Ethical assessment of privacy breaches in epidemiological investigations and information disclosure in the internet age: safeguarding identity information for infectious patients

While the Internet has brought convenience and speed to human life, it has also led to frequent privacy violations. In the context of epidemiological investigations and information disclosure regarding confirmed Covid-19 patients, many individuals have utilized the Internet as a means to disseminate information and engage in cyber manhunts, resulting in breaches of privacy for those involved. This phenomenon is particularly prevalent within the realm of the Internet, where the boundaries of privacy invasion become blurred. Various types of privacy infringements, both active and passive negligence, are evident on social networking platforms. The juxtaposition of the virtual world of the Internet with real-life scenarios presents novel challenges in the realm of privacy violations. The Internet era, coupled with the widespread use and integration of big data, has diminished the absolute right to privacy on the Internet. This paper examines the challenge of safeguarding the identity information of infectious patients through the lens of two theoretical frameworks -Kantianism and Utilitarianism- in an effort to address this ethical dilemma.

Aunque Internet ha aportado comodidad y rapidez a la vida humana, también ha dado lugar a frecuentes violaciones de la intimidad. En el contexto de las investigaciones epidemiológicas y la divulgación de información relativa a pacientes confirmados de covid-19, muchas personas han utilizado Internet como medio para difundir información y participar en cibercacerías, lo que ha dado lugar a violaciones en la intimidad de los implicados. Este fenómeno prevalece en el ámbito de Internet, donde los límites de la invasión de la intimidad se vuelven vagos. En las redes sociales, se manifiestan diversos tipos de violaciones de la intimidad, tanto por negligencia activa como pasiva. La yuxtaposición entre el mundo virtual de Internet con escenarios de la vida real plantea nuevos retos en el ámbito de las violaciones de la intimidad. La era de Internet, junto con el uso generalizado y la integración del bigdata, han mermado el derecho absoluto a la privacidad. Este artículo examina el reto de salvaguardar la información sobre la identidad de los pacientes infecciosos a través de la lente de dos marcos teóricos -el kantianismo y el utilitarismo- en un esfuerzo por abordar este dilema ético.

Enquanto a Internet trouxe conveniência e velocidade à vida humana, ela também levou a frequentes violações da privacidade. No contexto de investigações epidemiológicas e divulgação de informações em relação a pacientes confirmados de Covid-19, muitos indivíduos utilizaram a Internet como um meio para disseminar informação e participar de uma caçada cibernética, resultando em violações da privacidade para aqueles envolvidos. Esse fenômeno é particularmente prevalente no âmbito da Internet, onde os limites de invasão da privacidade se tornaram borrados. Vários tipos de infrações da privacidade, tanto negligências ativa como passiva, são evidentes em plataformas de redes sociais. A justaposição do mundo virtual da Internet com cenários da vida real apresenta novos desafios no âmbito das violações da privacidade. A era da Internet, juntamente com o amplo uso e integração de megadados (big data), diminuiu o direito absoluto à privacidade na Internet. Esse artigo examina o desafio de proteger a informação de identidade de pacientes infectantes através das lentes de dois enquadres teóricos -Kantianismo e Utilitarismo- em um esforço para abordar esse dilema ético.

Investigação de surtos e epidemias: transformações na teoria, nos conceitos e nas práticas do século XVIII ao século XXI / Outbreaks and epidemics investigations: changes in theories, concepts, and practices from the 18th to the 21st century

Resumo Este ensaio objetiva discutir as investigações de surtos e epidemias, desde os primeiros relatos disponíveis na literatura científica do século XVIII até o momento atual, utilizando para sua construção artigos científicos e livros sobre a temática. O principal argumento desenvolvido é a passagem de abordagens qualitativas da epidemiologia, predominantes nos períodos iniciais, para a abordagem quantitativa, que inicialmente convive com a qualitativa, mas se torna dominante a partir da segunda metade do século XIX. Conclui-se com uma breve reflexão sobre o momento atual de enfrentamento da epidemia da covid-19.

Abstract This essay aims to discuss the investigation of outbreaks and epidemics, from the first reports available in scientific literature from the 18th century to the present time, using scientific articles and books on the subject for its construction. The main argument developed is the transition from qualitative approaches of epidemiology, which predominated in the early periods, to the quantitative approach, which initially coexists with the qualitative one but became dominant from the second half of the 19th century. It concludes with a brief reflection on the current moment of confronting the COVID-19 epidemic.

