Sistema de evaluación y acreditación para la carrera de Estomatología

Se plantea  la conveniencia  de establecer un Sistema de Evaluación y Acreditación para la Carrera de Estomatología adecuado a las particularidades de esta carrera universitaria y los escenarios docentes donde se desarrolla la misma en el Sistema Nacional de Salud de Cuba. Se comentan aspectos de la investigación que se realiza para complementar las variables de calidad establecidas por el Sistema de Evaluación y Acreditación de Carreras Universitarias (SEA-CU) con variables  de calidad, indicadores y criterios de evaluación  propias de la Carrera de Estomatología

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

SISTEMA DE EVALUACION Y ACREDITACION PARA LA CARRERA DE ESTOMATOLOGIA System of evaluation and accreditation for the Dentistry career

Se plantea la conveniencia de establecer un Sistema de Evaluación y Acreditación para la Carrera de Estomatología adecuado a las particularidades de esta carrera universitaria y los escenarios docentes donde se desarrolla la misma en el Sistema Nacional de Salud de Cuba. Se comentan aspectos de la investigación que se realiza para complementar las variables de calidad establecidas por el Sistema de Evaluación y Acreditación de Carreras Universitarias (SEA-CU) con variables de calidad, indicadores y criterios de evaluación propias de la Carrera de Estomatología.<br>In this paper is analyzed the convenience of the establishment of an Evaluation and Accreditation System for the career of Dentistry adequate to the particularities of this university career and their teaching scenes where it is developed in the Health National System of Cuba. Some aspects of the research that is realized at the present are commented in order to complement the quality variables established by the Evaluation and Accreditation of University Careers System (SEA-CU) with quality variables, indicators and evaluation criterions owns of the career of Dentistry

SISTEMA DE EVALUACION Y ACREDITACION DE CARRERAS UNIVERSITARIAS: IMPLANTACION EN EL INSTITUTO SUPERIOR DE CIENCIAS MEDICAS DE LA HABANA

Se aborda la necesidad de establecer normas y patrones de calidad en los procesos docentes que se encargan de la formación integral de los recursos humanos en Salud en un mundo donde la cooperación nacional e internacional requiere el desarrollo cualitativo en la formación y superación de los profesionales que demanda la sociedad en la búsqueda de la excelencia académica, la justicia social y adecuados niveles de atención integral de la salud de la población. Se describen las particularidades de la Evaluación y Acreditación de las Instituciones de la Educación Superior y sus Carreras, la experiencia cubana en este tema, en general, y la del Instituto Superior de Ciencias Médicas de La Habana, en particular.In this paper is analyzed the necessity of the establishment of quality norms and patterns in the teaching process in charge of the integral formation of Health Human Resources in the present world in which the nacional and international cooperation needs a cualitative devepelopment in the formation and overcoming of the professionals that demands the society searching the academic excellence, social justice and suitables levels of population health integral attention. The peculiarities of the Evaluation and Acreditation of the Institutions and Careers of the Higher Education, the cuban experience in this matter in general and Havana Higher Institute of Medical Sciences experience in particular are described

Manejo ortodóncico-ortopédico del niño con microsomía facial Orthodontic-orthopedic management of a child with facial microsomia

Se conoce que la complejidad de las malformaciones congénitas craneofaciales deben tratarse en edades tempranas por medio de un equipo multidisciplinario donde el ortodoncista asume un rol protagónico destacado, aprovechando el potencial de crecimiento y desarrollo de los niños en esta etapa, lo que en ocasiones evita que al llegar a la etapa quirúrgica esta sea menos compleja, tanto para el paciente como para el cirujano. La microsomía hemifacial es una malformación congénita derivada de la alteración del primer y segundo arcos branquiales que puede estar asociada con otros síndromes. Puede existir afección unilateral o bilateral, pero con afectación más severa en uno de los 2 lados, y su etiología es multifactorial. La asimetría facial es una de las características propias de este síndrome, por ello en edades tempranas tratamos de redireccionar el crecimiento con el uso de un aparato funcional híbrido, o sea, adaptado específicamente a las características propias de cada paciente, con el que pueden obtenerse resultados altamente satisfactorios.<br>It is well known that complex congenital craniofacial malformations should be treated at early ages by a multidisciplinary team where the orthodontist takes on a leading role, taking advantage of the potentialities of growth and development of children at this stage, which occasionally makes it possible that the disorder be less complex when reaching the surgical stage, both for the patient and the surgeon. Hemifacial microsomia is a congenital malformation derived from alterations in the first and second brachial arches that might be associated to other syndromes. There can be unilateral or bilateral damage, although the most severe effect is often found in one of the two sides of the face and it has a multi-factor etiology. Facial asymmetry is one of the characteristics inherent to this syndrome, so at early ages, we try to re-direct the growth with the use of a hybrid functional appliance that is tailored-made to the specific features of each patient and may yield highly satisfactory results

Síndrome de Parry-Romberg: Visión de su tratamiento Parry-Romberg's syndrome: View of its treatment

El síndrome de Parry-Romberg o atrofia hemifacial progresiva, enfermedad de Romberg o también denominada trofoneurosis facial, fue descrito por Parry en 1925 y por Romberg en 1946. Se considera una malformación craneofacial poco frecuente en la práctica diaria y en edades tempranas, ya que es una enfermedad progresiva que suele empezar en la adolescencia. Se caracteriza por presentar la atrofia del tejido graso (celular subcutáneo), piel, músculos faciales y en algunos casos pueden estar afectados también los huesos y cartílagos de un lado de la cara; su evolución dura de 2 a 12 años, pero puede detenerse en cualquier momento. Su diagnóstico temprano, así como un adecuado plan de tratamiento, resultan importantes y se deben ejecutar por un equipo multidisciplinario para lograr un buen desarrollo funcional y psicológico, así como el establecimiento de una buena relación de oclusión que mejore la armonía facial, que eleve la calidad de vida de estos pacientes. El objetivo del presente trabajo es mostrar un caso que ha sido tratado por el equipo multidisciplinario de Cirugía Maxilofacial del Hospital Pediátrico de Centro Habana.<br>Parry-Romberg's syndrome or progressive hemifacial atrophy, Romberg's disease, or facial trophoneurosis as it is also called, was described by Parry in 1925 and by Romberg in 1926. It is considered an uncommon craniofacial malformation in the daily practice and at early ages, since it is a progressive disease that usually appears in adolescence. It is characterized by the atrophy of the fatty tissue (cellular subcutaneous), skin, facial muscles and in some cases the bones and cartilages of a side of the face may be affected. Its evolution lasts from 2 to 12 years, but it may stop at any time. Its early diagnosis, as well as an adequate treatment plan are important and they should be made by a multidisciplinary team to achieve a good functional and psychological development and the establishment of a good relation of occlusion that improves the facial harmony and increases the quality of life of these patients. The objective of this paper is to show a case that has been treated by the multidisciplinary team of Maxillofacial Surgery of the Pediatric Hospital of Centro Habana

Indagación bibliográfica de la lecto-escritura desde un enfoque constructivista y tradicional en el nivel pre-escolar

Tesis (Educador de Párvulos, Licenciado en Educación)Indagar diferentes bibliografías que nos aporten conocimiento acerca de la lecto-escritura. Recopilar información acerca de la lecto-escritura desde enfoque constructivista y tradicional en el nivel inicial. Observar situaciones de aplicación metodológica. Analizar puntos de encuentros y desencuentros entre el enfoque constructivista y enfoque tradicional de la lecto-escritura

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data