Evaluation of the evidence-based practices for the management of PCOS in the Latin America context: the consensus of the Latin American Association of Gynecological Endocrinology (ALEG).

Objectives: Polycystic Ovary Syndrome (PCOS) is a complex condition affecting approximately 1 in 10 women of reproductive age. However, limited data are available regarding the specific characteristics and needs of women with PCOS in Latin America. This consensus sought to evaluate the evidence-based practices for the management of PCOS for Latin American populations, consolidate regional insights, identify eventual gaps in implementation and identify key research opportunities.

Local resection in rectal cancer: when, who and how?

Local resection (LR) in rectal cancer is indicated in stage T1N0M0 without unfavorable pathological factors, achieving oncologically satisfactory outcomes through transanal endoscopic surgery techniques. However, the initial step involves accurate staging and selection of these tumors through specific tests conducted in specialized colorectal units. For T2N0M0 tumors and T1 tumors with poor prognostic factors, the standard treatment is total mesorectal excision (TME), a procedure associated with high postoperative morbidity and mortality, functional impairments, and reduced quality of life.

Prenatal diagnosis of congenital anomalies and birth institution complexity levels in Argentina.

Patiens with major congenital anomalies diagnosed prenatally should be referred to and delivered in institutions with the appropriate level of complexity, as this reduces morbidity and mortality. We aimed to assess the prevalence and prenatal diagnosis proportion of selected congenital abnormalities and the complexity levels of birth institutions in a sample of public maternity hospitals in Argentina. Data sources were (1) National Congenital Anomalies Registry, covering the period from 2013 to 2021; and (2) Categorization of birth institutions according to their complexity (high or low).

[Not Available].

El suicidio representa un desafío crítico de salud pública. La presente revisión narrativa se propuso actualizar la evidencia disponible sobre detección y prevención del riesgo, con la finalidad de promover líneas de acción para el abordaje temprano e integral de este complejo y multicausal problema; evaluar la posibilidad de fortalecer políticas, programas y acciones para potenciar los recursos existentes y/o promover la creación de otros nuevos. La prevención destaca la necesidad de estrategias personalizadas y colaboración interdisciplinaria.

Association of Total Mortality and Cardiovascular Endpoints With the Timing of the First and Second Systolic Peak of the Aortic Pulse Wave.

Prognostic significance of the timing in the cardiac cycle of the first (TP1) and second (TP2) systolic peak of the central aortic pulse wave is ill-defined. Incidence rates and standardized multivariable-adjusted hazard ratios (HRs) of adverse health outcomes associated with TP1 and TP2, estimated by the SphygmoCor software, were assessed in the International Database of Central Arterial Properties for Risk Stratification (IDCARS) (n = 5529). Model refinement was assessed by the integrated discrimination (ID) and net reclassification (NR) improvement.

A pilot study for continuous non-invasive intracranial pressure screening.

Intracranial hypertension (ICH) is a common and critical condition in neurocritical care, often requiring immediate intervention. Current methods for continuous intracranial pressure (ICP) monitoring are invasive and costly, limiting their use in resource-limited settings. This study investigates the potential of the electroencephalography (EEG) as a non-invasive alternative for ICP monitoring.

Experience with extracorporeal membrane oxygenation support in Latin America between 2016 and 2020.

Objective: To document the experience with ECMO therapy in healthcare institutions across Latin America between 2016 and 2020.

Design: Cross-sectional study.

Setting: Private and public health institutions from 7 countries.

Hemorrhagic cholecystitis: the forgotten differential diagnosis.

Hemorrhagic cholecystitis, a rare complication of acute cholecystitis, poses diagnostic challenges due to its varied clinical presentation and relative infrequency. This case involves a 59-year-old male with untreated diabetes and obesity, who presented with nonspecific abdominal pain. Initial results were inconclusive, leading to a delayed diagnosis.

[Advances in continuous glucose monitoring: evidence of a new generation technology].

Continuous glucose monitoring (CGM) provides comprehensive and dynamic information to guide the management of diabetes mellitus (DM). This paper summarizes the evidence and implications of the use of the new CGM system, FreeStyle Libre 2 (FSL2). A global review of the literature on the use of FSL2 in people with DM was performed.

[Prevalence and evolution of left ventricular insufficiency in patients undergoing severe aortic insufficiency].

Introduction: Aortic insufficiency (AR) evolves during follow-up with dilation of the left chambers and eventually with deterioration of the ejection fraction (EF). Treatment as well as evolution of EF after the procedure remains uncertain. The objective of the following work was to establish the prevalence of ventricular dysfunction and evaluate the evolution of EF at 6 months in patients with aortic valve replacement (AVR) due to AR.

[Activity of internal medicine services in the surgical area in Argentina].

Introduction: The aim of the study was to determine the organization of healthcare activity of internal medicine (IM) services in the surgical area of general acute care hospitals in Argentina.

