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

Pregnancy carries the potential risk of developing and maintaining a nutritional status characterized by persistent obesity. This can be magnified when weight gains exceed established recommendations. This postpartum weight retention can significantly contribute to long-term excess weight and cardiovascular events.

Objective: to describe weight retention at 3 and/or 6 months postpartum in women who consulted at the Pediatric Development and Research Institute (IDIP).

Methodology: analytical, retrospective cross-sectional study. Data were collected from the medical records of women who underwent health check-ups at 3 and/or 6 months postpartum. Multiple linear regressions were performed relating postpartum weight retention to those conditioning factors.

Results: The sample was made up of 257 women who underwent controls at 3 months and 577 at 6 months postpartum. Weight retention at 3 months postpartum was negatively associated with primiparity, higher level of education, newborn weight and exclusive breastfeeding, while at 6 months it was only found with these last two factors. Weight retention at 3 and 6 months was positively related to gestational weight gain.

Conclusion: Postpartum weight retention increases influenced by weight gain during pregnancy, but primiparity, schooling, newborn weight and breastfeeding seem to be factors that contribute to reducing it.

Introduction: Objective measurement of Health-Related Quality of Life (HRQoL) has proven useful in evaluating the effectiveness of medical management and its potential as a predictor of mortality and rehospitalization in patients with heart failure (HF). The aim of this study is to characterize HRQoL and determine its independent predictors in patients with chronic HF from a heart failure and transplant clinic in Colombia.

Methods: This was an analytical cross-sectional study. The outcome variable was HRQoL measured using The Minnesota Living with Heart Failure Questionnaire (MLHFQ). Descriptive analysis of sociodemographic and clinical characteristics was conducted. Simple and multiple linear regressions were performed to establish predictors, considering statistical significance at p < 0.05.

Results: A total of 200 patients were analyzed. 20% had Chagasic etiology. The median left ventricular ejection fraction (LVEF) was 30% (range 10 - 68%). The mean HRQoL score was 38.71 points (SD ± 22.67 points). "Multivariate analysis identified seven independent predictors of worse HRQoL: age (β=0.17), low vs. high socioeconomic status (β=13.45), HF etiology, Chagas vs. others (β=12.97), number of hospitalizations in the last year (β=2.94), Charlson index (β=3.47), digitalis use (β=7.34), and NYHA functional class III-IV vs. I-II (β=28.04). Angiotensin-converting enzyme use was associated with better HRQoL (β=-4.80).

Conclusion: This study shows that HRQoL in chronic HF is significantly determined by a set of socioeconomic, clinical, and management factors. The identification of these predictors underpins the need for comprehensive and personalized care strategies to improve the quality of life of these patients.

Introduction: Cri Du Chat Syndrome (CdCS) is an autosomal genetic disorder involving the complete or partial deletion of the short arm of chromosome 5 (5p). The size of the CdCS deletion ranges from approximately 10-45 Mb.

Clinical case: Female patient, one year and three months old, presents hyperextension of the knees. On physical examination, the patient presents bilateral cleft palate, absence of soft palate, cleft lip and tracheostomy, positive Hart sign, negative Peter Bade sign and fixed retrocurved knees with limited range of motion. Radiographs reveal bilateral hip dislocation and knee dislocation. Karyotype analysis confirms the diagnosis of CdCS.

Results: Surgery was performed to laterally release the knee joint capsule, lengthen the quadriceps tendon, capsuloplasty and closed reduction of the knee joint, followed by application of a co-pediatric plaster with knee flexion. After two months in a cast, physiotherapy was started. Approximately three months after surgery, the patient presented a healed surgical incision, full knee extension and almost complete flexion (100° flexion), in addition to a negative Lachmann test.

Conclusion: The presence of multiple congenital anomalies constitutes an exceptionally unique clinical picture. It is crucial to emphasize that congenital dislocation of the hips and knees in this patient is particularly rare and has not been described in the medical literature among CdCS patients.

Background: Medication-related osteonecrosis of the jaw (MRONJ) is an adverse effect associated with the use of antiresorptive/antiangiogenic medications. Few observational studies have been conducted in South America. Our aim was to describe patients with MRONJ from Córdoba, Argentina, focusing on demographic, pharmacological, and serological variables, as well as associated risk factors. Methods: We conducted a cross-sectional study involving MRONJ patients who visited two Oral Medicine Departments between 2016 and 2022. Chi-square tests and Student t-tests were used to compare proportions in categorical and quantitative variables. Additionally, we provided a review of the literature from the last 10 years. Results: A total of 53 patients were included in the study. There was a female predominance in the osteoporosis group. The average duration of antiresorptive treatment for osteoporosis was 10.43 years. Zoledronate was statistically associated with the development of MRONJ. The mandible was more frequently affected than the maxilla. Tooth extraction was the most common triggering factor, accounting for 75% of cases. Additionally, 43.4% of the patients were diagnosed with Stage 1 MRONJ.

