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ABSTRACT This article summarizes the clinical practice guideline (CPG) for the management of acute pancreatitis in the Social Security of Peru (EsSalud), to provide evidence-based clinical recommendations for the management of acute pancreatitis in EsSalud. A guideline development group (GEG) was formed that included medical specialists and methodologists. The GEG formulated 7 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and -when considered relevant-primary studies were carried out in PubMed during 2022. The evidence was selected to answer each of the clinical questions posed. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the GEG used the GRADE methodology to review the evidence and formulate the recommendations, the points of good clinical practice, and the corresponding ow charts. Finally, the CPG was approved with Resolution No. 105-IETSI-ESSALUD-2022. This CPG addressed 7 clinical questions on buid therapy, start of enteral nutrition, analgesia, type of nutrition, antibiotic, and surgical treatment. Based on these questions, 8 recommendations (1 strong and 7 conditional), 13 BPCs, and 1 flowchart were formulated. This article summarizes the methodology and evidence-based conclusions of the CPG for the management of acute pancreatitis in EsSalud.

RESUMEN El presente artículo resume la guía de práctica clínica (GPC) para el manejo de la pancreatitis aguda en el Seguro Social del Perú (EsSalud). Su objetivo es proveer recomendaciones clínicas basadas en evidencia para el manejo de la pancreatitis aguda en EsSalud. Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos. El GEG formuló 7 preguntas clínicas a ser respondidas por la presente GPC. Se realizó búsquedas sistemáticas de revisiones sistemáticas y -cuando fue considerado pertinente- estudios primarios en PubMed durante el 2022. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG usó la metodología GRADE para revisar la evidencia y formular las recomendaciones, los puntos de buenas prácticas clínicas y flujogramas correspondientes. Finalmente, la GPC fue aprobada con Resolución N° 105-IETSI-ESSALUD-2022. La presente GPC abordó 7 preguntas clínicas sobre fluidoterapia, momento de inicio de nutrición enteral, analgesia, tipo de nutrición, tratamiento antibiótico y quirúrgico. En base a dichas preguntas se formularon 8 recomendaciones (1 fuerte y 7 condicionales), 13 BPC, y 1 flujograma. El presente artículo resume la metodología y las conclusiones basadas en evidencia de la GPC para el manejo de la pancreatitis aguda en EsSalud.

https://doi.org/10.47892/rgp.2023.432.1523

Revisión sistemática de estudios sobre intervenciones que promueven la salud en conductores profesionales
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Valencia-Contrera, Miguel Andrez

; Valenzuela-Suazo, Sandra Verónica

; Rodríguez-Campo, Varinia Alejandra

; Jara-Concha, Patricia del Tránsito

; Sepúlveda-Guerra, Elena Belén

Enfermería: Cuidados Humanizados

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dec 2022, Volume 11 N. 2 elocation e2849

Abstract: Es En Pt | Text: Es En Pt | PDF: Es | PDF: En | PDF: Pt

Resumen: Introducción: Los trabajadores que se dedican al rubro de conducción están expuestos a factores que dificultan su quehacer laboral, tales como: problemas asociados a la temperatura, ruidos y vibraciones, ventilación insuficiente e ineficiente, atascos y relacionamientos interpersonales con los pasajeros. Objetivo: Identificar, en el estado del arte disponible, qué intervenciones promueven la salud de los conductores profesionales. Material y método: Revisión sistemática, siguiendo las recomendaciones de Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA), orientada por la pregunta: ¿qué intervenciones promueven la salud de los conductores profesionales? Resultados: La búsqueda arrojó 1303 artículos, de los cuales se incluyeron 11; las intervenciones identificadas se asociaron a dispositivos portátiles y mensajería de salud móvil, entrevistas motivacionales, documentos interactivos, exposición a entornos naturales, programas intensivos, asesoramiento, cambios a nivel de políticas, cambios ambientales y de sistemas. Conclusión: Se identificaron intervenciones que incluyeron a la tecnología, entrevistas, el ambiente y control estratégico. Se recomienda la implementación de las intervenciones identificadas, pues se torna perentorio el abordaje de la salud de los conductores profesionales, considerando las características descritas en el presente estudio.

Abstract: Introduction: Workers engaged in the driving field are exposed to factors that hinder their work tasks, such as: problems associated with temperature, noise and vibrations, insufficient and inefficient ventilation, traffic jams and interpersonal relationships with passengers. Objective: To identify, in the available state of the art, which interventions promote the health of professional drivers. Method: Systematic review, following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), guided by the question: what interventions promote the health of professional drivers? Results: The search yielded 1303 articles, of which 11 were included; the interventions identified were associated with handheld devices and mobile health messaging, motivational interviewing, interactive documents, exposure to natural environments, intensive programs, counseling, policy-level changes, environmental and systems changes. Conclusion: Interventions were identified that included technology, interviews, the environment and strategic control; the implementation of the identified interventions is recommended, since it is urgent to address the health of professional drivers, considering the characteristics described in this study.

