RESUMO
Resumen OBJETIVO: Comparar la capacidad predictiva de mioglobina, creatincinasa total y hemoglobina en orina de lesión renal aguda en pacientes con traumatismo. MATERIAL Y MÉTODO: Estudio transversal, analítico, comparativo, observacional, en el que se identificaron todos los pacientes mayores de 18 años con diagnóstico de traumatismo o politraumatismo, provenientes del servicio de urgencias, de agosto de 2017 a enero de 2018 en el Hospital General Xoco de la Secretaría de Salud de la Ciudad de México, se midieron: mioglobina, creatincinasa total, concentraciones de creatinina y hemoglobina en orina a su ingreso. RESULTADOS: Se incluyeron 24 pacientes de 20 a 79 años de edad, con predominio del género masculino. Al comparar las áreas bajo la curva de las pruebas se determinó que no hubo significación estadística (p = 0.266) para la creatincinasa de ingreso porque mostró un área bajo la curva de 0.636, el intervalo de confianza al 95% se encontró por debajo de 0.500. Asimismo, la mioglobina de ingreso se observó en un área bajo la curva de 0.657 (p = 0.198; IC 95% 0.423-0.891). CONCLUSIONES: Las concentraciones de creatincinasa total y mioglobina no demostraron ser predictores adecuados de lesión renal al no haber diferencia significativa; sin embargo, se encontró que las concentraciones de creatinina al ingreso tienen mayor capacidad predictiva de lesión renal aguda en pacientes con traumatismo e hiperCKemia.
Abstract OBJECTIVE: To compare the predictive capacity of myoglobin, total creatine kinase and urine hemoglobin for acute renal injury in patients with trauma. MATERIAL AND METHOD: A cross-sectional, analytical, comparative, observational study was made with all adults over 18 years of age with a diagnosis of trauma or polytraumatism from August 2017 to January 2018 in the General Hospital of Xoco, Mexico City. Myoglobin, total creatine kinase, creatinine and hemoglobin levels were measured in urine at their admission. RESULTS: There were studied 24 patients from 20 to 79 years old, with a predominance of the male gender. When comparing the areas under the test curve it was determined that there was no statistical significance (p = 0.266) for the creatine kinase at the patient's admission, as it showed an area under the curve of 0.636, the 95% confidence interval was below 0.500. Likewise, the myoglobin at the patient's admission was observed under the curve area of 0.657 (p = 0.198; IC 95% 0.423-0.891). CONCLUSIONS: Levels of total creatine kinase and myoglobin did not prove to be adequate predictors of kidney injury because there was no significant difference. However, creatinine levels at admission have greater predictive capacity of acute renal injury in patients with trauma and hyperCKemia.
RESUMO
INTRODUCTION: The major risk factors for stroke are obesity, diabetes mellitus, systemic arterial hypertension (SAH) and dyslipidemia. In 1994 leptin was identifies as adipokine produced by adipose tissue. Its main action is the regulation of energy balance. Currently, hyperleptinemia is associated with cardiovascular disease. OBJECTIVE: To determine the association between serum leptin and stroke in patients with SAH. METHODS: We determined serum leptin in subjects with stroke and SAH, and compared this with patients with SAH without stroke. We calculated Student t, χ², and odds ratio (OR) for quantitative and qualitative variables. RESULTS: 60 subjects were recruited, 30 subjects per group. Considering a value>3.93 ng/ml as hyperleptinemia, it also was found a t=2.8 (p=0.007), and χ² with one degree of freedom of 10.82 (p=0.001), obtaining an OR of 3.05 for the development of stroke in the presence of elevated leptin (95% CI: 0.9-9.6; p=0.05). CONCLUSIONS: Hyperleptinemia is more common in patients with stroke than in those without this condition. But the question remains whether hyperleptinemia is a stroke risk factor or protective factor.
