Propuesta de intervención para ancianos deprimidos

Se realizó un estudio de intervención a un grupo de ancianos previamente identificados como deprimidos en dos consultorios del médico de la familia perteneciente al policlínico "Dr. Gustavo Aldereguía Lima" de Las Tunas, con el objetivo de mejorar o eliminar este estado de ánimo negativo. El universo estuvo constituido por 48 seniles deprimidos, de los cuales 21 constituyeron el grupo de estudio y 27 el grupo control. Para la información fue elaborado un cuestionario y para el análisis estadístico fue calculado el porcentaje. Las principales conclusiones demostraron que con la aplicación del programa es posible eliminar la depresión en el 80,95 % de los casos, se demostró además que disminuyeron los casos con idea suicida y mejoraron las relaciones familiares<br>An intervention study was conducted in a group of aged people previously identified as depressed at 2 family physicians’offices from the "Dr. Gustavo Aldereguía Lima" Polyclinic, in Las Tunas, aimed at improving or eliminating this negtive condition. The group was composed of 48 depressed elderly of whom 21 were part of the case-base study and 27 of the control group. A questionnary was made to collect the information, whereas percentage was calculated for the statistical analysis. The main conclusions showed that with the application of the program it is possible to erradicate depression in 80.95 % of the cases. It was also proved that the cases with suicidal idea decreased and that the family relations were better than befor

Surgical, non-traumatic splenopathies

As our modern-day understanding about the role of the spleen in the immune system has developed, indications for splenectomies have also changed. Illnesses like idiopatic thrombocytopenic purple, hereditary spherocytosis, sickle cell anemia, beta thalassemia, portal hypertension and other non-traumatic disseases that carry out with congestive splenomegaly and hypersplenism, find an effective alternative with the total or partially splenectomy. We presented the Good Clinical Practices Guideline for Portal hypertension, approved by consensus in the 4th National Good Clinical Practices Workshop in Pediatric Surgery (Las Tunas, Cuba, March, 2005).</strong

Undescended testis.

Undescended testis constitute one of the most common congenital anomalies in newborn; it affects more than 3% of the children were born at the end of the gestation, and until 33% of premature infants. Surgical treatment reduces the risk of torsion, facilitates the exploration of the testicle, improves the endocrine function of the same one, make a scrotum with normal appearance and it is based on the theory that the early intervention prevents the secondary degeneration of the testicles caused by the high temperatures to those that it is subjected outside of the bag escrotal. We presented the Good Clinical Practices Guideline for Undescended testis, approved by consensus in the 4th National Good Clinical Practices Workshop in Pediatric Surgery (Las Tunas, Cuba; March 2005).</span

Accuracy of sentinel node mapping in patients with biopsy-proven metastatic axillary lymph nodes and upfront surgery: preliminary results of the Multimodal Targeted Axillary Surgery (MUTAS) trial

Background: Some studies suggested that the patients included in the Z0011 trial may represent patients with ultrasound-negative axillary nodes and axillary invasion diagnosed by sentinel node (SN) biopsy. Nevertheless, the National Comprehensive Cancer Network (NCCN) guidelines recommend SN mapping if 1 or 2 suspicious lymph nodes are identified on axillary ultrasound (AU). The aim of this preliminary phase of the Multimodal Targeted Axillary Surgery (MUTAS) trial was to establish the accuracy of SN mapping in patients with axillary involvement undergoing upfront surgery. Methods: Between September 2019 and March 2022, we recruited patients with biopsy-proven metastatic axillary nodes and upfront surgery from a single center. We performed SN mapping in these patients before the surgical intervention, which included axillary lymph node dissection. The biopsy-proven metastatic node, SNs and the remaining axillary nodes were excised separately. SN status was considered representative of the status of the remaining axillary nodes. We calculated the sensitivity, specificity, negative predictive value and positive predictive value of the SN, overall and in patients with palpable nodes, in those with non-palpable nodes and an AU leading to diagnosis of axillary involvement, in those with 1 or 2 suspicious nodes on AU, and in patients with a single suspicious node on AU. We evaluated clinical, imaging and pathology features as predictors of the status of the remaining axillary nodes, false-negatives, and false-positives. Results: We included 25 patients in this phase. The false-negative rate of SN mapping was 28% overall, 21.42% for patients with palpable nodes, 36.36% for patients with non-palpable nodes and an AU diagnosis of axillary involvement, 28.75% for those with 1 or 2 suspicious nodes on AU, and 15.38% in patients with a single suspicious node on AU. The negative predictive value was highest in patients with a single suspicious node on AU (75%). The only significant predictive factor was that FN showed a higher Ki67 index score. Conclusions: In this study, SN mapping was not reliable in patients with biopsy-proven metastatic axillary nodes and upfront surgery for any of the subgroups studied. Further research should elucidate the best staging pathways in these patients to avoid premature de-escalation