{"title":"Antibiotic resistance and adherence to clinical guidelines in the Emergency Department. Are we doing it right?","authors":"Eduardo Esteban-Zubero","doi":"10.53986/ibjm.2024.0019","DOIUrl":"https://doi.org/10.53986/ibjm.2024.0019","url":null,"abstract":"","PeriodicalId":13190,"journal":{"name":"Iberoamerican Journal of Medicine","volume":" 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141672184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"MicroRNAs and their role in newborn weight","authors":"Cristina García-Muro","doi":"10.53986/ibjm.2024.0008","DOIUrl":"https://doi.org/10.53986/ibjm.2024.0008","url":null,"abstract":"","PeriodicalId":13190,"journal":{"name":"Iberoamerican Journal of Medicine","volume":" 46","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139623246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vianey Guadalupe Tellez Bolaños, Alejandra Lizbeth Salinas Atriano, Karla Daniela Salgado Guizar, Louis Fernando Robles Fernandez, Francisco Javier Pedraza Murillo, Roberto Camarena Álvarez
Tuberculosis (Tb) is, currently, the deadliest infectious disease and is caused by organisms of the Mycobacterium tuberculosis complex; the most common clinical manifestation is pulmonary involvement; however, it can also manifest as extrapulmonary affection in immunocompromised patients, especially in patients with human immunodeficiency virus (HIV) chronic infection up to 20% of the cases, despite being on adequate antiretroviral therapy. Within the extrapulmonary manifestations, affection of the central nervous system by hematogenous dissemination occurs in up to 5%, however, the finding of tuberculomas, which is a form of central nervous system involvement, is rare and an important cause in secondary hydrocephalus in these patients. We present the case of a male patient with a history of HIV infection and meningeal tuberculosis, who presented dysfunction of his ventriculoperitoneal shunt and in the imaging study multiple tuberculomas were found, a cerebrospinal fluid study was performed where multi-resistant tuberculosis (MDR) was documented, therefore despite adequate management of Tb, tuberculomas developed.
{"title":"Cerebral tuberculomas: manifestation of extrapulmonary tuberculosis in an immunocompromised patient. A case report","authors":"Vianey Guadalupe Tellez Bolaños, Alejandra Lizbeth Salinas Atriano, Karla Daniela Salgado Guizar, Louis Fernando Robles Fernandez, Francisco Javier Pedraza Murillo, Roberto Camarena Álvarez","doi":"10.53986/ibjm.2023.0030","DOIUrl":"https://doi.org/10.53986/ibjm.2023.0030","url":null,"abstract":"Tuberculosis (Tb) is, currently, the deadliest infectious disease and is caused by organisms of the Mycobacterium tuberculosis complex; the most common clinical manifestation is pulmonary involvement; however, it can also manifest as extrapulmonary affection in immunocompromised patients, especially in patients with human immunodeficiency virus (HIV) chronic infection up to 20% of the cases, despite being on adequate antiretroviral therapy. Within the extrapulmonary manifestations, affection of the central nervous system by hematogenous dissemination occurs in up to 5%, however, the finding of tuberculomas, which is a form of central nervous system involvement, is rare and an important cause in secondary hydrocephalus in these patients. We present the case of a male patient with a history of HIV infection and meningeal tuberculosis, who presented dysfunction of his ventriculoperitoneal shunt and in the imaging study multiple tuberculomas were found, a cerebrospinal fluid study was performed where multi-resistant tuberculosis (MDR) was documented, therefore despite adequate management of Tb, tuberculomas developed.","PeriodicalId":13190,"journal":{"name":"Iberoamerican Journal of Medicine","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135353796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gerardo Jesus Farley Reina Gonzalez, Maria Daniela del Pilar Zambrano Arenas, Daniel Hernandez Cabarcas, German Daniel Matiz, Wilmer Giovanny Galvis Ballesteros, Miguel Andres Montalvo Clavijo, Rodrigo Alberto Caicedo, Michael Gregorio Ortega-Sierra
Since the 1990s, big strides have been made in plastic and reconstructive surgery, thanks to the implementation of new techniques and resources for its execution. In cases where restoration is sought for small defects, biosurgery, involving the utilization of stem cells, biomaterials, chemical engineering, and tissue engineering, can be employed. The potential to stimulate the innate regenerative capacity of tissue and generate a persistent response over time, minimizing surgical trauma and re-interventions, lies in stem cell transplantation. However, the evidence published on this matter is very scarce, leading to divergence of opinions, suggestions, and recommendations. The aim of this review is to analyze the most recent evidence concerning the outcomes of using fat grafts enriched with stem cells in facial reconstruction, as compared to autologous fat grafts. The review of the literature demonstrates a marked trend suggesting that fat grafts enriched with stem cells may be superior to autologous grafts in facial reconstruction, with potential benefits in medium-term volume retention and faster attainment of results.
