Medicina-buenos Aires最新文献_第7页

[The importance of immune system activation and vaccination in pediatrics]. [儿科免疫系统激活和疫苗接种的重要性]。

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2026-01-01

Guillermo Docena, Gabriela Barbas, Ana Ceballos, Daniela Hozbor, Ignacio Maglio, Mirta Roses Periago, Andrea Uboldi, Gabriela Vidal, Ángela Gentile

{"title":"[The importance of immune system activation and vaccination in pediatrics].","authors":"Guillermo Docena, Gabriela Barbas, Ana Ceballos, Daniela Hozbor, Ignacio Maglio, Mirta Roses Periago, Andrea Uboldi, Gabriela Vidal, Ángela Gentile","doi":"","DOIUrl":"","url":null,"abstract":"Vaccination has transformed child health worldwide, preventing millions of deaths from infectious diseases. Early life immune responses differ from adults due to the relative immaturity of innate and adaptive immunity, making early-life vaccination critical for individual and population-level protection. Vaccines mimic natural infection to induce targeted, controlled, and safe immune activation, promoting both effector responses and long-term immune memory while avoiding the risks of disease. Trained immunity, a form of innate immune memory induced by live attenuated vaccines, further enhances non-specific and heterologous protection in early life. Evidence consistently shows that pediatric vaccination is safe, does not overload the immune system, and is essential for individual health, herd immunity, and the prevention of disease resurgence. This communication highlights the immune mechanisms underlying vaccine responses, the distinctive features of the pediatric immune system, the public health impact of vaccination programs, and provides recommendations for optimizing immunization strategies.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"86 4","pages":"869-875"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761330","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

[Application of a short version of the Barthel Index for functional stratification in inpatients with multiple pathology (Mini-Barthel)]. [简易Barthel指数在多重病理住院患者功能分层中的应用（Mini-Barthel）]。

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2026-01-01

Dino Moretti, Guido Novello, Carina Cadavay, Matias Talamona, Karen Claverie, María Florencia Michel, María Paz Olivieri, Victoria Cagliero, Martín Migliaro, Juliana Castro, Francisco Rossi, Nadia Quiñones, Martín Buncuga

{"title":"[Application of a short version of the Barthel Index for functional stratification in inpatients with multiple pathology (Mini-Barthel)].","authors":"Dino Moretti, Guido Novello, Carina Cadavay, Matias Talamona, Karen Claverie, María Florencia Michel, María Paz Olivieri, Victoria Cagliero, Martín Migliaro, Juliana Castro, Francisco Rossi, Nadia Quiñones, Martín Buncuga","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Functional impairment is prevalent in patients with multiple pathologies (PP) and implies the need for caregivers, impaired quality of life, and increased mortality. The objective was to evaluate the functional stratification and prognostic performance of the MiniBarthel (MB), a short, simplified, three-dimensional version of the Barthel Index (BI), in hospitalized PP.Materials and methods: A prospective, observational study was conducted. The PROFUND prognostic score was administered upon admission, and patients were classified as MB0 (cannot do anything alone), MB1 (can feed themselves), MB2 (can feed and ambulate alone), and MB3 (can feed, ambulate, and climb stairs alone) by the attending physician. The BI was determined by the physical therapist to maintain the blinding. A 12-month follow-up was conducted to assess survival.Results: Ninety-nine patients were enrolled in the study, of whom 50 (50.5%) died during follow-up. They classified 21%, 17%, 17%, and 44% of patients as MB0, MB1, MB2, and MB3, with a median (IQR) BI of 10 (5- 20), 50 (40-60), 85 (75-90), and 95 (80-100) p < 0.001 and mortality of 66%, 64%, 52%, and 34% p 0.014, respectively. The area under the curve (AUC) (95% CI) of PROFUND, IB, and MB to discriminate 12-month mortality was 0.661 (0.553-0.769), 0.655 (0.547-0.762), and 0.654 (0.546-0.749), respectively.Conclusion: The Mini-Barthel's high performance, simplicity, and ease of use for functional stratification would enable a proactive approach to frailty and dependency care, focusing on functional decline and prognosis in hospitalized patients with multiple pathologies.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"86 2","pages":"425-438"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654402","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

Educational intervention to improve adherence after acute coronary syndrome. 教育干预提高急性冠脉综合征患者依从性。

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2026-01-01

Gabriel González Villa Monte, Juan Bacigalupe, Maximiliano De Abreu, Laura Antonietti, Gloria Luna, Carlos Tajer, Javier Mariani

