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

{"title":"A double threat: CNS toxoplasmosis and CMV encephalitis in a heart transplant recipient","authors":"Salwa Alhammadi, Tianyu Zhang, Aliya Szpindel, Márcio Luís Duarte, Leonardo Freitas","doi":"10.31053/1853.0605.v83.n2.48628","DOIUrl":"10.31053/1853.0605.v83.n2.48628","url":null,"abstract":"<p><p>A 73-year-old immunocompromised woman with a history of heart transplant presented with cognitive decline and left-sided neurological deficits. Imaging revealed atypical brain lesions. Initial biopsy was inconclusive. Despite extensive infectious workup, diagnosis remained unclear until a second brain biopsy confirmed central nervous system toxoplasmosis and cytomegalovirus (CMV) encephalitis. Treatment with antiparasitic and antiviral agents was initiated, but the patient's condition deteriorated, leading to palliative care. This case highlights diagnostic challenges in immunocompromised patients, the importance of considering atypical presentations of CNS infections, and the potential necessity of repeat biopsies when initial evaluations are non-diagnostic.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 2","pages":"e48628"},"PeriodicalIF":0.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362778","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":"Results and survival of Fassier-Duval rods in children with moderate Osteogenesis Imperfecta: a retrospective study in 36 cases","authors":"Claudio E Primomo, Rosario Ramos Mejia, Lautaro Garcia Osso, Gisela Isoldi, Santiago Iglesias, Virginia Fano","doi":"10.31053/1853.0605.v83.n2.49222","DOIUrl":"10.31053/1853.0605.v83.n2.49222","url":null,"abstract":"<p><strong>Introduction: </strong>Intramedullary rodding for long bone alignment in children with osteogenesis imperfecta (OI) improves mobility and reduces fracture frequency. However, complications and revision surgeries are common.</p><p><strong>Objectives: </strong>To describe outcomes, complications, and factors influencing implant survival in children with moderate OI whose lower limbs were aligned using Fassier-Duval (FD) rods, in a pediatric hospital.</p><p><strong>Methods: </strong>Retrospective analytical analysis of clinical records and X-rays of children with >1 year of postoperative follow-up. Clinical variables, treatment details, complications, and implant failure were registered. Descriptive and inferential statistics were performed.</p><p><strong>Results: </strong>A total of 101 FD rods were evaluated in 36 patients. The median ages at initial FD rodding and revision surgery were 5.3 and 9.4 years, respectively (wide ranges observed). Indications for treatment included previous implant replacement (48.5%), deformity correction (37.6%), and fracture management (13.9%). Mechanical complications occurred in 35.6% of FD rods, primarily due to fixation failure, with 24.8% requiring revision or replacement. A history of prior alignment was associated with improved implant survival, whereas younger surgical age and longer follow-up were associated with implant failure. Implant survival was higher in ambulatory patients and those receiving anti-resorptive therapy. Postoperatively, fracture frequency and deformity decreased, while ambulatory capacity was maintained. This retrospective study conducted at a single center did not allow confirmation of some findings of interest.</p><p><strong>Conclusions: </strong>Our findings align with existing literature. Implant survival was influenced by multiple factors, highlighting the need for a multidisciplinary approach. As not all patients reached skeletal maturity, some outcomes require longer-term follow-up.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 2","pages":"e49222"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362826","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":"Generalized gingival hyperplasia as a late manifestation of multiple myeloma: a case report","authors":"Gerardo Marcelo Gilligan, Juan Cruz Romero Panico, Rene Panico","doi":"10.31053/1853.0605.v83.n2.46439","DOIUrl":"10.31053/1853.0605.v83.n2.46439","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to present a clinical case of Multiple Myeloma (MM) with an unusual oral presentation, highlighting the importance of oral surveillance in the comprehensive diagnosis of hematological diseases.</p><p><strong>Clinical case: </strong>The case of a 70-year-old female patient who attended the Department of Stomatology \"A\" of the Faculty of Dentistry (Universidad Nacional de Córdoba) with bimaxillary gingival lesions of 6 months of evolution is presented. The patient, with no known medical history, presented significant weight loss and severe systemic symptoms. On clinical examination, painful gingival hyperplastic masses were observed, with generalized tooth mobility. Orthopantomography and tomography revealed alveolar resorption and osteolytic areas. Laboratory tests showed anemia, leukopenia, thrombocytopenia, and elevated inflammatory markers. The biopsy revealed a proliferation of monoclonal plasma cells positive for CD38 and kappa chains, leading to the diagnosis of MM. The patient was referred to oncohematology, but died quickly.</p><p><strong>Conclusion: </strong>This case highlights the importance of early recognition of oral manifestations of MM, which can be a diagnostic challenge due to their similarity to other common oral conditions. Timely identification of these lesions by dentists may be crucial to reduce the morbidity and mortality associated with this hematological disease.