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

{"title":"Renal cell carcinoma metastasis to the thyroid gland after drug-induced thyroid dysfunction: case report.","authors":"Juan Bautista Del Valle, Julio Cesar Roa Garcia, Mauricio Arturo Osorio Montaño, Cristian Andres Echavarria Cadena, Jesica Lorena Savluk, Matías Adrián Borensztein","doi":"10.31053/1853.0605.v82.n2.45462","DOIUrl":"10.31053/1853.0605.v82.n2.45462","url":null,"abstract":"<p><strong>Objective: </strong>Renal cell carcinoma may be associated with highly aggressive behavior and metastatic disease may be present in 30% of patients at the time of diagnosis. The most common sites of metastasis are the lungs, regional lymph nodes, liver, and bones. Metastases at rare sites include gums, larynx, nasal cavity, and thyroid gland. The objective of this article is to report an unusual manifestation of a known disease and present emerging technology useful in patient management.</p><p><strong>Clinical case: </strong>A 60-year-old male patient with a history of renal cell carcinoma. He initially received onco-specific treatment with nephrectomy and, ten years later, with zoledronate, pazopanib, and nivolumab due to metastatic progression. Four months after starting systemic treatment, drug-induced thyroid dysfunction was diagnosed, manifested by fatigue and abnormal laboratory results (TSH 9,23 uUI/mL). Due to the sensation of a lump in the neck, an ultrasound revealed a thyroid nodule on the right side.\u0000\u0000Aided by doppler ultrasound, and strain elastography, an ultrasound guided fine-needle aspiration biopsy of the thyroid nodule was performed, which confirmed metastasis of renal cell carcinoma.</p><p><strong>Conclusion: </strong>The emergence of a thyroid nodule in patients with a history of renal cell carcinoma and thyroid dysfunction could indicate oncological progression, even a long time after the initial diagnosis.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 2","pages":"419-430"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SARS-CoV-2 circulation in pregnant women from central Argentina: mortality rate, infecting variants and a positive impact of the vaccine","authors":"Leticia D Augero, Gonzalo M Castro, Paola Sicilia, Eugenio Cecchetto, Laura Lopez, Graciela Scruzzi, Paula Barbero, Maria Del Pilar Diaz, Maria Gabriela Babas, Viviana Re, Maria Belen Pisano","doi":"10.31053/1853.0605.v82.n2.45927","DOIUrl":"10.31053/1853.0605.v82.n2.45927","url":null,"abstract":"<p><strong>Introduction: </strong>SARS-CoV-2 can lead to a more severe infection during pregnancy. However, population-level data on COVID-19 disease and vaccine uptake in this population group are lacking, especially in South America.</p><p><strong>Objective: </strong>We aimed to describe SARS-CoV-2 infection in pregnant women from a central region of Argentina.</p><p><strong>Methodology: </strong>From March-2020 to March-2022, 2407 cases of pregnant women from Córdoba province with confirmed SARS-CoV-2 infection reported in the official records were analyzed. The infectivity and mortality rates were calculated; a control group of non-pregnant women infected with SARS-CoV-2 was included. Sixty-six samples were subjected to variants of concern (VOC) detection by real time RT-PCR.</p><p><strong>Results: </strong>The overall infection rate was 0.25%, and the number of infections mirrored the number of cases for general population. In September-2021 (when mass vaccination in pregnant women occurred) the infection rate decreased (0.35% in March 2020-September 2021 vs. 0.14% in October 2021-March 2022). The global fatality rate was 0.75% (18/2407). During March-2020 to September-2021 the fatality rate was higher than in the control group: 1.01% vs. 0.08% (p<0.05). Since then, no deaths were recorded in pregnant women (fatality rate 0% vs. 0.01% in the control group). The VOCs distribution was: Gamma: 56%, Delta: 20%, Omicron: 12%, Alpha: 3%, 9% of non-VOC lineages.</p><p><strong>Conclusions: </strong>The fatality rate found was similar to that obtained for the entire country in this group, and higher than the control group. The frequency of VOCs reflected what happened in the general population. The decrease in cases and deaths since September-2021 correlated with the mass vaccination in this group.