ISSN-L 1029-3035 RNPS 1821 RNSW A1235 Mediciego journal is a scientific publication of the University of Medical Sciences of Ciego de Ávila. It is aimed at students and professionals dedicated to health sciences topics in Cuba and other parts of the world. Its objetive is to publish scientific results related to human health and the training of human resources for the sector. It is a refereed, open access journal, in continuous publication; there are no charges for processing or publishing articles.
Universidad de Ciencias Médicas de Ciego de Ávila
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Risk factors for urinary incontinence in gynecological patients
Introduction: urinary incontinence is the accidental and involuntary loss of urine that represents a gynecological health problem. Objective: to describe the risk factors for urinary incontinence in gynecological patients treated in the outpatient clinic of “Santiago de Jinotepe” Hospital, between January and July 2023. Methods: descriptive, cross-sectional study based on a population of 150 patients, from which a sample of 80 was obtained who met the inclusion criteria in the research. Variables such as age, comorbidities, body mass index, risk factors for urinary incontinence, and type of treatment were analyzed. A data collection form was used from the clinical record, and the percentage was used to summarize the information. The principles of scientific research ethics were followed. Results: the study revealed a predominance of patients over 45 years of age (50.00 %). Of the patients with urinary incontinence, 38.75 % were overweight, while 66.25 % had diabetes mellitus, followed by constipation (10.00 %); 51.25 % required surgery. Conclusions: age is a determining factor in the prevalence of urinary incontinence, but risk factors such as diabetes mellitus, high blood pressure, and constipation are health problems that should be taken into account for prevention and control efforts. Surgical treatment was the most common option, highlighting the need for preventive measures such as educating women and optimizing nonsurgical treatment options
Copyright (c) 2025 Kevin Enmanuel García Vanegas, Krystel Tamara Brantome Gutiérrez, Letssy Fernanda Roldán Valerio https://creativecommons.org/licenses/by/4.0/deed.en
Automated detection of determining factors of pregnancy in adolescence
Introduction: pregnant adolescents are less likely to form stable romantic relationships and are more likely to suffer emotional disorders. They are also more susceptible to various complications during pregnancy and childbirth. Objective: to evaluate machine learning techniques to determine risk factors for teenage pregnancy. Methods: a research with a causal correlational design was carried out. The data was obtained from the Demographic and Family Health Survey - ENDES 2021 National and Departmental, which covered the years 2018 to 2020. At the time of the interviews, their database contained information on 16,825 Peruvian adolescent women aged 12 to 19 years, who constituted the study universe. Nine algorithms were implemented: support vector machine, binary logistic regression, decision tree, adaptive boosting (AdaBoost), gradient boosting, extreme gradient boosting (XGBoost), extremely random trees (ExtraTrees), bootstrap aggregation, and random forest. Their metrics were considered as variables to be taken into account in the evaluation, precision, and the area under the curve. Results: the most accurate algorithm was the random forest (0.965825), followed by gradient boosting (0.963744), decision tree, and support vector machines (0.963155, both). Conclusions: the random forest was the most accurate technique; in addition to the identification of the factors in question, the three most important ones were distinguished. This study is a valuable precedent for the application of machine learning techniques in the prediction of various variables necessary to improve public management
Copyright (c) 2025 Bernardo Céspedes Panduro, Zoraida Judith Huamán Gutiérrez https://creativecommons.org/licenses/by/4.0/deed.es
Information literacy competencies in medical science professors from the municipality of Fomento
Introduction: access to and efficient management of information resources and digital technologies are essential for teaching and research work in medical sciences; however, there are limitations in the mastery of these tools, which impacts professional development and teaching. Objective: to identify the information skills present in the Medical Sciences professors of the university health center in the municipality of Fomento during the period from January to June 2025. Methods: an observational, descriptive, cross-sectional study was carried out with 60 teachers selected through intentional non-probability sampling. The variables studied were: age, teaching category, scientific category and information skills; these were evaluated through three dimensions: knowledge, skills and attitudes. For knowledge of digital tools, citation standards and information management, a questionnaire validated by experts was applied. Information search, evaluation, and use skills were explored through an observation guide, and attitudes toward information management were assessed through a focus group. Ethical principles were followed. Results: teachers aged 50-64 (38.30 %) and assistant teachers (51.70 %) predominated. 70.00 % demonstrated low levels of knowledge. Barriers such as low connectivity, insufficient equipment, and technological anxiety were identified, although the motivation to update and share information persisted. Conclusions: teachers have a deficient theoretical and practical foundation in information literacy, reflecting the need to strengthen technological training and access to digital resources to improve teaching and research quality.
