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

The understanding of immunological processes associated with allergic diseases and advancements in antibody bioengineering has driven the development of specific biological therapies. Monoclonal antibodies, selectively targeting cytokines involved in the pathogenesis of allergic processes or their receptors, have emerged as a promising tool in treating various conditions, including asthma, allergic rhinitis, urticaria, and severe atopic dermatitis. Since the approval of the first anti-CD3 mouse monoclonal antibody in 1986, remarkable progress has been achieved, marked by the development of chimeric, 'humanized,' and 'fully human' antibodies. The 'humanization' of monoclonal antibodies has played a crucial role in reducing the risk of immunogenicity and minimizing adverse effects, thereby notably enhancing the safety and efficacy of these therapeutic interventions.The aim of this article is to address the characterization, development, pharmacokinetics, pharmacodynamics, and clinical utility of monoclonal antibodies, with a primary focus on allergic diseases.

Introduction: laparoscopic hepaticojejunostomy is a complex procedure indicated for different pathologies. Still, the laparoscopic approach is not the gold standard, but it is well known for its benefits regarding post operative recovery. We present our experience in 21 consecutive cases of laparoscopic hepaticojejunostomy done at King Fahad General Hospital in Jeddah.

Methods: 21 consecutives laparoscopic hepaticojejunostomies were done from January 2022 to December 2023. Gender: 10 male and 11 female, average age 46 years. The most common indication is due to multiple common bile duct stones.

Results: average surgical time: 180 minutes, average blood loss: 168 ml. According to Clavien-Dindo´s classification, we recorded one complication type: 3A. Average discharge days were 5.5; no mortality was reported.

Conclusion: We believe that the success of laparoscopic hepaticojejunostomy is related to excellent knowledge of the biliary system and an experienced surgeon in advanced laparoscopic procedures.

Hamartomas are benign tumors characterized by disorganized tissue native to a specific anatomical location. We present the case of a 61-year-old male with a history of COVID-19 infection who presented with a persistent cough. Chest tomography revealed an endobronchial lesion, which led to further investigation with a bronchoscopy. Using a cold loop, the lesion was successfully resected and pathology confirmed the diagnosis of a hamartoma.  Endobronchial resection is the preferred strategy for diagnosing and treating these tumors. This case highlights the successful management of an endobronchial hamartoma in a patient with a history of COVID-19 infection, emphasizing the importance of thorough investigation and appropriate intervention in similar cases.

Introduction: Cardiac myxomas are the most common benign neoplasms of the heart, mainly located in the left atrium. The preferred treatment is the resection of the myxoma. This method not only prevents complications but also has a low recurrence rate. Brain metastases usually occur when tumor fragments embolize and implant at the destination place.

Case presentation: We report the case of a patient with multiple brain metastases, found during follow-up, after the presentation of stroke. This case stands out because the embolization causing the brain metastasis might have occurred either during the ischemic stroke or when the cardiac myxoma was being removed. In our case, the patient was evaluated during follow-up with brain magnetic resonance imaging, finding multiple metastatic lesions. To determine the type of lesion, a biopsy was performed and the histological diagnosis, which was indicative of metastatic tissue of left atrial myxoma.

Conclusion: Patients with cardioembolism should undergo a complete diagnostic protocol to distinguish the cause of embolization, whether it is a blood clot or a tumor embolus. The treatment of choice is the resection of the myxoma, which cures the primary neurological symptoms and prevents neurological complications. However, it is essential to maintain active surveillance for a longer time for the detection and appropriate treatment of brain metastases.

Background: Thyroid dysfunction during pregnancy negatively impacts both the woman and her offspring, with the early gestational period being critical for potential repercussions. Establishing pre-conception and during-conception care strategies is crucial for favorable pregnancy outcomes.

Objective: This review aims to compile the most recent scientific evidence to guide diagnostic and therapeutic approaches based on clinical cases, including a description of thyroid physiology during pregnancy and strategies for identifying high-risk patients for treatment.

Method: This bibliographic review combined DeCS and MeSH terms from the PICOT question, spanning the period from 2015 to 2022 across 5 databases. Articles in both English and Spanish were included if they addressed the PICOT question and contributed to the explanation of two case reports.

Results: A total of 1452 articles were collected, which, following an initial elimination of duplicates and subsequent blind review based on inclusion and exclusion criteria by two reviewers, resulted in 32 articles included in this review.

Conclusions: Overt hypothyroidism is associated with adverse maternal-fetal outcomes, and its treatment improves these complications. However, in borderline conditions such as subclinical hypothyroidism, isolated hypothyroxinemia, and thyroid autoimmune conditions, uncertainty about the treatment's impact persists due to a scarcity of controlled trials. Emphasizing the importance of all physicians being familiar with this condition during gestation.

