22 results on '"Patricia Aruj"'
Search Results
2. Macrolide therapy is associated with lower mortality in community-acquired bacteraemic pneumonia
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Arnold, Forest, Peyrani, Paula, Ramirez, Julio, Ayesu, Kwabena, File, Thomas, Jr., Burdette, Steven, Blatt, Stephen, Restrepo, Marcos, Bordon, Jose, Gross, Peter, Musher, Daniel, Marrie, Thomas, Weiss, Karl, Roig, Jorge, Lode, Harmut, Welte, Tobias, Aliberti, Stephano, Blasi, Francesco, Cosentini, Roberto, Legnani, Delfino, Franzetti, Fabio, Montano, Nicola, Cervi, Giulia, Rossi, Paolo, Voza, Antonio, Ostrowsky, Belinda, Pesci, Alberto, Nava, Stefano, Viale, Pierluigi, Galavatti, Vanni, Patricia, Aruj, Dimas, Carlos, Piro, Roberto, Viscoli, Claudio, Torres, Antoni, Valenti, Vincenzo, Ojales, Daniel Portela, Bodi, Maria, Porras, Jose, Rello, Jordi, Menendez, Rosario, Stolz, Daiana, Schuetz, Philipp, Haubitz, Sebastian, Chalmers, James, Fardon, Tom, Benchetrit, Guillermo, Rodriguez, Eduardo, Corral, Jorge, Gonzalez, Jose, de Vedia, Lautaro, Lopardo, Gustavo, Luna, Carlos, Martinez, Jorge, Marzoratti, Lucia, Rodriguez, Maria, Videla, Alejandro, Saavedra, Federico, Lopez, Horacio, Gnoni, Martin, Victorio, Carlos, Riera, Fernando, Jimenez, Patricio, Fernandez, Patricia, Parada, Maria, Fuenzalida, Alejandro Díaz, Riquelme, Raul, Barros, Manuel, Luna, Juan Manuel, Toala, Ivan, Oze de Morvil, Guillermo Arbo, Fernandez, Ricardo, Aiello, Gonzalo, Alvarez, Pablo, Soca, Ana, Arteta, Federico, Delgado, Jose, Levy, Gur, Rivero, Ludwig, Rodriguez, Benito, Mirabal, Mario Perez, Mateo, Marilyn, Mendoza, Myrna, Feldman, Charles, Arnold, Forest W., Wiemken, Timothy L., Kelley, Robert, Mattingly, William A., Maurici, Rosemeri, and Ramirez, Julio A.
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- 2018
- Full Text
- View/download PDF
3. Antisynthetase syndrome related interstitial lung disease may have a better treatment response than other forms of Idiopathic Inflammatory Myopathies: a multi-national study
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Sebastian Leiva Aguero, Adrian Gaser, Federico Campins, Norma Naval, Javier Abdala, Monica Sacnun, Patricia Aruj, Carolina Isnardi, Beatriz L Gil, Viviana Moyano, Magdalena Romiti, Joaquin Maritano, Florencia Vivero, Soledad Altube, Capone Lilian, Pablo Malfante, María Laura Alberti, Esteban Gandara, Javier Adrián Sebastiani, Luciana Molinari, Federico Zenon, Gabriela Tabaj, Fabian Caro, Mariana Lagrutta, Marcela Usandivaras, Silvia Quadrelli, Victoria Basso, Ramiro Gomez, Diana Lancelloti, Brenda Varela, Santiago Auteri, Juan Ignacio Enghelmayer, Franco Pacello, Maria Otaola, and Francisco Paulin
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Interstitial lung disease ,Azathioprine ,Immunosuppression ,Antisynthetase syndrome ,respiratory system ,medicine.disease ,Gastroenterology ,Polymyositis ,respiratory tract diseases ,FEV1/FVC ratio ,DLCO ,Internal medicine ,Cohort ,medicine ,business ,medicine.drug - Abstract
Background: Interstitial lung disease (ILD), is the main cause of mortality in Idiopathic inflammatory myopathy (IIM). Epidemiological, prognostic and treatment information are scarce. The goal was to characterize a cohort of IIM patients and compare response to immunosuppression (IS) among different types of IIM. Methods: Observational, multi-centric study in 30 centers from Argentina and Uruguay. Outcomes: Response to IS was defined as worsening: decline FVC >10%; improvement: increase FVC >10%; stability: changes FVC Results: We studied 56 patients with IIM; mean age 51 years; 77% women. 64% patients had anti-synthetase syndrome (ASS), and 36% had demarto/polymyositis. Mean FVC at baseline was 65 % and mean DLCO 55%. Tomographic patterns were nonspecific interstitial pneumonia (NSIP) in 46%, organizing pneumonia (OP) in 12%, overlap NSIP/OP in 17%. Only 55% had positive ANA. From ANA negative patients, 54% had at least one Anti-tRNA-synthetase antibody. Glucocorticoid (GC) were used in 95% of patients. 30% received GC pulses. Other IS drugs were cyclophosphamide, mycophenolate and azathioprine. For the overall cohort the outcomes were: stability 62%, improvement 32% and worsening 6% at 6-12 months. When analyzing response to IS, ASS had a better treatment response than other forms of IIM (OR 1.97 [95%CI 1.06-3.34]; p=0.03) for stability or improvement. Conclusions: ASS related ILD had a better treatment response than other forms of IIM in our cohort. ANA is often negative.
