Medicina-buenos Aires最新文献_第10页

[Microbiology and antibiotic-therapy in patients admitted to a Community Hospital according to days of hospitalization, 2022-2023]. [2022-2023年社区医院住院患者微生物学和抗生素治疗情况分析]。

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2025-01-01

Marcelo A Beltran, Diego E Couñago, Fernando Sandoval

{"title":"[Microbiology and antibiotic-therapy in patients admitted to a Community Hospital according to days of hospitalization, 2022-2023].","authors":"Marcelo A Beltran, Diego E Couñago, Fernando Sandoval","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Microorganisms isolated from clinical samples in hospitalized patients vary in species and antibiotic sensitivity, depending on whether they are community or healthcare-associated infections. In a hospital in the Buenos Aires Metropolitan Area, bacterial isolates and their antibiotic resistance were related to the length of hospitalization, as a guide to adjust antibiotic therapy.Materials and methods: Microbiological isolates, antibiogram results, and antibiotic treatment of hospitalized patients were recorded weekly between 1/1/2022 and 12/31/2023. Four groups were assigned according to time since hospitalization: G1 (<3 days), G2 (3-7 days), G3 (7-14 days), and G4 (≥14 days).Results: In the first week of hospitalization, the main microorganism isolated, from community-acquired infection, was Escherichia coli (132 isolates), with high levels of resistance to quinolones, followed by Klebsiella pneumoniae (82 isolates) and Staphylococcus aureus (64 isolates). Between 11/10/23 and 8/12/23, an outbreak of K. pneumoniae carbapenemase MBL was detected in biliodigestive and urological surgery, and it was controlled. Of the antibiotics used: ciprofloxacin went from second in use in G1 and first in G2, to third and fifth in G4. Indications for amoxicillin/sulbactam decreased from G3. Carbapenems and colistin increased from G3. Piperacillin/tazobactam and vancomycin were widely used in all periods. This simple weekly control allowed us to know the microbiology in the hospital, its antibiotic sensitivity patterns, detect outbreaks, and adjust the rational use of antibiotics, especially empirical, notably in the abuse of ciprofloxacin in urinary or abdominal foci; and compare the isolations and therapeutic behaviors with national and international patterns.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 1","pages":"16-22"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Extra-renal non-cerebral malignant rhabdoid tumor in children: does maintenance chemotherapy play a role in survival? 儿童肾外非脑恶性横纹肌瘤：维持性化疗对生存有影响吗？

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2025-01-01

Daniela Fortunati, Andrea Montanari, Marianela Viso, Guido Felizzia, Eric Warriner, Andrea Bosaleh, Ana Rizzi, Verónica Solernou, Jéssica López Marti, Victoria Sobrero, Paula Flores, Walter Cacciavillano, Michelle Schwartz, Giulia Racca, Adriana Rose

{"title":"Extra-renal non-cerebral malignant rhabdoid tumor in children: does maintenance chemotherapy play a role in survival?","authors":"Daniela Fortunati, Andrea Montanari, Marianela Viso, Guido Felizzia, Eric Warriner, Andrea Bosaleh, Ana Rizzi, Verónica Solernou, Jéssica López Marti, Victoria Sobrero, Paula Flores, Walter Cacciavillano, Michelle Schwartz, Giulia Racca, Adriana Rose","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Malignant rhabdoid tumor (MRT) is a highly aggressive disease, mainly affecting infants and small children.Material and methods: Between January 2007 and May 2021 a retrospective study was conducted at the Hospital de Pediatría J. P. Garrahan in Buenos Aires, Argentina, including 13 patients diagnosed with ERNC-MRT (extra-renal non-cerebral malignant rhabdoid tumor). Event-free survival (EFS) and overall survival (OS) were assessed using the Kaplan-Meier method and compared using the log-rank test.Results: Seven patients were less than 1 year old, all of them died. Four of 13 had metastatic disease, all of them in the lungs, 2 had locoregional lymph node involvement. Six achieved complete remission, 4 of them remained alive. Five received maintenance therapy (MT) with cyclophosphamide/vinorelbine, 4 were alive at last follow-up. Only one was studied for germline mutations, the result was negative. With a median follow-up of 126 months (range: 72-161), 3 and 5-year EFS and OS were 30.7% and 38.4%, respectively.Discussion: Although the sample size is small, survival rates are similar or slightly lower than other series. Age was the main prognostic factor. All but one patient that received MT are alive, suggesting that MT might have a role in ERNC-MRT; however, the prognostic significance is not entirely clear since there are multiple confounding factors.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 1","pages":"101-111"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Myeloproliferative syndrome as a cause of chorea]. [引起舞蹈病的骨髓增生性综合征]。