{"title":"Use of stem cell-enriched fat grafts in facial reconstruction: have they demonstrated superiority over autologous fat grafting?","authors":"Gerardo Jesus Farley Reina Gonzalez, Maria Daniela del Pilar Zambrano Arenas, Daniel Hernandez Cabarcas, German Daniel Matiz, Wilmer Giovanny Galvis Ballesteros, Miguel Andres Montalvo Clavijo, Rodrigo Alberto Caicedo, Michael Gregorio Ortega-Sierra","doi":"10.53986/ibjm.2023.0028","DOIUrl":"https://doi.org/10.53986/ibjm.2023.0028","url":null,"abstract":"Since the 1990s, big strides have been made in plastic and reconstructive surgery, thanks to the implementation of new techniques and resources for its execution. In cases where restoration is sought for small defects, biosurgery, involving the utilization of stem cells, biomaterials, chemical engineering, and tissue engineering, can be employed. The potential to stimulate the innate regenerative capacity of tissue and generate a persistent response over time, minimizing surgical trauma and re-interventions, lies in stem cell transplantation. However, the evidence published on this matter is very scarce, leading to divergence of opinions, suggestions, and recommendations. The aim of this review is to analyze the most recent evidence concerning the outcomes of using fat grafts enriched with stem cells in facial reconstruction, as compared to autologous fat grafts. The review of the literature demonstrates a marked trend suggesting that fat grafts enriched with stem cells may be superior to autologous grafts in facial reconstruction, with potential benefits in medium-term volume retention and faster attainment of results.","PeriodicalId":13190,"journal":{"name":"Iberoamerican Journal of Medicine","volume":"166 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135353794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vladimir Zaichick, Denis Dogadkin, Irina Gromya, Vladimir Kolotov
Introduction: Breast cancer in women is an actual global medical and social problem. The etiology of this disease remains largely unclear. However, it is well known that the incidence of breast cancer increases with age. In the presented work, for the first time, the age dependence of Al, Ca, Cu, Fe, K, Mg, Na, P, S, Si, Sr, and Zn content in the mammary gland of women aged 16-60 years was investigated. Material and methods: For this purpose, a method of inductively coupled plasma atomic emission spectrometry (ICP-AES) was developed, which makes it possible to determine the content of these elements in microsamples (mass from 10 mg) of breast tissue. With the help of the developed technique, the material obtained during the autopsy of 38 practically healthy women aged 16-60 years who died suddenly was studied. Results: Using the parametric Student's t-test and the non-parametric Wilcoxon-Mann-Whitney U-test to compare two age groups (16-40 years and 41-60 years), as well as Pearson's correlation coefficients between age and chemical element content, it was found that the level of K, Mg, Na and S in normal breast tissue decrease with age. Conclusions: The phenomenon of the age-related decrease in the chemical element contents in the normal mammary gland, discovered for the first time, requires further detailed study.
