Examinando por Autor "Domínguez-Vargas, Alex"
Mostrando 1 - 9 de 9
Resultados por página
Opciones de ordenación
Ítem Association of FokI polymorphism of the VDR genewith systemic lupus erythematosus in anadolescent population of the Colombian Caribbean(Elsevier, 2023) Garavito, Gloria; Fang, Luis; Domínguez-Vargas, Alex; Moreno-Woo, Ana; López-Luch, Guillermo; Iglesias, Antonio; Aroca, Gustavo; Egea, EduardoVitamin D and vitamin D receptor (VDR) polymorphisms are associated withautoimmune diseases including systemic lupus erythematosus (SLE). The aim of this studyis to assess the genetic association between VDR polymorphisms: TaqI, ApaI, Bsml and FokIand SLE with serum levels of Vitamin D in the Colombian Caribbean population.Method: Case and control study. One hundred and thirty-three patients with SLE and 100healthy individuals were included. VDR polymorphism were genotyped by RT-PCR andTaqman®probes. Allelic, genotypic and haplotype associations were estimated. Serum vita-min D concentrations were quantified by Elisa. Values of 30 to 100 ng/ml were establishedas a normal reference range. P values <.05 were considered statistically significant.Results: A high prevalence of SLE was observed in women (94%) and was associated witha higher risk of SLE [OR: 10.8; 95% CI: 4.7–24.6] (p < .05). Moreover, higher risk of SLE wasobserved in individuals with FokI VDR [rs2228570] [OR: 1.58; 95% CI: 1.05−2.36] in allelic mod-els. The ACCA Haplotype of TaqI/ApaI/Bsml/FokI polymorphisms was associated with higherrisk of SLE [OR = 2.28, 95% CI = 1.12−4.66, psim <.01]. Vitamin D deficiency was evidenced in11.3% of the patients.Ítem Atypical hemolytic uremic syndrome: a nationwide Colombian pediatric series(Research Square Company, 2023) Espitaleta, Zilac; Domínguez-Vargas, Alex; Villamizar-Martínez, Johanna; Carrascal-Guzmán, Martha; Guerrero-Tinoco, Gustavo; Silva-Diaz, Diana; Baquero, Richard; Pinto-Bernal, Claudia; González-Chaparro, Luz; Rojas-Rosas, Luisa; Amado-Niño, Pilar; Castillo-Arteaga, Mariángel; Alvarez-Gomez, Yeferson; Arguello-Muñoz, Laura; Morales-Camacho, William; León-Guerra, Oscar; Egea, Eduardo; Galeano-Rodríguez, Ricardo; Quintero-Gómez, Ana; Aroca-Martínez, Gustavo; G. Musso, CarlosBackground Atypical hemolytic uremic syndrome (aHUS) is a rare complement-mediated kidney disease with genetic predisposition and represents up to 10% of pediatric hemolytic uremic syndrome (HUS) cases. Few studies have evaluated aHUS in Latin American population. We studied a Colombian pediatric cohort to delineate disease presentation and outcomes. Methods A multicenter cohort of 27 Colombian children with aHUS were enrolled between 2010 to 2019. Patients were grouped by age at onset. Clinical features were compared using analysis of variance (ANOVA) and Fisher exact tests. Renal biopsy was performed on six patients who were suspected of having other renal diseases before aHUS diagnosis. Results Most patients were male (70%). The onset of aHUS occurred frequently before age 4 years (60%) and followed gastroenteritis as the main triggering event (52%). Age groups were comparable in clinical presentation, disease severity, treatment, and outcomes. Pulmonary involvement (67%) was the main extrarenal manifestation. A higher frequency was observed in the 1–7 age group (p = 0.01). Renal biopsies were as follows: three had membranoproliferative glomerulonephritis (MPGN) type I, one MPGN type III, one C3-glomerulonephritis, and one rapidly progressive glomerulonephritis. Genetic screening was available in five patients and identified 2xCFHR5, 2xMCP, and 1xADAMTS-13/THBD mutations. A total of 15 relapses were seen, of which 8 (72%) occurred in the 1–7 age group. The renal outcome was not significantly different regardless of age group. Conclusion In our cohort, we observed a relatively high frequency of extrarenal involvement at first presentation represented by pulmonary manifestations. The renal prognosis at initial presentation was worse than in previous reports.