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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
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: COVID-19 among the inhabitants of the slums in the city of Buenos Aires

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

BMJ Open, Vol 11, Iss

a population-based study

2021 Volume 1

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. ... ...

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.
Keywords	Medicine ; R
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: High-dose vitamin D versus placebo to prevent complications in COVID-19 patients

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

Trials, Vol 22, Iss 1, Pp 1-

A structured summary of a study protocol for a randomised controlled trial (CARED-TRIAL)

2021 Volume 3

Abstract: 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	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 ...
Keywords	COVID-19 ; Randomised controlled trial ; protocol ; and vitamin D ; SARS-CoV-2 ; mechanical ventilation ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2021-02-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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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
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Evaluación del primer nivel de atención para el control de la tuberculosis en Buenos Aires, Argentina

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

Revista Panamericana de Salud Pública, Vol 44, Iss 156, Pp 1-

2020 Volume 9

Abstract: Objetivo. Evaluar las funciones de la atención primaria de salud desde la perspectiva de los pacientes con tuberculosis (TB) provenientes de villas de emergencia de la Ciudad Autónoma de Buenos Aires, Argentina. Métodos. Estudio observacional transversal ...

Abstract	Objetivo. Evaluar las funciones de la atención primaria de salud desde la perspectiva de los pacientes con tuberculosis (TB) provenientes de villas de emergencia de la Ciudad Autónoma de Buenos Aires, Argentina. Métodos. Estudio observacional transversal con pacientes adultos con TB y sin TB (NoTB), residentes en villas de emergencia (V) y fuera de ellas (NoV). La percepción de los participantes se evaluó mediante el cuestionario Primary Care Assessment Tool-usuarios (versión abreviada) que mide cuatro dimensiones principales (primer contacto, longitudinalidad de los cuidados, coordinación entre servicios e integralidad) y algunas secundarias. Se utilizó una escala de Likert, desde “No, en absoluto” (1 punto) hasta “Sí, sin duda” (4 puntos). Puntajes ≥ 3 se consideraron como cumplimiento adecuado de las funciones. Se calcularon promedios para cada dominio y dos puntajes globales: con y sin dominios secundarios. Resultados. Se incluyeron 83 participantes (20 TB-V, 21 TB-NV, 19 NoTB-V y 23 NoTB-NV). Las funciones evaluadas se percibieron como no adecuadas. El grupo TB-V tuvo los puntajes globales más bajos y en ningún dominio alcanzó 3 puntos. No hubo diferencias significativas en los dominios ni los puntajes globales entre grupos. Los participantes con TB dieron menores puntajes en todos los dominios, excepto en enfoque familiar que fue significativamente mayor que los de los participantes NoTB; el puntaje global sin dominios secundarios fue menor en los participantes con TB que en los NoTB. Conclusiones. Según la percepción de los participantes con TB y sin TB, las funciones de la atención primaria de salud no son satisfactorias, tanto dentro de las villas de emergencia como fuera de ellas.
Keywords	áreas de pobreza ; tuberculosis ; calidad de la atención de salud ; atención primaria de la salud ; argentina ; Medicine ; R ; Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2020-12-01T00:00:00Z
Publisher	Pan American Health Organization
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Acute coronary syndromes in public and non-public institutions of Argentina

Maximiliano de Abreu / Natalia Vensentini / Javier Mariani / Juan Gagliardi / Hernán Doval / Carlos Tajer

Medicina (Buenos Aires), Vol 79, Iss 6, Pp 461-

2019 Volume 467

Abstract: Treatment of acute coronary syndrome (ACS) may differ according to the health system coverage. The objective of this study was to evaluate demographic characteristics of patients with ACS assisted in public sector institutions compared to the non-public ... ...