Aproximación al diagnóstico infarto cerebral isquémico en adultos jóvenes

Introducción: El infarto cerebral isquémico (ICI) en adultos jóvenes ha emergido como un relevante problema de salud debido al incremento de su incidencia, alta mortalidad, larga duración del tiempo de la discapacidad y consecuencias sociales. Objetivo: Describir una aproximación al diagnóstico del infarto cerebral isquémico en adultos jóvenes sobre la base de la clasificación etiopatogénica, historia e investigaciones complementarias. Método: Se realizó una extensa revisión bibliográfica con el buscador Google Académico, en las bases de datos bibliográficas PubMed, SciELO y Medline, y con la búsqueda de palabras claves; siendo escogidos 32 artículos cuyo título y resumen se relacionaron con el tema de la presente revisión. Desarrollo: Los subtipos etiopatogénicos del infarto cerebral isquémico en adultos jóvenes difieren al compararlo con adultos mayores, y sus causas etiológicas son más variadas y heterogéneas. Los factores de riesgo, antecedentes patológicos personales y familiares, manifestaciones clínicas no neurológicas y neurológicas, permiten un acercamiento al diagnóstico, mientras que las investigaciones complementarias facilitan la confirmacióndel diagnóstico, la localización y tamaño del infarto isquémico, el establecimiento de la causa etiológica y el sustento de las decisiones terapéuticas. Consideraciones finales: La historia y manifestaciones clínicas obtenidas mediante el interrogatorio y examen físico, unidoa las investigaciones complementarias, posibilita la aproximación al diagnóstico del subtipo etiopatogénico y a la causa del infarto cerebral isquémico en adultos jóvenes, lo que mejoralas posibilidades de tratamiento del mismo.

Introduction: Ischemic stroke in young adults has emerged as a relevant health problem today due to its increased incidence, high mortality, the duration of the disability and social consequences. Objective: To describe an approach in diagnosis of ischemic stroke in young adults based on etiopathogenic classification, history and complementary investigations. Method: A wide-ranging bibliographic review was carried out using Google Scholar, searching in bibliographic databases like PubMed, SciELO and Medline, and searching different keywords; 32 articles were chosen in the process with title and abstract were linked with the subject of this review. Development: The etiopathogenic subtypes of ischemic stroke in young adults differ with regard to older adults, and its etiologic causes are more diverse and heterogeneous. Risk factors, personal and family pathological history, non-neurological and neurological clinical manifestations, allow an approach to diagnosis, while complementary investigations facilitate the confirmation of diagnosis, the location and size of the ischemic infarction, definition of the etiological cause and the support of therapeutic decisions. Final considerations: The history and clinical manifestations obtained through interrogation and physical examination, in association with complementary investigations, made it possible an approach to diagnosis of etiopathogenic subtype and the cause of ischemic brain infarction in young adults improving treatment possibilities.

Introdução: O acidente vascular cerebral (AVC) isquêmico em adultos jovens emergiu como um problema de saúde relevante devido à sua crescente incidência, elevada mortalidade, longa duração da incapacidade e consequências sociais. Objetivo: Descrever uma abordagem ao diagnóstico do AVC isquêmico em adultos jovens baseada na classificação etiopatogénica, na história e em exames complementares. Método: Foi realizado uma extensa revisão bibliográfica utilizando o motor de busca Google Scholar, as bases de dados bibliográficas PubMed, SciELO e Medline, e uma pesquisa por palavras-chave; foram selecionados 32 artigos cujo título e resumo estavam relacionados com o tema desta revisão. Desenvolvimento: Os subtipos etiopatogênicos do AVC isquêmico em adultos jovens diferem quando comparados aos adultos mais velhos, e suas causas etiológicas são mais variadas e heterogêneas. Os fatores de risco, os antecedentes patológicos pessoais e familiares, as manifestações clínicas não neurológicas e neurológicas permitem uma aproximação ao diagnóstico, enquanto as investigações complementares facilitam a confirmação do diagnóstico, a localização e o tamanho do infarto isquêmico, o estabelecimento da causa etiológica e o apoio às decisões terapêuticas. Considerações finais: A história e as manifestações clínicas obtidas por meio de questionamento e exame físico, juntamente com investigações complementares, permitem abordar o diagnóstico do subtipo etiopatogênico e a causa do AVC isquêmico em adultos jovens, melhorando as possibilidades de seu tratamento.

