Tuberculosis in renal transplant patients: The experience of a single center in Medellín-Colombia, 2005-2013

Introduction: Tuberculosis is a common opportunistic infection in renal transplant patients. Objective: To obtain a clinical and laboratory description of transplant patients diagnosed with tuberculosis and their response to treatment during a period ranging from 2005 to 2013 at the Pablo Tobón Uribe Hospital. Methods: Retrospective and descriptive study. Results: In 641 renal transplants, tuberculosis was confirmed in 12 cases. Of these, 25% had a history of acute rejection, and 50% had creatinine levels greater than 1.5 mg/dl prior to infection. The disease typically presented as pulmonary (50%) and disseminated (33.3%). The first phase of treatment consisted of 3 months of HZRE (isoniazid, pyrazinamide, rifampicin and ethambutol) in 75% of the cases and HZME (isoniazid, pyrazinamide, moxifloxacin and ethambutol) in 25% of the cases. During the second phase of the treatment, 75% of the cases received isoniazid and rifampicin, and 25% of the cases received isoniazid and ethambutol. The length of treatment varied between 6 and 18 months. In 41.7% of patients, hepatotoxicity was associated with the beginning of anti-tuberculosis therapy. During a year-long follow-up, renal function remained stable, and the mortality rate was 16.7%. Conclusion: Tuberculosis in the renal transplant population studied caused diverse nonspecific symptoms. Pulmonary and disseminated tuberculosis were the most frequent forms and required prolonged treatment. Antituberculosis medications had a high toxicity and mortality. This infection must be considered when patients present with a febrile syndrome of unknown origin, especially during the first year after renal transplant.

El escepticismo radical de Pierre Gassendi contra la filosofía natural de los aristotélicos

Este artículo tiene como objetivo dar cuenta del escepticismo radical de Pierre Gassendi propuesto en el Exercitationes paradoxicae Adversus Aristoteleos (Disertaciones paradójicas contra los aristotélicos). Para dar cuenta de ello nuestro artículo se divide en tres momentos: Primero, damos cuenta de la estructura de la obra; segundo, se presentan los argumentos centrales propuestos por Gassendi para comprender su actitud crítica al escolasticismo. Y tercero, se muestra la crítica que realiza a la lógica aristotélica. La idea fundamental que sostenemos en este trabajo es que la actitud crítica y de libre pensador que caracterizó a Gassendi tuvo su origen directo en la actitud escéptica. Además, revisar su obra de juventud y su actitud filosófica nos permite comprender una parte importante del alcance del escepticismo en la reforma de la filosofía natural del siglo XVII.