Factores de riesgo para falla de la técnica en diálisis peritoneal: estudio de cohorte retrospectivo

Contexto la falla de la técnica en diálisis peritoneal puede ocurrir de manera no planificada, afectando los costos en salud y la calidad de vida del paciente. Objetivo estimar la incidencia de falla de la técnica y mortalidad y determinar los factores de riesgo asociados con el tiempo a la falla de la técnica, por causas médicas en el primer año de la terapia de reemplazo renal. Metodología estudio de cohorte retrospectivo que incluyó 2192 pacientes incidentes en diálisis peritoneal, utilizando los registros de centros de terapia renal Baxter en Colombia, durante el periodo entre enero del 2016 y diciembre del 2017. Asimismo, se estimó la tasa de incidencia y la tasa de mortalidad y se usó el análisis de regresión de Cox multivariado para determinar los factores de riesgo para falla de la técnica. Resultados se estimó una tasa de incidencia de falla de la técnica de 8,8/100 personas/año. La tasa de mortalidad fue de 7,9/100 personas/año. El modelo de regresión de Cox multivariado mostró que los factores de riesgo fueron hipertensión arterial (HR: 1,59; IC 95 % 1,01-2,48) y género masculino (HR:1,62; IC 95 % 1,03-2,56) y los factores protectores fueron el Kt/V > 1,7 (HR: 0,41; IC 95 % 0,25-0,65) e incrementar 1 gr/dl la albúmina (HR: 0,61; IC 95 % 0,43-0,87). Conclusiones la tasa de incidencia de falla de la técnica en el primer año de diálisis peritoneal en Colombia fue baja y la disfunción mecánica fue la principal causa. Los factores de riesgo asociados con el tiempo a la falla de la técnica fueron hipertensión arterial y género masculino.

Background The technique failure in peritoneal dialysis can occur in an unplanned way, affecting health costs and the patient's quality of life. Purpose The aims of this study were to estimate the incidence of technique failure and mortality; and to determine the risk factors associated with time to failure of technique due to medical causes in the first year of renal replacement therapy. Methodology Retrospective cohort study that included 2192 incident patients on peritoneal dialysis using the records of Baxter renal therapy centers in Colombia, during the period January 2016 and December 2017. The incidence rate and mortality rate were estimated. Multivariate Cox regression analysis was used to determine risk factors for technique failure. Results An incidence rate of failure of the technique of 8.8/100 person-years was estimated. The mortality rate was 7.9/100 person-years. The multivariate Cox regression model showed as risk factors arterial hypertension (HR: 1.59; 95% CI 1.01-2.48) and male sex (HR: 1.62; 95% CI 1.03-2.56); and the protective factors were Kt / V> 1.7 (HR: 0.41; CI95% 0.25-0.65) and increase 1 gr / dl of albumin (HR: 0.61; CI95% 0.43-0.87). Conclusions The incidence rate of technique failure in the first year of peritoneal dialysis in Colombia was low and mechanical dysfunction was the main cause. The risk factors associated with time to failure of the technique were arterial hypertension and male gender.

Green synthesis and characterization of gold-based anisotropic nanostructures using bimetallic nanoparticles as seeds.

Nanostructured noble metals are of great interest because of their tunable optical and electronic properties. However, the green synthesis of anisotropic nanostructures with a defined geometry by the systematic nanoassembly of particles into specific shape, size, and crystallographic facets still faces major challenges. The present work aimed to establish an environmentally friendly methodology for synthesizing gold-based anisotropic nanostructures using starch-capped bimetallic silver/gold nanoparticles as seeds and hydrogen peroxide as a reducing agent.

Phenotypic and environmental correlates of natal dispersal in a long-lived territorial vulture.

Natal dispersal, the movement between the birth and the first breeding site, has been rarely studied in long-lived territorial birds with a long-lasting pre-breeding stage. Here we benefited from the long-term monitoring programs of six populations of Egyptian vultures (Neophron percnopterus) from Spain and France to study how the rearing environment determines dispersal. For 124 vultures, we recorded a median dispersal distance of 48 km (range 0-656 km). Linear models were used to assess the effect of population and individual traits on dispersal distance at two spatial scales. Dispersal distances were inversely related to vulture density in the natal population, suggesting that birds perceive the abundance of conspecifics as a signal of habitat quality. This was particularly true for declining populations, so increasing levels of opportunistic philopatry seemed to arise in high density contexts as a consequence of vacancies created by human-induced adult mortality. Females dispersed further than males, but males were more sensitive to the social environment, indicating different dispersal tactics. Both sexes were affected by different individual attributes simultaneously and interactively with this social context. These results highlight that complex phenotype-by-environment interactions should be considered for advancing our understanding of dispersal dynamics in long-lived organisms.

Differences in hospitalization due to infectious causes between patients with hemodialysis and those with peritoneal dialysis / Diferencias en la hospitalización por causas infecciosas entre pacientes con hemodiálisis y diálisis peritoneal

Abstract Introduction: approximately 50% of the annual health care expenditure of patients with chronic kidney disease on dialysis is related to hospitalizations. Infections represent the second reason for consultation, with a high morbidity and mortality. There are no studies comparing hospitalization time due to infectious causes between the different dialysis options. Objective: to determine the difference in hospitalization time for treatment of infectious diseases in patients with chronic kidney disease on dialysis, comparing patients on hemodialysis vs. peritoneal dialysis. Materials and methods: a retrospective, dynamic cohort study of patients on hemodialysis and peritoneal dialysis who were admitted to the emergency department at the Hospital Universitario Mayor due to infectious diseases. The study patients were included using nonprobabilistic methods. The sample size was calculated by comparison of means. A total of 172 hemodialysis patients and 85 peritoneal dialysis patients were included for statistical analysis. Results: hospitalization time is greater in patients on hemodialysis than in patients on peritoneal dialysis; 12 (IQR 8-21) vs. 10 (IQR 6.5-13) days, respectively, p= 0.004. Conclusions: hospitalization time due to infectious causes is greater in patients on hemodialysis than in patients on peritoneal dialysis. In addition, the incidence of treatment-related infections in our population is lower than the globally reported incidence.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1222).

Resumen Introducción: aproximadamente el 50% del gasto anual en salud de los pacientes con enfermedad renal crónica en diálisis está relacionada con hospitalizaciones; las causas infecciosas representan la segunda causa de consulta con una alta morbilidad y mortalidad. No existen estudios donde se compare el tiempo de hospitalización por causas infecciosas entre las diferentes opciones de diálisis. Objetivo: determinar las diferencias en tiempos de hospitalización que se deriva del manejo de patologías infecciosas en pacientes con enfermedad renal crónica en diálisis, comparando los pacientes que se encuentran en hemodiálisis vs diálisis peritoneal. Material y métodos: estudio de cohorte retrospectiva, dinámica, de pacientes en hemodiálisis y diálisis peritoneal que ingresan al servicio de urgencias del Hospital Universitario Mayor por patologías infecciosas. Los pacientes que ingresaron al estudio se incluyeron por métodos no probabilísticos. El cálculo de tamaño de muestra se realizó por comparación de medias. Para el análisis estadístico se incluyeron 172 pacientes en hemodiálisis y 85 en diálisis peritoneal. Resultados: el tiempo de hospitalización es mayor en pacientes con hemodiálisis en comparación con los pacientes en diálisis peritoneal, 12 (RIC 8-21) vs 10 (RIC 6.5-13) días respectivamente, p= 0.004. Conclusiones: el tiempo de hospitalización por causas infecciosas es mayor en los pacientes con hemodiálisis que los de diálisis peritoneal, adicionalmente la incidencia de infecciones asociadas a la terapia en nuestra población es menor que lo reportado a nivel mundial.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1222).

A morphological, reproductive, and molt phenology database for 379 bird species from the Colombian Tropical Andes.

The Colombian Tropical Andes are one of the regions with highest bird diversity on Earth. However, information on bird morphology, reproductive phenology, and molt is particularly scarce in this region. Also, this region is heavily impacted by deforestation, and it is vulnerable to climate change. Hence, providing baseline information on life history and morphological traits will be essential to support future research on functional diversity, climate change effects, conservation, evolution, and phenology. To fill this gap, we have compiled information on bird distribution, morphology, molt, and reproductive phenology at 52 localities of the Department of Caldas, covering an elevation range between 148 and 3845 m. This compilation comprises a wide range of habitats, including native forests, forestry plantations, croplands, and paramo. Our database presents information for 3,398 records belonging to 379 bird species (representing 23 orders, 53 families, and 258 genera). From those records, 2,843 correspond to information collected in the field between 2008 and 2019, and the remaining 555 records correspond to specimens deposited in the Natural History Museum of the Caldas University, collected between 1969 and 2014. We measured nine morphological traits from all specimens: total culmen, gape, bill width, bill depth, tarsus, wing length, tail length, total length, and mass. We also have reproductive condition information for 257 species and molt information available for 378 species. The information contained in this data set represents ~20% of the Colombian avifauna and ~11% of the bird species richness in South America. This data set is released for non-commercial use only. Credits should be given to this paper (i.e., proper citation), and the products generated with this database should be shared under the same license terms (CC BY-NC-SA).

