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Article ; Online: Inhibidores de la fosfodiesterasa 5 para el tratamiento de la insuficiencia cardiaca: revisión sistemática y metaanálisis de ensayos clínicos aleatorizados.

Monzón-Herrera, Ramiro / Listorti, Federico / Vensentini, Natalia / Mariani, Javier

2024

Abstract: Objective: The treatment with phosphodiesterase-5 (PDE-5) inhibitors was postulated in heart failure (HF). We conducted a systematic review and a meta-analysis on their beneficial and adverse effects in patients with HF.: Method: A meta-analysis of ... ...

Title translation	Phosphodiesterase 5 inhibitors for the treatment of heart failure: a systematic review and meta-analysis.
Abstract	Objective: The treatment with phosphodiesterase-5 (PDE-5) inhibitors was postulated in heart failure (HF). We conducted a systematic review and a meta-analysis on their beneficial and adverse effects in patients with HF. Method: A meta-analysis of randomized trials evaluating the chronic use of PDE-5 inhibitors in patients with HF was conducted. Endpoints included death, HF hospitalizations, functional capacity, pulmonary pressures, quality of life, and adverse effects. Random-effects models were used to pool outcomes. Categorical data were summarized with relative risks (RR) and 95% confidence intervals (95%CI), and continuous data with weighted mean differences and standardized mean differences. Results: Sixteen studies (1119 participants) were included. No effect was observed on mortality (RR: 1.16; 95%CI: 0.50-2.66; I2: 0.0%) or HF hospitalizations (RR: 0.75; 95%CI: 0.41-1.37; I2: 38.7%). Treatment significantly reduced pulmonary systolic pressure (-10.64 mmHg; 95%CI: -5.14 to -16.15 mmHg; I2: 96.0%), and increased peak oxygen consumption (2.06 ml/kg/min; 95%CI: 0.40-3.72; I2: 89.6%), although with high inconsistency. There were no significant effects on quality of life (-0.15; 95%CI: -0.48-0.18; I2: 0.0%). On the other hand, the risk of headaches was increased (RR: 1.63; 95%CI: 1.11-2.39; I2: 0.0%). Publication bias was identified for HF hospitalizations. Conclusions: Current data suggest that PDE-5 inhibitors therapy does not improve prognosis or quality of life among HF patients. Hemodynamic and functional effects could be relevant, and more studies are necessary to define its role.
Language	Spanish
Publishing date	2024-02-08
Publishing country	Mexico
Document type	English Abstract ; Journal Article
ZDB-ID	2059019-2
ISSN	1665-1731 ; 1665-1731
ISSN (online)	1665-1731
ISSN	1665-1731
DOI	10.24875/ACM.23000209
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Article ; Online: Post COVID-19 syndrome. Severity and evolution in 4673 health care workers.

Tajer, Carlos / Martínez, María José / Mariani, Javier / De Abreu, Maximiliano / Antonietti, Laura

Medicina

2023 Volume 83, Issue 5, Page(s) 669–682

Abstract: Background: The evolution of post COVID syndrome has been variable and we lack information on its impact on healthcare professionals, particularly in Latin America.: Methods: We conducted a survey through a social network in health professionals on ... ...

Title translation	Síndrome post COVID-19. Gravedad y evolución en 4673 trabajadores sanitarios.
Abstract	Background: The evolution of post COVID syndrome has been variable and we lack information on its impact on healthcare professionals, particularly in Latin America. Methods: We conducted a survey through a social network in health professionals on post COVID-19 syndrome cases confirmed with PCR. In a web-based questionnaire, we asked about 21 symptoms, their severity, duration, degree of activity impairment and return to work. Results: 4673 health professionals from 21 countries responded, mean age of 47.8 years, 64.2% women. The initial course was asymptomatic in 9.1%, mild symptoms 36.8%, moderate symptoms without hospitalization 40.8% or with hospitalization 11.7%, and severe symptoms with respiratory assistance 1.6%. The most prevalent symptoms were fatigue (67%), insomnia (44.2%), anxiety (42.3%), myalgia (41.9%) and anosmia (41.2%). Considering only severe symptoms (grades 3-4 on a subjective index from 1 to 4), the most prevalent were slowness (36.3%), impaired concentration (33.1%), anosmia (20.4%), fatigue (19.1%), impaired memory (18.1%) and dyspnea (15.9%). Prevalence dropped by half in the first 5 five months, but in many cases, it lasted for more than a year. In the multivariate analysis, symptoms tended to be grouped into clusters (cognitive, neuropsychiatric, cardiorespiratory, digestive, others). The need to change the work area was 16% and lack of return to work 7.8%, related to older age, number of symptoms and severity of the initial course. Conclusion: In conclusion, in many cases the persistence of post-COVID symptoms can be prolonged and have an occupational impact on healthcare professionals, requiring the adoption of specific policies to reduce harm.
MeSH term(s)	Humans ; Female ; Middle Aged ; Male ; Anosmia/epidemiology ; Anosmia/etiology ; COVID-19/complications ; Post-Acute COVID-19 Syndrome ; Fatigue/etiology ; Health Personnel
Language	English
Publishing date	2023-10-06
Publishing country	Argentina
Document type	Journal Article
ZDB-ID	411586-7
ISSN	1669-9106 ; 0025-7680 ; 0325-951X
ISSN (online)	1669-9106
ISSN	0025-7680 ; 0325-951X
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Article: Unsaturated Fatty Acid Intake During Periconception and Incidence of Achieving Pregnancy: A Systematic Review and Meta-Analysis.