Resumo: Introdução: Os trabalhadores envolvidos na condução estão expostos a fatores que dificultam o seu trabalho, tais como: problemas associados à temperatura, ruído e vibrações, ventilação insuficiente e ineficiente, engarrafamentos e relações interpessoais com os passageiros. Objetivo: Identificar, a partir do estado da arte disponível, quais as intervenções que promovem a saúde dos condutores profissionais. Método: Revisão sistemática, seguindo as recomendações dos itens Preferred Reporting Items for Systematic Reviews e Meta-Analyses (PRISMA), orientada pela pergunta: Quais intervenções promovem a saúde dos condutores profissionais? Resultados: A pesquisa produziu 1303 artigos, dos quais 11 foram incluídos; as intervenções identificadas foram associadas a dispositivos portáteis e mensagens de saúde móveis, entrevistas motivacionais, documentos interativos, exposição a ambientes naturais, programas intensivos, aconselhamento, mudanças a nível político, mudanças ambientais e de sistemas. Conclusão: Foram identificadas intervenções que incluíram tecnologia, entrevistas, ambiente e controle estratégico; recomenda-se a implementação das intervenções identificadas, pois é imperativo abordar a saúde dos condutores profissionais, considerando as características descritas no presente estudo.

https://doi.org/10.22235/ech.v11i2.2849

Atención odontológica bajo sedación endovenosa (R2) en niños hospitalizados con enfermedades respiratorias crónicas.
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Jara-Gálvez, Roxana

; Hola-Jacob, Sandra

; Hassi-Thumala, José

International journal of interdisciplinary dentistry

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apr 2022, Volume 15 N. 1 Pages 94 - 96

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT: The Josefina Martínez Hospital specializes in the care of children with chronic respiratory diseases. There, we implemented a model of dental care under intravenous sedation and cardiorespiratory monitoring, with the participation of a multidisciplinary team. Objective: Describe dental care in hospitalized patients with chronic respiratory diseases. Identify the most prevalent oral diseases and the treatments performed. Materials and Methodology: The study was conducted including dental care under intravenous sedation, between 2014 and 2016, considering 18 hospitalized patients. All received sedation and analgesia with Midazolam-Ketamine with continuous non-invasive monitoring during the procedure. Results: A high prevalence of gingivitis, dentomaxillary abnormalities and eruption disorders was found. Caries lesion had a low prevalence. The treatments performed were: prophylaxis, scaling, application of chlorhexidine and / or fluoride varnish, extractions, surgical exposure of teeth and restorations. Conclusion: It is important to show our experience, since we have made timely, efficient and low cost treatments, improving the oral health of children. In addition, they were attended without requiring the transfer to other health centers, which allowed to meet the emergencies and the comprehensive dental care of the patients.

RESUMEN: El Hospital Josefina Martínez está especializado en atención de niños con enfermedades respiratorias crónicas. En él hemos implementado un modelo de atención odontológica, bajo sedación endovenosa, monitorización cardiorespiratoria con participación de un equipo multidisciplinario. Objetivos: Describir la atención odontológica en pacientes hospitalizados con enfermedades respiratorias crónicas. Identificar las patologías bucales más prevalentes y los tratamientos realizados. Material y Método: El estudio se realizó incluyendo las atenciones odontológicas bajo sedación endovenosa, entre los años 2014-2016, considerando a 18 pacientes hospitalizados. Todos recibieron sedación y analgesia con Midazolam-Ketamina con monitorización continua no invasiva durante el procedimiento. Resultados: Se encontró una alta prevalencia de gingivitis, anomalías dentomaxilares y patologías de erupción. La lesión de caries tuvo baja prevalencia. Los tratamientos realizados fueron: profilaxis, destartarje, aplicación de barniz de clorhexidina y/o flúor, exodoncias, exposición quirúrgica de dientes y restauraciones. Conclusiones: Es importante mostrar nuestra experiencia, ya que hemos realizado tratamientos en forma oportuna, eficiente y de bajo costo, mejorando la salud bucal de los niños. Además fueron atendidos sin necesitar traslado a otro centro de salud, permitiendo resolver las urgencias y la atención odontológica integral de los pacientes.

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Heritable genomic diversity in breast cancer driver genes and associations with risk in a Chilean population
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Morales-Pison, Sebastian

; Gonzalez-Hormazabal, Patricio

; Tapia, Julio C.