Impacto de un modelo de gestión de enfermedad en una población con tratamiento de diálisis en Colombia / Impact of a disease management model on a population undergoing dialysis in Colombia

Resumen Introducción. La implementación de modelos de gestión de enfermedad (MGE) ha demostrado mejores desenlaces en salud. Objetivo. Describir la tasa de hospitalización y mortalidad en una cohorte de pacientes con tratamiento de diálisis en la que se implementó un MGE. Materiales y métodos. Estudio de cohorte prospectivo en el que se incluyeron pacientes prevalentes en diálisis, mayores de 18 años, pertenecientes a la entidad promotora de salud del régimen contributivo Nueva EPS y con al menos tres meses de intervención con MGE en la red Renal Therapy Services (RTS) entre el 1 de enero y el 31 de diciembre de 2014. Para el análisis se usaron modelos multivariables de supervivencia y estadística descriptiva. Resultados. Se evaluaron 2 525 pacientes; la mediana de edad fue 64.5 años (RIC=19), el 56.9% (n=1 437) estaban en hemodiálisis, el 59.5% (n=1 503) fueron hombres y se encontró una tasa de hospitalización de 1.15 eventos por paciente/año (IC95%: 1.10-1.19) con 9.6 días hospitalarios paciente/año. La tasa de mortalidad fue de 146 muertes por 1 000 pacientes/año (IC95%: 130.3-163.6). Conclusión. A pesar de la alta comorbilidad observada en esta población en diálisis intervenida con un MGE, se encontraron desenlaces clínicos favorables.

Abstract Introduction: The implementation of disease management models (DMM) has shown better health outcomes. Objective: To describe hospitalization and mortality rates in a cohort of patients on dialysis in which a DMM was implemented. Materials and methods: Prospective cohort study in which prevalent dialysis patients, older than 18 years of age, belonging to the health promoter of the contributory scheme (Nueva EPS), and with at least three months of intervention with DMM, were included in the Renal Therapy Services Network (RTS) between January 1 and December 31, 2014.To conduct the multivariate analysis, survival models and descriptive statistics were used. Results: 2 525 patients were evaluated; median age was 64.5 years (IR=19); 56.9% (n=1 437) were on hemodialysis; 59.5% (n=1,503) were male, and a hospitalization rate of 1.15 events per patient/year was found (95% CI: 1.10-1.19) with 9.6 hospital patient days/year. The mortality rate was 146 deaths per 1 000 patients/year (95% CI: 130.3-163.6). Conclusion: Despite the high comorbidity observed in the population undergoing dialysis managed with DMM, favorable clinical outcomes were found.

Cognitive impairment and depression in a population of patients with chronic kidney disease in Colombia: a prevalence study.

BACKGROUND: Growth of the elderly population is linked to the increase of comorbid conditions such as chronic kidney disease (CKD), depression, and cognitive impairment (CI). Cognitive impairment can vary from minimal deficits in the normal aging, to mild cognitive impairment with a prevalence ranging from 1 to 29 % in people ≥ 65 years of age, up to severe impairment with a prevalence of 6 to 42 %. The CI induced by depression usually affects the functional performance of the elderly. OBJECTIVE: The objective of the study is to describe the prevalence of CI and depression in patients ≥ 55 years with CKD stages 3 and 4, attending a secondary prevention program during 2012-2013. DESIGN: The design of the study is a cross-sectional study of simple random sampling, and 308 patients were invited to participate. SETTING: Patients were being treated in a CKD secondary prevention program in Bogotá, Colombia, during 2012-2013. PATIENTS: Participants were over 54 years diagnosed with CKD in stages 3 to 4 according to the K/DOQI classification. MEASUREMENTS: CI was assessed using NEUROPSI and modified Lawton Scale; depression was measured with Yesavage Geriatric Depression Scale and the MINI International Neuropsychiatric Interview. METHODS: Through an interview with the subjects, information regarding age, occupation, civil status, educational level, and clinical baseline variables was collected. Clinical assessment with specific instruments was performed by a multidisciplinary team composed of nephrologists, a psychiatrist, a neurologist, and a neuropsychologist. RESULTS: Two hundred and fifty-one patients agreed to participate. The average age was 76.3 (SD = 7.9) years, 67 % were males, and 86.5 % had CKD stage 3. Overall prevalence of CI was 51 % (95 % CI 44.7 to 57.2), and the prevalence of major depression reached 8 % (95 % CI 4.5 to 11.3); 4.8 % of the patients (n = 12) had both CI and depression. LIMITATIONS: A limitation of the study is its design, which does not allow establishing the direction of the association between predictors and outcomes. Suggested associations must be interpreted cautiously as they are generated as hypothesis, which should be investigated in properly designed trials. CONCLUSIONS: CI and depression are prevalent conditions among patients with CKD stages 3-4, with the greatest occurrence of CI, affecting half of the investigated Colombian patients with age ≥ 55 years.

