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

Paederus contact dermatitis is a skin disease caused by beetles of the genus Paederus and the release of a vesicant substance called paederin. It is worldwide distributed; However, it is more common in rainy seasons and hot climates. The clinical manifestations are vesicle-pustules that settle on erythematous skin. Treatment is based on washing with soap and water to neutralize the action of the toxin and the administration of topical steroids in short cycles. We report the case of a 28-year-old male patient who came to the dermatology clinic with a 48-hour history of two erythematous plaques with central blisters plus superficial ulceration located on the flexor aspect of the arm and right forearm, accompanied by a sensation of burning and itching at the site of the lesions, without other accompanying symptoms. As background, he states that he was on vacation in the coastal region of Ecuador when the lesions appeared. An incisional biopsy was performed and due to the clinical characteristics and the history of travel to a tropical region, it was diagnosed as Paederus dermatitis and treatment with antihistamines, topical steroids and cold compresses was indicated. After 8 days of treatment, the lesions subsided, leaving post-inflammatory hyperpigmentation.

60° aniversario del fallecimiento del Dr. Mirizzi.

Hepatic transplantation (HT) is the standard of care of end-stage liver disease with Cirrhotic Cardiomyopathy (CCM), but medical treatment with combination of diuretics and non-selective beta blockers are important before and after that. Owing to its particular pathophysiology unlike another etiologies of heart failure, in CCM angiotensin-converting enzyme inhibitors (ACEI), angiotensin II type I receptor blockers (ARB), and angiotensin receptor neprilysin inhibitor (ARNI) are not recommended. Transjugular intrahepatic porto-systemic shunt (TIPS) has indications in CMM but its potential benefits and risks must be considered and more researh is necessary. HT is a demanding therapy but the most effective one, and showed improvement in QTc, diastolic and systolic dysfunction; in recent decades, in spite of more severe ill patients (more severe MELD score), survival has improved significantly due to better surgical techniques, intensive care, immunosupresive drugs, and images.

Introduction: At the beginning of the COVID-19 pandemic, confinement measures were applied in many states around the world, producing changes in lifestyle and health habits, whose metabolic impact was different in different populations.

Objectives: Describe the metabolic and anthropometric changes in office patients in the City of Córdoba during the confinement period and determine possible associated factors.

Methods: Retrospective analytical observational study based on the review of the medical records of patients seen in an endocrinology clinic in Córdoba, Argentina. They were followed up during the 1-year period by evaluating metabolic and anthropometric characteristics.

Results: 149 patients were included, of which 116 (77.9%) were female and the median:IQR age was 50:36.5-58 years. At the end of follow-up, a significant increase in alcohol consumption (18.1% vs 11.4%, p=0.001) was observed, as well as the number of diabetic patients (diagnosis of 20 new cases). 49.67% of patients increased their body weight, with a median of 3.1 kg (IQR 25-75%: 1.4-7.5 kg). Patients who had longer follow-up (3 or more controls during the year) decreased their Body Mass Index and increased physical activity.

Conclusions: Although confinement was generally associated with an increase in obesity, diabetes and consumption of toxic substances, in patients who were monitored more frequently, better control of body weight and increased activity was observed. physical.

Introduction: Unplanned transfers from the General Ward to Critical Care Units occur due to a deterioration in the patient's clinical status. They are of great interest because of their negative impact, associated with longer hospital stays and higher mortality.

Objectives: To report the frequency at which these transfers occur, characteristics of these patients and causes of the transfer. Identify shortcomings in the care process that may allow improvement strategies.

Methodology: cross-sectional study. Cases were considered those who, during the first 24 hours of hospitalization in the General Ward, required transfer to the ICU between January - December 2022 in a high-complexity hospital in Buenos Aires. Results: Of 8317 admissions, 124 were transferred to the ICU, with a rate of 14 per 1000 and an average of 70 years. The most frequent comorbidities were high blood pressure, heart failure, cancer and overweight-obesity. The main causes of hospitalization were respiratory and gastrointestinal symptoms. 67% had non-alarming results in the NEWS score prior to transfer to the ICU. The most frequent causes were respiratory failure, hemodynamic instability and requirement for monitoring. Average hospital stay was 10 days and in-hospital mortality was 26%.

Conclusions: Respiratory decompensation in elderly male patients was the most common cause of transfer to a Closed Unit. One of the shortcomings of the care process seems to be the NEWS score, where in 67% of cases it did not warn about the high requirement of patient monitoring.

The study addresses the translation, cross-cultural adaptation and initial validation of the Oldenburg Burnout Inventory (OLBI) questionnaire into Spanish, particularly for the context of health personnel. The OLBI, based on the Job Demands - Resources Model, evaluates burnout and job disengagement. After a rigorous methodological process, two versions of the questionnaire were carried out, followed by a pilot test and cognitive interviews. Comprehension problems were identified in a question related to work disconnection. Adjustments were made to the final version, which was validated with a multiprofessional pediatric palliative care group. The results showed adequate reliability for the Exhaustion scale and acceptable for the Disconnection scale. The importance of considering the particularities of the work context in adapting the instrument was highlighted. Although limitations, such as sample size, are acknowledged, it is suggested that the OLBI – UY version is promising and can be used in future studies for a more comprehensive psychometric analysis. This study represents an original contribution by addressing the adaptation of a relevant instrument for measuring burnout in Spanish-speaking health personnel in the Río de la Plata.