{"title":"Age dependence of chemical element contents in normal human breast investigated using inductively coupled plasma atomic emission spectrometry","authors":"Vladimir Zaichick, Denis Dogadkin, Irina Gromya, Vladimir Kolotov","doi":"10.53986/ibjm.2023.0029","DOIUrl":"https://doi.org/10.53986/ibjm.2023.0029","url":null,"abstract":"Introduction: Breast cancer in women is an actual global medical and social problem. The etiology of this disease remains largely unclear. However, it is well known that the incidence of breast cancer increases with age. In the presented work, for the first time, the age dependence of Al, Ca, Cu, Fe, K, Mg, Na, P, S, Si, Sr, and Zn content in the mammary gland of women aged 16-60 years was investigated. Material and methods: For this purpose, a method of inductively coupled plasma atomic emission spectrometry (ICP-AES) was developed, which makes it possible to determine the content of these elements in microsamples (mass from 10 mg) of breast tissue. With the help of the developed technique, the material obtained during the autopsy of 38 practically healthy women aged 16-60 years who died suddenly was studied. Results: Using the parametric Student's t-test and the non-parametric Wilcoxon-Mann-Whitney U-test to compare two age groups (16-40 years and 41-60 years), as well as Pearson's correlation coefficients between age and chemical element content, it was found that the level of K, Mg, Na and S in normal breast tissue decrease with age. Conclusions: The phenomenon of the age-related decrease in the chemical element contents in the normal mammary gland, discovered for the first time, requires further detailed study.","PeriodicalId":13190,"journal":{"name":"Iberoamerican Journal of Medicine","volume":"135 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135352712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Although prevention of the disease and its spread is the primary goal in the fight against the pandemic, studies on the correct management of those who have the disease and the predictability of the prognosis are also important. This study aimed to determine whether lymphocyte-C-reactive protein ratio, together with other inflammation markers, would be useful in predicting intensive care unit admission and mortality in Coronavirus disease 2019 cases. Material and methods: 883 patients were followed in 758 wards and 125 intensive care units. Data of the patients included in the study were compared with those admitted to the service and intensive care unit, and with those who survived and developed mortality. Results: According to the receiver operating characteristic analysis to distinguish the patients followed in the intensive care unit from the patients hospitalized in the ward that was determined that lymphocyte-C-reactive protein ratio, C-reactive protein ratio, CRP-albumin ratio, and neutrophil-lymphocyte ratio were moderate (70%–80%). D-dimer was good (80%–90%) predicting follow-up in intensive care unit. Increase in age, increase in lactate dehydrogenase and interleukin-6 levels, and uptake in tomography were determined as independent risk factors that increase intensive care unit admission. 243 (27.5%) of the patients were mortal. The mean age of the patients with a mortal course was 70±14 years, and mortality increased with increasing age. In the receiver operating characteristic analysis of patients with a mortal course that was determined that lymphocyte-C-reactive protein ratio, neutrophil-lymphocyte ratio, and D-dimer had a good (80–90%) ability to distinguish patients with a mortal course. Age, fever, and increases in lactate dehydrogenase and interleukin-6 levels were determined to be independent risk factors increasing mortality. Conclusions: Low lymphocyte-C-reactive protein ratio and high D-Dimer, neutrophil-lymphocyte ratio, and CRP-albumin ratio can be used in clinical monitoring to reduce morbidity and mortality rates due to COVID-19.
