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Inhaled sedation with sevoflurane in a critically ill pediatric patient. 危重儿科患者吸入七氟醚镇静1例。
IF 0.6 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-01
María Florencia Courtois, Indalecio Carboni Bisso, Ignacio Fernandez Ceballos, Pablo Eulmesekian, Solange Vidal, Marcos Las Heras

In pediatric intensive care units (PICU), achieving adequate sedation for patients can be a challenging task for healthcare staff. While the use of intravenous sedatives helps improve comfort and treatment tolerance, it is a priority to develop strategies to use in patients who are difficult to sedate. This case study presents the first reported use of inhaled sevoflurane in a patient admitted to a PICU who was unresponsive to conventional intravenous sedatives. Sevoflurane was a safe and effective alternative.

在儿科重症监护病房(PICU),实现足够的镇静患者可以是一个具有挑战性的任务,为医护人员。虽然静脉注射镇静剂有助于提高患者的舒适度和治疗耐受性,但制定策略用于难以镇静的患者是一个优先事项。本病例研究首次报道了在PICU收治的对传统静脉注射镇静剂无反应的患者中使用吸入七氟醚的病例。七氟醚是一种安全有效的替代品。
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引用次数: 0
[Monkeypox: characteristics in female population, Buenos Aires, Argentina]. [猴痘:阿根廷布宜诺斯艾利斯女性人群的特征]。
IF 0.8 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-01
Javier Sánchez Doncell, Melina Lemos, José L Francos J, Pablo González Montaner

Monkeypox is a zoonotic viral disease caused by a virus of the genus Orthopoxvirus. As of January 1, 2022, it has been reported in 110 WHO Member States. It presents with fever, fatigue, painful lymphadenopathy, and rash. It lasts between 2 and 4 weeks. It is usually self-limited, but severe cases have been described in immunocompromised people. This study describes cases of monkeypox in women, diagnosed between June 2022 and February 2023, and it reports epidemiology, clinical aspects, and complications after infection. A retrospective observational study was carried out in the Febrile Emergency Unit (UFU), reviewing positive cases (RT-PCR) for monkeypox and the population with female biological sex was selected. They were questioned about gynecological complications, menstrual pattern, dyspareunia and pelvic pain. 340 consultations for monkeypox were made, 214 (63%) were positive, 211 cases (99%) male and 3 cases (1%) female. Among these cases is a trans woman, who was not included. The average age is 31 years, immunocompetent, with a negative serology report for HIV, syphilis, hepatitis B and C. Both cases had sexual intercourse without a barrier method. The most frequent symptoms are asthenia and skin lesions, especially in the upper and lower limbs, perianal and genital region. As a risk factor they presented unprotected sexual contact. Within the differential diagnoses, other sexually transmitted infections (STIs) should be considered. There were no gynecological complications reported during follow-up.

猴痘是一种由正痘病毒属病毒引起的人畜共患病毒性疾病。截至 2022 年 1 月 1 日,世卫组织有 110 个成员国报告了这种疾病。该病表现为发热、乏力、淋巴结肿大疼痛和皮疹。病程为 2 至 4 周。它通常是自限性的,但在免疫力低下的人群中也出现过严重病例。本研究描述了2022年6月至2023年2月期间确诊的女性猴痘病例,报告了流行病学、临床表现和感染后的并发症。这项回顾性观察研究在发热急诊室(UFU)进行,对猴痘阳性病例(RT-PCR)进行了复查,并选择了生理性别为女性的人群。他们被问及妇科并发症、月经模式、排便困难和盆腔疼痛等问题。共进行了 340 次猴痘咨询,其中 214 例(63%)呈阳性,211 例(99%)为男性,3 例(1%)为女性。在这些病例中,有一名变性女性,但未包括在内。平均年龄为 31 岁,免疫功能正常,艾滋病毒、梅毒、乙型肝炎和丙型肝炎血清学报告均为阴性。最常见的症状是气喘和皮损,尤其是在上下肢、肛周和生殖器部位。他们的危险因素是无保护的性接触。在鉴别诊断中,应考虑其他性传播感染(STI)。在随访期间,没有妇科并发症的报告。
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引用次数: 0
Herpesvirus 6 tracheobronchitis. 疱疹病毒 6 型气管支气管炎
IF 0.8 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-01
Indalecio Carboni Bisso, Leiniker Navarro Rey, Julieta González Anaya, Paola X de la Iglesia Niveyro, Ignacio Fernández Ceballos, Marcos Las Heras
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引用次数: 0
Physiological effect of high flow oxygen therapy measured by electrical impedance tomography in single-lung transplantation. 用电阻抗断层扫描测量单肺移植手术中大流量供氧疗法的生理效应。
IF 0.8 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-01
Ignacio Fernández Ceballos, Emilio Steinberg, Joaquin Ems, Juan Martín Nuñez Silveira, Matías Madorno, Indalecio Carboni Bisso, Marcos Las Heras, Rodrigo Cornejo

