Introduction: Mechanical or physical restraint is an exceptional therapeutic resource to immobilize a subject and thus guarantee the safety of the patient and/or third parties in the face of high-risk behaviors, but i...Introduction: Mechanical or physical restraint is an exceptional therapeutic resource to immobilize a subject and thus guarantee the safety of the patient and/or third parties in the face of high-risk behaviors, but it entails multiple crossings (bioethical, philosophical, medical, psychological, legal). Framed in the so-called “safety culture” developed by the WHO, based on the Protocol for its implementation of the CABA and attentive to its frequent use in CABA by different hospital services (medical clinic, geriatrics, intensive care and medical guards) we consider it necessary its study in terms of compliance with the risks it entails and its management. Objectives: Identify regulatory compliance with the GCABA Mechanical restraint (MR) Protocol from a patient safety perspective, as well as describe the clinical and medicolegal aspects, and propose the usefulness of a tool for its management and control. Methodology: Observational, descriptive, transversal and prospective work through the analysis of Clinical Records with indication of MR using a rubric-type form. 177 cases were analyzed between September-November 2023 from three hospitals of the Government of the City of Buenos Aires, statistical parameters were applied and graphs were made. Results: Only 12.99% complied with the Protocol. In the mental health specialized hospital compliance was almost 5 times greater than in the general one, and in the emergency services compliance was 12 times greater than in Inpatient services. We found that the start or end time of MR was not recorded and only 43% described the causes/justifications for the indication (mostly in Emergency and Specialized hospitals), with the MR average time being shorter in Emergency. Conclusions: Only 1.3 out of 10 patients reliably completed the Protocol and it was mostly in the mental health specialized hospital and the emergency services. The results show non-compliance behavior in the application and management of the risk that the use of mechanical restraints entails, being causes for criminal litigation. We consider that the checklists are useful to complete the Protocol and thus provide security to patients and professionals.展开更多
AIM： To determine prevalence of H pylori infection in symptomatic children in Buenos Aires, Argentina, and to investigate factors associated with HpyloH positivity. METHODS： A total of 395 children with upper gastro...AIM： To determine prevalence of H pylori infection in symptomatic children in Buenos Aires, Argentina, and to investigate factors associated with HpyloH positivity. METHODS： A total of 395 children with upper gastrointestinal symptoms referred to the Gastroenterology Unit of the Children Hospital ＂Sor Maria Ludovica＂ were evaluated for the presence of H py/or/by the ^13C-Urea Breath Test （^13C-UBT）. A questionnaire was applied to the recruited population. RESULTS： Prevalence of H pylo H infection was 40.0% in this population （mean age 9.97 ± 3.1 years）. The factors associated with H py/or/positivity were number of siblings （P 〈 0.001）, presence of pet cats （P = 0.03） and birds （P = 0.04） in the household, and antecedents of gastritis among family members （P = 0.01）. After multivariate analysis, number of siblings [Odds ratio （OR） = 1.39; 95% CI, 1.20-1.61] and contact with pet cats （OR = 1.76; 95% CI, 1.00-3.09） remained as variables associated with H pylori infection. CONCLUSION： The prevalence of H pylori infection in children with upper gastrointestinal symptoms in Argentina was similar to that reported in developed countries. Children from families with a higher crowding index and presence of pet cats have a higher risk of being colonized with Hpylori.展开更多
To the Editor:Liver procurement(LP)from a neurologically deceased donor(NDD)is one of the most important spotlights in liver transplanta-tion(LT)[1,2].The commonly used approaches include the“rapid”en-bloc dissectio...To the Editor:Liver procurement(LP)from a neurologically deceased donor(NDD)is one of the most important spotlights in liver transplanta-tion(LT)[1,2].The commonly used approaches include the“rapid”en-bloc dissection,the in vivo normothermic dissection,or a com-bination of both,according to the preferences and/or the experi-ence of the LP/LT team.A correct LP is essential to achieve optimal results.On the counterpart,defective execution of any of its steps can leave the liver graft unusable and/or cause severe complica-tions in the recipient[3].展开更多
About 60% of blueberry (Vaccinium corymbosum) plantations in Argentina are located in the provinces of Entre Ríos and Buenos Aires. Alternaria tenuissima and Pestalotiopsis guepinii have been reported as pathogen...About 60% of blueberry (Vaccinium corymbosum) plantations in Argentina are located in the provinces of Entre Ríos and Buenos Aires. Alternaria tenuissima and Pestalotiopsis guepinii have been reported as pathogens of blueberry, causing leaf spots and branch cankers. The aims of this research were to estimate the prevalence of these microorganisms on leaves and fruits taken from crops located in Entre Ríos and Buenos Aires, as well as to differentiate leaf symptoms after target inoculations with each pathogen individually and in mixtures. Both fungi were present in blueberry fields from 2010 to 2013. A. tenuissima was the most prevalent pathogen, as most of the symptoms detected in the fields had been caused by this species. As a result of inoculations on cv. O’Neal, injured tissues showed symptoms before undamaged ones. Leaf symptoms caused by A. tenuissima differed from those caused by P. guepinii because of their predominant reddish color and the absence of drop-off of the central part of the lesions. When inoculated in a mixture, incubation period on leaves was intermediate between the registered for individual inoculations. The leaves showed reddishbrown spots typical of A. tenuissima and dark brown spots typical of P. guepinii, both with red margins. Blight, defoliation and canker symptoms caused in each case were undistinguishable.展开更多
Background: The impact of urban air pollution and temperature changes over health is a growing concern for epidemiologists all over the world and particularly for developing countries where fewer studies have been per...Background: The impact of urban air pollution and temperature changes over health is a growing concern for epidemiologists all over the world and particularly for developing countries where fewer studies have been performed. Aim: The main goal of this paper is to analyze the short term effects of changes in temperature and atmospheric carbon monoxide on daily mortality in Buenos Aires, Argentina. Methods: We conducted a time series study focused on three age groups, gender, and cardiovascular and respiratory mortality, with lags up to four days and temporal variables as modifiers. Results: Temperature correlates positively with total mortality for summer months, with a RR = 1.0184 (95%, CI 1.0139, 1.0229) on the same day for each 1℃ increase. In winter this relationship reverses, as 1?C temperature increase exhibit a protective effect with a RR = 0.9894 (95%, CI 0.9864, 0.9924) at the 3 day lag. Carbon monoxide correlates always positively with mortality, with a RR = 1.0369 (95%, CI 1.0206, 1.0534) for each 1 ppm increase, on the previous day. Conclusions: Climate and pollution parameters measured in Buenos Aires City exhibit a correlation with health outcomes. The impacts of temperature and carbon monoxide vary with age and gender, being elderly the most susceptible subgroup. One day after an increase in CO of 1 ppm, about 4% extra deaths can be expected. The correlation found between increases in CO and mortality for greater lags may be ascribed to the role of CO as a chemical marker of urban air pollution, indicating the co-presence of other pollutants.展开更多
