RESUMO

Primary hepatic liposarcoma is an extremely rare malignant tumour derived from adipocytes and is part of the group of mesenchymal tumours. We present the case of a 43-year-old Hispanic male patient with a pleomorphic hepatic liposarcoma and absence of MDM2 gene amplification. Two years and six months after surgery, the patient is asymptomatic. The present case is the first report of this entity with positive immunohistochemical testing for p16, p53, S100, vimentin and absence of MDM2 gene amplification.

Assuntos

RESUMO

Granular cell tumors are predominantly benign soft tissue tumors originating from Schwann cells, whereas melanocytic nevi are benign proliferations of melanocytes. We present the case of a patient with the presence of both entities located in the cecum and anal canal, respectively, constituting an extremely rare coincidental finding. A 43-year-old woman was evaluated by colonoscopy for iron-deficiency microcytic anemia that had lasted for 1 year. Colonoscopy demonstrated a macular lesion of 0.3 cm with a melanocytic appearance in the anal canal; at the cecum level, a subepithelial, yellowish, and partially mobile firm nodular lesion measuring 1.3 cm was observed. A histopathological study showed a melanocytic nevus in the anal canal and a granular cell tumor in the cecum. This is the first reported case of a patient with the extremely rare coincidental-incidental finding of these 2 entities at the same time.

RESUMO

Se realizó una investigación documental sobre el tema de la clasificación de las investigaciones en salud, mediante un muestreo estratificado por tipos de investigaciones. Se analizaron 35 artículos que cumplieron el criterio de autoría reconocida en el tema, publicación en editoriales de impacto y alto nivel de actualidad, tanto nacional, como internacional. Las posibles causas de incoherencias y ambigüedades en las clasificaciones fueron indagadas por el estudio histórico-lógico, en cuya solución se elaboró una propuesta de escala para medir la evidencia científica de las investigaciones según su clasificación, que deviene en una clasificación mutuamente excluyente y exhaustiva (AU)

A documentary investigation about health research classification by means of a stratified sample by types of research was carried out with 35 articles fulfilling the criterion for authorship recognized in the field: publishing in high impact and current editorials, not only nationally, but also internationally. The possible causes of inconsistencies and ambiguities were investigated by the historic-logical study. To solve this situation a proposal to evaluate the scientific evidence of the health research according to its classification. This classification is mutually exclusive and exhaustive (AU)

Assuntos

RESUMO

Se realizó una investigación documental sobre el tema de la clasificación de las investigaciones en salud, mediante un muestreo estratificado por tipos de investigaciones, se analizaron 35 artículos que cumplieron el criterio de autoría reconocida en el tema, publicación en editoriales de impacto y alto nivel de actualidad, tanto nacional como internacional. Las posibles causas de incoherencias y ambigüedades en las clasificaciones fueron indagadas por el estudio histórico-lógico. Se concluyó que es posible elaborar un modelo de clasificación de investigaciones en salud simple, pero con rigor científico, que permita su gradual introducción en el postgrado académico (AU)

A documentary investigation about health research classification by means of a stratified sample by types of research was carried out with 35 articles fulfilling the criterion for authorship recognized in the field: publishing in high impact and current editorials, not only nationally, but also internationally. The possible causes of inconsistencies and ambiguities were investigated by the historic-logical study. It concludes that it is possible to develop a classification model of simple health research, scientifically rigorous to permit its gradual introduction into the postgraduate academic course (AU)

Assuntos

RESUMO

Se realiza un análisis crítico de la literatura de Metodología de la Investigación en Salud mas actualizada a la que se puede acceder en nuestra provincia, en busca de elementos metodológicos que expliquen las insuficiencias de nuestros investigadores en el planteamiento de problemas científicos y la coherencia de sus investigaciones. Se demuestra la necesidad de definir los conceptos: problema profesional e investigación profesional, los que permiten la elaboración consciente del planteamiento de problemas científicos y el uso adecuado del método científico, como la manera más eficiente de realizar una investigación científica, evitando la rutina de las investigaciones profesionales(AU)

