Revista del Hospital Italiano de Buenos Aires
La Revista del Hospital Italiano de Buenos Aires (E-ISSN 2314-3312) is a quarterly scientific publication with continuous frequency, published in Spanish and English by the Universidad Hospital Italiano (UHI). Its content is peer-reviewed under a double-blind system. It is open access (CC BY-NC-SA license), and the editing and publishing process is free of charge for authors. It publishes original works relevant to health sciences and related fields. [+ info] [Access the latest issue]
Accessibility at University: Inclusive Dialogues as an Institutional Program
Introduction: in 2023, University identified opportunities to improve the educational inclusion of people with disabilities, aligning with the Convention on the Rights of Persons with Disabilities. Within this framework, we designed Inclusive Dialogue Instances (EDIs) as an institutional mechanism that enables students, teaching teams, and university authorities to manage supports and reasonable accommodations through agreements. This article presents preliminary results from the EDI implementation. Methods: we used participatory action research with a qualitative approach to study the mechanisms' dynamics and outcomes over 18 months. Results: we organized the results into three main areas: (1) strengthening educational trajectories—most participants made progress, and one graduated; (2) the production of inclusive communication materials and pedagogical guidelines; and (3) teacher training on inclusion. Through dialogic exchanges, we addressed 12 situations, resulting in 14 agreements on supports and reasonable accommodations. These efforts contributed to strengthening participants’ educational trajectories, while also fostering the development of inclusive materials and their gradual integration into teacher training initiatives. Discussion: the dialogic approach of the EDIs encourages the community to review its assumptions and practices, and to gradually transform institutional culture. In this framework, the entire educational community collectively engages in educational inclusion and shares responsibility. Conclusions: this analysis finds ways to strengthen inclusive skills in disability and accessibility at the university and supports adding these perspectives to policies, practices, and culture.
Copyright (c) 2026 Revista del Hospital Italiano de Buenos Aires https://creativecommons.org/licenses/by-nc-sa/4.0
Virtual Course on Qualitative Research for Primary Care Professionals
Introduction: training in qualitative research is a key component of continuing education for Primary Health Care (PHC) professionals, as it strengthens methodological competencies and contributes to professional development. The aim was to describe the implementation and systematization of a qualitative research course, highlighting challenges, decisions, and lessons learned, as well as participants’ feedback. Materials and methods: a virtual course consisting of two synchronous sessions, held in 2023 during evening hours, with a participatory methodology based on real-life examples. It was financially supported by the Argentine Federation of Family and General Medicine. Teaching fees were covered, but the course was offered free of charge to members of the scientific society. Attendance was recorded, an anonymous post-session survey was administered, and certificates granting credits for specialty recertification were issued. Results: despite 39 pre-registered participants, only 41% attended, with 18 participants in the first synchronous session and 10 in the second. Most participants were from the provinces of Córdoba, Buenos Aires, and Misiones. Almost all respondents indicated they would likely apply what they had learned and would recommend the activity to colleagues. Overall satisfaction with the practical component and the interactive, participatory format was highlighted, although suggestions included improving the readability of some slides and adjusting the pace of the presentation. Three certificates of completion were issued (to those who submitted an individual asynchronous assignment on time), and 16 certificates of participation (without assessment). Conclusion: the academic proposal was well received; participants valued the theoretical-practical methodology and the interactive approach, which fostered exchange and participation. Despite the initial interest reflected in pre-registrations, actual attendance suggests the need to explore barriers to participation in free training activities. The virtual format facilitated the inclusion of professionals from different provinces, and the small group size encouraged active participation. Feedback identified areas for improvement that could be optimized in future editions.
Unraveling a dilemma in healthcare projects:Is it about Quality Improvement or Research?
In health sciences, differentiating between a research project and a management or quality project can be confusing, as both employ similar methods such as data collection, statistical analysis, and reporting of results. However, research seeks to generate generalizable knowledge and requires ethical approval, while quality improvement focuses on optimizing internal processes, with no intention of applying the findings outside the local setting. The confusion arises when a management/quality project uses methodologies specific to clinical research, or seeks to be communicated or published. The key lies in the purpose: if it seeks to answer a scientific question applicable beyond the immediate context, it is research; if the objective is to solve an operational problem in an institution, it is improvement. Consulting the institutional review board when in doubt is a good practice to ensure regulatory and ethical compliance.
