26 results on '"Pehuén Fernández"'
Search Results
2. Glomerulopathies after vaccination against COVID-19. Four cases with three different vaccines in Argentina
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Pehuén Fernández, María Luján Alaye, María Emilia García Chiple, Javier De Arteaga, Walter Douthat, Jorge De La Fuente, and Carlos Chiurchiu
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Diseases of the genitourinary system. Urology ,RC870-923 - Published
- 2023
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3. A single-oral bolus of 100,000 IU of cholecalciferol at hospital admission did not improve outcomes in the COVID-19 disease: the COVID-VIT-D—a randomised multicentre international clinical trial
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Jorge B. Cannata-Andía, Augusto Díaz-Sottolano, Pehuén Fernández, Carmen Palomo-Antequera, Pablo Herrero-Puente, Ricardo Mouzo, Natalia Carrillo-López, Sara Panizo, Guillermo H. Ibañez, Carlos A. Cusumano, Carolina Ballarino, Vicente Sánchez-Polo, Jacqueline Pefaur-Penna, Irene Maderuelo-Riesco, Jesús Calviño-Varela, Mónica D. Gómez, Carlos Gómez-Alonso, John Cunningham, Manuel Naves-Díaz, Walter Douthat, José L. Fernández-Martín, and the COVID-VIT-D trial collaborators
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SARS-CoV-2 ,COVID-19 disease ,Cholecalciferol ,Vitamin D ,Medicine - Abstract
Abstract Background Vitamin D status has been implicated in COVID-19 disease. The objective of the COVID-VIT-D trial was to investigate if an oral bolus of cholecalciferol (100,000 IU) administered at hospital admission influences the outcomes of moderate-severe COVID-19 disease. In the same cohort, the association between baseline serum calcidiol levels with the same outcomes was also analysed. Methods The COVID-VIT-D is a multicentre, international, randomised, open label, clinical trial conducted throughout 1 year. Patients older than 18 years with moderate-severe COVID-19 disease requiring hospitalisation were included. At admission, patients were randomised 1:1 to receive a single oral bolus of cholecalciferol (n=274) or nothing (n=269). Patients were followed from admission to discharge or death. Length of hospitalisation, admission to intensive care unit (ICU) and mortality were assessed. Results In the randomised trial, comorbidities, biomarkers, symptoms and drugs used did not differ between groups. Median serum calcidiol in the cholecalciferol and control groups were 17.0 vs. 16.1 ng/mL at admission and 29.0 vs. 16.4 ng/mL at discharge, respectively. The median length of hospitalisation (10.0 [95%CI 9.0–10.5] vs. 9.5 [95%CI 9.0–10.5] days), admission to ICU (17.2% [95%CI 13.0–22.3] vs. 16.4% [95%CI 12.3–21.4]) and death rate (8.0% [95%CI 5.2–12.1] vs. 5.6% [95%CI 3.3–9.2]) did not differ between the cholecalciferol and control group. In the cohort analyses, the highest serum calcidiol category at admission (>25ng/mL) was associated with lower percentage of pulmonary involvement and better outcomes. Conclusions The randomised clinical trial showed the administration of an oral bolus of 100,000 IU of cholecalciferol at hospital admission did not improve the outcomes of the COVID-19 disease. A cohort analysis showed that serum calcidiol at hospital admission was associated with outcomes. Trial registration COVID-VIT-D trial was authorised by the Spanish Agency for Medicines and Health products (AEMPS) and registered in European Union Drug Regulating Authorities Clinical Trials (EudraCT 2020-002274-28) and in ClinicalTrials.gov ( NCT04552951 ).
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- 2022
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4. Estimation of Glomerular Filtration Rate in Obese Patients: Utility of a New Equation
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Pehuén Fernández, María Laura Nores, Walter Douthat, Javier de Arteaga, Pablo Luján, Mario Campazzo, Jorge de La Fuente, and Carlos Chiurchiu
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glomerular filtration rate ,obesity ,creatinine-based equations ,kidney function tests ,iothalamate meglumine ,chronic kidney disease ,Nutrition. Foods and food supply ,TX341-641 - Abstract
There is no consensus on the best equation to estimate glomerular filtration rate (eGFR) in obese patients (OP). Objective: to evaluate the performance of the current equations and the new Argentinian Equation (“AE”) to estimate GFR in OP. Two validation samples were used: internal (IVS, using 10-fold cross-validation) and temporary (TVS). OP whose GFR was measured (mGFR) with clearance of iothalamate between 2007/2017 (IVS, n = 189) and 2018/2019 (TVS, n = 26) were included. To evaluate the performance of the equations we used: bias (difference between eGFR and mGFR), P30 (percentage of estimates within ±30% of mGFR), Pearson’s correlation (r) and percentage of correct classification (%CC) according to the stages of CKD. The median age was 50 years. Sixty percent had grade I obesity (G1-Ob), 25.1% G2-Ob and 14.9% G3-Ob, with a wide range in mGFR (5.6–173.1 mL/min/1.73 m2). In the IVS, AE obtained a higher P30 (85.2%), r (0.86) and %CC (74.4%), with lower bias (−0.4 mL/min/1.73 m2). In the TVS, AE obtained a higher P30 (88.5%), r (0.89) and %CC (84.6%). The performance of all equations was reduced in G3-Ob, but AE was the only one that obtained a P30 > 80% in all degrees. AE obtained better overall performance to estimate GFR in OP and could be useful in this population. Conclusions from this study may not be generalizable to all populations of obese patients since they were derived from a study in a single center with a very specific ethnic mixed population.