Copyright (c) 2025 Jim Alex González Consuegra, Miguel Angel Amaró Garrido, Alejo Fernando González Ledesma, Eliecer González Valdéz, Carlos Lázaro Jiménez Puerto https://creativecommons.org/licenses/by/4.0/deed.en
Evaluation of the quality of the vaccination service in the municipality of Santiago de Cuba
Introduction: vaccination is essential to providing quality care and achieving high levels of population satisfaction. Objective: to evaluate the quality of vaccination services in the municipality of Santiago de Cuba in 2023. Methods: an evaluative study was carried out on health systems and services, using a sample of vaccination centers in eight health areas of the Santiago de Cuba municipality, using the methodology proposed by the Faculty of Public Health of Havana for these studies. Structural criteria were taken into account: human and material resources of the vaccination centers; process criteria: professional performance of the vaccination service manager; and outcomes criteria: satisfaction of professionals with the service they provide and satisfaction of users with the quality of care received. The study used interviews, assessment guides, observations of nursing performance, and a satisfaction survey for service users and providers. Ethical principles of research were followed. Results: the structural evaluation was inadequate (74.30% of the criteria evaluated failed to meet the standard). In the process evaluation, 80 % of the performance criteria were adequate. All service satisfaction criteria were adequate. Overall, of 46 criteria established, 35 were adequate and 25 were inadequate Conclusions: the quality of the vaccination service in the municipality of Santiago de Cuba is unsatisfactory due to structural criteria; however, adequate criteria are observed regarding the process and outcomes
Copyright (c) 2025 Mireynis Quintana Miranda, Nelsa María Sagaró del Campo https://creativecommons.org/licenses/by/4.0/deed.en
Perceptions of the physical examination in preventive management of the diabetic foot
Introduction: diabetic foot is one of the most serious and frequent complications in patients with type II diabetes mellitus, associated with neuropathy, infection, and risk of amputation. Its prevention depends on regular physical examinations, health education, and adherence to self-care; however, various personal, cultural, and healthcare factors limit its systematic implementation. Objective: to analyze the perception of the physical examination in the preventive management of diabetic foot, in patients with type II diabetes mellitus at the "Pedro Narváez Cisneros" health center, Jinotepe, Nicaragua. Methods: a qualitative study with a phenomenological approach was developed between August and December 2024, with ten participants selected by intentional sampling. Semi-structured interviews were conducted, recorded, and transcribed verbatim. The analysis was carried out using thematic coding, which ensured the credibility and conformability of the process. Results: participants have general knowledge about diabetic foot, although some detail misconceptions. Despite recognizing the importance of self-care, preventive practices were irregular and conditioned by personal and occupational limitations and the lack of review by health personnel. They also expressed interest in receiving guidance and continuing education on prevention. Conclusion: there are gaps in education and preventive follow-up for diabetic foot. Strengthening communication between healthcare professionals and patients is needed, as well as integrating physical examinations into routine care. It is recommended to implement educational programs that promote constant self-care and early detection of injuries.
Copyright (c) 2025 Esther Elizabeth Ugarte Vega https://creativecommons.org/licenses/by/4.0/deed.en
Chronobiology in the evolution of Thrombolized ST elevation Acute Myocardial Infarction
Introduction: In recent decades, cardiovascular chronopathology has experienced increasing interest. Objective: to determine the influence of chronobiology on the evolution of patients with ST-segment elevation acute myocardial infarction who were thrombolyzed, hospitalized in the cardiology service of the Manuel Ascunce Domenech Provincial Hospital, January 2018 - December 2022. Method: A cross-sectional analytical observational study was carried out. The universe consisted of 99 patients. Result: male patients aged 60 to 69 years predominated, greater effectiveness of thrombolytic therapy was observed in the hours before the meridians, in the months of October and January, in the cold months and in the waxing moon, while complications were present in the meridian hours, in the cold months, in the waning quarter. Deaths occurred during the meridian hours, in the warm months and during the waning moon Conclusions: Males aged 60 to 69 years predominated. Treatment was effective during the pre-meridian hours of symptom onset, in October and the new moon. Complications prevailed during the past meridian hours of symptom onset. Fewer complications occurred on Tuesdays, in August, in the cold months and during the new moon. More patients died during the past meridian hours of symptom onset, on Saturdays, in May, in the warm months and during the waning moon.
Copyright (c) 2025 Maray Abreu-Navarro, Elizabeth Sellén-Sanchén, Delvis Serra-Reyes, Zailit González-Cruz, Yunior Rodríguez-López, Aymé Alberna-Cardoso https://creativecommons.org/licenses/by/4.0/deed.en
Risk factors associated with chronic kidney disease
Introduction: Chronic kidney disease is a global public health problem that has increased significantly over time due to the impact of risk factors on kidney function. Objective: To analyze the risk factors associated with chronic kidney disease in patients aged 40 to 60 years receiving care in the nephrology department of the "Antonio Lenin Fonseca" Hospital during 2023. Methods: A descriptive cross-sectional study was conducted with a population of 81 patients, from which a conventional sample of 71 was obtained. Sociodemographic variables and risk factors for chronic kidney disease were analyzed. A data collection form was used, and percentage was used to summarize the information. Results: The study revealed a predominance of female patients (54.90 %) aged 56 to 60 years (80.30 %). High blood pressure was the most common comorbidity, accounting for 60.60 % of the patients, while 43.70 % of the patients had a progression time of one to three years after diagnosis. Conclusions: Analysis of the risk factors found in this population confirms the need to explore the sociodemographic characteristics of patients (advanced age, female sex, homemaking) and the presence of diabetes and high blood pressure for better control of chronic kidney disease.
Copyright (c) 2025 José Carlos Suazo Alfaro, Jesse Merjana Figueroa Manzanares, Jennifer Dayanna Ruiz García https://creativecommons.org/licenses/by/4.0/deed.en
Creencias culturales en la gestión farmacológica de padres de niños con trastorno del espectro autista
Introduction: decisions regarding adherence to psychopharmaceuticals in children with autism spectrum disorder are often the responsibility of parents, who may be influenced by cultural taboos that undermine therapeutic effectiveness. Objective: to identify the cultural beliefs that influence the pharmacological management practices of parents of children with autism spectrum disorder at the special school “Divino Niño” in the city of Diriamba. Methods: a qualitative methodology was used, employing a phenomenological and cross-sectional approach. Data collection was carried out through a focus group with six parents of children with autism and an in-depth interview with a psychiatry specialist. Data triangulation was conducted by organizing information into categories, subcategories, and emerging patterns in schematic format, along with theoretical triangulation. The ethical principles of scientific research were observed. Results: the cultural beliefs of parents of children with autism shape their attitudes toward psychopharmaceuticals and adherence to treatment, leading them to prioritize alternative options and modify dosages. Consequently, pharmacological management is directly affected, influenced by the emotional impact of the diagnosis and resistance to medication due to fear of side effects. Conclusions: there is a need for healthcare professionals to understand and work based on parents’ cultural beliefs in order to improve communication and treatment adherence in children with autism, without compromising evidence-based medical care.
