bluuebunny/crossref_metadata_2025_split huggingface dataset:
Déficit de vitamina D y osteoporosis en una población rural de montaña en Córdoba – Argentina
Authors: Gobbi C. , Salica D. , Pepe G. , Petenian E. , Dotto G. , Martinez F. 
Published: September 2024

Introduction: Vitamin D deficiency is defined when blood levels of 25-hydroxyvitamin D (25 (OH) D) is less than 20 ng / mmol/L. The status of Vitamin D level is associated with clinical, pathological and physiological changes as increased of parathyroid hormone, bone remodeling, osteoporosis and increased risk of fractures. Moreover, vitamin D and its metabolites are known to be associated with multiple chronic diseases as diabetes mellitus, autoimmune, cardiovascular and neoplasia diseases. Objective: To assess the vitamin D status in a rural population of Córdoba Province in Argentina and its relation with bone mineral density. Material and Methods: We prospectively studied 31 patients over 50 years old who live in a rural population of Pampa de Achala in Córdoba Province, Argentina. This city is located in Córdoba High mountains. Blood vitamin D levels were tested in 24 patients and Bone mineral density in 31 patients. Vitamin D level was determined by HPLC. The vitamin D level were considered normal between 20-50 ng/ml in the winter season and 20-80 ng/ml in the summer season. Bone mineral density of lumbar spine and femoral neck was measured by DXA GE LUNAR DPX-L, according to World Health organization classification (37). The data were analyzed by Spearman coeficient and Chi cuadrado.Results: The vitamin D levels samples were avaliable in 24 patients. Mean blood Vitamin D level was 24.54 ng /ml. 8 of them (33%) had vitamin D level less than 20ng/ ml. 83% (20) of the analysed patients had vitamin D level less than 30 ng/ml and only 4 patients has vitamin D level more than 30 ng/ml.Low bone mineral density of lumbar spine and femoral neck was found in 66 % of the patients. 19 % of the patients were diagnosed of lumbar spine and femoral neck osteoporosis and 29% of them had lumbar spine meanwhile 25% had femoral neck. There was not statistically significant associaton between vitamin D level and bone mineral density analysed by Chi Cuadrado (p<0.07). A significant association was found between blood vitamin D level and low bone mineral density of femoral neck (Spearman 0.51) Conclusions: Vitamin D insufficiency is high in the rural adult population of Pampa de Achala in Córdoba and it could be a major health problem in this population.
Lesiones placentarias de embarazos de madre adolescente en una maternidad pública de la Argentina
Authors: Hernandorena Cintia , Garcia Juan Sebastián , Cavoti Sadonio Victoria , Grandi Carlos 
Published: September 2024

Introduction. In Argentina, 18.3% of all births are related to adolescent mothers. Adolescent pregnancy has been associated with an increase of adverse perinatal outcomes. Placental examination helps to identify etiology and predict recurrence of perinatal pathologies. The aim of this study was to describe placental weight and placental lesions and to estimate the risks of adolescent pregnancies compared with young adults mothers.Methods. We examined 50 placentas from adolescent mothers (<16 yrs, n = 18 and 17-19 yrs, n = 32) and 101 placentas from adults mothers between 20 and 29 years old attending the Sarda’ Maternity Hospital of Buenos Aires, Argentina. Conventional methods were used for macroscopic and histological examination.Results. No differences were found in placental weights. In half of examined placenta one or more lesions were present, predominantly in adolescents (p = 0.327). In < 16 ys placental lesions represented 77.78 % (14/18, 95% CI 54 – 91), in older teenagers 34.3% (11/32, 95% CI 20 – 51) (OR 2.26, 95% CI 1.32 – 3.38, p = 0.003), whereas in young adults figure was 41.5% (42/101, [95% CI 32 – 51]), a 1.87 (IC 95% 1.33 – 2.62, p = 0.004) and 0.83 (IC 95% 0.49 – 1.41, p = 0.469) crude risks of both adolescents’ groups compared with adults, respectively.Adjusted risk for placental lesions was four folds higher in adolescent at or below 16 years (p = 0.018). Conclusions. No differences were found in placental weights Younger teenagers (? 16 year age) have an increased risk for having placental lesions.
Impacto de la obesidad en la función reproductiva masculina
Authors: Martini Ana C. , Molina Rosa I. , Ruiz Rubén D. , Fiol de Cuneo Marta 
Published: September 2024

