Hospital Militar Central Dr Carlos J Finlay

Havana, Cuba

Hospital Militar Central Dr Carlos J Finlay

Havana, Cuba
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Zamora J.L.,Hospital Militar Central Dr Carlos J Finlay | Gonzalez G.F.,Institute Medicina Tropical Pedro Kouri
Revista Cubana de Medicina Militar | Year: 2016

In thoracic surgery, assessing a patient with very severe chronic obstructive pulmonary disease is a challenge for the surgical team, since spirometric results may contraindicate the intervention. This case report describes the criteria used to define surgical interventions, the strategy assumed by the thorax group, the anesthetic management and subsequent evolution of the patient, who underwent lung volume reduction surgery, with an initial unilateral approach in the right upper lobe and final surgery a month later, with posterior left posterolateral thoracotomy to resect a Pancoast tumor. There was a decrease in dyspnea and a gradual increase in physical capacity after each surgical procedure. The forced expiratory volume in the first second in relation to the predicted values improved from 25 % to 38 % after surgery, and 41% six months later. Tiffeneau index varied from 0.43 to 0.57 and 0.60 after two thoracic surgeries. As a single complication, the patient presented chronic chest pain for which he maintains medical treatment. It is concluded that the performance of pulmonary volume reduction surgery is an alternative to gauge in patients with lung cancer and bullous pulmonary emphysema. The multidisciplinary perioperative approach is a fundamental pillar to achieve satisfactory results. © 2016, Editorial Ciencias Medicas. All rights reserved.


Cabrera X.T.,Hospital Militar Central Dr Carlos J Finlay | Hernandez L.C.,Hospital Militar Central Dr Carlos J Finlay
Revista Cubana de Medicina Militar | Year: 2016

We present here an interesting case of mucopolysaccharidoses, which is not commonly seen in medical practice, specifically a Hunter syndrome. This presentation is done in order to make known to students and health professionals, through photos, the physical characteristics of the patient with such syndrome. This patient arrived malnourished at the hospital, he was operated on the umbilical hernia and improved his nutritional status by compensating for his liver disease. This patient had medical discharge in better conditions. © 2016, Editorial Ciencias Medicas. All rights reserved.


Munoz E.A.,Hospital Militar Central Dr Carlos J Finlay
Revista Cubana de Medicina Militar | Year: 2016

Equilibrium is the required state of a body by opposing and equal forces, it is the maintenance of the body position appropriate to each circumstance, both in static and dynamic condition. The posterior labyrinths regulate these forces to a great extent, and normality is based on the equality of their tones. They are made up of the semicircular ducts and the membranous vestibule (constituted by the utricle and the saccule). Semicircular ducts can be examined through rotational or bicalorical vestibular tests, otolithic organs (utricle and saccule) because of their anatomical location are limited in the study of their functions, however, there is a neurophysiological test (evoked vestibular myogenic potential) capable of exploring the function of the saccule and inferior vestibular nerve, which takes advantage of the ability of the saccule to be stimulated with high sound intensity at different frequencies. © 2016, Editorial Ciencias Medicas. All rights reserved.


Ramos G.E.L.,Hospital Militar Central Dr Carlos J Finlay
Revista Cubana de Medicina Militar | Year: 2016

Introduction: The fragility syndrome is a consequence of a decrease in resistance and physiological reserves of the elderly, which makes them vulnerable to adverse health effects. Objective: Estimate the prevalence of frailty in elderly, veterans of the defense, living in La Lisa municipality. Method: A descriptive, cross-sectional, door-to-door study was conducted. Validated criteria in a previous investigation, which applied the Delphi method, were used for this syndrome diagnosis. Results: Mean age: 70.4 years. The male sex predominated (88.2 %). 47.6 % were members of the Rebel Army. Comorbidities were present in 61.6 %, polypharmacy in 43.8 % and 64.8 % showed alterations in flexibility and mobility. 8.9 % had cognitive deficit. 13.7 % of the subject studied had mild depression were found. 25.7 % of the population suffered disability. 7.6 % self-perceived poor health. The majority (81.0 %) did not need permanent caregivers and had family support (81.0 %). A prevalence of fragility was 42.9 %. Conclusions: The prevalence of fragility is high and was among the expected values for the elderly living in Latin America and the Caribbean. © 2016, Editorial Ciencias Medicas. All rights reserved.


