Perceived instructor presence, interactive tools, student engagement, and satisfaction in hybrid education post-COVID-19 lockdown in Mexico.

Interactive communication platforms have been widely used to support online teaching. However, during the Coronavirus Diseases 2019 (COVID-19) pandemic they gained unprecedented relevance since they allowed educational processes to continue. This study investigated the relationship among interactive communication technology tools, perceived instructor presence, student satisfaction and engagement in hybrid courses post-COVID-19 lockdown. An electronic questionnaire was administered to 1086 students from a public university in Mexico that implemented a hybrid class model using Microsoft Teams after the lockdown. Jamovi and WarpPLS were used to perform confirmatory factor analysis and structural equation modeling. The findings revealed that interactive technological communication tools positively impact the instructor's perceived presence, student satisfaction and engagement. Similarly, commitment significantly positively impacted student satisfaction. The model demonstrated a good fit. The findings were consistent with studies before and during the lockdown. The instructor's perceived presence promotes student engagement and satisfaction, and Microsoft Teams effectively facilitates this presence. These findings suggest that interactive communication tools are and will be significant in educational contexts and modalities. This study provides useful insights for educators, course designers and educational administrators, emphasizing effective communication with students and implementing interactive technological communication tools to enhance hybrid learning in the post-pandemic era.

Structure analysis of the proteins associated with polyA repeat expansion disorders.

Repeat regions are low-complexity regions in the human genome that largely code for intrinsic disorder in proteins. Expansions outside the normal thresholds in repeat regions are likely to be pathogenic, leading to the so-called repeat expansion diseases. There have been numerous studies on the most common group of repeat expansion diseases, which are the polyglutamine (polyQ) repeat expansion diseases, but there has been much less work done on the second-largest group of expansion repeats disorders, which involves the expansion of polyalanine (polyA) repeat tracts. In this article, we present a comprehensive study of the structural changes predicted using I-TASSER when comparing the wild type and enlarged structures of all known polyA expansion disorders. The results show that there is a reduction in α helices, an increase in extended strands in parallel and/or anti-parallel ß-sheet conformation, an increase in random coils/loops and irregular elements, and a large increase in solvent-accessible surface area. When compared to the findings in polyQ expansions disorders we see similar trends, suggesting that the polyQ and polyA repeat expansion causes similar effects on the respective proteins, which lead to higher misfolding and aggregation propensities.Communicated by Ramaswamy H. Sarma.

Gestión de la calidad en el servicio de Ortodoncia / Orthodontic quality management service

RESUMEN Fundamento: Un sistema de gestión de calidad es una valiosa herramienta para perfeccionar los servicios de salud pública. Objetivo: Caracterizar el estado actual de la gestión de la calidad en el servicio de Ortodoncia para contribuir a una atención de calidad en pacientes con anomalías dentomaxilofaciales. Metodología: Se realizó un estudio descriptivo transversal entre septiembre de 2020 y julio de 2021 en la Clínica Estomatológica Docente Provincial de Sancti Spíritus. Se seleccionaron 3 directivos y 12 miembros del equipo básico de ortodoncia. Se midieron las variables: nivel de información y prácticas sobre gestión de la calidad. Se utilizaron métodos del nivel teórico, empírico y de la estadística descriptiva. Resultados: El 50 % de los miembros del equipo básico presentó un nivel bajo de información sobre la gestión de la calidad en el servicio de Ortodoncia. El 100 % de estos y sus directivos, mostraron prácticas medianamente adecuadas en tres de los cinco aspectos evaluados. Conclusiones: El proceso de gestión de la calidad en el servicio Ortodoncia permitió determinar que, aunque existen directivos con experiencia laboral y un equipo básico con preparación científico-técnica, predominaron con el nivel bajo de información, así como las prácticas medianamente adecuadas sobre la gestión de la calidad.

ABSTRACT Background: A quality management system is a valuable tool for improving public health services. Objective: To describe the current state of orthodontic quality management service to contribute to the patients' quality care with dentofacial abnormalities. Methodology: A descriptive cross-sectional study was conducted between September 2020 and July 2021 at the Sancti Spíritus provincial and teaching stomatology center. Three managers and 12 members of the basic orthodontic team were selected. The following variables were measured: level of information and quality management practices. Theoretical, empirical and descriptive statistical methods were used. Results: 50 % of the basic team members had a low level of information on the orthodontic quality management service. 100 % of them also their managers, showed moderately adequate practices in three of the five aspects evaluated. Conclusions: The orthodontic quality management service allowed us to determine that, although there are managers with work experience and a basic team with scientific-technical preparation, a low level of information prevailed, as well as moderately adequate practices on quality management.