Obesity and male infertility have increased in the last decades; therefore, a possible association between these pathologies has been explored. Studies inform that obesity may affect fertility througth different mechanisms, which alltogether could exert erectile dysfunction and/or sperm quality impairment. These include: 1) hypothalamic-pituitary-testicular (HPG) axis malfunction: obese hormonal profile is characterized by reduction of testosterone, gonadotrophins, SHBG and/or inhibin B concentrations (marker of Sertoli cells function) and hyperestrogenemy (consequence of aromatase overactivity ascribed to adipose tissue increase); 2) increased release of adipose-derived hormones: leptin increase could be responsible for some of the alterations on the HPG axis and could also exert direct deleterious effects on Leydig cells physiology, spermatogenesis and sperm function; 3) proinflammatory adipokines augmentation, higher scrotal temperature (due to fat accumulation in areas surrounding testes) and endocrine disruptors accumulation in adiposites, all of these responsible for the increase in testes oxidative stress and 4) sleep apnea, frequent in obese patients, suppresses the nocturnal testosterone rise needed for normal spermatogenesis. Finally, although controversial, all the above mentioned factors could comprise gametes quality; i.e. decrease sperm density and motility and increase DNA fragmentation, probably disturbing spermatogenesis and/or epididymal function. In summary, although obesity may impair male fertility by some/all of the described mechanisms, the fact is that only a small proportion of obese men are infertile, probably those genetically predisposed or morbidly obese. Nevertheless, it is likely that because the incidence of obesity is growing, the number of men with reduced fertility will increase as well.
Integración temática disciplinar en medicina: una propuesta desde histología y embriología
Authors: Bassan Norberto D , D'Ottavio Alberto E 
Published: September 2024

ResumenEste trabajo intenta aclarar un concepto con múltiples significados y una realidad compleja y proveer ejemplos de distinta dificultad centrados en la Histología y la Embriología, potencialmente útiles para currículos tradicionales y, esencialmente, para aquéllos en vías de transformación dentro de la Medicina en particular y de las Ciencias de la Salud en general. En ese sentido, propone secuencias lineales, ramificadas y gráficas de consolidación que, pivoteando en ambas disciplinas, pueden comprender también a otras ciencias básicas, todas de significado clave para el diagnóstico clínico. Tras registrar algunos resultados que, aunque limitados, revelarían la necesidad de su entrenamiento continuo y en complejidad creciente a lo largo de la carrera médica, se subraya su valor integrador intrínseco así como la potencialidad integradora que desarrolla en quienes las cultivan en virtud de su ligazón natural con otras disciplinas básicas. Asimismo, a la par que se reafirma la relevancia de una y otra en el grado, se vislumbran posibles variaciones en las mismas en virtud de los exponenciales avances científico-tecnológicos de la hora. AbstractThis paper intends to clarify a concept with multiple meanings and a complex reality. It starts providing varied histological and embryological examples apt to contribute the stimulation of teacher and student imaginations in favor of a crucial skill, as thematic integration is, into the present and changing curricula in Medicine in particular and Health Sciences in general. In this sense, it offers linear and branched sequences as well as consolidation graphics which focusing in both disciplines may also include other basic ones, key for clinic diagnosis, among the competences to be developed. After registering some preliminary results revealing the need of its continuous and progressive training along the complete medical career, its own integrative value and the integrative one for their teachers due to its natural link with other basic ones is outlined, its relevance for undergraduate is reaffirmed and possible future variations for them are previewed, considering the present exponential growth of science and technology.
Síndrome de vena cava superior: forma inicial de presentacion en enfermedades neoplásicas
Authors: Pérez Maure M , Subils G , Peresin Paz R , Cazaux A , Cambursano V H , Cortes J R 
Published: September 2024

Superior Cava Venous Syndrome (SVCS) encompasses a constellation of signsand symptoms resulting from partial or complete obstruction of blood flow through the superior vena cava (SVC) to the right atrium. Thrombosis can be caused by intrinsic (primary) or extrinsic compression (with or without secondary thrombosis).The causes of SVCS can be grouped according to their etiology in non-neoplastic and neoplastic. The causes malignant correspond to 65-90% of them, thrombosis and nonmalignant conditions are another causes.The presentation may be acute, clinically characterized by dyspnea and a characteristic triad (facial, neck and arms edema, cyanosis and collateral circulation).Early detection improves prognosis and is based on clinical data and imaging studies.We describe 8 cases where the SVCS was the first manifestation of neoplasticdiseases. Patients were predominantly of middle-aged, male, without association with consumption of tobacco and lymphoma was most frequent diagnosis
Comparación del control glucémico en pacientes diabéticos con y sin síndrome metabólico
Authors: Cruz del Castillo Aaron Humberto , Cordova Fernandez José A , Ramos Lagunes Ilse , Ortiz Solana Xochitl Erendira , Vigil Perez Claudia A , García Ramos Griselda 
Published: September 2024

