Hospital Durand

Buenos Aires, Argentina

Hospital Durand

Buenos Aires, Argentina
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Bechara A.,Hospital Durand | Casabe A.,Instituto Medico Especializado IME | Rodriguez Baigorri G.,Hospital Tornu | Cobreros C.,Instituto Urologico Of Buenos Aires
Journal of Sexual Medicine | Year: 2014

Introduction: Naturalistic clinical trials provide data on the effectiveness of drugs in nonexperimental and everyday situations and are extremely helpful for decision-making purposes and for confirming experimental findings in clinical trials. No data have been published from naturalistic studies performed in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) with or without erectile dysfunction (ED) and treated with phosphodiesterase type 5 inhibitors. Aim: The aim of this study (TadaLutsEd Study) was to assess, in the context of medical practice, the effectiveness of tadalafil 5mg once daily in patients with LUTS/BPH with or without erectile dysfunction. Methods: The study was a 6-week uncontrolled, prospective, open-label, multicentric, observational study. The patient population involved sexually active males aged ≥50 years, diagnosed with LUTS/BPH with or without concomitant ED, and treated with tadalafil 5mg daily in accordance with standard urological practice. Main Outcome Measures: Effectiveness was assessed through the self-administered International Prostate Symptom Score (IPSS) questionnaire; quality of life was evaluated through the IPSS quality of life section (IPSS-QoL). The patients were also evaluated with the International Index of Erectile Function (IIEF-5). Adverse events were recorded. Statistical analyses using paired data samples was applied (Wilcoxon signed-ranks test). Results: Sixty-two patients (mean age 62.2 years) completed the treatment, of whom 85.5% showed improvement in their urinary symptoms. Pre- and post-treatment differences in the IPSS, IPSS-QoL, and IIEF-5 scores were statistically significant at 4.4, 1, and 5.4 points, respectively (P<0.0001). Tadalafil was well tolerated, and adverse events were mild, with a discontinuation rate of 1.6%. Conclusion: According to study results, the use of tadalafil 5mg once daily in a nonselected patient population with LUTS/BPH with or without ED led to improvements in terms of symptoms and quality of life and exhibited a safety profile similar to that obtained in controlled tadalafil clinical trials. Bechara A, Casabe A, Rodriguez Baigorri G, and Cobreros C. Effectiveness of tadalafil 5mg once daily in the treatment of men with lower urinary tract symptoms suggestive to benign prostatic hyperplasia with or without erectile dysfunction: Results from naturalistic observational TadaLutsEd Study. © 2013 International Society for Sexual Medicine.


Sesarini C.V.,Institute Ciencias Basicas y Medicina Experimental ICBME | Costa L.,Institute Ciencias Basicas y Medicina Experimental ICBME | Naymark M.,Hospital Italiano Of Buenos Aires Hiba | Granana N.,Hospital Durand | And 3 more authors.
Autism Research | Year: 2014

Autism spectrum disorders (ASD) can be conceptualized as a genetic dysfunction that disrupts development and function of brain circuits mediating social cognition and language. At least some forms of ASD may be associated with high level of excitation in neural circuits, and gamma-aminobutyric acid (GABA) has been implicated in its etiology. Single-nucleotide polymorphisms (SNP) located within the GABA receptor (GABAR) subunit genes GABRA1, GABRG2, GABRB3, and GABRD were screened. A hundred and thirty-six Argentinean ASD patients and 150 controls were studied, and the contribution of the SNPs in the etiology of ASD was evaluated independently and/or through gene-gene interaction using multifactor dimensionality reduction (MDR) method. From the 18 SNP studied, 11 were not present in our Argentinean population (patients and controls) and 1 SNP had minor allele frequency <0.1%. For the remaining six SNPs, none provided statistical significant association with ASD when considering allelic or genotypic frequencies. Non-significant association with ASD was found for the haplotype analysis. MDR identified evidence for synergy between markers in GABRB3 (chromosome 15) and GABRD (chromosome 1), suggesting potential gene-gene interaction across chromosomes associated with increased risk for autism (testing balanced accuracy: 0.6081 and cross-validation consistency: 10/10, P<0.001). Considering our Argentinean ASD sample, it can be inferred that GABRB3 would be involved in the etiology of autism through interaction with GABRD. These results support the hypothesis that GABAR subunit genes are involved in autism, most likely via complex gene-gene interactions. Autism Res 2014, 7: 162-166. © 2013 International Society for Autism Research, Wiley Periodicals, Inc.