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- 2020
4. Dermatomyositis associated with anti-MDA5 autoantibody
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María Victoria Collado, María De Los ángeles Gargiulo, Ramiro Gómez, Graciela Gómez, Nicolás Pérez, Lorena Suarez, Ana Lía Taratuto, and Patricia Aruj
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interstitial lung disease ,lcsh:Immunologic diseases. Allergy ,dermatomyositis ,autoantibodies ,lcsh:R ,lcsh:Medicine ,lcsh:RC109-216 ,lcsh:RC581-607 ,melanoma differentiation associated protein-5 ,lcsh:Infectious and parasitic diseases - Abstract
Dematomyositis is an idiopathic inflammatory myopathy with a variable clinical spectrum. In recent years, a number of myositis-specific antibodies have been identified including anti-MDA5, which is us eful for diagnosis, prognosis and classification of the diverse clinical forms of the disease. This antibody is associated with cutaneous ulcers, rapidly progressive interstitial lung disease, early mortality and poor prognosis, so the detection of this antibody in a suitable clinical context, raises the need for an aggressive immunosuppressive treatment. We describe a case of dermatomyositis classified as hypomyopathic (i.e. involving mild muscle weakness), presenting specific skin lesions, interstitial lung disease, and presence of anti-MDA5 antibody that had a favorable response to combined treatment with cyclophosphamide, gamma globulin and corticosteroids.
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- 2018
5. Clinical manifestations of organizing pneumonia
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Martín, Hunter, Ana, Ludueña, Irene, Telias, Patricia, Aruj, Silvia, Rausch, and Juan Pablo, Suárez
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Adult ,Aged, 80 and over ,Male ,lcsh:Immunologic diseases. Allergy ,Fever ,bronchiolitis obliterans organizing pneumonia ,Biopsy ,Thoracoscopy ,cryptogenic organizing pneumonia ,lcsh:R ,lcsh:Medicine ,Middle Aged ,lcsh:Infectious and parasitic diseases ,Young Adult ,Dyspnea ,Treatment Outcome ,Cough ,Adrenal Cortex Hormones ,Humans ,Female ,lcsh:RC109-216 ,Tomography, X-Ray Computed ,lcsh:RC581-607 ,Lung ,Aged - Abstract
Organizing pneumonia is a clinical entity asociated with nonspecific symptoms and radiological findings and abnormalities in pulmonary function tests. It is defined by the characteristic histopathological pattern: filling of alveoli and respiratory bronchioles by plugs of granulation tissue. It can be idiopathic (COP) or secondary to other causes (SOP). It is an unusual finding and the clinical and radiographic findings are nonspecific. For specific diagnosis an invasive procedure has to be done, but often empirical treatment is started when there's a clinical suspicion. We describe the clinical characteristics of 13 patients with histological diagnosis of organizing pneumonia. Data was obtained from their medical records. The median age was 76 years and the median time to diagnosis from the onset of symptoms was 31 days. In 10 cases the diagnosis was made by transbronchial biopsy. 8 patients required hospitalization, 4 of them received high doses of steroids and 3 required ventilatory support. One patient died from a cause attributable to this entity and 5 relapsed. Dyspnea, cough and fever were the most frequent symptoms. Most patients had more than one tomographic pattern being the most common ground glass opacities and alveolar consolidation. Nine patients were diagnosed with COP and 4 with SOP. The most frequent underlying cause of SOP was drug toxicity. The clinical characteristics of the reported cases are consistent with previously published series. As an interesting feature, there was a group of patients that needed high doses of steroids and ventilatory support.
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- 2016
6. Blunted Hypercapnic Respiratory Drive Response in Subjects With Late-Onset Pompe Disease
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Sergio G Monteiro, Eduardo L De Vito, and Patricia Aruj
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Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Maximal Respiratory Pressures ,Adolescent ,Respiratory physiology ,Critical Care and Intensive Care Medicine ,pCO2 ,Late Onset Disorders ,Hypercapnia ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Glycogen storage disease type II ,medicine ,Respiratory muscle ,Humans ,Muscle Strength ,Glycogen Storage Disease Type II ,business.industry ,General Medicine ,Carbon Dioxide ,Middle Aged ,medicine.disease ,Respiratory Muscles ,Surgery ,Diaphragm (structural system) ,030228 respiratory system ,Control of respiration ,Case-Control Studies ,Respiratory Mechanics ,Cardiology ,Female ,medicine.symptom ,Respiratory Insufficiency ,business ,030217 neurology & neurosurgery - Abstract
BACKGROUND: Patients with late-onset Pompe disease develop progressive hypercapnic respiratory failure that can be disproportionate to the respiratory muscle compromise and/or thoracic restriction. Although recent studies have reported the presence of a blunted hypercapnic respiratory response in some subjects with neuromuscular disorders and chronic hypercapnia, no study has evaluated the integrity of the respiratory drive in subjects with late-onset Pompe disease. Thus, we endeavor to determine the CO2 rebreathing response in subjects with late-onset Pompe disease. METHODS: Respiratory muscle strength was assessed by measuring the maximum inspiratory pressure, and the maximum expiratory pressure. The maximum inspiratory pressure reflects the strength of the diaphragm and other inspiratory muscles, whereas the maximum expiratory pressure reflects the strength of the abdominal muscles and other expiratory muscles. We studied the hypercapnic drive response (measured as the ratio of the change in airway-occlusion pressure 0.1 s after the start of inspiration and end-tidal PCO2 in 13 subjects with late-onset Pompe disease and 51 healthy controls. RESULTS: Overall inspiratory muscle strength was within normal limits or slightly diminished in the late-onset Pompe disease group. Five subjects (38.5%) were chronically hypercapnic, and 9 (69.2%) had an increased breath-holding time. Compared with controls, the change in airway-occlusion pressure 0.1 s/change in end-tidal CO2 pressure slope (hypercapnic respiratory drive) was lower in the late-onset Pompe disease group (median 0.050 [interquartile range 0.027–0.118] vs 0.183 [0.153–0.233], P < .001). Nine subjects (69.2%) had a blunted change in airway-occlusion pressure 0.1 s/change in end-tidal carbon dioxide pressure slope. CONCLUSIONS: Subjects with late-onset Pompe disease had an impaired hypercapnic respiratory drive response. The clinical impact of this phenomenon in this subject subset deserves further investigation.
