Therapies for patients with coexisting heart failure with reduced ejection fraction and non-alcoholic fatty liver disease

Heart failure with reduced ejection fraction (HFrEF) and nonalcoholic fatty liver disease (NAFLD) are two common comorbidities that share similar pathophysiological mechanisms. There is a growing interest in the potential of targeted therapies to improve outcomes in patients with coexisting HFrEF and NAFLD. This manuscript reviews current and potential therapies for patients with coexisting HFrEF and NAFLD. Pharmacological therapies, including angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, mineralocorticoids receptor antagonist, and sodium-glucose cotransporter-2 inhibitors, have been shown to reduce fibrosis and fat deposits in the liver. However, there are currently no data showing the beneficial effects of sacubitril/valsartan, ivabradine, hydralazine, isosorbide nitrates, digoxin, or beta blockers on NAFLD in patients with HFrEF. This study highlights the importance of considering HFrEF and NAFLD when developing treatment plans for patients with these comorbidities. Further research is needed in patients with coexisting HFrEF and NAFLD, with an emphasis on novel therapies and the importance of a multidisciplinary approach for managing these complex comorbidities.Revisión por pare

Therapies for patients with coexisting heart failure with reduced ejection fraction and non-alcoholic fatty liver disease

Heart failure with reduced ejection fraction (HFrEF) and nonalcoholic fatty liver disease (NAFLD) are two common comorbidities that share similar pathophysiological mechanisms. There is a growing interest in the potential of targeted therapies to improve outcomes in patients with coexisting HFrEF and NAFLD. This manuscript reviews current and potential therapies for patients with coexisting HFrEF and NAFLD. Pharmacological therapies, including angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, mineralocorticoids receptor antagonist, and sodium-glucose cotransporter-2 inhibitors, have been shown to reduce fibrosis and fat deposits in the liver. However, there are currently no data showing the beneficial effects of sacubitril/valsartan, ivabradine, hydralazine, isosorbide nitrates, digoxin, or beta blockers on NAFLD in patients with HFrEF. This study highlights the importance of considering HFrEF and NAFLD when developing treatment plans for patients with these comorbidities. Further research is needed in patients with coexisting HFrEF and NAFLD, with an emphasis on novel therapies and the importance of a multidisciplinary approach for managing these complex comorbidities

Hipotiroidismo congenito en población pediatrica hospitalizada en el Hospital Regional Honorio Delgado 2004 -2014

TesisAntecedente: Solo se realizó un estudio acerca de hipotiroidismo en el Hospital Regional Honorio Delgado en los años 1985-1994 que abarcó todos los rangos etarios, no específicamente la edad pediátrica. Objetivo: Determinar la frecuencia características clínicas del hipotiroidismo congénito de pacientes hospitalizados en el servicio de Pediatría del Hospital Regional Honorio Delgado. Métodos: Se realizó un estudio observacional, retrospectivo y transversal. Se revisaron historias clínicas de pacientes de 0 a 12 meses con diagnóstico de hipotiroidismo congénito desde 2004 hasta 2014. Se registraron antecedentes personales, familiares y patológicos; características clínicas, laboratoriales y tratamiento. Resultados: Se encontraron 16 pacientes, 10 de los cuales en los años 2013-2014 que representan 62% del total de los últimos 10 años; 13(81%) fue hipotiroidismo congénito, 2(13%) hipotiroidismo congénito probable, 1(6%) hipotiroidismo subclínico. La relación es 3:1 más frecuente en mujeres. Entre las características clínicas se encontraron: hipotonía (67%), constipación (53%), fontanela posterior agrandada (47%). La edad al diagnóstico fluctúa entre 13 días hasta los 11 meses, con una media de 3.6 y una mediana 1.6 meses. El 62% presentó talla baja. Los motivos de ingreso hospitalario más frecuentes: 44% bronconeumonía, 22% bronconeumonía más insuficiencia cardiaca. Conclusión: La edad al momento del diagnóstico es tardía entre 13 días hasta los 11 meses. Debido a su repercusión en el desarrollo neurológico y somático, es importante que se cumpla la ley de tamizaje neonatal y su manejo por personal especializado