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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Cranioencephalic traumatism (CET) is a serious public health problem worldwide. Advances in treatment have reduced mortality, increasing the demand for rehabilitation. The objective was to describe the demographic characteristics and functional outcomes in adult patients with traumatic brain injury (TBI) treated in a rehabilitation center. ⋯ In Argentina, patients admitted to rehabilitation for TBI are predominantly young men, the main cause being car accidents. The implementation of an early and intensive rehabilitation program has shown significant improvements in functional outcomes. At discharge, most patients required home supervision and assistance in daily activities.
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The prevalence of polycystic ovary syndrome (PCOS) in transgender and non-binary genders assigned female at birth (TMNBG) men is controversial. Our objectives were to investigate the prevalence, phenotypic characteristics of PCOS, and cardiometabolic risk of TMNBG with and without PCOS prior to hormone therapy. ⋯ PCOS appears to be prevalent among TMNBG. Transgender people with PCOS may exhibit an unfavorable cardiometabolic risk profile compared to those without PCOS, especially due to a higher BMI. It is necessary to evaluate the specific components of PCOS before starting hormonal therapy due to the long-term implications it could have.
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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.