Anales de la Facultad de Medicina

Assessment of comorbidities in children and adolescents with obesity attended at a specialized center

Guillermo Brennan — 2025-11-24

La obesidad infantil es una enfermedad crónica y sistémica que afecta a un número creciente de niños y adolescentes. Deriva en complicaciones como diabetes mellitus, dislipemias, hipertensión arterial, síndrome de apnea hipopnea obstructiva del sueño, enfermedad del hígado graso no alcohólico, entre otros. Este estudio aborda la prevalencia de estas comorbilidades en niños de 5 a 15 años con obesidad atendidos en el Centro Hospitalario Pereira Rossell. Se realizó un estudio transversal, observacional, con recolección de datos retrospectivo, incluyendo a 62 niños que fueron atendidos entre 2022 y 2024.
Las variables evaluadas incluyen antecedentes familiares, sedentarismo, acantosis nigricans, parámetros clínicos y paraclínicos. Se utilizó el software JASP para el análisis, manteniendo consideraciones éticas. Se encontró alta prevalencia de antecedentes familiares de obesidad y de sedentarismo. El 64,5% presentó obesidad severa y dentro de este grupo fue donde se observó la mayor prevalencia de comorbilidades.
Entre las comorbilidades, la dislipemia fue la más frecuente (43,6%). Se encontró asociación entre el grado de obesidad y la cantidad de comorbilidades. La elevada prevalencia de obesidad severa y sus comorbilidades resalta la gravedad de este problema en niños y subraya su relación con factores del entorno obesogénico, como el sedentarismo y antecedentes familiares. A partir de los resultados obtenidos, se destaca la importancia de una intervención temprana en niños con obesidad para prevenir posibles comorbilidades. Asimismo, fomentar cambios en el estilo de vida, como mayor actividad física y educación nutricional, es crucial para reducir las complicaciones y minimizar su impacto a largo plazo.

Lower limb salvage after infrapopliteal arteries angioplasty

Cindy Coromoto Camacho Castro — 2025-11-24

Peripheral arterial disease of the lower limbs is one of the main causes of cardiovascular morbidity. This condition has a high prevalence both nationally and internationally. Advanced stage disease can lead to the loss of the affected limb.
The purpose of this work is to evaluate the clinical success of distal leg angioplasties in patients operated on at the Hospital de Clínicas Dr. Manuel Quintela, during the period 2016-2022. A retrospective observational study was carried out. The study population included patients from the Hospital de Clínicas with chronic lower limb ischemia undergoing revascularization using infrapopliteal angioplasty within the stipulated period.
A total of 51 patients were included, of which the average age was 66.5 years,. The proportion of male patients was 58%.
The study showed a limb salvage rate of 96% at one month, 76% at one year, and 72% at two years.
Amputation-free survival was 93.5%, 69.1% at one year, and 66.8% at two years. Twenty-eight percent of the limbs required major amputation in a two-year follow-up period. 15% of the treated limbs needed reintervention, and approximately half of these ultimately required amputation. In conclusion, the revascularization procedures had a high level of effectiveness, due to the high amputation-free survival and a high limb salvage rate during 2-year follow-up in our practice. The need for reintervention was low and the overall survival of the patients high.

Gastroesophageal motility disorders in Chagas disease, Hospital de Clínicas, Montevideo, Uruguay, 2024

Guillermina Caraballo — 2025-11-24

A descriptive and cross-sectional study was carried out, with the target population being patients over 18 years of age with Trypanosoma cruzi (T. cruzi) infection, assisted in the period from July 1 to September 1, 2024, at the Chagas Disease Clinic of the Hospital de Clínicas, Montevideo, Uruguay. Patients with swallowing disorders and pregnant women were excluded.
The method used to assess gastroesophageal involvement is esophageal transit through the use of radiotracers. It is a diagnostic study that uses a solution with a radioactive substance (metastable technetium 99) and liquid, which is ingested to evaluate its passage through the digestive tract. This was recorded in a sequence of images by a gamma camera, whose data were digitized in time-activity curves, characterizing the alterations in esophageal transit and gastric emptying.
20% had at least one digestive symptom. Of this percentage, all presented slow esophageal transit and 10% presented slow gastric emptying.
Of the eight asymptomatic patients (80%), 50% presented slow esophageal transit in the middle and distal third, 12.5% slow transit in the distal third, 12.5% slow transit throughout the esophageal transit, and 25% had a tortuous esophagus. Scintigraphy is a very sensitive but not very specific diagnostic method; it was concluded that it is relevant to include it in a study algorithm in this population. This allows measures to be taken to reduce the progression to a more severe symptomatic stage.

