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Ítem Prevalencia de genotipos de riesgo G1 y G2 del gen APOL1 en pacientes afrodescendientes con enfermedad renal crónica atendidos en una institución de referencia de cuarto nivel del pacífico colombiano(Universidad Icesi, 2018-01-01) Díaz Ordoñez, Leidy Lorena; Pachajoa, Harry; Asesor Tesisla Enfermedad Renal Crónica (ERC) representa una enfermedad de alto costo para el sistema de salud, debido a su carácter crónico, altas tasas de mortalidad y discapacidad reportadas, así como otras patologías que frecuentemente se derivan de la misma, tales como enfermedades mentales y cardio-cerebrovasculares. El Valle del Cauca es el departamento con mayor prevalencia de enfermedad renal crónica en Colombia. En los últimos años, múltiples estudios han asociado como causa genética de la ERC los llamados genotipos de riesgo G1 y G2, los cuales corresponden a mutaciones en el gen que codifica para la Apolipoproteina L1 (APOL1).Ítem Movilización temprana de pacientes en unidades de cuidados intensivos. [recurso electrónico](Universidad Icesi, 2014-05-22) Jaramillo Carbonell, Andrea; Uribe Becerra, Miguel; Asesor Tesis; Asesor TesisPropósito - Con esta investigación se llegará a una etapa de diseño que cumpla con las necesidades tanto de los pacientes como de la institución de salud que hagan uso del sistema para llevar a cabo la Movilización Temprana. Metodología - El enfoque que se dará a la investigación es de carácter mixto (estudio cuantitativo y cualitativo). Reuniones semanales con el grupo de investigación: ejercicio, discapacidad y limitaciones funcionales del sistema cardiopulmonar del Universidad del Valle, (Facultad de salud). Registro fotográfico (Clínica Farallones) donde se evidenciará el uso de los equipos médicos, el contexto global y particular del paciente y durante la realización de la terapia, con el fin de conocer las necesidades existentes y posibles variables por mejorar.
Ítem Indications, Results And Complications Of Flexible Bronchoscopy In The Intensive Care Unit Of Fundacion Valle Del Lili, A University Hospital Of Reference In Latin America(American Lung Association, 2016-01-01) Muñoz, Carlos A.; Sua, Luz F.; Granados, Marcela; Fernández, LilianaIn the present, the flexible bronchoscopy (FB) has become the procedure of election to explore the airways fue to its diagnostic and therapeutic capacity in pulmonary pathology. In the critically ill patient this tool gains advantage since it provides the availability of being used at the bedside with few complications. In this study we describe the indications, results and complications associated to the performance of FB in the Intensive Care Unit of Fundación Valle del Lili, a University Hospital Reference in Cali, Colombia during 2013.Ítem Monitoring the microcirculation in the critically ill patient: current methods and future approaches(Springer, 2010-11-01) De Backer, DanielTo discuss the techniques currently available to evaluate the microcirculation in critically ill patients. In addition, the most clinically relevant microcirculatory alterations will be discussed. Review of the literature on methods used to evaluate the microcirculation in humans and on microcirculatory alterations in critically ill patients. In experimental conditions, shock states have been shown to be associated with a decrease in perfused capillary density and an increase in the heterogeneity of microcirculatory perfusion, with non-perfused capillaries in close vicinity to perfused capillaries. Techniques used to evaluate the microcirculation in humans should take into account the heterogeneity of microvascular perfusion. Microvideoscopic techniques, such as orthogonal polarization spectral (OPS) and sidestream dark field (SDF) imaging, directly evaluate microvascular networks covered by a thin epithelium, such as the sublingual microcirculation. Laser Doppler and tissue O(2) measurements satisfactorily detect global decreases in tissue perfusion but not heterogeneity of microvascular perfusion. These techniques, and in particular laser Doppler and near-infrared spectroscopy, may help to evaluate the dynamic response of the microcirculation to a stress test. In patients with severe sepsis and septic shock, the microcirculation is characterized by a decrease in capillary density and in the proportion of perfused capillaries, together with a blunted response to a vascular occlusion test.Ítem Combination of arterial lactate levels and venous-arterial CO2 to arterial-venous O2 content difference ratio as markers of resuscitation in patients with septic shock(Springer Verlag, 2015-05-01) Arango Dávila, César AugustoPurpose. To evaluate the prognostic value of the Cv-aCO2/Da-vO2 ratio combined with lactate levels during the early phases of resuscitation in septic shock. Methods. Prospective observational study in a 60-bed mixed ICU. One hundred and thirty-five patients with septic shock were included. The resuscitation protocol targeted mean arterial pressure, pulse pressure variations or central venous pressure, mixed venous oxygen saturation, and lactate levels. Patients were classified into four groups according to lactate levels and Cv-aCO2/Da-vO2 ratio at 6 h of resuscitation (T6): group 1, lactate ≥2.0 mmol/L and Cv-aCO2/Da-vO2 >1.0; group 2, lactate ≥2.0 mmol/L and Cv-aCO2/Da-vO2 ≤1.0; group 3, lactate <2.0 mmol/L and Cv-aCO2/Da-vO2 >1.0; and group 4, lactate <2.0 mmol/L and Cv-aCO2/Da-vO2 ≤1.0.Ítem Monitoring and treatment of chronic patients through uHealth: Keys to sustainability (efficiency) and quality of care(Universidad Icesi, 2018-04-01) Velarde, José ManuelThis paper proposes an integrated model of social-health resources management. The authors present the actual challenges for health care, in an environment characterized by longer life expectancy and an increase in the number of patients with chronic pathologies, in a scenario of both, economic and financial crises. Their presentation includes management and fi - nancial issues, and the technological trends –such as the development of personalized and regenerative medicine– which will lead to an increase in health spending. The task of facing these challenges, they explain, cannot be postponed, the goals should be to improve: the efficiency in the use of health resources, the quality of health care and the level of patient satisfaction. Finally, they present some concepts about the application of information and communications technologies in health, show its relationship with the chronic patient care and present both, the current management models for this type of patient and the new proposed model.