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

[Abdominal pain and inconclusive ultrasound: a CT scan may not always be the best next step] 腹痛和超声波不确定。

Revista de la Facultad de Ciencias Medicas de Cordoba Pub Date : 2025-03-31 DOI: 10.31053/1853.0605.v82.n1.44691

Julio César Moreno-Alfonso, Sara Hernández Martín, Lidia Ayuso González, Alberto Perez Martínez

{"title":"[Abdominal pain and inconclusive ultrasound: a CT scan may not always be the best next step]","authors":"Julio César Moreno-Alfonso, Sara Hernández Martín, Lidia Ayuso González, Alberto Perez Martínez","doi":"10.31053/1853.0605.v82.n1.44691","DOIUrl":"10.31053/1853.0605.v82.n1.44691","url":null,"abstract":"A 4-year-old male presented to the emergency department with fever, mucous diarrhea, abdominal pain, and vomiting for 36 hours. On abdominal palpation, he had generalized pain without rebound and increased hydroaereal sounds. The blood count showed leukocytosis and elevated C-reactive protein, and an ultrasound revealed intestinal loops with abundant content, increased peristalsis, and a normal appendix. Due to the suspicion of invasive gastroenteritis, he was admitted for observation. Due to the persistence of symptoms, a new ultrasound was performed which showed pelvic free fluid but did not identify the appendix. An abdominal radiography was previously performed, which showed an image compatible with appendicolith. With the suspicion of appendicitis, surgery was indicated, and an appendicular peritonitis was identified. The patient recovered well and was discharged seven days later. Diagnosing appendicitis in children can be a complex process. The most sensitive diagnostic tests are ultrasound and tomography. Abdominal radiography, however, is a widely available test with low radiation and has a positive predictive value of 90% for appendicitis (detecting appendicolith or periappendicular 'air silence'). In ambiguous cases, an abdominal X-ray could avoid invasive tests that require sedation or high doses of radiation.","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 1","pages":"206-214"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755235","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}

引用次数: 0

[Anemia and heart failure with preserved ejection fraction in adult patients with cardiorenal syndrome: a cross-sectional study] [成人心肾综合征患者保留射血分数的贫血和心力衰竭：一项横断面研究]

Revista de la Facultad de Ciencias Medicas de Cordoba Pub Date : 2025-03-31 DOI: 10.31053/1853.0605.v82.n1.44359

Maria Teresa Politi, Gustavo Javier Daquarti, Damián Néstor Spagnuolo, Raúl Ferreyra, Mirta Diez, Guillermo Bortman

{"title":"[Anemia and heart failure with preserved ejection fraction in adult patients with cardiorenal syndrome: a cross-sectional study]","authors":"Maria Teresa Politi, Gustavo Javier Daquarti, Damián Néstor Spagnuolo, Raúl Ferreyra, Mirta Diez, Guillermo Bortman","doi":"10.31053/1853.0605.v82.n1.44359","DOIUrl":"https://doi.org/10.31053/1853.0605.v82.n1.44359","url":null,"abstract":"Introduction: Patients hospitalized for heart failure with preserved ejection fraction (HFpEF) have a higher prevalence of anemia than those hospitalized for heart failure with reduced ejection fraction (HFpEF). However, it is unknown if this relationship is maintained in patients with chronic kidney disease, forming cardiorenal syndrome type IV.Methods: Cross-sectional, multicenter study of patients with chronic kidney disease hospitalized for heart failure. The primary outcome was the difference in hemoglobin concentration. The secondary outcome was the difference in the prevalence of anemia.Results: 229 patients were enrolled. Hemoglobin concentration was lower in patients with HFpEF compared to patients with HFrEF (11.1±1.8 g/dl vs 12.3±2.0 g/dl; p < 0.0001). . Presenting HFpEF was associated with a lower hemoglobin concentration (β1 = -0.90 g/dl; p = 0.001), after including the use of iron supplements, moderate to severe deterioration of glomerular filtration rate, sex and age. The prevalence of anemia was higher in patients with HFpEF compared to those with HFrEF (72.3% vs 59.8%; p = 0.0462). Belonging to the HFpEF group was not associated with anemia (OR = 1.77; p = 0.078), after including the same covariates. Exploratory, belonging to the HFpEF group was associated with moderate to severe anemia, after including the same covariates.Conclusion: In patients with type IV cardiorenal syndrome, hemoglobin concentration is lower in patients hospitalized with HFpEF, possibly playing a role in the destabilization of these patients.","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 1","pages":"22-40"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755028","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}

引用次数: 0

[Role of ultrasound in critically ill patients with heart failure] 超声在心力衰竭危重患者中的作用。