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 2","pages":"e46439"},"PeriodicalIF":0.0,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362895","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":"Management of postoperative hypoxemia in pediatric patients with hepatopulmonary syndrome through ventilatory support strategies: a report of three cases","authors":"Leandro Grieco","doi":"10.31053/1853.0605.v83.n2.53243","DOIUrl":"10.31053/1853.0605.v83.n2.53243","url":null,"abstract":"<p><strong>Objective: </strong>To describe the ventilatory management strategies used for the treatment of refractory hypoxemia in the postoperative period of liver transplantation in pediatric patients with hepatopulmonary syndrome, also considering postoperative complications, duration of ventilatory support, and length of stay in the intensive care unit</p><p><strong>Materials and methods: </strong>An observational, descriptive, retrospective, and longitudinal study was conducted. All pediatric patients with HPS who underwent liver transplantation at Garrahan Hospital (Argentina) during 2023 were included. Diagnosis was established according to the criteria of the International Liver Transplantation Society. Ventilatory strategies, use of inhaled nitric oxide, individualized titration of PEEP and FiO₂, assessment of respiratory effort, and use of non-invasive ventilatory support after extubation were analyzed. Results: The cohort included three patients aged 20 to 168 months. All required invasive mechanical ventilation for 4 to 15 days and iNO for 8 to 19 days. Post-extubation non-invasive ventilation was implemented in all cases, lasting 2 to 17 days, allowing safe transition to low-flow oxygen therapy without associated respiratory complications such as atelectasis or secretion retention. ICU stay ranged from 16 to 34 days. Different recovery patterns were identified, highlighting the importance of dynamic adjustment of PEEP and FiO₂ and close monitoring of respiratory muscle function.</p><p><strong>Conclusion: </strong>The implementation of stepwise strategies, including prolonged and adjusted use of inhaled nitric oxide, higher levels of PEEP and FiO₂, quantification of respiratory effort, and systematic use of post-extubation non-invasive ventilation, allowed optimization of oxygenation, prevention of severe respiratory complications, and guidance of ventilator weaning.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 2","pages":"e53243"},"PeriodicalIF":0.0,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362903","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":"Revisión narrativa de los registros de enfermedades poco frecuentes.","authors":"María Sol Carregal, Ana Braslavsky, María Lourdes Posadas-Martínez","doi":"10.31053/1853.0605.v83.n2.49021","DOIUrl":"10.31053/1853.0605.v83.n2.49021","url":null,"abstract":"<p><strong>Introduction: </strong>Rare diseases affect between 8-10% of the population. There are registries that describe these diseases but there is limited literature that reviews their characteristics, scope and limitations.</p><p><strong>Materialsand methods: </strong>A narrative review was designed that would cover literature from the last 10 years that described the limitations and geographic localizations of rare diseases registries, following SANRA guidelines. The search was carried out on Medline, Lilacs, Cochrane, Clinical Trials and Orphanet.</p><p><strong>Results: </strong>978 articles were eligible from which 26 were selected for final review. 22 national registries were found, 10 from Europe. The scope was epidemiological, development of RCTs and improving interoperability between registries in most reviews. Regarding the country of origin, most were from USA, Italy, France, Spain and Germany. In Latin America, rare diseases registries are scarce, mostly from Uruguay and Argentina and depending on private funding.</p><p><strong>Discussion: </strong>Rare diseases registries correspond to a data collection system to describe a condition, typically of diseases related to each other. Their scope is mostly epidemiological and for recruitment of patients for RCTs. It is key to define primary and secondary objectives of rare diseases registries and perform quality control. The limitations are those of observational studies, such as selection bias, recollection bias and lack of standardized controls.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 2","pages":"e49021"},"PeriodicalIF":0.0,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362896","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":"Traffic accident mortality in large urban areas, Argentina 2010-2016","authors":"Ignacio Javier Yannone, Marcio Alazraqui","doi":"10.31053/1853.0605.v83.n2.49462","DOIUrl":"10.31053/1853.0605.v83.n2.49462","url":null,"abstract":"<p><strong>Objectiveobjetivo: </strong>to analyze traffic accident mortality in 33 cities in Argentina with a population of over 100,000 inhabitants during the period 2010-2016.</p><p><strong>Methods: </strong>Ecological study in 33 Argentine cities with more than 100,000 inhabitants. Data from the Dirección de Estadísticas e Información de Salud, linked to the cities of the SALURBAL project, were used. Deaths due to traffic accidents were identified with ICD-10 codes. Specific rates were calculated by age, sex and type of user, and age-adjusted rates were calculated using the direct method.</p><p><strong>Results: </strong>A total of 17,606 deaths were recorded. The crude rate was 8.65 per 100,000 population. Adjusted rates decreased in 2015 and 2016, with heterogeneity between cities. Males aged 20-24 years presented the highest risk. Automobile occupants had the highest rates in both sexes.</p><p><strong>Conclusions: </strong>This study provides an important advancement in the analysis of traffic accident mortality focused on large urban agglomerations in Argentina. These results, together with other approaches, allow for a comprehensive and detailed understanding of this complex problem in order to obtain valuable information that leads to effective and sustainable solutions for the prevention and reduction of traffic accidents, thereby improving road safety and protecting the health and lives of people.