Universidad de Ciencias Médicas de Guantánamo

Metaverse references an immersive three-dimensional digital space, conceptions about its specific nature and organization have changed over time, and more strongly emphasize the evolution from considering the metaverse as an extended version of a single virtual world to a wide network of an infinite number of interconnected worlds. The aim of this article is to describe the potential of the metaverse in health care. One potential feature of a doctor's office in the metaverse could be the use of virtual reality technology to create immersive, personalized treatment environments for patients. The doctor may also be able to use virtual reality tools to demonstrate treatment options or procedures, or to provide educational materials to the patient. There are several potential applications of the metaverse in medicine, including the use of virtual reality and other immersive technologies for patient care. Some examples of these applications include: Virtual reality exposure therapy for anxiety disorders; Virtual reality-based cognitive behavioral therapy for depression; Virtual reality-based rehabilitation and physical therapy; Virtual reality pain management; and Virtual reality education and training. There are several potential benefits to delivering clinical care in the metaverse. Metaverse may allow for more efficient and convenient access to care, particularly for patients who live in remote or underserved areas. These platforms will contribute for more personalized and immersive treatment experiences, as virtual reality technology can be used to create tailored environments and experiences for patients. There may also be concerns around patient privacy and security, as well as the potential for cyber-attacks.

Social responsibility is a key element in meeting the needs of the context in which an organization operates. In the healthcare sector, attention to this concept has involved studying internal aspects, as well as the contribution to its implementation in the management of processes and practices of the organization's agents. In order to analyze the relationship between social responsibility and hospital culture, a mixed study was conducted in two phases. First, a focused ethnography was implemented, followed by a systematic review study. The results showed a poor conceptual development of the category, the importance of organizational ethics, the values in the regulation exerted by hospital culture on social responsibility, and the need for the dual nature of social responsibility in terms of its design as an instrument or strategy of the organization. It is concluded that achieving a better operationalization of social responsibility is necessary for its reproduction in the hospital culture, as such responsibility must be promoted as an individual practice based on a solid worldview, and from this achievement, consolidated as a set of identifiable actions. Thus, quality must be a crossing in the design and description of the dimensions and indicators of social responsibility and an organizational value.

Introduction: Dementia is one of the most important organic brain disorders. It manifests itself chronically and progressively, with alterations in cognitive functions such as memory, thinking, orientation, calculation, language and learning ability without initially causing consciousness disorders. Objective: To characterize patients diagnosed with dementia syndrome in the Geriatrics Clinic of the "Policlínico Asdrúbal López Vázquez" in Guantánamo from June 2019 to July 2021. Methods: An observational, descriptive, cross-sectional study was conducted in the "Policlínico Asdrúbal López Vázquez" in the municipality and province of Guantánamo. In the statistical analysis, the following variables were extracted: gender, age group, educational level, toxic habits, family medical history, personal medical history, cognitive impairment group (according to Mini-Mental State Examination), and the level of patient independence (according to the Katz Index and Lawton Index). Descriptive indicators, as well as totals and percentages, were obtained using the statistical software SPSS 23.0. Results: According to the results of the Folstein´s Mini Mental State Examination and sex variable, we found a predominance of females in the group with cognitive impairment of 21.7% (17). It can also be observed that the educational level is a statistically significant factor (p = 0.001) in dementia syndrome, as individuals with a lower educational level have 5.53 times higher risk (RR=5.5). Conclusions: Female sex, low educational level, smoking and high blood pressure are risk factors for cognitive impairment.