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- 2016
7. Macrolide therapy is associated with lower mortality in community-acquired bacteraemic pneumonia
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Arnold, F, Lopardo, G, Wiemken, T, Kelley, R, Peyrani, P, Mattingly, W, Feldman, C, Gnoni, M, Maurici, R, Ramirez, J, Ayesu, K, File, T, Burdette, S, Blatt, S, Restrepo, M, Bordon, J, Gross, P, Musher, D, Marrie, T, Weiss, K, Roig, J, Lode, H, Welte, T, Aliberti, S, Blasi, F, Cosentini, R, Legnani, D, Franzetti, F, Montano, N, Cervi, G, Rossi, P, Voza, A, Ostrowsky, B, Pesci, A, Nava, S, Viale, P, Galavatti, V, Patricia, A, Dimas, C, Piro, R, Viscoli, C, Torres, A, Valenti, V, Ojales, D, Bodi, M, Porras, J, Rello, J, Menendez, R, Stolz, D, Schuetz, P, Haubitz, S, Chalmers, J, Fardon, T, Benchetrit, G, Rodriguez, E, Corral, J, Gonzalez, J, de Vedia, L, Luna, C, Martinez, J, Marzoratti, L, Rodriguez, M, Videla, A, Saavedra, F, Lopez, H, Victorio, C, Riera, F, Jimenez, P, Fernandez, P, Parada, M, Fuenzalida, A, Riquelme, R, Barros, M, Luna, J, Toala, I, Oze de Morvil, G, Fernandez, R, Aiello, G, Alvarez, P, Soca, A, Arteta, F, Delgado, J, Levy, G, Rivero, L, Rodriguez, B, Mirabal, M, Mateo, M, Mendoza, M, Arnold, Forest W., Lopardo, Gustavo, Wiemken, Timothy L., Kelley, Robert, Peyrani, Paula, Mattingly, William A., Feldman, Charles, Gnoni, Martin, Maurici, Rosemeri, Ramirez, Julio A., Arnold, Forest, Ramirez, Julio, Ayesu, Kwabena, File, Thomas, Burdette, Steven, Blatt, Stephen, Restrepo, Marcos, Bordon, Jose, Gross, Peter, Musher, Daniel, Marrie, Thomas, Weiss, Karl, Roig, Jorge, Lode, Harmut, Welte, Tobias, Aliberti, Stephano, Blasi, Francesco, Cosentini, Roberto, Legnani, Delfino, Franzetti, Fabio, Montano, Nicola, Cervi, Giulia, Rossi, Paolo, Voza, Antonio, Ostrowsky, Belinda, Pesci, Alberto, Nava, Stefano, Viale, Pierluigi, Galavatti, Vanni, Patricia, Aruj, Dimas, Carlos, Piro, Roberto, Viscoli, Claudio, Torres, Antoni, Valenti, Vincenzo, Ojales, Daniel Portela, Bodi, Maria, Porras, Jose, Rello, Jordi, Menendez, Rosario, Stolz, Daiana, Schuetz, Philipp, Haubitz, Sebastian, Chalmers, James, Fardon, Tom, Benchetrit, Guillermo, Rodriguez, Eduardo, Corral, Jorge, Gonzalez, Jose, de Vedia, Lautaro, Luna, Carlos, Martinez, Jorge, Marzoratti, Lucia, Rodriguez, Maria, Videla, Alejandro, Saavedra, Federico, Lopez, Horacio, Victorio, Carlos, Riera, Fernando, Jimenez, Patricio, Fernandez, Patricia, Parada, Maria, Fuenzalida, Alejandro Díaz, Riquelme, Raul, Barros, Manuel, Luna, Juan Manuel, Toala, Ivan, Oze de Morvil, Guillermo Arbo, Fernandez, Ricardo, Aiello, Gonzalo, Alvarez, Pablo, Soca, Ana, Arteta, Federico, Delgado, Jose, Levy, Gur, Rivero, Ludwig, Rodriguez, Benito, Mirabal, Mario Perez, Mateo, Marilyn, Mendoza, Myrna, Arnold, F, Lopardo, G, Wiemken, T, Kelley, R, Peyrani, P, Mattingly, W, Feldman, C, Gnoni, M, Maurici, R, Ramirez, J, Ayesu, K, File, T, Burdette, S, Blatt, S, Restrepo, M, Bordon, J, Gross, P, Musher, D, Marrie, T, Weiss, K, Roig, J, Lode, H, Welte, T, Aliberti, S, Blasi, F, Cosentini, R, Legnani, D, Franzetti, F, Montano, N, Cervi, G, Rossi, P, Voza, A, Ostrowsky, B, Pesci, A, Nava, S, Viale, P, Galavatti, V, Patricia, A, Dimas, C, Piro, R, Viscoli, C, Torres, A, Valenti, V, Ojales, D, Bodi, M, Porras, J, Rello, J, Menendez, R, Stolz, D, Schuetz, P, Haubitz, S, Chalmers, J, Fardon, T, Benchetrit, G, Rodriguez, E, Corral, J, Gonzalez, J, de Vedia, L, Luna, C, Martinez, J, Marzoratti, L, Rodriguez, M, Videla, A, Saavedra, F, Lopez, H, Victorio, C, Riera, F, Jimenez, P, Fernandez, P, Parada, M, Fuenzalida, A, Riquelme, R, Barros, M, Luna, J, Toala, I, Oze de Morvil, G, Fernandez, R, Aiello, G, Alvarez, P, Soca, A, Arteta, F, Delgado, J, Levy, G, Rivero, L, Rodriguez, B, Mirabal, M, Mateo, M, Mendoza, M, Arnold, Forest W., Lopardo, Gustavo, Wiemken, Timothy L., Kelley, Robert, Peyrani, Paula, Mattingly, William A., Feldman, Charles, Gnoni, Martin, Maurici, Rosemeri, Ramirez, Julio A., Arnold, Forest, Ramirez, Julio, Ayesu, Kwabena, File, Thomas, Burdette, Steven, Blatt, Stephen, Restrepo, Marcos, Bordon, Jose, Gross, Peter, Musher, Daniel, Marrie, Thomas, Weiss, Karl, Roig, Jorge, Lode, Harmut, Welte, Tobias, Aliberti, Stephano, Blasi, Francesco, Cosentini, Roberto, Legnani, Delfino, Franzetti, Fabio, Montano, Nicola, Cervi, Giulia, Rossi, Paolo, Voza, Antonio, Ostrowsky, Belinda, Pesci, Alberto, Nava, Stefano, Viale, Pierluigi, Galavatti, Vanni, Patricia, Aruj, Dimas, Carlos, Piro, Roberto, Viscoli, Claudio, Torres, Antoni, Valenti, Vincenzo, Ojales, Daniel Portela, Bodi, Maria, Porras, Jose, Rello, Jordi, Menendez, Rosario, Stolz, Daiana, Schuetz, Philipp, Haubitz, Sebastian, Chalmers, James, Fardon, Tom, Benchetrit, Guillermo, Rodriguez, Eduardo, Corral, Jorge, Gonzalez, Jose, de Vedia, Lautaro, Luna, Carlos, Martinez, Jorge, Marzoratti, Lucia, Rodriguez, Maria, Videla, Alejandro, Saavedra, Federico, Lopez, Horacio, Victorio, Carlos, Riera, Fernando, Jimenez, Patricio, Fernandez, Patricia, Parada, Maria, Fuenzalida, Alejandro Díaz, Riquelme, Raul, Barros, Manuel, Luna, Juan Manuel, Toala, Ivan, Oze de Morvil, Guillermo Arbo, Fernandez, Ricardo, Aiello, Gonzalo, Alvarez, Pablo, Soca, Ana, Arteta, Federico, Delgado, Jose, Levy, Gur, Rivero, Ludwig, Rodriguez, Benito, Mirabal, Mario Perez, Mateo, Marilyn, and Mendoza, Myrna
