Polymorphisms -374 T/A and -429 T/C of the Receptor for Advanced Glycation End-Products (RAGE) and Serum Levels of RAGE (sRAGE) Are Not Associated with Metabolic Syndrome.

RAGE is a multi-ligand transmembrane glycoprotein that promotes biological signals associated with inflammatory responses and degenerative diseases. sRAGE is a soluble variant, proposed as an inhibitor of RAGE activity. -374 T/A and -429 T/C polymorphisms of the advanced glycation end products receptor AGER gene are associated with the development of some diseases, such as type of cancer, cardiovascular disease, and micro and macrovascular disease in diabetes among others but their role in metabolic syndrome (MS) is still unknown. We studied 80 healthy men without MS, and 80 men with MS according to the harmonized criteria. -374 T/A and -429 T/C polymorphisms were genotyped by RT-PCR, and sRAGE was measured by ELISA. Allelic and genotypic frequencies did not differ between Non-MS and MS groups (-374 T/A p = 0.48, p = 0.57 and -429 T/C p = 0.36, p = 0.59). Significant differences were found in fasting glucose levels and diastolic blood pressure among the genotypes of the -374 T/A polymorphism in the Non-MS group (p < 0.01 and p = 0.008). Glucose levels were different between -429 T/C genotypes in the MS group (p = 0.02). sRAGE levels were similar in both groups, but in the Non-MS group showed a significant difference between individuals with only 1 or 2 components of the metabolic syndrome (p = 0.047). However, no associations of any SNP with MS were found (recessive model p = 0.48, dominant model p = 0.82 for -374 T/A; recessive model p = 0.48, dominant model p = 0.42 for -429 T/C). -374 T/A and -429 T/C polymorphisms are not associated with MS in Mexican population and have no influence on serum sRAGE levels.

Malformación de Chiari tipo I en una embarazada. Reporte de caso / Chiari malformation type I in pregnant women, case report

Resumen ANTECEDENTES: La malformación de Chiari es un padecimiento neurológico, congénito o adquirido, infrecuente. Se caracteriza por el desplazamiento de las estructuras rombencefálicas hacia el canal espinal, por debajo del foramen magno. Se desconoce la frecuencia y evolución que puede tener durante el embarazo porque existen cambios durante el trabajo de parto que pueden predisponer a la herniación del tronco encefálico con compresión medular. Esta situación plantea un desafío terapéutico porque no se dispone de recomendaciones unificadas acerca del momento del parto, vía del nacimiento y mejor técnica anestésica en estas pacientes. CASO CLÍNICO: Paciente primípara, de 24 años, con 34 semanas de embarazo. Acudió a Urgencias del Hospital Universitario de la Samaritana debido a un cuadro clínico de cefalea con signos de alarma. En la resonancia magnética cerebral se encontró una malformación de Chiari tipo I. Con el objetivo de limitar las maniobras de Vasalva durante el trabajo de parto se decidió la cesárea, con anestesia neuroaxial, sin complicaciones y con recién nacido sano. CONCLUSIÓN: La malformación de Chiari tipo I durante el embarazo es infrecuente. Las pacientes con diagnóstico previo al embarazo condicionan un seguimiento en el que se valora la indicación de tratamiento neuroquirúrgico antes de la concepción. Durante el embarazo no puede recomendarse un único método de finalización o anestesia y la atención médica debe estar a cargo un equipo multidisciplinario que formule un plan de atención individualizado para mejorar el desenlace materno y fetal.

Abstract BACKGROUND: Chiari malformation is a rare congenital or acquired neurological disorder, characterized by the displacement of the rhombencephalic structures towards the spinal canal below the level of the foramen magnum; The frequency and progression that can occur during pregnancy are unknown, since there are changes during labor that can predispose to brainstem herniation with spinal cord compression; which poses a therapeutic challenge since there are no unified recommendations about the moment of delivery, delivery route and the best anesthetic technique in these patients CLINICAL CASE: A 24-year-old patient, G1P0 with a 34-week pregnancy, consulted the emergency room of the Hospital Universitario de la Samaritana, due to a clinical profile of headache with warning signs; to the study of cerebral magnetic resonance with a finding of Chiari type I malformation. In order to limit the Valsalva maneuvers during labor, a caesarean section was performed at term under neuraxial anesthesia without complications with a healthy newborn. CONCLUSION: Chiari malformation type I during pregnancy is rare. Patients diagnosed prior to pregnancy condition a follow-up in which the indication for neurosurgical treatment prior to conception is assessed. During pregnancy, no single method of termination or anaesthesia can be recommended and medical care should be provided by a multidisciplinary team formulating an individualized care plan to improve maternal and fetal outcome.