; Salas-Burgos, Alexis

; Ampuero, Sandra

; Gómez, Fernando

; Waugh, Enrique

; Reyes, José Miguel

; Jara, Lilian

Biological Research

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2022, Volume 55 elocation 20

Abstract: En | Text: En | PDF: En

Abstract Background: Driver mutations are the genetic components responsible for tumor initiation and progression. These variants, which may be inherited, influence cancer risk and therefore underlie many familial cancers. The present study examines the potential association between SNPs in driver genes SF3B1 (rs4685), TBX3 (rs12366395, rs8853, and rs1061651) and MAP3K1 (rs72758040) and BC in BRCA1/2-negative Chilean families. Methods: The SNPs were genotyped in 486 BC cases and 1258 controls by TaqMan Assay. Results: Our data do not support an association between rs4685:C > T, rs8853:T > C, or rs1061651:T > C and BC risk. However, the rs12366395-G allele (A/G + G/G) was associated with risk in families with a strong history of BC (OR = 1.2 [95% CI 1.0–1.6] p = 0.02 and OR = 1.5 [95% CI 1.0–2.2] p = 0.02, respectively). Moreover, rs72758040-C was associated with increased risk in cases with a moderate-to-strong family history of BC (OR = 1.3 [95% CI 1.0–1.7] p = 0.02 and OR = 1.3 [95% CI 1.0–1.8] p = 0.03 respectively). Finally, risk was significantly higher in homozygous C/C cases from families with a moderate-to-strong BC history (OR = 1.8 [95% CI 1.0–3.1] p = 0.03 and OR = 1.9 [95% CI 1.1–3.4] p = 0.01, respectively). We also evaluated the combined impact of rs12366395-G and rs72758040-C. Familial BC risk increased in a dose-dependent manner with risk allele count, reflecting an additive effect (p-trend = 0.0002). Conclusions: Our study suggests that germline variants in driver genes TBX3 (rs12366395) and MAP3K1 (rs72758040) may influence BC risk in BRCA1/2-negative Chilean families. Moreover, the presence of rs12366395-G and rs72758040-C could increase BC risk in a Chilean population.

https://doi.org/10.1186/s40659-022-00384-4 42 downloads

Guía de práctica clínica para el tratamiento farmacológico inicial de nefritis lúpica en el Seguro Social del Perú (EsSalud)
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Ugarte-Gil, Manuel Francisco

; Goicochea-Lugo, Sergio

; Romero-Robles, Milton A.

; Ortiz-Benique, Zhamanda N.

; Ugaz-Zagarra, Milko

; Rodríguez-Mori, Juan E.

; Gomez-Lujan, Martin

; Gutierrez-Vargas, Mirella

; Lumbe-Diaz, Vidia

; Guevara-Rodríguez, Luis

; De la Jara, Jesús

; Perez-Medina, Wilkerson

; Huamanyauri-Saavedra, Paolo

; Hostia-Cardeña, Alvaro

; Sottec-Roque, Valentin

; Vilca-Flores, Miguel

; Vargas-Marquez, Sandra

; Delgado-Flores, Carolina J.

; García-Gomero, David

; Dolores-Maldonado, Gandy

; Taype-Rondan, Alvaro

; Salvador-Salvador, Stefany

; Carrera-Acosta, Lourdes

Revista del Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo

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dec 2021, Volume 14 N. 4 Pages 523 - 534

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Introduction: This article summarizes the clinical practice guideline (CPG) for the initial pharmacological treatment of lupus nephritis in the Social Security of Peru (EsSalud). Objective: To provide evidence-based clinical recommendations for initial pharmacological treatment of non-refractory adults with class I to V lupus nephritis in EsSalud. Methods: A guideline development group (GDG) was formed, which included specialist physicians and methodologists, who formulated clinical questions. Systematic searches were conducted for systematic reviews and - when deemed relevant - primary studies in PubMed during 2021. Evidence was selected to answer each of the clinical questions posed. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic working meetings, the GEG used the GRADE methodology to review the evidence and formulate recommendations. The CPG was reviewed by external experts before its approval. Results: The CPG addressed 6 clinical questions, divided into 2 topics: initial treatment of the induction and maintenance phase. Based on these questions, 11 recommendations were formulated (all conditional), 22 points of good clinical practice, and 2 flow charts. Conclusion: Evidence-based recommendations were issued for the management of patients with this pathology.