Copyright (c) 2025 Débora Rebeca Hernández Flores https://creativecommons.org/licenses/by/4.0/deed.en
Efficacy of subarachnoid anesthesia with hyperbaric bupivacaine and morphine in cesarean section
Introduction: spinal anesthesia with hyperbaric bupivacaine and low-dose morphine provides effective and safe analgesia during cesarean delivery. Objective: to evaluate the effectiveness of anesthesia with 0.5% hyperbaric bupivacaine and intrathecal morphine in patients undergoing cesarean section. Methods: a quasi-experimental study with a control group was conducted at the National Hospital “Guido Valadares,” Dili, Timor-Leste, between January and June 2024. The study included a population of 63 patients who underwent cesarean section under subarachnoid anesthesia. Variables assessed included age, gestational age; intraoperative vital parameters such as heart rate, mean arterial pressure, and peripheral oxygen saturation measured at the beginning and end of the operation; postoperative pain intensity; and complications. Ethical principles were observed. Results: the mean age was 33.16 ± 5.10 years and gestational age was 38.8 ± 0.7 weeks. No statistical differences were observed between groups in vital parameters (p > 0.05), although in the study group the initial heart rate showed a significant difference (p < 0.05), indicating a more stable hemodynamic response. This group presented lower scores on the visual analog scale during the immediate postoperative period (p = 0.00), reflecting lower pain intensity. The most frequent complications were pruritus (20.60%) and nausea (20.60%), with no cases of respiratory depression in either group. Conclusions: the combination of morphine and hyperbaric bupivacaine in subarachnoid anesthesia provides more effective postoperative analgesia compared to the use of bupivacaine alone.
Copyright (c) 2025 Yuliel Varona Rodríguez, Julio Michel Arias Manganelly, Liliam María Castillo Manresa https://creativecommons.org/licenses/by/4.0/deed.en
Metrics of articles on neurological rehabilitation in the Cuban Journal of Physical Medicine and Rehabilitation
Introduction: Pathologies of the nervous system affect people's mobility, so the application of physiotherapy guarantees recovery in the functionality of body movement. Therefore, research serves as instruments to analyze and improve these processes. Objective: Characterize the scientific production on the rehabilitation of nervous conditions in the Cuban Journal of Physical Medicine and Rehabilitation from 2020 to 2023. Methods: An observational, descriptive, cross-sectional, bibliometric study was carried out in the period from 2020 to 2023. Intentional non-probabilistic sampling was applied and 46 articles were selected. The variables analyzed were: year of publication of the articles, sex of the authors, bibliographic references, types of articles, citations and keywords. Absolute, percentage and average frequency statistics were calculated. Different bibliometric indicators were analyzed. Results: 46 articles were published between 2020 and 2023 with 698 bibliographic references and an average density of 14.80. Case presentations prevailed with a total of 18 investigations. The brief communications were those that included more up-to-date information with a Price Index of 0.83. Only 19.20% of the references were national. The female sex predominated with 70.67%. Conclusions: 2022 was where the largest number of articles was published with a predominance of case presentations. Multiple authorship prevailed along with the female sex. There was great international influence and a high degree of updating in the research analyzed in this period.
Copyright (c) 2025 Luis Manuel Abreu Pereira, Ilian Esteban Tarife Romero , Adriel Herrero Díaz https://creativecommons.org/licenses/by/4.0/
Nephroprotective measures in patients with type 2 diabetes mellitus
Introduction: type 2 diabetes is the leading cause of chronic kidney disease. Objective: to identify nephroprotective measures for patients with type 2 diabetes in the Internal Medicine Department of “Carlos Roberto Huembes” Teaching Hospital in 2023. Methods: a descriptive cross-sectional study in a population of 100 patients and a conventional sample of 80. Sociodemographic variables, risk factors for diabetic nephropathy and nephroprotective measures were analyzed. A data collection form was used, and percentage was used to summarize the information. Research ethics principles were followed. Results: female patients predominated (48 %) (60 %), with the age group 40 to 59 years (72.50 %) being the most significant. 86.40% of patients were overweight, while 88.80% had been overweight for less than 10 years. High blood pressure was present in 33.80% of cases. Optimal blood glucose levels were present in 62.50 % of cases; the most commonly used antihypertensive drug (80 %) was angiotensin-2 receptor antagonist (64 patients); metformin at a dose of 850 mg was the most prevalent glucose-lowering agent (96.30 %). Conclusions: type 2 diabetes mellitus was the main cause of chronic kidney disease, with a high prevalence of arterial hypertension as an associated comorbidity. Priority nephroprotective measures included the use of antihypertensives, along with oral hypoglycemic agents, predominantly metformin. Most patients showed adequate control of blood glucose and blood pressure.
Copyright (c) 2025 José Carlos Suazo Alfaro, Kevin Enmanuel García Vanegas, Marbet Gabriela Mendoza Cajina, Izamar del Socorro Molina Calderón https://creativecommons.org/licenses/by/4.0/
Incidence and characteristics of strabismus in patients from the Ecuadorian province of Tungurahua
Introduction: strabismus is an ocular disorder characterized by binocular misalignment. Its global prevalence in infants is estimated between 2.00 %-4.00 % of the world's population. In Ecuador, updated information on its incidence in local populations is insufficient. Hence, the importance of conducting studies focused on specific regions. Objective: to describe some epidemiological characteristics of strabismus in patients treated at the Ambato General Teaching Hospital. Methods: an observational, descriptive, and retrospective study; 103 medical records were reviewed. The variables analyzed were age, sex, and type of strabismus. Descriptive statistics and Pearson correlation analysis were used. Established ethical principles were adhered to. Results: 103 patients were diagnosed with strabismus; the cumulative incidence was 1.40 %. The convergent type was most common (32.10-50.20 %), followed by the divergent type (21.40-45.10 %), and the vertical type was least common (4.30-13.70 %). The ratio between the number of men (r = 0,915; p = 0,005) and women (r = 0,892; p = 0,013) treated was not statistically significant (r = 0,723; p = 0,087). Conclusions: the cumulative incidence of strabismus was below the figures reported in the international literature. The slight upward trend in this diagnosis among women should be investigated to identify possible predisposing factors. Although this study focused on a specific institution in the province of Tungurahua, the data it provided are relevant for future research at the national level
Copyright (c) 2025 Carlos Alberto Pérez Padilla, Zaihrys del Carmen Herrera Lazo, María del Carmen Yabor Labrada, Symone Shyram Villacrés Moya https://creativecommons.org/licenses/by/4.0/
Need and relevance of a teaching pharmacy at the Central University of Nicaragua
Introduction: in Nicaragua, few universities offer a Pharmacy degree, and none have professional practice spaces for students. This limits or hinders their training in technical and communication competencies, which—together with professional ethics—are essential for comprehensive pharmaceutical practice. Objective: to analyze the relevance and urgency of designing and implementing a community teaching pharmacy model as a supervised professional practice space for competency-based curricular training. Methods: a study with a mixed-methods approach and descriptive design was carried out. An online structured survey was administered to 61 Pharmacy students. Their perception of the importance of a teaching pharmacy was assessed using a Likert scale. Data were processed with the statistical program SPSS 30.0.0. Semi-structured interviews were conducted with three faculty members, and a literature review was carried out using Google Scholar, SciELO, and PubMed. Results: among the surveyed students, 77 % considered it very important to have a teaching pharmacy, while 86.90 % felt it would significantly benefit their practical learning. All three faculty members agreed on the educational relevance of the proposal. Conclusions: knowledge building through a community teaching pharmacy is a pertinent, innovative pedagogical strategy that adds value to the comprehensive training of pharmaceutical professionals. The significant interest expressed by the student community and the perceived relevance of the proposal by faculty demonstrate the positive impact it would have on the development of professional and personal competencies in the institution’s graduates.
