Santa Fe de la Laguna, Mexico
Santa Fe de la Laguna, Mexico

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PubMed | Fundacion Santa Fe de Bogota, Hospital Luis Fernando Martinez, University of Azuay, Pontifical Xavierian University and University of Los Andes, Colombia
Type: Journal Article | Journal: Archivos argentinos de pediatria | Year: 2017

To describe, in infants aged 1-4 months old living at 3200 meters above sea level (MASL), oxygen saturation (SpO2), sleep apnea indices, and periodic breathing (PB) during sleep. Polysomnographies were done in 18 healthy infants.The median SpO2 was 87%, and the median PB was 7.2% for the total sleep time. The median central sleep apnea index was 30.5/hour, which decreased to 5.4/hour once sleep apneas associated with PB were excluded. The 5th percentile for SpO2 was 76% among awake infants, and 66% among asleep infants.The SpO2 was lower than that observed at sea level, whereas PB and the central sleep apnea index were higher, once sleep apneas associated with PB were excluded. The latter was similar to that observed at sea level. At 3200 MASL, different cut-off points are required for a normal SpO2, one for infants during the waking state and one for infants during sleep.


Iris Suarez M.,University of Antioquia | Uribe D.,University of Antioquia | Jaramillo C.M.,University of Antioquia | Osorio G.,University of Antioquia | And 7 more authors.
Annals of Hepatology | Year: 2015

Background and aim: Hepatocellular carcinoma (HCC) is the most common primary liver cancer diagnosed worldwide. Deregulation of Wnt/β-catenin pathway has been associated with the development of HCC in a substantial number of cases in Europe and far less in Asia. Nothing is known about this pathway in HCC cases from South America. This study aimed to investigate the frequency of mutations in β-catenin gene (CTNNB1) and the subcellular localization of β-catenin in HCC cases from Colombia.Material and methods: We determine by direct sequencing the frequency of mutations in exon 3 of CTNNB1 gene and by immunohistochemistry the subcellular localization of β-catenin in 54 samples of HCC obtained from three pathology units in Bogota and Medellin cities.Results: Only three HCC cases (5.6%) were found mutated at residues (G34E, S45P, P44S, T41I) important for phosphorylation and ubiquitination of β-catenin protein. Strikingly, nuclear or cytoplasmic accumulation of β-catenin, hallmark of Wnt pathway activation, was found in 42.6% HCC cases (23/54). Interestingly, β-catenin accumulation was significantly more frequent in young patients and hepatitis B virus-related HCC.Conclusions: Although, CTNNB1 exon 3 mutations are not frequent in HCC from Colombian patients, our findings indicate that Wnt/β-catenin signaling is activated in 42.6% of HCC samples. Furthermore, Wnt signaling was demonstrated in HCC cases associated of HBV infection, one of the most important HCC risk factors in Colombia. © 2014 Annals of Hepatology. All rights reserved.


Patel M.M.,Columbia University | Chillrud S.N.,Lamont Doherty Earth Observatory | Correa J.C.,Fundacion Santa Fe de Bogota | Hazi Y.,Columbia University | And 6 more authors.
Environmental Health Perspectives | Year: 2010

