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

{"title":"From trauma to fibrosis: a case of ulnar nerve entrapment in Guyon’s canal","authors":"Luan Nascimento Lázaro, Pedro Henrique de Oliveira Alvarenga, Ocacir de Souza Reis Soares, Márcio Luís Duarte","doi":"10.31053/1853.0605.v83.n1.48175","DOIUrl":"10.31053/1853.0605.v83.n1.48175","url":null,"abstract":"<p><p>Guyon's canal syndrome is an uncommon distal ulnar neuropathy caused by compression within the wrist. We report a case of delayed ulnar nerve entrapment secondary to post-traumatic fibrosis, diagnosed nine years after wrist injury and surgery. High-resolution ultrasonography demonstrated focal nerve compression within Guyon's canal adjacent to fibrotic tissue. The patient presented with chronic sensory deficits and hypothenar atrophy. Conservative treatment led to partial symptom control. This case highlights delayed post-surgical fibrosis as a potential cause of Guyon's canal syndrome and underscores the diagnostic value of ultrasound in chronic compressive neuropathies.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 1","pages":"e48175"},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582474","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":"[Real-world evidence on the use of generic tofacitinib in patients with rheumatoid arthritis]","authors":"Luis Angel Di Giuseppe, Mariana Andrea Burgos, Maria Lourdes Posadas Martínez, Alfredo Lieber Vargas Casalles, Karina Elena Alvarez, Gabriela Buela, Maria Celeste Puga, Enrique Roberto Soriano Guppy, Javier Eduardo Rosa","doi":"10.31053/1853.0605.v83.n1.49067","DOIUrl":"10.31053/1853.0605.v83.n1.49067","url":null,"abstract":"<p><strong>Objective: </strong>To describe the clinical outcomes of using generic tofacitinib in patients with rheumatoid arthritis (RA) who either initiated it de novo or underwent a non-medical switch from the original formulation.</p><p><strong>Methods: </strong>Retrospective cohort of adults with RA who either initiated generic tofacitinib (JANVAX®) or switched from original tofacitinib (XELJANZ®). Patients were followed until treatment discontinuation, death, or end of follow-up (12 months). Effectiveness was assessed using the DAS28-ESR scale via mixed-effects models. The switch group was evaluated at 0, 6, and 12 months; the initiation group at 0, 3, 6, and 12 months. The occurrence of adverse events was assessed for safety.</p><p><strong>Results: </strong>A total of 42 RA patients were included (24 in the switch group and 18 in the initiation group). Nine patients discontinued treatment. In the switch group, DAS28-ESR remained stable (2.96; 3.08; 3.10; p = 0.70). In the initiation group, improvement was significant (5.3, 3.42, 3.49, 3.31; p < 0.001). No major cardiovascular events (MACE) were reported. There was one death of unknown cause, three serious infections, one pulmonary embolism, and one diagnosis of malignancy during follow-up.</p><p><strong>Conclusions: </strong>The non-medical switch to generic tofacitinib and treatment initiation were associated with a good clinical response in terms of effectiveness, with no evidence of new safety concerns. However, the limited sample size calls for further studies to confirm these findings.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 1","pages":"e49067"},"PeriodicalIF":0.0,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582463","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":"Blood in semen as a clue: a case of persistent Müllerian Duct Syndrome","authors":"Jheniffer Cação, Thais de Paiva Guimarães Barreiro, Thaís Nogueira Dantas Gastaldi, Márcio Luís Duarte","doi":"10.31053/1853.0605.v83.n1.48290","DOIUrl":"10.31053/1853.0605.v83.n1.48290","url":null,"abstract":"<p><p>A 21-year-old man presented with blood in his semen and was diagnosed with Persistent Müllerian Duct Syndrome (PMDS). This rare genetic condition occurs due to insufficient Anti-Müllerian Hormone (AMH) production or AMH insensitivity, resulting in the presence of female internal organs in genetically male individuals. PMDS is often discovered incidentally during surgery for undescended testes or infertility treatment. A variety of imaging techniques, including MRI, can assist in diagnosing PMDS. The condition poses an increased risk of malignancy in both the testes and Müllerian structures. Treatment generally involves the surgical removal of Müllerian remnants, often through laparoscopy.