Córdoba, Argentina
Córdoba, Argentina

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Centeno A.,Hospital Cordoba | Danielo C.,Hospital Cordoba | Campana R.,Hospital Cordoba | Orozco M.A.,Catholic University of Córdoba
Medicina Cutanea Ibero-Latino-Americana | Year: 2010

Its review the malign neoplasies principles in the oral cavity and it's describe the clinics characteristics, the differential diagnosis and the treatment. More than 90% of cancers of the oral cavity are squamous cell carcinomas. Squamous cells are flat, scale-like cells that normally form the lining of the oral cavity. The earliest form of squamous cell cancer is called carcinoma in situ, meaning that the cancer cells are present only in the lining layer of cells called the epithelium. Invasive squamous cell cancer means that the cancer cells have spread beyond this layer into deeper layers of the oral cavity. Verrucous carcinoma is a type of squamous cell carcinoma that makes up less than 5% of all oral cavity tumors. It is a low-grade cancer that rarely metastasizes but can deeply spread into surrounding tissue. Therefore, surgical removal of the tumor with a wide margin of surrounding tissue is advised. Minor salivary gland cancers can develop in the glands that are found throughout the mucosal lining. There are several types of minor salivary gland cancers including adenoid cystic carcinoma, mucoepidermoid carcinoma and polymorphous low-grade adenocarcinoma. The tonsils and base of tongue contain immune system (lymphoid) tissue that can develop into a cancer. There are other tumors that will be described in this article. The treatment and outlook for cure (prognosis) are different from different tumors.


Rigo D.H.,Sanatorio Allende | Ziraldo L.,Hospital Cordoba | Di Monte L.,Sanatorio Allende | Jimenez M.P.,Sanatorio Allende | And 6 more authors.
Transplantation Proceedings | Year: 2011

Introduction: Endstage renal disease (ESRD) is a prevalent, important cause of death. Transplantation increases survival and improves the quality of life of patients with ESRD while long-term dialysis is related to poor outcomes even among patients who undergo subsequent transplantations. Objectives: To compare the advantages of preemptive procedures with kidney transplants among patients on renal replacement therapy. Methods: This retrospective study was performed in two Córdoba city transplantation centers. Patients were divided into three groups: preemptive kidney transplant (PKT), patients on hemodialysis who received living donor kidney transplants (LDT), and subjects who received grafts from deceased donors (DDT). Serum creatinine, delayed graft function (DGF), subclinical rejection, and interstitial fibrosis/tubular atrophy (IF/TA) were evaluated at 6 months. Results: Eighty patients were included: PKT (n = 28), LDT (n = 27), DDT (n = 25) mean age 29, 30, and 35 years, respectively. Women predominated among PKT and men in the other groups. In all groups, cyclosporine was the calcineurin inhibitor mostly used. Creatinine at 6 months was lower in the living donor groups (1.26 mg/dL PKT and 1.32 mg/dL LDT; P = NS) in relation to the deceased donor group (1.96 mg/dL; P <.05). DDT had the highest rate of DGF: 44% DDT versus 11.5% LDT vs 0% PKT (P <.05). Subclinical rejection was significantly lower among preemptive transplantations: PKT 7.6% versus LDT 18.5% versus DDT 24% (P <.05). IF/TA was higher in transplants from deceased donors: PKT 11.1%; LDT 11.5%; DDT 32%. Conclusions: Preemptive kidney transplantation offered the advantages of a lower creatinine, no DGF, as well as a reduced incidence of subclinical rejection and chronic allograft nephropathy at 6 months posttransplantation. © 2011 Published by Elsevier Inc.


