Browsing by Autor "Jonathan Pineda"

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Caracterizacion de los factores de riesgo para osteoporosis en los pacientes del servicio de reumatologia del IAHULA Mérida 2016-2017
(2019) Luis Dulcey; Héctor Moreno; William Gonzales; Rodolfo Martheyn; Jonathan Pineda; José Sampayo; Diana Villamizar; A.O. Rosas; Vicente Martínez Rodríguez; Humberto Riera
Osteoporosis affects 20% of postmenopausal women in E.E.U.U. The lifetime risk of suffering a fracture after 50 years is 40% for women and 13% for men. In view of the fact that patients with rheumatological diseases present a higher risk for the development of osteoporosis, we set out to develop this study. Retrospective study aimed at determining the presence of risk factors in patients over 50 years of age who attend the IAHULA Rheumatology service in the period from 2016 to 2017. The main group of patients was the female gender and the ages between 50 and 65 years. The main rheumatological pathology was RA, followed by SLE, Arthrosis in 3 place and finally in the last cell other entities than those indicated. The 2 main risk factors for the development of osteoporosis were the use of steroids followed by obesity. The main type of osteoporosis of the 2 categories described was the non-serious one. Those with rheumatoid arthritis were the main group of rheumatological patients that was most associated with osteoporosis. 12% of patients with rheumatic disease and osteoporosis did not have appropriate therapy. There is a large percentage of patients with rheumatic disease who suffer from osteoporosis and as a special population, measures should be taken to prevent its appearance and to treat it in cases that suffer from it.
Hemorragia intracerebral espontanea revisión de la literatura
(Universidad Internacional de La Rioja, 2020) Luis Dulcey; Jonathan Pineda; José Sampayo; Héctor Moreno; Diana Villamizar; Raimondo Caltagironne
Spontaneous Intracerebral Hemorrhage remains a cause of significant morbidity and mortality around the world. After the cerebrovascular accident of ischemic origin, it constitutes the second cause of morbidity and mortality associated with vascular brain pathology. It has been shown that excellent medical care is associated with a favorable prognosis in the case of these patients. An important deterioration occurs in the first hours of development of the condition. More than 20% of patients will show a deterioration of more than 2 points in the Glasgow comma scale from diagnosis to arrival at the hospital. In view of the repercussions that this condition presents, a search of the literature was conducted in order to update the clinician on the management of this pathology in the topics related to arterial hypertension, surgical intervention, management of seizures and finally the prevention of recurrence which is very important especially in the first year of the event.
Primo convulsión como manifestación neurológica atípica del síndrome de Vogt Koyanagi Harada
(2022) Luis Dulcey; Marilyn de los Ángeles Peña; Mariana Vegas; Ariatna de los Ángeles Pinto; Jonathan Pineda; Héctor Moreno; José Sampayo; Nohemi Molina; Raimondo Caltagironne
El Síndrome de Vogt-Konayagi-Harada o síndrome uve meníngeo es considerado como una inflamación granulomatosa de múltiples órganos aparatos y sistemas, cuyos mecanismos patogénicos no se han dilucidado completamente. Masculino de 34 años, inicia enfermedad 7 días previo al ingreso cuando presenta cefalea Holo craneana con intensidad 7/10 la cual cede parcialmente con analgésicos acompañado de tinitus bilateral, posteriormente presencia de movimientos tónico-clónicos generalizados en múltiples ocasiones con duración mayor a 5 minutos las cuales inicialmente se acompañaban de recuperación del estado de consciencia pero en la ultima hora no recupera la consciencia por lo que es traído a este centro. Se apreciaba hemodinamicamente estable con signos clínicos de vitíligo, alopecia, uveítis con desprendimiento de retina exudativo. Adicionalmente ocurrieron convulsiones tónico clónicas generalizadas. Nuestro paciente contaba con los 5 elementos para el diagnóstico de esta condición, ya que no tenía antecedente de trauma o cirugía ocular previa, ningún hallazgo de enfermedad ocular previa, afectación ocular caracterizada por Uveitis anterior bilateral con desprendimiento de retina exudativo multifocal, signos meníngeos con pleocitosis del líquido cefalorraquídeo e síntomas auditivos previos y finalmente los hallazgos dermatológicos de alopecia e vitíligo. Este caso en particular es el primer reporte de una forma completa de esta condición en Venezuela y a su vez una de las pocas descripciones de la literatura donde se aprecian manifestaciones neurológicas e imagenologicas consistentes con Desmielinización del sistema nervioso central. El paciente fallece finalmente pese al manejo instaurado.
Reto terapéutico, los nuevos anticoagulantes orales en la práctica médica
(2019) Luis Dulcey; Raimondo Caltagironne; Héctor Moreno; C. Flores León; William Gonzales; Roldolfo Martheyn; Belkis Menoni; Jonathan Pineda; José Sampayo
Venezuelans Medicine faces difficult times because of the current crisis, however, it is not an excuse to be at the forefront of knowledge, and the topic of anticoagulation is one of the most important in recent times. At present we have new agents called new anticoagulants oral NACO, this generates a paradigm since some colleagues continue with the traditional anticoagulation schemes and others opt for these new agents, a conflict between the traditional and these new molecules for the facultative what daily treat millions of patients who receive these medications daily either as a treatment or to prevent the recurrence of thromboembolic events. It is then that it has been considered if the end of therapeutics with heparins or coumarins has come, this has generated a great controversy and there are many questions about this topic that have not been answered in the studies, it is for that reason that the extensive experience that has had with the traditional agents by multiple decades makes the doctors are cautious and do not dare to change the therapy, although everything points to that destination.