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Ramirez M.V.,CES University
Current Opinion in Anaesthesiology | Year: 2017

PURPOSE OF REVIEW: In order for the obstetric anesthesiologist to become a true perioperative / peripartum physician, a change in formative programs and certification process in anesthesia are needed. RECENT FINDINGS: Anesthesia training programs are migrating to competency based medical education (CBME) worldwide. The traditional model of attending lectures, grand rounds, reading textbooks and journal papers should be complemented by virtual modalities such as massive open online courses or online teaching tools. The gold standard for assessment of procedural skills in anesthesia consists of a combination of global rating scales and previously validated checklists. Behaviors in the perioperative environment not directly related to the use of drugs, equipment or medical expertise are known as anesthesiologist nontechnical skills and trainees must learn and practice these skills; nontechnical skills can determine 50–80% of adverse events in high-risk professions, including medicine. Regular certification programs are also an important component of the new approach in medical education, in some high-income countries, the specialist anesthesiologist is undertaking regular certification but the impact of these programs on overall outcomes is still unknown. SUMMARY: The obstetric population is becoming a higher risk population, requiring an obstetric anesthesiologist taking on the role of a perioperative / peripartum physician. It is essential that anesthesia training programs migrate to CBME through simulation-based curriculum that allow the achievement of nontechnical skills and team work competencies. It is also essential that regular certification for specialist anesthesiologists occur throughout their entire career. Copyright © 2017 YEAR Wolters Kluwer Health, Inc. All rights reserved.