Investigaciones biomédicas y psicosociales con enfoque comunitario en Ecuador / Biomedical and Psychosocial Research with Community Approach in Ecuador

Introducción: Varios miembros del Departamento de Investigaciones en Adicciones de la Universidad de Ciencias Médicas de La Habana participaron en el 2020 y 2021 como docentes, asesores y directores de tesis en dos programas de formación académica de estudiantes ecuatorianos: especialización en Medicina Familiar y Comunitaria y maestría en Psicología Clínica (mención en Salud Mental Comunitaria). Objetivo: Describir los resultados del estudio y las investigaciones concluidas en ambos programas de formación académica. Método: Se realizó un estudio descriptivo de corte transversal basado en el análisis de los 69 proyectos de investigación desarrollados. Para la descripción de los resultados se realizó el análisis de contenido del 20 por ciento de las investigaciones. Resultados: El 63,8 `por ciento de los estudios fueron investigaciones biomédicas, y el 36,1 por ciento fueron estudios psicosociales. En ambos casos, el contexto social en las comunidades fue de (84,7 por ciento). Entre las investigaciones médicas predominaron las dirigidas al paciente con hipertensión arterial (39,1 por ciento) centradas en la adherencia terapéutica (32,6 por ciento). En los estudios psicológicos predominaron los dirigidos a niños y adolescentes (23,0 por ciento) y a profesionales sanitarios (23,0 por ciento) centradas en las afecciones mentales (19,2 por ciento). Conclusiones: Los proyectos desarrollados concluyeron resultados satisfactorios, se describió con mayor sistematicidad el enfoque comunitario en las investigaciones biomédicas. Se abordaron contenidos relativos a la adherencia terapéutica y las afectaciones a la salud mental. El impacto de la COVID-19 fue valorado como generador de dificultades en niños y adolescentes, profesionales sanitarios y en la población(AU)

Introduction: In 2020 and 2021, the Department of Research on Addiction of Havana University of Medical Sciences participated as teachers, advisors and thesis directors in two academic training programs for Ecuadorian students: specialization in Family and Community Medicine and master's degree in Clinical Psychology with a mention in Community Mental Health. Objective: To describe the results of the study and the research concluded in both academic training programs. Methods: A descriptive cross-sectional study was carried out based on the analysis of the sixty nine research projects established. The content analysis of 20 percent of the investigations was carried out to describe the results. Results: 63.8percent of the studies were biomedical research and 36.1 percent were psychosocial studies. In both cases, communities was the social context (84.7percent). Among the medical investigations, those aimed at the patient with hypertension (39.1percent) focused on therapeutic adherence (32.6percent) predominated. In the psychological studies, those intended at children and adolescents (23.0percent) and health professionals (23.0percent) focused on mental disorders (19.2percent) prevailed. Conclusions: These projects yielded satisfactory results. The community approach in biomedical research was more systematically described. Contents related to therapeutic adherence and the effects on mental health were addressed. The impact of COVID-19 was assessed as generator of difficulties in children and adolescents, health professionals, and in the population(AU)

Systemic investigations in dry eye disease

The incidence of dry eye disease has increased manifold in the past few years with more patients presenting with these complaints to our clinics every day. In the more severe forms of disease, it is important to evaluate for any systemic association which could be driving the disease such as in Sjogren’s syndrome. Understanding the possible varied etiopathogenesis and knowing when to evaluate, form an important part of treating this condition effectively. In addition, it is sometimes confusing as to which investigations to order and how to prognosticate the disease in these situations. This article simplifies this into an algorithmic approach with insights from the ocular and systemic point of view

Initial investigations and clinical outcome in COVID-19 patients

Background: Coronavirus disease 2019 (COVID-19)has significant impact on the health infrastructure all over the world including India. We wanted to see whether the routine initial investigations done in COVID19 patients reflect the prognosis and outcome of the patient.Methods: It is a retrospective study involving the confirmed covid 19 patients admitted between April 2021 to May2021. The initial investigations done at the time of admission were studied in relation to outcome of the patient in the form of survival or death of the patient.Results: A total of 364 patients were studied. 295(81.05%) patients survived and 69(18.96%) patients died. Highest mortality was observed in 60% of patients with hemoglobinbelow 7.0mg/dl, 40.00% of patients with platelet count below 50000/cml, 28.80% with neutrophil lymphocyte ratio more than 5.5, 32.81% with CRP more than 100mg/L, 100% with D dimer more than 5000ng/ml, 33.33% with Ferritin more than 1500ng/ml, 29.54% with IL-6 more than 100pg/ml, 23.14% with Random blood sugar more than 200mg/dl, 37.50% with creatinine more than 2.0mg/dl, 75% with Bilirubin more than 2.0mg/dl, 42.85% with SGOT more than 201mg/dl, 22.22% with SGPT more than 201mg/dl, 38.46% with serum Procalcitonin more than 2.0mg/dl. CT Chest severity score of 21 to 30 and31 to 40 lead to mortality of 19.51% and 40.00% respectively. Conclusions: The physician who is taking care of COVID-19patients must get extra cautious regarding prognosis if he gets above initial parameters deranged in isolation or combination.

