Revista de la Facultad de Ciencias Medicas de Cordoba最新文献

{"title":"[How to design an interobserver reliability study for categorical variables: a literature review]","authors":"Ana Beatriz Rusconi Lagarrigue, Sebastián Andrés Sguiglia Schütz, Victoria Guarnieri, Eliana Ludmila Frutos, Pedro Mirsky, Julieta Caridi, Martina Micheletti, Manuela Velloso Colombres, María Florencia Bertarini, Noelia Capellato, María Virginia Campoy, María Eugenia Pérez Cortiñas, Anahí Lorena Belatti, Luis Daniel Mazzuoccolo, Mónica Beatriz Senillosa, Gastón Perman, Sergio Adrián Terrasa, María Lourdes Posadas Martínez, Sonia Elizabeth Benítez","doi":"10.31053/1853.0605.v83.n3.50187","DOIUrl":"10.31053/1853.0605.v83.n3.50187","url":null,"abstract":"<p><strong>Introduction: </strong>On many occasions, it is necessary to establish the degree of agreement between two or more observers, either as an end in itself or as an intermediate step in a research project. In this type of study, choosing the appropriate design is crucial, as it influences the applicability and generalizability of the methods.</p><p><strong>Objectives: </strong>In this article, we will present—using a real case from a study still in progress—the methodology for estimating the degree of agreement between two or more observers regarding a categorical variable.</p><p><strong>Materials and methods: </strong>To define the coefficients used, a bibliographic search was conducted in PubMed and Google Scholar. Results: We propose the use of weighted Fleiss's kappa and Gwet's AC2 as agreement metrics for this problem. AC2 is a new coefficient that overcomes some of the limitations associated with kappa, particularly the paradoxes described by Feinstein and Cichetti.</p><p><strong>Conclusion: </strong>In this article, we present the design of a study to evaluate the degree of interobserver agreement and describe the methodology in detail, including the characteristics of the judges, the subjects, and the categories to be evaluated, the choice of the coefficient of agreement and its interpretation, and the calculation of confidence intervals.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 3","pages":"e50187"},"PeriodicalIF":0.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Hereditary folate malabsorption due to an SLC46A1 mutation with cerebral folate deficiency and refractory epilepsy: first case reported in Argentina]","authors":"Carola Lucrecia Grosso, Lourdes Verónica Peralta, Marina Paviolo, Josefina Pautasso, Guillermo Ariel Guelbert, María Del Pilar Bovina Martijena, Laura Elena Laróvere","doi":"10.31053/1853.0605.v83.n3.50324","DOIUrl":"10.31053/1853.0605.v83.n3.50324","url":null,"abstract":"<p><p>Hereditary folate malabsorption (HFM) is an autosomal recessive metabolic disorder caused by pathogenic variants in SLC46A1, the gene encoding the proton-coupled folate transporter. This defect impairs intestinal folate absorption and its transport into the central nervous system (CNS), leading to cerebral folate deficiency even with normal serum levels. Clinically, it presents with megaloblastic anemia, gastrointestinal symptoms, immunological alterations, and progressive neurological involvement. Measurement of 5-methyltetrahydrofolate (5-MTHF) in cerebrospinal fluid (CSF) is the specific diagnostic method, and treatment is based on folinic acid or levofolinic acid administration. Case: A male patient with early-onset microangiopathic anemia, developmental delay, refractory epilepsy, and hyperhomocysteinemia. Whole-exome sequencing identified a homozygous pathogenic variant in the SLC46A1 gene, c.981_982del (p.Tyr327Ter). Upon diagnosis, folic acid was discontinued and treatment with folinic acid was initiated, later replaced by intramuscular levofolinic acid due to clinical deterioration and decreased CSF 5-MTHF levels. The multimodal therapeutic approach achieved normalization of biomarkers and control of refractory epilepsy. This is the first report of an Argentine patient with HFM due to an SLC46A1 mutation associated with cerebral folate deficiency. Early-onset refractory epilepsy and hyperhomocysteinemia were key diagnostic clues. Monitoring of CSF 5-MTHF proved essential for assessing therapeutic response. Levofolinic acid showed superior clinical and biochemical efficacy compared to leucovorin. This case broadens the genotypic and phenotypic spectrum of this rare disease and underscores the importance of early diagnosis and individualized management to optimize neurological outcomes.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 3","pages":"e50324"},"PeriodicalIF":0.