bluuebunny/crossref_metadata_2025 huggingface dataset:
Clasificación de la fibromialgia: ¿existen distintos tipos de pacientes?
Authors: Belenguer Rafael , Sisó Antoni , Ramos-Casals Manuel
Published: September 2024

Fibromyalgia (FM) is one of the most frequent diseases causing chronic pain. Due to the heterogeneity of its clinical expression and the lack of standardized instruments to classify the signs and symptoms, the availability of a classification system would allow more homogeneous groups of patients to be identified and would permit individualizing diagnostic and therapeutic management. Correct classification of patients with FM requires individual diagnostic evaluation by a multidisciplinary team comprising the family doctor, a specialist in rheumatology or autoimmune diseases, a trauma doctor and a psychologist/psychiatrist. The diagnostic contribution of each specialist together with analysis of the timeline of appearance of signs and symptoms is essential in order to decide to which FM subgroup the patient belongs.
Cistoadenocarcinoma mucinoso de páncreas
Authors: Davies Néstor Ricardo , Viotto Lucas E. , Kasparian Andrés C. , Moreno Walter E. , Gramática Luis
Published: September 2024

Mucinous cystadenocarcinoma of the pancreas represents around 6-36% of mucinous cystic neoplasm. The lesions are usually found in the body and tail of the pancreas and are generally solitary with a size range of 6-36 cm. We present a clinical case of a 63 years old patient with abdominal pain and weight loss. We used radiographic imaging studies.It was treated with surgery by distal pancreatectomy with splenectomy and transverse colectomy.Patient was not post operative complications.
Importancia del sexo del huésped en el desarrollo de la infección por Trypanosoma Cruzi
Authors: Bazán Paola C. , Micucci Lorena R. , Fauro Romina , Baez Alejandra , Lo Presti Maria L. , Triquel Maria F. , Paglini-Oliva Patricia A. , Rivarola Héctor W.
Published: September 2024

Multiple factors, both dependent on the host and the parasite are involved in determining resistance or susceptibility to infection with T. cruzi, but the influence of the sex of the host is a factor that has not been clearly established.In this paper we analyzed the influence of this factor upon the infected individuals. We used Swiss albino mice infected with 50 trypomastigotes / mouse of T. cruzi, strain Tulahuen: males (n = 73) and females (n = 64). The highest parasitemia was detected on day 21 post-infection (pi) in both males and females and became negative on day 56 pi, and males exhibited significantly higher levels of parasitemia (p <0.05). The highest mortality occurred between day 21 and day 28 pi; by day 270 pi (chronic stage) one male (3%) survived every 7.6 females (23%). In skeletal muscle of male and female mice on days 90, 180 and 270 pi, lympho-monocitary infiltrates were found nests of amastigotes, whereas the myocardium of these animals showed inflammatory infiltrates only. We conclude that males showed greater susceptibility to infection and higher mortality than females in this mouse model infected with T. cruzi, Tulahuen strain, but the characteristics of the infection and cardiomyopathy development are similar in nature.
Validación del sistema euroscore para cirugía cardíaca en la ciudad de Córdoba
Authors: Contreras Alejandro E. , Guadagnoli Adolfo Ferrero , Brenna Eduardo J. , Pogonza Pablo , Coppa Luis A. , Paladini Guillermo , Salomone Oscar A. , Chiotti Ivan G. , Estrada Carlos D.
Published: September 2024

Background:. We recommend the use of models to estimate mortality hospital risk in cardiac surgery (CC). The aim of this study was to validate a risk stratification system, widely used as the EuroSCORE (ES), in our institution.Material and methods: We retrospectively analyzed the records of patients undergoing CC consecutively between January 2006 and November 2008. The ES was calculated retrospectively based on data from medical records. Mortality was considered until the time of discharge. In all patients, the ES was calculated by logistic and additive. To study the validity of the model, we analyzed their ability to calibration and discrimination through the goodness of fit test of Hosmer and Lemeshow and area underResults: 153 patients were included, mean age 64.1 ± 9.5 years, 77.8% men. The CRM was 60.8%, 24.8% and 14.4% valvular surgery combined (bypass + valve). Overall mortality was 3.9%. The area under the curve of the logistic model was 0.87 and the Hosmer Lemeshow test was 0.84. The area under the curve of the additive model was 0.86 and the Hosmer Lemeshow test was p = 0.89. A score greater than 7 points is additive had a sensitivity of 66% and 91,5% specificity for predicting hospital mortality.Conclusion: The ES is a useful model and can be used to estimate the risk of hospital mortality in CC in the city of Cordoba.
Mecanismos de señalización cerebral durante la sepsis neonatal
Authors: Cuestas Eduardo , Rizzotti Alina , Agüero Guillermo
Published: September 2024

The brain and the immune system are the two major adaptive systems of the body. During an immune response the developing neonatal brain and the immune system "cross-talk" and this course of action is essential for maintaining homeostasis. Two pathway are involved in this intercommunication: the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS). Thisless attention than the role of HPA axis. Evidence suggests that norepinephrine (NE) is a neurotransmitter/ neuromodulator in different organs and tissues. Under stimulation, NE is released from the sympathetic nerve terminals in these organs and tissues .Through stimulation of specific receptors, locally released NE, or circulating catecholamines such as epinephrine, affect lymphocyte traffic, circulation, and proliferation, and modulate cytokine production and the functional activity of different lymphoid cells. In addition, recent evidence is discussed that NE and epinephrine, through stimulation of the beta(2)-adrenoreceptor-cAMP-protein kinase A pathway, inhibit the production of type 1/proinflammatory cytokines, such as interleukin (IL-12), tumor necrosis factor-alpha, and interferongamma by antigen-presenting cells and T helper (Th) 1 cells, whereas they stimulate the production of type 2/anti-inflammatory cytokines such as IL-10 and transforming growth factor-beta. Thus, the activation of SNS during an immune response might be aimed to localize the inflammatory response.
Resistencia a carbapenemes en Pseudomonas aeruginosa en un periodo de 10 años en el Hospital Rawson
Authors: Orecchini Luisa A. , López Teresa , Littvik Ana
Published: September 2024

