Medicina-buenos Aires最新文献_第2页

[The most serious comorbidities of ADHD: a worrying review].

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2025-03-01

Germán Casas, Carolina García S, Damaris Cote Martínez

{"title":"[The most serious comorbidities of ADHD: a worrying review].","authors":"Germán Casas, Carolina García S, Damaris Cote Martínez","doi":"","DOIUrl":"","url":null,"abstract":"Attention-deficit hyperactivity disorder (ADHD) is the most prevalent neurodevelopmental disorder in children and adolescents, and it is frequently associated with a range of comorbidities. However, an analysis of critical factors -such as mortality, legal issues, access to care, and academic or occupational impairment- reveals that the most serious comorbidities of ADHD are primarily psychiatric in nature. These include depression, suicidal behaviors, substance use disorders, legal problems, and personality disorders, particularly borderline and antisocial personalities. These comorbid conditions share core features, including difficulties with self-regulation, impulsivity and repetitive behaviors. They also exhibit overlapping neurological and genetic substrates, as well as common environmental risk factors. A review of the current literature underscores the significant morbidity and adverse outcomes associated with ADHD when these comorbidities are present. Given the complexity and severity of these conditions, it is crucial for clinicians working with children and adolescents, to be vigilant about monitoring their appearance. Early recognition and intervention may help mitigate the risk of developing these associated psychiatric disorders and their long-term consequences. Furthermore, evidence suggests that timely and appropriate treatment of ADHD can play a protective role in preventing the onset of these comorbid conditions.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 Suppl 1 ","pages":"16-21"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527912","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

[Neurophysiological approach to Attention Deficit Hyperactivity Disorder].

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2025-03-01

María Ángeles Idiazábal Alecha, Montserrat Palau Baduell

{"title":"[Neurophysiological approach to Attention Deficit Hyperactivity Disorder].","authors":"María Ángeles Idiazábal Alecha, Montserrat Palau Baduell","doi":"","DOIUrl":"","url":null,"abstract":"Attention Deficit Hyperactivity Disorder (ADHD) is the most common neurodevelopmental disorder in childhood. Its diagnosis and treatment are complex due to its clinical heterogeneity and comorbid pathologies, such as epilepsy and sleep disorders, which affect its evolution and management. Studies such as electroencephalogram (EEG), quantified EEG and event related potentials (ERP) provide key neurophysiological information to better understand this disorder. EEG allows the identification of abnormal patterns such as increased frontal theta activity and increased the theta/beta ratio, which are associated with problems with attention and inhibitory control. Comorbidity between epilepsy and ADHD is high. Patients with ADHD are more likely to present subclinical interictal discharges. EEG allows us to differentiate between ADHD and epilepsy symptoms, such as typical absences, which can be confused with inattention, as well as detect the presence of interictal epileptiform discharges, improving diagnosis and treatment. ERP, such as P300, evaluate cognitive functions such as attention, working memory and inhibitory control, providing information for the diagnosis, developmental monitoring and treatment of ADHD. In parallel, sleep studies using polysomnography reveal a high prevalence of sleep disorders such as respiratory disorders and decreased REM sleep, exacerbating ADHD symptoms. Neurophysiological studies allow a more precise approach to ADHD, integrating objective diagnoses and personalized treatments that improve clinical results and long-term prognosis.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 Suppl 1 ","pages":"42-47"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527895","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

[Computerized cognitive training as a treatment for ADHD: evidence summary and future directions].

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2025-03-01

Jacobo Albert, Sara López-Martín, Alberto J Sánchez-Carmona, Beatriz Calleja-Pérez, Ana L Fernández-Perrone, Nuria Muñoz-Jareño, Ana Jiménez de Domingo, Daniel Martín Fernández-Mayoralas, Alberto Fernández-Jaén