Decreased serotonin content and release in the ventral hippocampus of prenatally stressed male rats in response to forced swim test.

Prenatal stress modifies the serotonergic system by altering the synthesis, metabolism, receptors and serotonin content in the hippocampus. However, it is currently unknown whether serotonin release in the ventral hippocampus of prenatally stressed rats is altered. In this study, serotonin (5-HT) and its metabolite, 5­hydroxyindoleacetic acid (5-HIAA) levels were analysed in dialysates (in vivo) and in homogenates (in vitro) of the ventral hippocampus. This was made after the sucrose preference test and after forced swim test (FST) in male adult progeny from mothers that were stressed by immersion in cold water during the last week of gestation. Serum concentration of corticosterone was also evaluated in control and in prenatally stressed males. Sucrose preference was differently affected in prenatally stressed males: 69% showed decreased sucrose consumption, and were considered anhedonic; 31% exhibited sucrose consumption similar to control and were considered non­anhedonic. During the FST, increased immobility and decreased swimming were observed in prenatally stressed males. After sucrose test, content and release of 5­HT in prenatally stressed rats were similar to those in the control group, with higher metabolite. After the FST, 5-HT content increased, but its release increased slightly in anhedonic rats and did not change in non-anhedonic rats, with lower metabolite. The response of the adrenal axis to the FST was larger in anhedonic prenatally stressed males, than in control and non­anhedonic males. These data show that behavioural disruption caused by prenatal stress is related to low release and lower metabolism of serotonin in the ventral hippocampus in adult male offspring, as well as to hyperactivity and hyperreactivity of the adrenal axis.

Serotonin and noradrenaline content and release in the dorsal hippocampus during learning and spatial memory in prenatally stressed rats.

Prenatal stress causes learning and spatial memory deficits in adulthood by modifying hippocampal function. The dorsal hippocampus contains serotonergic and noradrenergic neuron terminals, which are related to cognitive processes. It is currently unknown whether prenatal stress modifies serotonin (5-HT) and noradrenaline (NA) content and their release in the hippocampus during cognitive performance. Therefore, we measured these variables in the dorsal hippocampus of prenatally stressed males during spatial learning and memory tests. Cognitive tests were performed in 3-month-old control and prenatally stressed male rats in the Morris Water Maze (MWM). After cognitive tests, the dorsal hippocampus was dissected to quantify 5-HT and NA content. In other males, 5-HT and NA release in the dorsal hippocampus was assessed by microdialysis, before and after cognitive tests. Prenatally stressed males showed longer latencies to reach the platform, compared to control animals. Hippocampal 5-HT content decreased during learning and memory tasks in both groups, while NA content was not modified in prenatally stressed males neither before, nor after learning and memory tests. 5-HT and NA release were significantly lower in prenatally stressed animals during spatial learning and memory tasks. Corticosterone response was greater in prenatally stressed animals compared to controls. These results show that cognitive disruption caused by prenatal stress is related to decreased 5-HT and NA release, and to higher adrenal axis response in prenatally stressed animals.

Workshop 2019: Encuentro de Editores de Revistas Médico Científicas / Workshop 2019: Meeting of Medical Scientific Journal Editors

INTRODUCCIÓN. Los encuentros académicos públicos de expertos en divulgación cien-tífica que a través de órganos de registro y difusión oficial de revistas promueven el progreso de la ciencia, son un canal de comunicación entre la comunidad científica, tra-ducen el conocimiento de las disciplinas, educan y actualizan al profesional en sus roles de autor, lector, revisor, editor. Se fundamentan en políticas públicas y conducta ética. OBJETIVO. Describir las memorias del encuentro de editores, noviembre 2019, como insumo para las autoridades competentes que contribuya a establecer políticas y estrate-gias que permitan elevar la calidad científica, así como el proceso editorial de las revistas científicas en salud del Ecuador. MATERIALES Y MÉTODOS. Estudio observacional, descriptivo, con población y muestra conocida, obtención de la información en el sistema de gestión documental del Hospital de Especialidades Carlos Andrade Marín, noviembre 2019. RESULTADOS. Estadística descriptiva del perfil de los asistentes, descripción de problemas, soluciones y aportes. CONCLUSIÓN. Obtención de insumos del encuentro de editores en las "Buenas Prácticas del Proceso Editorial". Organización, estructura, norma, rol del equipo editorial, revisión de pares y Plan Anual de Capacitación Continua.

