Percutaneous melody™ valve implantation in patients with dysfunctional right ventricular outflow tract [Implante percutáneo de la válvula melody® en pacientes con disfunción del conducto del tracto de salida del ventrículo derecho]
Henestrosa G.,Hospital Universitario Fundacion Favaloro |
Antoni D.,Hospital Universitario Fundacion Favaloro |
Mendiz O.,Hospital Universitario Fundacion Favaloro
Revista Argentina de Cardiologia | Year: 2016
Background: Percutaneous pulmonary valve implantation is currently considered the treatment of choice in selected cases with previous history of congenital heart disease that present with symptoms of right ventricular outflow tract (RVOT) obstruction and/ or pulmonary regurgitation. Objective: The aim of this study was to describe the initial experience with the Melody™ pulmonary valve in a tertiary care center of Argentina. Methods: All patients treated with the Melody™ valve from August 2013 to May 2016 (n=8) were included in the study. Results: Mean age was 25±18 years (range: 13-69), and weight was 56.9±9.3 kg (range: 45-73). Baseline heart diseases were aortic stenosis corrected with the Ross procedure (n=3), truncus arteriosus (n=2), tetralogy of Fallot (n=2) and transposition of the great vessels (n=1). Two patients had severe pulmonary regurgitation, 2 severe stenosis, and 4 double lesion. The number of stents prior to implantation was 2.1±0.64. The overall success rate was 100%. The right ventricular outflow tract gradient and the ratio between right ventricular pressure and systemic pressure diminished significantly (from 57.3±30 to 15±4.2 mmHg, and from 0.67±0.22 to 0.32±0.04, respectively) (p <0.001) with only trace or absent pulmonary regurgitation. No complications were observed. At a mean follow up of 14.3±10.3 months (range 34-1), all patients remained asymptomatic and free from significant pulmonary regurgitation. Conclusion: In our preliminary experience, the Melody™ pulmonary valve was found to be safe and effective, showing drastic right ventricular outflow tract gradient reduction, absence of significant regurgitation and marked clinical improvement. These findings confirm the excellent performance of this valve in patients with dysfunctional right ventricular outflow tract. © 2016, Sociedad Argentina de Cardiologia. All rights reserved.
PubMed | Hospital General Of Agudos Dr Cosme Argerich, University of Buenos Aires, Hospital Universitario Fundacion Favaloro, Hospital Interzonal Of Agudos Eva Peron and 2 more.
Type: Journal Article | Journal: Epidemiology and infection | Year: 2016
Acinetobacter baumannii is a significant nosocomial pathogen often associated with extreme drug resistance (XDR). In Argentina, isolates of A. baumannii resistant to tetracyclines have accounted for more than 40% of drug-resistant isolates in some hospitals. We have previously reported the dispersion of the tet(B) resistance element associated with the ISCR2 transposase in epidemiologically unrelated A. baumannii isolates recovered from 1983 to 2011. This study extends this surveillance to 77 recent (2009-2013) XDR A. baumannii isolates with different levels of minocycline susceptibility. Isolates were examined by a pan-PCR assay, which showed six different amplification patterns, and specific PCRs were used for the confirmation of the the ISCR2-tet(B)-tet(R)-ISCR2 element. The tet(B) gene was present in 66 isolates and the ISCR2 element in 68 isolates; the tet(B) gene was associated with ISCR2 in all tet(B)-positive isolates. We conclude that this element is widespread in XDR A. baumannii isolates from Argentina and could be responsible for the emergence of tetracycline resistance in recent years.
Vilacoba E.,University of Buenos Aires |
Almuzara M.,Hospital Interzonal Of Agudos Eva Peron |
Gulone L.,University of Buenos Aires |
Traglia G.M.,University of Buenos Aires |
And 5 more authors.