Best Practice Guidelines for Breast Imaging, Breast Imaging Society, India: Part—2

Breast imaging is a prerequisite for providing high quality breast health care. Choosing the appropriate investigation is central to diagnosing breast disease in patients who present to health professionals for treatment. These patients present to doctors of different subspecialties as well as to general practitioners in our country. It is important, therefore, to provide uniform guidance to doctors in different healthcare setups of our country, urban and rural, government and private, for optimal management of breast diseases. These guidelines framed by the task group set up by the Breast Imaging Society, India, have been formulated focusing primarily on the Indian patients and health care infrastructures. They aim to provide a framework for the referring doctors and practicing radiologists to enable them to choose the appropriate investigation for patients with breast symptoms and signs. The aim has been to keep this framework simple and practical so that it can guide not only subspecialists in breast care but also help doctors who do not routinely deal with breast diseases, so that breast cancer is not missed. Overall, the aim of this document is to provide a holistic approach to standardize breast care imaging services in India. Part 2 of these guidelines focuses on the best practice principles for breast interventions and provides algorithms for the investigation of specific common breast symptoms and signs. Ultrasound is the preferred imaging modality for image-guided breast interventions due to real-time needle visualization, easy availability, patient comfort and absence of radiation. Stereotactic mammography guided procedures are performed if the lesion is visualized on mammography but not visualized on ultrasound. 14-gauge automated core biopsy device is preferred for breast biopsies although vacuum assisted biopsy devices are useful for biopsy of certain abnormalities as well as for imaging guided excision of some pathologies. MRI guided biopsy is reserved for suspicious lesions seen only on MRI. Algorithms for investigation of patients presenting with mastalgia, breast lumps, suspicious nipple discharge, infections and inflammation of the breast have been provided. For early breast cancers routine use of investigations to detect occult distant metastasis is not advised. Metastatic work up for advanced breast cancer is required for selection of appropriate treatment options.

Genetic Diversity and Molecular Surveillance of Antimalarial Drug Resistance of Plasmodium falciparum among Hospitals Patients in Benue State Nigeria

Introduction: Malaria is a febrile illness caused by parasites of the genus Plasmodium and transmitted by female Anopheles mosquitoes. The genetic diversity and antimalarial drug resistance of Plasmodium falciparum are some of the major challenges of malaria control programme in Nigeria. Aim: This study was aimed at determining the genetic diversity, and molecular surveillance of antimalarial drug resistance among patients attending Government hospitals in Benue State, Nigeria. Methodology: Plasmodium falciparum deoxyribonucleic acid was extracted from dried blood spots of 60 positive malariacases among the patients. The diversity of Plasmodium falciparum was done by genotyping 3D7 and FC27 families of merozoite surface protein- 2 alleles. The Plasmodium falciparum multidrug resistance 1 and Plasmodium falciparum kelch13 genes of Plasmodium falciparum were also amplified and assessed by restriction fragment length polymorphism (RFLP) to survey molecular resistance to antimalarial drugs. Results: The results showed that the frequency of 3D7 allele 37(61.7%) was higher than FC27 allele 18(30.0%). The frequency of merozoite surface protein- 2 infections with both allelic types was 5(8.3%). There was a significant difference in the distribution of the merozoite surface protein two alleles (?2=25.9,df=2 P<.0.001). Both the Plasmodium falciparum multidrug resistance 1 Asparagine 86Tyrosine (N86Y) and Aspartic acid 1246Tyrosine (D1246Y), had 100 % mutant while the 100% while the Plasmodium falciparum kelch13 G449A had 100% wild type allele. Conclusion: The current study underscores the need for frequent monitoring of indicators of antimalaria drug resistance in Nigeria.

Plastic surgery professional misconduct: a cross-sectional study on cases between 2008 and 2017, filed before the São Paulo State Medical Board

ABSTRACT BACKGROUND: In plastic surgery, a lack of ethical and moral behavior by professionals can result in unfortunate circumstances and can justify ethical-disciplinary procedures. OBJECTIVE: To review 421 plastic surgery professional-misconduct cases filed before the São Paulo State Medical Board (CREMESP) between 2008 and 2017. DESIGN AND SETTING: Cross-sectional study conducted in a medical council. METHODS: The cases were categorized according to sex, age, medical specialty (plastic surgery, other field or none), medical ethics code chapter(s) involved, ethics code articles violated and board ruling/outcome. RESULTS: Most of the defendants were men over 40 years of age who were experienced in their professional practice and who graduated from public and private universities all over Brazil; 47.74% had a specialist title in plastic surgery. Violation of professional responsibility (medical malpractice, recklessness or negligence) was the commonest complaint (28.43%), followed by medical advertising (24.19%) and poor doctor-patient relationship (10.39%), in violation of articles 18, 51, 75 and 1. Among the 233 cases adjudicated over this period, 133 resulted in disciplinary sanction, 80 were ruled in the physician's favor and 20 were dismissed. CONCLUSION: Classification of plastic surgery professional-misconduct cases creates possibilities for adopting preventive measures for good practice in this specialty, which would consequently reduce the number of complaints to the regional medical boards.