Copyright (c) 2025 Karla Magdalena Chévez Villalta, Jerry Joel Pérez-Aguilar https://creativecommons.org/licenses/by/4.0/deed.en
Factors affecting treatment adherence in patients with type 2 diabetes mellitus
Introduction: lack of adherence to pharmacological treatment represents a significant issue, as it limits the effective control of diabetes mellitus and directly impacts patients’ quality of life. Objective: to describe the factors that affect treatment adherence in patients with type 2 diabetes mellitus at “Dr. Manolo Morales Peralta” Hospital in Managua, Nicaragua, from May 18 to June 18, 2024. Methods: a descriptive cross-sectional study was carried out based on a purposive sample of 90 patients who met the inclusion criteria. The Fantastic questionnaire was used to assess lifestyle, the Morisky-Green-Levine test to measure therapeutic adherence, and the Batalla test to evaluate knowledge about the disease. Descriptive statistical measures were applied, and the principles of research ethics were met. Results: 46.67 % of patients almost never carried out physical activity; 70.00 % did not follow a balanced diet, 62.22 % reported insufficient rest, and 86.60 % did not manage stress adequately. 52.00 % had poor knowledge of their disease, while 60.00 % were non-adherent to treatment. Conclusions: the lack of treatment adherence in patients with type 2 diabetes mellitus in this study was considered to be potentially due to unhealthy habits, difficulties in stress management, insufficient knowledge about the disease. Physical inactivity, an inadequate diet, and distrust in treatment also reflect educational gaps. These findings highlight the need for comprehensive strategies to improve therapeutic adherence among diabetic patients
Copyright (c) 2025 Edmundo Rafael Robleto Martínez, Romycheyla de Jesús Quintanilla Ulloa, Enrique José Bolaños Téllez https://creativecommons.org/licenses/by-nc/4.0/deed.en
Clinical-epidemiological characterization of patients with sepsis admitted to a municipal intensive care unit
Introduction: sepsis is a complex syndrome resulting from the body's response to an infection and constitutes a global public health problem. Objective: to characterize patients with sepsis admitted to the intensive care unit of the “Ricardo Santana Martínez” General Teaching Hospital in Fomento during the period 2022-2024. Methods: a cross-sectional descriptive study was carried out in the intensive care area of the “Ricardo Santana Martínez” General Teaching Hospital in the Fomento municipality, Sancti Spíritus province during the period 2022-2024. The sample consisted of 213 patients admitted to the institution during a defined period. A purposive sample of 51 patients diagnosed with sepsis was selected. Sociodemographic and clinical variables were studied. Results: a predominance of women (64.70 %) and a high concentration of patients over 80 years of age (37.20 %) were found. Respiratory infections, such as pneumonia and bronchopneumonia, were responsible for 41.10 % of sepsis cases. Streptococcus were the most common causative agents. Hospital stays ranged from 11 to 20 days. In terms of mortality, 78.40 % of patients survived sepsis. Conclusions: the study revealed that older adults, particularly women, are the most vulnerable group to respiratory sepsis, with Streptococcus being the main causative agent. Prolonged hospital stays contribute to a complex health situation in these patients
Copyright (c) 2025 Jim Alex González Consuegra, Miguel Angel Amaró Garrido, Eliecer González Valdéz, Cindy Naray López Peña, Yadelin Ruiz Cobo, Maridelis Puentes Claro https://creativecommons.org/licenses/by/4.0/deed.en
Characteristics of tuberculosis teaching-learning in the medical degree program in Cuba
Introduction: The training of Cuban physicians faces a changing healthcare context with the re-emergence of diseases, including tuberculosis. This condition influences the design of the teaching-learning process in the medical curriculum. Objective: To characterize the curricular design current state of the teaching-learning process of tuberculosis in the medical degree program. Methods: A pedagogical study was carried out at the Faculty of Medical Sciences of Ciego de Ávila. A documentary analysis was performed on the *Plan E* and 670 final theoretical exams, along with other evaluation instruments (a survey and a pedagogical test administered to 48 interns, and a survey given to 8 professors). Ethical principles were followed. Results: The curricular design revealed that tuberculosis content begins to be systematically taught in the first semester through the General Medicine discipline, the main integrating subject, and progressively connects with content from the Medical Psychology, Medical Pharmacology, and Research disciplines. Conclusions: Although the curricular design systematically integrates tuberculosis content through the core discipline and connects it with other professional disciplines, the current dynamics reveal insufficient student preparedness for early diagnosis, timely treatment, and follow-up of patients and their contacts
Copyright (c) 2025 Yanet Díaz García, Reinaldo Pablo García Pérez, Lina Martha Pérez Espinosa, Joyce Guevara Casas, Daimí Cabrera Viladons, Anny Viera Díaz https://creativecommons.org/licenses/by/4.0/
Quality of life of patients with chronic kidney disease undergoing peritoneal dialysis