PubMed | Consultorio privado, Hospital Of Ninos Ricardo Gutierrez, Hospital General Of Agudos Lopez Y Planes, Hospital Ramos Mejia and 49 more.
Type: Journal Article | Journal: American journal of hematology | Year: 2016

Patients with Gaucher type 1 (GD1) throughout Argentina were enrolled in the Argentine bone project to evaluate bone disease and its determinants. We focused on presence and predictors of bone lesions (BL) and their relationship to therapeutic goals (TG) with timing and dose of enzyme replacement therapy (ERT). A total of 124 patients on ERT were enrolled in a multi-center study. All six TG were achieved by 82% of patients: 70.1% for bone pain and 91.1% for bone crisis. However, despite the fact that bone TGs were achieved, residual bone disease was present in 108 patients on ERT (87%) at time 0. 16% of patients showed new irreversible BL (bone infarcts and avascular osteonecrosis) despite ERT, suggesting that they appeared during ERT or were not detected at the moment of diagnosis. We observed 5 prognostic factors that predicted a higher probability of being free of bone disease: optimal ERT compliance; early diagnosis; timely initiation of therapy; ERT initiation dose 45 UI/kg/EOW; and the absence of history of splenectomy. Skeletal involvement was classified into 4 major phenotypic groups according to BL: group 1 (12.9%) without BL; group 2 (28.2%) with reversible BL; group 3 (41.9%) with reversible BL and irreversible chronic BL; and group 4 (16.9%) with acute irreversible BL. Our study identifies prognostic factors for achieving best therapeutic outcomes, introduces new risk stratification for patients and suggests the need for a redefinition of bone TG. Am. J. Hematol. 91:E448-E453, 2016. 2016 Wiley Periodicals, Inc.


An aneurysm is a permanent dilatation of an artery due to a weal(ness in the arterial wall. The aortic aneurysm is defined as the enlargement of the diameter greater than 50% in his original size compared with a previous segment, or greater than 3 cm. If an abdominal aortic aneurysm is suspected on the basis of either the patient history or a prominent aortic pulse, an abdominal ultrasound examination should be done. The presence of an aneurysm is an indication for complete evaluation for strong consideration of surgical treatment Rupture of an abdominal aneurysm is associated with sudden, massive blood loss. Many of these patients die before reaching a hospital. The striiang difference in mortality rates between patients with ruptured aneurysms and those undergoing elective treatment makes a strong case for advising surgery to prevent deaths due to rupture. For these motives it is imperious to indicate ultrasound studies to provide concrete images of this disease. These considerations are expressed in this paper.


Casabe A.,Hospital Durand | Casabe A.,IME Instituto Medico Especializado | Bechara A.,Hospital Durand | Bechara A.,IME Instituto Medico Especializado | And 3 more authors.
Journal of Sexual Medicine | Year: 2011

Introduction. Peyronie's disease (PD) is a localized fibrosis that affects the tunica albuginea of the penis. Its origin can be associated with coital penile trauma in men with autoimmune hypersensitivity and a presumed genetic predisposition. Aim. To identify clinical and traumatic risk factors in a patient population with PD, when compared to a control group. Methods. From November 2007 to March 2010, 317 patients sought medical attention for PD. As control group, 147 consecutive patients, who came for a prostate exam, were studied. Clinical, traumatic, and sexual history of these patients was gathered. Risks factors were considered only if they had been present before the onset of PD symptoms. Main Outcome Measure. The International Index of Erectile Function and the International Prostate Symptoms Score. A univariate logistic regression model (chi-square) (odds ratios [ORs] and 95% confidence intervals [CI]) was used to estimate the association of risk factors with PD; and the Student's t-test was implemented for age. Results. The mean age of patients with PD and control group was 56.7 and 58.8, respectively (P<0.923). The mean evolution time of the disease was 17.7 months (2-48). Erectile dysfunction (ED) and coital trauma constituted the only two independent risk factors for PD compared to the control group (P<0.05 and 0.002, respectively) with an OR of 1.5 (95% CI 1.0-2.3) and 2.69 (95% CI 1.41-5.21), respectively. Patients with ED and diabetes mellitus and with a mild-to-moderate ED also presented a higher predisposition (P=0.008 and 0.00001), with an OR of 3.64 (95% CI 1.33-10.79) and 5.58 (95% CI 3.03-10.42), respectively. Conclusion. Erectile dysfunction and coital trauma have proven to be independent risk factors for the development of PD. © 2010 International Society for Sexual Medicine.


