16 research outputs found
Pituitary deficiency after aneurysmal subarachnoid hemorrhage
OBJECTIVE: Aneurysmal subarachnoid hemorrhage puts patients at high risk for the development of pituitary insufficiency. We evaluated the incidence of pituitary dysfunction in these patients and its correlation with clinical outcome. METHODS: Pituitary function was tested in 66 consecutive patients in the first 15 days after aneurysmal subarachnoid hemorrhage. The following were measured in all patients: thyroid-stimulating hormone, free thyroxine, triiodothyronine, luteinizing hormone, follicle-stimulating hormone, total testosterone (in males), estradiol (in females), prolactin, serum cortisol, plasma adrenocorticotropic hormone, growth hormone and insulin growth factor. RESULTS: The endocrine assessment was made at a mean of 7.4 days (standard deviation ±6.6) after subarachnoid hemorrhage. Forty-four (66.7%) female and 22 (33.3%) male patients were evaluated. Thirty-nine patients (59.1%) had some type of pituitary dysfunction. Follicle-stimulating hormone/luteinizing hormone deficiency was the most frequent disorder (34.8%), followed by growth hormone/insulin growth factor (28.7%), adrenocorticotropic hormone (18.1%) and thyroid-stimulating hormone (9%). Seventeen (25.7%) patients showed deficiencies in more than one axis. A greater incidence of hormone deficiency was observed in patients with a Glasgow Coma Scale score ≤13 (t test, p = 0.008), Hunt-Hess grade ≥4 (t test, p;0.05) with increased hospitalization or clinical outcome. CONCLUSION: Pituitary dysfunction was identified in a substantial portion of patients with previous aneurysmal subarachnoid hemorrhage, but no association was found between this dysfunction and poor clinical outcome
Análise da taxa de infecção de ferida operatória de hospital de Porto Alegre no período de 2005 a 2015
Complicações por colocação de Cateteres Venosos Totalmente Implantáveis - resultados preliminares
Análise das taxas de cancelamentos de cirurgias no Hospital de Clínidas (HCPA) entre 2006 e 2015
Uso de videolaringoscópio feitos em impressora 3D no ensino de IOT durante a pandemia de 2019/2020
Case-Serie of 4 COVID-19 patients hospitalized in an intensive care unit in a hospital institution in Barranquilla, Colombia
Objetivo: Presentar una serie de casos de COVID-19 con requerimiento
de ingreso a Unidad de Cuidados Intensivos. Métodos: La información fue tomada
de las historias clínicas, y su evaluación y diagnóstico fue realizado mediante
estudios paraclínicos en sangre, orina, PCR e imágenes diagnósticas en 4 pacientes
con diferentes comorbilidades y nexo epidemiológico presente para desarrollo de la
enfermedad. El caso 1 desarrolló falla orgánica múltiple, incluyendo injuria renal
aguda con una estancia en UCI de 4 dias antes de su fallecimiento, mientras los
casos 2, 3 y 4 tuvieron una evolución favorable y fueron dados de alta de UCI. Los
cuatro casos fueron manejados con cloroquina 300 mg via oral cada 12 horas y
azitromicina 1 gr via oral cada 24 horas durante 5 dias sin complicaciones ni
toxicidad asociada. Conclusiones: Se requieren estudios multicéntricos rápidos
que orienten científicamente hacia un mejor abordaje diagnóstico y manejo, en el
contexto de una enfermedad con un comportamiento clínico-epidemiologico que
debe estudiarse en profundidad y que probablemente cobrará muchas vidas,
ademas, debido a la ausencia de pruebas diagnósticas rápidas, la utilización de una
clasificación basada en la severidad de lesiones radiológicas llamada CO-RADS
(Covid-19 Imaging Reporting and Data System), podría ser de gran importancia para
instalar de manera temprana los tratamientos farmacológicos disponibles y la
asistencia respiratoria mecánica precoz.Objective: To present a COVID-19 case series with clinical admission
criteria to Intensive Care Unit. Methods: Patients information was obtained from
medical records, and daily clinical evaluation whereas diagnosis was carried out
through paraclinical studies in blood, urine, PCR and diagnostic images in 4 patients
with different comorbidities and epidemiological link for the development of COVID19. The case 1 developed multiple organ failure, including acute kidney injury with
an ICU stay of 4 days before his death, while cases 2, 3 and 4 had a favorable
evolution and were discharged from the ICU. All four cases were managed with
chloroquine 300 mg orally every 12 hours and azithromycin orally every 24 hours for
5 days without complications or associated toxicity. Conclusions: rapid multicenter
studies are required to scientifically guide a better diagnostic and management
approach, in the context of a disease with a clinical-epidemiological behavior that
must be studied in depth and will probably take many lives. In addition, due to the
absence of sufficiently rapid tests, the use of a classification based on the severity
of radiological lesions called CO-RADS (Covid-19 Imaging Reporting and Data
System), could be of great importance to install av
Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2
The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality