Hospital Universitario Of San Vicente Fundacion

San Vicente de Chucurí, Colombia

Hospital Universitario Of San Vicente Fundacion

San Vicente de Chucurí, Colombia
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Ossa-Giraldo A.C.,Co-operative University of Colombia | Echeverri-Toro L.M.,Hospital Universitario Of San Vicente Fundacion | Santos Z.M.,Major College of Antioquia | Garcia M.G.,Major College of Antioquia | And 3 more authors.
Revista Chilena de Infectologia | Year: 2014

Introduction: Multi-resistant Pseudomonas aeruginosa (MR) is frequently associated with healthcare infections. Its epidemiology is complex and few studies help to understand it. A study about risk factors associated with this type of bacteria is needed. Objective: To determine risk factors associated with MR P. aeruginosa infection in hospitalized patients from the Hospital Universitario San Vicente Foundation-Medellin. Materials and Methods: case-control study to identify risk factors associated with infection by MR P. aeruginosa. Results: 140 patients were included, 70 in each group. Bivariate analysis found association with previous use of carbapenems (OR 3.12 - IC 1.21 to 8.03, p = 0.02), aminoglycosides (OR 5.09 - CI: 1.38 to 18, 77, p = 0.01) and days of stay prior to isolation of the organism (OR 1.03 - CI: 1.01-1.05, p = 0.01). In multivariate analysis MR P. aeruginosa infection was associated with hospital stay (OR 1.03 - IC 1.01 to 1.05), use of aminoglycosides (OR 1.30 to 19.28) and treatment with two or more antimicrobials in the last 30 days (OR 3.09 - CI: 1.26 to 7.58). The risk of developing infection was 3% per day of hospital stay prior to isolation of the agent. Conclusion: Developing MR P. aeruginosa infection was associated with prior use of antimicrobials and prior hospital stay. © 2014, Sociedad Chilena de Infectologia. All rights reserved.


Forero J.E.,National University of Colombia | Posada V.M.,Hospital Universitario Of San Vicente Fundacion | Herrera V.H.,National University of Colombia | del Rio P.,Hospital Universitario Of San Vicente Fundacion | And 3 more authors.
Revista Colombiana de Ciencias Pecuarias | Year: 2014

Background: reports from traditional medicine suggest that chard (Beta vulgaris L. var Cicla) can have remarkable effects in diabetes therapy. Objective: to evaluate the cytotoxic activity of chard extracts in cell lines and determine the viability of cultured porcine pancreatic islets added with or without chard extracts. Methods: cytotoxic activity of chard extracts was assessed in non-tumor and tumor cell lines using the MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] technique, and the ability of extracts to maintain porcine pancreatic islets viability and regeneration in vitro was tested. Results: the 50% cytotoxic concentration (CC50) of extracts for non-tumor cell lines was above 1,000 μg/mL, while it was 825 μg/mL, 283 μg/mL, 136 μg/mL and 380 μg/mL, for hexane, ethyl acetate, ethanol and water extracts in the tumor cell line, respectively. The CC50 ratio between cell lines indicates that ethanol extract is 7.5 times more toxic to tumor than non-tumor cell lines. There was an increase in viability of porcine pancreatic islets cultured with aqueous, ethyl acetate, and ethanol extracts compared with standard media (CMRL1066) and Cyclosporine A (CsA) control groups. Furthermore, a greater than one regeneration index of islets cultured with ethanol extract at 1,000 μg/mL and 500 μg/mL concentrations during 15 days was observed, which remained constant and was significantly higher than CsA group. Conclusions: these results suggest that chard metabolites should be researched to develop antitumor therapies and human pancreatic islets recovery in diabetes treatment. © 2014 Universidad de Antioquia. All rights reserved.


