Browsing by Autor "Fernando Hakim"

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Burden of pediatric hydrocephalus in a Latin American upper-middle-income country: a nationwide ecological study in Colombia
(2025) Alexandra Ramos-Márquez; Karen E. Norato; Diana V. Garrido; Isabella Mejía-Michelsen; Diego F. Gómez; Juan Andrés Mejía; Enrique Jiménez; Fernando Hakim; Alexandra Porras; Juan Fernando Ramón
In this study, the estimated prevalence of pediatric hydrocephalus in Colombia was lower than the prevalence estimated worldwide, and even lower than that estimated for high-income areas. This is explained partially by a significant rate of underreporting; however, even accounting for the underreporting, the prevalence remains considerably lower than that estimated for developing regions like South America. This may suggest a trend of decreasing prevalence in developing countries whose economies have grown in recent years. These findings can guide public policy for adequate surveillance and prevention of pediatric hydrocephalus in Colombia and highlight the importance of further updated research in the region.
Cognitive Changes After Tap Test in Patients With Normal Pressure Hydrocephalus
(Research Square (United States), 2023) Pilar Mayorga; Cethinia Hurtado; Andrés Gempeler; Francy Cruz‐Sanabria; Martina González; Daniel Jaramillo; Isabella Mejía-Michelsen; Diego F. Gómez; Juan Fernando Ramón; Fernando Hakim
Abstract Background: Normal pressure hydrocephalus (NPH) leads to cognitive impairment (CI) as part of its triad of symptoms. Its assessments before and after a tap test in suspected patients can be used to inform diagnosis, differentiate NPH symptoms from alternative or concomitant causes of CI, and suggests the potential benefits of valve-placement. The aim of this study was to describe the assessment of domain-specific cognitive performance in patients with NPH diagnosis before and after a tap test, applied as part of the diagnostic workup upon initial NPH suspicion. Methods: Before-and-after study that included NPH patients that underwent cognitive assessments by neuropsychologists before and after a tap test. Clinical features at baseline and results in the CERAD, ADAS-COG, SVF, PVF, ROCF and IFS tests were recorded. The tests scores were converted to z-scores according to age and level of education. Absolute scores, z-scores are described for each domain and according to the presence of dementia. Changes after tap test were assessed with paired-samples hypothesis testing. This study was approved by the institutional ethics review board before start. Results: 76 NPH patients were included, their median age was 81 years (77-83) and 65 NPH patients (87.8%) were considered to have improved cognitive performance after tap test as part initial usual-care diagnostic assessment. We detected small differences in scores of ROCF (p=0.018) and IFS (p<0.001) between pre- and post-tap test assessments. No difference in the proportion of patients with altered cognitive performance was detected in this short 24-hour interval. Dementia was concomitant in 68.4% of patients, was negatively associated with improvement in SVF (2.9% vs. 28.6%, p=0.003) and IFS (0% vs. 16%, p=0.014) and may have affected detection of improvement for other tests. Conclusion : Executive function and praxis are the cognitive domains more susceptible to improvement after a tap test in a 24-hour interval in NPH patients upon initial assessment. These results are of interest to multidisciplinary groups involved in the diagnosis of NPH and could help inform patient selection for valve placement in NPH.
Tumor teratoide rabdoide atípico en un adulto joven.
(2012) Carlos Andrés Quintero; Christian Castro; Fernando Hakim; Nicolás Useche; Marcela Mejía; Adriana Flórez; Sonia Bermúdez; Fernando Velandia; Alfredo García Sánchez; León Darío Ortiz
Se presenta el caso de un hombre de 28 años con pérdida progresiva de la agudeza visual y cefalea asociada a polidipsia, poliuria e hipersomnia. La resonancia magnética cerebral mostró una masa heterogénea localizada a nivel selar/supraselar con realce intenso después de la administración del contraste. Se realizó una resección parcial con patología que evidenció una lesión tumoral de apariencia rabdoide con pérdida de la expresión del INI-1. Estos hallazgos fueron compatibles con un tumor teratoide/rabdoide atípico tratado con teleterapia y el esquema de quimioterapia ICE con adecuada respuesta. Se discute el resultado después de cinco meses de tratamiento en espera de la administración de quimioterapia con intensidad de dosis más rescate con progenitores obtenidos de sangre periférica. También se presenta una revisión de los datos referentes al manejo de esta neoplasia, al igual que de los mecanismos moleculares implicados en su fisiopatología.