Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 10.297
Filtrar
1.
Radiología (Madr., Ed. impr.) ; 65(1): 32-42, ene.-feb. 2023. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-215021

RESUMO

Antecedentes y objetivoEl manejo actual de la diverticulitis aguda de colon izquierdo requiere pruebas con alto valor pronóstico. Los objetivos del estudio son analizar la utilidad de la ecografía como método diagnóstico inicial y evaluar la validez de las clasificaciones actuales de gravedad de dicha enfermedad.PacientesEstudio observacional retrospectivo de pacientes con diverticulitis aguda de colon izquierdo. Se solicitó ecografía o tomografía computarizada (TC) siguiendo un algoritmo clínico. Tras los hallazgos de imagen, se clasificó la enfermedad como leve, localmente complicada y complicada. Se evaluaron la eficacia de la ecografía como herramienta diagnóstica inicial y las razones por las que se realizó una TC como técnica inicial. Se compararon los hallazgos con las clasificaciones de diverticulitis publicadas.ResultadosDe 311 pacientes con diverticulitis aguda, se seleccionaron 183 con diverticulitis aguda de colon izquierdo, que fueron clasificadas por imagen como leves (104), localmente complicadas (60) y complicadas (19). En 98 pacientes, el diagnóstico se realizó por ecografía, en 77 por TC y en 8 mediante ambas. Las principales razones de utilización inicial de TC fueron falta de experiencia del radiólogo en ecografía abdominal y falta de disponibilidad de un radiólogo de guardia. A 6 pacientes diagnosticados por ecografía se les realizó una nueva evaluación por TC, pero solo en 3 cambió la clasificación. Ninguna de las clasificaciones publicadas recoge todos los hallazgos en imagen.ConclusionesLa ecografía debería ser la primera técnica a utilizar para el diagnóstico de diverticulitis aguda de colon izquierdo. Para establecer el pronóstico de la enfermedad, son útiles diversos parámetros analíticos y hallazgos de imagen. Para una apropiada toma de decisión terapéutica se necesitarían nuevas clasificaciones de gravedad. (AU)


Background and aimsThe current management of acute diverticulitis of the left colon (ADLC) requires tests with high prognostic value. This paper analyzes the usefulness of ultrasonography (US) in the initial diagnosis of ADLC and the validity of current classifications schemes for ADLC.PatientsThis retrospective observational study included patients with ADLC scheduled to undergo US or computed tomography (CT) following a clinical algorithm. According to the imaging findings, ADLC was classified as mild, locally complicated, or complicated. We analyzed the efficacy of US in the initial diagnosis and the reasons why CT was used as the first-line technique. We compared the findings with published classifications schemes for ADLC.ResultsA total of 311 patients were diagnosed with acute diverticulitis; 183 had ADLC, classified at imaging as mild in 104, locally complicated in 60, and complicated in 19. The diagnosis was reached by US alone in 98 patients, by CT alone in 77, and by combined US and CT in 8. The main reasons for using CT as the first-line technique were the radiologist's lack of experience in abdominal US and the unavailability of a radiologists on call. Six patients diagnosed by US were reexamined by CT, but the classification changed in only three. None of the published classification schemes included all the imaging findings.ConclusionsUS should be the first-line imaging technique in patients with suspected ADLC. Various laboratory and imaging findings are useful in establishing the prognosis of ADLC. New schemes to classify the severity of ADLC are necessary to ensure optimal clinical decision making. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Índice de Gravidade de Doença , Doença Diverticular do Colo/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Doença Diverticular do Colo/classificação , Estudos Retrospectivos , Doença Aguda , Ultrassonografia , Reprodutibilidade dos Testes
2.
Rev. esp. cardiol. (Ed. impr.) ; 76(2): 103-111, feb. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-215047

RESUMO

Introducción y objetivos Recientemente los neurólogos han comenzado a realizar ecocardioscopia para la detección de cardiopatías en pacientes con ictus isquémico, lo cual requiere un proceso previo de formación acreditada. Se diseñó un estudio prospectivo con el objetivo de analizar la incidencia de cardiopatías detectadas por ecocardioscopia en una unidad de ictus integrada en red con una Unidad de Imagen Cardiaca y el pronóstico de la detección de cardiopatía estructural a 1 año de seguimiento. Métodos Se incluyeron los casos que ingresaron por ictus isquémico o accidente isquémico transitorio en un hospital clínico universitario de 2017 a 2021 y fueron evaluados mediante ecocardioscopia. Se estudió la presencia de cardiopatía estructural y cardiopatía embolígena. Se analizaron los eventos cardiovasculares (ECV) durante el primer año de seguimiento. Resultados Se realizó ecocardioscopia a 706 pacientes. Se detectó cardiopatía estructural en el 52,1% de los casos y cardiopatía embolígena en el 31,9%. El 5,49% había sufrido ECV al año de seguimiento. La presencia de cardiopatía estructural de novo se asoció de manera independiente con una mayor probabilidad de ECV (HR=1,72; IC95%, 1,01-2,91; p=0,046). Conclusiones La ecocardioscopia dentro de un proceso integrado en red de atención al ictus con unidades de imagen cardiaca es una técnica accesible y de alta rentabilidad diagnóstica. Su uso permite actuaciones clínicas y terapéuticas directas en la prevención de nuevas embolias cerebrales y otros ECV en este grupo de pacientes. (AU)


Introduction and objectives Recently, neurologists have begun to perform focused cardiac ultrasound for the detection of a cardiac source of embolism in stroke patients, requiring them to undergo a prior accredited training process. We designed a prospective study to analyze the incidence of heart disease detected by a focused cardiac ultrasound program within a stroke care network with cardiac imaging units and to identify the outcomes of detected structural heart disease at 1 year of follow-up. Methods We included patients admitted to a university hospital for ischemic stroke or a transient ischemic attack between 2017 and 2021 who were evaluated by focused cardiac ultrasound. We studied the presence of structural heart disease and cardioembolic sources. We analyzed cardiovascular events (CVE) during the first year of follow-up. Results Focused cardiac ultrasound was performed in 706 patients. Structural heart disease was detected in 52.1% and a cardioembolic source in 31.9%. Adverse CVE occurred in 5.49% of the patients in the first year of follow-up. The presence of de novo structural heart disease was independently associated with a higher probability of adverse CVE (HR, 1.72; 95%CI, 1.01- 2.91; P=.046). Conclusions Focused cardiac ultrasound within a stroke care network with cardiac imaging units is an accessible technique with high diagnostic yield. Its use allows clinical and therapeutic actions in the prevention of stroke recurrences and other CVEs in this group of patients. (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Cardiopatias/diagnóstico por imagem , Cardiopatias/complicações , Acidente Vascular Cerebral/complicações , Ecocardiografia Transesofagiana , Seguimentos , Estudos Prospectivos
3.
Artigo em Inglês | MEDLINE | ID: mdl-36707393

