Medicina-buenos Aires最新文献

The Guillain-Barré syndrome (GBS) represents a group of immune-mediated peripheral polyneuropathies, which are the most common cause of acute flaccid paralysis in clinical practice. Its most prevalent form is acute inflammatory demyelinating polyneuropathy (AIDP), though multiple variants are also recognized, such as axonal neuropathies (AMAN, AMSAN) and MillerFisher syndrome. Diagnosis remains primarily clinical, supported by findings in cerebrospinal fluid analysis, neurophysiological studies, and, in certain cases, specific serology. Early detection is crucial to prevent potentially fatal complications such as respiratory failure or severe dysautonomia. This article provides an updated review of the diagnostic and therapeutic approaches to GBS, emphasizing its pathophysiology, clinical manifestations, first-line therapeutic strategies, and emerging variants treatable with targeted immunotherapy.

Skin and soft tissue infections (SSTIs) are extremely common, and while the vast majority are mild, they can occasionally lead to serious local and systemic complications. Therefore, early recognition and appropriate medical and surgical management are of primary importance. In 2009, the Argentine Society of Infectious Diseases (SADI), along with other scientific societies, published its latest recommendations. This Guide was developed by specialists from the Argentine Society of Infectious Diseases (SADI) and discussed in a plenary meeting with the participation of representatives from six other Scientific Societies: Argentine Society of Dermatology, Argentine Association of Surgery, Argentine Society of Medicine, Argentine Association of Clinical Microbiology, Buenos Aires Society of Internal Medicine, and Argentine Society of Intensive Care, based on their experience in this subject. Each chapter contains recommendations based on scientific evidence and expert opinion, including useful diagnostic tools, with special emphasis on clinical assessment and differential diagnoses, and antimicrobial therapy, with attention to the responsible use of antibiotics.

Heparin and its different formulations and derivatives, the first and second generation low molecular weight heparins and pentasaccharides, are indirect parenteral anticoagulants that, with limitations and difficulties, continue to have a privileged place in the modern therapeutic arsenal. Even after many years of use, their unique properties make them the best possible anticoagulant in certain scenarios, such as in pregnancy, end stage renal insufficiency or patients that need a quick and reversible anticoagulation. They are also the anticoagulant of choice when it is important to inhibit clots related to external surfaces where the activation of the intrinsic coagulation pathway is especially relevant. Examples of the importance of these compounds are their nowadays first place recommendation in certain thrombosis like in cancer, hemodialysis, or extracorporeal cardiac devices. Also, in patients with venous thromboembolism and hemodynamic instability, high risk of bleeding or in the acute coronary syndrome, heparins are today the preferred anticoagulant. However, the management of heparins is complex and, in some cases, requires frequent laboratory measurements for monitoring. They can eventually cause severe adverse events, such as life-threatening bleeding episodes or thrombosis associated with immune activation of platelets. Understanding the characteristics of these anticoagulants, their use and correct monitoring will allow us to use the different heparins safely. The role of the haemostasis laboratory is essential to adjust the dose of unfractionated heparin, which have proven to be difficult to manage for the general practitioner. In this document we actualize the laboratory and clinical management of heparins and related drugs in the modern anticoagulation era.

Introduction: The neurobiological potentiality of cognitive resources in High Intellectual Ability (HIA) involves complex cognition and representation of the world. This is related to language and figurative language. Competence in figurative language and its forms, such as verbal irony, is an understudied aspect of High Intellectual Ability that could provide a broader understanding of the abilities that constitute it, compared to the development of typical intelligence. The aim of this study was to investigate how children with HIA, aged 7-9 years, understand verbal irony and to compare their competence with typical children of the same age.

Methods: A univariate analysis of variance was performed on responses to the VIrQ questionnaire from a sample of n=62 schoolchildren with HIA and an agematched control group of typical schoolchildren (n=62).

Results: Show the complexity of verbal irony comprehension in participants with HIA at the age of 7-9 years compared to typical schoolchildren.

Discussion: We conclude and discuss comparing the components of irony that were most easily understood in each group, as well as those that were most difficult, suggesting the relevance of this area of study for better understanding the functioning of high intellectual ability, the relationship of verbal irony to other higher-level cognitive processes, and its possible role as complementary information in differential cognitive assessment.

Introduction: In recent decades, different studies have shown the effectiveness of intervention programs that incorporate multiple components to optimize the results of the interventions. However, the analysis of the effectiveness of multicomponent programs in Spanish is relatively scarce. Therefore, the main objective of the present study was to analyze the effectiveness of a multicomponent program (i.e., phonological-based training with visual letter support, Reading fluency training, and motivational strategies) on Reading skills and Reading motivation in Spanish children with dyslexia.

Materials and methods: Twenty-four children with dyslexia between 9 and 12 years of age participated. Support teachers individually applied the multicomponent program for 20 weeks at a rate of three weekly sessions of about 40-50 minutes. Different measures of word, pseudo-word, text and comprehension reading, as well as Reading motivation indicators were taken.

