ABSTRACT Background: the peripheral blood extension or peripheral lamina, as it is also known, is the semi-quantitative morphological evaluation of the three hematopoietic series, in an extension of peripheral blood colored and observed through the microscope. Objective: to develop a methodological procedure for the extension of peripheral blood from an interdisciplinary perspective in the degree in Clinical Bioanalysis. Methods: cross-sectional descriptive study in the period from September to November 2018, in the Technological Faculty belonging to the University of Medical Sciences of Camagüey. Theoretical methods such as analysis and synthesis and inductive and deductive methods were used. Of the empirical methods, the analysis of documents, the exploratory diagnostic test, results of controls to classes, the interview and survey for the validation of the proposal were applied. Results: insufficiencies regarding the establishment of interdisciplinary relationships between the contents of Histology and the hematological component of the Laboratory Diagnostic subject I, the students showed difficulties in performing the technique and failed to characterize morphologically some of the hematopoietic cells. Conclusions: a methodological procedure was developed for the peripheral lamina technique from an interdisciplinary perspective and the validation of the proposal by means of the consensus method formed by a nominal group where the categories of very adequate and suitable for the development of the peripheral lamina technique result. The observation of extension peripherals is an important element in the orientation of the analysis of the different diseases, an essential component of the integral diagnosis of the clinical laboratory.

RESUMEN Fundamento: el extendido de sangre periférica o lámina periférica, como también se conoce, es la evaluación morfológica semicuantitativa de las tres series hematopoyéticas en una extensión de sangre periférica coloreada y observada a través del microscopio. Objetivo: elaborar un procedimiento metodológico para el extendido de sangre periférica desde una perspectiva interdisciplinar en la licenciatura en Bioanálisis Clínico. Métodos: se realizó un estudio descriptivo transversal desde septiembre a noviembre de 2018, en la facultad Tecnológica perteneciente a la Universidad de Ciencias Médicas de Camagüey. Se emplearon métodos teóricos como el análisis y síntesis, el inductivo y deductivo. De los métodos empíricos, fueron aplicados el análisis de documentos, la prueba diagnóstica exploratoria, resultados de controles a clases, la entrevista y encuesta para la validación de la propuesta. Resultados: insuficiencias en cuanto al establecimiento de las relaciones interdisciplinarias entre los contenidos de Histología y el componente hematológico de la asignatura Diagnóstico de Laboratorio I, los estudiantes mostraron dificultades en la realización de la técnica y no lograron caracterizar morfológicamente algunas de las células hematopoyéticas. Conclusiones: se elaboró un procedimiento metodológico para la técnica lámina periférica desde una perspectiva interdisciplinar y la validación de la propuesta mediante el método de consenso conformado por un grupo nominal, donde resultan las categorías de muy adecuado y adecuado para el desarrollo de la técnica lámina periférica, pues la observación de extendidos periféricos es un elemento importante en la orientación del análisis de las diferentes enfermedades, componente esencial del diagnóstico integral del laboratorio clínico.

Abstract In this study we analyze both seasonal and inter-annual variations in the community parameters of Brachyura zoea I in the Parque Nacional Sistema Arrecifal Veracruzano. Planktonic samples from four transects were collected during three weather conditions: cold fronts; rainy and dry conditions in 2011 and 2012; and cold fronts and dry conditions in 2013. We measured temperature, salinity, and dissolved oxygen, in situ, to determine whether these parameters could explain the observed variations in the community patterns of brachyuran zoea I. We collected zoeae I of 18 species of brachyurans. The dominant species were Libinia dubia H. Milne Edwards, 1834; Menippe nodifrons Stimpson, 1859; and Callinectes sapidus Rathbun, 1896. The temperature and dissolved oxygen were the highest during the rainy conditions and the salinity during the dry conditions in the southern transects. The highest species richness (14) and diversity (2.97 bits individual-1) were found in central transects during cold front conditions. However, we found the highest species richness and diversity during the dry conditions, in the southern transects. Libinia dubia presented the highest density during cold fronts with 1592 ± 127 zoeae 100 m−3 in the northern transect, followed by C. sapidus in the north-central transect, this was observed for both species in the offshore zone. In conclusion, the parameters of the community of zoea I were influenced by the physical parameters measured in each sampling zone.

