Hospital Universitario Of Neiva

Neiva, Colombia

Hospital Universitario Of Neiva

Neiva, Colombia
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Tejada J.H.,Hospital Universitario Of Neiva | Tejada J.H.,South Colombian University | Rivas C.V.,South Colombian University | Charry D.,South Colombian University
Archivos de Neurociencias | Year: 2016

Tranexamic acid (TXA) is a medication to priphylaxis use and excessive blood lost treat. As a consequience of CRASH 2 publishing earned itself an important área in the bleeding lost perioperative surgery field. A patient of 39 years old eith a big supratentorial tumor was taken to embolization without successful, using tranexamic acid such a bledding treatment clinic case.


Castaneda D.M.,South Colombian University | Salgado D.M.,South Colombian University | Salgado D.M.,Hospital Universitario Of Neiva | Narvaez C.F.,South Colombian University
Virology | Year: 2016

The CD27 and CD38 antigens are highly expressed on the plasmablast surface, and a massive plasmablast response has been described for dengue virus infection. Soluble CD27 and CD38 forms (sCD27 and sCD38, respectively) increase after immune activation. Here, we show increased sCD27 release in cultures of purified polyclonally stimulated B cells. T and B cells isolated from children with dengue spontaneously produced higher levels of sCD27 but not sCD38, compared with healthy children (P=0.03), and sCD27 levels positively correlated with plasmablast frequency in the cultures (rho=0.58, P=0.01). Children with dengue had higher plasma levels of sCD27 and sCD38 than healthy children, which decreased during convalescence. Plasma sCD27 was higher in severe than with mild dengue, but the opposite was observed for sCD38. These findings support a potential new role for B cells in dengue pathogenesis, and sCD27 and sCD38 are novel biomarkers associated with clinical outcome during dengue virus infection. © 2016 Elsevier Inc.


Perdomo-Celis F.,South Colombian University | Salgado D.M.,South Colombian University | Salgado D.M.,Hospital Universitario Of Neiva | Narvaez C.F.,South Colombian University
Virology | Year: 2017

During dengue virus (DENV) infection, a blockage of secretion of cytokines such as tumor necrosis factor (TNF)-α and members of the interferon (IFN) family has been described in vitro. We evaluated the functionality of monocytes as well as dendritic, B and T cells isolated from children with mild and severe dengue. Compared with those of healthy children, stimulated monocytes, CD4+ T cells and dendritic cells from children with dengue had lower production of proinflammatory cytokines. The interferon axis was dramatically modulated by infection as plasmacytoid dendritic cells (pDCs) and CD4+ T cells had low production of IFN-α and IFN-γ, respectively; plasma levels of IFN-α and IFN-γ were lower in severely ill children, suggesting a protective role. Patients with antigenemia had the highest levels of IFN-α in plasma but the lowest frequency of IFN-α-producing pDCs, suggesting that DENV infection stimulates a systemic type I IFN response but affects the pDCs function. © 2017 Elsevier Inc.


Guerrero C.D.,South Colombian University | Arrieta A.F.,South Colombian University | Ramirez N.D.,South Colombian University | Rodriguez L.-S.,Pontifical Xavierian University | And 8 more authors.
Cytokine | Year: 2013

Identification of early determinants of dengue disease progression, which could potentially enable individualized patient care are needed at present times. Soluble ST2 (sST2) has been recently reported to be elevated in the serum of children older than 2. years old and adults with dengue infection and it was correlated with secondary infections as well as with severe presentations of the disease. The mechanism by which secreted ST2 is linked to severe dengue and plasma leakage remains unclear. One possibility is that IL-33 ligand may be elevated, contributing to membrane bound ST2 as part of the immune activation in dengue infection. We determined plasma levels of sST2 and the ligand IL-33 in 66 children with acute secondary dengue infections clinically classified using the guidelines of the World Health Organization, 2009. Dengue infection showed significant increases in cytokines IL-12p70, IL-10, IL-8, IL-6, IL-1β and TNFα measured by flow cytometry based assay compared to uninfected individuals. In contrast, IL-33 levels remained unchanged between infected and uninfected individuals. The levels of sST2 positively correlated with values of IL-6 and IL-8 and inversely correlated with number of median value of platelet levels. In addition to circulating cytokine positive correlations we found that sST2 and isoenzyme creatine kinase-MB (CK-MB), a marker of myocardial muscle damage present in severe dengue cases were associated. Our pediatric study concluded that in dengue infections sST2 elevation does not involve concomitant changes of IL-33 ligand. We propose a study to assess its value as a predictor factor of disease severity. © 2013 Elsevier Ltd.