Abstract	Treatment of acute coronary syndrome (ACS) may differ according to the health system coverage. The objective of this study was to evaluate demographic characteristics of patients with ACS assisted in public sector institutions compared to the non-public sector of Argentina, as well as the therapeutic and its relationship with the resources of each sector. We analyzed patients hospitalized in institutions of a national, voluntary, prospective and multicenter registry. Between March 2006 and May 2016, 11 072 ACSs were registered in 64 institutions, 39% public (44% have hemodynamic laboratory) and 61% non-public (82% with hemodynamic). Public centers presented less structure and assisted a higher proportion of ST elevation acute coronary syndrome (STE-ACS). (52.5% vs. 36.1%, p < 0.001). Public sector patients were younger, more frequently men, smokers, and less dyslipemics. The proportion of patients reperfused in the STE-ACS was similar in both sectors. The use of coronary angiography in non-ST elevation acute coronary syndrome (NSTE-ACS) was higher in the public sector, whose patients presented more frequently electrocardiographic changes and biomarker elevation. Considering all ACS, 80.2% of patients in public and 90.1% in non-public institutions were incorporated by haemodynamic centers. The availability of hemodynamics was the variable most associated with reperfusion in NSTE-ACS, and invasive treatment in NSTE-ACS. This research demonstrates the complexity of a comparative analysis of health sectors, due to the relevance acquired by the level of resources installed and the demographic differences of the inpatient population, above the simple difference of belonging to the public or non-public system.
Keywords	acute coronary syndrome ; public health ; public hospital ; Medicine ; R ; Immunologic diseases. Allergy ; RC581-607 ; Infectious and parasitic diseases ; RC109-216
Subject code	610
Language	English
Publishing date	2019-12-01T00:00:00Z
Publisher	Fundación Revista Medicina
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Prevalence of non-alcoholic fatty liver disease and liver fibrosis in a general population cohort from Argentina

Federico Guillermo Villamil / Manuel Barbero / Nancy Elena Massenzio / Sandra Mónica Giani / Shigeru Kozima / Fernando Mario Cairo / Rodrigo Agustín Belloni / Javier Mariani / Mercedes Rodriguez Gazari / Paola Evangelina Coisson / Sonia Carolina Gallardo / Paula Andrea Cocco / Claudia Mabel Riboldi / Patricia Eugenia Gallardo

Annals of Hepatology, Vol 28, Iss 4, Pp 101111- (2023)

2023

Abstract: Introduction and Objectives: South America is one of the regions with the highest rates of non-alcoholic fatty liver disease (NAFLD). This study aimed to assess the prevalence and severity of NAFLD in suburban Argentina. Patients and Methods: The study ... ...

Abstract	Introduction and Objectives: South America is one of the regions with the highest rates of non-alcoholic fatty liver disease (NAFLD). This study aimed to assess the prevalence and severity of NAFLD in suburban Argentina. Patients and Methods: The study involved a general community cohort of 993 subjects evaluated sequentially with a comprehensive lifestyle questionnaire, laboratory testing, abdominal ultrasound (US) and transient elastography with XL probe. NAFLD was diagnosed according to standard criteria. Results: The prevalence of NAFLD by the US was 37.2% (326/875) overall, 50.3% in subjects with overweight/obesity, 58.6% with hypertriglyceridemia, 62.3% with diabetes/hyperglycemia and 72.1% with all three risk factors. Male gender (OR 1.42, 95% CI 1.03–1.47, p = 0.029), age (50–59 years: OR 1.98, 95 CI 1.16–3.39, p = 0.013 and ≥60 years: OR 1.86, 95% CI 1.13–3.09, p = 0.015), BMI (25–29: OR 2.87, 95% CI 1.86–4.51, p<0.001 and ≥30: OR 9.57, 95% CI 6.14–15.20, p<0.001), diabetes/hyperglycemia (OR 1.65, 95% CI 1.05–2.61, p = 0.029) and hypertriglyceridemia (OR 1.73, 95% CI 1.20–2.48, p = 0.002) were independent predictors of NAFLD. Among patients with steatosis, 22.2% (69/311) had ≥F2 fibrosis (overweight 25%, hypertriglyceridemia 32%, diabetes/hyperglycemia 34%). BMI (OR 5.22, 95% CI 2.64–11.74, p<0.001), diabetes/hyperglycemia (OR 2.12, 95% CI 1.05–4.29, p = 0.04) and hypertriglyceridemia (OR 1.94, 95% CI 1.03–3.68, p = 0.040) were independent predictors of liver fibrosis. Conclusions: This general population study from Argentina showed a high prevalence of NAFLD. Significant liver fibrosis was present in 22% of subjects with NAFLD. This information adds to the existing knowledge of NAFLD epidemiology in Latin America.
Keywords	Non-alcoholic fatty liver disease ; Epidemiology ; Noninvasive ; Liver fibrosis ; Transient elastography ; Specialties of internal medicine ; RC581-951
Subject code	610
Language	English
Publishing date	2023-07-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Concerns and demands regarding COVID-19. Survey of health personnel

