{"title":"[Cirrhotic cardiomyopathy – Clinically fact or academic curiosity? Review: Part 1: definition, epidemiology, pathology and clinical manifestations]","authors":"Hugo Ramos, Mario Altieri","doi":"10.31053/1853.0605.v81.n1.44416","DOIUrl":"10.31053/1853.0605.v81.n1.44416","url":null,"abstract":"<p><p>Severe cirrhosis affecting myocardial function provokes a syndrome called Cirrhotic Cardiomyopathy, defined as cardiac disfunction associated with hepatic cirrhosis in the absence of other known cardiac disease. The prevalence is variable according different groups of investigation owing to the latent or subclinical course until a stressful situation unmask it such as surgery, hemorrhage, infection, hepatic transplant or transjugular intrahepatic porto-systemic shunt. We aimed to review the definition, pathology, pathophysiology, clinical manifestations, diagnostic criteria, images, clinical relevance, pharmacological treatment and hepatic transplantation.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"81 1","pages":"178-195"},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307217","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}
Eugenia Conti, Sebastián Menazzi, Ana Mariel Finkelsteyn, María de Lourdes Figuerola
{"title":"Late-onset familial amyloidosis polyneuropathy associated with c.186G>C in transthyretin.","authors":"Eugenia Conti, Sebastián Menazzi, Ana Mariel Finkelsteyn, María de Lourdes Figuerola","doi":"10.31053/1853.0605.v81.n1.40992","DOIUrl":"10.31053/1853.0605.v81.n1.40992","url":null,"abstract":"<p><strong>Introduction: </strong>The most common form of hereditary amyloidosis is associated with variants of transthyretin (TTR). Familial amyloidosis polyneuropathy associated with variants of TTR (FAP-TTR) is an infrequent, multisystemic disease, with predominant involvement of the peripheral nervous system. More than 130 pathogenic variants have been identified so far and most of them are amyloidogenic, being Val30Met the most frequently described.</p><p><strong>Case report: </strong>A 74 year-old male was evaluated for progressive decreased sensitivity and associated loss of strength in four limbs in the previous two years, needing assistance for walking. Areflexia, bilateral tibialis anterior and gastrocnemius atrophy, bilateral anesthesia and apalesthesia were found in lower limbs. Bilateral hypoesthesia was reported in upper limbs. No painful dysesthesia, hyperalgesia or allodynia were found. DNA sequencing of the TTR gene led to the detection of the variant c.186G>C in heterozygous state. The resulting variant (Glu62Asp), located in the critical functional domain, has not been published before.</p><p><strong>Conclusion: </strong>The importance of considering late onset, sporadic FAP-TTR as a differential diagnosis of cryptogenic polyneuropathy is highlighted.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"81 1","pages":"167-177"},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307227","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":"[Predictive appendicitis scale for children under 4 years of age: Is it possible to apply artificial intelligence?]","authors":"Dayhana Arango Cárdenas, Jorge Andrés Castrillón Lozano, Ximena Areiza Ocampo","doi":"10.31053/1853.0605.v81.n1.44316","DOIUrl":"10.31053/1853.0605.v81.n1.44316","url":null,"abstract":"<p><p>Acute appendicitis in the pediatric population is a pathology of heterogeneous presentation that is currently diagnosed using various criteria or predictive scales, which have proven not to be sufficiently accurate to be standardized, however, methods have been created to establish a more accurate diagnosis, an aspect that has been provided by artificial intelligence, which through different algorithms has the ability to show the patient's condition and the most appropriate intervention for this, thus reducing the rate of unnecessary interventions and therefore possible related complications.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"81 1","pages":"196-203"},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307223","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":"[Sarcopenia: is a clinical diagnosis possible?]","authors":"Vanina Soledad Lerena, Elizabeth Carolina Coronello, Ilsen Catherine Torres Barrón, Sabrina Paola Lucas, Adriana Graciela Diaz","doi":"10.31053/1853.0605.v81.n1.42334","DOIUrl":"10.31053/1853.0605.v81.n1.42334","url":null,"abstract":"","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"81 1","pages":"83-95"},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307253","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}
Juan Pablo Ricarte-Bratti, Julio Oscar Emilio Bono, Matias Morsone, Hugo Jose Londero