Ítem Atypical Hemolytic Uremic Syndrome: A Nationwide Colombian Pediatric Series(Sage, 2024) Espitaleta, Zilac; Domínguez-Vargas, Alex; Villamizar-Martínez, Johanna; Carrascal-Guzmán, Martha; Guerrero-Tinoco, Gustavo; Pinto-Bernal, Claudia; González-Chaparro, Luz; Rojas-Rosas, Luisa; Amado-Niño, Pilar; Castillo-Arteaga, Mariángel; Alvarez-Gómez, Yeferson; Arguello-Muñoz, Laura; Morales-Camacho, William; León-Guerra, Oscar; Egea, Eduardo; Galeano-Rodríguez, Ricardo; Quintero-Gómez, Ana; Aroca-Martínez, Gustavo; Musso, Carlos G.Objectives. Atypical hemolytic uremic syndrome (aHUS) is a rare complement-mediated kidney disease with genetic predisposition and represents up to 10% of pediatric hemolytic uremic syndrome (HUS) cases. Few studies have evaluated aHUS in Latin American population. We studied a Colombian pediatric cohort to delineate disease presentation and outcomes. Methods. A multicenter cohort of 27 Colombian children with aHUS were included. Patients were grouped by age at onset. Clinical features were compared using analysis of variance (ANOVA) and Fisher exact tests. Renal biopsy was performed on 6 patients who were suspected of having other renal diseases before aHUS diagnosis. Results. Most patients were male (70%). The onset of aHUS occurred frequently before age 4 years (60%) and followed gastroenteritis as the main triggering event (52%). Age groups showed comparable clinical presentation, disease severity, treatment, and outcomes. Pulmonary involvement (67%) was the main extrarenal manifestation, particularly in the 1 to 7 age group (P = .01). Renal biopsies were as follows: 3 had membranoproliferative glomerulonephritis (MPGN) type I, one MPGN type III, one C3-glomerulonephritis, and one rapidly progressive GN. Genetic screening was available in 6 patients and identified 2xCFHR5, 2xMCP, 1xADAMTS13/ THBD, and 1xDGKE mutations. A total of 15 relapses were seen, of which 8 (72%) occurred in the 1 to 7 age group. The renal outcome was not significantly different regardless of age group. Conclusion. In our cohort, we observed a relatively high frequency of extrarenal involvement at first presentation represented by pulmonary manifestations. The renal prognosis at initial presentation was worse than in previous reports.Ítem Common interacting genetic variation shapes susceptibility to type 1 diabetes in a Colombian Caribbean community: In search of shared genetic markers(Elsevier, 2024) Garavito-De Egea, Gloria; Domínguez-Vargas, Alex; Vélez, Jorge I.; Aroca, Gustavo; Fang, Luis; Navarro-Quiroz, Elkin; Espitaleta, Zilac; Del Toro-Camargo, Kenny; Martínez-Ariza, Leticia; González-Vargas, Tatiana; García, Susana; Arcos-Burgos, MauricioIn summary, our study outlines oligogenic common variation underpinning the susceptibility to develop T1D. These genetic polymorphisms are also shared by patients suffering from other diseases such as LN and JIA, indicating that the shared genetic architecture defined by pleiotropy and epistasis shapes the genetic susceptibility of these disorders in this multiethnic population. Given the predicted functional nature of these genetic variants, it is very likely that in this understudied multiethnic population, genes harboring these mutations are major contributors to AID immunopathology and provide new insights into the autoimmune tautology in this group of diseases.Ítem Evaluation of Tacrolimus Combined With Corticosteroids vs Modified Ponticelli Regimen as Treatments for Refractory Primary Membranous Nephropathy(Canadian Center of Science and Education, 2018-11) Navarro-Quiroz, Elkin; Aroca-Martinez, Gustavo; Domínguez-Vargas, Alex; Alonso-López, María José; Alvarado-Echeverría, Rebeca; Navarro-Quiroz, Roberto; Silva-Díaz, Diana; Gomez Escorcia, Lorena; González-Tórres, Henry J.Objective: To evaluate the immunosuppressive treatment response to modified Ponticelli regimen (MPR) and oral corticosteroid (OC) plus tacrolimus (TAC) in patients with primary membranous nephropathy (PMN). Methods: Retrospective cohort analytical study. Adults patients (>18 years old) with diagnosis of refractory PMN (>50% increase in serum creatinine or a level >1.5mg/dl or proteinuria refractory to 6 months of supportive treatment), proved by renal biopsy and immunofluorescence between 2008 and 2016 from the Nephropathy Registry of Colombia (NEFRORED©) were included. Immunosuppressive treatment response was evaluated from baseline to 6 months after the start of therapy. Results: 128 patients with PMN were included, of which 74 (57%) were female. The most frequent syndromic diagnosis was nephrotic syndrome 90 (70%), followed by asymptomatic urinary disorders 31 (25%). Chronic kidney disease manifested concomitantly in 7 (5%) patients. At the end of 6 months, 86 (67%) cases achieved some degree of remission: 23 (18%) complete response (CR) and 63 (49%) cases with partial response (PR), while 42 (33%) cases did not achieved remission. In the TAC+OC group, CR and PR were seen in 14 (20%) and 33 (47%) patients, respectively; and 9 (16%) and 30 (51%) patients in the MPR group, respectively. No statistically significant differences were found when comparing the immunosuppressive treatment response rate with both treatment groups (p > 0.05). Conclusions: In the PMN, both immunosuppressive treatments (TAC+OC vs MPR) are comparable. We suggest a clinical follow-up of the anti-PLA2R/THSD7A titres at 6/12 months to be correlated with renal function in subsequent studies.