Hirschler V.,Hospital Durand | Molinari C.,University of Buenos Aires | Maccallini G.,Hospital Durand | Aranda C.,Hospital Durand | Oestreicher K.,University of Buenos Aires
Clinical Biochemistry | Year: 2011

Background: Anthropometric indices have been associated with dyslipidemia. Objective: To compare the abilities of BMI, waist circumference (WC) and WC/height to identify children's dyslipidemia. Methods: Students 1261 (639 male) age 9.5 ± 2.1. years. were examined for anthropometry and lipid levels. Triglycerides ≥ 1.69. mmol/L and high-density lipoprotein cholesterol (HDL-C) < 0.91. mmol/L were considered abnormal per American Heart Association. Results: The prevalence of abnormal triglycerides was 4.1% and HDL-C 8.1%. The areas under the receiver operator curves (ROC) were: BMI = 0.87, WC = 0.83, and WC/height = 0.84 in predicting both low HDL-C and high triglycerides. Multiple regression analyses showed that the odds ratios (OR) were highest for WC [6.5], followed by WC/height [5.4], and BMI [4.9], for dyslipidemia. Conclusions: The results suggest that WC, WC/height, and BMI similarly predicted dyslipidemia, using ROC analyses. However, regression analyses showed that WC followed by WC/height was most predictive of dyslipidemia. © 2011 The Canadian Society of Clinical Chemists.


Hirschler V.,Durand Hospital Maipu 812 5 M | Oestreicher K.,University of Buenos Aires | Maccallini G.,Hospital Durand | Aranda C.,Hospital Durand
Clinical Biochemistry | Year: 2010

Background: Argentina has experienced marked increases in the prevalence of childhood overweight (OW)/obesity over the last few decades. Objectives: We examined (1) the distribution of the mean values of lipids, glucose, and HOMA-IR according to the presence of OW/obesity, age, and sex and (2) the association between metabolic syndrome and OW/obesity, Tanner stage, gender, and HOMA-IR. Methods: Data were collected from 1009 children (508 males) in 10 elementary schools between April and September 2007. BMI, waist circumference, blood pressure, Tanner, lipids, insulin, and glucose were determined. Criteria analogous to ATPIII were used for metabolic syndrome in children. Results: Over 1009 children (508 males) aged 9.4 ± 2.0 years were evaluated. One hundred and sixty-five (16.4%) were obese (> 95th percentile), and 166 (16.5%) were OW (85-95th). Twenty-five (2.5%) were severely obese (BMI > 99th). Most of the children (62%; 613/979) were at Tanner 1. Triglycerides, insulin, and HOMA-IR were higher (p < 0.001) and HDL-C lower (p < 0.001) in OW/obesity in both age groups and genders. The prevalence of metabolic syndrome was 5.8% overall, 32% in severely obese, 16.4% in OW/obese and 0.4% in normal weight children. Multiple logistic regression showed that BMI (OR 24.48; 95% CI 9.14-65.57), and HOMA-IR (OR 2.09; 95% CI 1.04-4.18) were associated with metabolic syndrome adjusted by gender and Tanner stage. Multiple linear regression also showed that BMI and HOMA-IR were independently associated with the number of metabolic syndrome components (R2 = 0.46). Conclusions: A substantial number of OW/obese children have the metabolic syndrome. HOMA-IR and BMI were strong predictors of metabolic syndrome in children suggesting that OW/obese school children are at a higher risk for future cardiovascular disease. © 2009 The Canadian Society of Clinical Chemists.


Rubinstein F.,Institute for Clinical Effectiveness and Health Policy | Rubinstein F.,University of Buenos Aires | Rubinstein F.,Hospital Italiano Of Buenos Aires | Micone P.,Hospital Durand | And 9 more authors.
BMJ (Online) | Year: 2013

Objective To assess the risk of adverse perinatal events of vaccination of pregnant women with an MF59 adjuvanted vaccine. Design Cross sectional multicentre study. Setting 49 public hospitals in major cities in Argentina, from September 2010 to May 2011. Participants 30 448 mothers (7293 vaccinated) and their 30 769 newborns. Main outcome measure Primary composite outcome of low birth weight, preterm delivery, or fetal or early neonatal death up to seven days postpartum. Results Vaccinated women had a lower risk of the primary composite outcome (7.0% (n=513) v 9.3% (n=2160); adjusted odds ratio 0.80, 95% confidence interval 0.72 to 0.89). The propensity score analysis showed similar results. Adjusted odds ratios for vaccinated women were 0.74 (0.65 to 0.83) for low birth weight, 0.79 (0.69 to 0.90) for preterm delivery, and 0.68 (0.42 to 1.06) for perinatal mortality. These findings were consistent in further subgroup analysis. No significant differences in maternal outcomes were found. Conclusion This large study using primary data collection found that MF59 adjuvanted A/H1N1 influenza vaccine did not result in an increased risk of adverse perinatal events and suggested a lower risk among vaccinated women. These findings should contribute to inform stakeholders and decision makers on the prescription of vaccination against influenza A/H1N1 in pregnant women.