The heterogeneity of clinical presentations in psychiatric emergencies creates difficulties in the response by interdisciplinary Mental Health teams. This is aggravated and difficult when the care is carried out on pu...The heterogeneity of clinical presentations in psychiatric emergencies creates difficulties in the response by interdisciplinary Mental Health teams. This is aggravated and difficult when the care is carried out on public roads or the patient’s home, that is, it is a pre-hospital context. Our Psychiatric Emergency Hospital, located in the City of Buenos Aires, provides pre-hospital care with a psychiatric ambulance, which is then referred to general hospitals or other health system providers. Not all effectors in the network have the same resources and, at the time of the emergency, the reasons for consultation such as the patient’s clinic are heterogeneous and require the greatest effectiveness in the intervention that is taken. The triage system is a resource that allows the systematization of approaches against the multiplicity of reasons for consultation and presentation of mental pathologies in the emergency room, in addition to providing greater effectiveness in interventions, homogeneity for the health system and consensus among the health effectors. Framed in the Mental Health Law, and especially in the concept of risk, a triage proposal was designed for pre-hospital interventions by the psychiatric ambulance dependent on Hospital Alvear and under current legal regulations with the aim of homogenizing care and referrals with the highest rate of effectiveness to provide quality interdisciplinary medicine.展开更多
Incubation assay in trays was performed with two soils with different application histories of glyphosate: no application, and previous application. The soils used were Typic Argiudolls of Pergamino, province of Bueno...Incubation assay in trays was performed with two soils with different application histories of glyphosate: no application, and previous application. The soils used were Typic Argiudolls of Pergamino, province of Buenos Aires, and the treatments were: control (no application), and 20, 200 and 2000 mg of active ingredient per kg of soil. Sampling was performed at the beginning (T0) and 45 days after (T45). Catabolic response profiles (CRP), catabolic richness and catabolic uniformity were determined according to the methodology based on measuring the differences in respiration induced by substrate in a short time (4 hours). The substrates used in this study were 20, namely, two amines, 5 aminoacids, two carbohydrates, and 11 carboxylic acids. The objective of this work was to compare soils with different histories of application of glyphosate, measuring its effect on catabolic response profiles, catabolic uniformity and catabolic richness. In this study, no differences were observed between catabolic richness among the different sampling times and doses of glyphosate applied. Glyphosate application affected the structure of the soil microbial communities. At the end of the test, soils with all doses of previous herbicide application showed greater catabolic uniformity than soils without previous application.展开更多
No-tillage systems are able to reduce the negative effects of agricultural intensification on soil properties. However, knowledge of long-term impacts of no-tillage systems on soil properties is insufficient. It is es...No-tillage systems are able to reduce the negative effects of agricultural intensification on soil properties. However, knowledge of long-term impacts of no-tillage systems on soil properties is insufficient. It is essential to know which soil quality indicators are the most sensitive to management practices in each particular environment. Therefore, the objective of this work is to determine which soil quality prop-erties are more sensitive to the impact of two tillage systems in a vertic Argiaquoll soil from Buenos Aires, Argentina. This work started in 2006 and included crop rotation and tillage systems, including both tillage and no-tillage. Physical and chemical properties were measured in three consecutive years (2013-2015) at two depths (0-10 cm and 10-20 cm). The tillage system modified soil physical and chemical properties, mainly in the surface layer. No-tillage showed significantly higher bulk density (2013-2015 p < 0.05), gravimetric moisture (2013;2014 p < 0.05), organic carbon (2013-2015 p < 0.05), and ag-gregates stability in the face of a heavy rain (2013;2015 p<0.05), than soil under tillage. Soil saturation (or total porosity) was significantly greater under tillage. The tillage system did not affect hydraulic conductivity, total nitrogen and extractable phosphorus from the surface, nor physical and chemical properties from the second depth. No-tillage alleviates, but is not enough to mitigate, the loss of soil organic carbon and aggregate stability caused by continuous cropping in this vertic Argiaquall. Bulk density, organic carbon, aggregates stability and saturation are indicators for future studies performed in environments with similar soil and climate conditions.展开更多
In countries like Argentina,whose economy depends heavily on crop production,the estimation of harvests is an elementary requirement.Besides providing objectivity,the use of remote sensing allows estimating yield in a...In countries like Argentina,whose economy depends heavily on crop production,the estimation of harvests is an elementary requirement.Besides providing objectivity,the use of remote sensing allows estimating yield in advance.Since the time of maximum leaf area in wheat corresponds with the critical period of the crop,a good relationship is expected between the Normalized Difference Vegetation Index(NDVI)and yield.The present study was carried out in the North of Buenos Aires province,Argentina.Based on the type of soil,the study area can be divided into two homogeneous subzones:a subzone with lower clay content in the southwestand a subzone with higher clay content in the northeast.Nine growing seasons(2003–2011)were studied.In the first five years,an empirical model was calibrated and validated with field-observed wheat yields and MOD13q1 product-NDVI data,whereas in the other four years,the calibrated model was applied by means of yield maps and by comparing with official yields.The MOD13q1 image corresponding to Julian day 289 showed the best fit between NDVI and yield to estimate wheat yield early.Through yield maps,better weather conditions showedhigher yields and higher soil productivity presented a greater proportion of the area occupied by higher yields.At department level,an R2 value of 0.75 was found after relating the estimation of the calibrated empirical model with official yields.The method used allows predicting wheat yield 30 days before harvest.Through yield maps,the NDVI perceived the temporal and spatial variability in the study area.展开更多
