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

Introduction: The COVID-19 pandemic in Argentina has challenged health professionals to implement teleconsultation to maintain continuity of care.

Objectives: Describe the implementation of new technologies in teleconsultation by Nutrition professionals from Entre Ríos, from the beginning of the ASPO to the new normal.Methodology: Observational, descriptive, quantitative, and cross-sectional study, in which 72 Nutrition professionals from Entre Ríos, Argentina participated through a self-administered online questionnaire. The descriptive analysis of the data was carried out in the IBM® SPSS Statistics program.

Results: 84.7% of professionals began to implement new technologies in teleconsultation since the beginning of the ASPO. Although the majority did not experience significant changes in their income, relationships with patients, or time spent in teleconsultation compared to in-person care, 78% did not receive specific training for the implementation of these technologies in remote care. Despite this challenge, 80% expressed their intention to continue with this type of care in the new normal, allocating hours of their workload for this purpose.

Conclusions: The implementation of new technologies in teleconsultation has proven to be an ally in maintaining the continuity of nutritional care since the beginning of ASPO. However, to provide a quality service, it is necessary to select the most appropriate technologies and dedicate sufficient time to planning and implementation.

Background: Hernia through Winslow's hiatus, known as Blandin's hernia, a rare but potentially life-threatening condition, represents a diagnostic and therapeutic challenge. This case report describes a successful laparoscopic approach to a cecum hernia through the foramen of Winslow in a 63-year-old female.

Case presentation: The patient presented with 24 hours of abdominal pain and nausea. Abdominal CT scan revealed a herniated cecum and terminal ileum compressing the gastric chamber and portal vein, leading to periportal edema. Laparoscopic right colectomy was performed after successful colon content evacuation via the greater gastric curvature to facilitate reduction. This was done to aid in reduction, as there were indications of non-viability in the right colon. The procedure unfolded without complications. The patient developed postoperative abdominal collections requiring percutaneous drainage but recovered well and was discharged within two weeks.

Conclusion: This case highlights the value of laparoscopy in managing foramen of Winslow hernias, offering minimally invasive benefits. Early diagnosis through imaging tools like CT is crucial for prompt surgical intervention and preventing complications like intestinal ischemia or perforation.

Introduction: The importance of knowing the impact of work on people's health has increased after the COVID-19 pandemic. Burn Out (BO) syndrome arises from the tension emerging from the conflictive interaction between the worker and his or her employment. The objective was to describe the prevalence and frequency of diagnosis of BO in the health human resources of critical services of the Bahía Blanca Municipal Hospital in the context of the COVID-19 pandemic.Methods: Descriptive, cross-sectional study. The study population was the medical and nursing staff of the Intensive Care (IT), Emergency Medicine (SMU) and Clinic services who worked with COVID-19 during 2021. The Maslach Burnout Inventory (MBI) questionnaire was used and complementary closed questions to identify, among these cases, those that were diagnosed and treated by the institution.Results: Of the 219 workers, 55.3% (121/219) were nurses. In the SMU, 25% (24/96) of respondents had BO, followed by 20.4% (11/54) in Clinic and 8.7% (6/69) in IT (p value=0.004). Only 5.5% (12/219) of the total were diagnosed with BO by the institution and of this group, two people (0.9%) had previously consulted for characteristic symptoms.Discussion: A high prevalence of BO and a marked underdiagnosis were evident at the institutional level during the pandemic. Although the IT Service had the highest demand for attention, it was the one that presented the lowest BO values in relation to other services.

Background: spinal cord injury leaves as a sequel in the acute and chronic period, deficiencies in the stability of joint functions and in the function of voluntary movement control. Those with good trunk control have a greater probability of carrying out activities of daily living by themselves; up to now, we do not have reliable tools in Argentina that evaluate trunk control in these subjects.

Objectives: to cross-culturally adapt the trunk control test to Argentinean Spanish in subjects with sequelae of spinal cord injury and to establish interobserver and intraobserver reliability.

Methodology: the subjects were admitted using a non-probabilistic convenience sampling. Subjects who were between 15 and 75 years old and had a diagnosis of spinal cord injury were included. Subjects who had: another neurological diagnosis, alteration in sensory organs, conditions that prevent the performance of the test, and psychiatric illness were excluded.

Results: 30 subjects were included for cross-cultural adaptation and 55 for reliability. Semantic modifications were made to all items and response options. The intraobserver and interobserver reliability of the scale or subdomains did not achieve a sufficient score.

Conclusion: the trunk control test was adapted cross-culturally to Argentine Spanish and interobserver and intraobserver reliability was established. The adaptation was achieved through semantic changes and the reliability was not sufficient. In the future, studies should be carried out to improve the reliability and study the validity of the tool.

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.

Background: Surgical complications are preventable in up to 50% of cases, actually are various tools to avoid them, one of these are morbidity and mortality conferences. However, there are no guides that define their structure for them to be effective. Objective; Analyze the impact of a new modality of surgical conferences in a sector of benign biliary pathology, called quality evaluation conferences. Methodology: Descriptive observational study where the overall improvement of the sector, the decrease in complications and the quality of patient care are compared. For 6 months, a weekly quality evaluation conference was carried out. It had 5 stages; 1. Analysis of all discharged patients. 2. Review of adverse events. 3. Review of the list and order of patients in the surgical plan. 4. Reproduction of recorded surgeries and review of scientific articles. 5. Review of own scientific works in development.

Results: after implementing the conferences, there was a decrease in the number and severity of complications, as well as an improvement in the correct and timely surgical indication. Conclusion; Quality evaluation workshops as an evolution of morbidity and mortality workshops are a novel tool that, when well implemented, can help improve quality standards and in turn be used as a learning option in training centers.

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.