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Granados C.,Hospital Universitario Of La Samaritana | Suarez J.,University of La Sabana
Israel Medical Association Journal | Year: 2016

Background: Systemic lupus erythematosus (SLE) is an auto-immune disease with multiorgan involvement and wide variability in presentation and course. Although it can appear at any age, women of childbearing age are primarily affected. This has led to the proposal of a hormonal role in the development of SLE. Among the main hormones shown to have immunomodulatory effects are estradiol, progesterone and prolactin. Objectives: To report the levels of estradiol and prolactin in SLE patients and establish the relationship between these levels and disease activity, and to determine whether the phases of the menstrual cycle influence the activity of SLE and its relationship to hormone levels. Methods: In this cross-sectional study, we examined 60 women with SLE. We measured disease activity using SLEDAI and BILAG. We obtained peripheral blood samples to determine the levels of estradiol, progesterone and prolactin. Results: Patients’ age ranged between 16 and 65 years and the mean disease duration was 5.5 years (0-20). SLE was active (SLEDAI > 6) in 13 patients and inactive in 47. Thirty patients were in a pre-ovulatory menstrual cycle phase, 13 in a post-ovulatory cycle, and 17 were menopausal. We found a significant association between C4 levels and disease activity (P = 0.01) and between estradiol levels and disease activity in the kidney (P = 0.04). We did not find hyperprolactinemia in any patient. Conclusions: In this population, we found an association between estradiol levels and organ-specific activity in the kidney. One may speculate as to whether our population might benefit from the implementation of anti-estrogen therapy for control of disease activity, particularly in the kidney. © 2016, Israel Medical Association. All rights reserved.


Miguel-Cruz A.,El Rosario University | Usaquen S.,El Rosario University | Vanegas N.,Hospital Universitario Of La Samaritana
IFMBE Proceedings | Year: 2013

The goals of this research are (1) to obtain the characteristics of maintenance service providers that have a direct impact on performance of maintenance service quality using 20 independent co-variables (2) to determine the decrease or increase in risk these co-variables have on service quality, measured in terms of turnaround time of equipment (Cox Model). A survey was conducted to characterize the maintenance service providers. (n=19). The turnaround time was monitored by means of works orders (N=1025). The most significant results of this work are: (1) The non parametric test showed that the service providers capabilities do affect the maintenance performance. © 2013 Springer.


Orjuela A.,Hospital Universitario Of La Samaritana | Orjuela A.,Hospital Central Of La Policia | Orjuela A.,Hospital Santa Sofia Of Caldas
Revista Colombiana de Cardiologia | Year: 2011

The design of devices of cardiac stimulation in patients with dilated cardiomyopathy has become more sophisticated due to the increment of its implantation, devices that must satisfy the requirements for patients with anatomical changes that appear as a consequence of the cardiac dilation such as caliber modifications, course, length and number of coronary veins. Every time is more difficult to achieve the anatomical objectives, particularly the ideal place for the left ventricular stimulation electrode position in the coronary sinus. This situation limits in some cases the therapeutical benefit of this technique, occasionally facing to the need to submit the patient to thoracotomy for positioning the electrode in the left ventricle posteriorlateral epicardium. Thus, in order to shorten the times and morbidity and increment the implant success, we designed a strategy based on the hemodynamic technique to overcome coronary arteries obstruction and achieve through the angioplasty of the coronary sinus narrowness a more precise approach to a preselected determined epicardial vessel. We describe the technique used in the angioplasty of the coronary sinus for this purpose.


Martinez-Betancur O.,National University of Colombia | Quintero-Cusguen P.,Hospital Universitario Of La Samaritana | Mayor-Agredo L.,Hospital Universitario Of La Samaritana
Revista de Salud Publica | Year: 2016

Objective To test the hypothesis that DALYs, estimated individually for each patient with acute ischemic stroke upon hospital discharge, without reperfusion therapy, are not different between the different subtypes of ischemic stroke. Patients and Methods In the Hospital Universitario de la Samaritana in Bogotá, the health records of patients diagnosed with their first acute ischemic stroke event from admission and monitoring to discharge were selected. The subtype of acute ischemic stroke was classified according to the criteria established by the Trial of Org 10172 in Acute Stroke Treatment (TOAST). DALYs were estimated for each patient with acute ischemic stroke at hospital discharge. To establish differences of DALYs among the five acute ischemic stroke subtypes (TOAST), the Kruskal Wallis test was used. Results Of the 39 cases of acute ischemic stroke, 17 (43.6 %) were classified as artherosclerosis, 10 (25.6 %) as lacunar events, 6 (15.4 %) as cardioembolic attacks, and another 6 (15.4 %) cases with unclear etiology. At hospital discharge, the estimated total DALYs provided by patients with acute ischemic stroke was 316.9 years, without statistically significant differences between the subtypes of ischemic stroke. At hospital discharge, the average of optimal years free of disability lost by a patient surviving an acute ischemic stroke was 8.12. Conclusion Non conclusive results are attributed to the concurrence of dissimilar acute clinical care processes and to the risk factors distributions, comorbidities and patient complications. © 2016, Universidad Nacional de Colombia. All rights reserved.