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prevalence of risk factors, lifestyle habits and level of knowledge about arterial hypertension in school-aged students]","authors":"Walter Espeche, Julian Minetto, Fernanda De Francia, Jimena Fernandez, Eguenia Azame, Tomas Bruno, Rocio Casarini, Gustavo Cerri, Eric Crocci, Julián Greco, Ariana Martínez, Magali Molina, Gonzalo Narducci, Sofía Pacho Calvo, Thelma Teileche, Juan Todoroff, Lautaro Reitovich, Claudia Caldiz","doi":"10.31053/1853.0605.v83.n3.51383","DOIUrl":"10.31053/1853.0605.v83.n3.51383","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular diseases (CVDs) are the leading cause of death worldwide, with hypertension (HTN) being the major risk factor. In our country,\u00001 in 3 people with hypertension are unaware of their condition, with\u0000is even lower in people under 40.\u0000In addition, unhealthy habits such as smoking, obesity and excessive salt\u0000are ingrained from an early age. School-based education on healthy\u0000could potentially influence not only children but also their families.\u0000This study aimed to assess the risk factors, lifestyle habits and knowledge levels of 5th grade students.</p><p><strong>Methods: </strong>A cross-sectional descriptive study was conducted among 133 students from a public school in La Plata. Surveys on risk factors and lifestyle habits, followed by interactive workshops led by advanced students in the fields of medicine and biology. Blood pressure (BP) measurements using standardized techniques, and educational materials were provided for dissemination in the students' homes.</p><p><strong>Results: </strong>None of the students knew their BP values, and over 60% believed that BP should only be measured after the age of 14. Only 5% reported regular consumption of fruit and vegetables. While 40% of the students reported that one or both of their parents had HTN, 88% reported that salt was added to meals in their homes. In addition, 74% did not believe that CVD was the\u0000leading cause of death.</p><p><strong>Conclusion: </strong>The low level of awareness of HTN and healthy habits among preadolescents highlights the need for health education from an early age. . School-based interventions can serve as a cost-effective tool for CVD prevention, with the potential to influence both children and their families</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 3","pages":"e51383"},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What to learn and teach to implement Shared Care Planning for people with Amyotrophic Lateral Sclerosis? Nominal Group Technique","authors":"Julia Fila, Celeste Quiroga, Ma Stella Di Gennaro, Verónica Inés Veloso, Vilma Adriana Tripodoro","doi":"10.31053/1853.0605.v83.n3.50160","DOIUrl":"10.31053/1853.0605.v83.n3.50160","url":null,"abstract":"<p><strong>Background: </strong>Advance Care Planning (ACP) is crucial in neurodegenerative conditions such as Amyotrophic Lateral Sclerosis (ALS), yet its implementation in Latin America remains limited, partly due to the lack of specific professional training. The objective of this work is to identify, from the perspective of experienced professionals, the main barriers, tensions, and core contents for designing a training program in ACP for teams caring for people with ALS.</p><p><strong>Methods: </strong>A qualitative study using a participatory approach and Nominal Group Technique was conducted in Argentina in 2023. Seventeen professionals from clinical and psychosocial fields participated in the study. Thematic analysis was applied, with triangulation and consensus validation.</p><p><strong>Results: </strong>Implementation barriers and six thematic areas were identified. Key topics included ethical frameworks, communication tools, existential distress, and strategies for involving families. A cross-cutting axis was the influence of local culture, team emotional responses, and the prevailing biomedical model.</p><p><strong>Conclusion: </strong>This study offers a conceptual and practical foundation for developing ACP training programs in the context of progressive neurological diseases. It represents a first step toward addressing a training gap in the region.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 3","pages":"e50160"},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Scrotal tuberculosis in an immunocompetent patient: an atypical location of Koch's bacillus]","authors":"Juan Ramon Y Cajal Calvo, Javier Raymundez Valhondo, Laura Pérez Abad","doi":"10.31053/1853.0605.v83.n3.49728","DOIUrl":"10.31053/1853.0605.v83.n3.49728","url":null,"abstract":"<p><strong>Introduction: </strong>Scrotal tuberculosis is a rare infectious condition that is more common in immunosuppressed patients.</p><p><strong>Clinical case: </strong>A 19-year-old patient with no known drug allergies presented with testicular pain and swelling for 2 weeks, along with significant weight loss in the last month, with no other systemic symptoms. He reported previous risky sexual relations. Acute right-sided epididymo-orchitis was initially suspected, but empirical treatments were suspended after testing negative for several STDs. However, the patient worsened, showing complicated epididymo-orchitis with fistulization and scrotal collection formation, caused by Corynebacterium jeikeium. Additional tests revealed a positive PCR for Mycobacteria tuberculosis, confirming tuberculous orchitis.