Gatti, Cintia Romina / Gomez Ribot, Dalmiro / Mariani, Javier / Jawerbaum, Alicia

Frontiers in physiology

2021 Volume 12, Page(s) 757266

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2021-11-15
Publishing country	Switzerland
Document type	Systematic Review
ZDB-ID	2564217-0
ISSN	1664-042X
ISSN	1664-042X
DOI	10.3389/fphys.2021.757266
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Article ; Online: Vitamin D supplementation: An alternative to enhance the effectiveness of vaccines against SARS-CoV-2?

Inserra, Felipe / Tajer, Carlos / Antonietti, Laura / Mariani, Javier / Ferder, León / Manucha, Walter

Vaccine

2021 Volume 39, Issue 35, Page(s) 4930–4931

MeSH term(s)	COVID-19 ; COVID-19 Vaccines ; Dietary Supplements ; Humans ; SARS-CoV-2 ; Vaccines ; Vitamin D
Chemical Substances	COVID-19 Vaccines ; Vaccines ; Vitamin D (1406-16-2)
Language	English
Publishing date	2021-07-16
Publishing country	Netherlands
Document type	Letter
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2021.07.031
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Article ; Online: Evaluation of the first level of care for tuberculosis control in Buenos Aires, Argentina.

Mariani, Javier / Ferrante, Daniel / Battistella, Gabriel / Langsam, Martín / Pérez, Freddy / Macchia, Alejandro

Revista panamericana de salud publica = Pan American journal of public health

2021 Volume 45, Page(s) e22

Abstract: Objective: Evaluate primary health care functions from the perspective of patients with tuberculosis from slums in the city of Buenos Aires, Argentina.: Methods: Cross-sectional observational study with adult patients with tuberculosis (TB) and ... ...

Abstract	Objective: Evaluate primary health care functions from the perspective of patients with tuberculosis from slums in the city of Buenos Aires, Argentina. Methods: Cross-sectional observational study with adult patients with tuberculosis (TB) and without TB (NoTB), living in slums (S) and outside them (NoS). Participants' perceptions were evaluated using the Primary Care Assessment Tool for users (abbreviated version), which measures four main domains (first contact, ongoing care, coordination with specialists, and comprehensiveness) and selected secondary domains. A Likert scale was used, ranging from "No, not at all" (1 point) to "Yes, definitely" (4 points). Scores ≥ 3 were considered to indicate adequate performance of functions. Averages were calculated for each domain, as well as two overall scores: with and without secondary domains. Results: 83 participants were included (20 TB-S, 21 TB-NoS, 19 NoTB-S, and 23 NoTB-NoS). The evaluated functions were perceived as inadequate. The TB-S group gave the lowest overall scores, not reaching 3 points in any domain. There were no significant differences in domains or overall scores between groups. Participants with TB gave lower scores in all domains, except in family-centered care, where they gave a significantly higher score than NoTB participants. The overall score without secondary domains was lower for TB participants than for the NoTB groups. Conclusions: According to the perception of participants with TB and without TB, primary health care functions are not satisfactory, either in slums or outside them.
Language	English
Publishing date	2021-02-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	1376934-0
ISSN	1680-5348 ; 1020-4989
ISSN (online)	1680-5348
ISSN	1020-4989
DOI	10.26633/RPSP.2021.22
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Article ; Online: COVID-19 among the inhabitants of the slums in the city of Buenos Aires: a population-based study.