{"title":"The Value of Lymphocyte-CRP Ratio Predicting the Prognosis in COVID-19 Patients","authors":"Alper Tahmaz, Ayşegül Şeremet Keskin, Filiz Kizilateş, Nefise Öztorpak","doi":"10.53986/ibjm.2023.0025","DOIUrl":"https://doi.org/10.53986/ibjm.2023.0025","url":null,"abstract":"Introduction: Although prevention of the disease and its spread is the primary goal in the fight against the pandemic, studies on the correct management of those who have the disease and the predictability of the prognosis are also important. This study aimed to determine whether lymphocyte-C-reactive protein ratio, together with other inflammation markers, would be useful in predicting intensive care unit admission and mortality in Coronavirus disease 2019 cases. Material and methods: 883 patients were followed in 758 wards and 125 intensive care units. Data of the patients included in the study were compared with those admitted to the service and intensive care unit, and with those who survived and developed mortality. Results: According to the receiver operating characteristic analysis to distinguish the patients followed in the intensive care unit from the patients hospitalized in the ward that was determined that lymphocyte-C-reactive protein ratio, C-reactive protein ratio, CRP-albumin ratio, and neutrophil-lymphocyte ratio were moderate (70%–80%). D-dimer was good (80%–90%) predicting follow-up in intensive care unit. Increase in age, increase in lactate dehydrogenase and interleukin-6 levels, and uptake in tomography were determined as independent risk factors that increase intensive care unit admission. 243 (27.5%) of the patients were mortal. The mean age of the patients with a mortal course was 70±14 years, and mortality increased with increasing age. In the receiver operating characteristic analysis of patients with a mortal course that was determined that lymphocyte-C-reactive protein ratio, neutrophil-lymphocyte ratio, and D-dimer had a good (80–90%) ability to distinguish patients with a mortal course. Age, fever, and increases in lactate dehydrogenase and interleukin-6 levels were determined to be independent risk factors increasing mortality. Conclusions: Low lymphocyte-C-reactive protein ratio and high D-Dimer, neutrophil-lymphocyte ratio, and CRP-albumin ratio can be used in clinical monitoring to reduce morbidity and mortality rates due to COVID-19.","PeriodicalId":13190,"journal":{"name":"Iberoamerican Journal of Medicine","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135237216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The coronavirus disease-2019 pandemic has changed the daily lives of older adults in Japan, requiring them to wear masks and limit their movements. As lifestyle changes affect people's health, it is likely that some changes have occurred in their nutrition, which is the foundation of health. Therefore, this study aimed to examine the nutrition of older adults living at home during the pandemic period and identify the impact of the pandemic. Material and methods: The nutrition of older adults living at home was surveyed using the Mini-Nutrition Assessment Short Form (MNA-SF®). The target population was older adults living at home who were independent or in need of care. Surveys were conducted before and during the pandemic. Associations between the two survey periods and the MNA-SF® (nutrition assessment, sub-item) were analysed using χ-square or Fisher's test. The analysis was conducted separately for independent older adults and older adults in need of care. Results: Regarding nutrition assessment, our survey results indicated that 39.5% of older adults were considered "well-nourished," 46% were "at risk for malnutrition," and 14.5% were "malnourished" during the pandemic period. The analysis showed no significant differences in nutrition assessment by survey period for all participants. However, differences were observed in the sub-items before and during the pandemic. Significant differences were observed in neuropsychological problems and body mass index among independent older adults, and in neuropsychological problems, mobility, and reduced food intake among older adults in need of care. Conclusions: Our results suggest that the pandemic has changed the risk factors for undernutrition among older adults living at home, and that these changed factors may differ in part depending on whether they need care.
