Search

Colombia es un país rico en naturaleza; su diversidad destaca en muchos ámbitos, entre ellos la explotación de minas de carbón, esmeraldas, petróleo, oro, entre otros. Teniendo en cuenta estos aspectos, se ha logrado analizar la limitada explotación legal de estas minas, a más del hecho de que, en su gran mayoría, son empresas extranjeras las encargadas de realizar la explotación. Sin embargo, son muchos los pequeños mineros que las explotan de manera artesanal, quienes, a pesar de beneficiarse de este trabajo, han omitido la legalidad; esto sucede en varias zonas de Colombia, como es el caso del municipio de Mallama, ubicado en el departamento de Nariño. Se observa la situación en la que se encuentra esta zona del departamento de Nariño, frente a la formalidad en la explotación del oro, para lo cual es necesario emplear un tipo de investigación descriptiva que permita identificar, recopilar y analizar la información, tanto de cómo actualmente está el proceso en la extracción y explotación de minas, como del proceso de formalización de las personas naturales para la extracción de oro y sus responsabilidades fiscales en el municipio de Mallama. Para esto se llevó a cabo actividades como: el reconocimiento de las personas naturales que se dedican a la actividad minera, el conocimiento de los tipos de sociedades más favorables para su labor y, determinar cuáles son las responsabilidades fiscales en este proceso.

Suero Costeño (SC) is a fermented milk product, traditionally made in the Colombian Caribbean Region with native microorganisms. Due to its poorly controlled processes, it has undesirable microbiological and quality characteristics during storage, commercialization, and consumption. Directed fermentation processes with the usage of specific microorganisms help to improve fermented products characteristics. A mixture design using three types of indigenous lactic-acid Bacteria (LAB) was proposed in the Suero Costeño (SC) production process on a laboratory scale. The mixture that yielded the best sensory and physicochemical characteristics were selected for its scale-up on an artisan producer scale. A naturally fermented SC produced by an artisan producer was used as a control sample (SCC). The selected mixture contained L. plantarum 66.7%, and L. lactis 33.3%. This sample showed more stability during storage and the best attributes of sensory quality. Finally, the product made under the conditions of the artisan producer with this mixture had better quality and physicochemical properties than the SCC. Still, the fermentation time was longer, probably, due to the microorganism diversity that exists in natural fermentation processes, and the stress caused by freezing the strains.

Tranexamic acid (TXA), an antifibrinolytic drug, is usually administered intravenously; however, intra-articular administration has recently been proven to be as effective as intravenous administration. Limited information regarding the pharmacokinetics (PK) of TXA after intra-articular administration has been reported. The aim of this study was to develop a population PK model of TXA administered as a single intra-articular dose and as two intravenous doses, and to study the sources of interindividual variability (IIV) in the PK processes of TXA. The developed model was used to simulate PK profiles of TXA at different dosage regimens and in patients with renal impairment. Patients who underwent primary unilateral total knee replacement (TKR) received 1 g/10 mL (concentration of 100 mg/mL) of TXA applied directly to the surgical field before wound closure, or 2 g (two doses of 1 g) of intravenous TXA. A population PK model was developed using a nonlinear mixed-effects approach and sources of IIV, such as sex, age, body weight, height, body mass index (BMI), preoperative haemoglobin, preoperative haematocrit, and creatinine clearance. Twenty-four patients were included, 12 in each group. Twenty patients were female, mean age (standard deviation) was 73.7 years (5.6). The disposition of TXA was best described as a two-compartment model with clearance dependent on creatinine clearance. Bootstrap results indicated that the model was stable and robust. The estimated bioavailability for intra-articular administration was 81%. Simulations indicated that 100% of patients would have plasma concentrations associated with partial fibrinolysis at 8 h post-administration with the dosages and routes of administration used in the present study. Intra-articular administration would produce complete inhibition of fibrinolysis in only 12% of patients compared with 72.5% with intravenous administration. No adverse events were reported. This population PK model demonstrated that a single dose of high-concentration, low-volume intra-articular TXA can achieve antifibrinolytic plasma concentrations of the drug for 8 h, providing both local and systemic effects in patients undergoing TKR. TXA administration to the surgical field could be an alternative to the intravenous; route for patients undergoing TKR; however, clinical studies are needed to assess the toxic local effects of TXA. Spanish Clinical Studies Registry Number: 2017-004059-22. Date of registration: 12 April 2018.

