Anales de la Facultad de Medicina, Universidad de la República, Uruguay http://www.anfamed.edu.uy/index.php/rev <p>Anales de la Facultad de Medicina, AnFaMed, es una publicación semestral, arbitrada, en línea, que publica artículos científicos, de revisión y de opinión, reportes de caso, relatos o reportajes sobre temas de las ciencias biomédicas y de la salud, producida por la Facultad de Medicina de la Universidad de la República (Uruguay).</p> <p>Su objetivo es contribuir y dinamizar el campo de publicaciones académicas biomédicas a nivel mundial, publicando artículos originales de investigación y ejercicio profesional en medicina y profesiones afines, además de artículos varios, como revisiones u otros, orientados al mejoramiento de la salud pública y a facilitar la comunicación de conocimientos y experiencias entre docentes, estudiantes y profesionales.</p> <p style="font-family: 'Arial','sans-serif'; text-align: justify;">A los interesados en remitir artículos, les agradecemos enviar su contribución original&nbsp;<span style="font-family: Verdana, Arial, Helvetica, sans-serif;">adaptada a las&nbsp;</span><strong style="font-family: Verdana, Arial, Helvetica, sans-serif;"><a href="/index.php/rev/about/submissions#authorGuidelines" target="_blank" rel="noopener">Normas Editoriales</a>,&nbsp;</strong><span style="font-family: Arial, sans-serif;">al correo:&nbsp; &nbsp;</span><strong style="font-family: Arial, sans-serif;">anfamedudelar@gmail.com</strong></p> Facultad de Medicina, Universidad de la República, Uruguay. es-ES Anales de la Facultad de Medicina, Universidad de la República, Uruguay 2301-1254 <!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:TrackMoves/> <w:TrackFormatting/> <w:HyphenationZone>21</w:HyphenationZone> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> 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font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} </style> <![endif]--></p><p><a href="http://creativecommons.org/licenses/by/4.0/" rel="license"><img style="border-width: 0;" src="https://i.creativecommons.org/l/by/4.0/88x31.png" alt="Licencia Creative Commons" /></a> <a href="/index.php/rev/manager/setup/" target="_blank">Licencia Creative Commons Atribución 4.0 Internacional.</a></p><p align="left">Los lectores puede: leer, descargar, copiar, distribuir, imprimir, buscar o vincular a los textos completos de los artículos.</p> La incorporación de AnFaMed a Scientific Electronic Library Online (SciELO) y el compromiso con la visibilidad http://www.anfamed.edu.uy/index.php/rev/article/view/421 <p>Se nos ha conferido el grato cometido de dar apertura a una nueva entrega de nuestra revista AnFaMed.</p> <p>Como integrantes del Equipo Editorial, consideramos de interés revisar el proceso que ha vivido la publicación, que tanto contribuye con la Academia nacional y sus investigadores.</p> <p>Destacamos el avance marcado por la ampliación de la visibilidad, a nivel regional e internacional. Con la incorporación reciente (año 2017) a la base de datos SciELO, que posibilita la publicación y descarga gratuita, se ha desarrollado la comunicación e intercambio de los avances científicos.</p> Teresa Morelli Marcela Vázquez Rodríguez Derechos de autor 2019 Comité Editorial http://creativecommons.org/licenses/by/4.0 2019-11-26 2019-11-26 6 2 10.25184/anfamed2019v6n2a9 Rol de la información auditiva en el control motor del sistema del equilibrio en pacientes con implantes cocleares http://www.anfamed.edu.uy/index.php/rev/article/view/420 <p>Revisión de nuestros hallazgos experimentales sobre la relación entre audición y control motor del equilibrio en usuarios de implantes cocleares (UIC). Se realizó posturografía en 34 UIC en dos condiciones sensoriales:1- Implante encendido (ON). 2- Implante apagado (OFF)</p> <p>Se usó como medida el consumo de energía (CE) de la señal del centro de presión corporal. La marcha se analizó mediante la prueba de 10 m, implementada con: A - implante ON y ruido ambiental (EN), B - Implante ON, EN y Tarea dual cognitiva (DT) y C-implante OFF. Se registró la velocidad de marcha (GV) usando acelerómetros en los pies y la región retrosacra.