MISE EN CONTEXTE: On a constaté un lien entre la croissance de la population âgée et l'augmentation de pathologies comorbides telles que les maladies rénales chroniques et la dépression ou un trouble cognitif. Ce dernier peut varier de la déficience légère observée lors du vieillissement normal à un trouble cognitif léger, dont la prévalence s'étend de 1 à 29 % chez les gens âgés de plus de 65 ans, jusqu'à une déficience grave dont la prévalence se situe entre 6 et 42 %. Le trouble cognitif provoqué par la dépression a des répercussions sur les performances fonctionnelles des personnes âgées. OBJECTIFS DE L'ÉTUDE: Cette étude avait pour but de qualifier la prévalence d'un trouble cognitif et de la dépression chez les patients âgés de plus de 55 ans atteints d'insuffisance rénale chronique (IRC) de stade 3 ou de stade 4, et engagés dans un programme de prévention secondaire en 2012 et 2013. TYPE D'ÉTUDE: Il s'agit d'une étude transversale où on a utilisé un échantillonnage aléatoire simple et à laquelle 308 patients ont été invités à participer. PARTICIPANTS ET CADRE DE L'ÉTUDE: L'étude a porté sur des cas de patients provenant d'un programme de prévention secondaire à Bogota, en Colombie. Les participants étaient tous âgés de plus de 54 ans et avaient reçu un diagnostic d'IRC de stade 3 ou de stade 4 conformément au classement de la KDOQI (Kidney Disease Outcome Quality Initiative). MESURES: Le trouble cognitif a été mesuré à l'aide de l'évaluation neuropsychologique NEUROPSI et d'une échelle de Lawton modifiée. La dépression a été diagnostiquée en utilisant l'échelle de dépression gériatrique de Yesavage et le questionnaire MINI (Mini International Neuropsychiatric Interview). MÉTHODOLOGIE: Les renseignements personnels des participants tels que l'âge, la profession, l'état civil, le niveau de scolarité et les paramètres cliniques initiaux des participants ont été recueillis par le biais d'entrevues. L'évaluation clinique, effectuée à l'aide d'instruments spécifiques, est le fruit de la collaboration d'une équipe multidisciplinaire composée de néphrologues, d'un psychiatre, d'un neurologue et d'un neuropsychologue. RÉSULTATS: En tout, 251 patients ont accepté de participer à l'étude. Les hommes constituaient 67 % de la cohorte, l'âge médian se situait à 76,3 ans avec un écart-type de 7,9 ans et 85 % des participants souffraient d'IRC de stade 3. La prévalence globale d'un trouble cognitif était de 51 % (IC à 95 % entre 44,7 et 57,2) et la prévalence de dépression majeure se situait à 8 % (IC à 95 % entre 4,5 et 11,3). De plus, 4,8 % des participants (n = 12) présentaient à la fois un trouble cognitif et une forme de dépression. LIMITES DE L'ÉTUDE: La méthodologie de cette étude en limite la portée puisqu'elle ne permet pas d'établir la nature de l'association entre les indicateurs prévisionnels et les résultats. Ainsi, les liens potentiels devraient être interprétés avec prudence. Ils sont générés à titre d'hypothèses et devraient faire l'objet d'études ultérieures menées dans le cadre d'essais bien conçus. CONCLUSIONS: La dépression et les troubles cognitifs sont des affections prévalentes chez les patients souffrant d'IRC de stade 3 et de stade 4. Les troubles cognitifs se sont avérés très fréquents, affectant la moitié des patients Colombiens de plus de 55 ans ayant fait l'objet de cette étude.