INTRODUCTION. Public academic meetings of experts in scientific dissemination that through the registration and official dissemination bodies of journals promote the progress of science, are a channel of communication between the scientific community, transla-te knowledge of the disciplines, educate and update the professional in their roles as author, reader, reviewer, editor. They are based on public policies and ethical conduct. OBJECTIVE. Describe the memories of the meeting of editors, November 2019, as an input for the competent authorities that contributes to establishing policies and strategies that allow raising scientific quality, as well as the editorial process of scientific journals in health in Ecuador. MATERIALS AND METHODS. Descriptive study, with a population and a known sample, obtaining the information in the document management system of the Carlos Andrade Marin Specialties Hospital, November 2019. RESULTS. Descriptive statistics of the assistants profile, description of problems, solutions and contributions. CONCLUSION. Obtaining inputs from the meeting of editors in the "Good Practices of the Editorial Process". Organization, structure, norm, role of the editorial team, peer review and Annual Continuous Training Plan.

Intraoperative Human Papillomavirus Test Predicts 24-Month High-Grade Squamous Intraepithelial Lesion Recurrence Saving Costs: A Prospective Cohort Study.

OBJECTIVES: The human papilloma virus (HPV) test is recommended in the posttreatment follow-up of cervical intraepithelial neoplasia. The aim of the study was to assess whether the intraoperative HPV (IOP-HPV) test had a similar diagnostic accuracy that HPV test performed at 6 months to predict high-grade squamous intraepithelial lesion (HSIL) recurrence. MATERIALS AND METHODS: In a prospective cohort study, 304 women diagnosed with HSIL by biopsy and/or endocervical curettage before treatment and/or confirmation in the histological specimen were included. Immediately after surgery, HPV testing was performed. This test was compared with the test at 6 months and other predictors of recurrence. Patients were followed for 24 months. An economic analysis was performed to compare the costs of IOP-HPV and HPV test at 6 months. RESULTS: Recurrence rate of HSIL was 6.2% (19 patients). The diagnostic accuracy of the IOP-HPV test to predict HSIL recurrence at 24 months was similar to the HPV test at 6 months, with comparative sensitivities of 100% versus 86.7%, specificities of 82.0% versus 77.9%, positive predictive values of 27.1% versus 18.1%, and negative predictive values of 100% versus 99.0%. Direct economic saving per high-grade intraepithelial lesion patient was 172.8 &OV0556;. CONCLUSIONS: The HPV test performed after loop electrosurgical resection procedure predicted recurrence of HSIL at 24 months with a similar diagnostic accuracy than the HPV test at 6 months. The use of the IOP-HPV test in the management of HSIL will allow early detection of the risk of recurrent disease and to save costs because of potential suppression of the need of HPV and follow-up controls at 6 months.

Mesoscale Assembly of Bisteroidal Esters from Terephthalic Acid.

A new series of bisteroidal esters was synthesized using a spacer group, sterols and sapogenins as substrates. Steroidal dimers were prepared in high yields employing diesters of terephthalic acid as linkages at the 3ß, 3'ß steroidal positions. In all attempts to crystallize bisteroids, it was observed that the compounds tended to self-organize in solution, which was detected when employing various solvent systems. The non-covalent interactions (van der Waals) of the steroidal moieties of this series of symmetrical bisteroids, the polarity of the solvents systems, and the different solubilities of the bisteroid aggregates, indeed induce the molecules to self-assemble into supramolecular structures with well-defined organization. Our results show that the self-assembled structures for the bisteroidal derivatives depend on the solvent system used: with hexane/EtOAc, membrane-shaped structures were obtained, while pure EtOAc afforded strand-shaped arrangements. In the CHCl3/CH3OH system, thin strands were formed, since van der Waals interactions are lowered in this system, as a consequence of the increased solubility of the bisteroids in CHCl3. Based on the characterization by SEM and XRD, we show evidence that the phenomenon of self-assembly of bisteroids occurs presenting different morphologies depending on the solvent used. The new steroidal dimer derivatives were characterized by NMR, TGA, DSC, SEM, and XRD. Finally, the molecular structure of one bisteroid was confirmed by single-crystal X-ray analysis.

Efficacy of the treatment with dapagliflozin and metformin compared to metformin monotherapy for weight loss in patients with class III obesity: a randomized controlled trial.

