Biomédica: revista del Instituto Nacional de Salud (BIOMEDICA )

Publisher: Instituto Nacional de Salud (Colombia)


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Publications in this journal

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    ABSTRACT: Introduction: Photodynamic therapy (PDT) using 5-aminolevulinic acid-induced protoporphyrin IX (ALA-PpIX) constitutes an interesting alternative for cutaneous leishmaniasis treatment. Objective: To evaluate the production of PpIXbased on the administration of ALA and MAL and the effect of ALA-PDTat cellular level on non-infected and infected THP-1 cells using Leishmania (Viannia) panamensis or Leishmania (Leishmania) infantum (syn Leishmania chagasi) parasites. Materials and methods: Protoporphyrin IX (PpIX) production and mitochondrial colocalization were evaluated by confocal microscopy. Cell toxicities were evaluated after treatment with the compounds, followed by light irradiation (597-752 nm) at 2.5 J/cm2 fluency using a colorimetric MTT assay for THP-1 cells and a standard microscopic analysis of parasites. Results were expressed as compound concentration activity against 50% of cells or parasites (CC50 or IC50). Results: ALA or MAL induced an endogenous PpIX with a red fluorescence localized mainly in the mitochondria inside human cells. ALA and MAL-PDT induced a similar range of toxicities on THP-1 cells (CC50 0.16±0.01mM and 0.33±0.019 mM, respectively) without any apparent inhibition of intracellular parasites in the infected cells as compared to untreated controls. Exogenous PpIX-PDT was toxic to THP-1 cells (CC50 0.00032±0.00002 mM), L. (L.) infantum (IC50 0.003±0.0001 mM) and L. (V.) panamensis (IC50 0.024±0.0001 mM) promastigotes. Conclusions: Despite the effectiveness of exogenous PpIX on promastigotes and the production of PpIX by human infected cells, treatment with ALA or MAL before irradiation was unable to completely destroy L. (L.) infantum or L. (V.) panamensis intracellular amastigotes.
    Biomédica: revista del Instituto Nacional de Salud 08/2014; 34(4):589-98.
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    ABSTRACT: Introduction: The implementation of surveillance, control and prevention measures for Chagas´ disease requires an integrated approach. The sustainability of programs depends on community participation supported on a basic understanding of the problem. Objective: To evaluate the knowledge of people interviewed which facilitates or limits the surveillance, prevention and control of Chagas´ disease in two endemic Panamanian communities where Rhodnius pallescens is the main vector. Materials and methods: A questionnaire assessed the knowledge and risk factors related to Chagas´ disease in 201 people over 10 years of age from the endemic communities of Las Pavas and Lagartera Grande located on the western shore of Panama Canal. Additionally, with the help of the residents, the presence of triatomine bugs in 93 dwellings was evaluated during a year. Results: Of those interviewed, 69.2% (139/201) had poor or very poor knowledge about Chagas´ disease. Nearly 93% (187/201) was exposed to moderate or high risk factors. Triatomine bugs were collected in 20.4% (19/93) of the evaluated homes; 80% (66/76) of them were R. pallescens . Significant association was found between the presence of triatomines inside the houses and precarious housing (p<0.01). Conclusion: Despite having been exposed to health education-related programs, it is necessary to strengthen the basic knowledge about Chagas´ disease in the two communities before establishing prevention and surveillance measures which involve active participation of its inhabitants.
    Biomédica: revista del Instituto Nacional de Salud 06/2014; 34(2):260-270.
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    ABSTRACT: Introduction: Bacterial resistance is a public health problem worldwide that seriously compromises the possibility to treat infections. Objective: To identify levels of resistance to antibiotic markers in Enterobacteriaceae isolates from Colombian hospitals. Materials and methods: A systematic literature survey was done including articles indexed in Medline, Embase and LILACS. A manual search was made of Colombian scientific journals and other publications on infectious disease that were not available electronically. Results: In total, 43 observational studies and epidemiological reports were identified with information about resistance among Enterobacteriaceae isolates in Colombian hospitals, mainly from Bogotá, Cali and Medellín. The resistance rate of Escherichia coli ranges from 3 to 11%, 5 to 20% and from 0.2 to 0.8% for piperacillin-tazobactam, third generation cephalosporins and carbapenems, respectively. For Klebsiella pneumoniae resistance rates ranges from 21.8 to 48.1% to piperacillin-tazobactam, 20 to 35% to broad-spectrum cephalosporins and 3 to 8% to carbapenems, with significant variations by cities, levels of care and clinical settings. Conclusions: The spread of bacterial resistance in Enterobacteriaceae isolated in Colombian hospitals is a growing problem that calls for priority action to cut the chains of transmission.