导语:2019冠状病毒病大流行改变了日本老年人的日常生活，要求他们戴口罩，限制活动。由于生活方式的改变影响着人们的健康，很可能他们的营养也发生了一些变化，而营养是健康的基础。因此，本研究旨在检查大流行期间居住在家中的老年人的营养状况，并确定大流行的影响。材料和方法:采用Mini-Nutrition Assessment Short Form (MNA-SF®)对居住在家中的老年人进行营养调查。目标人群是独居或需要照顾的老年人。在大流行之前和期间进行了调查。两个调查期与MNA-SF®(营养评估分项)之间的相关性采用χ 2检验或Fisher检验进行分析。分析分别针对独立老年人和需要照顾的老年人进行。结果:关于营养评估，我们的调查结果表明，在大流行期间，39.5%的老年人被认为“营养良好”，46%的老年人“有营养不良风险”，14.5%的老年人“营养不良”。分析显示，各调查期间所有参与者的营养评估没有显著差异。然而，在大流行之前和期间，在分项上观察到差异。在独立老年人的神经心理问题和体重指数方面，以及在需要照顾的老年人的神经心理问题、活动能力和食物摄入量减少方面，观察到显著差异。结论:我们的研究结果表明，大流行改变了居家老年人营养不良的危险因素，这些改变的因素可能在一定程度上取决于他们是否需要护理。
{"title":"Assessing the Impact of the COVID-19 Pandemic on Nutrition in Older Adults in Japan: Insights from a Mini-Nutrition Assessment Short Form Survey","authors":"Morisaki Naoko, Numata Keizo, Morisawa Hiroyuki","doi":"10.53986/ibjm.2023.0027","DOIUrl":"https://doi.org/10.53986/ibjm.2023.0027","url":null,"abstract":"Introduction: The coronavirus disease-2019 pandemic has changed the daily lives of older adults in Japan, requiring them to wear masks and limit their movements. As lifestyle changes affect people's health, it is likely that some changes have occurred in their nutrition, which is the foundation of health. Therefore, this study aimed to examine the nutrition of older adults living at home during the pandemic period and identify the impact of the pandemic. Material and methods: The nutrition of older adults living at home was surveyed using the Mini-Nutrition Assessment Short Form (MNA-SF®). The target population was older adults living at home who were independent or in need of care. Surveys were conducted before and during the pandemic. Associations between the two survey periods and the MNA-SF® (nutrition assessment, sub-item) were analysed using χ-square or Fisher's test. The analysis was conducted separately for independent older adults and older adults in need of care. Results: Regarding nutrition assessment, our survey results indicated that 39.5% of older adults were considered \"well-nourished,\" 46% were \"at risk for malnutrition,\" and 14.5% were \"malnourished\" during the pandemic period. The analysis showed no significant differences in nutrition assessment by survey period for all participants. However, differences were observed in the sub-items before and during the pandemic. Significant differences were observed in neuropsychological problems and body mass index among independent older adults, and in neuropsychological problems, mobility, and reduced food intake among older adults in need of care. Conclusions: Our results suggest that the pandemic has changed the risk factors for undernutrition among older adults living at home, and that these changed factors may differ in part depending on whether they need care.","PeriodicalId":13190,"journal":{"name":"Iberoamerican Journal of Medicine","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135022417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammed Furkan Yücer, Alper Kaçar, Hüseyin Dağ, Ahmet İrdem
Obesity is an increasingly common public health problem in children. The main goal in the fight against obesity is to prevent the development of obesity by healthy eating, increasing physical activity and reducing screen time. Patients with obesity should be treated in a multidisciplinary manner in accordance with the guidelines. In children and adolescents, applications such as gastric Botox, which are not included in the guidelines and for which there is insufficient literature information, should be avoided. Obese patients with Botulism side effects should be questioned about this application and Botulism antitoxin should be administered in appropriate cases. In this case report, we present a 15-year-old adolescent girl who developed botulism after gastric Botox administration in another medical institution and was successfully treated with Botulism antitoxin and prostigmine.