In patients with chronic obstructive pulmonary disease (COPD), single lung transplantation (SLT) is sometimes performed as an alternative to bilateral lung transplantation due to limited organ availability. However, the postoperative management of SLT presents challenges, including complications related to the distinct compliance of each lung. This case report presents the case of a 65-year-old male patient who underwent SLT and was in the weaning period from mechanical ventilation. High-flow oxygen therapy (HFOT) was administered, and the physiological effects were measured using electrical impedance tomography (EIT). The results demonstrated that the application of HFOT increased air trapping and overdistention in the native lung without benefiting the transplanted lung. HFOT through a tracheostomy tube or nasal cannula resulted in a more heterogeneous distribution of ventilation, with increased end expiratory lung impedance, prolonged expiratory time constants, and an increase in silent spaces. The drop in tidal impedance after applying HFOT did not indicate hypoventilation but rather overdistention and air trapping in the native lung, while the transplanted lung showed evidence of hypoventilation. These findings suggest that HFOT may not be beneficial for SLT patients and could potentially worsen outcomes. However, due to the limited scope of this case report, further prospective studies with larger patient cohorts are needed to confirm these results.

在慢性阻塞性肺病(COPD)患者中,由于器官供应有限,单肺移植(SLT)有时被用来替代双肺移植。然而,单肺移植的术后管理面临挑战,包括与每个肺的不同顺应性有关的并发症。本病例报告的病例是一名 65 岁的男性患者,他接受了 SLT,当时正处于机械通气的断奶期。患者接受了高流量氧疗(HFOT),并使用电阻抗断层扫描(EIT)测量了其生理效应。结果表明,高流量氧疗增加了原生肺的空气潴留和过度滞留,但对移植肺无益。通过气管插管或鼻插管进行高频通气会导致通气分布更不均匀,呼气末肺阻抗增加,呼气时间常数延长,无声空间增加。应用 HFOT 后潮气阻抗下降并不表明通气不足,而是表明原生肺过度潴留和空气滞留,而移植肺则显示出通气不足的证据。这些研究结果表明,HFOT 对 SLT 患者可能并无益处,反而有可能加重病情。然而,由于该病例报告的范围有限,需要对更大的患者群体进行进一步的前瞻性研究,以证实这些结果。
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引用次数: 0
[De Robertis. Seventy years since the first structural image of a synapse]. [德-罗伯蒂斯:第一幅突触结构图像问世七十年]。
IF 0.6 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-01
Basilio A Kotsias
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引用次数: 0
[Evolution of the clinical situation in heart transplantation: an analysis of the last decade in Argentina]. [心脏移植临床情况的演变:对阿根廷过去十年的分析]。
IF 0.6 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-01
Lucrecia M Burgos, Juan M Vrancic, Franco N Ballari, Daniel O Navia, Rocío C Baro Vila, Juan C Espinoza, María A De Bortoli, Fernando Piccinini, Mirta Diez
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引用次数: 0
[Excess deaths in Argentina during the COVID-19 pandemic: analysis of mortality between 2020 and 2022]. [COVID-19大流行期间阿根廷死亡人数过多:2020年至2022年死亡率分析]。
IF 0.6 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-01
Javier Mariani, Alejandro Macchia