Resumen Introducción: El presente artículo resume la guía de práctica clínica (GPC) para el tratamiento farmacológico inicial nefritis lúpica en el Seguro Social del Perú (EsSalud). Objetivo: Proveer recomendaciones clínicas basadas en evidencia para tratamiento farmacológico inicial de adultos con nefritis lúpica clase I a V no refractarios en EsSalud. Métodos: Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos, el cual formuló preguntas clínicas. Se realizaron búsquedas sistemáticas de revisiones sistemáticas y -cuando fue considerado pertinente- estudios primarios en PubMed durante el 2021. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. Se evaluó la certeza de evidencia usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG usó la metodología GRADE para revisar la evidencia y formular las recomendaciones. La GPC fue revisada por expertos externos antes de su aprobación. Resultados: La GPC abordó 6 preguntas clínicas, divididas en 2 temas: tratamiento inicial de la fase de inducción y mantenimiento. En base a dichas preguntas se formularon 11 recomendaciones (todas condicionales), 22 puntos de buena práctica clínica, y 2 flujogramas. Conclusión: Se emitieron recomendaciones basadas en evidencia para el manejo de pacientes con esta patología.

https://doi.org/10.35434/rcmhnaaa.2021.144.1461

Neurodengue. Presentación poco frecuente de la enfermedad
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González, Silvia Adriana

; Galeano, Martha Sady

; Morel, Maida

; Moran, Elías

; Topacio, Mariano

; Díaz, Luis

; González, Romina

; Samundio, Sandra

; Jara, Elías

Anales de la Facultad de Ciencias Médicas (Asunción)

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dec 2019, Volume 52 N. 3 Pages 97 - 100

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Dengue is an arbovirus infection, with a low incidence of association with neurological symptoms. Presentations include encephalopathy, Guillain-Barré syndrome (GBS), acute motor weakness, seizures, among others. In 2018, in Paraguay, a total of 33,258 cases consistent with dengue were registered, but there are no statistical data on involvement neurological. For what, we consider to recognize this affectation, as a marker of severity of the disease. It is related to high mortality rate and / or sequelae. Then, three male cases with this condition, of which, they received Immunoglulin with total recovery in two of the three cases. It is very important to establish the treatment in a timely manner.

RESUMEN El Dengue es una infección por arbovirus, con baja incidencia de asociación con síntomas neurológicos. Las presentaciones incluyen encefalopatía, síndrome de Guillain-Barré (SGB), debilidad motora aguda, convulsiones, entre otras. En el 2018, en Paraguay, se registraron un total de 33.258 casos compatibles con dengue, pero no existen datos estadísticos de afectación neurológica. Por lo que consideramos reconocer esta afectación, como marcador de gravedad de la enfermedad. Se relaciona con alta tasa de mortalidad y/o secuelas. A continuación, tres casos masculinos con este padecimiento, de los cuales, recibieron Inmunoglulina con recuperación total en dos de los tres casos, por lo que es muy importante establecer el tratamiento de forma oportuna.

https://doi.org/10.18004/anales/2019.052.03.97-100 497 downloads

Diversity of clinical, radiographic and genealogical findings in 41 families with amelogenesis imperfecta
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Adorno-Farias, Daniela

; Ortega-Pinto, Ana

; Gajardo, Paulina

; Salazar, Ana

; Morales-Bozo, Irene

; Werlinger, Fabiola

; Rojas-Flores, Sandra

; Molina-Berríos, Alfredo

; Echeverría-López, Sonia

; Jara-Sandoval, José

; Jara, Lilian

; Urzúa, Blanca

Journal of Applied Oral Science

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2019, Volume 27 elocation e20180359

Abstract: En | Text: En | PDF: En

Abstract Amelogenesis imperfecta (AI) is a group of enamel development disorders that alter the structure and chemical composition of the tissue. There is great variability in the clinical presentation; according to Witkop, AI can be categorized into 14 subtypes, which makes its diagnosis extremely complex. Objective: This study aimed to describe and determine the frequency of clinical and radiographic features and inheritance patterns found in 41 Chilean families diagnosed with diverse types of AI. Material and Methods: We analyzed the clinical records, photographs, pedigrees and radiographs of 121 individuals recruited between 2003 and 2016. All of the information was included in a database that was analyzed using the application Stata 14. Results: The 72 affected individuals had average age of 16 years, and no sex association with the presence of AI was found. The most frequent clinical subtypes were as follows: 43% hypomature, 25% hypoplastic, 21% hypomature/hypoplastic, 7% hypocalcified and 4% hypocalcified/hypoplastic. The number of severely affected teeth was 22, which occurred in the patients with hypocalcified and hypocalcified/hypoplasic AI who presented the highest number of damaged teeth. Caries and periodontal disease were found in 47 and 32% of the patients, respectively. Malocclusions were observed in 43% of the individuals with AI, with open bite being the most frequent. Radiographically, the thickness of the enamel decreased in 51% of the patients, and 80% showed decreased radiopacity of the enamel compared to that of dentin. Autosomal dominant inheritance pattern was found in 37% of the families with hypoplastic AI, and autosomal recessive pattern was present in 56% of the other clinical subtypes, but more frequently in those affected with hypomature and hypocalcified AI. Conclusion: Of the five clinical subtypes, autosomal recessive hypomature, autosomal dominant hypoplastic and autosomal recessive hypomature/hypoplastic AI were the most prevalent subtypes in this group.