Introduction: Scientific research is essential for the advancement of medicine. Therefore, medical training should include the acquisition of research skills through the implementation of research courses and other mechanisms that promote the collective construction of knowledge. Bibliometrics involves statistical and quantitative analysis of publications within a specific research field. Objective: Characterize Internal Medicine articles published in the journal Gaceta Médica Estudiantil from 2020 to January 2023. Methods: A bibliometric, observational, cross-sectional study was conducted. The universe consisted of 21 scientific articles that have been published. The sampling technique was not used. The variables analyzed included year of publication, article type and topic, medical science field, author's origin, number of authors, readings, downloads, and bibliographic references. Descriptive statistics, degree of collaboration, and the Price Index were used.Results: In 2022, 11 articles (52,4 %) were published, making it the year with the highest number of publications and collaboration index. Original articles were the most prevalent, accounting for 11 (52,4 %) of the total. Articles with four authors were most prominent. Females predominated (35, 51,5 %). University of Medical Sciences of Guantánamo had the largest number of authors (22, 32,4 %). 974 references were used, and 715 of them were no older than five years

<strong>Introducción: </strong>la infertilidad adquiere cada día mayor auge en las sociedades. <strong>Objetivo: </strong>facilitar la labor del médico de la familia en la captación y seguimiento de los casos de infertilidad. <strong>Método: </strong>se realizó una revisión bibliográfica, mediante consulta digital de las revistas especializadas, actualizadas y de libre acceso disponibles en el sitio web de la Biblioteca Virtual de Salud. Para la localización de las publicaciones fueron empleadas varias palabras clave, que contuvieron fundamentalmente el términoinfertilidad.Las citas digitales más recientes y que mostraban el trabajo de manera íntegra, fueron sometidas a un análisis que permitió obtener la información. <strong>Desarrollo: </strong>dentro de las causas de infertilidad identificadas con mayor frecuencia se encuentran en el caso de las femeninas, las infecciones genitales y como exponente de la masculina con el varicocele. <strong>Consideraciones finales: </strong>fomentar la incorporación del conocimiento permitirá el diseño de acciones preventivas sobre los principales factores causales de la infertilidad desde la Atención Primaria de Salud.

Introduction: in the present century, dementia is one of the most disabling syndromes affecting the elderly population, which increases its frequency at an accelerated rate and has a high individual and social impact. Objective: to identify biopsychosocial factors that influence primary caregivers of patients diagnosed with dementia syndrome. Methods: descriptive longitudinal study in the Central Area of the municipality and province of Guantánamo, during the period from December 2019 to May 2022. The universe was constituted by the main caregivers of 43 elderly, the following variables were used: age, sex, schooling, marital status, occupation, personal pathological history before being a caregiver, personal pathological history after being a caregiver, type of caregiver, cognitive deterioration of the patient, time employed by the caregiver, level of overload, burn out syndrome - burned caregiver. Descriptive indicators were obtained through the SPSS 23.0 statistical package, as well as totals and percentages. Results: the factors most associated with the overload of the main caregiver of patients with dementia syndrome were female sex (OR=63; CI95%: 10,3-86,7; p=0,000), the affective ties of spouse/child (OR=61,8; IC95%: 7,0-67,1; p=0,001) and the degree of cognitive impairment (OR=45,0; IC95 % 4,8-93,6; p=0,001). Conclusions: female sex, spousal bonding and degree of cognitive impairment were identified as factors influencing the overload of primary caregivers of patients with dementia syndrome.

La presente investigacion se realizo con el objetivo de determinar como influye el funcionamiento familiar en la conducta sexual de riesgo de los adolescentes de la comunidad de Yanayacu, 2015-2016. El universo estuvo conformado por 71 adolescentes de 14 a 19 anos; es una investigacion descriptiva_correlacional de corte transversal. Se aplico los instrumentos: Encuesta de conductas sexuales de riesgo, modificada a partir de la guia de medicion de comportamiento de riesgo en adolescentes de America Latina y el Caribe, la revision documental de la ficha familiar y la aplicacion del test del funcionamiento familiar (FF-SIL). Se utilizaron los estadigrafos de tendencia central y dispersion como media, mediana, moda, desviacion estandar y para evaluar la posible asociacion entre variables cualitativas se utilizo el test de independencia Chi-Cuadrado. Los resultados muestran que el 49,3 % habian iniciado su vida sexual; entre las conductas sexuales de riesgo identificadas fueron: inicio temprano de la vida sexual, no uso de preservativo y mas de dos parejas sexuales con una P < 0,05 segun sexo. En cuanto al conocimiento de prevencion de estas conductas, mencionaron en su mayoria al preservativo, pero menos del 40% lo utilizaban; el 77% de adolescentes con vida sexual pertenecian a familias disfuncionales y moderadamente funcionales con una tipologia familiar ampliada y extensa. Conclusiones: familias extensas y ampliadas con una dinamica familiar disfuncional y moderadamente funcional, provocan mayor frecuencia de conductas sexuales de riesgo. El nivel de comunicacion, calidez y union desempenan un papel muy importante como protectores de estas conductas.

