Subarachnoid hemorrhage (SAH) is a devastating disease, with a mortality rate of 35%. Among patients who survive the initial bleeding, the leading cause of morbidity and mortality is delayed cerebral ischemia (DCI). Electroencephalography (EEG) can detect cerebral ischemia in the early stages. We report a 66-year-old female patient who consulted for ictal headache and impaired consciousness. On admission, she was confused, dysarthric, and with meningeal signs. Brain angio-CT showed SAH FISHER IV and an aneurysm of the left posterior cerebral artery. After excluding the aneurysm (by coiling), the patient recovered the altered consciousness. Continuous EEG monitoring was initiated. On the sixth day of follow up, she had a transient headache and apathy. The brain MRI showed low cerebral blood flow in the left frontotemporal area, without ischemic lesions. On the seventh day, she presented expression aphasia and right facial-brachial paresis. Angiography confirmed severe vasospasm in M1 and M2 segments bilaterally. Pharmacological angioplasty with nimodipine was performed, with an excellent radiological response, although not clinical. A second MRI was carried out on the eighth day, which showed a left insular infarction and generalized vasospasm. A second therapeutic angiography was performed; the patient persisted with aphasia and left central facial paresis. The quantitative EEG analysis performed retrospectively showed a generalized reduction in the spectral edge frequency 95 (SEF95; meaning slowing in the EEG signal) at the fourth day of follow up, three days earlier than the clinical and imaging diagnosis of DCI was established.

Abstract: The purpose of this paper is to analyze the literature on the subject of adoption of cloud computing technologies. The idea is to provide an overview of the current situation of research on cloud services and major adoption theories. The methodology used in the research is a systematic review of the literature for which 75 books and journals in the field of information systems have been reviewed to identify and categorize 24 articles on the subject. The exploratory analysis of the results has been based on content, methodologies and adoption models, referencing the main theoretical and empirical work on cloud computing services. The conclusions of this investigation show the importance of connecting the most used models in the field of research with the most relevant works carried out to date.

Resumen: El propósito de este trabajo es analizar la literatura sobre el tema de adopción de las tecnologías de computación en la nube (cloud computing). Se pretende proporcionar una visión general de la situación actual de la investigación sobre los servicios en la nube y las principales teorías sobre adopción aplicadas. La metodología utilizada en la investigación es una revisión sistemática de la literatura para la que se han revisado 75 libros, revistas del campo de sistemas de información para identificar y categorizar 24 artículos sobre el tema. El análisis exploratorio de los resultados se ha basado en los contenidos, las metodologías y los modelos de adopción, referenciando los principales trabajos teóricos y empíricos sobre los servicios de computación en la nube. Las conclusiones de esta investigación ponen de manifiesto la importancia de conectar los modelos más utilizados en el campo de la investigación con los trabajos más relevantes realizados hasta la fecha.

ABSTRACT Biomaterials are key components of an expanding branch in the medical-pharmaceutical industry that manufacture restoratives and reparative tissue materials, drug delivery systems and in vitro diagnostics. The Center of Biomaterials of the University of Havana has developed several biomaterial products: the tissue adhesive Tisuacryl®; Multilatex®, a solid support for the development of diagnostic reagents; and Biograft-G®, a bone filling material used in maxillofacial surgery. In the present work, the main results achieved for these products are reviewed, with emphasis in the commercialization strategy. As a promotion tool, attractive and modern images with a distinctive color were designed and included in all printed material accompanying the products, including the technical literature, the commercial brochure, the label of primary packaging and secondary packaging. Giant posters including results of the application of these biomaterials were printed for each product to be exhibited in commercial fairs and scientific meeting and congresses.

RESUMEN Los biomateriales son componentes fundamentales de una rama en expansión de la industria médico-farmacéutica que incluye, entre otros, materiales de reparación y restauración de tejidos, y sistemas de liberación de fármacos y de diagnóstico in vitro. El Centro de Biomateriales de la Universidad de La Habana ha obtenido productos biomateriales como el adhesivo tisular Tisuacryl®; Multilatex®, soporte sólido para la elaboración de reactivos para el diagnóstico; y Biograft-G®, para rellenar cavidades en defectos óseos maxilofaciales. En el presente trabajo se revisan los principales resultados obtenidos con esos productos, con énfasis en las estrategias de comercialización. Como herramienta promocional se diseñó una imagen con un color distintivo que se incluyó en los materiales impresos como la literatura técnica, el plegable comercial, las etiquetas del envase primario y el envase secundario. Se imprimieron gigantografías con resultados de la aplicación de esos biomateriales para exhibiciones en ferias comerciales, reuniones y congresos científicos.