Backgrounds: Pae is a non-fermenting, Gram-negative bacillus that is associated with nosocomial infections and can easily be transmitted through the hands of health staff from patient to patient. Pae has a wide variety of natural resistance mechanisms and a great capacity to acquire new resistance mechanisms or to increase the expression of their natural resistance. Carbapenems resistance may be offered by impermeability mechanisms, increase in the efflux or enzymatic pump (production of carbapenemases).Purpose: To determine prevailing carbapenems resistance mechanisms in Pae and their evolution.Materials and methods: 372 Pae strains were collected during a ten-year period. The strains were identified through biochemical tests and performed a sensitivity test through diffusion and microbiological method.Results: carbapenems resistance mechanisms for efflux in the year 2000 were, 50%; 2001 16.6%, 2002 6.3%, 2003 23.9%, 2004 18%, 2005 8.8%, 2006 17.8%, 2007 31.8%, 2008 2.5%, 2009 5.2%. As regards impermeability: 2000 33%, 2001 21.4%, 2002 8.5%, 2003 30.4%, 2004 14.7%, 2005 28.8%, 2006 23.5%, 2007 13.6%, 2008 2.5%, 2009 5.2%. The microbiological test was negative for all studied strains.Conclusion: carbapenems resistance during this period was offered by impermeability and an increase in the expression of the efflux mechanism, not by enzymatic mechanism in our hospital. This is a very important issue from an epidemiological point of view because of the rapid horizontal transmission of the strains with this resistance mechanism.
Rol de las mitocondrias y de las especies reactivas de oxigeno en la progresión de la insuficiencia cardíaca
Authors: Guzmán Mentesana Gustavo , Baez Alejandra , Cordoba Roque , Domínguez Ricardo , Lo Presti Silvana , Rivarola Walter , Pons Patricia , Fretes Ricardo , Paglini-Oliva Patrícia
Published: September 2024

Congestive heart failure (CHF) would be associated with mitochondrial abnormalities and increased of reactive species of oxygen (ROS). To clarify these issues we studied the structure, function of the mitochondrial enzyme nitro oxide synthase inducible (iNOS) and lipoperoxidation of membranes, one of their products through the peroxide nitrite ion (ONOO-), in the heart muscle of patients with heart failure congestive (ICC) grade III and IV (according to New York Heart Association). We included 25 patients who underwent cardiovas-cular surgery to biopsies of the heart muscle. They were stratified into a group with CHF (n = 18) and control group (n = 7). In di-chas bi-opsies analyzed the enzymatic activity of mitochondrial complex III spectrophotometrically, which was measured in mM.ubiquinona-1.mg prot, while the mitochondrial morphology was analyzed by the Zeiss electron microscope, the areas  were quantified with program Axionvision 4.6. Lipoperoxidation of membranes was measured by the presence of ONOO-by immunohistochemistry against primary an-tibody against 3-nitrotyrosine was used lab kit system biogenic steptobidin biotin peroxidase (SBA) and coloring triamiobencidina (TAB), it is made with semicuantificacion intensity SCORE test. The statistical test used was ANOVA. The heart muscle of patients with CHF showed that the mitochondrial area was reduced by 78% compared with the control (160.37 ?m2 ± 9.87) (936.81 ?m2 ± 78.48) p <0.0001. There was also a 70% reduction in complex III activity compared to control (1.9 10-2 mM ubiq.mim-prot 1.mg ± 12.6) (5.79 10-2mM ubiq.mim prot-1.mg ± 36.6) p <0.001. The presence of ONOO-was significantly increased in patients with CHF (p <0.05). Alterations ultraestructu-tural and functional mitochondria found in patients with CHF and increased ROS are involved in the measures of phy-siopathology CCI and whites should be taken into account for future therapies of this condition.
Paciente de 26 años trasplantado de Médula Ósea
Authors: Bürgesser María Virginia
Published: September 2024

26 year-old male patient with diagnosis of acute lymphoblastic leukemia in 2006, who underwent chemotherapy and suffered a relapse and pulmonary aspergillosis as a complication. In 2009, he received bone marrow transplant. After it, he developed cutaneous and intestinal graft versus host disease (GVH). He was admitted for diarrhea. Then he presented grade IV dyspnea, patchy alveolar infiltrates on chest computed tomography and pancytopenia with impaired renal function as laboratory findings. He entered Intensive Care Unit, dying 7 days later. The oncologist who discussed the case defined this patient as a high risk case because of type of transplant received, relapse and complications. His diagnostic hypotheses were: CMV infection, pulmonary aspergillosis reactivation, chronic GVH, Pneumocystis jiroveci infection, mycobacteriosis and pseudomembranous colitis. Parcial autopsy revealed diffuse intra-alveolar hemorrhage, diffuse alveolar damage, right pulmonary infarction with microthrombosis and bronchiolitis obliterans organizing pneumonia.
Brechas entre la prescripción de anthipertensivos y el control de las hipertensión en adultos mayores de los caps del conurbano bonaerense
Authors: Soriano Enrique R. , Dawidowski Adriana R. , Pereiro Natalia , Aliperti Valeria I. , Aragone Soledad , Abramovich Isabel , Figar Silvana Berta
Published: September 2024

