Editorial de la revista número 4 del año 2021

Abstract

In 2019, the first cohort of students enrolled in the Biomedical Engineering program at the University Institute of Hospital Italiano de Buenos Aires (IUHIBA). In the Letter to the Editor, Mariana B. Ríos and collaborators present the challenge of providing future biomedical engineers with technological and experimental tools oriented toward problem solving, using an innovative approach to bring them closer to the profession and to “hands-on know-how”.

The health assets model seeks to empower the community to participate in the identification of skills and resources to maintain individual and community health and well-being. In the Original Article section, Ludmila S. Cané and collaborators invited older adults from different geographic, economic, and sociocultural areas of the Autonomous City of Buenos Aires to participate in workshops, concluding that it is feasible to generate positive changes in the health of older adults, strengthen spaces for socialization, and contribute to the re-signification of the neighborhoods in which they live through health asset mapping.

Amyloidosis due to serum amyloid A protein deposition (AA amyloidosis), an acute-phase reactant synthesized in the liver in response to proinflammatory cytokines (TNF-α and interleukins 1 and 6), constitutes the most serious complication of chronic inflammatory disorders and chronic infections. Between 21% and 50% are classified as idiopathic. In the Brief Communications section, María A. Aguirre and collaborators present six cases of AA amyloidosis treated with tocilizumab, a monoclonal antibody that blocks IL-6 receptors.

Thirty percent of older adults with cancer develop new functional impairment during hospitalization, and after one year, fewer than 50% recover their usual functional status. Comprehensive geriatric assessment evaluates patient frailty, allowing individualized decision-making. In the Brief Review section, María Eugenia Riggi and collaborators review the parameters that should be evaluated in an older adult with cancer.

Multiple drug intolerance syndrome is characterized by intolerance to two or more unrelated medications. Álvaro Vallejos Narváez and collaborators present the case of a woman with recurrent urinary tract infection that posed therapeutic difficulties.

Gabriel Rondón Lozano and collaborators describe a case of allergic fungal sinusitis with massive bony destruction of the skull base and extradural intracranial and intraorbital extension.

In patients infected with COVID-19, clinical severity is associated with higher levels of interleukin-6. In the Questions to the Expert section, Federico Angriman reviews the usefulness of interleukin-6 blockade in patients with COVID-19.

Tocilizumab and sarilumab block the interleukin-6 receptor. Evidence indicates that in adults with COVID-19 who require some form of ventilatory support, early interleukin-6 blockade after clinical deterioration may be reasonable. Patients without severe disease and those with prolonged critical illness are unlikely to benefit from this therapeutic option.

In July 2021, widespread dissemination of the Delta variant occurred in the United States. When infections among healthcare workers were reviewed, it was observed that the effectiveness of the messenger RNA vaccine declined month by month, from 93.9% in March to 65.5% in July. Healthcare personnel vaccinated within the previous three months were the most protected. In Israel, administration of a third dose in individuals who had received two doses of the Pfizer vaccine at least five months earlier showed a lower incidence of confirmed infection and severe disease. In the Questions to the Expert section, María Inés Staneloni and Laura A. Barcán evaluate the evidence supporting a third dose of COVID-19 vaccine.

Between 2006 and 2016, the Institutional Registry of Thromboembolic Disease (RIET) collected 3,457 venous thromboembolic disease (VTE) events requiring hospitalization at Hospital Italiano de Buenos Aires. With the support of the Department of Health Informatics, potential cases were captured whenever physicians requested certain imaging and/or laboratory studies through the Electronic Health Record. Included patients were followed prospectively through systematic EHR review and telephone follow-up for up to four years after the event. In the Hospital Italiano in Medline section, María Florencia Grande Ratti and Fernando Javier Vázquez comment on their recent publication on this topic.

In post-COVID-19 syndrome, two types of clinical situations can be distinguished: 1) persistent symptoms in patients who experienced severe disease, which may be associated with objective sequelae, and 2) prolonged symptoms in generally younger patients who had milder courses. Evidence regarding the management of prolonged COVID-19 after mild cases is more limited than for severe cases. Management of this syndrome requires empathetic attention to the patient’s narrative, anchoring to the severity of the initial illness, and judicious use of available tools. In the Update and Advances in Research section, Joaquín Maritano Furcada discusses this topic.

This is the first of two articles addressing the steps necessary to develop a project applying Machine Learning techniques in health. In the Notes on Statistics and Research section, Nicolás H. Quiroz and collaborators introduce concepts related to data collection and analysis, selection and training of supervised machine learning models, and internal validation methods for each model.