BACKGROUND: Mexico has one of the highest prevalence rates of obesity worldwide. New pharmacological strategies that focus on people with class III obesity are required. Metformin and dapagliflozin are two drugs approved for the treatment of diabetes. Beyond its effects on glucose, metformin has been suggested by some studies to result in weight loss. Therapy with dapagliflozin is associated with a mild but sustained weight loss in patients with diabetes. The primary outcome of the study is to determine if the combined treatment with dapagliflozin and metformin is more effective than monotherapy with metformin for weight loss in patients with class III obesity and prediabetes or diabetes who are awaiting bariatric surgery (including those patients who do have surgery). We also aimed to assess the effect of this combined treatment on waist circumference, triglycerides, blood pressure, and inflammatory cytokines. METHODS: This randomized phase IV clinical trial will include patients with diabetes or prediabetes who are between the ages of 18 and 60 years and exhibit grade III obesity (defined as body mass index ≥ 40 kg/m2). Patients using insulin will be excluded. Subjects will be randomized to one of two groups as follows: 1) metformin tablets 850 mg PO bid or 2) metformin tablets 850 mg PO bid plus dapagliflozin tablets 10 mg PO qd. The sample size required is 108 patients, which allows for a 20% dropout rate: 54 patients in the metformin group and 54 in the metformin/dapagliflozin group. All participants will receive personalized nutritional advice during the study. A run-in period of one month will be used to assess tolerance and adherence to treatment regimens. Anthropometric and biochemical variables will be recorded at baseline and at 1, 3, 6, and 12 months. A serum sample to determine glucagon, ghrelin, adiponectin, resistin, interleukin 6, and interleukin 10 will be collected at baseline and before surgery, or at 12 months (whatever happens first). Adherence to treatment and adverse and secondary events will be recorded throughout the study. An intention-to-treat analysis will be used. DISCUSSION: Forty-six percent of the patients in our Obesity Clinic have been diagnosed with prediabetes (32%) or diabetes (14%). The use of dapagliflozin in this population could improve weight loss and other cardiovascular factors. This effect could be translated into less time before undergoing bariatric surgery and better control of associated comorbidities. TRIAL REGISTRATION: Clinicaltrials.gov, ID: NCT03968224. Retrospectively registered on May 29, 2019.

Recomendaciones ante el COVID-19 para la práctica de otología y audiología / Recomendations for the practice of otology and audiology during COVID-19

Hasta el momento, no se conoce con certeza si el virus SARS-CoV-2 se encuentra en la mucosa que recubre la trompa de Eustaquio, el oído medio o la mastoides, aunque es bastante probable que sí lo esté, dada la relación de vecindad anatómica y fisiológica que existe con la mucosa de la naso y orofaringe, ubicaciones en las que claramente se ha documentado alta carga viral. Actualmente, se encuentra en construcción científica la definición de los aspectos relacionados con la seguridad en la práctica integral otológica en el contexto de la pandemia de la enfermedad por coronavirus 2019 (COVID-19). Este documento pretende recopilar el conocimiento y las experiencias nacionales e internacionales relacionados con la pandemia, para ser aplicados en el día a día en la práctica médica como especialistas. Es pertinente aclarar que el contenido de estos lineamientos deberá ser actualizado a medida que se conozca nueva información o evidencia, puesto que esta se encuentra en constante y rápida evolución.

Until now, it is not known with certainty if the SARS-CoV-2 virus is found in the mucosa that covers the Eustachian tube, the middle ear and the mastoid, but it is quite probable that it is, given the relationship that exists with the mucosa of the nasopharynx and oropharynx, anatomical sites where a high viral load has clearly been documented. The definition of safety-related aspects for the otological practice is currently under construction in the context of the 2019 coronavirus disease pandemic (COVID-19). This document aims to gather the national and international knowledge and experiences related in order to be applied in the day to day of our medical practice as specialists. It is important to mention that the content of these guidelines should be updated as new information or evidence becomes known since it is constantly changing.

Detection of hearing loss in newborns: Definition of a screening strategy in Bogotá, Colombia.

OBJECTIVE: To describe the results from the hearing screening protocol adopted in a Hospital in Colombia emphasizing the importance of performing screening on an outpatient basis, when the newborn is more than 24 h old. METHODS: A prospective study at Hospital Universitario San Ignacio in Bogota, Colombia was carried out, from May 1st, 2016 to Nov 30th, 2017, the study sample included 2.088 newborns examined using transient otoacoustic emissions. RESULTS: We obtained written consent from the parents of 1.523 newborns and 24 individuals (1.6%) failed the first stage of the screening, nine cases unilateral and 15 bilateral. A total of nine neonates (0,6%) failed the second screening test, six cases unilateral and three bilateral. Four (0,3%) did not return to the second test. Our false altered screening rate was 0.7%. CONCLUSIONS: In a developing country with limited human and economic resources, in which newborn early discharge is the norm, a newborn hearing screening program linked to infants' check-ups, that uses otoacoustic emissions after 48 h of life, seems a feasible option compare to the standard US protocol aiming to conduct hearing screening prior to discharge.