    Biomédica: revista del Instituto Nacional de Salud 06/2014; 34(2):180-197.
  • Biomédica: revista del Instituto Nacional de Salud 06/2014; 34(2):161-163.
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    ABSTRACT: Introduction: Despite efforts to control malaria, around 10% of the world population is at risk of acquiring this disease. Plasmodium falciparum accounts for the majority of severe cases and deaths. Malaria control programs have failed due to the therapeutic failure of first-line antimalarials and to parasite resistance. Thus, new and better therapeutic alternatives are required. Proteomic analysis allows determination of protein expression levels under drug pressure, leading to the identification of new therapeutic drug targets and their mechanisms of action. Objective: The aim of this study was to analyze qualitatively the expression of P.falciparum trophozoite proteins (strain ITG2), after exposure to antimalarial drugs, through a proteomic approach. Materials and methods: In vitro cultured synchronized parasites were treated with quinine, mefloquine and the natural antiplasmodial diosgenone. Protein extracts were prepared and analyzed by two-dimensional electrophoresis. The differentially expressed proteins were selected and identified by MALDI-TOF mass spectrometry. Results: The following proteins were identified among those differentially expressed in the parasite in the presence of the drugs tested: enolase (PF10_0155), calcium-binding protein (PF11_0098), chaperonin (PFL0740c), the host cell invasion protein (PF10_0268) and proteins related to redox processes (MAL8P1.17). These findings are consistent with results of previous studies where the parasite was submitted to pressure with other antimalarial drugs. Conclusion: The observed changes in the P. falciparum trophozoite protein profile induced by antimalarial drugs involved proteins mainly related to the general stress response.
    Biomédica: revista del Instituto Nacional de Salud 06/2014; 34(2):237-249.
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    ABSTRACT: Introduction: Although a good deal of research in public health has been performed, large inequalities still exist in health. It is necessary to know how knowledge is generated and disseminated to the public in order for research to reach decision-makers. Objective: To characterize public health research networks in Santander, Colombia. Materials and methods: Analysis of social networks based on co-authorship of scientific publications by researchers living in Santander in 2012. Researchers were identified using a "snowball" technique. The publications search was conducted using national and international databases. The density and average geodesic distance of networks were calculated, as was the size, pairs, brokers and homophily of egocentric networks. Results: There were 531 researchers. Most worked in epidemiology (77.59%), and in more than one thematic field. The network density was 0.0058 and the average geodesic distance was 4.418. Several indicators suggested that the most cohesive egocentric networks were those in which researches investigated more than in one knowledge area or in epidemiology. Homophily was lower for health systems, biostatistics and social and behavioral sciences, as well as private hospitals and the public university. Conclusions: The network structure suggests a growth phase in research and a predominance of epidemi-ology. Other public health areas need strengthening so as to better address the health needs of the state.
    Biomédica: revista del Instituto Nacional de Salud 06/2014; 34(2):300-307.
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    ABSTRACT: Introduction: Professionalism is a subject of interest in medical schools around the world. The use of a questionnaire could be useful to assess professionalism in Colombia. Objective: To adapt The Penn State University College of Medicine Professionalism Questionnaire as a culturally valid instrument in the Spanish language. Materials and methods: We followed recommendations from the IQOLA project and used forward and back translation with four independent translations, as well as a pilot evaluation and an evaluation of psychometric features with 250 students. We evaluated item-scale correlations and internal consistency with Chronbach´s alpha test and conducted a principal components factor analysis. Results: Global Cronbach´s alpha was 0.86, the Kaiser-Meyer-Olkin measure of sampling adequacy was 0.83, and Bartlett´s test of sphericity had a p >0.00001. We found six factors that explained 93% of the total variance and four new factors emerged in the factor analysis, while eight items had high uniqueness. Conclusion: The Penn State University College of Medicine Scale measures professionalism attitudes in medical students with good reliability. However, the structure of the scale demonstrated differences when used in the Latin American medical student population.
    Biomédica: revista del Instituto Nacional de Salud 06/2014; 34(2):291-299.