de conocimientos en los temas relacionados con la enfermedad. Conclusiones: se comprobó el dominio en los conocimientos sobre la prevención y control de la COVID-19.
ABSTRACT Introduction: the World Health Organization declares a pandemic because as a novel disease named COVID-19, knowledge students have concerning this disease is significant to its prevention and control actions. Objective: to describe the level of knowledge with respect to the prevention and control actions for COVID-19 in fifth-academic-year medicine students belonging to a health area of Pinar del Río municipality. Methods: a descriptive and cross-sectional study was carried out at Raul Sanchez Rodriguez University Polyclinic between March 27 and April 27, 2020. The target group coincided with the sample, consisting of 94 students assigned to the institution who completed a questionnaire designed for the purposes of the study and evaluated on 100 points, with qualitative variables that were summarized using Descriptive Statistics. Results: few deficiencies were identified on the prevention and control actions for COVID-19 in medicine students, the general evaluation from 90 to 100 points prevailed in 93,6 % of the participants, with a predominant evaluation of Very Well level of knowledge in the topics related to this novel disease. Conclusions: mastery of knowledge concerning the prevention and control actions for COVID-19 was confirmed.
RESUMEN Introducción: las lesiones cervicales no cariosas son la pérdida patológica de la estructura dentaria, que no responden a un agente causal bacteriano. Objetivo: determinar la frecuencia de las lesiones cervicales no cariosas pertenecientes al área de salud Policlínico Universitario "Raúl Sánchez Rodríguez" del municipio Pinar del Río. Métodos: se realizó una investigación observacional, descriptiva y transversal. El universo de 120 pacientes y la selección de la muestra se realizó mediante un muestreo no probabilístico por criterios constituida por 80 pacientes con diagnóstico de lesiones cervicales no cariosas, desde enero a diciembre del 2018, en la Clínica Estomatológica "Ormani Arenado". Se recolectaron de las historias clínicas variables como: edad, sexo, tipo de lesión, grupo de diente, localización y factores de riesgo. Resultados: el grupo de edad más representado fue el de 48 a 62 años y el sexo femenino con un 57,50 y 60 % respectivamente, la lesión cervical de mayor frecuencia fue la abrasión con un 47,50 %, hubo 14 dientes afectados como máximo por pacientes y predominaron 13 pacientes afectados con 12 dientes con LCNC para un 16,25 %. El grupo dentario más comprometido fue el de premolares con un 48,96 %, siendo a su vez el maxilar superior el más afectado con un 75,00 %; se destacó el cepillado traumático y el bruxismo con el 70 y 60 % respectivamente. Conclusiones: Esta investigación mostró resultados muy similares a la búsqueda realizada. el cepillado traumático, el bruxismo constituyeron factores de riesgo que más se correspondieron con el desarrollo de esta lesión.
ABSTRACT Introduction: Non-carious cervical lesions are pathological loss of tooth structure, which do not respond to a bacterial causal agent. Objective: to determine the frequency of cervical non-carious lesions belonging to the health area of Raúl Sánchez Rodríguez University Polyclinic from Pinar del Río municipality. Methods: an observational, descriptive and cross-sectional research was carried out. The target group comprised 120 patients and the selection of the sample was carried out through a non-probabilistic sampling by criteria, it included 80 patients with the diagnosis of non-carious cervical injuries at Ormani Arenado Dentistry Clinic, from January to December 2018. Clinical histories were collected and the variables included were: age, sex, type of injury, tooth group, location and risk factors. Results: the most represented age group was from 48 to 62 years old and female sex with 57,50 and 60 % respectively, the most frequent cervical lesion was abrasion with 47,50 %, there were 14 teeth affected at most by patients and 13 patients affected with 12 teeth with LCNC for 16,25 % predominated. The most compromised dental group was the premolars with 48,96 %, being the upper jaw the most affected with 75,00 %; traumatic brushing and bruxism outweighed with 70 and 60 % respectively. Conclusions: This research showed results very similar to the search performed. traumatic brushing, bruxism constituted risk factors that most corresponded to the development of this lesion.
