Mederi Hospital Universitario Mayor

Bogotá, Colombia

Mederi Hospital Universitario Mayor

Bogotá, Colombia
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Isaza-Restrepo A.,El Rosario University | Isaza-Restrepo A.,Mederi Hospital Universitario Mayor | Bolivar-Saenz D.J.,Hospital Occidente Of Kennedy | Tarazona-Lara M.,Mederi Hospital Universitario Mayor | Tovar J.R.,University of Santiago de Cali
World Journal of Emergency Surgery | Year: 2017

Background: Trauma characteristics and its management is influenced by socioeconomic context. Cardiac trauma constitutes a challenge for surgeons, and outcomes depend on multiple factors including initial care, characteristics of the wounds, and surgical management. Methods: This is a retrospective cross-sectional case series of patients with penetrating cardiac injuries (PCI) from January 1999 to October 2009 who underwent surgery in a trauma referral center in Bogotá, Colombia. Demographic variables, trauma characteristics, treatment, and outcomes were analyzed. Results: The study included 240 cases: 96.2% males, mean age of 27.8 years. Overall mortality was 14.6%: 11.7% from stab wounds and 41.2% from gunshot wounds. Upon admission, 44% had a normal hemodynamic status and 67% had cardiac tamponade. About 32% had Grade II injuries and 29% Grade IV injuries. In 85% of the cases, there were ventricular compromise and 55% of patients had associated lesions. In 150 cases, a pericardial window was performed. Highest mortality occurred in wounds to the right atrium. In tamponade patients, mortality was 20% being higher for gunshot wounds (54.5%) than for stab wounds (18%) (p = 0.0120). Conclusions: The study evidenced predominance of stab wounds. Based on characteristics of the trauma, patients, and survival rate, there is most likely a high pre-hospitalization mortality rate. The difference in mortality due to stab wounds and those produced by gunshots was more related to technical difficulties of the surgical repair than with the type of injury established by the Injury Grading Scale. Mortality was higher in patients with cardiac tamponade. Surgical management was satisfactory using pericardial window as the diagnostic method and sternotomy as the surgical approach. © 2017 The Author(s).


PubMed | Instituto Nacional Of Salud, Mederi Hospital Universitario Mayor, University of California at Davis, Emory University and El Rosario University
Type: | Journal: Journal of autoimmunity | Year: 2017

We have focused on the epidemiology and immunobiology of Zika virus (ZIKV) infection and factors associated with the development of Guillain-Barr syndrome (GBS) and other neurological syndromes in Ccuta, the capital of North Santander department, Colombia. Data of patients with ZIKV disease reported to the national population-based surveillance system were used to calculate the basic reproduction number (R


Isaza-Restrepo A.,El Rosario University | Isaza-Restrepo A.,Mederi Hospital Universitario Mayor | Moreno-Mejia J.F.,Hospital San Rafael | Martin-Saavedra J.S.,El Rosario University | Ibanez-Pinilla M.,El Rosario University
World Journal of Emergency Surgery | Year: 2017

Background: There is a well known relationship between hypoperfusion and postoperative complications like anastomotic leak. No studies have been done addressing this relationship in the context of abdominal trauma surgery. Central venous oxygen saturation is an important hypoperfusion marker of potential use in abdominal trauma surgery for identifying the risk of anastomotic leak development. The purpose of this study was to identify the relationship between low values of central venous oxygen saturation and anastomotic leak of gastrointestinal sutures in the postoperative period in abdominal trauma surgery. Methods: A cross-sectional prospective study was performed. Patients over 14 years old who required surgical gastrointestinal repair secondary to abdominal trauma were included. Anastomotic leak diagnosis was confirmed through clinical manifestations and diagnostic images or secondary surgery when needed. Central venous oxygen blood saturation was measured at the beginning of surgery through a central catheter. Demographic data, trauma mechanism, anatomic site of trauma, hemoglobin levels, abdominal trauma index, and comorbidities were assessed as secondary variables. Results: Patients who developed anastomotic leak showed lower mean central venous oxygen saturation levels (60.0% ± 2.94%) than those who did not (69.89% ± 7.21%) (p = 0.010). Conclusions: Central venous oxygen saturation <65% was associated with the development of gastrointestinal leak during postoperative time of patients who underwent surgery secondary to abdominal trauma. © 2017 The Author(s).