Zulma Ortiz / Laura Antonietti / Alejandro Capriati / Silvina Ramos / Mariana Romero / Javier Mariani / Fabián Ortiz / Mario Pecheny

Medicina (Buenos Aires), Vol 80, Iss Suppl 3, Pp 16-

2020 Volume 24

Abstract: The COVID-19 pandemic affected the organization of health services and had consequences for health teams, according to the pre-existing safety and working conditions. During the first week of April 2020, a cross sectional study was carried out with a ... ...

Abstract	The COVID-19 pandemic affected the organization of health services and had consequences for health teams, according to the pre-existing safety and working conditions. During the first week of April 2020, a cross sectional study was carried out with a qualitative-quantitative approach. The aim was to explore the conditions determining the organizational climate: leadership, communication, institutional resources, cohesion/conflict management, and training; and how these were perceived by health personnel to deal with the pandemic. A total of 5670 healthcare workers participated in an online survey and 50 were interviewed, from all subsectors of the Argentinean health system (public, private and union-health insurance); 72.9% were women, 51.4% were physicians, and the predominant age group was under 40 years. In the qualitative sample (interviews), 52% were men, 62% were physicians, and the average age was 44.8 years. The dimensions of the organizational climate were stratified and five independent predictors of perception of conditions were identified: age, gender, tasks performed, health system subsector, and jurisdiction. The condition most frequently perceived as inadequate were the inaccessibility of institutional resources and the access to personal protective equipment was a major concern. Claims included the need of institutional strategies to support healthcare workers and of a clear and uniform communication. In conclusion, at the time of the study, the health personnel perceived serious deficits in their organizations regarding the conditions necessary to confront COVID-19, with differences among subsectors of the health system.
Keywords	health personnel ; covid-19 ; pandemic ; organizational climate ; working conditions ; Medicine ; R ; Immunologic diseases. Allergy ; RC581-607 ; Infectious and parasitic diseases ; RC109-216 ; covid19
Subject code	796
Language	English
Publishing date	2020-07-01T00:00:00Z
Publisher	Fundación Revista Medicina
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Prescripción facilitada de drogas antihipertensivas y disminución de la muerte prematura por accidente cerebrovascular

Javier Mariani / Marina Ridao / Gabriel González / Mauricio Monsalvo / Alejandro Macchia

Revista Argentina de Cardiología, Vol 84, Iss 2, Pp 126-

2016 Volume 131

Abstract: Introducción: Desde 2003, el programa Remediar (+Redes) distribuye gratuitamente medicación antihipertensiva. Durante este período, la mortalidad por accidente cerebrovascular disminuyó, aunque con inequidades entre grupos socioeconómicos. Objetivos: ... ...