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 1","pages":"e48290"},"PeriodicalIF":0.0,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581934","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":"[Uncommon complications of Acute Rhinosinusitis in pediatrics: a aeport of two cases]","authors":"Emanuel Bottino, Franca Massano, Adriana Severina, Gabriela Bassani, Laura Sasia","doi":"10.31053/1853.0605.v83.n1.48791","DOIUrl":"10.31053/1853.0605.v83.n1.48791","url":null,"abstract":"<p><strong>Objective: </strong>To describe two cases of complications associated with acute bacterial rhinosinusitis (ABRS) treated at our center, focusing on the diagnostic and therapeutic approach.</p><p><strong>Case presentations: </strong>Clinical Case No. 1: A 7-year-old male patient with no prior medical history was diagnosed with left maxillary and frontoethmoidal sinusitis complicated by osteomyelitis, a left epidural intracranial abscess, and left orbital cellulitis. He was hospitalized and received intravenous antibiotic treatment for three weeks, followed by discharge and oral antibiotic therapy for a total duration of six weeks, resulting in full recovery without sequelae.Clinical Case No. 2: An 11-year-old female patient with a history of atopy presented with frontal swelling and fever. She was diagnosed with Pott's puffy tumor and Streptococcus pyogenes bacteremia. She required a total of five days of hospitalization and 15 days of antibiotic therapy, with subsequent clinical improvement.</p><p><strong>Conclusions: </strong>Although the frequency of complications associated with ABRS is low, their occurrence significantly increases morbidity and mortality. Therefore, timely diagnosis and appropriate treatment are crucial to reduce the harmful effects of this particular group of conditions.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 1","pages":"e48791"},"PeriodicalIF":0.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582152","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":"[Ischemic stroke in dengue: Are we facing an immunomediated response? A case report]","authors":"Julieta Sala, Nicolás Pablo Valente, Aixa Ragaini, Celina Ferrario","doi":"10.31053/1853.0605.v83.n1.46236","DOIUrl":"10.31053/1853.0605.v83.n1.46236","url":null,"abstract":"<p><p>Neurological manifestations in dengue infection are atypical; even more so are cases of stroke, which have only been reported rarely. We present the case of a 41-year-old male patient who developed focal neurological deficit during his dengue infection. The patient had no known comorbidities. He presented with fever, headache, myalgia, and biochemical results showed thrombocytopenia. A plain brain CT scan did not reveal any lesions, leading to the diagnosis of ischemic stroke in the context of dengue infection. He showed improvement in neurological symptoms correlated with increasing platelet counts. Such association has been described in other reports of ischemic stroke due to dengue, possibly explained by immunomediated effects leading to a vasculitic condition. The aim of this work is to contribute to the existing evidence on this entity.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 1","pages":"e46236"},"PeriodicalIF":0.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582695","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":"[Epidemiology of acquired syphilis in youth populations in health regions of the Buenos Aires Metropolitan Area (2014–2023)]","authors":"Sebastián Ezequiel Sustas","doi":"10.31053/1853.0605.v83.n1.50271","DOIUrl":"10.31053/1853.0605.v83.n1.50271","url":null,"abstract":"<p><strong>Objetives: </strong>To analyze the trends of acquired syphilis among youth in Buenos Aires Province from 2014 to 2023, focusing on health regions within the metropolitan area and identifying territorial and gender disparities in notification rates.</p><p><strong>Methods: </strong>An observational and ecological study was conducted using data from the National Health Surveillance System. Age- and sex-specific notification rates were calculated for the 15–24 and 25–34 age groups, disaggregated by health region.