Medicina - Palmira

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https://repositorio.usc.edu.co/handle/20.500.12421/6056

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Perfil socioeconómico de los estudiantes admitidos al programa de medicina de la Universidad Santiago de Cali durante el período académico 2022-A y 2022-B
(Universidad Santiago de Cali, 2023) González Parra, Alejandra; Rivas Delbasto, Valentina; Rojas Gutiérrez, Daniela; Arana Domínguez, Johan Daniel (Director)
Síndrome de Leriche. Complicaciones de una enfermedad arterial periférica subdiagnosticada: reporte de caso
(Universidad Santiago de Cali, 2023) Altamirano Jiménez, Vivian Nicole; Andrade Cifuentes, Ana Valentina; Sánchez Correa, Mauren Julieth; Sánchez Ospina, Sara Daniela; Rodríguez Bayona, Fernando (Director)
Leriche Syndrome, an often underdiagnosed aorto-iliac occlusive disease characterized by complete arterial flow occlusion at the abdominal aorta and/or its bifurcation, requires diagnosis based on a comprehensive clinical history, physical examination, and angiotomography as the gold standard. A case is presented of a 48-year-old female patient with multiple risk factors whose clinical presentation began with lower limb pain, paresthesia, intermittent claudication, and absent lower limb pulses, ultimately requiring amputation of the left fifth toe; despite the clear clinical picture, the definitive diagnosis was delayed by multiple specialists' unfamiliarity with the pathology. The report's primary purpose is to highlight the importance of a correct initial clinical approach, including a rigorous physical examination and the appropriate use of diagnostic imaging, to achieve timely intervention and prevent severe complications of this syndrome.
Endocarditis por Streptococcus equi spp: reporte de caso
(Universidad Santiago de Cali, 2023) Imbacuan Moreno, Daniel Camilo; Villacorte Sánchez, Royman Gustavo; Quiceno Pulido, Mayerli Johana; Arana Domínguez, Johan Daniel (Director); Lozada Ramos, Heiler (Codirector)
The present case report and literature review support that, although severe human infections with Streptococcus equi spp are rare, they have a poor prognosis and lead to high patient morbidity and mortality; cases have been documented mainly in patients with close contact with animals, especially horses, and with consumption of unpasteurized dairy products. Worldwide, gram-positive bacteria account for approximately 80% of cases of native valve infective endocarditis (IE). These bacteria include Staphylococcus aureus in 35 to 40% of native IE cases, streptococci in 30 to 40% (Streptococcus viridans in approximately 20%, Streptococcus gallolyticus [formerly S. bovis] and other streptococci in approximately 15%, within this percentage streptococcus equi is included), and enterococci in 10% [2]. We present the case of a patient with infective endocarditis due to streptococcus equi spp, from which we will describe the clinical, microbiological and imaging diagnostic approach that are useful, as well as the current therapeutic approach for the management of infective endocarditis due to this germ.
Esclerodermia cutánea localizada (morfea) en un infante: reporte de caso
(Universidad Santiago de Cali, 2023) Palacio Herrera, John Edwin; Riascos Ceballos, Gloris; Rodríguez Moncaleano, Nathalya; Molano Agudelo, Pedro (Director)
Localized Scleroderma, a rare disease with an incidence of less than 3 new cases per 100,000 people annually, is the most common form in children, primarily affecting females, with an idiopathic etiology characterized by extracellular matrix alterations and collagen overproduction. This research presents the case of an 8-year-old boy with a one-year history of hyperpigmented, linear skin lesions on the left mandibular ramus and a depressed oval lesion on the left lumbar region. After receiving multiple unsuccessful treatments due to initial diagnostic uncertainty, a skin biopsy confirmed Localized Scleroderma Morphea type. The case concludes by emphasizing the need for up-to-date and accurate diagnostic knowledge regarding skin lesions and the importance of prompt differential diagnosis to initiate early and effective pharmacological treatment.
Suicidio en la infancia análisis bibliométrico del suicidio en la infancia entre los años 2016 al 2022
(Universidad Santiago de Cali, 2023) Córdoba Mosquera, María Fernanda; Cárdenas Sandoval, María Camila; Montalvo Quintero, Juan Camilo; Castro Penagos, Lilia Julieta (Directora)
The main objective of this research was to characterize the global scientific output on child suicide during the 2016-2022 period through a bibliometric analysis using the keyword "Child suicide" across the PubMed/MEDLINE, Web of Science, and Scopus databases; following an initial filter of 15,161 articles, 86 final works were selected, with the United States being the leading country in production with 34 publications, which confirms historical trends as previous studies also identified it as the major contributor. Currently, there are over 4,000 articles on the subject, with Scopus being the most comprehensive database, and the relevance of this research lies in the fact that its bibliometric indicators contribute to medicine by facilitating the identification of key areas for future researchers to delve into the study of child suicide.