PubMed | University of Cartagena, National University of Colombia, Hospital Universitario Of Neiva and University of Magdalena
Type: Journal Article | Journal: Bulletin of emergency and trauma | Year: 2016

To determine the effects of glycemic level on outcome patients with traumatic brain injury.From September 2010 to December 2012, all medical records of adult patients with TBI admitted to the Emergency Room of Laura Daniela Clinic in Valledupar City, Colombia, South America were enrolled. Both genders between 18 and 85 years who referred during the first 48 hours after trauma, and their glucose level was determined in the first 24 hours of admission were included. Adults older than 85 years, with absence of Glasgow Coma Scale (GCS) score and a brain Computerized Tomography (CT) scans were excluded. The cut-off value was considered 200 mg/dL to define hyperglycemia. Final GCS, hospital admission duration and complications were compared between normoglycemic and hyperglycemic patients.Totally 217 patients were identified with TBI. Considering exclusion criteria, 89 patients remained for analysis. The mean age was 43.019.6 years, the mean time of remission was 5.99.4 hours, the mean GCS on admission was 10.53.6 and the mean blood glucose level in the first 24 hours was 138.159.4 mg/dL. Hyperglycemia was present in 13.5% of patients. The most common lesions presented by patients with TBI were fractures (22.5%), hematoma (18.3%), cerebral edema (18.3%) and cerebral contusion (16.2%). Most of patients without a high glucose level at admission were managed only medically, whereas surgical treatment was more frequent in patients with hyperglycemia (p=0.042). Hyperglycemia was associated with higher complication (p=0.019) and mortality rate (p=0.039). GCS was negatively associated with on admission glucose level (r=0.11; p=0.46).Hyperglycemia in the first 24-hours of TBI is associated with higher rate of surgical intervention, higher complication and mortality rates. So hyperglycemia handling is critical to the outcome of patients with traumatic brain injury.


PubMed | Departasmento Of Cuidados Intensivos Hospital Santa Clara, South Colombian University, Hospital Universitario Of Neiva, Hospital Santa Clara and 4 more.
Type: Journal Article | Journal: Medicina intensiva | Year: 2016

Due to the increase in isolation of Candida spp. in critically ill patients, and the high mortality and economic costs which this infection entails, a study was made of the risk factors associated to candidemia in critically ill patients from 7 intensive care units in Colombia.A multicenter matched case-control study was conducted in 7 intensive care units of 3 university hospitals. Data on overall length of hospital stay (including both general wards and the intensive care unit) were recorded.A total of 243 subjects (81 cases and 162 controls) between January 2008 and December 2012 were included. In order of frequency, C. albicans, C. tropicalis and C. parapsilosis were isolated. The main identified risk factors were: overall length of hospital stay>25 days (OR 5.33, 95% CI 2.6-10.9), use of meropenem (OR 3.75, 95% CI 1.86-7.5), abdominal surgery (OR 2.9, 95% CI 1.39-6.06) and hemodialysis (OR 3.35, 95% CI 1.5-7.7). No differences in mortality between patients with candidemia and controls were found (39.5 vs. 36.5%, respectively, P=.66) were found.In Colombia, a long hospital stay, abdominal surgery, the use of meropenem and hemodialysis were identified as risk factors for candidemia.


Osorio J.,Hospital Universitario Of Neiva | Alvarez D.,Hospital Universitario Of Neiva | Pacheco R.,Centro Internacional Of Investigaciones Y Entrenamiento Medico Cideim | Gomezy C.A.,University of Pittsburgh | Lozano A.,Hospital Universitario Of Neiva
Revista Chilena de Infectologia | Year: 2013

Background: Central line-associated bloodstream infections (CLABSI) related to insertion and device care in intensive care units are frequent and preventable events. Aim: To evaluate the reduction in the rate of CLABSI through implementation of an insertion bundle. Methods: A study was conducted in the Adult-ICU at the University Hospital of Neiva comparing a pre-interventional period with an interventional one, each lasting 6 months; the intervention consisting of implementing a bundle of measures for the insertion of central venous catheters (CVC). In the pre-intervention period (2010) the rate of CLABSI and the population's characteristics were evaluated. The bundle for the insertion of the CVC consisted in: hands hygiene, use of 2% clorhexidine, maximum sterile barriers and avoiding femoral access. Results: The rate of CLABSI decreased from 5.56 to 3.26 per 1000 catheter days. The length of ICU stay and catheter duration were associated with a higher risk of infection associated to these devices (p < 0.05). Compliance with the bundle is a protective factor against the development of CLABSI (OR 0.45, p = 0.615). The staff adherence to the bundle was over 80%. Conclusion: Implementing a Central Line Insertion Bundle proved to be a useful measure in prevention of CLABSI in our hospital. This strategy could be implemented in other hospitals of similar complexity.


