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Osores PI, Vivacqua MN, Vazquez C, Marciano S, Giunta DH, Faccioli JL. Association Between Selective Serotonin Reuptake Inhibitors Prevalent Use and COVID-19-Related Mortality: A Retrospective Cohort Study. J Clin Psychopharmacol 2023; 43:411-416. [PMID: 37683229 DOI: 10.1097/jcp.0000000000001721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
PURPOSE/BACKGROUND Since the emergence of the coronavirus disease 2019 (COVID-19), many efforts have been made to prevent and to treat the disease. In this line, the anti-inflammatory effect of selective serotonin reuptake inhibitors (SSRI) as alternatives for treating chronic inflammatory diseases has been studied. There is previous evidence of the usefulness of these drugs for reducing COVID-19 impact. METHODS/PROCEDURES We conducted a retrospective single-center cohort study of adult patients with a positive reverse transcriptase-polymerase chain reaction for COVID-19, evaluating the association between SSRI use and in-hospital mortality. FINDINGS/RESULTS Of 1689 included patients, 182 (10.8%) were exposed to SSRI. A total of 291 patients died during the hospitalization, representing an in-hospital mortality of 17.2% (95% confidence interval [CI], 15.4%-19.0%): 44 (24.2%) of the exposed to SSRIs versus 247 (16.4%) of those not exposed to SSRIs (crude odds ratio [OR], 1.62; 95% CI, 1.12-2.34; P = 0.009). No independent effect of SSRIs on in-hospital mortality was found when applying either the inverse probability of treatment weighting (OR, 1.15; 95% CI, 0.71-1.89; P = 0.56) or with conventional multivariable analysis 0.81 (95 % CI: 0.28-2.31, P = 0.69). IMPLICATIONS/CONCLUSIONS In the present retrospective study of patients hospitalized for COVID-19, prior use of SSRIs did not reduce mortality.
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Affiliation(s)
| | | | | | - Sebastián Marciano
- Department or Research, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Diego Hernán Giunta
- Department or Research, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Giunta DH, Huespe IA, Alonso Serena M, Luna D, Gonzalez Bernaldo de Quirós F. Development and validation of nonattendance predictive models for scheduled adult outpatient appointments in different medical specialties. Int J Health Plann Manage 2023; 38:377-397. [PMID: 36324194 DOI: 10.1002/hpm.3590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/07/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Nonattendance is a critical problem that affects health care worldwide. Our aim was to build and validate predictive models of nonattendance in all outpatients appointments, general practitioners, and clinical and surgical specialties. METHODS A cohort study of adult patients, who had scheduled outpatient appointments for General Practitioners, Clinical and Surgical specialties, was conducted between January 2015 and December 2016, at the Italian Hospital of Buenos Aires. We evaluated potential predictors grouped in baseline patient characteristics, characteristics of the appointment scheduling process, patient history, characteristics of the appointment, and comorbidities. Patients were divided between those who attended their appointments, and those who did not. We generated predictive models for nonattendance for all appointments and the three subgroups. RESULTS Of 2,526,549 appointments included, 703,449 were missed (27.8%). The predictive model for all appointments contains 30 variables, with an area under the ROC (AUROC) curve of 0.71, calibration-in-the-large (CITL) of 0.046, and calibration slope of 1.03 in the validation cohort. For General Practitioners the model has 28 variables (AUROC of 0.72, CITL of 0.053, and calibration slope of 1.01). For clinical subspecialties, the model has 23 variables (AUROC of 0.71, CITL of 0.039, and calibration slope of 1), and for surgical specialties, the model has 22 variables (AUROC of 0.70, CITL of 0.023, and calibration slope of 1.01). CONCLUSION We build robust predictive models of nonattendance with adequate precision and calibration for each of the subgroups.
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Affiliation(s)
- Diego Hernán Giunta
- Internal Medicine Research Unit, Hospital Italiano de Buenos Aires, CABA, Argentina.,Research Department, Hospital Italiano de Buenos Aires, CABA, Argentina.,University Institute of Hospital Italiano de Buenos Aires (IUHI), CABA, Argentina.,National Council of Scientific and Technical Research (Consejo Nacional de Investigaciones Científicas y Técnicas - CONICET), CABA, Argentina
| | - Ivan Alfredo Huespe
- Internal Medicine Research Unit, Hospital Italiano de Buenos Aires, CABA, Argentina
| | - Marina Alonso Serena
- Internal Medicine Research Unit, Hospital Italiano de Buenos Aires, CABA, Argentina
| | - Daniel Luna
- National Council of Scientific and Technical Research (Consejo Nacional de Investigaciones Científicas y Técnicas - CONICET), CABA, Argentina.,Health Informatics Department, Hospital Italiano de Buenos Aires, CABA, Argentina
| | - Fernan Gonzalez Bernaldo de Quirós
- Internal Medicine Research Unit, Hospital Italiano de Buenos Aires, CABA, Argentina.,University Institute of Hospital Italiano de Buenos Aires (IUHI), CABA, Argentina.,Health Informatics Department, Hospital Italiano de Buenos Aires, CABA, Argentina
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Pasqualini I, Rossi LA, De Cicco FL, Tanoira I, Alonso Hidalgo I, Bongiovanni S, Giunta DH, Ranalletta M. The playing position significantly influences return to sports and recurrences after an arthroscopic Bankart repair in competitive rugby players. Shoulder Elbow 2022; 14:29-37. [PMID: 35845626 PMCID: PMC9284259 DOI: 10.1177/1758573221993089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/16/2021] [Accepted: 01/19/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND The purpose of our study was to investigate the influence of the different rugby playing positions on return to sports, functional outcomes, and recurrences after an arthroscopic Bankart repair. METHODS A total of 88 rugby players were treated for anterior shoulder instability in our institution between 2010 and 2018. Functional outcomes, return to sports, recurrences, complications, and revisions rates were evaluated according to the playing position. RESULTS Overall, 73.8% of the patients returned to rugby and 60% returned at the same level as before the injury. The tight forwards and outside backs experienced a significant decrease in their competitive level after surgery, and showed the lowest functional outcomes. The tight forwards and outside backs showed a statistically significant increase in recurrence and revision rates, and an OR for recurrence of 12.8 and 9.6, respectively. DISCUSSION The playing position significantly influenced return to sports and recurrences after an arthroscopic Bankart repair in competitive rugby players. Specifically, the tight forwards and outside backs have returned to a lower level than they had before surgery, showed the lowest functional outcomes, and a significant increase in recurrences and revisions rates than the other groups.
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Basquiera AL, Odstrcil Bobillo MS, Peroni ML, Sanchez Thomas D, Vitriu A, Berro M, Rosales Ostriz B, Milovic V, Martinez Rolón J, Jaimovich G, Hansen Krogh D, Tagliafichi V, Bisigniano L, Arbelbide JA, Giunta DH. Temporal trends in hematopoietic stem cell transplantation in Argentina between 2009 and 2018: A collaborative study by GATMO-TC and INCUCAI. Hematol Transfus Cell Ther 2022:S2531-1379(22)00045-1. [DOI: 10.1016/j.htct.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 01/14/2022] [Accepted: 02/13/2022] [Indexed: 10/18/2022] Open
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Abstract
BACKGROUND Stress-induced hyperglycemia is a phenomenon that occurs typically in patients hospitalized for acute disease and resolves spontaneously after regression of the acute illness. However, it can also occur in diabetes patients, a fact that is sometimes overlooked. It is thus important to make a proper diabetes diagnosis if hospitalized patients with episodes of hyperglycemia with and without diabetes are studied. AIMS To estimate the extent of the association between stress-induced hyperglycemia and in-hospital mortality in patients with hospital hyperglycemia (HH), and to explore potential differences between patients diagnosed with diabetes (HH-DBT) and those with stress-induced hyperglycemia (SH), but not diagnosed with diabetes. METHODS A cohort of adults with hospital hyperglycemia admitted to a tertiary, university hospital in Buenos Aires, Argentina, was analyzed retrospectively. RESULTS In the study, 2,955 patients were included and classified for analysis as 1,579 SH and 1,376 HH-DBT. Significant differences were observed in glycemic goal (35.53% SH versus 25.80% HH-DBT, p < 0.01), insulin use rate (26.66% SH versus 46.58% HH-DBT, p < 0.01), and severe hypoglycemia rate (1.32% SH versus 1.74% HH-DBT, p < 0.01). There were no differences in hypoglycemia rate (8.23% SH versus 10.53% HH-DBT) and hospital mortality. There was no increase in risk of mortality in the SH group adjusted for age, non-scheduled hospitalization, major surgical intervention, critical care, hypoglycemia, oncological disease, cardiovascular comorbidity, and prolonged hospitalization. CONCLUSIONS In this study, we observed better glycemic control in patients with SH than in those with HH-DBT, and there was no difference in hospital mortality.
