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Ítem Adverse drug reactions in internal medicine units at a university hospital: A descriptive pilot study(Universidad del Valle, 2010-01-01) Botero, MarcelaAdverse drug reactions (ADRs) are an important cause of morbidity and mortality among hospitalized patients. Objectives: This study was designed to describe the frequency, severity, and causality of ADRs in internal medicine units at a third-level university hospital. Materials and methods: A descriptive study was performed at internal medicine units, by means of a structured format, review of clinical records, and interview of hospitalized patients. The Naranjo algorithm was applied to patient adverse events to define causality. Additionally, ADRs were classified according to the Rawlins and Thompson criteria. Results: One hundred patients (50 men and 50 women) were included in the study. Ninety nine (99) adverse events were found among the patients. The Naranjo algorithm was applied to adverse events, resulting in twenty nine (29) probable ADRs, twenty (20) possible ADRs and fifty (50) doubtful ADRs. Cardiovascular drugs and antibiotics were the most frequent therapeutic groups associated with ADRs. In addition, two preventable medication errors were identified. Conclusions: Frequency of ADRs was similar to the number reported in other studies in internal medicine units. It is necessary to systematize efforts of pharmacological surveillance in hospital wards, toward an opportune detection and prevention of ADRs. © 2010 Universidad del Valle, Facultad de Salud.Ítem Análisis de la distribución espacial y temporal de los defectos congénitos registrados entre 2004 y 2008 en un hospital de tercer nivel en Cali, Colombia(Universidad del Valle, 2011-01-01) Cuartas, Daniel ElíasObjective: To describe the spatial and temporal distribution of major birth defects and to identify clusters at spatial, temporal and space-temporal levels. Methods: A descriptive study was developed about the space and time distribution of defects registered in Cali between March 2004 and October 2008 using principles of spatial statistics, namely the spatial data exploratory analysis. Results: Higher case density and prevalence was observed among neighborhoods of eastern Cali. Three districts («communes») of the 21 in the city showed a larger probability (50 to 100% larger) of major birth defects. Significant clusters (p<0.05) were proven in spatial, temporal and space-temporal analysis. Conclusions: Birth defects were confirmed clustered in several communes at the poorest areas of the city. Occurrence of defects in this area may be associated, at least in part, to social and environmental inequities. © 2011 Universidad del Valle, Facultad de Salud.Ítem 18p-syndrome: Presentation of two cases with alobar holoprosencenphaly(Colombia Médica, 2010-10-01) Pachajoa Londoño, Harry Mauricio; Isaza, Carolina; Saldarriaga, WilmarIntroduction: The syndrome by deletion of the short arm of chromosome 18 is an infrequent syndrome, and its phenotypical variability makes it difficult to recognize. Its most frequently observed clinical characteristics include mental retardation, growth retardation, craniofacial malformations, including long ears, microcephaly and short neck; other less frequent associated malformations include holoprosencephaly. Case report: We present two patients with deletion of the short arm of chromosome 18, one presented a de no vo muta tion and the other was produced by a balanced translocation 6p/18p of maternal origin. Both patients presented alobar holoprosencephaly and cebocephaly, low-frequency clinical characteristics in this syndrome. Discussion: alobar holoprosencephaly is a malformation appearing in 10% of patients with deletion of the short arm of chromosome 18; we review the probable physiopathology of holoprosencephaly in this syndrome. © 2010 Universidad del Valle, Facultad de Salud.Ítem Prevalencia de abuso y factores asociados en una escuela de medicina Colombiana(2011-10-01) Botero Restrepo, SoniaDifferent forms of abusive practices are very common in medical schools and have serious implications on vocational and professional formation. The aim of this study is to determine the prevalence of perception of abuse in a university in Colombia and to identify associated factors. Methods: A cross-sectional study was conducted from September to December 2008 in a private medical school. A proportional cycle-based stratified sampling technique and randomized sampling per semester was done. Socio demographic, academic, and abuse-related variables were obtained. Results: One hundred twenty-eight students participated in the study. The prevalence of perception of abuse was 40.6%. The most common type of abuse was psychological (98%) and unjustified critique (10.9%), ridiculing (10.7%), shouting (10%), and discredit (9.5%)
