Medicina
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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.
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In Argentina, dengue is an emerging health problem, with high morbidity during epidemic periods, which generates a significant burden on the population. Despite the efforts that have been made to control it, the disease has managed to spread rapidly due to the favorable conditions for its development. Faced with this situation, there is a need, in a private outpatient care center, for adequate control and clinical management of dengue cases, which is why the objective of carrying out a SWOT analysis (strengths, opportunities, weaknesses and threats) was established to develop a model that improves operational-care results. ⋯ The results include trained personnel, the possibility of early diagnosis and timely control generated from spontaneous demand, which is why we determined that the institution has the capacity to respond to outbreaks, epidemics and pandemics. This analysis presents a strengthening activity between different areas through a comprehensive approach and the identification of new cases, which can respond to the needs of the population with dengue. By this means, valid and reliable information is provided for the approach and strategy of possible new outbreaks.
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The clinical reasoning process for decision-making in medicine is complex and involves multiple factors, including diagnostic probabilities, study characteristics, costs, and patient preferences. This article highlights the role of pre-test probability in calculating the positive predictive value (PPV) and negative predictive value (NPV) of diagnostic tests and also likelihood ratios. ⋯ The notion of treatment and diagnostic thresholds is introduced, emphasizing their impact on medical decision-making. Finally, it underscores that diagnostic tests should only be requested if their results can change clinical management, promoting a rational and cost-effective approach to medical practice.