RESUMO

INTRODUCTION AND AIM: Thiopurine-related leukopenia is associated with polymorphisms in the thiopurine methyltransferase (TPMT) and nucleoside diphosphate-linked moiety X type motif 15 (NUDT15) genes. However, those polymorphisms explain only a fraction of thiopurine-related leukopenia. Our aim was to study the role of an inosine triphosphate pyrophosphatase (ITPA) polymorphism in patients with inflammatory bowel disease (IBD) and thiopurine-related leukopenia that was unexplained by the TPMT and NUDT15 polymorphisms. MATERIAL AND METHODS: We enrolled consecutive IBD patients on thiopurines (azathioprine or 6-mercaptopurine) from January 2019-March 2020, at a tertiary care center in North India. The presence of the ITPA (C.94C > A) polymorphism was evaluated in all patients, along with its association with thiopurine-related leukopenia. RESULTS: Of the 33 patients (from a total of 119 patients) that developed leukopenia, 8 had the TPMT (n = 1) or NUDT15 (n = 7) polymorphism. Of the remaining 111 patients, their mean age was 36.36 ±â€¯13.54 years and 57 (51.3%) were males. Twenty-five (21.01%) had unexplained leukopenia. The ITPA polymorphism was detected in 4 (16%) patients in the unexplained leukopenia group and 24 (27.9%) patients in the non-leukopenia group (p = 0.228). The odds ratio for predicting leukopenia with the ITPA polymorphism was 0.4921 (95% CI 0.1520-1.5830, p = 0.234). CONCLUSION: The ITPA (C.94C > A) polymorphism was frequently detected in the study population but was not predictive for leukopenia in patients with IBD on thiopurine therapy.

4.
Artigo em Inglês | MEDLINE | ID: mdl-36709799

RESUMO

BACKGROUND AND AIM: Although sensorineural hearing loss may have different aetiologies, we focused on autoimmune hearing loss since it may be reversible with corticosteroid therapy; this entity is sometimes associated with systemic autoimmune diseases. Hashimoto's thyroiditis or chronic autoimmune thyroiditis shows antibodies and may be harmful to hearing thresholds regardless of hypothyroidism effect. To date this effect has not been sufficiently studied and never with extended high frequencies. The aim of this work is to study by age groups whether hearing thresholds in the human auditory range (128-20.000 Hz) are affected in Hashimoto's disease. MATERIALS AND METHODS: Two groups of 128 patients affected by Hashimoto's thyroiditis were included. First group: patients with pathological antithyroid antibodies who do not need L-thyroxine treatment. Second group: patients controlled with L-thyroxine substitutive treatment. Audiometric threshold study comparing between the groups of patients and a group of 209 controls was performed. All patients underwent complete otorhinolaryngological examination, antithyroid antibodies, TSH, T3 and T4 blood levels, tympanometry, conventional pure-tone audiometry, and extended-high-frequency audiometry. RESULTS: All patients were women. Both groups showed worst audiometric thresholds than the control group; both study groups showed worse hearing than controls, this difference was statistically significant in all frequencies. In the 8-20 kHz frequency range, this difference was more than 10 dB, and in the 9-16 kHz and 20 kHz range this difference was more than 20 dB. When separated by age groups, in younger subjects (20-29 years) these differences were found in all frequencies, except for conversational frequencies (500-4,000 Hz); between 30 and 49 years the difference is statistically significant in all frequencies; and from 50 to 69 years differences are found, especially in the conversational frequencies. CONCLUSIONS: This first work studying the human auditory range in the chronic autoimmune thyroiditis or Hashimoto's thyroiditis confirms that hearing loss related to the autoimmune disorder predominates at extended-high-frequencies initially. But ends up involving all frequencies in pure-tone conventional audiometry, then it may be detected in routine clinical tests. These results support the role of extended-high-frequencies audiometry to diagnose subclinical hearing loss in patients affected by Hashimoto's thyroiditis.

5.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36716990

RESUMO

INTRODUCTION AND OBJECTIVES: The United Kingdom Prospective Diabetes Study (UKPDS) risk score has limited value for predicting coronary artery disease (CAD) events. We investigated the additive value of coronary computed tomography angiography (CCTA) on top of the UKPDS risk score in predicting 10-year adverse cardiac events in asymptomatic patients with type 2 diabetes. METHODS: We evaluated 589 asymptomatic diabetic patients without a history of CAD who underwent CCTA. The primary outcome was a composite of cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, and revascularization. We estimated the discrimination and reclassification ability for the prediction models, which included combinations of the UKPDS category, severity of stenosis, and coronary artery calcium score by CCTA. RESULTS: The incidence of the primary outcome was 12.4%. During 10 years of follow-up, patients without plaque by CCTA tended to have a low CAD event rate, while those with obstructive CAD tended to have a high event rate, irrespective of the baseline UKPDS risk category. The model that included only the UKPDS category had a Harrell's c-index of 0.658; adding the degree of stenosis to the model significantly increased the c-index by 0.066 (P = .004), while adding coronary artery calcium score increased the c-index by only 0.039 (P = .056). Overall, CCTA information in addition to the UKPDS risk category improved the reclassification rate for predicting the primary outcome. CONCLUSIONS: In asymptomatic patients with type 2 diabetes, CCTA information for CAD provided significant incremental discriminatory power beyond the UKPDS risk score category for predicting 10-year adverse coronary events.