{"title":"Educational intervention to improve adherence after acute coronary syndrome.","authors":"Gabriel González Villa Monte, Juan Bacigalupe, Maximiliano De Abreu, Laura Antonietti, Gloria Luna, Carlos Tajer, Javier Mariani","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Patients discharged with a diagnosis of acute coronary syndrome (ACS) are at increased risk for recurrent cardiovascular events. Improved adherence to treatment has been associated with better outcomes. The objective of this study was to evaluate the effect of an educational intervention on medication adherence in patients following ACS.Materials and methods: A single-center, randomized, open-label, controlled clinical trial with parallel groups and a six-month follow-up.Results: Sixty-three patients were randomized to the mixed educational intervention group and sixty-nine to the control group. Baseline characteristics were similar between groups: 82.6% were male, with a median age of 56 years (IQR 51-61), 73.5% had completed primary education. Mean ejection fraction (EF) was 47.7% (SD 12.33). Most patients were discharged with more than four medications, with a median of seven (IQR 6.0-8.0) tablets per day. At one month, adherence was 80.0% in the intervention group and 66.2% in the control group (RR 1.21; 95% CI 0.97-1.50; p = 0.12). At three months, adherence was 79.7% vs. 77.4% (RR 1.03; 95% CI 0.85-1.24; p = 0.94), and at six months -the primary endpoint- 73.3% vs. 71.9% (RR 1.02; 95% CI 0.82-1.27; p = 1.00). No significant differences were observed between groups in the occurrence of clinical events.Conclusion: The educational intervention was well accepted and feasible to implement, but it did not result in improved medication adherence or a reduction in clinical events over the medium term.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"86 4","pages":"923-934"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760196","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

[Barriers to timely HIV diagnosis in the rapid testing era]. [快速检测时代及时诊断艾滋病毒的障碍]。

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2026-01-01

Federico Cardozo, Sofía Frankel, Guillermo Viloria, Isabel Pastor, Marina Alonso, Lucas Saucedo, Ángel Parlante, Beatriz Aldea, Marcelo Losso, Mariana Kundro

{"title":"[Barriers to timely HIV diagnosis in the rapid testing era].","authors":"Federico Cardozo, Sofía Frankel, Guillermo Viloria, Isabel Pastor, Marina Alonso, Lucas Saucedo, Ángel Parlante, Beatriz Aldea, Marcelo Losso, Mariana Kundro","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Late diagnosis (LD) of HIV infection, defined as a CD4+ cell count below 350 cells/uL or the presence of an AIDS-defining illness, remains a major public health problem due to its association with increased morbidity, mortality, and ongoing transmission. We aimed to identify factors associated with LD among individuals with a new HIV diagnosis.Materials and methods: We conducted an observational mixed-methods study including adults with a recent HIV diagnosis consecutively enrolled at a referral hospital in Buenos Aires between October 2023 and January 2025. Quantitative analyses evaluated factors associated with LD, while qualitative interviews explored barriers to HIV testing and healthcare access.Results: A total of 102 patients were included (median age 32 years; median CD4+ count 294 cells/uL). Late diagnosis was observed in 59.8% of cases. Seven patients died from AIDS-related causes, all in the LD group. Older age and heterosexual orientation were independently associated with LD. Notably, 36.1% of participants had at least one healthcare visit in the year prior to diagnosis, representing missed opportunities for testing. During follow-up, 92.2% achieved viral suppression at six months, with no new AIDS-defining events. Qualitative findings identified self-perceived good health, low awareness of HIV testing, and perceived exclusion from healthcare services as barriers to timely diagnosis.Conclusion: More than half of patients were diagnosed late, with frequent missed opportunities for earlier detection. These findings support the need for expanded and targeted HIV testing strategies to reduce preventable morbidity and mortality.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"86 4","pages":"944-954"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765519","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

[Hydrodissection for the treatment of postoperative gynecologic neuropathic pain]. 【水解剖术治疗妇科术后神经性疼痛】。