Background Medications delivered to primary care centers (PCC) all over the country through the Remediar program (RP) covers 80% of the most prevalent diseases. Among them, the prevalence of hypertension is 77% of 65 years or older . Objective To describe the pharmacological treatment and its appropriateness, and to understand needs and barriers among hypertensive beneficiaries of RP at Buenos Aires suburbs. Method Qualitative-quantitative triangulation: cross-sectional study with revision of medical records (MR) and in-depth interviews between December/2008 and February/2009 to hypertensive patients of 65 years or older and CAPS’s staff. Prevalence of correct treatment (CT); appropriate Indication (AI); Optimal control (OC) were analyzed Results The following PCCs were selected: Moreno, Tigre, Lomas de Zamora, Lanus and San Isidro. Prevalence of: CT: (10.2%; 95%CI 6,7-15,1); AI: (84.8%; 95% CI 80-89 ), and OC: 11,6% (95%CI 7-16) and OC among patients with good registry: 35.7% (95%CI 24,9-48,1). Eighty two % of patients received a prescription for enalapril. Deficient registry was detected in MR. Interviewees expressed difficulties in accessing treatment, lack of medication and use of alternative circuits to get them. Both, staff and patients were exposed to barriers generated by CAPSs and RP. Conclusions A low degree of blood pressure control was observed, even with adequate prescription. Multifactorial problems explain several barriers to access and maintain hypertension treatment.
Hidatidosis osea primaria de tibia. presentación de un caso
Authors: Arancibia Agustín , Bürgesser María V. , Albertini Ricardo A. , Villalba Carlos B.
Published: September 2024

Primary hydatid disease of the tibia. Hydatidosis is an endemic disease in different parts of the world. Its causal agent is the cestode from the genus Echinococcus. The most commonly affected organs in humans are liver and lung. Bone hydatid disease is a very rare entity, accounting for 0.5 to 4% of total cases. We report a case of a 58 year-old woman from La Rioja, Argentina, who consulted for left infapatellar pain and walking disability of eight months duration. Imaging studies showed a cystic lesion which involved metaphysis and diaphysis of left proximal tibia. Surgical resection was performed and histopathological study confirmed that it was a hydatid cyst. The patient did well and completed three cycles of treatment with albendazole. Currently, she has no evidence of disease and she recovered motility of her left leg. Primary hydatid bone disease, where there is no evidence of systemic disease, is even more unusual. Tibia involvement occurs in up to 15% of the cases. These lesions clinically manifest when they suffer any type of complications. Preoperative diagnosis is mainly made by imaging studies. Lesions are usually osteolytic and can involve cortical bone and extend to soft tissues. Differential diagnosis with inflammatory processes and bone tumors should is mandatory. Treatment is surgical and prognosis is poor due to its high morbi-mortality rate and recurrence risk from 70 to 80%.
Capacidad predictiva de los parámetros clínico de bacteriemia en pacientes hemodializados
Authors: Egea Ana L. , Vilaró Mario , De la Fuente Jorge , Cuestas Eduardo , Bongiovanni Maria E.
Published: September 2024

Background: No clinical events to differentiate bacteteremia from other pathologies in hemodialysis patients therefore the physicians makes diagnosis and treatment decisions based on clinical evidence an local epidemiology Objective: the aim of this work was to study the frequency of microorganism isolated from blood culture of hemodialysis patients with suspected bacteraemia and evaluate Sensitivity (S) and Specificity (E) of medical diagnostic orientation in this cases of suspected Materials and methods: we performed an observational and prospective study for one year in hemodialysis patient with suspected bacteremia. We evaluated blood pressure, temperature (Tº), altered conscious state (AEC), respiratory frequency (FR), chills (ESC),diarrhea (DIARR), blood culture results and microbiological identification. We work with the mean ± standar desviation for continuous variables and frequencies for categorical variables We analyzed S, E, negative predictive value (VPN), positive predictive value (VPP) Resultados: a total of 87 events with suspected bacteremia 34 (39%) were confirmed with positive blood culture the most common microorganisms were cocci Gram positive (CGP) 65%,Most relevant clinical variables were PCP ? 2 (VPN 81%), Tº ? 38 (VPN 76%) and AEC (E 98% y VPP 80%). Conclusions: CGP were the most prevalent microorganisms None of the clinical variables shows high S and E indicating low usefulness as a predictive tool of bacteremia Excepting AEC with E98% and VPP 80% but it would be necessary to evaluate this variable with a more number patient. Results justify to routine HC use like diagnostic tool.
Prevalencia de síndrome metabólico y características clínicas en donadores de sangre
Authors: Cruz del Castillo Aaron H. , Fierro Rafael Garcia , Hess Moreno María I. , Vigil Pérez Claudia A. , Córdova Fernández José A. , Chuck Santiago Marco P. , Domínguez Morenoz Rogelio
Published: September 2024

