Clinical and Descriptive Study of Orofacial Clefts in Colombia: 2069 Patients From Operation Smile Foundation.

OBJECTIVE: To describe the population of patients with cleft lip and/or palate (CL/P) in terms of cleft phenotypes, gender, age, ethnic group, family history, clinical presentation (syndromic vs nonsyndromic), some environmental and behavioral factors, and some clinical features. DESIGN: Descriptive retrospective study. SETTING: Patients attending the genetics counseling practice in Operation Smile Foundation, Bogotá, Colombia, for over 8 years. PARTICIPANTS: No screening was conducted. All patients requiring clinical genetics assessment in Operation Smile Foundation were included in the study. RESULTS: Left cleft lip and palate (CLP) and nonsyndromic forms were the most frequent types of malformations in this population. Psychomotor retardation and heart disease were the most frequent comorbidities in these patients. A low proportion of mothers exposed to passive smoking during pregnancy was observed and low birth weight accounted for an important number of cases. Aarskog, velocardiofacial, and orofaciodigital syndromes were the most frequent syndromic forms of CLP in this population. CONCLUSIONS: In this study, the most frequent type of CL/P was the nonsyndromic complete left CLP. Aarskog, velocardiofacial, and orofaciodigital syndromes were the most frequent syndromic forms of CL/P in this population.

No Increase in Kawasaki Disease-Like Illnesses During the COVID-19 Pandemic Compared With 4 Previous Years: A Medical Records Review Analysis.

BACKGROUND: SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection produces a wide variety of inflammatory responses in children, including multisystem inflammatory syndrome in children, which has similar clinical manifestations as Kawasaki disease (KD). METHODS: We performed a chart review of all patients with KD-like illnesses from January 1, 2016, to May 31, 2020, at a tertiary care children's hospital within a larger health system. Relevant symptoms, comorbid illnesses, laboratory results, imaging studies, treatment, and outcomes were reviewed. Descriptive analyses to compare features over time were performed. RESULTS: We identified 81 cases of KD-like illnesses from January 1, 2016, to May 31, 2020. Few clinical features, such as gallbladder involvement, were more prevalent in 2020 than in previous years. A few patients in 2020 required more intensive treatment with interleukin 1 receptor antagonist therapy. There were no other clear differences in incidence, laboratory parameters, number of doses of intravenous immunoglobulin, or outcomes over the years of the study. CONCLUSIONS: There was no difference in incidence, laboratory parameters, or number of doses of intravenous immunoglobulin required for treatment of KD-like illnesses during the COVID-19 pandemic when compared with previous years at our institution. Kawasaki disease-like illnesses, including multisystem inflammatory syndrome in children, may not have changed substantially during the COVID-19 pandemic.

Thoracic Cardiovascular Complications of Tuberculosis.

ABSTRACT: Mycobacterium infection remains a leading cause of morbidity and mortality worldwide. Although rare, thoracic cardiovascular complications are associated with devastating consequences if not promptly diagnosed using computed tomography. Intrapulmonary complications include tuberculous aortitis, Rasmussen aneurysms, involvement of bronchial and nonbronchial systemic arteries, and thromboembolic events. Extrapulmonary complications include pericarditis, myocarditis, endocarditis, involvement of coronary arteries, annular-subvalvular left ventricle aneurysms and mediastinal fibrosis. This article will review these complications and their computed tomography features.

Human infection with Pseudoterranova cattani by ingestion of "ceviche" in Buenos Aires, Argentina.

Anisakidosis is an infection caused by larval nematodes that belong to several genera within the family Anisakidae. Anisakidosis has about 20000 cases reported to date, the vast majority (90%) in Japan. Usually, human anisakiosis is more common than human pseudoterranovosis in Japan and Europe, although in North America Pseudoterranova spp. is the more frequent. Cases of human pseudoterranovosis have been reported from Chile and Peru. We here report one of the few cases of human infection by Pseudoterranova cattani by consumption of "ceviche" in Buenos Aires, Argentina.

[Myiasis by Cochliomyia hominivorax in Argentina]. / Miasis por Cochliomyia hominivorax en la Argentina.

Miasis is the infestation of man and animals by larvae of flies belonging to the order Diptera, suborder Cyclorrapha. Eighty percent of miasis in Argentina is caused by Cochliomyia hominivorax, a species that induces pronounced tissue invasion and destruction, and results in severe clinical forms. Because of the aggressiveness of its larvae, it is important to reach a specific etiological diagnosis. We present four cases of miasis by C. hominivorax in two patients living in the city of Buenos Aires but working in a rural area and two patients living in the Greater Buenos Aires.

