Browsing by Author "Garcia, Dominga"

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    Erdheim Chester Histiocytosis as a Diagnostic Challenge in a Systemic Presentation: A Case Report
    (2024) Garcia, Dominga; Flores, Yorman; Vergara, Maximiliano; Solar, Cristian Labarca
    Histiocytosis are caused by pathogenic myeloid cells, and can be classified as Langerhans cell histiocytosis (LCH) and non-LCH. ErdheimChester disease (ECD) is a non-LCH, characterized by multi-organ involvement, typical imaging findings, and confirmatory histological studies. A case with multi-organ involvement and histological confirmation is presented. A male patient, 50 years old, presented muscle weakness associated with elevated inflammatory parameters, visual disturbances, and exophthalmos. Imaging studies revealed a non-specific retro-orbital mass and retroperitoneal fibrotic mass with perivascular, myocardial, and perirenal infiltration and bone hypermetabolism. Systemic corticosteroids were started, and a biopsy of the retroperitoneal mass informed foamy histiocytes, positive for CD68, negative for CD1a, and positive for BRAFV600 mutation. Treatment with Vemurafenib was started with a good response. Less than 500 cases of ECD have been reported in the literature. It has been described to present with multi-organ involvement, including bone, orbital, renal, and endocrinological involvement, among others. Its diagnostic criteria include imaging and histological alterations, consistent with those described in this patient. The first line of treatment is interferon alpha, which has been shown to improve survival but is associated with adverse effects. As a second line, it has been proposed Vemurafenib when BRAFV600 mutation is present.
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    Impact of COVID-19 Pandemic on Stroke Severity and Mortality in the South-East of Santiago, Chile
    (2021) Silva-Pozo, Andres; Vallejos, Jose; Almeida, Juan; Martoni, Mariano; Uribe-San Martin, Reinaldo; Miranda, Maria; Diaz, Pablo; Garcia, Dominga; Navia, Victor
    Background and purpose; Chile has been one of the most affected countries by the COVID-19 pandemic, with one of the highest case rates per population. This has affected the epidemiological behaviour of various pathologies. We analyze the impact of the pandemic on the number of admissions due to stroke, its severity and mortality in Santiago, Chile. Methods: a multicenter observational study based on the records of the 3 hospitals of the South East health service in Santiago, Chile. We recorded the number of patients admitted for ischemic stroke between 01 January 2020 and 30 June 2020. We grouped the cases into two periods, pre-pandemic and pandemic, according to the setting of the state of emergency in Chile. Results: 431 patients were admitted with ischemic stroke during the study period. There was a non -significant decrease in weekly admissions (17 vs 15 patients per week). No differences were observed in the proportion of patients with medical treatment (p = 0.810), IVT (p = 0.638), EVT (p = 0.503) or IVT + EVT (p = 0.501). There was a statistically significant increase in the NIHSS on admission (7.23 vs 8.78, p = 0.009) and mortality (5.2% vs 12.4%, p = 0.012). In a multivariate analysis the NIHSS on admission was associated with the increased mortality (RR 1.11, CI 1.04-1.19, p = 0.003). Conclusion: We found an increase in the severity of ischemic stroke on admission and in-hospital mortality during the pandemic period. The main factor to increase in-hospital mortality was the NIHSS on admission. (c) 2021 Elsevier Inc. All rights reserved.