Revista de la Facultad de Ciencias Medicas de Cordoba Pub Date : 2025-03-31 DOI: 10.31053/1853.0605.v82.n1.45185

Julieta Lozita, Juan Pablo Leopoldo Ricarte Bratti, Judith Mailen Vicentin, Nadia Elizabeth Pinto

{"title":"[Role of ultrasound in critically ill patients with heart failure]","authors":"Julieta Lozita, Juan Pablo Leopoldo Ricarte Bratti, Judith Mailen Vicentin, Nadia Elizabeth Pinto","doi":"10.31053/1853.0605.v82.n1.45185","DOIUrl":"10.31053/1853.0605.v82.n1.45185","url":null,"abstract":"Heart failure (HF) is a clinical syndrome with symptoms and/or signs caused by structural and/or functional cardiac abnormalities. After discharge, patients with acute heart failure (AHF) face a significant risk of rehospitalization and mortality. Detection of residual congestion is crucial to reduce readmissions, improve prognosis, and decrease mortality. Echocardiography provides critical information about the severity of left ventricular dysfunction, elevated filling pressures, valvular dysfunction, and estimation of pulmonary artery systolic pressure. The VExUS approach integrates ultrasound evaluation of the inferior vena cava, hepatic veins, portal vein, and renal veins, providing valuable information about systemic congestion. Lung ultrasound detects pulmonary congestion, facilitating early intervention to prevent progression and hospitalizations. Ultrasound evaluation of the internal jugular vein and femoral vein complements the evaluation of venous congestion. Distension of the internal jugular vein during the Valsalva maneuver or the relationship between the diameter of the internal jugular vein and the femoral vein can predict adverse outcomes in patients with HF. In conclusion, a comprehensive ultrasound approach is crucial in the management of patients with critically ill heart failure. Multiparameter ultrasound evaluation provides vital information, guiding appropriate therapeutic interventions and avoiding potentially harmful measures.","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 1","pages":"188-205"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755238","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}

引用次数: 0

[Dermatofibrosarcoma protuberans treated with Mohs surgery] 【莫氏手术治疗隆突性皮肤纤维肉瘤】

Revista de la Facultad de Ciencias Medicas de Cordoba Pub Date : 2025-03-31 DOI: 10.31053/1853.0605.v82.n1.45363

Lía Salomé Abeledo, Carla Barbini, Gerardo Russier, Corina Busso

引用次数: 0

Ophthalmoplegia as a Rare Initial Presentation of Cryptococcal Meningitis: A Case Report and Literature Review 双核间眼移植物作为隐球菌性脑膜炎的罕见初始表现。

Revista de la Facultad de Ciencias Medicas de Cordoba Pub Date : 2025-03-31 DOI: 10.31053/1853.0605.v82.n1.44952

Raymundo Solís-Gómez, Itzel A Hernández-Dehesa, Aztlani Adan-Ruiz, Adrián F Sánchez-Cruz, Eduardo Argüelles-González

{"title":"Ophthalmoplegia as a Rare Initial Presentation of Cryptococcal Meningitis: A Case Report and Literature Review","authors":"Raymundo Solís-Gómez, Itzel A Hernández-Dehesa, Aztlani Adan-Ruiz, Adrián F Sánchez-Cruz, Eduardo Argüelles-González","doi":"10.31053/1853.0605.v82.n1.44952","DOIUrl":"10.31053/1853.0605.v82.n1.44952","url":null,"abstract":"Introduction: Cryptococcal meningitis (CM) frequently associates immunocompromised patients, specifically in HIV infection, and it has high mortality. Neuro-ophthalmic manifestations are rare in patients with CM, especially internuclear ophthalmoplegia (INO) or wall-eyed bilateral internuclear ophthalmoplegia (WEBINO), most of them the result of secondary vasculitis.Case report: A 53-year-old woman with chronic hepatic failure, had sudden drowsiness, diplopia, fever, and internuclear ophthalmoplegia. MRI showed generalized leptomeningeal enhancement plus infratentorial nodular enhancement type in the midbrain and left cerebellar hemisphere. An India ink test was positive for Cryptococcus neoformans.Conclusion: Cryptococcal meningitis causes a wide spectrum of neurological manifestations, but neuro-ophthalmological signs are infrequent. Physicians should consider that these meningitis events are capable of generating symptoms due to intra-axial involvement of the Central Nervous System (CNS) due to vasculitis.","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 1","pages":"176-187"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755174","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}

引用次数: 0

[Residual hypoxemia during titration with self-adjusting CPAP at home in patients without prior adaptation] [未适应的患者在家中自行调节CPAP滴定时残留低氧血症]