Objective: To compare the glycemic level patients with type 2 diabetes (T2DM) with and without Metabolic syndrome (MS).
Methodology: cross sectional study. Included patients randomly DM2 corroborated in your clinical record. The SM was identified in patients with at least 3 of 5 criteria of ATP III (Adult Treatment Panel III). A questionnaire was structured. Hemoglobin was determined (HbA1c), HDL-cholesterol, triglycerides, hypertension (HBP), body mass index (BMI), waist circumference (WC) and hip (NCC). Results: 283 patients were included. Mean age was 59.8 ± 10.6. The predominant sex was female (73.6%). SM Criteria were : low HDL: 62.9%; hypertriglyceridemia: 56.3%; obesity abdominal (OA) 90.1%, hypertension (HBP): 62.5%. The prevalence of MS was 86.6% (95% CI 83% to 89%). There was significant difference in mean HbA1c level in patients with and without MS, HAS, OR, and low HDL. In contrast, subjects with hypertriglyceridemia had an HbA1c level significantly higher than those without hypertriglyceridemia (8.9% 2.3 vs 8.5% 2.1, respectively, P = 0.01). HbA1c is positively correlated with triglycerides (r = 0.24, p = 0.001), and negatively with weight (r = -0.19, p = 0.001), BMI (r = -0172, p = 0.004), CCI (r = -0.12, P = 0.004) and CCA (r = -0.14, p = 0.02). In adjusted multivariate analysis, only the duration of diabetes was associated with glycemic level (OR = 1.014, 95% in 1.010 to 1.016). Conclusions: We not found differences significant glycemic level in patients with and without MS.
Epidemiología de candidemia en Córdoba. Estudio de vigilancia de cinco instituciones
Authors: Riera F. , Medeot M , Sartori L , Bergallo C , Minoli J , Vilchez V , Sánchez P , Abiega C , Pincheira C , Correa S , Bartoli C , Figueroa M , Montamat M , Spitale N , Minguez A , Caeiro J O 
Published: September 2024

Resumen La incidencia de infecciones invasivas por Candida ha aumentado en forma dramática en los últimos 20 años, siendo causa importante de mortalidad en torno al 40% en los pacientes hospitalizados. Material y métodos: Se realizó un estudio retrospectivo, basado en reportes de laboratorio de cinco hospitales de tercer nivel de la ciudad de Córdoba entre enero de 2010 y agosto de 2012, con el objetivo de conocer la epidemiología regional. Resultados: 158 pacientes con candidemia, edad promedio de 55.8 años, el 60% internados en unidades de cuidados intensivos. Candida albicans 44%, Candida parapsilosis 22% y Candida tropicalis 12% fueron las principales especies aisladas. Candida parapsilosis estuvo comúnmente asociada a infecciones relacionadas a catéteres. Conclusiones: Esta serie local de la ciudad de Córdoba muestra que C. albicans, C. parapsilosis y C. tropicalis son las especies mas frecuentes coincidente con el perfil de las series publicadas en Argentina y Latinoamérica. Esto puede tener implicancias para decidir que agente antifúngico usar empíricamente para tratar las candidemias. Abstract The incidence rate of invasive infections due to Candida species has increased drastically in the last 20 years, causing a 40% mortality rate in hospitalized patients. In order to comprehend the epidemiology of Candida bloodstream infection, the study was carried out. Materials and methods: A retrospective study was done based on microbiology laboratory reports from five terciary care hospitals from the city of Cordoba between January 2010 and August 2012. Results: 158 patients had candidemia, the average age was 55,8 years, and 54% of patients were in the intensive care unit. Candida albicans (44%), Candida parapsilosis (22%) and Candida tropicalis (12%) were the main fungi isolated. Candida parapsilosis was commonly associated with catether infections. Conclusions: The data from the city of Cordoba showed that C. albicans, C. parapsilosis y C. tropicalis were the more frequent species isolated from blood cultures. This is similar to what is seen in other series published from Argentina and Latinamerica. This study may have implications when it comes to deciding which empiric antifugal agent is best for the treatment of candidemia.
Simple predictive model for early childhood caries of chilean children
Authors: Fierro Monti CLaudia , Perez Flores M , Brunotto M 
Published: September 2024

