Fundacion Santa Fe de Bogota

Santa Fe de la Laguna, Mexico

Fundacion Santa Fe de Bogota

Santa Fe de la Laguna, Mexico
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Martinez-Vega R.A.,Industrial University of Santander | Carrasquila G.,Fundacion Santa Fe de Bogota | Luna E.,University of Sao Paulo | Ramos-Castaneda J.,Instituto Nacional Of Salud Publica | Ramos-Castaneda J.,University of Texas Medical Branch
Vaccine | Year: 2017

The vaccine against Dengue virus (DENV), Dengvaxia® (CYD), produced by Sanofi-Pasteur, has been registered by several national regulatory agencies; nevertheless, the performance and security of this vaccine have been challenged in a series of recent papers. In this work, we intend to contribute to the debate by analyzing the concept of an enhancing vaccine, presenting objections to the epidemiological model base of the concept and, likewise, presenting data that contradict that concept. © 2017 Elsevier Ltd.

Carrizosa J.A.,Fundacion Santa Fe de Bogota | Aponte J.,University of La Sabana | Cartagena D.,University of La Sabana | Ospina M.T.,Hospital Universitario Of La Samaritana | Sanchez A.,Hospital Universitario Of La Samaritana
Frontiers in Immunology | Year: 2017

Patients with autoimmune diseases (ADs) are a challenge for the intensivist; it is hard to differentiate among infection, disease activity, and combinations of both, leading to high mortality. This study is a retrospective analysis of 124 critically ill patients admitted to the intensive care unit (ICU) in a university hospital between 2008 and 2016. Bivariate case-control analysis was performed, using patients who died as cases; later, analysis using a logistic regression model with variables that were associated with mortality was conducted. Four variables were consistently associated with mortality in the logistic regression model and had adequate prediction value (Hosmer and Lemeshow statistic = 0.760; Nagelkerke R-squared = 0.494). The risk of death was found to be statistically associated with the following: shock at admission to ICU [odds ratio (OR): 7.56; 95% confidence interval (CI): 1.78-31.97, p = 0.006], hemoglobin level < 8 g/dL (OR: 16.12; 95% CI: 3.35-77.52, p = 0.001), use of cytostatic agents prior to admission to the ICU (OR: 8.71; 95% CI: 1.23-61.5, p = 0.03), and low levels ofcomplement C3 (OR: 5.23; 95% CI: 1.28-21.35, p = 0.02). These variables can guide clinicians in the early identification of patients with AD with increased risk of death during hospitalization,leading to initial therapies seeking to improve survival. These results should be evaluated prospectively in future studies to establish their predictive power. © 2017 Carrizosa, Aponte, Cartagena,Cervera, Ospina and Sanchez.

Fuentes-Vallejo M.,Fundacion Santa Fe de Bogota | Fuentes-Vallejo M.,Laboratory of Social Dynamics and Spatial Reconstruction LADYSS
BMC Infectious Diseases | Year: 2017

Background: Dengue is a widely spread vector-borne disease. Dengue cases in the Americas have increased over the last few decades, affecting various urban spaces throughout these continents, including the tourism-oriented city of Girardot, Colombia. Interactions among mosquitoes, pathogens and humans have recently been examined using different temporal and spatial scales in attempts to determine the roles that social and ecological systems play in dengue transmission. The current work characterizes the spatial and temporal behaviours of dengue in Girardot and discusses the potential territorial dynamics related to the distribution of this disease. Methods: Based on officially reported dengue cases (2012-2015) corresponding to epidemic (2013) and inter-epidemic years (2012, 2014, 2015), space (Getis-Ord index) and space-time (Kulldorff's scan statistics) analyses were performed. Results: Geocoded dengue cases (n = 2027) were slightly overrepresented by men (52.1%). As expected, the cases were concentrated in the 0- to 15-year-old age group according to the actual trends of Colombia. The incidence rates of dengue during the rainy and dry seasons as well as those for individual years (2012, 2013 and 2014) were significant using the global Getis-Ord index. Local clusters shifted across seasons and years; nevertheless, the incidence rates clustered towards the southwest region of the city under different residential conditions. Space-time clusters shifted from the northeast to the southwest of the city (2012-2014). These clusters represented only 4.25% of the total cases over the same period (n = 1623). A general trend was observed, in which dengue cases increased during the dry seasons, especially between December and February. Conclusions: Despite study limitations related to official dengue records and available fine-scale demographic information, the spatial analysis results were promising from a geography of health perspective. Dengue did not show linear association with poverty or with vulnerable peripheral spaces in intra-urban settings, supporting the idea that the pathogenic complex of dengue is driven by different factors. A coordinated collaboration of epidemiological, public health and social science expertise is needed to assess the effect of "place" from a relational perspective in which geography has an important role to play. © 2017 The Author(s).

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.

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