Browsing by Author "Bonilla Bonilla, Diana Marcela"
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Item Actinomycosis: Mimicking Malignancies in Multiple Anatomical Sites—A Three-Patient Case Series(Multidisciplinary Digital Publishing Institute (MDPI), 2025-02-02) Montenegro, John Fernando; Correa Forero, Vanessa; Liscano, Yamil; Grueso Pineda, Andres; Bonilla Bonilla, Diana Marcela; Ruiz Jimenez, Paola AndreaBackground and Objectives: Actinomycosis is a rare chronic contagion caused by Actinomyces spp. known for its ability to mimic malignant processes across various anatomical locations. Its clinical presentation can often resemble malignancies, Mycobacterium tuberculosis infections, nocardiosis, fungal infections, or other granulomatous diseases. This case series presents three patients diagnosed with Actinomyces spp., highlighting the diagnostic challenges and diverse clinical manifestations of the disease. Materials and Methods: We reviewed the clinical course, diagnostic procedures, and treatment outcomes of three patients with confirmed Actinomyces spp. The first case involved a 51-year-old male with a history of rhabdomyosarcoma in remission who presented with dysphagia. Magnetic resonance imaging identified an irregularly enhancing mass in the tonsil, and subsequent tonsillectomy confirmed Actinomyces spp. The second patient, an 80-year-old female, presented with dysphagia and a sublingual mass initially suspected to be diffuse large B-cell non-Hodgkin lymphoma; however, a histopathological analysis confirmed Actinomyces spp. The third case involved a 72-year-old male with abdominal pain and an ulcerated gastric lesion, where subtotal gastrectomy and histopathological examination confirmed the diagnosis of Actinomyces spp. Results: These three cases highlight the ability of Actinomyces spp. to closely mimic malignant lesions, which significantly complicates the diagnostic process. Although personalized interventions were required for each patient, diagnoses were ultimately confirmed through histopathology. Despite these challenges, timely recognition and appropriate treatment were achieved, underscoring the need to consider Actinomyces spp. in the differential diagnosis of similar presentations. Conclusions: Actinomyces spp. remains a diagnostic challenge due to its ability to mimic a variety of malignant and contagion conditions. This case series emphasizes the need for a thorough histopathological examination and a high index of suspicion when encountering lesions with atypical presentations. Given the potential for misdiagnosis, awareness and consideration of Actinomyces spp. are crucial in the differential diagnosis of chronic contagion and mass lesions. Further studies are warranted to refine diagnostic and therapeutic approaches.Item Factores de riesgo de fibrilación auricular postoperatoria en cirugía de revascularización miocárdica: una experiencia de 15 años(Universidad Santiago de Cali, 2023) Bonilla Bonilla, Diana Marcela; Osorio Toro, Luis MiguelItem First case report of tumor lysis syndrome after third line systemic therapy with gemcitabine and pazopanib in a patient with lower extremity soft tissue sarcoma(AME Publishing Company, 2023-12-31) Benitez Escobar, Edith Norela; Galindes Casanova, Duvan Arley; Melo Burbano, Luis Álvaro; Bonilla Bonilla, Diana Marcela; Osorio Toro, Luis Miguel; Daza Arana, Jorge Enrique; Escobar Dávila, Santiago Leandro; Rivas Tafurt, Giovanna PatriciaBackground: Anaplastic lymphoma kinase (ALK) rearrangement generates an oncogenic ALK tyrosine kinase that activates numerous downstream signaling pathways, leading to increased cell proliferation and survival. About 5% of non-small cell lung cancer (NSCLC) patients are being diagnosed with tumor harboring ALK-positive. ALK rearrangement is an important molecular target for the treatment of NSCLC, and alectinib is a potent and highly selective second-generation ALK inhibitor. Alectinib as a neoadjuvant therapy has been reported in previous studies. However, cases of patients undergoing left total pulmonary resection after neoadjuvant therapy are rare. Case Description: In this report, a 52-year-old Asian woman’s chest computed tomography (CT) showed mass shadows in the left lung. Echinoderm microtubule-associated protein-like 4-ALK (EML4-ALK) fusion variant was detected by next-generation sequencing. We administered the targeted drug alectinib at 600 mg twice daily for two and a half months. Positron emission tomography (PET)-CT examination showed that the left lung mass and lymph nodes were significantly reduced. The tumor node metastasis (TNM) stage was reduced from cT4N2M0, IIIb to ycT2aN0M0, IB. Then she underwent thoracoscopic transthoracotomy of the left total lung. Oral alectinib therapy was continued after surgery, and the follow-up duration was one yearItem Oxaliplatin-Associated Takotsubo Cardiomyopathy in a Patient with Metastatic Gastric Cancer: A Case Report(2023-08-14) Osorio Toro, Luis Miguel; Bonilla Bonilla, Diana Marcela; Escobar Dávila, Santiago Leandro; Quintana Ospina, Jhon Herney; Melo Burbano, Luis Alvaro; Benitez Escobar, Edith Norela; Galindes Casanova, Duván Arley; Daza Arana, Jorge Enrique; Rivas Tafurt, Giovanna PatriciaWe present the case of a 64-year-old female with stage IV gastric adenocarcinoma, pulmonary, and abdominal wall metastases, and no history of cardiovascular disease. In palliative care, she received systemic