Abstract Previous reports of Gilvossius setimanus (De Kay, 1844) from the Gulf of Mexico have been based on a population of small specimens from deep offshore continental shelf waters off Texas and larger specimens from shorelines and shallow embayments of western Florida. The offshore population, herein designated Gilvossius fredericqae n. sp., reaches sexual maturity at much smaller size than does Gilvossius setimanus s.s. from the U.S. Atlantic seaboard, a species from which it differs in a number of morphological characters. While maturing at a similar size to G. setimanus s.s., a western Florida population, herein designated Gilvossius howellorum n. sp., differs from it in the 16S mt gene sequence, and from both it and the offshore species in morphology. An updated synonymy and rediagnosis of G. setimanus s.s. herein accompany descriptions of the two new species.

ABSTRACT Background: Higher education carries out profound transformations that become a key factor for the implementation of necessary processes in the face of world challenges. Objective: to develop a teaching aid for the teaching - learning of the hemolinfopoietic system, with emphasis on the spread of peripheral blood in the Clinical Bioanalysis degree. Methods: a descriptive cross-sectional study was carried out from September 2017-to February 2018, at the “Octavio de la Concepción y de la Pedraja” Technological Faculty of the “Carlos J. Finlay” Camagüey University of Medical Sciences. Theoretical methods were used: analytical-synthetic and inductive-deductive; Empirical ones: observation to classes, the survey in the form of teacher interviews and the exploratory test to students; and mathematical-statistics for the calculation of the absolute frequencies and the percentage. The product was valued by criteria of specialists. Results: inadequacies in the teaching-learning process were evidenced by teachers to work in a comprehensive way on the cognitive processes on peripheral blood as a way to analyze hematopoietic cells; Among the students, the incorrect use of techniques and procedures prevailed in the analysis and in the preparation of the reports based on the observation and interpretation of peripheral blood spreads as an essential component of Hematology. Conclusions: a teaching aid was developed that was assessed by criteria of specialists in the categories of very adequate and adequate in all the proposed indicators, so it was considered feasible to be applied.

RESUMEN Fundamento: la educación superior efectúa transformaciones profundas que se convierten en un factor clave para la puesta en marcha de procesos necesarios en el enfrentamiento a los desafíos del mundo existente. Objetivo: elaborar un material didáctico para la enseñanza aprendizaje del sistema hemolinfopoyético, con énfasis en el extendido de sangre periférica en la carrera de Bioanálisis Clínico. Métodos: se realizó un estudio descriptivo transversal en el período septiembre 2017-febrero 2018, en la Facultad Tecnológica “Octavio de la Concepción y de la Pedraja” de la Universidad de Ciencias Médicas “Carlos J. Finlay”, de Camagüey. Se emplearon métodos teóricos: analítico-sintético e inductivo-deductivo; empíricos: observación a clases, la encuesta en forma de entrevista a docentes y la prueba exploratoria a estudiantes; y matemático-estadísticos para el cálculo de las frecuencias absolutas y el porcentaje. El producto fue valorado por criterios de especialistas. Resultados: se evidenciaron insuficiencias en el proceso enseñanza aprendizaje por los profesores para trabajar de manera integrada los procesos cognitivos sobre extendidos de sangre periférica como una vía para analizar las células hematopoyéticas; entre los estudiantes primaron el uso incorrecto de técnicas y procederes en los análisis y en la elaboración de los informes a partir de la observación e interpretación de extendidos de sangre periférica como componente esencial de la Hematología. Conclusiones: se elaboró un material didáctico que fue valorado por criterios de especialistas en las categorías de muy adecuado y adecuado en todos los indicadores propuestos, por lo que se consideró factible de ser aplicado.

ABSTRACT The present study provides information on the morphology of stomatopod larvae found in two different reef systems which are also considered national parks: the Sistema Arrecifal Veracruzano (SAVNP) and Arrecife Puerto Morelos (APMNP). Zooplankton samples were collected at 26 stations of the SAVNP and four stations of the APMNP. Stomatopod larvae were identified and classified by their larval stage. We found representatives of three stomatopod superfamilies: the superfamily Gonodactyloidea Giesbrecht, 1910 was represented by Neogonodactylus oerstedii (Hansen, 1895), Neogonodactylus wennerae Manning and Heard, 1997, and Pseudosquillidae genus and species indeterminate; the superfamily Lysiosquilloidea Giesbrecht, 1910 was represented by Lysiosquilloidea genus and species indeterminate, Lysiosquilla sp., Lysiosquilla scabricauda (Lamarck, 1818) and Nannosquilla adkisoni Camp and Manning, 1982; the superfamily Squilloidea was represented by larvae of Alima neptuni (Linnaeus, 1768), Squilla spp., and Squilla empusa Say, 1818. We were able to identify and describe four stages of larval development for representatives of these superfamilies. This is the first study describing several stages of larval development of different species of the stomatopods from the Gulf of Mexico and Caribbean Sea.