Rodriguez E.A.,University of Antioquia | Correa M.M.,University of Antioquia | Ospina S.,Hospital Universitario Of San Vicente Fundacion | Atehortua S.L.,Hospital Universitario Of San Vicente Fundacion | Jimenez J.N.,University of Antioquia
PLoS ONE | Year: 2014

Background: Clinical significance of Staphylococcus aureus colonization has been demonstrated in hospital settings; however, studies in the community have shown contrasting results regarding the relevance of colonization in infection by community-associated MRSA (CA-MRSA). In Colombia there are few studies on S. aureus colonization. The aim of this study was to determine the molecular and epidemiological characteristics of nasal colonization by S. aureus (MSSA-MRSA) in children from a university hospital and day care centers (DCCs) of Medellin, Colombia. Methods: An observational cross-sectional study was conducted in 400 children (200 in each setting), aged 0 months to 5 years, during 2011. Samples were collected from each nostril and epidemiological information was obtained from the parents. Genotypic analysis included spa typing, PFGE, MLST, SCCmec typing, detection of genes for virulence factors and agr groups. Results: Frequency of S. aureus colonization was 39.8% (n = 159) (hospital 44.5% and DCCs 35.0%) and by MRSA, 5.3% (n = 21) (hospital 7.0% and DCCs 3.5%). Most S. aureus colonized children were older than two years (p = 0.005), the majority of them boys (59.1%), shared a bedroom with a large number of people (p = 0.028), with history of β-Lactamase inhibitors usage (p = 0.020). MSSA strains presented the greatest genotypic diversity with 15 clonal complexes (CC). MRSA isolates presented 6 CC, most of them (47.6%) belonged to CC8-SCCmec IVc and were genetically related to previously reported infectious MRSA strains. Conclusion: Differences in epidemiological and molecular characteristics between populations may be useful for the understanding of S. aureus nasal colonization dynamics and for the design of strategies to prevent S. aureus infection and dissemination. The finding of colonizing MRSA with similar molecular characteristics of those causing infection demonstrates the dissemination capacity of S. aureus and the risk of infection among the child population. © 2014 Rodriguez et al.


Agudelo M.,Hospital Universitario Of San Vicente Fundacion | Rodriguez C.A.,Hospital Universitario Of San Vicente Fundacion | Pelaez C.A.,Hospital Universitario Of San Vicente Fundacion | Vesga O.,Hospital Universitario Of San Vicente Fundacion | Vesga O.,University of Antioquia
Antimicrobial Agents and Chemotherapy | Year: 2014

Several studies with animal models have demonstrated that bioequivalence of generic products of antibiotics like vancomycin, as currently defined, do not guarantee therapeutic equivalence. However, the amounts and characteristics of impurities and degradation products in these formulations do not violate the requirements of the U.S. Pharmacopeia (USP). Here, we provide experimental data with three generic products of meropenem that help in understanding how these apparently insignificant chemical differences affect the in vivo efficacy. Meropenem generics were compared with the innovator in vitro by microbiological assay, susceptibility testing, and liquid chromatography/mass spectrometry (LC/MS) analysis and in vivo with the neutropenic guinea pig soleus infection model (Pseudomonas aeruginosa) and the neutropenic mouse thigh (P. aeruginosa), brain (P. aeruginosa), and lung (Klebisella pneumoniae) infection models, adding the dihydropeptidase I (DHP-I) inhibitor cilastatin in different proportions to the carbapenem. We found that the concentration and potency of the active pharmaceutical ingredient, in vitro susceptibility testing, and mouse pharmacokinetics were identical for all products; however, two generics differed significantly from the innovator in the guinea pig and mouse models, while the third generic was therapeutically equivalent under all conditions. Trisodium adducts in a bioequivalent generic made it more susceptible to DHP-I hydrolysis and less stable at room temperature, explaining its therapeutic nonequivalence. We conclude that the therapeutic nonequivalence of generic products of meropenem is due to greater susceptibility to DHP-I hydrolysis. These failing generics are compliant with USP requirements and would remain undetectable under current regulations. Copyright © 2014, American Society for Microbiology. All Rights Reserved.