RESUMEN Fundamento: existe desconocimiento sobre los beneficios de la lactancia materna para la salud bucal del futuro bebé. Objetivo: elevar el nivel de conocimientos en embarazadas sobre lactancia materna para la salud bucal del futuro bebé. Métodos: se realizó un estudio descriptivo, longitudinal, cuasi-experimental de intervención educativa en la Clínica Estomatológica Docente Ormani Arenado Llonch de la provincia Pinar del Río, durante el año 2017. El universo coincidió con la muestra, constituido por 100 embarazadas que cumplieron con los criterios de inclusión previo consentimiento informado. Los resultados fueron procesados y presentados a través de tablas. Se aplicaron medidas estadísticas de distribución de frecuencias absolutas y relativas. Resultados: relacionado con los conocimientos sobre lactancia materna posterior a la intervención educativa el 94 % de las gestantes obtuvieron resultados de bien, 21,3 % contaba con 36 y más años de edad y 69,6 % nivel escolar universitario. En cuanto a las ventajas de la lactancia materna primaron los conocimientos de bien después de la actividad educativa en las ventajas para recién nacidos, madre y salud bucal con más de un 90 %. Respecto a los hábitos bucales deformantes pasada la intervención se alcanzaron conocimientos en más de un 90 % sobre todos los hábitos bucales deformantes. Resultó efectiva la intervención educativa con un 87 % de aprobado. Conclusiones: la intervención educativa resultó efectiva en embarazadas estudiadas sobre beneficios de la lactancia materna en la salud bucal del futuro bebé.
ABSTRACT Background: there is ignorance about the benefits of breastfeeding for the oral health of the future baby. Objective: to raise awareness on pregnant women of breastfeeding for the oral health of the future baby. Methods: a descriptive, longitudinal study, quasi-experimental educational intervention was carried out in Ormani Arenado Llonch Dental Clinic, Pinar del Río, during the year 2017. The study population coincided with the sample, which consisted of 100 pregnant women, who met the inclusion criteria previous informed consent. The results were processed and presented through charts applying statistical measures of distribution of absolute and relative frequencies. Results: after the educational intervention, 94 % of pregnant women, have obtained good results about breastfeeding, 21.3 % of the women were 36 years old or more and 69.6% had university school level. As for the advantages of breastfeeding the knowledge prevailed of well after the educational activity in the advantages for newly born, mother and oral health with more than 90 %. Regarding the oral habits last deformities, the intervention knowledge was reached in more than 90 % on all the oral habits deformities. It was effective the educational intervention with 87 % of having approved. Conclusions: educational intervention was effective in pregnant studied about benefits of the maternal nursing in the oral health of the future baby.
Fundamento: existe desconocimiento sobre los beneficios de la lactancia materna para la salud bucal del futuro bebé. Objetivo: elevar el nivel de conocimientos en embarazadas sobre lactancia materna para la salud bucal del futuro bebé. Métodos: se realizó un estudio descriptivo, longitudinal, cuasi-experimental de intervención educativa en la Clínica Estomatológica Docente Ormani Arenado Llonch de la provincia Pinar del Río, durante el año 2017. El universo coincidió con la muestra, constituido por 100 embarazadas que cumplieron con los criterios de inclusión previo consentimiento informado. Los resultados fueron procesados y presentados a través de tablas. Se aplicaron medidas estadísticas de distribución de frecuencias absolutas y relativas. Resultados: relacionado con los conocimientos sobre lactancia materna posterior a la intervención educativa el 94 porciento de las gestantes obtuvieron resultados de bien, 21,3 porciento contaba con 36 y más años de edad y 69,6 porciento nivel escolar universitario. En cuanto a las ventajas de la lactancia materna primaron los conocimientos de bien después de la actividad educativa en las ventajas para recién nacidos, madre y salud bucal con más de un 90 porciento. Respecto a los hábitos bucales deformantes pasada la intervención se alcanzaron conocimientos en más de un 90 porciento sobre todos los hábitos bucales deformantes. Resultó efectiva la intervención educativa con un 87 porciento de aprobado. Conclusiones: la intervención educativa resultó efectiva en embarazadas estudiadas sobre beneficios de la lactancia materna en la salud bucal del futuro bebé (AU)
