South Health and Policy (Journal)
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Nutrition and probiotics in the care of older adults in Latin America
No full textPopulation ageing has posed a growing challenge for healthcare systems, especially in Latin America and Argentina. In this context, there has been an increase in the prevalence of chronic diseases and gastrointestinal disorders in older adults. Dietary interventions and the use of probiotics have gained relevance as strategies to improve intestinal health and quality of life in this group. Age-related physiological changes affecting gastrointestinal function were identified, and the role of a diet rich in fibre and certain probiotic strains in improving symptoms such as constipation and irritable bowel syndrome was highlighted. Health policies in Argentina began to incorporate these strategies, although challenges related to professional training and the need for more local scientific evidence persisted.
Fecal microbiota transplantation as an effective therapeutic alternative
No full textAntibiotic-associated diarrhoea was a common complication of antimicrobial treatment, mainly caused by an imbalance in the gut microbiota. Clostridioides difficile was identified as the most frequent causative agent, capable of triggering pseudomembranous colitis, especially in vulnerable patients. Given the high recurrence rates of conventional treatments, faecal microbiota transplantation was evaluated as an effective therapeutic alternative. This procedure involved transferring faecal material from a healthy donor to an affected recipient, achieving remarkable restoration of intestinal balance, reduced mortality, and significant clinical improvement. In addition to its efficacy, a favourable safety profile and reduced healthcare costs were documented, consolidating it as a key tool in the treatment of recurrent C. difficile infections
Learning needs of general practitioners in the management of acute myocardial infarction with ST segment elevation and pharmacological reperfusión strategies
No full textIntroduction: Ischemic heart disease is the leading cause of death worldwide. Initial management in primary care centers is associated with early recognition of the condition, as well as the implementation of immediate and effective therapeutic strategies. In this systematic review, the existing empirical evidence was gathered on the learning needs required by recently received general practitioners for the management of acute myocardial infarction with ST segment elevation and its respective pharmacological reperfusion strategy in the primary care of this pathology. Material and methods:A systematic review of more than 30 articles available from the literature was carried out, including the recommendations of national guidelines (Argentine Society of Cardiology), international guidelines (American Heart Association and European Society of Cardiology) as well as the most medical search engines. relevant for the management of AMI and its pharmacological reperfusion. Result: In this systematic review, deficits were revealed to include lack of recognition and adequate treatment of AMI symptoms, delays in care, deficiencies in ECG interpretation, and limitations in training in emergency procedures. Although there is a general understanding about the use of certain drugs (such as aspirin and beta- blockers), some physicians are unaware of treatment protocols, also identifying shortcomings in referral strategies and a limited availability of educational resources. Conclusión; The crucial role that primary care plays in the early identification and management of STEMI symptoms is highlighted. To improve primary care, it is suggested to train staff, implement standardized protocols, and use technology that facilitates diagnosis and treatment. It is essential that health policies prioritize primary care and promote the integration of services to address STEMI more effectively. There is great potential to improve care through collaboration between different sectors
Impact of the PIK3CA mutation on breast cancer
No full textBreast cancer was a health priority both globally and in Argentina, where it was the leading cause of death from tumours in women. Its molecular and genetic understanding has led to advances in diagnosis, prognosis and treatment. The luminal subtype, characterised by hormone receptors, and the PIK3CA gene mutation, involved in the PI3K/Akt/mTOR pathway, were highlighted as being associated with greater tumour aggressiveness and resistance to therapies. In Argentina, studies have shown a high prevalence of this mutation, prompting the use of targeted therapies such as Alpelisib. This personalised approach has improved the stratification and clinical management of the disease
Evaluation of the use of contrast agents in medical imaging
No full textAdvances in medical imaging techniques have significantly improved clinical diagnosis, and contrast agents have become essential tools in procedures such as computed tomography and magnetic resonance imaging. However, their use has been associated with significant risks, particularly contrast-induced nephropathy (CIN), which mainly affects patients with pre-existing renal or cardiovascular disease. The studies reviewed addressed the pathophysiological mechanisms of this complication, as well as the most effective prevention strategies, such as intravenous hydration and the use of agents with lower renal toxicity potential. The safety of iodinated and even gadolinium-based contrast agents was also analysed, highlighting that some compounds offered a safer profile. Despite advances, clinical controversies persisted, and the need for further research to optimise preventive management and ensure patient safety was emphasised
Relationship between endometriosis and infertility: systematic bibliographic review
No full textBackground: Endometriosis is a chronic condition affecting a significant percentage of women of reproductive age. It is associated with various complications, including infertility. This systematic review aims to analyze the relationship between endometriosis and infertility, addressing the underlying pathophysiological mechanisms and the impact of treatments. Material and methods: Searches were conducted in scientific databases, selecting 15 studies that met predefined criteria. Observational studies, systematic reviews, and meta-analyses were included. Data were organized to facilitate the comparison of results. Results: Findings indicate a significant association between endometriosis and infertility, with a probability of infertility ranging from 30% to 60% in diagnosed women. Hormonal, inflammatory, and oocyte quality alterations were identified as relevant pathophysiological mechanisms. Surgical treatments showed moderate benefits, though varying by case. Conclusion: Endometriosis is clearly related to infertility, emphasizing the importance of early diagnosis and appropriate management. Further research is needed to deepen the understanding of underlying mechanisms and improve treatment strategies.