Dextrocardia y bloqueo auriculoventricular completo con implantación de marcapaso en adulto mayor: reporte de caso
(Universidad Santiago de Cali, 2023) Fajardo Valdés, Natalia; Meneses Ortega, Carolina; Yela Girón, Lina Fernanda; Moreno Moriano, Diego Fernando (Director)
Fagoterapia: una nueva alternativa terapéutica en la resistencia a los antibióticos - revisión sistemática
(Universidad Santiago de Cali, 2023) Osorio Hernández, Sofía; Perea Gordillo, Laura Sofía; Arana Domínguez, Johan Daniel (Director); Molano Agudelo, Pedro (Codirector)
Discovered in 1917, bacteriophages are viruses that parasitize and lyse bacteria, releasing new phages and forming the basis of phage therapy, a non-antibiotic medical technique being investigated as an alternative to combat growing global antimicrobial resistance. Given this global challenge, a systematic review (following the PRISMA 2020 guidelines) was conducted in databases like Scopus and PubMed, including 28 articles published between 2017 and 2023. The collected evidence showed that Europe leads the research on phage therapy aimed at antibiotic resistance, highlighting its advantages such as high specificity, low cost, and low rate of side effects, along with its ability to control infections. However, phage therapy faces significant limitations hindering its widespread clinical use, including the lack of extensive studies to understand phages' genome and properties, the absence of a standard regulatory framework, and the complexity of selecting the correct bacteriophage for a specific bacterial infection.
Impacto de las intervenciones educativas en el manejo del dolor y variables biopsicosociales en adultos con dolor oncológico. Revisión sistemática
(Universidad Santiago de Cali, 2023) Henao Bermúdez, Laura Isabel; Domínguez Palacios, Lawrence; Ordoñez Mora, Leydi Tatiana (Directora)
Endocarditis infecciosa por Streptococo gallolyticus tipo: pasteurianus en un paciente de 13 años: caso clínico
(Universidad Santiago de Cali, 2023) Londoño Ospina, Lisa Manuela; Parra Lozada, Laura Alejandra; Guzmán Sandoval, Juan Camilo; Salcedo Libreros, Luis Felipe (Director)
Infective Endocarditis (IE) is an inflammatory and infectious process of the endocardium, primarily valvular, caused by hematogenous colonization, whose diagnosis is established through clinical presentation, blood cultures, and echocardiogram to identify the microorganism and initiate specific antibiotic treatment. The objective of this report is to describe the case of a 13-year-old male adolescent who presented with a five-day history of high fever, neck pain, severe headache, paresthesia, and altered consciousness. A transthoracic echocardiogram revealed emboli on a bicuspid aortic valve, suggesting severe insufficiency and high risk of systemic embolism. The diagnosis of IE due to Streptococcus gallolyticus pasteurianus, a causative microorganism in only 7% of IE cases, was confirmed, and antibiotic treatment with ceftriaxone and gentamicin was initiated.
Resistencia antifúngica a los antimicóticos usados en Colombia: agentes etiológicos y frecuencia de aislamientos - revisión sistemática
(Universidad Santiago de Cali, 2023) Cuenca Casanova, Laura Daniela; Moreno Fuelantala, Johana Lisbeth; Guerra Ordoñez, Dayra Valentina; Caicedo Bejarano, Luz Dary (Directora)
Ecthyma gangrenosum of fungal origin: case report
(Universidad Santiago de Cali, 2023) León Sánchez, Germán Andrés; Arana Domínguez, Johan Daniel (Director); Lozada Ramos, Heiler (Codirector)
Riesgos, beneficios e indicaciones del cannabis en el tratamiento del Parkinson, revisión sistemática
(Universidad Santiago de Cali, 2023) Rincón Valencia, Daniela; Arroyave Muñoz, Daniela; Cobo Restrepo, Silvana; Arana Domínguez, Johan Daniel (Director)
Parkinson's Disease (PD) is a neurodegenerative disorder with motor and non-motor manifestations, whose pathological process begins years before clinical symptoms, and medicinal cannabis has been investigated as a therapeutic option that acts as a neuromodulator and neuroprotector by influencing cannabinoid receptors (CB1R and CB2R). Through a systematic review of freely available articles published between 2015 and 2022, the study aimed to describe the benefits, risks, and indications of using cannabis for Parkinson's treatment to update therapies and improve patients' quality of life. The results indicate that a significant proportion of PD disability is attributable to motor complications and levodopa-insensitive symptoms, and while there has been an increase in therapeutic options for these complications, many are unavailable in our country or fail to meet all of the patients' individual clinical needs.