Background: there is ignorance about the benefits of breastfeeding for the oral health of the future baby.Objective: to raise awareness on pregnant women of breastfeeding for the oral health of the future baby.Methods: a descriptive, longitudinal study, quasi-experimental educational intervention was carried out in Ormani Arenado Llonch Dental Clinic, Pinar del Río, during the year 2017. The study population coincided with the sample, which consisted of 100 pregnant women, who met the inclusion criteria previous informed consent. The results were processed and presented through charts applying statistical measures of distribution of absolute and relative frequencies. Results: after the educational intervention, 94 percent of pregnant women, have obtained good results about breastfeeding, 21.3 percent of the women were 36 years old or more and 69.6 percent had university school level. As for the advantages of breastfeeding the knowledge prevailed of well after the educational activity in the advantages for newly born, mother and oral health with more than 90 percent. Regarding the oral habits last deformities, the intervention knowledge was reached in more than 90 percent on all the oral habits deformities. It was effective the educational intervention with 87 percent of having approved. Conclusions: educational intervention was effective in pregnant studied about benefits of the maternal nursing in the oral health of the future baby (AU)
Humans , Female , Pregnancy , Breast Feeding , Oral Health/education , Health Education/methods , Education, Dental/methods , Prenatal Education , Epidemiology, Descriptive , Longitudinal Studies
RESUMEN Introducción: la leptospirosis es una zoonosis de amplia distribución mundial que ocasiona grandes pérdidas a la salud del hombre. Objetivo: determinar las alteraciones morfométricas de corazón y pulmón en ratas Wistar infectadas con leptospira canícola durante la preñez. Métodos: estudio descriptivo, observacional y transversal, en el Laboratorio de Investigaciones Biomédicas de la Universidad de Ciencias Médicas de Pinar del Río, desde septiembre 2016 hasta agosto 2018, en 120 crías de ratas Wistar posterior al sacrificio, cuyas madres, durante la gestación fueron inoculadas con cepas del serogrupoleptospira canícula. Se estudiaron las variables: sexo, peso, volumen de corazón y pulmones, longitud transversa, longitud sagital, y grosor del ventrículo izquierdo. Se realizó examen morfométrico con la utilización del software MOTIC, y la digitalización de las imágenes con una cámara MOTIC-AM 3 acoplada a un estereoscopio, ambos conectados a un ordenador para la recogida y análisis de los datos. Resultados: predominaron los machos con un 55,84 %, donde se observó en ambos sexos, disminución del peso y volumen del corazón. El promedio morfométrico de la longitud transversa, longitud sagital, y el grosor del ventrículo izquierdo del corazón disminuyó sus longitudes. No existieron diferencias en ambos sexos en relación al peso y volumen de ambos pulmones. Conclusiones: resultados similares, sin evaluar otros daños, pueden ocurrir en el hombre cuando se infecta con leptospirosis. Se debe incentivar el desarrollo de investigaciones donde se utilicen otras cepas de leptospiras, que permitan evaluar y evitar defectos en el desarrollo humano.
ABSTRACT Introduction: leptospirosis is a zoonosis of wide-ranging distribution worldwide that causes great losses to human health. Objective: to determine the morphometric changes of heart and lung in Wistar rats infected with canine leptospira during pregnancy. Methods: descriptive, observational and cross-sectional study carried out at Pinar del Río University of Medical Sciences, mainly by the Biomedical Research Laboratory, from September 2016 to August 2018, on 120 offspring of Wistar rats posterior to the slaughter, whose mothers, during gestation, were inoculated with strains of the canicula serogroup leptospira. The following variables were included in the study: sex, weight, heart and lung volume, crosswise length, sagittal length, and left ventricle thickness. Morphometric examination was performed with the use of MOTIC software and digitalization of the images with a MOTIC-AM 3 camera coupled to a stereoscope, both connected to a computer for data collection and analysis. Results: male sex predominated with 55.84%, where a decrease in weight and heart volume was observed in both genders. The morphometric average of crosswise length, sagittal length and the thickness of the left ventricle of the heart decreased its lengths. There were no differences in both sexes in relation to the weight and volume of both lungs. Conclusions: similar results, without evaluating other damages, can occur in men when infected with leptospirosis. The development of researches where other strains of leptospira can be used should be encouraged, in order to evaluate and avoid defects in human development.