Miasis es la infestación de humanos y animales por larvas de dípteros ciclorrafos con invasión y destrucción tisular. Cochliomyia hominivorax es responsable del 80% de las miasis en la Argentina. Es importante realizar el diagnóstico etiológico específico debido a la agresividad de las larvas de esta especie, las que pueden provocar cuadros clínicos graves. Presentamos cuatro casos de miasis por C. hominivorax. Dos de los pacientes residían en la ciudad de Buenos Aires y trabajan en zona rural, y los otros dos residían en el Gran Buenos Aires.

Síndrome obstructivo sinusoidal hepático secundario al consumo de nitritos de alquilo. Presentación de caso / Hepatic sinusoidal obstructive syndrome due to the consumption of alkyl nitrites. A case report

El síndrome obstructivo sinusoidal es una causa de hipertensión portal hepática postsinusoidal. Se produce como consecuencia de agentes hepatotóxicos que lesionan el endotelio de la vénula central, lo que lleva a un bloqueo del flujo sanguíneo y congestión que generan hipertensión portal postsinusoidal. Esta patología es muy rara y su principal causa es el trasplante de células hematopoyéticas, aunque también se han descrito otras causas como el uso de agentes hepatotóxicos que incluyen quimioterapia, radioterapia e ingesta de alcaloides. La clínica de estos pacientes no varía significativamente con respecto a la clínica de los pacientes con otras causas de hipertensión portal por lo que las imágenes diagnósticas juegan un papel clave en el enfoque de estos pacientes. Se describe el caso de un paciente de 16 años de edad con antecedente de consumo de sustancias psicoactivas, quien se presenta con hipertensión portal hepática postsinusoidal por consumo de nitritos de alquilo.

The sinusoidal obstructive syndrome is a cause of post-sinusoidal hepatic portal hypertension. Caused by hepatotoxic agents that damage the endothelium of the central venule, which results in obstruction of the blood flow and congestion, leading to post-sinusoidal portal hypertension. This pathology is very rare, and its main etiology is hematopoietic cell transplantation, although other etiologies have been described such as the use of hepatotoxic agents that include chemotherapy, radiotherapy, and intake of alkaloids. The clinical presentation of these patients does not vary significantly with respect to the other causes of portal hypertension, and therefore diagnostic images play a key role in the initial approach of these patients. We present the case of a 16 year old patient with a history of consumption of psychoactive substances, who showed portal hypertension due to the consumption of alkyl nitrites.

Enfermedad cardiovascular aterosclerótica y sexualidad / Atherosclerotic Cardiovascular Disease and Sexuality

La enfermedad cardiovascular aterosclerótica es la primera causa de muerte en todo el mundo, y la principal causa de años de vida perdidos por discapacidad (AVADs) en los adultos. Sus factores de riesgo son muy prevalentes en la población, y su ocurrencia se ha asociado con disfunción sexual tanto en hombres como en mujeres, debido a que comparten un mecanismo fisiopatológico similar en el caso de la disfunción eréctil en los hombres y potencialmente en la disfunción sexual femenina. Además, los trastornos mentales asociados (principalmente ansiedad y depresión) y los efectos adversos de los medicamentos antihipertensivos y antidepresivos también contribuyen a las disfunciones sexuales. Por otro lado, los inhibidores de la fosfodiesterasa 5 (iFDE5s) han demostrado seguridad y beneficios cardiovasculares en los hombres, y en las mujeres hay evidencia creciente de su utilidad en las disfunciones sexuales. En esta revisión, se presentan las implicaciones de la enfermedad cardiovascular aterosclerótica y su tratamiento en la vida sexual de hombres y mujeres, los efectos cardiovasculares de los tratamientos de las disfunciones sexuales, y la consejería a los pacientes.

Atherosclerotic cardiovascular disease is the leading cause of death worldwide and the leading cause of disability-adjusted life years (DALYs). Its risk factors are very prevalent in the population, and its occurrence has been associated with sexual dysfunction in both men and women, because they share a similar pathophysiological mechanism in the case of erectile dysfunction in men and potentially in female sexual dysfunction. Furthermore, associated mental disorders (mainly anxiety and depression) and the adverse effects of antihypertensive drugs and antidepressants also contribute to sexual dysfunction. On the other hand, phosphodiesterase 5 inhibitors (PDE5is) have shown safety and cardiovascular benefits in men, and in women there is growing evidence of their usefulness in female sexual dysfunctions. The present review describes the implications of atherosclerotic cardiovascular disease and its treatment on the sexual lives of men and women, the cardiovascular effects of the treatments for sexual dysfunctions, and patient counseling.

