bluuebunny/crossref_metadata_2025 huggingface dataset:
Sindrome de Poems
Authors: Casacov Rolando , Díaz Moyano Oscar , Cassino Mercedes
Published: September 2024

Poems syndrome :s a rare multisistemic disorder. It manifestations are Polynueropathy, Organomegaly, Endocrinopathy,and / 01Edema. Monoclonal protein and changes in the Skin. (P.O.E.M.S.)Though some bibliography make no difference with osteoesclerotic mieloma it is considered a real syndrome.The polynueropathy is customarily severe. Although high levels of inrnullo- globulins has been found in the poems, it has not been isolatcd a specific antibody that explain the polynueropathy even though it is strongly suspected.The organomegaly, endocrinopathy, changes in the skin and other systems and involved organs could be in relationship toproducts secreted by plasmatic celis. Wc review the physiopathology and bibliography of the Poems, especially its neurological expression its nosologic location different from osteosclerotic myeloma and a possible relationship to the Herpes Virus S.It was crossed in Medline the terms P.O.E.M.S. and syndrome and were obtained 271 abstracts that were all examined and finallyselected the bibliography considerate meaningful for the objectives. It is presented briefly a case.P.O.E.M.S. is a syndrome that is associated to multiple plasma eclI dyscracia, included the osteoesclerotic myeloma.Prognosis and the treatment vary with the underlying diseasc. As physiopathology of this syndrome is insinuated the action of the interleukines 1- (IL-1 beta) and 6 (IL-6), the vascular growth endothelial factor (VGEF), the tunioral necrosis factor alpha (TNF-alpha) and antibodies anti- nerve.
The P.O.E.M.S. is a syndrome with own Palabras claves: Síndrome de POEMS aso- identity. ciado con mieloma múltiple.The Herpes Virus 8 may plays a key rol Material y Métodos to uncover the Poems physiopathology.
Metastasis de carcinoma de mama en ILEON -COLON y vesícula biliar simulando enfermedades inflamatorias
Authors: Calafat Patricia , B de Diller Ana , Sanchez Carmen
Published: September 2024

The metastasis in the extrahepatic digestive system are not very frequent and their caracteristie is appearing after a long latence period, which takes 3 to 20 years, their symptoms are unspecific and appear to be inflamatory diseases or a second tumor. The most common histological subtype is the lobular carcinoma.Here we show you two cases of breast carcinoma metastasis, one in the ileum-colon and the other in the gallbladder. Both patient started showing symptoms, which lcd to the diagnosis was done in the surgical specirnens wherelobular carcinoma cells which infiltrated from the serosa to the mucosa were observed,The inmunofenotipe resulted to be BCA225, estrogen and progesterone positive. The treatment whit radiotherapy, chemotherapy or hormonal therapy provides bettcr life quality but the average chance of survival after the diagnosis is of a year
Evaluación de un programa social estatal con componente alimentario implementado en la ciudad de Córdoba para la tercera edad. 1999
Authors: Acosta Raquel Susana , Fernández Karina , Fusta Myriam
Published: September 2024

Actually the nutrition programmes had become into a fundamental resource for people living in low social conditions, to cover theirfeeding requires. The elderly retired persons with high socio-economic vulnerability are the direct beneficiaries of a social programme that includes a nutritional intervention executed by the PAMI.Objective: Evaluate the ProBienestar programme at Córdoba Capital City during 1999. Material and method: Descriptive and transversal study. Target group: older aged persons from 60 years oid or more (n=330) and assistance units (n =26)Techniques: Survey observation Variables: Focal Criterions, accessibility, food assistance nutritional quality, socio-economic status, nutrition specialists participation, beneficiaries satisfaction assessed into the following dimensions "satisfaction with the mcl uding requirements", "food assistance regularity", "adjustment to the beneficiaries food consumption standard", "food quality".Results: The beneficiaries are between 60 and 74 years aged; most of them are widows and separated women that uve with their sons or/and daughters or/and grandchildren. The most are owners of the house they live in. There is a different opinion between beneficiaries and  assistance units' responsibles at the moment of establish the including criterions. The food assistance is regular and geographic and administrative accessible. There is sorne difficult by the way of the older aged beneficiaries to recali the food aid boxes. The nutritional quality of the complement for one- person box was assessed as good, while for the two-persons boxes the quality downs. It is adequate to the food consumption standard of the older aged beneficiaries. Conclusion: The satisfaction degreeof the beneficiaries is high. (73%)
Aislamiento de microbacterias medioambientales en suelos de la ciudad de Córdoba
Authors: Ballarino Guillermo , Eseverri Verónica , Andrea Salas , Giayetto Víctor , González Silvia , Wolff Lidia , Pessah Oscar
Published: September 2024

