Federico Suldrup, Nicolás R Della Nave, María Florencia Sanchez, Carolina Diego, Esteban González Salazar
{"title":"[Intestinal obstruction caused by colonic diaphragmatic ring secondary to chronic use of nonsteroidal anti-inflammatory drugs].","authors":"Federico Suldrup, Nicolás R Della Nave, María Florencia Sanchez, Carolina Diego, Esteban González Salazar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The case involves a 61-year-old female patient with a history of systemic lupus erythematosus, who sought urgent medical attention due to abdominal pain and an abdominal tomography consistent with colonic obstruction. Exploratory laparotomy followed by transverse colectomy was performed. The pathological examination of the specimen revealed a colonic diaphragmatic ring secondary to chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs). This condition primarily affects elderly women exposed to chronic NSAID therapy. It results from mucosal ulceration followed by submucosal inflammation and fibrosis. Management involves, in addition to discontinuation of the medication, surgical resection in acute cases, or diagnostic-therapeutic endoscopy in uncomplicated cases.</p>","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 1","pages":"217-220"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123224","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}
{"title":"[Synthesis of artificial life].","authors":"Sebastián A Correa","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 1","pages":"259"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122935","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}
{"title":"[Previous dengue infection, severity of a second infection and the possible role of DENV-2].","authors":"Isabel N Kantor","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 1","pages":"148-151"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123146","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}
Agustina Senese, Gabriel Goldraij, Débora Lema, Juan José Fernández Muñoz, Pilar Barenstein-Fonseca, Vilma A Tripodoro
{"title":"Argentinian validation of the attitudes Towards Euthanasia Scale.","authors":"Agustina Senese, Gabriel Goldraij, Débora Lema, Juan José Fernández Muñoz, Pilar Barenstein-Fonseca, Vilma A Tripodoro","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Although euthanasia is an issue on the Argentinean parliamentary agenda, there is still confusion about its conceptualisation and limitations to its study. Attitudes towards euthanasia among the seriously ill remain under-researched. We aimed to validate the Attitudes Towards Euthanasia scale in Argentina by cross-culturally adapting to the Spanish-Argentine language and exploring psychometric characteristics.</p><p><strong>Materials and methods: </strong>A cross-sectional study used the Attitudes Toward Euthanasia Scale on a non-probabilistic sample of short-life expectancy patients. We selected Argentina's sample from seven healthcare centres to recruit a broad socio-demographic spectrum of patients. Inclusion criteria were patients with advanced disease, over 18 years of age, aware that the disease was probably incurable, and able to sign an informed consent form.</p><p><strong>Results: </strong>The selected sample comprised 167 very sick patients. Among them, 72.5% had cancer. The average age of the participants was 68 (SD= 14.03), and 50.9% were female; 34.7% held university degrees; 58.7% reported being affiliated with a religious organisation. The scale's psychometric properties, including reliability and validity, were assessed using an exploratory and confirmatory factor analysis. The internal consistency throughout Cronbach's Alpha was 0.837. The range of items of homogeneity was from 0.179 to 0.745. The study found no significant differences in perceptions concerning euthanasia between variables such as diagnosis, gender, university studies level, and religious affiliation.</p><p><strong>Discussion: </strong>The validation of the Attitudes Towards Euthanasia scale to a sample of seriously ill Argentinean patients has shown adequate psychometric properties, with some limitations.</p>","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 2","pages":"296-304"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803520","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}
Andrea C Muñoz Cárdenas, María M Clavijo, Claudia E Casali, María A Vicente Reparaz, Carolina V Mahuad, María F Aizpurúa, Gonzalo M Garate
{"title":"[Antithrombotic therapy in deep venous thrombosis associated with port-a-cath catheter in patients with cancer: evidence in Argentina].","authors":"Andrea C Muñoz Cárdenas, María M Clavijo, Claudia E Casali, María A Vicente Reparaz, Carolina V Mahuad, María F Aizpurúa, Gonzalo M Garate","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Recommendations for treating catheter-associated deep vein thrombosis (DVT) and cancer are based on studies of lower extremity DVT, due to the lack of direct evidence. The aim of the study was to describe antithrombotic strategies, catheter management, and compare outcomes according to strategy and anticoagulant used, in a subanalysis of patients with port-a-cath-associated DVT from a cancer-related thrombosis cohort.</p><p><strong>Materials and methods: </strong>Retrospective, single-center cohort study, from January 2016 to March 2022. Three strategies were evaluated after 3-6 months of full anticoagulation: A) dose reduction, B) maintenance, and C) discontinuation. Major bleeding (MB), clinically relevant non-major bleeding (CMNMB), and recurrent venous thromboembolism (rVTE) rates were compared by strategy and anticoagulant.