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Affiliation(s)
- María Paula Russo
- Internal Medicine Research Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Santiago Nicolas Marquez Fosser
- Clinical and Health Informatics Research Group, McGill University, Montr??al, Qu??bec, Canada; Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | | | - Diego Hernán Giunta
- Internal Medicine Research Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - María Florencia Grande-Ratti
- Internal Medicine Research Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
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Binder F, Ungaro CM, Bonella MB, Cafferata CM, Giunta DH, Ferreyro BL. Timing of palliative care referral in patients with advanced Non-Small Cell Lung Cancer: a retrospective cohort study. Progress in Palliative Care 2021. [DOI: 10.1080/09699260.2021.1890914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Fernando Binder
- Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- Health Data Science Area, Health Informatics Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - María Belén Bonella
- Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Carlos Maria Cafferata
- Palliative Care Division, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Diego Hernán Giunta
- Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- Internal Medicine Research Area, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Bruno Leonel Ferreyro
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Medicine, Sinai Health System and University Health Network, Toronto, Canada
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Grande-Ratti MF, Esteban JA, Mongelos D, Díaz MH, Giunta DH, Martínez BJ. [Undertriage as quality of care parameter in an emergency department]. Rev Med Chil 2021; 148:602-610. [PMID: 33399753 DOI: 10.4067/s0034-98872020000500602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 05/07/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Undertriage or the underestimation of the urgency of the condition of a person arriving in an emergency department (ED) represents a measure of quality care. AIM To estimate the prevalence of undertriage in a high complexity hospital of Argentina; to describe characteristics and mortality of these patients. MATERIAL AND METHODS All consultations admitted to the ED during 2014 were analyzed. Those assigned to a lower level of admission risk (classified as Emergency Severity Index -ESI- 3 to 5) but required hospitalization in intensive care units (ICU) as the first hospitalization place were considered as an undertriage. A random sample of correctly categorized admissions (ESI 1 or 2), who were subsequently hospitalized in the ICU, was selected as a comparison group. RESULTS The global undertriage prevalence was 0.30% (316/104,832). Among patients admitted to the ICU, the prevalence was 21% (316/1,461; 95% confidence intervals (CI) 19-24). The 316 patients whose severity was underestimated had a median age of 73 years, and admitted between 7 a.m. and 9 p.m. in a greater proportion. Overall hospital mortality was 8.9% (95% CI 6.78-11.38), and all deaths occurred after the patient was transferred from the emergency room. There were no differences in mortality between patients with correct triage or undertriage (11 and 7% respectively, p = 0.09). No differences were observed either in the total number of critical interventions during care in the first 24 hours. Significant differences were observed in requirements for mechanical ventilation (11 and 4% respectively, p = 0.01), orotracheal intubation (10 and 5% respectively p = 0.01) and non-invasive ventilation (8 and 4% respectively, p = 0.05). CONCLUSIONS Undertriage rate in this series was low, but it can be improved.
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Affiliation(s)
| | - Jorge Ariel Esteban
- Hospital Italiano de Buenos Aires, Central de Emergencias de Adultos, Argentina
| | - Damazo Mongelos
- Hospital Italiano de Buenos Aires, Central de Emergencias de Adultos, Argentina
| | - Mario Hernán Díaz
- Hospital Italiano de Buenos Aires, Central de Emergencias de Adultos, Argentina
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Pagotto V, Martínez MLP, Hernán Giunta D, Pochettino PA, Salzberg S. [Trends in the frequency of obesity and gestational diabetes in an eleven years period]. Rev Med Chil 2021; 148:1068-1074. [PMID: 33399772 DOI: 10.4067/s0034-98872020000801068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 07/02/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The prevalence of gestational diabetes (GDM) is increasing along with obesity and gestational age. This prevalence varies in populations and with different guidelines used for the diagnoses. AIM To estimate the change in prevalence of GDM and obesity in a period 11 years. MATERIAL AND METHODS Analysis of pregnancies attended at an obstetrics ward of a general hospital between 2001 and 2018. Those women who were diabetic prior to their pregnancy were excluded from the analysis. Annual crude and adjusted prevalence using direct standardization by age were estimated. RESULTS We analyzed 33,985 pregnancies. GDM screening was performed in 20,139 (59%), and 1,466 (7%) had GDM. In 2007 the crude and adjusted prevalence of GDM were 4.9 and 5.2%, respectively. The figures in 2018 were 8.8 and 8.5%, respectively, with an annual percentage of change (APC) of 6.9% (p < 0.001). The frequency of obesity also increased with an APC of 4.1% (p < 0.001). In women with GDM the APC of obesity was 4.6% (p < 0.001). There was also an increase in the frequency of screening, with a joinpoint in 2011. The APC of screening in the periods 2007-2011 and 2011-2018 were 16.6 and 2.9%, respectively (p < 0.001). CONCLUSIONS The prevalence of GDM increased in this period of eleven years along with the prevalence of obesity.
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Affiliation(s)
- Vanina Pagotto
- Departamento de Investigación Clínica, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | | | - Diego Hernán Giunta
- Departamento de Investigación Clínica, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Pablo Andrés Pochettino
- Departamento de Tocoginecología, Sección Diabetes y Embarazo, Hospital Italiano Agustín Rocca, San Justo, Argentina
| | - Susana Salzberg
- Departamento de Investigación Clínica, Instituto Centenario, Ciudad de Buenos Aires, Argentina
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Maritano Furcada J, Castro HM, De Vito EL, Grande Ratti MF, Posadas-Martínez ML, Giunta DH, Vazquez FJ, Ferreyro BL. Diagnosis of pulmonary embolism in patients with acute exacerbations of chronic obstructive pulmonary disease: A cross-sectional study. Clin Respir J 2020; 14:1176-1181. [PMID: 32780471 DOI: 10.1111/crj.13257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 08/01/2020] [Accepted: 08/06/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Pulmonary embolism (PE) remains a frequent complication in patients with chronic obstructive pulmonary disease (COPD). It is unclear that the extent to which the traditional risk stratifying scores for PE are accurate in this population. METHODS Cross-sectional study of adult patients with COPD and suspected PE included in an Institutional Registry of Thromboembolic Disease at a tertiary teaching hospital in the city of Buenos Aires, Argentina. We estimated the area under the receiver operating characteristic curves (AU-ROC), sensitivity and specificity of the Wells and Geneva scores using a positive computed tomography angiography as the gold standard for PE. We also estimated the sensitivity and specificity for the presence of isolated worsening of dyspnea at presentation, without other cardinal symptoms of acute exacerbation of COPD. RESULTS A total of 168 patients were included, of which 22% had confirmed PE. The AUC was 0.66 (95% CI 0.56-0.76) and 0.56 (95% CI 0.45-0.67) for the Wells and Geneva, respectively. Considering the most widely used cutoff points, the sensitivity and specificity were 24% and 90% for the Wells and 59% and 43% for the Geneva score, respectively. Isolated worsening of dyspnea on presentation had a sensitivity of 92% and specificity of 37%. CONCLUSIONS Both Wells and Geneva scores exhibit poor diagnostic accuracy for the diagnosis of PE in patients with COPD. The presence of isolated worsening of dyspnea on presentation could be an easy to identify criteria for the initial triage in this population. Further validation of our findings remains warranted.