Prevalence of sensorineural hearing loss in newborns in a hospital from a developing country / Prevalencia de hipoacusia neurosensorial del recién nacido: hospital en un país en vía de desarrollo

ABSTRACT Objective This study aimed to determine the prevalence of nonsyndromic congenital sensorineural hearing loss at the Hospital Universitario San Ignacio, Bogotá, Colombia, and to describe the risk factors associated with this condition. Materials and Methods A prospective, observational cross-sectional study with bivariate analysis was conducted. A three-phase process using the Otoacoustic Emissions test screened all live newborns between June 2013 and June 2014. Negative cases were confirmed by Automated Auditory Brainstem Response test. Results A total of 962 newborns were screened with Otoacoustic Emissions test bilaterally: 401 males (46.36%), 464 females (53.64%). The mean weight was 2 798.10 g (95%CI: 2 766.51 - 2 839.76). The mean height was 48.60 cm (95%CI: 48.38 - 48.79). The mean age was 16.24 days (95%CI: 15.47 - 17.01). The mean maternal age was 27.37 years (95%CI: 26.76 - 27.98). There was a family history of hearing loss in 9.48% of the cases (n=90), and a family history of genetic diseases in 100 cases (10.56%). There were 14 cases of TORCH infections (1.45%), 375 admissions to the NICU (39.06%), 160 cases of neonatal jaundice (20.1%), and 79 cases of postpartum infections (8.21%). One live newborn presented with microtia. Conclusions The prevalence of congenital sensorineural hearing loss was 0.31% in both ears, and 0.11% in one ear. Currently, Colombia lacks a public universal newborn hearing screening program, and its future implementation faces great challenges.(AU)

RESUMEN Objetivos Este estudio busca determinar la prevalencia de la hipoacusia neurosensorial congénita no sindrómica en el Hospital Universitario San Ignacio de Bogotá, Colombia, y describir sus factores de riesgo. Materiales y Métodos Estudio observacional, transversal y prospectivo con análisis bivariado. Todos los nacidos vivos entre junio de 2013 y junio de 2014 fueron tamizados con Emisiones Otoacusticas. Los casos negativos fueron confirmados con Potenciales Evocados Auditivos de Tronco Cerebral. Resultados Un total de 962 neonatos fueron tamizados de forma bilateral con Emisiones Otoacústicas: 401 de sexo masculino (46,36%) y 464 de sexo femenino (53,64%). El peso promedio fue de 2 798,10 g (IC95%: 2 766,51 - 2 839,76). La talla promedio fue de 48.60 cm (IC95%: 48,38 - 48,79). La edad promedio fue de 16,24 días (IC95%: 15,47 -17,01). La edad materna promedio fue de 27,37 años (IC95%: 26,76 - 27,98). Se encontró historia familiar de hipoacusia en 9.48% de los casos (n=90) e historia familiar de enfermedades genéticas en 100 casos (10,56%). Hubo 14 casos de infecciones por TORCH (1,45%), 375 admisiones a la UCI Neonatal (39,06%), 160 casos de ictericia neonatal (20,1%) y 79 casos de infecciones postnatales (8,21%). Un nacido vivo presentó microtia. Conclusiones Se encontró una prevalencia de hipoacusia neurosensorial congénita del 0,31% en ambos oídos y de 0,11% en un oído. Actualmente Colombia carece de un programa nacional de tamización de hipoacusia neonatal, y su futura implementación conlleva grandes retos.(AU)

Prevalence of sensorineural hearing loss in newborns in a hospital from a developing country.

OBJECTIVE: This study aimed to determine the prevalence of nonsyndromic congenital sensorineural hearing loss at the Hospital Universitario San Ignacio, Bogotá, Colombia, and to describe the risk factors associated with this condition. MATERIALS AND METHODS: A prospective, observational cross-sectional study with bivariate analysis was conducted. A three-phase process using the Otoacoustic Emissions test screened all live newborns between June 2013 and June 2014. Negative cases were confirmed by Automated Auditory Brainstem Response test. RESULTS: A total of 962 newborns were screened with Otoacoustic Emissions test bilaterally: 401 males (46.36%), 464 females (53.64%). The mean weight was 2 798.10 g (95%CI: 2 766.51 - 2 839.76). The mean height was 48.60 cm (95%CI: 48.38 - 48.79). The mean age was 16.24 days (95%CI: 15.47 - 17.01). The mean maternal age was 27.37 years (95%CI: 26.76 - 27.98). There was a family history of hearing loss in 9.48% of the cases (n=90), and a family history of genetic diseases in 100 cases (10.56%). There were 14 cases of TORCH infections (1.45%), 375 admissions to the NICU (39.06%), 160 cases of neonatal jaundice (20.1%), and 79 cases of postpartum infections (8.21%). One live newborn presented with microtia. CONCLUSIONS: The prevalence of congenital sensorineural hearing loss was 0.31% in both ears, and 0.11% in one ear. Currently, Colombia lacks a public universal newborn hearing screening program, and its future implementation faces great challenges.

