Variación negativa de índice de masa corporal como factor asociado a multidrogoresistencia en tuberculosis pulmonar.

Objetivo: Demostrar si la variación negativa de índice de masa corporal es factor asociado a multidrogoresistencia en tuberculosis pulmonar en el Hospital Belén de Trujillo. Material y Métodos: Se llevó a cabo un estudio de tipo analítico, observacional, retrospectivo, de cohortes. La población de estudio estuvo constituida por 176 pacientes adultos; la cual fué dividida en 2 grupos: con variación negativa o sin variación negativa del índice de masa corporal; se calculó el riesgo relativo y la prueba Chi cuadrado. Resultados: No se registraron diferencias significativas respecto a las variables edad, género y procedencia entre los grupos de estudio (p>0.05). La frecuencia de multidrogoresistencia en pacientes con tuberculosis pulmonar y variación negativa de índice de masa corporal fue de 16%. La frecuencia de multidrogoresistencia en pacientes con tuberculosis pulmonar sin variación negativa de índice de masa corporal fue de 7%. La variación negativa de índice de masa corporal es factor asociado a multidrogoresistencia en pacientes con tuberculosis pulmonar con un riesgo relativo de 2.33 el cual fue significativo (p<0.05). Conclusiones: La variación negativa de índice de masa corporal es factor asociado a multidrogoresistencia en tuberculosis pulmonar en el Hospital Belén de Trujillo.Objective: To demonstrate if the negative variation in body mass index is a factor associated with multidrug resistance in pulmonary tuberculosis at Hospital Belen de Trujillo. Material and Methods: An analytical, observational, retrospective, cohort study was conducted. The study population consisted of 176 adult patients; which were divided into 2 groups: with negative variance or without negative variation of body mass index; the relative risk and chi-square test were calculated. Results: There were no significant differences regarding the variables age, gender and origin between the study groups (p>0.05). The frequency of multidrug resistance in patients with pulmonary tuberculosis and negative variation in BMI was 16%. The frequency of multidrug resistance in patients with pulmonary tuberculosis with no negative variation in BMI was 7%. The negative variation in body mass index is a factor associated with multidrug resistance in patients with pulmonary tuberculosis with a relative risk of 2.33 which was significant (p <0.05). Conclusions: The negative variation in body mass index is a factor associated with multidrug resistance in pulmonary tuberculosis at Hospital Belen de Trujillo.Tesi

Variación negativa de índice de masa corporal como factor asociado a multidrogoresistencia en tuberculosis pulmonar

Objetivo: Demostrar si la variación negativa de índice de masa corporal es factor asociado a multidrogoresistencia en tuberculosis pulmonar en el Hospital Belén de Trujillo. Material y Métodos: Se llevó a cabo un estudio de tipo analítico, observacional, retrospectivo, de cohortes. La población de estudio estuvo constituida por 176 pacientes adultos; la cual fué dividida en 2 grupos: con variación negativa o sin variación negativa del índice de masa corporal; se calculó el riesgo relativo y la prueba Chi cuadrado. Resultados: No se registraron diferencias significativas respecto a las variables edad, género y procedencia entre los grupos de estudio (p>0.05). La frecuencia de multidrogoresistencia en pacientes con tuberculosis pulmonar y variación negativa de índice de masa corporal fue de 16%. La frecuencia de multidrogoresistencia en pacientes con tuberculosis pulmonar sin variación negativa de índice de masa corporal fue de 7%. La variación negativa de índice de masa corporal es factor asociado a multidrogoresistencia en pacientes con tuberculosis pulmonar con un riesgo relativo de 2.33 el cual fue significativo (p<0.05). Conclusiones: La variación negativa de índice de masa corporal es factor asociado a multidrogoresistencia en tuberculosis pulmonar en el Hospital Belén de Trujillo.Objective: To demonstrate if the negative variation in body mass index is a factor associated with multidrug resistance in pulmonary tuberculosis at Hospital Belen de Trujillo. Material and Methods: An analytical, observational, retrospective, cohort study was conducted. The study population consisted of 176 adult patients; which were divided into 2 groups: with negative variance or without negative variation of body mass index; the relative risk and chi-square test were calculated. Results: There were no significant differences regarding the variables age, gender and origin between the study groups (p>0.05). The frequency of multidrug resistance in patients with pulmonary tuberculosis and negative variation in BMI was 16%. The frequency of multidrug resistance in patients with pulmonary tuberculosis with no negative variation in BMI was 7%. The negative variation in body mass index is a factor associated with multidrug resistance in patients with pulmonary tuberculosis with a relative risk of 2.33 which was significant (p <0.05). Conclusions: The negative variation in body mass index is a factor associated with multidrug resistance in pulmonary tuberculosis at Hospital Belen de Trujillo.Tesi