International Society for Peritoneal Dialysis. Baxter Health Care. Fresenius Medical Care, Germany. Ipsen. Medical Faculty of University of Cologne. Marga and Walter Boll-Foundation. Federal Ministry of Education & Research (BMBF): 01GM1515. European Rare Kidney Disease Reference Network (ERKNet).

Rationale & Objective Research on pediatric kidney replacement therapy (KRT) has primarily focused on Europe and North America. In this study, we describe the mortality risk of children treated with maintenance peritoneal dialysis (MPD) in different parts of the world and characterize the associated demographic and macroeconomic factors. Study Design Prospective cohort study. Setting & Participants Patients younger than 19 years at inclusion into the International Pediatric Peritoneal Dialysis Network registry, who initiated MPD between 1996 and 2017. Exposure Region as primary exposure (Asia, Western Europe, Eastern Europe, Latin America, North America, and Oceania). Other demographic, clinical, and macroeconomic (4 income groups based on gross national income) factors also were studied. Outcome All-cause MPD mortality. Analytical Approach Patients were observed for 3 years, and the mortality rates in different regions and income groups were calculated. Cause-specific hazards models with random effects were fit to calculate the proportional change in variance for factors that could explain variation in mortality rates. Results A total of 2,956 patients with a median age of 7.8 years at the start of KRT were included. After 3 years, the overall probability of death was 5%, ranging from 2% in North America to 9% in Eastern Europe. Mortality rates were higher in low-income countries than in high-income countries. Income category explained 50.1% of the variance in mortality risk between regions. Other explanatory factors included peritoneal dialysis modality at start (22.5%) and body mass index (11.1%). Limitations The interpretation of interregional survival differences as found in this study may be hampered by selection bias. Conclusions This study shows that the overall 3-year patient survival on pediatric MPD is high, and that country income is associated with patient survival.

IntroductionDeath following surgical procedures is a global health problem, accounting for 4.2 million deaths annually within the first 30 postoperative days. The fourth indicator ofThe LancetCommission on Global Surgery is essential as it seeks to standardise postoperative mortality. Consequently, it helps identify the strengths and weaknesses of each country’s healthcare system. Accurate information on this indicator is not available in Colombia, limiting the possibility of interventions applied to our population. We aim to describe the in-hospital perioperative mortality of the surgical procedures performed in Colombia. The data obtained will help formulate public policies, improving the quality of the surgical departments.Methods and analysisAn observational, analytical, multicentre prospective cohort study will be conducted throughout Colombia. Patients over 18 years of age who have undergone a surgical procedure, excluding radiological/endoscopic procedures, will be included. A sample size of 1353 patients has been projected to achieve significance in our primary objective; however, convenience sampling will be used, as we aim to include all possible patients. Data collection will be carried out prospectively for 1 week. Follow-up will continue until hospital discharge, death or a maximum of 30 inpatient days. The primary outcome is perioperative mortality. A descriptive analysis of the data will be performed, along with a case mix analysis of mortality by procedure-related, patient-related and hospital-related conditionsEthics and disseminationThe Fundación Cardioinfantil-Instituto de Cardiología Ethics Committee approved this study (No. 41–2021). The results are planned to be disseminated in three scenarios: the submission of an article for publication in a high-impact scientific journal and presentations at the Colombian Surgical Forum and the Congress of the American College of Surgeons.Trial registration numberNCT05147623.