News Article | November 30, 2016
Site: globenewswire.com

TORONTO, Nov. 30, 2016 (GLOBE NEWSWIRE) -- Dr. Patricio Stocker, President and CEO of PharmaCielo Ltd., announced the company has appointed a Medical Advisory Board (MAB) to provide guidance on the development of medicinal-grade cannabis oil extracts and related products appropriate for use by clinical practitioners. “Under the guidance of Dr. Delon Human, PharmaCielo Board of Directors member and Chair of the MAB, appointees will be able to provide significant input in the development of our medicinal-grade products through their ability to provide global expertise in the areas of healthcare policy, regulation, medical science and patient insights in addition to their clinical experience,” said Dr. Stocker. Dr. Human has assembled an experienced team of international medical clinicians whose expertise will be leveraged to provide guidance in the development of medicinal-grade cannabis oil based products, as well as international insight and understanding of worldwide healthcare policy and its implications for this emerging global industry. “The Medical Advisory Board will oversee PharmaCielo’s practices and processes, ensuring they are UN-aligned and performed ethically and according to Good Manufacturing and Good Medical Practice,” said Dr. Human.  “During the April 2016 UN General Assembly Special Session on Drugs, the UN and its member states strongly endorsed the need to ensure the accessibility and availability of internationally controlled drugs for medical and scientific purposes, including substances such as cannabinoids. In developing a global framework, this should be promoted within national legal systems, while simultaneously preventing diversion, abuse and trafficking. PharmaCielo has the opportunity to develop the world’s finest quality, naturally grown, pharma-grade cannabis oils.” Four appointees to the MAB were introduced (full biographies are available at www.pharmacielo.com): Dr. Delon Human is the president and CEO of Health Diplomats, a health advisory and consulting practice, providing strategic and technical advice on global health issues to Fortune 500 companies in the pharmaceutical, food, tobacco, nicotine and medical device industries as well as NGOs, governments and foundations. He has acted as adviser to WHO Director-Generals and UN Secretary-General Ban Ki Moon. He is a published author and specializes in global health strategy, corporate and product transformation, harm reduction and health communication. Formerly, he served as the Secretary-General of the International Food and Beverage Alliance (IFBA), which brings together the top food companies in the world. From 1997 to 2005, Dr. Human served as secretary general of the World Medical Association (WMA), the global representative body for physicians. He was instrumental in the establishment of the World Health Professions Alliance, an alliance of the global representative bodies of physicians, nurses, pharmacists, dentists and physical therapists. Dr. Human qualified as a physician in South Africa and completed his postgraduate studies in family medicine and child health in South Africa and Oxford, England. He was a clinician for two decades, part of the pediatric endocrinology research unit at the John Radcliffe Hospital and was involved in the establishment of several medical centers, a hospital and emergency clinic in South Africa. His business studies (MBA) were completed at the Edinburgh Business School. A former chair of the World Medical Association, Dr. Anders Milton is a highly sought-after consultant within the healthcare sector and has served as president of the European Regional Network on HIV/AIDS (ERNA) and as president of the Swedish Red Cross among a number of other positions, including appointment by the Swedish government as chairman of a committee on Swedish HIV/AIDS policies and a member of the Catastrophe Commission formed following the December 2004 tsunami. Recently he led a select committee studying organ donation and transplantation. Previously, Dr. Milton served as president and CEO of the Swedish Medical Association. A director of several public and privately held companies and foundations, Dr. Milton originally studied economics before turning to medicine, and after graduating university as a medical doctor and PhD he served as a clinician at the Department of Nephrology at the University Hospital at Uppsala. Throughout his career he has been engaged in work in support of human rights, ethics of medical practice and safe health care, of which effective pharmacotherapy is an integral part. Dr. Gutiérrez is a neuroradiologist in private practice and Director of the Neuroradiology Division at Centro Avanzado de Diagnostíco Médico (CEDIMED) in Colombia. Previously, Dr. Gutiérrez served at the University of Texas Health Science Center in San Antonio, TX as Associate Professor of Radiology, Vice Chair of Clinical Operations, Medical Director and Director of the Clinical Trials Division at the Radiology Department. He was formerly Director of Medical Development, Diagnostic Imaging and Associate Director of Clinical Development, Diagnostic Imaging for Bayer Healthcare (formerly Berlex Laboratories) in Montville, NJ. Dr. Gutiérrez also served as a medical monitor with Novartis (formerly Ciba-Geigy Labs) in Medellin. Dr. Gutiérrez has been the recipient of several awards for his work, and has been the lead researcher, international researcher and co-investigator on numerous clinical trials.  Regularly published, he has co-edited five medical books and authored or co-authored over 25 book chapters as well as 17 peer-reviewed articles and scores of abstracts and articles published in scientific research journals. Dr. Gutiérrez received a Doctorate in Medicine and Surgery from CES University in Medellin and Specialist in Clinical Radiology from Pontifical Xavierian University / San Ignacio Hospital in Bogota. He completed a research fellowship in Neuroradiology at Thomas Jefferson University / TJU Hospital in Philadelphia, PA and a visiting fellowship in Interventional Neuroradiology at the University of Miami / Jackson Memorial Hospital. Dr. Soto is Chairman of the Department of Radiology at Boston Medical Center and a Professor of Radiology at the Boston University School of Medicine. He has previously served as a general medical practitioner with the Hospital San Antonio de Prado in Colombia, section head of Body Imaging at University of San Vicente de Paúl Hospital, radiologist at CEDIMED in Medellin, assistant professor of Radiology at the University of Antioquia and was vice chairman of Boston Medical Center’s Department of Radiology for ten years. A native of Medellin with citizenship in both Colombia and the United States, Dr. Soto received his Doctor in Medicine and Surgery and Specialist in Diagnostic Radiology from CES University’s Health Sciences Institute in Medellin, and completed a Radiology Body Imaging Fellowship at Boston University Medical Center. Dr. Soto has received honors and awards from the Colombian Ministry of Education, Medellin Medicine Academy, Boston University Medical Center and numerous professional societies.  An extensively published researcher, Dr. Soto is a member of the editorial boards of Radiology and Abdominal Imaging, has edited seven books and has published over 85 original research papers and more than 35 reviews, book chapters and case reports. PharmaCielo Ltd. (the “Company”) is a global company privately held and headquartered in Canada, with a focus on processing and supplying all natural, medicinal-grade cannabis oil extracts and related products to large channel distributors.  The Company’s principal (and wholly-owned) subsidiary is PharmaCielo Colombia Holdings S.A.S., headquartered at its Nursery and Propagation Centre located in Rionegro, Colombia. The boards of directors and executive teams of both PharmaCielo and PharmaCielo Colombia Holdings are comprised of a diversely talented group of international business executives and specialists with relevant and varied expertise.  PharmaCielo recognized the significant role that Colombia’s ideal location will play in building a sustainable business in the medical cannabis industry, and the Company, together with its directors and executives, has built a compelling business plan focused on supplying the international marketplace. This press release contains forward-looking statements. Often, but not always, forward-looking statements can be identified by the use of words such as “plans”, “expects” or “does not expect”, “is expected”, “estimates”, “intends”, “anticipates” or “does not anticipate”, or “believes”, or “recurring” or variations of such words and phrases or state that certain actions, events or results “may”, “could”, “would”, “might” or “will” be taken, occur or be achieved. Forward-looking statements involve known and unknown risks, uncertainties and other factors, such as demand for the Company’s products, currency exchange changes and risks, internal funding and the financial condition of the Company, product roll-out, competition, technological changes, and other commercial matters involving the Company, its products, and the markets in which the Company operates, as well as general economic conditions, which may cause the actual results, performance or achievements of the Company to be materially different from any future results, performance or achievements expressed or implied by the forward-looking statements. Actual results and developments are likely to differ, and may differ materially, from those expressed or implied by the forward-looking statements contained in this press release. There can be no assurance that forward-looking statements will prove to be accurate, as actual results and future events could differ materially from those anticipated in such statements. Accordingly, readers should not place undue reliance on forward-looking statements. Except as required by law, we undertake no obligation to publicly update any forward-looking statements, whether as a result of new information, future events or otherwise. However, any further disclosures made on related subjects in subsequent reports should be consulted.