Copyright (c) 2026 Silvana Soli, Jennifer S. Appeceix, Mónica Senillosa, Gastón Perman, María F. Grande Ratti https://creativecommons.org/licenses/by-nc-sa/4.0
When Autonomy Conflicts with Harm Preventionts with Harm Prevention
Can a person with mild cognitive impairment make decisions about their own medical care? The editors of the Revista del Hospital Italiano de Buenos Aires invited two distinguished experts to reflect on a hypothetical clinical scenario. Dr. Oscar Mazza examines how to balance autonomy, beneficence, and protection in people with mild cognitive impairment, and discusses the roles of the family, the healthcare team, and advance directives. Read Dr. F. Giber’s commentary: [link]
Multicenter Studies in Clinical Research: Benefits, Challenges, and Recommendations forEffective Management
In clinical research, multicenter studies represent a key tool for collecting data from multiple centers, thus increasing the external validity and generalizability of results. The fact that they are conducted simultaneously in several institutions, localities, provinces, or even countries allows for a larger and more diverse sample, which favors representativeness and makes the information applicable to different populations and settings. This narrative review highlights their advantages and disadvantages and explores in depth the main challenges they entail (ethical, methodological, logistical, and operational). It also analyzes real and relevant examples that illustrate their impact on the generation of robust clinical evidence. Finally, conclusions and practical recommendations for the effective management of these projects are presented, emphasizing the importance of leadership, coordination between centers, the commitment of the research team, and rigorous adherence to ethical and methodological standards.
Virtual Learning in the Management of Frail Older Adults in Home Care in home care
Introduction: the rise of home health care (HHC), driven by system advantages, an aging population, and patient preferences, demands specialized training. A university postgraduate course titled "Introduction to the Management of the Frail Elderly in HHC" was designed. This study analyzed student performance, demographics, and feedback. Materials and Methods: the course was virtual, asynchronous, self-paced, free of charge, aimed at healthcare professionals and hosted on the Moodle platform. It was structured into four units: Introduction to HHC systems, HHC Admission, Home assessment, and Discharge from HHC. Teaching methods included audiovisual resources, supplemental readings, and self-assessment activities. The course granted 30-hour certificates. The course awarded certificates for 30 hours after the approval of the 4 self-assessment activities included throughout the training. A cross-sectional study was conducted, including students enrolled between January and August 2025. Data were gathered from educational platform analytics and voluntary feedback surveys from those who completed the course. Results: a total of 1,250 students enrolled, and 218 completed and passed the course (17.44%), with a mean final score of 90.76/100. Participants were 73% female and 82% from Argentina, with medicine and nursing as the primary professions. Feedback was received from 120 graduates (55% response rate). Regarding satisfaction, 99.17% felt the materials facilitated learning, 100% found the virtual campus easy to use, and 98.31% stated the course significantly aided their professional development. The highest-rated aspects were the online modality (64.60%), lecture quality (59.29%), and content (49.56%). Suggestions were received to integrate more rehabilitation topics. Conclusion: this experience was highly valued by graduates and contributed significantly to HHC training, promoting educational accessibility. The completion rate, typically lower in self-administered formats, was low due to a lack of engagement or early dropout. Increasing retention in self-managed modalities remains a challenge, potentially requiring enhanced faculty support if resources permit.
Preventive Check-Ups: Between the Promise of Certainty and the Uncertainty of Future Outcomes
Uncertainty permeates medical practice, yet it is often concealed beneath promises of certainty and control. This article invites reflection on how physicians and patients relate to uncertainty, and how communication and the therapeutic relationship can become central tools of care when no clear answers are available. Written from and for primary care, it uses a clinical vignette to raise questions that may enrich everyday practice.
Inclusive Dialogues: Lessons for a More Accessible University
Drawing on the experience of the Inclusive Dialogue Spaces, this editorial reflects on inclusion as a challenge that goes beyond individual support measures. It proposes viewing accessibility as an opportunity for institutional learning and highlights the need to strengthen faculty competencies in order to build more inclusive universities.
