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Laverde-Sabogal C.E.,Hospital Universitario San Ignacio | Garnica-Rosas L.M.,Pontifical Xavierian University | Correa-Gonzalez N.,Pontifical Xavierian University
Revista Colombiana de Anestesiologia | Year: 2016

Objectives: To present a clinical case and to conduct a non-systematic review of the literature on peripartum cardiomyopathy, and to describe its incidence, aetiology and pathophysiology. Material and methods: With the authorization of the Ethics Committee of our institution, we present the case of a patient of mestizo ethnic origin who developed asthenia, adynamia, lower limb asymmetrical pain and functional class deterioration during the post-partum period, and her management in the Intensive Care Unit and final outcome. The search of the literature was conducted in PubMed, Scielo and Bireme. Results: Peripartum cardiomyopathy is associated with significant morbidity and mortality. The clinical course varies between progressive improvement, heart failure, transplant or death. Some national reports were found. Conclusions: Peripartum cardiomyopathy affects a young and healthy population during a period of time ranging between the end of pregnancy and five months postpartum. The aetiology and pathogenesis are unknown, but several hypotheses have been proposed: viral myocarditis, autoimmune and/or abnormal haemodynamic response to the pregnancy, genetic susceptibility, malnutrition, and apoptosis. The prognosis of recovery of LVEF depends on early detection within seven days of the onset of symptoms, an initial LVEF greater than 30%, and a LVDD smaller than 60 mm. Mortality is associated with parity greater than four, older age and black ethnic background (6.4 times higher than in Caucasians). © 2015 Sociedad Colombiana de Anestesiología y Reanimación.

Vera M.,Nephrology and Renal Transplantation Service | Molano A.,Nephrology and Renal Transplantation Service | Rodriguez P.,Hospital Universitario San Ignacio
NDT Plus | Year: 2010

Turbid white urine 'albinuria' is defined as a urine discoloration described as milky or cloudy. One of the most frequent causes of turbid white urine is chyluria complicating filariasis (Table 1). The extant causes of albinuria are non parasitic and rare. Amongst their aetiologies stand excessive mineral sediment excretion such as calciuria and phosphaturia, massive pyuria and fungal infections, and rarely congenital malformations of the lymphatic vessels. Malingering is also possible, in patients adding milk to their urine. We observed a case of albinuria in which the diagnostic work up led to diagnosing an exceptional cause of chyluria in a patient living in a region of Colombia where filariasis is not endemic. © The Author 2009. Published by Oxford University Press.

Gomez-Aldana A.J.,Pontifical Xavierian University | Gomez-Aldana A.J.,Hospital Universitario San Ignacio
Revista Facultad de Medicina | Year: 2013

The peritoneal tuberculosis is one of the differential diagnosis of ascites, but its documentation is provided by the presence of necrotizing granulomas as mycobacterial growth in samples taken from the peritoneum. This article presents the case of a patient with abdominal pain and ascites with the documentation of nodular lesions in the peritoneal cavity, with markedly elevated levels of "Carbohidrate Antigen o Cancer Antigen" CA 125, without changes in other organs. The peritoneum biopsies reports necrotizing granulomas and growth of mycobacteria in culture, then she received anti TB treatment with adequate response reducing the ascites' amount and earning weight.

Carvajal C.A.,Hospital Universitario San Ignacio | Ardila D.J.,Pontifical Xavierian University
Revista Colombiana de Cardiologia | Year: 2015

Acute myocardial infarction is the leading cause of death worldwide. Dedicated management guidelines indicate urgent invasive study in cases of infarction with ST elevation or new left bundle branch block. Electrocardiographic patterns when present in the clinical setting of unstable angina or myocardial infarction predict the presence of severe coronary disease that can lead to death. The recognition of these patterns is very important to take management decisions. A description of Wellens’ syndrome as part of these high-risk predictors is offered. © 2014 Sociedad Colombiana de Cardiología y Cirugía Cardiovascular.

Gempeler F.E.,Pontificia University Javeriana | Diaz L.,Hospital Universitario San Ignacio | Sarmiento L.,Pontifical Xavierian University
Revista Colombiana de Anestesiologia | Year: 2012

Introduction: Obesity has increased in the past few years, more so for the morbidly obese; in whom comorbilities that complicate the perioperative anaesthetic and airway management have been identified. The pre-anaesthetic assessment of the patient includes parameters of physical examination and medical history that predict difficulties when intubating or failure to do so. In such cases, the Bonfils retromolar fibroscope has proven to be a useful tool. Goal: To observe and identify predicting evidence of a difficult airway through physical examination; to revise the incidence of difficult intubation and the use of tools for airway management of obese patients. Material and methods: This is a descriptive observational study carried out on 352 obese patients who underwent bariatric surgery at Hospital Universitario San Ignacio, Bogota. On these patients we assessed the following parameters: body mass index (BMI), oral opening, mallampati score, distance between thyroid and chin, neck circumference, use of laryngoscope or Bonfils retromolar fibroscope and the difficulties encountered for both. Conclusions: Intubation with the Bonfils retromolar fibroscope proves successfull in 100% of observed cases of obese patients, and intubation difficulty does not correlate with the parameters considered in our assessment. © 2011 Sociedad Colombiana de Anestesiología y Reanimación.

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