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 2","pages":"287-302"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ERCP performed and described by surgical endoscopists.","authors":"Ethan Craig, Carolina Jimenez, Robert Bowles, Jose Martinez, Robert Cubas","doi":"10.31053/1853.0605.v82.n2.45367","DOIUrl":"10.31053/1853.0605.v82.n2.45367","url":null,"abstract":"<p><p>Endoscopic retrograde cholangiopancreatography (ERCP) is an advanced endoscopic procedure that uses fluoroscopy to diagnose and treat diseases within the biliopancreatic system. The first ERCP was performed by surgeons in 1968 at George Washington University. While ERCP is most commonly performed by gastroenterologists, surgeons with training in advanced gastrointestinal endoscopy have demonstrated similar success rates and outcomes despite differing training pathways. The purpose of this review is to highlight basic tenants of ERCP and describe how ERCP is performed in our practice.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 2","pages":"446-457"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical presentation and unusual complications of appendicitis: a case report","authors":"Carolina Lucía Diego, Juliana Napoli, Jeremías Goransky","doi":"10.31053/1853.0605.v82.n2.45332","DOIUrl":"10.31053/1853.0605.v82.n2.45332","url":null,"abstract":"<p><strong>Objective: </strong>To describe a case of acute appendicitis with an atypical presentation, complicated by hemoperitoneum, retroperitoneal hematoma, and pylephlebitis.</p><p><strong>Case report: </strong>A 55-year-old female patient without relevant history presented with 8 days of epigastric and right hypochondrial pain, fever, dark urine, and vasovagal syncope. Laboratory tests showed anemia, thrombocytopenia, liver dysfunction, and signs of sepsis. CT scan revealed an enlarged cecal appendix with wall disruption, portal and superior mesenteric vein thrombosis, and free fluid. Emergency laparoscopy was converted to laparotomy due to hemodynamic instability, revealing hemoperitoneum and retroperitoneal hematoma. Appendectomy, abdominal packing, and delayed closure were performed. The patient completed 19 days of antibiotic therapy, was transferred to the general ward on postoperative day 17, and discharged on day 20 with full recovery.</p><p><strong>Conclusion: </strong>Acute appendicitis complicated by hemoperitoneum, retroperitoneal hematoma, and pylephlebitis is rare but severe. Early diagnosis and appropriate surgical management are key to improving outcomes.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 2","pages":"431-441"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the NUTRIC, NUTRICm and NUTRICpcr scores in critically ill patients ventilated for COVID-19.","authors":"Claudina Luchitta, Dino Moretti, Daniel Horacio Bagilet, Nicolas Sebastian Rocchetti, Sheila Diodati, Silvana Paola Gattino, Melisa Debora Re, Claudio Jesus Settecase","doi":"10.31053/1853.0605.v82.n2.43338","DOIUrl":"10.31053/1853.0605.v82.n2.43338","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic caused a dramatic increase in ICU admissions due to severe acute respiratory syndrome. The NUTRIC score (with IL-6) and its variants NUTRICm (without IL-6) and NUTRICpcr (CRP instead of IL-6) were proposed to evaluate nutritional risk (RN) and even prognosis in critically ill patients.</p><p><strong>Methods: </strong>Scores with inflammatory biomarkers (NUTRIC and NUTRICpcr) and without them (NUTRICm) were evaluated through a prospective and observational study to discriminate mortality and assess NB in patients ventilated for COVID-19.</p><p><strong>Results: </strong>418 patients were analyzed. The median (IQR) age and APACHE II were: 54 years (6-61) and 13 points (10-19). 79% died in the ICU. The highest agreement was between NUTRICm and NUTRICpcr (Kappa= 0.88). The AUCROC (95% CI) to discriminate mortality was: NUTRIC 0.661 (0.598-0.724), NUTRICpcr 0.635 (0.572-0.697) and NUTRICm 0.659 (0.596-0.722). The high RN classification showed differences between the scores with and without an inflammatory biomarker, being significant between NUTRIC and NUTRICm (14.6% vs 22.7%, p 0.0033).</p><p><strong>Conclusion: </strong>In ventilated COVID-19 patients, the three nutritional risk scores studied discriminate mortality in a similar way, but the assessment of high NR differs between them, with a higher prevalence for the NUTRICm, which omits the inflammatory biomarker.