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- 2023
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5. Características clínicas y epidemiológicas de pacientes hospitalizados por infección por SARS-CoV-2 en dos hospitales en Córdoba
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Emanuel José Saad, María Antonella Correa Barovero, Federico Ariel Marucco, Silvina Trinidad Rodríguez Bonazzi, Ayelén Tarditi Barra, Melani Zlotogora, Sofía María Villada, Augusto Douthat y Barrionuevo, María Celeste Heredia, Juan Pablo Caeiro, Pehuén Fernández, and Ricardo Arturo Albertini
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infecciones por coronavirus ,neumonía ,pacientes internos ,pronóstico ,betacoronavirus ,Medicine ,Medicine (General) ,R5-920 - Abstract
Introducción: La enfermedad COVID-19 muestra una marcada heterogeneidad en su curso clínico, habiéndose descripto algunos factores que se asocian un peor pronóstico. El conocimiento del comportamiento de la enfermedad en el escenario local es de gran relevancia para permitir un mejor abordaje. Métodos: Estudio retrospectivo en dos hospitales de la ciudad de Córdoba, Argentina, de pacientes de 18 años o más hospitalizados por infección activa por SARS-CoV-2, desde marzo a octubre del año 2020. Resultados: Se incluyeron 448 pacientes, de los cuales el 95.75% correspondieron a neumonía COVID-19. La mayoría de los episodios ocurrieron en hombres (63.6%), la mediana de edad fue 63 años (RIC:53-75), y las comorbilidades más frecuentes fueron hipertensión arterial (55.1%), obesidad (31.7%) y diabetes mellitus (28.1%). Requirieron ingreso a unidad de cuidados intensivos 162 pacientes (36.2%) y 66 (14.7%), asistencia respiratoria mecánica. Fallecieron 67 pacientes (15%) dentro de los primeros 30 días de seguimiento. En el análisis multivariado la única variable independiente predictora de mortalidad a los 30 días fue la edad (Odds ratio ajustado [ORa]=1.08, IC95%=1.04-1.11, p
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- 2021
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6. Acute kidney injury care units. Risk factors and mortality
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Jessica Betiana Rechene, Pehuén Fernández, and Walter Douthat
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fallo renal agudo ,insuficiencia renal aguda ,factores de riesgo ,mortalidad ,unidades de cuidados intensivos ,Medicine ,Specialties of internal medicine ,RC581-951 - Abstract
Introduction: Acute kidney injury (AKI) is a very common complication among patients in critical conditions and it is associated with a high morbidity and mortality rate. Objectives: The aims of this study were the following: analyze the incidence, risk factors and mortality related to AKI in patients in critical conditions, as well as to determine the incidence of RRT (renal replacement therapy) requirement. Methods: A prospective cohort observational study was performed. Patients admitted to the intensive care units of the Hospital Privado Universitario de Córdoba (Private Medical College Hospital of Córdoba) in 2016, between January and March, were included. A 7-day follow-up was conducted. Results: There were 150 patients included in this study. Incidence of AKI was of 44.7% (n=67). Causes of AKI were prerenal in 70.1% (n=47) of cases; whereas 73.1% (n=49) of patients were admitted due to some pathology. Risk factors for AKI found through multivariate analysis were Chronic Kidney Disease (CKD) and a high SOFA score. Adjusted for other variables, patients with CKD are four times more likely to suffer from AKI (adjusted OR= 4.76; 95% CI= 1.93-11.75; p=0.001), whereas for each additional point in the SOFA score, risk was 25% higher (adjusted OR=1.25; 95% CI=1.08-1.44; p=0.003). The same analysis showed that the mortality variables were the use of vasopressors and AKI. AKI patients had a mortality risk six times higher over time (adjusted HR=6.33; 95% CI= 1.41-28.4, p=0.016). Conclusion: Presence of CKD and a high SOFA score were the risk factors which triggered AKI, whereas AKI was an independent risk factor for short-term mortality.
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- 2018
7. Peritonitis in peritoneal dialysis. Epidemiology, risk factors, inclusion of BACTEC™ in traditional culture systems, and long-term mortality
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Pehuén Fernández, Fabián Ledesma, Walter Douthat, Carlos Chiurchiu, Mario Vilaró, Caludio Abiega, Jorge De la Fuente, and Javier De Arteaga
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peritonitis ,diálisis peritoneal ,diálisis renal ,factores de riesgo ,métodos de cultivo ,mortalidad ,BACTEC™ ,Medicine ,Specialties of internal medicine ,RC581-951 - Abstract
Introduction: Peritonitis is the most common complication in peritoneal dialysis (PD), with an effect on morbidity and mortality. The aim of this study was to analyze epidemiology, risk factors, implementation of the BACTEC™ blood culture system and mortality of peritoneal dialysis-associated peritonitis. Methods: In this retrospective, cohort study, all the patients who started PD between 1992 and 2017 at Hospital Privado Universitario de Córdoba (Córdoba Private Medical College Hospital) were included. Results: The total number of patients was 159, 63 (39.62%) of which had suffered from peritonitis at least once and 96 (60.38%) had never had it. The global peritonitis rate was 0.37 episodes per patient-year. The risk factors for peritonitis were the following: a history of hemodialysis before PD (OR=3.18; CI 95%=1.41-7.14; p=0.0051) and hypoalbuminemia (OR=3.10; CI 95%=1.36-7.06; p=0.0071). The implementation of the BACTEC™ system increased the percentage of positive blood cultures (from 73.55% to 96.55%; p=0.0076). The most frequent isolates were MSSA (23.66 %) and GNB (20.61 %). Differences were found between the 1992-2006 and 2006-2017 periods in the Candida isolates (1.49 % and 9.38 %; p=0.0448) and the “other bacteria” group (1.49 % and 9.38 %; p=0.0448). Although peritonitis patients showed a higher mortality rate (55.56 % versus 38.58 %; p=0.0480), the multivariate analysis revealed that this condition was not a mortality independent risk factor. Conclusion: The risk factors for peritonitis were hemodialysis prior to PD and hypoalbuminemia. The use of the BACTEC™ system increased the percentage of positive blood cultures. After 2006 the number of isolates from the Candida and the “other bacteria” groups was higher. Peritonitis was not a long-term mortality independent risk factor.