</p> <p>Estadística: Se utilizaron las pruebas de Wilcoxon y Mann-Whitney y el nivel de significación fue p = 0.05. El análisis de la postura en la adolescencia mostró un ajuste adaptativo, disminuyendo la CE con el IC-ON.p = &lt; 0,05, mientras con el CI-OFF no hubo disminución p =&gt; 0,05. En adultos, CI- OFF tuvieron valores más altos de CE en edades mayores, mientras que el CE no se incrementó con la edad con el CI-ON. En la marcha, la GV con el implante ON en EN solo disminuyó en UIC solo en aquellos que estaban implantado después de los 3 años. La UIC implantada antes de esta edad mostró un comportamiento de la marcha similar en comparación con los sujetos con audición normal como control. La información auditiva interviene en la postura y el comportamiento motor de la marcha, hechos que se analizan en esta revisión.</p> Hamlet Suárez Enrique Ferreira Derechos de autor 2019 Hamlet Suárez, Enrique Ferreira http://creativecommons.org/licenses/by/4.0 2019-11-26 2019-11-26 6 2 10.25184/anfamed2019v6n2a10 Megacariopoyesis humana in vitro: http://www.anfamed.edu.uy/index.php/rev/article/view/376 <p>El estudio de la megacariopoyesis humana se ha visto obstaculizado por la relativa escasez de megacariocitos en la médula ósea (0,05-0,2 % de las células medulares), lo que ha llevado a la optimización de protocolos de expansión <em>in vitro </em>a partir de precursores de diversos orígenes (cordón umbilical, médula ósea y sangre periférica con o sin movilización previa). Los cultivos celulares a partir de precursores han permitido la producción y el estudio tanto de megacariocitos así como de proplaquetas y plaquetas Sin embargo, la producción <em>in </em>vitro óptima de megacariocitos que culminen todos los estadios de diferenciación es un reto aún no resuelto. En este trabajo reportamos los hallazgos concernientes a la determinación de las condiciones y concentraciones de trombopoyetina para lograr una óptima relación entre la cantidad de trombopoyetina empleada y el porcentaje y grado de diferenciación megacariocítica en muestras obtenidas de cinco donantes alogénicos aceptados para trasplante de médula ósea.</p> Gerardo Romanelli Silvia Olivera-Bravo Carolina Beloso Lucía Veiga Noelia García Hugo Giordano Juan Claudio Benech Inés Rauschert Gustavo Folle Adriana Mimbacas Derechos de autor 2019 Gerardo Romanelli, S Olivera-Bravo, C Beloso, L Veiga, N García, H Giordano, JC Benech, I Rauschert, G Folle, A Mimbacas http://creativecommons.org/licenses/by/4.0 2019-10-07 2019-10-07 6 2 10.25184/anfamed2019v6n2a1 Screening de hemoglobina en una población de lactantes http://www.anfamed.edu.uy/index.php/rev/article/view/370 <p>La deficiencia de hierro es la causa más frecuente de anemia en pediatría. Su detección precoz, tratamiento correcto y profilaxis adecuada, constituyen una prioridad sanitaria en nuestro país. El objetivo del presente trabajo es describir la prevalencia de anemia en un centro de primer nivel de atención, y los factores de riesgo asociados. Se realizó un estudio observacional, descriptivo, retrospectivo, incluyendo los niños con edades entre 8 y 12 meses de edad, que recibieron control en salud entre mayo y octubre de 2015. Se revisaron sus historias clínicas, consignando datos epidemiológicos, antecedentes perinatales, alimentación recibida y si recibieron suplementación con hierro adecuada. Se registró si se había realizado la medición de hemoglobina por punción digital y el valor medido. Se comparó la prevalencia de factores de riesgo entre niños con y sin anemia.</p> <p>En el período evaluado fueron asistidos 62 niños: 3 pretérminos de 34 semanas o menos; 15 con peso al nacer menor a 3000 gramos; 42 con lactancia materna exclusiva durante 6 meses; 54 con alimentación complementaria adecuada; 45 con suplementación de hierro. Se realizó la medición de hemoglobina por punción digital a 55 niños. Tenían anemia 28 niños (82 % leve). No se encontró asociación de padecer anemia con los factores de riesgo estudiados excepto el cumplimiento de la profilaxis con suplemento de hierro. Concluimos que la prevalencia de anemia en este grupo fue elevada y que la suplementación con hierro es importante para su prevención.