The study of ionotropic receptors Ir21a, Ir25a y Ir93a in Drosophila melanogaster

Catalina Troncone — 2025-11-24

Many animals have thermosensory systems to avoid extreme temperatures, and also to find optimal temperatures. These systems are used by disease vector insects to locate their prey, such as mosquitoes, responsible for more than 700,000 deaths per year (1, 2).
The study of sensory systems in insects can provide clues to combat these vectors, as well as progress in the development of deterrent techniques to contain hematophages (3). In this project, the Drosophila melanogaster experimental model was used to study thermosensitive neurons (4).
There are fruit fly lines that allow the expression of GFP in the cells that express the receptors under study, in this way the expression patterns of receptors were studied in both larva and adult of this species using fluorescence and confocal microscopy. The calcium imaging technique was used for the physiological recording of thermosensitive neurons against temperature changes. Changes in fluorescence intensity dependent on temperature changes could be observed. Finally, a prediction of the structure of these receptors was carried out using different in silico techniques (5, 6).

Impact of cancer treatments on fertility: A literature review

Sandy Carrera Da SilvaARRERA DA SILVA — 2025-11-24

Nowadays, different effective methods have been developed to treat cancer that have successfully increased survival rates. Among them, in addition to traditional treatments such as chemotherapy and radiotherapy, targeted therapies stand out, which have been implemented in recent years. One of the aspects on which this review focuses is on gonadotoxicity as an adverse effect that they bring, an important fact given that it can generate repercussions not only on a biological level, but also on a psychological and social level.In the case of radiotherapy and chemotherapy, it was found that most of them cause direct gonadal damage, depletion of germ cells or endocrinological alterations.As for the new therapies (immunotherapy and targeted therapies) they proved to be equally effective and cause fewer adverse effects.From this, a new term called oncofertility arises, focused on providing information through a multidisciplinary team about the aforementioned risk and suggesting different methods in order to preserve fertility. Some of these are gonadal shielding, cryopreservation of gonadal tissue, stem cells and gametes.
For this review, the following databases were used: PubMed, Cochrane, Portal Timbó, Scielo, ScienceDirect and Lilacs. Taking into account the objectives set and the inclusion criteria, 56 articles were chosen. Inclusion criteria: randomized clinical trials, systematic reviews, narrative reviews, metaanalysis, medicine & public health, and exclusion: full text, free full text, children under 10 years of age, English and Spanish.

Interobserver agreement in the assessment of Prechtl’s general movements in newborns. Centro Hospitalario Pereira Rossell, Uruguay. 2024.

Verónica Abalos — 2025-11-24

General movements are spontaneous movements that involve the whole body in a variable sequence of movements of the upper limbs, lower limbs, neck and trunk. They are characterized by their complexity, variability, and fluidity. These characteristics determine the quality of these movements and are a reflection of the integrity of the central nervous system. There are several ways of evaluating general movements, one of the most recognized being the one developed by
Prechtl. This method has proven to be effective in predicting and diagnosing cerebral palsy and other neurological disorders early.
An observational, cross-sectional study was conducted with the aim of assessing inter-observer agreement in the General Movement Optimality Score-Revised score in newborns. Thirty newborns from the Centro Hospitalario Pereira Rossell were selected and evaluated by different observers with training in general movements. To evaluate inter-observer agreement, Fleiss’s Kappa, Cohen’s Kappa, Intraclass Correlation Coefficient and Krippendorff’s Alpha were used, as appropriate. In the variable video evaluation, a 𝜿 value of 0.334 (95% CI 0.267 - 0.402) was obtained. In the total score variable, the ICC was 0.43 (95% CI 0.21 - 0.74), while in the variable classification of movements the kappa was 0.242 (95% CI 0.124 - 0.359). The physiotherapists achieved significantly higher concordances in all the variables analyzed. From this study it can be concluded that the level of general agreement was regular.