{"title":"[MINOCA and Coronary Ectasia: a rare combination of causes of infarction]","authors":"Juan Pablo Ricarte-Bratti, Julio Oscar Emilio Bono, Matias Morsone, Hugo Jose Londero","doi":"10.31053/1853.0605.v81.n1.43231","DOIUrl":"10.31053/1853.0605.v81.n1.43231","url":null,"abstract":"<p><strong>Objective: </strong>to describe a patient with myocardial ischemia with multiple causes.</p><p><strong>Clinical case: </strong>This clinical case describes a 58-year-old man with a history of hypertension, dyslipidemia, COPD and previous myocardial infarction (AMI). He went to the emergency room with chest pain and dyspnea. Findings included bibasal crackles, electrocardiogram with old anterior fibrosis, elevated NT-ProBNP, and echocardiogram with septoapical akinesia. During hospitalization, he experienced tachyarrhythmia and hemodynamic deterioration, undergoing electrical cardioversion (CVE). Non-ST segment elevation acute coronary syndrome (NSTEACS) complicated with ventricular arrhythmia and acute pulmonary edema was diagnosed. Coronary angiography revealed coronary ectasias without obstructive lesions, but with mild stenosis in three vessels. The patient was successfully treated with non-invasive ventilation, diuretics, vasodilators and anticoagulation. The discharge was granted with the plan to further studies to optimize and guide treatment and finally the diagnosis of Myocardial Infarction with Non-Obstructive Arteries (MINOCA) and the presence of coronary ectasias was addressed.</p><p><strong>Conclusion: </strong>it is important to highlight the non-ischemic causes in MINOCA and the association between coronary ectasia and cardiovascular events, which is why we emphasize the need for more studies to better understand the relationship between these phenomena.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"81 1","pages":"155-166"},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307228","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}
Vanina Pagotto, Facundo Seoane, Diego Arrigo, Victoria Ardiles, Valeria Asprea, Florencia De Florio, Analia Ferloni, Valeria Aliperti
{"title":"[Effectiveness and safety of COVID-19 vaccines in healthcare workers in Buenos Aires City, Argentina.]","authors":"Vanina Pagotto, Facundo Seoane, Diego Arrigo, Victoria Ardiles, Valeria Asprea, Florencia De Florio, Analia Ferloni, Valeria Aliperti","doi":"10.31053/1853.0605.v81.n1.41155","DOIUrl":"10.31053/1853.0605.v81.n1.41155","url":null,"abstract":"<p><strong>Introduction: </strong>COVID-19 vaccination aids pandemic limitation. In Argentina, three vaccines are approved, and healthcare workers are priorized (HCWs). The aim was to determine the effectiveness of COVID-19 vaccines, analyzing change in Immunoglobulin G levels and the incidence of new COVID-19 cases up to 12 months after the second dose.</p><p><strong>Methods: </strong>Prospective cohort of HCWs between March 2021- 2022. COVIDAR IgG test was used to measure antibodies. A mixed-effects model was employed to compare the levels of immunoglobulin G at different time points, Kaplan Meier was used to estimate incident COVID-19 cases.</p><p><strong>Results: </strong>82 participants were included Adverse events were frequent but mild. All participant showed positive antibody at 12 months. Antibodies levels showed an increase one year after 2nd dose. Sinopharm took a long time to yield positive results. More than half of the people had mild COVID-19 disease.</p><p><strong>Conclusion: </strong>COVID-19 vaccines are safe and effective.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"81 1","pages":"115-127"},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307222","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":"[Advanced maternal age as a risk factor for adverse maternal and perinatal outcomes]","authors":"Maria Eugenia Carducci, Gustavo Izbizky","doi":"10.31053/1853.0605.v81.n1.41447","DOIUrl":"10.31053/1853.0605.v81.n1.41447","url":null,"abstract":"<p><strong>Introduction: </strong>A progressive increase in the age of women at first pregnancy is observed, a situation that has been associated with a greater risk of adverse maternal and perinatal effects.</p><p><strong>Objective: </strong>The aim of this study was to describe the characteristics and the maternal and perinatal outcomes of nulliparas of 40 years and older and compare them with those of nulliparas under 40.</p><p><strong>Study design: </strong>This was a retrospective cohort analysis of a database of pregnancy population who had attended their deliveries in a private university hospital.</p><p><strong>Results: </strong>An association was observed between maternal age ≥ 40 with the maternal compound adverse outcome (OR 1,3; 95% CI: 1,1-1,6), gestational diabetes (OR 3,6; 95% CI: 1,80-3,7), hypertensive disorders/preeclampsia (OR 2,2; 95% CI: 1,6-3,1) and postpartum hemorrhage (4,7; 95% CI: 1,2-16,3), with advanced maternal age persisting as an independent risk factor for the maternal compound adverse outcome (OR 1,3; 95% CI: 1,1 -1,6) and the perinatal compound adverse outcome (OR 1,40; 95% CI: 1,2-1,7) in the multivariate analysis. A higher rate of preterm birth was observed in the group of older nulliparas (OR 1,6; 95% CI: 1,3-2,0) with a higher requirement for admission to NICU for their newborns (OR 1,3; 95% CI: 1,0-1,8).</p><p><strong>Conclusions: </strong>Women with advanced maternal age constitute a high-risk population, whose attention and follow-up would require a differential approach aiming to improve maternal and perinatal outcomes.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"81 1","pages":"24-39"},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307221","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}