{"title":"[Computerized cognitive training as a treatment for ADHD: evidence summary and future directions].","authors":"Jacobo Albert, Sara López-Martín, Alberto J Sánchez-Carmona, Beatriz Calleja-Pérez, Ana L Fernández-Perrone, Nuria Muñoz-Jareño, Ana Jiménez de Domingo, Daniel Martín Fernández-Mayoralas, Alberto Fernández-Jaén","doi":"","DOIUrl":"","url":null,"abstract":"Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention and/or hyperactivity/impulsivity, which is associated with various neuropsychological deficits. These deficits are thought to mediate the relationship between etiological factors and the manifestation of the disorder, making them important targets for treatment. Within this context, and based on promising results, computerized cognitive training (CCT) through adaptive programs and/or video games has garnered considerable interest. Therapeutic programs and video games for ADHD have even been commercialized. However, the most rigorous and reliable evidence currently available suggests that CCT, in its current forms, lacks sufficient empirical support to be considered either a standalone or an alternative treatment to first-choice interventions for ADHD. Its effects on core ADHD symptoms are modest and limited, with minimal transfer or generalization to other contexts or functional skills. The complexity of ADHD suggests that highly specific, singular interventions such as CCT may be neither appropriate nor sufficient as standalone treatments. Further research is needed to evaluate the added effects of CCT when integrated with existing treatments, including its role within more holistic and comprehensive neuropsychological interventions.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 Suppl 1 ","pages":"30-35"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527887","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

[Scimitar syndrome].

IF 0.6 4区医学

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

Jacqueline M Galiano, Kevin Santana Alessio, Carlos A Soler

引用次数: 0

"I would prefer not to". Autonomy and the boundaries of medical intervention.

IF 0.6 4区医学

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

Gustavo Kusminsky

引用次数: 0

[Ectopic ACTH secretion by neuroendocrine carcinoma of the uterine cervix]. [宫颈神经内分泌癌异位分泌促肾上腺皮质激素]。

IF 0.6 4区医学

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

Eugenia C Authier Cipolla, Mara R Touriñan, Carolina B Lamonica, Agostina R Bazzi, Noelia Y Scagliarino, Silvina Tormo, Julieta Guyot, Paola C Vigna, Evangelina Giacoia

{"title":"[Ectopic ACTH secretion by neuroendocrine carcinoma of the uterine cervix].","authors":"Eugenia C Authier Cipolla, Mara R Touriñan, Carolina B Lamonica, Agostina R Bazzi, Noelia Y Scagliarino, Silvina Tormo, Julieta Guyot, Paola C Vigna, Evangelina Giacoia","doi":"","DOIUrl":"","url":null,"abstract":"Cushing's syndrome due to ectopic ACTH secretion (EAS) is a consequence of deregulated ACTH secretion by neuroendocrine neoplasms with different locations, most commonly in the thorax. Neuroendocrine tumors represent less than 2% of all invasive cervical cancers. They tend to be highly aggressive, showing rapid growth and distant metastasis at the time of diagnosis. We present a 25-year-old female, with no relevant medical history, who came to our hospital with 1-monthold acne-like lesions on the face, neck, and chest, facial edema, blurred vision, and progressed with delirium, incoherent speech, and suicidal ideation. Hypertension, hypokalemia, hyperglycemia, and metabolic alkalosis were found. The condition was interpreted as a severe, rapid-onset Cushing's syndrome, with significant compromise in general condition. The syndrome and its dependence on ACTH were confirmed by biochemical tests. Computed tomography revealed multiple lesions in the liver and spine suggesting metastatic cancer. After reporting a history of postcoital bleeding, a speculoscopy was performed, and a biopsy was taken of the cervix, as well as the liver lesions. In both cases, histopathological findings revealed the presence of small cell neuroendocrine carcinoma, and chemotherapy with cisplatin and etoposide was initiated. This case represents an example of an uncommon disease that usually implies an important diagnostic and therapeutic challenge. The severity of this condition may be a consequence of the aggressiveness of the ACTH-secreting tumor and/or hypercortisolism with its multiple complications.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 2","pages":"439-444"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803703","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

[In-hospital mortality from cerebrovascular accidents in an urban center in Argentina]. [阿根廷城市中心的脑血管意外住院死亡率]。

IF 0.6 4区医学

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

María Martina Echarri, Federico Rodríguez Lucci, Virginia Pujol Lereis, Marina Y Finkelsztein, Claudio D González, Sebastián F Ameriso