{"title":"Successful treatment of a 15 years-old obese adolescent patient with botulinum anti-toxin after gastric Botox and systemic botulism findings: a case report","authors":"Muhammed Furkan Yücer, Alper Kaçar, Hüseyin Dağ, Ahmet İrdem","doi":"10.53986/ibjm.2023.0024","DOIUrl":"https://doi.org/10.53986/ibjm.2023.0024","url":null,"abstract":"Obesity is an increasingly common public health problem in children. The main goal in the fight against obesity is to prevent the development of obesity by healthy eating, increasing physical activity and reducing screen time. Patients with obesity should be treated in a multidisciplinary manner in accordance with the guidelines. In children and adolescents, applications such as gastric Botox, which are not included in the guidelines and for which there is insufficient literature information, should be avoided. Obese patients with Botulism side effects should be questioned about this application and Botulism antitoxin should be administered in appropriate cases. In this case report, we present a 15-year-old adolescent girl who developed botulism after gastric Botox administration in another medical institution and was successfully treated with Botulism antitoxin and prostigmine.","PeriodicalId":13190,"journal":{"name":"Iberoamerican Journal of Medicine","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136163893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Sodium glucose cotransporter 2 inhibitors (SGLT2i) are the latest antidiabetic treatments that reduces mortality and cardiovascular outcomes. Its use in real life in very elderly patients is limited by its possible side effects. Material and methods: We conducted a retrospective study of patients treated with SGLT2i in our community (La Rioja) since 2014. The safety (adverse effects) and prognosis (mortality, cardiac decompensation, and cardiovascular events) during the first 24 months of treatment were evaluated. Results: We included 235 patients treated with SGLT2i, 114 of them were men (48.5%), and the mean age was 79.6 ± 3.9 years. The most used SGLT2i was empagliflozin (55.7%). The mean Hb1Ac at the time of inclusion was 7.9 ± 1.4, showing a decrease in 47.7% of the included patients during the follow up. The initial values of creatinine and glomerular filtration rate at the time of inclusion (0.94 ± 0.3 and 68.3 ± 16.4) presented an improvement at 24 months of treatment (0.94 ± 0.27 and 68.2 ± 15.8). During follow-up, 94 adverse events were described in 84 patients, and 53 treatment suspensions. This adverse events were related with sex (p 0.004), dapagliflozin (p < 0.001) and initial Hb1Ac values (p 0.04). The most common adverse event were genitourinary infections (63), followed by acute kidney injury (9), being the latter the most frequent cause of treatment interruption. Symptomatic hypoglycaemia during the follow-up was related with treatment of insulin, age and Hb1Ac (p <0.01). Conclusions: Treatment with SGLT2i is a safe and well-tolerated treatment in very elderly patients in real life. Genitourinary infections are the most common adverse events, but those that less frequently cause treatment interruption.
{"title":"Safety of SGLT2 inhibitors in very elderly diabetic type 2 patients in real life","authors":"R. Baeza-Trinidad, J. Mosquera-Lozano","doi":"10.53986/ibjm.2023.0023","DOIUrl":"https://doi.org/10.53986/ibjm.2023.0023","url":null,"abstract":"Introduction: Sodium glucose cotransporter 2 inhibitors (SGLT2i) are the latest antidiabetic treatments that reduces mortality and cardiovascular outcomes. Its use in real life in very elderly patients is limited by its possible side effects. Material and methods: We conducted a retrospective study of patients treated with SGLT2i in our community (La Rioja) since 2014. The safety (adverse effects) and prognosis (mortality, cardiac decompensation, and cardiovascular events) during the first 24 months of treatment were evaluated. Results: We included 235 patients treated with SGLT2i, 114 of them were men (48.5%), and the mean age was 79.6 ± 3.9 years. The most used SGLT2i was empagliflozin (55.7%). The mean Hb1Ac at the time of inclusion was 7.9 ± 1.4, showing a decrease in 47.7% of the included patients during the follow up. The initial values of creatinine and glomerular filtration rate at the time of inclusion (0.94 ± 0.3 and 68.3 ± 16.4) presented an improvement at 24 months of treatment (0.94 ± 0.27 and 68.2 ± 15.8). During follow-up, 94 adverse events were described in 84 patients, and 53 treatment suspensions. This adverse events were related with sex (p 0.004), dapagliflozin (p < 0.001) and initial Hb1Ac values (p 0.04). The most common adverse event were genitourinary infections (63), followed by acute kidney injury (9), being the latter the most frequent cause of treatment interruption. Symptomatic hypoglycaemia during the follow-up was related with treatment of insulin, age and Hb1Ac (p <0.01). Conclusions: Treatment with SGLT2i is a safe and well-tolerated treatment in very elderly patients in real life. Genitourinary infections are the most common adverse events, but those that less frequently cause treatment interruption.","PeriodicalId":13190,"journal":{"name":"Iberoamerican Journal of Medicine","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89503380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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