Introducción: La Diabetes Mellitus es una enfermedad metabólica que se caracteriza por hiperglucemia, debido a defectos en la secreción de insulina o a la acción de la insulina, o a la combinación de ambos; con gran impacto a nivel mundial. Los pacientes con diabetes mellitus son hospitalizados 2,4 veces más que el resto de los pacientes que ameritan hospitalización, esto amerita una inversión importante por parte del Estado, principal responsable de sostener los centros hospitalarios y por parte del paciente y su familia. Objetivo: Identificar factores epidemiológicos asociados a la duración de la estadía hospitalaria de pacientes diabéticos en el Hospital General Docente Dr. Agostinho NetoMétodo: Se realizó un estudio observacional, descriptivo y transversal en el Hospital General Docente Dr. Agostinho Neto en la provincia de Guantánamo en el año 2021. En el análisis estadístico se extrajeron las variables edad, sexo, hábitos tóxicos, índice de masa corporal, actividad física, tipo de diabetes, cifra de glicemia al ingreso y comorbilidades, a través del paquete estadístico SPSS 23.0, se obtuvieron los indicadores descriptivos, así como los totales y porcentajes.Resultado: se observó la mayor presencia del grupo etario mayor de 60 con un 49,1 %, se puede apreciar que el tipo de diabetes es estadísticamente significativo (p= 0,019) para hablar de estadía hospitalaria prolongada, el tipo 2 de DM tiene 1,03 veces más riesgo (OR=1,032).Conclusiones: Como factores predisponentes a una estadía hospitalaria prolongada, fueron identificados la Diabetes Mellitus tipo 2 y la edad avanzada.

Introduction: science and scientific production are spaces given to men for centuries, although in the 21st century, there are gaps in this sense. Aim: to describe from a gender perspective the scientific production in the academic journals of Cuban medical universities, period 2017-2021. Method: a descriptive bibliometric study was carried out. The universe consisted of all the academic journals of Cuban medical universities in the period 2017-2021, they were reviewed between December 2022 and March 2023. The sampling was non-probabilistic and the sample was 19. Only regular numbers were considered. Results: women were 19 % of the magazine directors and 44 % of the editorial board composition. 57,5 % of the editorials were written by men. 2,6 % of the articles dealt with the gender approach. 61,8 % of the authors were women and 38,2 % were men. Women were 55,7 % of the lead authors. In 32,3 % of the articles, women predominated as authors and 23,7 % were written only by women; gender equality represented 14,1 %. Conclusions: an empowerment of women in Cuba is evident as they are the majority within scientific production in medical universities. However, this is not reflected in the direction of the magazines and the composition of their editorial committees, where men predominate, nor in publications with a gender focus, which is still insufficient

Introduction: some toxic-environmental factors are frequently related to malignant hematological diseases, which have increased in recent years.Objective: to describe the frequency of appearance of toxic-environmental factors in patients diagnosed with hematological neoplasms.Method: a study was conducted cross-sectional descriptive study in patients diagnosed with hematological pathologies in the year 2020, a structured interview was applied to them looking for toxic-environmental factors, occupation, contact with toxic substances, origin, drinking water, toxic habits, diet, among others. Patients who used pesticides were given a second interview that collected: the type of substance, exposure time, time since last exposure, history of poisoning, protection measures, knowledge and application of the same. Results: patients with lymphoma predominated. non-Hodgkin (25,5 %), ages between 61-80 years (50 %), farmers (31 %), rural origin (57 %), those who had contact with toxins (64,4 %). The most used toxin was pesticides, the average exposure time was 14 years, the last contact 9,2 years, protection measures are used only sometimes, their need is unknown and 90 % do not know any protection measure. Conclusions: according to the results it is necessary to create strategies to guide the population about this risk and how to modify it

