South Health and Policy (Journal)
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Clinical Description of Pulmonary Tuberculosis in Cuba
No full textIntroduction: Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. The World Health Organization in 2023 states that it is the leading cause of death from infectious diseases worldwide. Cuba is among the countries with low incidence in the Americas. Efforts are ongoing to achieve the goals of the "End Tuberculosis Strategy."Objective: To describe the clinical aspects of pulmonary tuberculosis in Cuba.Materials and Methods: The historical-logical method was used. Data were obtained through the review of 20 publications from 2020 to 2025.Results and Discussion: Mycobacterium tuberculosis has virulence factors supported by cell wall characteristics that aid its survival and spread. Tuberculosis is contracted through inhalation of aerosol droplets containing Mycobacterium tuberculosis from a susceptible person. Symptoms include fever, cough, weight loss, fatigue, night sweats, and hemoptysis. In Cuba, diagnostic techniques include sputum smear microscopy, bacteriological culture, and the tuberculin test. Multidrug therapy is systematically administered in 100% of diagnosed cases
Human African trypanosomiasis (sleeping sickness): a pediatric case report
No full textHuman African trypanosomiasis is caused by protozoa of the genus Trypanosoma sp. and is primarily transmitted by the bite of the tsetse fly. This report presents a pediatric case diagnosed with human African trypanosomiasis in low-incidence areas of Central Africa, diagnosed by Cuban collaborators. Case presentation: A 12-year-old patient with a medical history had traveled to an area with active cases of trypanosomiasis within the last 2 years. The patient presented with recurrent fever, general weakness, and drowsiness. Rapid diagnostic tests were positive for salmonellosis and malaria. The patient was treated with antibiotics, with no clinical improvement. The diagnosis was positive for Trypanosoma sp. by thick blood smear and staining. Clinical improvement occurred after nifurtimox-eflornithine combination therapy according to the regional protocol for Trypanosoma brucei gambiense in the second phase of infection. Clinical improvement was seen at 48 hours. Conclusions: Human African trypanosomiasis is a common infection in regions where medical assistance is provided by Cuban medical personnel. The high endemism of other infections with similar symptoms and acquired immunity favors late identification without adequate knowledge and timely clinical-epidemiological analysis. A complementary definition and specific therapeutic measures ensure a good outcome and a better prognosis.
Characterization of Major Geriatric Syndromes. Family Doctor\u27s Office #32. San Cristobal
No full textIntroduction: Geriatric syndromes are a collection of conditions typically caused by the combination of diseases with a high prevalence in the elderly, and are a frequent source of functional or social disability. Objective: To characterize elderly individuals with Geriatric Syndromes, belonging to FDO 32 in San Cristobal. Method: An observational, descriptive, cross-sectional study was conducted in adults aged 60 years and older belonging to the population of said doctor\u27s office of the "Camilo Cienfuegos" Polyclinic, in the period between October 2021 and April 2024. The population consisted of 410 patients over 60 years of age, and the sample consisted of 296 patients with one of the major geriatric syndromes (immobility, incontinence, instability or falls, cognitive impairment, and frailty or functional decline), who met the inclusion criteria. A questionnaire was applied to identify them, as well as instruments designed to evaluate sub-variables such as depression and mental status. The data were represented in tables and graphs, processed using descriptive statistical methods, such as percentage assessment. Results: Geriatric syndromes were more frequent in the 80 to 85-year-old age group and in females. The most prevalent syndromes were instability and frailty. Regarding functional capacity in basic activities of daily living, mild dependence was the most common, and in instrumental activities of daily living, moderate dependence
Cocaine use during pregnancy and its relationship with eclampsia: an interdisciplinary approach
No full textIn Argentina, the prevalence of cocaine use among pregnant women varied according to the studies carried out and the methodologies applied. The detection of these cases was probably underestimated due to the social stigma and the lack of adequate screening tools. The ASSIST test was promoted as a method to improve the early identification of use. The use of cocaine during pregnancy was associated with an increase in the occurrence of hypertensive disorders, including preeclampsia and eclampsia. The mechanisms involved included uterine vasospasms, oxidative stress and reduced blood flow to the foetus, which led to serious consequences such as placental infarctions and premature births. Faced with this problem, the Argentine health system adopted an interdisciplinary approach, with the involvement of doctors, psychologists, social workers and other professionals. Early detection in prenatal check-ups was promoted, as well as the training of health teams. The treatment was designed to be comprehensive, including psychosocial therapies and medical support. After delivery, long-term follow-up was recommended to guarantee the well-being of the mother-child pair and prevent relapses or future consequences. This situation represented a major challenge for public health, underlining the urgency of implementing effective detection, treatment and support strategies
Necrotizing fasciitis secondary to crush trauma
No full textIntroduction: Necrotizing fasciitis is a devastating acute bacterial infection that affects the superficial and deep fascia, subcutaneous tissue, and, in severe cases, vascular and nervous structures. Although rare, its incidence has increased in recent years.Objective: To describe the successful therapeutic management of a case with Necrotizing fasciitis.Case report: A 21-year-old male patient with PPA due to a sella turcica tumor and epilepsy, for which he reports no treatment. He presented to the Emergency Department of Miguel Enríquez Hospital with pain in his right lower limb and a foul odor due to a traffic accident on February 3, 2025. The patient reported pain, increased volume, skin discoloration, and abundant fetid, bloody discharge, with a fever of 38-39°C since the previous afternoon. Therefore, the decision was made to admit the patient for surgical treatment.Conclusions: Skin grafting is considered an excellent coverage option for soft tissue defects and offers very favorable results in the reconstruction of the affected limb after necrotizing fasciitis