Between the late 19th and early 20th centuries,the productive Pampa cattle ranch,locally known as“estancia,”underwent three developmental stages in the process of territorialization within the northwestern province ...Between the late 19th and early 20th centuries,the productive Pampa cattle ranch,locally known as“estancia,”underwent three developmental stages in the process of territorialization within the northwestern province of Buenos Aires.Each of these stages covers various dimensions-social,economic,political,cultural,and environmental-that collectively define the estancia’s role as a territorial agent.The research employs a methodology that combines qualitative approaches through documentary analysis,along with bibliographical and cartographic review,complemented by fieldwork.This work examines into the changes and transformations within the territory,as well as housing adaptations,which are manifested in the construction of dwellings and their environs.These changes occur in a context where urban culture intertwined with the rural productive scene.Furthermore,it postulates that the inter-century territorial dynamics covering the 19th and 20th centuries serve as an enduring legacy of identity for the 21st century.展开更多
Stem cell proliferation is tightly regulated in developing and adult tissues through the coordinated action of cell-intrinsic and extracellular signals.Although many extracellular cues were identified,the cell-intrins...Stem cell proliferation is tightly regulated in developing and adult tissues through the coordinated action of cell-intrinsic and extracellular signals.Although many extracellular cues were identified,the cell-intrinsic mechanisms underlying the decision of a stem cell to proliferate,enter a dormant quiescent state or differentiate into a specific cell type remains incompletely understood.展开更多
In the words of the late Sir Colin Blakemore,neurologists have historically sought to infer brain functions in a manner akin to to king a hammer to a computeranalyzing localized anatomical lesions caused by trauma,tum...In the words of the late Sir Colin Blakemore,neurologists have historically sought to infer brain functions in a manner akin to to king a hammer to a computeranalyzing localized anatomical lesions caused by trauma,tumors,or strokes,noting deficits,and inferring what functions certain brain regions may be responsible for.This approach exemplifies a deletion heuristic,where the absence of a specific function reveals insights about the underlying structures or mechanisms responsible for it.By observing what is lost when a particular brain region is damaged,throughout the history of the field,neurologists have pieced together the intricate relationship between anatomy and function.展开更多
Traumatic brain injury is a global health crisis,causing significant death and disability worldwide.Neuroinflammation that follows traumatic brain injury has serious consequences for neuronal survival and cognitive im...Traumatic brain injury is a global health crisis,causing significant death and disability worldwide.Neuroinflammation that follows traumatic brain injury has serious consequences for neuronal survival and cognitive impairments,with astrocytes involved in this response.Following traumatic brain injury,astrocytes rapidly become reactive,and astrogliosis propagates from the injury core to distant brain regions.Homeostatic astroglial proteins are downregulated near the traumatic brain injury core,while pro-inflammatory astroglial genes are overexpressed.This altered gene expression is considered a pathological remodeling of astrocytes that produces serious consequences for neuronal survival and cognitive recovery.In addition,glial scar formed by reactive astrocytes is initially necessary to limit immune cell infiltration,but in the long term impedes axonal reconnection and functional recovery.Current therapeutic strategies for traumatic brain injury are focused on preventing acute complications.Statins,cannabinoids,progesterone,beta-blockers,and cerebrolysin demonstrate neuroprotective benefits but most of them have not been studied in the context of astrocytes.In this review,we discuss the cell signaling pathways activated in reactive astrocytes following traumatic brain injury and we discuss some of the potential new strategies aimed to modulate astroglial responses in traumatic brain injury,especially using cell-targeted strategies with miRNAs or lncRNA,viral vectors,and repurposed drugs.展开更多
Black soils represent only one-sixth of the global arable land area but play an important role in maintaining world food security due to their high fertility and gigantic potential for food production.With the ongoing...Black soils represent only one-sixth of the global arable land area but play an important role in maintaining world food security due to their high fertility and gigantic potential for food production.With the ongoing intensification of agricultural practices and negative natural factors,black soils are confronting enhanced degradation.The holistic overview of black soil degradation and the underlying mechanisms for soil health improvement will be key for agricultural sustainability and food security.In this review,the current status and driving factors of soil degradation in the four major black soil regions of the world are summarized,and effective measures for black soil conservation are proposed.The Northeast Plain of China is the research hotspot with 41.5%of the published studies related to black soil degradation,despite its relatively short history of agricultural reclamation,followed by the East European Plain(28.3%),the Great Plains of North America(20.7%),and the Pampas of South American(7.9%).Among the main types of soil degradation,soil erosion and soil fertility decline(especially organic matter loss)have been reported as the most common problems,with 27.6%and 39.4%of the published studies,respectively.In addition to the natural influences of climate and topography,human activities have been reported to have great influences on the degradation of black soils globally.Unsustainable farming practices and excess in agrochemical applications are common factors reported to accelerate the degradation process and threaten the sustainable use of black soils.Global efforts for black soil conservation and utilization should focus on standardizing evaluation criteria including real-time monitoring and the measures of prevention and restoration for sustainable management.International cooperation in technology and policy is crucial for overcoming the challenges and thus achieving the protection,sustainable use,and management of global black soil resources.展开更多