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- 2017
8. Características clínicas y epidemiológicas de pacientes hospitalizados por infección por SARS-CoV-2 en dos hospitales en Córdoba
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María Celeste Heredia, Silvina Trinidad Rodríguez Bonazzi, Pehuén Fernández, María Antonella Correa Barovero, Sofía María Villada, Ricardo Arturo Albertini, Emanuel José Saad, Federico Ariel Marucco, Juan Pablo Caeiro, Melani Zlotogora, Augusto Douthat Y Barrionuevo, and Ayelén Tarditi Barra
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General Medicine - Abstract
Introducción: La enfermedad COVID-19 muestra una marcada heterogeneidad en su curso clínico, habiéndose descripto algunos factores que se asocian un peor pronóstico. El conocimiento del comportamiento de la enfermedad en el escenario local es de gran relevancia para permitir un mejor abordaje. Métodos: Estudio retrospectivo en dos hospitales de la ciudad de Córdoba, Argentina, de pacientes de 18 años o más hospitalizados por infección activa por SARS-CoV-2, desde marzo a octubre del año 2020. Resultados: Se incluyeron 448 pacientes, de los cuales el 95.75% correspondieron a neumonía COVID-19. La mayoría de los episodios ocurrieron en hombres (63.6%), la mediana de edad fue 63 años (RIC:53-75), y las comorbilidades más frecuentes fueron hipertensión arterial (55.1%), obesidad (31.7%) y diabetes mellitus (28.1%). Requirieron ingreso a unidad de cuidados intensivos 162 pacientes (36.2%) y 66 (14.7%), asistencia respiratoria mecánica. Fallecieron 67 pacientes (15%) dentro de los primeros 30 días de seguimiento. En el análisis multivariado la única variable independiente predictora de mortalidad a los 30 días fue la edad (Odds ratio ajustado [ORa]=1.08, IC95%=1.04-1.11, p
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- 2021
9. Biomarkers of bone and mineral disorders (FGF-23, fetuin-A) and vascular calcification scores as predictive tools for cardiovascular death in dialysis patients, at 10 years of follow-up
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Pehuén, Fernández, Walter, Douthat, Mauro, Castellano, Gabriela, Cardozo, Gabriela, Garay, Javier, de Arteaga, Carlos, Chiurchiu, and Jorge, de la Fuente
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Minerals ,alpha-2-HS-Glycoprotein ,Infectious and parasitic diseases ,RC109-216 ,RC581-607 ,vascular calcifications ,mortality ,bone and mineral metabolism ,Fibroblast Growth Factor-23 ,Renal Dialysis ,chronic renal failure ,Humans ,Kidney Failure, Chronic ,Medicine ,Prospective Studies ,fgf 23 ,Immunologic diseases. Allergy ,Vascular Calcification ,fetuin a ,Biomarkers ,Follow-Up Studies - Abstract
Cardiovascular disorders represent the leading cause of death in dialysis patients. Alterations of bone and mineral metabolism (BMM) and vascular calcifications play a fundamental role in it. The objective of this study was to evaluate the predictive role on cardiovascular mortality of the measurement of biomarkers of BMM and vascular calcifications. A prospective cohort study was performed. All prevalent patients on chronic dialysis in September 2009 at our institution, who completed the total of the complementary studies, were studied. BMM biomarkers were measured (FGF 23, fetuin A, PTH, calcium and phosphorus) and the vascular calcifications were evaluated using the Kauppila and Adragao scores. Follow-up was carried out until 1/1/2019, death or transplant. Of the 30 patients included, 7 (23.3%) died due to cardiovascular causes. The follow-up time was 44.1 ± 30.4 (range = 1.4-112) months. The Adragao score was the only predictive variable of long-term cardiovascular mortality (area under the curve = 0.82; 95% CI 0.64-0.94; p0.001). The best cut-off point was 5 (sensitivity = 85.7%; specificity = 78.3%). It was also an independent risk factor for cardiovascular mortality adjusted for age, diabetes mellitus, coronary heart disease, aortic calcifications, time spent on dialysis and follow-up time (adjusted OR = 1.77; 95% CI = 1.06-2.96; p = 0.028). The vascular calcifications quantified from the Adragao score were the only independent predictor of long-term cardiovascular mortality. This score represents a simple, useful and superior tool to the biomarkers of BMM.Los trastornos cardiovasculares representan la primera causa de muerte en los pacientes en diálisis. Las alteraciones del metabolismo óseo y mineral (MOM) y las calcificaciones vasculares juegan un papel fundamental en la misma. El objetivo de este estudio fue evaluar el rol predictor sobre la mortalidad cardiovascular de la medición de los biomarcadores del MOM y las calcificaciones vasculares. Se realizó un estudio de cohorte prospectivo. Se estudiaron todos los pacientes prevalentes en diálisis crónica en septiembre del 2009 en nuestra institución que completaron el total de los estudios complementarios. Se midieron biomarcadores del MOM (FGF 23, fetuína A, PTH, calcio y fósforo) y se evaluaron las calcificaciones vasculares mediante los scores de Kauppila y de Adragao. Se realizó un seguimiento hasta el 1/1/2019, la muerte o el trasplante. De los 30 pacientes incluidos, 7 (23.3%) fallecieron por causa cardiovascular. El tiempo de seguimiento fue de 44.1 ± 30.4 (rango = 1.4-112) meses. El score de Adragao fue la única variable predictiva de muerte cardiovascular a largo plazo (área bajo la curva = 0.82; IC95% = 0.64-0.94; p0.001). El mejor punto de corte fue de 5 (sensibilidad = 85.7%; especificidad = 78.3%). Además, fue un factor de riesgo independiente de muerte cardiovascular ajustado por edad, diabetes mellitus, enfermedad coronaria, calcificaciones aorticas, tiempo de permanencia en diálisis y tiempo de seguimiento (OR ajustado = 1.77; IC95% = 1.06-2.96; p = 0.028). Las calcificaciones vasculares cuantificadas a partir del score de Adragao fueron el único predictor independiente de mortalidad cardiovascular a largo plazo. Este score representa una herramienta simple, útil y superior a los biomarcadores del MOM.
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- 2021
10. The incidence, risk factors and impact of acute kidney injury in hospitalized patients due to COVID-19
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Pehuén, Fernández, Emanuel J, Saad, Augusto, Douthat Barrionuevo, Federico A, Marucco, María Celeste, Heredia, Ayelén, Tarditi Barra, Silvina T, Rodriguez Bonazzi, Melani, Zlotogora, María Antonella, Correa Barovero, Sofía M, Villada, Juan Pablo, Maldonado, María Luján, Alaye, Juan Pablo, Caeiro, Ricardo A, Albertini, Jorge, De la Fuente, and Walter G, Douthat
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Risk Factors ,SARS-CoV-2 ,Incidence ,COVID-19 ,Humans ,Hospital Mortality ,Acute Kidney Injury ,Child ,Retrospective Studies - Abstract
The incidence of acute kidney injury (AKI) in hospitalized patients with COVID-19 is variable, being associated with worse outcomes. The objectives of the study were to evaluate the incidence, risk factors (considering demographic characteristics, comorbidities, initial clinical presentation and associated complications) and impact of AKI in subjects hospitalized for COVID-19 in two third-level hospitals in Córdoba, Argentina. A retrospective cohort study was conducted. We included 448 adults who were consecutively hospitalized for COVID-19 between March 3 and October 31, 2020 and were followed throughout the hospitalization. The incidence of AKI was 19% (n = 85; stage I = 43, stage II = 17, and stage III = 25, 18 required renal replacement therapy). In the multivariate analysis, the variables that were independently associated with AKI were: age (for every 10 years, adjusted odd ratio [95%CI] = 1.30 [1.04-1.63], p = 0.022), history of chronic kidney disease -CKD- (9.92 [4.52-21.77], p0.001), blood neutrophil count at admission -BNCA- (for every increase of 1000 BNCA, 1.09 [1.01-1.18], p = 0.037) and requirement for mechanical ventilation -MV- (6.69 [2.24-19.90], p = 0.001). AKI was associated with longer hospitalization, higher admission (63.5 vs. 29.7%; p0.001) and longer stay in the intensive care unit, a positive association with respiratory bacterial superinfection, sepsis, respiratory distress syndrome, MV requirement and mortality (mortality without AK I = 