Browsing by Author "Osorio Toro, Luis Miguel"
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Item Abdominal aortic aneurysm associated with chronic disseminated intravascular coagulation: A rare complication | [Aneurisma aórtico abdominal asociado a coagulación intravascular diseminada crónica: Una complicación rara](2021) Bedoya Joaqui,Vanessa; Casanova Valderrama,María; Ocampo Chaparro,José Mauricio; Osorio Toro, Luis MiguelDisseminated intravascular coagulation is a systemic process characterized by the widespread activation of coagulation with the potential for causing vascular thrombosis, hemorrhage and organ failure. Rarely, vascular anomalies like abdominal aor-tic aneurysm can trigger chronic disseminated intravascular coagulation. Large aortic aneurysms, dissection and expansion are risk factors. In these cases, subclinical symptoms predominate and coagulopathy is only identified by laboratory tests. Nowadays there is limited evidence based on experience from case series of chronic disseminated intravascular coagulation as complication in patients with abdominal aortic aneurysm. Furthermore, duration and therapeutic response with heparin therapy are not well known, mainly in those patients with conservative management. It is considered a diagnostic and therapeutic challenge due to the low presentation frequency. The clinical characteristics, laboratory and treatment of a patient with abdominal aortic aneurysm associated with chronic disseminated intravascular coagulation are described below.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 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 Late-onset Sheehan’s syndrome: a major diagnostic challenge—a case report(BioMed Central Ltd, 2025-02-26) Osorio Toro, Luis Miguel; Ordoñez Guzman, Yessica Alejandra; Montenegro Palacios, Jhon Fernando; Quintana Ospina, Jhon Herney; Pacichana Abadia, Julian Andres; Daza Arana, Jorge Enrique; Escobar Vargas, Hector Fabio; Restrepo Erazo, Katherine; García Ramos, Andrés FelipeBackground Sheehan’s syndrome is a form of maternal hypopituitarism resulting from excessive blood loss during or after childbirth. This extensive bleeding may reduce blood flow to the pituitary gland, causing pituitary cell damage and death (necrosis). The incidence of Sheehan’s syndrome has decreased in developed countries, whereas in developing countries, it remains a substantial cause of morbidity and mortality among at-risk populations. Case presentation We describe the case of a 59-year-old patient of mestizo ethnicity, with an unusual presentation of Sheehan’s syndrome 38 years after postpartum hemorrhage that affected hormone secretion at the adenohypophysis. During hospitalization, central adrenal insufficiency, low free thyroxine levels, decreased pituitary gland size, hypogonadotropic hypogonadism, and growth hormone deficiency were noted. The patient was treated with hydrocortisone and levothyroxine, with satisfactory clinical progress and improvement in her quality of life.Item 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 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.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 Semaglutide Effects on Metabolic Outcomes in Diabetes Mellitus Patients — Real World Study(Dove Medical Press Ltd, 2024) Balcázar Valencia, Carlos Mario; García Ramos, Andrés Felipe; Osorio Toro, Luis Miguel; Ordoñez Guzmán, Yessica Alejandra; Buitrago Gómez, Nathalia; Cabarcas López, William Fernando; Vizcaino Guerrero, Carlos Javier; Daza Arana, Jorge Enrique; Ramírez Rincón, Alex; Restrepo Erazo, KatherinePurpose: Diabetes is a public health problem that requires strategies to impact glycemic control and reduce the risk of long-term medical complications. Pharmacological management is a necessary treatment for this disease. Therefore, semaglutide is an essential tool to achieve the treatment targets. The present study aimed to evaluate the semaglutide effects on a cohort with type 2 diabetes mellitus (T2DM) in Colombia. Materials and Methods: The cohort included 49 patients with T2DM that have been treated in a specialized care center. Their glycemic outcomes, weight, renal function, and adverse events were evaluated through a 3-, 6-and 12-month follow-up. Results: Significant differences were observed in the outcome evaluation: reduction of glycated hemoglobin levels (MD −2.74 CI −1.95 to −3.52 in 6 months), fasting plasma glucose levels, body weight (MD −7.11 CI −5.97 to −8.24), and the albumin-to-creatinine ratio. The results were maintained throughout the treatment period. The adverse event rate was 16.3%, predominating gastrointestinal events. Conclusion: This real-world evidence shows the efficacy of semaglutide in achieving treatment goals in patients with T2DM.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.