ABSTRACT In the year 2021, research is being developed at the National Center for Medical Sciences Information to analyze the behavior of Cuban scientific production in health in several databases. As a result of these processes, a series of bibliometric reports were generated to support decision making by the system's managers. One of the components analyzed were the Cuban institutions that contribute to the country's scientific production in health-related topics. The objective of this work was to identify the main Cuban institutions that have the greatest impact on Cuban scientific production related to Health Sciences. A descriptive bibliometric analysis was carried out in multiple sources of information. The data were extracted during the first months of the year 2021. Health research institutions and biotechnology centers are the main contributors to publications. Several higher education centers also contribute a high number of publications. The University of Havana is the entity that contributes the largest number of articles in all the databases, followed by the University of Medical Sciences of Havana and the Central University "Marta Abreu" of Las Villas. This highlights the importance of universities and their role in the development of science and research in the country. Problems were detected in the processes of metadata declaration and errors in the names of the institutions in the databases, which directly influence the behavior of Cuban scientific production in health.

RESUMEN En el año 2021 se desarrollan investigaciones en el Centro Nacional de Información de Ciencias Médicas para analizar el comportamiento de la producción científica cubana en salud en varias bases de datos. Como resultado de estos procesos se generó una serie de informes bibliométricos enfocados en el apoyo a la toma de decisiones de los directivos del sistema. Uno de los componentes analizados fueron las instituciones cubanas que contribuyen a la producción científica del país en temas relacionados con la salud. Este trabajo tuvo como objetivo identificar las principales instituciones cubanas que más impacto tienen en la producción científica cubana relacionada con las Ciencias de la Salud. Se realizó un análisis bibliométrico descriptivo en múltiples fuentes de información. Los datos fueron extraídos durante los primeros meses del año 2021. Las instituciones investigativas de salud y centros de biotecnología son los que más aportan a las publicaciones. También contribuyen de forma elevada varios centros de enseñanza superior. Es la Universidad de La Habana la entidad que mayor cantidad de artículos tributa en todas las bases de datos, seguida por la Universidad de Ciencias Médicas de La Habana y la Universidad Central “Marta Abreu” de Las Villas. Esto destaca la importancia de las universidades y su rol para el desarrollo de la ciencia y la investigación en el país. Se detectaron problemas en los procesos de declaración de metadatos y errores en los nombres de las instituciones en las bases de datos, lo cual influye directamente en el comportamiento de la producción científica cubana en salud.

ABSTRACT With the objective of analyzing the scientific contribution of measles publications and graphing the collaboration networks between countries during the last 20 years. A bibliometric study was conducted between 1999 and 2018 of journals indexed in Scopus. Annual production data were analyzed and a co-occurrence analysis of production and collaboration between countries using VOSviewer was plotted. 587 documents were registered between 1999 and 2018, with a steady trend, the average of annual publications was 29 documents (range 1-44), being 72.4% were original articles. The countries of Brazil (53.3%) and Mexico (17.5%) had greater productivity and collaboration mainly with the United States and the United Kingdom. Measles research in Latin America presents a stationary trend. Brazil and Mexico were the countries with more publications and have greater networks of scientific collaboration with the United States and the United Kingdom.

RESUMEN Con el objetivo de analizar la contribución científica de las publicaciones sobre sarampión y representar gráficamente las redes de colaboración entre países durante los últimos 20 años, se realizó un estudio bibliométrico entre 1999 y 2018 de revistas indexadas en Scopus. Se analizaron datos de producción anual y se representó gráficamente un análisis de co-ocurrencia de producción y colaboración entre países utilizando VOSviewer. Se registraron 587 documentos entre los 1999 y 2018, con tendencia estacionaria; el promedio de publicaciones anual fue de 29 documentos (rango 13-44), siendo el 72,4 % artículos originales. Los países Brasil (53,3 %) y México (17,5 %) tuvieron mayor productividad y colaboración, principalmente con Estados Unidos y Reino Unido. La investigación sobre sarampión en Latinoamérica presenta una tendencia estacionaria. Brasil y México fueron los países con más publicaciones y tienen mayores redes de colaboración científica con Estados Unidos y Reino Unido.