A Rare Variant in ERF (rs144812092) Predisposes to Prostate and Bladder Cancers in an Extended Pedigree.

Pairs of related bladder cancer cases who belong to pedigrees with an excess of bladder cancer were sequenced to identify rare, shared variants as candidate predisposition variants. Candidate variants were tested for association with bladder cancer risk. A validated variant was assayed for segregation to other related cancer cases, and the predicted protein structure of this variant was analyzed. This study of affected bladder cancer relative pairs from high-risk pedigrees identified 152 bladder cancer predisposition candidate variants. One variant in ERF (ETS Repressing Factor) was significantly associated with bladder cancer risk in an independent population, was observed to segregate with bladder and prostate cancer in relatives, and showed evidence for altering the function of the associated protein. This finding of a rare variant in ERF that is strongly associated with bladder and prostate cancer risk in an extended pedigree both validates ERF as a cancer predisposition gene and shows the continuing value of analyzing affected members of high-risk pedigrees to identify and validate rare cancer predisposition variants.

An intronic variant in the CELF4 gene is associated with risk for colorectal cancer.

BACKGROUND: Germline predisposition variants associated with colorectal cancer (CRC) have been identified but all are not yet identified. We sought to identify the responsible predisposition germline variant in an extended high-risk CRC pedigree that exhibited evidence of linkage to the 18q12.2 region (TLOD = +2.81). METHODS: DNA from two distantly related carriers of the hypothesized predisposition haplotype on 18q12.2 was sequenced to identify candidate variants. The candidate rare variants shared by the related sequenced subjects were screened in 3,094 CRC cases and 5x population-matched controls from UKBiobank to test for association. Further segregation of the variant was tested via Taqman assay in other sampled individuals in the pedigree. RESULTS: Analysis of whole genome sequence data for the two related hypothesized predisposition haplotype carriers, restricted to the shared haplotype boundaries, identified multiple (n = 6) rare candidate non-coding variants that were tested for association with CRC risk in UKBiobank. A rare intronic variant ofCELF4 gene, rs568643870, was significantly associated with CRC (p = 0.004, OR = 5.0), and segregated with CRC in other members of the linked pedigree. CONCLUSION: Evidence of segregation in a high-risk pedigree, case-control association in an external dataset, and identification of additional CRC-affected carriers in the linked pedigree support a role for a rareCELF4 intronic variant in CRC risk.

Understanding protein structural changes for oncogenic missense variants.

Understanding and predicting the changes of protein structure and function upon mutation and their relationship to human health is a critical element to translate the genomic revolution into actionable interventions. Therefore, it is pertinent to explore how mutations result in structural changes leading to pathogenic proteins, but due to the protein structural knowledge gap, experimental approaches are lacking. Protein structure prediction methods, such as I-TASSER, have made it possible to predict the structure of a given amino acid sequence, thus opening a new way to explore protein structure changes upon mutations when experimental information is not available. Using known mutations from the Catalogue of Somatic Mutation in Cancer (COSMIC) and ClinVar databases, we compare predicted structure-derived properties from wild type (WT) and mutated proteins and find differences between the local and global 3D protein structures of the WT and the mutants. The studies in this relatively small sample reveal that the structural changes are quite diverse.

A role for the MEGF6 gene in predisposition to osteoporosis.

Osteoporosis is a common skeletal disorder characterized by deterioration of bone tissue. The set of genetic factors contributing to osteoporosis is not completely specified. High-risk osteoporosis pedigrees were analyzed to identify genes that may confer susceptibility to disease. Candidate predisposition variants were identified initially by whole exome sequencing of affected-relative pairs, approximately cousins, from 10 pedigrees. Variants were filtered on the basis of population frequency, concordance between pairs of cousins, affecting a gene associated with osteoporosis, and likelihood to have functionally damaging, pathogenic consequences. Subsequently, variants were tested for segregation in 68 additional relatives of the index carriers. A rare variant in MEGF6 (rs755467862) showed strong evidence of segregation with the disease phenotype. Predicted protein folding indicated the variant (Cys200Tyr) may disrupt structure of an EGF-like calcium-binding domain of MEGF6. Functional analyses demonstrated that complete loss of the paralogous genes megf6a and megf6b in zebrafish resulted in significant delay of cartilage and bone formation. Segregation analyses, in silico protein structure modeling, and functional assays support a role for MEGF6 in predisposition to osteoporosis.

