Publications by authors named "Gustavo Cardigni"

14 Publications

  • Page 1 of 1

[Severe chemical pneumonitis secondary to talc inhalation. A pediatric case].

Arch Argent Pediatr 2021 08;119(4):e345-e348

Servicio de Pediatría, Sanatorio de la Trinidad Palermo, Ciudad Autónoma de Buenos Aires, Argentina.

Talc is a hydrated magnesium silicate. It was part of traditional infant and young child care for decades. In children, its acute inhalation, generally accidental during diaper changes, although not frequent, is a potentially dangerous condition, and can cause severe respiratory distress and even death. We describe the case of a 14-month child who had an accidental inhalation of talc, chemical pneumonitis and severe respiratory compromise. The patient had acute respiratory distress syndrome requiring mechanical ventilation for one week. There is no standard treatment, we used systemic antibiotics and corticosteroids and aerosol therapy. He did not have complications in other organs or systems. He was hospitalized for ten days. In the follow up, he had isolated episodes of bronchial hyperresponsiveness.
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http://dx.doi.org/10.5546/aap.2021.e345DOI Listing
August 2021

[Diffuse pulmonary lymphangiomatosis with pleural and pericardial involvement. Pediatric case report].

Arch Argent Pediatr 2021 06;119(3):e264-e268

Servicio de Pediatría, Sanatorio de la Trinidad Palermo.

Diffuse pulmonary lymphangiomatosis is a rare disease characterized by marked proliferation and dilation of lymphatic vessels in the lungs, pleura, and mediastinum. The prevalence is unknown and the etiology is not fully understood. A 22-month-old girl was admitted for polyserositis, with pericardial and pleural effusion. She required pericardiocentesis and pleural drainage, presenting chyle drainage (1.5-4 liters/ day) without response to medical treatment (fasting, parenteral nutrition and octreotide). A lung biopsy was performed. The pathological anatomy showed findings compatible with diffuse pulmonary lymphangiomatosis. Treatment with sirolimus and propanolol began, decreasing losses due to pleural drainage one week after treatment. She progressed well, discontinued oxygen supply and pleural drainage was removed, leaving the patient after the fourth month of hospitalization. Early diagnosis of diffuse pulmonary lymphangiomatosis is difficult to achieve, but it allows the application of therapies that prevent disease progression, reducing morbidity and mortality.
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http://dx.doi.org/10.5546/aap.2021.e264DOI Listing
June 2021

[Severe upper limb trauma related to escalator use. Pediatric case report].

Arch Argent Pediatr 2021 06;119(3):e256-e60

Servicio de Pediatría, Sanatorio de la Trinidad Palermo, Ciudad de Buenos Aires, Argentina.

Escalator-related injuries are rare but can be a medical emergency with potentially dangerous complications. The severe upper limb involvement related to injury occurred on an escalator is described. A two year-old patient suffered a fall going down an escalator; her left arm was caught between one of the steps and the comb of the last step. She was admitted to the Emergency Room for the initial stabilization. The foreign body was removed in the operating room. No vascular or nervous compromise was found, but there was severe loss of subcutaneous cellular tissue. The metal comb was removed, and repair surgery was performed on the affected limb. She required four more surgical interventions for plastic and reconstructive surgery. The patient had a good clinical evolution and was discharged without functional sequelae.
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http://dx.doi.org/10.5546/aap.2021.e256DOI Listing
June 2021

[Hypopharyngeal injury due to displacement of brackets arch. Case report].

Arch Argent Pediatr 2020 12;118(6):e558-e561

Servicio de Pediatría, Sanatorio de la Trinidad Palermo, Ciudad Autónoma de Buenos Aires, Argentina.

Involuntary ingestion or aspiration of a brace device and/ or orthodontic arch part can constitute a medical emergency with potentially dangerous complications. The objective of this communication is to describe a rare complication of posterior displacement and ingestion of the brace arch. A 13-year-old girl, suffers from a break in orthodontia during feeding, with the subsequent ingestion of part of it. She presented dysphagia after the fact; it did not improve despite the intake of soft foods. She consulted in the Emergency Department for dysphagia, sialorrhea, pain in the pharynx and mild respiratory distress. Extraction of the orthodontic element was performed endoscopically. The embedded wire was observed at the level of the lower pole of the right amygdala and it was removed. Esophagoscopy was also performed, not observing remains of it in the esophagus. The patient was discharged without sequelae.
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http://dx.doi.org/10.5546/aap.2020.e558DOI Listing
December 2020

The pandemic, the future of children's health, and the development of pediatrics.

Arch Argent Pediatr 2020 12;118(6):378-380

Servicio de Pediatría, Sanatorio de la Trinidad Ramos Mejía, Unidad de Terapia Intensiva Pediátrica, Hospital Nacional Prof. Alejandro Posadas Buenos Aires, Argentina.

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http://dx.doi.org/10.5546/aap.2020.eng.378DOI Listing
December 2020

[Communication through electronic media in pediatrics. Use recommendations].

Arch Argent Pediatr 2019 08;117(4):S175-S179

.Subcomisión de Ejercicio Profesional. Sociedad Argentina de Pediatría.

New information and communication technologies have had an impact on our lives in general, as well as in our health care and pediatric practice. Given this fact, it is essential to establish an initial framework for this type of interactions between physicians and patients in order to provide the necessary security tools to all the involved parties. The existing legislative gap to date has not been an impediment to the use of these technologies in medical communication, but it is necessary to establish what the responsibilities, obligations and rights of each party are, arising from their use. This document briefly describes the available electronic communication channels, with their advantages and disadvantages, and suggests recommendations for the responsible and safe use. Our aim is to frame this new modality of interaction between doctors and their patients, in order to highlight its value and evaluate its limitations.
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http://dx.doi.org/10.5546/aap.2019.S175DOI Listing
August 2019

[Acute flaccid paralysis related to enterovirus with complete resolution of the neurological symptoms. A pediatric case report].