Background: Metabolic syndrome (MS) including obesity, diabetes mellitus, hypertension, dyslipidemia, etc.. is a major cause of morbidity and mortality worldwide. It was reported that 15.9% of blood donors showed changes in fasting plasma glucose.Objective:To determine the prevalence of MS in a population of healthy donors in a secondary hospital.Material and Methods: A cross-sectional study, included 726 healthy donors who attended the blood bank HGZ36. The SM was identified with at least 3 of 5 criteria of the NCEP ATPIII, we applied a structured questionnaire. We determined HDL cholesterol, triglycerides, glucose Abnormal Fasting (GAA), hypertension (SAH), body mass index (BMI), waist circumference (WC), hip circumference (NCC). Plan Analysis: prevalence, t student, Chi2.Results: Of the 726 donors, 85.1% were male, according to the ATPIII criteria, 54.8% (398) had a GAA, 63.2% (458) had hypertriglyceridemia, almost 17% (121) presented HDL hypocholesterolemia, 44.1% (320) were overweight by BMI, the prevalence of metabolic syndrome was 54.4%, in comparison by gender, men had a statistically significant difference compared to women, showing an OR = 2.27 (p = 0.0001, 95% CI 1.44-3.60). Conclusions: MS is highly prevalent in this population, which involves implementing preventive measures, changes in lifestyles and identify risk factors to be free from diseases like diabetes, hypertension, obesity and MS itself.
Hipertensión arterial resistente
Authors: Bendersky Mario
Published: September 2024

Resistant hypertension, defined as a persistent blood pressure over 140/90 mmHg despite the use of three antihypertensive agents including a diuretic, is unusual. The diagnosis requires ruling out initially pseudoresistance and a deficient compliance with treatment. Ambulatory blood pressure recording allow the recognition of white coat hypertension. When there is a clinical or laboratory suspicion, secondary causes of hypertension should be discarded. Excessive salt intake, the presence of concomitant diseases such diabetes, chronic renal failure, obesity, and psychiatric conditions as panic attacks, anxiety and depression, should also be wanted. The presence of target organ damage requires a more aggressive treatment of hypertension. Recent clinical studies indicate that the administration of aldosterone antagonists as a fourth therapeutic line provides significant additional blood pressure reduction, when added to previous antihypertensive regimens in subjects with resistant hypertension.
La salud y enfermedad desde una perspectiva sociocultural en la primera mitad del siglo xx
Authors: Moreyra Beatriz I. , Domínguez Inés M.B.
Published: September 2024

The social historians of ends of the 20th century placed in the center of his worries new topics and approaches, between them, the problems linked with the social question called. It is defined as the set of social problems arisen as consequence of the industrialization, the urbanization, the immigration between those who were the conflicts of the work, the poverty, the marginality, the disease, that they returned the protagonism of subjects forgotten as the patients, the madmen, the delinquents between others.The diseases in the society, raise a new historical object of reflection that provides a window to the social reality. To analyze the trilogy disease - health- service of an integrated way is to know an aspect that explains the social problematics.The response to the social problems came from the civil society and from the State, arising institutions of social assistance that were acting in a combined way. The present article approaches the topic of the disease- health- service and the response to this problematics for the State during the period 1900-1940 in Córdoba, seeking to reconstruct how the disease allows us to show the conditions of material and cultural life where they emerged and the social process of constitution of the Social State and the social citizenship, from the continuities, changes and transformations that were demonstrating in the sanitary field.
Monitoreo ambulatorio de presión arterial (mapa) y duración del efecto antihipertensivo: un estudio con una nueva forma farmacéutica de losartán de liberación sostenida (CRONOS)
Authors: Bendersky Mario , Juncos Luis , Waisman Gabriel , Piskorz Daniel , Santi Ricardo López , Montaña Oscar , Caruso Gustavo , Koretzky Martín , Gómez Roberto
Published: September 2024

Antihypertensive drugs action should last at least 24 h in order to enhance adherence, with positive impact on CV morbimortality. ABPM allow us to evaluate duration of action of drugs, against placebo, using Trough:Peak Ratio, antihypertensive effect in the last 4 h interdosis, and calculating the rate of BP morning surge. Losartán is an Antagonist At1 with good antihypertensive efficacy and renal, cardiac and cerebrovascular protection. Some studies shows less than 24 hs of action, that suggest twice a day dosing. The merge of a new formulation, Losartan Cronos, a bilayer tablet containing 50 mg of Losartan immediate release (IR) and 50 mg extended release (ER) would allow 24 h coverage, maintaining the previous advantages. Objectives: To assess antihypertensive duration of action of Losartán Cronos in patients with essential hypertension throughout a 24-h dosing interval, using ABPM and response rates, AASI and Smoothness Index. Methods: 97 essential hypertensives, where included and received a single morning dose of Losartán Cronos (50 mg of regular release and 50 mg of controlled and retarded release) during 8 weeks. Performed valid ABPM post placebo and post active treatment. Results Mean age 58 (26-86), 60% women. 63% treatment naïve. The mean reduction in BP from baseline to week 8 (end of treatment) was statistically significant for all times analyzed (24 hours, daytime, night-time, and last 4 hours monitoring). There were no significant changes in 24h heart rate. BP morning surge (mmHg/hour) decreased from 4.53 to 3,68 (p=0.03).T:P Ratio was 0.91 for SBP and 1.14 for DBP. Smoothness Index: SBP 2.86 (95% CI 1.84-3.7) - DBP 3.17 (95% CI 2.03-3.9) 19 patients had adverse events, no-one cough, all mild, without discontinuations. Conclusion Losartán Cronos demonstrated efficacy and safety, decreases BP without significant effects in heart rate, it reduces the pulse pressure, and its effect lasts for 24 hs, assessed by T:P ratio, last 4 hours effects, decreasing morning surge, also presenting homogeneous effect, since its Smoothness Index is high. Our results suggests daily monodose administration.
Sarcoma pleomórfico indiferenciado de alto grado/ fibrohistiocitoma maligno asociado a tofo gotoso. presentación de un caso
Authors: Szlabi Susana , Flores Jorge O. , L. de Diller Ana , Cabrera Marta B.
Published: September 2024