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2026-01-01

Agustín Montes Onganía, Pablo Young, Ariel Finkelsteyn, Gastón Espinet

{"title":"[Hydrodissection for the treatment of postoperative gynecologic neuropathic pain].","authors":"Agustín Montes Onganía, Pablo Young, Ariel Finkelsteyn, Gastón Espinet","doi":"","DOIUrl":"","url":null,"abstract":"Postoperative neuropathic pain following gynecologic surgery is a rare phenomenon and is usually self-limiting in most cases. As with other causes of neuropathic pain, its lack of resolution can be difficult to treat and associated with severe impairments in quality of life. Most cases of postoperative neuropathic pain in gynecology are due to involvement of the iliohypogastric, ilioinguinal, or genitofemoral nerves. For cases that do not respond to pharmacological treatment, we should consider minimally invasive treatment alternatives. Peripheral nerve hydrodissection presents growing evidence for the treatment of entrapment neuropathies due to its mechanical decompression effect and relief of regional glycopenia, although there are no reports in the literature for the treatment of iliohypogastric and ilioinguinal entrapment. We present a 40-year-old woman who developed severe neuropathic pain following myomectomy, refractory to pharmacological treatment, with significant functional and emotional impact. Ultrasound-guided hydrodissection of the iliohypogastric and ilioinguinal nerves achieved significant clinical improvement, allowing discontinuation of opioids and complete functional recovery.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"86 5","pages":"1301-1305"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207174","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

Barriers and facilitators to women's leadership in health in Argentina and Nigeria: survey findings. 阿根廷和尼日利亚妇女在卫生领域发挥领导作用的障碍和促进因素：调查结果。

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2026-01-01

Glenda Ernst, María Lourdes Gil Uliarte, Muriel Suarez, Mercedes Rumi, Isaac Oluwafemi Dipeolu, Pablo Young

{"title":"Barriers and facilitators to women's leadership in health in Argentina and Nigeria: survey findings.","authors":"Glenda Ernst, María Lourdes Gil Uliarte, Muriel Suarez, Mercedes Rumi, Isaac Oluwafemi Dipeolu, Pablo Young","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Women represent a significant proportion of the healthcare workforce in low- and middleincome countries (LMICs); however, their participation in leadership positions remains disproportionately low. Our objective was to examine the perceived barriers and facilitators to leadership among women in LMICs.Materials and methods: Cross-sectional study using a distributed online survey with open-ended questions. Purposive sampling was used to recruit women aged =18 years who held leadership positions in the health sector in LMICs. The responses were analysed using an inductive thematic content analysis approach using ATLAS.ti software.Results: Sixty-two women in leadership positions in the health sector responded to the survey: 31 were from Argentina, and 31 from Nigeria. The most common barriers to reaching leadership positions included challenges in interpersonal management, professional development, and work-life balance. Others were managing limited resources, staff conflicts, and experiences of gender discrimination. Participants identified conflict resolution, promoting equity, and empowering team members as key leadership responsibilities. Reported facilitators included leadership training, coaching, inclusive organisational cultures, and institutional support as key factors in counteracting persistent gender barriers.Conclusion: Women in health leadership positions in LMICs face barriers at individual, organisational, and structural levels that go beyond personal capabilities and reflect persistent inequities. The survey data highlight the importance of adopting systemic, forward-looking leadership approaches to advance gender equity in health leadership.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"86 5","pages":"1253-1259"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207231","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

[Frecuency of Bordetella pertussis infection in adults: a multicenter study in Argentina]. [成人百日咳杆菌感染的频率：阿根廷的一项多中心研究]。

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2026-01-01

Romina Mauas, Analia Mykietiuk, Rosa Contreras, Pablo Bonvehí, Mariana Gordóvil, María Fernanda Alzogaray, Agustin Romandetta, Victoria Vulcano, Florencia Pellice, María Victoria Leone, Natalin Grippo, Alejandra Salmerón, Cecilia Michelud, Analia Urueña

{"title":"[Frecuency of Bordetella pertussis infection in adults: a multicenter study in Argentina].","authors":"Romina Mauas, Analia Mykietiuk, Rosa Contreras, Pablo Bonvehí, Mariana Gordóvil, María Fernanda Alzogaray, Agustin Romandetta, Victoria Vulcano, Florencia Pellice, María Victoria Leone, Natalin Grippo, Alejandra Salmerón, Cecilia Michelud, Analia Urueña","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: The epidemiology of Bordetella pertussis (Bp) has changed following universal pediatric vaccination, with an increase in cases among adolescents and adults, who may have a higher risk of complications and behave as a reservoir for infection in infants. Reported prevalence in adults ranges from 2% to 32% worldwide. The aim of this study was to assess the frequency of Bp infection in adults with cough in Argentina.Materials and methods: This was a prospective, multicenter, observational cross-sectional study conducted between August 2023 and August 2024, including individuals aged =50 years with cough lasting 3-28 days who presented to outpatient clinics at four hospitals in Argentina. Nasopharyngeal swabs were collected and analyzed using multiplex PCR (FilmArray BioFire RP2.1, Biomérieux). Clinical and epidemiological data were collected at baseline and through telephone follow-up at 7 and 30 days.Results: A total of 391 participants were included. Nasopharyngeal swab positivity was 65% (n=255), significantly higher among individuals with <7 versus =7 days of cough at presentation (75% vs. 56%, p<0.001). Bp was detected in 1 of 391 individuals (0.3%; 95% CI 0.036%- 1.8%). In addition, 284 viruses and 8 bacteria were identified, including 34 coinfections (13%). The hospitalization rate was 5.6% and was significantly associated with the presence of comorbidities at presentation (OR 5.86; 95% CI 1.87-18.33; p=0.002).Conclusion: Detection of Bp was low, with viral pathogens predominating and complications occurring mainly in patients with comorbidities. Future studies with broader population, geographic, and temporal coverage may detect a higher frequency of this cyclically circulating pathogen.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"86 5","pages":"1103-1117"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207072","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