</p><p><strong>Results: </strong>A total of 112 patients were included, treated with rivaroxaban (48%), apixaban (2%), and enoxaparin (24%). Eighty-two patients underwent strategy A, B, or C, and 46 underwent catheter removal. The MB/CMNMB rate was 14%, and the MB/CMNMB rate was 1%. The MB/CMNMB rates were 5/42 for A, 6/36 for B, and 1/4 for C (p=0.7). One MB/CMNMB event was recorded in A and B, with no events in C (p=0.94). With apixaban, MB/CMNMB was 3/31; with enoxaparin, 6/27; and with rivaroxaban, 7/54 (p=0.36). The MS/SNMCR rate was 2/31 with apixaban, 0/54 with rivaroxaban and 0/27 with enoxaparin (p=0.06).</p><p><strong>Discussion: </strong>No significant differences were found in ETVr, MS or SNMCR between strategies or anticoagulants.</p>","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 2","pages":"305-313"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803651","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}
Paula Pérez Terns, Ezequiel Forte, Sergio Giménez, Augusto Lavalle Cobo
{"title":"[High/very high cardiovascular risk diabetes. How much does the cardiologist know?]","authors":"Paula Pérez Terns, Ezequiel Forte, Sergio Giménez, Augusto Lavalle Cobo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Type 2 diabetes mellitus (T2D) carries a significant cardiovascular (CV) risk, highlighting the key role of the cardiology specialist in its management. Based on a Spanish publication, Argentine cardiology specialists explored cardiologist knowledge on the diagnosis and treatment of T2D in patients with high/very high CV risk. Ninety-eight clinical cardiologists not expert in T2D were assessed using a self-audit questionnaire before and after watching four educational videos. After the educational intervention, greater attention was observed to key indicators, such as waist circumference, microalbuminuria, and oral glucose tolerance test, to define treatment plans. Likewise, strict control of arterial hypertension and LDL cholesterol levels was emphasized. In addition, a tendency was found to simplify pharmacotherapy and a trend towards simplifying drug therapy for better cardiovascular outcomes emerged. Although knowledge on the diagnosis and treatment of T2D by Argentine clinical cardiologists is adequate in certain aspects, there are areas that can be improved. Transforming these knowledge gaps into intervention opportunities allows for the development of strategies aimed at optimizing the diagnosis, management and prevention of CV complications in patients with T2D.</p>","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 2","pages":"404-423"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803706","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}
Carla Coca Carrasco, Daniela Pedrón, Magalí Crucci, Enrique Romero Leiva, Agostina Pellegrino, Diego F Baenas, Elisa B Novatti, Pehuén Fernández, Emanuel J Saad
{"title":"[Clinical and radiological characteristics of patients with low back pain treated in a hospital].","authors":"Carla Coca Carrasco, Daniela Pedrón, Magalí Crucci, Enrique Romero Leiva, Agostina Pellegrino, Diego F Baenas, Elisa B Novatti, Pehuén Fernández, Emanuel J Saad","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Low back pain is one of the main causes of medical consultation worldwide, with heterogeneous management in the request for complementary methods. This study sought to determine the frequency and clinical and imaging characteristics of patients with low back pain in a tertiary hospital, considering the presence or absence of red flags.</p><p><strong>Materials and methods: </strong>A retrospective analytical study was carried out at the Private University Hospital of Córdoba. Patients over 18 years of age who consulted for the first time for low back pain between January and June 2021 were included, excluding pregnant and those without complete records.</p><p><strong>Results: </strong>A total of 880 patients were included. Of these, 589 (67%) presented acute low back pain, 112 (13%) subacute and 179 (20%) chronic. Simple low back pain was the most common cause (n=652, 74%), followed by herniated disc (n=179, 20%) and spondylolisthesis (n=33, 4%). Red flags were identified in 190 (22%) patients according to American College of Radiology (ACR) criteria and in 420 (48%) according to the Agency for Health Care Policy and Research (AHCPR). Imaging studies were performed in 314 (75%) patients with AHCPR criteria and 255 (55%) with ACR criteria. Neoplasia/infection and vertebral fracture were diagnosed in 2 (2%) and 5 (9%) patients with red flags, respectively.</p><p><strong>Discussion: </strong>The first consultation for low back pain represented 1.8% of consultations, with acute low back pain being more frequent. Obesity was the most common comorbidity. About half of the patients had red flags according to AHCPR and 21% according to ACR.</p>","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 1","pages":"112-125"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123213","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}
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":"<p><strong>Introduction: </strong>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.</p><p><strong>Materials and methods: </strong>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).</p><p><strong>Results: </strong>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.</p>","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}