Revista de la Facultad de Ciencias Medicas de Cordoba Pub Date : 2025-03-31 DOI: 10.31053/1853.0605.v82.n1.44671

Julieta Franzoy, Magali Blanco, Glenda Ernst, Maria Belen Ginetti, Marcella Perri, Eduardo Borsini

{"title":"[Residual hypoxemia during titration with self-adjusting CPAP at home in patients without prior adaptation]","authors":"Julieta Franzoy, Magali Blanco, Glenda Ernst, Maria Belen Ginetti, Marcella Perri, Eduardo Borsini","doi":"10.31053/1853.0605.v82.n1.44671","DOIUrl":"https://doi.org/10.31053/1853.0605.v82.n1.44671","url":null,"abstract":"Introduction: Self-adjusting titration (APAP) at home is accepted to define therapeutic pressure (CPAPT). The APAP device report may be insufficient to ensure adequate therapeutic response in all patients. There is no consensus on the use of oximetry during APAP titration.Objective: To evaluate the prevalence and magnitude of residual hypoxemia (RH) in titration with APAP not monitored at home and to identify related variables.Materials and methods: Retrospective study based on APAP titrations with coupled oximetry, arterial blood gases and spirometry test. A T90 > 10% of the night was considered significant RH. Predictors of HR were identified by logistic regression (RL).Results: 116 cases were included. 41% in the group with RH. These were older (66.7 vs. 59.6 years, p: 0.02), lower absolute FEV1 (2.17 vs. 2.57 liters, p: 0.06), lower absolute FVC (2.9 vs. 3.3 liters, p: 0.02) and lower basal PO2 (77.3 vs. 84.2 mmHg, p: 0.04). The titration period reached 3.6 ± 1 nights, average adherence of 374 ± 88.4 minutes/night; CPAPT (cm H2O): 9.4 ± 1.8, AHIr; 3.1 ± 3.2 ev/h and leaks (liters/min): 19.7 ± 11.2. Multiple logistic regression identified age > 66 years as a predictor of RH (OR 3.32, 95% CI 1.43 - 7.69, p: 0.005) and FEV1 < 1.76 liters (OR 3.29 – IC95% 1.27 – 8.53, p: 0.0139).Conclusions: Incompletely corrected nocturnal oximetry was observed in a significant proportion of patients with APAP. Age over 66 years and absolute FEV1 < 1.76 liters were correlated with residual hypoxemia.","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 1","pages":"61-77"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755198","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}

引用次数: 0

[Hypoglycemia in a patient with pleural solitary fibrous tumor and response to pasireotide] [一例胸膜孤立性纤维性肿瘤患者的低血糖及对pasireotide的反应]

Revista de la Facultad de Ciencias Medicas de Cordoba Pub Date : 2025-03-31 DOI: 10.31053/1853.0605.v82.n1.44424

Elizabeth Karen Videla, Pablo Ferrada, Jorge Miller, Eduardo Torres, Analía Álvarez, Javier Herrera, Bertha De la Torre

{"title":"[Hypoglycemia in a patient with pleural solitary fibrous tumor and response to pasireotide]","authors":"Elizabeth Karen Videla, Pablo Ferrada, Jorge Miller, Eduardo Torres, Analía Álvarez, Javier Herrera, Bertha De la Torre","doi":"10.31053/1853.0605.v82.n1.44424","DOIUrl":"https://doi.org/10.31053/1853.0605.v82.n1.44424","url":null,"abstract":"Introduction: hypoglycemia is a common and multifactorial clinical condition. A rare cause is that associated with non-islet cell tumors.Objective: to report our experience on the management of severe hypoglycemia in a patient with solitary pleural fibrous tumor and his response to pasireotide.Clinical case: 63-year-old patient with a history of glomerulonephritis, hypothyroidism, arterial hypertension and a one-year diagnosis of solitary pleural fibrous tumor. Referred to endocrinology due to hypoglycemia for 6 months. Acromegaloid features were confirmed. Laboratory: Hct 36%, Hb 11.9 g/dl, GB 3570/mm3 (Eo 2%, Ba2%, Bac 4%, NS 36%, Li 30%, Mo 14% metamyelocytes 1%, myelocytes 11%), platelets 120,000 /mm3, ESR 10 mm, CRP 9 mg/L, TP 114%, TTPK 25 sec, blood glucose 57 mg/dL, renal function, hepatogram and lipid profile without particularities. IGF-1 84 ng/ml (VR 57 - 188), C-peptide 0.10 ng/ml (VR 1.10 - 4.40), somatotropin 0.98 ng/ml (VR up to 2.5) and basal insulin 0.4 uU/ml (VR 2.6 - 24) . IFG-2 measurement is not available in Argentina. A chest CT showed a pleural tumor measuring 13 cm. Without possibilities of surgical resection and without response to chemotherapy. Treatment was started with infusion of 25% dextrose, dexamethasone, pasireotide with good response. The patient died due to an infectious complication.Conclusion: pasireotide could be a therapeutic alternative in cases that are not candidates for surgery or refractory to other medical treatment.","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 1","pages":"127-139"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754943","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}