Bertet K.,University of La Rochelle | Monjardet B.,CES University
Theoretical Computer Science | Year: 2010

The notion of dependencies between "attributes" arises in many areas such as relational databases, data analysis, data-mining, formal concept analysis, knowledge structures .... Formalization of dependencies leads to the notion of so-called full implicational systems (or full family of functional dependencies) which is in one-to-one correspondence with the other significant notions of closure operator and of closure system. An efficient generation of a full implicational system (or a closure system) can be performed from equivalent implicational systems and in particular from the bases for such systems, for example, the so-called canonical basis. This paper shows the equality between five other bases originating from different works and satisfying various properties (in particular they are unit implicational systems). The three main properties of this unique basis are the directness, canonical and minimal properties, whence the name canonical direct unit implicational basis given to this unit implicational system. The paper also gives a nice characterization of this canonical basis and makes precise its link with the prime implicants of the Horn function associated to a closure operator. It concludes that it is necessary to compare more closely related works made independently, and with a different terminology, in order to take advantage of the really new results in these works. © 2010 Elsevier B.V. All rights reserved.

Ordonez J.E.,HEMO Group | Orozco J.J.,CES University
BMC Infectious Diseases | Year: 2014

Background: Nowadays, there are two vaccination strategies in Colombia to prevent pneumococcal diseases in people over 50 years. Our aim is to estimate cost-effectiveness of pneumococcal conjugate vaccine 13-valent (PCV13) versus pneumococcal polysaccharide vaccine 23-valent (PPSV23) to prevent pneumococcal diseases and their related mortality in people over 50 years old in Colombia.Methods: A Markov model was developed with national data, including pneumococcal serotypes distribution in Colombia between 2005 and 2010. Vaccination of a cohort was simulated and a five year time horizon was assumed. Analysis was done from a perspective of a third party payer. Direct costs were provided by a national insurance company; sensitive univariate and probabilistic analysis were done for epidemiological and clinical effectiveness parameters and costs.Results: PCV13 avoids 3 560 deaths by pneumococcal infections versus PPSV23 and 4 255 deaths versus no vaccine. PCV13 prevents 79 633 cases by all-cause pneumonia versus PPSV23 and 81 468 cases versus no vaccine. Total costs (healthcare and vaccines costs) with PCV13 would be U.S. $ 97,587,113 cheaper than PPSV23 and it would save U.S. $ 145,196,578 versus no vaccine.Conclusion: PCV13 would be a cost-saving strategy in the context of a mass vaccination program in Colombia to people over 50 years old because it would reduce burden of disease and specific mortality by pneumococcal diseases, besides, it saves money versus PPSV23. © 2014 Ordóñez and Orozco; licensee BioMed Central Ltd.

A detailed review was published in 2004 on the therapeutic properties of the medications used in the treatment of bipolar disorders (Tamayo, JM et al. Actas Esp Psiquiatr 2004;32(Supl. 1):3-17). At the time it could be concluded that although mood stabilizers (euthymics) share some action mechanisms, they are also significantly different from each other with respect to their therapeutic properties in the various phases of bipolar disorders. This led to a proposed change in their generic classification as "mood stabilizers" to a new classification that includes: antimanic medications, partial mood stabilizers, and euthymics. Since then, several randomized, double-blind studies and meta-analyses that explore the effectiveness and tolerability of these medications have been published. This updated review aims to assess the validity of the proposed classification in the light of new evidence.