https://doi.org/10.1590/1678-7757-2018-0359 4457 downloads

Ébola, abordaje clínico integral
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Leiva-Suero, Lizette Elena

; Morales, Jorge Marcelo

; Villacís-Valencia, Sandra Elizabeth

; Escalona-Rabaza, Milagros

; Quishpe-Jara, Graciela de las Mercedes

; Hernández-Navarro, Elena Vicenta

; Fernández-Nieto, Mirian

Revista de la Facultad de Medicina

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sep 2018, Volume 66 N. 3 Pages 293 - 299

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Introducción. El virus del Ébola, antes llamado fiebre hemorrágica del Ébola, es una enfermedad altamente contagiosa con mortalidad entre 50% y 90%, para la cual existen prometedoras opciones de tratamiento que se encuentran en fase de evaluación y uso compasional. Objetivos. Revisar la mejor evidencia médica publicada y analizar el comportamiento de las epidemias por virus del Ébola, sus manifestaciones clínicas, sus complicaciones, los elementos más significativos para su diagnóstico y las nuevas opciones terapéuticas disponibles, para así aprender y aplicar estas experiencias en nuevos brotes. Materiales y métodos. Se realizó una búsqueda sistemática en las bases de datos PubMed, ProQuest, Embase, Redalyc, Ovid, Medline, DynaMed y ClinicalKey durante el periodo 2009-2017 en el contexto internacional, regional y local. Resultados. La revisión sistemática de artículos aportó un total de 51 430 registros, de los cuales 772 eran elegibles; de estos, 722 no eran relevantes, por lo que quedaron incluidos 50. A punto de partida se pudieron precisar los aspectos objeto de esta revisión. Conclusión. La enfermedad causada por el virus del Ébola, a pesar de su alta mortalidad, puede ser prevenida, diagnosticada oportunamente y tratada con efectividad, lo cual permite evaluar su impacto epidemiológico en las áreas endémicas y a nivel mundial. Existe un potencial arsenal terapéutico en fase de experimentación con resultados prometedores.

Abstract Introduction: The Ebola virus, also known as Ebola hemorrhagic fever, is a highly contagious disease with mortality rates that range between 50% and 90%. There are promising treatment options that are currently under evaluation and compassionate use. Objectives: To review the best published medical material and analyze the behavior of Ebola virus outbreaks, clinical manifestations, complications, the most significant elements for diagnosis and new therapeutic options available, in order to learn and apply these experiences during new outbreaks. Materials and methods: A systematic search was carried out in the PubMed, ProQuest, Embase, Redalyc, Ovid, Medline, DynaMed and ClinicalKey databases during the 2009-2017 period in the international, regional and local context. Results: The systematic review yielded a total of 51 430 documents, of which 772 were eligible; of these, 722 were not relevant, and only 50 were included. Conclusion: Ebola virus disease, despite its high mortality, can be prevented, diagnosed promptly and treated effectively, which allows evaluating its epidemiological impact in endemic areas and worldwide. There are potential therapeutic tools under experimentation with promising results.

https://doi.org/10.15446/revfacmed.v66n3.64545 3225 downloads

Células tronco mesenquimales: definiciones, cultivo y aplicaciones potenciales
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Ceron, Willy

; Lozada-Requena, Iván

; Ventocilla, Kiomi

; Jara, Sandra

; Pinto, Milagros

; Cabello, Marco

; Aguilar, José L.

Revista Peruana de Medicina Experimental y Salud Pública

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dec 2016, Volume 33 N. 4 Pages 758 - 771

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT In recent years, mesenchymal stem cells (MSC) have become very important due to their high plasticity and their ability to release paracrine factors able to interact with various cell types, tissues and organs. The use of MSC in regenerative medicine became of vital importance, since they do not express histocompatibility MHC molecules class II nor costimulant molecules, and low expression of MHC class I, will not be rejected by individuals of same species, they could be used in an autologous, and eventually, allogeneic manner. However, it is important to scientifically demonstrate many properties, including immunomodulatory ones. Having several sources of obtaining, it should be standardized the best one to ensure the purity and quality of these cells. Finally, it is important when working with these cells, that characteristics of cell culture, immunophenotyping and differentiation capacity are fully demonstrated. MSC have been applied in several clinical uses. Among them, their ability to improve, and even heal chronic ulcers, as diabetic, has attracted attention for its potential therapeutic impact.

