Publications by authors named "Maria F Grande Ratti"

Article Synopsis
  • Unplanned transfers from the General Ward to Critical Care Units often happen when a patient's condition worsens, leading to longer hospital stays and increased mortality rates.
  • A study conducted on 8,317 admissions found that 124 patients (14 per 1,000) were transferred, primarily elderly individuals with conditions like hypertension, heart failure, and respiratory issues.
  • The findings indicate that a significant number of patients who were transferred showed stable NEWS scores beforehand, highlighting potential inadequacies in monitoring and care processes in the General Ward.
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This study aims to assess the value of a help desk in a Personal Health Record (PHR) for monitoring and improving PHR functionalities and processes. Through analysis of 327 help desk tickets categorized by users as telemedicine and PHR requests, we identified four main gaps: information and feedback, access to clinical documents, usability, and ubiquity. The tickets highlighted end users' needs such as timely feedback, contextual information, effective communication, and ease of access to clinical documentation.

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Objective: Clinical practice guidelines suggest performing an electrocardiogram (EKG) in patients with chest pain within the first 10 minutes in the emergency department, warning about subdiagnosis in women. Possible differences based on sex were analyzed.

Method: An observational and retrospective study in an Emergency Department, with adult patients admitted to the Chest Pain Unit in 2021.

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Objectives: To compare the occurrence of death, bleeding, and recurrence according to inpatient or outpatient management of venous thromboembolic disease (VTE).

Materials And Methods: . Retrospective cohort that included a consecutive sampling of VTE consultations between 2016 and 2019 diagnosed in the Emergency Center of a private hospital in Argentina.

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The aim was to explore the scope and limitations of teleconsultation during the pandemic from the perspective of primary care physicians at the Hospital Italiano de Buenos Aires, a private institution located in the Autonomous City of Buenos Aires. A qualitative study was conducted with ten individual semi-structured interviews between January and April 2022. The three major emerging topics were the transition to virtuality, accessibility, and the new care model.

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The aim of this paper was to report patient valuation of usability with our telemedicine system and to explore the effect of pandemic in its behavior. We conducted a cross-sectional study based on the prospective recollection of the results of the Spanish abbreviated version of the Telehealth Usability Questionnaire (TUQ), from October 2019 to July 2020. We observed an inflection point of growth of answers during the pandemic era and a trend of decrease in usability valuations coinciding with the massive and forced implementation of the system after lockdown.

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Objective: To estimate the proportion of individuals with established Type 2 Diabetes Mellitus (T2DM) and Cardiovascular Disease (CVD) who are receiving pharmacological anti-diabetic treatment with evidence of cardiovascular benefit at a hospital in Argentina.

Materials And Methods: Cross-sectional study conducted at the Italian Hospital of Buenos Aires. A consecutive sample of adult patients affiliated with the institutional prepaid health plan active in March 2020, diagnosed with T2DM and established CVD, was included.

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Background: The aim was to analyze changes in normal functional parameters of gait analysis by aging, sex, and body mass index (BMI).

Methods: A cross-sectional study with a consecutive sample of asymptomatic subjects was performed between 2014 and 2020. Primary outcomes were time and force parameters (contact time and center of force [CoF] time), in the heel, midfoot, and metatarsal areas, measured using an in-office force platform.

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Objective: To estimate the prevalence of Antidepressant use in patients with a history of venous thromboembolism (VTE). Describe the patient's characteristics and which drugs are the most prescribed.

Methods: A cross-sectional study involving a consecutive sample of patients included in the Registro de Enfermedad Tromboembólica (RIET) from the Hospital Italiano de Buenos Aires in a period between 01/01/2014 to 01/09/2018.

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Introduction: Cancer treatment is increasingly aggressive. The aim was to estimate who died due to cancer, to report use of chemotherapy (CT) in the last 3 months of life, and to describe clinical-epidemiological characteristics of these patients.

Methods: We included a consecutive sample of deceased during 2017, affiliated to Hospital Italiano de Buenos Aires.

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Introducción. La plantilla de órdenes múltiples es una herramienta informática que podría producir consecuencias inadvertidas pese a sus innumerables beneficios. Nos propusimos explorar el efecto de su inactivación sobre las solicitudes de estudios complementarios y los costos asociados.

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Introduction: The computerized provider order entry (CPOE) is a computing tool that could lead to unintended consequences despite its myriad benefits. We aimed to explore the effect of its inactivation on requests for complementary studies and the associated costs.

