Introduction: In Argentina, the influenza and pneumococcal disease mortality rate has increa-sed in recent years. Objective: the objective of this sub-analysis of the Inter-American Registry of Influenza and Pneumococcal Disease Vaccination (CorVacc) is to determine vaccination rates and analyze the factors that influence them in Argentina. Materials and methods: A cross-sectional survey of the general population was conducted in 19 Latin American countries. Adults over 18 years of age completed a 34-question online survey. The data were grouped into seven categories: demographic, socioeconomic, and vaccination profile.Results: 2,128 responses out of 21,389 were obtained from Argentina; 61% (n = 1,349) of the participants were female, and the mean age was 46.59 +/- 15.88 years; 58.23% of the sam-ple received annual influenza vaccination, 49.67% received the pneumococcal disease vaccine, and 88.33% received at least three doses of the COVID-19 vaccine. Low educational attainment and poor confidence on vaccines were the main barriers to vaccination. Older individuals and healthcare professionals received vaccines more frequently. Conclusions: the vaccination rate in Argentina is lower than that recommended by ministerial authorities and medical practice guidelines. The Inter-American Registry of Influenza and Pneumo-coccal Disease Vaccination (CorVacc) identified some of the implementation barriers. Public health authorities and health funders will be able to use this information to design their action plans.
Historically, individuals with hypertrophic cardiomyopathy (HCM) have been excluded from vigorous exercise and competitive sports due to the risk of sudden cardiac death (SCD), based on retrospective studies. Recent evidence has challenged this paradigm, demonstrating improvements in functional capacity, quality of life, cardiovascular and psychological health when competitive sports are included in low-risk individuals. For those who do not meet these criteria, the evidence is more limited. However, participation in competitive sports can still be considered on an individual basis. A contemporary approach to HCM should be based on individualized, goal-oriented exercise prescription, multidisciplinary intervention, and shared decision-making. In this review, we critically appraise the evidence on vigorous exercise and competitive sports and explore how new data are reshaping clinical practice and international guidelines, laying the groundwork for a new paradigm in the field.
INTRODUCTION:Surgical training in urology has undergone significant transformation due to the increasing complexity of procedures and the integration of advanced technologies. Simulation-based education is recognized as a fundamental component of residency programs. This study aimed to evaluate the current status of surgical training and the availability of simulation resources for urology residents and early-career urologists in the countries represented by the American Confederation of Urology. METHODS:A descriptive, cross-sectional survey was conducted with 402 participants from 19 countries. The questionnaire included multiple-choice questions addressing demographics, access to surgical procedures, simulation tools, evaluation methods, mentorship, and the impact of the COVID-19 pandemic. RESULTS:The study revealed significant heterogeneity in surgical training. Only 17.9% had access to robotic surgery and 32.8% to prostate enucleation. Over 80% reported the absence of virtual or wet labs at their institutions. Training was based on step-by-step instruction (89.9%), in laparoscopic (45%) and endoscopic (50.7%). However, 15.7% used simulators during surgical procedures. Additionally, 50.6% reported the absence of formal assessment or mentorship. Fellowship training was considered in 84.7%. The COVID-19 pandemic negatively impacted academic (50.3%) and surgical (66.9%) training. CONCLUSIONS:The findings highlight considerable variability in surgical training, limited access to simulation resources, and a general absence of standardized evaluation and mentorship systems. These results emphasize the need to implement structured and equitable training that incorporate simulation, these offer a safe and effective environment for developing surgical skills.
The Grupo Argentino de Tratamiento de la Leucemia Aguda (GATLA) LH-05 trial evaluated positron emission tomography-computed tomography (PET-CT)-guided ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) in patients with stage I-IV classic Hodgkin lymphoma (cHL). A total of 563 patients with cHL stages I-IV were included in the prospective, non-randomized GATLA LH-05 trial. Patients received three cycles of ABVD followed by PET-CT (PET3). Patients with PET3 Deauville score (DS) 1-2 discontinued treatment, DS 3-4 completed six ABVD with involved-field radiotherapy (IFRT) and DS 5 received salvage chemotherapy. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Prognostic factors for PFS were assessed using Cox regression. After a median follow-up of 93.5 months Interquartile Range (IQR) 54-139, 5- and 10-year PFS for the whole cohort were 78.9% 95% Confidence Interval (CI) 75.5-82.6 and 76.2% (95% CI 72.4-80.2) respectively. Five- and 10-year OS were 95.2% (95% CI 93.3-97.0) and 93.7% (95% CI 91.5-96.0). All PET3-negative patients achieved 10-year PFS of 84.4%. PET3 was the strongest predictor of PFS, while disease stage had no independent prognostic significance. With extended follow-up, PET-CT-adapted therapy after three cycles of ABVD provides durable disease control while reducing exposure to chemotherapy and radiotherapy. These results support PET-CT-guided treatment discontinuation in PET3-negative patients across all stages of cHL.
El herpes zóster (HZ) representa una complicación relevante en pacientes con enfermedades reumáticas inflamatorias crónicas autoinmunes (ERICA), especialmente en aquellos tratados con glucocorticoides, terapias biológicas e inhibidores de JAK. Este trabajo revisa la evidencia actual sobre el riesgo, impacto clínico y prevención del HZ en esta población vulnerable. Los estudios analizados muestran que la vacuna recombinante contra herpes zóster (RZV) es eficaz y segura, reduciendo significativamente la incidencia de HZ y sus complicaciones, incluso en pacientes inmunocomprometidos. Sin embargo, las tasas de vacunación continúan siendo bajas debido a barreras de acceso, falta de indicación médica y escasa percepción del riesgo. Se destaca la necesidad de fortalecer la educación médica, promover estrategias de vacunación y desarrollar recomendaciones prácticas que permitan optimizar la prevención del HZ y mejorar la calidad de vida de los pacientes con ERICA.
