Introduction Systemic lupus erythematosus is an autoimmune disease with multi-organ involvement. Complications, such as invasive fungal infections usually occur in patients with a greater severity of the disease. Objective The objective of this study was to determine the prevalence and risk variables associated with invasive fungal infections in a Colombian systemic lupus erythematosus population. Materials and methods A cross-sectional, retrospective study that evaluated patients with systemic lupus erythematosus for six years. The primary outcome was invasive fungal infection. Descriptive, group comparison and bivariate analysis was performed using Stata 12.0 software. Results Two hundred patients were included in this study; 84.5% of the patients were women and the median age was 36 years; 68% of the subjects had haematological complications; 53.3% had nephropathy; 45% had pneumopathy and 28% had pericardial impairment; 7.5% of patients had invasive fungal infections and the most frequently isolated fungus was Candida albicans. Pericardial disease, cyclophosphamide use, high disease activity, elevated ESR, C3 hypocomplementemia, anaemia and lymphopenia had a significant association with invasive fungal infection ( P < 0.05). Conclusions We describe for the first time the prevalence of invasive fungal infection in a Colombian population with systemic lupus erythematosus, which was higher than that reported in other latitudes. In this population the increase in disease activity, the presence of pericardial impairment and laboratory alterations (anaemia, lymphopenia, increased ESR and C3 hypocomplementemia) are associated with a greater possibility of invasive fungal infections. Regarding the use of drugs, unlike other studies, in the Colombian population an association was found only with the previous administration of cyclophosphamide. In addition, patients with invasive fungal infections and systemic lupus erythematosus had a higher prevalence of mortality and hospital readmission compared with patients with systemic lupus erythematosus without invasive fungal infection.
INTRODUCTION: Frailty predicts functional decline and could be associated with adverse outcomes such as disability, multiple hospitalizations, falls, loss of mobility, and cardiovascular disease. In Colombia 12.5% of prevalence has been reported. In the present study, the different clinical variables associated with frailty were evaluated in a population of hospitalized patients older than 65 years in Bucaramanga, Colombia, in order to predict the behavior of these variables to generate measurement tools of greater applicability than that of currently existing tools. METHODS: An analytical observational cross-sectional study with nonprobabilistic sampling was conducted from January 2016 to June 2017 in patients older than 65 years of follow-up > 48 hours by the internal medicine service. Fried criteria were used to evaluate patients on their last day of hospitalization. RESULTS: A total of 155 patients were included, of whom 60.6% were frail. A combined analysis of the variables that showed association with frailty revealed that a calf circumference lower than or equal to 31 cm, a gait speed lower than or equal to 0.8 m/s, and age above 75 years were associated with frailty. It was also shown that being male and having a BMI > 27 kg/m2 are protective factors for frailty. CONCLUSIONS: The prevalence of frailty in hospitalized older adults was higher than that reported in local studies for the community population. According to multivariate analysis, the variables, when analyzed together, have a predictive ability of 92% to estimate frailty in hospitalized patients.
Características clínicas y sociodemográficas de pacientes con diabetes tipo 1 en un Hospital Universitario de Colombia Resumen ANTECEDENTES: La diabetes mellitus tipo 1 es una enfermedad autoinmunitaria causada por la interacción de múltiples factores ambientales y genéticos que conducen a la destrucción autoinmunitaria de células B pancreáticas productoras de insulina. La incidencia y prevalencia de la diabetes mellitus tipo 1 varían considerablemente en todo el mundo. OBJETIVO: Establecer las características clínicas y sociodemográficas de los pacientes con diabetes mellitus tipo 1. MATERIAL Y MÉTODO: Estudio descriptivo de corte transversal y retrospectivo en el que se incluyeron pacientes con diabetes tipo 1 que ingresaron a un hospital universitario de Colombia en el periodo comprendido entre 2012 y 2016. Posteriormente se realizó análisis estadístico según las variables. RESULTADOS: La prevalencia intrahospitalaria de la diabetes mellitus tipo 1 fue de 19 casos por cada 100,000 pacientes mayores de 13 años. Fue más frecuente en mujeres con 61.3%, la edad promedio al diagnóstico fue de 14.89 años. El diagnóstico se estableció de forma clínica sin estudios de autoinmunidad, se trataba de pacientes con enfermedad no controlada con HbA1c promedio de 11.5%, las complicaciones más frecuentes fueron la cetoacidosis diabética con 46.6%, al igual que la hipoglucemia. La insulina más frecuentemente prescrita en este grupo de pacientes fue glargina, glulisina y e insulina regular. CONCLUSIÓN: Los hallazgos sugieren que algunas características de la diabetes mellitus tipo 1 podrían ser similares y algunas diferentes a lo reportado en otros estudios; sin embargo, pueden plantearse algunas posibles investigaciones tomando estos resultados como base.
Introducción: a pesar del amplio estudio de la Diabetes Mellitus, no existen en Colombia estudios recientes que busquen medir la prevalencia y su asociación con eventos cardiovasculares. Objetivo: determinar la prevalencia de Diabetes Mellitus y la asociación de niveles de hemoglobina glicosilada con eventos cardiovasculares, en el Hospital Universitario de Santander. Materiales y método: estudio observacional analítico retrospectivo con pacientes del servicio de medicina interna del Hospital Universitario de Santander en el año 2013. Resultados: la prevalencia de diabetes fue 31,2% (HbA1c≥6,5%), de estos, el 70,45% recibían tratamiento farmacológico y 52,2% eran mujeres. Ningún evento cardiovascular se asoció con bajo control metabólico, siendo el infarto agudo del miocardio (10,9%) el evento más frecuente. Se encontró que mayores de 65 años tenían 6 veces más probabilidad de sufrir un evento cerebrovascular (OR 6.29; IC95%: 1.71-23; p=0,006) a pesar de que sus niveles de hemoglobina HbA1c fuesen menores al 9%(p=0,002). Entre los pacientes con HbA1c >9%, el 62,02% recibían ≤4 dosis/día de medicamentos (p=0,000), con una prevalencia alta de muerte intrahospitalaria (88%) siendo el OR de 2,08 (IC95%: 0,85-5,1; p=0,107). Algunas variables contribuyeron a un modelo de predicción de control metabólico (AROC 0.67) y otras al modelo de predicción de muerte intrahospitalaria (AROC 0.7). Conclusiones: existe asociación significativa de riesgo entre niveles de HbA1c >9%, antecedente de enfermedad cerebrovascular y tabaquismo para desenlace de muerte intrahospitalaria. No se encontró relación entre pobre control metabólico y los eventos cardiovasculares a estudio.
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