Underground Coal Mining: Relationship between Coal Dust Levels and Pneumoconiosis, in Two Regions of Colombia, 2014.

In Colombia, coal miner pneumoconiosis is considered a public health problem due to its irreversibility, high cost on diagnosis, and lack of data related to its prevalence in the country. Therefore, a cross-sectional study was carried out in order to determine the prevalence of pneumoconiosis in underground coal mining workers in two regions of Colombia. The results showed a 35.9% prevalence of pneumoconiosis in the study group (42.3% in region 1 and 29.9% in region 2). An association was found between a radiologic diagnosis of pneumoconiosis and a medium risk level of exposure to carbon dust (OR: 2.901, 95% CI: 0.937, 8.982), medium size companies (OR: 2.301, 95% CI: 1.260-4.201), length of mining work greater than 25 years (OR: 3.222, 95% CI: 1.806-5.748), and a history of smoking for more than one year (OR: 1.479, 95% CI: 0.938-2.334). These results establish the need to generate an intervention strategy aimed at preventing the identified factors, as well as a timely identification and effective treatment of pneumoconiosis in coal miners, in which the commitment of the General Health and Social Security System and the workers compensation system is ensured.

Servicios de medicina del trabajo en Colombia / Occupational medicine services in Colombia

Objetivo: Caracterizar la calidad técnica de los servicios que en el área de medicina del trabajo ofertan las instituciones prestadoras de servicios de salud ocupacional (IPSSO) en las principales ciudades del país. Métodos: Corresponde a un estudio descriptivo de corte transversal (2009-2010) de cobertura nacional (15 ciudades) en el que mediante la aplicación de una encuesta diagnóstica se obtuvo información de 192 Instituciones Prestadoras de Servicios de Salud Ocupacional (IPSSO). Resultados: El estudio evidenció que el 74,7 % de las IPSSO cuentan con licencia vigente para la prestación de servicios en el área de medicina del trabajo, que la oferta de servicios se realiza sobre la base de la subcontratación tanto de profesionales como de equipos y que el uso de las guías de atención integral en salud ocupacional basadas en la evidencia (GATISO), es muy incipiente. Conclusiones: Se identificaron, entre otras, deficiencias técnicas, administrativas, de gestión, de infraestructura y de personal, que afectan la calidad de los servicios de medicina del trabajo ofertados por las IPSSO, las cuales no permiten asegurar que se estén estudiando a profundidad y con suficiencia los efectos de los factores de riesgo en la salud de los trabajadores.

Objective: Characterizing the technical quality of occupational medicine services being provided by occupational health supply providing institutions (OHSPI) in Colombia’s main cities. Materials and Methods: This was a national descriptive cross-sectional study (2009- 2010) in which a diagnostic survey was used for obtaining data regarding 192 OHSPI. Results: The study demonstrated that 76 % of the OHSPI had a license for offering occupational medicine services. Institutions provide services by subcontracting professionals and the necessary equipment. It also revealed infrequent use of integral attention for evidence-based occupational health guidelines (EBOHG). Conclusion: Deficiencies affecting the quality of occupational medicine services were identified. Such deficiencies hampered in-depth studies about the effects of the risk factors on workers’ health, meaning that monitoring and controlling occupational health care services offered by the OHSPI must be reinforced to assure the availability of resources and the execution of disease prevention programs to maintain and improve workers’ state of health.

[Occupational medicine services in Colombia]. / Servicios de medicina del trabajo en Colombia.

OBJECTIVE: Characterizing the technical quality of occupational medicine services being provided by occupational health supply providing institutions (OHSPI) in Colombia's main cities. MATERIALS AND METHODS: This was a national descriptive cross-sectional study (2009- 2010) in which a diagnostic survey was used for obtaining data regarding 192 OHSPI. RESULTS: The study demonstrated that 76 % of the OHSPI had a license for offering occupational medicine services. Institutions provide services by subcontracting professionals and the necessary equipment. It also revealed infrequent use of integral attention for evidence-based occupational health guidelines (EBOHG). CONCLUSION: Deficiencies affecting the quality of occupational medicine services were identified. Such deficiencies hampered in-depth studies about the effects of the risk factors on workers' health, meaning that monitoring and controlling occupational health care services offered by the OHSPI must be reinforced to assure the availability of resources and the execution of disease prevention programs to maintain and improve workers' state of health.

