Medicina
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The shock index (IS) is the quotient between the heart rate (HR) and the systolic blood pressure (SBP) (IS: HR / SBT), and the age-adjusted shock index (ISA) multiplying the IS by age. We evaluated its predictive value for the combined in-hospital event (EC), death and / or cardiogenic shock (CS) and for individual events in the patients included in the Argentine registry of ST-segment elevation infarction (ARGEN-ST-AMI); 248 with CS on admission were excluded. ROC curves were made for both indices using the best cut-off point to dichotomize the population. ⋯ The area under the ROC curve of the ISA for EC was significantly better than that of the IS (0.72 vs. 0.62, p < 0.001). In the multivariate analysis models performed, the IS had an OR: 2.56 (95% CI 1.56-4.02; p < 0.001) and the ISA: 3.43 (95% CI 2.08-5.65; p < 0.001) for EC. The IS and ISA predict death and / or the development of in-hospital cardiogenic shock in an unselected population of ST elevation infarcts.
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Positron emission tomography (PET) with prostate-specific membrane antigen (PSMA) improves prostate cancer staging. Furthermore, the intensity of intraprostatic uptake of PSMA can predict clinically relevant oncologic outcomes. The objective of this study is to evaluate whether the intensity of PSMA uptake is associated with clinically significant prostate cancer and to determine which value of PSMA uptake best discriminates this relationship. ⋯ Intraprostatic PSMA uptake intensity can be a new diagnostic tool in the detection of clinically significant prostate cancer. An uptake intensity equal or greater than 9.5 is correlated with clinically significant prostate cancer.
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To contribute to the study of the disease, data were recorded from all hospitalized patients in the Clinical Medicine room of Hospital Municipal Dr. Raúl Caccavo, Coronel Suárez, Buenos Aires province, diagnosed with COVID-19 in the first year of the pandemia (March 2020 to March 2021), the only health institution where patients were hospitalized in our city. A descriptive and retrospective transversal cut study was carried out with 178 patients (average age: 61 years old, range: 9 months -96 years), 90% of them hospitalized for a respiratory cause. ⋯ All patients hospitalized for respiratory causes were subjected to a thorax tomography, and 69% of them presented bilateral infiltration in ground glass. The laboratory tests revealed leucopenia in 15% of the patients and thrombocytopenia in 3% of them. These data could be an input for the development of COVID-19 clinical prediction models, although more evidence will be needed for that end.
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COVID-19 pandemic modified learning conditions in health professions' residences. The objective of the research was to explore Argentinian residents' perceptions regarding training conditions during the first year of pandemic. A descriptive, quali-quantitative study was developed through an online, anonymous questionnaire, with 42 items: 17 closed options and 25 Likert scale from 1 to 5; and 2 open questions. ⋯ They perceived as positive aspects the chance to strengthen bonds between residents and closeness with relatives, and negative aspects the effects on health due to stress and social distancing. In conclusion, the general conditions of training were affected. This leads to rethink the teaching and assessment curricular alternatives, as well as interventions related to the well-being of the residents.
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COVID-19 develops severe inflammatory responses that can lead to death. It is essential in a pandemic to have accessible instruments to estimate the prognosis of the disease. The lymphocyte-to-C-reactive protein ratio (LCR) is a predictive biomarker studied in oncology, which could have some advantages in COVID-19 patients in the early stages of the disease. Our objective was to estimate the risk of LCR < 100 and mortality in hospitalized patients with COVID-19. ⋯ LPCR <100 in the initial assessment of hospitalized patients with COVID-19 suggests a higher risk of mortality.