cytotoxic treatment with fluorouracil, leucovorin, oxaliplatin, and docetaxel protocol, which was well tolerated over five cycles. During cycle 6, she presented with cardiovascular symptoms with hemodynamic consequences while receiving oxaliplatin injection without docetaxel or 5-fluorouracil. She was transferred to the emergency department and then to the intensive care unit. She developed no complications during the hospital stay and was discharged after 10 days with preserved systolic function and no structural changes at the myocardial level. The electrocardiogram, echocardiogram, cardiac catheterization, and magnetic resonance imaging findings indicated an oxaliplatin-associated Takotsubo syndrome. The immunochemistry analysis showed PD-L1 expression level TPS: 40% and the foundation one genomic profiling revealed high mutation load, microsatellite instability, and HER2 not found. The patient is currently asymptomatic and on pembrolizumab monotherapy with good tolerance and partial treatment response.Item Prevalence of Anti-SARS-CoV-2 Antibodies and Associated Factors Among Health Care Workers in Santiago De Cali, Colombia(Dove Medical Press Ltd, 2023-02-23) Osorio Toro, Luis Miguel; Bonilla Bonilla, Diana Marcela; Daza Arana, Jorge Enrique; Aristizábal, Juan Carlos; Ávila Valencia, Juan Carlos; Ramírez Marmolejo, RobertoPurpose: This study aims to determine the seroprevalence of coronavirus disease (COVID-19) among health care workers and describe the associated sociodemographic and labor features. Patients and Methods: An observational study with an analytical component was conducted at a clinic in Cali, Colombia. The sample size was 708 health workers and they were selected by stratified random sampling. A Bayesian analysis was developed to determine the raw and adjusted prevalence. A Poisson regression model was used to estimate the prevalence ratios. Results: Overall seroprevalence of COVID-19 among healthcare workers was 29%. Miscellaneous services workers, healthcare, and administrative workers, was 38%, 33%, and 32%, respectively. Factors related to seropositivity were having a contact with a COVID-19 patient for >120 minutes and being diagnosed with COVID-19 by laboratory tests. Conclusion: The present study shows a adjusted seroprevalence of 29% in health workers, indicating a high level of disease transmission and an increased risk of infection in this population group.Item Risk Factors for Postoperative Atrial Fibrillation in Myocardial Revascularization Surgery: A 15-Year Experience(MDPI, 2024) Bonilla Bonilla, Diana Marcela; Osorio Toro, Luis Miguel; Daza Arana, Jorge Enrique; Quintana Ospina, Jhon H.; Ávila Valencia, Juan Carlos; Lozada Ramos, HeilerBackground: Myocardial revascularization surgery (MRV) is a revascularization therapy for coronary artery disease aimed at improving survival conditions. Elderly patients with increased comorbidities undergoing MRV face challenges in preventing postoperative complications, including atrial fibrillation (AF), a common arrhythmia occurring in 40% of cases or even in 80% of cases if the procedure is combined with valve surgery. This study aimed to determine the risk factors associated with the appearance of postoperative AF (POAF) in patients undergoing isolated MRV. Methods: This is an epidemiological, retrospective, and analytical case–control study (90 cases and 360 controls). Results: Mortality within the group of patients who presented with POAF in the study population was 15.5%, and 9.44% in the control group. Logistic regression showed an association of AF with the presurgical variables age >60 years and urgent/emergency surgery and the postsurgical variables cardiogenic shock, blood transfusion, pulmonary edema, pleural effusion, orotracheal reintubation, and mechanical ventilation time. Conclusions: Strategies should be proposed for the timely identification of risk factors and postoperative complications related to AF onset to avoid the increased morbidity and mortality associated with this type of arrhythmia during the postoperative period.Item Varicella pneumonia in an immunocompetent adult patient: Case report and review of the literature(W.B. Saunders Ltd, 2024) Arias Osorio, Carlos Felipe; Lozada Ramos, Heiler; Daza Arana, Jorge Enrique; Osorio Toro, Luis Miguel; Bonilla Bonilla, Diana MarcelaVaricella is a childhood disease characterized by its self-limiting and benign nature. However, it can also affect the adult population due to risk factors, leading to infection with numerous complications involving the central nervous system, kidneys, respiratory system, and skin. Varicella pneumonia, one of the most feared complications in adults, occurs in approximately 1 out of 400 patients with the disease. This complication primarily affects male patients with a history of heavy smoking and immunosuppression, either due to an underlying disease such as HIV and cancer, drug use, pregnancy or pulmonary disease. It is recommended that this complication should be treated with intravenous acyclovir at a dose of 10 mg/kg/8 hours. The prognosis depends on the development of respiratory failure; up to 50 % of patients with this complication require invasive mechanical ventilation. Here, we report the clinical case of an immunocompetent patient with a typical presentation of varicella that rapidly progressed to a respiratory infection requiring antiviral treatment and invasive mechanical ventilation.