Search

Introduction: the COVID-19-related infodemic makes necessary to evaluate all the indicators published and generated by science. Objective: to describe scientific articles about COVID-19 published on Cuban online medical school magazines. Method: an observational, descriptive and bibliometric study was carried through, checking on articles about COVID-19 on Cuban medical online magazines in the period January-June 2020. Every article about COVID-19 published in the 15 magazines currently online was downloaded in the same language and format they were available, taking into account the number of the volume, issue and section where they were published; the authors and the institutions they were affiliated to; place of origin and how many bibliographical references they had. Price´s transience index and variation rates were calculated. Results: 80 articles about COVID-19 were identified, 33.75% of them published in the magazine Revista Habanera de Ciencias Médica. Original articles prevailed (38.75%); 28.75% of them were written in Spanish and English as well, and 72.50% had multiple authors (244 of them, from 99 institutions). 1425 references were made, with a Price´s transience index of 0.86. 75 articles presented at least one quotation, and 75 citations were received. The number of publications peaked in May, with a variation rate of 80.95% compared to April. Conclusions: there is a low number of articles about COVID-19 in the online medical magazines issued by Cuban medicine schools, most of them in the on the magazines Revista Habanera de Ciencias Médicas and Medisur. The provinces and institutions with a higher number of articles coincide with the ones with the top publishing magazines.

Introducción: El plasma de convalecientes es una inmunoterapia pasiva que se ha usado para el tratamiento y prevención de muchas enfermedades infecciosas por más de un siglo. Dada la falta de tratamiento específico para el nuevo coronavirus SARS-CoV-2, el plasma de convalecientes es una alternativa terapéutica potencial contra la COVID-19. Objetivo: Realizar una revisión del empleo del plasma de convalecientes como alternativa terapéutica a la COVID-19. Desarrollo: Se empleó la estrategia de búsqueda del tema; consultando las bases de datos Pubmed, SciELO, Lilacs, Cochrane Library y Web of Science. El plasma de convalecientes ha mostrado efectividad en el tratamiento de varias enfermedades virales. Así, la evidencia sobre su uso en los pacientes con COVID-19 es escasa, aunque se han obtenido resultados alentadores, pero no concluyentes por falta de un número mayor ensayos clínicos. Al mismo tiempo, Cuba incluye en sus protocolos de actuación contra la COVID-19 este tratamiento. Conclusiones: Esta alternativa resulta una herramienta inmunoterapéutica en los pacientes con la COVID-19, ya que mejora el estado clínico y disminuir la tasa de letalidad. Sin embargo, se necesitan más ensayos clínicos controlados y aleatorizados que afirmen su efectividad y seguridad.

Introducción: En la actualidad, uno de los temas más polémicos que involucra en gran proporción al campo de la Medicina es el uso terapéutico de la marihuana y su legalización. Esta planta de reconocimiento milenario ha desatado en las últimas décadas disímiles de controversias dado el descubrimiento del sistema endocannabinoide que revolucionó la investigación sobre ella. Objetivo: Describir la situación actual del cannabis, sus beneficios terapéuticos y sus efectos adversos. Material y métodos: Se realizó una exhaustiva búsqueda y revisión empleando los Descriptores en Ciencias de la Salud, en idioma inglés y español, consultando las bases de datos Pubmed, Scielo, Lilacs, Cochrane Library y Web of Science, para los últimos 10 años, empleándose un total de 45 artículos como referencias bibliográficas. Desarrollo: Al Cannabis se le han atribuido efectos farmacológicos, tales como: antinociceptivo, antiepiléptico, inmunosupresivo, antiemético, estimulante del apetito, antimicrobiano, antiinflamatorio y neuroprotector. A su vez, presenta disímiles reacciones adversas como son la predisposición a varios tipos de cáncer, empeoramiento de desórdenes mentales, dificultades en el aprendizaje y el rendimiento escolar, que constituye una droga portera, entre otros. A pesar de las tendencias legalizadoras no son suficientes las razones para la legalización de esta droga, cuando su principal blanco resulta ser los adolescentes, donde los daños neurológicos que causa son irreversibles. Conclusiones: Se debe continuar explorando las potencialidades terapéuticas de los cannabinoides a partir de la elaboración de productos farmacológicos bien dosificados y controlados, pues el riesgo de sus efectos adversos es innegable y contundente.

