Medicina
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Observational Study
[Teledermatology during de COVID-19 pandemic in a public hospital].
Telemedicine refers to the use of information and communication technologies to provide health care. Dermatology is particularly suited for this virtual modality. The COVID-19 pandemic significantly increased the use of telemedicine worldwide which has demonstrated to be useful in promoting social distancing and in avoiding the overload of the healthcare system. ⋯ Most of the consultations were follow-up's and in a lower percentage, due to reactivation of the underlying disease or another reason. Patients who completed the survey reported not having difficulties and were able to resolve their consultations through virtual care. Doctors involved in this study were totally satisfied with the experience and they felt that teledermatology was a valid resource to continue with their medical training and would choose to use it in the near future.
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Critical asthma syndrome is a life-threatening medical condition that can lead to irreversible hypoxia or cardiorespiratory arrest. Invasive mechanical ventilation is one of the therapeutic pillars, however, it can also develop ventilator-induced lung injury. For this reason, the use of extracorporeal membrane oxygenation (ECMO) could be an additional strategy to improve gas exchange and reduce damage induced by mechanical ventilation. We present the case of a patient with critical asthma syndrome who required ECMO due to severe barotrauma.
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[Cryobiopsy in interstitial lung disease: a real-life experience from a single center in Argentina].
Cryobiopsy in interstitial lung disease: a real-life experience from a single center in Argentina. Transbronchial lung cryobiopsy (TBLC) has been recently introduced for the histological assessment of interstitial lung diseases. The objectives were to assess the diagnostic yield and safety of TBLC for interstitial lung diseases in our setting. ⋯ A 73.1% and 84.5% diagnostic yield was recorded through histology and added multidisciplinary evaluation respectively. The number of samples was associated to the diagnostic yield in a multivariate analysis (OR 2.15 - CI95% 1.16- 3.99). TBLC appears to be safe and effective for the assessment of interstitial lung diseases in a real life setting when applied in a center with access to multidisciplinary evaluation.
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Observational Study
[Clinical and demographic aspects of secondary progressive multiple sclerosis in Argentina].
The objective of the study was to describe the clinical and demographic aspects of patients with secondary progressive multiple sclerosis (SPMS) included in the Argentine MS Registry (RelevarEM, Clinical Trials registry number 03375177). RelevarEM is a longitudinal, strictly observational registry of patients with MS and neuromyelitis optica spectrum disorders. ⋯ In SPMS, the median age was 53 (inter quartile range [IQR] 47-62) years, 67% were women, median disease duration of 19.5 (IQR 14-26) years, median EDSS (expanded disability status scale) 6.5 and 48.3% were under treatment for their MS. Only 23.7% of patients with SPMS were actively working and 86% had a disability certificate; 35.6% of patients with SPMS presented new lesions in MRI and 5% had clinical relapses during the past 12 months of the registry entry showing a significantly lower disease activity compared with RRMS (p < 0.01).
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The COVID-19 pandemic declared in March 2020, has generated worldwide concern due to its effect on the health of the population and the potential health collapse. The strategy of "flattening the curve" through social distancing made it possible to adapt the resources of the health system to patients with COVID-19, but results in other areas of health could not be predicted. The objective of this work was to analyze the consequences of the pandemic on liver transplantation in general and for hepatocarcinoma (HCC). ⋯ The number of surgeries, hepato-bilio-pancreatic, resection of HCC and liver transplantation, were reduced by 47%, 49%, 31% and 36% respectively. The reduction in transplant activity mainly affected centers with high occupancy due to COVID-19. The final long-term outcome will need to be assessed.