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Imagen de apoyo de Biofunctionalization of REDV elastin-like recombinamers improves endothelialization on CoCr alloy surfaces for cardiovascular applications

Por: María Isabel; Gil Castellanos Arboleda | Fecha: 01/01/2015

To improve cardiovascular implant success, metal-based stents are designated to modulate endothelial cells adhesion and migration in order to prevent restenosis and late thrombosis diseases. Biomimetic coatings with extra-cellular matrix adhesive biomolecules onto stents surfaces are a strategy to recover a healthy endothelium. However, the appropriate bioactive sequences to selective promote growth of endothelium and the biomolecules surface immobilization strategy remains to be elucidated. In this study, biofunctionalization of cobalt chromium, CoCr, alloy surfaces with elastin-like recombinamers, ELR, genetically modified with an REDV sequence, was performed to enhance metal surfaces endothelialization. Moreover, physical adsorption and covalent bonding were used as biomolecules binding strategies onto CoCr alloy. Surfaces were activated with plasma and etched with sodium hydroxide previous to silanization with 3-chloropropyltriethoxysilane and functionalized with the ELR. CoCr alloy surfaces were successfully biofunctionalized and the use of an ELR with an REDV sequence, allows conferring bioactivity to the biomaterials surface, demonstrating a higher cell adhesion and spreading of HUVEC cells on the different CoCr surfaces. This effect is emphasized as increases the amount of immobilized biomolecules and directly related to the immobilization technique, covalent bonding, and the increase of surface charge electronegativity. Our strategy of REDV elastin-like recombinamers immobilization onto CoCr alloy surfaces via covalent bonding through organosilanes provides a bioactive surface that promotes endothelial cell adhesion and spreading.

Fuente: Biblioteca Virtual Banco de la República Tipo de contenido: Artículos

Temas:
Otros
Medicina

Imagen de apoyo de Palliative Care: A Human Rights Approach to Health Care

Por: Isabel Pereira Aranda | Fecha: 2018

This report compiles the results of a research project aimed at describing the current palliative care situation in eight Latin American countries. The project’s general objective—to raise awareness and influence public policy around the need to approach palliative care from a human rights perspective—was achieved through rapprochement among professionals from various fields in the region, which in and of itself is a key step forward in terms of bringing together communities that defend patients’ rights with communities that advocate a drug policy embracing a public health focus. We hope that this diagnostic report is useful for professional associations, health professionals, patients’ rights advocates, drug policy reform activists, and decision makers, who can rely on its findings to better integrate palliative care into general health services and to use human rights language to promote public policy reform and guarantee the human rights of those in the Americas who suffer from severe and chronic pain. Description tooked from: https://www.dejusticia.org/publication/palliative-care-a-human-rights-approach-to-health-care-2/ Consulte la versión en español en la siguiente URL: http://babel.banrepcultural.org/cdm/ref/collection/p17054coll31/id/30

Fuente: Biblioteca Virtual Banco de la República Tipo de contenido: Libros

Temas:
Otros
Medicina

Imagen de apoyo de Studies on centromere organisation and function inTrypanosoma brucei

Por: María Clara Echeverry Gaitán | Fecha: 2012

Abstract: Trypanosomes are unicellular early divergent eukaryotic microorganisms that cause sleeping sickness and Chagas disease. Genome sequencing has revealed that these parasites lack most of the highly conserved proteins involved in chromosome segregation. However, kinetochore-associated chromosome segregation has been proposed to occur in Trypanosoma brucei and the existence of centromeres, the locus that interacts with the kinetochores, has been inferred in T. brucei and Trypansoma cruzi. This work aimed to characterise, at a structural and functional level, the centromeres of Trypanosoma sp. Centromeres in T. brucei have been localised to chromosomal loci that contain an array of ~147 bp AT-rich tandem repeats. Using a long-range restriction endonuclease mapping approach, we found that the sizes of the arrays in T. brucei chromosomes 1-8 vary from 20 to 110 kb and present length heterogeneity between chromosome homologues. Topoisomerase II-? (TOP2?) plays a major role in sister chromatid segregation. TOP2? specific centromeric activity has been demonstrated in trypanosomes. In this project, we systematically evaluated through different approaches, regulatory mechanisms for the TOP2? activity/recruitment to trypanosome centromeres. In other eukaryotes, the Small Ubiquitin-like MOdifier (SUMO) interaction with TOP2? is required for it to be recruited to centromeres during mitosis. In independent experiments, we found no evidence for this association in bloodstream form (BSF) T. brucei . Modifications to the carboxyl terminal region (CTR) of TOP2?, other than SUMOylation, have been described that affect cell cycle specific localisation on chromosomes. Here, we undertook experiments to further delineate regions of the CTR of trypanosome TOP2?. Using a sequential deletion approach, we found that amino acids 1223-1312 in the CTR of enzyme are not required for its centromeric-specific activity. Finally, we found that the condensin unit SMC2 is essential for growth of T. brucei BSFs and not for TOP2? specific centromeric activity.