Central nervous system infections in post-neurosurgical patients. Intensive Care Unit, Hospital de Clínicas Dr. Manuel Quintela, Uruguay, 2020-2024

Bruno Deri — 2025-11-24

Post-neurosurgical infections occur in patients undergoing invasive neurosurgical procedures. In Uruguay, they represent 46% of complications. This observational, analytical, and retrospective study, conducted in the Intensive Care Unit of the Dr. Manuel Quintela Hospital de Clínicas from 2020 to 2024, sought to characterize central nervous system infections, with an emphasis on meningitis and ventriculitis.
The objectives were to determine their frequency, identify the most commonly associated type of intervention, the microorganisms involved, the characteristics of the cerebrospinal fluid, and identify factors predisposing to the development of infection and associated mortality. To this end, a review of electronic medical records authorized through informed or surrogate consent was conducted.
Of a total of 236 patients undergoing neurosurgery, 31 were considered for infection. Analysis of clinical, fluid characteristics, and cultures revealed that 21 were confirmed and 10 were probable. Eighty percent were male, and 58% were due to trauma. Gram-positive cocci predominated. Male sex and length of monitoring were associated with infection, while length of monitoring and vascular disease were associated with mortality. Some of the results were biased by population characteristics (especially etiology) and sample size. This is the first study in our unit to analyze this group of patients. The data obtained will inform clinical decisions.

Duration of immunity from vaccines administered in Uruguay: a bibliographic review

Josefina Álvarez — 2025-11-24

Vaccines are a crucial tool in protecting against infectious diseases, saving between 3.5 to 5 million lives annually, according to the WHO. The duration of the immune response generated by vaccines is a topic of great interest and concern, as uncertainty complicates the definition of appropriate vaccination strategies to prevent the resurgence of infections. This narrative literature review aimed to assess the current state of knowledge regarding the duration of the immune response and protection conferred by some of the vaccines currently in use in Uruguay. In particular, research was focused on vaccines against Human Papillomavirus (HPV), measles, mumps, and rubella (MMR vaccine), and influenza. The review was
conducted through searches in electronic databases and a selection of scientific articles based on their quality and level of evidence. It was found that vaccination against HPV provides a long-lasting immune response, but it is essential to continue monitoring the immune response elicited. Influenza vaccines elicit shorter immune responses, necessitating booster doses and annual vaccine reformulations. Regarding the MMR vaccine, there are also variations depending on the pathogen; for rubella, a single dose offers long-term protection, while immunity against mumps and measles wanes more quickly. More longitudinal studies are needed to evaluate the duration of immunity and to establish clear correlates of protection for vaccines.

Body Composition of Preterm Infants: Technique Development Using Deuterium. Pilot Study in Uruguay, 2024

Maximiliano García — 2025-11-25

In Uruguay, during 2022, there were 3138 births before 37 weeks of gestation, accounting for approximately 10 percent of all live births. A newborn is considered premature if born before 37 weeks. Understanding body composition, particularly fat and water content, is essential to evaluating growth and development in both the short and long term. This study aimed to assess body composition in a sample of preterm newborns older than 32 weeks using the deuterium oxide dilution technique.
Deuterium oxide was administered orally or through enteral feeding, with the dose adjusted according to birth weight. Saliva samples were then collected to analyze the proportions of total body water, fat, and fat-free mass. Thirteen newborns
between 32 and 36 weeks of gestational age were included; in four cases, valid results were not obtained. Body composition values were successfully measured. This pilot study demonstrated that the adapted technique can be used to evaluate body composition in preterm newborns. However, a larger sample and achieving the proper equilibrium time for the marker are necessary to obtain more accurate and reliable results.