A critical analysis about the most updated bibliography related to Health Research Methodology in our province was carried out in search of the methodological elements that might clarify the inadequacies of researchers when stating the scientific problems and coherence of their researches. The investigation shows the need of defining concepts like professional problem and professional research, both of which allow the conscious elaboration of the analysis of scientific problems and the adequate use of the scientific method as the most efficient way to conduct a scientific research avoiding the routine of professional researches (AU)

Assuntos

RESUMO

Se realizó una investigación documental sobre las categorías hipótesis y objetivos en temas relacionados con la metodología de la investigación, buscando en las mismas las coincidencias y divergencias respecto a su definición, requisitos, funciones, importancia y alcance en la investigación científica, con la finalidad de precisar con la mayor claridad posible y el adecuado rigor científico, el lugar de ambas categorías en el glosario de términos de la ciencia. Se concluye que a ambas categorías se le atribuyen similares requisitos, funciones e importancia para la investigación científica, y sólo se diferencian en la forma de redacción, en la estructura y en el papel interpretativo en las ciencias: las hipótesis los tienen definidos y los objetivos no. En este sentido se valora el alcance limitado del objetivo, al privar al investigador de la creatividad característica del proceso de investigación científica ante la disyuntiva de no poderlos alcanzar (AU)

A documentary research on the categories of hypothesis and objectives on issues related to research methodology was conducted, looking for their coincidences and differences according to their definition, requirements, functions, importance and scope in the scientific research in order to specify as clearly as possible and with the appropriate scientific rigor, the place of both categories in the glossary of scientific terms. As a conclusion the investigation states that both categories are assigned similar requirements, functions and importance for the scientific research, and they only differ in the form of writing, the structure and their interpretative role in science, all of which are defined in the hypothesis and not in the objectives. In this sense, the limited scope of aims is taken into account to deprive the researcher of the creative characteristic of the process of scientific research considering the dilemma of not meeting them (AU)

Assuntos

RESUMO

BACKGROUND: Leiomyoma is the most common benign esophageal tumor that originates in the muscular layer, with the most common site located in the distal third of the esophagus. Its growth causes symptoms due to partial obstruction of the esophageal lumen, leading to the diagnosis and subsequent treatment. Today, due to modern minimally invasive surgical techniques, complete removal of these tumors can be accomplished with minimal morbidity and excellent results. CASE REPORT: We report the case of a 49-year-old female with a history of dysphagia, epigastric pain, and halitosis. She was diagnosed with a benign tumor originating from the muscular layer of the distal esophagus. Multiple biopsies had previously been taken, without histological confirmation. The patient underwent surgery where complete tumor enucleation was done laparoscopically. CONCLUSIONS: Preoperative diagnosis of these tumors should be based on clinical history and studies such as esophagoscopy and endoscopic ultrasound. Laparoscopic enucleation is the treatment of choice for leiomyomas of the esophagogastric junction. Biopsy specimens should be avoided because histology is not always possible. Furthermore, they are related to rupture of the esophageal mucosa during surgical treatment. After enucleation in selected patients, anti-reflux procedure should be carried out in order to protect the area of surgical resection and prevent complications from weakening the lower esophageal sphincter, as well as to resolve reflux symptoms.

Assuntos

RESUMO

Se realizó una investigación exploratoria, empírica y teórica sobre la situación social que acarrea a las investigaciones médicas en la provincia de Las Tunas, con el objetivo de determinar la forma más eficaz de impulsar el desarrollo de las mismas, tomándose como unidad de observación para la parte empírica los informes de investigación presentados a diferentes niveles, de los cuales se recogen aspectos relacionados con sus autores, sus producciones científicas, el modo y estilo de vida en relación con la actividad científica. Todo lo cual es minuciosamente analizado bajo las concepciones histórico filosóficas del desarrollo del conocimiento científico de la humanidad, mediante consulta de fuentes documentales sobre el tema en cuestión, permitiendo identificar las siguientes características en el contexto estudiado: 1) el personal profesional de la salud en la provincia experimenta enajenación por la ciencia; 2) las Ciencias Médicas en la provincia están en el nivel de ciencia amateur; 3) una arista muy sensible de la problemática descrita, es la moral que sirve de base para la concepción de un modelo teórico para dar solución a la misma. Se propone, como instrumentación del modelo concebido, la aplicación de una estrategia de intervención comunitaria, a través de una investigación acción en la comunidad médica de la provincia Las Tunas (AU)

