ABSTRACT
BACKGROUND: Following lung transplantation (LT), receiving immunosuppressive therapy is crucial. Tacrolimus is considered a drug with a narrow therapeutic range and its use requires constant monitoring. This study aimed to evaluate the correlation between tacrolimus levels obtained from central venous catheter and direct venipuncture in adult patients undergoing LT. METHODS: This prospective study included LT patients hospitalized in conventional ward carrying a central catheter through which no intravenous tacrolimus was administered. Trough samples were obtained through direct puncture and from the central catheter. Pearson correlation coefficient was calculated to quantify the mean difference between the 2 measures. RESULTS: A total of 54 sample pairs from 16 LT patients were obtained, mostly male (81.3%) and bilateral transplant recipients (93.8%); the transplant procedure was the primary reason for admission (81.3%). The difference in tacrolimus levels between both samples was 0.3 (0.1-0.6) mcg/L, with the measurement for the samples obtained through venipuncture being mostly higher than that for those obtained from the catheter. A strong correlation was observed between the tacrolimus levels in the samples obtained from the catheter and through venipuncture (Pearson correlation coefficient, 0.991; P < 0.001; R2 = 0.982). CONCLUSIONS: There is an excellent correlation between tacrolimus levels obtained from venipuncture and those obtained from central venous catheter in LT patients undergoing oral tacrolimus therapy.
ABSTRACT
Introducción: el cáncer pancreático tiene el peor pronóstico entre los tumores malignos con solo 5 por ciento de supervivencia a los cinco años de diagnosticados los pacientes. Su diagnóstico, generalmente tardío, se hace cuando la enfermedad está avanzada o cuando hay metástasis.Objetivo: caracterizar los enfermos con diagnóstico histológico de cáncer de páncreas estadios III y IV, en los que se aplicó como técnica para toma de la muestra la biopsia por tru-cut.Método: se realizó un estudio descriptivo a 11 enfermos con cáncer pancreático estadios III y IV cuya confirmación histológica se logró mediante la biopsia por tru-cut en el Hospital General Provincial Docente de Ciego de Ávila en el período enero-diciembre de 2017. Las variables estudiadas fueron: edad, sexo, localización topográfica, factores de riesgo, histología, complicaciones y supervivencia.Resultados: predominaron el grupo de edades de 66-81 años (45,45 por ciento), el sexo masculino (63,64 por ciento), la localización en la cabeza (54,55 por ciento), y el tabaquismo (21,74 por ciento) como factor de riesgo. El adenocarcinoma bien diferenciado (36,36 por ciento) fue la neoplasia dominante. La supervivencia después de siete meses fue elevada (90,90 por ciento), y su rango mayor fue 10-12 meses. Las complicaciones fueron mínimas y no graves.Conclusiones: se caracterizó a los en enfermos diagnosticados de cáncer pancreático estadios III y IV según las variables a estudiar. En el curso de la investigación se mostró la sobrevida alcanzada en ellos dado a las posibilidades terapéuticas oncoespecíficas propiciadas por el estudio histológico, logrado mediante la biopsia por tru-cut(AU)
Introduction: pancreatic cancer has the worst prognosis among malignant tumors with only 5 percent survival after five years of diagnosed patients. The diagnosis, usually late, is carried out when the disease is advanced or when there is metastasis.Objective: to characterize the patients with histological diagnosis of stages III and IV pancreatic cancer, in which the tru-cut biopsy was applied as a technique for taking the sample.Method: a descriptive study was carried out on 11 patients with stages III and IV pancreatic cancer whose histological confirmation was achieved by means of the tru-cut biopsy in the General Provincial Teaching Hospital of Ciego de Ávila in the period January-December 2017. The variables studied were: age, sex, topographic location, risk factors, histology, complications and survival.Results: the age group of 66-81 years (45,45 percent), the male sex (63,64 percent), the location in the head (54,55 percent), and smoking (21,74 percent) as a risk factor prevailed. Survival after seven months was high (90,90 percent), and its highest range was 10-12 months. The complications were minimal and not serious. Conclusions: patients diagnosed with pancreatic cancer stages III and IV were characterized according to the variables to be studied. In the course of the investigation, the survival achieved in them was shown given the onco-specific therapeutic possibilities fostered by the histological study, achieved by means of a tru-cut biopsy(AU)
Subject(s)
Humans , Male , Female , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/epidemiology , Biopsy, Large-Core Needle , Pancreatic Neoplasms , Pancreatic Neoplasms/diagnosis , Epidemiology, Descriptive , SurvivalABSTRACT
Introducción: la hemorragia digestiva alta es una emergencia médica y quirúrgica que continúa teniendo una elevada morbilidad a pesar de los avances terapéuticos de los últimos años.Objetivo: describir las características clínicas y epidemiológicas de la hemorragia digestiva alta en los adultos mayores de 60 años ingresados durante el trienio 2012-2014.Método: se realizó un estudio observacional, descriptivo transversal en el Hospital General Provincial Docente de Ciego de Ávila.Resultados: predominaron el grupo de edades de 60 a 74 años y el sexo masculino. Las causas de hemorragia más frecuentes fueron: la úlcera gástrica, la gastritis erosiva y la úlcera péptica duodenal, y el tratamiento médico fue el más utilizado. La mortalidad fue mayor en los pacientes que recibieron tratamiento quirúrgico, la hipovolemia y el fallo multiorgánico fueron las principales causas de muerte. La mayor mortalidad se presentó en el grupo de más 75 años y en el sexo femenino.Conclusiones: la hemorragia digestiva alta constituye un problema de salud en el adulto mayor de 60 años y más de edad, sobre todo antes de los 74 años y en el sexo masculino. Las úlceras gástrica y duodenal, y la gastritis erosiva fueron las causas más frecuentes. El tratamiento médico resolvió el sangrado en la mayoría de los casos y la mortalidad fue superior en los ancianos intervenidos de forma quirúrgica(AU)
Introduction: upper gastrointestinal bleeding is a medical and surgical emergency that continues having high morbidity despite the therapeutic advances of the last years.Objective: to describe the clinical and epidemiological characteristics of upper gastrointestinal bleeding in adults over 60 years admitted during the triennium 2012-2014.Method: an observational, cross-sectional descriptive study was conducted at the General Provincial Teaching Hospital of Ciego de Ávila.Results: the age group of 60 to 74 years and the male sex predominated. The most frequent causes of hemorrhage were: gastric ulcer, erosive gastritis and duodenal peptic ulcer, and medical treatment was the most used. Mortality was higher in patients who received surgical treatment, hypovolemia and multiorgan failure were the main causes of death. The highest mortality occurred in the group over 75 years old and in the female sex.Conclusions: the upper digestive hemorrhage constitutes a health problem in the adult over 60 years of age and older, especially before 74 years of age and in the male sex. Gastric and duodenal ulcers, and erosive gastritis were the most frequent causes. Medical treatment resolved bleeding in most cases and mortality was higher in the surgically treated elderly(AU)