Valoración del método de estudio de caso virtual en el posgrado académico / Assessment of the virtual case study method in the academic postgraduate

Introducción: El método de estudio de caso por vía virtual es una herramienta didáctica de gran valor en el proceso pedagógico del posgrado. Este método, promueve el aprendizaje activo de los residentes, y posee inestimable valor como instrumento del posgrado que se imparte, su ejecución favorece el perfeccionamiento del programa de formación académica de la especialidad. Objetivo: Valorar la satisfacción de los residentes y profesores de la especialidad de Periodoncia con el método de estudio de caso virtual como herramienta didáctica. Métodos: Se realizó una investigación descriptiva, con enfoque cualitativo, desarrollada de enero a abril del 2020, en la Facultad de Estomatología de la Universidad de Ciencias Médicas de Villa Clara y en la Universidad de Ciencias Médicas de las FAR. La población estuvo compuesta por 6 profesores y 7 residentes de la especialidad de Periodoncia y 3 profesores de otras especialidades estomatológicas. Satisfacción con la utilización del caso clínico, residentes y profesores, constituyeron variables del estudio. Resultados: Los casos clínicos preparados por cada profesor, incluían dificultades que no tenían una única solución, para favorecer la comprensión de problemas divergentes y la adopción de soluciones mediante la reflexión. En el análisis de la satisfacción, la mayoría de las respuestas seleccionadas por los residentes y profesores fue siempre. Conclusiones: La satisfacción de residentes y profesores con el uso del estudio de caso virtual fue alta(AU)

Introduction: The virtual case study method is a valuable teaching tool in the postgraduate pedagogical process that can be used for the development of meaningful and autonomous learning. The case study by virtual means, promotes the active learning of the residents, and has invaluable value as an instrument of the postgraduate course that is taught, its execution favors the improvement of the academic training program of the specialty. Objective: To assess the satisfaction of residents and teachers of the periodontics specialty with the virtual case study method as a teaching tool. Method: A descriptive research, with a qualitative approach, was carried out from January to April 2020, at the Faculty of Stomatology of Villa Clara and at the University of Medical Sciences of the FAR. The population was made up of 6 professors and 7 residents of the periodontology specialty and 3 professors from other dental specialties. Satisfaction with the use of the clinical case, residents and teachers, were study variables. Results: The clinical cases prepared by each teacher included difficulties that did not have a single solution, to favor the understanding of divergent problems and the adoption of solutions through reflection. In the analysis of satisfaction; Most of the responses selected by residents and teachers were always. Conclusions: The satisfaction of residents and teachers of the Periodontics specialty with the use of the virtual case study method was high(AU)

Desarrollo histórico de la especialidad Ortodoncia en Sancti Spíritus / Historical development of the Orthodontic specialty in Sancti Spíritus

RESUMEN Fundamento: En la provincia Sancti Spíritus se constató la ausencia de evidencias documentales de la historia de la especialidad Ortodoncia, por lo que es necesario un estudio para rescatar información que contribuya al patrimonio científico cubano en ciencias de la salud, asimismo para la formación del potencial humano actual y futuro. Objetivo: Describir el desarrollo histórico de la especialidad Ortodoncia en la provincia Sancti Spíritus. Metodología: Se realizó una investigación cualitativa con el uso de métodos teóricos: histórico-lógico, analítico-sintético y empíricos: entrevista y análisis documental, en el período comprendido entre 1980 y 2018. Resultados: Desde el surgimiento de la especialidad en la provincia hasta 1999 se crearon instalaciones de salud para realizar la atención de Ortodoncia en la localidad, lo que potencializado por la creación del grupo y el capítulo, permitió la formación de los primeros especialistas a pesar de las limitaciones materiales. En un segundo momento hasta la actualidad se perfeccionó el plan de estudios, se extendieron los servicios a todos los municipios y se incrementó la producción científica (reconocimientos, premios, participación en eventos nacionales e internacionales y publicaciones). Conclusiones: La especialidad ha tenido un desarrollo progresivo en la provincia en la medida que se ha fortalecido el claustro de profesores, con una formación estable del capital humano que cubre las necesidades de atención de la población en el territorio y con resultados científico-técnicos que avalan su alto nivel actual. La descripción de su evolución histórica permite perfeccionar la formación de las futuras generaciones y profundizar en otras temáticas como la gestión de la calidad.