12.4% vs with AKI = 47.1%; stage I = 26%, stage II = 41% and stage III = 88%; p0.001). AKI was independently associated with higher mortality (3.32 [1.6-6.9], p = 0.001). In conclusion, the incidence of AKI in adults hospitalized for COVID-19 was 19% and had a clear impact on morbidity and mortality. The independent risk factors for AKI were: Age, CKD, BNCA and MV.Los objetivos del estudio fueron evaluar la incidencia, los factores de riesgo (considerando características demográficas, comorbilidades, presentación clínica inicial y complicaciones asociadas) y el impacto de la lesión renal aguda ‐LRA‐ en sujetos hospitalizados por COVID-19 en dos instituciones de alta complejidad de Córdoba, Argentina. Se realizó un estudio de cohorte retrospectivo. Se incluyeron 448 adultos que fueron hospitalizados por COVID-19 entre el 3 de marzo y el 31 de octubre del 2020 con seguimiento durante toda la hospitalización. La incidencia de LRA fue 19% (estadio I = 43, estadio II = 17 y estadío III = 25, 18 requirieron diálisis). Las variables que se asociaron de manera independiente con el LRA fueron: edad (por cada 10 años, odd ratio ajustado [IC95%] = 1.30 [1.04-1.63], p = 0.022), enfermedad renal crónica ‐ERC‐ (9.92 [4.52-21.77], p0.001), recuento de neutrófilos sanguíneos al ingreso ‐NSI‐ (por cada incremento de 1000 NSI, 1.09 [1.01‐1.18], p = 0.037) y asistencia respiratoria mecánica ‐ARM‐ (6.69 [2.24‐19.90], p = 0.001). Los sujetos con LRA presentaron una internación más prolongada, mayor requerimiento (63.5 vs. 29.7%; p0.001) y estadía más prolongada en unidad de cuidados intensivos, una asociación positiva con sobreinfección respiratoria bacteriana, sepsis, síndrome de distrés respiratorio, requerimiento de ARM y mortalidad (mortalidad sin LRA 12.4% vs. con LRA 47.1%; estadio I = 26%, estadio II = 41% y estadio III = 88%; p0.001). LRA se asoció de manera independiente a mayor mortalidad (3.3 [1.6‐6.9], p = 0.001). En conclusión, la incidencia de LRA en adultos hospitalizados por COVID-19 fue del 19% y tuvo un claro impacto en la morbi-mortalidad. Los factores de riesgo independientes de LRA fueron: edad, ERC, NSI y ARM.
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- 2021
11. [ABO incompatible living donor kidney transplantation in a center in Córdoba, Argentina]
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Pamela, Borgogno, Pehuén, Fernández, Walter, Douthat, Javier, de Arteaga, Juan Carlos, Damonte, Virginia, Giacomi, Jorge, de la Fuente, and Carlos, Chiurchiu
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Graft Rejection ,Blood Group Incompatibility ,Graft Survival ,Argentina ,Living Donors ,Humans ,Kidney ,Kidney Transplantation ,ABO Blood-Group System - Abstract
The ABO incompatible (ABOi) living donor (LD) kidney transplant allows increasing the number of donors and reducing the time on the waiting list. The objectives of this study were to compare graft survival, patient survival, rejection risk factors and complications during the first year p ost-transplantation in patients who received an ABOi LD kidney transplant between 2014 and 2019 in our institution, matched according to sex, age and immunological risk with a control group of ABO compatible (ABOc) LD kidney transplants in the same period. Thirteen patients were included in each group. No significant differences were found between ABOi and ABOc in the incidence of delayed graft function (n = 0 vs. 1), bleeding (0 vs. 0), infections (13 vs. 13), cellular rejection (1 vs. 3) and humoral rejection (4 vs. 3) in the first year after transplantation. The rejection rate in ABOi do not seem to be related to blood incompatibility. No risk factors associated with rejection were found. Overall survival of patients was 100% in both groups, and graft survival was 92.3% in ABOi and 100% in ABOc (p = 1). ABOi kidney transplantation is an adequate feasible option in our environment for those who do not have compatible donors.El trasplante renal con donante vivo (DV) ABO incompatible (ABOi) permite aumentar el número de donantes y reducir el tiempo en lista de espera. Los objetivos de este estudio fueron: comparar la supervivencia del injerto, del paciente, los factores de riesgo de rechazo y las complicaciones durante el primer año post-trasplante en los pacientes que recibieron un trasplante DV ABOi entre 2014 y 2019 en nuestra institución, emparejados según sexo, edad y riesgo inmunológico con un grupo control de trasplantados DV ABO compatibles (ABOc) en el mismo periodo. Se incluyeron 13 pacientes en cada grupo. No se hallaron diferencias significativas entre los ABOi vs ABOc en la incidencia de retardo de la función del injerto (n = 0 vs. 1), sangrado (0 vs. 0), infecciones (13 vs. 13), rechazo celular (1 vs. 3) y rechazo humoral (4 vs. 3) en el primer año posttrasplante. La tasa de rechazo en los pacientes ABOi no parece tener relación con la incompatibilidad sanguínea, ni se hallaron otros factores de riesgo asociados a rechazo. La supervivencia global de los pacientes fue del 100% en ambos grupos, y la del injerto fue del 92.3% en ABOi y 100% en ABOc (p = 1). El trasplante renal ABOi es una adecuada opción factible en nuestro medio para quienes que no cuentan con donantes compatibles.
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- 2021
12. Glomerulopathies after vaccination against COVID-19. Four cases with three different vaccines in Argentina
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Javier de Arteaga, Jorge de la Fuente, María Emilia García Chiple, Walter Douthat, Pehuén Fernández, Carlos Chiurchiu, and María Luján Alaye
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Vaccination ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,Nephrology ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,MEDLINE ,Medicine ,business ,Virology ,Letter to the Editor - Published
- 2021
13. 316.16: Which Patients Over 60 Years Old Are Candidates for a Kidney Transplant? Usefulness of a Mortality Predictive Score
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Pehuén Fernández, Facundo Schwarz, Juan Pablo Maldonado, Martín Cheballier, Esteban Metrebian, Andrés Parisi, Walter Douthat, Javier De Artega, Carlos Chiurchiu, and Jorge De La Fuente
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Transplantation - Published
- 2022
14. Acute kidney injury in hospitalized patients due to COVID-19
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Pehuén Fernández, Emanuel José Saad, María Celeste Heredia, Juan Pablo Maldonado, Sofía María Villada, Walter Douthat, María Antonella Correa Barovero, Silvina Trinidad Rodríguez Bonazzi, Ayelén Tarditi Barra, Federico Ariel Marucco, Ricardo Arturo Albertini, Jorge de la Fuente, Melani Zlotogora, Augusto Douthat, and Juan Pablo Caeiro
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medicine.medical_specialty ,Respiratory distress ,business.industry ,medicine.medical_treatment ,Incidence (epidemiology) ,Acute kidney injury ,Retrospective cohort study ,medicine.disease ,Intensive care unit ,law.invention ,Sepsis ,law ,Internal medicine ,medicine ,Renal replacement therapy ,business ,Kidney disease - Abstract
The incidence of acute kidney injury (AKI) in hospitalized patients with coronavirus disease 2019 (COVID-19) is variable, being associated with worse outcomes. The objectives of the study were to evaluate the incidence, risk factors and impact of AKI in subjects hospitalized for COVID-19 in two third- level hospitals in Córdoba, Argentina.A retrospective cohort study was conducted. 448 adults who were consecutively hospitalized for COVID-19 between March and the end of October 2020 at Hospital Privado Universitario de Córdoba and Hospital Raúl Angel Ferreyra were included. The incidence of AKI was 19% (n = 85). 50.6% presented AKI stage 1 (n=43), 20% stage 2 (n=17) and 29.4% stage 3 (n=25, of which 18 required renal replacement therapy). In the multivariate analysis, the variables that were independently associated with AKI were: age (adjusted Odd ratio -aOR- =1.30, 95%CI=1.04-1.63, p=0.022), history of chronic kidney disease (aOR=9.92, 95%CI=4.52-21.77, pIn conclusion, the incidence of AKI in adults hospitalized for COVID-19 was 19% and had a clear impact on morbidity and mortality. Local predisposing factors for AKI were identified.