The 1 nterest ror the research on enviromental mycobacteria has risen over the last decades, in part, due tu a significant incidence rate risc. Reports from afl over the world address the soil as the major source for human contamination. In Argentina two documents report the prevalence of atypical mycobacteriosis at Córdoba (1997), and the isolation of envir( mental mycohacteria from soils of [he Province of La Pampa (1999) respectively. The aim of our study vas lo conf irm the presence of enviromentalmycobacteria in soil of the city of Córdoba. The map of the city was divided in 9 regions according tu avcnues and major streetsdistribution. A total of 120 soil samples were reco!ected with spatula from a 10 x 10 cm scliic up lo 1 cm deep. Samples were kept at4°C no more than 7 days. Soil samples v ere homogenized with destiled water in a 1:1 prOportioi, and decontaminated according loPetrot'f's method. The cultures were macle in Lowestein-Jehnsen media and incubated at 37°C controlling development every 7 days for 2 months. An acid-fast-bacilli smear vas made from colonies obtained. Twenty three cultures (19%) were discarded due to contamination. Twcnty cultures (1717(;) developed acid tasi bacilli (AFB). Colonies obtained were seni to the Mycobacteria Service of the instituto Nacional de EnJrniedades infecciosas Di: Carlos G. Malbrán, in the City of Buenos Aires, for identification. A single isolation was idenlified as Mycobacteriu,n triviale. A positive correlation was obscrved between the &equcncy of positive AFB isolation and the number of sarnples taken from park areas. The presence of enviromental rnycohacteria in soils of Córdoba wasconfirmed. Resulis suggest higher odds of isolation in parklands and soils where anirnals live. Extensive works are needed to asset the features that allow and contribule the proliferation of mycobacteria in sol ls.
Cystoadenocarcinoma of the urachus
Authors: Zerbib Phillipe , Koury-Helou André , Paul Lada , André Brams , Marescaux Jacques , Chambon Jean
Published: September 2024

The cystoadenoma of the urachus is an uncommon disease which should evoked in case of a upper vesical (supra vesical) cysticrnass. Many authors recommended total cyslectomy but recent reports considered that conservative surgical trcatment improved thequality of life without modifying the survival rate.
Arteria hipogástrica. Su anatomía y ligadura
Authors: Jáuregui Esteban , Traverso Sergio , Garelli Andrés , Graneros Héctor , Sezín Mario
Published: September 2024

This anatomical study haas been done to determin [he diffcrcnt segnlcnts of the hipogastric arthery with it's relationships and the place in which it should be surgicatly ligated in emcrgency situations, particu]ary ginecologic and ohstetric
Tecoma luteinizado de ovario asociado con peritonitis esclerosante
Authors: Olenchuk Alejandro
Published: September 2024

Wc are reporting a case ofa 60 year oid woman who was operated oit of mal ignat tumor of ovary in 1990. Afier 10 ycars. she presentes a tumor in the other ovary that turned out lo he a luteinized thecoma with sclerosing peritonitis.
Síndrome de MÜNCHHAUSEN
Authors: Oviedo Belia , Salvini Stella , Bauducco Guillermo , Blangino Karina
Published: September 2024

Munchhausen Syndrome can be expresed in many differcnt ways. Wc report the case of a patient with cutaneous manifestations.Possible differential diagnostics are being analysed in both dermatology and psycopathologic aspects. Although the syndrome appears frequcntly, i ts unsuspected ways of presentation make difficult to diagnose it. It is necessary the knowledge of this syndrorne because of the morbid-mortality it implies.
Natriuretic peptides as markers of cardiovascular disease. Their use in diagnosis, prognosis and therapy
Authors: De Bold Adolfo
Published: September 2024

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Seudoquistogastrostomía espontánea manejo selectivo del seudoquiste agudo pancreático
Authors: Muñóz Juan , Montenegro Rolando , Cejas Hugo , Canga Carlos , Chércoles Ricardo , Gramática Luis
Published: September 2024

Background: In our medlum, acute pancreatic pseudocyst occur after severe acute pancreatitis or pancreatic trauma The Initial diagnosis Is made by ultrasound examination, computed axial tomography and less frequently, by clinical assessment. Treatment may be elther surgical or minimal invasive Objectives : To present a patient with a large acute pancreatic pseudocyst whlch had a spontaneous resolution. Material and Methods : The patient was a 71-year-olcl male who hacl an attack of severe acute pancreatitis complicated by infected pancreatic necrosis requiring serial necrosectomies and cholecystectoiny; he then developed a 20 cm acute pancreatic pseudocyst. The severity ofthe disease and its implication on the patient's general condition delayed treatment en the pseudocyst, whlch in lts natural course, spontaneously drainecl into the stomach with no cornpllcations or relapses. Conclusion: Acute pancreatie cysts larger than 6 cm persisting for more than 12 weeks are usually surgically treated. Sorne cases, as the one reported below, could be managed by non-surgical rneans with adequate follow-up.
Fracturas traumáticas del esternón
Authors: Sarquis Guillerno , Velez Sebastián , Suizer Alejandro , Reche Fabián
Published: September 2024

In human Chagas'dlsease previous work has shown the occurrence of a T- lymphocyte CD4-posltive population (a high producer of PAS-positive glycoprotelns) with evidence suggestlng a role In the formation of damages to the inyocardlum and neural structures in chagastc heart disease (ChHD) (5-7). Other workers have taken such facts Into consideration and have employed gangliosides (blological substances with neurotrophlc and !mmunomodulatory properties) in chagaslcs with chronic cardiomyopathy and disautonomic signs, obtainlng an improveinent in functional slgns and a decrease in the number of PAS+ lymphocytes (10). In the present work we have studied the effect of mixed gangliosides (Cronasslal') on cell cultures of total leukocytes, or on mononuclear cells preparecl through Flcoll-Hypaque. Bloocl vas obtalned from 14 patients with ChHD. Experlinents were undertaken to assess the effect of policlonal mltogens Phytohaernagglutinin (Phy) and Concanavalin A (Con A) on hlastic transformation, estimated by celi slze and cytologic study. In addition, the production of PAS+ substances by thelyniphocytes and blast were assessed. Gangliosides were added at final con centrations of 100 mg/ml or 200 ing/ ini. Ceil viability \vas assessed by means of the Trypan blue test. With respect to biastic transforination, results showecl a slgnlflcant ciecrease in the cultures that received gangliosides 24 hours before mit.ogen adnu nistration, as corupared with controis (1)<0.00 1) (both forPhyandCon A). Qn the other hand, the production of lyrnphocytic PAS+ substances decreaseci in the cultures of chagasics in which gangliosides were added. Sorne of these results confirmed previous findings on the matter (3). TI-te facts suggest that gangliosides can modulate sorne lyinphocytic activities In chagasics.
Enfermedad inflamatoria pelviana asociada a Bacteriemla por Neisseria Meningitidis
Authors: Leoni Alberto , Littvik Ana , Moreno Susana
Published: September 2024