Arch Argent Pediatr 2019 12;117(6):e664-e669

Servicio de Pediatría, Sanatorio de la Trinidad Palermo, Buenos Aires, Argentina.

Since the wild poliovirus no longer circulates, the number of cases of acute flaccid paralysis decreased. However, cases related to non-polio enteroviruses and neurotrope viruses continue to occur. We present a nine-year-old patient with meningitis and myelitis with motor involvement in the lower limbs and neurogenic bladder associated with enterovirus, with complete resolution of the neurological symptoms following the administration of hyperimmune gammaglobulin.
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http://dx.doi.org/10.5546/aap.2019.e664DOI Listing
December 2019

Professional burnout in pediatric intensive care units in Argentina.

Arch Argent Pediatr 2012 Dec;110(6):466-73

Hospital Nacional de Pediatría Prof. Dr. Juan P. Garrahan, Ciudad Autónoma de Buenos Aires, Argentina.

Introduction: There is currently a deficiency of physicians in pediatric intensive care units (PICU). The cause of this deficit is multifactorial, although the burnout phenomenon has been described as relevant.

Objective: To analyze the situation of human resource in the pediatric intensive care units in Argentina and measure the level of burnout.

Methods: An observational cross-sectional study through surveys administered electronically; the Maslach Burnout Inventory was used. Physicians that work at public o private pediatric intensive care units in Argentina during at least 24 hours per week were invited to participate.

Results: A total of 162 surveys were completed (response rate 60%). We observed a high risk of burnout in emotional exhaustion in 40 therapists (25%), in fulfillment in 9 (6%), and depersonalization in 31 (19%). In combination, 66 professionals (41%) had a high risk of burnout to some extent; there were independent protective factors of this risk as to be certified in the specialty (ORA 0.38, 95% CI 0.19 to 0.75) and work in public sector PICU (ORA 0.31, 95% CI 0.15 to 0.65), while working more than 36 hours/week on duty increased the risk (ORA 1.94, 95% CI 1.1 to 3.85). Additionally, 31% said that they did not plan to continue working in intensive care, and 86% did not think to continue with on call duties in the following years. Over 60% of respondents reported that changes in professional practice (salary, staff positions, early retirement, fewer loads on call) could prolong the expectation of continuing activities in PICU.

Conclusions: A significant percentage of doctors working in the PICU of Argentina have a high risk of burnout syndrome and a low expectation of continuing in the field.
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http://dx.doi.org/10.5546/aap.2012.466DOI Listing
December 2012

[Continuing the journey].

Authors:
Gustavo Cardigni

Arch Argent Pediatr 2012 Aug;110(4):282-3

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http://dx.doi.org/10.5546/aap.2012.282DOI Listing
August 2012

[Family-physician communication when a child dies in Pediatric Intensive Care: good intentions are not enough].

Authors:
Gustavo Cardigni

Arch Argent Pediatr 2008 Dec;106(6):487-9

Hospital Nacional de Pediatría Prof. Dr. Juan P. Garrahan.

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http://dx.doi.org/10.1590/S0325-00752008000600002DOI Listing
December 2008

Dying in the intensive care unit: collaborative multicenter study about forgoing life-sustaining treatment in Argentine pediatric intensive care units.

Pediatr Crit Care Med 2003 Apr;4(2):164-9

Hospital de Pediatría "J. P. Garrahan," Buenos Aires, Argentina.

Objective: Describe modes of death and factors involved in decision-making together with life support limitation (LSL) procedures.

Design: Prospective, descriptive, longitudinal, and noninterventional study.

Setting: Sixteen pediatric intensive care units in Argentina.

Patients: Every patient who died during a 1-yr period was included.

Measurements And Main Results: Age, sex, length of stay (LOS), primary and admission diagnosis, underlying chronic disease (CD), postoperative condition (PO). Deaths were classified in four groups: a) failed cardiopulmonary resuscitation (CPR); b) do-not-resuscitate (DNR) status; c) withholding or withdrawing life-sustaining treatment (WH/WD); and d) brain death (BD). Justifications were classified as a) imminent death; b) poor long-term prognosis; c) poor quality of life; and d) family request. Data were collected from medical records and interviews with the attending physicians. Descriptive statistics were performed. Differences among groups were analyzed through contingency tables and analysis of variance when required. Relative risks and confidence intervals of variables potentially related to LSL were analyzed, and logistic regression was performed. There were 6358 admissions and 457 deaths. CPR was performed in 52%, DNR in 16%, WH/WD in 20%, and BD in 11% of dead patients. BD patients were older, LOS and CD prevalence were higher in the WH/WD group. Inotropic drugs were the most frequently limited treatment in 110 patients (55%), CPR in 72 (35.6%), and mechanical ventilation in 63 (31%). Imminent death was the most frequently reported justification for LSL. CD and more staff were associated with a higher probability of LSL.

Conclusions: Most of the patients in Argentina underwent CPR before their death. We have a high proportion of patients with CD (65%) and low BD diagnosis. PO condition decreased LSL probability in chronically ill patients. Do-not-resuscitate orders and withholding new treatments were the most common LSL. Active withdrawal was exceptional. The Ethics Committee was consulted in 5% of the LSL population.
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http://dx.doi.org/10.1097/01.pcc.0000059428.08927.a9DOI Listing
April 2003
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