Salud Integral y Comunitaria (Journal)
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Quality of medication prescription in older adults
Full text linkIntroduction: the prescription to the biggest adult had characteristic own that differentiate them since of other age groups concomitan numerous illnesses that increase with declining of the life. Objective: to evaluate the quality of the prescription of medications in adults bigger belonging to the clinic 10 of the Policlínico Asdrúbal López Vázquez of the municipality Guantánamo. Method: He/she was carried out a descriptive, retrospective study, of traverse court during the period of June of 2023-April of the 2024. The study universe was conformed by 172 adults bigger than 60 years of which took a sample of 86 patients by means of the technique of sampling non probabilístico. The variables to investigate were age, sex, educational level, personal pathological antecedents, polypharmacy, indicators of quality. Results: the feminine sex prevailed, the antecedents pathological personnels of Arterial Hypertension, Diabetes Mellitus Type II and Inadequacy Renal Chronicle. The indicators more affected in the inadequate Medication belonging to the Axis 1 they were the sixteen, the fifteen, the four, the ten and both. In the Axis 2 appropriate Medication he/she hurtled as the most significant indicators the 23, the 21 and the 20 and they were arrived to final considerations. Conclusions: the results obtained in the evaluation of the quality of the prescription of medications in old men constituted an instrument to avoid the inadequate prescriptions and interactions medicamentosas that take to the biological and functional deterioration of the same ones.
Efficacy of pharmacological treatment for closure of patent ductus arteriosus in preterm newborns: a systematic review
Full text linkIntroduction: Patent ductus arteriosus (PDA) represents a relevant clinical problem due to its hemodynamic implications, especially in premature newborns, which has motivated multiple studies on its management. Currently, pharmacological treatment is one way to solve this problem, but there is no clear consensus as to which treatment is the most effective and least risky. Objective: The aim of this study was to find the drug with the highest rate of efficacy in PDA closure and with the least adverse effects. Methods: A descriptive systematic review was carried out following PRISMA guidelines. The search was carried out in SCOPUS, PUBMED, SCIELO, COCHRANE and LILACS databases. Results: After applying certain inclusion criteria, we obtained a total of 20 studies, most of which were systematic reviews and cohort studies. Among the studies reviewed, drugs such as indomethacin, ibuprofen, paracetamol and betamethasone have been used, finding that among the first three there is no statistically significant difference in efficacy. Closure rates and adverse effects vary considerably in the different studies, depending on factors such as dose, route of administration and gestational age of the neonate. Conclusions: The studies reviewed show that both ibuprofen and indomethacin have similar efficacy in PDA closure in preterm infants. Indomethacin is associated with higher risks of adverse effects. Acetaminophen appears to be a safe and effective alternative, with a superior safety profile compared to NSAIDs
Solitary spinal osteochondroma in childhood. Case report
Full text linkIntroduction: Osteochondroma is the most common benign bone tumor in children. These are benign cartilage-forming lesions. Spinal involvement is rare, and even more so in the solitary form, representing 1 to 4% of lesions. The overlapping course of its symptoms and signs delays diagnosis. Vertebral bone x-rays and soft tissue ultrasound are useful studies to corroborate suspicion. Other methods such as computed axial tomography and magnetic resonance imaging allow assessment of canal and neuroradicular involvement. This allows for early treatment and prevents deformities or permanent neurological damage. The objective of this article is to present a pediatric case of solitary spinal osteochondroma in which imaging studies were very useful for the diagnosis, corroborated by histopathological examination of the lesion.Clinical case: A 7-year-old female patient presented clinically with an increase in lumbar spine volume over the past year. Imaging studies such as ultrasound, lumbosacral X-ray, and computed tomography (CT) scan were used to diagnose the condition, which was confirmed by histopathological examination of the lesion following surgery. The patient\u27s progress was satisfactory. Conclusions: Diagnostic imaging techniques are a valuable tool in our field, allowing us to identify vertebral osteochondromas, correlating them with the clinical presentation, and providing appropriate patient management, as was the case in this case
Benefits and limitations of minimally invasive surgery in coronary revascularization: a systematic review