Agudelo M.,University of Antioquia | Agudelo M.,Hospital Universitario Of San Vicente Fundacion | Rodriguez C.A.,University of Antioquia | Zuluaga A.F.,University of Antioquia | And 2 more authors.
International Journal of Antimicrobial Agents | Year: 2015

After demonstrating with diverse intravenous antibacterials that pharmaceutical equivalence (PE) does not predict therapeutic equivalence, we tested a single generic product of piperacillin/tazobactam (TZP) in terms of PE, pharmacokinetics and in vitro/vivo pharmacodynamics against several pathogens in neutropenic mouse thigh, lung and brain infection models. A generic product was compared head-to-head against the innovator. PE was evaluated by microbiological assay. Single-dose serum pharmacokinetics were determined in infected mice, and the MIC/MBC were determined by broth microdilution. In vivo experiments were done in a blind fashion. Reproducibility was tested on different days using different infecting organisms and animal models. Neutropenic MPF mice were infected in the thighs with Staphylococcus aureus GRP-0057 or Pseudomonas aeruginosa PA01 and in the lungs or brain with Klebsiella pneumoniae ATCC 10031. Treatment started 2 h (thigh and brain) or 14 h (lung) after infection and was administered every 3 h over 24 h (thigh and lung) or 48 h (brain). Both products exhibited the same MIC/MBC against each strain, yielded overlaid curves in the microbiological assay (P > 0.21) and were bioequivalent (IC90 83-117% for AUC test/reference ratio). In vivo, the generic product and innovator were again undistinguishable in all models and against the different bacterial pathogens involved. The relevance of these neutropenic murine models of infection was established by demonstrating their accuracy to predict the biological response following simultaneous treatment with a generic product or the innovator of TZP. Therapeutic equivalence of the generic product was proved in every model and against different pathogens. © 2014 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.


PubMed | Hospital Universitario Of San Vicente Fundacion and University of Antioquia
Type: Journal Article | Journal: Revista colombiana de psiquiatria | Year: 2016

Patients with bipolar disorder type I (BDI) have an increased prevalence of psychotic symptoms, and these have been associated with higher cognitive impairment; however the issue has not been settled with the available evidence.To determine if the history of psychotic symptoms in a Colombian sample with BDI is associated with greater cognitive impairment.A case-control study was performed that included patients with BDI from the l PRISMA study. Of the 203 eligible subjects, 123 participants were included; 71 had a history of psychosis, and 52 did not. Cognitive function was characterised by neuropsychological tests that assessed intellectual coefficient, attention, executive function, verbal fluency, auditory and visual memory, and spatial location.No differences were found in most of the neuropsychological test results between the groups after adjusting for age, education, sex, duration of the disease, number of episodes, and use of benzodiazepines; however, there was differences in semantic FAS (P=.01), with a better performance in the group with a prior history of psychosis.The results suggest that there are no significant differences in the cognitive performance between patients with BDI in euthymic stage, with and without history of psychosis.


PubMed | Hospital Universitario Of San Vicente Fundacion and University of Antioquia
Type: Journal Article | Journal: Revista de neurologia | Year: 2016

IgG4-related disease is a recently described multisystemic clinical entity that can occur with different clinical manifestations. The most often affected organs are the pancreas, bile duct and salivary glands, with unusual central nervous system affection.A 33 year old woman who presented with cognitive impairment, hallucinations, headache, convulsive syndrome, maxillary sinus inflammation with bone involvement and evidence of pachymeningitis and panhypopytuirarism with meningeal biopsy that confirmed IgG4-related disease, after ruling out secondary causes. Treatment was started with steroids and azathioprine without relapses after 12 months follow-up.IgG4-related disease should be considered in cases of hypertrophic pachymeningitis and hypophysitis especially when no other cause has been found, even if they are not accompanied by other systemic disease manifestations, having ruled out other common causes. The treatment of choice is glucocorticoids and it could be needed to add another immuno-suppressant agent as steroid sparing and to prevent relapses. Prospective studies are needed to evaluate the different clinical and paraclinical manifestations and to establish the results of long-term treatment.