Background: Gout is a metabolic disease by deposition of uric acid crystals, which undertakes joint and soft tissue in both acute and chronic stages. Is a rare event the onset of a tumor in the site of the lesion.Objective: To present a rare case of association between sarcoma and tophi.Methods: 83 year old man who consulted for tumor in his left elbow about 40 years of evolution, which spontaneously started to hurt. With the presumptive diagnosis of tophi treated surgically. The lesion recurred after 60 days, reintervention and radiotherapy was performed for diagnosis of malignant mesenchymal tumor associated with tophi. At 10 months developed ipsilateral nodal metastases, died within 2 years of the initial consultation.Results: The diagnosis of the first material resected was tophi. In the reintervention material was diagnosed mesenchymal spindle cell high grade neoplasm associated with tophi; immunohistochemistry revealed: vimentin + / +, MYO D1 - / - ASMA - / -, FVIII - / -, A1ATT - / -, CD68-/ -, S100-/ - with final diagnosis the undifferentiated high grade pleomorphic sarcoma.Conclusions: It is uncommon for gouty tophi are associated with other diseases and even fewer do so to tumors. In the literature have reported three previous cases concurrent with neoplasms, which were angiosarcoma, giant cell tumor and malignant fibrous histiocytoma. The latter have a high tendency to recur locally and have ability to distant metastases, especially lung and regional lymph nodes.
La democratización de la salud. Las políticas sanitarias durante los gobiernos peronistas en Córdoba (1943-1955)
Authors: Ortiz Bergia María José , Segreti A.
Published: September 2024

The purpose of this paper is to analyze changes produced in the public health system of Córdoba during the peronist government and the performance of the provincial state in the process. We study the increase of health services, public social spending, health agencies and bureaucracies of the state of Córdoba between 1943 and 1955.
Risk factors associated with infection in tibial open fractures
Authors: Matos Marcos Almeida , Catro-Filho Rômulo Neves , Pinto da Silva Bruno Vieira
Published: September 2024

Background. The objective of the treatment of open fracture is to prevent infection, stabilize the bones, and restore function. However, infection is the most important step in achieving the latter aims. Objective. The objective of the current paper is to find risk factors associated with infection in a sample of tibial open fractures. Patients and Methods. A retrospective analysis was carried out. The study included all patients who underwent to tibial open fracture treatment in the Hospital Geral Roberto Santos-HGRS, Salvador, Bahia, Brasil, from March to October, 2009. Patients under the age of eight, with multiple fractures or suffering from systemic or bone disease were excluded. Clinical and demographic data were collected and Patient outcomes were divided into two groups: Group 1 comprises those without infection whereas group 2 comprises those with lesions which became infected. The two groups were evaluated in search for associated factors that could lead to infection. Results. We studied 50 patients. Our overall infection rate was 14 (28%; CI95%=15.5-40.5). Infection was significantly associated with place of trauma (OR 3.78; CI95%=1.4-5.5;p=0.02), and time delay superior to 24 hours (OR 3.4; CI95%=1.4-20.8; p=0.03). Fractures graded as Gustilo I, II and IIIA had a lower chance for infection compared to Gustilo IIIB and IIIC (OR 4.32; CI95%=1.3-19.1; p=0.01). Fractures graded Tscherne III and IV had a higher chance for infection, and it was the most significant isolated factor (OR 8.07; CI95%=2.4-47.1; p<0.00).Conclusions. We confirmed the relationships between infection with Gustilo classification and as well as between infection and trauma from the countryside of Bahia State. We also presented a new relationship between soft tissue and infection, and another relating time delay of more than 12 hours with infection.
Linfangitis carcinomatosa pulmonar: presentación como neumopatía aguda. Reporte de dos casos
Authors: Ré Danila P. , Cazaux Alexis , Cambursano Victor Hugo , Zaya A. , Cortés JR
Published: September 2024

Introduction: Carcinomatous lymphangitis of the lung accounts for 6-8% of lung s metastases. There are evidence that it can be a treatable condition with an impact on progression of dyspnea and radiographic lesions, and survival improvement. Two cases are reported, with the aim of increase the clinical suspicion at compatible cases. Methods:Case 1: woman 32 years old. Progressive dyspnea and cough two weeks ago, without antibiotic response. Tachypnea, increase of respiratory work, basal crackles.Respiratory failure. Radiography: basal alveolointerstitial opacities. Treatment for severe community-acquired pneumonia is started. She evolves unfavorably, with need of MRA and fatal outcome. Case 2: woman 46 years old. Progressive dyspnea and cough from one week ago. Tachypnea, diffuse crackles. Respiratory failure. Radiography: diffuse nodular-interstitialradiopacity, with radiopacy lesion in right apex. HRCT: nodular thickening of interlobular septum and peribrochovascular interstitial. Treatment for tuberculosis of the lung is started. She evolves unfavorably, with need of MRA and fatal outcome. In both cases a lung biopsy was performed, diagnosing carcinomatous lymphangitis. Discussion: Two cases are reported, with acute afebrilepneumopathyin young patients, whose manifestations guided to treatment of respiratory infection, and evolved quickly to refractory hypoxemic respiratory failure with need of MRA and fatal outcome.Conclusion: Carcinomatous lymphangitis of the lung should be included as a differential diagnosis of cases of acute lung pathology, especially when there was an unfavorable evolution under antibiotics or have excluded more common etiologies.
Particulate bone matrix usage for alveolar bone conservation
Authors: Fontana Sebastián , Plavnik Luis , Filippetti Miguel , Malberti Alicia Inés
Published: September 2024

