El tumor del internista. Reporte de un caso.

El hipernefroma, tumor de Grawits o tumor del internista por la variedad de formas clínicas que hoy podemos identificar y la diversidad de diagnósticos diferenciales, representa el 3 % de los cánceres en el adulto y del 90 al 95 % de los tumores malignos renales primarios. Casi siempre el diagnóstico es hecho por el internista. A propósito de un caso atendido en nuestra sala de clínica se realiza la presentación del mismo. Se precisan formas clínicas que deben tenerse en cuenta. A nuestro criterio la presentación de casos despierta el interés por el conocimiento en beneficio de su aplicación en nuestra practica clínica diaria. Se acompaña de las imágenes de la TAC, momento operatorio e informe anatomopatológico.  Palabras claves: hipernefroma, tumores renales, tumor del internista, nefrectomía

El proceso diagnóstico y su enseñanza en la medicina

El método clínico constituye una categoría fundamental en las Ciencias Clínicas y suutilización como método de enseñanza en las disciplinas y asignaturas en el cicloclínico de la carrera de Medicina. Contribuye a la sistematización de todas aquellashabilidades que, en forma de sistema, se integran en la ejecución del mismo. Eldesarrollo de estas habilidades es esencial en el proceso de diagnóstico en MedicinaEste artículo tiene como propósito su vinculación a la tarea docente de la DiscusiónDiagnóstica dentro de la Educación en el Trabajo con recursos didácticometodológicoscon fines docentes para la enseñanza y aprendizaje de habilidadesprofesionales del futuro médico.Palabras clave: Enseñanza, aprendizaje, métodos de estudio de la medicina,competencia clínica, proceso diagnóstico

Cardiomiopatía mixedematosa. Reporte de un caso

Introducción: El hipotiroidismo o enfermedad de Gull (1873) es la afección endocrina más frecuente en nuestros tiempos en los países de todo el mundo y en cualquier raza. La incidencia anual de nuevos casos en la población general es de 1-2%. Se ha estimado que alcanza 6-7% de la población femenina de edad superior a 60 años.Presentación: Se presenta el caso de una mujer negra de 32 años con hipotiroidismo postiroidectomia. Abandona el tratamiento e ingresa con insuficiencia cardiaca, derrame pericárdico y síntomas de hipotiroidismo con mixedema. Discusión: En esta cardiomiopatía se integran dilatación con hipocinesia, infiltración con restricción, trastornos de la conducción y el ritmo en algunos y en muchos de los casos aparece también afectación del pericardio con derrame asociada. Conclusión: Evolucionó satisfactoriamente al restituir tratamiento y otras medidas. En algunos casos el daño es irreversible.Palabras clave: Hhipotiroidismo, mixedema, cardiopatía mixedematosa. </p

Non Transmissible Chronic Diseases: Current Magnitude and Future Trends

The treatment to non-transmissible chronic diseases is currently on of the greatest challenges faced by the health systems worldwide. This is due to the fact that these diseases affect all age groups, all regions and countries regardless their level of development. Cuba is not the exception. The World Health Organization, however, points out that there is an inadequate management of these ailments, for different reasons, in most of the health systems. The objective of this article is the awareness of the current and future problem of chronic diseases where health promotion and prevention still is the main weapon to fight the challenge. The importance of these elements should be taken into consideration from the personnel in training, the need to set present and future strategies to guarantee the health of our population, mainly from the primary health care attention and organizations linked to them. The most affected population should be aware of what suffering from a chronic disease represents in general

Pyogenic Liver Abscess. A Case Report

Liver abscesses account for 13% of all abdominal abscesses and 48% of those occurring in the viscera. The bacterial or pyogenic liver abscesses are the most frequent. A case of a 34-year-old woman of mixed race with history of gallstones (2011), extrahepatic obstructive jaundice caused by cholelithiasis (May 2012), cholangitis after endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy (August 2012) due to gallstones is presented. In September 2012, she began suffering from high fever with chills every day, usually in the evenings. In addition, she presented night sweats, loss of appetite, weight loss, nausea and pain in the right upper quadrant of the abdomen which was sharp, permanent and annoying sometimes. The signs and symptoms, history, ultrasound scan and multislice computed tomography confirmed the diagnosis of pyogenic liver abscess. The risk factors leading to the infection were well-identified. The patient progressed satisfactorily with the medical treatment provided

Pyogenic Liver Abscess. A Case Report

Liver abscesses account for 13% of all abdominal abscesses and 48% of those occurring in the viscera. The bacterial or pyogenic liver abscesses are the most frequent. A case of a 34-year-old woman of mixed race with history of gallstones (2011), extrahepatic obstructive jaundice caused by cholelithiasis (May 2012), cholangitis after endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy (August 2012) due to gallstones is presented. In September 2012, she began suffering from high fever with chills every day, usually in the evenings. In addition, she presented night sweats, loss of appetite, weight loss, nausea and pain in the right upper quadrant of the abdomen which was sharp, permanent and annoying sometimes. The signs and symptoms, history, ultrasound scan and multislice computed tomography confirmed the diagnosis of pyogenic liver abscess. The risk factors leading to the infection were well-identified. The patient progressed satisfactorily with the medical treatment provided

Mistreatment or not the best treatment to the elder. Reality and challenge

There is inconsistency in the definition and understanding of abuse to the elder. An appropriate and unified definition is presented by the World Health Organization. It states that elder abuse is any isolated or repeated act, or the absence of appropriate action, that occurs in any relation from which confidence and safety is expected and produces damage or general discomfort. Mistreatment and the not best treatment to these people is a problem to be solved worldwide. In this article issues related to the topic are approached, some types of mistreatment, causes identified in studies carried out so as strategies and actions to fight them. These aspects are presented not only for the health system but for the society as well. Cuba is not exempted of this situation; the Cuban population ages and chronic non communicable diseases are a challenge to be concerned, mainly cancer, dementia, disability and prostration due to different causes which are the most frequent illnesses in elder people