The Pelvic Inl1ammatory clisease (PID) caused by Neisseria meningitidis (Nr-, as an extraneurological manifestatior considered as a case study with few precedents. it is so lar known that the occasional transposition of ecological niches occurs. There are severalbibliographieal reports that show an increase in the colonization of the genitourinary tract due to Nm. These may or may nol cause disease in individuals during colonization. In adults, the symptoms and any complications which may arise are similar to those caused by} Neisseria gonorrheae (Ng). It is highly necessary to correctly identil`y the agents of Neisseria gender which are obtainedfrom the genital tract. This permits an accurate diagnosis to be made and results in a better understanding of the epidemiology. Morbimortality arising from Nm infection is worth studying to produce a better knowledge of ihe phalogenia of the infection caused by this microorganism.
Prevalencia de infestación por pediculus humanus capitis en escolares de Despeñaderos (Provincia de Córdoba)
Authors: Ramírez Alejandra , Ludueña Almeida Francisco , Almirón Walter
Published: September 2024

Eriterococci causes serious ihlness in immunocompromised patients and in severely ill. hospi talized patienis. Thcy are comrnonly isolated from the human gastrointestinal tract, and rcsistance to vancomycin has increased in frequency during the past fewyears. We report three cases of nosocomial vancomycin resistant Enterococcus faecium (VRE) infections from September to December of 2000. A 54-year-old man presentedpost surgical wound infection due lo VRE after 2 months of hospitaliza tion. The seconcl is a 65-year-old neutropenic patient with a medical history of acute mieloici leukemia and esophageal carcinoma. In this case, central venous catheter was colonized with EVR. The third, a 65-year-old wornan who received therapy with ceftriaxone, ciprofloxacin and clindamicin had a urinary tract infection due to EVR. The three isolates were resistant to vancornycin (MIC value > 256 pg/ml). The DNA amplification pattern obtained by OD-PCR were similar in the three cases
Encelopatía de Creutzfeldt - Jakob con mutación E200K - A propósito de un caso resportado como "esporádico"
Authors: Cosacov Rolando , Taratuto Ana Lía , Ghiraridi Graciela , Barrionuevo Pilar , Díaz Anatilde , Begué Christian , Martinetto Horacio
Published: September 2024

reutzfeldt Jakob discase (CJD) has the highest incidence of the wholc group of transmissible spongiforin encephalopathies or prion diseases, which have the unique feature among all pathologies, to be able to appear as infectious/iatrogenic, sporadic or hereditary, bcing common to all, the deposition of an abnormal prion protein (PrP- , ) in (he central nervous system. More than 20 mutations of the gene (PRNP) (hat encodes (he prion protein have been described. Wc here report a case of CJ13(E200K) refered as probable 'sporadic' according Lo WHO. Methods: clinica.l, pathologíc, and molecular features of the disease were characLerized using EEG. neuropaLholo'. prionprotein (PrP) Westerri blot and gene (PRNP) analysis. Results: The paticnt developed visual hallucinations, myoclonus, memory loss, tremor, clisbasia and gencralized convulsives seizures dying six months after onset. On neuropathologic examination,spongiform changes were observed and PrP immunopositivity detected. Western blot analysis showed the presence of proteinaseK (PK)—resiskmt PrP (PrP 1 with the nonglycosylatedisoform of approximately 21 kd. and DNA restricuon fragment length polymorphism ( RFLP) analysis showed the E200K mutation. Discussion: The PRNP(E200K) mutaUon is (he mosi frequent cause of the hereditary-familial CJD (ÍCJD). Clusters of (bis variety have been described in Chileans, Slovaks from Orava, Jcws Israclies of Libyan origin, and Japanese. Thcre was no available data of affccted relatives of the patient which have suggcsted he was fCJD, but due (o his Chilcan origin PRNP studies werc carried out. In fact (he clinical and palhology of (his familial forrn, with remarkable cxceptions, resembles sporadic cases but has a greater incidence, in these groups (han sporadic in (he general population. Conclusion: This patien L. although clinically reponed as probable 'sporadic', after molecular characterization rcsulted a CJ13(E200K) probably belonging Lo (he Chilean cluster.
Factores de riesgo asociados a hemorragia digestiva alta, en sala común
Authors: Pérez Hernán , Escudero Millán Andrés , Savio Ver´´onica , Yorio Marcelo
Published: September 2024