6.
Nefrologia (Engl Ed) ; 2023 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-36717305

RESUMO

INTRODUCTION: Diabetic kidney disease is the main cause of chronic kidney disease (CKD) worldwide. Both CKD and diabetes mellitus (DMT2) are important risk factors for mortality. However, it is still unknown if the risk of death is modified by the simultaneous presence of these diseases. OBJECTIVE: To evaluate the presence of an interaction between DMT2 and CKD for mortality in a representative population of a Latin American country. METHODS: It is an analytical cohort study of patients with CKD, who were followed for 4 years (between 2004 and 2009). We calculated the incidence rate, progression, survival (using Kaplan-Meier curves), interaction (on the additive and multiplicative scales) and impact of the different stages of CKD in patients with and without DMT2 (using a cox proportional hazards model). RESULTS: In this population of 5663 individuals, both DMT2 and CKD are risk factors for mortality (p<0.001). We found a statistically significant difference in mortality between individuals with and without DMT2, who also had CKD stages 3-4 -5 (Log-rank p=0.0076). Additionally, we found a statistically significant interaction for mortality in both the additive and multiplicative scales between DMT2 and CKD (p=0.005). DMT2 was found to be a risk factor for mortality (Hazard Ratio 1.61 p<0.001), but in individuals with DMT2, the only risks significantly associated with mortality, were age, dyslipidemia and nephroprotective drugs. CONCLUSIóN: The interaction between CKD and DMT2 negatively modifies the risk of death of both diseases. This means that when the two diseases are present, the risk of mortality is lower than expected.

7.
Nefrologia (Engl Ed) ; 2023 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-36717306

RESUMO

Anti glomerular basement membrane disease (AGBM) is an autoinmune disorder characterised by the presence of anti-glomerular basement membrane (Anti-GBM) antibodies, alveolar hemorrhage, necrotizing glomerulonephritis, and linear deposition of immunoglobulins through direct inmunofluorescence. Genetic predisposition, among other factors, plays an important role in the development of the disease. Previous studies have shown that HLA-DR15 and HLA-DR4 increase the risk of presenting it, while HLA-DR1 and HLA-DR7 protect against its development. We describe the first case of two non-twin siblings with AGBM and identical HLA, with HLA-DR4 as risk factor and HLA-DR7 as protection factor. We propose the importance of analysing HLA in siblings of patients with AGBM, to determine the degree of genetic susceptibility and to carry out a close follow-up on them, with the aim of achieving an early diagnosis and treatment in case of presenting the disease.

8.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36717323

RESUMO

OBJECTIVES: GALIPEMIAS is a study designed to establish the prevalence of familial dyslipidemia in the general population of Galicia. The objective of the present study was to assess the prevalence of atherogenic dyslipidemia (AD), its relationship with other cardiovascular risk (CVR) factors, and the degree of lipid control. METHODS: Cross-sectional study carried out in the general population over 18 years of age residing in Galicia and with a health card from the Galician Health Service (N=1,000). Selection of the sample by means of random sampling by conglomerates. The AD prevalence adjusted for age and sex and the related variables were analyzed. RESULTS: The prevalence of AD adjusted for age and sex was 6.6% (95% CI: 5.0-8.3%). Arterial hypertension, altered basal glycemia, type 2 diabetes mellitus and cardiovascular disease were more frequent in subjects with AD than in the rest of the population. 47.5% of the subjects with AD had a high or very high CVR. Lipid-lowering drugs were received by 38.9% (30.5% statins) of the participants with AD (46.1% of those with high and 71.4% of those with very high CVR). 25.4% of the subjects with AD had target LDL-c levels, all of them with low or moderate CVR. CONCLUSIONS: The prevalence of AD in the general adult population of Galicia is not negligible, and it was related to several CVR factors and cardiovascular disease. Despite this, this lipid alteration was underdiagnosed and undertreated.

9.
Enferm. glob ; 22(69): 642-655, ene. 2023. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-214876

RESUMO

Objetivo: Identificar las patologías en la persona mayor asociadas a la soledad. Metodología: Investigación secundaria, de tipo revisión integrativa, estructurada según consenso de Crossetti. Resultados: Se identificaron tras la aplicación de descriptores y estrategias de búsqueda un total de 4.011 artículos, posterior a la aplicación de filtros, criterios de inclusión y criterios de exclusión quedaron seleccionados 27 artículos, de los cuales 17 corresponden a WOS, 9 a BVS y 1 a PUBMED. Conclusiones: Se destaca la asociación entre soledad y el deterioro cognitivo, disminución del estado físico, enfermedad de Alzheimer y eventos cardiovasculares. Se hace necesario establecer políticas públicas de preparación a las personas para su futuro proceso de envejecimiento. (AU)


Objective: Identify pathologies in the elderly associated with loneliness. Methodology: Secondary research, integrative review type, structured according to Crossetti’s consensus. Results: After applying descriptors and search strategies, a total of 4,011 articles were identified, after applying filters, inclusion, and exclusion criteria, 27 articles were selected; from these articles 17 corresponded to WoS, 9 to BVS and 1 to PubMed.Conclusions: The association between loneliness and cognitive impairment, decreased physical fitness, Alzheimer's disease and cardiovascular events is highlighted. It is necessary to establish public policies to prepare people for their future aging process. (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso de 80 Anos ou mais , Solidão , Envelhecimento , Disfunção Cognitiva
10.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 50(1): 100812-100812, Ene-Mar. 2023. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-214992

RESUMO

Sexual dysfunction is one of the common findings among chronic kidney disease (CKD) patients and can lead to a decline in sexual desire, fertility/potency, successful pregnancy, along with menorrhagia and occasionally, amenorrhoea. Successful kidney transplantation is an effective method to preserve sexual desire in both the sexes and to achieve successful pregnancy where reasonable planning can give favorable outcomes for both mother and embryo. This review summarizes some common reproductive alterations in men and women undergoing renal transplant.(AU)


La disfunción sexual es uno de los hallazgos comunes entre los pacientes con enfermedad renal crónica y puede provocar una disminución del deseo sexual, de la fertilidad, de la potencia, de la posibilidad de embarazo, además de menorragia y, ocasionalmente, amenorrea. El trasplante de riñón exitoso es un método efectivo para preservar el deseo sexual en ambos sexos y recuperar la posibilidad de un embarazo, para el que una planificación razonable brindará resultados favorables tanto para la madre como para el embrión. Esta revisión ha resumido algunas alteraciones reproductivas comunes en hombres y mujeres tras un trasplante renal.(AU)


Assuntos
Humanos , Masculino , Feminino , Transplante de Rim , Nefropatias , Disfunções Sexuais Fisiológicas , Assexualidade , Hormônios Esteroides Gonadais , Insuficiência Renal Crônica , Complicações na Gravidez , Gravidez
11.
Acta otorrinolaringol. esp ; 74(1): 8-14, enero 2023. tab, graf
Artigo em Inglês | IBECS | ID: ibc-213925