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Affiliation(s)
| | | | - Eduardo Luis De Vito
- Institute of Medical Research Alfredo Lanari, Universidad de Buenos Aires, Buenos Aires, Argentina
| | | | | | - Diego Hernán Giunta
- Internal Medicine Research Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Bruno Leonel Ferreyro
- Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.,Sinai Health System/University Health Network and Interdepartmental Division of Critical Care Medicine, University of Toronto, ON, Canada.,Institute for Health Policy, Management, and Evaluation, University of Toronto, ON, Canada
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Giunta DH, Marquez Fosser S, Boietti BR, Ación L, Pollan JA, Martínez B, Luna D, Bonella MB, Grande Ratti MF. Emergency department visits and hospital readmissions in an Argentine health system. Int J Med Inform 2020; 141:104236. [PMID: 32721852 PMCID: PMC7373686 DOI: 10.1016/j.ijmedinf.2020.104236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 06/21/2020] [Accepted: 07/19/2020] [Indexed: 12/02/2022]
Abstract
BACKGROUND AND GOAL OF STUDY The scope of health in the Sustainable Development Goals is much broader than the Millennium Development Goals, spanning functions such as health-system access and quality of care. Hospital readmission rate and ED-visits within 30 days from discharge are considered low-cost quality indicators. This work assesses an indicator of quality of care in a tertiary referral hospital in Argentina, using data available from clinical records. PURPOSE To estimate the rate of ED-visits and the hospital readmission rate (HRR) after a first hospitalization (First-H), and to identify associated factors. METHODS This retrospective cohort included patients who had a First-H in Hospital Italiano de Buenos Aires between 2014-2015. Follow-up occurred from discharge until ED-visit, readmission, death, disaffiliation from health insurance, or 13 months. We present HRR at 30 days and ED-visits rate at 72 h, using the Cox proportional-hazards regression model to explore associated factors, and reporting adjusted hazard ratios (HR) with their respective 95 %CI. RESULTS The study comprised 10,598 hospitalizations (median age was 68 years). Of these, 5966 had at least one consultation to the ED during follow up, resulting in a 24 h rate of consultations to ED of 1.51 % (95 %CI 1.29-1.72); at 48 h 3.18 % (95 %CI 2.86-3.54); at 72 h 4.71 % (95 %CI 4.32-5.13). In multivariable models, factors associated for 72 h ED-visits were: age (aHR 1.06), male (aHR 1.14), Charlson Comorbidity Index (aHR 1.16), unscheduled hospitalization (aHR 1.39), prior consultation with the ED (aHR 1.08) and long hospital stay (aHR 1.39). Meanwhile, 2345 patients had at least one hospital readmission (98 % unscheduled), resulting a 24 h rate of 0.5 % (95 %CI 0.42-0.71), at 48 h 0.98 % (95 %CI 0.80-1.18), at 72 h 1.4 % (95 %CI 1.2-1.6); at 30 days 7.7 % (95 %CI 7.2-8.2); at 90 days 13 % (95 %CI 12.4-13.8); and one-year 22.5 % (95 %CI 21.7-23.4). Associated factors for HRR at 30 days were: age (HR 1.16), male (HR 1.09), Charlson comorbidities score (HR 1.27), social service requirement during First-H (HR 1.37), unscheduled First-H (HR 1.16), previous ED-visits (HR 1.03) and length of stay (HR 1.08). CONCLUSION Priorities efforts to improve must include greater attention to patients' readiness prior discharge, to explore causes of preventable readmissions, and better support for patient self-management.
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Affiliation(s)
- Diego Hernán Giunta
- Internal Medicine Research Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Bruno Rafael Boietti
- Internal Medicine Research Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Laura Ación
- Instituto de Cálculo, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Javier Alberto Pollan
- Department of Internal Medicine, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Bernardo Martínez
- Department of Internal Medicine, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina; Emergency Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Daniel Luna
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Maria Belen Bonella
- Department of Internal Medicine, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - María Florencia Grande Ratti
- Internal Medicine Research Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Emergency Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina.
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Giunta DH, Alonso Serena M, Luna D, Peroni ML, Sanchez Thomas D, Binder F, Blugerman GA, Fuentes N, Elizondo CM, Gonzalez Bernaldo de Quirós F. Association between non‐attendance to outpatient clinics and emergency department consultations, hospitalizations and mortality in a Health Maintenance Organization. Int J Health Plann Manage 2020; 35:1140-1156. [DOI: 10.1002/hpm.3021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 05/07/2020] [Accepted: 06/05/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- Diego Hernán Giunta
- Internal Medicine Research Unit Hospital Italiano de Buenos Aires CABA Argentina
- Research Department Hospital Italiano de Buenos Aires CABA Argentina
| | - Marina Alonso Serena
- Internal Medicine Research Unit Hospital Italiano de Buenos Aires CABA Argentina
| | - Daniel Luna
- Health Informatics Department Hospital Italiano de Buenos Aires CABA Argentina
| | - Maria Leticia Peroni
- Internal Medicine Research Unit Hospital Italiano de Buenos Aires CABA Argentina
| | - Diego Sanchez Thomas
- Internal Medicine Research Unit Hospital Italiano de Buenos Aires CABA Argentina
| | - Fernando Binder
- Internal Medicine Research Unit Hospital Italiano de Buenos Aires CABA Argentina
| | | | - Nora Fuentes
- Internal Medicine Research Unit Hospital Italiano de Buenos Aires CABA Argentina
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Benchimol JA, Elizondo CM, Giunta DH, Schapira MC, Pollan JA, Barla JD, Carabelli GS, Boietti BR. Survival and functionality in the elderly over 85 years of age with hip fracture. Rev Esp Cir Ortop Traumatol (Engl Ed) 2020; 64:265-271. [PMID: 32247622 DOI: 10.1016/j.recot.2020.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 01/09/2020] [Accepted: 02/02/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND There is a tendency for the aging population to fracture their hips. Our aim was to compare survival and functionality at one year, among elderly and very elderly patients with hip fracture. MATERIAL AND METHODS A prospective cohort of patients included in the Institutional Registry of Elderly Patients with Hip Fracture between 2014 and 2017. We classified patients as elderly patients (EP) <65 and <85 years and very elderly patients (VEP) ≥85 years. RESULTS We included 952 patients, 43% were EP and 57% were VEP. The proportion of women was 84% and 86% (P=.33) and with 2 or more points in the Charlson comorbidities index (28 and 31%, P= .36), respectively. The VEP were more dependent according to the Barthel score (34% and 62%, P<.01) and frailer according to the Edmonton score (30% and 61%, P<.01). One-year survival was 91% (95% CI 86-93) in the EP and 76% (95% CI 70-89) in the VEP. In-hospital complications were more frequent in the VEP 12% (7% in the EP, P<.01). Age is an independent risk factor for one-year survival (HR 2.11; 95% CI 1.36-3.29, P<.001). CONCLUSIONS Age is a risk factor for the VEP group survival despite fragility and comorbidities. Because of their vulnerability, an appropriate care plan should be considered for VEP.