Trasplante de tejido retiniano y de células progenitoras retinianas: una promesa terapéutica para pacientes con enfermedad de la retina / Retinal tissue transplantation and retinal progenitor cells: a therapeutic promise for patients with retinal disease

La retinopatía diabética, la degeneración macular relacionada con la edad y la retinitis pigmentosason las enfermedades retinianas más frecuentes en todo el mundo. A pesar de no contar consuficientes estudios que demuestren resultados funcionales positivos en cuanto a recuperar lafunción visual, el uso de células madre y células progenitoras retinianas y el trasplante de retinafetal parecen bastante promisorios. Hasta el momento no se han podido obtener resultadospositivos sobre la funcionalidad de las células trasplantadas, pero sí se ha demostrado que elprocedimiento para transferir el tejido retiniano es seguro y confiable. Aún no se ha intentadoen seres humanos el trasplante de células progenitoras retinianas, pero dicho trasplante ha dadoresultados satisfactorios en modelos múridos. Los estudios con células progenitoras retinianashan logrado demostrar en modelos múridos que se activan y expresan los fotorreceptores. Existenalgunas barreras de disponibilidad para el uso de células progenitoras retinianas, que se debensuperar con el fin de adelantar estudios que permitan aumentar las posibilidades de integracióny diferenciación de dichas células hacia fotorreceptores.

Retinal tissue transplantation and retinal progenitor cells: A therapeutic promise for patients with retinal diseaseWorldwide, diabetic retinopathy, age-related macular degeneration, and retinitis pigmentosahave the highest incidence rate among retinal diseases. Despite the lack of enough trialsdemonstrating positive functional results on eyesight recovery, the use of stem cells, retinalprogenitor cells, and fetal retinal tissue transplantation seem very promising. So far positiveresults on the functionality of the transplanted cells have not been obtained. However, the safetyand reliability of the procedure to transfer retinal tissue have been demonstrated. Transplantationof retinal progenitor cells has not been tried on human beings, but there have been satisfactory results with it in murine models. Trials with retinalprogenitor cells have demonstrated activation andexpression of photoreceptors in murine models. Somebarriers of availability exist for the use of retinalprogenitor cells that must be overcome in order tocarry out studies to increase the possibility of theirintegration and differentiation towards photoreceptors.

Conocimientos y registros clínicos en el paciente con trauma craneoencefálico / Knowledge and clinical records in patients with head trauma

La atención del paciente con Trauma Craneoencefálico es llevado por un equipo integral de salud, siendo el objetivo rehabilitar al paciente con un correcto y adecuado tratamiento y cuidado, teniendo principios científicos para ello. Es por esto que es de gran importancia valorar el nivel de conocimientos del personal de enfermería acerca de los cuidados del paciente con Trauma Craneoencefálico y su relación con los registros clínicos que se realizan en la Unidad de Cuidados Intensivos DUMIAN del Hospital Universitario Erasmo Meoz; para lograr desarrollar un estudio cuantitativo descriptivo de corte correlacional en el cual la población fue de 10 enfermeros profesionales, Adscritos a la Unidad de Cuidados Intensivos DUMIAN del Hospital Universitario Erasmo Meoz; durante Octubre- Noviembre 2008. Para la recolección de información se emplearon dos instrumentos. El primero es una lista de cotejo de datos neurológicos hallados(o no) en la hoja de registros clínicos y el segundo evalúa el nivel de conocimientos en cuanto al manejo de los pacientes con Trauma Craneoencefálico. Al recoger los datos el 70 % de la población está en un rango de conocimientos sobresalientes y el 30 % tienen conocimientos aceptables. En los registros de enfermería se presentó que el 100% de la población tuvo un registro eficiente sobre la valoración del paciente con Trauma Craneoencefálico, encontrando que los profesionales de enfermería registran al ingreso y luego continúan registrando los auxiliares de enfermería, por tanto, existe una relación directa entre los conocimientos de enfermería y los registros en la historia clínica, ya que a mayor nivel de conocimientos sobresalientes mayor son los registros suficientes para el paciente con Trauma Cráneo Encefálico.

The TEC care of the patient is led by a team of health, the aim being to rehabilitate the patient with a correct and appropriate treatment and care, with scientific principles for doing so. That's why it is important to assess the level of knowledge of nurses about the care of the patient with TCE and its relationship to the clinical records that are made in the ICU DUMIAN Huemer; to achieve a study to develop cutting Quantitative Description correlational in which the population was 10 professional nurses, attached to the ICU of DUMIAN Huemer; during October-November 2008. For gathering the information is used two instruments. The first is a list of matching data neurological found (or not) in the leaves of clinical records and the second evaluates the level of knowledge regarding the management of patients with TCE. To collect data for 70% of the population is in a range of outstanding skills and 30% have knowledge acceptable. In the nursing records show that 100% of the population had an efficient registration on the assessment of the patient with TCE, finding that the nurses recorded at the entrance and then continue recording the nurse's aides, therefore, there is a relationship direct knowledge of nursing and clinical records in history, since a higher level of knowledge are more outstanding records sufficient for the patient with TCE.