Dune barrier systems represent highly sought-after coastal landscapes for tourism and urban development around the world.However,a century ago,they were considered hazardous environments due to their great dynamic nat...Dune barrier systems represent highly sought-after coastal landscapes for tourism and urban development around the world.However,a century ago,they were considered hazardous environments due to their great dynamic nature.As a result,stabilization practices were considered necessary.The systematic introduction of fast-growing exotic trees helped stabilize the sand,making it easier for tourism urbanization to take place,but also leading to erosion processes.This paper aims to assess long-term changes in vegetation cover over a large temperate barrier in Argentina.This complex region includes urban resorts,afforestation zones,and protected areas.A GIS-based geospatial analysis was conducted using a large satellite database(>350 images),and the future evolution of the vegetation was modeled.The results revealed two primary spatiotemporal patterns associated with a gradual expansion of vegetation cover,accompanied by a concurrent reduction in sandy areas.In 1986,the dune area comprised 75%more surface than vegetation,whereas in 2021,it represented 60%less than vegetation.Furthermore,the 2050 scenario suggests a potential 40%reduction of dunes in certain areas.It is necessary to enhance management actions aimed at maintaining dune mobility and ensuring local and regional sediment balance.Long-term management strategies must focus on restoring native plant communities and controlling invasive species,and avoiding new dune fixation initiatives based on the introduction of exotic species.展开更多
we critically review the authors’perspective and analyze the relevance of the results obtained in the original article of clinical research by Liu et al.We consider that additional factors associated with colon cance...we critically review the authors’perspective and analyze the relevance of the results obtained in the original article of clinical research by Liu et al.We consider that additional factors associated with colon cancer progression have recently been described in extensive clinical research,and should be included in this analysis to achieve a more accurate prognosis.These factors include inflammation,gut microbiota composition,immune status and nutritional balance,as they influence the post-surgical survival profile of patients with stage II colorectal cancer.We also address the clinical implementation and limitations of these analyses.Evaluation of the patient´s entire context is essential for selection of the most appropriate therapy.展开更多
The surgical approach for patellar instability usually refers to reconstruction of the medial patellofemoral ligament associated with an osteotomy of the tibial tuberosity or a trochleoplasty when required.The medial ...The surgical approach for patellar instability usually refers to reconstruction of the medial patellofemoral ligament associated with an osteotomy of the tibial tuberosity or a trochleoplasty when required.The medial patellotibial ligament and the medial patellomeniscal ligament are secondary stabilizers of the patella.Despite this,both the medial patellotibial and patellofemoral ligaments aid in patellar rotation and tilt when the knee is flexed beyond 45°.The medial patellotibial ligament plays a particularly important role in the final stages of stretching in extension and between 40 degrees to 90 degrees of flexion.The clinical relevance and surgical indications for medial patellotibial ligament reconstruction associated with medial patellofemoral ligament reconstruction are still controversial.This editorial explores the surgical indications and clinical results for medial patellotibial ligament reconstruction to improve readers’understanding of this technique,especially because reported clinical outcomes have remained sparse.展开更多
Cardio-cerebral coupling(CCC)refers to the dynamic interplay between cardiac function and cerebral blood flow,essential for maintaining hemodynamic stability.Disruptions in CCC are particularly relevant in critical ca...Cardio-cerebral coupling(CCC)refers to the dynamic interplay between cardiac function and cerebral blood flow,essential for maintaining hemodynamic stability.Disruptions in CCC are particularly relevant in critical care,where they can exacerbate primary and secondary brain injuries.Ultrasound-based techniques,including transcranial Doppler,transcranial color-coded Doppler,and echocardiography,provide non-invasive methods to assess this relationship at the bedside.This scoping review explores the pathophysiology of CCC,ultrasound methodologies for its evaluation,and its clinical relevance.Key mechanisms such as cerebral autoregulation and neurovascular coupling are discussed,along with ultrasound-derived parameters like pulsatility index,resistance index,and cerebral perfusion pressure.While ultrasound is a valuable tool,its limitations include operator dependency and equipment variability.Emerging evidence suggests that ultrasound-guided protocols,including ultrasound-guided cardio-cerebral resuscitation protocol and ultrasound-guided brain injury treatment protocol,may improve resuscitation strategies and neurocritical care monitoring.Despite its potential,further research is necessary to standardize assessment methods and integrate ultrasound-based CCC evaluation into routine clinical practice.Ongoing multicenter studies are expected to provide robust evidence supporting its clinical utility in managing brain-injured patients.展开更多
BACKGROUND Approval of teduglutide is an important addition to the limited treatment options for short bowel syndrome(SBS).However,real-world evidence on teduglutide therapy for SBS in Latin America is scarce.AIM To i...BACKGROUND Approval of teduglutide is an important addition to the limited treatment options for short bowel syndrome(SBS).However,real-world evidence on teduglutide therapy for SBS in Latin America is scarce.AIM To investigate the effectiveness and safety of teduglutide in clinical practice in Argentina with a 24-week follow-up.METHODS This non-interventional multicentre cohort study included consecutive patients(aged≥1 years)with SBS who were dependent on parenteral support(PS)and received≥1 dose of teduglutide according to currently approved indications.RESULTS The study population(n=45)included 21 adult and 24 pediatric patients.The proportion of adult and pediatric patients who showed clinical response(defined as a≥20%reduction in weekly PS volume)after 24 weeks of treatment was 90.4%[95%confidence interval(CI):69.6%-98.8%]and 83.3%(95%CI:62.6%-95.2%),respectively.Overall,12 patients(26.6%;95%CI:14.6-41.9)were weaned from PS support at the 24-week assessment,6(28.5%;95%CI:11.5-52.1)in the adult cohort,and 6(25%;95%CI:9.7-46.7)in the pediatric cohort.Only baseline PS requirement was inversely associated with weaning from PS(P=0.025).The most frequently reported treatmentemergent adverse events(TEAEs)were mild to moderate abdominal pain and abdominal distension(16.6%;and 9.5%,respectively).None of the reported TEAEs led to treatment discontinuation.CONCLUSION This prospective real-world study demonstrated the effectiveness and safety of teduglutide in adult and pediatric patients with SBS in Argentina.The clinical response observed in both adults and pediatric patients was greater than that reported in phase 3 trials and was consistent with the results of other real-world studies.展开更多