Results: The results of the comparison between pretreatment and post-treatment phase scores indicate that students with dyslexia increased their performance on Reading measures (e.g., word-reading efficiency, pseudowords, text reading speed and accuracy index, reading comprehension), as well as on reading motivation measures (e.g., reading self-concept, reading value, and reading engagement).

Discussion: Results are discussed with respect to effective interventions for students with dyslexia. Reflections on the limitations of the study provide a basis for recommending future lines of research.

Introduction: Pragmatics plays a crucial role in learning and socio-emotional adaptation and it is a core area of impairment in Autism Spectrum Disorder (ASD). The aim of this study is to examine the discriminant validity of the Spanish adaptation of the Language Use Inventory (LUI-Spanish), designed to assess pragmatic skills in children.

Materials and methods: The study included 40 children diagnosed with ASD and 40 typically developing (TD) children, aged between 24 and 42 months. The LUISpanish, a parent-report measure of pragmatic language, was used to assess communication through gestures, words and sentences. The Mann-Whitney U test was employed for group comparisons.

Results: Statistically significant differences were found between the ASD and TD groups in most of the LUI scales, except for Part 1 and the scales included. The TD group consistently scored higher, with large effect sizes. The instrument demonstrates both theoretical and practical relevance for assessing early pragmatic skills and guiding appropriate interventions.

Artificial intelligence (AI) has advanced significantly in recent decades, impacting sectors such as medicine, education, and entertainment. In contrast, natural intelligence (NI) is the result of over a billion years of evolution, culminating in the Homo sapiens brain approximately one hundred thousand years ago. This development has enabled the creation of a culture of accumulated knowledge, facilitating technological and scientific advancements. The combination of AI and NI holds the promise of overcoming cognitive limitations and addressing complex problems, provided it is managed ethically. Key areas of this integration include cognitive augmentation, health, education, resolution of global challenges, redefinition of NI boundaries, and subsequent ethical challenges. While both NI and AI share learning and adaptation capabilities, human intelligence is distinguished by consciousness, emotion, and creativity, facets that AI has yet to fully replicate. The future of this interaction will depend on proper management that allows for the coexistence and mutual benefit of humans and machines.

In this paper we have tried to give an overview of the way in which inflexibility manifests itself in people with ASD, the physiological and psychological factors that can trigger it, as well as the main reasons behind those behaviours that fall under the term inflexibility. We have also provided some guidelines on intervention with the aim of helping to reconsider and guide the approach to this type of behaviour, always based on respect and understanding.

Autism Spectrum Disorder (ASD) encompasses a range of neurodevelopmental conditions characterized by social challenges, repetitive behaviors, and communication difficulties. While diagnosis traditionally relies on behavioral observations, new biomedical approaches, such as the Research Domain Criteria (RDoC), aim to identify biomarkers that integrate genetic, neural, and behavioral factors. Notable biomarkers include genetic variants, molecular alterations such as abnormal neurotransmitter levels, and markers associated with immune dysfunction. Brain organoids have also enabled the investigation of specific neural mechanisms. In neuroimaging, techniques such as functional magnetic resonance imaging (fMRI) and functional near-infrared spectroscopy (fNIRS) have identified atypical connectivity patterns in infants at high risk for ASD. Similarly, measures like electroencephalography (EEG) and eye tracking have revealed differences in visual attention and brain activity, while physiological indicators such as electrodermal activity (EDA) and heart rate variability (HRV) reflect sensory and autonomic dysfunctions. The use of digital biomarkers is rapidly growing, with devices like tablets and virtual reality capturing data on children's interactions. Analyzed using artificial intelligence, these data show promise for improving early ASD detection, though further validation is needed. Integrating traditional and digital approaches is essential for advancing diagnosis and intervention strategies.

Introduction: ADHD has a safe and effective treatment, but treatment adherence is often low. Several factors contribute to this low adherence, some of which are modifiable.

Methods: We conducted a literature review of recent studies on medication adherence in children and adolescents with ADHD. We gathered data on ADHD treatment adherence from our clinic in the ADHD Program and the Child and Adolescent Mood Disorders Program (ChAMP) at the University of Texas Health-Houston Program. We analyzed factors related to medication adherence, such as patient age, sex, prescription type, release formula, and their association with adherence in 117 patients with ADHD who were prescribed stimulant or nonstimulant medications.

Results: We found publications identifying factors influencing medication adherence, including disorder characteristics, the patient, the healthcare system, socioeconomic factors, the medication itself, and the environment. Factors that can improve adherence include: knowledge about ADHD, the medication, its benefits, and potential side effects; simple, once-daily extendedrelease medication regimens; patients younger than 12 years old; female sex; reduced barriers to accessing healthcare; and a positive, proactive attitude of parents toward ADHD and medication use.

Discussion: Optimizing adherence and long-term prognosis of ADHD is achieved by reinforcing factors that increase adherence and reducing biases and lack of knowledge about ADHD.