Universidad de Ciencias Médicas de Santiago de Cuba: una mirada a su producción científica / University of Medical Sciences in Santiago de Cuba: a look to its scientific production

Las universidades son uno de los ejes principales del desarrollo científico de un país y su misión ha variado a lo largo del tiempo. Estas instituciones nacieron con una primera misión que es la docencia, pero actualmente sus actividades son mucho más amplias. Al respecto, se realizó el presente estudio con el objetivo de reflexionar en torno a la producción científica en la Universidad de Ciencias Médicas en Santiago de Cuba; asimismo, se indagó acerca de la colaboración e impacto alcanzados en la última edición del Ranking Iberoamericano de Instituciones de Educación Superior, 2020. Se evidenció que el uso de indicadores bibliométricos es una alternativa para medir y evaluar la producción científica de los profesionales de la salud, así como ampliar la productividad y la visibilidad a través de estrategias y políticas trazadas, a partir de la toma de decisiones oportunas.

The universities are one of the main focal points in the scientific development of a country and its mission has varied as time goes by. These institutions were born with a first mission that is teaching, but at the moment their activities are much wider. In this respect, the present study was carried out aimed at meditating around the scientific production in the University of Medical Sciences in Santiago de Cuba; also, there was an investigation about the collaboration and impact reached in the last edition of the Ibero-American Ranking of Higher Education Institutions, 2020. It was evidenced that the use of bibliometric indicatives is an alternative to measure and evaluate the scientific production of the health professionals, as well as to enlarge the productivity and visibility through strategies and politics drawn up, taking the opportune decisions making as a starting point.

Propuesta de utilización de harina de cabeza de pescado para fortificar alimentos de consumo popular altos en carbohidratos / Proposal for the use of fish head meal to fortify popular consumption foods high in carbohydrates

En esta investigación documental se presentan alternativas viables para utilizar cabezas de pescado, subproductos de la acuicultura, para elaborar harina que sirva como materia prima para la fortificación de productos alimenticios nutritivos. La harina de cabeza de pescado propuesta en esta investigación puede ser integrada exitosamente a alimentos para consumo humano, y usadas en las proporciones adecuadas no causa interferencias en las propiedades sensoriales de los productos formulados. Para masificar la producción de los alimentos fortificados con harina de cabeza de pescado propuestos en este estudio, es indispensable practicarle además una serie de pruebas denominadas "vida de anaquel".

In this documentary research, viable alternatives are presented to use fish heads, by-products of aquaculture, to make flour that serve as raw material for the fortification of nutritious food products. The fish head meal proposed in this research can be successfully integrated into food for human consumption, and used in the appropriate proportions does not cause interference in the sensory properties of the formulated products. To massify the production of foods fortified with fish head meal proposed in this study, it is essential to also perform a series of tests called "shelf life".

A study on the surgical management of abdominal tuberculosis in patients attending a tertiary hospital

Background: Tuberculosis is seen due to various factors such as overcrowding and unhygienic conditions. In order to diagnose a case of abdominal tuberculosis, a detailed history and a thorough clinical examination must be done. The objective of this article was to determine the number of patients who presented to a tertiary hospital with abdominal tuberculosis and in which of these patients management in the surgical department was required.Methods: A total of 50 patients who had abdominal tuberculosis were studied. The study was carried out at SRM Medical College Hospital and Research Center, Kattankulathur, Tamil Nadu, India. The study was carried out from February 2017 to January 2020. A detailed history was obtained and a thorough clinical examination was done. Investigations such as CBC, chest X-ray, abdomen X-ray, ultrasound scan and CT scan of the abdomen were done. When required, patients underwent surgery and the results obtained were analyzed and tabulated. In our study, out of a total of 50 patients, 32 patients were found to have required surgery. The statistics were analyzed using SPSS package 16.0.Results: It was seen that in this study, male patients were more commonly affected with abdominal tuberculosis, and resection and anastomosis was the most common surgical procedure done when required. The findings obtained were compared with other studies.Conclusions: In patients with abdominal tuberculosis, a detailed history and a thorough clinical examination are required in order to diagnose the condition as early as possible.

