Browsing by Autor "L. Castedo"

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Attention Deficit Hyperactivity Disorder: Advances in Epidemiology, Pathogenesis, and Neurobiology
(2025) Freddy Ednildon Bautista-Vanegas; Rodolfo R. Rosales; Ingrid Neysa Cabezas-Soliz; Daniel Ramiro Elías Vallejos-Rejas; Carmen Julia Salvatierra Rocha; Jhossmar Cristians Auza-Santiváñez; L. Castedo; Delly Espejo-Alanoca; Isaura Oberson Santander
Introduction. ADHD is a neurodevelopmental condition that affects approximately 5-7% of children and adolescents and persists in a significant number of cases into adulthood, with an estimated prevalence of 2.5% in adults globally. The impact goes far beyond school or work performance; it is associated with an increased risk of accidents, risky behaviors, comorbid disorders such as anxiety, depression, substance use disorders, and a significant reduction in quality of life. Methods. A search was conducted in the databases SciELO, Scopus, PubMed/MedLine, Google Scholar, Cochrane Library, as well as Clinical Keys services. The search terms for the search formulation were "ADHD", "Attention Deficit Disorder", "Hyperactivity", "depression", "autism spectrum", "anxiety", as well as their translations into English. Results. The reported prevalence of ADHD in children ranges from 2 to 18 percent depending on the diagnostic criteria and the population studied. The prevalence in school-aged children is estimated to be between 9 and 15 percent, making it one of the most common childhood disorders. Possible etiological factors include comorbid disorders, oppositional defiant disorder, conduct disorder, anxiety disorder, depression, developmental coordination disorder, autism spectrum disorder, and sleep disorders. Conclusion: ADHD constitutes a complex neurodevelopmental condition whose impact transcends clinical boundaries to become a multifaceted challenge for public health, neuroscience, and social justice.
Atypical rash, a diagnostic challenge in clinical practice: A Case Report from Bolivia
(2025) C. Roman; Jhossmar Cristians Auza-Santiváñez; Paola Nielsen Fuentes Luzcuber; L. Castedo; Mildred Ericka Kubatz La Madrid; Sara Milca Robles-Nina; Carmen Julia Salvatierra Rocha; Jorge Márquez-Molina
Hand-foot-and-mouth disease, commonly caused by Coxsackievirus A16, can manifest in atypical and severe forms associated with the CVA6 serotype, termed "eczema coxsackium," which may mimic serious pathologies. This report describes the case of a 10-year-old boy with a diffuse maculopapular rash, targetoid and bullous lesions, and systemic compromise, initially diagnosed as erythema multiforme major. The discussion focuses on the differential diagnostic challenge with eczema herpeticum, highlighting that despite the alarming clinical presentation, etiological confirmation via PCR for CVA6 was crucial to rule out other infections, discontinue unnecessary acyclovir, and focus treatment on supportive care, leading to a favorable outcome. In conclusion, eczema coxsackium due to CVA6 should be considered in severe vesiculobullous rashes, with PCR being essential for an accurate diagnosis and proper management, as its prognosis is generally benign.
