15 research outputs found

    Hipertensión arterial resistente en paciente obeso y diabético tipo 2

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    We present a case of a 56-year-old man with central obesity and resistant arterial hypertension refractory to quadruple therapy who, in his study, shows a cyclical alternation between periods of normal adrenal function with periods of hypercortisolism compatible with the diagnosis of cyclic Cushing's syndrome. This case report shows periodical hormone test is recommended in patients where Cushing syndrome is suspected. This practice allows to identify this disease, many times under diagnosed. Presentamos el caso de un varón de 56 años con obesidad central e hipertensión arterial resistente refractaria a cuádruple terapia que, en su estudio, muestra una alternancia cíclica entre períodos de normofunción suprarrenal con períodos de hipercortisolismo, compatible con el diagnóstico de síndrome de Cushing cíclico. Este caso pone de manifiesto que es recomendable realizar determinaciones analíticas hormonales periódicas durante el seguimiento de pacientes con alta sospecha clínica de síndrome de Cushing, para descartar esta entidad muchas veces infradiagnosticada

    Mielolipoma suprarrenal atípico en paciente con hipertensión arterial resistente

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    Adrenal myelolipoma is a slow-growing tumour, composed of fatty tissue and haematopoietic elements, typically non-secretory, although a low percentage is associated with endocrine pathology. We present the case of a 35-year-old man who, during the study of resistant arterial hypertension, was diagnosed with a large adrenal incidentaloma with an image congruent with adrenal myelolipoma, whose analytical determinations were anodyne, suggesting a non-functioning adenoma. After surgical resection, the anatomopathological study of the mass revealed pheochromocytoma cells, which produce catecholamines and are responsible for the patient's high blood pressure resistance.El mielolipoma suprarrenal es un tumor de lento crecimiento, compuesto por tejido graso y elementos hematopoyéticos, típicamente no secretor, aunque un bajo porcentaje asocia coexistencia con patología endócrina. Presentamos el caso de un varón de 35 años al que, durante el estudio de hipertensión arterial resistente, se le diagnostica de incidentaloma suprarrenal de gran tamaño con imagen congruente con mielolipoma suprarrenal, cuyas determinaciones analíticas eran anodinas sugiriendo un adenoma no funcionante. Tras la resección quirúrgica, el estudio anatomopatológico de dicha masa reveló células de feocromocitoma, productor de catecolaminas, que condiciona la resistencia de la hipertensión arterial del paciente

    Diurnal Triglyceridemia in Relation to Alcohol Intake in Men

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    __Abstract__ Fasting and postprandial triglyceride concentrations largely depend on dietary and lifestyle factors. Alcohol intake is associated with triglycerides, but the effect of alcohol on diurnal triglyceridemia in a free living situation is unknown. During three days, 139 men (range: 18-80 years) measured their own capillary triglyceride (cTG) concentrations daily on six fixed time-points before and after meals, and the total daily alcohol intake was recorded. The impact of daily alcohol intake (none; low, 30 g/day) on diurnal triglyceridemia was analyzed by the incremental area under the cTG curve (∆cTG-AUC) reflecting the mean of the six different time-points. Fasting cTG were similar between the alcohol groups, but a trend of increased cTG was observed in men with moderate and high alcohol intake after dinner and at bedtime (p for trend <0.001) which persisted after adjustment for age, smoking and body mass index. The ∆cTG-AUC was significantly lower in males with low alcohol intake (3.0 ± 1.9 mmol·h/L) (n = 27) compared to males with no (7.0 ± 1.8 mmol·h/L) (n = 34), moderate (6.5 ± 1.8 mmol·h/L) (n = 54) or high alcohol intake (7.2 ± 2.2 mmol·h/L) (n = 24), when adjusted for age, smoking and body mass index (adjusted p value < 0.05). In males, low alcohol intake was associated with decreased diurnal triglyceridemia, whereas moderate and high alcohol intake was associated with increased triglycerides after dinner and at bed time

    Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

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    Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

    A retrospective analysis of incidence and severity of COVID-19 among hypertensive patients: the other side