An exploratory empiric and theoretical research was carried out about the social situations of the medical research in Las Tunas, with the objective to determine the most effective form to develop this investigations; taking as observation unit for the empiric part the investigation reports presented at different levels, of which aspects related with their authors were selected, their scientific productions, the way and lifestyle in connection with the scientific activity; were analyzed in detail under the philosophical historical conceptions of the development of the humanity's scientific knowledge, by means of consultation of documental sources on the topic in question, allowing for the identification of the following characteristics in the context studied: 1) the professional personnel of public health in the county experiences alienation for science. 2) the Medical Sciences in the province are in the level of amateur science. 3) a very sensitive edge of the problem described is the moral that serves as base for the conception of a theoretical model to give its solution. It is proposed as instrumentation of the pattern designed , the application of a strategy of community intervention through action research in the medical community of Las Tunas province(AU)

Assuntos

RESUMO

BACKGROUND: Identifying the level of culture and awareness on patient safety is essential in order to improve the quality of care. The objective of our research was to assess patient safety culture in healthcare professionals. METHODS: Derived from the implementation of a survey on patient safety to 174 health professionals, data related to demographic characteristics were analyzed. Scores were determined on the 12 dimensions of the scale including additional items on perception and degree of overall patient safety, frequency and number of events reported, as well as Cronbach's alpha for the different dimensions. Descriptive statistics were used. RESULTS: Overall perception on safety was 51%. The lowest dimension was communication openness (38%), whereas organizational learning had the highest scores (68%). Analysis showed low Cronbach's alpha for dimensions of overall perception on safety (0.35), non-punitive response to error (0.55) and staff allocation (0.12). CONCLUSIONS: A low overall perception on patient safety indicates the need for increased institutional actions for improvement. Low Cronbach's alpha in some measurements may suggest the need for adjustments to the instrument. Results on the overall perception on patient safety, nonpunitive response to error and staff allocation (staffing) should be interpreted with caution, given the low reliability of such dimensions.

Assuntos

RESUMO

OBJECTIVE: To carry out the epidemiological analysis of 122 influenza A (H1N1) deaths confirmed by laboratory and help to improve the diagnosis and timely managing of cases. MATERIAL AND METHODS: A total of 122 clinical records were analyzed of patients with confirmed influenza A (H1N1) virus infection who died. RESULTS: Fifty-one percent of patients were female and 49% were male. A total of 45.l% who died were between 20 and 39 years old. Overall fatality was 2.2% and ranged between 0.3% for the l0 to l9 year-old group to 6.3% for the 50 to 59 year-old group. Forty-three percent of deaths were concentrated in only two of the thirty-two states and 5l% received medical attention in social security institutions. Only l7% received hospital attention within 72 hours and 42% died within 72 hours of hospital attention. DISCUSSION: Novel Influenza A (H1N1) virus produces higher mortality in young people whereas seasonal influenza has a greater impact on young children and older people. Delay in medical care and the associated morbidity were relevant factors for death.