RESUMEN En los últimos años, las células troncales mesenquimales (Mesenchymal Stem Cells, MSC) han adquirido mucha importancia debido a su gran plasticidad y su capacidad de liberar factores paracrinos con capacidad de interactuar con diversos tipos celulares, tejidos y órganos. El uso de MSC en medicina regenerativa es importante debido a que, al no expresar las moléculas del complejo mayor de histocompatibilidad (MHC) clase II ni moléculas co-estimuladoras y tener baja expresión del MHC clase I, haría que no sean rechazadas por individuos de la misma especie, es posible utilizarlas no sólo de manera autóloga, sino también, eventualmente, alogénica. Sin embargo, es importante demostrar científicamente muchas de sus propiedades, entre ellas las inmunomoduladoras. Al tener varias fuentes de obtención, se debe estandarizar la que sea la mejor para garantizar la pureza y calidad de las MSC. Finalmente, es importante que cuando se trabaje con estas células se demuestre completamente las características del cultivo celular, la inmunotipificación y su capacidad de diferenciación. Se están ensayando muchas aplicaciones clínicas de las MSC. Dentro de ellas, su capacidad para mejorar la recuperación y potencial curación de úlceras crónicas como las diabéticas, ha atraído la atención por su potencial impacto terapéutico.

https://doi.org/10.17843/rpmesp.2016.334.2563 814 downloads

10.

Células tronco mesenquimales: definiciones, cultivo y aplicaciones potenciales
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Ceron, Willy

; Lozada-Requena, Iván

; Ventocilla, Kiomi

; Jara, Sandra

; Pinto, Milagros

; Cabello, Marco

; Aguilar, José L

Revista Peruana de Medicina Experimental y Salud Publica

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oct 2016, Volume 33 N. 4 Pages 758 - 771

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

In recent years, mesenchymal stem cells (MSC) have become very important due to their high plasticity and their ability to release paracrine factors able to interact with various cell types, tissues and organs. The use of MSC in regenerative medicine became of vital importance, since they do not express histocompatibility MHC molecules class II nor co-stimulant molecules, and low expression of MHC class I, will not be rejected by individuals of same species, they could be used in an autologous, and eventually, allogeneic manner. However, it is important to scientifically demonstrate many properties, including immunomodulatory ones. Having several sources of obtaining, it should be standardized the best one to ensure the purity and quality of these cells. Finally, it is important when working with these cells, that characteristics of cell culture, immunophenotyping and differentiation capacity are fully demonstrated. MSC have been applied in several clinical uses. Among them, their ability to improve, and even heal chronic ulcers, as diabetic, has attracted attention for its potential therapeutic impact.

En los últimos años, las células troncales mesenquimales (Mesenchymal Stem Cells, MSC) han adquirido mucha importancia debido a su gran plasticidad y su capacidad de liberar factores paracrinos con capacidad de interactuar con diversos tipos celulares, tejidos y órganos. El uso de MSC en medicina regenerativa es importante debido a que, al no expresar las moléculas del complejo mayor de histocompatibilidad (MHC) clase II ni moléculas co-estimuladoras y tener baja expresión del MHC clase I, haría que no sean rechazadas por individuos de la misma especie, es posible utilizarlas no sólo de manera autóloga, sino también, eventualmente, alogénica. Sin embargo, es importante demostrar científicamente muchas de sus propiedades, entre ellas las inmunomoduladoras. Al tener varias fuentes de obtención, se debe estandarizar la que sea la mejor para garantizar la pureza y calidad de las MSC. Finalmente, es importante que cuando se trabaje con estas células se demuestre completamente las características del cultivo celular, la inmunotipificación y su capacidad de diferenciación. Se están ensayando muchas aplicaciones clínicas de las MSC. Dentro de ellas, su capacidad para mejorar la recuperación y potencial curación de úlceras crónicas como las diabéticas, ha atraído la atención por su potencial impacto terapéutico.

https://doi.org/10.17843/rpmesp.2016.334.2563

11.

LED fluorescence microscopy in the diagnosis of tuberculosis: Fading and restaining of smears for external quality assessment
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Allassia, Sonia

; Aranibar, Mónica

; Boutonnet, Mónica

; Caserío, Viviana

; Etchart, Ana Alicia

; Fajardo, Sandra

; García, Mónica

; Gomez, Noemí

; Gunia, Alba Marisa

; Gustincic, María Virginia

; Izquierdo, Viviana

; Jara, Arnaldo Andrés

; Kozicky, Graciela

; Matteo, Mario

; Pellegrini, Carlos

; Pellegrino, Silvia

; Pérez Catalán, Sebastián

; Poggi, Susana

; Sacramone, Carina

; Santiso, Gabriela María

; Souto, Alejandro

; Togneri, Ana María

; Wolff, Lidia

; Vilche, Sandra

; Eletti, Daniel

; Imaz, María Susana

Revista argentina de microbiología

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jun 2016, Volume 48 N. 2 Pages 122 - 127