Conclusion: This subgroup of Argentinean MRONJ patients exhibits similar characteristics to those reported in studies worldwide. The development of MRONJ in osteoporotic females may be linked to inadequate control of antiresorptive therapy. It is essential for general dentists and physicians to recognize the risk of MRONJ in these individuals.

In a world saturated with information, healthcare professionals face the challenge of combating misconceptions that threaten public health, such as vaccine resistance, the use of therapies without scientific support, or denial of diseases like COVID-19...

Introduction: Physical fitness is often low in people with spinal cord injury. It is related to functionality, participation, and wheelchair mobility. We have found discrepancies about what happens to physical fitness after rehabilitation discharge.

Objective: To describe the physical fitness of wheelchair users with spinal cord injury attending a rehabilitation institute. Secondary objective: to describe the level of mobility and community participation.

Methodology: Observational, cross-sectional study. Subjects living in the community were included. The main variable was the level of physical fitness according to the 6-minute manual propulsion test. Secondary variables such as community mobility (SCIM III and WST-Q) and participation perception (RNLI) were considered.

Results: Sixteen subjects were included. The level of physical fitness was low in 87.5% of them. Regarding community mobility, 56% moved independently over distances greater than 100 meters. As for the perception of participation, 62.5% had mild to moderate restrictions.

Conclusion: Physical fitness, community mobility, and participation in subjects with spinal cord injury were described. The majority of the sample has low physical fitness, requires some degree of assistance in community mobility, and has mild to moderate participation restrictions.

This article presents a rare case of a necrotizing soft tissue infection secondary to a strangulated and perforated femoral hernia. The patient had presented several days after the onset of symptoms and was in septic shock due to spillage of intestinal contents into the thigh. Urgent operative management was undertaken to obtain source control and debride the significant necrotic tissue that was present. Additionally, small bowel resection via a midline laparotomy was required as the bowel was necrotic on intraoperative evaluation. Specific management challenges included the closure of hernia defect in an infected field and the complex wound care regimen necessitated by the extent of tissue necrosis. Prompt surgical intervention, in the setting of a necrotizing soft tissue infection, is imperative to achieving a favorable outcome.

The article presents a necessary historical rectification regarding the authorship of the design and construction of the Hospital Nacional de Clínicas, inaugurated in Córdoba in 1913. Based on documentary and epistolary analysis, it becomes evident that the true author of the project was Engineer Rafael Aranda, who drafted the plans in 1882, inspired by the Hospital of Lugo (Italy), rather than Architect Francesco Tamburini, to whom the work has been mistakenly attributed in various circles. The article highlights the patrimonial implications of this omission, documents the roles of key academic and political figures in the hospital’s inception, and underscores the importance of safeguarding historical memory through reliable primary sources.

A 4-year-old male presented to the emergency department with fever, mucous diarrhea, abdominal pain, and vomiting for 36 hours. On abdominal palpation, he had generalized pain without rebound and increased hydroaereal sounds. The blood count showed leukocytosis and elevated C-reactive protein, and an ultrasound revealed intestinal loops with abundant content, increased peristalsis, and a normal appendix. Due to the suspicion of invasive gastroenteritis, he was admitted for observation. Due to the persistence of symptoms, a new ultrasound was performed which showed pelvic free fluid but did not identify the appendix. An abdominal radiography was previously performed, which showed an image compatible with appendicolith. With the suspicion of appendicitis, surgery was indicated, and an appendicular peritonitis was identified. The patient recovered well and was discharged seven days later. Diagnosing appendicitis in children can be a complex process. The most sensitive diagnostic tests are ultrasound and tomography. Abdominal radiography, however, is a widely available test with low radiation and has a positive predictive value of 90% for appendicitis (detecting appendicolith or periappendicular 'air silence'). In ambiguous cases, an abdominal X-ray could avoid invasive tests that require sedation or high doses of radiation.

Heart failure (HF) is a clinical syndrome with symptoms and/or signs caused by structural and/or functional cardiac abnormalities. After discharge, patients with acute heart failure (AHF) face a significant risk of rehospitalization and mortality. Detection of residual congestion is crucial to reduce readmissions, improve prognosis, and decrease mortality. Echocardiography provides critical information about the severity of left ventricular dysfunction, elevated filling pressures, valvular dysfunction, and estimation of pulmonary artery systolic pressure. The VExUS approach integrates ultrasound evaluation of the inferior vena cava, hepatic veins, portal vein, and renal veins, providing valuable information about systemic congestion. Lung ultrasound detects pulmonary congestion, facilitating early intervention to prevent progression and hospitalizations. Ultrasound evaluation of the internal jugular vein and femoral vein complements the evaluation of venous congestion. Distension of the internal jugular vein during the Valsalva maneuver or the relationship between the diameter of the internal jugular vein and the femoral vein can predict adverse outcomes in patients with HF. In conclusion, a comprehensive ultrasound approach is crucial in the management of patients with critically ill heart failure. Multiparameter ultrasound evaluation provides vital information, guiding appropriate therapeutic interventions and avoiding potentially harmful measures.