- Abstract
Background: Community-acquired pneumonia (CAP) has a potential complication of bacteremia. The objective of this study was to define the clinical outcomes of patients with CAP and bacteremia treated with and without a macrolide. Materials and methods: Secondary analysis of the Community-Acquired Pneumonia Organization database of hospitalized patients with CAP. Patients with a positive blood culture were categorized based on the presence or absence of a macrolide in their initial antimicrobial regimen, and severity of their CAP. Outcomes included in-hospital all-cause mortality, 30-day mortality, length of stay, and time to clinical stability. Results: Among 549 patients with CAP and bacteremia, 247 (45%) were treated with a macrolide and 302 (55%) were not. The primary pathogen was Streptococcus pneumoniae (74%). Poisson regression with robust error variance models were used to compare the adjusted effects of each study group on the outcomes. The unadjusted 30-day mortality was 18.4% in the macrolide group, and 29.6% in the non-macrolide group (adjusted relative risk (aRR)0.81; 95% confidence interval (CI)0.50–1.33; P = 0.41). Unadjusted in-hospital all-cause mortality was 7.3% in the macrolide group, and 18.9% in the non-macrolide group (aRR 0.54, 95% CI 0.30–0.98; P = 0.043). Length of stay and time to clinical stability were not significantly different. Conclusions: In-hospital mortality, but not 30-day mortality, was significantly better in the macrolide group. Our data support the use of a macrolide in hospitalized patients with CAP and bacteraemia
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- 2018
8. Burden of influenza in Latin America and the Caribbean: a systematic review and meta-analysis
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Agustín Ciapponi, Demián Glujovsky, Ariel Bardach, Luz Gibbons, Vilma Savy, Agustina Mazzoni, Romulo E Colindres, Eduardo Ortega-Barria, and Patricia Aruj
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Influenza-like illness ,Veterinary medicine ,education.field_of_study ,Epidemiology ,business.industry ,Incidence (epidemiology) ,Population ,Public Health, Environmental and Occupational Health ,virus diseases ,Cochrane Library ,Infectious Diseases ,Environmental health ,Human mortality from H5N1 ,Medicine ,Respiratory virus ,business ,education ,Cohort study - Abstract
Please cite this paper as: Savy et al. (2012) Burden of influenza in Latin America and the Caribbean: a systematic review and meta-analysis. Influenza and Other Respiratory Viruses DOI: 10.1111/irv.12036. Objective Influenza causes severe morbidity and mortality. This systematic review aimed to assess the incidence, etiology, and resource usage for influenza in Latin America and the Caribbean. Design Meta-analytic systematic review. Arcsine transformations and DerSimonian Laird random effects model were used for meta-analyses. Setting A literature search from 1980 to 2008 in MEDLINE, Cochrane Library, EMBASE, LILACS, Ministries of Health, PAHO, proceedings, reference lists, and consulting experts. Sample We identified 1092 references, of which 31 were finally included, in addition to influenza surveillance reports. We also used information from the 10 reports from the collaborative group for epidemiological surveillance of influenza and other respiratory virus (GROG), and information retrieved from the WHO global flu database FLUNET. Main outcome measures Incidence, percentage of influenza specimens out of the total received by influenza centers and resource-use outcomes. Results A total of 483 130 specimens of patients with influenza were analyzed. Meta-analysis showed an annual rate of 36 080 (95%CI 28 550 43 610) influenza-like illness per 100 000 persons-years. The percentage of influenza out of total specimens received by influenza centers ranged between 4.66% and 15.42%, with type A the most prevalent, and A subtype H3 predominating. The mean length of stay at hospital due to influenza ranged between 5.8 12.9 days, total workdays lost due to influenza-like illnesses were 17 150 days, and the mean direct cost of hospitalization was US$575 per laboratory-confirmed influenza case. Conclusions Our data show that seasonal influenza imposes a high morbidity and economic burden to the region. However, the vaccine-uptake rate has been low in this region. Population-based cohort studies are required to improve the knowledge about incidence and resource utilization, which would inform healthcare authorities for decision making.
