Biomedical subjects

Pablo Barbero

Publications and source records attributed to Pablo Barbero.

3 recordsLinked to original sources

PubMed2006

Retrospective analysis of surgical complications following cadaveric kidney transplantation in the modern transplant era.

BACKGROUND: Risk factors for surgical complications (SCs) following kidney transplantation in the modern transplant era need to be identified to perform appropriate prophylactic interventions. METHODS: Records from 870 consecutive adult cadaveric kidney transplants done at a single centre were reviewed. SCs were classified into four groups: (i) vascular (12%, thrombosis or stenosis); (ii) haemorrhagic (12%); (iii) ureteral (7.5%, leaks and stenosis) and (iv) wound (16%, lymphocoeles or dehiscences). RESULTS: One or more SCs occurred in 299 (34%) patients, with multiple SCs in 65 (7.4%). By logistic regression analysis, recipient vessel atherosclerosis and delayed graft function (DGF) were significantly associated with both thrombotic complications [odds ratio (OR) 4, 95% confidence interval (CI), 1.4-11, P = 0.010 and OR 3.8, 1.3-12, P < 0.00001, respectively] and graft artery stenosis (OR 2.9, 1.2-6.8, P = 0.015 and OR 5.6, 2.3-13.4, P < 0.0001, respectively). Acute rejection increased the risk of graft artery or ureteral stenosis by 2.5 (CI 1.02-6.4, P = 0.045) and 3.3 (CI 1.1-10, P = 0.034), respectively. Older recipients were related to urinary leak (OR 1.04, CI 1.01-1.07, P = 0.011). Difficult bench surgery, DGF and the use of antiplatelet drugs increased the risk of bleeding by 3.6 (CI 1.9-6.4, P < 0.0001), 2.7 (CI 1.5-4.7, P < 0.0001) and 1.8 (CI 1.03-3.29, P = 0.038), respectively. Each month on dialysis increased the risk by 1.02 (CI 1.01-1.03, P = 0.002). Sirolimus increased the risk for wound SCs by 4.1 (CI 2.1-8.3, P < 0.0001) and obesity, retransplant and acute rejection were additional risk factors. CONCLUSIONS: Adult renal transplant recipients at risk for SCs can be identified by age, DGF, graft vessel and recipient atheromatosis, difficult bench surgery, obesity, rejection and the use of antiplatelet drugs and rapamycin.

Adolescent↗

PubMed2006

[A census of medical genetics services in Argentina].

OBJECTIVE: To describe the medical genetics services in Argentina, in order to help organize a network to coordinate those services, decrease inequity in access to them, and promote the comprehensive development of medical genetics in the country. METHODS: In April-August 2004 a survey was conducted of centers providing medical genetics services in Argentina, looking at their human resources, diagnostic procedures, the services that patients use, and funding. The survey covered service centers that conduct genetic assessment, cytogenetic diagnostic testing, molecular biology testing, and biochemical testing to detect birth defects or genetic disorders. Centers that were devoted exclusively to research were not surveyed. RESULTS: A total of 134 centers fulfilled the selection criteria for the survey; 84 of them were private services, and the other 50 were publicly managed services, at universities and hospitals. The 50 public facilities had a total of 67 physicians who had studied clinical genetics, plus 133 non-medical laboratory professionals. A majority of the 50 centers performed clinical and cytogenetic diagnoses, with a smaller number performing molecular, biochemical, and prenatal diagnoses. More than 70% of the centers and human resources were located in an area that includes the city of Buenos Aires, the province of Buenos Aires, and the nearby north-central provinces of Córdoba and Santa Fe. The 50 public centers were found mainly in large cities; 10 of the country's 23 provinces had no public services. CONCLUSIONS: There is a great geographic disparity in the availability of resources as well as wide variability in the diagnostic procedures that are provided in the different service centers. The unequal distribution of the facilities is an organizational problem that will require the application of policies to guarantee minimum services for people in all regions of the country, as well as access to more complex diagnostic procedures.

Adult↗

PubMed2004

Acitretin embryopathy: a case report.

BACKGROUND: Acitretin is an aromatic retinoid analog of vitamin A. Drugs of this group are well-known teratogenic agents. Nevertheless, acitretin embryopathy has been described only in fetuses. CASE: An infant was exposed to 10 mg/day of acitretin from the beginning of pregnancy until the 10th gestational week. At term, the newborn showed the following abnormalities: microcephaly, epicanthal folds, low nasal bridge, high palate, cup-shaped ears, anteverted nostrils, atrial septal defect, and bilateral sensorineural deafness. At 18 months of age, the patient showed microcephaly and neurodevelopmental delay. CONCLUSIONS: Our patient shows a pattern of anomalies resembling that observed in isotretinoin- and etretinate-exposed children. After ingestion, acitretin is partially converted into etretinate, and etretinate is partially metabolized into acitretin. A similar phenotype would therefore be expected after prenatal exposure to either drug. Moreover, in the present case, teratogenic effects were observed even though the dose was lower than in the previously reported acitretin embryopathy cases. Therefore, we propose that different retinoids, acitretin included, produce only one malformation pattern with variable phenotypic expression.

Abnormalities, Multiple↗