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Affiliation(s)
- J A Benchimol
- Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina; Sección de Geriatría, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
| | - C M Elizondo
- Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina; Área de Investigación en Medicina Interna, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - D H Giunta
- Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina; Área de Investigación en Medicina Interna, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - M C Schapira
- Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina; Sección de Geriatría, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - J A Pollan
- Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - J D Barla
- Servicio de Ortopedia, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - G S Carabelli
- Servicio de Ortopedia, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - B R Boietti
- Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina; Área de Investigación en Medicina Interna, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina; Sección de Geriatría, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
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Roson M, Benchimol J, Rodota L, Cabrera P, Carabelli GS, Barla JD, Giunta DH, Elizondo MC, Boietti BR. [Effect of nutritional status on mortality and functional recovery in older adults with hip fracture]. Acta Ortop Mex 2020; 34:96-102. [PMID: 33244909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Malnutrition is a common problem in the elderly population but has not been fully studied in elderly people with hip fractures. The goal is to estimate annual mortality based on nutrition in the elderly with hip fracture and compare motor functionality. MATERIAL AND METHODS Retrospective cohort of patients over 65 years of age with hip fracture included in the Institutional Register of The Elderly with Hip Fracture of a University Hospital, between July 2014 and July 2018. Nutritional status with Mini Nutritional Assessment Short-Form (MNA-SF) was assessed at hospital admission. Motor functional capacity was evaluated with Parker Scale (PS) basal, at three and 12 months. RESULTS 1,253 patients were included. 49.92% (CI95% 47.12-52.72) were malnourished. The annual mortality of the well-nourished (WN) was 9.45% (CI95% 7.23-12.30) against 21.52% (CI95% 18.12-25.45; p 0.001) of the malnourished (MN). The risk of death was associated with malnutrition HR 2.45 (CI95% 1.75-3.43; p 0.001). After adjusting it by age, sex, fragility, AVD, Charlson comorbility index and dementia, the risk remained HR 1.71 (CI95% 17-2.49; p = 0.005). With respect to functionality, the basal Parker Scale median (EP) for the WN group was 9 (RIC6-9) and for MN was 5 (RIC3-9) p 0.001, 6 months (RIC3-6) and 4 (RIC2-6) p 0.001 and 12 months 6 (RIC4-7) and 3 (RIC2-6) p 0.001. CONCLUSIONS There is an association between the malnutrition of the elderly with hip fracture and its mortality with a year of evaluation; we also find a difference in motor functionality.
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Affiliation(s)
- M Roson
- Servicio de Alimentación. Hospital Italiano de Buenos Aires. Buenos Aires, Argentina
| | - J Benchimol
- Servicio de Clínica Médica. Hospital Italiano de Buenos Aires. Buenos Aires, Argentina
| | - L Rodota
- Servicio de Alimentación. Hospital Italiano de Buenos Aires. Buenos Aires, Argentina
| | - P Cabrera
- Servicio de Alimentación. Hospital Italiano de Buenos Aires. Buenos Aires, Argentina
| | - G S Carabelli
- Servicio de Ortopedia y Traumatología. Hospital Italiano de Buenos Aires. Buenos Aires, Argentina
| | - J D Barla
- Servicio de Ortopedia y Traumatología. Hospital Italiano de Buenos Aires. Buenos Aires, Argentina
| | - D H Giunta
- Servicio de Clínica Médica. Hospital Italiano de Buenos Aires. Buenos Aires, Argentina
| | - M C Elizondo
- Servicio de Clínica Médica. Hospital Italiano de Buenos Aires. Buenos Aires, Argentina
| | - B R Boietti
- Servicio de Clínica Médica. Hospital Italiano de Buenos Aires. Buenos Aires, Argentina
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Stonski E, Weissbrod D, Vicens J, Giunta DH, Liarte D, Agejas RJ, Lupi SM, Ondjian IA, Russi J, González Bernaldo-De-Quiros F, Darío-Waisman G, Baroni MV, Boietti BR, Camera LA. [Prevalence of pain among patients admitted to a clinical hospital]. Rev Med Chil 2019; 147:997-1004. [PMID: 31859964 DOI: 10.4067/s0034-98872019000800997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 08/07/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pain prevalence during hospital admission is variable, with estimates ranging from 32 to 77%. AIM To determine pain prevalence during admission to a clinical hospital. MATERIAL AND METHODS Patients admitted to medical and surgical wards were interrogated about the presence of pain within 48 to 72 hours after admission. Subjective pain was analyzed using a scale ranging from 0 to 10. Data was analyzed separately for medical, surgical, and obstetrical patients. RESULTS A total of 736 patients aged 18 to 94 years (416 women) were recruited. Pain prevalence at 48 hours after admission was 56% (95% confidence intervals (CI (52.7 to 60.1). Pain prevalence in medical, surgical and obstetric patients was 37% (95% CI 31.4 to 42.1), 70% (95% CI 64.5 to 75.5) and 77% (95% CI 68.6 to 84), respectively. The median pain intensities in medical, surgical, and obstetrical patients were 7 (interquartile range (IQR) 6-8), 7 (IQR 5-8) y 7 (IQR 5-8), respectively. CONCLUSIONS The prevalence of pain among patients admitted to the hospital is high, especially in obstetric and surgical units.
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Affiliation(s)
- Eduardo Stonski
- Servicio de Clínica Médica, Departamento de Medicina Interna, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Daniel Weissbrod
- Servicio de Clínica Médica, Departamento de Medicina Interna, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Jimena Vicens
- Servicio de Clínica Médica, Sección Epidemiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Diego Hernán Giunta
- Servicio de Clínica Médica, Área de Investigación en Medicina Interna, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Daniel Liarte
- Servicio de Clínica Médica, Área de Investigación en Medicina Interna, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Rodrigo Javier Agejas
- Servicio de Anestesiología, Departamento de Cirugía, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Silvina María Lupi
- Servicio de Anestesiología, Departamento de Cirugía, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Isabel Alicia Ondjian
- Servicio de Anestesiología, Departamento de Cirugía, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Juan Russi
- Servicio de Clínica Médica, Área de Investigación en Medicina Interna, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Gabriel Darío-Waisman
- Servicio de Clínica Médica, Departamento de Medicina Interna, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - María Verónica Baroni
- Servicio de Clínica Médica, Departamento de Medicina Interna, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Bruno Rafael Boietti
- Servicio de Clínica Médica, Área de Investigación en Medicina Interna, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Luis Alberto Camera
- Servicio de Clínica Médica, Departamento de Medicina Interna, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Briatore A, Tarsetti EV, Latorre A, Gonzalez Bernaldo de Quirós F, Luna D, Fuentes NA, Elizondo CM, Baum A, Alonso Serena M, Giunta DH. Causes of appointment attendance, nonattendance, and cancellation in outpatient consultations at a university hospital. Int J Health Plann Manage 2019; 35:207-220. [DOI: 10.1002/hpm.2890] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/07/2019] [Accepted: 08/08/2019] [Indexed: 11/08/2022] Open
Affiliation(s)
- Agustina Briatore
- Departamento de Informática en SaludHospital Italiano de Buenos Aires CABA Argentina
| | | | - Agustin Latorre
- Servicio de PediatríaHospital de Clínicas “José de San Martín” CABA Argentina
| | - Fernan Gonzalez Bernaldo de Quirós
- Área de Investigación en Medicina InternaHospital Italiano de Buenos Aires CABA Argentina