Classification of plastic surgery malpractice complaints brought before the São Paulo Medical Board that were treated as professional-misconduct cases: a cross-sectional study

ABSTRACT BACKGROUND: Nowadays, there is an ethical and moral necessity to establish rules that govern professional attitudes and conduct. In the medical field, these rules are multifaceted, given the health consequences inherent to medical procedures. Ethics is an even more delicate subject when it comes to plastic surgery, since one of the aims of this particular medical specialty is esthetic improvement of the body. OBJECTIVE: To survey and classify São Paulo State Medical Board investigations of plastic-surgery complaints that were treated as professional-misconduct cases between 2007 and 2016. DESIGN AND SETTING: Cross-sectional study conducted in a medical council. METHODS: A total of 360 cases were reviewed. Among these, 8 (2.23%) were dismissed, 1 (0.27%) became an administrative lawsuit and 351 (97.50%) were treated as professional-misconduct cases. RESULTS: A breakdown of the complaints filed over the nine-year period showed that complaints concerning malpractice were the most common (28.43%), followed by those regarding medical advertising (24.19%) and poor doctor-patient relationships (10.39%). CONCLUSION: Overall, the number of complaints lodged decreased over the last two years reviewed, although complaints regarding malpractice and poor doctor-patient relationships increased by 10% over the same period. In order to further reduce the number of medical board investigations, the medical establishment needs to carefully review the medical training of students and doctors at every stage of their careers.

Aportes de las investigaciones pedagógicas a la educación médica cubana / Contribution of the pedagogicalal investigations to the Cuban medical education

Introducción: Los retos de la educación superior en el área de las ciencias médicas precisan de un nuevo enfoque, fundamentado en los principios de excelencia, calidad y pertinencia; de ahí la importancia de las investigaciones pedagógicas para el perfeccionamiento continuo del proceso docente-educativo en la educación médica. Objetivos: Determinar los principales aportes de las investigaciones pedagógicas en la educación médica cubana. Métodos: Se realizó una investigación descriptiva, de corte pedagógico, de 80 tesis, obtenidas del repositorio de tesis doctorales del sitio Infomed, en el período de enero a diciembre del 2017. Resultados: En la investigación predominaron las tesis de obtención del grado científico de Doctor en Ciencias Pedagógicas, con 65 de ellas, y 50,0 % correspondieron a la didáctica de la educación superior. Igualmente, se destacaron los aportes teóricos y prácticos que desarrollan potencialidades metodológicas y, a la vez, contribuyen a la formación lógica de los profesionales, con lo cual se reveló su esencia pedagógica. Conclusiones: Se proyectó una visión de futuro en la formación de los profesionales, con las potencialidades necesarias para su desempeño y un carácter humanista, así como el marco ético pertinente para satisfacer las necesidades de la salud en Cuba y en otros pueblos.

Introduction: The challenges of higher education in the area of the medical sciences need a new approach, based on the principles of excellence, quality and pertinence; so the importance of the pedagogical investigations for the continuous improvement of the teaching-educational process in the medical education. Objectives: To determine the main contributions of the pedagogical investigations in the Cuban medical education. Methods: A descriptive and pedagogical investigation of 80 theses, obtained from the Infomed doctoral thesis repository, was carried out from January to December, 2017. Results: In the study, theses to obtain the scientific degree of Doctor in Pedagogical Sciences prevailed, with 65 of them, and 50.0% of the dissertations corresponded to the didactics of higher education. Likewise, the theoretical and practical contributions that develop methodological potentialities were remarkable and, at the same time, they contribute to the logical training of professionals, with which their pedagogical essence was revealed. Conclusions: A future vision in training the professionals was projected, with the necessary potentialities for their performance, a humanist character and the pertinent ethical framework to satisfy health necessities in Cuba and in other countries.

DNA and the displacement of certainties in brazilian family law / DNA e o deslocamento de certezas no direito de família brasileiro / ADN y el desplazamiento de verdades en la ley de la familia brasileña

Abstract Inquiring into the impact of DNA technology on Brazilian family law,, through the consultation of legislation, jurisprudence and specific legal briefs concerning paternity disputes, we map out trends over the past thirty years. We show how, after a moment of original skepticism, genetic evidence appears to dominate the legal scene, rendering personal testimony irrelevant. However, with growing concern about men who use a negative test result to disclaim their paternal status, this testimony is once again needed to clarify whether or not the man originally believed the child was his blood-related offspring. Finally, we look at a recent period, showing how reactions against the "real biological truth" have spawned a new juridical category-socio-affective paternity-that, spreading well beyond paternity tests, is altering some basic tenets of family law.