Methods: A cross-sectional descriptive observational study was performed between 03/01/19-05/01/19. A web survey about shared care (SC) and internal medicine consultations (IMC) was implemented.

[Cardiogenic shock assisted with venoarterial extracorporeal membrane oxygenation: experience of an Argentine institution].

Introduction: Cardiogenic shock carries a mortality rate of 40-50%. In cases that progress unfavorably despite pharmacological treatment, ventricular assist devices such as venoarterial extracorporeal membrane oxygenation play a prominent role. Although two recent controlled clinical trials have been published, the primary source of information remains observational studies, which are notably scarce in Argentina.

[Qualitative analysis of voluntary abortion in the Hospital Italiano de Buenos Aires].

Introduction: The Voluntary Interruption of Pregnancy (IVE) law 27.610, enacted in 2020, urges healthcare providers to guarantee this practice. Previous investigations at the Hospital Italiano de Buenos Aires (HIBA) revealed that the lack of clear institutional protocols hindered the management of abortion.

Risk factors associated with invasive pulmonary aspergillosis in severe COVID-19 patients: a casecontrol study.

Introduction: Since the onset of the COVID-19 pandemic, cases of COVID-19-associated pulmonary aspergillosis (CAPA) have been described. Possible risk factors for the development of this condition have been proposed, although evidence in Latin American populations is limited. The objectives were to identify risk factors for the development of CAPA and describe the characteristics of this infection.

Use of stool molecular panel in hospitalized patients with diarrhea. Experience in a tertiary care center.

Infectious diarrhea is a common health issue that affects a large number of individuals each year. It causes significant morbidity and mortality, greatly impacting healthcare system costs. Rapid detection of the causative organism and timely treatment alters the management and outcome of the condition.

Unmasking Neuroendocrine Prostate Cancer with a Machine Learning-Driven Seven-Gene Stemness Signature That Predicts Progression.

Prostate cancer (PCa) poses a significant global health challenge, particularly due to its progression into aggressive forms like neuroendocrine prostate cancer (NEPC). This study developed and validated a stemness-associated gene signature using advanced machine learning techniques, including Random Forest and Lasso regression, applied to large-scale transcriptomic datasets. The resulting seven-gene signature (, , , , , , and ) was validated across independent cohorts and patient-derived xenograft (PDX) models.

Central role of Galectin-3 at the cross-roads of cardiac inflammation and fibrosis: Implications for heart failure and transplantation.

Cardiac inflammation and fibrosis are central pathogenic mechanisms leading to heart failure. Transplantation is still the treatment of choice for many patients undergoing end-stage heart failure who remain symptomatic despite optimal medical therapy. In spite of considerable progress, the molecular mechanisms linking inflammation, fibrosis and heart failure remain poorly understood.

Factors predictive of severe thrombocytopenia and its impact on poor outcomes in Latin American patients with systemic lupus erythematosus: Data from a multiethnic Latin American cohort.

Objective: To examine the predictors of the occurrence of severe thrombocytopenia and its impact on damage accrual and mortality in SLE patients.

Methods: Factors associated with time to severe thrombocytopenia (platelet count ≤20,000/mm) occurring from the onset of SLE symptoms were assessed by Cox proportional hazards regressions. The association of severe thrombocytopenia with mortality was evaluated by logistic regression analyses while its impact on damage was by negative binomial regression.

[Not Available].

El espectro de enfermedades neurodegenerativas que afectan principalmente a la cognición y el comportamiento abarca desde la enfermedad preclínica asintomática hasta el deterioro cognitivo muy leve y la demencia franca. En este artículo se procedió a  la revisión  de los criterios actuales para el diagnóstico de la demencia con cuerpos de Lewy, segunda causa más frecuente de demencia neurodegenerativa en personas mayores de 65 años luego de la enfermedad de Alzheimer (EA) y las afasias progresivas primarias que se distinguen por producir un compromiso temprano y aislado de las funciones lingüísticas, y en cuya evolución desarrollan un síndrome complejo caracterizado, además del compromiso del lenguaje, por la presencia de deterioro cognitivo progresivo, trastornos de conducta y compromiso de los sistemas motores. También pueden representar la forma de comienzo de una variante atípica de la enfermedad de Alzheimer (EA), no siendo raras las formas mixtas o no caracterizables.

[Complicated right Bochdalek hernia].

The clinical case of a 53-year-old woman diagnosed with a right Bochdalek hernia complicated by intestinal obstruction is presented. This type of diaphragmatic hernia is rare, especially those located on the right side, but is the most common non-hiatal hernia. Her diagnosis focused on the computed tomography of the chest and abdomen and the repair was performed using a laparoscopic approach.

[Reevaluation of penicillin allergy labeling, appropriate use of β-lactam antibiotics, and multidrug resistance].

Approximately 10% of the population reports being allergic to penicillin, although usually less than 1% really are. In addition, people with proven allergies over the years may no longer be allergic. Unconfirmed penicillin allergy and use of alternative antimicrobials result in more treatment failures; more severe adverse effects.