RESUMO

Introduction and objectives: To compare clinical and psychoacoustic tinnitus characteristics in patients with the comorbidity of hyperacusis, hyperacusis and vertigo, and with Ménière's disease (MD).Materials and methodsThree hundred and twenty-nine tinnitus patients underwent audiological and otoneurological evaluation. Records of 94 individuals younger than 65 years, 40 women and 54 men (mean age 41.8, range 24–64 years), who complained of tinnitus and hyperacusis, were analyzed. One hundred and thirty-one ears with tinnitus were identified: 67 in the group of patients with tinnitus and hyperacusis (group 1; 41 patients); 28 in the group fulfilling criteria of MD diagnosis (group 2; 28); and 36 in the group with tinnitus, hyperacusis and typical symptoms of vertigo (group 3; 25).Results and conclusionsMean value of interaural difference in canal paresis in group 1 was 6.3%; in group 2: 23.7%; and in group 3: 25.9%; p<.001. Mean tinnitus pitch value was significantly lower in group 3 (1679Hz; SD=1139) and group 2 (2250Hz; SD=1162) compared to group 1 (4538Hz; SD=3123; p=.012). Values of tinnitus intensity and other characteristics did not significantly differ between the groups. Tinnitus and hyperacusis were most frequently preceded by acoustic trauma. Tinnitus coinciding with hyperacusis and vertigo was observed in patients after head trauma.Mean tinnitus pitch was lower in the groups of patients with hyperacusis and peripheral labyrinthine lesion than in tinnitus sufferers with hyperacusis alone. Tinnitus sufferers with low tinnitus pitch should undergo vestibular system evaluation. Hyperacusis and vertigo are likely comorbidities in tinnitus patients after head trauma. Hyperacusis may coincide in tinnitus patients after head trauma. (AU)


Introducción y objetivos: Comparar las características clínicas y psicoacústicas del tinnitus en pacientes con comorbilidad de hiperacusia, hiperacusia y vértigo, y con enfermedad de Ménière (EM).Materiales y métodosTrescientos veintinueve pacientes con tinnitus se sometieron a evaluación audiológica y otoneurológica. Se analizaron los registros de 94 pacientes menores de 65 años, 40 mujeres y 54 hombres (edad media 41,8, rango 24-64 años), que se quejaron de tinnitus e hiperacusia. Se identificaron 131 oídos con acúfenos: 67 en el grupo de pacientes con acúfenos e hiperacusia (grupo 1; 41 pacientes); 28 en el grupo que cumplía criterios de diagnóstico de enfermedad de Ménière (grupo 2; 28); y 36 en el grupo con acúfenos, hiperacusia y síntomas típicos de vértigo (grupo 3; 25).Resultados y conclusionesEl valor medio de la diferencia interaural en paresia del canal en el grupo 1 fue del 6,3%; en el grupo 2 del 23,7%; y en el grupo 3 del 25,9%; p<0,001. El valor medio del tono del tinnitus fue significativamente menor en el grupo 3 (1679Hz; DE=1139) y el grupo 2 (2250Hz; DE=1162), en comparación con el grupo 1 (4538Hz; DE=3123; p=0,012). Los valores de la intensidad del tinnitus y otras características no difirieron significativamente entre los grupos. El tinnitus y la hiperacusia fueron precedidos con mayor frecuencia por traumatismos acústicos. Se observó tinnitus coincidente con hiperacusia y vértigo en pacientes después de traumatismo craneoencefálico.El tono medio del tinnitus es menor en los grupos de pacientes con hiperacusia y lesión laberíntica periférica que en los que padecen tinnitus con hiperacusia. (AU)


Assuntos
Humanos , Audição , Zumbido , Vertigem , Hiperacusia , Doença de Meniere
12.
Acta otorrinolaringol. esp ; 74(1): 50-58, enero 2023. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-213930

RESUMO

Antecedentes y objetivo: Hay muchas causas de hipoacusia neurosensorial, entre las que tiene especial interés la patología autoinmune del oído interno por su posible reversibilidad con tratamiento esteroideo, a veces asociada a enfermedades sistémicas autoinmunes. La tiroiditis crónica autoinmune o de Hashimoto (TA) presenta anticuerpos que podrían afectar al oído interno independientemente del hipotiroidismo, efecto que no ha sido suficientemente estudiado y nunca mediante audiometría con extensión en altas frecuencias.El objetivo de este trabajo es estudiar si existe afectación de los umbrales auditivos en pacientes de TA, sin hipotiroidismo, en la totalidad del espectro auditivo humano (128 Hz – 20 kHz) distribuido por grupos de edad.Materiales y métodosSe han seleccionado 128 pacientes divididos en dos grupos. El primer grupo de pacientes presenta anticuerpos antitiroideos elevados sin necesitar tratamiento sustitutivo con tiroxina. El segundo grupo con tratamiento sustitutivo con tiroxina, bien controlados. Se comparan con el grupo control (GC) de 209 pacientes. En todos se realizó historia clínica, exploración otológica, estudio de niveles de anticuerpos antitiroideos, TSH (thyroid-stimulating hormone), T3 y T4 libres, timpanograma, estudio audiométrico convencional y con extensión en altas frecuencias.ResultadosTodos los pacientes fueron mujeres. Ambos grupos mostraron peor audición que los controles, siendo la diferencia estadísticamente significativa en todas las frecuencias; en el rango de frecuencias de 8 – 20 kHz con una diferencia de más de 10 dB, y en los rangos de 9-16 kHz y de 20 kHz de más de 20 dB. (AU)