Antimicrobial Agents and Chemotherapy | Year: 2013
Resistance to minocycline has emerged in multidrug-resistant Acinetobacter baumannii isolates from Buenos Aires hospitals. Few reports about the description and dispersion of tet genes in this species have been published. We observed the presence of tet(B) in all minocycline-resistant isolates. This gene was found to be associated with the ISCR2 mobile element, which may, in part, explain its dispersion. Copyright © 2013, American Society for Microbiology. All Rights Reserved.
Garg A.X.,University of Western Ontario |
Garg A.X.,McMaster University |
Devereaux P.J.,McMaster University |
Devereaux P.J.,Population Health Research Institute |
And 24 more authors.
JAMA - Journal of the American Medical Association | Year: 2014
IMPORTANCE: Most acute kidney injury observed in the hospital is defined by sudden mild or moderate increases in the serum creatinine concentration, which may persist for several days. Such acute kidney injury is associated with lower long-term kidney function. However, it has not been demonstrated that an intervention that reduces the risk of such acute kidney injury better preserves long-term kidney function. OBJECTIVES: To characterize the risk of acute kidney injury with an intervention in a randomized clinical trial and to determine if there is a difference between the 2 treatment groups in kidney function 1 year later. DESIGN, SETTING, AND PARTICIPANTS: The Coronary Artery Bypass Grafting Surgery Off- or On-pump Revascularisation Study (CORONARY) enrolled 4752 patients undergoing first isolated coronary artery bypass graft (CABG) surgery at 79 sites in 19 countries. Patients were randomized to receive CABG surgery either with a beating-heart technique (off-pump) or with cardiopulmonary bypass (on-pump). From January 2010 to November 2011, 2932 patients (from 63 sites in 16 countries) from CORONARY were enrolled into a kidney function substudy to record serum creatinine concentrations during the postoperative period and at 1 year. The last 1-year serum creatinine concentration was recorded on January 18, 2013. MAIN OUTCOMES AND MEASURES: Acute kidney injury within 30 days of surgery (≥50% increase in serum creatinine concentration from prerandomization concentration) and loss of kidney function at 1 year (≥20% loss in estimated glomerular filtration rate from prerandomization level). RESULTS Off-pump (n = 1472) vs on-pump (n = 1460) CABG surgery reduced the risk of acute kidney injury (17.5%vs 20.8%, respectively; relative risk, 0.83 [95%CI, 0.72-0.97], P = .01); however, there was no significant difference between the 2 groups in the loss of kidney function at 1 year (17.1%vs 15.3%, respectively; relative risk, 1.10 [95%CI, 0.95-1.29], P = .23). Results were consistent with multiple alternate continuous and categorical definitions of acute kidney injury or kidney function loss, and in the subgroup with baseline chronic kidney disease. CONCLUSIONS AND RELEVANCE: Use of off-pump compared with on-pump CABG surgery reduced the risk of postoperative acute kidney injury, without evidence of better preserved kidney function with off-pump CABG surgery at 1 year. In this setting, an intervention that reduced the risk of mild to moderate acute kidney injury did not alter longer-term kidney function. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00463294 Copyright 2014 American Medical Association. All rights reserved.
PubMed | Professor of Neurological Surgery, Federal University of Rio de Janeiro, Hospital Universitario Fundacion Favaloro, University of Toyama and 3 more.
Type: Journal Article | Journal: Indian journal of orthopaedics | Year: 2016
The number and quality of scientific publications reflects the standards of scientific research in a country. However, the contribution of Indian spine surgeons toward global publications is unknown. The goal is to study the publications of Indian spine surgeons between 2000 and 2013.A literature search of the publications by Indian spine surgeons was performed using MEDLINE. The search terms used were India and several spine-related terminologies. The main information of the selected papers including the year of publication, scientific journal, type of pathology studied, Neurosurgical or Orthopedic Department where the study was done, type of study, and the type of article was analyzed.A total of 4459 articles were identified using MEDLINE and after exclusion, 507 articles were analyzed. A growth of 440% in the number of publications was observed in the period between 2009 and 2013, during which 60.15% of the articles were published. Clinical studies (n = 492; 97.04) were the most common types of articles, followed by experimental studies and other types. The Neurosurgery department published the majority of the articles (58.2%). The three most common pathologies studied were spinal tumors (17.35%), surgical technique (15.4%), and spinal infection (15.2%).The current study shows that publications in the field of spine surgery have been increasing in the last few years, although it is less. Further efforts such as research training of spine surgeons, inducing collaborations and formulation of multicenter projects and periodically allocating adequate funds are key factors to improve the scientific publications from India.