Cyclospora cayetanensis: diagnóstico de un coccidio poco frecuente en la Argentina / Cyclospora cayetanensis: diagnosis of a rare coccidium in Argentina

Resumen Cyclospora cayetanensis es un coccidio intestinal relacionado con brotes epidémicos debido al consumo de alimentos y agua contaminados con ooquistes esporulados. Predomina en regiones tropicales y subtropicales y puede causar síntomas gastrointestinales que son más graves en inmunocomprometidos, en los que puede causar infecciones extraintestinales. El diagnóstico se realiza por la observación microscópica de ooquistes que presentan un tamaño entre 8 y 10 micrones, refringentes y con glóbulos internos. Se confirma con coloración ácido resistente; los ooquistes se tiñen de color fucsia y tienen la capacidad de autofluorescer. En este informe se describe el diagnóstico de Cyclospora cayetanensis en un paciente inmunocomprometido, oriundo de Perú, que reside actualmente en un barrio vulnerable de la Ciudad de Buenos Aires. Este informe representaría el sexto caso diagnosticado en la Argentina.

Abstract Cyclospora cayetanensis is an intestinal coccidium related to epidemic outbreaks due to consumption of food and water contaminated with sporulated oocysts. It predominates in tropical and subtropical regions and may cause gastrointestinal symptoms which are more severe in immunocompromised patients, to whom it may cause extraintestinal infections. Diagnosis is made by the microscopic observation of oocysts between 8 and 10 microns in size, with refractile globules inside of them. This diagnosis is confirmed by acid-fast staining where oocysts are observed red-stained. With ultraviolet epifluorescence, they stand out as bright blue or green staining circles. The aim of this report is to communicate the diagnosis of C. cayetanensis in an immunocompromised patient, born in Peru, but currently living in a vulnerable neighbourhood of Buenos Aires city. To our knowledge, this would be the sixth case of C. cayetanensis diagnosed in Argentina.

Resumo Cyclospora cayetanensis é um coccídio intestinal relacionado com surtos epidêmicos devido ao consumo de alimentos e água contaminados com oocistos esporulados. Predomina nas regiões tropicais e subtropicais e pode provocar sintomas gastrointestinais mais graves em pacientes imunodeprimidos, nos quais pode causar infecções extraintestinais. O diagnóstico é feito através da observação microscópica de oocistos com tamanho entre 8 e 10 mícrons, refringentes e com glóbulos internos. O diagnóstico é confirmado com coloração ácido-resistente; os oocistos são tingidos de cor fúcsia e eles têm a capacidade de auto-fluorescer. Este relatório descreve o diagnóstico de Cyclospora cayetanensis em um paciente imunodeprimido, nativo do Peru, atualmente residindo em um bairro vulnerável da cidade de Buenos Aires. Este relatório representaria o sexto caso diagnosticado na Argentina.

Deleterious coding variants in multi-case families with non-syndromic cleft lip and/or palate phenotypes.

Nonsyndromic Cleft Lip and/or Palate (NSCLP) is regarded as a multifactorial condition in which clefting is an isolated phenotype, distinguished from the largely monogenic, syndromic forms which include clefts among a spectrum of phenotypes. Nonsyndromic clefting has been shown to arise through complex interactions between genetic and environmental factors. However, there is increasing evidence that the broad NSCLP classification may include a proportion of cases showing familial patterns of inheritance and contain highly penetrant deleterious variation in specific genes. Through exome sequencing of multi-case families ascertained in Bogota, Colombia, we identify 28 non-synonymous single nucleotide variants that are considered damaging by at least one predictive score. We discuss the functional impact of candidate variants identified. In one family we find a coding variant in the MSX1 gene which is predicted damaging by multiple scores. This variant is in exon 2, a highly conserved region of the gene. Previous sequencing has suggested that mutations in MSX1 may account for ~2% of NSCLP. Our analysis further supports evidence that a proportion of NSCLP cases arise through monogenic coding mutations, though further work is required to unravel the complex interplay of genetics and environment involved in facial clefting.

Pulmonary involvement in systemic sclerosis.

Systemic sclerosis (SSc) is a multi-systemic autoimmune disease that mainly affects the skin, lungs, gastrointestinal tract, heart and kidneys. Pulmonary disease in patients with SSc is strongly associated with mortality. The mechanisms involved into its pathophysiology include the activation of autoimmune cells and hyperplasia of fibroblasts with an increased capacity to produce collagen and diminished collagen breakdown. Although pulmonary biopsy is the gold standard for the diagnosis of interstitial lung disease in SSc, the most commonly used method is high-resolution computed tomography due to its high sensitivity and specificity. Herein, a comprehensive review on the pulmonary involvement in SSc is presented highlighting the radiologic-pathologic correlations.

