Revista Médico Científica

CAUSES OF HOSPITAL ADMISSION AMONG ADULTS WITH CHRONIC KIDNEY DISEASE IN A PANAMA CITY TERTIARY-CARE CENTER.

2021-10-25T14:07:14+00:00

BACKGROUND: Chronic kidney disease (CKD) confers a significant social burden and high health costs. In Panama the prevalence is 12.6% and it causes 2.8% of annual deaths. People with renal insufficiency are susceptible to complications and hospitalizations. We aimed to determine the main causes of admission in adults with chronic kidney disease.

METHODS: Descriptive, cross-sectional, retrospective observational study on patients > 18 years old with a previous diagnosis of CKD hospitalized in the Internal Medicine Service of the Dr. Arnulfo Arias Madrid Hospital Complex in 2018 and 2019. Information was collected from clinical records on age, sex, residence, type of renal replacement therapy, comorbidities, substance abuse and admission diagnosis (infectious vs. non-infectious causes).

RESULTS: Of the 131 cases described, 75 (57.25%) belonged to male sex and 103 (78.63%) were over 45 years of age. Hypertension and diabetes were the most common comorbidities. Ninety people were on renal replacement therapy (68.7%), of which, 83 received hemodialysis. Infectious causes were the main reason for admission (51.14%). Among non-infectious etiologies, cardiovascular events had a high prevalence (28.24%), followed by venous thromboembolism (4.56%). Patients with CKD - S5 on dialysis were admitted more for infectious causes and have a lower probability of hospitalization for decompensated heart failure than the group with CKD - S5 on medical treatment (OR 0.244 (0.062 - 0.958), 95% CI, p 0.043).

CONCLUSION: In our population, individuals with chronic kidney disease are hospitalized mainly for infectious causes. The CKD – S5 on renal replacement therapy subgroup have a lower probability of admission for heart failure than CKD patients who do not receive dialysis.

Anomalous origin of coronary arteries

2020-05-10T05:17:39+00:00

We report the case of a 71-year-old woman with medical history of hypertension; she attends the hospital because of oppressive retrosternal pain and clinical data suggestive of an acute coronary syndrome. During treatment, the incidental finding of anomalous coronary arteries originating from the right Valsalva sinus is found. This congenital anomaly is very unusual and there is a reported prevalence of 0.0024% in the general population. Most patients are asymptomatic, although an association with ischemic symptoms has been reported. In symptomatic patients, an individualized approach must be given because there is no standard treatment due to the low prevalence of this anomaly.

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2022-05-11T03:01:22+00:00

Este texto busca dar a conocer brevemente el lugar que ocupa la Capilla San Juan de Dios de la Ciudad de Natá de los Caballeros en la historia de la medicina panameña, esto como homenaje a Natá por los 500 años de fundación cumplidos el 20 de mayo de 2022.

BLUNT RENAL TRAUMA

2021-08-20T02:08:34+00:00

This article provides an exhaustive analysis of blunt renal trauma. Its goal is to describe the risk factors, mechanism of trauma, diagnostic approach, updated management, and complications in a synthesized manner in order to maximize readers’ understanding of key concepts relevant to this important diagnosis and its treatment.

Traumatic injury is the leading cause of death in people 45 years of age and younger. Indeed, the kidney is the third most injured organ via abdominal trauma, and the most frequently impacted organ within the genitourinary system. Its importance is underscored by the countless, new studies emerging daily in which these lesions are analyzed — increasing the difficulty for practitioners to stay abreast of all new developments. Every physician should understand the intricacies of blunt renal trauma as well as the advances in diagnostics and management of these lesions.

Treatment via conservative and non-surgical approaches have evolved tremendously in the last decade, while their outcomes remain dependent on factors including, but not limited to, hemodynamic stability and concomitant lesions. Similarly, injuries resulting in the destruction of the parenchyma may also be treated with less invasive, non-surgical methods. These approaches not only increase organ preservation but preserve and improve quality of life.