Abstract Lymphangioma is a rare and understudied pathology that is usually detected in the first decade of life, and its appearance in adults is rare. This report details a 51-year-old man with morbid obesity who presented, for the last eight months, multiple asymmetric tumor lesions with extension to the scrotal region. The diagnosis of circumscribed lymphangioma with associated infection was confirmed. This case report demonstrates an unusual presentation of the characteristics of the lymphangioma that are seldom described in the literature.

Resumo Objetivo: Avaliar a associação entre distúrbios do sódio ou do cloro e mortalidade hospitalar de pacientes com insuficiência renal aguda (IRA) ou doença renal crônica (DRC) submetidos a hemodiálise aguda. Métodos: O presente estudo de coorte retrospectiva incluiu pacientes adultos submetidos a hemodiálise aguda com diagnóstico de IRA ou DRC em um hospital público de Lima, Peru. Os distúrbios do sódio foram classificados como hiponatremia (Na < 135mmol/L) ou hipernatremia (Na > 145mmol/L), enquanto os distúrbios do cloro foram classificados como hipocloremia (Cl < 98 mmol/L) ou hipercloremia (Cl > 109mmol/L). O desfecho de interesse foi mortalidade hospitalar. Utilizamos modelos de Poisson da família de modelos lineares generalizados com bootstrap não-paramétrico e correção de viés acelerado para estimar os riscos relativos na análise bruta (RR) e ajustada (RRa) para sexo, idade, HCO3 (para todos os pacientes) e escore de Liaño (apenas para IRA) com IC 95%. Resultados: Foram incluídos 263 pacientes (idade média 54,3 anos; 43% do sexo feminino), 191 com DRC e 72 com IRA. A mortalidade foi mais elevada nos pacientes com IRA (59,7%) do que nos indivíduos com DRC (14,1%). No geral, os pacientes com hipernatremia tiveram mortalidade hospitalar mais elevada do que os indivíduos com valores normais de sódio (RRa: 1,82; IC 95%: 1,17-2,83). Os pacientes com hiponatremia não apresentaram mortalidade diferente (RRa: 0,19; IC 95%: 0,69-2,04). Também identificamos que hipercloremia (RRa: 1,35; IC 95%: 0,83-2,18) e hipocloremia (RRa: 0,66; IC 95%: 0,30-14,78) não elevaram a mortalidade em comparação a indivíduos com níveis normais de cloro. Não foi encontrada associação entre distúrbios do sódio ou do cloro e mortalidade hospitalar nos subgrupos com DRC e IRA. Conclusões: Em nossa análise exploratória, apenas hipernatremia apresentou associação com mortalidade hospitalar em pacientes com IRA ou DRC submetidos a hemodiálise aguda.

Abstract Objective: To evaluate the association between dysnatremias or dyschloremias and mortality during hospitalization in patients with acute kidney injury (AKI) or chronic kidney disease (CKD) undergoing acute hemodialysis. Methods: We carried out a retrospective cohort study on adult patients undergoing acute hemodialysis with AKI or CKD diagnosis at a public hospital in Lima, Peru. Dysnatremias were categorized as hyponatremia (Na < 135mmol/L) or hypernatremia (Na > 145mmol/L), and dyschloremias were defined as hypochloremia (Cl < 98 mmol/L) or hyperchloremia (Cl > 109mmol/L). The outcome of interest was mortality during hospitalization. We performed generalized lineal Poisson family models with bias-corrected and accelerated non-parametric bootstrap to estimate the risk ratios at crude (RR) and adjusted analysis (aRR) by gender, age, HCO3 (for all patients) and Liaño score (only for AKI) with CI95%. Results: We included 263 patients (mean age: 54.3 years, females: 43%): 191 with CKD and 72 with AKI. Mortality was higher in patients with AKI (59.7%) than in patients with CKD (14.1%). In overall, patients with hypernatremia had a higher mortality during hospitalization compared to those who had normal sodium values (aRR: 1.82, 95% CI: 1.17-2.83); patients with hyponatremia did not have different mortality (aRR: 0.19, 95% CI: 0.69-2.04). We also found that hyperchloremia (aRR: 1.35, 95% CI: 0.83-2.18) or hypochloremia (aRR: 0.66, 95% CI: 0.30-14.78) did not increase mortality in comparison to normal chloride values. No association between dysnatremias or dyschloremias and mortality during hospitalization was found in CKD and AKI subgroups. Conclusions: In our exploratory analysis, only hypernatremia was associated with mortality during hospitalization among patients with AKI or CKD undergoing acute hemodialysis.