{"title":"[In-hospital mortality from cerebrovascular accidents in an urban center in Argentina].","authors":"María Martina Echarri, Federico Rodríguez Lucci, Virginia Pujol Lereis, Marina Y Finkelsztein, Claudio D González, Sebastián F Ameriso","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: In-hospital mortality is influenced by various factors. Despite the trend toward decreased mortality from acute stroke in the Northern Hemisphere, reports in our region show variable figures. This study reports in-hospital mortality for the second time from a medical center in Ciudad de Buenos Aires. Factors associated with mortality in these patients were also identified.Materials and methods: A retrospective study was conducted using data from the FLENI Stroke Database between 2010 and 2019, analyzing clinical characteristics, risk factors, complications, and mortality of hospitalized patients. Univariable and multivariable statistical analyses were used to identify risk factors associated with in-hospital mortality.Results: Data from 1645 patients were analysed, of which 1476 (90%) had ischemic stroke, 95 (6%) had hemorrhagic stroke, and 74 (4%) had aneurysmal subarachnoid hemorrhage (aSAH). There were 45 in-hospital deaths (2%): 26 deaths (1%) from ischemic stroke, 11 deaths (11%) from hemorrhagic stroke, and 8 deaths (10%) from aSAH. Factors associated with mortality include advanced age, low hemoglobin levels at admission, higher scores on the NIHSS scale at admission, and a history of diabetes mellitus.Discussion: In-hospital mortality from stroke remains low in our institution, with differences between ischemic and hemorrhagic stroke. Factors such as stroke severity, hemoglobin levels, and a history of diabetes mellitus are independent predictors of mortality.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 2","pages":"337-347"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803707","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

[Breastfeeding in people with HIV, from taboo to reality].

IF 0.6 4区医学

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

Leda Guzzi, Silvana Lauro, Gloria Amborosioni, Pilar Cancela, Mónica Castells, Claudio Comparato, Rocío López, Natalia Laufer, Isabel Casetti

引用次数: 0

[Dose banding. Observational study on cost optimization in chemotherapy].

IF 0.6 4区医学

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

José M Sanguinetti, Federico N Cisneros, Gustavo H Marin

{"title":"[Dose banding. Observational study on cost optimization in chemotherapy].","authors":"José M Sanguinetti, Federico N Cisneros, Gustavo H Marin","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: The cost of cancer treatments is a concern of the health system. The search for strategies that optimize the costs of these treatments is essential to ensure access to them. Dose banding is a methodology that has been successfully implemented in several countries, demonstrating effectiveness and efficiency. It is based on establishing dose bands rounding cytostatics ±5% and monoclonal antibodies ±10%, optimizing commercial presentations and avoiding waste. In our country there are no experiences with this system. The objective was to evaluate the savings in drug costs using dose banding.Material and methods: Observational study of the costs of oncology drugs in a sample of patients affiliated with the Institute of Social Work of the Armed Forces (IOSFA) diagnosed with breast, colon and prostate cancer who received treatment during June 2022. The cost of each dose was determined and was simulated according to the dose banding system.Results: Twenty-eight patients who received 29 doses were analysed.Diagnoses: colon cancer (n:7; 25.0%), breast cancer (n:18; 64.3%) and prostate cancer (n:3; 10.7%). Mean age 61.7 years (range 34-85 years); 22 patients were female. Drugs tested: bevacizumab, cabazitaxel, cetuximab, docetaxel, trastuzumab, and trastuzumab+emtasine. The total cost was $14 101 596.39 (U$S 112 605.58 -sale value of the U.S. dollar in the Banco Nación Argentina, June 30, 2022), the simulation of the application of dose banding showed a cost of $11 185 371.49 (U$S 89 318.63). The potential savings are 20.7%.Discussion: Dose standardization may represent a strategy that generates a significant decrease in cancer treatment costs.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 1","pages":"96-100"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123216","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

[Can narrative medicine help us?]

IF 0.6 4区医学

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

Carlos Tajer, Gustavo Kusminsky

引用次数: 0