Gondolesi G.E.,Hospital Universitario Fundacion Favaloro |
Mazariegos G.,Childrens Hospital of Pittsburgh of UPMC |
Starzl T.E.,University of Pittsburgh
Transplantation Proceedings | Year: 2016
At the 14th International Small Bowel Transplant Symposium, (ISBTS2015) held in Buenos Aires, a session to recognize the pioneers that have dedicated their lives to make our current field possible was organized. Dr Thomas Starzl received the first Living Legend Award. A video interview was obtained at his office, edited, and later presented during the scientific meeting. More than 600 people saw Dr Starzl's interview, which captivated the audience for 40 minutes, before smiles, tears and the final applause erupted at the conclusion. We would like to share this video with all of you to inspire the current generations and the generations to come. The manuscript has the main parts of the interview, which can also be accessed at http://isbts2015.tts.org/starzl.mp4. © 2016 Elsevier Inc.
PubMed | Childrens Hospital of Pittsburgh of UPMC, Hospital Universitario Fundacion Favaloro and University of Pittsburgh
Type: Journal Article | Journal: Transplantation proceedings | Year: 2016
At the 14th International Small Bowel Transplant Symposium, (ISBTS2015) held in Buenos Aires, a session to recognize the pioneers that have dedicated their lives to make our current field possible was organized. Dr Thomas Starzl received the first Living Legend Award. A video interview was obtained at his office, edited, and later presented during the scientific meeting. More than 600 people saw Dr Starzls interview, which captivated the audience for 40 minutes, before smiles, tears and the final applause erupted at theconclusion. We would like to share this video with all of you to inspire the current generations and the generations to come. The manuscript has the main parts of the interview, which can also be accessed at http://isbts2015.tts.org/starzl.mp4.
Burgos J.M.,Institute Ingenieria Genetica y Biologia Molecular |
Diez M.,Hospital Universitario Fundacion Favaloro |
Vigliano C.,Hospital Universitario Fundacion Favaloro |
Bisio M.,Institute Ingenieria Genetica y Biologia Molecular |
And 11 more authors.
Clinical Infectious Diseases | Year: 2010
Background. One hundred years after the discovery of Chagas disease, it remains a major neglected tropical disease. Chronic Chagas heart disease (cChHD) is the most severe manifestation. Heart transplantation is the proper treatment for end-stage heart failure, although reactivation of disease may result after receipt of immunosuppressive therapy. T. cruzi strains cluster into 6 discrete typing units (DTUs; I-VI) associated with different geographical distribution, transmission cycles and varying disease symptoms. In the southern cone of South America, T. cruzi II, V, and VI populations appear to be associated with Chagas disease and T. cruzi I with sylvatic cycles. Methods. Molecular characterization of DTUs, T. cruzi I genotypes (on the basis of spliced-leader gene polymorphisms), and minicircle signatures was conducted using cardiac explant specimens and blood samples obtained from a cohort of 16 Argentinean patients with cChHD who underwent heart transplantation and from lesion samples obtained from 6 of these patients who presented with clinical reactivation of Chagas disease. Results. Parasite persistence was associated with myocarditis progression, revealing T. cruzi I (genotype Id) in 3 explant samples and T. cruzi II, V, or VI in 5 explant samples. Post-heart transplantation follow-up examination of bloodstream DTUs identified T. cruzi I in 5 patients (genotypes Ia or Id) and T. cruzi II, V, or VI in 7 patients. T. cruzi I, V, and VI were detected in skin chagoma specimens, and T. cruzi V and VI were detected in samples obtained from patients with myocarditis reactivations. Multiple DTUs or genotypes at diverse body sites and polymorphic minicircle signatures at different cardiac regions revealed parasite histotropism. T. cruzi I infections clustered in northern Argentina (latitude, 23°S-27°S), whereas T. cruzi II, V, or VI DTUs were more ubiquitous. Conclusions. Multiple DTUs coexist in patients with Chagas disease. The frequent finding of T. cruzi I associated with cardiac damage was astounding, revealing its pathogenic role in cChHD at the southern cone. © 2010 by the Infectious Diseases Society of America.