Upper gastrointestinal bleeding -UGBas a complication, is well studied atintensive care units (l('IJ). but is lcss known in non ICU settings. Objectives To determine incidence and risk factorsof this cntity at clitiical itospitalization. Materials and Methods: A case-control study of patients with gastric ulcer discasediagnosecl by cndoscopy who presented with melena and hematemesis. Ten controls were taken for each case, matching sex, age and propliyltxis for gastric hemorrhage. Dcmographic data and othcr know risks factors were analyzed. Result: We found ten blecding case among 35070 discharges (incidence: 2.8/10000 clischargcs). Mortality vas not increased but the numnber of transfusion was higher in the bleecling group. Wc found an assocciation hetwen tJGB and systemic inflaniatory response synclrome -SIRS- (OR: 9.22 IC 95% 2.98-28.17) and diabetes (OR: 7.8 IC 95% 2.3-268). The resi of the factors studicd did not rich a statistical significance. Conclusions: UGB (lo ring clinical hospitalization is a rare coniplication that requires al] increased staying at hospital and a great numher of transfusions. It may be probably associated in a positive way with diabetes and SIRS.
Actividad física e insulinorresistencia en dos comunidades rurales de Córdoba - Argentina
Authors: Delera Carlos , Lúquez Hugo , Ferreyra Julio , Senestrari Daniel
Published: September 2024

From the AF, the smaller risk is controversial. The influence of the general and environmental cornponents on IR is not know in a satisfactoryway. Objectives: The influence of AF on the prevail IR in two rural cornmunities of Córdoba with different fenotipical configuration and IR risk. Material and methods: Transverse stucly (survey, clinical and biochemnical checkup) over 1143 people of Oncativo community (ON) and Dean Punes (DF), conclusion: n=673 (30-60 years oid) Normal ECG, no diabetics. Sorts AF according to the spend of calores (Kcal/sern): a) sedentary (<500), b) Iow(5001-1000), e) regular (1001-2500), and d) High (>2500). IR is HOMA> 2,5; where [HOMA = (Glucemia * Insulina) / 4.5]. Results:AF: 31,4%sedentary, 20,2%low, 26,3% regular and 22,1% high. 16,5% IR in ON opposite 34,8% en DF (P< 0,00 1), IR in ON 8,2% with AF high opposite 18,8% the rest (P=0,032), 36,8% and 34.2% like in DF (P= 0,67). With the adjusted results for age and community it was found less IMC (P= 0,002) and waist circumference (P= 0,042) than the most category of AF The blood pressure liad not a meaningful change, lipid profile or HOMA depending of AF Conclusion: if a benefit of AF over IR exists, it will be conditioned for genetics and environmental primaries determiners
Reconocimiento de Salud y registro de enfermedad en la promoción de la salud bucal
Authors: Ulber de Baluatti Valentina , Orué Carlos , Herrera Ariel , Gait María Teresa , Hilas Elena , Cornejo Lila
Published: September 2024

Background: At present, epidemiologic dentistry has nunterous indexes to measure illness such as DMPT, dnift ami S-OHI which are broadty used for illnessdiagnosis in clilferent population groups. Qn the other hand, the mdcx INSAO proposed cliffers from the approach focused on the disease itself. INSAO offers a paranieter to measure the degree of health of teeth and gums and thus provides the patient with the infornation about their health. Objetive: The aún of this study is to analyze the usefulness of the information provided by the traditional indexes and those recorded by INSAO, to the oral health evaluation in rural schools of the north of Córdoba, Argentina. Material and Methods: A cross-sectional study was carried out in school children, aged 5 to14 attending 8 rural primary schools. Data was collected froin a clínical exarnination. Caries experience vas measured according WHO indications. The drnf-t and DMF-T indexes were determincd. Oral hygiene was evaluated by means S-OHI. The total arnount of teeth present in the mouth, sound teeth number, and the state of the gum were registereci to built INSAO mdcx.. Results: Inverse correspondence is observed between dental health leve¡ through INSAO and the disease through pi-oportion of permanent and temporary teeth with cavities active recorded by dmft and DMF-T indexes. Conclusion: Theapplication of INSAO is presented as a valuable instrument in the promotion of oral health in conirnunities that belong to excluded social groups due to their special characteristics.
Resección toracoscopia de una glándula paratiroidea hipersecretante mediastina
Authors: Gramática (H) Luis , Mercado Luna Andrés , Verasay Guillermo , Brizuela Adrián , Gramática Luis
Published: September 2024

In general experienced hands, the inferior parathyroid glands, localized in the thymus or low extrathyrnus are the malo cause or surgical therapeutic fallure. When they could not be approached through cervicotomy, or when they were diagnosed after surgery the sternotoxny or the angiographic ablation were chosen as treatment. The limited number of thoracoscopic approach whit good results published so far, moved us to use this inethod. Material and method: patient of 49 years with a 7 year secondary hiperprathyroidism due to CRI. After a sub total parathyroidectomy with bilateral thimectomy, the patient did not present clinical or laboratory irnprovement. Through a thoracic centellogram sixth MIBI, NMR and CAT, a tumor In the rniddle mediastinurn was fond. The mediastinal structures have been easlly Iclentified through a left thoracoscopic approach. At the level of the aortopulmonary winclow, a turnoral mass is located and, with a simple dissection, et is easily extracted in bag. The biopsy through freezlng conflrms the parathyroid etiolo, of the gland. Result: clinical and laboratory evolution has been favorable, with hospital discharged at the 3- day, and being asyrnptomatic after two years. Conclusion: the hipersecretant parathyroid glands, located in middle mediastinum, that can not be approach through cervicotorny, can he successfully approach through thoracoscopic technique
Prevención del cáncer de Cérvix: puesta al día
Authors: Irico G , Escobar H , Marinelli B
Published: September 2024