Background: Exposure to traffic-related particulate matter (PM) has been associated with adverse respiratory health outcomes in children. Diesel exhaust particles (DEPs) are a local driver of urban fine PM [aerodynamic diameter ≤ 2.5 μm (PM2.5)]; however, evidence linking ambient DEP exposure to acute respiratory symptoms is relatively sparse, and susceptibilities of urban and asthmatic children are inadequately characterized. Objectives: We examined associations of daily ambient black carbon (BC) concentrations, a DEP indicator, with daily respiratory symptoms among asthmatic and nonasthmatic adolescents in New York City (NYC) and a nearby suburban community. Methods: BC and PM2.5were monitored continuously outside three NYC high schools and one suburban high school for 4-6 weeks, and daily symptom data were obtained from 249 subjects (57 asthmatics, 192 nonasthmatics) using diaries. Associations between pollutants and symptoms were characterized using multilevel generalized linear mixed models, and modification by urban residence and asthma status were examined. Results: Increases in BC were associated with increased wheeze, shortness of breath, and chest tightness. Multiple lags of nitrogen dioxide (NO2) exposure were associated with symptoms. For several symptoms, associations with BC and NO2 were significantly larger in magnitude among urban subjects and asthmatics compared with suburban subjects and nonasthmatics, respectively. PM2.5 was not consistently associated with increases in symptoms. Conclusions: Acute exposures to traffic-related pollutants such as DEPs and/or NO2 may contribute to increased respiratory morbidity among adolescents, and urban residents and asthmatics may be at increased risk. The findings provide support for developing additional strategies to reduce diesel emissions further, especially in populations susceptible because of environment or underlying respiratory disease.


Arenas E.,Fundacion Santa Fe de Bogota | Esquenazi S.,Louisiana State University Health Sciences Center | Anwar M.,Magrabi Eye Hospital | Terry M.,Devers Eye Institute
Survey of Ophthalmology | Year: 2012

Penetrating keratoplasty (PK) has been the gold standard for the surgical treatment of most corneal pathologies; lamellar keratoplasty that only replaces the diseased corneal layers has recently evolved as an alternative, however. Innovations in surgical technique and instrumentation provide visual outcomes comparable to PK. We review the indications and outcomes of various techniques of anterior lamellar surgery developed to treat stromal disorders. Similarly, we discuss posterior lamellar keratoplasty techniques such as Descemet stripping automated endothelial keratoplasty and Descemet membrane endothelial keratoplasty. Posterior lamellar keratoplasty provides faster visual rehabilitation than PK in cases of Fuchs endothelial dystrophy and pseudophakic bullous keratopathy. In addition, for medically unresponsive infectious keratitis, therapeutic anterior lamellar keratoplasty yields similar graft survival to PK without an increased risk of disease recurrence. © 2012 Elsevier Inc.


Yepes S.,National University of Colombia | Torres M.M.,National University of Colombia | Torres M.M.,University of Los Andes, Colombia | Saavedra C.,Fundacion Santa Fe de Bogota | And 2 more authors.
World Journal of Gastroenterology | Year: 2012

AIM: To assess the significance of chromosome translocation t(11;18)(q21;q21), B-cell lymphoma 10 (BCL-10) protein and Helicobacter pylori (H. pylori) infection in gastric mucosa-associated lymphoid tissue (MALT) lymphoma in Colombia. METHODS: Fifty cases of gastric MALT lymphoma and their respective post-treatment follow-up biopsies were examined to assess the presence of the translocation t(11;18)(q21;q21) as identified by fluorescence in situ hybridization; to detect protein expression patterns of BCL10 using immunohistochemistry; and for evaluation of tumor histology to determine the correlation of these factors and resistance to H. pylori eradication. RESULTS: Infection with H. pylori was confirmed in all cases of gastric MALT lymphoma in association with chronic gastritis. Bacterial eradication led to tumor regression in 66% of cases. The translocation t(11;18)(q21;q21) was not present in any of these cases, nor was there evidence of tumor transformation to diffuse large B-cell lymphoma. Thirty-four percent of the patients showed resistance to tumor regression, and within this group, 7 cases, representing 14% of all those analyzed, were considered to be t(11;18)(q21;q21)-positive gastric MALT lymphomas. Protein expression of BCL10 in the nucleus was associated with the presence of translocation and treatment resistance. Cases that were considered unresponsive to therapy were histologically characterized by the presence of homogeneous tumor cells and a lack of plasmacytic differentiation. Responder cases exhibited higher cellular heterogeneity and a greater frequency of plasma cells. CONCLUSION: Both t(11;18)(q21;q21)-positive MALT lymphoma cases and those with nuclear BCL10 expression are considered resistant to H. pylori eradication. It is suggested that chronic antigenic stimulation is not a dominant event in resistant cases. © 2012 Baishideng. All rights reserved.