Many plant species from the Apocynaceae, Loganiaceae and Rubiaceae families evolved a specialized metabolism leading to the synthesis of a broad palette of monoterpene indole alkaloids (MIAs). These compounds are believed to constitute a cornerstone of the plant chemical arsenal but above all several MIAs display pharmacological properties that have been exploited for decades by humans to treat various diseases. It is established that MIAs are produced in planta due to complex biosynthetic pathways engaging a multitude of specialized enzymes but also a complex tissue and subcellular organization. In this context, N-methyltransferases (NMTs) represent an important family of enzymes indispensable for MIA biosynthesis but their characterization has always remained challenging. In particular, little is known about the subcellular localization of NMTs in MIA-producing plants. Here, we performed an extensive analysis on the subcellular localization of NMTs from four distinct medicinal plants but also experimentally validated that two putative NMTs from Catharanthus roseus exhibit NMT activity. Apart from providing unprecedented data regarding the targeting of these enzymes in planta, our results point out an additional layer of complexity to the subcellular organization of the MIA biosynthetic pathway by introducing tonoplast and peroxisome as new actors of the final steps of MIA biosynthesis.

Altres ajuts: acords transformatius de la UAB Biologicals undergo modifications throughout their commercial lifecycle. Major changes can unintentionally magnify their inherent physicochemical variability. Although trials comparing the pre- and the post-change versions have been requested occasionally, analytical comparison is the most sensitive approach to anticipating clinical equivalence. Therefore, it may be concluded, by means of 'extrapolation', that non-identical versions of a given biologic will behave equally in all indications. Despite the lessons learned with original biologics, there are still controversies around the approval of biosimilars through extrapolation. Here, a comprehensive analysis of scattered information allows for an account of cases of original biologic versions approved in some indications with no patient trials involved. Healthcare professionals can be reassured that inasmuch as extrapolation has proven valid for new versions of original biologics, the same holds for biosimilars.

Introduction: The use of drugs may involve medication errors leading to hospitalization, increased costs related to care, and even death. Objective: To determine the prevalence of medication errors reported in a pharmacovigilance information system in Colombia between 2018 and 2019. Materials and methods: We conducted an observational study based on the records of medication errors from a pharmacovigilance system covering 8.5 million outpatients affiliated with the Colombian health system. The errors were categorized from A (potential situations to error) to I (an error that could lead to death). We performed a descriptive analysis and established the prevalence of medication errors. Results: During 2018 and 2019, 29,538 medication errors in outpatients were reported with a general prevalence of 1.93 per 10,000 drugs dispensed. The errors that reached the patient and caused damage (types E, F, and I) occurred in 0.02% (n=6) of the patients. Most of them were related to the dispensation (n=20,636; 69.9%) and the possible most common cause was the lack of concentration at the time of dispensing (n=9185; 31.1%). The pharmacological groups most involved in medication errors were antidiabetics (8.0%), renin-angiotensin system inhibitors (7.6%), and analgesics (6.0%). Conclusions: Medication errors are relatively rare situations, generally classified as circumstances or events capable of generating the error (type A error). In low proportion, they can reach the patient and cause damage or even death.Introducción. El uso de medicamentos puede conllevar errores de medicación que desemboquen en la hospitalización del paciente, el aumento de los costos relacionados con la atención e, incluso, la muerte. Objetivos. Determinar la prevalencia de errores de medicación notificados en un sistema de información de farmacovigilancia en Colombia entre el 2018 y el 2019. Materiales y métodos. Se hizo un estudio observacional a partir del registro de errores de medicación de un sistema de farmacovigilancia que cubre a 8,5 millones de pacientes ambulatorios afiliados al sistema de salud de Colombia. Los errores se categorizaron en ocho grupos de la A (situaciones potenciales de error) hasta la I (error que pudo llevar a la muerte). Se hizo el análisis descriptivo y se estableció la prevalencia de los errores de medicación. Resultados. Durante los años 2018 y 2019, se reportaron 29.538 errores de medicación en pacientes ambulatorios, con una prevalencia general de 1,93 por cada 10.000 medicamentos dispensados. En el 0,02 % (n=6) de los casos, se presentaron errores que llegaron a afectar a los pacientes y causaron daño (tipos E, F e I). La mayoría de los errores se asoció con la dispensación (n=20.636; 69,9 %) y la posible causa más común fue la falta de concentración en el momento de dispensar los medicamentos (n=9.185; 31,1 %). Los grupos farmacológicos más implicados en errores de medicación fueron los antidiabéticos (8,0 %), los inhibidores del sistema renina-angiotensina (7,6 %) y los analgésicos (6,0 %). Conclusiones. Los errores de medicación son relativamente poco frecuentes y con mayor frecuencia se catalogan como circunstancias o eventos capaces de generar un error de tipo A. Muy pocas veces, pueden causarle daño al paciente, incluso, hasta la muerte.