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 2","pages":"362-379"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with postpartum weight retention in women attending a public hospital in the Province of Buenos Aires.","authors":"Lucia Torres, Lucrecia María Rosa Fotia Perniciaro, Ignacio Mendez, Agustina Malpeli, Ana Luz Kruger","doi":"10.31053/1853.0605.v82.n2.45625","DOIUrl":"10.31053/1853.0605.v82.n2.45625","url":null,"abstract":"<p><p>Pregnancy carries the potential risk of developing and maintaining a nutritional status characterized by persistent obesity. This can be magnified when weight gains exceed established recommendations. This postpartum weight retention can significantly contribute to long-term excess weight and cardiovascular events.</p><p><strong>Objective: </strong>to describe weight retention at 3 and/or 6 months postpartum in women who consulted at the Pediatric Development and Research Institute (IDIP).</p><p><strong>Methodology: </strong>analytical, retrospective cross-sectional study. Data were collected from the medical records of women who underwent health check-ups at 3 and/or 6 months postpartum. Multiple linear regressions were performed relating postpartum weight retention to those conditioning factors.</p><p><strong>Results: </strong>The sample was made up of 257 women who underwent controls at 3 months and 577 at 6 months postpartum. Weight retention at 3 months postpartum was negatively associated with primiparity, higher level of education, newborn weight and exclusive breastfeeding, while at 6 months it was only found with these last two factors. Weight retention at 3 and 6 months was positively related to gestational weight gain.</p><p><strong>Conclusion: </strong>Postpartum weight retention increases influenced by weight gain during pregnancy, but primiparity, schooling, newborn weight and breastfeeding seem to be factors that contribute to reducing it.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 2","pages":"271-286"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Independent predictors of quality of life in patients with chronic heart failure.","authors":"Lyda Z Rojas, Laura M Cabeza, Adriana M Jurado, Luis E Echeverría, Juliana Alexandra Hernández-Vargas, Silvia Juliana Trujillo-Cáceres","doi":"10.31053/1853.0605.v82.n2.45573","DOIUrl":"10.31053/1853.0605.v82.n2.45573","url":null,"abstract":"<p><strong>Introduction: </strong>Objective measurement of Health-Related Quality of Life (HRQoL) has proven useful in evaluating the effectiveness of medical management and its potential as a predictor of mortality and rehospitalization in patients with heart failure (HF). The aim of this study is to characterize HRQoL and determine its independent predictors in patients with chronic HF from a heart failure and transplant clinic in Colombia.</p><p><strong>Methods: </strong>This was an analytical cross-sectional study. The outcome variable was HRQoL measured using The Minnesota Living with Heart Failure Questionnaire (MLHFQ). Descriptive analysis of sociodemographic and clinical characteristics was conducted. Simple and multiple linear regressions were performed to establish predictors, considering statistical significance at p < 0.05.</p><p><strong>Results: </strong>A total of 200 patients were analyzed. 20% had Chagasic etiology. The median left ventricular ejection fraction (LVEF) was 30% (range 10 - 68%). The mean HRQoL score was 38.71 points (SD ± 22.67 points). \"Multivariate analysis identified seven independent predictors of worse HRQoL: age (β=0.17), low vs. high socioeconomic status (β=13.45), HF etiology, Chagas vs. others (β=12.97), number of hospitalizations in the last year (β=2.94), Charlson index (β=3.47), digitalis use (β=7.34), and NYHA functional class III-IV vs. I-II (β=28.04). Angiotensin-converting enzyme use was associated with better HRQoL (β=-4.80).</p><p><strong>Conclusion: </strong>This study shows that HRQoL in chronic HF is significantly determined by a set of socioeconomic, clinical, and management factors. The identification of these predictors underpins the need for comprehensive and personalized care strategies to improve the quality of life of these patients.