The Path to a PhD: Ten Advices to Survive and Succeed in Doctoral Studiesctoral Studies
Starting a PhD is a transformative experience both personally and professionally. This article provides a practical guide with ten key tips for those who wish to embark on this academic challenge. Through a realistic and accessible approach it addresses essential aspects such as the importance of gaining prior research experience, the need for planning and organization, choosing the right time to start, building a strong research team, and seeking funding.
Autonomy and Decision-Making Capacity in Older Adults with Mild Cognitive Impairment
Can a person with mild cognitive impairment make decisions about their own medical care? The editors of the Revista del Hospital Italiano de Buenos Aires invited two distinguished experts to reflect on a hypothetical clinical scenario. Dr. Fabiana Giber discusses the limits of autonomy, the role of the family, and the importance of assessing decision-making capacity on an individual basis before making decisions on behalf of the patient. Read Dr. O. M. Mazza’s commentary: [link]
Lacto-Ovo-Vegetarian Diets for Myocardial Perfusion in Adults with Coronary Artery Disease: A Systematic Review
Introduction: Lacto-ovo-vegetarian diets have gained increasing popularity in recent decades. These diets are characterized by a low intake of saturated fat and a high consumption of vegetables and legumes. Several publications have shown that the consumption of these foods is associated with a lower incidence of non-communicable chronic diseases (NCDs). The aim of this systematic review was to evaluate the effects of lacto-ovo-vegetarian diets in adults with established coronary artery disease. We assessed their impact on myocardial perfusion, quality of life, mortality, type 2 diabetes, overweight, and obesity. Materials and methods: Systematic review with meta-analysis (CRD 42023456770). Results: We identified 3,601 records. After an independent screening process conducted by three authors, we included three studies in the systematic review, along with three additional secondary publications related to the included studies. The studies reported an improvement in myocardial perfusion measured by PET scan (+4.9 ± 3.3 in the vegetarian diet group vs. −8.8 ± 2.3 in the control group), as well as improvements in certain quality-of-life domains with lacto-ovo-vegetarian diets compared with non-restricted diets (80.84 [95% CI: 76.21–85.47] vs. 80.45 [95% CI: 75.55–85.35] in the control group). However, the impact of these diets on type 2 diabetes, overweight, and obesity was minimal. Conclusions: Lacto-ovo-vegetarian diets may improve myocardial perfusion and certain aspects of quality of life. Their effect on NCDs such as type 2 diabetes, overweight, and obesity appears to be minimal. Further studies with larger sample sizes are needed to assess the effect of lacto-ovo-vegetarian diets on the main outcomes considered in this review.
A comment reflecting on the COVID-19 pandemic, highlighting its global impact and the lessons learned. It emphasizes the cooperation between scientists, companies, and governments, particularly in biotechnology, to address the crisis. Additionally, it discusses the lasting effects of COVID-19, such as post-traumatic syndrome, and the importance of leveraging these advancements for future emergencies.
Copyright (c) 2024 Revista del Hospital Italiano de Buenos Aires https://creativecommons.org/licenses/by-nc-sa/4.0
Beyond Body Mass Index: Health or Illness Is Not About Weight
The weight-centered medical approach, based solely on BMI, overlooks biological, psychological, and social aspects, perpetuating stigmas and affecting self-esteem. Comprehensive and respectful evaluations, as recommended by the Ministry of Health guidelines in Argentina, are required to prevent discrimination and promote inclusive and appropriate care.
The Impact of Artificial Intelligence in Healthcare: Potentialities and Challenges
Artificial Intelligence in healthcare has the potential to streamline diagnoses, personalize treatments and revolutionize medical research. However, it faces ethical and regulatory challenges. Its transformative potential demands responsible and careful implementation to maximize its benefits.
Copyright (c) 2023 Revista del Hospital Italiano de Buenos Aires https://creativecommons.org/licenses/by-nc-sa/4.0
Overview of the possible causes and impact of infantile colic on the life of the affected baby and family.