Diaphragmatic function is central to respiration,and its evaluation is critical in intensive care unit(ICU)settings.Ultrasonography is a reliable bedside tool to assess diaphragmatic excursion(DE).[1,2]The conventiona...Diaphragmatic function is central to respiration,and its evaluation is critical in intensive care unit(ICU)settings.Ultrasonography is a reliable bedside tool to assess diaphragmatic excursion(DE).[1,2]The conventional M-mode(MM)offers high-resolution imaging but requires precise alignment,which can be diffi cult in ICU patients.[3-5]Anatomical M-mode(AMM)allows flexible line adjustment,enabling accurate DE measurements despite poor acoustic windows.[6]However,comparative data between MM and AMM are limited.This retrospective study evaluated the concordance between MM and AMM for assessing right DE.展开更多
文摘Introduction: Mechanical or physical restraint is an exceptional therapeutic resource to immobilize a subject and thus guarantee the safety of the patient and/or third parties in the face of high-risk behaviors, but it entails multiple crossings (bioethical, philosophical, medical, psychological, legal). Framed in the so-called “safety culture” developed by the WHO, based on the Protocol for its implementation of the CABA and attentive to its frequent use in CABA by different hospital services (medical clinic, geriatrics, intensive care and medical guards) we consider it necessary its study in terms of compliance with the risks it entails and its management. Objectives: Identify regulatory compliance with the GCABA Mechanical restraint (MR) Protocol from a patient safety perspective, as well as describe the clinical and medicolegal aspects, and propose the usefulness of a tool for its management and control. Methodology: Observational, descriptive, transversal and prospective work through the analysis of Clinical Records with indication of MR using a rubric-type form. 177 cases were analyzed between September-November 2023 from three hospitals of the Government of the City of Buenos Aires, statistical parameters were applied and graphs were made. Results: Only 12.99% complied with the Protocol. In the mental health specialized hospital compliance was almost 5 times greater than in the general one, and in the emergency services compliance was 12 times greater than in Inpatient services. We found that the start or end time of MR was not recorded and only 43% described the causes/justifications for the indication (mostly in Emergency and Specialized hospitals), with the MR average time being shorter in Emergency. Conclusions: Only 1.3 out of 10 patients reliably completed the Protocol and it was mostly in the mental health specialized hospital and the emergency services. The results show non-compliance behavior in the application and management of the risk that the use of mechanical restraints entails, being causes for criminal litigation. We consider that the checklists are useful to complete the Protocol and thus provide security to patients and professionals.
基金Supported by ARCAL LIV-6042 Project from the InternationalAtomic Energy Agency (IAEA), Vienna, Austria, UBACYTB077 Project from the University of Buenos Aires, Argentina,PICT 14243 Project from the National Agency of Scientifi c andTechnological Research, Argentina, and Project 2002-013 fromthe Thraser Research Fundation
文摘AIM： To determine prevalence of H pylori infection in symptomatic children in Buenos Aires, Argentina, and to investigate factors associated with HpyloH positivity. METHODS： A total of 395 children with upper gastrointestinal symptoms referred to the Gastroenterology Unit of the Children Hospital ＂Sor Maria Ludovica＂ were evaluated for the presence of H py/or/by the ^13C-Urea Breath Test （^13C-UBT）. A questionnaire was applied to the recruited population. RESULTS： Prevalence of H pylo H infection was 40.0% in this population （mean age 9.97 ± 3.1 years）. The factors associated with H py/or/positivity were number of siblings （P 〈 0.001）, presence of pet cats （P = 0.03） and birds （P = 0.04） in the household, and antecedents of gastritis among family members （P = 0.01）. After multivariate analysis, number of siblings [Odds ratio （OR） = 1.39; 95% CI, 1.20-1.61] and contact with pet cats （OR = 1.76; 95% CI, 1.00-3.09） remained as variables associated with H pylori infection. CONCLUSION： The prevalence of H pylori infection in children with upper gastrointestinal symptoms in Argentina was similar to that reported in developed countries. Children from families with a higher crowding index and presence of pet cats have a higher risk of being colonized with Hpylori.
文摘To the Editor:Liver procurement(LP)from a neurologically deceased donor(NDD)is one of the most important spotlights in liver transplanta-tion(LT)[1,2].The commonly used approaches include the“rapid”en-bloc dissection,the in vivo normothermic dissection,or a com-bination of both,according to the preferences and/or the experi-ence of the LP/LT team.A correct LP is essential to achieve optimal results.On the counterpart,defective execution of any of its steps can leave the liver graft unusable and/or cause severe complica-tions in the recipient[3].
文摘About 60% of blueberry (Vaccinium corymbosum) plantations in Argentina are located in the provinces of Entre Ríos and Buenos Aires. Alternaria tenuissima and Pestalotiopsis guepinii have been reported as pathogens of blueberry, causing leaf spots and branch cankers. The aims of this research were to estimate the prevalence of these microorganisms on leaves and fruits taken from crops located in Entre Ríos and Buenos Aires, as well as to differentiate leaf symptoms after target inoculations with each pathogen individually and in mixtures. Both fungi were present in blueberry fields from 2010 to 2013. A. tenuissima was the most prevalent pathogen, as most of the symptoms detected in the fields had been caused by this species. As a result of inoculations on cv. O’Neal, injured tissues showed symptoms before undamaged ones. Leaf symptoms caused by A. tenuissima differed from those caused by P. guepinii because of their predominant reddish color and the absence of drop-off of the central part of the lesions. When inoculated in a mixture, incubation period on leaves was intermediate between the registered for individual inoculations. The leaves showed reddishbrown spots typical of A. tenuissima and dark brown spots typical of P. guepinii, both with red margins. Blight, defoliation and canker symptoms caused in each case were undistinguishable.