Introducción: El priapismo se define como una erección prolongada y persistente del pene que no mantiene relación con el deseo sexual, que puede durar más de 4 horas, cconstituyendo una urgencia médica. La incidencia registrada en la población en general es de 1,5 casos por 100 000 personas-años y en mayores de 40 años llega a ser de 2,9. Objetivo: describir la clasificación, fisiopatología, diagnóstico y manejo terapéutico del priapismo. Método: Se realizó una búsqueda, en idioma inglés y español, consultando las bases de datos Pubmed, Scielo, Lilacs, Cochrane Library y Web of Science, quedando 24 artículos seleccionados. Desarrollo: Existen dos variantes fisiopatológicas del priapismo, el isquémico o de bajo flujo el cual cursa con dolor y es una urgencia, que puede llevar a la disfunción eréctil permanente, y el no isquémico o de alto flujo. El diagnóstico se establece por la historia clínica aunque es necesario realizar pruebas de laboratorio para confirmarlo. El tratamiento depende del tipo de priapismo. Conclusiones: Actualmente existen los conocimientos suficientes para comprender la enfermedad y diversas herramientas terapéuticas para tratarla. Aunque se debe insistir en aumentar el conocimiento de la población sobre esta para que los individuos que la presenten contribuyan en su rápida atención.

Aging and health, a challenge for Cuban medical services

Introduction: priapism is defined as a prolonged and persistent erection of the penis that is unrelated to sexual desire; it can last more than 4 hours and constitutes a medical emergency. The incidence recorded in the general population is 1,5 cases per 100,000 persons per year and in those over 40 years of age it reaches 2,9. Objective: to describe the pathophysiology, diagnosis and treatment of priapism. Method: a search for information was carried out in English and Spanish, consulting the Pubmed, SciELO, Lilacs, Cochrane Library and Web of Science databases. Twenty-four articles were chosen for the development of this review. Development: there are two pathophysiological variants of priapism, ischemic or low-flow priapism, which causes pain and is an emergency, which can lead to permanent erectile dysfunction, and non-ischemic or high-flow priapism. Diagnosis is mainly clinical, although tests that evaluate blood flow, such as Doppler ultrasound, are useful. Therapeutic management will depend on the cause of priapism and the time elapsed since the onset of the condition. Conclusions: priapism is a rare disease, with different forms of presentation depending on the etiology; where this determines the symptoms, evolution and damage to the male reproductive organ. Diagnosis is mainly clinical, although techniques such as Doppler ultrasound are useful. Therapeutic alternatives vary from primary administration of anti-androgens to surgical alternatives such as shunts and cavernostomy.

Introduction: On March 11, 2020, the World Health Organization declared COVID-19 a pandemic. Lung cancer patients are more susceptible to coronavirus infection, due to the state of immunosuppression caused by both cancer and treatments, such as chemotherapy or surgery. Objective: to characterize the therapeutic management of patients with lung cancer during the COVID-19 pandemic Method: a search for information was performed by combining terms in the PubMed, SciELO, LILACS, Cochrane Library and Web of Science databases; selecting 30 of these. Development: the successful management of lung cancer requires frequent visits to the hospital and admission for research, radiotherapy, chemotherapy, among others. Over the course of many weeks, this added to the immunosuppression and the poor functional and structural condition of the lungs, poses a great risk of SARS-CoV-2 infection. The treatment of lung cancer presents variations in the case of COVID-19 infection, limiting itself in some of the therapeutic options such as surgery and adjuvant therapy, which in some cases must be postponed. Conclusions: cancer patients may be more susceptible to infection. Treatment of lung neoplasia should be carried out with a series of adjustments according to the status of the local epidemic to reduce the risk of tumor progression and COVID-19 infection.

Background: the increase in the number of publications in scientific journals has raised the need to carry out periodic assessments of their scientific production or that of a specific area of knowledge.Objective: to characterize the articles on oncology, published in Cuban student scientific journals between January 2014 and April 2019.Methods: a bibliometric study was carried out on the type of articles declared in the objective, studying 28 articles. To gather the data, the journals’ Web pages were accessed, downloading the total articles founded. The following variables were assessed: journal, major of the first author, sex, number of authors, province of origin, medical specialty, type of article, references, price index (PI), citations and number of corrected citations (NCC).Results: 53,58 % of the articles were published in the 16 de Abril journal. 82,14 % of the first authors of each article belonged to the major of medicine and 57,55 % of the authors were male. There was a predominance of articles with 4 authors (36 %), from the specialty of general surgery (28,57 %), produced in Pinar del Río (28,57 %). An average of almost 20 references per article was found. The price index ranged between 0,28 and 0,86. 14,28 % of the articles were cited, with a predominance of review articles.Conclusions: the articles on oncology published in Cuban student scientific journals were characterized, finding a low scientific production, with low citation indexes.

