Medicina
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The respiratory tract, from the nose to the lung, behaves as an anatomical and pathophysiological unit under a holistic model. Lower airway abnormalities, such as bronchial hyperresponsiveness, reduced lung function and inflammation of the bronchial mucosa without clinical expression, have been observed in patients with rhinitis without asthma. ⋯ For unknown reasons, these patients do not exhibit a full clinical expression, which could mean an increased risk of developing asthma. In this review we address the frequency and characteristics of existing pulmonary abnormalities in children and adolescents with chronic rhinitis that derive from our previous research and, more recently, within the project "Allergic Respiratory Disease: The United Airway Concept" supported by the Universidad Católica de Córdoba, and a comparative analysis with the evidence provided by other authors in the medical literature.
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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. ⋯ Incorporating the reassessment of allergies and improving the prescription of antibiotics in this group of patients reduces the generation and spread of multi-resistant germs, and the associated costs. There are simple methods and specific scores that simplify allergy reassessment. The objective of this review is to expose how, through these methods, the delabeling of patients erroneously labeled as allergic and the safe prescription of β-lactam antibiotics can be achieved.
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Reports of excess mortality during the COVID-19 pandemic in Argentina have been partial and fragmented so far. This study aimed to quantify excess deaths and explore their demographic, temporal, and geographic distribution during the period 2020-2022. Using data from 1 192 963 death records from vital statistics and population projections, expected mortality was estimated using regression models. ⋯ Significant heterogeneity was found among the different argentine provinces. The results indicate an uneven impact of the pandemic, with higher excess mortality rates in some regions and more vulnerable age groups. These patterns suggest the need for differentiated strategies of healthcare response and support to the most vulnerable populations in scenarios of new epidemics.
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A new dengue vaccine has recently been licensed in Argentina, with the Argentine government planning to acquire it in order to develop a vaccination strategy. As the disease is gradually following a path to endemicity in some regions of the country, the incorporation of these vaccines will have the potential to tackle the growing incidence of the disease and to reduce the disease burden. However, the establishment of the vaccination programme may also be susceptible of threats related to the epidemiological shift of the disease. ⋯ Furthermore, the perception of protection following vaccine introduction in one jurisdiction may reduce adherence to vector control activities, increasing the risk of virus introduction and transmission in other areas not prioritised by the vaccination strategy, and the risk of other arboviral diseases such as Zika and chikungunya fever. These and other potential limitations to be considered prior to the implementation of vaccination programmes are discussed in this article, with a series of recommendations on how to address these concerns. These recommendations can help decision makers and public health practitioners at this early stage of the vaccination programme development.
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Multicenter Study
[Argentinean registry on the management of Helicobacter pylori infection: effectiveness and safety of first line treatment].
The optimal management of Helicobacter pylori (H pylori) infection remains unclear. Updated information concerning local data is needed to design the best strategy to treat H. pylori infection to reach high eradication rates. The Argentinean Registry (Hp-ArgReg) on H. pylori management was launched to monitor the eradication practices of gastroenterologists. The objective was to assess the effectiveness and safety of firstline H. pylori treatment in Argentina. ⋯ in Argentina, Quadruple therapies with or without bismuth and sequential therapy with zinc showed an H. pylori eradication effectiveness of over 90% in real clinical practice. Local Registries for H pylori management could help to control the spread of antibiotic resistance.