HIPOALBUMINEMIA TRATAMENTO PDF

Denise Rossato Silva; Marcelo Basso Gazzana; Paulo de Tarso Roth Dalcin Abstract Tuberculosis is a curable disease that can evolve to severe forms, requiring the treatment of the patients in an ICU, especially if there is a delay in the diagnosis or if it affects elderly patients, those on dialysis, or those with HIV infection or other states of immunosuppression, as well as in cases of multidrug resistant disease. Knowledge of the radiological presentation of the cases can help diagnose these severe forms, as can the introduction of new tests, such as the early detection of the etiological agent by PCR and chest CT, which favors the early initiation of treatment. In addition, the use of regimens without isoniazid and rifampin, as well as uncertain enteral absorption and low serum concentrations of antituberculosis drugs, can reduce the efficacy of treatment. For such patients, the prognosis is generally poor and mortality rates are high.

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Tabla 1. Principales causas de hipercalcemia Tabla 2. It is considered as a medical emergency that appears more frequently at advanced malignant disease, usually through the activation of parathyroid hormone-related protein. It should be treated promptly and an intensive therapy with fluids and intravenous bisphosphonates are the keys to achieve metabolic restoration.

At present, zoledronic acid is considered the most effective bisphosphonate for acute hypercalcemia. Otras causas de hipercalcemia maligna son los linfomas y las leucemias, aunque con menor frecuencia que los previamente descritos.

El resto de causas de hipercalcemia se describe detalladamente en la tabla 1. Hipercalcemia por osteolisis. Hipercalcemia humoral. En definitiva, el objetivo es administrar entre 4. Se emplean con cierta eficacia en las hipercalcemias inducidas por calcitriol, como las asociadas a linfomas. Sus principales efectos adversos son la nefrotoxicidad y la osteonecrosis mandibular. Se ha utilizado sobre todo en hipercalcemias asociadas a tumores de estirpe epidermoide.

Este efecto puede disminuirse con el uso concomitante de glucocorticoides. Los pacientes con neoplasia maligna subyacente precisan de un tratamiento dirigido a su tumor que contribuya a disminuir las posibilidades de desarrollar una hipercalcemia durante su enfermedad. Correspondencia: J. Servicio de Urgencias.

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