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عضویت

جستجوی مقالات مرتبط با کلیدواژه "colombia" در نشریات گروه "پزشکی"

  • Carlos Atencia-Flórez, Catalina Quintero-Valencia, María Mondragón-Arismendy, Andrés Cardona-Arias, Carlos Regino-Agamez, Julián Vélez-Urrego
    Background

      Multiple myeloma is the second most common hematologic malignancy after lymphomas. Few studies have characterized significant and full variables at the time of diagnosis of multiple myeloma in Colombia, and there is no data evaluating patients for follow-up.

    Materials and Methods

      A retrospective cohort study is presented, describing the clinical, laboratory, cytometric, and cytogenetic characteristics of patients with a de novo diagnosis of multiple myeloma evaluated in a reference hematology laboratory attached to a highly complex hospital in Medellín, Colombia.  We follow them until death as a main outcome.

    Results

      A total of 170 patients with a de novo diagnosis of multiple myeloma were collected from a database of 421 patients with different monoclonal gammopathies. Mainly, it was found that 50.8% of the patients were men; the median age was 62 years; 65.4% had secretion of the IgG kappa; half of the patients presented International Staging System (ISS) Stage III. The β2 macroglobulin >4 mg/L and creatinine >2 mg/dl were the main variables significantly associated with survival (Hazard Ratio (HR) 2.4 and 2, respectively). Eighty-five percent of patients presented with bone lytic lesion involvement and less than 3% with extramedullary involvement. Conventional Banding Karyotype (CBK) genetic risk assessment yield was poor, compared with although scarce data regarding Cytogenetic risk assessment based on Fluorescence in-situ Hybridization (FISH).

    Conclusion

      The clinical profile of the patients with a de novo diagnosis of multiple myeloma in our cohort is similar to that described in international studies. The diagnosis of multiple myeloma was documented at younger ages, with more advanced stages, anemia, and a high percentage of bone disease. ISS provides an excellent tool for prognosis purposes. Cytogenetic risk assessment based on FISH should be done for all MM patients from therapeutic implications. We need standardized protocols for bone marrow sample manipulation and processing in order to guarantee good correlation for plasma cells count methods.

    Keywords: Multiple myeloma, Cohort study, Survival, Colombia
  • Simon Turner *, Ana María Ulloa, Natalia Niño, Vivian Valencia Godoy
    Background

    The integration of health services with other sectors is hypothesised to support adaptation of health systems in response to coronavirus disease 2019 (COVID-19). This study identified barriers and enablers associated with intersectoral coordination at an early stage of the pandemic. The study focused on the roles played by the academic and private sector in different areas of public health planning and delivery concerning COVID-19 in Colombia.

    Methods

    A qualitative approach was used to understand stakeholders’ experiences and perceptions of intersectoral working in response to COVID-19 in three Colombian cities (Bogotá, Cali and Cartagena). Between March and November 2020, data was collected via semi-structured interviews conducted online with 42 key actors, including representatives of governmental bodies, universities, and professional associations. The dataset was analysed thematically using a combination of inductive and deductive methods.

    Results

    Organizations adjacent to the health system, including universities and the private sector, supported responses to COVID-19 by providing evidence to inform decision-making, additional service capacity, and supporting coordination (eg, convening intersectoral “roundtables”). The academic and private sector involvement in intersectoral coordination was stimulated by solidarity (being the “right thing to do”) and motivation for supporting local companies (reopening the economy). Intersectoral working was influenced by pre-existing (substantive) and emerging (situational) enablers and barriers.

    Conclusion

    This study showed that intersectoral coordination has played an important role in responding to COVID-19 in Colombia. Coordination was influenced by substantive and situational enablers and barriers. Based on our findings, policy-makers should focus on addressing substantive barriers to coordination, including the pre-existing tensions and mistrust among national and local healthcare actors, strict regulations and limited financial and human resources, while providing support for situational enablers, including alignment of public and private actors’ interests, intersectoral government support and establishing frequent communication channels and formal spaces of interaction among sector, in processes of decision-making.