ABSTRACT Introduction: Early Childhood Caries (ECC), in both industrialized and developing countries, is the most prevalent chronic disease in childhood and it is still a health public problem, affecting mainly populations considered as vulnerable, despite being preventable. Objective The purpose of this study was to obtain a simple predictive model based on risk factors for improving public health strategies for ECC prevention for 3-5 year-old children. Methods - Clinical, environmental and psycho-socio-cultural data of children (n=250) aged 3-5 years, of both genders, from the Health Centers, were recorded in a Clinical History and Behavioral Survey. Results-24% of children presented behavioral problems (bizarre behavior was the main feature observed as behavioral problems). The variables associated to dmf ?4 were: bad children temperament (OR=2.43 [1.34, 4.40]) and home stress (OR=3.14 [1.54, 6.41]). It was observed that the model for male gender has higher accuracy for ECC (AUC= 78%, p-value=0.000) than others. Conclusions- Based on the results, we proposed a model where oral hygiene, sugar intake, male gender, and difficult temperament are main factors for predicting ECC. This model could be a promising tool for cost-effective early childhood caries control. RESUMEN Introducción: Las caries temprana de la infancia (CTI), a pesar de ser una enfermedad prevenible, permanece como uno de los problemas de salud pública, tanto en países industrializados como en los que están en vías de desarrollo, afectando principalmente a poblaciones vulnerables. Objetivo: el objetivo de este trabajo fue generar un modelo sencillo basado en factores de riesgo que sea predictivo del riesgo de CTI en niños de 3-5 años de edad a fin de mejorar las estrategias preventivas a nivel de salud pública. Métodos: Se recolectaron datos clínicos, del hogar y psico-socio-cultural de niños (n=250) de ambos sexos que concurren a centros de salud en la región del Bio Bio –Chile mediante historia clínica y encuesta de comportamiento. Resultados: 24% de los niños presentó problemas de comportamiento (un comportamiento extraño fue la principal característica observada como problema de comportamiento). Las variables asociadas a ceo ?4 fueron: mal temperamento del niño (OR=2,43 [1,34; 4,40]) y estrés del hogar (OR=3,14 [1,54; 6,41]). Se observe que el modelo estratificado por género masculino fue el que presentó la mayor precisión diagnóstica de CTI (AUC= 78%, p-valor=0.000); además Conclusiones: Proponemos un modelo donde la higiene oral, el consumo de azúcar, el género masculino y el mal temperamento son los principales factores de predictivos de CTI. Este modelo podría ser una herramienta promisoria para el costo-efectividad del control de caries temprana.
Síndrome de piernas inquietas: una amenaza a la calidad de vida
Authors: Castaño-Cárcamo Mauricio , Escobar-Córdoba Franklin , Rey de Castro Jorge 
Published: September 2024

ResumenEl síndrome de piernas inquietas (SPI) es un trastorno relacionado con la necesidad imperiosa de mover las extremidades inferiores, inicia a diferentes horas del día y empeora en la noche. Es aliviado por la actividad y afecta la calidad de vida y del sueño de quienes lo padecen. A pesar de ser un trastorno común a cualquier edad, en adultos tiene una prevalencia de hasta el 10%, es poco diagnosticado por los médicos de primer nivel y especialistas, por lo cual las intervenciones diagnósticas y terapéuticas se ven retrasadas. Lo anterior contribuye a la perpetuación de sus síntomas y empeoramiento de la calidad de vida. Ya que su diagnóstico es netamente clínico, familiarizarse con este trastorno del ciclo sueño vigilia, es fundamental para garantizar un adecuado enfoque y así descartar otras patologías que suelen confundirse con ésta entidad. El SPI posee etiología multifactorial, que abarca desde un componente genético y hereditario, denominándose SPI primario, hasta su asociación con múltiples patologías, conocido como SPI secundario. En cuanto a su tratamiento farmacológico y no farmacológico está orientado al control de los síntomas, ya que su curación no es posible, aunque ocasionalmente esta entidad puede remitir, para luego en meses o años recaer nuevamente.AbstractRestless legs syndrome is a disorder associated with the imperative need to move the legs, starting at different times of day and it gets worse at night, relieved by activity, affecting the quality of life and sleep who sufferers it. Despite being a common disorder at any age, in adults with a prevalence of up to 10%, is not diagnosed by doctors and frst level specialists that is why diagnostic and therapeutic interventions get delayed contributing to the perpetuation of symptoms and worsening quality of life. Since its diagnosis is purely clinical, getting familiar with this disorder is essential to ensure proper focus and thus rule out other diseases commonly confused with this one. Restless legs syndrome has a multi-factorial etiology that ranges from a genetic and hereditary, which are called primary restless legs syndrome, to its association with multiple pathologies, known as secondary restless legs syndrome. As for its management, drug therapy and non-drug therapy is aimed at symptom control, as its cure is not possible, although occasionally the condition can refer to later repeat in months or years.
Actitud de residentes de urgencias hacia la relación médico-paciente en el Hospital de Clínicas- Asunción, Paraguay
Authors: Silvero R A , Aranda G R , Cristaldo R , Recalde M E , Arias R , Presentado D , Patiño D , Acosta A A , Apuril E S , Hidalgo D , Capurro M H 
Published: September 2024