- Servicio de Clínica MédicaHospital Italiano de Buenos Aires CABA Argentina
| | - Daniel Luna
- Departamento de Informática en SaludHospital Italiano de Buenos Aires CABA Argentina
| | - Nora Angélica Fuentes
- Área de Investigación en Medicina InternaHospital Italiano de Buenos Aires CABA Argentina
| | - Cristina Maria Elizondo
- Área de Investigación en Medicina InternaHospital Italiano de Buenos Aires CABA Argentina
- Servicio de Clínica MédicaHospital Italiano de Buenos Aires CABA Argentina
| | - Analia Baum
- Departamento de Informática en SaludHospital Italiano de Buenos Aires CABA Argentina
| | - Marina Alonso Serena
- Área de Investigación en Medicina InternaHospital Italiano de Buenos Aires CABA Argentina
| | - Diego Hernán Giunta
- Área de Investigación en Medicina InternaHospital Italiano de Buenos Aires CABA Argentina
- Servicio de Clínica MédicaHospital Italiano de Buenos Aires CABA Argentina
- Departamento de investigaciónHospital Italiano de Buenos Aires CABA Argentina
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16
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Nucifora EM, Aguirre MA, Sorroche P, Saez MS, Fantl D, Rocca JA, Perez de Arenaza D, Varela CF, Greloni G, García Rivello H, Basquiera AL, Alberbide JA, Giunta DH, Boietti BR, Posadas Martínez ML. AL amyloidosis in Argentina: hospital Italiano de Buenos Aires. Amyloid 2019; 26:99-100. [PMID: 31343332 DOI: 10.1080/13506129.2019.1582485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Elsa Mercedes Nucifora
- a Department of Medicine, Hospital Italiano de Buenos Aires (HIBA), Grupo de Estudio de la Amiloidosis , Buenos Aires , Argentina
| | - María Adela Aguirre
- a Department of Medicine, Hospital Italiano de Buenos Aires (HIBA), Grupo de Estudio de la Amiloidosis , Buenos Aires , Argentina
| | - Patricia Sorroche
- b Department of Laboratory, Hospital Italiano de Buenos Aires (HIBA), Grupo de Estudio de la Amiloidosis , Buenos Aires , Argentina
| | - María Soledad Saez
- b Department of Laboratory, Hospital Italiano de Buenos Aires (HIBA), Grupo de Estudio de la Amiloidosis , Buenos Aires , Argentina
| | - Dorotea Fantl
- a Department of Medicine, Hospital Italiano de Buenos Aires (HIBA), Grupo de Estudio de la Amiloidosis , Buenos Aires , Argentina
| | - Julieta Antonella Rocca
- a Department of Medicine, Hospital Italiano de Buenos Aires (HIBA), Grupo de Estudio de la Amiloidosis , Buenos Aires , Argentina
| | - Diego Perez de Arenaza
- a Department of Medicine, Hospital Italiano de Buenos Aires (HIBA), Grupo de Estudio de la Amiloidosis , Buenos Aires , Argentina
| | - Carlos Federico Varela
- c Nephrology Service, Hospital Italiano de Buenos Aires (HIBA), Grupo de Estudio de la Amiloidosis , Buenos Aires , Argentina
| | - Gustavo Greloni
- c Nephrology Service, Hospital Italiano de Buenos Aires (HIBA), Grupo de Estudio de la Amiloidosis , Buenos Aires , Argentina
| | - Hernán García Rivello
- d Pathological Anatomy Service, Hospital Italiano de Buenos Aires (HIBA), Grupo de Estudio de la Amiloidosis , Buenos Aires , Argentina
| | - Ana Lisa Basquiera
- a Department of Medicine, Hospital Italiano de Buenos Aires (HIBA), Grupo de Estudio de la Amiloidosis , Buenos Aires , Argentina
| | - Jorge Alberto Alberbide
- a Department of Medicine, Hospital Italiano de Buenos Aires (HIBA), Grupo de Estudio de la Amiloidosis , Buenos Aires , Argentina
| | - Diego Hernán Giunta
- a Department of Medicine, Hospital Italiano de Buenos Aires (HIBA), Grupo de Estudio de la Amiloidosis , Buenos Aires , Argentina
| | - Bruno Rafael Boietti
- a Department of Medicine, Hospital Italiano de Buenos Aires (HIBA), Grupo de Estudio de la Amiloidosis , Buenos Aires , Argentina
| | - María Lourdes Posadas Martínez
- a Department of Medicine, Hospital Italiano de Buenos Aires (HIBA), Grupo de Estudio de la Amiloidosis , Buenos Aires , Argentina
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Russo MP, Grande Ratti MF, Giunta DH, Elizondo CM. Hospitalized patients with stress hyperglycemia: incidence of diabetes and mortality on follow-up. ACTA ACUST UNITED AC 2018; 65:571-576. [PMID: 30293899 DOI: 10.1016/j.endinu.2018.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 07/10/2018] [Accepted: 07/12/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION The study objective was to estimate during post-discharge follow-up the incidence of diabetes and to ascertain mortality in hospitalized patients, classified during follow-up as having stress hyperglycemia (SH) or normoglycemia (NG) based on blood glucose levels. MATERIAL AND METHODS A retrospective cohort of non-diabetic adults with SH (> 140mg/dl and HbA1c <6.5%) or NG (all blood glucose values ≤ 140mg/dl) was used. RESULTS There were 3981 patients with NG and 884 with SH. During the observation period (median follow-up of 1.83 years), there were 255 cases of diabetes and 831 deaths. The cumulative incidence of diabetes per year was 1.59% (95% CI: 1.23-2.06) in patients with NG and 7.39% (95% CI: 5.70-9.56) in those with SH. SH was significantly associated to diabetes (crude HR 1.33, 95% CI: 1.13-1.73, p .025), even after adjusting for age and sex (adjusted HR 1.38, 95% CI 1.06-1.78, p .014). The mortality rate at one year was 10.07% (95% CI: 9.18-11.05) in NG patients and 13.24% (95% CI: 11.17-15.65) in SH patients. The sub-hazard ratio of developing diabetes considering death as a competitive event was 1.41 (95% CI 1.29-1.53, p <.001). CONCLUSIONS SH is a risk factor for diabetes. There were no differences in mortality during follow-up, but death appears to be a competitive event in development of diabetes in this population.
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Affiliation(s)
- María Paula Russo
- Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | - María Florencia Grande Ratti
- Área de Investigación en Medicina Interna, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Servicio Medicina Familiar y Comunitaria, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Área Epidemiológica de Dirección de Promoción de la Salud y Control de Enfermedades No Transmisibles, Ministerio de Salud de Nación, Argentina
| | - Diego Hernán Giunta
- Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Área de Investigación en Medicina Interna, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Departamento de Investigación, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Cristina María Elizondo
- Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Área de Investigación en Medicina Interna, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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18
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Genoud NW, Alonso Serena M, Díaz MH, Esteban JA, Peroni JH, Giunta DH, Grande Ratti MF, Martínez B. [Assessment of an educational intervention regarding blood cultures as process indicators in an emergency department in Argentina]. J Healthc Qual Res 2018; 33:278-283. [PMID: 30401423 DOI: 10.1016/j.jhqr.2018.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 05/08/2018] [Accepted: 05/10/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The aim of this study was to describe 2 process indicators related to taking blood cultures (BC) in an Adult Emergency Department of a tertiary university hospital in Buenos Aires,and to describe the changes after a series of educational activities for health professionals was implemented during May 2016 as regards the appropriate indication of BC and the proper collection technique. MATERIALS AND METHODS A retrospective cohort study was designed to assess its effectiveness, which consecutively included all patients admitted during 2015-2016. The BC request rate was used as a process indicator, and the percentage of contaminated BCs and the true positives rate were used as quality indicators. Both were measured monthly and prospectively during the period of study. RESULTS The annual adjusted rate of BC requests was 4.9% (95% CI 4.8-5) in 2015 and 2.9% (95% CI 2.8-2.9) in 2016. The rate of false positive (contaminated) BCs was 4.5% in 2015 and 4.3% after the educational intervention. The true positive BCs were 8.3% in 2015 and 12% post-intervention. CONCLUSIONS These findings prove how important and effective the educational interventions are.
