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Ítem Efficacy of anti-interleukin-6 receptor antibody (tocilizumab) in colombian patients with takayasu’s arteritis(BMJ Publishing Group Ltd, 2013-06-01) Izquierdo, Jorge H.Background Takayasu’s arteritis (TA) is a chronic vasculitis that involves aorta and its main branches, where interleukin-6 (IL-6) seems to play a pathogenic role (1,2). The effect in four patients treated with the anti-IL-6 receptor (IL-6R) antibody Tocilizumab was evaluated. Objectives to describe the effect of Tocilizumab in patients of Takayasu’s arteritis. Methods We reviewed the clinical records of 4 patients with TA diagnosed according to current criteria, treated between 2010 and 2011 in a tertiary center in Cali, Colombia. Four patients with a refractory disease to multiple treatments, was began treatment with Tocilizumab at a dose of 8 mg/kg every month in association with metothrexate and/or steroids. Two patients were treated previously with infliximab (IFX) without control of disease. This cases were reported previously (3). Results The cases summaries are as follows: Case 1. A 30 year-old woman with a diagnosis of TA since 2003 presented panaortitis, with involvement of supra-aortic,Ítem Comparative evaluation of adhesion formation of prosthetic meshes after intra-abdominal implantation in wistar rats(IEEE, 2014-07-10) Franco, M. H.Increasingly biomaterials for the repair of abdominal wall defects are used. The aim of this study was to evaluate adhesion formation of prosthetic meshes after intraabdominal implantation to repair a surgical defect in the anterior abdominal wall. This anatomical defect was repaired by one of the three types of previously sterilized meshes: 1) fibroin 2) fibroin with polyethylene glycol and 3) commercial polypropylene mesh as control. The grip score was significantly higher in the commercial polypropylene mesh. Fibroin is a promising biomaterial for treating defects of the abdominal wall.Ítem Utilidad del estudio dinámico del LCR por resonancia en el diagnóstico y predicción de respuesta en el síndrome de hidrocefalia de presión normal(Acta Neurológica Colombiana, 2013-01-01) Granados, Ana MariaLa Hidrocefalia de presión normal representa el 1% de las demencias y es una causa curable de esta. La amplia variabilidad clínica entre los pacientes hace difícil el diagnóstico basado solo en criterios clínicos (alteración de la marcha, incontinencia urinaria y demencia). Tradicionalmente el diagnóstico se fundamenta en los síntomas, descartando otras patologías con imágenes estáticas de resonancia o escanografía, y la evaluación de la respuesta clínica a la punción lumbar. El estudio dinámico de LCR por resonancia ofrece un análisis cualitativo y cuantitativo del flujo de LCR que permite estimar objetivamente losÍtem Intracavitary Irradiation as a Safe Alternative for Cystic Craniopharyngiomas: Case Report and Review of the Literature(Hindawi Publishing Corporation, 2016-06-05) Enriquez-Marulanda, AlejandroCraniopharyngioma treatment remains a challenge for clinicians and patients. There are many treatment alternatives; however one of them (intracavitary irradiation) seeks to control this type of benign brain tumor using minimally invasive techniques, with the specific aim of avoiding causing significant damage to important structures surrounding the sellar/suprasellar region. We present the case of a 3-year-old patient with a predominantly cystic craniopharyngioma who underwent intracavitary irradiation by stereotactic placement. Using this approach, the patient showed a successful response with remission of headaches and hydrocephalus. A reduction in the size of the cyst was achieved, without deterioration of visual fields, with no hormonal supplementation being needed, and with no evidence of focal neurological signs.Ítem Microcirculatory alterations are associated with pulmonary dead-space fraction in moderate and severe ards(Springer International Publishing, 2015-10-03) Salas, CEShunt-induced hypoxemia i s considered the primary pathophysiological abnormality and main diagnostic cri- teria of acute respiratory distress syndrome (ARDS). However, increases in dead- space ventilation (VD/VT) can also contribute to gas exchange alterations in ARDS. Systemic microcirculatory alterations described during inflammatory conditions are characterized by perfusion heterogeneity and theoretically pulmonary microcirculatory heterogene ity could lead to imbalance pulmonary ventilation/perfusion relationship. Thus, we hypothesized that systemic microvascular alterations could reflect increased VD/VT in ARDS.