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Buenos Aires, Argentina

Bilkis M.D.,Hospital de Ninos Ricardo Gutierrez
Archivos Argentinos de Pediatria | Year: 2015

Hyperglycemia is a rare finding in pediatric emergency. Hyperglycemia as pediatric emergency presentation (blood glucose ≥ 126 mg/dl), may correspond to a diabetes mellitus type 1, the finding of a casual hyperglycemia in an obese patient and type 2 diabetes, hyperglycemia without decompensation of the monogenic diabetes or stress hyperglycemia. The latter are often not ketosis, limited to acute illness and usually do not develop diabetes at follow-up. We found only 2.9% of patients (8/270 children) with stress hyperglycemia who developed diabetes mellitus at follow-up. The use of insulin in the most severe cases improves the evolution and decreases morbidity. There is an overlap of intermediate states in the presentation of hyperglycemia requiring specialist help to unravel the underlying state in the follow-up.


Portillo S.,Hospital de Ninos Ricardo Gutierrez
Surgical Neurology International | Year: 2014

Based on 82 cases reviewed, in 5% we observed pelvic associated anomalies. In children less than 3 years of age the consult was triggered by the lumbar-sacral mass. In older than 3 years (42%) neurological problems triggered the consult. Only 24% at that age were concerned by the mass. The objective of the surgery is to untether the cord, and not to remove the entirety of the lipoma. Filum lipoma is the simplest to treat. Event though the French School is popular in Argentina I favor preventive surgery for lipoma even in asymptomatic patients. We had only 2.5% of added motor impairment and 6% in long term urological deficit. © 2014 Portillo S.


Uruena A.,Ministerio de Salud de la Nacion | Pippo T.,Ministerio de Salud de la Nacion | Betelu M.S.,Ministerio de Salud de la Nacion | Virgilio F.,Ministerio de Salud de la Nacion | And 6 more authors.
Vaccine | Year: 2011

Objective: Since the 10-valent pneumococcal conjugate vaccine (PCV-10) and 13-valent pneumococcal conjugate vaccine (PCV-13) were recently licensed for use in Argentina, both vaccines were evaluated to estimate the costs, health benefits and cost-effectiveness of adding a PCV to the routine child immunization schedule. Methodology: The integrated TRIVAC vaccine cost-effectiveness model from Pan American Health Organization's ProVac Initiative (Version 1.0.65) was used to assess the health outcomes of 20 successive cohorts from birth to 5 years of age. PCV-10 and PCV-13 were each compared to a scenario assuming no PCV vaccination. A 3 + 1 (three doses + booster) schedule and a vaccination price of US$ 20.75 per dose was assumed in the base case for both vaccines. Results: Introduction of PCV-13 rather than PCV-10 would increase the number of life years gained (LYG) by at least 10%. The number of LYG (and LYG after adjustment for DALY morbidity weights) was 56,882 (64,252) for PCV-10 compared to 65,038 (71,628) for PCV-13. From the health system perspective, the cost per DALY averted was US$ 8973 and US$ 10,948 for PCV-10 and PCV-13 respectively, and US$ 8546 and US$ 10,510 respectively, after incorporating costs saved by households. When PCV13 was compared to PCV10 directly, the additional benefits of PCV-13 was conferred at a cost of US$ 28,147 per DALY averted. Cost-effectiveness was influenced mainly by vaccine price, serotype replacement, pneumonia mortality and discount rate. Conclusion: Routine vaccination against S. pneumoniae in Argentina would be cost-effective with either PCV-10 or PCV-13. PCV-13, with higher coverage of local serotypes, would prevent more cases of pneumonia, invasive pneumococcal disease, sequelae and deaths with a higher number of LYG and DALYs averted, but PCV-10, due its higher impact in the prevention of AOM, would save more costs to the healthcare system. © 2011 Elsevier Ltd.


Portillo S.,Hospital de Ninos Ricardo Gutierrez
Surgical Neurology International | Year: 2014

In Argentina there is national program for fortifying flour with folic acid. Prenatal diagnosis is not always accurate. Closure according to standard technique. We close muscle layer. We don × t favor corpectomy for kyphosis. We suture the placode to restore cylinder shape of the cord. We close muscle layer. Hydrocephalus: V-P shunt. Third ventriculostomy is not effective. Chiari II: Cervical laminectomy. Syringomyelia: We shunt the syrinx to the peritoneum. MMCL is the most common neural tube defect. It consists of a neural placode exposed to environment. The placode is surrounded by arachnoid and by thin epithelial tissue.


Gentile A.,Hospital de Ninos Ricardo Gutierrez | Ramonet M.D.,Hospital Posadas | Ciocca M.,Hospital Aleman
Archivos Argentinos de Pediatria | Year: 2013

Hepatitis A (HA) presents a benign evolution, but occasionally some patients develop a more severe disease. Previously to 2005 hepatitis A was an important cause of acute liver failure (ALF) and hepatic transplant. In 2003, a consensus in the Argentinian Pediatrics Society was done; it had just recommended the inclusion of the vaccine in the mandatory immunisation schedule. This was issued by the Health Ministery, and was applied on June 1 st, 2005. The schedule was one dose at the age of one year of age. Since then, an important reduction of HA was registered, without any case of ALF since 2006. Follow-up studies so far showed low viral circulation and persistence of antibodies to 5 years later.

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