Different filling materials have been used in an attempt to repair bone loss situations. Objective: The present study aimed to examine the effect of a bone matrix in post-extraction remodelling of the alveolar bone, and to perform a histomorphometric analysis of the residual alveolar ridges in Wistar rats.Material and Methods: Both rat first lower molars were extracted and the right alveoli were filled with particles of a bone matrix with mineral components (MO-UNC) (experimental group, EG). The left alveoli were used as a control group (CG). The animals were sacrificed at 0 hrs, 15, 30 and 60 days after extraction, and the samples were processed. Histological sections were made at the level of the mesial alveolus of the first lower molar.Repair of the alveoli was histologically evaluated and a histomorphometric study of total alveolar volume (TAV), height of the buccal plate (Bh), height of the lingual plate (Lh) and percentage of osseointegration (OI) of the particles was performed to compare the residual ridges of CG with those of the EG. Statistical analysis of the data was performed. Results: In the cases of the experimental group, newly-formed bone tissue was identified around the MO-UNC particles (osseointegration). Histomorphometric data indicate that, at 60 days post-extraction, TAV was significantly greater for EG when compared with CG (p<0.05) and the percentage of osseointegration of the particles increased as a function of time (57.6 %, 90.5% y 95.5%, for EG at 15, 30 y 60 days respectively). Conclusions: The bone matrix (MO-UNC) evaluated in this study is an osteoconductive material that prevents the collapse of post-extraction alveolar bone.
Modificación de formas farmacéuticas sólidas: relevamiento en un hospital de la provincia de Córdoba
Authors: Parisia Luciana R. , Olivera María E. , Sperandeo Norma R.
Published: September 2024

Background: In the hospital setting is frequent to manipulate solid dosage forms (SDF, tablets 16and capsules), which can affect their physicochemical and biopharmaceutical properties, the pharmacoloeffect and sometimes to cause the appearance of undesirable side effects.Objectives: To identify the medicines whose SDF is altered in a Hospital of Cordoba (Argentina), to determine how these modifications are made and to establish whether they were properly performed or not.Methods: We retrospectively analyzed the prescriptions made between the 5th and the 11th of March of 2012 and identified impaired requesting SDF modifications. Open interviews were held with nurses and service visits to each hospital to determine how they manipulated the SDF.Results: We analyzed 700 prescriptions for 113 patients, of which 61 (54%) had manipulations of the received SDF (49 for medical prescription, 7 because they had nasogastric tubes, 3 due to patient choice and 2 by nursing decision). Twenty three medicines were manipulated, but only 12 were correctly manipulated. The major changes were partition of tablets and grinding of tablets or microgranules and dispersible in water.Conclusion: The SDF of several medicines is altered in the analyzed hospital, many times without medical indication and scientific justification. It would be appropriate to conduct training courses and establish closer collaborations between pharmacy and nursing units in the investigated hospital.
Aspectos críticos do abuso de hormônios protéicos no exercício e no esporte: atualização
Authors: Bucalen Ferrari Carlos Kusano
Published: September 2024

The hormonal abuse in physical exercise practioners is very common. Many pleople believe these substances can promote skeletal muscle hyperthrophy and improve physical fitness without health damaging effects. However, this is another myth that science unmasked. This article updates information regarding abuse of insulin, growth hormone, thyroid hormones, and erythropoitin. The peptide hormone abuse can cause motor paralysis, skeletal muscle damage and loss, diabetes mellitus, hypothyroidism, arterial hypertension, sweating, headaches, vomiting and enhances the risk for atherosclerosis, thrombosis, osteoporosis, and cancer.
Enfermedad de Chagas cerebral en SIDA
Authors: Castrillon M E
Published: September 2024

Paciente masculino, 42 años.Consulta por pérdida de peso, Déficit cognitivo: 20 días, somnolencia: 24 hs. Diagnostico Reciente VIH, sin tratamiento antirretroviral.Examen físico: afebril, signos vitales normales.SNC: somnoliento, moviliza 4 miembros. Reflejos Normales. Pares Craneales: normal. Rigidez de nuca (+) Resto: normal. Lab: Leucocitos: 3800 mm3 - CD4: 31 mm3 - Serología Toxoplasmosis: Negativa.Serología Chagas: Positiva.PCR para CHAGAS: Positiva. Hemoparasitologico: Positivo.Biopsia de Cerebro: Positiva La reactivación de la infección crónica por Trypanosoma cruzi es infrecuente pero puede ocurrir en pacientes inmunocomprometidos; es una enfermedad marcadora de SIDA.
Overweight and Obesity in Southern Italy: their association with social and life-style characteristics and their effect on levels of biologic markers.
Authors: Osella Alberto R , Díaz María del Pilar , Cozzolongo Rafaelle , Bonfiglio Caterina , Franco Isabella , Abbrescia Daniela Isabel , Bianco Antonella , Buongiorno Gianpiero , ELba Silvana , Petruzzi José , Lanzilotta ELsa , Correale Mario , Mastrosimini Anna Maria , Leandro Gioacchino
Published: September 2024

