Medicina-buenos Aires最新文献_第7页

[Functional outcomes in patients with cranioencephalic traumatism: 20-year experience in a rehabilitation center in Argentina].

IF 0.6 4区医学

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

Melania Ron, María Elisa Rivas, Milagros Rosselló, Fernando Salierno, Ismael Calandri, Lucas Bonamico

{"title":"[Functional outcomes in patients with cranioencephalic traumatism: 20-year experience in a rehabilitation center in Argentina].","authors":"Melania Ron, María Elisa Rivas, Milagros Rosselló, Fernando Salierno, Ismael Calandri, Lucas Bonamico","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Cranioencephalic traumatism (CET) is a serious public health problem worldwide. Advances in treatment have reduced mortality, increasing the demand for rehabilitation. The objective was to describe the demographic characteristics and functional outcomes in adult patients with traumatic brain injury (TBI) treated in a rehabilitation center.Materials and methods: Retrospective study between 2002 and 2022. Patients received 4 hours of rehabilitation daily. The level of functional independence was assessed with the Functional Independence Measure (FIM) at admission and discharge.Results: 229 patients were included, the median (25-75 percentiles) time from injury to admission to rehabilitation was 56 (36-98) days; 76% were men. Mean age (standard deviation) 42 (17) years. The most frequent etiologies were car accidents and falls; 46.8% were under 40 years of age and the median length of stay was 82 days (14-132). At discharge, 79.9% of patients over 65 years of age had low to severe disability (GOS-E) and 79.5% returned home. The median (p 25-75) FIM at admission was 30 (20-55) and at discharge was 90 (58-106); a statistically significant difference was observed (p = 0.001). Differences in functional outcomes were found based on age and place of residence.Discussion: In Argentina, patients admitted to rehabilitation for TBI are predominantly young men, the main cause being car accidents. The implementation of an early and intensive rehabilitation program has shown significant improvements in functional outcomes. At discharge, most patients required home supervision and assistance in daily activities.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 1","pages":"126-134"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123222","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

[Hostile pedagogies in medical residencies: A structural problem of health training].

IF 0.6 4区医学

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

Carolina Roni, Julian A Mur, Rocio Deza, María Isabel Fernández Cedro, Fabiana Reboiras

{"title":"[Hostile pedagogies in medical residencies: A structural problem of health training].","authors":"Carolina Roni, Julian A Mur, Rocio Deza, María Isabel Fernández Cedro, Fabiana Reboiras","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Hostile learning environments in medicine are present at the undergraduate and postgraduate levels. Currently, international research continues to demonstrate this problem of a structural and universal nature. There are few antecedents in Argentina, the research carried out by Reboiras (2020) was the starting point of the present work. The objective was to characterize the mistreatment perceived by physicians during training in basic medical residency programs in Argentina.Materials and methods: A quantitative study was carried out using a descriptive-interpretative approach. The sample consisted of 509 residents, and data were collected between April 2022 and May 2023. The dimensions of analysis were educational mistreatment, psychoemotional abuse, discrimination, physical violence and sexual harassment. The study included 22 health care centers in 10 provinces of the 7 geographical regions of Argentina (Province of Buenos Aires, City of Buenos Aires, Pampas region, Cuyo region, Northwest region, Northeast region and Patagonia region).Results: A total of 95.5% reported having suffered some type of mistreatment during their education. Prevalences of 94.5% for educational mistreatment, 62.5% for psychoemotional mistreatment, 42.1% for discrimination, 13.9% for sexual harassment and 6.8% for physical mistreatment were reported.Discussion: There is evidence of a high prevalence of situations of mistreatment at the national level. The introjection of violence as a formative standard is confirmed, which enables the reproduction of hostile contexts and leads to difficulties in the development of professional skills such as empathy or compassion, which are key to care and quality of attention.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 1","pages":"135-143"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123223","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

[Use of antidementia drugs at the end of life].

IF 0.6 4区医学

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

Pedro A Del Campo, Julieta Bugianezi, Oriana Y Vescovo, Julieta Latorre, Javier A Pollán, Nicolás Tentoni, María T Politi, Augusto Ferraris

{"title":"[Use of antidementia drugs at the end of life].","authors":"Pedro A Del Campo, Julieta Bugianezi, Oriana Y Vescovo, Julieta Latorre, Javier A Pollán, Nicolás Tentoni, María T Politi, Augusto Ferraris","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: The use of antidementia drugs near the end of life remains controversial. We evaluated the prevalence of and factors associated with antidementia drug use in the last 6 months of life in older adults with dementia.Materials and methods: Observational retrospective study of adults ≥60 years, affiliated to the Hospital Italiano de Buenos Aires health maintenance organization, who died with a dementia diagnosis, between 2017 and 2021. The main event was the use of antidementia drugs in the 6 months prior to death. We fit a logistic regression model to estimate odds ratios (OR) and 95% confidence intervals (CI) of baseline variables associated with antidementia drug use.Results: A total of 540/1898 (28%) patients used antidementia drugs in the 6 months preceding death. Lewy body dementia (OR=1.97; 95%CI, 1.22-3.19) and Alzheimer's disease (OR=1.47; 95%CI, 1.12-1.92) were associated with higher odds of antidementia drug use. Heart failure (OR=0.65; 95%CI, 0.48-0.89), older age (OR=0.75; 95%CI, 0.68-0.81), and prior hospitalizations (OR=0.81; 95%CI, 0.70-0.93) were inversely associated with antidementia drug use.Discussion: One out of three patients with dementia receive antidementia drugs in the 6 months prior to death despite limited evidence in such a scenario.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 1","pages":"39-46"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122863","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

Towards a counter-pedagogy of cruelty in Medical Residencies.