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 2","pages":"e49462"},"PeriodicalIF":0.0,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362830","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":"Mental models and conceptual complexity in medicine","authors":"Eduardo Cuestas","doi":"10.31053/1853.0605.v83.n2.53138","DOIUrl":"10.31053/1853.0605.v83.n2.53138","url":null,"abstract":"<p><p>This editorial examines how mental models are constructed, organised and transformed throughout the medical training process, with a particular focus on cardiovascular physiology. The findings presented here are of direct relevance to final-year medical students and newly qualified doctors, who are at a critical stage in the consolidation and reconfiguration of their knowledge.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 2","pages":"e53138"},"PeriodicalIF":0.0,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362864","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":"Screening strategies for Chagas Disease: evaluation of a field diagnostic algorithm in Santiago del Estero","authors":"Andrea Marchiol, Diego Mendicino, Alicia Thelin, Gabriela Cazzari, Sandra Del Valle Seu","doi":"10.31053/1853.0605.v83.n2.50102","DOIUrl":"10.31053/1853.0605.v83.n2.50102","url":null,"abstract":"<p><strong>Introduction: </strong>Chagas disease is one of the main endemic diseases in Latin America, affecting between 6 and 7 million people and causing approximately 12,000 deaths annually. Although antiparasitic treatment is effective in acute and chronic stages, only 10% of patients are diagnosed and only 1% receive timely treatment. In Argentina, an estimated 1.5 million people are affected by the infection, and progress has been made in reducing cases thanks to different public health interventions.</p><p><strong>Methods: </strong>In Robles, Santiago del Estero, a diagnostic algorithm was implemented using rapid tests (RT) in the field, venous extraction of positive samples and approximately 10% of negative samples, and processing using conventional serology (CS) to improve access to diagnosis in at-risk populations.</p><p><strong>Results: </strong>This algorithm enabled serological diagnosis of CD for 1,380 people between November 2021 and June 2022 in the department of Robles, confirming 48 infected individuals through SC, with an estimated loss of 4 or 5 seropositive individuals.</p><p><strong>Conclusions: </strong>The strategy proved effective, with a low patient loss rate and improved access to diagnosis, especially for women of childbearing age. Implementing PR can facilitate diagnosis in resource-limited and difficult-to-reach areas, contributing to the control of this endemic disease.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 2","pages":"e50102"},"PeriodicalIF":0.0,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362733","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":"Evolution of daytime sleepiness and affective symptoms in patients with obstructive sleep apnea treated with Continuous Positive Airway Pressure","authors":"Stella Maris Valiensi, Agustín Folgueira","doi":"10.31053/1853.0605.v83.n2.50007","DOIUrl":"10.31053/1853.0605.v83.n2.50007","url":null,"abstract":"<p><p>Continuous Positive Airway Pressure (CPAP) is the treatment of choice for OSA. Objectives: To analyze and correlate the subjective symptoms of daytime sleepiness, depression, and anxiety before and after CPAP treatment. A retrospective, observational, longitudinal study was conducted. Data were extracted from questionnaires completed three times. The first questionnaire was submitted at the time of a nocturnal PSG with diagnostic oximetry. The second and third were administered during the nocturnal PSG with oximetry and titration with Auto-CPAP. The Epworth Sleepiness Scale, the Self-Report Anxiety Scale, and Beck Depression Inventory were used. Results: We found a significant decrease in the Epworth Sleepiness Scale over the years, but we found no differences in the scale for anxiety (p=0.45) and none for depression (p=0.52). Conclusion: The analysis of mood trauma and daytime sleepiness in patients using CPAP demonstrated that daytime sleepiness is reduced with the use of the device, but this was not the case with markers of mood trauma. Physicians should be aware of our discomfort to understand the magnitude of the benefit they can obtain from CPAP therapy on sleepiness and to inform decision-making in medical care.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 2","pages":"e50007"},"PeriodicalIF":0.0,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362825","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":"Ortner syndrome as a cause of sudden dysphonia, a little-known etiology","authors":"Juan Ramon Y Cajal Calvo, Jorge Miguel Briceño Revillo, Laura Perez Abad, Pablo Luis Vela Gajón","doi":"10.31053/1853.0605.v83.n2.49266","DOIUrl":"10.31053/1853.0605.v83.n2.49266","url":null,"abstract":"<p><strong>Clinical case: </strong>A 77-year-old woman was admitted with symptoms of heart failure and sudden dysphonia. Imaging tests revealed a pericardial effusion and the existence of severe cardiomegaly at the expense of an aneurysmal left atrium. Pericardiocentesis was performed, with improvement in the clinical picture of heart failure, although residual dysphonia persisted upon discharge.</p><p><strong>Discussion: </strong>Ortner syndrome or cardiovocal syndrome consists of paralysis of the left recurrent laryngeal nerve caused by a cardiovascular condition, usually and originally described by left atrial dilation in relation to rheumatic mitral valve disease. Early diagnosis can be useful to initiate immediate treatment and restore vocal cord function.</p><p><strong>Conclusion: </strong>When assessing possible causes of dysphonia, it is important to take into account the cardiac etiology, since despite the fact that this syndrome has a low prevalence, it is important to take it into account since its treatment requires multidisciplinary management.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 2","pages":"e49266"},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362869","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}