Episiotomy: beneficial for the doctor, the woman, or neither? Comparison with vaginal tear based on the complications of the technique
No full textIntroduction: Episiotomy, a surgical incision in the perineum during vaginal delivery, has been used with the goal of reducing high-grade tears. However, currently its routine use has led to reconsidering the benefits of this technique, since it can lead to complications that, in some cases, can be avoided. On the other hand, vaginal tear is not always high grade and is not a necessary condition in a vaginal birth, so the deliberate use of episiotomy is not justified, which can, in the end, have more complications than what it is intended to avoid. Objectives: To analyze the complications of episiotomy compared to those of perineal tear. Material and methods: systematic review of articles published in the last 4 years
Relationship of dysbiosis with autism spectrum Disorder
No full textIntroduction: Autism Spectrum Disorder (ASD) encompasses neurological development disorders present from birth. According to the Diagnostic and Statistical Manual of Mental Disorders DSM-5, this neuropsychiatric condition manifests itself in two main areas, persistent deficits in social communication and interaction in multiple contexts (verbal or non-verbal languages and socio- emotional reciprocity) as well as restrictive patterns and repetitive behavior, interests or activities. A recent line of research on autism has focused on the microbiota-gut-brain axis. Alteration of the gut microbiota or Dysbiosis has been implicated in neurodevelopmental behavioral changes and gastrointestinal problems in patients with autism spectrum disorder (ASD).Materials and methods: To carry out this review, a bibliographic search of scientific articles in computerized databases such as Pubmed and Scielo was used.Conclusion: Various studies have found that children with ASD present significant differences in the intestinal microbiota compared to neurotypical children. These differences not only seem to influence gastrointestinal symptoms, common in people with ASD, but also behavioral ones.
Clinical implications of dysbiosis in Autism Spectrum Disorder
No full textAutism Spectrum Disorder (ASD) has been addressed as a challenge in the field of neurodevelopment due to its clinical and etiological complexity. In recent years, interest in non-traditional factors, such as the gut microbiota, has intensified, with its influence on the microbiota-gut-brain axis being the subject of multiple studies. Microbial alterations have been documented in people with ASD, which have been linked to gastrointestinal and behavioural symptoms. Therapies such as probiotics, specific diets and faecal transfer have also been explored, showing clinical improvements in some cases. However, the causal relationship between dysbiosis and ASD remained under debate, highlighting the need for more rigorous studies to understand this complex interaction
Oral manifestations of HIV: analysis of oropharyngeal candidiasis as an immunological marker
No full textOropharyngeal candidiasis (OPC) is a highly prevalent fungal infection in immunosuppressed patients, especially those infected with human immunodeficiency virus (HIV). Candida albicans has been described as the main etiological agent, capable of changing its morphology to facilitate invasion of the oral mucosa. The onset of OP was found to be closely related to low CD4+ lymphocyte levels and was recognised as an early marker of progression to AIDS. In addition, the different clinical manifestations of OP and its higher frequency in patients not receiving effective antiretroviral therapy were analysed. The research concluded that early diagnosis, immunological monitoring, and appropriate antifungal therapy were essential for improving the quality of life of HIV-positive patients. Despite advances in antiretroviral therapy, oropharyngeal candidiasis persisted as a relevant infection, especially in resource-limited settings