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- 2012
9. [Monostotic fibrous dysplasia]
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Agustina, Sosa Beláustegui, Daniela, Tolosa Koury, Esteban, Bercellini, Silvana, Saldaña, Bárbara, Rellan, and Patricia, Aruj
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Male ,Young Adult ,Occipital Bone ,Humans ,Temporal Bone ,Tomography, X-Ray Computed ,Magnetic Resonance Imaging ,Fibrous Dysplasia, Monostotic - Published
- 2016
10. Epidemiology of community-acquired pneumonia in children of Latin America and the Caribbean: a systematic review and meta-analysis
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Romulo E Colindres, Juan Ignacio Calcagno, Demián Glujovsky, Ariel Bardach, Patricia Aruj, Angela Gentile, Agustín Ciapponi, Agustina Mazzoni, and Sebastián García-Martí
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Microbiology (medical) ,Pediatrics ,medicine.medical_specialty ,Community-acquired pneumonia ,MEDLINE ,Cochrane Library ,medicine.disease_cause ,Risk Assessment ,Streptococcus pneumoniae ,Epidemiology ,Pneumonia, Bacterial ,medicine ,Humans ,Child ,Disease burden ,Caribbean ,business.industry ,Incidence ,Incidence (epidemiology) ,General Medicine ,medicine.disease ,Haemophilus influenzae ,Mycoplasma pneumoniae ,Community-Acquired Infections ,Hospitalization ,Latin America ,Infectious Diseases ,Caribbean Region ,Meta-analysis ,Systematic review ,business - Abstract
Summary Background This systematic review evaluated the incidence, etiology, and use of resources in bacterial, non-tuberculosis community-acquired pneumonia (CAP) in immune-competent children aged Methods Systematic searches (1980–2008) were performed using MEDLINE, Cochrane Library, EMBASE, LILACS, generic, and academic Internet searches. Regional health ministries, the Pan American Health Organization (PAHO), regional proceedings, doctoral theses, and the reference lists of included studies were also searched, and experts were consulted. Arcsine transformations and the DerSimonian–Laird random-effects model were used for proportion meta-analyses. Results The search yielded 1220 references; 60 were included in the meta-analysis, giving a total 23 854 CAP episodes with an incidence of 919/100 000 child-years in children aged Streptococcus pneumoniae was the most frequently isolated agent (11.08%; 95% confidence interval (CI) 7.63−15.08), and pneumococcal serotype 14 was most prevalent (33.00%; 95% CI 25.95−40.45). Other common agents were Haemophilus influenzae and Mycoplasma pneumoniae . Health economics data on CAP in the region were scarce. About one-fourth of CAP patients required hospitalization (median length of stay 11 days, range 5−13.5 days). Conclusions The burden of CAP was substantial, with S. pneumoniae , H. influenzae , and M. pneumoniae being the most common pathogens identified. High quality primary studies on disease incidence, use of health resources, and standardized data collection on disease burden and circulating strains are essential to provide baseline data for the future evaluation of vaccine impact.