[Lipedema: update on diagnosis and treatment]. [水肿：诊断和治疗的最新进展]。

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2026-01-01

Ignacio Stoppani, María Azul Quiroga

引用次数: 0

[Dengue in Argentina 2023-2024: the largest recorded epidemic and its impact on morbidity and mortality]. [2023-2024年阿根廷登革热：有记录以来最大的流行病及其对发病率和死亡率的影响]。

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2026-01-01

Gabriela A Fernández, Silvina Ruvinsky, Rocío N Barrios, Mariana Vázquez, Macarena Roel, Yasmin D El Ahmed, María A Morales, Susana Lloveras, Anabel Sinchi, Tomás A Orduna, Patricia R González, Carla Tabachi, Mauro Bertolini, Victoria C Luppo, Andrea S Villalba, María G Codarini, Josefina G Pino, Federico M Santoro, Lucía S Gallardo, María E Fandiño, Carlos Giovacchini, Cecilia Gonzalez Lebrero

{"title":"[Dengue in Argentina 2023-2024: the largest recorded epidemic and its impact on morbidity and mortality].","authors":"Gabriela A Fernández, Silvina Ruvinsky, Rocío N Barrios, Mariana Vázquez, Macarena Roel, Yasmin D El Ahmed, María A Morales, Susana Lloveras, Anabel Sinchi, Tomás A Orduna, Patricia R González, Carla Tabachi, Mauro Bertolini, Victoria C Luppo, Andrea S Villalba, María G Codarini, Josefina G Pino, Federico M Santoro, Lucía S Gallardo, María E Fandiño, Carlos Giovacchini, Cecilia Gonzalez Lebrero","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Argentina experienced a historic increase in dengue incidence during the 2023/2024 season, far exceeding the levels reported in previous cycles. The objective was to characterize dengue-related morbidity and mortality during this period.Materials and methods: Descriptive observational study based on epidemiological surveillance. Data were obtained from the National Health Surveillance System (SNVS 2.0).Data analysis: R Studio.Results: A total of 583 259 dengue cases were analyzed. The Northwest region showed the highest cumulative incidence, whereas the Central region registered the largest absolute number of cases. Adults accounted for 78% of cases and children/adolescents for 22%. Females represented 55%. Severe forms occurred in 0.3% of cases. There were 419 deaths, with an overall case-fatality rate of 0.07% (92% adults and 8% children/adolescents). Median age was 52 years [IQR 37-72] in adults and 8 years [IQR 3-14] in children/adolescents. Comorbidities were present in 38% of adults and 21% of children/adolescents (p=0.04). Median time from symptom onset to consultation was 3 days [IQR 1-5], and to death, 6 days [IQR 4-9]. Serotype identification was achieved in 45% of cases: DENV-2 (59%), DENV-1 (40%), and coinfections (1%). Atypical presentations were documented in 7%.Conclusion: The epidemiological scenario showed dynamism and heterogeneity, underscoring the need to strengthen health-system preparedness, optimize surveillance, and improve clinical response to reduce dengue-related morbidity and mortality and to anticipate and mitigate future epidemics.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"86 3","pages":"625-636"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148302339","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

[Anaplastic thyroid carcinoma: Importance of early diagnosis and treatment]. 甲状腺间变性癌：早期诊断和治疗的重要性。

IF 0.6 4区医学

Medicina-buenos Aires Pub Date : 2026-01-01

Sabrina Musache, Eduardo Faure, Laila Bielski

引用次数: 0