文摘Background: The impact of urban air pollution and temperature changes over health is a growing concern for epidemiologists all over the world and particularly for developing countries where fewer studies have been performed. Aim: The main goal of this paper is to analyze the short term effects of changes in temperature and atmospheric carbon monoxide on daily mortality in Buenos Aires, Argentina. Methods: We conducted a time series study focused on three age groups, gender, and cardiovascular and respiratory mortality, with lags up to four days and temporal variables as modifiers. Results: Temperature correlates positively with total mortality for summer months, with a RR = 1.0184 (95%, CI 1.0139, 1.0229) on the same day for each 1℃ increase. In winter this relationship reverses, as 1?C temperature increase exhibit a protective effect with a RR = 0.9894 (95%, CI 0.9864, 0.9924) at the 3 day lag. Carbon monoxide correlates always positively with mortality, with a RR = 1.0369 (95%, CI 1.0206, 1.0534) for each 1 ppm increase, on the previous day. Conclusions: Climate and pollution parameters measured in Buenos Aires City exhibit a correlation with health outcomes. The impacts of temperature and carbon monoxide vary with age and gender, being elderly the most susceptible subgroup. One day after an increase in CO of 1 ppm, about 4% extra deaths can be expected. The correlation found between increases in CO and mortality for greater lags may be ascribed to the role of CO as a chemical marker of urban air pollution, indicating the co-presence of other pollutants.
文摘The heterogeneity of clinical presentations in psychiatric emergencies creates difficulties in the response by interdisciplinary Mental Health teams. This is aggravated and difficult when the care is carried out on public roads or the patient’s home, that is, it is a pre-hospital context. Our Psychiatric Emergency Hospital, located in the City of Buenos Aires, provides pre-hospital care with a psychiatric ambulance, which is then referred to general hospitals or other health system providers. Not all effectors in the network have the same resources and, at the time of the emergency, the reasons for consultation such as the patient’s clinic are heterogeneous and require the greatest effectiveness in the intervention that is taken. The triage system is a resource that allows the systematization of approaches against the multiplicity of reasons for consultation and presentation of mental pathologies in the emergency room, in addition to providing greater effectiveness in interventions, homogeneity for the health system and consensus among the health effectors. Framed in the Mental Health Law, and especially in the concept of risk, a triage proposal was designed for pre-hospital interventions by the psychiatric ambulance dependent on Hospital Alvear and under current legal regulations with the aim of homogenizing care and referrals with the highest rate of effectiveness to provide quality interdisciplinary medicine.
文摘Incubation assay in trays was performed with two soils with different application histories of glyphosate: no application, and previous application. The soils used were Typic Argiudolls of Pergamino, province of Buenos Aires, and the treatments were: control (no application), and 20, 200 and 2000 mg of active ingredient per kg of soil. Sampling was performed at the beginning (T0) and 45 days after (T45). Catabolic response profiles (CRP), catabolic richness and catabolic uniformity were determined according to the methodology based on measuring the differences in respiration induced by substrate in a short time (4 hours). The substrates used in this study were 20, namely, two amines, 5 aminoacids, two carbohydrates, and 11 carboxylic acids. The objective of this work was to compare soils with different histories of application of glyphosate, measuring its effect on catabolic response profiles, catabolic uniformity and catabolic richness. In this study, no differences were observed between catabolic richness among the different sampling times and doses of glyphosate applied. Glyphosate application affected the structure of the soil microbial communities. At the end of the test, soils with all doses of previous herbicide application showed greater catabolic uniformity than soils without previous application.
基金We are grateful to the"Comisión Nacional de Energía Atómica, Gobierno de Argentina"for providing the field for this study and helping with field work.
文摘No-tillage systems are able to reduce the negative effects of agricultural intensification on soil properties. However, knowledge of long-term impacts of no-tillage systems on soil properties is insufficient. It is essential to know which soil quality indicators are the most sensitive to management practices in each particular environment. Therefore, the objective of this work is to determine which soil quality prop-erties are more sensitive to the impact of two tillage systems in a vertic Argiaquoll soil from Buenos Aires, Argentina. This work started in 2006 and included crop rotation and tillage systems, including both tillage and no-tillage. Physical and chemical properties were measured in three consecutive years (2013-2015) at two depths (0-10 cm and 10-20 cm). The tillage system modified soil physical and chemical properties, mainly in the surface layer. No-tillage showed significantly higher bulk density (2013-2015 p < 0.05), gravimetric moisture (2013;2014 p < 0.05), organic carbon (2013-2015 p < 0.05), and ag-gregates stability in the face of a heavy rain (2013;2015 p<0.05), than soil under tillage. Soil saturation (or total porosity) was significantly greater under tillage. The tillage system did not affect hydraulic conductivity, total nitrogen and extractable phosphorus from the surface, nor physical and chemical properties from the second depth. No-tillage alleviates, but is not enough to mitigate, the loss of soil organic carbon and aggregate stability caused by continuous cropping in this vertic Argiaquall. Bulk density, organic carbon, aggregates stability and saturation are indicators for future studies performed in environments with similar soil and climate conditions.
基金This study was supported by INTA,the Argentinean National Institute of Agricultural Technology.
文摘In countries like Argentina,whose economy depends heavily on crop production,the estimation of harvests is an elementary requirement.Besides providing objectivity,the use of remote sensing allows estimating yield in advance.Since the time of maximum leaf area in wheat corresponds with the critical period of the crop,a good relationship is expected between the Normalized Difference Vegetation Index(NDVI)and yield.The present study was carried out in the North of Buenos Aires province,Argentina.Based on the type of soil,the study area can be divided into two homogeneous subzones:a subzone with lower clay content in the southwestand a subzone with higher clay content in the northeast.Nine growing seasons(2003–2011)were studied.In the first five years,an empirical model was calibrated and validated with field-observed wheat yields and MOD13q1 product-NDVI data,whereas in the other four years,the calibrated model was applied by means of yield maps and by comparing with official yields.The MOD13q1 image corresponding to Julian day 289 showed the best fit between NDVI and yield to estimate wheat yield early.Through yield maps,better weather conditions showedhigher yields and higher soil productivity presented a greater proportion of the area occupied by higher yields.At department level,an R2 value of 0.75 was found after relating the estimation of the calibrated empirical model with official yields.The method used allows predicting wheat yield 30 days before harvest.Through yield maps,the NDVI perceived the temporal and spatial variability in the study area.