Racca M.A.,Hospital Cordoba | Novoa P.A.,Hospital Cordoba | Rodriguez I.,Hospital Cordoba | Della Vedova A.B.,National University of Cordoba | And 3 more authors.
Transplant International | Year: 2015

Summary Chronic renal allograft injury is reflected by interstitial fibrosis and tubular atrophy (IF/TA) and by the accumulation of extracellular matrix (ECM). Metalloproteinases (MMPs) are renal physiologic regulators of ECM degradation. Changes in MMPs expression or activity may disturb ECM turnover leading to glomerular scarring and worsening renal function. Our goal was to investigate intragraft MMP2 and MMP9 activities and their correlation with renal dysfunction. Plasma MMP2 and MMP9 activities were analyzed as noninvasive markers of renal allograft deterioration. Transplanted patients were biopsied and histopathologically characterized as IF/TA+ or IF/TA-. Renal function was evaluated by serum creatinine, glomerular filtration rate (GFR) estimated by Modification of Diet in Renal Disease equation and urinary protein/creatinine ratio. Kidney and plasma MMP2 and MMP9 activities were analyzed by zymography. A significant renal dysfunction was observed in IF/TA+ patients. Intragraft proMMP9 showed a significant higher activity in IF/TA+ than in IF/TA- samples and was inversely correlated with the GFR. Intragraft proMMP2 activity tended to increase in IF/TA+ samples, although no statistic significance was reached. Circulating proMMP2 and proMMP9 activities did not show significant differences between groups. Our data provide evidence that correlates intragraft proMMP9 activity with the fibrotic changes and renal dysfunction observed in IF/TA. © 2014 Steunstichting ESOT.


Fernandez A.A.,Hospital Cordoba | Chiarini F.E.,Hospital Cordoba | Fassi M.E.,Hospital Cordoba | de la Vega M.F.,Hospital Cordoba | Pessah G.,Hospital Cordoba
Revista de la Federacion Argentina de Cardiologia | Year: 2015

The aim of the study was to assess by means of indicators, the quality of care for patients with STEACS assisted on the hemodynamics service of the Cordoba Hospital, in the years 2012 and 2013, comparing both periods; to benchmark (benchmarking) with quality studies conducted in other reference sites of the Argentina; and to understand the characteristics of the population studied and treated by STEACS - AMI, on the hemodynamics service of the Cordoba Hospital in the aforementioned periods. Methods: Descriptive, prospective, cross-sectional analysis conducted on the total of patients assisted by STEACS - AMI during 2012 and 2013. Data were processed on an Excel spreadsheet. Quality indicators proper of the pathology were used in the study.Results: There were 139 patients attended. Male predominance. Age: 55 ± 7 years. Anterior location of AMI and Killip class I at the clinic were the most frequent findings. Five patients were admitted with cardiac arrest. Antiplatelet therapy exceeded 95%; and anticoagulation more than 92%. Reperfusion with fibrinolytic agents reached 9%. Ideal first-medical-contact-to-balloon time: 25% in average. Ideal door-to-balloon time: 46% and 33% in 2012 and 2013 respectively. Echocardiogram: 19% and 57% in 2012 and 2013 respectively. Lipid-lowering more than 97%; ACE 89% and 87%; Betablockers 96% and 78% in 2012 and 2013 respectively. Death rate: 3% in 2012 and 2% in 2013. Conclusions: The quality of care in the service of hemodynamics of the Cordoba Hospital is adequate according to international standards of care, similar to other reference national centers. There are no substantial differences in benchmarking. The present study findings must activate an alarm regarding the time of reperfusion. © 2015, Federacion Argentina de Cardiologia. All rights reserved.


Albert M.A.,Harvard University | Glynn R.J.,Harvard University | Fonseca F.A.H.,University of Sao Paulo | Lorenzatti A.J.,Hospital Cordoba | And 3 more authors.
American Heart Journal | Year: 2011

Objectives: The aim of this study was to evaluate the effect of statin treatment in primary prevention of cardiovascular events in different race/ethnic groups. Background: Clinical trial evidence about the efficacy of statins in the primary prevention of cardiovascular events among nonwhites is uncertain. Methods: JUPITER trial, a randomized, double-blind, placebo-controlled evaluation of rosuvastatin 20 mg in the primary prevention of myocardial infarction (MI), stroke, arterial revascularization, hospitalization for unstable angina, and cardiovascular death included 12,683 whites and 5,117 nonwhites with low-density lipoprotein levels <130 mg/dL and high-sensitivity C-reactive protein levels ≥2.0 mg/L. Results: Random allocation to rosuvastatin resulted in a 45% reduction in the primary end point among whites (hazard ratio [HR] 0.55, 95% CI 0.43-0.69) and a 37% reduction among nonwhites (HR 0.63, 95% CI 0.41-0.99). Blacks (HR 0.65, 95% CI 0.35-1.22) and Hispanics (HR 0.58, 95% CI 0.25-1.39) had similar risk reductions. Among nonwhites in the placebo group, the stroke rate exceeded the MI rate (0.44 vs 0.20 per 100 person-years); an opposite pattern was observed among whites (0.31 vs 0.42 per 100 person-years). Nonwhites had higher death rates than whites (2.25 vs 0.93 per 100 person-years); however, all-cause mortality was similar at 20% with rosuvastatin treatment in both participant groups. Conclusions: When used in primary prevention among individuals with low-density lipoprotein <130 mg/dL and high-sensitivity C-reactive protein ≥2 mg/L, rosuvastatin significantly reduced first MI, stroke, arterial revascularization, hospitalization for unstable angina, and cardiovascular death among whites and nonwhites. © 2011 Mosby, Inc.