Perdomo-Celis F.,South Colombian University | Salgado D.M.,South Colombian University | Salgado D.M.,Hospital Universitario Of Neiva | Castaneda D.M.,South Colombian University | Narvaez C.F.,South Colombian University
Clinical and Vaccine Immunology | Year: 2016

Cryopreserved peripheral blood mononuclear cells (PBMCs) are widely used in studies of dengue. In this disease, elevated frequency of apoptotic PBMCs has been described, and molecules such as soluble tumor necrosis factor (TNF)-related apoptosisinducing ligands (sTRAIL) are involved. This effect of dengue may affect the efficiency of PBMC cryopreservation. Here, we evaluate the viability (trypan blue dye exclusion and amine-reactive dye staining) and functionality (frequency of gamma interferon [IFN-λ-producing T cells after polyclonal stimulation) of fresh and cryopreserved PBMCs from children with dengue (in acute and convalescence phases), children with other febrile illnesses, and healthy children as controls. Plasma sTRAIL levels were also evaluated. The frequencies of nonviable PBMCs detected by the two viability assays were positively correlated (r=0.74; P≤ 0.0001). Cryopreservation particularly affected the PBMCs of children with dengue, who had a higher frequency of nonviable cells than healthy children and children with other febrile illnesses (P≶0.02), and PBMC viability levels were restored in the convalescent phase. In the acute phase, an increased frequency of CD3+ CD8+amine-positive cells was found before cryopreservation (P=0.01). Except for B cells in the acute phase, cryopreservation usually did not affect the relative frequencies of viable PBMC subpopulations. Dengue infection reduced the frequency of IFN-λ-producing CD3+ cells after stimulation compared with healthy controls and convalescent-phase patients (P≤0.003), and plasma sTRAIL correlated with this decreased frequency in dengue (rho=0.56; P≤0.01). Natural dengue infection in children can affect the viability and functionality of cryopreserved PBMCs. © Copyright 2016, American Society for Microbiology. All Rights Reserved.


PubMed | University of Cartagena and Hospital Universitario Of Neiva
Type: Journal Article | Journal: Bulletin of emergency and trauma | Year: 2016

This is a case series which report the clinical results of decompressive craniectomy in 4 patients with dilated pupils secondary to traumatic brain injury and postoperative edema. Between 2011 and 2012, four patients, 3 males and 1 female, aged between 35 and 64 with mean age of 50.18.9 years, underwent decompressive craniectomy due to brain traumatic edema. The follow up period ranged between 1 to 6 months. All patients had Glasgow coma score (GCS) of 3-4 at admission, and the duration of pupils being mydriatic was less than 20 minutes before the operation. All patients had moderate disability with GCS of 4 after the operation. Decompressive craniectomy can be a life-saving procedure which provides a better outcome in patients with dilated pupils secondary to brain trauma injury and postoperative edema with timing of less than 20 minutes. However, the small number of the patients in this study is the main limitation to the accuracy of the results, and more studies with larger number of patients are warranted to evaluate the efficiency of decompressive craniectomy in patients with dilated pupils.


PubMed | Hospital Universitario Of Neiva
Type: Comparative Study | Journal: Revista chilena de infectologia : organo oficial de la Sociedad Chilena de Infectologia | Year: 2013

Central line-associated bloodstream infections (CLABSI) related to insertion and device care in intensive care units are frequent and preventable events.To evaluate the reduction in the rate of CLABSI through implementation of an insertion bundle.A study was conducted in the Adult-ICU at the University Hospital of Neiva comparing a pre-interventional period with an interventional one, each lasting 6 months; the intervention consisting of implementing a bundle of measures for the insertion of central venous catheters (CVC). In the pre-intervention period (2010) the rate of CLABSI and the populations characteristics were evaluated. The bundle for the insertion of the CVC consisted in: hands hygiene, use of 2% clorhexidine, maximum sterile barriers and avoiding femoral access.The rate of CLABSI decreased from 5.56 to 3.26 per 1000 catheter days. The length of ICU stay and catheter duration were associated with a higher risk of infection associated to these devices (p < 0.05). Compliance with the bundle is a protective factor against the development of CLABSI (OR 0.45, p = 0.615). The staff adherence to the bundle was over 80%.Implementing a Central Line Insertion Bundle proved to be a useful measure in prevention of CLABSI in our hospital. This strategy could be implemented in other hospitals of similar complexity.

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