Background and aim: Although sensorineural hearing loss may have different aetiologies, we focused on autoimmune hearing loss since it may be reversible with corticosteroid therapy; this entity is sometimes associated with systemic autoimmune diseases. Hashimoto's thyroiditis or chronic autoimmune thyroiditis shows antibodies and may be harmful to hearing thresholds regardless of hypothyroidism effect. To date this effect has not been sufficiently studied and never with extended high frequencies. The aim of this work is to study by age groups whether hearing thresholds in the human auditory range (128 to 20.000 Hz) are affected in Hashimoto's disease.Materials and methodsTwo groups of 128 patients affected by Hashimoto's thyroiditis were included. First group: patients with pathological antithyroid antibodies who do not need L-thyroxine treatment. Second group: patients controlled with L-thyroxine substitutive treatment. Audiometric threshold study comparing between the groups of patients and a group of 209 controls was performed. All patients underwent complete otorhinolaryngological examination, antithyroid antibodies, TSH, T3 and T4 blood levels, tympanometry, conventional pure-tone audiometry, and extended-high-frequency audiometry.ResultsAll patients were women. Both groups showed worst audiometric thresholds than the control group; both study groups showed worse hearing than controls, this difference was statistically significant in all frequencies. In the 8-20 kHz frequency range this difference was more than 10 dB, and in the 9-16 kHz and 20 kHz range this difference was more than 20 dB. When separated by age groups, in younger subjects (20-29 years) these differences were found in all frequencies, except for conversational frequencies (500 - 4,000 Hz); between 30 and 49 years the difference is statistically significant in all frequencies; and from 50 to 69 years differences are found, especially in the conversational frequencies. (AU)


Assuntos
Tireoidite Autoimune , Perda Auditiva , Doença de Hashimoto , Orelha Interna , Anticorpos
13.
Reumatol. clín. (Barc.) ; 19(1): 53-56, Ene. 2023. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-214167

RESUMO

Systemic juvenile idiopathic arthritis (sJIA) is a chronic childhood inflammatory disease. SJIA accounts for approximately 5–15 per cent of all cases of JIA and has a high morbidity and mortality rate. In this disease, pulmonary complications (PC) other than pleuritis are much less frequent and not easily recognised by clinicians. Pulmonary hypertension, the most severe PC, is associated with uncontrolled disease and use of biologic therapies. We present a case of a school-age female with sJIA who died of acute cardiopulmonary instability secondary to pulmonary venous-occlusive disease demonstrated by necropsy. We describe her clinical evolution. We also undertook a narrative review of the literature about PC in sJIA to discuss the current state of the art regarding this complication. High disease activity and the use of multiple therapies include disease-modifying anti-rheumatic drugs should be a red flag for clinicians when discounting PC and pulmonary hypertension. The combination of chest X-ray, electrocardiogram and echocardiogram appear to be the best tests to achieve an early diagnosis.(AU)


La artritis idiopática juvenil sistémica (AIJs) es una enfermedad juvenil crónica que representa aproximadamente del 5 al 15% de todos los casos de AIJ y tiene una elevada tasa de morbimortalidad. En esta enfermedad, las complicaciones pulmonares (CP) distintas a pleuritis son mucho menos frecuentes, y no fácilmente reconocibles por los clínicos. La hipertensión pulmonar, la CP más grave, está asociada a la enfermedad incontrolada y el uso de terapias biológicas. Presentamos el caso de una mujer en edad escolar con AIJs que falleció debido a inestabilidad cardiopulmonar aguda secundaria a enfermedad venosooclusiva confirmada en la necropsia. Describimos su evolución clínica, y también realizamos una revisión narrativa de la literatura relativa a CP en AIJs, para debatir los avances más recientes sobre esta complicación. La elevada actividad de la enfermedad y el uso de terapias múltiples que incluyen fármacos antirreumáticos modificadores de la enfermedad deberían servir de signo de alarma a los clínicos para descartar CP e hipertensión pulmonar. La combinación de placas de tórax, electrocardiograma y ecocardiograma parece ser el mejor conjunto de pruebas para lograr un diagnóstico precoz.(AU)


Assuntos
Humanos , Feminino , Criança , Artrite Juvenil , Hipertensão Pulmonar , Antirreumáticos , Morte , Pacientes Internados , Exame Físico , Reumatologia , Doenças Reumáticas
14.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 41(1): 36-39, Ene. 2023. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-214215

RESUMO

Introducción: Las enfermedades infecciosas pueden beneficiarse de la aplicación de la telemedicina (TM). Este estudio realiza una descripción de las enfermedades infecciosas atendidas por el Servicio de Telemedicina del Hospital Central de la Defensa Gómez Ulla (STM-HCDGU). Métodos: Análisis de las e-consultas realizadas por miembros de las Fuerzas Armadas de España desplazados a zona de operaciones en el periodo comprendido entre el 1 de enero del 2015 y el 31 de diciembre del 2018 que desarrollaron sintomatología infecciosa. Resultados: Se diagnosticaron 127 enfermedades infecciosas, siendo las más frecuentes las de etiología respiratoria y posteriormente la malaria. Geográficamente, África y los contingentes embarcados fueron los más significados. Fue necesario evacuar a 18 pacientes al HCDGU, siendo el diagnóstico de malaria el motivo de evacuación más frecuente, causa del único caso mortal. Conclusiones: Las enfermedades infecciosas se benefician de la aplicación de la TM, siendo una herramienta importante para el diagnóstico y tratamiento de estas, constituyendo una oportunidad para ampliar a otras poblaciones desplazadas o remotas.(AU)


Introduction: Infectious pathologies can benefit from the application of Telemedicine (TM). This study provides a description of the infectious pathology treated by the Telemedicine Service of the Hospital Central de la Defensa Gómez Ulla (STM-HCDGU). Methods: Analysis of the e-consultations made by members of the Armed Forces of Spain displaced to the area of operations in the period between 01/1/2015 and 31/12/2018 who developed symptoms of infectious diseases. Results: 127 infectious diseases were diagnosed, the most frequent being those of respiratory etiology and later malaria. Geographically Africa and embarked contingents were the most significant. It was necessary to evacuate 18 patients to the HCDGU, being the diagnosis of malaria the most frequent reason for evacuation, cause of the only fatal case. Conclusions: infectious diseases benefit from the application of TM, being an important tool for the diagnosis and treatment of these, constituting an opportunity to expand to other displaced or remote populations.(AU)


Assuntos
Humanos , Telemedicina , Doenças Transmissíveis , Consulta Remota , 51708 , Epidemiologia Descritiva , Espanha
15.
Rev. clín. esp. (Ed. impr.) ; 223(1): 17-24, ene. 2023.
Artigo em Espanhol | IBECS | ID: ibc-214305