Cor triatriatum sinister, reporte de un caso

We report a case of cor triatriatum sinister associated with anomalous pulmonary venous drainage in an adult patient who presented with palpitations, lower limb edema, dyspnea, orthopnea, bendopnea and ascites. The clinical picture began with episodes of atrial fibrillation, associated with rehospitalizations for right heart failure, so angiotomography and transesophageal echography were requested, which led to the final diagnosis. The surgical approach was performed by total excision of the multifenestrating fibromuscular septum and double valvular plasty, due to severe mitral and tricuspid insufficiency, which improved the patient’s clinical condition. The importance of considering this acyanotic congenital heart disease within the differential diagnosis of the causes of right heart failure originating in the left atrium is recognized.Se reporta un caso de cor triatriatum sinister asociado a drenaje venoso pulmonar anómalo, en paciente adulto que debutó con palpitaciones, edema de miembros inferiores, disnea, posteriormente ortopnea, bendopnea y ascitis. El cuadro clínico se inició con episodios de fibrilación auricular, asociado a rehospitalizaciones por falla cardiaca derecha, por lo que se solicitó angiotomografía y ecografía transesofágica que dieron con el diagnostico final. El abordaje quirúrgico se realizó mediante exéresis total del septum fibromuscular multifenestrado y doble plastia valvular, debido a que presentaba insuficiencia mitral y tricuspidea severas; lo que mejoró la condición clínica del paciente. Se reconoce la importancia de considerar dentro del diagnóstico diferencial de las causas de insuficiencia cardiaca derecha originadas en el atrio izquierdo a esta cardiopatía congénita acianótica

Aortic valve replacement through minithoracotomy. Results from the Peruvian experience

Objectives. To assess mortality, major valve-related events (MAVRE), and other complications in the perioperative period and follow up in patients with aortic valve replacement (AVR) through minithoracotomy (MT). Methods. We retrospectively analyzed patients aged &lt;80 who underwent AVR through MT between January 2017 and December 2021 in a national reference center in Lima, Peru. Patients undergoing other surgical approaches (mini-sternotomy, etc.), other concomitant cardiac procedures, redo, and emergency surgeries were excluded. We measured the variables (MAVRE, mortality, and other clinical variables) at 30 days and a mean follow-up of 12 months. Results. Fifty-four patients were studied, the median age was 69.5 years, and 65% were women. Aortic valve (AV) stenosis was the main indication for surgery (65%), and bicuspid AV represented 55.6% of cases. At 30-days, MAVRE occurred in two patients (3.7%), with no in-hospital mortality. One patient had an intraoperative ischemic stroke, and one required a permanent pacemaker. No patient underwent reoperation due to prosthesis dysfunction or endocarditis. In a mean follow-up of one year, MAVRE occurrence did not show variations with the perioperative period, most patients remained in NYHA I (90.7%) or II (7.4%) compared to the preoperative period (p&lt;0.001). Conclusions. AV replacement through MT is a safe procedure in our center for patients under 80 years.Objectives. To assess mortality, major valve-related events (MAVRE), and other complications in the perioperative period and follow up in patients with aortic valve replacement (AVR) through minithoracotomy (MT). Methods. We retrospectively analyzed patients aged &lt;80 who underwent AVR through MT between January 2017 and December 2021 in a national reference center in Lima, Peru. Patients undergoing other surgical approaches (mini-sternotomy, etc.), other concomitant cardiac procedures, redo, and emergency surgeries were excluded. We measured the variables (MAVRE, mortality, and other clinical variables) at 30 days and a mean follow-up of 12 months. Results. Fifty-four patients were studied, the median age was 69.5 years, and 65% were women. Aortic valve (AV) stenosis was the main indication for surgery (65%), and bicuspid AV represented 55.6% of cases. At 30-days, MAVRE occurred in two patients (3.7%), with no in-hospital mortality. One patient had an intraoperative ischemic stroke, and one required a permanent pacemaker. No patient underwent reoperation due to prosthesis dysfunction or endocarditis. In a mean follow-up of one year, MAVRE occurrence did not show variations with the perioperative period, most patients remained in NYHA I (90.7%) or II (7.4%) compared to the preoperative period (p&lt;0.001). Conclusions. AV replacement through MT is a safe procedure in our center for patients under 80 years