Síndrome de activación macrofagocítica en un paciente pediátrico. Reporte de caso
(Universidad Santiago de Cali, 2023) Arias Eusse, María Camila; Basto Domínguez, Carolina; Montoya Hurtado, Carolina; Arana Domínguez, Johan Daniel (Director)
Hemophagocytic syndrome (SHF), also known as hemophagocytic lymphohistiocytosis (HLH), usually occurs mainly in childhood being a serious disease resulting from a deregulation of the immune system either by infectious causes, neoplastic, genetic, metabolic or rheumatological leading to an exaggerated immune response. This syndrome acts quickly and puts the patient’s life at risk, so the diagnosis must be based on clinical and paraclinical criteria and then HLH-2004 protocol must be initiated. This case report will be important to make this pathology visible since it is uncommon, which occurs in all age groups, but mainly in pediatric age, has an incidence of 1 in 50,000 live births and varies by geographical region (1). We present the case of a minor patient with a diagnosis of Hemophagocytic Syndrome in whom paraclinics and diagnostic images are taken, biopsy and bone marrow aspirate plus study of the Cerebrospinal Fluid.
Síndrome de Williams Beuren en lactante mayor con retraso pondoestatural sin presencia de cardiopatía congénita: reporte de caso
(Universidad Santiago de Cali, 2023) Bahena Marín, Valentina; Campo Gallego, Vanessa; Restrepo Gaviria, Deisy Lorena; Kanan Mohamed, Ahmad Talat (Director)
Williams Syndrome (WS) is a rare neurodevelopmental genetic disorder (incidence 1/10,000) characterized by growth and intellectual delay, congenital heart disease, and distinctive facial features. This case report describes the early diagnosis of WS in a toddler, despite the absence of the typical congenital heart disease, confirmed by genetic and imaging tests. Key phenotypic features leading to diagnostic suspicion included epicanthal folds, a broad nasal bridge, thick lips, and bitemporal narrowing, with the patient's marked weight/height and psychomotor delay being particularly prominent. The report aims to increase the visibility of WS and promote early recognition of its clinical features for comprehensive and improved management of this rare disease.
Trombastenia de Glanzmann en paciente pediátrico, reporte de caso
(Universidad Santiago de Cali, 2023) Cárdenas Ruiz, Brian; Hernández, Maryuri; Portilla Velásquez, Kevin; Salcedo, Luis Felipe (Director)
Glanzmann's Thrombasthenia (GT) is a rare bleeding disorder (1/1,000,000) caused by alterations in platelet membrane receptors, resulting in significant hemorrhages and bruising, often around the eyes and mouth. More prevalent in certain regions of Africa and Asia (such as Pakistan), GT is difficult to diagnose and requires specialized testing. Treatment focuses on dental hygiene to prevent bleeding (like gingivitis), education about triggers (such as menstrual bleeding), and the use of intravenous platelets for acute hemorrhages. This case report illustrates GT in a pediatric patient who presented with mucocutaneous, subconjunctival, and digestive hemorrhages, managed with tranexamic acid, aiming to raise awareness of the condition and its appropriate diagnostic and therapeutic approach.
Aplasia cutis congénita tipo I en un recién nacido, reporte de caso
(Universidad Santiago de Cali, 2023) Aluma López, María Alexandra; Kanan, Ahmad Talat (Director); Salcedo Libreros, Luis Felipe (Codirector)
Aplasia cutis (ACC) is a congenital condition with an unusual appearance in pediatrics, especially in newborns, characterized by the absence of skin that can compromise the epidermis, dermis, and even underlying tissues such as the pericranium and meninges. ¹ A case report of a newborn clinically diagnosed with ACC is presented. According to Frieden's characteristics, it corresponds to the type 1 classification, taking into account the size and location of the lesion. The objective of this systematic review is to describe the aesthetic and functional results in a patient with ACC with conservative treatment.
