Browsing by Autor "Valentina Cabrera Peña"

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DESCRIPTION OF THE METABOLIC SYNDROME AND ITS INDIVIDUALIZED RISK IN A LATIN AMERICAN COHORT OF GERIATRIC PATIENTS WITH HYPOTHYROIDISM
(2023) Luis Dulcey; Juan Sebastián Theran León; Jaime Gomez; Rafael Guillermo Parales Strauch; Raimondo Caltagirone; Edgar Blanco; María Paula Ciliberti Artavia; Juan Camilo Martínez; Valentina Cabrera Peña; Maria Amaya
Abstract Introduction It is still discussed whether hypothyroidism as an independent risk factor for cardiovascular events. Our objective was to evaluate the association between hypothyroidism and the risks of cardiovascular events and mortality through 3 stratification systems. Methods A retrospective study was carried out by reviewing medical records in the period of January 2015 - December 2017 in a South American hospital. Patients had fasting total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and plasma glucose were included. Quantitative variables are presented as mean ± standard deviation or median (interquartile range) according to their distribution, and qualitative variables as percentages. Student’s test was performed to assess the differences between two variables. all statistical analyzes of the database results were performed with (SPSS for Windows, v.20.1; Chicago, IL). Results The present study has demonstrated metabolic syndrome criteria present in patients diagnosed with hypothyroidism in a high proportion. The male gender was 32% compared to the female 68%. The Framingham equation classified a higher percentage of women patients with hypothyroidism as low cardiovascular risk compared to the PROCAM and SCORE equations. Item was found that there was a greater cardiovascular risk in those patients with still uncontrolled hypothyroidism profile, showing a statistical correlation of this alteration for the 3 stratification systems used. Conclusions Hypothyroidism is a risk factor for cardiovascular disease. Uncontrolled hypothyroidism in the present study is associated with greater adverse outcomes in the medium and long term, the present study warns about the need to better characterize this patient cohorts.
Epilepsia secundaria a encefalitis por el virus de Epstein Barr
(2023) Luis Dulcey; Juan Sebastián Theran León; Valentina Cabrera Peña; Rafael Guillermo Parales Strauch; Raimondo Caltagirone; Edgar Blanco; María Paula Ciliberti Artavia
Presentación del caso. Se trata de una mujer de 44 años de edad, con historia de cefalea occipital, lenguaje incoherente y pensamiento confuso. Inicialmente presentaba diez puntos en la escala de Glasgow y una hemiparesia izquierda. La tomografía computarizada de cráneo, reportó edema cerebral con lesión hipodensa talámica derecha y deterioro neurológico progresivo. El electroencefalograma evidenció desaceleración unilateral hemisférica derecha. El estudio del líquido cefalorraquídeo describió hiperproteinorraquia y un recuento a predominio linfocitario de 450 células con glucorraquia conservada, sin presencia de bacterias.Intervención terapéutica. se manejó con soporte ventilatorio invasivo y con tratamiento antibiótico y antiviral a dosis meníngeas, además de anticonvulsivantes. Los hallazgos tomográficos de control reportaron una hidrocefalia; se colocó una derivación ventricular tipo Becker. La serología IgM resultó positiva para virus de Epstein Barr y se identificó el genoma viral en el líquido cefalorraquídeo, a través de la prueba de reacción en cadena de polimerasa. La tomografía cerebral de control, evidenció la persistencia de la ventriculomegalia y de edema cerebral, lo que generó el diagnóstico de una encefalitis de etiología viral complicada con epilepsia secundaria por una lesión estructural desmielinizante del hemisferio cerebral derecho. Evolución clínica. La intervención terapéutica con inmunoglobulina intravenosa generó una mejoría del estado general. Fue posible retirar la derivación ventricular y la ventilación pulmonar diez y 19 días después del ingreso, respectivamente. La paciente se encuentra actualmente en fisioterapia con persistencia de hemiparesia izquierda, alteraciones de la marcha, disartria y episodios convulsivos controlados durante los últimos seis meses.