Introduction: the Nipah virus causes severe disease with high mortality rates in humans. Since its discovery, it has been studied for its pandemic potential and lethality. Objective: analyze the scientific production on the Nipah virus, to identify its trend at an international level. Method: a descriptive, longitudinal and retrospective study of the scientific production related to the Nipah virus published in open access on the Web of Science Core Collection between 2000 and 2020 was carried out. The information search used the equation "Nipah NOT Hendra", and of each record Information regarding the year of publication, authors with their institutional affiliation, type of publication and title of the journal (for articles), country of origin of the authors was extracted. VOSviewer 1.6.17 was used to map the collaboration networks between authors and countries, as well as the co-citation network and the concurrency of keywords. Results: 443 documents were recovered, where 79.23% are articles and 99.79% were published in English. The most productive sources are: Journal of Virology and Emerging Infections Diseases. A total of 1.724 authors were identified, observing a trend towards an increase in scientific production on the Nipah virus in the period analyzed, which allows the construction of theoretical frameworks that support strategies on this virus. Conclusions: the analysis carried out responds to the WHO priority on monitoring this pathogen, classified as one of those with the greatest potential to generate pandemic outbreaks and high morbidity and mortality

An investigation was carried out with the objective of identifying the trends of Cuban scientific production on some Enabling Technologies for Digital Transformation (THD) in Cuba indexed in Scopus in the period 1997-2022 and analyzing the behavior based on bibliometric indicators such as: intellectual structure, conceptual and social of them. It was carried out from the combination of said indicators and bibliometric techniques to obtain features of their behavior and the production practices of the specialized scientific community. Among the results, it was found that the annual evolution showed a linear growth both in documents and in the number of citations received, production found mainly in foreign journals and in the core area of the topic addressed. There was a coincidence in the prominent author in the co-citation network and the leader of one of the collaborative networks. The most referenced sources were: Lecture Notes in Computer Science, Information Sciences and Neurocomputing. The participation of universities and collaborations with Spain and Belgium predominated. There were most of the themes of artificial intelligence, machine learning, learning systems, human computer interaction and data mining related to health. The study highlighted the importance of contextualizing bibliometric indicators. In addition, it allowed us to compare the trends shown by Cuban scientific production with respect to the international context. Final ideas are offered on future lines of research and the importance of the results found.

Introduction: in the care of women with precursor lesions of cervical cancer, preventing possible progression to invasive cancer without over-treating the high chances of regression is extremely important. Over time, different treatments and protocols have been tested in order to obtain the best results in the control of this condition with conservative techniques. Objective: to identify predictors of residual disease depending on the intrinsic characteristics of the patients with conization, due to high-grade epithelial lesions or with microinvasion. Methods: A prospective descriptive study was conducted to determine the relationship between the diagnosis of residual disease and clinical- epidemiological variables dependent on the patient, in 1090 patients with high-grade cervical epithelial lesions who were treated at the "Héroes del Baire" General Teaching Hospital on the Isle of Youth (Cuba) during the period 2014-2019. Result: a linear trend of the association of age and residual disease was observed, as well as an association with glandular disease, histological severity and infection by oncogenic serotypes of the human papillomavirus. HPV infection (OR=11.3), history of previous lesion (OR=9.8), persistence of viral infection (OR=4.9) and glandular involvement (OR=3.1) were the factors that showed the greatest association with residual disease. Conclusion: the severity and size of the lesion, the glandular extension and the persistent infection by the human papilloma virus were the predictive factors that contribute to the existence of residual lesion.