Infecciones en varones por gardnerella vaginalis- revisión bibliográfica

Introducción: Gardnerella vaginalis ha sido aislada de orina, semen, descarga uretral, hisopos endouretrales, rectales y del prepucio, en algunos casos asociada a manifestaciones clínicas; se han descrito uretritis y balanopostitis con diversos porcentajes. Los hallazgos en frotis rectal, semen y prepucio deben interpretarse cuidadosamente para otorgarles significado clínico. Ha quedado demostrado que el hombre la adquiere de sus parejas sexuales y en su forma cohesiva. Objetivo: Explorar el papel patógeno de G. vaginalis como causa de infección en los hombres. Método: La estrategia de búsqueda se realizó en: PubMed/ Medline, Scopus Cochrane Library, SciELO Lilacs, Redalyc; Google Scholar con proveedores como: EB-SCO y tesauros MeSH y DeCS. Resultados: Las diferentes publicaciones indicaron detección de G. vaginalis en muestras uretrales con reportes desde 1,5 %, 4,2 % hasta 14 % con manifestaciones clínicas de uretritis. Otros reportes indican 4,5 %, 5 %, 6,3 %, 7,2 % y 14,5 % sin uretritis. Dos estudios de infecciones del tracto urinario presentan porcentajes de 30,8 % y 67 % de G. vaginalis en hombres con síntomas urinarios. G vaginalis se reporta en frotis rectal, semen e hisopados del prepucio, pero sin clara atribución de etiología patógena. Conclusión: Es recomendable la búsqueda de G. vaginalis en hombres con uretritis no gonocócica, balanopostitis, e infecciones del tracto urinario por su probable significado patógeno, mientras que su papel en semen en pacientes con infertilidad y en el frotis rectal, requiere más estudios de investigación.

Introduction: Gardnerella vaginalis has been isolated from urine, semen, urethral discharge, and endourethral, rectal, and foreskin swabs, in some cases associated with clinical manifestations. Urethritis and balanoposthitis have been described in different percentages. Rectal swab, semen, and foreskin findings must be carefully interpreted for clinical significance. It has been demonstrated that man acquires it from her sexual partners in its cohesive form. Objective: To explore the role of G. vaginalis as a cause of infections in men. Method: Bibliography was searched through PubMed/ Medline, Scopus Cochrane Library, SciELO Lilacs, Redalyc; Google Scholar, and providers like EBSCO and thesauros MeSH y DeCS. Results: Several publications show the detection of G. vaginallis in urethral samples with reports of 1,5%, 4,2%, even 14% of urethritis. Some other reports show a 4,5%, 5%, 6,3%, 7,2% and 14,5% without urethritis. Two studies of urinary tract infections show a 30,8% and 67% of G. vaginalis in men with urinary symptoms. G. vaginalis is reported in rectal smears, semen, and foreskin swabs but without clear attribution of pathogenic etiology. Conclusion: The search for G. vaginalis in men with non-gonococcal urethritis, balanoposthitis, or urinary tract infections is recommended due to its probable pathogenic significance, while its role in patients with infertility and rectal smears requires further investigation, due to the presence in semen.

Infecciones en varones por Gardnerella Vaginalis: Revisión bibliográfica / Gardnerella vaginalis infections in men: literature review / Infecções por Gardnerella vaginalis nos homens: uma revisão da literatura

Introducción. Gardnerella vaginalis ha sido aislada de orina, semen, descarga uretral, hisopos endouretrales, rectales y del prepucio, en algunos casos asociada a manifestaciones clínicas; se han descrito uretritis y balanopostitis con diversos porcentajes. Los hallazgos en frotis rectal, semen y prepucio deben interpretarse cuidadosamente para otorgarles significado clínico. Ha quedado demostrado que el hombre la adquiere de sus parejas sexuales y en su forma cohesiva. Objetivo. Explorar el papel patógeno de G.vaginalis como causa de infección en los hombres. Método. La estrategia de búsqueda se realizó en: PubMed/ Medline, Scopus Cochrane Library, SciELO Lilacs, Redalyc; Google Scholar con proveedores como: EBSCO y tesauros MeSH y DeCS. Resultados. Las diferentes publicaciones indicaron detección de G. vaginalis en muestras uretrales con reportes desde 1.5%, 4.2% hasta 14% con manifestaciones clínicas de uretritis. Otros reportes indican 4.5%, 5%, 6.3%, 7.2% y 14.5% sin uretritis. Dos estudios de infecciones del tracto urinario presentan porcentajes de 30.8% y 67% de G. vaginalis en hombres con síntomas urinarios. G vaginalis se reporta en frotis rectal, semen e hisopados del prepucio, pero sin clara atribución de etiología patógena. Conclusión. Es recomendable la búsqueda de G. vaginalis en hombres con uretritis no gonocócica, balanopostitis, e infecciones del tracto urinario por su probable significado patógeno, mientras que su papel en semen en pacientes con infertilidad y en el frotis rectal, requiere más estudios de investigación