</p><p><strong>Results: </strong>A sustained increase in syphilis notification rates was observed until 2019, followed by a sharp decline in 2020 associated with the COVID-19 pandemic, and a partial recovery in the subsequent years. Territorial, age group, and gender disparities were identified in notification levels, along with potential difficulties in diagnostic access among young people.</p><p><strong>Conclusions: </strong>Findings highlight the need to strengthen primary healthcare, enhance local surveillance systems, and implement gender-sensitive and territorially focused interventions to address the structural inequities affecting youth sexual health.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 1","pages":"e50271"},"PeriodicalIF":0.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582461","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":"The positioning of pedicle screws in the first instrumented lumbar vertebra influences the reoperation rate due to the development of adjacent segment disease.","authors":"Valentino Latallade, Matías Pereira Duarte, Ivan Alfredo Huespe, Gonzalo Kido, Matías Petracchi, Marcelo Gruenberg, Carlos Sola","doi":"10.31053/1853.0605.v83.n1.49006","DOIUrl":"10.31053/1853.0605.v83.n1.49006","url":null,"abstract":"<p><strong>Introduction: </strong>Adjacent Segment Disease (ASD) is a significant concern following lumbar arthrodesis, particularly in patients aged 55 and older. While various risk factors for ASD have been investigated, modifiable surgical factors related to pedicle screw (PS) positioning remain underexplored.</p><p><strong>Objectives: </strong>This study aims to specifically evaluate the correlation between PS positioning and reoperation rates due to ASD in elderly patients undergoing lumbar arthrodesis, identifying specific surgical parameters that could mitigate the risk of ASD.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 48 patients aged 55 and older who underwent posterior lumbar arthrodesis from May 2013 to May 2021. Patients had 2 to 4 segments fused between L2 and S1 and a minimum follow-up of 2 years. We assessed PS positioning parameters, including the angle between the first PS and the upper vertebral endplate (VE) and the PS tip-VE distance, using logistic regression to analyze associations with reoperation rates. ROC curve analysis was performed to identify optimal cut-off points.</p><p><strong>Results: </strong>Out of the 48 patients, 7 (14.6%) required reoperations for ASD, with an average follow-up of 6.5 years. A greater PS tip-VE distance was significantly associated with a lower probability of reoperation (OR: 0.68; p = 0.001), while a higher PS-VE angle correlated with an increased risk (OR: 1.48; p = 0.001). Critical cut-off values identified included a PS tip-VE distance of ≥ 7.5% (sensitivity: 90.63%) and a PS-VE angle of ≥ 10° (sensitivity: 75.00%).</p><p><strong>Conclusions: </strong>Our findings indicate that optimizing pedicle screw positioning-specifically maintaining a PS tip-VE distance of at least 7.5% and a PS-VE angle below 10°-can significantly reduce reoperation rates due to ASD in patients over 55. Implementing these specific parameters in surgical practice may lead to improved patient outcomes and reduced incidence of ASD-related interventions.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 1","pages":"e49006"},"PeriodicalIF":0.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582483","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":"Complication rates in thoracolumbar fracture-dislocations with and without neurological injury.","authors":"Guillermo Ricciardi, Ignacio Cirillo, Rodrigo Pons Belmonte, Juan Pablo Cabrera, Alfredo Guiroy, Charles Carazzo, Ratko Yurac","doi":"10.31053/1853.0605.v83.n1.48345","DOIUrl":"10.31053/1853.0605.v83.n1.48345","url":null,"abstract":"<p><strong>Introduction: </strong>Thoracolumbar fracture-dislocations from high-energy trauma are severe injuries requiring surgical stabilization. The risks faced by neurologically intact patients remain unclear.</p><p><strong>Objectives: </strong>To compare early complication rates in surgically treated patients with thoracolumbar fracture-dislocations according to neurological status.