Revista Digital de Postgrado

Health in contemporary political models

Jesús Manuel Rodríguez — 2025-04-15

Approximation of the costing and financing of a national supply program for Venezuela based on the modified CAPEX/OPEX method

Maritza Durán — 2025-04-15

This document contains the design of a public financing model for a maternal health policy in Venezuela whose essential intervention consists on the
provision of ideal environments for professional delivery care (delivery rooms). Aiming to this goal and based on the analysis of the epidemiological situation and the risk factors that affect pregnancy and childbirth care in Venezuela, we propose a modification of the CAPEX/OPEX costing method to estimate the cost per unit of care (vaginal birth, delivery by cesarean section and curettage plus uterine revision) within the framework of such a policy.

Kangaroo Mother Method: level of knowledge and attitude of the mother of the premature baby

Ibrahim Peralta — 2025-04-15

Introduction: Preterm birth represents a public health problem that entails high morbidity and mortality rates. The Kangaroo Mother Method emerged as an
alternative for the care of premature neonates. Objective: to determine the level of knowledge and attitude of the mother of the premature infant towards this method in the Neonatology Service of the Concepción Palacios Maternity Hospital in Caracas. Methods: quantitative, descriptive, observational and cross-sectional field research, with a sample of 288 mothers of newborns in the period from June to August 2024. Results: the
mothers were predominantly young (19 - 35 years 53.8%)of urban origin (95.8 %), high school graduates (56.9%) and single (58.7 %). The majority lived with the father of their child (78.8%), received family support (80.2%) and belonged to extended families (61.5%). With a history of up to three pregnancies (75.7%) and three births (93.1%), abortions and molars were recorded in 19.1% and 2.8%. 74.3% of births were by cesarean section, and 9.7% had a history of prematurity. The newborns were mostly male (64.2%), born between 32 and 37 weeks of gestation (76.7%), with a weight of 1,500- 2,500 gr (78.1%). The level of knowledge about the Kangaroo Mother method was high (91.7%) and the attitude of the mothers was positive (100%). Conclusion: the mothers showed a high knowledge and favorable attitude towards the method. Sociodemographic factors such as family type and urban origin influence this knowledge.

Prostate antigen density and multiplanar resonance as predictors in cancer diagnosis

Lizbeidy Vinaja — 2025-04-15

To evaluate prostate antigen density and relationship with prostate multiparametric resonance imaging (mMRI) findings as a predictor in the diagnosis of prostate cancer. Methods: The study was descriptive, retrospective, cross-sectional; the sample was taken from the database in the Picture Archiving Communication System (PACS) of the Imaging Service of the Metropolitan Polyclinic (Caracas), the prostate mpMRI performed in the period January to December 2023. The data were emptied into Microsoft Excel and imported into the IBM SPSS Statistics 20 statistical program.
Results: Patients were aged between 60 and 70 years 51.6 % (n=81), with total PSA of 4.6 ng/ml to 6.5 ng/ml with 28.7 % (n=45), prostate volume between 50 and 80 cc: 31.8 % (n=50), density less than 0.15 ng/ml: 91.7 % (n=144). In prostate mMRI, there were diffuse hypointense bands: 57.3 % (n=90), followed by nodule in the peripheral area <1.5 cm: 21.7 % (n=34), PIRADS 2: 57.3 % (n=90), followed by PIRADS 4 with 21.7 %
(n=34). Pearson's Chi-square correlation of prostate antigen density with mMRI findings is 42.689a with a pvalue of 0.005. Regarding the biopsy results, of 37
patients biopsied with PIRADS of 4 and 5, most had a Gleason score of 3+4=7, which corresponded to the area of suspicion: 67.6% (n=25). Conclusion: It was possible to show that prostate antigen density is a diagnostic tool that helps predict prostate cancer and increases the sensitivity of negative or indefinite MRIs: in this way, unnecessary prostate biopsies could be avoided.

Characterization of cutaneous signs and their annexes in children under 5 years of age with severe malnutrition

María González — 2025-04-15

Objective: To evaluate cutaneous and appendageal signs (skin and nails) in children under 5 years of age referred with a diagnosis of severe malnutrition, who attended the "Dr. Carlos Arvelo" University Military Hospital between January and June 2024. Methods: Descriptive, prospective, observational, and cross-sectional study based on data recorded in the medical history and application of the modified Standardized Clinical Score of cutaneous signs in infants with severe malnutrition. Results: The sample consisted of 28 patients; according to age groups, the majority were between 1 and 24 months, with a mean age of 9.21 months, predominantly male with 64.28 %. Pigmentation changes and extreme thinness were the most common signs, representing 31,48 % and 16,66 % respectively. Regarding other cutaneous signs, the following were observed: ichthyosis (7.40 %), pityriasis alba (18.51 %), angular cheilitis (9.25%), perifollicular dermatitis (5.55 %), skin scaling (7.40 %), and mucocutaneous pallor (3.70 %). Dry, thin, and brittle hair was predominant at 37.93 %, followed by telogen effluvium at 27.58 %. Brittle nails were present in 46.43 %, and thin nails in 32.14 %. Conclusions: Cutaneous manifestations resulting from nutritional deficiencies are diverse, regardless of the type of malnutrition; pigmentation changes and extreme thinness are the most common signs.

