ABSTRACT
Background: There is a lack of epidemiological data around heart failure (HF) in Latin America; the potential impact description of this disease in middle-income countries is relevant. Objective: This study aimed to describe the characteristics and healthcare resource utilization patterns of HF patients at baseline and six-month follow-up. Methods: This retrospective observational study used data from the RECOLFACA (Registro Colombiano de Falla Cardíaca) registry, which includes data obtained from the examination of clinical records from 2,528 patients in 60 Colombian healthcare institutions. Baseline and six-month follow-up data were evaluated from patients with previous hospital admissions due to HF during the 12 months prior to enrollment. Results: This study analyzed 2,045 patients (42.8% female) with a mean age of 67.71 ± 13.64 years. The most common etiologies were ischemic (44.4%) and hypertensive heart disease (38.5%). At baseline, 53.4% of patients were classified with NYHA class II, and 73.6% had a reduced left ventricle ejection fraction (LVEF). A year prior to entering the registry, patients were hospitalized an average of 1.4 ± 1.1 times due to HF. Prescription of evidence-based treatment at baseline included sacubitril/valsartan (10%), ACEI (33%), ARB (41%), beta-blocker (79%), diuretics (68%), and MRA (56%). The average quality of life score measured using the EQ-5D-3L questionnaire was 78.7 ± 20.8 at baseline and 82.3 ± 20.1 at the six-month follow-up. The mortality rate was 6.7%. Conclusions: The use of information from the RECOLFACA registry allowed characterization as well as analyses of healthcare resource utilization of patients with heart failure in Colombia. The results of this study show that multiple evidence-based treatments for HF are being widely used in Colombia, but there seems to be room for improvement regarding some interventions for the treatment of patients with HF.
Subject(s)
Angiotensin Receptor Antagonists , Heart Failure , Aged , Aged, 80 and over , Aminobutyrates , Angiotensin Receptor Antagonists/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/adverse effects , Biphenyl Compounds , Female , Heart Failure/diagnosis , Heart Failure/epidemiology , Heart Failure/therapy , Humans , Male , Middle Aged , Quality of Life , Registries , Stroke Volume , Treatment OutcomeABSTRACT
OBJECTIVE: The purpose of this study was to establish a new approach to improve detection of deafness due to rubella. METHODS: Colombian institutes for the deaf were visited by a medical team to perform in all enrolled individuals an ophthalmological examination with emphasis in fundus eye by a retina specialist. In cases where ocular alterations compatible with CRS were found, a medical interview by a clinical geneticist analyzing pre-and postnatal history and a thorough medical examination was done. RESULTS: A total of 1383 deaf institutionalized individuals were evaluated in 9 Colombian cities in the period of 2005 to 2006, finding a total of 463 positive cases for salt-and-pepper retinopathy (33.5%), in which rubella could be the etiology of deafness. Medellin, Cartagena, Bucaramanga and Barranquilla were the cities with the highest percentage of Congenital rubella, corresponding to 22.8% of analyzed population. The analysis performed on cases in which reliable prenatal history was obtained in a second appointment (n=88) showed association between positive viral symptoms during pregnancy and salt-and-pepper retinopathy in 62.5% of cases, while both (retinopathy and viral symptoms) were absent in 29.5% of cases; showing a correlation in 92% of cases. CONCLUSIONS: The frequency of deafness by rubella obtained by this study is significantly high compared with previous Colombian studies and with international reports. It was possible to correlate the antecedent of symptoms during pregnancy with the presence of salt-and-pepper retinopathy in this deaf population when reliable prenatal history was available, therefore eye testing with emphasis in fundus examination is a good indicator of rubella induced deafness. We propose a new approach in the search of deafness causes, based on a thorough ophthalmologic examination in all deaf people.
Subject(s)
Deafness/etiology , Pregnancy Complications, Infectious/diagnosis , Retinal Diseases/diagnosis , Retinal Diseases/epidemiology , Rubella Syndrome, Congenital/complications , Colombia/epidemiology , Cross-Sectional Studies , Deafness/congenital , Deafness/epidemiology , Developing Countries , Early Diagnosis , Female , Fundus Oculi , Humans , Incidence , Male , Ophthalmoscopy/methods , Predictive Value of Tests , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Risk Assessment , Rubella Syndrome, Congenital/diagnosis , Rubella Syndrome, Congenital/epidemiologyABSTRACT
Introducción. La retinoschisis juvenil ligada a X se caracteriza por la escisión de la fóvea; afecta a los varones y es transmitida por mujeres portadoras. Se realizó la genotipificación en 90 mujeres de la mutación 639delG con el fin de determinar el estado de ser portadoras o de no serlo. Metodología. Previa firma del consentimiento informado, se extrajo el ADN en 90 mujeres y se identificó la mutación 639delG por PCRRFLP. Resultados. Se identificó la mutación 639delG en 55 mujeres (61,1% portadoras) y no se identificó en 35 (38,9% no portadoras). Conclusiones. Se logró establecer que 55 mujeres de esta familia (61,1%) eran portadoras, número mayor al calculado previamente como necesariamente portadoras. Gracias al diagnóstico molecular es posible ofrecer una asesoría genética completa y precisa. Con estos resultados ya es posible pasar a la segunda fase del trabajo en el que se estudiarán las manifestaciones clínicas de las mujeres portadoras.
Subject(s)
Humans , DNA , Macular Degeneration , Fovea CentralisABSTRACT
Los autores analizan varios métodos de autoinjerto, usados para el tratamiento quirúrgico del vitiligo. Las técnicas principales emplean respectivamente ampollas por succión, injertos por sacabocado, injertospor dermatomo y empleo de folículos pilosos. Los autores hacen énfasis en este último y describen sus técnicas las cuales se basan sobre procedimientos empleados originalmente para transplante de pelos
Subject(s)
General Surgery , Technology Assessment, Biomedical , Transplantation, Autologous , Treatment Outcome , Vitiligo , Dermatology , VenezuelaABSTRACT
El epitelioma basocelular tiene origen en las células basales, aunque actualmente se considere que es anexial. Estos son tumores malignos localizados, sin adenopatía o metástasis y de evolución lenta. Se presenta el caso de un paciente de 54 años con lesión papuloeritematosa en la punta de la nariz de 127 años de evolución que fue aumentando de tamaño hasta llegar a ulcerarse. se realizan estudios histológicos para descartar diferentes patologías que pudiesen producir el mismo cuadro clínico, y se llegó al diagnóstico de Ulcus Rodens clínico y patológico. Se presenta este cuadro clínico, por lo poco frecuente que es ver este tipo de lesiones y acentuar que un diagnóstico precoz hubiese evitado esta evaluación