基金Grants SIB 0164/170516/19 was funded by Universidad Nacional del Noroeste de la Provincia de Buenos Aires。
文摘Between the late 19th and early 20th centuries,the productive Pampa cattle ranch,locally known as“estancia,”underwent three developmental stages in the process of territorialization within the northwestern province of Buenos Aires.Each of these stages covers various dimensions-social,economic,political,cultural,and environmental-that collectively define the estancia’s role as a territorial agent.The research employs a methodology that combines qualitative approaches through documentary analysis,along with bibliographical and cartographic review,complemented by fieldwork.This work examines into the changes and transformations within the territory,as well as housing adaptations,which are manifested in the construction of dwellings and their environs.These changes occur in a context where urban culture intertwined with the rural productive scene.Furthermore,it postulates that the inter-century territorial dynamics covering the 19th and 20th centuries serve as an enduring legacy of identity for the 21st century.
基金supported by the Argentine Agency for the Promotion of Science and Technology ANPCyT(PICT2019-1472 to GP,PICT2019-4597 to FL,PICT2020-1524 to GP,and PICT2021-00627 to FL)supported by an Independent Career Position from CONICETsupported by a postdoctoral fellowship from ANPCyT。
文摘Stem cell proliferation is tightly regulated in developing and adult tissues through the coordinated action of cell-intrinsic and extracellular signals.Although many extracellular cues were identified,the cell-intrinsic mechanisms underlying the decision of a stem cell to proliferate,enter a dormant quiescent state or differentiate into a specific cell type remains incompletely understood.
文摘In the words of the late Sir Colin Blakemore,neurologists have historically sought to infer brain functions in a manner akin to to king a hammer to a computeranalyzing localized anatomical lesions caused by trauma,tumors,or strokes,noting deficits,and inferring what functions certain brain regions may be responsible for.This approach exemplifies a deletion heuristic,where the absence of a specific function reveals insights about the underlying structures or mechanisms responsible for it.By observing what is lost when a particular brain region is damaged,throughout the history of the field,neurologists have pieced together the intricate relationship between anatomy and function.
基金supported by grants PICT 2019-08512017-2203,UBACYT and PIP CONICET(to AJR).
文摘Traumatic brain injury is a global health crisis,causing significant death and disability worldwide.Neuroinflammation that follows traumatic brain injury has serious consequences for neuronal survival and cognitive impairments,with astrocytes involved in this response.Following traumatic brain injury,astrocytes rapidly become reactive,and astrogliosis propagates from the injury core to distant brain regions.Homeostatic astroglial proteins are downregulated near the traumatic brain injury core,while pro-inflammatory astroglial genes are overexpressed.This altered gene expression is considered a pathological remodeling of astrocytes that produces serious consequences for neuronal survival and cognitive recovery.In addition,glial scar formed by reactive astrocytes is initially necessary to limit immune cell infiltration,but in the long term impedes axonal reconnection and functional recovery.Current therapeutic strategies for traumatic brain injury are focused on preventing acute complications.Statins,cannabinoids,progesterone,beta-blockers,and cerebrolysin demonstrate neuroprotective benefits but most of them have not been studied in the context of astrocytes.In this review,we discuss the cell signaling pathways activated in reactive astrocytes following traumatic brain injury and we discuss some of the potential new strategies aimed to modulate astroglial responses in traumatic brain injury,especially using cell-targeted strategies with miRNAs or lncRNA,viral vectors,and repurposed drugs.
基金funded by the Science and Technology Plan for the Belt and Road Innovation Cooperation Project of Jiangsu Province,China(No.BZ2023003)the National Key Research and Development Program of China(No.2021YFD1500202)+2 种基金the Strategic Priority Research Program of Chinese Academy of Sciences(No.XDA28010100)the“14th Five-Year Plan”Self-Deployment Project of the Institute of Soil Science,Chinese Academy of Sciences(No.ISSAS2418)the National Natural Science Foundation of China(No.42107334)。
文摘Black soils represent only one-sixth of the global arable land area but play an important role in maintaining world food security due to their high fertility and gigantic potential for food production.With the ongoing intensification of agricultural practices and negative natural factors,black soils are confronting enhanced degradation.The holistic overview of black soil degradation and the underlying mechanisms for soil health improvement will be key for agricultural sustainability and food security.In this review,the current status and driving factors of soil degradation in the four major black soil regions of the world are summarized,and effective measures for black soil conservation are proposed.The Northeast Plain of China is the research hotspot with 41.5%of the published studies related to black soil degradation,despite its relatively short history of agricultural reclamation,followed by the East European Plain(28.3%),the Great Plains of North America(20.7%),and the Pampas of South American(7.9%).Among the main types of soil degradation,soil erosion and soil fertility decline(especially organic matter loss)have been reported as the most common problems,with 27.6%and 39.4%of the published studies,respectively.In addition to the natural influences of climate and topography,human activities have been reported to have great influences on the degradation of black soils globally.Unsustainable farming practices and excess in agrochemical applications are common factors reported to accelerate the degradation process and threaten the sustainable use of black soils.Global efforts for black soil conservation and utilization should focus on standardizing evaluation criteria including real-time monitoring and the measures of prevention and restoration for sustainable management.International cooperation in technology and policy is crucial for overcoming the challenges and thus achieving the protection,sustainable use,and management of global black soil resources.
基金supported by the Ministry of Science,Technology and Innovation of Argentina trough the project“Topografía,escurrimiento superficial y monitoreo de playas en el Partido de Villa Gesell,provincia de Buenos Aires”(Impact.AR N°106-RESOL-2022-224-APN-SACT#MCT)by the Nacional Council of Scientific and Technical Research(CONICET)through the project“Impactos de la reversión del nivel del mar en Buenos Aires,Argentina”(PIP 21/2311220200100041CO-RESOL-2021-1639-APN-DIR#CONICET)。
文摘Dune barrier systems represent highly sought-after coastal landscapes for tourism and urban development around the world.However,a century ago,they were considered hazardous environments due to their great dynamic nature.As a result,stabilization practices were considered necessary.The systematic introduction of fast-growing exotic trees helped stabilize the sand,making it easier for tourism urbanization to take place,but also leading to erosion processes.This paper aims to assess long-term changes in vegetation cover over a large temperate barrier in Argentina.This complex region includes urban resorts,afforestation zones,and protected areas.A GIS-based geospatial analysis was conducted using a large satellite database(>350 images),and the future evolution of the vegetation was modeled.The results revealed two primary spatiotemporal patterns associated with a gradual expansion of vegetation cover,accompanied by a concurrent reduction in sandy areas.In 1986,the dune area comprised 75%more surface than vegetation,whereas in 2021,it represented 60%less than vegetation.Furthermore,the 2050 scenario suggests a potential 40%reduction of dunes in certain areas.It is necessary to enhance management actions aimed at maintaining dune mobility and ensuring local and regional sediment balance.Long-term management strategies must focus on restoring native plant communities and controlling invasive species,and avoiding new dune fixation initiatives based on the introduction of exotic species.