Radiological measurement of the diaphyseal angle of the cervical femur in a Venezuelan population

Alvaro Barrientos — 2025-04-15

The objective of the study was to determine the cervico-diaphyseal angle of adults seen in the radiology service of the CEMO Clinic, in Caracas,
between October 2020 and August 2023. Retrospective, descriptive, cross-sectional study, included radiological studies of healthy hips in radiological projections of the pelvis centered on the pubis. Sample of 111 patients between 18 and 95 years old (36 males, 75 females, 81 right and 89 left). The results obtained were compared between sexes and with results from other studies. The findings were as follows: the mean cervico-diaphyseal angle was (133.30 ° ± 5.13) on the right side 132.24 ° and 134.26 ° on the left; The mean cervico-diaphyseal angle for women was 132.48° ± 4.31, and for men: 134.84° ± 6.10. There were no statistically significant differences between sexes. Differences were found between the cervico-diaphyseal angle values from similar studies in
different ethnic groups, with similarities between the Venezuelan and Caucasian American cervico-diaphyseal angles. The study established the cervico-diaphyseal angle value for a Venezuelan population sample, demonstrating several differences and similarities with other countries

Redesign of the Biochemistry competency-based program for the José María Vargas School of Medicine

Ingrist Alemán — 2025-04-15

Introduction: The educational model for the next generations must enhance the capabilities of each human being individually, but, at the same time, it must
allow the confluence of all these individual capabilities as a single force. With the purpose of training medical
students with the integration of skills, attitudes and knowledge that will allow them to better perform their profession in the future, the redesign of the Biochemistry career program at the José María Vargas School of Medicine of the University Central Venezuela was presented. Methods: The development of the program by competencies of the Biochemistry subject of the José María Vargas School of Medicine was carried out in seven stages: 1) Identify the general and specific competencies, 2) Establish the criteria for the organization of the Study Program , 3) Distribute the Competencies using the T Model, 4) Select the contents required in each Module, 5) Select the Learning strategies, 6) Determine the modalities of evaluation of the competencies and 7)
Establish the feedback strategies. Results: The subject program was developed with the necessary consistent, coherent and clear information about what the student will learn, the teaching strategies to be used and the way in which it will be evaluated. This program constitutes one of the first steps in the implementation of an educational model in accordance with the guidelines issued by UNESCO. Conclusions: The redesign of the program of the Biochemistry subject of the José María Vargas School of Medicine was carried out, organizing the competencies to be developed according to the planning established in Model T.

Melanoma on the right Hallux: A case report

Jonathan Mauricio Rosillo Maica — 2025-04-15

Cutaneous melanoma is a malignant neoplasm originating in the melanocytes of the skin. Primary melanomas are usually darkly pigmented but can be amelanotic, and diagnosis is based on a combination of clinical and histopathological findings. Primary melanoma is treated with a wide excision, with margins determined by tumor thickness. Subsequent treatment depends on the stage of the disease; appropriate surgical management is essential for the diagnosis, staging, and optimal treatment of primary cutaneous melanoma. We present the case of a 68-year-old female patient who, two years prior to admission, suffered trauma with a sharp object (knife) to a mole located on the right hallux. She subsequently developed an ulcerated lesion that progressed in diameter and thickness, accompanied by changes in color toward blackish and reddish tones, in addition to a small amount of blood discharge. Amputation of the right hallux was performed, along with sentinel lymph node and lymph node dissection. The pathological anatomy reported: right hallux: Nodular melanoma with partial ulceration, areas of necrosis and recent hemorrhage, completely resected, Clark level: IV
Breslow: 1.6 mm and lymph node dissection of the external right inguinal group plus deep superior right inguinal lymph node group and medial right inguinal lymph node group, respectively: lymph nodes due to known primary melanoma. The patient was discharged due to satisfactory clinical evolution.

Future care of trauma patients in the cities

Juan Carlos Valls — 2025-04-15

Population tendencies determinate the emergence of slum cities. The inequality and marginalization increase the urban violence and determinate than many wounded assist to hospital civil. Tactical centres identified critical zones with new form of violence. The management of this patient’s determinate
new concept and incorporate innovative strategies. Many researchers define a strategic plan for trauma. Hemostatic dispositive, drones, strategies for protect the organs, and preservative management represent some of the innovations. Many challenges must to affront the Trauma Team: access to the critical zone, the security of the team, the correct maneuver application, and the fast transfer. New technological advances and incorporate innovative
strategies need to affront the challenges in the metropolis of tomorrow.

Reflective analysis of the teaching-learning process in surgical specialties: competency-based education approach

Manuel Da Silva — 2025-04-15

This study addresses the teaching-learning process in surgical specialties from the perspective of Competency-Based Education (CBE), highlighting the need to transform traditional models, such as Halsted's tutelary model, into adaptive approaches aligned with the contemporary demands of the health system. A
qualitative, descriptive and reflexive methodology was used, based on an exhaustive documentary analysis. This approach allowed to evaluate the strengths,
opportunities, weaknesses and threats in surgical training, with data collected in academic databases and publications between 2013 and the present. The results highlighted the integration of innovative methodologies such as high-fidelity simulators and virtual reality, essential to strengthen clinical practice and guarantee patient safety. Weaknesses were also identified, such as the lack of uniformity in evaluation methods and resistance to change in academic institutions, as well as threats associated with budgetary restrictions and regulatory policies. The discussion highlights the importance of a strategic analysis to contextualize surgical programs in local and regional realities, adapting international standards. CBE proves to be a comprehensive framework that combines technical, cognitive, and ethical skills with humanistic values. In conclusion, this work highlights the need for profound reforms in pedagogical and organizational models, supported by strategic analysis tools, to ensure adaptive, safe, and ethical surgical training, aligned with the needs of current and future health systems.