Rincon C.A.D.,Hospital Universitario Of La Samaritana
Revista Colombiana de Gastroenterologia | Year: 2011

Obesity is considered to be the epidemic of the 21st century. Until now there are no known medical or pharmacological methods to manage obesity in ways that control it and signifi cantly reduce the comorbidities associated with it. Bariatric surgery has become the best alternative for management of obesity. Management of patients undergoing bariatric surgery requires referral centers with multidisciplinary medical groups committed to choice and long term follow-up of these patients. Bariatric surgery continues to be the gold standard for surgical management of morbid obesity. © 2011 Asociaciones Colombianas de Gastroenterología, Endoscopia digestiva, Coloproctología y Hepatología.


Cortes J.A.,National University of Colombia | Leal A.L.,National University of Colombia | Montanez A.M.,National University of Colombia | Buitrago G.,National University of Colombia | And 2 more authors.
Brazilian Journal of Infectious Diseases | Year: 2013

Objective: The aim of this study was to describe the most frequently found bacterial microorganisms in bloodstream isolates taken from patients in intensive care units in Colombia and their resistance profiles. Methods: This was a multicentre descriptive observational study that was carried out between January 2001 and June 2008 with laboratory data from 33 participating hospitals in a surveillance network. Results: The most frequently found microorganisms were coagulase-negative Staphylococci 39.6%, Staphylococcus aureus 12.3%, Klebsiella pneumoniae 8.2%, Escherichia coli 5.7%, Acinetobacter baumannii, 4.0% and Pseudomonas aeruginosa 3.8%. Coagulase-negative Staphylococci registered greater than 70% oxacillin resistance rate. S. aureus presented a change in its multiresistance profile during the years of follow-up. There was a trend towards a lower resistance rate among E. coli and K. pneumoniae isolates during the study period while A. baumannii carbapenem resistance rate exceeded 50%. Discussion: There has been a change in the frequency of species being isolated with a higher frequency of enterobacteriaceae compared to Gram-positive microorganisms, in general with a high resistance rate. © 2013 Elsevier Editora Ltda.


Pena O.R.,Hospital Universitario Of La Samaritana | Gomez Gelvez A.,Hospital Universitario Of La Samaritana | Espinosa K.A.,Hospital Universitario Of La Samaritana | Cardona J.R.,Hospital Universitario Of La Samaritana
Archives of Orthopaedic and Trauma Surgery | Year: 2015

Introduction: Impingement and penetration of the anterior cortex of the femur have been reported as complications after cephalomedullary nailing. The purpose of this study was to determine factors related to nail impingement in our population of Hispanic patients. Materials and methods: A non-matched case–control study was carried out and 156 patients who underwent cephalomedullary nailing from 2010 and 2013 were included; 78 cases with anterior cortical impingement and 78 control cases without impingement were documented. Demographic variables and specifications of the nails such as manufacture and radius of curvature were recorded. The presence of impingement, angle of incidence on radiographs—indirect measurement of the femoral bow on the sagittal plane—and nail entry site were determined. Bivariate and multivariate logistic regression analyses were performed to identify the factors associated with cortical impingement. Results: The distribution by sex corresponded to 87 females (56 %) and 69 males (44 %) with a mean age of 75 years [SD 18.2]. Cortical impingement was presented in 78 cases (50 %) and 6 (3.8 %) patients evidenced penetration of the anterior cortex of the femur. On the bivariate analysis the posterior nail start site is highlighted, which showed a positive association with impingement (OR 4.3; 95 % CI 1.1–36 and p = 0.04). After the multivariate analysis, the factors associated with anterior cortical impingement included female gender (OR 2.2; 95 % CI 1.1–4.6 and p ≤ 0.038), straight nails—short nails—(OR 4.9; 95 % CI 2.2–10 and p ≤ 0.001) and angle of incidence ≥7° (OR 4.9; 95 % CI 2.2–10 and p ≤ 0.001), the latter showing a likelihood of 57 % for impingement, increasing to 90 % with an angle of incidence of 11°. Conclusions: Posterior entry site should be avoided and an anterior site should be used. Female gender, straight nails and greater angle of incidence of the femur were associated with cortical impingement. A specific intramedullary nail design is needed for the Hispanic population due to high impingement and anterior cortical penetration rates seen with conventional nails. Short curved nails and long nails with a lower radius of curvature are required. © 2015, Springer-Verlag Berlin Heidelberg.