</p><p><strong>Discussion: </strong>Scrotal tuberculosis is a rare infectious condition that is more common in immunosuppressed patients, characterized by the identification of the tuberculous bacillus by bacilloscopy. Early diagnostic suspicion is of vital importance, especially in immunosuppressed patients with urinary tract infection. Imaging findings are highly suggestive of this pathology and constitute the differential element for its definitive diagnosis.</p><p><strong>Conclusion: </strong>Scrotal tuberculosis is an unusual pathology, but it can present high morbidity and mortality. In most cases, it has a good prognosis with antituberculosis treatment and early diagnosis.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 3","pages":"e49728"},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access to diagnostic methods for diffuse gliomas in adults in Argentina","authors":"Elias Ortega Chahla, Natalia Gudiño, Matías Agustín Atencio, M Áximo Barros, Lucas Caussa, Laura Haron, Viviana Leiva, Alejandro Muggeri, Blanca Diez","doi":"10.31053/1853.0605.v83.n3.50178","DOIUrl":"10.31053/1853.0605.v83.n3.50178","url":null,"abstract":"<p><strong>Introduction: </strong>Adult diffuse gliomas require molecular testing for accurate diagnosis and personalized treatment. In Argentina, access to these biomarkers is uneven, influenced by regional, institutional, and health coverage factors. Objectives: To analyze access to pathological and molecular diagnostic methods for adult diffuse gliomas in Argentina, identifying inequalities and barriers.</p><p><strong>Methods: </strong>Observational, descriptive, cross-sectional study based on a structured survey of 52 specialists (oncology, neurosurgery, pathology, radiotherapy) conducted between October–December 2024. Biomarker availability, healthcare coverage, and patient volume were assessed. Chi-square, Fisher, and Cochran-Armitage tests were applied.</p><p><strong>Results: </strong>The most available biomarkers were IDH1/2 non-canonical mutations and 1p/19q codeletion (67%), followed by ATRX/TP53 (62%) and IDH1 R132H (56%). Less available were EGFR and MGMT (44%), BRAF (40%), CDKN2A (23%), TERTp/H3K27M (14%), and Chr7/Chr10 (<10%). Availability was associated with province, workplace, specialty, and patient load. Patients without insurance reported lower access (mean 2.39/5) compared with those with insurance (3.35/5).</p><p><strong>Conclusion: </strong>Molecular diagnostics for adult diffuse gliomas in Argentina remain limited and uneven, with regional and institutional gaps affecting equity. Strengthening diagnostic infrastructure and public funding is essential to ensure precision oncology.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 3","pages":"e50178"},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Functional assessment and performance of the shoulder in amateur bodybuilders]","authors":"Mauricio Samaniego Acosta, Lelis Morales-Clemotte, Walter Vázquez García","doi":"10.31053/1853.0605.v83.n3.51505","DOIUrl":"10.31053/1853.0605.v83.n3.51505","url":null,"abstract":"<p><p></p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 3","pages":"e51505"},"PeriodicalIF":0.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Systematic review on treatment adherence in people diagnosed with Inborn Errors of Metabolism and their families]","authors":"Morena Bossie, Florencia Assalone, Javiera Ortega","doi":"10.31053/1853.0605.v83.n3.50013","DOIUrl":"10.31053/1853.0605.v83.n3.50013","url":null,"abstract":"<p><strong>Introduction: </strong>Inborn Errors of Metabolism (IEM) are rare diseases that affect multiple systems and require strict treatment adherence. However, maintaining adherence is a challenge that directly impacts the quality of life (QoL) of patients and their families.</p><p><strong>Objective: </strong>To review treatment adherence in patients with IEM or their caregivers, considering its relationship with QoL. Methods: A systematic review was conducted in PubMed following PRISMA guidelines. Articles in English and Spanish published between 2013 and 2024 were included.</p><p><strong>Results: </strong>Twenty-two studies were selected, most focused on phenylketonuria (PKU). The main barriers to adherence were lack of disease understanding, treatment burden and complexity, limited access to special foods and substitutes, economic impact, social stigma, and reduced adherence during adolescence and adulthood. Facilitators included family and social support, resilience, disease education, and home-based care. Adequate adherence was associated with better metabolic control, reduced neurological impact, and physical, emotional, and social benefits, while poor adherence negatively affected all QoL dimensions.