Introduction. Gardnerella vaginalis has been isolated from urine, semen, urethral discharge, endourethral, rectal and foreskin swabs, in some cases associated with clinical manifestations; urethritis and balanoposthitis have been described with varying percentages. The findings in rectal smear, semen and foreskin must be carefully interpreted to give them clinical significance. It has been demonstrated that men acquire it from their sexual partners and in its cohesive form. Objective. To explore the pathogenic role of G.vaginalis as a cause of infection in men. Method. The search strategy was performed in: PubMed/ Medline, Scopus Cochrane Library, SciELO Lilacs, Redalyc; Google Scholar with providers such as: EBSCO and thesauri MeSH and DeCS. Results. The different publications indicated detection of G. vaginalis in urethral samples with reports ranging from 1.5%, 4.2% to 14% with clinical manifestations of urethritis. Other reports indicate 4.5%, 5%, 6.3%, 7.2% and 14.5% without urethritis. Two studies of urinary tract infections present percentages of 30.8% and 67% of G. vaginalis in men with urinary symptoms. G vaginalis is reported in rectal swabs, semen and foreskin swabs, but without clear attribution of pathogenic etiology. Conclusion. A search for G. vaginalis in men with non-gonococcal urethritis, balanoposthitis, and urinary tract infections is advisable because of its probable pathogenic significance, while its role in semen in patients with infertility is unclear.

Introdução. A Gardnerella vaginalis foi isolada da urina, do sémen, do corrimento uretral, de esfregaços endouretrais, rectais e do prepúcio, em alguns casos associada a manifestações clínicas; a uretrite e a balanopostite foram descritas em taxas variáveis. Os achados do esfregaço rectal, do sémen e do prepúcio devem ser cuidadosamente interpretados para lhes conferir significado clínico. Foi demonstrado que os homens a adquirem dos seus parceiros sexuais e na sua forma coesiva. Objetivo. Explorar o papel patogénico da G.vaginalis como causa de infeção nos homens. Método. A estratégia de busca foi realizada em: PubMed/ Medline, Scopus Cochrane Library, SciELO Lilacs, Redalyc; Google Scholar com provedores como: EBSCO e thesauri MeSH e DeCS. Resultados. As diferentes publicações indicaram a deteção de G. vaginalis em amostras uretrais com relatos variando de 1,5%, 4,2% a 14% com manifestações clínicas de uretrite. Outros relatos indicam 4,5%, 5%, 6,3%, 7,2% e 14,5% sem uretrite. Dois estudos sobre infecções do trato urinário indicam percentagens de 30,8% e 67% de G. vaginalis em homens com sintomas urinários. A G. vaginalis é registada em esfregaços rectais, sémen e esfregaços do prepúcio, mas sem atribuição clara de etiologia patogénica. Conclusão. A pesquisa de G. vaginalis em homens com uretrite não gonocócica, balanopostite e infecções do trato urinário é aconselhável devido à sua provável importância patogénica, enquanto o seu papel no sémen de doentes com infertilidade não é claro.

Variables electrocardiográficas asociadas a la aparición de eventos cardiovasculares adversos en el infarto agudo de miocardio sin elevación del segmento ST / Electrocardiographic variables associated to the occurrence of adverse cardiovascular events in non-ST elevation acute myocardial infarction

Introducción: La frecuencia de infarto agudo de miocardio sin elevación del segmento ST se está incrementando y, con ella, los resultados adversos en pacientes con enfermedad coronaria isquémica aguda. Objetivo: Identificar las variables electrocardiográficas asociadas a la aparición de eventos cardiovasculares adversos en el infarto agudo de miocardio sin elevación del segmento ST. Método: Se realizó un estudio transversal, de tipo correlacional, con 68 pacientes con infarto agudo de miocardio sin elevación del segmento ST atendidos en el Hospital Arnaldo Milián Castro, en la provincia de Villa Clara. Se estudiaron los hallazgos electrocardiográficos y eventos cardiacos adversos durante el ingreso. Se hicieron análisis bivariados para establecer la relación de ambas variables, utilizando el estadígrafo chi cuadrado y el riesgo relativo. Resultados: Los hallazgos electrocardiográficos más frecuentes fueron la inversión de la onda T (#8805; 2mm), depresión del segmento ST y el QT corregido largo mediante la fórmula de Bazzet. El 26,5 por ciento presentaron eventos cardiovasculares adversos. La depresión del segmento ST, el QT largo corregido y la elevación del segmento ST en aVR se asociaron significativamente con eventos adversos intrahospitalarios (p lt; 0,05). Conclusiones: La asociación de la depresión del segmento ST, la elevación del segmento ST en aVR y el QT largo corregido con la ocurrencia de eventos cardiovasculares adversos intrahospitalarios, sugiere que estos hallazgos se pueden tener en cuenta como posibles indicadores de evolución desfavorable en pacientes con infarto agudo de miocardio sin elevación del segmento ST(AU)