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    Objective The role of hypertension in COVID-19 has not been clearly elucidated yet. The aim of this study was to evaluate the incidence and severity of COVID-19 in a hypertensive population and assess whether there is a link between blood pressure control and SARS-CoV-2 infection outcomes. Methods This was a single-center retrospective observational study that evaluated the incidence and severity of COVID-19 in a chronic hypertensive population (n=1,637) from a specialized consultation of Hypertension and Cardiovascular Risk of Internal Medicine in a tertiary hospital in Madrid (Spain). Results A total of 147 COVID-19 patients (9%) were found, with a median age of 59 (±14) years, where 77 (52.4%) patients were male. Forty patients required hospitalization (27.2%), 15 patients had severe COVID-19 (10.2%), and 6 patients died (4.1%). Among the causes of hypertension, 104 (70.7%) patients had essential hypertension and 22 (15%) patients presented primary hyperaldosteronism; and 66 (44.9%) patients presented RH. Severe COVID-19 was associated with age over 65 years (crude OR 4.43 [95% CI 1.3–14.2; p = .012]) and diabetes mellitus (crude OR 4.15 [95% CI 1.3–12.9; p = .014]). Conclusion This study showed a lower rate of incidence, hospitalization, and severity of COVID-19 in the hypertensive population

    Métodos y mediciones

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    Actitud y conducta hacia la salud oral en estudiantes de la comuna de AraucoAn&aacute;lisis de instrumentos de registro odontol&oacute;gicos en la red de APS de la Regi&oacute;n MetropolitanaAn&aacute;lisis de la eficiencia relativa del Hospital de Cabildo mediante la aplicaci&oacute;n del an&aacute;lisis de fronteraAn&aacute;lisis de letalidad intrahospitalaria y acumulada a 30 d&iacute;as de eventos IAM, 2003-2007An&aacute;lisis del programa de c&aacute;ncer cervicouterino en Chile con metodolog&iacute;a de marco l&oacute;gicoA&ntilde;os de vida perdidos por muerte prematura: efecto de diferentes criterios de correcci&oacute;n de subregistrosCalidad global de la alimentaci&oacute;n de mujeres asistidas por el sistema de salud p&uacute;blico chilenoCarga de mortalidad para el estado de R&iacute;o de Janeiro, BrasilCausas de extracciones permanentes en adultos atendidos en la Posta Central, ChileComparaci&oacute;n del consumo de drogas en escolares hombres utilizando metodolog&iacute;a de pares y cuestionario autoregistradoCuidado hospitalario de pacientes con accidente cerebrovascular isqu&eacute;mico atendidos bajo r&eacute;gimen GESDescripci&oacute;n de dimensiones del constructo de calidad de vida en ni&ntilde;os de 2-5 a&ntilde;osDistribuci&oacute;n de benzodiacepinas en establecimientos del SNSS, per&iacute;odo 2006-2008Evaluaci&oacute;n de calidad, implementaci&oacute;n del control odontol&oacute;gico del ni&ntilde;o sano en CAP'S, Regi&oacute;n del MauleEvaluaci&oacute;n de la satisfacci&oacute;n del usuario interno de la Unidad de Cuidados B&aacute;sicos del Hospital MetropolitanoEvaluaci&oacute;n del protocolo de referencia de cefalea tensional y migra&ntilde;a en consultorio Llay-LlayEvaluaci&oacute;n econ&oacute;mica del Programa de Fluoraci&oacute;n del Agua en ChileFactores de riesgo de enfermedad hipertensiva del embarazo en la UCI del H.G EcatepecImpacto de reforma sanitaria en autorizaciones sanitarias y de desempe&ntilde;o en instalaciones de radiodiagn&oacute;stico dentalInstitucionalidad de la investigaci&oacute;n en salud p&uacute;blica en ChileLetalidad intrahospitalaria y a 30 d&iacute;as de los eventos de accidente cerebrovascular isqu&eacute;mico en ChileLimitaciones y desaf&iacute;os de la investigaci&oacute;n en salud p&uacute;blica en ChileMejora de agudeza visual y utilizaci&oacute;n cirug&iacute;a de segundo ojo en pacientes con cataratas GESMortalidad infantil en la Regi&oacute;n Metropolitana II del Estado de R&iacute;o de Janeiro, 1981-2008Mortalidad por c&aacute;ncer de tiroides en Chile en el per&iacute;odo 1985-2007Mortalidad por tumores cerebrales en poblaci&oacute;n infantil y adolescente, ciudad R&iacute;o de Janeiro, 1980-2007Mortalidad por tumores del sistema nervioso central en adultos, R&iacute;o de Janeiro, 1980 a 2007Prevalencia de anemia ferropriva en una muestra representativa de beneficiarios del PNACPrevalencia de caries y fluorosis previo a la fluoruraci&oacute;n del agua potable en TemucoPrevalencia de traumatismos dentoalveolares en ni&ntilde;os del Hospital Dr. S&oacute;tero del R&iacute;o, enero-junio 2010Propuesta de un indicador de la calidad para los centros de salud familiarSalud p&uacute;blica y la emergencia del dispositivo cl&iacute;nico en la modernidad nacionalSatisfacci&oacute;n de funcionalidad familiar en adolescentes entre 12 y 18 a&ntilde;os consumidores de drogasValidaci&oacute;n cualitativa del cuestionario ASAQ para la determinaci&oacute;n de la conducta sedentaria en escolare