Salazar A.J.,University of Los Andes, Colombia | Camacho J.C.,Fundacion Santa Fe de Bogota | Aguirre D.A.,Fundacion Santa Fe de Bogota
Telemedicine and e-Health | Year: 2011

Objective: Film digitizers are a specialized technology that is available for scanning X-ray radiographs; however, their cost makes them unaffordable for developing countries. Thus, less expensive alternatives are used. The purpose of this study was to compare three devices for digital capture of X-ray films: a film digitizer (US $15,000), a flatbed scanner (US $1800), and a 10-megapixel digital camera (US $450), in terms of diagnostic accuracy, defined as the area under the receiver operating characteristic curves and computed tomography as the gold standard. Materials and Methods: The sample included 136 chest X-ray cases with computed tomography confirmation of the presence or absence of pneumothorax, interstitial opacities, or nodules. The readers were six radiologists who made observations of eight variables for each digital capture of the X-ray films: three main variables to determine the accuracy in the detection of the above-mentioned pathologies, four secondary variables to categorize other pathological classifications, and one variable regarding digital image quality. Results: The receiver operating characteristic curves for each device and pathology were very similar. For the main variables, there was no significant statistical difference in diagnostic accuracy between the devices. For the secondary variables, >84% of cases were correctly classified, even those that were classified with the lowest image quality. High accuracy was determined for the three main variables (0.75 to 0.96), indicating good performance for all tested devices, despite their very different prices. Conclusions: Choosing a device for a teleradiology service should involve additional factors, such as capture time, maintenance concerns, and training requirements. © 2011, Mary Ann Liebert, Inc.


Park S.K.,University of Michigan | Auchincloss A.H.,Drexel University | O'Neill M.S.,University of Michigan | Prineas R.,Wake forest University | And 6 more authors.
Environmental Health Perspectives | Year: 2010

Background: Cardiac autonomic dysfunction has been suggested as a possible biologic pathway for the association between fine particulate matter ≤ 2.5 μm in diameter (PM 2.5) and cardiovascular disease (CVD). We examined the associations of PM 2.5 with heart rate variability, a marker of autonomic function, and whether metabolic syndrome (MetS) modified these associations. Methods: We used data from the Multi-Ethnic Study of Atherosclerosis to measure the standard deviation of normal-to-normal intervals (SDNN) and the root mean square of successive differences (rMSSD) of 5,465 participants 45-84 years old who were free of CVD at the baseline examination (2000-2002). Data from the U.S. regulatory monitor network were used to estimate ambient PM 2.5 concentrations at the participants' residences. MetS was defined as having three or more of the following criteria: abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol, high blood pressure, and high fasting glucose. Results: After controlling for confounders, we found that an interquartile range (IQR) increase in 2-day average PM 2.5 (10.2 μg/m 3) was associated with a 2.1% decrease in rMSSD [95% confidence interval (CI), -4.2 to 0.0] and nonsignificantly associated with a 1.8% decrease in SDNN (95% CI, -3.7 to 0.1). Associations were stronger among individuals with MetS than among those without MetS: an IQR elevation in 2-day PM 2.5 was associated with a 6.2% decrease in rMSSD (95% CI, -9.4 to -2.9) among participants with MetS, whereas almost no change was found among participants without MetS (p-interaction = 0.005). Similar effect modification was observed in SDNN (p-interaction = 0.011). Conclusion: These findings suggest that autonomic dysfunction may be a mechanism through which PM exposure affects cardiovascular risk, especially among persons with MetS.