Ítem The Brain-Dead Organ Donor(Springer, 2012-09-25) Echeverri, Gabriel J.; Gridelli, Bruno G.; Bacigalupo, Félix; Huerta Fernández, Daniela A.; Keller, Curtis M; Chulpayev, Boris; Hoffmann, Michael; Fox, Mark D.; Munoz, Ricky T.; Floerchinger, Bernhard; Tilney, Nicholas L.; Tullius, Stefan G.; Novitzky, Dimitri; Wicomb, Winston N.; Cooper, David K.C.; Shapiro, Lawrence E.; Baron, Tatiana; Barklin, Anne; Lodberg Hvas, Christine; Toennesen, Else; Jassem, Wayel; Fuggle, Susan V.; Hoeger, Simone; Yard, Benito A.; Seelen, Marc A.; Leuvenink, Henri G.D.; Ploeg, Rutger J.; Ravindra, Kadiyala V.; Lunsford, Keri E.; Kuo, Paul C.; Theodoropoulos Nicole M.; Ison, Michael G.; Nalesnik, Michael A.; Shapiro, Ron; Ekser, Burcin; Demetriades, Demetrios; Lam, Lydia; Peter S. Macdonald,; Aneman, Anders E.M.; Bhonagiri, Deepak; Jones, Daryl A.; O’Callaghan, Gerry; Opdam, Helen I.; Silvester, William; Dobb, Geoffrey J.; Farina, Nicole T.; Michael J. Anstadt,; Paul C. Kuo,; Anstadt, Michael J.; Bae, Coney; Watkins, Anthony; Henry, Scot D.; Guarrera, James V.; Yeung, Jonathan C.; Cypel, Marcelo; Keshavjee, Shaf; Pajaro, Octavio E.; Kirklin, James K.; Katz, Eliezer; Novitzky, Dimitri; Cooper, David K. C.Addressing all aspects of brain death and thoroughly detailing how a potential organ donor should be maintained to ensure maximum use of the organs and cells, The Brain-Dead Organ Donor: Pathophysiology and Management is a landmark addition to the literature. This first-of-its-kind, multidisciplinary volume will be of interest to a large section of the medical community. The first section of the book reviews the historical, medical, legal, and ethical aspects of brain death. That is followed by two chapters on the pathophysiology of brain death as investigated in small and large animal models. This includes a review of the many hormonal changes, including the neuroendocrine- adrenergic ‘storm’, that takes place during and following the induction of brain death, and how they impact metabolism. The next section of the book reviews various effects of brain death, namely its impact on thyroid function, the inflammatory response that develops, and those relating to innate immunity. The chapters relating to assessment and management of potential organ donors will be of interest to a very large group of transplant surgeons and physicians as well as critical care and neurocritical care physicians and nurses. Neurologists, endocrinologists, neurosurgeons, and pathologists will also be interested, especially in the more basic science sections on various aspects of brain-death and hormonal therapy. Organ procurement organizations and transplant coordinators worldwide will also be interested in this title. Other chapters will be of interest to medical historians, medico-legal experts, and ethicists.Ítem A new mutation of the PCNT gene in a Colombian patient with microcephalic osteodysplastic primordial dwarfism type II: a case report.(BioMed Central Ltd., 2014-06-13) Ruiz Botero, FelipeMicrocephalic osteodysplastic primordial dwarfism is a syndrome characterized by the presence of intrauterine growth restriction, post-natal growth deficiency and microcephaly. Microcephalic osteodysplastic primordial dwarfism type II is the most distinctive syndrome in this group of entities. Individuals affected by this disease present at an adult height of less than 100cm, a post-pubertal head circumference of 40cm or less, mild mental retardation, an outgoing personality and bone dysplasia. Case presentation. We report the first case of a five-year-old Colombian boy of mixed race ancestry (mestizo), with clinical features of microcephaly, prominent and narrow nose, arched palate, amelogenesis imperfecta, short stature, tall and narrow pelvis, disproportionate shortening of fore-arms and legs, and mild coxa vara. Analysis of the PCNT gene by sequencing showed the presence of a nucleotide change in exon 10, c. 1468C>T, evidencing a new mutation not reported in the literature for microcephalic osteodysplastic primordial dwarfism. Conclusion: The new mutation identified in this case could be associated with the severity of the phenotypic expression of the disease, resulting in the extreme short stature of the patient. Further studies are required to reach an explanation that can justify such findings, and it is vital to emphasize the importance of detection and follow-up by the epidemiological surveillance groups in birth defects and rare diseases. © 2014 Pachajoa et al.; licensee BioMed Central Ltd.Ítem Autoimmune/Inflammatory Syndrome Induced by Adjuvants Causing Myositis and Pulmonary Fibrosis(Israel Medical Association, 2013-11-01) García, José F.Anaphylaxis is defined as a serious, rapid onset, systemic allergic reaction that may cause death.1-5 The diagnosis is based primarily on clinical history, and clinical criteria for accurate and early identification of anaphylaxis have recently been established.1 The lifetime prevalence of anaphylaxis from all triggers is estimated to range from 0.05% to 2.6%. Data on anaphylaxis Anaphylaxis online survey in Latin America Sole´ D et al.