Full text linkCoronary artery disease is one of the leading causes of mortality in the world, with treatments such as coronary artery bypass surgery seeking to restore arterial flow. Traditionally, this procedure is performed via sternotomy, with significant recovery times and risks. For this reason, minimally invasive surgery (MIDCAB) has emerged as a promising alternative, reducing complications. This work evaluates the benefits and limitations of MIDCAB. METHODS: A search was conducted in SCOPUS, PUBMED and SCIELO for studies published between 2020 and 2025, in Spanish and English, with open access, cohort and retrospective studies that addressed mortality rates, perioperative complications, hospitalization and recovery times. The final synthesis was based on 20 articles after filtering. RESULTS show that MIDCAB has low perioperative mortality rates (0.6%-3.5%) and limited complications, such as stroke (0%-2.3%) and perioperative myocardial infarction (0.6%-1, 6%). Hospitalization and recovery times were also shorter, with average ICU stays of 0.4 to 6.6 days. In the long term, MIDCAB showed a 10-year survival of 94.3%, highlighting its durability and effectiveness. CONCLUSION, MIDCAB represents a safe and effective option for coronary revascularization, especially in patients at high surgical risk or with limitations for more invasive procedures. However, the heterogeneity in the studies and the predominance of retrospective designs underscore the need for more robust prospective investigations to confirm these findings and guide clinical practice
Exodus of Cuban Doctors: Socioeconomic and Political Drivers of a Healthcare Crisis (2020–2025)
Full text linkIntroduction: Between 2020 and 2025, Cuba experienced a profound healthcare collapse, exposing structural weaknesses in a system long praised for universal coverage. Economic decline, political constraints, and institutional limitations hindered service delivery, leading to shortages of essential supplies and personnel.Objective: To examine the main factors driving the deterioration of Cuba’s healthcare workforce and assess the resulting public health consequences, including maternal and child health, resurgence of preventable diseases, and urban–rural disparities.Methods: A review of secondary sources, including official Cuban statistics, international health reports, and independent media, was conducted to analyze trends in physician migration, workforce shortages, resource limitations, and health outcomes.Results: Low salaries, restrictive policies, and supply shortages triggered a large-scale exodus of physicians and healthcare professionals. Consequences include rising maternal and infant mortality, outbreaks of preventable diseases such as measles and dengue, and widening urban–rural health disparities. Cuba’s diminished capacity has also weakened its role in global health diplomacy, threatening regional health security.Conclusions: Without urgent economic, institutional, and policy reforms, Cuba’s healthcare system risks irreversible deterioration. Immediate measures are needed to retain healthcare professionals, ensure adequate resources, and maintain domestic and international public health standards
Person-centered care in rehabilitation nursing: Integrating sexual health into transformative nursing practice
Full text linkIntroduction: McCance and McCormack’s Person-Centred Practice Theory is grounded in dignity, respect, and the active involvement of the person in their care. Rehabilitation Nursing in Portugal shares these principles, promoting autonomy and functionality throughout the life cycle. Sexuality, integrated within human functionality, constitutes an essential dimension of care, often neglected due to taboos and lack of specific policies.Objective: To critically analyse how the person-centred approach can be applied in Rehabilitation Nursing, emphasizing the integration of sexual health as a component of transformative care.Method: a theoretical-reflective study based on a literature review conducted between September and October 2025 using Google Scholar, EBSCOhost, and PubMed, employing MeSH and DeCS descriptors related to nursing care, rehabilitation, sexuality, and care models.Development: person-centred practice fosters ethical, empathetic, and collaborative relationships. In Rehabilitation Nursing, it reinforces personalized care and the recognition of sexuality as part of overall wellbeing. The Registered Nurses’ Association of Ontario supports this integration, promoting inclusive practices grounded in human rights. However, cultural and organizational barriers, such as the predominance of the biomedical model, hinder addressing sexuality by Specialist Rehabilitation Nurses.Conclusions: integrating sexuality within person-centred practice promotes ethical and humanized care. Overcoming barriers and investing in professional training are essential to establish inclusive, transformative practices supported by institutional policies
State of more health of adults
