Pub Date : 2022-03-03DOI: 10.24265/horizmed.2022.v22n1.09
Pedro Torres-Cabezas, Santiago Xavier Aguayo-Moscoso, Mario Montalvo-Villagómez, Fernando E. Jara-González, P. Vélez-Paez, Gustavo Velarde-Montero, Amílcar Tinoco-Solórzano, J. Vélez-Páez
{"title":"Lactato y catecolaminas: respuesta fisiológica en el paciente crítico","authors":"Pedro Torres-Cabezas, Santiago Xavier Aguayo-Moscoso, Mario Montalvo-Villagómez, Fernando E. Jara-González, P. Vélez-Paez, Gustavo Velarde-Montero, Amílcar Tinoco-Solórzano, J. Vélez-Páez","doi":"10.24265/horizmed.2022.v22n1.09","DOIUrl":"https://doi.org/10.24265/horizmed.2022.v22n1.09","url":null,"abstract":"","PeriodicalId":396953,"journal":{"name":"Horizonte Médico (Lima)","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121977393","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}
Pub Date : 2022-03-03DOI: 10.24265/horizmed.2022.v22n1.04
Lisset Haydee Sapo Solano, Cesar Asbel Aranda Castillo
Objective: To determine the clinical adverse events related to the use of femoral and radial artery access in patients who underwent interventional cardiology procedures in the Hospital Nacional Hipólito Unanue from 2015 to 2017. Materials and methods: A comparative, retrospective, observational and analytical study was conducted with a total of 151 medical records of patients who had clinical adverse events. Medical record review was used as data collection technique, and a data collection sheet designed by the researcher was used as instrument. The R software was used for the analysis. Results: Out of 151 cardiac catheterizations, 51.66 % were performed by a femoral artery access and 48.34 % by a radial artery access. The average age of the patients was 59.6 ± 11.3 years, out of which 39.73 % ranged between 60 and 70 years, and 73.50 % of the patients were males. The most frequent comorbidities were arterial hypertension Horiz Med (Lima) 2022; 22(1): e1719 Sapo Solano Lisset Haydee; Aranda Castillo Cesar Asbel https://doi.org/10.24265/horizmed.2022.v22n1.04 INTRODUCCIÓN Para Echeverri et al. (1), la cardiología intervencionista es mínimamente invasiva y estudia el corazón y las arterias coronarias. Incluye estudios diagnósticos (coronariografía) y terapéuticos (angioplastia) que implican el uso de medicamentos, la técnica de cine intracardiacas y la participación de un equipo médico multidisciplinario. Tamayo et al. (2) mencionan que el método de acceso vascular más usado, durante muchas décadas, ha sido el vascular femoral debido a la habilidad del personal médico y su menor curva de aprendizaje. Sin embargo, Medina et al. (3) afirman que el acceso vascular radial se está implementando con gran éxito y es la mejor elección en los centros de intervencionismo; y, según sea la selección y uso de la técnica intervencionista, existen complicaciones de mayor o menor riesgo, así como también beneficios para el paciente. Para Tamayo et al. (2), los eventos clínicos adversos relacionados con las vías de acceso vascular son inesperados en el paciente: las complicaciones más frecuentes se deben a la compresión nerviosa en el acceso vascular femoral; las complicaciones más frecuentes del acceso radial se deben al diámetro pequeño de la arteria radial, lo que puede ocasionar lesiones en la región de la muñeca. Romagnoli et al. refieren que el método radial presenta bajas tasas de complicaciones vasculares y hemorrágicas (4), y su principal ventaja es que reduce notablemente la morbilidad y mortalidad relacionada con la zona de punción (5). Por su parte, el método femoral permite un mejor manejo del material (catéter, stent, balón, entre otros), además, utiliza menor dosis de radiación en comparación con el método radial (6) y, sobre todo, es eficaz en grupos femeninos y añosos, en portadores de enfermedad renal crónica y en pacientes con síndrome isquémico agudo que son sometidos a procedimientos de cardiología intervencionista (7). Esta investigación será