EXPRESSION OF VARIABILITY OF THE CYP2C19*2 GENE IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION FROM A SOUTH AMERICAN HOSPITAL AND ITS FUTURE RELEVANCE IN THE INTERACTION BETWEEN GENETICS AND CARDIOLOGY
(2023) Luis Dulcey; Juan Sebastián Theran León; Jaime Gomez; Rafael Guillermo Parales Strauch; Raimondo Caltagirone; Edgar Blanco; María Paula Ciliberti Artavia; Juan Camilo Martínez; Valentina Cabrera Peña; Maria Amaya
Abstract Introduction Some Polymorphisms of the CYP2C19 gene are associated with a decrease in the activity of the enzyme they encode, being the case of CYP2C19*2 in causing a lower generation of active metabolite of clopidogrel and therefore a low or null antiplatelet action depending on the genotype present. Antiplatelet therapy, mainly clopidogrel, is considered essential treatment in the management of acute coronary syndromes (ACS). Target The frequency of the CYPC19*2 polymorphism, identified as relevant in resistance to clopidogrel, is unknown in the population of this part of South America. Methods A descriptive, observational and cross-sectional study was designed to determine the frequency of the CYP2C19*2 allele in patients with ACS admitted to a South American hospital during the period between 2015-2016, being the first study to determine polymorphism in our population. fifty-nine adults patients diagnosed with ACS were included, 48 male (81.3%) and 11 female (18.7%), aged between 54 and 86 years. The genotype for the CYP2C19 gene was determined through the PCRRFLP (Restriction Fragments Length Polymorphism) technique from DNA extracted desde peripheral blood . Results The allelic frequency of the CYP2C19*2 polymorphism was 28.5%. Three subgroups of metabolizers were characterized : extensive (*1/*1) 40 (67.8%), intermediate (*1/*2) 17 (28.9%) and poor (*2/*2) 2 (3.3%). Conclusions This high number of carriers of the CYP2C19*2 polymorphism in the context of ACS is relevant due to its association with a lower responsiveness to clopidogrel and the possible involvement in the choice of antiplatelet therapy, for which characterization studies are required most appropriate to identify the best therapeutic strategies in our populations through pharmacogenomics.
FERROKINETIC EVALUATION OF PATIENTS WITH ACUTE CORONARY SYNDROME AT A SOUTH AMERICAN HOSPITAL, PILOT STUDY
(2023) Luis Dulcey; Juan Sebastián Theran León; Valentina Cabrera Peña; Rafael Guillermo Parales Strauch; Raimondo Caltagirone; Edgar Blanco; María Paula Ciliberti Artavia; Juan Camilo Martínez
Abstract Introduction Alterations in the ferrokinetic profile are associated with cardiovascular disease, and the short- and long-term prognosis of these alterations is currently unknown. Design Prospective cohort analytical observational study Methods To determine the prognostic value of the alterations of the ferrokinetic profile in patients with myocardial infarction with and without ST-segment elevation, in a Health institution from July 2017 to May 2018. Results : From 72 patients, the main affected gender was male, in ages over 56 years old, the infarction with ST elevation being the most frequent. Among the associated comorbidities, the main one was hypertension with (n: 22; 53.7%) for infarction with elevation and (n: 23; 74.2%) for infarction without ST elevation. The most frequent alteration of the parameters of the ferrokinetic profile studied, was the iron deficit, found in (n:15; 36.6%) of the patients with ST elevation and (n:13; 41.9%) without ST elevation. Low levels of hemoglobin were present at admission (n:10; 24.4%) of the subgroup with ST elevation and (n:10; 32.3%) for no ST elevation, increasing the percentage to (n:13; 31.7%) (RR: 2) (95% CI -0.131-30.63), associated with low hemoglobin values at day 7 of hospitalization. There were 2 deaths (2.77%), which presented low levels of iron without anemia and infarction with ST elevation complicated by cardiogenic shock. Conclusions iron deficiency is a common comorbidity with a high mortality rate, and the decrease in hemoglobin after hospital admission was related to mortality, so both parameters should be taken into account in Infarction and cardiovascular disease.