INTRODUCTION The steadily increasing prevalence of diabetes globally has captured researchers’ attention. Cuban production of scientific articles on diabetes has not been studied from a bibliometric perspective. OBJECTIVE Characterize the production and impact of research and review articles on diabetes by Cuban authors in journals listed in the Scopus bibliographic database, as well as related collaboration among Cuban institutions and between Cuban and non-Cuban institutions. METHODS A bibliometric analysis was conducted using 2000–2017 data from the Scopus database. The following search strategy was used: descriptor (diabetes), country (Cuba), publication source (journal), article type (original research, review article). Bibliographic indicators of production, visibility, impact and collaboration were examined. RESULTS Cuba contributed 3.2% of Latin American production and 0.1% of global production related to diabetes. Within Cuba’s scientific production (610 articles, 538 original research and 72 review), 85.9% had a Cuban corresponding author (Cuban leadership). In articles with international collaboration (22.9%), however, most (67.9%) had non-Cuban corresponding authors. A total of 47% (287) were articles involving a single institution. Only 11.1% were published in top-ranked journals, and 14.4% were cited >10 times. Cubans were lead authors on 0.3% of the most frequently cited (top 10%) articles on diabetes in Scopus. A total of 38.4% of this production appeared in low-impact journals and 57.9% in Cuban journals. Articles published in English accounted for 30% of total and obtained higher impact in terms of citations than articles in Spanish. The strongest networks for scientific collaboration were those that connected Cuban and US researchers. CONCLUSIONS Cuban scientists conduct research on diabetes, but their work is not highly visible in the peer-reviewed literature, particularly in top-ranked journals. The problem is not simply one of publishing more, but of knowing how and where to publish. It is urgent that Cuban universities training health professionals at all levels include instruction on scientific writing.

ABSTRACT The new university law 30220 of 2014 introduced the mandatory institutional licensing of all Peruvian universities by the National Superintendence of Higher University Education (SUNEDU, in Spanish). The first undergraduate program to go through this process will be medicine. The licensing of medical programs is necessary to ensure that the conditions in which the program is taught in Peru are adequate, with a high probability of closing some medical schools. Once a medical school has demonstrated that it meets the basic conditions of quality, a qualitative and quantitative evaluation is carried out that includes three criteria: scientific production in the Web of Science, impact measured through the H index, and results of the national medical exam, to determine the years of licensing. This article evaluates the quantitative indicators linked to research using Web of Science and Scopus, in addition to making technical and methodological revisions of them. Suggestions for the other indicators are also covered by this article.

RESUMEN La nueva ley universitaria 30220 del 2014 creó la obligatoriedad del licenciamiento institucional de todas las universidades peruanas a cargo de la Superintendencia Nacional de Educación Superior Universitaria - SUNEDU, el primer programa de pregrado en pasar por el mismo proceso será medicina. El licenciamiento de programas de medicina es necesario para garantizar que las condiciones en que se imparte la carrera en el Perú son las adecuadas, con la alta posibilidad de cierre de algunas escuelas de medicina. Una vez que una escuela de medicina haya demostrado que cumple con las condiciones básicas de calidad, se realiza una evaluación cualitativa y una cuantitativa que incluye tres criterios: producción científica en Web of Science, impacto medido a través del índice H, y resultados del examen nacional de medicina, para determinar los años de licenciamiento. Este artículo realiza una evaluación de los indicadores cuantitativos vinculados a investigación usando Web of Science y Scopus, además de hacer revisiones técnicas y metodológicas de los mismos; así como sugerencias para los otros indicadores.