目的:了解2015年至2017年在国立Hipólito Unanue医院行介入心脏科手术的患者使用股动脉和桡动脉通路的临床不良事件。材料与方法:对151例发生临床不良事件的患者病历进行比较、回顾性、观察性和分析性研究。资料收集技术采用病案查阅，资料收集表为工具，由研究者自行设计。采用R软件进行分析。结果:151例心导管置入中，51.66%经股动脉置入，48.34%经桡动脉置入。患者平均年龄59.6±11.3岁，60 ~ 70岁占39.73%，男性占73.50%。最常见的合并症是动脉高血压Horiz Med (Lima) 2022;22(1): e1719 Sapo Solano Lisset Haydee;Aranda Castillo Cesar Asbel https://doi.org/10.24265/horizmed.2022.v22n1.04 INTRODUCCIÓN Para Echeverri等人(1)，la cardiología intercionista es mínimamente侵入性研究el corazón冠状动脉。包括estudios diagnósticos (coronariografía)和血管成形术(血管成形术)与药物使用有关，心血管内成形术(心血管成形术)与participación和设备成形术(心血管成形术)多学科。Tamayo等人(2)mencionan que el msamutodo de acceso vascular más usado, durante muchas dsamucadas, the sido el vascular股debido和la habilidad del personal msamudico y su menor curva de aprendizaje。Sin禁运，Medina等人(3)，(3)确定了一种方法，即通过对主要的<s:1>干预中心(centrros de intercionismo)的研究，确定了一种方法，即获取血管径向se est <e:1>;Y, según sea la selección Y . so . de . la . tamamicnica interventionista，存在并发症de . mayor或menoresgo, así como . tamamicnicos . para el pacente。Para Tamayo等人(2)，los eventtos clínicos adverse relative ados con las vías de accesco vascular son inesperados en el paciente: las complicaciones más freutes se deben a la compresión nerviosa en el accesco vascular femoral;1例并发症más桡动脉动脉栓塞1例diámetro pequeño桡动脉栓塞1例，1例并发症2例región桡动脉栓塞1例muñeca。Romagnoli等人，refieren que el msametdo radial presenta bajas tasas de complicaciones vasculares y hemorrágicas (4)， y susuprincipal ventaja es que reducnotablemente la morbilidad y mortalidad relatisionada con la zona de punción (5)， Por suparte, el msametdo股骨permit in major manjo del material (catsameter, stent, balón, entre otros)， además, utiliza menor dosis de radiación en comparación, el msametdo radial (6) y, sobre todo, es eficaz en group of femininos y añosos，en portadores de enfermedad renal crónica y en patients es con síndrome isquemicmico agudo que son sometidos a procedimitos de cardiología intercionista (7). Esta investigación ser<e:1> útil como fuente de información para futuros estudios relacionados con el servir<e:1> como material docente para el personal msamicdico no msamicdico involucrado en el área。3 .坦桑尼亚的薪金和其他<s:1>多份薪金和其他<s:1>多份薪金和其他<s:1>多份薪金和其他<s:1>多份薪金和其他<s:2>多份薪金和其他<s:1>多份薪金和其他<s:1>多份薪金和其他<s:1>多份薪金和其他<s:1>多份薪金和其他<s:1>多份薪金和其他<s:1>多份薪金和其他<s:1>多份薪金和其他。术后并发症的诊断与诊断(8):术后并发症的诊断与诊断(8):术后并发症的诊断与诊断(8):术后并发症的诊断与诊断(8):术后并发症的诊断与诊断(8):术后并发症的诊断与诊断。En su estudio, Jaramillo (9) demostró que existenres并发症血管30 días para vía桡动脉En comparación con el accesco股动脉。Otra investigación effecada por Seriel等人(10)，con guía ecocardiográfica多普勒桡动脉旁动脉，tambin mostró血管病变，以桡动脉狭窄为例más具有代表性。在sudamimica中，与tamamimica相似，与tamamimica相似，与tamamimica相似，与血管桡骨相似，与股动脉相似。Así， una publicación en Argentina de Abud等人(11)，脑膜异常vía动脉桡动脉肌隔性骨折，报告动脉血管不良事件发生率30 días异常vía股骨。En Colombia, Tamayo等。(2)桡骨动脉血管内血肿与股骨血管内血肿的对位并发症;mientras que para Meneses (12)， en Chile, el假性动脉瘤(complicación más)。En el Perú