Ítem Pathophysiological Relationship between Infections and Systemic Vasculitis.(Hindawi, 2015-07-07) Muñoz Grajales, CarolinaThe development of autoimmune disorders requires a combination of genetic, immunological, and environmental factors. Infectious agents, such as viruses and bacteria, can trigger autoimmunity through different mechanisms, and for systemic vasculitis in particular, microbial agents have been suggested to be involved in its pathogenesis. Although the exact mechanisms have not been fully elucidated, different theories have been postulated. This review considers the role of infections in the etiology of primary vasculitis, emphasizing their related immunological events.Ítem Correlación clínica imagenológica en síndrome afásico en un adulto joven: descripción de Caso(Asociación Colombiana de Neurología, 2013-01-01) Muñoz Ospina, BeatrizLa prevalencia de la enfermedad cerebrovascular en adultos entre 15 y 45 años es del 3 al 5% y las lesiones en la arteria cerebral media (ACM) corresponden al 23%. Entre los factores de riesgo en adultos jóvenes están: dislipidemia (38%), tabaquismo (34%) e hipertensión arterial (20%). El perfil clínico característico del evento isquémico de la ACM puede incluir déficit senso - riomotor y/o trastornos del lenguaje. Puesto que el lenguaje se soporta por redes interconectadas, la tractografía por resonancia magnética permite evaluar los tractos de sustancia blanca implicados en esta función y contribuye en la comprensión del espectro clínico.Ítem A reliability assessment software using Kinect to complement the clinical evaluation of Parkinson's disease(Institute of Electrical and Electronics Engineers Inc., 2015-11-04) Arango Paredes, Juan davidParkinson's disease is characterized by alterations in the gait pattern that may increase the risk of falls. Variations in the gait pattern cannot be objectively measured in clinical examination, so it is necessary to adapt devices to measure objectively, valid and replicable changes in gait patterns that are part of the evolution of the disease and / or pharmacotherapy. In an interdisciplinary effort, we developed the 'e-Motion Capture System' software, which is able to calculate motor (cadence, stride and step length) and spatiotemporal (velocity and acceleration) parameters that affect quality of life in patients with Parkinson's disease.Ítem Effect of Prolonged Strenuous Exercise on Endothelial Function in Non-Elite Runners(Sociedad Brasileira De Cardiologia, 2010-05-10) Ramírez Vélez, Robinsonresult in an acute depression in endothelial function. However, little is known about the effect of this type of exercise in non-elite runners. Objective: To determine the impact of prolonged strenuous exercise on endothelial function in nonelite runners.Ítem Hyperferritinemic syndrome: Still’s disease and catastrophic antiphospholipid syndrome triggered by fulminant Chikungunya infection: a case report of two patients(Springer-Verlag London Ltd, 2015-08-02) Echeverry, Alex A.There are four medical conditions characterized by high levels of ferritin, the macrophage activation syndrome (MAS), adult onset Still’ s disease (AOSD), catastrophic antiphospholipid syndrome (CAPS), and septic shock, that share similar clinical and laboratory features, suggesting a common pathogenic mechanism. This common syndrome entity is termed “the hyperferritinemic syndrome.” Here, we describe two different cases of hyperferritinemic syndrome triggered by Chikungunya fever virus infection: a 21-year-old female with SLE and a 32-year-old male patient who developed AOSD after the coinfection of dengue and Chikungunya viruses.Ítem Mucopolisacaridosis tipo VI (síndrome Maroteaux-Lamy) en la cultura precolombina de Colombia(Universidad del Valle, 2014-04-01) Rodriguez, Carlos ArmandoMucopolysaccharidosis type VI or Maroteaux Lamy syndrome is an autosomal recessive lysosomal storage disorder resulting from a deficiency of arylsulfatase B, the clinical features include short stature, hepatosplenomegaly, dysostosis multiplex, stiff joints, corneal clouding, cardiac abnormalities, and facial dysmorphism, with intelligence usually normal. We present evidence of the possible existence of Maroteaux Lamy syndrome in pre-Columbian pottery 2000 years ago, in the Colombo-Ecuadorian Pacific coast of the Tumaco-Tolita culture.Ítem Design and fabrication of a stainless steel base for biomechanical testing of Wistar rat abdominal wall.