Publications by authors named "Valdez Pascual"

Introduction: The aim of the study was to determine the organization of healthcare activity of internal medicine (IM) services in the surgical area of general acute care hospitals in Argentina.

Methods: A cross-sectional descriptive observational study was performed between 03/01/19-05/01/19. A web survey about shared care (SC) and internal medicine consultations (IMC) was implemented.

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Introduction: The objective was to analyze the prevalence of classic CVRFs in specialist doctors and establish if there are differences by sex, age and specialty.

Materials And Methods: Observational, cross-sectional study carried out through an anonymous selfadministered survey of specialist doctors throughout the country. Sociodemographic and CVRF data were collected by self-report.

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Obesity is one of the non-communicable chronic diseases with the highest increase in recent decades in Latin America, affecting children, adolescents, and especially young adults. Forty percent of adults have a body mass index greater than 25 kg/m2. Numerous studies have demonstrated a relationship between obesity and cardiovascular diseases such as hypertension, coronary artery disease, heart failure, cardiac arrhythmias, diabetes, sleep apnea, and oncological diseases, among others.

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  • * Daily PM₂.₅ (a harmful air pollutant) levels were significantly higher on wildfire days (34 µg/m) compared to non-wildfire days (25.75 µg/m), indicating a link to fire events.
  • * The risk of ST-elevation myocardial infarction (STEMI) increased with higher PM₂.₅ levels, especially when concentrations exceeded 20 µg/m, suggesting that wildfires contribute to heart health risks.
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  • The study investigates clinical bioethics differences among internists from Spain, Mexico, and Argentina, focusing on ethical conflicts they face.
  • A survey was conducted with 762 participants, revealing that major conflicts revolve around end-of-life decisions, clinical relationships, and patient autonomy.
  • Findings indicate that internists in Spain and Argentina face similar and more frequent ethical challenges than their counterparts in Mexico, with socio-cultural factors influencing these differences.
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Introduction: The COVID-19 pandemic has had significant impacts on society, particularly on children and adolescents, who have faced serious social, educational, and health consequences due to the loss of their primary caregivers.

Materials And Methods: Female fertility rates were analyzed, and estimates of male fertility were made to calculate the number of children under 18 years old by age group. Demographic and mortality information from COVID-19 infection was used to calculate the resulting orphanhood in Argentina during the period 2020-2021, considering the loss of one or both parents or the main caregiver grandparent.

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Cardiovascular diseases (CVD), mainly ischemic heart disease and stroke, is the main cause of death worldwide and each year more people die from CVD than from any other cause. These data call for a paradigm shift, where health promotion and cardiovascular prevention will acquire a central role in health policies. From this perspective, dedicating time during the consultation to promoting the acquisition of heart-healthy habits would be indicated in all individuals, regardless of cardiovascular risk classification, the role of the internist being fundamental.

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Introduction: The COVID-19 vaccine became an effective instrument to prevent severe SARS-CoV-2 infections. However, 5% of vaccinated patients will have moderate or severe disease.

Objective: to compare mortality and days between the symptom onset to the peak disease severity, in vaccinated vs.

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Introduction: The objective of our study was to estimate the prevalence of prenatal exposure to drugs and the neonatal impact.

Material And Methods: Prospective, observational, cross-sectional and analytical study of pregnant women and newborns admitted between March and September 2021. To estimate the prevalence of consumption, the survey and detection of drugs in maternal urine were used as a detection method.

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  • New variants of SARS-CoV-2, changes in public health measures, and decreased immunity in high-risk groups are leading to predictions of increased hospitalizations and intensive care admissions, highlighting a need for effective Early Warning Scores (EWSs) to predict patient complications within 24-48 hours.* -
  • The developed COVID-19 Early Warning Score (COEWS) relies on easily accessible laboratory parameters, distinguishing it from existing models like NEWS2, and assesses risk in both vaccinated and unvaccinated patients.* -
  • The COEWS model incorporates key lab results, transforming predictive coefficients into individual scores that help identify patients at risk of mechanical ventilation or death; its predictive performance shows promising results with a discrimination score of
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The aim of this study was to analyze whether the coronavirus disease 2019 (COVID-19) vaccine reduces mortality in patients with moderate or severe COVID-19 disease requiring oxygen therapy. A retrospective cohort study, with data from 148 hospitals in both Spain (111 hospitals) and Argentina (37 hospitals), was conducted. We evaluated hospitalized patients for COVID-19 older than 18 years with oxygen requirements.

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Cardiovascular diseases (CVD), mainly ischemic heart disease and stroke, is the main cause of death worldwide and each year more people die from CVD than from any other cause. These data call for a paradigm shift, where health promotion and cardiovascular prevention will acquire a central role in health policies. From this perspective, dedicating time during the consultation to promoting the acquisition of heart-healthy habits would be indicated in all individuals, regardless of cardiovascular risk classification, the role of the internist being fundamental.

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Background: South America's substance use profile, poverty, income inequality, and cocaine-supplier role make it a unique place for substance use research. This study investigated the burden of disease attributable to amphetamine use disorder, cannabis use disorder (CAD), cocaine use disorder, and opioid use disorder (OUD) in South America from 1990 to 2019, on the basis of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.