Racional: Delaitre e Maignien realizaram a primeira esplenectomia laparoscópica bem sucedida em 1991. Depois disso, a esplenectomia laparoscópica tornou-se um dos procedimentos laparoscópicos de órgãos sólidos mais frequentemente realizadas. Objetivo: Demonstrar a técnica cirúrgica de esplenectomia laparoscópica com portais reduzidos. Métodos: A esplenectomia laparoscópica reduzida em potais foi realizada usando um trocarte de 10 mm e dois de 5 mm. A entrada abdominal se dá pela técnica aberta trans-umbilical e um trocarte de 10 mm foi aí colocado. Um de 5 mm subcostal foi colocado sob visão direta no nível da linha axilar anterior e outra trocarte de 5 mm foi inserido na região médio-epigástrica. Uma vez completamente dissecado e liberado todos os seus ligamentos do hilo, a artéria e veia esplênicas foram ligadas com hem-o-lock e seccionado com tesoura. Em seguida, um Endobag foi usado para retirar o baço após ser ele morcelado através da incisão umbilical. Resultado: Esta técnica foi utilizada em uma jovem de 15 anos com dor epigástrica e em hipocôndrio esquerdo. Ultrassom abdominal mostrou um cisto gigante localizado no baço. Exames complementares tiveram resultados normais. TC mostrou um cisto gigante, que projetava-se para o estômago. A paciente tolerou bem o procedimento, com pós-operatório normal. Ela teve alta hospitalar em 72 h após a operação. Conclusão: A diminuição de portais minimiza o trauma abdominal e tem as vantagens conhecidas de menor tempo de pós-operatório, maior controle da dor, e melhor efeito cosmético. A esplenectomia laparoscópica para cistos gigantes usando trocárteres reduzidos é segura, viável e menos invasiva.

Background: Delaitre and Maignien performed the first successful laparoscopic splenectomy in 1991. After that, laparoscopic splenectomy has become one of the most frequently performed laparoscopic solid organ procedures. Aim: To demonstrate the surgical techique of laparoscopic splenetomy with reduced portals. Methods: A reduce port laparoscopic splenectomy was performed by using a 10 mm and two 5 mm trocars. To entered the abdomen a trans-umbilical open technique was done and a 10 mm trocar was placed. A subcostal 5 mm trocar was placed under direct vision at the level of the anterior axillary line and another 5 mm port was inserted at the mid-epigastric region. Once it was completely dissected and freed from all of its attachments the hilum, splenic artery and vein, was clipped with hem-o-lock and divided with scissors. Then an endobag was used to retrieve the spleen after being morcellated trough the umbilical incision. Results: This technique was used in a 15 years old female with epigastric and left upper quadrant pain. An abdominal ultrasound demonstrated a giant cyst located in the spleen. Laboratory tests findings were normal. The CT scan was also done, and showed a giant cyst, which squeeze the stomach. The patient tolerated well the procedure, with an unremarkable postoperative. She was discharge home 72 h after the surgery. Conclusion: The use of reduce port minimizes abdominal trauma and has the hypothetical advantages of shorter postoperative stay, greater pain control, and better cosmesis. Laparoscopic splenectomy for giant cysts by using reduce port trocars is safe and feasible and less invasive.

La parálisis cerebral es un trastorno motor debido a inmadurez cerebral con numerosos déficits asociados, incluidos los adaptativos, sociales, motores, cognitivos y de la comunicación, y con gran impacto en el desarrollo. El objetivo del presente estudio fue estudiar el desarrollo durante un año de niños con parálisis cerebral de uno a seis años. El método empleado fue un diseño ex post facto evolutivo secuencial. Se utilizó la prueba de screening del Inventario de Desarrollo de Battelle en un pretest y en un postest transcurrido un año. La muestra estuvo compuesta por 41 niños de entre 1 y 6 años de edad con diagnóstico de parálisis cerebral infantil. Los niños mostraban puntuaciones en el postest significativamente superiores en todas las áreas estudiadas. Se observó una mejora generalizada en las capacidades de la mayoría de los sujetos. Se discuten las posibles influencias que contribuyen a estas mejoras en los cocientes de desarrollo en la obtención de estos resultados.

Cerebral palsy is a motor disorder due to brain immaturity associated with deficit including adaptive deficits, social, engines, cognitive and communication and with great impact on development. The aim was to study the development during a year of children with cerebral palsy from one to six years. The method was a sequential evolutionary ex post facto design. We utilized the screening test of the Battelle Developmental Inventory in a pre-test and a post-test after one year. The sample consisted of 41 children aged between 1 and 6 years of age diagnosed with cerebral palsy. Children in the posttest scores showed significantly higher in all areas studied. There has been an overall improvement in the capabilities of most subjects. Are discussed the possible influences contributing to these improvements in the ratios of development to obtain these results.