Macchia, Alejandro / Ferrante, Daniel / Battistella, Gabriel / Mariani, Javier / González Bernaldo de Quirós, Fernán

BMJ open

2021 Volume 11, Issue 1, Page(s) e044592

Abstract: Objective: To summarise the unfolding of the COVID-19 epidemic among slum dwellers and different social strata in the city of Buenos Aires during the first 20 weeks after the first reported case.: Design: Observational study using a time-series ... ...

Abstract	Objective: To summarise the unfolding of the COVID-19 epidemic among slum dwellers and different social strata in the city of Buenos Aires during the first 20 weeks after the first reported case. Design: Observational study using a time-series analysis. Natural experiment in a big city. Setting: Population of the city of Buenos Aires and the integrated health reporting system records of positive RT-PCR for COVID-19 tests. Participants: Records from the Argentine Integrated Health Reporting System for all persons with suspected and RT-PCR-confirmed diagnosis of COVID-19 between 31 January and 14 July 2020. Outcomes: To estimate the effects of living in a slum on the standardised incidence rate of COVID-19, corrected Poisson regression models were used. Additionally, the impact of socioeconomic status was performed using an ecological analysis at the community level. Results: A total of 114 052 people were tested for symptoms related with COVID-19. Of these, 39 039 (34.2%) were RT-PCR positive. The incidence rates for COVID-19 towards the end of the 20th week were 160 (155 to 165) per 100 000 people among the inhabitants who did not reside in the slums (n=2 841 997) and 708 (674 to 642) among slums dwellers (n=233 749). Compared with the better-off socioeconomic quintile (1.00), there was a linear gradient on incidence rates: 1.36 (1.25 to 1.46), 1.61 (1.49 to 1.74), 1.86 (1.72 to 2.01), 2.94 (2.74 to 3.16) from Q2 to Q5, respectively. Slum dwellers were associated with an incidence rate of 14.3 (13.4 to 15.4). Conclusions: The distribution of the epidemic is socially conditioned. Slum dwellers are at a much higher risk than the rest of the community. Slum dwellers should not be considered just another risk category but an entirely different reality that requires policies tailored to their needs.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Argentina/epidemiology ; COVID-19/epidemiology ; COVID-19 Nucleic Acid Testing/statistics & numerical data ; Child ; Child, Preschool ; Female ; Health Policy ; Health Status Disparities ; Humans ; Incidence ; Infant ; Infant, Newborn ; Logistic Models ; Male ; Middle Aged ; Poverty Areas ; Residence Characteristics/statistics & numerical data ; Young Adult
Language	English
Publishing date	2021-01-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2020-044592
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Article ; Online: Insuficiencia renal comórbida en la insuficiencia cardíaca

Javier Mariani

Revista Argentina de Cardiología, Vol 77, Iss 4, Pp 255-

2009 Volume 256

Keywords	Medicine ; R ; Internal medicine ; RC31-1245 ; Specialties of internal medicine ; RC581-951 ; Diseases of the circulatory (Cardiovascular) system ; RC666-701
Language	English
Publishing date	2009-01-01T00:00:00Z
Publisher	Sociedad Argentina de Cardiología
Document type	Article ; Online
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Article ; Online: High-dose vitamin D versus placebo to prevent complications in COVID-19 patients: A structured summary of a study protocol for a randomised controlled trial (CARED-TRIAL).

Mariani, Javier / Tajer, Carlos / Antonietti, Laura / Inserra, Felipe / Ferder, León / Manucha, Walter

Trials

2021 Volume 22, Issue 1, Page(s) 111

Abstract: Objectives: To evaluate whether a single high dose of oral cholecalciferol improves the respiratory outcomes as compared with placebo among adults COVID-19 patients at moderate risk of clinical complications.: Trial design: The CARED trial is an ... ...