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- 2012
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11. Burden and typing of rotavirus group A in Latin America and the Caribbean: systematic review and meta-analysis
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Juan A. Stupka, Ariel Bardach, Analía Rearte, Agustín Ciapponi, Alexandre da Costa Linhares, Agustina Mazzoni, Demián Glujovsky, Jefferson A. Buendía Rodriguez, Tatiana M. Lanzieri, Romulo E Colindres, Eduardo Ortega-Barria, and Patricia Aruj
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Pediatrics ,medicine.medical_specialty ,Latin Americans ,business.industry ,Incidence (epidemiology) ,MEDLINE ,Cochrane Library ,medicine.disease_cause ,Group A ,Infectious Diseases ,Virology ,Meta-analysis ,Internal medicine ,Rotavirus ,medicine ,Typing ,business - Abstract
SUMMARY The efficacy of licensed rotavirus vaccines has only been shown against certain rotavirus group A (RV-A) types. It is critical to understand the burden of rotavirus gastroenteritis (RVGE) and its prevalent types to assess the potential impact of these vaccines in Latin America and the Caribbean (LA&C). We performed a systematic review and metaanalyses of all the available evidence reported from 1990 to 2009 on the burden of rotavirus disease and strains circulating in LA&C. Eligible studies—185 country-level reports, 174951 faecal samples—were selected from MEDLINE, Cochrane Library, EMBASE, LILACS, regional Ministries of Health, PAHO, regional proceedings, doctoral theses, reference lists of included studies and consulting experts. Arc-sine transformations and DerSimonian‐Laird random-effects model were used for meta-analyses. The proportion of gastroenteritis cases due to rotavirus was 24.3% (95%CI 22.3‐26.4) and the incidence of RVGE was 170 per 1000 children-years (95%CI 130‐210). We estimated a global annual mortality for 22 countries of 88.2 (95%CI 79.3‐97.1) deaths per 100000 under 5 years (47000 deaths).The most common G type detected was G1 (34.2%), followed by G9 (14.6%), and G2 (14.4%). The most common P types detected were P[8] (56.2%), P[4] (22.1%) and P[1] 5.4%, and the most prevalent P‐G type associations were P[8]G1 17.9%, P[4]G2 9.1% and P[8]G9 8.8%. In the last 10 years, G9 circulation increased remarkably and G5 almost disappeared. More recently, G12 appeared and P[4]G2 re-emerged. To our knowledge, this is the first meta-analysis of rotavirus infection and burden of disease in LA&C. Copyright # 2011 John Wiley & Sons, Ltd.
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- 2011
12. Neumonía por Legionella pneumophila: Experiencia en un Hospital Universitario de Buenos Aires Neumonia due to Legionella pneumophila. Experience gathered in a University Hospital in Buenos Aires
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Carlos M. Luna, Javier Brea Folco, Patricia Aruj, Karina Rébora, Claudia Balsebre, Rubén Absi, Carlos Vay, Carmen De Mier, and Angela Famiglietti
- Subjects
lcsh:Immunologic diseases. Allergy ,Neumonía bacteriana ,Gram-negative bacilli ,Etiology ,lcsh:R ,Bacilos gram-negativos ,Enfermedad de los legionarios ,lcsh:Medicine ,lcsh:RC109-216 ,lcsh:RC581-607 ,Bacterial pneumonia ,Legionnaires’ disease ,lcsh:Infectious and parasitic diseases - Abstract
La enfermedad de los legionarios es una causa de neumonía adquirida en la comunidad (NAC) reconocida en todo el mundo. En Latinoamérica su incidencia es desconocida. En este estudio se analizó a 9 pacientes con NAC por Legionella pneumophila atendidos entre 1997 y 2001 en el Hospital de Clínicas José de San Martín de la Universidad de Buenos Aires. Se registraron datos de antecedentes, enfermedad actual, contactos, exposición laboral, examen físico, pruebas de laboratorio y uso previo de antibióticos, y se tomó en cuenta la presencia de criterios de gravedad. Nueve pacientes presentaron diagnóstico de NAC por Legionella, ninguno refirió antecedentes de viajes recientes; cuatro de ellos debieron ser internados en unidades de cuidado intensivo. Siete pacientes tenían antecedentes de tabaquismo, 4 tenían EPOC y un paciente linfoma no-Hodgkin. Nuestra casuística corrobora la baja especificidad de la clínica y estudios complementarios para predecir esta etiología. El aislamiento de Legionella es dificultoso, la seroconversión permite el diagnóstico retrospectivo y requiere plazos prolongados y el antígeno urinario aporta un diagnóstico inmediato. Cuando la legionelosis aparece en casos aislados, como ocurriría en Argentina, si no se piensa en esta etiología no se llegará al diagnóstico. Legionella pneumophila es un patógeno de NAC en nuestro medio, debe buscarse mejor, particularmente en pacientes graves, inmunodeprimidos y en fumadores con enfermedad pulmonar obstructiva crónica (EPOC).Legionnaires’ disease is a well recognized cause of community acquired pneumonia (CAP) all around the world. In Latin America its incidence remains unknown. This study analyzed a cohort of 9 patients with CAP due to Legionella pneumophila observed from 1997 to 2001, in the Hospital de Clínicas José de San Martín, University of Buenos Aires. Clinical history included recent illnesses, work exposure, physical exam, prior antibiotic use and severity of illness criteria. None of the 9 patients had a history of recent travels, and 4 of them required admission in intensive care unit (ICU). Seven patients had a cigarette smoking history, four of them also had COPD, and one patient had a non-Hodgkin lymphoma. This study confirms the low specificity of clinical and general laboratory criteria to predict this etiology. Legionella isolation is difficult, and serological testing allows retrospective diagnosis but takes several weeks, while urinary antigen test gives a bed-side diagnosis. When Legionella appears in isolated cases, as happens in Argentina, it should be necessary to have a high index of suspicion to successfully arrive at an etiological diagnosis. Legionella pneumophila is a pathogen causing CAP in our area. A surveillance should be established preferably focused on selected populations including severe CAP, immunocompromised hosts and patients with chronic obstructive pulmonary disease.