Reports of excess mortality during the COVID-19 pandemic in Argentina have been partial and fragmented so far. This study aimed to quantify excess deaths and explore their demographic, temporal, and geographic distribution during the period 2020-2022. Using data from 1 192 963 death records from vital statistics and population projections, expected mortality was estimated using regression models. Excess death was calculated as the difference between observed and expected mortality. An excess of 160 676 deaths (95% CI 146 861 to 174 491) was estimated, representing a rate of 116.9 (95% CI 115.5 to 118.3) additional deaths per 100 000 personyears. Significant heterogeneity was found among the different argentine provinces. The results indicate an uneven impact of the pandemic, with higher excess mortality rates in some regions and more vulnerable age groups. These patterns suggest the need for differentiated strategies of healthcare response and support to the most vulnerable populations in scenarios of new epidemics.

迄今为止,有关阿根廷 COVID-19 大流行期间超额死亡率的报告既不全面也不完整。本研究旨在量化 2020-2022 年期间的超额死亡人数,并探讨其人口、时间和地理分布情况。利用来自生命统计和人口预测的 1 192 963 份死亡记录的数据,使用回归模型估算了预期死亡率。超额死亡的计算方法是观察死亡率与预期死亡率之间的差值。估计超额死亡为 160 676 例(95% CI 146 861 至 174 491),即每 100 000 人年增加 116.9 例死亡(95% CI 115.5 至 118.3)。阿根廷各省之间存在显著的异质性。结果表明,大流行病的影响并不均衡,一些地区和较脆弱的年龄组的超额死亡率较高。这些模式表明,在出现新的流行病的情况下,有必要采取有区别的医疗保健应对战略,并为最脆弱的人群提供支持。
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引用次数: 0
[Impact of hepatic resection in the treatment of hepatocellular carcinoma]. [肝切除对肝细胞癌治疗的影响]。
IF 0.6 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-01
Jose G Cervantes, Lourdes Mollard, Rodrigo A Gasque, Magalí Chahdi Beltrame, Marcelo E Lenz, M Eugenia Fernández, Suzuki Ichiro, Emilio G Quiñonez, Francisco J Mattera

Introduction: Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the third leading cause of cancer-related deaths worldwide. Hepatic resection is the treatment of choice for non-cirrhotic patients, while in cirrhotic individuals, the choice depends on tumor stage and liver function.

Methods: In this retrospective study conducted at Hospital El Cruce between 2015 and 2022, patients with HCC undergoing hepatic resection, both cirrhotic and non-cirrhotic, were evaluated. Morbidity, mortality, recurrence rate, and survival were analyzed.

Results: A total of 262 hepatectomies were performed, with 44 for HCC treatment. Among them, 35 were minor hepatectomies, and 9 were major hepatectomies (noncirrhotic patients). The majority were males (77%) with an average age of 58.5 years. Twenty-nine patients had cirrhosis, with hepatitis C (HCV) being the main cause in 48%, HCV with alcohol as a cofactor (21%), and alcohol alone (17%). Morbidity was 47.7%, with predominance of minor complications. Disease recurrence occurred in 59% of patients, and associated factors included tumor size and elevated AFP levels. Survival was better in cirrhotic patients compared to non-cirrhotic ones.

Discussion: Results tion 5837 Hepatic resection is an effective option for treating HCC in well-selected cirrhotic and non-cirrhotic patients, with encouraging results in terms of survival and disease control. Additionally, close surveillance for early recurrence detection and timely interventions is suggested.