Fuente: Biblioteca Virtual Banco de la República Tipo de contenido: Tesis

Temas:
Otros
Medicina

Imagen de apoyo de The morbidity of oral mucosal lesions in an adult Swedish population

Por: Jairo; Mattsson Robledo Sierra | Fecha: 01/01/2013

Abstract: OBJECTIVE: To study the severity of symptoms and estimate the prevalence of oral mucosal lesions in a non-referral adult Swedish population, as registered by general dental practitioners. This study also aims to evaluate the possibility of dental practitioners collecting large quantities of reliable and accurate clinical data on oral mucosal lesions. STUDY DESIGN: Data from 6,448 adult Swedish patients were collected by general dental practitioners using a standardized registration method. A correlation analysis between a group with oral mucosal lesions and a control group, with no oral mucosal lesions, was performed for various parameters such as symptoms from the oral mucosa, systemic diseases, medication, allergy history, tobacco habits and the patient's own assessment of their general health. In addition, clinical photos were taken of all oral mucosal lesions in order to determine the degree of agreement between the diagnoses made by general dental practitioners and those made by oral medicine specialists. RESULTS: A total of 950 patients (14.7%) presented with some type of oral mucosal lesion and of these, 141 patients (14.8%) reported subjective symptoms. On a visual analogue scale, 43 patients (4.5%) scored their symptoms <30, 65 patients (6.8%) scored their symptoms ?30, and 28 patients (2.6%) scored their symptoms ?60. The most debilitating condition was aphthous stomatitis and the most common oral mucosal lesion was snuff dipper's lesion (4.8%), followed by lichenoid lesions (2.4%) and geographic tongue (2.2%). There was agreement between the oral medicine specialists and the general practitioners over the diagnosis of oral mucosal lesions on the basis of a clinical photograph in 85% of the cases (n=803). CONCLUSIONS: Nearly 15% of the patients with oral mucosal lesions reported symptoms. General practitioners could contribute significantly to the collection of large quantities of reliable and accurate clinical data, although there is a risk that the prevalence of oral mucosal lesions may be underestimated." Resumen: OBJETIVO: Estudiar la severidad de los síntomas y estimar la prevalencia de lesiones de la mucosa oral en una población de Suecia no referida, y registrada por odontólogos generales. Este estudio también tiene como objetivo evaluar la posibilidad de que odontólogos generales recolecten de forma confiable y precisa grandes cantidades de datos clínicos sobre lesiones de la mucosa oral. DISEÑO DEL ESTUDIO: Datos de 6.448 pacientes adultos suecos fueron recolectados por odontólogos generales usando un método estandarizado de registro. Un análisis de correlación entre un grupo de pacientes con lesiones de la mucosa oral y un grupo control, sin lesiones de la mucosa oral, fue realizado para varios parámetros como síntomas en la mucosa oral, enfermedades sistémicas, medicamentos, alergias, tabaquismo, y la percepción del propio paciente sobre su estado de salud. Además, se tomaron fotos clínicas de todas las lesiones de la mucosa oral con el fin de determinar el grado de concordancia entre los diagnósticos realizados por los odontólogos generales y los especialistas en medicina oral. RESULTADOS: Un total de 950 pacientes (14.7%) presentó algún tipo de lesión de la mucosa oral, y de estos, 141 pacientes (14.8%) reportaron síntomas subjetivos. En una escala analógica visual, 43 pacientes (4.5%) calificaron sus síntomas <30, 65 pacientes (6.8%) calificaron sus síntomas ≥30, y 28 pacientes (2.6%) calificaron sus síntomas ≥60. La condición más debilitante fue la stomatitis aftosa y la lesión más común fue la lesión causada por el tabaco húmedo (4.8%), seguida por reacciones liquenoides (2.4%) y lengua geográfica (2.2%). Basado en las fotografías clínicas, hubo una concordancia en el diagnóstico de lesiones de la mucosa oral entre los especialistas en medicina oral y los odontólogos generales en el 85% de los casos (n=803). CONCLUSION: Aproximadamente el 15% de los pacientes con lesiones de la mucosa oral reportaron síntomas. Los odontólogos generales pueden contribuir significativamente en la recolección confiable y precisa de grandes cantidades de datos clínicos, aunque existe un riego de que la prevalencia de lesiones de la mucosa oral pueda ser subestimada."