(IEEE Computer Society, 2014-01-01) 9th Pan American Health Care Exchanges Conference; Arboleda Carvajal, Alejandro; Franco, Maurizio H.The mechanical property of materials allows us to know how and how their performance will then be subject to the conditions for which it was designed. The biomechanical properties of biological tissues give an approximation to loads which it may be subjected in its biological environment. The objective of this project was to design a support to allow the biomechanical plunger tests on a sample of tissue from the abdominal wall of Wistar rat. The 1010 stainless steel support was 102 mm diameter and 50 mm of high, and 40 mm diameter extrusion in the middle was attached to the Instron 3366 universal testing machineÍtem Comparative evaluation of adhesion formation of prosthetic meshes after intra-abdominal implantation in wistar rats / Evaluación comparativa de la formación de adherencias de mallas protésicas después de la implantación intraabdominal en ratas(IEEE, 2012-04-07) Arboleda, A.Increasingly biomaterials for the repair of abdominal wall defects are used. The aim of this study was to evaluate adhesion formation of prosthetic meshes after intraabdominal implantation to repair a surgical defect in the anterior abdominal wall. This anatomical defect was repaired by one of the three types of previously sterilized meshes: 1) fibroin 2) fibroin with polyethylene glycol and 3) commercial polypropylene mesh as control. The grip score was significantly higher in the commercial polypropylene mesh. Fibroin is a promising biomaterial for treating defects of the abdominal wall. © 2014 IEEE.Ítem Concentración y pureza del ADN de muestras sanguíneas en papel Whatman FTA almacenadas entre 1 a 3 años.(Universidad del Valle, 2013-01-01) Pachajoa Londoño, Harry MauricioEl papel Whatman FTA es una alternativa para transportar y almacenar diferentes tipos de muestras y optimizar el tiempo, espacio de almacenamiento y costos. Desde hace varios años se utiliza este método de forma rutinaria y muchos centros médicos almacenan muestras por periodos de tiempo prolongados. Objetivo: Determinar el efecto del tiempo de almacenamiento de muestras de sangre en papel Whatman sobre la concentración del ADN. Materiales y métodos: Se utilizaron 110 muestras de sangre periférica que fueron guardadas en papel filtro durante un periodo de tiempo de uno a tres años. Estas muestras fueron guardadas como parte de programa ECLAMC. La extracción del ADN se realizó por medio de resinas de intercambio iónico (Chelex-100®). Se verificó la amplificación por medio de PCR. Se utilizó el gen GAPDH. Por medio de espectrofotometría utilizando el NanoDrop, se cuantificó cada una de las muestras evaluadas. Resultados: El tiempo de almacenamiento fue diferencial con un rango de 520 a 1135 días. La concentración de ADN presentó variabilidad desde 0.81ng/uL a 5.54ng/ uL. La relación 260/280 osciló desde -5.22 hasta 14.17nm.Ítem Echocardiographic assessment of valve prostheses in the pediatric population(Sociedad Colombiana de Cardiologia y Cirugia Cardiovascular, 2014-01-01) Gutiérrez, Jaiber ClaudioEn niños con insuficiencia o estenosis valvular significativa, la intervención de la válvula, ya sea valvuloplastia o reemplazo valvular, suele ser inevitable. El seguimiento de estos pacientes puede ser complejo; los síntomas iniciales de disfunción valvular protésica son inespecíficos y en ocasiones es difícil diferenciar entre los efectos de la disfunción valvular, las patologías no cardíacas, la disfunción ventricular y la hipertensión pulmonar. Aunque el examen físico puede alertar al clínico acerca de alteraciones, se requieren otros métodos diagnósticos para evaluar la función de la prótesis. La ecocardiografía Doppler es el método de elección no invasivo para estudiar la función valvular y pese a que muchas de las mediciones y parámetros de normalidad y anormalidad son extrapolados de estudios en adultos, se han tratado de definir estándares en pacientes pediátricos. Este documento ofrece una revisión acerca de las técnicas usadas en el estudio de las válvulas protésicas con base en literatura científica, consensos internacionales y opiniones de expertos.Ítem Tolerancia a inhibidores selectivos de la ciclooxigenasa 2 en casos de alergia o intolerancia a los antiinflamatorios no esteroideos convencionales: experiencia en un centro.