Cura C.I.,CONICET |
Lattes R.,Institute Nefrologia |
Nagel C.,Hospital Universitario Fundacion Favaloro |
Gimenez M.J.,Polytechnic University of Valencia |
And 6 more authors.
American Journal of Transplantation | Year: 2013
Organ transplantation (TX) is a novel transmission modality of Chagas disease. The results of molecular diagnosis and characterization of Trypanosoma cruzi acute infection in naïve TX recipients transplanted with organs from infected deceased donors are reported. Peripheral blood and cerebrospinal fluid samples from the TX recipients of organs from infected donors were prospectively and sequentially studied for detection of T. cruzi by means of kinetoplastid DNA polymerase chain reaction (kDNA-PCR). In positive blood samples, a PCR algorithm for identification of T. cruzi Discrete Typing Units (DTUs) and quantitative real-time PCR (qPCR) to quantify parasitic loads were performed. Minicircle signatures of T. cruzi infecting populations were also analyzed using restriction fragment length polymorphism (RFLP)-PCR. Eight seronegative TX recipients from four infected donors were studied. In five, the infection was detected at 68.4 days post-TX (36-98 days). In one case, it was transmitted to two of three TX recipients. The comparison of the minicircle signatures revealed nearly identical RFLP-PCR profiles, confirming a common source of infection. The five cases were infected by DTU TcV. This report reveals the relevance of systematic monitoring of TX recipients using PCR strategies in order to provide an early diagnosis allowing timely anti-trypanosomal treatment. Polymerase chain reaction strategies allow for the early diagnosis of acute Chagas disease in naïve recipients transplanted with organs from Trypanosoma cruzi-infected donors. See editorial by Machado on page 3065. © Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.
Gondolesi G.,Hospital Universitario Fundacion Favaloro |
Ramisch D.,Hospital Universitario Fundacion Favaloro |
Padin J.,Hospital Universitario Fundacion Favaloro |
Almau H.,Hospital Universitario Fundacion Favaloro |
And 5 more authors.
American Journal of Transplantation | Year: 2012
Normal small bowel length (SBL) has been reported within a wide range, but never studied in a cohort of either pediatric or adult deceased donors. Between 5/2006 and 2/2011, SBL was measured in all grafts procured for intestinal transplantation at a single center and used for either isolated intestinal transplant (15) or multiorgan transplants (5) employing a standardized method. SBL was the only not significantly different variable among pediatric and adult donors divided by age 16. Furthermore, donors were classified in 3 groups: group 1: Height < 70 cm, group 2:71-150 cm and group 3: ≥ 151 cm. Mean age was: 0.58, 5.6, 22.01 years, respectively. Mean height and weight were 65.8, 123.2, 166.1 cm (p = 0.001) and 6.9, 23.8, 65.2 kg (p = 0.001), for each group. The SBL by group was: 283.0, 324.7, 356.0 cm, remaining as the only nonsignificant variable (p = 0.06), in contrast to BMI, BSA (p = 0.001). The SBL/height ratio: 4.24, 2.7, 2.12 (p = 0.001; rho: -0.623) or SBL/BSA ratio was 8.36, 3.7, and 2.03, respectively (p: 0.0001; rho: -0.9). SBL does not increase with growth like other anthropometric variables. The SBL/height ratio significantly decreases with growth; however, bowel diameter increases, which needs further evaluation. © Copyright 2012 The American Society of Transplantation.