Introduction: The frequency of non-ST elevation acute myocardial infarction is on the increase, and so is the number of adverse results in patients with acute ischemic coronary disease. Objective: Identify the electrocardiographic variables associated to the occurrence of adverse cardiovascular events in non-ST elevation acute myocardial infarction. Method: A cross-sectional correlational study was conducted of 68 patients with non-ST elevation acute myocardial infarction cared for at Arnaldo Milián Castro Hospital in the province of Villa Clara. Attention was paid to electrocardiographic findings and adverse cardiac events occurring during the hospital stay. Bivariate analyses were performed to establish the relationship between the two variables, using the chi square statigram and relative risk estimation. Results: The most common electrocardiographic findings were T-wave inversion (#8805; 2 mm), ST depression and long corrected QT by Bazzet's formula. Of the total study subjects 26.5 percent had adverse cardiovascular events. ST depression, long corrected QT and ST elevation in aVR were significantly associated to in-hospital adverse events (p < 0.05). Conclusions: Association of ST depression, ST elevation in aVR and long corrected QT with the occurrence of adverse in-hospital cardiovascular events suggests that these findings may be taken into account as possible indicators of an unfavorable evolution in patients with non-ST elevation acute myocardial infarction(AU)

Pulmonary hydatidosis from Southern Argentina.

Hydatidosis or cystic echinococcosis is a zoonosis caused by the larval stage of the cestode Echinococcus. Even though different measures are taken including the use of a vaccine in livestock to stop transmission, the continuous diagnoses of cases, mainly of liver and pulmonary hydatidosis, show the failure of the control programs for hydatidosis in our country. A clinical case of pulmonary hydatidosis in a patient from a rural endemic area in Southern Argentina is described.

Caracterización de la población que consulta por epistaxis al servicio de otorrinolaringología del Hospital Universitario Mayor Méderi (HUM) / Characterization of the population that consults by epistaxis to the Otolaryngology Service of the Hospital Universitario Mayor Méderi (HUM)

Introducción: la epistaxis es uno de los principales motivos de consulta por urgencias en el servicio de otorrinolaringología (ORL). La mayoría de los episodios se originan en el septo nasal anterior y su tratamiento tiende a ser conservador. Objetivo: caracterizar la población que consulta por epistaxis al servicio de otorrinolaringología del Hospital Universitario Mayor Méderi (HUM) entre marzo de 2017 y febrero de 2018. Metodología: estudio observacional, descriptivo y de corte transversal, con una recolección de datos de forma retrospectiva de pacientes que ingresan a urgencias del HUM por epistaxis, registrados en la base de datos del servicio de otorrinolaringología. Se analizaron datos demográficos, localización del sangrado, tratamiento, comorbilidades, fármacos y cifras tensionales. Resultados: un total de 587 pacientes; el 57 % son mujeres, con un promedio de 66 años +/- 16,15 años. La comorbilidad más frecuente fue la hipertensión arterial (60 %) y el 26 % de los pacientes presentaron cifras tensionales >140/90 mm Hg. En antecedentes farmacológicos, el 64,9 % pertenecían al grupo de antihipertensivos y el 37,6 % a los antiagregantes. La localización de los sangrados fue anterior (> área II de Cottle). El principal tratamiento fue el taponamiento nasal anterior con gasa (36,4 %), seguido por la cauterización con nitrato de plata (36,1 %). Conclusiones: en el HUM, los pacientes que consultan por epistaxis son adultos de edad media y avanzada, cuyo sangrado nasal tiene una localización anterior, que solamente requirieron tratamiento médico. Se requieren otros estudios para determinar la modalidad de tratamiento más efectiva según la gravedad de la epistaxis.

Background: epistaxis is one of the main reasons for emergency consultations in the Otolaryngology department. Most episodes originate in the anterior nasal septum and their management tends to be conservative. Aim: characterize the population that consults by epistaxis to the Otolaryngology department of the Hospital Universitario Mayor Méderi (HUM) between March 2017 and February 2018. Methods: observational, descriptive, cross-sectional study, with retrospective data collection of patients admitted to the emergency department of the HUM by epistaxis, registered in the database of the Otolaryngology Department. Demographic data, location of bleeding, treatment, comorbidities, drugs, and blood pressure were analyzed. Results: a total of 587 patients; 57 % women with an average of 66 years +/- 16.15 years. The most frequent comorbidity was arterial hypertension (60 %) and 26 % of the patients presented blood pressure levels >140/90 mm Hg. In pharmacological history, 64.9 % belonged to the group of antihypertensives and 37.6 % to antiplatelet agents. The location of the bleeds was anterior (> Cottle area II). The main treatment was the anterior nasal gauze packing (36.4 %), followed by silver nitrate cauterization (36.1 %). Conclusions: in the HUM, patients who consult for epistaxis are middle-aged and elderly adults, with anterior localization of nasal bleeding, which only required medical management. Other studies are required to determine the most effective treatment modality according to the severity of epistaxis.

