Browsing by Autor "J. Triana"

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Chapter 7. Hypocalcemia in Emergency Care
(2025) Ariel Sosa Remón; J. Triana; Jhossmar Cristians Auza-Santiváñez
INTRODUCCINLa hipocalcemia puede asociarse con manifestaciones clnicas, que van desde pocos sntomas (o ninguno) si la hipocalcemia es leve hasta convulsiones potencialmente mortales, insuficiencia cardaca refractaria o laringoespasmo si es grave.Adems de la gravedad, la velocidad de desarrollo de la hipocalcemia y su
Paracoccidioidomycosis in a 16-year-old adolescent patient. A case report from Bolivia
(2025) C. Roman; Jhossmar Cristians Auza-Santiváñez; Daniel Ramiro Elías Vallejos-Rejas; D. Padilla; Marlon Carbonell González; Jose Luis Diaz-Guerrero; L. Castedo; J. Triana
Introduction: Paracoccidioidomycosis (PCM) is the most common systemic mycosis in Latin America. Case: A 16-year-old female patient from Bolivia presented with a 6-month history of ulcerative nasal lesions and cervical lymphadenopathy. Initial histopathology suggested tuberculosis with a positive Ziehl-Neelsen stain. Direct KOH examination revealed characteristic "steering wheel" yeasts of Paracoccidioides brasiliensis. Antituberculosis treatment was discontinued and itraconazole was started with a favorable response. Discussion: Juvenile paracoccidioidomycosis represents a significant diagnostic challenge due to its variable clinical presentation and its ability to mimic other more prevalent pathologies such as tuberculosis and lymphoproliferative syndromes. This case illustrates the importance of maintaining a high index of clinical suspicion in adolescent patients from endemic areas who present with lymphadenopathy and mucocutaneous lesions, especially when tuberculosis studies are negative. A broad differential diagnosis is important, as is the need for specific complementary testing in the event of clinical discrepancies. Direct mycological examination is crucial as a rapid and definitive diagnostic method for paracoccidioidomycosis.
Prognostic scale for death in critically ill cancer patients due to neurological complications
(2025) Ariel Sosa Remón; Freddy Ednildon Bautista-Vanegas; José Bernardo Antezana-Muñoz; Osman Arteaga Iriarte; Yudiel Pérez-Yero; Arian Jesús Cuba Naranjo; Miguel Emilio García Rodríguez; Jhossmar Cristians Auza-Santiváñez; Ana Esperanza Jeréz Álvarez; J. Triana
Introduction: The scales used to predict death in cancer patients are scarce and have not been adequately validated in populations with neurological complications. Objective: To design a prognostic scale for death in critically ill cancer patients due to neurological complications. Method: An observational, prospective cohort study was conducted from January 2017 to 2024 in the Oncology Intensive Care Unit of the Institute of Oncology and Radiobiology in Havana, Cuba. The study population consisted of 265 patients. Clinical, oncological, laboratory, and life support variables were studied. Binary logistic regression analysis was used to determine the variables with the best prognostic power for the model. The final variable was mortality in the Intensive Care Unit. Results: The final model consisted of the following variables: ECOG III (OR: 3.62; 95% CI: 1.05 - 12.46; p= 0.041), absence of pupillary reflex (OR: 9.35; 95% CI: 2.24 - 38.99; p= 0.002), intracranial hypertension (OR: 17.91; 95% CI: 3.02 - 105.91; p= 0.001), hyperglycemia (OR: 5.85; 95% CI: 2.07 - 16.49; p= 0.001), hypoxemia (OR: 19.09; 95% CI: 2.91 - 61.67; p= 0.000) and artificial mechanical ventilation (OR: 9.59; 95% CI: 2.59 – 35.51; p = 0.001).Conclusions: The prognostic score classified mortality into 3 risk groups: low (0 to 2 points), moderate (3 to 6 points), and high (7 to 13 points). Mortality was higher in patients with higher scores. Internal validation showed excellent calibration and discrimination.