Medicina
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The use of antidementia drugs near the end of life remains controversial. We evaluated the prevalence of and factors associated with antidementia drug use in the last 6 months of life in older adults with dementia. ⋯ One out of three patients with dementia receive antidementia drugs in the 6 months prior to death despite limited evidence in such a scenario.
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Klebsiella pneumoniae liver abscess syndrome due to hypermucoviscous strains is defined by the presence of monomicrobial liver abscess, without biliary tree or colorectal disease. These strains may be easily identified in the laboratory by performing a string test. It has the potential to spread to other organs, leading to a high morbimortality. We report two cases of liver abscess due to naturally susceptible Klebsiella pneumoniae, one of them with endogenous endophthalmitis as metastatic involvement that required evisceration.
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Phlegmonous gastritis in an uncommon bacterial infection of the gastric wall, predominantly affects immunocompromised patients, with high mortality rates despite appropriate treatment. Various risk factors compromising gastric mucosal integrity have been described. ⋯ Available literature on patients with oncohematological diseases or undergoing chemotherapy who develop phlegmonous gastritis, is limited. We present the case of a female patient with relapsed acute lymphoblastic leukemia who developed phlegmonous gastritis during the neutropenic period following chemotherapy.
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Tuberculosis (TB) in Argentina has been on the rise in recent years, with a higher notification rate in the 15 to 49-year-old age group. Although it is estimated that the incidence of TB in pregnant and postpartum individuals is higher than in the general population, there is insufficient data in our country. ⋯ We report a case of congenital TB transmission diagnosed through epidemiological criteria and molecular methods. We emphasize the importance of implementing TB screening algorithms in pregnancy, tailored to the populations served and the resources available, and we highlight the contribution of genomic sequencing at clinical and epidemiological levels.
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Hostile learning environments in medicine are present at the undergraduate and postgraduate levels. Currently, international research continues to demonstrate this problem of a structural and universal nature. There are few antecedents in Argentina, the research carried out by Reboiras (2020) was the starting point of the present work. The objective was to characterize the mistreatment perceived by physicians during training in basic medical residency programs in Argentina. ⋯ There is evidence of a high prevalence of situations of mistreatment at the national level. The introjection of violence as a formative standard is confirmed, which enables the reproduction of hostile contexts and leads to difficulties in the development of professional skills such as empathy or compassion, which are key to care and quality of attention.