<strong>Introducción</strong>: la educación interprofesional se enmarca en la tercera gran reforma de la educación sanitaria. Consiste en una docencia basada en sistemas sanitarios, enfocada en competencias locales y globales. Es el sustento de una práctica colaborativa interprofesional que garantice la Atención Médica Integral centrada en el paciente, la familia y la comunidad. <strong>Objetivo</strong>: fundamentar la necesidad de la educación interprofesional en la formación de pre y posgrado en Ciencias de la Salud como garantía de una práctica colaborativa interprofesional eficaz que tribute a una Atención Médica Integral sostenible e inclusiva. <strong>Método</strong>: se efectuó un estudio documental en idioma inglés y español en diversas bases de datos: Google Académico, SciELO y Red Nacional de Información en Salud (Infomed). Se sistematizaron las informaciones y se efectuaron valoraciones críticas de los autores. <strong>Desarrollo</strong>: la práctica colaborativa e interprofesional ha tenido un ascenso en diferentes escenarios y deviene en condición esencial para la atención de calidad según demanda la sociedad y los sistemas de salud en los últimos años en todo el mundo, y es un requisito necesario para una atención de la salud de calidad y segura. La educación colaborativa interprofesional mejora la coordinación, integración y fusión de saberes útiles entre distintos profesionales de la salud y en la atención social. Se requiere un estrecho nexo entre los ministerios de salud y las instituciones formadoras en función de una educación interprofesional desde el pregrado, posgrado y durante la formación continua. <strong>Conclusiones</strong>: la educación colaborativa interprofesional en la formación salubrista tributa a una práctica colaborativa interprofesional sostenible.

Introduction: In recent years the relationship between the systematic practice of physical exercise, cardiovascular dynamics and the functioning of the autonomic nervous system has been recognized. Objective: To determine the modifications that nonlinear parameters undergo in the autonomic cardiovascular regulation of the heart rate variability with the systematic practice of physical exercise. Methodological Design: Retrospective cohort analytical study in the period from February 2016 to August 2018. Universe and sample of 36 individuals (Group 1: 18 high performance baseball athletes, Group 2: 18 students from the University of Medical Sciences of Santiago de Cuba). The data were collected in the Biomedical Basic Sciences Laboratory of the University's Faculty 1, through the 8-channel PowerLab polygraph, and stored using the Kubios Software version 3.0.4 Premium. Results: Statistically significant differences were found in heart rate values (p = 0.000); SD1 (p = 0.025); SD2 / SD1 ratio (p = 0.007); sample entropy (p = 0.011); short-term fluctuations alpha 1 (p = 0.019); linear average length (p = 0.016); linear maximum length (p = 0.001); recurrence rate (p = 0.034); determinism (p = 0.010) and Shannon entropy (p = 0.015). The parameters of SD1 (C = 906) and sample entropy (C = 712) were significantly associated with a heart rate ≤ 70 beats / min. Conclusions: With the systematic practice of physical exercise, the non-linear dynamics of the autonomic cardiovascular regulation of the heart rate variability undergoes modifications that respond to a better adaptability of the autonomic nervous system, and to a greater capacity to regulate cardiovascular function.

Introduction: the world's population is increasingly aging. Care of elderly demands committed professionals and an educative work with families and community. Objective: the implementation of an educative intervention aimed for preparing caregivers of elderly in the Family Doctor's Office No. 6 of the Policlínico Universitario "Mártires del 4 de Agosto", in Guantánamo. Methods: a prospective, educative intervention-type study was conducted from September 2018 to June 2019. The total of all elderly caregivers (as universe), associated to the Medical office, were enrolled in the study and 38 of them were selected as sample intentionally according to inclusion criteria. The variables studied were: knowledge of risk factors in elderly and their prevention, orientation and control of the duties to be done, necessary means and tools for care, knowledge of first aid. The educative intervention was carried out in three different stages with their respective objectives and methods of execution. Absolute and relative frequency was used as a summary measure. Results: before applying the educative intervention, 63.1% of caregivers showed insufficient level of preparation in their duties; after intervention, the theoretical and practical deficiencies previously arose, so decreased to 31.5%. The 46.9% of caregivers (p<0.05) increased their skills, thus promoting the usefulness of the use of the educative intervention designed. Conclusions: the educative intervention made it possible the improvement on the skills of caregivers.

