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The final sample consisted of 44 subjects. According to spirometry and GOLD, 7 patients (15.9%) classified in group 1 (mild), 19 (43.2%) in group 2 (moderate), 11 (25%) in group 3 (severe) and 7 (15.9%) in group 4 (very serious). Of the 44 patients recruited, 28 (63.6%) had normal cognitive function and 16 (36.3%) had some degree of cognitive impairment. Memory was the most compromised function.

Difficulties in recruitment impeded reaching the expected sample size. However, a trend was observed favoring the association. It is important to insist on avoiding smoking because it seems to increase the risk of cognitive impairment that further disrupts the quality of life and makes treatment difficult.

Difficulties in recruitment impeded reaching the expected sample size. However, a trend was observed favoring the association. It is important to insist on avoiding smoking because it seems to increase the risk of cognitive impairment that further disrupts the quality of life and makes treatment difficult.

This study describes the knowledge and perceptions regarding colorectal cancer screening (CRC) in a population of teachers from primary and secondary schools in Carcarañá, Santa Fe. The proportion of participants who underwent the screening is described, as well as the facilitating factors and barriers that could affect test adherence.

An observational, descriptive and cross-sectional study was carried out through a self-administered survey of the population of teachers aged 50 or over from all primary and secondary schools in the city.

96 teachers, 87 women (90.6%) and 9 men (9.4%) were surveyed. Average age 53.2 ± 2.5 years. 66.7% knew about CRC screening. However, only 13.5% knew the recommended time to start performing these tests. 28.1% had adhered to some of the screening tests. 94.8% agreed that CRC has a greater chance of cure if it is discovered early, and 92.7% reported that screening is part of good health care. .

The positive perception regarding screening is not consistent with adherence to screening. Lack of knowledge, lack of information and medical indication are the most important barriers to adherence. The main facilitating factor was the existence of a family history of CRC. New research that addresses this issue would be necessary in order to develop strategies aimed at modifying these barriers and reducing mortality from this neoplasm

The positive perception regarding screening is not consistent with adherence to screening. Lack of knowledge, lack of information and medical indication are the most important barriers to adherence. Baf-A1 nmr The main facilitating factor was the existence of a family history of CRC. New research that addresses this issue would be necessary in order to develop strategies aimed at modifying these barriers and reducing mortality from this neoplasm

Alcohol use in college students and related consequences, such as risky sexual behaviors, are a public health issue. Impulsivity is relevant to study alcohol use behaviors. This study aimed to analyze the effect of trait impulsivity (UPPS-P model), age of onset of alcohol use (AOA) and of sexual intercourse (AOS), alcohol use and risky sexual behavior under the influence of alcohol (RSBA).

196 students (71.9% women, M age= 22.46; SD = 2.74) from the National University of Córdoba completed an online survey. We conducted bivariate and multivariate analyzes to examine the relationship between risk factors and RSBA.

AOA and AOS had a negative association with RSBA, while alcohol quantity and trait impulsivity was positively associated with RSBA. link2 At the multivariate level, AOA and alcohol quantity directly influenced RSBA. The AOS and sensation seeking had an indirect effect via alcohol quantity.

This results provide evidence on the role of early initiation in alcohol use, impulsivity and alcohol use on RSBA in college students. This information can be useful for the development of preventive programs specifically designed for this population.

This results provide evidence on the role of early initiation in alcohol use, impulsivity and alcohol use on RSBA in college students. This information can be useful for the development of preventive programs specifically designed for this population.

The study analyzes social and gender health realities regarding access to public health systems in the Argentine interior. Objective to analyze the relationship between social determinants, gender, with inequities of access in frequent users of the public health system in a region of Argentina.

Descriptive, cross-sectional and analytical study, data collected between March and November 2018 by maximum variation sampling, with analysis of absolute, relative frequencies, standard error, confidence intervals; Multivariate logistic regression analysis with 95% CI and statistical significance of p <0.05.

With an n = 345, in an adjusted model, being a woman increased the risk of having problems in accessing the health system 2.2 times more (p = 0.032). People with a primary education level or less are 2.4 times more at risk of paying values ​​equal to or greater than $ 71.4 for health care in the public health system compared to those with a higher educational level (p = 0.000). No statistically significant associations were found between urban / rural location, with the variables of inconveniences in access to health care and out-of-pocket spending.

Social inequities measured by level of education and gender have a negative impact on the scope of the right to universal access to health in the analyzed population. It is recommended to review state initiatives that seek to reduce health inequities from a perspective of social and gender determinants.

Social inequities measured by level of education and gender have a negative impact on the scope of the right to universal access to health in the analyzed population. It is recommended to review state initiatives that seek to reduce health inequities from a perspective of social and gender determinants.

Peptic ulcers are acid-induced lesions found in the stomach and duodenum. The prevalence of peptic ulcer disease in the United States is estimated to be 8.4%.

Describe an atypical presentation of complicated duodenal ulcer that causes jaundice and review the literature.

A 42-year-old male patient, who consulted for generalized jaundice and coluria, associated with low back pain treated with non-steroidal anti-inflammatory drugs. In the laboratory, total bilirubin increased to direct prevalence. A magnetic resonance cholangiography was performed that revealed duodenal thickening, with a decrease in its lumen; and a double contrast computed tomography, where thickening of the duodenal walls was observed, without oral contrast leakage. Subsequently, an upper digestive video-endoscopy was performed where a 30 mm duodenal bulb ulcer was observed. The patient presented good evolution with medical treatment, being discharged on the fifth day of hospitalization.

Jaundice can be caused by a duodenal ulcer that causes obstruction of the common bile duct. Medical treatment may specify in selected patients. In the present case, it was established to opt for medical treatment since the patient presented hemodynamic stability, without signs of generalized peritonitis, with complementary studies in favor of a contained duodenal ulcer without free air.

We are dealing with a case of duodenal ulcer complicated with jaundice that presented good evolution with medical treatment.

We are dealing with a case of duodenal ulcer complicated with jaundice that presented good evolution with medical treatment.

Neurologic involvement in hemolytic uremic syndrome related to Shiga toxin–producing Escherichia coli (STEC-HUS) is the main cause of death. In last years has been demonstrated that activation of complement alternative pathway also contributes to organ damage. This finding led to the recognition of decreased C3 levels at admission as a marker of poor prognosis as well as the evaluation of the use of eculizumab in cases with neurologic compromise.

to report a patient with STEC-HUS and hypocomplementemia with neurological involvement treated with eculizumab.

A 17-month-old male was admitted due to seizures and anuria for last 24 h with a history of 48 h of bloody diarrhea. He presented a laboratory profile compatible with STEC-HUS and severe hyponatremia, results of brain tomography were normal. Also there was complement activation C3 73 mg/dl (normal > 90 mg/dL) and C5b-9 778.9 ng/ml (normal 135.8-385.3 ng/ml). Initial treatment includes normal saline solution and anticonvulsants drugs, sodium correction and peritoneal dialysis. On third day of hospitalization, because of progression of the neurologic involvement a dose of eculizumab (300 mg) was given, showing at 24 h a markedly neurologic improvement along with and increasing platelet count and a descending lactic dehydrogenase levels. He was discharged after 14 days in a good condition. Later a STEC O157H7 infection was confirmed and he also normalized the C3 level.

This case shows that decreased C3 level at admission was associated to neurologic involvement and suggests that eculizumab might be a favorable therapeutic option.

This case shows that decreased C3 level at admission was associated to neurologic involvement and suggests that eculizumab might be a favorable therapeutic option.

Patient Blood Management (PBM) programs improve patient care and reduce health costs. It includes detection of presurgical anemia, reduction of blood loss and improvement of patient-specific anemic reserve. The aim of this study is to assess the effect of a PBM program on transfusion rate, length of stay (LOS) and adverse events.

We developed a retrospective observational study. We included patients who underwent total hip (THR) o knee replacement (TKR). Our PBM involved preoperative assessment, administration of 2 doses of tranexamic acid, application of restrictive transfusion criteria and use of IV iron. We compared results between the group of patients before and the one after the PBM implementation.

We included 179 patients (80 TKR and 99 THR) who underwent surgery before PBM implementation from January to December 2014 (Group A), and 187 patients (103 TKR and 84 THR) who underwent arthroplasty after PBM application from January to November 2016 (Group B). In Group A, hemoglobin drop was larger than in Group B, for TKR (5.1±1.2 vs. 4.2±1.2 g/dl; p<0,05) and for THR (4.7±1.3 vs. 3.8±1.3 g/dl; p<0,05). In group A, more patients were transfused (31.8% vs. 2.7%; p<0.001). LOS was longer for patients in group A, in both surgeries (for TKA, 3.98±1.4days vs. link3 2.99±0.95 days; p<0.0001; for THA 3.68±1.06days vs. 2.88±0.75days; p<0.0001). No significant differences were found regarding adverse events.

Our PBM program saved transfusions after primary TKR and THR and lowered LOS, without risking patients to higher number of complications or death.

Our PBM program saved transfusions after primary TKR and THR and lowered LOS, without risking patients to higher number of complications or death.

Intermittent chronic hypoxia produced during obstructive sleep apneas (OSA) leads to oxidative stress, and consequently to a state of systemic inflammation. There are no biomarkers that assess the degree of inflammation and are related to the severity of this disease. The red cell distribution amplitude and the ultrasensitive reactive C protein are sensitive to the systemic inflammation generated by oxidative stress. We intend to correlate the reactive C protein and red cell distribution amplitude values ​​with the degree of severity of OSA.

An observational, prospective, analytical study was performed. OSA patients participated. Spearman's correlation coefficient was used to estimate the correlation between red cell distribution amplitude and reactive C protein with OSA severity according to apnea hypopnea index (AHI).

95 patients participated, of which 79 were men. Only 10 (10.5%) patients presented normal BMI. The correlations between AHI with reactive C protein and red cell distribution amplitude were weak (r = 0.

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