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

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.

The diagnosis of Cirrhotic Cardiomyopathy is based on severe hepatic cirrosis with deterioration of cardiac function without previous cardiopathy, but this is subclinical during a long time. In this second part we review the non-invasive diagnostic methods and their prognostic value in patients with or without hepatic transplant, from ECG to cardiac images of magnetic resonance.

In solid tumors, hypereosinophilia is a rare phenomenon and is mainly associated with mucin-secreting carcinomas. Thyroid tumors associated with neutrophilia and/or eosinophilia have been described exclusively in patients with anaplastic thyroid cancer. Eosinophilia associated with papillary thyroid cancer is extremely rare and there are very few cases currently described. It has been suggested that three cytokines, namely interleukin-3 (IL-3), interleukin-5 (IL-5), and granulocyte-macrophage colony-stimulating factor (GM-CSF), may act as a peptide potential eosinophilic. To date, only three patients with differentiated thyroid cancer associated with eosinophilia have been reported, two of the papillary type and one of the medullary type. A 48-year-old patient consulted in 2022 due to bilateral cervical lymphadenopathy of 3 years' duration associated with wasting syndrome and hypereosinophilia. PET CT was requested, which showed hypermetabolic focus in the right thyroid lobe and lymph node, lung, bone, and liver metastases; Thyroid ultrasound showing a nodule of high suspicion of malignancy and a conglomerate of lymphadenopathy in the right lobe with positive needle wash for thyroglobulin. Hypereosinophilia was evaluated with initial leukocytosis values of GB 30,310/mm3 (10,608/mm3 of eosinophils) to maximum values of GB 77,090/mm3 (eosinophils 20,814/mm3). It was interpreted as paraneoplastic syndrome and corticosteroid therapy was started at immunosuppressive doses without response. Our observations presented in this article are in line with most studies reflecting that paraneoplastic hypereosinophilia is characterized by more advanced disease and poor prognosis.

Introduction: The World Health Organization recommends prioritizing safe and effective drugs proven by clinical or epidemiological studies. However, in population groups with little research, a drug can be used for an indication or pharmaceutical form different from that approved by the regulatory agency (off-label), extrapolating data from studies in adults and exposing pediatric patients. to develop an Adverse Drug Reaction (ADR) due to safety considerations that have not been systematically studied. Intravenous immunoglobulin (IVIg), a high-cost drug, is used with scant evidence in some low-prevalence pathologies. This paper describes and analyzes the off-label use of IVIg at the J. P. Garrahan Pediatric Hospital.

Methods: Observational, descriptive, prospective study on off-label indications of IVIg. The sampling technique was non-probabilistic and for convenience during 7 months.

Results: 305 IVIg infusions were studied, corresponding to 111 patients. The indication classification showed that 22% (n=67) of the infusions were off-label. In neurology there was a higher percentage of off-label indications (46%) and within them 45% corresponded to the use in neurological disorders. 81% of the doses indicated off-label were in the range 0.8-1g/kg. The off-label infusions presented 61.5% (n=8) of the ADRs. Those from the Neurology service represented 87.5%; 75% being from the "Neurological disorders" group.

Conclusion: In some cases, IVIg was indicated in an off-label manner, finding a statistically significant relationship with the appearance of ADR. This finding motivates the proposition of new hypotheses to carry out more studies.

The guinea pig in Ecuador is synonymous with our ancestral gastronomy and cultural tradition, but because of the diet rich in L-canavanine (alfalfa) that they receive; could limit its consumption in patients with primary immune thrombocytopenia (ITP).Ingestion of alfalfa in humans can cause kidney failure and lupus-like syndrome. The John Hopkins Lupus Center recommends avoiding it in the diet of patients with Systemic Lupus Erythematosus (SLE), as it aggravates inflammation by stimulating immune activity (flares).We present two cases of patients with ITP linked to guinea pig ingestion. It is probable

Introduction: Cerebral gas embolism is an unusual but extremely serious condition that occurs when air is introduced into the arterial or venous circulation of the brain. Although rare, it can lead to significant neurological deficits and even the death of the patient.

Clinical case: 76-year-old patient with pre-existing diffuse interstitial lung disease, who experienced a massive stroke due to spontaneous pneumomediastinum. Her presentation included confusion, seizures, and motor weakness. Imaging tests revealed air bubbles in the cerebral sulci and hypodense areas in the cerebellum and parietooccipitals. In addition, pneumothorax and air in the upper mediastinum were noted on chest radiographs and chest CT scan. Despite therapeutic measures such as hyperbaric oxygen, the patient unfortunately died due to multiple organ failure.

Discussion: The diagnosis of cerebral gas embolism generally involves performing a cerebral computed tomography, which is highly sensitive for detecting the presence of air in the cerebral vessels. Management includes monitoring of vital and neurological signs, as well as specific measures such as airway closure, venous catheter aspiration, Trendelenburg positioning, and hyperbaric oxygen.

Conclusion: Cerebral gas embolism is a potentially fatal condition that requires a brain computed tomography for diagnosis and it is vitally important to know the prevention measures to avoid the appearance of this complication and also to know the general measures to adopt when it occurs.