Hipertensión arterial secundaria a fibrodisplasia de la arteria renal izquierda en un paciente joven: reporte de caso
(Universidad Santiago de Cali, 2024) Menjuren Tapie, Angie Catalina; Prado Jiménez, Joseph David; Moyano, Pablo Andrés (Director)
Fibromuscular dysplasia (FMD) is a rare systemic vascular disease that primarily affects young women and accounts for 10% to 20% of all cases of renal artery stenosis worldwide. Renovascular hypertension accounts for 1% to 2% of all cases of hypertension in the general population, but plays a major role in treatable causes of hypertension in young people. Fibromuscular disease is thought to be a rare cause of renovascular hypertension and once diagnosed, patients may require angioplasty, but due to recurrence, long-term follow-up is necessary. (1) The aim of this paper is to present a clinical case of hypertension secondary to fibromuscular dysplasia of the renal artery in a young patient, reviewing the history, diagnostic methods and management in a hypertensive patient at an early age. The aim is to provide a comprehensive overview of this rare but significant condition. Furthermore, this case report serves as a research and educational tool for medical personnel, providing evidence that may be useful in future research and improving the understanding and management of fibromuscular dysplasia in clinical practice.
Gangrena de Fournier en hombre: reporte de un caso
(Universidad Santiago de Cali, 2024) Bravo Muñoz, Nicolle Dayhana; Manzano Jiménez, Sebastián; Valencia Betancourt, Rony Stiven; Romero Ortiz, Justy (Director)
This case report describes a 69-year-old male patient with a history of chronic kidney disease and type 2 diabetes mellitus who was admitted to the ICU with a diagnosis of soft tissue sepsis secondary to Fournier's gangrene, despite a one-month history of hemorrhoids. Following a physical examination revealing necrosis in the perineum and anus, a colostomy and debridement were performed immediately. In the ICU, the patient developed severe complications including septic shock, hemodynamic instability, acute respiratory failure, and acute on chronic renal failure, requiring vasoactive support, mechanical ventilation, and renal replacement therapy. Despite intensive management, the condition deteriorated, and following cardiopulmonary arrest and subsequent neurological decline, the patient passed away after the family decided to withhold further resuscitation. This case highlights the complexity and severity of Fournier's gangrene, the necessity of early and aggressive management, and the ethical considerations in high-complexity cases.
Meningitis aséptica asociada a parotiditis viral en paciente adulto inmunocompetente: reporte de caso y revisión de la literatura
(Universidad Santiago de Cali, 2024) Astudillo Ponce, Nicolás; Vargas Gutiérrez, Anderson; Lozada Ramos, Heiler (Director)
Aseptic meningitis due to the mumps virus is a rare complication. Although mumps is the most common clinical manifestation, the virus can cause serious complications such as meningitis, which in some cases can trigger severe neurological sequelae. This case report addresses an adult patient diagnosed with meningitis due to the mumps virus, describing the clinical presentation, the diagnostic and therapeutic approach, and emphasizing vaccination as a preventive measure. This case alerts us to the importance of rigorous clinical surveillance combined with early detection of meningeal complications in individuals with mumps. A timely intervention can reduce diagnosis time, thereby achieving adequate management and prompt detection of complications, having a positive impact by reducing costs and sequelae.
Distribución del volumen pulmonar mediante tomografía de impedancia eléctrica durante una maniobra de titulación de PEEP en pacientes con SDRA moderado- severo asociado con COVID-19
(Universidad Santiago de Cali, 2024) Benítez, María Camila; Lozano, María José; Segura, Alejandro (Director)
This retrospective observational study aimed to determine lung volume distribution in 21 adult patients with COVID-19-associated ARDS using an Electrical Impedance Tomography (EIT) monitor during a decremental Positive End-Expiratory Pressure (PEEP) titration maneuver. The results indicated that ventilation was better in the basal zone than the ventral zone. Optimal PEEP levels were identified in the $18-16-14 \text{ cmH}_2\text{O}$ range for high values and $12-10 \text{ cmH}_2\text{O}$ for low values, with the largest change in lung volume (peak $\Delta\text{EELI}$) occurring between $14 \text{ and } 12 \text{ cmH}_2\text{O}$. The study concludes that the PEEP range between $12 \text{ and } 14 \text{ cmH}_2\text{O}$ was optimal for improving Functional Residual Capacity in these patients, emphasizing the importance of individualized PEEP titration guided by patient physiology.

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