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- 2021
15. Clinical and epidemiological characteristics of patients hospitalized for SARS-CoV-2 infection in two hospitals in Córdoba
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Emanuel José, Saad, María Antonella, Correa Barovero, Federico Ariel, Marucco, Silvina Trinidad, Rodríguez Bonazzi, Ayelén, Tarditi Barra, Melani, Zlotogora, Sofía María, Villada, Augusto, Douthat Y Barrionuevo, María Celeste, Heredia, Juan Pablo, Caeiro, Pehuén, Fernández, and Ricardo Arturo, Albertini
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pacientes internados ,SARS-CoV-2 ,Argentina ,infecciones por coronavirus ,COVID-19 ,neumonía ,Hospitals ,betacoronavirus ,inpatients ,pronóstico ,coronavirus infections ,prognóstico ,Humans ,pneumonia ,pacientes internos ,Artículos Originales ,prognosis ,infecções por coronavirus - Abstract
COVID-19 disease shows a marked heterogeneity in its clinical course, with descriptions of some factors associated with a worse prognosis. Knowledge of the disease behavior in the local scenario is relevant to allow a better approach.Retrospective study in two hospitals in the city of Córdoba, Argentina, with patients aged 18 years or more, hospitalized for active SARS-CoV-2 infection, from March to October, 2020.448 patients were included, of which 95.75% corresponded to COVID-19 pneumonia. Most of the episodes occurred in men (63.6%), the median age was 63 years (IQR: 53-75), and the most frequent comorbidities were arterial hypertension (55.1%), obesity (31.7%) and diabetes mellitus (28.1%). 162 patients (36.2%) needed admission to the intensive care unit and 66 (14.7%) were placed on mechanical ventilation. 67 patients (15%) died within the first 30 days of follow-up. In the multivariate analysis, the only independent variable predictive of mortality at 30 days was age (adjusted Odds ratio [aOR] = 1.08, 95% CI = 1.04-1.11, p0.001). The 4C-Score and CALL-Score prognostic scores showed good discrimination (Area under the curve [AUC] = 0.766, 95% CI = 0.72-0.80 and AUC = 0.785, 95% CI = 0.70-0.85 respectively) and the predicted percentages of mortality were quite close to what was observed in the present study.Most of the patients hospitalized with SARS-CoV-2 infection presented comorbidities and were admitted with pneumonia, associated with high mortality. The prognostic scores with the best performance to predict complications were the 4C-score and the CALL-score.La enfermedad COVID-19 muestra una marcada heterogeneidad en su curso clínico, habiéndose descripto algunos factores que se asocian un peor pronóstico. El conocimiento del comportamiento de la enfermedad en el escenario local es de gran relevancia para permitir un mejor abordaje.Estudio retrospectivo en dos hospitales de la ciudad de Córdoba, Argentina, de pacientes de 18 años o más hospitalizados por infección activa por SARS-CoV-2, desde marzo a octubre del año 2020.Se incluyeron 448 pacientes, de los cuales el 95.75% correspondieron a neumonía COVID-19. La mayoría de los episodios ocurrieron en hombres (63.6%), la mediana de edad fue 63 años (RIC:53-75), y las comorbilidades más frecuentes fueron hipertensión arterial (55.1%), obesidad (31.7%) y diabetes mellitus (28.1%). Requirieron ingreso a unidad de cuidados intensivos 162 pacientes (36.2%) y 66 (14.7%), asistencia respiratoria mecánica. Fallecieron 67 pacientes (15%) dentro de los primeros 30 días de seguimiento. En el análisis multivariado la única variable independiente predictora de mortalidad a los 30 días fue la edad (Odds ratio ajustado [ORa]=1.08, IC95%=1.04-1.11, p0.001). Los scores pronósticos 4C-Score y CALL-Score presentaron muy buena discriminación (Área bajo la curva [ABC]=0.766, IC95%=0.72-0.80 y ABC=0.785, IC95%=0.70-0.85, respectivamente) y los porcentajes predichos de mortalidad se aproximaron bastante a lo observado en el presente estudio.La mayoría de los pacientes hospitalizados por infección por SARS-CoV-2 presentaban comorbilidades y se presentaron como neumonía, asociada a una elevada mortalidad. Los scores pronósticos con mejor rendimiento para predecir complicaciones fueron el 4C-Score y el CALL score.