Methods: Cross sectional study at the Emergency Department of Hospital Italiano de Buenos Aires, which included a consecutive sample of pre-intervention (January-February 2020) and post-intervention (2021) consultations.

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Background: Hospital hypoglycemia (HH) is an important problem since it is linked to hospital death, prolonged stay and higher costs, both in people with and without diabetes, in the critical area and general ward, especially in cases of severe hypoglycemia. The objective of our work was to compare hospital mortality, transfer to the critical area and hospitalization periods in adults with HH according to its severity.

Methods: We conducted a retrospective cohort of adults hospitalized with hypoglycemia at the Hospital Italiano de Buenos Aires between 2013 and 2018.

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Objective: To estimate prevalence of diabetes in outpatient care and to describe its epidemiological characteristics, comorbidities, and related vascular complications.

Methods: Observational cross-sectional study which included all adults affiliated from a private insurance health plan on March 2019, at Hospital Italiano de Buenos Aires, from Argentina.

Results: The global prevalence of diabetes resulted in 8.

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Introduction: To explore perceptions, concerns and needs of healthcare professionals in an emergency department (ED) from Argentina.

Methods: Participatory action research, coordinated and carried out by ED healthcare professionals, which included physicians, nurses and administrative staff who actively engaged in both data collection and analysis. Mixed methodologies were used: documentary analysis of complaints and written claims by patients, 10 individual interviews, and two reflective focus groups of 10 healthcare professionals (who differed in occupation, seniority and experience, including residents in training).

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Objectives: Describe the use and findings of cardiopulmonary imaging-chest X-ray (cX-ray), echocardiography (cEcho), chest CT (cCT), lung ultrasound (LUS), and/or cardiac magnetic resonance imaging (cMRI)-in COVID-19 hospitalizations in Latin America (LATAM).

Background: There is a lack of information on the images used and their findings during the SARS-CoV-2 pandemic in LATAM.

Methods: Multicenter, prospective, observational study of COVID-19 inpatients, conducted from March to December 2020, from 12 high-complexity centers, in nine LATAM countries.

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Background: The treatment for severe hallux valgus deformity presents a challenge with high risk of complications. Third generation MIS techniques have increased their publications in recent years. The aim was to compare clinical and radiologic outcomes in moderate and severe cases and report minor and major complications.

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For immunosuppressed or transplanted patients, appropriate triage is a timely topic, especially in the Emergency Department (ED) of a high-volume referral center. We implemented a new Program called Rapid Clinical Care by Internal Medicine Specialists, as a preferential care route for these patients, which combines the proposed informatics framework in the field of total quality management in the healthcare units, as an example of digital technologies that can improve processes in the clinical routine. Our study aimed to describe waiting-time and attention-time in ED and to explore the effect on patients' clinical outcomes after discharge.

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Since Argentina's government declared a national emergency to combat the COVID-19 pandemic with a lockdown status, it has produced consequences on the healthcare system. We aimed to quantify the effect on the Emergency Department (ED) visits at Hospital Italiano de Buenos Aires. Our electronic health data showed that ED in-person visits declined 46% during the COVID-19 pandemic, from an overall of 176,370 visits during 2019 to 95,421 visits during 2020.

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Electronic Health Records offer an opportunity to improve patient care (in terms of quality and/or safety) by making available patient health information stored in a single Clinical Data Repository. We aimed to estimate the frequency of hypoglycemic recurrences in hospitalized adult patients in non-critical areas. We designed a cross sectional study with hospitalizations between 2017 and 2018, which included patients with at least one hypoglycemia health record (defined as a value <70 mg/dL, either by capillary glycemic monitoring or serum measurement).

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Due to the COVID-19 pandemic, changes and improvements regarding the organization have been made to adapt quickly at the Emergency Department (ED) of the Hospital Italiano de Buenos Aires, Argentina. This article describes the design, implementation, and use of an electronic dashboard which provided monitoring of patients discharged home, during follow-up with telehealth. It was useful to access essential information to organize and coordinate professional work and patients' surveillance, providing highly relevant data in real-time as proxy variables for quality and safety during home isolation.

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Computerized Provider Order Entry (CPOE) systems may cause unintended consequences. This study aimed to describe the on-going system for CPOE order sets, and to explore an economic evaluation at the Emergency Department. First, we developed a costs dashboard which showed us the significant and excessive use of medical tests per consultation.

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Errors in medication administration involve risks to patient safety. "Bar-Coding Medication Administration" is implemented to prevent these errors. Adoption by nurses is one of the main determinants of their effectiveness.

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