IF 0.6 4区医学

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

Eduardo L De Vito

引用次数: 0

[King Baldouin IV "The Saint" and leprosy: reflections from the history of medicine].

IF 0.6 4区医学

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

Manuel E Cortés, Eduardo Herrera-Aliaga

引用次数: 0

[Phage therapy: uncovering the classics to tackle modern challenges].

IF 0.6 4区医学

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

Juan Pablo Espinoza, Patricio Retamal, Mario Castillo-Ruiz

引用次数: 0

[Malignant transformation in mature sacrococcygeal teratoma in an adult patient].

IF 0.6 4区医学

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

Debora Pellegrini, Sergio Quildrian, Walter Nardi, Pablo Jalon, Pablo Dezanzo, Pablo Young

{"title":"[Malignant transformation in mature sacrococcygeal teratoma in an adult patient].","authors":"Debora Pellegrini, Sergio Quildrian, Walter Nardi, Pablo Jalon, Pablo Dezanzo, Pablo Young","doi":"","DOIUrl":"","url":null,"abstract":"Teratomas are tumors derived from two or more of the germ layers. They are more frequent in childhood than in adulthood and are predominant in women. Although they usually originate in the ovaries, there are other less frequent locations. The sacrococcygeal location is rare, observed in 1:40 000 births. Although most are benign, up to 2% may present malignant transformation. We present the case of a 60-year-old woman with a history of en bloc resection of a presacral pelvic tumor whose pathology reported a mature teratoma. After 2 years she developed sacrococcygeal pain. Imaging studies revealed a 6 cm tumor with bone involvement of the last sacral vertebrae. A core needle biopsy was performed, which reported recurrence of mature teratoma. After staging, which did not show systemic disease, she was evaluated by a multidisciplinary committee and surgical resection was indicated. An en bloc resection consisting of distal sacrectomy at the level of S3 and surrounding muscles was performed. The pathological report confirmed the presence of a mature teratoma with malignant transformation to colorectal adenocarcinoma, with negative margins. After multidisciplinary evaluation a strict follow-up without adjuvant treatment was indicated. The patient remained disease-free for 24 months, after which she presented impairment in performance status with systemic progression, passing away 2 months later. Sacrococcygeal teratomas are uncommon tumors. Malignancy is a rare event and complete resection is the treatment of choice.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 2","pages":"424-428"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803328","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

Sprengel deformity due to an omovertebral bone.

IF 0.6 4区医学

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

Alessa Cury Da Cunha, Gabriella Magalhães Forni, Maria Eduarda Storti, Paulo Polatto Pulino Palumbo, Márcio L Duarte

引用次数: 0

[Phlegmonous gastritis in a patient with chemotherapy induced neutropenia].

IF 0.6 4区医学

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

Eugenio Cautures, Octavio E Chiocca, María Antonela Orellano, Juan Ignacio Ibarzabal, Juan Carlos Pendino, Lisandro R Bettini

引用次数: 0

[Encapsulated pseudoaneurysm post-left ventricular rupture: unusual presentation and follow-up].

IF 0.6 4区医学

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

Mariano G Bergier, Santiago Del Castillo, Rodrigo Bagnati, Juan Benger, Sebastián Tonso, Diego Pérez De Arenaza, Mariano Falconi, Rodolfo Pizarro

{"title":"[Encapsulated pseudoaneurysm post-left ventricular rupture: unusual presentation and follow-up].","authors":"Mariano G Bergier, Santiago Del Castillo, Rodrigo Bagnati, Juan Benger, Sebastián Tonso, Diego Pérez De Arenaza, Mariano Falconi, Rodolfo Pizarro","doi":"","DOIUrl":"","url":null,"abstract":"External cardiac rupture with the development of a pseudoaneurysm is an uncommon complication of acute myocardial infarction (AMI) and do not always have typical presentations and can be challenging to diagnose. We present the case of a 59-year-old woman with no relevant cardiovascular history whose disease course was unusual. She initially presented with chest pain, dyspnea, and fever, and was diagnosed and treated for community-acquired pneumonia. Due to persistent symptoms, she went to the hospital where an electrocardiogram showed signs of an infarction. An echocardiogram revealed apical akinesia with a severely depressed ejection fraction and an associated thrombus. An AMI with differential diagnoses of an apical aneurysm versus a pseudoaneurysm was considered, and she was transferred to our center for further evaluation. The coronary angiography revealed an occlusion in the mid-left anterior descending artery, with no other significant lesions. The magnetic resonance imaging and the computed tomography scans showed severe left ventricular dysfunction, subacute infarction, and an apical pseudoaneurysm with a fragmented thrombus. A surgical resolution was considered, but the computed tomography scans revealed severe emphysema, and the pulmonary function tests showed severe obstructive ventilatory impairment. Any type of intervention was considered high risk, and it was decided to continue with medical treatment. Nine months later, the patient is still alive and asymptomatic.","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":"85 1","pages":"225-228"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123217","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