Abstract Background: In the last decades, overweight and obesity have been transformed from minor public health issues to a major threat to public health affecting the most affluent societies and also the less developed ones. Objectives: To estimate overweight-obesity prevalence in adults, their association with some social determinants and to assess the effect of these two conditions on levels of biologic and biochemical characteristics, by means of a population-based study. Methods: A random sample of the general population of Putignano was drawn. All participants completed a general pre-coded and a Food Frequency questionnaire; anthropometric measures were taken and a venous blood sample was drawn. All subjects underwent liver ultra-sonography. Data description was done by means of tables and then Quantile Regression was performed. Results: Overall prevalence of overweight and obesity were 34.5% and 16.1% respectively. Both overweight and obesity were more frequent among male, married and low socio-economic position subjects. There were increasing frequencies of normal weight with higher levels of education. Overweight and obese subjects had more frequently Nonalcoholic Fatty Liver Disease, Hypertension and altered biochemical markers. Quantile regression showed a statistically significant association of age with overweight and obesity (maximum about 64.8 yo), gender (female) and low levels of education in both overweight and obesity. More than 10 gr/day of wine intake was associated with overweight. Conclusions: The prevention and treatment of overweight/obesity on a population wide basis are needed. Population-based strategies should also improve social and physical environmental contexts for healthful lifestyles.
Bronquio traqueal
Authors: Castrillon María Elena , Videla Ricardo , Paulazo Carolina
Published: September 2024

Se define bronquio traqueal a aquel que se origina en la tráquea por sobre la carina principal. Frecuencia: 0,1-2% de la población. Usualmente emerge desde la pared lateral derecha de la tráquea entre dos a seis centímetros por arriba de la carina y puede suplir a todo el lóbulo superior derecho, su segmento apical o subsegmentos, o lóbulos pulmonares supernumerarios (1-3). En 78% de los casos se asocia a diversas patologías, tales como síndrome de Down, síndrome de Klippel-Feil, asociación VATER, malformaciones con origen embrionario en común con esta entidad como fístula traqueoesofágica, membrana laríngea, estenosis traqueal, malformaciones del intestino anterior, malformaciones pulmonares como hipoplasia pulmonar, malformación adenomatoidea quística, quiste broncogénico, secuestro pulmonar, además malformaciones costales, pectus excavatum, cardiopatías congénitas siendo la más frecuente la tetralogía de Fallot (1). El diagnóstico se establece mediante estudio de imágenes y visualización directa de la vía aérea (3,5). En 20% de los casos  se logra detectar su presencia en la radiografía de tórax, al observar su emergencia a partir de la tráquea (5). La Tomografía Computada es actualmente el método de elección para el diagnóstico (4).
Valoración subjetiva de salud en el paciente joven con coxoartrosis: aplicación del cuestionario SF-36
Authors: Angulo Tabernero Marina , Fernández Letamendi Teresa , Aguilar Ezquerra Andres , Ungria Murillo Julia , Panisello Sebastiá Juan José , Agudo Jesús Mateo
Published: September 2024

Resumen: Objetivo: Determinar el estado de salud general percibida por los pacientes sometidos a artroplastia total de cadera con mini-vástago.Material y Método: Se ha administrado el cuestionario de salud SF-36 para evaluar el estado de salud percibido por 13 pacientes varones con una edad media de 46,62 (34-53) años en los que seimplantó una artroplastia total de cadera no cementada tipo MiniHip® (CorinMedical) tras un seguimiento medio de 23,2 (12-47) meses. Los resultados obtenidos se compararon con los valores de referencia de la población española en varones de 45 a 54 año.Resultados: Se hallaron diferencias en aspectos como rol físico y emocional, función física, función social y dolor; mientras que en el resto de los ítems la puntuación fue similar a la de la población de referencia. Discusión: Existe la necesidad de conocer en qué grado afectan nuestras intervenciones a la calidad    de vida del paciente y la manera en que es percibida por él mismo para complementar los resultados de nuestras intervenciones.Conclusión: Es necesaria una nueva perspectiva para la valoración funcional y de calidad de vida de los pacientes jóvenes sometidos a una artroplastia total de cadera.     Abstract:Objective: To determine the general health status perceived by patients undergoing total hip arthroplasty with mini-stem.Material and Methods: Health questionnaire SF-36 has been used to assess health perceived by 13 male patients with a mean age of 46.62 (34-53) years after the implantation of an uncemented, MiniHip® (CorinMedical) total hip arthroplasty, after a mean follow up of 23.2 (12-47) months. Results were compared with the reference values of Spanish men population from 45 to 54 years.Results: Differences were found in areas such as physical and emotional role, physical function, social function and pain; while scores of the remaining items were similar to the population of reference.Discussion: It is important to know how our surgical actions affect the quality of life of patients and how it is perceived by them to complement the results of our surgeries.
Los cuidados médicos en la práctica del futbol, Su temprano proceso de institucionalización en Córdoba en las primeras décadas del siglo XX
Authors: Reyna Franco Damian
Published: September 2024

El artículo se propone dar cuenta de los avances iniciales en el proceso de medicalización de la práctica del fútbol en las asociaciones deportivas cordobesas en las primeras décadas del siglo XX. El objetivo es indagar cómo en la interacción entre los jugadores y esas entidades se fue institucionalizando el acceso de los deportistas a los cuidados médicos. En la investigación seanalizan el desarrollo del fútbol como un factor de salud e higiene, la evolución de la atención médica a los jugadores y su proceso de descentralización a partir de su anclaje espacial en las entidades deportivas.Abstract:The article examines the initial advances in the process of medicalización of the practice of football in the sports associations of Córdoba in the first decades of the 20th century.The objective is to investigate how, in the interaction between the players and these entities, there was becoming institutionalized the access of the sportsmen to medical care. In the research we analyze the development of football as a factor of health and hygiene, the evolution of the medical attention to the players and his process of decentralization as result of its spatial anchorage in the sports entities.
Síndrome de ovario poliquístico: impacto en la salud reproductiva y materno fetal
Authors: Fux Otta Carolina , Iraci Gabriel Santino , Szafryk de Mereshian Paula , Fiol de Cuneo Marta
Published: September 2024