- Published
- 2004
13. Vancomycin, unbeatable for methicillin-resistant Staphylococcus aureus hospital-acquired pneumonia? Really?*
- Author
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Patricia Aruj, Carlos M. Luna, and Didier Bruno
- Subjects
medicine.medical_specialty ,business.industry ,Ventilator-associated pneumonia ,Critical Care and Intensive Care Medicine ,medicine.disease ,medicine.disease_cause ,Hospital-acquired pneumonia ,Methicillin-resistant Staphylococcus aureus ,chemistry.chemical_compound ,Pneumonia ,chemistry ,Staphylococcus aureus ,Internal medicine ,Linezolid ,medicine ,Vancomycin ,business ,medicine.drug - Published
- 2010
14. [Oblito]
- Author
-
Agustina, Sosa Beláustegui, Claudio, Yaryour, and Patricia, Aruj
- Subjects
Surgical Sponges ,Cysts ,Humans ,Female ,Middle Aged ,Foreign Bodies - Published
- 2013
15. Nosocomial Acinetobacter pneumonia
- Author
-
Carlos M. Luna and Patricia Aruj
- Subjects
Pulmonary and Respiratory Medicine ,Acinetobacter baumannii ,medicine.medical_specialty ,Tigecycline ,Drug resistance ,Comorbidity ,Microbiology ,Risk Factors ,Ampicillin ,medicine ,Pneumonia, Bacterial ,Humans ,Intensive care medicine ,biology ,business.industry ,Ventilator-associated pneumonia ,Pneumonia, Ventilator-Associated ,Drug Resistance, Microbial ,Sulbactam ,Acinetobacter ,Length of Stay ,biology.organism_classification ,medicine.disease ,Drug Therapy, Combination ,business ,Pneumonia (non-human) ,medicine.drug ,Acinetobacter Infections - Abstract
Acinetobacter spp. (A. baumannii is the prevalent genomic species, but others may cause infection) has become an increasingly important cause of nosocomial pneumonia, particularly in mechanically ventilated patients (VAP). This organism has intrinsic resistance to some antimicrobials but easily acquires resistance to many others; Acinetobacter spp. can survive for long periods of time in the environment. All of these characteristics have contributed to protracted outbreaks associated with significant morbidity and mortality. High rates of colonization are found in debilitated hospitalized patients. Infecting or colonizing organisms in nosocomial infections are more likely to be from cross-transmission or from the hospital environment than from endogenous sources. VAP caused by Acinetobacter spp. is emerging as a prominent hospital complication. The incidence of this microorganism varies from site to site, but it is the second commonest aetiological agent among the gram-negative bacteria. Longer periods of hospitalization, longer time on mechanical ventilation and prior use of antibiotics are the recognized factors increasing the risk of VAP due to Acinetobacter spp. Treatment needs to clearly differentiate infection from colonization, and the agents with the most antimicrobial activity are imipenem/cilastatin, amikacin, colistin, ampicillin/sulbactam and tigecycline. Monotherapy can be adequate if the patient does not have significant comorbidities. Infection control procedures have a major role to play in preventing transmission of this microorganism. Emphasis on initial control measures should, however, be on strict isolation of infected or colonized patients to limit dissemination of outbreak strains in the environment. The variety of potential sources of contamination with Acinetobacter spp. in the hospital environment makes control of these outbreaks one of the more difficult challenges. Persistence of Acinetobacter spp. in the environment provides ample opportunities for contamination of patients and staff and may explain continuing long-term outbreaks.
- Published
- 2007
16. Pneumothorax in dysferlin myopathy associated with mechanical ventilation
- Author
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Patricia Aruj and Martín Hunter
- Subjects
Mechanical ventilation ,Pathology ,medicine.medical_specialty ,biology ,business.industry ,medicine.medical_treatment ,Free access ,Electronic journal ,medicine.disease ,Surgery ,Dysferlin ,Pneumothorax ,medicine ,biology.protein ,medicine.symptom ,business ,Myopathy - Abstract
is not required for Clinical Images (This page in not part of the published article.) International Journal of Case Reports and Images, Vol. 6 No. 4, April 2015. ISSN – [0976-3198] Int J Case Rep Images 2015;6(4):245–247. www.ijcasereportsandimages.com Hunter et al. 245 CASE REPORT OPEN ACCESS Pneumothorax in dysferlin myopathy associated with mechanical ventilation Martin Hunter, Patricia Karina Aruj
- Published
- 2015
17. Appropriateness and delay to initiate therapy in ventilator-associated pneumonia
- Author
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Patricia Aruj, Carlos M. Luna, S Baquero, Fernando Rios, Michael S. Niederman, D. Violi, J. Garzón, A. Prignoni, and S. Gando
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Time Factors ,Severity of Illness Index ,law.invention ,law ,Internal medicine ,Severity of illness ,medicine ,Pneumonia, Bacterial ,Humans ,Prospective Studies ,Intensive care medicine ,Prospective cohort study ,Survival analysis ,Aged ,Analysis of Variance ,Cross Infection ,Ventilators, Mechanical ,business.industry ,Respiratory disease ,Ventilator-associated pneumonia ,Middle Aged ,medicine.disease ,Prognosis ,Intensive care unit ,Survival Analysis ,respiratory tract diseases ,Anti-Bacterial Agents ,Pneumonia ,Intensive Care Units ,Treatment Outcome ,Clinical diagnosis ,Female ,business ,Bronchoalveolar Lavage Fluid - Abstract
Inappropriate therapy (IT) and delayed initiation of appropriate therapy (DIAT) result in inadequate therapy in patients with ventilator-associated pneumonia (VAP). The aim of the current study was to assess the impact of DIAT in VAP. A total of 76 mechanically ventilated patients with bacteriologically confirmed VAP were prospectively evaluated in the intensive care unit of six hospitals in Buenos Aires, Argentina. Appropriate therapy was defined as coverage of all the identified pathogens by the antimicrobial therapy administered at the time of VAP clinical diagnosis. The clinical pulmonary infection score was measured during the 3 days before, at the onset and during the days which followed the onset of VAP. A total of 24 patients received adequate therapy; mortality was 29.2%. The remaining 52 patients received either IT (n = 16) or DIAT (n = 36); the mortality was 63.5% combined, and 75.0 and 58.3% for IT and DIAT, respectively (statistically significant compared with adequate therapy). Inappropriate therapy and delayed initiation of appropriate therapy increased the mortality of ventilator-associated pneumonia. Patients with inappropriate therapy and/or delayed initiation of appropriate therapy had a more gradual increase in clinical pulmonary infection score than those receiving adequate therapy, and this increase was found to occur prior to the time of the clinical diagnosis. In conclusion, these findings might provide the rationale for a trial of earlier initiation of therapy, based on clinical grounds in an effort to improve the outcome of patients with ventilator-associated pneumonia.