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Blinded rechecking is a method proposed for external quality assurance (EQA) of auramine-stained acid-fast bacilli (AFB) smears using fluorescence microscopy (FM), however, this procedure is not well developed and slides fading over time could compromise its implementation. Since bleaching of fluorescent molecules involves temperature-dependent chemical reactions, it is likely that low temperatures could slow down this process. We stored auramine-stained slides under different environmental conditions, including −20 °C, and examined them over time. The slides stored in all the environments faded. At −20 °C, fading was not reduced in relation to room temperature. Restaining and re-examining smears after five months showed that the slides containing saliva and storage at −20 °C were associated with failure in AFB reappearance. In conclusion, the practice of freezing slides until they are viewed should be discouraged as it has a negative effect on blinded rechecking by reducing reading concordance after restaining. Specimen quality should be considered when interpreting FM-EQA results.

La relectura usando microscopía fluorescente con lámpara LED es una metodología propuesta para la evaluación externa de calidad (EEC) de los extendidos teñidos con auramina empleados para detectar bacilos ácido-alcohol resistentes (BAAR), pero el procedimiento está parcialmente desarrollado y la decoloración de los BAAR con el transcurso del tiempo puede comprometer su implementación. La decoloración de moléculas fluorescentes involucra reacciones químicas temperatura-dependientes, por lo que la reducción de la temperatura podría enlentecerla. Guardamos extendidos coloreados en distintas condiciones, incluyendo a −20 °C, y los examinamos a distintos tiempos. Las láminas guardadas en todos los ambientes se decoloraron; a −20 °C la decoloración fue más rápida que a temperatura ambiente. La recoloración evidenció que en extendidos de saliva o conservados a −20 °C existía mayor probabilidad de que los BAAR no reaparecieran. En conclusión, la conservación de extendidos en freezer debe evitarse, ya que reduciría la concordancia de lectura luego de recolorear para la EEC. La calidad de la muestra debe considerarse para interpretar la EEC.

https://doi.org/10.1016/j.ram.2016.03.006 362 downloads

12.

Central obesity and not age increases skeletal muscle lipids, without influencing lean body mass and strength
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Maza, María Pía de la

; Hirsch, Sandra

; Jara, Natalia

; Leiva, Laura

; Barrera, Gladys

; Claudio, Silva

; Pañella, Loreto

; Henríquez, Sandra

; Bunout, Daniel

Nutrición Hospitalaria

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mar 2015, Volume 31 N. 3 Pages 1134 - 1141

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Background/Aims: To measure skeletal muscle lipid infiltration, its association with insulin resistance (IR) lean mass and function, in Chilean men differing in age and body composition. Our hypothesis was that muscle lipid accumulation would be higher among older and heavier individuals and this would deteriorate insulin sensitivity (IS) and decrease muscle mass and function, both features of the ageing process. Methods: Healthy men (38 < 55 and 18 > 65 years), underwent anthropometric measurements, body composition assessment through radiologic densitometry, Nuclear Magnetic Resonance spectroscopy at the tibialis anterioris muscle to measure intra (IMCL) and extramyocellular lipids (EMCL), quadriceps and handgrip strength, 12 minute walking distance and serum biochemistry (haemoglobin, lipoproteins, creatinine, ultrasensitive C Reactive Protein, fasting and post glucose insulin and glucose concentrations, to assess IS). Physical activity was estimated by actigraphy. Results: 23 men were eutrophic, 26 were overweight and 7 were obese and mostly sedentary, independent of age. Both IMCL and EMCL were higher in overweight/ obese men. Abdominal fat was negatively associated with IS and positively correlated with muscle lipid accretion (both IMCL and EMCL), but not with age. As expected, older individuals had lower muscle mass and strength, but not more adipose tissue nor intramyocellular lipids, yet were more glucose intolerant. Conclusions: central obesity was associated with IMCL and EMCL infiltration and IR. This type of lipid accretion was not related with ageing nor age-related sarcopenia. Older individuals were more glucose intolerant, which was explained by a decrease of insulin secretion more than adiposity-related IR.