It has been seen an increase of the cervical cancer and of intraephitlial cancer in the last  years. The most irnportant risk factors for cerviz cancer are sexual conduct, early of sexual  relationships.number of partners, cigarretts, oral anticonceptive, pregnancy,  inmunosupresion, sexually transmited illnes. And an important role of the human Papiloma  Virus. The I-IPV has been clasified lo 3 groups; low risk, the most frecuents are 11 and 6,  middle risk, tipe 31, 33 and 35, and high risk, 16 and 18, that have frecuent asociation with  cervical cancer and with high grade intraephitlial lesions. The cervicovaginal citology is  still the most accurate diagnosis mcthod to detect SIL or CIN and invasive cancer lo early  stages, it is discussed the periodicity and group of women to whom the method must point.  There are diferent options depending if it ¡s a SIL of low or high grade or and cancer. With  the possibility of doing folow up or treatmcnt, such as. LLETZ, Laser, Criotraphy, cone and interferon for the preneoplastic lesons. The achievement of a vaccine for HPV could have a a significant impact en these phatology.
Una experiencia del uso de las NTIC (nuevas tecnologías de información y comunicación) en la enseñanza del sistema inmune
Authors: Novak Ivón
Published: September 2024

Introduction: Not very often an integrated approach is applied in knowledge arcas as lmmune System, instead, the contents are usually a sort of "atomization" that prevents from having a holistic vision of the set as a whole. At the mornent, our university students usually incorporate the Internet lo their study work, similarly, the teachers can resort tu this tool to "widen" the boundaries of the real classes. Perhaps, to achieve a deeper study leve¡ in this knowledge field, the use of NTIC may resultan appropriate resource for complementing and supporting the current conventional techniques. Objective: To create a communication space designed to deepen and up-date knowledge as well as to help the student construct a comprehensive, signlficant structure of knowledge by making iriterrelations with concepts previously acquired. Material and Methods: Course supported in a digital platform Moodle like, in LEV. FCEF and N, UNC. http:// routerlab.efn.uncor.edu/moodle Category: Natural Sciences. http://lev.efn.uncor.edu/course / category.php)id=2 Resources: Power Point files: "Immune System" and "Cytokines"; forum discussion. Contents selected and organized upon a constructivist approach aiming at a reflective student responsible for his own learning (self learning). Results: The students according to their own concerns and time availability selected to deepen the knowledge fleid. The possibility to interact perrnanently in the discussion forum generated closer bonds between the participants, enriched the analysis about the different dealt issues, raised concerns that altogether brought about the rebuilding of the contents in a signiflcant learning. Conclusions: Bearing in mmd that the educational contents are vital, it also has been proved that the use of NTIC provides of tools for the distance education courses and of useful resources for the teaching-learning sciences. Gratefulness: Eng. Carlos Bartó, Director of LEV, FCEF and N, UNC.
Seguridad del tratamiento combinado de metotrexato y leflunomida en pacientes con artritis reumatoidea.
Authors: Nesa L , Gobbi Carla Andrea , Alba Paula , Exeni Ida Elena , Babini Alejandra , Albiero Eduardo Horacio
Published: September 2024

Rheumatoid Arthritis (RA) is a chronic  discase leacling to functional impairrncnt and early mortality. Treatment with diseasernodifying antirheumat.ic drugs have shown to achicvc disease remission and improves its evolution. The use of combined therapy should have a biological efficacy, no increased toxicity and have an acceptable dose interval. Also, it shoulcl begin its action quickly and he cost-effective. Aims: to assess the security of the combinen treatment withMethotrexate (MTX) and Leflunomide (LF) in patients with Rheurnatoid Arthritis (RA) and to evaluate whethcr the dose and route of MTX administration influence on the toxicity. Patients and Methocls: Patients with RA who fulfihlecl ACR entena and they attencled to the Rheumatology Unit at Córdoba Hospital in the Iast 2 years were assessed. All the patients that received combined treatment with MTX in doses from 7.5 mg to 25 mg weekly orally (PO) orintramuscularly (TM) that started LF treatment in doses of 20 mg/day due to disease activity persistericc were retrospectively assessed.Patients having at least 6 months of combined treatment were inclucled. Data ontreatment and adverse events were collected. They were evaluated at the hegirining, at 6 and 12 months of treatment. The presence of adverse events as well as the stop of combined treatment was evaluated at 6 and 12 months 01treatment. Adverse events in patients with oral and IM MTX treatment and in different doses were compared for the analyses. P<0.05 was considered significant. Results: 62 patients with a mean age of 54 were included. 89% were female and had positive rheumatoid factor and 83% had radiological erosions. Eighty eight percent were in doses of I5mg MTX, 4.9%with lomg and 2flrngattheheginning of LE treatment. Twentv four percent suffered from adverse events and 33% left the medication by 6 months. Among adverse events, 6 patients had cliarrhea, 5 increased hepatic enzymes, 3 alopecia, 3 weight loss, and2 had anemia and leucopenia. Eight patients stopped the medication in 6 months, but only 5 did because of adverse events. There was not significant statistical differcncc in adverse events hetween patients with different dose or routes of administration of MTX. Conclusions: The presence of adverse events in MTX and LF combined treatment was low and it developed dunng the first 6 months of treatment in our patients. The MTX route of administration and doses did not influence on the toxicity of the combined treatment with LF. The combinedtherapy seems to be a sale treatment option in RA patients.
Nefritis Lupica
Authors: Alba Paula B. , Albiero Eduardo H. , Yorio Marcelo A.
Published: September 2024