</p><p><strong>Conclusions: </strong>Treatment adherence in IEM is a complex process influenced by individual, family, social, and health system factors. Strengthening psychosocial and educational support, as well as improving access to resources, is essential to optimize adherence and QoL.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 3","pages":"e50013"},"PeriodicalIF":0.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Desempeño de la fotografía corporal total y dermatoscopía digital en el diagnóstico de melanoma en el Hospital Universitario Austral.","authors":"Maria Victoria Montes, María Clara De Diego, María Walker, Denise Chavit Emerson, Dolores Martin, Paloma Juarez, Juliana Adela Scarpa, María Josefina Landa, Lucía Dedeu, Corina Busso","doi":"10.31053/1853.0605.v83.n3.50140","DOIUrl":"10.31053/1853.0605.v83.n3.50140","url":null,"abstract":"<p><p>Few studies have investigated sleep quality in postmenopausal women and the causes that disrupt it. Objectives: Evaluate sleep quality and identify the reasons that interrupt them. To evaluate daytime sleepiness in the postmenopausal period and also to analyze the association of reasons that interrupt sleep with the time elapsed in the postmenopause Methods: Cross-sectional study. N=196 surveys were selected. Quality and reasons for sleep fragmentation were assessed using the Pittsburgh Sleep Quality Index and sleepiness by the Epworth Sleepiness Scale. Protocol approved by the Ethics and Research Committee. Results: 46.4% reported poor sleep quality. 65% reported nocturia, 61% having to wake up in the middle of the night and 57% feeling hot. More postmenopausal years were inversely associated with daytime sleepiness, p=0.02. Conclusion: We found poor sleep quality in 46.4% and the reasons frequently cited were nocturia, waking up in the middle of the night or early in the morning, having a feeling of heat and difficulty falling asleep in the first 30 minutes as causes of sleep fragmentation. Greater sleepiness was associated during the first years of postmenopause. The study allowed us to know certain aspects that motivate poor sleep quality, although it is possible to increase the n and plan actions to improve sleep in this menopause.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 3","pages":"e50140"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Impact of two nutritional monitoring strategies: conventional monitoring vs telemonitoring with a mobile application]","authors":"Hugo Villafañe, Alicia Garrone, Hernán Pérez, Daniela Werbin, Belen Urbaneja, Eugenia Ferreiro, Carolina Seratoni, Cynthia Cebreiro, Mariana Laurent, Graciela Fabiana Scruzzi","doi":"10.31053/1853.0605.v83.n3.50057","DOIUrl":"10.31053/1853.0605.v83.n3.50057","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment engagement is a key factor in the success of weight loss programs. Digital tools such as mobile applications have shown potential to improve nutritional follow-up, although their real impact still requires empirical validation.</p><p><strong>Methodology: </strong>An open-label experimental study with random allocation to two parallel groups was conducted among adult patients with overweight or obesity attending the Nutrition Service of Clínica Universitaria Reina Fabiola (CURF), Córdoba, Argentina. One group received conventional nutritional follow-up (biweekly in-person visits), while the other combined monthly in-person visits with asynchronous monitoring through a mobile application for three months. Sociodemographic, anthropometric, and dietary variables were assessed. Treatment engagement was defined as completing the program with weight loss and/or reduction in caloric intake. Statistical analysis included parametric and non-parametric tests and logistic regression.</p><p><strong>Results: </strong>A total of 53 participants were included, with 30 completing the program. The app group showed a significantly higher treatment engagement rate (39% vs. 16%; p = 0.03). Only this group exhibited significant reductions in body weight, BMI, total caloric intake, carbohydrate, and total fat consumption. Logistic regression analysis showed that using the app increased the likelihood of treatment engagement by nearly five times (OR = 4.85; 95% CI: 1.03–22.63; p = 0.045).</p><p><strong>Conclusions: </strong>The use of a mobile application in nutritional follow-up was associated with greater treatmente engagement and improved clinical outcomes. This hybrid model could be implemented in real-world clinical settings to enhance the effectiveness of behavior change programs.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 3","pages":"e50057"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}