Ítem La acondroplasia entre las poblaciones antiguas de mesoamérica y sudamérica: Evidencia iconográfica y arqueológica(Universidad del Valle, 2012-07-30) Pachajoa Londoño, Harry MauricioIntroducción: La acondroplasia es la forma más frecuente de enanismo. Los individuos presentan acortamiento rizomélico de las extremidades, facies característica con prominencia frontal, hipoplasia media de la cara, genu varo, y la mano tridente. Aunque la etiología de esta enfermedad fue reportada en 1994, evidencia de la existencia esta enfermedad se ha encontrado en poblaciones del antiguo Egipto (2500 aC) y ha sido documentada en poblaciones americanas antiguas. Objetivo: Analizar la presencia de personas con acondroplasia en la sociedad del estado maya de México y Guatemala, durante el período clásico (100- 950 aC ) y postclásico ( 950 a 1519 aC ), del mismo modo, en la sociedad de Tumaco-la Tolita (300 aC - 600 dC) de la costa del Pacífico entre Colombia y Ecuador, y el Estado y la sociedad Moche (100- 600 aC ) de la costa norte del Perú. Métodos: Se realizaron estudios iconográficos y clínico morfológico de algunas de las representaciones artísticas más importantes de las personas de talla baja en estas tres culturas. Conclusiones: Se presenta la hipótesis de que los individuos con talla baja se asociaban de alguna manera con la élite del poder político y religioso.Ítem Embarazo De Gemelo Acárdico Coexistente Con Gemelo Anencefálico, Asociado A Exposición A Varicela En El Primer Trimestre: Reporte de caso y revisión de la literatura(Colombiana de Obstetricia y Ginecología, 2010-10-01) Tabares, KatherineIntroduction: an acardiac twin is a congenital malformation having low prevalence (1 in 35,000) births and is found in about 1 in every 100 monozygotic twins. The association of an acardiac twin with a second twin having greater malformations occurs in around 10% of cases. This article was aimed at reporting a case having very low prevalence and a review of the literature published about the etiology and physiopathology associated with acardiac anomaly, as well as the congenital anomalies associated with it and infection by the chicken pox virus. Materials and methods: the case of monochorionicdiamniotic twin pregnancy involving an acardius mylacephalus twin and a second anencephalic twin is presented, the mother having been exposed to chicken pox during the first trimester of pregnancy. G-band kariot yping showed 46 XY having no structural abnormalities. A search was made of the literature published during the last 10 years in the PubMed, Ovid and HINARI databases. Conclusion: the importance of this report lies in the fact that only one report of the association of acardiac twin coexisting with anencephalic twin was found in the pertinent literature. This is also the first report of the relationship between this combination of greater malformations in twin pregnancy and exposure to chicken pox during the first trimester of pregnancy.Ítem Variaciones anatómicas del proceso uncinado en tomografía computada multidetector en pacientes con rinosinusitis crónica(Sociedad Argentina de Radiología, 2014-04-01) Valladares Torres LilianaObjective To describe the uncinate process anatomy and its variations observed through coronal, multislice computed tomography (MSCT) in patients with chronic rhinosinusitis. Introduction As reviewed in the literature, no studies of anatomical variations ostiomeatal complex in Colombian adults were found. The reports agree that the anatomical variations of this complex are part of the causes of chronic sinusitis refractory to medical treatment, which motivated the present work to study the anatomy of this complex and identify possible anatomic variations in adult patients from Colombia, diagnosed with chronic sinusitis. Materials and methods A descriptive, cross-sectional, observational and retrospective study. Continuous variables were estimated with measures of central tendency and dispersion, with a confidence interval of 95%. Categorical variables were determined with frequencies and percentages. Results The total sample was 143 cases. In the sample, 53.8% were men and 46.2% were women. Both of the right and left, the uncinate process of the ethmoid was inserted into the lamina papyracea in 49.7% and 53.1% of cases, respectively. The insertion of the uncinate process in the cribriform plate of the ethmoid (T6) had a frequency to the right side of 25.2%, but for the left side was the insertion into the middle nasal concha (T1) (23.8%). In most cases, the uncinate process had a lateral orientation and 51% on the right side and 56.6% on the left side. Conclusion The uncinate process is a highly variable anatomical structure at each side of the nasal cavity, arranged in different insertion sites, changes in angle and different lengths which is important from the point of view of surgical management of chronic rinosinusitis. © 2013 Sociedad Argentina de Radiología. Published by Elsevier España, S.L. All rights reserved.