ABSTRACT Background: In Sancti Spíritus province, the absence of documentary evidence about the history of the Orthodontic specialty was verified, so it is necessary a study to rescue information that contributes to the Cuban scientific heritage in health sciences, thus for the formation of the current and future human potential. Objective: To describe the historical development of the Orthodontic specialty in Sancti Spíritus province. Methodology: A qualitative research was carried out with the use of theoretical methods: historical-logical, analytical-synthetic and empirical: interview and documentary analysis, from 1980 to 2018. Results: From the emergence of the specialty in the province until 1999, health facilities were created to carry out Orthodontic care in the locality, which, potentiated by the creation of the group and the chapter, allowed the training of the first specialists despite the material limitations. In a second moment until today, the study plan was developed, services were extended to all municipalities and scientific production was increased (recognitions, awards, participation in national and international events and publications). Conclusions: The specialty has had a progressive development in the province as the teachers cloister has been strengthened, with a stable training of human capital that covers the care needs of the population in the territory and with scientific-technical results that endorse its current high level. The description of its historical evolution allows improving on the training of future generations thus, deep into other topics such as quality management.

Desarrollo histórico de la especialidad Ortodoncia en Sancti Spíritus / Historical development of the Orthodontic specialty in Sancti Spíritus

RESUMEN Fundamento: En la provincia Sancti Spíritus se constató la ausencia de evidencias documentales de la historia de la especialidad Ortodoncia, por lo que es necesario un estudio para rescatar información que contribuya al patrimonio científico cubano en ciencias de la salud, asimismo para la formación del potencial humano actual y futuro. Objetivo: Describir el desarrollo histórico de la especialidad Ortodoncia en la provincia Sancti Spíritus. Metodología: Se realizó una investigación cualitativa con el uso de métodos teóricos: histórico-lógico, analítico-sintético y empíricos: entrevista y análisis documental, en el período comprendido entre 1980 y 2018. Resultados: Desde el surgimiento de la especialidad en la provincia hasta 1999 se crearon instalaciones de salud para realizar la atención de Ortodoncia en la localidad, lo que potencializado por la creación del grupo y el capítulo, permitió la formación de los primeros especialistas a pesar de las limitaciones materiales. En un segundo momento hasta la actualidad se perfeccionó el plan de estudios, se extendieron los servicios a todos los municipios y se incrementó la producción científica (reconocimientos, premios, participación en eventos nacionales e internacionales y publicaciones). Conclusiones: La especialidad ha tenido un desarrollo progresivo en la provincia en la medida que se ha fortalecido el claustro de profesores, con una formación estable del capital humano que cubre las necesidades de atención de la población en el territorio y con resultados científico-técnicos que avalan su alto nivel actual. La descripción de su evolución histórica permite perfeccionar la formación de las futuras generaciones y profundizar en otras temáticas como la gestión de la calidad.

ABSTRACT Background: In Sancti Spíritus province, the absence of documentary evidence about the history of the Orthodontic specialty was verified, so it is necessary a study to rescue information that contributes to the Cuban scientific heritage in health sciences, thus for the formation of the current and future human potential. Objective: To describe the historical development of the Orthodontic specialty in Sancti Spíritus province. Methodology: A qualitative research was carried out with the use of theoretical methods: historical-logical, analytical-synthetic and empirical: interview and documentary analysis, from 1980 to 2018. Results: From the emergence of the specialty in the province until 1999, health facilities were created to carry out Orthodontic care in the locality, which, potentiated by the creation of the group and the chapter, allowed the training of the first specialists despite the material limitations. In a second moment until today, the study plan was developed, services were extended to all municipalities and scientific production was increased (recognitions, awards, participation in national and international events and publications). Conclusions: The specialty has had a progressive development in the province as the teachers cloister has been strengthened, with a stable training of human capital that covers the care needs of the population in the territory and with scientific-technical results that endorse its current high level. The description of its historical evolution allows improving on the training of future generations thus, deep into other topics such as quality management.