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 2","pages":"380-398"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cri du Chat Syndrome and congenital dislocation of the hips and knees: case report.","authors":"Natã Nascimento de Jesus Graça, Maria Luiza Alessi Ribeiro, Márcio Luís Duarte","doi":"10.31053/1853.0605.v82.n2.45341","DOIUrl":"10.31053/1853.0605.v82.n2.45341","url":null,"abstract":"<p><strong>Introduction: </strong>Cri Du Chat Syndrome (CdCS) is an autosomal genetic disorder involving the complete or partial deletion of the short arm of chromosome 5 (5p). The size of the CdCS deletion ranges from approximately 10-45 Mb.</p><p><strong>Clinical case: </strong>Female patient, one year and three months old, presents hyperextension of the knees. On physical examination, the patient presents bilateral cleft palate, absence of soft palate, cleft lip and tracheostomy, positive Hart sign, negative Peter Bade sign and fixed retrocurved knees with limited range of motion. Radiographs reveal bilateral hip dislocation and knee dislocation. Karyotype analysis confirms the diagnosis of CdCS.</p><p><strong>Results: </strong>Surgery was performed to laterally release the knee joint capsule, lengthen the quadriceps tendon, capsuloplasty and closed reduction of the knee joint, followed by application of a co-pediatric plaster with knee flexion. After two months in a cast, physiotherapy was started. Approximately three months after surgery, the patient presented a healed surgical incision, full knee extension and almost complete flexion (100° flexion), in addition to a negative Lachmann test.</p><p><strong>Conclusion: </strong>The presence of multiple congenital anomalies constitutes an exceptionally unique clinical picture. It is crucial to emphasize that congenital dislocation of the hips and knees in this patient is particularly rare and has not been described in the medical literature among CdCS patients.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 2","pages":"399-408"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-related jaw osteonecrosis: a 6-year retrospective study from two centers in Argentina.","authors":"Nicolás Leonardi, Gerardo Gilligan, Federico Garola, Eduardo Piemonte, René Panico","doi":"10.31053/1853.0605.v82.n2.46061","DOIUrl":"10.31053/1853.0605.v82.n2.46061","url":null,"abstract":"<p><strong>Background: </strong>Medication-related osteonecrosis of the jaw (MRONJ) is an adverse effect associated with the use of antiresorptive/antiangiogenic medications. Few observational studies have been conducted in South America. Our aim was to describe patients with MRONJ from Córdoba, Argentina, focusing on demographic, pharmacological, and serological variables, as well as associated risk factors. Methods: We conducted a cross-sectional study involving MRONJ patients who visited two Oral Medicine Departments between 2016 and 2022. Chi-square tests and Student t-tests were used to compare proportions in categorical and quantitative variables. Additionally, we provided a review of the literature from the last 10 years. Results: A total of 53 patients were included in the study. There was a female predominance in the osteoporosis group. The average duration of antiresorptive treatment for osteoporosis was 10.43 years. Zoledronate was statistically associated with the development of MRONJ. The mandible was more frequently affected than the maxilla. Tooth extraction was the most common triggering factor, accounting for 75% of cases. Additionally, 43.4% of the patients were diagnosed with Stage 1 MRONJ.</p><p><strong>Conclusion: </strong>This subgroup of Argentinean MRONJ patients exhibits similar characteristics to those reported in studies worldwide. The development of MRONJ in osteoporotic females may be linked to inadequate control of antiresorptive therapy. It is essential for general dentists and physicians to recognize the risk of MRONJ in these individuals.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 2","pages":"318-342"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to combat false ideas in medicine: lessons from Hugo Mercier's theory.","authors":"Eduardo Cuestas","doi":"10.31053/1853.0605.v82.n2.48178","DOIUrl":"10.31053/1853.0605.v82.n2.48178","url":null,"abstract":"<p><p>In a world saturated with information, healthcare professionals face the challenge of combating misconceptions that threaten public health, such as vaccine resistance, the use of therapies without scientific support, or denial of diseases like COVID-19...</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 2","pages":"231-236"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}