ResumenIntroducción: La relación médico-paciente está alcanzando gran importancia en los últimos tiempos, se resalta su importancia en aspectos tan variados como la satisfacción, el cumplimiento, la percepción de la competencia profesional, la frecuencia de problemas legales en relación a la mala praxis e incluso el pronóstico de la enfermedad o el estado de salud general del enfermo.Objetivo: Evaluar la relación médico-paciente desde el punto de vista de residentes de urgencia.Métodos: Se realizó un estudio observacional, de tipo descriptivo. La muestra consistió en 36 médicos de diferentes sectores de las Salas de Urgencias del Hospital de Clínicas – Asunción, Paraguay. Para estudiar la relación médico-paciente se utilizó el instrumento desarrollado por RA Chavarría-Islas et al., con cuatro indicadores: Respeto, Información, Consentimiento y Esmero.Resultados: El 69,4% de los residentes poseen una relación médico-paciente regular, no obstante el 2,78% posee una relación buena, 25% una relación mala y 2,78% una relación muy mala.Conclusión: Deficiencias en la relación médico-paciente. Es interesante invertir mayores esfuerzos para potenciar la relación médico-paciente como uno de las aristas para mejorar la atención médica, la cual es de vital importancia en los cuidados de emergencia. Summary Introduction: The doctor-patient relationship is reaching great importance in recent times, is highlighted their importance in areas as varied as satisfaction, compliance, perception of professional competence, the frequency of legal issues relating to malpractice and even the prognosis of the disease or the general health of the patient.Objective: To evaluate the doctor-patient relationship from the point of view of residents of emergency unit.Methods: An observational, descriptive study. The sample consisted of 36 doctors from different areas of the Emergency Rooms of the Hospital de Clínicas- Asunción, Paraguay. The patient-physician relationship was evaluated using an instrument developed by RA Chavarria-Islas et al. with four indicators: Respect, Information, Consent and Dedication. Results: 69.4% of residents have a regular patient-physician relationship; despite the 2.78% has a good relationship, 25% bad relationship and 2.78% a very bad relationship.Conclusion: Gaps in doctor-patient relationship were found in this study.. It is interesting to invest greater efforts to enhance the doctor-patient relationship as one of the edges to improve health care, which is vital in emergency care.
Osteoporosis y estatinas, Revisión
Authors: Astesana P , Gobbi C A , Alba Paula , Yorio M A 
Published: September 2024

La osteoporosis (OP) es una enfermedad ósea metabólica caracterizada por la presencia de baja masa ósea y deterioro microarquitectónico del tejido óseo, que predisponen a un incremento en la fragilidad del hueso y del riesgo de sufrir fracturas no traumáticas.La OP es considerada actualmente como un problema mayor en salud pública con más de 200 millones de personas afectadas en todo el mundo. En los últimos años, se ha reportado un incremento de su incidencia en América Latina y según datos de la OMS, el número de fracturas que se registrarán en esta región en los próximos 50 años casi igualará a las de Estados Unidos y Europa. Actualmente se estima que más del 50% de las mujeres y del 30 % de los hombres padecerán fracturas osteoporóticas a lo largo de su vida, y que número de fracturas de cadera aumentará en todo el mundo desde 1,7 millones (año 1990) hasta más de 6 millones para el 2050. Es importante destacar, que si bien es más frecuente en mujeres que hombres, la mortalidad debido a fracturas osteoporóticas es mayor en hombres que en mujeres...