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Affiliation(s)
- N W Genoud
- Sección de Infectología, Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Central de Emergencias de Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - M Alonso Serena
- Área de Investigación en Medicina Interna, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | - M H Díaz
- Central de Emergencias de Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - J A Esteban
- Central de Emergencias de Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - J H Peroni
- Central de Emergencias de Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Sección de Neumonología, Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - D H Giunta
- Área de Investigación en Medicina Interna, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Departamento de Investigación, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - M F Grande Ratti
- Área de Investigación en Medicina Interna, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Servicio de Medicina Familiar y Comunitaria, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Área Epidemiológica, Dirección de Promoción de la Salud y Control de Enfermedades no Transmisibles, Ministerio de Salud de la Nación, Buenos Aires, Argentina
| | - B Martínez
- Central de Emergencias de Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Giunta DH, Pedretti AS, Elizondo CM, Grande Ratti MF, González Bernaldo de Quiros F, Waisman GD, Peroni HJ, Martínez B. [Analysis of Crowding in an Adult Emergency Department of a tertiary university hospital]. Rev Med Chil 2017; 145:557-563. [PMID: 28898330 DOI: 10.4067/s0034-98872017000500001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 06/01/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Crowding in Emergency Departments (ED), results from the imbalance between the simultaneous demand for health care and the ability of the system to respond. The NEDOCS scale (National Emergency Department Crowding Scale) measures the degree of crowding in an ED. AIM To describe ED Crowding characteristics, using the NEDOCS scale, in an Argentinean hospital. MATERIAL AND METHODS A retrospective cohort study was conducted with all adult patient consultations between July 2013 and July 2014 at the ED of Hospital Italiano de Buenos Aires. We included all hours in the analysis period (365 days x 24 h = 8,760). The NEDOCS value was calculated for each hour using an automatic algorithm and was quantified in a six points score. Levels 4 (overcrowded), 5 (severely overcrowded) and 6 (dangerously overcrowded) were defined as overcrowding. Contour plots analysis was applied to identify patterns. RESULTS During the study period, 124,758 visits to the ED were registered. Overcrowding was present in 57.7% (5,055) of the analyzed hours. A predominance of scores between four and five was observed between 10:00 and 24:00 hours. The months with predominance of overcrowding were June, July and August (southern winter). CONCLUSIONS The calculation of the NEDOCS score and the analysis of its temporal distribution are highly relevant to identify opportunities for improvement and to develop mechanisms to prevent the highest categories of overcrowding.
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Affiliation(s)
- Diego Hernán Giunta
- Área de Investigación en Medicina Interna, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina,
| | - Ana Soledad Pedretti
- Central de Emergencias de Adultos, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina
| | - Cristina María Elizondo
- Área de Investigación en Medicina Interna, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina,
| | - María Florencia Grande Ratti
- Área de Investigación en Medicina Interna, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina,
| | | | - Gabriel Darío Waisman
- Sección Hipertensión, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina
| | - Hector José Peroni
- Sección Neumonología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina
| | - Bernardo Martínez
- Central de Emergencias de Adultos, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina
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20
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Giunti G, Giunta DH, Guisado-Fernandez E, Bender JL, Fernandez-Luque L. A biopsy of Breast Cancer mobile applications: state of the practice review. Int J Med Inform 2017; 110:1-9. [PMID: 29331247 DOI: 10.1016/j.ijmedinf.2017.10.022] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 09/11/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Breast cancer is the most common cancer in women. The use of mobile software applications for health and wellbeing promotion has grown exponentially in recent years. We systematically reviewed the breast cancer apps available in today's leading smartphone application stores and characterized them based on their features, evidence base and target audiences. METHODS A cross-sectional study was performed to characterize breast cancer apps from the two major smartphone app stores (iOS and Android). Apps that matched the keywords "breast cancer" were identified and data was extracted using a structured form. Reviewers independently evaluated the eligibility and independently classified the apps. RESULTS A total of 1473 apps were a match. After removing duplicates and applying the selection criteria only 599 apps remained. Inter-rater reliability was determined using Fleiss-Cohen's Kappa. The majority of apps were free 471 (78.63%). The most common type of application was Disease and Treatment information apps (29.22%), Disease Management (19.03%) and Awareness Raising apps (15.03%). Close to 1 out of 10 apps dealt with alternative or homeopathic medicine. The majority of the apps were intended for patients (75.79%). Only one quarter of all apps (24.54%) had a disclaimer about usage and less than one fifth (19.70%) mentioned references or source material. Gamification specialists determined that 19.36% contained gamification elements. CONCLUSIONS This study analyzed a large number of breast cancer-focused apps available to consumers. There has been a steady increase of breast cancer apps over the years. The breast cancer app ecosystem largely consists of start-ups and entrepreneurs. Evidence base seems to be lacking in these apps and it would seem essential that expert medical personnel be involved in the creation of medical apps.
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Affiliation(s)
- G Giunti
- Salumedia Tecnologias, Seville, Spain; University of Oulu, Oulu, Finland.
| | - D H Giunta
- Internal Medicine Research Unit, Department of Internal Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - E Guisado-Fernandez
- University College Dublin, Dublin, Ireland; Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - J L Bender
- ELLICSR Health, Wellness and Cancer Survivorship Centre, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Centre for Global eHealth Innovation, Toronto General Hospital, University Health Network, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - L Fernandez-Luque
- Qatar Computing Research Institute, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
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Russo MP, Elizondo CM, Giunta DH, Grande Ratti MF. Prevalence of hyperglycemia and incidence of stress hyperglycemia in hospitalized patients: A retrospective cohort. Eur J Intern Med 2017; 43:e15-e17. [PMID: 28465029 DOI: 10.1016/j.ejim.2017.04.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 04/19/2017] [Indexed: 11/18/2022]
Affiliation(s)
- María Paula Russo
- Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | | | - Diego Hernán Giunta
- Internal Medicine Research Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Serra MM, Besada CH, Cabana Cal A, Saenz A, Stefani CV, Bauso D, Golimstok AB, Bandi JC, Giunta DH, Elizondo CM. Central nervous system manganese induced lesions and clinical consequences in patients with hereditary hemorrhagic telangiectasia. Orphanet J Rare Dis 2017; 12:92. [PMID: 28521822 PMCID: PMC5437640 DOI: 10.1186/s13023-017-0632-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 04/13/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Around 47-74% of patients with hereditary hemorrhagic telangiectasia (HHT) have hepatic vascular malformations (HVMs); magnetic resonance images (MRI) of the central nervous system (CNS) might show in T1 sequences a hyper-intensity signal in different areas, mainly in the basal ganglia (BG) as consequence of manganese (Mn) deposits as observed in cirrhotic patients. These patients might suffer from different neuropsychiatric disorders (hepatic encephalopathy). In HHT patients, even in the presence of hepatic shunts, hepatocellular function is usually preserved. Additionally, Mn shares iron absorption mechanisms, transferrin and CNS transferrin receptors. In iron deficiency conditions, the Mn may harbor transferrin and access BG. The objectives were to describe frequency of BG Mn deposit-induced lesions (BGMnIL) in HHT patients, its relationship with iron deficiency anemia (IDA) and HVMs. Finally, explore the association between neuropsychological and motor consequences. We performed a cross-sectional study. We determined HHT patients with or without BG-MnIL by the MRI screening of the CNS. We included all patients with lesions and a random sample of those without lesions. All patients underwent standardized and validated neuropsychological assessment to evaluate BG actions. Results were analyzed with multiple logistic regression, adjusting for potential confounders. RESULTS Among 307 participants from a cohort included in the Institutional HHT Registry, 179 patients had MRI performed and Curaçao Criteria ≥3. The prevalence of BG-MnIL was 34.6% (95%CI 27.69-42.09). While neuropsychological symptoms were present in all patients, BG-MnIL patients performed poorly in three of the neuropsychological tests (serial dotting, line tracing time, number connection test A). HVMs frequency in BG-MnIL was 95.1%, versus 71.4% in those without lesions (p < 0.001). IDA frequency was 90.3% versus 54% (p < 0.001). When IDA is present, estimated risk for BG-MnIL is remarkably high (OR 7.73, 95%CI 2.23-26.73). After adjustment for possible confounders (gender, age, presence of HVMs), IDA was still associated with increased risk of BG-MnIL (adjusted OR 6.32, 95% CI 2.32-17.20; p < 0.001). CONCLUSIONS Physicians should assess BG-MnIL in HHT patients in CNS-MRI. IDA and HVMs present increased risk of lesions. Patients with BG-MnIL have neuropsychological impairment, and they might benefit from sparing IDA, or undergoing future therapeutic options. TRIAL REGISTRATION NCT01761981 . Registered January 3rd 2013.
