ABSTRACT
Resumen La porfiria intermitente aguda (PIA) es una enfermedad poco frecuente, considerada huérfana, que se caracteriza por crisis neuroviscerales, el dolor abdominal siendo su síntoma más común, acompañado en muchos casos, de síntomas inespecíficos, haciendo difícil su diagnóstico temprano. El retraso en el diagnóstico y tratamiento de esta entidad puede resultar catastrófico o incluso fatal, provocando daño neurológico a largo plazo o permanente. Reportamos el caso de un adulto joven que consulta en varias ocasiones por dolor abdominal inespecífico y 24 horas después de la admisión desarrolla inestabilidad autonómica simpática con cifras tensionales elevadas y taquicardia. Posteriormente debilidad muscular que evoluciona hasta cuadriplejia e hiponatremia con criterios para secreción inadecuada de hormona antidiurética (SIADH). Estos datos, junto con coloración rojiza en orina, llevan al diagnóstico de porfiria. Presentamos las características clínicas y bioquímicas enfatizando la importancia de incluir la porfiria dentro de los diagnósticos diferenciales de dolor abdominal y disautonomia de causa indeterminada. (Acta Med Colomb 2017; 42: 140-143).
Abstract Acute intermittent porphyria (AIP) is an infrequent and considered orphan disease, characterized by neurovisceral crisis, being abdominal pain the most common symptom, accompanied in many cases by non-specific symptoms, making early diagnosis difficult. The delay in the diagnosis and treatment of this entity can be catastrophic or even fatal, causing long-term or permanent neurological damage. The case of a young adult who attends medical consultation several times for non-specific abdominal pain and 24 hours after admission develops sympathetic autonomic instability with elevated blood pressure and tachycardia is presented. He subsequently presents muscular weakness that evolves to quadriplegia and hyponatremia with criteria for inadequate secretion of antidiuretic hormone (SIADH). These data together with reddish urine staining lead to the diagnosis of porphyria. The clinical and biochemical characteristics emphasizing the importance of including porphyria within the differential diagnoses of abdominal pain and dysautonomia of indeterminate cause are presented. (Acta Med Colomb 2017; 42: 140-143).
Subject(s)
Humans , Male , Adult , Porphyrias , Quadriplegia , Porphyria, Acute Intermittent , Primary Dysautonomias , Inappropriate ADH SyndromeABSTRACT
Objective: Determine the epidemiological behavior of the Urinary Tract Infections and thechanges in sensibility and antibiotic resistance of Escherichia coli in the Hospital Universidaddel Norte, Soledad, Atlántico. January 2005 to december 2006.Materials and methods: There was realized a descriptive study of retrospective type,with a sample of 537 cultures of the patients who consult at Hospital Universidad delNorte. The cultures were evaluated across the colonies forming units (CFU) and then theantibiograms reports were analyzed, annotating the information for resistance, antibioticsensibility and evaluating the epidemiological behavior of the principal antibiotics used inthe clinical practice at this institution.Results: The percentage distribution of Urinary Tract Infection f (UTI) found in 2005in women: 72.9 percent, men: 27.1 percent, and in 2006, women: 73.8 percent, men: 26.2 percent. The mostfrecuent microorganisms in 2005 were Escherichia coli (66.24 percent), Klebsiella (10.63 percent) andfor 2006: Escherichia coli (85 percent), Proteus (5.29 percent). The major rates of antibiotic resistanceof the Escherichia coli in 2005 was: ampicilina, trimetoprim sulfa and ciprofloxacina. In2006 the behavior was similar, but decrease is observed in the resistance to fluoroquinolonas;the major rates of sensibility in 2005 include nitrofurantoína, ampicilina/sulbactam andaminoglucosidos in relation to 2006, in which decrease is observed in the sensibility to thefirst and the second one.Conclusion: The percentage distribution shows that UTI is more frequent in women. Thecausal microorganism of most of UTIs cases is Escherichia coli. Decrease was demonstrated inthe rates of resistance to ampicilina, trimetoprim sulfametaxol, first generation cefalosporinesand ciprofloxacina in 2006 with relation to 2005.
Subject(s)
Humans , Male , Female , Escherichia coli , Urinary Tract Infections , Klebsiella , Proteus , Sensitivity and Specificity , Urinary Tract , Bacteriuria , Environmental Monitoring , UrethraABSTRACT
There is presented the case of a feminine patient twenty one years old, which presents bledby external genitalia of fifteen (15) days of evolution, that deserved transvaginal ultrasoundscan, where is demonstrated retained abortion, that makes necessary uterine curetage. Shepersists with the bled, which is associated to pancitopenia thats why is decided bony marrowbiopsia fundamentally being situated hipocelularidad. The aplastic anemia during pregnancyis a rare event associated with a high morbidity and mortality mother and foetal.
Subject(s)
Female , Pregnancy , Anemia , Anemia, Aplastic , Pregnancy , Abortion, Missed , Morbidity , Fetal Mortality , Maternal MortalityABSTRACT
Se estudiaron 42 recién nacidos normales de ambos sexos y diferentes edades gestacionales (rango: 26 a 41 semanas) entre las 24 y 48 horas de vida con el propósito de evaluar la velocidad de filtración glomerular y la excreción renal de agua y electrolitos. La depuración de creatinina se relacionó directamente con edad gestacional (r:0.67). La excreción fraccional de sodio se relacionó inversamente con la edad gestacional (r: - 0.84). No hubo correlación entre excreción urinaria de potasio y edad gestacional, pero se encontró correlación inversa entre esta última y los niveles de potasio plasmático (r: - 0.67). El volumen urinario y la excreción de agua libre presentaron una correlación inversa con la edad gestacional (r: - 0.83 y r: - 0.54). Las diferencias encontradas entre el grupo de recién nacidos de término y pretérmino para estos parámetros reflejan fundamentalmente diferencias en el gradiente madurativo funcional renal, aunque a las 24 horas de vida factores hemodinámicos postnatales pudieran influenciar estos resultados