</p><p><strong>Methods: </strong>This retrospective multicenter cohort study included patients from 24 institutions in 9 Latin American countries who underwent surgery for thoracolumbar fracture-dislocation between 2015 and 2023. Eligible patients were aged ≥16, of any gender, with high-energy trauma requiring surgery. The primary outcome was early postoperative complications from admission to discharge or death, with patients categorized by neurological injury at admission.</p><p><strong>Results: </strong>A total of 262 patients were analyzed, primarily young men (n=212; 80.6%) with a mean age of 36.8 years (SD=13.7). The thoracic and thoracolumbar regions were most affected. Only 18% had no neurological damage, and over half with deficits had complete spinal cord injuries. A total of 268 complications were identified (median=1; range 0-9). Postoperative complications occurred in 28.6% of patients without neurological injury and 74.3% with neurological injury (p<0.001). Neurological injury was strongly associated with complications (OR=7.4; 95% CI=3.6-15.4; p<0.001), and clinical instability also had a significant association (OR=3.2; 95% CI=1.6-6.4; p=0.001).</p><p><strong>Conclusions: </strong>Patients with neurological damage face a markedly higher risk of early postoperative complications after thoracolumbar fracture-dislocation surgery. Results may have limited generalizability due to non-probabilistic institutional sampling.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 1","pages":"e48345"},"PeriodicalIF":0.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582145","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":"[Professor Dr. Marta Fiol, the first female Dean of a 148-year-old Faculty]","authors":"Andrés A Ponce","doi":"10.31053/1853.0605.v83.n1.50492","DOIUrl":"10.31053/1853.0605.v83.n1.50492","url":null,"abstract":"<p><p>The Professor Dra Marta Fiol, is the first woman elected in the history of the Faculty of Medical Sciences of the National University of Córdoba, as Dean of Medicine.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"83 1","pages":"e50492"},"PeriodicalIF":0.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582496","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":"[Diaphragmatic Paralysis in Parsonage-Turner syndrome: beyond brachial neuralgia]","authors":"Nazareno Zelaya de Leon, Marcella Perri, Matias Almeida Souto, Eduardo Borsini","doi":"10.31053/1853.0605.v82.n4.48288","DOIUrl":"10.31053/1853.0605.v82.n4.48288","url":null,"abstract":"<p><strong>Objective: </strong>To describe a case of bilateral diaphragmatic paralysis secondary to Parsonage–Turner syndrome, emphasizing its uncommon clinical presentation, the multidisciplinary diagnostic approach, and the therapeutic strategies implemented.</p><p><strong>Case report: </strong>A 63-year-old male, former smoker with hypertension and type 2 diabetes, presented with sudden and intense pain in both upper limbs followed by proximal paresis. Within 24 hours, he developed hypercapnic respiratory failure requiring invasive mechanical ventilation. Chest computed tomography revealed elevation of both hemidiaphragms, and diaphragmatic ultrasound confirmed bilateral dysfunction. Neurophysiological studies demonstrated a sensory–motor neuropathy without associated structural abnormalities. After excluding other causes, a diagnosis of bilateral diaphragmatic paralysis secondary to Parsonage–Turner syndrome was established. Non-invasive positive pressure ventilation was initiated, leading to clinical improvement and no hospital readmissions. At one-year follow-up, the patient remains clinically stable with good tolerance to nocturnal ventilatory support.</p><p><strong>Conclusion: </strong>This case highlights the importance of considering Parsonage–Turner syndrome in the differential diagnosis of diaphragmatic dysfunction, particularly in patients with recent viral infections and neuromuscular symptoms. The combined use of functional assessments such as maximal transdiaphragmatic pressure (PdiMax) measurement and diaphragmatic ultrasound enables objective characterization of diaphragmatic function and represents a high-value diagnostic approach to guide ventilatory management and respiratory rehabilitation.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"82 4","pages":"869-881"},"PeriodicalIF":0.0,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12863396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811431","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}