Desarrollo histórico de la especialidad Ortodoncia en Sancti Spíritus / Historical development of the Orthodontic specialty in Sancti Spíritus

Fundamento: En la provincia Sancti Spíritus se constató la ausencia de evidencias documentales de la historia de la especialidad Ortodoncia, por lo que es necesario un estudio para rescatar información que contribuya al patrimonio científico cubano en ciencias de la salud, asimismo para la formación del potencial humano actual y futuro(AU)

Background: In Sancti Spíritus province, the absence of documentary evidence about the history of the Orthodontic specialty was verified, so it is necessary a study to rescue information that contributes to the Cuban scientific heritage in health sciences, thus for the formation of the current and future human potential

A novel CDKN2A variant (p16L117P ) in a patient with familial and multiple primary melanomas.

Germline mutations in CDKN2A (p16) are commonly found in patients with family history of melanoma or personal history of multiple primary melanomas. The p16 tumor suppressor gene regulates cell cycle progression and senescence through binding of cyclin-dependent kinases (CDK) and also regulates cellular oxidative stress independently of cell cycle control. We identified a germline missense (c.350T>C, p.Leu117Pro) CDKN2A mutation in a patient who had history of four primary melanomas, numerous nevi, and self-reported family history of melanoma. This particular CDKN2A mutation has not been previously reported in prior large studies of melanoma kindreds or patients with multiple primary melanomas. Compared with wild-type p16, the p16L117P mutant largely retained binding capacity for CDK4 and CDK6 but exhibited impaired capacity for repressing cell cycle progression and inducing senescence, while retaining its ability to reduce mitochondrial reactive oxygen species. Structural modeling predicted that the Leu117Pro mutation disrupts a putative adenosine monophosphate (AMP) binding pocket involving residue 117 in the fourth ankyrin domain. Identification of this new likely pathogenic variant extends our understanding of CDKN2A in melanoma susceptibility and implicates AMP as a potential regulator of p16.

Fuentes de información de patentes y procedimiento para las búsquedas de libertad de acción en Cuba / Patent information sources and procedure for freedom-to-operate searches in Cuba

Objetivo: proponer un procedimiento metodológico para la realización de búsquedas de libertad de acción utilizando información técnica legal de documentos de patentes. Métodos: primeramente se caracterizaron numerosas bases de datos de patentes de acceso gratuito disponibles en internet (Patentescope®, Latipat, Espacenet, Invenes, Depatisnet, Lens.org y Patentinspiration) con respecto a la cobertura temporal y a la cantidad de patentes cubanas, y se identificaron y estudiaron dos fuentes de información que recogen estados legales de estas (INPADOC y WIPO Register Portal). Resultados: Patentscope® e Invenes se consideraron como las mejores bases, ya que permiten la búsqueda en el documento completo (título, resumen, descripción y reivindicaciones) mediante palabras clave; y Depatisnet se considera útil cuando se consulta mediante el Código Internacional de Patentes reclasificado por la Oficina de Patentes Alemana. No obstante, se recomienda el uso de todas las bases estudiadas para evadir errores relacionados con los contenidos y otras limitaciones relacionadas con las facilidades de búsqueda. A partir de las prestaciones detectadas en las fuentes de información analizadas, se implementó y perfeccionó un proceso de búsqueda sobre un medicamento preventivo contra el VIH/SIDA que demostró que existía libertad de acción en Cuba para su explotación, así como también la pertinencia de las herramientas y la metodología utilizadas para realizar este tipo de búsquedas. Conclusiones: este estudio de caso permite poner en práctica un procedimiento para realizar búsquedas y evidencia la importancia de la implementación del servicio de búsqueda libertad de acción para facilitar el acceso a invenciones patentadas, especialmente en el campo médico-farmacéutico(AU)