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Affiliation(s)
- M M Serra
- Internal Medicine Department. Hospital Italiano de Buenos Aires. Argentina (HIBA), Presidente Perón 4190, Cuidad Autónoma de Buenos Aires, C1199ABB, Argentina. .,HHT Unit. Hospital Italiano de Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina. .,ARG (Argentine Rendu Study Group), Ciudad Autonoma de Buenos Aires, Argentina.
| | - C H Besada
- Radiology Department, HIBA, Ciudad Autonoma de Buenos Aires, Argentina
| | - A Cabana Cal
- Neurology Department, HIBA, Ciudad Autonoma de Buenos Aires, Argentina
| | - A Saenz
- ARG (Argentine Rendu Study Group), Ciudad Autonoma de Buenos Aires, Argentina
| | - C V Stefani
- Neurology Department, HIBA, Ciudad Autonoma de Buenos Aires, Argentina
| | - D Bauso
- Neurology Department, HIBA, Ciudad Autonoma de Buenos Aires, Argentina
| | - A B Golimstok
- Neurology Department, HIBA, Ciudad Autonoma de Buenos Aires, Argentina
| | - J C Bandi
- Internal Medicine Department. Hospital Italiano de Buenos Aires. Argentina (HIBA), Presidente Perón 4190, Cuidad Autónoma de Buenos Aires, C1199ABB, Argentina.,HHT Unit. Hospital Italiano de Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina.,Hepatology area, HIBA, Ciudad Autonoma de Buenos Aires, Argentina
| | - D H Giunta
- Internal Medicine Department. Hospital Italiano de Buenos Aires. Argentina (HIBA), Presidente Perón 4190, Cuidad Autónoma de Buenos Aires, C1199ABB, Argentina.,Internal Medicine Research Unit, HIBA, Ciudad Autonoma de Buenos Aires, Argentina
| | - C M Elizondo
- Internal Medicine Department. Hospital Italiano de Buenos Aires. Argentina (HIBA), Presidente Perón 4190, Cuidad Autónoma de Buenos Aires, C1199ABB, Argentina.,ARG (Argentine Rendu Study Group), Ciudad Autonoma de Buenos Aires, Argentina.,Internal Medicine Research Unit, HIBA, Ciudad Autonoma de Buenos Aires, Argentina
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23
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Aguirre MA, Nucifora EM, Rugiero M, Sorroche P, Saez MS, Giunta DH, Posadas-Martinez ML, Boietti BR. Transthyretin-related hereditary amyloidosis in an Argentinian family with TTR Tyr114Cys mutation. Amyloid 2017; 24:102. [PMID: 28434328 DOI: 10.1080/13506129.2017.1291422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | | | - Patricia Sorroche
- b Department of Diagnosis and Treatment , Instituto Universitario Hospital Italiano de Buenos Aires , Buenos Aires , Argentina
| | - María Soledad Saez
- b Department of Diagnosis and Treatment , Instituto Universitario Hospital Italiano de Buenos Aires , Buenos Aires , Argentina
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24
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Day PF, Loto MG, Glerean M, Picasso MFR, Lovazzano S, Giunta DH. Incidence and prevalence of clinically relevant pituitary adenomas: retrospective cohort study in a Health Management Organization in Buenos Aires, Argentina. Arch Endocrinol Metab 2016; 60:554-561. [PMID: 27982201 PMCID: PMC10522164 DOI: 10.1590/2359-3997000000195] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 03/07/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The main purpose of this study was to estimate the incidence rate and prevalence of clinically relevant pituitary adenomas (PAs) within the Hospital Italiano Medical Care Program (HIMCP), a well-defined population of 150,000 members living in the urban and suburban area of the city of Buenos Aires. We defined clinically relevant PAs as those associated with endocrine dysfunction and/or mass effect. SUBJECTS AND METHODS A retrospective open cohort study was conducted, including all members of the HIMCP over 18 years old, with active memberships during the period of the study, from January 1st 2003, to January 1, 2014. The incidence rates (IRs) were standardized (SIR) to the World Health Organization (WHO) 2000 standard population and were expressed per 100,000 members/year. Prevalence was estimated at January 1, 2014, and was expressed per 100,000 persons. The clinical records have been electronically managed since 2001. All lab and imaging studies were done in-house. RESULTS The overall SIR was 7.39/100,000/year (95% CI 4.47-10.31). Female patients had a specific IR significantly higher than male patients (5.85 vs.1.54) and represented 73% of the affected members. Regarding tumor size, 61.4% were microadenomas, and the mean age at diagnosis was 46.4 years. Prolactinomas had the highest SIR (5.41), followed by acromegaly (Acro) and non-functioning adenomas (NFAs) with overlapping 95% CIs (0.44-1.41 and 0.31-0.99, respectively). Microprolactinomas were more frequent in female (72.6%) (p < 0.01) and younger members (38 vs.60 years; p < 0.04). The overall prevalence rate was 97.76/100,000. Prolactinomas had the highest prevalence (56.29), followed by NFAs (21.48), Acro (14.07) and CD (5.93). CONCLUSION Our results demonstrate that clinically relevant PAs are more common than usually suspected, especially prolactinomas and growth-hormone secreting PAs. These data highlight the need to increase the awareness of PAs, thereby enabling early diagnosis and treatment.
