Search

The present work is a systematization of the experiences of the implementation of the Audit Program for Quality Improvement (PAMEC), in a private IPS of medium complexity in the city of Cali from January to December of the year 2019. This systematization process used a qualitative-participatory methodological approach. Among the main results of the systematization, it was found that, within the observed quality, the majority of user care standards were above the average and a few areas such as Diagnostic and Therapeutic Support were below the minimum standards. This document socializes both the weaknesses and strengths of the services enabled through said program., El presente trabajo es una sistematización sobre las experiencias de la implementación del Programa de Auditoria para el Mejoramiento de la Calidad (PAMEC), en una IPS privada de mediana complejidad en la ciudad de Cali de enero a diciembre del año 2019. Este proceso de sistematización utilizó un enfoque metodológico cualitativo-participativo. Entre los principales resultados de la sistematización, se encontró que, dentro de la calidad observada, la mayoría de los estándares sobre la atención a usuarios estaban por encima de la media y algunas pocas áreas como Apoyo Diagnóstico y Terapéutico se encontraron por debajo de los estándares mínimos. Este documento socializa tanto las debilidades y fortalezas de los servicios habilitados a través de dicho programa.

OBJECTIVE: In utero exposure of the fetus to Ro/La autoantibodies may lead to congenital heart block (CHB). In the mother, these autoantibodies are associated with activation of the type I interferon (IFN)-system. As maternal autoantibodies are transferred to the fetus during pregnancy, we investigated whether the type I IFN-system is activated also in newborns of anti-Ro/La positive mothers, and whether fetal IFN activation is affected by maternal immunomodulatory treatment. METHODS: Blood drawn at birth from anti-Ro/La positive mothers, their newborns and healthy control pairs was separated into plasma and peripheral blood mononuclear cells (PBMC). PBMC were analysed directly or cultured. mRNA expression was analysed by microarrays, cell surface markers by flow cytometry, and IFNα levels by immunoassays. RESULTS: We observed increased expression of IFN-regulated genes and elevated plasma IFNα levels not only in anti-Ro/La positive women, but also in their newborns. CD14+ monocytes of both anti-Ro/La positive mothers and their neonates showed increased expression of Sialic acid-binding Ig-like lectin-1, indicating cellular activation. Notably, the IFN score of neonates born to mothers receiving immunomodulatory treatment was similar to that of controls, despite persistent IFN activation in the mothers. In both maternal and neonatal PBMC, IFNα production was induced when cells were cultured with anti-Ro/La positive plasma. CONCLUSIONS: Ro/La autoantibody-exposed neonates at risk of CHB have signs of an activated immune system with an IFN signature. This study further demonstrates that neonatal cells can produce IFNα when exposed to autoantibody-containing plasma, and that maternal immunomodulatory treatment may diminish the expression of IFN-regulated genes in the fetus.

Systemic autoimmune diseases are characterized by the overexpression of type I IFN stimulated genes, and accumulating evidence indicate a role for type I IFNs in these diseases. However, the underlying mechanisms for this are still poorly understood. To explore the role of type I IFN regulated miRNAs in systemic autoimmune disease, we characterized cellular expression of miRNAs during both acute and chronic type I IFN responses. We identified a Tcell-specific reduction of miR-31-5p levels, both after intramuscular injection of IFN and in patients with Sjogren's syndrome (SjS). To interrogate the role of miR-31-51p in Tcells we transfected human CD4(+) Tcells with a miR-31-5p inhibitor and performed metabolic measurements. This identified an increase in basal levels of glucose metabolism after inhibition of miR-31-5p. Furthermore, treatment with IFN- also increased the basal levels of human CD4(+) T-cell metabolism. In all, our results suggest that reduced levels of miR-31-5p in Tcells of SjS patients support autoimmune T-cell responses during chronic type I IFN exposure.

Introduction: High cost diseases have become today a determinant and indicator of durability, quality and provision of health services in the health promoters (Eps) of the city of Bucaramanga. Added to this, the high cost has been growing in this city in an uncontrolled way, because people are not following conditions of healthy living habits and efficient health controls, which are recommended according to their health scheme, clinical picture and health factors. health identified. All this negatively affects the provision of health services, since it causes a higher administrative cost that entails the protection and provision with quality of health schemes to combat the mitigation of factors and the same high-cost illness. Objective: to analyze the financial and health risk of high cost diseases in an eps of the city of Bucaramanga in 2018. Methodology: a descriptive, cross-sectional, prospective study with a quantitative approach. Conclusions High cost diseases place the eps of the city of Bucaramanga at financial and administrative risk due to the high cost that must be had to mitigate them and improve the quality of life of users., Introducción: Las enfermedades de alto costo se han convertido hoy en di a en un determinante e indicador de perdurabilidad, calidad y prestación de servicios de salud en las empresas promotoras de salud (Eps) de la ciudad de Bucaramanga. Sumado a esto, el alto costo viene creciendo en esta ciudad de forma descontrolada, debido a que las personas no están siguiendo condiciones de hábitos de vida saludables y controles eficientes de salud, que son recomendados según su esquema de salud, cuadro clínico y factores de salud identificados. Todo esto repercute de forma negativa en la prestación de servicios de salud, ya que ocasiona un costo administrativo mayor que conlleva el amparo y prestación con calidad de esquemas de salud para combatir la mitigación de factores y la misma enfermedad de alto costo. Objetivo: analizar el riesgo financiero y de salud de las enfermedades des alto costo en una eps de la ciudad de Bucaramanga en el año 2018. Metodología: estudio descriptivo, transversal, prospectivo con enfoque cuantitativo. Conclusiones. Las enfermedades de alto costo colocan en riesgo financiero – administrativo las eps de la ciudad de Bucaramanga debido al costo elevado que se debe tener para la mitigación de las mismas y mejorar la calidad de vida de los usuarios.