Introduction: advanced stages of chronic kidney disease require replacement therapies such as peritoneal dialysis, which generate significant changes in patients' lives and affect their well-being. Objective: analyze the perception of the quality of life in patients with chronic kidney disease in treatment with peritoneal dialysis at the “Antonio Lenin Fonseca” School Hospital in Managua, Nicaragua during the year 2024. Methods: a descriptive cross-sectional study was carried out with 26 patients with at least six months of peritoneal dialysis treatment. Sociodemographic, clinical, and quality of life variables were analyzed using the EuroQol-5D-5L questionnaire and the visual analog scale. Data were processed with descriptive statistics using SPSS software. The ethical principles of scientific research were followed. Results: most patients were male (61.50 %), single (69.20 %), with low educational level (57.70%) and living in rural areas (88.50 %). The comorbidities found in the patients studied were high blood pressure, heart disease, and diabetes mellitus. The most affected dimensions of quality of life were: pain/discomfort (69.20% with moderate problems) and anxiety/depression (57.70 % with moderate symptoms). The overall perception of health status was lower in men with a lower educational level (mean = 54.20). Conclusions: the quality of life of patients on peritoneal dialysis is compromised mainly in emotional and functional aspects. Educational level, comorbidities, and social environment influence self-perception of health status. The need for comprehensive interventions that include not only medical treatment but also emotional and social support for the patient is evident
Copyright (c) 2025 Luisa de los Ángeles Mendieta Espinoza https://creativecommons.org/licenses/by/4.0/deed.en
Introduction: breast cancer is the most prevalent oncological disease in women worldwide. Mastectomy is one of the main pillars of its treatment and can be associated with chronic postoperative pain with variable impact on the quality of life of patients. Objective: to present the current knowledge on chronic post-mastectomy pain and some strategies applied for its prevention. Methods: a bibliographic review was conducted in the SciELO, ClinicalKey, RedALyC, Scopus, PubMed, Clinical Evidence Cochrane databases and using the Google Scholar search engine. The descriptors used were: pain, postoperative pain, cancer, breast surgery. 75 articles were located between the years 2010 and 2024 in Spanish and English, 38 of which were chosen. The analytical-synthetic, historical-logical, and inductive-deductive theoretical methods were used. Development: post-mastectomy pain syndrome includes a wide range of unpleasant and painful sensations in the arms, chest, shoulders and armpits. The main risk factors are: age, traumatic nature of the procedure, acute postoperative pain of greater intensity, depression, anxiety, among others. The neuropathic component makes its treatment difficult, so the detection of risk factors and adequate treatment of acute postoperative pain, followed by the guidelines of multimodal analgesia with the use of neuraxial and locoregional anesthesia, opioid analgesics, nonsteroidal anti-inflammatory drugs, physical and psychological therapy, are key to reducing the incidence of this syndrome. Conclusions: chronic postoperative pain after breast surgery is a multifactorial phenomenon that significantly affects the quality of life of patients, with poor response to treatment, so the need to focus on preventive strategies should be considered. Adequate treatment of acute postoperative pain based on multimodal strategies, the use of regional techniques, opioid and non-opioid analgesics, physical and psychological therapy, are essential in reducing the incidence of pain.
Copyright (c) 2025 Marcos Antonio Meneses Labrada, Evelín Garcés Roja, Aidan Abel Pérez Pérez https://creativecommons.org/licenses/by/4.0/
Relationship between gut microbiota and chronic non-communicable diseases: implications for health
Introduction: the gut microbiota plays an essential role in overall body health. Its imbalance is linked to various chronic diseases. Objective: to analyze the available theoretical evidence on the relationship between gut microbiota and chronic non-communicable diseases. Methods: narrative review, based on Google Scholar, the SciElo, LILACS and Pubmed databases and on official websites of the World Health Organization and the Pan American Health Organization. Original articles, review articles, short communications, theses, letters to the editor, and systematic reviews were examined. of the 95 documents reviewed in Spanish and English, 40 met the inclusion criteria. Results: the role of the intestinal microbiota was analyzed, with emphasis on the complexity, variety of species and implication, negative or positive, in chronic non-communicable diseases. Changes in the microbiota can negatively influence lipid, carbohydrate, and fatty acid metabolism and contribute to the risk of obesity, diabetes mellitus, alcoholic fatty liver disease, cardiovascular disease, and cancer. Conclusions: the gut microbiota plays a fundamental role in health and is closely related to chronic non-communicable diseases. An imbalance in the microbial community causes inflammatory processes that influence their presentation and severity. Adopting a healthy diet can improve the microbiota and reduce the risk of the onset and complications of these diseases.