Miasis por Cochliomyia hominivorax en la Argentina / Myiasis by Cochliomyia hominivorax in Argentina

Miasis es la infestación de humanos y animales por larvas de dípteros ciclorrafos con invasión y destrucción tisular. Cochliomyia hominivorax es responsable del 80% de las miasis en la Argentina. Es importante realizar el diagnóstico etiológico específico debido a la agresividad de las larvas de esta especie, las que pueden provocar cuadros clínicos graves. Presentamos cuatro casos de miasis por C. hominivorax. Dos de los pacientes residían en la ciudad de Buenos Aires y trabajan en zona rural, y los otros dos residían en el Gran Buenos Aires.

Miasis is the infestation of man and animals by larvae of flies belonging to the order Diptera, suborder Cyclorrapha. Eighty percent of miasis in Argentina is caused by Cochliomyia hominivorax, a species that induces pronounced tissue invasion and destruction, and results in severe clinical forms. Because of the aggressiveness of its larvae, it is important to reach a specific etiological diagnosis. We present four cases of miasis by C. hominivorax in two patients living in the city of Buenos Aires but working in a rural area and two patients living in the Greater Buenos Aires.

Sexualidad, alcohol y sustancias psicoactivas en relación con el embarazo no deseado en universitarios / Sexuality, alcohol, psycoative substances and relation with unwanted pregnancy in university students / Sexualidade, álcool e substancias psicoactivas em relação com a gravindez não desejada em universitarios

Objetivo: determinar la relación entre sexualidad, consumo de alcohol, consumo de sustancias psicoactivas y embarazo no deseado en estudiantes universitarios Métodos: estudio descriptivo de corte transversal con intención analítica. Se aplicó una encuesta sobre salud sexual y reproductiva y bienestar basada en el cuestionario Reig-Ferrer. Las variables cualitativas se analizaron mediante frecuencias y porcentajes y las cuantitativas mediante medidas de tendencia central y dispersión. Se calcularon razones de prevalencia utilizando la prueba chi cuadrado que evaluó relación entre embarazo no deseado y algunas conductas de riesgo. Resultados: participaron 2767 estudiantes con edad promedio de 21 (RIC: 19-23) años. La mediana de edad de inicio las relaciones sexuales fueron de 16 (RIC: 15-18) años. El 56,1% refirió consumir alcohol y el 12,7% sustancias psicoactivas (SPA), con alguna frecuencia. Respecto a las mujeres; el 18,9 % ha estado embarazada, y de éstas, el 61,4% ha tenido un embarazo no deseado. El análisis bivariado mostró relación estadísticamente significativa entre el embarazo no deseado y variables como la edad de inicio de las relaciones sexuales, el consumo de SPA y el mantener o no relaciones sexuales bajo el efecto del alcohol y SPA. Conclusiones: el estudio mostró condiciones que pueden favorecer los problemas relacionados con la salud sexual y reproductiva de jóvenes universitarios. Se pone de manifiesto la necesidad de estudiar algunas conductas de riesgo de manera particular, mediante un abordaje integral que permita posteriormente reorientar las actividades de la promoción de la salud sexual en pro de re-conocer conductas de cuidado y de riesgo.

Objective: To determine the relationship between sexuality, alcohol consumption, psychoactive substance consumption and unwanted pregnancy in university students. Methods: Cross sectional study with analytical intention. A sexual and reproductive health and wellness survey based on the Reig-Ferrer questionnaire was applied. The qualitative variables were analyzed using frequencies and percentages, and the quantitative variables using measures of central tendency and dispersion. Prevalence ratios were calculated using the chi square test that evaluated the relationship between unwanted pregnancy and some risk behaviors. Results: A total of 2767 students with an average age of 21 (RIC: 19-23) years participated. The median age of onset of sexual intercourse was 16 (RIC: 15-18) years. Overall, 56.1% reported consuming alcohol and 12.7% psychoactive substances (PS), with some frequency. Regarding women, 18.9% have been pregnant, and of these, 61.4% have had an unwanted pregnancy. The bivariate analysis showed a statistically significant relationship between unwanted pregnancy and variables such as the age of onset of sexual intercourse, the consumption of PS and whether or not to have sexual intercourse under the influence of alcohol and PS. Conclusions: The study showed conditions that can favor the problems related to the sexual and reproductive health of young university students. The need to study some risk behaviors in a particular way through a comprehensive approach that allows reorienting the activities of sexual health promotion in order to re-know care and risk behaviors, is highlighted.