{"title":"Eventos clínicos adversos relacionados con el uso del método femoral y método radial en pacientes sometidos a procedimientos de cardiología intervencionista en el Hospital Nacional Hipólito Unanue","authors":"Lisset Haydee Sapo Solano, Cesar Asbel Aranda Castillo","doi":"10.24265/horizmed.2022.v22n1.04","DOIUrl":"https://doi.org/10.24265/horizmed.2022.v22n1.04","url":null,"abstract":"Objective: To determine the clinical adverse events related to the use of femoral and radial artery access in patients who underwent interventional cardiology procedures in the Hospital Nacional Hipólito Unanue from 2015 to 2017. Materials and methods: A comparative, retrospective, observational and analytical study was conducted with a total of 151 medical records of patients who had clinical adverse events. Medical record review was used as data collection technique, and a data collection sheet designed by the researcher was used as instrument. The R software was used for the analysis. Results: Out of 151 cardiac catheterizations, 51.66 % were performed by a femoral artery access and 48.34 % by a radial artery access. The average age of the patients was 59.6 ± 11.3 years, out of which 39.73 % ranged between 60 and 70 years, and 73.50 % of the patients were males. The most frequent comorbidities were arterial hypertension Horiz Med (Lima) 2022; 22(1): e1719 Sapo Solano Lisset Haydee; Aranda Castillo Cesar Asbel https://doi.org/10.24265/horizmed.2022.v22n1.04 INTRODUCCIÓN Para Echeverri et al. (1), la cardiología intervencionista es mínimamente invasiva y estudia el corazón y las arterias coronarias. Incluye estudios diagnósticos (coronariografía) y terapéuticos (angioplastia) que implican el uso de medicamentos, la técnica de cine intracardiacas y la participación de un equipo médico multidisciplinario. Tamayo et al. (2) mencionan que el método de acceso vascular más usado, durante muchas décadas, ha sido el vascular femoral debido a la habilidad del personal médico y su menor curva de aprendizaje. Sin embargo, Medina et al. (3) afirman que el acceso vascular radial se está implementando con gran éxito y es la mejor elección en los centros de intervencionismo; y, según sea la selección y uso de la técnica intervencionista, existen complicaciones de mayor o menor riesgo, así como también beneficios para el paciente. Para Tamayo et al. (2), los eventos clínicos adversos relacionados con las vías de acceso vascular son inesperados en el paciente: las complicaciones más frecuentes se deben a la compresión nerviosa en el acceso vascular femoral; las complicaciones más frecuentes del acceso radial se deben al diámetro pequeño de la arteria radial, lo que puede ocasionar lesiones en la región de la muñeca. Romagnoli et al. refieren que el método radial presenta bajas tasas de complicaciones vasculares y hemorrágicas (4), y su principal ventaja es que reduce notablemente la morbilidad y mortalidad relacionada con la zona de punción (5). Por su parte, el método femoral permite un mejor manejo del material (catéter, stent, balón, entre otros), además, utiliza menor dosis de radiación en comparación con el método radial (6) y, sobre todo, es eficaz en grupos femeninos y añosos, en portadores de enfermedad renal crónica y en pacientes con síndrome isquémico agudo que son sometidos a procedimientos de cardiología intervencionista (7). Esta investigación será","PeriodicalId":396953,"journal":{"name":"Horizonte Médico (Lima)","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134390609","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}
Pub Date : 2022-03-03DOI: 10.24265/horizmed.2022.v22n1.08
Angela N. Coaguila Talavera, Giovanni F. Salas Oporto, L. R. Pantoja Sánchez
