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17. Síndrome neuroléptico maligno inducido por risperidona y facilitado por sepsis de origen urinario: clínica y fisiopatología

Author

Muñoz, Omar H., Vargas-Rodríguez, Ledmar J., Benavidez-Jiménez, Hernando A., and Vega-Sepúlveda, Ana C.

Abstract

Risperidone is a selective monoaminergic antagonist with a high affinity for dopamine receptors that can cause neuroleptic malignant syndrome (NMS), considered a life-threatening medical emergency. It has an incidence of up to 3% and its mortality is between 10 and 20%. The case of a 56-year-old female who met the clinical criteria of NMS, induced by the use of risperidone and facilitated by a sepsis of urinary origin, is reported. It was managed with a dopamine agonist and the change of antipsychotic, which resulted in a favorable clinical course. The NMS is a low-prevalence entity whose diagnosis has specificity and sensitivity greater than 90%, reason for which must be clearly differentiated from other pathologies. The mechanism by which urinary infection could facilitate the occurrence of this disease is discussed. Early diagnosis improves the response to an adequate management to be established in each case. La risperidona es un antagonista selectivo monoaminérgico, con una elevada afinidad por receptores dopaminérgicos, que puede producir síndrome neuroléptico maligno (SNM), considerado una emergencia médica con alto riesgo de muerte. Tiene una incidencia de hasta el 3% y su mortalidad está entre el 10 y 20%. Se reporta el caso de una paciente de 56 años, que reunía los criterios clínicos del SNM, inducido por el uso de risperidona y facilitado por una sepsis de origen urinario. El tratamiento se condujo con un agente agonista dopaminérgico y cambio del antipsicótico, procedimientos que resultaron en una adecuada evolución clínica. El SNM es una entidad de baja prevalencia, para la cual existen criterios diagnósticos con especificidad y sensibilidad mayor del 90%, por lo que debe diferenciarse claramente de otras patologías. Se discute el mecanismo mediante el cual la infección urinaria facilitaría la ocurrencia de esta enfermedad. El diagnóstico precoz mejora la respuesta al manejo adecuado que se establezca en cada caso.

Published
2019

19. Prevalencia de úlceras por presión en pacientes con insuficiencia cardiaca en un hospital universitario de Colombia.

Author

Guerrero Peña, Paula Andrea, Barrera Corredor, Angélica Paola, Méndez Martínez, Nicole Tatiana, Gil Forero, María Camila, Velasco Castro, Julio Cesar, Aguilar Ramírez, Camila Alejandra, Rozo Ortiz, Edward J., Acosta Pérez, Camila Andrea, and Vargas Rodríguez, Ledmar J.

Abstract

OBJECTIVE: To determine the prevalence of pressure ulcers in patients hospitalized with heart failure. MATERIALS AND METHODS: Descriptive observational study performed from May 6, 2018 to November 21, 2021, in which hospitalized patients with heart failure treated at the San Rafael Hospital in Tunja, Colombia, were included. It was used a method of data collection, which consisted of involving patients who presented pressure ulcers, these were identified by the international code of diseases(ICD-10), which was assessed by reviewing the clinical history and relevant information was passed to a database. RESULTS: There were included 347 patients with heart failure, 25 of them with pressure ulcers within the hospital stay, which will be evaluated taking into account risk factors, history and pharmacological treatment. CONCLUSIONS: It is important to note that pressure ulcers represent a significant burden to the individual and society, increasing to about 3 million adults a year in the United States; the prevalence of pressure ulcers has remained virtually unchanged, while associated care costs continue rising. [ABSTRACT FROM AUTHOR]

Published
2023
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