Systemic Lupus erythematosus (SLE) is an autoimmune, multisystemic disease characterized by numerous patterns of clinical and immunological manifestations. One of the distinctive markers is the production of autoantibodies, especially to nuclear antigens that include double chain DNA (ds-DNA), histones and soluble ribonucleoproteins (RNP) and Sm antigen. Numerous factors contribute to the formation of these and these include: the loss of tolerance of B and T cells, an increase in concentration and an abnormal presentation of autoantibodies (e.g. nucleosomes), and defects in the clereance of apoptotic cells among others. The variability in these events influences the nature and organic commitment in SLE.
Genetic of obesity
Authors: Cuestas Eduardo
Published: September 2024

Background: Obesity is a complex phenomenon that involves interactions between environmental and genetics factors. The genetic studies in animal models and humans has allowed great progress in the knowledge of body weight regulation. Identifying the hypothalamic leptin/melanocortin pathway as critical in many cases of monogenic obesity has permitted targeted, hypothesis-driven experiments to be performed, and has implicated new candidates as causative for previously uncharacterized clinical cases of obesity.Data sources: Narrative review. PubMed, Lilacs and ScieLo databases were searched with the terms “obesity”, “genetics” and limited only for “ all child 0-18 years”.Results: Numerous studies in children and adolescents, have tried to identify candidate genes. At present, the results are not conclusive. Thus, is yet premature genotype obese child on a large scale for predictive testing. Meanwhile, the effects of mutations in the melanocortin-4 receptor gene, for which the obese phenotype varies in the degree of severity among individuals, are now thought to be influenced by one's environmental surroundings. Molecular approaches have revealed that syndromes previously assumed to be controlled by a single gene are conversely regulated by multiple elements.Conclusions: When specific treatments based on recent discoveries become available, genetic testing could help to discriminate different types of obesity that may respond differentially to therapeutic measures.
Non acid gastroesophageal reflux episodes decrease with age as determined by multichannel intraluminal impedance-ph monitoring in symptomatic children
Authors: Orsi Marina , Cohen-Sabban Judith , Grandi Carlos , Donato María Gabriela , Lifschitz Carlos , D’Agostino Daniel
Published: September 2024

Objectives: To determine whether changes related to age in gastroesophageal reflux (GER) in infants and children are due to acid, non acid reflux or both, as determined by 24 hr pH probe (pH) and Multichannel Intraluminal Impedance (MII).Methods: Tracings of simultaneous pH-MII from 243 infants and children who presented with either digestive or respiratory symptoms attributable to GER were reviewed and analyzed using Mann-Whitney U test.Results: The number of GER episodes recorded was similar among children with predominantly gastrointestinal and those with respiratory symptoms. A significantly higher total number of GER episodes was observed by pH probe and MII in children under 22.8 mos of age compared with those who were older (median 159 vs. 110.5, p = 0.002). There was no significant change with age of acid reflux (AR) parameters. The changes observed were due to the significant decrease of non AR for all parameters measured, regardless of the presenting symptom.Conclusions: The decrease in GER parameters that is observed after a mean of 22.8 mos. of age is at the expense of non AR. This finding may have an impact on the choice and results of therapeutic modalities in children versus that in infants.
Síndrome antifosfolípido
Authors: Alba Paula , Yorio Marcelo
Published: September 2024

Since the first detailed description of antiphospholipid syndrome (PAS) by Dr. Graham Hughes, this condition is today one of the most frequent autoimmune diseases. The impact of this description has been enormous, as the recognition of individuals with connective tissue diseases requiring anticoagulation instead of steroid treatment or with non-steroidal anti-inflammatory drugs has led to a fundamental change in medical practice.
Utilidad clínica de la hemoglobina reticulocitaria equivalente en pacientes en hemodialisis crónica
Authors: Eckhardt Andrea , Freiberg M. , De la Fuente Jorge Luis , Douthat Walter G. , Capra Raúl Horacio
Published: September 2024

Background. Iron deficiency is the main cause of failure to respond to erythropoietin (EPO) in haemodialysis patients. Several laboratory tests to detect the deficiency, ferritin and transferrin saturation (TSat) are the most commonly used but its limitations in this patient population are necessary to find other parameters to improve the identification of iron-deficient state. Objective. To evaluate the ability of Reticulocyte Hemoglobin Equivalent (RET-He) to predict iron deficiency, taking as a reference standard to the increase of hemoglobin in response to iron intake. Materials and Methods. 44 patients on chronic hemodialysis and fixed-dose EPO received 400 mg of intravenous iron. Were measured Hb, Ret-He, IRF, and ferritin prior to iron administration. After 20 to 30 days of completion of loading the patients were classified as responders if hemoglobin increased by at least 0.8 g / L and non-responders if this increase did not occur. Result. 25 patients were reponders, the ROC curves analysis showed the Ret-He with the largest AUC of 0.862 similar to the AUC of 0.833 that showed the IST, but the first is more sensitive (72% CI 95%: 51-88% vs 52% 95% CI 31-72%) and similar specificity (94.7% CI 95%: 74-100% vs 100% 95% CI 82-100%). Ferritin AUC was 0.772 and finally the IRF AUC was 0.7. The Ret-He, to a cutoff of 29.5 pg was the best combination of sensitivity and specificity (72 and 94.7 respectively), and the sensitivity of the combination Ret-He/IST rose to 80% specificity 94.7%. Conclusions. According to these results it could consider to Ret-He and the Ret-He/IST combination of clinical utility for the identification of the iron deficit in patients in chronic haemodialysis.
Las nuevas estrategias para inventar enfermedades
Authors: Cuestas Eduardo
Published: September 2024