Resumo Enfocando o impacto da tecnologia do DNA no direito de família brasileiro, pela análise de leis, jurisprudência e processos particulares lidando com disputas de paternidade, mapeamos tendências de mudança ao longo dos últimos trinta anos. Mostramos como, após um momento de ceticismo inicial, a evidência genética parece dominar o cenário legal, tornando os depoimentos pessoais irrelevantes. Entretanto, com a atenção crescente dirigida para homens que usam um resultado negativo para refutar seu status paterno, a importância de depoimentos volta para esclarecer se o pai registral originalmente acreditava ou não que tinha um vínculo consanguíneo com seu filho. Finalmente, olhamos para um período recente, rastreando como reações contra a "verdade real" da biologia geram uma nova categoria jurídica - paternidade socioafetiva - que, estendendo-se muito além dos testes de paternidade, está alterando alguns princípios básicos do direito da família.

Resumen Centrándonos en el impacto de la tecnología del ADN en el derecho de familia brasileño, analizando las leyes, la jurisprudencia y las demandas particulares relacionadas con disputas de paternidad, trazando tendencias cambiantes en los últimos treinta años. Mostramos como, después de un momento de escepticismo inicial, la evidencia genética parece dominar el panorama legal, haciendo irrelevantes los testimonios personales. Sin embargo, con la atención cada vez mayor dirigida a los hombres que usan un resultado negativo para refutar su paternidad, la importancia de los testimonios vuelve a aclarar si el padre de registro originalmente creía o no, tener un vínculo consanguíneo con su hijo. Finalmente, observamos un período reciente, rastreando como las reacciones contra la "verdad real" de la biología, generan una nueva categoría legal, paternidad socioafectiva, que, más allá de las pruebas de paternidad, está alterando algunos principios básicos del derecho de familia.

Caracterización de la producción científica sobre la salud de los adolescentes en revistas médicas cubanas / Characterization of the investigations and the scientific production on adolescence in Cuban medical magazines

Introducción: La adolescencia es un periodo de desarrollo y crecimiento durante el cual las personas establecen su sentido de identidad individual, adaptación a capacidades intelectuales más maduras, a las exigencias de la sociedad en lo que respecta a la conducta, internalización de un sistema de valores personales y la preparación para roles de adultos. En este periodo acontecen transformaciones biológicas, psicológicas y sociales que requieren de atención especializada. Los resultados de la investigación científica que se traducen en producción científica pueden contribuir al perfeccionamiento de la atención integral a los adolescentes. Objetivo: Caracterizar el comportamiento de la producción científica relacionada con la adolescencia. Métodos: Se realizó un estudio descriptivo bibliométrico, se definieron las producciones científicas e investigaciones que abordan los principales problemas de salud de los adolescentes cubanos. Para el estudio se tomó el universo de la producción científica de la Revista Cubana de Salud Pública, Revista Cubana de Pediatría y Revista Cubana de Medicina Familiar en el periodo 2011-2015. Resultados: Se identificaron de forma armónica la correspondencia entre los principales problemas de salud de los adolescentes y las temáticas abordadas en las revistas seleccionadas. Conclusiones: La generalización de la comunicación científica favorece la solución de los principales problemas de salud identificados en los adolescentes cubanos(AU)

Introduction: The adolescence is a period of development and growth during which the persons establish its sense of individual identity, adaptation to more mature intellectual capacities, to the requirements of the society as for the conduct, internalization of a system of personal values and the preparation for adults' rolls. In this period there happen biological, psychological and social transformations that need of specializing attention. The results of the scientific investigation that are translated in scientific production can contribute to the improving of the integral attention to and the adolescents. Objective: To characterize the behavior of the scientific production related to the adolescence, bibliométricos realized a descriptive study, defining the scientific productions and investigations that tackle the main problems of health of and the Cuban adolescents. Methods: For the study there took the universe of the scientific production of the Cuban Magazine of Public health, Cuban Magazine of Paediatrics and Cuban Magazine of Familiar Medicine in the period 2011-2015. Results: The present investigation allowed to identify of harmonic form the mail between the main problems of health of and the adolescents and the subject-matters tackled in the chosen magazines. Conclusions: The generalization of the scientific communication favors the solution of the main problems of health identified in and the Cuban adolescents(AU)