RESUMO

Introducción La osteonecrosis avascular (ONA) de cadera y de hombro es una enfermedad poco estudiada y no se conocen bien los factores de riesgos predisponentes para desarrollarla. Existe un porcentaje alto de pacientes diagnosticados como osteonecrosis idiopática. Este estudio tiene como objetivo investigar la prevalencia de los posibles factores etiológicos de la ONA y realizar un cribado de la enfermedad de Gaucher en los pacientes diagnosticados de ONA idiopática. Material y método Estudio observacional retrospectivo y unicéntrico de los pacientes que hayan presentado al menos un episodio de osteonecrosis avascular de la cadera o del hombro en el Hospital de Poniente (Almería, España) desde enero de 2010 a diciembre de 2019. Se recogieron datos clínicos y analíticos. Los pacientes en cuya historia clínica no se describían factores etiológicos fueron cribados para enfermedad de Gaucher. Resultados Se incluyeron un total de 81 pacientes, de los cuales 58 eran hombres. La edad media de presentación de ONA fue de 45,9 años. Presentaron necrosis unilateral de cadera (n = 43), necrosis bilateral de cadera (n = 34), necrosis bilateral de cadera y unilateral de hombro (n = 3) y necrosis unilateral de hombro (n = 1). Los potenciales factores etiológicos más frecuentes fueron tabaquismo (46,9%) y obesidad (17,3%). Se realizó un cribado de la enfermedad de Gaucher en 10 pacientes, que resultó ser negativo. Conclusiones En nuestro estudio los principales potenciales factores etiológicos de aparición de la ONA fueron el tabaquismo y la obesidad. Existe un porcentaje alto de pacientes diagnosticados de osteonecrosis avascular idiopática. Creemos que en estos casos se debería realizar un estudio más exhaustivo de los factores de riesgo menos frecuentes (AU)


Introduction Avascular necrosis (AON) of the hip and shoulder is a little studied disease and the predisposing risk factors for its development are not well known. A high percentage of patients are diagnosed with idiopathic osteonecrosis. This study aims to investigate the prevalence of potential etiological factors for AON and to screen for Gaucher disease among patients with idiopathic AON. Material and methods This retrospective, single-center, observational study was conducted on patients who had at least one episode of AON of the hip or shoulder at the Hospital de Poniente (Almería, Spain) from January 2010 to December 2019. Clinical and analytical data were collected. Patients whose medical record described no etiological factors for this disease were screened for Gaucher disease. Result The study sample consisted of 81 patients, of whom 58 were male. The mean age at presentation of AON was 45.9 years. They presented with unilateral hip necrosis (n = 43), bilateral hip necrosis (n = 34), bilateral hip and unilateral shoulder necrosis (n = 3), and unilateral shoulder necrosis (n = 1). The most frequent potential etiological factors were smoking (46.9%) and obesity (17.3%). Screening for Gaucher disease was performed in ten patients, all of whom tested negative. Conclusions In our study population, the main potential etiological factors the onset of AON of the shoulder or hip were smoking and obesity. A high percentage of patients were diagnosed with idiopathic AON. We believe that a more exhaustive study of less frequent risk factors should be carried out in these cases (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Doença de Gaucher/diagnóstico , Osteonecrose/diagnóstico , Osteonecrose/etiologia , Quadril/patologia , Ombro/patologia , Estudos Retrospectivos , Programas de Rastreamento , Fatores de Risco , Prevalência
16.
Rev. clín. esp. (Ed. impr.) ; 223(1): 25-31, ene. 2023.
Artigo em Espanhol | IBECS | ID: ibc-214306

RESUMO

Introducción La cornea verticillata (CV) o queratopatía vortex se caracteriza por la presencia de depósitos en forma de espiral en el epitelio corneal. Las causas más frecuentes son los fármacos antipalúdicos y la amiodarona, y dentro de las causas sistémicas la enfermedad de Fabry (EF). Material y métodos Se realiza un estudio descriptivo prospectivo multidisciplinar en un centro de tercer nivel y de referencia en la Comunidad Foral de Navarra, tras la implementación de un programa de despistaje de la EF en los pacientes atendidos en consultas del servicio de oftalmología que eran diagnosticados de CV y posteriormente fueron remitidos a la consulta de enfermedades minoritarias del servicio de Medicina Interna del Hospital Universitario de Navarra para la realización del estudio de la EF. Resultados Dos mujeres y 4 varones, con una edad media de 76,8 años, se diagnosticaron de CV, de un total de 17.280 pacientes valorados en consultas externas por 3 especialistas de oftalmología durante el periodo de abril de 2018 a abril de 2020. Una paciente falleció antes de realizar el estudio de despistaje y en ningún paciente se diagnosticó la EF. Conclusiones A pesar de que el programa de despistaje de la EF en pacientes con CV en el Hospital Universitario de Navarra no confirmó ningún caso con EF, los especialistas en oftalmología deben tener en cuenta el posible diagnóstico de la EF en aquellos pacientes con CV en sus consultas rutinarias (AU)


Introduction Cornea verticillata (CV) or vortex keratopathy is characterized by the presence of spiral-shaped deposits in the corneal epithelium. The most frequent causes are antimalarial drugs and amiodarone and, among systemic causes, Fabry disease (FD). Material and methods A multidisciplinary, prospective, descriptive study was conducted in a tertiary reference center in Spain's Autonomous Community of Navarre after the implementation of a FD screening program for patients attended to in the Ophthalmology Department. The study analyzed those diagnosed with CV, who were subsequently referred to the rare disease clinic of the University Hospital of Navarre's Internal Medicine Department for an FD study. Results Two women and four men with a mean age of 76.8 years were diagnosed with CV out of a total of 17,280 patients evaluated in outpatient consultations by three ophthalmology specialists during the period from April 2018 to April 2020. One patient died before performing the screening study and no patients were diagnosed with FD. Conclusions Despite the fact that the University Hospital of Navarre's FD screening program for patients with CV did not confirm any cases of FD, ophthalmology specialists should consider the possible diagnosis of FD in patients with CV in their routine consultations (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doença de Fabry/diagnóstico , Doenças da Córnea/diagnóstico , Estudos Prospectivos , Programas de Rastreamento
17.
Rev. neurol. (Ed. impr.) ; 76(1): 1-8, Ene. 2023. tab, graf
Artigo em Inglês, Espanhol | IBECS | ID: ibc-214335