    Keywords: Intersectoral Coordination, COVID-19, Academia, Private Sector, Colombia
  • Gloria Carrillo, Elizabeth Vargas Rosero, Oscar Franco, July Forero, Alejandra Moreno, Melisa Castellanos
    Background & Aim

    The Memorial Symptom Assessment Scale measures the presence, frequency, severity, and distress of symptoms. The scale is available in Spanish, but it has not been validated in Colombia. This study aims to translate, validate, and culturally adapt the Memorial Symptom Assessment Scale for adults with cancer in Colombia.

    Methods & Materials

    Adults with cancer undergoing chemotherapy in an oncological outpatient center in Bogota, Colombia, were invited to participate in the study. Patients in end-of-life care or with cognitive deficits were excluded. Psychometric research was carried out and included: 1) Translation and cultural adaptation of the scale from English, 2) Construct validity and reliability with a convenience sample of 249 cancer patients. A factorial analysis of principal components was carried out with the Varimax rotation method in IBM SPSS v26.0. The reliability of the scale was estimated using Cronbach's Alpha; subsequently, factor analysis was carried out using structural equations in MPlus.

    Results

    The scale was adapted to the Colombian context. Two factors (physical and psychological) of the scale structure were produced by the factorial analysis that contributes 47.9% of the accumulated variance. The alpha coefficient of Cronbach ranged between 0.75 and 0.79. The final model goodness of fit was also adequate [X2 (128)=184.47, p = 0.008, CFI = 0.94, RMSEA: 0.04 [0.03, 0.06], SRMR: 0.06, TLI= 0.92].

    Conclusion

    The Memorial Symptom Assessment Scale has adequate validity and reliability to measure the prevalence, frequency, stress, and severity of symptoms in adults with cancer in Colombia.

    Keywords: neoplasms, symptom assessment, psychometrics, validation study, Colombia
  • Julián Felipe PORRAS VILLAMIL, Mario Javier OLIVERA*, Nadia Katherine RÍOS CAMARGO
    Background

    SARS-CoV-2 virus is the causative agent of COVID-19 disease. It is essential to understand the epidemiological characteristics of the first few cases in each country. This study aimed to describe the geographical distribution, and temporal appearance of the first few hundred cases in Colombia.

    Methods

    This observational study was conducted to review the literature and key documentary information from public health institutions, websites and news reports were examined.

    Results

    The first few 100 cases for COVID-19 were confirmed in Colombia. According to sex, men with 54% predominate, the most affected age group was 20 to 29 yr old (26%), 9% of the cases required hospitalization and no deaths were reported. Most of the confirmed subjects were from the departments of Cundinamarca. To date, most cases are imported (63%), especially from Spain.

    Conclusion

    The COVID-19 pandemic puts in evidence the lack of understanding, prevention and contention power of the different countries around the world is not as good as it could be. Politics must not affect the different proposed measures.

    Keywords: Coronavirus, Case reports, Public health, Pandemic, Colombia
  • Kiarash Ghazvini, Masoud Youssefi, Masoud Keikha *

    Helicobacter pylori is one of the most common bacteria in the stomach, colonizing about one-half of the population in the world, while most of them remain asymptomatic throughout their lives and gastric cancer (GC) occurs in only 1-2% of people. It seems that the final outcomes of Helicobacter pylori infection are dependent on bacterial virulence factors, host genetic characteristics, and the environmental conditions. In this study, we compared the expression of 20 known virulence factors associated with the development of GC in the isolated Helicobacter pylori strains from the Colombian patients belonging to the regions with low and high GC risks. Based on the results of the present study, it was found that the 20 studied virulence factors are closely related with each other and regulate their expressions through the required intermediates. We also showed that the Helicobacter pylori strains belonging to the region with high GC risk were more virulent and have developed into GC by destroying the intercellular bindings, cell skeletal dysregulation, and cell survival and proliferation stimulation, while the H. pylori strains in the region with low GC risk expressed virulence factors related to the chronic inflammation and apoptosis; adhesion factors were also different in both groups.