- Published
- 2021
16. Infections in the first year after renal transplant
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Emanuel J. Saad, Pehuén Fernández, Anyelo E. Cardozo Azua, Virginia Ellena, Cecilia Diz, Guillermo Giordano, Pamela Borgogno, Silvana Nuñez, Daniela Sarmantano, Aljandra Guzman, Facundo Schwarz, Sofía Naser, María Fernanda Flores, María Luján Alaye, Juan Pablo Caeiro, and Jorge De la Fuente
- Subjects
lcsh:Immunologic diseases. Allergy ,immunosuppression ,lcsh:R ,lcsh:Medicine ,opportunistic infections ,Kidney Transplantation ,Tissue Donors ,lcsh:Infectious and parasitic diseases ,Risk Factors ,Urinary Tract Infections ,Humans ,lcsh:RC109-216 ,infections ,lcsh:RC581-607 ,Child ,cytomegalovirus ,Retrospective Studies - Abstract
Infections are frequent complications of kidney transplants. We aimed at determining the frequency and type of infections that occur in renal transplant recipients during the early (0-1 month), intermediate (1-6 months) and late (6-12 months) post-transplant period and analyzing the risk factors for infection. To this aim, we conducted a retrospective cohort study on 1-year post-transplant follow-up in two third-level university hospitals in Cordoba city. All consecutive recipients of renal transplants performed between 2009 and 2015 were included, except those with multiple solid organ transplantation and pediatric patients. We included 375 recipients, of which 235 (62.7%) had at least one episode of infection during follow-up. There were 504 episodes of infection, of which 131 (26%) occurred in the early, 272 (53.9%) in the intermediate, and 101 (20.1%) in the late post-transplant period. The most frequent infections in all periods were caused by bacteria (mainly urinary tract infections), and the most frequent viral infection was caused by Cytomegalovirus (mainly in the second and third period). In the multivariate analysis, infection risk factors were: age60 years (adjusted odds ratio [aOR] = 1.92; 95% CI = 1.05-3.49), organ transplantation from deceased donor (aOR = 8.19; 95% CI = 2.32-28.9), use of pigtail catheter for urinary tract drainage (aOR = 4.06; 95% CI = 1.27-12.9), and number of days in hospital after transplant (aOR = 1.05; 95% CI = 1.01-1.11). In conclusion, infections in renal transplant recipients represent a very frequent health problem in our hospitals. Understanding the local epidemiology of infection and the potential risk factors for infection acquires utmost importance.Las infecciones son complicaciones frecuentes de los trasplantes renales. Los objetivos del estudio fueron determinar la frecuencia y el tipo de infecciones que ocurren en el período post-trasplante temprano (0-1 mes), intermedio (1-6 meses) y tardío (6-12 meses) en nuestro medio y analizar los factores de riesgo de infección. Se realizó un estudio de cohorte retrospectivo que incluyó todos los pacientes con trasplantes renales realizados entre 2009 y 2015 en dos hospitales universitarios de tercer nivel de la ciudad de Córdoba, excluidos los receptores de trasplante simultáneo de múltiples órganos sólidos y los menores de 18 años. Fueron incluidos 375 pacientes, de los cuales 235 (62.7%) tuvieron al menos un episodio de infección. Hubo 504 episodios de infección: 131 (26%) ocurrieron en el período temprano, 272 (53.9%) en el intermedio y 101 (20.1%) en el tardío. La mayoría de las infecciones fueron de origen bacteriano (principalmente del tracto urinario). La mayoría de las infecciones virales ocurrieron en el segundo y el tercer período y Citomegalovirus fue el responsable más frecuente. En el análisis multivariado, los factores de riesgo de infección post-transplante renal fueron: edad60 años (odds ratio ajustado [aOR] 1.92; IC95% 1.05-3.49), donante cadavérico (aOR 8.19; IC95% 2.32-28.9), uso de catéter pigtail (aOR 4.06; IC95% 1.27-12.9) y número de días internado postrasplante (aOR 1.05; IC95% 1.01-1.11). En conclusión, confirmamos que las infecciones en pacientes con trasplante renal son muy frecuentes en nuestro medio, por lo cual es importante conocer la epidemiología local y los factores de riesgo.
- Published
- 2020
17. Recurrent atypical hemolytic uremic syndrome after renal transplantation: treatment with eculizumab
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Ana B, Latzke, Pehuén, Fernández, Carlos, Chiurchiu, Daniela, Sarmantano, Javier, De Arteaga, Walter, Douthat, and Jorge, De la Fuente
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Graft Rejection ,lcsh:Immunologic diseases. Allergy ,recurrence ,Adolescent ,atypical hemolytic uremic syndrome ,lcsh:R ,lcsh:Medicine ,Acute Kidney Injury ,renal transplantation ,Antibodies, Monoclonal, Humanized ,urologic and male genital diseases ,Kidney Transplantation ,thrombotic microangiopathy ,lcsh:Infectious and parasitic diseases ,Humans ,Female ,eculizumab ,lcsh:RC109-216 ,lcsh:RC581-607 ,Immunosuppressive Agents - Abstract
Atypical hemolytic uremic syndrome (aHUS) is a rare entity. It is characterized by a thrombotic microangiopathy (nonimmune hemolytic anemia, thrombocytopenia, and acute renal failure), with a typical histopathology of thickening of capillary and arteriolar walls and an obstructive thrombosis of the vascular lumen. The syndrome is produced by a genetic or acquired deregulation of the alternative pathway of the complement system, with high rates of end stage renal disease, post-transplant recurrence, and high mortality. Mutations associated with factor H, factor B and complement C3 show the worst prognosis. Even though plasma therapy is occasionally useful, eculizumab is effective both for treatment and prevention of post-transplant recurrence. We describe here an adult case of congenital aHUS (C3 mutation) under preventive treatment with eculizumab after renal transplantation, with neither disease recurrence nor drug-related adverse events after a 36-months follow-up.
- Published
- 2018
18. Inadequate doses of hemodialysis. Predisposing factors, causes and prevention
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Pehuén, Fernández, Silvana, Núñez, Javier, De Arteaga, Carlos, Chiurchiu, Walter, Douthat, and Jorge, De La Fuente
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Male ,lcsh:Immunologic diseases. Allergy ,hemodialysis ,lcsh:R ,lcsh:Medicine ,dialysis dose ,Middle Aged ,lcsh:Infectious and parasitic diseases ,Cross-Sectional Studies ,Renal Dialysis ,Risk Factors ,sub-dialysis ,urea kinetic modeling ,Humans ,Kidney Failure, Chronic ,Female ,lcsh:RC109-216 ,lcsh:RC581-607 ,Algorithms - Abstract
Patients receiving sub-optimal dose of hemodialysis have increased morbidity and mortality. The objectives of this study were to identify predisposing factors and causes of inadequate dialysis, and to design a practical algorithm for the management of these patients. A cross-sectional study was conducted. Ninety patients in chronic hemodialysis at Hospital Privado Universitario de Córdoba were included, during September 2015. Twenty two received sub-optimal dose of hemodialysis. Those with urea distribution volume (V) greater than 40 l (72 kg body weight approximately) are 11 times more likely (OR = 11.6; CI 95% = 3.2 to 51.7, p < 0.0001) to receive an inadequate dose of hemodialysis, than those with a smaller V. This situation is more frequent in men (OR = 3.5; 95% CI 1.01-15.8; p = 0.0292). V greater than 40 l was the only independent predictor of sub-dialysis in the multivariate analysis (OR = 10.3; 95% CI 2.8-37; p < 0.0004). The main cause of suboptimal dialysis was receiving a lower blood flow (Qb) than the prescribed (336.4 ± 45.8 ml/min vs. 402.3 ± 28.8 ml/min respectively, p < 0.0001) (n = 18). Other causes were identified: shorter duration of the session (n = 2), vascular access recirculation (n = 1), and error in the samples (n = 1). In conclusion, the only independent predisposing factor found in this study for sub-optimal dialysis is V greater than 40 l. The main cause was receiving a slower Qb than prescribed. From these findings, an algorithm for the management of these patients was developed