The new university law 30220 of 2014 introduced the mandatory institutional licensing of all Peruvian universities by the National Superintendence of Higher University Education (SUNEDU, in Spanish). The first undergraduate program to go through this process will be medicine. The licensing of medical programs is necessary to ensure that the conditions in which the program is taught in Peru are adequate, with a high probability of closing some medical schools. Once a medical school has demonstrated that it meets the basic conditions of quality, a qualitative and quantitative evaluation is carried out that includes three criteria: scientific production in the Web of Science, impact measured through the H index, and results of the national medical exam, to determine the years of licensing. This article evaluates the quantitative indicators linked to research using Web of Science and Scopus, in addition to making technical and methodological revisions of them. Suggestions for the other indicators are also covered by this article.

La nueva ley universitaria 30220 del 2014 creó la obligatoriedad del licenciamiento institucional de todas las universidades peruanas a cargo de la Superintendencia Nacional de Educación Superior Universitaria - SUNEDU, el primer programa de pregrado en pasar por el mismo proceso será medicina. El licenciamiento de programas de medicina es necesario para garantizar que las condiciones en que se imparte la carrera en el Perú son las adecuadas, con la alta posibilidad de cierre de algunas escuelas de medicina. Una vez que una escuela de medicina haya demostrado que cumple con las condiciones básicas de calidad, se realiza una evaluación cualitativa y una cuantitativa que incluye tres criterios: producción científica en Web of Science, impacto medido a través del índice H, y resultados del examen nacional de medicina, para determinar los años de licenciamiento. Este artículo realiza una evaluación de los indicadores cuantitativos vinculados a investigación usando Web of Science y Scopus, además de hacer revisiones técnicas y metodológicas de los mismos; así como sugerencias para los otros indicadores.

Resumen El registro de patentes es considerado como uno de los índices de desarrollo industrial y científico de los países, siendo utilizado para medir la capacidad de esa actividad en la transformación de conocimiento en productos, procesos o innovación tecnológica. En el contexto de las actividades científicas, tecnológicas y de innovación en Perú, se plantea la cuestión: ¿cómo se comporta la producción de patentes en el país? El foco principal es identificar la producción de las patentes, así como sus inventores principales. El objetivo de este trabajo fue determinar el grado de productividad de patentes en Perú. El enfoque de análisis en este estudio fueron las patentes válidas de inventores peruanos, en el período 2003 - 2013. La estrategia de búsqueda fue basada en la base de patentes Esp@cenet, en el campo “Inventores”, usando la expresión “[PE]”, representando al país del inventor, seleccionando el período del estudio arriba mencionado. En una segunda etapa, se realizó una limpieza de datos para identificar si la estrategia fue exitosa; se identificaron 1104 patentes, que fueron tabuladas posteriormente. Entre los diversos resultados de esta investigación, una interesante observación es el predominio de las citas de patentes de los Estados Unidos, prácticamente monopolizando la muestra. En 47 ocasiones aparece el país estadounidense, mientras que las patentes de Alemania se citan 4 veces y de Gran Bretaña 2 veces. Durante el período estudiado, se puede notar un crecimiento del 60 % en el registro de patentes. Los principales productores de patentes del Perú tienen interesantes características, donde se puede notar una reserva de mercado en algunos seguimientos como higiene, productos de consumo y de lo cotidiano. Por último, se puede identificar un predominio tecnológico y de innovación en sectores donde la industria está instalada y que tiene interferencia directa en los productos que se dirigen a la población peruana.

Abstract The patent registration is considered one of the industrial and scientific development indexes of countries, once used to measure the capacity of this activity in the transformation of knowledge into products, processes or technological innovation. In view of the whole scientific, technological and innovation contexts activities in Peru, we ask: how does the patent production process behave in the country? The main focus is to identify the production of patents, as well as their inventors. The main objective of this study is to determine the degree of patent productivity in Peru. The search strategy was based on the Esp@cenet patent base, in the Inventors field, using the expression "[PE]" representing the country of inventor, selecting the period of study mentioned above. In a second step, a data cleansing was performed to identify if the strategy was successful, 1104 patents were identified, which were tabulated later. Among the several results of this research, an interesting observation is the predominance of US patent citations, practically monopolizing the sample. On 47 occasions the US country appears, while patents from Germany are cited 4 times and from Great Britain 2 times. During the study period, a 60 % increase in patent registrations was observed. The main patent producers in Peru have interesting characteristics, where one can notice a market reserve in some segments such as hygiene, consumer products and daily life. Finally, one can identify a technological and innovative predominance in sectors where the industry is installed and that has direct interference in the products that are directed to the Peruvian population.