RESUMO

Introducción: Se buscó determinar el tiempo transcurrido desde el inicio del tratamiento con fármacos antiparkinsonianos hasta la modificación en la terapia y establecer sus factores relacionados en un grupo de pacientes con enfermedad de Parkinson de Colombia. Pacientes y métodos: Estudio de cohorte retrospectiva que recolectó información sobre el tratamiento de pacientes con enfermedad de Parkinson que iniciaron terapia farmacológica entre junio de 2011 y diciembre de 2013; se realizó seguimiento a cinco años. Se generaron análisis de sobrevida para el tiempo trascurrido hasta la modificación de la terapia y se determinaron los factores relacionados con estos cambios utilizando modelos de regresión de Cox. Resultados: Un total de 3.224 pacientes (51,8%, hombres), con edad media de 73,1 ± 13,5 años, iniciaron tratamiento con fármacos antiparkinsonianos. Después de cinco años, 2.046 pacientes (63,5%) tuvieron modificaciones en la terapia farmacológica, con un promedio de tiempo de 36,4 meses (intervalo de confianza al 95%: 35,7-37,1). Un total de 1.216 pacientes (37,8%) requirió adición de otro principio activo, mientras que 830 (25,7%) tuvieron un cambio por otro medicamento. En el análisis multivariado, el sexo masculino, la edad mayor de 65 años y el inicio de amantadina se identificaron como factores que aumentaron la probabilidad de modificar la terapia. El uso de bromocriptina y biperideno, y la monoterapia como tratamiento inicial redujeron dicho riesgo. Conclusión: Después de cinco años de tratamiento, el 63,5% de los pacientes con enfermedad de Parkinson requirió modificaciones de la terapia, con un tiempo promedio de tres años. El sexo masculino, la edad mayor de 65 años y recibir terapia inicial con amantadina afectaron a la probabilidad de cambio de terapia en estos pacientes en Colombia.(AU)


Introduction: The aim was to determine the time elapsed between the start of treatment with antiparkinsonian agents and the modification of the pharmacological therapy, and to establish its related factors, in a group of patients with Parkinson’s disease from Colombia. Patients and methods: Retrospective cohort study that collected information about the treatment of patients with Parkinson’s disease who started drug therapy between June, 2011 and December, 2013; a five-year follow-up was performed. Survival analyses for time to therapy modification were generated, and factors related to these changes were determined using Cox regression models. Results: A total of 3,224 patients (51.8% men) with a mean age of 73.1 ± 13.5 years started treatment with antiparkinsonian agents. After five years, 2,046 patients (63.5%) had modifications in drug therapy, in a mean time of 36.4 months (95% confidence interval: 35.7-37.1). A total of 1,216 patients (37.8%) required the addition of another active principle, while 830 (25.7%) had a switch to another drug. In the multivariate analysis, male sex, age over 65 years, and the start of amantadine were identified as factors that increased the likelihood of therapy modification. The use of bromocriptine, biperiden, and monotherapy as an initial treatment were associated with a reduction in this likelihood. Conclusions: After five years of treatment, 63.5% of the patients with Parkinson’s disease required modifications to their therapy, with a mean time of three years. Male sex, age over 65 years, and receiving initial therapy with amantadine affected the likelihood of switching therapy in these patients in Colombia.(AU)


Assuntos
Humanos , Masculino , Feminino , Antiparkinsonianos , Doença de Parkinson , Tratamento Farmacológico , Transtornos dos Movimentos , Colômbia , Estudos de Coortes , Estudos Retrospectivos
18.
Rev. neurol. (Ed. impr.) ; 76(1): 15-19, Ene. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-214337

RESUMO

Introducción: La distrofia miotónica de tipo 1 (DM1), o enfermedad de Steinert (ORPHA 273; OMIM #160900), es un trastorno de origen genético poco frecuente con manifestaciones musculares (debilidad muscular y miotonía), cataratas de inicio temprano (antes de los 50 años) y manifestaciones sistémicas (cerebral, endocrina, cardíaca, del tubo digestivo, del útero, de la piel y del sistema inmunitario). Su expresividad clínica es muy variable y se extiende desde formas letales en la lactancia hasta una enfermedad leve de aparición tardía. Su baja frecuencia impide que los profesionales de urgencias médicas se familiaricen con las precauciones imprescindibles para su tratamiento. Con el propósito de paliar esta falta de información, los afectados por DM1 disponen, en los países de nuestro entorno, de una tarjeta de emergencia médica (TEM) que el paciente siempre debe llevar consigo y entregar al facultativo antes de recibir asistencia urgente. Objetivos: Definir la TEM, describir las TEM para la DM1 ya implantadas y enumerar las ventajas para pacientes y profesionales que supone su utilización. Material y métodos. Se describen algunas de las TEM para la DM1 actualmente en uso en Francia y el Reino Unido. Resultados: Se exponen pormenorizadamente los argumentos que justifican su implantación en nuestro medio.Conclusiones: La TEM para la DM1 gestionada por un facultativo puede mejorar la asistencia en emergencias médicas de los pacientes afectados por la enfermedad de Steinert.


Introduction: Myotonic dystrophy type 1 (DM1) or Steinert’s disease (ORPHA 273; OMIM #160900) is a rare disorder of genetic origin with muscular manifestations (muscle weakness and myotonia), early-onset cataracts (before 50 years of age) and systemic manifestations (cerebral, endocrine, cardiac, gastrointestinal tract, uterus, skin and immune system). Its clinical expressivity is highly variable and ranges from lethal forms in infancy to mild late-onset disease. Its low frequency prevents emergency medical professionals from becoming familiar with the essential precautions for its treatment. In order to alleviate this lack of information, those affected by DM1 have, in the countries of our environment, a medical emergency card (Tarjeta de Emergencias Médicas, TEM) that the patient should always carry with him/her and give to the physician before receiving emergency care. Objectives: To define the TEM. To describe the TEM for DM1 already implemented. To list the advantages for patients and professionals of their use. Material and methods: Some of the TEM for DM1 currently in use in France and the United Kingdom are described. Results: The arguments justifying their implantation in our setting are presented in detail. Conclusions: The TEM for DM1 managed by a physician can improve the emergency medical care of patients affected by Steinert’s disease.(AU)


Assuntos
Humanos , Distrofia Miotônica , Debilidade Muscular , Miotonia , Neurologia , Doenças Raras
19.
Rev. neurol. (Ed. impr.) ; 76(1): 21-30, Ene. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-214338