ABSTRACT The objective of this study was to describe the morphology of Clibanarius antillensis Stimpson, 1859 megalopae collected in the vicinity of Isla Sacrificios, Mexico, and compare it to previous descriptions originated from Brazilian and Panamanian specimens raised in laboratory conditions. We found four meristic differences between the Brazilian and the Panamanian and Mexican populations with the Brazilian population: the outer flagellum of antennule in the Panamanian and Mexican populations has more aesthetascs on the second, third, and fourth segments of the outer flagellum (0, 6, 5, 3, 0) than the Brazilian population (0, 4, 4, 2, 0); the maxilla has more setae on the scaphognathite in the Brazilian specimens (70) than in the Mexican and Panamanian specimens (49-62); the crista dentata of the third maxilliped is formed by only three denticles in the Brazilian specimens, while 4 or 6 denticles form the same structure in the Panamanian and Mexican populations; there are fewer number of setae on the endopod of the uropod in the Brazilian population. The differences may be explained by intraspecific variation.

Background: neurocutaneous melanosis is a non-hereditary congenital disorder characterized by the association of multiple or large pigmented nevus and an excessive proliferation of melanocytes in the central nervous system. Neurological symptoms are usually of early onset in the infant stage with convulsions of difficult control, making the forecast reserved. Objective: to present a case with clinical diagnosis of neurocutaneous melanosis with neurological manifestations such as seizures from the infant stage. Clinical case: a male patient born with a giant melanoma stain that extends from the thorax to the abdomen, inguinal region, genital and lower limbs as a dressing. In the posterior region of the back, it begins in both flanks, sacral region until the misty of both legs, presenting convulsions at one month old. Continuing the appearance of hyperpigmented spots all over the body, which at the age of life are larger darker accompanied by thick hair, with epileptic seizures refractory to treatment. Conclusions: this disease that is produced by the increase of melanin to the skin and the central nervous system requires a monitoring of dermal lesions and a control of seizures, considering the importance of neurodevelopmental follow-up in a multidisciplinary way for timely intervention if necessary.

Fundamento: la melanosis neurocutánea es un trastorno congénito no hereditario que se caracteriza por la asociación de nevus pigmentados múltiples o de gran tamaño y una excesiva proliferación de melanocitos en el sistema nervioso central. Por lo general los síntomas neurológicos son de temprana aparición en la etapa de lactante con presencia de convulsiones de difícil control, al crear un pronóstico reservado. Objetivo: presentar un caso con diagnóstico clínico de melanosis neurocutánea con manifestaciones neurológicas como son las convulsiones desde la etapa de lactante. Caso clínico: paciente masculino que nace con mancha melánica gigante que se extiende desde el tórax al abdomen, región inguinal, genital y miembros inferior como pieza de vestir. En la región posterior de espalda, comienza en ambos flancos, región sacra hasta la mitad de ambas piernas, aparecen convulsiones al mes de nacido. Al continuar la aparición de manchas hiperpigmentada por todo el cuerpo, que ya al año de vida son mayores más oscuras acompañadas de vello grueso, con crisis epilépticas refractaria al tratamiento. Conclusiones: esta enfermedad que se produce por el aumento de melanina a la piel y el sistema nervioso central, requiere una vigilancia de las lesiones dérmicas y un control de las crisis convulsivas. Se considera importante el seguimiento del neurodesarrollo de forma multidisciplinario para intervención oportuna si fuera necesario.