Objetivo: determinar a relação entre sexualidade, consumo de álcool, consumo de substâncias psicoativas e gravidez não desejado em estudantes universitários Métodos: estudo descritivo de corte transversal com intenção analítica. Aplicou-se uma enquete sobre saúde sexual e reprodutiva e bem-estar baseada no questionario Reig-Ferrer. As variáveis qualitativas se analisaram mediante frequências e porcentagens e as quantitativas mediante medidas de tendência central e dispersão. Calcularam-se razões de prevalência utilizando a prova chi quadrado que avaliou relação entre gravidez não desejado e algumas condutas de risco. Resultados: participaram 2767 estudantes com idade média de 21 (RIC: 19-23) anos. A mediana de idade de início as relações sexuais foram de 16 (RIC: 15-18) anos. O 56,1% referiu consumir álcool e o 12,7% substancias psicoativas (SPA), com alguma frequência. Respeito às mulheres; o 18,9 % tem estado gravidas, e destas, o 61,4% tem tido uma gravidez não desejado. O analise bivariado amostrou relação estatisticamente significativa entre uma gravidez não desejado e variáveis como a idade de início das relações sexuais, o consumo de SPA e o manter ou não relações sexuais baixo o efeito do álcool e SPA. Conclusões: O estudo amostrou condições que podem favorecer os problemas relacionados com a saúde sexual e reprodutiva de jovens universitários. É preciso criar a necessidade de estudar algumas condutas de risco de maneira particular, mediante uma abordagem integral que permita posteriormente reorientar as atividades da promoção da saúde sexual em pro de reconhecer condutas de cuidado e de risco.

Human infection with Pseudoterranova cattani by ingestion of "ceviche" in Buenos Aires, Argentina / Infección humana con Pseudoterranova cattani por ingesta de ceviche en Buenos Aires, Argentina

Abstract Anisakidosis is an infection caused by larval nematodes that belong to several genera within the family Anisakidae. Anisakidosis has about 20000 cases reported to date, the vast majority (90%) in Japan. Usually, human anisakiosis is more common than human pseudoterranovosis in Japan and Europe, although in North America Pseudoterranova spp. is the more frequent. Cases of human pseudoterranovosis have been reported from Chile and Peru. We here report one of the few cases of human infection by Pseudoterranova cattani by consumption of ``ceviche'' in Buenos Aires, Argentina.

Resumen La anisakidosis es una infección por larvas de nematodos que pertenecen a varios géneros dentro de la familia Anisakidae. Se han registrado aproximadamente 20.000 casos hasta la fecha, la mayoría (90%) en Japón. En Europa y Japón la anisakidosis es más frecuente en el humano que la pseudoterranovosis. En cambio, en América del Norte es más frecuente la infección humana por Pseudoterranova spp. También se han informado casos de pseudoterranovosis humana en Chile y en Perú. Informamos uno de los pocos casos de infección humana por Pseudoterranova cattani por consumo de ceviche en Buenos Aires, Argentina.

Alteraciones en el olfato y el gusto asociadas con la infección por SARS-CoV-2: una revisión / Olfactory and taste disorders associated with SARS-CoV-2 infection: a review

Los sentidos químicos, como el olfato y el gusto, son determinantes en la calidad de vida y el desempeño de algunas labores de la vida diaria, ya que desempeñan un papel fundamental tanto en la rutina como en las relaciones interpersonales. Existen múltiples patologías que alteran estos sentidos, entre estas las enfermedades por infección viral. A través de los últimos meses, se ha demostrado que el virus responsable de la pandemia actual (SARS-CoV-2) puede generar cambios en el olfato y en el gusto secundarios a la infección por este, siendo estas alteraciones, en ocasiones, las primeras manifestaciones. En esta revisión se busca recopilar la información encontrada en la literatura médica y resaltar la importancia de tener en cuenta estas alteraciones al momento de examinar a un paciente y generar una alerta en cuanto a las posibles medidas de aislamiento y/o tratamiento de estos pacientes.

Chemical senses such as smell and taste are decisive in the quality of life and performance of some tasks of daily life. They are senses that play a fundamental role in everyday life and in interpersonal relationships. There are multiple pathologies that alter these senses, including viral infection diseases. Over the last few months, it has been shown that the virus responsible for the current pandemic (SARS-CoV-2) can generate changes in smell and taste secondary to its infection, these alterations being sometimes the first demonstrations. This review seeks to compile the information found in the medical literature and conclude the importance of taking these alterations into account when examining a patient and generating an alert regarding the possible isolation and / or treatment measures for these patients.