(Asociacion Colombiana de Dermatologia y Cirugia Dermatologica, 2012-07-01) Serrano Reyes, Carlos DanielBackground: Patients with non-steroidal anti-inflammatory drugs (NSAID) sensitivity have a low prevalence of cross-reaction to COX-2 selective inhibitors. Oral drug challenge with these agents can be done in a clinical setting with a good safety profile. Objective: To evaluate tolerance to COX-2 selective inhibitors in patients with history of NSAID sensitivity using a shortened oral drug challenge. Methods: Patients with NSAID sensitivity were included. A shortened oral drug challenge with a COX-2 selective inhibitor (meloxicam or etoricoxib) was carried out. The challenge was considered positive if any of the following symptoms appeared: urticaria, rhinoconjunctivitis, angioedema, anaphylaxis or bronchospasm, the latter defined as a fall in FEV1 equal or greater than 20%. Results: Fifty-four patients were enrolled (78% were women), with a mean age of 39.6 years (range, 13 to 70 years). Forty three patients were challenged with meloxicam (79.6%) and 11 with etoricoxib (20.4%). Forty nine patients tolerated the drug challenge (90.7%), and only five patients (all challenged with meloxicam) developed a reaction (9.3%): urticaria in two, urticaria plus angioedema in one, and broncospasm in other two. From these, three were rechallenged with etoricoxib and all of them tolerated it. Conclusion: Most of the subjects with NSAID sensitivity tolerated a COX-2 selective inhibitor by means of a shortened oral drug challenge. This is the first cohort of patients with NSAID sensitivity and its tolerance to COX-2 selective inhibitors published in our country. (English) [ABSTRACT FROM AUTHOR]Ítem Toxic Epidermal Necrolysis Successfully Treated With Infliximab(Esmon Publicidad S A,, 2013-01-01) Serrano Reyes, Carlos DanielToxic epidermal necrolysis (TEN) is a life-threatening drug-induced cutaneous reaction characterized by widespread apoptosis and detachment of the epidermis. The main causes of death are secondary infections resulting from epidermal damage and multiorgan failure [1]. The severity of illness score (SCORTEN) [2] analyzes 7 independent risk factors and predicts mortality. Older age, significant comorbidity, and greater skin involvement correlate with a worse prognosis [2]. The pathogenesis of TEN is unknown. Several studies suggest that tumor necrosis factor (TNF) α released from inflammatory cells and activated keratinocytes in the epidermis plays an important role in the immune response by inducing direct cytotoxicity and apoptosis [3].Ítem Neuralgias Craneales(Distribuna : Asociación Colombiana de Medicina Interna, 2013-01-01) Takeuchi Tan, Yuri; Archila, Paulo Emilio; Senior Sánchez, Juan ManuelDesde el año 2010, recién comenzó sus labores la Junta Directiva de la Asociación Colombiana de Medicina Interna, en asocio con el Editor General y el Editor Emérito de Acta Médica Colombiana se propuso como parte de su misión de educación la edición de un texto propio de medicina interna cuyo objeto fuera la consulta y el aprendizaje de medicina basada en problemas, tanto para el internista y el sub especialista, como para el médico en formación. Los principios del aprendizaje basado en problemas (ABP) clínicos que tienen diversa complejidad, conducen a plantear múltiples alternativas para llegar a un diagnóstico diferencial hasta culminar en el diagnóstico definitivo y el tratamiento. El método del ABP implica procesos de: Pensar en el entorno y la realidad de la medicina colombiana; reconocer las situaciones problema y los conflictos cognitivos; formular en forma precisa el problema del caso clínico; desarrollar mediante análisis y raciocinio clínico el diagnóstico diferencial y sintetizar posibles medidas diagnósticas, profilácticas y terapéuticas. El comité de educación de la ACMI ha propuesto este texto como material educativo básico para los programas de recertificación en la especialidad que desarrollará la asociación y su promulgación en todas las escuelas de medicina del país.Ítem Enfermedades neuromusculares : miastenia gravis, enfermedades de la neurona motora y enfermedades del músculo(Corporación para Investigaciones Biológicas, 2010-01-01) Takeuchi Tan, YuriLa miasrenia gravis (MG) y las demás enfer· mcdades que afectan la unión ncu romuscular se caracterizan desde el punto de vista clíni· ro y clectrofisiológico por debilidad muscu· lar fluctuante y fatigable, que afectan grupos musculares específicos, se desencadenan o empeoran con la actividad y mejoran con el reposo. La miastenia gravis tiene una preva· lcncia estimada de 43 a 84 casos por millón de habirnntes y la tasa de incidencia anual es de aproximadamente 1 por 300.000Ítem Historia del lupus y embarazo(Ediciones Universidad Tecnologica de Boliva, 2011-01-01) Toro, CarlosRealizar análisis periódicos de la información contenida en el registro. Determinar la frecuencia de las diferentes enfermedades autoinmunes diagnosticadas, manejadas y seguidas en la FVL