Browsing by Author "Aguirre Bermeo, Hernan Marcelo"

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Endoscopic endonasal approach for pituitary adenomas: results from a multidisciplinary management
(2021) Jimenez Encalada, Marcia Gabriela
Abstract Background Endoscopic endonasal approach (EEA) has gained increasing acceptance in the world; however, pituitary adenomas require multidisciplinary management for good outcomes. The aim of this study is to report the results of this management of a consecutive series of patients who underwent a purely endoscopic endonasal approach for pituitary adenomas resection in our hospital and compare them to other series. Methods A retrospective review of clinical and radiographic records of 80 consecutive patients with pituitary adenomas who were operated on using an EEA between 2011 and 2019 was performed. The patientś clinical, ophthalmologic, endocrinologic and radiographic outcomes were evaluated. Results 57% were women and 43% men. The age ranged from 10 to 79 years. 72 tumours (90%) were macroadenomas; in 19 patients (23.75%) the cavernous sinus was invaded. There were 58 non-functioning adenomas and 17 growth hormone secreting, 4 prolactin-secreting, and 1 thyroid-stimulating hormone-secreting adenomas. Gross total resection was achieved in 76.2% of tumours without cavernous sinus invasion. Of the 53 patients presenting with visual loss, 47 (88.6%) improved or normalized. The remission rates with EEA alone were 58% in the GH-secreting adenomas and 75% in the prolactinomas group. Complications included CSF leak in 12.5%, new hormonal deficit in 18.75%, epistaxis in 6.25%, sella hematoma in 3.75% and neuroinfection in 1 patient (1.25%). We did not have mortality. The follow-up was from 6 to 87 months. Conclusions A multidisciplinary management is required for the adequate treatment of pituitary adenomas. With good surgical training, the EEA is safe and effective around the world. Our results are similar compared with those reported in previous series of microscopic or endoscopic approaches.
Equipos de protección personal
(Universidad del Azuay, 2020) Salamea Molina, Juan Carlos
Imágenes diagnósticas en la infección por COVID-19
(Universidad del Azuay, 2020) Faican Cabrera, Christian Gabriel
Protocolo de inmunosupresión en trasplante hepático: revisión de la literatura.
(2022) Gonzalez Dominguez, Esteban Horacio; Cordova Reyes, Diego Andres; Abad Polo, Paula Gabriela; González, Eduardo; Gonzalez Dominguez, Camila Maria; Cordero Velastegui, Juan Jose; Flores Siguenza, Luis Francisco; Aguirre Bermeo, Hernan Marcelo
Liver transplantation is the last option for the treatment of liver disease. Immunosuppression schemes are required to avoid graft rejection, which have evolved over the years. A literature review was carried out in PubMed on the immunosuppressive therapies available to avoid graft rejection in liver transplantation, as well as on the schemes used, adverse effects, interactions and their modifications from the induction phase to subsequent follow-up. The usual induction was found to be with steroids or clonal immune therapy. In maintenance, calcineurin inhibitors are the most widely used, and their doses should be adjusted according to their serum levels and the presence of adverse effects such as nephrotoxicity or diabetes. On the other hand, mTOR inhibitors have been considered to reduce the risk of hepatocellular cancer recurrence. The characteristics of the patient and their comorbidities (pregnancy, kidney failure, diabetes, sepsis, hepatocellular carcinoma) require modification and individualization of the treatment
Protocolo de manejo de paciente con insuficiencia respiratoria aguda bajo sospecha de COVID 19
(Universidad del Azuay, 2020) Aguirre Bermeo, Hernan Marcelo; Tirape Castro, Hugo Arturo; Martinez Carvallo, Luis Alberto
Respuesta de un Hospital Regional ante la pandemia plan general del Hospital Vicente Corral Moscoso
(Universidad del Azuay, 2020) Tirape Castro, Hugo Arturo; Martinez Carvallo, Luis Alberto; Aguirre Bermeo, Hernan Marcelo
Tratamiento de pacientes con afectación grave por COVID-19, con plasma de pacientes convalecientes de COVID-19
(Universidad del Azuay, 2020) Espinoza Calle, Glenda Iralda; Paredes Sanchez, Johanna Elizabeth; Aguirre Bermeo, Hernan Marcelo; Martinez Carvallo, Luis Alberto; Peña Patiño, Sandra Gioconda; Lopez Aguirre, Wilson Javier; Holguin Carvajal, Juan Pablo; Cobos Villavicencio, Paul Ramiro; Ortega Berrezueta, Jaime Fernando; Hernandez Quito, Elvia Lucrecia; Dita Salabert, Liermis Michael; Duque Proaño, Galo Ruben
Tratamiento y evolución clínica de un paciente con diagnóstico presuntivo de síndrome antifosfolipídico catastrófico
(2022) Aguirre Bermeo, Hernan Marcelo
The catastrophic antiphospholipid syndrome represents less than 1% of cases registered worldwide, the multi-organ involvement develops in a period of less than a week, with very high mortality. We report the case of a patient with history of varicose veins and family history of antiphospholipid syndrome and systemic lupus erythematosus. The clinical condition began with a thrombotic storm after an aneurysmectomy, in the context of undiagnosed antiphospholipid syndrome. The sudden symptoms required management in intensive care unit and treatment with methylprednisolone and infliximab. The patient's evolution was not favorable and she died due to probable disseminated intravascular coagulation associated with catastrophic antiphospholipid syndrome. The case highlights the importance of the clinical method in the early diagnosis and treatment of rare diseases.