Basili M.,University of Siena | Chateauneuf A.,CES University
International Journal of Approximate Reasoning | Year: 2011

This paper introduces a multiple quantile utility model of Cumulative Prospect Theory in an ambiguous setting. We show a representation theorem in which a prospect is valued by a composite value function. The composite value function is able to represent asymmetric attitude on extreme events and a rational prudence on ordinary events. © 2011 Published by Elsevier Inc.

Cohen M.,CES University
Mathematical Population Studies | Year: 2015

The classical expected utility model of decision under risk has been criticized from an experimental point of view (Allais’ paradox) as well as for its restrictive lack of explanatory power. The Rank-Dependent Expected Utility model answers some of these criticisms. The decision maker is characterized by two functions: a utility function on consequences measuring preferences over sure outcomes and a probability weighting function measuring the subjective weighting of probabilities. The model allows for more diversified types of behavior: it is consistent with the behavior revealed by the Allais paradox; the decision maker could dislike risk (prefer its expectation to any lottery) without necessarily avoiding any increase in risk; diminishing marginal utility may coexist with “weak” risk-seeking attitudes; decision makers with the same utility function may differ in their choices between lotteries when they have different probability weighting functions; furthermore, the same decision maker may have different, context-dependent, subjective beliefs on events. © 2015, Taylor & Francis Group, LLC.

Salazar L.M.,CES University | Herrera A.M.,CES University
Lung | Year: 2011

Lung tissue remodeling in chronic obstructive pulmonary disease (COPD) involves diverse processes characterized by epithelial disruption, smooth muscle hypertrophy/hyperplasia, airway wall fibrosis, and alveolar destruction. According to the accepted current theory of COPD pathogenesis, tissue remodeling in COPD is predominantly a consequence of an imbalance between proteolytic and antiproteolytic activities. However, most of the studies carried out during the last few years have focused on mechanisms related to degradation of extracellular matrix (ECM) structural proteins, neglecting those involved in ECM protein deposition. This review revisits some of the latest findings related to fibrotic changes that occur in the airway wall of COPD patients, as well as the main cellular phenotypes relevant to these processes. © 2011 Springer Science+Business Media, LLC.

Urrego R.,University of Antioquia | Urrego R.,CES University | Rodriguez-Osorio N.,University of Antioquia | Niemann H.,Institute of Farm Animal Genetics
Epigenetics | Year: 2014

The use of Assisted Reproductive Technologies (ARTs) in modern cattle breeding is an important tool for improving the production of dairy and beef cattle. A frequently employed ART in the cattle industry is in vitro production of embryos. However, bovine in vitro produced embryos differ greatly from their in vivo produced counterparts in many facets, including developmental competence. The lower developmental capacity of these embryos could be due to the stress to which the gametes and/or embryos are exposed during in vitro embryo production, specifically ovarian hormonal stimulation, follicular aspiration, oocyte in vitro maturation in hormone supplemented medium, sperm handling, gamete cryopreservation, and culture of embryos. The negative effects of some ARTs on embryo development could, at least partially, be explained by disruption of the physiological epigenetic profile of the gametes and/or embryos. Here, we review the current literature with regard to the putative link between ARTs used in bovine reproduction and epigenetic disorders and changes in the expression profile of embryonic genes. Information on the relationship between reproductive biotechnologies and epigenetic disorders and aberrant gene expression in bovine embryos is limited and novel approaches are needed to explore ways in which ARTs can be improved to avoid epigenetic disorders. © 2014 Landes Bioscience.

Cardona-Castro N.,CES University
Leprosy review | Year: 2013

Leprosy in Colombia is not considering as a public health problem since a prevalence rate less than 1/10000 was achieved more than ten years ago. Nevertheless, reports of 2012 from 11 of 27 departments (48%) showed incidence rates from 0.12 to 4.73 cases per 100000 inhabitants. The Ministry of Health and the National Institute of Health direct and organize the National Leprosy Program (NLP), which plan the activities for prevention, surveillance, and control at national level. The operational activities are delegated to the regional levels (municipalities, districts, departments) however in many areas poor hospital infrastructure, high costs, lack of health personnel trained, difficult access to the health services are some of the barriers that impede the development and access to the activities that the NLP publishes in guides. The above mentioned facts have as consequence late case detection with 30% of disability rates (grade 1 and 2) at the time of diagnosis. Also, there is not awareness in general population neither in health professionals about the existence of leprosy cases in Colombia. This is a review of the situation of leprosy in Colombia, taking into account not only statistical data, but also some aspects that influence late diagnosis and disability found in patients at the time of diagnosis. In this review may appear author's personal perceptions that may differ from others.

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