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2025-01-01

Marta Zerga, Miguel Wilken, Anahí Vijnovich Barón, Noemí Pintos, Irene Rey

{"title":"[Myeloproliferative syndrome as a cause of chorea].","authors":"Marta Zerga, Miguel Wilken, Anahí Vijnovich Barón, Noemí Pintos, Irene Rey","doi":"","DOIUrl":"","url":null,"abstract":"With the aim of reporting an unusual association, we present the case of a 78-year-old female, with a diagnosis of essential thrombocytemia (ET), JAK 2 positive, of more the 20 years' evolution, without evidence of acute transformation, and with the appearance of an associated neurological condition characterized by abnormal choreic movements, during the last year of the evolution of the hematological disease. On the other hand, chorea is a type of movement disorder characterized by involuntary, sudden movements, that can occur in one part of the body and then spread to others. Most cases of chorea are caused by structural or functional problems in the basal ganglia. It can be hereditary or acquired. In the literature, there are isolated reports of the association between adult-onset chorea and JAK2 mutation, especially related to polycythemia vera. The pathogenesis of chorea associated with myeloproliferative syndromes is unknown. It has been postulated that the gain of a function conferred by the JAK 2 mutation on the non-mutated gene could lead to a pro-inflammatory status in the neurons of the basal ganglia, which would alter their signaling pathways and therefore their functioning. For this reason, neurologists usually recommend ruling out the possibility of underlying myeloproliferative processes in adult patients diagnosed with acquired chorea whose etiology has not been established.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 3","pages":"615-617"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Marcus Gunn syndrome: a released phylogenetic old reflex? Marcus Gunn综合征：释放的系统发育反射？

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2025-01-01

Pablo Young, Bárbara C Finn, Tomás Romero, Tomás Moya, Ricardo C Reisin

引用次数: 0

Smoke inhalation injury. 烟雾吸入伤害。

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2025-01-01

Eugenio Cautures, Walter D Sacchi, Juan Ignacio Ibarzabal, Lisandro R Bettini

引用次数: 0

[Ondine syndrome: myth meets reality]. [在线综合症：神话遇到现实]。

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2025-01-01

Martín Ingrisani, Eduardo Borsini, Sebastián Menazzi, María Ana Redal, Bethy Camargo, Glenda Ernst, Pablo Young

引用次数: 0

[DRESS syndrome due to antituberculosis drugs. Review and comments]. 抗结核药物引起的DRESS综合征。回顾和评论]。

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2025-01-01

Laura Lagrutta, Ana Gamberale, Bruno Bartoletti, Adriana Rodríguez Mieres, Rodrigo Failde, Fernanda Bornengo, Sandra Inwentarz, Marisa Vescovo, Graciela Casado, Domingo Palmero

引用次数: 0

[Prevention and treatment of infections in phlebology and lymphology]. [静脉、淋巴感染的预防与治疗]。

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2025-01-01

Fanny Rodríguez Santos, Oscar Bottini, Yanina Nuccetelli, María Paula Herrera, Felipe Huaier, Lorena Abusamra, Laura De Aguilar, Marcelo Gañete, Cristina Freuler, Marta Torres, Alicia Sisto, Rosana Cuini, Edith Carbone, Guillermo Recupero, María Victoria Loson, Cecilia Jorge, Sofía Rochet, Marcelo Morales, Roberto Mengarelli, Benilde C Aroca Fraccia, Pablo Mañanes, María Monserrat Diaz, Marcelo Kornberg, Eduardo Halusch, Carlos Simkin, Rubén Velletaz, Daniela Calcina, Daniel Guglielmone, Eugenia Di Líbero, María Inés Staneloni