The crisis and crossroads experienced by a psychiatry in search of the future
On the understanding we accept where psychiatry would today be located in the metaphor of the crossroads, as proposed by Santiago Levín, the purpose of this article is to explore certain aspects of a paradigmatic crisis in mental medicine that has raised some concerns as to its future. Certain deep epistemological questions are addressed, such as the schema of "truth", where experts should supposedly manage themselves, and the dilemmas raised from the two key elements of a clinical session: diagnosis and treatment. Finally, the study emphasises the importance of the ethical, social, and political aspects of rethinking knowledge and practices.
Copyright (c) 2023 https://creativecommons.org/licenses/by-nc-sa/4.0
Death has always implied confusion, so accompanying this end-of-life process entails a highexistential commitment. If we add to this difficult task the hospital or legal constraints suffered bypatients in their agony, we are facing a terrifying death, very far from a departure that can be considered a loving one. As we know, the word «clinical» refers to the practice of caring for the patient very close to the bed, alleviating the pain of whom is about to leave; however, the "legal corset" of death is separating the doctor from the one who should receive all his attention and care, preventing him from accompanying the pacient in his/her good dying. We should discuss and agree on a strategy that enriches the experience of the end of life, so that patients could choose the way to leave. It is of incalculable value to awaken compassion on this important issue that has concerned human beings since the dawn of time. It would be very fruitful if we take advantage of the enormous wisdom of ancient cultures that have humbly cared for life until the moment of death.
Educational and Professional Trajectory of Graduates
Editorial commentary on a paper by Elizondo et al. in which they investigate the educational and labor trajectories of a group of undergraduate and postgraduate graduates
Rare Presentation of a Spinal Lymphoma: Case Report and Diagnosis by Magnetic Resonance Imaging.
A primary central nervous system lymphoma is a form of extranodal disease originating in the brain, leptomeninges, spinal cord, or eyes. Spinal tumors are low-prevalence neoplasms and can cause considerable neurological morbidity and mortality. An isolated lymphoma emerging within the dural canal is the rarest form of primary central nervous system lymphoma: it accounts for approximately 1% of cases occurring more often in the context of secondary dissemination than as the primary site of origin. Symptoms are nonspecific and depend on the spinal level involved. The presentation is insidious and includes dorsalgia, weakness, and progressive difficulty in ambulatory function. MRI is the modality of choice to search for lesions within the spinal/rachial canal in patients presenting with neurological symptoms. Surgical treatment is not helpful, and the main objective of surgery is to know the histological diagnosis.
A 57-year-old patient, undergoing treatment with acenocoumarol, who attended the Emergency Department due to low back pain radiating to the left iliac fossa. The blood test revealed impaired renal function and a computed tomography scan showed an image suggestive of a left perirenal hematoma in the left kidney with signs of active bleeding.
Drug-induced severe cutaneous adverse reactions in a patient after COVID-19 infection. Case report
During the COVID-19 pandemic, various adverse drug reactions were observed. This could have been related to a greater immunological susceptibility of patients with SARS-CoV-2 to present this type of symptoms, as well as exposure to multiple drugs used in their treatment. We report the case of a patient with a severe respiratory infection due to COVID-19, who presented 2 serious adverse drug reactions associated with paracetamol in a short period of time.
NPS (Net Promoter Score), Customer experience metrics/Construction and analysis of the indicator of private medical coverage
Introduction: The NPS (Net Promoter Score) is an indicator used in customer experience programs to measure the satisfaction of said target audience and their loyalty. Our purpose was to send the survey and consolidate the NPS for the first time in a high complexity prepaid hospital in Buenos Aires (PS-HIBA) in search of an objective indicator from the customer's perspective. Methods: An analytical, cross-sectional observational study was carried out. Data obtained from members' responses to the PS-HIBA were included in the study. Results: The first NPS indicator of PS-HIBA was consolidated: 22 points. The three customer profiles were displayed, obtaining 45.7% promoters, 22.3% detractors and 32% passive or neutral. Complementarily, the reasons for these qualifications were identified, being the three main ones: the problem of accessibility to medical appointments, the medical attention and the professionals valued positively. Conclusion: This study provides an objective indicator which facilitates a common language in the organization and a comparison with the market from the customer's point of view. The NPS as a system seeks to promote the construction of a customer-focused culture, in order to improve their loyalty and allow feedback. Thus, it is possible to keep the customer's voice in mind, identify, prioritize and address the perceived problems. It allows us to establish the guidelines for opportunities to improve from the patients' perspective.