Characterization of ophthalmological manifestations in patients recovered from COVID-19
(2025) Kirenia Sera Herrero; Dayami Pérez Gómez; L. Castedo; Jorge Márquez-Molina; Mildred Ericka Kubatz La Madrid; José Bernardo Antezana-Muñoz; Dilma Villca-Villca; Ingrid Neysa Cabezas-Soliz; Jhossmar Cristians Auza-Santiváñez
Introduction: Since the end of 2019, the world has been immersed in a health crisis caused by COVID-19, with millions of deaths globally. Ocular involvement is associated with respiratory symptoms and may be the first manifestation of the disease. Objective: To describe the short- and long-term ophthalmological manifestations in patients recovered from COVID-19. Methodological design: A descriptive, longitudinal and prospective study was carried out. The universe was composed of patients recovered from COVID-19, who were being followed up in the national convalescent care protocol at the Hermanos Ameijeiras Hospital, and were referred to the Ophthalmology clinic from February 2021 to June 2023. The sample consisted of 180 eyes of 90 patients, who met the selection criteria. Results: There was a predominance of the age group composed of women between 40 and 49 years, which represented 34% of the total. Most cases (65.5%) were evaluated less than 3 months after the initial diagnosis. 25.5% of patients presented at least one ocular disease, with conjunctivitis being the most frequent (26.5%), followed by dry eye (18.3%). Conclusions: In the evolutionary follow-up, a decrease in ocular diseases initially diagnosed as conjunctivitis was observed, however, others such as dry eye remained unchanged in their percentage of presentation and clinical manifestations. Patients evaluated with a shorter time of evolution of COVID-19 presented more severe ocular conditions
Multiple and bilateral renoureteral malformations. Case report and literature review
(2025) Mildred Ericka Kubatz La Madrid; Yamila Cruz Cruz; Jennifer Collazo Cruz; Yamily Cruz Pino; Jhossmar Cristians Auza-Santiváñez; L. Castedo; Giovanni Callizaya Macedo; Roger Mamani Plata
Congenital malformations constitute anomalies of structure and/or function of prenatal origin, which are often asymptomatic or cause few symptoms, but currently have a high incidence. With the aim of showing the findings detected in the imaging studies carried out, the case of a young adult with repeated mild urinary sepsis is presented, who was diagnosed with multiple and bilateral renoureteral malformations in the infertility consultation. The majority of congenital renoureteral malformations imply serious biopsychosocial problems for the patient, with the consequent impact on the psychological sphere and the social life of family members when diagnosed in the prenatal stage, so they inevitably constitute a health problem, since they contribute to fetal and infant mortality or increased morbidity in any age group. For this reason, early diagnosis is essential to guarantee appropriate behavior and quality of life. Keywords: congenital malformations; renoureteral malformations; early diagnostic; ultrasound; descending urogram; double excretory system; ureterocele; reflux vesicoureteral
OHVIRA syndrome: report of a case in Bolivia
(2024) L. Castedo; Jhossmar Cristians Auza-Santiváñez; Roberto Carlos Jiménez Fernández; Elier Carrera González; Alba Rossio López Castillo; Jorge Soneira Pérez
Introduction: the OHVIRA Syndrome was described by Herlyn Werner Wunderlich and in 1976 Wunderlichdescribed a grouping of right renal aplasia with bicornuate uterus and simple vagina in the presence of an isolated hematocervix, as a characteristic triad uterus didelphys, intercepted hemivagina and ipsilateral renal anomaly, it is generally performed The diagnosis occurs in puberty at the beginning of menarche, with manifest symptoms of progressive dysmenorrhea and non-specific abdominal pain in the hypochondrium; urinary retention, urinary infection or a pelvic mass usually appear.Clinical case: the case of a 13 - year - old patient is presented, who comes to the clinic with abdominal pain andtransvaginal bleeding. Imaging studies are performed and due to the characteristics of said studies, the presence of OHVIRA Syndrome is suspected.Discussion: once the imaging studies were performed and the diagnosis confirmed, a surgical procedure wasperformed under general anesthesia. Through exploratory laparotomy, a bicornuate uterus was visualized, theright uterus larger than the left, and adherence to the abdominal wall, so an open intervention was decided.Conclusions: OHVIRA syndrome coexists with a rare malformation and is often misdiagnosed as other morecommon etiologies of dysmenorrhea in adolescents, as a consequence it delays a correct and early diagnosis,increasing the risk of kidney damage and its complications. In our clinical case, a timely diagnosis was made andsurgical treatment was subsequently planned with a favorable outcome
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.
Purple urine bag syndrome in urinary tract infection. Case report from Bolivia
(2025) L. Castedo; Jhossmar Cristians Auza-Santiváñez; Daniel Ramiro Elías Vallejos-Rejas; Carla Lorena Suarez Aponte; Shirley Nicole Andrade Azcui; Marlon Carbonell González; Ingrid Neysa Cabezas-Soliz; Roger Mamani Plata
Purple bag syndrome is a rare manifestation of urine discoloration associated primarily with chemical reactions caused by the indoxyl sulfatase/phosphatase activity of some bacteria or as secondary metabolites of food or supplement intake, whether oral or parenteral. Its presence causes confusion, leading to unnecessary laboratory tests and treatments. Is reported the clinical case of a 49-year-old oncology patient admitted to the trauma service for a pathological fracture and urinary tract infection. She was fitted with a urinary catheter, which contained purple urine. Laboratory tests were requested to identify the causative bacteria. The catheter was replaced, and antibiotic treatment was started, leading to resolution of the clinical picture.