Medicina-buenos Aires最新文献

Introduction: Children and adolescents with autism spectrum disorder (ASD) exhibit diverse functioning and share challenges in social communication and repetitive behaviors. Diagnostic classifications do not fully capture their daily strengths and limitations, making functional assessments essential. The International Classification of Functioning, Disability and Health (ICF) highlights activities and participation as fundamental aspects to describe health conditions. TEA-CIFunciona, an ICF based tool, standardizes functional assessment and defines intervention goals for children with ASD in Argentina. This study aims to: 1) describe the functioning of children with ASD across age-based groups and 2) compare functional needs and intervention goals within each subgroup.

Materials and methods: TEA-CIFunciona was administered in follow-up consultations of children under 16 years of age with a confirmed ASD diagnosis, from 2019 to October 2024.

Results: The functional profile of a sample of 497 children and adolescents was established. Functional categories (activities, participation and contextual factors) were compared between two age subgroups.

Discussion: TEA-CIFunciona facilitated the functional assessment, the systematization of data collection necessary to adapt the follow-up of children and adolescents with ASD at national level. It also enabled the identification of individual and group intervention objectives.

Introduction: This study aimed to identify the main allergens causing allergic rhinitis (AR) in Zhangjiagang and analyze their epidemiological features.

Materials and methods: From July 2018 to June 2019, 1684 patients with suspected allergic rhinitis in the outpatient department of the First People's Hospital of Zhangjiagang City were tested with an allergen skin prick test (SPT) and statistically analyzed.

Results: The overall SPT positive rate was 65.3%. House dust mites (56.2%) and dust mites (56.0%) were the predominant inhalant allergens. Inhalant allergen positivity (59.4%) significantly exceeded ingested allergens (3.4%). The positive rate of inhalation allergens was significantly higher than that of ingestion allergens (χ2=1224.83, p<0.05). There was no significant difference in SPT positive rate between males and females (χ2=1.342, p>0.05). Positivity rates declined with age. Seasonally, autumn showed the highest positivity (74.0%), followed by winter (69.3%), summer (64.6%), and spring (54.7%). Specific allergens like birch, willow, rapeseed, Chinese parasol, and ragweed peaked in autumn, while Alternaria alternata peaked in summer, and cockroach was higher in autumn/winter.

Conslusion: House dust mites (56.2%) and dust mites (56.0%) are the predominant allergens triggering allergic rhinitis in Zhangjiagang's humid subtropical climate, with inhalant allergens (59.4%) significantly exceeding ingested allergens (3.4%). The distinct age-related decline in allergen positivity, higher cockroach sensitization in males compared to females, and seasonal variation with peak positivity in autumn (74.0%) collectively inform tailored prevention strategies and region-specific immunotherapy protocols for allergic rhinitis management in this region.

Introduction: Colorectal cancer (CRC) is a leading cause of cancer-related mortality among older adults. Delays in diagnosis and treatment negatively impact survival outcomes. In Argentina, access barriers in this population have not been adequately characterized.

Materials and methods: We conducted an ambispective cohort study including older adults diagnosed with CRC within the past five years. Telephone interviews were carried out to collect data on time intervals and perceived barriers across five stages of the diagnostictherapeutic process (from symptom onset or screening to treatment initiation). Multivariable linear and logistic regression models were used to assess associations between sociodemographic factors, perceived barriers, and both total time to treatment and stage-specific delays.

Results: A total of 225 participants were included. The median time to treatment initiation was 6 months. Perception of barriers was significantly associated with a higher likelihood of delay in all stages analyzed. The most frequently reported barrier was accessibility -mainly difficulties in obtaining medical appointments- present throughout the care continuum. In later stages, resource shortages were also reported. Female sex was associated with longer time to treatment.

Conclusion: Our findings highlight the need for structural health system interventions aimed at reducing treatment delays in older adults with CRC. Identifying and addressing perceived barriers could enhance equity and efficiency in access to oncological care. Time to treatment exceeded internationally recommended standards. Perceived barriers were present in all stages and were significantly associated with delays in care delivery.

Preclinical trials in laboratory animals, particularly those aimed at evaluating potential effects on reproduction and offspring development, have gained importance in recent years due to the development of new drugs and vaccines intended for both children and individuals of reproductive age. The current challenge lies in the need for reliable and rapidly obtainable data to enable the transition of new compounds to clinical phases and eventual approval. Since pregnant and breastfeeding women are often excluded from clinical vaccine trials, including those assessing toxicity, there is limited knowledge about this vulnerable population and their offspring. In this context, preclinical studies designed to assess the effects of vaccine and therapeutic candidates on reproduction and development must rely on in vivo models that accurately replicate key aspects of the pathogenesis observed in human disease. When evaluating the reproductive toxicity of vaccines, it is essential not only to assess potential effects on fertility, embryogenesis, development, and reproduction, but also to consider the interactions of the vaccine with the immune system of both the mother and her offspring. This review updates and describes preclinical studies in laboratory animals for new vaccines, particularly those developed against COVID-19, highlighting published studies on reproductive and developmental toxicity, as well as the current regulatory framework governing such studies.

Introduction: There are few recent population-based studies on mortality in Argentina outside the context of the COVID-19 pandemic. Our objective was to describe overall and cause-based mortality in the General Villegas District (Buenos Aires) between 2015 and 2020, and to compare it with provincial and national rates.

Materials and methods: We conducted a population-based observational cohort study that included all deaths among individuals aged ≥18 years occurring between June 2015 and May 2020 in General Villegas (total population: 35 251 inhabitants). Data were obtained from death certificates, medical records, interviews, and verbal autopsies. Causes of death were classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision: ICD-10. Crude and age--and sex-adjusted mortality rates were calculated using the Argentine standard population, the WHO standard population, and the modified Segi standard for Latin America.

Results: A total of 1031 deaths were recorded (56.5% men), yielding a crude mortality rate of 9.7‰, higher than the provincial (8.2‰) and national (7.9‰) rates. The rate was higher in men (11.0‰) than in women (8.4‰). Adjusted mortality rates were 5.2‰ (Argentina), 6.8‰ (modified Segi), and 5.8‰ (WHO). Cardiovascular diseases (170/100 000; 25.4%) and neoplasms (140/100 000; 21.5%) were the leading causes of death. In individuals aged 18-39 years, external causes predominated (36%).

Discussion: General Villegas shows a mortality profile comparable to the national average. Data obtained from this stable and representative setting may contribute to the design of regional public health strategies targeting chronic diseases and preventable external causes.

Hidradenitis suppurativa and psoriasis are chronic inflammatory systemic dermatoses. The immune system plays a fundamental role in their pathogenesis, as each involves an immunological imbalance and the participation of numerous cytokines, including interleukin-17. The coexistence of these conditions can significantly impair quality of life, thus requiring integrated and targeted therapeutic approaches. We report the case of a 47-year-old woman diagnosed with hidradenitis suppurativa who developed psoriasis lesions over time. After receiving multiple therapeutic regimens without response, she began treatment with secukinumab, with excellent outcomes for both entities.