RESUMENIntroducción: la aspergilosis pulmonar crónica es una patología infrecuente, su prevalencia aumenta en asociación con alteraciones estructurales, esto resalta la importancia de su conocimiento teniendo en cuenta la elevada incidencia de tuberculosis en Colombia. Por el carácter angioinvasivo del hongo la posibilidad de desarrollar hemoptisis es alta, pudiendo llegar a comprometer la vida de quien la padece. Objetivo: estudiar la forma de presentación y abordaje diagnóstico de la aspergilosis y su asociación con secuelas de tuberculosis pulmonar. Presentación de caso: se presenta el caso de un paciente masculino de 44 años, con secuelas pulmonares por tuberculosis, que requirió hospitalización por hemoptisis recurrente; con hallazgos imagenológicos sugestivos de aspergilosis pulmonar, requirió estabilización clínica, embolización arterial selectiva y resección de la lesión. Conclusión: la aspergilosis es una enfermedad inusual y se requiere de la integración de aspectos clínicos e imagenológicos representativos para hacer un diagnóstico acertado. Hemoptysis related to chronic cavitary aspergillosis of the lung: case reportABSTRACT Introduction: the chronic pulmonary aspergillosis is an uncommon condition, its prevalence increases in association with structural alterations, this highlights the importance of its knowledge bearing in mind the high incident of tuberculosis in Colombia. for the angioinvasive behavior of the fungus, the possibility of developing hemoptysis is high even life threatening. Objective: to study the form of presentation and diagnostic approach of the aspergilosis and his association with sequels of pulmonary tuberculosis. Case Report: we present a case of a 44-year-old masculine patient, with pulmonary sequels for tuberculosis who required hospitalization because of recurring hemoptysis; some imagenologic findings were found suggesting of pulmonary aspergillosis, he required clinical stabilization, selective arterial embolization and finally resection of the lesion. Conclusion: the aspergillosis is an unusual disease and requires integration of non-accurate clinical aspects and some representative imagenologic findings to make a proper diagnostic. MÉD.UIS. 2017;30(1):79-86.
Introduction: Postoperative nausea and vomiting are frequent adverse effects of anesthesia and surgery. Impact is greater in pediatric populations compared to adults and the reported incidences are heterogeneous. Objective: To describe the incidence of postoperative vomiting in a pediatric population and to identify associated risk factors. Materials and methods: This prospective cohort study included 190 children aged 3 to 12 years undergoing surgery and anesthesia in a maternal and child health clinic in Bucaramanga (Colombia). The main outcome variable was postoperative vomiting. Data were analyzed using bivariate, multivariate analysis and logistic regression to assess the associated risk factors. Results: The overall incidence of postoperative vomiting was 18.95% (95% CI: 13.32 - 24.57), with a higher incidence at home vs. hospital (12.63% vs. 9.47%). After adjustment, associated risk factors were anesthesia time longer than 45 minutes (OR: 2.33; 95% CI: 1.10-4.90) and postoperative use of opioids (OR: 4.17; 95% IC: 1.65-10.5). The incidence of postoperative vomiting was higher in patients who underwent emergency surgery. Conclusion: This is the first study in Colombia that evaluates the incidence of postoperative vomiting in children. The incidence in our pediatric population is within the ranges reported worldwide. Associated risk factors were anesthesia time longer than 45 minutes and postoperative use of opioids. Further research is required in order to study emergency surgery as a potential risk factor.
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