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Browsing by Autor "Maiko Alejandro Tavera Diaz"

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    Embolia por colesterol en miembros inferiores: reporte de caso
    (2023) Maiko Alejandro Tavera Diaz; Annia Aguilar Loayza; Rommer Alex Ortega Martínez
    La embolia por cristales de colesterol es efecto de la desestabilización de una placa de ateroma tras un evento desencadenante, produciendo la migración de cristales de colesterol hasta arteriolas periféricas, desencadenando un proceso inflamatorio endotelial; el espectro clínico varía desde ser asintomático hasta con un compromiso multiorgánico; la sospecha diagnóstica es principalmente clínica y será la biopsia de piel por su fácil accesibilidad, la que confirme el diagnóstico. El tratamiento es aún controvertido y no existe un consenso de las medidas terapéuticas para aplicar. A continuación, se presenta el caso de un paciente varón de 72 años de edad con una ateroembolia por cristales de colesterol en miembros inferiores, secundaria a una manipulación endovascular por angioplastia previa.
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    Timing of Initiation of Kidney Replacement Therapy in Acute Kidney Injury in the Critically Ill Patient
    (IntechOpen, 2023) Maiko Alejandro Tavera Diaz
    Acute kidney injury (AKI) represents one of the most frequent complications in critically ill patients. In recent years, mortality rates have exceeded 50%, and 10% of them require kidney replacement therapy (KRT). Since the 60’s, the question of when to start KRT has been raised, classically the time of temporality when life-threatening is present (hyperkalemia, metabolic acidosis, uremia, and fluid overload); Therefore, in the last decade, the possibility of early initiation was raised as a strategy to achieve better outcomes. Current evidence shows that the timing of late onset dialysis has the same results as the strategy of early begining. We will also review the considerations in relation to renal capacity and demand generated by the acute pathology in a critically ill patient and the set of variables to make better decisions.

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