Ítem Glomerular Diseases in the Colombian Caribbean: Data from the Colombian Nephropathy Registry (NEFRORED®)(Wolters Kluwer, 2022) Aroca-Martínez, Gustavo; González-Torres, Henry J.; Domínguez-Vargas, Alex; García- Tolosa, Raúl; Castillo-Parodi, Luis; Conde-Manotas, Juan; Navarro-Quiroz, Elkin; Acuña- Freyte, Andersson; Depine, Santos Ángel; Cadena-Bonfanti, Andrés; Musso, Carlos G.Our study aimed to describe the glomerular diseases, both primary glomerular disease (PGD) and secondary glomerular disease (SGD) in the Colombian Caribbean based on the first regional Colombian Nephropathy Registry (NEFRORED®). A descriptive and retrospective study of adult patients with glomerular diseases from the Colombian Caribbean region was made. All diagnoses by renal biopsy with light microscopy and immunofluorescence obtained between January 2008 and June 2018 were recorded. Eight hundred and seventy-one renal biopsies were obtained. The main clinical indication for biopsy was nephritic syndrome (36%). SGD was more frequent than PGD (55% vs. 45%). Within SGD group, lupus nephritis (LN) was the most frequent etiology (83%). Within PGD group, membranous nephropathy (33%) and focal segmental glomerulosclerosis (FSGS) (19%) were the most common glomerular diseases. At a 24-month follow-up, the patients with FSGS and paraproteinemia-mediated glomerular disease had the worst renal survival prognosis. This is the first Colombian Nephropathy Registry in a Caribbean population, demonstrating a high predominance of SGD due to LN.Ítem Infective endocarditis in the colombian caribbean region: clinical profile, microbiological insights, and risk factors for mortality(ACADEMIA NACIONAL DE MEDICINA, 2023) Solarte Bastidas, Gabriela; Herrera Calle, Pedro; Domínguez-Vargas, Alex; Iglesias Pertuz, Shirley; González-Torres, Henry J.Infective endocarditis (IE) is defined as the infectious and inflammatory process of the heart’s internal structures. It can be caused by a broad group of bacteria and, rarely, fungi, with potentially life-threatening consequences. Objective: To profile bacterial resistance and identify mortality risk factors in IE patients. Methods: This crosssectional study included clinically diagnosed IE patients. Sociodemographic, comorbidity, clinical, and microbiological data were recorded. Descriptive analyses, Chi-Square/Fisher’s exact tests, and Student’s t-tests examined variables in relation to IE outcomes (survival vs. mortality). Multivariate logistic regression calculated odds ratios and confidence intervals. Results: We enrolled 39 patients (mean age 51 ± 19.5 years, 54 % male). Common comorbidities included acute kidney injury (AKI) (46 %), heart failure (26 %), and ischemic stroke (21 %). Deceased patients had higher rates of fatigue (p=0.03), lower limb edema (p=0.01), and AKI (p=0.01) than survivors. Fifteen (38 %) patients had positive cultures; Staphylococcus aureus predominated in survivors (13 %) and deceased (13 %) patients (p=0.06). Multi-drug-resistant bacteria were found in six (15 %) patients, and one (2.6 %) had Extensively Drug-Resistant bacteria. Multivariate Logistic Regression indicated that lower limb edema (OR 8.6, 95 % CI 1.5–49, p=0.01), and AKI (OR 7.8, 95 % CI 1.65–37.2, p=0.01) increased mortality risk in IE patients. Conclusion: In this study, lower limb edema and AKI were significant predictors of mortality in IE patients, emphasizing their clinical importance in IE progression and resolution. Further research should explore additional variables and risk factors to enhance our ability to predict and manage outcomes in this population.Ítem Kidney health in Colombian indigenous communities: are we doing enough?