The perception of health is increasingly bombarded by a series of seductive messages that state that the ideal of health is reached through the consumption of drugs, operations or other medical interventions that produce apparent well-being.In contemporary Western societies, based on the maximization of economic benefits above all else, it is increasingly common for patients to be transmuted to clients-consumers, and these have gradually and increasingly become accustomed to buying, within the possibilities and coverage of each person, everything they want, desire or understand that will make them happy.
Premios nobel 2011: Células dentríticas, receptores toll y sus aportes a la medicina básica y translacional
Authors: Geffner Jorge , Rabinovich Gabriel A.
Published: September 2024

On October 3 of this year the Nobel Assembly of the Karolinska Institute jointly awarded the 2011 Nobel Prize in Medicine to Bruce A. Beutler and Jules A. Hoffman in recognition of their discoveries about the activation of innate immunity. Beutler and Jules A. Hoffman in recognition of their discoveries about the activation of innate immunity, and Ralph M. Steinman for his discovery of dendritic cells and their role in adaptive immunity.
Hematoma mediastinal espontáneo secundario a ruptura de adenoma quístico de paratiroides ectoópica
Authors: Bürgesser María Virginia , Diller Ana , Bustos Mario Eduardo , Debernardi Diego Martín , Bernabeu Francisco
Published: September 2024

Atraumatic spontaneous mediastinal hematomas are uncommon. They are secondary to trauma, rupture of great vessels or heart and associated to iatrogenic events. We report a case of a 61 year-old woman who consults for mediastinal hematoma without previous trauma. Imaging studies ruled out cardiac or vascular lesions. At exploratory thoracotomy, a large mediastinal hematoma was evidenced without obvious mass or bleeding vessel. The material sent to the Pathology service was diagnosed as cystic adenoma of ectopic parathyroid gland. Mediastinal hematomas are related to traumatic causes, cardiac or great vessels rupture or iatrogenic proceedings. Once these causes are ruled out, an injury of ectopic parathyroid tissue must be considered in the differential diagnosis because mediastinum is the most frequent ectopic location. Histopathological and immunohistochemical studies are useful in determining the cause-related hematoma, as in this case determined the parathyroid origin of the lesion, and to rule out involvement by other tumors.
Calidad de vida en pacientes EPOC con oxigenoterapia crónica domiciliaria
Authors: Balbo Noélia A. , Acosta Mara A. , Kevorkof Gregorio V.
Published: September 2024

Chronic Obstructive Pulmonary Disease (COPD) leads to disability, being long-term oxygen therapy (LTOT) fundamental in final stages. It is important to assess its impact on patient's daily life.Objectives: To describe factors that determine the quality of life in COPD patients with LTOT, taking into account demographic variables: age and sex, Physiological: POST BD FEV1, BMI, hours of use of OCD and SpO2, Psychological: Dyspnea: St. George's questionnaire (SGRQ ) and Hospital Anxiety and depression Scale .Material and Methods: Observational, cross. 26 patients were included without associated comorbidities.Results: 73.07% male, age: 61.73 ± 1.48 years, the average hours of use of LTOT was equal to 18.88 ± 0.77 hours, the average post-BD FEV 1 was 34.23 ± 2.63%. More anxiety and depression were observed among females. Age had an inverse correlation with the lung function but it had positive lineal correlation with the perception of dyspnea. There was less perception of dyspnea with more hours of use of LTOT. Statistical significance was achieved for the perception of dyspnea and post BD FEV1 as well as with perception of dyspnea and anxiety /depression (p <0.05).Conclusions: Anxiety and depression are highly prevalent symptoms in patients with severe COPD that also use LTOT, being higher in women. We stress the importance of using validated scales of quality of life and mental health status, to assess the overall impact of disease and optimize the treatment.
Evaluación comparativa de eficacia y tolerancia de hierro sulfato y hierro polimaltosato para el tratamiento de anemia ferropenica en lactantes
Authors: Amaral Diego , Galimberti Griselda , Cuesta Soledad , Pinto Juana , Ferrario Claudia , Graciela Elena
Published: September 2024

Introduction: Iron deficiency anemia is the most common nutritional deficiency in children under 2 years, affecting to 34.1% in Argentina. Iron supplementation is the standard treatment. The aim of our study was to evaluate the efficacy and tolerability of two iron containing drugs. Methods: Randomized, double-blind, controlled trial, including children aged 6 to 18 months with iron deficiency anemia (hemoglobin < 11 g/dl, transferrine saturation < 20%). Patients were randomly assigned to one of two treatments: iron polymaltose  complex (IPC) or ferrous sulphate (FS). Efficacy, tolerance and adverse events occurrence were evaluated. Results: 60 children with iron deficiency anemia were included; 29 in the FS group and 31 in the IPC group. There were no significant differences between groups regarding hemoglobin at baseline (10,09 ± 0,92 vs. 10,26 ± 0,41; p= 0,17) and after 90 days treatment (11,26 ± 0,49 vs. 11,14 ± 0,60; p= 0,21).Also, there were no differences regarding adverse events frequency (FS: 4/29  y IPC: 9/31; p=0,2). Conclusions: In our study, there were no differences in efficacy and safety between FS and IPC in the treatment of children with iron deficiency anemia.
(Des)-Encuentro Medico-Paciente
Authors: Estévez Alberto , Broschi Marcos
Published: September 2024