Abstract	Objectives: To evaluate whether a single high dose of oral cholecalciferol improves the respiratory outcomes as compared with placebo among adults COVID-19 patients at moderate risk of clinical complications. Trial design: The CARED trial is an investigator-initiated, multicentre, randomized, parallel, two-arm, sequential, double-blind and placebo-controlled clinical trial. It was planned as a pragmatic trial since the inclusion criteria are broad and the study procedures are as simple as possible, in order to be implemented in the routine clinical practice in general wards in the pandemic setting and a middle-income country context. The sequential design involves two stages. The first stage will assess the effects of vitamin D supplementation on blood oxygenation (physiological effects). The second stage will assess the effects on clinical outcomes. Participants: Participants of either gender admitted to general adult wards in 21 hospital sites located in four provinces of Argentina are invited to participate in the study if they meet the following inclusion criteria and none of the exclusion criteria: Inclusion criteria SARS-CoV-2 confirmed infection by RT-PCR; Hospital admission at least 24 hours before; Expected hospitalization in the same site ≥24 hours; Oxygen saturation ≥90% (measured by pulse oximetry) breathing ambient air; Age ≥45 years or at least one of the following conditions: ○ Hypertension; ○ Diabetes; ○ At least moderate COPD or asthma; ○ Cardiovascular disease (history of myocardial infarction, percutaneous transluminal coronary angioplasty, coronary artery bypass grafting or valve replacement surgery); ○ Body mass index ≥30; Willingness to sign informed consent (online supplementary material 1 and 2). Exclusion criteria: Age <18 years; Women in childbearing age; >= 72 hs since current admission; Requirement for a high dose of oxygen (>5 litres/minute) or mechanical ventilation (non-invasive or invasive); History of chronic kidney disease requiring haemodialysis or chronic liver failure; Inability for oral intake. Chronic supplementation with pharmacological vitamin D; Current treatment with anticonvulsants; History of: ○ Sarcoidosis; ○ Malabsorption syndrome; ○ Known hypercalcemia or serum calcium >10.5 mg/dL; Life expectancy <6 months; Known allergy to study medication; Any condition at discretion of investigator impeding to understand the study and give informed consent. Intervention and comparator: The intervention consists in a single oral dose of 500.000 IU of commercially available cholecalciferol soft gel capsules (5 capsules of 100.000 IU) or matching placebo MAIN OUTCOMES: The primary outcome for the first stage is the change in the respiratory Sepsis-related Organ Failure Assessment (SOFAr) score between pre-treatment value and the worst value recorded during the first 7 seven days of hospitalization, the death or discharge, whichever occurs first. The SOFAr score measured as the ratio between the pulse oximetry saturation (SpO Randomisation: A computer-generated random sequence and the treatment assignment is performed through the web-based randomization module available in the electronic data capture system (Castor®). A randomization ratio 1:1, stratified and with permuted blocks was used. Stratification variables were diabetes (yes/no), age (≤60/>60 years) and the site. Blinding (masking): Double-blind was achieved by using placebo soft gel capsules with the same organoleptic properties as the active medication. Central management of the medication is carried out by a pharmacist in charge of packaging the study drug in unblinded fashion, who have no contact with on-site investigators. Medication is packaged in opaque white bottles, each containing five soft gel capsules of the active drug or matching placebo, corresponding to complete individual treatment. Treatment codes are kept under the pharmacist responsibility, and all researchers are unaware of them. Numbers to be randomised (sample size): The first stage is planned to include 200 patients (100 per group), the second stage is planned to include 1064 additional patients. The total sample size is 1264 patients. Trial status: Currently the protocol version is the number 1.4 (from October 13 Trial registration: The study protocol is registered in ClinicalTrials.gov (identifier number NCT04411446 ) on June 2, 2020. Full protocol: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).
MeSH term(s)	Aged ; Aged, 80 and over ; Argentina/epidemiology ; COVID-19/complications ; COVID-19/diet therapy ; COVID-19/epidemiology ; COVID-19/virology ; Cholecalciferol/administration & dosage ; Double-Blind Method ; Female ; Humans ; Male ; Middle Aged ; Multicenter Studies as Topic ; Pandemics ; Patient Admission ; Pragmatic Clinical Trials as Topic ; Reverse Transcriptase Polymerase Chain Reaction ; SARS-CoV-2/genetics ; Treatment Outcome ; Vitamins/administration & dosage
Chemical Substances	Vitamins ; Cholecalciferol (1C6V77QF41)
Language	English
Publishing date	2021-02-01
Publishing country	England
Document type	Clinical Trial Protocol ; Letter
ZDB-ID	2040523-6
ISSN	1745-6215 ; 1468-6694 ; 1745-6215
ISSN (online)	1745-6215
ISSN	1468-6694 ; 1745-6215
DOI	10.1186/s13063-021-05073-3
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Article ; Online: Comparison of sodium nitroprusside and adenosine for fractional flow reserve assessment: a systematic review and meta-analysis.