{"title":"Flujo lagrimal en población de 20 a 30 años en ciudades drelativa en Perú, 2019","authors":"Angela N. Coaguila Talavera, Giovanni F. Salas Oporto, L. R. Pantoja Sánchez","doi":"10.24265/horizmed.2022.v22n1.08","DOIUrl":"https://doi.org/10.24265/horizmed.2022.v22n1.08","url":null,"abstract":"","PeriodicalId":396953,"journal":{"name":"Horizonte Médico (Lima)","volume":"39 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114122198","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}
Pub Date : 2022-03-03DOI: 10.24265/horizmed.2022.v22n1.07
Ian Falvy-Bockos, Fernado Runzer Colmenares, J. Parodi
Objective: To find out the benefits of a multimodal exercise program for muscle function improvement in older adults from the Hospital de la Fuerza Aérea del Perú in 2018. Materials and methods: An interventional, analytical, prospective and longitudinal study. A total of 66 patients were assessed, out of whom only 24 completed the six-month intervention period. Results: The patients’ median age was 75 ± 7.01. The Short Physical Performance Battery (SPPB), which combines the results of the balance, gait speed and chair stand tests, had a positive impact on the intervention group and showed statistically significant results. No statistical significance was found in grip strength in kilograms or calf circumference measurement. Conclusions: The multimodal exercise program for older adults from the Peruvian Air Force has a positive impact on muscle function.
{"title":"Programa de ejercicio multimodal para mejorar la función muscular en adultos mayores del Hospital de la Fuerza Aérea del Perú, 2018","authors":"Ian Falvy-Bockos, Fernado Runzer Colmenares, J. Parodi","doi":"10.24265/horizmed.2022.v22n1.07","DOIUrl":"https://doi.org/10.24265/horizmed.2022.v22n1.07","url":null,"abstract":"Objective: To find out the benefits of a multimodal exercise program for muscle function improvement in older adults from the Hospital de la Fuerza Aérea del Perú in 2018. Materials and methods: An interventional, analytical, prospective and longitudinal study. A total of 66 patients were assessed, out of whom only 24 completed the six-month intervention period. Results: The patients’ median age was 75 ± 7.01. The Short Physical Performance Battery (SPPB), which combines the results of the balance, gait speed and chair stand tests, had a positive impact on the intervention group and showed statistically significant results. No statistical significance was found in grip strength in kilograms or calf circumference measurement. Conclusions: The multimodal exercise program for older adults from the Peruvian Air Force has a positive impact on muscle function.","PeriodicalId":396953,"journal":{"name":"Horizonte Médico (Lima)","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122803596","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}
Pub Date : 2022-03-03DOI: 10.24265/horizmed.2022.v22n1.12
Iván David Lozada Martínez, Andres Llamas Nieves, Christian German Ospina Pérez, Ana Milena Álvarez Acuña, Rosa María Ospina Pérez
Amyand’s hernia is defined as the presence of the vermiform appendix within an inguinal hernial sac. Less than 1 % of the world medical publications on hernias address this disease, out of which very few come from Latin America and the Caribbean. This is the case of a 78-year-old male patient who experienced signs and symptoms for approximately five months. He felt a lump in the right inguinal region which progressively increased in size. Two days prior to admission to the intensive care unit, he said his pain level was 8/10. During the right inguinal approach, the hernial sac was opened, revealing parts of the right colon, cecum and appendix with edematous changes. Therefore, the patient underwent an appendectomy and repair with polypropylene mesh.