- Published
- 2006
18. [Pneumonia due to Legionella pneumophila. Experience gathered in a University Hospital in Buenos Aires]
- Author
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Carlos M, Luna, Javier, Brea Folco, Patricia, Aruj, Karina, Rebora, Claudia, Balsebre, Ruben, Absi, Carlos, Vay, Carmen, De Mier, and Angela, Famiglietti
- Subjects
Male ,Smoking ,Argentina ,Middle Aged ,Legionella pneumophila ,Community-Acquired Infections ,Pulmonary Disease, Chronic Obstructive ,Risk Factors ,Pneumonia, Bacterial ,Humans ,Female ,Legionnaires' Disease ,Aged ,Retrospective Studies - Abstract
Legionnaires' disease is a well recognized cause of community acquired pneumonia (CAP) all around the world. In Latin America its incidence remains unknown. This study analyzed a cohort of 9 patients with CAP due to Legionella pneumophila observed from 1997 to 2001, in the Hospital de Clínicas José de San Martin, University of Buenos Aires. Clinical history included recent illnesses, work exposure, physical exam, prior antibiotic use and severity of illness criteria. None of the 9 patients had a history of recent travels, and 4 of them required admission in intensive care unit (ICU). Seven patients had a cigarette smoking history, four of them also had COPD, and one patient had a non-Hodgkin lymphoma. This study confirms the low specificity of clinical and general laboratory criteria to predict this etiology. Legionella isolation is difficult, and serological testing allows retrospective diagnosis but takes several weeks, while urinary antigen test gives a bed-side diagnosis. When Legionella appears in isolated cases, as happens in Argentina, it should be necessary to have a high index of suspicion to successfully arrive at an etiological diagnosis. Legionella pneumophila is a pathogen causing CAP in our area. A surveillance should be established preferably focused on selected populations including severe CAP, immunocompromised hosts and patients with chronic obstructive pulmonary disease.
- Published
- 2005
19. Sirolimus-Associated Interstitial Pneumonia in Four Renal Transplant Recipients
- Author
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Teresita Rosenbaum, Edgardo Sobrino, Patricia Aruj, Clarisa Alvarez, Luciana Molinari, and Cristina Aguirre
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Renal transplant ,business.industry ,Sirolimus ,Urology ,medicine ,Interstitial pneumonia ,Cardiology and Cardiovascular Medicine ,Critical Care and Intensive Care Medicine ,business ,medicine.drug - Published
- 2014
20. Audit of the Coverage Decision-Making Process in a Government Agency in Uruguay: From the Guidelines Till the Patients
- Author
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A Pichon-Riviere, Demián Glujovsky, A. Rodríguez, S. Garcia Marti, Patricia Aruj, and Ariel Bardach
- Subjects
Government ,business.industry ,Health Policy ,Agency (sociology) ,Public Health, Environmental and Occupational Health ,Accounting ,Business ,Audit ,Decision-making - Published
- 2013
21. Pielonefritis xantogranulomatosa
- Author
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Agustina Sosa Beláustegui, Vanesa Pantano, and Patricia Aruj
- Subjects
lcsh:Immunologic diseases. Allergy ,lcsh:R ,lcsh:Medicine ,lcsh:RC109-216 ,lcsh:RC581-607 ,lcsh:Infectious and parasitic diseases - Published
- 2013
22. PRS1 TOBACCO AND INCOME LEVEL: A SYSTEMATIC REVIEW AND META-ANALYSIS
- Author
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Luz Gibbons, Demián Glujovsky, Daniel Comandé, Brunilda Casetta, Agustín Ciapponi, Ariel Bardach, B Linetzky, Agustina Mazzoni, and Patricia Aruj
- Subjects
Consumption (economics) ,Index (economics) ,business.industry ,Health Policy ,Tobacco control ,Public Health, Environmental and Occupational Health ,Random effects model ,Checklist ,Standardized mortality ratio ,Meta-analysis ,Income level ,Medicine ,business ,Demography - Abstract
To quantify the association between tobacco consumption, tobacco expenditures and morbi-mortality attributed to tobacco, and income level. Specifically, to compare high-income versus lower income groups in terms of smoking prevalence, quantity of tobacco consumption, disease incidence and mortality attributed to AIM assessment of IL. We searched in the main literature databases, conferences index, tobacco control agencies, and contacted experts. Two independent researchers by register screened titles and abstracts (agreement >0.9). The full text of selected studies and its risk of bias (using a STROBE-based checklist) were assessed by two researches. One reviewer extracted data, and a second one checked it. Disagreements were solved by consensus. We conducted a random effects meta-analysis based on adjusted OR using Stata 9.0. We performed pre-planned subgroup and sensitivity analysis to evaluate heterogeneity (I2>50%) by calendar decade, continent, WHO region, country standardized mortality rate, risk of bias, gender, and age.
- Published
- 2009
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