Epilepsia: personalidad, depresión, atención y memoria / Epilepsy: personality, depression, attention and memory

El objetivo principal de esta investigación fue identificar la presencia de alteraciones en la personalidad, el estado de ánimo (depresión), la atención y la memoria en 20 pacientes epilépticos, cuyas edades oscilaron entre 18 y 40 años. Esta evaluación se realizó utilizando la escala multidimensional abreviada del MMPI (minimult) para personalidad, el inventario de depresión de Beck (BDI) para depresión, el trail making test (TMT) para el nivel atencional y la escala de memoria de Weschler (WMS-III) para memoria. Los resultados obtenidos muestran ausencia de alteraciones clínicamente significativas de las dimensiones evaluadas. Las implicaciones de esta investigación se presentan en la discusión.

The main purpose of this research was to identify the presence of personality, mood (depression), at-tention and memory disorders in 20 epileptic patients aged between 18 and 40 years. This evaluation was conducted with an abbreviated multidimensional scale of the Minnesota Multiphasic Personality Inventory [MMPI (Minimult)j to assess personality, Beck Depression Inventory (BDI) to assess de-pression, the Trail Making Test (TMT) to measure the level of attention and Wechsler Memory Scale to assess memory. Results show no clinically significant alterations of the assessed issues. Implications of this research are stated in the discussion.

Evaluación de características morfológicas e inmunofenotipo de células madre mesenquimales en cultivo obtenidas a partir de sangre de cordón umbilical y médula ósea / Assessment of morphologic characteristics and immunophenotype of mesenchimal stem cell culture obtained from umbilical cord blood and bone marrow

La sangre del cordón umbilical y la médula ósea humana son una alternativa para el aislamiento y cultivo de células madre mesenquimales, útiles en terapias de regeneración tisular e inmunomodulación. El objetivo de este trabajo fue aislar y cultivar células madre mesenquimales a partir de la sangre del cordón umbilical y de la médula ósea. Se recolectaron muestras de sangre de cordón umbilical en el servicio de Gineco-Obstetricia del Hospital Occidente de Kennedy en Bogotá, Colombia. La recolección de médula ósea se realizó en los servicios de ortopedia y traumatología del hospital universitario San Ignacio de Bogotá, Colombia. Se evaluó la tasa de generación celular, características morfológicas por microscopia invertida y tinción de Wright, asi como el inmunofenotipo de las poblaciones celulares por citometría de flujo. La eficiencia de aislamiento de las células madre mesenquimales a partir de sangre de cordón umbilical fue del 30/100 con una tasa de generación entre 20 y 50 minutos. A partir de médula ósea el aislamiento fue del 100/100, con un tiempo de generación entre 16 y 39 minutos. Se observaron diferencias morfológicas por tinción de Wright y la presencia de progenitores hematopoyéticos durante el cultivo primario (3.54/100 de CD34+/CD45+), que disminuían cuando se realizaba el primer pase del cultivo (0.19/100 de CD34+/CD45+). El aislamiento de células madre mesenquimales es más eficiente a partir de medula ósea. Se observan diferencias morfológicas por microscopia invertida y tinción de Wright entre células aisladas de sangre de cordón umbilical y médula ósea. El antígeno CD105 constituye un marcador importante en el establecimiento del perfil inmunofenotípico de células madre mesenquimales.

Células madre mesenquimales: características biológicas y aplicaciones clínicas / Mesenchymal stem cells: Biological characteristics and clinical applications

Las células madre mesenquimales son células pluripotentes y adultas con morfología fibroblastoide y plasticidad hacia diversos linajes celulares como condrocitos, osteocitos y adipocitos entre otros. Estas células pueden ser aisladas principalmente de médula ósea, sangre de cordón umbilical y tejido adiposo de donde se han logrado establecer cultivos que han permitido estudiar sus propiedades funcionales y fenotípicas. Aunque la información obtenida hasta la fecha no brinda un conocimiento completo, se espera que con el desarrollo de próximas investigaciones se aclaren diversos aspectos biológicos para implementar su uso en medicina regenerativa. Esta revisión presenta una visión general sobre las células madre mesenquimales: morfología e inmunofenotipo, ontogenia, fuentes de obtención y aplicaciones clínicas.