Objective: a methodological procedure is proposed to conduct freedom-to-operate searches using patent documentation-related legal technical information. Methods: first, characterization was performed of a large number of open-access patent databases available on the Internet (Patentescope®, Latipat, Espacenet, Invenes, Depatisnet, Lens.org and Patentinspiration) with respect to time coverage and number of Cuban patents, followed by identification and analysis of two information sources referring to their legal status (INPADOC y WIPO Register Portal). Results: Patentscope® and Invenes were considered to be the best databases, since they allow to search the entire document (title, abstract, description and claims) by means of key words. Depatisnet was found to be useful for inquiries about the International Patent Classification as re-classified by the German Patent Office. However, it is recommended to use all the databases studied to avoid content-related errors and other limitations to do with search functions. Based on the possibilities offered by the information sources analyzed, a search procedure for an HIV/AIDS preventive drug was implemented and perfected, showing that there was freedom-to-operate in Cuba for its exploitation, as well as the relevance of the tools and the methodology used to perform this type of search. Conclusions: in this case study a procedure is made operational and evidence is provided of the importance of implementing the freedom-to-operate search service to facilitate access to patented inventions, especially in the medical-pharmaceutical field(AU)

Fuentes de información de patentes y procedimiento para las búsquedas de libertad de acción en Cuba / Patent information sources and procedure for freedom-to-operate searches in Cuba

Objetivo: proponer un procedimiento metodológico para la realización de búsquedas de libertad de acción utilizando información técnica legal de documentos de patentes. Métodos: primeramente se caracterizaron numerosas bases de datos de patentes de acceso gratuito disponibles en internet (Patentescope®, Latipat, Espacenet, Invenes, Depatisnet, Lens.org y Patentinspiration) con respecto a la cobertura temporal y a la cantidad de patentes cubanas, y se identificaron y estudiaron dos fuentes de información que recogen estados legales de estas (INPADOC y WIPO Register Portal). Resultados: Patentscope® e Invenes se consideraron como las mejores bases, ya que permiten la búsqueda en el documento completo (título, resumen, descripción y reivindicaciones) mediante palabras clave; y Depatisnet se considera útil cuando se consulta mediante el Código Internacional de Patentes reclasificado por la Oficina de Patentes Alemana. No obstante, se recomienda el uso de todas las bases estudiadas para evadir errores relacionados con los contenidos y otras limitaciones relacionadas con las facilidades de búsqueda. A partir de las prestaciones detectadas en las fuentes de información analizadas, se implementó y perfeccionó un proceso de búsqueda sobre un medicamento preventivo contra el VIH/SIDA que demostró que existía libertad de acción en Cuba para su explotación, así como también la pertinencia de las herramientas y la metodología utilizadas para realizar este tipo de búsquedas. Conclusiones: este estudio de caso permite poner en práctica un procedimiento para realizar búsquedas y evidencia la importancia de la implementación del servicio de búsqueda libertad de acción para facilitar el acceso a invenciones patentadas, especialmente en el campo médico-farmacéutico(AU)

Objective: a methodological procedure is proposed to conduct freedom-to-operate searches using patent documentation-related legal technical information. Methods: first, characterization was performed of a large number of open-access patent databases available on the Internet (Patentescope®, Latipat, Espacenet, Invenes, Depatisnet, Lens.org and Patentinspiration) with respect to time coverage and number of Cuban patents, followed by identification and analysis of two information sources referring to their legal status (INPADOC y WIPO Register Portal). Results: Patentscope® and Invenes were considered to be the best databases, since they allow to search the entire document (title, abstract, description and claims) by means of key words. Depatisnet was found to be useful for inquiries about the International Patent Classification as re-classified by the German Patent Office. However, it is recommended to use all the databases studied to avoid content-related errors and other limitations to do with search functions. Based on the possibilities offered by the information sources analyzed, a search procedure for an HIV/AIDS preventive drug was implemented and perfected, showing that there was freedom-to-operate in Cuba for its exploitation, as well as the relevance of the tools and the methodology used to perform this type of search. Conclusions: in this case study a procedure is made operational and evidence is provided of the importance of implementing the freedom-to-operate search service to facilitate access to patented inventions, especially in the medical-pharmaceutical field(AU)

Necrólisis tóxica epidérmica inducida por cotrimoxazol / Epidermic toxic necrolysis induced by co-trimoxazole

Se describe el caso clínico de una paciente de 60 años de edad con antecedentes de hipertensión arterial, por lo cual llevaba tratamiento con nifedipino, quien asistió al Cuerpo de Guardia del Hospital General Docente "Orlando Pantoja Tamayo" en el municipio de Contramaestre, Santiago de Cuba, por presentar deposiciones diarreicas, vómitos, hipertermia (38 0C) y lesiones generalizadas en la piel en forma de pústulas eritemato-costrosas con flictenas y dolor. La paciente refirió que solía automedicarse con cotrimoxazol por la reiteración de infecciones urinarias y que desde hacía 3 días estaba consumiendo dicho medicamento. El estudio histopatológico mostró una necrólisis tóxica epidérmica (síndrome de Lyell). A pesar de los cuidados médicos, evolucionó desfavorablemente y se complicó con una insuficiencia renal aguda, lo que le condujo a la muerte