Abstract The total anomalous pulmonary venous drainage, is characterized by lack of direct connection between all of the pulmonary vein and left atrium, it is a very rare heart disease with incidence of 1 to 3%. It is the second leading cause of death in children under one year, with variable mortality ranging from 2-23%. In Mexico, it occupies 7% in frequency. Clinical case. A nine-day old male weighing 2,300 grams with a diagnosis of cardiopathy disease congenital cyanotic type drain venous anomalous total pulmonary, infracardiaco to hepatic vein, pulmonary hypertension and heart failure, after stabilization with levosimendan, anastomosis tube collector was performed to left atrium with ligation of vertical vein and closing of PCA, under extracorporeal circulation, with satisfactory evolution. Clinical case. A nine-day old male weighing 2,300 grams with a diagnosis of cardiopathy disease congenital cyanotic type drain venous anomalous total pulmonary, infracardiaco to hepatic vein, pulmonary hypertension and heart failure, after stabilization with levosimendan, anastomosis tube collector was performed to left atrium with ligation of vertical vein and closing of PCA, under extracorporeal circulation, with satisfactory evolution. Discussion. This cardiopathy is a surgical emergency so his preoperative management aims to achieve good stabilization in the fastest posible way. The amines and the levosimendan used in the perioperative improved the prognosis of the patient. Conclusions: Good early diagnosis and appropriate surgical plan as well as to decrease possible risk factors associated with mortality prior to the surgery, improve the survival of patients with this pathology. Levosimendam is a drug that we consider favored the necessary preoperative cardiac stability preoperative, transanestesico and postoperative.

Resumen El drenaje venoso pulmonar anómalo total, se caracteriza por ausencia de conexión directa entre todas las venas pulmonares y la aurícula izquierda, es una cardiopatía poco frecuente con incidencia del 1 al 3%. Es la segunda causa de muerte en menores de un año, con una mortalidad variable que va desde 2-23%. En México ocupa el 7% en frecuencia. Caso clínico. Paciente masculino de término de nueve días de vida, peso 2300 gramos, con diagnóstico de cardiopatía congénita cianógena tipo drenaje venoso pulmonar anómalo total, infracardiaco a vena hepática, con hipertensión pulmonar y falla cardiaca, previa estabilización con levosimendan, se realizó anastomosis de tubo colector a aurícula izquierda con ligadura de vena vertical y cierre de PCA, bajo circulación extracorpórea, con evolución satisfactoria. Discusión. Esta cardiopatía constituye una urgencia quirúrgica, por lo que su manejo preoperatorio está encaminado a conseguir buena estabilización lo más rápido posible, las aminas y el levosimendan utilizados en el perioperatorio contribuyeron a mejorar el pronóstico del paciente. Conclusiones: Un buen diagnóstico temprano y un plan quirúrgico adecuado, así como disminuir los factores de riesgo posibles asociados a mortalidad previos a la cirugía, mejoran la sobrevida de los pacientes con esta patología. Levosimendam es un fármaco que consideramos que favoreció la estabilidad cardiaca necesaria en el preoperatorio, transanestesico y postoperatorio.

Introduction: Aarskog's syndrome is a genetic disease with variable manifestation, characterized by growth retardation, typical facial features, short hand and feet, intellectual disability and genital anomalies. It was described a pattern of recessive inheritance linked to X chromosome, with partial expression in women. Cases with dominanta autosomal transmission have been reported. Objective: describing the phenotypical characteristics of ten patients with Aarskog's syndrome diagnosis, found as much in female as in male patients. Materials and methods: we carried out a descriptive, retrospective study, from January to December 2015, with a sample formed by ten patients from Urbano Noris Municipality, province of Holguin. Results: the most frequent facial characteristics were wide nasal bridge (90 %), anteverted nares (40 %), long philtrum (90 %), with thick lips (60 %) and palpebral fissures down (90 %), followed by hypertelorism and thick eyebrows in a 70 %; brachydactyly was the most common alteration of the limbs (70 %) and membranous syndactyly (80 %), accompanied by mild intellectual disability in 80 %. Conclusions: the patients showed variability of the clinical expression, found as much in female as in male ones; the phenotypical differences may be explained by the syndrome´s genetic heterogeneity. There are not still in the country molecular researches allowing the genotypic characterization of these patients.