Mahecha M.P.,El Rosario University | Ojeda E.,Mederi Hospital Universitario Mayor | Vega D.A.,Mederi Hospital Universitario Mayor | Sarmiento-Monroy J.C.,El Rosario University | Anaya J.-M.,El Rosario University
Immunologic Research | Year: 2017

Guillain–Barré syndrome (GBS) is a rapid-onset muscle weakness disease caused by the immune-mediated damage of the peripheral nervous system. Since there is an increase incidence of GBS cases in Latin America, particularly in Colombia, and most of them are currently preceded by Zika virus (ZIKV) infection, we aimed to assess the available evidence of the disease in Colombia through a systematic literature review. Out of 51 screened abstracts, only 16 corresponded to articles that met inclusion criteria, of which 15 were case reports or case series. A total of 796 cases of GBS were reported in the included articles. The majority of patients were males (66.8 %) and younger than 50 years old (94 %). An infectious disease before the onset of GBS was registered in 31 % of patients, with gastrointestinal or respiratory symptoms being the most frequently observed. In those cases in which electrodiagnostic tests were performed, the most common subphenotype was acute inflammatory demyelinating polyneuropathy (17 %). Death was reported in 15 % of patients. Data regarding GBS in Colombia is scant and heterogeneous. Taking into account the burden of the disease and the recent rise of GBS cases associated with ZIKV, a careful patient evaluation and a systematic collection of data are warranted. A form to data gathering is proposed. © 2016, Springer Science+Business Media New York.


Anaya J.-M.,El Rosario University | Anaya J.-M.,Mederi Hospital Universitario Mayor | Reyes B.,El Rosario University | Reyes B.,Mederi Hospital Universitario Mayor | And 4 more authors.
Clinical and Experimental Rheumatology | Year: 2015

This was a case study in which 3 patients with autoimmune/auto-inflammatory syndrome induced by adjuvants (ASIA) after quadrivalent human papillomavirus vaccination (HPV) were evaluated and described. All the patients were women. Diagnosis consisted of HLA-B27 enthesitis related arthritis, rheumatoid arthritis and systemic lupus erythematous, respectively. Our results highlight the risk of developing ASIA after HPV vaccination and may serve to increase the awareness of such a complication. Factors that are predictive of developing autoimmune diseases should be examined at the population level in order to establish preventive measures in at-risk individuals for whom healthcare should be personalised and participatory. © Clinical and Experimental Rheumatology 2015.


PubMed | Mederi Hospital Universitario Mayor and El Rosario University
Type: | Journal: Immunologic research | Year: 2016

Guillain-Barr syndrome (GBS) is a rapid-onset muscle weakness disease caused by the immune-mediated damage of the peripheral nervous system. Since there is an increase incidence of GBS cases in Latin America, particularly in Colombia, and most of them are currently preceded by Zika virus (ZIKV) infection, we aimed to assess the available evidence of the disease in Colombia through a systematic literature review. Out of 51 screened abstracts, only 16 corresponded to articles that met inclusion criteria, of which 15 were case reports or case series. A total of 796 cases of GBS were reported in the included articles. The majority of patients were males (66.8%) and younger than 50years old (94%). An infectious disease before the onset of GBS was registered in 31% of patients, with gastrointestinal or respiratory symptoms being the most frequently observed. In those cases in which electrodiagnostic tests were performed, the most common subphenotype was acute inflammatory demyelinating polyneuropathy (17%). Death was reported in 15% of patients. Data regarding GBS in Colombia is scant and heterogeneous. Taking into account the burden of the disease and the recent rise of GBS cases associated with ZIKV, a careful patient evaluation and a systematic collection of data are warranted. A form to data gathering is proposed.

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