Lluis Ramos G.E.,Hospital Militar Central Dr Carlos J Finlay
Revista Cubana de Medicina Militar | Year: 2016

Aging leads to variations in hospital structures. The author's experience for more than 20 years in hospital care for elderly reservists and veterans allows us to affirm that we must continue working to improve structural capacities and geriatric care. An investigation in elderly veterans of the defense showed the existence of high prevalence of diverse deficiencies and chronic diseases that affect health. Central Military Hospitals and Army Hospitals must have a Geriatrics Service where the elderly will be fully evaluated. Preparing health institutions to meet the challenge of aging population is a strategic projection of work conceived in the Cuban Communist Party Guidelines. © 2016, Editorial Ciencias Medicas. All rights reserved.


Martin J.L.D.,Hospital Militar Central Dr Carlos J Finlay
Revista Cubana de Medicina Militar | Year: 2016

Paratesticular fibroma is a benign proliferative process of uncertain origin, probably non-tumor reactive inflammatory. The aim of the study is to present a case of paratesticular fibroma, as well as the diagnostic and therapeutic sequence implemented. We present a 55 year old patient with a history of hypertension. This patient visits the Urology outpatient clinic because of an increase in volume of the right testicle, a year of evolution, which in the last three months had caused slight discomfort. No history of trauma or inflammation was recorded in the testicle. On the physical examination he presented, to the lower pole of the testis and tail of the right epididymis, a mass of irregular stony consistency, 3 to 4 cm in diameter, fixed and painless. The testicular ultrasound reported the presence of a complex image, towards the lower pole, heterogeneous hypo and hyperechoic calcified inside, which measured 33 x 18 x 34 mm for 11 cm3 volume, and with associated light hydrocele. The patient underwent right radical orchiectomy with no complications. The histopathological result was nodular and hyalinizing fibrous proliferation affecting the tunica albuginea, calcified fibroma of the right testicle. Postoperative evolution was satisfactory. Although the definitive diagnosis of paratesticular fibroma is histopathological, its clinical and ultrasound characteristics make it one of the differential diagnoses to be considered with malignant tumors of the testis. © 2017, Editorial Ciencias Medicas. All rights reserved.


Collar T.L.R.,Hospital Militar Central Dr Carlos J Finlay
Revista Habanera de Ciencias Medicas | Year: 2014

Introduction: the lymphangitis sclerosing of the penis is a rare condition, benign and non venereal, that associates with frequency to the traumatism of the penis during the sexual relations or the masturbation. Although his resolution can be spontaneous, is reason of alarm and worry in the one who suffers it. Objective: present a new case with diagnostic of lymphangitis sclerosing of the penis, and the treatment applied. Case presentation: patient of 34 years that assisted to the query by increase of volume of the penis by behind the glans, of 4 days of evolution, after several days of sexual activity repeated and that produced him light. They did not collect antecedents of illnesses of sexual transmission. To the physical examination ascertained a soft tissue cord, mobile, of cartilaginous consistency and no painful, by behind the groove balano-prepuce and parallel to the same, more prominent rightwards. To perform this investigation had the consent informed of the patient. In the ultrasound of the penis did not detect alterations in the blood circulation, neither in the soft parts. I indicate sexual rest, oral anti-inflammatories and cold promotion venue. The evolution was favourable with the total resolution of the picture in 2 weeks. Conclusions: the lymphangitis sclerosing of the penis saves intimate relation with the traumatisms of the sexual activity. His diagnostic is clinical and the generally favourable evolution with the sexual rest, being able to accelerate his resolution with the employment of oral anti-inflammatories and cold promotions venues.