The Role of the Navigator Person for a Patient with Lung Cancer
Introduction: Value-based medicine has succeeded in improving the quality of patient care and or patient satisfaction, reducing costs, and obtaining better outcomes. It rests on three fundamental pillars: evidence-based medicine, patient-centered care, and sustainability. However, there are few publications on the people navigator strategy for lung cancer patients, which could be a crucial tool for providing support, ensuring that they have access to the knowledge and resources needed to complete the recommended clinical care pathway. State of the art: It is a health intervention whose main objective is to overcome care-related barriers (e.g., logistical, bureaucratic-administrative, communication, and financial) to improve quality and access to health in the context of cancer care. These individuals play a guiding role for patients during the diagnostic and active treatment process. Their job is to link the patient with clinical providers, provide a support system, ensure individualized accompaniment, and guarantee that they get access to the knowledge and resources necessary to complete the appropriate follow-up and, or treatment. Discussion/Conclusion: Undoubtedly, patient navigators represent an increasingly recognized element of high-quality, patient-centered cancer programs. Its implementation will be of specific interest in the Integrated Practice Unit for people with lung cancer.
Review of the Knowledge on Selective Serotonin Reuptake Inhibitors (SSRIs) for Depression Management by Residents and Concurrent Physicians of the Medical Clinic of 5 Hospitals in CABA
Introduction: Depression is an increasingly common disorder around the world. General practitioners are the most frequently consulted health professionals by depressed patients. More than 70% of all depressed patients receive treatment by general practitioners and not by psychiatric specialists. According to studies conducted in Buenos Aires, more than 25% of all patients admitted to the Clinical Services in public hospitals present depression. These patients are usually under the care and follow-up of clinical trainee physicians, residents, or interns. This study aimed to analyze the knowledge about selective serotonin reuptake inhibitors (SSRIs) of clinical trainee residents and interns in five hospitals in the Ciudad Autónoma de Buenos Aires (CABA) and to describe their treatment of a depressive patient. Material and methods: We conducted a descriptive cross-sectional study with a non-probabilistic sampling. We used a semi-structured questionnaire arranged into two sections as a measuring tool. One, with demographic data to describe the sample. The other, with 15 items, explores respondents' knowledge of SSRIs and the treatment of depression. Four experts reviewed the questionnaire, which was anonymous. We applied it to 59 clinical medical trainees, residents, and interns from five CABA hospitals who volunteered to participate during August-September 2022. Results: Most clinical trainees do not treat depressive conditions and, when confronted with a depressed patient, request an assessment by a Mental Health specialist. Only 6.8% medicate the patient with an antidepressant. More than 75% of the sample reported remembering their knowledge of SSRIs from the Pharmacology course and 13.6% from the Psychiatry course at the School of Medicine. Conclusion: There is a deficient knowledge about SSRIs in trainee residents and interns of Clínica Médica. We believe it is necessary to reinforce training on depression and management of antidepressants during residency/internship practice in Clínica Médica.
A Review of the Mental Health Care of Families in the Neonatal Intensive Care Unit
Introduction: This paper reviews practices addressing the perinatal mental health of families hospitalized in Neonatal Intensive Care Units (NICU). Achievements in increased survival of high-risk newborns involve prolonged hospitalization and emotional care of their families. State of the art: the conceptual framework refers to person-centred care and its perinatal expression in the Safe and Family-Centered Maternity Model (SCMF). It includes experiences of local and international referents that guide interventions in the field. Conclusions: the importance of emotional care in highly stressful scenarios is highlighted, given its impact on the care and construction of early bonds between hospitalized newborns (NB) and their primary referents. It mentions psychological risk factors and possible approaches. We propose actions for promotion, prevention, and assistance in this context.