Introduction: traumatic brain injury is one of the major public health problems in contemporary society. Objective: to characterize patients treated with head trauma at Dr. Carlos Juan Finlay Central Military Hospital. Methods: an observational, descriptive and cross-sectional study was conducted. The target group consisted of 115 patients with a diagnosis of cranioencephalic trauma; the whole target group was included in the study. Demographic variables were analyzed; type of lesion, initial evaluation according to the Glasgow coma scale, mortality, surgical procedures and complications. A descriptive analysis was performed using absolute and relative percentage frequencies for the qualitative variables, and for the quantitative variables, the arithmetic mean and standard deviation were established. Results: the most representative ages were between 19 and 33 (28 %), with mild trauma predominating (72 %). The mortality rate ranged 14 %; the most frequent lesions were cerebral contusion and chronic subdural hematoma (22 %). The most frequent procedures were trepanation and evacuation (46 %). Respiratory infections predominated as a complication (36 %). Conclusion: young-aged patients and in early third age prevailed. A low mortality rate was obtained. Nearly half of the patients underwent surgery, where trepanation and evacuation were the surgical procedures most applied, as seen in relation to the removal of chronic subdural hematomas. More than half of those studied were free of complications.

Introduction: left ventricular hypertrophy (LVH) is defined as the increase in the thickness of the wall or the interventricular septal portion (or both). This entity represents an important risk factor that is related to the increase in mortality. Its diagnosis is based on voltage criteria that become visible on the is based on voltage criteria that become visible on the electrocardiogram, such as that the R-wave voltage criterion in lead aVL (RaVL). Objective: to evaluate the diagnostic utility of the R-wave voltage criterion in lead aVL (RaVL) for left ventricular hypertrophy. Methods: an observational, analytical and cross-sectional study was conducted, where 127 patients were studied. Clinical and electrocardiographic variables were studied. Results: left ventricular hypertrophy was identified by echocardiography in 69 % of patients. The voltage criterion of the R-wave in lead aVL (RaVL) had a low sensitivity (14,9 %), high specificity (92,5 %) and high positive predictive value (81,3%). The Odds ratio of the R-wave in lead aVL (RaVL) for concentric left ventricular hypertrophy was 0,85 while for the severe one it was 6,13. Conclusions: the voltage criterion of the R-wave voltage in lead aVL (RaVL) was more useful to confirm the cases that in reality present left ventricular hypertrophy and not to deny such existence, but not to discriminate between both types of left ventricular hypertrophy. This criterion is very useful to detect severe forms of this entity.

Fundamento: La hiperplasia prostática benigna es el tumor benigno más frecuente en hombres. El aceite extraído de la semilla de calabaza (Curcubita pepo) se emplea en el tratamiento de los síntomas asociados a dicha enfermedad. Sin embargo, los estudios en humanos son escasos, y la evidencia disponible, insuficiente.Objetivos: determinar la efectividad de la semilla de calabaza en el tratamiento de la hiperplasia prostática benigna realizar revisión sistemática y meta-análisis sobre la.Métodos: se realizó revisión sistemática y meta-análisis, de la literatura existente en las bases de datos Pubmed/Medline, Ebsco, Scopus y Scielo. Fueron seleccionados los ensayos clínicos aleatorizados, en cualquier idioma, que evaluaron la efectividad de fitomedicamentos compuestos por la Cucurbita pepo, comparándolo con un placebo; en pacientes con diagnóstico de hiperplasia prostática comprobado; y con un tiempo de evaluación mayor a seis meses.Resultados: la población total estudiada en los estudios seleccionados fue de 1403 hombres, todos mayores de 50 años. Todos los estudios evaluaron la efectividad del aceite de la semilla de calabaza. La diferencia de medias global fue significativa (DM: -0,76 IC 95%: -1,40; -0,13; I2=26,75 %). No se encontró una mejoría significativa en cuanto a la calidad de vida, parámetros uroflujométricos, volumen residual, valores del antígeno prostático de superficie y el tamaño de la próstata.Conclusión: Los resultados mostraron, con un nivel de evidencia moderado, que los fitomedicamentos basados en la semilla de calabaza o su extracto no se asociaron con una mejoría clínica ni funcional de la hiperplasia prostática benigna.