Abstract	Introducción: Desde 2003, el programa Remediar (+Redes) distribuye gratuitamente medicación antihipertensiva. Durante este período, la mortalidad por accidente cerebrovascular disminuyó, aunque con inequidades entre grupos socioeconómicos. Objetivos: Evaluar la asociación entre la mortalidad por accidente cerebrovascular y la provisión de fármacos antihipertensivos. Estudiar la posible interacción entre los efectos de los antihipertensivos sobre la mortalidad y el nivel socioeconómico. Material y métodos: Se realizó un estudio ecológico para datos de panel. La mortalidad se expresa como tasas estandarizadas.Los fármacos antihipertensivos están ajustados a la población entre la que se distribuyeron y se expresan en cuartiles dedispensación. El nivel socioeconómico se midió por las necesidades básicas insatisfechas. Resultados: Desde el inicio del programa en 2003, la distribución de antihipertensivos aumentó significativamente, sobre todo en los grupos menos afluentes (p < 0,001). No hubo una asociación estadísticamente significativa entre la tasa de dispensaciónde antihipertensivos y la mortalidad por accidente cerebrovascular globalmente. Sin embargo, en los análisis de interacción se observó que en los quintiles 3 a 5 de necesidades básicas insatisfechas (menos afluentes), los cuartiles en los que se distribuyeron más antihipertensivos tuvieron significativamente menor mortalidad por accidente cerebrovascular (p = 0,004,p = 0,015 y p = 0,017, para los quintiles 3 a 5 de nivel socioeconómico). Conclusiones: Los resultados del presente análisis sugieren la ausencia de efectos globales de la provisión de antihipertensivossobre la mortalidad por accidente cerebrovascular. Sin embargo, los datos muestran que, entre los grupos más desfavorecidos,la distribución de antihipertensivos estuvo asociada con una reducción de la mortalidad por esta causa.
Keywords	Accidente cerebrovascular/mortalidad ; Hipertensión/tratamiento farmacológico ; Epidemiología ; Argentina ; Medicine ; R ; Internal medicine ; RC31-1245 ; Specialties of internal medicine ; RC581-951 ; Diseases of the circulatory (Cardiovascular) system ; RC666-701
Language	English
Publishing date	2016-04-01T00:00:00Z
Publisher	Sociedad Argentina de Cardiología
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Multivessel versus Single Vessel Angioplasty in Non-ST Elevation Acute Coronary Syndromes

Javier Mariani / Alejandro Macchia / Maximiliano De Abreu / Gabriel Gonzalez Villa Monte / Carlos Tajer

PLoS ONE, Vol 11, Iss 2, p e

A Systematic Review and Metaanalysis.

2016 Volume 0148756

Abstract: BACKGROUND:Multivessel disease is common in acute coronary syndrome patients. However, if multivessel percutaneous coronary intervention is superior to culprit-vessel angioplasty has not been systematically addressed. METHODS:A metaanalysis was conducted ...

Abstract	BACKGROUND:Multivessel disease is common in acute coronary syndrome patients. However, if multivessel percutaneous coronary intervention is superior to culprit-vessel angioplasty has not been systematically addressed. METHODS:A metaanalysis was conducted including studies that compared multivessel angioplasty with culprit-vessel angioplasty among non-ST elevation ACS patients. Since all studies were observational adjusted estimates of effects were used. Pooled estimates of effects were computed using the generic inverse of variance with a random effects model. RESULTS:Twelve studies were included (n = 117,685). Median age was 64.1 years, most patients were male, 29.3% were diabetic and 36,9% had previous myocardial infarction. Median follow-up was 12 months. There were no significant differences in mortality risk (HR 0.79; 95% CI 0.58 to 1.09; I2 67.9%), with moderate inconsistency. Also, there were no significant differences in the risk of death or MI (HR 0.90; 95% CI 0.69 to 1.17; I2 62.3%), revascularization (HR 0.76; 95% CI 0.55 to 1.05; I2 49.9%) or in the combined incidence of death, myocardial infarction or revascularization (HR 0.83; 95% CI 0.66 to 1.03; I2 70.8%). All analyses exhibited a moderate degree of inconsistency. Subgroup analyses by design reduced the inconsistency of the analyses on death or myocardial infarction, revascularization and death, myocardial infarction or revascularization. There was evidence of publication bias (Egger's test p = 0.097). CONCLUSION:Routine multivessel angioplasty in non-ST elevation acute coronary syndrome patients with multivessel disease was not superior to culprit-vessel angioplasty. Randomized controlled trials comparing safety and effectiveness of both strategies in this setting are needed.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2016-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
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