PubMed | Hospital Universitario Of San Vicente Fundacion and University of Antioquia
Type: Journal Article | Journal: PloS one | Year: 2014

Clinical significance of Staphylococcus aureus colonization has been demonstrated in hospital settings; however, studies in the community have shown contrasting results regarding the relevance of colonization in infection by community-associated MRSA (CA-MRSA). In Colombia there are few studies on S. aureus colonization. The aim of this study was to determine the molecular and epidemiological characteristics of nasal colonization by S. aureus (MSSA-MRSA) in children from a university hospital and day care centers (DCCs) of Medellin, Colombia.An observational cross-sectional study was conducted in 400 children (200 in each setting), aged 0 months to 5 years, during 2011. Samples were collected from each nostril and epidemiological information was obtained from the parents. Genotypic analysis included spa typing, PFGE, MLST, SCCmec typing, detection of genes for virulence factors and agr groups.Frequency of S. aureus colonization was 39.8% (n=159) (hospital 44.5% and DCCs 35.0%) and by MRSA, 5.3% (n=21) (hospital 7.0% and DCCs 3.5%). Most S. aureus colonized children were older than two years (p=0.005), the majority of them boys (59.1%), shared a bedroom with a large number of people (p=0.028), with history of -Lactamase inhibitors usage (p=0.020). MSSA strains presented the greatest genotypic diversity with 15 clonal complexes (CC). MRSA isolates presented 6 CC, most of them (47.6%) belonged to CC8-SCCmec IVc and were genetically related to previously reported infectious MRSA strains.Differences in epidemiological and molecular characteristics between populations may be useful for the understanding of S. aureus nasal colonization dynamics and for the design of strategies to prevent S. aureus infection and dissemination. The finding of colonizing MRSA with similar molecular characteristics of those causing infection demonstrates the dissemination capacity of S. aureus and the risk of infection among the child population.


Vanegas-Garcia A.L.,Hospital Universitario Of San Vicente Fundacion | Vanegas-Garcia A.L.,University of Antioquia | Calle-Lopez Y.,University of Antioquia | Zapata C.H.,University of Antioquia | And 3 more authors.
Revista de Neurologia | Year: 2016

Introduction. IgG4-related disease is a recently described multisystemic clinical entity that can occur with different clinical manifestations. The most often affected organs are the pancreas, bile duct and salivary glands, with unusual central nervous system affection. Case report. A 33 year old woman who presented with cognitive impairment, hallucinations, headache, convulsive syndrome, maxillary sinus inflammation with bone involvement and evidence of pachymeningitis and panhypopytuirarism with meningeal biopsy that confirmed IgG4-related disease, after ruling out secondary causes. Treatment was started with steroids and azathioprine without relapses after 12 months follow-up. Conclusions. IgG4-related disease should be considered in cases of hypertrophic pachymeningitis and hypophysitis especially when no other cause has been found, even if they are not accompanied by other systemic disease manifestations, having ruled out other common causes. The treatment of choice is glucocorticoids and it could be needed to add another immunosuppressant agent as steroid sparing and to prevent relapses. Prospective studies are needed to evaluate the different clinical and paraclinical manifestations and to establish the results of long-term treatment. © 2016 Revista de Neurología. All rights reserved.


Vasquez-Arenas M.I.,Hospital Universitario Of San Vicente Fundacion | Echeverri-Alvarez L.,Hospital Of San Jose | Rendon-Pereira G.,Institute Cancerologia | Pareja-Franco R.,Institute Cancerologia
Revista Colombiana de Obstetricia y Ginecologia | Year: 2015

Objective: To present the case of a patient with stage IB1 cervical cancer larger than 2 centimetres who received neo-adjuvant chemotherapy followed by laparoscopic radical cervicectomy and pelvic lymphadenectomy for fertility preservation; and to review the literature for case reports emphasizing obstetric and oncologic outcomes. Materials and methods: Case presentation and search of the literature in Medline through PubMed of articles published in English, French and Spanish between January 2000 and August 2014 on the topic of neo-adjuvant chemotherapy and fertility preservation surgery in patients with stage IB cervical cancer. Results: Overall, 12 relevant articles were selected totalling 55 patients. Over follow-up period ranging between 14 and 69 months there were 4 relapses and only one death attributable to the disease. Obstetric outcomes included 30 pregnancies, 24 births, 3 miscarriages, 1 ectopic pregnancy, and 2 on going pregnancies. Conclusion: Neo-adjuvant chemotherapy followed by conservative, fertility preservation surgery may be an option for the management of selected patients with stage IB cervical cancer involving large tumours sizes, who wish to preserve their fertility.

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