Study of electrolytes in patients of Dengue in a tertiary care hospital in India

Background: Dengue is a mosquito borne viral infection. It is the most common arboviral disease globally. In the year 2017, India had 1,53,635 cases of dengue with 226 deaths. Electrolyte disturbances reported in dengue infection are hyponatremia, hypokalaemia and hyperchloremia. Considering the serious nature of effects of dyselectrolytemias and high incidence of dengue in India, it is necessary to have a thorough understanding about electrolyte disturbances in Dengue, so as to predict, diagnose and treat them accordingly.Methods: This study was performed in a tertiary care centre in Mumbai, India. The study was a prospective observational cross-sectional study. 150 Patients diagnosed with Dengue were enrolled for the study. Patients’ demographic data, clinical history, examination findings and investigations including electrolyte values were recorded and analysed.Results: A higher incidence of dengue was seen in young age group among admitted patients (74%). Hyponatremia (45.33%) and Hypokalaemia (10.60%) were more commonly observed than hypernatremia (3.33%) and hyperkalaemia (3.33%). Hypochloraemia (6.66%) was seen slightly more than hyperchloraemia (6.00%). Fever was Present in 98.66%, retro orbital headache in 86.66%, vomiting in 56.00%, joint pain in 69.00%, lethargy in 70.66%, breathlessness in 36.00%, bleeding in 8.66%, abdominal pain /tenderness in 18.00%. 85.00% had low platelet count, 30.66% had low hemoglobin and 36.66% had leucopenia. Haematocrit was found to be less in 27.33% and high in 1.33%.Conclusions: From the above results we concluded that, there is a need to have a degree of suspicion about dyselectrolytemias while managing patients with Dengue. Also, patients need to be subjected to necessary lab investigations early during management so that if abnormalities are found, they can be promptly and appropriately managed as some of these abnormalities may lead to increased severity as well as mortality.

Survey on patent situation of medical research institutions in Guizhou Province / 中华医学科研管理杂志

Objective In recent years,driven by our country's policy of strengthening independent innovation capabilities,there is dramatic increasing of the Patent application volume in Guizhou Province.This article analyzes the patent application and authorization of Guizhou medical research institutes,explored its existing problems and proposed countermeasures.Methods In this paper,the author searched the patent data of Guizhou Medical Scientific Research Institutions,including medical universities and their affiliated hospitals,medical colleges,and people's hospitals at all levels,through the Baiten Patent Data Retrieval Website.Data about the number of patent applications,types of applications,technical composition,legal status,legal events were analyzed to understand the existing problems,and proposed further solutions.Results At present,the medical scientific research units in Guizhou Province still have many problems in patent applications,such as low quality,Pay attention to the application but neglect the maintenance,low patent transactions,lack of patent knowledge for scientific researchers,and low patent consulting services.Conclusions These problems can be solved by improving the intellectual property management department,strengthening information literacy education,running a new mode of school-enterprise cooperation,and adding patent service organizations.

A broad-range PCR technique for the diagnosis of infective endocarditis

Abstract Infective endocarditis (IE) remains a severe and potentially fatal disease demanding sophisticated diagnostic strategies for detection of the causative microorganisms. The aim of the present study was to develop a broad-range 16S ribosomal RNA gene polymerase chain reaction in the routine diagnostic of IE for the early diagnosis of fatal disease. A broad-range PCR technique was selected and evaluated in terms of its efficiency in the diagnosis of endocarditis using 19 heart valves from patients undergoing cardiovascular surgeries at the Habib Bourguiba Hospital of Sfax, Tunisia, on the grounds of suspected IE. The results demonstrated the efficiency of this technique particularly in cases involving a limited number of bacteria since it helped to increase detection sensitivity. The technique proved to be efficient, particularly, in the bacteriological diagnosis of IE in contexts involving negative results from conventional culture methods and other contexts involving bacterial species that were not amenable to identification by phenotypic investigations. Indeed, the sequencing of the partial 16S ribosomal RNA gene revealed the presence of Bartonella henselae, Enterobacter sp., and Streptococcus pyogenes in three heart valves with the negative culture. It should be noted that the results obtained from the polymerase chain reaction-sequencing identification applied to the heart valve and the strain isolated from the same tissue were not consistent with the ones found by the conventional microbiological methods in the case of IE caused by Gemella morbillorum. In fact, the results from the molecular identification revealed the presence of Lactobacillus jensenii. Overall, the results have revealed that the proposed method is sensitive, reliable and might open promising opportunities for the early diagnosis of IE.

Abdominal tuberculosis: a surgical perplexity

Abdominal tuberculosis is one of the most challenging forms of extra pulmonary tuberculosis. The diagnosis of the disease itself poses the greatest challenge due to the variability of presentation. Clinical presentations in various forms with conflicting results on a multitude of haematological, immunological and radiological tests causes a lot of confusion in interpreting and correlating the symptoms to arrive at a diagnosis. This adds to the perplexity in surgical management of this complex disease especially in an era where AIDS has added to the problems. Having arrived at a diagnosis, chemotherapy is the mainstay of treatment. Surgery is indicated when the response to medical therapy is poor or complications supervene. Deciding the optimum procedure is again a major issue. Understanding the pathophysiology therefore is pivotal in making a value decision. The article briefly outlines the approach to this surgical perplexity.