{"title":"Corrección de hernia de Amyand con malla y apendicetomía: reporte de caso","authors":"Iván David Lozada Martínez, Andres Llamas Nieves, Christian German Ospina Pérez, Ana Milena Álvarez Acuña, Rosa María Ospina Pérez","doi":"10.24265/horizmed.2022.v22n1.12","DOIUrl":"https://doi.org/10.24265/horizmed.2022.v22n1.12","url":null,"abstract":"Amyand’s hernia is defined as the presence of the vermiform appendix within an inguinal hernial sac. Less than 1 % of the world medical publications on hernias address this disease, out of which very few come from Latin America and the Caribbean. This is the case of a 78-year-old male patient who experienced signs and symptoms for approximately five months. He felt a lump in the right inguinal region which progressively increased in size. Two days prior to admission to the intensive care unit, he said his pain level was 8/10. During the right inguinal approach, the hernial sac was opened, revealing parts of the right colon, cecum and appendix with edematous changes. Therefore, the patient underwent an appendectomy and repair with polypropylene mesh.","PeriodicalId":396953,"journal":{"name":"Horizonte Médico (Lima)","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128784581","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}
Pub Date : 2022-03-03DOI: 10.24265/horizmed.2022.v22n1.13
Santiago Gerardo Ruiz-Laos, Aníbal Díaz-Lazo
{"title":"Inestabilidad hemodinámica por efecto Macklin en un paciente con COVID-19: reporte de caso","authors":"Santiago Gerardo Ruiz-Laos, Aníbal Díaz-Lazo","doi":"10.24265/horizmed.2022.v22n1.13","DOIUrl":"https://doi.org/10.24265/horizmed.2022.v22n1.13","url":null,"abstract":"","PeriodicalId":396953,"journal":{"name":"Horizonte Médico (Lima)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129064694","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}
Pub Date : 2022-03-03DOI: 10.24265/horizmed.2022.v22n1.11
Fernando D. Solís-Guevara, Angi I. Aguilar-Huillca, Milagros H. Cruz-Quilla
{"title":"Producción científica de asesores de tesis: ¿cuál es la realidad de la carrera de Nutrición en el Perú?","authors":"Fernando D. Solís-Guevara, Angi I. Aguilar-Huillca, Milagros H. Cruz-Quilla","doi":"10.24265/horizmed.2022.v22n1.11","DOIUrl":"https://doi.org/10.24265/horizmed.2022.v22n1.11","url":null,"abstract":"","PeriodicalId":396953,"journal":{"name":"Horizonte Médico (Lima)","volume":"735 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129826138","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}
Pub Date : 2022-03-03DOI: 10.24265/horizmed.2022.v22n1.00
Gloria Ubillús Arriola de Pimentel
{"title":"La simulación clínica en la enseñanza de la medicina","authors":"Gloria Ubillús Arriola de Pimentel","doi":"10.24265/horizmed.2022.v22n1.00","DOIUrl":"https://doi.org/10.24265/horizmed.2022.v22n1.00","url":null,"abstract":"","PeriodicalId":396953,"journal":{"name":"Horizonte Médico (Lima)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128832748","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}
Pub Date : 2022-03-03DOI: 10.24265/horizmed.2022.v22n1.02
Andrea Carolina Fabian-Sánchez, L. Podestá-Gavilano, R. A. Ruiz-Arias
{"title":"Calidad de atención y satisfacción del paciente atendido en una cadena de clínicas odontológicas. Lima-Perú, 2019-2020","authors":"Andrea Carolina Fabian-Sánchez, L. Podestá-Gavilano, R. A. Ruiz-Arias","doi":"10.24265/horizmed.2022.v22n1.02","DOIUrl":"https://doi.org/10.24265/horizmed.2022.v22n1.02","url":null,"abstract":"","PeriodicalId":396953,"journal":{"name":"Horizonte Médico (Lima)","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116790690","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}
Pub Date : 2022-03-03DOI: 10.24265/horizmed.2022.v22n1.05
Teodoro Julio Oscanoa Espinoza, Saul Moscol, J. Luque, Silvia Leon-Curiñaupa, José Amado-Tineo