简介肝细胞癌(HCC)是最常见的原发性肝癌,也是全球癌症相关死亡的第三大原因。肝切除术是非肝硬化患者的首选治疗方法,而肝硬化患者的选择则取决于肿瘤分期和肝功能:这项回顾性研究于 2015 年至 2022 年在埃尔克鲁斯医院进行,对接受肝切除术的 HCC 患者(包括肝硬化和非肝硬化患者)进行了评估。研究分析了发病率、死亡率、复发率和存活率:结果:共进行了 262 例肝切除术,其中 44 例用于治疗 HCC。其中,35 例为小肝切除术,9 例为大肝切除术(非肝硬化患者)。大多数患者为男性(77%),平均年龄为 58.5 岁。29 名患者患有肝硬化,其中 48% 的主要病因是丙型肝炎 (HCV),21% 的主要病因是伴有酒精的丙型肝炎 (HCV),17% 的主要病因是单纯酒精。发病率为 47.7%,以轻微并发症为主。59%的患者疾病复发,相关因素包括肿瘤大小和甲胎蛋白水平升高。与非肝硬化患者相比,肝硬化患者的生存率更高:第 5837 号研究结果 肝切除术是治疗经过严格筛选的肝硬化和非肝硬化患者 HCC 的有效方法,在生存率和疾病控制方面取得了令人鼓舞的结果。此外,建议密切监测以早期发现复发并及时干预。
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引用次数: 0
[On the death of Alexander the Great: between fascination, intrigue and myth for the history of medicine]. [亚历山大大帝之死:医学史的魅力、阴谋与神话]。
IF 0.6 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-01
Eduardo Herrera-Aliaga, Lissett Muñoz-Carrasco, Manuel E Cortés
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引用次数: 0
[Sarcopenia: new cut-off value of handgrip in postmenopausal Argentine women]. [肌肉疏松症:绝经后阿根廷妇女手握力的新临界值]。
IF 0.6 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-01
Vanina S Lerena, Karina Danilowicz, Sabrina P Lucas, Adriana G Diaz

Introduction: Sarcopenia is a global health problem, there are currently several criteria for its diagnosis and the implementation of its own cut-off values for each population is recommended. The objective was to evaluate the handgrip strength (HG) in postmenopausal women from Buenos Aires and establish a cut-off value.

Methods: A total of 704 women ≥50 years of age were evaluated, who answered a questionnaire on osteoporosis risk and HG was taken. Those with arthritis or pain in the hands were excluded, leaving 678 women for analysis. A subpopulation of 148 healthy women was selected to define the minimum normal value of the HG of our population.

Results: The HG was 20.44 ± 5.19 kg, with a significant decrease in values after 70 years. The HG in the group of healthy women was 22.08 ± 5.13 kg. And the cutoff value of 17.5 kg was established in our population (first quintile). 28.6% of the total population presented decreased HG and reached 53.7% in women >80 years. HG <17.5 kg was associated with a 67% increased risk of falls in the total group of women >50 years.

Discussion: The HG is a simple tool that is easy to implement in clinical practice and is considered the first step for the diagnosis of sarcopenia. The cut-off value of HG <17.5 kg could be used for the evaluation of sarcopenia in women >50 years of Buenos Aires.

简介肌肉疏松症是一个全球性的健康问题,目前有多种诊断标准,建议针对不同人群采用不同的临界值。我们的目的是评估布宜诺斯艾利斯绝经后妇女的手握力(HG),并确定一个临界值:方法:共对 704 名年龄≥50 岁的妇女进行了评估,她们回答了有关骨质疏松症风险的问卷,并进行了握力测定。有关节炎或手部疼痛的妇女被排除在外,剩下 678 名妇女接受了分析。我们还选取了 148 名健康妇女作为亚群,以确定我们人群中 HG 的最低正常值:HG值为20.44±5.19千克,70岁以后HG值明显下降。健康妇女组的 HG 值为 22.08 ± 5.13 千克。而我们的人群(第一五分位)的临界值为 17.5 千克。总人口中有 28.6% 的人 HG 值下降,80 岁以上妇女的 HG 值下降率高达 53.7%。讨论:HG是一种简单的工具,易于在临床实践中使用,被认为是诊断肌肉疏松症的第一步。布宜诺斯艾利斯的 HG 临界值为 50 岁。
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引用次数: 0
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Medicina-buenos Aires
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