Hirschler V.,Hospital Durand | Molinari C.,University of Buenos Aires | Maccallini G.,Hospital Durand | Aranda C.,Hospital Durand
Pediatric Diabetes | Year: 2010

Background: Different studies in adults have shown that obesity is an independent risk factor for end-stage renal disease. Objective: It was to (i) determine the association between albuminuria and age, gender, BMI, waist circumference (WC), and blood pressure (ii) relate albuminuria to gender and age in healthy school children. Methods: Over 1564 students (806 males) aged 9.35 ± 2.00 yr from 9 elementary schools in Buenos Aires, were examined between April and September 2005. BMI, WC, blood pressure, urinary albumin excretion and albumin/creatinine ratio (ACR) were determined. Results: Over 220 (14.1%) children were obese (OB), and 300 (19.2%) overweight (OW) using centers for disease control (CDC) norms. Median ACR and urinary albumin levels were higher in normal weight children than in OW/OB children (p < 0.01). Median values for ACR were higher in girls than in boys (p < 0.001). OW/OB proved to be a protective factor against ACR [OR, 0.77 (95% CI 0.64-0.92)], whereas female gender [OR, 2.72 (95% CI 2.13-3.47)] was associated with a higher ACR adjusted for age systolic and diastolic blood pressure in the multiple logistic regression analysis. Therefore, children with OW/OB had 23% lower odds of having ACR ≥ III quartile and girls had more than two and half times the risk of having high ACR. Conclusions: Our results suggest that OW/OB is inversely associated with childhood albuminuria while female gender is positively associated. Whether the results can be explained by the increased physical activity in lean children should be the subject of future investigations. These results suggest that micro-albuminuria in children may not be a useful tool in the early identification of children at risk for future renal and cardiovascular disease (CVD). © 2009 John Wiley & Sons A/S.


PubMed | Hospital Durand
Type: Journal Article | Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology | Year: 2016

9685 Background: It is known that envirommental and life style changes may play a role in the development of breast cancer.In our country,the patients originally seen with this pathology were Spanish and Italian immigrants who came to Argentina until 1950.We analized the changes that took place with respect tothe age of breast cancer onset and menopause in this population along the last century.Two thousand and eleven female pts with breast cancer diagnosis (dx),seen at Hospital Rawson (1962-1978) and Hospital Durand (1979-2oo3), were retrospectively analyzed.All of them were born between 1900 and 1970.The following variables were taken into account: date of birth, age and menopausal status at dx.The whole population was divided into three groups based on age : Born between 1900 and 1930 Group A (GA),between 1931 and 1960 Group B (GB) and from 1961 on,Group C(GC).The overall mean age was 55 +/-13 years (yrs).GA 63+/-11 yrs;GB 50+/-9 yrs; GC 35+/-4 yrs.(GA vs.GB p=0.001).As regards the menopausal status at dx,the relation between pre and postmenopausal women was GA:92/620 pts,GB:550/496 pts and GC:95/4 pts.(GA vs GB p=0.001).The age at dx for premenopausal women was GA:46+/- 6yrs,GB:44+/-6 yrs and GC 35+/- 4yrs.(GA vs. GB p=0.001) and in postmenopausal women :GA 66+/-9 yrs,GB56+/-7 yrs and GC 38 +/-3 yrs (GA vs. GB p=0.001).The time between menopause and dx was 18 yrs for GA and 10 yrs for GB.The number of women with childbearing potential under 40 years old who constituted the High Risk Premenopausal Group (HRPG) were 19,176 and 98 for Groups A,B and C respectively.This HRPG correspondedf to 13% of the total number of cases.In our country,the tnedency clearly shows that women are younger at the time of diagnosis (diferences between age Groups A,B and C) and that there is a predominant increase in the number of women who are premenopausal at diagnosis.The differences among Groups A,B and C are more than 10 years.This not only may reflect the early diagnosis and consultation but also other factors that need yet to be determined.The creation of a National Tumor Database could be the only means to confirm these findings. No significant financial relationships to disclose.

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