Objective: To describe the clinical characteristics of drug-induced liver injury (DILI) in multidrug-resistant tuberculosis (MDR-TB) patients. Materials and methods: A retrospective study conducted in hospitalized patients with MDR-TB and DILI. The criteria of the DILI Expert Working Group were used for the diagnosis of DILI, and the RUCAM (Roussel Uclaf Causality Assessment Method) for the causality analysis. The specific association between DILI and antitubercular drugs was established by drug rechallenge or discontinuation and recovery. Results: Seven cases of MDR-TB and DILI are described in this research. The mean age (standard deviation) was 39.10 (3.30) years. Mean DILI occurred 30.40 (27.70) days after starting the treatment. Three (43.00 %) patients presented jaundice. Regarding the type of injury, four (57.00 %) had hepatocellular injury and three (43.00 %) cholestatic injury. Four patients showed mild DILI and three moderate DILI. All the patients had taken pyrazinamide (pyrazinamide alone: four patients; pyrazinamide and ethionamide: one patient; pyrazinamide, rifampin and isoniazid: one patient; pyrazinamide and rifampicin: one patient). The mean hospital stay was 48.10 (48.70) days. The mean serum alkaline phosphatase (AP), alanine aminotransferase (ALT) and gamma-glutamyl-transpeptidase (GGT) were 2.40 (1.10), 7.90 (7.10) and 5.60 (3.70) times the upper limit of normal (ULN), respectively. The mean total bilirubin was 2.30 (2.00), with a range of 0.50 to 6.40 mg/dl. As part of the discharge plan, quinolones were given to seven patients (levofloxacin: six patients; ofloxacin: one patient) and amoxicillin/clavulanic acid was added to one patient. Conclusions: MDR-TB patients may develop DILI after the first month of treatment. Hepatocellular injury was the most common type of liver injury, and pyrazinamide was the most frequently used antimycobacterial. MeSH NLM).
{"title":"Hepatotoxicidad por antituberculosos en pacientes con tuberculosis multidrogorresistente","authors":"Teodoro Julio Oscanoa Espinoza, Saul Moscol, J. Luque, Silvia Leon-Curiñaupa, José Amado-Tineo","doi":"10.24265/horizmed.2022.v22n1.05","DOIUrl":"https://doi.org/10.24265/horizmed.2022.v22n1.05","url":null,"abstract":"Objective: To describe the clinical characteristics of drug-induced liver injury (DILI) in multidrug-resistant tuberculosis (MDR-TB) patients. Materials and methods: A retrospective study conducted in hospitalized patients with MDR-TB and DILI. The criteria of the DILI Expert Working Group were used for the diagnosis of DILI, and the RUCAM (Roussel Uclaf Causality Assessment Method) for the causality analysis. The specific association between DILI and antitubercular drugs was established by drug rechallenge or discontinuation and recovery. Results: Seven cases of MDR-TB and DILI are described in this research. The mean age (standard deviation) was 39.10 (3.30) years. Mean DILI occurred 30.40 (27.70) days after starting the treatment. Three (43.00 %) patients presented jaundice. Regarding the type of injury, four (57.00 %) had hepatocellular injury and three (43.00 %) cholestatic injury. Four patients showed mild DILI and three moderate DILI. All the patients had taken pyrazinamide (pyrazinamide alone: four patients; pyrazinamide and ethionamide: one patient; pyrazinamide, rifampin and isoniazid: one patient; pyrazinamide and rifampicin: one patient). The mean hospital stay was 48.10 (48.70) days. The mean serum alkaline phosphatase (AP), alanine aminotransferase (ALT) and gamma-glutamyl-transpeptidase (GGT) were 2.40 (1.10), 7.90 (7.10) and 5.60 (3.70) times the upper limit of normal (ULN), respectively. The mean total bilirubin was 2.30 (2.00), with a range of 0.50 to 6.40 mg/dl. As part of the discharge plan, quinolones were given to seven patients (levofloxacin: six patients; ofloxacin: one patient) and amoxicillin/clavulanic acid was added to one patient. Conclusions: MDR-TB patients may develop DILI after the first month of treatment. Hepatocellular injury was the most common type of liver injury, and pyrazinamide was the most frequently used antimycobacterial. MeSH NLM).","PeriodicalId":396953,"journal":{"name":"Horizonte Médico (Lima)","volume":"92 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130907408","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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