Resumo A glomerulonefrite rapidamente progressiva pauci-imune apresenta-se geralmente associada a vasculite de pequenos vasos, com poucos casos associados a outras doenças imunes como o lúpus eritematoso sistêmico (LES). Apresentamos no presente artigo o caso de uma mulher de 34 anos de idade com sintomas de insuficiência renal aguda e indicação de terapia renal substitutiva, no contexto de diagnóstico clínico de LES. A biópsia renal realizada revelou que a maioria dos glomérulos apresentavam um certo grau de esclerose segmentar e sinéquias com a cápsula de Bowman. Sessenta e sete por cento dos glomérulos apresentava crescentes fibroepiteliais. Além disso, o espaço intersticial exibia infiltrado linfomononuclear moderado e fibrose discreta. Nas arteríolas, as paredes encontravam-se espessadas por esclerose subintimal. A imunofluorescência direta detectou depósitos limitados de IgM e C3 nas alças capilares e mesângio negativo para IgG, IgA e C1q. Tratamento com corticosteroides e ciclofosfamida endovenosa foi iniciado com evolução estável. A glomerulonefrite rapidamente progressiva pauci-imune associada a LES é uma patologia rara com manifestação clínica e evolução variada, sem tratamento clínico padronizado.

Abstract The pauci-immune crescentic glomerulonephritis (PICGN) is generally associated with small-vessel vasculitis with a few reported cases associated with other autoimmune diseases such as Systemic Lupus Erythematosus (SLE). We present the case of a female 34-year-old patient with acute kidney injury symptoms with indication for renal replacement therapy in the context of clinical SLE diagnosis. A kidney biopsy was conducted and it was found that most glomeruli showed some segmental sclerosis with synechia to the Bowman's capsule. 67% of the glomeruli had fibroepithelial crescents. Moreover, the interstitial space had a moderate lymphomononuclear infiltration and mild fibrosis. In the arterioles, there were walls thickened by subintimal sclerosis. Direct immunofluorescence detected limited IgM and C3 deposits in capillary loops and negative mensangium for IgG, IgA and C1q. A therapy using corticosteroids and intravenous cyclophosphamide was initiated with stable evolution. PICGN associated with SLE is a rare pathology with clinical presentation, varied evolution and without a standard medical treatment.

ABSTRACT This non-systematic bibliographic review examines the published Peruvian medical literature on arterial hypertension (HTN) as of December 2016. The results were divided into three thematic areas: self-knowledge, adherence to treatment, and control. We identified 197 articles, although only 15 were used for the analysis. Despite improvement in recent years, we found that the level of self-knowledge about HTN is poor. The level is better in urban areas, but is generally worse than in other Latin American cities. Moreover, despite improvement, HTN control is insufficient and worse than in other Latin American countries. Finally, adherence to treatment may be worse in the provinces.

RESUMEN Se describe la producción científica peruana sobre hipertensión arterial (HTA) que se publicó en la literatura médica, mediante una revisión bibliográfica no sistemática hasta diciembre del 2016. Los resultados se dividieron en tres áreas temáticas: autoconocimiento, adherencia al tratamiento y control. Se encontraron 197 artículos, pero solo 15 se utilizaron para el análisis. Los resultados sugieren que el nivel de autoconocimiento de la HTA es deficiente, aunque ha mejorado en los últimos años. Esto es mejor en las poblaciones urbanas y en general, peor que en otras ciudades latinoamericanas. De igual forma, aunque el control de la HTA ha mejorado, es insuficiente y por debajo de otros países latinoamericanos. Finalmente, es posible que la adherencia al tratamiento sea peor en provincias.