El síndrome metabólico (SM) es una entidad compuesta por diversas alteraciones que confieren un aumento del riesgo cardiovascular y de diabetes a largo plazo. Sus características en pacientes con síndromes coronarios agudos (SCA) son prácticamente desconocidas. ObjetivosDeterminar la prevalencia, las características y el valor pronóstico del síndrome metabólico (SM) en los síndromes coronarios agudos (SCA). Evaluar su correlación con los factores de riesgo coronario (FRC) y los hábitos dietéticos y analizar una nueva definición recientemente propuesta. Material y métodosSe incluyeron pacientes consecutivos ingresados en Unidad Coronaria con infarto agudo de miocardio o angina inestable. Se diagnosticó SM en base a los criterios del NCEP-ATP III. La nueva definición analizada fue la propuesta por la International Diabetes Federation. ResultadosSe incluyeron en el estudio 239 pacientes. El SM estuvo presente en el 53,3 % de los casos y fue más frecuente en las mujeres (OR 2,53; IC 95%: 1,24-5,18) (p = 0,005). No presentó correlación significativa con el pronóstico hospitalario ni con los hábitos dietéticos. Su prevalencia según la nueva definición fue casi idéntica (53%) y si bien tuvo valor pronóstico en el análisis univariado, no lo conservó en el multivariado. ConclusionesLa prevalencia del SM en los SCA es más elevada que la informada para otras poblaciones. No parece tener valor pronóstico a corto plazo. La nueva definición no modificó su prevalencia ni agregó información pronóstica independiente.
Resumen es: Los diferentes modelos de protesis valvulares mecanicas son numerosos y su reconocimiento por ecocardiografia es dificil. La cinefluoroscopia (CF) puede ...
Interleukin-23 inhibitors (IL-23i) are effective in psoriatic arthritis (PsA) in randomized trials; however, real-world data from Latin America remain limited. We described baseline characteristics and treatment line at IL-23i initiation, physician-reported reasons for selecting IL-23 inhibition, and pragmatic effectiveness and persistence at 6 and 12 months in Argentina. Multicenter, observational, retrospective cohort study across seven Argentine sites. Adults with rheumatologist-diagnosed PsA initiating IL-23i (guselkumab or risankizumab) in routine care were included. Baseline demographics, disease duration, domains, key activity measures, prior advanced therapy lines, and physician-reported rationale were abstracted from records. Patients were assessed at 6 and 12 months. Primary outcome was physician-recorded minimal disease activity (MDA); persistence was remaining on IL-23i. Analyses were descriptive, with no inferential/predictive analyses due to sample size. Fifty-five patients were included (48
Laparoscopic cholecystectomy is the gold standard for treating symptomatic gallstones. Despite established safety strategies, variability in their adoption leads to inconsistent outcomes. Artificial intelligence (AI) offers potential for real-time recognition of procedural stages, contributing to surgical standardization and safety. A prospective observational study was conducted between February 2023 and March 2024. Patients undergoing laparoscopic cholecystectomy for symptomatic gallstones or class 1 cholecystitis (Tokyo classification) were included. From 141 surgical videos, 131 were used to extract 1,841 annotated images representing seven predefined stages: cavity entry, port placement, gallbladder traction, dissection, clipping and sectioning, specimen removal, and final checking. A ResNet-50 neural network was trained and validated using a 90/10 split. Performance was evaluated on 10 unseen videos and tested live in 10 surgeries, comparing AI stage detection with expert surgical judgment. Validation accuracy ranged from 80.15 to 91.74%. In live testing, the system achieved 100% agreement with expert surgeons. The dissection phase was consistently the longest. Real-time processing speed ranged from 1 to 2 frames per second. AI-based recognition of laparoscopic cholecystectomy stages is feasible and demonstrates high concordance with expert evaluation. This approach may support procedural standardization and improve intraoperative decision-making. Further multicenter validation is recommended.
