Pneumocystis jirovecii en recién nacidos pretérmino: prevalencia y posibles implicaciones clínicas

1 página. IX Jornadas de Salud Investiga. Cádiz 20-22 octubre, 2010.Pneumocystis jirovecii, conocido previa-mente como Pneumocystis carinii sp. f. hominis, es un hongo oportunista atípico, no cultivable, que infecta exclusivamente al ser humano y del que se desconocen aún muchos aspectos de su epidemiología y fisiopatología. La vía aérea se supone la forma de transmisión más importante en la especie humana, pero recientemente se ha podido comprobar su capacidad de transmisión transplacentaria. En modelos animales la infección por Pneumocystis produce disminución de las proteínas B y C del surfactante pulmonar, sustancia tensoactiva cuyo déficit constituye la base del síndrome de distrés respiratorio neonatal (SDRN). El objetivo de nuestro trabajo fue conocer la prevalencia de infección por P. jirovecii en neonatos prematuros y su posible relación con el SDRN.Peer reviewe

Incidence and Risk Factors for Development of Cardiac Toxicity in Adult Patients with Newly Diagnosed Acute Myeloid Leukemia

The incidence of cardiac morbimortality in acute myeloid leukemia (AML) is not well known. We aim to estimate the cumulative incidence (CI) of cardiac events in AML patients and to identify risk factors for their occurrence. Among 571 newly diagnosed AML patients, 26 (4.6%) developed fatal cardiac events, and among 525 treated patients, 19 (3.6%) experienced fatal cardiac events (CI: 2% at 6 months; 6.7% at 9 years). Prior heart disease was associated with the development of fatal cardiac events (hazard ratio (HR) = 6.9). The CI of non-fatal cardiac events was 43.7% at 6 months and 56.9% at 9 years. Age ≥ 65 (HR = 2.2), relevant cardiac antecedents (HR = 1.4), and non-intensive chemotherapy (HR = 1.8) were associated with non-fatal cardiac events. The 9-year CI of grade 1–2 QTcF prolongation was 11.2%, grade 3 was 2.7%, and no patient had grade 4–5 events. The 9-year CI of grade 1–2 cardiac failure was 1.3%, grade 3–4 was 15%, and grade 5 was 2.1%; of grade 1–2, arrhythmia was 1.9%, grade 3–4 was 9.1%, and grade 5 was 1%. Among 285 intensive therapy patients, median overall survival decreased in those experiencing grade 3–4 cardiac events (p < 0.001). We observed a high incidence of cardiac toxicity associated with significant mortality in AML