PubMed | Hospital Cordoba
Type: Journal Article | Journal: Transplantation proceedings | Year: 2011

The purpose of two similarly designed multicenter, prospective, parallel-group, open-label studies was to evaluate early cyclosporine (CsA) elimination versus minimization from an everolimus-CsA-steroid regimen in de novo renal transplant patients.Within 24 hours after transplantation, 170 renal transplant patients received everolimus (trough levels 3-8 ng/mL), CsA, and steroids. Those eligible (n = 114) were randomized (1:1) at 3 months to have CsA elimination by month 4 to 6 (1 week) with everolimus trough levels maintained at 6 to 12 ng/mL or CsA minimization, until 12 months. The randomized population excluded those who discontinued the study prior to randomization due to adverse events, acute rejection episodes of Banff grade IIb/III, or worsening renal function during the month prior to randomization.At 12 months, the estimated glomerular filtration rate (Nankivell) with CsA elimination was noninferior versus CsA minimization (P < .0001, -level 0.05; 90% confidence interval 0.6-8.5) by 7 mL/min/1.73 m(2) (noninferiority margin). Composite efficacy failure was comparable with CsA elimination and CsA minimization (18.9% and 17.5%, respectively, P = 1.000) and no graft loss or death was reported after randomization. Cytomegalovirus infections were rare under everolimus treatment, and no pneumonitis episode was reported.In our selected randomized study population, immediate initiation of everolimus allowed CsA elimination. Renal function was stable on everolimus-based, CsA-free maintenance regimen without compromising efficacy.


PubMed | Hospital Cordoba
Type: Journal Article | Journal: Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina) | Year: 2010

Infective endocarditis (IE) is still a disease with high morbidity and mortality. Its diagnosis and treatment are still a major challenge in clinical practice. There have been very few studies published about IE in Argentina.We reviewed all the studies about IE published in the Argentine Medicine Society from 1980 to 2003 and we analyzed demographic, clinical and bacteriological data.27 studies with 628 patients were included. Mean age of patients was 50.7 years old. The most frequent clinical data were fever, murmur and elevated sedimentation rate. Stafilococcus spp was the most common causative organism, followed by streptococcus spp. The echocardiographic demonstration allowed the definitive diagnosis in 2/3 of the patients.The IE data of Argentina are not different from other data published in different countries and this study shows some clinical features of IE in Argentina.


PubMed | Hospital Cordoba
Type: Journal Article | Journal: Transplant international : official journal of the European Society for Organ Transplantation | Year: 2014

Chronic renal allograft injury is reflected by interstitial fibrosis and tubular atrophy (IF/TA) and by the accumulation of extracellular matrix (ECM). Metalloproteinases (MMPs) are renal physiologic regulators of ECM degradation. Changes in MMPs expression or activity may disturb ECM turnover leading to glomerular scarring and worsening renal function. Our goal was to investigate intragraft MMP2 and MMP9 activities and their correlation with renal dysfunction. Plasma MMP2 and MMP9 activities were analyzed as noninvasive markers of renal allograft deterioration. Transplanted patients were biopsied and histopathologically characterized as IF/TA+ or IF/TA-. Renal function was evaluated by serum creatinine, glomerular filtration rate (GFR) estimated by Modification of Diet in Renal Disease equation and urinary protein/creatinine ratio. Kidney and plasma MMP2 and MMP9 activities were analyzed by zymography. A significant renal dysfunction was observed in IF/TA+ patients. Intragraft proMMP9 showed a significant higher activity in IF/TA+ than in IF/TA- samples and was inversely correlated with the GFR. Intragraft proMMP2 activity tended to increase in IF/TA+ samples, although no statistic significance was reached. Circulating proMMP2 and proMMP9 activities did not show significant differences between groups. Our data provide evidence that correlates intragraft proMMP9 activity with the fibrotic changes and renal dysfunction observed in IF/TA.