La remoción de los contaminantes de un agua residual combinada (doméstica y pecuaria) considera la utilización de tecnologías de tratamiento, como los filtros percoladores, con lechos en policloruro de vinilo (PVC) y sin recirculación de efluentes, para la disminución de la carga orgánica medible como demanda química de oxígeno (DQO); los resultados experimentales indican que las remociones de DQO fueron superiores al 60 %, el pH presentó un intervalo de 6,5 a 7,0 y el valor promedio de la constante cinética de degradación en el filtro fue de 0.175 d

This research was carried out with the purpose of identifying how and which risk and protective factors affect academic outcomes. The study explored how different family and individual environmental factors foster academic resilience. The exploratory study took place with a group of six students from a public school in Bogotá, Colombia. The school is located in a low-income and marginalized area of the city, where social problems such as poverty and violence are common. Data collection techniques included document analysis, as well as interviews with teachers and parents. The data collection was focused on identifying how academic resiliency skills can be developed in vulnerable young people. It was found that it is possible to identify and describe different protective factors from the family, such as family guidance, family support, and opportunities for meaningful family involvement that explicitly foster academic resilience in at risk-students. It was also possible to address how individual characteristics also foster positive outcomes, including optimism, perseverance, or motivation.

Steroids are the cornerstone of therapy for nephrotic syndrome (NS) with a remission rate as high as 90%. In patients who do not respond to them or are steroid dependent, other immunosuppressive drugs have been used. Although rituximab use in NS is off-label, many authors have published their experience with it. Objective and methods: To describe retrospectively a group of seven children with nephrotic syndrome, either steroid-dependent (SDNS) or steroid-resistant (SRNS), treated with rituximab and mycophenolate, at Pablo Tobón Uribe Hospital, in Medellín, Colombia. Results: Two patients with SDNS and five with SRNS were evaluated; median age at diagnosis was 2 years (p25-75: 1-5); six months after treatment with rituximab there was reduction in proteinuria (93%), in the steroid dose (100%) and in the relapse episodes. However, proteinuria reappeared 12 months after treatment. Conclusion: During the first year after rituximab treatment of NS there is reduction in proteinuria and in the steroid dose, but thereafter there is relapse. It is suggested to carry out another study using a second dose of rituximab one year after the first one. RESUMEN: Los esteroides son el tratamiento de elección del síndrome nefrótico con tasas de éxito hasta del 90%. En pacientes que no responden adecuadamente a ellos, se han usado diferentes esquemas de inmunosupresión. Objetivo y métodos: describir la respuesta terapéutica en un grupo de siete niños con síndrome nefrótico córtico-dependiente (SNCD) o córtico-resistente (SNCR) que recibieron tratamiento con rituximab y micofenolato mofetil en un hospital universitario de la ciudad de Medellín durante los años 2010-2012. Resultados: dos pacientes tenían SNCD y cinco, SNCR; la mediana de edad en el momento del diagnóstico fue de 2 años (p25-75: 1-5); seis meses después de la aplicación del rituximab se encontró disminución de la proteinuria en el 93% de los pacientes; los esteroides se lograron suspender en el 100%; además, disminuyó el número de recaídas; sin embargo, la proteinuria reapareció un año después de dicho tratamiento. Conclusión: con el rituximab disminuyen la proteinuria y la dosis de esteroides, pero la enfermedad recurre 12 meses después de usarlo. Se sugiere hacer otro estudio evaluando el efecto de una segunda dosis de rituximab al año de la primera. COL0058784