Assuntos

RESUMO

OBJETIVO: Efectuar el análisis epidemiológico de 122 defunciones por influenza A (H1N1) confirmadas por laboratorio y contribuir a mejorar el diagnóstico y atención oportuna de casos. MATERIAL Y MÉTODOS: Se Analizaron 122 expedientes de pacientes fallecidos por influenza A (H1N1). RESULTADOS: Una proporción de 51 por ciento correspondió a mujeres y 49 por ciento a varones. Hasta 45.1 por ciento ocurrió entre los 20 y 39 años. La letalidad general fue de 2.2 por ciento y varió entre 0.3 por ciento en el grupo de 10 a 19 años y 6.3 por ciento en el de 50 a 59. Una cifra de 43 por ciento de las defunciones se concentró en dos de las 32 entidades federativas y 5l por ciento se atendió en instituciones de seguridad social. Sólo 17 por ciento recibió atención hospitalaria en las primeras 72 horas y 42 por ciento falleció en las primeras 72 horas de hospitalización. En 58.2 por ciento de los fallecidos había algún padecimiento asociado. DISCUSIÓN: El Nuevo virus A (H1N1) produce mayor mortalidad en personas jóvenes, al contrario de lo que sucede con la influenza estacional que muestra un mayor impacto en niños pequeños y personas de edad avanzada. El retraso de la atención médica y la morbilidad asociada fueron factores relevantes del fallecimiento.

OBJECTIVE: To carry out the epidemiological analysis of 122 influenza A (H1N1) deaths confirmed by laboratory and help to improve the diagnosis and timely managing of cases. MATERIAL AND METHODS: A total of 122 clinical records were analyzed of patients with confirmed influenza A (H1N1) virus infection who died. RESULTS: Fifty-one percent of patients were female and 49 percent were male. A total of 45.l percent who died were between 20 and 39 years old. Overall fatality was 2.2 percent and ranged between 0.3 percent for the l0 to l9 year-old group to 6.3 percent for the 50 to 59 year-old group. Forty-three percent of deaths were concentrated in only two of the thirty-two states and 5l percent received medical attention in social security institutions. Only l7 percent received hospital attention within 72 hours and 42 percent died within 72 hours of hospital attention. DISCUSSION: Novel Influenza A (H1N1) virus produces higher mortality in young people whereas seasonal influenza has a greater impact on young children and older people. Delay in medical care and the associated morbidity were relevant factors for death.

Assuntos

RESUMO

Se realizó un estudio longitudinal retrospectivo a través de una pesquisa de glaucoma en la población del municipio de Las Tunas, que incluyó todos los grupos de edades, en el período comprendido desde enero de 2003 hasta diciembre de 2004, con la finalidad de precisar la incidencia y los principales factores de riesgo del glaucoma primario de ángulo abierto. Se examinaron 3 789 pacientes. La enfermedad se presentó con una incidencia de 1, 97 para todos los grupos de edades. Los factores de riesgo identificados fueron la edad, la hipertensión arterial y la hipertensión ocular(AU)

Assuntos

RESUMO

Se realizó un estudio longitudinal retrospectivo a través de una pesquisa de glaucoma en la población del municipio de Las Tunas, que incluyó todos los grupos de edades, en el período comprendido desde enero de 2003 hasta diciembre de 2004, con la finalidad de precisar la incidencia y los principales factores de riesgo del glaucoma primario de ángulo abierto. Se examinaron 3 789 pacientes. La enfermedad se presentó con una incidencia de 1, 97 para todos los grupos de edades. Los factores de riesgo identificados fueron la edad, la hipertensión arterial y la hipertensión ocular

Assuntos

RESUMO

Contenido: Introducción. 1) Generalidades. 2) El proceso cognitivo. 3) Metacognición y estrategias de aprendizaje. 4) Preferencias de aprendizaje y modalidades pedagógicas. 5) Presentación electrónica de informacióny el medio virtual. 6) Aprendizaje basado en problemas. 7) Medicina basada en evidencias. 8) Recursos pedagógicos en internet. 9) Educación a distancia, telemedicina e internet2. Glosario

Assuntos

RESUMO

Se realiza un estudio de los pacientes portadores de cáncer gástrico en 18 meses (Enero/94-Junio/95). Se registran 114 casos cuyo promedio de edad es de 58.5 años. El 92 por ciento tuvo cáncer gástrico avanzado y sólo el 8 por ciento fue temprano. El 53 por ciento se encontraba en EIV. El 26 por ciento pudo acceder a una cirugía curativa.

Assuntos