Impact of competitive sport on QT interval prolongation
No full textBackground: Regular and sustained physical activity is beneficial for the cardiovascular system. However, sudden cardiac death (SCD) events occasionally occur during physical activity in young and apparently healthy individuals, associated with long QT syndrome (LQTS). The aim of this study is to clarify and characterize SCD among those who practice physical activity as a consequence of LQTS in those involved in physical activity and to determine the possibilities for screening, in order to collaborate with future prevention measures. Material and methods: A systematic review of the Pubmed database was carried out using articles published between 2006 and 2024, in Spanish, English and Portuguese, classified as books and papers, clinical studies, randomized controlled trials, controlled clinical trials, meta-analyses and systematic reviews. For the writing of the final text, only those studies aligned with the objectives established in this research were selected. Results: High-performance athletes can be affected by channelopathies induced by the cardiac remodeling required by the activity. However, studies show that the ability of cardiologists and specialists to analyze and interpret electrocardiograms (ECGs) remains less than ideal. The correct medical approach to sports continuity and performance remains a challenge for the scientific medical community, which adopts restrictive recommendations for athletes diagnosed with any cardiovascular abnormality. Conclusion: LQTS includes various disorders, ranging from genetic mutations to pharmacological interactions and electrolyte imbalances, which are sometimes difficult to diagnose. Due to the risk of malignant arrhythmias and sudden death, early detection and appropriate treatment are essential for accurate diagnosis and treatment. Therefore, it is crucial for the cardiologist to interpret the characteristic electrocardiographic signs of this syndrome
Understanding the working mechanism of neural networks
No full textNeural networks are a foundational component of artificial intelligence and machine learning. This article explores the structure and functioning of neural networks, focusing on core concepts such as weight loss functions, activation functions, and backpropagation with gradient descent. The discussion includes an overview of the complete process of how neural networks operate, with detailed mathematical formulations, equations, and diagrams to aid comprehension.
Clinical characterization and mortality predictors in a terminal hospital
No full textIntroduction: the stroke represents one of the main causes of morbidity and mortality globally, with a significant impact on public health. The identification of mortality predictors is essential for clinical decision making.Aim: characterize patients diagnosed with stroke and determine mortality predictors.Methods: an observational, analytical and retrospective study was carried out at the Dr. Miguel Enriquez Surgical Clinical Hospital from January to December 2024. The qualitative variables were summarized in absolute frequencies and percentages. The quantitative variables in average and standard deviation. To evaluate the association between qualitative variables the JI square test was applied. To determine the factors associated with mortality, a multivariate binary regression model was adjusted.Results: 883 patients were studied. The ischemic stroke was the most frecuent and within in the cerebral infarction of therotrombotic etiology prevailed (79.9%). With respect to the age variable, for each additional year the probability of death increases by 5%, OR 1.05 (IC 95%: 1.02-1.08, p< 0. 001). As for the Glasgow scale for each additional point, the probability of death decreases by 15%, OR 0.85 (IC 95%: 0.80- 0.90). On the other hand, patients with cerebral edema have 3.5 times higher risk of death OR 3.50 (IC 95%: 2.40- 5.10).Conclusions: the influence of clinical and demographic factors on ICTUS mortality provides tools to stratify the risk, contributing to optimize decisions in medical practice
Update on Cardiac Arrhythmias in Patients with COVID-19
No full textCurrently the world population is besieged by COVID-19, a disease caused by the SARS-CoV-2 coronavirus; and it has been declared by the WHO as a pandemic. COVID-19 disease usually presents with mild respiratory symptoms, some patients have pneumonia, and in severe cases, acute respiratory distress syndrome (ARDS) and shock are seen. Cardiovascular complications in the course of COVID-19 are responsible for high mortality. A bibliographic review was carried out in order to characterize the pathophysiology of heart rhythm disorders caused by COVID-19 and its complications. A total of 22 bibliographic references were reviewed between books, medical journals and web pages of the Scielo and Infomed platforms. It is evident that those who suffer from previous heart disease are at risk of decompensation and have higher mortality. The drugs used during the treatment of this condition confer a proarrhythmogenic effect
Factors influencing mortality in patients diagnosed with intraparenchymal hemorrhage
No full textIntroduction: apoplexy or apoplectic stroke is the clinical term given to the acute loss of blood supply to a region of the brain, resulting in ischemia and loss of neurological function. Objective: to describe the factors that influence mortality in patients diagnosed with intraparenchymal hemorrhage in studies published in the PubMed and LILACS databases during the period 2020-2025. Method: a literature review study was conducted in the LILACS and PubMed databases in April 2025. A total of 21 articles were obtained from LILACS and 36 articles from PubMed, and 57 articles were preselected. Development: age and a history of diabetes mellitus are strongly associated with mortality. Additional studies show variability in incidence, with the presence of ventricular extension, blood glucose at admission, and measurement of the ipsilateral dilated optic nerve sheath as prognostic factors in this group. Conclusions: age, the presence of ventricular extension, and blood glucose at admission are highly associated with mortality. Several prognostic scales are used, with various limitations, but the Glasgow Coma Score was the most widely used in this study