    Keywords: Helicobacter pylori, Gastric cancer, Virulence factor, Colombia
  • Marcela Vélez *, Michael G. Wilson, Julia Abelson, John N. Lavis, Guillermo Paraje
    Background Chile and Colombia are examples of Latin American countries with health systems shaped by similar values. Recently, both countries have crafted policies to regulate the participation of private for-profit insurance companies in their health systems, but through very different mechanisms. This study asks: what values are important in the decision-making processes that crafted these policies? And how and why are they used?   Methods An embedded multiple-case study design was carried out for 2 specific decisions in each country: (1) in Chile, the development of the Universal Plan of Explicit Entitlements - AUGE/GES - and mandating universal coverage of treatments for high-cost diseases; and (2) in Colombia, the declaration of health as a fundamental right and a mechanism to explicitly exclude technologies that cannot be publicly funded. We interviewed key informants involved in one or more of the decisions and/or in the policy analysis and development process that contributed to the eventual decision. The data analysis involved a constant comparative approach and thematic analysis for each case study.   Results From the 40 individuals who were invited, 28 key informants participated. A tension between 2 important values was identified for each decision (eg, solidarity vs. individualism for the AUGE/GES plan in Chile; human dignity vs. sustainability for the declaration of the right to health in Colombia). Policy-makers used values in the decisionmaking process to frame problems in meaningful ways, to guide policy development, as a pragmatic instrument to make decisions, and as a way to legitimize decisions. In Chile, values such as individualism and free choice were incorporated in decision-making because attaining private health insurance was seen as an indicator of improved personal economic status. In Colombia, human dignity was incorporated as the core value because the Constitutional Court asserted its importance in its use of judicial activism as a check on the power of the executive and legislative branches.   Conclusion There is an opportunity to open further exploration of the role of values in different health decisions, political sectors besides health, and even other jurisdictions.
    Keywords: Chile, Colombia, Values, Health System Financing, Decision-Making
  • Gregory L. Peck *, Joseph S. Hanna
    In 2015, the Lancet Commission on Global Surgery (LCoGS) working groups developed a National Surgical, Obstetric, and Anesthesia Plan (NSOAP) framework to guide national surgical system development globally predicated on six data points (indicators) which can assess surgical systems. Zambia as well as other subSaharan Africa (SSA) countries have forged ahead in designing and implementing interventions based on LCoGS indicators collected to inform NSOAP. Concurrently, the Zambian team and others have recognized the need for rigorous scientific inquiry to assess and iteratively improve upon the NSOAP process and outputs. Based on the Zambian experience, as well as that of ours in Colombia, we have identified “core principles” through convergent works which inform a scientific framework through which NSOAP can be evaluated. We propose that when contextualized, participatory action research (PAR) and dissemination and implementation science are methodologies upon which a robust framework can be developed to achieving objective and iterative NSOAP evaluation, and ultimately universal health coverage as envisioned by the World Health Organization (WHO).
    Keywords: Surgery Systems Science, Participatory Action Research, Dissemination, Implementation Science, Colombia, GSRU
  • Robinson Ramirez, Velez *, Rodrigo Argothyd, Jose Francisco Meneses, Echavez, Maria Beatriz Sanchez, Puccini, Carlos Alejandro Lopez, Alban, Daniel Dylan Cohen
    Background
    Wrestling was an important part of the ancient Olympic Games and is still one of the most popular events of the modern Olympic Games. Studies indicate that general physiologic profile of successful wrestlers is high anaerobic power and capacity, muscular strength, above average aerobic power, exceptional flexibility, fat free mass, and a mesomorphic somatotype.
    Objectives
    The objective of the present study was to evaluate anthropometric characteristics and physical performance of elite male wrestlers.Patients and