基金Supported by Consejo Nacional de Investigaciones Científicas y Técnicas,No.PIP11220200103061COAgencia Nacional de promoción Científica y Tecnológica,No.PICT-2020-SERIEA-03440Universidad Nacional del Sur,No.PGI 24/B303 and No.PGI 24/ZB01.
文摘we critically review the authors’perspective and analyze the relevance of the results obtained in the original article of clinical research by Liu et al.We consider that additional factors associated with colon cancer progression have recently been described in extensive clinical research,and should be included in this analysis to achieve a more accurate prognosis.These factors include inflammation,gut microbiota composition,immune status and nutritional balance,as they influence the post-surgical survival profile of patients with stage II colorectal cancer.We also address the clinical implementation and limitations of these analyses.Evaluation of the patient´s entire context is essential for selection of the most appropriate therapy.
文摘The surgical approach for patellar instability usually refers to reconstruction of the medial patellofemoral ligament associated with an osteotomy of the tibial tuberosity or a trochleoplasty when required.The medial patellotibial ligament and the medial patellomeniscal ligament are secondary stabilizers of the patella.Despite this,both the medial patellotibial and patellofemoral ligaments aid in patellar rotation and tilt when the knee is flexed beyond 45°.The medial patellotibial ligament plays a particularly important role in the final stages of stretching in extension and between 40 degrees to 90 degrees of flexion.The clinical relevance and surgical indications for medial patellotibial ligament reconstruction associated with medial patellofemoral ligament reconstruction are still controversial.This editorial explores the surgical indications and clinical results for medial patellotibial ligament reconstruction to improve readers’understanding of this technique,especially because reported clinical outcomes have remained sparse.
文摘Cardio-cerebral coupling(CCC)refers to the dynamic interplay between cardiac function and cerebral blood flow,essential for maintaining hemodynamic stability.Disruptions in CCC are particularly relevant in critical care,where they can exacerbate primary and secondary brain injuries.Ultrasound-based techniques,including transcranial Doppler,transcranial color-coded Doppler,and echocardiography,provide non-invasive methods to assess this relationship at the bedside.This scoping review explores the pathophysiology of CCC,ultrasound methodologies for its evaluation,and its clinical relevance.Key mechanisms such as cerebral autoregulation and neurovascular coupling are discussed,along with ultrasound-derived parameters like pulsatility index,resistance index,and cerebral perfusion pressure.While ultrasound is a valuable tool,its limitations include operator dependency and equipment variability.Emerging evidence suggests that ultrasound-guided protocols,including ultrasound-guided cardio-cerebral resuscitation protocol and ultrasound-guided brain injury treatment protocol,may improve resuscitation strategies and neurocritical care monitoring.Despite its potential,further research is necessary to standardize assessment methods and integrate ultrasound-based CCC evaluation into routine clinical practice.Ongoing multicenter studies are expected to provide robust evidence supporting its clinical utility in managing brain-injured patients.
基金Supported by Takeda Argentina SA,No.TAK-633-4003.
文摘BACKGROUND Approval of teduglutide is an important addition to the limited treatment options for short bowel syndrome(SBS).However,real-world evidence on teduglutide therapy for SBS in Latin America is scarce.AIM To investigate the effectiveness and safety of teduglutide in clinical practice in Argentina with a 24-week follow-up.METHODS This non-interventional multicentre cohort study included consecutive patients(aged≥1 years)with SBS who were dependent on parenteral support(PS)and received≥1 dose of teduglutide according to currently approved indications.RESULTS The study population(n=45)included 21 adult and 24 pediatric patients.The proportion of adult and pediatric patients who showed clinical response(defined as a≥20%reduction in weekly PS volume)after 24 weeks of treatment was 90.4%[95%confidence interval(CI):69.6%-98.8%]and 83.3%(95%CI:62.6%-95.2%),respectively.Overall,12 patients(26.6%;95%CI:14.6-41.9)were weaned from PS support at the 24-week assessment,6(28.5%;95%CI:11.5-52.1)in the adult cohort,and 6(25%;95%CI:9.7-46.7)in the pediatric cohort.Only baseline PS requirement was inversely associated with weaning from PS(P=0.025).The most frequently reported treatmentemergent adverse events(TEAEs)were mild to moderate abdominal pain and abdominal distension(16.6%;and 9.5%,respectively).None of the reported TEAEs led to treatment discontinuation.CONCLUSION This prospective real-world study demonstrated the effectiveness and safety of teduglutide in adult and pediatric patients with SBS in Argentina.The clinical response observed in both adults and pediatric patients was greater than that reported in phase 3 trials and was consistent with the results of other real-world studies.
文摘Diaphragmatic function is central to respiration,and its evaluation is critical in intensive care unit(ICU)settings.Ultrasonography is a reliable bedside tool to assess diaphragmatic excursion(DE).[1,2]The conventional M-mode(MM)offers high-resolution imaging but requires precise alignment,which can be diffi cult in ICU patients.[3-5]Anatomical M-mode(AMM)allows flexible line adjustment,enabling accurate DE measurements despite poor acoustic windows.[6]However,comparative data between MM and AMM are limited.This retrospective study evaluated the concordance between MM and AMM for assessing right DE.