Methods: GBD 2019 estimated the incidence, prevalence, mortality, years of life lost (YLL), years of life lived with disability (YLD), and disability-adjusted life-years (DALYs) due to substance use disorders in each of the 12 South American countries (Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Guyana, Paraguay, Peru, Suriname, Uruguay, and Venezuela).

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Stroke is the leading cause of neurological disability in people over 40 years of age and the fourth leading cause of death in Argentina. In the last ten years, the indexed publications related to the treatment of ischemic stroke were more numerous than those of hemorrhagic stroke. The objective of this material is to provide local and updated recommendations for the management of patients with spontaneous intracerebral hemorrhage during hospitalization.

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SARS-CoV-2 infection usually manifests as an acute respiratory syndrome, characterized by fever, cough, sore throat and dyspnea. Nonetheless, since the beginning of the pandemic in December 2019, less frequent initial symptoms were reported, as the sudden appearance of hiccups (singultus). We describe a clinical case of a 62-year-old male with a medical history of arterial hypertension, diabetes and chronic cardiac insufficiency, who complained of persistent hiccups as initial manifestation of COVID-19, followed by respiratory symptoms.

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  • New SARS-CoV-2 variants, breakthrough infections, waning immunity, and low vaccination rates are causing increased hospitalizations and deaths, highlighting the need for better resource allocation tools in hospitals, especially in resource-limited areas.
  • The CODOP tool, developed using machine learning, predicts the clinical outcomes of hospitalized COVID-19 patients by analyzing 12 clinical parameters, demonstrating high accuracy levels (AUROC: 0.90-0.96) before clinical resolution.
  • CODOP's effectiveness is consistent across different virus variants and vaccination statuses, and it includes online calculators for efficient patient triage, validated through extensive testing in Latin America.
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  • * Results showed that 99.7% of participants developed anti-S1 IgG antibodies, with an average titer of 4197 AU/ml, and those who had prior COVID-19 infection had significantly higher antibody levels than those without it.
  • * The findings indicate that vaccinated individuals generally produced a robust immune response, and prior infection enhances antibody production post-vaccination.
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A multicenter registry that included adults hospitalized for COVID-19 was carried out in various provinces of Argentina, from March to October 2020. The objectives were to describe the epidemiological characteristics, clinical manifestations, treatments, complications and risk factors, need for admission to critical care units and mortality. The registry included information on 4776 patients in 37 health centers in Argentina.

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Background: While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria.

Methods: In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation.

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Guidelines on resource allocation, ethics, triage processes with admission and discharge criteria from critical care and palliative care units during the pandemia are here presented. The interdisciplinary and multi-society panel that prepared these guidelines represented by bioethicists and specialists linked to the end of life: clinicians, geriatricians, emergentologists, intensivists, and experts in palliative care and cardiopulmonary resuscitation. The available information indicates that approximately 80% of people with COVID-19 will develop mild symptoms and will not require hospital care, while 15% will require intermediate or general room care, and the remaining 5% will require assistance in intensive care units.

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The second part of the Inter-Society Argentine Consensus on Urinary Tract Infection (UTI) includes the analysis of special situations. In patients with urinary catheter, urine culture should be requested only in the presence of UTI symptomatology, before instrumentation of the urinary tract, or as a post-transplant control. The antibiotics recommended for empirical treatment in patients without risk factors are third-generation cephalosporins or aminoglycosides.

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The Argentine Society of Infectious Diseases and other scientific societies have updated these recommendations based on data on urinary tract infections in adults obtained from a prospective multicenter study conducted in Argentina during 2016-2017. Asymptomatic bacteriuria should be treated only in pregnant women, who should also be systematically investigated; the antibiotics of choice are nitrofurantoin, amoxicillin, clavulanic/amoxicillin, cephalexin and trimethoprim-sulfamethoxazole. In procedures involving injury to the urinary tract with bleeding, it is recommended to request urine culture and, in the presence of bacteriuria, antimicrobial treatment according to sensitivity should be prescribed from immediately before up to 24 hours after the intervention.

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  • Injuries significantly impact global health, with the number of injury deaths rising from approximately 4.26 million in 1990 to about 4.48 million in 2017, despite a decline in age-standardized mortality rates.
  • The Global Burden of Disease study measured both fatal and non-fatal injuries through years of life lost (YLLs) and years lived with disability (YLDs), which were combined into disability-adjusted life years (DALYs).
  • While overall injury incidence increased, age-standardized DALYs decreased, indicating a need for ongoing research focused on injury prevention, better data collection, and improving access to medical care in high-burden areas.
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Background: Drowning is a leading cause of injury-related mortality globally. Unintentional drowning (International Classification of Diseases (ICD) 10 codes W65-74 and ICD9 E910) is one of the 30 mutually exclusive and collectively exhaustive causes of injury-related mortality in the Global Burden of Disease (GBD) study. This study's objective is to describe unintentional drowning using GBD estimates from 1990 to 2017.

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Epidemiological studies on dual pathology reveal that these patients have less adherence to treatment and worse evolution than non-dual patients. However, most of the studies come from mental health centers and not from addiction centers, and local studies are scarce. Our purpose was to compare the continuity in the treatment for addiction between patients with and without associated psychosis.

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