Fuente: Biblioteca Virtual Banco de la República Tipo de contenido: Artículos

Temas:
Otros
Medicina

Imagen de apoyo de Performance Evaluation Of The Clinimacs System For The Positive Selection Of CD34+ Cells From Stem Cell Products Factors Affecting CD34+ Cell Recovery

Por: Guillermo Andrés Orjuela Falla | Fecha: 2009

CD34+ cell dose in the transplanted product is still considered a measure of the engraftment potential in haemopoietic stem cell transplantation (HSCT). CD34+ selected products are characterised by their high purity and depleted T-cells. These characteristics have made them traditionally suitable to decrease the incidence of graft versus host disease, particularly in haploidentical HSCT. The CliniMACS is a state of the art cell sorting system based on magnetic particles conjugated to CD34 antibodies. This study retrospectively evaluated the CliniMACS system performance in terms of CD34+ purity and cell recovery, and T-cell depletion in the selected product. The results were compared against target values fixed by the processing centre, as well as against published data. Factors affecting the CD34+ cell recovery were also investigated and a pilot study was carried out to assess the effect of cryopreservation on the viability of the selected products. In total, 151 procedures were analysed. The mean recovery and purity were 64.82 + 16.19 and 88.0 + 11.0% respectively. The mean T-cell depletion was 4.7021 + 0.5129 logs. Only purity was slightly below the specification (90%), with the lowest values obtained from peripheral blood (PB) collections. Factors affecting the recoveries were the overall age of the product (p=0.001), overnight storage (p=0.002), and the use of a particular tubing set with the instrument (p=0.002). The mean CD34+ viability was not significantly different to the value before cryopreservation (p=0.068). Results from this study were comparable with published data of the CliniMACS system performance. Local investigations regarding the purity of PB products should be performed. For the first time, using a magnetic separation method, factors affecting CD34+ recovery were identified. The significance of the effect of product age and overnight storage on cell recovery, provide a rationale for further prospective studies

Fuente: Biblioteca Virtual Banco de la República Tipo de contenido: Tesis

Temas:
Otros
Medicina

Imagen de apoyo de Public policy frameworks for reducing social and health inequities based on determinants of health and transectorality: an exploratory qualitative study on the policy-makers’ perspectives on the Cundinamarca - Colombia experiences

Por: Ana Ragonesi Muñoz | Fecha: 2015

CONTEXT: Equity-oriented policies based on social determinants of health (SDH) and intersectoral approaches have become a high level priority on the public sector agenda (Whitehead et al, 2006) and generated much research (Roberts, 2009). However, little is known on the conditions leading to successful implementation of these policies and the challenges facing decision-makers (PAHO, 2014, WHO, 2015). This study aimed to provide more evidence on these conditions and challenges by drawing on the experience of Cundinamarca-Colombia. RESOURCES AND METHODS: This study followed an exploratory qualitative approach. Key informant interviews method was used, with face-to-face semi-structure interviews conducted with public policy-making leaders at the national (Colombia) and subnational levels (Cundinamarca). Thirty interviews were conducted from February 26 to April 14, 2015. Thematic content analysis was carried out on the interviews and Governmental documents and secondary data sources were reviewed (published literature from 1985 - 2015). RESULTS: Among the key elements identified by the participants to work on the “determinants of health” and “transectoral” approaches was the “paradigm shift” from a “dominant health thinking” of the public policies to the adoption of more “inclusive concepts” such as the determinants of quality of life. The strengthening of “territorial planning” and sectoral competencies”, the interrelation of “synergistic approaches”, and the use of Information and Communication Technologies were also mentioned. Likewise, respondents reported on a number of challenges such as the State structure and the uneven development of sectors; and barriers related to “sectoral sovereignty”. CONCLUSIONS: The analysis of the experience of Cundinamarca-Colombia has shown that emerging concepts such as “transectorality”, “Health Management Models”, and “Determinants of Quality of Life” along with considerations regarding the State structure and the role of subnational governments and communities should inform the implementation of equity-based policies. However, further work is needed to cover the full range of conditions to successful implementation and to better appraise the impact of these approaches on the population.