- Published
- 2017
19. Filtrado glomerular estimado por fórmulas en pacientes obesos
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Pehuén Fernández, Jorge de la Fuente, Mario Campazzo, Pablo Luján, Carlos Chiurchiu, Javier de Arteaga, and Walter Douthat
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Gynecology ,03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,business.industry ,medicine ,030212 general & internal medicine ,030204 cardiovascular system & hematology ,business - Abstract
Resumen Introduccion Estimar el filtrado glomerular (FG) en sujetos obesos es un desafio. Analizamos el rendimiento de las formulas de estimacion en esta poblacion. Material y metodos Estudio de corte transversal que incluyo a 100 sujetos con diversos grados de obesidad, evaluados entre 2008 y 2015. Se midio el FG con iotalamato (patron de referencia) y se estimo con formulas basadas en creatinina serica: Cockroft Gault, MDRD, CKD-EPI, MCQ y CKD-MCQ (promedio de estas). Se creo un score de performance global (S-P-Global) con puntajes, para unificar todos los criterios de analisis. Resultados En obesidad grado i (n = 53) la formula de mejor rendimiento fue CKD-MCQ (sesgo 1,6 ± 17,4 ml/min × 1,73 m 2 ; correlacion [r] = 0,87; area bajo la curva [AUC] = 0,978; sensibilidad [S] = 100% y especificidad [E] = 87,8%). En obesidad grado ii (n = 25) las de menor sesgo fueron MCQ y CKD-MCQ (1,8 ± 22.3 y –4,4 ± 21,9 ml/min × 1,7 3m 2 ), esta ultima con mayor r (r = 0,89) e igual AUC, S, y E (AUC = 0,976; S = 85,7%; E = 100%). En obesidad grado iii (n = 22), MDRD fue la de menor sesgo (–0,2 ± 31,1 ml/min × 1,73 m 2 ) y CKD-MCQ la de mayor r y AUC (r = 0,66; AUC = 0,929); con igual S y E (S = 80%; E = 94.1%) que MDRD. CKD-MCQ fue la unica ecuacion en la que no se hallaron diferencias significativas con el patron de referencia, en ninguno de los grados de obesidad; y en el S-P-Global fue la que mayor puntaje obtuvo (39/48). Conclusion La formula de mayor rendimiento global para estimar el FG en sujetos con diversos grados de obesidad fue CKD-MCQ.
- Published
- 2017
20. Infecciones urinarias en el primer año postrasplante renal
- Author
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Paula Vilella, Juan Pablo Maldonado, Pehuen Fernández, María Fernanda Flores, Camila De Bernardi, Karen Y Vilte Velazquez, Daniela Hernández, Jorge Luis De La Fuente, and Emanuel José Saad
- Subjects
trasplante de riñón ,infecciones urinarias ,infecciones ,huésped inmunocomprometido ,Medicine ,Medicine (General) ,R5-920 - Abstract
Introducción: Las infecciones del tracto urinario (ITU) constituyen la infección más frecuente en los trasplantados renales (TR). El objetivo principal fue determinar las características clínicas y microbiológicas de las ITU que ocurren durante el primer año posterior al TR. Metodología: Estudio de cohorte retrospectivo, donde se incluyeron pacientes mayores 18 años que recibieron un TR entre 2009-2020 en dos hospitales de la ciudad de Córdoba. A través del registro en las historias clínicas se realizó seguimiento de los pacientes durante el primer año postrasplante y se analizaron los que presentaron al menos un episodio de ITU. Resultados: En el período de estudio, se realizaron 568 TR, de los cuales 207(36,4%) tuvieron al menos un episodio de ITU. En total hubo 419 episodios de ITU, 6(1,4%) episodios de ITU polimicrobianos, se identificaron un total de 426 microorganismos en total en los urocultivos. Del total de episodios 206(49,2%) ocurrieron entre los 31-180 días postrasplante. El principal agente etiológico fue E. coli con 225 aislamientos(52,8%) seguido de Klebsiella sp. con 94(22,1%). El 52,1% del total de episodios fueron causados por microorganismos multirresistentes (MMR). Entre los aislamientos de E. coli, 94(41,8%) fueron MMR. El principal factor de riesgo asociado a ITU por MMR fue el antecedente de ITUs recurrentes (RR=1,62; IC95%=1,29-2,02; p
- Published
- 2023
- Full Text
- View/download PDF
21. Hepatitis E virus infection in hemodialysis patients: A prospective analysis
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Carla Cristani, Guadalupe Di Cola, Jose D. Debes, Fernando Diehl, Andrea Bolomo, Domingo Balderramo, María Belén Pisano, Pehuén Fernández, Viviana Ré, James S. Leathers, Jorge de la Fuente, and Maribel G. Martinez‐Wassaf
- Subjects
0301 basic medicine ,medicine.medical_specialty ,HEMODIALYSIS ,CIENCIAS MÉDICAS Y DE LA SALUD ,medicine.medical_treatment ,MEDLINE ,Argentina ,Ciencias de la Salud ,03 medical and health sciences ,Prospective analysis ,0302 clinical medicine ,Renal Dialysis ,Internal medicine ,medicine ,Hepatitis E virus ,Humans ,Prospective Studies ,Prospective cohort study ,ARGENTINA ,business.industry ,Incidence (epidemiology) ,Incidence ,Hepatitis E ,medicine.disease ,Enfermedades Infecciosas ,030104 developmental biology ,Nephrology ,HEPATITIS E ,Kidney Failure, Chronic ,030211 gastroenterology & hepatology ,Hemodialysis ,business ,Hepatitis E virus infection - Abstract
This study highlights variations in HEV serological status inpatients with ESRD undergoing HD.To assess the dynamics of HEV infection in thispopulation, we prospectively evaluated individuals with end-stagerenal disease (ESRD) undergoing HD at a private hospital in Cordoba, Argentina, between November 2014 and November 2017. Fil: Pisano, María Belén. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Cordoba. Facultad de Medicina. Instituto de Virología; Argentina Fil: Leathers, James. Vanderbilt University School Of Medicine; Estados Unidos Fil: Balderramo, Domingo. Hospital Privado Centro Médico de Córdoba; Argentina Fil: Diehl, Fernando. Hospital Privado Centro Médico de Córdoba; Argentina Fil: Bolomo, Andrea. Hospital Privado Centro Médico de Córdoba; Argentina Fil: Fernández, Pehuen. Hospital Privado Centro Médico de Córdoba; Argentina Fil: Martínez Wassaf, Maribel. Laboratorios Clínicos Especializados- Lace; Argentina Fil: Cristani, Carla. Universidad Católica de Córdoba. Facultad de Ciencias Químicas; Argentina Fil: Di Cola Bucciarelli, Guadalupe. Universidad Nacional de Cordoba. Facultad de Medicina. Instituto de Virología; Argentina. Universidad Católica de Córdoba. Facultad de Ciencias Químicas; Argentina Fil: De la Fuente, Jorge. Hospital Privado Centro Médico de Córdoba; Argentina Fil: Debes, José D.. Universidad de Minnesota; Estados Unidos Fil: Ré, Viviana Elizabeth. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Cordoba. Facultad de Medicina. Instituto de Virología; Argentina
- Published
- 2018
22. Enzyme Replacement Therapy in Pregnant Women with Fabry Disease: A Case Series
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Segundo Pastor Fernández, Pehuén Fernández, Shunko Oscar Fernández, Tabaré Fernández, Jacqueline Griselda Mariela Gonzalez, and Cinthia Claudia Fernández
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0301 basic medicine ,Pregnancy ,Pediatrics ,medicine.medical_specialty ,business.industry ,Breastfeeding ,Enzyme replacement therapy ,medicine.disease ,Fabry disease ,Article ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,medicine ,030212 general & internal medicine ,Adverse effect ,business - Abstract
Fabry disease is a rare inherited lysosomal storage disorder caused by the deficiency of the enzyme alpha-galactosidase A. There is uncertainty regarding the safety of enzyme replacement therapy during pregnancy. We describe the course and outcome of seven pregnancies in six patients with Fabry disease who continued or reinitiated enzyme replacement therapy during pregnancy. No adverse events, in both mothers and children, were observed.