Density-dependent productivity in a colonial vulture at two spatial scales.

Understanding how density dependence modifies demographic parameters in long-lived vertebrates is a challenge for ecologists. Two alternative hypotheses have been used to explain the mechanisms behind density-dependent effects on breeding output: habitat heterogeneity and individual adjustment (also known as interference competition). A number of studies have highlighted the importance of habitat heterogeneity in density dependence in territorial species, but less information exists on demographic processes in colonial species. For these, we expect density-dependent mechanisms to operate at two spatial scales: colony and breeding unit. In this study, we used long-term data from a recovering population of Cinereous Vultures (Aegypius monachus) in southern Spain. We analyzed a long-term data set with information on 2162 breeding attempts at four colonies over a nine-year period (2002-2010) to evaluate environmental and population parameters influencing breeding output. Our results suggest that breeding productivity is subject to density-dependent processes at the colony and the nest site scale and is best explained by interference competition. Factors intrinsic to each colony, as well as environmental constraints linked to physiography and human presence, also play a role in regulatory processes. We detected the existence of a trade-off between the disadvantages of nesting too close to conspecifics and the benefits of coloniality. These could be mediated by the agonistic interactions between breeding pairs and the benefits derived from social sharing of information by breeding individuals. We propose that this trade-off may play a role in defining colony structure and may hold true for other colonial breeding bird species. Our findings also have important management implications for the conservation of this threatened species.

Uneven large-scale movement patterns in wild and reintroduced pre-adult bearded vultures: conservation implications.

After the quasi-extinction of much of the European vertebrate megafauna during the last few centuries, many reintroduction projects seek to restore decimated populations. However, the future of numerous species depends on the management scenarios of metapopulations where the flow of individuals can be critical to ensure their viability. This is the case of the bearded vulture Gypaetus barbatus, an Old World, large body-sized and long-lived scavenger living in mountain ranges. Although persecution in Western Europe restrained it to the Pyrenees, the species is nowadays present in other mountains thanks to reintroduction projects. We examined the movement patterns of pre-adult non-breeding individuals born in the wild population of the Pyrenees (n = 9) and in the reintroduced populations of the Alps (n = 24) and Andalusia (n = 13). Most birds were equipped with GPS-GSM radio transmitters, which allowed accurate determination of individual dispersal patterns. Two estimators were considered: i) step length (i.e., the distance travelled per day by each individual, calculated considering only successive days); and ii) total dispersal distance (i.e., the distance travelled between each mean daily location and the point of release). Both dispersal estimators showed a positive relationship with age but were also highly dependent on the source population, birds in Andalusia and Alps moving farther than in Pyrenees. Future research should confirm if differences in dispersal distances are the rule, in which case the dynamics of future populations would be strongly influenced. In summary, our findings highlight that inter-population differences can affect the flow of individuals among patches (a key aspect to ensure the viability of the European metapopulation of the endangered bearded vulture), and thus should be taken into account when planning reintroduction programs. This result also raises questions about whether similar scenarios may occur in other restoration projects of European megafauna.

Estudios individualizados de maestría y de doctorado de la Facultad de Medicina de la Universidad Central de Venezuela: evolución y resultados de la aplicación del programa (1996-2002) / Study individuality of mastery and of doctorate of the Facultad of Medicina of the Universidad Central of Venezuela: evolution and result of the application of the program (1996-2002)

Entre Noviembre de 1996 y julio del 2002 se han inscrito en el programa de Estudios Individualizados de Maestría y de Doctorado de la Facultad de Medicina de la Universidad Central de Venezuela (FM-UCV) un total de 110 aspirantes. De estos, el 50 por ciento han pasado a ser cursantes. De los 55 cursantes, seis se han graduado (cuatro Doctores y dos Magisters) y de los 49 restantes 35 se encuentran en la Fase 1 de los estudios, 12 en la Fase II y dos en la Fase III listos para entregar la Tesis Doctoral. La mayoría de los aspirantes y cursantes han sido Médicos o Biólogos adscritos a las Escuelas e Institutos de la FM-UCV. La demanda del personal docente y de investigación de algunas Escuelas como las de Bioanálisis, Nutrición y Dietética, Enfermería y Salud Pública ha sido escasa o ausente. Se observa una demanda progresivamente creciente del personal del personal de Facultad de Medicina o de otras Facultades vinculadas a las Ciencias de la Salud de otras universidades nacionales. Se recomienda que las actividades de investigación pasen a ser actividad prioritaria en la FM-UCV para reforzar el programa y una mayor promoción de este entre el personal docente y de investigación de la Facultad. Se ha acumulado suficiente experiencia hasta el presente con la implementación de los estudios, por lo que el Comite Académico procederá a una evaluación de la calidad del mismo y a solicitar su acreditación ante el Consejo Nacional de Universidades.