This paper examines the significant contribution of Dr. Valentín Grandis and Dr. Virgilio Ducceschi to the founding and development of experimental physiology at the Faculty of Medical Sciences of the National University of Córdoba (UNC), Argentina. Although the most notable contribution to the field of experimental physiology in Argentina is attributed to Bernardo Alberto Houssay, this study highlights the importance of the previous and fundamental efforts of Grandis and Ducceschi, two Italian professors whose work in Buenos Aires and Córdoba laid the foundations for research and teaching in this discipline. The paper details how, in 1904, the arrival of Valentin Grandis at the UNC marked the formal beginning of the teaching and practice of experimental physiology at the institution, followed by the incorporation of Virgilio Ducceschi, who continued and expanded Grandis' legacy. The work of these two Italian masters involved not only the installation of a state-of-the-art laboratory but also the establishment of a solid academic and scientific foundation that would influence future generations of Argentine physicians and researchers. Through a detailed analysis of their biographies, scientific contributions, and the impact of their work, this paper illustrates how Grandis and Ducceschi were key figures in the development of medical science in Argentina, particularly in the field of experimental physiology. Furthermore, the study highlights the importance of their educational approach and their ability to train disciples who would continue their research, thus ensuring the permanence of their legacy at the National University of Córdoba and in Argentine science in general. In conclusion, this paper vindicates and celebrates the contributions of Valentín Grandis and Virgilio Ducceschi to the initiation of research and experimentation in physiology and biological chemistry at the UNC, highlighting their importance in the advancement of medicine and science in Argentina.

Introduction: The brain drain of physicians from lower-middle-income countries to high-income countries is a growing phenomenon that contributes to global health inequalities. Retention strategies are difficult to implement locally and to specifically target the population at risk of migrating. We hypothesize that medical students who are teaching assistants have greater intentions to migrate to practice Medicine abroad.

Methods: Medical students from Argentina were invited to an online survey of 22 multiple-choice questions based on the LIRHUS Network survey, previously used in Latin America.

Results: 2,301 medical students were enrolled. Most were young (23 [20-25] years old), single (90%), and female (79%). The majority studied at public universities (87%). The intention to migrate to practice Medicine abroad was more frequent among teaching assistants (36% vs 31%; χ2 = 4.4982; p = 0.0339). After adjusting for sex and age, being a teaching assistant was associated with the intention to migrate to practice Medicine abroad (OR = 1.26; 95% CI 1.02 - 1.55; p = 0.002).

Conclusions: Argentine teaching assistants have a greater risk of migrating to practice Medicine abroad. Given their high academic profile, these are valuable human resources trained using the public financing of low-middle-income countries. The loss of these resources could contribute to health inequalities. This is an easily identifiable and accessible subgroup toward which local retention policies could be directed.

When large amounts of Fluoride are consumed produces insulin resistance, but exercise can reverse insulin resistance in rats, because of a high fluoride uptake by bone tissue. However, bone quality has not been studied in those experiments. Therefore, the aim of this work was to evaluate bone quality in rats treated with fluoride when performing exercise. Sprague-Dawley rats were divided into 3 groups (n=6 per group): Control (drinking water without fluoride), Fluoride (drinking water with fluoride 15 mg/L for 30 days) and Exercise (daily running on a treadmill and drinking water with fluoride 15 mg/L for 30 days).  Then, bone mineral density, mechanical and histological properties and bone fluoride level were measured. No effect of treatment on any bone parameters were observed. These results indicate that exercise normalizes glucose metabolism in insulin-resistant rats by bone fluoride uptake; however, this increase in bone fluoride does not manifest in bone deterioration.

Introduction:

Objetives: Obtain a version to validate it in a population of adults with AD.

Materials and methods: 1) Translation into Spanish and cross-cultural adaptation of the questionnaire from the original version in English, through a seven-step process. 2) Evaluation of the unidimensionality of the resulting scale by means of an exploratory factor analysis (EFA), of its reliability by means of Cronbach's alpha coefficient, and of its validity by evaluating the correlation of its score with those of the POEM and DLQI questionnaires. (external reference criteria).

Results: The version resulting from the translation and cross-cultural adaptation process was well understood by the target population. The AFE of the 66 questionnaires documented the unidimensionality of the scale based on compliance with all the criteria used for its verification. Its reliability was excellent (Cronbach's Alpha: 0.917) and its score had a very high correlation with the external reference criteria (POEM: Spearman's Rho 0.85; p < 0.0001; DLQI Spearman's Rho = 0.81; p < 0 .0001).

Conclusions: The version translated into Spanish and adapted for transculturation of the ADCT questionnaire has appropriate psychometric characteristics, which will contribute to optimizing the care processes of Spanish-speaking patients.