Childhood and screens: checking for updates…
Given the increasing access of children to technological devices, the pandemic has raised the need to review agreements on their use and exposure. The new reality leads us to other questions about ways to accompany them from the adult world to rethink limits, make the most of their capabilities, and, above all, find meanings.
Threats of digital life in professional practice
The digitalization of the reality in which we live is advancing inexorably and it would seem that it is increasingly difficult to combine science and humanism. We must try to overcome the false opposition of humanism versus technology; both are fundamental to continue advancing in an increasingly integrative medical model that can meet the needs of society as a whole.
Surgical menopause in patients with BRCA mutation, the role of hormone therapy
Introduction: Women with BRCA1/2 (mBRCA) mutation have an increased risk of developing breast (BC) and ovarian (OC) cancer. Bilateral salpingo-oophorectomy (BOS) is associated with an 80% risk reduction for OC and 50% for BC. The recommended age for this procedure is 35 to 40 years. The consequence is premature menopause, which hurts the quality of life due to the presence of climacteric symptoms, increased risk of cardiovascular disease, osteoporosis, and a higher risk of cognitive impairment. Hormone therapy (HTM) is the most effective treatment for preventing these symptoms. State of the art: Different studies have shown an increased risk of BC in postmenopausal women receiving HTM, particularly with combined therapy, estrogen + progesterone (E+P). According to the meta-analysis by Marchetti et al., in women carrying mBRCA who received HTM, there was no difference in the risk of BC compared to E alone with E+P. In the Kostopoulos study, there was also a possible protective effect in those who used E alone. Another study in healthy carriers showed that in women younger than 45 years at the time of BOS, HTM did not affect BC rates. However, in women older than 45 years, BC rates were higher. As the E+P scheme is associated with a higher RR of BC, the doses of progestogens should be limited, choosing natural progesterone byproducts of intermittent use to decrease systemic exposure. According to various international guidelines, healthy mBRCA carriers undergoing BOS should be offered HTM until the average age of menopause. Conclusion: premature menopause decreases life expectancy, which is why one of the tools to improve and prevent deterioration of quality of life is THM. Short-term use of MHT appears safe for women with mBRCA who undergo BOS before age 45 as it does not counteract the reduction in the risk of MC obtained by surgery.
Anthropometric profile of Argentine elite Judokas
Introduction: Judo is a combat sport whose competitive classification depends on body weight, intended to promote even and equitable competitions in terms of physical abilities. Advances in the sciences of training and sports nutrition have led to an improvement in the body composition of athletes, resulting in an increase in muscle mass and a decrease in adipose mass. This study aimed to estimate the body composition of judo fighters participating in the 2021 Argentine National Championship. Materials and methods: we conducted a descriptive cross-sectional study of participants of the 2021 national judo championship. We evaluated 183 judokas (51 women and 132 men) applying the ISAK measurement protocol. We used the Kerry Ross five-component fractional anatomic method to determine body composition. Results: the average for female judo players was 30.5% for adipose mass and 44.5% for muscle mass; we found no statistically significant differences in the different age groups. The average value for males was 22.4% for adipose mass and 49.1% for muscle mass; in this case, we found significant differences between the different age groups for adipose mass and muscle and bone mass. Discussion: there is a need for more studies with stratified groups according to body weight division to establish specific reference standards for the work in exercise science and nutrition. Conclusion: the optimization of the body composition of female and male judo players has a positive effect on the improvement of specific physical capacities. The data presented constitute a relevant reference for the evaluation and follow-up of judokas. The stratification by age groups and body weight division will allow a better delimitation of the values of each age category. Linking body composition with physical tests and results is considered relevant to obtain a better profile of the Argentinian judo player.
The importance of empathic communication with patients and their families
Reading personal experiences in situations involving health problems reflects the impact that inadequate communication has on patients and their families. This article reviews texts from the literature with paradigmatic examples, mentions possible reasons for the use of medical jargon and reflects on the importance of adequate communication with patients and their families, emphasizing active listening, personalized approach considering contextual circumstances, habits and skills that must be present in critical situations meetings. The importance of developing training programs that include simulation scenarios is underlined.