Solernó, Raúl / Pedroni, Pablo / Mariani, Javier / Sarmiento, Ricardo

Expert review of cardiovascular therapy

2018 Volume 16, Issue 10, Page(s) 765–770

Abstract: Background: Fractional flow reserve (FFR) has become a useful tool in the assessment of physiological significance of coronary artery stenosis (CAS), and Adenosine (ADE) is associated with a high incidence of transient side effects. Sodium nitroprusside ...

Abstract	Background: Fractional flow reserve (FFR) has become a useful tool in the assessment of physiological significance of coronary artery stenosis (CAS), and Adenosine (ADE) is associated with a high incidence of transient side effects. Sodium nitroprusside (NPS) has been proposed as an alternative vasodilator agent. A meta-analysis of studies comparing ADE and NPS for FFR assessment in the same coronary lesions was performed. Methods: Authors searched for articles comparing NPS and ADE for FFR assessment in intermediate coronary lesions published through January 2018. The following keywords were used: 'fractional flow reserve' AND 'nitroprusside'. Data were summarized using weighted mean differences for paired data. Results: Seven studies were identified comprising 342 patients and 401 lesions. Four studies evaluated intravenous ADE and 3 studies intracoronary ADE administration. Weighted means FFR values obtained with ADE and NPS were 0.8411 and 0.8445, respectively (weighted mean difference: 0.00, 95% confidence interval (CI) -0.01 to 0.01, p = 0,548). Adverse events were significantly reduced with IC NPS (RR = 0.08, 95%CI 0.02-0.30, P < 0.0001). Conclusions: NPS produces similar FFR measurements compared to ADE with a significant reduction in adverse effects. These results may support its use as a suitable alternative to ADE for FFR assessment.
MeSH term(s)	Adenosine/therapeutic use ; Coronary Stenosis/drug therapy ; Coronary Stenosis/physiopathology ; Fractional Flow Reserve, Myocardial/physiology ; Humans ; Nitroprusside/therapeutic use ; Vasodilator Agents/therapeutic use
Chemical Substances	Vasodilator Agents ; Nitroprusside (169D1260KM) ; Adenosine (K72T3FS567)
Language	English
Publishing date	2018-08-24
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	2192343-7
ISSN	1744-8344 ; 1477-9072
ISSN (online)	1744-8344
ISSN	1477-9072
DOI	10.1080/14779072.2018.1513789
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Article ; Online: Evaluation of the first level of care for tuberculosis control in Buenos Aires, Argentina

Javier Mariani / Daniel Ferrante / Gabriel Battistella / Martín Langsam / Freddy Pérez / Alejandro Macchia

Revista Panamericana de Salud Pública, Vol 45, Iss 22, Pp 1-

2021 Volume 9

Abstract: Objective. Evaluate primary health care functions from the perspective of patients with tuberculosis from slums in the city of Buenos Aires, Argentina. Methods. Cross-sectional observational study with adult patients with tuberculosis (TB) and without TB ...

Abstract	Objective. Evaluate primary health care functions from the perspective of patients with tuberculosis from slums in the city of Buenos Aires, Argentina. Methods. Cross-sectional observational study with adult patients with tuberculosis (TB) and without TB (NoTB), living in slums (S) and outside them (NoS). Participants’ perceptions were evaluated using the Primary Care Assessment Tool for users (abbreviated version), which measures four main domains (first contact, ongoing care, coordination with specialists, and comprehensiveness) and selected secondary domains. A Likert scale was used, ranging from “No, not at all” (1 point) to “Yes, definitely” (4 points). Scores ≥ 3 were considered to indicate adequate performance of functions. Averages were calculated for each domain, as well as two overall scores: with and without secondary domains. Results. 83 participants were included (20 TB-S, 21 TB-NoS, 19 NoTB-S, and 23 NoTB-NoS). The evaluated functions were perceived as inadequate. The TB-S group gave the lowest overall scores, not reaching 3 points in any domain. There were no significant differences in domains or overall scores between groups. Participants with TB gave lower scores in all domains, except in family-centered care, where they gave a significantly higher score than NoTB participants. The overall score without secondary domains was lower for TB participants than for the NoTB groups. Conclusions. According to the perception of participants with TB and without TB, primary health care functions are not satisfactory, either in slums or outside them.
Keywords	poverty areas ; tuberculosis ; quality of health care ; primary health care ; argentina ; Medicine ; R ; Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2021-02-01T00:00:00Z
Publisher	Pan American Health Organization
Document type	Article ; Online
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