</p> Marcos Delfino Camila Silveira Natalia Liebstreich Ana Laura Casuriaga Karina Machado María Catalina Pírez Derechos de autor 2019 Marcos Delfino, Camila Silveira, Natalia Liebstreich, Ana Laura Casuriaga, Karina Machado, María Catalina Pírez http://creativecommons.org/licenses/by/4.0 2019-10-07 2019-10-07 6 2 10.25184/anfamed2019v6n2a2 Evaluación de la experiencia de la implantación de la ley de interrupción voluntaria del embarazo en el Hospital de Clínicas http://www.anfamed.edu.uy/index.php/rev/article/view/349 <p>Objetivos: Evaluar los datos clínicos obtenido en la policlínica de Salud Sexual y Reproductiva del Hospital Universitario a los 6 años de la implementación de la ley de interrupción voluntaria del embarazo (IVE).</p> <p>Métodos: revisión de historias clínicas de diciembre de 2012 a diciembre de 2018.</p> <p>Resultados: de 448 pacientes, 361 completaron el proceso IVE, 63 requirieron una segunda dosis de Misoprostol. Cuarenta pacientes decidieron continuar sus embarazos y siguieron con el control en el servicio y 32 no volvieron tras su primera entrevista.</p> <p>Conclusiones: basado en los resultados de la investigación, el procedimiento médico de IVE es efectivo en todos los casos, solo en 33 pacientes se requirió procedimientos quirúrgicos adicionales.</p> <p lang="es-UY" style="margin-bottom: 0cm; line-height: 150%; widows: 2; orphans: 2;" align="LEFT">La ley IVE representa un progreso considerable en la salud reproductiva de la mujer uruguaya. La IVE ha asegurado asistencia médica, salud y el respeto a los derechos reproductivos sexuales y humanos, incluyendo oportunidad, continuidad y humanización de la interrupción del embarazo. La existencia de la ley de por sí no garantiza que las mujeres opten por abortar.</p> Grazzia Rey Laura Curi Gabriela Laporte Christians Rodríguez Derechos de autor 2019-10-28 2019-10-28 6 2 10.25184/anfamed2019v6n2a3 Melanoma anal, patología infrecuente, reporte de un caso http://www.anfamed.edu.uy/index.php/rev/article/view/375 <p>El melanoma anal (MA) es un tumor infrecuente, caracterizado por presentar un comportamiento agresivo y mal pronóstico.</p> <p>La sintomatología inespecífica con la cual se presenta y su similitud con etiologías benignas anorrectales, dificulta el diagnóstico y puede conducir a un retraso en el mismo. Por lo tanto, es necesaria una exploración física minuciosa y un elevado índice de sospecha.</p> <p>Se discute el caso de una paciente que consultó por tumoración anal dolorosa, no pigmentada y rectorragia; a la que se le realiza diagnóstico de melanoma anal.</p> María Alejandra Arriola Ximena Pazos Omar Figuerido Mauricio Rodríguez Derechos de autor 2019 María Alejandra Arriola, X Pazos, O Figuerido, M Rodríguez http://creativecommons.org/licenses/by/4.0 2019-10-06 2019-10-06 6 2 10.25184/anfamed2019v6n2a4 Luxación erecta expuesta de hombro en un niño http://www.anfamed.edu.uy/index.php/rev/article/view/407 <p>La luxación erecta expuesta de hombro es una asociación lesional de muy baja frecuencia en la edad pediátrica. Son más frecuentes las lesiones fisarias y epifisarias que las luxaciones y lesiones ligamentarias. Esto es debido a la presencia de un tejido óseo con gran poder de deformidad elástica y un periostio grueso.</p> <p>Presentamos un caso clínico de un paciente de 11 años de edad que sufrió una luxación erecta expuesta de hombro derecho, producto de una caída de 1 metro y medio de altura.</p> <p>El tratamiento consistió en una limpieza quirúrgica de urgencia, reducción gleno humeral y antibioticoterapia empírica, penicinila 400.000 UI/kg/día fraccionado cada 6 hs y gentamicina 3mg/Kg/día fraccionada cada 8 h por 10 días, inmovilización por 3 semanas con cabestrillo seguido de rehabilitación, y un <em>follow up</em> de 2 años al final del cual el paciente no presento secuelas funcionales en la articulación glenohumeral derecha.</p> Silvia Morales Alejandra Núñez Domingo Beltramelli Viviana Teske Derechos de autor 2019 Alejandra Núñez, Silvia Morales, Domingo Beltramelli, Viviana Teske http://creativecommons.org/licenses/by/4.0 2019-10-28 2019-10-28 6 2 10.25184/anfamed2019v6n2a5 Luxación anterior obturatriz traumática de cadera en la edad pediátrica http://www.anfamed.edu.uy/index.php/rev/article/view/418 <p class="Cuerpo"><span class="Ninguno"><span lang="FR">La luxaci</span></span><span class="Ninguno"><span lang="ES-TRAD">ón de cadera de tipo anterior – obturatriz es una patología inusual en la ortopedia pediátrica pero con complicaciones potencialmente graves en la evolució</span></span><span class="Ninguno"><span lang="PT">n. A