The great medical act, in the field of medicine for which they prepare with special emphasis all the medical students, it's the meeting doctor - patient, commonly known as medical consultation or simply consultation....
Efecto de la altitud sobre el peso al nacer y eventos perinatales adversos en dos poblaciones argentinas
Authors: Grandi Carlos , Dipierri José , Luchtenberg Guillermo , Moresco Angélica , Alfaro Emma
Published: September 2024

Introduction: Depending on the geographical altitude the purpose of this work was to analyze in two argentine populations the variation of birth weight (BW) and adverse perinatal outcomes, adjusting for maternal and obstetric factors.Material and Methods: Data from 4000 births in the provinces of Jujuy and 4000 in Buenos Aires (Sarda Maternity Hospital) (1996-2000) recruited and randomized from the Perinatal Information System was used. The data were grouped according to an altitudinal gradient composed by Sarda Maternity (20 masl) and the geographic regions of Jujuy province: Ramal (500 masl), Valle (1200 masl), Quebrada (2500 masl) and Puna (3500 masl). Outcome variables were BW > 3000 g, BW <2500 g, ponderal index (PI), prematurity, small for gestational age (SGA) and intrauterine growth restriction (FGR), while potentially confounding variables were: age, type of partner, education, overweight, obesity, smoking, hypertension, preeclampsia, urinary infection, growth restriction and cesarean section.Results: An increasing altitudinal gradient for adolescent mothers (<19years) and decreasing for the rest of the maternal obstetric variables was observed. The BW, BW>3000 g, BW<2500g and PI were negatively associated with altitude (p <0.001). Prematurity, SGA and FGR showed an opposite trend (p <0.001). Adjusted for confounding variables BW <3000 g, SGA, FGR<0.90 and PI <2.53 showed an increased risk with geographical altitude (p <0.05).Conclusions: Altitude was independently associated with BW restriction and adverse perinatal outcomes. Given the impact of BW reduction in the risk of chronic no communicable diseases this relationship in other populations, regardless of their location altitude, should be assess.
Predictores de coqueluche al ingreso en lactantes hospitalizados con infección respiratoria aguda baja
Authors: Laura Moreno , Montanaro Patricia , Bujedo Elizabeth , Cámara Jorge , Abilar C. , Terzoni M. , Romano M. , Inés Marqués , Quiroga Daniel , Orecchini Alejandra , Jacome Javier , Ferrero Fernando
Published: September 2024

Background. Pertussis, or whooping cough, caused by Bordetella pertussis (BP) is a re-emerging problem in our environment. Although generally considered that the disease is relatively easy to identify infections respiratory syncytial virus (RSV) can present with similar symptoms in infants remains difficult discrimination.Objective. Compare clinical symptoms at admission and complementary studies in infants hospitalized with acute respiratory infection (ARI) and RSV by BP to establish markers that enable their early clinical prediction.Materials and methods. Observational, analytical, case-crossover cross comparing younger than 6 months hospitalized with suspected IRA and pertussis (2007-2012) in which BP identified (PCR and culture) and / or VRS (immunofluorescence in nasal secretions). Coinfections were excluded. Bivariate analysis was  comparaperformed by calculating OR with 95% CI. Were considered significant at p <0.05. The variables studied were age, sex, hits cough, cyanosis, vomiting, apnea, wheezing and CBC with differential.Results. We included 174 infants, 72 (41%) BP and 102 (59%) VRS. Age 2 ± 1 months (range :1-6). In both groups was documented cough and wheeze (OR: 1.2 (0.9 to 1.5) p: 0.1 and OR = 0.9 (0.8 to 1.06) p: 0.2, respectively ). Cyanosis (87% vs. 6%, OR: 14.8 p <0.01), apnea (38% vs. 3%, OR: 13.4 p <0.01) and vomiting (26% vs. 5% , OR: 3.4 p <0.01) were more frequent in infants with BP. The absolute lymphocyte count was significantly higher in children with BP (9387 ± 6317 vs. 5127 ± 2766, p <0.01). By ROC curve was identified at 9000 cells / ml as the best point to differentiate VSR BP (AUC = 0.73, 95% CI :0,64-0, 81).Conclusions. In infants under 6 months with IRA income presence of apnea, cyanosis and lymphocytosis allowing predict significantly differentiate between pertussis those with RSV infections.
Investigación científica y la industria farmacéutica
Authors: Grandi C
Published: September 2024

Se esperaría que el esfuerzo en investigación tenga relación con alguna medida que cuantifique la carga que las enfermedades producen en la sociedad (a mayor carga mayor investigación).Las “enfermedades abandonadas” como la malaria, la tuberculosis, las disenterías, leishmaniasis y enfermedad de Chagas causan 35.000 muertes por día en el mundo en desarrollo con significativa morbilidad. En el período 1975-1999, se introdujeron en el mercado 1.393 nuevas entidades químicas o medicamentos (NEQ), de los cuales solo 16 estaban indicadas en estas enfermedades olvidadas.La magnitud de la desproporción puede verse cuando se lee que la cantidad invertida en investigación en esos años en enfermedades respiratorias no infecciosas superó en 100 veces a la invertida en enfermedades tropicales.En el año 2004, los gastos en investigación sobrepasaron los 100.000 millones de dólares, pero solo el 10% de esa suma se destinó a la investigación de entidades patológicas responsables del 90% de la carga enfermedad. Esta disparidad ha sido llamada la “brecha 90/10” y superarla es uno de los grandes desafíos de la humanidad...