Browsing by Author "Melo Burbano, Luis Álvaro"
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Item Autoimmune Hemolytic Anemia Caused by Cold Agglutinin Antibodies in Systemic Lupus erythematosus—a Rare Association: Case Report(Dove Medical Press Ltd, 2023-09-04) Osorio Toro, Luis Miguel; Quintana Ospina, Jhon Herney; Melo Burbano, Luis Álvaro; Ruiz Jiménez, Paola Andrea; Daza Arana, Jorge Enrique; Rivas Tafurt, Giovanna Patricia; Izquierdo Loaiza, Jorge HernánAutoimmune hemolytic anemias (AIHAs) are rare and heterogeneous disorders characterized by the destruction of redblood cells by warm or cold antibodies. Hemolytic anemia associated with warm antibodies is the most common, whereas coldantibodies are rare and infrequent in cases published in the scientific literature. Herein, we present the case of a young patient withsystemic lupus erythematosus (SLE) and autoimmune hemolytic anemia caused by cold antibodies. Initially, infectious etiology andhematological malignancy were considered, which were ruled out. She required management in the intensive care unit due to severehematological involvement and responded well to immunomodulatory therapy. This case illustrates the importance of a strong clinicalsuspicion of AIHA due to cold agglutinins associated with SLE when faced with similar clinical symptoms in order to achieve a timelydiagnosis and provide optimal therapy.Item Desenlaces clínicos del reparo mitral percutáneo con dispositivo mitraclip®. Estudio mitra-angio-cdo.(Universidad Santiago de Cali, 2023) Melo Burbano, Luis ÁlvaroItem 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 Frequency of antibiotic prescribing in adults hospitalized for SARS-CoV-2 in a high complexity institution in Santiago de Cali, Colombia(Asociacion Colombiana de Infectologia, 2023-04-23) Melo Burbano, Luis Álvaro; Galindes Casanova, Duván Arley; Benitez Escobar, Edith Norela; Assis Reveiz, Jorge Karim; Daza Arana, Jorge Enrique; Oñate Gutiérrez, José MillánObjective: To determine the frequency of antibiotic use and to know which clinical and socio-demographic variables were related to the probability of suffering infections associated with COVID-19.Methods: Adults hospitalized for COVID-19 who received one or more antibiotics during hospitalization were evaluated. We performed a descriptive analysis of variables in the general population' bivariate analysis in two groups (documented vs. presumed infection) and multivariate logistic regression of factors associated with mortality.Results: We determined that 60.4% of adults hospitalized for COVID-19, received antibiotics. Co-infection was documented in 6.2% and superinfection in 23.3%. Gram-negative germs were reported in 75.8% of cultures, fungi in 17.8% and gram-positive in 14.2%. Variables such as age, comorbidities, ICU, anemia, steroids, mechanical ventilation, hemofiltration were statistically significantly related to documented infection. High-flow cannula was associated as a protective factor. Overall mortality was 43.9%, 57.8% in the first group and 38.1% in the second (p=0.002).Item Frequent Cardiovascular Manifestations Associated With SARS Cov-2 Infection: Experience at a Tertiary Hospital In Cali, Colombia(Sociedade Brasileira de Cardiologia, 2023-11-17) Galindes Casanova, Duvan Arley; Benitez Escobar, Edith Norela; Melo Burbano, Luis Álvaro; Murillo Benitez, Nelson Eduardo; Avila Valencia, Juan Carlos; Daza Arana, Jorge EnriqueBackground: Coronavirus disease 2019 (COVID-19) mainly affects the respiratory system, while the most common extrapulmonary complication of COVID-19 is cardiovascular involvement. Objective: To identify the frequency of electrocardiographic changes and cardiac arrhythmias in patients hospitalized with COVID-19 infection. Methods: This was a cross-sectional study, including patients aged >18 years with diagnosis of severe acute respiratory syndrome coronavirus 2 infection in a high-complexity hospital in Santiago de Cali, Colombia, from March to September 2020. A descriptive analysis with an analytical component and multiple logistic regression analysis were performed; all estimates were established with a 95% confidence level (CI) and a 5% significance level. Results: This study included 183 individuals; of whom 160 were considered for electrocardiographic analysis, 63% of which evidenced significant findings, the most frequent being sinus tachycardia (29.4%). The frequency of myocardial injury was 21.9% and was more common among non-survivors than among survivors (41.7% vs. 12.2%, p < 0.001). Myocardial injury was also significantly more common in patients who presented electrocardiographic findings than those who did not (26.5% vs. 12.1%, p = 0.032) and in those who required intensive care admission (31.8% vs 10.5%, p < 0.001). The strongest mortality-associated factor was the need for mechanical ventilation — odds ratio (OR), 9.14; 95% confidence interval, 3.4–24.5.Item Postoperative Empyema Due to Leclercia adecarboxylata Following Mesothelioma Surgery: A Case Report(Multidisciplinary Digital Publishing Institute (MDPI), 2025-01-30) Montenegro, John Fernando; Diaz Diaz, Miguel Ángel; Vidal Cañas, Sinthia; Urriago, Gustavo; Correa, Vanessa; Melo Burbano, Luis Álvaro; Liscano, YamilBackground/Objectives: Leclercia adecarboxylata (L. adecarboxylata) is a rare opportunistic pathogen that can cause severe infections like empyema, particularly in immunocompromised individuals. We aim to highlight the importance of the early detection and personalized treatment of L. adecarboxylata infections in patients with comorbidities such as malignant mesothelioma. Methods: We present the case of a 57-year-old man with type 2 diabetes mellitus, hypertension, and malignant mesothelioma who developed a parapneumonic effusion that progressed to empyema. After undergoing pleurectomy and pleurodesis, intraoperative cultures identified L. adecarboxylata. Targeted antibiotic therapy was initiated based on the culture results, and the patient’s response was closely monitored. Results: The patient responded well to targeted antibiotic therapy with ampicillin/sulbactam following the initial empirical treatment with piperacillin/tazobactam. The identification of L. adecarboxylata—a rare finding in empyema cases—was crucial for effective management. The patient recovered fully without complications, highlighting the importance of the early identification and individualized treatment of infections caused by rare pathogens. Conclusions: This case underscores the need to consider L. adecarboxylata in immunocompromised patients presenting with unusual infections. Early detection through advanced diagnostic techniques and personalized antibiotic therapy can improve clinical outcomes and help prevent antimicrobial resistance. Increased clinical awareness and further research into the resistance patterns and treatment approaches for L. adecarboxylata are essential to enhance patient care.Item Pulmonary Thromboembolism in Pregnancy: A Case Report and Literature Review(Dove Medical Press Ltd, 2023-06-03) Urriago Osorio, Gustavo Andrés; Melo Burbano, Luis Álvaro; Van Den Berghe, Juanita López; Muñoz Córdoba, Angela María; Daza Arana, Jorge Enrique; Contreras Zúñiga, EduardoData on the optimal diagnostic management of pregnant women with suspected pulmonary embolism are limited. Despite a lack of compelling evidence in some practices, clinical practice guidelines focus on the management of these patients. We present the case of a 24-year-old patient at 36 weeks of pregnancy in whom pulmonary thromboembolism (PTE) was diagnosed in a timely manner also with hemodynamic instability and echocardiographic images with clear involvement of the right cavities. She received thrombolytic therapy with alteplase 100 mg intravenously over 2 hours, which resulted in excellent outcomes for both the pregnant woman and fetus. Understanding the acute approach and management of these patients will improve our clinical practice; therefore, we reviewed a case report of a pregnant patient with high-risk PTE and compared it with current evidence. In conclusion, PE is a common disease with a high mortality rate during pregnancy. Therefore, having made a timely diagnosis using the relevant diagnostic aids and performing thrombolysis with rtPA increase the probability of survival in our patient, leading to successful results for both her and the fetus.Item Report of Henoch-Schönlein purpura associated with trastuzumab emtansine(ecancer Global Foundation, 2024) Escobar Dávila, Santiago Leandro; Rivas Tafurt, Giovanna Patricia; Melo Burbano, Luis Álvaro; Osorio Toro, Luis Miguel; Benítez Escobar, Edith Norela; Galindes Casanova, Duván Arley; Izquierdo Loaiza, Jorge Hernán; Cárdenas Perilla, Rodrigo Andrés; Orozco De la Hoz, CarlosVasculitides are a set of pathologies that can affect one or several organs, in the short and long term. They are associated with various etiologies, among which paraneoplastic syndromes and medications stand out. Although everyday cancer therapies are more directed against a therapeutic target, their use can cause a wide spectrum of complications. Some treatments against human epidermal growth factor 2 (HER2) have been associated with cutaneous and pulmonary vasculitis. We present the first case of Henoch-Schönlein purpura associated with the use of T-DM1 in a patient with HER2 breast cancer.