- Published
- 2018
23. Trypanosoma cruzi, organ transplant related
- Author
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Jorge de la Fuente, Pehuén Fernández, Florencia Bonisconti, Ana Belén Latzke, Juan Pablo Caeiro, Carlos Chiurchiu, and Sebastián Caliva
- Subjects
0301 basic medicine ,medicine.medical_specialty ,biology ,business.industry ,030106 microbiology ,MEDLINE ,biology.organism_classification ,Bioinformatics ,Case Illustrated ,Organ transplantation ,03 medical and health sciences ,Infectious Diseases ,medicine ,business ,Trypanosoma cruzi - Published
- 2017
24. Trasplante renal y disminución de la mortalidad en los programas de diálisis crónica
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Walter G. Douthat, Pehuén Fernández, Jessica Rechene, Carlos R. Chiurchiu, Javier De Arteaga, Pablo U. Massari, and Jorge De La Fuente
- Subjects
lcsh:Immunologic diseases. Allergy ,Trasplante renal ,lcsh:R ,Diálisis ,lcsh:Medicine ,lcsh:RC109-216 ,Insuficiencia renal crónica ,lcsh:RC581-607 ,lcsh:Infectious and parasitic diseases - Abstract
El trasplante renal (TR) presenta mejor supervivencia, calidad de vida y costos que la diálisis en la insuficiencia renal crónica (IRC). Estudiamos pacientes en diálisis que recibieron TR durante 2010, las causas de finalización del tratamiento y la supervivencia en diálisis. Evaluamos si criterios más amplios para la aceptación de trasplantes hubieran afectado los resultados del procedimiento en ese período. Incluimos 118 pacientes en diálisis, edad media 56.9 ± 18.4 años, tiempo en diálisis 45.5 ± 59.6 meses, 35 (30%) presentaban diabetes como causa de IRC, y 58 (49%) estaban en espera del TR. Treinta y cuatro finalizaron diálisis, 18 por TR y 12 por fallecimiento. Las principales causas de muerte fueron cardiovasculares, 6 (50%) e infecciones, 2 (17%). La supervivencia al año fue 85% para el grupo total, 98% para los pacientes inscriptos en lista de espera y 72% para no inscriptos. Durante 2010 se realizaron 88 TR (62 con donantes cadavéricos [DC], 18 donantes vivos y 8 dobles trasplantes páncreas-riñón). Los receptores de DC tenían en promedio 50.7 años, 67 meses en diálisis, 8 (13%) eran diabéticos, 12 (20%) con TR previos y 3 cross match contra panel de anticuerpos > 20%. Los donantes tenían edad media 45 años, 28 (45%) con criterios expandidos y 27.7 h de isquemia fría. A los 11.4 meses de seguimiento, 13 (21%) presentó rechazo agudo, la supervivencia para injerto fue de 88% y 93% para pacientes. La principal causa de finalización de diálisis fue TR, sin detectarse que el empleo de DC afectara la supervivencia del TR.
- Published
- 2014
25. Hydrocele Caused by Peritoneal Fluid Leakage through Inguinal Canal
- Author
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Pehuén Fernández, J. de Arteaga, Carlos Chiurchiu, J. de la Fuente, and Walter Douthat
- Subjects
Ascitic fluid ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Peritoneal fluid ,Urology ,General Medicine ,medicine.disease ,Inguinal canal ,Peritoneal dialysis ,medicine.anatomical_structure ,Nephrology ,Hydrocele ,medicine ,Hernia ,business ,Leakage (electronics) - Published
- 2017
26. [The role of kidney transplantation in reducing mortality in a chronic dialysis program]
- Author
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Walter G, Douthat, Pehuén, Fernández, Jessica, Rechene, Carlos R, Chiurchiu, Javier, De Arteaga, Pablo U, Massari, and Jorge, De La Fuente
- Subjects
Adult ,Graft Rejection ,Male ,Waiting Lists ,Incidence ,Argentina ,Middle Aged ,Kidney Transplantation ,Tissue Donors ,Survival Rate ,Hemodialysis Units, Hospital ,Renal Dialysis ,Chronic Disease ,Cadaver ,Prevalence ,Humans ,Female ,Peritoneal Dialysis ,Follow-Up Studies - Abstract
For patients with chronic renal failure (CRF), kidney transplant (KT) is a better alternative to dialysis in terms of survival, life quality and costs. We studied the general characteristics, causes and survival rate of the dialysis population in 2010. We evaluated broader criteria for acceptance of transplants has affected the results of the procedure in that period. A total of 118 dialysis patients were included; mean age 56.9 ± 18.4 years, dialysis duration 45.5 ± 59.6 months, main cause of CRF was diabetes in 35 (30%), and 58 (49%) were included in waiting list for KT. Of the 34 patients who finished dialysis in 2010, 18 (53%) were KT, while 12 (35%) died (cardiovascular 50%, infectious 17%). Survival at 12 months was 85% for the total group, 98% on waiting list and 72% those who were not enrolled. During 2010 there were 88 KT, 62 with cadaveric donors (CD), 18 with living donors and 8 with double pancreas-kidney transplants. Recipients of CD were 50.7 years old, with 67 months on dialysis, 8 (13%) diabetics, and 12 (20%) with previous KT. Donors had a mean age of 45 years, 28 (45%) expanded criteria, and 27.7 hours of cold ischemia time. During an approximate follow-up of 11.4 months, 13 (21%) suffered acute graft rejection, survival was 88% for graft and 93% for patients. We emphasize KT as the main cause of success as regards dialysis. No differences in risk factors were found to significantly affect graft or patient survival.
- Published
- 2014
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