Introduction: The adherence to a gluten-free diet in people with celiac disease is a constant challenge for them and their family environment. Not everyone is able to adapt to the new eating style and may develop maladaptive behaviors. The objective was to evaluate the factors of adherence to the gluten-free diet in people with celiac disease in Paraguay in 2023.

Methodology: We perform an observational, cross-sectional design in adolescent and adult subjects with celiac disease. A telematic questionnaire containing demographic and clinical data was applied. The adherence to the diet was evaluated with the Leffler questionnaire, eating attitudes and behaviors with the CD-FAB instrument, and family support with the family APGAR test. Descriptive and analytical statistics were applied with SPSS Statistics 25™ software. The research respected ethical aspects.

Results: The final sample consisted of 292 people. The median age was 33 years and predominated the female sex (85.3%). Good adherence to the gluten-free diet was detected in 151 (51.7%) people and good adaptation to it in 164 (56.2%). In 141 cases (48.3%) it was stated that they had family support. The analysis showed that prolonged time since diagnosis and having family support were significantly associated with adherence to the gluten-free diet (p <0.05).

Conclusions: In people with celiac disease, adherence to the gluten-free diet was related to a prolonged time since diagnosis and receiving family support. It is recommended to investigate the causes of maladaptive behaviors to the gluten-free diet.

Introducción: Nuestro objetivo fue determinar en una cohorte de pacientes de un hospital de la ciudad de Buenos Aires, cómo fue la distribución de ritmo circadiano y el impacto según el tipo de comportamiento circadiano en la tasa de eventos cardiovasculares en el seguimiento. Material y métodos: Estudio de cohorte retrospectiva que incluyó pacientes adultos que se realizaron una presurometría ambulatoria en un hospital de la ciudad de Buenos Aires, incorporados a un registro propio entre marzo de 2017 y julio de 2020, con seguimiento de hasta 36 meses de la presurometría índice.

Resultados: De 522 sujetos, se incluyeron 494 en el análisis final. El 48% eran de sexo masculino y la edad promedio fue de 58,9 años. El 62% (n = 308) presentó hipertensión arterial nocturna. El patrón dipper invertido fue el grupo que presentó más eventos cardiovasculares en el seguimiento (6% n: 24). Además, en el tiempo libre de evento globales, se evidencio menos tasas de supervivencia para el grupo con patrón dipper invertido (Log Rank test p: 0.0033).

Conclusión: En una cohorte contemporánea y de la ciudad de Buenos Aires, el grupo patrón dipper invertido se asoció con la aparición de desenlaces cardiovasculares. En base a estos hallazgos, se deben implementar medidas para incrementar su diagnóstico en nuestro medio.

Erratum for:Bachmeier E, Wietz FM, Porta DJ, Moine L, Dubersarsky CG, Francia CM, Samar ME, Rivoira MA, Mazzeo MA. Melatonin reverses oxidative damage in the submandibular gland of rats treated with Cyclophosphamide. Rev Fac Cien Med Univ Nac Cordoba. 2023 Dec 26;80(4):404-419. doi: 10.31053/1853.0605.v80.n4.40930.

Introduction: The complications associated with the chronic pathophysiological process of type 2 diabetes mellitus (T2DM) have a significant impact on the affected population. The Diabetes Knowledge Questionnaire (DKQ-24) determines the level of knowledge about diabetes, providing health professionals with information to carry out useful educational interventions and prevent both acute and chronic complications of the disease

Objective: To assess the long-term effect of implementing a hospital-based therapeutic diabetes education model (self-care and knowledge) on patients with type 2 diabetes mellitus (T2DM) in a population from southern Colombia.

Materials and methods: Longitudinal study, prospective type, conducted on 60 hospitalized T2DM patients. The DKQ-24 was used for pre-assessment, and after 90 days, it was administered again, along with the collection of biometric variables. The intervention consisted of 5 sessions of therapeutic diabetes education in hospital settings.

Results: The average results according to the DKQ-2 questionnaire pre-intervention (10.13±3.28) and post-intervention (20.13±2.77) showed significant differences (p<0.000). The biometric profile indicated significant differences (p<0.000) during pre and post-intervention, except for systolic blood pressure (p=0.275). The Cronbach's alpha for the DKQ 24 had an adequate value of 0.86. The intraclass correlation coefficient (ICC) for average measures was 0.860, considered "good" (p<0.000).

Conclusions: The diabetes educational intervention demonstrated significant changes in basic knowledge levels regarding the disease, glycemic control, and complication prevention, improving the patient's biometric profile and highlighting its importance.

Labyrinthitis ossificans is a pathology consisting of calcification of the membranous labyrinth resulting in profound sensory deafness. It is usually due to an acute inflammatory process that progresses to ossification of the labyrinth. The clinical manifestations are irreversible hearing loss, dizziness and vomiting. It is diagnosed by computed tomography (CT) and magnetic resonance imaging (MRI). It is important to make the correct diagnosis before cochlear implantation, as ossification of the labyrinth can hinder or prevent the implantation of electrodes.