Introducción: el síndrome Aarskog es una enfermedad genética con expresividad variable y está caracterizada por retardo del crecimiento, rasgos faciales típicos, manos y pies cortos, discapacidad intelectual y anomalías en genitales. Se describió un patrón de herencia recesiva ligada al cromosoma X, con expresión parcial en mujeres. Se han reportado casos con transmisión autosómica dominante. Objetivos: identificar las características fenotípicas de diez pacientes afectados con diagnóstico del síndrome Aarskog, encontrado tanto hembras como varones. Materiales y métodos: se realizó un estudio descriptivo, donde la muestra estuvo formada por diez enfermos del municipio Urbano Noris, provincia de Holguín, durante enero a diciembre de 2015. Resultados: la característica facial más frecuente fue el puente nasal ancho (90 %), narinas antevertidas (40 %), el filtrum largo (90 %), con labios gruesos (60 %) y la fisuras palpebrales hacia abajo (90 %); seguido por el hipertelorismo y las cejas gruesas en un 70 %; la braquidactílea fue la alteración en los miembros más común (70 %) y la sindactílea membranosa en 80 %, que se acompañó de discapacidad intelectual leve en el 80 %. Conclusiones: existió variabilidad de expresión clínica entre los enfermos, estando tanto en hembras como en varones, existiendo diferencias fenotípicas que se pudieran explicarse a través de la heterogeneidad genética del síndrome. Aún no se cuenta en el país con estudios moleculares que permitan caracterizar genotípicamente a estos afectados.

A perspective epidemiological study on the teratogenic effects of carbamazepine was carried out in the Neurology and Neurosurgery Department of “Vladimir Ilich Lenin” provincial hospital in Holguín from 1992 to 1998. Epileptic pregnant women treated with monotherapy or combined therapy were selected for the study. Also a control group of non-epileptic pregnant women from the clinical teratology service of the provincial center of genetics participated in it. It was demonstrated that all the pregnant women received periconceptional treatment at a dose of 1 mg of folic acid per day and further follow-up with 5 mg up to the 20th week of gestation when they continued to receive prenatal vitamin supplement. It was found that the reproductive quality was negative in the previous obstetric history of these women because of a high rate of induced abortions, miscarriages, incidence of rivanol in pregnancy terminations because of congenital malformations and late fetal mortality. In the studied pregnancies, rates of 7.4% for miscarriages under both therapeutical regimes and of 3,7% for pregnancy terminations by the rivanol method due to congenital malformations were recorded. The malformations were complex congenital cardiopathies. There was no late fetal death. The control group did not present gestational failures. Somatometry at birth was within standard limits, but the head circunference reached 32,6 cm in the neonates of the group of women under combined therapy. Carbamazepine administered in monotherapy or combined therapy had the same teratogenic expression, caused miscarriages and complex congenital cardiopathies whereas when it was administred in combined therapy, it affected the development of head circunference and in lesser extent, the weight and size figures.

Se realizó un estudio epidemiológico perspectivo sobre los efectos teratogénicos de la carbamazepina, en el servicio de Neurología y Neurocirugía del hospital provincial "Vladimir I. Lenin" de Holguín, durante los años 1992-1998. Se seleccionaron las gestantes epilépticas tratadas con régimen de monoterapia o politerapia. Se constituyó un grupo control con gestantes no epilépticas, procedentes de la consulta de Teratología Clínica del Centro provincial de Genética. Se comprobó que todas las gestantes recibieron tratamiento periconcepcional con 1 mg/d de ácido fólico y seguimiento ulterior de 5 mg, hasta las 20 sem, cuando continuaron con suplemento vitamínico de prenatal. Se halló que la calidad reproductiva fue desfavorable en la historia obstétrica precedente, con alto índice de abortos provocados, espontáneos, incidencia de rivanol por malformaciones congénitas y mortalidad fetal tardía. En las gestaciones propósitos, se obtuvieron tasas de 7,4 % para los abortos espontáneos en ambos regímenes terapéuticos y de 3,7 %, respectivamente para las interrupciones de malformaciones congénitas por el método de rivanol, que se correspondieron con cardiopatías congénitas complejas. No hubo muertes fetales tardías. El grupo control no tuvo fracasos gestacionales. La somatometría al nacer estuvo dentro de límites normales, aunque la circunferencia cefálica alcanzó valor de 32,6 cm, para el grupo de politerapia. La carbamazepina, en régimen terapéutico de monoterapia y politerapia alcanzó la misma expresión teratogénica, provocó abortos espontáneos y cardiopatías congénitas complejas, mientras en régimen de politerapia afectó el desarrollo de la circunferencia cefálica y, en menor grado, el valor del peso y la talla.