Copyright (c) 2025 Cynthia Reyes Flores https://creativecommons.org/licenses/by/4.0/deed.en
Advances in neuroprotection strategies for newborns
Introduction: neurodevelopment and its executive function, essential for learning, face challenges associated with prematurity and perinatal conditions, mitigated through neuroprotective strategies. Objective: to review updated information on advances in neuroprotection strategies for newborns. Methods: a narrative bibliographic review was carried out using information published in different databases, in the period 2003-2025, in four languages. The following keywords were used: neonatal encephalopathy, brain injury, neurodevelopment, prematurity, and neuroprotection. A total of 143 articles were found, including systematic reviews, meta-analyses, e-books, and original articles. Thirty-eight studies that met the inclusion criteria were selected. Case studies and case series were excluded. Analytic-synthetic, historical-logical, and inductive-deductive theoretical methods were employed. Development: five strategies are effective in premature neonates: prenatal corticosteroids, magnesium sulfate, delayed cord clamping, caffeine, and kangaroo mother care. Only therapeutic hypothermia is effective in newborns with hypoxic-ischemic encephalopathy. Emerging therapies explore solutions such as melatonin, erythropoietin, and stem cells to mitigate neurological damage associated with prematurity and optimize brain development. Therapeutic prospects for term neonates consider advanced options such as erythropoietin, melatonin, xenon, allopurinol and other promising molecules. Conclusions: neonatal brain injury can result from developmental abnormalities in premature infants or damage to formed tissues in full-term neonates. Current strategies include corticosteroids, magnesium sulfate, delayed clamping, caffeine, and therapeutic hypothermia. Advances such as melatonin, erythropoietin, stem cells, noble gases, and allopurinol promise more personalized and effective therapies
Copyright (c) 2025 Carlos Enrique Piña Borrego https://creativecommons.org/licenses/by/4.0/deed.en
Community therapeutic physical exercises in paraplegic patients
Introduction: the physical problems caused by paraplegia can be treated with physical therapy, supported by assistive devices designed for specific motor and sensory impairments. Community-based rehabilitation is a strategy with significant social impact. Objective: to analyze the available scientific evidence on the effectiveness of community-based therapeutic physical exercises in paraplegic patients. Methods: a narrative literature review was carried out. The search criteria were based on MeSH and DeCS descriptors: paraplegia, physical exercise, exercise therapy, physical therapy, and rehabilitation, using the bibliographic databases Medline, PubMed, and CUMED. These terms were also used to search Latin American databases such as LILACS and Redalyc, the academic directory Dialnet, the search engine Google Scholar, and the online scientific library SciELO. A total of 32 articles published between 2019 and 2024 in Spanish and English were selected. Development: the active participation of paraplegic patients in rehabilitation should begin from the moment the spinal cord injury occurs. The reduction in the number of complications is directly related to the quality of care received in the early stages. Conclusions: Community-based therapeutic physical exercises help reduce the side effects caused by lack of mobility and improve the quality of life of paraplegic patients. The research provided valuable information to consider this rehabilitation approach as a valid and essential option
Copyright (c) 2025 María Felipa Marrero Oquendo, Yoandra Pérez Pardo, Iliana Leyva Domínguez https://creativecommons.org/licenses/by/4.0/deed.en
Impact of diabetic foot ulcers in the social sphere
Introduction: diabetes mellitus is a chronic disease that can lead to serious complications, including diabetic foot, one of the most devastating and common. Objective: to analyze the impact of diabetic foot ulcers on the health, economy and quality of life of patients. Methods: a review of national and international literature was carried out in recognized databases such as Scielo, Pubmed and Clinical Key using the Google Scholar search engine in Spanish and English. 35 articles were reviewed and 25 were used, which were published between 2019 and 2024. Development: diabetic foot ulcer is a severe complication of diabetes mellitus that considerably affects the physical and mental health of patients. The increasing incidence of these represents a significant economic burden with deterioration in quality of life and limitations in daily activities. A multidisciplinary approach that considers both medical and psychosocial aspects is needed to improve the overall well-being of patients. Conclusions: diabetic foot ulcers represent a health challenge that requires a comprehensive approach. It is vital to combine medical care with psychosocial considerations, implement prevention strategies and promote self-care education. Health systems must adopt evidence-based measures to improve quality of life and prevent this disease.
Copyright (c) 2025 Jim Alex González Consuegra, Miguel Angel Amaró Garrido https://creativecommons.org/licenses/by/4.0/
Benefits of the plant species boldo and basil in non-alcoholic fatty liver disease
Introduction: the efficacy of boldo (Peumus boldus L.) and basil (Ocimum basilicum L.) in the treatment of non-alcoholic fatty liver disease has aroused great interest as a phytopharmaceutical, due to the high prevalence of this disease and its complications. Objective: to analyze the scientific literature on the hepatoprotective effect of boldo and basil and its feasibility for the design of phytopharmaceuticals for oral use. Methods: a systematic review of 14 sources was carried out, corresponding to seven original articles from indexed journals, available in SciElo in Spanish and PubMed in English, three master's theses, published between 2020 and 2025, two pharmacognosy books and two current official pharmaceutical compendia. Development: boldo and basil possess significant hepatoprotective potential, derived from their antioxidant, anti-inflammatory, and chemopreventive properties. The following metabolites have been identified in boldo: boldine, sesquiterpenes, flavonoids, sterols, and saponins; in basil: linalool, estragole, eugenol, quercetin, and phenolic acids. The trends found lie in the experimental designs, the extraction processes in which ultrasonic extraction stands out, and the analysis methods, mainly chromatographic. Conclusions: there is consensus on the therapeutic potential of both species. It is recommended to advance in the standardization of extracts, characterization of active metabolites, conduct clinical trials, and promote the formulation of phytopharmaceuticals for the treatment of non-alcoholic fatty liver disease.
Orofacial piercing and its relationship with oral disorders in adolescents
Introduction: orofacial piercing is a common practice among adolescents; however, it entails risks that can make it a public health problem. Complications occur during the piercing or at any time during the period in which the jewelry remains inserted. Objective: to gather information on oral disorders associated with the use of orofacial piercings in adolescents. Methods: a descriptive bibliographic review was carried out. The documentary search included the ScieLO, Elsevier, Springer, Science Direct, PubMed, and ClinicalKey databases, and the Google Scholar search engine. The terms orofacial piercing, oral-dental alterations, and adolescents were used. Development: in the oral cavity, the most frequent sites for piercings and their corresponding jewelry are: tongue, lips, cheeks, uvula, and combinations thereof. Of these, the lower lip and tongue are the most common. The negative consequences of this practice for oral health vary from mild to severe, occasionally life-threatening: inflammation, edema, pain, receding gum, local bleeding, mouth ulcers, malocclusion, trismus, foreign body reactions, Ludwig's angina, dental fractures, infections, mucogingival trauma, and gingival recession. Conclusions: oral and dental alterations associated with the use of orofacial piercings in adolescents are a public health problem due to their frequency and the risks and complications they entail. This research can be a starting point for designing and implementing health promotion and education interventions aimed at preventing the negative consequences of the use of orofacial piercings.
