Depression is one of the most prevalent psychological disorders and the leading cause of disability worldwide. The development of effective strategies for the prevention and treatment of depression requires valid and reliable instruments capable of accurately assessing this condition. The present study examined the internal structure and measurement invariance of the Patient Health Questionnaire–9 (PHQ-9) in an Argentine population. Several measurement models proposed in the international literature were tested in a large Argentine sample (N = 5,950), comprising three independent subsamples: an online sample (n = 4,803), a clinical sample of individuals seeking psychological assistance (n = 98), and a random telephone sample (n = 1,049). PHQ-9 item responses were analyzed using Confirmatory Factor Analysis (CFA) and Exploratory Structural Equation Modeling (ESEM). In addition, measurement invariance was evaluated across gender, age groups, and administration formats. The unidimensional model demonstrated good fit across most indices. Although two-factor models showed marginal improvements in fit, correlations between latent factors were consistently high (> 0.80). ESEM analyses indicated that these high correlations were not attributable to estimation bias arising from restrictive CFA specifications, further supporting a unidimensional structure. Moreover, the unidimensional model exhibited measurement invariance across gender, age groups, and administration formats. The findings support the use of the PHQ-9 to derive a global measure (e.g., sum score) of depressive symptom severity in the Argentine population, without systematic bias associated with demographic characteristics or mode of data collection. Further studies are warranted to replicate these results and extend validity evidence.
BACKGROUND:Dextrocardia with situs inversus totalis is a rare congenital anomaly that complicates diagnosis and percutaneous coronary intervention (PCI) for acute coronary syndromes due to mirror-image anatomy. CASE SUMMARY:A 50-year-old man with situs inversus totalis presented with severe angina, syncope, and markedly elevated troponin (non-ST-segment elevation myocardial infarction). Initial electrocardiogram (ECG) showed right axis deviation and atypical R-wave progression. Lead reversal confirmed ischemic changes. Coronary angiography revealed complete right coronary artery occlusion and multivessel disease. The right coronary artery was successfully revascularized, achieving TIMI flow grade 3. DISCUSSION:This case illustrates the rare combination of acute coronary syndrome in a patient with situs inversus. It reinforces that standard myocardial infarction management protocols must be applied with necessary, specific anatomical adaptations in both ECG interpretation and PCI technique. TAKE-HOME MESSAGE:Accurate ECG interpretation in dextrocardia requires lead reversal, and successful PCI in situs inversus depends on adaptation of catheter selection and fluoroscopic imaging.
Uterine fibroids are the most common benign tumors of the female reproductive system and a frequent cause of abnormal uterine bleeding, pelvic pain, and reproductive morbidity in women of reproductive age. Their clinical management should be individualized according to symptoms, fibroid characteristics, comorbidities, and reproductive goals. A 33-year-old woman, gravida 5 para 4 with one prior abortion, with chronic hypertension controlled with candesartan and a history of multiple prior abdominal surgeries, including three cesarean sections and right oophorectomy, presented with persistent abnormal uterine bleeding refractory to medical therapy. Clinical and imaging evaluation revealed a solitary uterine fibroid and the absence of the right ovary. Endometrial biopsy showed secretory endometrium with focal irregular maturation and a minute fragment of squamous epithelium with koilocytic atypia, interpreted as likely cervical or vaginal contamination. After multidisciplinary assessment, total abdominal hysterectomy with wedge resection of a hemorrhagic cyst in the left ovary and uterosacral ligament suspension following the principles of McCall culdoplasty was performed. The procedure was completed without complications, with minimal blood loss. The postoperative course was uneventful, and the patient was discharged on the second postoperative day. Histopathological analysis confirmed intramural leiomyomas, benign hemorrhagic cyst, chronic nonspecific cervicitis, and irregular endometrial maturation without malignancy. This case illustrates the complexity of managing persistent abnormal uterine bleeding in a young woman with multiple prior abdominal surgeries, unilateral oophorectomy, and chronic hypertension. Although conservative options may be considered in selected patients, the combination of refractory symptoms, surgical history, and the need to preserve ovarian function supported a definitive surgical approach. Open abdominal hysterectomy allowed safe and controlled management, while partial preservation of the remaining ovary helped maintain endocrine function and reduce the risk of premature menopause. Total abdominal hysterectomy with partial ovarian preservation can be a safe and definitive option in young women with persistent abnormal uterine bleeding, uterine fibroids, prior abdominal surgeries, and associated risk factors. This case underscores the value of individualized surgical planning and multidisciplinary decision-making to achieve favorable outcomes.
Despite advances in digital implant planning, biological and prosthetic complications remain difficult to anticipate prior to implant placement because conventional workflows largely rely on static anatomical information. This narrative review examines whether emerging computational technologies, including artificial intelligence, Digital Twins, radiomics and deep learning, can support predictive, patient-specific planning and the preoperative estimation of implant complications. Literature published within the last five years was retrieved from PubMed, Embase and Web of Science and evidence from clinical, computational, experimental, imaging-based and systematic review sources was synthesized. For biological outcomes, models built on integrated patient data perform well, with reported accuracies up to 94.5% and areas under the curve above 0.90 for implant survival, peri-implantitis, marginal bone remodeling and osseointegration; however, external validation is limited and prosthetic complication prediction remains comparatively underdeveloped. Digital Twins provide a dynamic framework that integrates anatomical, functional and biomechanical data to support risk assessment and treatment simulation, while radiomics and deep learning convert CBCT into quantitative bone-quality biomarkers. Current evidence indicates that artificial intelligence cannot yet predict implant failure with certainty before placement, but it can meaningfully enhance risk assessment and advance personalized, predictive implant dentistry.