prop</span></span><span class="Ninguno"><span lang="ES-TRAD">ósito, presentamos el caso de una niñ</span></span><span class="Ninguno"><span lang="PT">a de 14 a</span></span><span class="Ninguno"><span lang="ES-TRAD">ños que sufrió una luxación anterior-obturatriz secundario a un traumatismo de alta energía. Se le realizo reducción cerrada en block quirúrgico bajo anestesia general, con buena evolución y sin complicaciones en un seguimiento 24 meses. </span></span></p> Gerónimo Methol Gastambide Marcelo Dupont Rogelio Rey Alejandro Cuneo Derechos de autor 2019 Geronimo Methol Gastambide http://creativecommons.org/licenses/by/4.0 2019-10-29 2019-10-29 6 2 10.25184/anfamed2019v6n2a8 Accidente cerebro vascular visualizado en gammagrafía con Tc-99m MDP, un hallazgo extraóseo inusual http://www.anfamed.edu.uy/index.php/rev/article/view/384 <p align="JUSTIFY"><span style="font-family: Verdana, serif;"><span style="font-size: medium;">Se presenta el caso de un paciente con antecedente de adenocarcinoma de próstata y diagnóstico de ACV isquémico con transformación hemorrágica. La gammagrafía ósea con Tc-99m MDP complementada con SPECT e imágenes de fusión con TC cerebral simple, realizada a los 15 días, muestra hipercaptación en la región temporal izquierda, correspondiente al ACV en etapa subaguda.</span></span></p> <p>&nbsp;</p> Juan Carlos Ramírez Yepes Andrés Ilich González Ramírez Walter Efrén Roldan Cubides Marylin Acuña Hernández Derechos de autor 2019 Anales de la Facultad de Medicina, Universidad de la República, Uruguay http://creativecommons.org/licenses/by/4.0 2019-10-07 2019-10-07 6 2 10.25184/anfamed2019v6n2a6 Trombosis vascular en injerto renal visualizado en renograma con 99mtc - mag3, un evento infrecuente http://www.anfamed.edu.uy/index.php/rev/article/view/387 <p>El trasplante renal es el tratamiento de elección para la enfermedad renal terminal. Pueden presentarse diversas complicaciones médicas y quirúrgicas posteriores, entre ellas las vasculares (trombosis/estenosis de la vena y/o arteria renal) que son poco frecuentes y resultan en la pérdida del injerto. Presentamos el caso de un paciente masculino que al tercer día posterior al trasplante persisten con anuria y elevación de azoados, realizándose renograma con 99m – Tc MAG3 con hallazgos compatibles de trombosis vascular.</p> José Ramón Arriaza Madrid Adriana Rosales Morales Marylin Acuña Hernández Christian Erick García Castellón Leonardo Cadavid Blanco Derechos de autor 2019 José Ramon Arriaza Arriaza Madrid, Adriana Rosales Rosales Morales, Marylin Acuña Acuña Hernandez, Christian Erick García García Castellón http://creativecommons.org/licenses/by/4.0 2019-10-07 2019-10-07 6 2 10.25184/anfamed2019v6n2a7 66.º Aniversario del Hospital de Clínicas http://www.anfamed.edu.uy/index.php/rev/article/view/422 <p>Este año, la tradicional Semana Académica del Hospital de Clínicas (HC) de la Facultad de Medicina de la Universidad de la República, Uruguay, tuvo lugar del 23 al 27 de setiembre.</p> Comisión Directiva Hospital de Clínicas Derechos de autor 2019 Teresa Morelli http://creativecommons.org/licenses/by/4.0 2019-11-27 2019-11-27 6 2 Primeras Jornadas de Intervención e Investigación en Consumo de Alcohol en Uruguay http://www.anfamed.edu.uy/index.php/rev/article/view/423 <p><strong>Mesas temáticas sobre: alcohol y ciencias básicas; políticas públicas y prevención; epidemiología; clínica e intervenciones sociales.</strong></p> <p>Organizadas por:</p> <p>Centro de Investigación Clínica en Psicología, Facultad de Psicología, Universidad de la República (UdelaR)</p> <p>Facultad de Veterinaria, Universidad de la República (UdelaR)</p> <p>Auspiciadas por:</p> <p>Junta Nacional de Drogas (JND) y Latin American Society for Biomedical Research on Alcoholism (LASBRA)</p> Centro de Investigación Clínica en Psicología Facultad de Psicología, Universidad de la República (UdelaR) Facultad de Veterinaria Universidad de la República (UdelaR) Derechos de autor 2019 Teresa Morelli http://creativecommons.org/licenses/by/4.0 2019-11-27 2019-11-27 6 2 Carta a los lectores http://www.anfamed.edu.uy/index.php/rev/article/view/403 Anali Diaz Quispe Angely Curay-Ancalada Derechos de autor 2019 Anali Diaz Quispe, Angely Curay-Ancalada http://creativecommons.org/licenses/by/4.0 2019-10-14 2019-10-14 6 2