Copyright (c) 2025 Reifford Radamés Benítez Valdivia, Odalys Rodríguez Martín, Miriela Betancourt Valladares https://creativecommons.org/licenses/by/4.0/
Systematic review on suicide prevention in pediatric ages
Introduction: suicide attempt is a self-destructive behavior or act, carried out with a lethal intent, resulting in death. Its prevention is approached from a variety of perspectives. Objective: to review updated information on preventive actions carried out in hospital emergency services following failed suicide attempts in pediatric patients. Methods: a systematic review was carried out that included original studies, case reports, letters to the editor, editorials, bibliographic reviews, and systematic reviews published between January 2016 and October 2024, in Spanish, Portuguese, and English. To do so, the protocol of the International Prospective Register of Systematic Reviews and the methodology of the PRISMA 2020 Declaration were followed. Development: from the 21 articles, a sample of six was selected: four American, one British, and one Spanish. The studies reviewed corroborated the importance of preventing suicide attempts; their recommendations focus on brief interventions to detect and assess risks, delivered by pediatricians in hospital pediatric emergency departments. Conclusions: evidence demonstrates the importance of the pediatrician in preventive actions carried out in hospital emergency services following failed suicide attempts in pediatric patients. Intervention options focus on the application of tools to detect and assess the risks of re-initiating harmful acts. This work provides useful elements for designing suicide prevention interventions in pediatric patients and for making decisions regarding their regulatory policies.
Copyright (c) 2025 Sara Rodríguez Garcia, Mayelin Llanes Santos, Milena Hidalgo Ávila https://creativecommons.org/licenses/by/4.0/
Stanford type A aortic dissection and sudden death due to ventricular fibrillation. Case report
Introduction: aortic dissection is a serious condition characterized by the formation of a false lumen due to the rupture of the aortic intima. Its annual incidence ranges between 2.7 and 7.2x 100,000 inhabitats; its mortality rate is 0.7 to 3.2. Sudden death associated with ventricular fibrillation occurs in 22 % of patients, usually due to coronary, renal, or electrolyte compromise. Objective: to describe an unusual case of aortic dissection and sudden death due to ventricular fibrillation. Case presentation: a 55-year-old caucasian male patient with hypertension was admitted to the hypertensive emergency department with sudden, severe retrosternal pain, syncope, and exertional dyspnea. Angiotomography diagnosed Stanford type A aortic dissection extending to the right common iliac artery. During surgery, he suffered ventricular fibrillation, which was reversed with the first shock. In postoperative intensive care, ventricular fibrillation recurred, and after the second shock, he presented asystole. After 30 minutes of resuscitation maneuvers and administration of intravenous epinephrine, the patient did not recover and died. Conclusions: the progression of aortic dissection is rapid and torpid; therefore, it is an emergency. Of the essential imaging techniques for diagnosis, angiographic computed tomography is the gold standard. Treatment is usually open surgery, with or without aortic valve replacement. This case provided unique diagnostic and imaging evidence regarding aortic dissection and renal or electrolyte compromise as causes of ventricular fibrillation. The latter is a rare but fatal complication.
Copyright (c) 2025 Yander Luis Izaguirre Campillo, Melissa Hernández Cardoso , Luis Alejandro Wong Pitty https://creativecommons.org/licenses/by/4.0/deed.en
Introduction: uveal melanoma is the most common type of intraocular cancer in adults, which originates in pigmented cells called melanocytes, present in the uvea of the eye. The diagnosis is made based on clinical evaluation which includes techniques such as fundoscopy, ultrasound and optical coherence tomography. Surgical treatment of uveal melanoma is an integral part of the management of this disease. Objective: to present the case of a patient diagnosed with uveal melanoma. Case presentation: female patient, 43 years old with ocular history of pigmentary glaucoma in the right eye. She presented intense pain in his right eye, decreased vision, redness, tearing, and photophobia. Through the ophthalmological examination and imaging studies, she was diagnosed with uveal melanoma. Right eye enucleation plus biopsy was carried out, confirming the clinical diagnosis. Conclusions: early identification of uveal melanoma and a proactive approach are essential for treatment choice and improving patient prognosis. Objective: to present the case of a patient diagnosed with uveal melanoma. Case presentation: Female patient, 43 years old with ocular history of Pigmentary Glaucoma right eye. He presented intense pain in his right eye, decreased vision, redness, tearing, and photophobia. Through the ophthalmological examination and imaging studies, he was diagnosed with Uveal Melanoma. Right eye enucleation plus biopsy was performed, confirming the clinical diagnosis. Conclusions: Early identification of uveal melanoma and a proactive approach are essential for treatment choice and improving patient prognosis. Keywords: uveal melanoma, uvea, enucleation.
Copyright (c) 2025 Yisell Hernández Barzagas, Odalys Piña Jerez, Denisse del Carmen Alvarez Ortiz https://creativecommons.org/licenses/by/4.0/
Atypical presentation of a renal tumor with pyelonephritis and deep vein thrombosis in the lower limb. Case report
Introduction: renal tumors with atypical presentations—such as severe urinary infections or thromboembolic complications—are uncommon, and their symptoms resemble those of other diseases, which poses diagnostic challenges for specialists. Objective: to present a patient diagnosed with a renal tumor with atypical manifestations (pyelonephritis and deep venous thrombosis in a lower limb), emphasizing the difficulty of diagnosis due to overlapping symptoms. Case presentation: a 60-year-old black male patient, with no comorbidities. Three days prior to consultation, he developed general malaise, fever of 38–39 °C, chills, moderate lumbar pain, and temperature changes, along with increased volume and pain in the right leg. Physical examination revealed positive posterior costovertebral angle tenderness and percussion pain, with no palpable masses, dysuria, or hematuria. In the right leg, the femoral, popliteal, dorsalis pedis, and posterior tibial pulses were present. He was diagnosed with renal cell carcinoma with vascular compression and was admitted. The urine culture tested positive, and Doppler ultrasound confirmed deep venous thrombosis. He was treated with antibiotics and anticoagulants; the infection resolved and the edema decreased. He declined surgical intervention; therefore, continued follow-up by the oncologist was maintained. Conclusions: this report provides scientific evidence on the interaction between oncologic disease, infection, and vascular symptoms; this unusual scenario carries critical prognostic implications. Hence the importance of considering broad differential diagnoses in patients with atypical findings, as well as ensuring multidisciplinary care.
