The Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (Military Central Hospital Chief Surgeon Dr. Cosme Argerich) also known as Hospital Militar Central (Military Central Hospital) is a hospital owned by the Argentine Army in the city of Buenos Aires, Argentina for the use of military personnel and their families..
Background:Early-onset colorectal cancer (EOCRC) is increasing worldwide and now accounts for a growing share of cancer deaths in younger adults. Data from middle- and low-income regions are scarce. We aimed to characterize the incidence, tumor stage distribution, lymph node positivity and metastasis patterns of EOCRC in Argentina. Methods:In this retrospective, multicenter cohort study, we analyzed adult patients who underwent colorectal cancer surgery between April 2022 and December 2023. The registry included 1829 patients, of whom 961 were male (52.5%) and 868 were female (47.5%). Mean age was 41.6 years (range 18-49) in the EOCRC group and 68.8 years (range 50-98) in the late-onset colorectal cancer (LOCRC) group. Descriptive statistics were used to summarize patient and tumor characteristics. Comparisons between EOCRC (<50 years) and LOCRC (≥50 years) were performed using χ2 tests. Ethnicity data were not available. Findings:EOCRC accounted for 15.4% of surgically treated cases, with over two-thirds occurring among individuals aged 40-49 years. Compared with LOCRC, EOCRC patients more frequently presented with advanced tumor stages (T3-T4), higher lymph node positivity, and a greater prevalence of metastases. Tumor location differed between groups, with EOCRC predominating in the rectum and LOCRC showing a right-sided predominance. Interpretation:This national multicenter surgical registry analysis reveals substantial differences in stage and metastatic burden between younger and older colorectal cancer patients in Argentina. The high prevalence of advanced disease among individuals aged 40-49 years supports consideration of earlier initiation of colorectal cancer screening. Funding:The Universidad Abierta Interamericana provided partial funding for the publication of this work.
Hydrocephalus is one of the most common brain disorders in pediatric patients. It is a highly complex condition and a leading cause of neurological sequelae, primally resulting from prematurity, intraventricular hemorrhage, or infections. We present the case of a 5-month-old male with a medical history of emergency cesarean delivery at 31.5 weeks due to preeclampsia, who developed grade IV intraventricular hemorrhage with secondary obstructive hydrocephalus and multicystic encephalomalacia. Initial management with a ventriculoperitoneal shunt was complicated by malposition of the proximal ventricular catheter. The patient subsequently underwent a neuroendoscopic procedure, which included third ventriculostomy, septal fenestration. We also performed an endoscopic repositioning of the proximal catheter. This endoscopic maneuver successfully avoided a more invasive procedure for removal and complete replacement of a new shunt system.
Background: Diagnosis and treatment of systemic lupus erythematosus (SLE) are often delayed in Latin America due to barriers at the patient, provider, and health care system levels. Methods: This qualitative study, conducted in 16 countries, explored the experiences and recommendations of persons with SLE and rheumatologists to identify key needs and strategies to improve care. Semistructured interviews and focus groups were analyzed thematically. Results: Six main themes emerged: (1) education and training, (2) access to specialized care, (3) health care system organization, (4) awareness, (5) patient organizations, and (6) research. Participants underscored the need to strengthen professional competencies, decentralize care, reduce administrative barriers, and raise awareness among decision-makers and society. Conclusions: The perspectives of persons with SLE and rheumatologists converge on the urgent need for coordinated, equitable, and patient- and caregiver-centered approaches to SLE care. Implementing these recommendations—through improved education, health care system reform, advocacy, and research—could substantially reduce diagnostic and treatment delays and improve outcomes for people living with SLE in Latin America.
This study employs a multilayer network approach to analyze the spatial and temporal patterns of suicide and depression across Mexican municipalities from 2015 to 2020. Using a panel dataset of mental health cases, substance use, and healthcare infrastructure, we constructed a multilayer graph based on cosine similarity. The Infomap clustering algorithm was then applied to identify communities of municipalities with similar mental health profiles. Our results reveal five distinct clusters with significant variations in the levels and temporal dynamics of the analyzed indicators. Notably, two clusters consistently exhibited higher rates of substance use and adverse mental health outcomes. These findings demonstrate the efficacy of network-based methods for identifying at-riskmunicipal groupings, thereby informing targeted public health interventions.
This Pituitary Society Consensus article presents an evidence-based consensus on the management of pituitary incidentaloma, defined as an unexpected sellar or parasellar finding incidentally discovered on an imaging study that was not performed for a clinically suspected pituitary lesion. Recommendations are offered for when endocrinology, neurosurgery and ophthalmology consultation, dedicated pituitary imaging, pituitary hormone testing and visual assessment are warranted for macroadenomas, microadenomas, cystic lesions and empty sella, as well as when surgical resection is indicated for incidental pituitary adenomas and cystic sellar lesions. Special considerations in patients with multiple endocrine neoplasia type 1, children and adolescents, older people, and pregnant women are addressed. The Consensus workshop concluded that diagnostic and management approaches should be individualized to the specific clinical context of an incidentally discovered pituitary lesion. Consultation with a multidisciplinary pituitary tumour centre of excellence should be considered in the presence of new or deteriorating lesion-specific signs or symptoms, particularly when surgical or other adjuvant interventions are being considered and when there is uncertainty about the most appropriate subsequent management. This international Consensus Statement provides guidelines on the management of pituitary incidentalomas.