PubMed | Hospital Cordoba
Type: Journal Article | Journal: Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina) | Year: 2010

Vitamin D deficiency is defined when blood levels of 25-hydroxyvitamin D (25 (OH) D) is less than ng / mmol/L. The status of Vitamin D level is associated with clinical, pathological and physiological changes as increased of parathyroid hormone, bone remodeling, osteoporosis and increased risk of fractures. Moreover,vitamin D and its metabolites are known to be associated with multiple chronic diseases as diabetes mellitus, autoimmune, cardiovascular and neoplasia diseases.To assess the vitamin D status in a rural population of Crdoba Province in Argentina and its relation with bone mineral density.We prospectively studied 31 patients over 50 years old who live in a rural population of Pampa de Achala in Crdoba Province, Argentina. This city is located in Crdoba High mountains. Blood vitamin D levels were tested in 24 patients and Bone mineral density in 31 patients. Vitamin D level was determined by HPLC. The vitamin D level were considered normal between 20-50 ng/ml in the winter season and 20-80 ng/ml in the summer season. Bone mineral density of lumbar spine and femoral neck was measured by DXA GE LUNAR DPX-L, according to World Health organization classification (37). The data were analyzed by Spearman coefficient and Chi cuadrado.The vitamin D levels samples were available in 24 patients. Mean blood Vitamin D level was 24.54 ng /ml. 8 of them (33%) had vitamin D level less than 20ng/ ml. 83% (20) of the analysed patients had vitamin D level less than 30 ng/ml and only 4 patients has vitamin D level more than 30 ng/ml. Low bone mineral density of lumbar spine and femoral neck was found in 66 % of the patients. 19 % of the patients were diagnosed of lumbar spine and femoral neck osteoporosis and 29 % of them had lumbar spine meanwhile 25 % had femoral neck. There was not statistically significant association between vitamin D level and bone mineral density analysed by Chi Cuadrado (p<0.07). A significant association was found between blood vitamin D level and low bone mineral density of femoral neck (Spearman 0.51) CONCLUSIONS: Vitamin D insufficiency is high in the rural adult population of Pampa de Achala in Crdoba and it could be a major health problem in this population.


PubMed | Hospital Cordoba and National University of Cordoba
Type: | Journal: Hipertension y riesgo vascular | Year: 2016

The endothelin system, for its vasoconstrictor action, is related to the development of essential hypertension (HTAe). The polymorphism analysis of their genes represents a new approach to the study of this disease. We propose to analyze the interaction between stages of essential hypertension (HTAe) and risk factors with polymorphisms 138ex1 ins/del A gene endothelin-1 (ET-1) and H323H receptor gene A ET-1 (ETRA).We included 300 patients of both sexes, unrelated, who consecutively attended the clinic hypertension medical service. Each one underwent a complete physical examination, electrocardiogram, echocardiogram, and Rx thorax. The degree of severity of hypertension was determined in stages. The determination of polymorphisms was performed by amplification followed by cutting by specific restriction enzyme from DNA obtained from peripheral blood.The 46% of patients had HTAe controlled, 17.6% had organ damage or cardiovascular, brain or kidney disease. It was observed that the 4A/4A carriers showed lower frequency of cardiovascular disease, kidney and brain (P<.032; 95% CI: 11.1-21.4). For H323H polymorphism, the evaluation by images showed a higher frequency of the dilations of left auricular (P=.02) and auricular fibrillation (P=.03) between the T/T carrier, a higher frequency of cardiomegaly was detected in C/C patients (P=.04).The genotypes, 4A/4A of the ET-1 gene and the T/T from ETRA gene might be involved in worse outcome of cardiovascular damage. Their identification could help recognize subgroups of the hypertensive patients with different risk.

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