Copyright (c) 2025 Lilibet Muñoa Garrido, Julio Michel Arias Manganelly, Reinaldo Enrique Díaz González https://creativecommons.org/licenses/by/4.0/deed.en
Use of therapeutic laser in dog bite wound: case report
Introduction: dogs cause between 76% and 94% of animal bites world wide. Their usual complications are due to infections with anaerobic and aerobic germs. For this reason, laser treatment of lesions is indicated to reduce the risk of infections, deformities, and scars. In addition to inducing analgesia in the irradiated area, its anti-inflammatory and anti-edema effects accelerate all phases of the healing process, which occurs more quickly, with better collagen organization, and fewer complications. Objective: to present a pediatric patient, bitten by a dog, whose injuries were treated with laser applied to acupuncture points. Case presentation: a 12-year-old male high school student, white skin color, who 72 hours earlier was bitten by his mixed breed dog while playing in the house. The wounds were cleaned and irrigated with saline solution, and the largest one on the face was sutured. She was instructed to follow up her condition in consultation with specialists in natural and traditional medicine for the application of laser to acupuncture points for 15 sessions. Conclusions: dog bite injuries are common in children. Timely treatment of wounds, which includes laser treatment at acupuncture points, enables a satisfactory healing process, with acceptable aesthetic results for patients. This work provided scientific evidence on a procedure insufficiently addressed in the national medical literature
Copyright (c) 2025 Yenneis Rodríguez Sánchez , María Asunción Tosar Pérez , Alina Carla Pérez Rodríguez https://creativecommons.org/licenses/by/4.0/
Ophthalmologic manifestations of cri-du-chat syndrome. Case report
Introduction: cri-du-chat syndrome (maladie du cri du chat, in French) is a genetic disorder caused by the deletion of the distal short arm of chromosome 5 (5p-). It is rare and predominates in girls. It is diagnosed at birth by a characteristic high-pitched cry resembling a feline's sound. Objective: to present the case of a minor diagnosed with cri-du-chat syndrome, with emphasis on the associated ophthalmological conditions. Case presentation: a four-year-old female mixed-race minor. She resides in Ambato, Tungurahua province (Ecuador). At birth, she emitted the characteristic cry. She presents tetralogy of Fallot, global developmental delay, and decreased visual acuity. Ophthalmological examination revealed bilateral epicanthus, hypertelorism, and divergent strabismus. Additional testing was indicated for her and her parents; they also received genetic counseling. Her regular follow-up was maintained in the clinic to ensure appropriate therapeutic treatment based on the progression of her visual impairment. Conclusions: the ophthalmological conditions associated with this disease caused the patient's visual impairment. Regular checkups in the ophthalmology clinic were recommended because there is no specific treatment for this syndrome. Early, systematic, and multidisciplinary rehabilitation is the key to improving the quality of life for the patient and her family. This case provided scientific evidence on the importance of comprehensive pregnancy monitoring and assessment, and early diagnosis and treatment of patients.
Copyright (c) 2025 Carlos Alberto Pérez Padilla, Zaihrys del Carmen Herrera Lazo, Marco Fabricio Naranjo Del Toro https://creativecommons.org/licenses/by/4.0/
Regarding a case of arteriovenous malformations of the left parietal lobe
Introduction: arteriovenous malformations are a rare disease of the central nervous system that occurs as a result of a fistulous connection between arteries and veins without intervention of the preexisting capillary bed. Its incidence is approximately 1.34 per 100,000 inhabitants in developed countries. It primarily affects men and the areas corresponding to the anterior, middle, and posterior cerebral arteries. Objective: to describe a case of atypically located cerebral arteriovenous malformations in adults. Case presentation: a case with varied characteristics was presented in which an arteriovenous malformation located in the left parietal lobe of the cerebral cortex was diagnosed by neuroimaging. In this patient, early medical intervention prevented the development of cerebral hemorrhage. She was successfully treated with Ganma Knife radiosurgery and progressed well without recurrence during follow-up. Conclusions: the diagnosis of this condition is made using neuroimaging techniques in all patients with these symptoms. Ganma Knife radiosurgery may be the ideal therapy in some cases, but not in others; it all depends on how the patient is classified according to the Spetzler and Martin scale. This article provides solid evidence on the role of imaging in the diagnosis and preoperative stratification of these patients.
Copyright (c) 2025 Rolando Dornes Ramón, Yander Luis Izaguirre Campillo , Lizandra Pujol Arias https://creativecommons.org/licenses/by/4.0/deed.en
Prevention of retained teeth of permanent maxillary canines in primary health care
Although canine impaction is asymptomatic, its aesthetic and functional complications are varied and serious: dental misalignment, alterations in facial symmetry, aesthetic changes in the lips, negative effects on phonation, and malocclusions. Therefore, dentists consider this condition a health problem and a challenge in their practice.
Copyright (c) 2025 Yudel García Rosell, Yordania Blanco Ruiz https://creativecommons.org/licenses/by/4.0/
Peripheral neuropathy: a common complication of diabetes in Africa?
Worldwide, the number of people with diabetes mellitus is increasing exponentially and in a worrying way. According to the International Diabetes Federation (IDF),(1) in 2021 there were an estimated 536.6 million people with diabetes, specifically adults aged 20 to 79 living in 215 countries and territories. The highest number of deaths is recorded in low- and middle-income countries, where 80.6 % of people with diabetes live. This disease causes fatal, disabling, and costly complications, which shorten life expectancy.
Copyright (c) 2025 Dagoberto Álvarez Aldana https://creativecommons.org/licenses/by/4.0/
Transition towards the production of an increasingly open science
Between March 14 and 16, 2018, the University of Medical Sciences of Ciego de Ávila hosted the fourth National Meeting on Scientific Publication in Health Sciences, where directors of the Provincial Centers of Information on Medical Sciences, representatives of the Editorial Committees of scientific journals and the Editorial Center met.
Copyright (c) 2025 Roberto Zayas Mujica https://creativecommons.org/licenses/by/4.0/deed.en