La apomorfina es un agonista dopa que se viene usando desde hace más 25 años en el tratamiento de la enfermedad de Parkinson avanzada con complicaciones motoras complejas, por lo cual sigue siendo de gran importancia en el tratamiento de esta etapa de la enfermedad. En el siguiente escrito, realizado por el Comité de Movimientos Anormales de la Asociación Colombiana de Neurología, se hace una revisión respecto a la medicación, su eficacia y el papel en el manejo de la enfermedad de Parkinson, así como una comparación entre las diferentes terapias avanzadas disponibles hoy en día. De la misma manera el Comité hace recomendaciones sobre las indicaciones, elección de candidatos y protocolos para el inicio de las diferentes formas de administración (intermitente e infusión continua) para optimizar el uso de esta terapia y facilitar la adherencia al tratamiento. Por otra parte, se revisan los efectos adversos relacionados con la terapia y se hacen recomendaciones sobre el manejo de las mismas, el seguimiento que se debe hacer a los pacientes que reciban apomorfina y las claves en el tratamiento a largo plazo. long term.
Apomorphine is a dopamine agonist that has been used for more than 25 years in the treatment of advanced Parkinson's disease with complex motor complications, becoming an important treatment option for this stage of the disease. In the following document, written by the movement disorders committee of the Colombian Association of Neurology, an extensive review is made about this medication, its efficacy and role in the management of Parkinson's disease as well as a comparison between the different advanced therapies available today. Additionally, recommendations about the indications, election of candidates and protocols for choosing between the different forms of administration (intermittent and continuous infusion) are establish according current evidence in order to help clinicians to optimize the use of this therapy and facilitate adherence to treatment. On the other hand, adverse effects related to the therapy are reviewed and recommendations are made about their management, as well as a protocol to follow-up patients receiving apomorphine and keys in the long term.
Humans , Parkinson Disease , Infusion Pumps , Apomorphine , Consensus
Se realizó un estudio observacional, descriptivo, de corte transversal, de 63 embarazadas que acudieron a la Clínica Estomatológica Docente Ormani Arenado Llonch de Pinar del Río, de enero a julio de 2015, a fin de caracterizarles y determinar la manifestación de algunas enfermedades periodontales (gingivitis crónica edematosa, gingivitis crónica fibroedematosa y estomatitis aftosa) en ellas. En la investigación se obtuvo una preponderancia del grupo etario de 21-26 años (32,0 por ciento), cuyas pacientes estuvieron mayormente afectadas por estomatitis aftosa (34,4 por ciento), y como principales factores de riesgo figuraron la dieta cariogénica (79,4 por ciento) y la mala higiene bucal (71,4 por ciento). De igual modo, resultaron más frecuentes el cálculo dental (71,4 por ciento) y el dolor (66,7 por ciento) entre los síntomas y signos de las enfermedades periodontales, con predominio del último en todas las gestantes que presentaban estomatitis aftosa(AU)
An observational, descriptive, cross-sectional study, of 63 pregnant women, that went to Ormani Arenado Llonch Teaching Stomatological Clinic was carried out in Pinar del Río, from January to July, 2015, in order to characterize them and determine the manifestation of some periodontal diseases (chronic edematous gingivitis, chronic fibroedematous gingivitis and aphthous stomatitis). In the investigation there was a prevalence of the 21-26 age group (32.0 percent) whose patients were mostly affected by aphthous stomatitis (34.4 percent), and as main risk factors we can mention the cariogenic diet (79.4 percent) and poor oral hygiene (71.4 percent). Likewise, dental calculus (71.4 percent) and pain (66.7 percent) were more frequent among the symptoms and signs of periodontal diseases, with prevalence of the latter in all the pregnant women that presented aphthous stomatitis(AU)
Humans , Female , Pregnancy , Periodontal Diseases , Stomatitis, Aphthous , Gingivitis , Epidemiology, Descriptive , Cross-Sectional Studies , Observational Studies as Topic