The case report of a 60 years patient with a history of hypertension, reason why she had treatment with nifedipine, who went to the Emergency Room of "Orlando Pantoja Tamayo" Teaching General Hospital in Contramaestre, Santiago de Cuba, due to diarrheical stools, vomits, hyperthermia (38 0C) and generalized skin injuries in the type of erythemato-scabby pustules with flictenas and pain is described. The patient referred that she was accustomed to self-medication with co-trimoxazole due to repeated urinary infections and that she was consuming this medication for 3 days. The pathological study showed an epidermic toxic necrolysis (Lyell syndrome). In spite of the medical cares, she had an unfavorable clinical course and she complicated with an acute renal failure, leading to death

Necrólisis tóxica epidérmica inducida por cotrimoxazol / Epidermic toxic necrolysis induced by co-trimoxazole

Se describe el caso clínico de una paciente de 60 años de edad con antecedentes de hipertensión arterial, por lo cual llevaba tratamiento con nifedipino, quien asistió al Cuerpo de Guardia del Hospital General Docente Orlando Pantoja Tamayo en el municipio de Contramaestre, Santiago de Cuba, por presentar deposiciones diarreicas, vómitos, hipertermia (38 0C) y lesiones generalizadas en la piel en forma de pústulas eritemato-costrosas con flictenas y dolor. La paciente refirió que solía automedicarse con cotrimoxazol por la reiteración de infecciones urinarias y que desde hacía 3 días estaba consumiendo dicho medicamento. El estudio histopatológico mostró una necrólisis tóxica epidérmica (síndrome de Lyell). A pesar de los cuidados médicos, evolucionó desfavorablemente y se complicó con una insuficiencia renal aguda, lo que le condujo a la muerte(AU)

The case report of a 60 years patient with a history of hypertension, reason why she had treatment with nifedipine, who went to the Emergency Room of Orlando Pantoja Tamayo Teaching General Hospital in Contramaestre, Santiago de Cuba, due to diarrheical stools, vomits, hyperthermia (38 0C) and generalized skin injuries in the type of erythemato-scabby pustules with flictenas and pain is described. The patient referred that she was accustomed to self-medication with co-trimoxazole due to repeated urinary infections and that she was consuming this medication for 3 days. The pathological study showed an epidermic toxic necrolysis (Lyell syndrome). In spite of the medical cares, she had an unfavorable clinical course and she complicated with an acute renal failure, leading to death(AU)

Efectividad del tratamiento homeopático en pacientes con trastorno del sueño / Effectiveness of the homeopathic treatment in patients with sleeping disorder

Se realizó un estudio experimental, de tipo intervención terapéutica, en 48 pacientes con trastorno del sueño, atendidos en el Centro de Salud Mental del municipio de Contramaestre, de la provincia de Santiago de Cuba, desde enero hasta junio de 2015, con vistas evaluar la respuesta al tratamiento con homeopatía. Se conformaron 2 grupos de 24 integrantes cada uno: el primero recibió los beneficios de los remedios homeopáticos y el segundo, tratamiento convencional. Entre los resultados principales predominaron el trastorno ansioso (50,0 %) y el uso de la pasiflora (45,0 %). El tratamiento homeopático resultó ser tan efectivo como el convencional, la evolución clínica fue más rápida y no produjo reacciones adversas.

An experimental, of therapeutic intervention study type was carried out, in 48 patients with sleeping disorder, assisted in the Mental Health Center of Contramaestre, in Santiago de Cuba, from January to June, 2015, aimed at evaluating the response to the treatment with homeopathy. Two groups of 24 members each were formed: the first one received the benefits of the homeopathic remedies and the second, conventional treatment. Among the main results the anxious disorder (50.0%) and the use of passiflora (45.0%) prevailed. The homeopathic treatment was as effective as the conventional one, the clinical course was faster and it didn't produce adverse reactions.