Luis Alfredo Hernández Villarroel, Mercedes De Lera Alfonso
{"title":"[Medullary infarction secondary to endovascular treatment of thoracoabdominal aortic aneurysm]","authors":"Luis Alfredo Hernández Villarroel, Mercedes De Lera Alfonso","doi":"10.31053/1853.0605.v81.n1.41439","DOIUrl":"10.31053/1853.0605.v81.n1.41439","url":null,"abstract":"<p><p>Medullary infarction is a severe and infrequent pathology, which represents 1% of all ischemic strokes, and is also a rare complication of different surgical procedures. It is caused by the acute interruption of the blood flow of the spinal cord, manifesting itself with clinical neurological deficits related to the affected vascular territory.</p><p><strong>Methods: </strong>We present the case of an 80-year-old patient, with cardiovascular risk factors, who is present on post-surgical day 13, after placement of a vascular endoprosthesis for a thoracoabdominal aneurysm, sudden appearance of paraparesis with progression to paraplegia and hypoesthesia in both lower extremities. CT angiography of the aorta rules out local complications in the endoprosthesis. Medullary MRI showed images compatible with acute dorsal medullary infarction from level D9.</p><p><strong>Results: </strong>On discharge, the patient presented paraplegia and hypoesthesia of both lower extremities with fecal and urinary incontinence.</p><p><strong>Conclusion: </strong>Spinal cord infarction may be limited to a vascular territory or be more extensive according to its pathogenesis. The affectation of the anterior spinal artery is the most common and is characterized by bilateral motor deficits and loss of thermoalgesic sensitivity, which could have a great impact on the quality of life of patients. Its etiology is varied, including aortic surgery within its causes. MRI is very useful for its diagnosis and currently there are no clinical guides for the optimal treatment.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"81 1","pages":"143-154"},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307226","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}
Eloy Salinas, María Cecilia De Pauw, María Fernanda Aguirre, María Jimena Marro, Christian Ballejo, Alejandro Félix Sturniolo, Alicia E B Lawrynowicz
{"title":"[Prevalence of noncommunicable diseases and risk factors in rural population of San Luis, Argentina]","authors":"Eloy Salinas, María Cecilia De Pauw, María Fernanda Aguirre, María Jimena Marro, Christian Ballejo, Alejandro Félix Sturniolo, Alicia E B Lawrynowicz","doi":"10.31053/1853.0605.v81.n1.42138","DOIUrl":"10.31053/1853.0605.v81.n1.42138","url":null,"abstract":"<p><p>The objective of this study was to estimate the prevalence of diabetes mellitus (DM) and cardiovascular risk factors in a rural population in the province of San Luis, Argentina. Cross-sectional study developed between September and November 2017 with 18-year-old inhabitants and more than four towns in the Juan Martín de Pueyrredón department, San Luis. The participants answered questions by self-report on sociodemographic aspects, habits, psychosocial and risk factors for non-communicable diseases; physical measurements, FINDIRSC questionnaire and blood sample extraction were performed. Univariate estimates stratified by sex with their 95% confidence interval (95%CI) were obtained. We worked with sample expansion factors; crude and adjusted prevalences were calculated. The population consisted of 424 men (52.5%, 95%CI: 46.0-58.9) and 384 women (47.5%, 95%CI: 41.1-54.0). The adjusted prevalences for both sexes (by self-report) were: DM 11.8% (95%CI: 8.2-15.4); arterial hypertension (AHT): 35.5% (95% CI: 31.0-40.1); high cholesterol: 20.3% (CI 16.0-24.7). Males had significantly higher desirable HDL cholesterol and elevated blood pressure than females; women abdominal obesity in greater magnitude. 16.4% (95% CI: 11.0 - 23.6) had a high-very high risk of developing type 2 DM in the next 10 years. The adjusted prevalences of DM, hypertension, and high cholesterol were lower than those of the urban population of the province of San Luis. We highlight the pioneering contribution of this work to the knowledge of the health profile of rural communities in Argentina.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"81 1","pages":"5-23"},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307252","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":"[Dengue in Argentina: confirmation of our worst suspicions]","authors":"Adrián Diaz","doi":"10.31053/1853.0605.v81.n1.44575","DOIUrl":"10.31053/1853.0605.v81.n1.44575","url":null,"abstract":"<p><p>.</p>","PeriodicalId":38814,"journal":{"name":"Revista de la Facultad de Ciencias Medicas de Cordoba","volume":"81 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307220","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}