    Methods
    The Colombian Wrestling Team was evaluated while in preparation for the Olympic Games (n = 21; age, 27.9 ± 6.7 years). Athletes were tested on anthropometric and fitness parameters: body composition, somatotype distribution according to Heath-Carter, aerobic capacity, vertical jump, and anaerobic power.
    Results
    The evaluations showed a mean body fat percentage of 13.6% ± 3.0% (95% CI, 12.2%-15%), muscle mass of 46.4% ± 2.2% (95% CI, 45.4%-47.4%), Ponderal index of 41.0 ± 1.8 (95% CI, 40.2-41.8), body adiposity index (BAI) 25.1 ± 3.6 (95% CI, 23.5-26.8), and somatotype distribution mesomorphic-ectomorph (5.3-1.6-3.8). Mean aerobic capacity was 45.9 ± 6.6 mL/kg/min (95% CI, 42.8-48.9), vertical jump was 36.4 ± 6.6 cm (95% CI, 11.8-16.6), and anaerobic power was 92.6 ± 19.5 kg/s (95% CI, 83.7-101.5).
    Conclusions
    These results provided a profile of elite wrestlers that could be used as training targets for developing athletes. The results may also provide information for training and tactical planning.
    Keywords: Wrestling, Anthropometric, Aerobic Power, Anaerobic Power, Anaerobic Capacity, Colombia
  • Laura Del Pilar Cadena Afanador, Daniel Sebastian, Salazar Radi, Luis Enriqueva, Squez Pinto, Cristian Eduardo Perez Pinzon, Manuel Felipe Castro Carreno
    Background
    Tobacco smoking is the leading cause of preventable mortality. The prevalence of smoking in adolescents in high schools ranges from 23.5% to 41%, respectively. In Colombia, these figures are similar and students entering the University are exposed to initiate smoking. The purpose of this study was to establish the determinants associated with the initiation of tobacco smoking among university students.
    Methods
    A case–control paired by sex and age study design was used. The study population was the students of a private university of Bucaramanga, Santander, Colombia. The final sample consisted of 167 cases and 314 controls randomly select undergraduate university students. Data analysis was performed using a Logistic regression model adjusted by gender and age; using the initiation of tobacco smoking as the dependent variable, and as independent variables relationship with parents, history of parental smoking, university social environment, being away from hometown, steady girlfriend/boyfriend who smokes, alcohol consumption, physical activity, and Francis Score.
    Results
    The social environment (odds ratio [OR]: 32.70, 7.40-144.55), being away from hometown (OR: 3.06, 1.55-6.07), history of steady girlfriend/boyfriend who smoke (OR: 2.87, 1.43-5.76), a bad relationship with the father (OR: 8.01, 2.01-31.83), history of tobacco consumption of the mother (OR: 2.66, 1.37-5.17) and alcohol consumption (OR: 4.79, 1.91-12.00) appeared as determinants of initiation of tobacco smoking. As protector factors we found media advertisement (OR: 0.19, 0.05-0.71), light physical activity 2-3 times a week (OR: 0.33, 0.12-0.88), and a high result in Francis score (OR: 0.95, 0.919-0.99).
    Conclusions
    University efforts for tobacco‑free policies should focus on preventive advertisement, promoting physical activity and awareness among young students of social environmental factors that could influence their decision to start smoking tobacco.
    Keywords: Colombia, epidemiologic determinants, smoking, students, universities
  • Jf Sanchez, Suarez, I. Riveros, G. Delgado
    Background
    The leishmanicidal and cytotoxic activity of ten essential oils obtained from ten plant specimens were evaluated.
    Methods
    Essential oils were obtained by the steam distillation of plant leaves without any prior processing. Cytotoxicity was tested on J774 macrophages and leishmanicidal activity was assessed against four species of Leishmania associated with cutaneous leishmaniasis.
    Results
    Seven essential oils exhibited activity against Leishmania parasites, five of which were toxic against J774 macrophages. Selectivity indices of >6 and 13 were calculated for the essential oils of Ocimum basilicum and Origanum vulgare, respectively.
    Conclusion
    The essential oil of Ocimum basilicum was active against promastigotes of Leishmania and innocuous to J774 macrophages at concentrations up to 1600 µg/mL and should be further investi­gated for leishmanicidal activity in others in vitro and in vivo experimental models.
    Keywords: Essential oils, Antileishmanial properties, Leishmania, Plant, Colombia
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