RESUMO

Introducción: La esclerosis múltiple afecta principalmente a mujeres en edad fértil, y el período de gestación y posparto es de especial interés por las peculiaridades que comporta en cuanto a evolución de la enfermedad y por las consecuencias terapéuticas que se derivan. En el período de lactancia materna (LM), la elección de la estrategia de tratamiento debe poner en una balanza, por un lado, los beneficios bien establecidos de la LM para el recién nacido y su madre y, por el otro, el perfil de seguridad y potenciales efectos adversos en el lactante derivados de la exposición a los fármacos modificadores de la enfermedad, por transferencia a través de leche materna. Desarrollo: Se realiza una revisión de la evidencia actual acerca de la seguridad de los fármacos modificadores de la enfermedad disponibles para el tratamiento de la esclerosis múltiple durante el período de LM, y se recogen datos de transferencia de los diferentes fármacos a la leche materna, así como los potenciales efectos adversos descritos en el lactante. Los fármacos considerados de primera elección durante este período son el interferón beta y el acetato de glatiramer. El resto de los fármacos modificadores de la enfermedad no están aceptados para su utilización en el período de LM por ficha técnica. Sin embargo, en los últimos años, se han publicado datos de estudios de práctica clínica y series de casos que indican que algunos de estos fármacos podrían utilizarse con seguridad durante este período. Conclusiones: Teniendo en cuenta los beneficios reconocidos de la LM para la salud tanto de la madre como del lactante, se debe recomendar la LM exclusiva a las pacientes con esclerosis múltiple siempre que sea posible. Es fundamental realizar una evaluación individualizada previa al embarazo y valorar las diferentes opciones de tratamiento en función de cada paciente.(AU)


Introduction: Multiple sclerosis mainly affects women of childbearing age, and the pregnancy and postpartum period is of special interest because of the peculiarities of the disease course and the therapeutic consequences that derive from it. During the period of breastfeeding (BF), the choice of treatment strategy must weigh up the well-established benefits of BF for both the newborn and the mother against the safety profile and potential adverse effects on the infant resulting from exposure to disease-modifying drugs transferred through breast milk. Development: The study reviews the current evidence on the safety of disease-modifying drugs available for the treatment of multiple sclerosis during the BF period, and gathers data on the transfer of the different drugs into breast milk, as well as the potential adverse effects described in the infant. The drugs of first choice during this period are interferon beta and glatiramer acetate. The rest of the disease modifying drugs are not accepted for use in the BF period according to their summary of product characteristics. However, in recent years, data from studies of clinical practice and case series have been published suggesting that some of these drugs could be used safely during this period. Conclusions: Given the recognised health benefits of BF for both mother and infant, exclusive breastfeeding is recommended whenever possible. It is essential to carry out an individualised assessment prior to pregnancy and to evaluate the different treatment options depending on each patient.(AU)


Assuntos
Humanos , Masculino , Feminino , Aleitamento Materno , Esclerose Múltipla , Período Pós-Parto , Planejamento Familiar , Antirreumáticos , Doenças Reumáticas
20.
Gastroenterol. hepatol. (Ed. impr.) ; 46(1): 10-16, Ene. 2023. tab, graf
Artigo em Inglês | IBECS | ID: ibc-214364

RESUMO

Background/Aims: Absent contractility is considered a disorder of peristalsis. The literature about the etiology and clinical characteristics is scarce and the evidence on systemic diseases associated with this esophageal disorder is limited. Therefore, we aimed to determine the etiology of absent contractility in our population using the clinical algorithm recently described in the literature. Methods: We conducted a retrospective, descriptive study at a single tertiary hospital of all patients diagnosed of absent contractility between May 2018 and February 2020. Data on demographic characteristics, medication, comorbidities, and laboratory and paraclinical tests were recorded from clinical records. Results: A total of 72 patients with absent contractility were included for analysis. There was a predominance of female sex (n=43, 59.7%), with a mean age of 55.4 (±15.0) years. We identified a systemic disorder associated with absent contractility in 64 (88.9%) patients. From these, 31 (43.1%) patients were diagnosed with a systemic autoimmune disease, 26 (36.1%) patients were considered to have absent contractility secondary to pathological exposure to acid-reflux and 15 (20.8%) patients were diagnosed with other non-autoimmune systemic disorders. In the remaining eight (11.1%) patients, there were no underlying systemic disorders that could justify the diagnosis of absent contractility. Conclusions: A systematic approach to search for an underlying cause in patients diagnosed with absent contractility is warranted. Up to 90% of patients with absent contractility have a systemic disorder associated with this condition.(AU)


Antecedentes: La contractilidad ausente se considera un trastorno de la peristalsis esofágica. La literatura que existe sobre la etiología y las características clínicas es escasa y la evidencia sobre enfermedades sistémicas asociadas a este trastorno esofágico es limitada. Nuestro objetivo fue determinar la etiología de la contractilidad ausente en nuestra población utilizando el algoritmo clínico recientemente descrito en la literatura. Métodos: Se realizó un estudio descriptivo retrospectivo en un hospital terciario de todos los pacientes diagnosticados de ausencia de contractilidad entre mayo de 2018 y febrero de 2020. Se recogieron datos de características demográficas, medicación, comorbilidades y pruebas de laboratorio y estudios paraclínicos. Resultados: Se incluyeron para el análisis un total de 72 pacientes con ausencia de contractilidad. Predominó el sexo femenino (n=43, 59,7%), con una edad media de 55,4 (±15,0) años. Identificamos un trastorno sistémico asociado con la ausencia de contractilidad en 64 (88,9%) pacientes. De estos 31 (43,1%) pacientes fueron diagnosticados de una enfermedad autoinmune sistémica, 26 (36,1%) pacientes se consideraron con ausencia de contractilidad secundaria a exposición patológica al reflujo ácido y 15 (20,8%) fueron diagnosticados con otras enfermedades no autoinmunes sistémicas. En los 8 pacientes restantes (11,1%) no hubo trastornos sistémicos subyacentes que pudieran justificar el diagnóstico de contractilidad ausente. Conclusiones: Un enfoque sistemático está justificado para investigar una causa subyacente en pacientes diagnosticados de contractilidad ausente. Hasta el 90% de los pacientes con contractilidad ausente tienen un trastorno sistémico asociado con esta afectación de la motilidad esofágica.(AU)


Assuntos
Manometria , Peristaltismo , Transtornos da Motilidade Esofágica , Esôfago , Refluxo Gastroesofágico , Gastroenterologia , Estudos Retrospectivos , Gastroenteropatias
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...