Mejia M.C.N.,Fundacion Santa Fe de Bogota
Revista Mexicana de Anestesiologia | Year: 2011

The intraoperative awareness is the experience of explicit memory of actual events during general anesthesia, despite suppressive property of anesthetics on memory. For the occurrence of this complication is necessary collection event aware of what we call explicit memory formation. The annual incidence is around 0.1 to 0.02% in adults and children is 0.6 to 1%. There are several known risk factors such as the superficiality of anesthesia, various types of surgery such as obstetrics and cardiac patients with low functional reserve, patients with increased drug requirement. The diagnosis of this potentially serious complication should be justified based assessment test in interrogations conducted and since complications can be serious and disabling long-term, usually require multidisciplinary management of the case. The severity of this complication has aroused the interest of anesthesiologists know and avoid secure his appearance and methods of neurological monitoring of brain activity have proliferated in current practice, showing variable but results so far show significant progress to remove in the future this scourge.


Penaranda A.,Fundacion Santa Fe de Bogota | Garcia J.M.,Fundacion Santa Fe de Bogota
International Journal of Pediatric Otorhinolaryngology | Year: 2015

Objective: To present the otoscopic and audiological findings of studies carried out in groups of 5-14 year old schoolchildren in diverse indigenous, White, and African descended communities in the Republic of Colombia. Materials and methods: The present study is descriptive and cross-sectional. We obtained a convenience sample for the analysis. We define acute otitis media (AOM), (bulging or redness); tympanic perforation (TP), (disruption of continuity in the tympanic membrane) and sequelea (scarring, myringosclerosis, retractions, secrections). Our results are described as frequencies in percentages. Audiometry was performed in every student. Readings were taken at 250, 500, 1000, 2000, 4000, and 8000. Hz for air-conduction and bone-conduction thresholds. Normal hearing is considered up to 20. dB, mild sensorineural hearing loss between 21 and 39. dB, moderate between 40 and 59. dB, severe between 60 and 89. dB and profound more than 90. dB. For conductive hearing loss the air-bone gap is measured. Results: 3052 otoscopies were conducted in 1526 schoolchildren. Males predominated in each group except in the Wayuu group. Otoscopic abnormalities rates varied between 1.5% in Providencia group, up to 9.6% in the Amazon groups. No perforations were found in the Wayuu Indian schoolchildren and the highest frequency of Tympanic perforations (1.2%) and sequelaes (8.2)% in the Amazon groups. Audiometric findings were normal in 94-98% of cases. Conductive hearing loss (CHL) was found in 5.5% of Amazon groups and the lowest (1.4%) in the Wayuu groups. Slight to moderate Neurosensorial Hearing Loss (NHL) were found in 1.3% in the Arhuaca communities and moderate 0.9% in the Amazon groups. Conclusions: The present study is the first conducted in Colombia to evaluate the frequency of ear diseases and sequelae in populations of 5-14 year old children. High prevalences of sequelaes were found in the indigenous groups of the Amazon and the lowest in the Black schoolchildren on the island of Providencia. It is recommended that medical anthropological studies be conducted in these areas, and evaluation done on the probable connection between these types of diseases and processes of intercultural interaction. © 2015 Elsevier Ireland Ltd.


Solano M.E.,El Rosario University | Castillo I.,University of La Sabana | Nino De Mejia M.C.,Fundacion Santa Fe de Bogota
Revista Colombiana de Anestesiologia | Year: 2012

in neurosurgical procedures. A few years back there used to be some medical skepticism about the potential of cerebral ischemia and today we know that it is detrimental and worsens the patient's condition and prognosis. Objective: To review the adverse effects of hypocapnia on various organs -mainly the brain- and to identify the current recommendations about its use. Methodology: We conducted a PubMed literature search using MeSH terminology including the key words. The search was expanded to include a review of several texts and the bibliography of the most relevant articles. Results: The literature review showed that hypocapnia is harmful for the brain and for other tissues and the current recommendation is to use it for two situations only: in case of imminent herniation and to improve the surgical field, limited to 20 minutes. Conclusions: Hyperventilation should not be a routine anesthetic intervention for the management of the neurosurgical patient; there must be a precise indication and once the situation is corrected, the intervention must be immediately withdrawn. © 2011 Sociedad Colombiana de Anestesiología y Reanimación.

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