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Affiliation(s)
- Patricia Fainstein Day
- Department of Endocrinology and Nuclear MedicineHospital Italiano de Buenos AiresBuenos AiresArgentinaDepartment of Endocrinology and Nuclear Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Monica Graciela Loto
- Department of Endocrinology and Nuclear MedicineHospital Italiano de Buenos AiresBuenos AiresArgentinaDepartment of Endocrinology and Nuclear Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Mariela Glerean
- Department of Endocrinology and Nuclear MedicineHospital Italiano de Buenos AiresBuenos AiresArgentinaDepartment of Endocrinology and Nuclear Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - María Fabiana Russo Picasso
- Department of Endocrinology and Nuclear MedicineHospital Italiano de Buenos AiresBuenos AiresArgentinaDepartment of Endocrinology and Nuclear Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Soledad Lovazzano
- Department of Endocrinology and Nuclear MedicineHospital Italiano de Buenos AiresBuenos AiresArgentinaDepartment of Endocrinology and Nuclear Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Diego Hernán Giunta
- Research in Internal Medicine UnitDepartment of Internal MedicineHospital Italiano de Buenos AiresBuenos AiresArgentinaResearch in Internal Medicine Unit, Department of Internal Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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25
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Garipe LY, Bravo B, Fernández M, García M, Petrosini A, Soriano MM, Perman G, Giunta DH. [Not Available]. Acta Gastroenterol Latinoam 2015; 45:190-197. [PMID: 28590109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
UNLABELLED Celiac disease is an autoimmune enteropathy. The only known treatment consists of a permanent adherence to a strict gluten-free diet, which represents an important challenge for patients. Objective. To describe the gluten-free processed food offer in food locals from 3 neighborhoods representative of high, middle and low economic status in Buenos Aires, Argentina. METHODS Cross-sectional study. Specially trained monitors performed a standardized direct assessment of food locals. Whenever direct observation was not possible, we interviewed the personnel as an indirect assessment. We classified dish offer in different categories, and evaluated the processes of food elaboration, storage and distribution. RESULTS We included 112 food locals. Results for neighborhoods representative of high, middle and low economic status were, respectively: no gluten free dish available in 27.5% (45/62), 27.0% (27/37) and 30.8% (9/13), (p = 0.96); adequate elaboration in 17.7%, 13.5% and 7.7%, (p = 0.61); appropriate food storage in 12.9% (8), 13.5% (5) and 7.7% (1); (p = 0.85); adequate distribution in 8.1%, 8.1% and 0% (0), (p = 0.56). Conclusion. In 1 out of 4 food locals there was not even one gluten free dish. In addition, there was a lack of compliance with safety measures to avoid gluten cross-contamination.
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Vázquez FJ, Posadas-Martínez ML, Sevilla SG, Giunta DH, Gándara E. The role compression ultrasound in hospitalized patients with suspected pulmonary embolism. Thromb Res 2014; 134:1162-3. [PMID: 25220940 DOI: 10.1016/j.thromres.2014.08.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 08/18/2014] [Accepted: 08/19/2014] [Indexed: 11/24/2022]
Affiliation(s)
- F J Vázquez
- Internal Medicine Research Unit, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | - M L Posadas-Martínez
- Internal Medicine Research Unit, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | - S G Sevilla
- Department of Medicine, Austral University, Pilar Buenos Argentina.
| | - D H Giunta
- Internal Medicine Research Unit, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | - E Gándara
- Divison of Hematology-Department of Medicine. University of Ottawa-Ottawa Hospital. Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada
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Posadas-Martínez ML, Vázquez FJ, Giunta DH, Waisman GD, de Quirós FGB, Gándara E. Performance of the Wells score in patients with suspected pulmonary embolism during hospitalization: A delayed-type cross sectional study in a community hospital. Thromb Res 2014; 133:177-81. [DOI: 10.1016/j.thromres.2013.11.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 10/30/2013] [Accepted: 11/19/2013] [Indexed: 10/26/2022]
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Vázquez FJ, Posadas-Martínez ML, Vicens J, González Bernaldo de Quirós F, Giunta DH. Incidence rate of symptomatic venous thromboembolic disease in patients from a medical care program in Buenos Aires, Argentina: a prospective cohort. Thromb J 2013; 11:16. [PMID: 24060275 PMCID: PMC3750410 DOI: 10.1186/1477-9560-11-16] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Accepted: 07/05/2013] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The incidence of venous thromboembolic disease (VTED) is estimated to be, on average, 1-2 cases per 1,000 individuals per year worldwide. There are few data concerning the incidence rate (IR) of VTED in the Argentinean population at large.Our aim was to estimate the IR of VTED at the Italian Hospital Medical Care Program (IHMCP) in Buenos Aires, the most populous city in Argentina. METHODS This prospective cohort study evaluated all consecutive incident cases of pulmonary thromboembolism (PTE) and deep vein thrombosis (DVT) confirmed in patients over the age of 17 who were members of the IHMCP from June 2006 to May 2012. Any patient who had an initial confirmed VTED episode and was a member of the IHMCP at the time of diagnosis was considered an incident case. RESULTS There were 1,138 cases of VTED for 687,871 person-years of follow-up. The crude IR of VTED was 1.65 (95% CI: 1.56 to 1.75) per 1,000 person-years. The highest IR was found in subjects >80 years old (5.92 per 1,000 person years; 95% CI: 5.41 to 6.49).The IRs adjusted to the population of the city of Buenos Aires were 0.90 (95% CI: 0.84 to 0.95) for VTED, 0.71 (95% CI: 0.66 to 0.76) for DVT, and 0.34 (95% CI: 0.31 to 0.37) for PTE. CONCLUSIONS VTED is a common health problem with a high IR in members of the IHMCP, especially the elderly. This is the first paper to report prospectively the cumulative incidence of VTED in Latin America.
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Affiliation(s)
- Fernando Javier Vázquez
- Departamento de Medicina Interna [Internal Medicine Department], 2° piso [2nd floor], Hospital Italiano de Buenos Aires [Italian Hospital of Buenos Aires], Perón 4190 Buenos Aires C1181ACH, Argentina.
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Bettini M, Vicens J, Giunta DH, Rugiero M, Cristiano E. Incidence and prevalence of amyotrophic lateral sclerosis in an HMO of Buenos Aires, Argentina. Amyotroph Lateral Scler Frontotemporal Degener 2013; 14:598-603. [DOI: 10.3109/21678421.2013.808225] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Cristiano E, Rojas JI, Romano M, Frider N, Machnicki G, Giunta DH, Calegaro D, Corona T, Flores J, Gracia F, Macias-Islas M, Correale J. The epidemiology of multiple sclerosis in Latin America and the Caribbean: a systematic review. Mult Scler 2012; 19:844-54. [DOI: 10.1177/1352458512462918] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The incidence and prevalence of multiple sclerosis (MS) varies geographically as shown through extensive epidemiological studies performed mainly in developed countries. Nonetheless, scant data is available in Latin America and the Caribbean (LAC). The objective of this review is to assess epidemiological data of MS in LAC. We conducted a systematic review of published articles and gray literature from January 1995 to May 2011. Twenty-two studies met the inclusion criteria after full-text review. Incidence data were found in only three studies and ranged from 0.3 to 1.9 annual cases per 100,000 person-years. Prevalence was reported in 10 studies and ranged from 0.83 to 21.5 cases per 100,000 inhabitants. The most prevalent subtype of MS was the relapsing–remitting form (48% to 91% of the series). No data about mortality were found. This study showed low frequency for MS in LAC compared with North American and European countries. The role of environmental and genetic factors should be well studied, providing new insights about its etiology.
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Affiliation(s)
- E Cristiano
- Department of Neurology, MS Clinic, Hospital Italiano de Buenos Aires, Argentina
| | - JI Rojas
- Department of Neurology, MS Clinic, Hospital Italiano de Buenos Aires, Argentina
| | - M Romano
- Department of Neurocience, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno, CEMIC, Argentina
| | - N Frider
- Regional Medical Director in Neuroscience, Novartis Latinoamerica & Canada
| | - G Machnicki
- Global Health Economics and Outcomes Research, Novartis Latinoamerica & Canada
| | - DH Giunta
- Department of Internal Medicine, Section of Epidemiology, Hospital Italiano de Buenos Aires, Argentina
| | - D Calegaro
- Hospital das Clinicas-Universidade de São Paulo, Brazil
| | - T Corona
- Laboratory of Neurodegenerative Diseases, National Institute of Neurology and Neurosurgery, Mexico
| | - J Flores
- Laboratory of Neurodegenerative Diseases, National Institute of Neurology and Neurosurgery, Mexico
| | - F Gracia
- Multiple Sclerosis Clinic, Santo Tomás Hospital, Panamá
| | - M Macias-Islas
- Neurosciences Department, CUCS, Guadalajara University, Mexico
| | - J Correale
- Department of Neurology, Raúl Carrea Institute for Neurological Research, FLENI, Argentina
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