{"title":"[Prevention and treatment of infections in phlebology and lymphology].","authors":"Fanny Rodríguez Santos, Oscar Bottini, Yanina Nuccetelli, María Paula Herrera, Felipe Huaier, Lorena Abusamra, Laura De Aguilar, Marcelo Gañete, Cristina Freuler, Marta Torres, Alicia Sisto, Rosana Cuini, Edith Carbone, Guillermo Recupero, María Victoria Loson, Cecilia Jorge, Sofía Rochet, Marcelo Morales, Roberto Mengarelli, Benilde C Aroca Fraccia, Pablo Mañanes, María Monserrat Diaz, Marcelo Kornberg, Eduardo Halusch, Carlos Simkin, Rubén Velletaz, Daniela Calcina, Daniel Guglielmone, Eugenia Di Líbero, María Inés Staneloni","doi":"","DOIUrl":"","url":null,"abstract":"Skin and soft tissue infections in patients with venous and lymphatic diseases are a common occurrence with a notable impact on quality of life and healthcare costs. Furthermore, there are challenges in diagnosing and managing these infections, as inflammatory conditions linked to chronic venous disease can mimic infections, leading to the inappropriate use of antimicrobials and increased antimicrobial resistance. To effectively manage these infections, a multidisciplinary approach is essential, integrating non-pharmacological treatments and promoting the rational use of antimicrobials, particularly in resource-limited contexts like Latin America, where local needs are not adequately addressed by existing guidelines. This document, developed in collaboration with the Argentine Society of Infectology and national and regional Phlebology and Lymphology Societies, presents recommendations to prevent and effectively treat infections associated with venous and lymphatic pathologies in adults. Additionally, it incorporates the perspective of patient societies to provide a comprehensive and contextualized approach.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 4","pages":"785-809"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Evolution of biological management during pregnancy: from uncertainty to evidence in rheumatoid arthritis]. [妊娠期生物管理的演变：从不确定性到类风湿关节炎的证据]。

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2025-01-01

Juan Pablo Vinicki, José L Velasco Zamora

{"title":"[Evolution of biological management during pregnancy: from uncertainty to evidence in rheumatoid arthritis].","authors":"Juan Pablo Vinicki, José L Velasco Zamora","doi":"","DOIUrl":"","url":null,"abstract":"Over the last decade, the management of biologic therapies during pregnancy in rheumatoid arthritis (RA) patients has significantly evolved, shifting from uncertainty to robust evidence. Initially, in 2006, the use of these treatments was discouraged due to insufficient safety data and potential fetal risks. Notable cases, such as the fatal disseminated BCG infection in a newborn exposed to infliximab, highlighted the importance of neonatal monitoring and led to guidelines restricting live-virus vaccinations until 12 months. Later studies demonstrated significant differences in placental transfer among biologics: infliximab and adalimumab exhibit high transplacental transfer, whereas certolizumab pegol shows minimal transfer due to its molecular structure. Recent observational studies and meta-analyses have not demonstrated significant increases in spontaneous abortions, major congenital defects, or serious infections among offspring exposed to anti-TNF biologics. However, certain studies suggest a slight elevation in congenital defects, potentially attributable to methodological biases. Current international guidelines recommend the continued use of anti-TNF biologics throughout pregnancy, with individualized evaluation during the third trimester for biologics containing the Fc fragment. Evidence remains limited for non-anti-TNF biologics and JAK inhibitors, underscoring the need for further research. Postnatal monitoring remains critical, particularly deferring live attenuated vaccines in exposed infants until 6-12 months. In summary, accumulated evidence now supports the relative safety of continuing anti-TNF biologics throughout pregnancy in RA patients but emphasizes the necessity for ongoing long-term safety assessments.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 4","pages":"778-784"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Compartment syndrome of the leg secondary to a muscle tear in an anticoagulated elderly patient]. [老年抗凝患者继发于肌肉撕裂的腿部筋膜室综合征]。

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2025-01-01

Juan Ignacio Perez-Abdala, Rocío Avanzi, Franco Villa-Duarte, Jorge Barla, Danilo Taype, Carlos Sancineto, Guido Carabelli

引用次数: 0