Introducción/Objetivos: medir la infiltración grasa en el músculo esquelético, su asociación con resistencia a la insulina (RI) y con masa y función muscular, en hombres chilenos de diferente edad y composición corporal. Nuestra hipótesis era que habría más acumulación de grasa en el tejido muscular entre las personas de mayor edad y peso, lo cual deterioraría la sensibilidad a la insulina (SI) y afectaría negativamente la masa y la función muscular, ambas características del proceso de envejecimiento. Métodos: se estudiaron hombres sanos (38 < 55 años y 18 > 65 años), que fueron sometidos a mediciones antropométricas, evaluación de la composición corporal mediante densitometría radiológica (DEXA), espectroscopia de resonancia nuclear magnética en el músculo tibial anterior para medir lípidos intra (LIM) y extramiocelulares (LEM), fuerza de mano y cuádriceps, test de 12 minutos y bioquímica sérica (glicemia, hemoglobina, lipoproteínas, creatinina y proteína C reactiva ultrasensible en ayunas, además de glucosa e insulina post carga de glucosa para evaluar SI). La actividad física se estimó mediante actigrafía. Resultados: 23 hombres eran eutróficos, 26 tenían sobrepeso y 7 eran obesos, todos eran sedentarios según el registro actigráfico, independiente de la edad. Tanto LIM como LEM resultaron más altos entre los hombres con sobrepeso / obesidad. La grasa abdominal se asoció negativamente con la SI y se correlacionó positivamente con la acumulación de grasa en el músculo (tanto LIM como LEM), pero no con la edad. Como era de esperar, las personas mayores tenían menor masa magra y fuerza, pero no más tejido adiposo ni lípidos intramiocelulares, aunque eran más intolerantes a la glucosa. Conclusiones: La obesidad central se asoció con infiltración de grasa intramuscular y con RI. Esta distribución adiposa no se relacionó con edad ni con sarcopenia asociada al envejecimiento. Las personas mayores resultaron más intolerantes a la glucosa, explicable por una disminución de la secreción de insulina más que por RI relacionada con mayor adiposidad.

https://doi.org/10.3305/nh.2015.31.3.7979 274 downloads

13.

Evaluación de un programa ministerial para manejo del síndrome metabólico en adultos con sobrepeso y obesidad
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Henríquez, Sandra

; Barrera, Gladys

; Hirsch, Sandra

; de la Maza, María P

; Jara, Natalia

; Leiva, Laura

; Bunot, Daniel

Revista médica de Chile

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jul 2014, Volume 142 N. 7 Pages 817 - 825

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Background: The Chilean Ministry of Health developed a healthy lifestyles intervention directed to adults with overweight and cardiovascular risk factors, called "Program on Healthy Eating and Physical Activity" (PASAF). Aim: To evaluate the impact of PASAF on nutritional status and metabolic parameters. Patients and Methods: We analyzed databases from three primary care centers belonging to a municipality of Metropolitan Santiago. We selected adults enrolled in the PASAF during three years (2007-2009). The program lasted four months and included an assessment of anthropometric and metabolic parameters at baseline and at the end, eight workshops with a nutritionist, seven with a psychologist and 32 sessions of physical activity. Result: We evaluated 526 subjects aged ≥ 18 years (93% females), of whom 85.6% attended the last appointment for assessment. Analyzing available data, attendance to workshops was < 50% of the scheduled sessions. Weight, body mass index and waist circumference decreased significantly (median: -1.4 kg, -0.6 kg/m² and -3 cm, respectively). The median weight loss was 1.8% of initial weight and 17.1% of participants experienced a decrease ≥ 5% of their initial weight. There were significant improvements in lipid levels and blood pressure among participants with lower initial excess weight. A reduction in fasting blood glucose was observed only among subjects who lost ≥ 5% of their initial weight. Conclusions: The PASAF modestly reduced nutritional parameters. Correction of metabolic parameters was especially effective in less obese subjects. The attendance to workshops was low.

6990 downloads

14.

Calabrese, Elisa. Prólogo de María Rosa Lojo. Sábato. Historia y apocalipsis. Córdoba: Alción Editora, Universidad Nacional de Córdoba, 2013, 276 páginas
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Jara, Sandra

Anclajes

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jun 2014, Volume 18 N. 1 Pages 91 - 93

Abstract: Es | Text: Es | PDF: Es

156 downloads

15.

Costeo basado en actividades: una metodología de gestión en tratamientos intensivos
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Alvear V, Sandra

; Canteros G, Jorge

; Jara M, Juan

; Rodríguez C, Patricia

Revista médica de Chile

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nov 2013, Volume 141 N. 11 Pages 1371 - 1381

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Background: An accurate estimation of resources use by individual patients is crucial in hospital management. Aim: To measure financial costs of health care actions in intensive care units of two public regional hospitals in Chile. Material and Methods: Prospective follow up of 716 patients admitted to two intensive care units during 2011. The financial costs of health care activities was calculated using the Activity-Based Costing methodology. The main activities recorded were procedures and treatments, monitoring, response to patient needs, patient maintenance and coordination. Results: Activity-Based Costs, including human resources and assorted indirect costs correspond to 81 to 88% of costs per disease in one hospital and 69 to 80% in the other. The costs associated to procedures and treatments are the most significant and are approximately $100,000 (Chilean pesos) per day of hospitalization. The second most significant cost corresponds to coordination activities, which fluctuates between $86,000 and 122,000 (Chilean pesos). Conclusions: There are significant differences in resources use between the two hospitals studied. Therefore cost estimation methodologies should be incorporated in the management of these clinical services.

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