No abstract
Objective: Characterize clinically and epidemiologically patients with von Willebrand disease and abnormal uterine bleeding. Methods: A cross-sectional descriptive observational study was carried out. The study population was women with a diagnosis of von Willebrand’s disease who consulted in a highly complex institution in the city of Medellín. The analysis was carried out through the SPSS V 24 program. Results: 70 patients were included, 50 of these were discarded because they did not present abnormal uterine bleeding or had other diagnoses that could intervene in the characterization as antiphospholipid syndrome. The median age of the included patients was 19.5 years (Min: 11, Max: 52). 9 patients (60%) used contraceptive methods, the reported methods were combined oral contraceptives (26.7%), intrauterine devices (20%) and surgical methods (13.3%). Regarding the clinical characterization, it was found that the most frequent manifestations were the presence of bruises 40% (8) and epistaxis 40% (8). Most of the patients, 65% (13) had not received treatment for abnormal uterine bleeding. Laboratory tests showed the following: hemoglobin 13 g/dL (6.6 - 15.7), hematocrit 37.5% (20.3 - 46.1), platelets 279,000 cells/mm3 (106,000 - 393,000), von Willebrand factor plasma antigen 68.5 IU (19.7 - 205), von Willebrand factor plasma activity 44 IU (23 - 126). Conclusion: Abnormal uterine hemorrhage is a frequent manifestation in women with von Willebrand disease and can present at different stages of life, despite its diagnosis, women do not receive management of this clinical manifestation until their consultation with gynecology. Key words: von Willebrand Diseases, von Willebrand Factor, Abnormal uterine bleeding, Metrorrhagia.
ANTECEDENTES: La cateterización intravascular es un procedimiento para insertar un catéter en el espacio endoluminal, con el fin de administrar fluidos, fármacos o determinar constantes fisiológicas.OBJETIVO: Identificar los factores asociados con la mortalidad en recién nacidos con un catéter central en tres instituciones de alto nivel de complejidad de Medellín, Colombia.MATERIALES Y MÉTODOS: Estudio observacional, analítico, de cohorte retrospectiva llevado a cabo en neonatos a quienes se colocó un catéter central venoso o arterial en la unidad de cuidados intensivos. Fuente de información: historias clínicas. Se estimaron las frecuencias absolutas y relativas para resumir las variables cualitativas y cuantitativas: se resumieron con mediana y rango intercuartílico. Para determinar qué variables se asociaban con la muerte se estimaron pruebas de c2 y RR con IC95%.RESULTADOS: Se incluyeron 149 neonatos: 56 (37.6%) de sexo femenino y 93 del masculino (62.4%). La principal forma de parto fue vértice espontáneo para 78 (52.3%) neonatos y 84 (56.4%) prematuros. En cuanto a peso adecuado para la edad gestacional lo tuvieron 107 (71.8%) y 32 (21.5%) fallecieron durante la atención. La cromosomopatía y la hipertensión pulmonar se relacionaron con incremento en la mortalidad.CONCLUSIÓN: Se lograron determinar las principales características clínicas de los pacientes a quienes se instaló un catéter intravascular, que concuerdan con lo descrito en la bibliografía y permiten tener mayor certeza, de manera anticipada, respecto de los neonatos que podrán requerir este tipo de intervenciones.
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