Gonzalez Cardenas V.H.,Hospital Universitario Of La Samaritana
Revista Colombiana de Anestesiologia | Year: 2012

Objective: To establish the prevalence of neonatal respiratory depression in patients exposed to intrathecal fentanyl during Cesarean section. Methods: Cross-sectional Analytical Observational Retrospective Study conducted at the Mother and Child Clinic of the Saludcoop Corporation in patients undergoing C-section who received intrathecal fentanyl for regional anesthesia in 2007 and 2008. Primary endpoints: low APGAR score (APGAR<7) and severe APGAR (APGAR<4). Results: 2165 records of C-sections and intrathecal fentanyl with a mean dose of 19.21mcg (SD=0.206mcg). Prevalence of low APGAR at 1, 5 and 10 minutes was 1.77% (SD=0.63%), 0.11% (SD 0.163%), and 0%, respectively. The latter two values were different from the 1-minute value (ANOVA Scheffé Test, p=0.031) and there was no difference between them (minutes 5 and 10) (ANOVA p=0.861). Severely diminished APGAR results were, 0.059% (SD 0.058) 1 minute after birth and 0% at 5 and 10 minutes. There were no statistically significant differences between the three severely diminished values (ANOVA p=0.861). Conclusions: The prevalence of respiratory depression measured with the APGAR test at birth is low; severely compromised APGAR shows a trend towards 0 in the different minutes of assessment. However, the reliability of the diagnostic tool (APGAR) is questionable, considering discrepancies when the analysis is done with a far more sensitive diagnostic tool (Silverman test). The importance of this study relates only to the assessment of prevalence and its use as a source of a research hypothesis, and not as an association or prediction study. © 2011 Sociedad Colombiana de Anestesiología y Reanimación.


Carrillo Franco J.,Hospital Universitario Of La Samaritana | Lopez L.,National University of Colombia
Revista Gerencia y Politicas de Salud | Year: 2014

Objective: Describe the cultural dynamics in social participation in health of a group of women from Chapinero, Bogota - Colombia . Materials and methods: Qualitative research with oral history was developed with six women, community leaders in Bogotá. Were analyzed inductively and interpretative. Results: We present the cultural theme: Women participating and building a possible paradise, a category two subcategories. In the cultural theme of the relationship and tension organizing migrant women to achieve the dream of legitimizing the property, have economic opportunities, make changes in their lives and the institutional responses is revealed. Cultural meanings are changing, while the institutions maintain a technical and hierarchical language. Conclusion: The community self-organization relates to solve your needs with the social participation in health. Therefore, Cultural dynamics should be considered for dialogue with community processes.


PubMed | Hospital Universitario Of La Samaritana
Type: Journal Article | Journal: Archives of orthopaedic and trauma surgery | Year: 2015

Impingement and penetration of the anterior cortex of the femur have been reported as complications after cephalomedullary nailing. The purpose of this study was to determine factors related to nail impingement in our population of Hispanic patients.A non-matched case-control study was carried out and 156 patients who underwent cephalomedullary nailing from 2010 and 2013 were included; 78 cases with anterior cortical impingement and 78 control cases without impingement were documented. Demographic variables and specifications of the nails such as manufacture and radius of curvature were recorded. The presence of impingement, angle of incidence on radiographs--indirect measurement of the femoral bow on the sagittal plane--and nail entry site were determined. Bivariate and multivariate logistic regression analyses were performed to identify the factors associated with cortical impingement.The distribution by sex corresponded to 87 females (56%) and 69 males (44%) with a mean age of 75 years [SD 18.2]. Cortical impingement was presented in 78 cases (50%) and 6 (3.8%) patients evidenced penetration of the anterior cortex of the femur. On the bivariate analysis the posterior nail start site is highlighted, which showed a positive association with impingement (OR 4.3; 95% CI 1.1-36 and p = 0.04). After the multivariate analysis, the factors associated with anterior cortical impingement included female gender (OR 2.2; 95 % CI 1.1-4.6 and p 0.038), straight nails-short nails-(OR 4.9; 95% CI 2.2-10 and p 0.001) and angle of incidence 7 (OR 4.9; 95% CI 2.2-10 and p 0.001), the latter showing a likelihood of 57 % for impingement, increasing to 90% with an angle of incidence of 11.Posterior entry site should be avoided and an anterior site should be used. Female gender, straight nails and greater angle of incidence of the femur were associated with cortical impingement. A specific intramedullary nail design is needed for the Hispanic population due to high impingement and anterior cortical penetration rates seen with conventional nails. Short curved nails and long nails with a lower radius of curvature are required.

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