Munoz E.A.,Hospital Militar Central Dr Carlos J Finlay
Revista Cubana de Cirugia | Year: 2011

Introduction: nowadays, the electro-nystagmography is used for diagnosis; it is the process by which it is possible to register the position and movement of ocular eyeball to identify the changes in the electric field around the eye in modifying its position. Objective: to assess the usefulness of the electro-nystagmography in comparison with the traditional vestibular test for topographic diagnosis of auditory sequelae present in the patients presenting with cranial base fracture. Methods: a cross-sectional, analytical and observational study was conducted in the "Dr. Carlos J. Finlay" Military Hospital from January, 2006 to January, 2008. Universe included 210 patients divided into two groups: a study group with vestibular auditory sequealae after a fracture of cranial base and a control group consisting of healthy subjects. Results: dizziness was the symptom present in the 100% of patients. From the total of 118 cases with positive electro-nystagmography, 47 (39.8%) had negative results in the vestibular test. Conclusions: the electro-nystagmography was positive en most of study cases with a high sensitivity demonstrating that cases presenting with labyrinth weakness and directional predominance were not diagnosed by means of traditional vestibular test.


Lluis Ramos G.M.C.,Hospital Militar Central Dr Carlos J Finlay
Revista Cubana de Medicina Militar | Year: 2013

Introduction: frailty in older adults is a syndrome characterized by a reduction in resistance and physiological reserves. Objective: describe the prevalence of frailty in terms of biopsychosocial and functional variables. Methods: descriptive analytical cross-sectional door-to-door case-control prevalence study. 315 elderly persons were selected from the municipality of La Lisa. Frailty was diagnosed on the basis of expert criteria. With the purpose of finding risk factors, a univariate analysis was conducted between each of the explanatory covariables and the response variable, using the chi-square test. Poisson regression was performed for the univariate analysis, estimating the prevalence ratio. Results: the prevalence of frailty was 42.9 %. A higher prevalence was found among women (59.5 %) and among subjects with comorbidity (61.9 %), polypharmacy (63.8 %), poor mobility (61.3 %), low weight (51.9 %), severe depression (100.0 %), cognitive impairment (100.0 %), disability (84.0 %), poor self-perception of health (75.0 %) and family support limited to critical events (71.4 %). Comorbidity, altered mobility and flexibility test results, nutritional status, low weight, cognitive impairment, disability, falls and poor self-perception of health were the factors associated with the emergence of the syndrome in the population. Conclusions: prevalence of the frailty syndrome was found to be high in the community studied, and was associated to biomedical, psychological and functional health risk factors.


Rodriguez Collar T.L.,Hospital Militar Central Dr Carlos J Finlay
Revista Cubana de Medicina Militar | Year: 2014

Epididymus tumors are rare and the majority of them are benign, so there is not much information about them in the medical literature. Reaching the final histological diagnosis implies multiple testing and represents a challenge for the physician's performance. The present paper made an anatomical and physiological review of the epididymus as well as provided updating on the tumors affecting this organ in terms of diagnosis and treatment. Literature search was made in databases Hinari, PubMed, Medline and in Goggle from 2009 to 2013. The MeSH terms were paratesticular tumors, intrascrotal tumors and epididymal tumors in Spanish and English. Reference books and specialized journals were also reviewed. This paper confirmed the value of questioning and of the detailed physical exam in order to set the topographic and differential diagnosis of these tumors. Although ultrasound is the imaging study of choice for initial assessment, it is often inconclusive; therefore, it is necessary to obtain nuclear magnetic resonance images so as to have additional information. When the clinical picture and the findings from images may indicate a benign tumor, then fine needle aspiration cytology is a reliable option to make the final classification. Nevertheless, if this technique is not conclusive, then there is the biopsy through transoperative freezing, which is taken with inguinotomy, thus avoiding unnecessary radical orchiectomies. The adjuvant treatments for malignant tumors are very customized since they depend on the patient's age, the histological type and the tumor staging. © 2014, Editorial Ciencias Medicas. All Rights reserved.

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