Fuente: Biblioteca Virtual Banco de la República Tipo de contenido: Tesis

Temas:
Otros
Medicina

Imagen de apoyo de Literature review and formative research on adolescent pregnancy interventions: recommendations for policy and practice in Mitú, Colombia

Por: Claudia Alejandra Patiño González | Fecha: 2011

Pregnancy during adolescence is a worldwide public health concern. In developing countries, 14 million adolescents give birth each year, which accounts for 90% of all worldwide pregnancies. The proportion of adolescent women aged 10-19 whom have been pregnant in Mitú, Colombia is of approximately 25%, in comparison to 19.5% at the national level. This report aims to review the effectiveness and identifying best practice of adolescent pregnancy interventions in low and middle income countries and use formative research to make specific recommendations for policy and practice to prevent adolescent pregnancy in Mitú, Colombia. EMBASE, Medline, CINHAL, Cochrane library, GLOBAL HEALTH, ADOLEC, Popline, LILACS and REPRODUCTIVE HEALTH LIBRARY were searched to identify studies examining adolescent pregnancy prevention interventions in developing countries. GOOGLE was searched to identify grey literature. Five semi-structured interviews were also conducted with key service providers in the field of Adolescent Sexual and Reproductive Health in Mitú to explore the needs of the region in regards to adolescent pregnancy prevention and the barriers and facilitators for programme implementation. The literature review found that adolescent pregnancy prevention interventions in developing countries had a positive impact on the knowledge of pregnancy prevention and may contribute to the delay of sexual initiation. However, impact on the use of contraceptive methods and reduction of adolescent pregnancy inconclusive. Interviews revealed key societal, familial and individual factors that were viewed to be linked to adolescent pregnancy in Mitú. Relationships between military personnel and young women appeared to be an important factor in high teenage pregnancy rates. Barriers for the adequate implementation and continuation of programmes included lack of political commitment, lack of financial, human and material resources and lack of inter-institutional collaboration, the high rate of staff turnover and the lack of monitoring programmes. Only few facilitators were mentioned that consisted mainly in the willing of both adolescent and military to collaborate in the implementation of adolescent pregnancy prevention interventions. In conclusion, evidence suggests that adolescent pregnancy prevention strategies are effective in increasing knowledge of pregnancy and might delay sexual initiation in low and middle-income countries. Features of effective programmes were identified and discussed and are important in designing and developing new strategies. However, cultural, environmental and social barriers need to be addressed through political commitment and inter-institutional collaboration in order to develop effective interventions for pregnancy prevention in Mitú.

Fuente: Biblioteca Virtual Banco de la República Tipo de contenido: Tesis

Temas:
Otros
Medicina

Imagen de apoyo de Strategisches Nachhaltigkeitsmanagement für Krankenhäuser: Erzielung von Wettbewerbsvorteilen im kolum=Gestión Estratégica Sostenible en Hospitales: Logro de ventajas competitivas en el sector salud colombiano por medio de una estrategia de sosteniblidad