Glomerulonefritis lupica: relación entre severidad de la nefropatía y variables funcionales renales / Lupus Nephritis: correlation between severity of nephropaty and renal functional parameters

Para investigar la diferencia de la proteinuria (Pr) de acuerdo a la severidad de la nefropatía y a su posible origen inmunológico o hemodinámico, se investigó el comportamiento de lagunos parámetros funcionales renales en pacientes con Lupus Eritematoso Sistémico y Nefropatía (GN-LES) leve o severa antes y después de la sobrecarga de proteínas de alto valor biológico (PAVB). Se estudiaron 23 pacientes con GN-LES y 10 controles sanos. A pacientes y controles se les practicó ecosonograma renal y perfil inmunológico para lupus eritematoso sistémico; Pr cuantitativa, tasa de filtración glomerular (TFG) medida por la depuración de creatinina (DCr), excreción fraccional de sodio (FeNa) y reserva funcional renal (RFR) fueron determinadas en condiciones basales y postcarga. Los 23 pacientes con GN-LES fueron sometidos a biopsia renal y sus lesiones clasificadas en leves y (Clases IIa y IIb; n=5) y severas (clases III,IV, y V; n=18) de acuerdo a los criterios de la OMS. La diferencia en la magnitud de la Pr entre ambos grupos fue marcada clínicamente, sin significancia estadística (p=0.110). El grupo con GN-LES leve presentó una Pr basal y postcarga de 0.281 ± g/24 horas y 0.480 ± 0.306 g/24 horas respectivamente, (p=0.05). La TFG en las formas leves varió postsobrecarga (86.84 ± 36.98 ml/min vs. 140.86 ± 38.35 ml/min; p=0.036), indicando RFR normal. En las formas severas la TFG se modificó poco postcarga (79.46 ± 42.48 ml/min vs. 89.63 ± 65.13 ml/min) p=0.58, representando una RFR reducida o ausente. La FeNa fue normal en ambos grupos tanto en condiciones basales como postcarga. Los parámetros funcionales renales evaluados no se correlacionaron directamente con la actividad y cronicidad de la GN-LES, ni con el posible origen inmunológico o hemodinámico de la proteinuria. En pacientes con GN-LES la sobrecarga con PAVB, mostró ser un método útil en la determinación de la RFR y en la detección de daño parenquimatoso renal precoz

Estado actual del programa de estudios individualizados de Maestría y Doctorado de la Facultad de Medicina de la Universidad Central de Venezuela / Current of the individualized studies for Master and Doctoral degrees in the Faculty of Medicine of the Universidad Central de Venezuela

En la actualidad 40 profesionales universitarios se encuentran cursando el programa de estudios individualizados de Maestría y de Doctorado (EIMD) de la Comisión de Estudios de Postgrado 8CEPG) de la Facultad de Medicina (FM) de al Universidad Central de Venezuela (UCV) iniciado en noviembre de 1996. La mayoríason adultos mayores, especialistas, médicos, biológos y bioanalistas, docentes e investigadores activos de la FM-UCV. Los proyectos de Trabajo Grado de Maestría y de Tesis Doctoral son en su mayoría de las áreas de clínica médica, inmunología y parasitología., y se realizan en Escuelas e Institutos de la FM-UCV. Este programa de EIMD en plena evolución, constituye una opción real para el desarrollo académico del personal dedicado a Ciencias de la Salud y una solución administrativa al requisito de doctorado para los profesores que quieren ascender al escalafón de Asociados o Títular de la UCV

Paracoccidiomicosis en el área suburbana de Caracas / Paracoccidiodomycosis at the sub urban area of Caracas

Se presentan dos casos con impresión diagnóstica de paracoccidiomicosis provenientes de la zona suburbana de Caracas. La importancia de este reporte es más que todo epidemiológica