Full text linkIntroduction: the functional valuation is one of the pillars of the valuation integral geriatric and it consists on the study of the old man\u27s physical capacities in all its spectrum, from the tasks simpler motorboats and its car capacity taken care until the exercise and the independence in the environment. Objective: to characterize the state of the biggest population\u27s of adults health, belonging to the Medical Clinic of the Family (CMF) Moncada, Policlínico Community Siblings Martínez Tamayo of the municipality Baracoa, during the period of April 2022 -to January 2022 Methods: he/she was carried out a descriptive, retrospective and traverse study. The study population was conformed by the biggest 100 adults (60 years and but) of both sexes, which completed the proposed inclusion approaches. The information was obtained through an interview to patient and relatives supported in a guide in correspondence with the variables to investigate (age, sex, biomedical, functional, psychological and social evaluation) and of the ambulatory clinical histories. The results were presented in distribution charts using as summary measure the number and percent, word processor Microsoft Word and Excel. Results: in the studied population the feminine sex prevailed on the masculine one. Starting from the 60 years they begin to appear the sensorial alterations and less than half of the studied old men they are functionally independent, while starting from the 80 years the dependence prevalence increases. The old men that are dependent for the ABVD are also it for the AIVD. Conclusions: the studied bigger population of adults has a good state of health
Comprehensive Surgical Approach To Acute Abdomen With Combined Pathologies: A Case Report From Paraguay
Full text linkAcute abdomen requires urgent intervention for potentially life-threatening conditions. We report the case of a 59-year-old male with acute abdominal pain and bloody stools treated at the Regional Hospital of Pilar, Paraguay. Exploratory laparotomy revealed intestinal ischemia with necrosis, congestive appendicitis, inguinal hernia, colocolic intussusception, and diverticulosis. A comprehensive surgical approach resulted in favorable postoperative recovery. This case highlights the critical role of timely diagnosis and multidisciplinary management in optimizing outcomes for complex acute abdomen presentations
Incidence Of Anemia In Pregnant Women In A District Hospital In Paraguay, During The Year 2024
Full text linkIntroduction: Iron deficiency anemia is the most common during pregnancy, caused by a decrease in hemoglobin concentration, a decrease in hematimetric indices and producing maternal-fetal complications during pregnancy. Objectives: Determine the incidence of anemia in pregnant women in a District hospital in Paraguay, during the year 2024. Methodology: observational, descriptive cross-sectional. Through the registration of data from a district hospital in Paraguay without any type of intervention in the course of these. The sample consisted of 185 pregnant women. Results and discussion: the majority age was 28 and 37 years (52%), mostly from the city of Limpio (67%) and with a secondary educational level (53%). The educational and economic level is related to the appearance, The number of births and nutritional deficiencies can contribute to anemia, affecting fetal development. In the study, 54% of the patients had mild anemia, and 42% had moderate anemia, with the number of prenatal controls being a key factor in preventing complications. The absence of treatment in the mother affects fetal development, increasing the risk of premature birth. and limit the production of hemoglobin and oxygen in the maternal body.
Conclusion: It was possible to identify the sociodemographic and clinical variables of the pregnant patients such as age, marital status, origin, educational level, parity, gestational age and diagnosis method, the type of anemia was satisfactorily determined according to the trimester of pregnancy and was correlated with the number of prenatal checkups
Medical students’ perceptions and attitudes toward translational medicine education: a cross-sectional study in Paraguay
Full text linkIntroduction: Translational medicine seeks to bridge the gap between scientific discoveries and clinical practice, yet its integration in undergraduate medical education remains limited. Understanding students’ perceptions of this field is key to designing curricula that foster translational competencies. Methods: A descriptive, cross-sectional study with a quantitative approach was conducted among 108 medical students from the Universidad María Auxiliadora (Paraguay, 2024 cohort). A validated 25-item questionnaire assessed three dimensions: understanding of translational medicine, perceived importance of including it in the curriculum, and expectations of its future applicability. Descriptive and bivariate analyses were performed. Results: Only 15% of students reported good or complete understanding of translational medicine (mean self-perceived comprehension = 2.4/5), while 85% agreed that it should be formally included in medical education. Most participants (≈80%) anticipated that such training would enhance clinical reasoning, scientific updating, and professional innovation. The main barriers identified were lack of time (61%), mentorship (52%), and methodological knowledge (48%). Nearly all students (93%) expressed willingness to participate in translational research if supported institutionally. Conclusions: Although students’ conceptual knowledge of translational medicine is limited, they recognize its relevance and express motivation to learn and apply it. Integrating translational content and mentorship programs into the curriculum could strengthen research culture and prepare future physicians to bridge science and clinical practice