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

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.

A 69-year-old man underwent liver transplantation with a deceased donor for cirrhosis secondary to steatohepatitis. The arterial anastomosis was performed between the celiac trunk of the donor and the hepatic artery of the recipient. In the second postoperative month, he developed abdominal pain and abnormal liver function tests. MRI angiography and subsequent digital angiography confirmed a 50 x 60 mm hepatic artery pseudoaneurysm (PAH) with dilation of the bile duct and bilomas in both hepatic lobes. Endovascular treatment could not be performed due to the absence of contrast passage to the intrahepatic branches during angiography. A surgical ligation and resection of the PAH that compromised both hepatic arteries was chosen. The primary anastomosis was not viable because it was not possible to identify a viable proximal end or ostium. Given the ischemic compromise of the bile duct, an exception route for re-transplantation was requested from INCUCAI, thus entering the waiting list and accessing a new graft 30 days later. His subsequent evolution was favorable. Now he's asymptomatic under follow-up after 9 years of the liver re-transplantation.

New evidence has emerged on pleiotropic properties of Statins (St), that would be potentially beneficial in the treatment of osteoporosis (OP)

Our objective was to study the effect of St on bone mineral density (BMD) in postmenopausal women.

Methods: This is a cross-sectional, analytical study, that analyze postmenopausal women with hypercholesterolemia who received treatment with St for at least 6 months, and as a control group (CG), postmenopausal women who did not receive St assisted in two rheumatology services in the city of Córdoba from August 2014 to September 2018.

Results: 202 postmenopausal women received St and 203 constituted the CG. The average age, weight and BMI were 62.54 years, 69.60 kg and 27.13 in the St group vs 58.58 years, 65.70 kg and 26.83 in the control group (p= 0.0001, p= 0.01, p=ns respectively). Lumbar, femoral neck and total hip BMD were statistically higher in patients who received St than in controls (-0.87 vs -1.74 p=0.00, - 1.15 vs 1.56 p= 0.00 and - 0.33 vs - 0.75 p= 0.01). Regarding the time of St treatment, a significant difference was found only in relation to BMD and lumbar spine between the groups of 6 to 12 months and those that received between 12 and 36 months. No relationship was found between BMD and the different types of St received.

Conclusion: Treatment with St could improve BMD in hypercholesterolemic postmenopausal women who takes these drugs.

Introduction: Mothers are the main mediators in the process of selecting and buying food for their children.

Objective: Describe the purchasing attitude of mothers in response to the demand for ultra-processed foods by children between 8 and 12 years of age. For this, it was proposed: i) Characterize the ultra-processed foods that children request according to their mothers, ii) ii) Identify the factors considered when purchasing the foods requested by their children, iii) Evaluate their perception of the influence of advertising in their children's demand for food, and iv) Describe their attitude towards the behavior of children during purchases of ultra-processed foods.

Methods: Non-experimental, cross-sectional, and descriptive quantitative study. An online survey was designed that allowed reaching the participation of 126 mothers of 153 children. Data were analyzed using univariate descriptive analysis techniques.

Results: Sweet and salty cookies, desserts and ice creams, and sugary drinks were the products most requested by children. Mothers mainly considered price and nutritional quality when purchasing these foods. In addition, 83.3% of mothers stated that food advertising influences their children's demands. At the insistence of the children, more than 50% of the mothers occasionally agreed to purchase, although 73.8% had no difficulties refusing the requests.

Conclusion: The purchasing attitude of mothers mediates between the demands of their children and their own decisions, establishing limits regarding certain foods requested.

Introduction: metabolic dysfunction associated fatty liver disease (MAFLD) is a condition characterized by hepatic steatosis (HS) of metabolic origin. To predict it, HS serum indices (HSSI) have been proposed and validated, whose performance in indigenous populations is unknown.

Objectives: to describe the variation of cardiometabolic risk (CMR) indicators according to four SHSI in indigenous Venezuelans of the Piaroa ethnic group, and to explore the frequency of non-alcoholic fatty liver disease (NAFLD) and MAFLD in this population.

Methodology: non-experimental, descriptive, correlational and cross-sectional study, with non-probabilistic and intentional sampling, in 75 indigenous Piaroas adults (18 to 65 years). The HSSI were used: FLI (Fatty Liver Index), HSI (Liver Steatosis Index), LAP (Lipid Accumulation Product) and VAI (Visceral Adiposity Index).

Results: FLI values were higher in men and LAP values in women. FLI, LAP and VAI were higher in individuals ≥ 40 years old. Individuals with body mass index (BMI) ≥ 25 kg/m2 showed higher FLI, HSI and LAP values compared to individuals with lower BMI. Depending on the applied HSSI, the frequency of NAFLD varied between 1.3% and 40.5%, while for MAFLD it was between 2.7 and 21.6%.

Conclusion: the increase in HSSI was associated with changes in CMR indicators compatible with the presence of fatty liver. The study of the metabolic profile of HS in the Piaroas indigenous people must be expanded, in order to design better focused prevention and therapeutic strategies

Transthyretin Amyloid Cardiomyopathy (ATTR-CM) was considered an uncommon disease until a few years ago, but advances in the epidemiology and non-invasive diagnostic tests have increased its timely detection. We report a 71 years-old man with history of hypertension and an incidental carcinoma of the left kidney detected 6 years ago, without heart failure who was performed cardiac magnetic resonance images (MRI) by suspicion of hypertrophic cardiomyopathy. Before his cardiologist be aware of the result, he suffered a severe sustained ventricular tachycardia (SVT) that required emergency cardioversion. Echocardiogram and cardiac MRI were suggestive for cardiac amyloidosis and the diagnosis was confirmed by scintigraphy with PYPTc99m (Perugini +3). Serum levels of light chains kappa and lambda were normal, and serum and urine immunofixation were negative; a genetic test had no variants, so supporting an ATTR-CM wild type. PET-CT did not detect metastasis of the renal tumor, but showed cardiac hypermetabolism and pericardial effusion. An implantable cardioverter defibrillator (ICD) was placed and after nine days a shock was delivered by the ICD due to a new event of SVT; in addition a Holter monitoring registered runs of asymptomatic atrial fibrillation. Etiologic treatment for ATTR-CM with Tafamidis 61 mg was started, amiodarone and rivaroxaban were added for control of arrhythmias and prevention of systemic embolism, respectively. After 14 months of follow-up, he is stable in class I NYHA. ATTR-CM is a complex disease, and the treatments should be indicated by a multidisciplinary team that consider the risks, benefits, and costs of each intervention.