Se presentó el caso de una paciente femenina de 20 años de edad que acudió al servicio de Neurocirugía por presentar dolor en la región lumbar. Al interrogatorio la paciente refirió tener constipación, retención urinaria y dolor lumbar. En los exámenes complementarios lo más significativo fue la resonancia magnética nuclear que mostró una imagen hiperdensa a nivel de D12-L5. Se realizó laminectomía de D12-L5, durotomía y extracción tumoral, fijación transpedicular con tornillos ubicados en T12-L1-L3-L4 con barras de titanio, se obtuvo un diagnóstico de astrocitoma grado II-III. Al analizar los diferentes aspectos del caso en cuestión, los investigadores concluyen que con la conducta terapéutica tomada con este caso se sientan las bases para un correcto manejo de posteriores pacientes.

<strong>Introducción</strong>: se revelan limitaciones en la socialización de las consecuencias de la infección por coronavirus 2 causal de la enfermedad COVID-19 en la salud materna y perinatal. <strong>Objetivo</strong>: recopilar información en relación con la influencia de la COVID-19 sobre el embarazo. <strong>Método</strong>: entre enero y febrero de 2021, se efectuó una investigación en el Hospital General Docente “Dr. Agostinho Neto”, Guantánamo, que consistió en una revisión narrativa. Se realizó el estudio documental de referencias, que incluyeron revisiones sistemáticas y artículos originales. La búsqueda se ejecutó en las bases de datos bibliográficas PubMed, Medline, Science Direct y SciELO, con el buscador Google Académico y el uso de las palabras clave y conectores COVID-19 AND embarazo; SARS-CoV-2 AND gestación y los correspondientes términos en español. <strong>Desarrollo</strong>: se sintetizaron aspectos epidemiológicos, clínicos, inmunológicos e implicaciones clínicas de la enfermedad en pacientes embarazadas, pilares respecto al uso de medicamentos, para un abordaje de este tipo de paciente con COVID-19. <strong>Conclusiones</strong>: la gestante infectada por el SARS-CoV-2 es más vulnerable que el resto de la población, sin embargo, se requiere de investigaciones científicas que certifiquen su influencia real sobre la salud de la gestante y la perinatal, así como aquellos factores que modulan la enfermedad durante el embarazo.

A historical and pedagogical analysis of the medical training inCubafrom the revolutionary victory on, is presented in this work. The pedagogical tendencies through which this training goes are identified, what characterizes the movement of the process in each historically determined stage by these authors. This analysis allowed to reveal 3 stages, from the main landmarks in the values training process after the University Reform of 1962 to2018 inCubaand it was stated in each of them the conception of the professional training process for the medicine career, as well as the methodological and didactic limitations of the value responsibility in this process.

Introducción: durante los últimos años, la humanidad ha sufrido la inmensa carga y efecto negativo de la pandemia de Covid-19 causada por el coronavirus tipo SARS-CoV-2. La República Bolivariana de Venezuela fue uno de los países afectados. Objetivo: caracterizar desde una perspectiva clínica y epidemiológica a los profesionales sanitarios cubanos, enfermos de Covid-19 en el Estado Carabobo, República Bolivariana de Venezuela en el período enero a diciembre de 2022. Materiales y métodos: el estudio se clasificó como observacional descriptivo transversal. El universo quedó conformado por los profesionales sanitarios cubanos que enfermaron por Covid-19 (N =142). Se analizaron las variables sociodemográficas: sexo y ocupación; dentro de las clínicas, en la consulta inicial: estado de salud, manifestaciones clínicas y posible fuente de infección. Resultados: del total de casos, el 53,52 % era del sexo femenino. La mayoría de los profesionales eran enfermeras (24,64 % de los pacientes). El 59,15 % estaba asintomático, el 40,84 % presentó secreción nasal y malestar general. La fuente de infección laboral se identificó en 88 profesionales (61,97 %). Conclusiones: predominan los enfermos del sexo femenino con la ocupación de enfermeras, la mayoría asintomáticas en la consulta inicial. Dentro de las manifestaciones clínicas se identifica la secreción nasal y malestar general. La posible fuente de infección más común es laboral.