(Ediciones Universidad Simón Bolívar, 2020) Cadena-Bonfanti, Andrés; Ardila-Cárdenas, María E.; Gonzáles-Torres, Henry J.; Luna-González, María L.; Espítaleta-Vergara, Zilac; Ángel, Santos; Conde, Carlos; Echeverry, Sandra; Anaya, Marco; Mercado, Álvaro; Charris, Amalfi; Torres, Jaime; Montejo, Juan Diego; Rojas, Mirian; Nieto-González, Iván; Ballesteros, David; Ramírez, Roberto; Garcia, Enrique; Builes, Sheila; Carvajal, Alberto; Barros, Luis; Baquero, Richard; Henao, Carlos Mario; Lopera, Jhon; Soto, Andrés; Acosta, Claudia; Sánchez Garcia, Melany Margarita; Buitrago, Cristóbal; Puche-Martínez, Efraín; Soto, Manuel; Ramírez-Pérez, Roger; De La Espriella-Badel, Víctor; Angulo, Milena; Coronado, Jorge; Puello, Luis; Daza, Rodrigo; Alfaro, Mercedes; Roncayo, Angélica; Hernadez, Andrés; Alcocer, Carlos; ahumada, Gustavo; Morón, Javier; Aguirre, Marcelo; Domínguez-Vargas, Alex; V. Perez, Rafael; Peña Vargas, William; Cotes-Araujo, Luis; Hernández-Agudelo, Sandra; Peña, Zuleima; Coronel Montenegro, Carlos; Castro-Ahumada, Eddie; Isaza, Rafael; Alejandra Montoya, Jennifer; Martínez-Bayona, Álvaro; Vélez-Verbel, María; Correa-Monterrosa, Mileidys; Aroca-Martínez, GustavoObjetivo: Caracterizar los factores asociados a la salud renal en las comunidades indígenas colombianas. Materiales y Métodos: En el marco del día mundial del riñón, se realizó un estudio observacional en la población indígena colombiana, se tomaron datos de 16 etnias. Mayores de 18 años. Se realizó una encuesta de salud renal y se midieron los valores de tensión arterial, glucosa en sangre, hematuria y proteinuria. Se realizó un sumario estadístico y se evaluó la asociación entre variables mediante χ². Resultados: La población estudiada fue de 1.177 indígenas (figura 1). El 49.8% fueron hombres con edad de 43±17 años. En cuanto a la educación, 34,5% manifestaron no tener estudios. El 39% de la población tenía sobrepeso y 16% obesidad, asociándose a las mujeres (p=0,0003). 1,4% había sido diagnosticado con diabetes; 1,7% no recordó. Referente a la hipertensión arterial (HTA) 10,4% tenía diagnóstico, de estos 35% no tenía tratamiento; 40% de quienes no tenían HTA, tuvo cifras tensionales >130/85mmHg. Se encontró proteinuria en 8,8% y hematuria en 4,2%. Aunque 94,1% pertenecían al SGSSS, sin embargo, el 52,6% considero difícil o muy difícil acceder al servicio, y un tercio no había tenido revisión médica en los dos últimos años. Se encontró una asociación multivariada entre el sexo, factores de riesgo y el acceso a salud. Siendo “Difícil” o “Muy difícil” acceder a servicio médico para las mujeres que vivían en zonas rurales e hipertensas se asociaron significativamente a zonas rurales, sexo femenino e hipertensión. Conclusión: La incidencia de ERC es 1,5 veces mayor en minorías étnicas de países desarrollados, cuyos principales factores de riesgo son HTA y diabetes, en nuestra población se suma la pobreza que influye al acceso de servicios de salud.Ítem Respuesta a la farmacoterapia en pacientes con glomerulonefritis membranoproliferativa en una clínica de Barranquilla, Colombia. 2007-2014(Universidad Nacional de Colombia, 2018-07) Aroca-Martínez, Gustavo; González-Torres, Henry Joseth; Domínguez-Vargas, Alex; Fontalvo-Pastorizo, Jossie; Silva-Díaz, Diana; Cadena-Bonfanti, AndrésIntroducción. La glomerulonefritis membranoproliferativa (GnMP) es un patrón de lesión glomerular hipercelular mesangial con adelgazamiento de la membrana basal glomerular y proliferación endocapilar que está mediado por las inmunoglobulinas o el sistema del complemento en el mesangio y endotelio capilar. Objetivo. Evaluar la respuesta a la farmacoterapia en pacientes diagnosticados con GnMP en una clínica de Barranquilla entre los años 2007 y 2014. Materiales y métodos. Estudio de cohorte retrospectivo en el que se evaluaron 58 pacientes con diagnóstico de GnMP por biopsia renal, quienes se clasificaron como respondedores y no respondedores. Se realizó una evaluación de tratamiento estándar según tipo de GnMP: mediado por complemento y mediado por inmunocomplejos e inmunofluorescencia negativa a los 6 y 12 meses de tratamiento. Resultados. La edad promedio de los participantes fue de 35±13 años. De 58 pacientes, 52% eran mujeres, 63% desarrolló enfermedad renal crónica (ERC) al año de evaluación, 25.8% logró remisión (22.4% completa y 3.4% parcial) y 74.2% no logró entrar en remisión. Conclusión. La GnMP es una causa importante de ERC entre la población estudiada. La respuesta al tratamiento inmunosupresor no demostró beneficios estadísticamente significativos, independiente del tipo de GnMP.