Efectividad del tratamiento homeopático en pacientes con trastorno del sueño / Effectiveness of the homeopathic treatment in patients with sleeping disorder

Se realizó un estudio experimental, de tipo intervención terapéutica, en 48 pacientes con trastorno del sueño, atendidos en el Centro de Salud Mental del municipio de Contramaestre, de la provincia de Santiago de Cuba, desde enero hasta junio de 2015, con vistas evaluar la respuesta al tratamiento con homeopatía. Se conformaron 2 grupos de 24 integrantes cada uno: el primero recibió los beneficios de los remedios homeopáticos y el segundo, tratamiento convencional. Entre los resultados principales predominaron el trastorno ansioso (50,0 por ciento) y el uso de la pasiflora (45,0 por ciento). El tratamiento homeopático resultó ser tan efectivo como el convencional, la evolución clínica fue más rápida y no produjo reacciones adversas(AU)

An experimental, of therapeutic intervention study type was carried out, in 48 patients with sleeping disorder, assisted in the Mental Health Center of Contramaestre, in Santiago de Cuba, from January to June, 2015, aimed at evaluating the response to the treatment with homeopathy. Two groups of 24 members each were formed: the first one received the benefits of the homeopathic remedies and the second, conventional treatment. Among the main results the anxious disorder (50.0 percent) and the use of passiflora (45.0 percent) prevailed. The homeopathic treatment was as effective as the conventional one, the clinical course was faster and it didn't produce adverse reactions(AU)

Efectividad de la acupuntura en la crisis aguda de asma bronquial / Effectiveness of the acupuncture in bronchial asthma acute crisis

El asma bronquial es una enfermedad respiratoria con significativa prevalencia y una de las principales causas de ingreso hospitalario y la acupuntura una forma terapéutica de la Medicina Tradicional y Natural con múltiples indicaciones, dentro de ellas esta afección. Determinar la evolución de los pacientes asmáticos persistentes moderados de ambos sexos antes y después del tratamiento con acupuntura en el servicio de urgencia en el Hospital General Docente Abel Santamaría Cuadrado de Pinar del Río. Se realizó un estudio de intervención, prospectivo, longitudinal, utilizando la acupuntura como modalidad terapéutica de la Medicina Tradicional China en pacientes que acudieron al cuerpo de guardia de Medicina Interna del Hospital General Docente Abel Santamaría Cuadrado de Pinar del Rio, en el período comprendido entre octubre-diciembre del 2013. El universo lo integraron todos los pacientes que acudieron a la consulta con crisis aguda de asma bronquial (223) y la muestra, 83 pacientes clasificados como asmáticos persistentes moderados utilizándose acupuntura en los puntos pulmón 7, vaso concepción 17 y vejiga 13 al grupo de estudio (41 pacientes) y 42 con tratamiento convencional. Al tratar estos pacientes se ha evidenciado que el 78,4 por ciento de ellos mejoró por la aplicación de este método milenario. Ninguno presentó complicaciones y sólo 11 pacientes no mejoraron. Los pacientes respondieron de igual forma al tratamiento sin distinción de edad y sexo, demostrando este método ser eficiente, de fácil aplicación con aparición de menos reacciones adversas y además económico(AU)

Bronchial asthma is a respiratory disease with significant prevalence, and one of the main causes of hospitalization and acupuncture is a therapeutic may in natural and traditional medicine with multiple indications, among them this affection. The objective was to determine the evolution of moderate-to-persistent asthmatic patients of both sexes before and after acupuncture treatment in the urgency service of Pinar del Río Abel Santamaría Cuadrado General Teaching Hospital. A prospective, longitudinal study of intervention was carried out using acupuncture as a therapeutic modality of natural and traditional medicine on patients attending the internal medicine emergency room at Pinar del Río Abel Santamaría Cuadrado General Teaching Hospital in the period from October to December 2013. The target group was composed by all the patients attending the service with bronchial asthma acute crisis (223) and the sample was of 83 patient classified as moderate-to-persistent asthmatic, using acupuncture in the point lung-7, spleen-cenception-17 and urinary bladder-13 to the study group (43 patients) and 42 with conventional treatment. On treating these patients, it has been evinced that 78.4 per cent of them improved their health by application of this millenary method. None of them presented complications and only 11 of them did not improve their health. Conclusions: the patients responded equally to the treatment with no distinction of sex or age, this method proving efficient, of easy application with onset of fewer adverse reactions and also economical(AU)