El síndrome de ovario poliquístico (SOP), se caracteriza por hiperandrogenismo (H), oligoanovulación (O) y/u ovarios poliquísticos (P). Actualmente existe escasa información sobre las complicaciones perinatales. Objetivo: investigar las características obstétricas y neonatales en mujeres con SOP de nuestra población. Material y Métodos: estudiamos 87 embarazadas con SOP (categorizadas en cuatro fenotipos según Consenso de Rotterdam: A (H+O+P) n=53; B (H+O) n=9; C (H+P) n=16 y D (O+P) n=9) y 96 sin SOP (control). Analizamos características clínicas y bioquímicas (edad, antropometría, hirsutismo, acantosis nigricans, PTOG, insulinemia, perfil lipídico, andrógenos y gonadotrofinas) pre-concepcionales y gestacionales (ganancia ponderal, presión arterial, PTOG y complicaciones obstétricas y neonatales). Resultados: no hallamos diferencias en la edad (29.4±4 y 28.7±5 años) ni el índice de masa corporal (28.2±6 y 27.8±6 kg/m2) en ambos grupos; mientras que las pacientes con SOP presentaron mayor circunferencia de cintura, presión arterial y acantosis nigricans respecto al control. A pesar de la similar ganancia de peso, las pacientes con SOP presentaron mayor porcentaje de complicaciones perinatales (86 vs 32%, p=0.007). En el fenotipo A el RR para resultados adversos materno-neonatales fue de 2.37 (IC:1.67-3.36, p<0.001). El índice HOMA-IR pre-concepción y la glucemia de ayuno durante el embarazo fueron las variables predictoras de dichas complicaciones (p=0.01). Conclusión: las pacientes con SOP tienen mayor riesgo de padecer complicaciones durante el embarazo y mayor frecuencia de recién nacidos tanto de bajo peso como macrosómicos. Una cuidadosa historia clínica permite reconocer a las pacientes con mayores condiciones de presentar compromiso perinatal.
Resultado tras el tratamientoquirúrgico de tumores de células gigantes
Authors: Aguilar Ezquerra Andrés , López Subías Jorge , Lillo Adán Marina , Gracia Torralba Lorena , Peguero Bona Antonio
Published: September 2024

Resumen: Introducción: El tumor de células gigantes se presenta en adultos jóvenes, y su capacidad metastásica obliga a realizar un tratamiento quirúrgico, aunque su tasa de recurrencias hace que no haya consenso respecto a su manejo terapéutico. Material y métodos: 23 pacientes fueron intervenidos en el periodo de 1996 a 2012 en el hospital Miguel Servet, realizándose un seguimiento medio de 8,9 años. Resultados: el resultado funcional fue satisfactorio en todos los casos, pudiendo reanudar su actividad física habitual. Se detectaron 6 recurrencias, que fueron tratadas quirúrgicamente, mostrando los pacientes una recuperación total. Un paciente falleció a causa de metástasis pulmonares. Conclusión: El tratamiento quirúrgico es el más indicado en tumores de células gigantes, habiendo demostrado buenos resultados tanto en el tratamiento del tumor primario como en el de las recidivas.
Identificación y descripción epidemiológica de artículos de revisión de efectos adversos en la atención sanitaria publicados en idioma español
Authors: Weitz Dario , Avila Aylén , Molina Gabriel , Piskulic Laura , Allasia María Belén , Caraballo Lucía , Díaz Pacifico Fernando , Quaglia Nora , Marzi Marta
Published: September 2024

Antecedentes: Las revisiones sistemáticas de la literatura científica constituyen una importante fuente de evidencia para la toma de decisiones en medicina particularmente al momento de contemplar posibles efectos adversos (EA) de las intervenciones. Estudios anteriores han caracterizado epidemiológicamente artículos de revisión publicados sin utilizar restricción alguna de idioma o limitándose al inglés, mientras que no sonabundantes los estudios de revisiones escritos en español.Objetivos: Identificar artículos de revisión de efectos adversos en la atención sanitaria publicados en idioma español y describirlos epidemiológicamente.Métodos: Se realizó una búsqueda en MEDLINE, BVS y DARE utilizando estrategias que incluían términos afines a “efecto adverso” y “revisión”, para el período 2010-2014 e idioma español. De los artículos recuperados se registraron características relevantes, calcularon frecuencias y se analizó homogeneidad. Resultados: Se recuperaron 62 revisiones narrativas (RN) y 29 revisiones sistemáticas/metaanálisis (RS/MA). La palabra “Revisión” en el título fue empleada en 16,1% de RN y en 89,6% de RS/MA (p<0,0001).  En el 76,9% de las revisiones, estudiar los EA no fue el principal objetivo y en el 68,1% la intervención fue farmacológica. El número de autores fue mayor en las RS/MA que en las RN (p=0,0371).Discusión: Se considera insuficiente el número de revisiones de EA recuperados en español. Dado que las RS/MA, al estar elaboradas con rigor metodológico, aportan evidencia confiable para la toma de decisiones en la práctica clínica, su escaso número no favorece la actualización de los profesionales de habla hispana.