Por: Mayra Alejandra Barrero Delgado | Fecha: 2010

Das Krankenhaus als Schlüsselakteur im Gesundheitswesen muss heutzutage die Herausforderungen des Marktes und Wettbewerbes annehmen, dafür soll es eine Wettbewerbsstrategie folgen. Die zunehmenden Umweltprobleme mit der einhergehenden sozialen Ungerechtigkeit und Armut haben die Notwendigkeit erweckt, Unternehmen stärker in die Verantwortlichkeit ihres Handelns einzubinden. Krankenhäuser sind wichtiger Arbeitgeber, bedeutender Verbraucher von Ressourcen, und damit auch größere Erzeuger von Emissionen und Abfälle. Die vorliegende Arbeit soll klären, welche Wettbewerbsvorteile durch Nachhaltigkeitsmanagement in kolumbianischen Krankenhäusern aufgebaut und gehalten werden können. In der Einführung dieser Masterarbeit wird das kolumbianische Gesundheitssystem kurz vorgestellt sowie das externe Umfeld der Krankenhäuser erläutert, um eine allgemeine Strategie zu empfehlen. Im Anschluss wird der Einfluss von Nachhaltigkeitsmaßnahmen auf Wettbewerbsvorteile analysiert. Das kolumbianische System für soziale Sicherheit im Gesundheitswesen fördert die Qualität der Dienstleistung und Patientenorientierung als Grundlagen für die Wahl der Gesundheitseinrichtung bei Patienten. Neben den Ergebnissen der Analyse des Makroumfelds wird die Schlussfolgerung gezogen, dass eine Differenzierungsstrategie, die auf Qualität und Patientenorientierung basiert ist, das Konzept der Lebensqualität durch Wohlbefinden, Vitalität und Gesundheit in ihrer Struktur als Basis immer enthalten sollte. Der positive Einfluss von Nachhaltigkeitsmaßnahmen auf Wettbewerbsvorteile wird durch Ursache-Wirkungsbeziehungen dargestellt. Entlang der gesamten Wertschöpfungskette ist dann ihre Anwendung aufgezeigt. Einige der in der Masterarbeit identifizierten Maßnahmen sind: Risikoanalyse, Biosicherheit, Weiterbildung, Ethikkodex, effizientere Technologie, nachhaltige Beschaffung, Corporate Citizenship, u.a. Am Ende der Masterarbeit kommt der Autor zu dem Entschluss, sowohl Investitionen in Qualität als auch eine Rationalisierung von Kosten durch die Anwendung von Öko- und Sozioeffizienz in einer Weise durchzuführen, dass die Qualität der Dienstleistungen nicht belastet wird. Durch diesen Lösungsvorschlag kann das Krankenhaus attraktive Preise mit Krankenkasse handeln und gleichzeitig die Treue der Patienten behalten.

Fuente: Biblioteca Virtual Banco de la República Tipo de contenido: Tesis

Temas:
Otros
Medicina

Imagen de apoyo de Du traitement des kystes de l'ovaire

Por: Joaquín M. Vengoechea | Fecha: 1857

Tesis de Joaquín Vengochea para optar al título de Doctor en Medicina, en la Facultad de Medicina de París, en 1857. A lo largo del texto, Vengochea analiza el tratamiento de los quistes en los ovarios. El texto está escrito en francés.

Fuente: Biblioteca Virtual Banco de la República Tipo de contenido: Libros

Temas:
Otros
Medicina

Imagen de apoyo de Risk factors for health care–associated infection in hospitalized adults: Systematic review and meta-analysis

Por: Alba Luz; Almeida Rodríguez Acelas | Fecha: 01/01/2017

Background: Health care–associated infections (HAIs) are a public health problem that increase health care costs. This article aimed to systematically review the literature and meta-analyze studies investigating risk factors (RFs) independently associated with HAIs in hospitalized adults. Methods: Electronic databases (MEDLINE, Embase, and LILACS) were searched to identify studies from 2009-2016. Pooled risk ratios (RRs) or odds ratios (ORs) or mean differences (MDs) and 95% confidence intervals (CIs) were calculated and compared across the groups. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results: Of 867 studies, 65 met the criteria for review, and the data of 18 were summarized in the meta-analysis. The major RFs independently associated with HAIs were diabetes mellitus (RR, 1.76; 95% CI, 1.27-2.44), immunosuppression (RR, 1.24; 95% CI, 1.04-1.47), body temperature (MD, 0.62; 95% CI, 0.41-0.83), surgery time in minutes (MD, 34.53; 95% CI, 22.17-46.89), reoperation (RR, 7.94; 95% CI, 5.49-11.48), cephalosporin exposure (RR, 1.77; 95% CI, 1.30-2.42), days of exposure to central venous catheter (MD, 5.20; 95% CI, 4.91-5.48), intensive care unit (ICU) admission (RR, 3.76; 95% CI, 1.79-7.92), ICU stay in days (MD, 21.30; 95% CI, 19.81-22.79), and mechanical ventilation (OR, 12.95; 95% CI, 6.28-26.73). Conclusions: Identifying RFs that contribute to develop HAIs may support the implementation of strategies for their prevention, therefore maximizing patient safety.

Fuente: Biblioteca Virtual Banco de la República Tipo de contenido: Artículos

Temas:
Otros
Medicina