    Métodos y mediciones

    Get PDF
    Actitud y conducta hacia la salud oral en estudiantes de la comuna de AraucoAn&aacute;lisis de instrumentos de registro odontol&oacute;gicos en la red de APS de la Regi&oacute;n MetropolitanaAn&aacute;lisis de la eficiencia relativa del Hospital de Cabildo mediante la aplicaci&oacute;n del an&aacute;lisis de fronteraAn&aacute;lisis de letalidad intrahospitalaria y acumulada a 30 d&iacute;as de eventos IAM, 2003-2007An&aacute;lisis del programa de c&aacute;ncer cervicouterino en Chile con metodolog&iacute;a de marco l&oacute;gicoA&ntilde;os de vida perdidos por muerte prematura: efecto de diferentes criterios de correcci&oacute;n de subregistrosCalidad global de la alimentaci&oacute;n de mujeres asistidas por el sistema de salud p&uacute;blico chilenoCarga de mortalidad para el estado de R&iacute;o de Janeiro, BrasilCausas de extracciones permanentes en adultos atendidos en la Posta Central, ChileComparaci&oacute;n del consumo de drogas en escolares hombres utilizando metodolog&iacute;a de pares y cuestionario autoregistradoCuidado hospitalario de pacientes con accidente cerebrovascular isqu&eacute;mico atendidos bajo r&eacute;gimen GESDescripci&oacute;n de dimensiones del constructo de calidad de vida en ni&ntilde;os de 2-5 a&ntilde;osDistribuci&oacute;n de benzodiacepinas en establecimientos del SNSS, per&iacute;odo 2006-2008Evaluaci&oacute;n de calidad, implementaci&oacute;n del control odontol&oacute;gico del ni&ntilde;o sano en CAP'S, Regi&oacute;n del MauleEvaluaci&oacute;n de la satisfacci&oacute;n del usuario interno de la Unidad de Cuidados B&aacute;sicos del Hospital MetropolitanoEvaluaci&oacute;n del protocolo de referencia de cefalea tensional y migra&ntilde;a en consultorio Llay-LlayEvaluaci&oacute;n econ&oacute;mica del Programa de Fluoraci&oacute;n del Agua en ChileFactores de riesgo de enfermedad hipertensiva del embarazo en la UCI del H.G EcatepecImpacto de reforma sanitaria en autorizaciones sanitarias y de desempe&ntilde;o en instalaciones de radiodiagn&oacute;stico dentalInstitucionalidad de la investigaci&oacute;n en salud p&uacute;blica en ChileLetalidad intrahospitalaria y a 30 d&iacute;as de los eventos de accidente cerebrovascular isqu&eacute;mico en ChileLimitaciones y desaf&iacute;os de la investigaci&oacute;n en salud p&uacute;blica en ChileMejora de agudeza visual y utilizaci&oacute;n cirug&iacute;a de segundo ojo en pacientes con cataratas GESMortalidad infantil en la Regi&oacute;n Metropolitana II del Estado de R&iacute;o de Janeiro, 1981-2008Mortalidad por c&aacute;ncer de tiroides en Chile en el per&iacute;odo 1985-2007Mortalidad por tumores cerebrales en poblaci&oacute;n infantil y adolescente, ciudad R&iacute;o de Janeiro, 1980-2007Mortalidad por tumores del sistema nervioso central en adultos, R&iacute;o de Janeiro, 1980 a 2007Prevalencia de anemia ferropriva en una muestra representativa de beneficiarios del PNACPrevalencia de caries y fluorosis previo a la fluoruraci&oacute;n del agua potable en TemucoPrevalencia de traumatismos dentoalveolares en ni&ntilde;os del Hospital Dr. S&oacute;tero del R&iacute;o, enero-junio 2010Propuesta de un indicador de la calidad para los centros de salud familiarSalud p&uacute;blica y la emergencia del dispositivo cl&iacute;nico en la modernidad nacionalSatisfacci&oacute;n de funcionalidad familiar en adolescentes entre 12 y 18 a&ntilde;os consumidores de drogasValidaci&oacute;n cualitativa del cuestionario ASAQ para la determinaci&oacute;n de la conducta sedentaria en escolare
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