引用次数: 0

[Incidence of acquired morbidity and its impact on patients in a pediatric intensive care unit based on the functional status scale] [基于功能状态量表的儿童重症监护病房患者获得性发病发生率及其影响]

Revista de la Facultad de Ciencias Medicas de Cordoba Pub Date : 2025-03-31 DOI: 10.31053/1853.0605.v82.n1.45328

Judith Frydman, Mara Inés López

{"title":"[Incidence of acquired morbidity and its impact on patients in a pediatric intensive care unit based on the functional status scale]","authors":"Judith Frydman, Mara Inés López","doi":"10.31053/1853.0605.v82.n1.45328","DOIUrl":"https://doi.org/10.31053/1853.0605.v82.n1.45328","url":null,"abstract":"Introduction: a significant number of children suffer cognitive, physical, mental and social limitations as a result of critical illnesses and their subsequent treatment. Pollack et al. developed the functional status scale with the purpose of measuring the change in functional status during hospitalization.Objectives: evaluate the acquired morbidity upon discharge from the Pediatric Intensive Care Unit (PICU). Specific objectives: compare mortality and acquired morbidity rates, analyze changes in functional status categories, identify the most affected domains, describe relationships between domain affection and admission diagnosis, between domain affection and age group, between morbidity and days in invasive mechanical ventilation (IMV), non-invasive ventilation and high-flow oxygen therapy.Methodology: observational, descriptive, prospective and longitudinal study. Patients between 1 and 180 months of age requiring ventilatory support for at least 48 hours, between February 2021 and February 2024, were included.Results: 90.9% survived, and of these, 26.9% developed acquired morbidity. The 42% of patients changed their functional status at least one point. The most affected domains were motor and feeding. Those who died had fewer days of IMV and hospitalization.Conclusion: The incidence of acquired morbidity was higher than mortality in the analyzed period. Children who developed morbidity remained hospitalized for a longer period of time and had greater requirements and days of IMV. Increased survival makes mortality an insufficient outcome metric. More studies with longer follow-up are needed.","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 1","pages":"41-60"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755058","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}

引用次数: 0

[Advanced maternal age as a risk factor for adverse perinatal outcomes] 母亲年龄大是围产期不良结果的危险因素。

Revista de la Facultad de Ciencias Medicas de Cordoba Pub Date : 2025-03-31 DOI: 10.31053/1853.0605.v82.n1.45349

Anyhely Yhoan Escudero Quispe, José Luis Vivanco Osorio

{"title":"[Advanced maternal age as a risk factor for adverse perinatal outcomes]","authors":"Anyhely Yhoan Escudero Quispe, José Luis Vivanco Osorio","doi":"10.31053/1853.0605.v82.n1.45349","DOIUrl":"10.31053/1853.0605.v82.n1.45349","url":null,"abstract":"This study finds a gradual increase in women's age at first pregnancy, a situation that has been associated with an increased risk of adverse maternal and postpartum events. While in the mid-1970s there were 1.7 per thousand pregnant nulliparous women between 35 and 39 years old, in 2012 this figure increased to 11 per thousand pregnant women, a six-fold increase. The global prevalence of pregnant women over 35 years of age is estimated at 12.3%. Maternal and perinatal characteristics and outcomes of nulliparous women aged 40 years and older are described and compared with characteristics of nulliparous women younger than 40 years. During the time of said study, approximately 4095 nulliparous female patients who met the inclusion criteria were treated; however, a limitation was found because it was a closed population treated in a highly complex tertiary hospital, the majority with high level of schooling and middle class socioeconomic level. In conclusion, older women constitute a high-risk population whose management and follow-up would require a different approach aimed at improving maternal and postpartum outcomes.","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 1","pages":"223-230"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755144","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}

引用次数: 0

[ Accumulation of hyaluronic acid in rhinoseptoplasty: intraoperative finding] 鼻整形术中透明质酸的积累。

Revista de la Facultad de Ciencias Medicas de Cordoba Pub Date : 2025-03-31 DOI: 10.31053/1853.0605.v82.n1.45169

Sebastián Abad-Cuenca, Xavier Eduardo Abad-González

引用次数: 0